Table 2 Scored likelihoods of the linear pooled estimates
From: Whole genome sequencing in oncology: using scenario drafting to explore future developments
Scenario questions (Q) | Brief description | Experts (n) | Mean | Median | 80% HDI | 80% HDI bandwidth |
|---|---|---|---|---|---|---|
Scenario 1 | Innovation in WGS devices | Â | Â | Â | Â | Â |
 Q1 | WGS testing kit with 50% cheaper initial investment costs | 18 | 65.5 | 69.2 | 51.5–100.0 | 48.5 |
 Q2 | Interpretation MTB only required for 5% of the patients | 17 | 38.8 | 31.6 | 1.8–68.9 | 67.1 |
 Q3 | Average turnaround time reduced to 7 days | 17 | 54.2 | 63.4 | 17.6–98.1 | 80.5 |
 Q4 | Overall scenario taking place within the next 5 years | 16 | 46.0 | 52.1 | 0.1–85.5 | 85.4 |
Scenario 2 | The discovery of a new actionable biomarker for immunotherapy | Â | Â | Â | Â | Â |
 Q1 | WGS is the only technique that can identify new biomarkers | 17 | 28.3 | 21.8 | 0.0–49.0 | 49.0 |
 Q2 | WGS detects new biomarker for immunotherapy in 20% of the patients | 17 | 46.9 | 48.4 | 11.6–90.2 | 78.6 |
 Q3 | 90% of the physicians offer WGS to patients | 16 | 65.5 | 72.1 | 43.7–98.0 | 54.3 |
 Q4 | 90% of patients prefer WGS to other molecular diagnostics | 15 | 66.7 | 80.3 | 25.9–99.3 | 73.4 |
 Q5 | Overall scenario taking place within the next 5 years | 17 | 45.3 | 45.5 | 0.3–81.3 | 81.0 |
Scenario 3 | The effects of centralizing WGS | Â | Â | Â | Â | Â |
 Q1 | Centralizing WGS leads to large reduction costs and turnaround time | 16 | 52.5 | 51.4 | 19.3–88.8 | 69.5 |
 Q2 | Costs WGS decreased to €1000.- per patient | 16 | 54.9 | 54.9 | 30.7–85.6 | 54.9 |
 Q3 | Turnaround time WGS decreased to 5 days | 16 | 37.9 | 29.9 | 0.0–69.5 | 69.5 |
 Q4 | All hospitals will adopt WGS | 15 | 58.7 | 68.7 | 24.1–97.1 | 73.0 |
 Q5 | Overall scenario taking place within the next 5 years | 15 | 26.5 | 24.1 | 0.0–45.1 | 45.1 |
Scenario 4 | Introducing WGS as a clinical diagnostic | Â | Â | Â | Â | Â |
 Q1 | WGS available as standard diagnostic test in clinical practice | 17 | 64.5 | 76.1 | 31.6–99.9 | 68.3 |
 Q2 | WGS detects actionable target (targeted therapy) in 12% of the patients | 17 | 68.8 | 74.7 | 55.3–100.0 | 44.7 |
 Q3 | Turnaround time WGS decreased to 14 days | 17 | 76.1 | 80.3 | 61.2–99.8 | 38.6 |
 Q4 | Costs WGS decreased to €3000.- per patient | 16 | 81.1 | 83.6 | 69.7–99.8 | 30.1 |
 Q5 | WGS will be used instead of standard diagnostics | 17 | 58.7 | 65.7 | 23.2–95.9 | 72.7 |
 Q6 | Overall scenario taking place within next 5 years | 17 | 55.3 | 68.3 | 15.5–99.0 | 83.5 |
Scenario 5 | A new competing NGS panel ‘X’ |  |  |  |  |  |
 Q1 | New liquid NGS panel ‘X’ enters the market | 16 | 67.1 | 75.7 | 45.0–100.0 | 55.0 |
 Q2 | NGS panel ‘X’ detects actionable targets in 8% of the patients | 15 | 66.6 | 77.4 | 46.2–95.2 | 49.0 |
 Q3 | Less invasive liquid biopsies can be used for NGS panel ‘X’ | 15 | 56.1 | 59.9 | 16.7–88.0 | 71.3 |
 Q4 | Turnaround time NGS panel ‘X’ is on average 2 days | 15 | 48.5 | 51.9 | 0.0–74.5 | 74.5 |
 Q5 | Costs NGS panel ‘X’ are €300.- per patient | 15 | 51.6 | 51.6 | 18.4–93.4 | 75.0 |
 Q6 | NGS panel ‘X’ will be used instead of WGS | 16 | 56.3 | 62.4 | 21.6–94.2 | 72.6 |
 Q7 | Overall scenario taking place within the next 5 years | 15 | 40.8 | 39.8 | 0.0–78.1 | 78.1 |
Scenario 6 | Technical performance | Â | Â | Â | Â | Â |
 Q1 | Success rate tissue biopsies and sequencing process of WGS improve | 15 | 59.0 | 64.7 | 22.9–86.1 | 63.2 |
 Q2 | Tissue biopsies successfully taken in 80% of the patients | 15 | 55.1 | 58.5 | 20.2–96.9 | 76.7 |
 Q3 | Sequencing process of WGS successful in 95% of the patients | 14 | 50.7 | 59.6 | 0.0–73.3 | 73.3 |
 Q4 | More than 80% of the patients sequenced successful | 14 | 52.7 | 58.4 | 18.5–89.9 | 71.4 |
 Q5 | Costs WGS stay fixed at €4500.- per patient | 14 | 47.0 | 47.3 | 22.8–80.0 | 57.2 |
 Q6 | Overall scenario taking place within the next 5 years | 15 | 40.0 | 39.2 | 0.0–69.7 | 69.7 |
Scenario 7 | Approval of new drugs for new actionable targets | Â | Â | Â | Â | Â |
 Q1 | Approval new targeted therapies for new targets discovered by WGS | 14 | 55.0 | 54.6 | 26.1–97.8 | 71.7 |
 Q2 | New actionable targets can only be detected by WGS | 15 | 34.6 | 27.9 | 0.0–56.2 | 56.2 |
 Q3 | WGS detects new biomarker for targeted therapy in 20% of the patients | 15 | 41.5 | 44.4 | 0.0–62.8 | 62.8 |
 Q4 | 90% of the physicians prefer using WGS as molecular diagnostic | 14 | 66.8 | 71.4 | 53.6–95.2 | 41.6 |
 Q5 | 90% of patients prefer to receive WGS as molecular diagnostics | 14 | 68.6 | 78.6 | 28.4–98.7 | 70.3 |
 Q6 | Overall scenario taking place within the next 5 years | 14 | 35.5 | 28.1 | 0.0–69.8 | 69.8 |
Scenario 8 | Approval for off-label drug prescription | Â | Â | Â | Â | Â |
 Q1 | Off-label drug use will be allowed based on research on WGS data | 15 | 65.6 | 66.9 | 39.5–99.7 | 60.2 |
 Q2 | Off-label drug prescription only allowed for targets found by WGS | 14 | 47.9 | 42.0 | 6.3–92.0 | 85.7 |
 Q3 | WGS detects actionable target for off-label targeted therapy in 5% of the patients | 14 | 60.4 | 73.1 | 17.8–89.8 | 72.0 |
 Q4 | 95% of the physicians prefer using WGS as molecular diagnostic | 15 | 72.1 | 83.6 | 43.9–98.8 | 54.9 |
 Q5 | All patients prefer to receive WGS as molecular diagnostics | 14 | 69.5 | 85.2 | 36.6–99.5 | 62.9 |
 Q6 | Overall scenario taking place within the next 5 years | 14 | 47.3 | 43.9 | 25.2–92.3 | 67.1 |
Scenario 9 | Better response to actionable targets found by WGS | Â | Â | Â | Â | Â |
 Q1 | Better treatment response in patients with targets identified with WGS | 14 | 18.5 | 9.3 | 0.0–39.7 | 39.7 |
 Q2 | Treatment response targeted therapy increased to 10% | 16 | 35.7 | 24.0 | 0.0–73.7 | 73.7 |
 Q3 | WGS detects biomarkers that are better predictors for treatment response | 14 | 42.5 | 48.6 | 0.0–64.7 | 64.7 |
 Q4 | All physicians prefer using WGS as molecular diagnostic | 16 | 54.6 | 60.3 | 13.1–96.4 | 83.3 |
 Q5 | All patients prefer to receive WGS as molecular diagnostics | 16 | 55.5 | 60.5 | 15.9–96.9 | 81.0 |
 Q6 | Overall scenario taking place within the next 5 years | 15 | 25.7 | 26.1 | 0.0–42.3 | 42.3 |