It helps to maintain a trusting relationship between the counselor and the client; Veracity, which involves the provision of accurate and reliable information regarding the results of psychological research, testing, etc. The survey respondents highlighted that variant misclassification was common and interpretation of a VUS as a benign or pathogenic variant was the most frequently observed form of variant misinterpretation. Respondents also listed other reasons, such as lack of knowledge about VUS reclassification, as the basis for pathogenic variants being interpreted as benign. Thanks for helping us catch any problems with articles on DeepDyve. In his/her professional activities, a psychologist is guided by his/her knowledge and experience according to which he/she takes his/her own decision and is personally responsible for it. Interpreting Test Results in Counseling - JSTOR Online genetic counseling from the providers' perspective: counselors' evaluations and a time and cost analysis, The future is now: technology's impact on the practice of genetic counseling. Table 2 briefly describes each case as well as the (1) perceived consequence of the reported error and (2) perceived contributing factors to the reported error. The least reported misinterpretation is a pathogenic variant interpreted as benign. Amendola LM, Lautenbach D, Scollon S, et al. Illustrative case studies in the return of exome and genome sequencing results, Integration of genetics into clinical teaching in medical school education. One possible explanation may be that counselor training has focused on technical aspects of testing and has not emphasized higher level application skills. Incorrect result Interpretation and lack of genetic counseling were listed as the most common factors contributing to misinterpretations. Challenges and opportunities for genomics education: insights from an Institute of Medicine Roundtable Activity, Primary care Physicians' knowledge, attitudes, and experience with personal genetic testing. Exome sequencing results returned with a possible homozygous exon deletion. Perceived patient stress was often cited as an outcome, but there were multiple instances where this misconception was felt to lead to an incorrect diagnosis, referral to another specialist, additional testing, and inappropriate treatment. This document presents a client centered approach to testing and interpretation. Abstract The interpretation of genetic testing results is subject to error. Measurement Concepts and Test Interpretation 23 Measures of Central Tendency and Variability 25 Norms and Types of Scores 26 Correlation 29 Reliability 29 Validity 33. The values were chi-squared for ten interest areas; social service, outdoor, mechanical, clerical, computational, persuasive, scientific, artistic, literary, and musical. Increasing the number and size of training programs for genetic counselors and medical geneticists is critical.43,44 Additionally, the development of innovative service delivery models that leverage digital tools (such as chatbots and health information technology) may help increase access to genetic services, maximizing the efficiency of genetics professionals.4550 Telegenetics has also become a popular option to reach more patients while simultaneously decreasing wait time and increasing patient volume.5154. In general, the ethical requirements presented by ASCA and ACA have much in common and argue that the ethical behavior of a counselor is directly related to the level of his/her competence, which finds its expression in the course of testing. Research on the Effects of Test Interpretation: A Review Case reports highlighting pitfalls in interpretation. Times ranged from days to years, but most often was reported to be weeks to months (45%). Responses were compiled in graphical and tabular forms and the results were generated using Qualtrics and Microsoft Excel. To assist students with formulating goals commensurate with their interests and abilities, a study incorporating planned testing and group counseling was conducted at a community college in the West. Maiese DR, Keehn A, Lyon M, Flannery D, Watson M. Working groups of the National Coordinating Center for seven regional genetics service Collaboratives. Wiley. The authors would like to thank the following members of the CSER Consortium who provided feedback on this manuscript: Kelly East, MS, CGC (HudsonAlpha Institute for Biotechnology); Laura G Hendon, MA, MS, CGC (University of Mississippi Medical Center); Katie Gallagher, MS, CGC (Montefiore Medical Center). TINSLEY, HOWARD E.A. For example, for the proper application of individual intelligence tests and most of personality tests a relatively long period of intensive training and supervision of the testing process is required, while testing of educational achievements needs minimal professional preparation. Test interpretation may be enhanced by providingthe counselor with an expanded and consistent knowl-edge base to assist in the interpretation of test data. We'll do our best to fix them. This left the mother distraught and assuming misattributed paternity, which was later included in the infans chart. While this is helpful from an anecdotal standpoint, the data we collected are not intended to identify ways to fix pitfalls and challenges in providing results. As this is a self-reported, observational study, the impacts of misinterpretation described by participants may be subjective. Study: genetic tests often overused and misinterpreted, https://uk.reuters.com/article/us-health-overtreatment-idUSTRE81F15Y20120216, https://www.eurekalert.org/pub_releases/2018-02/uos-iom022118.php, https://medicalxpress.com/news/2017-05-genetic-overused-misinterpreted.html, A newborn with a congenital anomaly had a targeted genetic test panel done prenatally and found a benign parentally-inherited variant was identified. This process helps reduce the chance of a client misunderstanding the test results or recalling them inaccurately. The goal of this study was primarily descriptive: to identify and highlight instances in which these genetic professionals have encountered situations where they consider that medical professionals have misunderstood a genetic test result. The authors address this oversight, identifying and explaining principles and procedures for counselors to follow in interpreting tests to clients. Download Free PDF View PDF. Marchant G, Barnes M, Evans JP, LeRoy B, Wolf SM. Interpretation and Use of Tests in Counseling Adults Test interpretation in counseling. - APA PsycNet In practice, counseling psychologists try to gain an understanding of how each individual thinks, feels, and acts, and their assessment practices cover the entire range of human cognitive, conative, and affective attributes. Challenges in bettering genomics education also remain, especially regarding education standardization and student knowledge retainment.3639 Involvement of genetic counselors and medical geneticists in the training of healthcare professionals would be ideal. It has been shown that clients who receive test interpretations generally make greater gains in incorporating the results. A counselor should be able to select a test based on its task and the features of a counselee correctly. Infant with intrauterine growth restriction (IUGR), microcephaly, brain malformations, and prenatal cardiac compromise had compound heterozygous pathogenic/likely pathogenic variants interpreted by provider as definitely causative of all of the childs symptoms, who quoted a 25% recurrence risk. Challen K, Harris HJ, Julian-Reynier C, et al. The respondents listed facets of the case that they believe contributed to the result misunderstanding. ; BRADLEY, RICHARD W. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png, http://www.deepdyve.com/lp/wiley/test-interpretation-lw2RiGF09z. Specific suggestions are made for communicating the information in a manner that would be acceptable to the client. Source of clients to be tested is highly desirable. Ethics in Testing, Assessment and Interpretation The interpretation of genetic testing results is subject to error. showed a significant variation between cancer genetic test reports, which differed in content, length, recommendations, layout, and test description, among other parameters.55 They also reported significant difference in the reports' average reading grade level, which varied between 7th and 12th grade. Each student, using the Ryan Personal Inventory test, rated himself on a 5-point scale. Other suggestions included increased and clear communication between ordering providers, genetic professionals, and laboratory professionals (Supplementary Table 2). An official website of the United States government. Mother was incorrectly told that child had this condition. Other publications have discussed ways to reduce the likelihood of misinterpretation, and improved education of medical professionals has emerged as a common theme.3235 While the need for increased education of non-genetics professionals in clinical genetics has long been appreciated, it is clear that pitfalls in interpretation can still occur with formal genetics training. Brierley KL, Blouch E, Cogswell W, et al. Competent test users implement appropriate and standardized administration procedures. Case submissions revealed that pinpointing the exact cause of a perceived genetic test report misinterpretation may not always be possible. Find any of these words, separated by spaces, Exclude each of these words, separated by spaces, Search for these terms only in the title of an article, Most effective as: LastName, First Name or Lastname, FN, Search for articles published in journals where these words are in the journal name, Personreferenced test interpretation: A learning process, Tests and counseling: The marriage that failed, The effects of different methods of test introduction and interpretation on client learning in counseling. Respondents were allowed to select more than one answer to account for the involvement of different types of healthcare professionals for respondents who had experienced multiple examples of result misconception. Select data courtesy of the U.S. National Library of Medicine. B. Further quantitative research in this area is indicated to better understand how effective healthcare provider education will be in improving result interpretation. The synthesis of various tests with background and behavioral information is stressed, as are interviewing techniques necessary for introducing and interpreting test batteries to clients. This descriptive study also adds to the valued literature which has been documenting experiences with misinterpretation of genetic results. Include any more information that will help us locate the issue and fix it faster for you. The effects of two styles of test interpretation, namely directive and collaborative, and clients' perceptions of the technical status of tests, namely high and low, were compared for 32 . The genetics professionals who participated in our study have encountered multiple pitfalls in the interpretation of genetic test results. We also recognize that there are legitimate instances in clinical genetics where a provider will interpret and disclose results to a patient in a classification that differs from the laboratory report. Select data courtesy of the U.S. National Library of Medicine. Reliability and validity results. Moreover, a counselor should avoid subjectivism, which prevents proper judgment in regard to clients, as well as to exclude any possible negative impact on them stemming from his/her behavior. Counselors need to develop skills in test administration, scoring, interpretation of test results, and communicating results to their clients. Chatbots & artificial intelligence to scale genetic information delivery, The counselor will videoconference you now: addressing opportunities and challenges with patient-clinician communication in the telemedicine era. The survey and case report data provide numerous examples of reported pitfalls and challenges in genetic testing interpretation by a diverse group of medical providers that include professionals with and without formal training in genetics. Other examples of misunderstanding of genetic concepts include incorrect interpretation of de novo versus inherited variants (#1), the role of cis versus trans variants in autosomal recessive inheritance (#4), and the definition of incidental (secondary) versus primary findings (#2). Many of the respondents (survey and case report) listed lack of genetic counseling as a possible cause for challenges in interpretation. The effects of test interpretation styles and the status of tests in You can change your cookie settings through your browser. Projecting the supply and demand for certified genetic counselors: a workforce study. The data that support the findings of this study are available from the corresponding author upon reasonable request. Carroll JC, Allanson J, Morrison S, et al. Pitfalls and challenges in genetic test interpretation: An exploration Medical geneticists and genetic counselors were also implicated with 29 and 25 reported cases of misinterpretation, respectively. Physician preparedness for big genomic data: a review of genomic medicine education initiatives in the United States, Genetics education in medical school: a qualitative study exploring educational experiences and needs, Addressing gaps in physician education using personal genomic testing, Professional medical education and genomics, Genomics education for health care professionals in the 21st century, Mainstreaming genetics and genomics: a systematic review of the barriers and facilitators for nurses and physicians in secondary and tertiary care. In addition, a psychologist should be aware of the limits of his/her competence and not to use the methods that do not meet professional standards established in specific areas of research. Our ultimate goal was to better understand the situations that can challenge interpretation of a genetic test result. Introduction to formal assessment. Choose an answer and hit 'next'. LawSeq liability task force. In essence, most counselors may never have learned how to go about, Journal of Counseling & Development Link/Page Citation Psychological tests are used frequently in counseling. In his/her activities, a counselor should always keep in mind the principle of no harm. - Definition & Purpose Quiz, The Counseling Intake Process & Initial Interview, The Counseling Intake Process & Initial Interview Quiz, Testing and Assessment in Counseling: Types & Uses Quiz, What Is the DSM? Communicating Assessment Results in the Counseling Interview. A counselor must do everything possible not to cause any mental or psychological harm to the minor with whom he/she works. Respondents were asked if they had experienced each of the following cases: (1) a benign or likely benign variant interpreted as pathogenic, (2) a variant of unknown significance (VUS) interpreted as benign or pathogenic, and (3) a pathogenic variant interpreted as benign If respondents experienced a perceived misinterpretation in more than one scenario, they were able to respond appropriately. Individuals should not be told the results of testing without their interpretation. Communicating Assessment Results in the Counseling Interview.