Department of Social Medicine and Healthcare Organization, Faculty of Public Health, Medical University of Varna, Varna, Bulgaria.
J Med Internet Res. 2020 Aug 18;22(8):e22214. doi: 10.2196/22214.
The ownership of patient information in the context of big data is a relatively new problem, which is not yet fully recognized by the medical academic community. The problem is interdisciplinary, incorporating legal, ethical, medical, and aspects of information and communication technologies, requiring a sophisticated analysis. However, no previous scoping review has mapped existing studies on the subject.
This study aims to map and assess published studies on patient data ownership in the context of big data as viewed by the academic community.
A scoping review was conducted based on the 5-stage framework outlined by Arksey and O'Malley and further developed by Levac, Colquhoun, and O'Brien. The organization and reporting of results of the scoping review were conducted according to PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses and its extensions for Scoping Reviews). A systematic and comprehensive search of 4 scientific information databases, PubMed, ScienceDirect, Scopus, and Springer, was performed for studies published between January 2000 and October 2019. Two authors independently assessed the eligibility of the studies and the extracted data.
The review included 32 eligible articles authored by academicians that correspond to 3 focus areas: problem (ownership), area (health care), and context (big data). Five major aspects were studied: the scientific area of publications, aspects and academicians' perception of ownership in the context of big data, proposed solutions, and practical applications for data ownership issues in the context of big data. The aspects in which publications consider ownership of medical data are not clearly distinguished but can be summarized as ethical, legal, political, and managerial. The ownership of patient data is perceived primarily as a challenge fundamental to conducting medical research, including data sales and sharing, and to a lesser degree as a means of control, problem, threat, and opportunity also in view of medical research. Although numerous solutions falling into 3 categories, technology, law, and policy, were proposed, only 3 real applications were discussed.
The issue of ownership of patient information in the context of big data is poorly researched; it is not addressed consistently and in its integrity, and there is no consensus on policy decisions and the necessary legal regulations. Future research should investigate the issue of ownership as a core research question and not as a minor fragment among other topics. More research is needed to increase the body of knowledge regarding the development of adequate policies and relevant legal frameworks in compliance with ethical standards. The combined efforts of multidisciplinary academic teams are needed to overcome existing gaps in the perception of ownership, the aspects of ownership, and the possible solutions to patient data ownership issues in the reality of big data.
大数据背景下患者信息的所有权是一个相对较新的问题,尚未得到医学学术界的充分认识。这个问题具有跨学科性质,涉及法律、伦理、医疗以及信息和通信技术等方面,需要进行复杂的分析。然而,之前没有系统评价综述对该主题进行过梳理。
本研究旨在梳理和评估学术界对大数据背景下患者数据所有权的现有研究。
采用 Arksey 和 O'Malley 提出的 5 阶段框架,并进一步采用 Levac、Colquhoun 和 O'Brien 提出的方法,开展系统评价综述。根据 PRISMA-ScR(系统评价和荟萃分析的首选报告项目及其对范围综述的扩展)对系统评价综述的组织和报告进行规范。对 2000 年 1 月至 2019 年 10 月期间发表的研究进行了 4 个科学信息数据库(PubMed、ScienceDirect、Scopus 和 Springer)的系统而全面的检索。两名作者独立评估研究的合格性并提取数据。
综述纳入了 32 篇由学者撰写的符合条件的文章,对应 3 个重点领域:问题(所有权)、领域(医疗保健)和背景(大数据)。研究了 5 个主要方面:出版物的科学领域、大数据背景下所有权的各个方面和学者的看法、提出的解决方案以及大数据背景下数据所有权问题的实际应用。出版物考虑医疗数据所有权的方面没有明确区分,但可以概括为伦理、法律、政治和管理。患者数据的所有权主要被视为开展医疗研究(包括数据销售和共享)的基本挑战,在一定程度上也被视为控制、问题、威胁和机遇,这也与医疗研究有关。尽管提出了归入 3 个类别(技术、法律和政策)的众多解决方案,但仅讨论了 3 个实际应用。
大数据背景下患者信息所有权问题的研究不足;该问题没有得到一致和完整的处理,在政策决策和必要的法律监管方面也没有达成共识。未来的研究应该将所有权问题作为核心研究问题进行调查,而不是作为其他主题的一个次要部分。需要开展更多的研究,以增加关于制定符合伦理标准的适当政策和相关法律框架的知识体系。需要多学科学术团队的共同努力,以克服对患者数据所有权问题的认识、所有权方面以及可能的解决方案方面的现有差距,在大数据的现实中加以应对。