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López-Díaz Á, Palermo-Zeballos FJ, Gutierrez-Rojas L, Alameda L, Gotor-Sánchez-Luengo F, Garrido-Torres N, Métrailler J, Alerci L, Bonnarel V, Cano-Domínguez P, Avanesi-Molina E, Soto-Ontoso M, Torrecilla-Olavarrieta R, Muñoz-Manchado LI, Torres-Hernández P, González-Higueras F, Prados-Ojeda JL, Herrera-Cortés M, Meca-García JM, Gordillo-Urbano RM, Sánchez-Robles C, Delgado-Durán T, Soriano-Peña MF, Golay P, Conus P, Crespo-Facorro B, Ruiz-Veguilla M. Proxy measures for the assessment of psychotic and affective symptoms in studies using electronic health records. BJPsych Open 2024; 10:e22. [PMID: 38179604 PMCID: PMC10790217 DOI: 10.1192/bjo.2023.623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 10/31/2023] [Accepted: 11/14/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND There is a lack of standardised psychometric data in electronic health record (EHR)-based research. Proxy measures of symptom severity based on patients' clinical records may be useful surrogates in mental health EHR research. AIMS This study aimed to validate proxy tools for the short versions of the Positive and Negative Syndrome Scale (PANSS-6), Young Mania Rating Scale (YMRS-6) and Montgomery-Åsberg Depression Rating Scale (MADRS-6). METHOD A cross-sectional, multicentre study was conducted in a sample of 116 patients with first-episode psychosis from 12 public hospitals in Spain. Concordance between PANSS-6, YMRS-6 and MADRS-6 scores and their respective proxies was evaluated based on information from EHR clinical notes, using a variety of statistical procedures, including multivariate tests to adjust for potential confounders. Bootstrapping techniques were used for internal validation, and an independent cohort from the Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne, Switzerland) for external validation. RESULTS The proxy versions correlated strongly with their respective standardised scales (partial correlations ranged from 0.75 to 0.84) and had good accuracy and discriminatory power in distinguishing between patients in and not in remission (percentage of patients correctly classified ranged from 83.9 to 91.4% and bootstrapped optimism-corrected area under the receiver operating characteristic curve ranged from 0.76 to 0.89), with high interrater reliability (intraclass correlation coefficient of 0.81). The findings remained robust in the external validation data-set. CONCLUSIONS The proxy instruments proposed for assessing psychotic and affective symptoms by reviewing EHR provide a feasible and reliable alternative to traditional structured psychometric procedures, and a promising methodology for real-world practice settings.
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Affiliation(s)
- Álvaro López-Díaz
- Mental Health Clinical Management Unit, Virgen Macarena University Hospital, Seville, Spain; Translational Psychiatry Research Group (PsyNal), Seville Biomedical Research Centre (IBiS), Spain; Spanish Network for Research in Mental Health, Carlos III Institute (CIBERSAM, ISCIII), Seville, Spain; Department of Psychiatry, School of Medicine, University of Seville, Spain; and First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain
| | - Fernanda Jazmín Palermo-Zeballos
- Mental Health Clinical Management Unit, Virgen Macarena University Hospital, Seville, Spain; and First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain
| | - Luis Gutierrez-Rojas
- First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain; Mental Health Clinical Management Unit, San Cecilio University Hospital, Granada, Spain; Psychiatry and Neurosciences Research Group (CTS-549), Institute of Neurosciences, University of Granada, Spain; and Department of Psychiatry, University of Granada, Spain
| | - Luis Alameda
- Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP), Lausanne University Hospital and University of Lausanne, Switzerland; and Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Francisco Gotor-Sánchez-Luengo
- Department of Psychiatry, School of Medicine, University of Seville, Spain; First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain; and Mental Health Clinical Management Unit, Virgen del Rocío University Hospital, Seville, Spain
| | - Nathalia Garrido-Torres
- Translational Psychiatry Research Group (PsyNal), Seville Biomedical Research Centre (IBiS), Spain; Spanish Network for Research in Mental Health, Carlos III Institute (CIBERSAM, ISCIII), Seville, Spain; First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain; and Mental Health Clinical Management Unit, Virgen del Rocío University Hospital, Seville, Spain
| | - Johann Métrailler
- Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP), Lausanne University Hospital and University of Lausanne, Switzerland
| | - Livia Alerci
- Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP), Lausanne University Hospital and University of Lausanne, Switzerland
| | - Vincent Bonnarel
- Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP), Lausanne University Hospital and University of Lausanne, Switzerland
| | - Pablo Cano-Domínguez
- First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain; and Mental Health Clinical Management Unit, Virgen de la Victoria University Hospital, Málaga, Spain
| | - Elma Avanesi-Molina
- First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain; and Mental Health Clinical Management Unit, Virgen de la Victoria University Hospital, Málaga, Spain
| | - Miguel Soto-Ontoso
- First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain; and Mental Health Clinical Management Unit, Torrecárdenas University Hospital, Almería, Spain
| | - Rocio Torrecilla-Olavarrieta
- First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain; and Mental Health Clinical Management Unit, Jerez University Hospital, Cádiz, Spain
| | - Leticia Irene Muñoz-Manchado
- First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain; and Mental Health Clinical Management Unit, Jerez University Hospital, Cádiz, Spain
| | - Pedro Torres-Hernández
- First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain; and Mental Health Clinical Management Unit, Jaén University Hospital, Spain
| | - Fermín González-Higueras
- First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain; and Mental Health Clinical Management Unit, Jaén University Hospital, Spain
| | - Juan Luis Prados-Ojeda
- First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain; and Mental Health Clinical Management Unit, Reina Sofía University Hospital, Córdoba, Spain
| | - Mario Herrera-Cortés
- First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain; and Mental Health Clinical Management Unit, Reina Sofía University Hospital, Córdoba, Spain
| | - José Miguel Meca-García
- First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain; and Mental Health Clinical Management Unit, Poniente University Hospital, Almería, Spain
| | - Rafael Manuel Gordillo-Urbano
- First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain; and Mental Health Clinical Management Unit, Infanta Margarita Hospital, Córdoba, Spain
| | - Cristina Sánchez-Robles
- First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain; and Mental Health Clinical Management Unit, Juan Ramón Jiménez Hospital, Huelva, Spain
| | - Tomás Delgado-Durán
- First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain; and Mental Health Clinical Management Unit, Juan Ramón Jiménez Hospital, Huelva, Spain
| | - María Felipa Soriano-Peña
- First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain; and Mental Health Clinical Management Unit, San Agustín University Hospital, Linares, Spain
| | - Philippe Golay
- Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP), Lausanne University Hospital and University of Lausanne, Switzerland
| | - Philippe Conus
- Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP), Lausanne University Hospital and University of Lausanne, Switzerland
| | - Benedicto Crespo-Facorro
- Translational Psychiatry Research Group (PsyNal), Seville Biomedical Research Centre (IBiS), Spain; Spanish Network for Research in Mental Health, Carlos III Institute (CIBERSAM, ISCIII), Seville, Spain; Department of Psychiatry, School of Medicine, University of Seville, Spain; First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain; and Mental Health Clinical Management Unit, Virgen del Rocío University Hospital, Seville, Spain
| | - Miguel Ruiz-Veguilla
- Translational Psychiatry Research Group (PsyNal), Seville Biomedical Research Centre (IBiS), Spain; Spanish Network for Research in Mental Health, Carlos III Institute (CIBERSAM, ISCIII), Seville, Spain; Department of Psychiatry, School of Medicine, University of Seville, Spain; First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain; and Mental Health Clinical Management Unit, Virgen del Rocío University Hospital, Seville, Spain
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Looi JCL, Kisely S, Allison S, Bastiampillai T, Maguire PA. The unfulfilled promises of electronic health records. AUST HEALTH REV 2023; 47:744-746. [PMID: 37866822 DOI: 10.1071/ah23192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Accepted: 10/05/2023] [Indexed: 10/24/2023]
Abstract
We provide a brief update on the current evidence on electronic health records' benefits, risks, and potential harms through a rapid narrative review. Many of the promised benefits of electronic health records have not yet been realised. Electronic health records are often not user-friendly. To enhance their potential, electronic health record platforms should be continuously evaluated and enhanced by carefully considering feedback from all stakeholders.
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Affiliation(s)
- Jeffrey C L Looi
- Academic Unit of Psychiatry and Addiction Medicine, The Australian National University School of Medicine and Psychology, Canberra Hospital, Building 4, Level 2, PO Box 11, Canberra, ACT 2605, Australia; and Consortium of Australian-Academic Psychiatrists for Independent Policy and Research Analysis (CAPIPRA), Canberra, ACT, Australia
| | - Steve Kisely
- Consortium of Australian-Academic Psychiatrists for Independent Policy and Research Analysis (CAPIPRA), Canberra, ACT, Australia; and School of Medicine, The University of Queensland, Princess Alexandra Hospital, Ipswich Road, Woolloongabba, Brisbane, Qld, Australia; and Departments of Psychiatry, Community Health and Epidemiology, Dalhousie University, Halifax, NS, Canada
| | - Stephen Allison
- Consortium of Australian-Academic Psychiatrists for Independent Policy and Research Analysis (CAPIPRA), Canberra, ACT, Australia; and College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Tarun Bastiampillai
- Consortium of Australian-Academic Psychiatrists for Independent Policy and Research Analysis (CAPIPRA), Canberra, ACT, Australia; and College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia; and Department of Psychiatry, Monash University, Wellington Road, Clayton, Vic., Australia
| | - Paul A Maguire
- Academic Unit of Psychiatry and Addiction Medicine, The Australian National University School of Medicine and Psychology, Canberra Hospital, Building 4, Level 2, PO Box 11, Canberra, ACT 2605, Australia; and Consortium of Australian-Academic Psychiatrists for Independent Policy and Research Analysis (CAPIPRA), Canberra, ACT, Australia
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Beusink M, Koetsveld F, van Scheijen S, Janssen T, Buiter M, Schmidt MK, Rebers S. Health Research with Data in a Time of Privacy: Which Information do Patients Want? J Empir Res Hum Res Ethics 2023; 18:304-316. [PMID: 37309128 PMCID: PMC10496423 DOI: 10.1177/15562646231181439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 04/12/2023] [Accepted: 05/05/2023] [Indexed: 06/14/2023]
Abstract
When hospitals ask broad consent for the secondary use of patient data for scientific research, it is unknown for which studies the data will be used. We investigated what patients at a cancer hospital consider to be an adequate level and most suitable method of information provision using questionnaires (n = 71) and interviews (n = 24). A part of the respondents indicated that they would feel sufficiently informed by either being notified about potential further use, or by receiving a general brochure before being asked for consent. Others stated that additional information would be interesting and appreciated. Yet, when discussing required resources needed to provide additional information, interviewees lowered the bar of what they considered minimally required, voicing the importance of spending resources on research.
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Affiliation(s)
- Miriam Beusink
- Department of Molecular Pathology, The Netherlands Cancer Institute – Antoni van Leeuwenhoek hospital, Amsterdam, The Netherlands
- Health-RI, Utrecht, The Netherlands
| | - Folkert Koetsveld
- Department of Molecular Pathology, The Netherlands Cancer Institute – Antoni van Leeuwenhoek hospital, Amsterdam, The Netherlands
- Department of Radiotherapy, The Netherlands Cancer Institute - Antoni van Leeuwenhoek hospital, Amsterdam, The Netherlands
| | - Sonja van Scheijen
- Department of Molecular Pathology, The Netherlands Cancer Institute – Antoni van Leeuwenhoek hospital, Amsterdam, The Netherlands
| | - Tomas Janssen
- Department of Molecular Pathology, The Netherlands Cancer Institute – Antoni van Leeuwenhoek hospital, Amsterdam, The Netherlands
- Department of Radiotherapy, The Netherlands Cancer Institute - Antoni van Leeuwenhoek hospital, Amsterdam, The Netherlands
| | - Maarten Buiter
- Department of Molecular Pathology, The Netherlands Cancer Institute – Antoni van Leeuwenhoek hospital, Amsterdam, The Netherlands
- Department of Radiotherapy, The Netherlands Cancer Institute - Antoni van Leeuwenhoek hospital, Amsterdam, The Netherlands
| | - Marjanka K Schmidt
- Department of Molecular Pathology, The Netherlands Cancer Institute – Antoni van Leeuwenhoek hospital, Amsterdam, The Netherlands
| | - Susanne Rebers
- Department of Molecular Pathology, The Netherlands Cancer Institute – Antoni van Leeuwenhoek hospital, Amsterdam, The Netherlands
- Health-RI, Utrecht, The Netherlands
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Shau WY, Setia S, Shinde S, Santoso H, Furtner D. Generating fit-for-purpose real-world evidence in Asia: How far are we from closing the gaps? Perspect Clin Res 2023; 14:108-113. [PMID: 37554247 PMCID: PMC10405531 DOI: 10.4103/picr.picr_193_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 12/29/2022] [Accepted: 01/12/2023] [Indexed: 08/10/2023] Open
Abstract
Evidence generated by randomized controlled trials (RCTs) does not often represent the patient journey and clinical outcomes in the real world due to limited external validity or generalizability. Studies based on real-world data are intended to generalize results to the broader population; however, if the influence of external factors or confounders is not effectively managed, the cause-and-effect relationship and internal validity may be challenged, resulting in flawed results. The collection of quality real-world evidence (RWE) is crucial in Asia as there is often an underrepresentation of Asian populations in RCTs. In addition, few countries in Asia are catching up with the Western world in issuing practical foundational principles and guidance for conducting and adopting evidence for regulatory and reimbursement decisions. However, privacy and data protection laws are generally lagging behind technological developments in electronic medical records. While leveraging RWE in clinical and regulatory decision-making holds excellent potential, collective efforts across industry, governments, and research institutions are required for generating standardized practices and building capabilities for developing fit-for-purpose RWE in Asia.
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Affiliation(s)
- Wen-Yi Shau
- Medical Affairs, Emerging Asia, Pfizer Corporation Hong Kong Limited, Quarry Bay, Hong Kong
| | - Sajita Setia
- Executive Office Transform Medical Communications Limited, Wanganui, New Zealand
| | - Salil Shinde
- Medical Affairs, Emerging Asia, Pfizer Corporation Hong Kong Limited, Quarry Bay, Hong Kong
| | - Handoko Santoso
- Medical Affairs, Emerging Asia, Pfizer Corporation Hong Kong Limited, Quarry Bay, Hong Kong
| | - Daniel Furtner
- Executive Office Transform Medical Communications Limited, Wanganui, New Zealand
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5
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Stoumpos AI, Kitsios F, Talias MA. Digital Transformation in Healthcare: Technology Acceptance and Its Applications. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3407. [PMID: 36834105 PMCID: PMC9963556 DOI: 10.3390/ijerph20043407] [Citation(s) in RCA: 26] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 02/08/2023] [Accepted: 02/10/2023] [Indexed: 05/27/2023]
Abstract
Technological innovation has become an integral aspect of our daily life, such as wearable and information technology, virtual reality and the Internet of Things which have contributed to transforming healthcare business and operations. Patients will now have a broader range and more mindful healthcare choices and experience a new era of healthcare with a patient-centric culture. Digital transformation determines personal and institutional health care. This paper aims to analyse the changes taking place in the field of healthcare due to digital transformation. For this purpose, a systematic bibliographic review is performed, utilising Scopus, Science Direct and PubMed databases from 2008 to 2021. Our methodology is based on the approach by Wester and Watson, which classify the related articles based on a concept-centric method and an ad hoc classification system which identify the categories used to describe areas of literature. The search was made during August 2022 and identified 5847 papers, of which 321 fulfilled the inclusion criteria for further process. Finally, by removing and adding additional studies, we ended with 287 articles grouped into five themes: information technology in health, the educational impact of e-health, the acceptance of e-health, telemedicine and security issues.
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Affiliation(s)
- Angelos I. Stoumpos
- Healthcare Management Postgraduate Program, Open University Cyprus, P.O. Box 12794, Nicosia 2252, Cyprus
| | - Fotis Kitsios
- Department of Applied Informatics, University of Macedonia, 156 Egnatia Street, GR54636 Thessaloniki, Greece
| | - Michael A. Talias
- Healthcare Management Postgraduate Program, Open University Cyprus, P.O. Box 12794, Nicosia 2252, Cyprus
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Skovgaard L, Grundtvig A. Who tweets what about personalised medicine? Promises and concerns from Twitter discussions in Denmark. Digit Health 2023; 9:20552076231169832. [PMID: 37113257 PMCID: PMC10126701 DOI: 10.1177/20552076231169832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 03/29/2023] [Indexed: 04/29/2023] Open
Abstract
Digital health data are seen as valuable resources for the development of better and more efficient treatments, for instance through personalised medicine. However, health data are information about individuals who hold opinions and can challenge how data about them are used. Therefore it is important to understand public discussions around reuse of digital health data. Social media have been heralded as enabling new forms of public engagement and as a place to study social issues. In this paper, we study a public debate on Twitter about personalised medicine. We explore who participates in discussions about personalised medicine on Twitter and what they tweet about. Based on user-generated biographies we categorise users as having a 'Professional interest in personalised medicine' or as 'Private' users. We describe how users within the field tweet about the promises of personalised medicine, while users unaffiliated with the field tweet about the concrete realisation of these ambitions in the form of a new infrastructure and express concerns about the conditions for the implementation. Our study serves to remind people interested in public opinion that Twitter is a platform used for multiple purposes by different actors and not simply a bottom-up democratic forum. This study contributes with insights relevant to policymakers wishing to expand infrastructures for reuse of health data. First, by providing insights into what is discussed about health data reuse. Second, by exploring how Twitter can be used as a platform to study public discussions about reuse of health data.
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Affiliation(s)
- Lea Skovgaard
- Department of Public Health, University of
Copenhagen, Copenhagen K, Denmark
- Lea Skovgaard, Department of Public Health,
University of Copenhagen, Øster Farigmagsgade 5, Copenhagen K 1014, Denmark.
| | - Anders Grundtvig
- Department of Public Health, University of
Copenhagen, Copenhagen K, Denmark
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Gale SA, Heidebrink J, Grill J, Graff-Radford J, Jicha GA, Menard W, Nowrangi M, Sami S, Sirivong S, Walter S, Karlawish J. Preclinical Alzheimer Disease and the Electronic Health Record: Balancing Confidentiality and Care. Neurology 2022; 99:987-994. [PMID: 36180237 PMCID: PMC9728033 DOI: 10.1212/wnl.0000000000201347] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 08/19/2022] [Indexed: 01/07/2023] Open
Abstract
Because information technologies are increasingly used to improve clinical research and care, personal health information (PHI) has wider dissemination than ever before. The 21st Century Cures Act in the United States now requires patient access to many components of the electronic health record (EHR). Although these changes promise to enhance communication and information sharing, they also bring higher risks of unwanted disclosure, both within and outside of health systems. Having preclinical Alzheimer disease (AD), where biological markers of AD are identified before the onset of any symptoms, is sensitive PHI. Because of the melding of ideas between preclinical and "clinical" (symptomatic) AD, unwanted disclosure of preclinical AD status can lead to personal harms of stigma, discrimination, and changes to insurability. At present, preclinical AD is identified mainly in research settings, although the consensus criteria for a clinical diagnosis may soon be established. There is not yet adequate legal protection for the growing number of individuals with preclinical AD. Some PHI generated in preclinical AD trials has clinical significance, necessitating urgent evaluations and longitudinal monitoring in care settings. AD researchers are obligated to both respect the confidentiality of participants' sensitive PHI and facilitate providers' access to necessary information, often requiring disclosure of preclinical AD status. The AD research community must continue to develop ethical, participant-centered practices related to confidentiality and disclosure, with attention to sensitive information in the EHR. These practices will be essential for translation into the clinic and across health systems and society at large.
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Affiliation(s)
- Seth A Gale
- From the Department of Neurology (S.A.G.), Center for Brain/Mind Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (J.H.), the University of Michigan, Ann Arbor, MI; Institute for Memory Impairments and Neurological Disorders (J.G., Shirley Sirivong), University of California Irvine; Department of Neurology (J.G.-R.), Mayo Clinic, Rochester, MN; Department of Neurology (G.A.J.), Sanders-Brown Center on Aging, University of Kentucky, Lexington; Memory and Aging Program (W.M.), Butler Hospital; Division of Geriatric Psychiatry and Neuropsychiatry (M.N.), Department of Psychiatry, Johns Hopkins University School of Medicine; Brain Health and Memory Center (Susie Sami), University Hospitals, Cleveland Medical Center; Alzheimer's Therapeutic Research Institute (S.W.), University of Southern California; and University of Pennsylvania (J.K.), Departments of Medicine, Medical Ethics and Health Policy, and Neurology, Penn Memory Center.
| | - Judith Heidebrink
- From the Department of Neurology (S.A.G.), Center for Brain/Mind Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (J.H.), the University of Michigan, Ann Arbor, MI; Institute for Memory Impairments and Neurological Disorders (J.G., Shirley Sirivong), University of California Irvine; Department of Neurology (J.G.-R.), Mayo Clinic, Rochester, MN; Department of Neurology (G.A.J.), Sanders-Brown Center on Aging, University of Kentucky, Lexington; Memory and Aging Program (W.M.), Butler Hospital; Division of Geriatric Psychiatry and Neuropsychiatry (M.N.), Department of Psychiatry, Johns Hopkins University School of Medicine; Brain Health and Memory Center (Susie Sami), University Hospitals, Cleveland Medical Center; Alzheimer's Therapeutic Research Institute (S.W.), University of Southern California; and University of Pennsylvania (J.K.), Departments of Medicine, Medical Ethics and Health Policy, and Neurology, Penn Memory Center
| | - Joshua Grill
- From the Department of Neurology (S.A.G.), Center for Brain/Mind Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (J.H.), the University of Michigan, Ann Arbor, MI; Institute for Memory Impairments and Neurological Disorders (J.G., Shirley Sirivong), University of California Irvine; Department of Neurology (J.G.-R.), Mayo Clinic, Rochester, MN; Department of Neurology (G.A.J.), Sanders-Brown Center on Aging, University of Kentucky, Lexington; Memory and Aging Program (W.M.), Butler Hospital; Division of Geriatric Psychiatry and Neuropsychiatry (M.N.), Department of Psychiatry, Johns Hopkins University School of Medicine; Brain Health and Memory Center (Susie Sami), University Hospitals, Cleveland Medical Center; Alzheimer's Therapeutic Research Institute (S.W.), University of Southern California; and University of Pennsylvania (J.K.), Departments of Medicine, Medical Ethics and Health Policy, and Neurology, Penn Memory Center
| | - Jonathan Graff-Radford
- From the Department of Neurology (S.A.G.), Center for Brain/Mind Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (J.H.), the University of Michigan, Ann Arbor, MI; Institute for Memory Impairments and Neurological Disorders (J.G., Shirley Sirivong), University of California Irvine; Department of Neurology (J.G.-R.), Mayo Clinic, Rochester, MN; Department of Neurology (G.A.J.), Sanders-Brown Center on Aging, University of Kentucky, Lexington; Memory and Aging Program (W.M.), Butler Hospital; Division of Geriatric Psychiatry and Neuropsychiatry (M.N.), Department of Psychiatry, Johns Hopkins University School of Medicine; Brain Health and Memory Center (Susie Sami), University Hospitals, Cleveland Medical Center; Alzheimer's Therapeutic Research Institute (S.W.), University of Southern California; and University of Pennsylvania (J.K.), Departments of Medicine, Medical Ethics and Health Policy, and Neurology, Penn Memory Center
| | - Gregory A Jicha
- From the Department of Neurology (S.A.G.), Center for Brain/Mind Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (J.H.), the University of Michigan, Ann Arbor, MI; Institute for Memory Impairments and Neurological Disorders (J.G., Shirley Sirivong), University of California Irvine; Department of Neurology (J.G.-R.), Mayo Clinic, Rochester, MN; Department of Neurology (G.A.J.), Sanders-Brown Center on Aging, University of Kentucky, Lexington; Memory and Aging Program (W.M.), Butler Hospital; Division of Geriatric Psychiatry and Neuropsychiatry (M.N.), Department of Psychiatry, Johns Hopkins University School of Medicine; Brain Health and Memory Center (Susie Sami), University Hospitals, Cleveland Medical Center; Alzheimer's Therapeutic Research Institute (S.W.), University of Southern California; and University of Pennsylvania (J.K.), Departments of Medicine, Medical Ethics and Health Policy, and Neurology, Penn Memory Center
| | - William Menard
- From the Department of Neurology (S.A.G.), Center for Brain/Mind Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (J.H.), the University of Michigan, Ann Arbor, MI; Institute for Memory Impairments and Neurological Disorders (J.G., Shirley Sirivong), University of California Irvine; Department of Neurology (J.G.-R.), Mayo Clinic, Rochester, MN; Department of Neurology (G.A.J.), Sanders-Brown Center on Aging, University of Kentucky, Lexington; Memory and Aging Program (W.M.), Butler Hospital; Division of Geriatric Psychiatry and Neuropsychiatry (M.N.), Department of Psychiatry, Johns Hopkins University School of Medicine; Brain Health and Memory Center (Susie Sami), University Hospitals, Cleveland Medical Center; Alzheimer's Therapeutic Research Institute (S.W.), University of Southern California; and University of Pennsylvania (J.K.), Departments of Medicine, Medical Ethics and Health Policy, and Neurology, Penn Memory Center
| | - Milap Nowrangi
- From the Department of Neurology (S.A.G.), Center for Brain/Mind Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (J.H.), the University of Michigan, Ann Arbor, MI; Institute for Memory Impairments and Neurological Disorders (J.G., Shirley Sirivong), University of California Irvine; Department of Neurology (J.G.-R.), Mayo Clinic, Rochester, MN; Department of Neurology (G.A.J.), Sanders-Brown Center on Aging, University of Kentucky, Lexington; Memory and Aging Program (W.M.), Butler Hospital; Division of Geriatric Psychiatry and Neuropsychiatry (M.N.), Department of Psychiatry, Johns Hopkins University School of Medicine; Brain Health and Memory Center (Susie Sami), University Hospitals, Cleveland Medical Center; Alzheimer's Therapeutic Research Institute (S.W.), University of Southern California; and University of Pennsylvania (J.K.), Departments of Medicine, Medical Ethics and Health Policy, and Neurology, Penn Memory Center
| | - Susie Sami
- From the Department of Neurology (S.A.G.), Center for Brain/Mind Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (J.H.), the University of Michigan, Ann Arbor, MI; Institute for Memory Impairments and Neurological Disorders (J.G., Shirley Sirivong), University of California Irvine; Department of Neurology (J.G.-R.), Mayo Clinic, Rochester, MN; Department of Neurology (G.A.J.), Sanders-Brown Center on Aging, University of Kentucky, Lexington; Memory and Aging Program (W.M.), Butler Hospital; Division of Geriatric Psychiatry and Neuropsychiatry (M.N.), Department of Psychiatry, Johns Hopkins University School of Medicine; Brain Health and Memory Center (Susie Sami), University Hospitals, Cleveland Medical Center; Alzheimer's Therapeutic Research Institute (S.W.), University of Southern California; and University of Pennsylvania (J.K.), Departments of Medicine, Medical Ethics and Health Policy, and Neurology, Penn Memory Center
| | - Shirley Sirivong
- From the Department of Neurology (S.A.G.), Center for Brain/Mind Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (J.H.), the University of Michigan, Ann Arbor, MI; Institute for Memory Impairments and Neurological Disorders (J.G., Shirley Sirivong), University of California Irvine; Department of Neurology (J.G.-R.), Mayo Clinic, Rochester, MN; Department of Neurology (G.A.J.), Sanders-Brown Center on Aging, University of Kentucky, Lexington; Memory and Aging Program (W.M.), Butler Hospital; Division of Geriatric Psychiatry and Neuropsychiatry (M.N.), Department of Psychiatry, Johns Hopkins University School of Medicine; Brain Health and Memory Center (Susie Sami), University Hospitals, Cleveland Medical Center; Alzheimer's Therapeutic Research Institute (S.W.), University of Southern California; and University of Pennsylvania (J.K.), Departments of Medicine, Medical Ethics and Health Policy, and Neurology, Penn Memory Center
| | - Sarah Walter
- From the Department of Neurology (S.A.G.), Center for Brain/Mind Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (J.H.), the University of Michigan, Ann Arbor, MI; Institute for Memory Impairments and Neurological Disorders (J.G., Shirley Sirivong), University of California Irvine; Department of Neurology (J.G.-R.), Mayo Clinic, Rochester, MN; Department of Neurology (G.A.J.), Sanders-Brown Center on Aging, University of Kentucky, Lexington; Memory and Aging Program (W.M.), Butler Hospital; Division of Geriatric Psychiatry and Neuropsychiatry (M.N.), Department of Psychiatry, Johns Hopkins University School of Medicine; Brain Health and Memory Center (Susie Sami), University Hospitals, Cleveland Medical Center; Alzheimer's Therapeutic Research Institute (S.W.), University of Southern California; and University of Pennsylvania (J.K.), Departments of Medicine, Medical Ethics and Health Policy, and Neurology, Penn Memory Center
| | - Jason Karlawish
- From the Department of Neurology (S.A.G.), Center for Brain/Mind Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (J.H.), the University of Michigan, Ann Arbor, MI; Institute for Memory Impairments and Neurological Disorders (J.G., Shirley Sirivong), University of California Irvine; Department of Neurology (J.G.-R.), Mayo Clinic, Rochester, MN; Department of Neurology (G.A.J.), Sanders-Brown Center on Aging, University of Kentucky, Lexington; Memory and Aging Program (W.M.), Butler Hospital; Division of Geriatric Psychiatry and Neuropsychiatry (M.N.), Department of Psychiatry, Johns Hopkins University School of Medicine; Brain Health and Memory Center (Susie Sami), University Hospitals, Cleveland Medical Center; Alzheimer's Therapeutic Research Institute (S.W.), University of Southern California; and University of Pennsylvania (J.K.), Departments of Medicine, Medical Ethics and Health Policy, and Neurology, Penn Memory Center
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Piasecki J, Cheah PY. Ownership of individual-level health data, data sharing, and data governance. BMC Med Ethics 2022; 23:104. [PMID: 36309719 PMCID: PMC9617739 DOI: 10.1186/s12910-022-00848-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 10/24/2022] [Indexed: 12/03/2022] Open
Abstract
Background The ownership status of individual-level health data affects the manner in which it is used. In this paper we analyze two competing models of the ownership status of the data discussed in the literature recently: private ownership and public ownership. Main body In this paper we describe the limitations of these two models of data ownership with respect to individual-level health data, in particular in terms of ethical principles of justice and autonomy, risk mitigation, as well as technological, economic, and conceptual issues. We argue that undifferentiated application of neither private ownership nor public ownership will allow us to resolve all the problems associated with effective, equitable, and ethical use of data. We suggest that, instead of focusing on data ownership, we should focus on the institutional and procedural aspects of data governance, such as using Data Access Committees (DACs) or equivalent managed access processes, which can balance the elements of these two ownership frameworks. Conclusion Undifferentiated application of the ownership concept (private or public) is not helpful in resolving problems associated with sharing individual-level health data. DACs or equivalent managed access processes should be an integral part of data governance. They can approve or disapprove data access requests after considering the potential benefits and harms to data subjects, their communities, primary researchers, and the wider society.
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