Stakeholder-Beteiligung in der klinischen Forschung: eine ethische Analyse

Current practice of stakeholder engagement: researchers' experiences in North America, DACH countries and China

Aim: To explore the current practice of stakeholder engagement in clinical trials and its evaluation in North America (USA and Canada), DACH countries (Germany, Austria and Switzerland) and China. Participants & methods: We conducted a web-based, anonymous, international, cross-sectional online survey for clinical researchers. Data were analyzed using descriptive and explorative statistical analysis including analysis of variance and analysis of covariance. Results: Stakeholder engagement is more prominent and higher accepted among researchers in North America. Researchers in DACH countries have less knowledge of the stakeholder engagement method and are less likely to apply it. Conclusion: Stakeholder engagement is perceived very differently among participants from DACH countries, North America and China. For a broader acceptance and implementation institutional support and motivational conditions might be needed.

My Data, My Choice? - German Patient Organizations' Attitudes towards Big Data-Driven Approaches in Personalized Medicine. An Empirical-Ethical Study

Personalized medicine (PM) operates with biological data to optimize therapy or prevention and to achieve cost reduction. Associated data may consist of large variations of informational subtypes e.g. genetic characteristics and their epigenetic modifications, biomarkers or even individual lifestyle factors. Present innovations in the field of information technology have already enabled the procession of increasingly large amounts of such data (‘volume’) from various sources (‘variety’) and varying quality in terms of data accuracy (‘veracity’) to facilitate the generation and analyzation of messy data sets within a short and highly efficient time period (‘velocity’) to provide insights into previously unknown connections and correlations between different items (‘value’). As such developments are characteristics of Big Data approaches, Big Data itself has become an important catchphrase that is closely linked to the emerging foundations and approaches of PM. However, as ethical concerns have been pointed out by experts in the debate already, moral concerns by stakeholders such as patient organizations (POs) need to be reflected in this context as well. We used an empirical-ethical approach including a website-analysis and 27 telephone-interviews for gaining in-depth insight into German POs’ perspectives on PM and Big Data. Our results show that not all POs are stakeholders in the same way. Comparing the perspectives and political engagement of the minority of POs that is currently actively involved in research around PM and Big Data-driven research led to four stakeholder sub-classifications: ‘mediators’ support research projects through facilitating researcher’s access to the patient community while simultaneously selecting projects they preferably support while ‘cooperators’ tend to contribute more directly to research projects by providing and implemeting patient perspectives. ‘Financers’ provide financial resources. ‘Independents’ keep control over their collected samples and associated patient-related information with a strong interest in making autonomous decisions about its scientific use. A more detailed terminology for the involvement of POs as stakeholders facilitates the adressing of their aims and goals. Based on our results, the ‘independents’ subgroup is a promising candidate for future collaborations in scientific research. Additionally, we identified gaps in PO’s knowledge about PM and Big Data. Based on these findings, approaches can be developed to increase data and statistical literacy. This way, the full potential of stakeholder involvement of POs can be made accessible in discourses around PM and Big Data.

Evaluating the German Biobank Node as Coordinating Institution of the German Biobank Alliance: Engaging with Stakeholders via Survey Research

Background: The German Biobank Node (GBN) is the central hub for German biobank activities and coordinates the German Biobank Alliance (GBA) to which 11 biobank sites in Germany belong. GBN, in cooperation with designated members of GBA, has developed various services and products for the German biobank community. To ensure that services and products are well aligned with the needs and interests of relevant stakeholders, GBN actively engages with its diverse stakeholder groups through different methods. Important stakeholder groups are the members of GBA who are generally the first users of developed products and services. Methods and Materials: Members of GBA were surveyed anonymously through a web-based application. The survey was sent to all members registered with an internal communication platform. Participants were primarily asked about their experiences with GBN, developed products and services, their wishes for the future of GBN/GBA, and their attitudes toward intensified cooperation on the European level. Answers were analyzed using descriptive statistics and qualitative content analysis. Results: Overall 63 of 110 registered GBA members (response rate of 57%) finished the survey. Participants were overall satisfied with the work of GBN and developed products and services. They also pointed out room for improvement. Participants, for example, proposed to shorten the survey developed for biobanks to engage with their users. They also shared what additional support wishes they had, for example, uniform cost models or use and access policies for the GBA community. Discussion: The survey was helpful to get a good overview of the experiences and attitudes of GBA members before making services and products available to other actors in the German biobank community. GBN will use the feedback to improve its work and to guide future strategy development. Survey research has shown an adequate method to engage with this particular stakeholder group, but further research on choosing methods for stakeholder engagement might be helpful.

[Consulting or engaging? The role of stakeholders in health research. A conference report by the organizers]

Increasingly, researchers are required to engage stakeholders in health-related research projects. "Stakeholder" in this context are those people who may be directly or indirectly affected by the planned research or the research object. This could be, for example, patients, relatives, and health personnel, but also political decision-makers. Those conducting stakeholder engagement are faced with many open questions like what activities are meant by engagement, for what purpose researchers should engage stakeholders, who should be involved, or how best to design engagement activities.From 28 to 29 March 2019 the interdisciplinary conference "Consulting or Engaging? The Role of Stakeholders in Health Research" took place at LMU Munich. The aim of the conference was to facilitate cross-disciplinary discourse on research engagement of various stakeholder groups. Different application contexts were examined, such as public health research, clinical research, health services research, and bioethical deliberation.This conference report structures and explains the main topics discussed during the conference from the perspective of the organizers. It thereby addresses the question of inclusivity and exclusivity of frequently used terms for stakeholder engagement, reflects on different strategies for justifying stakeholder engagement, and provides an overview of different approaches to stakeholder engagement as well as of methodological and practical challenges in implementing engagement activities.