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Song R. Waiving the consent requirement to mitigate bias in observational precision medicine research. Int J Equity Health 2024; 23:142. [PMID: 39026212 PMCID: PMC11256561 DOI: 10.1186/s12939-024-02221-4] [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: 10/21/2022] [Accepted: 06/25/2024] [Indexed: 07/20/2024] Open
Abstract
Consent bias is a type of selection bias in biomedical research where those consenting to the research differ systematically from those not consenting. It is particularly relevant in precision medicine research because the complexity of these studies prevents certain subgroups from understanding, trusting, and consenting to the research. Because consent bias distorts research findings and causes inequitable distribution of research benefits, scholars propose two types of schemes to reduce consent bias: reforming existing consent models and removing the consent requirement altogether. This study explores the possibility of waiving consent in observational studies using existing data, because they involve fewer risks to participants than clinical trials if privacy safeguards are strengthened. It suggests that data protection mechanisms such as security enhancement and data protection impact assessment should be conducted to protect data privacy of participants in observational studies without consent.
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Affiliation(s)
- Ruifeng Song
- Faculty of Law, The University of Hong Kong, Pokfulam, Hong Kong, China.
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From "Bad Blood" to "Racial Disparities:" Will Geriatric Psychiatrists Transcend the Wrongdoings of Tuskegee? Am J Geriatr Psychiatry 2022; 30:851-853. [PMID: 35835502 DOI: 10.1016/j.jagp.2022.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Black Parker C, McCall WV, Spearman-McCarthy EV, Rosenquist P, Cortese N. Clinicians' Racial Bias Contributing to Disparities in Electroconvulsive Therapy for Patients From Racial-Ethnic Minority Groups. Psychiatr Serv 2021; 72:684-690. [PMID: 33730880 DOI: 10.1176/appi.ps.202000142] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Patients from racial-ethnic minority groups undergo disparate electroconvulsive therapy (ECT) treatment compared with Caucasian peers. One leading hypothesis is that clinicians may unknowingly display racial bias when considering ECT for patients of color. Studies have consistently shown that patients of color face numerous racially driven, provider-level interpersonal and perceptual biases that contribute to clinicians incorrectly overdiagnosing them as having a psychotic-spectrum illness rather than correctly diagnosing a severe affective disorder. A patient's diagnosis marks the entry to evidence-based service delivery, and ECT is best indicated for severe affective disorders rather than for psychotic disorders. As a consequence of racially influenced clinician misdiagnosis, patients from racial-ethnic minority groups are underrepresented among those given severe affective diagnoses, which are most indicated for ECT referral. Evidence also suggests that clinicians may use racially biased treatment rationales when considering ECT after they have given a diagnosis of a severe affective or psychotic disorder, thereby producing secondary inequities in ECT referral. Increasing the use of gold-standard treatment algorithms when considering ECT for patients of color is contingent on clinicians transcending the limitations posed by aversive racism to develop culturally unbiased, clinically indicated diagnostic and treatment rationales.
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Affiliation(s)
- Carmen Black Parker
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut (Parker); Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, Augusta (McCall, Spearman-McCarthy, Rosenquist, Cortese)
| | - William V McCall
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut (Parker); Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, Augusta (McCall, Spearman-McCarthy, Rosenquist, Cortese)
| | - E Vanessa Spearman-McCarthy
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut (Parker); Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, Augusta (McCall, Spearman-McCarthy, Rosenquist, Cortese)
| | - Peter Rosenquist
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut (Parker); Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, Augusta (McCall, Spearman-McCarthy, Rosenquist, Cortese)
| | - Niayesh Cortese
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut (Parker); Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, Augusta (McCall, Spearman-McCarthy, Rosenquist, Cortese)
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Editor's Roundup for Issue #4 of 2020: Racial Disparities in Access to Electroconvulsive Therapy, an Effective and Safe Treatment. J ECT 2020; 36:225. [PMID: 33122501 DOI: 10.1097/yct.0000000000000730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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