Incidental findings in neuroimaging research: a framework for anticipating the next frontier.
Incidental findings in neuroimaging research: a framework for anticipating the next frontier.
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DOI：
10.1525/jer.2012.7.1.53
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发表时间：
2012-02
影响因子：
1.3
通讯作者：
Illes, Judy
中科院分区：
文献类型：
--
作者：
Scott, Nadia A.;Murphy, Timothy H.;Illes, Judy
虽然世界各地的神经影像实验室已经制定和实施了处理研究志愿者脑部扫描中不寻常和可能具有临床意义的解剖学发现的策略，但几乎没有采取具体步骤来考虑下一个前沿：功能异常。根据遗传学文献，神经影像学的早期工作认为，可诉性是决定是否以及何时向被检测到的个体披露发现的驱动力，因为固有的不确定性会引发潜在的伦理困境，即误诊和将人错误标记为患者。在这里，我们考虑的可能性，偶然发现在休息状态下的脑功能。我们的方法并没有锚静息状态作为功能性偶然发现的必要条件，而是作为思考它们在未来可能出现的地方以及我们的专业团体需要如何思考它们的途径。我们认为，今天在一个最大限度灵活和可修改的框架内积极主动地审议这些问题，比事后在没有任何框架的情况下作出反应要好。我们认为，有责任考虑可能的偶然发现，尽管数据解释的模糊性，同时努力防止不必要的警报。
while strategies for handling unusual and possibly clinically significant anatomical findings on brain scans of research volunteers have been developed and implemented across neuroimaging laboratories worldwide, few concrete steps have been taken to consider the next frontier: functional anomalies. Drawing on the genetics literature, early work in neuroimaging considered actionability to be a driving force for determining if and when findings should be disclosed to individuals in whom they are detected, as inherent uncertainty raises potential ethical dilemmas of misdiagnosing and mislabelling people as patients. Here we consider the possibility of incidental findings in brain function during the resting state. Our approach does not anchor the resting state as the sine qua non of functional incidental findings, but as a path to thinking about where they may emerge in the future and how our professional communities need to think about thinking about them. We suggest that considering the issues proactively today, within a framework that is maximally flexible and open to modification, is better than responding reactively after the fact and with no framework at all. We argue that there is a duty to consider possible incidental findings despite the ambiguities of data interpretation, while working hard to prevent unnecessary alarm.
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