Ethics of disclosure of onset‐predictive biomarker test results for genetic frontotemporal dementia in the research context

Abstract Onset‐predictive biomarker tests (OPBTs) for genetic frontotemporal dementia (FTD) may predict symptom onset in coming years. OPBT results could be used as inclusion criterion for clinical trials for FTD, but this requires disclosure of OPBT results to potential participants for informed co...

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Main Authors: Charlotte H. Graafland, Laura Donker Kaat, Edo Richard, John C. vanSwieten, Harro Seelaar, Eline M. Bunnik
Format: Article
Language:English
Published: Wiley 2025-04-01
Series:Alzheimer’s & Dementia: Diagnosis, Assessment & Disease Monitoring
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Online Access:https://doi.org/10.1002/dad2.70133
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author Charlotte H. Graafland
Laura Donker Kaat
Edo Richard
John C. vanSwieten
Harro Seelaar
Eline M. Bunnik
author_facet Charlotte H. Graafland
Laura Donker Kaat
Edo Richard
John C. vanSwieten
Harro Seelaar
Eline M. Bunnik
author_sort Charlotte H. Graafland
collection DOAJ
description Abstract Onset‐predictive biomarker tests (OPBTs) for genetic frontotemporal dementia (FTD) may predict symptom onset in coming years. OPBT results could be used as inclusion criterion for clinical trials for FTD, but this requires disclosure of OPBT results to potential participants for informed consent. This creates a dilemma, as disclosure may be psychologically burdensome. Yet, individuals at risk of FTD may value OPBTs to relieve uncertainty and support planning for the future. This article provides an overview of considerations regarding disclosure using four themes (actionability, respect for autonomy and informed consent, psychological impact, social and societal impact), based on literature on return of individual research results and biomarker disclosure in Alzheimer's disease. Based on this, we argue that clinical validity and context of use are important considerations, and suggest that (1) counseling facilitates informed decision making, (2) clinical and psychological follow‐up provides necessary support, and (3) impacts may be monitored in a pilot study. Highlights Ethical considerations regarding disclosure of onset‐predictive biomarker test (OPBT) results include actionability, respect for autonomy and informed consent, psychological impact, and social and societal impact. The weight of each consideration depends heavily on the clinical validity of the OPBT results and the context of use. OPBT result disclosure to individuals at risk of genetic frontotemporal dementia (FTD) for clinical trial recruitment seems ethically acceptable. We suggest embedding OPBT results disclosure in counseling, follow‐up, and a pilot study on impacts of OPBT results disclosure.
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spelling doaj-art-0e2c9de89bcb43b1901756120abd36e42025-08-20T03:30:28ZengWileyAlzheimer’s & Dementia: Diagnosis, Assessment & Disease Monitoring2352-87292025-04-01172n/an/a10.1002/dad2.70133Ethics of disclosure of onset‐predictive biomarker test results for genetic frontotemporal dementia in the research contextCharlotte H. Graafland0Laura Donker Kaat1Edo Richard2John C. vanSwieten3Harro Seelaar4Eline M. Bunnik5Department of Public HealthProgram Medical Ethics, Philosophy and History of MedicineErasmus University Medical CenterRotterdam the NetherlandsDepartment of Clinical GeneticsErasmus University Medical CenterRotterdamthe NetherlandsDepartment of NeurologyDonders Institute for BrainCognition and Behaviour, Radboud University Medical CenterNijmegenthe NetherlandsDepartment of Neurology and Alzheimer CenterErasmus University Medical CenterRotterdamthe NetherlandsDepartment of Neurology and Alzheimer CenterErasmus University Medical CenterRotterdamthe NetherlandsDepartment of Public HealthProgram Medical Ethics, Philosophy and History of MedicineErasmus University Medical CenterRotterdam the NetherlandsAbstract Onset‐predictive biomarker tests (OPBTs) for genetic frontotemporal dementia (FTD) may predict symptom onset in coming years. OPBT results could be used as inclusion criterion for clinical trials for FTD, but this requires disclosure of OPBT results to potential participants for informed consent. This creates a dilemma, as disclosure may be psychologically burdensome. Yet, individuals at risk of FTD may value OPBTs to relieve uncertainty and support planning for the future. This article provides an overview of considerations regarding disclosure using four themes (actionability, respect for autonomy and informed consent, psychological impact, social and societal impact), based on literature on return of individual research results and biomarker disclosure in Alzheimer's disease. Based on this, we argue that clinical validity and context of use are important considerations, and suggest that (1) counseling facilitates informed decision making, (2) clinical and psychological follow‐up provides necessary support, and (3) impacts may be monitored in a pilot study. Highlights Ethical considerations regarding disclosure of onset‐predictive biomarker test (OPBT) results include actionability, respect for autonomy and informed consent, psychological impact, and social and societal impact. The weight of each consideration depends heavily on the clinical validity of the OPBT results and the context of use. OPBT result disclosure to individuals at risk of genetic frontotemporal dementia (FTD) for clinical trial recruitment seems ethically acceptable. We suggest embedding OPBT results disclosure in counseling, follow‐up, and a pilot study on impacts of OPBT results disclosure.https://doi.org/10.1002/dad2.70133biomarkerclinical trialdisclosureethicsfrontotemporal dementiainformed consent
spellingShingle Charlotte H. Graafland
Laura Donker Kaat
Edo Richard
John C. vanSwieten
Harro Seelaar
Eline M. Bunnik
Ethics of disclosure of onset‐predictive biomarker test results for genetic frontotemporal dementia in the research context
Alzheimer’s & Dementia: Diagnosis, Assessment & Disease Monitoring
biomarker
clinical trial
disclosure
ethics
frontotemporal dementia
informed consent
title Ethics of disclosure of onset‐predictive biomarker test results for genetic frontotemporal dementia in the research context
title_full Ethics of disclosure of onset‐predictive biomarker test results for genetic frontotemporal dementia in the research context
title_fullStr Ethics of disclosure of onset‐predictive biomarker test results for genetic frontotemporal dementia in the research context
title_full_unstemmed Ethics of disclosure of onset‐predictive biomarker test results for genetic frontotemporal dementia in the research context
title_short Ethics of disclosure of onset‐predictive biomarker test results for genetic frontotemporal dementia in the research context
title_sort ethics of disclosure of onset predictive biomarker test results for genetic frontotemporal dementia in the research context
topic biomarker
clinical trial
disclosure
ethics
frontotemporal dementia
informed consent
url https://doi.org/10.1002/dad2.70133
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