Development and evaluation of patient-centred polygenic risk score reports for glaucoma screening

Abstract Background Polygenic risk scores (PRS), which provide an individual probabilistic estimate of genetic susceptibility to develop a disease, have shown effective risk stratification for glaucoma onset. However, there is limited best practice evidence for reporting PRS and patient-friendly rep...

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Main Authors: Georgina L Hollitt, Mark M Hassall, Owen M Siggs, Jamie E Craig, Emmanuelle Souzeau
Format: Article
Language:English
Published: BMC 2025-01-01
Series:BMC Medical Genomics
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Online Access:https://doi.org/10.1186/s12920-024-02079-z
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author Georgina L Hollitt
Mark M Hassall
Owen M Siggs
Jamie E Craig
Emmanuelle Souzeau
author_facet Georgina L Hollitt
Mark M Hassall
Owen M Siggs
Jamie E Craig
Emmanuelle Souzeau
author_sort Georgina L Hollitt
collection DOAJ
description Abstract Background Polygenic risk scores (PRS), which provide an individual probabilistic estimate of genetic susceptibility to develop a disease, have shown effective risk stratification for glaucoma onset. However, there is limited best practice evidence for reporting PRS and patient-friendly reports for communicating PRS effectively are lacking. Here we developed patient-centred PRS reports for glaucoma screening based on the literature, and evaluated them with participants using a qualitative research approach. Methods We first reviewed existing PRS reports and literature on probabilistic risk communication. This informed the development of a draft glaucoma screening PRS report for a hypothetical high risk individual from the general population. We designed three versions of the report to illustrate risk using a pictograph, a pie chart and a bell curve. We then conducted semi-structured interviews to assess preference of visual risk communication aids, understanding of risk, content, format and structure of the reports. Participants were invited from an existing study, which aims to evaluate the clinical validity of glaucoma PRS among individuals > 50 years from the general population. Numeracy and literacy levels were assessed. Results We interviewed 12 individuals. The cohort was highly educated (42% university education), all were European and 50% were female. Numeracy (mean 2.1 ± 0.9, range 0 to 3), graph literacy (mean 2.8 ± 0.8, range 0 to 4) and genetic literacy (mean 24.2 ± 6.2, range − 20 to + 46) showed a range of levels. We analysed the reports under three main themes: visual preferences, understanding risk and reports formatting. The visual component was deemed important to understanding risk, with the pictograph being the preferred visual risk representation, followed by the pie chart and the bell curve. Participants expressed preference for absolute risk in understanding risk, along with the written content explaining the results. The importance of follow-up recommendations and time to glaucoma onset were deemed important. Participants expressed varied opinions in the level of information and the colours used, which informed revisions of the report. Conclusions Our study revealed preferences for reporting PRS information in the context of glaucoma screening, to support the development of clinical PRS reporting. Further research is needed to assess PRS communication in other groups representative of target populations and with other target audiences (e.g. referring clinicians), and its potential psychosocial impact in the wider community.
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spelling doaj-art-e5e35ca6af354f9da7cdd4ea97243c3f2025-02-02T12:46:38ZengBMCBMC Medical Genomics1755-87942025-01-0118111010.1186/s12920-024-02079-zDevelopment and evaluation of patient-centred polygenic risk score reports for glaucoma screeningGeorgina L Hollitt0Mark M Hassall1Owen M Siggs2Jamie E Craig3Emmanuelle Souzeau4Department of Ophthalmology, Flinders Medical and Health Research Institute, Flinders UniversityDepartment of Ophthalmology, Flinders Medical and Health Research Institute, Flinders UniversityDepartment of Ophthalmology, Flinders Medical and Health Research Institute, Flinders UniversityDepartment of Ophthalmology, Flinders Medical and Health Research Institute, Flinders UniversityDepartment of Ophthalmology, Flinders Medical and Health Research Institute, Flinders UniversityAbstract Background Polygenic risk scores (PRS), which provide an individual probabilistic estimate of genetic susceptibility to develop a disease, have shown effective risk stratification for glaucoma onset. However, there is limited best practice evidence for reporting PRS and patient-friendly reports for communicating PRS effectively are lacking. Here we developed patient-centred PRS reports for glaucoma screening based on the literature, and evaluated them with participants using a qualitative research approach. Methods We first reviewed existing PRS reports and literature on probabilistic risk communication. This informed the development of a draft glaucoma screening PRS report for a hypothetical high risk individual from the general population. We designed three versions of the report to illustrate risk using a pictograph, a pie chart and a bell curve. We then conducted semi-structured interviews to assess preference of visual risk communication aids, understanding of risk, content, format and structure of the reports. Participants were invited from an existing study, which aims to evaluate the clinical validity of glaucoma PRS among individuals > 50 years from the general population. Numeracy and literacy levels were assessed. Results We interviewed 12 individuals. The cohort was highly educated (42% university education), all were European and 50% were female. Numeracy (mean 2.1 ± 0.9, range 0 to 3), graph literacy (mean 2.8 ± 0.8, range 0 to 4) and genetic literacy (mean 24.2 ± 6.2, range − 20 to + 46) showed a range of levels. We analysed the reports under three main themes: visual preferences, understanding risk and reports formatting. The visual component was deemed important to understanding risk, with the pictograph being the preferred visual risk representation, followed by the pie chart and the bell curve. Participants expressed preference for absolute risk in understanding risk, along with the written content explaining the results. The importance of follow-up recommendations and time to glaucoma onset were deemed important. Participants expressed varied opinions in the level of information and the colours used, which informed revisions of the report. Conclusions Our study revealed preferences for reporting PRS information in the context of glaucoma screening, to support the development of clinical PRS reporting. Further research is needed to assess PRS communication in other groups representative of target populations and with other target audiences (e.g. referring clinicians), and its potential psychosocial impact in the wider community.https://doi.org/10.1186/s12920-024-02079-zPolygenic risk scoresGlaucomaRisk communicationReportsVisual aids
spellingShingle Georgina L Hollitt
Mark M Hassall
Owen M Siggs
Jamie E Craig
Emmanuelle Souzeau
Development and evaluation of patient-centred polygenic risk score reports for glaucoma screening
BMC Medical Genomics
Polygenic risk scores
Glaucoma
Risk communication
Reports
Visual aids
title Development and evaluation of patient-centred polygenic risk score reports for glaucoma screening
title_full Development and evaluation of patient-centred polygenic risk score reports for glaucoma screening
title_fullStr Development and evaluation of patient-centred polygenic risk score reports for glaucoma screening
title_full_unstemmed Development and evaluation of patient-centred polygenic risk score reports for glaucoma screening
title_short Development and evaluation of patient-centred polygenic risk score reports for glaucoma screening
title_sort development and evaluation of patient centred polygenic risk score reports for glaucoma screening
topic Polygenic risk scores
Glaucoma
Risk communication
Reports
Visual aids
url https://doi.org/10.1186/s12920-024-02079-z
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