title: Technical and policy approaches to balancing patient privacy and data sharing in clinical and translational research.
abstract: BACKGROUND
  Clinical researchers need to share data to support scientific validation and information reuse and to comply with a host of regulations and directives from funders. Various organizations are constructing informatics resources in the form of centralized databases to ensure reuse of data derived from sponsored research. The widespread use of such open databases is contingent on the protection of patient privacy.
  
  
  METHODS
  We review privacy-related problems associated with data sharing for clinical research from technical and policy perspectives. We investigate existing policies for secondary data sharing and privacy requirements in the context of data derived from research and clinical settings. In particular, we focus on policies specified by the US National Institutes of Health and the Health Insurance Portability and Accountability Act and touch on how these policies are related to current and future use of data stored in public database archives. We address aspects of data privacy and identifiability from a technical, although approachable, perspective and summarize how biomedical databanks can be exploited and seemingly anonymous records can be reidentified using various resources without hacking into secure computer systems.
  
  
  RESULTS
  We highlight which clinical and translational data features, specified in emerging research models, are potentially vulnerable or exploitable. In the process, we recount a recent privacy-related concern associated with the publication of aggregate statistics from pooled genome-wide association studies that have had a significant impact on the data sharing policies of National Institutes of Health-sponsored databanks.
  
  
  CONCLUSIONS
  Based on our analysis and observations we provide a list of recommendations that cover various technical, legal, and policy mechanisms that open clinical databases can adopt to strengthen data privacy protection as they move toward wider deployment and adoption.
authors.affiliation: Department of Biomedical Informatics, Vanderbilt University, Nashville, TN 37203, USA. b.malin@vanderbilt.edu
authors.forename: Bradley
authors.initials: B
authors.lastname: Malin
authors.forename: David
authors.initials: D
authors.lastname: Karp
authors.forename: Richard H
authors.initials: RH
authors.lastname: Scheuermann
mesh_terms: D001483:Base Sequence; D016494:Computer Security; D055106:Genome-Wide Association Study; D005838:Genotype; D006801:Humans; D033181:Information Dissemination; D009316:National Institutes of Health (U.S.); D010641:Phenotype; D018907:Privacy; D057170:Translational Research, Biomedical; D014481:United States