Abstract
In addition to highlighting NIPT as a safe, sensitive screening option, the new ACOG practice bulletin places a heavy emphasis on pre- and post-test counseling for patients considering prenatal genetic testing.
“It's so important for us to inform patients about what each test is and what its limitations are, and also take the time to understand a woman's preferences and values,” says Kaimal, a clinician who helped craft the new ACOG guidelines. “We want to make sure that the decision that we make moving forward is informed by the best evidence that we have, and also weighted based on the patient's preferences so that people get the test that makes the most sense for them and receive the information they value.”
Kaimal says patients often need help differentiating between screening and diagnostic tests, especially because companies differ in how they report results.
In the case of cfDNA-based NIPT, patients must also be aware that screening results occasionally reveal previously unknown maternal health information, such as indicators of cancer or autoimmune disorders.
Some biotech companies are seeking to partner with clinicians in patient education efforts. In early 2020, Roche launched an app called “iPrenatal,” which provides very information about chromosomes, trisomies, and screening and diagnostic testing options. The app has a chatbot-like functionality, walking patients through choose-your-own-adventure text threads that present verbal definitions along with simple graphics and short explanatory videos.
“We at Roche have a ferocious commitment to patient education,” says Schmid, the company head of medical affairs. “We feel that that is one of the key aspects that need to be addressed to make sure that patients actually have access and benefit from this new technology.”