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Niño de Rivera S, Masterson Creber R, Zhao Y, Eslami S, Mangal S, Dugdale LS, Reading Turchioe M. Public perspectives on increased data sharing in health research in the context of the 2023 National Institutes of Health Data Sharing Policy. PLoS One 2024; 19:e0309161. [PMID: 39197051 PMCID: PMC11357082 DOI: 10.1371/journal.pone.0309161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 08/07/2024] [Indexed: 08/30/2024] Open
Abstract
The National Institutes of Health (NIH) is the largest public research funder in the world. In an effort to make publicly funded data more accessible, the NIH established a new Data Management and Sharing (DMS) Policy effective January 2023. Though the new policy was available for public comment, the patient perspective and the potential unintended consequences of the policy on patients' willingness to participate in research have been underexplored. This study aimed to determine: (1) participant preferences about the types of data they are willing to share with external entities, and (2) participant perspectives regarding the updated 2023 NIH DMS policy. A cross-sectional, nationally representative online survey was conducted among 610 English-speaking US adults in March 2023 using Prolific. Overall, 50% of the sample identified as women, 13% as Black or African American, and 7% as Hispanic or Latino, with a mean age of 46 years. The majority of respondents (65%) agreed with the NIH policy, but racial differences were noted with a higher percentage (28%) of Black participants indicating a decrease in willingness to participate in research studies with the updated policy in place. Participants were more willing to share research data with healthcare providers, yet their preferences for data sharing varied depending on the type of data to be shared and the recipients. Participants were less willing to share sexual health and fertility data with health technology companies (41%) and public repositories (37%) compared to their healthcare providers (75%). The findings highlight the importance of adopting a transparent approach to data sharing that balances protecting patient autonomy with more open data sharing.
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Affiliation(s)
- Stephanie Niño de Rivera
- Columbia University School of Nursing, Columbia University Irving Medical Center, New York, New York, United States of America
| | - Ruth Masterson Creber
- Columbia University School of Nursing, Columbia University Irving Medical Center, New York, New York, United States of America
| | - Yihong Zhao
- Columbia University School of Nursing, Columbia University Irving Medical Center, New York, New York, United States of America
| | - Sarah Eslami
- Columbia University School of Nursing, Columbia University Irving Medical Center, New York, New York, United States of America
| | - Sabrina Mangal
- Biobehavioral Nursing & Health Informatics, University of Washington School of Nursing, Seattle, Washington, United States of America
| | - Lydia S. Dugdale
- Center for Clinical Medical Ethics, Columbia University Vagelos College of Physicians & Surgeons, New York, New York, United States of America
| | - Meghan Reading Turchioe
- Columbia University School of Nursing, Columbia University Irving Medical Center, New York, New York, United States of America
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2
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Natri HM, Chapman CR, Heraty S, Dwyer P, Walker N, Kapp SK, Dron HA, Martinez-Agosto JA, Mikkola L, Doherty M. Ethical challenges in autism genomics: Recommendations for researchers. Eur J Med Genet 2023; 66:104810. [PMID: 37478903 DOI: 10.1016/j.ejmg.2023.104810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 07/07/2023] [Accepted: 07/19/2023] [Indexed: 07/23/2023]
Abstract
Equitable and just genetic research and clinical translation require an examination of the ethical questions pertaining to vulnerable and marginalized communities. Autism research and advocate communities have expressed concerns over current practices of genetics research, urging the field to shift towards paradigms and practices that ensure benefits and avoid harm to research participants and the wider autistic community. Building upon a framework of bioethical principles, we provide the background for the concerns and present recommendations for ethically sustainable and justice-oriented genetic and genomic autism research. With the primary goal of enhancing the health, well-being, and autonomy of autistic persons, we make recommendations to guide priority setting, responsible research conduct, and informed consent practices. Further, we discuss the ethical challenges particularly pertaining to research involving highly vulnerable individuals and groups, such as those with impaired cognitive or communication ability. Finally, we consider the clinical translation of autism genetics studies, including the use of genetic testing. These guidelines, developed by an interdisciplinary working group comprising autistic and non-autistic individuals, will aid in leveraging the potential of genetics research to enhance the quality of life of autistic individuals and are widely applicable across stigmatized traits and vulnerable communities.
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Affiliation(s)
- Heini M Natri
- Translational Genomics Research Institute (TGen), Phoenix, AZ, 85004, USA.
| | - Carolyn R Chapman
- Department of Population Health (Division of Medical Ethics), NYU Grossman School of Medicine, New York, NY, 10016, USA; Center for Human Genetics and Genomics, NYU Grossman School of Medicine, New York, NY, 10016, USA
| | - Síofra Heraty
- Centre for Brain and Cognitive Development, Department of Psychological Sciences, University of London, Birkbeck, London, WC1E 7HX, UK
| | - Patrick Dwyer
- Center for Mind and Brain, UC Davis, Davis, CA, 95618, USA; Department of Psychology, UC Davis, Davis, CA, 95618, USA; MIND Institute, UC Davis Health, Sacramento, CA, 95817, USA
| | - Nick Walker
- California Institute of Integral Studies, San Francisco, CA, 94103, USA
| | - Steven K Kapp
- Department of Psychology, University of Portsmouth, Portsmouth, Hampshire, PO1 2UP, UK
| | - Heather A Dron
- Sterilization and Social Justice Lab, UCLA Institute for Genetics and Society, Los Angeles, CA, 90095, USA
| | | | - Lea Mikkola
- Turku Bioscience Center, InFLAMES Research Flagship Center, University of Turku, Turku, 20520, Finland
| | - Mary Doherty
- Department of Neuroscience, Brighton and Sussex Medical School, Brighton, BN1 9PX, UK
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de Man Y, Wieland-Jorna Y, Torensma B, de Wit K, Francke AL, Oosterveld-Vlug MG, Verheij RA. Opt-In and Opt-Out Consent Procedures for the Reuse of Routinely Recorded Health Data in Scientific Research and Their Consequences for Consent Rate and Consent Bias: Systematic Review. J Med Internet Res 2023; 25:e42131. [PMID: 36853745 PMCID: PMC10015347 DOI: 10.2196/42131] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 11/29/2022] [Accepted: 12/19/2022] [Indexed: 03/01/2023] Open
Abstract
BACKGROUND Scientific researchers who wish to reuse health data pertaining to individuals can obtain consent through an opt-in procedure or opt-out procedure. The choice of procedure may have consequences for the consent rate and representativeness of the study sample and the quality of the research, but these consequences are not well known. OBJECTIVE This review aimed to provide insight into the consequences for the consent rate and consent bias of the study sample of opt-in procedures versus opt-out procedures for the reuse of routinely recorded health data for scientific research purposes. METHODS A systematic review was performed based on searches in PubMed, Embase, CINAHL, PsycINFO, Web of Science Core Collection, and the Cochrane Library. Two reviewers independently included studies based on predefined eligibility criteria and assessed whether the statistical methods used in the reviewed literature were appropriate for describing the differences between consenters and nonconsenters. Statistical pooling was conducted, and a description of the results was provided. RESULTS A total of 15 studies were included in this meta-analysis. Of the 15 studies, 13 (87%) implemented an opt-in procedure, 1 (7%) implemented an opt-out procedure, and 1 (7%) implemented both the procedures. The average weighted consent rate was 84% (60,800/72,418 among the studies that used an opt-in procedure and 96.8% (2384/2463) in the single study that used an opt-out procedure. In the single study that described both procedures, the consent rate was 21% in the opt-in group and 95.6% in the opt-out group. Opt-in procedures resulted in more consent bias compared with opt-out procedures. In studies with an opt-in procedure, consenting individuals were more likely to be males, had a higher level of education, higher income, and higher socioeconomic status. CONCLUSIONS Consent rates are generally lower when using an opt-in procedure compared with using an opt-out procedure. Furthermore, in studies with an opt-in procedure, participants are less representative of the study population. However, both the study populations and the way in which opt-in or opt-out procedures were organized varied widely between the studies, which makes it difficult to draw general conclusions regarding the desired balance between patient control over data and learning from health data. The reuse of routinely recorded health data for scientific research purposes may be hampered by administrative burdens and the risk of bias.
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Affiliation(s)
- Yvonne de Man
- Nivel, Netherlands Institute for Health Services Research, Utrecht, the Netherlands
| | - Yvonne Wieland-Jorna
- Nivel, Netherlands Institute for Health Services Research, Utrecht, the Netherlands
| | - Bart Torensma
- Leiden University Medical Centre, Leiden, the Netherlands
| | - Koos de Wit
- Department of Gastroenterology and Hepatology, Amsterdam UMC, University of Amsterdam, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam, the Netherlands
| | - Anneke L Francke
- Nivel, Netherlands Institute for Health Services Research, Utrecht, the Netherlands.,Department of Public and Occupational Health, Location Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | | | - Robert A Verheij
- Nivel, Netherlands Institute for Health Services Research, Utrecht, the Netherlands.,Tranzo, School of Social Sciences and Behavioural Research, Tilburg University, Tilburg, the Netherlands
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Wang Z, Stell A, Sinnott RO. A GDPR-Compliant Dynamic Consent Mobile Application for the Australasian Type-1 Diabetes Data Network. Healthcare (Basel) 2023; 11:healthcare11040496. [PMID: 36833030 PMCID: PMC9957235 DOI: 10.3390/healthcare11040496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 01/25/2023] [Accepted: 02/06/2023] [Indexed: 02/11/2023] Open
Abstract
Australia has a high prevalence of diabetes, with approximately 1.2 million Australians diagnosed with the disease. In 2012, the Australasian Diabetes Data Network (ADDN) was established with funding from the Juvenile Diabetes Research Foundation (JDRF). ADDN is a national diabetes registry which captures longitudinal information about patients with type-1 diabetes (T1D). Currently, the ADDN data are directly contributed from 42 paediatric and 17 adult diabetes centres across Australia and New Zealand, i.e., where the data are pre-existing in hospital systems and not manually entered into ADDN. The historical data in ADDN have been de-identified, and patients are initially afforded the opportunity to opt-out of being involved in the registry; however, moving forward, there is an increased demand from the clinical research community to utilise fully identifying data. This raises additional demands on the registry in terms of security, privacy, and the nature of patient consent. General Data Protection Regulation (GDPR) is an increasingly important mechanism allowing individuals to have the right to know about their health data and what those data are being used for. This paper presents a mobile application being designed to support the ADDN data collection and usage processes and aligning them with GDPR. The app utilises Dynamic Consent-an informed specific consent model, which allows participants to view and modify their research-driven consent decisions through an interactive interface. It focuses specifically on supporting dynamic opt-in consent to both the registry and to associated sub-projects requesting access to and use of the patient data for research purposes.
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Kasprzak J, Frey S, Oetlinger H, Benedikt Westphalen C, Erickson N, Heinemann V, Nasseh D. Swapping data: A pragmatic approach for enabling academic-industrial partnerships. Digit Health 2023; 9:20552076231172120. [PMID: 37188076 PMCID: PMC10176540 DOI: 10.1177/20552076231172120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 04/10/2023] [Indexed: 05/17/2023] Open
Abstract
Objectives Academic institutions have access to comprehensive sets of real-world data. However, their potential for secondary use-for example, in medical outcomes research or health care quality management-is often limited due to data privacy concerns. External partners could help achieve this potential, yet documented frameworks for such cooperation are lacking. Therefore, this work presents a pragmatic approach for enabling academic-industrial data partnerships in a health care environment. Methods We employ a value-swapping strategy to facilitate data sharing. Using tumor documentation and molecular pathology data, we define a data-altering process as well as rules for an organizational pipeline that includes the technical anonymization process. Results The resulting dataset was fully anonymized while still retaining the critical properties of the original data to allow for external development and the training of analytical algorithms. Conclusion Value swapping is a pragmatic, yet powerful method to balance data privacy and requirements for algorithm development; therefore, it is well suited to enable academic-industrial data partnerships.
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Affiliation(s)
- Julia Kasprzak
- Comprehensive Cancer Center Munich, University Hospital, LMU Munich, Munich, Germany
| | - Simon Frey
- Roche Pharma AG, Grenzach-Wyhlen, Germany
| | | | | | - Nicole Erickson
- Comprehensive Cancer Center Munich, University Hospital, LMU Munich, Munich, Germany
| | - Volker Heinemann
- Comprehensive Cancer Center Munich, University Hospital, LMU Munich, Munich, Germany
- German Cancer Consortium (DKTK, partner
site Munich), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Daniel Nasseh
- Comprehensive Cancer Center Munich, University Hospital, LMU Munich, Munich, Germany
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Yin D, Li X, Liu R, Zhang L, Zhan QM. China's Personal Information Protection Law. BMJ 2022; 379:e072619. [PMID: 36252979 DOI: 10.1136/bmj-2022-072619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Daoxin Yin
- National Institute of Health Data Science at Peking University, Beijing, China
- Advanced Institute of Information Technology, Peking University, Hangzhou, China
| | - Xiaojie Li
- Department of Medical Ethics and Law, Peking University Health Science Center, Beijing, China
- Department of Situation and Policy, University of International Business and Economics, Beijing, China
| | - Ruishuang Liu
- Department of Medical Ethics and Law, Peking University Health Science Center, Beijing, China
| | - Luxia Zhang
- National Institute of Health Data Science at Peking University, Beijing, China
- Advanced Institute of Information Technology, Peking University, Hangzhou, China
- Institute for Artificial Intelligence, Peking University, Beijing, China
| | - Qi-Min Zhan
- National Institute of Health Data Science at Peking University, Beijing, China
- Advanced Institute of Information Technology, Peking University, Hangzhou, China
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Kremeike K, Bausewein C, Freytag A, Junghanss C, Marx G, Schnakenberg R, Schneider N, Schulz H, Wedding U, Voltz R. [DNVF Memorandum: Health Services Research in the Last Year of Life]. DAS GESUNDHEITSWESEN 2022. [PMID: 36220106 DOI: 10.1055/a-1889-4705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
This memorandum outlines current issues concerning health services research on seriously ill and dying people in the last year of their lives as well as support available for their relatives. Patients in the last phase of life can belong to different disease groups, they may have special characteristics (e. g., people with cognitive and complex impairments, economic disadvantage or migration background) and be in certain phases of life (e. g., parents of minor children, (old) age). The need for a designated memorandum on health services research in the last year of life results from the special situation of those affected and from the special features of health services in this phase of life. With reference to these special features, this memorandum describes methodological and ethical specifics as well as current issues in health services research and how these can be adequately addressed using quantitative, qualitative and mixed methods. It has been developed by the palliative medicine section of the German Network for Health Services Research (DNVF) according to the guidelines for DNVF memoranda.
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Affiliation(s)
- Kerstin Kremeike
- Zentrum für Palliativmedizin, Universitätsklinikum Köln, Köln, Deutschland
| | - Claudia Bausewein
- Klinik und Poliklinik für Palliativmedizin, LMU Klinikum München, München, Deutschland
| | - Antje Freytag
- Institut für Allgemeinmedizin, Universitätsklinikum Jena, Jena, Deutschland
| | - Christian Junghanss
- Hämatologie, Onkologie und Palliativmedizin, Zentrum für Innere Medizin, Universitätsmedizin Rostock, Rostock, Deutschland
| | - Gabriella Marx
- Institut und Poliklinik Allgemeinmedizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
| | | | - Nils Schneider
- Institut für Allgemeinmedizin und Palliativmedizin, Medizinische Hochschule Hannover, Hannover, Deutschland
| | - Holger Schulz
- Institut und Poliklinik für Medizinische Psychologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
| | - Ulrich Wedding
- Abteilung Palliativmedizin, Universitätsklinikum Jena, Jena, Deutschland
| | - Raymond Voltz
- Zentrum für Palliativmedizin, Universitätsklinikum Köln, Köln, Deutschland
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8
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Silva P, Dahlke DV, Smith ML, Charles W, Gomez J, Ory MG, Ramos KS. An Idealized Clinicogenomic Registry to Engage Underrepresented Populations Using Innovative Technology. J Pers Med 2022; 12:713. [PMID: 35629136 PMCID: PMC9144063 DOI: 10.3390/jpm12050713] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 04/18/2022] [Accepted: 04/26/2022] [Indexed: 11/26/2022] Open
Abstract
Current best practices in tumor registries provide a glimpse into a limited time frame over the natural history of disease, usually a narrow window around diagnosis and biopsy. This creates challenges meeting public health and healthcare reimbursement policies that increasingly require robust documentation of long-term clinical trajectories, quality of life, and health economics outcomes. These challenges are amplified for underrepresented minority (URM) and other disadvantaged populations, who tend to view the institution of clinical research with skepticism. Participation gaps leave such populations underrepresented in clinical research and, importantly, in policy decisions about treatment choices and reimbursement, thus further augmenting health, social, and economic disparities. Cloud computing, mobile computing, digital ledgers, tokenization, and artificial intelligence technologies are powerful tools that promise to enhance longitudinal patient engagement across the natural history of disease. These tools also promise to enhance engagement by giving participants agency over their data and addressing a major impediment to research participation. This will only occur if these tools are available for use with all patients. Distributed ledger technologies (specifically blockchain) converge these tools and offer a significant element of trust that can be used to engage URM populations more substantively in clinical research. This is a crucial step toward linking composite cohorts for training and optimization of the artificial intelligence tools for enhancing public health in the future. The parameters of an idealized clinical genomic registry are presented.
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Affiliation(s)
- Patrick Silva
- Health Science Center, Texas A&M University, 8441 Riverside Pkwy, Bryan, TX 77807, USA; (J.G.); (K.S.R.)
| | - Deborah Vollmer Dahlke
- School of Public Health, Texas A&M Health Science Center, 212 Adriance Lab Rd., College Station, TX 77843, USA; (D.V.D.); (M.L.S.); (M.G.O.)
| | - Matthew Lee Smith
- School of Public Health, Texas A&M Health Science Center, 212 Adriance Lab Rd., College Station, TX 77843, USA; (D.V.D.); (M.L.S.); (M.G.O.)
| | - Wendy Charles
- BurstIQ, 9635 Maroon Circle, #310, Englewood, CO 80112, USA;
| | - Jorge Gomez
- Health Science Center, Texas A&M University, 8441 Riverside Pkwy, Bryan, TX 77807, USA; (J.G.); (K.S.R.)
| | - Marcia G. Ory
- School of Public Health, Texas A&M Health Science Center, 212 Adriance Lab Rd., College Station, TX 77843, USA; (D.V.D.); (M.L.S.); (M.G.O.)
| | - Kenneth S. Ramos
- Health Science Center, Texas A&M University, 8441 Riverside Pkwy, Bryan, TX 77807, USA; (J.G.); (K.S.R.)
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Gefenas E, Lekstutiene J, Lukaseviciene V, Hartlev M, Mourby M, Cathaoir KÓ. Controversies between regulations of research ethics and protection of personal data: informed consent at a cross-road. MEDICINE, HEALTH CARE, AND PHILOSOPHY 2022; 25:23-30. [PMID: 34787769 PMCID: PMC8595272 DOI: 10.1007/s11019-021-10060-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/09/2021] [Indexed: 06/13/2023]
Abstract
This paper explores some key discrepancies between two sets of normative requirements applicable to the research use of personal data and human biological materials: (a) the data protection regime which follows the application of the European Union General Data Protection Regulation (GDPR), and (b) the Declaration of Helsinki, CIOMS guidelines and other research ethics regulations. One source of this controversy is that the GDPR requires consent to process personal data to be clear, concise, specific and granular, freely given and revocable and therefore has challenged the concept of 'broad consent', which has been widely applied in the context of biobanking. Another source of controversy is the interplay between regulations of research ethics and protection of personal data related to the secondary use of personal data and biological materials. In this case, the GDPR 'research condition' provides an alternative to re-consent for the use of previously collected personal data and biological materials. Although the mentioned controversies have been raised in the legal literature, they have not been explicitly addressed from the research ethics perspective. Should consent be regarded as a priority legal basis for personal data processing in health data research? Can broad consent still be a suitable legal ground for biobanking? What should be the role of research ethics provisions that differ from the GDPR standards, and what should be the role and function of research ethics committees in the changing environment of health data research? These are the ongoing controversies to be explored in the paper.
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Affiliation(s)
- Eugenijus Gefenas
- Centre for Health Ethics, Law and History, Faculty of Medicine, Vilnius University, M. K. Ciurlionis str. 21/27, 03101, Vilnius, LT, Lithuania.
| | - J Lekstutiene
- Department of Public Health, Faculty of Medicine, Vilnius University, Vilnius, LT, Lithuania
| | - V Lukaseviciene
- Centre for Health Ethics, Law and History, Faculty of Medicine, Vilnius University, M. K. Ciurlionis str. 21/27, 03101, Vilnius, LT, Lithuania
| | - M Hartlev
- Faculty of Law, University of Copenhagen, Copenhagen, Denmark
| | - M Mourby
- Centre for Health, Law and Emerging Technologies (HeLEX), University of Oxford, Oxford, UK
| | - K Ó Cathaoir
- Faculty of Law, University of Copenhagen, Copenhagen, Denmark
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Antoniades A, Papaioannou M, Malatras A, Papagregoriou G, Müller H, Holub P, Deltas C, Schizas CN. Integration of Biobanks in National eHealth Ecosystems Facilitating Long-Term Longitudinal Clinical-Omics Studies and Citizens' Engagement in Research Through eHealthBioR. Front Digit Health 2021; 3:628646. [PMID: 34713101 PMCID: PMC8521893 DOI: 10.3389/fdgth.2021.628646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 05/11/2021] [Indexed: 11/13/2022] Open
Abstract
Biobanks have long existed to support research activities with BBMRI-ERIC formed as a European research infrastructure supporting the coordination for biobanking with 20 country members and one international organization. Although the benefits of biobanks to the research community are well-established, the direct benefit to citizens is limited to the generic benefit of promoting future research. Furthermore, the advent of General Data Protection Regulation (GDPR) legislation raised a series of challenges for scientific research especially related to biobanking associate activities and longitudinal research studies. Electronic health record (EHR) registries have long existed in healthcare providers. In some countries, even at the national level, these record the state of the health of citizens through time for the purposes of healthcare and data portability between different providers. The potential of EHRs in research is great and has been demonstrated in many projects that have transformed EHR data into retrospective medical history information on participating subjects directly from their physician's collected records; many key challenges, however, remain. In this paper, we present a citizen-centric framework called eHealthBioR, which would enable biobanks to link to EHR systems, thus enabling not just retrospective but also lifelong prospective longitudinal studies of participating citizens. It will also ensure strict adherence to legal and ethical requirements, enabling greater control that encourages participation. Citizens would benefit from the real and direct control of their data and samples, utilizing technology, to empower them to make informed decisions about providing consent and practicing their rights related to the use of their data, as well as by having access to knowledge and data generated from samples they provided to biobanks. This is expected to motivate patient engagement in future research and even leads to participatory design methodologies with citizen/patient-centric designed studies. The development of platforms based on the eHealthBioR framework would need to overcome significant challenges. However, it would shift the burden of addressing these to experts in the field while providing solutions enabling in the long term the lower monetary and time cost of longitudinal studies coupled with the option of lifelong monitoring through EHRs.
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Affiliation(s)
- Athos Antoniades
- eHealth Lab, Department of Computer Science, University of Cyprus, Nicosia, Cyprus
| | - Maria Papaioannou
- eHealth Lab, Department of Computer Science, University of Cyprus, Nicosia, Cyprus
| | - Apostolos Malatras
- biobank.cy Center of Excellence in Biobanking and Biomedical Research, University of Cyprus, Nicosia, Cyprus
| | - Gregory Papagregoriou
- biobank.cy Center of Excellence in Biobanking and Biomedical Research, University of Cyprus, Nicosia, Cyprus
| | - Heimo Müller
- Institute of Pathology, Medical University of Graz, Graz, Austria.,Biobanking and Biomolecular Resources Research Infrastructure - European Research Infrastructure Consortium, Biobanks and Biomolecular Resources Research Infrastructure Consortium, Graz, Austria
| | - Petr Holub
- Biobanking and Biomolecular Resources Research Infrastructure - European Research Infrastructure Consortium, Biobanks and Biomolecular Resources Research Infrastructure Consortium, Graz, Austria
| | - Constantinos Deltas
- biobank.cy Center of Excellence in Biobanking and Biomedical Research, University of Cyprus, Nicosia, Cyprus
| | - Christos N Schizas
- eHealth Lab, Department of Computer Science, University of Cyprus, Nicosia, Cyprus
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11
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Toh HJ, Ballantyne A, Ong SAK, Sankaran C, Tay HY, Singh M, Zaidi R, Chia R, Singh S, Samachittananda S, Shi YG, Tan Z, Lysaght T. Religious Perspectives on Precision Medicine in Singapore. Asian Bioeth Rev 2021; 13:473-483. [PMID: 34611464 PMCID: PMC8486897 DOI: 10.1007/s41649-021-00180-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 07/06/2021] [Accepted: 07/07/2021] [Indexed: 11/30/2022] Open
Abstract
Precision medicine (PM) aims to revolutionise healthcare, but little is known about the role religion and spirituality might play in the ethical discourse about PM. This Perspective reports the outcomes of a knowledge exchange fora with religious authorities in Singapore about data sharing for PM. While the exchange did not identify any foundational religious objections to PM, ethical concerns were raised about the possibility for private industry to profiteer from social resources and the potential for genetic discrimination by private health insurers. According to religious authorities in Singapore, sharing PM data with private industry will require a clear public benefit and robust data governance that incorporates principles of transparency, accountability and oversight.
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Affiliation(s)
- Hui Jin Toh
- Centre for Biomedical Ethics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Angela Ballantyne
- Centre for Biomedical Ethics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Department of Primary Health Care and General Practice, University of Otago, Wellington, New Zealand
| | - Serene Ai Kiang Ong
- Centre for Biomedical Ethics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | | | | | - Raza Zaidi
- Jaafari Muslim Association Singapore, Singapore
| | - Roland Chia
- National Council of Churches of Singapore, Singapore
| | | | | | | | | | - Tamra Lysaght
- Centre for Biomedical Ethics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Vodosin P, Jorgensen AK, Mendy M, Kozlakidis Z, Caboux E, Zawati MH. A Review of Regulatory Frameworks Governing Biobanking in the Low and Middle Income Member Countries of BCNet. Biopreserv Biobank 2021; 19:444-452. [PMID: 33945303 DOI: 10.1089/bio.2020.0101] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Biomedical research based on the sharing and use of ever larger volumes of samples and data is increasingly becoming an essential component of scientific discovery. The success of biobanking and genomic research is dependent on the broad sharing of resources for use by investigators. However, important ethical challenges need to be addressed for the sample and data sharing to be successful. Despite low- and middle-income countries (LMICs) carrying a higher burden of disease, biomedical research conducted to date has mainly focused on high-income countries. In order for LMICs to benefit from the advances in such research, normative documents (such as laws and guidelines) play a significant role in allowing LMIC projects to partake and be represented in global biomedical research. The administration and management of the ethical aspects of biobanking, including informed consent, are key components in ensuring that samples and data can legally and ethically be used and shared. As part of its support to the LMIC biobanks, the International Agency for Research on Cancer (IARC) established a biobank and population cohort building network (BCNet) in 2013 with the aims of providing support (including education and training) and facilitating the development and improvement of biobanking infrastructure in LMICs. A comparative analysis of the laws and guidelines in BCNet countries was completed to highlight some of the ethical and legal issues related to biobanking in LMICs and to identify examples of effective systems of governance already in operation.
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Affiliation(s)
| | | | - Maimuna Mendy
- MRC Unit The Gambia at LSHTM, London School of Health and Tropical Medicine, London, United Kingdom
| | - Zisis Kozlakidis
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Elodie Caboux
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Ma'n H Zawati
- Center of Genomics and Policy, McGill University, Montreal, Canada
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Naeim A, Dry S, Elashoff D, Xie Z, Petruse A, Magyar C, Johansen L, Werre G, Lajonchere C, Wenger N. Electronic Video Consent to Power Precision Health Research: A Pilot Cohort Study. JMIR Form Res 2021; 5:e29123. [PMID: 34313247 PMCID: PMC8459215 DOI: 10.2196/29123] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 04/26/2021] [Accepted: 05/31/2021] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Developing innovative, efficient, and institutionally scalable biospecimen consent for remnant tissue that meets the National Institutes of Health consent guidelines for genomic and molecular analysis is essential for precision medicine efforts in cancer. OBJECTIVE This study aims to pilot-test an electronic video consent that individuals could complete largely on their own. METHODS The University of California, Los Angeles developed a video consenting approach designed to be comprehensive yet fast (around 5 minutes) for providing universal consent for remnant biospecimen collection for research. The approach was piloted in 175 patients who were coming in for routine services in laboratory medicine, radiology, oncology, and hospital admissions. The pilot yielded 164 completed postconsent surveys. The pilot assessed the usefulness, ease, and trustworthiness of the video consent. In addition, we explored drivers for opting in or opting out. RESULTS The pilot demonstrated that the electronic video consent was well received by patients, with high scores for usefulness, ease, and trustworthiness even among patients that opted out of participation. The revised more animated video pilot test in phase 2 was better received in terms of ease of use (P=.005) and the ability to understand the information (P<.001). There were significant differences between those who opted in and opted out in their beliefs concerning the usefulness of tissue, trusting researchers, the importance of contributing to science, and privacy risk (P<.001). The results showed that "I trust researchers to use leftover biological specimens to promote the public's health" and "Sharing a biological sample for research is safe because of the privacy protections in place" discriminated opt-in statuses were the strongest predictors (both areas under the curve were 0.88). Privacy concerns seemed universal in individuals who opted out. CONCLUSIONS Efforts to better educate the community may be needed to help overcome some of the barriers in engaging individuals to participate in precision health initiatives.
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Affiliation(s)
- Arash Naeim
- UCLA Center for SMART Health, Clinical and Translational Science Institute, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States
| | - Sarah Dry
- David Geffen School of Medicine at UCLA, Los Angeles, CA, United States
| | - David Elashoff
- David Geffen School of Medicine at UCLA, Los Angeles, CA, United States
| | - Zhuoer Xie
- Mayo Clinic, Rochester, MN, United States
| | - Antonia Petruse
- Embedded Clinical Research and Innovation Unit, CTSI Office of Clinical Research, Los Angeles, CA, US
| | - Clara Magyar
- David Geffen School of Medicine at UCLA, Los Angeles, CA, United States
| | - Liliana Johansen
- Embedded Clinical Research and Innovation Unit, CTSI Office of Clinical Research, Los Angeles, CA, US
| | - Gabriela Werre
- Embedded Clinical Research and Innovation Unit, CTSI Office of Clinical Research, Los Angeles, CA, US
| | - Clara Lajonchere
- Institute for Precision Health, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States
| | - Neil Wenger
- David Geffen School of Medicine at UCLA, Los Angeles, CA, United States
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Eisenhauer ER, Tait AR, Low LK, Arslanian-Engoren CM. Women's Choices Regarding Use of Their Newborns' Residual Dried Blood Samples in Research. J Obstet Gynecol Neonatal Nurs 2021; 50:424-438. [PMID: 34033759 DOI: 10.1016/j.jogn.2021.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/01/2021] [Indexed: 09/30/2022] Open
Abstract
OBJECTIVE To determine the proportion of informed choices women made about donating their newborns' blood samples for research. DESIGN A quantitative analysis of informed choice using data on women's knowledge and attitudes from a descriptive, cross-sectional survey. SETTING The state of Michigan. PARTICIPANTS Women (N = 69, ≥18 years old) who had (a) newborns 0 to 3 months of age, (b) yes or no decisions regarding use of the blood sample for research on file, (c) no evidence of an infant death in the state database, (d) completed the knowledge scale, (e) completed the attitude scale, and (f) recalled the decision (i.e., yes or no) about donating blood samples. METHODS We used the multidimensional measure of informed choice to calculate the proportion of informed choices in data on women's knowledge, attitudes, and decisions about biospecimen research. RESULTS Fifty-five percent (38/69) of participants made informed choices about donating newborn blood samples for research, and 45% made uninformed choices (31/69). Inadequate knowledge about biospecimen research contributed to 87% of uniformed choices (27/31). Participants who declined to donate their newborns' blood samples struggled with making decisions consistent with their values. CONCLUSION Nearly half of the participants made uninformed choices about donating the blood samples of their newborns for research. Women need more information about genetics and the storage and research use of newborns' blood samples to make informed choices. Nurses need to be made aware of the ethical, legal, and social implications of such research because they are primary sources of advocacy, information, and support for childbearing women and may be charged with overseeing or obtaining informed consent. Additional research with larger, more diverse samples is needed.
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Deserno TM, Dugas M, Löbe M, Stausberg J. A Topical Collection on ICT for Health Science Research - EFMI Special Topic Conference. J Med Syst 2021; 45:70. [PMID: 34002277 PMCID: PMC8128354 DOI: 10.1007/s10916-021-01739-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Thomas M. Deserno
- Peter L. Reichertz Institute for Medical Informatics of TU Braunschweig and Hannover Medical School, Braunschweig, Germany
| | - Martin Dugas
- Institute of Medical Informatics, University Hospital Heidelberg, Heidelberg, Germany
| | - Matthias Löbe
- Institute for Medical Informatics, Statistics and Epidemiology (IMISE), University of Leipzig, Leipzig, Germany
| | - Jürgen Stausberg
- Institute for Medical Informatics, Biometry and Epidemiology (IMIBE), Faculty of Medicine, University Duisburg-Essen, Essen, Germany
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