Privacy-Preserving Methods for Feature Engineering Using Blockchain: Review, Evaluation, and Proof of Concept

Recent Developments in Privacy-Preserving Mining of Clinical Data

With the dramatic increases in both the capability to collect personal data and the capability to analyze large amounts of data, increasingly sophisticated and personal insights are being drawn. These insights are valuable for clinical applications but also open up possibilities for identification and abuse of personal information. In this paper, we survey recent research on classical methods of privacy-preserving data mining. Looking at dominant techniques and recent innovations to them, we examine the applicability of these methods to the privacy-preserving analysis of clinical data. We also discuss promising directions for future research in this area.

Applications of Blockchain in the Medical Field: Narrative Review

Background

As a distributed technology, blockchain has attracted increasing attention from stakeholders in the medical industry. Although previous studies have analyzed blockchain applications from the perspectives of technology, business, or patient care, few studies have focused on actual use-case scenarios of blockchain in health care. In particular, the outbreak of COVID-19 has led to some new ideas for the application of blockchain in medical practice.

Objective

This paper aims to provide a systematic review of the current and projected uses of blockchain technology in health care, as well as directions for future research. In addition to the framework structure of blockchain and application scenarios, its integration with other emerging technologies in health care is discussed.

Methods

We searched databases such as PubMed, EMBASE, Scopus, IEEE, and Springer using a combination of terms related to blockchain and health care. Potentially relevant papers were then compared to determine their relevance and reviewed independently for inclusion. Through a literature review, we summarize the key medical scenarios using blockchain technology.

Results

We found a total of 1647 relevant studies, 60 of which were unique studies that were included in this review. These studies report a variety of uses for blockchain and their emphasis differs. According to the different technical characteristics and application scenarios of blockchain, we summarize some medical scenarios closely related to blockchain from the perspective of technical classification. Moreover, potential challenges are mentioned, including the confidentiality of privacy, the efficiency of the system, security issues, and regulatory policy.

Conclusions

Blockchain technology can improve health care services in a decentralized, tamper-proof, transparent, and secure manner. With the development of this technology and its integration with other emerging technologies, blockchain has the potential to offer long-term benefits. Not only can it be a mechanism to secure electronic health records, but blockchain also provides a powerful tool that can empower users to control their own health data, enabling a foolproof health data history and establishing medical responsibility.

A Blockchain and Artificial Intelligence-Based, Patient-Centric Healthcare System for Combating the COVID-19 Pandemic: Opportunities and Applications

The world is facing multiple healthcare challenges because of the emergence of the COVID-19 (coronavirus) pandemic. The pandemic has exposed the limitations of handling public healthcare emergencies using existing digital healthcare technologies. Thus, the COVID-19 situation has forced research institutes and countries to rethink healthcare delivery solutions to ensure continuity of services while people stay at home and practice social distancing. Recently, several researchers have focused on disruptive technologies, such as blockchain and artificial intelligence (AI), to improve the digital healthcare workflow during COVID-19. Blockchain could combat pandemics by enabling decentralized healthcare data sharing, protecting users' privacy, providing data empowerment, and ensuring reliable data management during outbreak tracking. In addition, AI provides intelligent computer-aided solutions by analyzing a patient's medical images and symptoms caused by coronavirus for efficient treatments, future outbreak prediction, and drug manufacturing. Integrating both blockchain and AI could transform the existing healthcare ecosystem by democratizing and optimizing clinical workflows. In this article, we begin with an overview of digital healthcare services and problems that have arisen during the COVID-19 pandemic. Next, we conceptually propose a decentralized, patient-centric healthcare framework based on blockchain and AI to mitigate COVID-19 challenges. Then, we explore the significant applications of integrated blockchain and AI technologies to augment existing public healthcare strategies for tackling COVID-19. Finally, we highlight the challenges and implications for future research within a patient-centric paradigm.

An Overview of Existing Publications and Most Relevant Projects/Platforms on the Use of Blockchain in Medicine and Neurology

Background

Blockchain is a new methodology involving a data structure with list of records, called blocks, which are linked using cryptography. The aim of the review is to overview the existing publication, projects, and platforms on the use of blockchain in Medicine and Neurology.

Methods

We searched the bibliographic database of MEDLINE and BASE. We also accessed ICObench, Coinmarketcap, and Mobihealthnews databases to explore upcoming, ongoing, and ended projects.

Results

In medicine, there are many projects related to health care, disease prevention, and promotion of healthy life style. In neurology, only one project looks promising: Neuro, an ongoing scientific-technical project uniting scientists, engineers, and programmers for development of new architectures and algorithms of neural networks. Bibliographic searches found 117 publications on Medline and 203 publications on BASE referring to the use of blockchain technology in medicine. Most of them are presented as reviews (narrative, systematic, or minireview), opinions and hypotheses, commentaries, or perspectives. As for Neurology, only one publication refers to the use of blockchain, specifically to Parkinson’s disease.

Discussion

Among the problems related to medicine, there is the lack of information on the patient’s clinical history that could allow accurate diagnosis and treatment. The possibility of having a register based on blockchain technology could help doctors in many ways, including patient management, choosing and monitoring treatments, and standardization of clinical trials.

Conclusion

The use of the blockchain technology in medicine has been repetitively proposed to solve different problems. In this article, we highlight the possible benefits of this technology, with attention to Neurology. Blockchain use can lead to quantifiable benefits in the treatment of neurodegenerative diseases, especially in clinical trials that can fail because of an incorrect patient recruitment.

Applying Blockchain Technology to Address the Crisis of Trust During the COVID-19 Pandemic

BACKGROUND

The widespread death and disruption caused by the COVID-19 pandemic has revealed deficiencies of existing institutions regarding the protection of human health and well-being. Both a lack of accurate and timely data and pervasive misinformation are causing increasing harm and growing tension between data privacy and public health concerns.

OBJECTIVE

This aim of this paper is to describe how blockchain, with its distributed trust networks and cryptography-based security, can provide solutions to data-related trust problems.

METHODS

Blockchain is being applied in innovative ways that are relevant to the current COVID-19 crisis. We describe examples of the challenges faced by existing technologies to track medical supplies and infected patients and how blockchain technology applications may help in these situations.

RESULTS

This exploration of existing and potential applications of blockchain technology for medical care shows how the distributed governance structure and privacy-preserving features of blockchain can be used to create "trustless" systems that can help resolve the tension between maintaining privacy and addressing public health needs in the fight against COVID-19.

CONCLUSIONS

Blockchain relies on a distributed, robust, secure, privacy-preserving, and immutable record framework that can positively transform the nature of trust, value sharing, and transactions. A nationally coordinated effort to explore blockchain to address the deficiencies of existing systems and a partnership of academia, researchers, business, and industry are suggested to expedite the adoption of blockchain in health care.

Blockchain in Health Care: Hope or Hype?

There has been an increasing interest in blockchain technology from the health care sector in the last couple of years. The value proposition for using blockchain technology in the health care sector is to share sensitive patient data among health care entities securely and to empower patients. Blockchain technology allows patients to have an active role in developing and updating their own patient data. However, is blockchain technology really the silver bullet it seems to be? With this paper, we aim to understand the benefits and challenges of blockchain technology in the health care sector. We discuss innovation and security implications concerning blockchain technology in health care. Furthermore, we show that there is a need for more use cases to ensure the secure sharing of data within the health care sector. In our opinion, blockchain technology will not solve the issues encountered by the health care sector; in fact, it may raise more issues than it will solve.

Blockchain-Authenticated Sharing of Genomic and Clinical Outcomes Data of Patients With Cancer: A Prospective Cohort Study

Background

Efficiently sharing health data produced during standard care could dramatically accelerate progress in cancer treatments, but various barriers make this difficult. Not sharing these data to ensure patient privacy is at the cost of little to no learning from real-world data produced during cancer care. Furthermore, recent research has demonstrated a willingness of patients with cancer to share their treatment experiences to fuel research, despite potential risks to privacy.

Objective

The objective of this study was to design, pilot, and release a decentralized, scalable, efficient, economical, and secure strategy for the dissemination of deidentified clinical and genomic data with a focus on late-stage cancer.

Methods

We created and piloted a blockchain-authenticated system to enable secure sharing of deidentified patient data derived from standard of care imaging, genomic testing, and electronic health records (EHRs), called the Cancer Gene Trust (CGT). We prospectively consented and collected data for a pilot cohort (N=18), which we uploaded to the CGT. EHR data were extracted from both a hospital cancer registry and a common data model (CDM) format to identify optimal data extraction and dissemination practices. Specifically, we scored and compared the level of completeness between two EHR data extraction formats against the gold standard source documentation for patients with available data (n=17).

Results

Although the total completeness scores were greater for the registry reports than those for the CDM, this difference was not statistically significant. We did find that some specific data fields, such as histology site, were better captured using the registry reports, which can be used to improve the continually adapting CDM. In terms of the overall pilot study, we found that CGT enables rapid integration of real-world data of patients with cancer in a more clinically useful time frame. We also developed an open-source Web application to allow users to seamlessly search, browse, explore, and download CGT data.

Conclusions

Our pilot demonstrates the willingness of patients with cancer to participate in data sharing and how blockchain-enabled structures can maintain relationships between individual data elements while preserving patient privacy, empowering findings by third-party researchers and clinicians. We demonstrate the feasibility of CGT as a framework to share health data trapped in silos to further cancer research. Further studies to optimize data representation, stream, and integrity are required.

Building a Secure Biomedical Data Sharing Decentralized App (DApp): Tutorial

Decentralized apps (DApps) are computer programs that run on a distributed computing system, such as a blockchain network. Unlike the client-server architecture that powers most internet apps, DApps that are integrated with a blockchain network can execute app logic that is guaranteed to be transparent, verifiable, and immutable. This new paradigm has a number of unique properties that are attractive to the biomedical and health care communities. However, instructional resources are scarcely available for biomedical software developers to begin building DApps on a blockchain. Such apps require new ways of thinking about how to build, maintain, and deploy software. This tutorial serves as a complete working prototype of a DApp, motivated by a real use case in biomedical research requiring data privacy. We describe the architecture of a DApp, the implementation details of a smart contract, a sample iPhone operating system (iOS) DApp that interacts with the smart contract, and the development tools and libraries necessary to get started. The code necessary to recreate the app is publicly available.