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Malakar Y, Lacey J, Twine NA, McCrea R, Bauer DC. Balancing the safeguarding of privacy and data sharing: perceptions of genomic professionals on patient genomic data ownership in Australia. Eur J Hum Genet 2024; 32:506-512. [PMID: 36631540 PMCID: PMC11061115 DOI: 10.1038/s41431-022-01273-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 11/09/2022] [Accepted: 12/15/2022] [Indexed: 01/13/2023] Open
Abstract
There are inherent complexities and tensions in achieving a responsible balance between safeguarding patients' privacy and sharing genomic data for advancing health and medical science. A growing body of literature suggests establishing patient genomic data ownership, enabled by blockchain technology, as one approach for managing these priorities. We conducted an online survey, applying a mixed methods approach to collect quantitative (using scale questions) and qualitative data (using open-ended questions). We explored the views of 117 genomic professionals (clinical geneticists, genetic counsellors, bioinformaticians, and researchers) towards patient data ownership in Australia. Data analysis revealed most professionals agreed that patients have rights to data ownership. However, there is a need for a clearer understanding of the nature and implications of data ownership in this context as genomic data often is subject to collective ownership (e.g., with family members and laboratories). This research finds that while the majority of genomic professionals acknowledge the desire for patient data ownership, bioinformaticians and researchers expressed more favourable views than clinical geneticists and genetic counsellors, suggesting that their views on this issue may be shaped by how closely they interact with patients as part of their professional duties. This research also confirms that stronger health system infrastructure is a prerequisite for enabling patient data ownership, which needs to be underpinned by appropriate digital infrastructure (e.g., central vs. decentralised data storage), patient identity ownership (e.g., limited vs. self-sovereign identity), and policy at both federal and state levels.
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Affiliation(s)
- Yuwan Malakar
- Responsible Innovation Future Science Platform, Commonwealth Scientific and Industrial Research Organisation (CSIRO), Brisbane, Queensland, Australia.
| | - Justine Lacey
- Responsible Innovation Future Science Platform, Commonwealth Scientific and Industrial Research Organisation (CSIRO), Brisbane, Queensland, Australia
| | - Natalie A Twine
- Transformational Bioinformatics, Commonwealth Scientific and Industrial Research Organisation (CSIRO), Sydney, Australia
- Applied BioSciences, Faculty of Science and Engineering, Macquarie University, Macquarie Park, Australia
| | - Rod McCrea
- Responsible Innovation Future Science Platform, Commonwealth Scientific and Industrial Research Organisation (CSIRO), Brisbane, Queensland, Australia
| | - Denis C Bauer
- Transformational Bioinformatics, Commonwealth Scientific and Industrial Research Organisation (CSIRO), Sydney, Australia
- Applied BioSciences, Faculty of Science and Engineering, Macquarie University, Macquarie Park, Australia
- Department of Biomedical Sciences, Faculty of Medicine and Health Science, Macquarie University, Macquarie Park, Australia
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2
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Lorenzo D, Esquerda M, Bofarull M, Cusi V, Roig H, Bertran J, Carrera J, Torralba F, Cambra FJ, Vila M, Garriga M, Palau F. The reuse of genetic information in research and informed consent. Eur J Hum Genet 2023; 31:1393-1397. [PMID: 37699995 PMCID: PMC10689789 DOI: 10.1038/s41431-023-01457-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 05/28/2023] [Accepted: 08/31/2023] [Indexed: 09/14/2023] Open
Abstract
Important advances in genetics research have been made in recent years. Such advances have facilitated the availability of huge amounts of genetic information that could potentially be reused beyond the original purpose for which such information was obtained. Any such reuse must meet certain ethical criteria to ensure that the dignity, integrity, and autonomy of the individual from whom that information was obtained are protected. The aim of this paper is to reflect on these criteria through a critical analysis of the literature. To guarantee these values, ethical criteria need to be established in several respects. For instance, the question must be posed whether the information requires special attention and protection (so-called genetic exceptionalism). Another aspect to bear in mind is the most appropriate type of consent to be given by the person involved, on the one hand favouring research and the reuse of genetic information while on the other protecting the autonomy of that person. Finally, there is a need to determine what protection such reuse should have in order to avoid detrimental consequences and protect the rights of the individual. The main conclusions are that genetic information requires special care and protection (genetic exceptionalism) and that broad consent is the most practical and trustworthy type of consent for the reuse of genetic information.
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Affiliation(s)
- David Lorenzo
- Institut Borja de Bioetica, Universitat Ramon Llull, Barcelona, Spain
- EUI San Joan de Deu, Barcelona, Spain
| | - Montse Esquerda
- Institut Borja de Bioetica, Universitat Ramon Llull, Barcelona, Spain.
- Sant Joan de Deu Terres de Lleida, Lleida, Spain.
| | | | - Victoria Cusi
- Institut Borja de Bioetica, Universitat Ramon Llull, Barcelona, Spain
| | - Helena Roig
- Institut Borja de Bioetica, Universitat Ramon Llull, Barcelona, Spain
| | - Joan Bertran
- Institut Borja de Bioetica, Universitat Ramon Llull, Barcelona, Spain
| | - Joan Carrera
- Institut Borja de Bioetica, Universitat Ramon Llull, Barcelona, Spain
| | - Francesc Torralba
- Institut Borja de Bioetica, Universitat Ramon Llull, Barcelona, Spain
| | - Francisco José Cambra
- Institut Borja de Bioetica, Universitat Ramon Llull, Barcelona, Spain
- Hospital Universitari Sant Joan de Déu Barcelona, Barcelona, Spain
| | - Martí Vila
- Institut Borja de Bioetica, Universitat Ramon Llull, Barcelona, Spain
| | - Martina Garriga
- Institut Borja de Bioetica, Universitat Ramon Llull, Barcelona, Spain
| | - Francesc Palau
- Department of Genetic Medicine and Pediatric Institut of Rare Diseases, Hospital Sant Joan de Déu, Barcelona, Spain
- Institut de Recerca Sant Joan de Déu, Barcelona, Spain
- CIBER de Enfermedades Raras, ISCIII, Madrid, Spain
- Division of Pediatrics, University of Barcelona School of Medicine and Health Sciences, Barcelona, Spain
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3
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Abu-Elmagd M, Assidi M, Alrefaei AF, Rebai A. Editorial: Advances in genomic and genetic tools, and their applications for understanding embryonic development and human diseases. Front Cell Dev Biol 2022; 10:1016400. [PMID: 36478744 PMCID: PMC9720382 DOI: 10.3389/fcell.2022.1016400] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 10/04/2022] [Indexed: 10/10/2023] Open
Abstract
Significant advances have been recently made in the development of the genetic and genomic platforms. This has greatly contributed to a better understanding of gene expression and regulation machinery. Consequently, this led to considerable progress in unraveling evidence of the genotype-phenotype correlation between normal/abnormal embryonic development and human disease complexity. For example, advanced genomic tools such as next-generation sequencing, and microarray-based CGH have substantially helped in the identification of gene and copy number variants associated with diseases as well as in the discovery of causal gene mutations. In addition, bioinformatic analysis tools of genome annotation and comparison have greatly aided in data analysis for the interpretation of the genetic variants at the individual level. This has unlocked potential possibilities for real advances toward new therapies in personalized medicine for the targeted treatment of human diseases. However, each of these genomic and bioinformatics tools has its limitations and hence further efforts are required to implement novel approaches to overcome these limitations. It could be possible that the use of more than one platform for genotype-phenotype deep analysis is an effective approach to disentangling the cause and treatment of the disease complexities. Our research topic aimed at deciphering these complexities by shedding some light on the recent applications of the basic and advanced genetic/genomic and bioinformatics approaches. These include studying gene-gene, protein-protein, and gene-environment interactions. We, in addition, aimed at a better understanding of the link between normal/abnormal embryonic development and the cause of human disease induction.
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Affiliation(s)
- Muhammad Abu-Elmagd
- Center of Excellence in Genomic Medicine Research, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mourad Assidi
- Center of Excellence in Genomic Medicine Research, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Abdulmajeed F. Alrefaei
- Department of Biology, Jamoum University College, Umm Al-Qura University, Mecca, Saudi Arabia
| | - Ahmed Rebai
- Centre of Biotechnology of Sfax, University of Sfax, Sfax, Tunisia
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4
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Walker A. Diversity, Profit, Control: An Empirical Study of Industry Employees' Views on Ethics in Private Sector Genomics. AJOB Empir Bioeth 2022; 13:166-178. [PMID: 35435802 PMCID: PMC10194829 DOI: 10.1080/23294515.2022.2063993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
BACKGROUND Large amounts of capital are currently being invested in genomics companies across the "bench to clinic pipeline" - companies which are now shaping the future of biomedicine globally. Understanding the perspectives of people who work in such companies can contribute to shaping this industry in service of just and equitable futures of medicine. METHODS Using in-depth interviews as the primary method, this paper analyzes perspectives on ethical and social issues in private sector genomics expressed by members of the commercial genomics industry in the US. RESULTS Interviewees described a wide range of issues as pressing ethical concerns in commercial genomics. Key themes included concerns about diversity in genetic datasets, data governance and control, and pricing and profits in the industry. However, concern about diversity of datasets was not accompanied by expressions of concern about diversity in the industry workforce. CONCLUSIONS Most interviewees described concerns in the industry that are rather removed from their own work. But along with this "ethical distancing," moral concerns appeared to be the basis for competition amongst companies - to attract both employees and customers. Research in business ethics suggests that expanding moral analysis of one's own work helps improve day to day decision-making in the interest of justice. Opening space for people to examine ethics in their own subsector may provide a means for the private sector genomics industry to become a leader in ethics in the biosciences and a model for equity in our current moment of late capitalism.
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Affiliation(s)
- Alexis Walker
- Department of Medical Humanities and Ethics, Columbia University, New York, NY, USA
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5
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Albalwy F, Brass A, Davies A. A Blockchain-Based Dynamic Consent Architecture to Support Clinical Genomic Data Sharing (ConsentChain): Proof-of-Concept Study. JMIR Med Inform 2021; 9:e27816. [PMID: 34730538 PMCID: PMC8600428 DOI: 10.2196/27816] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 06/15/2021] [Accepted: 07/25/2021] [Indexed: 11/30/2022] Open
Abstract
Background In clinical genomics, sharing of rare genetic disease information between genetic databases and laboratories is essential to determine the pathogenic significance of variants to enable the diagnosis of rare genetic diseases. Significant concerns regarding data governance and security have reduced this sharing in practice. Blockchain could provide a secure method for sharing genomic data between involved parties and thus help overcome some of these issues. Objective This study aims to contribute to the growing knowledge of the potential role of blockchain technology in supporting the sharing of clinical genomic data by describing blockchain-based dynamic consent architecture to support clinical genomic data sharing and provide a proof-of-concept implementation, called ConsentChain, for the architecture to explore its performance. Methods The ConsentChain requirements were captured from a patient forum to identify security and consent concerns. The ConsentChain was developed on the Ethereum platform, in which smart contracts were used to model the actions of patients, who may provide or withdraw consent to share their data; the data creator, who collects and stores patient data; and the data requester, who needs to query and access the patient data. A detailed analysis was undertaken of the ConsentChain performance as a function of the number of transactions processed by the system. Results We describe ConsentChain, a blockchain-based system that provides a web portal interface to support clinical genomic sharing. ConsentChain allows patients to grant or withdraw data requester access and allows data requesters to query and submit access to data stored in a secure off-chain database. We also developed an ontology model to represent patient consent elements into machine-readable codes to automate the consent and data access processes. Conclusions Blockchains and smart contracts can provide an efficient and scalable mechanism to support dynamic consent functionality and address some of the barriers that inhibit genomic data sharing. However, they are not a complete answer, and a number of issues still need to be addressed before such systems can be deployed in practice, particularly in relation to verifying user credentials.
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Affiliation(s)
- Faisal Albalwy
- Department of Computer Science, University of Manchester, Manchester, United Kingdom.,Department of Computer Science, College of Computer Science and Engineering, Taibah University, Madinah, Saudi Arabia.,Division of Informatics, Imaging and Data Sciences, University of Manchester, Manchester, United Kingdom
| | - Andrew Brass
- Department of Computer Science, University of Manchester, Manchester, United Kingdom.,Division of Informatics, Imaging and Data Sciences, University of Manchester, Manchester, United Kingdom
| | - Angela Davies
- Division of Informatics, Imaging and Data Sciences, University of Manchester, Manchester, United Kingdom
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6
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Genetic and epigenetic analyses of panic disorder in the post-GWAS era. J Neural Transm (Vienna) 2020; 127:1517-1526. [PMID: 32388794 PMCID: PMC7578165 DOI: 10.1007/s00702-020-02205-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 05/03/2020] [Indexed: 02/07/2023]
Abstract
Panic disorder (PD) is a common and debilitating neuropsychiatric disorder characterized by panic attacks coupled with excessive anxiety. Both genetic factors and environmental factors play an important role in PD pathogenesis and response to treatment. However, PD is clinically heterogeneous and genetically complex, and the exact genetic or environmental causes of this disorder remain unclear. Various approaches for detecting disease-causing genes have recently been made available. In particular, genome-wide association studies (GWAS) have attracted attention for the identification of disease-associated loci of multifactorial disorders. This review introduces GWAS of PD, followed by a discussion about the limitations of GWAS and the major challenges facing geneticists in the post-GWAS era. Alternative strategies to address these challenges are then proposed, such as epigenome-wide association studies (EWAS) and rare variant association studies (RVAS) using next-generation sequencing. To date, however, few reports have described these analyses, and the evidence remains insufficient to confidently identify or exclude rare variants or epigenetic changes in PD. Further analyses are therefore required, using sample sizes in the tens of thousands, extensive functional annotations, and highly targeted hypothesis testing.
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7
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Dankar FK, Gergely M, Malin B, Badji R, Dankar SK, Shuaib K. Dynamic-informed consent: A potential solution for ethical dilemmas in population sequencing initiatives. Comput Struct Biotechnol J 2020; 18:913-921. [PMID: 32346464 PMCID: PMC7182686 DOI: 10.1016/j.csbj.2020.03.027] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 03/29/2020] [Accepted: 03/30/2020] [Indexed: 01/13/2023] Open
Abstract
While the majority of population-level genome sequencing initiatives claim to follow the principles of informed consent, the requirements for informed consent have not been-well defined in this context. In fact, the implementation of informed consent differs greatly across these initiatives - spanning broad consent, blanket consent, and tiered consent among others. As such, this calls for an investigation into the requirements for consent to be "informed" in the context of population genomics. One particular strategy that claims to be fully informed and to continuously engage participants is called "dynamic consent". Dynamic consent is based on a personalised communication platform that aims to facilitate the consent process. It is oriented to support continuous two-way communication between researchers and participants. In this paper, we analyze the requirements of informed consent in the context of population genomics, review various current implementations of dynamic consent, assess whether they fulfill the requirement of informed consent, and, in turn, enable participants to make autonomous and informed choices on whether or not to participate in research projects.
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Affiliation(s)
- Fida K. Dankar
- College of Information Technology, UAEU, Al-Ain, United Arab Emirates
| | - Marton Gergely
- College of Information Technology, UAEU, Al-Ain, United Arab Emirates
| | - Bradley Malin
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, United States
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, United States
- Department of Electrical Engineering and Computer Science, Vanderbilt University, Nashville, TN, United States
| | | | | | - Khaled Shuaib
- College of Information Technology, UAEU, Al-Ain, United Arab Emirates
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8
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Ahmed E, Shabani M. DNA Data Marketplace: An Analysis of the Ethical Concerns Regarding the Participation of the Individuals. Front Genet 2019; 10:1107. [PMID: 31749843 PMCID: PMC6844291 DOI: 10.3389/fgene.2019.01107] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 10/15/2019] [Indexed: 01/18/2023] Open
Abstract
Personal genomic data and the related health data are valuable resources for both public-funded research, and for-profit entities in development of new drugs, therapies, and diagnostic tests. In order to access to large datasets, pharmaceutical and biotech companies have developed partnerships with public and private entities such as direct-to-consumer genetic testing companies to buy genomic and health related databases collected from research participants and customers. Although individuals mainly support data sharing for research purposes, the for-profit nature of such data sharing raises some questions regarding the rights of the data subjects and fairness in sharing benefits. In response, a new generation of sequencing and data sharing startups such as Nebula Genomics, LunaDNA, and EncrypGen are emerging which aim for leaving the data control in the hands of each individual customer. In particular, such so-called "DNA data marketplaces" allow individuals to receive various types of monetary incentives to sequence their genome and share it with interested commercial parties. This paper aims to provide an exploratory and critical review of the ethical challenges related to establishing such marketplaces for genomic and health data sharing. In the view of the growing number of startups developing such marketplaces, a thorough analysis of the relevant ethical concerns is timely and needed.
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Affiliation(s)
- Eman Ahmed
- Center for Biomedical Ethics and Law, Department of Public Health and Primary Care, University of Leuven, Leuven, Belgium.,Clinical Pharmacology Department, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Mahsa Shabani
- Center for Biomedical Ethics and Law, Department of Public Health and Primary Care, University of Leuven, Leuven, Belgium.,Metamedica, Faculty of Law and Criminology, Ghent University, Ghent, Belgium
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9
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Borry P, Bentzen HB, Budin-Ljøsne I, Cornel MC, Howard HC, Feeney O, Jackson L, Mascalzoni D, Mendes Á, Peterlin B, Riso B, Shabani M, Skirton H, Sterckx S, Vears D, Wjst M, Felzmann H. The challenges of the expanded availability of genomic information: an agenda-setting paper. J Community Genet 2018; 9:103-116. [PMID: 28952070 PMCID: PMC5849701 DOI: 10.1007/s12687-017-0331-7] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Accepted: 09/03/2017] [Indexed: 01/20/2023] Open
Abstract
Rapid advances in microarray and sequencing technologies are making genotyping and genome sequencing more affordable and readily available. There is an expectation that genomic sequencing technologies improve personalized diagnosis and personalized drug therapy. Concurrently, provision of direct-to-consumer genetic testing by commercial providers has enabled individuals' direct access to their genomic data. The expanded availability of genomic data is perceived as influencing the relationship between the various parties involved including healthcare professionals, researchers, patients, individuals, families, industry, and government. This results in a need to revisit their roles and responsibilities. In a 1-day agenda-setting meeting organized by the COST Action IS1303 "Citizen's Health through public-private Initiatives: Public health, Market and Ethical perspectives," participants discussed the main challenges associated with the expanded availability of genomic information, with a specific focus on public-private partnerships, and provided an outline from which to discuss in detail the identified challenges. This paper summarizes the points raised at this meeting in five main parts and highlights the key cross-cutting themes. In light of the increasing availability of genomic information, it is expected that this paper will provide timely direction for future research and policy making in this area.
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Affiliation(s)
- Pascal Borry
- Centre for Biomedical Ethics and Law, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium.
- Leuven Institute for Human Genomics and Society, 3000, Leuven, Belgium.
- Faculty of Medicine, University of Leuven, Leuven, Belgium.
| | - Heidi Beate Bentzen
- Centre for Medical Ethics, Faculty of Medicine, University of Oslo, Oslo, Norway
- Norwegian Research Center for Computers and Law, Faculty of Law, University of Oslo, Oslo, Norway
- Norwegian Cancer Genomics Consortium, Oslo, Norway
| | - Isabelle Budin-Ljøsne
- Norwegian Cancer Genomics Consortium, Oslo, Norway
- Centre for Medical Ethics, Institute of Health and Society, University of Oslo, P.O Box 1130, Blindern, 0318, Oslo, Norway
- Cohort Studies, Norwegian Institute of Public Health, Oslo, Norway
| | - Martina C Cornel
- Department of Clinical Genetics, Section of Community Genetics, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, the Netherlands
| | - Heidi Carmen Howard
- Centre for Research Ethics and Bioethics, Uppsala University, Uppsala, Sweden
| | - Oliver Feeney
- Centre of Bioethical Research and Analysis (COBRA), National University of Ireland (Galway), Galway, Republic of Ireland
| | - Leigh Jackson
- RILD Building, Royal Devon and Exeter Hospital, University of Exeter Medical School, Exeter, UK
| | - Deborah Mascalzoni
- Centre for Research Ethics and Bioethics, Uppsala University, Uppsala, Sweden
- EURAC Research, Bolzano, Italy
| | - Álvaro Mendes
- i3S, Instituto de Investigação e Inovação em Saúde, IBMC-UnIGENe and Centre for Predictive and Preventive Genetics, Universidade do Porto, Porto, Portugal
| | - Borut Peterlin
- Clinical Institute of Medical Genetics, University Medical Center Ljubljana, Šlajmerjeva 4, 1000, Ljubljana, Slovenia
| | - Brigida Riso
- Instituto Universitário de Lisboa (ISCTE-IUL), CIES-IUL, Lisbon, Portugal
| | - Mahsa Shabani
- Centre for Biomedical Ethics and Law, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
- Leuven Institute for Human Genomics and Society, 3000, Leuven, Belgium
| | - Heather Skirton
- Faculty of Health and Human Sciences, University of Plymouth, Drake Circus, Plymouth, PL4 8AA, UK
| | - Sigrid Sterckx
- Bioethics Institute Ghent, Ghent University, Blandijnberg 2, 9000, Ghent, Belgium
| | - Danya 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, 3000, Leuven, Belgium
| | - Matthias Wjst
- Helmholtz Center Munich, National Research Centre for Environmental Health, Institute of Lung Biology and Disease, Munich, Germany
- Institute of Medical Statistics, Epidemiology and Medical Informatics, Technical University Munich, Munich, Germany
| | - Heike Felzmann
- Centre of Bioethical Research and Analysis (COBRA), National University of Ireland (Galway), Galway, Republic of Ireland
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10
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Badalato L, Kalokairinou L, Borry P. Third party interpretation of raw genetic data: an ethical exploration. Eur J Hum Genet 2017; 25:1189-1194. [PMID: 28832567 PMCID: PMC5643961 DOI: 10.1038/ejhg.2017.126] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Revised: 06/10/2017] [Accepted: 07/04/2017] [Indexed: 12/22/2022] Open
Abstract
In the wake of recent regulations targeting direct-to-consumer genetic testing (DTC-GT), an increasing number of websites have emerged that offer consumers alternative means to derive health information from their DTC-GT raw data. While the ethical concerns associated with DTC-GT have been extensively discussed in the literature, the implications of third party interpretation (TPI) websites have remained largely unexplored. Here we sought to describe these services and elucidate their ethical implications in the context of the current DTC-GT debate. We reviewed five popular TPI websites that use SNP-based genomic data to report health-related information: Promethease, Interpretome, LiveWello, Codegen.eu, and Enlis Personal. We found that many of the ethical concerns previously described in DTC-GT also applied to TPI websites, including inadequate informed consent, questionable clinical validity and utility, and lack of medical supervision. However, some concerns about data usage and privacy reported in DTC-GT were less prominent in the five TPI websites we studied: none of them sold or shared user data, and 3/5 sites did not retain data in the long term. In addition, while exaggerated claims and inaccurate advertising have been frequently problematic in DTC-GT, advertising was minimal in the TPI sites we assessed, and 4/5 made no claims of health benefits. Overall, TPI adds a new dimension to the ethical debate surrounding DTC-GT, and awareness of these services will become increasingly important as personal genomics continues to expand. This study constitutes the first detailed ethical analysis of these services, and presents a starting point for further research and ethical reflection.
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Affiliation(s)
- Lauren Badalato
- Department of Genetics, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
- Centre for Biomedical Ethics and Law, Department of Public Health and Primary Care, University of Leuven, Leuven, Belgium
| | - Louiza Kalokairinou
- Centre for Biomedical Ethics and Law, Department of Public Health and Primary Care, University of Leuven, Leuven, Belgium
| | - Pascal Borry
- Centre for Biomedical Ethics and Law, Department of Public Health and Primary Care, University of Leuven, Leuven, Belgium
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11
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Haga SB, Friedman B, Richard G. Considering the Benefits and Risks of Research Participants' Access to Sequence Data. Genet Test Mol Biomarkers 2017; 21:717-721. [PMID: 29045186 DOI: 10.1089/gtmb.2017.0143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The use of sequencing technologies has greatly expanded in both research and clinical settings. The generation of voluminous datasets has raised several issues regarding data sharing and access. Current regulations require clinical laboratories and some research laboratories to provide access to test data, including sequencing data, directly to patients upon request. There is some controversy over whether this access right may be somewhat broader, encompassing research data as well-a question beyond the scope of this article. It is clear that in the research setting, deposition of sequencing data into public or private databases often occurs, although little information exists about the return of data files to research participants (in contrast to the extensive deliberations regarding return of results). Thus, further consideration of the issue of access to data files is warranted as well as more effort to understand both patients' and research participants' use of the data.
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Affiliation(s)
- Susanne B Haga
- 1 Center for Applied Genomics and Precision Medicine, Duke University School of Medicine , Durham, North Carolina
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12
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Riso B, Tupasela A, Vears DF, Felzmann H, Cockbain J, Loi M, Kongsholm NCH, Zullo S, Rakic V. Ethical sharing of health data in online platforms - which values should be considered? LIFE SCIENCES, SOCIETY AND POLICY 2017; 13:12. [PMID: 28825221 PMCID: PMC5563504 DOI: 10.1186/s40504-017-0060-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Accepted: 08/08/2017] [Indexed: 05/12/2023]
Abstract
Intensified and extensive data production and data storage are characteristics of contemporary western societies. Health data sharing is increasing with the growth of Information and Communication Technology (ICT) platforms devoted to the collection of personal health and genomic data. However, the sensitive and personal nature of health data poses ethical challenges when data is disclosed and shared even if for scientific research purposes.With this in mind, the Science and Values Working Group of the COST Action CHIP ME 'Citizen's Health through public-private Initiatives: Public health, Market and Ethical perspectives' (IS 1303) identified six core values they considered to be essential for the ethical sharing of health data using ICT platforms. We believe that using this ethical framework will promote respectful scientific practices in order to maintain individuals' trust in research.We use these values to analyse five ICT platforms and explore how emerging data sharing platforms are reconfiguring the data sharing experience from a range of perspectives. We discuss which types of values, rights and responsibilities they entail and enshrine within their philosophy or outlook on what it means to share personal health information. Through this discussion we address issues of the design and the development process of personal health data and patient-oriented infrastructures, as well as new forms of technologically-mediated empowerment.
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Affiliation(s)
- Brígida Riso
- Instituto Universitário de Lisboa (ISCTE-IUL), Edifício ISCTE, Av. das Forças Armadas, 1649-026 Lisboa, Portugal
| | - Aaro Tupasela
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Danya F. Vears
- Centre for Biomedical Ethics and Law, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
- Leuven Institute for Human Genetics and Society, Leuven, Belgium
| | - Heike Felzmann
- Centre of Bioethical Research and Analysis, Philosophy, School of Humanities, NUI Galway, Galway, Ireland
| | | | - Michele Loi
- Institute of Biomedical Ethics and History of Medicine, University of Zurich, Zurich, Switzerland
- ETH Zürich, Department of Biology, Institute of Molecular Systems Biology, Zürich, Switzerland
| | | | - Silvia Zullo
- Department of Legal Studies, CIRSFID, University of Bologna, Bologna, Italy
| | - Vojin Rakic
- Centre for the Study of Bioethics, University of Belgrade, Belgrade, Serbia
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13
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Budin-Ljøsne I, Teare HJA, Kaye J, Beck S, Bentzen HB, Caenazzo L, Collett C, D'Abramo F, Felzmann H, Finlay T, Javaid MK, Jones E, Katić V, Simpson A, Mascalzoni D. Dynamic Consent: a potential solution to some of the challenges of modern biomedical research. BMC Med Ethics 2017; 18:4. [PMID: 28122615 PMCID: PMC5264333 DOI: 10.1186/s12910-016-0162-9] [Citation(s) in RCA: 155] [Impact Index Per Article: 22.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Accepted: 12/26/2016] [Indexed: 01/04/2023] Open
Abstract
Background Innovations in technology have contributed to rapid changes in the way that modern biomedical research is carried out. Researchers are increasingly required to endorse adaptive and flexible approaches to accommodate these innovations and comply with ethical, legal and regulatory requirements. This paper explores how Dynamic Consent may provide solutions to address challenges encountered when researchers invite individuals to participate in research and follow them up over time in a continuously changing environment. Methods An interdisciplinary workshop jointly organised by the University of Oxford and the COST Action CHIP ME gathered clinicians, researchers, ethicists, lawyers, research participants and patient representatives to discuss experiences of using Dynamic Consent, and how such use may facilitate the conduct of specific research tasks. The data collected during the workshop were analysed using a content analysis approach. Results Dynamic Consent can provide practical, sustainable and future-proof solutions to challenges related to participant recruitment, the attainment of informed consent, participant retention and consent management, and may bring economic efficiencies. Conclusions Dynamic Consent offers opportunities for ongoing communication between researchers and research participants that can positively impact research. Dynamic Consent supports inter-sector, cross-border approaches and large scale data-sharing. Whilst it is relatively easy to set up and maintain, its implementation will require that researchers re-consider their relationship with research participants and adopt new procedures.
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Affiliation(s)
- Isabelle Budin-Ljøsne
- Centre for Medical Ethics, Institute of Health and Society, University of Oslo, Blindern, P.O. Box 1130, NO-0318, Oslo, Norway. .,Norwegian Cancer Genomics Consortium, cancergenomics.no, Oslo, Norway.
| | - Harriet J A Teare
- Centre for Health, Law and Emerging Technologies (HeLEX), Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Jane Kaye
- Centre for Health, Law and Emerging Technologies (HeLEX), Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Stephan Beck
- UCL Cancer Institute, University College London, London, United Kingdom
| | - Heidi Beate Bentzen
- Centre for Medical Ethics, Institute of Health and Society, University of Oslo, Blindern, P.O. Box 1130, NO-0318, Oslo, Norway.,Norwegian Cancer Genomics Consortium, cancergenomics.no, Oslo, Norway.,Norwegian Research Center for Computers and Law, Faculty of Law, University of Oslo, Oslo, Norway
| | | | | | | | - Heike Felzmann
- Centre of Bioethical Research & Analysis, NUI Galway, Galway, Ireland
| | - Teresa Finlay
- Centre for Health, Law and Emerging Technologies (HeLEX), Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Muhammad Kassim Javaid
- NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom
| | - Erica Jones
- UCL Cancer Institute, University College London, London, United Kingdom
| | - Višnja Katić
- School of Medicine, University of Rijeka, Rijeka, Croatia
| | | | - Deborah Mascalzoni
- Centre for Research Ethics and Bioethics, Uppsala University, Uppsala, Sweden.,Centre for Biomedicine, EURAC, Bolzano, Italy
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14
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Kuchinke W, Krauth C, Bergmann R, Karakoyun T, Woollard A, Schluender I, Braasch B, Eckert M, Ohmann C. Legal assessment tool (LAT): an interactive tool to address privacy and data protection issues for data sharing. BMC Med Inform Decis Mak 2016; 16:81. [PMID: 27751180 PMCID: PMC5067915 DOI: 10.1186/s12911-016-0325-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2015] [Accepted: 06/17/2016] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND In an unprecedented rate data in the life sciences is generated and stored in many different databases. An ever increasing part of this data is human health data and therefore falls under data protected by legal regulations. As part of the BioMedBridges project, which created infrastructures that connect more than 10 ESFRI research infrastructures (RI), the legal and ethical prerequisites of data sharing were examined employing a novel and pragmatic approach. METHODS We employed concepts from computer science to create legal requirement clusters that enable legal interoperability between databases for the areas of data protection, data security, Intellectual Property (IP) and security of biosample data. We analysed and extracted access rules and constraints from all data providers (databases) involved in the building of data bridges covering many of Europe's most important databases. These requirement clusters were applied to five usage scenarios representing the data flow in different data bridges: Image bridge, Phenotype data bridge, Personalised medicine data bridge, Structural data bridge, and Biosample data bridge. A matrix was built to relate the important concepts from data protection regulations (e.g. pseudonymisation, identifyability, access control, consent management) with the results of the requirement clusters. An interactive user interface for querying the matrix for requirements necessary for compliant data sharing was created. RESULTS To guide researchers without the need for legal expert knowledge through legal requirements, an interactive tool, the Legal Assessment Tool (LAT), was developed. LAT provides researchers interactively with a selection process to characterise the involved types of data and databases and provides suitable requirements and recommendations for concrete data access and sharing situations. The results provided by LAT are based on an analysis of the data access and sharing conditions for different kinds of data of major databases in Europe. CONCLUSIONS Data sharing for research purposes must be opened for human health data and LAT is one of the means to achieve this aim. In summary, LAT provides requirements in an interactive way for compliant data access and sharing with appropriate safeguards, restrictions and responsibilities by introducing a culture of responsibility and data governance when dealing with human data.
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15
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Rosenstein BS, Capala J, Efstathiou JA, Hammerbacher J, Kerns SL, Kong FMS, Ostrer H, Prior FW, Vikram B, Wong J, Xiao Y. How Will Big Data Improve Clinical and Basic Research in Radiation Therapy? Int J Radiat Oncol Biol Phys 2016; 95:895-904. [PMID: 26797542 PMCID: PMC4864183 DOI: 10.1016/j.ijrobp.2015.11.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Revised: 11/03/2015] [Accepted: 11/04/2015] [Indexed: 12/25/2022]
Abstract
Historically, basic scientists and clinical researchers have transduced reality into data so that they might explain or predict the world. Because data are fundamental to their craft, these investigators have been on the front lines of the Big Data deluge in recent years. Radiotherapy data are complex and longitudinal data sets are frequently collected to track both tumor and normal tissue response to therapy. As basic, translational and clinical investigators explore with increasingly greater depth the complexity of underlying disease processes and treatment outcomes, larger sample populations are required for research studies and greater quantities of data are being generated. In addition, well-curated research and trial data are being pooled in public data repositories to support large-scale analyses. Thus, the tremendous quantity of information produced in both basic and clinical research in radiation therapy can now be considered as having entered the realm of Big Data.
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Affiliation(s)
- Barry S Rosenstein
- Departments of Radiation Oncology, Genetics and Genomic Sciences, Dermatology and Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Radiation Oncology, New York University School of Medicine, New York, New York.
| | - Jacek Capala
- Clinical Radiation Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Jason A Efstathiou
- Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Jeff Hammerbacher
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Sarah L Kerns
- Department of Radiation Oncology, University of Rochester Medical Center, Rochester, New York
| | - Feng-Ming Spring Kong
- Department of Radiation Oncology, GRU Cancer Center and Medical College of Georgia, Georgia Regents University, Augusta, Georgia
| | - Harry Ostrer
- Departments of Pathology and Pediatrics, Albert Einstein College of Medicine, Bronx, New York
| | - Fred W Prior
- Department of Biomedical Informatics, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Bhadrasain Vikram
- Clinical Radiation Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - John Wong
- Department of Radiation Oncology, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Ying Xiao
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania
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16
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Overby CL, Heale B, Aronson S, Cherry JM, Dwight S, Milosavljevic A, Nelson T, Niehaus A, Weaver MA, Ramos EM, Williams MS. Providing Access to Genomic Variant Knowledge in a Healthcare Setting: A Vision for the ClinGen Electronic Health Records Workgroup. Clin Pharmacol Ther 2016; 99:157-60. [PMID: 26418054 PMCID: PMC4724305 DOI: 10.1002/cpt.270] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Accepted: 09/24/2015] [Indexed: 11/10/2022]
Abstract
The Clinical Genome Resource (ClinGen) is a National Institutes of Health (NIH)-funded collaborative program that brings together a variety of projects designed to provide high-quality, curated information on clinically relevant genes and variants. ClinGen's EHR (Electronic Health Record) Workgroup aims to ensure that ClinGen is accessible to providers and patients through EHR and related systems. This article describes the current scope of these efforts and progress to date. The ClinGen public portal can be accessed at www.clinicalgenome.org.
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Affiliation(s)
- C L Overby
- Program for Personalized and Genomic Medicine & Center for Health-related Informatics and Bioimaging, University of Maryland School of Medicine, Baltimore, Maryland, USA
- Genomic Medicine Institute, Geisinger Health System, Danville, Pennsylvania, USA
| | - B Heale
- University of Utah, Salt Lake City, Utah, USA
| | - S Aronson
- Partners HealthCare Personalized Medicine, Cambridge, Massachusetts, USA
| | - J M Cherry
- Stanford University, School of Medicine, Stanford, California, USA
| | - S Dwight
- Stanford University, School of Medicine, Stanford, California, USA
| | | | - T Nelson
- Genomic Medicine Institute, Geisinger Health System, Danville, Pennsylvania, USA
| | - A Niehaus
- National Human Genome Research Institute, National Institutes of Health, Rockville, Maryland, USA
| | - M A Weaver
- American College of Medical Genetics and Genomics, Bethesda, Maryland, USA
| | - E M Ramos
- National Human Genome Research Institute, National Institutes of Health, Rockville, Maryland, USA
| | - M S Williams
- Genomic Medicine Institute, Geisinger Health System, Danville, Pennsylvania, USA
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