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Dolan DD, Cho MK, Lee SSJ. Spotlighting Structural Constraints on Decisions About Participation in Genomic and Precision Medicine. AJOB Empir Bioeth 2024; 15:87-92. [PMID: 38776221 PMCID: PMC11180498 DOI: 10.1080/23294515.2024.2355893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/24/2024]
Affiliation(s)
- Deanne Dunbar Dolan
- Center for ELSI Resources and Analysis (CERA), Stanford University School of Medicine, Stanford, California, USA
| | - Mildred K Cho
- Stanford Center for Biomedical Ethics, Stanford University School of Medicine, Stanford, California, USA
| | - Sandra Soo-Jin Lee
- Division of Ethics, Department of Medical Humanities & Ethics, Columbia University, New York, New York, USA
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Gabel M, Denny A, Llibre-Guerra J, Morris JC, Phillips J, Vaidyanathan A. Remuneration and Recruitment of Study Participants for AD Cohort Studies From the General Public and From Minority Communities. Alzheimer Dis Assoc Disord 2023; 37:107-112. [PMID: 37145978 PMCID: PMC10239367 DOI: 10.1097/wad.0000000000000556] [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: 12/20/2022] [Accepted: 03/12/2023] [Indexed: 05/07/2023]
Abstract
INTRODUCTION Offering remuneration for participation in studies of aging and Alzheimer Disease (AD) may improve recruitment, particularly among minoritized and low-income groups. But remuneration may also raise ethical problems and reduce altruistic motivations for participation. METHODS A nationally representative sample of Americans (N=2030) with large (N=500) Black and Hispanic oversamples was asked about willingness to participate in a longitudinal AD cohort study after random assignment of remuneration ($0, $50/visit, $100/visit). Respondents were then asked about their perceived burden, risks, and societal contribution from participation. RESULTS An offer of remuneration increased willingness to participate, with no difference between $50 and $100. The increase was similar across racial, ethnic, and income groups. Remuneration did not affect perceived risks or altruistic benefits. Compensation caused Whites and Hispanics, but not Blacks, to lower the perceived burden. DISCUSSION Modest levels of remuneration are likely to improve recruitment to AD research studies without causing collateral ethical or motivation problems. Remuneration does not differentially enhance minority recruitment.
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Huebner H, Ruebner M, Kurbacher C, Hadji P, Hartkopf AD, Lux MP, Huober J, Uhrig S, Taran FA, Overkamp F, Tesch H, Häberle L, Lüftner D, Wallwiener M, Müller V, Beckmann MW, Hein A, Belleville E, Untch M, Janni W, Fehm TN, Kolberg HC, Wallwiener D, Brucker SY, Schneeweiss A, Ettl J, Fasching PA, Michel LL. Return of individual genomic research results within the PRAEGNANT multicenter registry study. Breast Cancer Res Treat 2023; 197:355-368. [PMID: 36409394 PMCID: PMC9822879 DOI: 10.1007/s10549-022-06795-x] [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: 07/26/2022] [Accepted: 10/30/2022] [Indexed: 11/22/2022]
Abstract
PURPOSE The PRAEGNANT study is a registry study for metastatic breast cancer patients, focusing on biomarker detection. Recently, within this study, genetic alterations in 37 breast cancer predisposition genes were analyzed and genetic findings were detected for 396 participants. The aim of this project was to return genetic results to the physicians and to analyze actions taken (e.g., disclosure of results to patients, validation of results, clinical impact, and impact on the patient's quality of life) using a questionnaire. METHODS 235 questionnaires were sent out to the study centers, with each questionnaire representing one patient with a genetic finding. The questionnaire consisted of twelve questions in the German language, referring to the disclosure of results, validation of test results, and their impact on treatment decisions and on the patient's quality of life. RESULTS 135 (57.5%) questionnaires were completed. Of these, 46 (34.1%) stated that results were returned to the patients. In 80.0% (N = 36) of cases where results were returned, the patient had not been aware of the finding previously. For 27 patients (64.3%), genetic findings had not been validated beforehand. All validation procedures (N = 15) were covered by the patients' health insurance. For 11 (25.0%) patients, physicians reported that the research results influenced current or future decision-making on treatment, and for 37.8% (N = 17) the results influenced whether family members will be genetically tested. CONCLUSION This study provides novel insights into the return of research results and into clinical and personal benefits of disclosure of genetic findings within a German registry.
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Affiliation(s)
- Hanna Huebner
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Matthias Ruebner
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Christian Kurbacher
- Department of Gynecology and Obstetrics, Medizinisches Zentrum Bonn Friedensplatz, Bonn, Germany
| | - Peyman Hadji
- Frankfurt Center for Bone Health, 60313 Frankfurt, Germany
| | - Andreas D. Hartkopf
- Department of Obstetrics and Gynecology, University of Tübingen, Tübingen, Germany
| | - Michael P. Lux
- Klinik Für Gynäkologie und Geburtshilfe Frauenklinik St. Louise, St. Josefs-Krankenhaus, Salzkotten, Kooperatives Brustzentrum Paderborn, Paderborn, Germany
| | - Jens Huober
- Department of Gynecology and Obstetrics, Ulm University Hospital, Ulm, Germany
| | - Sabrina Uhrig
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Florin-Andrei Taran
- Department of Obstetrics and Gynecology, University of Tübingen, Tübingen, Germany
| | | | - Hans Tesch
- Oncology Practice at Bethanien Hospital Frankfurt, Frankfurt, Germany
| | - Lothar Häberle
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany ,Biostatistics Unit, Department of Gynecology and Obstetrics, University Hospital Erlangen, Erlangen, Germany
| | - Diana Lüftner
- Immanuel Hospital Märkische Schweiz, Buckow, Germany ,Immanuel Campus Rüdersdorf/Medical University of Brandenburg, Brandenburg, Germany
| | - Markus Wallwiener
- Department of Obstetrics and Gynecology, University of Heidelberg, Heidelberg, Germany
| | - Volkmar Müller
- Department of Gynecology, Hamburg-Eppendorf University Medical Center, Hamburg, Germany
| | - Matthias W. Beckmann
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Alexander Hein
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | | | - Michael Untch
- Department of Gynecology and Obstetrics, Helios Clinics Berlin Buch, Berlin, Germany
| | - Wolfgang Janni
- Department of Gynecology and Obstetrics, Ulm University Hospital, Ulm, Germany
| | - Tanja N. Fehm
- Department of Gynecology and Obstetrics, University Hospital of Düsseldorf, Düsseldorf, Germany
| | | | - Diethelm Wallwiener
- Department of Obstetrics and Gynecology, University of Tübingen, Tübingen, Germany
| | - Sara Y. Brucker
- Department of Obstetrics and Gynecology, University of Tübingen, Tübingen, Germany
| | - Andreas Schneeweiss
- National Center for Tumor Diseases, University Hospital and German Cancer Research Center, Heidelberg, Germany
| | - Johannes Ettl
- Department of Obstetrics and Gynecology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Peter A. Fasching
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Laura L. Michel
- National Center for Tumor Diseases, University Hospital and German Cancer Research Center, Heidelberg, Germany
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Tsuchida A, Kigawa M, Matsumura K, Ito M, Tanaka T, Hamazaki K, Inadera H. Provision of educational events and subsequent questionnaire response rates in a large-scale birth cohort study from Japan. BMJ Open 2022; 12:e064229. [PMID: 36600436 PMCID: PMC9772631 DOI: 10.1136/bmjopen-2022-064229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES We examined whether providing educational events for participants in a birth cohort study would increase the response rates of study questionnaires. DESIGN Birth cohort study. SETTING Questionnaires were distributed and returned by post twice in 1 year. We developed and implemented two educational sessions; a Baby Food lecture for mothers with children around 8 months old (analysis 1) and a Eurythmic session for mothers with children around 1 year and 8 months old (analysis 2). Mothers with children over the target ages were not invited (not-invited group). The invited participants were divided into three groups: those who did not apply to attend (not-applied group), those who applied but did not attend (applied group), and those who applied and attended (attended group). PARTICIPANTS The participants were 5379 mother-child pairs registered with the Toyama Regional Center of the Japan Environment and Children's Study (JECS). OUTCOME MEASURE The outcome measure was return of the JECS questionnaire for 1 year old sent out after the Baby Food lecture and the JECS questionnaire for 2 years old sent out after the Eurythmic session. The questionnaires were returned to us by post. RESULTS The response rate for the attended group of the Baby Food lecture was 99.7%, and the odds ratio (OR) was significantly higher for this group than for the not-invited group (crude OR 24.54; 95% confidence interval (CI) 3.42 to 176.13; analysis 1). After the exclusion of participants who had previously attended the Baby Food lecture, the response rate for the attended group of the Eurythmic session was 97.8%, and the OR was significantly higher for this group than for the not-invited group (adjusted OR 5.66; 95% CI 1.93 to 16.54; analysis 2). CONCLUSION Providing educational events that are appropriate to the age and needs of the participants may increase questionnaire response rates in birth cohort studies. TRIAL REGISTRATION NUMBER UMIN 000030786.
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Affiliation(s)
- Akiko Tsuchida
- Department of Public Health, Faculty of Medicine, University of Toyama, Toyama, Japan
- Toyama Regional Center for Japan Environment and Children's Study, University of Toyama, Toyama, Japan
| | - Mika Kigawa
- Department of Public Health, Faculty of Medicine, University of Toyama, Toyama, Japan
- Department of Liberal Arts and Human Development, Kanagawa University of Human Services, Yokosuka, Japan
| | - Kenta Matsumura
- Department of Public Health, Faculty of Medicine, University of Toyama, Toyama, Japan
- Toyama Regional Center for Japan Environment and Children's Study, University of Toyama, Toyama, Japan
| | - Mika Ito
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Tomomi Tanaka
- Toyama Regional Center for Japan Environment and Children's Study, University of Toyama, Toyama, Japan
- Department of Pediatrics, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Kei Hamazaki
- Department of Public Health, Faculty of Medicine, University of Toyama, Toyama, Japan
- Department of Public Health, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Hidekuni Inadera
- Department of Public Health, Faculty of Medicine, University of Toyama, Toyama, Japan
- Toyama Regional Center for Japan Environment and Children's Study, University of Toyama, Toyama, Japan
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Oksas C, Brody JG, Brown P, Boronow KE, DeMicco E, Charlesworth A, Juarez M, Geiger S, Schantz SL, Woodruff TJ, Morello-Frosch R, Padula AM. Perspectives of peripartum people on opportunities for personal and collective action to reduce exposure to everyday chemicals: Focus groups to inform exposure report-back. ENVIRONMENTAL RESEARCH 2022; 212:113173. [PMID: 35351450 PMCID: PMC9244766 DOI: 10.1016/j.envres.2022.113173] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 02/15/2022] [Accepted: 03/22/2022] [Indexed: 05/30/2023]
Abstract
Participants in biomonitoring studies who receive personal exposure reports seek information to reduce exposures. Many chemical exposures are driven by systems-level policies rather than individual actions; therefore, change requires engagement in collective action. Participants' perceptions of collective action and use of report-back to support engagement remain unclear. We conducted virtual focus groups during summer 2020 in a diverse group of peripartum people from cohorts in the Environmental influences on Child Health Outcomes (ECHO) Program (N = 18). We assessed baseline exposure and collective action experience, and report-back preferences. Participants were motivated to protect the health of their families and communities despite significant time and cognitive burdens. They requested time-conscious tactics and accessible information to enable action to reduce individual and collective exposures. Participant input informed the design of digital report-back in the cohorts. This study highlights opportunities to shift responsibility from individuals to policymakers to reduce chemical exposures at the systems level.
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Affiliation(s)
- Catherine Oksas
- University of California San Francisco School of Medicine, San Francisco, CA, USA.
| | | | - Phil Brown
- Department of Sociology and Anthropology and Department of Health Sciences, Northeastern University, Boston, MA, USA.
| | | | - Erin DeMicco
- Program for Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, CA, USA.
| | - Annemarie Charlesworth
- Program for Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, CA, USA.
| | - Maribel Juarez
- Program for Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, CA, USA.
| | - Sarah Geiger
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA.
| | - Susan L Schantz
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Champaign, IL, USA.
| | - Tracey J Woodruff
- Program for Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, CA, USA.
| | - Rachel Morello-Frosch
- School of Public Health and Department of Environmental Science, Policy and Management University of California Berkeley, Berkeley, CA, USA.
| | - Amy M Padula
- Program for Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, CA, USA.
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Tschigg K, Consoli L, Biasiotto R, Mascalzoni D. Ethical, legal and social/societal implications (ELSI) of recall-by-genotype (RbG) and genotype-driven-research (GDR) approaches: a scoping review. Eur J Hum Genet 2022; 30:1000-1010. [PMID: 35705790 PMCID: PMC9437022 DOI: 10.1038/s41431-022-01120-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 03/17/2022] [Accepted: 05/05/2022] [Indexed: 11/29/2022] Open
Abstract
Recall by Genotype (RbG), Genotype-driven-recall (GDR), and Genotype-based-recall (GBR) strategies are increasingly used to conduct genomic or biobanking sub-studies that single out participants as eligible because of their specific individual genotypic information. However, existing regulatory and governance frameworks do not apply to all aspects of genotype-driven research approaches. The recall strategies disclose or withhold personal genotypic information with uncertain clinical utility. Accordingly, this scoping review aims to identify peculiar, explicit and implicit ethical, legal, and societal/social implications (ELSI) of RbG study designs. We conducted a systematic literature search of three electronic databases from November 2020 to February 2021. We investigated qualitative and quantitative research methods used to report ELSI aspects in RbG research. Congruent with other research findings, we identified a lack of qualitative research investigating the particular ELSI challenges with RbG. We included and analysed the content of twenty-five publications. We found a consensus on RbG posing significant ethical issues, dilemmas, barriers, concerns and societal challenges. However, we found that the approaches to disclosure and study-specific recall and communication strategies employed consent models and Return of Research Results (RoRR) policies varied considerably. Furthermore, we identified a high heterogeneity in perspectives of participants and experts about ELSI of study-specific RbG policies. Therefore, further fine-mapping through qualitative and empirical research is needed to draw conclusions and re-fine ELSI frameworks.
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Affiliation(s)
- Katharina Tschigg
- Department of Cellular, Computational, and Integrative Biology, University of Trento, Trento, Italy. .,Institute for Biomedicine & Affiliated Institute of the University of Lübeck, Eurac Research, Bolzano, Italy, Bozen, Italy.
| | - Luca Consoli
- Institute for Science in Society, Radboud University, Nijmegen, Netherlands
| | - Roberta Biasiotto
- Institute for Biomedicine & Affiliated Institute of the University of Lübeck, Eurac Research, Bolzano, Italy, Bozen, Italy.,Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Deborah Mascalzoni
- Institute for Biomedicine & Affiliated Institute of the University of Lübeck, Eurac Research, Bolzano, Italy, Bozen, Italy.,Department of Public Health and Caring Sciences, Center for Research Ethics and Bioethics, Uppsala University, Uppsala, Sweden
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Madrid SD, Blum-Barnett E, Lemke AA, Pan V, Paolino V, McGlynn EA, Burnett-Hartman AN. "A Gift to My Family for Their Future": Attitudes about Genetic Research Participation. Public Health Genomics 2022; 25:1-10. [PMID: 35545013 DOI: 10.1159/000524462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 04/01/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Broad participation in genetic research is needed to promote equitable advances in disease treatment and prevention. OBJECTIVES The objective of the study was to assess motivations for, and concerns about, genetic research participation. METHODS The Genetics in Research and Health Care Survey was sent in winter 2017-2018 to 57,331 adult Kaiser Permanente (KP) members from 7 US regions to assess attitudes about genetic testing in health care and research. The survey included an open-ended question on why members would or would not participate in genetic research. Open text responses to this question were coded in the qualitative analysis software Dedoose and analyzed using a thematic analysis approach. Code summaries were organized by major themes, subthemes, and exemplary quotes. RESULTS Of the 10,369 participants who completed the survey, 2,645 (25%) provided a comment describing reasons they would or would not participate in research involving genetic testing. Respondents who provided a text comment were 64% female, 49% non-Hispanic (NH) White, 17% Asian/Pacific Islander, 20% Hispanic, and 14% NH Black. The primary themes identified were (1) altruism; (2) decision-making and planning; (3) data use; and (4) data security. These major themes were consistent across each race and ethnic group. CONCLUSIONS To promote broad participation in genetic research, it is important that recruitment materials address the primary motivators for genetic research participation, including altruism and the potential use of results for personal decision-making. Study materials should also address concerns about possible misuse of genetic information and fears over potential data breaches.
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Affiliation(s)
- Sarah D Madrid
- Institute for Health Research, Kaiser Permanente Colorado, Aurora, Colorado, USA
| | - Erica Blum-Barnett
- Institute for Health Research, Kaiser Permanente Colorado, Aurora, Colorado, USA
| | - Amy A Lemke
- NorthShore University HealthSystem, Evanston, Illinois, USA
- Norton Children's Research Institute, University of Louisville School of Medicine, Louisville, Kentucky, USA
| | - Vivian Pan
- University of Illinois Cancer Center, Chicago, Illinois, USA
| | - Valerie Paolino
- Institute for Health Research, Kaiser Permanente Colorado, Aurora, Colorado, USA
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Schupmann W, Miner SA, Sullivan HK, Glover JR, Hall JE, Schurman SH, Berkman BE. Exploring the motivations of research participants who chose not to learn medically actionable secondary genetic findings about themselves. Genet Med 2021; 23:2281-2288. [PMID: 34326490 PMCID: PMC8633056 DOI: 10.1038/s41436-021-01271-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 06/29/2021] [Accepted: 06/30/2021] [Indexed: 11/24/2022] Open
Abstract
PURPOSE Proposals to return medically actionable secondary genetic findings (SFs) in the clinical and research settings have generated controversy regarding whether to solicit individuals' preferences about their "right not to know" genetic information. This study contributes to the debate by surveying research participants who have actively decided whether to accept or refuse SFs. METHODS Participants were drawn from a large National Institutes of Health (NIH) environmental health study. Participants who had accepted SFs (n = 148) or refused SFs (n = 83) were given more detailed information about the types of SFs researchers could return and were given an opportunity to revise their original decision. RESULTS Forty-one of 83 initial refusers (49.4%) opted to receive SFs following the informational intervention. Nearly 75% of these "reversible refusers" thought they had originally accepted SFs. The 50.6% of initial refusers who continued to refuse ("persistent refusers") demonstrated high levels of understanding of which SFs would be returned postintervention. The most prominent reason for refusing was concern about becoming worried or sad (43.8%). CONCLUSION This study demonstrates the need for a more robust informed consent process when soliciting research participants' preferences about receiving SFs. We also suggest that our data support implementing a default practice of returning SFs without actively soliciting preferences.
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Affiliation(s)
- Will Schupmann
- National Institutes of Health, Department of Bioethics, Bethesda, MD, USA
| | - Skye A Miner
- National Institutes of Health, Department of Bioethics, Bethesda, MD, USA
| | - Haley K Sullivan
- Graduate School of Arts and Sciences, Harvard University, Cambridge, MA, USA
| | | | - Janet E Hall
- National Institutes of Health, National Institute of Environmental Health Sciences, Clinical Research Branch, Durham, NC, USA
| | - Shepherd H Schurman
- National Institutes of Health, National Institute of Environmental Health Sciences, Clinical Research Branch, Durham, NC, USA
| | - Benjamin E Berkman
- National Institutes of Health, Department of Bioethics; National Human Genome Research Institute, Bethesda, MD, USA.
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Unselected Women's Experiences of Receiving Genetic Research Results for Hereditary Breast and Ovarian Cancer: A Qualitative Study. Genet Test Mol Biomarkers 2021; 25:741-748. [DOI: 10.1089/gtmb.2021.0115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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Return of individual research results from genomic research: A systematic review of stakeholder perspectives. PLoS One 2021; 16:e0258646. [PMID: 34748551 PMCID: PMC8575249 DOI: 10.1371/journal.pone.0258646] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 10/02/2021] [Indexed: 12/19/2022] Open
Abstract
Despite the plethora of empirical studies conducted to date, debate continues about whether and to what extent results should be returned to participants of genomic research. We aimed to systematically review the empirical literature exploring stakeholders’ perspectives on return of individual research results (IRR) from genomic research. We examined preferences for receiving or willingness to return IRR, and experiences with either receiving or returning them. The systematic searches were conducted across five major databases in August 2018 and repeated in April 2020, and included studies reporting findings from primary research regardless of method (quantitative, qualitative, mixed). Articles that related to the clinical setting were excluded. Our search identified 221 articles that met our search criteria. This included 118 quantitative, 69 qualitative and 34 mixed methods studies. These articles included a total number of 118,874 stakeholders with research participants (85,270/72%) and members of the general public (40,967/35%) being the largest groups represented. The articles spanned at least 22 different countries with most (144/65%) being from the USA. Most (76%) discussed clinical research projects, rather than biobanks. More than half (58%) gauged views that were hypothetical. We found overwhelming evidence of high interest in return of IRR from potential and actual genomic research participants. There is also a general willingness to provide such results by researchers and health professionals, although they tend to adopt a more cautious stance. While all results are desired to some degree, those that have the potential to change clinical management are generally prioritized by all stakeholders. Professional stakeholders appear more willing to return results that are reliable and clinically relevant than those that are less reliable and lack clinical relevance. The lack of evidence for significant enduring psychological harm and the clear benefits to some research participants suggest that researchers should be returning actionable IRRs to participants.
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Staunton C, Kösters M, Pramstaller PP, Mascalzoni D. Return of research results (RoRR) to the healthy CHRIS cohort: designing a policy with the participants. J Community Genet 2021; 12:577-592. [PMID: 34241790 PMCID: PMC8554916 DOI: 10.1007/s12687-021-00536-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 06/06/2021] [Indexed: 11/30/2022] Open
Abstract
Legal, financial and organizational challenges and the absence of coherent international guidelines and legal frameworks still discourage many genetic studies to share individual research results with their participants. Studies and institutions deciding to return genetic results will need to design their own study-specific return policy after due consideration of the ethical responsibilities. The Cooperative Health Research in South Tyrol (CHRIS) study, a healthy cohort study, did not foresee the return of individual genomic results during its baseline phase. However, as it was expected that the follow-up phase would generate an increasing amount of reliable genetic results, an update of the return of research results (RoRR) policy became necessary. To inform this revision, an empirical study using mixed methods was developed to investigate the views of CHRIS research participants (20), local general practitioners (3) and the local genetic counselling service (1). During the interviews, three different examples of potential genetic results with a very diverse potential impact on participants were presented: breast cancer, Parkinson disease and Huntington disease. The CHRIS participants also completed a short questionnaire, collecting personal information and asking for a self-evaluation of their knowledge about genetics. This study made it clear that research participants want to make autonomous decisions on the disclosure or non-disclosure of their results. While the motivations for participants' decisions were very diverse, we were able to identify several common criteria that had a strong influence on their choices. Providing information on these factors is crucial to enable participants to make truly informed decisions.
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Affiliation(s)
- Ciara Staunton
- Institute for Biomedicine, Eurac Research, Affiliated Institute of the University of Lübeck, Via Galvani 31, 39100, Bolzano, Italy
- School of Law, Middlesex University, Room WG35, The Burroughs, Hendon, London, NW4 4BT, UK
| | - Maria Kösters
- Institute for Biomedicine, Eurac Research, Affiliated Institute of the University of Lübeck, Via Galvani 31, 39100, Bolzano, Italy
| | - Peter P Pramstaller
- Institute for Biomedicine, Eurac Research, Affiliated Institute of the University of Lübeck, Via Galvani 31, 39100, Bolzano, Italy
- Department of Neurology, Central Hospital, 39100, Bolzano, Italy
| | - Deborah Mascalzoni
- Institute for Biomedicine, Eurac Research, Affiliated Institute of the University of Lübeck, Via Galvani 31, 39100, Bolzano, Italy.
- Department of Public Health and Caring Science, Uppsala University, CRB, P.O. Box 256, 751 05, Uppsala, Sweden.
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Return of individual research results: What do participants prefer and expect? PLoS One 2021; 16:e0254153. [PMID: 34324495 PMCID: PMC8320928 DOI: 10.1371/journal.pone.0254153] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 06/21/2021] [Indexed: 11/20/2022] Open
Abstract
Newer data platforms offer increased opportunity to share multidimensional health data with research participants, but the preferences of participants for which data to receive and how is evolving. Our objective is to describe the preferences and expectations of participants for the return of individual research results within Project Baseline Health Study (PBHS). The PBHS is an ongoing, multicenter, longitudinal cohort study with data from four initial enrollment sites. PBHS participants are recruited from the general population along with groups enriched for heart disease and cancer disease risk. Cross-sectional data on return of results were collected in 2017–2018 from an (1) in-person enrollment survey (n = 1,890), (2) benchmark online survey (n = 1,059), and (3) participant interviews (n = 21). The main outcomes included (1) preferences for type of information to be added next to returned results, (2) participant plans for sharing returned results with a non-study clinician, and (3) choice to opt-out of receiving genetic results. Results were compared by sociodemographic characteristics. Enrollment and benchmark survey respondents were 57.1% and 53.5% female, and 60.0% and 66.2% white, respectively. Participants preferred the following data types be added to returned results in the future: genetics (29.9%), heart imaging, (16.4%), study watch (15.8%), and microbiome (13.3%). Older adults (OR 0.60, 95% CI: 0.41–0.87) were less likely to want their genetic results returned next. Forty percent of participants reported that they would not share all returned results with their non–study clinicians. Black (OR 0.64, 95% CI 0.43–0.95) and Asian (OR 0.47, 95% CI 0.30–0.73) participants were less likely, and older participants more likely (OR 1.45–1.61), to plan to share all results with their clinician than their counterparts. At enrollment, 5.8% of participants opted out of receiving their genetics results. The study showed that substantial heterogeneity existed in participant’s preferences and expectations for return of results, and variations were related to sociodemographic characteristics.
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Abstract
ELSI (Ethical, Legal, and Social Issues) is a widely used acronym in the bioethics literature that encompasses a broad range of research examining the various impacts of science and technology on society. In Canada, GE3LS (Genetics, Ethical, Economic, Environmental, Legal, Social issues) is the term used to describe ELSI studies in the context of genetics and genomics research. It is intentionally more expansive in that GE3LS explicitly brings economic and environmental issues under its purview. ELSI/GE3LS research is increasingly relevant in recent years as there has been a greater emphasis on "translational research" that moves genomic discoveries from the bench to the clinic. The purpose of this chapter is to outline a range of ELSI-related work that might be conducted as part of a large scale genetics or genomics research project, and to provide some practical insights on how a scientific research team might incorporate a strong and effective ELSI program within its broader research mandate. We begin by describing the historical context of ELSI research and the development of GE3LS research in the Canadian context. We then illustrate how some ELSI research might unfold by outlining a variety of GE3LS research questions or content domains and the methodologies that might be employed in studying them. We conclude with some practical suggestions about how to build an effective ELSI/GE3LS team and focus within a broader scientific research program.
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14
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Viberg Johansson J, Bentzen HB, Shah N, Haraldsdóttir E, Jónsdóttir GA, Kaye J, Mascalzoni D, Veldwijk J. Publics’ preferences for sharing health data: a discrete choice experiment (Preprint). JMIR Med Inform 2021; 9:e29614. [PMID: 36260402 PMCID: PMC8406119 DOI: 10.2196/29614] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 05/11/2021] [Accepted: 05/17/2021] [Indexed: 01/17/2023] Open
Abstract
Background Digital technological development in the last 20 years has led to significant growth in digital collection, use, and sharing of health data. To maintain public trust in the digital society and to enable acceptable policy-making in the future, it is important to investigate people’s preferences for sharing digital health data. Objective The aim of this study is to elicit the preferences of the public in different Northern European countries (the United Kingdom, Norway, Iceland, and Sweden) for sharing health information in different contexts. Methods Respondents in this discrete choice experiment completed several choice tasks, in which they were asked if data sharing in the described hypothetical situation was acceptable to them. Latent class logistic regression models were used to determine attribute-level estimates and heterogeneity in preferences. We calculated the relative importance of the attributes and the predicted acceptability for different contexts in which the data were shared from the estimates. Results In the final analysis, we used 37.83% (1967/5199) questionnaires. All attributes influenced the respondents’ willingness to share health information (P<.001). The most important attribute was whether the respondents were informed about their data being shared. The possibility of opting out from sharing data was preferred over the opportunity to consent (opt-in). Four classes were identified in the latent class model, and the average probabilities of belonging were 27% for class 1, 32% for class 2, 23% for class 3, and 18% for class 4. The uptake probability varied between 14% and 85%, depending on the least to most preferred combination of levels. Conclusions Respondents from different countries have different preferences for sharing their health data regarding the value of a review process and the reason for their new use. Offering respondents information about the use of their data and the possibility to opt out is the most preferred governance mechanism.
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Affiliation(s)
- Jennifer Viberg Johansson
- Centre for Research Ethics & Bioethics, Department of Public Health and Caring Sciences, Uppsala Universitet, Uppsala, Sweden
| | - Heidi Beate Bentzen
- Norwegian Research Center for Computers and Law, Faculty of Law, University of Oslo, Oslo, Norway
| | - Nisha Shah
- Centre for Health, Law, and Emerging Technologies, Faculty of Law, University of Oxford, Oxford, United Kingdom
| | - Eik Haraldsdóttir
- Social Science Research Institute, University of Iceland, Reykjavik, Iceland
| | | | - Jane Kaye
- Centre for Health, Law, and Emerging Technologies, Faculty of Law, University of Oxford, Oxford, United Kingdom
- Centre for Health, Law and Emerging Technologies, Melbourne Law School, University of Melbourne, Melbourne, Australia
| | - Deborah Mascalzoni
- Centre for Research Ethics & Bioethics, Department of Public Health and Caring Sciences, Uppsala Universitet, Uppsala, Sweden
- Institute for Biomedicine, Bolzano, Italy
| | - Jorien Veldwijk
- Centre for Research Ethics & Bioethics, Department of Public Health and Caring Sciences, Uppsala Universitet, Uppsala, Sweden
- Erasmus School of Health Policy and Management, Erasmus University, Rotterdam, Netherlands
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15
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Vears DF, Minion JT, Roberts SJ, Cummings J, Machirori M, Murtagh MJ. Views on genomic research result delivery methods and informed consent: a review. Per Med 2021; 18:295-310. [PMID: 33822658 DOI: 10.2217/pme-2020-0139] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
There has been little discussion of the way genomic research results should be returned and how to obtain informed consent for this. We systematically searched the empirical literature, identifying 63 articles exploring stakeholder perspectives on processes for obtaining informed consent about return of results and/or result delivery. Participants, patients and members of the public generally felt they should choose which results are returned to them and how, ranging from direct (face-to-face, telephone) to indirect (letters, emails, web-based delivery) communication. Professionals identified inadequacies in result delivery processes in the research context. Our findings have important implications for ensuring participants are supported in deciding which results they wish to receive or, if no choice is offered, preparing them for potential research outcomes.
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Affiliation(s)
- Danya F Vears
- Melbourne Law School, University of Melbourne, Carlton 3052, Australia.,Biomedical Ethics Research Group, Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville 3052, Australia.,Center for Biomedical Ethics & Law, Department of Public Health & Primary Care, KU Leuven, Leuven 3000, Belgium.,Leuven Institute for Human Genetics & Society, Leuven 3000, Belgium
| | - Joel T Minion
- Policy, Ethics & Life Sciences (PEALS) Research Centre, Newcastle University, Newcastle NE1 7RU, UK
| | - Stephanie J Roberts
- Policy, Ethics & Life Sciences (PEALS) Research Centre, Newcastle University, Newcastle NE1 7RU, UK
| | - James Cummings
- School of Art, Media & American Studies, University of East Anglia, NR4 7TJ, UK
| | - Mavis Machirori
- School of Social & Political Sciences, University of Glasgow, G12 8QQ, UK
| | - Madeleine J Murtagh
- Policy, Ethics & Life Sciences (PEALS) Research Centre, Newcastle University, Newcastle NE1 7RU, UK.,School of Social & Political Sciences, University of Glasgow, G12 8QQ, UK
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16
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Sabatello M, Jackson Scroggins M, Goto G, Santiago A, McCormick A, Morris KJ, Daulton CR, Easter CL, Darien G. Structural Racism in the COVID-19 Pandemic: Moving Forward. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2021; 21:56-74. [PMID: 33345745 DOI: 10.1080/15265161.2020.1851808] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
The COVID-19 pandemic has taken a substantial human, social and economic toll globally, but its impact on Black/African Americans, Latinx, and American Indian/Alaska Native communities in the U.S. is unconscionable. As the U.S. continues to combat the current COVID-19 cycle and prepares for future pandemics, it will be critical to learn from and rectify past and contemporary wrongs. Drawing on experiences in genomic research and intersecting areas in medical ethics, health disparities, and human rights, this article considers three key COVID-19-related issues: research to identify remedies; testing, contact tracing and surveillance; and lingering health needs and disability. It provides a pathway for the future: community engagement to develop culturally-sensitive responses to the myriad genomic/bioethical dilemmas that arise, and the establishment of a Truth and Reconciliation Commission to transition the country from its contemporary state of segregation in healthcare and health outcomes into an equitable and prosperous society for all.
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17
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Abul-Husn NS, Soper ER, Braganza GT, Rodriguez JE, Zeid N, Cullina S, Bobo D, Moscati A, Merkelson A, Loos RJF, Cho JH, Belbin GM, Suckiel SA, Kenny EE. Implementing genomic screening in diverse populations. Genome Med 2021; 13:17. [PMID: 33546753 PMCID: PMC7863616 DOI: 10.1186/s13073-021-00832-y] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 01/14/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Population-based genomic screening has the predicted ability to reduce morbidity and mortality associated with medically actionable conditions. However, much research is needed to develop standards for genomic screening and to understand the perspectives of people offered this new testing modality. This is particularly true for non-European ancestry populations who are vastly underrepresented in genomic medicine research. Therefore, we implemented a pilot genomic screening program in the BioMe Biobank in New York City, where the majority of participants are of non-European ancestry. METHODS We initiated genomic screening for well-established genes associated with hereditary breast and ovarian cancer syndrome (HBOC), Lynch syndrome (LS), and familial hypercholesterolemia (FH). We evaluated and included an additional gene (TTR) associated with hereditary transthyretin amyloidosis (hATTR), which has a common founder variant in African ancestry populations. We evaluated the characteristics of 74 participants who received results associated with these conditions. We also assessed the preferences of 7461 newly enrolled BioMe participants to receive genomic results. RESULTS In the pilot genomic screening program, 74 consented participants received results related to HBOC (N = 26), LS (N = 6), FH (N = 8), and hATTR (N = 34). Thirty-three of 34 (97.1%) participants who received a result related to hATTR were self-reported African American/African (AA) or Hispanic/Latinx (HL), compared to 14 of 40 (35.0%) participants who received a result related to HBOC, LS, or FH. Among the 7461 participants enrolled after the BioMe protocol modification to allow the return of genomic results, 93.4% indicated that they would want to receive results. Younger participants, women, and HL participants were more likely to opt to receive results. CONCLUSIONS The addition of TTR to a pilot genomic screening program meant that we returned results to a higher proportion of AA and HL participants, in comparison with genes traditionally included in genomic screening programs in the USA. We found that the majority of participants in a multi-ethnic biobank are interested in receiving genomic results for medically actionable conditions. These findings increase knowledge about the perspectives of diverse research participants on receiving genomic results and inform the broader implementation of genomic medicine in underrepresented patient populations.
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Affiliation(s)
- Noura S Abul-Husn
- The Institute for Genomic Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Emily R Soper
- The Institute for Genomic Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Giovanna T Braganza
- The Institute for Genomic Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jessica E Rodriguez
- The Institute for Genomic Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Natasha Zeid
- Cardiogenetics, GeneDx Inc., Gaithersburg, MD, USA
| | - Sinead Cullina
- The Institute for Genomic Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Dean Bobo
- The Institute for Genomic Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Arden Moscati
- The Institute for Genomic Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Amanda Merkelson
- The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ruth J F Loos
- The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Judy H Cho
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Gillian M Belbin
- The Institute for Genomic Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sabrina A Suckiel
- The Institute for Genomic Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Eimear E Kenny
- The Institute for Genomic Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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18
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The ideological divide in confidence in science and participation in medical research. Sci Rep 2021; 11:3120. [PMID: 33542334 PMCID: PMC7862386 DOI: 10.1038/s41598-021-82516-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 01/19/2021] [Indexed: 01/30/2023] Open
Abstract
In the United States, the wide ideological divergence in public confidence in science poses a potentially significant problem for the scientific enterprise. We examine the behavioral consequences of this ideological divide for Americans' contributions to medical research. Based on a mass survey of American adults, we find that engagement in a wide range of medical research activities is a function of a latent propensity to participate. The propensity is systematically higher among liberals than among conservatives. A substantial part of this ideological divide is due to conservative Americans' lower confidence in science. These findings raise important issues for the recruitment of subjects for medical studies and the generalizability of results from such studies.
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19
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Broekstra R, Aris-Meijer J, Maeckelberghe E, Stolk R, Otten S. Demographic and prosocial intrapersonal characteristics of biobank participants and refusers: the findings of a survey in the Netherlands. Eur J Hum Genet 2021; 29:11-19. [PMID: 32737438 PMCID: PMC7852517 DOI: 10.1038/s41431-020-0701-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 06/03/2020] [Accepted: 07/07/2020] [Indexed: 11/09/2022] Open
Abstract
Research in genetics relies heavily on voluntary contributions of personal data. We aimed to acquire insights into the differences between participants and refusers of participation in a Dutch population-based biobank. Accordingly, we assessed the demographic and prosocial intrapersonal characteristics of respondents who participated (n = 2615) or refused to participate (n = 404) in the Lifelines biobank and databank. Our results indicated that health-related values critically influence participation decisions. The participation threshold for Lifelines was determined by an absence of health-related values and of trust in government. Therefore, considering these factors in communication and recruitment strategies could enhance participation in biomedical research. No indications were found of a stronger general prosociality of participants or their trust in researchers beyond the context of biobanking. This emphasizes the contextual understanding of the decision of participation in biobanking. Our findings may contribute to improving recruitment strategies by incorporating relevant values and/or highlighting prosocial benefits. Moreover, they foreground the need to address trust issues in collaborations between data repositories and commercial companies. Future research should explore how prosocial intrapersonal characteristics drive participation and withdrawal decisions and relate to contextual attributes.
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Affiliation(s)
- Reinder Broekstra
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
- Department of Social Psychology, Faculty of Behavioral and Social Sciences, University of Groningen, Groningen, The Netherlands.
| | - Judith Aris-Meijer
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Els Maeckelberghe
- Wenckebach Institute for Medical Education and Training, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Ronald Stolk
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Sabine Otten
- Department of Social Psychology, Faculty of Behavioral and Social Sciences, University of Groningen, Groningen, The Netherlands
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20
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Love-Nichols J, Uhlmann WR, Arscott P, Willer C, Hornsby W, Roberts JS. A survey of aortic disease biorepository participants' preferences for return of research genetic results. J Genet Couns 2020; 30:645-655. [PMID: 33319384 DOI: 10.1002/jgc4.1341] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 09/02/2020] [Accepted: 09/08/2020] [Indexed: 11/10/2022]
Abstract
There is ongoing debate on whether and what research genetic results to return to study participants. To date, no study in this area has focused on aortopathy populations despite known genes that are clinically actionable. Participants (n = 225, 79% male, mean age = 61 years) with an aortopathy were surveyed to assess preferences for receiving research genetic results. Participants were 'very' or 'extremely likely' to want results for pathogenic variants in aortopathy genes with implications for family members (81%) or that would change medical management (76%). Similarly, participants were 'very' or 'extremely likely' to want actionable secondary findings related to cancer (75%) or other cardiac diseases (70%). Significantly lower interest was observed for non-actionable findings-pathogenic variants in aortopathy genes that would not change medical management (51%) and variants of uncertain significance (38%) (p < .0001). Higher health and genomic literacy were positively associated with interest in actionable findings. Most participants (>63%) were accepting of any means of return; however, a substantial minority (18%-38%) deemed certain technological means unacceptable (e.g., patient portal). Over 90% of participants reported that a range of health professionals, including cardiovascular specialists, genetics specialists, and primary care providers, were acceptable to return results. Participants with aortopathies are highly interested in research genetic results perceived to be medically actionable for themselves or family members. Participants are accepting of a variety of means for returning results. Findings suggest that research participants should be asked what results are preferred at time of informed consent and that genetic counseling may clarify implications of results that are not personally medically actionable.
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Affiliation(s)
| | - Wendy R Uhlmann
- Department of Human Genetics, University of Michigan Medical School, Ann Arbor, MI, USA.,Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA.,Center for Bioethics and Social Sciences in Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Patricia Arscott
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Cristen Willer
- Department of Human Genetics, University of Michigan Medical School, Ann Arbor, MI, USA.,Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA.,Department of Computational Medicine and Bioinformatics, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Whitney Hornsby
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
| | - J Scott Roberts
- Center for Bioethics and Social Sciences in Medicine, University of Michigan, Ann Arbor, MI, USA.,Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, USA
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21
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Perceptions of best practices for return of results in an international survey of psychiatric genetics researchers. Eur J Hum Genet 2020; 29:231-240. [PMID: 33011736 PMCID: PMC7532738 DOI: 10.1038/s41431-020-00738-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 09/02/2020] [Accepted: 09/22/2020] [Indexed: 12/20/2022] Open
Abstract
Many research sponsors and genetic researchers agree that some medically relevant genetic findings should be offered to participants. The scarcity of research specific to returning genetic results related to psychiatric disorders hinders the ability to develop ethically justified and empirically informed guidelines for responsible return of results for these conditions. We surveyed 407 psychiatric genetics researchers from 39 countries to examine their perceptions of challenges to returning individual results and views about best practices for the process of offering and returning results. Most researchers believed that disclosure of results should be delayed if a patient-participant is experiencing significant psychiatric symptoms. Respondents felt that there is little research on the impact of returning results to participants with psychiatric disorders and agreed that return of psychiatric genetics results to patient-participants may lead to discrimination by insurance companies or other third parties. Almost half of researchers believed results should be returned through a participant's treating psychiatrist, but many felt that clinicians lack knowledge about how to manage genetic research results. Most researchers thought results should be disclosed by genetic counselors or medical geneticists and in person; however, almost half also supported disclosure via telemedicine. This is the first global survey to examine the perspectives of researchers with experience working with this patient population and with these conditions. Their perspectives can help inform the development of much-needed guidelines to promote responsible return of results related to psychiatric conditions to patients with psychiatric disorders.
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22
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Hong SJ, Drake B, Goodman M, Kaphingst KA. Race, Trust in Doctors, Privacy Concerns, and Consent Preferences for Biobanks. HEALTH COMMUNICATION 2020; 35:1219-1228. [PMID: 31167570 PMCID: PMC6893100 DOI: 10.1080/10410236.2019.1623644] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
This study investigates how patients' privacy concerns about research uses of biospecimen and trust in doctors are associated with their preferences for informed consent and need for control over biospecimens in a biobank. Particularly, this study focuses on the perspectives of Communication Privacy Management theory, precision medicine, and racial health disparities. We recruited 358 women aged 40 and older stratified by race (56% African American and 44% European American). Multivariable linear regression models examined hypothesis and research questions. Individuals' privacy concerns and trust in doctors were significantly associated with their need for control. Although participants' privacy concerns were positively associated with their preference for study-specific model, trust in doctors had no effect on the preference. African American participants needed more control over their sample and were more likely to prefer study-specific model compared to European American participants. Significant interactions by race on the associations between trust and need for control and between privacy concerns and preference for study-specific model were found. These findings suggest that when developing large diverse biobanks for future studies it is important to consider privacy concerns, trust, and need for control with an understanding that there are differences in preferences by race.
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Affiliation(s)
- Soo Jung Hong
- Department of Communications and New Media, National University of Singapore, Singapore
| | - Bettina Drake
- Division of Public Health Sciences, Washington University School of Medicine, St. Louis, MO
| | - Melody Goodman
- Department of Biostatistics, NYU College of Global Public Health, New York City, NY
| | - Kimberly A. Kaphingst
- Department of Communication, University of Utah, Salt Lake City, UT
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT
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23
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Moriarty K, Wolf SM, Veach PM, LeRoy B, MacFarlane IM, Zierhut HA. A roadmap for precision medicine research recruitment: empirical assessment of the public's willingness to participate. Per Med 2020; 17:345-359. [PMID: 32804044 DOI: 10.2217/pme-2019-0125] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Aim: Precision medicine research recruitment poses challenges. To better understand factors impacting recruitment, this study assessed hypothetical willingness, public opinions of and familiarity with precision medicine research. Materials & methods: Adult attendees (n = 942) at the 2017 Minnesota State Fair completed an electronic survey. Results: Few respondents had heard of 'precision medicine' (18%), and familiarity came mostly from media (43%). Fifty-six percent expressed hypothetical willingness to participate in precision medicine research. Significant predictors of willingness were: comfort with unconditional research; perceiving precision medicine research as beneficial, trustworthy and confidential; having a graduate degree; comfort with self- but not family-participation; and familiarity with precision/personalized medicine. Conclusion: This study identified predictors of hypothetical willingness to participate in precision medicine research. Alternative recruitment strategies are needed.
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Affiliation(s)
- Kelsey Moriarty
- Department of Genetics, Cell Biology & Development, University of Minnesota - Twin Cities, Minneapolis, MN 55455 USA
| | - Susan M Wolf
- Law School, Medical School & Consortium on Law & Values in Health, Environment & The Life Sciences, University of Minnesota - Twin Cities, Minneapolis, MN 55455 USA
| | - Patricia M Veach
- Department of Genetics, Cell Biology & Development, University of Minnesota - Twin Cities, Minneapolis, MN 55455 USA
| | - Bonnie LeRoy
- Department of Genetics, Cell Biology & Development, University of Minnesota - Twin Cities, Minneapolis, MN 55455 USA
| | - Ian M MacFarlane
- Department of Psychology, Elizabethtown College, Elizabethtown, PA 17022 USA
| | - Heather A Zierhut
- Department of Genetics, Cell Biology & Development, University of Minnesota - Twin Cities, Minneapolis, MN 55455 USA
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24
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Beskow LM, Hammack-Aviran CM, Brelsford KM. Developing model biobanking consent language: what matters to prospective participants? BMC Med Res Methodol 2020; 20:119. [PMID: 32414333 PMCID: PMC7227271 DOI: 10.1186/s12874-020-01001-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 04/30/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Efforts to improve informed consent have led to calls for providing information a reasonable person would want to have, in a way that facilitates understanding of the reasons why one might or might not want to participate. At the same time, advances in large-scale genomic research have expanded both the opportunities and the risks for participants, families, and communities. To advance the use of effective consent materials that reflect this landscape, we used empirical data to develop model consent language, as well as brief questions to assist people in thinking about their own values relative to participation. METHODS We conducted in-person interviews to gather preliminary input on these materials from a diverse sample (n = 32) of the general population in Nashville, Tennessee. We asked them to highlight information they found especially reassuring or concerning, their hypothetical willingness to participate, and their opinions about the values questions. RESULTS Consent information most often highlighted as reassuring included the purpose of the biobank, the existence and composition of a multidisciplinary oversight committee, the importance of participants' privacy and efforts to protect it, and controlled access to a scientific database. Information most often highlighted as concerning included the deposition of data in a publicly accessible database, the risk of unintended access to data, the potential for non-research use of data, and use of medical record information in general. Seventy-five percent of participants indicated initial willingness to participate in the hypothetical biobank; this decreased to 66% as participants more closely considered the information over the course of the interview. A large majority rated the values questions as helpful. CONCLUSIONS These results are consistent with other research on public perspectives on biobanking and genomic cohort studies, suggesting that our model language effectively captures commonly expressed reasons for and against participation. Our study enriches this literature by connecting specific consent form disclosures with qualitative data regarding what participants found especially reassuring or concerning and why. Interventions that facilitate individuals' closer engagement with consent information may result in participation decisions more closely aligned with their values.
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Affiliation(s)
- Laura M Beskow
- Center for Biomedical Ethics and Society, Vanderbilt University Medical Center, 2525 West End Avenue, Suite 400, Nashville, TN, 37203, USA.
| | - Catherine M Hammack-Aviran
- Center for Biomedical Ethics and Society, Vanderbilt University Medical Center, 2525 West End Avenue, Suite 400, Nashville, TN, 37203, USA
| | - Kathleen M Brelsford
- Center for Biomedical Ethics and Society, Vanderbilt University Medical Center, 2525 West End Avenue, Suite 400, Nashville, TN, 37203, USA
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Burnett-Hartman AN, Blum-Barnett E, Carroll NM, Madrid SD, Jonas C, Janes K, Alvarado M, Bedoy R, Paolino V, Aziz N, McGlynn EA. Return of Research-Related Genetic Test Results and Genetic Discrimination Concerns: Facilitators and Barriers of Genetic Research Participation in Diverse Groups. Public Health Genomics 2020; 23:59-68. [PMID: 32289795 DOI: 10.1159/000507056] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 03/08/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Most genetics studies lack the diversity necessary to ensure that all groups benefit from genetic research. OBJECTIVES To explore facilitators and barriers to genetic research participation. METHODS We conducted a survey on genetics in research and healthcare from November 15, 2017 to February 28, 2018 among adult Kaiser Permanente (KP) members who had been invited to participate in the KP biobank (KP Research Bank). We used logistic regression to calculate adjusted odds ratios (ORs) and 95% confidence intervals (CIs) comparing the willingness to participate in genetic research under different return of results scenarios and genetic discrimination concerns between groups, according to their demographic characteristics. RESULTS A total of 57,331 KP members were invited to participate, and 10,369 completed the survey (18% response rate). Respondents were 65% female, 44% non-Hispanic White (NH White), 22% Asian/Native Hawaiian or other Pacific Islander (Asian/PI), 19% non-Hispanic Black (NH Black), and 16% Hispanic. Respondents willing to participate in genetic research ranged from 22% with no results returned to 87% if health-related genetic results were returned. We also found variation by race/ethnicity; when no results were to be returned, Asian/PIs, Hispanics, and NH Blacks were less likely to want to participate than NH Whites (p < 0.05). However, when results were returned, disparities in the willingness to participate disappeared for NH Blacks and Hispanics. Genetic discrimination concerns were more prevalent in Asian/PIs, Hispanics, and NH Blacks than in NH Whites (p < 0.05). CONCLUSIONS Policies that prohibit the return of results and do not address genetic discrimination concerns may contribute to a greater underrepresentation of diverse groups in genetic research.
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Affiliation(s)
| | - Erica Blum-Barnett
- Institute for Health Research, Kaiser Permanente Colorado, Aurora, Colorado, USA
| | - Nikki M Carroll
- Institute for Health Research, Kaiser Permanente Colorado, Aurora, Colorado, USA
| | - Sarah D Madrid
- Institute for Health Research, Kaiser Permanente Colorado, Aurora, Colorado, USA
| | - Cabell Jonas
- Mid-Atlantic Permanente Research Institute, Kaiser Permanente Mid-Atlantic States, Rockville, Maryland, USA
| | - Kristen Janes
- Kaiser Permanente Care Management Institute, Oakland, California, USA
| | - Monica Alvarado
- Southern California Permanente Medical Group, Pasadena, California, USA
| | - Ruth Bedoy
- Institute for Health Research, Kaiser Permanente Colorado, Aurora, Colorado, USA
| | - Valerie Paolino
- Institute for Health Research, Kaiser Permanente Colorado, Aurora, Colorado, USA
| | - Nazneen Aziz
- Variant Genomics, Inc., Oakland, California, USA
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26
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Briscoe F, Ajunwa I, Gaddis A, McCormick J. Evolving public views on the value of one's DNA and expectations for genomic database governance: Results from a national survey. PLoS One 2020; 15:e0229044. [PMID: 32160204 PMCID: PMC7065739 DOI: 10.1371/journal.pone.0229044] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 01/28/2020] [Indexed: 12/17/2022] Open
Abstract
We report results from a large survey of public attitudes regarding genomic database governance. Prior surveys focused on the context of academic-sponsored biobanks, framing data provision as altruistic donation; our survey is designed to reflect four growing trends: genomic databases are found across many sectors; they are used for more than academic biomedical research; their value is reflected in corporate transactions; and additional related privacy risks are coming to light. To examine how attitudes may evolve in response to these trends, we provided survey respondents with information from mainstream media coverage of them. We then found only 11.7% of respondents willing to altruistically donate their data, versus 50.6% willing to provide data if financially compensated, and 37.8% unwilling to provide data regardless of compensation. Because providing one's genomic data is sometimes bundled with receipt of a personalized genomic report, we also asked respondents what price they would be willing to pay for a personalized report. Subtracting that response value from one's expected compensation for providing data (if any) yields a net expected payment. For the altruistic donors, median net expected payment was -$75 (i.e. they expected to pay $75 for the bundle). For respondents wanting compensation for their data, however, median net expected payment was +$95 (i.e. they expected to receive $95). When asked about different genomic database governance policies, most respondents preferred options that allowed them more control over their data. In particular, they favored policies restricting data sharing or reuse unless permission is specifically granted by the individual. Policy preferences were also relatively consistent regardless of the sector in which the genomic database was located. Together these findings offer a forward-looking window on individual preferences that can be useful for institutions of all types as they develop governance approaches in this area of large-scale data sharing.
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Affiliation(s)
- Forrest Briscoe
- Smeal College of Business, The Pennsylvania State University, University Park, Pennsylvania, United States of America
- * E-mail:
| | - Ifeoma Ajunwa
- Industrial and Labor Relations (ILR) School, Cornell University, Ithaca, New York, United States of America
| | - Allison Gaddis
- Schreyer Honors College, The Pennsylvania State University, University Park, Pennsylvania, United States of America
| | - Jennifer McCormick
- Department of Humanities, College of Medicine, Penn State Clinical and Translational Science Institute, Penn State University Hershey, Hershey, Pennsylvania, United States of America
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Hong SJ, Drake B, Goodman M, Kaphingst KA. Relationships of health information orientation and cancer history on preferences for consent and control over biospecimens in a biobank: A race-stratified analysis. J Genet Couns 2020; 29:479-490. [PMID: 31990114 DOI: 10.1002/jgc4.1217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2019] [Revised: 12/31/2019] [Accepted: 01/06/2020] [Indexed: 11/11/2022]
Abstract
In this study, we investigated how patients' self-reported health information efficacy, relationship with health providers, and cancer history are associated with their preferences for informed consent and need for control over biobank biospecimens. We recruited 358 women aged 40 and older (56% African American; 44% European American) and analyzed the data using multivariable regression models. Results show that African American participants' health information efficacy was significantly and negatively associated with their need for control over biospecimens and preference for a study-specific model. European American participants' dependency on doctors was a significant and negative predictor of their preference for a study-specific model. Several significant interaction effects, which varied across races, were found with regard to health information efficacy, personal cancer history, need for control, and preference for a study-specific model. The study findings suggest it is important to consider health information efficacy, relationship with providers, and need for control when developing large diverse biobanks.
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Affiliation(s)
- Soo Jung Hong
- Department of Communications and New Media, National University of Singapore, Singapore
| | - Bettina Drake
- Division of Public Health Science, Washington University School of Medicine, St. Louis, MO, USA
| | - Melody Goodman
- Department of Biostatistics, New York University College of Global Public Health, New York, NY, USA
| | - Kimberly A Kaphingst
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA.,Department of Communication, University of Utah, Salt Lake City, UT, USA
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Crawford DC, Lin J, Bailey JNC, Kinzy T, Sedor JR, O’Toole JF, Bush WS. Frequency of ClinVar Pathogenic Variants in Chronic Kidney Disease Patients Surveyed for Return of Research Results at a Cleveland Public Hospital. PACIFIC SYMPOSIUM ON BIOCOMPUTING. PACIFIC SYMPOSIUM ON BIOCOMPUTING 2020; 25:575-586. [PMID: 31797629 PMCID: PMC6931908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Return of results is not common in research settings as standards are not yet in place for what to return, how to return, and to whom. As a pioneer of large-scale of return of research results, the Precision Medicine Initiative Cohort now known of All of Us plans to return pharmacogenomic results and variants of clinical significance to its participants starting late 2019. To better understand the local landscape of possibilities regarding return of research results, we assessed the frequency of pathogenic variants and APOL1 renal risk variants in a small diverse cohort of chronic kidney disease patients (CKD) ascertained from a public hospital in Cleveland, Ohio genotyped on the Illumina Infinium MegaEX. Of the 23,720 ClinVar-designated variants directly assayed by the MegaEX, 8,355 (35%) had at least one alternate allele in the 130 participants genotyped. Of these, 18 ClinVar variants deemed pathogenic by multiple submitters with no conflicts in interpretation were distributed across 27 participants. The majority of these pathogenic ClinVar variants (14/18) were associated with autosomal recessive disorders. Of note were four African American carriers of TTR rs76992529 associated with amyloidogenic transthyretin amyloidosis, otherwise known as familial transthyretin amyloidosis (FTA). FTA, an autosomal dominant disorder with variable penetrance, is more common among African-descent populations compared with European-descent populations. Also common in this CKD population were APOL1 renal risk alleles G1 (rs73885319) and G2 (rs71785313) with 60% of the study population carrying at least one renal risk allele. Both pathogenic ClinVar variants and APOL1 renal risk alleles were distributed among participants who wanted actionable genetic results returned, wanted genetic results returned regardless of actionability, and wanted no results returned. Results from this local genetic study highlight challenges in which variants to report, how to interpret them, and the participant's potential for follow-up, only some of the challenges in return of research results likely facing larger studies such as All of Us.
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Affiliation(s)
- Dana C. Crawford
- Cleveland Institute for Computational Biology, Case Western Reserve University, Wolstein Research Building, 2103 Cornell Road, Cleveland, OH 44106, USA,Department of Population and Quantitative Health Sciences, Case Western Reserve University, Wolstein Research Building, 2103 Cornell Road, Cleveland, OH 44106, USA,Department of Genetics and Genome Sciences, Case Western Reserve University, Wolstein Research Building, 2103 Cornell Road, Cleveland, OH 44106, USA
| | - John Lin
- Cleveland Institute for Computational Biology, Case Western Reserve University, Wolstein Research Building, 2103 Cornell Road, Cleveland, OH 44106, USA
| | - Jessica N. Cooke Bailey
- Cleveland Institute for Computational Biology, Case Western Reserve University, Wolstein Research Building, 2103 Cornell Road, Cleveland, OH 44106, USA,Department of Population and Quantitative Health Sciences, Case Western Reserve University, Wolstein Research Building, 2103 Cornell Road, Cleveland, OH 44106, USA
| | - Tyler Kinzy
- Cleveland Institute for Computational Biology, Case Western Reserve University, Wolstein Research Building, 2103 Cornell Road, Cleveland, OH 44106, USA
| | - John R. Sedor
- Department of Physiology and Biophysics, Case Western Reserve University,Department of Nephrology and Hypertension, Glickman Urology and Kidney and Lerner Research Institutes, Cleveland Clinic, Cleveland, OH 44106, USA
| | - John F. O’Toole
- Department of Nephrology and Hypertension, Glickman Urology and Kidney and Lerner Research Institutes, Cleveland Clinic, Cleveland, OH 44106, USA
| | - William S. Bush
- Cleveland Institute for Computational Biology, Case Western Reserve University, Wolstein Research Building, 2103 Cornell Road, Cleveland, OH 44106, USA,Department of Population and Quantitative Health Sciences, Case Western Reserve University, Wolstein Research Building, 2103 Cornell Road, Cleveland, OH 44106, USA,Department of Genetics and Genome Sciences, Case Western Reserve University, Wolstein Research Building, 2103 Cornell Road, Cleveland, OH 44106, USA
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29
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Joffe S, Sellers DE, Ekunwe L, Antoine-Lavigne D, McGraw S, Levy D, Splansky GL. Preferences for Return of Genetic Results Among Participants in the Jackson Heart Study and Framingham Heart Study. CIRCULATION-GENOMIC AND PRECISION MEDICINE 2019; 12:e002632. [PMID: 31756304 DOI: 10.1161/circgen.119.002632] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Surveys suggest that most research participants desire access to secondary (incidental) genomic findings. However, few studies clarify whether preferences vary by the nature of the finding. METHODS We surveyed members of the JHS (Jackson Heart Study, n=960), the FHS (Framingham Heart Study; n=955), and African American members of the FHS Omni cohort (n=160) who had consented to genomic studies. Each factorial survey included 3 vignettes, randomly selected from a set of 64, that described a secondary genomic result. Vignettes varied systematically by 5 factors identified by expert panels as salient: phenotype severity, actionability (preventability), reproductive significance, and relative and absolute risk of the phenotype. Respondents indicated whether they would want to receive the result. Data were analyzed separately by cohort using generalized linear mixed models. RESULTS Response rates ranged from 67% to 73%. Across vignettes, 88% to 92% of respondents would definitely or probably want to learn the result. In multivariate analyses among JHS respondents, desire for results was associated with positive attitudes towards genetic testing, lower education, higher subjective numeracy, and younger age, but not with any of the 5 factors. Among FHS respondents, desire for results was associated with higher absolute risk, preventability, reproductive risk, and positive attitudes towards genetic testing. Among FHS Omni respondents, desire for results was associated with positive attitudes towards genetic testing and younger age. CONCLUSIONS Most genetic research participants desire return of secondary genetic results. Several factors identified by expert panels as salient are associated with preferences among FHS, but not JHS or FHS Omni, participants.
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Affiliation(s)
- Steven Joffe
- Department of Medical Ethics and Health Policy, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA (S.J.).,Division of Oncology, Children's Hospital of Philadelphia, PA (S.J.)
| | - Deborah E Sellers
- Bronfenbrenner Center for Translational Research, College of Human Ecology, Cornell University, Ithaca, NY (D.E.S.)
| | - Lynette Ekunwe
- School of Public Health, Jackson Heart Study, Jackson State University, Jackson, MS (L.E.)
| | | | | | - Daniel Levy
- Framingham Heart Study, Framingham, MA (D.L., G.L.S.).,Population Sciences Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD (D.L.)
| | - Greta Lee Splansky
- Framingham Heart Study, Framingham, MA (D.L., G.L.S.).,Boston University School of Medicine, Boston, MA (G.L.S.)
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Kostick K, Pereira S, Brannan C, Torgerson L, Lázaro-Muñoz G. Psychiatric genomics researchers' perspectives on best practices for returning results to individual participants. Genet Med 2019; 22:345-352. [PMID: 31477844 PMCID: PMC7000323 DOI: 10.1038/s41436-019-0642-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 08/13/2019] [Indexed: 12/26/2022] Open
Abstract
Purpose Large-scale array-based and sequencing studies have advanced our understanding of the genetic architecture of psychiatric disorders, but also increased the potential to generate an exponentially larger amount of clinically relevant findings. As genomic testing becomes more widespread in psychiatry research, urgency grows to establish best practices for offering return of results (RoR) to individuals at risk or diagnosed with a psychiatric disorder. Methods We interviewed an international sample (n = 39) of psychiatric genetics researchers to examine conceptualizations of “best practices” for RoR to individual research participants. Results While the vast majority of researchers do not offer RoR, most believed medically actionable findings (85%) and clinically valid but non–medically actionable findings (54%) should be offered. Researchers identified three main areas for improvement: interfacing with individual participants; interdisciplinary training, guidance, and integration; and quality planning and resource allocation for returning results. Conclusion There are significant gaps between researchers’ visions for “best” versus “actual” RoR practices. While researchers call for participant-centered practices, including consent practices that consider any special needs of participants with psychiatric disorders, return of individually meaningful results, and effective follow-up and provisions for treatment, the current reality is that consent and RoR practices lack standardized and evidence-based norms.
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Affiliation(s)
- Kristin Kostick
- Center for Medical Ethics & Health Policy, Baylor College of Medicine, Houston, TX, USA
| | - Stacey Pereira
- Center for Medical Ethics & Health Policy, Baylor College of Medicine, Houston, TX, USA
| | - Cody Brannan
- Center for Medical Ethics & Health Policy, Baylor College of Medicine, Houston, TX, USA
| | - Laura Torgerson
- Center for Medical Ethics & Health Policy, Baylor College of Medicine, Houston, TX, USA
| | - Gabriel Lázaro-Muñoz
- Center for Medical Ethics & Health Policy, Baylor College of Medicine, Houston, TX, USA.
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31
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Lin JC, Hsiao WWW, Fan CT. Managing "incidental findings" in biobank research: Recommendations of the Taiwan biobank. Comput Struct Biotechnol J 2019; 17:1135-1142. [PMID: 31462969 PMCID: PMC6709371 DOI: 10.1016/j.csbj.2019.07.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 07/11/2019] [Accepted: 07/15/2019] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND In this article, incidental findings (IF) refer to unforeseen findings made possible through biobanking research and advances in medical diagnostic technologies that raise issues regarding the obligation and/or responsibility of biobank-users and biobanks to return clinically significant information to participants. The World Medical Association (WMA) Declaration of Taipei (2016) highlights the possibility of encountering IF and requires that research on biospecimens address biobank feedback policies in their informed consent process, leaving open the possibility that the policy may be "no return". As clinicians and researchers begin to use these "resources", the possibility of finding clinically significant IF is becoming a reality. DISCUSSION In line with the WMA's Declaration of Taipei, a pragmatic approach is needed to deal with the issue of returning IF in biobank governance. Indeed, the impacts and concerns associated with the return of IF differ across different stakeholder groups and jurisdictions. Therefore, the framework governing IF return needs to be custom-built, taking into account the nature of each research project and the unique features of biobanks. To this end, in addition to facilitating biobank transparency, establishing an endurable and horizontal connection among biobanks and clinical institutions under a public health system will improve efficiency and effectiveness. Hence, subject to contemporary Taiwanese ethical and/or legal regulations, this article argues for the establishment of an updated framework for imaging-related and genetic-related IF return within the Taiwan Biobank (TWB), mainly based on a limited obligation to disclose life-threatening information revealed by imaging, but not genetic, information. SUMMARY After discussing some of the ethical, legal and social issues encountered by the TWB and accounting for the experiences of other international biobanks, we propose a systematic framework for returning IF, mainly on a "limited obligation" basis, which offers better and more comprehensive protection for biobank-participants' rights and health.
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Key Words
- Biobanks
- Bioethics
- EGF, Ethical Governance Framework
- ELSI, Ethical, Legal and Social Implications
- ESC, European Society of Cardiology
- Framework
- GNC, German National Cohort
- GP, General Practitioners
- IF, Incidental Findings
- IRBs, Institutional Review Boards
- Incidental finding
- MRI, Magnetic Resonance Imaging
- NHI, National Health Insurance
- NIH, National Institutes of Health
- P3G, Public Population Project in Genomics and Society
- TWB, Taiwan Biobank
- The WMA Declaration of Taipei (2016)
- UNESCO, United Nations Education Scientific and Cultural Organization
- WMA, World Medical Association
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Affiliation(s)
- Jui-Chu Lin
- College of Liberal Arts and Social Sciences, National Taiwan University of Science and Technology, Taipei, Taiwan, ROC
- Law & Technology Innovation Center, National Taiwan University of Science and Technology, Taipei, Taiwan, ROC
- Ethical, Legal and Social Implications (ELSI) of the Taiwan Biobank, Taipei, Taiwan, ROC
| | - Wesley Wei-Wen Hsiao
- Law & Technology Innovation Center, National Taiwan University of Science and Technology, Taipei, Taiwan, ROC
- Genomics Research Center, Academia Sinica, Taipei, Taiwan, ROC
| | - Chien-Te Fan
- Institute of Law for Science and Technology, National Tsing Hua University, Hsin-Chu, Taiwan, ROC
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Parikh R, O'Keefe L, Salowe R, Mccoskey M, Pan W, Sankar P, Miller-Ellis E, Addis V, Lehman A, Maguire M, O'Brien J. Factors associated with participation by African Americans in a study of the genetics of glaucoma. ETHNICITY & HEALTH 2019; 24:694-704. [PMID: 28669230 PMCID: PMC5748378 DOI: 10.1080/13557858.2017.1346189] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Accepted: 06/14/2017] [Indexed: 06/07/2023]
Abstract
Objective: African Americans have been historically underrepresented in research studies. Our aim was to evaluate factors influencing enrollment in the Primary Open-Angle African American Glaucoma Genetics (POAAGG) study. Design: Patients approached to enroll in the POAAGG study were asked to complete a 15-item survey addressing demographic characteristics, knowledge of genetics and glaucoma, and opinions on human research. Survey responses were compared between subjects who enrolled (Enrollers) and did not enroll (Decliners) in the POAAGG study. Results: Enrollers (N = 190) were 3.7 years younger (P = 0.007) and had similar gender, education, and income level to Decliners (N = 117). Knowledge about genetics and glaucoma was similar between groups. Enrollers were more comfortable providing DNA for research studies (93.1% vs 54.1%; P < 0.001) and more likely to have participated in prior studies (P = 0.003) and consider participating in future studies (P < 0.001). Among Decliners, lack of time was the primary reason given for not enrolling. Conclusion: To increase participation of African Americans in genetic research studies, efforts should be made to raise comfort with DNA donation.
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Affiliation(s)
- Rupin Parikh
- a Scheie Eye Institute , University of Pennsylvania , Philadelphia , PA , USA
| | - Laura O'Keefe
- a Scheie Eye Institute , University of Pennsylvania , Philadelphia , PA , USA
| | - Rebecca Salowe
- a Scheie Eye Institute , University of Pennsylvania , Philadelphia , PA , USA
| | - Makayla Mccoskey
- a Scheie Eye Institute , University of Pennsylvania , Philadelphia , PA , USA
| | - Wei Pan
- a Scheie Eye Institute , University of Pennsylvania , Philadelphia , PA , USA
| | - Prithvi Sankar
- a Scheie Eye Institute , University of Pennsylvania , Philadelphia , PA , USA
| | - Eydie Miller-Ellis
- a Scheie Eye Institute , University of Pennsylvania , Philadelphia , PA , USA
| | - Victoria Addis
- a Scheie Eye Institute , University of Pennsylvania , Philadelphia , PA , USA
| | - Amanda Lehman
- a Scheie Eye Institute , University of Pennsylvania , Philadelphia , PA , USA
| | - Maureen Maguire
- a Scheie Eye Institute , University of Pennsylvania , Philadelphia , PA , USA
| | - Joan O'Brien
- a Scheie Eye Institute , University of Pennsylvania , Philadelphia , PA , USA
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Kent S, Bardach SH, Zhang X, Abner EL, Grill JD, Jicha GA. Public Understanding and Opinions regarding Genetic Research on Alzheimer's Disease. Public Health Genomics 2019; 21:228-237. [PMID: 31326966 DOI: 10.1159/000501464] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 06/11/2019] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Participants willing to provide genetic samples are needed to propel research on Alzheimer's disease (AD) treatment and prevention forward. A limited public understanding of what AD genetic research entails and concerns about participation may constitute recruitment challenges. OBJECTIVES This study seeks to understand how well older adults understand AD genetic research and whether their understanding is related to concerns about participation or willingness to engage. METHODS Our surveys included a mock consent form with corresponding knowledge and opinion questions regarding AD. The surveys were mailed to participants from the University of Kentucky Alzheimer's Disease Center and to a list of randomly selected individuals within the same age range from a local voter registration list. Descriptive and multivariable linear regression analyses were conducted. RESULTS The returned surveys (n = 502) demonstrated limits to what the respondents understood immediately after reading the relevant material, with a mean summary knowledge score of 74.5 out of 100. While comprehension gaps were not related to level of concern or willingness to engage, concerns were related to willingness to engage. Concerns were greater among individuals not actively involved in research, individuals from minority groups, and those with higher levels of education. CONCLUSIONS Focusing on concerns specifically, rather than on knowledge more generally, may help increase participation.
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Affiliation(s)
- Saida Kent
- University of Kentucky College of Medicine, Lexington, Kentucky, USA
| | - Shoshana H Bardach
- Sanders-Brown Center on Aging, University of Kentucky, Lexington, Kentucky, USA, .,University of Kentucky College of Public Health, Lexington, Kentucky, USA,
| | - Xuan Zhang
- Johns Hopkins University School of Nursing, Baltimore, Maryland, USA
| | - Erin L Abner
- Sanders-Brown Center on Aging, University of Kentucky, Lexington, Kentucky, USA.,University of Kentucky College of Public Health, Lexington, Kentucky, USA
| | - Joshua D Grill
- Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, California, USA
| | - Gregory A Jicha
- University of Kentucky College of Medicine, Lexington, Kentucky, USA.,Sanders-Brown Center on Aging, University of Kentucky, Lexington, Kentucky, USA
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Dyke SOM, Saulnier KM, Dupras C, Webster AP, Maschke K, Rothstein M, Siebert R, Walter J, Beck S, Pastinen T, Joly Y. Points-to-consider on the return of results in epigenetic research. Genome Med 2019; 11:31. [PMID: 31122281 PMCID: PMC6533659 DOI: 10.1186/s13073-019-0646-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
As epigenetic studies become more common and lead to new insights into health and disease, the return of individual epigenetic results to research participants, in particular in large-scale epigenomic studies, will be of growing importance. Members of the International Human Epigenome Consortium (IHEC) Bioethics Workgroup considered the potential ethical, legal, and social issues (ELSI) involved in returning epigenetic research results and incidental findings in order to produce a set of 'Points-to-consider' (P-t-C) for the epigenetics research community. These P-t-C draw on existing guidance on the return of genetic research results, while also integrating the IHEC Bioethics Workgroup's ELSI research on and discussion of the issues associated with epigenetic data as well as the experience of a return of results pilot study by the Personal Genome Project UK (PGP-UK). Major challenges include how to determine the clinical validity and actionability of epigenetic results, and considerations related to environmental exposures and epigenetic marks, including circumstances warranting the sharing of results with family members and third parties. Interdisciplinary collaboration and good public communication regarding epigenetic risk will be important to advance the return of results framework for epigenetic science.
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Affiliation(s)
- Stephanie O M Dyke
- Centre of Genomics and Policy, Faculty of Medicine, McGill University, Montreal, Quebec, H3A 0G1, Canada.
- Montreal Neurological Institute, Faculty of Medicine, McGill University, Montreal, Quebec, H3A 2B4, Canada.
| | - Katie M Saulnier
- Centre of Genomics and Policy, Faculty of Medicine, McGill University, Montreal, Quebec, H3A 0G1, Canada
| | - Charles Dupras
- Centre of Genomics and Policy, Faculty of Medicine, McGill University, Montreal, Quebec, H3A 0G1, Canada
| | - Amy P Webster
- UCL Cancer Institute, University College London, London, WC1E 6DD, UK
| | | | - Mark Rothstein
- Institute for Bioethics, Health Policy and Law, University of Louisville School of Medicine, Louisville, KY, 40202, USA
| | - Reiner Siebert
- Institute of Human Genetics, Ulm University Medical Center, 89091, Ulm, Germany
| | - Jörn Walter
- Saarland University, 66123, Saarbrücken, Germany
| | - Stephan Beck
- UCL Cancer Institute, University College London, London, WC1E 6DD, UK
| | - Tomi Pastinen
- Department of Human Genetics, McGill University and Genome Quebec Innovation Centre, Montreal, Quebec, H3A 0G1, Canada
- Center for Pediatric Genomic Medicine, Children's Mercy Kansas City, Kansas City, MO, 64108, USA
| | - Yann Joly
- Centre of Genomics and Policy, Faculty of Medicine, McGill University, Montreal, Quebec, H3A 0G1, Canada
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Zhu X, Leof ER, Rabe KG, McCormick JB, Petersen GM, Radecki Breitkopf C. Psychological Impact of Learning CDKN2A Variant Status as a Genetic Research Result. Public Health Genomics 2019; 21:154-163. [PMID: 30999302 DOI: 10.1159/000496556] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Accepted: 01/04/2019] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES Little is known about genetic research participants' responses to receiving individual research results (IRR) from cancer genetic research. We examined the immediate and delayed psychological impact of returning a CDKN2A variant result that is associated with increased risk of pancreatic cancer and melanoma. METHODS One hundred and thirty-three pancreas research registry enrollees whose samples were tested in a research laboratory for the CDKN2A variant were invited by mail to learn the result by telephone and participate in a study about the disclosure process. Self-rated health, quality of life, and emotional responses were surveyed before and 6 months after disclosure. Genetic testing-specific distress, uncertainty, and positive experiences were assessed 6 months after disclosure. RESULTS Eighty individuals agreed to participate; 63 completed the study. Both carriers and noncarriers showed no change over time in self-rated health, quality of life, or anxiety levels. Carriers reported more sadness than noncarriers before and 6 months after disclosure. Both carriers and noncarriers showed more hopefulness 6 months after than before disclosure. Carriers experienced greater test-specific distress and uncertainty than noncarriers, but levels were low. -Conclusions: Return of IRR in conjunction with cancer prevention counseling led to low levels of test-specific distress and uncertainty among carriers. No other adverse psychological outcomes were observed.
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Affiliation(s)
- Xuan Zhu
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Emma R Leof
- Infectious Disease Epidemiology, Prevention, and Control Division, Minnesota Department of Health, St. Paul, Minnesota, USA
| | - Kari G Rabe
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Jennifer B McCormick
- Department of Humanities, College of Medicine, Pennsylvania State University, Hershey, Pennsylvania, USA
| | - Gloria M Petersen
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
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Viberg Johansson J, Langenskiöld S, Segerdahl P, Hansson MG, Hösterey UU, Gummesson A, Veldwijk J. Research participants' preferences for receiving genetic risk information: a discrete choice experiment. Genet Med 2019; 21:2381-2389. [PMID: 30992550 DOI: 10.1038/s41436-019-0511-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Accepted: 03/25/2019] [Indexed: 11/09/2022] Open
Abstract
PURPOSE This study aims to determine research participants' preferences for receiving genetic risk information when participating in a scientific study that uses genome sequencing. METHODS A discrete choice experiment questionnaire was sent to 650 research participants (response rate 60.5%). Four attributes were selected for the questionnaire: type of disease, disease penetrance probability, preventive opportunity, and effectiveness of the preventive measure. Panel mixed logit models were used to determine attribute level estimates and the heterogeneity in preferences. Relative importance of the attribute and the predicted uptake for different information scenarios were calculated from the estimates. In addition, this study estimates predicted uptake for receiving genetic risk information in different scenarios. RESULTS All characteristics influenced research participants' willingness to receive genetic risk information. The most important characteristic was the effectiveness of the preventive opportunity. Predicted uptake ranged between 28% and 98% depending on what preventive opportunities and levels of effectiveness were presented. CONCLUSION Information about an effective preventive measure was most important for participants. They valued that attribute twice as much as the other attributes. Therefore, when there is an effective preventive measure, risk communication can be less concerned with the magnitude of the probability of developing disease.
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Affiliation(s)
- Jennifer Viberg Johansson
- Centre for Research Ethics & Bioethics, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
| | - Sophie Langenskiöld
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden.,Department of Learning, Informatics, Management and Ethics, Medical Management Centre, Karolinska Institute, Stockholm, Sweden
| | - Pär Segerdahl
- Centre for Research Ethics & Bioethics, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Mats G Hansson
- Centre for Research Ethics & Bioethics, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Ulrika Ugander Hösterey
- Department of Clinical Pathology and Genetics, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Anders Gummesson
- Department of Clinical Pathology and Genetics, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Jorien Veldwijk
- Centre for Research Ethics & Bioethics, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.,Erasmus School of Health Policy and Management; Erasmus Choice Modelling Centre, Erasmus University, Rotterdam, The Netherlands
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Motivations for data sharing-views of research participants from four European countries: A DIRECT study. Eur J Hum Genet 2019; 27:721-729. [PMID: 30700834 DOI: 10.1038/s41431-019-0344-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Revised: 12/06/2018] [Accepted: 12/18/2018] [Indexed: 11/08/2022] Open
Abstract
The purpose of this study was to explore and compare different countries in what motivated research participants' decisions whether to share their de-identified data. We investigated European DIRECT (Diabetes Research on Patient Stratification) research project participants' desire for control over sharing different types of their de-identified data, and with who data could be shared in the future after the project ends. A cross-sectional survey was disseminated among DIRECT project participants. The results found that there was a significant association between country and attitudes towards advancing research, protecting privacy, and beliefs about risks and benefits to sharing data. When given the choice to have control, some participants (<50% overall) indicated that having control over what data is shared and with whom was important; and control over what data types are shared was less important than respondents deciding who data are shared with. Danish respondents indicated higher odds of desire to control data types shared, and Dutch respondents showed higher odds of desire to control who data will be shared with. Overall, what research participants expect in terms of control over data sharing needs to be considered and aligned with sharing for future research and re-use of data. Our findings show that even with de-identified data, respondents prioritise privacy above all else. This study argues to move research participants from passive participation in biomedical research to considering their opinions about data sharing and control of de-identified biomedical data.
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Lewis KL, Facio FM, Berrios CD. Using the diffusion of innovations model to guide participant engagement in the genomics era. J Genet Couns 2019; 28:419-427. [PMID: 30653790 DOI: 10.1002/jgc4.1090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 12/06/2018] [Accepted: 12/09/2018] [Indexed: 12/12/2022]
Abstract
Exome and genome sequencing (EGS) are increasingly the genetic testing modalities of choice among researchers owing to their ready availability, low cost, and large data output. Recruitment of larger, more diverse cohorts into long-term studies with extensive data collection is fundamental to the success of EGS research and to the widespread benefit of genomic medicine to various populations. Effective engagement will be critical to meeting this demand. The Diffusion of Innovation (DOI) model provides a framework for how new technologies are adopted in communities, including antecedents of an individual's decision to adopt the technology, how the technology's attributes influence its acceptability, the predictors of sustained use of that technology, and its diffusion through society. We apply the DOI model to frame participant engagement in EGS research and to guide the proposal of potential strategies that aim to overcome forecasted challenges. Finally, we suggest a variety of ways genetic counselors can apply their skills and training to the development and implementation of these strategies.
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Affiliation(s)
- Katie L Lewis
- Medical Genomics and Metabolic Genetics Branch, National Human Genome Research Institute, Bethesda, Maryland
| | - Flavia M Facio
- Medical Genomics and Metabolic Genetics Branch, National Human Genome Research Institute, Bethesda, Maryland
| | - Courtney D Berrios
- Center for Pediatric Genomic Medicine, Children's Mercy Kansas City, Kansas City, Missouri
- School of Medicine, University of Missouri Kansas City, Kansas City, Missouri
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Kaphingst KA, Ivanovich J, Lyons S, Biesecker B, Dresser R, Elrick A, Matsen C, Goodman M. Preferences for learning different types of genome sequencing results among young breast cancer patients: Role of psychological and clinical factors. Transl Behav Med 2018; 8:71-79. [PMID: 29385583 DOI: 10.1093/tbm/ibx042] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
The growing importance of genome sequencing means that patients will increasingly face decisions regarding what results they would like to learn. The present study examined psychological and clinical factors that might affect these preferences. 1,080 women diagnosed with breast cancer at age 40 or younger completed an online survey. We assessed their interest in learning various types of genome sequencing results: risk of preventable disease or unpreventable disease, cancer treatment response, uncertain meaning, risk to relatives' health, and ancestry/physical traits. Multivariable logistic regression was used to examine whether being "very" interested in each result type was associated with clinical factors: BRCA1/2 mutation status, prior genetic testing, family history of breast cancer, and psychological factors: cancer recurrence worry, genetic risk worry, future orientation, health information orientation, and genome sequencing knowledge. The proportion of respondents who were very interested in learning each type of result ranged from 16% to 77%. In all multivariable models, those who were very interested in learning a result type had significantly higher knowledge about sequencing benefits, greater genetic risks worry, and stronger health information orientation compared to those with less interest (p-values < .05). Our findings indicate that high interest in return of various types of genome sequencing results was more closely related to psychological factors. Shared decision-making approaches that increase knowledge about genome sequencing and incorporate patient preferences for health information and learning about genetic risks may help support patients' informed choices about learning different types of sequencing results.
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Affiliation(s)
| | - Jennifer Ivanovich
- Division of Public Health Sciences, Washington University in St. Louis, St. Louis, MO, USA
| | - Sarah Lyons
- Division of Public Health Sciences, Washington University in St. Louis, St. Louis, MO, USA
| | - Barbara Biesecker
- Social and Behavioral Research Branch, National Human Genome Research Institute, Bethesda, MD, USA
| | - Rebecca Dresser
- School of Law, Washington University in St. Louis, St. Louis, MO, USA
| | - Ashley Elrick
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Cindy Matsen
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Melody Goodman
- College of Global Public Health, New York University, New York, NY, USA
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Sharing data for future research-engaging participants' views about data governance beyond the original project: a DIRECT Study. Genet Med 2018; 21:1131-1138. [PMID: 30262927 DOI: 10.1038/s41436-018-0299-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Accepted: 08/30/2018] [Indexed: 12/25/2022] Open
Abstract
PURPOSE Biomedical data governance strategies should ensure that data are collected, stored, and used ethically and lawfully. However, research participants' preferences for how data should be governed is least studied. The Diabetes Research on Patient Stratification (DIRECT) project collected substantial amounts of health and genetic information from patients at risk of, and with type II diabetes. We conducted a survey to understand participants' future data governance preferences. Results will inform the postproject data governance strategy. METHODS A survey was distributed in Denmark, Sweden, The Netherlands, and the United Kingdom. RESULTS In total 855 surveys were returned. Ninety-seven percent were supportive of sharing data postproject, and 90% were happy to share data with universities, and 56% with commercial companies. The top three priorities for data sharing were highly secure database, DIRECT researchers to monitor data used by other researchers, and researchers cannot identify participants. Respondents frequently suggested that a postproject Data Access Committee should involve a DIRECT researcher, diabetes clinician, patient representative, and a DIRECT participant. CONCLUSION Preferences of how data should be governed, and what data could be shared and with whom varied between countries. Researchers are considered as key custodians of participant data. Engaging participants aids in designing governance to support their choices.
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Ottman R, Freyer C, Mefford HC, Poduri A, Lowenstein DH. Return of individual results in epilepsy genomic research: A view from the field. Epilepsia 2018; 59:1635-1642. [PMID: 30098010 DOI: 10.1111/epi.14530] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 06/13/2018] [Accepted: 07/15/2018] [Indexed: 12/15/2022]
Abstract
Genomic findings are emerging rapidly in 2 large, closely related epilepsy research consortia: the Epilepsy Phenome/Genome Project and Epi4K. Disclosure of individual results to participants in genomic research is increasingly viewed as an ethical obligation, but strategies for return of results were not included in the design of these consortia, raising complexities in establishing criteria for which results to offer, determining participant preferences, managing the large number of sites involved, and covering associated costs. Here, we describe the challenges faced, alternative approaches considered, and progress to date. Experience from these 2 consortia illustrates the importance, for genomic research in epilepsy and other disorders, of including a specific plan for return of results in the study design, with financial support for obtaining clinical confirmation and providing ongoing support for participants. Participant preferences for return of results should be established at the time of enrollment, and methods for allowing future contacts with participants should be included. In addition, methods should be developed for summarizing meaningful, comprehensible information about findings in the aggregate that participants can access in an ongoing way.
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Affiliation(s)
- Ruth Ottman
- Departments of Epidemiology and Neurology, and G. H. Sergievsky Center, Columbia University, New York, New York.,Division of Translational Epidemiology, New York State Psychiatric Institute, New York, New York
| | - Catharine Freyer
- Department of Neurology, University of California, San Francisco, San Francisco, California
| | - Heather C Mefford
- Division of Genetic Medicine, Department of Pediatrics, University of Washington, Seattle, Washington
| | - Annapurna Poduri
- Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Epilepsy Genetics Program, Boston Children's Hospital, Boston, Massachusetts.,Department of Neurology, Harvard Medical School, Boston, Massachusetts
| | - Daniel H Lowenstein
- Department of Neurology, University of California, San Francisco, San Francisco, California
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Willingness to Participate in a National Precision Medicine Cohort: Attitudes of Chronic Kidney Disease Patients at a Cleveland Public Hospital. J Pers Med 2018; 8:jpm8030021. [PMID: 29949895 PMCID: PMC6164471 DOI: 10.3390/jpm8030021] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Revised: 06/19/2018] [Accepted: 06/20/2018] [Indexed: 12/27/2022] Open
Abstract
Multiple ongoing, government-funded national efforts longitudinally collect health data and biospecimens for precision medicine research with ascertainment strategies increasingly emphasizing underrepresented groups in biomedical research. We surveyed chronic kidney disease patients from an academic, public integrated tertiary care system in Cleveland, Ohio, to examine local attitudes toward participation in large-scale government-funded studies. Responses (n = 103) indicate the majority (71%) would participate in a hypothetical national precision medicine cohort and were willing to send biospecimens to a national repository and share de-identified data, but <50% of respondents were willing to install a phone app to track personal data. The majority of participants (62%) indicated that return of research results was very important, and the majority (54%) also wanted all of their research-collected health and genetic data returned. Response patterns did not differ by race/ethnicity. Overall, we found high willingness to participate among this Cleveland patient population already participating in a local genetic study. These data suggest that despite common perceptions, subjects from communities traditionally underrepresented in genetic research will participate and agree to store samples and health data in repositories. Furthermore, most participants want return of research results, which will require a plan to provide these data in a secure, accessible, and understandable manner.
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McGowan ML, Prows CA, DeJonckheere M, Brinkman WB, Vaughn L, Myers MF. Adolescent and Parental Attitudes About Return of Genomic Research Results: Focus Group Findings Regarding Decisional Preferences. J Empir Res Hum Res Ethics 2018; 13:371-382. [PMID: 29806518 DOI: 10.1177/1556264618776613] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Opportunities to participate in genomic sequencing studies, as well as recommendations to screen for variants in 59 medically actionable genes anytime clinical genomic sequencing is performed, indicate adolescents will increasingly be involved in decisions about learning secondary findings from genome sequencing. However, how adolescents want to be involved in such decisions is unknown. We conducted five focus groups with adolescents (2) and parents (3) to learn their decisional preferences about return of genomic research results to adolescents. Discussions about decisional preferences centered around three themes: feelings about receiving genomic risk information, adolescent involvement and capacity to participate in decision-making, and recommendations for parental versus collaborative decision-making. We address the contested space between parental duties to act in their children's best interests when choosing which results to return and adolescents' desires to make autonomous decisions. A collaborative decision-making approach is recommended for obtaining consent from adolescents and their parents for genome sequencing research.
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Affiliation(s)
- Michelle L McGowan
- 1 Cincinnati Children's Hospital Medical Center, USA.,2 University of Cincinnati, USA
| | | | | | - William B Brinkman
- 1 Cincinnati Children's Hospital Medical Center, USA.,2 University of Cincinnati, USA
| | - Lisa Vaughn
- 1 Cincinnati Children's Hospital Medical Center, USA.,2 University of Cincinnati, USA
| | - Melanie F Myers
- 1 Cincinnati Children's Hospital Medical Center, USA.,2 University of Cincinnati, USA
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Nobile H, Borry P, Pischon T, Steinbrecher A, Boeing H, Vigl M, Bergmann MM. Participants' decision to enroll in cohort studies with biobanks: quantitative insights from two German studies. Per Med 2018; 14:477-485. [PMID: 29749857 DOI: 10.2217/pme-2017-0049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
AIM To understand participants' actual motivations to enroll in cohort studies with biobanks. METHODS Participants of two such studies currently ongoing in Germany were invited to fill in a questionnaire about their decision to enroll. RESULTS From the 623 questionnaires completed, contributing to scientific knowledge appeared as a main motive for enrollment, followed by learning about personal health status and receiving personal medical advice. CONCLUSION Motivating participation as a way to contribute to the common good rather than as a way to obtain personal benefits appears to be particularly appropriate to ensure participants' long-term commitment and should therefore be further investigated in this setting.
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Affiliation(s)
- Hélène Nobile
- Department of Epidemiology, German Institute for Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany.,Center for Biomedical Ethics & Law, Department of Public Health & Primary Care, KU Leuven, Leuven, Belgium
| | - Pascal Borry
- Center for Biomedical Ethics & Law, Department of Public Health & Primary Care, KU Leuven, Leuven, Belgium
| | - Tobias Pischon
- Molecular Epidemiology Research Group, Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany
| | - Astrid Steinbrecher
- Molecular Epidemiology Research Group, Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany
| | - Heiner Boeing
- Department of Epidemiology, German Institute for Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany
| | - Matthäus Vigl
- Department of Epidemiology, German Institute for Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany
| | - Manuela M Bergmann
- Department of Epidemiology, German Institute for Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany
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Burke W, Beskow LM, Trinidad SB, Fullerton SM, Brelsford K. Informed Consent in Translational Genomics: Insufficient Without Trustworthy Governance. THE JOURNAL OF LAW, MEDICINE & ETHICS : A JOURNAL OF THE AMERICAN SOCIETY OF LAW, MEDICINE & ETHICS 2018; 46:79-86. [PMID: 29962827 PMCID: PMC6023399 DOI: 10.1177/1073110518766023] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Neither the range of potential results from genomic research that might be returned to participants nor future uses of stored data and biospecimens can be fully predicted at the outset of a study. Informed consent procedures require clear explanations about how and by whom decisions are made and what principles and criteria apply. To ensure trustworthy research governance, there is also a need for empirical studies incorporating public input to evaluate and strengthen these processes.
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Affiliation(s)
- Wylie Burke
- Department of Bioethics and Humanities, Box 357120, University of Washington, Seattle WA 98195; Work phone: 206-221-5482; Home phone 206-232-6760; Cell phone: 206-619-3191
| | - Laura M Beskow
- Center for Biomedical Ethics and Society, Vanderbilt University Medical Center, 2525 West End Aves, Suite 400, Nashville TN 37203; Work phone: 615-936-2686
| | - Susan Brown Trinidad
- Department of Bioethics and Humanities, Box 357120, University of Washington, Seattle WA 98195; Work phone:206-543-2508;Home phone: 206-842-9241;Cell phone: 360-850-3428
| | - Stephanie M Fullerton
- Department of Bioethics and Humanities, Box 357120, University of Washington, Seattle WA 98195; Work phone: 206-616-1864; Home phone: 206-297-1005; Cell phone: 206-529-7029
| | - Kathleen Brelsford
- Center for Biomedical Ethics and Society, Vanderbilt University Medical Center, 2525 West End Aves, Suite 400, Nashville TN 37203; Work phone: 615-936-2686
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Mitchell PB, Ziniel SI, Savage SK, Christensen KD, Weitzman ER, Green RC, Huntington NL, Mathews DJ, Holm IA. Enhancing Autonomy in Biobank Decisions: Too Much of a Good Thing? J Empir Res Hum Res Ethics 2018; 13:125-138. [PMID: 29471711 DOI: 10.1177/1556264617753483] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The opportunity to receive individual research results (IRRs) in accordance with personal preferences may incentivize biobank participation and maximize perceived benefit. This trial investigated the relationship between parents' preferences and intent to participate (ITP) in biobank research utilizing their child's genetic information. We randomized parents of pediatric patients to four hypothetical biobanks, one of which employed a preference-setting model for return of results regarding their child. ITP was highest among those desiring all types of IRRs (93.3%) and decreased as participants became increasingly selective with their preferences ( p < .0001). We demonstrated that most parents would participate in a biobank that allows for preference setting; however, those who set preferences to receive a narrower set of IRRs are less likely to participate.
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Affiliation(s)
| | - Sonja I Ziniel
- 2 Center for Patient Safety and Quality Research, Boston, MA, USA.,3 University of Colorado, Aurora, USA.,4 Children's Hospital Colorado, Aurora, USA
| | | | | | - Elissa R Weitzman
- 6 Harvard University, Boston, MA, USA.,7 Boston Children's Hospital, MA, USA
| | - Robert C Green
- 6 Harvard University, Boston, MA, USA.,8 Brigham and Women's Hospital, Boston, MA, USA
| | - Noelle L Huntington
- 6 Harvard University, Boston, MA, USA.,7 Boston Children's Hospital, MA, USA
| | | | - Ingrid A Holm
- 6 Harvard University, Boston, MA, USA.,7 Boston Children's Hospital, MA, USA
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Goodman D, Bowen D, Wenzel L, Tehrani P, Fernando F, Khacheryan A, Chowdhury F, Johnson CO, Edwards K. The research participant perspective related to the conduct of genomic cohort studies: A systematic review of the quantitative literature. Transl Behav Med 2018; 8:119-129. [PMID: 29385589 PMCID: PMC6065547 DOI: 10.1093/tbm/ibx056] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Observational genome-wide association studies require large sample sizes. Evaluating the interplay between genomic, environmental, and lifestyle factors can require even larger sample sizes. The All of Us Research Program will recruit 1 million participants to facilitate research on genomic, environmental, and lifestyle factors. Integrating participant preferences into the research process is a new paradigm and a necessary component of the All of Us Research Program. The purpose of the study is to summarize quantitative studies of participant preferences related to participation in observational genomic research studies, starting with consent through return of results. Integrating this information into the conduct of genomic studies may benefit participants, and improve participant satisfaction, recruitment, and retention. We conducted a systematic review of the literature regarding participant views related to reconsent and broad consent, use of de-identified data, contribution of data to a biorepository, risk of identification, return of individual genetic results, and motivation for participation in genomic studies. Twenty-three articles met our inclusion and exclusion criteria. Study results found that most participants support broad consent; however, significant differences related to reconsent preferences have been shown by gender and age. Most participants support the return of individual genomic results and do not feel it is necessary to maintain a link to their de-identified data. Reasons given for joining research studies varied by population source. These findings, in addition to the knowledge that participants are more accepting of broad informed consent methods when the rationale is explained, can assist in developing guidelines for future observational genomic research.
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Affiliation(s)
- Deborah Goodman
- Department of Epidemiology, University of California, Irvine, CA, USA
| | - Deborah Bowen
- Department of Health Services, University of Washington, Seattle, WA, USA
| | - Lari Wenzel
- Department of Medicine, University of California,, CA, USA
| | - Paris Tehrani
- Department of Epidemiology, University of California, Irvine, CA, USA
| | - Francis Fernando
- Department of Epidemiology, University of California, Irvine, CA, USA
| | - Araksi Khacheryan
- Department of Epidemiology, University of California, Irvine, CA, USA
| | - Farihah Chowdhury
- Department of Epidemiology, University of California, Irvine, CA, USA
| | | | - Karen Edwards
- Department of Epidemiology, University of California, Irvine, CA, USA
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48
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Political Ideology, Confidence in Science, and Participation in Alzheimer Disease Research Studies. Alzheimer Dis Assoc Disord 2018; 32:179-184. [PMID: 29351092 DOI: 10.1097/wad.0000000000000244] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Americans' confidence in science varies based on their political ideology. This ideological divide has potentially important effects on citizens' engagement with and participation in clinical studies of Alzheimer disease (AD). METHODS A probability sample of 1583 Americans was surveyed about their willingness to participate in longitudinal AD research and about their political attitudes. These survey results were compared with a survey of 382 participants in a longitudinal AD study at the Knight Alzheimer Disease Research Center. RESULTS Among Americans, more conservative ideology decreases willingness to participate in a hypothetical longitudinal cohort study of AD both directly and through its negative effect on confidence in science. The Knight Alzheimer Disease Research Center study participants expressed more liberal ideology and greater confidence in science than Americans in general. Of the survey respondents opposed to participation, over a quarter changed to neutral or positive if the study returned their research results to them. CONCLUSIONS AND RELEVANCE Clinical studies of AD are likely biased toward participants who are more liberal and have higher confidence in science than the general population. This recruitment bias may be reduced by lowering the trust demanded of participants through measures such as returning research results to participants.
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49
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Lázaro-Muñoz G, Farrell MS, Crowley JJ, Filmyer DM, Shaughnessy RA, Josiassen RC, Sullivan PF. Improved ethical guidance for the return of results from psychiatric genomics research. Mol Psychiatry 2018; 23:15-23. [PMID: 29158581 PMCID: PMC5752587 DOI: 10.1038/mp.2017.228] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Revised: 09/27/2017] [Accepted: 10/02/2017] [Indexed: 12/21/2022]
Abstract
There is an emerging consensus that genomic researchers should, at a minimum, offer to return to individual participants clinically valid, medically important and medically actionable genomic findings (for example, pathogenic variants in BRCA1) identified in the course of research. However, this is not a common practice in psychiatric genetics research. Furthermore, psychiatry researchers often generate findings that do not meet all of these criteria, yet there may be ethically compelling arguments to offer selected results. Here, we review the return of results debate in genomics research and propose that, as for genomic studies of other medical conditions, psychiatric genomics researchers should offer findings that meet the minimum criteria stated above. Additionally, if resources allow, psychiatry researchers could consider offering to return pre-specified 'clinically valuable' findings even if not medically actionable-for instance, findings that help corroborate a psychiatric diagnosis, and findings that indicate important health risks. Similarly, we propose offering 'likely clinically valuable' findings, specifically, variants of uncertain significance potentially related to a participant's symptoms. The goal of this Perspective is to initiate a discussion that can help identify optimal ways of managing the return of results from psychiatric genomics research.
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Affiliation(s)
- G Lázaro-Muñoz
- Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX, USA
| | - M S Farrell
- Department of Genetics, University of North Carolina, Chapel Hill, NC, USA
| | - J J Crowley
- Department of Genetics, University of North Carolina, Chapel Hill, NC, USA
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweeden
| | - D M Filmyer
- Translational Neuroscience LLC, Conshohocken, PA, USA
| | - R A Shaughnessy
- Translational Neuroscience LLC, Conshohocken, PA, USA
- Department of Psychiatry, Drexel University College of Medicine, Philadelphia, PA, USA
| | - R C Josiassen
- Translational Neuroscience LLC, Conshohocken, PA, USA
| | - P F Sullivan
- Department of Genetics, University of North Carolina, Chapel Hill, NC, USA
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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50
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Yamamoto K, Hachiya T, Fukushima A, Nakaya N, Okayama A, Tanno K, Aizawa F, Tokutomi T, Hozawa A, Shimizu A. Population-based biobank participants' preferences for receiving genetic test results. J Hum Genet 2017; 62:1037-1048. [PMID: 28794501 PMCID: PMC5709720 DOI: 10.1038/jhg.2017.81] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 06/22/2017] [Accepted: 06/28/2017] [Indexed: 01/18/2023]
Abstract
There are ongoing debates on issues relating to returning individual research results (IRRs) and incidental findings (IFs) generated by genetic research in population-based biobanks. To understand how to appropriately return genetic results from biobank studies, we surveyed preferences for returning IRRs and IFs among participants of the Tohoku Medical Megabank Project (TMM). We mailed a questionnaire to individuals enrolled in the TMM cohort study (Group 1; n=1031) and a group of Tohoku region residents (Group 2; n=2314). The respondents were required to be over 20 years of age. Nearly 90% of Group 1 participants and over 80% of Group 2 participants expressed a preference for receiving their genetic test results. Furthermore, over 60% of both groups preferred to receive their genetic results ‘from a genetic specialist.’ A logistic regression analysis revealed that engaging in ‘health-conscious behaviors’ (such as regular physical activity, having a healthy diet, intentionally reducing alcohol intake and/or smoking and so on) was significant, positively associated with preferring to receive their genetic test results (odds ratio=2.397 (Group 1) and 1.897 (Group 2)). Our findings provided useful information and predictors regarding the return of IRRs and IFs in a population-based biobank.
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Affiliation(s)
- Kayono Yamamoto
- Division of Innovation and Education, Iwate Tohoku Medical Megabank Organization, Disaster Reconstruction Center, Iwate Medical University, Iwate, Japan.,Department of Clinical Genetics, School of Medicine, Iwate Medical University, Iwate, Japan
| | - Tsuyoshi Hachiya
- Division of Biomedical Information Analysis, Iwate Tohoku Medical Megabank Organization, Disaster Reconstruction Center, Iwate Medical University, Iwate, Japan
| | - Akimune Fukushima
- Division of Innovation and Education, Iwate Tohoku Medical Megabank Organization, Disaster Reconstruction Center, Iwate Medical University, Iwate, Japan.,Department of Clinical Genetics, School of Medicine, Iwate Medical University, Iwate, Japan
| | - Naoki Nakaya
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Akira Okayama
- Research Institute of Strategy for Prevention, Tokyo, Japan
| | - Kozo Tanno
- Department of Hygiene and Preventive Medicine, School of Medicine, Iwate Medical University, Iwate, Japan.,Division of Clinical Research and Epidemiology, Iwate Tohoku Medical Megabank Organization, Disaster Reconstruction Center, Iwate Medical University, Iwate, Japan
| | - Fumie Aizawa
- Center for Liberal Arts and Sciences, Iwate Medical University, Iwate, Japan
| | - Tomoharu Tokutomi
- Division of Innovation and Education, Iwate Tohoku Medical Megabank Organization, Disaster Reconstruction Center, Iwate Medical University, Iwate, Japan.,Department of Clinical Genetics, School of Medicine, Iwate Medical University, Iwate, Japan
| | - Atsushi Hozawa
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Atsushi Shimizu
- Division of Biomedical Information Analysis, Iwate Tohoku Medical Megabank Organization, Disaster Reconstruction Center, Iwate Medical University, Iwate, Japan
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