Department of Biomedical Informatics, UC San Diego Health, University of California, San Diego, La Jolla.
School of Nursing, Duke University, Durham, North Carolina.
JAMA Netw Open. 2019 Aug 2;2(8):e199550. doi: 10.1001/jamanetworkopen.2019.9550.
Patients increasingly demand transparency in and control of how their medical records and biospecimens are shared for research. How much they are willing to share and what factors influence their sharing preferences remain understudied in real settings.
To examine whether and how various presentations of consent forms are associated with differences in electronic health record and biospecimen sharing rates and whether these rates vary according to user interface design, data recipients, data and biospecimen items, and patient characteristics.
DESIGN, SETTING, AND PARTICIPANTS: For this survey study, a data and biospecimen sharing preference survey was conducted at 2 academic hospitals from May 1, 2017, to September 31, 2018, after simple randomization of patients to 1 of 4 options with different layout and formats of indicating sharing preferences: opt-in simple, opt-in detailed, opt-out simple, and opt-out detailed.
All participants were presented with a list of data and biospecimen items that could be shared for research within the same health care organization or with other nonprofit or for-profit institutions. Participating patients were randomly asked to select the items that they would share (opt-in) or were asked to select items they would not share (opt-out). Patients in these 2 groups were further randomized to select only among 18 categories vs 59 detailed items (simple vs detailed form layout).
The primary end points were the percentages of patients willing to share data and biospecimen categories or items.
Among 1800 eligible participants, 1246 (69.2%) who completed their data sharing survey were included in the analysis, and 850 of these patients (mean [SD] age, 51.1 [16.7] years; 507 [59.6%] female; 677 [79.6%] white) responded to the satisfaction survey. A total of 46 participants (3.7%) declined sharing with the home institution, 352 (28.3%) with nonprofit institutions, and 590 (47.4%) with for-profit institutions. A total of 836 (67.1%) indicated that they would share all items with researchers from the home institution. When comparing opt-out with opt-in interfaces, all 59 sharing choice variables (100%) were associated with the sharing decision. When comparing simple with detailed forms, only 14 variables (23.7%) were associated with the sharing decision.
The findings suggest that most patients are willing to share their data and biospecimens for research. Allowing patients to decide with whom they want to share certain types of data may affect research that involves secondary use of electronic health records and/or biosamples for research.
患者越来越要求对其病历和生物样本的共享方式进行透明化和控制。他们愿意共享多少以及哪些因素影响他们的共享偏好,这些在实际环境中仍研究不足。
研究不同的同意书呈现方式是否以及如何与电子健康记录和生物样本的共享率存在差异,以及这些率是否根据用户界面设计、数据接收者、数据和生物样本项目以及患者特征而有所不同。
设计、设置和参与者:这项调查研究在 2 家学术医院进行,2017 年 5 月 1 日至 2018 年 9 月 31 日,患者随机分为 4 种选项之一,选项具有不同的布局和格式来表示共享偏好:选择加入简单、选择加入详细、选择退出简单和选择退出详细。
所有参与者都提供了一份可以在同一医疗机构内或与其他非营利或营利性机构共享的研究用数据和生物样本项目清单。参与的患者被随机要求选择他们愿意共享的项目(选择加入)或选择他们不愿意共享的项目(选择退出)。这两组患者进一步被随机要求从 18 个类别中选择,而不是从 59 个详细项目中选择(简单布局与详细布局)。
主要终点是愿意共享数据和生物样本类别的患者百分比。
在 1800 名符合条件的参与者中,有 1246 名(69.2%)完成了他们的数据共享调查,被纳入分析,其中 850 名患者(平均[标准差]年龄,51.1[16.7]岁;507[59.6%]为女性;677[79.6%]为白人)对满意度调查做出了回应。共有 46 名患者(3.7%)拒绝与本机构共享,352 名患者(28.3%)拒绝与非营利机构共享,590 名患者(47.4%)拒绝与营利性机构共享。共有 836 名患者(67.1%)表示愿意与本机构的研究人员共享所有项目。与选择退出相比,所有 59 个共享选择变量(100%)都与共享决策相关。与简单形式相比,只有 14 个变量(23.7%)与共享决策相关。
研究结果表明,大多数患者愿意为研究共享他们的数据和生物样本。允许患者决定与谁共享某些类型的数据可能会影响涉及电子病历和/或生物样本的二次使用以进行研究的工作。