《中华流行病学杂志》和American Journal of Epidemiology 的医学伦理问题比较

为比较近5年中国与西方国家流行病学杂志中相关伦理意识的发展现状,发现中国流行病学研究中存在的主要伦理学问题.查阅《中华流行病学杂志》和American Journal of Epidemiology(两刊)2006年1月至2010年12月刊登的文献,对其中以人为研究对象的原始论著的伦理意识进行比较.中美两刊分别纳入论著749和1221篇.结果显示:(1)中美两刊中说明“经受试者知情同意”的论文分别为29.24％和38.08％(x2=16.02,P＜0.001);声明“通过伦理委员会审批”分别为6.94％和63.23％(x2=604.40,P＜0.0001).(2)两刊伦理意识均呈逐年上升趋势.(3)试验性研究论文的伦理意识好于观察性研究.(4) American Journal of Epidemiology中涉及的伦理审 查、采集受试者生物标本和隐私信息等方面的伦理意识均好于《中华流行病学杂志》.与American Journal of Epidemiology相比,《中华流行病学杂志》无论总体上还是在不同作者机构、采集标本和收集隐私等方面,其伦理审查和知情同意意识均有较大差距.

Differences on ethical consciousness issues between the Chinese Journal of Epidemiology and the American Journal of Epidemiology

To compare the differences on current ethical issues in the areas of epidemiological practice between China and America,to identify the major ethical problems existing in the epidemiological studies in China.Through searching and reviewing papers published on Chinese Journal of Epidemiology and American Journal of Epidemiology from Jan.2006 to Dec.2010,we made a comparison on ethical issues involved in the original studies that focusing on human beings.In total,749 Chinese articles and 1221 American articles were recruited,with the following findings: (1)The proportion with announcements of “Informed consent by the subjects” was 29.24％ in Chinese literature and 38.08％ in the Americans (x2=16.02,P＜0.001 ).The proportion with “having had approvals from the ethic committees” was 29.24％ in Chinese,while 38.08％ in American ( x2=604.40,P＜ 0.0001 ).(2) Both in China and America,there had been an increase of ethical issues in the last 5 years.(3)Articles derived from trial studies had better involvement on ethics than those from observational studies.(4) The level on ethical issues in the American Research Institutes exceeded those in China (5)American studies also had showed better ideas on Ethic issues on biological specimens collection and privacy protection,than those in Chinese studies.Among the studies on Chinese Journal of Epidemiology,the proportion of ‘informed consent' was higher than in ethical review,but both ethical review and awareness on ‘informed consent' had left far behind than the American Journal of Epidemiology.This could be seen at the institution level of the writers,during specimen collection and privacy protection,as well as at the overall level.The results reminded us that the Departments of Technology Management should spend more efforts on the improvement of public education regarding ethics for researchers and to update the process of edition for Journals as well as to reinforce the rules of ethics in epidemiological research.