Department of Psychiatry, Columbia University Medical Center and New York State Psychiatric Institute, New York, New York, USA.
1] Department of Pediatrics, Columbia University Medical Center, New York, New York, USA [2] Department of Medicine, Columbia University Medical Center, New York, New York, USA.
Genet Med. 2014 Apr;16(4):311-7. doi: 10.1038/gim.2013.140. Epub 2013 Sep 26.
Studies have begun exploring whether researchers should return incidental findings in genomic studies, and if so, which findings should be returned; however, how researchers make these decisions-the processes and factors involved-has remained largely unexplored.
We interviewed 28 genomics researchers in-depth about their experiences and views concerning the return of incidental findings.
Researchers often struggle with questions concerning which incidental findings to return and how to make those decisions. Multiple factors shape their views, including information about the gene variant (e.g., pathogenicity and disease characteristics), concerns about participants' well-being and researcher responsibility, and input from external entities. Researchers weigh the evidence, yet they face conflicting pressures, with relevant data frequently being unavailable. Researchers vary in who they believe should decide: participants, principal investigators, institutional review boards, and/or professional organizations. Contextual factors can influence these decisions, including policies governing return of results by institutions and biobanks and the study design. Researchers vary in desires for: guidance from institutions and professional organizations, changes to current institutional processes, and community-wide genetics education.
These data, the first to examine the processes by which researchers make decisions regarding the return of genetic incidental findings, highlight several complexities involved and have important implications for future genetics research, policy, and examinations of these issues.
已有研究开始探索研究人员是否应当在基因组研究中报告偶然发现,如果应当报告,那么应当报告哪些发现;然而,研究人员如何做出这些决策——所涉及的过程和因素——在很大程度上仍未得到探索。
我们深入访谈了 28 位基因组学研究人员,了解他们在报告偶然发现方面的经验和看法。
研究人员经常纠结于应当报告哪些偶然发现以及如何做出这些决策的问题。多种因素影响他们的观点,包括有关基因变异的信息(例如致病性和疾病特征)、对参与者福祉和研究人员责任的担忧,以及来自外部实体的意见。研究人员权衡证据,但面临相互冲突的压力,相关数据往往不可用。在谁应当做出决策的问题上,研究人员存在分歧:参与者、主要研究者、机构审查委员会和/或专业组织。背景因素会影响这些决策,包括机构和生物库对结果报告的政策以及研究设计。研究人员在以下方面存在不同的愿望:机构和专业组织的指导、对现行机构流程的改变,以及全社区的遗传学教育。
这些数据首次考察了研究人员在报告遗传偶然发现方面做出决策的过程,突出了所涉及的一些复杂性,并对未来的遗传学研究、政策以及对这些问题的审查具有重要意义。