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      Participatory governance over research in an academic research network: the case of Diabetes Action Canada

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          Abstract

          Digital data generated in the course of clinical care are increasingly being leveraged for a wide range of secondary purposes. Researchers need to develop governance policies that can assure the public that their information is being used responsibly. Our aim was to develop a generalisable model for governance of research emanating from health data repositories that will invoke the trust of the patients and the healthcare professionals whose data are being accessed for health research. We developed our governance principles and processes through literature review and iterative consultation with key actors in the research network including: a data governance working group, the lead investigators and patient advisors. We then recruited persons to participate in the governing and advisory bodies. Our governance process is informed by eight principles: (1) transparency; (2) accountability; (3) follow rule of law; (4) integrity; (5) participation and inclusiveness; (6) impartiality and independence; (7) effectiveness, efficiency and responsiveness and (8) reflexivity and continuous quality improvement. We describe the rationale for these principles, as well as their connections to the subsequent policies and procedures we developed. We then describe the function of the Research Governing Committee, the majority of whom are either persons living with diabetes or physicians whose data are being used, and the patient and data provider advisory groups with whom they consult and communicate. In conclusion, we have developed a values-based information governance framework and process for Diabetes Action Canada that adds value over-and-above existing scientific and ethics review processes by adding a strong patient perspective and contextual integrity. This model is adaptable to other secure data repositories.

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          Evaluating patient and stakeholder engagement in research: moving from theory to practice.

          Despite the growing demand for research that engages stakeholders, there is limited evidence in the literature to demonstrate its value - or return on investment. This gap indicates a general lack of evaluation of engagement activities. To adequately inform engagement activities, we need to further investigate the dividends of engaged research, and how to evaluate these effects. This paper synthesizes the literature on hypothesized impacts of engagement, shares what has been evaluated and identifies steps needed to reduce the gap between engagement's promises and the underlying evidence supporting its practice. This assessment provides explicit guidance for better alignment of engagement's promised benefits with evaluation efforts and identifies specific areas for development of evaluative measures and better reporting processes.
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            Google DeepMind and healthcare in an age of algorithms

            Data-driven tools and techniques, particularly machine learning methods that underpin artificial intelligence, offer promise in improving healthcare systems and services. One of the companies aspiring to pioneer these advances is DeepMind Technologies Limited, a wholly-owned subsidiary of the Google conglomerate, Alphabet Inc. In 2016, DeepMind announced its first major health project: a collaboration with the Royal Free London NHS Foundation Trust, to assist in the management of acute kidney injury. Initially received with great enthusiasm, the collaboration has suffered from a lack of clarity and openness, with issues of privacy and power emerging as potent challenges as the project has unfolded. Taking the DeepMind-Royal Free case study as its pivot, this article draws a number of lessons on the transfer of population-derived datasets to large private prospectors, identifying critical questions for policy-makers, industry and individuals as healthcare moves into an algorithmic age.
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              Building a pan-Canadian primary care sentinel surveillance network: initial development and moving forward.

              The development of a pan-Canadian network of primary care research networks for studying issues in primary care has been the vision of Canadian primary care researchers for many years. With the opportunity for funding from the Public Health Agency of Canada and the support of the College of Family Physicians of Canada, we have planned and developed a project to assess the feasibility of a network of networks of family medicine practices that exclusively use electronic medical records. The Canadian Primary Care Sentinel Surveillance Network will collect longitudinal data from practices across Canada to assess the primary care epidemiology and management of 5 chronic diseases: hypertension, diabetes, depression, chronic obstructive lung disease, and osteoarthritis. This article reports on the 7-month first phase of the feasibility project of 7 regional networks in Canada to develop a business plan, including governance, mission, and vision; develop memorandum of agreements with the regional networks and their respective universities; develop and obtain approval of research ethics board applications; develop methods for data extraction, a Canadian Primary Care Sentinel Surveillance Network database, and initial assessment of the types of data that can be extracted; and recruitment of 10 practices at each network that use electronic medical records. The project will continue in phase 2 of the feasibility testing until April 2010.
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                Author and article information

                Journal
                BMJ Open
                BMJ Open
                bmjopen
                bmjopen
                BMJ Open
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                2044-6055
                2019
                20 April 2019
                : 9
                : 4
                : e026828
                Affiliations
                [1 ] departmentInstitute of Health Policy, Management and Evaluation , University of Toronto , Toronto, Ontario, Canada
                [2 ] departmentDalla Lana School of Public Health , University of Toronto , Toronto, Ontario, Canada
                [3 ] departmentFamily and Community Medicine , University of Toronto , Toronto, Ontario, Canada
                [4 ] departmentFamily and Community Medicine , North York General Hospital , Toronto, Ontario, Canada
                [5 ] Infoclin , Toronto, Canada
                [6 ] Patent Representative , Toronto, Ontario, Canada
                [7 ] departmentSchool of Medicine , University of St. Andrews , St Andrews, UK
                Author notes
                [Correspondence to ] Dr Donald J Willison; don.willison@ 123456utoronto.ca
                Author information
                http://orcid.org/0000-0002-2848-3791
                http://orcid.org/0000-0001-8957-0285
                http://orcid.org/0000-0003-1317-7035
                http://orcid.org/0000-0002-6623-4964
                Article
                bmjopen-2018-026828
                10.1136/bmjopen-2018-026828
                6500288
                31005936
                cca0d87f-09f8-4276-bec5-f02fc35f97fd
                © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

                This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

                History
                : 21 September 2018
                : 15 February 2019
                : 18 February 2019
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100008097, Department of Family and Community Medicine, University of Toronto;
                Funded by: FundRef http://dx.doi.org/10.13039/501100000035, Institute of Nutrition, Metabolism and Diabetes;
                Funded by: North York General Hospital;
                Categories
                Health Informatics
                Communication
                1506
                1702
                1684
                Custom metadata
                unlocked

                Medicine
                information governance,research governance,participatory governance
                Medicine
                information governance, research governance, participatory governance

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