Abstract

BackgroundImmense volumes of personal health information (PHI) are required to realize the anticipated benefits of artificial intelligence in clinical medicine. To maintain public trust in medical research, consent policies must evolve to reflect contemporary patient preferences.MethodsPatients were invited to complete a 27-item survey focusing on: (a) broad versus specific consent; (b) opt-in versus opt-out approaches; (c) comfort level sharing with different recipients; (d) attitudes towards commercialization; and (e) options to track PHI use and study results.Results222 participants were included in the analysis; 83% were comfortable sharing PHI with researchers at their own hospital, although younger patients (≤ 49 years) were more uncomfortable than older patients (50 + years; 13% versus 2% uncomfortable, p < 0.05). While 56% of patients preferred broad consent, 38% preferred specific consent; 6% preferred not sharing at all. The majority of patients (63%) preferred to be asked for permission before entry into a contact pool. Again, this trend was more pronounced for younger patients (≤ 49 years: 76%). Approximately half of patients were uncomfortable sharing PHI with commercial enterprises (51% uncomfortable, 27% comfortable, 22% neutral). Most patients preferred to track PHI usage (61%), with the highest proportion once again reported by the youngest patients (≤ 49 years: 71%). A majority of patients also wished to be notified regarding study results (70%).ConclusionsWhile most patients were willing to share their PHI with researchers within their own institution, many preferred a transparent and reciprocal consent process. These data also suggest a generational shift, wherein younger patients preferred more specific consent options. Modernizing consent policies to reflect increased autonomy is crucial in fostering sustained public engagement with medical research.

Highlights

  • Immense volumes of personal health information (PHI) are required to realize the anticipated benefits of artificial intelligence in clinical medicine

  • Full list of author information is available at the end of the article

  • Full Research Ethics Board (REB) approval was granted from the University Health Network (UHN)

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Summary

Introduction

Immense volumes of personal health information (PHI) are required to realize the anticipated benefits of artificial intelligence in clinical medicine. To maintain public trust in medical research, consent policies must evolve to reflect contemporary patient preferences. The use of PHI for research without explicit consent is occurring [3, 6], leading some health law experts to raise the concern that consent issues are poised to become a major social controversy [4, 7]. Proper informed consent is the foundation upon which trusting relationships are built; a wellrecognized principle in health law, and prominent feature of international codes of ethics including the Declaration of Helsinki and the Nuremburg Code [10,11,12,13]. While advocates for non-consensual access to PHI for research do exist, many scholars have been unequivocal that further public engagement is crucial to ensure the use of PHI is ethically defensible and patient-centered [4, 9, 10, 15,16,17]

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