Complexity in Interpreting Test Results

The increase in availability of precision medicine tests across the pathway of care raises challenges for health care professionals when ordering tests and interpreting their results. Many health care professionals (e.g., primary care practitioners, pharmacists, oncologists) report having limited awareness and knowledge of how to order and interpret precision medicine test results. The clinical significance of precision medicine test results is not always clear and results are not always actionable (i.e., directly provide guidance about a certain therapy). The potential for incidental and secondary findings (that is, additional information that may not be directly related to the reasons testing was undertaking), and their implications for patients and family members, adds to the complexity of testing.

Test ordering can be complicated in health systems where precision medicine is not embedded into the clinical workflow. Moreover, depending on the pathway of care, the provider ordering the test may not be the same person who interprets the test results and who communicates the results and follow-up information to the person undergoing testing, which adds complexity to the process of interpreting and delivering results.

In addition to improving the capacity of health care professionals through broad training initiatives, further opportunities exist to address complexity in interpreting precision medicine test results. For instance:

• Building patient-centred models of care: Patient-centred care can address test result complexity by ensuring that patients’ experiences guide the design of care pathways.
• Developing processes related to incidental and secondary result: Ensuring patients are able to provide their informed consent to receive (or not) incidental or secondary results and guidance and recommendations to support their return if, for instance, they are medically actionable.

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