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Bruns A, Winkler EC. Dynamic consent: a royal road to research consent? JOURNAL OF MEDICAL ETHICS 2024:jme-2024-110153. [PMID: 39048154 DOI: 10.1136/jme-2024-110153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Accepted: 07/15/2024] [Indexed: 07/27/2024]
Abstract
In recent years, the principle of informed consent has come under significant pressure with the rise of biobanks and data infrastructures for medical research. Study-specific consent is unfeasible in the context of biobank and data infrastructure research; and while broad consent facilitates research, it has been criticised as being insufficient to secure a truly informed consent. Dynamic consent has been promoted as a promising alternative approach that could help patients and research participants regain control over the use of their biospecimen and health data in medical research. Critical voices have focused mainly on concerns around its implementation; but little has been said about the argument that dynamic consent is morally superior to broad consent as a way to respect people's individual autonomy. In this paper, we identify two versions of this argument-an information-focused version and a control-focused version-and then argue that both fail to establish the moral superiority of dynamic over broad consent. In particular, we argue that since autonomous choices are a certain species of choices, it is neither obvious that dynamic consent would meaningfully enhance people's autonomy, nor that it is morally justifiable to act on every kind of consent choice enabled by dynamic consent.
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Affiliation(s)
- Andreas Bruns
- Section of Translational Medical Ethics, National Center for Tumor Diseases, Department of Medical Oncology, University Hospital Heidelberg, Heidelberg, Baden-Württemberg, Germany
| | - Eva C Winkler
- Section of Translational Medical Ethics, National Center for Tumor Diseases, Department of Medical Oncology, University Hospital Heidelberg, Heidelberg, Baden-Württemberg, Germany
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Hoffmann K, Nesterow I, Peng Y, Henke E, Barnett D, Klengel C, Gruhl M, Bartos M, Nüßler F, Gebler R, Grummt S, Seim A, Bathelt F, Reinecke I, Wolfien M, Weidner J, Sedlmayr M. Streamlining intersectoral provision of real-world health data: a service platform for improved clinical research and patient care. Front Med (Lausanne) 2024; 11:1377209. [PMID: 38903818 PMCID: PMC11188485 DOI: 10.3389/fmed.2024.1377209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 05/08/2024] [Indexed: 06/22/2024] Open
Abstract
Introduction Obtaining real-world data from routine clinical care is of growing interest for scientific research and personalized medicine. Despite the abundance of medical data across various facilities - including hospitals, outpatient clinics, and physician practices - the intersectoral exchange of information remains largely hindered due to differences in data structure, content, and adherence to data protection regulations. In response to this challenge, the Medical Informatics Initiative (MII) was launched in Germany, focusing initially on university hospitals to foster the exchange and utilization of real-world data through the development of standardized methods and tools, including the creation of a common core dataset. Our aim, as part of the Medical Informatics Research Hub in Saxony (MiHUBx), is to extend the MII concepts to non-university healthcare providers in a more seamless manner to enable the exchange of real-world data among intersectoral medical sites. Methods We investigated what services are needed to facilitate the provision of harmonized real-world data for cross-site research. On this basis, we designed a Service Platform Prototype that hosts services for data harmonization, adhering to the globally recognized Health Level 7 (HL7) Fast Healthcare Interoperability Resources (FHIR) international standard communication format and the Observational Medical Outcomes Partnership (OMOP) common data model (CDM). Leveraging these standards, we implemented additional services facilitating data utilization, exchange and analysis. Throughout the development phase, we collaborated with an interdisciplinary team of experts from the fields of system administration, software engineering and technology acceptance to ensure that the solution is sustainable and reusable in the long term. Results We have developed the pre-built packages "ResearchData-to-FHIR," "FHIR-to-OMOP," and "Addons," which provide the services for data harmonization and provision of project-related real-world data in both the FHIR MII Core dataset format (CDS) and the OMOP CDM format as well as utilization and a Service Platform Prototype to streamline data management and use. Conclusion Our development shows a possible approach to extend the MII concepts to non-university healthcare providers to enable cross-site research on real-world data. Our Service Platform Prototype can thus pave the way for intersectoral data sharing, federated analysis, and provision of SMART-on-FHIR applications to support clinical decision making.
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Affiliation(s)
- Katja Hoffmann
- Faculty of Medicine Carl Gustav Carus, Institute for Medical Informatics and Biometry, Technische Universität Dresden, Dresden, Germany
| | - Igor Nesterow
- Faculty of Medicine Carl Gustav Carus, Institute for Medical Informatics and Biometry, Technische Universität Dresden, Dresden, Germany
| | - Yuan Peng
- Faculty of Medicine Carl Gustav Carus, Institute for Medical Informatics and Biometry, Technische Universität Dresden, Dresden, Germany
| | - Elisa Henke
- Faculty of Medicine Carl Gustav Carus, Institute for Medical Informatics and Biometry, Technische Universität Dresden, Dresden, Germany
| | - Daniela Barnett
- Data Integration Center, Center for Medical Informatics, University Hospital Carl Gustav Carus, Dresden, Germany
| | - Cigdem Klengel
- Faculty of Medicine Carl Gustav Carus, Institute for Medical Informatics and Biometry, Technische Universität Dresden, Dresden, Germany
| | - Mirko Gruhl
- Faculty of Medicine Carl Gustav Carus, Institute for Medical Informatics and Biometry, Technische Universität Dresden, Dresden, Germany
| | - Martin Bartos
- Department of Informatics, Klinikum Chemnitz gGmbH, Chemnitz, Germany
| | - Frank Nüßler
- Department of Informatics, Klinikum Chemnitz gGmbH, Chemnitz, Germany
| | - Richard Gebler
- Faculty of Medicine Carl Gustav Carus, Institute for Medical Informatics and Biometry, Technische Universität Dresden, Dresden, Germany
| | - Sophia Grummt
- Faculty of Medicine Carl Gustav Carus, Institute for Medical Informatics and Biometry, Technische Universität Dresden, Dresden, Germany
| | - Anne Seim
- Faculty of Medicine Carl Gustav Carus, Institute for Medical Informatics and Biometry, Technische Universität Dresden, Dresden, Germany
| | | | - Ines Reinecke
- Data Integration Center, Center for Medical Informatics, University Hospital Carl Gustav Carus, Dresden, Germany
| | - Markus Wolfien
- Faculty of Medicine Carl Gustav Carus, Institute for Medical Informatics and Biometry, Technische Universität Dresden, Dresden, Germany
- Center for Scalable Data Analytics and Artificial Intelligence, Dresden, Germany
| | - Jens Weidner
- Faculty of Medicine Carl Gustav Carus, Institute for Medical Informatics and Biometry, Technische Universität Dresden, Dresden, Germany
| | - Martin Sedlmayr
- Faculty of Medicine Carl Gustav Carus, Institute for Medical Informatics and Biometry, Technische Universität Dresden, Dresden, Germany
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Palojoki S, Lehtonen L, Vuokko R. Semantic Interoperability of Electronic Health Records: Systematic Review of Alternative Approaches for Enhancing Patient Information Availability. JMIR Med Inform 2024; 12:e53535. [PMID: 38686541 PMCID: PMC11066539 DOI: 10.2196/53535] [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: 10/10/2023] [Revised: 02/21/2024] [Accepted: 02/24/2024] [Indexed: 05/02/2024] Open
Abstract
Background Semantic interoperability facilitates the exchange of and access to health data that are being documented in electronic health records (EHRs) with various semantic features. The main goals of semantic interoperability development entail patient data availability and use in diverse EHRs without a loss of meaning. Internationally, current initiatives aim to enhance semantic development of EHR data and, consequently, the availability of patient data. Interoperability between health information systems is among the core goals of the European Health Data Space regulation proposal and the World Health Organization's Global Strategy on Digital Health 2020-2025. Objective To achieve integrated health data ecosystems, stakeholders need to overcome challenges of implementing semantic interoperability elements. To research the available scientific evidence on semantic interoperability development, we defined the following research questions: What are the key elements of and approaches for building semantic interoperability integrated in EHRs? What kinds of goals are driving the development? and What kinds of clinical benefits are perceived following this development? Methods Our research questions focused on key aspects and approaches for semantic interoperability and on possible clinical and semantic benefits of these choices in the context of EHRs. Therefore, we performed a systematic literature review in PubMed by defining our study framework based on previous research. Results Our analysis consisted of 14 studies where data models, ontologies, terminologies, classifications, and standards were applied for building interoperability. All articles reported clinical benefits of the selected approach to enhancing semantic interoperability. We identified 3 main categories: increasing the availability of data for clinicians (n=6, 43%), increasing the quality of care (n=4, 29%), and enhancing clinical data use and reuse for varied purposes (n=4, 29%). Regarding semantic development goals, data harmonization and developing semantic interoperability between different EHRs was the largest category (n=8, 57%). Enhancing health data quality through standardization (n=5, 36%) and developing EHR-integrated tools based on interoperable data (n=1, 7%) were the other identified categories. The results were closely coupled with the need to build usable and computable data out of heterogeneous medical information that is accessible through various EHRs and databases (eg, registers). Conclusions When heading toward semantic harmonization of clinical data, more experiences and analyses are needed to assess how applicable the chosen solutions are for semantic interoperability of health care data. Instead of promoting a single approach, semantic interoperability should be assessed through several levels of semantic requirements A dual model or multimodel approach is possibly usable to address different semantic interoperability issues during development. The objectives of semantic interoperability are to be achieved in diffuse and disconnected clinical care environments. Therefore, approaches for enhancing clinical data availability should be well prepared, thought out, and justified to meet economically sustainable and long-term outcomes.
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Affiliation(s)
- Sari Palojoki
- Department of Steering of Healthcare and Social Welfare, Ministry of Social Affairs and Health, Helsinki, Finland
| | - Lasse Lehtonen
- Diagnostic Center, Helsinki University Hospital District, Helsinki, Finland
| | - Riikka Vuokko
- Department of Steering of Healthcare and Social Welfare, Ministry of Social Affairs and Health, Helsinki, Finland
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Gutsche A, Salameh P, Aulenbacher F, Buttgereit T, Weller K, Siebenhaar F, Maurer M. Response to "Clinical applicability of the Urticaria control test in patients with chronic urticaria: Further evidence from 622 adult and pediatric patients with different disease subtypes". Allergy 2024; 79:265-267. [PMID: 37921400 DOI: 10.1111/all.15941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 10/25/2023] [Indexed: 11/04/2023]
Affiliation(s)
- Annika Gutsche
- Urticaria Center of Reference and Excellence (UCARE), Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany
| | - Pascale Salameh
- Urticaria Center of Reference and Excellence (UCARE), Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany
- School of Medicine, Lebanese American University, Byblos, Lebanon
- Institut National de Santé Publique d'Épidémiologie Clinique et de Toxicologie-Liban (INSPECT-LB), Beirut, Lebanon
- Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus
| | - Felix Aulenbacher
- Urticaria Center of Reference and Excellence (UCARE), Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany
| | - Thomas Buttgereit
- Urticaria Center of Reference and Excellence (UCARE), Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany
| | - Karsten Weller
- Urticaria Center of Reference and Excellence (UCARE), Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany
| | - Frank Siebenhaar
- Urticaria Center of Reference and Excellence (UCARE), Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany
| | - Marcus Maurer
- Urticaria Center of Reference and Excellence (UCARE), Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany
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Scaglione GL, Pignata S, Pettinato A, Paolillo C, Califano D, Scandurra G, Lombardo V, Di Gaudio F, Pecorino B, Mereu L, Scollo P, Capoluongo ED. Homologous Recombination Deficiency (HRD) Scoring, by Means of Two Different Shallow Whole-Genome Sequencing Pipelines (sWGS), in Ovarian Cancer Patients: A Comparison with Myriad MyChoice Assay. Int J Mol Sci 2023; 24:17095. [PMID: 38069422 PMCID: PMC10707691 DOI: 10.3390/ijms242317095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 11/29/2023] [Accepted: 12/02/2023] [Indexed: 12/18/2023] Open
Abstract
High-grade serous ovarian cancer (HGSOC) patients carrying the BRCA1/2 mutation or deficient in the homologous recombination repair system (HRD) generally benefit from treatment with PARP inhibitors. Some international recommendations suggest that BRCA1/2 genetic testing should be offered for all newly diagnosed epithelial ovarian cancer, along with HRD assessment. Academic tests (ATs) are continuously under development, in order to break down the barriers patients encounter in accessing HRD testing. Two different methods for shallow whole-genome sequencing (sWGS) were compared to the reference assay, Myriad. All these three assays were performed on 20 retrospective HGSOC samples. Moreover, HRD results were correlated with the progression-free survival rate (PFS). Both sWGS chemistries showed good correlation with each other and a complete agreement, even when compared to the Myriad score. Our academic HRD assay categorized patients as HRD-Deficient, HRM-Mild and HRN-Negative. These three groups were matched with PFS, providing interesting findings in terms of HRD scoring and months of survival. Both our sWGS assays and the Myriad test correlated with the patient's response to treatments. Finally, our AT confirms its capability of determining HRD status, with the advantage of being faster, cheaper, and easier to carry out. Our results showed a prognostic value for the HRD score.
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Affiliation(s)
- Giovanni L. Scaglione
- Laboratory of Molecular Oncology, IDI-IRCCS, Via dei Monti di Creta, 104, 00167 Rome, Italy;
| | - Sandro Pignata
- Department of Urology and Gynecology, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Via Mariano Semmola, 53, 80131 Naples, Italy;
| | - Angela Pettinato
- Department of Pathological Anatomy, A.O.E. Cannizzaro, Via Messina, 829, 95126 Catania, Italy;
| | - Carmela Paolillo
- Department of Clinical and Experimental Medicine, University of Foggia, Viale Luigi Pinto, 71122 Foggia, Italy;
| | - Daniela Califano
- Functional Genomic Unit, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Via Mariano Semmola, 53, 80131 Naples, Italy;
| | - Giuseppa Scandurra
- Department of Medical Oncology, A.O.E. Cannizzaro, Via Messina, 829, 95126 Catania, Italy; (G.S.); (V.L.)
| | - Valentina Lombardo
- Department of Medical Oncology, A.O.E. Cannizzaro, Via Messina, 829, 95126 Catania, Italy; (G.S.); (V.L.)
| | | | - Basilio Pecorino
- Department of Obstetrics and Gynecology, A.O.E. Cannizzaro, Via Messina, 829, 95126 Catania, Italy; (B.P.); (P.S.)
| | - Liliana Mereu
- Division of Obstetrics and Gynecology, Department of General Surgery and Medical-Surgical Specialism, University of Catania, P.O. “G Rodolico”, Via Santa Sofia, 78, 95123 Catania, Italy;
| | - Paolo Scollo
- Department of Obstetrics and Gynecology, A.O.E. Cannizzaro, Via Messina, 829, 95126 Catania, Italy; (B.P.); (P.S.)
- Faculty of Medicine, “Kore” University, Cittadella Universitaria, 94100 Enna, Italy
| | - Ettore D. Capoluongo
- Department of Clinical Pathology and Genomics, A.O.E. Cannizzaro, Via Messina 829, 95126 Catania, Italy
- Department of Molecular Medicine and Medical Biotechnology, Federico II University, Via Pansini, 5, 80131 Naples, Italy
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6
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Horgan D, Capoluongo E, Dube F, Trapani D, Malapelle U, Rovite V, Omar MI, Alix-Panabières C, Rutkowski P, Bayle A, Hackshaw A, Hofman P, Subbiah V. Clouds across the new dawn for clinical, diagnostic and biological data: accelerating the development, delivery and uptake of personalized medicine. Diagnosis (Berl) 2023; 10:356-362. [PMID: 37036891 DOI: 10.1515/dx-2023-0022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 03/22/2023] [Indexed: 04/11/2023]
Abstract
Growing awareness of the genetic basis of disease is transforming the opportunities for improving patient care by accelerating the development, delivery and uptake of personalised medicine and diseases diagnostics. This can mean more precise treatments reaching the right patients at the right time at the right cost. But it will be possible only with a coherent European Union (EU) approach to regulation. For clinical and biological data, on which the EU is now legislating with its planned European Health Data Space (EHDS), it is crucial that the design of this new system respects the constraints also implicit in the testing which generates data. The current EHDS proposal may fail to meet this requirement. It risks being over-ambitious, while taking insufficient account of the demanding realities of data access in daily practice and current economics/business models. It is marred by imprecision and ambiguity, by overlaps with other EU legislation, and by lack of clarity on funding. This paper identifies key issues where legislators should ensure that the opportunities are not squandered by the adoption of over-hasty or ill-considered provisions that jeopardise the gains that could be made in improved healthcare.
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Affiliation(s)
- Denis Horgan
- European Alliance for Personalised Medicine, Brussels, Belgium
- Department of Molecular and Cellular Engineering, Jacob Institute of Biotechnology and Bioengineering Sam Higginbottom University of Agriculture, Technology and Sciences, Prayagraj, India
| | - Ettore Capoluongo
- Department of Clinical Pathology, Azienda Ospedaliera per l'Emergenza Cannizzaro, Catania, Italy
| | | | - Dario Trapani
- European Institute of Oncology, IRCCS, Milan, Italy
- Department of Oncology and Haematology, University of Milan, Milan, Italy
| | - Umberto Malapelle
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Vita Rovite
- Latvian Biomedical Research and Study Centre, Riga, Latvia
| | | | - Catherine Alix-Panabières
- Laboratory of Rare Human Circulating Cells (LCCRH), University medical center of Montpellier, Montpellier, France
- European Liquid Biopsy Society, Hamburg, Germany
| | - Piotr Rutkowski
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Arnaud Bayle
- Drug Development Department (DITEP) Gustave Roussy-Cancer Campus, Villejuif, France
- Faculté de Médicine, Université Paris Saclay, Université Paris-Sud, Paris, France
- Labeled Ligue Contre le Cancer, Paris-Saclay University, Villejuif, France
| | - Allan Hackshaw
- Cancer Research UK & UCL Cancer Trials Centre, University College London, London, UK
| | - Paul Hofman
- European Liquid Biopsy Society, Hamburg, Germany
- Laboratory of Clinical and Experimental Pathology, FHU OncoAge, BB-0033-00025, IRCAN, Nice Hospital Centre, University Côte d'Azur, Nice, France
| | - Vivek Subbiah
- Department of Investigational Cancer Therapeutics, Division of Cancer Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Khalid MI, Ahmed M, Kim J. Enhancing Data Protection in Dynamic Consent Management Systems: Formalizing Privacy and Security Definitions with Differential Privacy, Decentralization, and Zero-Knowledge Proofs. SENSORS (BASEL, SWITZERLAND) 2023; 23:7604. [PMID: 37688060 PMCID: PMC10490780 DOI: 10.3390/s23177604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 08/23/2023] [Accepted: 08/29/2023] [Indexed: 09/10/2023]
Abstract
Dynamic consent management allows a data subject to dynamically govern her consent to access her data. Clearly, security and privacy guarantees are vital for the adoption of dynamic consent management systems. In particular, specific data protection guarantees can be required to comply with rules and laws (e.g., the General Data Protection Regulation (GDPR)). Since the primary instantiation of the dynamic consent management systems in the existing literature is towards developing sustainable e-healthcare services, in this paper, we study data protection issues in dynamic consent management systems, identifying crucial security and privacy properties and discussing severe limitations of systems described in the state of the art. We have presented the precise definitions of security and privacy properties that are essential to confirm the robustness of the dynamic consent management systems against diverse adversaries. Finally, under those precise formal definitions of security and privacy, we have proposed the implications of state-of-the-art tools and technologies such as differential privacy, blockchain technologies, zero-knowledge proofs, and cryptographic procedures that can be used to build dynamic consent management systems that are secure and private by design.
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Affiliation(s)
- Muhammad Irfan Khalid
- Department of Information and Electrical Engineering and Applied Mathematics, University of Salerno Fisciano, 84084 Fisciano, Italy
| | - Mansoor Ahmed
- ADAPT Centre, Innovative Value Institute, Maynooth University, W23 A3HY Maynooth, Ireland;
| | - Jungsuk Kim
- Research Laboratory, Cellico Inc., Seongnam-si 13449, Gyeonggi-do, Republic of Korea
- Department of Biomedical Engineering, Gachon University, Seongnam-si 13120, Gyeonggi-do, Republic of Korea
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Castelo-Branco L, Lee R, Brandão M, Cortellini A, Freitas A, Garassino M, Geukens T, Grivas P, Halabi S, Oliveira J, Pinato DJ, Ribeiro J, Peters S, Pentheroudakis G, Warner JL, Romano E. Learning lessons from the COVID-19 pandemic for real-world evidence research in oncology-shared perspectives from international consortia. ESMO Open 2023; 8:101596. [PMID: 37418836 PMCID: PMC10277850 DOI: 10.1016/j.esmoop.2023.101596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 06/02/2023] [Accepted: 06/07/2023] [Indexed: 07/09/2023] Open
Affiliation(s)
- L Castelo-Branco
- Scientific and Medical Division, ESMO (European Society for Medical Oncology), Lugano, Switzerland; NOVA National School of Public Health, NOVA University, Lisbon, Portugal.
| | - R Lee
- Faculty of Biology, Medicine and Health, The University of Manchester, Manchester; Medical Oncology Department, The Christie NHS Foundation Trust, Manchester, UK
| | - M Brandão
- Medical Oncology Department, Institut Jules Bordet, Brussels, Belgium
| | - A Cortellini
- Medical Oncology, Fondazione Policlinico Universitario Campus Bio-Medico, Roma, Italy; Department of Surgery and Cancer, Hammersmight Hospital Campus, Imperial College London, London
| | - A Freitas
- Department of Computer Science/CRUK Manchester Institute, The University of Manchester, Manchester, UK; IDIAP Research Institute, Martigny, Switzerland
| | - M Garassino
- Department of medicine, Hematology Oncology section, The University of Chicago, Chicago, USA
| | - T Geukens
- Laboratory for Translational Breast Cancer Research, Department of Oncology, KU Leuven, Leuven, Belgium
| | - P Grivas
- Department of Medicine, Division of Oncology, University of Washington, Seattle; Clinical Research Division, Fred Hutchinson Cancer Center, Seattle
| | - S Halabi
- Department of Biostatistics and Bioinformatics, Duke University, Durham, USA
| | - J Oliveira
- Department of Medicine, Instituto Português de Oncologia, Porto, Portugal
| | - D J Pinato
- Department of Surgery and Cancer, Imperial College London, London, UK; Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
| | - J Ribeiro
- Gustave Roussy, Department of Cancer Medicine, Villejuif, France
| | - S Peters
- Oncology Department, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - G Pentheroudakis
- Scientific and Medical Division, ESMO (European Society for Medical Oncology), Lugano, Switzerland
| | - J L Warner
- Center for Clinical Cancer Informatics and Data Science, Division of Hematology/Oncology, Department of Medicine, Brown University, Providence, USA
| | - E Romano
- Emanuela Romano Center of Cancer Immunotherapy, Department of Oncology, Institut Curie, Paris, France
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Lee WB, Choi SJ. Secondary Use Provisions in the European Health Data Space Proposal and Policy Recommendations for Korea. Healthc Inform Res 2023; 29:199-208. [PMID: 37591675 PMCID: PMC10440198 DOI: 10.4258/hir.2023.29.3.199] [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: 01/31/2023] [Revised: 07/23/2023] [Accepted: 07/24/2023] [Indexed: 08/19/2023] Open
Abstract
OBJECTIVES This article explores the secondary use provisions of the European Health Data Space (EHDS), proposed by the European Commission in May 2022, and offers policy recommendations for South Korea. METHODS The authors analyzed the texts of the EHDS proposal and other documents published by the European Union, as well as surveyed the relevant literature. RESULTS The EHDS proposal seeks to create new patient rights over electronic health data collected and used for primary care; and establish a data sharing system for the re-use of electronic health data for secondary purposes, including research, the provision of personalized healthcare, and developing healthcare artificial intelligence (AI) applications. These provisions envisage requiring both private and public data holders to share certain types of electronic health data on a mandatory basis with third parties. New government bodies, called health data access bodies, would review data access applications and issue data permits. CONCLUSIONS The overarching aim of the EHDS proposal is to make electronic health data, which are currently held in the hands of a small number of organizations, available for re-use by third parties to stimulate innovation and research. While it will be very challenging for South Korea to adopt a similar scheme and require private entities to share their proprietary data with third parties, the South Korean government should consider making at least health data collected through publicly funded research more readily available for secondary use.
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Cascini F, Gentili A, Causio FA, Altamura G, Melnyk A, Beccia F, Pappalardo C, Lontano A, Ricciardi W. Strengthening and promoting digital health practice: results from a Global Digital Health Partnership's survey. Front Public Health 2023; 11:1147210. [PMID: 37404277 PMCID: PMC10315462 DOI: 10.3389/fpubh.2023.1147210] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 05/22/2023] [Indexed: 07/06/2023] Open
Abstract
Background and objective The capacity to promote and disseminate the best evidence-based practices in terms of digital health innovations and technologies represents an important goal for countries and governments. To support the digital health maturity across countries the Global Digital Health Partnership (GDHP) was established in 2019. The mission of the GDHP is to facilitate global collaboration and knowledge-sharing in the design of digital health services, through the administration of surveys and white papers. Objective The scope of this study is to critically analyze and discuss results from the Evidence and Evaluation GDHP Work Stream's survey, understand how governments and countries intend to address main obstacles to the digital health implementation, identify their strategies for a communication of effective digital health services, and promote the sharing of international based best practices on digital health. Methods This survey followed a cross-sectional study approach. A multiple-choice questionnaire was designed to gather data. Choices were extracted from research publications retrieved through a rapid review. Results Out of 29 countries receiving the survey, 10 returned it. On a scale from 1 to 5, eHealth systems/platforms (mean = 3.56) were indicated as the most important tool for centralized infrastructure to collect information on digital health, while primary care (mean = 4.0) represented the most voted item for healthcare services to collect information on digital health. Seven Countries out of 10 identified lack of organization, skepticism of clinicians, and accessibility of the population as a barriers to adopt digital health implementation, resulting to be the most voted items. Finally, the most endorsed priorities in digital health for Countries were the adoption of data-driven approaches (6 Countries), and telehealth (5 Countries). Conclusion This survey highlighted the main tools and obstacles for countries to promote the implementation of evidence-based digital health innovations. Identifying strategies that would communicate the value of health care information technology to healthcare professionals are particularly imperative. Effective communication programs for clinicians and the general population in addition to improved digital health literacy (both for clinicians and citizens) will be the key for the real implementation of future digital health technologies.
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Konopik J, Blunck D. Development of an Evidence-Based Conceptual Model of the Health Care Sector Under Digital Transformation: Integrative Review. J Med Internet Res 2023; 25:e41512. [PMID: 37289482 PMCID: PMC10288351 DOI: 10.2196/41512] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 12/14/2022] [Accepted: 04/07/2023] [Indexed: 06/09/2023] Open
Abstract
BACKGROUND Digital transformation is currently one of the most influential developments. It is fundamentally changing consumers' expectations and behaviors, challenging traditional firms, and disrupting numerous markets. Recent discussions in the health care sector tend to assess the influence of technological implications but neglect other factors needed for a holistic view on the digital transformation. This calls for a reevaluation of the current state of digital transformation in health care. Consequently, there is a need for a holistic view on the complex interdependencies of digital transformation in the health care sector. OBJECTIVE This study aimed to examine the effects of digital transformation on the health care sector. This is accomplished by providing a conceptual model of the health care sector under digital transformation. METHODS First, the most essential stakeholders in the health care sector were identified by a scoping review and grounded theory approach. Second, the effects on these stakeholders were assessed. PubMed, Web of Science, and Dimensions were searched for relevant studies. On the basis of an integrative review and grounded theory methodology, the relevant academic literature was systematized and quantitatively and qualitatively analyzed to evaluate the impact on the value creation of, and the relationships among, the stakeholders. Third, the findings were synthesized into a conceptual model of the health care sector under digital transformation. RESULTS A total of 2505 records were identified from the database search; of these, 140 (5.59%) were included and analyzed. The results revealed that providers of medical treatments, patients, governing institutions, and payers are the most essential stakeholders in the health care sector. As for the individual stakeholders, patients are experiencing a technology-enabled growth of influence in the sector. Providers are becoming increasingly dependent on intermediaries for essential parts of the value creation and patient interaction. Payers are expected to try to increase their influence on intermediaries to exploit the enormous amounts of data while seeing their business models be challenged by emerging technologies. Governing institutions regulating the health care sector are increasingly facing challenges from new entrants in the sector. Intermediaries increasingly interconnect all these stakeholders, which in turn drives new ways of value creation. These collaborative efforts have led to the establishment of a virtually integrated health care ecosystem. CONCLUSIONS The conceptual model provides a novel and evidence-based perspective on the interrelations among actors in the health care sector, indicating that individual stakeholders need to recognize their role in the system. The model can be the basis of further evaluations of strategic actions of actors and their effects on other actors or the health care ecosystem itself.
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Affiliation(s)
- Jens Konopik
- Institute of Management, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nuremberg, Germany
| | - Dominik Blunck
- Institute of Management, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nuremberg, Germany
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Schmidt AE, Bobek J, Mathis-Edenhofer S, Schwarz T, Bachner F. Cross-border healthcare collaborations in Europe (2007–2017): Moving towards a European Health Union? Health Policy 2022. [DOI: 10.1016/j.healthpol.2022.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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