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医疗照护范围之外的个人健康信息使用:来自一所学术性医疗机构患者的同意偏好

The use of personal health information outside the circle of care: consent preferences of patients from an academic health care institution.

作者信息

Tosoni Sarah, Voruganti Indu, Lajkosz Katherine, Habal Flavio, Murphy Patricia, Wong Rebecca K S, Willison Donald, Virtanen Carl, Heesters Ann, Liu Fei-Fei

机构信息

Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, ON, Canada.

Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada.

出版信息

BMC Med Ethics. 2021 Mar 24;22(1):29. doi: 10.1186/s12910-021-00598-3.

Abstract

BACKGROUND

Immense volumes of personal health information (PHI) are required to realize the anticipated benefits of artificial intelligence in clinical medicine. To maintain public trust in medical research, consent policies must evolve to reflect contemporary patient preferences.

METHODS

Patients were invited to complete a 27-item survey focusing on: (a) broad versus specific consent; (b) opt-in versus opt-out approaches; (c) comfort level sharing with different recipients; (d) attitudes towards commercialization; and (e) options to track PHI use and study results.

RESULTS

222 participants were included in the analysis; 83% were comfortable sharing PHI with researchers at their own hospital, although younger patients (≤ 49 years) were more uncomfortable than older patients (50 + years; 13% versus 2% uncomfortable, p < 0.05). While 56% of patients preferred broad consent, 38% preferred specific consent; 6% preferred not sharing at all. The majority of patients (63%) preferred to be asked for permission before entry into a contact pool. Again, this trend was more pronounced for younger patients (≤ 49 years: 76%). Approximately half of patients were uncomfortable sharing PHI with commercial enterprises (51% uncomfortable, 27% comfortable, 22% neutral). Most patients preferred to track PHI usage (61%), with the highest proportion once again reported by the youngest patients (≤ 49 years: 71%). A majority of patients also wished to be notified regarding study results (70%).

CONCLUSIONS

While most patients were willing to share their PHI with researchers within their own institution, many preferred a transparent and reciprocal consent process. These data also suggest a generational shift, wherein younger patients preferred more specific consent options. Modernizing consent policies to reflect increased autonomy is crucial in fostering sustained public engagement with medical research.

摘要

背景

要实现人工智能在临床医学中预期的益处,需要大量的个人健康信息(PHI)。为了维持公众对医学研究的信任,同意政策必须不断发展以反映当代患者的偏好。

方法

邀请患者完成一项包含27个项目的调查,重点关注:(a)宽泛同意与具体同意;(b)选择加入与选择退出的方式;(c)与不同接收者分享时的舒适度;(d)对商业化的态度;以及(e)跟踪PHI使用情况和研究结果的选项。

结果

222名参与者纳入分析;83%的人愿意与自己医院的研究人员分享PHI,不过年轻患者(≤49岁)比年长患者(50岁及以上)更不愿意(分别为13%和2%不愿意,p<0.05)。虽然56%的患者倾向于宽泛同意,38%倾向于具体同意;6%根本不愿意分享。大多数患者(63%)希望在进入联系人池之前被征求许可。同样,这种趋势在年轻患者中更为明显(≤49岁:76%)。约一半患者不愿意与商业企业分享PHI(51%不愿意,27%愿意,22%中立)。大多数患者倾向于跟踪PHI的使用情况(61%),最年轻患者(≤49岁)报告的比例再次最高(71%)。大多数患者也希望得到关于研究结果的通知(70%)。

结论

虽然大多数患者愿意与自己机构内的研究人员分享他们的PHI,但许多人更喜欢透明且相互的同意过程。这些数据还表明了一种代际转变,即年轻患者更喜欢更具体的同意选项。使同意政策现代化以反映更大的自主权对于促进公众持续参与医学研究至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cd9d/7992944/f8f6de7f0a98/12910_2021_598_Fig1_HTML.jpg

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