Mapping ethical and social aspects of biomarker research and its application in atopic dermatitis and psoriasis: a systematic review of reason

Abstract

Biomarker research is associated with high hopes for atopic dermatitis and psoriasis research. Although various effectivetreatments have been developed, many challenges remain concerning diagnostics and the development of targeted treat-ments, but also regarding a number of ethical and social issues. In this paper, building on a systematic literature reviewand review of reason, we examine the ethical and social debate on biomarker research for atopic dermatitis and psoriasis.We discuss topics such as risks and benefits of stratification of patient groups, ethical aspects of big data and advancedanalytics for biomarker use in atopic dermatitis and psoriasis. Our systematic literature review of reason, based on estab-lished methodological standards, includes argument-based ethics publications and scientificliteraturewithimplicitlyethi-cally relevant aspects. Thefirst search of biomarker research in dermatology and adjacentfields (e.g., oncology) resultedin a large amount of literature concerning general normative aspects of biomarker research, but suggested a lack of explicitargument-based ethical literature in atopic dermatitis and psoriasis research. We, therefore, conducted a second system-atic search, focusing specifically on atopic dermatitis and psoriasis biomarker research. The 43 relevant articles identifiedthrough both systematic searches were clustered into three topic groups: (i) ethical aspects of stratification and precisionmedicine, (ii) digital ethics and (iii) research ethics with a focus on complexity and validation. We found that compared tootherfields, such as cancer research, the ethical aspects of atopic dermatitis and psoriasis are rarely explained andaddressed in detail. In particular, more work is required on scientific standards, digital ethics and responsible clinical appli-cation of biomarkers for atopic dermatitis and psoriasis, patient participation and ethical implications of biomarker use forchildren or young people with atopic dermatitis and psoriasis. We close with suggestions on how to address the ethicaland social dimension of atopic dermatitis and psoriasis research and practice more directly in future.