Health Research with Big Data: Time for Systemic Oversight

To address the ethical challenges in big data health research we propose the concept of systemic oversight. This approach is based on six defining features (adaptivity, flexibility, monitoring, responsiveness, reflexivity, and inclusiveness) and aims at creating a common ground across the oversight pipeline of biomedical big data research. Current trends towards enhancing granularity of informed consent and specifying legal provisions to address informational privacy and discrimination concerns in data-driven health research are laudable. However, these solutions alone cannot have the desired impact unless oversight activities by different stakeholders acquire a common substantive orientation.

[1]  Kerina H. Jones,et al.  The other side of the coin: harm due to the non-use of health-related data , 2016, Int. J. Medical Informatics.

[2]  Alessandro Blasimme,et al.  Biomedical Big Data: New Models of Control Over Access, Use and Governance , 2017, Journal of Bioethical Inquiry.

[3]  Marcel Salathé,et al.  Precision global health in the digital age. , 2017, Swiss medical weekly.

[4]  J. Stilgoe,et al.  Developing a framework for responsible innovation* , 2013, The Ethics of Nanotechnology, Geoengineering and Clean Energy.

[5]  A. Cambon-Thomsen,et al.  Genomic Incidental Findings: Reducing the Burden to Be Fair , 2013, The American journal of bioethics : AJOB.

[6]  I. Kohane,et al.  Finding the missing link for big biomedical data. , 2014, JAMA.

[7]  Helge Toutenburg,et al.  The Social Control of Technology , 1982 .

[8]  Audley Genus Rethinking constructive technology assessment as democratic, reflective, discourse , 2006 .

[9]  Robert Cook-Deegan,et al.  Broad Consent for Research With Biological Samples: Workshop Conclusions , 2015, The American journal of bioethics : AJOB.

[10]  J. Voss,et al.  The Politics of Reflexive Governance: Challenges for Designing Adaptive Management and Transition Management , 2011 .

[11]  E. Vayena,et al.  Digital health: meeting the ethical and policy challenges. , 2018, Swiss medical weekly.

[12]  Marcel Salathé,et al.  Ethical Challenges of Big Data in Public Health , 2015, PLoS Comput. Biol..

[13]  Vilhjalmur Arnason,et al.  Coding and Consent: Moral Challenges of the Database Project in Iceland , 2004, Bioethics.

[14]  Eric Elenko,et al.  Defining digital medicine , 2015, Nature Biotechnology.

[15]  R. Rhodes,et al.  The New Governance: Governing without Government , 1996 .

[16]  Stacey Pereira,et al.  Should you profit from your genome? , 2017, Nature Biotechnology.

[17]  A Cecile J W Janssens,et al.  A tiered-layered-staged model for informed consent in personal genome testing , 2012, European Journal of Human Genetics.

[18]  G. Laurie Reflexive governance in biobanking: on the value of policy led approaches and the need to recognise the limits of law , 2011, Human Genetics.

[19]  G. Henderson Is Informed Consent Broken? , 2011, The American journal of the medical sciences.

[20]  David H. Guston,et al.  Real-time technology assessment , 2020, Emerging Technologies: Ethics, Law and Governance.

[21]  Urs Gasser,et al.  Elements of a new ethical framework for big data research , 2016 .

[22]  Brian W. Powers,et al.  The digital phenotype , 2015, Nature Biotechnology.

[23]  Barbara J. Evans,et al.  Barbarians at the Gate , 2016, American Journal of Law & Medicine.

[24]  George Packer The Broken Contract , 2011 .

[25]  Pascal Borry,et al.  From the principles of genomic data sharing to the practices of data access committees , 2015, EMBO molecular medicine.

[26]  W. Nicholson Price,et al.  Black-Box Medicine , 2014 .

[27]  Ruben Amarasingham,et al.  The legal and ethical concerns that arise from using complex predictive analytics in health care. , 2014, Health affairs.

[28]  B. Elger,et al.  Consent and anonymization in research involving biobanks , 2006, EMBO reports.

[29]  L. Rich Prestidigitation vs. Public Trust: Or How We Can Learn to Change the Conversation and Prevent Powers From “Organizing the Discontent” , 2017, Journal of Bioethical Inquiry.

[30]  Barbara J Evans,et al.  Power to the People: Data Citizens in the Age of Precision Medicine. , 2017, Vanderbilt journal of entertainment and technology law.

[31]  G. Church,et al.  From genetic privacy to open consent , 2008, Nature Reviews Genetics.

[32]  E. Emanuel,et al.  The debate over research on stored biological samples: what do sources think? , 2002, Archives of internal medicine.

[33]  E. Vayena,et al.  Becoming partners, retaining autonomy: ethical considerations on the development of precision medicine , 2016, BMC medical ethics.

[34]  B. Koenig,et al.  Linking Broad Consent to Biobank Governance: Support From a Deliberative Public Engagement in California , 2015, The American journal of bioethics : AJOB.

[35]  E. Vayena,et al.  Opinion: Learning as we go: Lessons from the publication of Facebook’s social-computing research , 2014, Proceedings of the National Academy of Sciences.

[36]  A. McGuire,et al.  Informed consent in genomics and genetic research. , 2010, Annual review of genomics and human genetics.

[37]  S. Beck,et al.  Dynamic Consent: a potential solution to some of the challenges of modern biomedical research , 2017, BMC Medical Ethics.

[38]  R. Gallagher,et al.  From consent to institutions: designing adaptive governance for genomic biobanks. , 2011, Social science & medicine.

[39]  E. Vayena,et al.  Informed Consent and the Disclosure of Clinical Results to Research Participants , 2017, The American journal of bioethics : AJOB.

[40]  Frank A. Pasquale The Black Box Society: The Secret Algorithms That Control Money and Information , 2015 .

[41]  Kyle Kubler The Black Box Society: the secret algorithms that control money and information , 2016 .

[42]  Matthew Kearnes,et al.  Nanotechnology, Governance, and Public Deliberation: What Role for the Social Sciences? , 2005 .

[43]  Taha A. Kass-Hout,et al.  Digital Drug Safety Surveillance: Monitoring Pharmaceutical Products in Twitter , 2014, Drug Safety.

[44]  D. Collingridge The social control of technology , 1980 .

[45]  E. Vayena,et al.  Caught in the Web: Informed Consent for Online Health Research , 2013, Science Translational Medicine.

[46]  E. Vayena,et al.  “Tailored-to-You”: Public Engagement and the Political Legitimation of Precision Medicine , 2017, Perspectives in biology and medicine.

[47]  L. Floridi The Onlife Manifesto: Being Human in a Hyperconnected Era , 2014 .

[48]  A. Cambon-Thomsen,et al.  Disclosing Results to Genomic Research Participants: Differences That Matter , 2012, The American journal of bioethics : AJOB.

[49]  Joakim Dillner,et al.  Should donors be allowed to give broad consent to future biobank research? , 2006, The Lancet. Oncology.

[50]  Gurumurthy Ramachandran,et al.  Recommendations for oversight of nanobiotechnology: dynamic oversight for complex and convergent technology , 2011, Emerging Technologies: Ethics, Law and Governance.

[51]  S. Vadhan,et al.  Integrating Approaches to Privacy Across the Research Lifecycle: When Is Information Purely Public? , 2015 .

[52]  Jeremy Sugarman,et al.  Examining Provisions Related to Consent in the Revised Common Rule , 2017, The American journal of bioethics : AJOB.

[53]  B. Koenig Have we asked too much of consent? , 2014, The Hastings Center report.

[54]  B Hofmann,et al.  Broadening consent—and diluting ethics? , 2009, Journal of Medical Ethics.

[55]  D. Wendler Broad versus blanket consent for research with human biological samples. , 2013, The Hastings Center report.

[56]  G. Helgesson In Defense of Broad Consent , 2011, Cambridge Quarterly of Healthcare Ethics.

[57]  Timothy Caulfield,et al.  DNA databanks and consent: A suggested policy option involving an authorization model , 2003, BMC medical ethics.

[58]  T. Tomlinson Respecting donors to biobank research. , 2013, The Hastings Center report.

[59]  Urs Gasser,et al.  “Strictly Biomedical? Sketching the Ethics of the Big Data Ecosystem in Biomedicine” , 2016 .

[60]  F. Collins,et al.  A new initiative on precision medicine. , 2015, The New England journal of medicine.

[61]  John Grin,et al.  Contextualizing Reflexive Governance: the Politics of Dutch Transitions to Sustainability , 2007 .

[62]  Michael Morrison,et al.  Dynamic consent: a patient interface for twenty-first century research networks , 2014, European Journal of Human Genetics.

[63]  J. Brownstein,et al.  Digital disease detection--harnessing the Web for public health surveillance. , 2009, The New England journal of medicine.

[64]  Fred H. Cate,et al.  Notice and consent in a world of Big Data , 2013 .

[65]  E. Vayena,et al.  Genetic incidental findings: autonomy regained? , 2013, Genetics in Medicine.

[66]  W. Riley,et al.  Precision Public Health for the Era of Precision Medicine. , 2016, American journal of preventive medicine.

[67]  Joanne Scott,et al.  Mind the Gap: Law and New Approaches to Governance in the European Union , 2002 .

[68]  A. Sheikh,et al.  Policy implications of big data in the health sector , 2017, Bulletin of the World Health Organization.

[69]  Thomas J. Misa,et al.  Constructive Technology Assessment: A New Paradigm for Managing Technology in Society , 1995 .

[70]  D. Nafus Quantified: Biosensing Technologies in Everyday Life , 2016 .

[71]  Erika Check Hayden,et al.  Informed consent: A broken contract , 2012, Nature.

[72]  S. Holm,et al.  Ethical Endgames: Broad Consent for Narrow Interests; Open Consent for Closed Minds , 2011, Cambridge Quarterly of Healthcare Ethics.