[Comment] Research in planetary health: a call for abstracts

Since the publication of the Rockefeller–Lancet Commission Report on Planetary Health,1 interest in planetary health has grown. Planetary health has been defined as the health of human civilisation and the state of the natural systems on which it depends.1 Planetary health research focuses on quantifying the human health effects of accelerating environmental change. To catalyse innovative ideas among the disparate yet integrally related fields, The Lancet will publish a booklet of outstanding abstracts in planetary health research, in conjunction with the annual meeting of the Planetary Health Alliance on April 10–11, 2017, in Washington, DC, USA.

[Correspondence] Use of personal information in medical research in Japan

In Japan, the revised Act on Personal Information Protection was approved in September, 2015, and is scheduled to be put into effect in April, 2017.1 Under this revision, medical history, in addition to race, beliefs, and social status, was newly designated as sensitive personal information. Academic research has been excluded from the application of the Act on Personal Information Protection since before the revision.2 However, the government guidelines to which clinical research other than clinical trials for new drug approval,3 to which the Pharmaceutical Affairs Act applies, must include the same items as the Act on Personal Information Protection.

[Perspectives] Marc Feldmann: a trailblazer of modern immunology

Marc Feldmann, Emeritus Professor at the Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences at the University of Oxford, UK, retired from directing the Kennedy Institute of Rheumatology 2 years ago, and is enjoying a new lease of life, dividing his time between Oxford and New York City’s Mount Sinai Medical School. Research for Feldmann now means a focus on translational science with potential clinical impact, mainly done by mentoring younger researchers.

[Department of Error] Department of Error

Zhang L, Huang Y, Hong S, et al. Gemcitabine plus cisplatin versus fluorouracil plus cisplatin in recurrent or metastatic nasopharyngeal carcinoma: a multicentre, randomised, open-label, phase 3 trial. Lancet 2016; 388: 1883–92—The funding information in the summary should read “Sun Yat-Sen University Clinical Research 5010 Programme, Chinese National Natural Science Foundation project (grant numbers 81372502 and 81201917), the National High Technology Research and Development Program of China (863 program numbers 2012AA02A501 and 2012AA02A502), and the Natural Science Foundation of Guangdong (grant number S2013010016564)”.

[Perspectives] Winnie Yip: tracking health policy and economics in China

Although not born into an academic family—her father was a Hong Kong businessman—it didn’t take Winnie Yip long to discover the rewards of learning. And at the best institutions. A degree in economics from the University of California, Berkeley, was followed, in 1994, by a PhD at the Massachusetts Institute of Technology. Then it was research at Harvard and Oxford and now Harvard again—this time as its newly appointed Professor of the Practice of International Health Policy and Economics. The reward she’s acquired over this time is an international reputation in both these topics.

[Perspectives] Distorted memories: literary perspectives on HM and ethics

Few stories from neuroscience have grabbed the public imagination more than that of an American amnesiac known in published research only by his initials, HM. In 1953, when Henry Molaison was 27 years old, neurosurgeon William Scoville did a medial temporal lobotomy to alleviate his epilepsy. After the operation, Molaison could no longer form long-term memories. For the next five decades he lived in a perpetual present, while research on his brain transformed the understanding of memory.

[Comment] No more neglect of helminths and HIV

Helminths are parasitic worms that disproportionately affect the world’s poorest people and cause chronic disease in a quarter of the global population.1 Helminth infections, such as lymphatic filariasis, schistosomiasis, and intestinal nematodiases, are classified by WHO as neglected tropical diseases.2 For years, these neglected tropical diseases have received minimal global attention and less than 1% of global research funding.3

Medicare data breach prompts law change

The Federal Government has moved to tighten privacy laws after doctor provider numbers were disclosed in a breach of security around Medicare and Pharmaceutical Benefit Scheme data.

Attorney-General George Brandis has announced plans to amend the Privacy Act to make it a criminal offence to re-identify de-identified Government data following a discovery that encrypted MBS and PBS data published by the Health Department had been compromised.

The Department was alerted on 12 September to the worrying security lapse by Melbourne University Department of Computing and Information researchers Dr Chris Culnane, Dr Benjamin Rubinstein and Dr Vanessa Teague, who found they were able to decrypt some service provider ID numbers in the publicly available Medicare 10 per cent dataset. They immediately alerted the Department.

In a statement, the Department said no patient information had been compromised in the incident.

“The dataset does not include names and addresses of service providers, and no patient information was identified,” the Department said. “However, as a result of the potential to extract some doctor and other service provider ID numbers, the Department of Health immediately removed the dataset from the website to ensure the security and integrity of the data is maintained.”

But Shadow Health Minster Catherine King questioned why it had taken the Government 17 days to reveal the security breach, and voiced concerns that there may have been 1500 downloads of the dataset before it was withdrawn by the Department.

“The Government’s 17 day delay in admitting to a breach of health data under their watch is unacceptable,” Ms King said.

Notice of the breach came as a Senate inquiry heard concerns about data security surrounding the decision to award Telstra Health $220 million contract to design and operate the National Cancer Screening Registry, and follows the collapse of Australian Bureau of Statistics systems on census night.

The AMA said that although the data security breach was concerning, it should not result in governments withholding data from being available for research and policy development.

The Association said that although it was paramount that personal information be properly secured and protected, it was important that de-identified and encrypted data be made available by Government to help inform research and the analysis of health information.

Senator Brandis reassured that the Government remained committed to making valuable data publicly available.

“The publication of major datasets is an important part of twenty-first century government providing a great benefit to the community,” the Attorney-General said. “It enables…policymakers, researchers and other interested persons to take full advantage of the opportunities that new technology creates to improve research and policy outcomes.”

But Senator Brandis said that advances in technology had meant that methods used in the past to de-identify data “may become susceptible to re-identification in the future”.

Under his proposed changes to the Privacy Act, it would be a criminal offence to re-identify de-identified Government data, encourage someone else to do it, or to publish or communicate such data.

The Health Department said it was conducting a “full, independent audit” of the process followed in compiling, reviewing and publishing the data, and promised that “this dataset will only be restored when concerns about its potential vulnerabilities are resolved”.

The Office of the Australian Information Commission is undertaking a separate investigation.

Adrian Rollins

Wrist action little help in weight loss

Fitbits and other wearable activity tracking devices could soon join exercise bikes and ab crunch machines in the list of fitness and weight loss technologies that fail to deliver.

While the devices are sure to find their way into many Christmas stockings this year, researchers at the University of Pittsburgh have questioned whether they really help to put people on a path to a leaner, fitter self.

They recruited 471 adults aged between 18 and 35 years with a body mass index of between 25 and 40. All were put on a low-calorie diet with prescribed increases in physical activity and group counselling sessions.

After six months, participants were randomly allocated to one of two groups. The first group began monitoring their diet and activity themselves, and recorded the data on a website, while the second group were given a wearable device and accompanying web technology.

While, over a two-year period, both groups recorded significant improvements in body composition, fitness, physical activity and diet, the group without the wearable devices lost an average of 5.9 kilograms, while those with the devices lost 3.5 kilograms.

The researchers admitted that the results could not be generalised to other age groups, and said the wearable technology used (attached to the upper arm) was different to more contemporary wrist-based devices.

But the results suggest people should be cautious in what benefit they expect such devices might confer in the battle against flab.

“Devices that monitor and provide feedback on physical activity may not offer an advantage over standard behavioural weight loss approaches,” they said.

The study was published in the Journal of the American Medical Association.

Adrian Rollins

Nutting allergies out

Exposing babies to peanuts and eggs may head off a lifetime of unpleasant and potentially deadly allergies.

As researchers puzzle over the proliferation of food and other allergies in Western populations, a high-level analysis of results from 146 studies has found that parents could reduce the risk of allergic reactions in their child to eggs and peanuts later in life by introducing but foods at an early stage.

They found that children introduced to eggs at four to six months of age were less likely to develop an allergy, as were those exposed to peanuts between four and 11 months.

But this inuring effect did not necessarily apply to other foods and substances.

The researchers said there was low certainty that feeding fish to babies early on would result in “reduced allergic sensitisation and rhinitis”.

Similarly, “there was high-certainty evidence that timing of gluten introduction was not associated with celiac disease risk, and timing of allergenic food introduction was not associated with other outcomes”.

While the conclusions are based on the findings of a large number of studies, the researchers were cautious about drawing any definitive conclusions.

“Certainty of evidence was downgraded because of imprecision of effect estimates and indirectness of the populations and interventions studied,” they said. “Timing of egg or peanut introduction was not associated with risk of allergy to other foods.”

Adrian Rollins