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Domaradzki J, Czekajewska J, Walkowiak D. Trust and Support for Cancer Research Biobanks: Insights from Cancer Patients in Poland. Med Sci Monit 2024; 30:e944263. [PMID: 38867418 DOI: 10.12659/msm.944263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2024] Open
Abstract
BACKGROUND Biobanks are legally regulated entities that acquire, store, prepare, preserve, test, analyze, and distribute defined biological material and related information and data from human sources. This study aimed to evaluate trust, support and willingness to donate personal data and tissue samples for biobanking from cancer patients attending oncology departments in Poznań, Poland. MATERIAL AND METHODS This study utilized data from questionnaire-based survey conducted from February to June 2023 among 548 patients from 2 Poznań hospitals equipped with oncology treatment units. The survey employed convenience sampling. Statistical analysis was carried out using JASP 0.18.3 and PQStat1.8.6., with significance levels set at 0.05. Descriptive statistics and logistic regression were utilized to present the results. RESULTS 92.2% of cancer patients supported the establishment of cancer research biobank in Poland, and 93.1% declared the willingness to share their cancer tissues for research purposes. Patients' willingness to donate was associated with biomedical research conducted by biobanks and types of biobank institutions. Most patients were willing to donate for research on cancer, genetic and autoimmune diseases or dementia, but were reluctant to participate in research on sexual identity, intelligence, aggression and for-profit research. Patients were willing to donate to biobanks managed by medical universities, public institutions, clinical hospitals and national biobanks but not to foreign and private biobanks. CONCLUSIONS Although patients' support for cancer biobank is high it is not unconditional as their willingness to participate in cancer-related research is associated with types of biomedical research conducted by biobanks and different types of biobank institutions.
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Affiliation(s)
- Jan Domaradzki
- Department of Social Sciences and Humanities, Poznań University of Medical Sciences, Poznań, Poland
| | - Justyna Czekajewska
- Department of Social Sciences and Humanities, Poznań University of Medical Sciences, Poznań, Poland
| | - Dariusz Walkowiak
- Department of Organization and Management in Health Care, Poznań University of Medical Sciences, Poznań, Poland
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Majchrowska A, Pawlikowski J, Sak J, Świerczyńska B, Suchodolska M. Genetic tests as the strongest motivator of cooperation between participants and biobanks-Findings from cross-sectional study. Front Genet 2024; 15:1321690. [PMID: 38826803 PMCID: PMC11140032 DOI: 10.3389/fgene.2024.1321690] [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: 10/14/2023] [Accepted: 04/18/2024] [Indexed: 06/04/2024] Open
Abstract
Introduction The development of the scientific potential linked with biobanking and research on human biological material is highly dependent on the willingness of potential donors to cooperate with entities that collect the material. For this reason, it is crucial to identify the circumstances and factors that may encourage potential participants to donate their biological material. In particular, knowledge of the motivational factors that can be modified by the persons managing a biobank may prove notably important for shaping the organizational and communication policy of the biobank and other scientific institutions. Material and methods The research was carried out on a group of 1,100 people over 18 years of age representing the adult population of Poland in 2021. Results More than half of the respondents declared their willingness to donate a blood sample for research purposes to a biobank (57.8%). The most often indicated incentives among the factors supporting the donation of biological material were offers of: obtaining the results of genetic tests predicting the risk of diseases (77.1%), blood tests (71.3%), the possibility of obtaining a small remuneration (64.6%) and the carrying out of genetic ancestry tests (60.4%). Conclusion Offering the possibility of performing additional diagnostic tests, especially genetic tests, may significantly increase the willingness of potential donors to cooperate with biobanks and other entities collecting human biological material for the purpose of scientific research. However, attention should also be paid to the challenges and risks linked with respecting the privacy and autonomy of research participants.
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Affiliation(s)
- Anita Majchrowska
- Department of Humanities and Social Medicine, Medical University of Lublin, Lublin, Poland
| | - Jakub Pawlikowski
- Department of Humanities and Social Medicine, Medical University of Lublin, Lublin, Poland
| | - Jarosław Sak
- Department of Humanities and Social Medicine, Medical University of Lublin, Lublin, Poland
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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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McEnhill R, Borghese H, Moore SA. Pet owner perspectives, motivators and concerns about veterinary biobanking. Front Vet Sci 2024; 11:1359546. [PMID: 38444781 PMCID: PMC10912476 DOI: 10.3389/fvets.2024.1359546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 02/07/2024] [Indexed: 03/07/2024] Open
Abstract
Introduction Veterinary biobanks store samples for future use and distribute samples to academic researchers and industry entities; however, informed consent provided by owners for pets contributing to biobanks can be complicated by limited understanding of goals, purpose, and logistics of biobanking. Methods This survey-based study aimed to gather feedback from pet owners on how they viewed allowing their pet to contribute to a veterinary biobank, with the goal of identifying opportunities to improve education, awareness of veterinary biobanking initiatives, and the consent processes. An electronic survey was distributed to a listserv of 2,119 pet owners and responses were received from 118 respondents (5.6%). Results Most respondents (67%) were not familiar with the concept of veterinary biobanking prior to having responded to the survey. Most (89%) were willing to allow their healthy pet to contribute samples to a veterinary biobanking program. Ninety-five percent would allow their sick pet to contribute. Most were neutral about financial incentives as a motivator to participate, although 40% indicated that if their pet's condition resulted in a decision to humanely euthanize, they would be more likely to contribute to the biobank if the veterinary biobanking program covered the cost of euthanasia. Common concerns included security/confidentiality (36%), that results would not be shared with them (33%) or that samples would be used for other purposes beyond those advertised (22%). Discussion These results suggest veterinary biobanking initiatives are well received by owners and most are willing to allow their pets to participate. Respondent concerns represent opportunities for veterinary biobanks to improve messaging and dissemination of results from work they support.
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Affiliation(s)
- Richard McEnhill
- Blue Buffalo Veterinary Clinical Trials Office, Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, OH, United States
- MedVet Medical and Cancer Centers for Pets, Columbus, OH, United States
| | - Holly Borghese
- Blue Buffalo Veterinary Clinical Trials Office, Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, OH, United States
| | - Sarah A. Moore
- Blue Buffalo Veterinary Clinical Trials Office, Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, OH, United States
- BluePearl Science, Tampa, FL, United States
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Passmore SR, Gerbitz A, Hancock GR, Evans L, Green-Harris G, Edwards DF, Jackson T, Thomas SB. "My Blood, You Know, My Biology Being out There…": Consent and Participant Control of Biological Samples. J Empir Res Hum Res Ethics 2024; 19:3-15. [PMID: 38192107 PMCID: PMC10957312 DOI: 10.1177/15562646231222665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2024]
Abstract
The widespread and persistent underrepresentation of groups experiencing health disparities in research involving biospecimens is a barrier to scientific knowledge and advances in health equity. To ensure that all groups have the opportunity to participate in research and feel welcome and safe doing so, we must understand how research studies may be shaped to promote inclusion. In this study, we explored the decision to participate in hypothetical research scenarios among African American adults (n = 169) that varied on the basis of four attributes (form of consent, reason for research, institutional affiliation and race of the researcher). Findings indicate that participants were largely willing to contribute to biobanks but significantly preferred opportunities where they had control over the use of their biological samples through tiered or study-specific forms of consent. Broad consent procedures, although common and perhaps preferred by participants with high trust in researchers, may amount to an exclusionary practice.
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Affiliation(s)
| | - Abigail Gerbitz
- School of Nursing, University of Wisconsin, Madison, WI, USA
| | - Gregory R. Hancock
- Department of Human Development and Quantitative Methodology, College of Education, University of Maryland, College Park, MD, USA
| | - Laura Evans
- Human Development and Family Studies, School of Human Ecology, University of Wisconsin, Madison, WI, USA
| | - Gina Green-Harris
- Center for Community Engagement and Health Partnerships, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin, Madison, USA
| | - Dorothy Farrar Edwards
- School of Nursing, University of Wisconsin, Madison, WI, USA
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin, Madison, USA
- Department of Kinesiology, School of Education, University of Wisconsin, Madison, USA
| | - Tyson Jackson
- School of Nursing, University of Wisconsin, Madison, WI, USA
| | - Stephen B. Thomas
- Center for Health Equity, School of Public Health, University of Maryland, College Park, MD, USA
- Department of Health Policy and Management, School of Public Health, University of Maryland, College Park, MD, USA
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Yadav BK, Ng W, Vu H, Fachiroh J, Tsuruyama T, Zhou L, Henderson MK, Gokhale S, Furuta K. Improving Public Trust in Biobanking: Roundtable Discussions from the 2021 ISBER Annual Meeting. Biopreserv Biobank 2023; 21:308-312. [PMID: 35834557 PMCID: PMC10398726 DOI: 10.1089/bio.2022.0046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Biobanking is a relatively newly recognized and innovative branch of science, which includes the collection of samples and associated data from hospitals, diagnostic centers, and voluntary donations for biomedical and environmental research. It involves diverse stakeholders at the junction of society, science, ethics, law, and politics. A key element in the success of a biobank is the trust and support of public donors, clinicians, and scientists. To achieve trust, it is important to implement strategies that can increase biobank awareness in common people, and different types of communities. Biobank laws and regulations and transparent governance by the biobanks are also crucial to achieving public trust.
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Affiliation(s)
| | - Wayne Ng
- Victorian Cancer Biobank, Melbourne, Australia
| | - Hanh Vu
- Integrated Glyco-Molecular Science Center, Institute for Glyco-core Research (iGCORE), Gifu University, Gifu, Japan
| | - Jajah Fachiroh
- Biobank Development Team/Department of Histology and Cell Biology, Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Tatsuaki Tsuruyama
- Kitano Medical Institute, Osaka, Japan
- Kyoto University Hospital, Kyoto, Japan
| | - Li Zhou
- Tumour Bank, The Children's Hospital at Westmead (CHWTB), Westmead, Australia
| | - Marianne K. Henderson
- Center for Global Health, National Cancer Institute, NIH/DHHS, Rockville, Maryland, USA
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Caroline D, Marie-France M. Get this thing out of my body! Factors determining consent for translational oncology research: a qualitative research. J Transl Med 2023; 21:336. [PMID: 37211597 DOI: 10.1186/s12967-023-04039-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 03/05/2023] [Indexed: 05/23/2023] Open
Abstract
BACKGROUND Depending on the needs of scientific research at a given time, biobanks make biological samples and data available to researchers. In this article, we aim to describe the reasons and underlying logic that determine the decision to grant or deny consent to the conservation of tumour samples in a biological resource platform for research purposes. We make use of the CARPEM biological resource platform model, where broad consent is required. METHODS The results are based on semi-structured interviews, conducted between 2019 and 2021, with 25 individuals having various profiles. RESULTS All the people interviewed readily accepted the principle of conserving a tumour sample for research purposes. They explained their decision by citing the desire to participate in research dedicated to improving therapeutic medicine. Their trust in research institutions or in doctors was an important factor in their consent. The tumorous nature of the samples also played an important role, as did the absence of constraints. Finally, the high level of consent was also based on the difficulty they had in conceiving what the future risks might be once the sample had been taken, whereas the fact that they did not know the nature or purpose of the research to be carried out when they signed the consent form posed some problems. These results stem from a lack of a culture of ethics among the people interviewed. CONCLUSION The information provided in the context of consent at the CARPEM tumour bank seems inadequate for consent to be considered 'informed', given the low level of knowledge that people have of the risks and issues. Information is missing even though we feel it would not change consent or only marginally. This raises questions, since part of the act of granting consent is based on the implicit trust French people have in the hospital that collects the data and in research practices in general. In the minds of those who participate, transparency is the ground on which trust rests. Lack of transparency could be deleterious for future research practices. However, it is not by striving to improve information leaflets that the consent-related information will improve but, rather, by more effectively helping future patients to assimilate that information.
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Affiliation(s)
- Desprès Caroline
- Centre de Recherche des Cordeliers, Sorbonne Université, Université Paris Cité, Inserm, Laboratoire Êtres, Unité Fonctionnelle d'Éthique Médicale, Hôpital Necker-Enfants Malades, APHP, Paris, France.
| | - Mamzer Marie-France
- Centre de Recherche des Cordeliers, Sorbonne Université, Université Paris Cité, Inserm, Laboratoire Êtres, Unité Fonctionnelle d'Éthique Médicale, Hôpital Necker-Enfants Malades, APHP, Paris, France
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Merz S, Jaehn P, Pischon T, Fischer B, Wirkner K, Rach S, Guenther K, Obi N, Holmberg C. Investigating people's attitudes towards participating in longitudinal health research: an intersectionality-informed perspective. Int J Equity Health 2023; 22:23. [PMID: 36721141 PMCID: PMC9887766 DOI: 10.1186/s12939-022-01807-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 12/14/2022] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Increasing evidence suggests that participation proportions in longitudinal health research vary according to sex/gender, age, social class, or migration status. Intersectionality scholarship purports that such social categories cannot be understood in isolation and makes visible the co-dependent nature of the social determinants of health and illness. This paper uses an intersectionality-informed approach in order to expand the understanding of why people participate in health research, and the impact of intersecting social structures and experiences on these attitudes. METHODS A sample of 80 respondents who had previously either accepted or declined an invitation to participate in the German National Cohort (NAKO) participated in our interview study. Interviews were semi-structured and contained both narrative elements and more structured probes. Data analysis proceeded in two steps: first, the entire data set was analysed thematically (separately for participants and non-participants); second, key themes were compared across self-reported sex/gender, age group and migration status to identify differences and commonalities. RESULTS Respondents' attitudes towards study participation can be categorised into four themes: wanting to make a contribution, seeking personalised health information, excitement and feeling chosen, and seeking social recognition. Besides citing logistical challenges, non-participants narrated adverse experiences with or attitudes towards science and the healthcare system that deterred them from participating. A range of social experiences and cultural value systems shaped such attitudes; in particular, this includes the cultural authority of science as an arbiter of social questions, transgressing social categories and experiences of marginalisation. Care responsibilities, predominantly borne by female respondents, also impacted upon the decision to take part in NAKO. DISCUSSION Our findings suggest that for participants, health research constitutes a site of distinction in the sense of making a difference and being distinct or distinguishable, whereas non-participants inhabited an orientation towards science that reflected their subjective marginalisation through science. No clear relationship can thereby be presumed between social location and a particular attitude towards study participation; rather, such attitudes transgress and challenge categorical boundaries. This challenges the understanding of particular populations as more or less disadvantaged, or as more or less inclined to participate in health research.
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Affiliation(s)
- Sibille Merz
- grid.473452.3Institute of Social Medicine and Epidemiology, Brandenburg Medical School Theodor Fontane, Hochstr. 15, 14770 Brandenburg an der Havel, Germany
| | - Philipp Jaehn
- grid.473452.3Institute of Social Medicine and Epidemiology, Brandenburg Medical School Theodor Fontane, Hochstr. 15, 14770 Brandenburg an der Havel, Germany ,grid.11348.3f0000 0001 0942 1117Faculty of Health Sciences, joint Faculty of the Brandenburg University of Technology Cottbus – Senftenberg, Brandenburg Medical School, University of Potsdam, Fehrbelliner Str. 38, 16816 Neuruppin, Germany
| | - Tobias Pischon
- grid.419491.00000 0001 1014 0849Max-Delbrueck-Center for Molecular Medicine in the Helmholtz Association (MDC), Molecular Epidemiology Research Group, Robert-Rössle-Straße 10, 13125 Berlin, Germany ,grid.419491.00000 0001 1014 0849Max-Delbrueck-Center for Molecular Medicine in the Helmholtz Association (MDC), Biobank Technology Platform, Robert-Rössle-Straße 10, 13125 Berlin, Germany ,grid.484013.a0000 0004 6879 971XBerlin Institute of Health at Charité - Universitätsmedizin Berlin, Core Facility Biobank, Anna-Louisa-Karsch-Straße 2, 10178 Berlin, Germany ,grid.6363.00000 0001 2218 4662Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitépl. 1, 10117 Berlin, Germany
| | - Beate Fischer
- grid.7727.50000 0001 2190 5763University of Regensburg, Department of Epidemiology and Preventive Medicine, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany
| | - Kerstin Wirkner
- LIFE – Leipzig Research Centre for Civilization Diseases, Philipp-Rosenthal-Straße 27, 04103 Leipzig, Germany
| | - Stefan Rach
- grid.418465.a0000 0000 9750 3253Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstraße 30, 28359 Bremen, Germany
| | - Kathrin Guenther
- grid.418465.a0000 0000 9750 3253Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstraße 30, 28359 Bremen, Germany
| | - Nadia Obi
- grid.13648.380000 0001 2180 3484University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20251 Hamburg, Germany
| | - Christine Holmberg
- grid.473452.3Institute of Social Medicine and Epidemiology, Brandenburg Medical School Theodor Fontane, Hochstr. 15, 14770 Brandenburg an der Havel, Germany ,grid.11348.3f0000 0001 0942 1117Faculty of Health Sciences, joint Faculty of the Brandenburg University of Technology Cottbus – Senftenberg, Brandenburg Medical School, University of Potsdam, Fehrbelliner Str. 38, 16816 Neuruppin, Germany
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Desprès C, Mamzer MF. Le consentement éclairé en question dans le cadre de collections en biobanque. Bull Cancer 2022; 109:948-959. [DOI: 10.1016/j.bulcan.2022.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 03/23/2022] [Accepted: 03/29/2022] [Indexed: 10/18/2022]
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Loosman I, Nickel PJ. Towards a Design Toolkit of Informed Consent Models Across Fields: A Systematic Review. SCIENCE AND ENGINEERING ETHICS 2022; 28:42. [PMID: 36042065 PMCID: PMC9427926 DOI: 10.1007/s11948-022-00398-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 08/01/2022] [Indexed: 06/15/2023]
Abstract
In the 60+ years that the modern concept of informed consent has been around, researchers in various fields of practice, especially medical ethics, have developed new models to overcome theoretical and practical problems. While (systematic) literature reviews of such models exist within given fields (e.g., genetic screening), this article breaks ground by analyzing academic literature on consent models across fields. Three electronic research databases (Scopus, Google Scholar, and Web of Science) were searched for publications mentioning informed consent models. The titles, abstracts, and if applicable, full publications were screened and coded. The resulting data on fields, models, and themes were then analyzed. We scanned 300 sources from three databases to find 207 uniquely named consent models, and created a network visualization displaying which models occur primarily in one field, and which models overlap between fields. This analysis identifies trends in the consent debate in different fields, as well as common goals of consent models. The most frequently occurring consent models are identified and defined. The analysis contributes toward a cross-disciplinary "consent design toolkit" and highlights that there are more interrelationships between models and fields than are acknowledged in the literature. Where some models are designed to solve distinctively field-specific issues and are specific to biomedical ethics, some may be adaptable and applicable for other fields including engineering and design.
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Affiliation(s)
- Iris Loosman
- Department of Philosophy and Ethics, School of Innovation Sciences, Eindhoven University of Technology, PO Box 513, 5600 MB, Eindhoven, The Netherlands.
| | - Philip J Nickel
- Department of Philosophy and Ethics, School of Innovation Sciences, Eindhoven University of Technology, PO Box 513, 5600 MB, Eindhoven, The Netherlands
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Wignarajah A, Alvero R, Lathi RB, Aghajanova L, Eisenberg M, Winn VD, Behr B, Murugappan G. Implementation of a comprehensive fertility biobanking initiative. F&S SCIENCE 2022; 3:228-236. [PMID: 35977803 PMCID: PMC9386165 DOI: 10.1016/j.xfss.2022.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 01/04/2022] [Accepted: 01/07/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To present the framework of Stanford Fertility and Reproductive Health's comprehensive reproductive biobanking initiatives and the results of the first year of recruitment. DESIGN Technical description article. SETTING Academic fertility center. PATIENT(S) Fertility patients >18 years of age. INTERVENTION(S) Enroll the patients interested in research in biobanking protocols. MAIN OUTCOME MEASURE(S) Patient recruitment and sample inventory from September 2020 to September 2021. RESULT(S) A total of 253 patients have enrolled in the Stanford Fertility and Reproductive Health biobanking initiatives since September 2020. The current inventory consists of 1,176 samples, including serums, plasmas, buffy coats, endometria, maternal deciduae, miscarriage chorionic villi, and human embryos (zygote, cleavage, and blastocyst stages). CONCLUSION(S) This biobanking initiative addresses a critical, unmet need in reproductive health research to make it possible for patients to donate excess embryos and gametes and preserves, for future research, valuable somatic and reproductive tissues that would otherwise be discarded. We present the framework of this biobanking initiative in order to support future efforts of establishing similar biorepositories.
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Affiliation(s)
- Anjali Wignarajah
- Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, Stanford University, Sunnyvale, California
| | - Ruben Alvero
- Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, Stanford University, Sunnyvale, California
| | - Ruth B Lathi
- Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, Stanford University, Sunnyvale, California
| | - Lusine Aghajanova
- Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, Stanford University, Sunnyvale, California
| | | | - Virginia D Winn
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Stanford University, Stanford, California
| | - Barry Behr
- Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, Stanford University, Sunnyvale, California
| | - Gayathree Murugappan
- Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, Stanford University, Sunnyvale, California.
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Neilan AM, Tyagi A, Tong Y, Farkas EJ, Burns MD, Fialkowski A, Park G, Hardcastle M, Gootkind E, Bassett IV, Shebl FM, Yonker LM. Pediatric biorepository participation during the COVID-19 pandemic: predictors of enrollment and biospecimen donation. BMC Pediatr 2022; 22:130. [PMID: 35279115 PMCID: PMC8917327 DOI: 10.1186/s12887-022-03185-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 03/03/2022] [Indexed: 11/21/2022] Open
Abstract
Background Patient-level predictors of enrollment in pediatric biorepositories are poorly described. Especially in pandemic settings, understanding who is likely to enroll in a biorepository is critical to interpreting analyses conducted on biospecimens. We describe predictors of pediatric COVID-19 biorepository enrollment and biospecimen donation to identify gaps in COVID-19 research on pediatric biospecimens. Methods We compared data from enrollees and non-enrollees aged 0–25 years with suspected or confirmed COVID-19 infection who were approached for enrollment in the Massachusetts General Hospital pediatric COVID-19 biorepository between April 12, 2020, and May 28, 2020, from community or academic outpatient or inpatient settings. Demographic and clinical data at presentation to care were from automatic and manual chart extractions. Predictors of enrollment and biospecimen donation were assessed with Poisson regression models. Results Among 457 individuals approached, 214 (47%) enrolled in the biorepository. A COVID-19 epidemiologic risk factor was recorded for 53%, and 15% lived in a US Centers for Disease Control and Prevention-defined COVID-19 hotspot. Individuals living in a COVID-19 hotspot (relative risk (RR) 2.4 [95% confidence interval (CI): 1.8–3.2]), with symptoms at presentation (RR 1.8 [95% CI: 1.2–2.7]), or admitted to hospital (RR 1.8 [95% CI: 1.2–2.8]) were more likely to enroll. Seventy-nine percent of enrollees donated any biospecimen, including 97 nasopharyngeal swabs, 119 oropharyngeal swabs, and 105 blood, 16 urine, and 16 stool specimens, respectively. Age, sex, race, ethnicity, and neighborhood-level socioeconomic status based on zip code did not predict enrollment or biospecimen donation. Conclusions While fewer than half of individuals approached consented to participate in the pediatric biorepository, enrollment appeared to be representative of children affected by the pandemic. Living in a COVID-19 hotspot, symptoms at presentation to care and hospital admission predicted biorepository enrollment. Once enrolled, most individuals donated a biospecimen. Supplementary Information The online version contains supplementary material available at 10.1186/s12887-022-03185-6.
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Kasperbauer TJ, Waltz A, Hudson B, Hawryluk B, Moore C, Schmidt K, Schwartz PH. Collecting Biospecimens and Obtaining Biobank Consent From Patients in an Academic Health Care Setting: Practical and Ethical Considerations. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2022; 97:62-68. [PMID: 34524131 DOI: 10.1097/acm.0000000000004418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Academic health centers and health systems increasingly ask patients to enroll in research biobanks as part of standard care, raising important practical and ethical questions for integrating biobank consent processes into health care settings. This article aims to assist academic health centers and health systems considering implementing these integrated consent processes by outlining the 5 main issues-and the key practical and ethical considerations for each issue-that Indiana University Health and the Indiana Biobank faced when integrating biobank consent into their health system, as well as the key obstacles encountered. The 5 main issues to consider include the specimen to collect (leftover, new collection, or add-ons to clinical tests), whether to use opt-in or opt-out consent, where to approach patients, how to effectively use digital tools for consent, and how to appropriately simplify consent information.
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Affiliation(s)
- T J Kasperbauer
- T.J. Kasperbauer is a postdoctoral fellow, Indiana University Center for Bioethics, Indiana University School of Medicine, Indianapolis, Indiana
| | - Amy Waltz
- A. Waltz is associate director, Office of Research Compliance, Indiana University, Indianapolis, Indiana
| | - Brenda Hudson
- B. Hudson is director of strategic operations, Indiana Clinical and Translational Sciences Institute, Indianapolis, Indiana
| | - Bridget Hawryluk
- B. Hawryluk is human-centered designer, Research Jam, Patient Engagement Core, Indiana Clinical and Translational Sciences Institute, Indianapolis, Indiana
| | - Courtney Moore
- C. Moore is human-centered designer, Research Jam, Patient Engagement Core, Indiana Clinical and Translational Sciences Institute, Indianapolis, Indiana
| | - Karen Schmidt
- K. Schmidt is project manager, Indiana University Center for Bioethics, Indiana University School of Medicine, Indianapolis, Indiana
| | - Peter H Schwartz
- P.H. Schwartz is director, Indiana University Center for Bioethics, and associate professor of medicine, Indiana University School of Medicine, Indianapolis, Indiana
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14
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Lysaght T, Ballantyne A, Toh HJ, Lau A, Ong S, Schaefer O, Shiraishi M, van den Boom W, Xafis V, Tai ES. Trust and Trade-Offs in Sharing Data for Precision Medicine: A National Survey of Singapore. J Pers Med 2021; 11:921. [PMID: 34575698 PMCID: PMC8465970 DOI: 10.3390/jpm11090921] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 09/13/2021] [Accepted: 09/13/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Precision medicine (PM) programs typically use broad consent. This approach requires maintenance of the social license and public trust. The ultimate success of PM programs will thus likely be contingent upon understanding public expectations about data sharing and establishing appropriate governance structures. There is a lack of data on public attitudes towards PM in Asia. METHODS The aim of the research was to measure the priorities and preferences of Singaporeans for sharing health-related data for PM. We used adaptive choice-based conjoint analysis (ACBC) with four attributes: uses, users, data sensitivity and consent. We recruited a representative sample of n = 1000 respondents for an in-person household survey. RESULTS Of the 1000 respondents, 52% were female and majority were in the age range of 40-59 years (40%), followed by 21-39 years (33%) and 60 years and above (27%). A total of 64% were generally willing to share de-identified health data for IRB-approved research without re-consent for each study. Government agencies and public institutions were the most trusted users of data. The importance of the four attributes on respondents' willingness to share data were: users (39.5%), uses (28.5%), data sensitivity (19.5%), consent (12.6%). Most respondents found it acceptable for government agencies and hospitals to use de-identified data for health research with broad consent. Our sample was consistent with official government data on the target population with 52% being female and majority in the age range of 40-59 years (40%), followed by 21-39 years (33%) and 60 years and above (27%). CONCLUSIONS While a significant body of prior research focuses on preferences for consent, our conjoint analysis found consent was the least important attribute for sharing data. Our findings suggest the social license for PM data sharing in Singapore currently supports linking health and genomic data, sharing with public institutions for health research and quality improvement; but does not support sharing with private health insurers or for private commercial use.
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Affiliation(s)
- Tamra Lysaght
- Centre for Biomedical Ethics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore; (T.L.); (A.B.); (S.O.); (O.S.); (M.S.); (V.X.)
| | - Angela Ballantyne
- Centre for Biomedical Ethics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore; (T.L.); (A.B.); (S.O.); (O.S.); (M.S.); (V.X.)
- Department of Primary Health Care & General Practice, University of Otago, Wellington 6021, New Zealand
| | - Hui Jin Toh
- Centre for Biomedical Ethics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore; (T.L.); (A.B.); (S.O.); (O.S.); (M.S.); (V.X.)
| | - Andrew Lau
- Projective Insights Consultants, Singapore 590003, Singapore;
| | - Serene Ong
- Centre for Biomedical Ethics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore; (T.L.); (A.B.); (S.O.); (O.S.); (M.S.); (V.X.)
| | - Owen Schaefer
- Centre for Biomedical Ethics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore; (T.L.); (A.B.); (S.O.); (O.S.); (M.S.); (V.X.)
| | - Makoto Shiraishi
- Centre for Biomedical Ethics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore; (T.L.); (A.B.); (S.O.); (O.S.); (M.S.); (V.X.)
| | - Willem van den Boom
- Yale-NUS College, National University of Singapore, Singapore 138527, Singapore;
| | - Vicki Xafis
- Centre for Biomedical Ethics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore; (T.L.); (A.B.); (S.O.); (O.S.); (M.S.); (V.X.)
| | - E Shyong Tai
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore;
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore 117549, Singapore
- Precision Health Research, Singapore 139234, Singapore
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15
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Amin L, Olesen A, Mahadi Z, Ibrahim M. Current Status and Future Challenges of Biobank Research in Malaysia. Asian Bioeth Rev 2021; 13:297-315. [PMID: 34295385 PMCID: PMC8245627 DOI: 10.1007/s41649-021-00171-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 03/08/2021] [Accepted: 03/10/2021] [Indexed: 11/24/2022] Open
Abstract
The establishment of MyCohort in 2005 showed that there is a growing interest on the part of the Malaysian government in the creation of biobanks in the country. This project can be considered as the biggest and most comprehensive cohort study in Malaysia, where hundreds of thousands of human samples are stored for epidemiological and biomedical research. However, little is known about the current issues or the situation related to biobank research in Malaysia. There are pressing issues that need answers such as the governance of the national biobank as well as other privately owned biobanks in the nation, the public perspectives and perceptions regarding biobanks, and other matters such as the ethical, legal, and social issues related to biobank research. This article will highlight the status and issues related to biobank research in Malaysia and provide suggestions on future research practices that we feel need to be seriously considered. These suggestions are designed to advance and enlighten researchers' knowledge, as well as provide the public with information on issues associated to biobanking. Good governance increases public knowledge and trust, and religious acceptance of biobank research and accountability can lead to increased participation in biobank research. The direct implications of the discussion about the ethical, legal, and social issues of biobanks are pertinent for the foundation of knowledge relating to biobanks, as well as the forward gestures for future medicine for mankind.
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Affiliation(s)
- Latifah Amin
- Pusat Citra Universiti, Universiti Kebangsaan Malaysia, Bangi, Selangor Malaysia
| | - Angelina Olesen
- Pusat Citra Universiti, Universiti Kebangsaan Malaysia, Bangi, Selangor Malaysia
| | - Zurina Mahadi
- Pusat Citra Universiti, Universiti Kebangsaan Malaysia, Bangi, Selangor Malaysia
| | - Maznah Ibrahim
- Pusat Citra Universiti, Universiti Kebangsaan Malaysia, Bangi, Selangor Malaysia
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16
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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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17
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Tosoni S, Voruganti I, Lajkosz K, Habal F, Murphy P, Wong RKS, Willison D, Virtanen C, Heesters A, Liu FF. The use of personal health information outside the circle of care: consent preferences of patients from an academic health care institution. BMC Med Ethics 2021; 22:29. [PMID: 33761938 PMCID: PMC7992944 DOI: 10.1186/s12910-021-00598-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 03/04/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Immense volumes of personal health information (PHI) are required to realize the anticipated benefits of artificial intelligence in clinical medicine. To maintain public trust in medical research, consent policies must evolve to reflect contemporary patient preferences. METHODS Patients were invited to complete a 27-item survey focusing on: (a) broad versus specific consent; (b) opt-in versus opt-out approaches; (c) comfort level sharing with different recipients; (d) attitudes towards commercialization; and (e) options to track PHI use and study results. RESULTS 222 participants were included in the analysis; 83% were comfortable sharing PHI with researchers at their own hospital, although younger patients (≤ 49 years) were more uncomfortable than older patients (50 + years; 13% versus 2% uncomfortable, p < 0.05). While 56% of patients preferred broad consent, 38% preferred specific consent; 6% preferred not sharing at all. The majority of patients (63%) preferred to be asked for permission before entry into a contact pool. Again, this trend was more pronounced for younger patients (≤ 49 years: 76%). Approximately half of patients were uncomfortable sharing PHI with commercial enterprises (51% uncomfortable, 27% comfortable, 22% neutral). Most patients preferred to track PHI usage (61%), with the highest proportion once again reported by the youngest patients (≤ 49 years: 71%). A majority of patients also wished to be notified regarding study results (70%). CONCLUSIONS While most patients were willing to share their PHI with researchers within their own institution, many preferred a transparent and reciprocal consent process. These data also suggest a generational shift, wherein younger patients preferred more specific consent options. Modernizing consent policies to reflect increased autonomy is crucial in fostering sustained public engagement with medical research.
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Affiliation(s)
- Sarah Tosoni
- Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Indu Voruganti
- Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, ON, Canada
- Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada
| | - Katherine Lajkosz
- Department of Biostatistics, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Flavio Habal
- Department of Medicine, University Health Network, Toronto, ON, Canada
| | - Patricia Murphy
- Department of Anaesthesia, University Health Network, Toronto, ON, Canada
| | - Rebecca K S Wong
- Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, ON, Canada
- Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Donald Willison
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Carl Virtanen
- University Health Network Digital, Toronto, ON, Canada
| | - Ann Heesters
- Department of Bioethics, University Health Network, Toronto, ON, Canada
- Joint Centre for Bioethics, University of Toronto, Toronto, ON, Canada
| | - Fei-Fei Liu
- Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, ON, Canada.
- Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada.
- Princess Margaret Cancer Centre, Department of Radiation Oncology, 700 University Avenue, Toronto, ON, M5G 2M9, Canada.
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18
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Cumyn A, Dault R, Barton A, Cloutier AM, Ethier JF. Citizens, Research Ethics Committee Members and Researchers' Attitude Toward Information and Consent for the Secondary Use of Health Data: Implications for Research Within Learning Health Systems. J Empir Res Hum Res Ethics 2021; 16:165-178. [PMID: 33710932 PMCID: PMC8236664 DOI: 10.1177/1556264621992214] [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] [Indexed: 11/15/2022]
Abstract
A survey was conducted to assess citizens, research ethics committee members, and researchers' attitude toward information and consent for the secondary use of health data for research within learning health systems (LHSs). Results show that the reuse of health data for research to advance knowledge and improve care is valued by all parties; consent regarding health data reuse for research has fundamental importance particularly to citizens; and all respondents deemed important the existence of a secure website to support the information and consent processes. This survey was part of a larger project that aims at exploring public perspectives on alternate approaches to the current consent models for health data reuse to take into consideration the unique features of LHSs. The revised model will need to ensure that citizens are given the opportunity to be better informed about upcoming research and have their say, when possible, in the use of their data.
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Affiliation(s)
- Annabelle Cumyn
- Groupe de Recherche Interdisciplinaire en Informatique de la Santé (GRIIS), Faculté de Médecine et des Sciences de la Santé, 7321Université de Sherbrooke, Sherbrooke, Québec, Canada.,Département de Médecine, Faculté de Médecine et des Sciences de la Santé, 7321Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Roxanne Dault
- Groupe de Recherche Interdisciplinaire en Informatique de la Santé (GRIIS), Faculté de Médecine et des Sciences de la Santé, 7321Université de Sherbrooke, Sherbrooke, Québec, Canada.,Département de Médecine, Faculté de Médecine et des Sciences de la Santé, 7321Université de Sherbrooke, Sherbrooke, Québec, Canada.,Data Access Component, Quebec SPOR Support Unit, 98629Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Adrien Barton
- Groupe de Recherche Interdisciplinaire en Informatique de la Santé (GRIIS), Faculté de Médecine et des Sciences de la Santé, 7321Université de Sherbrooke, Sherbrooke, Québec, Canada.,27051Centre National de la Recherche Scientifique-Institut de Recherche en Informatique de Toulouse (CNRS-IRIT), Toulouse, Île-de-France, France
| | - Anne-Marie Cloutier
- Groupe de Recherche Interdisciplinaire en Informatique de la Santé (GRIIS), Faculté de Médecine et des Sciences de la Santé, 7321Université de Sherbrooke, Sherbrooke, Québec, Canada.,Département de Médecine, Faculté de Médecine et des Sciences de la Santé, 7321Université de Sherbrooke, Sherbrooke, Québec, Canada.,Data Access Component, Quebec SPOR Support Unit, 98629Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Jean-François Ethier
- Groupe de Recherche Interdisciplinaire en Informatique de la Santé (GRIIS), Faculté de Médecine et des Sciences de la Santé, 7321Université de Sherbrooke, Sherbrooke, Québec, Canada.,Département de Médecine, Faculté de Médecine et des Sciences de la Santé, 7321Université de Sherbrooke, Sherbrooke, Québec, Canada.,Data Access Component, Quebec SPOR Support Unit, 98629Université de Sherbrooke, Sherbrooke, Québec, Canada
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19
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McKeown A, Mourby M, Harrison P, Walker S, Sheehan M, Singh I. Ethical Issues in Consent for the Reuse of Data in Health Data Platforms. SCIENCE AND ENGINEERING ETHICS 2021; 27:9. [PMID: 33538942 PMCID: PMC7862505 DOI: 10.1007/s11948-021-00282-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 12/21/2020] [Indexed: 05/08/2023]
Abstract
Data platforms represent a new paradigm for carrying out health research. In the platform model, datasets are pooled for remote access and analysis, so novel insights for developing better stratified and/or personalised medicine approaches can be derived from their integration. If the integration of diverse datasets enables development of more accurate risk indicators, prognostic factors, or better treatments and interventions, this obviates the need for the sharing and reuse of data; and a platform-based approach is an appropriate model for facilitating this. Platform-based approaches thus require new thinking about consent. Here we defend an approach to meeting this challenge within the data platform model, grounded in: the notion of 'reasonable expectations' for the reuse of data; Waldron's account of 'integrity' as a heuristic for managing disagreement about the ethical permissibility of the approach; and the element of the social contract that emphasises the importance of public engagement in embedding new norms of research consistent with changing technological realities. While a social contract approach may sound appealing, however, it is incoherent in the context at hand. We defend a way forward guided by that part of the social contract which requires public approval for the proposal and argue that we have moral reasons to endorse a wider presumption of data reuse. However, we show that the relationship in question is not recognisably contractual and that the social contract approach is therefore misleading in this context. We conclude stating four requirements on which the legitimacy of our proposal rests.
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Affiliation(s)
- Alex McKeown
- Department of Psychiatry, Wellcome Centre for Ethics and Humanities, Warneford Hospital, University of Oxford, Oxford, OX3 7JX, UK.
| | - Miranda Mourby
- Centre for Health, Law and Emerging Technologies (HeLEX), University of Oxford, Oxford, UK
| | - Paul Harrison
- Department of Psyhiatry, Oxford Health NHS Foundation Trust, University of Oxford, Oxford, UK
| | - Sophie Walker
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Mark Sheehan
- Ethox, Wellcome Centre for Ethics and Humanities, University of Oxford, Oxford, UK
| | - Ilina Singh
- Department of Psychiatry, Wellcome Centre for Ethics and Humanities, University of Oxford, Oxford, UK
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20
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Biobank Oversight and Sanctions Under the General Data Protection Regulation. GDPR AND BIOBANKING 2021. [DOI: 10.1007/978-3-030-49388-2_8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
AbstractThis contribution offers an insight into the function and problems of the oversight and sanctions mechanisms outlined in the General Data Protection Regulation as they relate to the biobanking context. These mechanisms might be considered as meta-mechanisms—mechanisms relating to, but not consisting of, substantive legal principles—functioning in tandem to ensure biobank compliance with data protection principles. Each of the mechanisms outlines, on paper at least, comprehensive and impressive compliance architecture—both expanding on their capacity in relation to Directive 95/46. Accordingly, each mechanism looks likely to have a significant and lasting impact on biobanks and biobanking. Despite this comprehensiveness, however, the mechanisms are not immune from critique. Problems appear regarding the standard of protection provided for research subject rights, regarding the disproportionate impact on legitimate interests tied up with the biobanking process—particularly genomic research interests—and regarding their practical implementability in biobanking.
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21
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Wendler D, Berkman BE. Maximizing the value of human biospecimens: Lessons from coronavirus and the Seattle flu study. Am J Med Genet A 2020; 182:2826-2828. [PMID: 33010181 PMCID: PMC7675309 DOI: 10.1002/ajmg.a.61891] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 09/13/2020] [Accepted: 09/13/2020] [Indexed: 11/16/2022]
Affiliation(s)
- David Wendler
- Department of Bioethics, NIH Clinical Center, Bethesda, Maryland, USA
| | - Benjamin E Berkman
- Department of Bioethics, NIH Clinical Center, Bethesda, Maryland, USA.,National Human Genome Research Institute, Bethesda, Maryland, USA
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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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Donation of discarded ocular tissue in patients undergoing SMILE laser refractive surgery: developing appropriate guidelines. Cell Tissue Bank 2020; 21:605-613. [PMID: 32700115 DOI: 10.1007/s10561-020-09850-3] [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] [Received: 02/03/2020] [Accepted: 07/10/2020] [Indexed: 10/23/2022]
Abstract
Tissue Biobanks represent an invaluable resource. Despite the majority of people supporting tissue donation, the actual rate remains low overall. Tissue discarded from surgical procedures represents a further avenue for collection for use in research. We aim to understand the information and consent requirements in a cohort of healthy, post-ophthalmic surgical subjects to optimise future tissue collection in living donors. Patients attending an ophthalmic clinic following refractive surgery for myopia (SMILE) were identified. Patient consent was implied with the completion of the provided survey. The questionnaire included gender, age range and education status. The majority of 31 subjects identified a benefit for future patients as the main motive for potential donation of discarded tissue (71%). Payment for the discarded tissue would not influence their decision in 77.4%. Explanation of the potential benefits of research was the most important information to consider before making a decision to donate. Only 12.9% of patients would have refused to include further information. Almost half of patients felt that the Biobank became the owner of tissue following donation. Current surgical patients may be more inclined to participate in research than the general public because of a sense of duty or an increased understanding of the role of research in evolving treatment. Despite minor uncertainty about the eventual use of the tissue and data, most subjects were positive to donation of discarded ocular tissue and de-identified information. Consent and education processes should be revised within an ophthalmic practice to minimise future patient anxiety.
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24
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Pacyna JE, McCormick JB, Olson JE, Winkler EM, Bublitz JT, Hathcock MA, Sharp RR. Assessing the stability of biobank donor preferences regarding sample use: evidence supporting the value of dynamic consent. Eur J Hum Genet 2020; 28:1168-1177. [PMID: 32327712 PMCID: PMC7608348 DOI: 10.1038/s41431-020-0625-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 03/03/2020] [Accepted: 03/24/2020] [Indexed: 01/06/2023] Open
Abstract
Dynamic consent has been proposed as a strategy for addressing the limitations of traditional, broad consent for biobank participation. Although the argument for dynamic consent has been made on theoretical grounds, empirical studies evaluating the potential utility of dynamic consent are needed to enhance deliberations about the merits of dynamic consent. Few studies have assessed such considerations as whether donor preferences may change over time or if participants would use a dynamic consent mechanism to modify preferences when they change. We administered a 66-item survey to participants in a large DNA biobank. The survey sought to gauge the stability of donor preferences specified at the time of biobank enrollment, specifically the stability of donors’ preference regarding posthumous availability of biospecimens to next-of-kin. We received 1164 completed surveys for a response rate of 72%. Forty percent of respondents indicated a preference regarding sample availability on the survey (T2) that was inconsistent with the preference they had expressed when they enrolled in the biobank (T1). Most (94%) individuals with inconsistent preferences regarding sample availability had initially restricted sample availability at T1 but were comfortable with broader availability when asked at the time of the survey (T2). Our findings demonstrate that preferences regarding sample use expressed at the time of enrollment in a DNA biobank may not be reliable indicators of donor preferences over time. These findings lend empirical support to the case for a dynamic consent model in which biobank participants are approached over time to clarify their views regarding sample use.
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Affiliation(s)
- Joel E Pacyna
- Biomedical Ethics Research Program, Mayo Clinic, Rochester, MN, USA
| | | | - Janet E Olson
- Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Erin M Winkler
- Center for Individualized Medicine, Mayo Clinic, Rochester, MN, USA
| | - Josh T Bublitz
- Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | | | - Richard R Sharp
- Biomedical Ethics Research Program, Mayo Clinic, Rochester, MN, USA. .,Health Sciences Research, Mayo Clinic, Rochester, MN, USA.
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25
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Cumyn A, Barton A, Dault R, Cloutier A, Jalbert R, Ethier J. Informed consent within a learning health system: A scoping review. Learn Health Syst 2020; 4:e10206. [PMID: 32313834 PMCID: PMC7156861 DOI: 10.1002/lrh2.10206] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 09/18/2019] [Accepted: 10/08/2019] [Indexed: 12/27/2022] Open
Abstract
INTRODUCTION A major consideration for the implementation of a learning health system (LHS) is consent from participants to the use of their data for research purposes. The main objective of this paper was to identify in the literature which types of consent have been proposed for participation in research observational activities in a LHS. We were particularly interested in understanding which approaches were seen as most feasible and acceptable and in which context, in order to inform the development of a Quebec-based LHS. METHODS Using a scoping review methodology, we searched scientific and legal databases as well as the gray literature using specific terms. Full-text articles were reviewed independently by two authors on the basis of the following concepts: (a) LHS and (b) approach to consent. The selected papers were imported in NVivo software for analysis in the light of a conceptual framework that distinguishes various, largely independent dimensions of consent. RESULTS A total of 93 publications were analysed for this review. Several studies reach opposing conclusions concerning the best approach to consent within a LHS. However, in the light of the conceptual framework we developed, we found that many of these results are distorted by the conflation between various characteristics of consent. Thus, when these characteristics are distinguished, the results mainly suggest the prime importance of the communication process, by contrast to the scope of consent or the kind of action required by participants (opt-in/opt-out). We identified two models of consent that were especially relevant for our purpose: metaconsent and dynamic consent. CONCLUSIONS Our review shows the importance of distinguishing carefully the various features of the consent process. It also suggests that the metaconsent model is a valuable model within a LHS, as it addresses many of the issues raised with regards to feasibility and acceptability. We propose to complement this model by adding the modalities of the information process to the dimensions relevant in the metaconsent process.
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Affiliation(s)
- Annabelle Cumyn
- Département de médecine, Faculté de médecine et des sciences de la santéUniversité de SherbrookeQuebecCanada
- Groupe de recherche interdisciplinaire en informatique de la santé (GRIIS), Faculté de médecine et des sciences de la santé/Faculté des sciencesUniversité de SherbrookeQuebecCanada
| | - Adrien Barton
- Groupe de recherche interdisciplinaire en informatique de la santé (GRIIS), Faculté de médecine et des sciences de la santé/Faculté des sciencesUniversité de SherbrookeQuebecCanada
- Centre national de la recherche scientifique ‐ Institut de recherche en informatique de Toulouse (CNRS‐IRIT)ToulouseFrance
| | - Roxanne Dault
- Groupe de recherche interdisciplinaire en informatique de la santé (GRIIS), Faculté de médecine et des sciences de la santé/Faculté des sciencesUniversité de SherbrookeQuebecCanada
| | - Anne‐Marie Cloutier
- Groupe de recherche interdisciplinaire en informatique de la santé (GRIIS), Faculté de médecine et des sciences de la santé/Faculté des sciencesUniversité de SherbrookeQuebecCanada
| | - Rosalie Jalbert
- Groupe de recherche interdisciplinaire en informatique de la santé (GRIIS), Faculté de médecine et des sciences de la santé/Faculté des sciencesUniversité de SherbrookeQuebecCanada
| | - Jean‐François Ethier
- Département de médecine, Faculté de médecine et des sciences de la santéUniversité de SherbrookeQuebecCanada
- Groupe de recherche interdisciplinaire en informatique de la santé (GRIIS), Faculté de médecine et des sciences de la santé/Faculté des sciencesUniversité de SherbrookeQuebecCanada
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Clayton EW. What Should We Be Asking of Informed Consent? THE JOURNAL OF LAW, MEDICINE & ETHICS : A JOURNAL OF THE AMERICAN SOCIETY OF LAW, MEDICINE & ETHICS 2020; 48:185-187. [PMID: 32342792 PMCID: PMC8607992 DOI: 10.1177/1073110520917009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- Ellen Wright Clayton
- Ellen Wright Clayton, M.D., J.D., is the Craig-Weaver Professor of Pediatrics and Professor of Health Policy at Vanderbilt University Medical Center and Professor of Law at Vanderbilt University. She has devoted much of her career to studying the ethical, legal, and society implications of research and the translation of its findings to clinical care
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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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Hallinan D. Broad consent under the GDPR: an optimistic perspective on a bright future. LIFE SCIENCES, SOCIETY AND POLICY 2020; 16:1. [PMID: 31903508 PMCID: PMC6943899 DOI: 10.1186/s40504-019-0096-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 12/04/2019] [Indexed: 06/10/2023]
Abstract
Broad consent - the act of gaining one consent for multiple potential future research projects - sits at the core of much current genomic research practice. Since the 25th May 2018, the General Data Protection Regulation (GDPR) has applied as valid law concerning genomic research in the EU and now occupies a dominant position in the legal landscape. Yet, the position of the GDPR concerning broad consent has recently been cause for concern in the genomic research community. Whilst the text of the GDPR apparently supports the practice, recent jurisprudence contains language which is decidedly less positive. This article takes an in-depth look at the situation concerning broad consent under the GDPR and - despite the understandable concern flowing from recent jurisprudence - offers a positive outlook. This positive outlook is argued from three perspectives, each of which is significant in defining the current, and ongoing, legitimacy and utility of broad consent under the GDPR: the principled, the legal technical, and the practical.
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Affiliation(s)
- Dara Hallinan
- FIZ Karlsruhe - Leibniz-Institut für Informationsinfrastruktur, Hermann-von-Helmholtz-Platz 1, 76344, Eggenstein-Leopoldshafen, Germany.
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Jahns R, Geiger J, Schlünder I, Strech D, Brumhard M, von Kielmansegg SG. Broad donor consent for human biobanks in Germany and Europe: a strategy to facilitate cross-border sharing and exchange of human biological materials and related data. J LAB MED 2019. [DOI: 10.1515/labmed-2017-0064] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
Human biobanks are generally recognized as essential resources for effective biomedical research. All over the world biosamples and data from human subjects are collected in large biobanks. The biological material is stored long term for current and future (undetermined) research issues, which often require cross-border exchange of biosamples and related data.
Content
Commonly, the informed consent for research on human biospecimen is intended to cover only defined, specific research objectives. In June 2016, the biobank Task-Force of the Working Party of the German Medical Ethics Committees (WP-GMEC) updated its template for the broad use of human biological samples and related data. It complies with the current Organisation for Economic Co-operation and Development (OECD) and World Medical Association (WMA) recommendations and furnishes a framework that permits long-term storage and multi-purpose research use of human biological material and related data, including cross-border research.
However, both (i) human biobanks storing and (ii) research projects requesting “broad consent” biological samples generally require an ethical approval; in addition, “broad consent” conditions should be reciprocated by making biobank processes transparent and by fostering both donor and public involvement.
Outlook
The broad consent template of the WP-GMEC clearly states that biological samples and data donated for medical research serve to address current and future research questions. It appears perfectly suited as a template for a Europe-wide harmonized broad consent facilitating biobank-based cross-border research.
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Cardillo L, Cahill F, Wylie H, Williams A, Zylstra J, Davies A, Fullwood L, Van Hemelrijck M. Patients' perspectives on opt-out consent for observational research: systematic review and focus group. ACTA ACUST UNITED AC 2019; 27:1321-1329. [PMID: 30525978 DOI: 10.12968/bjon.2018.27.22.1321] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND: observational research is increasingly important in clinical decision-making. Opt-out consent has been proposed as a more practical way to obtain participants' consent for such research. The authors evaluated patients' views on opt-out consent for observational research by identifying perceived benefits and barriers. METHODS: following a systematic literature review of research on participants' perspectives on opt-out consent, a focus group interview was conducted with oncological patients and their family members. RESULTS: the review identified 13 articles detailing perspectives on opt-out consent. Perceived advantages included benefitting medicine and future generations. These findings were confirmed in the focus group. The main reported barriers to opt-out consent are concerns regarding privacy and the sharing of data with third parties. Participants also demonstrated concerns on insufficient education on opt-out consent. CONCLUSION: participants demonstrated willingness to participate in observational studies utilising opt-out consent. Special focus should be placed on outlining existing safeguards in research.
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Affiliation(s)
- Luca Cardillo
- Medical Student, King's College London, School of Cancer and Pharmaceutical Sciences, Translational Oncology & Urology Research
| | - Fidelma Cahill
- Research Nurse, King's College London, School of Cancer and Pharmaceutical Sciences, Translational Oncology & Urology Research
| | - Harriet Wylie
- Clinical Trial Coordinator, King's College London, School of Cancer and Pharmaceutical Sciences, Translational Oncology & Urology Research
| | - Ambi Williams
- Research Manager, King's College London, School of Cancer and Pharmaceutical Sciences
| | - Janine Zylstra
- Clinical Research Manager, Department of Upper Gastrointestinal Surgery, Guy's and St Thomas' NHS Foundation Trust, London
| | - Andrew Davies
- Consultant oesophagogastric and general surgeon, Department of Upper Gastrointestinal Surgery, Guy's and St Thomas' NHS Foundation Trust, London
| | | | - Mieke Van Hemelrijck
- Reader in Cancer Epidemiology, King's College London, School of Cancer and Pharmaceutical Sciences, Translational Oncology & Urology Research
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Weidman J, Aurite W, Grossklags J. On Sharing Intentions, and Personal and Interdependent Privacy Considerations for Genetic Data: A Vignette Study. IEEE/ACM TRANSACTIONS ON COMPUTATIONAL BIOLOGY AND BIOINFORMATICS 2019; 16:1349-1361. [PMID: 30004885 DOI: 10.1109/tcbb.2018.2854785] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Genetics and genetic data have been the subject of recent scholarly work, with significant attention paid towards understanding consent practices for the acquisition and usage of genetic data as well as genetic data security. Attitudes and perceptions concerning the trustworthiness of governmental institutions receiving test-taker data have been explored, with varied findings, but no robust models or deterministic relationships have been established that account for these differences. These results also do not explore in detail the perceptions regarding other types of organizations (e.g., private corporations). Further, considerations of privacy interdependence arising from blood relative relationships have been absent from the conversation regarding the sharing of genetic data. This paper reports the results from a factorial vignette survey study in which we investigate how variables of ethnicity, age, genetic markers, and association of data with the individual's name affect the likelihood of sharing data with different types of organizations. We also investigate elements of personal and interdependent privacy concerns. We document the significant role these factors have in the decision to share or not share genetic data. We support our findings with a series of regression analyses.
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Public Attitudes toward Biobanking of Human Biological Material for Research Purposes: A Literature Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16122209. [PMID: 31234457 PMCID: PMC6617000 DOI: 10.3390/ijerph16122209] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 06/19/2019] [Accepted: 06/19/2019] [Indexed: 01/07/2023]
Abstract
Background: During the past few decades there has been a growing interest on the part of many governments in the creation of biobanks. Nevertheless, this would be impossible without participation of many donors who offer samples of their biological material for scientific research. Therefore, the aim of this paper is to provide an overview of the existing research on social attitudes towards biobanking. Material and Methods: A literature search was conducted in the database of MEDLINE (PubMed). 61 papers were included in the analysis. The retrieved articles were assessed using a thematic analysis. Results: Eight main themes were identified: (1) public knowledge about biobanks, (2) public views on biobanking, (3) willingness to donate, (4) donors’ motivations, (5) perceived benefits and risks of biobanking, (6) preferred type of consent, (7) trust toward biobanks, and (8) demographic characteristics of potential donors. Conclusions: Although the public lacks knowledge about biobanking, many individuals declare willingness to donate. Their will is influenced by: their knowledge about biobanking, the type of donated tissue, research purpose, concerns over the safety of the data, preferred type of consent, and trust towards biobanks.
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Domaradzki, Pawlikowski. Public Attitudes toward Biobanking of Human Biological Material for Research Purposes: A Literature Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:2209. [DOI: http:/doi:10.3390/ijerph16122209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/24/2023]
Abstract
Background: During the past few decades there has been a growing interest on the part of many governments in the creation of biobanks. Nevertheless, this would be impossible without participation of many donors who offer samples of their biological material for scientific research. Therefore, the aim of this paper is to provide an overview of the existing research on social attitudes towards biobanking. Material and Methods: A literature search was conducted in the database of MEDLINE (PubMed). 61 papers were included in the analysis. The retrieved articles were assessed using a thematic analysis. Results: Eight main themes were identified: (1) public knowledge about biobanks, (2) public views on biobanking, (3) willingness to donate, (4) donors’ motivations, (5) perceived benefits and risks of biobanking, (6) preferred type of consent, (7) trust toward biobanks, and (8) demographic characteristics of potential donors. Conclusions: Although the public lacks knowledge about biobanking, many individuals declare willingness to donate. Their will is influenced by: their knowledge about biobanking, the type of donated tissue, research purpose, concerns over the safety of the data, preferred type of consent, and trust towards biobanks.
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34
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Esmaeilzadeh P. Consumers’ Perceptions of Using Health Information Exchanges (HIEs) for Research Purposes. INFORMATION SYSTEMS MANAGEMENT 2019. [DOI: 10.1080/10580530.2018.1553649] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Pouyan Esmaeilzadeh
- Department of Information Systems and Business Analytics, College of Business, Florida International University, Miami, Florida, USA
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35
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Sutton EJ, Pacyna JE, Hathcock M, McCormick JB, Nowakowski K, Olson JE, Sharp RR. Managing the Unimaginable: Biobank Participant Views on Reconsent for Whole Genome Sequencing of Stored Biospecimens. Biopreserv Biobank 2019; 17:296-302. [PMID: 30912675 DOI: 10.1089/bio.2018.0077] [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] [Indexed: 11/12/2022] Open
Abstract
Background: DNA biobanks frequently obtain broad permissions from sample donors, who agree to allow their biospecimens to be used for a variety of future purposes. A limitation of this approach is that it may not be possible to discuss or anticipate all potential uses of biospecimens at the time patient consent is obtained. We surveyed biobank participants to clarify their views regarding the need to be informed about research involving whole genome sequencing (WGS). Methods: We invited 1200 participants in the Mayo Clinic Biobank to complete a survey inquiring about their support for WGS; their interest in being recontacted before WGS of their biospecimens; whether they would consent to WGS if asked; and the acceptability of proceeding with WGS if sample donors could not be reached. Results: Six hundred eighty-seven biobank participants returned completed surveys (57% response). More than 96% of biobank participants were supportive of WGS and would give permission for WGS of their sample, if asked. Nonetheless, 61% of biobank participants felt they should be recontacted before WGS was done. Participants were divided regarding the permissibility of conducting WGS if efforts to recontact sample donors were unsuccessful. Discussion: Our findings highlight a potential discrepancy between the broad permissions granted by biobank participants at the time they donated biospecimens and their views about the application of WGS to their samples. Biobank participants appear to value the ability to confirm their commitment to genetic research when the studies in question involve WGS, a technological capacity they may not have anticipated at the time they donated their biospecimens. Efforts to reevaluate biobank participants' views about the acceptability of new technologies may help to ensure alignment of participants' current beliefs and research applications that would have been difficult to anticipate at the time biospecimens were collected.
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Affiliation(s)
- Erica J Sutton
- 1Biomedical Ethics Research Program, Mayo Clinic, Rochester, Minnesota.,2Center for Individualized Medicine, and Mayo Clinic, Rochester, Minnesota.,3Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
| | - Joel E Pacyna
- 1Biomedical Ethics Research Program, Mayo Clinic, Rochester, Minnesota.,2Center for Individualized Medicine, and Mayo Clinic, Rochester, Minnesota
| | - Matthew Hathcock
- 3Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
| | - Jennifer B McCormick
- 4Department of Humanities, College of Medicine, Pennsylvania State University, University Park, Texas
| | | | - Janet E Olson
- 3Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
| | - Richard R Sharp
- 1Biomedical Ethics Research Program, Mayo Clinic, Rochester, Minnesota.,2Center for Individualized Medicine, and Mayo Clinic, Rochester, Minnesota.,3Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
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Abstract
Contrary to the revised Common Rule, and contrary to the views of many bioethicists and researchers, we argue that broad consent should be sought for anticipated later research uses of deidentified biospecimens and health information collected during medical care. Individuals differ in the kinds of risk they find concerning and in their willingness to permit use of their biospecimens for future research. For this reason, asking their permission for unspecified research uses is a fundamental expression of respect for them as persons and should be done absent some compelling moral consideration to the contrary. We examine three moral considerations and argue that each of them fails: that there is a duty of easy rescue binding on all, that seeking consent creates a selection bias that undermines the validity of biospecimen research, and that seeking and documenting consent will be prohibitively expensive.
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Affiliation(s)
- Tom Tomlinson
- Professor at the Center for Ethics and Humanities in the Life Sciences at Michigan State University
| | - Raymond G De Vries
- Professor at the Center for Bioethics and Social Sciences in Medicine at the University of Michigan
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Rumbold J, Pierscionek B. Contextual Anonymization for Secondary Use of Big Data in Biomedical Research: Proposal for an Anonymization Matrix. JMIR Med Inform 2018; 6:e47. [PMID: 30467101 PMCID: PMC6284146 DOI: 10.2196/medinform.7096] [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: 12/06/2016] [Revised: 04/20/2017] [Accepted: 06/21/2018] [Indexed: 12/28/2022] Open
Abstract
Background The current law on anonymization sets the same standard across all situations, which poses a problem for biomedical research. Objective We propose a matrix for setting different standards, which is responsive to context and public expectations. Methods The law and ethics applicable to anonymization were reviewed in a scoping study. Social science on public attitudes and research on technical methods of anonymization were applied to formulate a matrix. Results The matrix adjusts anonymization standards according to the sensitivity of the data and the safety of the place, people, and projects involved. Conclusions The matrix offers a tool with context-specific standards for anonymization in data research.
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Affiliation(s)
- John Rumbold
- School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom
| | - Barbara Pierscionek
- School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom
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Rumbold J, Pierscionek B. Contextual Anonymization for Secondary Use of Big Data in Biomedical Research: Proposal for an Anonymization Matrix. JMIR Med Inform 2018; 6:e47. [PMID: 30467101 PMCID: PMC6284146 DOI: 10.2196/medinform.7096 10.2196/medinform.7096] [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: 01/02/2023] Open
Abstract
BACKGROUND The current law on anonymization sets the same standard across all situations, which poses a problem for biomedical research. OBJECTIVE We propose a matrix for setting different standards, which is responsive to context and public expectations. METHODS The law and ethics applicable to anonymization were reviewed in a scoping study. Social science on public attitudes and research on technical methods of anonymization were applied to formulate a matrix. RESULTS The matrix adjusts anonymization standards according to the sensitivity of the data and the safety of the place, people, and projects involved. CONCLUSIONS The matrix offers a tool with context-specific standards for anonymization in data research.
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Affiliation(s)
- John Rumbold
- School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom
| | - Barbara Pierscionek
- School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom
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Yip S, Fleming J, Shepherd HL, Walczak A, Clark J, Butow P. "As Long as You Ask": A Qualitative Study of Biobanking Consent-Oncology Patients' and Health Care Professionals' Attitudes, Motivations, and Experiences-the B-PPAE Study. Oncologist 2018; 24:844-856. [PMID: 30413662 DOI: 10.1634/theoncologist.2018-0233] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Accepted: 08/28/2018] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Consent to biobanking remains controversial, with little empirical data to guide policy and practice. This study aimed to explore the attitudes, motivations, and concerns of both oncology patients and health care professionals (HCPs) regarding biobanking. MATERIALS AND METHODS Qualitative interviews were conducted with oncology patients and HCPs purposively selected from five Australian hospitals. Patients were invited to give biobanking consent as part of a clinical trial and/or for future research were eligible. HCPs were eligible if involved in consenting patients to biobanking or to donate specimens to clinical trials. RESULTS Twenty-two patients participated, with head and neck (36%) and prostate (18%) the most common cancer diagnoses; all had consented to biobanking. Twenty-two HCPs participated, from across eight cancer streams and five disciplines. Themes identified were (a) biobanking is a "no brainer"; (b) altruism or scientific enquiry; (c) trust in clinicians, science, and institutions; (d) no consent-just do it; (e) respecting patient choice ("opt-out"); (f) respectful timing of the request; (g) need for emotional/family support; (h) context of the biobanking request matters; and (i) factors for biobanking success. DISCUSSION These findings reinforced previous findings regarding high public trust in, and support for, biobanking. An initial opt-in consent approach with the option of later opt-out was favored by patients to respect and recognize donor generosity, whereas HCPs preferred an upfront opt-out model. Factors impacting biobanking success included the context of the request for use in a trial or specific research question, pre-existing patient and HCP rapport, a local institution champion, and infrastructure. IMPLICATIONS FOR PRACTICE Patients and health care professionals (HCPs) who experienced cancer biobanking consent were overwhelmingly supportive of biobanking. The motivations and approaches to seeking consent were largely mirrored between the groups. The findings of this study support the opt-in model of biobanking favored by patients; however, HCPs preferred an opt-out model. Both groups recognize the importance of making the request for biobanking at an appropriate time, preferably with emotional or family support, and respecting the timing of the request and privacy of the patient. Biobanking success can be promoted by hospital departments with a research focus by identifying an institutional biobanking champion and ensuring local infrastructure is available.
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Affiliation(s)
- Sonia Yip
- Sydney Catalyst Translational Cancer Research Centre, University of Sydney, Sydney, Australia
| | - Jennifer Fleming
- Sydney Catalyst Translational Cancer Research Centre, University of Sydney, Sydney, Australia
| | - Heather L Shepherd
- Psycho-oncology Co-operative Research Group, School of Psychology, University of Sydney, Sydney, Australia
| | | | - Jonathan Clark
- Central Clinical School, University of Sydney, Sydney, Australia
| | - Phyllis Butow
- Centre for Medical Psychology and Evidence-Based Decision-Making, University of Sydney, Sydney, Australia
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Rothwell E, Botkin JR, Cheek-O'Donnell S, Wong B, Case GA, Johnson E, Matheson T, Wilson A, Robinson NR, Rawlings J, Horejsi B, Lopez AM, Byington CL. An empirical assessment of the short-term impacts of a reading of Deborah Zoe Laufer's drama Informed Consent on attitudes and intentions to participate in genetic research. AJOB Empir Bioeth 2018; 9:69-76. [PMID: 29513089 PMCID: PMC6092928 DOI: 10.1080/23294515.2018.1449771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVE This study assessed the short-term impact of the play "Informed Consent" by Deborah Zoe Laufer (a fictionalized look at the controversy over specimens collected from the Havasupai Tribe for diabetes research in 1989) on perceptions of trust, willingness to donate biospecimens, and attitudes toward harm and privacy among the medical and undergraduate students, faculty, and the public in the Intermountain West. METHODS Surveys were administered before and after a staged reading of the play by professional actors. Survey items included the short form Trust in Medical Researchers, and single-item questions about group identity, ethics of genetic testing in children, and willingness to donate biospecimens. In addition, respondents were given the option to answer open-ended questions through e-mail. RESULTS Out of the 481 who attended the play, 421 completed both the pre and post surveys, and 166 participants completed open-ended questions online approximately 1 week after the play. Across all participants, there were significant declines for trust in medical researchers and for the survey item "is it ethical for investigators to test children for adult onset diseases" (p < .001 for both) following the play. There was a significant increase in agreement to improve group identity protections (p < .001) and there were no differences on willingness to donate biospecimens to research (p = .777). Qualitative data provided extensive contextual data supporting these perspectives. DISCUSSION This is one of the first studies to document short-term impacts of a theatrical performance on both attitudes and behavioral intentions toward research ethics and clinical research participation. Future research should continue to explore the impact of theatrical performances among public and investigators on the ethical issues and complexities in clinical research.
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Affiliation(s)
| | | | | | - Bob Wong
- a University of Utah , Salt Lake City , Utah , USA
| | | | - Erin Johnson
- a University of Utah , Salt Lake City , Utah , USA
| | | | - Alena Wilson
- a University of Utah , Salt Lake City , Utah , USA
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41
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Warner TD, Weil CJ, Andry C, Degenholtz HB, Parker L, Carithers LJ, Feige M, Wendler D, Pentz RD. Broad Consent for Research on Biospecimens: The Views of Actual Donors at Four U.S. Medical Centers. J Empir Res Hum Res Ethics 2018; 13:115-124. [PMID: 29390947 PMCID: PMC5869128 DOI: 10.1177/1556264617751204] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Commentators are concerned that broad consent may not provide biospecimen donors with sufficient information regarding possible future research uses of their tissue. We surveyed with interviews 302 cancer patients who had recently provided broad consent at four diverse academic medical centers. The majority of donors believed that the consent form provided them with sufficient information regarding future possible uses of their biospecimens. Donors expressed very positive views regarding tissue donation in general and endorsed the use of their biospecimens in future research across a wide range of contexts. Concerns regarding future uses were limited to for-profit research and research by investigators in other countries. These results support the use of broad consent to store and use biological samples in future research.
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Affiliation(s)
| | | | | | | | | | - Latarsha J. Carithers
- National Cancer Institute, National Institutes of Health (USA)
- Now at the National Institute of Dental & Craniofacial Research (USA)
| | - Michelle Feige
- Association for the Accreditation of Human Research Protection Programs, Inc. (USA)
| | | | - Rebecca D. Pentz
- Winship Cancer Institute, Emory University School of Medicine (USA)
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42
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Gehlert S, Mozersky J. Seeing Beyond the Margins: Challenges to Informed Inclusion of Vulnerable Populations in Research. THE JOURNAL OF LAW, MEDICINE & ETHICS : A JOURNAL OF THE AMERICAN SOCIETY OF LAW, MEDICINE & ETHICS 2018; 46:30-43. [PMID: 30093794 PMCID: PMC6077979 DOI: 10.1177/1073110518766006] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Although the importance of including vulnerable populations in medical research is widely accepted, identifying how to achieve such inclusion remains a challenge. Ensuring that the language of informed consent is comprehensible to this group is no less of a challenge. Although a variety of interventions show promise for increasing the comprehensibility of informed consent and increasing a climate of exchange, consensus is lacking on which interventions should be used in which situations and current regulations provide little guidance. We argue that the notion of individual autonomy — a foundational principle of informed consent — may be too narrow for some vulnerable populations by virtue of its failure to acknowledge their unique histories and current circumstances. It has a different meaning for members of structured groups like American Indians than for unstructured groups, such as African Americans, whose complicated histories foster group identity. Ensuring broad participation in research and selecting appropriate methods for obtaining informed consent — namely, methods aligned with the source of vulnerability and level of risk — require new ways of thinking that might produce guidelines for matching informed consent models and processes with subpopulations.
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Affiliation(s)
- Sarah Gehlert
- Sarah Gehlert, Ph.D., is the E. Desmond Lee Professor of Racial and Ethnic Diversity at Washington University in St. Louis. She holds an M.A. in Anthropology and an M.S.W. from the University of Missouri-Columbia and a Ph.D. in Social Work from Washington University (St. Louis). Jessica Mozersky, Ph.D., is an Assistant Professor at Washington University in St. Louis. She holds an M.B.E. from the University of Pennsylvania and a Ph.D. in Anthropology from University College London's Interdisciplinary Institute for Human Genetics and Health
| | - Jessica Mozersky
- Sarah Gehlert, Ph.D., is the E. Desmond Lee Professor of Racial and Ethnic Diversity at Washington University in St. Louis. She holds an M.A. in Anthropology and an M.S.W. from the University of Missouri-Columbia and a Ph.D. in Social Work from Washington University (St. Louis). Jessica Mozersky, Ph.D., is an Assistant Professor at Washington University in St. Louis. She holds an M.B.E. from the University of Pennsylvania and a Ph.D. in Anthropology from University College London's Interdisciplinary Institute for Human Genetics and Health
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43
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Tomlinson T, De Vries RG, Kim HM, Gordon L, Ryan KA, Krenz CD, Jewell S, Kim SYH. Effect of deliberation on the public's attitudes toward consent policies for biobank research. Eur J Hum Genet 2018; 26:176-185. [PMID: 29348694 PMCID: PMC5838972 DOI: 10.1038/s41431-017-0063-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Revised: 11/02/2017] [Accepted: 11/18/2017] [Indexed: 01/07/2023] Open
Abstract
In this study, we evaluate the effect of education and deliberation on the willingness of members of the public to donate tissue to biobank research and on their attitudes regarding various biobank consent policies. Participants were randomly assigned to a democratic deliberation (DD) group, an education group that received only written materials, and a control group. Participants completed a survey before the deliberation and two surveys post-deliberation: one on (or just after) the deliberation day, and one 4 weeks later. Subjects were asked to rate 5 biobank consent policies as acceptable (or not) and to identify the best and worst policies. Analyses compared acceptability of different policy options and changes in attitudes across the three groups. After deliberation, subjects in the DD group were less likely to find broad consent (defined here as consent for the use of donations in an unspecified range of future research studies, subject to content and process restrictions) and study-by-study consent acceptable. The DD group was also significantly less likely to endorse broad consent as the best policy (OR = 0.34), and more likely to prefer alternative consent options. These results raise ethical challenges to the current widespread reliance on broad consent in biobank research, but do not support study-by-study consent.
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Affiliation(s)
- Tom Tomlinson
- Center for Ethics and Humanities in the Life Sciences, Michigan State University, East Lansing, MI, USA.
| | - Raymond G De Vries
- Center for Bioethics and Social Sciences in Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
| | - H Myra Kim
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA
| | - Linda Gordon
- Center for Ethics and Humanities in the Life Sciences, Michigan State University, East Lansing, MI, USA
| | - Kerry A Ryan
- Center for Bioethics and Social Sciences in Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Chris D Krenz
- Center for Bioethics and Social Sciences in Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Scott Jewell
- Van Andel Research Institute, Grand Rapids, MI, USA
| | - Scott Y H Kim
- Department of Bioethics, Clinical Center, National Institutes of Health, Bethesda, MD, USA
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
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44
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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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45
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Abstract
When obtaining samples from biobanks, resolving ethical and legal concerns is a time-consuming task where researchers need to balance the needs of privacy, trust and scientific progress. The Biobanking and Biomolecular Resources Research Infrastructure-Large Prospective Cohorts project has resolved numerous such issues through intense communication between involved researchers and experts in its mission to unite large prospective study sets in Europe. To facilitate efficient communication, it is useful for nonexperts to have an at least basic understanding of the regulatory system for managing biological samples. Laws regulating research oversight are based on national law and normally share core principles founded on international charters. In interview studies among donors, chief concerns are privacy, efficient sample utilization and access to information generated from their samples. Despite a lack of clear evidence regarding which concern takes precedence, scientific as well as public discourse has largely focused on privacy concerns and the right of donors to control the usage of their samples. It is therefore important to proactively deal with ethical and legal issues to avoid complications that delay or prevent samples from being accessed. To help biobank professionals avoid making unnecessary mistakes, we have developed this basic primer covering the relationship between ethics and law, the concept of informed consent and considerations for returning findings to donors.
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Affiliation(s)
- Tomas Klingstrom
- Corresponding author: Tomas Klingström, SLU-Global Bioinformatics Centre, Department of Animal Breeding and Genetics, Swedish University of Agricultural Sciences, Sweden. Tel.: +4618-672126; E-mail:
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46
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Harle CA, Golembiewski EH, Rahmanian KP, Krieger JL, Hagmajer D, Mainous AG, Moseley RE. Patient preferences toward an interactive e-consent application for research using electronic health records. J Am Med Inform Assoc 2017; 25:360-368. [PMID: 29272408 DOI: 10.1093/jamia/ocx145] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 11/07/2017] [Accepted: 11/17/2017] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE The purpose of this study was to assess patient perceptions of using an interactive electronic consent (e-consent) application when deciding whether or not to grant broad consent for research use of their identifiable electronic health record (EHR) information. MATERIALS AND METHODS For this qualitative study, we conducted a series of 42 think-aloud interviews with 32 adults. Interview transcripts were coded and analyzed using a modified grounded theory approach. RESULTS We identified themes related to patient preferences, reservations, and mixed attitudes toward consenting electronically; low- and high-information-seeking behavior; and an emphasis on reassuring information, such as data protections and prohibitions against sharing data with pharmaceutical companies. Participants expressed interest in the types of information contained in their EHRs, safeguards protecting EHR data, and specifics on studies that might use their EHR data. DISCUSSION This study supports the potential value of interactive e-consent applications that allow patients to customize their consent experience. This study also highlights that some people have concerns about e-consent platforms and desire more detailed information about administrative processes and safeguards that protect EHR data used in research. CONCLUSION This study contributes new insights on how e-consent applications could be designed to ensure that patients' information needs are met when seeking consent for research use of health record information. Also, this study offers a potential electronic approach to meeting the new Common Rule requirement that consent documents contain a "concise and focused" presentation of key information followed by more details.
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Affiliation(s)
- Christopher A Harle
- Department of Health Policy and Management, Indiana University, Indianapolis, IN, USA
| | | | - Kiarash P Rahmanian
- Department of Community Health and Family Medicine, University of Florida, Gainesville, FL, USA
| | - Janice L Krieger
- Department of Advertising, University of Florida, Gainesville, FL, USA
| | - Dorothy Hagmajer
- Department of Advertising, University of Florida, Gainesville, FL, USA
| | - Arch G Mainous
- Department of Community Health and Family Medicine, University of Florida, Gainesville, FL, USA.,Department of Health Services Research, Management and Policy, University of Florida, Gainesville, FL, USA
| | - Ray E Moseley
- Department of Community Health and Family Medicine, University of Florida, Gainesville, FL, USA
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47
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Murad AM, Myers MF, Thompson SD, Fisher R, Antommaria AHM. A qualitative study of adolescents' understanding of biobanks and their attitudes toward participation, re-contact, and data sharing. Am J Med Genet A 2017; 173:930-937. [PMID: 28328120 DOI: 10.1002/ajmg.a.38114] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Revised: 10/21/2016] [Accepted: 12/11/2016] [Indexed: 12/27/2022]
Abstract
While biobanks have become more prevalent, little is known about adolescents' views of key governance issues. We conducted semi-structured interviews with adolescents between 15 and 17 years old to solicit their views. All interviews were audiotaped and transcribed. Two investigators coded the transcripts and resolved any discrepancies through consensus. We conducted 18 interviews before reaching data saturation. Four participants (22%) had previously heard of a biobank. Many participants had misunderstandings about biobanks, some of which persisted after education. Participants believed that enrolling in a biobank would benefit others through scientific research. Many study participants were unable to identify risks of biobank participation. Thirteen participants (72%) were willing to enroll in a biobank and only one (6%) initially was not. Participants believed that if they were unable to provide assent when enrolled, then they should be re-contacted at the age of majority and their data should not be shared until that time. Participants emphasized the importance of being aware of their enrollment and the possibility of disagreeing with their parents. Participants' misunderstanding of biobanks suggests that assent may not be adequately informed without additional education. While adolescents had positive attitudes toward biobanks, they emphasized the importance of awareness of and involvement in the decision to enroll.
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Affiliation(s)
- Andrea M Murad
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.,University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Melanie F Myers
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.,University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Susan D Thompson
- University of Cincinnati College of Medicine, Cincinnati, Ohio.,Center for Autoimmune and Genomics Etiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Rachel Fisher
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.,University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Armand H Matheny Antommaria
- University of Cincinnati College of Medicine, Cincinnati, Ohio.,Ethics Center, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
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48
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Abstract
From a research perspective, the interest in biobanking continues to intensify. Governments and industry have invested heavily in biobanks, as exemplified by initiatives like the United Kingdom Biobank and United States' Precision Medicine Initiative. But despite this enthusiasm, many profound legal and ethical challenges remain unresolved. Indeed, there continues to be disagreements about how best to obtain consent and the degree and nature of control that research participants retain over donated samples and health information. Emerging social trends-including concerns about commercialization and perceived rights of continuing control ("biorights")-seem likely to intensify these issues.
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Affiliation(s)
- Timothy Caulfield
- Health Law Institute, Faculty of Law, University of Alberta, Edmonton, Alberta, Canada
| | - Blake Murdoch
- Health Law Institute, Faculty of Law, University of Alberta, Edmonton, Alberta, Canada
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49
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Assessment of knowledge about biobanking among healthcare students and their willingness to donate biospecimens. BMC Med Ethics 2017; 18:32. [PMID: 28464877 PMCID: PMC5414189 DOI: 10.1186/s12910-017-0195-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2016] [Accepted: 04/27/2017] [Indexed: 11/18/2022] Open
Abstract
Background Biobanks and biospecimen collections are becoming a primary means of delivering personalized diagnostics and tailoring individualized therapeutics. This shift towards precision medicine (PM) requires interactions among a variety of stakeholders, including the public, patients, healthcare providers, government, and donors. Very few studies have investigated the role of healthcare students in biobanking and biospecimen donations. The main aims of this study were (1) to evaluate the knowledge of senior healthcare students about biobanks and (2) to assess the students’ willingness to donate biospecimens and the factors influencing their attitudes. Methods A cross-sectional study was conducted among senior healthcare students at King Abdulaziz University (KAU), Saudi Arabia. The data were obtained using a self-administered questionnaire in English. In addition to the respondents’ biographical data section, the questionnaire assessed the respondents’ general knowledge about biobanking, the factors influencing their willingness to donate biospecimens to biobanks and their general attitudes towards biomedical research. Results A total of 597 senior healthcare students were included in the study. The general knowledge score was 3.2 (±1.6) out of 7. Only approximately 44% and 27% of students were aware of the terms “Human Genome Project” (HGP) and “biobank,” respectively. The majority of the students (89%) were willing to donate biospecimens to biobanks. Multiple factors were significantly associated with their willingness to donate, including their perceived general health (p < 0.001), past experience with both tissue testing (p < 0.04) and tissue donation (p < 0.001), biobanking knowledge score (p < 0.001) and biomedical research attitude score (p < 0.001). The main reasons for students’ willingness to donate were advancement of medical research and societal benefits, whereas misuse of biospecimens and confidentiality breaches were the main reasons for a reluctance to donate. Conclusion Despite their strong willingness to donate biospecimens, students exhibited a notable lack of knowledge about biobanking and the HGP. To expedite the transition towards PM, it is highly recommended to enhance healthcare curricula by including more educational and awareness programmes to familiarize students with OMICs technologies in addition to the scope of research and clinical applications.
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50
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Rumbold JMM, Pierscionek BK. A critique of the regulation of data science in healthcare research in the European Union. BMC Med Ethics 2017; 18:27. [PMID: 28388916 PMCID: PMC5385067 DOI: 10.1186/s12910-017-0184-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Accepted: 03/21/2017] [Indexed: 12/23/2022] Open
Abstract
The EU offers a suitable milieu for the comparison and harmonisation of healthcare across different languages, cultures, and jurisdictions (albeit with a supranational legal framework), which could provide improvements in healthcare standards across the bloc. There are specific ethico-legal issues with the use of data in healthcare research that mandate a different approach from other forms of research. The use of healthcare data over a long period of time is similar to the use of tissue in biobanks. There is a low risk to subjects but it is impossible to gain specific informed consent given the future possibilities for research. Large amounts of data on a subject present a finite risk of re-identification. Consequently, there is a balancing act between this risk and retaining sufficient utility of the data. Anonymising methods need to take into account the circumstances of data sharing to enable an appropriate balance in all cases. There are ethical and policy advantages to exceeding the legal requirements and thereby securing the social licence for research. This process would require the examination and comparison of data protection laws across the trading bloc to produce an ethico-legal framework compatible with the requirements of all member states. Seven EU jurisdictions are given consideration in this critique.
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Affiliation(s)
- John M M Rumbold
- Faculty of Science, Engineering and Computing, Kingston University London, Penrhyn Road, Kingston upon Thames, KT1 2EE, UK
| | - Barbara K Pierscionek
- School of Science and Technology School of Science and Technology, Nottingham Trent University, 50 Shakespeare Street, Nottingham, NG1 4FQ, UK.
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