在瘤学中采用基因检测的障碍:来自巴基斯坦的跨部门调查
Insia Mushtaq Ali1, Maya Hashmi2, Waqas Ahmed Khan3
1Section of Medical Oncology, Department of Oncology, Aga Khan University Hospital, Karachi, Pakistan.
概括
遗传检测实验室的有限访问和遗传学培训不足是巴基斯坦个性化癌症护理的关键障碍. 改善基础设施和教育对于在瘤学中更广泛地采用基因测试至关重要.
科学领域:
- 在瘤学瘤学.
- 遗传学 是一个遗传学.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 个性化癌症护理在很大程度上依赖于基因检测.
- 在像巴基斯坦这样的低收入和中等收入国家 (LMICs) 采用基因测试是有限的.
- 在LMICs中采用基因测试的障碍尚未得到充分了解.
研究的目的:
- 确定影响巴基斯坦瘤学中基因测试使用的关键障碍.
- 探索加强在临床实践中采用基因测试的实际策略.
主要方法:
- 巴基斯坦49名瘤临床医生的横截面调查 (2023年8月至12月).
- 评估临床医生的信心,订购实践,知识,培训和感知的障碍.
- 使用费舍尔的精确测试和赔率比率分析了结果 (信心低,不经常订单).
- 使用诱导性主题方法对开放式响应进行定性分析.
主要成果:
- 14%的人表示信心低,18%的人很少订购基因测试.
- 实验室访问有限与低可信度 (OR 22.0) 和不经常订购 (OR 14.0) 密切相关.
- 患者成本 (93%) 和耻辱感 (69%) 是常见的,但不是临床医生行为的显著预测因素.
- 定性主题:系统工作流程延迟,临床医师培训缺口,患者财务/误解问题.
结论:
- 改善实验室和转诊基础设施对于扩大精确瘤学准入至关重要.
- 整合遗传学教育和支持性政策可以加强巴基斯坦和类似的低低收入国家常规癌症遗传检测.
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