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American Journal of Epidemiology Vol. 152, No. 4 : 371-378
Copyright © 2000 by The Johns Hopkins University School of Hygiene and Public Health


ORIGINAL CONTRIBUTIONS

Current Medicolegal and Confidentiality Issues in Large, Multicenter Research Programs

Patricia A. Carney1, Berta M. Geller2, Howard Moffett3, Molly Ganger3, Matson Sewell1, William E. Barlow4, Nancy Stalnaker5, Stephen H. Taplin4, Cynthia Sisk4, Virginia L. Ernster6, Heather A. Wilkie6, Bonnie Yankaskas7, Steven P. Poplack1, Nicole Urban8, Michele M. West9, Robert D. Rosenberg10, Sharon Michael11, Thomas D. Mercurio12 and Rachel Ballard-Barbash13

1 Norris Cotton Cancer Center/Dartmouth-Hitchcock Medical Center/Department of Community and Family Medicine, Dartmouth Medical School, Hanover/Lebanon, NH.
2 Office of Health Promotion Research, University of Vermont, College of Medicine, Burlington, VT.
3 Orr and Reno, Professional Association, Concord, NH.
4 Center for Health Studies, Group Health Cooperative of Puget Sound, Seattle, WA.
5 Office of Sponsored Programs, University of Vermont, Burlington, VT.
6 Department of Epidemiology and Biostatistics, University of California, San Francisco, CA.
7 Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC.
8 Fred Hutchinson Cancer Research Center, Seattle, WA.
9 Department of Preventive Medicine, University of Iowa College of Medicine, Iowa City, IA.
10 Department of Radiology, University of New Mexico, Albuquerque, NM.
11 Cancer Prevention and Control Program, Colorado Department of Public Health and Environment, Denver, CO.
12 General Counsel, University of Vermont, Burlington, VT.
13 Applied Research Branch, Cancer Control Program, National Cancer Institute, Bethesda, MD.

The convenience of fast computers and the Internet have encouraged large collaborative research efforts by allowing transfers of data from multiple sites to a single data repository; however, standards for managing data security are needed to protect the confidentiality of participants. Through Dartmouth Medical School, in 1996–1998, the authors conducted a medicolegal analysis of federal laws, state statutes, and institutional policies in eight states and three different types of health care settings, which are part of a breast cancer surveillance consortium contributing data electronically to a centralized data repository. They learned that a variety of state and federal laws are available to protect confidentiality of professional and lay research participants. The strongest protection available is the Federal Certificate of Confidentiality, which supersedes state statutory protection, has been tested in court, and extends protection from forced disclosure (in litigation) to health care providers as well as patients. This paper describes the careful planning necessary to ensure adequate legal protection and data security, which must include a comprehensive understanding of state and federal protections applicable to medical research. Researchers must also develop rules or guidelines to ensure appropriate collection, use, and sharing of data. Finally, systems for the storage of both paper and electronic records must be as secure as possible. Am J Epidemiol 2000;152:371–8.

confidentiality; liability; legal; privacy

Abbreviations: IRB, institutional review board; NCI, National Cancer Institute; QA, quality assurance.


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