Slashinski M J, Whitney S N, Achenbaum L S, Keitel W A, McCurdy S A, McGuire A L
Center for Medical Ethics and Health Policy, Department of Family and Community Medicine, Baylor College of Medicine, University of Texas School of Public Health, Houston, TX 77030, USA.
Public Health Genomics. 2013;16(3):127-33. doi: 10.1159/000350308. Epub 2013 Apr 24.
Human microbiome research has the potential to transform the practice of medicine, fundamentally shifting the ways in which we think not only about human health, illness and disease, but also about clinical practice and public health interventions. Drawing from a larger qualitative study on ethical, legal and social dimensions of human microbiome research, in this article, we document perspectives related to the translation of human microbiome research into clinical practice, focusing particularly on implications for health, illness and disease.
We conducted 60 in-depth, semi-structured interviews (2009-2010) with 63 researchers and National Institutes of Health project leaders ('investigators') involved with human microbiome research. The interviews explored a range of ethical, legal and social implications of human microbiome research, including investigators' perspectives on potential strategies for translating findings to clinical practice. Using thematic content analysis, we identified and analyzed emergent themes and patterns.
We identified 3 themes: (1) investigators' general perspectives on the clinical utility of human microbiome research, (2) investigators' perspectives on antibiotic use, overuse and misuse, and (3) investigators' perspectives concerning future challenges of translating data to clinical practice.
The issues discussed by investigators concerning the clinical significance of human microbiome research, including embracing a new paradigm of health and disease, the importance of microbial communities, and clinical utility, will be of critical importance as this research moves forward.
人类微生物组研究有潜力变革医学实践,从根本上改变我们思考人类健康、疾病以及临床实践和公共卫生干预的方式。本文借鉴了一项关于人类微生物组研究伦理、法律和社会层面的大型定性研究,记录了与人类微生物组研究转化为临床实践相关的观点,特别关注对健康、疾病的影响。
2009年至2010年,我们对63名参与人类微生物组研究的研究人员和美国国立卫生研究院项目负责人(“研究人员”)进行了60次深入的半结构化访谈。访谈探讨了人类微生物组研究的一系列伦理、法律和社会影响,包括研究人员对将研究结果转化为临床实践的潜在策略的看法。通过主题内容分析,我们识别并分析了新出现的主题和模式。
我们识别出3个主题:(1)研究人员对人类微生物组研究临床效用的总体看法;(2)研究人员对抗生素使用、过度使用和滥用的看法;(3)研究人员对将数据转化为临床实践未来挑战的看法。
随着这项研究的推进,研究人员讨论的有关人类微生物组研究临床意义的问题,包括接受健康和疾病的新范式、微生物群落的重要性以及临床效用,将至关重要。