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LeBlanc J, Tarling T, Lawrence K, Babinszky S, Dee S, O'Donoghue S, Watson PH. Incorporating Equity, Diversity and Inclusion in a Canadian Biobank. Biopreserv Biobank 2024. [PMID: 38938206 DOI: 10.1089/bio.2024.0032] [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: 06/29/2024] Open
Abstract
Equity, diversity, and inclusion (EDI) is an established concept and is an important issue in health research. It is now recognized that measures to address EDI in research can have a positive impact on the value of health research outputs and health outcomes based on this knowledge. EDI strategies, guidelines, and education and training are now embraced by national research funders and local research organizations. However, these initiatives are very broad and not specific to the field of biobanking. We have, therefore, set out to develop and implement a formal research biobank EDI action plan. This article describes the creation of an EDI action plan that provides an intentional approach to identifying and achieving EDI actions and priorities for our research biobank. The plan is framed by the definitions of EDI and an understanding of the topics, issues, and groups within the EDI field. The plan is founded on a set of guiding principles and delineates three pillars of work that align with team, participant, and researcher domains. The plan identifies a set of 31 actions that are categorized by implementation time frames, in order to positively address EDI issues across these pillars. The completion of these actions will help us to mitigate against bias and enrich our biobanking and research services. Ultimately, our goal is to realize more diverse participation in research supported by our biobank. This would support health research to explore and better understand differences in disease biology and the efficacy of medical treatments across all people.
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Affiliation(s)
- Jodi LeBlanc
- Biobanking and Biospecimen Research Services, Deeley Research Centre, BC Cancer, Victoria, British Columbia, Canada
| | - Tamsin Tarling
- Biobanking and Biospecimen Research Services, Deeley Research Centre, BC Cancer, Victoria, British Columbia, Canada
- Canadian Tissue Repository Network, Vancouver, British Columbia, Canada
| | - Kate Lawrence
- Biobanking and Biospecimen Research Services, Deeley Research Centre, BC Cancer, Victoria, British Columbia, Canada
| | - Sindy Babinszky
- Biobanking and Biospecimen Research Services, Deeley Research Centre, BC Cancer, Victoria, British Columbia, Canada
| | - Simon Dee
- Biobanking and Biospecimen Research Services, Deeley Research Centre, BC Cancer, Victoria, British Columbia, Canada
- Canadian Tissue Repository Network, Vancouver, British Columbia, Canada
| | - Sheila O'Donoghue
- Biobanking and Biospecimen Research Services, Deeley Research Centre, BC Cancer, Victoria, British Columbia, Canada
- Canadian Tissue Repository Network, Vancouver, British Columbia, Canada
| | - Peter H Watson
- Biobanking and Biospecimen Research Services, Deeley Research Centre, BC Cancer, Victoria, British Columbia, Canada
- Canadian Tissue Repository Network, Vancouver, British Columbia, Canada
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Akyüz K, Goisauf M, Martin GM, Mayrhofer MT, Antoniou S, Charalambidou G, Deltas C, Malatras A, Papagregoriou G, Stefanou C, Voutounou M. Risk mapping for better governance in biobanking: the case of biobank.cy. Front Genet 2024; 15:1397156. [PMID: 38948356 PMCID: PMC11211562 DOI: 10.3389/fgene.2024.1397156] [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: 03/06/2024] [Accepted: 05/27/2024] [Indexed: 07/02/2024] Open
Abstract
Introduction: Risk governance is central for the successful and ethical operation of biobanks and the continued social license for being custodians of samples and data. Risks in biobanking are often framed as risks for participants, whereas the biobank's risks are often considered as technical ones. Risk governance relies on identifying, assessing, mitigating and communicating all risks based on technical and standardized procedures. However, within such processes, biobank staff are often involved tangentially. In this study, the aim has been to conduct a risk mapping exercise bringing biobank staff as key actors into the process, making better sense of emerging structure of biobanks. Methods: Based on the qualitative research method of situational analysis as well as the card-based discussion and stakeholder engagement processes, risk mapping was conducted at the biobank setting as an interactive engagement exercise. The analyzed material comprises mainly of moderated group discussions. Results: The findings from the risk mapping activity are framed through an organismic metaphor: the biobank as a growing, living organism in a changing environment, where trust and sustainability are cross-cutting elements in making sense of the risks. Focusing on the situatedness of the dynamics within biobanking activity highlights the importance of prioritizing relations at the core of risk governance and promoting ethicality in the biobanking process by expanding the repertoire of considered risks. Conclusion: With the organismic metaphor, the research brings the diverse group of biobank staff to the central stage for risk governance, highlighting how accounting for such diversity and interdependencies at the biobank setting is a prerequisite for an adaptive risk governance.
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Affiliation(s)
- Kaya Akyüz
- Department of ELSI Services and Research, BBMRI-ERIC, Graz, Austria
| | - Melanie Goisauf
- Department of ELSI Services and Research, BBMRI-ERIC, Graz, Austria
| | | | | | - Stella Antoniou
- Biobank.cy Center of Excellence in Biobanking and Biomedical Research, Nicosia, Cyprus
| | - Georgia Charalambidou
- Biobank.cy Center of Excellence in Biobanking and Biomedical Research, Nicosia, Cyprus
| | - Constantinos Deltas
- Biobank.cy Center of Excellence in Biobanking and Biomedical Research, Nicosia, Cyprus
- University of Cyprus Medical School, Nicosia, Cyprus
| | - Apostolos Malatras
- Biobank.cy Center of Excellence in Biobanking and Biomedical Research, Nicosia, Cyprus
| | - Gregory Papagregoriou
- Biobank.cy Center of Excellence in Biobanking and Biomedical Research, Nicosia, Cyprus
| | - Charalambos Stefanou
- Biobank.cy Center of Excellence in Biobanking and Biomedical Research, Nicosia, Cyprus
| | - Mariel Voutounou
- Biobank.cy Center of Excellence in Biobanking and Biomedical Research, Nicosia, Cyprus
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Rivera-Alcántara JA, Esparza-Hurtado N, Galán-Ramírez GA, Cruz-Bautista I, Mehta R, Aguilar-Salinas CA, Martagon AJ. A systematic review of biobanks in Latin America: Strengths and limitations for biomedical research. Int J Biol Markers 2024; 39:91-106. [PMID: 38613331 DOI: 10.1177/03936155241239672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2024]
Abstract
Biobanks are valuable tools for developing and applying scientific research and international cooperation through the collection of biological materials and their associated data. Systematic research following the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines was conducted in late 2022 in PubMed and Scopus, and generated 17 articles to be reviewed in depth and critically assessed using the Critical Appraisal Skills Programme Checklist due to the limited available data; 12 relevant health organizations and government websites outside of peer-reviewed journals were also included. Our research identified 44 biobanks in Latin America. In general, there is a lack of regulation and legislation guaranteeing the stored materials' quality and institutional collaboration. We believe a consensus needs to be reached regarding the terminology and definitions used for biobanks. The design for informed consent should also be agreed upon to ensure the privacy of the data shared among institutions. In conclusion, in Latin America, there is a clear need for government support in creating specific procedures for biobanks and providing further support for existing biobanks.
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Affiliation(s)
| | | | - Gabriela A Galán-Ramírez
- Escuela de Medicina y Ciencias de la Salud, Tecnologico de Monterrey, Mexico City, Mexico
- Unidad de Investigación de Enfermedades Metabólicas, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Ivette Cruz-Bautista
- Unidad de Investigación de Enfermedades Metabólicas, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Roopa Mehta
- Unidad de Investigación de Enfermedades Metabólicas, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Carlos A Aguilar-Salinas
- Escuela de Medicina y Ciencias de la Salud, Tecnologico de Monterrey, Mexico City, Mexico
- Unidad de Investigación de Enfermedades Metabólicas, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Alexandro J Martagon
- Escuela de Medicina y Ciencias de la Salud, Tecnologico de Monterrey, Mexico City, Mexico
- Unidad de Investigación de Enfermedades Metabólicas, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
- The Institute for Obesity Research, Tecnologico de Monterrey, Monterrey, Mexico
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Brock DJP, Markwalter T, Li L, Venkatesh S, Helms C, Reid A, Zoellner JM. Exploring biorepository donation patterns, experiences, and recommendations: a mixed-methods study among Appalachian adults enrolled in a sugary drink reduction program. Front Public Health 2024; 12:1371768. [PMID: 38784591 PMCID: PMC11111869 DOI: 10.3389/fpubh.2024.1371768] [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: 01/17/2024] [Accepted: 04/23/2024] [Indexed: 05/25/2024] Open
Abstract
Background Under-represented subgroups in biomarker research linked to behavioral health trials may impact the promise of precision health. This mixed methods study examines biorepository donations across an Appalachian sample enrolled in a sugary drink reduction intervention trial. Methods Participants enrolled in the behavioral trial were asked to join an optional biomarker study and were tracked for enrollment and biospecimen returns (stool and/or buccal sample). At 6 months, participants completed a summative interview on decision-making process, experiences collecting samples, and recommendations to encourage biospecimen donation. Return rates were analyzed across demographics (i.e., age, gender, race, education, income, health literacy status, and rurality status) using chi-squares. Qualitative data were content coded with differences compared by biomarker study enrollment and donation choices. Results Of the 249 invited participants, 171 (61%) enrolled, and 63% (n = 157) returned buccal samples and 49% (n = 122) returned stool samples. Metro residing participants were significantly more likely (56%) to return stool samples compared to non-metro (39%) counterparts [x2(1) = 6.61; p = 0.01]. Buccal sample return had a similar trend, 67 and 57%, respectively for metro vs. non-metro [x2(1) = 2.84; p = 0.09]. An additional trend indicated that older (≥40 years) participants were more likely (55%) to donate stool samples than younger (43%) participants [x2(1) = 3.39; p = 0.07]. No other demographics were significantly associated with biospecimen return. Qualitative data indicated that societal (66-81%) and personal (41-51%) benefits were the most reported reasons for deciding to donate one or both samples, whereas mistrust (3-11%) and negative perceptions of the collection process (44-71%) were cited the most by those who declined one or both samples. Clear instructions (60%) and simple collection kits (73%) were donation facilitators while challenges included difficult stool collection kits (16%) and inconveniently located FedEx centers (16%). Recommendations to encourage future biorepository donation were to clarify benefits to science and others (58%), provide commensurate incentives (25%), explain purpose (19%) and privacy protections (20%), and assure ease in sample collection (19%). Conclusion Study findings suggest the need for biomarker research awareness campaigns. Researchers planning for future biomarker studies in medically underserved regions, like Appalachia, may be able to apply findings to optimize enrollment.
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Affiliation(s)
- Donna-Jean P. Brock
- School of Medicine, Public Health Sciences, University of Virginia, Charlottesville, VA, United States
| | - Theresa Markwalter
- School of Medicine, Public Health Sciences, University of Virginia, Charlottesville, VA, United States
| | - Li Li
- School of Medicine, Family Medicine, University of Virginia, Charlottesville, VA, United States
| | - Samyukta Venkatesh
- School of Medicine, Family Medicine, University of Virginia, Charlottesville, VA, United States
| | - Cheyanne Helms
- School of Medicine, Public Health Sciences, University of Virginia, Charlottesville, VA, United States
| | - Annie Reid
- School of Medicine, Public Health Sciences, University of Virginia, Charlottesville, VA, United States
| | - Jamie M. Zoellner
- School of Medicine, Public Health Sciences, University of Virginia, Charlottesville, VA, United States
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Aryal B, Bizhanova Z, Joseph EA, Yin Y, Wagner PL, Dalton E, LaFramboise WA, Bartlett DL, Allen CJ. Navigating Precision Oncology: Insights from an Integrated Clinical Data and Biobank Repository Initiative across a Network Cancer Program. Cancers (Basel) 2024; 16:760. [PMID: 38398150 PMCID: PMC10886699 DOI: 10.3390/cancers16040760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 02/03/2024] [Accepted: 02/07/2024] [Indexed: 02/25/2024] Open
Abstract
Advancing cancer treatment relies on the rapid translation of new scientific discoveries to patient care. To facilitate this, an oncology biobank and data repository program, also referred to as the "Moonshot" program, was launched in 2021 within the Integrated Network Cancer Program of the Allegheny Health Network. A clinical data program (CDP) and biospecimen repository were established, and patient data and blood and tissue samples have been collected prospectively. To date, the study has accrued 2920 patients, predominantly female (61%) and Caucasian (90%), with a mean age of 64 ± 13 years. The most common cancer sites were the endometrium/uterus (12%), lung/bronchus (12%), breast (11%), and colon/rectum (11%). Of patients diagnosed with cancer, 34% were diagnosed at stage I, 25% at stage II, 26% at stage III, and 15% at stage IV. The CDP is designed to support our initiative in advancing personalized cancer research by providing a comprehensive array of patient data, encompassing demographic characteristics, diagnostic details, and treatment responses. The "Moonshot" initiative aims to predict therapy responses and clinical outcomes through cancer-related biomarkers. The CDP facilitates this initiative by fostering data sharing, enabling comparative analyses, and informing the development of novel diagnostic and therapeutic methods.
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Affiliation(s)
- Bibek Aryal
- Allegheny Singer Research Institute, Allegheny Health Network, Pittsburgh, PA 15212, USA; (B.A.); (Z.B.); (E.A.J.); (Y.Y.)
| | - Zhadyra Bizhanova
- Allegheny Singer Research Institute, Allegheny Health Network, Pittsburgh, PA 15212, USA; (B.A.); (Z.B.); (E.A.J.); (Y.Y.)
| | - Edward A. Joseph
- Allegheny Singer Research Institute, Allegheny Health Network, Pittsburgh, PA 15212, USA; (B.A.); (Z.B.); (E.A.J.); (Y.Y.)
| | - Yue Yin
- Allegheny Singer Research Institute, Allegheny Health Network, Pittsburgh, PA 15212, USA; (B.A.); (Z.B.); (E.A.J.); (Y.Y.)
| | - Patrick L. Wagner
- Division of Surgical Oncology, Institute of Surgery, Allegheny Health Network, Pittsburgh, PA 15212, USA;
| | | | | | - David L. Bartlett
- Allegheny Health Network Cancer Institute, Pittsburgh, PA 15212, USA;
| | - Casey J. Allen
- Division of Surgical Oncology, Institute of Surgery, Allegheny Health Network, Pittsburgh, PA 15212, USA;
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He Y, Martin AR. We need more-diverse biobanks to improve behavioural genetics. Nat Hum Behav 2024; 8:197-200. [PMID: 38158402 DOI: 10.1038/s41562-023-01795-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Affiliation(s)
- Yixuan He
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Alicia R Martin
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA.
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA.
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA.
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Lee AR, Koo D, Kim IK, Lee E, Kim HH, Yoo S, Kim JH, Choi EK, Lee HY. Identifying facilitators of and barriers to the adoption of dynamic consent in digital health ecosystems: a scoping review. BMC Med Ethics 2023; 24:107. [PMID: 38041034 PMCID: PMC10693132 DOI: 10.1186/s12910-023-00988-9] [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: 06/07/2023] [Accepted: 11/21/2023] [Indexed: 12/03/2023] Open
Abstract
BACKGROUND Conventional consent practices face ethical challenges in continuously evolving digital health environments due to their static, one-time nature. Dynamic consent offers a promising solution, providing adaptability and flexibility to address these ethical concerns. However, due to the immaturity of the concept and accompanying technology, dynamic consent has not yet been widely used in practice. This study aims to identify the facilitators of and barriers to adopting dynamic consent in real-world scenarios. METHODS This scoping review, conducted in December 2022, adhered to the PRISMA Extension for Scoping Reviews guidelines, focusing on dynamic consent within the health domain. A comprehensive search across Web of Science, PubMed, and Scopus yielded 22 selected articles based on predefined inclusion and exclusion criteria. RESULTS The facilitators for the adoption of dynamic consent in digital health ecosystems were the provision of multiple consent modalities, personalized alternatives, continuous communication, and the dissemination of up-to-date information. Nevertheless, several barriers, such as consent fatigue, the digital divide, complexities in system implementation, and privacy and security concerns, needed to be addressed. This study also investigated current technological advancements and suggested considerations for further research aimed at resolving the remaining challenges surrounding dynamic consent. CONCLUSIONS Dynamic consent emerges as an ethically advantageous method for digital health ecosystems, driven by its adaptability and support for continuous, two-way communication between data subjects and consumers. Ethical implementation in real-world settings requires the development of a robust technical framework capable of accommodating the diverse needs of stakeholders, thereby ensuring ethical integrity and data privacy in the evolving digital health landscape.
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Affiliation(s)
- Ah Ra Lee
- Office of eHealth Research and Business, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Dongjun Koo
- Office of eHealth Research and Business, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
- Interdisciplinary Program in Bioengineering, Seoul National University, Seoul, Republic of Korea
| | - Il Kon Kim
- School of Computer Science & Engineering, College of IT Engineering, Kyungpook National University, Daegu, Republic of Korea
| | - Eunjoo Lee
- College of Nursing, Research Institute of Nursing Science, Kyungpook National University, Daegu, Republic of Korea
| | - Hyun Ho Kim
- Department of Pediatrics, Research Institute of Clinical Medicine, Jeonbuk National University, Jeonju, Republic of Korea
- Biomedical Research Institute of Clinical Medicine, Jeonbuk National University Hospital, Jeonju, Republic of Korea
| | - Sooyoung Yoo
- Office of eHealth Research and Business, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Jeong-Hyun Kim
- Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
- Department of Public Health Medical Services, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
- Institute of Human Behavioral Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea
| | - Eun Kyung Choi
- Department of Medical Humanities and Medical Education, Kyungpook National University School of Medicine, Daegu, Republic of Korea
| | - Ho-Young Lee
- Office of eHealth Research and Business, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
- Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
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Gereis JM, Hetherington K, Robertson EG, Daly R, Donoghoe MW, Ziegler DS, Marshall GM, Lau LMS, Marron JM, Wakefield CE. Parents' and adolescents' perspectives and understanding of information about childhood cancer precision medicine. Cancer 2023; 129:3645-3655. [PMID: 37376781 DOI: 10.1002/cncr.34914] [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: 09/27/2022] [Revised: 03/24/2023] [Accepted: 05/03/2023] [Indexed: 06/29/2023]
Abstract
BACKGROUND Precision medicine is projected to become integral to childhood cancer care. As such, it is essential to support families to understand what precision medicine entails. METHODS A total of 182 parents and 23 adolescent patients participating in Precision Medicine for Children with Cancer (PRISM), an Australian precision medicine clinical trial for high-risk childhood cancer, completed questionnaires after study enrollment (time 0 [T0]). Of the parents, 108 completed a questionnaire and 45 completed an interview following return of precision medicine results (time 1 [T1]). We analyzed the mixed-methods data comprising measures exploring families' perceptions and understanding of PRISM's participant information sheet and consent form (PISCF), and factors associated with understanding. RESULTS Most parents were satisfied with the PISCF, rating it as at least "somewhat" clearly presented (n = 160/175; 91%) and informative (n = 158/175; 90%). Many suggested improvements including the use of clearer language and a more visually engaging format. Parents' actual understanding of precision medicine was low on average, but scores improved between T0 and T1 (55.8/100-60.0/100; p = .012). Parents from culturally and/or linguistically diverse backgrounds (n = 42/177; 25%) had lower actual understanding scores than those from a Western/European background whose first language was English (p = .010). There was little correlation between parents' perceived and actual understanding scores (p = .794; Pearson correlation -0.020; 95% CI, -0.169 to 0.116). Most adolescent patients read the PISCF either "briefly" or "not at all" (70%) and had a perceived understanding score of 63.6/100 on average. CONCLUSIONS Our study revealed gaps in families' understanding of childhood cancer precision medicine. We highlighted areas for potential intervention such as through targeted information resources. PLAIN LANGUAGE SUMMARY Precision medicine is projected to become part of the standard of care for children with cancer. Precision medicine aims to give the right treatment to the right patient and involves several complex techniques, many of which may be challenging to understand. Our study analyzed questionnaire and interview data from parents and adolescent patients enrolled in an Australian precision medicine trial. Findings revealed gaps in families' understanding of childhood cancer precision medicine. Drawing on parents' suggestions and the literature, we make brief recommendations about improving information provision to families, such as through targeted information resources.
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Affiliation(s)
- Jessica M Gereis
- School of Clinical Medicine, UNSW Medicine & Health, UNSW Sydney, Sydney, New South Wales, Australia
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Sydney, Australia
| | - Kate Hetherington
- School of Clinical Medicine, UNSW Medicine & Health, UNSW Sydney, Sydney, New South Wales, Australia
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Sydney, Australia
| | - Eden G Robertson
- School of Clinical Medicine, UNSW Medicine & Health, UNSW Sydney, Sydney, New South Wales, Australia
| | - Rebecca Daly
- School of Clinical Medicine, UNSW Medicine & Health, UNSW Sydney, Sydney, New South Wales, Australia
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Sydney, Australia
| | - Mark W Donoghoe
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Sydney, Australia
- Stats Central, Mark Wainwright Analytical Centre, UNSW Sydney, Sydney, New South Wales, Australia
| | - David S Ziegler
- School of Clinical Medicine, UNSW Medicine & Health, UNSW Sydney, Sydney, New South Wales, Australia
- Kids Cancer Centre, Sydney Children's Hospital, Sydney, Australia
- Children's Cancer Institute, UNSW Sydney, Sydney, Australia
| | - Glenn M Marshall
- Kids Cancer Centre, Sydney Children's Hospital, Sydney, Australia
- Children's Cancer Institute, UNSW Sydney, Sydney, Australia
| | - Loretta M S Lau
- School of Clinical Medicine, UNSW Medicine & Health, UNSW Sydney, Sydney, New South Wales, Australia
- Kids Cancer Centre, Sydney Children's Hospital, Sydney, Australia
- Children's Cancer Institute, UNSW Sydney, Sydney, Australia
| | - Jonathan M Marron
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
- Division of Hematology/Oncology, Boston Children's Hospital, Boston, Massachusetts, USA
- Center for Bioethics, Harvard Medical School, Boston, Massachusetts, USA
| | - Claire E Wakefield
- School of Clinical Medicine, UNSW Medicine & Health, UNSW Sydney, Sydney, New South Wales, Australia
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Sydney, Australia
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9
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Wiertz S. How to Design Consent for Health Data Research? An Analysis of Arguments of Solidarity. Public Health Ethics 2023; 16:261-270. [PMID: 38333768 PMCID: PMC10849178 DOI: 10.1093/phe/phad025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Indexed: 02/10/2024] Open
Abstract
The article discusses the impact different concepts of solidarity can have on debates on models of consent for non-interventional research. It introduces three concepts of solidarity that have been referenced in bioethical debates: a purely descriptive concept, a concept that claims some derivative value for most but not all practices of solidarity, as well as a clearly normative concept where solidarity is tied to justice and taken to ground moral duties. It shows that regarding the rivalling models of study-specific consent, tiered consent and broad consent, the first two concepts can be taken to favour tiered consent while only normative solidarity supports a model of broad consent-or an argument to allow non-interventional research without requiring consent at all. As normative solidarity is tied to considerations of justice, however, the argument appears less straightforward than one might expect: It presupposes that the research contributes to overcoming existing social injustices.
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Affiliation(s)
- Svenja Wiertz
- Department of Medical Ethics and the History of Medicine, University of Freiburg, 79104 Freiburg, Germany. Tel.: +49 (0)761/203-5044; Fax: +49 (0)761/203-5039;
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10
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Lee YH, Thaweethai T, Sheu YH, Feng YCA, Karlson EW, Ge T, Kraft P, Smoller JW. Impact of selection bias on polygenic risk score estimates in healthcare settings. Psychol Med 2023; 53:7435-7445. [PMID: 37226828 DOI: 10.1017/s0033291723001186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
BACKGROUND Hospital-based biobanks are being increasingly considered as a resource for translating polygenic risk scores (PRS) into clinical practice. However, since these biobanks originate from patient populations, there is a possibility of bias in polygenic risk estimation due to overrepresentation of patients with higher frequency of healthcare interactions. METHODS PRS for schizophrenia, bipolar disorder, and depression were calculated using summary statistics from the largest available genomic studies for a sample of 24 153 European ancestry participants in the Mass General Brigham (MGB) Biobank. To correct for selection bias, we fitted logistic regression models with inverse probability (IP) weights, which were estimated using 1839 sociodemographic, clinical, and healthcare utilization features extracted from electronic health records of 1 546 440 non-Hispanic White patients eligible to participate in the Biobank study at their first visit to the MGB-affiliated hospitals. RESULTS Case prevalence of bipolar disorder among participants in the top decile of bipolar disorder PRS was 10.0% (95% CI 8.8-11.2%) in the unweighted analysis but only 6.2% (5.0-7.5%) when selection bias was accounted for using IP weights. Similarly, case prevalence of depression among those in the top decile of depression PRS was reduced from 33.5% (31.7-35.4%) to 28.9% (25.8-31.9%) after IP weighting. CONCLUSIONS Non-random selection of participants into volunteer biobanks may induce clinically relevant selection bias that could impact implementation of PRS in research and clinical settings. As efforts to integrate PRS in medical practice expand, recognition and mitigation of these biases should be considered and may need to be optimized in a context-specific manner.
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Affiliation(s)
- Younga Heather Lee
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Tanayott Thaweethai
- Harvard Medical School, Boston, Massachusetts, USA
- Biostatistics Center, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Yi-Han Sheu
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Yen-Chen Anne Feng
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
- Analytic and Translational Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
- Division of Biostatistics and Data Science, Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan
| | - Elizabeth W Karlson
- Harvard Medical School, Boston, Massachusetts, USA
- Division of Rheumatology, Immunity, and Inflammation, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Tian Ge
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
- Center for Precision Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Peter Kraft
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Jordan W Smoller
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
- Center for Precision Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
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11
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Oikawa M, Takimoto Y, Akabayashi A. Attitudes of the Public Toward Consent for Biobank Research in Japan. Biopreserv Biobank 2023; 21:518-526. [PMID: 36576410 DOI: 10.1089/bio.2022.0041] [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: 12/29/2022] Open
Abstract
Background: Parallel to the rapid advancement of biological and information technologies, the role and forms of biobank research have been constantly changing. The ethical, legal, and social implications of consent in biobank research are in a state of flux. This study aimed to clarify current Japanese public preferences regarding the consent model and explore how public attitudes are determined. Methods: We conducted an online, population-based quantitative survey among Japanese residents aged between 20 and 69 years. Statistical analyses consisted of univariate and multivariate logistic regression. Results: Of the 1580 respondents, 60.9% preferred autonomy-based consent (specific or dynamic consent) and 23.9% preferred broad-type consent (opt-out or broad consent). Marital status, gender, and privacy concerns were significantly associated with the preference for a consent model. Conclusions: Our results demonstrated the public's current preference for autonomy-based consent, including dynamic consent. However, our findings also revealed that approximately half of the respondents considered broad consent as somewhat preferable.
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Affiliation(s)
- Masanori Oikawa
- Uehiro Research Division for iPS Cell Ethics, Center for iPS Cell Research and Application, Kyoto University, Kyoto, Japan
| | - Yoshiyuki Takimoto
- Department of Biomedical Ethics, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Akira Akabayashi
- Department of Biomedical Ethics, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
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12
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Soares GH, Hedges J, Sethi S, Poirier B, Jamieson L. From biocolonialism to emancipation: considerations on ethical and culturally respectful omics research with indigenous Australians. MEDICINE, HEALTH CARE, AND PHILOSOPHY 2023; 26:487-496. [PMID: 37171744 PMCID: PMC10425494 DOI: 10.1007/s11019-023-10151-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/04/2023] [Indexed: 05/13/2023]
Abstract
As part of a (bio)colonial project, the biological information of Indigenous Peoples has historically been under scientific scrutiny, with very limited benefits for communities and donors. Negative past experiences have contributed to further exclude Indigenous communities from novel developments in the field of omics research. Over the past decade, new guidelines, reflections, and projects of genetic research with Indigenous Peoples have flourished in Australia, providing opportunities to move the field into a place of respect and ethical relationships. This review explores the ethical and cultural implications of the use of biological samples from Indigenous communities in biomedical research. A structured framework outlining emerging topics of interest for the development of respectful omics research partnerships with Indigenous Australians is presented. This paper highlights aspects related to Indigenous governance, community and individual consent, respectful handling of biological samples, data management, and communication in order to protect Indigenous interests and rights and to promote communities' autonomy.
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Affiliation(s)
- Gustavo H Soares
- Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide, SA, Australia.
| | - Joanne Hedges
- Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide, SA, Australia
| | - Sneha Sethi
- Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide, SA, Australia
| | - Brianna Poirier
- Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide, SA, Australia
| | - Lisa Jamieson
- Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide, SA, Australia
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13
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Caroline D, Marie-France M. Get this thing out of my body! Factors determining consent for translational oncology research: a qualitative research. J Transl Med 2023; 21:336. [PMID: 37211597 DOI: 10.1186/s12967-023-04039-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 03/05/2023] [Indexed: 05/23/2023] Open
Abstract
BACKGROUND Depending on the needs of scientific research at a given time, biobanks make biological samples and data available to researchers. In this article, we aim to describe the reasons and underlying logic that determine the decision to grant or deny consent to the conservation of tumour samples in a biological resource platform for research purposes. We make use of the CARPEM biological resource platform model, where broad consent is required. METHODS The results are based on semi-structured interviews, conducted between 2019 and 2021, with 25 individuals having various profiles. RESULTS All the people interviewed readily accepted the principle of conserving a tumour sample for research purposes. They explained their decision by citing the desire to participate in research dedicated to improving therapeutic medicine. Their trust in research institutions or in doctors was an important factor in their consent. The tumorous nature of the samples also played an important role, as did the absence of constraints. Finally, the high level of consent was also based on the difficulty they had in conceiving what the future risks might be once the sample had been taken, whereas the fact that they did not know the nature or purpose of the research to be carried out when they signed the consent form posed some problems. These results stem from a lack of a culture of ethics among the people interviewed. CONCLUSION The information provided in the context of consent at the CARPEM tumour bank seems inadequate for consent to be considered 'informed', given the low level of knowledge that people have of the risks and issues. Information is missing even though we feel it would not change consent or only marginally. This raises questions, since part of the act of granting consent is based on the implicit trust French people have in the hospital that collects the data and in research practices in general. In the minds of those who participate, transparency is the ground on which trust rests. Lack of transparency could be deleterious for future research practices. However, it is not by striving to improve information leaflets that the consent-related information will improve but, rather, by more effectively helping future patients to assimilate that information.
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Affiliation(s)
- Desprès Caroline
- Centre de Recherche des Cordeliers, Sorbonne Université, Université Paris Cité, Inserm, Laboratoire Êtres, Unité Fonctionnelle d'Éthique Médicale, Hôpital Necker-Enfants Malades, APHP, Paris, France.
| | - Mamzer Marie-France
- Centre de Recherche des Cordeliers, Sorbonne Université, Université Paris Cité, Inserm, Laboratoire Êtres, Unité Fonctionnelle d'Éthique Médicale, Hôpital Necker-Enfants Malades, APHP, Paris, France
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14
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Vest A, Sonn B, Puls R, Arnold C, Devney Z, Ahmed A, Pallisard O, Monte AA. Characteristics of Emergency Medicine Specimen Bank Participants Compared to the Overall Emergency Department Population. West J Emerg Med 2023; 24:312-321. [PMID: 36976586 PMCID: PMC10047721 DOI: 10.5811/westjem.2022.11.57981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 11/14/2022] [Indexed: 03/29/2023] Open
Abstract
INTRODUCTION Biorepositories lack diversity both demographically and with regard to the clinical complaints of patients enrolled. The Emergency Medicine Specimen Bank (EMSB) seeks to enroll a diverse cohort of patients for discovery research in acute care conditions. Our objective in this study was to determine the differences in demographics and clinical complaints between participants in the EMSB and the overall emergency department (ED) population. METHODS This was a retrospective analysis of participants of the EMSB and the entire UCHealth at University of Colorado Anschutz Medical Center (UCHealth AMC) ED population across three periods: peri-EMSB; post-EMSB; and COVID-19. We compared patients consented to the EMSB to the entire ED population to determine differences in age, gender, ethnicity, race, clinical complaints, and severity of illness. We used chi-square tests to compare categorical variables and the Elixhauser Comorbidity Index to determine differences in the severity of illness between the groups. RESULTS Between February 5, 2018-January 29, 2022, there were 141,670 consented encounters in the EMSB, representing 40,740 unique patients and over 13,000 blood samples collected. In that same time, the ED saw approximately 188,402 unique patients for 387,590 encounters. The EMSB had significantly higher rates of participation from the following: patients 18-59 years old (80.3% vs 77.7%); White patients (52.3% vs 47.8%), and women (54.8% vs 51.1%) compared to the overall ED population. The EMSB had lower rates of participation from patients ≥70 years, Hispanic patients, Asian patients, and men. The EMSB population had higher mean comorbidity scores. During the six months after Colorado's first COVID-19 case, the rate of consented patients and samples collected increased. The odds of consent during the COVID-19 study period were 1.32 (95% CI 1.26-1.39), and the odds of sample capture were 2.19 (95% CI 2.0-2.41). CONCLUSION The EMSB is representative of the overall ED population for most demographics and clinical complaints.
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Affiliation(s)
- Alexis Vest
- University of Colorado School of Medicine, Department of Emergency Medicine, Aurora, Colorado
| | - Brandon Sonn
- University of Colorado, Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, Colorado
| | - Richie Puls
- University of Colorado School of Medicine, Department of Emergency Medicine, Aurora, Colorado
| | - Cosby Arnold
- University of Colorado School of Medicine, Department of Emergency Medicine, Aurora, Colorado
| | - Zach Devney
- University of Colorado School of Medicine, Department of Emergency Medicine, Aurora, Colorado
| | - Arwah Ahmed
- University of Colorado School of Medicine, Department of Emergency Medicine, Aurora, Colorado
| | - Olivia Pallisard
- University of Colorado School of Medicine, Department of Emergency Medicine, Aurora, Colorado
| | - Andrew A Monte
- University of Colorado, Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, Colorado
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15
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Lilley CM, Mirza KM. Critical role of pathology and laboratory medicine in the conversation surrounding access to healthcare. JOURNAL OF MEDICAL ETHICS 2023; 49:148-152. [PMID: 33863832 DOI: 10.1136/medethics-2021-107251] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 03/09/2021] [Accepted: 03/21/2021] [Indexed: 06/12/2023]
Abstract
Pathology and laboratory medicine are a key component of a patient's healthcare. From academic care centres, community hospitals, to clinics across the country, pathology data are a crucial component of patient care. But for much of the modern era, pathology and laboratory medicine have been absent from health policy conversations. Though select members in the field have advocated for an enhanced presence of these specialists in policy conversations, little work has been done to thoroughly evaluate the moral and ethical obligations of the pathologist and the role they play in healthcare justice and access to care. In order to make any substantive improvements in access to care, pathology and laboratory medicine must have a seat at the table. Specifically, pathologists and laboratorians can assist in bringing about change through improving clinician test choice, continuing laboratory improvement programmes, promoting just advanced diagnostic distribution, triage testing and be good stewards of healthcare dollars, and recruiting a more robust laboratory workforce. In order to get to that point, much work has to be done in pathology education and the laboratory personnel training pipeline but there also needs to be adjustments at the system level to better involve this invaluable group of specialists in these policy conversations.
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Affiliation(s)
- Cullen M Lilley
- Department of Pathology and Laboratory Medicine, Loyola University Chicago Stritch School of Medicine, Maywood, Illinois, USA
| | - Kamran M Mirza
- Department of Pathology and Laboratory Medicine, Loyola University Chicago Stritch School of Medicine, Maywood, Illinois, USA
- Department of Pathology and Laboratory Medicine, Loyola University Medical Center, Maywood, Illinois, USA
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16
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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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17
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Isaković J, Šerer K, Barišić B, Mitrečić D. Mesenchymal stem cell therapy for neurological disorders: The light or the dark side of the force? Front Bioeng Biotechnol 2023; 11:1139359. [PMID: 36926687 PMCID: PMC10011535 DOI: 10.3389/fbioe.2023.1139359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 02/13/2023] [Indexed: 03/08/2023] Open
Abstract
Neurological disorders are recognized as major causes of death and disability worldwide. Because of this, they represent one of the largest public health challenges. With awareness of the massive burden associated with these disorders, came the recognition that treatment options were disproportionately scarce and, oftentimes, ineffective. To address these problems, modern research is increasingly looking into novel, more effective methods to treat neurological patients; one of which is cell-based therapies. In this review, we present a critical analysis of the features, challenges, and prospects of one of the stem cell types that can be employed to treat numerous neurological disorders-mesenchymal stem cells (MSCs). Despite the fact that several studies have already established the safety of MSC-based treatment approaches, there are still some reservations within the field regarding their immunocompatibility, heterogeneity, stemness stability, and a range of adverse effects-one of which is their tumor-promoting ability. We additionally examine MSCs' mechanisms of action with respect to in vitro and in vivo research as well as detail the findings of past and ongoing clinical trials for Parkinson's and Alzheimer's disease, ischemic stroke, glioblastoma multiforme, and multiple sclerosis. Finally, this review discusses prospects for MSC-based therapeutics in the form of biomaterials, as well as the use of electromagnetic fields to enhance MSCs' proliferation and differentiation into neuronal cells.
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Affiliation(s)
- Jasmina Isaković
- Omnion Research International, Zagreb, Croatia.,Department of Histology and Embryology, University of Zagreb School of Medicine, Zagreb, Croatia
| | - Klara Šerer
- University of Zagreb School of Medicine, Zagreb, Croatia
| | - Barbara Barišić
- University of Zagreb School of Dental Medicine, Zagreb, Croatia
| | - Dinko Mitrečić
- Department of Histology and Embryology, University of Zagreb School of Medicine, Zagreb, Croatia.,Laboratory for Stem Cells, Croatian Institute for Brain Research, University of Zagreb School of Medicine, Zagreb, Croatia
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18
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Mascalzoni D, Melotti R, Pattaro C, Pramstaller PP, Gögele M, De Grandi A, Biasiotto R. Ten years of dynamic consent in the CHRIS study: informed consent as a dynamic process. Eur J Hum Genet 2022; 30:1391-1397. [PMID: 36064788 PMCID: PMC9441838 DOI: 10.1038/s41431-022-01160-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 06/13/2022] [Accepted: 07/14/2022] [Indexed: 11/30/2022] Open
Abstract
The Cooperative Health Research in South Tyrol (CHRIS) is a longitudinal study in Northern Italy, using dynamic consent since its inception in 2011. The CHRIS study collects health data and biosamples for research, and foresees regular follow-ups over time. We describe the experience with the CHRIS study dynamic consent, providing an overview of its conceptualization and implementation, and of the participant-centered strategies used to assess and improve the process, directly linked to participation and communication. In order to comply with high ethical standards and to allow broadness in the areas of research, CHRIS dynamic consent was conceived as an interactive process: based on a strong governance and an ongoing tailored communication with participants, it aims to promote autonomy and to develop a trust-based engaged relationship with participants, also relevant for retention. Built within an online platform, the consent allows granular choices, which can be changed over time. In a process of co-production, participants views have been investigated and kept into account in policy development. Participants showed a high degree of participation, thus enabling the consolidation of the CHRIS resources. Even though a low change rate was reported in the baseline, participants valued the possibility of changing their informed consent choices. Communication (language-tailored, ongoing, multimedia) was important for participants, and for participation and retention. In our experience, dynamic consent was proven to be a flexible consent model, which allowed to meet ethical and legal standards for participation in research, and to accommodate participants' and researchers' needs.
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Affiliation(s)
- Deborah Mascalzoni
- grid.511439.bInstitute for Biomedicine, Eurac Research, Affiliated Institute of the University of Lübeck, Bolzano, Italy ,grid.8993.b0000 0004 1936 9457Center for Research Ethics and Bioethics, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Roberto Melotti
- grid.511439.bInstitute for Biomedicine, Eurac Research, Affiliated Institute of the University of Lübeck, Bolzano, Italy
| | - Cristian Pattaro
- grid.511439.bInstitute for Biomedicine, Eurac Research, Affiliated Institute of the University of Lübeck, Bolzano, Italy
| | - Peter Paul Pramstaller
- grid.511439.bInstitute for Biomedicine, Eurac Research, Affiliated Institute of the University of Lübeck, Bolzano, Italy
| | - Martin Gögele
- grid.511439.bInstitute for Biomedicine, Eurac Research, Affiliated Institute of the University of Lübeck, Bolzano, Italy
| | - Alessandro De Grandi
- grid.511439.bInstitute for Biomedicine, Eurac Research, Affiliated Institute of the University of Lübeck, Bolzano, Italy
| | - Roberta Biasiotto
- Institute for Biomedicine, Eurac Research, Affiliated Institute of the University of Lübeck, Bolzano, Italy. .,Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.
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19
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Goncharov L, Suominen H, Cook M. Dynamic consent and personalised medicine. Med J Aust 2022; 216:547-549. [PMID: 35611469 PMCID: PMC9544476 DOI: 10.5694/mja2.51555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 02/09/2022] [Accepted: 02/16/2022] [Indexed: 11/17/2022]
Affiliation(s)
- Liza Goncharov
- Institute for Communication in Health Care Australian National University Canberra ACT
| | - Hanna Suominen
- Australian National University Canberra ACT
- University of Turku Turku Finland
| | - Matthew Cook
- Australian National University Canberra ACT
- Canberra Health Services Canberra ACT
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20
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Wiertz S, Boldt J. Evaluating models of consent in changing health research environments. MEDICINE, HEALTH CARE AND PHILOSOPHY 2022; 25:269-280. [PMID: 35286521 PMCID: PMC9135890 DOI: 10.1007/s11019-022-10074-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 02/11/2022] [Accepted: 02/14/2022] [Indexed: 11/30/2022]
Abstract
While Specific Informed Consent has been the established standard for obtaining consent for medical research for many years, it does not appear suitable for large-scale biobank and health data research. Thus, alternative forms of consent have been suggested, based on a variety of ethical background assumptions. This article identifies five main ethical perspectives at stake. Even though Tiered Consent, Dynamic Consent and Meta Consent are designed to the demands of the self-determination perspective as well as the perspective of research as a public good, they are still also criticized from both perspectives. In addition, criticisms based on concerns of justice, participation and democratic deliberation, and relational concerns have been levelled at each of the models. As all of these perspectives have valid points to make, the task at hand lies in balancing these ethical perspectives. What constitutes an adequate balancing depends on contextual factors. These factors include digital infrastructure and digital literacy, data safety regulation, good scientific and clinical practice, transparent debates on ethically relevant features of research, social inequalities, anti-discrimination laws and practices, trust in health care institutions and recognition of patient preferences, and consensus on unethical research. We argue that the role of context in determining acceptable models of consent puts the ethical importance of models of consent into perspective. Since altering contextual factors can help to live up to the ethical concerns at stake in debates about models of consent, opting for such a shift of focus comes without ethical loss.
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Affiliation(s)
- Svenja Wiertz
- Department of Medical Ethics and the History of Medicine, University of Freiburg, Stefan-Meier-Str. 26, 79104 Freiburg, Germany
| | - Joachim Boldt
- Department of Medical Ethics and the History of Medicine, University of Freiburg, Stefan-Meier-Str. 26, 79104 Freiburg, Germany
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21
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Treff NR, Savulescu J, de Melo-Martín I, Shulman LP, Feinberg EC. Should preimplantation genetic testing for polygenic disease be offered to all - or none? Fertil Steril 2022; 117:1162-1167. [PMID: 35513906 DOI: 10.1016/j.fertnstert.2022.03.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 03/29/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Nathan R Treff
- Genomic Prediction Inc., North Brunswick, New Jersey; Department of Obstetrics Gynecology and Reproductive Sciences, Rutgers University, New Brunswick, New Jersey
| | - Julian Savulescu
- Oxford Uehiro Centre for Practical Ethics, Faculty of Philosophy, University of Oxford, Oxford, United Kingdom; Biomedical Ethics Research Group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia; Melbourne Law School, University of Melbourne, Melbourne, Victoria, Australia
| | | | - Lee P Shulman
- Feinberg School of Medicine-Northwestern University, Chicago, Illinois; Reproductive Genetics Innovations, Chicago, Illinois
| | - Eve C Feinberg
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
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22
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Kissler K, Breman RB, Carlson N, Tilden E, Erickson E, Phillippi J. Innovations in Prospective Perinatal Research as a Result Of the COVID-19 Pandemic. J Midwifery Womens Health 2022; 67:264-269. [PMID: 35166432 PMCID: PMC9026651 DOI: 10.1111/jmwh.13329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
In 2020, in‐person research activities were stopped because of the spread of the novel coronavirus, severe acute respiratory syndrome coronavirus 2, and the resulting disease, coronavirus disease 2019. Our collaborative team of nurse and midwife scientists at universities across the United States adapted research activities to continue prospective perinatal research during the pandemic. These adaptations included development of new research techniques and the implementation of previously developed, but underused, strategies to conduct research from a distance. These strategies included online recruitment, virtual enrollment and consent, qualitative data collection via video conferencing, new applications of smart phone technology, wearable biological measurement, and participant self‐collection of biological samples. In addition to allowing research to continue during the pandemic, these innovative strategies may increase access to research for low‐income, rural, and racially diverse pregnant and postpartum populations. Decreased travel requirements, flexible scheduling, wearable devices, and the capacity to self‐collect biologic samples may improve recruitment and the experience of research participation. The rapid implementation of these research strategies has advanced innovation toward wider, more inclusive and increasingly diverse perinatal research access, and many of these strategies will continue to be used and refined.
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Affiliation(s)
- Katherine Kissler
- College of Nursing, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | | | - Nicole Carlson
- Emory University Nell Hodgson Woodruff School of Nursing, Atlanta, Georgia
| | - Ellen Tilden
- Oregon Health and Science University, School of Nursing, Portland, Oregon
| | - Elise Erickson
- Oregon Health and Science University, School of Nursing, Portland, Oregon
| | - Julia Phillippi
- Vanderbilt University School of Nursing, Nashville, Tennessee
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23
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Akyüz K, Chassang G, Goisauf M, Kozera Ł, Mezinska S, Tzortzatou O, Mayrhofer MT. Biobanking and risk assessment: a comprehensive typology of risks for an adaptive risk governance. LIFE SCIENCES, SOCIETY AND POLICY 2021; 17:10. [PMID: 34903285 PMCID: PMC8666836 DOI: 10.1186/s40504-021-00117-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 12/01/2021] [Indexed: 05/03/2023]
Abstract
Biobanks act as the custodians for the access to and responsible use of human biological samples and related data that have been generously donated by individuals to serve the public interest and scientific advances in the health research realm. Risk assessment has become a daily practice for biobanks and has been discussed from different perspectives. This paper aims to provide a literature review on risk assessment in order to put together a comprehensive typology of diverse risks biobanks could potentially face. Methodologically set as a typology, the conceptual approach used in this paper is based on the interdisciplinary analysis of scientific literature, the relevant ethical and legal instruments and practices in biobanking to identify how risks are assessed, considered and mitigated. Through an interdisciplinary mapping exercise, we have produced a typology of potential risks in biobanking, taking into consideration the perspectives of different stakeholders, such as institutional actors and publics, including participants and representative organizations. With this approach, we have identified the following risk types: economic, infrastructural, institutional, research community risks and participant's risks. The paper concludes by highlighting the necessity of an adaptive risk governance as an integral part of good governance in biobanking. In this regard, it contributes to sustainability in biobanking by assisting in the design of relevant risk management practices, where they are not already in place or require an update. The typology is intended to be useful from the early stages of establishing such a complex and multileveled biomedical infrastructure as well as to provide a catalogue of risks for improving the risk management practices already in place.
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Affiliation(s)
- Kaya Akyüz
- BBMRI-ERIC, Graz, Austria.
- Department of Science and Technology Studies, University of Vienna, Vienna, Austria.
| | - Gauthier Chassang
- BBMRI-ERIC, Graz, Austria
- CERPOP, Université de Toulouse, Inserm, Université Paul Sabatier, Toulouse, France
| | - Melanie Goisauf
- BBMRI-ERIC, Graz, Austria
- Department of Science and Technology Studies, University of Vienna, Vienna, Austria
| | | | - Signe Mezinska
- BBMRI-ERIC, Graz, Austria
- Institute of Clinical and Preventive Medicine, University of Latvia, Riga, Latvia
| | - Olga Tzortzatou
- BBMRI-ERIC, Graz, Austria
- Biomedical Research Foundation of the Academy of Athens, Athens, Greece
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24
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Bell J, Prictor M, Davenport L, O'Brien L, Wake M. Digital Mega-Studies as a New Research Paradigm: Governing the Health Research of the Future. J Empir Res Hum Res Ethics 2021; 16:344-355. [PMID: 34498950 DOI: 10.1177/15562646211041492] [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: 11/15/2022]
Abstract
'Digital Mega-Studies' are entirely or extensively digitised, longitudinal, population-scale initiatives, collecting, storing, and making available individual-level research data of different types and from multiple sources, shaped by technological developments and unforeseeable risks over time. The Australian 'Gen V' project exemplifies this new research paradigm. In 2019, we undertook a multidisciplinary, multi-stakeholder process to map Digital Mega-Studies' key characteristics, legal and governance challenges and likely solutions. We conducted large and small group processes within a one-day symposium and directed online synthesis and group prioritisation over subsequent weeks. We present our methods (including elicitation, affinity mapping and prioritisation processes) and findings, proposing six priority governance principles across three areas-data, participation, trust-to support future high-quality, large-scale digital research in health.
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Affiliation(s)
- Jessica Bell
- Melbourne Law School, 90147University of Melbourne, Carlton, Victoria, Australia.,School of Law, 2707University of Warwick, Coventry, West Midlands, UK
| | - Megan Prictor
- Melbourne Law School, 90147University of Melbourne, Carlton, Victoria, Australia
| | - Lauren Davenport
- 34361Murdoch Children's Research Institute, Parkville, Australia
| | - Lynda O'Brien
- 34361Murdoch Children's Research Institute, Parkville, Australia
| | - Melissa Wake
- 34361Murdoch Children's Research Institute, Parkville, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia.,Liggins Institute, 1415University of Auckland, Auckland, New Zealand
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25
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Pirastu N, Cordioli M, Nandakumar P, Mignogna G, Abdellaoui A, Hollis B, Kanai M, Rajagopal VM, Parolo PDB, Baya N, Carey CE, Karjalainen J, Als TD, Van der Zee MD, Day FR, Ong KK, Morisaki T, de Geus E, Bellocco R, Okada Y, Børglum AD, Joshi P, Auton A, Hinds D, Neale BM, Walters RK, Nivard MG, Perry JRB, Ganna A. Genetic analyses identify widespread sex-differential participation bias. Nat Genet 2021; 53:663-671. [PMID: 33888908 DOI: 10.1101/2020.03.22.001453v1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 03/16/2021] [Indexed: 05/25/2023]
Abstract
Genetic association results are often interpreted with the assumption that study participation does not affect downstream analyses. Understanding the genetic basis of participation bias is challenging since it requires the genotypes of unseen individuals. Here we demonstrate that it is possible to estimate comparative biases by performing a genome-wide association study contrasting one subgroup versus another. For example, we showed that sex exhibits artifactual autosomal heritability in the presence of sex-differential participation bias. By performing a genome-wide association study of sex in approximately 3.3 million males and females, we identified over 158 autosomal loci spuriously associated with sex and highlighted complex traits underpinning differences in study participation between the sexes. For example, the body mass index-increasing allele at FTO was observed at higher frequency in males compared to females (odds ratio = 1.02, P = 4.4 × 10-36). Finally, we demonstrated how these biases can potentially lead to incorrect inferences in downstream analyses and propose a conceptual framework for addressing such biases. Our findings highlight a new challenge that genetic studies may face as sample sizes continue to grow.
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Affiliation(s)
- Nicola Pirastu
- Centre for Global Health Research, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Mattia Cordioli
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
| | | | - Gianmarco Mignogna
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
- Department of Statistics and Quantitative Methods, University of Milano Bicocca, Milan, Italy
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Abdel Abdellaoui
- Department of Psychiatry, Amsterdam Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Benjamin Hollis
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge, UK
- The Kennedy Institute of Rheumatology, University of Oxford, Oxford, UK
| | - Masahiro Kanai
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA, USA
- Department of Statistical Genetics, Osaka University Graduate School of Medicine, Suita, Japan
| | - Veera M Rajagopal
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
- Centre for Genomics and Personalized Medicine, Center for Genimics and Personalized Medice, Aarhus University, Aarhus, Denmark
- Centre for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark
| | | | - Nikolas Baya
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
- Stanley Center for Psychiatric Disease, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Caitlin E Carey
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
- Stanley Center for Psychiatric Disease, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Juha Karjalainen
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Thomas D Als
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
- Centre for Genomics and Personalized Medicine, Center for Genimics and Personalized Medice, Aarhus University, Aarhus, Denmark
- Centre for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark
| | - Matthijs D Van der Zee
- Faculty of Behavioural and Movement Sciences, Biological Psychology, Vrije Universiteit, Amsterdam, the Netherlands
| | - Felix R Day
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge, UK
| | - Ken K Ong
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge, UK
- Department of Paediatrics, University of Cambridge, Cambridge, UK
| | - Takayuki Morisaki
- Division of Molecular Pathology, Institute of Medical Sciences, University of Tokyo, Tokyo, Japan
- BioBank Japan, Institute of Medical Science, University of Tokyo, Tokyo, Japan
- Department of Internal Medicine, Institute of Medical Science, University of Tokyo Hospital, Tokyo, Japan
| | - Eco de Geus
- Faculty of Behavioural and Movement Sciences, Biological Psychology, Vrije Universiteit, Amsterdam, the Netherlands
- Amsterdam Public Health Research institute, Amsterdam, the Netherlands
| | - Rino Bellocco
- Department of Statistics and Quantitative Methods, University of Milano Bicocca, Milan, Italy
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Yukinori Okada
- Department of Statistical Genetics, Osaka University Graduate School of Medicine, Suita, Japan
- Laboratory of Statistical Immunology, World Premier International Immunology Frontier Research Center, Osaka University, Suita, Japan
- Integrated Frontier Research for Medical Science Division, Institute for Open and Transdisciplinary Research Initiatives, Osaka University, Suita, Japan
| | - Anders D Børglum
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
- Centre for Genomics and Personalized Medicine, Center for Genimics and Personalized Medice, Aarhus University, Aarhus, Denmark
- Centre for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark
| | - Peter Joshi
- Centre for Global Health Research, Usher Institute, University of Edinburgh, Edinburgh, UK
| | | | | | - Benjamin M Neale
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
- Stanley Center for Psychiatric Disease, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Raymond K Walters
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
- Stanley Center for Psychiatric Disease, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Michel G Nivard
- Faculty of Behavioural and Movement Sciences, Biological Psychology, Vrije Universiteit, Amsterdam, the Netherlands
- Amsterdam Public Health, Methodology Program, Amsterdam, the Netherlands
- Amsterdam Neuroscience-Mood, Anxiety, Psychosis, Stress & Sleep, Amsterdam, the Netherlands
| | - John R B Perry
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge, UK.
| | - Andrea Ganna
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland.
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA.
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA.
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26
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Pirastu N, Cordioli M, Nandakumar P, Mignogna G, Abdellaoui A, Hollis B, Kanai M, Rajagopal VM, Parolo PDB, Baya N, Carey CE, Karjalainen J, Als TD, Van der Zee MD, Day FR, Ong KK, Morisaki T, de Geus E, Bellocco R, Okada Y, Børglum AD, Joshi P, Auton A, Hinds D, Neale BM, Walters RK, Nivard MG, Perry JRB, Ganna A. Genetic analyses identify widespread sex-differential participation bias. Nat Genet 2021; 53:663-671. [PMID: 33888908 DOI: 10.1038/s41588-021-00846-7] [Citation(s) in RCA: 88] [Impact Index Per Article: 29.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 03/16/2021] [Indexed: 01/22/2023]
Abstract
Genetic association results are often interpreted with the assumption that study participation does not affect downstream analyses. Understanding the genetic basis of participation bias is challenging since it requires the genotypes of unseen individuals. Here we demonstrate that it is possible to estimate comparative biases by performing a genome-wide association study contrasting one subgroup versus another. For example, we showed that sex exhibits artifactual autosomal heritability in the presence of sex-differential participation bias. By performing a genome-wide association study of sex in approximately 3.3 million males and females, we identified over 158 autosomal loci spuriously associated with sex and highlighted complex traits underpinning differences in study participation between the sexes. For example, the body mass index-increasing allele at FTO was observed at higher frequency in males compared to females (odds ratio = 1.02, P = 4.4 × 10-36). Finally, we demonstrated how these biases can potentially lead to incorrect inferences in downstream analyses and propose a conceptual framework for addressing such biases. Our findings highlight a new challenge that genetic studies may face as sample sizes continue to grow.
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Affiliation(s)
- Nicola Pirastu
- Centre for Global Health Research, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Mattia Cordioli
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
| | | | - Gianmarco Mignogna
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland.,Department of Statistics and Quantitative Methods, University of Milano Bicocca, Milan, Italy.,Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Abdel Abdellaoui
- Department of Psychiatry, Amsterdam Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Benjamin Hollis
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge, UK.,The Kennedy Institute of Rheumatology, University of Oxford, Oxford, UK
| | - Masahiro Kanai
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA.,Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA.,Department of Biomedical Informatics, Harvard Medical School, Boston, MA, USA.,Department of Statistical Genetics, Osaka University Graduate School of Medicine, Suita, Japan
| | - Veera M Rajagopal
- Department of Biomedicine, Aarhus University, Aarhus, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark.,Centre for Genomics and Personalized Medicine, Center for Genimics and Personalized Medice, Aarhus University, Aarhus, Denmark.,Centre for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark
| | | | - Nikolas Baya
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA.,Stanley Center for Psychiatric Disease, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Caitlin E Carey
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA.,Stanley Center for Psychiatric Disease, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Juha Karjalainen
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland.,Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA.,Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Thomas D Als
- Department of Biomedicine, Aarhus University, Aarhus, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark.,Centre for Genomics and Personalized Medicine, Center for Genimics and Personalized Medice, Aarhus University, Aarhus, Denmark.,Centre for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark
| | - Matthijs D Van der Zee
- Faculty of Behavioural and Movement Sciences, Biological Psychology, Vrije Universiteit, Amsterdam, the Netherlands
| | - Felix R Day
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge, UK
| | - Ken K Ong
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge, UK.,Department of Paediatrics, University of Cambridge, Cambridge, UK
| | | | | | | | - Takayuki Morisaki
- Division of Molecular Pathology, Institute of Medical Sciences, University of Tokyo, Tokyo, Japan.,BioBank Japan, Institute of Medical Science, University of Tokyo, Tokyo, Japan.,Department of Internal Medicine, Institute of Medical Science, University of Tokyo Hospital, Tokyo, Japan
| | - Eco de Geus
- Faculty of Behavioural and Movement Sciences, Biological Psychology, Vrije Universiteit, Amsterdam, the Netherlands.,Amsterdam Public Health Research institute, Amsterdam, the Netherlands
| | - Rino Bellocco
- Department of Statistics and Quantitative Methods, University of Milano Bicocca, Milan, Italy.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Yukinori Okada
- Department of Statistical Genetics, Osaka University Graduate School of Medicine, Suita, Japan.,Laboratory of Statistical Immunology, World Premier International Immunology Frontier Research Center, Osaka University, Suita, Japan.,Integrated Frontier Research for Medical Science Division, Institute for Open and Transdisciplinary Research Initiatives, Osaka University, Suita, Japan
| | - Anders D Børglum
- Department of Biomedicine, Aarhus University, Aarhus, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark.,Centre for Genomics and Personalized Medicine, Center for Genimics and Personalized Medice, Aarhus University, Aarhus, Denmark.,Centre for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark
| | - Peter Joshi
- Centre for Global Health Research, Usher Institute, University of Edinburgh, Edinburgh, UK
| | | | | | - Benjamin M Neale
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA.,Stanley Center for Psychiatric Disease, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Raymond K Walters
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA.,Stanley Center for Psychiatric Disease, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Michel G Nivard
- Faculty of Behavioural and Movement Sciences, Biological Psychology, Vrije Universiteit, Amsterdam, the Netherlands.,Amsterdam Public Health, Methodology Program, Amsterdam, the Netherlands.,Amsterdam Neuroscience-Mood, Anxiety, Psychosis, Stress & Sleep, Amsterdam, the Netherlands
| | - John R B Perry
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge, UK.
| | - Andrea Ganna
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland. .,Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA. .,Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA.
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27
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Rychnovská D. Anticipatory Governance in Biobanking: Security and Risk Management in Digital Health. SCIENCE AND ENGINEERING ETHICS 2021; 27:30. [PMID: 33881646 PMCID: PMC8058749 DOI: 10.1007/s11948-021-00305-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 04/04/2021] [Indexed: 06/12/2023]
Abstract
Although big-data research has met with multiple controversies in diverse fields, political and security implications of big data in life sciences have received less attention. This paper explores how threats and risks are anticipated and acted on in biobanking, which builds research repositories for biomedical samples and data. Focusing on the biggest harmonisation cluster of biomedical research in Europe, BBMRI-ERIC, the paper analyses different logics of risk in the anticipatory discourse on biobanking. Based on document analysis, interviews with ELSI experts, and field research, three types of framing of risk are reconstructed: data security, privacy, and data misuse. The paper finds that these logics downplay the broader social and political context and reflects on the limits of the practices of anticipatory governance in biobanking. It argues that this regime of governance can make it difficult for biobanks to address possible future challenges, such as access to biomedical data by authorities, pressures for integrating biobank data with other type of personal data, or their use for profiling beyond medical purposes. To address potential controversies and societal implications related to the use of big data in health research and medicine, the paper suggests to expand the vocabulary and practices of anticipatory governance, in the biobanking community and beyond.
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Affiliation(s)
- Dagmar Rychnovská
- Department of International Relations, University of Sussex, Brighton, UK.
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28
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Vears DF, Minion JT, Roberts SJ, Cummings J, Machirori M, Murtagh MJ. Views on genomic research result delivery methods and informed consent: a review. Per Med 2021; 18:295-310. [PMID: 33822658 DOI: 10.2217/pme-2020-0139] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
There has been little discussion of the way genomic research results should be returned and how to obtain informed consent for this. We systematically searched the empirical literature, identifying 63 articles exploring stakeholder perspectives on processes for obtaining informed consent about return of results and/or result delivery. Participants, patients and members of the public generally felt they should choose which results are returned to them and how, ranging from direct (face-to-face, telephone) to indirect (letters, emails, web-based delivery) communication. Professionals identified inadequacies in result delivery processes in the research context. Our findings have important implications for ensuring participants are supported in deciding which results they wish to receive or, if no choice is offered, preparing them for potential research outcomes.
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Affiliation(s)
- Danya F Vears
- Melbourne Law School, University of Melbourne, Carlton 3052, Australia.,Biomedical Ethics Research Group, Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville 3052, Australia.,Center for Biomedical Ethics & Law, Department of Public Health & Primary Care, KU Leuven, Leuven 3000, Belgium.,Leuven Institute for Human Genetics & Society, Leuven 3000, Belgium
| | - Joel T Minion
- Policy, Ethics & Life Sciences (PEALS) Research Centre, Newcastle University, Newcastle NE1 7RU, UK
| | - Stephanie J Roberts
- Policy, Ethics & Life Sciences (PEALS) Research Centre, Newcastle University, Newcastle NE1 7RU, UK
| | - James Cummings
- School of Art, Media & American Studies, University of East Anglia, NR4 7TJ, UK
| | - Mavis Machirori
- School of Social & Political Sciences, University of Glasgow, G12 8QQ, UK
| | - Madeleine J Murtagh
- Policy, Ethics & Life Sciences (PEALS) Research Centre, Newcastle University, Newcastle NE1 7RU, UK.,School of Social & Political Sciences, University of Glasgow, G12 8QQ, UK
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29
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The Andalusian Registry of Donors for Biomedical Research: Five Years of History. BIOTECH 2021; 10:biotech10010006. [PMID: 35822778 PMCID: PMC9245482 DOI: 10.3390/biotech10010006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 03/07/2021] [Accepted: 03/09/2021] [Indexed: 11/17/2022] Open
Abstract
The mission of the Andalusian Public Health System Biobank is to offer the best options for biological samples of human origin and associated clinical information, protecting the rights of citizens who donate their samples for research. Since the Andalusian Biobank provides high-quality biological samples of all types in a specified format, adapting the preanalytical phase according to the requirements of the research, prospective collection and distribution of samples are being prioritized in order to contribute to the sustainability of the Biobank. The Andalusian Registry of Donors for Biomedical Research is a tool for the recruitment of donors and the prospective collection of samples. Its operation is based on the informed consent of donors for their incorporation into the Registry and contact with possible donors under request from specific projects. An additional advantage of this unique initiative is to ensure that societal actors work together throughout the entire research process, establishing alliances with patient associations and groups to develop joint actions and promote biomedical research. Here, we describe the creation, ethical–legal aspects, management and results of the Andalusian Registry of Donors for Biomedical Research after five years of operation.
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30
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Jacquier E, Laurent-Puig P, Badoual C, Burgun A, Mamzer MF. Facing new challenges to informed consent processes in the context of translational research: the case in CARPEM consortium. BMC Med Ethics 2021; 22:21. [PMID: 33653311 PMCID: PMC7927247 DOI: 10.1186/s12910-021-00592-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 02/22/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND In the context of translational research, researchers have increasingly been using biological samples and data in fundamental research phases. To explore informed consent practices, we conducted a retrospective study on informed consent documents that were used for CARPEM's translational research programs. This review focused on detailing their form, their informational content, and the adequacy of these documents with the international ethical principles and participants' rights. METHODS Informed consent forms (ICFs) were collected from CARPEM investigators. A content analysis focused on information related to biological samples and data treatment (context of sampling and collect, aims, reuse, consent renewal), including the type of consent. An automatic assessment of the readability of the ICFs were performed with the IT program "Flesch Score". RESULTS 29 ICFs from 25 of 49 studies were analyzed after selection criteria were applied. Three types of consent were identified: 11 broad consents, six specific consents, and two opt-out consents. The Flesch Scores showed that most of the documents were too complex to be fully understood by most of the potential research participants. Most of the biological samples were collected during the healthcare routine, but the information content about secondary use of biological samples varied between ICFs. All documents mentioned personal data treatment but information about their reuse was not standardized in the ICFs. CONCLUSIONS Our review of current IC procedures of CARPEM showed that practices could be improved considering new translational research methods. "Old fashion written ICFs" should be adapted to the translational research approach, to better respect individual rights and international research ethics principles. In this context, theoretically, a digital tool allowing dynamic information and consent of participants, through an electronic interactive platform may be a good way to promote more active participation in research. Nevertheless, its feasibility in the complex environment of biological samples and data research remains to prove. The way of a combination of a broad consent followed by dynamic information may be alternatively tested.
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Affiliation(s)
- Elise Jacquier
- Centre de Recherche Des Cordeliers (UMRS 1138), INSERM, Sorbonne Université, Université de Paris, Team ETREs, 75006 Paris, France
| | - Pierre Laurent-Puig
- Centre de Recherche Des Cordeliers (UMRS 1138), Team Personalized Medicine, INSERM, Sorbonne Université, Université de Paris, Pharmacogenomics and Therapeutic Optimization, 75006 Paris, France
- Pharmacogénétique Et Oncologie Moléculaire, Hôpital Européen Georges Pompidou, Assistance publique – Hôpitaux de Paris, Paris, France
| | - Cécile Badoual
- Centre de Ressources Biologiques, Service d’anatomo-pathologie, Hôpital Européen Georges Pompidou, Assistance publique – Hôpitaux de Paris, Paris, France
| | - Anita Burgun
- Département D’informatique Médicale, de Biostatistique Et de Santé Publique, Hôpital Européen Georges Pompidou, Assistance publique – Hôpitaux de Paris, Paris, France
- UMR-S 1138, Centre de Recherche Des Cordeliers, Paris, France
- Faculté de Médecine, Université Paris Descartes, Sorbonne Universités, Paris, France
| | - Marie-France Mamzer
- Centre de Recherche Des Cordeliers (UMRS 1138), INSERM, Sorbonne Université, Université de Paris, Team ETREs, 75006 Paris, France
- Unité Fonctionnelle D’éthique Et Médecine Légale, Hôpital Necker-Enfants Maladies, Paris, France
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31
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Wallace SE, Miola J. Adding dynamic consent to a longitudinal cohort study: A qualitative study of EXCEED participant perspectives. BMC Med Ethics 2021; 22:12. [PMID: 33563268 PMCID: PMC7874652 DOI: 10.1186/s12910-021-00583-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 01/31/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Dynamic consent has been proposed as a process through which participants and patients can gain more control over how their data and samples, donated for biomedical research, are used, resulting in greater trust in researchers. It is also a way to respond to evolving data protection frameworks and new legislation. Others argue that the broad consent currently used in biobank research is ethically robust. Little empirical research with cohort study participants has been published. This research investigated the participants' opinions of adding a dynamic consent interface to their existing study. METHODS Adult participants in the Extended Cohort for E-health, Environment and DNA (EXCEED) longitudinal cohort study who are members of the EXCEED Public and Participant Engagement Group were recruited. Four focus groups were conducted and analysed for thematic content. Discussion topics were derived from a review of the current literature on dynamic consent. RESULTS Participants were in favour of many aspects of a dynamic consent interface, such as being able to update their information, add additional data to their records and choose withdrawal options. They were supportive provided it was simple to use and not intrusive. Participants expressed a markedly high level of trust in the study and its investigators and were unanimously happy with their current participation. No strong support was found for adding a dynamic consent interface to EXCEED. CONCLUSIONS Trust in the study researchers was the strongest theme found. Openness and good data security were needed to retain their trust. While happy to discuss dynamic consent, participants were satisfied with the current study arrangements. There were indications that changing the study might unnecessarily disturb their trust. This raised the question of whether there are contexts where dynamic consent is more appropriate than others. This study was limited by the small number of participants who were committed to the study and biased towards it. More research is needed to fully understand the potential impact of adding a dynamic consent interface to an existing cohort study.
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Affiliation(s)
- Susan E Wallace
- Department of Health Sciences, University of Leicester, Leicester, UK.
| | - José Miola
- School of Law, University of Leeds, Leeds, UK
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32
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Haas MA, Teare H, Prictor M, Ceregra G, Vidgen ME, Bunker D, Kaye J, Boughtwood T. 'CTRL': an online, Dynamic Consent and participant engagement platform working towards solving the complexities of consent in genomic research. Eur J Hum Genet 2021; 29:687-698. [PMID: 33408362 PMCID: PMC8115139 DOI: 10.1038/s41431-020-00782-w] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 11/09/2020] [Accepted: 11/18/2020] [Indexed: 11/20/2022] Open
Abstract
The complexities of the informed consent process for participating in research in genomic medicine are well-documented. Inspired by the potential for Dynamic Consent to increase participant choice and autonomy in decision-making, as well as the opportunities for ongoing participant engagement it affords, we wanted to trial Dynamic Consent and to do so developed our own web-based application (web app) called CTRL (control). This paper documents the design and development of CTRL, for use in the Australian Genomics study: a health services research project building evidence to inform the integration of genomic medicine into mainstream healthcare. Australian Genomics brought together a multi-disciplinary team to develop CTRL. The design and development process considered user experience; security and privacy; the application of international standards in data sharing; IT, operational and ethical issues. The CTRL tool is now being offered to participants in the study, who can use CTRL to keep personal and contact details up to date; make consent choices (including indicate preferences for return of results and future research use of biological samples, genomic and health data); follow their progress through the study; complete surveys, contact the researchers and access study news and information. While there are remaining challenges to implementing Dynamic Consent in genomic research, this study demonstrates the feasibility of building such a tool, and its ongoing use will provide evidence about the value of Dynamic Consent in large-scale genomic research programs.
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Affiliation(s)
- Matilda A Haas
- Australian Genomics Health Alliance, Parkville, VIC, Australia. .,Murdoch Children's Research Institute, Parkville, VIC, Australia.
| | - Harriet Teare
- Centre for Health, Law and Emerging Technologies, Faculty of Law, University of Oxford, Oxford, UK
| | - Megan Prictor
- Centre for Health, Law and Emerging Technologies, Melbourne Law School, University of Melbourne, Carlton, VIC, Australia
| | | | - Miranda E Vidgen
- QIMR Berghofer Medical Research Institute, Herston, QLD, Australia.,Queensland Genomics Health Alliance, Herston, QLD, Australia
| | - David Bunker
- Queensland Genomics Health Alliance, Herston, QLD, Australia
| | - Jane Kaye
- Centre for Health, Law and Emerging Technologies, Faculty of Law, University of Oxford, Oxford, UK.,Centre for Health, Law and Emerging Technologies, Melbourne Law School, University of Melbourne, Carlton, VIC, Australia
| | - Tiffany Boughtwood
- Australian Genomics Health Alliance, Parkville, VIC, Australia.,Murdoch Children's Research Institute, Parkville, VIC, Australia
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Rothstein MA. Informed Consent for Secondary Research under the New NIH Data Sharing Policy. THE JOURNAL OF LAW, MEDICINE & ETHICS : A JOURNAL OF THE AMERICAN SOCIETY OF LAW, MEDICINE & ETHICS 2021; 49:489-494. [PMID: 34665099 DOI: 10.1017/jme.2021.69] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The new NIH data sharing policy, effective January 2023, requires researchers to submit a data management and data sharing plan in their grant application. Expanded data sharing, encouraged by NIH to facilitate secondary research, will require informed consent documents to explain data sharing plans, limitations, and procedures.
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Reflections on dynamic consent in biomedical research: the story so far. Eur J Hum Genet 2020; 29:649-656. [PMID: 33249421 PMCID: PMC7695991 DOI: 10.1038/s41431-020-00771-z] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 09/30/2020] [Accepted: 10/22/2020] [Indexed: 12/30/2022] Open
Abstract
Dynamic consent (DC) was originally developed in response to challenges to the informed consent process presented by participants agreeing to ‘future research’ in biobanking. In the past 12 years, it has been trialled in a number of different projects, and examined as a new approach for consent and to support patient engagement over time. There have been significant societal shifts during this time, namely in our reliance on digital tools and the use of social media, as well as a greater appreciation of the integral role of patients in biomedical research. This paper reflects on the development of DC to understand its importance in an age where digital health is becoming the norm and patients require greater oversight and control of how their data may be used in a range of settings. As well as looking back, it looks forwards to consider how DC could be further utilised to enhance the patient experience and address some of the inequalities caused by the digital divide in society.
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Critchley C, Wiersma M, Lipworth W, Light E, Dive L, Kerridge I. Examining diversity in public willingness to participate in offshore human biobanking: An Australian mixed methods study. PUBLIC UNDERSTANDING OF SCIENCE (BRISTOL, ENGLAND) 2020; 29:757-769. [PMID: 32806999 DOI: 10.1177/0963662520948034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
To ensure their sustainability and scientific utility, human biobanks are networking internationally. Sharing biospecimens and associated data across jurisdictions raise a number of practical, ethical, legal and social challenges that could reduce the publics' willingness to donate their much needed tissue for research purposes. This research aims to identify the impact of biobank location on willingness to donate through a national quantitative survey (n = 750) and 16 in-depth interviews. A latent class analysis in combination with qualitative results suggests that a large proportion of Australians are willing to donate and/or allow their tissue to be stored offshore to help others, but others are reluctant due to uncertainty around foreign ethical and regulatory standards and the loss of potential local benefits. The results highlight for the first time the diversity of public views, and provide important guidance for policy makers and science communicators eager to tailor strategies for specific publics.
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Affiliation(s)
- Christine Critchley
- Swinburne University of Technology, Australia
- University of Tasmania, Australia
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Mezinska S, Kaleja J, Mileiko I, Santare D, Rovite V, Tzivian L. Public awareness of and attitudes towards research biobanks in Latvia. BMC Med Ethics 2020; 21:65. [PMID: 32736554 PMCID: PMC7393882 DOI: 10.1186/s12910-020-00506-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 07/16/2020] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Public awareness and engagement are among the main prerequisites for protecting the rights of research participants and for successful and sustainable functioning of research biobanks. The aim of our study was to analyse public awareness and attitudes towards research biobanks in Latvia, and to compare these data with the results of the 2010 Eurobarometer study. We also analysed the influence of awareness and attitudes towards biobanks on willingness to participate in biobank studies and on preferred type of informed consent. METHODS We developed a 12-question survey repeating seven questions about biobanks from the 2010 Eurobarometer questionnaire and adding five others. After describing the study variables, we performed a two-stage analysis of the results. In the first stage we analysed differences between the answers from 2010 and 2019 and conducted univariate analyses of relationships among particular variables, and between those variables and the socio-demographic characteristics of participants. In the second stage we investigated multivariable associations of willingness to participate and type of consent with awareness, trust and the socio-economic characteristics of participants. RESULTS According to our study, the general public in Latvia is still not well informed about research biobanks. Fewer respondents have heard about research biobanks than in 2010. At the same time, the number of respondents who are willing to donate biological samples and personal data to a biobank has increased, e.g. the number of respondents who would definitely or probably be willing to provide information about themselves has increased from 25.8.% to 40.7 since 2010. Overall, concerns about the donation of different types of biological samples and data to a biobank have slightly decreased. CONCLUSIONS Public awareness about biobanks is important for their sustainability. It needs to be increased not only by traditional methods of informing the public, but also by more innovative and participatory approaches, e.g. by citizen science projects. There is a need to strengthen the public visibility and trustworthiness of ethics committees in Latvia in the field of biobanking.
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Affiliation(s)
- S. Mezinska
- Institute of Clinical and Preventive Medicine, University of Latvia, Rainis Boulevard 19, Riga, LV-1586 Latvia
| | - J. Kaleja
- Institute of Clinical and Preventive Medicine, University of Latvia, Rainis Boulevard 19, Riga, LV-1586 Latvia
| | - I. Mileiko
- Institute of Clinical and Preventive Medicine, University of Latvia, Rainis Boulevard 19, Riga, LV-1586 Latvia
| | - D. Santare
- Institute of Clinical and Preventive Medicine, University of Latvia, Rainis Boulevard 19, Riga, LV-1586 Latvia
| | - V. Rovite
- Latvian Biomedical Research and Study Centre, Ratsupites Str. 1-k1, Riga, LV-1067 Latvia
| | - L. Tzivian
- Institute of Clinical and Preventive Medicine, University of Latvia, Rainis Boulevard 19, Riga, LV-1586 Latvia
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Mamo N, Martin GM, Desira M, Ellul B, Ebejer JP. Dwarna: a blockchain solution for dynamic consent in biobanking. Eur J Hum Genet 2020; 28:609-626. [PMID: 31844175 PMCID: PMC7170942 DOI: 10.1038/s41431-019-0560-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 11/13/2019] [Accepted: 11/26/2019] [Indexed: 11/08/2022] Open
Abstract
Dynamic consent aims to empower research partners and facilitate active participation in the research process. Used within the context of biobanking, it gives individuals access to information and control to determine how and where their biospecimens and data should be used. We present Dwarna-a web portal for 'dynamic consent' that acts as a hub connecting the different stakeholders of the Malta Biobank: biobank managers, researchers, research partners, and the general public. The portal stores research partners' consent in a blockchain to create an immutable audit trail of research partners' consent changes. Dwarna's structure also presents a solution to the European Union's General Data Protection Regulation's right to erasure-a right that is seemingly incompatible with the blockchain model. Dwarna's transparent structure increases trustworthiness in the biobanking process by giving research partners more control over which research studies they participate in, by facilitating the withdrawal of consent and by making it possible to request that the biospecimen and associated data are destroyed.
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Affiliation(s)
- Nicholas Mamo
- Centre for Molecular Medicine and Biobanking, Biomedical Sciences Building, University of Malta, Msida, MSD 2080, Malta
| | - Gillian M Martin
- Centre for Molecular Medicine and Biobanking, Biomedical Sciences Building, University of Malta, Msida, MSD 2080, Malta
- Department of Sociology, Faculty of Arts, University of Malta, Msida, MSD 2080, Malta
- BBMRI-ERIC, Neue Stiftingtalstraße 2/B/6, 8010, Graz, Austria
| | - Maria Desira
- Centre for Molecular Medicine and Biobanking, Biomedical Sciences Building, University of Malta, Msida, MSD 2080, Malta
| | - Bridget Ellul
- Department of Pathology, Faculty of Medicine and Surgery, University of Malta, Msida, MSD 2080, Malta
| | - Jean-Paul Ebejer
- Centre for Molecular Medicine and Biobanking, Biomedical Sciences Building, University of Malta, Msida, MSD 2080, Malta.
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Hudson M, Garrison NA, Sterling R, Caron NR, Fox K, Yracheta J, Anderson J, Wilcox P, Arbour L, Brown A, Taualii M, Kukutai T, Haring R, Te Aika B, Baynam GS, Dearden PK, Chagné D, Malhi RS, Garba I, Tiffin N, Bolnick D, Stott M, Rolleston AK, Ballantyne LL, Lovett R, David-Chavez D, Martinez A, Sporle A, Walter M, Reading J, Carroll SR. Rights, interests and expectations: Indigenous perspectives on unrestricted access to genomic data. Nat Rev Genet 2020; 21:377-384. [DOI: 10.1038/s41576-020-0228-x] [Citation(s) in RCA: 84] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2020] [Indexed: 12/19/2022]
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Prictor M, Lewis MA, Newson AJ, Haas M, Baba S, Kim H, Kokado M, Minari J, Molnár-Gábor F, Yamamoto B, Kaye J, Teare HJA. Dynamic Consent: An Evaluation and Reporting Framework. J Empir Res Hum Res Ethics 2019; 15:175-186. [DOI: 10.1177/1556264619887073] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Dynamic consent (DC) is an approach to consent that enables people, through an interactive digital interface, to make granular decisions about their ongoing participation. This approach has been explored within biomedical research, in fields such as biobanking and genomics, where ongoing contact is required with participants. It is posited that DC can enhance decisional autonomy and improve researcher–participant communication. Currently, there is a lack of evidence about the measurable effects of DC-based tools. This article outlines a framework for DC evaluation and reporting. The article draws upon the evidence for enhanced modes of informed consent for research as the basis for a logic model. It outlines how future evaluations of DC should be designed to maximize their quality, replicability, and relevance based on this framework. Finally, the article considers best-practice for reporting studies that assess DC, to enable future research and implementation to build upon the emerging evidence base.
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Affiliation(s)
- Megan Prictor
- Melbourne Law School, The University of Melbourne, Carlton, Victoria, Australia
| | | | - Ainsley J. Newson
- Sydney Health Ethics, Faculty of Medicine and Health, School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Matilda Haas
- Australian Genomics Health Alliance, Parkville, Victoria, Australia
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
| | | | - Hannah Kim
- Yonsei University, Seoul, Republic of Korea
| | | | - Jusaku Minari
- Uehiro Research Division for iPS Cell Ethics, CiRA, Kyoto University, Japan
| | | | | | - Jane Kaye
- Melbourne Law School, The University of Melbourne, Carlton, Victoria, Australia
- University of Oxford, Oxford, United Kingdom
| | - Harriet J. A. Teare
- Melbourne Law School, The University of Melbourne, Carlton, Victoria, Australia
- University of Oxford, Oxford, United Kingdom
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Savatt J, Pisieczko CJ, Zhang Y, Lee MTM, Faucett WA, Williams JL. Biobanks in the Era of Genomic Data. CURRENT GENETIC MEDICINE REPORTS 2019. [DOI: 10.1007/s40142-019-00171-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Elsum I, McEwan C, Kowal EE, Cadet-James Y, Kelaher M, Woodward L. Inclusion of Indigenous Australians in biobanks: a step to reducing inequity in health care. Med J Aust 2019; 211:7-9.e1. [PMID: 31155726 PMCID: PMC6852395 DOI: 10.5694/mja2.50219] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- Imogen Elsum
- Centre for Health Policy, University of Melbourne, Melbourne, VIC
| | - Callum McEwan
- Centre for Health Policy, University of Melbourne, Melbourne, VIC
| | - Emma E Kowal
- Alfred Deakin Centre for Citizenship and Globalisation, Deakin University, Melbourne, VIC
| | - Yvonne Cadet-James
- Indigenous Education and Research Centre, James Cook University, Townsville, QLD
| | - Margaret Kelaher
- Centre for Health Policy, University of Melbourne, Melbourne, VIC
| | - Lynn Woodward
- College of Medicine and Dentistry and Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD
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Abdul Aziz MF, Mohd Yusof AN. Can dynamic consent facilitate the protection of biomedical big data in biobanking in Malaysia? Asian Bioeth Rev 2019; 11:209-222. [PMID: 33717312 PMCID: PMC7747242 DOI: 10.1007/s41649-019-00086-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 04/22/2019] [Accepted: 04/30/2019] [Indexed: 12/24/2022] Open
Abstract
As with many other countries, Malaysia is also developing and promoting biomedical research to increase the understanding of human diseases and possible interventions. To facilitate this development, there is a significant growth of biobanks in the country to ensure continuous collection of biological samples for future research, which contain extremely important personal information and health data of the participants involved. Given the vast amount of samples and data accumulated by biobanks, they can be considered as reservoirs of precious biomedical big data. It is therefore imperative for biobanks to have in place regulatory measures to ensure ethical use of the biomedical big data. Malaysia has yet to introduce specific legislation for the field of biobanking. However, it can be argued that its existing Personal Data Protection Act 2010 (PDPA) has laid down legal principles that can be enforced to protect biomedical big data generated by the biobanks. Consent is a mechanism to enable data subjects to exercise their autonomy by determining how their data can be used and ensure compliance with legal principles. However, there are two main concerns surrounding the current practice of consent in biomedical big data in Malaysia. First, it is uncertain that the current practice would be able to respect the underlying notion of autonomy, and second, it is not in accordance with the legal principles of the PDPA. Scholars have deliberated on different strategies of informed consent, and a more interactive approach has recently been introduced: dynamic consent. It is argued that a dynamic consent approach would be able to address these concerns.
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Affiliation(s)
- Mohammad Firdaus Abdul Aziz
- Centre for Law and Ethics in Science and Technology (CELEST), Faculty of Law, University of Malaya, Kuala Lumpur, Malaysia
| | - Aimi Nadia Mohd Yusof
- Medical Ethics and Law Unit, Faculty of Medicine, Universiti Teknologi MARA (UiTM), Shah Alam, Selangor Malaysia
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