By Don Sadler In:
Validity of Tests In housing health hazards research, both routine clinical tests and experimental tests may be done, depending on the study design and the problem under investigation. For clinical tests, there are standardized testing methods, age-specific normal ranges, predictive value for various diagnoses or conditions, and levels at which clinical interventions should be instituted.
Blood lead measurements are an example of a clinical test often used in housing health hazards research: If researchers carry out tests that are also used in clinical practice, they typically provide patients or their physicians with the results, a description of the normal range of values, and the implications of results outside the normal range.
Providing results of clinical tests in the range of concern to parents of child subjects in a timely manner is ethically required because it allows appropriate medical follow-up to be obtained.
In contrast, experimental tests may have uncertain validity. Indeed, one goal of the research may be to determine the validity of a new method of measuring a variable or the strength of an association between a new measurement and a clinically meaningful outcome. Analytical validity indicates how well the test measures the property or characteristic it was intended to measure: Clinical validity refers to the probability that a test result correctly diagnoses a condition or predicts a disease or clinical condition.
In research on housing health hazards, some experimental tests may be carried out to help characterize the extent of potential exposure. For most such results, a description of the normal range of values and an assessment of the implications of the results is uncertain or unknown.
Many types of tissue and environmental sample measurements do not have established analytical protocols, well-established laboratory quality control and assurance processes, or normative reference ranges or health benchmarks that permit ready interpretation of the test results Centers for Disease Control and Prevention, The significance of results from such experimental tests for an individual subject may be unknown or uncertain until long after the samples have been collected, often not until all study data have been analyzed, and sometimes not even then.
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There is no clinical benefit to reporting the results to individual parents if they cannot be meaningfully interpreted. In biomedical research, when the validity of experimental tests on biological specimens is not established, individual results generally are not reported to participants.
In some cases, some validity of the test can be established at the completion of the study; if so, the researchers may agree to then offer the tests results.
Or they may simply want to have information about themselves even if there are no actions they could take that are known to reduce their risk of health hazards.
That is, they may value the information about themselves for its own sake, even though its significance is unclear. Researchers report that in some cases community groups would like the results of experimental tests such as urinary pesticide metabolite levels without clear clinical implications to be nonetheless made available to the tested individuals if requested Eskenazi et al.
When such disagreements arise, researchers have several ethical obligations that are not spelled out in the federal regulations. As a first step, they should discuss with parents of potential child subjects and community representatives what tests they will be conducting, explaining the limitations of the experimental tests and the potential misinterpretation of results.
They also need to discuss whether test results should be made available. In some cases, researchers may persuade community representatives that there is little benefit and much risk to making results of unvalidated experimental tests available.
In other cases, the community may persuade researchers that the results of individual tests should be made available to all the parents whose children are in the study. If researchers decide to make results of experimental tests available, they need to consider how to do so in ways that minimize the harms and maximize the benefits of providing results.
First, the researchers should offer parents a choice of whether or not to receive results of experimental tests. Some parents will want to know such information, while others will not. Respect for persons requires that individual parents be given a choice.
Second, parents need to understand the potential significance and limita- Page Share Cite Suggested Citation: Parents also need to know where, if anywhere, they might go for help e.
Third, the researchers need to make clear during the informed consent process whether, when, and how the results of experimental tests will be offered to parents.
Some tests are run shortly after samples are taken, while others may be run in batches, sometimes at the end of the study after all samples have been obtained. In some cases, the health significance of particular test results will become known over time, for example, as research on a particular biomarker advances.
Parents should be told in the informed consent process what the researcher will do in such situations.
Similarly, some test results e.Public prosecutors are employed by the government. The public prosecutor in federal criminal cases is called a U.S. attorney. In cases tried in state/local courts, the public prosecutor may be referred to as prosecuting attorney, state prosecutor, state's attorney, district attorney, county attorney, or city attorney.
Ethical Considerations for Research on Housing-Related Health Hazards Involving Children explores the ethical issues posed when conducting research designed to identify, understand, or ameliorate housing-related health hazards among children. Such research involves children as subjects and is conducted in the home and in communities.
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Scholars should consider this cascading process, and they should identify at-risk populations as well as the most important modifiable risk and protective factors in their social relationships. Scholars should also help to clarify when social ties impact health habits, as well as identify which social ties are most important to health at.
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