Privacy Policy and Technology in Biomedical Data Science

Secure and federated genome-wide association studies for biobank-scale datasets

Sharing data across institutions for genome-wide association studies (GWAS) would enhance the discovery of genetic variation linked to health and disease1,2. However, existing data-sharing regulations limit the scope of such collaborations3. Although cryptographic tools for secure computation promise to enable collaborative analysis with formal privacy guarantees, existing approaches either are computationally impractical or do not implement current state-of-the-art methods4-6. We introduce secure federated genome-wide association studies (SF-GWAS), a combination of secure computation frameworks and distributed algorithms that empowers efficient and accurate GWAS on private data held by multiple entities while ensuring data confidentiality. SF-GWAS supports widely used GWAS pipelines based on principal-component analysis or linear mixed models. We demonstrate the accuracy and practical runtimes of SF-GWAS on five datasets, including a UK Biobank cohort of 410,000 individuals, showcasing an order-of-magnitude improvement in runtime compared to previous methods. Our work enables secure collaborative genomic studies at unprecedented scale.

Bridging Innovation and Equity: Advancing Public Health Through Just-in-Time Adaptive Interventions

This review explores the transformative potential of just-in-time adaptive interventions (JITAIs) as a scalable solution for addressing health disparities in underserved populations. JITAIs, delivered via mobile health technologies, could provide personalized, context-aware interventions based on real-time data to address public health challenges such as addiction treatment, chronic disease management, and mental health support. JITAIs can dynamically adjust intervention strategies, enhancing accessibility and engagement for marginalized communities. We highlight the utility of JITAIs in reducing opportunity costs associated with traditional in-person health interventions. Examples from various health domains demonstrate the adaptability of JITAIs in tailoring interventions to meet diverse needs. The review also emphasizes the need for community involvement, robust evaluation frameworks, and ethical considerations in implementing JITAIs, particularly in low- and middle-income countries. Sustainable funding models and technological innovations are necessary to ensure equitable access and effectively scale these interventions. By bridging the gap between research and practice, JITAIs could improve health outcomes and reduce disparities in vulnerable populations.

Enabling Demonstrated Consent for Biobanking with Blockchain and Generative AI

Participation in research is supposed to be voluntary and informed. Yet it is difficult to ensure people are adequately informed about the potential uses of their biological materials when they donate samples for future research. We propose a novel consent framework which we call "demonstrated consent" that leverages blockchain technology and generative AI to address this problem. In a demonstrated consent model, each donated sample is associated with a unique non-fungible token (NFT) on a blockchain, which records in its metadata information about the planned and past uses of the sample in research, and is updated with each use of the sample. This information is accessible to a large language model (LLM) customized to present this information in an understandable and interactive manner. Thus, our model uses blockchain and generative AI technologies to track, make available, and explain information regarding planned and past uses of donated samples.

Secure and federated quantitative trait loci mapping with privateQTL

Understanding the relationship between genotypes and phenotypes is crucial for advancing personalized medicine. Expression quantitative trait loci (eQTL) mapping plays a significant role by correlating genetic variants to gene expression levels. Despite the progress made by large-scale projects, eQTL mapping still faces challenges in statistical power and privacy concerns. Multi-site studies can increase sample sizes but are hindered by privacy issues. We present privateQTL, a novel framework leveraging secure multi-party computation for secure and federated eQTL mapping. When tested in a real-world scenario with data from different studies, privateQTL outperformed meta-analysis by accurately correcting for covariates and batch effect and retaining higher accuracy and precision for both eGene-eVariant mapping and effect size estimation. In addition, privateQTL is modular and scalable, making it adaptable for other molecular phenotypes and large-scale studies. Our results indicate that privateQTL is a practical solution for privacy-preserving collaborative eQTL mapping.

Artificial Intelligence and Machine Learning for Inborn Errors of Immunity: Current State and Future Promise

Artificial intelligence (AI) and machine learning (ML) research within medicine has exponentially increased over the last decade, with studies showcasing the potential of AI/ML algorithms to improve clinical practice and outcomes. Ongoing research and efforts to develop AI-based models have expanded to aid in the identification of inborn errors of immunity (IEI). The use of larger electronic health record data sets, coupled with advances in phenotyping precision and enhancements in ML techniques, has the potential to significantly improve the early recognition of IEI, thereby increasing access to equitable care. In this review, we provide a comprehensive examination of AI/ML for IEI, covering the spectrum from data preprocessing for AI/ML analysis to current applications within immunology, and address the challenges associated with implementing clinical decision support systems to refine the diagnosis and management of IEI.

Distributed non-disclosive validation of predictive models by a modified ROC-GLM

BACKGROUND

Distributed statistical analyses provide a promising approach for privacy protection when analyzing data distributed over several databases. Instead of directly operating on data, the analyst receives anonymous summary statistics, which are combined into an aggregated result. Further, in discrimination model (prognosis, diagnosis, etc.) development, it is key to evaluate a trained model w.r.t. to its prognostic or predictive performance on new independent data. For binary classification, quantifying discrimination uses the receiver operating characteristics (ROC) and its area under the curve (AUC) as aggregation measure. We are interested to calculate both as well as basic indicators of calibration-in-the-large for a binary classification task using a distributed and privacy-preserving approach.

METHODS

We employ DataSHIELD as the technology to carry out distributed analyses, and we use a newly developed algorithm to validate the prediction score by conducting distributed and privacy-preserving ROC analysis. Calibration curves are constructed from mean values over sites. The determination of ROC and its AUC is based on a generalized linear model (GLM) approximation of the true ROC curve, the ROC-GLM, as well as on ideas of differential privacy (DP). DP adds noise (quantified by the ℓ 2 sensitivityΔ 2 ( f ^ ) ) to the data and enables a global handling of placement numbers. The impact of DP parameters was studied by simulations.

RESULTS

In our simulation scenario, the true and distributed AUC measures differ by Δ AUC < 0.01 depending heavily on the choice of the differential privacy parameters. It is recommended to check the accuracy of the distributed AUC estimator in specific simulation scenarios along with a reasonable choice of DP parameters. Here, the accuracy of the distributed AUC estimator may be impaired by too much artificial noise added from DP.

CONCLUSIONS

The applicability of our algorithms depends on the ℓ 2 sensitivityΔ 2 ( f ^ ) of the underlying statistical/predictive model. The simulations carried out have shown that the approximation error is acceptable for the majority of simulated cases. For models with highΔ 2 ( f ^ ) , the privacy parameters must be set accordingly higher to ensure sufficient privacy protection, which affects the approximation error. This work shows that complex measures, as the AUC, are applicable for validation in distributed setups while preserving an individual's privacy.

Privacy-Enhancing Technologies in Biomedical Data Science

The rapidly growing scale and variety of biomedical data repositories raise important privacy concerns. Conventional frameworks for collecting and sharing human subject data offer limited privacy protection, often necessitating the creation of data silos. Privacy-enhancing technologies (PETs) promise to safeguard these data and broaden their usage by providing means to share and analyze sensitive data while protecting privacy. Here, we review prominent PETs and illustrate their role in advancing biomedicine. We describe key use cases of PETs and their latest technical advances and highlight recent applications of PETs in a range of biomedical domains. We conclude by discussing outstanding challenges and social considerations that need to be addressed to facilitate a broader adoption of PETs in biomedical data science.

OHDSI-compliance: a set of document templates facilitating the implementation and operation of a software stack for real-world evidence generation

Introduction

The open-source software offered by the Observational Health Data Science and Informatics (OHDSI) collective, including the OMOP-CDM, serves as a major backbone for many real-world evidence networks and distributed health data analytics platforms. While container technology has significantly simplified deployments from a technical perspective, regulatory compliance can remain a major hurdle for the setup and operation of such platforms. In this paper, we present OHDSI-Compliance, a comprehensive set of document templates designed to streamline the data protection and information security-related documentation and coordination efforts required to establish OHDSI installations.

Methods

To decide on a set of relevant document templates, we first analyzed the legal requirements and associated guidelines with a focus on the General Data Protection Regulation (GDPR). Moreover, we analyzed the software architecture of a typical OHDSI stack and related its components to the different general types of concepts and documentation identified. Then, we created those documents for a prototypical OHDSI installation, based on the so-called Broadsea package, following relevant guidelines from Germany. Finally, we generalized the documents by introducing placeholders and options at places where individual institution-specific content will be needed.

Results

We present four documents: (1) a record of processing activities, (2) an information security concept, (3) an authorization concept, as well as (4) an operational concept covering the technical details of maintaining the stack. The documents are publicly available under a permissive license.

Discussion

To the best of our knowledge, there are no other publicly available sets of documents designed to simplify the compliance process for OHDSI deployments. While our documents provide a comprehensive starting point, local specifics need to be added, and, due to the heterogeneity of legal requirements in different countries, further adoptions might be necessary.

sfkit: a web-based toolkit for secure and federated genomic analysis

Advances in genomics are increasingly depending upon the ability to analyze large and diverse genomic data collections, which are often difficult to amass due to privacy concerns. Recent works have shown that it is possible to jointly analyze datasets held by multiple parties, while provably preserving the privacy of each party's dataset using cryptographic techniques. However, these tools have been challenging to use in practice due to the complexities of the required setup and coordination among the parties. We present sfkit, a secure and federated toolkit for collaborative genomic studies, to allow groups of collaborators to easily perform joint analyses of their datasets without compromising privacy. sfkit consists of a web server and a command-line interface, which together support a range of use cases including both auto-configured and user-supplied computational environments. sfkit provides collaborative workflows for the essential tasks of genome-wide association study (GWAS) and principal component analysis (PCA). We envision sfkit becoming a one-stop server for secure collaborative tools for a broad range of genomic analyses. sfkit is open-source and available at: https://sfkit.org.

A hierarchical strategy to minimize privacy risk when linking "De-identified" data in biomedical research consortia

Linking data across studies offers an opportunity to enrich data sets and provide a stronger basis for data-driven models for biomedical discovery and/or prognostication. Several techniques to link records have been proposed, and some have been implemented across data repositories holding molecular and clinical data. Not all these techniques guarantee appropriate privacy protection; there are trade-offs between (a) simple strategies that can be associated with data that will be linked and shared with any party and (b) more complex strategies that preserve the privacy of individuals across parties. We propose an intermediary, practical strategy to support linkage in studies that share de-identified data with Data Coordinating Centers. This technology can be extended to link data across multiple data hubs to support privacy preserving record linkage, considering data coordination centers and their awardees, which can be extended to a hierarchy of entities (e.g., awardees, data coordination centers, data hubs, etc.) b.

Session Introduction: TOWARDS ETHICAL BIOMEDICAL INFORMATICS: LEARNING FROM OLELO NOEAU, HAWAIIAN PROVERBS

Innovations in human-centered biomedical informatics are often developed with the eventual goal of real-world translation. While biomedical research questions are usually answered in terms of how a method performs in a particular context, we argue that it is equally important to consider and formally evaluate the ethical implications of informatics solutions. Several new research paradigms have arisen as a result of the consideration of ethical issues, including but not limited for privacy-preserving computation and fair machine learning. In the spirit of the Pacific Symposium on Biocomputing, we discuss broad and fundamental principles of ethical biomedical informatics in terms of Olelo Noeau, or Hawaiian proverbs and poetical sayings that capture Hawaiian values. While we emphasize issues related to privacy and fairness in particular, there are a multitude of facets to ethical biomedical informatics that can benefit from a critical analysis grounded in ethics.

The ethical and legal landscape of brain data governance

Neuroscience research is producing big brain data which informs both advancements in neuroscience research and drives the development of advanced datasets to provide advanced medical solutions. These brain data are produced under different jurisdictions in different formats and are governed under different regulations. The governance of data has become essential and critical resulting in the development of various governance structures to ensure that the quality, availability, findability, accessibility, usability, and utility of data is maintained. Furthermore, data governance is influenced by various ethical and legal principles. However, it is still not clear what ethical and legal principles should be used as a standard or baseline when managing brain data due to varying practices and evolving concepts. Therefore, this study asks what ethical and legal principles shape the current brain data governance landscape? A systematic scoping review and thematic analysis of articles focused on biomedical, neuro and brain data governance was carried out to identify the ethical and legal principles which shape the current brain data governance landscape. The results revealed that there is currently a large variation of how the principles are presented and discussions around the terms are very multidimensional. Some of the principles are still at their infancy and are barely visible. A range of principles emerged during the thematic analysis providing a potential list of principles which can provide a more comprehensive framework for brain data governance and a conceptual expansion of neuroethics.

Predictive Modelling in Clinical Bioinformatics: Key Concepts for Startups

Clinical bioinformatics is a newly emerging field that applies bioinformatics techniques for facilitating the identification of diseases, discovery of biomarkers, and therapy decision. Mathematical modelling is part of bioinformatics analysis pipelines and a fundamental step to extract clinical insights from genomes, transcriptomes and proteomes of patients. Often, the chosen modelling techniques relies on either statistical, machine learning or deterministic approaches. Research that combines bioinformatics with modelling techniques have been generating innovative biomedical technology, algorithms and models with biotech applications, attracting private investment to develop new business; however, startups that emerge from these technologies have been facing difficulties to implement clinical bioinformatics pipelines, protect their technology and generate profit. In this commentary, we discuss the main concepts that startups should know for enabling a successful application of predictive modelling in clinical bioinformatics. Here we will focus on key modelling concepts, provide some successful examples and briefly discuss the modelling framework choice. We also highlight some aspects to be taken into account for a successful implementation of cost-effective bioinformatics from a business perspective.

Genome Privacy and Trust

Genomics data are important for advancing biomedical research, improving clinical care, and informing other disciplines such as forensics and genealogy. However, privacy concerns arise when genomic data are shared. In particular, the identifying nature of genetic information, its direct relationship to health status, and the potential financial harm and stigmatization posed to individuals and their blood relatives call for a survey of the privacy issues related to sharing genetic and related data and potential solutions to overcome these issues. In this work, we provide an overview of the importance of genomic privacy, the information gleaned from genomics data, the sources of potential private information leakages in genomics, and ways to preserve privacy while utilizing the genetic information in research. We discuss the relationship between trust in the scientific community and protecting privacy, illuminating a future roadmap for data sharing and study participation.

Sociotechnical safeguards for genomic data privacy

Recent developments in a variety of sectors, including health care, research and the direct-to-consumer industry, have led to a dramatic increase in the amount of genomic data that are collected, used and shared. This state of affairs raises new and challenging concerns for personal privacy, both legally and technically. This Review appraises existing and emerging threats to genomic data privacy and discusses how well current legal frameworks and technical safeguards mitigate these concerns. It concludes with a discussion of remaining and emerging challenges and illustrates possible solutions that can balance protecting privacy and realizing the benefits that result from the sharing of genetic information.

Distributed learning for heterogeneous clinical data with application to integrating COVID-19 data across 230 sites

Integrating real-world data (RWD) from several clinical sites offers great opportunities to improve estimation with a more general population compared to analyses based on a single clinical site. However, sharing patient-level data across sites is practically challenging due to concerns about maintaining patient privacy. We develop a distributed algorithm to integrate heterogeneous RWD from multiple clinical sites without sharing patient-level data. The proposed distributed conditional logistic regression (dCLR) algorithm can effectively account for between-site heterogeneity and requires only one round of communication. Our simulation study and data application with the data of 14,215 COVID-19 patients from 230 clinical sites in the UnitedHealth Group Clinical Research Database demonstrate that the proposed distributed algorithm provides an estimator that is robust to heterogeneity in event rates when efficiently integrating data from multiple clinical sites. Our algorithm is therefore a practical alternative to both meta-analysis and existing distributed algorithms for modeling heterogeneous multi-site binary outcomes.

Functional genomics data: privacy risk assessment and technological mitigation

The generation of functional genomics data by next-generation sequencing has increased greatly in the past decade. Broad sharing of these data is essential for research advancement but poses notable privacy challenges, some of which are analogous to those that occur when sharing genetic variant data. However, there are also unique privacy challenges that arise from cryptic information leakage during the processing and summarization of functional genomics data from raw reads to derived quantities, such as gene expression values. Here, we review these challenges and present potential solutions for mitigating privacy risks while allowing broad data dissemination and analysis.

Mega-analysis methods in ENIGMA: The experience of the generalized anxiety disorder working group

The ENIGMA group on Generalized Anxiety Disorder (ENIGMA-Anxiety/GAD) is part of a broader effort to investigate anxiety disorders using imaging and genetic data across multiple sites worldwide. The group is actively conducting a mega-analysis of a large number of brain structural scans. In this process, the group was confronted with many methodological challenges related to study planning and implementation, between-country transfer of subject-level data, quality control of a considerable amount of imaging data, and choices related to statistical methods and efficient use of resources. This report summarizes the background information and rationale for the various methodological decisions, as well as the approach taken to implement them. The goal is to document the approach and help guide other research groups working with large brain imaging data sets as they develop their own analytic pipelines for mega-analyses.

SmartMedChain: A Blockchain-Based Privacy-Preserving Smart Healthcare Framework

Nowadays, the adoption of Internet of Things (IoT) technology worldwide is accelerating the digital transformation of healthcare industry. In this context, smart healthcare (s-healthcare) solutions are ensuring better and innovative opportunities for healthcare providers to improve patients' care. However, these solutions raise also new challenges in terms of security and privacy due to the diversity of stakeholders, the centralized data management, and the resulting lack of trustworthiness, accountability, and control. In this paper, we propose an end-to-end Blockchain-based and privacy-preserving framework called SmartMedChain for data sharing in s-healthcare environment. The Blockchain is built on Hyperledger Fabric and stores encrypted health data by using the InterPlanetary File System (IPFS), a distributed data storage solution with high resiliency and scalability. Indeed, compared to other propositions and based on the concept of smart contracts, our solution combines both data access control and data usage auditing measures for both Medical IoT data and Electronic Health Records (EHRs) generated by s-healthcare services. In addition, s-healthcare stakeholders can be held accountable by introducing an innovative Privacy Agreement Management scheme that monitors the execution of the service in respect of patient preferences and in accordance with relevant privacy laws. Security analysis and experimental results show that the proposed SmartMedChain is feasible and efficient for s-healthcare environments.

An efficient and accurate distributed learning algorithm for modeling multi-site zero-inflated count outcomes

Clinical research networks (CRNs), made up of multiple healthcare systems each with patient data from several care sites, are beneficial for studying rare outcomes and increasing generalizability of results. While CRNs encourage sharing aggregate data across healthcare systems, individual systems within CRNs often cannot share patient-level data due to privacy regulations, prohibiting multi-site regression which requires an analyst to access all individual patient data pooled together. Meta-analysis is commonly used to model data stored at multiple institutions within a CRN but can result in biased estimation, most notably in rare-event contexts. We present a communication-efficient, privacy-preserving algorithm for modeling multi-site zero-inflated count outcomes within a CRN. Our method, a one-shot distributed algorithm for performing hurdle regression (ODAH), models zero-inflated count data stored in multiple sites without sharing patient-level data across sites, resulting in estimates closely approximating those that would be obtained in a pooled patient-level data analysis. We evaluate our method through extensive simulations and two real-world data applications using electronic health records: examining risk factors associated with pediatric avoidable hospitalization and modeling serious adverse event frequency associated with a colorectal cancer therapy. In simulations, ODAH produced bias less than 0.1% across all settings explored while meta-analysis estimates exhibited bias up to 12.7%, with meta-analysis performing worst in settings with high zero-inflation or low event rates. Across both applied analyses, ODAH estimates had less than 10% bias for 18 of 20 coefficients estimated, while meta-analysis estimates exhibited substantially higher bias. Relative to existing methods for distributed data analysis, ODAH offers a highly accurate, computationally efficient method for modeling multi-site zero-inflated count data.

Deep learning-based six-type classifier for lung cancer and mimics from histopathological whole slide images: a retrospective study

BACKGROUND

Targeted therapy and immunotherapy put forward higher demands for accurate lung cancer classification, as well as benign versus malignant disease discrimination. Digital whole slide images (WSIs) witnessed the transition from traditional histopathology to computational approaches, arousing a hype of deep learning methods for histopathological analysis. We aimed at exploring the potential of deep learning models in the identification of lung cancer subtypes and cancer mimics from WSIs.

METHODS

We initially obtained 741 WSIs from the First Affiliated Hospital of Sun Yat-sen University (SYSUFH) for the deep learning model development, optimization, and verification. Additional 318 WSIs from SYSUFH, 212 from Shenzhen People's Hospital, and 422 from The Cancer Genome Atlas were further collected for multi-centre verification. EfficientNet-B5- and ResNet-50-based deep learning methods were developed and compared using the metrics of recall, precision, F1-score, and areas under the curve (AUCs). A threshold-based tumour-first aggregation approach was proposed and implemented for the label inferencing of WSIs with complex tissue components. Four pathologists of different levels from SYSUFH reviewed all the testing slides blindly, and the diagnosing results were used for quantitative comparisons with the best performing deep learning model.

RESULTS

We developed the first deep learning-based six-type classifier for histopathological WSI classification of lung adenocarcinoma, lung squamous cell carcinoma, small cell lung carcinoma, pulmonary tuberculosis, organizing pneumonia, and normal lung. The EfficientNet-B5-based model outperformed ResNet-50 and was selected as the backbone in the classifier. Tested on 1067 slides from four cohorts of different medical centres, AUCs of 0.970, 0.918, 0.963, and 0.978 were achieved, respectively. The classifier achieved high consistence to the ground truth and attending pathologists with high intraclass correlation coefficients over 0.873.

CONCLUSIONS

Multi-cohort testing demonstrated our six-type classifier achieved consistent and comparable performance to experienced pathologists and gained advantages over other existing computational methods. The visualization of prediction heatmap improved the model interpretability intuitively. The classifier with the threshold-based tumour-first label inferencing method exhibited excellent accuracy and feasibility in classifying lung cancers and confused nonneoplastic tissues, indicating that deep learning can resolve complex multi-class tissue classification that conforms to real-world histopathological scenarios.

Racial differences in patient consent policy preferences for electronic health information exchange

OBJECTIVE

This study aimed to explore the association between demographic variables, such as race and gender, and patient consent policy preferences for health information exchange as well as self-report by VHA enrollees of information continuity between Veterans Health Administration (VHA) and community non-VHA heath care providers.

MATERIALS AND METHODS

Data were collected between March 25, 2016 and August 22, 2016 in an online survey of 19 567 veterans. Three questions from the 2016 Commonwealth Fund International Health Policy Survey, which addressed care continuity, were included. The survey also included questions about consent policy preference regarding opt-out, opt-in, and "break the glass" consent policies.

RESULTS

VHA enrollees had comparable proportions of unnecessary laboratory testing and conflicting information from providers when compared with the United States sample in the Commonwealth Survey. However, they endorsed medical record information being unavailable between organizations more highly. Demographic variables were associated with gaps in care continuity as well as consent policy preferences, with 56.8% of Whites preferring an opt-out policy as compared with 40.3% of Blacks, 44.9% of Hispanic Latinos, 48.3% of Asian/Pacific Islanders, and 38.3% of Native Americans (P < .001).

DISCUSSION

Observed large differences by race and ethnicity in privacy preferences for electronic health information exchange should inform implementation of these programs to ensure cultural sensitivity. Veterans experienced care continuity comparable to a general United States sample, except for less effective exchange of health records between heath care organizations. VHA followed an opt-in consent policy at the time of this survey which may underlie this gap.

Open science in psychophysiology: An overview of challenges and emerging solutions

The present review is the result of a one-day workshop on open science, held at the Annual Meeting of the Society for Psychophysiological Research in Washington, DC, September 2019. The contributors represent psychophysiological researchers at different career stages and from a wide spectrum of institutions. The state of open science in psychophysiology is discussed from different perspectives, highlighting key challenges, potential benefits, and emerging solutions that are intended to facilitate open science practices. Three domains are emphasized: data sharing, preregistration, and multi-site studies. In the context of these broader domains, we present potential implementations of specific open science procedures such as data format harmonization, power analysis, data, presentation code and analysis pipeline sharing, suitable for psychophysiological research. Practical steps are discussed that may be taken to facilitate the adoption of open science practices in psychophysiology. These steps include (1) promoting broad and accessible training in the skills needed to implement open science practices, such as collaborative research and computational reproducibility initiatives, (2) establishing mechanisms that provide practical assistance in sharing of processing pipelines, presentation code, and data in an efficient way, and (3) improving the incentive structure for open science approaches. Throughout the manuscript, we provide references and links to available resources for those interested in adopting open science practices in their research.

Precision health data: Requirements, challenges and existing techniques for data security and privacy

Precision health leverages information from various sources, including omics, lifestyle, environment, social media, medical records, and medical insurance claims to enable personalized care, prevent and predict illness, and precise treatments. It extensively uses sensing technologies (e.g., electronic health monitoring devices), computations (e.g., machine learning), and communication (e.g., interaction between the health data centers). As health data contain sensitive private information, including the identity of patient and carer and medical conditions of the patient, proper care is required at all times. Leakage of these private information affects the personal life, including bullying, high insurance premium, and loss of job due to the medical history. Thus, the security, privacy of and trust on the information are of utmost importance. Moreover, government legislation and ethics committees demand the security and privacy of healthcare data. Besides, the public, who is the data source, always expects the security, privacy, and trust of their data. Otherwise, they can avoid contributing their data to the precision health system. Consequently, as the public is the targeted beneficiary of the system, the effectiveness of precision health diminishes. Herein, in the light of precision health data security, privacy, ethical and regulatory requirements, finding the best methods and techniques for the utilization of the health data, and thus precision health is essential. In this regard, firstly, this paper explores the regulations, ethical guidelines around the world, and domain-specific needs. Then it presents the requirements and investigates the associated challenges. Secondly, this paper investigates secure and privacy-preserving machine learning methods suitable for the computation of precision health data along with their usage in relevant health projects. Finally, it illustrates the best available techniques for precision health data security and privacy with a conceptual system model that enables compliance, ethics clearance, consent management, medical innovations, and developments in the health domain.

Developments in Mobile Health Just-in-Time Adaptive Interventions for Addiction Science

PURPOSE OF REVIEW

Addiction is a serious and prevalent problem across the globe. An important challenge facing intervention science is how to support addiction treatment and recovery while mitigating the associated cost and stigma. A promising solution is the use of mobile health (mHealth) just-in-time adaptive interventions (JITAIs), in which intervention options are delivered in situ via a mobile device when individuals are most in need.

RECENT FINDINGS

The present review describes the use of mHealth JITAIs to support addiction treatment and recovery, and provides guidance on when and how the micro-randomized trial (MRT) can be used to optimize a JITAI. We describe the design of five mHealth JITAIs in addiction and three MRT studies, and discuss challenges and future directions.

SUMMARY

This review aims to provide guidance for constructing effective JITAIs to support addiction treatment and recovery.

[Medical biostatistics with GMRC Shiny Stats - learning by doing]

Biostatistics are omnipresent in the scientific and medical literature and are an essential skill for any health student. We have developed a practical training tool - GMRC Shiny stats - an interactive application specifically dedicated to medical data statistical analysis. The application has been designed to provide an analysis workflow corresponding to the usual progression of an experienced statistician during data analysis. The most common statistical analyses can be performed (descriptive statistics, inferences according to frequentist methods, survival analyses, correlation, agreement measurements, etc.). GMRC Shiny stats is intuitive and user-friendly and assists students in choosing the most appropriate statistical tests. With all these functionalities, students can learn statistical analysis by doing. Getting involved in the statistical analysis and processing of their own data is likely to improve their biostatistics skills.

The Data Tags Suite (DATS) model for discovering data access and use requirements

BACKGROUND

Data reuse is often controlled to protect the privacy of subjects and patients. Data discovery tools need ways to inform researchers about restrictions on data access and re-use.

RESULTS

We present elements in the Data Tags Suite (DATS) metadata schema describing data access, data use conditions, and consent information. DATS metadata are explained in terms of the administrative, legal, and technical systems used to protect confidential data.

CONCLUSIONS

The access and use metadata items in DATS are designed from the perspective of a researcher who wants to find and re-use existing data. We call for standard ways of describing informed consent and data use agreements that will enable automated systems for managing research data.