A Video Intervention to Improve Patient Understanding of Tumor Genomic Testing in Patients with Cancer

Abstract

Background: Tumor genomic testing (TGT) has become standard-of-care for most patients with advanced/metastatic cancer. Despite established guidelines, patient education prior to TGT is variable or frequently omitted. The purpose of this study was to evaluate the impact of a concise (3-4 minute) video for patient education prior to TGT. Methods: Based on a quality improvement cycle, an animated video was created to be applicable to any cancer type, incorporating culturally diverse images, available in English and Spanish. Patients undergoing standard-of care TGT were enrolled at a tertiary academic institution and completed validated survey instruments immediately prior to video viewing (T1) and immediately post-viewing (T2). Instruments included: 1) 10-question objective genomic knowledge/understanding; 2) 10-question video message-specific knowledge/recall; 3) 11-question Trust in Physician/Provider; 4) attitudes regarding TGT. The primary objective was change in outcomes from before to after the video was assessed with Wilcoxon signed rank test. Results: From April 2022 to May 2023, a total of 150 participants were enrolled (MBC n=53, LC n=38, OC n=59). For the primary endpoint, there was a significant increase in video message-specific knowledge (median 10 point increase; p<0.0001) with no significant change in genomic knowledge/understanding (p=0.89) or Trust in Physician/Provider (p=0.59). Results for five questions significantly improved, including the likelihood of TGT impact on treatment decision, incidental germline findings, and cost of testing. Improvement in video message-specific knowledge was consistent across demographic groups, including age, income, and education. Individuals with less educational attainment had had greater improvement from before to after video viewing. Conclusions: A concise, 3-4 minute, broadly applicable video incorporating culturally diverse images administered prior to TGT significantly improved video message-specific knowledge across all demographic groups. This resource is publicly available at http://www.tumor-testing.com, with a goal to efficiently educate and empower patients regarding TGT while addressing guidelines within the flow of clinical practice. Clinical Trial Registration: ClinicalTrials.gov NCT05215769

Competing Interest Statement

HH is on the scientific advisory board for Invitae Genetics, Genome Medical, and Promega. She has stock/stock options in Genome Medical and GI OnDemand. LS is a consultant and speaker for AstraZeneca. DS served on an advisory board for Novartis. CJP received payment for patient education material development through Jazz Pharmaceuticals.

Clinical Trial

ClinicalTrials.gov NCT05215769

Funding Statement

This work was supported by National Institutes of Health (NIH) grant 1R21CA259985 (LW, LS, SRH, HLH, AET, CJP, DGS), P30CA016058 (LW, TS, AET), 1R01 CA215151 (AET), CJP is supported by 1K76AG074923-01.

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The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

The Ohio State Cancer Institutional Review Board

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