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社区对公共卫生生物样本库的看法:对密歇根健康生物信托基金社区会议的分析

Community perspectives on public health biobanking: an analysis of community meetings on the Michigan BioTrust for Health.

作者信息

Thiel Daniel B, Platt Tevah, Platt Jodyn, King Susan B, Kardia Sharon L R

机构信息

University of Michigan School of Public Health Life Sciences and Society Program, Ann Arbor, MI, USA,

出版信息

J Community Genet. 2014 Apr;5(2):125-38. doi: 10.1007/s12687-013-0162-0. Epub 2013 Jul 27.

Abstract

Biobanks raise challenges for developing ethically sound and practicable consent policies. Biobanks comprised of dried bloodspots (DBS) left over from newborn screening, maintained for long-term storage, and potential secondary research applications are no exception. Michigan has been a leader in transforming its DBS collection, marketing its biobank of de-identified samples for health research use. The Michigan BioTrust for Health includes approximately 4 million unconsented retrospective samples collected as early as 1984 and prospective samples added since the fall of 2010 with blanket parental consent. We engaged Michigan citizens to ascertain public attitudes, knowledge, and beliefs about the BioTrust and informed consent. A convenience sampling of 393 participants from communities around the state of Michigan (oversampling for minority populations) participated in meetings addressing newborn screening, the BioTrust and informed consent, yielding quantitative and qualitative survey and discussion data. Participants affirmed the principle of voluntary informed participation in research and advocated for greater public awareness of the existence of the BioTrust. Most expressed support for the use of DBS for research and a desire for greater involvement in granting permission for research use. Opinions varied as to which specific research uses were acceptable. Participants indicated a desire for greater engagement, public awareness, and more active decision making on the part of biobank participants and parents. Diversity of opinion over which research areas were deemed acceptable problematizes the blanket consent model that currently applies to the BioTrust's prospective DBS collection and that could become the new norm for research using de-identified data under proposed changes to the Common Rule.

摘要

生物样本库给制定符合伦理且切实可行的同意政策带来了挑战。由新生儿筛查剩余的干血斑(DBS)组成、用于长期存储以及潜在二次研究应用的生物样本库也不例外。密歇根州在转变其DBS收集方式方面一直处于领先地位,将其去识别化样本的生物样本库推向市场以供健康研究使用。密歇根健康生物信托库包括早在1984年收集的约400万份未经同意的回顾性样本,以及自2010年秋季以来在获得家长全面同意后添加的前瞻性样本。我们与密歇根州公民进行了接触,以确定公众对生物信托库和知情同意的态度、知识和信念。从密歇根州各地社区便利抽样选取的393名参与者(对少数族裔进行了过度抽样)参加了关于新生儿筛查、生物信托库和知情同意的会议,产生了定量和定性的调查及讨论数据。参与者肯定了自愿知情参与研究的原则,并主张提高公众对生物信托库存在的认识。大多数人表示支持将DBS用于研究,并希望更多地参与授予研究使用许可。对于哪些特定的研究用途是可接受的,意见不一。参与者表示希望生物样本库参与者和家长能有更多参与、提高公众意识并做出更积极的决策。对于哪些研究领域被认为是可接受的,意见存在多样性,这使得目前适用于生物信托库前瞻性DBS收集的全面同意模式成了问题,而在对《通用规则》的拟议修改下,这种模式可能会成为使用去识别化数据进行研究的新规范。

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