The Patient in Precision Medicine: A Systematic Review Examining Evaluations of Patient-Facing Materials.

Precision medicine (PM) has the potential to tailor healthcare to the individual patient by using their genetic information to guide treatment choices. However, this process is complex and difficult to understand for patients and providers alike. With a recent push in the healthcare community to understand the patient experience and engage patients in their care, it is important to give patients the opportunity to learn about PM. We performed a systematic review to identify previous work assessing the quality of patient-facing PM materials from 2008 to July 2018. Ten studies were identified, which used varying methods and measures. A qualitative assessment was conducted to compare key elements of the studies, including study design, characteristics of the participant population, what measurements were used to assess the PM materials, understandability, preference, psychological reactions, and the type of PM materials being assessed. The studies identified provide important groundwork by highlighting consistent aspects of design that aid in comprehension. Eight of the ten studies focused on the content and organization of genomic test results, while the remaining two assessed educational tools. Two main design elements that appeared across the studies were appropriately designed visual aids and simplified language. The studies identified were limited by the participant populations that were used, which were primarily white and well educated. Only one study attempted to oversample patient populations typically underrepresented in this type of research. Through our systematic review, it is evident that the breadth of knowledge in this field is limited in scope and that more work must be done to ensure that patients can engage in their care when faced with PM.

The Impact of Interruptions on Chest Radiograph Interpretation: Effects on Reading Time and Accuracy.

RATIONALE AND OBJECTIVES: The objective of this study was to experimentally test the effect of interruptions on image interpretation by comparing reading time and response accuracy of interrupted case reads to uninterrupted case reads in resident and attending radiologists. MATERIALS AND METHODS: Institutional review board approval was obtained before participant recruitment from an urban academic health-care system during January 2016-March 2016. Eleven resident and 12 attending radiologists examined 30 chest radiographs, rating their confidence regarding the presence or the absence of a pneumothorax. Ten cases were normal (ie, no pneumothorax present), 10 cases had an unsubtle pneumothorax (ie, readily perceivable by a nonexpert), and 10 cases had a subtle pneumothorax. During three reads of each case type, the participants were interrupted with 30 seconds of a secondary task. The total reading time and the accuracy of interrupted and uninterrupted cases were compared. A mixed-factors analysis of variance was run on reading time and accuracy with experience (resident vs attending) as a between-subjects factor and case type (normal, unsubtle, or subtle) and interruption (interruption vs no interruption) as within-subjects factors. RESULTS: Interrupted tasks had significantly longer reading times than uninterrupted cases (P = .032). During subtle cases, interruptions reduced accuracy (P = .034), but during normal cases, interruptions increased accuracy (P = .038). CONCLUSIONS: Interruptions increased reading times and increased the tendency for a radiologist to conclude that a case is normal for both resident and attending radiologists, demonstrating that interruptions reduce efficiency and introduce patient safety concerns during reads of abnormal cases.

Does greater phonological storage capacity correlate with levels of intentionality and theory of mind?

Greater phonological storage capacity may be associated with levels of intentionality, and therefore by assumption, Theory of Mind. The participants were 34 high school students in the Midwest (15 girls, 19 boys; age range= 15 to 17 years). The measures were digits forward and digits backward from the Digit Span subtest of the Wechsler Adult Intelligence Scale-III and a measure purporting to assess Theory of Mind and Levels of Intentionality (Kinderman, Dunbar, & Bentall, 1998). There was found to be a weak nonsignificant correlation between digits forward and Levels of Intentionality, and a moderate and significant correlation between digits backward and Levels of Intentionality. The latter correlation was significantly larger. The digits backward test requires not only greater phonological storage capacity but also appears to tap working memory resources. Findings suggest that greater phonological storage capacity is associated with higher intentionality, and by implication, perhaps more elaborate Theory of Mind, but only when the phonological task requires working memory functions.