PO45 Evaluation of a Novel Genetic Testing Pathway for Inherited Cardiac Conditions through the Genetic testing Video (GenVid) study: a Revolution or Evolution?

Background Growing demand for genetic testing has led to lengthy waiting lists in Clinical Genetics. For Inherited Cardiac Conditions (ICC), this causes significant patient risk and is unacceptable. Identifying efficient methods to improve workflow is crucial. Digitalised testing pathways have been shown to be feasible and acceptable internationally. To our knowledge, they have not been used in the UK for pre-symptomatic testing (PST) in ICCs. Purpose We evaluated whether GenVid, a novel video augmented pathway, could improve time to genetic testing whilst maintaining patient satisfaction and education. Methods Adults fluent in English with a known familial pathogenic/likely pathogenic variant were identified from the clinic waiting list. Those who opted in were provided with access to a genetic testing video, a phlebotomy appointment (with optional genetic counselling) and completed a modified validated questionnaire. They were phoned with their results. Gene-positive individuals were referred for an urgent ICC cardiology appointment. GenVid results were compared to a standard approach with a genetic counsellor appointment. Results Of 109 eligible patients, 54 (50%) consented and 49 (57% female) attended for testing. Only 1 (2%) patient requested pre-test counselling at the phlebotomy appointment. Demographics were similar between groups, GenVid vs. standard approach: age 39.6 years (SD 18.2) vs. 46.9 years (SD 18.3, p = 0.17), Scottish Index of Multiple Deprivation, SIMD 5 (IQR 5.5) vs. 6 (IQR 7, p = 0.91) with testing for a similar range of ICCs. Comparison between GenVid and standard approach showed significantly lower time to appointment (41 days IQR 82 vs. 127 days IQR 616, p<0.0001), time to genetic result (63 days IQR 79 vs. 154 days IQR 638, p<0.0001), time to cardiology referral (79 days SD 14 vs. 260 days SD 198, p<0.001), and time to cardiology review (170 days IQR 204 vs. 378 days IQR 755, p<0.01). Knowledge, understanding and patient satisfaction were high in both pathways. Conclusions Innovative approaches to genetic testing are necessary to tackle lengthy waiting lists, especially for ICCs that result in patient risk. The introduction of a novel pathway with video augmented genetic testing through GenVid led to a significant reduction in time to appointment, result and clinician time. Participant understanding and satisfaction were good. The GenVid model is being implemented within standard clinical practice, and preliminary findings regarding its impact and feasibility will be available imminently.