{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T16:21:46Z","timestamp":1775492506598,"version":"3.50.1"},"reference-count":63,"publisher":"Public Library of Science (PLoS)","issue":"11","license":[{"start":{"date-parts":[[2021,11,30]],"date-time":"2021-11-30T00:00:00Z","timestamp":1638230400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Freie Akademische Gesellschaft Basel"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\"><jats:title>Background<\/jats:title><jats:p>Decision-making concerning predictive genetic testing for hereditary cancer syndromes is inherently complex. This study aims to investigate what kind of complexities adults undergoing genetic counseling in Switzerland experience, how they deal with them, and what heuristics they use during the decision-making process.<\/jats:p><\/jats:sec><jats:sec id=\"sec002\"><jats:title>Methods<\/jats:title><jats:p>Semi-structured qualitative interviews with eighteen Swiss adults seeking genetic counseling for hereditary cancer syndrome genetic testing and two counseling physicians were conducted and analyzed using a grounded theory approach.<\/jats:p><\/jats:sec><jats:sec id=\"sec003\"><jats:title>Results<\/jats:title><jats:p>Counselees stated that once they were aware of their eligibility for genetic testing they perceived an inevitable necessity to make a decision in a context of uncertainties. Some counselees perceived this decision as simple, others as very complex. High emotional involvement increased perceived complexity. We observed six heuristics that counselees used to facilitate their decision: Anticipating the test result; Focusing on consequences; Dealing with information; Interpreting disease risk; Using external guidance; and (Re-)Considering the general uncertainty of life.<\/jats:p><\/jats:sec><jats:sec id=\"sec004\"><jats:title>Limitations<\/jats:title><jats:p>Our findings are limited to the context of predictive genetic testing for hereditary cancer syndromes. This qualitative study does not allow extrapolation of the relative frequency of which heuristics occur.<\/jats:p><\/jats:sec><jats:sec id=\"sec005\"><jats:title>Conclusions<\/jats:title><jats:p>The use of heuristics is an inherent part of decision-making, particularly in the complex context of genetic testing for inherited cancer predisposition. However, some heuristics increase the risk of misinterpretation or exaggerated external influences. This may negatively impact informed decision-making. Thus, this study illustrates the importance of genetic counselors and medical professionals being aware of these heuristics and the individual manner in which they might be applied in the context of genetic testing decision-making. Findings may offer practical support to achieve this, as they inductively focus on the counselees\u2019 perspective.<\/jats:p><\/jats:sec>","DOI":"10.1371\/journal.pone.0260597","type":"journal-article","created":{"date-parts":[[2021,11,30]],"date-time":"2021-11-30T20:27:56Z","timestamp":1638304076000},"page":"e0260597","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":3,"title":["The use of heuristics in genetic testing decision-making: A qualitative interview study"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7047-4496","authenticated-orcid":true,"given":"Bettina Maria","family":"Zimmermann","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David Martin","family":"Shaw","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bernice","family":"Elger","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Insa","family":"Kon\u00e9","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2021,11,30]]},"reference":[{"key":"pone.0260597.ref001","doi-asserted-by":"crossref","first-page":"e113","DOI":"10.5301\/tj.5000350","article-title":"That tumor you\u2019re going to get tomorrow \u2026 maybe: making an informed decision.","volume":"101","author":"E Aitini","year":"2015","journal-title":"Tumori"},{"key":"pone.0260597.ref002","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1007\/s10897-016-0015-1","article-title":"Educational and Psychosocial Support Needs in Lynch Syndrome: Implementation and Assessment of an Educational Workshop and Support Group","volume":"26","author":"MJ Corines","year":"2017","journal-title":"J Genet Couns"},{"key":"pone.0260597.ref003","doi-asserted-by":"crossref","first-page":"1052","DOI":"10.1136\/bmj.322.7293.1052","article-title":"The complexities of predictive genetic testing","volume":"322","author":"JP Evans","year":"2001","journal-title":"BMJ"},{"key":"pone.0260597.ref004","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1111\/j.1369-7625.2008.00494.x","article-title":"BRCA mutation-negative women from hereditary breast and ovarian cancer families: A qualitative study of the BRCA-negative experience","volume":"11","author":"AD Bakos","year":"2008","journal-title":"Health Expect"},{"key":"pone.0260597.ref005","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1097\/NCC.0000000000000438","article-title":"Moving In and Out of the What-Ifs: The Experiences of Unaffected Women Living in Families Where a Breast Cancer 1 or 2 Genetic Mutation Was Not Found.","volume":"40","author":"D Schroeder","year":"2017","journal-title":"Cancer Nurs."},{"key":"pone.0260597.ref006","doi-asserted-by":"crossref","first-page":"93","DOI":"10.3200\/BMED.31.3.93-106","article-title":"Surveillance behavior and prophylactic surgery after predictive testing for hereditary breast\/ovarian cancer","volume":"31","author":"E Claes","year":"2005","journal-title":"Behav Med"},{"key":"pone.0260597.ref007","doi-asserted-by":"crossref","first-page":"502","DOI":"10.1177\/1049732310387798","article-title":"Preserving the self: The process of decision making about hereditary breast cancer and ovarian cancer risk reduction","volume":"21","author":"AF Howard","year":"2011","journal-title":"Qual Health Res"},{"key":"pone.0260597.ref008","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1002\/ajmg.c.31607","article-title":"Genetic counseling globally: Where are we now?","volume":"178","author":"KE Ormond","year":"2018","journal-title":"Am J Med Genet C Semin Med Genet"},{"key":"pone.0260597.ref009","volume-title":"A history and theory of informed consent:","author":"RR Faden","year":"1986"},{"key":"pone.0260597.ref010","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1007\/s10728-006-0035-3","article-title":"Becoming in-formed: genetic counselling, ambiguity and choice.","volume":"15","author":"J. 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