The following questions refer to genetics within the ...



Motivating factors for testing in the clinical care of venous thrombosis: a survey of Group Health physicians

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The purpose of this survey is to learn more about physicians’ actions and opinions concerning genetic and other tests in the clinical care of venous thrombosis (deep vein thrombosis and pulmonary embolism). The following tests are discussed: Factor V Leiden (an inherited thrombophilia), and lupus anticoagulant or anticardiolipin (an acquired thrombophilia).

The survey is estimated to take approximately 20 minutes.

By completing and returning this survey, I agree that I have reviewed the accompanying information sheet and that the investigators may use these data for research purposes.

SECTION 1

The following questions refer to past behaviors regarding Factor V Leiden (an inherited thrombophilia) and lupus anticoagulant or ANTICARDIOLIPIN (an acquired thrombophilia) tests in clinical practice.

1.1 Have you ever ordered a test for Factor V Leiden in the setting of venous thrombosis? (Check one.)

(1) YES (2) NO (9) UNSURE

1.2 In clinical practice, what would be your primary reasons for ordering the Factor V Leiden test in the context of venous thrombosis? (Check all that apply and among those checked, rank in order from most to least compelling.)

|Check |Rank (1 = most compelling) |

| |________ |1.2.1 Make a diagnosis of venous thrombosis |

| |______ |1.2.2 Advise patients about risk of recurrence |

| |______ |1.2.3 Make treatment decisions (e.g., use or duration of anticoagulation, use of prophylactic anticoagulation, or use of |

| | |other drugs such as hormones) |

| |______ |1.2.4 Make clinical decisions about venous thrombosis prevention |

| |______ |1.2.5 Explain the occurrence of venous thrombosis |

| |______ |1.2.6 Satisfy a patient request |

| |______ |1.2.7 Teach medical students, residents, etc. |

| |______ |1.2.8 Other (write out): |

| |______ |1.2.9 None of the above |

1.3 Compared to other doctors with similar case loads, would you estimate that you order MORE, FEWER, or ABOUT THE SAME NUMBER of Factor V Leiden tests than they do?

(1) More tests

(2) Fewer tests

(3) About the same number of tests

(9) Don’t know

1.4 Have you ever ordered a test for lupus anticoagulant or ANTICARDIOLIPIN in the context of venous thrombosis? (Check one.)

(1) YES (2) NO (9) UNSURE

1.5 In clinical practice, what would be your primary reasons for ordering a lupus anticoagulant or ANTICARDIOLIPIN test in the context of venous thrombosis? (Check all that apply and among those checked, rank in order from most to least compelling.)

|Check |Rank (1 = most compelling) |

| |______ |1.5.1 Make a diagnosis of venous thrombosis |

| |______ |1.5.2 Advise patients about risk of recurrence |

| |______ |1.5.3 Make treatment decisions (e.g., use or duration of anticoagulation, use of prophylactic anticoagulation, or use of |

| | |other drugs such as hormones) |

| |______ |1.5.4 Make clinical decisions about venous thrombosis prevention |

| |______ |1.5.5 Explain the occurrence of venous thrombosis |

| |______ |1.5.6 Satisfy a patient request |

| |______ |1.5.7 Teach medical students, residents, etc. |

| |______ |1.5.8 Other (write out): |

| |______ |1.5.9 None of the above |

1.6 Compared to other doctors with similar case loads, would you estimate that you order MORE, FEWER, or ABOUT THE SAME NUMBER of lupus anticoagulant or ANTICARDIOLIPIN tests than they do?

(1) More tests

(2) Fewer tests

(3) About the same number of tests

(9) Don’t know

SECTION 2

When deciding whether to order a Factor V Leiden test, how important would the following factors be to you? In the right-hand column, check the boxes that correspond to the three most compelling statements.

|Factor |Very |High |Fair |Low |Very |What are the 3 most compelling |

| |High | | | |Low |factors? |

|2.2 Gender | | | | | | |

| |(1) |(2) |(3) |(4) |(5) | |

|2.4 Family history of venous thrombosis | | | | | | |

| |(1) |(2) |(3) |(4) |(5) | |

|2.6 Site of venous thrombosis | | | | | | |

| |(1) |(2) |(3) |(4) |(5) | |

|2.8 Consultation with a specialist | | | | | | |

| |(1) |(2) |(3) |(4) |(5) | |

|2.10 Professional society guidelines (CAP, ACMG, ACCP) | | | | | | |

| |(1) |(2) |(3) |(4) |(5) | |

|2.12 Patient access to genetic counseling | | | | | | |

| |(1) |(2) |(3) |(4) |(5) | |

|2.14 Other (write in): | | | | | | |

| |(1) |(2) |(3) |(4) |(5) | |

|4.2 It is unclear whether the test result would alter| | | | | | |

|patient management |(1) |(2) |(3) |(4) |(5) | |

|4.4 Current guidelines at GHC do not encourage | | | | | | |

|genetic testing |(1) |(2) |(3) |(4) |(5) | |

|4.6 Patients must first express an interest in the | | | | | | |

|test |(1) |(2) |(3) |(4) |(5) | |

|4.8 It is inconvenient (for either patients or | | | | | | |

|practitioners) to obtain the test |(1) |(2) |(3) |(4) |(5) | |

|4.10 I am concerned about my patients’ privacy/ | | | | | | |

|confidentiality of genetic test results |(1) |(2) |(3) |(4) |(5) | |

SECTION 5

The following questions ask about practices and skills related to Factor V Leiden testing.

| |Very high |High |Fair |Low |Very low |

|5.2 How would you rate your confidence in interpreting the results of Factor V| | | | | |

|Leiden tests? |(1) |(2) |(3) |(4) |(5) |

SECTION 6

The following questions ask about provider and practice characteristics.

6.1 What is your area of practice? (Choose one.)

(1) Internal medicine

(2) Family medicine

(3) Hematology/oncology

(4) OB/GYN

(5) Other (Please describe.) ___________________________________

6.2 What year did you complete medical school? _______

6.3 What year did you complete residency? _______

6.4 Did you receive your medical degree from a medical school in the United States?

(1) Yes

(0) No

6.5 During a typical year, how many patients with venous thrombosis do you see?

_______ patients per year

6.6 What is your age? ___________ years old

6.7 What is your gender? (Check one.)

(1) Female

(2) Male

6.8 How is your time allocated among the following activities (percentages should add up to 100%):

Practice ________ %

Research ________ %

Administration ________ %

Teaching ________ %

Other ________ % (Please specify: __________________________)

6.9 Additional comments:

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