Redsell S A, Cheater F M
Clinical Governance Research and Development Unit, Department of General Practice and Primary Health Care, Leicester Warwick Medical School, University of Leicester, Leicester LE5 4PW, UK.
J Adv Nurs. 2001 Aug;35(4):508-13. doi: 10.1046/j.1365-2648.2001.01867.x.
This paper reports on the methods used in two studies to obtain access to subjects to comply with the common law duty of confidence laid out in the Data Protection Act (1998) and discusses the researchers' problems in interpreting the procedures.
The amendments to the United Kingdom (UK) Data Protection Act (1998) are causing confusion within the health service and academic institutions. There is a need to balance patient confidentiality with the requirement to conduct vital, unbiased research in which health service professionals are not subject to ethical dilemmas. This paper examines the recruitment methods used in two studies in which the researchers' attempts to adhere to the requirements lengthened the study costs and may have produced less reliable results.
The methodological difficulties in two studies are presented. In Study 1, the difficulties encountered when the Multicentre Research Ethics Committee refused permission for researchers to recruit patients directly to a multicentre randomized controlled trial are discussed. In Study 2, the method used to compile a sampling frame for a national questionnaire survey following the eight principles of the Act are described.
Our experience has shown that health care professionals are increasingly required to recruit patients to intervention trials, and that researchers are not allowed access to the names of patients or other subjects to ask them for consent to participate in a study. The requirement for researchers to use "intermediaries" to obtain consent from and recruit subjects to studies increases the risk of selection bias, may expose the practitioner to ethical difficulties and may compromise the external validity of trial results. There is also a danger that research costs will soar when the Data Protection Act (1998) is fully realized.
The Data Protection Act (1998) is currently being interpreted in a number of different ways. We conclude there is an urgent need for consensus within the health service and academic communities.
本文报告了两项研究中为获取研究对象而采用的方法,以符合《1998年数据保护法》规定的普通法保密义务,并讨论了研究人员在解释这些程序时遇到的问题。
英国《1998年数据保护法》的修正案在医疗服务机构和学术机构中引发了混乱。需要在保护患者隐私与开展重要、无偏见研究的要求之间取得平衡,在这类研究中,医疗服务专业人员不应面临伦理困境。本文审视了两项研究中所采用的招募方法,在这两项研究中,研究人员试图遵守相关要求,却延长了研究成本,且可能产生了可靠性较低的结果。
介绍了两项研究中的方法学难题。在研究1中,讨论了多中心研究伦理委员会拒绝允许研究人员直接招募患者参与多中心随机对照试验时遇到的困难。在研究2中,描述了依据该法案的八项原则为全国问卷调查编制抽样框架所采用的方法。
我们的经验表明,医疗保健专业人员越来越多地被要求招募患者参与干预试验,而研究人员不被允许获取患者或其他研究对象的姓名以请求他们同意参与研究。要求研究人员使用“中间人”来获取研究对象的同意并招募他们参与研究,增加了选择偏倚的风险,可能使从业者面临伦理困境,并可能损害试验结果的外部有效性。当《1998年数据保护法》全面实施时,研究成本也有飙升的风险。
目前,人们对《1998年数据保护法》有多种不同的解读。我们得出结论,医疗服务机构和学术界迫切需要达成共识。