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为基于学术医院的生物样本库建模制定知情同意书:来自印度尼西亚的经验。

Developing Informed Consent for Academic Hospital-Based Biobank Modeling: An Experience from Indonesia.

作者信息

Hartanti Wika, Wahdi Amirah Ellyza, Prasetiawati Tika, Izhati Qurry Amanda, Fachiroh Jajah

机构信息

Center for Bioethics and Medical Humanities, Department of Medical Education and Bioethics, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia.

Biobank Unit, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia.

出版信息

Biopreserv Biobank. 2024 Aug 21. doi: 10.1089/bio.2024.0001.

Abstract

Informed consent (IC) for biobank practice is vital to ensure that sample collection, storage, and utilization are ethical. However, the standard practices in biobanking in upper-middle-income countries such as Indonesia often rely on specific consent, leading to restricted sample use and ethical concerns. This article describes the development of an IC model that meets ethical standards and yet is acceptable for biobanking practice in an Indonesian academic hospital. We conducted a study involving Universitas Gadjah Mada (UGM) Biobank Unit and the UGM Academic Hospital, Yogyakarta, Indonesia, between 2019 and 2021. The IC development process consisted of four stages: (1) conceptualization, (2) preparation, (3) pilot, and (4) evaluation. These activities were part of a more extensive pilot study for an academic hospital-based biobank (Medical Biobank for Research in Indonesia (MBRIO) study). We conceptualized a broad consent model, consisting of an information sheet, comprehension test, agreement sheet, and exit survey. We tested and revised the broad consent document to ensure readability, trained 10 consenting staff (1 surgeon and 9 nurses), and then piloted the IC procedure on 24 patients with elective surgery. The evaluation showed that patients understood the information objectively and subjectively. Consenting staff considered the broad consent model acceptable for the academic hospital setting and suggested improvements to increase the readability of information sheets and have more trained staff for better coordination. The IC development process and model consent are ethically sufficient, acceptable and feasible to be implemented in academic hospital-based biobanks in Indonesia adjusted to the business processes.

摘要

生物样本库操作的知情同意对于确保样本采集、存储和使用符合伦理道德至关重要。然而,在印度尼西亚等中高收入国家,生物样本库的标准操作通常依赖于特定同意,这导致样本使用受限并引发伦理问题。本文描述了一种知情同意模型的开发,该模型符合伦理标准,同时在印度尼西亚一家学术医院的生物样本库实践中是可接受的。我们在2019年至2021年期间开展了一项涉及印度尼西亚日惹加查马达大学(UGM)生物样本库单位和UGM学术医院的研究。知情同意的开发过程包括四个阶段:(1)概念化,(2)准备,(3)试点,以及(4)评估。这些活动是一项针对基于学术医院的生物样本库的更广泛试点研究(印度尼西亚医学研究生物样本库(MBRIO)研究)的一部分。我们构思了一个广泛同意模型,包括一份信息表、理解测试、同意书和退出调查。我们测试并修订了广泛同意文件以确保可读性,培训了10名同意程序工作人员(1名外科医生和9名护士),然后在24名择期手术患者身上试点了知情同意程序。评估表明患者在客观和主观上都理解了信息。同意程序工作人员认为广泛同意模型在学术医院环境中是可接受的,并建议进行改进以提高信息表的可读性,并配备更多训练有素的工作人员以实现更好的协调。知情同意的开发过程和模型同意在伦理上是充分的、可接受的且可行的,可根据业务流程在印度尼西亚基于学术医院的生物样本库中实施。

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