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<http://schema.org/articleBody>
"Pre-test counseling about multigene panel testing involves many uncertainties  Ideally  counselees are informed about uncertainties in a way that enables them to make an informed decision about panel testing  It is presently unknown whether and how uncertainty is discussed during initial cancer genetic counseling  We therefore investigated whether and how counselors discuss and address uncertainty  and the extent of shared decision-making  SDM   and explored associations between counselors    communication and their characteristics in consultations on panel testing for cancer  For this purpose  consultations of counselors discussing a multigene panel with a simulated patient were videotaped  Simulated patients represented a counselee who had had multiple cancer types  according to a script  Before and afterwards  counselors completed a survey  Counselors    uncertainty expressions  initiating and the framing of expressions  and their verbal responses to scripted uncertainties of the simulated patient were coded by two researchers independently  Coding was done according to a pre-developed coding scheme using The Observer XT software for observational analysis  Additionally  the degree of SDM was assessed by two observers  Correlation and regression analyses were performed to assess associations of communicated uncertainties  responses and the extent of SDM  with counselors    background characteristics  In total  twenty-nine counselors  including clinical geneticists  genetic counselors  physician assistants-in-training  residents and interns  participated of whom working experience varied between 0 and 25 years  Counselors expressed uncertainties mainly regarding scientific topics  94   and on their own initiative  95    Most expressions were framed directly  77    e g  We don   t know   and were emotionally neutral  59   without a positive negative value   Counselors mainly responded to uncertainties of the simulated patient by explicitly referring to the uncertainty  69    without providing space for further disclosure  66    More experienced counselors provided less space to further disclose uncertainty   p   0 02   and clinical geneticists scored lower on SDM compared with other types of counselors   p   0 03   Our findings that counselors mainly communicate scientific uncertainties and use space-reducing responses imply that the way counselors address counselees    personal uncertainties and concerns during initial cancer genetic counseling is suboptimal  Electronic supplementary material The online version of this article  doi 10 1007 s10689-019-00154-4  contains supplementary material  which is available to authorized users "
<https://www.mysciencework.com/publication/facets/journal/Familial%2520Cancer>