Core elements of participant consent documents for Canadian human genomics research and the National Human Genome Library: guidance for policy

Canadian College of Medical Geneticists: clinical practice advisory document - responsibility to recontact for reinterpretation of clinical genetic testing

BACKGROUND

Advances in technology and knowledge have facilitated both an increase in the number of patient variants reported and variants reclassified. While there is currently no duty to recontact for reclassified genetic variants, there may be a responsibility. The purpose of this clinical practice advisory document is to provide healthcare practitioners guidance for recontact of previously identified and classified variants, suggest methods for recontact, and principles to consider, taking account patient safety, feasibility, ethical considerations, health service capacity and resource constraints. The target audience are practitioners who order genetic testing, follow patients who have undergone genetic testing and those analysing and reporting genetic testing.

METHODS

A multidisciplinary group of laboratory and ordering clinicians, patient representatives, ethics and legal researchers and a genetic counsellor from the Canadian Association of Genetic Counsellors reviewed the existing literature and guidelines on responsibility to recontact in a clinical context to make recommendations. Comments were collected from the Canadian College of Medical Geneticists (CCMG) Education, Ethics, and Public Policy, Clinical Practice and Laboratory Practice committees, and the membership at large.

RESULTS

Following incorporation of feedback, and external review by the Canadian Association of Genetic Counsellors and patient groups, the document was approved by the CCMG Board of Directors. The CCMG is the Canadian organisation responsible for certifying laboratory and medical geneticists who provide medical genetics services, and for establishing professional and ethical standards for clinical genetics services in Canada.

CONCLUSION

The document describes the ethical and practical factors and suggests a shared responsibility between patients, ordering clinician and laboratory practitioners.

Population Neuroscience: Strategies to Promote Data Sharing While Protecting Privacy

Population neuroscience aims to advance our understanding of how genetic and environmental factors influence brain development and brain health over the life span, by integrating genomics, epidemiology, and neuroscience at population scale. This big data approach depends on data sharing strategies at both the micro- and macro-level, as well as attention to effective data management and protection of participant privacy. At the micro-level, researchers participate in international consortia that support collaboration, standards, and data sharing. They also seek to link together cohort studies, administrative health databases, and measures of the physical, built, and social environment in creative ways. Large-scale, longitudinal, and multi-modal cohorts are being designed to support explorations of genetic and environmental impacts on the brain. At a macro-level, funding agency policies now require data across health research domains to be managed according to the FAIR (findable, accessible, interoperable, and re-useable) Data principles and made available to the research community in a timely manner to support reproducibility and re-use. Data repositories provide technical infrastructure for storing, accessing, and increasingly also analyzing rich population-level data. Federated and cloud-based approaches are being leveraged to improve the security, remote accessibility, and performance of repositories. Finally, legal frameworks are being developed to facilitate secure health data access, integration, and analysis, providing new opportunities for the field.

Public attitudes towards genomic data sharing: results from a provincial online survey in Canada

BACKGROUND

While genomic data sharing can facilitate important health research and discovery benefits, these must be balanced against potential privacy risks and harms to individuals. Understanding public attitudes and perspectives on data sharing is important given these potential risks and to inform genomic research and policy that aligns with public preferences and needs.

METHODS

A cross sectional online survey measured attitudes towards genomic data sharing among members of the general public in an Eastern Canadian province.

RESULTS

Results showed a moderate comfort level with sharing genomic data, usually into restricted scientific databases with controlled access. Much lower comfort levels were observed for sharing data into open or publicly accessible databases. While respondents largely approved of sharing genomic data for health research permitted by a research ethics board, many general public members were concerned with who would have access to their data, with higher rates of approval for access from clinical or academic actors, but much more limited approval of access from commercial entities or governments. Prior knowledge about sequencing and about research ethics boards were both related to data sharing attitudes.

CONCLUSIONS

With evolving regulations and guidelines for genomics research and data sharing, it is important to consider the perspectives of participants most impacted by these changes. Participant information materials and informed consent documents must be explicit about the safeguards in place to protect genomic data and the policies governing the sharing of data. Increased public awareness of the role of research ethics boards and of the need for genomic data sharing more broadly is also needed.