Feasibility of an Assessment Tool for Children's Competence to Consent to Predictive Genetic Testing: a Pilot Study

Verfasser / Beitragende:
[Irma Hein, Pieter Troost, Robert Lindeboom, Imke Christiaans, Thomas Grisso, Johannes van Goudoever, Ramón Lindauer]
Ort, Verlag, Jahr:
2015
Enthalten in:
Journal of Genetic Counseling, 24/6(2015-12-01), 971-977
Format:
Artikel (online)
ID: 605544271
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024 7 0 |a 10.1007/s10897-015-9835-7  |2 doi 
035 |a (NATIONALLICENCE)springer-10.1007/s10897-015-9835-7 
245 0 0 |a Feasibility of an Assessment Tool for Children's Competence to Consent to Predictive Genetic Testing: a Pilot Study  |h [Elektronische Daten]  |c [Irma Hein, Pieter Troost, Robert Lindeboom, Imke Christiaans, Thomas Grisso, Johannes van Goudoever, Ramón Lindauer] 
520 3 |a Knowledge on children's capacities to consent to medical treatment is limited. Also, age limits for asking children's consent vary considerably between countries. Decision-making on predictive genetic testing (PGT) is especially complicated, considering the ongoing ethical debate. In order to examine just age limits for alleged competence to consent in children, we evaluated feasibility of a standardized assessment tool, and investigated cutoff ages for children's competence to consent to PGT. We performed a pilot study, including 17 pediatric outpatients between 6 and 18years at risk for an autosomal dominantly inherited cardiac disease, eligible for predictive genetic testing. The reference standard for competence was established by experts trained in the relevant criteria for competent decision-making. The MacArthur Competence Assessment Tool for Treatment (MacCAT-T) served as index test. Data analysis included raw agreement between competence classifications, difference in mean ages between children judged competent and judged incompetent, and estimation of cutoff ages for judgments of competence. Twelve (71%) children were considered competent by the reference standard, and 16 (94%) by the MacCAT-T, with an overall agreement of 76%. The expert judgments disagreed in most cases, while the MacCAT-T judgments agreed in 65%. Mean age of children judged incompetent was 9.3years and of children judged competent 12.1years (p = .035). With 90% sensitivity, children younger than 10.0years were judged incompetent, with 90% specificity children older than 11.8years were judged competent. Feasibility of the MacCAT-T in children is confirmed. Initial findings on age cutoffs are indicative for children between the age of 12 and 18 to be judged competent for involvement in the informed consent process. Future research on appropriate age-limits for children's alleged competence to consent is needed. 
540 |a The Author(s), 2015 
690 7 |a Sensitivity and specificity  |2 nationallicence 
690 7 |a Decision-making  |2 nationallicence 
690 7 |a Minors  |2 nationallicence 
690 7 |a Genetic testing  |2 nationallicence 
690 7 |a Informed consent  |2 nationallicence 
690 7 |a Mental competence  |2 nationallicence 
700 1 |a Hein  |D Irma  |u Department of Child and Adolescent Psychiatry, Academic Medical Center, Meibergdreef 5, 1105 AZ, Amsterdam, The Netherlands  |4 aut 
700 1 |a Troost  |D Pieter  |u Department of Child and Adolescent Psychiatry, Academic Medical Center, Meibergdreef 5, 1105 AZ, Amsterdam, The Netherlands  |4 aut 
700 1 |a Lindeboom  |D Robert  |u Department of Clinical Methods and Public Health, Academic Medical Center, Amsterdam, The Netherlands  |4 aut 
700 1 |a Christiaans  |D Imke  |u Department of Clinical Genetics, Academic Medical Center, Amsterdam, The Netherlands  |4 aut 
700 1 |a Grisso  |D Thomas  |u Department of Psychology, Law and Psychiatry, University of Massachusetts Medical School, Worcester, MA, USA  |4 aut 
700 1 |a van Goudoever  |D Johannes  |u Department of Pediatrics, Emma Children's Hospital, Academic Medical Center, and Department of Pediatrics, VU University Medical Center, Amsterdam, The Netherlands  |4 aut 
700 1 |a Lindauer  |D Ramón  |u Department of Child and Adolescent Psychiatry, Academic Medical Center, Meibergdreef 5, 1105 AZ, Amsterdam, The Netherlands  |4 aut 
773 0 |t Journal of Genetic Counseling  |d Springer US; http://www.springer-ny.com  |g 24/6(2015-12-01), 971-977  |x 1059-7700  |q 24:6<971  |1 2015  |2 24  |o 10897 
856 4 0 |u https://doi.org/10.1007/s10897-015-9835-7  |q text/html  |z Onlinezugriff via DOI 
898 |a BK010053  |b XK010053  |c XK010000 
900 7 |a Metadata rights reserved  |b Springer special CC-BY-NC licence  |2 nationallicence 
908 |D 1  |a research-article  |2 jats 
949 |B NATIONALLICENCE  |F NATIONALLICENCE  |b NL-springer 
950 |B NATIONALLICENCE  |P 856  |E 40  |u https://doi.org/10.1007/s10897-015-9835-7  |q text/html  |z Onlinezugriff via DOI 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Hein  |D Irma  |u Department of Child and Adolescent Psychiatry, Academic Medical Center, Meibergdreef 5, 1105 AZ, Amsterdam, The Netherlands  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Troost  |D Pieter  |u Department of Child and Adolescent Psychiatry, Academic Medical Center, Meibergdreef 5, 1105 AZ, Amsterdam, The Netherlands  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Lindeboom  |D Robert  |u Department of Clinical Methods and Public Health, Academic Medical Center, Amsterdam, The Netherlands  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Christiaans  |D Imke  |u Department of Clinical Genetics, Academic Medical Center, Amsterdam, The Netherlands  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Grisso  |D Thomas  |u Department of Psychology, Law and Psychiatry, University of Massachusetts Medical School, Worcester, MA, USA  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a van Goudoever  |D Johannes  |u Department of Pediatrics, Emma Children's Hospital, Academic Medical Center, and Department of Pediatrics, VU University Medical Center, Amsterdam, The Netherlands  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Lindauer  |D Ramón  |u Department of Child and Adolescent Psychiatry, Academic Medical Center, Meibergdreef 5, 1105 AZ, Amsterdam, The Netherlands  |4 aut 
950 |B NATIONALLICENCE  |P 773  |E 0-  |t Journal of Genetic Counseling  |d Springer US; http://www.springer-ny.com  |g 24/6(2015-12-01), 971-977  |x 1059-7700  |q 24:6<971  |1 2015  |2 24  |o 10897