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Schmit C, Ferdinand AO, Giannouchos T, Kum HC. Case study on communicating with research ethics committees about minimizing risk through software: an application for record linkage in secondary data analysis. JAMIA Open 2024; 7:ooae010. [PMID: 38425705 PMCID: PMC10903982 DOI: 10.1093/jamiaopen/ooae010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 12/22/2023] [Accepted: 01/20/2024] [Indexed: 03/02/2024] Open
Abstract
Objective In retrospective secondary data analysis studies, researchers often seek waiver of consent from institutional Review Boards (IRB) and minimize risk by utilizing complex software. Yet, little is known about the perspectives of IRB experts on these approaches. To facilitate effective communication about risk mitigation strategies using software, we conducted two studies with IRB experts to co-create appropriate language when describing a software to IRBs. Materials and Methods We conducted structured focus groups with IRB experts to solicit ideas on questions regarding benefits, risks, and informational needs. Based on these results, we developed a template IRB application and template responses for a generic study using privacy-enhancing software. We then conducted a three-round Delphi study to refine the template IRB application and the template responses based on expert panel feedback. To facilitate participants' deliberation, we shared the revisions and a summary of participants' feedback during each Delphi round. Results 11 experts in two focus groups generated 13 ideas on risks, benefits, and informational needs. 17 experts participated in the Delphi study with 13 completing all rounds. Most agreed that privacy-enhancing software will minimize risk, but regardless all secondary data studies have an inherent risk of unexpected disclosures. The majority (84.6%) noted that subjects in retrospective secondary data studies experience no greater risks than the risks experienced in ordinary life in the modern digital society. Hence, all retrospective data-only studies with no contact with subjects would be minimal risk studies. Conclusion First, we found fundamental disagreements in how some IRB experts view risks in secondary data research. Such disagreements are consequential because they can affect determination outcomes and might suggest IRBs at different institutions might come to different conclusions regarding similar study protocols. Second, the highest ranked risks and benefits of privacy-enhancing software in our study were societal rather than individual. The highest ranked benefits were facilitating more research and promoting responsible data governance practices. The highest ranked risks were risk of invalid results from systematic user error or erroneous algorithms. These societal considerations are typically more characteristic of public health ethics as opposed to the bioethical approach of research ethics, possibly reflecting the difficulty applying a bioethical approach (eg, informed consent) in secondary data studies. Finally, the development of privacy-enhancing technology for secondary data research depends on effective communication and collaboration between the privacy experts and technology developers. Privacy is a complex issue that requires a holistic approach that is best addressed through privacy-by-design principles. Privacy expert participation is important yet often neglected in this design process. This study suggests best practice strategies for engaging the privacy community through co-developing companion documents for software through participatory design to facilitate transparency and communication. In this case study, the final template IRB application and responses we released with the open-source software can be easily adapted by researchers to better communicate with their IRB when using the software. This can help increase responsible data governance practices when many software developers are not research ethics experts.
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Affiliation(s)
- Cason Schmit
- Population Informatics Lab, Texas A&M University, College Station, TX 77843, United States
- Department of Health Policy & Management, Texas A&M University, College Station, TX 77843, United States
| | - Alva O Ferdinand
- Department of Health Policy & Management, Texas A&M University, College Station, TX 77843, United States
| | - Theodoros Giannouchos
- Population Informatics Lab, Texas A&M University, College Station, TX 77843, United States
- Department of Health Policy & Organization, The University of Alabama at Birmingham, School of Public Health, Birmingham, AL 35233, United States
| | - Hye-Chung Kum
- Population Informatics Lab, Texas A&M University, College Station, TX 77843, United States
- Department of Health Policy & Management, Texas A&M University, College Station, TX 77843, United States
- Department of Computer Science and Engineering, Texas A&M University, College Station, TX 77843, United States
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Baines R, Stevens S, Austin D, Anil K, Bradwell H, Cooper L, Maramba ID, Chatterjee A, Leigh S. Patient and Public Willingness to Share Personal Health Data for Third-Party or Secondary Uses: Systematic Review. J Med Internet Res 2024; 26:e50421. [PMID: 38441944 PMCID: PMC10951832 DOI: 10.2196/50421] [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] [Received: 06/30/2023] [Revised: 12/01/2023] [Accepted: 12/18/2023] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND International advances in information communication, eHealth, and other digital health technologies have led to significant expansions in the collection and analysis of personal health data. However, following a series of high-profile data sharing scandals and the emergence of COVID-19, critical exploration of public willingness to share personal health data remains limited, particularly for third-party or secondary uses. OBJECTIVE This systematic review aims to explore factors that affect public willingness to share personal health data for third-party or secondary uses. METHODS A systematic search of 6 databases (MEDLINE, Embase, PsycINFO, CINAHL, Scopus, and SocINDEX) was conducted with review findings analyzed using inductive-thematic analysis and synthesized using a narrative approach. RESULTS Of the 13,949 papers identified, 135 were included. Factors most commonly identified as a barrier to data sharing from a public perspective included data privacy, security, and management concerns. Other factors found to influence willingness to share personal health data included the type of data being collected (ie, perceived sensitivity); the type of user requesting their data to be shared, including their perceived motivation, profit prioritization, and ability to directly impact patient care; trust in the data user, as well as in associated processes, often established through individual choice and control over what data are shared with whom, when, and for how long, supported by appropriate models of dynamic consent; the presence of a feedback loop; and clearly articulated benefits or issue relevance including valued incentivization and compensation at both an individual and collective or societal level. CONCLUSIONS There is general, yet conditional public support for sharing personal health data for third-party or secondary use. Clarity, transparency, and individual control over who has access to what data, when, and for how long are widely regarded as essential prerequisites for public data sharing support. Individual levels of control and choice need to operate within the auspices of assured data privacy and security processes, underpinned by dynamic and responsive models of consent that prioritize individual or collective benefits over and above commercial gain. Failure to understand, design, and refine data sharing approaches in response to changeable patient preferences will only jeopardize the tangible benefits of data sharing practices being fully realized.
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Affiliation(s)
- Rebecca Baines
- Centre for Health Technology, University of Plymouth, Plymouth, United Kingdom
| | - Sebastian Stevens
- Centre for Health Technology, University of Plymouth, Plymouth, United Kingdom
- Prometheus Health Technologies Ltd, Newquay, United Kingdom
| | - Daniela Austin
- Centre for Health Technology, University of Plymouth, Plymouth, United Kingdom
| | | | - Hannah Bradwell
- Centre for Health Technology, University of Plymouth, Plymouth, United Kingdom
| | - Leonie Cooper
- Centre for Health Technology, University of Plymouth, Plymouth, United Kingdom
| | | | - Arunangsu Chatterjee
- Centre for Health Technology, University of Plymouth, Plymouth, United Kingdom
- School of Medicine, University of Leeds, Leeds, United Kingdom
| | - Simon Leigh
- Prometheus Health Technologies Ltd, Newquay, United Kingdom
- Warwick Medical School, University of Warwick, Conventry, United Kingdom
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Lalova-Spinks T, Saesen R, Silva M, Geissler J, Shakhnenko I, Camaradou JC, Huys I. Patients' knowledge, preferences, and perspectives about data protection and data control: an exploratory survey. Front Pharmacol 2024; 14:1280173. [PMID: 38445168 PMCID: PMC10912650 DOI: 10.3389/fphar.2023.1280173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 12/26/2023] [Indexed: 03/07/2024] Open
Abstract
Background: In the European Union, the General Data Protection Regulation (GDPR) plays a central role in the complex health research legal framework. It aims to protect the fundamental right to the protection of individuals' personal data, while allowing the free movement of such data. However, it has been criticized for challenging the conduct of research. Existing scholarship has paid little attention to the experiences and views of the patient community. The aim of the study was to investigate 1) the awareness and knowledge of patients, carers, and members of patient organizations about the General Data Protection Regulation, 2) their experience with exercising data subject rights, and 3) their understanding of the notion of "data control" and preferences towards various data control tools. Methods: An online survey was disseminated between December 2022 and March 2023. Quantitative data was analyzed descriptively and inferentially. Answers to open-ended questions were analyzed using the thematic analysis method. Results: In total, 220 individuals from 28 European countries participated. The majority were patients (77%). Most participants had previously heard about the GDPR (90%) but had not exercised any of their data subject rights. Individual data control tools appeared to be marginally more important than collective tools. The willingness of participants to share personal data with data altruism organizations increased if patient representatives would be involved in the decision-making processes of such organizations. Conclusion: The results highlighted the importance of providing in-depth education about data protection. Although participants showed a slight preference towards individual control tools, the reflection based on existing scholarship identified that individual control holds risks that could be mitigated through carefully operationalized collective tools. The discussion of results was used to provide a critical view into the proposed European Health Data Space, which has yet to find a productive balance between individual control and allowing the reuse of personal data for research.
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Affiliation(s)
- Teodora Lalova-Spinks
- Clinical Pharmacology and Pharmacotherapy, Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium
- Center for IT & IP Law (CiTiP), KU Leuven, Leuven, Belgium
| | - Robbe Saesen
- Clinical Pharmacology and Pharmacotherapy, Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium
- European Organisation for Research and Treatment of Cancer (EORTC), Brussels, Belgium
| | | | | | - Iryna Shakhnenko
- European Organisation for Research and Treatment of Cancer (EORTC), Brussels, Belgium
| | | | - Isabelle Huys
- Clinical Pharmacology and Pharmacotherapy, Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium
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Braunack‐Mayer AJ, Adams C, Nettel‐Aguirre A, Fabrianesi B, Carolan L, Beilby J, Flack F. Community views on the secondary use of general practice data: Findings from a mixed-methods study. Health Expect 2024; 27:e13984. [PMID: 38361335 PMCID: PMC10869884 DOI: 10.1111/hex.13984] [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: 05/17/2023] [Revised: 09/29/2023] [Accepted: 01/23/2024] [Indexed: 02/17/2024] Open
Abstract
INTRODUCTION General practice data, particularly when combined with hospital and other health service data through data linkage, are increasingly being used for quality assurance, evaluation, health service planning and research. In this study, we explored community views on sharing general practice data for secondary purposes, including research, to establish what concerns and conditions need to be addressed in the process of developing a social licence to support such use. METHODS We used a mixed-methods approach with focus groups (November-December 2021), followed by a cross-sectional survey (March-April 2022). RESULTS The participants in this study strongly supported sharing general practice data with the clinicians responsible for their care, and where there were direct benefits for individual patients. Over 90% of survey participants (N = 2604) were willing to share their general practice information to directly support their health care, that is, for the primary purpose of collection. There was less support for sharing data for secondary purposes such as research and health service planning (36% and 45% respectively in broad agreement) or for linking general practice data to data in the education, social services and criminal justice systems (30%-36%). A substantial minority of participants were unsure or could not see how benefits would arise from sharing data for secondary purposes. Participants were concerned about the potential for privacy breaches, discrimination and data misuse and they wanted greater transparency and an opportunity to consent to data release. CONCLUSION The findings of this study suggest that the public may be more concerned about sharing general practice data for secondary purposes than they are about sharing data collected in other settings. Sharing general practice data more broadly will require careful attention to patient and public concerns, including focusing on the factors that will sustain trust and legitimacy in general practice and GPs. PATIENT AND PUBLIC CONTRIBUTION Members of the public were participants in the study. Data produced from their participation generated study findings. CLINICAL TRIAL REGISTRATION Not applicable.
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Affiliation(s)
- Annette J. Braunack‐Mayer
- Australian Centre for Health Engagement, Evidence and Values (ACHEEV), School of Health and Society, Faculty of the Arts, Social Sciences and HumanitiesUniversity of WollongongWollongongNew South WalesAustralia
- Australia Health Services Research InstituteUniversity of WollongongWollongongNew South WalesAustralia
| | - Carolyn Adams
- Macquarie Law SchoolMacquarie UniversitySydneyNew South WalesAustralia
| | - Alberto Nettel‐Aguirre
- National Institute for Applied Statistics Research AustraliaUniversity of WollongongWollongongNew South WalesAustralia
| | - Belinda Fabrianesi
- Australian Centre for Health Engagement, Evidence and Values (ACHEEV), School of Health and Society, Faculty of the Arts, Social Sciences and HumanitiesUniversity of WollongongWollongongNew South WalesAustralia
| | - Lucy Carolan
- Australian Centre for Health Engagement, Evidence and Values (ACHEEV), School of Health and Society, Faculty of the Arts, Social Sciences and HumanitiesUniversity of WollongongWollongongNew South WalesAustralia
| | - Justin Beilby
- School of Health and SocietyUniversity of WollongongWollongongNew South WalesAustralia
| | - Felicity Flack
- Population Health Research NetworkUniversity of Western AustraliaPerthWestern AustraliaAustralia
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Cervera de la Cruz P, Shabani M. Conceptualizing fairness in the secondary use of health data for research: A scoping review. Account Res 2023:1-30. [PMID: 37851101 DOI: 10.1080/08989621.2023.2271394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 10/12/2023] [Indexed: 10/19/2023]
Abstract
With the introduction of the European Health Data Space (EHDS), the secondary use of health data for research purposes is attracting more attention. Secondary health data processing promises to address novel research questions, inform the design of future research and improve healthcare delivery generally. To comply with the existing data protection regulations, the secondary data use must be fair, among other things. However, there is no clear understanding of what fairness means in the context of secondary use of health data for scientific research purposes. In response, we conducted a scoping review of argument-based literature to explore how fairness in the secondary use of health data has been conceptualized. A total of 35 publications were included in the final synthesis after abstract and full-text screening. Using an inductive approach and a thematic analysis, our review has revealed that balancing individual and public interests, reducing power asymmetries, setting conditions for commercial involvement, and implementing benefit sharing are essential to guarantee fair secondary use research. The findings of this review can inform current and future research practices and policy development to adequately address concerns about fairness in the secondary use of health data.
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Affiliation(s)
| | - Mahsa Shabani
- Metamedica, Faculty of Law and Criminology, University of Ghent, Ghent, Belgium
- Law Centre for Health and Life, Faculty of Law, University of Amsterdam, Amsterdam, The Netherlands
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Dahlberg M, Lek M, Malmqvist Castillo M, Bylund A, Hasson H, Riggare S, Reinius M, Wannheden C. Objectives and outcomes of patient-driven innovations published in peer-reviewed journals: a qualitative analysis of publications included in a scoping review. BMJ Open 2023; 13:e071363. [PMID: 37263703 PMCID: PMC10255190 DOI: 10.1136/bmjopen-2022-071363] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 05/20/2023] [Indexed: 06/03/2023] Open
Abstract
OBJECTIVES The aim of this study was to gain a deeper understanding of the objectives and outcomes of patient-driven innovations that have been published in the scientific literature, focusing on (A) the unmet needs that patient-driven innovations address and (B) the outcomes for patients and healthcare that have been reported. METHODS We performed an inductive qualitative content analysis of scientific publications that were included in a scoping review of patient-driven innovations, previously published by our research group. The review was limited to English language publications in peer-reviewed journals, published in the years 2008-2020. RESULTS In total, 83 publications covering 21 patient-driven innovations were included in the analysis. Most of the innovations were developed for use on an individual or community level without healthcare involvement. We created three categories of unmet needs that were addressed by these innovations: access to self-care support tools, open sharing of information and knowledge, and patient agency in self-care and healthcare decisions. Eighteen (22%) publications reported outcomes of patient-driven innovations. We created two categories of outcomes: impact on self-care, and impact on peer interaction and healthcare collaboration. CONCLUSIONS The patient-driven innovations illustrated a diversity of innovative approaches to facilitate patients' and informal caregivers' daily lives, interactions with peers and collaborations with healthcare. As our findings indicate, patients and informal caregivers are central stakeholders in driving healthcare development and research forward to meet the needs that matter to patients and informal caregivers. However, only few studies reported on outcomes of patient-driven innovations. To support wider implementation, more evaluation studies are needed, as well as research into regulatory approval processes, dissemination and governance of patient-driven innovations.
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Affiliation(s)
- Marie Dahlberg
- Department of Learning, Informatics, Management and Ethics, Karolinska Institute, Stockholm, Sweden
| | - Madelen Lek
- Department of Learning, Informatics, Management and Ethics, Karolinska Institute, Stockholm, Sweden
| | - Moa Malmqvist Castillo
- Department of Learning, Informatics, Management and Ethics, Karolinska Institute, Stockholm, Sweden
| | - Ami Bylund
- Department of Learning, Informatics, Management and Ethics, Karolinska Institute, Stockholm, Sweden
| | - Henna Hasson
- Department of Learning, Informatics, Management and Ethics, Karolinska Institute, Stockholm, Sweden
- Unit for Implementation and Evaluation, Center for Epidemiology and Community Medicine, Region Stockholm, Stockholms Lans Landsting, Stockholm, Sweden
| | - Sara Riggare
- Participatory eHealth and Health Data, Department of Women's and Children's Health, Uppsala Universitet, Uppsala, Sweden
| | - Maria Reinius
- Department of Learning, Informatics, Management and Ethics, Karolinska Institute, Stockholm, Sweden
| | - Carolina Wannheden
- Department of Learning, Informatics, Management and Ethics, Karolinska Institute, Stockholm, Sweden
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Cumyn A, Ménard JF, Barton A, Dault R, Lévesque F, Ethier JF. Patients and Members of the Public’s Wishes Regarding Transparency in the Context of Secondary Use of Health Data: A Scoping Review (Preprint). J Med Internet Res 2022; 25:e45002. [PMID: 37052967 PMCID: PMC10141314 DOI: 10.2196/45002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 02/09/2023] [Accepted: 03/03/2023] [Indexed: 03/06/2023] Open
Abstract
BACKGROUND Secondary use of health data has reached unequaled potential to improve health systems governance, knowledge, and clinical care. Transparency regarding this secondary use is frequently cited as necessary to address deficits in trust and conditional support and to increase patient awareness. OBJECTIVE We aimed to review the current published literature to identify different stakeholders' perspectives and recommendations on what information patients and members of the public want to learn about the secondary use of health data for research purposes and how and in which situations. METHODS Using PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines, we conducted a scoping review using Medline, CINAHL, PsycINFO, Scopus, Cochrane Library, and PubMed databases to locate a broad range of studies published in English or French until November 2022. We included articles reporting a stakeholder's perspective or recommendations of what information patients and members of the public want to learn about the secondary use of health data for research purposes and how or in which situations. Data were collected and analyzed with an iterative thematic approach using NVivo. RESULTS Overall, 178 articles were included in this scoping review. The type of information can be divided into generic and specific content. Generic content includes information on governance and regulatory frameworks, technical aspects, and scientific aims. Specific content includes updates on the use of one's data, return of results from individual tests, information on global results, information on data sharing, and how to access one's data. Recommendations on how to communicate the information focused on frequency, use of various supports, formats, and wording. Methods for communication generally favored broad approaches such as nationwide publicity campaigns, mainstream and social media for generic content, and mixed approaches for specific content including websites, patient portals, and face-to-face encounters. Content should be tailored to the individual as much as possible with regard to length, avoidance of technical terms, cultural competence, and level of detail. Finally, the review outlined 4 major situations where communication was deemed necessary: before a new use of data, when new test results became available, when global research results were released, and in the advent of a breach in confidentiality. CONCLUSIONS This review highlights how different types of information and approaches to communication efforts may serve as the basis for achieving greater transparency. Governing bodies could use the results: to elaborate or evaluate strategies to educate on the potential benefits; to provide some knowledge and control over data use as a form of reciprocity; and as a condition to engage citizens and build and maintain trust. Future work is needed to assess which strategies achieve the greatest outreach while striking a balance between meeting information needs and use of resources.
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Affiliation(s)
- Annabelle Cumyn
- Département de médecine, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada
- Groupe de recherche interdisciplinaire en informatique de la santé, Faculté des sciences/Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Jean-Frédéric Ménard
- Groupe de recherche interdisciplinaire en informatique de la santé, Faculté des sciences/Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada
- Faculté de droit, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Adrien Barton
- Groupe de recherche interdisciplinaire en informatique de la santé, Faculté des sciences/Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada
- Institut de recherche en informatique de Toulouse, Toulouse, France
| | - Roxanne Dault
- Groupe de recherche interdisciplinaire en informatique de la santé, Faculté des sciences/Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Frédérique Lévesque
- Groupe de recherche interdisciplinaire en informatique de la santé, Faculté des sciences/Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Jean-François Ethier
- Département de médecine, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada
- Groupe de recherche interdisciplinaire en informatique de la santé, Faculté des sciences/Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada
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Bakken V, Koposov R, Røst TB, Clausen C, Nytrø Ø, Leventhal B, Westbye OS, Koochakpour K, Mandahl A, Hafstad H, Skokauskas N. Attitudes of Mental Health Service Users Toward Storage and Use of Electronic Health Records. Psychiatr Serv 2022; 73:1013-1018. [PMID: 35291817 DOI: 10.1176/appi.ps.202100477] [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] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Electronic health records (EHRs) are used for both clinical practice and research. Because mental health service users' views are underrepresented in perspectives on EHR use, the authors examined service users' awareness, attitudes, and opinions about EHR data storage and sharing. METHODS A mixed-methods, cross-sectional design was used to examine attitudes of 253 Norwegian mental health service users who were recruited online to complete a quantitative and qualitative (free-text) survey about EHR utilization. RESULTS Most participants were aware that EHRs were stored (95%) and shared (58%). Most thought that patients benefited from EHR storage (84%), trusted authorities with EHR sharing (71%), were willing to share their EHRs to help others (75%), felt they benefited from EHR sharing (75%), and thought EHR sharing was ethical for health care and research (71%). Fewer were aware of EHR sharing for research (36%), and 62% were aware that shared data were anonymized. Of the participants, 69% recognized privacy risks associated with sharing. Lack of transparency and skepticism about anonymization and misuse of EHR data were concerns and perceived risks. Mental health service users thought that EHRs should be shared for policy development (81%), education and training (85%), improving care quality (89%), research (91%), and clinical decision support (81%). CONCLUSIONS Participants were aware of and supported EHR sharing for research and clinical care. They supported sharing to help others and were willing to fully participate in clinical care and research, as well as to share EHR information for their own care, research, and the care of others.
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Affiliation(s)
- Victoria Bakken
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU) Central Norway, Department of Mental Health, Faculty of Medicine and Health Sciences (Bakken, Clausen, Westbye, Skokauskas), and Department of Computer Science (Nytrø, Koochakpour), Norwegian University of Science and Technology, Trondheim, Norway; RKBU Northern Norway, Arctic University of Norway, Tromsø (Koposov); Sechenov First Moscow State Medical University, Moscow (Koposov); Vivit AS, Trondheim, Norway (Røst); Department of Psychiatry, Division of Child and Adolescent Psychiatry, University of California, San Francisco (Leventhal); Department of Child and Adolescent Psychiatry, St. Olav's University Hospital, Trondheim, Norway (Westbye); Vårres Regional User-Controlled Center of Central Norway, Trondheim, Norway (Mandahl, Hafstad)
| | - Roman Koposov
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU) Central Norway, Department of Mental Health, Faculty of Medicine and Health Sciences (Bakken, Clausen, Westbye, Skokauskas), and Department of Computer Science (Nytrø, Koochakpour), Norwegian University of Science and Technology, Trondheim, Norway; RKBU Northern Norway, Arctic University of Norway, Tromsø (Koposov); Sechenov First Moscow State Medical University, Moscow (Koposov); Vivit AS, Trondheim, Norway (Røst); Department of Psychiatry, Division of Child and Adolescent Psychiatry, University of California, San Francisco (Leventhal); Department of Child and Adolescent Psychiatry, St. Olav's University Hospital, Trondheim, Norway (Westbye); Vårres Regional User-Controlled Center of Central Norway, Trondheim, Norway (Mandahl, Hafstad)
| | - Thomas Brox Røst
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU) Central Norway, Department of Mental Health, Faculty of Medicine and Health Sciences (Bakken, Clausen, Westbye, Skokauskas), and Department of Computer Science (Nytrø, Koochakpour), Norwegian University of Science and Technology, Trondheim, Norway; RKBU Northern Norway, Arctic University of Norway, Tromsø (Koposov); Sechenov First Moscow State Medical University, Moscow (Koposov); Vivit AS, Trondheim, Norway (Røst); Department of Psychiatry, Division of Child and Adolescent Psychiatry, University of California, San Francisco (Leventhal); Department of Child and Adolescent Psychiatry, St. Olav's University Hospital, Trondheim, Norway (Westbye); Vårres Regional User-Controlled Center of Central Norway, Trondheim, Norway (Mandahl, Hafstad)
| | - Carolyn Clausen
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU) Central Norway, Department of Mental Health, Faculty of Medicine and Health Sciences (Bakken, Clausen, Westbye, Skokauskas), and Department of Computer Science (Nytrø, Koochakpour), Norwegian University of Science and Technology, Trondheim, Norway; RKBU Northern Norway, Arctic University of Norway, Tromsø (Koposov); Sechenov First Moscow State Medical University, Moscow (Koposov); Vivit AS, Trondheim, Norway (Røst); Department of Psychiatry, Division of Child and Adolescent Psychiatry, University of California, San Francisco (Leventhal); Department of Child and Adolescent Psychiatry, St. Olav's University Hospital, Trondheim, Norway (Westbye); Vårres Regional User-Controlled Center of Central Norway, Trondheim, Norway (Mandahl, Hafstad)
| | - Øystein Nytrø
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU) Central Norway, Department of Mental Health, Faculty of Medicine and Health Sciences (Bakken, Clausen, Westbye, Skokauskas), and Department of Computer Science (Nytrø, Koochakpour), Norwegian University of Science and Technology, Trondheim, Norway; RKBU Northern Norway, Arctic University of Norway, Tromsø (Koposov); Sechenov First Moscow State Medical University, Moscow (Koposov); Vivit AS, Trondheim, Norway (Røst); Department of Psychiatry, Division of Child and Adolescent Psychiatry, University of California, San Francisco (Leventhal); Department of Child and Adolescent Psychiatry, St. Olav's University Hospital, Trondheim, Norway (Westbye); Vårres Regional User-Controlled Center of Central Norway, Trondheim, Norway (Mandahl, Hafstad)
| | - Bennett Leventhal
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU) Central Norway, Department of Mental Health, Faculty of Medicine and Health Sciences (Bakken, Clausen, Westbye, Skokauskas), and Department of Computer Science (Nytrø, Koochakpour), Norwegian University of Science and Technology, Trondheim, Norway; RKBU Northern Norway, Arctic University of Norway, Tromsø (Koposov); Sechenov First Moscow State Medical University, Moscow (Koposov); Vivit AS, Trondheim, Norway (Røst); Department of Psychiatry, Division of Child and Adolescent Psychiatry, University of California, San Francisco (Leventhal); Department of Child and Adolescent Psychiatry, St. Olav's University Hospital, Trondheim, Norway (Westbye); Vårres Regional User-Controlled Center of Central Norway, Trondheim, Norway (Mandahl, Hafstad)
| | - Odd Sverre Westbye
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU) Central Norway, Department of Mental Health, Faculty of Medicine and Health Sciences (Bakken, Clausen, Westbye, Skokauskas), and Department of Computer Science (Nytrø, Koochakpour), Norwegian University of Science and Technology, Trondheim, Norway; RKBU Northern Norway, Arctic University of Norway, Tromsø (Koposov); Sechenov First Moscow State Medical University, Moscow (Koposov); Vivit AS, Trondheim, Norway (Røst); Department of Psychiatry, Division of Child and Adolescent Psychiatry, University of California, San Francisco (Leventhal); Department of Child and Adolescent Psychiatry, St. Olav's University Hospital, Trondheim, Norway (Westbye); Vårres Regional User-Controlled Center of Central Norway, Trondheim, Norway (Mandahl, Hafstad)
| | - Kaban Koochakpour
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU) Central Norway, Department of Mental Health, Faculty of Medicine and Health Sciences (Bakken, Clausen, Westbye, Skokauskas), and Department of Computer Science (Nytrø, Koochakpour), Norwegian University of Science and Technology, Trondheim, Norway; RKBU Northern Norway, Arctic University of Norway, Tromsø (Koposov); Sechenov First Moscow State Medical University, Moscow (Koposov); Vivit AS, Trondheim, Norway (Røst); Department of Psychiatry, Division of Child and Adolescent Psychiatry, University of California, San Francisco (Leventhal); Department of Child and Adolescent Psychiatry, St. Olav's University Hospital, Trondheim, Norway (Westbye); Vårres Regional User-Controlled Center of Central Norway, Trondheim, Norway (Mandahl, Hafstad)
| | - Arthur Mandahl
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU) Central Norway, Department of Mental Health, Faculty of Medicine and Health Sciences (Bakken, Clausen, Westbye, Skokauskas), and Department of Computer Science (Nytrø, Koochakpour), Norwegian University of Science and Technology, Trondheim, Norway; RKBU Northern Norway, Arctic University of Norway, Tromsø (Koposov); Sechenov First Moscow State Medical University, Moscow (Koposov); Vivit AS, Trondheim, Norway (Røst); Department of Psychiatry, Division of Child and Adolescent Psychiatry, University of California, San Francisco (Leventhal); Department of Child and Adolescent Psychiatry, St. Olav's University Hospital, Trondheim, Norway (Westbye); Vårres Regional User-Controlled Center of Central Norway, Trondheim, Norway (Mandahl, Hafstad)
| | - Hege Hafstad
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU) Central Norway, Department of Mental Health, Faculty of Medicine and Health Sciences (Bakken, Clausen, Westbye, Skokauskas), and Department of Computer Science (Nytrø, Koochakpour), Norwegian University of Science and Technology, Trondheim, Norway; RKBU Northern Norway, Arctic University of Norway, Tromsø (Koposov); Sechenov First Moscow State Medical University, Moscow (Koposov); Vivit AS, Trondheim, Norway (Røst); Department of Psychiatry, Division of Child and Adolescent Psychiatry, University of California, San Francisco (Leventhal); Department of Child and Adolescent Psychiatry, St. Olav's University Hospital, Trondheim, Norway (Westbye); Vårres Regional User-Controlled Center of Central Norway, Trondheim, Norway (Mandahl, Hafstad)
| | - Norbert Skokauskas
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU) Central Norway, Department of Mental Health, Faculty of Medicine and Health Sciences (Bakken, Clausen, Westbye, Skokauskas), and Department of Computer Science (Nytrø, Koochakpour), Norwegian University of Science and Technology, Trondheim, Norway; RKBU Northern Norway, Arctic University of Norway, Tromsø (Koposov); Sechenov First Moscow State Medical University, Moscow (Koposov); Vivit AS, Trondheim, Norway (Røst); Department of Psychiatry, Division of Child and Adolescent Psychiatry, University of California, San Francisco (Leventhal); Department of Child and Adolescent Psychiatry, St. Olav's University Hospital, Trondheim, Norway (Westbye); Vårres Regional User-Controlled Center of Central Norway, Trondheim, Norway (Mandahl, Hafstad)
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Building from Patient Experiences to Deliver Patient-Focused Healthcare Systems in Collaboration with Patients: A Call to Action. Ther Innov Regul Sci 2022; 56:848-858. [PMID: 35854183 PMCID: PMC9356929 DOI: 10.1007/s43441-022-00432-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 06/30/2022] [Indexed: 11/03/2022]
Abstract
Patients’ experiences of their diagnosis, condition, and treatment (including the impact on their lives), and their experiences surrounding expectations of care, are becoming increasingly important in shaping healthcare systems that meet the evolving needs and priorities of different patient communities over time; this is an ongoing goal of all healthcare stakeholders. Current approaches that capture patient experiences with data are fragmented, resulting in duplication of effort, numerous requests for information, and increased patient burden. Application of patient experience data to inform healthcare decisions is still emerging and there remains an opportunity to align diverse stakeholders on the value of these data to strengthen healthcare systems. Given the collective value of understanding patient experiences across multiple stakeholder groups, we propose a more aligned approach to the collection of patient experience data. This approach is built on the principle that the patients’ experiences are the starting point, and not just something to be considered at the end of the process. It must also be based on meaningful patient engagement, where patients are collaborators and decision makers at each step, thereby ensuring their needs and priorities are accurately reflected. The resulting data and evidence should be made available for all stakeholders, to inform their decision making and healthcare strategies in ways that meet patient priorities. We call for multi-stakeholder collaboration that will deliver healthcare systems and interventions that are better centered around and tailored to patient experiences, and that will help address patients’ unmet needs.
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10
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Pavarini G, Yosifova A, Wang K, Wilcox B, Tomat N, Lorimer J, Kariyawasam L, George L, Alí S, Singh I. Data sharing in the age of predictive psychiatry: an adolescent perspective. EVIDENCE-BASED MENTAL HEALTH 2022; 25:69-76. [PMID: 35346984 PMCID: PMC9046833 DOI: 10.1136/ebmental-2021-300329] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 01/10/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Advances in genetics and digital phenotyping in psychiatry have given rise to testing services targeting young people, which claim to predict psychiatric outcomes before difficulties emerge. These services raise several ethical challenges surrounding data sharing and information privacy. OBJECTIVES This study aimed to investigate young people's interest in predictive testing for mental health challenges and their attitudes towards sharing biological, psychosocial and digital data for such purpose. METHODS Eighty UK adolescents aged 16-18 years took part in a digital role-play where they played the role of clients of a fictional predictive psychiatry company and chose what sources of personal data they wished to provide for a risk assessment. After the role-play, participants reflected on their choices during a peer-led interview. FINDINGS Participants saw multiple benefits in predictive testing services, but were highly selective with regard to the type of data they were willing to share. Largely due to privacy concerns, digital data sources such as social media or Google search history were less likely to be shared than psychosocial and biological data, including school grades and one's DNA. Participants were particularly reluctant to share social media data with schools (but less so with health systems). CONCLUSIONS Emerging predictive psychiatric services are valued by young people; however, these services must consider privacy versus utility trade-offs from the perspective of different stakeholders, including adolescents. CLINICAL IMPLICATIONS Respecting adolescents' need for transparency, privacy and choice in the age of digital phenotyping is critical to the responsible implementation of predictive psychiatric services.
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Affiliation(s)
- Gabriela Pavarini
- Department of Psychiatry, University of Oxford, Oxford, UK
- Wellcome Centre for Ethics and Humanities, University of Oxford, Oxford, Oxfordshire, UK
- Ethox Centre, Department of Population Health, University of Oxford, Oxford, UK
| | - Aleksandra Yosifova
- Department of Cognitive Science and Psychology, New Bulgarian University, Sofia, Bulgaria
| | - Keying Wang
- Institute of Cognitive Neuroscience, University College London, London, UK
| | - Benjamin Wilcox
- Department of Neuroscience, University of Sheffield, Sheffield, UK
| | - Nastja Tomat
- Department of Philosophy, Faculty of Arts, University of Ljubljana, Ljubljana, Slovenia
| | - Jessica Lorimer
- Department of Psychiatry, University of Oxford, Oxford, UK
- Wellcome Centre for Ethics and Humanities, University of Oxford, Oxford, Oxfordshire, UK
| | | | - Leya George
- Division of Psychology & Language Sciences, University College London, London, UK
| | - Sonia Alí
- Department of Psychology, University of Sussex, Brighton, UK
| | - Ilina Singh
- Department of Psychiatry, University of Oxford, Oxford, UK
- Wellcome Centre for Ethics and Humanities, University of Oxford, Oxford, Oxfordshire, UK
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11
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McCormick JB, Hopkins M, Lehman EB, Green MJ. Mining the Data: Exploring Rural Patients' Attitudes about the Use of Their Personal Information in Research. AJOB Empir Bioeth 2022; 13:89-106. [PMID: 35271430 PMCID: PMC10038193 DOI: 10.1080/23294515.2022.2040644] [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] [Indexed: 10/18/2022]
Abstract
BACKGROUND This study examines rural patients' perceived importance of knowing or being consulted about researchers' access and use of their personal data (identifiable and de-identified health information, and identifiable and de-identified non-health information) across five scenarios. This study also examines their views on stewardship or governance of their personal information by researchers in their healthcare systems. METHODS We conducted a survey by mail. Data were analyzed using descriptive statistics. Multivariable regression analyses were conducted across each scenario and type of personal data with the same variables included in each model. RESULTS The majority of participants said it was "very important/absolutely essential" to know the purpose of the study, to be asked every time, and to know the policies governing researcher access and use of their identifiable health information. Just over two-thirds of respondents thought it "very important/absolutely essential" to know who serves on the data governance committee and to have a community member serve. Distrust in healthcare organizations was positively correlated with the scenarios while willingness to give permission to donate leftover biological specimens was negatively correlated. CONCLUSION Our study findings indicate that the type of personal information being accessed and used generally matters to 1,407 patients living in rural Pennsylvania. We also demonstrate that knowing their healthcare organizations' governance policies and practices for managing their personal data is important to many rural Pennsylvania patients. Biomedical researchers need to recognize and attend to those differences as much as possible in order to expand opportunities for and participation in research by residents of these rural communities. Supplemental data for this article is available online at.
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Affiliation(s)
- Jennifer B McCormick
- Department of Humanities, Pennsylvania State University College of Medicine, Hershey, PA, USA
| | - Margaret Hopkins
- Department of Humanities, Pennsylvania State University College of Medicine, Hershey, PA, USA
| | - Erik B Lehman
- Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, PA, USA
| | - Michael J Green
- Department of Humanities, Pennsylvania State University College of Medicine, Hershey, PA, USA
- Department of Medicine, Pennsylvania State University College of Medicine, Hershey, PA, USA
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12
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Jordanian views regarding sharing of medical data for research: A cross-sectional study during COVID-19 pandemic. PLoS One 2022; 17:e0265695. [PMID: 35312726 PMCID: PMC8936458 DOI: 10.1371/journal.pone.0265695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Accepted: 03/06/2022] [Indexed: 02/03/2023] Open
Abstract
PURPOSE In the current study, the views of Jordanian regarding sharing medical reports for research purposes were investigated during the COVID-19 pandemic. In addition, motivators and barriers regarding sharing of medical records were examined. METHODS This observational survey-based cross-sectional study was conducted using an electronic questionnaire during the COVID-19 pandemic (second half of 2020). The questionnaire link was disseminated through two social media platforms (WhatsApp and Facebook), targeting Jordanian adults (age >18 years). RESULTS In this study, 1,194 participants agreed to complete the study survey. Results showed that 58.3% of them (n = 696) reported to be willing to share their medical data. while 17.6% of the participants (n = 210) showed hesitancy to share their medical information. The most important motivators as perceived by the study participants were helping other patients who have similar health conditions (n = 995, 83.3%). Moreover, fearing from stigma (n = 753, 63.1%), and the lack of confidence in data security and privacy (n = 728, 61.0%) were among the main barriers preventing participants from sharing their information. Finally, results showed that participants with higher educational level (bachelor or higher) (OR = 0.299, P<0.001), or those living in center of Jordan (OR = 0.270, P<0.001) showed a lower tendency to share their medical data. While participants those who have shared data before showed a higher tendency to share their medical data (OR = 2.524, P<0.001). CONCLUSION In this study, many of the participants had a positive attitude towards sharing biomedical data for scientific research during the COVID-19 pandemic, many had doubts in the control over their data. Thus, policymakers and data users should address the concerns and values of patients and understand their preferences in favor of an ethically scrupulous use of data in research.
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13
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Igumbor JO, Bosire EN, Vicente-Crespo M, Igumbor EU, Olalekan UA, Chirwa TF, Kinyanjui SM, Kyobutungi C, Fonn S. Considerations for an integrated population health databank in Africa: lessons from global best practices. Wellcome Open Res 2022; 6:214. [PMID: 35224211 PMCID: PMC8844538 DOI: 10.12688/wellcomeopenres.17000.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2021] [Indexed: 12/17/2022] Open
Abstract
Background: The rising digitisation and proliferation of data sources and repositories cannot be ignored. This trend expands opportunities to integrate and share population health data. Such platforms have many benefits, including the potential to efficiently translate information arising from such data to evidence needed to address complex global health challenges. There are pockets of quality data on the continent that may benefit from greater integration. Integration of data sources is however under-explored in Africa. The aim of this article is to identify the requirements and provide practical recommendations for developing a multi-consortia public and population health data-sharing framework for Africa. Methods: We conducted a narrative review of global best practices and policies on data sharing and its optimisation. We searched eight databases for publications and undertook an iterative snowballing search of articles cited in the identified publications. The Leximancer software
© enabled content analysis and selection of a sample of the most relevant articles for detailed review. Themes were developed through immersion in the extracts of selected articles using inductive thematic analysis. We also performed interviews with public and population health stakeholders in Africa to gather their experiences, perceptions, and expectations of data sharing. Results: Our findings described global stakeholder experiences on research data sharing. We identified some challenges and measures to harness available resources and incentivise data sharing. We further highlight progress made by the different groups in Africa and identified the infrastructural requirements and considerations when implementing data sharing platforms. Furthermore, the review suggests key reforms required, particularly in the areas of consenting, privacy protection, data ownership, governance, and data access. Conclusions: The findings underscore the critical role of inclusion, social justice, public good, data security, accountability, legislation, reciprocity, and mutual respect in developing a responsive, ethical, durable, and integrated research data sharing ecosystem.
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Affiliation(s)
- Jude O Igumbor
- School of Public Health, University of the Witwatersrand, Johannesburg, Gauteng, 2193, South Africa
| | - Edna N Bosire
- School of Public Health, University of the Witwatersrand, Johannesburg, Gauteng, 2193, South Africa
| | - Marta Vicente-Crespo
- School of Public Health, University of the Witwatersrand, Johannesburg, Gauteng, 2193, South Africa.,African Population and Health Research Centre, Nairobi, Kenya
| | - Ehimario U Igumbor
- Nigeria Centre for Disease Control, Abuja, Nigeria.,School of Public Health, University of the Western Cape, Cape Town, Western Cape, South Africa
| | - Uthman A Olalekan
- Warwick-Centre for Applied Health Research and Delivery (WCAHRD), Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Tobias F Chirwa
- School of Public Health, University of the Witwatersrand, Johannesburg, Gauteng, 2193, South Africa
| | | | | | - Sharon Fonn
- School of Public Health, University of the Witwatersrand, Johannesburg, Gauteng, 2193, South Africa
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Reinius M, Mazzocato P, Riggare S, Bylund A, Jansson H, Øvretveit J, Savage C, Wannheden C, Hasson H. Patient-driven innovations reported in peer-reviewed journals: a scoping review. BMJ Open 2022; 12:e053735. [PMID: 35074818 PMCID: PMC8788234 DOI: 10.1136/bmjopen-2021-053735] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 12/03/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Awareness of patients' innovative capabilities is increasing, but there is limited knowledge regarding the extent and nature of patient-driven innovations in the peer-reviewed literature. OBJECTIVES The objective of the review was to answer the question: what is the nature and extent of patient-driven innovations published in peer-reviewed scientific journals? ELIGIBILITY CRITERIA We used a broad definition of innovation to allow for a comprehensive review of different types of innovations and a narrow definition of 'patient driven' to focus on the role of patients and/or family caregivers. The search was limited to years 2008-2020. SOURCES OF EVIDENCE Four electronic databases (Medline (Ovid), Web of Science Core Collection, PsycINFO (Ovid) and Cinahl (Ebsco)) were searched in December 2020 for publications describing patient-driven innovations and complemented with snowball strategies. CHARTING METHODS Data from the included articles were extracted and categorised inductively. RESULTS A total of 96 articles on 20 patient-driven innovations were included. The number of publications increased over time, with 69% of the articles published between 2016 and 2020. Author affiliations were exclusively in high income countries with 56% of first authors in North America and 36% in European countries. Among the 20 innovations reported, 'Do-It-Yourself Artificial Pancreas System' and the online health network 'PatientsLikeMe', were the subject of half of the articles. CONCLUSIONS Peer-reviewed publications on patient-driven innovations are increasing and we see an important opportunity for researchers and clinicians to support patient innovators' research while being mindful of taking over the work of the innovators themselves.
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Affiliation(s)
- Maria Reinius
- Department of Learning, Informatics, Management and Ethics, Medical Management Centre, Karolinska Institutet, Stockholm, Sweden
| | - Pamela Mazzocato
- Department of Learning, Informatics, Management and Ethics, Medical Management Centre, Karolinska Institutet, Stockholm, Sweden
| | - Sara Riggare
- Department of Women's and Children's Health, Healthcare Sciences and E-Health, Uppsala University, Uppsala, Sweden
| | - Ami Bylund
- Department of Learning, Informatics, Management and Ethics, Medical Management Centre, Karolinska Institutet, Stockholm, Sweden
| | - Hanna Jansson
- Department of Learning, Informatics, Management and Ethics, Medical Management Centre, Karolinska Institutet, Stockholm, Sweden
| | - John Øvretveit
- Department of Learning, Informatics, Management and Ethics, Medical Management Centre, Karolinska Institutet, Stockholm, Sweden
- Department of Research Development and Education, Region Stockholm, Stockholm, Sweden
| | - Carl Savage
- Department of Learning, Informatics, Management and Ethics, Medical Management Centre, Karolinska Institutet, Stockholm, Sweden
| | - Carolina Wannheden
- Department of Learning, Informatics, Management and Ethics, Medical Management Centre, Karolinska Institutet, Stockholm, Sweden
| | - Henna Hasson
- Department of Learning, Informatics, Management and Ethics, Medical Management Centre, Karolinska Institutet, Stockholm, Sweden
- Unit for Implementation and Evaluation, Center for Epidemiology and Community Medicine, Region Stockholm, Stockholm, Sweden
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15
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Kalkman S, van Delden J, Banerjee A, Tyl B, Mostert M, van Thiel G. Patients' and public views and attitudes towards the sharing of health data for research: a narrative review of the empirical evidence. JOURNAL OF MEDICAL ETHICS 2022; 48:3-13. [PMID: 31719155 PMCID: PMC8717474 DOI: 10.1136/medethics-2019-105651] [Citation(s) in RCA: 84] [Impact Index Per Article: 42.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 10/24/2019] [Accepted: 10/28/2019] [Indexed: 05/12/2023]
Abstract
INTRODUCTION International sharing of health data opens the door to the study of the so-called 'Big Data', which holds great promise for improving patient-centred care. Failure of recent data sharing initiatives indicates an urgent need to invest in societal trust in researchers and institutions. Key to an informed understanding of such a 'social license' is identifying the views patients and the public may hold with regard to data sharing for health research. METHODS We performed a narrative review of the empirical evidence addressing patients' and public views and attitudes towards the use of health data for research purposes. The literature databases PubMed (MEDLINE), Embase, Scopus and Google Scholar were searched in April 2019 to identify relevant publications. Patients' and public attitudes were extracted from selected references and thematically categorised. RESULTS Twenty-seven papers were included for review, including both qualitative and quantitative studies and systematic reviews. Results suggest widespread-though conditional-support among patients and the public for data sharing for health research. Despite the fact that participants recognise actual or potential benefits of data research, they expressed concerns about breaches of confidentiality and potential abuses of the data. Studies showed agreement on the following conditions: value, privacy, risk minimisation, data security, transparency, control, information, trust, responsibility and accountability. CONCLUSIONS Our results indicate that a social license for data-intensive health research cannot simply be presumed. To strengthen the social license, identified conditions ought to be operationalised in a governance framework that incorporates the diverse patient and public values, needs and interests.
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Affiliation(s)
- Shona Kalkman
- Department of Medical Humanities, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Johannes van Delden
- Department of Medical Humanities, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Amitava Banerjee
- Farr Institute of Health Informatics Research, University College London, London, UK
| | - Benoît Tyl
- Cardiovascular Center for Therapeutic Innovation, Institut de Recherches Internationales Servier, Suresnes, France
| | - Menno Mostert
- Julius Center for Health Sciences and Primary Care, Medical Humanities, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Ghislaine van Thiel
- Department of Medical Humanities, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
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16
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Redmond S, Leppin AL, Fischer K, Hanson G, Doubeni C, Takahashi P. Connecting community-delivered evidence-based programs and the healthcare system: Piloting a learning "wellcare" system. Learn Health Syst 2021; 5:e10240. [PMID: 34667870 PMCID: PMC8512735 DOI: 10.1002/lrh2.10240] [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: 04/10/2020] [Revised: 07/07/2020] [Accepted: 07/09/2020] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION Many evidence-based programs (EBPs) have been determined in randomized controlled trials to be effective, but few studies explore the real-world effectiveness of EBPs implemented in the natural community setting. Our study evaluated whether a novel linked infrastructure would enable such insights and continuous improvement as part of a learning healthcare-community bridged "wellcare" ecosystem. METHODS We created a secure, web-based data entry and storage platform with a network of Minnesota community-based organizations to record EBP participants' demographics and attendance, and program details. We then linked participant's information to their Rochester Epidemiology Project (REP) medical records. With this infrastructure, we conducted a proof of concept, retrospective cohort study by matching EBP participants to REP controls and comparing medical record-documented outcomes over 1 year follow-up. RESULTS We successfully linked EBP participant records with medical records in 77.6% of cases, and the infrastructure proved feasible and scalable. Still, key challenges remain in obtaining participant consent for data sharing. Upfront resource investments and the availability of REP-like warehouses limit generalizability. Optimal learning will be improved by enhancements that better track program fidelity. Our pilot study established a proof-of-concept, but sample sizes (n = 99 for falls prevention and n = 97 chronic disease/pain management EBP completers) were too small to detect significant differences in hospital admittance as compared to matched controls for either EBP group, (OR = 0.66[0.36, 1.19]) and (OR = 0.81[0.43, 1.54]), respectively. Events were too rare to gather meaningful information about effects on fall rates. CONCLUSIONS Our pilot demonstrates the feasibility of developing an online infrastructure that connects information from community leaders with medical record documented health outcomes, bridging the knowledge gap between community programs and the health care system. Insights gleaned from our infrastructure can be used to continuously shape community program delivery to reduce the need for formal health care services.
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Affiliation(s)
- Sarah Redmond
- Robert D. and Patricia E. Kern Center for the Science of Healthcare DeliveryMayo ClinicRochesterMinnesotaUSA
| | - Aaron L. Leppin
- Center for Clinical and Translational Sciences and Division of Health Care Policy and ResearchMayo ClinicRochesterMinnesotaUSA
| | - Karen Fischer
- Department of Health Sciences ResearchMayo ClinicRochesterMinnesotaUSA
| | - Gregory Hanson
- Division of Community Internal Medicine and Division of Geriatrics and GerontologyMayo ClinicRochesterMinnesotaUSA
| | - Chyke Doubeni
- Center for Health Equity and Community Engagement in Research and Department of Family and Community MedicineMayo ClinicRochesterMinnesotaUSA
| | - Paul Takahashi
- Division of Community Internal Medicine and Division of Geriatrics and GerontologyMayo ClinicRochesterMinnesotaUSA
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17
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Giannouchos TV, Ferdinand AO, Ilangovan G, Ragan E, Nowell WB, Kum HC, Schmit CD. Identifying and prioritizing benefits and risks of using privacy-enhancing software through participatory design: a nominal group technique study with patients living with chronic conditions. J Am Med Inform Assoc 2021; 28:1746-1755. [PMID: 34010404 DOI: 10.1093/jamia/ocab073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 03/01/2021] [Accepted: 03/29/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE While patients often contribute data for research, they want researchers to protect their data. As part of a participatory design of privacy-enhancing software, this study explored patients' perceptions of privacy protection in research using their healthcare data. MATERIALS AND METHODS We conducted 4 focus groups with 27 patients on privacy-enhancing software using the nominal group technique. We provided participants with an open source software prototype to demonstrate privacy-enhancing features and elicit privacy concerns. Participants generated ideas on benefits, risks, and needed additional information. Following a thematic analysis of the results, we deployed an online questionnaire to identify consensus across all 4 groups. Participants were asked to rank-order benefits and risks. Themes around "needed additional information" were rated by perceived importance on a 5-point Likert scale. RESULTS Participants considered "allowance for minimum disclosure" and "comprehensive privacy protection that is not currently available" as the most important benefits when using the privacy-enhancing prototype software. The most concerning perceived risks were "additional checks needed beyond the software to ensure privacy protection" and the "potential of misuse by authorized users." Participants indicated a desire for additional information with 6 of the 11 themes receiving a median participant rating of "very necessary" and rated "information on the data custodian" as "essential." CONCLUSIONS Patients recognize not only the benefits of privacy-enhancing software, but also inherent risks. Patients desire information about how their data are used and protected. Effective patient engagement, communication, and transparency in research may improve patients' comfort levels, alleviate patients' concerns, and thus promote ethical research.
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Affiliation(s)
- Theodoros V Giannouchos
- Population Informatics Lab, School of Public Health, Texas A&M University, College Station, Texas, USA.,Pharmacotherapy Outcomes Research Center, College of Pharmacy, University of Utah, Salt Lake City, Utah, USA
| | - Alva O Ferdinand
- Department of Health Policy and Management, School of Public Health, Texas A&M University, College Station, Texas, USA.,Southwest Rural Health Research Center, School of Public Health, Texas A&M University, College Station, Texas, USA
| | - Gurudev Ilangovan
- Population Informatics Lab, School of Public Health, Texas A&M University, College Station, Texas, USA
| | - Eric Ragan
- Department of Computer and Information Science and Engineering, University of Florida, Gainesville, Florida, USA
| | - W Benjamin Nowell
- Patient-Centered Research, Global Healthy Living Foundation, Upper Nyack, New York, USA
| | - Hye-Chung Kum
- Population Informatics Lab, School of Public Health, Texas A&M University, College Station, Texas, USA.,Department of Health Policy and Management, School of Public Health, Texas A&M University, College Station, Texas, USA
| | - Cason D Schmit
- Population Informatics Lab, School of Public Health, Texas A&M University, College Station, Texas, USA.,Department of Health Policy and Management, School of Public Health, Texas A&M University, College Station, Texas, USA
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18
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Wilson NA, Reich AJ, Graham J, Bhatt DL, Nguyen LL, Weissman JS. Patient perspectives on the need for implanted device information: Implications for a post-procedural communication framework. Health Expect 2021; 24:1391-1402. [PMID: 33974346 PMCID: PMC8369078 DOI: 10.1111/hex.13273] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 03/05/2021] [Accepted: 04/15/2021] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Shared decision making and patient-centred communication have become part of pre-procedural decisions and perioperative care across medical specialties. However, gaps exist in patient communication about the implanted device received and the benefits in sharing information about their procedure and device. OBJECTIVE To understand the patients' knowledge of identifying information for their implanted devices and perspectives on sharing their implanted device information. METHODS Four focus groups were conducted with patients who had received a cardiac or vascular implanted device from one of the study sites within the previous 6 months. Data were transcribed and thematically analysed. RESULTS Five themes emerged: lack of awareness of identifying information on implanted devices; value of information on implanted devices; varying trust with sharing device information; perceived risk with sharing device information; and lack of consensus on a systematic process for tracking implanted devices. DISCUSSION Patients desire post-procedural information on their implanted device and a designated plan for longitudinal follow-up, but lack trust and perceive risk with broadly sharing their implanted device information. CONCLUSION After receiving an implanted device, post-procedural patient communication needs to be expanded to include identifying information on the device including the unique device identifier, how long-term tracking will be supported and the process for notification in case of a problem with the device. This communication should also include education on how sharing device information supports patients' long-term health care, post-market safety surveillance and research. PATIENT OR PUBLIC CONTRIBUTION The research team included members who were also patients with implanted devices.
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Affiliation(s)
- Natalia A Wilson
- College of Health Solutions, Arizona State University, Phoenix, AZ, USA
| | - Amanda J Reich
- Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, MA, USA
| | | | - Deepak L Bhatt
- Heart and Vascular Center, Brigham and Women's Hospital, Boston, MA, USA
| | - Louis L Nguyen
- Division of Vascular and Endovascular Surgery, Brigham and Women's Hospital, Boston, MA, USA
| | - Joel S Weissman
- Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, MA, USA
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Schmit C, Ajayi KV, Ferdinand AO, Giannouchos T, Ilangovan G, Nowell WB, Kum HC. Communicating With Patients About Software for Enhancing Privacy in Secondary Database Research Involving Record Linkage: Delphi Study. J Med Internet Res 2020; 22:e20783. [PMID: 33320097 PMCID: PMC7772068 DOI: 10.2196/20783] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 09/24/2020] [Accepted: 10/26/2020] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND There is substantial prior research on the perspectives of patients on the use of health information for research. Numerous communication barriers challenge transparency between researchers and data participants in secondary database research (eg, waiver of informed consent and knowledge gaps). Individual concerns and misconceptions challenge the trust in researchers among patients despite efforts to protect data. Technical software used to protect research data can further complicate the public's understanding of research. For example, MiNDFIRL (Minimum Necessary Disclosure For Interactive Record Linkage) is a prototype software that can be used to enhance the confidentiality of data sets by restricting disclosures of identifying information during the record linkage process. However, software, such as MiNDFIRL, which is used to protect data, must overcome the aforementioned communication barriers. One proposed solution is the creation of an interactive web-based frequently asked question (FAQ) template that can be adapted and used to communicate research issues to data subjects. OBJECTIVE This study aims to improve communication with patients and transparency about how complex software, such as MiNDFIRL, is used to enhance privacy in secondary database studies to maintain the public's trust in researchers. METHODS A Delphi technique with 3 rounds of the survey was used to develop the FAQ document to communicate privacy issues related to a generic secondary database study using the MiNDFIRL software. The Delphi panel consisted of 38 patients with chronic health conditions. We revised the FAQ between Delphi rounds and provided participants with a summary of the feedback. We adopted a conservative consensus threshold of less than 10% negative feedback per FAQ section. RESULTS We developed a consensus language for 21 of the 24 FAQ sections. Participant feedback demonstrated preference differences (eg, brevity vs comprehensiveness). We adapted the final FAQ into an interactive web-based format that 94% (31/33) of the participants found helpful or very helpful. The template FAQ and MiNDFIRL source code are available on GitHub. The results indicate the following patient communication considerations: patients have diverse and varied preferences; the tone is important but challenging; and patients want information on security, identifiers, and final disposition of information. CONCLUSIONS The findings of this study provide insights into what research-related information is useful to patients and how researchers can communicate such information. These findings align with the current understanding of health literacy and its challenges. Communication is essential to transparency and ethical data use, yet it is exceedingly challenging. Developing FAQ template language to accompany a complex software may enable researchers to provide greater transparency when informed consent is not possible.
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Affiliation(s)
- Cason Schmit
- Population Informatics Lab, Department of Health Policy & Management, Texas A&M University School of Public Health, College Station, TX, United States
| | - Kobi V Ajayi
- Population Informatics Lab, Department of Health Policy & Management, Texas A&M University School of Public Health, College Station, TX, United States
| | - Alva O Ferdinand
- Southwest Rural Health Research Center, Department of Health Policy & Management, Texas A&M University School of Public Health, College Station, TX, United States
| | - Theodoros Giannouchos
- Population Informatics Lab, Department of Health Policy & Management, Texas A&M University School of Public Health, College Station, TX, United States
- Pharmacotherapy Outcomes Research Center, College of Pharmacy, University of Utah, Salt Lake City, UT, United States
| | - Gurudev Ilangovan
- Population Informatics Lab, Department of Health Policy & Management, Texas A&M University School of Public Health, College Station, TX, United States
| | | | - Hye-Chung Kum
- Population Informatics Lab, Department of Health Policy & Management, Texas A&M University School of Public Health, College Station, TX, United States
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20
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Schmit C, Giannouchos T, Ramezani M, Zheng Q, Morrisey MA, Kum HC. US Privacy Laws Go Against Public Preferences: Impeding Public Health and Research (Preprint). J Med Internet Res 2020; 23:e25266. [PMID: 36260399 PMCID: PMC8406123 DOI: 10.2196/25266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 12/08/2020] [Accepted: 04/30/2021] [Indexed: 12/01/2022] Open
Abstract
Background Reaping the benefits from massive volumes of data collected in all sectors to improve population health, inform personalized medicine, and transform biomedical research requires the delicate balance between the benefits and risks of using individual-level data. There is a patchwork of US data protection laws that vary depending on the type of data, who is using it, and their intended purpose. Differences in these laws challenge big data projects using data from different sources. The decisions to permit or restrict data uses are determined by elected officials; therefore, constituent input is critical to finding the right balance between individual privacy and public benefits. Objective This study explores the US public’s preferences for using identifiable data for different purposes without their consent. Methods We measured data use preferences of a nationally representative sample of 504 US adults by conducting a web-based survey in February 2020. The survey used a choice-based conjoint analysis. We selected choice-based conjoint attributes and levels based on 5 US data protection laws (Health Insurance Portability and Accountability Act, Family Educational Rights and Privacy Act, Privacy Act of 1974, Federal Trade Commission Act, and the Common Rule). There were 72 different combinations of attribute levels, representing different data use scenarios. Participants were given 12 pairs of data use scenarios and were asked to choose the scenario they were the most comfortable with. We then simulated the population preferences by using the hierarchical Bayes regression model using the ChoiceModelR package in R. Results Participants strongly preferred data reuse for public health and research than for profit-driven, marketing, or crime-detection activities. Participants also strongly preferred data use by universities or nonprofit organizations over data use by businesses and governments. Participants were fairly indifferent about the different types of data used (health, education, government, or economic data). Conclusions Our results show a notable incongruence between public preferences and current US data protection laws. Our findings appear to show that the US public favors data uses promoting social benefits over those promoting individual or organizational interests. This study provides strong support for continued efforts to provide safe access to useful data sets for research and public health. Policy makers should consider more robust public health and research data use exceptions to align laws with public preferences. In addition, policy makers who revise laws to enable data use for research and public health should consider more comprehensive protection mechanisms, including transparent use of data and accountability.
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Affiliation(s)
- Cason Schmit
- Population Informatics Lab, Department of Health Policy and Management, Texas A&M University, College Station, TX, United States
| | - Theodoros Giannouchos
- Population Informatics Lab, Department of Health Policy and Management, Texas A&M University, College Station, TX, United States
- Pharmacotherapy Outcomes Research Center, College of Pharmacy, University of Utah, Salt Lake City, UT, United States
| | - Mahin Ramezani
- Population Informatics Lab, Department of Health Policy and Management, Texas A&M University, College Station, TX, United States
| | - Qi Zheng
- Department of Epidemiology and Biostatistics, Texas A&M University, College Station, TX, United States
| | - Michael A Morrisey
- Population Informatics Lab, Department of Health Policy and Management, Texas A&M University, College Station, TX, United States
| | - Hye-Chung Kum
- Population Informatics Lab, Department of Health Policy and Management, Texas A&M University, College Station, TX, United States
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21
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Staccini P, Lau AYS. Social Media, Research, and Ethics: Does Participant Willingness Matter? Yearb Med Inform 2020; 29:176-183. [PMID: 32823313 PMCID: PMC7442513 DOI: 10.1055/s-0040-1702022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Objective
: To summarise the state of the art published in 2019 in consumer health informatics and education, with a special emphasis on “Ethics and Health Informatics”.
Methods
: We conducted a systematic search of articles published in PubMed using a predefined set of queries, which identified 368 potential articles for review. These articles were screened according to topic relevance and 15 were selected for consideration of best paper candidates, which were then presented to a panel of international experts for full paper review and scoring. The top five papers according to the external reviewers’ ranking were discussed in a consensus meeting. Finally, the paper that received the highest score from four of the five experts was selected as the best paper on social media and ethics for patients and consumers of the year 2019.
Results
: Despite using the terms “ethics” and “ethical” in the search query, we retrieved very few articles. The bibliometric analysis identified three major clusters centred on “social”, “health”, and “study”. Among the top five papers, one was a review where the authors identified ethical issues across four areas at the intersection of social media and health: 1) the impact of social networking sites on the doctor-patient relationship; 2) the development of e-health platforms to deliver care; 3) the use of online data and algorithms to inform health research; and 4) the broader public health consequences of widespread social media use. The other papers highlighted ethical concerns in using social media to interact with patients at different phases of a clinical research protocol, such as recruitment phase, participant engagement, data linkage, and detection and monitoring of adverse events.
Conclusions
: Findings suggest that most users do not think that using social media for patient monitoring in clinical research, for example using Twitter for clinical trial recruitment, constitutes inappropriate surveillance or a violation of privacy. However, further research is needed to identify whether and how views on ethical concerns differed between social media platforms and across populations.
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Affiliation(s)
- Pascal Staccini
- IRIS Department, Lab RETINES, Faculté de Médecine, Université Côte d'Azur, France
| | - Annie Y S Lau
- Centre for Health Informatics, Australian Institute of Health Innovation, Macquarie University, Australia
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22
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Mansfield KL, Gallacher JE, Mourby M, Fazel M. Five models for child and adolescent data linkage in the UK: a review of existing and proposed methods. EVIDENCE-BASED MENTAL HEALTH 2020; 23:39-44. [PMID: 32046992 PMCID: PMC7034351 DOI: 10.1136/ebmental-2019-300140] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 01/08/2020] [Accepted: 01/09/2020] [Indexed: 01/10/2023]
Abstract
Over the last decade dramatic advances have been made in both the technology and data available to better understand the multifactorial influences on child and adolescent health and development. This paper seeks to clarify methods that can be used to link information from health, education, social care and research datasets. Linking these different types of data can facilitate epidemiological research that investigates mental health from the population to the patient; enabling advanced analytics to better identify, conceptualise and address child and adolescent needs. The majority of adolescent mental health research is not able to maximise the full potential of data linkage, primarily due to four key challenges: confidentiality, sampling, matching and scalability. By presenting five existing and proposed models for linking adolescent data in relation to these challenges, this paper aims to facilitate the clinical benefits that will be derived from effective integration of available data in understanding, preventing and treating mental disorders.
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Affiliation(s)
- Karen Laura Mansfield
- Department of Psychiatry, University of Oxford, Oxford, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
| | | | - Miranda Mourby
- Centre for Health, Law and Emerging Technologies (HeLEX), Faculty of Law, University of Oxford, Oxford, UK
| | - Mina Fazel
- Department of Psychiatry, University of Oxford, Oxford, UK
- Children's Psychological Medicine, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
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23
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Pratt NL, Mack CD, Meyer AM, Davis KJ, Hammill BG, Hampp C, Setoguchi S, Raman SR, Chun DS, Stürmer T, Lund JL. Data linkage in pharmacoepidemiology: A call for rigorous evaluation and reporting. Pharmacoepidemiol Drug Saf 2019; 29:9-17. [DOI: 10.1002/pds.4924] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 09/17/2019] [Accepted: 10/21/2019] [Indexed: 12/28/2022]
Affiliation(s)
- Nicole L. Pratt
- Quality Use of Medicines and Pharmacy Research CentreUniversity of South Australia Adelaide South Australia Australia
| | - Christina D. Mack
- Real‐World and Analytic SolutionsIQVIA, Research Triangle Park Durham NC USA
- Department of Epidemiology, Gillings School of Global Public HealthUniversity of North Carolina Chapel Hill NC USA
| | - Anne Marie Meyer
- Real‐World and Analytic SolutionsIQVIA, Research Triangle Park Durham NC USA
| | - Kourtney J. Davis
- Department of Epidemiology, Gillings School of Global Public HealthUniversity of North Carolina Chapel Hill NC USA
- Global EpidemiologyJanssen R&D Titusville NJ 08650
| | - Bradley G. Hammill
- Department of Population Health Sciences, School of MedicineDuke University Durham NC USA
| | - Christian Hampp
- Office of Surveillance and EpidemiologyCenter for Drug Evaluation and Research, U.S. Food and Drug Administration Rockville Maryland
| | - Soko Setoguchi
- Institute for Health, Health Care Policy and Aging Research, RWJ Medical School, Center for Pharmacoepidemiology and Treatment ScienceRutgers University New Brunswick NJ USA
| | - Sudha R. Raman
- Department of Population Health Sciences, School of MedicineDuke University Durham NC USA
| | - Danielle S. Chun
- Department of Epidemiology, Gillings School of Global Public HealthUniversity of North Carolina Chapel Hill NC USA
| | - Til Stürmer
- Department of Epidemiology, Gillings School of Global Public HealthUniversity of North Carolina Chapel Hill NC USA
| | - Jennifer L. Lund
- Department of Epidemiology, Gillings School of Global Public HealthUniversity of North Carolina Chapel Hill NC USA
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