Use of metaphors about exome and whole genome sequencing

Abstract

Clinical and research uses of exome and whole genome sequencing (ES/WGS) are growing rapidly. An enhanced understanding of how individuals conceptualize and communicate about sequencing results is needed to ensure effective, mutual exchange of information between care providers and patients and between researchers and participants. Focus groups and interviews participants were recruited to discuss their attitudes and preferences for receiving hypothetical results from ES/WGS. African Americans were intentionally oversampled. We qualitatively analyzed participants' speech to identify unsolicited metaphorical language pertaining to genes and health, and grouped these occurrences into metaphorical concepts. Participants compared genetic information to physical objects including tools, weapons, contents of boxes, and formal documents or reports. These metaphorical concepts centered on several key themes, including locus of control; containment versus release of information; and desirability, usability, interpretability, and ownership of genetic results. Metaphorical language is often used intentionally or unintentionally in discussions about receiving results from ES/WGS in both clinical and research settings. Awareness of the use of metaphorical language and attention to its varied meanings facilitates effective communication about return of ES/WGS results. In turn, both should foster shared and informed decision-making and improve the translation of genetic information by clinicians and researchers.

Betting is Loving and Bettors are Predators: A Conceptual Metaphor Approach to Online Sports Betting Advertising

“…The influence of CMT on scholarly work has become evident in recent years. CMT has produced or indirectly influenced research on heterogeneous topics including the public shaping of the gun debate in the US (David et al 2016 ), the negative impact of metaphors representing cancer as an enemy that patients need to fight against (Hauser and Schwarz 2015 ), the use of metaphors to communicate to the public complex issues like gene therapy (Nelson et al 2016 ), the educational context for teaching new technologies (Koc 2013 ), how higher education is shaped (Franz and Feld 2015 ), how women recall and verbalise traumatic child birth experiences (Beck 2016 ), the build-up to democratic elections in Turkey (Hamarat 2016 ), the message structure of the tourism market in Ghana (Adu-Ampong 2016 ), or how educational science students communicate preconceptions regarding teaching and learning (Saban et al 2007 ).…”

Using Metaphors to Explain Molecular Testing to Cancer Patients

“…Two types of metaphors were then excluded: (a) any metaphor that concerned subjects other than molecular testing and (b) any literal metaphors. Literal metaphors are those in which the object of comparison has become interchangeable with the medical jargon [16]. For example, "the genome is a code" refers to the biological concept that DNA codes for proteins and is therefore considered a literal metaphor [16].…”

“…Literal metaphors are those in which the object of comparison has become interchangeable with the medical jargon [16]. For example, "the genome is a code" refers to the biological concept that DNA codes for proteins and is therefore considered a literal metaphor [16]. Each metaphor was then linked to the molecular testing term it described.…”

“…In line with this framework, Casarett et al use a “tomato seed” metaphor to explain stem cells in cancer treatment: “the stem cells we have are like tomato seeds, and think of the tomato fruit as the cells that circulate in the blood. So the stem cells are like seeds we take out of you so we can give very high doses of chemotherapy that can damage what's left in you and then we give you back those seeds so it can regrow.” Over time, specific metaphors for cancer terms have developed to reflect scientific understanding . For example, to describe hereditary genetic information, patients have compared this information to physical objects, such as tools and weapons, suggesting the practical application of such information, but also to the contents of Pandora's box, indicating the difficulty of dealing with the information .…”

“…Although it is known that metaphors in cancer are used to aid in patient understanding [19], provide a common language in the overall picture of cancer [8,12], and have successfully been used to help describe cancer genetics [16,20], whether and how they are adopted in the clinic by oncologists to describe molecular testing remain unknown. Therefore, we conducted a secondary analysis of the data from a molecular testing communication study to (a) describe metaphors used by oncologists to explain molecular testing and results of molecular testing and (b) assess patients' understanding of the metaphors used and perceptions of their usefulness.…”