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Ward TH, Gilbert DC, Higginbotham G, Morris CM, Speirs V, Curtin NJ. Radiotherapy biobanking: current landscape, opportunities, challenges, and future aspirations. JOURNAL OF PATHOLOGY CLINICAL RESEARCH 2021; 8:3-13. [PMID: 34658150 PMCID: PMC8682944 DOI: 10.1002/cjp2.246] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 08/09/2021] [Accepted: 09/21/2021] [Indexed: 01/01/2023]
Abstract
Half of all cancer patients receive radiotherapy, which makes a substantial contribution to their long‐term disease control/cure. There are significant inter‐patient differences in response, both in terms of efficacy and toxicity (frequently delayed onset) which are difficult to predict. With the introduction of technological improvements (e.g. stereotactic body radiotherapy and proton therapy) and development of combination therapies (e.g. radiotherapy and immune checkpoint inhibition), predictive biomarkers are needed even more. Whilst genomic studies have contributed significantly to predictions of response to anticancer therapy, there is no doubt that more information can be gathered from patient tissue samples. Patients are willing to donate their tissues to biobanks and wish them to be used as widely as possible for high‐quality research. We report here a survey of the current practices in the UK from several groups collecting material from patients in radiotherapy trials and have identified barriers to collecting and sharing data and samples. We believe the current situation represents a significant missed opportunity to improve the personalisation of radiotherapy. We propose a greater involvement of patients and/or their advocates, a standardisation of the patient information leaflet, consent form content and data set, with easy linkage to clinical data, which would facilitate widespread sample and data discovery and availability to other researchers. The greater sharing of data and samples, nationally and internationally, would facilitate robust multicentre studies and avoid duplication of effort.
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Affiliation(s)
- Tim H Ward
- Patient Advocate, National Cancer Research Institute (NCRI), London, UK
| | - Duncan C Gilbert
- Sussex Cancer Centre, Royal Sussex County Hospital, Brighton, UK.,MRC Clinical Trials Unit at UCL, London, UK
| | | | - Chris M Morris
- Newcastle Brain Tissue Resource, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Valerie Speirs
- Institute of Medical Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - Nicola J Curtin
- Newcastle Centre for Cancer, Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
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Gobat N, Butler CC, Mollison J, Francis NA, Gal M, Harris V, Webb SAR, Byrne JP, Watkins A, Sukumar P, Hood K, Nichol A. What the public think about participation in medical research during an influenza pandemic: an international cross-sectional survey. Public Health 2019; 177:80-94. [PMID: 31557667 DOI: 10.1016/j.puhe.2019.07.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 06/03/2019] [Accepted: 07/02/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVES The public and patients are primary contributors and beneficiaries of pandemic-relevant clinical research. However, their views on research participation during a pandemic have not been systematically studied. We aimed to understand public views regarding participation in clinical research during a hypothetical influenza pandemic. STUDY DESIGN This is an international cross-sectional survey. METHODS We surveyed the views of nationally representative samples of people in Belgium, Poland, Spain, Ireland, the United Kingdom, Canada, Australia and New Zealand, using a scenario-based instrument during the 2017 regional influenza season. Descriptive and regression analyses were conducted. RESULTS Of the 6804 respondents, 5572 (81.8%) thought pandemic-relevant research was important, and 5089 (74.8%) thought 'special rules' should be applied to make this research feasible. The respondents indicated willingness to take part in lower risk (4715, 69.3%) and higher risk (3585, 52.7%) primary care and lower risk (4780, 70.3%) and higher risk (4113, 60.4%) intensive care unit (ICU) study scenarios. For primary care studies, most (3972, 58.4%) participants preferred standard enrolment procedures such as prospective written informed consent, but 2327 (34.2%) thought simplified procedures would be acceptable. For ICU studies, 2800 (41.2%) preferred deferred consent, and 2623 (38.6%) preferred prospective third-party consent. Greater knowledge about pandemics, trust in a health professional, trust in the government, therapeutic misconception and having had ICU experience as a patient or carer predicted increased willingness to participate in pandemic-relevant research. CONCLUSIONS Our study indicates current public support for pandemic-relevant clinical research. Tailored information and initiatives to advance research literacy and maintain trust are required to support pandemic-relevant research participation and engagement.
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Affiliation(s)
- N Gobat
- Nuffield Department of Primary Care Health Sciences, University of Oxford, United Kingdom.
| | - C C Butler
- Nuffield Department of Primary Care Health Sciences, University of Oxford, United Kingdom
| | - J Mollison
- Clinical Trials Unit, Nuffield Department of Primary Care Health Sciences, University of Oxford, United Kingdom
| | - N A Francis
- Division of Population Medicine, School of Medicine, Cardiff University, Wales, United Kingdom
| | - M Gal
- Division of Population Medicine, School of Medicine, Cardiff University, Wales, United Kingdom
| | - V Harris
- Clinical Trials Unit, Nuffield Department of Primary Care Health Sciences, University of Oxford, United Kingdom
| | - S A R Webb
- University of Western Australia, Perth, Australia
| | | | - A Watkins
- Division of Population Medicine, School of Medicine, Cardiff University, Wales, United Kingdom
| | | | - K Hood
- Centre for Trials Research, Cardiff University, Wales, United Kingdom
| | - A Nichol
- HRB Funded Irish Critical Care-Clinical Trials Network, St Vincent's University Hospital-Clinical Research Centre, University College Dublin, Ireland and the Alfred Hospital and Australian and New Zealand Intensive Care- Research Centre, Monash University, Melbourne, Australia
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Cardillo L, Cahill F, Wylie H, Williams A, Zylstra J, Davies A, Fullwood L, Van Hemelrijck M. Patients' perspectives on opt-out consent for observational research: systematic review and focus group. ACTA ACUST UNITED AC 2019; 27:1321-1329. [PMID: 30525978 DOI: 10.12968/bjon.2018.27.22.1321] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND: observational research is increasingly important in clinical decision-making. Opt-out consent has been proposed as a more practical way to obtain participants' consent for such research. The authors evaluated patients' views on opt-out consent for observational research by identifying perceived benefits and barriers. METHODS: following a systematic literature review of research on participants' perspectives on opt-out consent, a focus group interview was conducted with oncological patients and their family members. RESULTS: the review identified 13 articles detailing perspectives on opt-out consent. Perceived advantages included benefitting medicine and future generations. These findings were confirmed in the focus group. The main reported barriers to opt-out consent are concerns regarding privacy and the sharing of data with third parties. Participants also demonstrated concerns on insufficient education on opt-out consent. CONCLUSION: participants demonstrated willingness to participate in observational studies utilising opt-out consent. Special focus should be placed on outlining existing safeguards in research.
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Affiliation(s)
- Luca Cardillo
- Medical Student, King's College London, School of Cancer and Pharmaceutical Sciences, Translational Oncology & Urology Research
| | - Fidelma Cahill
- Research Nurse, King's College London, School of Cancer and Pharmaceutical Sciences, Translational Oncology & Urology Research
| | - Harriet Wylie
- Clinical Trial Coordinator, King's College London, School of Cancer and Pharmaceutical Sciences, Translational Oncology & Urology Research
| | - Ambi Williams
- Research Manager, King's College London, School of Cancer and Pharmaceutical Sciences
| | - Janine Zylstra
- Clinical Research Manager, Department of Upper Gastrointestinal Surgery, Guy's and St Thomas' NHS Foundation Trust, London
| | - Andrew Davies
- Consultant oesophagogastric and general surgeon, Department of Upper Gastrointestinal Surgery, Guy's and St Thomas' NHS Foundation Trust, London
| | | | - Mieke Van Hemelrijck
- Reader in Cancer Epidemiology, King's College London, School of Cancer and Pharmaceutical Sciences, Translational Oncology & Urology Research
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Qiu S, Song Y, Wang J, Gao P, Chen J, Chen R, Bao N, Liu S. Factors That Affect Chinese Parents' Willingness to Donate Children's Biospecimens in Pediatric Research. Biopreserv Biobank 2018; 16:402-410. [DOI: 10.1089/bio.2018.0051] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Shanshan Qiu
- Pediatric Translational Medicine Institute, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Department of Pediatric Neurosurgery, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yunhai Song
- Department of Pediatric Neurosurgery, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Jing Wang
- Pediatric Translational Medicine Institute, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Pingping Gao
- Department of Pediatric Neurosurgery, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Jing Chen
- Department of Pediatric Oncological Surgery, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Ru Chen
- Department of Pediatric Internal Medicine, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Nan Bao
- Department of Pediatric Neurosurgery, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Shijian Liu
- Pediatric Translational Medicine Institute, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
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Groth SW, Dozier A, Demment M, Li D, Fernandez ID, Chang J, Dye T. Participation in Genetic Research: Amazon's Mechanical Turk Workforce in the United States and India. Public Health Genomics 2016; 19:325-335. [PMID: 27811475 DOI: 10.1159/000452094] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Accepted: 09/28/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Genomic research has innumerable benefits. However, if people are unwilling to participate in genomic research, application of knowledge will be limited. This study examined the likelihood of respondents from a high- and a low- to middle-income country to participate in genetic research. METHODS Cross-sectional data were collected using Amazon's Mechanical Turk workforce to ascertain attitudes toward participation in genetic research. Registered country of residence was either the US (n = 505) or India (n = 505). Multiple logistic regression models were used to assess adjusted effects of demographic characteristics, health, social status, beliefs and concerns on 4 genetic research outcomes. RESULTS Participants from India who believed chance and powerful others influenced their health were more likely to participate in genetic research (OR = 1.0, 95% CI 1.0-1.1) and to agree with sharing of DNA data (OR = 1.1, 95% CI 1.1-1.2). US participants were more likely to be concerned about protection of family history, which they indicated would affect participation (OR = 3.6, 95% CI 2.1-6.0). Commonalities for the likelihood of participation were beliefs that genetic research could help find new treatments (India OR = 2.3, 95% CI 1.0-5.4; US OR = 4.7, 95% CI 2.0-11.2) and descendants would benefit (India OR = 2.6, 95% CI 1.2-5.5; US OR = 3.0, 95% CI 1.3-7.1). CONCLUSIONS Concurrence of beliefs on benefits and concerns about genetic research suggest they may be common across countries. Consideration of commonalities may be important to increase global participation in genetic research.
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Bin P, Delbon P, Piras M, Paternoster M, Di Lorenzo P, Conti A. Donation of the body for scientific purposes in Italy: ethical and medico-legal considerations. Open Med (Wars) 2016; 11:316-320. [PMID: 28352814 PMCID: PMC5329847 DOI: 10.1515/med-2016-0060] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2016] [Accepted: 06/07/2016] [Indexed: 11/15/2022] Open
Abstract
In recent years in Italy (and in the other European Countries) a new debated topic involves anatomists and the scientific world: donation of the body after death for scientific purposes. The aim of our analysis is to analyze the issue of voluntary body donation in Italy focusing first of all, on key principles of the disciplines of donation. Considering the rise of exhibitions and events in which death is spectacularized, the debate is focus on will, on respect and overall on the purpose for which the body is donated. Anatomical dissection is considered necessary in the direct learning of the human body, of surgical practices and new scientific techniques but the scarcity of programmes and regulations regarding the donation of bodies for study and research make it an uncommon practice. After discussing what are the constitutional principles underlying the issue we want to emphasize the need of a more effective and updated regulation to set limits and methods of a practice still essential for scientific progress.
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Affiliation(s)
- Paola Bin
- Department of Surgery, Radiology and Public Health, Public Health and Humanities Section, University of Brescia Italy -Forensic Medicine Institute, 25123 Brescia, Italy
| | - Paola Delbon
- Department of Surgery, Radiology and Public Health, Public Health and Humanities Section, University of Brescia - Centre of Bioethics Research, Italy
| | - Mauro Piras
- Department of Surgery, Radiology and Public Health, Public Health and Humanities Section, University of Brescia Italy -Forensic Medicine Institute, Brescia, Italy
| | - Mariano Paternoster
- Department of Adavanced Biomedical Sciences, University of Naples " Federico II", Naples, Italy
| | - Pierpaolo Di Lorenzo
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy
| | - Adelaide Conti
- Department of Surgery, Radiology and Public Health, Public Health and Humanities Section, University of Brescia - Centre of Bioethics Research, Italy
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A Randomised Controlled Trial of Consent Procedures for the Use of Residual Tissues for Medical Research: Preferences of and Implications for Patients, Research and Clinical Practice. PLoS One 2016; 11:e0152509. [PMID: 27028128 PMCID: PMC4814081 DOI: 10.1371/journal.pone.0152509] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Accepted: 03/13/2016] [Indexed: 12/03/2022] Open
Abstract
Background Despite much debate, there is little evidence on consequences of consent procedures for residual tissue use. Here, we investigated these consequences for the availability of residual tissue for medical research, clinical practice, and patient informedness. Methods We conducted a randomised clinical trial with three arms in six hospitals. Participants, patients from whom tissue had been removed for diagnosis or treatment, were randomised to one of three arms: informed consent, an opt-out procedure with active information provision (opt-out plus), and an opt-out procedure without active information provision. Participants received a questionnaire six weeks post-intervention; a subsample of respondents was interviewed. Health care providers completed a pre- and post-intervention questionnaire. We assessed percentage of residual tissue samples available for medical research, and patient and health care provider satisfaction and preference. Health care providers and outcome assessors could not be blinded. Results We randomised 1,319 patients, 440 in the informed consent, 434 in the opt-out plus, and 445 in the opt-out arm; respectively 60.7%, 100%, and 99.8% of patients’ tissue samples could be used for medical research. Of the questionnaire respondents (N = 224, 207, and 214 in the informed consent, opt-out plus, and opt-out arms), 71%, 69%, and 31%, respectively, indicated being (very) well informed. By questionnaire, the majority (53%) indicated a preference for informed consent, whereas by interview, most indicated a preference for opt-out plus (37%). Health care providers (N = 35) were more likely to be (very) satisfied with opt-out plus than with informed consent (p = 0.002) or opt-out (p = 0.039); the majority (66%) preferred opt-out plus. Conclusion We conclude that opt-out with information (opt-out plus) is the best choice to balance the consequences for medical research, patients, and clinical practice, and is therefore the most optimal consent procedure for residual tissue use in Dutch hospitals. Trial Registration Dutch Trial Register NTR2982
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Consenting postpartum women for use of routinely collected biospecimens and/or future biospecimen collection. J Community Genet 2016; 7:153-8. [PMID: 26869364 DOI: 10.1007/s12687-016-0261-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Accepted: 01/17/2016] [Indexed: 12/31/2022] Open
Abstract
The National Children's Study (NCS) Harris County, Texas Study Center participated in the NCS Provider Based Sampling (PBS) substudy of the NCS Vanguard Phase pilot. As part of the hospital-based birth cohort component of the PBS substudy, we conducted a secondary data analysis to evaluate the proportion of postpartum women who consented to future biospecimen collection alone and to both future collection and use of residual birth biospecimens. In phase 1, 32 postpartum women at one hospital were asked to consent only to maternal future biospecimen collection. In phase 2, 40 other postpartum women from the same hospital were asked for an additional consent to use residual clinical biospecimens from the birth event that otherwise would be discarded, including cord blood and maternal blood and urine. Among 103 eligible women, a total of 72 participated. They were 28.3 ± 5.9 years old on average; 58 % were Hispanic; 63 % consented in English, and 37 % in Spanish; 39 % had some college education; 42 % were married; 60 % had an annual family income <$30,000; and 51 % were employed. In phase 1, 59 % consented to future biospecimen collection, and in phase 2, 95 % consented to both future collection and use of at least one residual birth biospecimen, with a difference between phases of 36 % [95 % CI 17-54 %]. Demographic characteristics did not differ among those who did and did not consent. Postpartum women were significantly more likely to grant consent for use of future and residual hospital-obtained biospecimens than future biospecimen collection alone.
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Patterson C, McDaid LM, Hilton S. Gay and Bisexual Men's Perceptions of the Donation and Use of Human Biological Samples for Research: A Qualitative Study. PLoS One 2015; 10:e0129924. [PMID: 26053741 PMCID: PMC4459996 DOI: 10.1371/journal.pone.0129924] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Accepted: 05/14/2015] [Indexed: 11/30/2022] Open
Abstract
Human biological samples (biosamples) are increasingly important in diagnosing, treating and measuring the prevalence of illnesses. For the gay and bisexual population, biosample research is particularly important for measuring the prevalence of human immunodeficiency virus (HIV). By determining people's understandings of, and attitudes towards, the donation and use of biosamples, researchers can design studies to maximise acceptability and participation. In this study we examine gay and bisexual men's attitudes towards donating biosamples for HIV research. Semi-structured telephone interviews were conducted with 46 gay and bisexual men aged between 18 and 63 recruited in commercial gay scene venues in two Scottish cities. Interview transcripts were analysed thematically using the framework approach. Most men interviewed seemed to have given little prior consideration to the issues. Participants were largely supportive of donating tissue for medical research purposes, and often favourable towards samples being stored, reused and shared. Support was often conditional, with common concerns related to: informed consent; the protection of anonymity and confidentiality; the right to withdraw from research; and ownership of samples. Many participants were in favour of the storage and reuse of samples, but expressed concerns related to data security and potential misuse of samples, particularly by commercial organisations. The sensitivity of tissue collection varied between tissue types and collection contexts. Blood, urine, semen and bowel tissue were commonly identified as sensitive, and donating saliva and as unlikely to cause discomfort. To our knowledge, this is the first in-depth study of gay and bisexual men's attitudes towards donating biosamples for HIV research. While most men in this study were supportive of donating tissue for research, some clear areas of concern were identified. We suggest that these minority concerns should be accounted for to develop inclusive, evidence-informed research protocols that balance collective benefits with individual concerns.
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Affiliation(s)
- Chris Patterson
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, United Kingdom
| | - Lisa M. McDaid
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, United Kingdom
| | - Shona Hilton
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, United Kingdom
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Lewis C, Clotworthy M, Hilton S, Magee C, Robertson MJ, Stubbins LJ, Corfield J. Public views on the donation and use of human biological samples in biomedical research: a mixed methods study. BMJ Open 2013; 3:bmjopen-2013-003056. [PMID: 23929915 PMCID: PMC3740256 DOI: 10.1136/bmjopen-2013-003056] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE A mixed methods study exploring the UK general public's willingness to donate human biosamples (HBSs) for biomedical research. SETTING Cross-sectional focus groups followed by an online survey. PARTICIPANTS Twelve focus groups (81 participants) selectively sampled to reflect a range of demographic groups; 1110 survey responders recruited through a stratified sampling method with quotas set on sex, age, geographical location, socioeconomic group and ethnicity. MAIN OUTCOME MEASURES (1) Identify participants' willingness to donate HBSs for biomedical research, (2) explore acceptability towards donating different types of HBSs in various settings and (3) explore preferences regarding use and access to HBSs. RESULTS 87% of survey participants thought donation of HBSs was important and 75% wanted to be asked to donate in general. Responders who self-reported having some or good knowledge of the medical research process were significantly more likely to want to donate (p<0.001). Reasons why focus group participants saw donation as important included: it was a good way of reciprocating for the medical treatment received; it was an important way of developing drugs and treatments; residual tissue would otherwise go to waste and they or their family members might benefit. The most controversial types of HBSs to donate included: brain post mortem (29% would donate), eyes post mortem (35%), embryos (44%), spare eggs (48%) and sperm (58%). Regarding the use of samples, there were concerns over animal research (34%), research conducted outside the UK (35%), and research conducted by pharmaceutical companies (56%), although education and discussion were found to alleviate such concerns. CONCLUSIONS There is a high level of public support and willingness to donate HBSs for biomedical research. Underlying concerns exist regarding the use of certain types of HBSs and conditions under which they are used. Improved education and more controlled forms of consent for sensitive samples may mitigate such concerns.
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Affiliation(s)
| | | | - Shona Hilton
- CSO Social & Public Health Sciences Unit, Medical Research Council, Glasgow, UK
| | - Caroline Magee
- Confederation of Cancer Biobanks, National Cancer Research Institute, London, UK
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