1
|
Ankolekar A, Eppings L, Bottari F, Pinho IF, Howard K, Baker R, Nan Y, Xing X, Walsh SLF, Vos W, Yang G, Lambin P. Using artificial intelligence and predictive modelling to enable learning healthcare systems (LHS) for pandemic preparedness. Comput Struct Biotechnol J 2024; 24:412-419. [PMID: 38831762 PMCID: PMC11145382 DOI: 10.1016/j.csbj.2024.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 05/07/2024] [Accepted: 05/07/2024] [Indexed: 06/05/2024] Open
Abstract
In anticipation of potential future pandemics, we examined the challenges and opportunities presented by the COVID-19 outbreak. This analysis highlights how artificial intelligence (AI) and predictive models can support both patients and clinicians in managing subsequent infectious diseases, and how legislators and policymakers could support these efforts, to bring learning healthcare system (LHS) from guidelines to real-world implementation. This report chronicles the trajectory of the COVID-19 pandemic, emphasizing the diverse data sets generated throughout its course. We propose strategies for harnessing this data via AI and predictive modelling to enhance the functioning of LHS. The challenges faced by patients and healthcare systems around the world during this unprecedented crisis could have been mitigated with an informed and timely adoption of the three pillars of the LHS: Knowledge, Data and Practice. By harnessing AI and predictive analytics, we can develop tools that not only detect potential pandemic-prone diseases early on but also assist in patient management, provide decision support, offer treatment recommendations, deliver patient outcome triage, predict post-recovery long-term disease impacts, monitor viral mutations and variant emergence, and assess vaccine and treatment efficacy in real-time. A patient-centric approach remains paramount, ensuring patients are both informed and actively involved in disease mitigation strategies.
Collapse
Affiliation(s)
- Anshu Ankolekar
- Department of Precision Medicine, GROW School for Oncology, Maastricht University Medical Centre+, Maastricht, the Netherlands
| | - Lisanne Eppings
- Department of Precision Medicine, GROW School for Oncology, Maastricht University Medical Centre+, Maastricht, the Netherlands
| | | | | | | | | | - Yang Nan
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Xiaodan Xing
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Simon LF Walsh
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Wim Vos
- Radiomics (Oncoradiomics SA), Liege, Belgium
| | - Guang Yang
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
- Bioengineering Department and I-X, Imperial College London, London, United Kingdom
| | - Philippe Lambin
- Department of Precision Medicine, GROW School for Oncology, Maastricht University Medical Centre+, Maastricht, the Netherlands
| |
Collapse
|
2
|
Lalova-Spinks T, Valcke P, Ioannidis JPA, Huys I. EU-US data transfers: an enduring challenge for health research collaborations. NPJ Digit Med 2024; 7:215. [PMID: 39152232 PMCID: PMC11329736 DOI: 10.1038/s41746-024-01205-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 07/29/2024] [Indexed: 08/19/2024] Open
Abstract
EU-US data transfers for health research remain a particularly thorny issue in view of the stringent rules of the EU General Data Protection Regulation (GDPR) and the challenges related to US mass surveillance programs, particularly the manner in which US law enforcement and national security agencies can access personal data originating from the EU. Since the entry into force of the GDPR, evidence of impeded collaborations is increasing, particularly in the case of sharing data with US public institutions. The adoption of a new EU-US adequacy decision in July 2023 does not hold the promise for a long-lasting solution due to the risks of being challenged and invalidated - yet again - at the Court of Justice of the EU. As the research community is calling for answers, the new proposal for a European Health Data Space regulation may hold a key to solving some of the existing issues. In this paper, we critically discuss the current rules and outline a possible way forward for transfers between public bodies.
Collapse
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.
| | - Peggy Valcke
- Center for IT & IP law (CiTiP), KU Leuven, Leuven, Belgium
| | - John P A Ioannidis
- Meta-Research Innovation Center at Stanford, Stanford University, Stanford, CA, USA
| | - Isabelle Huys
- Clinical Pharmacology and Pharmacotherapy, Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium
| |
Collapse
|
3
|
Kurihara C, Applegate KE, Jeong JH, Akahane K, Kang KW. Radiological protection in human research ethics using a case study: toward update of the ICRP Publication 62. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2023; 43:044002. [PMID: 37857271 DOI: 10.1088/1361-6498/ad04f0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 10/19/2023] [Indexed: 10/21/2023]
Abstract
The benefits of biomedical research involving humans are well recognised, along with the need for conformity to international standards of science and ethics. When human research involves radiation imaging procedures or radiotherapy, an extra level of expert review should be provided from the point of view of radiological protection. The relevant publication of the International Commission for Radiological Protection (ICRP) is now three decades old and is currently undergoing an update. This paper aims to provoke discussions on how the risks of radiation dose and the benefits of research should be assessed, using a case study of diagnostic radiology involving volunteers for whom there is no direct benefit. Further, the paper provides the current understanding of key concepts being considered for review and revision-such as the dose constraint and the novel research methods on the horizon, including radiation biology and epidemiology. The analysis revisits the perspectives described in the ICRP Publication 62, and considers the recent progress in both radiological protection ethics and medical research ethics.
Collapse
Affiliation(s)
| | - Kimberly E Applegate
- Department of Radiology, University of Kentucky College of Medicine, Lexington, KY, United States of America
| | - Jee Hyang Jeong
- Department of Neurology, Ewha Womans University School of Medicine, Seoul, Republic of Korea
| | - Keiichi Akahane
- National Institutes for Quantum Science and Technology, Chiba, Japan
| | - Keon Wook Kang
- Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| |
Collapse
|
4
|
Tiberghien P, Rodrigues B, Jacques M, O'Leary P, Domanović D. The European health data space proposal: An opportunity for improved blood donor protection and transfusion recipient care. Transfus Clin Biol 2023; 30:369-370. [PMID: 37758062 DOI: 10.1016/j.tracli.2023.09.390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/03/2023]
Affiliation(s)
- Pierre Tiberghien
- European Blood Alliance, Brussels, Belgium; Etablissement Français du Sang, La Plaine Saint-Denis, France.
| | | | - Marjolaine Jacques
- European Blood Alliance, Brussels, Belgium; Etablissement Français du Sang, La Plaine Saint-Denis, France
| | | | | |
Collapse
|
5
|
Knoppers BM, Bernier A, Bowers S, Kirby E. Open Data in the Era of the GDPR: Lessons from the Human Cell Atlas. Annu Rev Genomics Hum Genet 2023; 24:369-391. [PMID: 36791787 DOI: 10.1146/annurev-genom-101322-113255] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
The Human Cell Atlas (HCA) is striving to build an open community that is inclusive of all researchers adhering to its principles and as open as possible with respect to data access and use. However, open data sharing can pose certain challenges. For instance, being a global initiative, the HCA must contend with a patchwork of local and regional privacy rules. A notable example is the implementation of the European Union General Data Protection Regulation (GDPR), which caused some concern in the biomedical and genomic data-sharing community. We examine how the HCA's large, international group of researchers is investing tremendous efforts into ensuring appropriate sharing of data. We describe the HCA's objectives and governance, how it defines open data sharing, and ethico-legal challenges encountered early in its development; in particular, we describe the challenges prompted by the GDPR. Finally, we broaden the discussion to address tools and strategies that can be used to address ethical data governance.
Collapse
Affiliation(s)
- Bartha Maria Knoppers
- Centre of Genomics and Policy, School of Biomedical Sciences, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada; , ,
| | - Alexander Bernier
- Centre of Genomics and Policy, School of Biomedical Sciences, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada; , ,
| | | | - Emily Kirby
- Centre of Genomics and Policy, School of Biomedical Sciences, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada; , ,
| |
Collapse
|
6
|
Li X, Cong Y, Liu R. Research under China’s personal information law. Science 2022; 378:713-715. [DOI: 10.1126/science.abq7402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The new law may present obstacles to some kinds of research
Collapse
Affiliation(s)
- Xiaojie Li
- Department of Medical Ethics and Law, Peking University Health Science Center, Beijing, China
- Department of Situation and Policy, University of International Business and Economics, Beijing, China
| | - Yali Cong
- Department of Medical Ethics and Law, Peking University Health Science Center, Beijing, China
- National Institute of Health Data Science, Peking University, Beijing, China
| | - Ruishuang Liu
- Department of Medical Ethics and Law, Peking University Health Science Center, Beijing, China
- National Institute of Health Data Science, Peking University, Beijing, China
| |
Collapse
|
7
|
3-Methylmethcathinone (3-MMC) Poisonings: Acute Clinical Toxicity and Time Trend Between 2013 and 2021 in the Netherlands. Ann Emerg Med 2022; 80:203-212. [PMID: 35752518 DOI: 10.1016/j.annemergmed.2022.04.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 03/18/2022] [Accepted: 04/15/2022] [Indexed: 11/22/2022]
Abstract
STUDY OBJECTIVE The synthetic cathinone 3-methylmethcathinone (3-MMC, or metaphedrone) has recently gained popularity. We studied the numbers of 3-MMC poisonings over time and the clinical effects following poisonings with 3-MMC. METHODS We performed a retrospective study on the numbers of self-reported 3-MMC poisonings to the Dutch Poisons Information Center (DPIC) from 2013 to June 2021. For poisonings reporting 3-MMC only, the symptoms were extracted and the Poisoning Severity Score (PSS) was determined. From 2016 to June 2019, a prospective cohort study on poisonings reporting only 3-MMC was performed, in which details on the clinical courses were collected through telephone interviews. RESULTS From 2013 to June 2021, the DPIC was consulted on 184 3-MMC poisonings. The number of poisonings increased from 1 in 2013 to 70 in the first half of 2021. In 84 poisonings with only 3-MMC (46%), sympathomimetic symptoms were commonly reported, including tachycardia (n=29, 35%), hypertension (n=17, 20%), and agitation (n=16, 19%). The initial PSS was usually minor (n=37, 44%) to moderate (n=39, 46%). Five patients (6%) experienced severe effects, including 3 patients experienced severe hypertension (systolic blood pressure >180 mmHg; n=3) and nonfatal cardiac arrest (n=1). Sympathomimetic symptoms (n=8) were also reported in the prospective cohort study. The percentage of moderate poisonings increased (n=6, 75%), and 1 (13%) severe poisoning was observed. Analytical confirmation of 3-MMC exposure was performed in 2 cases. CONCLUSION The number of 3-MMC poisonings reported to the DPIC has increased over time. Most poisonings with 3-MMC resulted in moderate toxicity and involved sympathomimetic effects, while severe effects were observed in 5 cases.
Collapse
|
8
|
Bentzen HB. Exchange of Human Data Across International Boundaries. Annu Rev Biomed Data Sci 2022; 5:233-250. [PMID: 35537460 DOI: 10.1146/annurev-biodatasci-122220-110811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
There is a need to share personal data across jurisdictional boundaries. However, the laws regulating such transfers are not harmonized, and sometimes even conflict, causing challenges and occasional data stalls. This review describes the legal landscape for transfer of human data across international boundaries. The European Union's data protection legislation is used as the starting point for illustrating the legislation of countries across the world, how these diverge, and one's options for exchanging human data internationally in a legally compliant manner. Expected final online publication date for the Annual Review of Biomedical Data Science, Volume 5 is August 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
Collapse
Affiliation(s)
- Heidi Beate Bentzen
- Norwegian Research Center for Computers and Law, Faculty of Law, and Centre for Medical Ethics, Faculty of Medicine, University of Oslo, Oslo, Norway;
| |
Collapse
|
9
|
Abstract
Questions of consent and public interest research loom large.
Collapse
Affiliation(s)
- Mahsa Shabani
- Metamedica, Faculty of Law and Criminology, Ghent University, Campus Aula, Ghent, Belgium
| |
Collapse
|
10
|
Eke DO, Bernard A, Bjaalie JG, Chavarriaga R, Hanakawa T, Hannan AJ, Hill SL, Martone ME, McMahon A, Ruebel O, Crook S, Thiels E, Pestilli F. International data governance for neuroscience. Neuron 2022; 110:600-612. [PMID: 34914921 PMCID: PMC8857067 DOI: 10.1016/j.neuron.2021.11.017] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 06/16/2021] [Accepted: 11/15/2021] [Indexed: 12/19/2022]
Abstract
As neuroscience projects increase in scale and cross international borders, different ethical principles, national and international laws, regulations, and policies for data sharing must be considered. These concerns are part of what is collectively called data governance. Whereas neuroscience data transcend borders, data governance is typically constrained within geopolitical boundaries. An international data governance framework and accompanying infrastructure can assist investigators, institutions, data repositories, and funders with navigating disparate policies. Here, we propose principles and operational considerations for how data governance in neuroscience can be navigated at an international scale and highlight gaps, challenges, and opportunities in a global brain data ecosystem. We consider how to approach data governance in a way that balances data protection requirements and the need for open science, so as to promote international collaboration through federated constructs such as the International Brain Initiative (IBI).
Collapse
Affiliation(s)
- Damian O Eke
- Centre for Computing and Social Responsibility, De Montfort University, Leicester, UK; Human Brain Project
| | | | | | - Ricardo Chavarriaga
- Center for Artificial Intelligence, School of Engineering, Zurich University of Applied Sciences, Zurich, Switzerland
| | | | - Anthony J Hannan
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia
| | - Sean L Hill
- Krembil Centre for Neuroinformatics, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | | | | | - Oliver Ruebel
- Scientific Data Division, Lawrence Berkeley National Laboratory, Berkeley, CA, USA
| | - Sharon Crook
- School of Mathematical and Statistical Sciences, Arizona State University, Tempe, AZ, USA
| | - Edda Thiels
- National Science Foundation, Alexandria, VA, USA
| | - Franco Pestilli
- Department of Psychology, Center for Perceptual Systems, Center for Theoretical and Computational Neuroscience, and Institute for Neuroscience, University of Texas, Austin, TX, USA.
| |
Collapse
|
11
|
Molnar-Gabor F, Beauvais MJ, Bernier A, Nicolas P, Recuero Lineares M, Knoppers BM. Bridging the European Data Sharing Divide in Genomic Science (Preprint). J Med Internet Res 2022; 24:e37236. [DOI: 10.2196/37236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 06/08/2022] [Accepted: 08/19/2022] [Indexed: 11/13/2022] Open
|
12
|
Ursin G, Bentzen HB. Open science and sharing personal data widely - legally impossible for Europeans? Acta Oncol 2021; 60:1555-1556. [PMID: 34797207 DOI: 10.1080/0284186x.2021.1995894] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Giske Ursin
- Cancer Registry of Norway, Oslo, Norway
- Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Heidi Beate Bentzen
- Cancer Registry of Norway, Oslo, Norway
- Norwegian Research Center for Computers and Law, Faculty of Law, University of Oslo, Oslo, Norway
| |
Collapse
|
13
|
Hallinan D, Bernier A, Cambon-Thomsen A, Crawley FP, Dimitrova D, Medeiros CB, Nilsonne G, Parker S, Pickering B, Rennes S. International transfers of personal data for health research following Schrems II: a problem in need of a solution. Eur J Hum Genet 2021; 29:1502-1509. [PMID: 33953344 PMCID: PMC8099706 DOI: 10.1038/s41431-021-00893-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 03/31/2021] [Accepted: 04/06/2021] [Indexed: 02/07/2023] Open
Abstract
On 16 July 2020, the Court of Justice of the European Union issued their decision in the Schrems II case concerning Facebook's transfers of personal data from the EU to the US. The decision may have significant effects on the legitimate transfer of personal data for health research purposes from the EU. This article aims: (i) to outline the consequences of the Schrems II decision for the sharing of personal data for health research between the EU and third countries, particularly in the context of the COVID-19 pandemic; and, (ii) to consider certain options available to address the consequences of the decision and to facilitate international data exchange for health research moving forward.
Collapse
Affiliation(s)
- Dara Hallinan
- FIZ Karlsruhe-Leibniz-Institut für Informationsinfrastruktur, Hermann-von-Helmholtz-Platz 1, Eggenstein-Leopoldshafen, Germany.
| | - Alexander Bernier
- McGill University Faculty of Medicine, Centre of Genomics and Policy, Montreal, Canada
| | - Anne Cambon-Thomsen
- CNRS, Center for Epidemiology and Research in POPulation health (CERPOP), Université de Toulouse, Inserm, UPS, Joint Unit 1295, Toulouse, France
| | - Francis P Crawley
- Good Clinical Practice Alliance-Europe (GCPA) and Strategic Initiative for Developing Capacity in Ethical Review (SIDCER), Leuven, Belgium
| | - Diana Dimitrova
- FIZ Karlsruhe-Leibniz-Institut für Informationsinfrastruktur, Hermann-von-Helmholtz-Platz 1, Eggenstein-Leopoldshafen, Germany
| | | | - Gustav Nilsonne
- Department of Clinical Neuroscience, Karolinska Institutet, Solna, Sweden
- Swedish National Data Service, University of Gothenburg, Gothenburg, Sweden
| | - Simon Parker
- Cancer Research UK, London, UK
- German Human Genome-phenome Archive, DKFZ, Heidelberg, Germany
| | | | - Stéphanie Rennes
- INRAE, Direction des affaires juridiques, Paris, France
- University of Strasbourg, Bureau d'économie théorique et appliquée, Joint Unit 7522, Strasbourg, France
| |
Collapse
|
14
|
Knoppers BM, Beauvais MJS. Three decades of genetic privacy: a metaphoric journey. Hum Mol Genet 2021; 30:R156-R160. [PMID: 34155499 PMCID: PMC8490012 DOI: 10.1093/hmg/ddab164] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 06/14/2021] [Accepted: 06/16/2021] [Indexed: 12/03/2022] Open
Abstract
Debates surrounding genetic privacy have taken on different forms over the past 30 years. Taking genetic privacy to mean an interest that individuals, families, or even communities have with respect to genetic information, we examine the metaphors used in these debates to chronicle the development of genetic privacy. In 1990-2000, we examine claims for ownership and of 'humanity' spurred by the launch of the Human Genome Project and related endeavors. In 2000-2010, we analyze the interface of law and ethics with research infrastructures such as biobanks, for which notions of citizenship and 'public goods' were central. In 2010-2020, we detail the relational turn of genetic privacy in response of large international research consortia and big data. Although each decade had its leading conceptions of genetic privacy, the subject is neither strictly chronological nor static. We conclude with reflections on the nature of genetic privacy and the necessity to bring together the unique and private genetic self with the human other.
Collapse
Affiliation(s)
- Bartha Maria Knoppers
- Centre of Genomics and Policy, Department of Human Genetics, Faculty of Medicine, McGill University, 740 av Dr Penfield, Montreal, Quebec H3A 0G1 Canada
- Canada Research Chair in Law and Medicine
| | - Michael J S Beauvais
- Centre of Genomics and Policy, Department of Human Genetics, Faculty of Medicine, McGill University, 740 av Dr Penfield, Montreal, Quebec H3A 0G1 Canada
| |
Collapse
|
15
|
Perez-Pozuelo I, Spathis D, Gifford-Moore J, Morley J, Cowls J. Digital phenotyping and sensitive health data: Implications for data governance. J Am Med Inform Assoc 2021; 28:2002-2008. [PMID: 33647989 PMCID: PMC8363798 DOI: 10.1093/jamia/ocab012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 01/14/2021] [Accepted: 01/21/2020] [Indexed: 01/08/2023] Open
Abstract
In this perspective we want to highlight the rise of what we call "digital phenotyping" or inferring insights about peopleãs health and behavior from their digital devices and data, and the challenges this introduces. Indeed, the collection, processing, and storage of data comes with significant ethical, security and data governance considerations. The COVID-19 pandemic has laid bare the importance of scientific data and modeling, both to understand the nature and spread of the disease, and to develop treatment. But digital devices have also played a (controversial) role, with track and trace systems and increasingly "vaccine passports" being rolled out to help societies open back up. These systems epitomize a wider and longer-standing trend towards seeing almost any form of personal data as potentially health data, especially with the rise of consumer health trackers and other gadgets. Here, we offer an overview of the risks this introduces, drawing on the earlier revolution in genomic sequencing, and propose guidelines to help protect privacy whilst utilizing personal data to help get society back up to speed.
Collapse
Affiliation(s)
- Ignacio Perez-Pozuelo
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
- The Alan Turing Institute, London, United Kingdom
| | - Dimitris Spathis
- Department of Computer Science and Technology, University of Cambridge, Cambridge, United Kingdom
| | | | - Jessica Morley
- Oxford Internet Institute, University of Oxford, Oxford, United Kingdom
- Nuffield Department of Primary Care, University of Oxford, Oxford, United Kingdom
| | - Josh Cowls
- The Alan Turing Institute, London, United Kingdom
- Oxford Internet Institute, University of Oxford, Oxford, United Kingdom
| |
Collapse
|
16
|
Bentzen HB, Castro R, Fears R, Griffin G, Ter Meulen V, Ursin G. Remove obstacles to sharing health data with researchers outside of the European Union. Nat Med 2021; 27:1329-1333. [PMID: 34345050 PMCID: PMC8329618 DOI: 10.1038/s41591-021-01460-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
COVID-19 has shown that international collaborations and global data sharing are essential for health research, but legal obstacles are preventing data sharing for non–pandemic-related research among public researchers across the world, with potentially damaging effects for citizens and patients.
Collapse
Affiliation(s)
- Heidi Beate Bentzen
- Norwegian Research Center for Computers and Law, Faculty of Law, University of Oslo, Oslo, Norway.,Cancer Registry of Norway, Oslo, Norway
| | - Rosa Castro
- Federation of European Academies of Medicine, Brussels, Belgium.
| | - Robin Fears
- European Academies Science Advisory Council, German National Academy of Sciences Leopoldina, Halle (Saale), Germany
| | - George Griffin
- Department of Infectious Diseases and Medicine, St. George's University of London, London, UK
| | - Volker Ter Meulen
- European Academies Science Advisory Council, German National Academy of Sciences Leopoldina, Halle (Saale), Germany
| | - Giske Ursin
- Cancer Registry of Norway, Oslo, Norway.,Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.,Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, Los Angeles, CA, USA
| |
Collapse
|
17
|
Knoppers BM, Bernier A, Granados Moreno P, Pashayan N. Of Screening, Stratification, and Scores. J Pers Med 2021; 11:736. [PMID: 34442379 PMCID: PMC8398020 DOI: 10.3390/jpm11080736] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 07/24/2021] [Indexed: 12/16/2022] Open
Abstract
Technological innovations including risk-stratification algorithms and large databases of longitudinal population health data and genetic data are allowing us to develop a deeper understanding how individual behaviors, characteristics, and genetics are related to health risk. The clinical implementation of risk-stratified screening programmes that utilise risk scores to allocate patients into tiers of health risk is foreseeable in the future. Legal and ethical challenges associated with risk-stratified cancer care must, however, be addressed. Obtaining access to the rich health data that are required to perform risk-stratification, ensuring equitable access to risk-stratified care, ensuring that algorithms that perform risk-scoring are representative of human genetic diversity, and determining the appropriate follow-up to be provided to stratification participants to alert them to changes in their risk score are among the principal ethical and legal challenges. Accounting for the great burden that regulatory requirements could impose on access to risk-scoring technologies is another critical consideration.
Collapse
Affiliation(s)
- Bartha M. Knoppers
- Centre of Genomics and Policy, Faculty of Medicine, McGill University, 740 Avenue Dr. Penfield, Suite 5200, Montreal, QC H3A 0G1, Canada; (A.B.); (P.G.M.)
| | - Alexander Bernier
- Centre of Genomics and Policy, Faculty of Medicine, McGill University, 740 Avenue Dr. Penfield, Suite 5200, Montreal, QC H3A 0G1, Canada; (A.B.); (P.G.M.)
| | - Palmira Granados Moreno
- Centre of Genomics and Policy, Faculty of Medicine, McGill University, 740 Avenue Dr. Penfield, Suite 5200, Montreal, QC H3A 0G1, Canada; (A.B.); (P.G.M.)
| | - Nora Pashayan
- Department of Applied Health Research, University College London, 1-19 Torrington Place, London WC1E 7HB, UK;
| |
Collapse
|
18
|
Bernier A, Knoppers BM. Longitudinal Health Studies: Secondary Uses Serving the Future. Biopreserv Biobank 2021; 19:404-413. [PMID: 34171963 DOI: 10.1089/bio.2020.0171] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Our research compares the ethical and institutional conditions that govern the sharing and secondary use of longitudinal population health data from multiple cohorts. The data use and data sharing conditions applicable to 27 population health cohorts were assessed. This assessment was performed in consulting the informed consent materials and institutional policies applicable to the use of data. Descriptions drawn from the research ethics consent materials were refined through dialog with the institutional staff responsible for overseeing access to data, where possible. Our results demonstrate that data of longitudinal population health cohorts assessed can generally be shared and used for secondary purposes. However, the purposes of secondary use and the preconditions applicable thereto are highly variable. Heterogeneous use conditions can also impede the storage of legacy research data and the pooling thereof for the purpose of common reuse.
Collapse
Affiliation(s)
- Alexander Bernier
- Centre of Genomics and Policy, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Bartha Maria Knoppers
- Centre of Genomics and Policy, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| |
Collapse
|
19
|
Affiliation(s)
- Kenneth D Mandl
- From the Computational Health Informatics Program, Boston Children's Hospital, and the Department of Biomedical Informatics, Harvard Medical School - both in Boston (K.D.M.); and the Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (E.D.P.)
| | - Eric D Perakslis
- From the Computational Health Informatics Program, Boston Children's Hospital, and the Department of Biomedical Informatics, Harvard Medical School - both in Boston (K.D.M.); and the Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (E.D.P.)
| |
Collapse
|
20
|
Beauvais MJS, Knoppers BM. Coming Out to Play: Privacy, Data Protection, Children's Health, and COVID-19 Research. Front Genet 2021; 12:659027. [PMID: 33936177 PMCID: PMC8080022 DOI: 10.3389/fgene.2021.659027] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 03/19/2021] [Indexed: 12/29/2022] Open
Abstract
The COVID-19 pandemic has underscored the need for new ways of thinking about data protection. This is especially so in the case of health research with children. The responsible use of children's data plays a key role in promoting children's well-being and securing their right to health and to privacy. In this article, we contend that a contextual approach that appropriately balances children's legal and moral rights and interests is needed when thinking about data protection issues with children. We examine three issues in health research through a child-focused lens: consent to data processing, data retention, and data protection impact assessments. We show that these issues present distinctive concerns for children and that the General Data Protection Regulation provides few bright-line rules. We contend that there is an opportunity for creative approaches to children's data protection when child-specific principles, such as the best interests of the child and the child's right to be heard, are put into dialogue with the structure and logic of data protection law.
Collapse
Affiliation(s)
- Michael J. S. Beauvais
- Centre of Genomics and Policy, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Bartha Maria Knoppers
- Centre of Genomics and Policy, Faculty of Medicine, McGill University, Montreal, QC, Canada
- Canada Research Chair in Law and Medicine, Montreal, QC, Canada
| |
Collapse
|
21
|
Abstract
The implementation of the EU General Data Protection Regulation (GDPR) has had significant impacts on biomedical research, often complicating data sharing among researchers. The recently announced proposal for a new EU Data Governance Act is a promising step towards facilitating data sharing, if it can interplay well with the GDPR.
Collapse
Affiliation(s)
- Mahsa Shabani
- MetamedicaFaculty of Law and CriminologyGhent UniversityGhentBelgium
| |
Collapse
|
22
|
Scheibner J, Raisaro JL, Troncoso-Pastoriza JR, Ienca M, Fellay J, Vayena E, Hubaux JP. Revolutionizing Medical Data Sharing Using Advanced Privacy-Enhancing Technologies: Technical, Legal, and Ethical Synthesis. J Med Internet Res 2021; 23:e25120. [PMID: 33629963 PMCID: PMC7952236 DOI: 10.2196/25120] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 01/06/2021] [Accepted: 01/16/2021] [Indexed: 12/03/2022] Open
Abstract
Multisite medical data sharing is critical in modern clinical practice and medical research. The challenge is to conduct data sharing that preserves individual privacy and data utility. The shortcomings of traditional privacy-enhancing technologies mean that institutions rely upon bespoke data sharing contracts. The lengthy process and administration induced by these contracts increases the inefficiency of data sharing and may disincentivize important clinical treatment and medical research. This paper provides a synthesis between 2 novel advanced privacy-enhancing technologies-homomorphic encryption and secure multiparty computation (defined together as multiparty homomorphic encryption). These privacy-enhancing technologies provide a mathematical guarantee of privacy, with multiparty homomorphic encryption providing a performance advantage over separately using homomorphic encryption or secure multiparty computation. We argue multiparty homomorphic encryption fulfills legal requirements for medical data sharing under the European Union's General Data Protection Regulation which has set a global benchmark for data protection. Specifically, the data processed and shared using multiparty homomorphic encryption can be considered anonymized data. We explain how multiparty homomorphic encryption can reduce the reliance upon customized contractual measures between institutions. The proposed approach can accelerate the pace of medical research while offering additional incentives for health care and research institutes to employ common data interoperability standards.
Collapse
Affiliation(s)
- James Scheibner
- Health Ethics and Policy Laboratory, Department of Health Sciences and Technology, Eidgenössische Technische Hochschule Zürich, Zürich, Switzerland
- College of Business, Government and Law, Flinders University, Adelaide, Australia
| | - Jean Louis Raisaro
- Precision Medicine Unit, Lausanne University Hospital, Lausanne, Switzerland
- Data Science Group, Lausanne University Hospital, Lausanne, Switzerland
| | - Juan Ramón Troncoso-Pastoriza
- Laboratory for Data Security, School of Computer and Communication Sciences, École polytechnique fédérale de Lausanne, Lausanne, Switzerland
| | - Marcello Ienca
- Health Ethics and Policy Laboratory, Department of Health Sciences and Technology, Eidgenössische Technische Hochschule Zürich, Zürich, Switzerland
| | - Jacques Fellay
- Precision Medicine Unit, Lausanne University Hospital, Lausanne, Switzerland
- School of Life Sciences, École polytechnique fédérale de Lausanne, Lausanne, Switzerland
- Host-Pathogen Genomics Laboratory, Swiss Institute of Bioinformatics, Lausanne, Switzerland
| | - Effy Vayena
- Health Ethics and Policy Laboratory, Department of Health Sciences and Technology, Eidgenössische Technische Hochschule Zürich, Zürich, Switzerland
| | - Jean-Pierre Hubaux
- Laboratory for Data Security, School of Computer and Communication Sciences, École polytechnique fédérale de Lausanne, Lausanne, Switzerland
| |
Collapse
|
23
|
Bledsoe MJ, Garcia DL. ISBER's Role in Shaping Global Policies and Regulations. Biopreserv Biobank 2021; 19:94-96. [PMID: 33464148 DOI: 10.1089/bio.2021.29080.mjb] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Marianna J Bledsoe
- Independent Consultant, Colorado Springs, Colorado, USA
- Chair, ISBER Science Policy Committee
- Deputy Editor, Biopreservation and Biobanking
| | - Debra Leiolani Garcia
- Independent Consultant, San Francisco, California, USA
- ISBER Past President, 2020-2021
| |
Collapse
|