nach oben

Erschienen in:

02.03.2017 | Review Paper

A Systematic Review of Randomized Controlled Trials to Assess Outcomes of Genetic Counseling

verfasst von: Barbara A. Athens, Samantha L. Caldwell, Kendall L. Umstead, Philip D. Connors, Ethan Brenna, Barbara B. Biesecker

Erschienen in: Journal of Genetic Counseling | Ausgabe 5/2017

Einloggen, um Zugang zu erhalten

Abstract

With the advancements in precision medicine and health care reform, it is critical that genetic counseling practice respond to emerging evidence to maximize client benefit. The objective of this review was to synthesize evidence on outcomes from randomized controlled trials (RCTs) of genetic counseling to inform clinical practice. Seven databases were searched in conducting this review. Studies were selected for inclusion if they were: (a) RCTs published from 1990 to 2015, and (b) assessed a direct outcome of genetic counseling. Extracted data included study population, aims, and outcomes. Risk of bias was evaluated using the Cochrane Handbook for Systematic Reviews of Interventions guidelines. A review of 1654 abstracts identified 58 publications of 54 unique RCTs that met inclusion criteria, the vast majority of which were conducted in cancer genetic counseling setting. Twenty-seven publications assessed ‘enhancements’ to genetic counseling, and 31 publications compared delivery modes. The methodological rigor varied considerably, highlighting the need for attention to quality criteria in RCT design. While most studies assessed several client outcomes hypothesized to be affected by genetic counseling (e.g., psychological wellbeing, knowledge, perceived risk, patient satisfaction), disparate validated and reliable scales and other assessments were often used to evaluate the same outcome(s). This limits opportunity to compare findings across studies. While RCTs of genetic counseling demonstrate enhanced client outcomes in a number of studies and pave the way to evidence-based practice, the heterogeneity of the research questions suggest an important need for more complementary studies with consistent outcome assessments.

Nur mit Berechtigung zugänglich

As an example, the search query utilized for PubMed was: “(“Genetic Counseling”[MeSH] OR ((“Genetic Testing”[MeSH] OR “Genetic Counseling”[tiab] OR “Genetic Counselling”[tiab] OR “Genetic Testing”[tiab]) AND (educati*[tiab] OR information[tiab] OR informing[tiab] OR “Counseling”[Mesh] OR Counsel*[tiab] OR consultation*[tiab] OR randomized[tiab]))) AND (Clinical Trial[ptyp] OR Multicenter Study[ptyp] OR Randomized Controlled Trial[ptyp] OR Controlled Clinical Trial[ptyp] OR Evaluation Studies[ptyp] OR Patient Education Handout[ptyp] OR “Clinical Trials as Topic”[Mesh] OR randomized[tiab])”

Albada, A., van Dulmen, S., Spreeuwenberg, P., & Ausems, M. G. (2015). Follow-up effects of a tailored pre-counseling website with question prompt in breast cancer genetic counseling. Patient Education and Counseling, 98, 69–76. doi:10.1016/j.pec.2014.10.005.CrossRefPubMed

Barton, S. (2000). Which clinical studies provide the best evidence? The best RCT still trumps the best observational study. The BMJ, 321, 255–256.CrossRefPubMedPubMedCentral

Bennett, P., Phelps, C., Brain, K., Hood, K., & Gray, J. (2007). A randomized controlled trial of a brief self-help coping intervention designed to reduce distress when awaiting genetic risk information. Journal of Psychosomatic Research, 63, 59–64. doi:10.1016/j.jpsychores.2007.01.016.CrossRefPubMed

Bernhardt, B. A., Biesecker, B. B., & Mastromarino, C. L. (2000). Goals, benefits, and outcomes of genetic counseling: Client and genetic counselor assessment. American Journal of Medical Genetics, 94(3), 189–197.CrossRefPubMed

Biesecker, B. B. (2001). Goals of genetic counseling. Clinical Genetics, 60, 323–330.CrossRefPubMed

Bowen, D. J., & Powers, D. (2010). Effects of a mail and telephone intervention on breast health behaviors. Health Education & Behavior, 37, 479–489. doi:10.1177/1090198109348463.CrossRef

Bowen, D. J., Burke, W., Yasui, Y., McTiernan, A., & McLeran, D. (2002). Effects of risk counseling on interest in breast cancer genetic testing for lower risk women. Genetics in Medicine, 4(5), 359–365.

Bowen, D. J., Burke, W., McTiernan, A., Yasui, Y., & Andersen, M. R. (2004). Breast cancer risk counseling improves women's functioning. Patient Education and Counseling, 53, 79–86. doi:10.1016/s0738-3991(03)00122-8.CrossRefPubMed

Bowen, D. J., Burke, W., Culver, J. O., Press, N., & Crystal, S. (2006). Effects of counseling Ashkenazi Jewish women about breast cancer risk. Cultural Diversity and Ethnic Minority Psychology, 12, 45–56. doi:10.1037/1099-9809.12.1.45.CrossRefPubMed

Brain, K., Gray, J., Norman, P., France, E., Anglim, C., Barton, G., et al. (2000). Randomized trial of a specialist genetic assessment service for familial breast cancer. Journal of the National Cancer Institute, 92, 1345–1351.CrossRefPubMed

Brain, K., Sivell, S., Bennert, K., Howell, L., France, L., Jordan, S., et al. (2005). An exploratory comparison of genetic counselling protocols for HNPCC predictive testing. Clinical Genetics, 68, 255–261. doi:10.1111/j.1399-0004.2005.00491.x.CrossRefPubMed

Braithwaite, D., Sutton, S., Mackay, J., Stein, J., & Emery, J. (2005). Development of a risk assessment tool for women with a family history of breast cancer. Cancer Detection and Prevention, 29, 433–439. doi:10.1016/j.cdp.2005.06.001.CrossRefPubMed

Buchanan, A. H., Datta, S. K., Skinner, C. S., Hollowell, G. P., Beresford, H. F., Freeland, T., et al. (2015). Randomized trial of telegenetics vs. in-person cancer genetic counseling: Cost, patient satisfaction and attendance. Journal of Genetic Counseling, 24, 961–970. doi:10.1007/s10897-015-9836-6.CrossRefPubMedPubMedCentral

Butrick, M., Kelly, S., Peshkin, B. N., Luta, G., Nusbaum, R., Hooker, G. W., et al. (2015). Disparities in uptake of BRCA1/2 genetic testing in a randomized trial of telephone counseling. Genetics in Medicine, 17, 467–475. doi:10.1038/gim.2014.125.CrossRefPubMed

Calzone, K. A., Prindiville, S. A., Jourkiv, O., Jenkins, J., DeCarvalho, M., Wallerstedt, D. B., et al. (2005). Randomized comparison of group versus individual genetic education and counseling for familial breast and/or ovarian cancer. Journal of Clinical Oncology, 23, 3455–3464. doi:10.1200/jco.2005.04.050.CrossRefPubMed

Cameron, L. D., Biesecker, B. B., Peters, E., Taber, J. M., & Klein, W. M. P. (2017). Self-regulation principles underlying risk perception and decision making within the context of genomic testing. Social and Personality Psychology Compass (in press)

Castellani, C., Perobelli, S., Bianchi, V., Seia, M., Melotti, P., Zanolla, L., et al. (2011). An interactive computer program can effectively educate potential users of cystic fibrosis carrier tests. American Journal of Medical Genetics Part A, 155a, 778–785. doi:10.1002/ajmg.a.33870.CrossRefPubMed

Charles, S., Kessler, L., Stopfer, J. E., Domchek, S., & Halbert, C. H. (2006). Satisfaction with genetic counseling for BRCA1 and BRCA2 mutations among African American women. Patient Education and Counseling, 63, 196–204. doi:10.1016/j.pec.2005.10.007.CrossRefPubMed

Eijzenga, W., Aaronson, N. K., Hahn, D. E., Sidharta, G. N., Van der Kolk, L. E., Velthuizen, M. E., et al. (2014). Effect of routine assessment of specific psychosocial problems on personalized communication, counselors' awareness, and distress levels in cancer genetic counseling practice: A randomized controlled trial. Journal of Clinical Oncology, 32, 2998–3004. doi:10.1200/jco.2014.55.4576.CrossRefPubMed

Eijzenga, W., Bleiker, E. M., Ausems, M. G., Sidharta, G. N., Van der Kolk, L. E., Velthuizen, M. E., et al. (2015). Routine assessment of psychosocial problems after cancer genetic counseling: Results from a randomized controlled trial. Clinical Genetics, 87, 419–427. doi:10.1111/cge.12473.CrossRefPubMed

Fagerlin, A., Zikmund-Fisher, B. J., & Ubel, P. A. (2011). Helping patients decide: Ten steps to better risk communication. Journal of the National Cancer Institute, 103, 1436–1443.CrossRefPubMedPubMedCentral

Glanz, K., Steffen, A. D., & Taglialatela, L. A. (2007). Effects of colon cancer risk counseling for first-degree relatives. Cancer Epidemiology, Biomarkers & Prevention, 16, 1485–1491. doi:10.1158/1055-9965.epi-06-0914.CrossRef

Graves, K. D., Wenzel, L., Schwartz, M. D., Luta, G., Wileyto, P., Narod, S., et al. (2010). Randomized controlled trial of a psychosocial telephone counseling intervention in BRCA1 and BRCA2 mutation carriers. Cancer Epidemiology, Biomarkers & Prevention, 19, 648–654. doi:10.1158/1055-9965.epi-09-0548.CrossRef

Green, M. J., Biesecker, B. B., McInerney, A. M., Mauger, D., & Fost, N. (2001a). An interactive computer program can effectively educate patients about genetic testing for breast cancer susceptibility. American Journal of Medical Genetics, 103, 16–23.CrossRefPubMed

Green, M. J., McInerney, A. M., Biesecker, B. B., & Fost, N. (2001b). Education about genetic testing for breast cancer susceptibility: Patient preferences for a computer program or genetic counselor. American Journal of Medical Genetics, 103, 24–31.CrossRefPubMed

Green, M. J., Peterson, S. K., Baker, M. W., Harper, G. R., Friedman, L. C., Rubinstein, W. S., et al. (2004). Effect of a computer-based decision aid on knowledge, perceptions, and intentions about genetic testing for breast cancer susceptibility: A randomized controlled trial. Journal of the American Medical Association, 292, 442–452. doi:10.1001/jama.292.4.442.CrossRefPubMedPubMedCentral

Green, M. J., Peterson, S. K., Baker, M. W., Friedman, L. C., Harper, G. R., Rubinstein, W. S., et al. (2005). Use of an educational computer program before genetic counseling for breast cancer susceptibility: Effects on duration and content of counseling sessions. Genetics in Medicine, 7, 221–229.CrossRefPubMedPubMedCentral

Green, R. C., Christensen, K. D., Cupples, L. A., Relkin, N. R., Whitehouse, P. J., Royal, C. D., et al. (2014). A randomized noninferiority trial of condensed protocols for genetic risk disclosure of Alzheimer's disease. Alzheimer's & Dementia, 11, 1222–1230. doi:10.1016/j.jalz.2014.10.014.CrossRef

Haga, S. B., Barry, W. T., Mills, R., Svetkey, L., Suchindran, S., Willard, H. F., et al. (2014). Impact of delivery models on understanding genomic risk for type 2 diabetes. Public Health Genomics, 17, 95–104. doi:10.1159/000358413.CrossRefPubMedPubMedCentral

Halbert, C. H., Kessler, L., Troxel, A. B., Stopfer, J. E., & Domchek, S. (2010). Effect of genetic counseling and testing for BRCA1 and BRCA2 mutations in African American women: A randomized trial. Public Health Genomics, 13, 440–448. doi:10.1159/000293990.CrossRefPubMedPubMedCentral

Hanprasertpong, T., Rattanaprueksachart, R., Janwadee, S., Geater, A., Kor-anantakul, O., Suwanrath, C., et al. (2013). Comparison of the effectiveness of different counseling methods before second trimester genetic amniocentesis in Thailand. Prenatal Diagnosis, 33, 1189–1193. doi:10.1002/pd.4222.CrossRefPubMed

Helmes, A. W., Culver, J. O., & Bowen, D. J. (2006). Results of a randomized study of telephone versus in-person breast cancer risk counseling. Patient Education and Counseling, 64, 96–103. doi:10.1016/j.pec.2005.12.002.CrossRefPubMed

Henneman, L., Oosterwijk, J. C., van Asperen, C. J., Menko, F. H., Ockhuysen-Vermey, C. F., Kostense, P. J., et al. (2013). The effectiveness of a graphical presentation in addition to a frequency format in the context of familial breast cancer risk communication: A multicenter controlled trial. BMC Medical Informatics and Decision Making, 13, 55. doi:10.1186/1472-6947-13-55.CrossRefPubMedPubMedCentral

Higgins, J. P. T., & Green, S. (2011). Cochrane handbook for systematic reviews of interventions 5.1.0 (updated March 2011): The Cochrane Collaboration, 2011. Available from: www.cochrane-handbook.org.

Hodgson, J., Metcalfe, S., Gaff, C., Donath, S., Delatycki, M. B., Winship, I., et al. (2015). Outcomes of a randomised controlled trial of a complex genetic counselling intervention to improve family communication. European Journal of Human Genetics, 24, 356–360.CrossRefPubMedPubMedCentral

Hooker, G. W., Leventhal, K. G., DeMarco, T., Peshkin, B. N., Finch, C., Wahl, E., et al. (2011). Longitudinal changes in patient distress following interactive decision aid use among BRCA1/2 carriers: A randomized trial. Medical Decision Making, 31, 412–421. doi:10.1177/0272989x10381283.CrossRefPubMed

Hunter, A. G., Cappelli, M., Humphreys, L., Allanson, J. E., Chiu, T. T., Peeters, C., et al. (2005). A randomized trial comparing alternative approaches to prenatal diagnosis counseling in advanced maternal age patients. Clinical Genetics, 67, 303–313. doi:10.1111/j.1399-0004.2004.00405.x.CrossRefPubMed

Hwa, H. L., Huang, L. H., Hsieh, F. J., & Chow, S. N. (2010). Informed consent for antenatal serum screening for down syndrome. Taiwanese Journal of Obstetrics & Gynecology, 49, 50–56. doi:10.1016/s1028-4559(10)60009-5.CrossRef

Jenkins, J., Calzone, K. A., Dimond, E., Liewehr, D. J., Steinberg, S. M., Jourkiv, O., et al. (2007). Randomized comparison of phone versus in-person BRCA1/2 predisposition genetic test result disclosure counseling. Genetics in Medicine, 9, 487–495. doi:10.1097/GIM.0b013e31812e6220.

Kinney, A. Y., Butler, K. M., Schwartz, M. D., Mandelblatt, J. S., Boucher, K. M., Pappas, L. M., et al. (2014). Expanding access to BRCA1/2 genetic counseling with telephone delivery: A cluster randomized trial. Journal of the National Cancer Institute, 106. doi:10.1093/jnci/dju328

Kitson, A., Harvey, G., & McCormack, B. (1998). Enabling the implementation of evidence based practice: A conceptual framework. Quality in Health Care, 7, 149–158. doi:10.1136/qshc.7.3.149.CrossRefPubMedPubMedCentral

Kuppermann, M., Pena, S., Bishop, J. T., Nakagawa, S., Gregorich, S. E., Sit, A., et al. (2014). Effect of enhanced information, values clarification, and removal of financial barriers on use of prenatal genetic testing: A randomized clinical trial. Journal of the American Medical Association, 312, 1210–1217. doi:10.1001/jama.2014.11479.CrossRefPubMedPubMedCentral

Lerman, C., Biesecker, B., Benkendorf, J. L., Kerner, J., Gomez-Caminero, A., Hughes, C., et al. (1997). Controlled trial of pretest education approaches to enhance informed decision-making for BRCA1 gene testing. Journal of the National Cancer Institute, 89, 148–157.CrossRefPubMed

Lerman, C., Hughes, C., Benkendorf, J. L., Biesecker, B., Kerner, J., Willison, J., et al. (1999). Racial differences in testing motivation and psychological distress following pretest education for BRCA1 gene testing. Cancer Epidemiology, Biomarkers & Prevention, 8, 361–367.

Lowery, J. T., Horick, N., Kinney, A. Y., Finkelstein, D. M., Garrett, K., Haile, R. W., et al. (2014). A randomized trial to increase colonoscopy screening in members of high-risk families in the colorectal cancer family registry and cancer genetics network. Cancer Epidemiology, Biomarkers & Prevention, 23, 601–610. doi:10.1158/1055-9965.epi-13-1085.CrossRef

Matloff, E. T., Moyer, A., Shannon, K. M., Niendorf, K. B., & Col, N. F. (2006). Healthy women with a family history of breast cancer: Impact of a tailored genetic counseling intervention on risk perception, knowledge, and menopausal therapy decision making. Journal of Women's Health, 15, 843–856. doi:10.1089/jwh.2006.15.843.CrossRefPubMed

McAllister, M., Wood, A. M., Dunn, G., Shiloh, S., & Todd, C. (2011). The genetic counseling outcome scale: A new patient-reported outcome measure for clinical genetics services. Clinical Genetics, 79(5), 413–424.CrossRefPubMed

McInerney-Leo, A., Biesecker, B. B., Hadley, D. W., Kase, R. G., Giambarresi, T. R., Johnson, E., et al. (2004). BRCA1/2 testing in hereditary breast and ovarian cancer families: Effectiveness of problem-solving training as a counseling intervention. American Journal of Medical Genetics Part A, 130a, 221–227. doi:10.1002/ajmg.a.30265.CrossRefPubMed

Miedzybrodzka, Z. H., Hall, M. H., Mollison, J., Templeton, A., Russell, I. T., Dean, J. C., et al. (1995). Antenatal screening for carriers of cystic fibrosis: Randomised trial of stepwise v couple screening. The BMJ, 310, 353–357.CrossRefPubMedPubMedCentral

Miller, S. M., Roussi, P., Daly, M. B., Buzaglo, J. S., Sherman, K., Godwin, A. K., et al. (2005). Enhanced counseling for women undergoing BRCA1/2 testing: Impact on subsequent decision making about risk reduction behaviors. Health Education & Behavior, 32, 654–667. doi:10.1177/1090198105278758.CrossRef

Montgomery, S. V., Barsevick, A. M., Egleston, B. L., Bingler, R., Ruth, K., Miller, S. M., et al. (2013). Preparing individuals to communicate genetic test results to their relatives: Report of a randomized control trial. Familial Cancer, 12, 537–546. doi:10.1007/s10689-013-9609-z.CrossRefPubMedPubMedCentral

Nishigaki, M., Tokunaga-Nakawatase, Y., Nishida, J., & Kazuma, K. (2014). The effect of genetic counseling for adult offspring of patients with type 2 diabetes on attitudes toward diabetes and its heredity: A randomized controlled trial. Journal of Genetic Counseling, 23, 762–769. doi:10.1007/s10897-013-9680-5.CrossRefPubMed

Platten, U., Rantala, J., Lindblom, A., Brandberg, Y., Lindgren, G., & Arver, B. (2012). The use of telephone in genetic counseling versus in-person counseling: A randomized study on counselees' outcome. Familial Cancer, 11, 371–379. doi:10.1007/s10689-012-9522-x.CrossRefPubMedPubMedCentral

Redlinger-Grosse, K., Veach, P. M., Cohen, S., LeRoy, B. S., MacFarlane, I. M., & Zierhut, H. (2016). Defining our clinical practice: The identification of genetic counseling outcomes utilizing the reciprocal engagement model. Journal of Genetic Counseling, 25(2), 239–257.CrossRefPubMed

Roberts, J. S., Chen, C. A., Uhlmann, W. R., & Green, R. C. (2012). Effectiveness of a condensed protocol for disclosing APOE genotype and providing risk education for Alzheimer disease. Genetics in Medicine, 14, 742–748. doi:10.1038/gim.2012.37.CrossRefPubMedPubMedCentral

Roshanai, A. H., Rosenquist, R., Lampic, C., & Nordin, K. (2009). Does enhanced information at cancer genetic counseling improve counselees' knowledge, risk perception, satisfaction and negotiation of information to at-risk relatives? A randomized study. Acta Oncologica, 48, 999–1009. doi:10.1080/02841860903104137.CrossRefPubMed

Roussi, P., Sherman, K. A., Miller, S., Buzaglo, J., Daly, M., Taylor, A., et al. (2010). Enhanced counselling for women undergoing BRCA1/2 testing: Impact on knowledge and psychological distress-results from a randomised clinical trial. Psychology & Health, 25, 401–415. doi:10.1080/08870440802660884.CrossRef

Schwartz, M. D., Benkendorf, J., Lerman, C., Isaacs, C., Ryan-Robertson, A., & Johnson, L. (2001). Impact of educational print materials on knowledge, attitudes, and interest in BRCA1/BRCA2: Testing among Ashkenazi Jewish women. Cancer, 92, 932–940.CrossRefPubMed

Schwartz, M. D., Valdimarsdottir, H. B., DeMarco, T. A., Peshkin, B. N., Lawrence, W., Rispoli, J., et al. (2009). Randomized trial of a decision aid for BRCA1/BRCA2 mutation carriers: Impact on measures of decision making and satisfaction. Health Psychology, 28, 11–19. doi:10.1037/a0013147.CrossRefPubMedPubMedCentral

Schwartz, M. D., Valdimarsdottir, H. B., Peshkin, B. N., Mandelblatt, J., Nusbaum, R., Huang, A. T., et al. (2014). Randomized noninferiority trial of telephone versus in-person genetic counseling for hereditary breast and ovarian cancer. Journal of Clinical Oncology, 32, 618–626. doi:10.1200/jco.2013.51.3226.CrossRefPubMedPubMedCentral

Sibbald, B., & Roland, M. (1998). Understanding controlled trials. Why are randomised controlled trials important? The BMJ, 316, 201

Temme, R., Gruber, A., Johnson, M., Read, L., Lu, Y., & McNamara, J. (2015). Assessment of parental understanding of positive newborn screening results and carrier status for cystic fibrosis with the use of a short educational video. Journal of Genetic Counseling, 24, 473–481. doi:10.1007/s10897-014-9767-7.CrossRefPubMed

Van Tulder, M., Furlan, A., Bombardier, C., Bouter, L., & Editorial Board of the Cochrane Collaboration Back Review Group. (2003). Updated method guidelines for systematic reviews in the Cochrane collaboration back review group. Spine, 28(12), 1290–1299.PubMed

Voorwinden, J. S., Jaspers, J. P., ter Beest, J. G., Kievit, Y., Sijmons, R. H., & Oosterwijk, J. C. (2012). The introduction of a choice to learn pre-symptomatic DNA test results for BRCA or lynch syndrome either face-to-face or by letter. Clinical Genetics, 81, 421–429. doi:10.1111/j.1399-0004.2011.01811.x.CrossRefPubMed

Wakefield, C. E., Meiser, B., Homewood, J., Taylor, A., Gleeson, M., Williams, R., et al. (2008). A randomized trial of a breast/ovarian cancer genetic testing decision aid used as a communication aid during genetic counseling. Psychooncology, 17, 844–854. doi:10.1002/pon.1353.CrossRefPubMed

Wang, C., Gonzalez, R., Milliron, K. J., Strecher, V. J., & Merajver, S. D. (2005). Genetic counseling for BRCA1/2: A randomized controlled trial of two strategies to facilitate the education and counseling process. American Journal of Medical Genetics Part A, 134a, 66–73. doi:10.1002/ajmg.a.30577

Watson, M., Duvivier, V., Wade Walsh, M., Ashley, S., Davidson, J., Papaikonomou, M., et al. (1998). Family history of breast cancer: What do women understand and recall about their genetic risk? Journal of Medical Genetics, 35, 731–738.CrossRefPubMedPubMedCentral

Wevers, M. R., Aaronson, N. K., Verhoef, S., Bleiker, E. M., Hahn, D. E., Kuenen, M. A., et al. (2014). Impact of rapid genetic counselling and testing on the decision to undergo immediate or delayed prophylactic mastectomy in newly diagnosed breast cancer patients: Findings from a randomised controlled trial. British Journal of Cancer, 110, 1081–1087. doi:10.1038/bjc.2013.805.CrossRefPubMedPubMedCentral

Yee, L. M., Wolf, M., Mullen, R., Bergeron, A. R., Cooper Bailey, S., Levine, R., et al. (2014). A randomized trial of a prenatal genetic testing interactive computerized information aid. Prenatal Diagnosis, 34, 552–557. doi:10.1002/pd.4347.CrossRefPubMedPubMedCentral

Youngblut, J. M., & Brooten, D. (2001). Evidence-based nursing practice: Why is it important? AACN Clinical Issues, 12, 468–476.CrossRefPubMed

Zierhut, H. A., Shannon, K. M., Cragun, D. L., & Cohen, S. A. (2016). Elucidating genetic counseling outcomes from the perspective of genetic counselors. Journal of Genetic Counseling, 1–9.

Titel: A Systematic Review of Randomized Controlled Trials to Assess Outcomes of Genetic Counseling
verfasst von: Barbara A. Athens
Samantha L. Caldwell
Kendall L. Umstead
Philip D. Connors
Ethan Brenna
Barbara B. Biesecker
Publikationsdatum: 02.03.2017
Verlag: Springer US
Erschienen in: Journal of Genetic Counseling / Ausgabe 5/2017
Print ISSN: 1059-7700
Elektronische ISSN: 1573-3599
DOI: https://doi.org/10.1007/s10897-017-0082-y

Neu im Fachgebiet Gynäkologie und Geburtshilfe

23.04.2024 | Medikamente in Schwangerschaft und Stillzeit | Nachrichten

Update Gynäkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.

Newsletter bestellen

Springer Medizin

A Systematic Review of Randomized Controlled Trials to Assess Outcomes of Genetic Counseling

Abstract

Neu im Fachgebiet Gynäkologie und Geburtshilfe

ICI-Therapie in der Schwangerschaft wird gut toleriert

Weniger postpartale Depressionen nach Esketamin-Einmalgabe

Bei RSV-Impfung vor 60. Lebensjahr über Off-Label-Gebrauch aufklären!

Harnwegsinfektprophylaxe: Es geht auch ohne Antibiotika

Update Gynäkologie

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 5/2017

Using Patient-Reported Outcome Measures for Quality Improvement in Clinical Genetics: an Exploratory Study

A Psychological Perspective on Factors Predicting Prophylactic Salpingo-Oophorectomy in a Sample of Italian Women from the General Population. Results from a Hypothetical Study in the Context of BRCA Mutations

Reasons for Declining Preconception Expanded Carrier Screening Using Genome Sequencing

Performing and Declining PGD: Accounts of Jewish Israeli Women Who Carry a BRCA1/2 Mutation or Partners of Male Mutation Carriers

Outcomes of a Randomized Controlled Trial of Genomic Counseling for Patients Receiving Personalized and Actionable Complex Disease Reports

Seekers, Finders, Settlers, and Stumblers: Identifying the Career Paths of Males in the Genetic Counseling Profession

Neu im Fachgebiet Gynäkologie und Geburtshilfe

ICI-Therapie in der Schwangerschaft wird gut toleriert

Weniger postpartale Depressionen nach Esketamin-Einmalgabe

Bei RSV-Impfung vor 60. Lebensjahr über Off-Label-Gebrauch aufklären!

Harnwegsinfektprophylaxe: Es geht auch ohne Antibiotika

Update Gynäkologie