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Vears DF, Hallowell N, Bentzen HB, Ellul B, Nøst TH, Kerasidou A, Kerr SM, Th Mayrhofer M, Mežinska S, Ormondroyd E, Solberg B, Sand BW, Budin-Ljøsne I. A practical checklist for return of results from genomic research in the European context. Eur J Hum Genet 2023; 31:687-695. [PMID: 36949262 PMCID: PMC10250331 DOI: 10.1038/s41431-023-01328-6] [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: 09/12/2022] [Revised: 02/13/2023] [Accepted: 02/21/2023] [Indexed: 03/24/2023] Open
Abstract
An increasing number of European research projects return, or plan to return, individual genomic research results (IRR) to participants. While data access is a data subject's right under the General Data Protection Regulation (GDPR), and many legal and ethical guidelines allow or require participants to receive personal data generated in research, the practice of returning results is not straightforward and raises several practical and ethical issues. Existing guidelines focusing on return of IRR are mostly project-specific, only discuss which results to return, or were developed outside Europe. To address this gap, we analysed existing normative documents identified online using inductive content analysis. We used this analysis to develop a checklist of steps to assist European researchers considering whether to return IRR to participants. We then sought feedback on the checklist from an interdisciplinary panel of European experts (clinicians, clinical researchers, population-based researchers, biobank managers, ethicists, lawyers and policy makers) to refine the checklist. The checklist outlines seven major components researchers should consider when determining whether, and how, to return results to adult research participants: 1) Decide which results to return; 2) Develop a plan for return of results; 3) Obtain participant informed consent; 4) Collect and analyse data; 5) Confirm results; 6) Disclose research results; 7) Follow-up and monitor. Our checklist provides a clear outline of the steps European researchers can follow to develop ethical and sustainable result return pathways within their own research projects. Further legal analysis is required to ensure this checklist complies with relevant domestic laws.
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Affiliation(s)
- Danya F Vears
- Biomedical Ethics Research Group, Murdoch Children's Research Institute, Parkville, VIC, 3052, Australia.
- University of Melbourne, Parkville, VIC, 3052, Australia.
- Centre for Biomedical Ethics and Law, KU Leuven, Leuven, 3000, Belgium.
- Uehiro Centre for Practical Ethics, University of Oxford, Oxford, OX3 7RF, UK.
| | - Nina Hallowell
- Ethox Centre and Wellcome Centre for Ethics and Humanities, Nuffield department of Population Health, University of Oxford, Oxford, OX3 7RF, UK
| | - Heidi Beate Bentzen
- Centre for Medical Ethics, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Bridget Ellul
- Centre for Molecular Medicine and Biobanking, University of Malta, Msida, Malta
| | - Therese Haugdahl Nøst
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, N-9037, Tromsø, Norway
- K. G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health, NTNU, Norwegian University of Science and Technology, N- 7491, Trondheim, Norway
| | - Angeliki Kerasidou
- Ethox Centre and Wellcome Centre for Ethics and Humanities, Nuffield department of Population Health, University of Oxford, Oxford, OX3 7RF, UK
| | - Shona M Kerr
- MRC Human Genetics Unit, Institute of Genetics and Cancer, University of Edinburgh, Western General Hospital, Edinburgh, EH4 2XU, UK
| | | | - Signe Mežinska
- Institute of Clinical and Preventive Medicine, University of Latvia, Riga, Latvia
| | - Elizabeth Ormondroyd
- Radcliffe Department of Medicine, NIHR Oxford Biomedical Research Centre United Kingdom, University of Oxford, Oxford, UK
| | - Berge Solberg
- Department of Public Health and Nursing, The Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | | | - Isabelle Budin-Ljøsne
- Division of Climate and Environmental Health, Department of Food Safety, Norwegian Institute of Public Health, Oslo, Norway
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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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Klingler C, von Jagwitz-Biegnitz M, Baber R, Becker KF, Dahl E, Eibner C, Fuchs J, Groenewold MK, Hartung ML, Hummel M, Jahns R, Kirsten R, Kopfnagel V, Maushagen R, Nussbeck SY, Schoneberg A, Winter T, Specht C. Stakeholder engagement to ensure the sustainability of biobanks: a survey of potential users of biobank services. Eur J Hum Genet 2022; 30:1344-1354. [PMID: 34031552 PMCID: PMC9712417 DOI: 10.1038/s41431-021-00905-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 04/06/2021] [Accepted: 04/29/2021] [Indexed: 12/17/2022] Open
Abstract
Biobanks are important infrastructures facilitating biomedical research. After a decade of rolling out such infrastructures, a shift in attention to the sustainability of biobanks could be observed in recent years. In this regard, an increase in the as yet relatively low utilisation rates of biobanks has been formulated as a goal. Higher utilisation rates can only be achieved if the perspectives of potential users of biobanks-particularly researchers not yet collaborating with biobanks-are adequately considered. To better understand their perspectives, a survey was conducted at ten different research institutions in Germany hosting a centralised biobank. The survey targeted potential users of biobank services, i.e. researchers working with biosamples. It addressed the general demand for biosamples, strategies for biosample acquisition/storage and reasons for/against collaborating with biobanks. In total, 354 researchers filled out the survey. Most interestingly, only a minority of researchers (12%) acquired their biosamples via biobanks. Of the respondents not collaborating with biobanks on sample acquisition, around half were not aware of the (services of the) respective local biobank. Those who actively decided against acquiring biosamples via a biobank provided different reasons. Most commonly, respondents stated that the biosamples required were not available, the costs were too high and information about the available biosamples was not readily accessible. Biobanks can draw many lessons from the results of the survey. Particularly, external communication and outreach should be improved. Additionally, biobanks might have to reassess whether their particular collection strategies are adequately aligned with local researchers' needs.
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Affiliation(s)
- Corinna Klingler
- German Biobank Node, Charité Universitätsmedizin Berlin, Berlin, Germany.
| | | | - Ronny Baber
- grid.9647.c0000 0004 7669 9786Leipzig Medical Biobank, University Leipzig, Leipzig, Germany ,grid.9647.c0000 0004 7669 9786Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University of Leipzig Medical Center, Leipzig, Germany
| | - Karl-Friedrich Becker
- grid.6936.a0000000123222966Gewebebank des Klinikums rechts der Isar und der Technischen Universität München, Am Institut für Pathologie der TU München, Trogerstr. 18, 81675 München, Germany
| | - Edgar Dahl
- grid.1957.a0000 0001 0728 696XRWTH centralized Biomaterial Bank (RWTH cBMB), Institute of Pathology, RWTH Aachen University, Aachen, Germany
| | - Cornelius Eibner
- grid.275559.90000 0000 8517 6224Integrated Biobank Jena (IBBJ), Institute for Clinical Chemistry and Laboratory Diagnostics, University Hospital Jena, Am Klinikum 1, D-07747 Jena, Germany
| | - Jörg Fuchs
- grid.411760.50000 0001 1378 7891Interdisciplinary Bank of Biomaterials and Data Würzburg (ibdw), University Hospital of Würzburg, Straubmühlweg 2a, building A8/A9, 97078 Würzburg, Germany
| | - Maike K. Groenewold
- Research Unit of Molecular Epidemiology/Core Facility Biobank, Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Mara Lena Hartung
- grid.6363.00000 0001 2218 4662German Biobank Node, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Michael Hummel
- grid.6363.00000 0001 2218 4662German Biobank Node, Charité Universitätsmedizin Berlin, Berlin, Germany ,grid.6363.00000 0001 2218 4662Central Biobank Charité (ZeBanC), Institute of Pathology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Roland Jahns
- grid.411760.50000 0001 1378 7891Interdisciplinary Bank of Biomaterials and Data Würzburg (ibdw), University Hospital of Würzburg, Straubmühlweg 2a, building A8/A9, 97078 Würzburg, Germany
| | - Romy Kirsten
- grid.5253.10000 0001 0328 4908NCT Liquid Biobank, National Center for Tumor Diseases and BioMaterialBank Heidelberg (BMBH), University Hospital Heidelberg, Heidelberg, Germany
| | - Verena Kopfnagel
- grid.10423.340000 0000 9529 9877Hannover Unified Biobank, Hannover Medical School, Hannover, Germany
| | - Regina Maushagen
- grid.4562.50000 0001 0057 2672Interdisciplinary Center for Biobanking-Lübeck (ICB-L), University of Lübeck, Lübeck, Germany
| | - Sara Yasemin Nussbeck
- grid.411984.10000 0001 0482 5331Central Biobank UMG, University Medical Center Göttingen, Göttingen, Germany
| | - Anne Schoneberg
- grid.411984.10000 0001 0482 5331Central Biobank UMG, University Medical Center Göttingen, Göttingen, Germany
| | - Theresa Winter
- grid.5603.0Integrated Research Biobank Greifswald, University Medicine Greifswald, Greifswald, Germany
| | - Cornelia Specht
- grid.6363.00000 0001 2218 4662German Biobank Node, Charité Universitätsmedizin Berlin, Berlin, Germany
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Return of individual research results from genomic research: A systematic review of stakeholder perspectives. PLoS One 2021; 16:e0258646. [PMID: 34748551 PMCID: PMC8575249 DOI: 10.1371/journal.pone.0258646] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 10/02/2021] [Indexed: 12/19/2022] Open
Abstract
Despite the plethora of empirical studies conducted to date, debate continues about whether and to what extent results should be returned to participants of genomic research. We aimed to systematically review the empirical literature exploring stakeholders’ perspectives on return of individual research results (IRR) from genomic research. We examined preferences for receiving or willingness to return IRR, and experiences with either receiving or returning them. The systematic searches were conducted across five major databases in August 2018 and repeated in April 2020, and included studies reporting findings from primary research regardless of method (quantitative, qualitative, mixed). Articles that related to the clinical setting were excluded. Our search identified 221 articles that met our search criteria. This included 118 quantitative, 69 qualitative and 34 mixed methods studies. These articles included a total number of 118,874 stakeholders with research participants (85,270/72%) and members of the general public (40,967/35%) being the largest groups represented. The articles spanned at least 22 different countries with most (144/65%) being from the USA. Most (76%) discussed clinical research projects, rather than biobanks. More than half (58%) gauged views that were hypothetical. We found overwhelming evidence of high interest in return of IRR from potential and actual genomic research participants. There is also a general willingness to provide such results by researchers and health professionals, although they tend to adopt a more cautious stance. While all results are desired to some degree, those that have the potential to change clinical management are generally prioritized by all stakeholders. Professional stakeholders appear more willing to return results that are reliable and clinically relevant than those that are less reliable and lack clinical relevance. The lack of evidence for significant enduring psychological harm and the clear benefits to some research participants suggest that researchers should be returning actionable IRRs to participants.
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Lhousni S, Boulouiz R, Abda N, Tajir M, Bellaoui M, Ouarzane M. Assessment of Knowledge, Attitudes and Support of Health Professionals towards Biobanks in Eastern Morocco. ACTA ACUST UNITED AC 2019. [DOI: 10.4236/ojepi.2019.93016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Genomic information and a person's right not to know: A closer look at variations in hypothetical informational preferences in a German sample. PLoS One 2018; 13:e0198249. [PMID: 29924808 PMCID: PMC6010220 DOI: 10.1371/journal.pone.0198249] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Accepted: 05/16/2018] [Indexed: 01/02/2023] Open
Abstract
In clinical practice and in research, there is an ongoing debate on how to return incidental and secondary findings of genetic tests to patients and research participants. Previous investigations have found that most of the people most of the time are in favor of full disclosure of results. Yet, the option to reject disclosure, based on the so-called right not to know, can be valuable especially for some vulnerable subgroups of recipients. In the present study we investigated variations in informational preferences in the context of genetic testing in a large and diverse German sample. This survey examined health care professionals, patients, participants of genetic counseling sessions and members of the general population (N = 518). Survey participants were assessed regarding their openness to learning about findings under various hypothetical scenarios, as well as their attitudes about the doctor-patient-relationship in a disclosure situation and about informational transfer to third parties. While the majority of participants wanted to learn about their findings, the extent of support of disclosure varied with features of the hypothetical diagnostic scenarios (e.g., controllability of disease; abstract vs. concrete scenario description) and demographic characteristics of the subjects. For example, subjects with higher levels of education were more selective with regards to the kind of information they want to receive than those with lower levels of education. We discuss implications of these findings for the debate about the right not to know and for the clinical practice of informed consent procedures.
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Abstract
Biobank research has the potential to return results that could have beneficial and even life-saving consequences for participants. This possibility raises some important questions, not only about the ethical duty to return results within a research setting, but also about participants' right to refuse results and researchers' responsibility to respect that choice. This article argues in favor of adopting a return-of-results policy that limits participants' ability to refuse clinically relevant and actionable results. We state that biobanks should allow donors only if they are aware of and agree to this return policy. If they do not agree to this, they retain the option not to participate in the biobank research. The aim of this article is to discuss the practical and ethical reasons in favor of this return-of-result policy and, thus, to underline the importance of "honesty" in biobanking regulations.
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Affiliation(s)
- Bernice S. Elger
- Institute for Biomedical Ethics, University of Basel, Basel, Switzerland
- University Center of Legal Medicine of Geneva and Lausanne, University of Geneva, Geneva, Switzerland
| | - Eva De Clercq
- Institute for Biomedical Ethics, University of Basel, Basel, Switzerland
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Moodley K, Singh S. "It's all about trust": reflections of researchers on the complexity and controversy surrounding biobanking in South Africa. BMC Med Ethics 2016; 17:57. [PMID: 27724893 PMCID: PMC5057490 DOI: 10.1186/s12910-016-0140-2] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2016] [Accepted: 09/27/2016] [Indexed: 01/05/2023] Open
Abstract
Background Biobanks are precariously situated at the intersection of science, genetics, genomics, society, ethics, the law and politics. This multi-disciplinarity has given rise to a new discourse in health research involving diverse stakeholders. Each stakeholder is embedded in a unique context and articulates his/her biobanking activities differently. To researchers, biobanks carry enormous transformative potential in terms of advancing scientific discovery and knowledge. However, in the context of power asymmetries in Africa and a distrust in science born out of historical exploitation, researchers must balance the scientific imperative of collecting, storing and sharing high quality biological samples with obligations to donors/participants, communities, international collaborators, regulatory and ethics authorities. To date, researcher perspectives on biobanking in South Africa have not been explored and documented. Methods In-depth qualitative interviews were conducted with a purposive sample of 21 researchers – 8 in the Western Cape, 3 in Gauteng and 10 in Kwa-Zulu Natal. Interviews lasted approximately 40–60 min and were audiotaped with consent. Thematic analysis of the transcribed interviews was conducted by the co-authors. Results Researchers articulated serious concerns over standardised regulatory approaches that failed to consider the heterogeneity of biobanks. Given that biobanks differ considerably, guidelines and RECs need to stratify risk accordingly and governance processes and structures must be flexible. While RECs were regarded as an important component of the governance structure researchers expressed concern about their expertise in biobanking. Operational management of biobanks was regarded as an ethical imperative and a pre-requisite to building trust during consent processes. While broad general consent was preferred, tiered consent was thought to be more consistent with respect for autonomy and building trust. Material Transfer Agreements (MTAs) were often lacking when biosamples were exported and this was perceived to impact negatively on trust. On the other hand, researchers believed that authentic community engagement would help to build trust. Conclusion Building trust will best be achieved via a system of governance structures and processes that precede the establishment of a biobank and monitor progress from the point of sample collection through to future use, including export. Such governance structures must be robust and must include comprehensive national legislation, policy and contextualised guidelines. Currently such governance infrastructure appears to be lacking in many African countries including South Africa. Capacity development of all stakeholders including REC members will enhance expeditious and efficient review of biobanking protocols which in turn will reinforce trust in the researcher-donor relationship. Science translation and community engagement in biobanking is integral to the success of biobanking in South Africa. Electronic supplementary material The online version of this article (doi:10.1186/s12910-016-0140-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Keymanthri Moodley
- Centre for Medical Ethics and Law, Department of Medicine, Faculty of Health Sciences, Stellenbosch University, Tygerberg, South Africa.
| | - Shenuka Singh
- Centre for Medical Ethics and Law, Department of Medicine, Faculty of Health Sciences, Stellenbosch University, Tygerberg, South Africa
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Caixeiro NJ, Byun HL, Descallar J, Levesque JV, de Souza P, Soon Lee C. Health professionals' opinions on supporting a cancer biobank: identification of barriers to combat biobanking pitfalls. Eur J Hum Genet 2016; 24:626-32. [PMID: 26328505 PMCID: PMC4930095 DOI: 10.1038/ejhg.2015.191] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Revised: 06/17/2015] [Accepted: 07/28/2015] [Indexed: 11/08/2022] Open
Abstract
Although rarely acknowledged, a successful biobank is highly dependent on the support of the health professionals who assist the biobank in all aspects of its activities. In many cases, the lack of health professional support can be a limiting factor in the biobanking process of collecting and processing high-quality biospecimens. The aim of this study was to determine the attitudes of health professionals towards cancer biobanking. Using a 5-point Likert scale questionnaire, important aspects of biobanking, including accrual, quality, knowledge, responsiveness, impact, access, trust, governance and accreditation, were investigated. In total, 95 of 124 health and medical practitioners who were approached participated in this study (77% response rate). Health professionals in general supported the aims of biobanking with 56% of participants showing willingness to create a biobank and recruit donors (accrual), 85% understanding the importance in the storage and distribution of biospecimens (quality), 88% having an appreciation for the role of a biobank in furthering cancer research (knowledge), 70% showing awareness of the use of biospecimens in future research initiatives (responsiveness) and 73% demonstrating support for a biobank with proper control, authority and credibility measures in place (governance and accreditation). Overall, provided that proper information about the activities of the biobank and researcher access was transparent, health professionals were very willing to support cancer biobanking. These findings may assist in developing strategies for the establishment and maintenance of biobanks and aid the implementation of more effective policies and procedures to embed biobanking into routine hospital practices.
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Affiliation(s)
- Nicole J Caixeiro
- Centre for Oncology Education and Research Translation (CONCERT), Liverpool, NSW, Australia
- Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia
- Discipline of Pathology, School of Medicine, University of Western Sydney, Liverpool, NSW, Australia
| | - Hei Lan Byun
- Department of Oncology, Liverpool Hospital, Liverpool, NSW, Australia
| | - Joseph Descallar
- Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia
- School of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Janelle V Levesque
- Centre for Oncology Education and Research Translation (CONCERT), Liverpool, NSW, Australia
- Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia
- School of Medicine, University of New South Wales, Sydney, NSW, Australia
- Psycho-Oncology Research Group, University of New South Wales, Sydney, NSW, Australia
| | - Paul de Souza
- Centre for Oncology Education and Research Translation (CONCERT), Liverpool, NSW, Australia
- Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia
- Discipline of Pathology, School of Medicine, University of Western Sydney, Liverpool, NSW, Australia
- Department of Oncology, Liverpool Hospital, Liverpool, NSW, Australia
- School of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Cheok Soon Lee
- Centre for Oncology Education and Research Translation (CONCERT), Liverpool, NSW, Australia
- Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia
- Discipline of Pathology, School of Medicine, University of Western Sydney, Liverpool, NSW, Australia
- Department of Oncology, Liverpool Hospital, Liverpool, NSW, Australia
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Abstract
Biobanking involves the collection, processing, storage, and distribution of biological specimens and the policies and procedures necessary to accomplish those aims successfully. Although biobanking may also involve collections for environmental studies or museum archives, most efforts to standardize biobanking practices have been directed toward human biomedical research. Initially focused primarily on collecting samples for diagnostic purposes in pathology settings, biobanks have evolved into complex organizations engaged in advancing personalized (or precision) medicine and translational research. This evolution has involved the development of biobanking best practices and the transformation of a field driven by empirical approaches into the emerging area of biospecimen science. It has become increasingly important to develop evidence-based practices for collecting biospecimens and data that can be shared with confidence with international collaborators. Aside from these technical approaches, other factors play crucial roles, such as ethical and regulatory issues, business planning and sustainability, and approaches to data collection and sharing.
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Affiliation(s)
- Jim Vaught
- International Society for Biological and Environmental Repositories, Vancouver, British Columbia V5Z 1B3, Canada.,Biopreservation & Biobanking, Kensington, Maryland 20895;
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Master Z, Campo-Engelstein L, Caulfield T. Scientists' perspectives on consent in the context of biobanking research. Eur J Hum Genet 2015; 23:569-74. [PMID: 25074466 PMCID: PMC4402622 DOI: 10.1038/ejhg.2014.143] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2014] [Revised: 05/28/2014] [Accepted: 06/25/2014] [Indexed: 12/21/2022] Open
Abstract
Most bioethics studies have focused on capturing the views of patients and the general public on research ethics issues related to informed consent for biobanking and only a handful of studies have examined the perceptions of scientists. Capturing the opinions of scientists is important because they are intimately involved with biobanks as collectors and users of samples and health information. In this study, we performed interviews with scientists followed by qualitative analysis to capture the diversity of perspectives on informed consent. We found that the majority of scientists in our study reported their preference for a general consent approach although they do not believe there to be a consensus on consent type. Despite their overall desire for a general consent model, many reported several concerns including donors needing some form of assurance that nothing unethical will be done with their samples and information. Finally, scientists reported mixed opinions about incorporating exclusion clauses in informed consent as a means of limiting some types of contentious research as a mechanism to assure donors that their samples and information are being handled appropriately. This study is one of the first to capture the views of scientists on informed consent in biobanking. Future studies should attempt to generalize findings on the perspectives of different scientists on informed consent for biobanking.
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Affiliation(s)
- Zubin Master
- Alden March Bioethics Institute, Albany Medical College, Albany, NY, USA
- Health Law Institute, Law Centre, University of Alberta, Edmonton, Alberta, Canada
| | - Lisa Campo-Engelstein
- Alden March Bioethics Institute, OBGYN Department, Albany Medical College, Albany, NY, USA
| | - Timothy Caulfield
- Health Law Institute, Faculty of Law and School of Public Health, Law Centre, University of Alberta, Edmonton, Alberta, Canada
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Miller J, Soulier A, Bertier G, Cambon-Thomsen A. Professionals' attitudes regarding large-scale genetic information generated through next generation sequencing in research: a pilot study. J Empir Res Hum Res Ethics 2015; 9:56-8. [PMID: 25746785 DOI: 10.1177/1556264614540595] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Under the auspices of a multi-national European scientific project involving whole genome sequencing, GEUVADIS, we set out to investigate the attitudes of the participating scientists of having their own genome sequenced. The views of such researchers on this subject have not been fully explored before and we utilized questionnaires and discussion groups to elicit their opinions. Many said that it was the first time that they had an opportunity to discuss ethical and social issues about sequencing. The many ongoing multi-national science projects present a good opportunity for social science research involving scientists and would benefit from rigorous research methodology, taking into account any language barriers.
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Husedzinovic A, Ose D, Schickhardt C, Fröhling S, Winkler EC. Stakeholders' perspectives on biobank-based genomic research: systematic review of the literature. Eur J Hum Genet 2015; 23:1607-14. [PMID: 25735479 DOI: 10.1038/ejhg.2015.27] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Revised: 01/19/2015] [Accepted: 01/27/2015] [Indexed: 11/09/2022] Open
Abstract
The success of biobank-based genomic research is widely dependent on people's willingness to donate their tissue. Thus, stakeholders' opinions should be considered in the development of best practice guidelines for research and recruiting participants. We systematically analyzed the empirical literature describing different stakeholders' views towards ethical questions with regard to type of consent, data sharing and return of incidental findings. Patients are more open to one-time general consent than the public. Only a small proportion desires recontact if the research aim changed. A broad consent model would prevent only a small proportion of patients from participating in research. Although professionals are concerned about a risk of reidentification, patients and the public support data sharing and find that the benefit of research outweighs the potential risk of reidentification. However, they desire detailed information about the privacy protection measures. Regarding the return of incidental findings, the public and professionals focus on clinically actionable results, whereas patients are interested in receiving as much information as possible. For professionals, concrete guidelines that help managing the return of incidental findings should be warranted. For this it would be helpful addressing the different categories - actionable, untreatable and inheritable diseases - upfront with patients and public.
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Affiliation(s)
- Alma Husedzinovic
- Programme for Ethics and Patient-Oriented Care in Oncology, National Center for Tumor Diseases (NCT), Heidelberg University Hospital, Heidelberg, Germany.,Department of Translational Oncology, National Center for Tumor Diseases (NCT), German Cancer Research Center (DKFZ), Heidelberg University Hospital, Heidelberg, Germany
| | - Dominik Ose
- Department of General Practice and Health Services Research, Heidelberg University Hospital, Heidelberg, Germany
| | - Christoph Schickhardt
- Programme for Ethics and Patient-Oriented Care in Oncology, National Center for Tumor Diseases (NCT), Heidelberg University Hospital, Heidelberg, Germany
| | - Stefan Fröhling
- Department of Translational Oncology, National Center for Tumor Diseases (NCT), German Cancer Research Center (DKFZ), Heidelberg University Hospital, Heidelberg, Germany
| | - Eva C Winkler
- Programme for Ethics and Patient-Oriented Care in Oncology, National Center for Tumor Diseases (NCT), Heidelberg University Hospital, Heidelberg, Germany
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Petersen GM, Van Ness B. Returning a Research Participant's Genomic Results to Relatives: Perspectives from Managers of Two Distinct Research Biobanks. THE JOURNAL OF LAW, MEDICINE & ETHICS : A JOURNAL OF THE AMERICAN SOCIETY OF LAW, MEDICINE & ETHICS 2015; 43:523-528. [PMID: 26479561 PMCID: PMC4617601 DOI: 10.1111/jlme.12294] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Research biobanks are heterogeneous and exist to manage diverse biosample types with the goal of facilitating and serving biomedical discovery. The perspectives of biobank managers are reviewed, and the perspectives of two biobank directors, one with experience in institutional biobanks and the other with national cooperative group banks, are presented. Most research biobanks are not designed, nor do they have the resources, to return research results and incidental findings to participants or their families.
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Affiliation(s)
- Gloria M Petersen
- Professor of Epidemiology in the Department of Health Sciences Research at Mayo Clinic College of Medicine in Rochester, Minnesota. She earned her Master's degree in Anthropology from the University of Oregon, and Ph.D. in Anthropology from UCLA. She is a Founding Fellow of the American College of Medical Genetics and Genomics
| | - Brian Van Ness
- Professor of Genetics, Cell Biology and Development at the University of Minnesota. He earned his doctorate in Biochemistry from the University of Minnesota and completed a postdoctoral fellowship at Fox Chase Cancer Center in Philadelphia, and has served as the Department Head and Director of the Institute of Human Genetics at the University of Minnesota
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Gourna EG, Armstrong N, Wallace SE. Incidental findings from clinical sequencing in Greece: reporting experts' attitudes. J Community Genet 2014; 5:383-93. [PMID: 25048384 PMCID: PMC4159477 DOI: 10.1007/s12687-014-0194-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Accepted: 07/03/2014] [Indexed: 12/20/2022] Open
Abstract
Unprecedented progress in sequencing technologies and decreasing cost have brought genomic testing into the clinical setting. At the same time, the debate in the literature concerning the return of incidental findings (IFs) has made this an important issue internationally. These developments reflect a shift in genetics that will also affect smaller countries, such as Greece, that are just starting to implement these technologies and may look to other countries for examples of good practice. Ten in-depth interviews were conducted with Greek experts in clinical sequencing. Previous experiences and attitudes toward IFs and clinical sequencing were investigated as well as views on the existing policy regarding managing genetic information generated through testing. . Interviews were analysed using thematic analysis. All participants reported the lack of any legal or other supportive mechanism. IFs are currently managed at a “local” level, i.e. within the clinic or the laboratory in an ad hoc way. All participants thought that clinically valid and actionable IFs should be returned, but always with caution and in respect to patients’ wishes, although several experts reported returning IFs according to their clinical discretion. Experts reported that most patients ask for all tests available but they felt that more counselling is needed to understand and manage genetic information. Due to the lack of any supporting mechanisms, professionals in Greece, even those with established experience in the field of genetic and genomic testing, have difficulties dealing with IFs. All experts agreed that it is now time, before the full integration of genomic testing into everyday clinical practice, for guidance to help Greek physicians work with patients and their families when IFs are discovered.
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Affiliation(s)
- E G Gourna
- Department of Health Sciences, University of Leicester, Adrian Building, Leicester, LE1 7RH, UK,
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Return of genetic results in the familial dilated cardiomyopathy research project. J Genet Couns 2012; 22:164-74. [PMID: 22886719 DOI: 10.1007/s10897-012-9532-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2011] [Accepted: 07/20/2012] [Indexed: 01/06/2023]
Abstract
The goal of the Familial Dilated Cardiomyopathy (FDC) Research Project, initiated in 1993, has been to identify and characterize FDC genetic cause. All participating individuals have been consented for the return of genetic results, an important but challenging undertaking. Since the inception of the Project we have enrolled 606 probands, and 269 of these had 1670 family members also enrolled. Each subject was evaluated for idiopathic dilated cardiomyopathy (IDC) and pedigrees were categorized as familial or sporadic. The coding regions of 14 genes were resequenced in 311 to 324 probands in five studies. Ninety-two probands were found to carry nonsynonymous rare variants absent in controls, and with Clinical Laboratory Improvement Amendment of 1988 (CLIA) compliant protocols, relevant genetic results were returned to these probands and their consented relatives by study genetic counselors and physicians in 353 letters. In 10 of the 51 families that received results >1 year ago, at least 23 individuals underwent CLIA confirmation testing for their family's rare variant. Return of genetic results has been successfully undertaken in the FDC Research Project. This report describes the methods utilized in the process of returning research results. We use this information as a springboard for providing guidance to other genetic research groups and proposing future directions in this arena.
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