Why Information Alone Is Not Enough: Behavioral Economics and the Future of Genomic Medicine
Authors: J.S. Blumenthal-Barby, Amy L. McGuire, Peter A. Ubel
Journal: Annals of Internal Medicine (2014)

Editorials21 October 2014Why Information Alone Is Not Enough: Behavioral Economics and the Future of Genomic MedicineJ.S. Blumenthal-Barby, PhD, MA, Amy L. McGuire, JD, PhD, and Peter A. Ubel, MDJ.S. Blumenthal-Barby, PhD, MAFrom Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, Texas, and Fuqua School of Business and Sanford School of Public Policy, Duke University, Durham, North Carolina.Search for more papers by this author, Amy L. McGuire, JD, PhDFrom Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, Texas, and Fuqua School of Business and Sanford School of Public Policy, Duke University, Durham, North Carolina.Search for more papers by this author, and Peter A. Ubel, MDFrom Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, Texas, and Fuqua School of Business and Sanford School of Public Policy, Duke University, Durham, North Carolina.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M14-2074 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Much energy and money are being invested to integrate genome-wide testing into routine clinical care (1). One goal of personalized genomics is to improve health by motivating persons with elevated genomic risk profiles to seek preventive screening and early intervention. However, as Weinberg and colleagues (2) report in this issue, achieving this goal may be more difficult than anticipated.At enrollment, adults who were nonadherent to recommended colorectal cancer (CRC) screening were randomly assigned to usual care or a genetic and environmental risk assessment that determined whether the combination of a single gene polymorphism and serum vitamin level indicated whether ...References1. Kuehn BM. NIH shifts focus from sequencing genes to fostering clinical applications. JAMA. 2012;307:132. [PMID: 22235074] doi:10.1001/jama.2011.1925 CrossrefMedlineGoogle Scholar2. Weinberg DS, Myers RE, Keenan E, Ruth K, Sifri R, Ziring B, et al. Genetic and environmental risk assessment and colorectal cancer screening in an average-risk population. A randomized trial. Ann Intern Med. 2014;161:537-45. doi:10.7326/M14-0765 LinkGoogle Scholar3. Lipkus IM, Klein WM. Effects of communicating social comparison information on risk perceptions for colorectal cancer. J Health Commun. 2006;11:391-407. [PMID: 16720537] CrossrefMedlineGoogle Scholar4. Garcia C, Wendt J, Lyon L, Jones J, Littell RD, Armstrong MA, et al. Risk management options elected by women after testing positive for a BRCA mutation. Gynecol Oncol. 2014;132:428-33. [PMID: 24355485] doi:10.1016/j.ygyno.2013.12.014 CrossrefMedlineGoogle Scholar5. Blumenthal-Barby JS, Krieger H. Cognitive biases and heuristics in medical decision making: a critical review using a systematic search strategy. Med Decis Making. 2014. [PMID: 25145577] MedlineGoogle Scholar6. Fagerlin A, Zikmund-Fisher BJ, Ubel PA. How making a risk estimate can change the feel of that risk: shifting attitudes toward breast cancer risk in a general public survey. Patient Educ Couns. 2005;57:294-9. [PMID: 15893211] CrossrefMedlineGoogle Scholar7. Halpern SD, Ubel PA, Asch DA. Harnessing the power of default options to improve health care. N Engl J Med. 2007;357:1340-4. [PMID: 17898105] CrossrefMedlineGoogle Scholar8. Cameron KA, Persell SD, Brown T, Thompson J, Baker DW. Patient outreach to promote colorectal cancer screening among patients with an expired order for colonoscopy: a randomized controlled trial. Arch Intern Med. 2011;171:642-6. [PMID: 21149742] doi:10.1001/archinternmed.2010.468 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: J.S. Blumenthal-Barby, PhD, MA; Amy L. McGuire, JD, PhD; Peter A. Ubel, MDAffiliations: From Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, Texas, and Fuqua School of Business and Sanford School of Public Policy, Duke University, Durham, North Carolina.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M14-2074.Corresponding Author: J.S. Blumenthal-Barby, PhD, MA, Center for Medical Ethics and Health Policy, Baylor College of Medicine, One Baylor Plaza, MS 420, Houston, TX 77030; e-mail, [email protected]edu.Current Author Addresses:Drs. Blumenthal-Barby and McGuire: Center for Medical Ethics and Health Policy, Baylor College of Medicine, One Baylor Plaza, MS 420, Houston, TX 77030.Dr. Ubel: Fuqua School of Business and Sanford School of Public Policy, Duke University, 100 Fuqua Drive, Durham, NC 27708. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoGenetic and Environmental Risk Assessment and Colorectal Cancer Screening in an Average-Risk Population David S. Weinberg , Ronald E. Myers , Eileen Keenan , Karen Ruth , Randa Sifri , Barry Ziring , Eric Ross , and Sharon L. Manne Genetic and Environmental Risk Assessment and Colorectal Cancer Screening in an Average-Risk Population David S. Weinberg , Ronald E. Myers , Eileen Keenan , Karen Ruth , Randa Sifri , Barry Ziring , Eric Ross , and Sharon L. Manne Metrics Cited byPublic awareness of cancer screeningBehavioral Economics: A New Lens for Understanding Genomic Decision MakingCare delivery considerations for widespread and equitable implementation of inherited cancer predisposition testingClinical Sequencing Exploratory Research Consortium: Accelerating Evidence-Based Practice of Genomic MedicineThe effect of genetic test-based risk information on behavioral outcomes: A critical examination of failed trials and a call to action 21 October 2014Volume 161, Issue 8Page: 605-606KeywordsBehaviorGenetic counselingGenetic determinismGenetic testingGeneticsGenomicsMedical ethicsMedical geneticsNursesRisk assessments ePublished: 21 October 2014 Issue Published: 21 October 2014 Copyright & PermissionsCopyright © 2014 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...