Chen Stephanie C, Berkman Benjamin E, Hull Sara Chandros
Department of Bioethics, Clinical Center, National Institutes of Health, Bethesda, Maryland, USA.
National Human Genome Research Institute, Bethesda, Maryland, USA.
Genet Med. 2017 Aug;19(8):883-889. doi: 10.1038/gim.2016.207. Epub 2017 Jan 26.
Facilitating genomic research may require the use of samples and data collected via consent processes that did not include specific descriptions of secondary uses. We explore whether a waiver of consent with notification and the option to withdraw (WNOW) is a viable alternative to written informed consent for secondary uses of samples and data.
We developed a retrospective case study of a rare-disease protocol involving 1,978 participants that implemented WNOW for genomic data-sharing activities. We analyzed institutional review board and investigator records and conducted in-depth semistructured interviews with key staff members.
WNOW was largely successful at achieving its goals in this case, although the recontact effort, relative to proceeding with a waiver, decreased participation in genomic data sharing by 13.8% (n = 253), primarily because 224 letters were returned as undeliverable. A small number of participants responded (n = 89), and some of them expressed confusion and frustration. In the pediatric arm of the study, the research may have been practicable without a waiver, given the relationship between the pediatric clinicians and families.
The practicability of conducting research on existing specimens without a waiver of informed consent, and whether WNOW is a viable alternative, depend on contextual factors, including a reliable way to communicate with participants.Genet Med advance online publication 26 January 2017.
促进基因组研究可能需要使用通过同意程序收集的样本和数据,而这些程序并未包含对二次使用的具体描述。我们探讨放弃知情同意并进行通知以及提供退出选项(WNOW)是否是样本和数据二次使用书面知情同意的可行替代方案。
我们开展了一项针对一项罕见病方案的回顾性案例研究,该方案涉及1978名参与者,对基因组数据共享活动实施了WNOW。我们分析了机构审查委员会和研究者的记录,并对关键工作人员进行了深入的半结构化访谈。
在这种情况下,WNOW在很大程度上成功实现了其目标,尽管与直接进行豁免相比,再次联系的工作导致参与基因组数据共享的比例下降了13.8%(n = 253),主要原因是224封信被退回无法投递。少数参与者做出了回应(n = 89),其中一些人表示困惑和沮丧。在该研究的儿科部分,考虑到儿科临床医生与家庭之间的关系,即使不进行豁免,研究可能也是可行的。
在不放弃知情同意的情况下对现有样本进行研究的可行性,以及WNOW是否是一种可行的替代方案,取决于包括与参与者进行可靠沟通方式在内的背景因素。《遗传医学》2017年1月26日在线优先发表。