Policy Guidance for Direct-to-Consumer Genetic Testing Services: Framework Development Study

Policy Guidance for Direct-to-Consumer Genetic Testing Services: Framework Development Study

The online offer of commercial genetic tests, also called direct-to-consumer genetic tests (DTC-GTs), enables citizens to gain insight into their health and disease risk based on their genetic profiles. DTC-GT offers often consist of a combination of services or aspects, including advertisements, in...

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Bibliographic Details
Published in:Journal of medical Internet research Vol. 26; no. 3; p. e47389
Main Authors: Onstwedder, Suzanne Maria, Jansen, Marleen Elizabeth, Cornel, Martina Cornelia, Rigter, Tessel
Format: Journal Article
Language:English
Published: Canada Journal of Medical Internet Research 17-07-2024
JMIR Publications
Subjects:
Direct-To-Consumer Screening and Testing
Genetic screening
Genetic Testing - standards
Health aspects
Health Policy
Humans
Marketing research
Original Paper
Public health
Safety and security measures
Services industry
policy decision
direct-to-consumer testing
health policy
informed consent
mobile health
genetic testing
genetic privacy
mHealth
privacy
online market
public health genomics
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Summary:The online offer of commercial genetic tests, also called direct-to-consumer genetic tests (DTC-GTs), enables citizens to gain insight into their health and disease risk based on their genetic profiles. DTC-GT offers often consist of a combination of services or aspects, including advertisements, information, DNA analysis, and medical or lifestyle advice. The risks and benefits of DTC-GT services have been debated and studied extensively, but instruments that assess DTC-GT services and aid policy are lacking. This leads to uncertainty among policy makers, law enforcers, and regulators on how to ensure and balance both public safety and autonomy and about the responsibilities these 3 parties have toward the public. This study aimed to develop a framework that outlines aspects of DTC-GTs that lead to policy issues and to help provide policy guidance regarding DTC-GT services. We performed 3 steps: (1) an integrative literature review to identify risks and benefits of DTC-GT services for consumers and society in Embase and Medline (January 2014-June 2022), (2) structuring benefits and risks in different steps of the consumer journey, and (3) development of a checklist for policy guidance. Potential risks and benefits of DTC-GT services were mapped from 134 papers and structured into 6 phases. In summary, these phases were called the consumer journey: (1) exposure, (2) pretest information, (3) DNA analysis, (4) data management, (5) posttest information, and (6) individual and societal impact. The checklist for evaluation of DTC-GT services consisted of 8 themes, covering 38 items that may raise policy issues in DTC-GT services. The themes included the following aspects: general service content, validity and quality assurance, potential data and privacy risks, scientific evidence and robustness, and quality of the provided information. Both the consumer journey and the checklist break the DTC-GT offer down into key aspects that may impact and compromise individual and public health, safety, and autonomy. This framework helps policy makers, regulators, and law enforcers develop methods to interpret, assess, and act in the DTC-GT service market.
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ISSN:1438-8871
1439-4456
1438-8871
DOI:10.2196/47389