Laboratory for Medical Research and Consumers Involvement, Department of Public Health, IRCCS Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy.
Zadig Agenzia di Editoria Scientifica, Milan, Italy.
Eur J Public Health. 2018 Oct 1;28(5):973-977. doi: 10.1093/eurpub/cky032.
Health technology assessment and ethical issues have to be dealt with in deciding on national carrier screening for cystic fibrosis (CF)-the most frequent severe autosomal recessive disease in Caucasian populations and several stakeholders need to be involved. A citizens' jury is one way to ask citizens to deliberate on controversial topics in the interests of a society. The aims of this project were to gather opinions about CF carrier screening through citizens' jury deliberations and to match them with the findings of a large online consultation survey open to the general population, people with CF and families and health professionals.
Three citizens' juries and an online survey were asked: 'Should the Health Service organize screening of the population with the aim of identifying healthy people who may have children with CF?' The jurors had no medical background and no personal or family CF history. The survey was open to people with CF, families, and healthcare professionals.
Jurors and survey respondents were in favour of CF carrier screening, mainly considering the severity of CF, the value of informed reproductive choices and the equality of the screening. All the citizens' juries felt positively about the health service actively offer CF carrier screening to provide women and couples of reproductive age equal access and standardized information on the pros and cons.
Considering the favourable attitude towards CF screening, the feasibility of CF screening, in terms of best setting, target age and healthcare professionals providing it, should be tested in a clinical trial.
在决定是否对囊性纤维化(CF)进行国家携带者筛查时,必须考虑卫生技术评估和伦理问题,并且需要涉及多个利益相关者。公民陪审团是一种让公民参与审议有争议话题的方式,以符合社会利益。该项目的目的是通过公民陪审团的审议来收集有关 CF 携带者筛查的意见,并将其与针对普通人群、CF 患者及其家属和卫生专业人员开放的大型在线咨询调查的结果进行匹配。
三个公民陪审团和一个在线调查被问到:“卫生服务机构是否应该组织对人口进行筛查,以确定可能生育 CF 患儿的健康人群?”陪审员没有医学背景,也没有个人或家族 CF 病史。该调查对 CF 患者、家庭和医疗保健专业人员开放。
陪审员和调查受访者赞成 CF 携带者筛查,主要考虑 CF 的严重性、知情生殖选择的价值以及筛查的平等性。所有公民陪审团都对卫生服务机构积极主动地提供 CF 携带者筛查表示肯定,以便为有生育能力的妇女和夫妇提供平等的机会,并提供有关利弊的标准化信息。
考虑到对 CF 筛查的有利态度,应该在临床试验中测试 CF 筛查的可行性,包括最佳设置、目标年龄以及提供筛查的卫生专业人员。