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Hardcastle F, Lyle K, Horton R, Samuel G, Weller S, Ballard L, Thompson R, De Paula Trindade LV, Gómez Urrego JD, Kochin D, Johnson T, Tatz-Wieder N, Redrup Hill E, Robinson Adams F, Eskandar Y, Harriss E, Tsosie KS, Dixon P, Mackintosh M, Nightingale L, Lucassen A. The ethical challenges of diversifying genomic data: A qualitative evidence synthesis. CAMBRIDGE PRISMS. PRECISION MEDICINE 2023; 2:e1. [PMID: 38549845 PMCID: PMC10953735 DOI: 10.1017/pcm.2023.20] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 07/28/2023] [Accepted: 08/17/2023] [Indexed: 09/07/2024]
Abstract
This article aims to explore the ethical issues arising from attempts to diversify genomic data and include individuals from underserved groups in studies exploring the relationship between genomics and health. We employed a qualitative synthesis design, combining data from three sources: 1) a rapid review of empirical articles published between 2000 and 2022 with a primary or secondary focus on diversifying genomic data, or the inclusion of underserved groups and ethical issues arising from this, 2) an expert workshop and 3) a narrative review. Using these three sources we found that ethical issues are interconnected across structural factors and research practices. Structural issues include failing to engage with the politics of knowledge production, existing inequities, and their effects on how harms and benefits of genomics are distributed. Issues related to research practices include a lack of reflexivity, exploitative dynamics and the failure to prioritise meaningful co-production. Ethical issues arise from both the structure and the practice of research, which can inhibit researcher and participant opportunities to diversify data in an ethical way. Diverse data are not ethical in and of themselves, and without being attentive to the social, historical and political contexts that shape the lives of potential participants, endeavours to diversify genomic data run the risk of worsening existing inequities. Efforts to construct more representative genomic datasets need to develop ethical approaches that are situated within wider attempts to make the enterprise of genomics more equitable.
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Affiliation(s)
- Faranak Hardcastle
- Clinical Ethics, Law and Society group (CELS), and Centre for Personalised Medicine, Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK
- Clinical Ethics, Law and Society (CELS), The NIHR Southampton Biomedical Research Centre, University of Southampton, Southampton, UK
| | - Kate Lyle
- Clinical Ethics, Law and Society group (CELS), and Centre for Personalised Medicine, Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK
- Clinical Ethics, Law and Society (CELS), The NIHR Southampton Biomedical Research Centre, University of Southampton, Southampton, UK
| | - Rachel Horton
- Clinical Ethics, Law and Society group (CELS), and Centre for Personalised Medicine, Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK
| | - Gabrielle Samuel
- Clinical Ethics, Law and Society group (CELS), and Centre for Personalised Medicine, Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK
- King’s College London, London, UK
| | - Susie Weller
- Clinical Ethics, Law and Society group (CELS), and Centre for Personalised Medicine, Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK
- Clinical Ethics, Law and Society (CELS), The NIHR Southampton Biomedical Research Centre, University of Southampton, Southampton, UK
| | - Lisa Ballard
- Clinical Ethics, Law and Society (CELS), The NIHR Southampton Biomedical Research Centre, University of Southampton, Southampton, UK
| | - Rachel Thompson
- Clinical Ethics, Law and Society group (CELS), and Centre for Personalised Medicine, Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK
| | - Luiz Valerio De Paula Trindade
- Clinical Ethics, Law and Society (CELS), The NIHR Southampton Biomedical Research Centre, University of Southampton, Southampton, UK
| | - José David Gómez Urrego
- Clinical Ethics, Law and Society (CELS), The NIHR Southampton Biomedical Research Centre, University of Southampton, Southampton, UK
| | - Daniel Kochin
- Clinical Ethics, Law and Society group (CELS), and Centre for Personalised Medicine, Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK
| | - Tess Johnson
- Clinical Ethics, Law and Society group (CELS), and Centre for Personalised Medicine, Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK
| | | | | | - Florence Robinson Adams
- Clinical Ethics, Law and Society group (CELS), and Centre for Personalised Medicine, Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK
- Centre for Science and Policy, University of Cambridge, Cambridge, UK
| | - Yoseph Eskandar
- Clinical Ethics, Law and Society group (CELS), and Centre for Personalised Medicine, Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK
| | - Eli Harriss
- Bodleian Health Care Libraries, University of Oxford, Oxford, UK
| | | | - Padraig Dixon
- Clinical Ethics, Law and Society group (CELS), and Centre for Personalised Medicine, Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | | | | | - Anneke Lucassen
- Clinical Ethics, Law and Society group (CELS), and Centre for Personalised Medicine, Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK
- Clinical Ethics, Law and Society (CELS), The NIHR Southampton Biomedical Research Centre, University of Southampton, Southampton, UK
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Green S, Prainsack B, Sabatello M. Precision medicine and the problem of structural injustice. MEDICINE, HEALTH CARE, AND PHILOSOPHY 2023; 26:433-450. [PMID: 37231234 PMCID: PMC10212228 DOI: 10.1007/s11019-023-10158-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/24/2023] [Indexed: 05/27/2023]
Abstract
Many countries currently invest in technologies and data infrastructures to foster precision medicine (PM), which is hoped to better tailor disease treatment and prevention to individual patients. But who can expect to benefit from PM? The answer depends not only on scientific developments but also on the willingness to address the problem of structural injustice. One important step is to confront the problem of underrepresentation of certain populations in PM cohorts via improved research inclusivity. Yet, we argue that the perspective needs to be broadened because the (in)equitable effects of PM are also strongly contingent on wider structural factors and prioritization of healthcare strategies and resources. When (and before) implementing PM, it is crucial to attend to how the organisation of healthcare systems influences who will benefit, as well as whether PM may present challenges for a solidaristic sharing of costs and risks. We discuss these issues through a comparative lens of healthcare models and PM-initiatives in the United States, Austria, and Denmark. The analysis draws attention to how PM hinges on-and simultaneously affects-access to healthcare services, public trust in data handling, and prioritization of healthcare resources. Finally, we provide suggestions for how to mitigate foreseeable negative effects.
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Affiliation(s)
- Sara Green
- Section for History and Philosophy of Science, Department of Science Education, University of Copenhagen, Niels Bohr Building (NBB), Universitetsparken 5, 2100 Copenhagen Ø, Denmark
- Centre for Medical Science and Technology Studies, Department of Public Health, University of Copenhagen, Oester Farimagsgade 5, 1014 Copengagen, Denmark
| | - Barbara Prainsack
- Department of Political Science, University of Vienna, Universitätsstraße 7, 1010 Vienna, Austria
- School of Social and Political Sciences, Faculty of Arts and Social Sciences, University of Sydney, Camperdown, NSW 2006 Australia
| | - Maya Sabatello
- Center for Precision Medicine and Genomics, Department of Medicine, Columbia University, New York, USA
- Division of Ethics, Department of Medical Humanities and Ethics, Columbia University, New York, USA
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3
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Cumyn A, Ménard JF, Barton A, Dault R, Lévesque F, Ethier JF. Patients' and Members of the Public's Wishes Regarding Transparency in the Context of Secondary Use of Health Data: Scoping Review. J Med Internet Res 2023; 25:e45002. [PMID: 37052967 PMCID: PMC10141314 DOI: 10.2196/45002] [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: 12/12/2022] [Revised: 02/09/2023] [Accepted: 03/03/2023] [Indexed: 03/06/2023] Open
Abstract
BACKGROUND Secondary use of health data has reached unequaled potential to improve health systems governance, knowledge, and clinical care. Transparency regarding this secondary use is frequently cited as necessary to address deficits in trust and conditional support and to increase patient awareness. OBJECTIVE We aimed to review the current published literature to identify different stakeholders' perspectives and recommendations on what information patients and members of the public want to learn about the secondary use of health data for research purposes and how and in which situations. METHODS Using PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines, we conducted a scoping review using Medline, CINAHL, PsycINFO, Scopus, Cochrane Library, and PubMed databases to locate a broad range of studies published in English or French until November 2022. We included articles reporting a stakeholder's perspective or recommendations of what information patients and members of the public want to learn about the secondary use of health data for research purposes and how or in which situations. Data were collected and analyzed with an iterative thematic approach using NVivo. RESULTS Overall, 178 articles were included in this scoping review. The type of information can be divided into generic and specific content. Generic content includes information on governance and regulatory frameworks, technical aspects, and scientific aims. Specific content includes updates on the use of one's data, return of results from individual tests, information on global results, information on data sharing, and how to access one's data. Recommendations on how to communicate the information focused on frequency, use of various supports, formats, and wording. Methods for communication generally favored broad approaches such as nationwide publicity campaigns, mainstream and social media for generic content, and mixed approaches for specific content including websites, patient portals, and face-to-face encounters. Content should be tailored to the individual as much as possible with regard to length, avoidance of technical terms, cultural competence, and level of detail. Finally, the review outlined 4 major situations where communication was deemed necessary: before a new use of data, when new test results became available, when global research results were released, and in the advent of a breach in confidentiality. CONCLUSIONS This review highlights how different types of information and approaches to communication efforts may serve as the basis for achieving greater transparency. Governing bodies could use the results: to elaborate or evaluate strategies to educate on the potential benefits; to provide some knowledge and control over data use as a form of reciprocity; and as a condition to engage citizens and build and maintain trust. Future work is needed to assess which strategies achieve the greatest outreach while striking a balance between meeting information needs and use of resources.
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Affiliation(s)
- Annabelle Cumyn
- Département de médecine, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada
- Groupe de recherche interdisciplinaire en informatique de la santé, Faculté des sciences/Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Jean-Frédéric Ménard
- Groupe de recherche interdisciplinaire en informatique de la santé, Faculté des sciences/Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada
- Faculté de droit, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Adrien Barton
- Groupe de recherche interdisciplinaire en informatique de la santé, Faculté des sciences/Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada
- Institut de recherche en informatique de Toulouse, Toulouse, France
| | - Roxanne Dault
- Groupe de recherche interdisciplinaire en informatique de la santé, Faculté des sciences/Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Frédérique Lévesque
- Groupe de recherche interdisciplinaire en informatique de la santé, Faculté des sciences/Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Jean-François Ethier
- Département de médecine, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada
- Groupe de recherche interdisciplinaire en informatique de la santé, Faculté des sciences/Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada
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Sabatello M, Martschenko DO, Cho MK, Brothers KB. Data sharing and community-engaged research. Science 2022; 378:141-143. [PMID: 36227983 PMCID: PMC10155868 DOI: 10.1126/science.abq6851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Data sharing must be accompanied by responsibility sharing.
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Affiliation(s)
- Maya Sabatello
- Center for Precision Medicine and Genomics at the Department of Medicine, Columbia University Irving Medical Center; Division of Ethics, Department of Medical Humanities and Ethics, Columbia University Irving Medical Center; New York, NY 10032, USA
| | - Daphne O Martschenko
- Stanford Center for Biomedical Ethics and Departments of Medicine and Pediatrics, Stanford Medicine, Stanford, CA 94305, USA
| | - Mildred K Cho
- Stanford Center for Biomedical Ethics and Departments of Medicine and Pediatrics, Stanford Medicine, Stanford, CA 94305, USA
| | - Kyle B Brothers
- Norton Children's Research Institute Affiliated with the University of Louisville School of Medicine, Louisville, KY 40202, USA
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Lemke AA, Esplin ED, Goldenberg AJ, Gonzaga-Jauregui C, Hanchard NA, Harris-Wai J, Ideozu JE, Isasi R, Landstrom AP, Prince AER, Turbitt E, Sabatello M, Schrier Vergano SA, Taylor MRG, Yu JH, Brothers KB, Garrison NA. Addressing underrepresentation in genomics research through community engagement. Am J Hum Genet 2022; 109:1563-1571. [PMID: 36055208 PMCID: PMC9502069 DOI: 10.1016/j.ajhg.2022.08.005] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The vision of the American Society of Human Genetics (ASHG) is that people everywhere will realize the benefits of human genetics and genomics. Implicit in that vision is the importance of ensuring that the benefits of human genetics and genomics research are realized in ways that minimize harms and maximize benefits, a goal that can only be achieved through focused efforts to address health inequities and increase the representation of underrepresented communities in genetics and genomics research. This guidance is intended to advance community engagement as an approach that can be used across the research lifecycle. Community engagement uniquely offers researchers in human genetics and genomics an opportunity to pursue that vision successfully, including by addressing underrepresentation in genomics research.
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Affiliation(s)
- Amy A Lemke
- Professional Practice and Social Implications Committee, American Society of Human Genetics, Rockville MD, USA; Professional Practice and Social Implications Community Engagement Guidance Writing Group, American Society of Human Genetics, Rockville, MD, USA; Norton Children's Research Institute, affiliated with the University of Louisville School of Medicine, Louisville, KY, USA.
| | - Edward D Esplin
- Professional Practice and Social Implications Committee, American Society of Human Genetics, Rockville MD, USA; Professional Practice and Social Implications Community Engagement Guidance Writing Group, American Society of Human Genetics, Rockville, MD, USA; Invitae, San Francisco, CA, USA
| | - Aaron J Goldenberg
- Professional Practice and Social Implications Community Engagement Guidance Writing Group, American Society of Human Genetics, Rockville, MD, USA; Department of Bioethics, Case Western Reserve University School of Medicine, Cleveland OH, USA
| | - Claudia Gonzaga-Jauregui
- Professional Practice and Social Implications Community Engagement Guidance Writing Group, American Society of Human Genetics, Rockville, MD, USA; International Laboratory for Human Genome Research, Laboratorio Internacional de Investigación sobre el Genoma Humano, Universidad Nacional Autónoma de México, Querétaro, México
| | - Neil A Hanchard
- Professional Practice and Social Implications Community Engagement Guidance Writing Group, American Society of Human Genetics, Rockville, MD, USA; Childhood Complex Disease Genomics Section, Center for Precision Health Research, National Human Genomics Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - Julie Harris-Wai
- Professional Practice and Social Implications Community Engagement Guidance Writing Group, American Society of Human Genetics, Rockville, MD, USA; University of California at San Francisco, Department of Social and Behavioral Sciences, Program on Bioethics, Institute for Health and Aging, San Francisco CA, USA
| | - Justin E Ideozu
- Professional Practice and Social Implications Committee, American Society of Human Genetics, Rockville MD, USA; Professional Practice and Social Implications Community Engagement Guidance Writing Group, American Society of Human Genetics, Rockville, MD, USA; Genomic Medicine, Genetic Research Center, AbbVie, Chicago, IL, USA
| | - Rosario Isasi
- Professional Practice and Social Implications Community Engagement Guidance Writing Group, American Society of Human Genetics, Rockville, MD, USA; Dr. J. T. Macdonald Foundation Department of Human Genetics, University of Miami Leonard M. Miller School of Medicine, Miami FL, USA; John P. Hussman Institute for Human Genomics, University of Miami Leonard M. Miller School of Medicine, Miami FL, USA
| | - Andrew P Landstrom
- Professional Practice and Social Implications Committee, American Society of Human Genetics, Rockville MD, USA; Professional Practice and Social Implications Community Engagement Guidance Writing Group, American Society of Human Genetics, Rockville, MD, USA; Department of Pediatrics, Division of Pediatric Cardiology, Duke University School of Medicine, Durham, NC, USA
| | - Anya E R Prince
- Professional Practice and Social Implications Community Engagement Guidance Writing Group, American Society of Human Genetics, Rockville, MD, USA; University of Iowa College of Law, Iowa City IA, USA
| | - Erin Turbitt
- Professional Practice and Social Implications Committee, American Society of Human Genetics, Rockville MD, USA; Professional Practice and Social Implications Community Engagement Guidance Writing Group, American Society of Human Genetics, Rockville, MD, USA; Discipline of Genetic Counselling, University of Technology Sydney, Ultimo NSW 2007, Australia
| | - Maya Sabatello
- Professional Practice and Social Implications Community Engagement Guidance Writing Group, American Society of Human Genetics, Rockville, MD, USA; Center for Precision Medicine and Genomics, Department of Medicine, Columbia University, New York, NY, USA; Division of Ethics, Department of Medical Humanities and Ethics, Columbia University, New York, NY, USA
| | - Samantha A Schrier Vergano
- Professional Practice and Social Implications Committee, American Society of Human Genetics, Rockville MD, USA; Professional Practice and Social Implications Community Engagement Guidance Writing Group, American Society of Human Genetics, Rockville, MD, USA; Division of Medical Genetics and Metabolism, Children's Hospital of The King's Daughters, Norfolk, VA, USA
| | - Matthew R G Taylor
- Professional Practice and Social Implications Committee, American Society of Human Genetics, Rockville MD, USA; Professional Practice and Social Implications Community Engagement Guidance Writing Group, American Society of Human Genetics, Rockville, MD, USA; Adult Medical Genetics Program, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Joon-Ho Yu
- Professional Practice and Social Implications Community Engagement Guidance Writing Group, American Society of Human Genetics, Rockville, MD, USA; Division of Genetic Medicine, Department of Pediatrics , University of Washington School of Medicine, Seattle, WA, USA; Division of Bioethics and Palliative Care, Department of Pediatrics , University of Washington School of Medicine, Seattle, WA, USA; Institute for Public Health Genetics, School of Public Health, University of Washington, Seattle, WA, USA; Treuman Katz Center for Pediatric Bioethics, Seattle Children's Hospital and Research Institute, Seattle, WA, USA
| | - Kyle B Brothers
- Professional Practice and Social Implications Committee, American Society of Human Genetics, Rockville MD, USA; Professional Practice and Social Implications Community Engagement Guidance Writing Group, American Society of Human Genetics, Rockville, MD, USA; Norton Children's Research Institute, affiliated with the University of Louisville School of Medicine, Louisville, KY, USA
| | - Nanibaa' A Garrison
- Professional Practice and Social Implications Committee, American Society of Human Genetics, Rockville MD, USA; Professional Practice and Social Implications Community Engagement Guidance Writing Group, American Society of Human Genetics, Rockville, MD, USA; Institute for Society and Genetics, University of California, Los Angeles, Los Angeles, CA, USA; Institute for Precision Health, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA; Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
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Erdmann A, Rehmann-Sutter C, Bozzaro C. Patients' and professionals' views related to ethical issues in precision medicine: a mixed research synthesis. BMC Med Ethics 2021; 22:116. [PMID: 34465328 PMCID: PMC8406914 DOI: 10.1186/s12910-021-00682-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 08/20/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Precision medicine development is driven by the possibilities of next generation sequencing, information technology and artificial intelligence and thus, raises a number of ethical questions. Empirical studies have investigated such issues from the perspectives of health care professionals, researchers and patients. We synthesize the results from these studies in this review. METHODS We used a systematic strategy to search, screen and assess the literature for eligibility related to our research question. The initial search for empirical studies in five data bases provided 665 different records and we selected 92 of these publications for inclusion in this review. Data were extracted in a spreadsheet and categorized into different topics representing the views on ethical issues in precision medicine. RESULTS Many patients and professionals expect high benefits from precision medicine and have a positive attitude towards it. However, patients and professionals also perceive some risks. Commonly perceived risks include: lack of evidence for accuracy of tests and efficacy of treatments; limited knowledge of patients, which makes informed consent more difficult; possible unavailability of access to precision medicine for underprivileged people and ethnic minorities; misuse of data by insurance companies and employers, potential of racial stigmatization due to genetic information; unwanted communication of incidental findings; changes in doctor-patient-relationship through focusing on data; and the problem that patients could feel under pressure to optimize their health. CONCLUSIONS National legislation and guidelines already minimize many risks associated with precision medicine. However, from our perspective some problems require more attention. Should hopes for precision medicine's benefits be fulfilled, then the ethical principle of justice would require an unlimited access to precision medicine for all people. The potential for autonomous patients' decisions must be greatly enhanced by improvements in patient education. Harm from test results must be avoided in any case by the highest possible data security level and communication guidelines. Changes in the doctor-patient relationship and the impact of precision medicine on the quality of life should be further investigated. Additionally, the cost-effectiveness of precision medicine should be further examined, in order to avoid malinvestment.
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Affiliation(s)
- Anke Erdmann
- Institute for Experimental Medicine, Medical Ethics Working Group, Kiel University (CAU), Kiel, Germany.
| | | | - Claudia Bozzaro
- Institute for Experimental Medicine, Medical Ethics Working Group, Kiel University (CAU), Kiel, Germany
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Sabatello M, Zhang Y, Chen Y, Appelbaum PS. In Different Voices: The Views of People with Disabilities about Return of Results from Precision Medicine Research. Public Health Genomics 2020; 23:42-53. [PMID: 32294660 DOI: 10.1159/000506599] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 02/16/2020] [Indexed: 12/18/2022] Open
Abstract
PURPOSE Returning genetic results to research participants is gaining momentum in the USA. It is believed to be an important step in exploring the impact of efforts to translate findings from research to bedside and public health benefits. Some also hope that this practice will incentivize research participation, especially among people from historically marginalized communities who are commonly underrepresented in research. However, research participants' interest in receiving nongenomic medical and nonmedical results that may emerge from precision medicine research (PMR) is understudied and no study to date has explored the views of people with disabilities about return of genomic and nongenomic results from PMR. METHODS In a national online survey of people with disabilities, participants were queried about their interest in receiving biological, environmental, and lifestyle results from PMR (n = 1,294). Analyses describe findings for all of the participants and comparisons for key demographic characteristics and disability subgroups. RESULTS The participants expressed high interest in biological and health-related results and less interest in other findings. However, the interest among the study participants was lower than that found in comparable studies of the general population. Moreover, this interest varied significantly across gender, race/ethnicity, and disability subgroups. Possible reasons for these differences are discussed. CONCLUSION Insofar as return of results from PMR may impact translational efforts, it is important to better understand the role of sociomedical marginalization in decisions about return of results from PMR and to develop strategies to address existing barriers.
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Affiliation(s)
- Maya Sabatello
- Center for Research on Ethical, Legal and Social Implications of Psychiatric, Neurologic and Behavioral Genetics, Department of Psychiatry, Columbia University, New York, New York, USA,
| | - Yuan Zhang
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Ying Chen
- Research Scientist and Biostatistician, New York State Psychiatric Institute, New York, New York, USA
| | - Paul S Appelbaum
- Center for Research on Ethical, Legal and Social Implications of Psychiatric, Neurologic and Behavioral Genetics, Department of Psychiatry, Columbia University, New York, New York, USA
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