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公民对加拿大新生儿筛查中储存样本研究的价值观。

Citizens' values regarding research with stored samples from newborn screening in Canada.

机构信息

Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada.

出版信息

Pediatrics. 2012 Feb;129(2):239-47. doi: 10.1542/peds.2011-2572. Epub 2012 Jan 16.

Abstract

OBJECTIVES

Newborn screening (NBS) programs may store bloodspot samples and use them for secondary purposes. Recent public controversies and lawsuits over storage and secondary uses underscore the need to engage the public on these issues. We explored Canadian values regarding storage and use of NBS samples for various purposes and the forms of parental choice for anonymous research with NBS samples.

METHODS

We conducted a mixed-methods, public engagement study comprising 8 focus groups (n = 60), an educational component, deliberative discussion, and pre- and post-questionnaires assessing knowledge and values toward storage and parental choice.

RESULTS

Canadian citizens supported the storage of NBS samples for quality control, confirmatory diagnosis, and future anonymous research (>90%). There was broad support for use of NBS samples for anonymous research; however, opinions were split about the extent of parental decision-making. Support for a "routinized" approach rested on trust in authorities, lack of concern for harms, and an assertion that the population's interest took priority over the interests of individuals. Discomfort stemmed from distrust in authorities, concern for harms, and prioritizing individual interests, which supported more substantive parental choice. Consensus emerged regarding the need for greater transparency about the storage and secondary use of samples.

CONCLUSIONS

Our study provides novel insights into the values that underpin citizens' acceptance and discomfort with routine storage of NBS samples for research, and supports the need to develop well-designed methods of public education and civic discourse on the risks and benefits of the retention and secondary use of NBS samples.

摘要

目的

新生儿筛查(NBS)计划可能会储存血斑样本,并将其用于次要目的。最近有关存储和二次使用的公众争议和诉讼突显了就这些问题让公众参与的必要性。我们探讨了加拿大在各种目的下储存和使用 NBS 样本的价值观,以及在匿名 NBS 样本研究中父母选择的形式。

方法

我们进行了一项混合方法的公众参与研究,包括 8 个焦点小组(n=60)、教育部分、审议讨论以及预调查和后调查,以评估对储存和父母选择的知识和价值观。

结果

加拿大公民支持为质量控制、确认诊断和未来的匿名研究储存 NBS 样本(>90%)。广泛支持使用 NBS 样本进行匿名研究;然而,对于父母决策的程度存在分歧。对“常规化”方法的支持基于对权威机构的信任、对危害的不关注,以及认为公众利益优先于个人利益的主张。对权威机构的不信任、对危害的关注以及对个人利益的重视,导致了对更实质性的父母选择的不满。关于需要提高对样本储存和二次使用的透明度达成了共识。

结论

我们的研究提供了新颖的见解,了解了公民对 NBS 样本常规储存用于研究的接受程度和不适感的价值观基础,并支持需要制定精心设计的公众教育方法和公民话语,讨论 NBS 样本保留和二次使用的风险和益处。

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