Searched for: person:owensk06
in-biosketch:yes
Those designing healthcare algorithms must become actively anti-racist
Owens, Kellie; Walker, Alexis
PMCID:7810137
PMID: 32908272
ISSN: 1546-170x
CID: 5197502
From "Human in the Loop" to a Participatory System of Governance for AI in Healthcare [Comment]
Griffen, Zachary; Owens, Kellie
PMID: 39226015
ISSN: 1536-0075
CID: 5686952
Protect newborn screening programs [Letter]
Owens, Kellie; Chapman, Carolyn; Caplan, Arthur
PMID: 36996201
ISSN: 1095-9203
CID: 5463382
How Clinicians Conceptualize "Actionability" in Genomic Screening
Owens, Kellie; Sankar, Pamela; Asfaha, Dina M
Over the last decade, the concept of actionability has become a primary framework for assessing whether genetic data is useful and appropriate to return to patients. Despite the popularity of this concept, there is little consensus about what should count as "actionable" information. This is particularly true in population genomic screening, where there is considerable disagreement about what counts as good evidence and which clinical actions are appropriate for which patients. The pathway from scientific evidence to clinical action is not straightforward-it is as much social and political as it is scientific. This research explores the social dynamics shaping the integration of "actionable" genomic data into primary care settings. Based on semi-structured interviews with 35 genetics experts and primary care providers, we find that clinicians vary in how they define and operationalize "actionable" information. There are two main sources of disagreement. First, clinicians differ on the levels and types of evidence required for a result to be actionable, such as when we can be confident that genomic data provides accurate information. Second, there are disagreements about the clinical actions that must be available so that patients can benefit from that information. By highlighting the underlying values and assumptions embedded in discussions of actionability for genomic screening, we provide an empirical basis for building more nuanced policies regarding the actionability of genomic data in terms of population screening in primary care settings.
PMCID:9959215
PMID: 36836524
ISSN: 2075-4426
CID: 5423172
The passivists: Managing risk through institutionalized ignorance in genomic medicine
Owens, Kellie
As the era of big data transforms modern medicine, clinicians have access to more health data than ever. How do medical providers determine which data are relevant to patient care, which are irrelevant, and which may be inappropriately used to justify potentially harmful interventions? One of the most prominent medical fields to address these questions head on - clinical genomics - is actively debating how to assess the value of genomic data. In-depth interviews with clinicians and a content analysis of policy documents demonstrate that while many clinicians believe that collecting as much patient data as possible will lead to better patient care, a sizeable minority of clinicians preferred to collect less data. These clinicians worried that large genomic tests provided too much data, leading to confusion and inappropriate treatment. Clinical geneticists have also started developing the concept of "actionability" to assess which types of genomic data are worth collecting and interpreting. By classifying data as useful when it can or should lead to action, clinicians can formalize and institutionalize what types of data should be ignored. But achieving consensus about what counts as "actionable" has proven difficult and highlights the different values and risk philosophies of clinicians. At the same time, many clinicians are fighting against the ignorance arising from genomic databases predominantly filled with samples from European ancestry populations. Debates about how and when to institutionalize ignorance of health data are not unique to clinical genomics, but have spread throughout many fields of medicine. As the amount of health data available to clinicians and patients grows, social science research on the politics of knowledge and ignorance should inform debates about the value of data in medicine.
PMCID:8821417
PMID: 35033797
ISSN: 1873-5347
CID: 5197532
"The ultimate risk:" How clinicians assess the value and meaning of genetic data in cardiology
Owens, Kellie
In modern medicine, health risks are often managed through the collection of health data and subsequent intervention. One of the goals of clinical genetics, for example, is to identify genetic predisposition to disease so that individuals can intervene to prevent potential harms. But recently, some clinicians have suggested that patients should undergo less testing and monitoring in an effort to reduce overdiagnosis and overtreatment. In this paper, I explore how clinicians navigate the tension between identifying real disease risks for their patients with concerns about overdiagnosis and overtreatment. I focus on clinicians ordering genetic testing for inherited cardiovascular diseases. Of the genes determined to be "clinically actionable" by the American College of Medical Genetics and Genomics (ACMG), half are related to cardiovascular diseases. But, due in part to high levels of uncertainty surrounding cardiovascular genetics, there is still disagreement within the field about how to order and interpret these tests. Based on semi-structured, in-depth interviews with 20 clinicians who order genetic testing for cardiovascular diseases, I find that there is considerable variability in the ways that clinicians determine which types of genetic tests are appropriate for their patients and how they interpret test results. Most importantly, I find that many providers do not presume that more genetic data will lead to better care. Instead, increased genetic data can lead to confusion and inappropriate treatment. This re-valuation of the utility of medical data is crucial for bioethicists to explore, especially as medical fields are sorting through increasing amounts of data.
PMCID:8514197
PMID: 34650330
ISSN: 1477-7509
CID: 5197522
Too Much of a Good Thing? American Childbirth, Intentional Ignorance, and the Boundaries of Responsible Knowledge
Owens, Kellie
ISI:000407155000005
ISSN: 0162-2439
CID: 5197562
Colorblind Science? Perceptions of the Importance of Racial Diversity in Science Research
Owens, Kellie
ISI:000382505400003
ISSN: 1913-0465
CID: 5197552
From Classification to Governance: Ethical Challenges of Adaptive Learning in Medicine [Comment]
Griffen, Zachary; Rosen, Kyra; Horwitz, Leora; Owens, Kellie
PMID: 39283393
ISSN: 1536-0075
CID: 5720022
From Classification to Governance: Ethical Challenges of Adaptive Learning in Medicine [Comment]
Griffen, Zachary; Rosen, Kyra; Horwitz, Leora; Owens, Kellie
PMID: 39283393
ISSN: 1536-0075
CID: 5720012