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Arora A, Loveday A, Burge S, Gosling A, Ercole A, Pountain S, Street H, Kabare S, Jena R. Generalisable Overview of Study Risk for Lead Investigators Needing Guidance (GOSLING): A data governance risk tool. PLoS One 2024; 19:e0309308. [PMID: 39163388 PMCID: PMC11335139 DOI: 10.1371/journal.pone.0309308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2024] [Accepted: 08/08/2024] [Indexed: 08/22/2024] Open
Abstract
INTRODUCTION Digitisation of patient records, coupled with a moral imperative to use routinely collected data for research, necessitate effective data governance that both facilitates evidence-based research and minimises associated risks. The Generalisable Overview of Study Risk for Lead Investigators Needing Guidance (GOSLING) provides the first quantitative risk-measure for assessing the data-related risks of clinical research projects. METHODS GOSLING employs a self-assessment designed to standardise risk assessment, considering various domains, including data type, security measures, and public co-production. The tool categorises projects into low, medium, and high-risk tiers based on a scoring system developed with the input of patient and public members. It was validated using both real and synthesised project proposals to ensure its effectiveness at triaging the risk of requests for health data. RESULTS The tool effectively distinguished between fifteen low, medium, and high-risk projects in testing, aligning with subjective expert assessments. An interactive interface and an open-access policy for the tool encourage researchers to self-evaluate and mitigate risks prior to submission for data governance review. Initial testing demonstrated its potential to streamline the review process by identifying projects that may require less scrutiny or those that pose significant risks. DISCUSSION GOSLING represents the first quantitative approach to measuring study risk, answering calls for standardised risk assessments in using health data for research. Its implementation could contribute to advancing ethical data use, enhancing research transparency, and promoting public trust. Future work will focus on expanding its applicability and exploring its impact on research efficiency and data governance practices.
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Affiliation(s)
- Anmol Arora
- School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Adam Loveday
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Sarah Burge
- Department of Oncology, Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, United Kingdom
| | - Amy Gosling
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
| | - Ari Ercole
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Sarah Pountain
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
| | - Helen Street
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Stephanie Kabare
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
| | - Raj Jena
- Department of Oncology, University of Cambridge, Cambridge, United Kingdom
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Wyatt KA, Bell J, Cooper J, Constable L, Siero W, Pozo Jeria C, Darling S, Smith R, Hughes EK. Involvement of children and young people in the conduct of health research: A rapid umbrella review. Health Expect 2024; 27:e14081. [PMID: 38845155 PMCID: PMC11156690 DOI: 10.1111/hex.14081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 05/02/2024] [Accepted: 05/06/2024] [Indexed: 06/10/2024] Open
Abstract
BACKGROUND Patient and public involvement and engagement (PPIE) have long been considered important to good research practice. There is growing, yet diverse, evidence in support of PPIE with children and young people (CYP). We must now understand the various approaches to involvement of CYP in research. AIMS This rapid umbrella review aimed to provide an overview of when, how and to what extent CYP are involved in the conduct of health research, as well as the reported benefits, challenges, and facilitators of involvement. METHODS We searched OVID Medline, Embase and PubMed. Published reviews were included if they reported meaningful involvement of CYP in the conduct of health research. Extracted data were synthesised using thematic analysis. RESULTS The 26 reviews included were predominately systematic and scoping reviews, published within the last decade, and originating from North America and the United Kingdom. CYPs were involved in all stages of research across the literature, most commonly during research design and data collection, and rarely during research funding or data sharing and access. Researchers mostly engaged CYP using focus groups, interviews, advisory panels, questionnaires, and to a lesser extent arts-based approaches such as photovoice and drawing. Visual and active creative methods were more commonly used with children ≤12 years. The evidence showed a shared understanding of the benefits, challenges, and facilitators for involvement of CYP, such as time and resource commitment and building partnership. CONCLUSION Overall, the review identified consistency in the range of methods and approaches used, and stages of research with which CYP are commonly involved. There is a need for more consistent reporting of PPIE in the literature, both in terminology and detail used. Furthermore, the impact of approaches to CYP involvement on research and community outcomes must be better evaluated. PATIENT/PUBLIC CONTRIBUTION This review forms part of broader research initiatives being led by the authors. Together, these projects aim to support embedding of child voices in research practice and to explore the desirability and suitability of Young Persons Advisory Groups within birth cohort studies. The findings from this review, alongside public and stakeholder consultation, will inform development of resources such as practice recommendations to guide future involvement of CYP in health research undertaken at the author's respective institutions.
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Affiliation(s)
| | | | - Jason Cooper
- Murdoch Children's Research InstituteParkvilleVictoriaAustralia
- Centre for Community Child HealthRoyal Children's HospitalParkvilleVictoriaAustralia
| | - Leanne Constable
- Murdoch Children's Research InstituteParkvilleVictoriaAustralia
- Centre for Community Child HealthRoyal Children's HospitalParkvilleVictoriaAustralia
| | - William Siero
- Murdoch Children's Research InstituteParkvilleVictoriaAustralia
- Department of PaediatricsThe University of MelbourneParkvilleVictoriaAustralia
| | - Carla Pozo Jeria
- Murdoch Children's Research InstituteParkvilleVictoriaAustralia
- Centre for Community Child HealthRoyal Children's HospitalParkvilleVictoriaAustralia
| | - Simone Darling
- Murdoch Children's Research InstituteParkvilleVictoriaAustralia
- Centre for Community Child HealthRoyal Children's HospitalParkvilleVictoriaAustralia
- Department of PaediatricsThe University of MelbourneParkvilleVictoriaAustralia
| | - Rachel Smith
- Murdoch Children's Research InstituteParkvilleVictoriaAustralia
- Centre for Community Child HealthRoyal Children's HospitalParkvilleVictoriaAustralia
- Department of PaediatricsThe University of MelbourneParkvilleVictoriaAustralia
| | - Elizabeth K. Hughes
- Murdoch Children's Research InstituteParkvilleVictoriaAustralia
- Department of PaediatricsThe University of MelbourneParkvilleVictoriaAustralia
- School of Psychological SciencesThe University of MelbourneParkvilleVictoriaAustralia
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Hartung T, Morales Pantoja IE, Smirnova L. Brain organoids and organoid intelligence from ethical, legal, and social points of view. Front Artif Intell 2024; 6:1307613. [PMID: 38249793 PMCID: PMC10796793 DOI: 10.3389/frai.2023.1307613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 12/07/2023] [Indexed: 01/23/2024] Open
Abstract
Human brain organoids, aka cerebral organoids or earlier "mini-brains", are 3D cellular models that recapitulate aspects of the developing human brain. They show tremendous promise for advancing our understanding of neurodevelopment and neurological disorders. However, the unprecedented ability to model human brain development and function in vitro also raises complex ethical, legal, and social challenges. Organoid Intelligence (OI) describes the ongoing movement to combine such organoids with Artificial Intelligence to establish basic forms of memory and learning. This article discusses key issues regarding the scientific status and prospects of brain organoids and OI, conceptualizations of consciousness and the mind-brain relationship, ethical and legal dimensions, including moral status, human-animal chimeras, informed consent, and governance matters, such as oversight and regulation. A balanced framework is needed to allow vital research while addressing public perceptions and ethical concerns. Interdisciplinary perspectives and proactive engagement among scientists, ethicists, policymakers, and the public can enable responsible translational pathways for organoid technology. A thoughtful, proactive governance framework might be needed to ensure ethically responsible progress in this promising field.
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Affiliation(s)
- Thomas Hartung
- Center for Alternatives to Animal Testing (CAAT), Health and Whiting School of Engineering, Johns Hopkins University, Baltimore, MD, United States
- CAAT-Europe, University of Konstanz, Konstanz, Germany
| | - Itzy E. Morales Pantoja
- Center for Alternatives to Animal Testing (CAAT), Health and Whiting School of Engineering, Johns Hopkins University, Baltimore, MD, United States
| | - Lena Smirnova
- Center for Alternatives to Animal Testing (CAAT), Health and Whiting School of Engineering, Johns Hopkins University, Baltimore, MD, United States
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Wagner JK, Yu JH, Fullwiley D, Moore C, Wilson JF, Bamshad MJ, Royal CD. Guidelines for genetic ancestry inference created through roundtable discussions. HGG ADVANCES 2023; 4:100178. [PMID: 36798092 PMCID: PMC9926022 DOI: 10.1016/j.xhgg.2023.100178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 01/03/2023] [Indexed: 01/15/2023] Open
Abstract
The use of genetic and genomic technology to infer ancestry is commonplace in a variety of contexts, particularly in biomedical research and for direct-to-consumer genetic testing. In 2013 and 2015, two roundtables engaged a diverse group of stakeholders toward the development of guidelines for inferring genetic ancestry in academia and industry. This report shares the stakeholder groups' work and provides an analysis of, commentary on, and views from the groundbreaking and sustained dialogue. We describe the engagement processes and the stakeholder groups' resulting statements and proposed guidelines. The guidelines focus on five key areas: application of genetic ancestry inference, assumptions and confidence/laboratory and statistical methods, terminology and population identifiers, impact on individuals and groups, and communication or translation of genetic ancestry inferences. We delineate the terms and limitations of the guidelines and discuss their critical role in advancing the development and implementation of best practices for inferring genetic ancestry and reporting the results. These efforts should inform both governmental regulation and self-regulation.
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Affiliation(s)
- Jennifer K. Wagner
- School of Engineering Design and Innovation, Pennsylvania State University, University Park, PA 16802, USA
- Institute for Computational and Data Science, Pennsylvania State University, University Park, PA 16802, USA
- Department of Biomedical Engineering, Pennsylvania State University, University Park, PA 16802, USA
- Rock Ethics Institute, Pennsylvania State University, University Park, PA 16802, USA
- Penn State Law, University Park, PA 16802, USA
- Huck Institutes of the Life Sciences, Pennsylvania State University, University Park, PA 16802, USA
| | - Joon-Ho Yu
- Department of Pediatrics and Institute for Public Health Genetics, University of Washington, Seattle, WA 98195, USA
- Treuman Katz Center for Pediatric Bioethics, Seattle Children’s Hospital and Research Institute, Seattle, WA 98101, USA
| | - Duana Fullwiley
- Department of Anthropology, Stanford University, Stanford, CA 94305, USA
| | | | - James F. Wilson
- Centre for Global Health Research, Usher Institute, University of Edinburgh, Edinburgh EH8 9AG, Scotland
| | - Michael J. Bamshad
- Department of Pediatrics and Department of Genome Sciences, University of Washington, Seattle, WA 98195, USA
- Division of Genetic Medicine, Seattle Children’s Hospital, Seattle, WA 98101, USA
| | - Charmaine D. Royal
- Departments of African and African American Studies, Biology, Global Health, and Family Medicine and Community Health, Duke University, Durham, NC 27708, USA
| | - Genetic Ancestry Inference Roundtable Participants
- School of Engineering Design and Innovation, Pennsylvania State University, University Park, PA 16802, USA
- Institute for Computational and Data Science, Pennsylvania State University, University Park, PA 16802, USA
- Department of Biomedical Engineering, Pennsylvania State University, University Park, PA 16802, USA
- Rock Ethics Institute, Pennsylvania State University, University Park, PA 16802, USA
- Penn State Law, University Park, PA 16802, USA
- Huck Institutes of the Life Sciences, Pennsylvania State University, University Park, PA 16802, USA
- Department of Pediatrics and Institute for Public Health Genetics, University of Washington, Seattle, WA 98195, USA
- Treuman Katz Center for Pediatric Bioethics, Seattle Children’s Hospital and Research Institute, Seattle, WA 98101, USA
- Department of Anthropology, Stanford University, Stanford, CA 94305, USA
- The DNA Detectives, Dana Point, CA, USA
- Centre for Global Health Research, Usher Institute, University of Edinburgh, Edinburgh EH8 9AG, Scotland
- Department of Pediatrics and Department of Genome Sciences, University of Washington, Seattle, WA 98195, USA
- Division of Genetic Medicine, Seattle Children’s Hospital, Seattle, WA 98101, USA
- Departments of African and African American Studies, Biology, Global Health, and Family Medicine and Community Health, Duke University, Durham, NC 27708, USA
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Guerrini CJ, Majumder MA, Robinson JO, Cook-Deegan R, Blank M, Bollinger J, Geary J, Gutierrez AM, Shrikant M, McGuire AL. Fresh takes on five health data sharing domains: Quality, privacy, equity, incentives, and sustainability. Front Big Data 2023; 6:1095119. [PMID: 36814524 PMCID: PMC9939819 DOI: 10.3389/fdata.2023.1095119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 01/16/2023] [Indexed: 02/08/2023] Open
Abstract
As entities around the world invest in repositories and other infrastructure to facilitate health data sharing, scalable solutions to data sharing challenges are needed. We conducted semi-structured interviews with 24 experts to explore views on potential issues and policy options related to health data sharing. In this Perspective, we describe and contextualize unconventional insights shared by our interviewees relevant to issues in five domains: data quality, privacy, equity, incentives, and sustainability. These insights question a focus on granular quality metrics for gatekeeping; challenge enthusiasm for maximalist risk disclosure practices; call attention to power dynamics that potentially compromise the patient's voice; encourage faith in the sharing proclivities of new generations of scientists; and endorse accounting for personal disposition in the selection of long-term partners. We consider the merits of each insight with the broad goal of encouraging creative thinking to address data sharing challenges.
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Affiliation(s)
- Christi J. Guerrini
- Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX, United States
| | - Mary A. Majumder
- Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX, United States
| | - Jill O. Robinson
- Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX, United States
| | - Robert Cook-Deegan
- Consortium for Science, Policy & Outcomes, Arizona State University, Washington, DC, United States
| | - Matthew Blank
- Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX, United States
| | - Juli Bollinger
- Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX, United States
| | - Janis Geary
- Consortium for Science, Policy & Outcomes, Arizona State University, Washington, DC, United States
| | - Amanda M. Gutierrez
- Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX, United States
| | - Maya Shrikant
- Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX, United States
| | - Amy L. McGuire
- Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX, United States
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Muller SHA, van Thiel GJMW, Mostert M, van Delden JJM. Dynamic consent, communication and return of results in large-scale health data reuse: Survey of public preferences. Digit Health 2023; 9:20552076231190997. [PMID: 37599899 PMCID: PMC10434987 DOI: 10.1177/20552076231190997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 07/13/2023] [Indexed: 08/22/2023] Open
Abstract
Dynamic consent forms a comprehensive, tailored approach for interacting with research participants. We conducted a survey study to inquire how research participants evaluate the elements of consent, information provision, communication and return of results within dynamic consent in a hypothetical health data reuse scenario. We distributed a digital questionnaire among a purposive sample of patient panel members. Data were analysed using descriptive and nonparametric inferential statistics. Respondents favoured the potential to manage changing consent preferences over time. There was much agreement between people favouring closer and more specific control over data reuse approval and those in favour of broader approval, facilitated by an opt-out system or an independent data reuse committee. People want to receive more information about reuse, outcomes and return of results. Respondents supported an interactive model of research participation, welcoming regular, diverse and interactive forms of communication, like a digital communication platform. Approval for reuse and providing meaningful information, including meaningful return of results, are intricately related to facilitating better communication. Respondents favoured return of actionable research results. These findings emphasize the potential of dynamic consent for enabling participants to maintain control over how their data are being used for which purposes by whom. Allowing different options to shape a dynamic consent interface in health data reuse in a personalized manner is pivotal to accommodate plurality in a flexible though robust manner. Interaction via dynamic consent enables participants to tailor the elements of participation they deem relevant to their own preferences, engaging diverse perspectives, interests and preferences.
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Affiliation(s)
- Sam HA Muller
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Ghislaine JMW van Thiel
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Menno Mostert
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Johannes JM van Delden
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
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7
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The ethical and legal landscape of brain data governance. PLoS One 2022; 17:e0273473. [PMID: 36580464 PMCID: PMC9799320 DOI: 10.1371/journal.pone.0273473] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 08/09/2022] [Indexed: 12/30/2022] Open
Abstract
Neuroscience research is producing big brain data which informs both advancements in neuroscience research and drives the development of advanced datasets to provide advanced medical solutions. These brain data are produced under different jurisdictions in different formats and are governed under different regulations. The governance of data has become essential and critical resulting in the development of various governance structures to ensure that the quality, availability, findability, accessibility, usability, and utility of data is maintained. Furthermore, data governance is influenced by various ethical and legal principles. However, it is still not clear what ethical and legal principles should be used as a standard or baseline when managing brain data due to varying practices and evolving concepts. Therefore, this study asks what ethical and legal principles shape the current brain data governance landscape? A systematic scoping review and thematic analysis of articles focused on biomedical, neuro and brain data governance was carried out to identify the ethical and legal principles which shape the current brain data governance landscape. The results revealed that there is currently a large variation of how the principles are presented and discussions around the terms are very multidimensional. Some of the principles are still at their infancy and are barely visible. A range of principles emerged during the thematic analysis providing a potential list of principles which can provide a more comprehensive framework for brain data governance and a conceptual expansion of neuroethics.
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Data governance functions to support responsible data stewardship in pediatric radiology research studies using artificial intelligence. Pediatr Radiol 2022; 52:2111-2119. [PMID: 35790559 DOI: 10.1007/s00247-022-05427-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 04/13/2022] [Accepted: 06/06/2022] [Indexed: 03/03/2023]
Abstract
The integration of human and machine intelligence promises to profoundly change the practice of medicine. The rapidly increasing adoption of artificial intelligence (AI) solutions highlights its potential to streamline physician work and optimize clinical decision-making, also in the field of pediatric radiology. Large imaging databases are necessary for training, validating and testing these algorithms. To better promote data accessibility in multi-institutional AI-enabled radiologic research, these databases centralize the large volumes of data required to effect accurate models and outcome predictions. However, such undertakings must consider the sensitivity of patient information and therefore utilize requisite data governance measures to safeguard data privacy and security, to recognize and mitigate the effects of bias and to promote ethical use. In this article we define data stewardship and data governance, review their key considerations and applicability to radiologic research in the pediatric context, and consider the associated best practices along with the ramifications of poorly executed data governance. We summarize several adaptable data governance frameworks and describe strategies for their implementation in the form of distributed and centralized approaches to data management.
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9
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Muller SHA, van Thiel GJMW, Vrana M, Mostert M, van Delden JJM. Patients' and Publics' Preferences for Data-Intensive Health Research Governance: Survey Study. JMIR Hum Factors 2022; 9:e36797. [PMID: 36069794 PMCID: PMC9494211 DOI: 10.2196/36797] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 05/18/2022] [Accepted: 07/18/2022] [Indexed: 11/28/2022] Open
Abstract
Background Patients and publics are generally positive about data-intensive health research. However, conditions need to be fulfilled for their support. Ensuring confidentiality, security, and privacy of patients’ health data is pivotal. Patients and publics have concerns about secondary use of data by commercial parties and the risk of data misuse, reasons for which they favor personal control of their data. Yet, the potential of public benefit highlights the potential of building trust to attenuate these perceptions of harm and risk. Nevertheless, empirical evidence on how conditions for support of data-intensive health research can be operationalized to that end remains scant. Objective This study aims to inform efforts to design governance frameworks for data-intensive health research, by gaining insight into the preferences of patients and publics for governance policies and measures. Methods We distributed a digital questionnaire among a purposive sample of patients and publics. Data were analyzed using descriptive statistics and nonparametric inferential statistics to compare group differences and explore associations between policy preferences. Results Study participants (N=987) strongly favored sharing their health data for scientific health research. Personal decision-making about which research projects health data are shared with (346/980, 35.3%), which researchers/organizations can have access (380/978, 38.9%), and the provision of information (458/981, 46.7%) were found highly important. Health data–sharing policies strengthening direct personal control, like being able to decide under which conditions health data are shared (538/969, 55.5%), were found highly important. Policies strengthening collective governance, like reliability checks (805/967, 83.2%) and security safeguards (787/976, 80.6%), were also found highly important. Further analysis revealed that participants willing to share health data, to a lesser extent, demanded policies strengthening direct personal control than participants who were reluctant to share health data. This was the case for the option to have health data deleted at any time (P<.001) and the ability to decide the conditions under which health data can be shared (P<.001). Overall, policies and measures enforcing conditions for support at the collective level of governance, like having an independent committee to evaluate requests for access to health data (P=.02), were most strongly favored. This also applied to participants who explicitly stressed that it was important to be able to decide the conditions under which health data can be shared, for instance, whether sanctions on data misuse are in place (P=.03). Conclusions This study revealed that both a positive attitude toward health data sharing and demand for personal decision-making abilities were associated with policies and measures strengthening control at the collective level of governance. We recommend pursuing the development of this type of governance policy. More importantly, further study is required to understand how governance policies and measures can contribute to the trustworthiness of data-intensive health research.
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Affiliation(s)
- Sam H A Muller
- Department of Medical Humanities, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Ghislaine J M W van Thiel
- Department of Medical Humanities, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | | | - Menno Mostert
- Department of Medical Humanities, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Johannes J M van Delden
- Department of Medical Humanities, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
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The potential of digital molecular diagnostics for infectious diseases in sub-Saharan Africa. PLOS DIGITAL HEALTH 2022; 1:e0000064. [PMID: 36812544 PMCID: PMC9931288 DOI: 10.1371/journal.pdig.0000064] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
There is a large gap between diagnostic needs and diagnostic access across much of sub-Saharan Africa (SSA), particularly for infectious diseases that inflict a substantial burden of morbidity and mortality. Accurate diagnostics are essential for the correct treatment of individuals and provide vital information underpinning disease surveillance, prevention, and control strategies. Digital molecular diagnostics combine the high sensitivity and specificity of molecular detection with point-of-care format and mobile connectivity. Recent developments in these technologies create an opportunity for a radical transformation of the diagnostic ecosystem. Rather than trying to emulate diagnostic laboratory models in resource-rich settings, African countries have the potential to pioneer new models of healthcare designed around digital diagnostics. This article describes the need for new diagnostic approaches, highlights advances in digital molecular diagnostic technology, and outlines their potential for tackling infectious diseases in SSA. It then addresses the steps that will be necessary for the development and implementation of digital molecular diagnostics. Although the focus is on infectious diseases in SSA, many of the principles apply to other resource-limited settings and to noncommunicable diseases.
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Nwebonyi N, Silva S, de Freitas C. Public Views About Involvement in Decision-Making on Health Data Sharing, Access, Use and Reuse: The Importance of Trust in Science and Other Institutions. Front Public Health 2022; 10:852971. [PMID: 35619806 PMCID: PMC9127133 DOI: 10.3389/fpubh.2022.852971] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 03/28/2022] [Indexed: 11/24/2022] Open
Abstract
Background Data-intensive and needs-driven research can deliver substantial health benefits. However, concerns with privacy loss, undisclosed surveillance, and discrimination are on the rise due to mounting data breaches. This can undermine the trustworthiness of data processing institutions and reduce people's willingness to share their data. Involving the public in health data governance can help to address this problem by imbuing data processing frameworks with societal values. This study assesses public views about involvement in individual-level decisions concerned with health data and their association with trust in science and other institutions. Methods Cross-sectional study with 162 patients and 489 informal carers followed at two reference centers for rare diseases in an academic hospital in Portugal (June 2019–March 2020). Participants rated the importance of involvement in decision-making concerning health data sharing, access, use, and reuse from “not important” to “very important”. Its association with sociodemographic characteristics, interpersonal trust, trust in national and international institutions, and the importance of trust in research teams and host institutions was tested. Results Most participants perceived involvement in decision-making about data sharing (85.1%), access (87.1%), use (85%) and reuse (79.9%) to be important or very important. Participants who ascribed a high degree of importance to trust in research host institutions were significantly more likely to value involvement in such decisions. A similar position was expressed by participants who valued trust in research teams for data sharing, access, and use. Participants with low levels of trust in national and international institutions and with lower levels of education attributed less importance to being involved in decisions about data use. Conclusion The high value attributed by participants to involvement in individual-level data governance stresses the need to broaden opportunities for public participation in health data decision-making, namely by introducing a meta consent approach. The important role played by trust in science and in other institutions in shaping participants' views about involvement highlights the relevance of pairing such a meta consent approach with the provision of transparent information about the implications of data sharing, the resources needed to make informed choices and the development of harm mitigation tools and redress.
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Affiliation(s)
- Ngozi Nwebonyi
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal.,Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto (FMUP), Porto, Portugal
| | - Susana Silva
- Departamento de Sociologia, Instituto de Ciências Sociais, Universidade do Minho, Braga, Portugal.,Centro em Rede de Investigação em Antropologia, Universidade do Minho, Braga, Portugal
| | - Cláudia de Freitas
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal.,Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto (FMUP), Porto, Portugal.,EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.,Centre for Research and Studies in Sociology, University Institute of Lisbon (ISCTE-IUL), Lisbon, Portugal
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McKay F, Williams BJ, Prestwich G, Treanor D, Hallowell N. Public governance of medical artificial intelligence research in the UK: an integrated multi-scale model. RESEARCH INVOLVEMENT AND ENGAGEMENT 2022; 8:21. [PMID: 35598004 PMCID: PMC9123617 DOI: 10.1186/s40900-022-00357-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 05/11/2022] [Indexed: 06/15/2023]
Abstract
There is a growing consensus among scholars, national governments, and intergovernmental organisations of the need to involve the public in decision-making around the use of artificial intelligence (AI) in society. Focusing on the UK, this paper asks how that can be achieved for medical AI research, that is, for research involving the training of AI on data from medical research databases. Public governance of medical AI research in the UK is generally achieved in three ways, namely, via lay representation on data access committees, through patient and public involvement groups, and by means of various deliberative democratic projects such as citizens' juries, citizen panels, citizen assemblies, etc.-what we collectively call "citizen forums". As we will show, each of these public involvement initiatives have complementary strengths and weaknesses for providing oversight of medical AI research. As they are currently utilized, however, they are unable to realize the full potential of their complementarity due to insufficient information transfer across them. In order to synergistically build on their contributions, we offer here a multi-scale model integrating all three. In doing so we provide a unified public governance model for medical AI research, one that, we argue, could improve the trustworthiness of big data and AI related medical research in the future.
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Affiliation(s)
- Francis McKay
- Department of Population Health, The Ethox Centre and the Wellcome Centre for Ethics and Humanities, Nuffield, University of Oxford, Oxford, OX3 7LF England
| | - Bethany J. Williams
- Department of Histopathology, St James University Hospital, Bexley Wing, Leeds, LS9 7TF England
| | - Graham Prestwich
- Yorkshire and Humber Academic Health Science Network, Unit 1, Calder Close, Calder Park, Wakefield, WF4 3BA England
| | - Darren Treanor
- Department of Histopathology, St James University Hospital, Leeds, LS9 7TF England
| | - Nina Hallowell
- Department of Population Health, The Ethox Centre and the Wellcome Centre for Ethics and Humanities, Nuffield, University of Oxford, Oxford, OX3 7LF England
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13
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Milne R, Sorbie A, Dixon-Woods M. What can data trusts for health research learn from participatory governance in biobanks? JOURNAL OF MEDICAL ETHICS 2022; 48:323-328. [PMID: 33741681 PMCID: PMC9046739 DOI: 10.1136/medethics-2020-107020] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 02/18/2021] [Accepted: 02/23/2021] [Indexed: 05/13/2023]
Abstract
New models of data governance for health data are a focus of growing interest in an era of challenge to the social licence. In this article, we reflect on what the data trust model, which is founded on principles of participatory governance, can learn from experiences of involving and engagement of members of the public and participants in the governance of large-scale biobanks. We distinguish between upstream and ongoing governance models, showing how they require careful design and operation if they are to deliver on aspirations for deliberation and participation. Drawing on this learning, we identify a set of considerations important to future design for data trusts as they seek to ensure just, proportionate and fair governance. These considerations relate to the timing of involvement of participants, patterns of inclusion and exclusion, and responsiveness to stakeholder involvement and engagement. We emphasise that the evolution of governance models for data should be matched by a commitment to evaluation.
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Affiliation(s)
- Richard Milne
- Society and Ethics Research, Wellcome Genome Campus, Cambridge, UK
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Annie Sorbie
- Mason Institute for Medicine, Life Sciences and the Law, Edinburgh Law School, University of Edinburgh, Edinburgh, UK
| | - Mary Dixon-Woods
- The Healthcare Improvement Studies Institute, University of Cambridge, Cambridge, UK
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14
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Pysar R, Wallingford CK, Boyle J, Campbell SB, Eckstein L, McWhirter R, Terrill B, Jacobs C, McInerney-Leo AM. Australian human research ethics committee members' confidence in reviewing genomic research applications. Eur J Hum Genet 2021; 29:1811-1818. [PMID: 34446835 PMCID: PMC8633339 DOI: 10.1038/s41431-021-00951-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 08/06/2021] [Accepted: 08/12/2021] [Indexed: 02/07/2023] Open
Abstract
Human research ethics committees (HRECs) are evaluating increasing quantities of genomic research applications with complex ethical considerations. Genomic confidence is reportedly low amongst many non-genetics-experts; however, no studies have evaluated genomic confidence levels in HREC members specifically. This study used online surveys to explore genomic confidence levels, predictors of confidence, and genomics resource needs of members from 185 HRECs across Australia. Surveys were fully or partially completed by 145 members. All reported having postgraduate 94 (86%) and/or bachelor 15 (14%) degrees. Participants consisted mainly of researchers (n = 45, 33%) and lay members (n = 41, 30%), affiliated with either public health services (n = 73, 51%) or public universities (n = 31, 22%). Over half had served their HREC [Formula: see text]3 years. Fifty (44%) reviewed genomic studies [Formula: see text]3 times annually. Seventy (60%) had undertaken some form of genomic education. While most (94/103, 91%) had high genomic literacy based on familiarity with genomic terms, average genomic confidence scores (GCS) were moderate (5.7/10, n = 119). Simple linear regression showed that GCS was positively associated with years of HREC service, frequency of reviewing genomic applications, undertaking self-reported genomic education, and familiarity with genomic terms (p < 0.05 for all). Conversely, lay members and/or those relying on others when reviewing genomic studies had lower GCSs (p < 0.05 for both). Most members (n = 83, 76%) agreed further resources would be valuable when reviewing genomic research applications, and online courses and printed materials were preferred. In conclusion, even well-educated HREC members familiar with genomic terms lack genomic confidence, which could be enhanced with additional genomic education and/or resources.
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Affiliation(s)
- Ryan Pysar
- grid.117476.20000 0004 1936 7611Genetic Counseling, Graduate School of Health, University of Technology Sydney, Sydney, NSW Australia ,grid.414009.80000 0001 1282 788XCentre for Clinical Genetics, Sydney Children’s Hospital, Randwick, NSW Australia
| | - Courtney K. Wallingford
- grid.1003.20000 0000 9320 7537University of Queensland Diamantina Institute, University of Queensland, Dermatology Research Centre, Woolloongabba, QLD Australia
| | - Jackie Boyle
- grid.511220.50000 0005 0259 3580NSW Genetics of Learning Disability (GOLD) Service, Hunter Genetics, Waratah, NSW Australia
| | - Scott B. Campbell
- grid.412744.00000 0004 0380 2017Department of Nephrology, Princess Alexandra Hospital, Woolloongabba, QLD Australia
| | - Lisa Eckstein
- grid.1009.80000 0004 1936 826XFaculty of Law University of Tasmania, Hobart, TAS Australia
| | - Rebekah McWhirter
- grid.1021.20000 0001 0526 7079School of Medicine, Faculty of Health, Deakin University, Geelong, VIC Australia
| | - Bronwyn Terrill
- grid.415306.50000 0000 9983 6924Kinghorn Centre for Clinical Genomics, Garvan Institute of Medical Research, Darlinghurst, NSW Australia ,grid.1005.40000 0004 4902 0432St Vincent’s Clinical School, UNSW Sydney, Sydney, NSW Australia
| | - Chris Jacobs
- grid.117476.20000 0004 1936 7611Genetic Counseling, Graduate School of Health, University of Technology Sydney, Sydney, NSW Australia
| | - Aideen M. McInerney-Leo
- grid.1003.20000 0000 9320 7537University of Queensland Diamantina Institute, University of Queensland, Dermatology Research Centre, Woolloongabba, QLD Australia
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Murtagh MJ, Machirori M, Gaff CL, Blell MT, de Vries J, Doerr M, Dove ES, Duncanson A, Hastings Ward J, Hendricks-Sturrup R, Ho CWL, Johns A, Joly Y, Kato K, Katsui K, Kumuthini J, Maleady-Crowe F, Middleton A, Milne R, Minion JT, Matshaba M, Mulrine S, Patch C, Ryan R, Viney W. Engaged genomic science produces better and fairer outcomes: an engagement framework for engaging and involving participants, patients and publics in genomics research and healthcare implementation. Wellcome Open Res 2021; 6:311. [PMID: 35592835 PMCID: PMC9086526 DOI: 10.12688/wellcomeopenres.17233.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2021] [Indexed: 12/12/2022] Open
Abstract
Genomic science is increasingly central to the provision of health care. Producing and applying robust genomics knowledge is a complex endeavour in which no single individual, profession, discipline or community holds all the answers. Engagement and involvement of diverse stakeholders can support alignment of societal and scientific interests, understandings and perspectives and promises better science and fairer outcomes. In this context we argue for F.A.I.R.E.R. data and data use that is Findable, Accessible, Interoperable, Reproducible,
Equitable and
Responsible. Yet there is a paucity of international guidance on how to engage publics, patients and participants in genomics. To support meaningful and effective engagement and involvement we developed an
Engagement Framework for involving and engaging participants, patients and publics in genomics research and health implementation. The
Engagement Framework is intended to support all those working in genomics research, medicine, and healthcare to deliberatively consider approaches to participant, patient and public engagement and involvement in their work. Through a series of questions, the
Engagement Framework prompts new ways of thinking about
the aims and purposes of engagement, and support reflection on the strengths, limitations, likely outcomes and impacts of choosing different approaches to engagement. To guide genomics activities, we describe four themes and associated questions for deliberative reflection: (i) fairness; (ii) context; (iii) heterogeneity, and (iv) recognising tensions and conflict. The four key components in the
Engagement provide a framework to assist those involved in genomics to reflect on decisions they make for their initiatives, including the strategies selected, the participant, patient and public stakeholders engaged, and the anticipated goals.
The Engagement Framework is one step in an actively evolving process of building genomics research and implementation cultures which foster responsible leadership and are attentive to objectives which increase equality, diversity and inclusion in participation and outcomes.
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Affiliation(s)
| | | | - Clara L. Gaff
- University of Melbourne, Melbourne, Australia
- Melbourne Genomics Health Alliance, Melbourne, Australia
| | | | | | | | | | | | | | | | | | - Amber Johns
- International Cancer Genome Consortium, Glasgow, UK
- Garvan Institute of Medical Research, Sydney, Australia
| | - Yann Joly
- Centre of Genomics and Policy, McGill University, Montreal, Canada
| | - Kazuto Kato
- GEM-Japan, Tokyo, Japan
- Osaka University, Suita, Japan
| | - Keiko Katsui
- Japan Agency for Medical Research and Development, Tokyo, Japan
| | - Judit Kumuthini
- University of Western Cape, Cape Town, South Africa
- H3ABioNet/H3Africa, Cape Town, South Africa
| | | | | | | | | | - Mogomotsi Matshaba
- H3ABioNet/H3Africa, Cape Town, South Africa
- Botswana-Baylor Children’s Clinical Centre of Excellence, Gabrorone, Botswana
| | | | - Christine Patch
- Genomics England, London, UK
- Wellcome Connecting Science, Cambridge, UK
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Plana A, Furner B, Palese M, Dussault N, Birz S, Graglia L, Kush M, Nicholson J, Hecker-Nolting S, Gaspar N, Rasche M, Bisogno G, Reinhardt D, Zwaan CM, Koscielniak E, Frazier AL, Janeway K, S Hawkins D, Kolb EA, Cohn SL, Pearson ADJ, Volchenboum SL. Pediatric Cancer Data Commons: Federating and Democratizing Data for Childhood Cancer Research. JCO Clin Cancer Inform 2021; 5:1034-1043. [PMID: 34662145 DOI: 10.1200/cci.21.00075] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
The international pediatric oncology community has a long history of research collaboration. In the United States, the 2019 launch of the Children's Cancer Data Initiative puts the focus on developing a rich and robust data ecosystem for pediatric oncology. In this spirit, we present here our experience in constructing the Pediatric Cancer Data Commons (PCDC) to highlight the significance of this effort in fighting pediatric cancer and improving outcomes and to provide essential information to those creating resources in other disease areas. The University of Chicago's PCDC team has worked with the international research community since 2015 to build data commons for children's cancers. We identified six critical features of successful data commons design and implementation: (1) establish the need for a data commons, (2) develop and deploy the technical infrastructure, (3) establish and implement governance, (4) make the data commons platform easy and intuitive for researchers, (5) socialize the data commons and create working knowledge and expertise in the research community, and (6) plan for longevity and sustainability. Data commons are critical to conducting research on large patient cohorts that will ultimately lead to improved outcomes for children with cancer. There is value in connecting high-quality clinical and phenotype data to external sources of data such as genomic, proteomics, and imaging data. Next steps for the PCDC include creating an informed and invested data-sharing culture, developing sustainable methods of data collection and sharing, standardizing genetic biomarker reporting, incorporating radiologic and molecular analysis data, and building models for electronic patient consent. The methods and processes described here can be extended to any clinical area and provide a blueprint for others wishing to develop similar resources.
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Affiliation(s)
- Alejandro Plana
- Department of Pediatrics, University of Chicago, Chicago, IL
| | - Brian Furner
- Center for Research Informatics, University of Chicago, Chicago, IL
| | - Monica Palese
- Department of Pediatrics, University of Chicago, Chicago, IL
| | - Nicole Dussault
- Pritzker School of Medicine, University of Chicago, Chicago, IL
| | - Suzi Birz
- Department of Pediatrics, University of Chicago, Chicago, IL
| | - Luca Graglia
- Department of Pediatrics, University of Chicago, Chicago, IL
| | - Maura Kush
- Department of Pediatrics, University of Chicago, Chicago, IL
| | - James Nicholson
- Department of Paediatric Oncology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Stefanie Hecker-Nolting
- Klinikum Stuttgart-Olgahospital, Zentrum für Kinder-, Jugend- und Frauenmedizin; Pädiatrie 5 (Onkologie, Hämatologie, Immunologie), Stuttgart Cancer Center, Stuttgart, Germany
| | - Nathalie Gaspar
- Département of Oncology for Child and Adolescent, Gustave Roussy, Villejuif, France
| | - Mareike Rasche
- Department of Pediatric Hematology-Oncology, Pediatrics III, University Hospital of Essen, Essen, Germany
| | - Gianni Bisogno
- Maternal and Child Health Department, Padua University Hospital, Padua, Italy
| | - Dirk Reinhardt
- Department of Pediatric Hematology-Oncology, Pediatrics III, University Hospital of Essen, Essen, Germany
| | - C Michel Zwaan
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Ewa Koscielniak
- Klinikum Stuttgart-Olgahospital, Zentrum für Kinder-, Jugend- und Frauenmedizin; Pädiatrie 5 (Onkologie, Hämatologie, Immunologie), Stuttgart Cancer Center, Stuttgart, Germany.,University of Tuebingen, Tuebingen, Germany
| | - A Lindsay Frazier
- Department of Pediatrics, Harvard University, Dana Farber Cancer Institute, Boston, MA
| | - Katherine Janeway
- Department of Pediatrics, Harvard University, Dana Farber Cancer Institute, Boston, MA
| | | | - E Anders Kolb
- Nemours Center for Cancer and Blood Disorders, Alfred I. duPont Hospital for Children, Wilmington, DE
| | - Susan L Cohn
- Department of Pediatrics, University of Chicago, Chicago, IL
| | - Andrew D J Pearson
- Division of Clinical Studies, Institute of Cancer Research, Royal Marsden Hospital, Sutton, United Kingdom.,retired
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Abstract
A huge array of data in nephrology is collected through patient registries, large epidemiological studies, electronic health records, administrative claims, clinical trial repositories, mobile health devices and molecular databases. Application of these big data, particularly using machine-learning algorithms, provides a unique opportunity to obtain novel insights into kidney diseases, facilitate personalized medicine and improve patient care. Efforts to make large volumes of data freely accessible to the scientific community, increased awareness of the importance of data sharing and the availability of advanced computing algorithms will facilitate the use of big data in nephrology. However, challenges exist in accessing, harmonizing and integrating datasets in different formats from disparate sources, improving data quality and ensuring that data are secure and the rights and privacy of patients and research participants are protected. In addition, the optimism for data-driven breakthroughs in medicine is tempered by scepticism about the accuracy of calibration and prediction from in silico techniques. Machine-learning algorithms designed to study kidney health and diseases must be able to handle the nuances of this specialty, must adapt as medical practice continually evolves, and must have global and prospective applicability for external and future datasets.
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Igumbor JO, Bosire EN, Vicente-Crespo M, Igumbor EU, Olalekan UA, Chirwa TF, Kinyanjui SM, Kyobutungi C, Fonn S. Considerations for an integrated population health databank in Africa: lessons from global best practices. Wellcome Open Res 2021; 6:214. [PMID: 35224211 PMCID: PMC8844538 DOI: 10.12688/wellcomeopenres.17000.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2021] [Indexed: 12/17/2022] Open
Abstract
Background: The rising digitisation and proliferation of data sources and repositories cannot be ignored. This trend expands opportunities to integrate and share population health data. Such platforms have many benefits, including the potential to efficiently translate information arising from such data to evidence needed to address complex global health challenges. There are pockets of quality data on the continent that may benefit from greater integration. Integration of data sources is however under-explored in Africa. The aim of this article is to identify the requirements and provide practical recommendations for developing a multi-consortia public and population health data-sharing framework for Africa. Methods: We conducted a narrative review of global best practices and policies on data sharing and its optimisation. We searched eight databases for publications and undertook an iterative snowballing search of articles cited in the identified publications. The Leximancer software © enabled content analysis and selection of a sample of the most relevant articles for detailed review. Themes were developed through immersion in the extracts of selected articles using inductive thematic analysis. We also performed interviews with public and population health stakeholders in Africa to gather their experiences, perceptions, and expectations of data sharing. Results: Our findings described global stakeholder experiences on research data sharing. We identified some challenges and measures to harness available resources and incentivise data sharing. We further highlight progress made by the different groups in Africa and identified the infrastructural requirements and considerations when implementing data sharing platforms. Furthermore, the review suggests key reforms required, particularly in the areas of consenting, privacy protection, data ownership, governance, and data access. Conclusions: The findings underscore the critical role of inclusion, social justice, public good, data security, accountability, legislation, reciprocity, and mutual respect in developing a responsive, ethical, durable, and integrated research data sharing ecosystem.
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Affiliation(s)
- Jude O. Igumbor
- School of Public Health, University of the Witwatersrand, Johannesburg, Gauteng, 2193, South Africa
| | - Edna N. Bosire
- School of Public Health, University of the Witwatersrand, Johannesburg, Gauteng, 2193, South Africa
| | - Marta Vicente-Crespo
- School of Public Health, University of the Witwatersrand, Johannesburg, Gauteng, 2193, South Africa
- African Population and Health Research Centre, Nairobi, Kenya
| | - Ehimario U. Igumbor
- Nigeria Centre for Disease Control, Abuja, Nigeria
- School of Public Health, University of the Western Cape, Cape Town, Western Cape, South Africa
| | - Uthman A. Olalekan
- Warwick-Centre for Applied Health Research and Delivery (WCAHRD), Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Tobias F. Chirwa
- School of Public Health, University of the Witwatersrand, Johannesburg, Gauteng, 2193, South Africa
| | | | | | - Sharon Fonn
- School of Public Health, University of the Witwatersrand, Johannesburg, Gauteng, 2193, South Africa
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19
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Muller SHA, Kalkman S, van Thiel GJMW, Mostert M, van Delden JJM. The social licence for data-intensive health research: towards co-creation, public value and trust. BMC Med Ethics 2021; 22:110. [PMID: 34376204 PMCID: PMC8353823 DOI: 10.1186/s12910-021-00677-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 08/03/2021] [Indexed: 11/10/2022] Open
Abstract
Background The rise of Big Data-driven health research challenges the assumed contribution of medical research to the public good, raising questions about whether the status of such research as a common good should be taken for granted, and how public trust can be preserved. Scandals arising out of sharing data during medical research have pointed out that going beyond the requirements of law may be necessary for sustaining trust in data-intensive health research. We propose building upon the use of a social licence for achieving such ethical governance. Main text We performed a narrative review of the social licence as presented in the biomedical literature. We used a systematic search and selection process, followed by a critical conceptual analysis. The systematic search resulted in nine publications. Our conceptual analysis aims to clarify how societal permission can be granted to health research projects which rely upon the reuse and/or linkage of health data. These activities may be morally demanding. For these types of activities, a moral legitimation, beyond the limits of law, may need to be sought in order to preserve trust. Our analysis indicates that a social licence encourages us to recognise a broad range of stakeholder interests and perspectives in data-intensive health research. This is especially true for patients contributing data. Incorporating such a practice paves the way towards an ethical governance, based upon trust. Public engagement that involves patients from the start is called for to strengthen this social licence. Conclusions There are several merits to using the concept of social licence as a guideline for ethical governance. Firstly, it fits the novel scale of data-related risks; secondly, it focuses attention on trustworthiness; and finally, it offers co-creation as a way forward. Greater trust can be achieved in the governance of data-intensive health research by highlighting strategic dialogue with both patients contributing the data, and the public in general. This should ultimately contribute to a more ethical practice of governance. Supplementary Information The online version contains supplementary material available at 10.1186/s12910-021-00677-5.
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Affiliation(s)
- Sam H A Muller
- Department of Medical Humanities, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Universiteitsweg 100, 3584 CX, Utrecht, The Netherlands.
| | - Shona Kalkman
- Department of Medical Humanities, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Universiteitsweg 100, 3584 CX, Utrecht, The Netherlands
| | - Ghislaine J M W van Thiel
- Department of Medical Humanities, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Universiteitsweg 100, 3584 CX, Utrecht, The Netherlands
| | - Menno Mostert
- Department of Medical Humanities, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Universiteitsweg 100, 3584 CX, Utrecht, The Netherlands
| | - Johannes J M van Delden
- Department of Medical Humanities, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Universiteitsweg 100, 3584 CX, Utrecht, The Netherlands
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Knoppers BM, Bernier A, Granados Moreno P, Pashayan N. Of Screening, Stratification, and Scores. J Pers Med 2021; 11:736. [PMID: 34442379 PMCID: PMC8398020 DOI: 10.3390/jpm11080736] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 07/24/2021] [Indexed: 12/16/2022] Open
Abstract
Technological innovations including risk-stratification algorithms and large databases of longitudinal population health data and genetic data are allowing us to develop a deeper understanding how individual behaviors, characteristics, and genetics are related to health risk. The clinical implementation of risk-stratified screening programmes that utilise risk scores to allocate patients into tiers of health risk is foreseeable in the future. Legal and ethical challenges associated with risk-stratified cancer care must, however, be addressed. Obtaining access to the rich health data that are required to perform risk-stratification, ensuring equitable access to risk-stratified care, ensuring that algorithms that perform risk-scoring are representative of human genetic diversity, and determining the appropriate follow-up to be provided to stratification participants to alert them to changes in their risk score are among the principal ethical and legal challenges. Accounting for the great burden that regulatory requirements could impose on access to risk-scoring technologies is another critical consideration.
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Affiliation(s)
- Bartha M. Knoppers
- Centre of Genomics and Policy, Faculty of Medicine, McGill University, 740 Avenue Dr. Penfield, Suite 5200, Montreal, QC H3A 0G1, Canada; (A.B.); (P.G.M.)
| | - Alexander Bernier
- Centre of Genomics and Policy, Faculty of Medicine, McGill University, 740 Avenue Dr. Penfield, Suite 5200, Montreal, QC H3A 0G1, Canada; (A.B.); (P.G.M.)
| | - Palmira Granados Moreno
- Centre of Genomics and Policy, Faculty of Medicine, McGill University, 740 Avenue Dr. Penfield, Suite 5200, Montreal, QC H3A 0G1, Canada; (A.B.); (P.G.M.)
| | - Nora Pashayan
- Department of Applied Health Research, University College London, 1-19 Torrington Place, London WC1E 7HB, UK;
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21
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Mobile apps for travel medicine and ethical considerations: A systematic review. Travel Med Infect Dis 2021; 43:102143. [PMID: 34256131 DOI: 10.1016/j.tmaid.2021.102143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 06/30/2021] [Accepted: 07/02/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND The advent of mobile applications for health and medicine will revolutionize travel medicine. Despite their many benefits, such as access to real-time data, mobile apps for travel medicine are accompanied by many ethical issues, including questions about security and privacy. METHODS A systematic literature review as conducted following PRISMA guidelines. Database screening yielded 1795 results and seven papers satisfied the criteria for inclusion. Through a mix of inductive and deductive data extraction, this systematic review examined both the benefits and challenges, as well as ethical considerations, of mobile apps for travel medicine. RESULTS Ethical considerations were discussed with varying depth across the included articles, with privacy and data protection mentioned most frequently, highlighting concerns over sensitive information and a lack of guidelines in the digital sphere. Additionally, technical concerns about data quality and bias were predominant issues for researchers and developers alike. Some ethical issues were not discussed at all, including equity, and user involvement. CONCLUSION This paper highlights the scarcity of discussion around ethical issues. Both researchers and developers need to better integrate ethical reflection at each step of the development and use of health apps. More effective oversight mechanisms and clearer ethical guidance are needed to guide the stakeholders in this endeavour.
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22
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Rivas Velarde MC, Tsantoulis P, Burton-Jeangros C, Aceti M, Chappuis P, Hurst-Majno S. Citizens' views on sharing their health data: the role of competence, reliability and pursuing the common good. BMC Med Ethics 2021; 22:62. [PMID: 34006284 PMCID: PMC8130128 DOI: 10.1186/s12910-021-00633-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 05/12/2021] [Indexed: 11/19/2022] Open
Abstract
Background In this article, we address questions regarding how people consider what they do or do not consent to and the reasons why. This article presents the findings of a citizen forum study conducted by the University of Geneva in partnership with the Geneva University Hospitals to explore the opinions and concerns of members of the public regarding predictive oncology, genetic sequencing, and cancer.
Methods This paper presents the results of a citizen forum that included 73 participants. A research tool titled "the mechanics of consent" was designed for this study. This tool is a table encouraging participants to reflect on social and research actors, types of data, and desired levels of control while sharing different types of data with different actors. Participants’ discussion that led to the completion of each table were audio-recorded, transcribed, and analyzed using thematic analysis. Results The results are a compilation of responses from the mechanics of consent tool divided into two sections; the first presents quantitative results of collective responses regarding attitudes to consent to donate their data. The second section present qualitative findings emerged from the discussion amongst participants. Discussion Choice and control of personal data is crucial for the public to be able to decide who and how to trust. Key information to be disclosed to potential research participants shall include information about potential risks and benefits; who will be accessing and using their data; as well as assurances that their choice will be respected. Furthermore, researchers ought to make sure they are trustworthy, by acting in a competent, reliable, and honest manner. Governance systems ought to be better equipped to address ethical issues raise by the growing presence of non-traditional research actors, consent of exchanges of data via digital devices and online activity such as social media and fairness of data trading. Finally, informed consent is one of the various elements that contribute to conducting ethical research. More needs to be done to strengthen governance and ensure adequate protection of research participants, particularly to address issues related to predictive health analytics.
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Affiliation(s)
- Minerva C Rivas Velarde
- Faculty of Medicine, Institute Ethics History Humanities, University of Geneva, CMU/1 rue Michel Servet, 1211, Genève 4, Switzerland.
| | - Petros Tsantoulis
- Department of Oncology, Geneva University Hospital, Rue Gabrielle Perret-Gentil 4, 1205, Genève, Switzerland
| | - Claudine Burton-Jeangros
- Département de Sociologie, University of Geneva, Bd. du Pont-d'Arve 40, 1211, Genève 4, Switzerland
| | - Monica Aceti
- Institute of Sociological Research, University of Geneva, Bd. du Pont-d'Arve 40, 1211, Genève 4, Switzerland
| | - Pierre Chappuis
- Oncogenetics and Cancer Prevention Unit, Geneva University Hospital, Rue Gabrielle-Perret-Gentil 4, 1205, Genève, Switzerland
| | - Samia Hurst-Majno
- Faculty of Medicine, Department of Community Medicine, University of Geneva, CMU 1 rue Michel-Servet, 1211, Genève 4, Switzerland
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Constraints in Clinical Cardiology and Personalized Medicine: Interrelated Concepts in Clinical Cardiology. CARDIOGENETICS 2021. [DOI: 10.3390/cardiogenetics11020007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Systems biology is established as an integrative computational analysis methodology with practical and theoretical applications in clinical cardiology. The integration of genetic and molecular components of a disease produces interacting networks, modules and phenotypes with clinical applications in complex cardiovascular entities. With the holistic principle of systems biology, some of the features of complexity and natural progression of cardiac diseases are approached and explained. Two important interrelated holistic concepts of systems biology are described; the emerging field of personalized medicine and the constraint-based thinking with downward causation. Constraints in cardiovascular diseases embrace three scientific fields related to clinical cardiology: biological and medical constraints; constraints due to limitations of current technology; and constraints of general resources for better medical coverage. Systems healthcare and personalized medicine are connected to the related scientific fields of: ethics and legal status; data integration; taxonomic revisions; policy decisions; and organization of human genomic data.
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Trein P, Wagner J. Governing Personalized Health: A Scoping Review. Front Genet 2021; 12:650504. [PMID: 33968134 PMCID: PMC8097042 DOI: 10.3389/fgene.2021.650504] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 03/17/2021] [Indexed: 01/03/2023] Open
Abstract
Genetic research is advancing rapidly. One important area for the application of the results from this work is personalized health. These are treatments and preventive interventions tailored to the genetic profile of specific groups or individuals. The inclusion of personalized health in existing health systems is a challenge for policymakers. In this article, we present the results of a thematic scoping review of the literature dealing with governance and policy of personalized health. Our analysis points to four governance challenges that decisionmakers face against the background of personalized health. First, researchers have highlighted the need to further extend and harmonize existing research infrastructures in order to combine different types of genetic data. Second, decisionmakers face the challenge to create trust in personalized health applications, such as genetic tests. Third, scholars have pointed to the importance of the regulation of data production and sharing to avoid discrimination of disadvantaged groups and to facilitate collaboration. Fourth, researchers have discussed the challenge to integrate personalized health into regulatory-, financing-, and service provision structures of existing health systems. Our findings summarize existing research and help to guide further policymaking and research in the field of personalized health governance.
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Affiliation(s)
- Philipp Trein
- Department of Political Science and International Relations, University of Geneva, Geneva, Switzerland
| | - Joël Wagner
- Department of Actuarial Science, Faculty of Business and Economics (HEC Lausanne), University of Lausanne, Lausanne, Switzerland.,Swiss Finance Institute, University of Lausanne, Lausanne, Switzerland
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25
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Dagliati A, Malovini A, Tibollo V, Bellazzi R. Health informatics and EHR to support clinical research in the COVID-19 pandemic: an overview. Brief Bioinform 2021; 22:812-822. [PMID: 33454728 PMCID: PMC7929411 DOI: 10.1093/bib/bbaa418] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 10/29/2020] [Accepted: 12/19/2020] [Indexed: 12/15/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has clearly shown that major challenges and threats for humankind need to be addressed with global answers and shared decisions. Data and their analytics are crucial components of such decision-making activities. Rather interestingly, one of the most difficult aspects is reusing and sharing of accurate and detailed clinical data collected by Electronic Health Records (EHR), even if these data have a paramount importance. EHR data, in fact, are not only essential for supporting day-by-day activities, but also they can leverage research and support critical decisions about effectiveness of drugs and therapeutic strategies. In this paper, we will concentrate our attention on collaborative data infrastructures to support COVID-19 research and on the open issues of data sharing and data governance that COVID-19 had made emerge. Data interoperability, healthcare processes modelling and representation, shared procedures to deal with different data privacy regulations, and data stewardship and governance are seen as the most important aspects to boost collaborative research. Lessons learned from COVID-19 pandemic can be a strong element to improve international research and our future capability of dealing with fast developing emergencies and needs, which are likely to be more frequent in the future in our connected and intertwined world.
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Affiliation(s)
- Arianna Dagliati
- Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Italy
| | | | | | - Riccardo Bellazzi
- Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Italy
- IRCCS Istituti Clinici Scientifici Maugeri, Pavia, Italy
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26
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de Freitas C, Amorim M, Machado H, Leão Teles E, Baptista MJ, Renedo A, Provoost V, Silva S. Public and patient involvement in health data governance (DATAGov): protocol of a people-centred, mixed-methods study on data use and sharing for rare diseases care and research. BMJ Open 2021; 11:e044289. [PMID: 33722870 PMCID: PMC7959217 DOI: 10.1136/bmjopen-2020-044289] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 02/17/2021] [Accepted: 02/26/2021] [Indexed: 01/16/2023] Open
Abstract
INTRODUCTION International policy imperatives for the public and patient involvement in the governance of health data coexist with conflicting cross-border policies on data sharing. This can challenge the planning and implementation of participatory data governance in healthcare services locally. Engaging with local stakeholders and understanding how their needs, values and preferences for governing health data can be articulated with policies made at the supranational level is crucial. This paper describes a protocol for a project that aims to coproduce a people-centred model for involving patients and the public in decision-making processes about the use and sharing of health data for rare diseases care and research. METHODS AND ANALYSIS This multidisciplinary project draws on an explanatory sequential mixed-methods study. A hospital-based survey with patients, informal carers, health professionals and technical staff recruited at two reference centres for rare diseases in Portugal will be conducted first. The qualitative study will follow consisting of semi-structured interviews and scenario-based workshops with a subsample of the participant groups recruited at baseline. Quantitative data will be analysed using descriptive and inferential statistics. Inductive and deductive approaches will be combined to analyse the qualitative interviews. Data from scenario-based workshops will be iteratively compared using the constant comparison method to identify cross-cutting themes and categories. ETHICS AND DISSEMINATION The Ethics Committee for Health from the University Hospital Centre São João/Faculty of Medicine of University of Porto approved the study protocol (Ref. 99/19). Research findings will be disseminated at academic conferences and science promotion events, and through public meetings involving patient representatives, practitioners, policy-makers and students, a project website and peer-reviewed journal publications.
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Affiliation(s)
- Cláudia de Freitas
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Centre for Research and Studies in Sociology, University Institute of Lisbon (ISCTE-IUL), Lisboa, Portugal
| | - Mariana Amorim
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Helena Machado
- Communication and Society Research Centre (CECS), Institute of Social Sciences, University of Minho, Braga, Portugal
| | - Elisa Leão Teles
- Centro de Referência de Doenças Hereditárias do Metabolismo do Centro Hospitalar Universitário São João, Porto, Portugal
| | - Maria João Baptista
- Centro de Referência de Cardiopatias Congénitas do Centro Hospitalar Universitário São João, Porto, Portugal
- Departamento de Ginecologia, Obstetrícia e Pediatria, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Alicia Renedo
- Public Health Environments and Society, London School of Hygiene and Tropical Medicine, London, UK
| | - Veerle Provoost
- Bioethics Institute Ghent, Department of Philosophy and Moral Sciences Ghent University, Ghent, Belgium
| | - Susana Silva
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
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O'Doherty KC, Shabani M, Dove ES, Bentzen HB, Borry P, Burgess MM, Chalmers D, De Vries J, Eckstein L, Fullerton SM, Juengst E, Kato K, Kaye J, Knoppers BM, Koenig BA, Manson SM, McGrail KM, McGuire AL, Meslin EM, Nicol D, Prainsack B, Terry SF, Thorogood A, Burke W. Toward better governance of human genomic data. Nat Genet 2021; 53:2-8. [PMID: 33414545 PMCID: PMC8450011 DOI: 10.1038/s41588-020-00742-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
In this Commentary, we argue that in line with the dramatic increase in the collection, storage, and curation of human genomic data for biomedical research, genomic data repositories and consortia have adopted governance frameworks to address the dual objectives of enabling wide access while protecting against possible harms. However, there are ongoing debates in the scientific community about the merits and limitations of different governance frameworks in achieving these twin aims; and indeed, best practices and points for consideration are notably absent when it comes to devising a governance framework for genomic databases. Based on our collective experience of devising and assessing governance frameworks, our Commentary identifies five key functions of “good governance” (or what makes “better governance”) and three areas where trade-offs should be considered when specifying policies within those functions. We apply these functions as a benchmark to describe, as an example, the governance frameworks of six large-scale international genomic projects.
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Affiliation(s)
| | - Mahsa Shabani
- Metamedica, Faculty of Law and Criminology, Ghent University, Ghent, Belgium
| | - Edward S Dove
- School of Law, University of Edinburgh, Edinburgh, UK.
| | - Heidi Beate Bentzen
- Center for Medical Ethics, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Pascal Borry
- Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Michael M Burgess
- School of Population and Public Health, University of British Columbia, Kelowna, British Columbia, Canada
| | - Don Chalmers
- Faculty of Law, University of Tasmania, Hobart, Tasmania, Australia
| | - Jantina De Vries
- Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Lisa Eckstein
- Faculty of Law, University of Tasmania, Hobart, Tasmania, Australia
| | | | - Eric Juengst
- Department of Social Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Kazuto Kato
- Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Jane Kaye
- Faculty of Law, University of Oxford, Oxford, UK
| | | | | | - Spero M Manson
- Colorado School of Public Health, University of Colorado, Aurora, CO, USA
| | - Kimberlyn M McGrail
- School of Population and Public Health, University of British Columbia, Kelowna, British Columbia, Canada
| | - Amy L McGuire
- Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX, USA
| | - Eric M Meslin
- Council of Canadian Academies, Ottawa, Ontario, Canada
| | - Dianne Nicol
- Faculty of Law, University of Tasmania, Hobart, Tasmania, Australia
| | - Barbara Prainsack
- Department of Political Science, University of Vienna, Vienna, Austria
- Department of Global Health & Social Medicine, King's College London, London, UK
| | | | - Adrian Thorogood
- Centre of Genomics and Policy, McGill University, Montreal, Québec, Canada
| | - Wylie Burke
- Department of Bioethics and Humanities, University of Washington, Seattle, WA, USA
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Lensink MA, Boers SN, Jongsma KR, Carter SE, van der Ent CK, Bredenoord AL. Organoids for personalized treatment of Cystic Fibrosis: Professional perspectives on the ethics and governance of organoid biobanking. J Cyst Fibros 2020; 20:443-451. [PMID: 33303364 DOI: 10.1016/j.jcf.2020.11.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 10/07/2020] [Accepted: 11/17/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Organoid technology is emerging rapidly as a valuable tool for precision medicine, particularly in the field of Cystic Fibrosis (CF). However, biobank storage and use of patient-derived organoids raises specific ethical and practical challenges that demand sound governance. We examined the perspectives of professionals affiliated with CF or organoids on the ethical aspects of organoid biobanking for CF precision medicine. By conducting this study parallel to the process of innovation and development of organoid biobanking, its findings are valuable for the design of responsible governance frameworks. METHODS To identify relevant themes and attitudes we conducted 21 semi-structured qualitative interviews with professionals in the field of organoid technology, biobanking, or CF research and care. RESULTS We identified three key challenges, as well as the suggestions of professionals on how to address them: (1) The challenges associated with commercial involvement, trust, and ownership, (2) Navigating the blurring boundary between research and clinical care, (3) Appropriate approaches to the informed consent procedure. CONCLUSION Sound governance of organoid biobanks aimed at precision medicine requires coming to terms with the fact that its stakeholders no longer belong to separate domains. Responsible governance should be aimed at finding a sound, context-sensitive balance between integration of ongoing co-operation and mutual consideration of interests, and maintaining a feasible and sustainable research climate.
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Affiliation(s)
- Michael A Lensink
- Julius Center for Health Sciences and Primary Care, Department of Medical Humanities, University Medical Center Utrecht, Internal Post Str. 6.131, P.O. Box 85500, 3508 GA Utrecht, The Netherlands.
| | - Sarah N Boers
- Julius Center for Health Sciences and Primary Care, Department of Medical Humanities, University Medical Center Utrecht, Internal Post Str. 6.131, P.O. Box 85500, 3508 GA Utrecht, The Netherlands.
| | - Karin R Jongsma
- Julius Center for Health Sciences and Primary Care, Department of Medical Humanities, University Medical Center Utrecht, Internal Post Str. 6.131, P.O. Box 85500, 3508 GA Utrecht, The Netherlands.
| | - Sarah E Carter
- Julius Center for Health Sciences and Primary Care, Department of Medical Humanities, University Medical Center Utrecht, Internal Post Str. 6.131, P.O. Box 85500, 3508 GA Utrecht, The Netherlands.
| | - Cornelis K van der Ent
- Department of Pediatric Pulmonology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Internal Post KH.01.419.0, P.O. Box 85090, 3508 AB Utrecht, The Netherlands.
| | - Annelien L Bredenoord
- Julius Center for Health Sciences and Primary Care, Department of Medical Humanities, University Medical Center Utrecht, Internal Post Str. 6.131, P.O. Box 85500, 3508 GA Utrecht, The Netherlands.
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Morrison M, Mourby M, Gowans H, Coy S, Kaye J. Governance of research consortia: challenges of implementing Responsible Research and Innovation within Europe. LIFE SCIENCES, SOCIETY AND POLICY 2020; 16:13. [PMID: 33190636 PMCID: PMC7667809 DOI: 10.1186/s40504-020-00109-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 10/27/2020] [Indexed: 06/11/2023]
Abstract
Responsible Research and Innovation ('RRI') is a cross-cutting priority for scientific research in the European Union and beyond. This paper considers whether the way such research is organised and delivered lends itself to the aims of RRI. We focus particularly on international consortia, which have emerged as a common model to organise large-scale, multi-disciplinary research in contemporary biomedical science. Typically, these consortia operate through fixed-term contracts, and employ governance frameworks consisting of reasonably standard, modular components such as management committees, advisory boards, and data access committees, to co-ordinate the activities of partner institutions and align them with funding agency priorities. These have advantages for organisation and management of the research, but can actively inhibit researchers seeking to implement RRI activities. Conventional consortia governance structures pose specific problems for meaningful public and participant involvement, data sharing, transparency, and 'legacy' planning to deal with societal commitments that persist beyond the duration of the original project. In particular, the 'upstream' negotiation of contractual terms between funders and the institutions employing researchers can undermine the ability for those researchers to subsequently make decisions about data, or participant remuneration, or indeed what happens to consortia outputs after the project is finished, and can inhibit attempts to make project activities and goals responsive to input from ongoing dialogue with various stakeholders. Having explored these challenges, we make some recommendations for alternative consortia governance structures to better support RRI in future.
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Affiliation(s)
- Michael Morrison
- Centre for Health, Law, and Emerging Technologies (HeLEX), Faculty of Law, University of Oxford, Oxford, UK
| | - Miranda Mourby
- Centre for Health, Law, and Emerging Technologies (HeLEX), Faculty of Law, University of Oxford, Oxford, UK
| | - Heather Gowans
- Centre for Health, Law, and Emerging Technologies (HeLEX), Faculty of Law, University of Oxford, Oxford, UK
| | - Sarah Coy
- Centre for Health, Law, and Emerging Technologies (HeLEX), Faculty of Law, University of Oxford, Oxford, UK
| | - Jane Kaye
- Centre for Health, Law, and Emerging Technologies (HeLEX), Faculty of Law, University of Oxford, Oxford, UK
- Melbourne Law School, University of Melbourne, Melbourne, Australia
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Chawinga WD, Zinn S. Research data management at an African medical university: Implications for academic librarianship. JOURNAL OF ACADEMIC LIBRARIANSHIP 2020. [DOI: 10.1016/j.acalib.2020.102161] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Chawinga WD, Zinn S. Research data management at a public university in Malawi: the role of “three hands”. LIBRARY MANAGEMENT 2020. [DOI: 10.1108/lm-03-2020-0042] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeConsidering that research data is increasingly hailed as an important raw material for current and future science discoveries, many research stakeholders have joined forces to create mechanisms for preserving it. However, regardless of generating rich research data, Africa lags behind in research data management thereby potentially losing most of this valuable data. Therefore, this study was undertaken to investigate the research data management practices at a Malawian public university with the aim to recommend appropriate data management strategies.Design/methodology/approachThe study is inspired by the pragmatic school of thought thereby adopting quantitative and qualitative research approaches. Quantitative data was collected using a questionnaire from 150 researchers and 25 librarians while qualitative data was collected by conducting an interview with the Director of Research.FindingsResearchers are actively involved in research activities thereby generating large quantities of research data. Although researchers are willing to share their data, only a handful follow through. Data preservation is poor because the university uses high risk data storage facilities, namely personal computers, flash disks, emails and external hard drives. Researchers and librarians lacked core research data-management competencies because of the lack of formal and information training opportunities. Challenges that frustrate research data-management efforts are many but the key ones include absence of research data management policies, lack of incentives, lack of skills and unavailability of data infrastructure.Research limitations/implicationsThe study's findings are based on one out of four public universities in the country; hence, the findings may not adequately address the status of research data management practices in the other universities.Practical implicationsConsidering that the university under study and its counterparts in Malawi and Africa in general operate somewhat in a similar economic and technological environment, these findings could be used as a reference point for other universities intending to introduce research data management initiatives.Originality/valueWith seemingly limited studies about research data management in Africa and particularly in Malawi, the study sets the tone for research data management debates and initiatives in the country and other African countries.
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Lensink MA, Jongsma KR, Boers SN, Noordhoek JJ, Beekman JM, Bredenoord AL. Responsible use of organoids in precision medicine: the need for active participant involvement. Development 2020; 147:147/7/dev177972. [DOI: 10.1242/dev.177972] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
ABSTRACT
Organoids are three-dimensional multicellular structures grown in vitro from stem cells and which recapitulate some organ function. They are derivatives of living tissue that can be stored in biobanks for a multitude of research purposes. Biobank research on organoids derived from patients is highly promising for precision medicine, which aims to target treatment to individual patients. The dominant approach for protecting the interests of biobank participants emphasizes broad consent in combination with privacy protection and ex ante (predictive) ethics review. In this paradigm, participants are positioned as passive donors; however, organoid biobanking for precision medicine purposes raises challenges that we believe cannot be adequately addressed without more ongoing involvement of patient-participants. In this Spotlight, we argue why a shift from passive donation towards more active involvement is particularly crucial for biobank research on organoids aimed at precision medicine, and suggest some approaches appropriate to this context.
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Affiliation(s)
- Michael A. Lensink
- Department of Medical Humanities, University Medical Center Utrecht, Utrecht University, PO Box 85500, 3508 GA Utrecht, The Netherlands
| | - Karin R. Jongsma
- Department of Medical Humanities, University Medical Center Utrecht, Utrecht University, PO Box 85500, 3508 GA Utrecht, The Netherlands
| | - Sarah N. Boers
- Department of Medical Humanities, University Medical Center Utrecht, Utrecht University, PO Box 85500, 3508 GA Utrecht, The Netherlands
| | - Jacquelien J. Noordhoek
- Dutch Cystic Fibrosis Foundation (NCFS), Dr. A. Schweitzerweg 3A, 3744 MG Baarn, The Netherlands
| | - Jeffrey M. Beekman
- Department of Pediatric Pulmonology, Wilhelmina Children's Hospital, Regenerative Medicine Center, University Medical Center, Internal post KH.01.419.0, P.O. Box 85090, 3508 AB Utrecht, The Netherlands
| | - Annelien L. Bredenoord
- Department of Medical Humanities, University Medical Center Utrecht, Utrecht University, PO Box 85500, 3508 GA Utrecht, The Netherlands
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Petersen C. User-focused data sharing agreements: a foundation for the genomic future. JAMIA Open 2020; 2:402-406. [PMID: 32025634 PMCID: PMC6993993 DOI: 10.1093/jamiaopen/ooz043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 06/21/2019] [Accepted: 09/04/2019] [Indexed: 12/30/2022] Open
Abstract
Data sharing agreements that clearly describe what individuals are agreeing to and what responsibilities data stewards will undertake are crucial for the establishment, maintenance, and flourishing of genomic datasets. To optimize genomic data resources, researchers, care professionals, and informaticians must regard system design, user objectives, and environmental considerations through users' eyes, identifying fundamental values on which to build and potential barriers to success that must be avoided. Design of agreements that promote desired data sharing and protect valuable data resources as necessary begins with a review of user interests and concerns. Nontraditional approaches for informed consent (eg, abbreviated informed consent, electronic informed consent, and dynamic consent) can facilitate achievement of data donors' privacy-related goals while making data available to researchers. Transparency in individual-researcher interactions, recognition and accommodation of cultural differences, and identification of shared needs and goals create a foundation for data sharing agreements that work over short and long terms.
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Affiliation(s)
- Carolyn Petersen
- Division of Biomedical Statistics and Informatics, Global Business Solutions, Mayo Clinic, Rochester, Minnesota, USA
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Gregory S, Bunnik EM, Callado AB, Carrie I, De Boer C, Duffus J, Fauria K, Forster S, Gove D, Knezevic I, Laquidain A, Pennetier D, Saunders S, Sparks S, Rice J, Ritchie CW, Milne R. Involving research participants in a pan-European research initiative: the EPAD participant panel experience. RESEARCH INVOLVEMENT AND ENGAGEMENT 2020; 6:62. [PMID: 33088590 PMCID: PMC7566117 DOI: 10.1186/s40900-020-00236-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 10/01/2020] [Indexed: 05/13/2023]
Abstract
BACKGROUND Including participants in patient and public involvement activities is increasingly acknowledged as a key pillar of successful research activity. Such activities can influence recruitment and retention, as well as researcher experience and contribute to decision making in research studies. However, there are few established methodologies of how to set up and manage participant involvement activities. Further, there is little discussion of how to do so when dealing with collaborative projects that run across countries and operate in multiple linguistic and regulatory contexts. METHODS In this paper we describe the set-up, running and experiences of the EPAD participant panel. The EPAD study was a pan-European cohort study with the aim to understand risks for developing Alzheimer's disease and build a readiness cohort for Phase 2 clinical trials. Due to the longitudinal nature of this study, combined with the enrolment of healthy volunteers and those with mild cognitive impairments, the EPAD team highlighted participant involvement as crucial to the success of this project. The EPAD project employed a nested model, with local panels meeting in England, France, Scotland, Spain and The Netherlands, and feeding into a central study panel. The local panels were governed by terms of reference which were adaptable to local needs. RESULTS The impact of the panels has been widespread, and varies from feedback on documentation, to supporting with design of media materials and representation of the project at national and international meetings. CONCLUSIONS The EPAD panels have contributed to the success of the project and the model established is easily transferable to other disease areas investigating healthy or at-risk populations.
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Affiliation(s)
- S. Gregory
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - E. M. Bunnik
- Department of Medical Ethics and Philosophy of Medicine, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - A. B. Callado
- BarcelonaBeta Brain Research Center, Pasqual Maragall Fundation, Barcelona, Spain
| | - I. Carrie
- Centre de Recherche Clinique du Gérontopôle, Toulouse University Hospital, Toulouse, France
| | - C. De Boer
- VUmc Alzheimercentrum, Amsterdam, The Netherlands
| | - J. Duffus
- Participant panel member, Barcelona, Spain
| | - K. Fauria
- BarcelonaBeta Brain Research Center, Pasqual Maragall Fundation, Barcelona, Spain
| | - S. Forster
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - D. Gove
- Alzheimer Europe, Luxembourg, Luxembourg
| | - I. Knezevic
- BarcelonaBeta Brain Research Center, Pasqual Maragall Fundation, Barcelona, Spain
| | | | - D. Pennetier
- Centre de Recherche Clinique du Gérontopôle, Toulouse University Hospital, Toulouse, France
| | - S. Saunders
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - S. Sparks
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - J. Rice
- Participant panel member, Barcelona, Spain
| | - C. W. Ritchie
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - R. Milne
- Institute of Public Health, University of Cambridge, Cambridge, UK
- Society and Ethics Research, Wellcome Genome Campus, Hinxton, UK
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35
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Middleton A, Milne R, Howard H, Niemiec E, Robarts L, Critchley C, Nicol D, Prainsack B, Atutornu J, Vears DF, Smith J, Steed C, Bevan P, Scott ER, Bobe J, Goodhand P, Kleiderman E, Thorogood A, Morley KI. Members of the public in the USA, UK, Canada and Australia expressing genetic exceptionalism say they are more willing to donate genomic data. Eur J Hum Genet 2019; 28:424-434. [PMID: 31784701 PMCID: PMC7080803 DOI: 10.1038/s41431-019-0550-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 10/29/2019] [Accepted: 11/01/2019] [Indexed: 01/01/2023] Open
Abstract
Public acceptance is critical for sharing of genomic data at scale. This paper examines how acceptance of data sharing pertains to the perceived similarities and differences between DNA and other forms of personal data. It explores the perceptions of representative publics from the USA, Canada, the UK and Australia (n = 8967) towards the donation of DNA and health data. Fifty-two percent of this public held ‘exceptionalist’ views about genetics (i.e., believed DNA is different or ‘special’ compared to other types of medical information). This group was more likely to be familiar with or have had personal experience with genomics and to perceive DNA information as having personal as well as clinical and scientific value. Those with personal experience with genetics and genetic exceptionalist views were nearly six times more likely to be willing to donate their anonymous DNA and medical information for research than other respondents. Perceived harms from re-identification did not appear to dissuade publics from being willing to participate in research. The interplay between exceptionalist views about genetics and the personal, scientific and clinical value attributed to data would be a valuable focus for future research.
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Affiliation(s)
- Anna Middleton
- Society and Ethics Research, Connecting Science, Wellcome Genome Campus, Hinxton, CB10 1SA, UK. .,Faculty of Education, University of Cambridge, Cambridge, UK.
| | - Richard Milne
- Society and Ethics Research, Connecting Science, Wellcome Genome Campus, Hinxton, CB10 1SA, UK.,Institute of Public Health, University of Cambridge, Cambridge, UK
| | - Heidi Howard
- Centre for Research Ethics and Bioethics, Uppsala University, Uppsala, Sweden
| | - Emilia Niemiec
- Centre for Research Ethics and Bioethics, Uppsala University, Uppsala, Sweden
| | - Lauren Robarts
- Society and Ethics Research, Connecting Science, Wellcome Genome Campus, Hinxton, CB10 1SA, UK
| | - Christine Critchley
- Department of Statistics and Epidemiology, Swinburne University of Technology, Melbourne, & Centre for Law and Genetics, University of Tasmania, Hobart, TAS, Australia
| | - Dianne Nicol
- Centre for Law and Genetics, University of Tasmania, Hobart, TAS, Australia
| | - Barbara Prainsack
- Department of Political Science, University of Vienna, Vienna, Austria.,Department of Global Health & Social Medicine, King's College London, London, UK
| | - Jerome Atutornu
- Society and Ethics Research, Connecting Science, Wellcome Genome Campus, Hinxton, CB10 1SA, UK.,Faculty of Education, University of Cambridge, Cambridge, UK.,School of Health Sciences, University of Suffolk, Ipswich, UK
| | - Danya F Vears
- Centre for Biomedical Ethics and Law, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium.,Leuven Institute for Human Genomics and Society (LIGAS), KU Leuven, Leuven, Belgium.,Melbourne Law School, University of Melbourne, Parkville, VIC, Australia.,Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - James Smith
- Web Team, Wellcome Sanger Institute, Wellcome Genome Campus, Cambridge, UK
| | - Claire Steed
- Web Team, Wellcome Sanger Institute, Wellcome Genome Campus, Cambridge, UK
| | - Paul Bevan
- Web Team, Wellcome Sanger Institute, Wellcome Genome Campus, Cambridge, UK
| | - Erick R Scott
- Department of Genetics & Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jason Bobe
- Department of Genetics & Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Institute for Next Generation Healthcare, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Peter Goodhand
- Ontario Institute for Cancer Research, MaRS Centre, Toronto, ON, Canada
| | - Erika Kleiderman
- Centre of Genomics and Policy, McGill University, Montreal, QC, Canada
| | - Adrian Thorogood
- Centre of Genomics and Policy, McGill University, Montreal, QC, Canada
| | - Katherine I Morley
- Society and Ethics Research, Connecting Science, Wellcome Genome Campus, Hinxton, CB10 1SA, UK.,Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK.,Centre for Epidemiology and Biostatistics, Melbourne School of Global and Population Health, University of Melbourne, Melbourne, VIC, Australia.,RAND Europe, Cambridge, UK
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36
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Milne R, Morley KI, Howard H, Niemiec E, Nicol D, Critchley C, Prainsack B, Vears D, Smith J, Steed C, Bevan P, Atutornu J, Farley L, Goodhand P, Thorogood A, Kleiderman E, Middleton A. Trust in genomic data sharing among members of the general public in the UK, USA, Canada and Australia. Hum Genet 2019; 138:1237-1246. [PMID: 31531740 PMCID: PMC6874520 DOI: 10.1007/s00439-019-02062-0] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 09/09/2019] [Indexed: 01/08/2023]
Abstract
Trust may be important in shaping public attitudes to genetics and intentions to participate in genomics research and big data initiatives. As such, we examined trust in data sharing among the general public. A cross-sectional online survey collected responses from representative publics in the USA, Canada, UK and Australia (n = 8967). Participants were most likely to trust their medical doctor and less likely to trust other entities named. Company researchers were least likely to be trusted. Low, Variable and High Trust classes were defined using latent class analysis. Members of the High Trust class were more likely to be under 50 years, male, with children, hold religious beliefs, have personal experience of genetics and be from the USA. They were most likely to be willing to donate their genomic and health data for clinical and research uses. The Low Trust class were less reassured than other respondents by laws preventing exploitation of donated information. Variation in trust, its relation to areas of concern about the use of genomic data and potential of legislation are considered. These findings have relevance for efforts to expand genomic medicine and data sharing beyond those with personal experience of genetics or research participants.
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Affiliation(s)
- Richard Milne
- Society and Ethics Research, Connecting Science, Wellcome Genome Campus, Cambridge, UK
- Institute of Public Health, University of Cambridge, Cambridge, UK
| | - Katherine I Morley
- RAND Europe, Cambridge, UK
- National Addiction Centre, King's College London Institute of Psychiatry, Psychology and Neuroscience, London, UK
- Centre for Epidemiology and Biostatistics, Melbourne School of Global and Population Health, The University of Melbourne, Melbourne, Australia
| | - Heidi Howard
- Centre for Research Ethics and Bioethics, Uppsala University, Uppsala, Sweden
| | - Emilia Niemiec
- Centre for Research Ethics and Bioethics, Uppsala University, Uppsala, Sweden
| | - Dianne Nicol
- Centre for Law and Genetics, University of Tasmania, Hobart, Australia
| | - Christine Critchley
- Centre for Law and Genetics, University of Tasmania, Hobart, Australia
- Department of Statistics and Epidemiology, Swinburne University of Technology, Melbourne, Australia
| | - Barbara Prainsack
- Department of Political Science, University of Vienna, Vienna, Austria
- Department of Global Health and Social Medicine, King's College, London, UK
| | - Danya Vears
- Melbourne Law School, University of Melbourne, Parkville, VIC, Australia
- Murdoch Children's Research Institute, Parkville, VIC, Australia
- Department of Public Health and Primary Care, Centre for Biomedical Ethics and Law, KU Leuven, Leuven, Belgium
- Leuven Institute for Human Genomics and Society (LIGAS), KU Leuven, Leuven, Belgium
| | - James Smith
- Web Team, Wellcome Sanger Institute, Wellcome Genome Campus, Cambridge, UK
| | - Claire Steed
- Web Team, Wellcome Sanger Institute, Wellcome Genome Campus, Cambridge, UK
| | - Paul Bevan
- Web Team, Wellcome Sanger Institute, Wellcome Genome Campus, Cambridge, UK
| | - Jerome Atutornu
- Society and Ethics Research, Connecting Science, Wellcome Genome Campus, Cambridge, UK
- School of Health Sciences, University of Suffolk, Ipswich, UK
| | - Lauren Farley
- Society and Ethics Research, Connecting Science, Wellcome Genome Campus, Cambridge, UK
| | - Peter Goodhand
- Ontario Institute for Cancer Research, MaRS Centre, Toronto, ON, Canada
| | - Adrian Thorogood
- Centre of Genomics and Policy, McGill University, Montreal, QC, Canada
| | - Erika Kleiderman
- Centre of Genomics and Policy, McGill University, Montreal, QC, Canada
| | - Anna Middleton
- Society and Ethics Research, Connecting Science, Wellcome Genome Campus, Cambridge, UK.
- Faculty of Education, University of Cambridge, Cambridge, UK.
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37
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Aubry S. The Future of Digital Sequence Information for Plant Genetic Resources for Food and Agriculture. FRONTIERS IN PLANT SCIENCE 2019; 10:1046. [PMID: 31543884 PMCID: PMC6728410 DOI: 10.3389/fpls.2019.01046] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 07/29/2019] [Indexed: 05/27/2023]
Abstract
The recent debates on the legal status of "digital sequence information" (DSI) at the international level could have extensive consequences for the future of agriculture and food security. A large majority of recent advances in biology, medicine, or agriculture were achieved by sharing and mining of freely accessible sequencing data. It is most probably because of the tremendous success of modern genomics and advances of synthetic biology that concerns were raised about possible fair and equitable ways of sharing data. The DSI concept is relatively new, and all concerned parties agreed upon the need for a clear definition. For example, the extent to which DSI understanding is limited only to genetic sequence data has to be clarified. In this paper, I focus on a subset of DSI essential to humankind: the DSI originating from plant genetic resources for food and agriculture (PGRFA). Two international agreements shape the conservation and use of plant genetic resources: the Convention on Biodiversity and the International Treaty for Plant Genetic Resources for Food and Agriculture. In an attempt to mobilize DSI users and producers involved in research, breeding, and conservation, I describe here how the increasing amount of genomic data, information, and studies interact with the existing legal framework at the global level. Using possible scenarios, I will emphasize the complexity of the issues surrounding DSI for PGRFA and propose potential ways forward for developing an inclusive governance and fair use of these genetic resources.
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Affiliation(s)
- Sylvain Aubry
- Department of Plant and Microbial Science, University of Zurich, Zurich, Switzerland
- Section Genetic Resources and Technology, Swiss Federal Office for Agriculture, Bern, Switzerland
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38
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Rothstein MA, Zawati MH, Knoppers BM. Regulatory Landscape of International Direct-to-Participant (DTP) Genomic Research: Time to Untie the Gordian Knot? THE JOURNAL OF LAW, MEDICINE & ETHICS : A JOURNAL OF THE AMERICAN SOCIETY OF LAW, MEDICINE & ETHICS 2019; 47:336-341. [PMID: 31298096 DOI: 10.1177/1073110519857291] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- Mark A Rothstein
- Mark A. Rothstein, J.D., is the Herbert F. Boehl Chair of Law and Medicine and Director, Institute for Bioethics, Health Policy and Law, University of Louisville Schoool of Medicine. Ma'n H. Zawati, Ph.D., is Academic Coordinator of the Centre of Genomics and Policy, and an Associate member of the Biomedical Ethics Unit, McGill University. Bartha Maria Knoppers, Ph.D., is Professor of Medicine and Director of the Centre of Genomics and Policy at McGill University
| | - Ma'n H Zawati
- Mark A. Rothstein, J.D., is the Herbert F. Boehl Chair of Law and Medicine and Director, Institute for Bioethics, Health Policy and Law, University of Louisville Schoool of Medicine. Ma'n H. Zawati, Ph.D., is Academic Coordinator of the Centre of Genomics and Policy, and an Associate member of the Biomedical Ethics Unit, McGill University. Bartha Maria Knoppers, Ph.D., is Professor of Medicine and Director of the Centre of Genomics and Policy at McGill University
| | - Bartha Maria Knoppers
- Mark A. Rothstein, J.D., is the Herbert F. Boehl Chair of Law and Medicine and Director, Institute for Bioethics, Health Policy and Law, University of Louisville Schoool of Medicine. Ma'n H. Zawati, Ph.D., is Academic Coordinator of the Centre of Genomics and Policy, and an Associate member of the Biomedical Ethics Unit, McGill University. Bartha Maria Knoppers, Ph.D., is Professor of Medicine and Director of the Centre of Genomics and Policy at McGill University
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39
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Chawinga WD, Zinn S. Global perspectives of research data sharing: A systematic literature review. LIBRARY & INFORMATION SCIENCE RESEARCH 2019. [DOI: 10.1016/j.lisr.2019.04.004] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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40
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Patient views on research use of clinical data without consent: Legal, but also acceptable? Eur J Hum Genet 2019; 27:841-847. [PMID: 30683927 DOI: 10.1038/s41431-019-0340-6] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 11/27/2018] [Accepted: 12/25/2018] [Indexed: 01/11/2023] Open
Abstract
The research exemption implemented in the new EU General Data Protection Regulation (EU-GDPR) gives member states leeway in determining whether patient consent is required for secondary data use in medical research. However, even though broad consent has become common in data-rich medical research in many EU countries, giving up consent altogether is likely to be controversial. The aim of this study was to examine whether abolishing consent for secondary data use would be acceptable to patients. A questionnaire study was conducted among 700 outpatients of a northern German university hospital to assess their attitude towards use of clinical data for scientific research without consent. There was both strong willingness to give broad consent for secondary data use (468 of 503 responders, 93.0%) and strong approval of abolishing patient consent (n = 381, 75.7%) among study participants. The willingness to give consent was moderately associated with approval of the respective stipulations by the EU-GDPR. In research settings where broad consent is widely accepted (e.g. university hospitals), abolishing consent for secondary research use of clinical data will likely be acceptable to a large majority of patients.
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41
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Ambrosini A, Calabrese D, Avato FM, Catania F, Cavaletti G, Pera MC, Toscano A, Vita G, Monaco L, Pareyson D. The Italian neuromuscular registry: a coordinated platform where patient organizations and clinicians collaborate for data collection and multiple usage. Orphanet J Rare Dis 2018; 13:176. [PMID: 30286784 PMCID: PMC6172847 DOI: 10.1186/s13023-018-0918-z] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Accepted: 09/21/2018] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The worldwide landscape of patient registries in the neuromuscular disease (NMD) field has significantly changed in the last 10 years, with the international TREAT-NMD network acting as strong driver. At the same time, the European Medicines Agency and the large federations of rare disease patient organizations (POs), such as EURORDIS, contributed to a great cultural change, by promoting a paradigm shift from product-registries to patient-centred registries. In Italy, several NMD POs and Fondazione Telethon undertook the development of a TREAT-NMD linked patient registry in 2009, with the referring clinical network providing input and support to this initiative through the years. This article describes the outcome of this joint effort and shares the experience gained. METHODS The Italian NMD registry is based on an informatics technology platform, structured according to the most rigorous legal national and European requirements for management of patient sensitive data. A user-friendly web interface allows both direct patients and clinicians' participation. The platform's design permits expansion to incorporate new modules and new registries, and is suitable of interoperability with other international efforts. RESULTS When the Italian NMD Registry was initiated, an ad hoc legal entity (NMD Registry Association) was devised to manage registries' data. Currently, several disease-specific databases are hosted on the platform. They collect molecular and clinical details of individuals affected by Duchenne or Becker muscular dystrophy, Charcot-Marie-Tooth disease, transthyretin type-familial amyloidotic polyneuropathy, muscle glycogen storage disorders, spinal and bulbar muscular atrophy, and spinal muscular atrophy. These disease-specific registries are at different stage of development, and the NMD Registry itself has gone through several implementation steps to fulfil different technical and governance needs. The new governance model is based on the agreement between the NMD Registry Association and the professional societies representing the Italian NMD clinical network. Overall, up to now the NMD registry has collected data on more than 2000 individuals living with a NMD condition. CONCLUSIONS The Italian NMD Registry is a flexible platform that manages several condition-specific databases and is suitable to upgrade. All stakeholders participate in its management, with clear roles and responsibilities. This governance model has been key to its success. In fact, it favored patient empowerment and their direct participation in research, while also engaging the expert clinicians of the Italian network in the collection of accurate clinical data according to the best clinical practices.
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Affiliation(s)
| | - Daniela Calabrese
- UOC Malattie neurodegenerative e neurometaboliche rare, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | | | | | - Guido Cavaletti
- School of Medicine and Surgery and Experimental Neurology Unit, University of Milano-Bicocca, Monza, Italy
| | - Maria Carmela Pera
- Paediatric Neurology and Centro Clinico Nemo, Catholic University and Policlinico Gemelli, Rome, Italy
| | - Antonio Toscano
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Giuseppe Vita
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Lucia Monaco
- Fondazione Telethon, Via Poerio 14, 20129 Milan, Italy
| | - Davide Pareyson
- UOC Malattie neurodegenerative e neurometaboliche rare, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
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