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      FEEDBACK OF RESEARCH FINDINGS FOR VACCINE TRIALS: EXPERIENCES FROM TWO MALARIA VACCINE TRIALS INVOLVING HEALTHY CHILDREN ON THE KENYAN COAST

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          Abstract

          Internationally, calls for feedback of findings to be made an ‘ethical imperative’ or mandatory have been met with both strong support and opposition. Challenges include differences in issues by type of study and context, disentangling between aggregate and individual study results, and inadequate empirical evidence on which to draw. In this paper we present data from observations and interviews with key stakeholders involved in feeding back aggregate study findings for two Phase II malaria vaccine trials among children under the age of 5 years old on the Kenyan Coast. In our setting, feeding back of aggregate findings was an appreciated set of activities. The inclusion of individual results was important from the point of view of both participants and researchers, to reassure participants of trial safety, and to ensure that positive results were not over-interpreted and that individual level issues around blinding and control were clarified. Feedback sessions also offered an opportunity to re-evaluate and re-negotiate trial relationships and benefits, with potentially important implications for perceptions of and involvement in follow-up work for the trials and in future research. We found that feedback of findings is a complex but key step in a continuing set of social interactions between community members and research staff (particularly field staff who work at the interface with communities), and among community members themselves; a step which needs careful planning from the outset. We agree with others that individual and aggregate results need to be considered separately, and that for individual results, both the nature and value of the information, and the context, including social relationships, need to be taken into account.

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          Most cited references17

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          Ethical and practical guidelines for reporting genetic research results to study participants: updated guidelines from a National Heart, Lung, and Blood Institute working group.

          In January 2009, the National Heart, Lung, and Blood Institute convened a 28-member multidisciplinary Working Group to update the recommendations of a 2004 National Heart, Lung, and Blood Institute Working Group focused on Guidelines to the Return of Genetic Research Results. Changes in the genetic and societal landscape over the intervening 5 years raise multiple questions and challenges. The group noted the complex issues arising from the fact that technological and bioinformatic progress has made it possible to obtain considerable information on individuals that would not have been possible a decade ago. Although unable to reach consensus on a number of issues, the working group produced 5 recommendations. The working group offers 2 recommendations addressing the criteria necessary to determine when genetic results should and may be returned to study participants, respectively. In addition, it suggests that a time limit be established to limit the duration of obligation of investigators to return genetic research results. The group recommends the creation of a central body, or bodies, to provide guidance on when genetic research results are associated with sufficient risk and have established clinical utility to justify their return to study participants. The final recommendation urges investigators to engage the broader community when dealing with identifiable communities to advise them on the return of aggregate and individual research results. Creation of an entity charged to provide guidance to institutional review boards, investigators, research institutions, and research sponsors would provide rigorous review of available data, promote standardization of study policies regarding return of genetic research results, and enable investigators and study participants to clarify and share expectations for the handling of this increasingly valuable information with appropriate respect for the rights and needs of participants.
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            Communicating the Results of Clinical Research to Participants: Attitudes, Practices, and Future Directions

            The authors discuss the available data on the effects of communicating aggregate and individual research results on participants, investigators, and the research enterprise.
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              Medical researchers' ancillary clinical care responsibilities.

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                Author and article information

                Journal
                Dev World Bioeth
                Dev World Bioeth
                dewb
                Developing World Bioethics
                Blackwell Publishing Ltd
                1471-8731
                1471-8847
                April 2013
                21 February 2013
                : 13
                : 1
                : 48-56
                Author notes
                Address for correspondence: Sassy Molyneux, KEMRI – Wellcome Trust Research Programme, 230, Kilifi, Coast 80108, Kenya, Email: SMolyneux@ 123456kilifi.kemri-wellcome.org .

                Conflict of interest statement: No conflicts declared

                Article
                10.1111/dewb.12010
                3662995
                23433355
                fa81e8d8-d38e-4fcd-a4e8-e12c74b5e92a
                Copyright © 2013 Blackwell Publishing Ltd

                Re-use of this article is permitted in accordance with the Creative Commons Deed, Attribution 2.5, which does not permit commercial exploitation.

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                research ethics,sub-saharan africa,empirical ethics,clinical trials,benefit sharing

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