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Martinez GS, Perez-Rueda E, Kumar A, Dutt M, Maya CR, Ledesma-Dominguez L, Casa PL, Kumar A, de Avila e Silva S, Kelvin DJ. CDBProm: the Comprehensive Directory of Bacterial Promoters. NAR Genom Bioinform 2024; 6:lqae018. [PMID: 38385146 PMCID: PMC10880602 DOI: 10.1093/nargab/lqae018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 01/12/2024] [Accepted: 01/29/2024] [Indexed: 02/23/2024] Open
Abstract
The decreasing cost of whole genome sequencing has produced high volumes of genomic information that require annotation. The experimental identification of promoter sequences, pivotal for regulating gene expression, is a laborious and cost-prohibitive task. To expedite this, we introduce the Comprehensive Directory of Bacterial Promoters (CDBProm), a directory of in-silico predicted bacterial promoter sequences. We first identified that an Extreme Gradient Boosting (XGBoost) algorithm would distinguish promoters from random downstream regions with an accuracy of 87%. To capture distinctive promoter signals, we generated a second XGBoost classifier trained on the instances misclassified in our first classifier. The predictor of CDBProm is then fed with over 55 million upstream regions from more than 6000 bacterial genomes. Upon finding potential promoter sequences in upstream regions, each promoter is mapped to the genomic data of the organism, linking the predicted promoter with its coding DNA sequence, and identifying the function of the gene regulated by the promoter. The collection of bacterial promoters available in CDBProm enables the quantitative analysis of a plethora of bacterial promoters. Our collection with over 24 million promoters is publicly available at https://aw.iimas.unam.mx/cdbprom/.
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Affiliation(s)
- Gustavo Sganzerla Martinez
- Microbiology and Immunology, Dalhousie University, Halifax, Nova Scotia B3H 4H7, Canada
- Pediatrics, Izaak Walton Killam (IWK) Health Center. Canadian Center for Vaccinology (CCfV), Halifax, Nova Scotia B3H 4H7, Canada
- BioForge Canada Limited, Halifax, Nova Scotia B3N 3B9, Canada
| | - Ernesto Perez-Rueda
- Instituto de Investigaciones en Matemáticas Aplicadas y en Sistemas, Universidad Nacional Autonóma de México, Unidad Académica del Estado de Yucatán, Mérida 97302, Yucatán, Mexico
| | - Anuj Kumar
- Microbiology and Immunology, Dalhousie University, Halifax, Nova Scotia B3H 4H7, Canada
- Pediatrics, Izaak Walton Killam (IWK) Health Center. Canadian Center for Vaccinology (CCfV), Halifax, Nova Scotia B3H 4H7, Canada
- BioForge Canada Limited, Halifax, Nova Scotia B3N 3B9, Canada
| | - Mansi Dutt
- Microbiology and Immunology, Dalhousie University, Halifax, Nova Scotia B3H 4H7, Canada
- Pediatrics, Izaak Walton Killam (IWK) Health Center. Canadian Center for Vaccinology (CCfV), Halifax, Nova Scotia B3H 4H7, Canada
- BioForge Canada Limited, Halifax, Nova Scotia B3N 3B9, Canada
| | - Cinthia Rodríguez Maya
- Facultad de Ciencias e Ingeniería, Universidad Nacional Autonoma de Mexico, Mexico City 04510, Mexico
| | - Leonardo Ledesma-Dominguez
- Instituto de Investigaciones en Matematicas Aplicadas y en Sistemas, Universidad Nacional Autonoma de Mexico, Mexico City 04510, Mexico
| | - Pedro Lenz Casa
- Biotechnology Institute, Universidade de Caxias do Sul, Caxias do Sul, Rio Grande do Sul 95070-560, Brazil
| | - Aditya Kumar
- Molecular Biology and Biotechnology, Tezpur University, Tezpur, Assam 784028, India
| | - Scheila de Avila e Silva
- Biotechnology Institute, Universidade de Caxias do Sul, Caxias do Sul, Rio Grande do Sul 95070-560, Brazil
| | - David J Kelvin
- Microbiology and Immunology, Dalhousie University, Halifax, Nova Scotia B3H 4H7, Canada
- Pediatrics, Izaak Walton Killam (IWK) Health Center. Canadian Center for Vaccinology (CCfV), Halifax, Nova Scotia B3H 4H7, Canada
- BioForge Canada Limited, Halifax, Nova Scotia B3N 3B9, Canada
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Lynch F, Meng Y, Best S, Goranitis I, Savulescu J, Gyngell C, Vears DF. Australian public perspectives on genomic data governance: responsibility, regulation, and logistical considerations. Eur J Hum Genet 2024; 32:295-301. [PMID: 37165103 PMCID: PMC10923910 DOI: 10.1038/s41431-023-01381-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 03/13/2023] [Accepted: 04/26/2023] [Indexed: 05/12/2023] Open
Abstract
Genomic sequencing generates huge volumes of data, which may be collected or donated to form large genomic databases. Such information can be stored for future use, either for the data donor themselves or by researchers to help improve our understanding of the genetic basis of disease. Creating datasets of this magnitude and diversity is only possible if patients, their families, and members of the public worldwide share their data. However, there is no consensus on the best technical approach to data sharing that also minimises risks to individuals and exploration of stakeholders' views on aspects of genomic data governance models-the ways genomic data is stored, managed, shared and used-has been minimal. To address this need, we conducted focus groups with 39 members of the Australian public exploring their views and preferences for different aspects of genomic data governance models. We found that consent and control were essential to participants, as they wanted the option to choose who had access to their data and for what purposes. Critically, participants wanted a trustworthy body to enforce regulation of data storage, sharing and usage. While participants recognised the importance of data accessibility, they also expressed a strong desire for data security. Finally, financial responsibility for data storage raised concerns for inequity as well as organisations and individuals using data in ethically contentious ways to generate profit. Our findings highlight some of the trade-offs that need to be considered in the development of genomic data governance systems.
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Affiliation(s)
- Fiona Lynch
- Murdoch Children's Research Institute, Parkville, VIC, 3052, Australia
- The University of Melbourne, Parkville, VIC, 3052, Australia
| | - Yan Meng
- The University of Melbourne, Parkville, VIC, 3052, Australia
| | - Stephanie Best
- The University of Melbourne, Parkville, VIC, 3052, Australia
- Peter MacCallum Cancer Centre, Parkville, VIC, 3052, Australia
- Victorian Comprehensive Cancer Centre, Parkville, VIC, 3052, Australia
- Australian Genomics Health Alliance, Parkville, VIC, Australia
| | - Ilias Goranitis
- Murdoch Children's Research Institute, Parkville, VIC, 3052, Australia
- The University of Melbourne, Parkville, VIC, 3052, Australia
- Australian Genomics Health Alliance, Parkville, VIC, Australia
| | - Julian Savulescu
- Murdoch Children's Research Institute, Parkville, VIC, 3052, Australia
- The University of Melbourne, Parkville, VIC, 3052, Australia
- Chen Su Lan Centennial Professor in Medical Ethics, Centre for Biomedical Ethics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Christopher Gyngell
- Murdoch Children's Research Institute, Parkville, VIC, 3052, Australia
- The University of Melbourne, Parkville, VIC, 3052, Australia
| | - Danya F Vears
- Murdoch Children's Research Institute, Parkville, VIC, 3052, Australia.
- The University of Melbourne, Parkville, VIC, 3052, Australia.
- Center for Biomedical Ethics and Law, Department of Public Health and Primary Care, Leuven, 3000, Belgium.
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Abondio P, Bruno F, Passarino G, Montesanto A, Luiselli D. Pangenomics: A new era in the field of neurodegenerative diseases. Ageing Res Rev 2024; 94:102180. [PMID: 38163518 DOI: 10.1016/j.arr.2023.102180] [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: 09/07/2023] [Revised: 12/14/2023] [Accepted: 12/28/2023] [Indexed: 01/03/2024]
Abstract
A pangenome is composed of all the genetic variability of a group of individuals, and its application to the study of neurodegenerative diseases may provide valuable insights into the underlying aspects of genetic heterogenetiy for these complex ailments, including gene expression, epigenetics, and translation mechanisms. Furthermore, a reference pangenome allows for the identification of previously undetected structural commonalities and differences among individuals, which may help in the diagnosis of a disease, support the prediction of what will happen over time (prognosis) and aid in developing novel treatments in the perspective of personalized medicine. Therefore, in the present review, the application of the pangenome concept to the study of neurodegenerative diseases will be discussed and analyzed for its potential to enable an improvement in diagnosis and prognosis for these illnesses, leading to the development of tailored treatments for individual patients from the knowledge of the genomic composition of a whole population.
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Affiliation(s)
- Paolo Abondio
- Laboratory of Ancient DNA, Department of Cultural Heritage, University of Bologna, Via degli Ariani 1, 48121 Ravenna, Italy.
| | - Francesco Bruno
- Academy of Cognitive Behavioral Sciences of Calabria (ASCoC), Lamezia Terme, Italy; Regional Neurogenetic Centre (CRN), Department of Primary Care, Azienda Sanitaria Provinciale Di Catanzaro, Viale A. Perugini, 88046 Lamezia Terme, CZ, Italy; Association for Neurogenetic Research (ARN), Lamezia Terme, CZ, Italy
| | - Giuseppe Passarino
- Department of Biology, Ecology and Earth Sciences, University of Calabria, Rende 87036, Italy
| | - Alberto Montesanto
- Department of Biology, Ecology and Earth Sciences, University of Calabria, Rende 87036, Italy
| | - Donata Luiselli
- Laboratory of Ancient DNA, Department of Cultural Heritage, University of Bologna, Via degli Ariani 1, 48121 Ravenna, Italy
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Musanabaganwa C, Ruton H, Ruhangaza D, Nsabimana N, Kayitare E, Muvunyi TZ, Semakula M, Ntirenganya F, Musoni E, Ndoli J, Hategekimana E, Nassir A, Makokha F, Uwimana A, Gasana J, Munezero PC, Uwinkindi F, Muvunyi CM, Nyirazinyoye L, Mazarati JB, Mutesa L. An Assessment of the Knowledge and Perceptions of Precision Medicine (PM) in the Rwandan Healthcare Setting. J Pers Med 2023; 13:1707. [PMID: 38138934 PMCID: PMC10744509 DOI: 10.3390/jpm13121707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 09/19/2023] [Accepted: 09/25/2023] [Indexed: 12/24/2023] Open
Abstract
INTRODUCTION Precision medicine (PM) or personalized medicine is an innovative approach that aims to tailor disease prevention and treatment to consider the differences in people's genes, environments, and lifestyles. Although many efforts have been made to accelerate the universal adoption of PM, several challenges need to be addressed in order to advance PM in Africa. Therefore, our study aimed to establish baseline data on the knowledge and perceptions of the implementation of PM in the Rwandan healthcare setting. METHOD A descriptive qualitative study was conducted in five hospitals offering diagnostics and oncology services to cancer patients in Rwanda. To understand the existing policies regarding PM implementation in the country, two additional institutions were surveyed: the Ministry of Health (MOH), which creates and sets policies for the overall vision of the health sector, and the Rwanda Biomedical Center (RBC), which coordinates the implementation of health sector policies in the country. The researchers conducted 32 key informant interviews and assessed the functionality of available PM equipment in the 5 selected health facilities. The data were thematically categorized and analyzed. RESULTS The study revealed that PM is perceived as a complex and expensive program by most health managers and health providers. The most cited challenges to implementing PM included the following: the lack of policies and guidelines; the lack of supportive infrastructures and limited suppliers of required equipment and laboratory consumables; financial constraints; cultural, behavioral, and religious beliefs; and limited trained, motivated, and specialized healthcare providers. Regarding access to health services for cancer treatment, patients with health insurance pay 10% of their medical costs, which is still too expensive for Rwandans. CONCLUSION The study participants highlighted the importance of PM to enhance healthcare delivery if the identified barriers are addressed. For instance, Rwandan health sector leadership might consider the creation of specialized oncology centers in all or some referral hospitals with all the necessary genomic equipment and trained staff to serve the needs of the country and implement a PM program.
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Affiliation(s)
- Clarisse Musanabaganwa
- Division of Research Innovation and Data Science, Rwanda Biomedical Center, Kigali P.O. Box 7162, Rwanda; (M.S.); (J.G.); (C.M.M.)
- Center of Human Genetics, College of Medicine and Health Sciences, University of Rwanda, Kigali P.O. Box 4285, Rwanda
| | - Hinda Ruton
- School of Public Health, University of Rwanda, Kigali P.O. Box 3286, Rwanda; (H.R.); (L.N.)
| | | | - Nicaise Nsabimana
- Butaro District Hospital, Burera P.O. Box 59, Rwanda; (D.R.); (N.N.); (E.K.)
| | - Emmanuel Kayitare
- Butaro District Hospital, Burera P.O. Box 59, Rwanda; (D.R.); (N.N.); (E.K.)
| | | | - Muhammed Semakula
- Division of Research Innovation and Data Science, Rwanda Biomedical Center, Kigali P.O. Box 7162, Rwanda; (M.S.); (J.G.); (C.M.M.)
| | - Faustin Ntirenganya
- University Teaching Hospital of Kigali, Kigali P.O. Box 655, Rwanda; (F.N.); (E.M.)
| | - Emile Musoni
- University Teaching Hospital of Kigali, Kigali P.O. Box 655, Rwanda; (F.N.); (E.M.)
| | - Jules Ndoli
- University Teaching Hospital of Butare, Huye P.O. Box 254, Rwanda; (J.N.); (E.H.)
| | - Elisee Hategekimana
- University Teaching Hospital of Butare, Huye P.O. Box 254, Rwanda; (J.N.); (E.H.)
| | - Angus Nassir
- Kenya Institute of Bioinfomatics, Nairobi P.O. Box 918, Kenya;
| | - Francis Makokha
- Directorate of Research and Development, Mount Kenya University, Thika P.O. Box 342-01000, Kenya;
| | - Aline Uwimana
- Malaria and Other Parasitic Diseases Division, Rwanda Biomedical Center, Kigali P.O. Box 7162, Rwanda;
| | - Joel Gasana
- Division of Research Innovation and Data Science, Rwanda Biomedical Center, Kigali P.O. Box 7162, Rwanda; (M.S.); (J.G.); (C.M.M.)
| | - Pierre Celestin Munezero
- Department of Microbiology and Parasitology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Huye P.O. Box 117, Rwanda;
| | - Francois Uwinkindi
- Division of Non-Communicable Diseases, Rwanda Biomedical Center, Kigali P.O. Box 7162, Rwanda;
| | - Claude Mambo Muvunyi
- Division of Research Innovation and Data Science, Rwanda Biomedical Center, Kigali P.O. Box 7162, Rwanda; (M.S.); (J.G.); (C.M.M.)
| | - Laetitia Nyirazinyoye
- School of Public Health, University of Rwanda, Kigali P.O. Box 3286, Rwanda; (H.R.); (L.N.)
| | - Jean Baptiste Mazarati
- School of Medicine, University of Global Health Equity, University of Global Health Equity, Kigali P.O. Box 6955, Rwanda;
| | - Leon Mutesa
- Center of Human Genetics, College of Medicine and Health Sciences, University of Rwanda, Kigali P.O. Box 4285, Rwanda
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Shahrier S, Gaydarska H, Takashima K, Yoshizawa G, Minari J. A conceptual analysis of public opinion regarding genome research in Japan. Front Genet 2023; 14:1170794. [PMID: 38098474 PMCID: PMC10720899 DOI: 10.3389/fgene.2023.1170794] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 10/27/2023] [Indexed: 12/17/2023] Open
Abstract
In the 20 years since the completion of the Human Genome Project, the gap between scientific development and public understanding of genome research has been widening. While genome research has been increasingly utilized for social and clinical purposes in a multifaceted manner, this has resulted in an increase in the potential risks associated with genomic data. In this context, our study aims to consider the nature of public perceptions of genome research, primarily by using as a case study the results of previous public surveys relevant to donations for social benefits in Japan. We explored certain types of awareness, attitude, and intention (A-A-I) in such surveys and discussed the resultant key findings through the cultural transmission framework. Reframing the public's response toward genome research based on A-A-I analysis and behavioral science may contribute to developing more systematic communication approaches with the public. With a view to establishing such approaches, our perspective suggests some new insights to discuss the science-society gap in genome research internationally.
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Affiliation(s)
- Shibly Shahrier
- Teesside University International Business School, Teesside University, Tees Valley, United Kingdom
| | - Hristina Gaydarska
- Center for iPS Cell Research and Application, Kyoto University, Kyoto, Kyoto, Japan
| | - Kayo Takashima
- Center for iPS Cell Research and Application, Kyoto University, Kyoto, Kyoto, Japan
| | - Go Yoshizawa
- Innovation System Research Center, Kwansei Gakuin University, Nishinomiya, Hyogo, Japan
| | - Jusaku Minari
- Center for iPS Cell Research and Application, Kyoto University, Kyoto, Kyoto, Japan
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Marchesin S, Menotti L, Giachelle F, Silvello G, Alonso O. Building a large gene expression-cancer knowledge base with limited human annotations. Database (Oxford) 2023; 2023:baad061. [PMID: 37768281 PMCID: PMC10533344 DOI: 10.1093/database/baad061] [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: 05/26/2023] [Revised: 07/27/2023] [Accepted: 08/25/2023] [Indexed: 09/29/2023]
Abstract
Cancer prevention is one of the most pressing challenges that public health needs to face. In this regard, data-driven research is central to assist medical solutions targeting cancer. To fully harness the power of data-driven research, it is imperative to have well-organized machine-readable facts into a knowledge base (KB). Motivated by this urgent need, we introduce the Collaborative Oriented Relation Extraction (CORE) system for building KBs with limited manual annotations. CORE is based on the combination of distant supervision and active learning paradigms and offers a seamless, transparent, modular architecture equipped for large-scale processing. We focus on precision medicine and build the largest KB on 'fine-grained' gene expression-cancer associations-a key to complement and validate experimental data for cancer research. We show the robustness of CORE and discuss the usefulness of the provided KB. Database URL https://zenodo.org/record/7577127.
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Affiliation(s)
- Stefano Marchesin
- Department of Information Engineering, University of Padova, Via G. Gradenigo 6b, Padova 35131, Italy
| | - Laura Menotti
- Department of Information Engineering, University of Padova, Via G. Gradenigo 6b, Padova 35131, Italy
| | - Fabio Giachelle
- Department of Information Engineering, University of Padova, Via G. Gradenigo 6b, Padova 35131, Italy
| | - Gianmaria Silvello
- Department of Information Engineering, University of Padova, Via G. Gradenigo 6b, Padova 35131, Italy
| | - Omar Alonso
- Applied Science, Amazon, 3075 Olcott St., Santa Clara, California 95054, USA
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Abondio P, Cilli E, Luiselli D. Human Pangenomics: Promises and Challenges of a Distributed Genomic Reference. Life (Basel) 2023; 13:1360. [PMID: 37374141 DOI: 10.3390/life13061360] [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: 05/15/2023] [Revised: 06/02/2023] [Accepted: 06/08/2023] [Indexed: 06/29/2023] Open
Abstract
A pangenome is a collection of the common and unique genomes that are present in a given species. It combines the genetic information of all the genomes sampled, resulting in a large and diverse range of genetic material. Pangenomic analysis offers several advantages compared to traditional genomic research. For example, a pangenome is not bound by the physical constraints of a single genome, so it can capture more genetic variability. Thanks to the introduction of the concept of pangenome, it is possible to use exceedingly detailed sequence data to study the evolutionary history of two different species, or how populations within a species differ genetically. In the wake of the Human Pangenome Project, this review aims at discussing the advantages of the pangenome around human genetic variation, which are then framed around how pangenomic data can inform population genetics, phylogenetics, and public health policy by providing insights into the genetic basis of diseases or determining personalized treatments, targeting the specific genetic profile of an individual. Moreover, technical limitations, ethical concerns, and legal considerations are discussed.
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Affiliation(s)
- Paolo Abondio
- Laboratory of Ancient DNA, Department of Cultural Heritage, University of Bologna, Via degli Ariani 1, 48121 Ravenna, Italy
| | - Elisabetta Cilli
- Laboratory of Ancient DNA, Department of Cultural Heritage, University of Bologna, Via degli Ariani 1, 48121 Ravenna, Italy
| | - Donata Luiselli
- Laboratory of Ancient DNA, Department of Cultural Heritage, University of Bologna, Via degli Ariani 1, 48121 Ravenna, Italy
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Paneque M, Guimarães L, Bengoa J, Pasalodos S, Cordier C, Esteban I, Lemos C, Moldovan R, Serra-Juhé C. An European overview of genetic counselling supervision provision. Eur J Med Genet 2023; 66:104710. [PMID: 36731744 DOI: 10.1016/j.ejmg.2023.104710] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 12/28/2022] [Accepted: 01/22/2023] [Indexed: 02/03/2023]
Abstract
Genetic testing is becoming more commonplace in general and specialist health care, and should always be accompanied by genetic counselling, according to legislation in many European countries and recommendations by professional bodies. Personal and professional competence is necessary to provide safe and effective genetic counselling. Clinical and counselling supervision of genetics healthcare practitioners plays a key role in quality assurance, providing a safe environment not only for patients but for professionals too. However, in many European countries, genetic counsellors are still an emerging professional group and counselling supervision is not routinely offered and there are no enough evidences on the impact of these insufficiencies. This study aimed to explore the current status of genetic counselling supervision provision across Europe and to ascertain factors that might be relevant for the successful implementation of counselling supervision. A total of 100 practitioners responded to an online survey; respondents were from 18 countries, with the majority working in France (27%) and Spain (17%). Only 34 participants reported having access to genetic counselling supervision. Country of origin, the existence of a regulation system and years of experience were factors identified as relevant, influencing access and characteristics of counselling supervision. Although there is a growing number of genetic counsellors trained at European level, just a few countries have implemented and required as mandatory the access to genetic counselling supervision. Nevertheless, this is essential to ensure a safe and effective genetic counselling and should be regulated at the European genetic healthcare services.
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Affiliation(s)
- Milena Paneque
- i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal; CGPP - Centro de Genética Preditiva e Preventiva, IBMC - Instituto de Biologia Molecular e Celular, i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal; Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal.
| | - Lídia Guimarães
- Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal; AAJUDE - Associação de Apoio à Juventude Deficiente, Portugal
| | | | - Sara Pasalodos
- Department of Medical Genetics, Complejo Hospitalario de Navarra, Universidad Publica de Navarra (UPNA), Navarra-biomed-IdiSNA (Navarra Institute for Health Research), Pamplona, Navarra, Spain
| | | | - Irene Esteban
- Clinical Genetics Department, Queen Elizabeth University Hospital. Glasgow, Scotland, United Kingdom
| | - Carolina Lemos
- i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal; Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
| | - Ramona Moldovan
- Department of Psychology, Babeş-Bolyai University, Romania; Division of Evolution and Genomic Sciences, University of Manchester, United Kingdom, Manchester Centre for Genomic Medicine, Manchester University Hospitals NHS Foundation Trust, UK
| | - Clara Serra-Juhé
- Genetics Department, IIB Sant Pau, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, 08041, Spain; Centro de Investigación Biomédica en Red en Enfermedades Raras (CIBERER), Spain
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Akyüz K, Goisauf M, Chassang G, Kozera Ł, Mežinska S, Tzortzatou-Nanopoulou O, Mayrhofer MT. Post-identifiability in changing sociotechnological genomic data environments. BIOSOCIETIES 2023:1-28. [PMID: 37359141 PMCID: PMC10042674 DOI: 10.1057/s41292-023-00299-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2023] [Indexed: 03/30/2023]
Abstract
Data practices in biomedical research often rely on standards that build on normative assumptions regarding privacy and involve 'ethics work.' In an increasingly datafied research environment, identifiability gains a new temporal and spatial dimension, especially in regard to genomic data. In this paper, we analyze how genomic identifiability is considered as a specific data issue in a recent controversial case: publication of the genome sequence of the HeLa cell line. Considering developments in the sociotechnological and data environment, such as big data, biomedical, recreational, and research uses of genomics, our analysis highlights what it means to be (re-)identifiable in the postgenomic era. By showing how the risk of genomic identifiability is not a specificity of the HeLa controversy, but rather a systematic data issue, we argue that a new conceptualization is needed. With the notion of post-identifiability as a sociotechnological situation, we show how past assumptions and ideas about future possibilities come together in the case of genomic identifiability. We conclude by discussing how kinship, temporality, and openness are subject to renewed negotiations along with the changing understandings and expectations of identifiability and status of genomic data.
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Affiliation(s)
- Kaya Akyüz
- Department of Science and Technology Studies, University of Vienna, Universitätsstraße 7/Stiege II/6, Stock (NIG), 1010 Vienna, Austria
- BBMRI-ERIC, Graz, Austria
| | - Melanie Goisauf
- Department of Science and Technology Studies, University of Vienna, Universitätsstraße 7/Stiege II/6, Stock (NIG), 1010 Vienna, Austria
- BBMRI-ERIC, Graz, Austria
| | - Gauthier Chassang
- CERPOP, Université de Toulouse, Inserm, Université Paul Sabatier, Toulouse, France
- Plateforme GenoToul Societal “Ethique et Biosciences”, Toulouse, France
| | | | - Signe Mežinska
- Institute of Clinical and Preventive Medicine, University of Latvia, Riga, Latvia
- BBMRI.LV, Riga, Latvia
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McWilliams L, Evans DG, Payne K, Harrison F, Howell A, Howell SJ, French DP. Implementing Risk-Stratified Breast Screening in England: An Agenda Setting Meeting. Cancers (Basel) 2022; 14:cancers14194636. [PMID: 36230559 PMCID: PMC9563640 DOI: 10.3390/cancers14194636] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 09/20/2022] [Accepted: 09/21/2022] [Indexed: 11/16/2022] Open
Abstract
It is now possible to accurately assess breast cancer risk at routine NHS Breast Screening Programme (NHSBSP) appointments, provide risk feedback and offer risk management strategies to women at higher risk. These strategies include National Institute for Health and Care Excellence (NICE) approved additional breast screening and risk-reducing medication. However, the NHSBSP invites nearly all women three-yearly, regardless of risk. In March 2022, a one-day agenda setting meeting took place in Manchester to discuss the feasibility and desirability of implementation of risk-stratified screening in the NHSBSP. Fifty-eight individuals participated (38 face-to-face, 20 virtual) with relevant expertise from academic, clinical and/or policy-making perspectives. Key findings were presented from the PROCAS2 NIHR programme grant regarding feasibility of risk-stratified screening in the NHSBSP. Participants discussed key uncertainties in seven groups, followed by a plenary session. Discussions were audio-recorded and thematically analysed to produce descriptive themes. Five themes were developed: (i) risk and health economic modelling; (ii) health inequalities and communication with women; (iii); extending screening intervals for low-risk women; (iv) integration with existing NHSBSP; and (v) potential new service models. Most attendees expected some form of risk-stratified breast screening to be implemented in England and collectively identified key issues to be resolved to facilitate this.
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Affiliation(s)
- Lorna McWilliams
- Manchester Centre for Health Psychology, Division of Psychology & Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Oxford Road, Manchester M13 9PL, UK
- NIHR Manchester Biomedical Research Centre, Manchester Academic Health Science Centre, Manchester University NHS Foundation Trust, Manchester M13 9WU, UK
- Correspondence:
| | - D. Gareth Evans
- NIHR Manchester Biomedical Research Centre, Manchester Academic Health Science Centre, Manchester University NHS Foundation Trust, Manchester M13 9WU, UK
- Genomic Medicine, Division of Evolution and Genomic Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, St Mary’s Hospital, Manchester University NHS Foundation Trust, Oxford Road, Manchester M13 9WL, UK
- Nightingale & Prevent Breast Cancer Research Unit, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Southmoor Road, Wythenshawe, Manchester M23 9LT, UK
- Manchester Breast Centre, Manchester Cancer Research Centre, University of Manchester, 55 Wilmslow Road, Manchester M20 4GJ, UK
| | - Katherine Payne
- NIHR Manchester Biomedical Research Centre, Manchester Academic Health Science Centre, Manchester University NHS Foundation Trust, Manchester M13 9WU, UK
- Manchester Centre for Health Economics, School of Health Sciences, Faculty of Biology Medicine and Health, University of Manchester, Oxford Road, Manchester M13 9PL, UK
| | | | - Anthony Howell
- NIHR Manchester Biomedical Research Centre, Manchester Academic Health Science Centre, Manchester University NHS Foundation Trust, Manchester M13 9WU, UK
- Nightingale & Prevent Breast Cancer Research Unit, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Southmoor Road, Wythenshawe, Manchester M23 9LT, UK
- Manchester Breast Centre, Manchester Cancer Research Centre, University of Manchester, 55 Wilmslow Road, Manchester M20 4GJ, UK
- Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine & Health, University of Manchester, Oxford Road, Manchester M13 9PL, UK
| | - Sacha J. Howell
- NIHR Manchester Biomedical Research Centre, Manchester Academic Health Science Centre, Manchester University NHS Foundation Trust, Manchester M13 9WU, UK
- Nightingale & Prevent Breast Cancer Research Unit, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Southmoor Road, Wythenshawe, Manchester M23 9LT, UK
- Manchester Breast Centre, Manchester Cancer Research Centre, University of Manchester, 55 Wilmslow Road, Manchester M20 4GJ, UK
- Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine & Health, University of Manchester, Oxford Road, Manchester M13 9PL, UK
| | - David P. French
- Manchester Centre for Health Psychology, Division of Psychology & Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Oxford Road, Manchester M13 9PL, UK
- NIHR Manchester Biomedical Research Centre, Manchester Academic Health Science Centre, Manchester University NHS Foundation Trust, Manchester M13 9WU, UK
- Manchester Breast Centre, Manchester Cancer Research Centre, University of Manchester, 55 Wilmslow Road, Manchester M20 4GJ, UK
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11
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Piergentili R, Basile G, Nocella C, Carnevale R, Marinelli E, Patrone R, Zaami S. Using ncRNAs as Tools in Cancer Diagnosis and Treatment-The Way towards Personalized Medicine to Improve Patients' Health. Int J Mol Sci 2022; 23:ijms23169353. [PMID: 36012617 PMCID: PMC9409241 DOI: 10.3390/ijms23169353] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 08/14/2022] [Accepted: 08/16/2022] [Indexed: 12/06/2022] Open
Abstract
Although the first discovery of a non-coding RNA (ncRNA) dates back to 1958, only in recent years has the complexity of the transcriptome started to be elucidated. However, its components are still under investigation and their identification is one of the challenges that scientists are presently facing. In addition, their function is still far from being fully understood. The non-coding portion of the genome is indeed the largest, both quantitatively and qualitatively. A large fraction of these ncRNAs have a regulatory role either in coding mRNAs or in other ncRNAs, creating an intracellular network of crossed interactions (competing endogenous RNA networks, or ceRNET) that fine-tune the gene expression in both health and disease. The alteration of the equilibrium among such interactions can be enough to cause a transition from health to disease, but the opposite is equally true, leading to the possibility of intervening based on these mechanisms to cure human conditions. In this review, we summarize the present knowledge on these mechanisms, illustrating how they can be used for disease treatment, the current challenges and pitfalls, and the roles of environmental and lifestyle-related contributing factors, in addition to the ethical, legal, and social issues arising from their (improper) use.
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Affiliation(s)
- Roberto Piergentili
- Institute of Molecular Biology and Pathology, Italian National Research Council (CNR-IBPM), 00185 Rome, Italy
| | - Giuseppe Basile
- Trauma Unit and Emergency Department, IRCCS Galeazzi Orthopedics Institute, 20161 Milan, Italy
- Head of Legal Medicine Unit, Clinical Institute San Siro, 20148 Milan, Italy
| | - Cristina Nocella
- Department of Clinical Internal, Anaesthesiological and Cardiovascular Sciences, “Sapienza” University of Rome, Viale del Policlinico, 155, 00161 Rome, Italy
| | - Roberto Carnevale
- Department of Medico-Surgical Sciences and Biotechnologies, “Sapienza” University of Rome, 04100 Latina, Italy
- Mediterranea Cardiocentro-Napoli, Via Orazio, 80122 Naples, Italy
| | - Enrico Marinelli
- Department of Medico-Surgical Sciences and Biotechnologies, “Sapienza” University of Rome, 04100 Latina, Italy
- Correspondence:
| | - Renato Patrone
- PhD ICTH, University of Federico II, HPB Department INT F. Pascale IRCCS of Naples, Via Mariano Semmola, 80131 Naples, Italy
| | - Simona Zaami
- Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Section of Forensic Medicine, “Sapienza” University of Rome, 00161 Rome, Italy
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12
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Amorim M, Silva S, Machado H, Teles EL, Baptista MJ, Maia T, Nwebonyi N, de Freitas C. Benefits and Risks of Sharing Genomic Data for Research: Comparing the Views of Rare Disease Patients, Informal Carers and Healthcare Professionals. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148788. [PMID: 35886636 PMCID: PMC9319916 DOI: 10.3390/ijerph19148788] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 07/10/2022] [Accepted: 07/11/2022] [Indexed: 01/25/2023]
Abstract
Assessing public and patients’ expectations and concerns about genomic data sharing is essential to promote adequate data governance and engagement in rare diseases genomics research. This cross-sectional study compared the views of 159 rare disease patients, 478 informal carers and 63 healthcare professionals in Northern Portugal about the benefits and risks of sharing genomic data for research, and its associated factors. The three participant groups expressed significantly different views. The majority of patients (84.3%) and informal carers (87.4%) selected the discovery of a cure for untreatable diseases as the most important benefit. In contrast, most healthcare professionals revealed a preference for the development of new drugs and treatments (71.4%), which was the second most selected benefit by carers (48.3%), especially by the more educated (OR (95% CI): 1.58 (1.07–2.34)). Lack of security and control over information access and the extraction of information exceeding research objectives were the two most often selected risks by patients (72.6% and 50.3%, respectively) and carers (60.0% and 60.6%, respectively). Conversely, professionals were concerned with genomic data being used to discriminate citizens (68.3%), followed by the extraction of information exceeding research objectives (54.0%). The latter risk was more frequently expressed by more educated carers (OR (95% CI): 1.60 (1.06–2.41)) and less by those with blue-collar (OR (95% CI): 0.44 (0.25–0.77) and other occupations (OR (95% CI): 0.44 (0.26–0.74)). Developing communication strategies and consent approaches tailored to participants’ expectations and needs can benefit the inclusiveness of genomics research that is key for patient-centred care.
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Affiliation(s)
- Mariana Amorim
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), 4050-600 Porto, Portugal; (M.A.); (T.M.); (N.N.)
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, 4050-600 Porto, Portugal
| | - Susana Silva
- Centro em Rede de Investigação em Antropologia, Universidade do Minho, 4710-057 Braga, Portugal;
- Instituto de Ciências Sociais, Universidade do Minho, 4710-057 Braga, Portugal;
| | - Helena Machado
- Instituto de Ciências Sociais, Universidade do Minho, 4710-057 Braga, Portugal;
| | - Elisa Leão Teles
- Centro de Referência de Doenças Hereditárias do Metabolismo, Centro Hospitalar Universitário São João, 4200-319 Porto, Portugal;
| | - Maria João Baptista
- Centro de Referência de Cardiopatias Congénitas, Centro Hospitalar Universitário São João, 4200-319 Porto, Portugal;
- Departamento de Ginecologia, Obstetrícia e Pediatria, Faculdade de Medicina, Universidade do Porto, 4200-319 Porto, Portugal
| | - Tiago Maia
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), 4050-600 Porto, Portugal; (M.A.); (T.M.); (N.N.)
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, 4050-600 Porto, Portugal
| | - Ngozi Nwebonyi
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), 4050-600 Porto, Portugal; (M.A.); (T.M.); (N.N.)
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, 4050-600 Porto, Portugal
| | - Cláudia de Freitas
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), 4050-600 Porto, Portugal; (M.A.); (T.M.); (N.N.)
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, 4050-600 Porto, Portugal
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, 4200-319 Porto, Portugal
- Correspondence:
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13
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Tan YC, Lahiri C. Promising Acinetobacter baumannii Vaccine Candidates and Drug Targets in Recent Years. Front Immunol 2022; 13:900509. [PMID: 35720310 PMCID: PMC9204607 DOI: 10.3389/fimmu.2022.900509] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Accepted: 04/26/2022] [Indexed: 12/14/2022] Open
Abstract
In parallel to the uncontrolled use of antibiotics, the emergence of multidrug-resistant bacteria, like Acinetobacter baumannii, has posed a severe threat. A. baumannii predominates in the nosocomial setting due to its ability to persist in hospitals and survive antibiotic treatment, thereby eventually leading to an increasing prevalence and mortality due to its infection. With the increasing spectra of drug resistance and the incessant collapse of newly discovered antibiotics, new therapeutic countermeasures have been in high demand. Hence, recent research has shown favouritism towards the long-term solution of designing vaccines. Therefore, being a realistic alternative strategy to combat this pathogen, anti-A. Baumannii vaccines research has continued unearthing various antigens with variable results over the last decade. Again, other approaches, including pan-genomics, subtractive proteomics, and reverse vaccination strategies, have shown promise for identifying promiscuous core vaccine candidates that resulted in chimeric vaccine constructs. In addition, the integration of basic knowledge of the pathobiology of this drug-resistant bacteria has also facilitated the development of effective multiantigen vaccines. As opposed to the conventional trial-and-error approach, incorporating the in silico methods in recent studies, particularly network analysis, has manifested a great promise in unearthing novel vaccine candidates from the A. baumannii proteome. Some studies have used multiple A. baumannii data sources to build the co-functional networks and analyze them by k-shell decomposition. Additionally, Whole Genomic Protein Interactome (GPIN) analysis has utilized a rational approach for identifying essential proteins and presenting them as vaccines effective enough to combat the deadly pathogenic threats posed by A. baumannii. Others have identified multiple immune nodes using network-based centrality measurements for synergistic antigen combinations for different vaccination strategies. Protein-protein interactions have also been inferenced utilizing structural approaches, such as molecular docking and molecular dynamics simulation. Similar workflows and technologies were employed to unveil novel A. baumannii drug targets, with a similar trend in the increasing influx of in silico techniques. This review integrates the latest knowledge on the development of A. baumannii vaccines while highlighting the in silico methods as the future of such exploratory research. In parallel, we also briefly summarize recent advancements in A. baumannii drug target research.
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Affiliation(s)
- Yong Chiang Tan
- School of Postgraduate Studies, International Medical University, Kuala Lumpur, Malaysia
| | - Chandrajit Lahiri
- Department of Biological Sciences, Sunway University, Petaling Jaya, Malaysia
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14
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Tschigg K, Consoli L, Biasiotto R, Mascalzoni D. Ethical, legal and social/societal implications (ELSI) of recall-by-genotype (RbG) and genotype-driven-research (GDR) approaches: a scoping review. Eur J Hum Genet 2022; 30:1000-1010. [PMID: 35705790 PMCID: PMC9437022 DOI: 10.1038/s41431-022-01120-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 03/17/2022] [Accepted: 05/05/2022] [Indexed: 11/29/2022] Open
Abstract
Recall by Genotype (RbG), Genotype-driven-recall (GDR), and Genotype-based-recall (GBR) strategies are increasingly used to conduct genomic or biobanking sub-studies that single out participants as eligible because of their specific individual genotypic information. However, existing regulatory and governance frameworks do not apply to all aspects of genotype-driven research approaches. The recall strategies disclose or withhold personal genotypic information with uncertain clinical utility. Accordingly, this scoping review aims to identify peculiar, explicit and implicit ethical, legal, and societal/social implications (ELSI) of RbG study designs. We conducted a systematic literature search of three electronic databases from November 2020 to February 2021. We investigated qualitative and quantitative research methods used to report ELSI aspects in RbG research. Congruent with other research findings, we identified a lack of qualitative research investigating the particular ELSI challenges with RbG. We included and analysed the content of twenty-five publications. We found a consensus on RbG posing significant ethical issues, dilemmas, barriers, concerns and societal challenges. However, we found that the approaches to disclosure and study-specific recall and communication strategies employed consent models and Return of Research Results (RoRR) policies varied considerably. Furthermore, we identified a high heterogeneity in perspectives of participants and experts about ELSI of study-specific RbG policies. Therefore, further fine-mapping through qualitative and empirical research is needed to draw conclusions and re-fine ELSI frameworks.
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Affiliation(s)
- Katharina Tschigg
- Department of Cellular, Computational, and Integrative Biology, University of Trento, Trento, Italy. .,Institute for Biomedicine & Affiliated Institute of the University of Lübeck, Eurac Research, Bolzano, Italy, Bozen, Italy.
| | - Luca Consoli
- Institute for Science in Society, Radboud University, Nijmegen, Netherlands
| | - Roberta Biasiotto
- Institute for Biomedicine & Affiliated Institute of the University of Lübeck, Eurac Research, Bolzano, Italy, Bozen, Italy.,Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Deborah Mascalzoni
- Institute for Biomedicine & Affiliated Institute of the University of Lübeck, Eurac Research, Bolzano, Italy, Bozen, Italy.,Department of Public Health and Caring Sciences, Center for Research Ethics and Bioethics, Uppsala University, Uppsala, Sweden
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15
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Paneque M, Serra Juhé C, Melegh B, Carreira I, Moog U, Liehr T. Erratum zu: Über die Notwendigkeit der Anerkennung von sog. Kernberufsgruppen innerhalb der genetischen Gesundheitsversorgung in Europa. MED GENET-BERLIN 2022; 34:189-191. [PMID: 38835907 PMCID: PMC11006359 DOI: 10.1515/medgen-2022-2122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2024]
Abstract
[This corrects the article DOI: 10.1515/medgen-2022-2116.].
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Affiliation(s)
- Milena Paneque
- i3S – Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
- IBMC – Institute for Molecular and Cell Biology, Universidade do Porto, Porto, Portugal
- Centre for Predictive and Preventive Genetics (CGPP), Universidade do Porto, Porto, Portugal
| | - Clara Serra Juhé
- U705 CIBERER, Genetics Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, 08193Barcelona, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Raras (CIBERER), 28029Madrid, Spain
| | - Bela Melegh
- Department of Medical Genetics, University of Pécs, School of Medicine, Pécs, Hungary
| | - Isabel Carreira
- Cytogenetics and Genomics Laboratory, CACC, iCBR/CIMAGO, CIBB, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Ute Moog
- Institut für Humangenetik, Universität Heidelberg, Heidelberg, Germany
| | - Thomas Liehr
- Universitätsklinik Jena, Friedrich Schiller Universität, Institut für Human Genetik, D-07740Jena, Germany
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16
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Paneque M, Liehr T, Serra Juhé C, Moog U, Melegh B, Carreira I. The need for recognition of core professional groups in genetics healthcare services in Europe. Eur J Hum Genet 2022; 30:639-640. [PMID: 35283482 DOI: 10.1038/s41431-022-01080-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 02/28/2022] [Indexed: 11/09/2022] Open
Affiliation(s)
- Milena Paneque
- i3S-Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal. .,IBMC-Institute for Molecular and Cell Biology, Universidade do Porto, Porto, Portugal. .,Centre for Predictive and Preventive Genetics (CGPP), Universidade do Porto, Porto, Portugal.
| | - Thomas Liehr
- Jena University Hospital, Friedrich Schiller University, Institute of Human Genetics, Jena, Germany
| | - Clara Serra Juhé
- U705 CIBERER, Genetics Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, 08193, Barcelona, Spain.,Centro de Investigación Biomédica en Red en Enfermedades Raras (CIBERER), 28029, Madrid, Spain
| | - Ute Moog
- Institute of Human Genetics, Heidelberg University, Heidelberg, Germany
| | - Bela Melegh
- Department of Medical Genetics, University of Pécs, School of Medicine, Pécs, Hungary
| | - Isabel Carreira
- Cytogenetics and Genomics Laboratory, CACC, iCBR/CIMAGO, CIBB, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
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17
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Paneque M, Serra Juhé C, Melegh B, Carreira I, Moog U, Liehr T. Über die Notwendigkeit der Anerkennung von sog. Kernberufsgruppen innerhalb der genetischen Gesundheitsversorgung in Europa. MED GENET-BERLIN 2022; 34:81-83. [PMID: 38836018 PMCID: PMC11006253 DOI: 10.1515/medgen-2022-2116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2024]
Affiliation(s)
- Milena Paneque
- i3S – Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
- IBMC – Institute for Molecular and Cell Biology, Universidade do Porto, Porto, Portugal
- Centre for Predictive and Preventive Genetics (CGPP), Universidade do Porto, Porto, Portugal
| | - Clara Serra Juhé
- U705 CIBERER, Genetics Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, 08193Barcelona, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Raras (CIBERER), 28029Madrid, Spain
| | - Bela Melegh
- Department of Medical Genetics, University of Pécs, School of Medicine, Pécs, Hungary
| | - Isabel Carreira
- Cytogenetics and Genomics Laboratory, CACC, iCBR/CIMAGO, CIBB, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Ute Moog
- Institut für Humangenetik, Universität Heidelberg, Heidelberg, Germany
| | - Thomas Liehr
- Universitätsklinik Jena, Friedrich Schiller Universität, Institut für Human Genetik, D-07740Jena, Germany
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18
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Akyüz K, Chassang G, Goisauf M, Kozera Ł, Mezinska S, Tzortzatou O, Mayrhofer MT. Biobanking and risk assessment: a comprehensive typology of risks for an adaptive risk governance. LIFE SCIENCES, SOCIETY AND POLICY 2021; 17:10. [PMID: 34903285 PMCID: PMC8666836 DOI: 10.1186/s40504-021-00117-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 12/01/2021] [Indexed: 05/03/2023]
Abstract
Biobanks act as the custodians for the access to and responsible use of human biological samples and related data that have been generously donated by individuals to serve the public interest and scientific advances in the health research realm. Risk assessment has become a daily practice for biobanks and has been discussed from different perspectives. This paper aims to provide a literature review on risk assessment in order to put together a comprehensive typology of diverse risks biobanks could potentially face. Methodologically set as a typology, the conceptual approach used in this paper is based on the interdisciplinary analysis of scientific literature, the relevant ethical and legal instruments and practices in biobanking to identify how risks are assessed, considered and mitigated. Through an interdisciplinary mapping exercise, we have produced a typology of potential risks in biobanking, taking into consideration the perspectives of different stakeholders, such as institutional actors and publics, including participants and representative organizations. With this approach, we have identified the following risk types: economic, infrastructural, institutional, research community risks and participant's risks. The paper concludes by highlighting the necessity of an adaptive risk governance as an integral part of good governance in biobanking. In this regard, it contributes to sustainability in biobanking by assisting in the design of relevant risk management practices, where they are not already in place or require an update. The typology is intended to be useful from the early stages of establishing such a complex and multileveled biomedical infrastructure as well as to provide a catalogue of risks for improving the risk management practices already in place.
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Affiliation(s)
- Kaya Akyüz
- BBMRI-ERIC, Graz, Austria.
- Department of Science and Technology Studies, University of Vienna, Vienna, Austria.
| | - Gauthier Chassang
- BBMRI-ERIC, Graz, Austria
- CERPOP, Université de Toulouse, Inserm, Université Paul Sabatier, Toulouse, France
| | - Melanie Goisauf
- BBMRI-ERIC, Graz, Austria
- Department of Science and Technology Studies, University of Vienna, Vienna, Austria
| | | | - Signe Mezinska
- BBMRI-ERIC, Graz, Austria
- Institute of Clinical and Preventive Medicine, University of Latvia, Riga, Latvia
| | - Olga Tzortzatou
- BBMRI-ERIC, Graz, Austria
- Biomedical Research Foundation of the Academy of Athens, Athens, Greece
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19
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Albalwy F, Brass A, Davies A. A Blockchain-Based Dynamic Consent Architecture to Support Clinical Genomic Data Sharing (ConsentChain): Proof-of-Concept Study. JMIR Med Inform 2021; 9:e27816. [PMID: 34730538 PMCID: PMC8600428 DOI: 10.2196/27816] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 06/15/2021] [Accepted: 07/25/2021] [Indexed: 11/30/2022] Open
Abstract
Background In clinical genomics, sharing of rare genetic disease information between genetic databases and laboratories is essential to determine the pathogenic significance of variants to enable the diagnosis of rare genetic diseases. Significant concerns regarding data governance and security have reduced this sharing in practice. Blockchain could provide a secure method for sharing genomic data between involved parties and thus help overcome some of these issues. Objective This study aims to contribute to the growing knowledge of the potential role of blockchain technology in supporting the sharing of clinical genomic data by describing blockchain-based dynamic consent architecture to support clinical genomic data sharing and provide a proof-of-concept implementation, called ConsentChain, for the architecture to explore its performance. Methods The ConsentChain requirements were captured from a patient forum to identify security and consent concerns. The ConsentChain was developed on the Ethereum platform, in which smart contracts were used to model the actions of patients, who may provide or withdraw consent to share their data; the data creator, who collects and stores patient data; and the data requester, who needs to query and access the patient data. A detailed analysis was undertaken of the ConsentChain performance as a function of the number of transactions processed by the system. Results We describe ConsentChain, a blockchain-based system that provides a web portal interface to support clinical genomic sharing. ConsentChain allows patients to grant or withdraw data requester access and allows data requesters to query and submit access to data stored in a secure off-chain database. We also developed an ontology model to represent patient consent elements into machine-readable codes to automate the consent and data access processes. Conclusions Blockchains and smart contracts can provide an efficient and scalable mechanism to support dynamic consent functionality and address some of the barriers that inhibit genomic data sharing. However, they are not a complete answer, and a number of issues still need to be addressed before such systems can be deployed in practice, particularly in relation to verifying user credentials.
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Affiliation(s)
- Faisal Albalwy
- Department of Computer Science, University of Manchester, Manchester, United Kingdom.,Department of Computer Science, College of Computer Science and Engineering, Taibah University, Madinah, Saudi Arabia.,Division of Informatics, Imaging and Data Sciences, University of Manchester, Manchester, United Kingdom
| | - Andrew Brass
- Department of Computer Science, University of Manchester, Manchester, United Kingdom.,Division of Informatics, Imaging and Data Sciences, University of Manchester, Manchester, United Kingdom
| | - Angela Davies
- Division of Informatics, Imaging and Data Sciences, University of Manchester, Manchester, United Kingdom
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Beauvais MJS, Thorogood AM, Szego MJ, Sénécal K, Zawati MH, Knoppers BM. Parental Access to Children's Raw Genomic Data in Canada: Legal Rights and Professional Responsibility. Front Genet 2021; 12:535340. [PMID: 33868358 PMCID: PMC8044527 DOI: 10.3389/fgene.2021.535340] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 03/05/2021] [Indexed: 11/13/2022] Open
Abstract
Children with rare and common diseases now undergo whole genome sequencing (WGS) in clinical and research contexts. Parents sometimes request access to their child's raw genomic data, to pursue their own analyses or for onward sharing with health professionals and researchers. These requests raise legal, ethical, and practical issues for professionals and parents alike. The advent of widespread WGS in pediatrics occurs in a context where privacy and data protection law remains focused on giving individuals control-oriented rights with respect to their personal information. Acting in their child's stead and in their best interests, parents are generally the ones who will be exercising these informational rights on behalf of the child. In this paper, we map the contours of parental authority to access their child's raw genomic data. We consider three use cases: hospital-based researchers, healthcare professionals acting in a clinical-diagnostic capacity, and "pure" academic researchers at a public institution. Our research seeks to answer two principal questions: Do parents have a right of access to their child's raw WGS data? If so, what are the limits of this right? Primarily focused on the laws of Ontario, Canada's most populous province, with a secondary focus on Canada's three other most populous provinces (Quebec, British Columbia, and Alberta) and the European Union, our principal findings include (1) parents have a general right of access to information about their children, but that the access right is more capacious in the clinical context than in the research context; (2) the right of access extends to personal data in raw form; (3) a consideration of the best interests of the child may materially limit the legal rights of parents to access data about their child; (4) the ability to exercise rights of access are transferred from parents to children when they gain decision-making capacity in both the clinical and research contexts, but with more nuance in the former. With these findings in mind, we argue that professional guidelines, which are concerned with obligations to interpret and return results, may assist in furthering a child's best interests in the context of legal access rights. We conclude by crafting recommendations for healthcare professionals in the clinical and research contexts when faced with a parental request for a child's raw genomic data.
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Affiliation(s)
- Michael J S Beauvais
- Centre of Genomics and Policy, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Adrian M Thorogood
- ELIXIR-LU, Luxembourg Centre for Systems Biomedicine, University of Luxembourg, Belvaux, Luxembourg
| | - Michael J Szego
- Centre for Clinical Ethics, Unity Health, Toronto, ON, Canada.,Departments of Family and Community Medicine and Molecular Genetics, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | | | - Ma'n H Zawati
- Centre of Genomics and Policy, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Bartha Maria Knoppers
- Centre of Genomics and Policy, Faculty of Medicine, McGill University, Montreal, QC, Canada
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21
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Schumann S, Gschmeidler B, Pellegrini G. Knowing, relationships and trust-citizens' perceptions of whole genome sequencing for the Genetics Clinic of the Future. J Community Genet 2020; 12:67-80. [PMID: 32997319 DOI: 10.1007/s12687-020-00486-0] [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: 05/07/2020] [Accepted: 07/10/2020] [Indexed: 10/23/2022] Open
Abstract
The objective of this article is to present various views from different groups of citizens on the topic of whole genome sequencing (WGS). Sixteen focus groups were carried out in Italy and Austria which aimed at reflecting on the question of how to ensure that the implementation of WGS into the clinic is relevant and responsive to the needs of all members of society. In the qualitative analysis of the focus groups, three key themes (knowing, relationships and trust) were investigated. Although the majority of the participants favoured a person-centred care approach, we also found more radical perspectives in the relationship theme. This includes a self-centred orientation in which health care institutions should be prepared to integrate self-interpretation efforts of citizens and develop strategies to deal with them. Different attitudes towards getting to know genetic information (knowing) and varied approaches to decision-making for or against the use of WGS were observed. Personal capacities, in particular those to handle medical information, were emphasized as key factors. This means that it is important not to connect the desire not to know with a rejection of the technology per se but rather to support information and consultancy processes that effectively involve citizens. Concerning the third theme, we have underlined the important role of mistrust in addition to trust because it mostly points to areas or conditions considered problematic. Thus, mistrust is also a way to articulate critique, for example, of the profit-making with patient data, that has to be taken seriously by governance.
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22
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Suranova TG, Suvorov GN, Zenin SS. Conceptual principles and patterns of legal regulation of the processes of storage, access and data protection of genome sequencing in foreign countries as the basis for the modernization of Russian legislation. Klin Lab Diagn 2020; 65:580-586. [PMID: 33245645 DOI: 10.18821/0869-2084-2020-65-9-580-586] [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] [Indexed: 06/11/2023]
Abstract
The relevance of the study of the general principles and patterns of legal regulation of access storage processes and data protection of genome sequencing in foreign countries is determined by the need to develop a general concept of legal regulation of this type of activity in Russia. The purpose of this study is to develop the system-forming principles and patterns of access storage and data protection of genome sequencing in Russia. To achieve this goal, tasks were set and solved to identify and study the general principles and patterns of legal regulation of access storage processes and data protection of genome sequencing in foreign countries. The international documents regulating the features of regulation of access storage processes and data protection of genome-wide sequencing, the doctrinal sources of Great Britain, the USA, France, Israel, and Japan are studied. Methods used: general philosophical, general scientific, private scientific, special (structural-legal, comparative-legal, formal-legal). The general principles for the formation of the concept of legal regulation of genome sequencing in Russia are proposed. It was revealed that the creation of a universal regulatory regulator aimed at protecting the subject of personal data in view of the prevalence of public interests over private ones and the constant expansion of the scope of application of genetic data obtained as a result of genome-wide sequencing is the main problem in developing a legal regulation mechanism in the studied area. For the first time, the authors determine the basic principles for developing the concept of genome-wide sequencing in Russia, including: recognition of human rights and human dignity as the highest value, the necessity of researchers' responsibility for the well-being of participants in view of the obtained research results, the mandatory informed consent of which should be voluntary, permanent, their right to get acquainted with the results obtained if it concerns their health, access to such information, ensuring the right to non-knowledge of research results and others.
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Affiliation(s)
- T G Suranova
- Federal Research and Clinical Center of the Federal Medical-Biological Agency
| | - G N Suvorov
- Federal Research and Clinical Center of the Federal Medical-Biological Agency
| | - S S Zenin
- Kutafin Moscow State Law University (MSAL)
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23
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Turner H, Jackson L. Evidence for penetrance in patients without a family history of disease: a systematic review. Eur J Hum Genet 2020; 28:539-550. [PMID: 31937893 PMCID: PMC7170932 DOI: 10.1038/s41431-019-0556-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 10/08/2019] [Accepted: 11/26/2019] [Indexed: 01/21/2023] Open
Abstract
Family-based penetrance is frequently cited as a major challenge for translating penetrance estimates from familial populations to asymptomatic populations. A systematic review was performed to assess the literature evidencing penetrance estimates in patients without a family history of disease, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework. Initially 1592 papers were identified, which were filtered to a final nine, through application of inclusion and exclusion criteria. Fundamental differences in the identified papers prevented combination of papers using meta-analysis, so thematic analysis to produce a narrative synthesis was performed. Key themes included disease risk modifiers, evidence, study limitations and bias. A methodological appraisal too was used to assess quality of included studies. It is evident from the findings that the evidence base for penetrance estimates in individuals without a family history of disease is limited. Future work is needed to refine design of penetrance studies and the impact of incorrect estimates.
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Affiliation(s)
- Heather Turner
- University of Exeter Medical School, 4.07 RILD, Royal Devon & Exeter Hospital, Barrack Road, Exeter, EX2 5DW, UK
| | - Leigh Jackson
- University of Exeter Medical School, 4.07 RILD, Royal Devon & Exeter Hospital, Barrack Road, Exeter, EX2 5DW, UK.
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Milne R, Morley KI, Howard H, Niemiec E, Nicol D, Critchley C, Prainsack B, Vears D, Smith J, Steed C, Bevan P, Atutornu J, Farley L, Goodhand P, Thorogood A, Kleiderman E, Middleton A. Trust in genomic data sharing among members of the general public in the UK, USA, Canada and Australia. Hum Genet 2019; 138:1237-1246. [PMID: 31531740 PMCID: PMC6874520 DOI: 10.1007/s00439-019-02062-0] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 09/09/2019] [Indexed: 01/08/2023]
Abstract
Trust may be important in shaping public attitudes to genetics and intentions to participate in genomics research and big data initiatives. As such, we examined trust in data sharing among the general public. A cross-sectional online survey collected responses from representative publics in the USA, Canada, UK and Australia (n = 8967). Participants were most likely to trust their medical doctor and less likely to trust other entities named. Company researchers were least likely to be trusted. Low, Variable and High Trust classes were defined using latent class analysis. Members of the High Trust class were more likely to be under 50 years, male, with children, hold religious beliefs, have personal experience of genetics and be from the USA. They were most likely to be willing to donate their genomic and health data for clinical and research uses. The Low Trust class were less reassured than other respondents by laws preventing exploitation of donated information. Variation in trust, its relation to areas of concern about the use of genomic data and potential of legislation are considered. These findings have relevance for efforts to expand genomic medicine and data sharing beyond those with personal experience of genetics or research participants.
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Affiliation(s)
- Richard Milne
- Society and Ethics Research, Connecting Science, Wellcome Genome Campus, Cambridge, UK
- Institute of Public Health, University of Cambridge, Cambridge, UK
| | - Katherine I Morley
- RAND Europe, Cambridge, UK
- National Addiction Centre, King's College London Institute of Psychiatry, Psychology and Neuroscience, London, UK
- Centre for Epidemiology and Biostatistics, Melbourne School of Global and Population Health, The University of Melbourne, Melbourne, Australia
| | - Heidi Howard
- Centre for Research Ethics and Bioethics, Uppsala University, Uppsala, Sweden
| | - Emilia Niemiec
- Centre for Research Ethics and Bioethics, Uppsala University, Uppsala, Sweden
| | - Dianne Nicol
- Centre for Law and Genetics, University of Tasmania, Hobart, Australia
| | - Christine Critchley
- Centre for Law and Genetics, University of Tasmania, Hobart, Australia
- Department of Statistics and Epidemiology, Swinburne University of Technology, Melbourne, Australia
| | - Barbara Prainsack
- Department of Political Science, University of Vienna, Vienna, Austria
- Department of Global Health and Social Medicine, King's College, London, UK
| | - Danya Vears
- Melbourne Law School, University of Melbourne, Parkville, VIC, Australia
- Murdoch Children's Research Institute, Parkville, VIC, Australia
- Department of Public Health and Primary Care, Centre for Biomedical Ethics and Law, KU Leuven, Leuven, Belgium
- Leuven Institute for Human Genomics and Society (LIGAS), KU Leuven, Leuven, Belgium
| | - James Smith
- Web Team, Wellcome Sanger Institute, Wellcome Genome Campus, Cambridge, UK
| | - Claire Steed
- Web Team, Wellcome Sanger Institute, Wellcome Genome Campus, Cambridge, UK
| | - Paul Bevan
- Web Team, Wellcome Sanger Institute, Wellcome Genome Campus, Cambridge, UK
| | - Jerome Atutornu
- Society and Ethics Research, Connecting Science, Wellcome Genome Campus, Cambridge, UK
- School of Health Sciences, University of Suffolk, Ipswich, UK
| | - Lauren Farley
- Society and Ethics Research, Connecting Science, Wellcome Genome Campus, Cambridge, UK
| | - Peter Goodhand
- Ontario Institute for Cancer Research, MaRS Centre, Toronto, ON, Canada
| | - Adrian Thorogood
- Centre of Genomics and Policy, McGill University, Montreal, QC, Canada
| | - Erika Kleiderman
- Centre of Genomics and Policy, McGill University, Montreal, QC, Canada
| | - Anna Middleton
- Society and Ethics Research, Connecting Science, Wellcome Genome Campus, Cambridge, UK.
- Faculty of Education, University of Cambridge, Cambridge, UK.
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25
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Middleton A, Milne R, Thorogood A, Kleiderman E, Niemiec E, Prainsack B, Farley L, Bevan P, Steed C, Smith J, Vears D, Atutornu J, Howard HC, Morley KI. Attitudes of publics who are unwilling to donate DNA data for research. Eur J Med Genet 2019; 62:316-323. [PMID: 30476628 PMCID: PMC6582635 DOI: 10.1016/j.ejmg.2018.11.014] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 11/20/2018] [Accepted: 11/22/2018] [Indexed: 12/17/2022]
Abstract
With the use of genetic technology, researchers have the potential to inform medical diagnoses and treatment in actionable ways. Accurate variant interpretation is a necessary condition for the utility of genetic technology to unfold. This relies on the ability to access large genomic datasets so that comparisons can be made between variants of interest. This can only be successful if DNA and medical data are donated by large numbers of people to 'research', including clinical, non-profit and for-profit research initiatives, in order to be accessed by scientists and clinicians worldwide. The objective of the 'Your DNA, Your Say' global survey is to explore public attitudes, values and opinions towards willingness to donate and concerns regarding the donation of one's personal data for use by others. Using a representative sample of 8967 English-speaking publics from the UK, the USA, Canada and Australia, we explore the characteristics of people who are unwilling (n = 1426) to donate their DNA and medical information, together with an exploration of their reasons. Understanding this perspective is important for making sense of the interaction between science and society. It also helps to focus engagement initiatives on the issues of concern to some publics.
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Affiliation(s)
- Anna Middleton
- Society and Ethics Research, Connecting Science, Wellcome Genome Campus, Cambridge, UK; Faculty of Education, University of Cambridge, Cambridge, UK.
| | - Richard Milne
- Society and Ethics Research, Connecting Science, Wellcome Genome Campus, Cambridge, UK; Institute of Public Health, University of Cambridge, Cambridge, UK
| | - Adrian Thorogood
- Centre of Genomics and Policy, McGill University, Montreal, Quebec, Canada
| | - Erika Kleiderman
- Centre of Genomics and Policy, McGill University, Montreal, Quebec, Canada
| | - Emilia Niemiec
- Centre for Research Ethics and Bioethics, Uppsala University, Uppsala, Sweden
| | - Barbara Prainsack
- Department of Political Science, University of Vienna, Austria; Department of Global Health & Social Medicine, King's College London, UK
| | - Lauren Farley
- Society and Ethics Research, Connecting Science, Wellcome Genome Campus, Cambridge, UK
| | - Paul Bevan
- Web Team, Wellcome Sanger Institute, Wellcome Genome Campus, Cambridge, UK
| | - Claire Steed
- Web Team, Wellcome Sanger Institute, Wellcome Genome Campus, Cambridge, UK
| | - James Smith
- Web Team, Wellcome Sanger Institute, Wellcome Genome Campus, Cambridge, UK
| | - Danya Vears
- Center for Biomedical Ethics and Law, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium; Melbourne Law School, The University of Melbourne, Melbourne, Australia; Biomedical Ethics Research Group, Murdoch Children's Research Institute, Parkville, Australia
| | - Jerome Atutornu
- Society and Ethics Research, Connecting Science, Wellcome Genome Campus, Cambridge, UK; Faculty of Education, University of Cambridge, Cambridge, UK; School of Health Sciences, University of Suffolk, Ipswich, UK
| | - Heidi C Howard
- Society and Ethics Research, Connecting Science, Wellcome Genome Campus, Cambridge, UK; Centre for Research Ethics and Bioethics, Uppsala University, Uppsala, Sweden
| | - Katherine I Morley
- Society and Ethics Research, Connecting Science, Wellcome Genome Campus, Cambridge, UK; Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK; Centre for Epidemiology and Biostatistics, Melbourne School of Global and Population Health, The University of Melbourne, Melbourne, Australia
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26
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Bilkey GA, Burns BL, Coles EP, Bowman FL, Beilby JP, Pachter NS, Baynam G, J. S. Dawkins H, Nowak KJ, Weeramanthri TS. Genomic Testing for Human Health and Disease Across the Life Cycle: Applications and Ethical, Legal, and Social Challenges. Front Public Health 2019; 7:40. [PMID: 30915323 PMCID: PMC6421958 DOI: 10.3389/fpubh.2019.00040] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 02/14/2019] [Indexed: 12/23/2022] Open
Abstract
The expanding use of genomic technologies encompasses all phases of life, from the embryo to the elderly, and even the posthumous phase. In this paper, we present the spectrum of genomic healthcare applications, and describe their scope and challenges at different stages of the life cycle. The integration of genomic technology into healthcare presents unique ethical issues that challenge traditional aspects of healthcare delivery. These challenges include the different definitions of utility as applied to genomic information; the particular characteristics of genetic data that influence how it might be protected, used and shared; and the difficulties applying existing models of informed consent, and how new consent models might be needed.
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Affiliation(s)
- Gemma A. Bilkey
- Office of Population Health Genomics, Public and Aboriginal Health Division, Department of Health, Government of Western Australia, East Perth, WA, Australia
- Office of the Chief Health Officer, Public and Aboriginal Health Division, Department of Health, Government of Western Australia, East Perth, WA, Australia
| | - Belinda L. Burns
- Office of Population Health Genomics, Public and Aboriginal Health Division, Department of Health, Government of Western Australia, East Perth, WA, Australia
| | - Emily P. Coles
- Office of Population Health Genomics, Public and Aboriginal Health Division, Department of Health, Government of Western Australia, East Perth, WA, Australia
| | - Faye L. Bowman
- Office of Population Health Genomics, Public and Aboriginal Health Division, Department of Health, Government of Western Australia, East Perth, WA, Australia
| | - John P. Beilby
- PathWest Laboratory Medicine, Sir Charles Gairdner Hospital, Nedlands, WA, Australia
- Faculty of Health and Medical Sciences, School of Biomedical Sciences, The University of Western Australia, Crawley, WA, Australia
| | - Nicholas S. Pachter
- Genetic Services of Western Australia, King Edward Memorial Hospital, Department of Health, Government of Western Australia, Subiaco, WA, Australia
- Faculty of Health and Medical Sciences, School of Medicine, The University of Western Australia, Crawley, WA, Australia
| | - Gareth Baynam
- Office of Population Health Genomics, Public and Aboriginal Health Division, Department of Health, Government of Western Australia, East Perth, WA, Australia
- Genetic Services of Western Australia, King Edward Memorial Hospital, Department of Health, Government of Western Australia, Subiaco, WA, Australia
- Faculty of Health and Medical Sciences, School of Medicine, The University of Western Australia, Crawley, WA, Australia
- Western Australian Register of Developmental Anomalies, King Edward Memorial Hospital, Department of Health, Government of Western Australia, Subiaco, WA, Australia
- Centre for Child Health Research, The University of Western Australia and Telethon Kids Institute, Perth, WA, Australia
| | - Hugh J. S. Dawkins
- Office of Population Health Genomics, Public and Aboriginal Health Division, Department of Health, Government of Western Australia, East Perth, WA, Australia
- Faculty of Health and Medical Sciences, School of Biomedical Sciences, The University of Western Australia, Crawley, WA, Australia
- Sir Walter Murdoch School of Policy and International Affairs, Murdoch University, Murdoch, WA, Australia
- School of Public Health, Curtin University of Technology, Bentley, WA, Australia
| | - Kristen J. Nowak
- Office of Population Health Genomics, Public and Aboriginal Health Division, Department of Health, Government of Western Australia, East Perth, WA, Australia
- Faculty of Health and Medical Sciences, School of Biomedical Sciences, The University of Western Australia, Crawley, WA, Australia
- Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands, WA, Australia
| | - Tarun S. Weeramanthri
- Office of the Chief Health Officer, Public and Aboriginal Health Division, Department of Health, Government of Western Australia, East Perth, WA, Australia
- Faculty of Health and Medical Sciences, School of Population and Global Health, The University of Western Australia, Crawley, WA, Australia
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27
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Bilkey GA, Burns BL, Coles EP, Mahede T, Baynam G, Nowak KJ. Optimizing Precision Medicine for Public Health. Front Public Health 2019; 7:42. [PMID: 30899755 PMCID: PMC6416195 DOI: 10.3389/fpubh.2019.00042] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 02/14/2019] [Indexed: 01/15/2023] Open
Abstract
Advances in precision medicine have presented challenges to traditional public health decision-making paradigms. Historical methods of allocating healthcare funds based on safety, efficacy, and efficiency, are challenged in a healthcare delivery model that focuses on individualized variations in pathology that form the core of precision medicine. Public health policy and decision-making must adapt to this new frontier of healthcare delivery to ensure that the broad public health goals of reducing healthcare disparities and improving the health of populations are achieved, through effective and equitable allocation of healthcare funds. This paper discusses contemporary applications of precision medicine, and the potential impacts of these on public health policy and decision-making, with particular focus on patients living with rare diseases and rare cancers. The authors then reconcile these, presenting precision public health as the bridge between these seemingly competing fields.
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Affiliation(s)
- Gemma A Bilkey
- Office of Population Health Genomics, Public and Aboriginal Health Division, Department of Health, Government of Western Australia, Perth, WA, Australia.,Office of the Chief Health Officer, Public and Aboriginal Health Division, Department of Health, Government of Western Australia, Perth, WA, Australia
| | - Belinda L Burns
- Office of Population Health Genomics, Public and Aboriginal Health Division, Department of Health, Government of Western Australia, Perth, WA, Australia
| | - Emily P Coles
- Office of Population Health Genomics, Public and Aboriginal Health Division, Department of Health, Government of Western Australia, Perth, WA, Australia
| | - Trinity Mahede
- Office of Population Health Genomics, Public and Aboriginal Health Division, Department of Health, Government of Western Australia, Perth, WA, Australia
| | - Gareth Baynam
- Office of Population Health Genomics, Public and Aboriginal Health Division, Department of Health, Government of Western Australia, Perth, WA, Australia.,Genetic Services of Western Australia, King Edward Memorial Hospital, Department of Health, Government of Western Australia, Perth, WA, Australia.,Western Australian Register of Developmental Anomalies, King Edward Memorial Hospital, Department of Health, Government of Western Australia, Perth, WA, Australia
| | - Kristen J Nowak
- Office of Population Health Genomics, Public and Aboriginal Health Division, Department of Health, Government of Western Australia, Perth, WA, Australia.,Faculty of Health and Medical Sciences, School of Biomedical Sciences, The University of Western Australia, Perth, WA, Australia.,Harry Perkins Institute of Medical Research, Queen Elizabeth II Medical Centre, Perth, WA, Australia
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28
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Exome sequencing in clinical settings: preferences and experiences of parents of children with rare diseases (SEQUAPRE study). Eur J Hum Genet 2019; 27:701-710. [PMID: 30710147 DOI: 10.1038/s41431-018-0332-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Revised: 11/28/2018] [Accepted: 12/11/2018] [Indexed: 12/14/2022] Open
Abstract
Exome sequencing (ES) has revolutionized diagnostic procedures in medical genetics, particularly for developmental diseases. The variety and complexity of the information produced has raised issues regarding its use in a clinical setting. Of particular interest are patients' expectations regarding the information disclosed, the accompaniment provided, and the value patients place on these. To explore these issues in parents of children with developmental disorders and no diagnosis with known etiology, a multidisciplinary group of researchers from social and behavioral sciences and patient organizations conducted a mixed-methodology study (quantitative and qualitative) in two centers of expertise for rare diseases in France. The quantitative study aimed to determine the preferences of 513 parents regarding the disclosure of ES results. It showed that parents wished to have exhaustive information, including variants of unknown significance possibly linked to their child's disorder and secondary findings. This desire for information could be a strategy to maximize the chances of obtaining a diagnosis. The qualitative study aimed to understand the expectations and reactions of 57 parents interviewed just after the return of ES results. In-depth analysis showed that parents had ambivalent feelings about the findings whatever the results returned. The contrasting results from these studies raise questions about the value of the information provided and parents' high expectations regarding the results. The nature of parental expectations has emerged as an important topic in efforts to optimize accompaniment and support for families during the informed decision-making process and after disclosure of the results in an overall context of uncertainty.
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29
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Abstract
OBJECTIVE To review ethical, legal, and social implications of genomics, a ground-breaking science that when applied improves cancer care outcomes. DATA SOURCES PubMed, Cumulative Index to Nursing and Allied Health (CINAHL), Cochrane Library, consensus statements, and professional guidelines. CONCLUSION Ethical, legal, and social domains of genomics are not fully delineated. Areas needing further discussion and policies include return of findings, informed consent, electronic health records, and data resources and sharing. IMPLICATIONS FOR NURSING PRACTICE All nurses need a basic understanding of the ethical, legal, and social implications of genomics.
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30
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Kim H, Kim SY, Joly Y. South Korea: in the midst of a privacy reform centered on data sharing. Hum Genet 2018; 137:627-635. [PMID: 30121900 PMCID: PMC6132641 DOI: 10.1007/s00439-018-1920-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Accepted: 07/28/2018] [Indexed: 12/23/2022]
Abstract
With rapid developments in genomic and digital technologies, genomic data sharing has become a key issue for the achievement of precision medicine in South Korea. The legal and administrative framework for data sharing and protection in this country is currently under intense scrutiny from national and international stakeholders. Policymakers are assessing the relevance of specific restrictions in national laws and guidelines for better alignment with international approaches. This manuscript will consider key issues in international genome data sharing in South Korea, including consent, privacy, security measures, compatible adequacy and oversight, and map out an approach to genomic data sharing that recognizes the importance of patient engagement and responsible use of data in South Korea.
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Affiliation(s)
- Hannah Kim
- Asian Institute for Bioethics and Health Law, Yonsei University, Seoul, South Korea
| | - So Yoon Kim
- Asian Institute for Bioethics and Health Law, Yonsei University, Seoul, South Korea
| | - Yann Joly
- Centre of Genomics and Policy, McGill University, Montreal, Canada.
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31
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Kaye J, Terry SF, Juengst E, Coy S, Harris JR, Chalmers D, Dove ES, Budin-Ljøsne I, Adebamowo C, Ogbe E, Bezuidenhout L, Morrison M, Minion JT, Murtagh MJ, Minari J, Teare H, Isasi R, Kato K, Rial-Sebbag E, Marshall P, Koenig B, Cambon-Thomsen A. Including all voices in international data-sharing governance. Hum Genomics 2018. [PMID: 29514717 PMCID: PMC5842530 DOI: 10.1186/s40246-018-0143-9] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Background Governments, funding bodies, institutions, and publishers have developed a number of strategies to encourage researchers to facilitate access to datasets. The rationale behind this approach is that this will bring a number of benefits and enable advances in healthcare and medicine by allowing the maximum returns from the investment in research, as well as reducing waste and promoting transparency. As this approach gains momentum, these data-sharing practices have implications for many kinds of research as they become standard practice across the world. Main text The governance frameworks that have been developed to support biomedical research are not well equipped to deal with the complexities of international data sharing. This system is nationally based and is dependent upon expert committees for oversight and compliance, which has often led to piece-meal decision-making. This system tends to perpetuate inequalities by obscuring the contributions and the important role of different data providers along the data stream, whether they be low- or middle-income country researchers, patients, research participants, groups, or communities. As research and data-sharing activities are largely publicly funded, there is a strong moral argument for including the people who provide the data in decision-making and to develop governance systems for their continued participation. Conclusions We recommend that governance of science becomes more transparent, representative, and responsive to the voices of many constituencies by conducting public consultations about data-sharing addressing issues of access and use; including all data providers in decision-making about the use and sharing of data along the whole of the data stream; and using digital technologies to encourage accessibility, transparency, and accountability. We anticipate that this approach could enhance the legitimacy of the research process, generate insights that may otherwise be overlooked or ignored, and help to bring valuable perspectives into the decision-making around international data sharing.
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Affiliation(s)
- Jane Kaye
- Centre for Health Law and Emerging Technologies, NDPH, University of Oxford, Ewert House, Ewert Place, Summertown, Oxford, OX2 7DD, UK. .,Melbourne Law School, University of Melbourne, 185 Pelham Street, Carlton, Victoria, 3053, Australia.
| | - Sharon F Terry
- Genetic Alliance USA, 4301 Connecticut Ave NW, Suite 404, Washington DC, 20008-2369, USA
| | - Eric Juengst
- Center for Bioethics, University of North Carolina at Chapel Hill, 333 McNider Hall, Chapel Hill, NC, 27599-7240, USA
| | - Sarah Coy
- Centre for Health Law and Emerging Technologies, NDPH, University of Oxford, Ewert House, Ewert Place, Summertown, Oxford, OX2 7DD, UK
| | - Jennifer R Harris
- Department of Genetics and Bioinformatics, Norwegian Institute of Public Health, PO Box 4404, Nydalen, 0403, Oslo, Norway
| | - Don Chalmers
- Faculty of Law, University of Tasmania, Private Bag 89, Hobart, Tasmania, 7001, Australia
| | - Edward S Dove
- School of Law, University of Edinburgh, Old College, South Bridge, Edinburgh, EH8 9YL, UK
| | - Isabelle Budin-Ljøsne
- Cohort Studies, Norwegian Institute of Public Health, PO Box 4404, Nydalen, 0403, Oslo, Norway
| | - Clement Adebamowo
- Center for Bioethics and Research, Ibadan, Nigeria.,Institute of Human Virology Nigeria, Abuja, Nigeria.,Greenebaum Comprehensive Cancer Center and Institute of Human Virology, University of Maryland School of Medicine, 725 W. Lombard St. Suite 445, Baltimore, MD, 21201, USA
| | - Emilomo Ogbe
- International Centre for Reproductive Health, University of Gent, De Pintepark II, De Pintelaan 185, 9000, Ghent, Belgium
| | - Louise Bezuidenhout
- Institute for Science, Innovation and Society, University of Oxford, 64 Banbury Road, Oxford, OX2 6PN, UK
| | - Michael Morrison
- Centre for Health Law and Emerging Technologies, NDPH, University of Oxford, Ewert House, Ewert Place, Summertown, Oxford, OX2 7DD, UK
| | - Joel T Minion
- Policy, Ethics and Life Sciences (PEALS) Research Centre, Newcastle University, Newcastle upon Tyne, NE1 7RU, UK
| | - Madeleine J Murtagh
- Policy, Ethics and Life Sciences (PEALS) Research Centre, Newcastle University, Newcastle upon Tyne, NE1 7RU, UK
| | - Jusaku Minari
- Uehiro Research Division for iPS Cell Ethics, Center for iPS Cell Research and Application, Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Harriet Teare
- Centre for Health Law and Emerging Technologies, NDPH, University of Oxford, Ewert House, Ewert Place, Summertown, Oxford, OX2 7DD, UK.,Melbourne Law School, University of Melbourne, 185 Pelham Street, Carlton, Victoria, 3053, Australia
| | - Rosario Isasi
- Institute for Bioethics and Health Policy, Department of Human Genetics, Leonard M. Miller School of Medicine, University of Miami, 1501 NW 10th Avenue, Biomedical Research Building (BRB) Room 361, Miami, FL, 33136, USA
| | - Kazuto Kato
- Department of Biomedical Ethics and Public Policy, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Emmanuelle Rial-Sebbag
- National Institute for Research and Health (Inserm), UMR 1027 Inserm, Toulouse University, 37 allées Jules Guesde, 31000, Toulouse, France
| | - Patricia Marshall
- Department of Bioethics, School of Medicine, TA200, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH, 44106-4976, USA
| | - Barbara Koenig
- UCSF School of Nursing, Institute for Health and Aging, University of California, San Francisco, 3333 Calif. St, Laurel Heights, San Francisco, CA, 94118, USA
| | - Anne Cambon-Thomsen
- CNRS, Toulouse, France; Joint research unit on epidemiology and public health, Inserm (National Institute for Health and Medical Research) and University Toulouse III Paul Sabatier, Toulouse, France
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“Bridge to the Literature”? Third-Party Genetic Interpretation Tools and the Views of Tool Developers. J Genet Couns 2018; 27:770-781. [DOI: 10.1007/s10897-018-0217-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Accepted: 01/15/2018] [Indexed: 12/14/2022]
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