Basic reporting

There are several tables in this manuscript; at the very least, I think Table 7 can be deleted and summarized in the text.

Experimental design

Methods – Please describe the development of the interview guide – were the questions adapted from other studies (several studies referenced about patients’ responses to BRCA1/2 testing), particularly how were the six options constructed to ascertain emotional response, was the guide piloted for understandability and clarity, was the interviewer allowed to ask follow-up questions not included in the guide, etc.

There is no information about how the authors analyzed the data. I’m assuming the interviews were recorded and transcribed. How did they identify themes, how did they code the data, etc? Were participants’ comprehension/recall of results compared to actual results?

While gender and BRCA-carrier status are the major variables analyzed, can the authors provide more insight about the effect of age – presumably responses were different from individuals in their 20’s compared to those in their 70’s? Also, is it possible to link some of responses? For example, was the woman who misunderstood that she would be getting a definitive answer about carrier status and then her anxiety was increased following genetic counseling session also one of the respondents who indicated being ‘moderately upset, surprise, or shocked.’

Could the authors comment on how long after the receipt of results that the interview was conducted? This could impact the many of the comments by the consumers, as well as comprehension and behaviors.

Validity of the findings

RESULTS – some of the sections seem a bit redundant; some reorganization could limit data from being repeated and shorten this section overall. For example, in the section “Actions taken or planned in response…” , the sharing of data is mentioned again. The quotes only appear in the latter half of Results section – can it be more balanced throughout, such as including some in the Emotional Response section? Maybe have a section on Familial Implications?

Regarding comment on perceived worth of PGS, I think it should be clarified whether their response was based on the BRCA finding or overall. There certainly may have been other data that would influence this response.

Comments for the author

This manuscript presents some interesting data about consumers’ responses to receipt of BRCA1/2 mutations from their purchase of the 23andMe Personal Genome Services. Some further information on their methods and analyses would be helpful as suggested.