1
|
Baliga S, Abou-Foul AK, Parente P, Szturz P, Thariat J, Shreenivas A, Nankivell P, Bertolini F, Biau J, Blakaj D, Brennan S, Brunet A, De Oliveira TB, Burtness B, Maseda AC, Chow VLY, Chua ML, de Ridder M, Garikipati S, Hanai N, Ho FCH, Huang SH, Kiyota N, Klinghammer K, Kowalski LP, Kwong DL, McDowell LJ, Merlano MC, Nair S, Economopoulou P, Overgaard J, Psyrri A, Tribius S, Waldron J, Yom SS, Mehanna H. Essential data variables for a minimum dataset for head and neck cancer trials and clinical research: HNCIG consensus recommendations and database. Eur J Cancer 2024; 203:114038. [PMID: 38579517 DOI: 10.1016/j.ejca.2024.114038] [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: 02/27/2024] [Accepted: 03/17/2024] [Indexed: 04/07/2024]
Abstract
The Head and Neck Cancer International Group (HNCIG) has undertaken an international modified Delphi process to reach consensus on the essential data variables to be included in a minimum database for HNC research. Endorsed by 19 research organisations representing 34 countries, these recommendations provide the framework to facilitate and harmonise data collection and sharing for HNC research. These variables have also been incorporated into a ready to use downloadable HNCIG minimum database, available from the HNCIG website.
Collapse
Affiliation(s)
- Sujith Baliga
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
| | - Ahmad K Abou-Foul
- Institute for Head and neck studies and education, University of Birmingham, UK.
| | - Pablo Parente
- Department of Otolaryngology and Head and Neck Surgery, Hospital Universitario Lucus Augusti, Lugo, Spain.
| | - Petr Szturz
- Medical Oncology, Department of Oncology, Lausanne University Hospital (CHUV), 1011 Lausanne, Switzerland; Faculty of Biology and Medicine, University of Lausanne (UNIL), 1011 Lausanne, Switzerland.
| | - Juliette Thariat
- Department of Radiation Oncology, Comprehensive Cancer Centre François Baclesse, Caen, France.
| | - Aditya Shreenivas
- Department of Hematology and Oncology, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA.
| | - Paul Nankivell
- Institute for Head and Neck Studies and Education, University of Birmingham, UK.
| | | | - Julian Biau
- INSERM U1240 IMoST, University of Clermont Auvergne, Clermont-Ferrand, France; Department of radiation therapy, Centre Jean Perrin, Clermont-Ferrand, France, University of Clermont Auvergne, Clermont-Ferrand, France.
| | | | | | - Aina Brunet
- Department of Otorhinolaryngology and Head and Neck Surgery, Hospital Universitari Bellvitge, Institut d'Investigacio Biomedica (IDIBELL), Barcelona, Spain.
| | | | - Barbara Burtness
- Department of Internal Medicine and Yale Cancer Center, Yale School of Medicine, CT, USA.
| | | | - Velda Ling-Yu Chow
- Department of Surgery, The University of Hong Kong, Hong Kong, SAR China.
| | - Melvin Lk Chua
- Oncology Academic Programme, Duke-NUS Medical School, Singapore; Division of Radiation Oncology, National Cancer Centre Singapore, Duke-NUS Medical School, Singapore.
| | - Mischa de Ridder
- Department of radiotherapy, University Medical Center Utrecht, the Netherlands.
| | | | - Nobuhiro Hanai
- Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Aichi, Japan.
| | | | - Shao Hui Huang
- Department of Radiation Oncology, Princess Margaret Cancer Centre / University of Toronto, Tornoto, Canada.
| | - Naomi Kiyota
- Cancer Center, Kobe Univesity Hospital, Kobe, Japan.
| | - Konrad Klinghammer
- Department of Hematology, Oncology and Cancer Immunology, Campus Benjamin Franklin Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin Hindenburgdamm, Berlin, Germany.
| | - Luiz P Kowalski
- Department of Head and Neck Surgery, University of São Paulo Medical School, São Paulo, Brazil; Department of Head and Neck Surgery and Otorhinolaryngology, A C Camargo Cancer Center, São Paulo, Brazil.
| | - Dora L Kwong
- Department of Clinical Oncology, Centre of Cancer Medicine, School of Clinical Medicine, LSK Faculty of Medicine, the University of Hong Kong, Hong Kong, SAR China.
| | - Lachlan J McDowell
- Faculty of Medicine, University of Queensland, Brisbane, Australia; Department of Radiation Oncology, Princess Alexandra Hospital, Woollongabba, Australia, University of Queensland, Brisbane, Australia.
| | | | - Sudhir Nair
- Department of Surgical Oncology, Advanced Centre for Treatment, Research and Education in Cancer, Tata Memorial Centre, Mumbai, India.
| | - Panagiota Economopoulou
- Medical Oncology Unit, 2nd Department of Internal Medicine, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece.
| | - Jens Overgaard
- Department of Experimental Clinical Oncology, Aarhus University Hospital, Denmark.
| | - Amanda Psyrri
- Medical Oncology Unit, 2nd Department of Internal Medicine, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece.
| | - Silke Tribius
- Hermann, Holthusen Institute of Radiation Oncology Asklepios Klinik St. Georg Asklepios Tumorzentrum, Hamburg, Germany.
| | - John Waldron
- Princess Margaret Cancer Center University of Toronto, Canada.
| | - Sue S Yom
- University of California San Francisco, San Francisco, CA, USA.
| | - Hisham Mehanna
- Institute for Head and neck studies and education, University of Birmingham, Birmingham, UK.
| |
Collapse
|
2
|
Ohta T, Hananoe A, Fukushima-Nomura A, Ashizaki K, Sekita A, Seita J, Kawakami E, Sakurada K, Amagai M, Koseki H, Kawasaki H. Best practices for multimodal clinical data management and integration: An atopic dermatitis research case. Allergol Int 2024; 73:255-263. [PMID: 38102028 DOI: 10.1016/j.alit.2023.11.006] [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: 05/12/2023] [Revised: 10/06/2023] [Accepted: 11/03/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND In clinical research on multifactorial diseases such as atopic dermatitis, data-driven medical research has become more widely used as means to clarify diverse pathological conditions and to realize precision medicine. However, modern clinical data, characterized as large-scale, multimodal, and multi-center, causes difficulties in data integration and management, which limits productivity in clinical data science. METHODS We designed a generic data management flow to collect, cleanse, and integrate data to handle different types of data generated at multiple institutions by 10 types of clinical studies. We developed MeDIA (Medical Data Integration Assistant), a software to browse the data in an integrated manner and extract subsets for analysis. RESULTS MeDIA integrates and visualizes data and information on research participants obtained from multiple studies. It then provides a sophisticated interface that supports data management and helps data scientists retrieve the data sets they need. Furthermore, the system promotes the use of unified terms such as identifiers or sampling dates to reduce the cost of pre-processing by data analysts. We also propose best practices in clinical data management flow, which we learned from the development and implementation of MeDIA. CONCLUSIONS The MeDIA system solves the problem of multimodal clinical data integration, from complex text data such as medical records to big data such as omics data from a large number of patients. The system and the proposed best practices can be applied not only to allergic diseases but also to other diseases to promote data-driven medical research.
Collapse
Affiliation(s)
- Tazro Ohta
- Medical Data Mathematical Reasoning Team, Advanced Data Science Project, RIKEN Information R&D and Strategy Headquarters, RIKEN, Kanagawa, Japan; Institute for Advanced Academic Research, Chiba University, Chiba, Japan; Department of Artificial Intelligence Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Ayaka Hananoe
- Medical Data Mathematical Reasoning Team, Advanced Data Science Project, RIKEN Information R&D and Strategy Headquarters, RIKEN, Kanagawa, Japan; Laboratory for Developmental Genetics, RIKEN Center for Integrative Medical Sciences, RIKEN, Kanagawa, Japan; Department of Dermatology, Keio University School of Medicine, Tokyo, Japan
| | | | - Koichi Ashizaki
- Laboratory for Developmental Genetics, RIKEN Center for Integrative Medical Sciences, RIKEN, Kanagawa, Japan; Department of Dermatology, Keio University School of Medicine, Tokyo, Japan; Advanced Data Science Project, RIKEN Information R&D and Strategy Headquarters, RIKEN, Kanagawa, Japan
| | - Aiko Sekita
- Laboratory for Developmental Genetics, RIKEN Center for Integrative Medical Sciences, RIKEN, Kanagawa, Japan
| | - Jun Seita
- Laboratory for Integrative Genomics, RIKEN Center for Integrative Medical Sciences, RIKEN, Kanagawa, Japan; Medical Data Deep Learning Team, Advanced Data Science Project, RIKEN Information R&D and Strategy Headquarters, RIKEN, Kanagawa, Japan; Medical Data Sharing Unit, Infrastructure Research and Development Division, RIKEN Information R&D and Strategy Headquarters, RIKEN, Saitama, Japan
| | - Eiryo Kawakami
- Medical Data Mathematical Reasoning Team, Advanced Data Science Project, RIKEN Information R&D and Strategy Headquarters, RIKEN, Kanagawa, Japan; Institute for Advanced Academic Research, Chiba University, Chiba, Japan; Department of Artificial Intelligence Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Kazuhiro Sakurada
- Advanced Data Science Project, RIKEN Information R&D and Strategy Headquarters, RIKEN, Kanagawa, Japan; Department of Extended Intelligence for Medicine, The Ishii-Ishibashi Laboratory, Keio University School of Medicine, Tokyo, Japan
| | - Masayuki Amagai
- Department of Dermatology, Keio University School of Medicine, Tokyo, Japan; Laboratory for Skin Homeostasis, RIKEN Center for Integrative Medical Sciences, RIKEN, Kanagawa, Japan
| | - Haruhiko Koseki
- Laboratory for Developmental Genetics, RIKEN Center for Integrative Medical Sciences, RIKEN, Kanagawa, Japan
| | - Hiroshi Kawasaki
- Laboratory for Developmental Genetics, RIKEN Center for Integrative Medical Sciences, RIKEN, Kanagawa, Japan; Department of Dermatology, Keio University School of Medicine, Tokyo, Japan; Laboratory for Skin Homeostasis, RIKEN Center for Integrative Medical Sciences, RIKEN, Kanagawa, Japan.
| |
Collapse
|
3
|
Kuo NIH, Perez-Concha O, Hanly M, Mnatzaganian E, Hao B, Di Sipio M, Yu G, Vanjara J, Valerie IC, de Oliveira Costa J, Churches T, Lujic S, Hegarty J, Jorm L, Barbieri S. Enriching Data Science and Health Care Education: Application and Impact of Synthetic Data Sets Through the Health Gym Project. JMIR MEDICAL EDUCATION 2024; 10:e51388. [PMID: 38227356 PMCID: PMC10828942 DOI: 10.2196/51388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 10/20/2023] [Accepted: 11/08/2023] [Indexed: 01/17/2024]
Abstract
Large-scale medical data sets are vital for hands-on education in health data science but are often inaccessible due to privacy concerns. Addressing this gap, we developed the Health Gym project, a free and open-source platform designed to generate synthetic health data sets applicable to various areas of data science education, including machine learning, data visualization, and traditional statistical models. Initially, we generated 3 synthetic data sets for sepsis, acute hypotension, and antiretroviral therapy for HIV infection. This paper discusses the educational applications of Health Gym's synthetic data sets. We illustrate this through their use in postgraduate health data science courses delivered by the University of New South Wales, Australia, and a Datathon event, involving academics, students, clinicians, and local health district professionals. We also include adaptable worked examples using our synthetic data sets, designed to enrich hands-on tutorial and workshop experiences. Although we highlight the potential of these data sets in advancing data science education and health care artificial intelligence, we also emphasize the need for continued research into the inherent limitations of synthetic data.
Collapse
Affiliation(s)
- Nicholas I-Hsien Kuo
- Centre for Big Data Research in Health, The University of New South Wales, Sydney, Australia
| | - Oscar Perez-Concha
- Centre for Big Data Research in Health, The University of New South Wales, Sydney, Australia
| | - Mark Hanly
- Centre for Big Data Research in Health, The University of New South Wales, Sydney, Australia
| | | | - Brandon Hao
- The University of New South Wales, Sydney, Australia
| | | | - Guolin Yu
- The University of New South Wales, Sydney, Australia
| | - Jash Vanjara
- The University of New South Wales, Sydney, Australia
| | | | - Juliana de Oliveira Costa
- Medicines Intelligence Research Program, School of Population Health, The University of New South Wales, Sydney, Australia
| | - Timothy Churches
- School of Clinical Medicine, University of New South Wales, Sydney, Australia
- Ingham Institute of Applied Medical Research, Liverpool, Sydney, Australia
| | - Sanja Lujic
- Centre for Big Data Research in Health, The University of New South Wales, Sydney, Australia
| | - Jo Hegarty
- Sydney Local Health District, Sydney, Australia
| | - Louisa Jorm
- Centre for Big Data Research in Health, The University of New South Wales, Sydney, Australia
| | - Sebastiano Barbieri
- Centre for Big Data Research in Health, The University of New South Wales, Sydney, Australia
| |
Collapse
|
4
|
Dellacasa C, Ortali M, Rossi E, Abu Attieh H, Osmo T, Puskaric M, Rinaldi E, Prasser F, Stellmach C, Cataudella S, Agarwal B, Mata Naranjo J, Scipione G. An innovative technological infrastructure for managing SARS-CoV-2 data across different cohorts in compliance with General Data Protection Regulation. Digit Health 2024; 10:20552076241248922. [PMID: 38766364 PMCID: PMC11100396 DOI: 10.1177/20552076241248922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 04/04/2024] [Indexed: 05/22/2024] Open
Abstract
Background The ORCHESTRA project, funded by the European Commission, aims to create a pan-European cohort built on existing and new large-scale population cohorts to help rapidly advance the knowledge related to the prevention of the SARS-CoV-2 infection and the management of COVID-19 and its long-term sequelae. The integration and analysis of the very heterogeneous health data pose the challenge of building an innovative technological infrastructure as the foundation of a dedicated framework for data management that should address the regulatory requirements such as the General Data Protection Regulation (GDPR). Methods The three participating Supercomputing European Centres (CINECA - Italy, CINES - France and HLRS - Germany) designed and deployed a dedicated infrastructure to fulfil the functional requirements for data management to ensure sensitive biomedical data confidentiality/privacy, integrity, and security. Besides the technological issues, many methodological aspects have been considered: Berlin Institute of Health (BIH), Charité provided its expertise both for data protection, information security, and data harmonisation/standardisation. Results The resulting infrastructure is based on a multi-layer approach that integrates several security measures to ensure data protection. A centralised Data Collection Platform has been established in the Italian National Hub while, for the use cases in which data sharing is not possible due to privacy restrictions, a distributed approach for Federated Analysis has been considered. A Data Portal is available as a centralised point of access for non-sensitive data and results, according to findability, accessibility, interoperability, and reusability (FAIR) data principles. This technological infrastructure has been used to support significative data exchange between population cohorts and to publish important scientific results related to SARS-CoV-2. Conclusions Considering the increasing demand for data usage in accordance with the requirements of the GDPR regulations, the experience gained in the project and the infrastructure released for the ORCHESTRA project can act as a model to manage future public health threats. Other projects could benefit from the results achieved by ORCHESTRA by building upon the available standardisation of variables, design of the architecture, and process used for GDPR compliance.
Collapse
Affiliation(s)
- Chiara Dellacasa
- HPC Department, CINECA Consorzio Interuniversitario,
Bologna, Italy
| | - Maurizio Ortali
- HPC Department, CINECA Consorzio Interuniversitario,
Bologna, Italy
| | - Elisa Rossi
- HPC Department, CINECA Consorzio Interuniversitario,
Bologna, Italy
| | - Hammam Abu Attieh
- Berlin Institute of Health (BIH), Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Thomas Osmo
- Département Archivage et Services aux Données (DASD), Centre Informatique National de l'Enseignement Supérieur (CINES), Montpellier, France
| | - Miroslav Puskaric
- High Performance Computing Center Stuttgart (HLRS), University of Stuttgart, Stuttgart, Germany
| | - Eugenia Rinaldi
- Berlin Institute of Health (BIH), Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Fabian Prasser
- Berlin Institute of Health (BIH), Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Caroline Stellmach
- Berlin Institute of Health (BIH), Charité – Universitätsmedizin Berlin, Berlin, Germany
| | | | - Bhaskar Agarwal
- HPC Department, CINECA Consorzio Interuniversitario,
Bologna, Italy
| | | | | |
Collapse
|
5
|
Bo ZH, Guo Y, Lyu J, Liang H, He J, Deng S, Xu F, Lou X, Dai Q. Relay learning: a physically secure framework for clinical multi-site deep learning. NPJ Digit Med 2023; 6:204. [PMID: 37925578 PMCID: PMC10625523 DOI: 10.1038/s41746-023-00934-4] [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: 04/04/2023] [Accepted: 09/25/2023] [Indexed: 11/06/2023] Open
Abstract
Big data serves as the cornerstone for constructing real-world deep learning systems across various domains. In medicine and healthcare, a single clinical site lacks sufficient data, thus necessitating the involvement of multiple sites. Unfortunately, concerns regarding data security and privacy hinder the sharing and reuse of data across sites. Existing approaches to multi-site clinical learning heavily depend on the security of the network firewall and system implementation. To address this issue, we propose Relay Learning, a secure deep-learning framework that physically isolates clinical data from external intruders while still leveraging the benefits of multi-site big data. We demonstrate the efficacy of Relay Learning in three medical tasks of different diseases and anatomical structures, including structure segmentation of retina fundus, mediastinum tumors diagnosis, and brain midline localization. We evaluate Relay Learning by comparing its performance to alternative solutions through multi-site validation and external validation. Incorporating a total of 41,038 medical images from 21 medical hosts, including 7 external hosts, with non-uniform distributions, we observe significant performance improvements with Relay Learning across all three tasks. Specifically, it achieves an average performance increase of 44.4%, 24.2%, and 36.7% for retinal fundus segmentation, mediastinum tumor diagnosis, and brain midline localization, respectively. Remarkably, Relay Learning even outperforms central learning on external test sets. In the meanwhile, Relay Learning keeps data sovereignty locally without cross-site network connections. We anticipate that Relay Learning will revolutionize clinical multi-site collaboration and reshape the landscape of healthcare in the future.
Collapse
Affiliation(s)
- Zi-Hao Bo
- School of Software, Tsinghua University, Beijing, China
- BNRist, Tsinghua University, Beijing, China
| | - Yuchen Guo
- BNRist, Tsinghua University, Beijing, China.
| | - Jinhao Lyu
- Department of Radiology, Chinese PLA General Hospital / Chinese PLA Medical School, Beijing, China
| | - Hengrui Liang
- Department of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Jianxing He
- Department of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Shijie Deng
- Department of Radiology, The 921st Hospital of Chinese PLA, Changsha, China
| | - Feng Xu
- School of Software, Tsinghua University, Beijing, China.
- BNRist, Tsinghua University, Beijing, China.
| | - Xin Lou
- Department of Radiology, Chinese PLA General Hospital / Chinese PLA Medical School, Beijing, China.
| | - Qionghai Dai
- BNRist, Tsinghua University, Beijing, China.
- Department of Automation, Tsinghua University, Beijing, China.
| |
Collapse
|
6
|
Tozzi AE, Croci I, Voicu P, Dotta F, Colafati GS, Carai A, Fabozzi F, Lacanna G, Premuselli R, Mastronuzzi A. A systematic review of data sources for artificial intelligence applications in pediatric brain tumors in Europe: implications for bias and generalizability. Front Oncol 2023; 13:1285775. [PMID: 38016063 PMCID: PMC10646175 DOI: 10.3389/fonc.2023.1285775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 10/16/2023] [Indexed: 11/30/2023] Open
Abstract
Introduction Europe works to improve cancer management through the use of artificialintelligence (AI), and there is a need to accelerate the development of AI applications for childhood cancer. However, the current strategies used for algorithm development in childhood cancer may have bias and limited generalizability. This study reviewed existing publications on AI tools for pediatric brain tumors, Europe's most common type of childhood solid tumor, to examine the data sources for developing AI tools. Methods We performed a bibliometric analysis of the publications on AI tools for pediatric brain tumors, and we examined the type of data used, data sources, and geographic location of cohorts to evaluate the generalizability of the algorithms. Results We screened 10503 publications, and we selected 45. A total of 34/45 publications developing AI tools focused on glial tumors, while 35/45 used MRI as a source of information to predict the classification and prognosis. The median number of patients for algorithm development was 89 for single-center studies and 120 for multicenter studies. A total of 17/45 publications used pediatric datasets from the UK. Discussion Since the development of AI tools for pediatric brain tumors is still in its infancy, there is a need to support data exchange and collaboration between centers to increase the number of patients used for algorithm training and improve their generalizability. To this end, there is a need for increased data exchange and collaboration between centers and to explore the applicability of decentralized privacy-preserving technologies consistent with the General Data Protection Regulation (GDPR). This is particularly important in light of using the European Health Data Space and international collaborations.
Collapse
Affiliation(s)
- Alberto Eugenio Tozzi
- Predictive and Preventive Medicine Research Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Ileana Croci
- Predictive and Preventive Medicine Research Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Paul Voicu
- Department of Neuroscience and Imaging, “SS Annunziata” Hospital, “G. D’Annunzio” University, Chieti, Italy
| | - Francesco Dotta
- Imaging Department, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | | | - Andrea Carai
- Department of Neurosciences, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Francesco Fabozzi
- Department of Hematology/Oncology, Cell and Gene Therapy, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Giuseppe Lacanna
- Predictive and Preventive Medicine Research Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Roberto Premuselli
- Department of Hematology/Oncology, Cell and Gene Therapy, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Angela Mastronuzzi
- Department of Hematology/Oncology, Cell and Gene Therapy, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| |
Collapse
|
7
|
Smit JAR, van der Graaf R, Mostert M, Vaartjes I, Zuidgeest M, Grobbee DE, van Delden JJM. Overcoming ethical and legal obstacles to data linkage in health research: stakeholder perspectives. Int J Popul Data Sci 2023; 8:2151. [PMID: 38414541 PMCID: PMC10898216 DOI: 10.23889/ijpds.v8i1.2151] [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] [Indexed: 02/29/2024] Open
Abstract
Introduction Data linkage for health research purposes enables the answering of countless new research questions, is said to be cost effective and less intrusive than other means of data collection. Nevertheless, health researchers are currently dealing with a complicated, fragmented, and inconsistent regulatory landscape with regard to the processing of data, and progress in health research is hindered. Aim We designed a qualitative study to assess what different stakeholders perceive as ethical and legal obstacles to data linkage for health research purposes, and how these obstacles could be overcome. Methods Two focus groups and eighteen semi-structured in-depth interviews were held to collect opinions and insights of various stakeholders. An inductive thematic analysis approach was used to identify overarching themes. Results This study showed that the ambiguity regarding the 'correct' interpretation of the law, the fragmentation of policies governing the processing of personal health data, and the demandingness of legal requirements are experienced as causes for the impediment of data linkage for research purposes by the participating stakeholders. To remove or reduce these obstacles authoritative interpretations of the laws and regulations governing data linkage should be issued. The participants furthermore encouraged the harmonisation of data linkage policies, as well as promoting trust and transparency and the enhancement of technical and organisational measures. Lastly, there is a demand for legislative and regulatory modifications amongst the participants. Conclusions To overcome the obstacles in data linkage for scientific research purposes, perhaps we should shift the focus from adapting the current laws and regulations governing data linkage, or even designing completely new laws, towards creating a more thorough understanding of the law and making better use of the flexibilities within the existing legislation. Important steps in achieving this shift could be clarification of the legal provisions governing data linkage by issuing authoritative interpretations, as well as the strengthening of ethical-legal oversight bodies.
Collapse
Affiliation(s)
- Julie-Anne R Smit
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Rieke van der Graaf
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Menno Mostert
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Ilonca Vaartjes
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Mira Zuidgeest
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Diederik E Grobbee
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Johannes J M van Delden
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| |
Collapse
|
8
|
Yao Y, Yang F. Overcoming personal information protection challenges involving real-world data to support public health efforts in China. Front Public Health 2023; 11:1265050. [PMID: 37808971 PMCID: PMC10559907 DOI: 10.3389/fpubh.2023.1265050] [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: 07/21/2023] [Accepted: 09/11/2023] [Indexed: 10/10/2023] Open
Abstract
In the information age, real-world data-based evidence can help extrapolate and supplement data from randomized controlled trials, which can benefit clinical trials and drug development and improve public health decision-making. However, the legitimate use of real-world data in China is limited due to concerns over patient confidentiality. The use of personal information is a core element of data governance in public health. In China's public health data governance, practical problems exist, such as balancing personal information protection and public value conflict. In 2021, China adopted the Personal Information Protection Law (PIPL) to provide a consistent legal framework for protecting personal information, including sensitive medical health data. Despite the PIPL offering critical legal safeguards for processing health data, further clarification is needed regarding specific issues, including the meaning of "separate consent," cross-border data transfer requirements, and exceptions for scientific research. A shift in the law and regulatory framework is necessary to advance public health research further and realize the potential benefits of combining real-world evidence and digital health while respecting privacy in the technological and demographic change era.
Collapse
Affiliation(s)
| | - Fei Yang
- School of Law, China Jiliang University, Hangzhou, China
| |
Collapse
|
9
|
Huth M, Arruda J, Gusinow R, Contento L, Tacconelli E, Hasenauer J. Accessibility of covariance information creates vulnerability in Federated Learning frameworks. Bioinformatics 2023; 39:btad531. [PMID: 37647639 PMCID: PMC10516515 DOI: 10.1093/bioinformatics/btad531] [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] [Received: 04/05/2023] [Revised: 06/27/2023] [Accepted: 08/28/2023] [Indexed: 09/01/2023] Open
Abstract
MOTIVATION Federated Learning (FL) is gaining traction in various fields as it enables integrative data analysis without sharing sensitive data, such as in healthcare. However, the risk of data leakage caused by malicious attacks must be considered. In this study, we introduce a novel attack algorithm that relies on being able to compute sample means, sample covariances, and construct known linearly independent vectors on the data owner side. RESULTS We show that these basic functionalities, which are available in several established FL frameworks, are sufficient to reconstruct privacy-protected data. Additionally, the attack algorithm is robust to defense strategies that involve adding random noise. We demonstrate the limitations of existing frameworks and propose potential defense strategies analyzing the implications of using differential privacy. The novel insights presented in this study will aid in the improvement of FL frameworks. AVAILABILITY AND IMPLEMENTATION The code examples are provided at GitHub (https://github.com/manuhuth/Data-Leakage-From-Covariances.git). The CNSIM1 dataset, which we used in the manuscript, is available within the DSData R package (https://github.com/datashield/DSData/tree/main/data).
Collapse
Affiliation(s)
- Manuel Huth
- Institute of Computational Biology, Helmholtz Munich, Neuherberg 85764, Germany
- Life and Medical Sciences Institute, Faculty of Mathematics and Natural Sciences, University of Bonn, Bonn 53115, Germany
| | - Jonas Arruda
- Life and Medical Sciences Institute, Faculty of Mathematics and Natural Sciences, University of Bonn, Bonn 53115, Germany
| | - Roy Gusinow
- Institute of Computational Biology, Helmholtz Munich, Neuherberg 85764, Germany
- Life and Medical Sciences Institute, Faculty of Mathematics and Natural Sciences, University of Bonn, Bonn 53115, Germany
| | - Lorenzo Contento
- Life and Medical Sciences Institute, Faculty of Mathematics and Natural Sciences, University of Bonn, Bonn 53115, Germany
| | - Evelina Tacconelli
- Division of Infectious Diseases, Department of Diagnostics and Public Health, University of Verona, Verona 37124, Italy
| | - Jan Hasenauer
- Life and Medical Sciences Institute, Faculty of Mathematics and Natural Sciences, University of Bonn, Bonn 53115, Germany
| |
Collapse
|
10
|
Clayton EW, Tritell AM, Thorogood AM. Avoiding Liability and Other Legal Land Mines in the Evolving Genomics Landscape. Annu Rev Genomics Hum Genet 2023; 24:333-346. [PMID: 36630592 DOI: 10.1146/annurev-genom-100722-021725] [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: 01/13/2023]
Abstract
This article reviews evolving legal implications for clinicians and researchers as genomics is used more widely in both the clinic and in translational research, reflecting rapid changes in scientific knowledge as well as the surrounding cultural and political environment. Professionals will face new and changing duties to make or act upon a genetic diagnosis, address direct-to-consumer genetic testing in patient care, consider the health implications of results for patients' family members, and recontact patients when test results change over time. Professional duties in reproductive genetic testing will need to be recalibrated in response to disruptive changes to reproductive rights in the United States. We also review the debate over who controls the flow of genetic information and who is responsible for its protection, considering the globally influential European Union General Data Protection Regulation and the rapidly evolving data privacy law landscape of the United States.
Collapse
Affiliation(s)
- Ellen Wright Clayton
- Department of Pediatrics and Center for Biomedical Ethics and Society, Vanderbilt University Medical Center, Nashville, Tennessee, USA;
- School of Law, Vanderbilt University, Nashville, Tennessee, USA;
| | - Alex M Tritell
- School of Law, Vanderbilt University, Nashville, Tennessee, USA;
| | | |
Collapse
|
11
|
Kuo NIH, Garcia F, Sönnerborg A, Böhm M, Kaiser R, Zazzi M, Polizzotto M, Jorm L, Barbieri S. Generating synthetic clinical data that capture class imbalanced distributions with generative adversarial networks: Example using antiretroviral therapy for HIV. J Biomed Inform 2023; 144:104436. [PMID: 37451495 DOI: 10.1016/j.jbi.2023.104436] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 06/24/2023] [Accepted: 06/30/2023] [Indexed: 07/18/2023]
Abstract
OBJECTIVE Clinical data's confidential nature often limits the development of machine learning models in healthcare. Generative adversarial networks (GANs) can synthesise realistic datasets, but suffer from mode collapse, resulting in low diversity and bias towards majority demographics and common clinical practices. This work proposes an extension to the classic GAN framework that includes a variational autoencoder (VAE) and an external memory mechanism to overcome these limitations and generate synthetic data accurately describing imbalanced class distributions commonly found in clinical variables. METHODS The proposed method generated a synthetic dataset related to antiretroviral therapy for human immunodeficiency virus (ART for HIV). We evaluated it based on five metrics: (1) accurately representing imbalanced class distribution; (2) the realism of the individual variables; (3) the realism among variables; (4) patient disclosure risk; and (5) the utility of the generated dataset for developing downstream machine learning models. RESULTS The proposed method overcomes the issue of mode collapse and generates a synthetic dataset that accurately describes imbalanced class distributions commonly found in clinical variables. The generated data has a patient disclosure risk of 0.095%, lower than the 9% threshold stated by Health Canada and the European Medicines Agency, making it suitable for distribution to the research community with high security. The generated data also has high utility, indicating the potential of the proposed method to enable the development of downstream machine learning algorithms for healthcare applications using synthetic data. CONCLUSION Our proposed extension to the classic GAN framework, which includes a VAE and an external memory mechanism, represents a promising approach towards generating synthetic data that accurately describe imbalanced class distributions commonly found in clinical variables. This method overcomes the limitations of GANs and creates more realistic datasets with higher patient cohort diversity, facilitating the development of downstream machine learning algorithms for healthcare applications.
Collapse
Affiliation(s)
- Nicholas I-Hsien Kuo
- Centre for Big Data Research in Health, the University of New South Wales, Sydney, Australia.
| | - Federico Garcia
- Instituto de Investigación Ibs.Granada, Spain; Hospital Universitario San Cecilio, Spain; CIBER de Enfermedades Infecciosas, Spain
| | | | | | - Rolf Kaiser
- Uniklinik Köln, Universität zu Köln, Germany
| | | | | | - Louisa Jorm
- Centre for Big Data Research in Health, the University of New South Wales, Sydney, Australia
| | - Sebastiano Barbieri
- Centre for Big Data Research in Health, the University of New South Wales, Sydney, Australia
| |
Collapse
|
12
|
Azizi Z, Lindner S, Shiba Y, Raparelli V, Norris CM, Kublickiene K, Herrero MT, Kautzky-Willer A, Klimek P, Gisinger T, Pilote L, El Emam K. A comparison of synthetic data generation and federated analysis for enabling international evaluations of cardiovascular health. Sci Rep 2023; 13:11540. [PMID: 37460705 DOI: 10.1038/s41598-023-38457-3] [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: 09/25/2022] [Accepted: 07/08/2023] [Indexed: 07/20/2023] Open
Abstract
Sharing health data for research purposes across international jurisdictions has been a challenge due to privacy concerns. Two privacy enhancing technologies that can enable such sharing are synthetic data generation (SDG) and federated analysis, but their relative strengths and weaknesses have not been evaluated thus far. In this study we compared SDG with federated analysis to enable such international comparative studies. The objective of the analysis was to assess country-level differences in the role of sex on cardiovascular health (CVH) using a pooled dataset of Canadian and Austrian individuals. The Canadian data was synthesized and sent to the Austrian team for analysis. The utility of the pooled (synthetic Canadian + real Austrian) dataset was evaluated by comparing the regression results from the two approaches. The privacy of the Canadian synthetic data was assessed using a membership disclosure test which showed an F1 score of 0.001, indicating low privacy risk. The outcome variable of interest was CVH, calculated through a modified CANHEART index. The main and interaction effect parameter estimates of the federated and pooled analyses were consistent and directionally the same. It took approximately one month to set up the synthetic data generation platform and generate the synthetic data, whereas it took over 1.5 years to set up the federated analysis system. Synthetic data generation can be an efficient and effective tool for enabling multi-jurisdictional studies while addressing privacy concerns.
Collapse
Affiliation(s)
- Zahra Azizi
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, 5252 De Maisonneuve Blvd, Office 2B.39, Montréal, QC, H4A 3S5, Canada
| | - Simon Lindner
- Department of Internal Medicine III, Division of Endocrinology and Metabolism, Gender Medicine Unit, Medical University of Vienna, Vienna, Austria
| | - Yumika Shiba
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, 5252 De Maisonneuve Blvd, Office 2B.39, Montréal, QC, H4A 3S5, Canada
- Faculty of Medicine, McGill University, Montreal, Canada
| | - Valeria Raparelli
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Colleen M Norris
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
- Heart and Stroke Strategic Clinical Networks, Alberta Health Services, Alberta, Canada
| | | | - Maria Trinidad Herrero
- Clinical & Experimental Neuroscience (NiCE-IMIB-IUIE), School of Medicine, University of Murcia, Murcia, Spain
| | - Alexandra Kautzky-Willer
- Department of Internal Medicine III, Division of Endocrinology and Metabolism, Gender Medicine Unit, Medical University of Vienna, Vienna, Austria
| | - Peter Klimek
- Section for Science of Complex Systems, CeMSIIS, Medical University of Vienna, Vienna, Austria
- Complexity Science Hub Vienna, Vienna, Austria
| | - Teresa Gisinger
- Division of Endocrinology and Metabolism, Medical University of Vienna, Vienna, Austria
| | - Louise Pilote
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, 5252 De Maisonneuve Blvd, Office 2B.39, Montréal, QC, H4A 3S5, Canada.
- Divisions of Clinical Epidemiology and General Internal Medicine, McGill University Health Centre Research Institute, Montreal, QC, Canada.
| | - Khaled El Emam
- Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada.
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada.
- Replica Analytics Ltd, Ottawa, ON, Canada.
| |
Collapse
|
13
|
D'Amico S, Dall’Olio D, Sala C, Dall’Olio L, Sauta E, Zampini M, Asti G, Lanino L, Maggioni G, Campagna A, Ubezio M, Russo A, Bicchieri ME, Riva E, Tentori CA, Travaglino E, Morandini P, Savevski V, Santoro A, Prada-Luengo I, Krogh A, Santini V, Kordasti S, Platzbecker U, Diez-Campelo M, Fenaux P, Haferlach T, Castellani G, Della Porta MG. Synthetic Data Generation by Artificial Intelligence to Accelerate Research and Precision Medicine in Hematology. JCO Clin Cancer Inform 2023; 7:e2300021. [PMID: 37390377 PMCID: PMC10569771 DOI: 10.1200/cci.23.00021] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 03/16/2023] [Accepted: 04/05/2023] [Indexed: 07/02/2023] Open
Abstract
PURPOSE Synthetic data are artificial data generated without including any real patient information by an algorithm trained to learn the characteristics of a real source data set and became widely used to accelerate research in life sciences. We aimed to (1) apply generative artificial intelligence to build synthetic data in different hematologic neoplasms; (2) develop a synthetic validation framework to assess data fidelity and privacy preservability; and (3) test the capability of synthetic data to accelerate clinical/translational research in hematology. METHODS A conditional generative adversarial network architecture was implemented to generate synthetic data. Use cases were myelodysplastic syndromes (MDS) and AML: 7,133 patients were included. A fully explainable validation framework was created to assess fidelity and privacy preservability of synthetic data. RESULTS We generated MDS/AML synthetic cohorts (including information on clinical features, genomics, treatment, and outcomes) with high fidelity and privacy performances. This technology allowed resolution of lack/incomplete information and data augmentation. We then assessed the potential value of synthetic data on accelerating research in hematology. Starting from 944 patients with MDS available since 2014, we generated a 300% augmented synthetic cohort and anticipated the development of molecular classification and molecular scoring system obtained many years later from 2,043 to 2,957 real patients, respectively. Moreover, starting from 187 MDS treated with luspatercept into a clinical trial, we generated a synthetic cohort that recapitulated all the clinical end points of the study. Finally, we developed a website to enable clinicians generating high-quality synthetic data from an existing biobank of real patients. CONCLUSION Synthetic data mimic real clinical-genomic features and outcomes, and anonymize patient information. The implementation of this technology allows to increase the scientific use and value of real data, thus accelerating precision medicine in hematology and the conduction of clinical trials.
Collapse
Affiliation(s)
| | | | - Claudia Sala
- Experimental, Diagnostic and Specialty Medicine—DIMES, Bologna, Italy
| | | | | | | | | | - Luca Lanino
- IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Giulia Maggioni
- IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | | | | | | | | | - Elena Riva
- IRCCS Humanitas Research Hospital, Milan, Italy
| | - Cristina A. Tentori
- IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Erica Travaglino
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | | | | | - Armando Santoro
- IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Iñigo Prada-Luengo
- Department of Computer Science & Center for Health Data Science, University of Copenhagen, Copenhagen, Denmark
| | - Anders Krogh
- Department of Computer Science & Center for Health Data Science, University of Copenhagen, Copenhagen, Denmark
| | - Valeria Santini
- Hematology, Azienda Ospedaliero-Universitaria Careggi & University of Florence, Florence, Italy
| | - Shahram Kordasti
- Hematology, Guy's Hospital & Comprehensive Cancer Centre, King's College, London, United Kingdom
- Hematology Department & Stem Cell Transplant Unit, DISCLIMO-Università Politecnica delle Marche, Ancona, Italy
| | - Uwe Platzbecker
- Medical Clinic and Policlinic 1, Hematology and Cellular Therapy, University Hospital Leipzig, Leipzig, Germany
| | - Maria Diez-Campelo
- Hematology Department, Hospital Universitario de Salamanca, Salamanca, Spain
| | - Pierre Fenaux
- Hematology and Bone Marrow Transplantation, Hôpital Saint-Louis/University Paris 7, Paris, France
| | | | - Gastone Castellani
- Department of Physics and Astronomy (DIFA), Bologna, Italy
- Experimental, Diagnostic and Specialty Medicine—DIMES, Bologna, Italy
| | - Matteo Giovanni Della Porta
- IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| |
Collapse
|
14
|
Baumgartner HA, Alessandroni N, Byers-Heinlein K, Frank MC, Hamlin JK, Soderstrom M, Voelkel JG, Willer R, Yuen F, Coles NA. How to build up big team science: a practical guide for large-scale collaborations. ROYAL SOCIETY OPEN SCIENCE 2023; 10:230235. [PMID: 37293356 PMCID: PMC10245199 DOI: 10.1098/rsos.230235] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 05/15/2023] [Indexed: 06/10/2023]
Abstract
The past decade has witnessed a proliferation of big team science (BTS), endeavours where a comparatively large number of researchers pool their intellectual and/or material resources in pursuit of a common goal. Despite this burgeoning interest, there exists little guidance on how to create, manage and participate in these collaborations. In this paper, we integrate insights from a multi-disciplinary set of BTS initiatives to provide a how-to guide for BTS. We first discuss initial considerations for launching a BTS project, such as building the team, identifying leadership, governance, tools and open science approaches. We then turn to issues related to running and completing a BTS project, such as study design, ethical approvals and issues related to data collection, management and analysis. Finally, we address topics that present special challenges for BTS, including authorship decisions, collaborative writing and team decision-making.
Collapse
Affiliation(s)
- Heidi A. Baumgartner
- Center for the Study of Language and Information, Stanford University, Stanford, CA, USA
| | | | | | - Michael C. Frank
- Department of Psychology, Stanford University, Stanford, CA, USA
| | - J. Kiley Hamlin
- Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Melanie Soderstrom
- Department of Psychology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Jan G. Voelkel
- Department of Sociology, Stanford University, Stanford, CA, USA
| | - Robb Willer
- Department of Sociology, Stanford University, Stanford, CA, USA
| | - Francis Yuen
- Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Nicholas A. Coles
- Center for the Study of Language and Information, Stanford University, Stanford, CA, USA
| |
Collapse
|
15
|
Garralda E, Laurie SA, Seymour L, de Vries EGE. Towards evidence-based response criteria for cancer immunotherapy. Nat Commun 2023; 14:3001. [PMID: 37225715 DOI: 10.1038/s41467-023-38837-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 05/17/2023] [Indexed: 05/26/2023] Open
Affiliation(s)
- Elena Garralda
- Research Unit, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - Scott A Laurie
- Division of Medical Oncology, The Ottawa Hospital Cancer Centre, Ottawa, Canada
| | - Lesley Seymour
- Canadian Cancer Trials Group, Queens University, Cancer Centre of South Eastern Ontario, Kingston, ON, Canada
| | - Elisabeth G E de Vries
- Department of Medical Oncology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
| |
Collapse
|
16
|
Bentzen HB, Olav HK, Ursin G. Maximizing the GDPR potential for data transfers: first in Europe. THE LANCET REGIONAL HEALTH. EUROPE 2023; 27:100600. [PMID: 36923519 PMCID: PMC10009713 DOI: 10.1016/j.lanepe.2023.100600] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 02/08/2023] [Accepted: 02/09/2023] [Indexed: 03/08/2023]
Affiliation(s)
- Heidi Beate Bentzen
- Cancer Registry of Norway, Oslo, Norway.,Centre for Medical Ethics, Faculty of Medicine, University of Oslo, Oslo, Norway
| | | | - Giske Ursin
- Cancer Registry of Norway, Oslo, Norway.,Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| |
Collapse
|
17
|
Casolino R, Johns AL, Courtot M, Lawlor RT, De Lorenzo F, Horgan D, Mateo J, Normanno N, Rubin M, Stein L, Subbiah V, Westphalen BC, Lawler M, Park K, Perdomo S, Yoshino T, Wu J, Biankin AV. Accelerating cancer omics and precision oncology in health care and research: a Lancet Oncology Commission. Lancet Oncol 2023; 24:123-125. [PMID: 36725142 DOI: 10.1016/s1470-2045(23)00007-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 01/05/2023] [Indexed: 02/01/2023]
Affiliation(s)
- Raffaella Casolino
- Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Glasgow G61 1BD, UK.
| | - Amber L Johns
- Garvan Institute of Medical Research and The Kinghorn Cancer Centre, Cancer Division, Sydney, NSW, Australia
| | | | - Rita T Lawlor
- ARC-NET Research Centre, University and Hospital Trust of Verona, Verona, Italy
| | | | - Denis Horgan
- European Alliance for Personalised Medicine, Brussels, Belgium
| | - Joaquin Mateo
- ESMO Translational Research and Precision Medicine Working Group, Lugano, Switzerland; Medical Oncology, Vall d'Hebron Institute of Oncology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Nicola Normanno
- Cell Biology and Biotherapy Unit, Istituto Nazionale Tumori "Fondazione G. Pascale"-IRCCS, Naples, Italy
| | - Mark Rubin
- Department for BioMedical Research, University of Bern, Bern, Switzerland; Bern Center for Precision Medicine, Inselspital, University Hospital of Bern, Bern, Switzerland
| | - Lincoln Stein
- Ontario Institute for Cancer Research, Toronto, ON, Canada
| | - Vivek Subbiah
- ESMO Translational Research and Precision Medicine Working Group, Lugano, Switzerland; Department of Investigational Cancer Therapeutics, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Benedikt C Westphalen
- ESMO Translational Research and Precision Medicine Working Group, Lugano, Switzerland; Department of Medicine III and Comprehensive Cancer Center, University Hospital, LMU Munich, Munich, Germany
| | - Mark Lawler
- Patrick G Johnston Centre for Cancer Research, Faculty of Medicine, Health and Life Sciences, Queen's University Belfast, Belfast, UK
| | - Keunchil Park
- Department of Thoracic/Head and Neck Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Sandra Perdomo
- Genomic Epidemiology Branch, International Agency for Research on Cancer, Lyon, France
| | - Takayuki Yoshino
- Department of Gastroenterology and Gastrointestinal Oncology and Division for the Promotion of Drug and Diagnostic Development, National Cancer Center Hospital East, Kashiwa, Japan
| | - Jianmin Wu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Center for Cancer Bioinformatics, Peking University Cancer Hospital & Institute, Beijing, China
| | - Andrew V Biankin
- Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Glasgow G61 1BD, UK; West of Scotland Pancreatic Unit, Glasgow Royal Infirmary, Glasgow, UK; South Western Sydney Clinical School, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| |
Collapse
|
18
|
Mohammadpour M, Delavari S, Kavosi Z, Peyravi M, Izadi R, Bastani P. The necessity revealed by COVID-19 pandemic: Paradigm shift of Iran's healthcare system. Front Public Health 2023; 11:1041123. [PMID: 36761138 PMCID: PMC9902771 DOI: 10.3389/fpubh.2023.1041123] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 01/04/2023] [Indexed: 01/26/2023] Open
Abstract
Background COVID-19 pandemic has resulted in drastic changes around the world, revealing vulnerable aspects of healthcare systems. This study aimed to explore how Iranian healthcare system experienced the paradigm shift during the pandemic and determine the aspects that need improvement during the pandemic era. Method This qualitative study was conducted in 2021. A framework analysis approach was used to analyze the content of the 19 semi-structured interviews with the healthcare system experts from Shiraz University of Medical Sciences (SUMS). The interviews' audio files changed into transcript after each session and data was saturated at the 19 interview. To increase the trustworthiness of the study, Guba and Lincoln's criteria including credibility, transferability, dependability, and confirmability were used. Goldsmith's five-step framework analysis was used applying MAX QDA version 10 software. Result Eight main themes and 20 subthemes were explored. The main themes included "strengthening the electronic health infrastructure," "research for evidence-based decision making," "dedicated financing to the pandemic," "prevention of disruption in the effective provision of services and medicines," "enriching the authority of the Ministry of Health by focusing on interactions," "recruiting, managing and empowering health human resources with attention to financial and non-financial incentives," "reforming educational approaches in training students in medical universities," as well as "lessons learned from neglected aspects." Conclusion To be ready to respond to a possible future pandemic and for a paradigm shift, bold steps must be taken to make fundamental changes in various aspects of the healthcare system including e-health development, evidence-based decision making, dedicated budgets for pandemics, reinforcement of interactions at the national and international level, as well as sufficient attention to healthcare workers from all financial, non-financial and educational aspects.
Collapse
Affiliation(s)
- Mohammadtaghi Mohammadpour
- Student Research Committee, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sajad Delavari
- Health Human Resources Research Center, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Kavosi
- Health Human Resources Research Center, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahmoudreza Peyravi
- Department of Health in Disasters and Emergencies, Health Human Resources Research Center, School of Management and Medical Informatics, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Reyhane Izadi
- Department of Health Care Management, School of Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Peivand Bastani
- Health Human Resources Research Center, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| |
Collapse
|
19
|
Scheibner J, Ienca M, Vayena E. Health data privacy through homomorphic encryption and distributed ledger computing: an ethical-legal qualitative expert assessment study. BMC Med Ethics 2022; 23:121. [PMID: 36451210 PMCID: PMC9713155 DOI: 10.1186/s12910-022-00852-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 10/28/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Increasingly, hospitals and research institutes are developing technical solutions for sharing patient data in a privacy preserving manner. Two of these technical solutions are homomorphic encryption and distributed ledger technology. Homomorphic encryption allows computations to be performed on data without this data ever being decrypted. Therefore, homomorphic encryption represents a potential solution for conducting feasibility studies on cohorts of sensitive patient data stored in distributed locations. Distributed ledger technology provides a permanent record on all transfers and processing of patient data, allowing data custodians to audit access. A significant portion of the current literature has examined how these technologies might comply with data protection and research ethics frameworks. In the Swiss context, these instruments include the Federal Act on Data Protection and the Human Research Act. There are also institutional frameworks that govern the processing of health related and genetic data at different universities and hospitals. Given Switzerland's geographical proximity to European Union (EU) member states, the General Data Protection Regulation (GDPR) may impose additional obligations. METHODS To conduct this assessment, we carried out a series of qualitative interviews with key stakeholders at Swiss hospitals and research institutions. These included legal and clinical data management staff, as well as clinical and research ethics experts. These interviews were carried out with two series of vignettes that focused on data discovery using homomorphic encryption and data erasure from a distributed ledger platform. RESULTS For our first set of vignettes, interviewees were prepared to allow data discovery requests if patients had provided general consent or ethics committee approval, depending on the types of data made available. Our interviewees highlighted the importance of protecting against the risk of reidentification given different types of data. For our second set, there was disagreement amongst interviewees on whether they would delete patient data locally, or delete data linked to a ledger with cryptographic hashes. Our interviewees were also willing to delete data locally or on the ledger, subject to local legislation. CONCLUSION Our findings can help guide the deployment of these technologies, as well as determine ethics and legal requirements for such technologies.
Collapse
Affiliation(s)
- James Scheibner
- grid.5801.c0000 0001 2156 2780Health Ethics and Policy Laboratory, Department of Health Sciences and Technology (D-HEST), ETH Zürich, Zurich, Switzerland ,grid.1014.40000 0004 0367 2697College of Business, Government and Law, Flinders University, Adelaide, Australia
| | - Marcello Ienca
- grid.5801.c0000 0001 2156 2780Health Ethics and Policy Laboratory, Department of Health Sciences and Technology (D-HEST), ETH Zürich, Zurich, Switzerland ,grid.5333.60000000121839049College of Humanities, EPFL, Lausanne, Switzerland
| | - Effy Vayena
- grid.5801.c0000 0001 2156 2780Health Ethics and Policy Laboratory, Department of Health Sciences and Technology (D-HEST), ETH Zürich, Zurich, Switzerland ,grid.5801.c0000 0001 2156 2780Department of Health Sciences and Technology, ETH Zürich, Zurich, Switzerland
| |
Collapse
|
20
|
Ling-Hu T, Rios-Guzman E, Lorenzo-Redondo R, Ozer EA, Hultquist JF. Challenges and Opportunities for Global Genomic Surveillance Strategies in the COVID-19 Era. Viruses 2022; 14:2532. [PMID: 36423141 PMCID: PMC9698389 DOI: 10.3390/v14112532] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 11/11/2022] [Accepted: 11/14/2022] [Indexed: 11/19/2022] Open
Abstract
Global SARS-CoV-2 genomic surveillance efforts have provided critical data on the ongoing evolution of the virus to inform best practices in clinical care and public health throughout the pandemic. Impactful genomic surveillance strategies generally follow a multi-disciplinary pipeline involving clinical sample collection, viral genotyping, metadata linkage, data reporting, and public health responses. Unfortunately, current limitations in each of these steps have compromised the overall effectiveness of these strategies. Biases from convenience-based sampling methods can obfuscate the true distribution of circulating variants. The lack of standardization in genotyping strategies and bioinformatic expertise can create bottlenecks in data processing and complicate interpretation. Limitations and inconsistencies in clinical and demographic data collection and sharing can slow the compilation and limit the utility of comprehensive datasets. This likewise can complicate data reporting, restricting the availability of timely data. Finally, gaps and delays in the implementation of genomic surveillance data in the public health sphere can prevent officials from formulating effective mitigation strategies to prevent outbreaks. In this review, we outline current SARS-CoV-2 global genomic surveillance methods and assess roadblocks at each step of the pipeline to identify potential solutions. Evaluating the current obstacles that impede effective surveillance can improve both global coordination efforts and pandemic preparedness for future outbreaks.
Collapse
Affiliation(s)
- Ted Ling-Hu
- Division of Infectious Diseases, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
- Center for Pathogen Genomics and Microbial Evolution, Robert J. Havey, MD Institute for Global Health, Northwestern University, Chicago, IL 60611, USA
| | - Estefany Rios-Guzman
- Division of Infectious Diseases, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
- Center for Pathogen Genomics and Microbial Evolution, Robert J. Havey, MD Institute for Global Health, Northwestern University, Chicago, IL 60611, USA
| | - Ramon Lorenzo-Redondo
- Division of Infectious Diseases, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
- Center for Pathogen Genomics and Microbial Evolution, Robert J. Havey, MD Institute for Global Health, Northwestern University, Chicago, IL 60611, USA
| | - Egon A. Ozer
- Division of Infectious Diseases, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
- Center for Pathogen Genomics and Microbial Evolution, Robert J. Havey, MD Institute for Global Health, Northwestern University, Chicago, IL 60611, USA
| | - Judd F. Hultquist
- Division of Infectious Diseases, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
- Center for Pathogen Genomics and Microbial Evolution, Robert J. Havey, MD Institute for Global Health, Northwestern University, Chicago, IL 60611, USA
| |
Collapse
|
21
|
Rajotte JF, Bergen R, Buckeridge DL, El Emam K, Ng R, Strome E. Synthetic data as an enabler for machine learning applications in medicine. iScience 2022; 25:105331. [DOI: 10.1016/j.isci.2022.105331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
|
22
|
Abstract
Human genetics can inform the biology and epidemiology of coronavirus disease 2019 (COVID-19) by pinpointing causal mechanisms that explain why some individuals become more severely affected by the disease upon infection by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus. Large-scale genetic association studies, encompassing both rare and common genetic variants, have used different study designs and multiple disease phenotype definitions to identify several genomic regions associated with COVID-19. Along with a multitude of follow-up studies, these findings have increased our understanding of disease aetiology and provided routes for management of COVID-19. Important emergent opportunities include the clinical translatability of genetic risk prediction, the repurposing of existing drugs, exploration of variable host effects of different viral strains, study of inter-individual variability in vaccination response and understanding the long-term consequences of SARS-CoV-2 infection. Beyond the current pandemic, these transferrable opportunities are likely to affect the study of many infectious diseases.
Collapse
Affiliation(s)
- Mari E K Niemi
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
| | - Mark J Daly
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
- Broad Institute, Cambridge, MA, USA
- Analytical and Translational Genetics Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Andrea Ganna
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland.
- Broad Institute, Cambridge, MA, USA.
- Analytical and Translational Genetics Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
| |
Collapse
|
23
|
Tachkov K, Zemplenyi A, Kamusheva M, Dimitrova M, Siirtola P, Pontén J, Nemeth B, Kalo Z, Petrova G. Barriers to Use Artificial Intelligence Methodologies in Health Technology Assessment in Central and East European Countries. Front Public Health 2022; 10:921226. [PMID: 35910914 PMCID: PMC9330148 DOI: 10.3389/fpubh.2022.921226] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 06/20/2022] [Indexed: 12/05/2022] Open
Abstract
The aim of this paper is to identify the barriers that are specifically relevant to the use of Artificial Intelligence (AI)-based evidence in Central and Eastern European (CEE) Health Technology Assessment (HTA) systems. The study relied on two main parallel sources to identify barriers to use AI methodologies in HTA in CEE, including a scoping literature review and iterative focus group meetings with HTx team members. Most of the other selected articles discussed AI from a clinical perspective (n = 25), and the rest are from regulatory perspective (n = 13), and transfer of knowledge point of view (n = 3). Clinical areas studied are quite diverse—from pediatric, diabetes, diagnostic radiology, gynecology, oncology, surgery, psychiatry, cardiology, infection diseases, and oncology. Out of all 38 articles, 25 (66%) describe the AI method and the rest are more focused on the utilization barriers of different health care services and programs. The potential barriers could be classified as data related, methodological, technological, regulatory and policy related, and human factor related. Some of the barriers are quite similar, especially concerning the technologies. Studies focusing on the AI usage for HTA decision making are scarce. AI and augmented decision making tools are a novel science, and we are in the process of adapting it to existing needs. HTA as a process requires multiple steps, multiple evaluations which rely on heterogenous data. Therefore, the observed range of barriers come as a no surprise, and experts in the field need to give their opinion on the most important barriers in order to develop recommendations to overcome them and to disseminate the practical application of these tools.
Collapse
Affiliation(s)
| | - Antal Zemplenyi
- Syreon Research Institute, Budapest, Hungary
- Center for Health Technology Assessment and Pharmacoeconomic Research, University of Pecs, Pecs, Hungary
| | - Maria Kamusheva
- Faculty of Pharmacy, Medical University of Sofia, Sofia, Bulgaria
| | - Maria Dimitrova
- Faculty of Pharmacy, Medical University of Sofia, Sofia, Bulgaria
| | - Pekka Siirtola
- Biomimetics and Intelligent Systems Group, University of Oulu, Oulu, Finland
| | - Johan Pontén
- Dental and Pharmaceutical Benefits Agency, Stockholm, Sweden
| | | | - Zoltan Kalo
- Syreon Research Institute, Budapest, Hungary
- Centre for Health Technology Assessment, Semmelweis University, Budapest, Hungary
| | - Guenka Petrova
- Faculty of Pharmacy, Medical University of Sofia, Sofia, Bulgaria
- *Correspondence: Guenka Petrova
| |
Collapse
|
24
|
Bentzen HB. Exchange of Human Data Across International Boundaries. Annu Rev Biomed Data Sci 2022; 5:233-250. [PMID: 35537460 DOI: 10.1146/annurev-biodatasci-122220-110811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
There is a need to share personal data across jurisdictional boundaries. However, the laws regulating such transfers are not harmonized, and sometimes even conflict, causing challenges and occasional data stalls. This review describes the legal landscape for transfer of human data across international boundaries. The European Union's data protection legislation is used as the starting point for illustrating the legislation of countries across the world, how these diverge, and one's options for exchanging human data internationally in a legally compliant manner. Expected final online publication date for the Annual Review of Biomedical Data Science, Volume 5 is August 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
Collapse
Affiliation(s)
- Heidi Beate Bentzen
- Norwegian Research Center for Computers and Law, Faculty of Law, and Centre for Medical Ethics, Faculty of Medicine, University of Oslo, Oslo, Norway;
| |
Collapse
|
25
|
Abstract
Questions of consent and public interest research loom large.
Collapse
Affiliation(s)
- Mahsa Shabani
- Metamedica, Faculty of Law and Criminology, Ghent University, Campus Aula, Ghent, Belgium
| |
Collapse
|
26
|
Ursin G, Bentzen HB. Open science and sharing personal data widely - legally impossible for Europeans? Acta Oncol 2021; 60:1555-1556. [PMID: 34797207 DOI: 10.1080/0284186x.2021.1995894] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Giske Ursin
- Cancer Registry of Norway, Oslo, Norway
- Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Heidi Beate Bentzen
- Cancer Registry of Norway, Oslo, Norway
- Norwegian Research Center for Computers and Law, Faculty of Law, University of Oslo, Oslo, Norway
| |
Collapse
|