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Table 2 Decisional Conflict

From: Impact of a genetic counseling requirement prior to genetic testing

   GC Requirement Policy BRCA1/2 Testing
Total
N (%)
Before
N (%)
After
N (%)
P-value Tested
N (%)
Not Tested
N (%)
P-value
This decision was hard for me
 Strongly Disagree (0 points) 509 (40.8%) 127 (42.6%) 382 (40.3%) 0.17 439 (47.7%) 70 (31%) < 0.0001
 Disagree (1) 365 (29.3%) 90 (30.2%) 275 (29.0%) 285 (31%) 80 (35.4%)
 Neither Disagree nor Agree (2) 105 (8.4%) 17 (5.7%) 88 (9.3%) 71 (7.7%) 34 (15%)
 Agree (3) 127 (10.2%) 28 (9.4%) 99 (10.4%) 96 (10.4%) 31 (13.7%)
 Strongly Agree (4) 31 (2.5%) 7 (2.4%) 24 (2.5%) 23 (2.5%) 8 (3.5%)
 Do Not Know 9 (0.7%) 5 (1.7%) 4 (0.4%) 6 (0.7%) 3 (1.3%)
 Missing/declined 101 (8.1%) 24 (8.1%) 77 (8.1%) 46 (4.8%) 45 (16.6%)
 Mean Score (SD) 0.93 (1.10) 0.83 (1.05) 0.96 (1.11) 0.11 0.86 (1.08) 1.22 (1.14) < 0.0001
I was unsure what to do in this decision
 Strongly Disagree (0 points) 479 (38.4%) 119 (39.9%) 360 (37.9%) 0.24 424 (46.2%) 55 (24.7%) < 0.0001
 Disagree (1) 402 (32.2%) 98 (32.9%) 304 (32.0%) 323 (35.2%) 79 (35.4%)
 Neither Disagree nor Agree (2) 113 (9.1%) 20 (6.7%) 93 (9.8%) 75 (8.2%) 38 (17%)
 Agree (3) 105 (8.4%) 27 (9.1%) 78 (8.2%) 66 (7.2%) 39 (17.5%)
 Strongly Agree (4) 25 (2.0%) 2 (0.7%) 23 (2.4%) 19 (2.1%) 6 (2.7%)
 Do Not Know 16 (1.3%) 6 (2.0%) 10 (1.1%) 10 (1.1%) 6 (2.7%)
 Missing/declined 107 (8.6%) 26 (8.7%) 81 (8.5%) 49 (5.1%) 48 (17.7%)
 Mean Score (SD) 0.91 (1.03) 0.81 (0.96) 0.93 (1.05) 0.08 0.80 (0.98) 1.36 (1.12) < 0.0001
I was aware of the choices I had in this decision
 Strongly Disagree (4 points) 35 (2.8%) 8 (2.7%) 27 (2.9%) 0.04 24 (2.6%) 11 (4.9%) < 0.0001
 Disagree (3) 38 (3.1%) 11 (3.7%) 27 (2.9%) 21 (2.3%) 17 (7.6%)
 Neither Disagree nor Agree (2) 82 (6.6%) 28 (9.4%) 54 (5.7%) 57 (6.2%) 25 (11.1%)
 Agree (1) 485 (38.9%) 111 (37.3%) 374 (39.4%) 368 (40.3%) 117 (52%)
 Strongly Agree (0) 483 (38.7%) 108 (36.2%) 375 (39.5%) 434 (47.5%) 49 (21.8%)
 Do Not Know 15 (1.2%) 8 (2.7%) 7 (0.7%) 9 (1%) 6 (2.7%)
Missing/declined 109 (8.7%) 24 (8.1%) 85 (9.0%) 53 (5.5%) 46 (17.0%)
Mean Score (SD) 0.78 (0.91) 0.81 (0.91) 0.77 (0.92) 0.50 0.69 (0.88) 1.16 (0.98) < 0.0001
I needed more advice and information about the choices
 Strongly Disagree (0 points) 301 (24.1%) 71 (23.8%) 230 (24.2%) 0.22 264 (28.8%) 37 (16.6%) < 0.0001
 Disagree (1) 378 (30.3%) 88 (29.5%) 290 (30.6%) 318 (34.7%) 60 (26.9%)
 Neither Disagree nor Agree (2) 254 (20.4%) 62 (20.8%) 192 (20.2%) 197 (21.5%) 57 (25.6%)
 Agree (3) 129 (10.3%) 31 (10.4%) 98 (10.3%) 87 (9.5%) 42 (18.8%)
 Strongly Agree (4) 57 (4.6%) 11 (3.7%) 46 (4.9%) 39 (4.3%) 18 (8.1%)
 Do Not Know 20 (1.6%) 10 (3.4%) 10 (1.1%) 11 (1.2%) 9 (4%)
 Missing/declined 108 (8.7%) 25 (8.4%) 83 (8.7%) 50 (5.2%) 48 (17.7%)
 Mean Score (SD) 1.31 (1.12) 1.28 (1.10) 1.32 (1.13) 0.64 1.23 (1.10) 1.66 (1.16) < 0.0001
I feel I made an informed choice
 Strongly Disagree (4 points) 21 (1.7%) 6 (2.0%) 15 (1.6%) 0.47 14 (1.5%) 7 (3.1%) < 0.0001
 Disagree (3) 24 (1.9%) 6 (2.0%) 18 (1.9%) 11 (1.2%) 13 (5.8%)
 Neither Disagree nor Agree (2) 1 (0.1%) 0 (0.0%) 1 (0.1%) 45 (4.9%) 51 (22.7%)
 Agree (1) 386 (31.0%) 93 (31.2%) 293 (30.9%) 290 (31.7%) 96 (42.7%)
 Strongly Agree (0) 596 (47.8%) 135 (45.3%) 461 (48.6%) 550 (60%) 46 (20.4%)
 Do Not Know 18 (1.4%) 8 (2.7%) 10 (1.1%) 6 (0.7%) 12 (5.3%)
 Missing/declined 106 (8.5%) 23 (7.7%) 83 (8.7%) 50 (5.2%) 46 (17.0%)
 Mean Score (SD) 0.64 (0.85) 0.67 (0.88) 0.62 (0.85) 0.42 0.50 (0.78) 1.22 (0.94) < 0.0001
Decisional Conflict Scorea, mean (SD) 22.8 (18.2) 22.1 (18.0) 23.0 (18.3) 0.46 20.5 (17.1) 33.0 (19.5) < 0.0001
Adjusted Decisional Conflict Score, mean (SE)b 22.5 (17.3) 22.0 (1.31) 22.6 (0.79) 0.16 20.3 (0.69) 32.7 (1.36) < 0.0001
  1. aAverage score across all decisional conflict questions multiplied by 25
  2. bAdjusted scores control for GC-mandate period, BRCA1/2 testing completions, and visit with a genetic counselor prior to testing