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Zimmermann BM, Shaw DM, Elger B, et al. The use of heuristics in genetic testing decision-making: A qualitative interview study. PLoS One. 2021;16(11):e0260597doi: 10.1371/journal.pone.0260597.
Zimmermann, B. M., Shaw, D. M., Elger, B., & Koné, I. (2021). The use of heuristics in genetic testing decision-making: A qualitative interview study. PloS one, 16(11), e0260597. https://doi.org/10.1371/journal.pone.0260597
Zimmermann, Bettina Maria, et al. "The use of heuristics in genetic testing decision-making: A qualitative interview study." PloS one vol. 16,11 (2021): e0260597. doi: https://doi.org/10.1371/journal.pone.0260597
Zimmermann BM, Shaw DM, Elger B, Koné I. The use of heuristics in genetic testing decision-making: A qualitative interview study. PLoS One. 2021 Nov 30;16(11):e0260597. doi: 10.1371/journal.pone.0260597. eCollection 2021. PMID: 34847204; PMCID: PMC8631642.
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PLoS One. 2021 Nov 30;16(11):e0260597. doi: 10.1371/journal.pone.0260597. eCollection 2021.

The use of heuristics in genetic testing decision-making: A qualitative interview study.

PloS one

Bettina Maria Zimmermann, David Martin Shaw, Bernice Elger, Insa Koné

Affiliations

  1. Institute for Biomedical Ethics, University of Basel, Basel, Switzerland.
  2. Institute of History and Ethics in Medicine, School of Medicine, Technical University of Munich, Munich, Germany.
  3. Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands.
  4. Center for Legal Medicine, University of Geneva, Geneva, Switzerland.

PMID: 34847204 PMCID: PMC8631642 DOI: 10.1371/journal.pone.0260597

Abstract

BACKGROUND: Decision-making concerning predictive genetic testing for hereditary cancer syndromes is inherently complex. This study aims to investigate what kind of complexities adults undergoing genetic counseling in Switzerland experience, how they deal with them, and what heuristics they use during the decision-making process.

METHODS: Semi-structured qualitative interviews with eighteen Swiss adults seeking genetic counseling for hereditary cancer syndrome genetic testing and two counseling physicians were conducted and analyzed using a grounded theory approach.

RESULTS: Counselees stated that once they were aware of their eligibility for genetic testing they perceived an inevitable necessity to make a decision in a context of uncertainties. Some counselees perceived this decision as simple, others as very complex. High emotional involvement increased perceived complexity. We observed six heuristics that counselees used to facilitate their decision: Anticipating the test result; Focusing on consequences; Dealing with information; Interpreting disease risk; Using external guidance; and (Re-)Considering the general uncertainty of life.

LIMITATIONS: Our findings are limited to the context of predictive genetic testing for hereditary cancer syndromes. This qualitative study does not allow extrapolation of the relative frequency of which heuristics occur.

CONCLUSIONS: The use of heuristics is an inherent part of decision-making, particularly in the complex context of genetic testing for inherited cancer predisposition. However, some heuristics increase the risk of misinterpretation or exaggerated external influences. This may negatively impact informed decision-making. Thus, this study illustrates the importance of genetic counselors and medical professionals being aware of these heuristics and the individual manner in which they might be applied in the context of genetic testing decision-making. Findings may offer practical support to achieve this, as they inductively focus on the counselees' perspective.

Conflict of interest statement

The authors have declared that no competing interests exist.

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