Disclosure of research results from cancer genomic studies: state of the science.
Although the cancer research community has supported a "nondisclosure" position about the return of individual results to research subjects, new technologies, such as genome wide association studies, will reveal clinically relevant findings, some of which cannot be ignored. What recommendations exist that can guide researchers and Institutional Review Boards (IRBs) about this issue? This article summarizes the relevant public documents about the disclosure of individual research results to inform policy development. Four stakeholder groups were selected to make this comparison: federal, professional, advisory, and advocacy groups. Regardless of a group's position on disclosure, there was consensus that if research results were to be disclosed under any condition, the results must be analytically and clinically validated and that the researcher should not make this decision alone, but in conjunction with the IRB. There was no consensus, however, on the specific determinants for disclosure or what constitutes clinical validity. Although sufficient agreement exists to begin developing general guidelines about the process for disclosure of individual research results, the actual determinants with which to guide this decision remain challenging. An alternate framework that addresses the threshold of uncertainty a stakeholder is willing to accept, the positive predictive value of the research finding, and the magnitude of harm of returning results may be more effective to guide decision making. These assessments, along with what is considered useful information, requires the involvement of the research subject community to inform decision-making and move the policy process forward.
Dressler
Lynn G
LG
University of North Carolina School of Pharmacy, Division of Pharmaceutical Outcomes and Policy, Institute for Pharmacogenomics and Individualized Therapy, Chapel Hill, North Carolina, USA. lynn_dressler@unc.edu
D035843:Biomedical Research / Q000941:ethics / Q000331:legislation & jurisprudence / Q000639:trends*; D030881:Disclosure / Q000941:ethics / Q000639:trends; D055106:Genome-Wide Association Study / Q000941:ethics / Q000639:trends; D023281:Genomics / Q000941:ethics / Q000331:legislation & jurisprudence / Q000639:trends; D033161:Government Regulation; D006287:Health Planning Guidelines; D006801:Humans; D009369:Neoplasms / Q000235:genetics*; D010344:Patient Advocacy / Q000331:legislation & jurisprudence / Q000523:psychology; D011050:Policy Making