The Use Of Molecular Biomarker Tests: An Interview Study With Healthcare Providers About A Molecular Biomarker Test For Prostate Cancer

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.