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Knoppers T, Haley CE, Bouhouita-Guermech S, Hagan J, Bradbury-Jost J, Alarie S, Cosquer M, Zawati MH. From code to care: Clinician and researcher perspectives on an optimal therapeutic web portal for acute myeloid leukemia. PLoS One 2024; 19:e0302156. [PMID: 38635542 PMCID: PMC11025855 DOI: 10.1371/journal.pone.0302156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 03/28/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND Acute myeloid leukemia (AML), a rapidly progressing cancer of the blood and bone marrow, is the most common and fatal type of adult leukemia. Therapeutic web portals have great potential to facilitate AML research advances and improve health outcomes by increasing the availability of data, the speed and reach of new knowledge, and the communication between researchers and clinicians in the field. However, there is a need for stakeholder research regarding their optimal features, utility, and implementation. METHODS To better understand stakeholder perspectives regarding an ideal pan-Canadian web portal for AML research, semi-structured qualitative interviews were conducted with 17 clinicians, researchers, and clinician-researchers. Interview guides were inspired by De Laat's "fictive scripting", a method where experts are presented with scenarios about a future technology and asked questions about its implementation. Content analysis relied on an iterative process using themes extracted from both existing scientific literature and the data. RESULTS Participants described potential benefits of an AML therapeutic portal including facilitating data-sharing, communication, and collaboration, and enhancing clinical trial matchmaking for patients, potentially based on their specific genomic profiles. There was enthusiasm about researcher, clinician, and clinician-researcher access, but some disagreement about the nature of potential patient access to the portal. Interviewees also discussed two key elements they believed to be vital to the uptake and thus success of a therapeutic AML web portal: credibility and user friendliness. Finally, sustainability, security and privacy concerns were also documented. CONCLUSIONS This research adds to existing calls for digital platforms for researchers and clinicians to supplement extant modes of communication to streamline research and its dissemination, advance precision medicine, and ultimately improve patient prognosis and care. Findings are applicable to therapeutic web portals more generally, particularly in genomic and translational medicine, and will be of interest to portal end-users, developers, researchers, and policymakers.
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Affiliation(s)
- Terese Knoppers
- Centre of Genomics and Policy, McGill University, Montreal, Quebec, Canada
| | - Cassandra E. Haley
- Centre of Genomics and Policy, McGill University, Montreal, Quebec, Canada
| | | | - Julie Hagan
- Centre of Genomics and Policy, McGill University, Montreal, Quebec, Canada
| | | | - Samuel Alarie
- Centre of Genomics and Policy, McGill University, Montreal, Quebec, Canada
| | - Marie Cosquer
- Centre of Genomics and Policy, McGill University, Montreal, Quebec, Canada
| | - Ma’n H. Zawati
- Centre of Genomics and Policy, McGill University, Montreal, Quebec, Canada
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2
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Wolf SM, Green RC. Return of Results in Genomic Research Using Large-Scale or Whole Genome Sequencing: Toward a New Normal. Annu Rev Genomics Hum Genet 2023; 24:393-414. [PMID: 36913714 PMCID: PMC10497726 DOI: 10.1146/annurev-genom-101122-103209] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
Abstract
Genome sequencing is increasingly used in research and integrated into clinical care. In the research domain, large-scale analyses, including whole genome sequencing with variant interpretation and curation, virtually guarantee identification of variants that are pathogenic or likely pathogenic and actionable. Multiple guidelines recommend that findings associated with actionable conditions be offered to research participants in order to demonstrate respect for autonomy, reciprocity, and participant interests in health and privacy. Some recommendations go further and support offering a wider range of findings, including those that are not immediately actionable. In addition, entities covered by the US Health Insurance Portability and Accountability Act (HIPAA) may be required to provide a participant's raw genomic data on request. Despite these widely endorsed guidelines and requirements, the implementation of return of genomic results and data by researchers remains uneven. This article analyzes the ethical and legal foundations for researcher duties to offer adult participants their interpreted results and raw data as the new normal in genomic research.
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Affiliation(s)
- Susan M Wolf
- Law School and Medical School, University of Minnesota, Minneapolis, Minnesota, USA;
| | - Robert C Green
- Genomes2People Research Program, Harvard Medical School, Mass General Brigham, Broad Institute, and Ariadne Labs, Boston, Massachusetts, USA;
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3
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Giannella E, Notarangelo V, Motta C, Sancesario G. Biobanking for Neurodegenerative Diseases: Challenge for Translational Research and Data Privacy. Neuroscientist 2023; 29:190-201. [PMID: 34353130 DOI: 10.1177/10738584211036693] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Biobanking has emerged as a strategic challenge to promote knowledge on neurological diseases, by the application of translational research. Due to the inaccessibility of the central nervous system, the advent of biobanks, as structure collecting biospecimens and associated data, are essential to turn experimental results into clinical practice. Findings from basic research, omics sciences, and in silico studies, definitely require validation in clinically well-defined cohorts of patients, even more valuable when longitudinal, or including preclinical and asymptomatic individuals. Finally, collecting biological samples requires a great effort to guarantee respect for transparency and protection of sensitive data of patients and donors. Since the European General Data Protection Regulation 2016/679 has been approved, concerns about the use of data in biomedical research have emerged. In this narrative review, we focus on the essential role of biobanking for translational research on neurodegenerative diseases. Moreover, we address considerations for biological samples and data collection, the importance of standardization in the preanalytical phase, data protection (ethical and legal) and the role of donors in improving research in this field.
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Affiliation(s)
- Emilia Giannella
- Biobank, IRCCS Santa Lucia Foundation, Rome, Italy.,Experimental Neuroscience, European Center for Brain Research, Rome, Italy
| | | | - Caterina Motta
- Dept Clinical and Behavioural Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Giulia Sancesario
- Biobank, IRCCS Santa Lucia Foundation, Rome, Italy.,Experimental Neuroscience, European Center for Brain Research, Rome, Italy
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4
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Zimmerman KO, Perry B, Hanlen‐Rosado E, Nsonwu A, Lane MD, Benjamin DK, Becker M, Corneli A. Developing lay summaries and thank you notes in paediatric pragmatic clinical trials. Health Expect 2022; 25:1029-1037. [PMID: 35246906 PMCID: PMC9122399 DOI: 10.1111/hex.13448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 01/11/2022] [Accepted: 01/18/2022] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Better transparency of research results and participant engagement may help address poor participant accrual in paediatric clinical research. We conducted formative research to assess the acceptability of lay summaries and thank you notes, as well as to refine and expand guidance on participant and family engagement in Pediatric Trials Network's (PTN) pragmatic paediatric clinical research. METHODS Informed by draft PTN guidance, we conducted in-depth qualitative interviews with adolescent clinical trial participants and caregivers of paediatric participants in four trials conducted by PTN across eight sites. Participants were shown multiple versions of mock lay summaries and thank you notes and asked questions on their preferences for content and layout, and on trial communications. We used applied thematic analysis to analyse the data. RESULTS We interviewed 27 individuals engaged in PTN research: 24 caregivers and 3 adolescents. During a trial, participants want regular updates on study progress, reminders of the study purpose and reassurances of data confidentiality. After the trial, participants want to learn the aggregated results, particularly medication effectiveness. Participants reported that lay summaries should include a review of the study's purpose, methods and length, and that they expect to learn individual-level results. Participants stated that thank you notes must be of sufficient length to be meaningful. CONCLUSIONS This is the first study to describe stakeholder preferences for thank you note content and layout. Using these findings, we finalized PTN's trial communication guidance for use in future PTN trials. Research is needed to determine the effect of lay summaries and thank you notes on improving public transparency regarding clinical trials and paediatric trial recruitment and completion. PATIENT OR PUBLIC CONTRIBUTION By design, stakeholders (adolescent trial participants and caregivers of pediatric trial participants) contributed to PTN's guidance on the content and layout of lay summaries and thank you notes through their participation in the in-depth interviews.
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Affiliation(s)
- Kanecia O. Zimmerman
- Duke Clinical Research Institute, Duke University School of MedicineDurhamNorth CarolinaUSA
- Department of PediatricsDuke UniversityDurhamNorth CarolinaUSA
| | - Brian Perry
- Department of Population Health SciencesDuke UniversityDurhamNorth CarolinaUSA
| | - Emily Hanlen‐Rosado
- Department of Population Health SciencesDuke UniversityDurhamNorth CarolinaUSA
| | - Adora Nsonwu
- Department of Population Health SciencesDuke UniversityDurhamNorth CarolinaUSA
| | - Morgan D. Lane
- Duke Clinical Research Institute, Duke University School of MedicineDurhamNorth CarolinaUSA
| | - Daniel K. Benjamin
- Duke Clinical Research Institute, Duke University School of MedicineDurhamNorth CarolinaUSA
- Department of PediatricsDuke UniversityDurhamNorth CarolinaUSA
| | - Mara Becker
- Duke Clinical Research Institute, Duke University School of MedicineDurhamNorth CarolinaUSA
- Department of PediatricsDuke UniversityDurhamNorth CarolinaUSA
| | - Amy Corneli
- Duke Clinical Research Institute, Duke University School of MedicineDurhamNorth CarolinaUSA
- Department of Population Health SciencesDuke UniversityDurhamNorth CarolinaUSA
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5
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Chad L, Szego MJ. Please give me a copy of my child's raw genomic data. NPJ Genom Med 2021; 6:15. [PMID: 33597540 PMCID: PMC7889911 DOI: 10.1038/s41525-021-00175-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 12/24/2020] [Indexed: 11/23/2022] Open
Abstract
In this work, we explore whether raw genetic data generated during sequencing ought to be returned to a pediatric patient and/or their parents/guardians. We identify the principles used by various professional societies in their guidelines on the return of secondary findings and apply them to this new context. We conclude that since each situation is unique, decisions should be made on a case-by-case basis according to the best interests of the child.
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Affiliation(s)
- Lauren Chad
- Clinical and Metabolic Genetics, The Hospital for Sick Children, Toronto, ON, Canada.,Department of Bioethics, The Hospital for Sick Children, Toronto, ON, Canada.,Department of Paediatrics, University of Toronto, Toronto, ON, Canada
| | - Michael J Szego
- Centre for Clinical Ethics, Unity Health Toronto, Toronto, ON, Canada. .,The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON, Canada. .,Dalla Lana School of Public Health, Departments of Family and Community Medicine and Molecular Genetics, University of Toronto, Toronto, ON, Canada.
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6
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Ethical challenges of precision cancer medicine. Semin Cancer Biol 2020; 84:263-270. [PMID: 33045356 DOI: 10.1016/j.semcancer.2020.09.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 08/25/2020] [Accepted: 09/20/2020] [Indexed: 11/21/2022]
Abstract
Amongst common diseases, cancer is often both a leader in self-regulatory policy, or the field for contentious ethical issues such as the patenting of the BRCA1/2 genes. With the advent of genomic sequencing technologies, achieving precision cancer medicine requires prospective norms due to the large and varied sources of data involved. Here, we discuss the ethical and legal aspects of the policy debate around the relevant topics in precision cancer medicine: the return of incidental findings and sequencing raw data to patients, the communication of genetic results to patients' relatives, privacy and communication risks with concomitant oversight strategies, patient participation and consent models. We present the arguments and empirical data supporting specific policy solutions delineating still contested areas. What type of consent and oversight are required to acquire genomic data or to access it where desired, either by the participant/patient or third-party researchers? Most of the raw sequencing data is still uninterpretable and the variants revealed subject to reinterpretation over time. No doubt the ethical challenges of precision cancer medicine are a prototype of what's to come for other diseases. They are also paradigmatic for regulatory and ethical questions of the translational endeavors since the two worlds - basic science and patient care - are governed by different ethical and legal principles that need to be reconciled in precision cancer medicine.
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7
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Narayanasamy S, Markina V, Thorogood A, Blazkova A, Shabani M, Knoppers BM, Prainsack B, Koesters R. Genomic Sequencing Capacity, Data Retention, and Personal Access to Raw Data in Europe. Front Genet 2020; 11:303. [PMID: 32435258 PMCID: PMC7218066 DOI: 10.3389/fgene.2020.00303] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Accepted: 03/13/2020] [Indexed: 12/30/2022] Open
Abstract
Whole genome/exome sequencing (WGS/WES) has become widely adopted in research and, more recently, in clinical settings. Many hope that the information obtained from the interpretation of these data will have medical benefits for patients and—in some cases—also their biological relatives. Because of the manifold possibilities to reuse genomic data, enabling sequenced individuals to access their own raw (uninterpreted) genomic data is a highly debated issue. This paper reports some of the first empirical findings on personal genome access policies and practices. We interviewed 39 respondents, working at 33 institutions in 21 countries across Europe. These sequencing institutions generate massive amounts of WGS/WES data and represent varying organisational structures and operational models. Taken together, in total, these institutions have sequenced ∼317,259 genomes and exomes to date. Most of the sequencing institutions reported that they are able to store raw genomic data in compliance with various national regulations, although there was a lack of standardisation of storage formats. Interviewees from 12 of the 33 institutions included in our study reported that they had received requests for personal access to raw genomic data from sequenced individuals. In the absence of policies on how to process such requests, these were decided on an ad hoc basis; in the end, at least 28 requests were granted, while there were no reports of requests being rejected. Given the rights, interests, and liabilities at stake, it is essential that sequencing institutions adopt clear policies and processes for raw genomic data retention and personal access.
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Affiliation(s)
| | | | - Adrian Thorogood
- Centre of Genomics and Policy, McGill University, Montreal, QC, Canada
| | - Adriana Blazkova
- Megeno S.A., Esch-sur-Alzette, Luxembourg.,Faculty of Language and Literature, Humanities, Arts and Education, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Mahsa Shabani
- Metamedica, Faculty of Law and Criminology, Ghent University, Ghent, Belgium
| | - Bartha M Knoppers
- Centre of Genomics and Policy, McGill University, Montreal, QC, Canada
| | - Barbara Prainsack
- Department of Political Science, University of Vienna, Vienna, Austria.,Department of Global Health & Social Medicine, King's College London, London, United Kingdom
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8
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Wolf SM. Return of Results in Participant-Driven Research: Learning from Transformative Research Models. THE JOURNAL OF LAW, MEDICINE & ETHICS : A JOURNAL OF THE AMERICAN SOCIETY OF LAW, MEDICINE & ETHICS 2020; 48:159-166. [PMID: 32342739 DOI: 10.1177/1073110520917042] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Participant-driven research (PDR) is a burgeoning domain of research innovation, often facilitated by mobile technologies (mHealth). Return of results and data are common hallmarks, grounded in transparency and data democracy. PDR has much to teach traditional research about these practices and successful engagement. Recommendations calling for new state laws governing research with mHealth modalities common in PDR and federal creation of review mechanisms, threaten to stifle valuable participant-driven innovation, including in return of results.
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Affiliation(s)
- Susan M Wolf
- Susan M. Wolf, J.D., is McKnight Presidential Professor of Law, Medicine & Public Policy; Faegre Baker Daniels Professor of Law; and Professor of Medicine at the University of Minnesota. She chairs the University's Consortium on Law and Values in Health, Environment & the Life Sciences
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9
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Kim Y, Lee B, Choe EK. Investigating data accessibility of personal health apps. J Am Med Inform Assoc 2020; 26:412-419. [PMID: 30861531 PMCID: PMC6433179 DOI: 10.1093/jamia/ocz003] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2018] [Revised: 12/15/2018] [Accepted: 01/08/2019] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Despite the potential values self-tracking data could offer, we have little understanding of how much access people have to "their" data. Our goal of this article is to unveil the current state of the data accessibility-the degree to which people can access their data-of personal health apps in the market. MATERIALS AND METHODS We reviewed 240 personal health apps from the App Store and selected 45 apps that support semi-automated tracking. We characterized the data accessibility of these apps using two dimensions-data access methods and data types. RESULTS More than 90% of our sample apps (n = 41) provide some types of data access support, which include synchronizing data with a health platform (ie, Apple Health), file download, and application program interfaces. However, the two approachable data access methods for laypeople-health platform and file download-typically put a significant limit on data format, granularity, and amount, which constrains people from easily repurposing the data. DISCUSSION Personal data should be accessible to the people who collect them, but existing methods lack sufficient support for people in accessing the fine-grained data. Lack of standards in personal health data schema as well as frequent changes in market conditions are additional hurdles to data accessibility. CONCLUSIONS Many stakeholders including patients, healthcare providers, researchers, third-party developers, and the general public rely on data accessibility to utilize personal data for various goals. As such, improving data accessibility should be considered as an important factor in designing personal health apps and health platforms.
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Affiliation(s)
- Yoojung Kim
- Graduate School of Convergence Science and Technology, Seoul National University, Seoul, South Korea
| | | | - Eun Kyoung Choe
- College of Information Studies, University of Maryland, College Park, Maryland, USA
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10
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Schickhardt C, Fleischer H, Winkler EC. Do patients and research subjects have a right to receive their genomic raw data? An ethical and legal analysis. BMC Med Ethics 2020; 21:7. [PMID: 31948449 PMCID: PMC6966790 DOI: 10.1186/s12910-020-0446-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Accepted: 01/02/2020] [Indexed: 11/27/2022] Open
Abstract
Background As Next Generation Sequencing technologies are increasingly implemented in biomedical research and (translational) care, the number of study participants and patients who ask for release of their genomic raw data is set to increase. This raises the question whether research participants and patients have a legal and moral right to receive their genomic raw data and, if so, how this right should be implemented into practice. Methods In a first step we clarify some central concepts such as “raw data”; in a second step we sketch the international legal framework. The third step provides an extensive ethical analysis which comprehends two parts: an evaluation of whether there is a prima facie moral right to receive one’s raw data, and a contextualization and discussion of the right in light of potentially conflicting interests and rights of the data subject herself and third parties; in a last fourth step we emphasize the main practical consequences of the ethical analyses and propose recommendations for the release of raw data. Results In several legislations like the new European General Data Protection Regulation, patients do in principle have the right to receive their raw data. However, the procedural implementation of this right and whether it involves genetic counselling is at the discretion of the Member States. Even more questions remain with respect to the research context. The ethical analysis suggests that patients and research subjects have a moral right to receive their genomic raw data and addresses aspects which are also of relevance for the legal discussion such as the costs of release of raw data and its impact on academic freedom. Conclusion Taking into account the specific nature and implications of genomic raw data and the contexts of research and health care, several concerns and potentially conflicting interests of the data subjects themselves and involved researchers, physicians, biomedical institutions and relatives arise. Instead of using them to argue in favor of restrictions of the data subjects’ legal and moral right to genomic raw data, the concerns should be addressed through provision of information and other measures. To this end, we propose relevant recommendations.
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Affiliation(s)
- Christoph Schickhardt
- National Center for Tumor Diseases (NCT), Department of Medical Oncology, Heidelberg University Hospital, Heidelberg, Germany
| | - Henrike Fleischer
- Institute for German, European and International Medical Law, Public Health Law and Bioethics (IMGB), Universities of Heidelberg and Mannheim, Mannheim, Germany
| | - Eva C Winkler
- National Center for Tumor Diseases (NCT), Department of Medical Oncology, Heidelberg University Hospital, Heidelberg, Germany.
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11
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Goisauf M, Martin G, Bentzen HB, Budin-Ljøsne I, Ursin L, Durnová A, Leitsalu L, Smith K, Casati S, Lavitrano M, Mascalzoni D, Boeckhout M, Mayrhofer MT. Data in question: A survey of European biobank professionals on ethical, legal and societal challenges of biobank research. PLoS One 2019; 14:e0221496. [PMID: 31532777 PMCID: PMC6750647 DOI: 10.1371/journal.pone.0221496] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 08/07/2019] [Indexed: 12/13/2022] Open
Abstract
Biobanks have evolved, and their governance procedures have undergone important transformations. Our paper examines this issue by focusing on the perspective of the professionals working in management or scientific roles in research-based biobanks, who have an important impact on shaping these transformations. In particular, it highlights that recent advances in molecular medicine and genomic research have raised a range of ethical, legal and societal implications (ELSI) related to biobank-based research, impacting directly on regulations and local practices of informed consent (IC), private-public partnerships (PPPs), and engagement of participants. In our study, we investigate the ways that these concerns influence biobanking practices and assess the level of satisfaction of the cross-national biobanking research communities with the ELSI related procedures that are currently in place. We conducted an online survey among biobankers and researchers to investigate secondary use of data, informing and/or re-contacting participants, sharing of data with third parties from industry, participant engagement, and collaboration with industrial partners. Findings highlight the need for a more inclusive and transparent biobanking practice where biobanks are seen in a more active role in providing information and communicating with participants; the need to improve the current IC procedures and the role of biobanks in sharing of samples and data with industry partners and different countries, and the need for practical, tangible and hands-on ethical and legal guidance.
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Affiliation(s)
| | - Gillian Martin
- BBMRI-ERIC, Graz, Austria
- Department of Sociology, University of Malta, Msida, Malta
| | - Heidi Beate Bentzen
- Norwegian Research Center for Computers and Law, Faculty of Law, University of Oslo, Oslo, Norway
- Centre for Medical Ethics, Faculty of Medicine, University of Oslo, Oslo, Norway
| | | | - Lars Ursin
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
| | - Anna Durnová
- BBMRI-ERIC, Graz, Austria
- Institute for Advanced Studies, Vienna, Austria
| | - Liis Leitsalu
- BBMRI-ERIC, Graz, Austria
- Institute of Genomics, Estonian Genome Center, University of Tartu, Tartu, Estonia
| | - Katharine Smith
- Centre for Health Policy, Institute of Global Health Innovation, Imperial College London, London, England, United Kingdom
| | - Sara Casati
- Department of Medicine and Surgery, University Milano—Bicocca, Milan, Italy
| | | | - Deborah Mascalzoni
- Department of Public Health, Center for Research Ethics and Bioethics, University of Uppsala CRB, Uppsala, Sweden
- EURAC Research, Institute of Biomedicine, Bolzano, Italy
| | - Martin Boeckhout
- Department of Medical Humanities, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
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12
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Nelson SC, Bowen DJ, Fullerton SM. Third-Party Genetic Interpretation Tools: A Mixed-Methods Study of Consumer Motivation and Behavior. Am J Hum Genet 2019; 105:122-131. [PMID: 31204012 DOI: 10.1016/j.ajhg.2019.05.014] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 05/20/2019] [Indexed: 12/27/2022] Open
Abstract
In an effort to meet ethical obligations and/or participant expectations, researchers may consider offering "raw" or uninterpreted genetic data for result return. It is therefore important to understand the motivations, behaviors, and perspectives of individuals who might choose to access raw data before such return becomes routine. In the direct-to-consumer (DTC) context, where raw data are often made available to customers, the use of third-party interpretation tools has raised concerns about genotype accuracy, data privacy, reliability of interpretation, and consumption of limited health care resources. However, relatively little is known about why individuals access raw data or what they do with the information received from third-party interpretation. Accordingly, we conducted a survey on raw data access and third-party tool usage among 1,137 DTC customers recruited through social media. Most survey respondents (89%) reported downloading their raw data. Among downloaders, 94% used at least one tool, most commonly Promethease (63%) or GEDmatch (84%). More than half (56%) used both health-related and non-health-related tools and differed significantly from those who used only one tool type in terms of demographics, participation in research, DTC tests ordered, and testing motivations. Exploratory interviews were conducted with 10 respondents and illustrated how social networking, initial lack of interesting findings, and general curiosity contributed to use of multiple tool types. These results suggest that even when initially motivated by ancestry and genealogy, consumers frequently also pursue health information in a largely unregulated and expanding suite of third-party tools, raising both challenges and opportunities for the professional genetics community.
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13
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Brieger K, Zajac GJM, Pandit A, Foerster JR, Li KW, Annis AC, Schmidt EM, Clark CP, McMorrow K, Zhou W, Yang J, Kwong AM, Boughton AP, Wu J, Scheller C, Parikh T, de la Vega A, Brazel DM, Frieser M, Rea-Sandin G, Fritsche LG, Vrieze SI, Abecasis GR. Genes for Good: Engaging the Public in Genetics Research via Social Media. Am J Hum Genet 2019; 105:65-77. [PMID: 31204010 PMCID: PMC6612519 DOI: 10.1016/j.ajhg.2019.05.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 05/08/2019] [Indexed: 01/06/2023] Open
Abstract
The Genes for Good study uses social media to engage a large, diverse participant pool in genetics research and education. Health history and daily tracking surveys are administered through a Facebook application, and participants who complete a minimum number of surveys are mailed a saliva sample kit ("spit kit") to collect DNA for genotyping. As of March 2019, we engaged >80,000 individuals, sent spit kits to >32,000 individuals who met minimum participation requirements, and collected >27,000 spit kits. Participants come from all 50 states and include a diversity of ancestral backgrounds. Rates of important chronic health indicators are consistent with those estimated for the general U.S. population using more traditional study designs. However, our sample is younger and contains a greater percentage of females than the general population. As one means of verifying data quality, we have replicated genome-wide association studies (GWASs) for exemplar traits, such as asthma, diabetes, body mass index (BMI), and pigmentation. The flexible framework of the web application makes it relatively simple to add new questionnaires and for other researchers to collaborate. We anticipate that the study sample will continue to grow and that future analyses may further capitalize on the strengths of the longitudinal data in combination with genetic information.
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Affiliation(s)
- Katharine Brieger
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA; Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA
| | - Gregory J M Zajac
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA
| | - Anita Pandit
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA.
| | - Johanna R Foerster
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA
| | - Kevin W Li
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA
| | - Aubrey C Annis
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA
| | - Ellen M Schmidt
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA; Wellcome Sanger Institute, Hinxton CB10 1SA, UK
| | - Chris P Clark
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA
| | - Karly McMorrow
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA
| | - Wei Zhou
- Department of Computational Medicine and Bioinformatics, University of Michigan School of Medicine, Ann Arbor, MI 48109, USA
| | - Jingjing Yang
- Department of Human Genetics, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Alan M Kwong
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA
| | - Andrew P Boughton
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA
| | - Jinxi Wu
- School of Information, University of Michigan, Ann Arbor, MI 48109, USA
| | - Chris Scheller
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA
| | - Tanvi Parikh
- Institute for Behavioral Genetics, University of Colorado Boulder, Boulder, CO 80309, USA
| | - Alejandro de la Vega
- Institute for Behavioral Genetics, University of Colorado Boulder, Boulder, CO 80309, USA
| | - David M Brazel
- Institute for Behavioral Genetics, University of Colorado Boulder, Boulder, CO 80309, USA; Department of Molecular, Cellular, and Developmental Biology, University of Colorado Boulder, Boulder, CO 80309, USA
| | - Maia Frieser
- Institute for Behavioral Genetics, University of Colorado Boulder, Boulder, CO 80309, USA; Department of Psychology, University of Colorado Boulder, Boulder, CO 80309, USA
| | - Gianna Rea-Sandin
- Department of Psychology, Arizona State University, Tempe, AZ 85281, USA
| | - Lars G Fritsche
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA
| | - Scott I Vrieze
- Department of Psychology, University of Minnesota, Minneapolis, MN 55455, USA
| | - Gonçalo R Abecasis
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA.
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Abstract
Introduction The purpose of this research was to understand the preferences of patients receiving integrative medicine services for return of aggregate study results. Methods A brief online survey (survey 1) was sent to 341 cancer patients receiving integrative medicine interventions; subsequently, a minimally revised survey (survey 2) was sent to 812 individuals with various medical conditions who had been either research participants in integrative medicine studies (n = 446) or patients (n = 346) of mind-body medicine. Results Feedback to a model plain language summary was elicited from survey 1 and survey 2 respondents. Seventy-seven survey recipients (23%) responded to survey 1, and 134 survey recipients (17%) responded to survey 2. The majority of respondents to the surveys were female and 51-70 years of age. Ninety percent of responders to survey 1 and 89% of responders to survey 2 indicated that researchers should share overall results of a study with participants. In terms of the means of result distribution, 37%-47% preferred email, while 22%-27% indicated that, as long as the results are shared, it did not matter how this occurred. Of 38 survey 1 respondents who had previously participated in a clinical trial, 37% had received the results of their study. In survey 2, 63 individuals indicated that they previously participated in clinical trials, but only 16% recalled receiving results. Conclusions These results confirm that the majority (89%-90%) of integrative medicine patients are interested in receiving the results of clinical trials. The majority (82%-94%) of respondents felt the model plain language summary of results provided was helpful.
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Buyx A, Del Savio L, Prainsack B, Völzke H. Every participant is a PI. Citizen science and participatory governance in population studies. Int J Epidemiol 2018; 46:377-384. [PMID: 28100583 DOI: 10.1093/ije/dyw204] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/24/2016] [Indexed: 11/14/2022] Open
Affiliation(s)
- Alena Buyx
- Institute for Experimental Medicine, Department for Biomedical Ethics, Christian-Albrechts-University Kiel, Kiel, Germany
| | - Lorenzo Del Savio
- Institute for Experimental Medicine, Department for Biomedical Ethics, Christian-Albrechts-University Kiel, Kiel, Germany
| | - Barbara Prainsack
- Department of Global Health & Social Medicine, King's College London, London, UK and
| | - Henry Völzke
- Institute for Community Medicine, Department SHIP/ Clinical-Epidemiology Research, University Medicine Greifswald, Greifswald, Germany
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16
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Baldini G, Botterman M, Neisse R, Tallacchini M. Ethical Design in the Internet of Things. SCIENCE AND ENGINEERING ETHICS 2018; 24:905-925. [PMID: 26797878 PMCID: PMC5972157 DOI: 10.1007/s11948-016-9754-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Accepted: 01/09/2016] [Indexed: 06/05/2023]
Abstract
Even though public awareness about privacy risks in the Internet is increasing, in the evolution of the Internet to the Internet of Things (IoT) these risks are likely to become more relevant due to the large amount of data collected and processed by the "Things". The business drivers for exploring ways to monetize such data are one of the challenges identified in this paper for the protection of Privacy in the IoT. Beyond the protection of privacy, this paper highlights the need for new approaches, which grant a more active role to the users of the IoT and which address other potential issues such as the Digital Divide or safety risks. A key facet in ethical design is the transparency of the technology and services in how that technology handles data, as well as providing choice for the user. This paper presents a new approach for users' interaction with the IoT, which is based on the concept of Ethical Design implemented through a policy-based framework. In the proposed framework, users are provided with wider controls over personal data or the IoT services by selecting specific sets of policies, which can be tailored according to users' capabilities and to the contexts where they operate. The potential deployment of the framework in a typical IoT context is described with the identification of the main stakeholders and the processes that should be put in place.
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Affiliation(s)
| | | | - Ricardo Neisse
- European Commission, Joint Research Centre, Ispra, Italy
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17
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Boucher P, Nascimento S, Tallacchini M. Emerging ICT for Citizens' Veillance: Theoretical and Practical Insights. SCIENCE AND ENGINEERING ETHICS 2018; 24:821-830. [PMID: 29492765 DOI: 10.1007/s11948-018-0039-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Accepted: 02/23/2018] [Indexed: 06/08/2023]
Abstract
In ubiquitous surveillance societies, individuals are subjected to observation and control by authorities, institutions, and corporations. Sometimes, citizens contribute their own knowledge and other resources to their own surveillance. In addition, some of "the watched" observe "the watchers" "through" sous-veillant activities, and various forms of self-surveillance for different purposes. However, information and communication technologies are also increasingly used for social initiatives with a bottom up structure where citizens themselves define the goals, shape the outcomes and profit from the benefits of watching activities. This model, which we define as citizens' veillance and explore in this special issue, may present opportunities for individuals and collectives to be more prepared to meet the challenges they face in various domains including environment, health, planning and emergency response.
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Affiliation(s)
- Philip Boucher
- European Parliament - European Parliamentary Research Service, Brussels, Belgium.
| | - Susana Nascimento
- European Commission - Joint Research Centre (JRC), Brussels, Belgium
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18
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Thorogood A, Bobe J, Prainsack B, Middleton A, Scott E, Nelson S, Corpas M, Bonhomme N, Rodriguez LL, Murtagh M, Kleiderman E. APPLaUD: access for patients and participants to individual level uninterpreted genomic data. Hum Genomics 2018; 12:7. [PMID: 29454384 PMCID: PMC5816450 DOI: 10.1186/s40246-018-0139-5] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 02/04/2018] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND There is a growing support for the stance that patients and research participants should have better and easier access to their raw (uninterpreted) genomic sequence data in both clinical and research contexts. MAIN BODY We review legal frameworks and literature on the benefits, risks, and practical barriers of providing individuals access to their data. We also survey genomic sequencing initiatives that provide or plan to provide individual access. Many patients and research participants expect to be able to access their health and genomic data. Individuals have a legal right to access their genomic data in some countries and contexts. Moreover, increasing numbers of participatory research projects, direct-to-consumer genetic testing companies, and now major national sequencing initiatives grant individuals access to their genomic sequence data upon request. CONCLUSION Drawing on current practice and regulatory analysis, we outline legal, ethical, and practical guidance for genomic sequencing initiatives seeking to offer interested patients and participants access to their raw genomic data.
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Affiliation(s)
- Adrian Thorogood
- Centre of Genomics and Policy, Department of Human Genetics, McGill University Faculty of Medicine, Montreal, Quebec H3A 0G1 Canada
| | - Jason Bobe
- Icahn School of Medicine at Mount Sinai, New York, USA
| | - Barbara Prainsack
- Department of Political Science, University of Vienna, Vienna, Austria
- Department of Global Health & Social Medicine, King’s College London, London, UK
| | - Anna Middleton
- Society and Ethics Research, Connecting Science, Wellcome Genome Campus, Hinxton, UK
- Faculty of Education, University of Cambridge, Cambridge, UK
| | - Erick Scott
- Icahn Institute for Genomics & Multiscale Biology, New York, USA
| | | | | | | | - Laura Lyman Rodriguez
- National Human Genome Research Institute, National Institutes of Health, Bethesda, USA
| | | | - Erika Kleiderman
- Centre of Genomics and Policy, Department of Human Genetics, McGill University Faculty of Medicine, Montreal, Quebec H3A 0G1 Canada
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“Bridge to the Literature”? Third-Party Genetic Interpretation Tools and the Views of Tool Developers. J Genet Couns 2018; 27:770-781. [DOI: 10.1007/s10897-018-0217-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Accepted: 01/15/2018] [Indexed: 12/14/2022]
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Wouters RHP, Bijlsma RM, Frederix GWJ, Ausems MGEM, van Delden JJM, Voest EE, Bredenoord AL. Is It Our Duty To Hunt for Pathogenic Mutations? Trends Mol Med 2017; 24:3-6. [PMID: 29246758 DOI: 10.1016/j.molmed.2017.11.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Accepted: 11/25/2017] [Indexed: 01/01/2023]
Abstract
Should professionals systematically screen whole-genome sequencing (WGS) data to check for life-threatening mutations? Alternatively, should genome analysis focus on the primary reason for testing - that is, aiming to achieve precision medicine? We present an ethical review of the arguments and compare the act of searching for mutations with disclosing mutations that are discovered incidentally.
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Affiliation(s)
- Roel H P Wouters
- Department of Medical Humanities, Julius Center, University Medical Center, Utrecht, The Netherlands.
| | - Rhodé M Bijlsma
- Department of Medical Oncology, University Medical Center, Utrecht, The Netherlands
| | - Geert W J Frederix
- Department of Health Technology Assessment, Julius Center, University Medical Center, Utrecht, The Netherlands
| | | | - Johannes J M van Delden
- Department of Medical Humanities, Julius Center, University Medical Center, Utrecht, The Netherlands
| | - Emile E Voest
- Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Annelien L Bredenoord
- Department of Medical Humanities, Julius Center, University Medical Center, Utrecht, The Netherlands
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21
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Aledavood T, Triana Hoyos AM, Alakörkkö T, Kaski K, Saramäki J, Isometsä E, Darst RK. Data Collection for Mental Health Studies Through Digital Platforms: Requirements and Design of a Prototype. JMIR Res Protoc 2017; 6:e110. [PMID: 28600276 PMCID: PMC5483244 DOI: 10.2196/resprot.6919] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2016] [Revised: 02/13/2017] [Accepted: 04/02/2017] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Mental and behavioral disorders are the main cause of disability worldwide. However, their diagnosis is challenging due to a lack of reliable biomarkers; current detection is based on structured clinical interviews which can be biased by the patient's recall ability, affective state, changing in temporal frames, etc. While digital platforms have been introduced as a possible solution to this complex problem, there is little evidence on the extent of usability and usefulness of these platforms. Therefore, more studies where digital data is collected in larger scales are needed to collect scientific evidence on the capacities of these platforms. Most of the existing platforms for digital psychiatry studies are designed as monolithic systems for a certain type of study; publications from these studies focus on their results, rather than the design features of the data collection platform. Inevitably, more tools and platforms will emerge in the near future to fulfill the need for digital data collection for psychiatry. Currently little knowledge is available from existing digital platforms for future data collection platforms to build upon. OBJECTIVE The objective of this work was to identify the most important features for designing a digital platform for data collection for mental health studies, and to demonstrate a prototype platform that we built based on these design features. METHODS We worked closely in a multidisciplinary collaboration with psychiatrists, software developers, and data scientists and identified the key features which could guarantee short-term and long-term stability and usefulness of the platform from the designing stage to data collection and analysis of collected data. RESULTS The key design features that we identified were flexibility of access control, flexibility of data sources, and first-order privacy protection. We also designed the prototype platform Non-Intrusive Individual Monitoring Architecture (Niima), where we implemented these key design features. We described why each of these features are important for digital data collection for psychiatry, gave examples of projects where Niima was used or is going to be used in the future, and demonstrated how incorporating these design principles opens new possibilities for studies. CONCLUSIONS The new methods of digital psychiatry are still immature and need further research. The design features we suggested are a first step to design platforms which can adapt to the upcoming requirements of digital psychiatry.
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Affiliation(s)
| | | | - Tuomas Alakörkkö
- Department of Computer Science, Aalto University, Espoo, Finland
| | - Kimmo Kaski
- Department of Computer Science, Aalto University, Espoo, Finland
| | - Jari Saramäki
- Department of Computer Science, Aalto University, Espoo, Finland
| | - Erkki Isometsä
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Richard K Darst
- Department of Computer Science, Aalto University, Espoo, Finland
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22
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Cook-Deegan R, McGuire AL. Moving beyond Bermuda: sharing data to build a medical information commons. Genome Res 2017; 27:897-901. [PMID: 28373484 PMCID: PMC5453323 DOI: 10.1101/gr.216911.116] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Accepted: 03/21/2017] [Indexed: 01/09/2023]
Abstract
The ubiquity of DNA sequencing and the advent of medical imaging, electronic health records, and "omics" technologies have produced a deluge of data. Making meaning of those data-creating scientific knowledge and useful clinical information-will vastly exceed the capacity of even the largest institutions. Data must be shared to achieve the promises of genomic science and precision medicine.
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Affiliation(s)
| | - Amy L McGuire
- Baylor College of Medicine, Houston, Texas 77030, USA
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23
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Psychological and behavioural impact of returning personal results from whole-genome sequencing: the HealthSeq project. Eur J Hum Genet 2017; 25:280-292. [PMID: 28051073 PMCID: PMC5315514 DOI: 10.1038/ejhg.2016.178] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Revised: 10/18/2016] [Accepted: 11/01/2016] [Indexed: 11/29/2022] Open
Abstract
Providing ostensibly healthy individuals with personal results from whole-genome sequencing could lead to improved health and well-being via enhanced disease risk prediction, prevention, and diagnosis, but also poses practical and ethical challenges. Understanding how individuals react psychologically and behaviourally will be key in assessing the potential utility of personal whole-genome sequencing. We conducted an exploratory longitudinal cohort study in which quantitative surveys and in-depth qualitative interviews were conducted before and after personal results were returned to individuals who underwent whole-genome sequencing. The participants were offered a range of interpreted results, including Alzheimer's disease, type 2 diabetes, pharmacogenomics, rare disease-associated variants, and ancestry. They were also offered their raw data. Of the 35 participants at baseline, 29 (82.9%) completed the 6-month follow-up. In the quantitative surveys, test-related distress was low, although it was higher at 1-week than 6-month follow-up (Z=2.68, P=0.007). In the 6-month qualitative interviews, most participants felt happy or relieved about their results. A few were concerned, particularly about rare disease-associated variants and Alzheimer's disease results. Two of the 29 participants had sought clinical follow-up as a direct or indirect consequence of rare disease-associated variants results. Several had mentioned their results to their doctors. Some participants felt having their raw data might be medically useful to them in the future. The majority reported positive reactions to having their genomes sequenced, but there were notable exceptions to this. The impact and value of returning personal results from whole-genome sequencing when implemented on a larger scale remains to be seen.
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Angrist M. Start me up: ways to encourage sharing of genomic information with research participants. Nat Rev Genet 2015; 16:435-6. [PMID: 26184591 DOI: 10.1038/nrg3981] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Personalized and precision medicine initiatives explicitly call for researchers to treat research participants as partners. One way to realize that goal is by returning individual research results to participants. I propose a number of concrete steps that could facilitate that process.
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Affiliation(s)
- Misha Angrist
- Duke Initiative for Science &Society, Duke University, 237 North Building, Durham, North Carolina 27708-0222, USA
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25
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Linderman MD, Bashir A, Diaz GA, Kasarskis A, Sanderson SC, Zinberg RE, Mahajan M, Shah H, Suckiel S, Zweig M, Schadt EE. Preparing the next generation of genomicists: a laboratory-style course in medical genomics. BMC Med Genomics 2015; 8:47. [PMID: 26264128 PMCID: PMC4534145 DOI: 10.1186/s12920-015-0124-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Accepted: 07/27/2015] [Indexed: 11/17/2022] Open
Abstract
The growing gap between the demand for genome sequencing and the supply of trained genomics professionals is creating an acute need to develop more effective genomics education. In response we developed “Practical Analysis of Your Personal Genome”, a novel laboratory-style medical genomics course in which students have the opportunity to obtain and analyze their own whole genome. This report describes our motivations for and the content of a “practical” genomics course that incorporates personal genome sequencing and the lessons we learned during the first three iterations of this course.
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Affiliation(s)
- Michael D Linderman
- Icahn Institute for Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1498, New York, NY, 10029, USA. .,Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY, 10029, USA.
| | - Ali Bashir
- Icahn Institute for Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1498, New York, NY, 10029, USA. .,Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY, 10029, USA.
| | - George A Diaz
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY, 10029, USA.
| | - Andrew Kasarskis
- Icahn Institute for Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1498, New York, NY, 10029, USA. .,Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY, 10029, USA.
| | - Saskia C Sanderson
- Icahn Institute for Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1498, New York, NY, 10029, USA. .,Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY, 10029, USA.
| | - Randi E Zinberg
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY, 10029, USA.
| | - Milind Mahajan
- Icahn Institute for Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1498, New York, NY, 10029, USA. .,Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY, 10029, USA.
| | - Hardik Shah
- Icahn Institute for Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1498, New York, NY, 10029, USA. .,Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY, 10029, USA.
| | - Sabrina Suckiel
- Icahn Institute for Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1498, New York, NY, 10029, USA. .,Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY, 10029, USA.
| | - Micol Zweig
- Icahn Institute for Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1498, New York, NY, 10029, USA. .,Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY, 10029, USA.
| | - Eric E Schadt
- Icahn Institute for Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1498, New York, NY, 10029, USA. .,Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY, 10029, USA.
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Leonelli S, Spichtinger D, Prainsack B. Sticks AND Carrots: Encouraging Open Science at its source. GEO : GEOGRAPHY AND ENVIRONMENT 2015; 2:12-16. [PMID: 26435842 PMCID: PMC4591465 DOI: 10.1002/geo2.2] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Revised: 11/25/2014] [Accepted: 11/28/2014] [Indexed: 05/19/2023]
Abstract
The Open Science (OS) movement has been seen as an important facilitator for public participation in science. This has been underpinned by the assumption that widespread and free access to research outputs leads to (i) better and more efficient science, (ii) economic growth, in particular for small and medium-sized enterprises wishing to capitalise on research findings and (iii) increased transparency of knowledge production and its outcomes. The latter in particular could function as a catalyst for public participation and engagement. Whether OS is likely to help realise these benefits, however, will depend on the emergence of systemic incentives for scientists to utilise OS in a meaningful manner. While some areas, the environmental sciences have a long tradition of open ethos, citizen inclusion and global collaborations, such activities need to be more systematically supported and promoted by funders and learned societies in order to improve scientific research and public participation.
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Affiliation(s)
- Sabina Leonelli
- Exeter Centre for the Study of the Life Sciences and Department of Sociology, Philosophy and AnthropologyUniversity of ExeterExeter
| | - Daniel Spichtinger
- European CommissionDG Research and Innovation, Unit A.6. – Science Policy, Foresight and DataBrusselsBelgium
| | - Barbara Prainsack
- Department of Social Science, Health and MedicineKing's College LondonLondon
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28
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Kelly SE, Spector TD, Cherkas LF, Prainsack B, Harris JM. Evaluating the consent preferences of UK research volunteers for genetic and clinical studies. PLoS One 2015; 10:e0118027. [PMID: 25761107 PMCID: PMC4356519 DOI: 10.1371/journal.pone.0118027] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Accepted: 01/06/2015] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To establish the views of research volunteers on the consent process; to explore their views on the consent process in different research scenarios; to inform debate on emerging models of consent for participation in research. DESIGN, SETTING AND PARTICIPANTS 2,308 adult volunteers from the TwinsUK Registry (www.twinsuk.ac.uk) completed an online survey about their views on the consent process for use of their DNA and medical information in research. Their views on the re-consenting process in different scenarios were assessed. RESULTS The majority of volunteers preferred to be informed of the identity of the main researcher of a study in which they are participating, which is contrary to current practice. Over 80% were willing to complete the consent process online instead of face to face. On the whole, respondents did not view their DNA differently from their medical information with regard to the consent process. Research participants were more willing to give broad consent to cover future research if their DNA was to be used by the original researcher than by another researcher, even if the disease under investigation varied, in contrast to the traditional 'gold standard' whereby specific consent is required for all new research projects. DISCUSSION In some scenarios, research participants reported that they would be comfortable with not signing a new consent form for future research uses of their data and DNA, and are comfortable with secure, online consent processes rather than traditional face-to-face consent processes. Our findings indicate that the perceived relationship between research participants and researchers plays an important role in shaping preferences regarding the consent process and suggest that this relationship is not captured by traditional consent processes. We argue that the development of new formats of consent should be informed by empirical research on volunteers' perceptions and preferences regarding the consent process.
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Affiliation(s)
- Susan E. Kelly
- Centre for the Study of Life Sciences (Egenis), University of Exeter, Exeter, United Kingdom
| | - Timothy D. Spector
- Department of Twin Research & Genetic Epidemiology, King’s College London, London, United Kingdom
| | - Lynn F. Cherkas
- Department of Twin Research & Genetic Epidemiology, King’s College London, London, United Kingdom
| | - Barbara Prainsack
- Department of Twin Research & Genetic Epidemiology, King’s College London, London, United Kingdom
- Department of Social Science, Health & Medicine, King’s College London, London, United Kingdom
| | - Juliette M. Harris
- Department of Twin Research & Genetic Epidemiology, King’s College London, London, United Kingdom
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Erlich Y, Williams JB, Glazer D, Yocum K, Farahany N, Olson M, Narayanan A, Stein LD, Witkowski JA, Kain RC. Redefining genomic privacy: trust and empowerment. PLoS Biol 2014; 12:e1001983. [PMID: 25369215 PMCID: PMC4219652 DOI: 10.1371/journal.pbio.1001983] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Current models of protecting human subjects create a zero-sum game of privacy versus data utility. We propose shifting the paradigm to techniques that facilitate trust between researchers and participants. Fulfilling the promise of the genetic revolution requires the analysis of large datasets containing information from thousands to millions of participants. However, sharing human genomic data requires protecting subjects from potential harm. Current models rely on de-identification techniques in which privacy versus data utility becomes a zero-sum game. Instead, we propose the use of trust-enabling techniques to create a solution in which researchers and participants both win. To do so we introduce three principles that facilitate trust in genetic research and outline one possible framework built upon those principles. Our hope is that such trust-centric frameworks provide a sustainable solution that reconciles genetic privacy with data sharing and facilitates genetic research.
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Affiliation(s)
- Yaniv Erlich
- Whitehead Institute for Biomedical Research, Nine Cambridge Center, Cambridge, Massachusetts, United States of America
- * E-mail:
| | | | - David Glazer
- Google Inc., Mountain View, California, United States of America
| | - Kenneth Yocum
- Illumina Inc., San Diego, California, United States of America
| | - Nita Farahany
- Duke University School of Law, Duke Science & Society, Durham, North Carolina, United States of America
| | - Maynard Olson
- University of Washington, Port Orford, Oregon, United States of America
| | - Arvind Narayanan
- Department of Computer Science, Princeton University, Princeton, New Jersey, United States of America
| | - Lincoln D. Stein
- Ontario Institute for Cancer Research, Toronto, Ontario, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
| | - Jan A. Witkowski
- Banbury Center, Cold Spring Harbor Laboratory, Huntington, New York, United States of America
| | - Robert C. Kain
- Illumina Inc., San Diego, California, United States of America
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30
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Sequencing your genome: your future is here, but are you sure you want to know it? Genet Res (Camb) 2014; 96:e006. [PMID: 25023198 DOI: 10.1017/s0016672314000093] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Next-generation sequencing (NGS; also known as deep sequencing or ultra-high throughput sequencing) has probably been the most important tool for genomic research over the past few years. NGS has led to numerous discoveries and scientific breakthroughs in the genetic field. The sequencing technology that has entered the research laboratory in the past decade is now being introduced into the clinical diagnostic laboratory. Consequently, NGS results are becoming available in the medical arena as abundance of clinically relevant variants, conferring predisposition to disease, are being discovered at a growing rate (Stanley, 2014).
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Issa NT, Byers SW, Dakshanamurthy S. Big data: the next frontier for innovation in therapeutics and healthcare. Expert Rev Clin Pharmacol 2014; 7:293-8. [PMID: 24702684 DOI: 10.1586/17512433.2014.905201] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Advancements in genomics and personalized medicine not only effect healthcare delivery from patient and provider standpoints, but also reshape biomedical discovery. We are in the era of the '-omics', wherein an individual's genome, transcriptome, proteome and metabolome can be scrutinized to the finest resolution to paint a personalized biochemical fingerprint that enables tailored treatments, prognoses, risk factors, etc. Digitization of this information parlays into 'big data' informatics-driven evidence-based medical practice. While individualized patient management is a key beneficiary of next-generation medical informatics, this data also harbors a wealth of novel therapeutic discoveries waiting to be uncovered. 'Big data' informatics allows for networks-driven systems pharmacodynamics whereby drug information can be coupled to cellular- and organ-level physiology for determining whole-body outcomes. Patient '-omics' data can be integrated for ontology-based data-mining for the discovery of new biological associations and drug targets. Here we highlight the potential of 'big data' informatics for clinical pharmacology.
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Affiliation(s)
- Naiem T Issa
- Department of Oncology, Lombardi Cancer Center, Georgetown University Medical Center, Washington, DC USA
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Angrist M. Open window: when easily identifiable genomes and traits are in the public domain. PLoS One 2014; 9:e92060. [PMID: 24647311 PMCID: PMC3960179 DOI: 10.1371/journal.pone.0092060] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2014] [Accepted: 02/14/2014] [Indexed: 11/30/2022] Open
Abstract
“One can't be of an enquiring and experimental nature, and still be very sensible.” - Charles Fort [1] As the costs of personal genetic testing “self-quantification” fall, publicly accessible databases housing people's genotypic and phenotypic information are gradually increasing in number and scope. The latest entrant is openSNP, which allows participants to upload their personal genetic/genomic and self-reported phenotypic data. I believe the emergence of such open repositories of human biological data is a natural reflection of inquisitive and digitally literate people's desires to make genomic and phenotypic information more easily available to a community beyond the research establishment. Such unfettered databases hold the promise of contributing mightily to science, science education and medicine. That said, in an age of increasingly widespread governmental and corporate surveillance, we would do well to be mindful that genomic DNA is uniquely identifying. Participants in open biological databases are engaged in a real-time experiment whose outcome is unknown.
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Affiliation(s)
- Misha Angrist
- Institute for Genome Sciences and Policy, Duke University, Durham, North Carolina, United States of America
- Program in Science and Society, Duke University, Durham, North Carolina, United States of America
- Sanford School of Public Policy, Duke University, Durham, North Carolina, United States of America
- * E-mail:
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Ball MP, Bobe JR, Chou MF, Clegg T, Estep PW, Lunshof JE, Vandewege W, Zaranek A, Church GM. Harvard Personal Genome Project: lessons from participatory public research. Genome Med 2014; 6:10. [PMID: 24713084 PMCID: PMC3978420 DOI: 10.1186/gm527] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2013] [Accepted: 02/05/2014] [Indexed: 12/22/2022] Open
Abstract
Background Since its initiation in 2005, the Harvard Personal Genome Project has enrolled thousands of volunteers interested in publicly sharing their genome, health and trait data. Because these data are highly identifiable, we use an ‘open consent’ framework that purposefully excludes promises about privacy and requires participants to demonstrate comprehension prior to enrollment. Discussion Our model of non-anonymous, public genomes has led us to a highly participatory model of researcher-participant communication and interaction. The participants, who are highly committed volunteers, self-pursue and donate research-relevant datasets, and are actively engaged in conversations with both our staff and other Personal Genome Project participants. We have quantitatively assessed these communications and donations, and report our experiences with returning research-grade whole genome data to participants. We also observe some of the community growth and discussion that has occurred related to our project. Summary We find that public non-anonymous data is valuable and leads to a participatory research model, which we encourage others to consider. The implementation of this model is greatly facilitated by web-based tools and methods and participant education. Project results are long-term proactive participant involvement and the growth of a community that benefits both researchers and participants.
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Evans BJ. Economic regulation of next-generation sequencing. THE JOURNAL OF LAW, MEDICINE & ETHICS : A JOURNAL OF THE AMERICAN SOCIETY OF LAW, MEDICINE & ETHICS 2014; 42 Suppl 1:51-66. [PMID: 25298291 PMCID: PMC4460792 DOI: 10.1111/jlme.12162] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Next-generation sequencing broadens the debate about appropriate regulatory oversight of genetic testing and may force scholars to move beyond familiar privacy and health and safety regulatory issues to address new problems with industry structure and economic regulation. The genetic testing industry is passing through a period of profound structural change in response to shifts in technology and in the legal environment. Making genetic testing safe and effective for consumers increasingly requires access to comprehensive genomic data infrastructures that can support accurate, state-of-the-art interpretation of genetic test results. At present, there are significant barriers to access and there is no sector-specific regulator with power to ensure appropriate data access. Without it, genetic testing will not be safe for consumers even when it is performed at CLIA-certified laboratories using tests that have been FDA-cleared or approved. This article explores the emerging structure of the genetic testing industry and describes its present economic regulatory vacuum. In view of this gap in regulation, the article explores whether generally applicable law, particularly antitrust law, may offer solutions to the industry's data access problems. It concludes that courts may have a useful role to play, particularly in Europe and other jurisdictions where the essential facilities doctrine enjoys continued vitality. After Verizon Communications v. Law Offices of Curtis V. Trinko, the role of U.S. federal courts is less certain. Congress has demonstrated willingness to address access issues as they emerged in other infrastructure industries in recent decades. This article expresses no preference between legislative and judicial solutions. Its aim is simply to highlight an emerging economic regulatory issue which, if left unresolved, presents real health and safety concerns for consumers who receive genetic tests.
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Affiliation(s)
- Barbara J Evans
- Professor of Law, the George Butler Research Professor, and the Director of the Center for Biotechnology & Law at the University of Houston Law Center
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