The Use of Molecular Biomarker Tests: An Interview Study with Healthcare Providers about a Molecular Biomarker Test for Prostate Cancer

Abstract

Aim: Investigate why healthcare providers are not always willing to use molecular biomarker tests, even though they promise to personalize disease diagnosis and treatment. Materials & methods: We interviewed 20 Dutch urological healthcare providers to ascertain why they used or did not use SelectMDx, a biomarker test for prostate cancer. Results: Whether and how it was used differed from the developers’ expectations, because users and nonusers disagreed about its perceived advantages; the scientific and clinical evidence; the advantages of MRI; and the value of PCA3 testing. Financial issues and the absence of SelectMDx in professional guidelines and hospital care pathways also hampered its use. Conclusion: Eliciting users’ and nonusers’ views is important to better understand how biomarker tests can be embedded in clinical practice.

Lay abstract

Molecular biomarkers are molecules, found in urine or blood, for instance, that help healthcare providers to diagnose a disease and provide a prognosis. This assists their clinical decision-making. However, not all healthcare providers use molecular biomarkers, and we wanted to find out why. We focused on a test for prostate cancer called the SelectMDx test. We interviewed 20 Dutch healthcare providers and found that whether they used the SelectMDx test and how they used it depended on things like their interpretation of the scientific evidence; how they valued other technologies; the financial disadvantages; and the test’s absence in professional guidelines. By eliciting users’ and nonusers views, we have gained a better understanding of how biomarker tests can be embedded in clinical practice.

Keywords::

• interviews
• molecular biomarkers
• prostate cancer
• technology adoption
• user involvement

Acknowledgments

The authors would like to thank MDxHealth Netherlands for sharing the contact information of some urological healthcare providers with us. Furthermore, the authors would like to thank the interviewees for their time and valuable insights.

Financial & competing interests disclosure

This work received financial support from The Netherlands Organisation for Scientific Research (NWO MVI project 313-99-335). To receive this grant, an in-cash contribution was required from private partners. MDxHealth, the company behind the SelectMDx test, has provided an in cash contribution for this grant. MDxHealth has contributed 10% and NWO 90%. In line with the consortium agreement MDxHealth did not influence the design and execution of our research. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Ethical conduct of research

The authors state that for investigations involving human subjects, informed consent has been obtained from the participants involved.

Additional information

Funding

This work received financial support from The Netherlands Organisation for Scientific Research (NWO MVI project 313-99-335). To receive this grant, an in-cash contribution was required from private partners. MDxHealth, the company behind the SelectMDx test, has provided an in cash contribution for this grant. MDxHealth has contributed 10% and NWO 90%. In line with the consortium agreement MDxHealth did not influence the design and execution of our research. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. No writing assistance was utilized in the production of this manuscript.