Patients' experiences using an educational virtual assistant for review of reproductive genetic screening results

This observational study aimed to capture patients' experiences after reviewing carrier screening (CS) and/or noninvasive prenatal cell-free DNA testing (NIPT) results with Natera's Educational Virtual Assistant (NEVA). Patients, partners of patients, or other individuals designated to review the patients' results were included if they consented to follow-up contact. Eligible individuals were sent a text message or e-mail requesting that they complete a survey. The survey collected demographic data and patients' experiences with NEVA across five domains (overall satisfaction, ease of use, overall sentiments, knowledge and perceived understanding, and preferences for results delivery and education) using a combination of multiple-choice, ranking, and Likert-scale questions. Comparisons were made across group proportions for survey responses. Ordinal and logistic regression models were constructed to examine the relationships while adjusting for previous knowledge of test results. Among 1133 survey respondents, 193 had negative CS, 79 had positive CS, 845 had low-risk NIPT, and 16 had high-risk NIPT results. Across all groups, 79.1% reported being satisfied with their experience, 90.5% indicated that NEVA was easy to use, 71.8% reported favorable sentiments regarding their interaction with NEVA, 77.8% correctly reported knowledge of their results, and 86.4% indicated perceived understanding of their results. The most preferred method for reviewing results was using a virtual assistant across the negative CS, positive CS, and low-risk NIPT cohorts; participants with high-risk NIPT preferred talking to a genetic counselor. Participants with low-risk NIPT had greater odds of reporting overall satisfaction (OR: 3.98, p < 0.001) and favorable sentiments (OR: 9.49, p < 0.001) compared to participants with high-risk NIPT. No differences were found among participants who received CS. Survey responses demonstrate the feasibility and utility of NEVA for reproductive genetic testing results delivery and suggest some differences in acceptance for patients receiving NIPT results.