Evaluating clinician acceptability of the prototype CanRisk tool for predicting risk of breast and ovarian cancer: A multi-methods study.
Identifieur interne : 000216 ( Main/Exploration ); précédent : 000215; suivant : 000217Evaluating clinician acceptability of the prototype CanRisk tool for predicting risk of breast and ovarian cancer: A multi-methods study.
Auteurs : Stephanie Archer [Royaume-Uni] ; Chantal Babb De Villiers [Royaume-Uni] ; Fiona Scheibl [Royaume-Uni] ; Tim Carver [Royaume-Uni] ; Simon Hartley [Royaume-Uni] ; Andrew Lee [Royaume-Uni] ; Alex P. Cunningham [Royaume-Uni] ; Douglas F. Easton [Royaume-Uni] ; Jennifer G. Mcintosh [Australie] ; Jon Emery [Royaume-Uni, Australie] ; Marc Tischkowitz [Royaume-Uni] ; Antonis C. Antoniou [Royaume-Uni] ; Fiona M. Walter [Royaume-Uni, Australie]Source :
- PloS one [ 1932-6203 ] ; 2020.
Descripteurs français
- KwdFr :
- MESH :
- diagnostic : Tumeurs de l'ovaire, Tumeurs du sein.
- psychologie : Personnel de santé.
- Adulte, Adulte d'âge moyen, Auto-efficacité, Femelle, Humains, Interface utilisateur, Mâle, Risque, Soins de santé primaires.
English descriptors
- KwdEn :
- MESH :
- diagnosis : Breast Neoplasms, Ovarian Neoplasms.
- psychology : Health Personnel.
- Adult, Female, Humans, Male, Middle Aged, Primary Health Care, Risk, Self Efficacy, User-Computer Interface.
Abstract
BACKGROUND
There is a growing focus on the development of multi-factorial cancer risk prediction algorithms alongside tools that operationalise them for clinical use. BOADICEA is a breast and ovarian cancer risk prediction model incorporating genetic and other risk factors. A new user-friendly Web-based tool (CanRisk.org) has been developed to apply BOADICEA. This study aimed to explore the acceptability of the prototype CanRisk tool among two healthcare professional groups to inform further development, evaluation and implementation.
METHOD
A multi-methods approach was used. Clinicians from primary care and specialist genetics clinics in England, France and Germany were invited to use the CanRisk prototype with two test cases (either face-to-face with a simulated patient or via a written vignette). Their views about the tool were examined via a semi-structured interview or equivalent open-ended questionnaire. Qualitative data were subjected to thematic analysis and organised around Sekhon's Theoretical Framework of Acceptability.
RESULTS
Seventy-five clinicians participated, 21 from primary care and 54 from specialist genetics clinics. Participants were from England (n = 37), France (n = 23) and Germany (n = 15). The prototype CanRisk tool was generally acceptable to most participants due to its intuitive design. Primary care clinicians were concerned about the amount of time needed to complete, interpret and communicate risk information. Clinicians from both settings were apprehensive about the impact of the CanRisk tool on their consultations and lack of opportunities to interpret risk scores before sharing them with their patients.
CONCLUSIONS
The findings highlight the challenges associated with developing a complex tool for use in different clinical settings; they also helped refine the tool. This prototype may not have been versatile enough for clinical use in both primary care and specialist genetics clinics where the needs of clinicians are different, emphasising the importance of understanding the clinical context when developing cancer risk assessment tools.
DOI: 10.1371/journal.pone.0229999
PubMed: 32142536
PubMed Central: PMC7059924
Affiliations:
- Australie, Royaume-Uni
- Angleterre, Angleterre de l'Est, Midlands de l'Ouest, Victoria (État)
- Birmingham, Cambridge, Melbourne
- Université de Birmingham, Université de Cambridge, Université de Melbourne
Links toward previous steps (curation, corpus...)
Le document en format XML
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Cunningham</name><affiliation wicri:level="4"><nlm:affiliation>Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, United Kingdom.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge</wicri:regionArea><placeName><settlement type="city">Cambridge</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Angleterre de l'Est</region></placeName><orgName type="university">Université de Cambridge</orgName></affiliation></author><author><name sortKey="Easton, Douglas F" sort="Easton, Douglas F" uniqKey="Easton D" first="Douglas F" last="Easton">Douglas F. Easton</name><affiliation wicri:level="4"><nlm:affiliation>Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, United Kingdom.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge</wicri:regionArea><placeName><settlement type="city">Cambridge</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Angleterre de l'Est</region></placeName><orgName type="university">Université de Cambridge</orgName></affiliation></author><author><name sortKey="Mcintosh, Jennifer G" sort="Mcintosh, Jennifer G" uniqKey="Mcintosh J" first="Jennifer G" last="Mcintosh">Jennifer G. Mcintosh</name><affiliation wicri:level="4"><nlm:affiliation>Centre for Cancer Research and Department of General Practice, University of Melbourne, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Centre for Cancer Research and Department of General Practice, University of Melbourne</wicri:regionArea><placeName><settlement type="city">Melbourne</settlement><region type="état">Victoria (État)</region></placeName><orgName type="university">Université de Melbourne</orgName></affiliation></author><author><name sortKey="Emery, Jon" sort="Emery, Jon" uniqKey="Emery J" first="Jon" last="Emery">Jon Emery</name><affiliation wicri:level="4"><nlm:affiliation>Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, United Kingdom.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge</wicri:regionArea><placeName><settlement type="city">Cambridge</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Angleterre de l'Est</region></placeName><orgName type="university">Université de Cambridge</orgName></affiliation><affiliation wicri:level="4"><nlm:affiliation>Centre for Cancer Research and Department of General Practice, University of Melbourne, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Centre for Cancer Research and Department of General Practice, University of Melbourne</wicri:regionArea><placeName><settlement type="city">Melbourne</settlement><region type="état">Victoria (État)</region></placeName><orgName type="university">Université de Melbourne</orgName></affiliation></author><author><name sortKey="Tischkowitz, Marc" sort="Tischkowitz, Marc" uniqKey="Tischkowitz M" first="Marc" last="Tischkowitz">Marc Tischkowitz</name><affiliation wicri:level="4"><nlm:affiliation>Academic Department of Medical Genetics, University of Cambridge, United Kingdom.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Academic Department of Medical Genetics, University of Cambridge</wicri:regionArea><placeName><settlement type="city">Cambridge</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Angleterre de l'Est</region></placeName><orgName type="university">Université de Cambridge</orgName></affiliation></author><author><name sortKey="Antoniou, Antonis C" sort="Antoniou, Antonis C" uniqKey="Antoniou A" first="Antonis C" last="Antoniou">Antonis C. Antoniou</name><affiliation wicri:level="4"><nlm:affiliation>Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, United Kingdom.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge</wicri:regionArea><placeName><settlement type="city">Cambridge</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Angleterre de l'Est</region></placeName><orgName type="university">Université de Cambridge</orgName></affiliation></author><author><name sortKey="Walter, Fiona M" sort="Walter, Fiona M" uniqKey="Walter F" first="Fiona M" last="Walter">Fiona M. Walter</name><affiliation wicri:level="4"><nlm:affiliation>Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, United Kingdom.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge</wicri:regionArea><placeName><settlement type="city">Cambridge</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Angleterre de l'Est</region></placeName><orgName type="university">Université de Cambridge</orgName></affiliation><affiliation wicri:level="4"><nlm:affiliation>Centre for Cancer Research and Department of General Practice, University of Melbourne, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Centre for Cancer Research and Department of General Practice, University of Melbourne</wicri:regionArea><placeName><settlement type="city">Melbourne</settlement><region type="état">Victoria (État)</region></placeName><orgName type="university">Université de Melbourne</orgName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2020">2020</date><idno type="RBID">pubmed:32142536</idno><idno type="pmid">32142536</idno><idno type="doi">10.1371/journal.pone.0229999</idno><idno type="pmc">PMC7059924</idno><idno type="wicri:Area/Main/Corpus">000214</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000214</idno><idno type="wicri:Area/Main/Curation">000214</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Curation">000214</idno><idno type="wicri:Area/Main/Exploration">000214</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Evaluating clinician acceptability of the prototype CanRisk tool for predicting risk of breast and ovarian cancer: A multi-methods study.</title><author><name sortKey="Archer, Stephanie" sort="Archer, Stephanie" uniqKey="Archer S" first="Stephanie" last="Archer">Stephanie Archer</name><affiliation wicri:level="4"><nlm:affiliation>Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, United Kingdom.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge</wicri:regionArea><placeName><settlement type="city">Cambridge</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Angleterre de l'Est</region></placeName><orgName type="university">Université de Cambridge</orgName></affiliation></author><author><name sortKey="Babb De Villiers, Chantal" sort="Babb De Villiers, Chantal" uniqKey="Babb De Villiers C" first="Chantal" last="Babb De Villiers">Chantal Babb De Villiers</name><affiliation wicri:level="4"><nlm:affiliation>Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, United Kingdom.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge</wicri:regionArea><placeName><settlement type="city">Cambridge</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Angleterre de l'Est</region></placeName><orgName type="university">Université de Cambridge</orgName></affiliation></author><author><name sortKey="Scheibl, Fiona" sort="Scheibl, Fiona" uniqKey="Scheibl F" first="Fiona" last="Scheibl">Fiona Scheibl</name><affiliation wicri:level="4"><nlm:affiliation>Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, United Kingdom.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge</wicri:regionArea><placeName><settlement type="city">Cambridge</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Angleterre de l'Est</region></placeName><orgName type="university">Université de Cambridge</orgName></affiliation></author><author><name sortKey="Carver, Tim" sort="Carver, Tim" uniqKey="Carver T" first="Tim" last="Carver">Tim Carver</name><affiliation wicri:level="4"><nlm:affiliation>Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, United Kingdom.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge</wicri:regionArea><placeName><settlement type="city">Cambridge</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Angleterre de l'Est</region></placeName><orgName type="university">Université de Cambridge</orgName></affiliation></author><author><name sortKey="Hartley, Simon" sort="Hartley, Simon" uniqKey="Hartley S" first="Simon" last="Hartley">Simon Hartley</name><affiliation wicri:level="4"><nlm:affiliation>Centre for Computational Biology, University of Birmingham, United Kingdom.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Centre for Computational Biology, University of Birmingham</wicri:regionArea><placeName><settlement type="city">Birmingham</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Midlands de l'Ouest</region></placeName><orgName type="university">Université de Birmingham</orgName></affiliation></author><author><name sortKey="Lee, Andrew" sort="Lee, Andrew" uniqKey="Lee A" first="Andrew" last="Lee">Andrew Lee</name><affiliation wicri:level="4"><nlm:affiliation>Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, United Kingdom.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge</wicri:regionArea><placeName><settlement type="city">Cambridge</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Angleterre de l'Est</region></placeName><orgName type="university">Université de Cambridge</orgName></affiliation></author><author><name sortKey="Cunningham, Alex P" sort="Cunningham, Alex P" uniqKey="Cunningham A" first="Alex P" last="Cunningham">Alex P. Cunningham</name><affiliation wicri:level="4"><nlm:affiliation>Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, United Kingdom.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge</wicri:regionArea><placeName><settlement type="city">Cambridge</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Angleterre de l'Est</region></placeName><orgName type="university">Université de Cambridge</orgName></affiliation></author><author><name sortKey="Easton, Douglas F" sort="Easton, Douglas F" uniqKey="Easton D" first="Douglas F" last="Easton">Douglas F. Easton</name><affiliation wicri:level="4"><nlm:affiliation>Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, United Kingdom.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge</wicri:regionArea><placeName><settlement type="city">Cambridge</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Angleterre de l'Est</region></placeName><orgName type="university">Université de Cambridge</orgName></affiliation></author><author><name sortKey="Mcintosh, Jennifer G" sort="Mcintosh, Jennifer G" uniqKey="Mcintosh J" first="Jennifer G" last="Mcintosh">Jennifer G. Mcintosh</name><affiliation wicri:level="4"><nlm:affiliation>Centre for Cancer Research and Department of General Practice, University of Melbourne, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Centre for Cancer Research and Department of General Practice, University of Melbourne</wicri:regionArea><placeName><settlement type="city">Melbourne</settlement><region type="état">Victoria (État)</region></placeName><orgName type="university">Université de Melbourne</orgName></affiliation></author><author><name sortKey="Emery, Jon" sort="Emery, Jon" uniqKey="Emery J" first="Jon" last="Emery">Jon Emery</name><affiliation wicri:level="4"><nlm:affiliation>Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, United Kingdom.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge</wicri:regionArea><placeName><settlement type="city">Cambridge</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Angleterre de l'Est</region></placeName><orgName type="university">Université de Cambridge</orgName></affiliation><affiliation wicri:level="4"><nlm:affiliation>Centre for Cancer Research and Department of General Practice, University of Melbourne, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Centre for Cancer Research and Department of General Practice, University of Melbourne</wicri:regionArea><placeName><settlement type="city">Melbourne</settlement><region type="état">Victoria (État)</region></placeName><orgName type="university">Université de Melbourne</orgName></affiliation></author><author><name sortKey="Tischkowitz, Marc" sort="Tischkowitz, Marc" uniqKey="Tischkowitz M" first="Marc" last="Tischkowitz">Marc Tischkowitz</name><affiliation wicri:level="4"><nlm:affiliation>Academic Department of Medical Genetics, University of Cambridge, United Kingdom.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Academic Department of Medical Genetics, University of Cambridge</wicri:regionArea><placeName><settlement type="city">Cambridge</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Angleterre de l'Est</region></placeName><orgName type="university">Université de Cambridge</orgName></affiliation></author><author><name sortKey="Antoniou, Antonis C" sort="Antoniou, Antonis C" uniqKey="Antoniou A" first="Antonis C" last="Antoniou">Antonis C. Antoniou</name><affiliation wicri:level="4"><nlm:affiliation>Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, United Kingdom.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge</wicri:regionArea><placeName><settlement type="city">Cambridge</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Angleterre de l'Est</region></placeName><orgName type="university">Université de Cambridge</orgName></affiliation></author><author><name sortKey="Walter, Fiona M" sort="Walter, Fiona M" uniqKey="Walter F" first="Fiona M" last="Walter">Fiona M. Walter</name><affiliation wicri:level="4"><nlm:affiliation>Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, United Kingdom.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge</wicri:regionArea><placeName><settlement type="city">Cambridge</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Angleterre de l'Est</region></placeName><orgName type="university">Université de Cambridge</orgName></affiliation><affiliation wicri:level="4"><nlm:affiliation>Centre for Cancer Research and Department of General Practice, University of Melbourne, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Centre for Cancer Research and Department of General Practice, University of Melbourne</wicri:regionArea><placeName><settlement type="city">Melbourne</settlement><region type="état">Victoria (État)</region></placeName><orgName type="university">Université de Melbourne</orgName></affiliation></author></analytic><series><title level="j">PloS one</title><idno type="eISSN">1932-6203</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult (MeSH)</term><term>Breast Neoplasms (diagnosis)</term><term>Female (MeSH)</term><term>Health Personnel (psychology)</term><term>Humans (MeSH)</term><term>Male (MeSH)</term><term>Middle Aged (MeSH)</term><term>Ovarian Neoplasms (diagnosis)</term><term>Primary Health Care (MeSH)</term><term>Risk (MeSH)</term><term>Self Efficacy (MeSH)</term><term>User-Computer Interface (MeSH)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte (MeSH)</term><term>Adulte d'âge moyen (MeSH)</term><term>Auto-efficacité (MeSH)</term><term>Femelle (MeSH)</term><term>Humains (MeSH)</term><term>Interface utilisateur (MeSH)</term><term>Mâle (MeSH)</term><term>Personnel de santé (psychologie)</term><term>Risque (MeSH)</term><term>Soins de santé primaires (MeSH)</term><term>Tumeurs de l'ovaire (diagnostic)</term><term>Tumeurs du sein (diagnostic)</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Breast Neoplasms</term><term>Ovarian Neoplasms</term></keywords><keywords scheme="MESH" qualifier="diagnostic" xml:lang="fr"><term>Tumeurs de l'ovaire</term><term>Tumeurs du sein</term></keywords><keywords scheme="MESH" qualifier="psychologie" xml:lang="fr"><term>Personnel de santé</term></keywords><keywords scheme="MESH" qualifier="psychology" xml:lang="en"><term>Health Personnel</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Primary Health Care</term><term>Risk</term><term>Self Efficacy</term><term>User-Computer Interface</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Auto-efficacité</term><term>Femelle</term><term>Humains</term><term>Interface utilisateur</term><term>Mâle</term><term>Risque</term><term>Soins de santé primaires</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>There is a growing focus on the development of multi-factorial cancer risk prediction algorithms alongside tools that operationalise them for clinical use. BOADICEA is a breast and ovarian cancer risk prediction model incorporating genetic and other risk factors. A new user-friendly Web-based tool (CanRisk.org) has been developed to apply BOADICEA. This study aimed to explore the acceptability of the prototype CanRisk tool among two healthcare professional groups to inform further development, evaluation and implementation.</p></div><div type="abstract" xml:lang="en"><p><b>METHOD</b></p><p>A multi-methods approach was used. Clinicians from primary care and specialist genetics clinics in England, France and Germany were invited to use the CanRisk prototype with two test cases (either face-to-face with a simulated patient or via a written vignette). Their views about the tool were examined via a semi-structured interview or equivalent open-ended questionnaire. Qualitative data were subjected to thematic analysis and organised around Sekhon's Theoretical Framework of Acceptability.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>Seventy-five clinicians participated, 21 from primary care and 54 from specialist genetics clinics. Participants were from England (n = 37), France (n = 23) and Germany (n = 15). The prototype CanRisk tool was generally acceptable to most participants due to its intuitive design. Primary care clinicians were concerned about the amount of time needed to complete, interpret and communicate risk information. Clinicians from both settings were apprehensive about the impact of the CanRisk tool on their consultations and lack of opportunities to interpret risk scores before sharing them with their patients.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>The findings highlight the challenges associated with developing a complex tool for use in different clinical settings; they also helped refine the tool. This prototype may not have been versatile enough for clinical use in both primary care and specialist genetics clinics where the needs of clinicians are different, emphasising the importance of understanding the clinical context when developing cancer risk assessment tools.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">32142536</PMID><DateCompleted><Year>2020</Year><Month>06</Month><Day>22</Day></DateCompleted><DateRevised><Year>2020</Year><Month>06</Month><Day>22</Day></DateRevised><Article PubModel="Electronic-eCollection"><Journal><ISSN IssnType="Electronic">1932-6203</ISSN><JournalIssue CitedMedium="Internet"><Volume>15</Volume><Issue>3</Issue><PubDate><Year>2020</Year></PubDate></JournalIssue><Title>PloS one</Title><ISOAbbreviation>PLoS One</ISOAbbreviation></Journal><ArticleTitle>Evaluating clinician acceptability of the prototype CanRisk tool for predicting risk of breast and ovarian cancer: A multi-methods study.</ArticleTitle><Pagination><MedlinePgn>e0229999</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1371/journal.pone.0229999</ELocationID><Abstract><AbstractText Label="BACKGROUND">There is a growing focus on the development of multi-factorial cancer risk prediction algorithms alongside tools that operationalise them for clinical use. BOADICEA is a breast and ovarian cancer risk prediction model incorporating genetic and other risk factors. A new user-friendly Web-based tool (CanRisk.org) has been developed to apply BOADICEA. This study aimed to explore the acceptability of the prototype CanRisk tool among two healthcare professional groups to inform further development, evaluation and implementation.</AbstractText><AbstractText Label="METHOD">A multi-methods approach was used. Clinicians from primary care and specialist genetics clinics in England, France and Germany were invited to use the CanRisk prototype with two test cases (either face-to-face with a simulated patient or via a written vignette). Their views about the tool were examined via a semi-structured interview or equivalent open-ended questionnaire. Qualitative data were subjected to thematic analysis and organised around Sekhon's Theoretical Framework of Acceptability.</AbstractText><AbstractText Label="RESULTS">Seventy-five clinicians participated, 21 from primary care and 54 from specialist genetics clinics. Participants were from England (n = 37), France (n = 23) and Germany (n = 15). The prototype CanRisk tool was generally acceptable to most participants due to its intuitive design. Primary care clinicians were concerned about the amount of time needed to complete, interpret and communicate risk information. Clinicians from both settings were apprehensive about the impact of the CanRisk tool on their consultations and lack of opportunities to interpret risk scores before sharing them with their patients.</AbstractText><AbstractText Label="CONCLUSIONS">The findings highlight the challenges associated with developing a complex tool for use in different clinical settings; they also helped refine the tool. This prototype may not have been versatile enough for clinical use in both primary care and specialist genetics clinics where the needs of clinicians are different, emphasising the importance of understanding the clinical context when developing cancer risk assessment tools.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Archer</LastName><ForeName>Stephanie</ForeName><Initials>S</Initials><Identifier Source="ORCID">0000-0003-1349-7178</Identifier><AffiliationInfo><Affiliation>Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, United Kingdom.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Babb de Villiers</LastName><ForeName>Chantal</ForeName><Initials>C</Initials><Identifier Source="ORCID">0000-0003-1334-1819</Identifier><AffiliationInfo><Affiliation>Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, United Kingdom.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Scheibl</LastName><ForeName>Fiona</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, United Kingdom.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Carver</LastName><ForeName>Tim</ForeName><Initials>T</Initials><AffiliationInfo><Affiliation>Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, United Kingdom.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Hartley</LastName><ForeName>Simon</ForeName><Initials>S</Initials><Identifier Source="ORCID">0000-0001-7991-0581</Identifier><AffiliationInfo><Affiliation>Centre for Computational Biology, University of Birmingham, United Kingdom.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lee</LastName><ForeName>Andrew</ForeName><Initials>A</Initials><Identifier Source="ORCID">0000-0003-0677-0252</Identifier><AffiliationInfo><Affiliation>Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, United Kingdom.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Cunningham</LastName><ForeName>Alex P</ForeName><Initials>AP</Initials><AffiliationInfo><Affiliation>Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, United Kingdom.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Easton</LastName><ForeName>Douglas F</ForeName><Initials>DF</Initials><AffiliationInfo><Affiliation>Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, United Kingdom.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>McIntosh</LastName><ForeName>Jennifer G</ForeName><Initials>JG</Initials><AffiliationInfo><Affiliation>Centre for Cancer Research and Department of General Practice, University of Melbourne, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Emery</LastName><ForeName>Jon</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, United Kingdom.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Centre for Cancer Research and Department of General Practice, University of Melbourne, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Tischkowitz</LastName><ForeName>Marc</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Academic Department of Medical Genetics, University of Cambridge, United Kingdom.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Antoniou</LastName><ForeName>Antonis C</ForeName><Initials>AC</Initials><AffiliationInfo><Affiliation>Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, United Kingdom.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Walter</LastName><ForeName>Fiona M</ForeName><Initials>FM</Initials><AffiliationInfo><Affiliation>Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, United Kingdom.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Centre for Cancer Research and Department of General Practice, University of Melbourne, Australia.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><GrantList CompleteYN="Y"><Grant><GrantID>C12292/A20861</GrantID><Agency>Cancer Research UK</Agency><Country>United Kingdom</Country></Grant><Grant><GrantID>203477/B/16/Z</GrantID><Agency>Wellcome Trust</Agency><Country>United Kingdom</Country></Grant><Grant><GrantID>GPH-129344</GrantID><Agency>CIHR</Agency><Country>Canada</Country></Grant><Grant><Agency>Department of Health</Agency><Country>United Kingdom</Country></Grant><Grant><GrantID>C8640/A23385</GrantID><Agency>Cancer Research UK</Agency><Country>United Kingdom</Country></Grant></GrantList><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>03</Month><Day>06</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>PLoS One</MedlineTA><NlmUniqueID>101285081</NlmUniqueID><ISSNLinking>1932-6203</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D001943" MajorTopicYN="N">Breast Neoplasms</DescriptorName><QualifierName UI="Q000175" MajorTopicYN="Y">diagnosis</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006282" MajorTopicYN="N">Health Personnel</DescriptorName><QualifierName UI="Q000523" MajorTopicYN="Y">psychology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D010051" MajorTopicYN="N">Ovarian Neoplasms</DescriptorName><QualifierName UI="Q000175" MajorTopicYN="Y">diagnosis</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011320" MajorTopicYN="N">Primary Health Care</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012306" MajorTopicYN="N">Risk</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D020377" MajorTopicYN="N">Self Efficacy</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D014584" MajorTopicYN="Y">User-Computer Interface</DescriptorName></MeshHeading></MeshHeadingList><CoiStatement>The BOADICEA model has been licensed to Cambridge Enterprise for commercialization, with the authors D.F.E., A.C.A., A.P.C., A.L. and T.C. listed as its inventors. These authors may receive royalties in the future if commercialization is realized. This does not alter our adherence to PLOS ONE policies on sharing data and materials. The other authors declare no conflicts of interest.</CoiStatement></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2019</Year><Month>12</Month><Day>06</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2020</Year><Month>02</Month><Day>19</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>3</Month><Day>7</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>3</Month><Day>7</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>6</Month><Day>23</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>epublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">32142536</ArticleId><ArticleId IdType="doi">10.1371/journal.pone.0229999</ArticleId><ArticleId IdType="pii">PONE-D-19-33335</ArticleId><ArticleId 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