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Should free-text data in electronic medical records be shared for research? A citizens’ jury study in the UK
  1. Elizabeth Ford1,
  2. Malcolm Oswald2,
  3. Lamiece Hassan3,
  4. Kyle Bozentko4,
  5. Goran Nenadic5,
  6. Jackie Cassell1
  1. 1 Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, UK
  2. 2 Citizens’ Juries CIC, Manchester, UK
  3. 3 Division of Informatics, Imaging and Data Sciences, School of Health Sciences, University of Manchester, Manchester, UK
  4. 4 Jefferson Center, Saint Paul, Minnesota, USA
  5. 5 Department of Computer Science, The University of Manchester, Manchester, United Kingdom
  1. Correspondence to Dr Elizabeth Ford, Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton BN1 9PH, UK; e.m.ford{at}bsms.ac.uk

Abstract

Background Use of routinely collected patient data for research and service planning is an explicit policy of the UK National Health Service and UK government. Much clinical information is recorded in free-text letters, reports and notes. These text data are generally lost to research, due to the increased privacy risk compared with structured data. We conducted a citizens’ jury which asked members of the public whether their medical free-text data should be shared for research for public benefit, to inform an ethical policy.

Methods Eighteen citizens took part over 3 days. Jurors heard a range of expert presentations as well as arguments for and against sharing free text, and then questioned presenters and deliberated together. They answered a questionnaire on whether and how free text should be shared for research, gave reasons for and against sharing and suggestions for alleviating their concerns.

Results Jurors were in favour of sharing medical data and agreed this would benefit health research, but were more cautious about sharing free-text than structured data. They preferred processing of free text where a computer extracted information at scale. Their concerns were lack of transparency in uses of data, and privacy risks. They suggested keeping patients informed about uses of their data, and giving clear pathways to opt out of data sharing.

Conclusions Informed citizens suggested a transparent culture of research for the public benefit, and continuous improvement of technology to protect patient privacy, to mitigate their concerns regarding privacy risks of using patient text data.

  • stakeholder participation
  • medical text
  • natural language processing
  • text mining
  • privacy
  • healthcare
https://creativecommons.org/licenses/by/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.

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Footnotes

  • Twitter @drelizabethford

  • Contributors EF conceived the study and acquired the funding. EF and MO designed the study and led the design of the study materials, with input and consensus from all authors. EF, LM, MO, KB and JC were involved in running the jury. EF drafted the manuscript and all authors contributed to and approved the final version.

  • Funding This study was funded by a grant from the UK Healthcare Text Analytics Network, which is funded by the Engineering and Physical Sciences Research Council.

  • Competing interests EF, LH, GN and JC are members of the UK Healthcare Text Analytics Network, which funded the study.

  • Patient consent for publication Not required.

  • Ethics approval This study was reviewed by the Brighton and Sussex Medical School Research Governance and Ethics Committee (RGEC), which granted ethical and research governance approval to proceed (ref. ER/BSMS2730/4).

  • Provenance and peer review Not commissioned; externally peer reviewed.

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