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Teixeira da Silva JA, Bornemann-Cimenti H, Daly T, Türp JC. Beyond disclaimers: the need for a curation-based model of PubMed. Curr Med Res Opin 2024:1-7. [PMID: 38700245 DOI: 10.1080/03007995.2024.2350612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 04/29/2024] [Indexed: 05/05/2024]
Abstract
According to its own description, the biomedical meta-database PubMed exists "with the aim of improving health-both globally and personally." Unfortunately, PubMed contains an increasing amount of low-quality research that may detract from this goal. Currently, PubMed warns its users and protects itself from such problems with a disclaimer stating that the presence of any article, book, or document in PubMed does not imply an endorsement of, or concurrence with, its contents by the NLM, the National Institutes of Health (NIH), or the U.S. Federal Government. However, we are critical of a "disclaimer-only" stance and encourage PubMed to take further action against low-quality research being found and indexed in its database, and thus available for use. To address this problem, we offer two lines of reasoning to argue that PubMed should not function merely as a passive index of health-related research. Instead, we first argue that only trustworthy published research is able to further PubMed's goal of health improvement. Secondly, on the basis of surveys, we argue that researchers place a high level of trust in articles that are referenced in this meta-database. We cannot expect any one set of actors to ensure trustworthy content on PubMed, which requires collective responsibility among authors, peer reviewers, editors, and indexers alike. Instead, we propose a curation-based model that incorporates three mechanisms of collaborative content curation: open expert feedback on indexed content, journal auditing, and constant transparent reassessment of indexed entities.
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Affiliation(s)
| | - Helmar Bornemann-Cimenti
- Department of Anesthesiology and Intensive Care Medicine, Medical University of Graz, Graz, Austria
| | - Timothy Daly
- Bioethics Program, FLACSO Argentina, Buenos Aires, Argentina
- Science Norms Democracy UMR 8011, Sorbonne Université, Paris, France
| | - Jens C Türp
- Department of Oral Health & Medicine, University Center for Dental Medicine UZB, University of Basel, Basel, Switzerland
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Robillard JM, Masellis M, Martin SE, Khachaturian AS, Dixon RA. The Return of Biomarker Results in Research: Balancing Complexity, Precision, and Ethical Responsibility. J Alzheimers Dis 2024; 97:1083-1090. [PMID: 38306053 PMCID: PMC10836546 DOI: 10.3233/jad-230359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
Recent research aimed at the discovery, integration, and communication of health outcome measures (or "biomarkers") in Alzheimer's disease has raised challenging questions related to whether, how and when results from these investigations should be disclosed to research participants. Reflecting the apparent heterogeneity of many neurodegenerative diseases, biomarker or other risk factor results are often probabilistic, interactive, multi-modal, and selective. Such characteristics make it very complex to summarize and communicate to clinicians, researchers, and research participants. Whereas the format and content of academic literature is well-managed by the peer-review process, reporting individualized results to participants involves complex, sensitive, and ethical considerations. This paper describes three key factors to consider in decisions about the return of results to research participants: complexity, precision, and responsibility. The paper also presents six practical recommendations for implementing meaningful and ethical communication with research participants.
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Affiliation(s)
- Julie M Robillard
- Department of Medicine, Division of Neurology, University of British Columbia, Vancouver, BC, Canada
- BC Children's and Women's Hospital, Vancouver, BC, Canada
| | - Mario Masellis
- Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
| | - Susanna E Martin
- Department of Medicine, Division of Neurology, University of British Columbia, Vancouver, BC, Canada
- BC Children's and Women's Hospital, Vancouver, BC, Canada
| | - Ara S Khachaturian
- The Campaign to Prevent Alzheimer's Disease 2020, Inc. Rockville, MD, USA
| | - Roger A Dixon
- Department of Psychology, Faculty of Science, University of Alberta, Edmonton, AB, Canada
- Neuroscience and Mental Health Institute, University of Alberta, Edmonton, AB, Canada
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Daly T. Improving Clinical Trials of Antioxidants in Alzheimer's Disease. J Alzheimers Dis 2024; 99:S171-S181. [PMID: 37781800 DOI: 10.3233/jad-230308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/03/2023]
Abstract
Maintaining diversity in drug development in research into Alzheimer's disease (AD) is necessary to avoid over-reliance on targeting AD neuropathology. Treatments that reduce or prevent the generation of oxidative stress, frequently cited for its causal role in the aging process and AD, could be useful in at-risk populations or diagnosed AD patients. However, in this review, it is argued that clinical research into antioxidants in AD could provide more useful feedback as to the therapeutic value of the oxidative stress theory of AD. Improving comparability between randomized controlled trials (RCTs) is vital from a waste-reduction and priority-setting point of view for AD clinical research. For as well as attempting to improve meaningful outcomes for patients, RCTs of antioxidants in AD should strive to maximize the extraction of clinically useful information and actionable feedback from trial outcomes. Solutions to maximize information flow from RCTs of antioxidants in AD are offered here in the form of checklist questions to improve ongoing and future trials centered around the following dimensions: adhesion to reporting guidelines like CONSORT, biomarker enrichment, simple tests of treatment, and innovative trial design.
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Affiliation(s)
- Timothy Daly
- Science Norms Democracy UMR 8011, Sorbonne Université, Paris, France
- Bioethics Program, FLACSO Argentina, Buenos Aires, Argentina
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Daly T, Epelbaum S. The Accelerated Approval of Aducanumab Invites a Rethink of the Current Model of Drug Development for Alzheimer's Disease. AJOB Neurosci 2023; 14:332-335. [PMID: 35263240 DOI: 10.1080/21507740.2022.2048721] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Affiliation(s)
- Timothy Daly
- Science Norms Democracy UMR 8011, Sorbonne Université, Paris, France. .,Bioethics Program, FLACSO Argentina, Buenos Aires, Argentina.
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Daly T, Mastroleo I. The First Survivors of Alzheimer’s: How Patients Recovered Life and Hope in Their Own Words by Dale Bredesen, Avery, 2021, 272 pp. J Alzheimers Dis 2022; 87:1413-1414. [DOI: 10.3233/jad-220185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Timothy Daly
- Sorbonne Université, Science Norms Democracy, UMR 8011, Paris, France
- Programa de Bioética, Facultad Latinoamericanade Ciencias Sociales (FLACSO), Buenos Aires, Argentina National Scientific and Technical Research Council (CONICET), Argentina
| | - Ignacio Mastroleo
- Programa de Bioética, Facultad Latinoamericanade Ciencias Sociales (FLACSO), Buenos Aires, Argentina National Scientific and Technical Research Council (CONICET), Argentina
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Gillie M, Ali D, Vadlamuri D, Carstarphen KJ. Telehealth Literacy as a Social Determinant of Health: A Novel Screening Tool to Support Vulnerable Patient Equity. J Alzheimers Dis Rep 2022; 6:67-72. [PMID: 35360275 PMCID: PMC8925120 DOI: 10.3233/adr-210024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Accepted: 01/15/2022] [Indexed: 11/28/2022] Open
Abstract
Background: Telehealth has evolved as a solution to COVID-19 isolation precautions and remote care with well-established health, socioeconomic, and practical benefits. However, there are many gaps in the current literature regarding telehealth use among older, low health literate, and resource-limited populations. There are ethical considerations that warrant understanding this digital divide. Objective: The objective of this review is to propose the Telehealth Literacy Screening Tool (TLST) for use in older adults and support the future inclusion of telehealth literacy as an important social determinant of health (SDOH). Methods: Initially a four-week outreach was performed that targeted older adults and low-health literate patients at the MedVantage Clinic (MVC) within Ochsner Health (OH) to identify common barriers to patient engagement with the OH Epic MyChart telehealth platform. Themes from those barriers directed a meta-synthetic review of the methods and ethical considerations of current, validated technological and telehealth literacy screening tools. Those findings were reported based on the standards of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement. Results: Based on the barriers identified during our MVC patient outreach, PRISMA-reported review of telehealth literacy screening research, and evaluation of the MyChart platform and the technological resources required for its use; we developed a multidimensional questionnaire for telehealth literacy screening of older adults. Conclusion: The TLST is designed to identify patients in need of additional interventions for successful connection to telehealth services. This is an important step towards addressing the ethical obligation to decrease disparities in telehealth literacy for vulnerable populations and identifying telehealth literacy as a SDOH.
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Affiliation(s)
- Monica Gillie
- Ochsner Health, New Orleans, LA, USA
- Stanford - O’Connor Family Medicine Residency, San Jose, CA, USA
| | - Diab Ali
- Ochsner Health, New Orleans, LA, USA
- Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO, USA
| | - Diamler Vadlamuri
- Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - Kathy Jo Carstarphen
- Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia
- Department of Internal Medicine, Ochsner Health, New Orleans, LA, USA
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Daly T, Mastroleo I, Henry V, Bourdenx M. An Argument for Simple Tests of Treatment of Alzheimer's Disease. J Alzheimers Dis 2022; 86:49-52. [PMID: 35001895 DOI: 10.3233/jad-215492] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Two potential disease-modifying approaches for dementia are being vigorously tested: the early targeting of the neuropathology of Alzheimer's disease (AD) and multi-domain lifestyle interventions to promote resilience to neuropathology. We apply the "web of information" model of clinical translation to both approaches to argue firstly that tests of treatments aiming to achieve clinically meaningful outcomes should remain simple, and secondly, that building clinically-meaningful treatments should be kept separate from public health policy which means promoting wide-reaching action against risk factors now with available information.
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Affiliation(s)
- Timothy Daly
- Science Norms Democracy, UMR 8011 Sorbonne University, Paris, France
| | - Ignacio Mastroleo
- National Scientific and Technical Research Council (CONICET) and Programa de Bioetica, Buenos Aires, Argentina
| | | | - Mathieu Bourdenx
- Institute des Maladies Neurodégénératives, UMR 5293, Université de Bordeaux, Bordeaux, France.,Institute des Maladies Neurodégénératives, UMR 5293, CNRS, Bordeaux, France
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Daly T. Are trailblazing trials for reducing cognitive decline putting the cart before the horse? ALZHEIMER'S & DEMENTIA: TRANSLATIONAL RESEARCH & CLINICAL INTERVENTIONS 2022; 8:e12298. [PMID: 35733646 PMCID: PMC9191824 DOI: 10.1002/trc2.12298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Timothy Daly
- Sorbonne Université, UMR 8011, Science, Norms, Democracy Philosophy Department Paris France
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Mastroleo I, Daly T. Avoiding Exceptionalism and Silver Bullets: Lessons from Public Health Ethics and Alzheimer's Disease. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2021; 21:25-28. [PMID: 34806968 DOI: 10.1080/15265161.2021.1991049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Affiliation(s)
- Ignacio Mastroleo
- National Scientific and Technical Research Council (CONICET) and Programa de Bioetica, Facultad Latinoamericana de Ciencias Sociales (FLACSO)
| | - Timothy Daly
- Sorbonne Université, UMR8011 Science Norms Democracy
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Mastroleo I, Daly T. Seeing the Forest for the Trees: The Importance of Unifying Ethical and Legal Considerations for Non-Validated Practice of Neurotherapies. AJOB Neurosci 2021; 12:270-272. [PMID: 34704906 DOI: 10.1080/21507740.2021.1973149] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Ignacio Mastroleo
- National Scientific and Technical Research Council (CONICET) and Programa de Bioetica, Facultad Latinoamericana de Ciencias Sociales (FLACSO)
| | - Timothy Daly
- Sorbonne Université, UMR8011 Science Norms Democracy
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Helgesson G. What is a reasonable framework for new non-validated treatments? THEORETICAL MEDICINE AND BIOETHICS 2020; 41:239-245. [PMID: 33586046 PMCID: PMC7935739 DOI: 10.1007/s11017-020-09537-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/08/2020] [Indexed: 06/12/2023]
Affiliation(s)
- Gert Helgesson
- Stockholm Centre for Healthcare Ethics, Karolinska Institutet, Stockholm, Sweden.
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