Cancer Control Research
5R03CA070638-03
Green, Michael J.
BREAST CANCER GENE EDUCATION--COMPUTER VS PRACTITIONER
AbstractDESCRIPTION: (Applicant's Abstract) The objective of the proposed study
is to determine whether computer-based education is as effective as
practitioner-based education for increasing understanding of genetic
testing for breast cancer. For patients to make informed choices about
genetic susceptibility testing for breast cancer, they need information
about the meaning of test results, risks and benefits of screening,
alternatives to genetic evaluation, and options for those with positive
test results. This is particularly important with genetic susceptibility
to breast cancer, since some proposed "treatments" for positive test
results (such as prophylactic bilateral mastectomy) are invasive, of
profound impact, and unproven. Despite the need for information prior
to screening, one-on-one education is costly, primary care practitioners
are unlikely to have the time or specialized knowledge to counsel about
the breast cancer gene, and genetic counselors are scarce.
Practitioners could use a low cost, effective, reliable and acceptable
method to provide information about genetic screening for breast cancer
to patients. In other contexts, computers have been used successfully
to disseminate medical information. It is not known, however, whether
a computer approach to genetic education can effectively assist patients
in making informed choices about genetic screening for breast cancer.
The primary study hypothesis is that comprehension scores on a test of
immediate recall of information about genetic screening for breast
cancer will be as high for patients informed by computer-based education
as by practitioner-based education. The secondary hypotheses are that
knowledge will affect intent to receive testing and that computer-based
education is less costly than practitioner-based education. We will test
these hypotheses by a randomized controlled clinical trial using 150
women at high risk for familial breast cancer at two study sites.
Consenting eligible subjects will be randomized to receive either
education by computer or by genetic counselor. Immediately following
the educational intervention, subjects will be given a multiple choice
test of comprehension. Scores on this test will be measured, and group
means will be compared. Intent to receive testing for the breast cancer
susceptibility gene will be measured before and after the education
intervention, and results will be compared to assess the effect of
knowledge on intention to undergo genetic screening. Costs of computer-
based education will be compared to practitioner-based education.
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