亟需替代性服务模式以应对对遗传学服务的需求增加以及提供前期测试咨询服务的遗传学专家有限的问题。我们进行了一项前瞻性随机对照试验，研究了未达到国家综合癌症网络(NCCN)遗传测试标准的0-III期乳腺癌患者。患者被随机分配到与聊天机器人或认证遗传顾问(GC)进行前期测试咨询。参与者填写了关于乳腺癌遗传学知识的问卷和评估其对前期测试咨询决策的满意度的调查。共有39名患者入组，其中37名患者随机进行了使用自动聊天机器人或传统遗传咨询；19名进入聊天机器人组，18名进行传统遗传咨询，有13名(38.2%)的患者有家族成员患有乳腺癌，但不符合NCCN标准。所有患者选择进行遗传测试。测试结果显示五名患者中有六个致病变异(13.5%)：CHEK2 (n = 2)、MSH3 (n = 1)、MUTYH (n = 1)、BRCA1 和 HOXB13 (n = 1)。由于遗传测试回转时间，没有患者的治疗时间出现延迟，也没有患者进行了额外的风险降低手术。聊天机器人和传统咨询之间的知识分数中位数差异没有显著性 (11 vs. 12, p = 0.09)，患者满意度评分中位数也没有显著性差异(30 vs. 30, p = 0.19)。乳腺癌患者接受自动聊天机器人进行前期测试遗传咨询的满意度和理解力与面对面遗传测试相当。使用这项技术可以提供改善的医疗资源获取和急需的前期测试咨询替代方案。© 2023. 外科肿瘤学会(Society of Surgical Oncology)。

Alternative service delivery models are critically needed to address the increasing demand for genetics services and limited supply of genetics experts available to provide pre-test counseling.We conducted a prospective randomized controlled trial of women with stage 0-III breast cancer not meeting National Comprehensive Cancer Network (NCCN) criteria for genetic testing. Patients were randomized to pre-test counseling with a Chatbot or a certified genetic counselor (GC). Participants completed a questionnaire assessing their knowledge of breast cancer genetics and a survey assessing satisfaction with their decision regarding pre-test counseling.A total of 39 patients were enrolled and 37 were randomized to genetic counseling with an automated Chatbot or a GC; 19 were randomized to Chatbot and 18 to traditional genetic counseling, and 13 (38.2%) had a family member with breast cancer but did not meet NCCN criteria. All patients opted to undergo genetic testing. Testing revealed six pathogenic variants in five patients (13.5%): CHEK2 (n = 2), MSH3 (n = 1), MUTYH (n = 1), and BRCA1 and HOXB13 (n = 1). No patients had a delay in time-to-treatment due to genetic testing turnaround time, nor did any patients undergo additional risk reducing surgery. There was no significant difference in median knowledge score between Chatbot and traditional counseling (11 vs. 12, p = 0.09) or in median patient satisfaction score (30 vs. 30, p = 0.19).Satisfaction and comprehension in patients with breast cancer undergoing pre-test genetic counseling using an automated Chatbot is comparable to in-person genetic testing. Utilization of this technology can offer improved access to care and a much-needed alternative for pre-test counseling.© 2023. Society of Surgical Oncology.