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      Issues and Challenges Associated with Data-Sharing in LMICs: Perspectives of Researchers in Thailand

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          Abstract.

          Data-sharing helps advance scientific research and assures the benefits of research data are maximized. Previous work has highlighted ethical challenges, especially in low- and middle-income countrie (LMIC) countries. This study examined the views of researchers in a middle-income country, Thailand, regarding the most important data-sharing challenges. The target researchers worked in biomedical and related research. The survey was distributed to 38 academic and health-science institutes, 18 university hospitals, 84 nonuniversity hospitals, and 22 research institutes across Thailand; 229 researchers in clinical/basic and social/behavioral sciences, and pubxxlic health/policy participated. Thai researchers were less concerned with informed consent and the feasibility of conducting research and sharing data, focusing on the importance of safeguards when handling data, including transfer to others, and possible lack of control over subsequent data use. The respondents felt that researchers should decide what types of project data are shareable and which data are likely useful to the scientific community. They were more concerned with appropriate acknowledgment and protecting the legal rights of the primary data collectors and providers. Although they had concerns about data access conditions, they rated sharing sufficient data and metadata to reproduce the analysis of the primary outcomes as highly important. These results are important for future efforts of the LMIC countries to develop efficient data-sharing frameworks and establish institutional data access committees. They highlight the importance, for the sustainability and fairness of these efforts, to ensure that parties in LMIC countries receive appropriate credit and are involved in determining where/when/how their data may be used.

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          A systematic review of barriers to data sharing in public health

          Background In the current information age, the use of data has become essential for decision making in public health at the local, national, and global level. Despite a global commitment to the use and sharing of public health data, this can be challenging in reality. No systematic framework or global operational guidelines have been created for data sharing in public health. Barriers at different levels have limited data sharing but have only been anecdotally discussed or in the context of specific case studies. Incomplete systematic evidence on the scope and variety of these barriers has limited opportunities to maximize the value and use of public health data for science and policy. Methods We conducted a systematic literature review of potential barriers to public health data sharing. Documents that described barriers to sharing of routinely collected public health data were eligible for inclusion and reviewed independently by a team of experts. We grouped identified barriers in a taxonomy for a focused international dialogue on solutions. Results Twenty potential barriers were identified and classified in six categories: technical, motivational, economic, political, legal and ethical. The first three categories are deeply rooted in well-known challenges of health information systems for which structural solutions have yet to be found; the last three have solutions that lie in an international dialogue aimed at generating consensus on policies and instruments for data sharing. Conclusions The simultaneous effect of multiple interacting barriers ranging from technical to intangible issues has greatly complicated advances in public health data sharing. A systematic framework of barriers to data sharing in public health will be essential to accelerate the use of valuable information for the global good. Electronic supplementary material The online version of this article (doi:10.1186/1471-2458-14-1144) contains supplementary material, which is available to authorized users.
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            Broad Consent for Research With Biological Samples: Workshop Conclusions.

            Different types of consent are used to obtain human biospecimens for future research. This variation has resulted in confusion regarding what research is permitted, inadvertent constraints on future research, and research proceeding without consent. The National Institutes of Health (NIH) Clinical Center's Department of Bioethics held a workshop to consider the ethical acceptability of addressing these concerns by using broad consent for future research on stored biospecimens. Multiple bioethics scholars, who have written on these issues, discussed the reasons for consent, the range of consent strategies, and gaps in our understanding, and concluded with a proposal for broad initial consent coupled with oversight and, when feasible, ongoing provision of information to donors. This article describes areas of agreement and areas that need more research and dialogue. Given recent proposed changes to the Common Rule, and new guidance regarding storing and sharing data and samples, this is an important and timely topic.
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              Data Sharing Statements for Clinical Trials: A Requirement of the International Committee of Medical Journal Editors

              The International Committee of Medical Journal Editors (ICMJE) believes there is an ethical obligation to responsibly share data generated by interventional clinical trials because trial participants have put themselves at risk. In January 2016 we published a proposal aimed at helping to create an environment in which the sharing of deidentified individual participant data becomes the norm. In response to our request for feedback we received many comments from individuals and groups.1 Some applauded the proposals while others expressed disappointment they did not more quickly create a commitment to data sharing. Many raised valid concerns regarding the feasibility of the proposed requirements, the necessary resources, the real or perceived risks to trial participants, and the need to protect the interests of patients and researchers. It is encouraging that data sharing is already occurring in some settings. Over the past year, however, we have learned that the challenges are substantial and the requisite mechanisms are not in place to mandate universal data sharing at this time. Although many issues must be addressed for data sharing to become the norm, we remain committed to this goal. Therefore, ICMJE will require the following as conditions of consideration for publication of a clinical trial report in our member journals: As of July 1, 2018 manuscripts submitted to ICMJE journals that report the results of clinical trials must contain a data sharing statement as described below. Clinical trials that begin enrolling participants on or after January 1, 2019 must include a data sharing plan in the trial's registration. The ICMJE's policy regarding trial registration is explained at www.icmje.org/recommendations/browse/publishing-and-editorial-issues/clinical-trial-registration.html . If the data sharing plan changes after registration this should be reflected in the statement submitted and published with the manuscript, and updated in the registry record. Data sharing statements must indicate the following: whether individual deidentified participant data (including data dictionaries) will be shared; what data in particular will be shared; whether additional, related documents will be available (e.g., study protocol, statistical analysis plan, etc.); when the data will become available and for how long; by what access criteria data will be shared (including with whom, for what types of analyses and by what mechanism). Illustrative examples of data sharing statements that would meet these requirements are in the Table. Table Examples of data sharing statements that fulfill these ICMJE requirements*. Example 1 Example 2 Example 3 Example 4 Will individual participant data be available (including data dictionaries)? Yes Yes Yes No What data in particular will be shared? All of the individual participant data collected during the trial, after deidentification. Individual participant data that underlie the results reported in this article, after deidentification (text, tables, figures, and appendices). Individual participant data that underlie the results reported in this article, after deidentification (text, tables, figures and appendices). Not available What other documents will be available? Study Protocol, Statistical Analysis Plan, Informed Consent Form, Clinical Study Report, Analytic Code Study Protocol, Statistical Analysis Plan, Analytic Code Study Protocol Not available When will data be available (start and end dates)? Immediately following publication. No end date. Beginning 3 months and ending 5 years following article publication. Beginning 9 months and ending 36 months following article publication. Not applicable With whom? Anyone who wishes to access the data. Researchers who provide a methodologically sound proposal. Investigators whose proposed use of the data has been approved by an independent review committee (“learned intermediary”) identified for this purpose. Not applicable For what types of analyses? Any purpose. To achieve aims in the approved proposal. For individual participant data meta-analysis. Not applicable By what mechanism will data be made available? Data are available indefinitely at (Link to be included). Proposals should be directed to xxx@yyy. To gain access, data requestors will need to sign a data access agreement. Data are available for 5 years at a third party website. (Link to be included) Proposals may be submitted up to 36 months following article publication. After 36 months the data will be available in our University's data warehouse but without investigator support other than deposited metadata. Information regarding submitting proposals and accessing data may be found at (Link to be provided). Not applicable * These examples are meant to illustrate a range of, but not all, data sharing options. These initial requirements do not yet mandate data sharing, but investigators should be aware that editors may take into consideration data sharing statements when making editorial decisions. These minimum requirements are intended to move the research enterprise closer to fulfilling our ethical obligation to participants. Some ICMJE member journals already maintain, or may choose to adopt, more stringent requirements for data sharing. Sharing clinical trial data is one step in the process articulated by the World Health Organization (WHO) and other professional organizations as best practice for clinical trials: universal prospective registration; public disclosure of results from all clinical trials (including through journal publication); and data sharing. Although universal compliance with the requirement to prospectively register clinical trials has not yet been achieved and requires continued emphasis, we must work toward fulfilling the other steps of best practice as well-including data sharing. As we move forward into this new norm where data are shared, greater understanding and collaboration among funders, ethics committees, journals, trialists, data analysts, participants, and others will be required. We are currently working with members of the research community to facilitate practical solutions to enable data sharing. The United States Office for Human Research Protections has indicated that provided the appropriate conditions are met by those receiving them, the sharing of deidentified individual participant data from clinical trials does not require separate consent from trial participants.2 Specific elements to enable data sharing statements that meet these requirements have been adopted at ClinicalTrials.gov (https://prsinfo.clinicaltrials.gov/definitions.html#shareData). The WHO also supports the addition of such elements at the primary registries of the International Clinical Trials Registry Platform. Unresolved issues remain, including appropriate scholarly credit to those who share data, and the resources needed for data access, the transparent processing of data requests, and data archiving. We welcome creative solutions to these problems at www.icmje.org. We envision a global research community in which sharing deidentified data becomes the norm. Working toward this vision will help maximize the knowledge gained from the efforts and sacrifices of clinical trial participants.
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                Author and article information

                Journal
                Am J Trop Med Hyg
                Am. J. Trop. Med. Hyg
                tpmd
                tropmed
                The American Journal of Tropical Medicine and Hygiene
                The American Society of Tropical Medicine and Hygiene
                0002-9637
                1476-1645
                July 2020
                11 May 2020
                11 May 2020
                : 103
                : 1
                : 528-536
                Affiliations
                [1 ]Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand;
                [2 ]Office of Research Services, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand;
                [3 ]Mahidol Vivax Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand;
                [4 ]Department of Philosophy, University of Bergen, Bergen, Norway;
                [5 ]Department of Bioethics, National Institutes of Health Clinical Center, National Institutes of Health, Bethesda, Maryland
                Author notes
                [* ]Address correspondence to Pornpimon Adams, Office of Research Services, Faculty of Tropical Medicine, Mahidol University, 420-6 Ratchawithi Rd., Ratchathewi, Bangkok 10400, Thailand. E-mail: pornpimon.ada@ 123456mahidol.edu

                Disclosure: This study was approved by the Ethics Committee of the Faculty of Tropical Medicine, Mahidol University, Thailand, Approval Number TMEC 18-042. Data are shared in the attachment file.

                Disclaimer: The study participants were informed about the study purpose and answered the questionnaire anonymously; they were free to skip any item they did not wish to answer. David Wendler works for the U.S. NIH Clinical Center. However, the views expressed are the author’s own. They do not represent the position or policy of the U.S. NIH or Federal Government.

                Authors’ addresses: Jaranit Kaewkungwal, Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand, E-mail: jaranit.kae@ 123456mahidol.ac.th . Pornpimon Adams, Office of Research Services, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand, E-mail: pornpimon.ada@ 123456mahidol.edu . Jetsumon Sattabongkot, Mahidol Vivax Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand, E-mail: jetsumon.pra@ 123456mahidol.ac.th . Reidar K. Lie, Department of Philosophy, University of Bergen, Bergen, Norway, E-mail: reidar.lie@ 123456uib.no . David Wendler, Department of Bioethics, National Institutes of Health Clinical Center, National Institutes of Health, Bethesda, MD, E-mail: dwendler@ 123456cc.nih.gov .

                Article
                tpmd190651
                10.4269/ajtmh.19-0651
                7356467
                32394875
                7c1926fb-1eda-4597-9bf9-72a497526169
                © The American Society of Tropical Medicine and Hygiene

                This is an open-access article distributed under the terms of the Creative Commons Attribution (CC-BY) License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 02 September 2019
                : 08 April 2020
                Page count
                Pages: 9
                Categories
                Articles

                Infectious disease & Microbiology
                Infectious disease & Microbiology

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