| 1. |
|
|
| 2. |
- Forouzanfar, Mohammad H, et al.
(författare)
-
Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990-2013 : a systematic analysis for the Global Burden of Disease Study 2013.
- 2015
-
Ingår i: The Lancet. - 0140-6736 .- 1474-547X. ; 386:10010, s. 2287-2323
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The Global Burden of Disease, Injuries, and Risk Factor study 2013 (GBD 2013) is the first of a series of annual updates of the GBD. Risk factor quantification, particularly of modifiable risk factors, can help to identify emerging threats to population health and opportunities for prevention. The GBD 2013 provides a timely opportunity to update the comparative risk assessment with new data for exposure, relative risks, and evidence on the appropriate counterfactual risk distribution.METHODS: Attributable deaths, years of life lost, years lived with disability, and disability-adjusted life-years (DALYs) have been estimated for 79 risks or clusters of risks using the GBD 2010 methods. Risk-outcome pairs meeting explicit evidence criteria were assessed for 188 countries for the period 1990-2013 by age and sex using three inputs: risk exposure, relative risks, and the theoretical minimum risk exposure level (TMREL). Risks are organised into a hierarchy with blocks of behavioural, environmental and occupational, and metabolic risks at the first level of the hierarchy. The next level in the hierarchy includes nine clusters of related risks and two individual risks, with more detail provided at levels 3 and 4 of the hierarchy. Compared with GBD 2010, six new risk factors have been added: handwashing practices, occupational exposure to trichloroethylene, childhood wasting, childhood stunting, unsafe sex, and low glomerular filtration rate. For most risks, data for exposure were synthesised with a Bayesian meta-regression method, DisMod-MR 2.0, or spatial-temporal Gaussian process regression. Relative risks were based on meta-regressions of published cohort and intervention studies. Attributable burden for clusters of risks and all risks combined took into account evidence on the mediation of some risks such as high body-mass index (BMI) through other risks such as high systolic blood pressure and high cholesterol.FINDINGS: All risks combined account for 57·2% (95% uncertainty interval [UI] 55·8-58·5) of deaths and 41·6% (40·1-43·0) of DALYs. Risks quantified account for 87·9% (86·5-89·3) of cardiovascular disease DALYs, ranging to a low of 0% for neonatal disorders and neglected tropical diseases and malaria. In terms of global DALYs in 2013, six risks or clusters of risks each caused more than 5% of DALYs: dietary risks accounting for 11·3 million deaths and 241·4 million DALYs, high systolic blood pressure for 10·4 million deaths and 208·1 million DALYs, child and maternal malnutrition for 1·7 million deaths and 176·9 million DALYs, tobacco smoke for 6·1 million deaths and 143·5 million DALYs, air pollution for 5·5 million deaths and 141·5 million DALYs, and high BMI for 4·4 million deaths and 134·0 million DALYs. Risk factor patterns vary across regions and countries and with time. In sub-Saharan Africa, the leading risk factors are child and maternal malnutrition, unsafe sex, and unsafe water, sanitation, and handwashing. In women, in nearly all countries in the Americas, north Africa, and the Middle East, and in many other high-income countries, high BMI is the leading risk factor, with high systolic blood pressure as the leading risk in most of Central and Eastern Europe and south and east Asia. For men, high systolic blood pressure or tobacco use are the leading risks in nearly all high-income countries, in north Africa and the Middle East, Europe, and Asia. For men and women, unsafe sex is the leading risk in a corridor from Kenya to South Africa.INTERPRETATION: Behavioural, environmental and occupational, and metabolic risks can explain half of global mortality and more than one-third of global DALYs providing many opportunities for prevention. Of the larger risks, the attributable burden of high BMI has increased in the past 23 years. In view of the prominence of behavioural risk factors, behavioural and social science research on interventions for these risks should be strengthened. Many prevention and primary care policy options are available now to act on key risks.FUNDING: Bill & Melinda Gates Foundation.
|
|
| 3. |
- Arora, Anmol, et al.
(författare)
-
The value of standards for health datasets in artificial intelligence-based applications
- 2023
-
Ingår i: Nature Medicine. - : NATURE PORTFOLIO. - 1078-8956 .- 1546-170X. ; 29, s. 2929-2938
-
Tidskriftsartikel (refereegranskat)abstract
- Artificial intelligence as a medical device is increasingly being applied to healthcare for diagnosis, risk stratification and resource allocation. However, a growing body of evidence has highlighted the risk of algorithmic bias, which may perpetuate existing health inequity. This problem arises in part because of systemic inequalities in dataset curation, unequal opportunity to participate in research and inequalities of access. This study aims to explore existing standards, frameworks and best practices for ensuring adequate data diversity in health datasets. Exploring the body of existing literature and expert views is an important step towards the development of consensus-based guidelines. The study comprises two parts: a systematic review of existing standards, frameworks and best practices for healthcare datasets; and a survey and thematic analysis of stakeholder views of bias, health equity and best practices for artificial intelligence as a medical device. We found that the need for dataset diversity was well described in literature, and experts generally favored the development of a robust set of guidelines, but there were mixed views about how these could be implemented practically. The outputs of this study will be used to inform the development of standards for transparency of data diversity in health datasets (the STANDING Together initiative). A systematic review, combined with a stakeholder survey, presents an overview of current practices and recommendations for dataset curation in health, with specific focuses on data diversity and artificial intelligence-based applications.
|
|
| 4. |
- Eerkes-Medrano, Dafne, et al.
(författare)
-
A community assessment of the demersal fish and benthic invertebrates of the Rosemary Bank Seamount marine protected area (NE Atlantic)
- 2020
-
Ingår i: Deep Sea Research Part I. - : PERGAMON-ELSEVIER SCIENCE LTD. - 0967-0637 .- 1879-0119. ; 156
-
Tidskriftsartikel (refereegranskat)abstract
- The Rosemary Bank Seamount in the NE Atlantic was designated a Marine Protected Area in 2014 by the Scottish Government. Visual and trawl surveys of the seamount have been undertaken since 2007. Here these data are compiled and analysed to provide an assessment of the communities of demersal fish and benthic invertebrates found there. The fish and benthic invertebrate communities changed markedly with depth. Cluster analysis revealed at least four distinct communities of fish: those on the summit, the mid slope, the lower slope and the deep moat at the base of the seamount. The invertebrate community changed at a depth of 1100 m, where mixed-species sponge aggregations dominated to depths of 1500 m. The seamount is an important site for vulnerable marine ecosystems, most notably the extensive and unusually diverse deep-sea sponge grounds on the lower slope. Other prioritised conservation species and habitats recorded included cold water corals, orange roughy, blue ling, leafscale gulper shark and the Portuguese dogfish. Due to sampling constraints some areas of the seamount still remain unknown. A precautionary approach to protecting the entire seamount would achieve multiple conservation objectives. The data presented here serve as a base-line to assess the impact of management intervention in the future.
|
|
| 5. |
|
|
| 6. |
- Hibar, Derrek P., et al.
(författare)
-
Novel genetic loci associated with hippocampal volume
- 2017
-
Ingår i: Nature Communications. - : Springer Science and Business Media LLC. - 2041-1723. ; 8
-
Tidskriftsartikel (refereegranskat)abstract
- The hippocampal formation is a brain structure integrally involved in episodic memory, spatial navigation, cognition and stress responsiveness. Structural abnormalities in hippocampal volume and shape are found in several common neuropsychiatric disorders. To identify the genetic underpinnings of hippocampal structure here we perform a genome-wide association study (GWAS) of 33,536 individuals and discover six independent loci significantly associated with hippocampal volume, four of them novel. Of the novel loci, three lie within genes (ASTN2, DPP4 and MAST4) and one is found 200 kb upstream of SHH. A hippocampal subfield analysis shows that a locus within the MSRB3 gene shows evidence of a localized effect along the dentate gyrus, subiculum, CA1 and fissure. Further, we show that genetic variants associated with decreased hippocampal volume are also associated with increased risk for Alzheimer's disease (r(g) = -0.155). Our findings suggest novel biological pathways through which human genetic variation influences hippocampal volume and risk for neuropsychiatric illness.
|
|
| 7. |
|
|
| 8. |
- McKay, Francis, et al.
(författare)
-
Artificial intelligence and medical research databases: ethical review by data access committees
- 2023
-
Ingår i: BMC Medical Ethics. - : BMC. - 1472-6939. ; 24:1
-
Forskningsöversikt (refereegranskat)abstract
- BackgroundIt has been argued that ethics review committees-e.g., Research Ethics Committees, Institutional Review Boards, etc.- have weaknesses in reviewing big data and artificial intelligence research. For instance, they may, due to the novelty of the area, lack the relevant expertise for judging collective risks and benefits of such research, or they may exempt it from review in instances involving de-identified data.Main bodyFocusing on the example of medical research databases we highlight here ethical issues around de-identified data sharing which motivate the need for review where oversight by ethics committees is weak. Though some argue for ethics committee reform to overcome these weaknesses, it is unclear whether or when that will happen. Hence, we argue that ethical review can be done by data access committees, since they have de facto purview of big data and artificial intelligence projects, relevant technical expertise and governance knowledge, and already take on some functions of ethical review. That said, like ethics committees, they may have functional weaknesses in their review capabilities. To strengthen that function, data access committees must think clearly about the kinds of ethical expertise, both professional and lay, that they draw upon to support their work.ConclusionData access committees can undertake ethical review of medical research databases provided they enhance that review function through professional and lay ethical expertise.
|
|
| 9. |
- McKay, Francis, et al.
(författare)
-
Inalienable data: Ethical imaginaries of de-identified health data ownership
- 2023
-
Ingår i: SSM-QUALITATIVE RESEARCH IN HEALTH. - : ELSEVIER. - 2667-3215. ; 4
-
Tidskriftsartikel (refereegranskat)abstract
- Many legal, ethical, and regulatory frameworks allow de-identified health data to be shared for research without patients opt-in consent. However, there may be public concerns about this practice, as people may feel they should have some say in how such data is used. This paper introduces the concept of the "inalienability of deidentified data," to describe a key assumption underlying that public concern and preference. The assumption, derived from ethnographic research with public and professional stakeholders in AI driven medical image analysis over the past two years, refers to a sense of felt ownership over de-identified health data, even where the subject has been obscured as referent and no clear legal rights of data ownership otherwise exist. The concept is important to medical ethics because it underpins public expectations regarding the rights people should have over the sharing of medical data (including expectations for consent). We note that where those expectations go counter to current legal and bioethical frameworks for de-identified data sharing, they provide a challenge for public support of big data and artificial intelligence driven health research.
|
|
| 10. |
- McKay, Francis, et al.
(författare)
-
The ethical challenges of artificial intelligence-driven digital pathology
- 2022
-
Ingår i: The journal of pathology. Clinical research. - : Wiley. - 2056-4538. ; 8:3, s. 209-216
-
Forskningsöversikt (refereegranskat)abstract
- Digital pathology - the digitalisation of clinical histopathology services through the scanning and storage of pathology slides - has opened up new possibilities for health care in recent years, particularly in the opportunities it brings for artificial intelligence (Al)-driven research. Recognising, however, that there is little scholarly debate on the ethics of digital pathology when used for Al research, this paper summarises what it sees as four key ethical issues to consider when deploying Al infrastructures in pathology, namely, privacy, choice, equity, and trust. The themes are inspired from the authors experience grappling with the challenge of deploying an ethical digital pathology infrastructure to support Al research as part of the National Pathology Imaging Cooperative (NPIC), a collaborative of universities, hospital trusts, and industry partners largely located across the North of England. Though focusing on the UK case, internationally, few pathology departments have gone fully digital, and so the themes developed here offer a heuristic for ethical reflection for other departments currently making a similar transition or planning to do so in the future. We conclude by promoting the need for robust public governance mechanisms in Al-driven digital pathology.
|
|
