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Vezyridis P. 'Kindling the fire' of NHS patient data exploitations: The care.data controversy in news media discourses. Soc Sci Med 2024; 348:116824. [PMID: 38598987 DOI: 10.1016/j.socscimed.2024.116824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 03/14/2024] [Accepted: 03/21/2024] [Indexed: 04/12/2024]
Abstract
This paper explores news media discourse about care.data: an NHS England programme of work for amalgamating and sharing patient data from primary care for planning and research. It was scrapped in 2016 after three years of public outcry, delays and around 1.5 million opt-outs. I examine UK news media coverage of this programme through the 'fire object' metaphor, focusing upon the visions of purpose and value it inspired, the abrupt discontinuities, juxtapositions and transformations it performed, and the matters of concern that went unheeded. Findings suggest that, in care.data's pursuit of a societal consensus on NHS patient data exploitations, various visions for new and fluid data flows brought to presence narratives of transforming the NHS, saving lives, and growing the economy. Other realities and concerns that mattered for certain stakeholders, such as data ownership and commercialisation, public engagement and informed consent, commitment and leadership, operational capabilities, and NHS privatisation agendas, remained absent or unsettled. False dichotomies kept the controversy alive, sealing its fate. I conclude by arguing that such failed programmes can turn into phantom-like objects, haunting future patient data schemes of similar aspirations. The paper highlights the role news media can have in understanding such energetic public controversies.
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Affiliation(s)
- Paraskevas Vezyridis
- Centre for Health Innovation, Leadership and Learning (CHILL), Nottingham University Business School, Jubilee Campus, Wollaton Road, Nottingham, NG8 1BB, UK.
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Litvinova O, Matin FB, Matin M, Zima-Kulisiewicz B, Tomasik C, Siddiquea BN, Stoyanov J, Atanasov AG, Willschke H. Patient safety discourse in a pandemic: a Twitter hashtag analysis study on #PatientSafety. Front Public Health 2023; 11:1268730. [PMID: 38035302 PMCID: PMC10687459 DOI: 10.3389/fpubh.2023.1268730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 10/27/2023] [Indexed: 12/02/2023] Open
Abstract
Background The digitalization of medicine is becoming a transformative force in modern healthcare systems. This study aims to investigate discussions regarding patient safety, as well as summarize perceived approaches to mitigating risks of adverse events expressed through the #PatientSafety Twitter hashtag during the COVID-19 pandemic. Methods This research is grounded in the analysis of data extracted from Twitter under the hashtag #PatientSafety between December 1, 2019 and February 1, 2023. Symplur Signals, which represents a tool offering a method to monitor tweets containing hashtags registered with the Symplur Healthcare Hashtag Project, was used for analyzing the tweets shared in the study period. For text analytics of the relevant data, we further used the word cloud generator MonkeyLearn, and VOSviewer. Results The analysis encompasses 358'809 tweets that were shared by 90'079 Twitter users, generating a total of 1'183'384'757 impressions. Physicians contributed to 18.65% of all tweets, followed by other healthcare professionals (14.31%), and health-focused individuals (10.91%). Geographically, more than a third of tweets (60.90%) were published in the United States. Canada and India followed in second and third positions, respectively. Blocks of trending terms of greater interest to the global Twitter community within the hashtag #PatientSafety were determined to be: "Patient," "Practical doctors," and "Health Care Safety Management." The findings demonstrate the engagement of the Twitter community with COVID-19 and problems related to the training, experience of doctors and patients during a pandemic, communication, the vaccine safety and effectiveness, and potential use of off-label drugs. Noteworthy, in the field of pharmacovigilance, Twitter has the possibility of identifying adverse reactions associated with the use of drugs, including vaccines. The issue of medical errors has been also discussed by Twitter users using the hashtag #PatientSafety. Conclusion It is clear that various stakeholders, including students, medical practitioners, health organizations, pharmaceutical companies, and regulatory bodies, leverage Twitter to rapidly exchange medical information, data on the disease symptoms, and the drug effects. Consequently, there is a need to further integrate Twitter-derived data into the operational routines of healthcare organizations.
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Affiliation(s)
- Olena Litvinova
- Department of Management and Quality Assurance in Pharmacy, National University of Pharmacy of the Ministry of Health of Ukraine, Kharkiv, Ukraine
- Ludwig Boltzmann Institute Digital Health and Patient Safety, Medical University of Vienna, Vienna, Austria
| | - Farhan Bin Matin
- Department of Pharmacy, East West University, Aftabnagar, Dhaka, Bangladesh
| | - Maima Matin
- Institute of Genetics and Animal Biotechnology of the Polish Academy of Sciences, Jastrzebiec, Poland
| | - Bogumila Zima-Kulisiewicz
- Institute of Genetics and Animal Biotechnology of the Polish Academy of Sciences, Jastrzebiec, Poland
| | - Cyprian Tomasik
- Institute of Genetics and Animal Biotechnology of the Polish Academy of Sciences, Jastrzebiec, Poland
| | - Bodrun Naher Siddiquea
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | | | - Atanas G. Atanasov
- Ludwig Boltzmann Institute Digital Health and Patient Safety, Medical University of Vienna, Vienna, Austria
- Institute of Genetics and Animal Biotechnology of the Polish Academy of Sciences, Jastrzebiec, Poland
| | - Harald Willschke
- Ludwig Boltzmann Institute Digital Health and Patient Safety, Medical University of Vienna, Vienna, Austria
- Department of Anaesthesia, Intensive Care Medicine and Pain Medicine, Medical University Vienna, Vienna, Austria
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Teodorowski P, Rodgers SE, Fleming K, Tahir N, Ahmed S, Frith L. 'To me, it's ones and zeros, but in reality that one is death': A qualitative study exploring researchers' experience of involving and engaging seldom-heard communities in big data research. Health Expect 2023; 26:882-891. [PMID: 36691930 PMCID: PMC10010102 DOI: 10.1111/hex.13713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 12/21/2022] [Accepted: 01/05/2023] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Big data research requires public support. It has been argued that this can be achieved by public involvement and engagement to ensure that public views are at the centre of research projects. Researchers should aim to include diverse communities, including seldom-heard voices, to ensure that a range of voices are heard and that research is meaningful to them. OBJECTIVE We explored how researchers involve and engage seldom-heard communities around big data research. METHODS This is a qualitative study. Researchers who had experience of involving or engaging seldom-heard communities in big data research were recruited. They were based in England (n = 5), Scotland (n = 4), Belgium (n = 2) and Canada (n = 1). Twelve semistructured interviews were conducted on Zoom. All interviews were audio-recorded and transcribed, and we used reflexive thematic analysis to analyse participants' experiences. RESULTS The analysis highlighted the complexity of involving and engaging seldom-heard communities around big data research. Four themes were developed to represent participants' experiences: (1) abstraction and complexity of big data, (2) one size does not fit all, (3) working in partnership and (4) empowering the public contribution. CONCLUSION The study offers researchers a better understanding of how to involve and engage seldom-heard communities in a meaningful way around big data research. There is no one right approach, with involvement and engagement activities required to be project-specific and dependent on the public contributors, researchers' needs, resources and time available. PATIENT AND PUBLIC INVOLVEMENT Two public contributors are authors of the paper and they were involved in the study design, analysis and writing.
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Affiliation(s)
- Piotr Teodorowski
- Department of Public Health, Policy & Systems, University of Liverpool, Liverpool, UK
| | - Sarah E Rodgers
- Department of Public Health, Policy & Systems, University of Liverpool, Liverpool, UK
| | - Kate Fleming
- National Disease Registration Service, NHS Digital, Liverpool, UK
| | | | | | - Lucy Frith
- Department of Law, University of Manchester, Manchester, UK
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Skovgaard L, Grundtvig A. Who tweets what about personalised medicine? Promises and concerns from Twitter discussions in Denmark. Digit Health 2023; 9:20552076231169832. [PMID: 37113257 PMCID: PMC10126701 DOI: 10.1177/20552076231169832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 03/29/2023] [Indexed: 04/29/2023] Open
Abstract
Digital health data are seen as valuable resources for the development of better and more efficient treatments, for instance through personalised medicine. However, health data are information about individuals who hold opinions and can challenge how data about them are used. Therefore it is important to understand public discussions around reuse of digital health data. Social media have been heralded as enabling new forms of public engagement and as a place to study social issues. In this paper, we study a public debate on Twitter about personalised medicine. We explore who participates in discussions about personalised medicine on Twitter and what they tweet about. Based on user-generated biographies we categorise users as having a 'Professional interest in personalised medicine' or as 'Private' users. We describe how users within the field tweet about the promises of personalised medicine, while users unaffiliated with the field tweet about the concrete realisation of these ambitions in the form of a new infrastructure and express concerns about the conditions for the implementation. Our study serves to remind people interested in public opinion that Twitter is a platform used for multiple purposes by different actors and not simply a bottom-up democratic forum. This study contributes with insights relevant to policymakers wishing to expand infrastructures for reuse of health data. First, by providing insights into what is discussed about health data reuse. Second, by exploring how Twitter can be used as a platform to study public discussions about reuse of health data.
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Affiliation(s)
- Lea Skovgaard
- Department of Public Health, University of
Copenhagen, Copenhagen K, Denmark
- Lea Skovgaard, Department of Public Health,
University of Copenhagen, Øster Farigmagsgade 5, Copenhagen K 1014, Denmark.
| | - Anders Grundtvig
- Department of Public Health, University of
Copenhagen, Copenhagen K, Denmark
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Teodorowski P, Rodgers SE, Fleming K, Frith L. Use of the Hashtag #DataSavesLives on Twitter: Exploratory and Thematic Analysis. J Med Internet Res 2022; 24:e38232. [DOI: 10.2196/38232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 08/16/2022] [Accepted: 09/16/2022] [Indexed: 11/17/2022] Open
Abstract
Background
“Data Saves Lives” is a public engagement campaign that highlights the benefits of big data research and aims to establish public trust for this emerging research area.
Objective
This study explores how the hashtag #DataSavesLives is used on Twitter. We focused on the period when the UK government and its agencies adopted #DataSavesLives in an attempt to support their plans to set up a new database holding National Health Service (NHS) users’ medical data.
Methods
Public tweets published between April 19 and July 15, 2021, using the hashtag #DataSavesLives were saved using NCapture for NVivo 12. All tweets were coded twice. First, each tweet was assigned a positive, neutral, or negative attitude toward the campaign. Second, inductive thematic analysis was conducted. The results of the thematic analysis were mapped under 3 models of public engagement: deficit, dialogue, and participatory.
Results
Of 1026 unique tweets available for qualitative analysis, discussion around #DataSavesLives was largely positive (n=716, 69.8%) or neutral (n=276, 26.9%) toward the campaign with limited negative attitudes (n=34, 3.3%). Themes derived from the #DataSavesLives debate included ethical sharing, proactively engaging the public, coproducing knowledge with the public, harnessing potential, and gaining an understanding of big data research. The Twitter discourse was largely positive toward the campaign. The hashtag is predominantly used by similar-minded Twitter users to share information about big data projects and to spread positive messages about big data research when there are public controversies. The hashtag is generally used by organizations and people supportive of big data research. Tweet authors recognize that the public should be proactively engaged and involved in big data projects. The campaign remains UK centric. The results indicate that the communication around big data research is driven by the professional community and remains 1-way as members of the public rarely use the hashtag.
Conclusions
The results demonstrate the potential of social media but draws attention to hashtag usage being generally confined to “Twitter bubbles”: groups of similar-minded Twitter users.
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Walsh L, Hyett N, Juniper N, Li C, Hill S. The Experiences of Stakeholders Using Social Media as a Tool for Health Service Design and Quality Improvement: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192214851. [PMID: 36429570 PMCID: PMC9690250 DOI: 10.3390/ijerph192214851] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 11/08/2022] [Accepted: 11/08/2022] [Indexed: 05/12/2023]
Abstract
BACKGROUND Health organisations and stakeholders use social media for a range of functions, including engaging stakeholders in the design and quality improvement (QI) of services. Social media may help overcome some of the limitations of traditional stakeholder engagement methods. This scoping review explores the benefits, risks, barriers and enablers for using social media as a tool for stakeholder engagement in health service design and QI. METHODS The searches were conducted on 16 August 2022. Inclusion criteria were: studies of any health service stakeholders, in any health setting, where social media was used as a tool for service design or QI. Data was analysed using deductive content analysis. A committee of stakeholders provided input on research questions, data analysis and key findings. RESULTS 61 studies were included. Benefits included improved organisational communication and relationship building. Risks/limitations included low quality of engagement and harms to users. Limited access and familiarity with social media were frequently reported barriers. Making discussions safe and facilitating access were common enablers. CONCLUSION The benefits, risks, barriers and enablers identified highlight the complexity of social media as an engagement tool for health service design and QI. Understanding these experiences may help implementers design more effective social media-based engagement activities.
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Affiliation(s)
- Louisa Walsh
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Melbourne, VIC 3083, Australia
- Correspondence: ; Tel.: +61-3-9479-1578
| | - Nerida Hyett
- La Trobe Rural Health School, La Trobe University, Bendigo, VIC 3550, Australia
| | | | - Chi Li
- Albury Wodonga Health, Wodonga, VIC 3690, Australia
| | - Sophie Hill
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Melbourne, VIC 3083, Australia
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Dusetzina PhD SB, Enewold Mph PhD L, Gentile PhD D, Ramsey Md PhD SD, Halpern MT. New Data Resources, Linkages, and Infrastructure for Cancer Health Economics Research: Main Topics From a Panel Discussion. J Natl Cancer Inst Monogr 2022; 2022:68-73. [PMID: 35788378 DOI: 10.1093/jncimonographs/lgac016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 04/06/2022] [Indexed: 11/14/2022] Open
Abstract
Although a broad range of data resources have played a key role in the substantial achievements of cancer health economics research, there are now needs for more comprehensive data that represent a fuller picture of the cancer care experience. In particular, researchers need information that represents more diverse populations; includes more clinical details; and provides greater context on individual- and neighborhood-level factors that can affect cancer prevention, screening, treatment, and survivorship, including measures of financial health or toxicity, health-related social needs, and social determinants of health. This article highlights 3 critical topics for cancer health economics research: the future of the National Cancer Institute's Surveillance, Epidemiology, and End Results-Centers for Medicare & Medicaid Services-linked data resources; use of social media data for cancer outcomes research; and multi-site-linked electronic health record data networks. These 3 topics represent different approaches to enhance data resources, linkages, and infrastructures and are complementary strategies to provide more complete information on activities involved in and factors affecting the cancer control continuum. These and other data resources will assist researchers in examining the complex and nuanced questions now at the forefront of cancer health economics research.
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Affiliation(s)
| | | | | | - Scott D Ramsey Md PhD
- Fred Hutchinson Cancer Center, Hutchinson Institute for Cancer Outcomes Research, Seattle, WA, USA
| | - Michael T Halpern
- Healthcare Delivery Research Program, National Cancer Institute, Bethesda, MD, USA
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Boukobza A, Burgun A, Roudier B, Tsopra R. Deep neural networks for simultaneously capturing public topics and sentiments during a pandemic. Application to a COVID-19 tweet dataset. JMIR Med Inform 2022; 10:e34306. [PMID: 35533390 PMCID: PMC9135113 DOI: 10.2196/34306] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 02/14/2022] [Accepted: 04/21/2022] [Indexed: 11/24/2022] Open
Abstract
Background Public engagement is a key element for mitigating pandemics, and a good understanding of public opinion could help to encourage the successful adoption of public health measures by the population. In past years, deep learning has been increasingly applied to the analysis of text from social networks. However, most of the developed approaches can only capture topics or sentiments alone but not both together. Objective Here, we aimed to develop a new approach, based on deep neural networks, for simultaneously capturing public topics and sentiments and applied it to tweets sent just after the announcement of the COVID-19 pandemic by the World Health Organization (WHO). Methods A total of 1,386,496 tweets were collected, preprocessed, and split with a ratio of 80:20 into training and validation sets, respectively. We combined lexicons and convolutional neural networks to improve sentiment prediction. The trained model achieved an overall accuracy of 81% and a precision of 82% and was able to capture simultaneously the weighted words associated with a predicted sentiment intensity score. These outputs were then visualized via an interactive and customizable web interface based on a word cloud representation. Using word cloud analysis, we captured the main topics for extreme positive and negative sentiment intensity scores. Results In reaction to the announcement of the pandemic by the WHO, 6 negative and 5 positive topics were discussed on Twitter. Twitter users seemed to be worried about the international situation, economic consequences, and medical situation. Conversely, they seemed to be satisfied with the commitment of medical and social workers and with the collaboration between people. Conclusions We propose a new method based on deep neural networks for simultaneously extracting public topics and sentiments from tweets. This method could be helpful for monitoring public opinion during crises such as pandemics.
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Affiliation(s)
- Adrien Boukobza
- Université Paris Cité, Sorbonne Université, Inserm, Centre de Recherche des Cordeliers, F-75006 Paris, FR.,Inria, HeKA, PariSanté Campus, Paris, FR.,Department of Medical Informatics, AP-HP, Hôpital Européen Georges-Pompidou, F-75015 Paris, FR
| | - Anita Burgun
- Université Paris Cité, Sorbonne Université, Inserm, Centre de Recherche des Cordeliers, F-75006 Paris, FR.,Inria, HeKA, PariSanté Campus, Paris, FR.,Department of Medical Informatics, AP-HP, Hôpital Européen Georges-Pompidou, F-75015 Paris, FR
| | | | - Rosy Tsopra
- Université Paris Cité, Sorbonne Université, Inserm, Centre de Recherche des Cordeliers, F-75006 Paris, FR.,Inria, HeKA, PariSanté Campus, Paris, FR.,Department of Medical Informatics, AP-HP, Hôpital Européen Georges-Pompidou, F-75015 Paris, FR
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9
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Cottingham MD, Rose A. Tweeting Jokes, Tweeting Hope: Humor Practices during the 2014 Ebola Outbreak. HEALTH COMMUNICATION 2022:1-10. [PMID: 35255759 DOI: 10.1080/10410236.2022.2045059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
In this article, we examine how humor practices on Twitter resist dominant emotion norms during an emerging disease outbreak. Humor may seem frivolous or irreverent but can constitute a powerful practice for channeling and managing difficult emotions - like anxiety and fear - during an outbreak. We find that the use of AAVE (African-American Vernacular English) and Black cultural references were widespread in Ebola-related tweets using humor. Together these communicative practices constitute Black Twitter. Humor can signal membership in Black culture while also performing and managing specific emotions in relation to epidemic risk in online spaces. Humor practices on Black Twitter were more likely to reimagine social connections despite the risks posed by the epidemic, whereas mainstream forms of humor emphasized retreat and self-isolation in response to an epidemic threat. These findings center the agency and creativity of this influential digital community while showing the variability of communication practices among a group facing disproportionate vulnerability to outbreaks and public health threats. The implications for public health messaging are discussed.
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Affiliation(s)
| | - Ariana Rose
- Department of Sociology, University of Amsterdam
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10
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Gille F, Smith S, Mays N. Evidence-based guiding principles to build public trust in personal data use in health systems. Digit Health 2022; 8:20552076221111947. [PMID: 35874863 PMCID: PMC9297454 DOI: 10.1177/20552076221111947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 06/19/2022] [Indexed: 11/24/2022] Open
Abstract
Objective Public trust in health systems is pivotal for their effective and efficient functioning. In particular, public trust is essential for personal data use, as demonstrated in debates in many countries, for example, about whether data from COVID-19 contact tracing apps should be pooled or remain on individuals’ smartphones. Low levels of public trust pose a risk not only to health system legitimacy but can also harm population health. Methods Synthesising our previous qualitative and theoretical research in the English National Health Service which enabled us to conceptualise the nature of public trust in health systems, we present guiding principles designed to rebuild public trust, if lost, and to maintain high levels of public trust in personal data use within the health system, if not. Results To build public trust, health system actors need to not rush trust building; engage with the public; keep the public safe; offer autonomy to the public; plan for diverse trust relationships; recognise that trust is shaped by both emotion and rational thought; represent the public interest; and work towards realising a net benefit for the health system and the public. Conclusions Beyond policymakers and government officials, the guiding principles address a wide range of actors within health systems so that they can work collectively to build public trust. The guiding principles can be used to inform policymaking in health and health care and to analyse the performance of different governments to see if those governments that operate in greater conformity with the guiding principles perform better.
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Affiliation(s)
- Felix Gille
- University of Zurich, Digital Society Initiative (DSI), Zürich, CH, Switzerland
- University of Zurich, Institute for Implementation Science in Health Care (IfIS), Zürich, CH, Switzerland
| | - Sarah Smith
- Department of Health Services Research and Policy, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Nicholas Mays
- Department of Health Services Research and Policy, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
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Karmegam D, Mappillairaju B. Information extraction using a mixed method analysis of social media data: A case study of the police shooting during the anti-Sterlite protests at Thoothukudi, India. INFORMATION DEVELOPMENT 2021. [DOI: 10.1177/02666669211049153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
During unexpected social events, information extracted from social media content posted by the people could play a crucial role in understanding the public opinion about the event. In this study, a mixed method procedure, which combines automated and human-based methods, is proposed to mine information from tweets to understand people's thoughts toward an unexpected turn of events. The proposed framework was applied on tweets posted regarding the police shooting to disperse protesters during the anti-Sterlite protests on May 22, 2018, at Thoothukudi in the Indian state of Tamil Nadu. The tweets were analyzed in two ways: (i) sentiment classification with automated computational methods and (ii) qualitatively examining the context of the expressed sentiments. In the case of anti-Sterlite protests, people expressed mixed emotions toward the protests for the closure of the Sterlite plant. A large negative sentiment toward the police shooting could be gleaned from the tweets. Analyzing tweets by the proposed method provides clear insights regarding the incident, which in turn will aid in planning an emergency response.
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Affiliation(s)
- Dhivya Karmegam
- School of Public Health, SRM Institute of Science and Technology, Chennai, India
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12
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Gille F, Brall C. Limits of data anonymity: lack of public awareness risks trust in health system activities. LIFE SCIENCES, SOCIETY AND POLICY 2021; 17:7. [PMID: 34304736 PMCID: PMC8310702 DOI: 10.1186/s40504-021-00115-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 06/16/2021] [Indexed: 06/13/2023]
Abstract
Public trust is paramount for the well functioning of data driven healthcare activities such as digital health interventions, contact tracing or the build-up of electronic health records. As the use of personal data is the common denominator for these healthcare activities, healthcare actors have an interest to ensure privacy and anonymity of the personal data they depend on. Maintaining privacy and anonymity of personal data contribute to the trustworthiness of these healthcare activities and are associated with the public willingness to trust these activities with their personal data. An analysis of online news readership comments about the failed care.data programme in England revealed that parts of the public have a false understanding of anonymity in the context of privacy protection of personal data as used for healthcare management and medical research. Some of those commenting demanded complete anonymity of their data to be willing to trust the process of data collection and analysis. As this demand is impossible to fulfil and trust is built on a false understanding of anonymity, the inability to meet this demand risks undermining public trust. Since public concerns about anonymity and privacy of personal data appear to be increasing, a large-scale information campaign about the limits and possibilities of anonymity with respect to the various uses of personal health data is urgently needed to help the public to make better informed choices about providing personal data.
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Affiliation(s)
- Felix Gille
- Department of Health Sciences and Technology, Ethics and Policy Lab, ETH Zürich, Zürich, Switzerland.
| | - Caroline Brall
- Department of Health Sciences and Technology, Ethics and Policy Lab, ETH Zürich, Zürich, Switzerland
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13
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Cumyn A, Barton A, Dault R, Safa N, Cloutier AM, Ethier JF. Meta-consent for the secondary use of health data within a learning health system: a qualitative study of the public's perspective. BMC Med Ethics 2021; 22:81. [PMID: 34187453 PMCID: PMC8240433 DOI: 10.1186/s12910-021-00647-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 06/10/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The advent of learning healthcare systems (LHSs) raises an important implementation challenge concerning how to request and manage consent to support secondary use of data in learning cycles, particularly research activities. Current consent models in Quebec were not established with the context of LHSs in mind and do not support the agility and transparency required to obtain consent from all involved, especially the citizens. Therefore, a new approach to consent is needed. Previous work identified the meta-consent model as a promising alternative to fulfill the requirements of LHSs, particularly large-scale deployments. We elicited the public's attitude toward the meta-consent model to evaluate if the model could be understood by the citizens and would be deemed acceptable to prepare for its possible implementation in Quebec. METHODS Eight focus groups, with a total of 63 members of the general public from various backgrounds were conducted in Quebec, Canada, in 2019. Explicit attention was given to literacy levels, language spoken at home and rural vs urban settings. We assessed attitudes, concerns and facilitators regarding key components of the meta-consent model: predefined categories to personalized consent requests, a dynamic web-based infrastructure to record meta-consent, and default settings. To analyse the discussions, a thematic content analysis was performed using a qualitative software. RESULTS Our findings showed that participants were supportive of this new approach of consent as it promotes transparency and offers autonomy for the management of their health data. Key facilitators were identified to be considered in the implementation of a meta-consent model in the Quebec LHSs: information and transparency, awareness campaigns, development of educational tools, collaboration of front-line healthcare professionals, default settings deemed acceptable by the society as well as close partnerships with recognized and trusted institutions. CONCLUSIONS This qualitative study reveals the openness of a sample of the Quebec population regarding the meta-consent model for secondary use of health data for research. This first exploratory study conducted with the public is an important step in guiding decision-makers in the next phases of implementing the various strategies to support access and use of health data in Quebec.
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Affiliation(s)
- Annabelle Cumyn
- Groupe de Recherche Interdisciplinaire en Informatique de la Santé (GRIIS), Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, 2500 Boulevard de l'Université, Sherbrooke, QC, J1K 2R1, Canada
| | - Adrien Barton
- Groupe de Recherche Interdisciplinaire en Informatique de la Santé (GRIIS), Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, 2500 Boulevard de l'Université, Sherbrooke, QC, J1K 2R1, Canada
- Centre National de la Recherche Scientifique (CNRS) - Institut de Recherche en Informatique de Toulouse (IRIT), 29 rue Jeanne Marvig, 31055, Toulouse, France
| | - Roxanne Dault
- Groupe de Recherche Interdisciplinaire en Informatique de la Santé (GRIIS), Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, 2500 Boulevard de l'Université, Sherbrooke, QC, J1K 2R1, Canada
| | - Nissrine Safa
- Groupe de Recherche Interdisciplinaire en Informatique de la Santé (GRIIS), Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, 2500 Boulevard de l'Université, Sherbrooke, QC, J1K 2R1, Canada
| | - Anne-Marie Cloutier
- Groupe de Recherche Interdisciplinaire en Informatique de la Santé (GRIIS), Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, 2500 Boulevard de l'Université, Sherbrooke, QC, J1K 2R1, Canada
| | - Jean-François Ethier
- Groupe de Recherche Interdisciplinaire en Informatique de la Santé (GRIIS), Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, 2500 Boulevard de l'Université, Sherbrooke, QC, J1K 2R1, Canada.
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Hassan L, Nenadic G, Tully MP. A Social Media Campaign (#datasaveslives) to Promote the Benefits of Using Health Data for Research Purposes: Mixed Methods Analysis. J Med Internet Res 2021; 23:e16348. [PMID: 33591280 PMCID: PMC7925154 DOI: 10.2196/16348] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 07/27/2020] [Accepted: 12/07/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Social media provides the potential to engage a wide audience about scientific research, including the public. However, little empirical research exists to guide health scientists regarding what works and how to optimize impact. We examined the social media campaign #datasaveslives established in 2014 to highlight positive examples of the use and reuse of health data in research. OBJECTIVE This study aims to examine how the #datasaveslives hashtag was used on social media, how often, and by whom; thus, we aim to provide insights into the impact of a major social media campaign in the UK health informatics research community and further afield. METHODS We analyzed all publicly available posts (tweets) that included the hashtag #datasaveslives (N=13,895) on the microblogging platform Twitter between September 1, 2016, and August 31, 2017. Using a combination of qualitative and quantitative analyses, we determined the frequency and purpose of tweets. Social network analysis was used to analyze and visualize tweet sharing (retweet) networks among hashtag users. RESULTS Overall, we found 4175 original posts and 9720 retweets featuring #datasaveslives by 3649 unique Twitter users. In total, 66.01% (2756/4175) of the original posts were retweeted at least once. Higher frequencies of tweets were observed during the weeks of prominent policy publications, popular conferences, and public engagement events. Cluster analysis based on retweet relationships revealed an interconnected series of groups of #datasaveslives users in academia, health services and policy, and charities and patient networks. Thematic analysis of tweets showed that #datasaveslives was used for a broader range of purposes than indexing information, including event reporting, encouraging participation and action, and showing personal support for data sharing. CONCLUSIONS This study shows that a hashtag-based social media campaign was effective in encouraging a wide audience of stakeholders to disseminate positive examples of health research. Furthermore, the findings suggest that the campaign supported community building and bridging practices within and between the interdisciplinary sectors related to the field of health data science and encouraged individuals to demonstrate personal support for sharing health data.
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Affiliation(s)
- Lamiece Hassan
- Division of Informatics, Imaging and Data Sciences, The University of Manchester, Manchester, United Kingdom
| | - Goran Nenadic
- Department of Computer Science, The University of Manchester, Manchester, United Kingdom
| | - Mary Patricia Tully
- Division of Pharmacy and Optometry, The University of Manchester, Manchester, United Kingdom
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Gille F, Axler R, Blasimme A. Transparency About Governance Contributes to Biobanks' Trustworthiness: Call for Action. Biopreserv Biobank 2020; 19:83-85. [PMID: 33124891 DOI: 10.1089/bio.2020.0057] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
This article examines biobank transparency mechanisms vis-à-vis their public information, as found on the public biobank webpages. Two independent studies about biobank governance in Europe and Canada identified a lack of governance-related information provided by biobanks on their public webpages. This lack of transparency stands in contrast to governance best practice guidelines highlighting the importance of transparency as a principle of good governance. Transparency is especially important as many biobanks are publicly funded, and it contributes to accountability and supports the development of donor trust in biobanks. Empirical evidence shows that the public supports greater transparency about biobank governance. It will be important that information provided online is relevant and accessible for a variety of different stakeholders (e.g. public and private sector scientists and institutions, donors and potential donors, members of the public). Transparency standards, however, need to be proportionate to avoid the situation that only large-scale biobanks can allocate appropriate resources to fulfil them. Implementing adequate standards of transparency about biobanks' governance will increase accountability but also allow current and future participants to make more informed decisions about their participation in biobank activities.
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Affiliation(s)
- Felix Gille
- Health Ethics and Policy Lab, Department of Health Sciences and Technology, ETH Zürich, Zürich, Switzerland
| | - Renata Axler
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
| | - Alessandro Blasimme
- Health Ethics and Policy Lab, Department of Health Sciences and Technology, ETH Zürich, Zürich, Switzerland
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Ford E, Kazempour Y, Cooper MJF, Katikireddi SV, Boyd A. Media content analysis of general practitioners' reactions to care.data expressed in the media: what lessons can be learned for future NHS data-sharing initiatives? BMJ Open 2020; 10:e038006. [PMID: 32912990 PMCID: PMC7485233 DOI: 10.1136/bmjopen-2020-038006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Care.data was a 2013 UK government initiative to extract patient data from general practices in England to form a centralised whole-population database for service planning and health research. After a public outcry, the scheme was postponed and cancelled. Public views of care.data have previously been analysed; this study aimed to understand contemporary general practitioners' (GPs) views of the scheme, which may have been influential in its downfall. DESIGN Systematic search of media articles, followed by media content analysis. SETTING UK-based mainstream and GP-facing media in 2013 and 2014. PARTICIPANTS Articles were eligible if they focused on care.data, and GPs were quoted, authored the article, or if articles were written for a majority GP audience. INTERVENTIONS N/A. PRIMARY AND SECONDARY OUTCOME MEASURES Themes which explained GPs' reactions to care.data and which could explain support for or opposition to the scheme. RESULTS 162 media articles met inclusion criteria and were drawn from newspapers, news websites and GP-facing websites. GPs recognised care.data's potential value for research and improving care, but had grave concerns about the scheme's implementation. These centred the lack of safeguards and purpose around the scheme which meant patients were not able to make informed decisions about opt-out. GPs perceived they were poorly resourced to meet competing demands to both share patients' data and protect confidentiality. They distrusted the government's likely uses of the data and perceived a risk of patient reidentification if the data were sold onto commercial entities. CONCLUSIONS Findings show specific concerns which GPs had about care.data which led to the withdrawal of support. Future NHS patient data-sharing schemes should engage with GPs and other clinicians as key stakeholders from the earliest moments of planning, so that their views and needs are incorporated into the design of such schemes.
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Affiliation(s)
- Elizabeth Ford
- Primary Care and Public Health, Brighton & Sussex Medical School, Brighton, UK
| | - Yalda Kazempour
- Primary Care and Public Health, Brighton & Sussex Medical School, Brighton, UK
| | - Maxwell J F Cooper
- Primary Care and Public Health, Brighton & Sussex Medical School, Brighton, UK
| | | | - Andy Boyd
- School of Social and Community Medicine, University of Bristol, Bristol, UK
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Ní Shé É, O’Donnell D, O’Shea M, Stokes D. New Ways of Working? A Rapid Exploration of Emerging Evidence Regarding the Care of Older People during COVID19. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186442. [PMID: 32899652 PMCID: PMC7558069 DOI: 10.3390/ijerph17186442] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 08/21/2020] [Accepted: 08/29/2020] [Indexed: 12/15/2022]
Abstract
Health and social care staff have had to quickly adapt, respond and improve teamwork, as a response to the COVID-19 pandemic. Our objective was to rapidly summarize the emerging evidence of new ways of working in the care of older people during this period. We conducted an exploration of the emerging evidence within the timeframe of 1 March 2020 to 11 May 2020. To capture a broad perspective, we undertook thematic analysis of Twitter data which was extracted through a broad search for new ways of working in health and social care. For a more in-depth focus on the health and social care of older people, we undertook a systematic scoping of newspapers using the Nexis UK database. We undertook a validation workshop with members of the interprofessional working group of the Irish National Integrated Care Programme for Older People, and with researchers. A total of 317 tweets were extracted related to six new ways of working. There was evidence of using telehealth to provide ongoing care to patients; interprofessional work; team meetings using online platforms; trust and collaboration within teams; as well as teams feeling empowered to change at a local level. 34 newspaper articles were extracted related to new ways of working in the care of older people, originating in England (n = 17), Wales (n = 6), Scotland (n = 6), Ireland (n = 4) and Germany (n = 1). Four main themes were captured that focused on role expansion, innovations in communication, environmental restructuring and enablement. The results of this exploration of emerging evidence show that health and social care teams can transform very rapidly. Much of the change was based on goodwill as a response to the pandemic. Further analysis of empirical evidence of changing practices should include the perspectives of older people and should capture the resources needed to sustain innovations, as well as evaluate gaps in service provision.
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Affiliation(s)
- Éidín Ní Shé
- School of Nursing, Midwifery and Health Systems, University College Dublin, Belfield 4 Dublin, Ireland; (É.N.S.); (M.O.)
| | - Deirdre O’Donnell
- School of Nursing, Midwifery and Health Systems, University College Dublin, Belfield 4 Dublin, Ireland; (É.N.S.); (M.O.)
- Correspondence:
| | - Marie O’Shea
- School of Nursing, Midwifery and Health Systems, University College Dublin, Belfield 4 Dublin, Ireland; (É.N.S.); (M.O.)
| | - Diarmuid Stokes
- Liaison Librarian for Health and Science, University College Dublin, Belfield 4 Dublin, Ireland;
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Yamaguchi A, Queralt-Rosinach N. A proof-of-concept study of extracting patient histories for rare/intractable diseases from social media. Genomics Inform 2020; 18:e17. [PMID: 32634871 PMCID: PMC7362943 DOI: 10.5808/gi.2020.18.2.e17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 06/18/2020] [Indexed: 12/22/2022] Open
Abstract
The amount of content on social media platforms such as Twitter is expanding rapidly. Simultaneously, the lack of patient information seriously hinders the diagnosis and treatment of rare/intractable diseases. However, these patient communities are especially active on social media. Data from social media could serve as a source of patient-centric knowledge for these diseases complementary to the information collected in clinical settings and patient registries, and may also have potential for research use. To explore this question, we attempted to extract patient-centric knowledge from social media as a task for the 3-day Biomedical Linked Annotation Hackathon 6 (BLAH6). We selected amyotrophic lateral sclerosis and multiple sclerosis as use cases of rare and intractable diseases, respectively, and we extracted patient histories related to these health conditions from Twitter. Four diagnosed patients for each disease were selected. From the user timelines of these eight patients, we extracted tweets that might be related to health conditions. Based on our experiment, we show that our approach has considerable potential, although we identified problems that should be addressed in future attempts to mine information about rare/intractable diseases from Twitter.
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Cumyn A, Barton A, Dault R, Cloutier A, Jalbert R, Ethier J. Informed consent within a learning health system: A scoping review. Learn Health Syst 2020; 4:e10206. [PMID: 32313834 PMCID: PMC7156861 DOI: 10.1002/lrh2.10206] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 09/18/2019] [Accepted: 10/08/2019] [Indexed: 12/27/2022] Open
Abstract
INTRODUCTION A major consideration for the implementation of a learning health system (LHS) is consent from participants to the use of their data for research purposes. The main objective of this paper was to identify in the literature which types of consent have been proposed for participation in research observational activities in a LHS. We were particularly interested in understanding which approaches were seen as most feasible and acceptable and in which context, in order to inform the development of a Quebec-based LHS. METHODS Using a scoping review methodology, we searched scientific and legal databases as well as the gray literature using specific terms. Full-text articles were reviewed independently by two authors on the basis of the following concepts: (a) LHS and (b) approach to consent. The selected papers were imported in NVivo software for analysis in the light of a conceptual framework that distinguishes various, largely independent dimensions of consent. RESULTS A total of 93 publications were analysed for this review. Several studies reach opposing conclusions concerning the best approach to consent within a LHS. However, in the light of the conceptual framework we developed, we found that many of these results are distorted by the conflation between various characteristics of consent. Thus, when these characteristics are distinguished, the results mainly suggest the prime importance of the communication process, by contrast to the scope of consent or the kind of action required by participants (opt-in/opt-out). We identified two models of consent that were especially relevant for our purpose: metaconsent and dynamic consent. CONCLUSIONS Our review shows the importance of distinguishing carefully the various features of the consent process. It also suggests that the metaconsent model is a valuable model within a LHS, as it addresses many of the issues raised with regards to feasibility and acceptability. We propose to complement this model by adding the modalities of the information process to the dimensions relevant in the metaconsent process.
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Affiliation(s)
- Annabelle Cumyn
- Département de médecine, Faculté de médecine et des sciences de la santéUniversité de SherbrookeQuebecCanada
- Groupe de recherche interdisciplinaire en informatique de la santé (GRIIS), Faculté de médecine et des sciences de la santé/Faculté des sciencesUniversité de SherbrookeQuebecCanada
| | - Adrien Barton
- Groupe de recherche interdisciplinaire en informatique de la santé (GRIIS), Faculté de médecine et des sciences de la santé/Faculté des sciencesUniversité de SherbrookeQuebecCanada
- Centre national de la recherche scientifique ‐ Institut de recherche en informatique de Toulouse (CNRS‐IRIT)ToulouseFrance
| | - Roxanne Dault
- Groupe de recherche interdisciplinaire en informatique de la santé (GRIIS), Faculté de médecine et des sciences de la santé/Faculté des sciencesUniversité de SherbrookeQuebecCanada
| | - Anne‐Marie Cloutier
- Groupe de recherche interdisciplinaire en informatique de la santé (GRIIS), Faculté de médecine et des sciences de la santé/Faculté des sciencesUniversité de SherbrookeQuebecCanada
| | - Rosalie Jalbert
- Groupe de recherche interdisciplinaire en informatique de la santé (GRIIS), Faculté de médecine et des sciences de la santé/Faculté des sciencesUniversité de SherbrookeQuebecCanada
| | - Jean‐François Ethier
- Département de médecine, Faculté de médecine et des sciences de la santéUniversité de SherbrookeQuebecCanada
- Groupe de recherche interdisciplinaire en informatique de la santé (GRIIS), Faculté de médecine et des sciences de la santé/Faculté des sciencesUniversité de SherbrookeQuebecCanada
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What is public trust in the healthcare system? A new conceptual framework developed from qualitative data in England. SOCIAL THEORY & HEALTH 2020. [DOI: 10.1057/s41285-020-00129-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Vezyridis P, Timmons S. Resisting big data exploitations in public healthcare: free riding or distributive justice? SOCIOLOGY OF HEALTH & ILLNESS 2019; 41:1585-1599. [PMID: 31423602 DOI: 10.1111/1467-9566.12969] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
We draw on findings from qualitative interviews with health data researchers, GPs and citizens who opted out from NHS England's care.data programme to explore controversies and negotiations around data sharing in the NHS. Drawing on theoretical perspectives from science and technology studies, we show that the new socio-technical, ethical and economic arrangements were resisted not only on the basis of individual autonomy and protection from exploitation, but also as a collective effort to protect NHS services and patient data. We argue that the resulting opt-outs were a call for more personal control over data use. This was not because these citizens placed their personal interests above those of society. It was because they resisted proposed arrangements by networks of stakeholders, not seen as legitimate, to control flows and benefits of NHS patient data. Approaching informed consent this way helps us to explore resistance as a collective action for influencing the direction of such big data programmes towards the preservation of public access to healthcare as well as the distribution of ethical decision-making between independent, trustworthy institutions and individual citizens.
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Mourby MJ, Doidge J, Jones KH, Aidinlis S, Smith H, Bell J, Gilbert R, Dutey-Magni P, Kaye J. Health Data Linkage for UK Public Interest Research: Key Obstacles and Solutions. Int J Popul Data Sci 2019; 4:1093. [PMID: 32935027 PMCID: PMC7482514 DOI: 10.23889/ijpds.v4i1.1093] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
INTRODUCTION Analysis of linked health data can generate important, even life-saving, insights into population health. Yet obstacles both legal and organisational in nature can impede this work. APPROACH We focus on three UK infrastructures set up to link and share data for research: the Administrative Data Research Network, NHS Digital, and the Secure Anonymised Information Linkage Databank. Bringing an interdisciplinary perspective, we identify key issues underpinning their challenges and successes in linking health data for research. RESULTS We identify examples of uncertainty surrounding legal powers to share and link data, and around data protection obligations, as well as systemic delays and historic public backlash. These issues require updated official guidance on the relevant law, approaches to linkage which are planned for impact and ongoing utility, greater transparency between data providers and researchers, and engagement with the patient population which is both high-profile and carefully considered. CONCLUSIONS Health data linkage for research presents varied challenges, to which there can be no single solution. Our recommendations would require action from a number of data providers and regulators to be meaningfully advanced. This illustrates the scale and complexity of the challenge of health data linkage, in the UK and beyond: a challenge which our case studies suggest no single organisation can combat alone. Planned programmes of linkage are critical because they allow time for organisations to address these challenges without adversely affecting the feasibility of individual research projects.
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Affiliation(s)
- Miranda Jane Mourby
- Centre for Health, Law and Emerging Technologies, University of Oxford, Ewert House, Oxford, OX2 7DD, UK
| | - James Doidge
- Great Ormond Street Hospital Institute of Child Health and UCL Institute of Informatics, 222 Euston Road, London NW1 2DA, UK
- Intensive Care National Audit & Research Centre, 24 High Holborn, London WC1V, UK
| | - Kerina H Jones
- Data Science Building, Swansea University Medical School, Singleton Park, Swansea SA2 8PP, UK
| | - Stergios Aidinlis
- Centre for Health, Law and Emerging Technologies, University of Oxford, Ewert House, Oxford, OX2 7DD, UK
| | - Hannah Smith
- Centre for Health, Law and Emerging Technologies, University of Oxford, Ewert House, Oxford, OX2 7DD, UK
| | - Jessica Bell
- Centre for Health, Law and Emerging Technologies, University of Oxford, Ewert House, Oxford, OX2 7DD, UK
- Centre for Health, Law and Emerging Technologies, Melbourne Law School, Level 9, 185 Pelham Street, University of Melbourne, Victoria 3010, Australia
| | - Ruth Gilbert
- Great Ormond Street Hospital Institute of Child Health and UCL Institute of Informatics, 222 Euston Road, London NW1 2DA, UK
| | - Peter Dutey-Magni
- Great Ormond Street Hospital Institute of Child Health and UCL Institute of Informatics, 222 Euston Road, London NW1 2DA, UK
| | - Jane Kaye
- Centre for Health, Law and Emerging Technologies, University of Oxford, Ewert House, Oxford, OX2 7DD, UK
- Centre for Health, Law and Emerging Technologies, Melbourne Law School, Level 9, 185 Pelham Street, University of Melbourne, Victoria 3010, Australia
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Skovgaard LL, Wadmann S, Hoeyer K. A review of attitudes towards the reuse of health data among people in the European Union: The primacy of purpose and the common good. Health Policy 2019; 123:564-571. [PMID: 30961905 PMCID: PMC6558994 DOI: 10.1016/j.healthpol.2019.03.012] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 03/13/2019] [Accepted: 03/14/2019] [Indexed: 12/14/2022]
Abstract
Studies of attitudes towards reuse of health data mainly from the UK. Studies show lack of awareness of current usages of health data among people living in the EU. Studies report positive attitudes towards the sharing of health data. Concerns about commercial use of health data is expressed in the studies. Attitudes towards informed consent are inconsistent.
Health data are used for still more purposes, and policies are enacted to facilitate data reuse within the European Union. This literature synthesis explores attitudes among people living in the European Union towards the use of health data for purposes other than treatment. Our findings indicate that while a majority hold positive attitudes towards the use of health data for multiple purposes, the positive attitudes are typically conditional on the expectation that data will be used to further the common good. Concerns evolve around the commercialisation of data, data security and the use of data against the interests of the people providing the data. Studies of these issues are limited geographically as well as in scope. We therefore identify a need for cross-national exploration of attitudes among people living in the European Union to inform future policies in health data governance.
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Affiliation(s)
- Lea L Skovgaard
- Department of Public Health, University of Copenhagen, Øster Farigmagsgade 5, 1014 Copenhagen K, Denmark.
| | - Sarah Wadmann
- The Danish Center for Social Science Research, VIVE, Herluf Trolles Gade 11. 1052, Copenhagen K, Denmark
| | - Klaus Hoeyer
- Department of Public Health, University of Copenhagen, Øster Farigmagsgade 5, 1014 Copenhagen K, Denmark
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Stockdale J, Cassell J, Ford E. "Giving something back": A systematic review and ethical enquiry into public views on the use of patient data for research in the United Kingdom and the Republic of Ireland. Wellcome Open Res 2019; 3:6. [PMID: 30854470 PMCID: PMC6402072 DOI: 10.12688/wellcomeopenres.13531.2] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/07/2019] [Indexed: 01/02/2023] Open
Abstract
Background: Use of patients' medical data for secondary purposes such as health research, audit, and service planning is well established in the UK. However, the governance environment, as well as public understanding about this work, have lagged behind. We aimed to systematically review the literature on UK and Irish public views of patient data used in research, critically analysing such views though an established biomedical ethics framework, to draw out potential strategies for future good practice guidance and inform ethical and privacy debates. Methods: We searched three databases using terms such as patient, public, opinion, and electronic health records. Empirical studies were eligible for inclusion if they surveyed healthcare users, patients or the public in UK and Ireland and examined attitudes, opinions or beliefs about the use of patient data for medical research. Results were synthesised into broad themes using a framework analysis. Results: Out of 13,492 papers and reports screened, 20 papers or reports were eligible. While there was a widespread willingness to share patient data for research for the common good, this very rarely led to unqualified support. The public expressed two generalised concerns about the potential risks to their privacy. The first of these concerns related to a party's competence in keeping data secure, while the second was associated with the motivation a party might have to use the data. Conclusions: The public evaluates trustworthiness of research organisations by assessing their competence in data-handling and motivation for accessing the data. Public attitudes around data-sharing exemplified several principles which are also widely accepted in biomedical ethics. This provides a framework for understanding public attitudes, which should be considered in the development in any guidance for regulators and data custodians. We propose four salient questions which decision makers should address when evaluating proposals for the secondary use of data.
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Affiliation(s)
- Jessica Stockdale
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, UK
- Department of Philosophy, School of History, Art History and Philosophy, University of Sussex, Brighton, UK
| | - Jackie Cassell
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, UK
| | - Elizabeth Ford
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, UK
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Dijkstra S, Kok G, Ledford JG, Sandalova E, Stevelink R. Possibilities and Pitfalls of Social Media for Translational Medicine. Front Med (Lausanne) 2018; 5:345. [PMID: 30574495 PMCID: PMC6291449 DOI: 10.3389/fmed.2018.00345] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2018] [Accepted: 11/23/2018] [Indexed: 12/13/2022] Open
Abstract
We live in an age where the sharing of scientific findings and ideas is no longer confined to people with access to academic libraries or scientific journals. Social media have permitted for knowledge and ideas to be shared with an unprecedented speed and magnitude. This has made it possible for research findings to have a greater impact and to be rapidly implemented in society. However, the spread of unfiltered, unreferenced, and non-peer-reviewed articles through social media comes with dangers as well. In this perspective article, we aim to address both the possibilities and pitfalls of social media for translational medicine. We describe how social media can be used for patient engagement, publicity, transparency, sharing of knowledge, and implementing findings in society. Moreover, we warn about the potential pitfalls of social media, which can cause research to be misinterpreted and false beliefs to be spread. We conclude by giving advice on how social media can be harnessed to combat the pitfalls and provide a new avenue for community engagement in translational medicine.
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Affiliation(s)
| | - Gautam Kok
- University Medical Center Utrecht, Utrecht, Netherlands
| | - Julie G. Ledford
- Department of Cellular and Molecular Medicine, The University of Arizona, Tucson, AZ, United States
| | - Elena Sandalova
- Danone Nutricia Research, Singapore, Singapore
- Department of Pharmaceutical Sciences, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, Netherlands
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Banerjee A, Drumright LN, Mitchell ARJ. Can the NHS be a learning healthcare system in the age of digital technology? BMJ Evid Based Med 2018; 23:161-165. [PMID: 29959156 DOI: 10.1136/bmjebm-2018-110953] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/11/2018] [Indexed: 01/14/2023]
Affiliation(s)
- Amitava Banerjee
- Farr Institute of Health Informatics Research, University College London, London, UK
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McLennan S, Kahrass H, Wieschowski S, Strech D, Langhof H. The spectrum of ethical issues in a Learning Health Care System: a systematic qualitative review. Int J Qual Health Care 2018; 30:161-168. [PMID: 29394354 DOI: 10.1093/intqhc/mzy005] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 01/08/2018] [Indexed: 02/06/2023] Open
Abstract
Purpose To determine systematically the spectrum of ethical issues that is raised for stakeholders in a 'Learning Health Care System' (LHCS). Data sources The systematic review was conducted in PubMed and Google Books between the years 2007 and 2015. Study selection The literature search retrieved 1258 publications. Each publication was independently screened by two reviewers for eligibility for inclusion. Ethical issues were defined as arising when a relevant normative principle is not adequately considered or two principles come into conflict. Data extraction A total of 65 publications were included in the final analysis and were analysed using an adapted version of qualitative content analysis. A coding frame was developed inductively from the data, only the highest-level categories were generated deductively for a life-cycle perspective. Results of data synthesis A total of 67 distinct ethical issues could be categorized under different phases of the LHCS life-cycle. An overarching theme that was repeatedly raised was the conflict between the current regulatory system and learning health care. Conclusion The implementation of a LHCS can help realize the ethical imperative to continuously improve the quality of health care. However, the implementation of a LHCS can also raise a number of important ethical issues itself. This review highlights the importance for health care leaders and policy makers to balance the need to protect and respect individual participants involved in learning health care activities with the social value of improving health care.
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Affiliation(s)
- Stuart McLennan
- Institute for History, Ethics and Philosophy of Medicine, Hannover Medical School, OE 5450, Carl-Neuberg-Str. 1, 30625 Hannover, Germany.,Institute for Biomedical Ethics, Universität Basel, Bernoullistrasse 28, 4056 Basel, Switzerland
| | - Hannes Kahrass
- Institute for History, Ethics and Philosophy of Medicine, Hannover Medical School, OE 5450, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Susanne Wieschowski
- Institute for History, Ethics and Philosophy of Medicine, Hannover Medical School, OE 5450, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Daniel Strech
- Institute for History, Ethics and Philosophy of Medicine, Hannover Medical School, OE 5450, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Holger Langhof
- Institute for History, Ethics and Philosophy of Medicine, Hannover Medical School, OE 5450, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
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Sinha S, Bhatnagar V, Bansal A. Multi-Label Naïve Bayes Classifier for Identification of Top Destination and Issues to Accost by Tourism Sector. JOURNAL OF GLOBAL INFORMATION MANAGEMENT 2018. [DOI: 10.4018/jgim.2018070104] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
This article describes how the tourism sector plays very important role in the social and economic growth of any country. Technologies like the internet and mobile technologies have changed the marketing strategy of the sector. It has been observed that business operators and the workforce employed in the tourism industry do not have sufficient knowledge, tools and/or strategy to implement technology correctly. Technology can be used in all the dimensions of tourism for gaining a competitive edge and providing a wide range of services to customers. For better customer satisfaction, the industry should know the major issues confronting tourism. Experiences shared by tourists on social media, i.e. Facebook, Twitter, Instagram and YouTube, can be used and analyzed to gain insight on customer needs. In this article, the authors propose a unified framework and have used tweets shared by tourists for the identification of major issues faced by tourism sectors. Identified issues are categorized into four main categories. The obtained results will help players of tourism sector for improving the services and growth of the sector.
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Affiliation(s)
- Sapna Sinha
- Amity Institute of Information and Technology, Noida, India
| | - Vishal Bhatnagar
- Ambedkar Institute of Advanced Communication Technologies and Research, Delhi, India
| | - Abhay Bansal
- Amity School of Engineering and Technology, Noida, India
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GPs' views of health policy changes: a qualitative 'netnography' study of UK general practice online magazine commentary. Br J Gen Pract 2018; 68:e441-e448. [PMID: 29686131 PMCID: PMC6001998 DOI: 10.3399/bjgp18x696161] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2017] [Accepted: 01/19/2018] [Indexed: 11/03/2022] Open
Abstract
Background Shifts in health policy since 2010 have brought major structural changes to the English NHS, with government stating intentions to increase GPs’ autonomy and improve access to care. Meanwhile, GPs’ levels of job satisfaction are low, while stress levels are high. PulseToday is a popular UK general practice online magazine that provides a key discussion forum on news relevant to general practice. Aim To analyse readers’ reactions to news stories about health policy changes published in an online general practice magazine. Design and setting A qualitative ’netnography’ was undertaken of readers’ comments to PulseToday. Method A sample of readers’ comments on articles published in PulseToday was collated and subjected to thematic analysis. Results Around 300 comments on articles published between January 2012 and March 2016 were included in the analysis, using ‘access to care’ as a tracer theme. Concern about the demand and strain on general practice was perhaps to be expected. However, analysis revealed various dimensions to this concern: GPs’ underlying feelings about their work and place in the NHS; constraints to GPs’ control of their own working practices; a perceived loss of respect for the role of GP; and disappointment with representative bodies and GP leadership. Conclusion This study shows a complex mix of resistance and resignation in general practice about the changing character of GPs’ roles. This ambivalence deserves further attention because it could potentially shape responses to further change in primary care in ways that are as yet unknown.
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Stockdale J, Cassell J, Ford E. "Giving something back": A systematic review and ethical enquiry of public opinions on the use of patient data for research in the United Kingdom and the Republic of Ireland. Wellcome Open Res 2018; 3:6. [PMID: 30854470 PMCID: PMC6402072 DOI: 10.12688/wellcomeopenres.13531.1] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2018] [Indexed: 11/20/2022] Open
Abstract
Background: Use of medical data for secondary purposes such as health research, audit, and service planning is well established in the UK. However, the governance environment, as well as public opinion and understanding about this work, have lagged behind. We aimed to systematically review the literature on UK and Irish public opinions of medical data use in research, critically analysing such opinions though an established biomedical ethics framework, to draw out potential strategies for future good practice guidance and inform ethical and privacy debates. Methods: We searched three databases using terms such as patient, public, opinion, and electronic health records. Empirical studies were eligible for inclusion if they surveyed healthcare users, patients or the wider public in UK and Ireland and examined attitudes, opinions or beliefs about the use of patient data for medical research. Results were synthesised into broad themes using a Framework Analysis. Results: Out of 13,492 papers and reports screened, 20 papers or reports were eligible. While there was a widespread willingness to share EHRs for research for the common good, this very rarely led to unqualified support. The public expressed two generalised concerns through a variety of hypothetical examples. The first of these concerns related to a party's competence in keeping data secure, while the second was associated with the motivation a party might have to use the data. Conclusions: The public evaluates trustworthiness of research organisations by assessing their competence in data-handling and motivation for accessing the data. Public attitudes around data-sharing exemplified several principles which are also widely accepted in biomedical ethics. This provides a framework for understanding public attitudes, which should be considered in the development in any guidance for regulators and data custodians. We propose four salient questions which data guardians should address when evaluating proposals for the secondary use of data.
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Affiliation(s)
- Jessica Stockdale
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, UK
- Department of Philosophy, School of History, Art History and Philosophy, University of Sussex, Brighton, UK
| | - Jackie Cassell
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, UK
| | - Elizabeth Ford
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, UK
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Sexton A, Shepherd E, Duke-Williams O, Eveleigh A. A balance of trust in the use of government administrative data. ARCHIVAL SCIENCE 2017. [DOI: 10.1007/s10502-017-9281-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Vezyridis P, Timmons S. Dissenting from care.data: an analysis of opt-out forms. JOURNAL OF MEDICAL ETHICS 2016; 42:792-796. [PMID: 27884968 DOI: 10.1136/medethics-2016-103654] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2016] [Revised: 07/26/2016] [Accepted: 09/14/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Care.data was a programme of work led by NHS England for the extraction of patient-identifiable and coded information from general practitioner (GP) records for secondary uses. This study analyses the forms (on the websites of GP practices) which enabled patients to opt out. METHODS Theoretical sampling and summative content analysis were used to collect and analyse dissent forms used by patients to opt out from care. DATA Domains included basic information about the programme, types of objections and personal details required for identification purposes. RESULTS One hundred opt-out forms were analysed. Fifty-four forms mentioned that this programme was run by NHS England. 81 forms provided two types of objections to data-sharing, and 15 provided only one objection. Only 26 forms mentioned that direct care would not be affected and 32 that patients maintain their right to opt back anytime. All but one of the opt-out forms we reviewed requested the name of the person wishing to opt out. 94 required a date of birth and 33 an NHS number. 82 required an address, 42 a telephone number and 7 an email address. CONCLUSIONS Numbers of patients (not) opting out should be treated with caution, because the variability of information provided and the varied options for dissent may have caused confusion among patients. To ensure that dissent is in accordance with individual preferences and moral values, we recommend that well-designed information material and standardised opt-out forms be developed for such data-sharing initiatives.
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Affiliation(s)
- Paraskevas Vezyridis
- Centre for Health Innovation, Leadership and Learning (CHILL), Business School, Nottingham University, Nottingham, UK
| | - Stephen Timmons
- Centre for Health Innovation, Leadership and Learning (CHILL), Business School, Nottingham University, Nottingham, UK
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Gille F, Smith S, Mays N. Towards a broader conceptualisation of ‘public trust’ in the health care system. SOCIAL THEORY & HEALTH 2016. [DOI: 10.1057/s41285-016-0017-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Palomino M, Taylor T, Göker A, Isaacs J, Warber S. The Online Dissemination of Nature-Health Concepts: Lessons from Sentiment Analysis of Social Media Relating to "Nature-Deficit Disorder". INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:E142. [PMID: 26797628 PMCID: PMC4730533 DOI: 10.3390/ijerph13010142] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Revised: 12/24/2015] [Accepted: 12/30/2015] [Indexed: 12/18/2022]
Abstract
Evidence continues to grow supporting the idea that restorative environments, green exercise, and nature-based activities positively impact human health. Nature-deficit disorder, a journalistic term proposed to describe the ill effects of people's alienation from nature, is not yet formally recognized as a medical diagnosis. However, over the past decade, the phrase has been enthusiastically taken up by some segments of the lay public. Social media, such as Twitter, with its opportunities to gather "big data" related to public opinions, offers a medium for exploring the discourse and dissemination around nature-deficit disorder and other nature-health concepts. In this paper, we report our experience of collecting more than 175,000 tweets, applying sentiment analysis to measure positive, neutral or negative feelings, and preliminarily mapping the impact on dissemination. Sentiment analysis is currently used to investigate the repercussions of events in social networks, scrutinize opinions about products and services, and understand various aspects of the communication in Web-based communities. Based on a comparison of nature-deficit-disorder "hashtags" and more generic nature hashtags, we make recommendations for the better dissemination of public health messages through changes to the framing of messages. We show the potential of Twitter to aid in better understanding the impact of the natural environment on human health and wellbeing.
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Affiliation(s)
- Marco Palomino
- School of Computing and Digital Media, Robert Gordon University, Aberdeen, Scotland AB10 7GE, UK.
| | - Tim Taylor
- European Centre for Environment and Human Health, University of Exeter Medical School, Truro, Cornwall TR1 3HD, UK.
| | - Ayse Göker
- School of Computing and Digital Media, Robert Gordon University, Aberdeen, Scotland AB10 7GE, UK.
| | - John Isaacs
- School of Computing and Digital Media, Robert Gordon University, Aberdeen, Scotland AB10 7GE, UK.
| | - Sara Warber
- European Centre for Environment and Human Health, University of Exeter Medical School, Truro, Cornwall TR1 3HD, UK.
- Department of Family Medicine, University of Michigan Medical School, Ann Arbor, MI 48104-1213, USA.
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