Are we ready for rapid genomic testing in acute pediatrics? Attitudes of Australian health professionals

Abstract

Aim: To investigate the attitudes of healthcare professionals towards the application of genomic testing in neonatal and pediatric intensive care units (NICU/PICU). Methods: Before initiating a multicentre implementation study of rapid genomic testing across 18 Australian NICUs/PICUs, we surveyed 289 participating intensive care physicians and genetics professionals about perceived usefulness of results, preferences for service delivery models, and implementation readiness. We examined the confidence of intensivists with microarray and genomic testing, and preferences for professional development in genomics, and conducted semi-structured interviews. Results: The overall response rate was 58%, 46% for intensivists (79/170) and 75% (89/119) for genetics professionals. Intensivists reported only moderate confidence with using microarray tests and even lower confidence with genomic tests. Twentythree percent reported having engaged in genomics-related professional development activities. The majority of intensivists (76%), clinical geneticists (87%) and genetic counselors (81%) favored a clinical genetics-led service delivery model of genomic testing in the NICU/PICU. Among clinicians who favored an intensivist-led model, result interpretation was highlighted as a key area likely to require additional support from clinical genetics. Perceived utility of genomic results was lower in the intensivist group compared to the genetics professionals group (20% vs. 40%, p = .024). While support for implementation was high, the main concerns expressed by genetics professionals related to implementation climate and organizational readiness. Conclusion: Successful large-scale implementation of genomic testing in NICU/PICU will require the development of interdisciplinary service delivery models that support adoption of genomics by the intensive careworkforce while ensuring safety, sustainability and efficiency.L6298898562019-11-22 <br />