Alternative option labeling impacts decision‐making in noninvasive prenatal screening

• Published in: Journal of genetic counseling 2020-12, Vol.29 (6), p.910-918
• Main Authors: Fisher, Camille F., Birkeland, Laura E., Reiser, Catherine A., Zhao, Qianqian, Palmer, Christina G. S., Zikmund‐Fisher, Brian J., Petty, Elizabeth M.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Clinical decision making; Decision Making; Female; genetic counseling; Genetic screening; Genetic testing; Genetic Testing - methods; Humans; Labeling; Male; Medical decision making; Medical diagnosis; Non-invasive; noninvasive prenatal screening; Noninvasive Prenatal Testing; options; Patient control; Patients; Pregnancy; Prenatal care; prenatal diagnosis; Prenatal Diagnosis - methods; Prenatal testing; prenatal whole genome sequencing; Regression analysis; Statistical analysis; Testing laboratories; United States; Young Adult
• ISSN: 1059-7700; 1573-3599
• DOI: 10.1002/jgc4.1191

Prenatal genetic screening should be an informed, autonomous patient choice. Extrinsic factors which influence patient decision‐making threaten the ethical basis of prenatal genetic screening. Prior research in the area of medical decision‐making has identified that labeling may have unanticipated effects on patient perceptions and decision‐making processes. This Internet‐administered study explored the impact of option labeling on the noninvasive prenatal screening (NIPS) selections of US adults. A total of 1,062 participants were recruited through Amazon Mechanical Turk (MTurk) and randomly assigned to one of three possible label sets reflecting provider‐derived and industry‐derived option labels used in prenatal screening. Multinomial logistic regression analysis showed option labeling had a statistically significant impact on the NIPS selections of study participants (p = .0288). Outcomes of the Satisfaction with Decision Scale (SWD) indicated option labels did not play a role in participant satisfaction with screening selection. The results of this study indicate a need for further evaluation of the impact NIPS option labeling has on patient screening decisions in real‐world clinical interactions. Clinical providers and testing laboratories offering NIPS should give careful consideration to the option labels used with prenatal screening so as to minimize influence on patient screening selection and decision‐making processes.