1
|
Stafinski T, Street J, Young A, Menon D. Moving beyond the Court of Public Opinion: A Citizens' Jury Exploring the Public's Values around Funding Decisions for Ultra-Orphan Drugs. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:633. [PMID: 36612953 PMCID: PMC9819519 DOI: 10.3390/ijerph20010633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 12/23/2022] [Accepted: 12/26/2022] [Indexed: 06/17/2023]
Abstract
Health system decision-makers need to understand the value of new technology to make "value for money" decisions. Typically, narrow definitions of value are used. This paper reports on a Canadian Citizens' Jury which was convened to elicit those aspects of value that are important to the public. The criteria used by the public to determine value included those related to the patient, those directly related to caregivers and those directly created for society. Their choices were not binary (e.g., cost vs. health gained), but rather involved multiple factors (e.g., with respect to patient factors: disease severity, health gained with the drug, existence of alternatives, life expectancy, patient age and affordability). Overall, Jurors prioritized funding treatments for ultra-rare disease populations when the treatment offered significant improvements in health and quality of life, and when the pre-treatment health state was considered extremely poor. The prevalence of the disease by itself was not a factor in the choices. Some of the findings differ from previous work, which use survey methods. In our Citizens' Jury, Jurors were able to become more familiar with the question at hand and were exposed to a broad and balanced collection of viewpoints before and throughout engaging in the exercises. This deliberative approach allows for a more nuanced approach to understanding value.
Collapse
Affiliation(s)
- Tania Stafinski
- Health Technology & Policy Unit, School of Public Health, 4-343, Edmonton Clinic Health Academy, Edmonton, AB T6G 1C9, Canada
| | - Jacqueline Street
- Australian Centre for Engagement, Evidence and Values, University of Wollongong, Northfields Ave, Wollongong 2522, Australia
| | - Andrea Young
- Health Technology & Policy Unit, School of Public Health, 4-343, Edmonton Clinic Health Academy, Edmonton, AB T6G 1C9, Canada
| | - Devidas Menon
- Health Technology & Policy Unit, School of Public Health, 4-343, Edmonton Clinic Health Academy, Edmonton, AB T6G 1C9, Canada
| |
Collapse
|
2
|
Lannin NA, Coulter M, Laver K, Hyett N, Ratcliffe J, Holland AE, Callaway L, English C, Bragge P, Hill S, Unsworth CA. Public perspectives on acquired brain injury rehabilitation and components of care: A Citizens' Jury. Health Expect 2020; 24:352-362. [PMID: 33264470 PMCID: PMC8077088 DOI: 10.1111/hex.13176] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 10/27/2020] [Accepted: 11/15/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Brain injury rehabilitation is an expensive and long-term endeavour. Very little published information or debate has underpinned policy for service delivery in Australia. Within the context of finite health budgets and the challenges associated with providing optimal care to persons with brain injuries, members of the public were asked 'What considerations are important to include in a model of care of brain injury rehabilitation?' METHODS Qualitative study using the Citizen Jury method of participatory research. Twelve adult jurors from the community and seven witnesses participated including a health services funding model expert, peak body representative with lived experience of brain injury, carer of a person with a brain injury, and brain injury rehabilitation specialists. Witnesses were cross-examined by jurors over two days. RESULTS Key themes related to the need for a model of rehabilitation to: be consumer-focused and supporting the retention of hope; be long-term; provide equitable access to services irrespective of funding source; be inclusive of family; provide advocacy; raise public awareness; and be delivered by experts in a suitable environment. A set of eight recommendations were made. CONCLUSION Instigating the recommendations made requires careful consideration of the need for new models of care with flexible services; family involvement; recruitment and retention of highly skilled staff; and providing consumer-focused services that prepare individuals and their carers for the long term. PATIENT AND PUBLIC CONTRIBUTION As jury members, the public deliberated information provided by expert witnesses (including a person with a head injury) and wrote the key recommendations.
Collapse
Affiliation(s)
- Natasha A Lannin
- Department of Neuroscience, Central Clinical School, Monash University, Clayton, Vic., Australia.,Occupational Therapy Department, Alfred Health, Melbourne, Vic., Australia
| | - Megan Coulter
- Occupational Therapy Department, Alfred Health, Melbourne, Vic., Australia
| | - Kate Laver
- Flinders University, Adelaide, SA, Australia
| | - Nerida Hyett
- La Trobe Rural Health School, La Trobe University, Melbourne, Vic., Australia
| | - Julie Ratcliffe
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
| | - Anne E Holland
- Central Clinical School, Monash University, Clayton, Vic., Australia.,Physiotherapy Department, Alfred Health, Melbourne, Vic., Australia
| | | | - Coralie English
- School of Health Sciences, Priority Research Centre for Stroke and Brain Injury, University of Newcastle, Callaghan, NSW, Australia
| | - Peter Bragge
- BehaviourWorks Australia, Monash Sustainable Development Institute, Monash University, Clayton, Vic., Australia
| | - Sophie Hill
- Centre for Health Communication and Participation and School of Psychology and Public Health, La Trobe University, Melbourne, Vic., Australia
| | - Carolyn A Unsworth
- Department of Neuroscience, Central Clinical School, Monash University, Clayton, Vic., Australia.,School of Health, Federation University, Churchill, Vic., Australia.,Department of Rehabilitation, Jonkoping University, Jonkoping, Sweden
| |
Collapse
|
3
|
Delatycki MB, Alkuraya F, Archibald A, Castellani C, Cornel M, Grody WW, Henneman L, Ioannides AS, Kirk E, Laing N, Lucassen A, Massie J, Schuurmans J, Thong M, Langen I, Zlotogora J. International perspectives on the implementation of reproductive carrier screening. Prenat Diagn 2019; 40:301-310. [DOI: 10.1002/pd.5611] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 09/22/2019] [Accepted: 11/07/2019] [Indexed: 12/21/2022]
Affiliation(s)
- Martin B. Delatycki
- Victorian Clinical Genetics Services Parkville Victoria Australia
- Murdoch Children's Research Institute Parkville Victoria Australia
- Department of PaediatricsUniversity of Melbourne Parkville Victoria Australia
| | - Fowzan Alkuraya
- Department of GeneticsKing Faisal Specialist Hospital and Research Centre Riyadh Saudi Arabia
- Saudi Human Genome ProgramKing Abdulaziz City for Science and Technology Riyadh Saudi Arabia
- College of MedicineAlfaisal University Riyadh Saudi Arabia
| | - Alison Archibald
- Victorian Clinical Genetics Services Parkville Victoria Australia
- Murdoch Children's Research Institute Parkville Victoria Australia
- Department of PaediatricsUniversity of Melbourne Parkville Victoria Australia
| | - Carlo Castellani
- Cystic Fibrosis CentreIRCCS Istituto Giannina Gaslini Genoa Italy
| | - Martina Cornel
- Department of Clinical GeneticsAmsterdam UMC, Vrije Universiteit Amsterdam Amsterdam The Netherlands
- Amsterdam Reproduction and Development Research Institute Amsterdam The Netherlands
| | - Wayne W. Grody
- Divisions of Medical Genetics and Molecular Diagnostics, Departments of Pathology and Laboratory Medicine, Pediatrics, and Human GeneticsUCLA School of Medicine Los Angeles California USA
- UCLA Institute for Society and Genetics, Molecular Diagnostic Laboratories and Clinical Genomics CenterUCLA Medical Center Los Angeles California USA
| | - Lidewij Henneman
- Department of Clinical GeneticsAmsterdam UMC, Vrije Universiteit Amsterdam Amsterdam The Netherlands
- Amsterdam Reproduction and Development Research Institute Amsterdam The Netherlands
| | | | - Edwin Kirk
- Sydney Children's Hospital Randwick New South Wales Australia
- New South Wales Health Pathology Randwick New South Wales Australia
- School of Women's and Children's HealthUniversity of New South Wales Randwick New South Wales Australia
| | - Nigel Laing
- University of Western Australia Centre for Medical Research and Harry Perkins Institute of Medical ResearchQEII Medical Centre Nedlands Western Australia Australia
- Neurogenetic Unit, Department of Diagnostic Genomics, PathWest Laboratory MedicineQEII Medical Centre Nedlands Western Australia Australia
| | - Anneke Lucassen
- Faculty of Medicine, Southampton Medical SchoolUniversity of Southampton Southampton UK
| | - John Massie
- Murdoch Children's Research Institute Parkville Victoria Australia
- Department of PaediatricsUniversity of Melbourne Parkville Victoria Australia
- Department of Respiratory MedicineRoyal Children's Hospital Parkville Victoria Australia
| | - Juliette Schuurmans
- Faculty of Medicine, Southampton Medical SchoolUniversity of Southampton Southampton UK
- Department of Genetics, University Medical Center GroningenUniversity of Groningen Groningen The Netherlands
| | - Meow‐Keong Thong
- Genetics and Metabolism Unit, Department of Paediatrics, Faculty of MedicineUniversity of Malaya Kuala Lumpur Malaysia
| | - Irene Langen
- Department of Genetics, University Medical Center GroningenUniversity of Groningen Groningen The Netherlands
| | - Joël Zlotogora
- Hadassah‐Hebrew University Medical School Jerusalem Israel
| |
Collapse
|
4
|
Jagsi R, Griffith KA, Jones RD, Krenz C, Gornick M, Spence R, De Vries R, Hawley ST, Zon R, Bolte S, Sadeghi N, Schilsky RL, Bradbury AR. Effect of Public Deliberation on Patient Attitudes Regarding Consent and Data Use in a Learning Health Care System for Oncology. J Clin Oncol 2019; 37:3203-3211. [PMID: 31577472 DOI: 10.1200/jco.19.01693] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
PURPOSE We sought to generate informed and considered opinions regarding acceptable secondary uses of deidentified health information and consent models for oncology learning health care systems. METHODS Day-long democratic deliberation sessions included 217 patients with cancer at four geographically and sociodemographically diverse sites. Patients completed three surveys (at baseline, immediately after deliberation, and 1-month follow-up). RESULTS Participants were 67.3% female, 21.7% black, and 6.0% Hispanic. The most notable changes in perceptions after deliberation related to use of deidentified medical-record data by insurance companies. After discussion, 72.3% of participants felt comfortable if the purpose was to make sure patients receive recommended care (v 79.5% at baseline; P = .03); 24.9% felt comfortable if the purpose was to determine eligibility for coverage or reimbursement (v 50.9% at baseline; P < .001). The most notable change about secondary research use related to believing it was important that doctors ask patients at least once whether researchers can use deidentified medical-records data for future research. The proportion endorsing high importance decreased from baseline (82.2%) to 68.7% immediately after discussion (P < .001), and remained decreased at 73.1% (P = .01) at follow-up. At follow-up, non-Hispanic whites were more likely to consider it highly important to be able to conduct medical research with deidentified electronic health records (96.8% v 87.7%; P = .01) and less likely to consider it highly important for doctors to get a patient's permission each time deidentified medical record information is used for research (23.2% v 51.6%; P < .001). CONCLUSION This research confirms that most patients wish to be asked before deidentified medical records are used for research. Policies designed to realize the potential benefits of learning health care systems can, and should be, grounded in informed and considered public opinion.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | - Robin Zon
- Michiana Hematology-Oncology PC, Mishawaka, IN
| | | | | | | | | |
Collapse
|
5
|
Bowman FL, Molster CM, Lister KJ, Bauskis AT, Garton-Smith J, Vickery AW, Watts GF, Martin AC. Identifying Perceptions and Preferences of the General Public Concerning Universal Screening of Children for Familial Hypercholesterolaemia. Public Health Genomics 2019; 22:25-35. [PMID: 31330524 PMCID: PMC6878743 DOI: 10.1159/000501463] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 06/11/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND/AIMS Familial hypercholesterolaemia (FH) is a common genetic disorder that, if untreated, predisposes individuals to premature coronary heart disease. As most individuals with FH remain undiagnosed, new approaches to detection are needed and should be considered a priority in public health genomics. Universal screening of children for FH has been proposed, and this study explores public perspectives on the acceptability of this approach. METHODS A one-day deliberative public forum was held in Perth, WA, Australia. Thirty randomly selected individuals were recruited, with self-reported sociodemographic characteristics used to obtain discursive representation. Participants were presented with information from a variety of perspectives and asked to discuss the information provided to identify points of consensus and disagreement. The data collected were analysed using thematic analysis. RESULTS Of the 17 participants at the forum, 16 deemed universal screening of children for FH to be acceptable. Fifteen of these 16 believed this was best performed at the time of an immunisation. Participants proposed a number of conditions that should be met to reduce the likelihood of unintended harm resulting from the screening process. DISCUSSION/CONCLUSION The outcomes of the forum suggest that establishing a universal screening programme for FH in childhood is acceptable to the general public in WA.
Collapse
Affiliation(s)
- Faye L Bowman
- Office of Population Health Genomics, Public and Aboriginal Health Division, Western Australian Department of Health, East Perth, Washington, Australia,
| | - Caron M Molster
- Office of Population Health Genomics, Public and Aboriginal Health Division, Western Australian Department of Health, East Perth, Washington, Australia
| | - Karla J Lister
- Office of Population Health Genomics, Public and Aboriginal Health Division, Western Australian Department of Health, East Perth, Washington, Australia
| | - Alicia T Bauskis
- Office of Population Health Genomics, Public and Aboriginal Health Division, Western Australian Department of Health, East Perth, Washington, Australia
| | - Jacquie Garton-Smith
- Health Networks, Clinical Excellence Division, Western Australian Department of Health, East Perth, Washington, Australia
| | - Alistair W Vickery
- School of Medicine, Faculty of Health and Medical Sciences, University of Western Australia, Crawley, Washington, Australia
| | - Gerald F Watts
- School of Medicine, Faculty of Health and Medical Sciences, University of Western Australia, Crawley, Washington, Australia
- Lipid Disorders Clinic, Cardiometabolic Service, Department of Cardiology, Royal Perth Hospital, Perth, Washington, Australia
| | - Andrew C Martin
- Department of General Paediatrics, Perth Children's Hospital, Perth, Washington, Australia
- School of Paediatrics and Child Health, Faculty of Health and Medical Sciences, University of Western Australia, Crawley, Washington, Australia
| |
Collapse
|
6
|
Mosconi P, Colombo C, Roberto A, Candiani G, Greco MT, Satolli R, Castellani C. Deciding on cystic fibrosis carrier screening: three citizens' juries and an online survey. Eur J Public Health 2019; 28:973-977. [PMID: 29562330 PMCID: PMC6148966 DOI: 10.1093/eurpub/cky032] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Background Health technology assessment and ethical issues have to be dealt with in deciding on national carrier screening for cystic fibrosis (CF)—the most frequent severe autosomal recessive disease in Caucasian populations and several stakeholders need to be involved. A citizens’ jury is one way to ask citizens to deliberate on controversial topics in the interests of a society. The aims of this project were to gather opinions about CF carrier screening through citizens' jury deliberations and to match them with the findings of a large online consultation survey open to the general population, people with CF and families and health professionals. Methods Three citizens’ juries and an online survey were asked: ‘Should the Health Service organize screening of the population with the aim of identifying healthy people who may have children with CF?’ The jurors had no medical background and no personal or family CF history. The survey was open to people with CF, families, and healthcare professionals. Results Jurors and survey respondents were in favour of CF carrier screening, mainly considering the severity of CF, the value of informed reproductive choices and the equality of the screening. All the citizens’ juries felt positively about the health service actively offer CF carrier screening to provide women and couples of reproductive age equal access and standardized information on the pros and cons. Conclusion Considering the favourable attitude towards CF screening, the feasibility of CF screening, in terms of best setting, target age and healthcare professionals providing it, should be tested in a clinical trial.
Collapse
Affiliation(s)
- Paola Mosconi
- Laboratory for Medical Research and Consumers Involvement, Department of Public Health, IRCCS Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
| | - Cinzia Colombo
- Laboratory for Medical Research and Consumers Involvement, Department of Public Health, IRCCS Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
| | - Anna Roberto
- Laboratory for Medical Research and Consumers Involvement, Department of Public Health, IRCCS Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
| | | | - Maria Teresa Greco
- Laboratory of Methodology for Clinical Research, Department of Oncology, IRCCS Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
| | | | - Carlo Castellani
- Centro Fibrosi Cistica dell'Azienda Ospedaliera Interuniversitaria Integrata, Verona, Italy.,Centro Fibrosi Cistica, Ospedale Gaslini, Genoa, Italy
| |
Collapse
|
7
|
Chokoshvili D, Belmans C, Poncelet R, Sanders S, Vaes D, Vears D, Janssens S, Huys I, Borry P. Public Views on Genetics and Genetic Testing: A Survey of the General Public in Belgium. Genet Test Mol Biomarkers 2017; 21:195-201. [PMID: 28306397 DOI: 10.1089/gtmb.2016.0418] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
AIMS To explore the views of the Belgian public on various topics surrounding genetics and genetic testing (GT). MATERIALS AND METHODS A written questionnaire was administered to visitors of the annual cartoon festival in Knokke-Heist, Belgium, during the summer of 2014. The main theme of the festival was challenges and progress in human genetics and it was attended by more than 100,000 visitors. RESULTS The survey was completed by 1182 respondents, resulting in a demographically diverse sample with a mean age of 48.5 years. Our respondents expressed moderate interest in predictive GT, with 39.1% willing to learn about their predisposition to diseases through GT and 49.5% indicating interest in getting tested exclusively for treatable/preventable diseases. We observed higher interest in GT for reproductive purposes, such as preconception screening for recessive disorders (53.8%) and prenatal GT (60.7%). A substantial minority (46.4%) of the respondents were worried that GT could further stigmatize people with disabilities, while 39.7% believed that carrier screening for recessive diseases would lead to an inferior image of people affected by them. CONCLUSION Paying due attention to the attitudes, beliefs, and concerns of the general public is important to ensure ethically sound and socially acceptable implementation of new genetic technologies.
Collapse
Affiliation(s)
- Davit Chokoshvili
- 1 Department of Public Health and Primary Care, Centre for Biomedical Ethics and Law, University of Leuven, Leuven, Belgium
| | - Carmen Belmans
- 1 Department of Public Health and Primary Care, Centre for Biomedical Ethics and Law, University of Leuven, Leuven, Belgium
| | - Roxanne Poncelet
- 1 Department of Public Health and Primary Care, Centre for Biomedical Ethics and Law, University of Leuven, Leuven, Belgium
| | - Sofie Sanders
- 1 Department of Public Health and Primary Care, Centre for Biomedical Ethics and Law, University of Leuven, Leuven, Belgium
| | - Deborah Vaes
- 1 Department of Public Health and Primary Care, Centre for Biomedical Ethics and Law, University of Leuven, Leuven, Belgium
| | - Danya Vears
- 1 Department of Public Health and Primary Care, Centre for Biomedical Ethics and Law, University of Leuven, Leuven, Belgium
| | - Sandra Janssens
- 2 Centre for Medical Genetics Ghent, University Hospital Ghent , Ghent, Belgium
| | - Isabelle Huys
- 1 Department of Public Health and Primary Care, Centre for Biomedical Ethics and Law, University of Leuven, Leuven, Belgium
| | - Pascal Borry
- 1 Department of Public Health and Primary Care, Centre for Biomedical Ethics and Law, University of Leuven, Leuven, Belgium
| |
Collapse
|
8
|
Janssens S, Chokoshvili D, Vears D, De Paepe A, Borry P. Attitudes of European Geneticists Regarding Expanded Carrier Screening. J Obstet Gynecol Neonatal Nurs 2016; 46:63-71. [PMID: 27875676 DOI: 10.1016/j.jogn.2016.08.012] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2016] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVE To explore attitudes of clinical and molecular geneticists about the implementation of multi-disease or expanded carrier screening (ECS) for monogenic recessive disorders. DESIGN Qualitative; semistructured interviews. SETTING In person or via Skype. Interviews were audiorecorded and transcribed verbatim. PARTICIPANTS European clinical and molecular geneticists with expertise in carrier screening (N = 16). METHODS Inductive content analysis was used to identify common content categories in the data. RESULTS Participants recognized important benefits of ECS, but they also identified major challenges, including limited benefit of ECS for most couples in the general population, lack of knowledge on carrier screening among nongenetic health care providers and the general public, potential negative implications of ECS for society, and limited economic resources. Participants favored an evidence-based approach to the implementation of population-wide ECS and were reluctant to actively offer ECS in the absence of demonstrable benefits. However, there was a consensus among the participants that ECS should be made available to couples who request the test. In addition, they believed ECS could be routinely offered to all people who use assisted reproduction. CONCLUSION Although a limited ECS offer is practical, it also raises concerns over equality in access to screening. A comprehensive risk-benefit analysis is needed to determine the desirability of systematic population-wide ECS.
Collapse
|
9
|
Chokoshvili D, Janssens S, Vears D, Borry P. Designing expanded carrier screening panels: results of a qualitative study with European geneticists. Per Med 2016; 13:553-562. [DOI: 10.2217/pme-2016-0018] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Aim: To explore the views of clinical and molecular geneticists on the inclusion of disorders and specific pathogenic mutations into expanded carrier screening (ECS) tests for reproductive purposes. Materials & methods: In-depth semistructured interviews were conducted with 16 European geneticists between April and September 2014. Results: All participants supported carrier screening for severe, childhood-onset autosomal recessive disorders with known natural history. Some participants were also in favor of screening for late-onset and X-linked disorders. Regarding selection of specific pathogenic mutations, our participants argued that ECS should include highly penetrant pathogenic mutations with known genotype–phenotype associations. Conclusion: This study highlights main challenges surrounding the development of ECS panels and offers suggestions for future research in this rapidly advancing field.
Collapse
Affiliation(s)
- Davit Chokoshvili
- Centre for Biomedical Ethics & Law, Department of Public Health and Primary Care, University of Leuven, Kapucijnenvoer 35, Box 7001, 3000 Leuven, Belgium
| | - Sandra Janssens
- Centre for Medical Genetics Ghent, University Hospital Ghent. De Pintelaan 185, 9000 Ghent, Belgium
| | - Danya Vears
- Centre for Biomedical Ethics & Law, Department of Public Health and Primary Care, University of Leuven, Kapucijnenvoer 35, Box 7001, 3000 Leuven, Belgium
| | - Pascal Borry
- Centre for Biomedical Ethics & Law, Department of Public Health and Primary Care, University of Leuven, Kapucijnenvoer 35, Box 7001, 3000 Leuven, Belgium
| |
Collapse
|
10
|
Thomas R, Sims R, Degeling C, Street JM, Carter SM, Rychetnik L, Whitty JA, Wilson A, Ward P, Glasziou P. CJCheck Stage 1: development and testing of a checklist for reporting community juries - Delphi process and analysis of studies published in 1996-2015. Health Expect 2016; 20:626-637. [PMID: 27704684 PMCID: PMC5513001 DOI: 10.1111/hex.12493] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/05/2016] [Indexed: 12/25/2022] Open
Abstract
Background Opportunities for community members to actively participate in policy development are increasing. Community/citizen's juries (CJs) are a deliberative democratic process aimed to illicit informed community perspectives on difficult topics. But how comprehensive these processes are reported in peer‐reviewed literature is unknown. Adequate reporting of methodology enables others to judge process quality, compare outcomes, facilitate critical reflection and potentially repeat a process. We aimed to identify important elements for reporting CJs, to develop an initial checklist and to review published health and health policy CJs to examine reporting standards. Design Using the literature and expertise from CJ researchers and policy advisors, a list of important CJ reporting items was suggested and further refined. We then reviewed published CJs within the health literature and used the checklist to assess the comprehensiveness of reporting. Results CJCheck was developed and examined reporting of CJ planning, juror information, procedures and scheduling. We screened 1711 studies and extracted data from 38. No studies fully reported the checklist items. The item most consistently reported was juror numbers (92%, 35/38), while least reported was the availability of expert presentations (5%, 2/38). Recruitment strategies were described in 66% of studies (25/38); however, the frequency and timing of deliberations was inadequately described (29%, 11/38). Conclusions Currently CJ publications in health and health policy literature are inadequately reported, hampering their use in policy making. We propose broadening the CJCheck by creating a reporting standards template in collaboration with international CJ researchers, policy advisors and consumer representatives to ensure standardized, systematic and transparent reporting.
Collapse
Affiliation(s)
- Rae Thomas
- Centre for Research in Evidence-Based Practice (CREBP), Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Qld, Australia
| | - Rebecca Sims
- Centre for Research in Evidence-Based Practice (CREBP), Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Qld, Australia
| | - Chris Degeling
- Centre for Values, Ethics and the Law in Medicine, University of Sydney, Sydney, NSW, Australia
| | - Jackie M Street
- School of Public Health, The University of Adelaide, Adelaide, SA, Australia
| | - Stacy M Carter
- Centre for Values, Ethics and the Law in Medicine, University of Sydney, Sydney, NSW, Australia
| | - Lucie Rychetnik
- School of Medicine, University of Notre Dame, Sydney, NSW, Australia.,School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - Jennifer A Whitty
- Health Economics Group, Norwich Medical School, University of East Anglia, Norwich, UK
| | - Andrew Wilson
- Menzies Centre for Health Policy, University of Sydney, Sydney, NSW, Australia
| | - Paul Ward
- Discipline of Public Health, School of Health Sciences, Faculty of Medicine, Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
| | - Paul Glasziou
- Centre for Research in Evidence-Based Practice (CREBP), Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Qld, Australia
| |
Collapse
|
11
|
Mosconi P, Colombo C, Satolli R, Carzaniga S. Involving a Citizens' Jury in Decisions on Individual Screening for Prostate Cancer. PLoS One 2016; 11:e0143176. [PMID: 26751212 PMCID: PMC4709131 DOI: 10.1371/journal.pone.0143176] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Accepted: 11/01/2015] [Indexed: 12/20/2022] Open
Abstract
AIMS Most public health agencies and learned societies agree that the prostate-specific antigen (PSA) test in asymptomatic men should not be recommended, on account of its potential for harm. Yet PSA is still widely used as a screening test and is not being abandoned. This remains a significant public health issue, and citizens' engagement is needed. This study was designed to produce a deliberation on the PSA screening test by a citizens' jury. METHODS Fifteen citizens were selected and balanced for sex, age, and education. They received an information booklet and participated in a two-day meeting with experts to reach a deliberation on the question "Should the National Health Service discourage or recommend PSA as an individual screening test for prostate cancer in men 55-69 years old?". A facilitator ran the jurors' discussion. RESULTS All except three of the jurors decided that the National Health Service should discourage the use of PSA as an individual screening test for prostate cancer in 55-69 year-old men. The jury was particularly convinced by the uncertainty of the test outcomes, the utility of the test, and its cost/benefit ratio. Before the meeting 60% of jurors would have recommended the test to a relative, and all the male jurors would have done so. After the meeting these percentages fell to 15% and 12%. CONCLUSIONS This experience confirms the feasibility and effectiveness of delegating to a group of citizens the responsibility to decide on public health issues on behalf of the community. Public health authorities should invest in information campaigns aimed at the public and in educational initiatives for physicians. This also provided an opportunity to disseminate information on screening, over-diagnosis, and over-treatment.
Collapse
Affiliation(s)
- Paola Mosconi
- Laboratory for medical research and consumer involvement, IRCCS Istituto di Ricerche Farmacologiche Mario Negri, Milano, Italy
- * E-mail:
| | - Cinzia Colombo
- Laboratory for medical research and consumer involvement, IRCCS Istituto di Ricerche Farmacologiche Mario Negri, Milano, Italy
| | | | - Sara Carzaniga
- Agenzia Nazionale per i servizi Sanitari regionali Agenas, Roma, Italy
| | | |
Collapse
|