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澳大利亚成年人对保护其健康信息在统计数据库中隐私的看法。

Perspectives of Australian adults about protecting the privacy of their health information in statistical databases.

机构信息

School of Electrical Engineering & Computer Science, Faculty of Engineering & Built Environment, The University of Newcastle, Callaghan NSW 2308, Australia.

出版信息

Int J Med Inform. 2012 Apr;81(4):279-89. doi: 10.1016/j.ijmedinf.2012.01.005. Epub 2012 Feb 10.

Abstract

OBJECTIVES

The aim of this study was to discover the public's attitude and views towards privacy in health care. This is a part of a larger project which aims to gain an insight into what kind of privacy is needed and develop technical measures to provide such privacy.

METHODS

The study was a two-stage process which combined qualitative and quantitative research. Stage One of the study comprised arranging and facilitating focus groups while in Stage Two we conducted a social survey.

MEASUREMENTS

We measured attitudes towards privacy, medical research and consent; privacy concern about sharing one's health information for research; privacy concern about the possibility that some specific information from medical records could be linked to the patient's name in a situation that was not related to medical treatment.

RESULTS

The results of the study revealed both great support for medical research (98%), and concern about privacy of health information (66%). Participants prefer to be asked for their permission before their health information is used for any purpose other than medical treatment (92%), and they would like to know the organisation and details of the research before allowing the use of their health records (83%). Age, level of education, place of birth and employment status are most strongly associated with privacy concerns. The study showed that there are some particularly sensitive issues and there is a concern (42-60%) about any possibility of linking these kinds of data to the patient's name in a situation that is not related to medical treatment. Such issues include sexually transmitted diseases, abortions and infertility, family medical history/genetic disorders, mental illness, drug/alcohol related incidents, lists of previous operations/procedures/dates and current medications.

CONCLUSIONS

Participants believe they should be asked for permission before their health information is used for any purpose other than medical treatment. However, consent and privacy concerns are not necessary related. Assuring individuals that their personal health information is de-identified reduces their concern about the necessity of consent for releasing health information for research purposes, but many people are not aware that removing their names and other direct identifiers from medical records does not guarantee full privacy protection for their health information. Privacy concerns decrease as extra security measures are introduced to protect privacy. Therefore, instead of "tailoring concern" as proposed by Willison we suggest improving privacy protection of personal information by introducing additional security measures in data publishing.

摘要

目的

本研究旨在了解公众对医疗保健隐私的态度和看法。这是一个更大项目的一部分,该项目旨在深入了解需要什么样的隐私,并开发提供这种隐私的技术措施。

方法

该研究采用定性和定量研究相结合的两阶段过程。第一阶段包括安排和促进焦点小组,而在第二阶段,我们进行了一项社会调查。

测量

我们测量了对隐私、医疗研究和同意的态度;对为研究目的共享个人健康信息的隐私关注;对病历中的某些特定信息在与医疗无关的情况下可能与患者姓名相关联的可能性的隐私关注。

结果

研究结果显示,人们对医疗研究(98%)给予了极大的支持,同时对健康信息的隐私(66%)表示关注。参与者更愿意在其健康信息被用于医疗以外的任何目的之前被要求同意(92%),并希望在允许使用其健康记录之前了解研究的组织和细节(83%)。年龄、教育程度、出生地和就业状况与隐私问题的关联性最强。研究表明,存在一些特别敏感的问题,人们担心(42-60%)在与医疗无关的情况下,将这些类型的数据与患者姓名相关联的任何可能性。这些问题包括性传播疾病、堕胎和不孕、家族病史/遗传疾病、精神疾病、药物/酒精相关事件、以往手术/程序/日期和当前药物清单。

结论

参与者认为,在其健康信息被用于医疗以外的任何目的之前,应先征得他们的同意。然而,同意和隐私问题并非必然相关。向个人保证他们的个人健康信息是去识别的,可以减少他们对出于研究目的发布健康信息所需同意的关注,但许多人没有意识到从病历中删除他们的姓名和其他直接标识符并不能为他们的健康信息提供完全的隐私保护。随着隐私保护措施的增加,隐私问题会减少。因此,我们建议通过在数据发布中引入额外的安全措施来改善个人信息的隐私保护,而不是像Willison 所建议的那样“量身定制关注”。

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