Practice Patterns and Barriers to Vascular Genetic Testing Among Vascular Surgeons
Engaging patients living with or at risk of aortic dissection via the Aortic Dissection Collaborative, physician education in vascular genetics was identified as a research priority. We surveyed vascular surgeons to characterize practice patterns, motivations, and barriers regarding aortopathy genet...
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| Veröffentlicht in: | Annals of vascular surgery 2024-08, Vol.105, p.140-149 |
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| container_title | Annals of vascular surgery |
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| creator | Dittman, James M. Prakash, Siddharth K. Gupta, Prem Chand Wiszniewski, Wojciech Singh, Niten Smeds, Matthew R. Shalhub, Sherene |
| description | Engaging patients living with or at risk of aortic dissection via the Aortic Dissection Collaborative, physician education in vascular genetics was identified as a research priority. We surveyed vascular surgeons to characterize practice patterns, motivations, and barriers regarding aortopathy genetic testing.
An anonymous 27-question survey was distributed on social media platforms between November and December 2022. Domains included demographics, vascular genetic education, testing attitudes and utilization, and experience in treating patients with genetic vascular aortopathies. The analysis included summary statistics and unpaired t-test to compare responses by interest in incorporating testing and practice type.
A total of 171 vascular surgeons from 15 countries responded to the survey (23% trainees). Over half received vascular genetics education during training (59%), and most (86%) were interested in incorporating genetic testing into their practice. Academic surgeons were more likely to have cared for a patient with a known genetic aortopathy over the past year than surgeons in hospital-based and private practices (83% vs. 56% vs. 27%; P |
| doi_str_mv | 10.1016/j.avsg.2024.01.032 |
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An anonymous 27-question survey was distributed on social media platforms between November and December 2022. Domains included demographics, vascular genetic education, testing attitudes and utilization, and experience in treating patients with genetic vascular aortopathies. The analysis included summary statistics and unpaired t-test to compare responses by interest in incorporating testing and practice type.
A total of 171 vascular surgeons from 15 countries responded to the survey (23% trainees). Over half received vascular genetics education during training (59%), and most (86%) were interested in incorporating genetic testing into their practice. Academic surgeons were more likely to have cared for a patient with a known genetic aortopathy over the past year than surgeons in hospital-based and private practices (83% vs. 56% vs. 27%; P < 0.01), to have ever made a referral to a medical geneticist (78% vs. 51% vs. 9%; P < 0.01), and have access to genetic counselors or geneticists (66% vs. 46% vs. 0%; P < 0.01). Barriers to genetic testing were rated as more significant by surgeons in nonacademic practices, with top barriers being insurance coverage of testing, cost of genetic testing, and access to genetic counselors. Evidence-based professional society guidelines were the strongest rated motivating factor for testing incorporation among respondents.
Vascular surgeon attitudes are not major barriers to incorporating genetic testing for patients with aortopathies; however, practical challenges regarding genetic testing and counseling are barriers to implementation especially for vascular surgeons in nonacademic practices. Future efforts should focus on evidence-based society guidelines, continuing medical education to increase adoption, and facilitating access to genetic counseling.
•Eighty-five percent of vascular surgeons would incorporate aortopathy genetic testing into practice.•The top motivation for incorporating testing was evidence-based society guidelines.•Top barriers were insurance coverage, genetic testing costs, and counseling access.</description><identifier>ISSN: 0890-5096</identifier><identifier>ISSN: 1615-5947</identifier><identifier>EISSN: 1615-5947</identifier><identifier>DOI: 10.1016/j.avsg.2024.01.032</identifier><identifier>PMID: 38599485</identifier><language>eng</language><publisher>Netherlands: Elsevier Inc</publisher><subject>Adult ; Attitude of Health Personnel ; Female ; Genetic Counseling ; Genetic Predisposition to Disease ; Genetic Testing ; Health Care Surveys ; Health Knowledge, Attitudes, Practice ; Humans ; Male ; Middle Aged ; Motivation ; Phenotype ; Practice Patterns, Physicians' - trends ; Predictive Value of Tests ; Risk Factors ; Surgeons ; Vascular Surgical Procedures</subject><ispartof>Annals of vascular surgery, 2024-08, Vol.105, p.140-149</ispartof><rights>2024 Elsevier Inc.</rights><rights>Copyright © 2024 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c307t-8c47094cc4e1fd7f455933184a73d6e99005c77b1c5a2d1f175c2494ac31426a3</cites><orcidid>0000-0002-0970-9409</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.avsg.2024.01.032$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38599485$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Dittman, James M.</creatorcontrib><creatorcontrib>Prakash, Siddharth K.</creatorcontrib><creatorcontrib>Gupta, Prem Chand</creatorcontrib><creatorcontrib>Wiszniewski, Wojciech</creatorcontrib><creatorcontrib>Singh, Niten</creatorcontrib><creatorcontrib>Smeds, Matthew R.</creatorcontrib><creatorcontrib>Shalhub, Sherene</creatorcontrib><title>Practice Patterns and Barriers to Vascular Genetic Testing Among Vascular Surgeons</title><title>Annals of vascular surgery</title><addtitle>Ann Vasc Surg</addtitle><description>Engaging patients living with or at risk of aortic dissection via the Aortic Dissection Collaborative, physician education in vascular genetics was identified as a research priority. We surveyed vascular surgeons to characterize practice patterns, motivations, and barriers regarding aortopathy genetic testing.
An anonymous 27-question survey was distributed on social media platforms between November and December 2022. Domains included demographics, vascular genetic education, testing attitudes and utilization, and experience in treating patients with genetic vascular aortopathies. The analysis included summary statistics and unpaired t-test to compare responses by interest in incorporating testing and practice type.
A total of 171 vascular surgeons from 15 countries responded to the survey (23% trainees). Over half received vascular genetics education during training (59%), and most (86%) were interested in incorporating genetic testing into their practice. Academic surgeons were more likely to have cared for a patient with a known genetic aortopathy over the past year than surgeons in hospital-based and private practices (83% vs. 56% vs. 27%; P < 0.01), to have ever made a referral to a medical geneticist (78% vs. 51% vs. 9%; P < 0.01), and have access to genetic counselors or geneticists (66% vs. 46% vs. 0%; P < 0.01). Barriers to genetic testing were rated as more significant by surgeons in nonacademic practices, with top barriers being insurance coverage of testing, cost of genetic testing, and access to genetic counselors. Evidence-based professional society guidelines were the strongest rated motivating factor for testing incorporation among respondents.
Vascular surgeon attitudes are not major barriers to incorporating genetic testing for patients with aortopathies; however, practical challenges regarding genetic testing and counseling are barriers to implementation especially for vascular surgeons in nonacademic practices. Future efforts should focus on evidence-based society guidelines, continuing medical education to increase adoption, and facilitating access to genetic counseling.
•Eighty-five percent of vascular surgeons would incorporate aortopathy genetic testing into practice.•The top motivation for incorporating testing was evidence-based society guidelines.•Top barriers were insurance coverage, genetic testing costs, and counseling access.</description><subject>Adult</subject><subject>Attitude of Health Personnel</subject><subject>Female</subject><subject>Genetic Counseling</subject><subject>Genetic Predisposition to Disease</subject><subject>Genetic Testing</subject><subject>Health Care Surveys</subject><subject>Health Knowledge, Attitudes, Practice</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Motivation</subject><subject>Phenotype</subject><subject>Practice Patterns, Physicians' - trends</subject><subject>Predictive Value of Tests</subject><subject>Risk Factors</subject><subject>Surgeons</subject><subject>Vascular Surgical Procedures</subject><issn>0890-5096</issn><issn>1615-5947</issn><issn>1615-5947</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kMlOwzAQhi0EomV5AQ4oRy4J4y22JS6A2CQkKrarZZxJlapNip1U4u1x1dIjl5nDfPNr5iPkjEJBgZaXs8Kt4rRgwEQBtADO9siYllTm0gi1T8agDeQSTDkiRzHOACjTQh-SEdfSGKHlmLxOgvN94zGbuL7H0MbMtVV240JoMMSs77JPF_0wdyF7wBYTmr1j7Jt2ml0vulR347chTLFr4wk5qN084um2H5OP-7v328f8-eXh6fb6OfccVJ9rLxQY4b1AWleqFlIazqkWTvGqRGMApFfqi3rpWEVrqqRnwgjnORWsdPyYXGxyl6H7HtJNdtFEj_O5a7EbouXAFTdaM5NQtkF96GIMWNtlaBYu_FgKdu3SzuzapV27tEBtcpmWzrf5w9cCq93Kn7wEXG0ATF-uki4bfYOtx6oJ6Htbdc1_-b_4rISp</recordid><startdate>202408</startdate><enddate>202408</enddate><creator>Dittman, James M.</creator><creator>Prakash, Siddharth K.</creator><creator>Gupta, Prem Chand</creator><creator>Wiszniewski, Wojciech</creator><creator>Singh, Niten</creator><creator>Smeds, Matthew R.</creator><creator>Shalhub, Sherene</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-0970-9409</orcidid></search><sort><creationdate>202408</creationdate><title>Practice Patterns and Barriers to Vascular Genetic Testing Among Vascular Surgeons</title><author>Dittman, James M. ; Prakash, Siddharth K. ; Gupta, Prem Chand ; Wiszniewski, Wojciech ; Singh, Niten ; Smeds, Matthew R. ; Shalhub, Sherene</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c307t-8c47094cc4e1fd7f455933184a73d6e99005c77b1c5a2d1f175c2494ac31426a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adult</topic><topic>Attitude of Health Personnel</topic><topic>Female</topic><topic>Genetic Counseling</topic><topic>Genetic Predisposition to Disease</topic><topic>Genetic Testing</topic><topic>Health Care Surveys</topic><topic>Health Knowledge, Attitudes, Practice</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Motivation</topic><topic>Phenotype</topic><topic>Practice Patterns, Physicians' - trends</topic><topic>Predictive Value of Tests</topic><topic>Risk Factors</topic><topic>Surgeons</topic><topic>Vascular Surgical Procedures</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Dittman, James M.</creatorcontrib><creatorcontrib>Prakash, Siddharth K.</creatorcontrib><creatorcontrib>Gupta, Prem Chand</creatorcontrib><creatorcontrib>Wiszniewski, Wojciech</creatorcontrib><creatorcontrib>Singh, Niten</creatorcontrib><creatorcontrib>Smeds, Matthew R.</creatorcontrib><creatorcontrib>Shalhub, Sherene</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Annals of vascular surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dittman, James M.</au><au>Prakash, Siddharth K.</au><au>Gupta, Prem Chand</au><au>Wiszniewski, Wojciech</au><au>Singh, Niten</au><au>Smeds, Matthew R.</au><au>Shalhub, Sherene</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Practice Patterns and Barriers to Vascular Genetic Testing Among Vascular Surgeons</atitle><jtitle>Annals of vascular surgery</jtitle><addtitle>Ann Vasc Surg</addtitle><date>2024-08</date><risdate>2024</risdate><volume>105</volume><spage>140</spage><epage>149</epage><pages>140-149</pages><issn>0890-5096</issn><issn>1615-5947</issn><eissn>1615-5947</eissn><abstract>Engaging patients living with or at risk of aortic dissection via the Aortic Dissection Collaborative, physician education in vascular genetics was identified as a research priority. We surveyed vascular surgeons to characterize practice patterns, motivations, and barriers regarding aortopathy genetic testing.
An anonymous 27-question survey was distributed on social media platforms between November and December 2022. Domains included demographics, vascular genetic education, testing attitudes and utilization, and experience in treating patients with genetic vascular aortopathies. The analysis included summary statistics and unpaired t-test to compare responses by interest in incorporating testing and practice type.
A total of 171 vascular surgeons from 15 countries responded to the survey (23% trainees). Over half received vascular genetics education during training (59%), and most (86%) were interested in incorporating genetic testing into their practice. Academic surgeons were more likely to have cared for a patient with a known genetic aortopathy over the past year than surgeons in hospital-based and private practices (83% vs. 56% vs. 27%; P < 0.01), to have ever made a referral to a medical geneticist (78% vs. 51% vs. 9%; P < 0.01), and have access to genetic counselors or geneticists (66% vs. 46% vs. 0%; P < 0.01). Barriers to genetic testing were rated as more significant by surgeons in nonacademic practices, with top barriers being insurance coverage of testing, cost of genetic testing, and access to genetic counselors. Evidence-based professional society guidelines were the strongest rated motivating factor for testing incorporation among respondents.
Vascular surgeon attitudes are not major barriers to incorporating genetic testing for patients with aortopathies; however, practical challenges regarding genetic testing and counseling are barriers to implementation especially for vascular surgeons in nonacademic practices. Future efforts should focus on evidence-based society guidelines, continuing medical education to increase adoption, and facilitating access to genetic counseling.
•Eighty-five percent of vascular surgeons would incorporate aortopathy genetic testing into practice.•The top motivation for incorporating testing was evidence-based society guidelines.•Top barriers were insurance coverage, genetic testing costs, and counseling access.</abstract><cop>Netherlands</cop><pub>Elsevier Inc</pub><pmid>38599485</pmid><doi>10.1016/j.avsg.2024.01.032</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-0970-9409</orcidid></addata></record> |
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| subjects | Adult Attitude of Health Personnel Female Genetic Counseling Genetic Predisposition to Disease Genetic Testing Health Care Surveys Health Knowledge, Attitudes, Practice Humans Male Middle Aged Motivation Phenotype Practice Patterns, Physicians' - trends Predictive Value of Tests Risk Factors Surgeons Vascular Surgical Procedures |
| title | Practice Patterns and Barriers to Vascular Genetic Testing Among Vascular Surgeons |
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