Centre of Genomics and Policy, McGill University, Montreal, Quebec, Canada.
Department of Medical Oncology, Programme for Ethics and Patient-Oriented Care in Oncology, National Center for Tumor Diseases, Heidelberg University Hospital, Heidelberg Germany.
JAMA Pediatr. 2018 May 1;172(5):476-481. doi: 10.1001/jamapediatrics.2017.5500.
Accurate clinical interpretation of children's whole-genome and whole-exome sequences relies on comparing the patient's linked genomic and phenotypic data with variant reference databases of both healthy and affected patients. The robustness of such comparisons, in turn, is made possible by sharing pediatric genomic and associated clinical data. Despite this, sparse ethical-legal policy attention has been paid to making such sharing routine in practice. The interdisciplinary Paediatric Task Team of the Global Alliance for Genomics and Health considered in detail the current ethical, legal, and social implications of sharing genomic and associated clinical data involving children. An initial set of points to consider was presented at a meeting of the Paediatric Task Team at the 4th Plenary of the Global Alliance for Genomics and Health. The Key Implications for Data Sharing (KIDS) framework for pediatric genomics was developed based on feedback from this group and was supplemented by findings from a critical appraisal of the data-sharing literature. The final points to consider that comprise the KIDS framework are categorized into the following 4 primary themes: children's involvement, parental consent, balancing benefits and risks, and data protection and release requirements.
准确解读儿童全基因组和外显子组序列依赖于将患者的关联基因组和表型数据与健康和患病患者的变异参考数据库进行比较。这种比较的稳健性反过来又通过共享儿科基因组和相关临床数据成为可能。尽管如此,在实践中,很少有伦理法律政策关注使这种共享成为常规。全球基因组与健康联盟的儿科跨学科任务组详细考虑了涉及儿童的基因组和相关临床数据共享的当前伦理、法律和社会影响。在全球基因组与健康联盟第四次全体会议上,儿科任务组的一次会议上提出了一套初步的考虑要点。基于该小组的反馈,制定了儿科基因组学的关键数据共享影响(KIDS)框架,并通过对数据共享文献的批判性评估补充了发现。构成 KIDS 框架的最终考虑要点分为以下 4 个主要主题:儿童的参与、父母同意、平衡利益和风险,以及数据保护和发布要求。