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  • 1
    In: Journal of Law, Medicine & Ethics, Cambridge University Press (CUP), Vol. 47, No. 1 ( 2019), p. 12-20
    Abstract: Drawing on a landscape analysis of existing data-sharing initiatives, in-depth interviews with expert stakeholders, and public deliberations with community advisory panels across the U.S., we describe features of the evolving medical information commons (MIC). We identify participant-centricity and trustworthiness as the most important features of an MIC and discuss the implications for those seeking to create a sustainable, useful, and widely available collection of linked resources for research and other purposes.
    Type of Medium: Online Resource
    ISSN: 1073-1105 , 1748-720X
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    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2019
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    SSG: 2
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  • 2
    In: AJOB Empirical Bioethics, Informa UK Limited, Vol. 7, No. 2 ( 2016-04-02), p. 76-91
    Type of Medium: Online Resource
    ISSN: 2329-4515 , 2329-4523
    Language: English
    Publisher: Informa UK Limited
    Publication Date: 2016
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  • 3
    Online Resource
    Online Resource
    Springer Science and Business Media LLC ; 2016
    In:  Nature Biotechnology Vol. 34, No. 5 ( 2016-5), p. 466-470
    In: Nature Biotechnology, Springer Science and Business Media LLC, Vol. 34, No. 5 ( 2016-5), p. 466-470
    Type of Medium: Online Resource
    ISSN: 1087-0156 , 1546-1696
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2016
    detail.hit.zdb_id: 1494943-X
    detail.hit.zdb_id: 1311932-1
    SSG: 12
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  • 4
    In: Clinical Transplantation, Wiley, Vol. 33, No. 7 ( 2019-07)
    Abstract: HIV+ to HIV+ solid organ transplants in the United States are now legally permitted. Currently, these transplants must adhere to the HIV Organ Policy Equity (HOPE) Act Safeguards and Research Criteria that require the provision of an independent recipient advocate, a novel requirement for solid organ transplant programs. The objective of this study was to understand the experiences of the first advocates serving in this role. Methods We conducted semi‐structured interviews with 15 HOPE independent recipient advocates (HIRAs) from 12 institutions. Results All HIRAs had a professional degree and experience in transplantation or infectious diseases. HIRAs' encounters with potential recipients varied in length, modality, and timing. The newness of the role and the lack of guidance were associated with unease among some HIRAs. Some questioned whether their role was redundant to others involved in transplantation and research since some potential recipients experienced informational fatigue. Conclusions HOPE independent recipient advocates are ensuring the voluntariness of potential participants’ decision to accept an HIV‐infected organ. Many suggested additional guidance would be helpful and alleviate unease. Concerns about potential role redundancy raise the question of whether the HIRA requirement may be inadvertently increasing burden for potential recipients. Future work that captures the experiences of potential recipients is warranted.
    Type of Medium: Online Resource
    ISSN: 0902-0063 , 1399-0012
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2019
    detail.hit.zdb_id: 2739458-X
    detail.hit.zdb_id: 2004801-4
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  • 5
    In: Medical Care, Ovid Technologies (Wolters Kluwer Health), Vol. 55, No. 11 ( 2017-11), p. 970-978
    Abstract: For pragmatic clinical research comparing commonly used treatments, questions exist about if and how to notify participants about it and secure their authorization for participation. Objective: To determine how patients react when they seek clinical care and encounter one of several different pragmatic clinical research studies. Research Design: In an online survey using a between-subjects experimental design, respondents read and responded to 1 of 24 hypothetical research scenarios reflecting different types of studies and approaches to notification and authorization (eg, general notification, oral consent, written consent). Subjects: English-speaking US adults 18 years and older. Measures: Willingness to participate in the hypothetical study, acceptability of the notification and authorization approach, understanding of the study, perceptions of benefit/harm, trust, and perception of amount of study information received. Results: Willingness to participate did not differ by notification and authorization approach. Some (21%–36%) of the patients randomized to general notification with an explicit opt-out provision were not aware they would be enrolled by default. Acceptability was greatest for and similar among notification and authorization approaches that actively engaged the patient (eg, oral or written consent) and lower for approaches with less engagement (eg, general notification). Problems of understanding were found among 20%–55% of respondents, depending on the particular scenario. Most respondents (77%–94%) felt that participation in the hypothetical study posed no risks of harm to their health or privacy. Conclusions: Current attitudes about notification and authorization approaches and difficulties understanding pragmatic clinical research pose significant challenges for pragmatic research. Data from this study provide a starting point to developing solutions to these surprisingly complex issues.
    Type of Medium: Online Resource
    ISSN: 0025-7079
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2017
    detail.hit.zdb_id: 2045939-7
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  • 6
    Online Resource
    Online Resource
    Ovid Technologies (Wolters Kluwer Health) ; 2023
    In:  JAIDS Journal of Acquired Immune Deficiency Syndromes Vol. 93, No. 2 ( 2023-06-1), p. 87-91
    In: JAIDS Journal of Acquired Immune Deficiency Syndromes, Ovid Technologies (Wolters Kluwer Health), Vol. 93, No. 2 ( 2023-06-1), p. 87-91
    Abstract: HIV molecular epidemiology (HIV-ME) is now being used in a variety of ways, including molecular HIV surveillance to help identify and respond to emerging HIV transmission clusters as specified in the Ending the HIV Epidemic in the U.S. initiative. However, HIV-ME in general, and its use for cluster detection and response, in particular, raises significant ethical and social concerns, which have spurred vigorous debates. Nevertheless, there is a paucity of information regarding how these potential benefits and concerns are perceived among people living with HIV and people without HIV at an increased risk. Setting: Virtual engagement with US participants. Methods: We rigorously developed a brief informational video about HIV-ME and conducted a series of in-depth interviews with people living with HIV and people without HIV at an increased risk. Results: Through extensive stakeholder engagement during the video development process and subsequent in-depth interviews (N = 24), several preliminary findings surfaced. In contrast to the high level of concern raised by some critics of HIV-ME, our data appear to show broad support for it. In addition, we observed conflation of perspectives about HIV-ME with concerns about HIV public health surveillance more generally. Conclusion: Our experiences reveal substantial communication challenges related to the nature of HIV-ME that need to be overcome to ensure that it is properly understood, which is necessary for meaningfully engaging stakeholders in discussions about its use. Moreover, ongoing, responsive, engagement efforts are critical. Additional systematic data are needed to help inform policy making and practice regarding HIV-ME.
    Type of Medium: Online Resource
    ISSN: 1525-4135
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    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2023
    detail.hit.zdb_id: 2038673-4
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  • 7
    Online Resource
    Online Resource
    Oxford University Press (OUP) ; 2017
    In:  Journal of Law and the Biosciences Vol. 4, No. 3 ( 2017-12-01), p. 542-564
    In: Journal of Law and the Biosciences, Oxford University Press (OUP), Vol. 4, No. 3 ( 2017-12-01), p. 542-564
    Type of Medium: Online Resource
    ISSN: 2053-9711
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2017
    detail.hit.zdb_id: 2756090-9
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  • 8
    Online Resource
    Online Resource
    Wiley ; 2012
    In:  Journal of Genetic Counseling Vol. 21, No. 3 ( 2012-06), p. 413-422
    In: Journal of Genetic Counseling, Wiley, Vol. 21, No. 3 ( 2012-06), p. 413-422
    Abstract: Direct‐to‐consumer genetic testing has generated speculation about how customers will interpret results and how these interpretations will influence healthcare use and behavior; however, few empirical data on these topics exist. We conducted an online survey of DTC customers of 23andMe, deCODEme, and Navigenics to begin to address these questions. Random samples of U.S. DTC customers were invited to participate. Survey topics included demographics, perceptions of two sample DTC results, and health behaviors following DTC testing. Of 3,167 DTC customers invited, 33% ( n  = 1,048) completed the survey. Forty‐three percent of respondents had sought additional information about a health condition tested; 28% had discussed their results with a healthcare professional; and 9% had followed up with additional lab tests. Sixteen percent of respondents had changed a medication or supplement regimen, and one‐third said they were being more careful about their diet. Many of these health‐related behaviors were significantly associated with responses to a question that asked how participants would perceive their colon cancer risk (as low, moderate, or high) if they received a test result showing an 11% lifetime risk, as compared to 5% risk in the general population. Respondents who would consider themselves to be at high risk for colon cancer were significantly more likely to have sought information about a disease ( p  = 0.03), discussed results with a physician ( p  = 0.05), changed their diet ( p  = 0.02), and started exercising more ( p  = 0.01). Participants’ personal health contexts—including personal and family history of disease and quality of self‐perceived health—were also associated with health‐related behaviors after testing. Subjective interpretations of genetic risk data and personal context appear to be related to health behaviors among DTC customers. Sharing DTC test results with healthcare professionals may add perceived utility to the tests.
    Type of Medium: Online Resource
    ISSN: 1059-7700 , 1573-3599
    Language: English
    Publisher: Wiley
    Publication Date: 2012
    detail.hit.zdb_id: 2016899-8
    SSG: 12
    SSG: 5,2
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  • 9
    Online Resource
    Online Resource
    Cambridge University Press (CUP) ; 2019
    In:  Journal of Law, Medicine & Ethics Vol. 47, No. 1 ( 2019), p. 88-96
    In: Journal of Law, Medicine & Ethics, Cambridge University Press (CUP), Vol. 47, No. 1 ( 2019), p. 88-96
    Abstract: Accessing BRCA1/2 data facilitates the detection of disease-associated variants, which is critical to informing clinical management of risks. BRCA1/2 data sharing is complex and many practices exist. We describe current BRCA1/2 data-sharing practices, in the United States and globally, and discuss obstacles and incentives to sharing, based on 28 interviews with personnel at U.S. and non-U.S. clinical laboratories and databases. Our examination of the BRCA1/2 data-sharing landscape demonstrates strong support for and robust sharing of BRCA1/2 data around the world, increasing global accesses to diverse data sets.
    Type of Medium: Online Resource
    ISSN: 1073-1105 , 1748-720X
    RVK:
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2019
    detail.hit.zdb_id: 2052584-9
    SSG: 2
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  • 10
    In: BMC Medical Ethics, Springer Science and Business Media LLC, Vol. 22, No. 1 ( 2021-12)
    Abstract: Genetics and genomics research (GGR) is increasingly being conducted around the world; yet, researchers and research oversight entities in many countries have struggled with ethical challenges. A range of ethics and regulatory issues need to be addressed through comprehensive policy frameworks that integrate with local environments. While important efforts have been made to enhance understanding and awareness of ethical dimensions of GGR in Africa, including through the H3Africa initiative, there remains a need for in-depth policy review, at a country-level, to inform and stimulate local policy development and revision on the continent. Methods To identify and characterize existing ethics-related guidelines and laws applicable to GGR across much of Africa, we conducted a scoping review of English language policy documents identified through databases, repositories, and web searches. Thirty-six documents were included and coded using a framework that contained a range of themes across five analytical categories: (1) respect, (2) beneficence, (3) justice, (4) independent oversight, and (5) bans and prohibitions. Data analysis software (NVivo 12) was used to organize, code, and tabulate information according to document characteristics and topics. Illustrative examples of policy requirements were selected for inclusion. Results Documents that met inclusion criteria spanned 20 years; published between 1996 and 2018, with the majority (58%) published after 2009. About two-thirds were denoted as “guidelines,” and slightly more than half were non-exclusive to GGR. Very few (six) country-level documents identified were specific to GGR. Requirements related to the principle of “respect” appeared most often across all documents, relative to other principles and processes. The most commonly stated ban was on reproductive cloning. Other prohibitions applied to germline editing, undue inducements in research, sample use for commercial purposes, employee mandatory DNA testing, fetal sex selection, stem cell use, eugenics, and research without public health benefits. Conclusions Enforceable policies that are indispensable to the ethical conduct and review of GGR are either deficient or missing in many African countries. Existing international, GGR-specific ethics guidelines can be used to inform GGR policy development at a country-level, in conjunction with insight from country specific ethics committees and other local stakeholders.
    Type of Medium: Online Resource
    ISSN: 1472-6939
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 2041552-7
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