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利用新生儿筛查足跟血样本进行研究:公众对政策选择的偏好。

Using Newborn Screening Bloodspots for Research: Public Preferences for Policy Options.

机构信息

Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada;

Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada;

出版信息

Pediatrics. 2016 Jun;137(6). doi: 10.1542/peds.2015-4143. Epub 2016 May 17.

Abstract

OBJECTIVES

Retaining residual newborn screening (NBS) bloodspots for medical research remains contentious. To inform this debate, we sought to understand public preferences for, and reasons for preferring, alternative policy options.

METHODS

We assessed preferences among 4 policy options for research use of residual bloodspots through a bilingual national Internet survey of a representative sample of Canadians. Fifty percent of respondents were randomly assigned to select reasons supporting these preferences. Understanding of and attitudes toward screening and research concepts, and demographics were assessed.

RESULTS

Of 1102 respondents (94% participation rate; 47% completion rate), the overall preference among policy options was ask permission (67%); this option was also the most acceptable choice (80%). Assume permission was acceptable to 46%, no permission required was acceptable to 29%, and no research allowed was acceptable to 26%. The acceptability of the ask permission option was reduced among participants assigned to the reasoning exercise (84% vs 76%; P = .004). Compared with assume/no permission required, ordered logistic regression showed a significant reduction in preference for the ask permission option with greater understanding of concepts (odds ratio, 0.87; P < .001), greater confidence in science (odds ratio, 0.16; P < .001), and a perceived responsibility to contribute to research (odds ratio, 0.39; P < .001).

CONCLUSIONS

Surveyed Canadians prefer that explicit permission is sought for storage and research use of NBS bloodspots. This preference was diminished when reasons supporting and opposing routine storage, and other policy options, were presented. Findings warrant consideration as NBS communities strategize to respond to shifting legislative contexts.

摘要

目的

保留新生儿筛查(NBS)血斑进行医学研究仍然存在争议。为了了解这一争论,我们试图了解公众对替代政策选择的偏好及其原因。

方法

我们通过一项针对加拿大代表性样本的双语国家互联网调查,评估了对剩余血斑进行研究的 4 种政策选择的偏好。50%的受访者被随机分配选择支持这些偏好的理由。评估了对筛查和研究概念的理解以及对这些概念的态度,以及人口统计学特征。

结果

在 1102 名受访者中(94%的参与率;47%的完成率),政策选择的总体偏好是征求同意(67%);这种选择也是最可接受的选择(80%)。假设获得同意的比例为 46%,不需要获得同意的比例为 29%,不允许进行研究的比例为 26%。在被分配到推理练习的参与者中,征求同意的选择的可接受性降低(84%比 76%;P=0.004)。与假设/不需要获得同意相比,有序逻辑回归显示,随着对概念的理解程度(比值比,0.87;P<0.001)、对科学的信心(比值比,0.16;P<0.001)以及对研究的责任感(比值比,0.39;P<0.001)的增加,对征求同意选项的偏好显著降低。

结论

调查的加拿大公民更倾向于为 NBS 血斑的储存和研究使用征求明确的同意。当提出支持和反对常规储存以及其他政策选择的理由时,这种偏好就会减弱。这些发现值得在 NBS 社区制定策略应对立法环境变化时加以考虑。

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