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Hasner MC, van Opijnen MP, de Vos FYF, Cuppen E, Broekman MLD. Whole genome sequencing in (recurrent) glioblastoma: challenges related to informed consent procedures and data sharing. Acta Neurochir (Wien) 2024; 166:266. [PMID: 38874628 PMCID: PMC11178618 DOI: 10.1007/s00701-024-06158-z] [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: 03/18/2024] [Accepted: 06/04/2024] [Indexed: 06/15/2024]
Abstract
Increased use of whole genome sequencing (WGS) in neuro-oncology for diagnostics and research purposes necessitates a renewed conversation about informed consent procedures and governance structures for sharing personal health data. There is currently no consensus on how to obtain informed consent for WGS in this population. In this narrative review, we analyze the formats and contents of frameworks suggested in literature for WGS in oncology and assess their benefits and limitations. We discuss applicability, specific challenges, and legal context for patients with (recurrent) glioblastoma. This population is characterized by the rarity of the disease, extremely limited prognosis, and the correlation of the stage of the disease with cognitive abilities. Since this has implications for the informed consent procedure for WGS, we suggest that the content of informed consent should be tailor-made for (recurrent) glioblastoma patients.
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Affiliation(s)
- Mira C Hasner
- Department of Neurosurgery, Haaglanden Medical Center, The Hague, The Netherlands
| | - Mark P van Opijnen
- Department of Neurosurgery, Haaglanden Medical Center, The Hague, The Netherlands.
- Department of Cell and Chemical Biology, Leiden University Medical Center, Albinusdreef 2, Leiden, 2333 ZA, The Netherlands.
| | - Filip Y F de Vos
- Department of Medical Oncology, Utrecht University Medical Center, Utrecht, The Netherlands
| | - Edwin Cuppen
- Hartwig Medical Foundation, Amsterdam, The Netherlands
- Center for Molecular Medicine and Oncode Institute, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Marike L D Broekman
- Department of Neurosurgery, Haaglanden Medical Center, The Hague, The Netherlands
- Department of Cell and Chemical Biology, Leiden University Medical Center, Albinusdreef 2, Leiden, 2333 ZA, The Netherlands
- Department of Neurosurgery, Leiden University Medical Center, Leiden, The Netherlands
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Zebrack JE, Yang W, Milone M, Coppes MJ. Comparing the attitudes of physicians and non-physicians toward communicating a patient's BRCA1 mutation to a first-degree relative against a patient's wishes. J Community Genet 2022; 13:403-410. [PMID: 35596048 DOI: 10.1007/s12687-022-00591-2] [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: 02/05/2022] [Accepted: 05/14/2022] [Indexed: 11/29/2022] Open
Abstract
Although genetic testing can be vastly informative, it creates a dilemma if a patient does not want to disclose an abnormal genetic test to at-risk relatives. A sample of 200 participants from Nevada (100 physicians, 100 non-physicians) completed an 11-item questionnaire asking demographic information, familiarity with genetics and genetic testing, and opinions about a physician's role in a hypothetical case in which a patient does not wish to communicate her BRCA1 mutation to her sister. Although most respondents did not think the physician should notify the sister against the patient's wishes, more non-physicians (40%) than physicians (23%) contended that the physician should do so (p = 0.0119). Most respondents from both groups agreed that the physician should not have the legal duty to notify the sister, would not be morally justified in sharing genetic test results with the sister, but should have the right to notify a patient's relatives if the disease is "serious, preventable, and treatable." More non-physicians than physicians agreed that physicians should have an educational requirement on how to communicate genetic test results to patients and their family (88% vs 65%, p = 0.0002). Most physicians (70%) reported a familiarity/strong familiarity with genetic testing compared to non-physicians (33%; p < 0.0001). Future qualitative research should assess physicians' understanding of issues surrounding familial communication of genetic test results. Educational interventions to facilitate effective communication to patients and families are needed and welcomed by most physicians. Discrepancies between the attitudes of physicians and patients or the public need to be better understood and addressed.
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Affiliation(s)
| | - Wei Yang
- School of Public Health, University of Nevada, Reno, Reno, NV, USA
| | - Matthew Milone
- Legal Affairs, University of Nevada, Reno School of Medicine, Reno, NV, USA
| | - Max J Coppes
- Department of Pediatrics, University of Nevada, Reno School of Medicine, Reno, NV, USA
- Renown Children's Hospital, Reno, NV, USA
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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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Abstract
OBJECTIVE To review information concerning current federal genetic nondiscrimination laws to increase awareness and knowledge of these laws for oncology nurses. DATA SOURCES Genetic information nondiscrimination policy research, case law, professional organization Web sites, peer-reviewed journals. CONCLUSION Genetic nondiscrimination is addressed in four major federal laws. The need continues for comprehensive federal genetic nondiscrimination legislation, applicable to all Americans regardless of their genetic predisposition. IMPLICATIONS FOR NURSING PRACTICE Oncology nurses need to effectively advocate for patients and their families by interpreting and disseminating provisions and limitations contained in existing federal genetic discrimination laws.
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Childers CP, Childers KK, Maggard-Gibbons M, Macinko J. National Estimates of Genetic Testing in Women With a History of Breast or Ovarian Cancer. J Clin Oncol 2017; 35:3800-3806. [PMID: 28820644 DOI: 10.1200/jco.2017.73.6314] [Citation(s) in RCA: 228] [Impact Index Per Article: 32.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Purpose In the United States, 3.8 million women have a history of breast (BC) or ovarian cancer (OC). Up to 15% of cases are attributable to heritable mutations, which, if identified, provide critical knowledge for treatment and preventive care. It is unknown how many patients who are at high risk for these mutations have not been tested and how rates vary by risk criteria. Methods We used pooled cross-sectional data from three Cancer Control Modules (2005, 2010, 2015) of the National Health Interview Survey, a national in-person household interview survey. Eligible patients were adult females with a history of BC and/or OC meeting select 2017 National Comprehensive Cancer Network eligibility criteria on the basis of age of diagnosis and family history. Outcomes included the proportion of individuals reporting a history of discussing genetic testing with a health professional, being advised to undergo genetic testing, or undergoing genetic testing for BC or OC. Results Of 47,218 women, 2.7% had a BC history and 0.4% had an OC history. For BC, 35.6% met one or more select eligibility criteria; of those, 29.0% discussed, 20.2% were advised to undergo, and 15.3% underwent genetic testing. Testing rates for individual eligibility criteria ranged from 6.2% (relative with OC) to 18.2% (diagnosis ≤ 45 years of age). For OC, 15.1% discussed, 13.1% were advised to undergo, and 10.5% underwent testing. Using only four BC eligibility criteria and all patients with OC, an estimated 1.2 to 1.3 million individuals failed to receive testing. Conclusion Fewer than one in five individuals with a history of BC or OC meeting select National Cancer Comprehensive Network criteria have undergone genetic testing. Most have never discussed testing with a health care provider. Large national efforts are warranted to address this unmet need.
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Affiliation(s)
- Christopher P Childers
- Christopher P. Childers and Melinda Maggard-Gibbons, David Geffen School of Medicine at University of California-Los Angeles; Christopher P. Childers and James Macinko, Fielding School of Public Health at University of California-Los Angeles; and Kimberly K. Childers, Providence Health & Services Southern California, Los Angeles, California
| | - Kimberly K Childers
- Christopher P. Childers and Melinda Maggard-Gibbons, David Geffen School of Medicine at University of California-Los Angeles; Christopher P. Childers and James Macinko, Fielding School of Public Health at University of California-Los Angeles; and Kimberly K. Childers, Providence Health & Services Southern California, Los Angeles, California
| | - Melinda Maggard-Gibbons
- Christopher P. Childers and Melinda Maggard-Gibbons, David Geffen School of Medicine at University of California-Los Angeles; Christopher P. Childers and James Macinko, Fielding School of Public Health at University of California-Los Angeles; and Kimberly K. Childers, Providence Health & Services Southern California, Los Angeles, California
| | - James Macinko
- Christopher P. Childers and Melinda Maggard-Gibbons, David Geffen School of Medicine at University of California-Los Angeles; Christopher P. Childers and James Macinko, Fielding School of Public Health at University of California-Los Angeles; and Kimberly K. Childers, Providence Health & Services Southern California, Los Angeles, California
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