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Salamanca-Buentello F, Katz R, Silva DS, Upshur REG, Smith MJ. Research ethics review during the COVID-19 pandemic: An international study. PLoS One 2024; 19:e0292512. [PMID: 38626030 PMCID: PMC11020390 DOI: 10.1371/journal.pone.0292512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 03/23/2024] [Indexed: 04/18/2024] Open
Abstract
Research ethics review committees (ERCs) worldwide faced daunting challenges during the COVID-19 pandemic. There was a need to balance rapid turnaround with rigorous evaluation of high-risk research protocols in the context of considerable uncertainty. This study explored the experiences and performance of ERCs during the pandemic. We conducted an anonymous, cross-sectional, global online survey of chairs (or their delegates) of ERCs who were involved in the review of COVID-19-related research protocols after March 2020. The survey ran from October 2022 to February 2023 and consisted of 50 items, with opportunities for descriptive responses to open-ended questions. Two hundred and three participants [130 from high-income countries (HICs) and 73 from low- and middle-income countries (LMICs)] completed our survey. Respondents came from diverse entities and organizations from 48 countries (19 HICs and 29 LMICs) in all World Health Organization regions. Responses show little of the increased global funding for COVID-19 research was allotted to the operation of ERCs. Few ERCs had pre-existing internal policies to address operation during public health emergencies, but almost half used existing guidelines. Most ERCs modified existing procedures or designed and implemented new ones but had not evaluated the success of these changes. Participants overwhelmingly endorsed permanently implementing several of them. Few ERCs added new members but non-member experts were consulted; quorum was generally achieved. Collaboration among ERCs was infrequent, but reviews conducted by external ERCs were recognized and validated. Review volume increased during the pandemic, with COVID-19-related studies being prioritized. Most protocol reviews were reported as taking less than three weeks. One-third of respondents reported external pressure on their ERCs from different stakeholders to approve or reject specific COVID-19-related protocols. ERC members faced significant challenges to keep their committees functioning during the pandemic. Our findings can inform ERC approaches towards future public health emergencies. To our knowledge, this is the first international, COVID-19-related study of its kind.
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Affiliation(s)
- Fabio Salamanca-Buentello
- Lunenfeld-Tanenbaum Research Institute, Bridgepoint Collaboratory for Research and Innovation, Sinai Health, Toronto, Canada
| | - Rachel Katz
- Institute for the History and Philosophy of Science and Technology, University of Toronto, Toronto, Canada
| | - Diego S. Silva
- School of Public Health, The University of Sydney, Sydney, Australia
| | - Ross E. G. Upshur
- Lunenfeld-Tanenbaum Research Institute, Bridgepoint Collaboratory for Research and Innovation, Sinai Health, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
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Beshir L. Research Ethics Committees in Laboratory Medicine. EJIFCC 2020; 31:282-291. [PMID: 33376468 PMCID: PMC7745300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Biomedical research that involves human subjects requires compliance with ethical principles and guidelines. The ethical and scientific standards of research have been thoroughly discussed by international ethical guidelines and declarations. Compliance with these ensures the autonomy, dignity and well-being of research subjects; as well as the integrity and credibility of research results. Research ethics committees (RECs) are mandated to ensure that research proposals are scientifically sound and ethical. In this review, we define RECs in laboratory medicine and describe their role based on the examination of the requirements of ethical research; discuss particular ethical issues that arise in laboratory medicine research using biological samples, what challenges they face and how they can ensure the quality of their review. RECs need to be put into a broader framework that ensures institutional governance with continuous evaluation and auditing that ensure the quality of ethical review.
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Affiliation(s)
- Lamis Beshir
- Department of Clinical Immunology, Sudan Medical Specialization Board, Khartoum, Sudan
- On behalf of the IFCC Task Force on Ethics (TF-E)
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Ballantyne A, Schaefer GO. Public interest in health data research: laying out the conceptual groundwork. JOURNAL OF MEDICAL ETHICS 2020; 46:610-616. [PMID: 32376719 DOI: 10.1136/medethics-2020-106152] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 03/31/2020] [Accepted: 04/10/2020] [Indexed: 06/11/2023]
Abstract
The future of health research will be characterised by three continuing trends: rising demand for health data; increasing impracticability of obtaining specific consent for secondary research; and decreasing capacity to effectively anonymise data. In this context, governments, clinicians and the research community must demonstrate that they can be responsible stewards of health data. IRBs and RECs sit at heart of this process because in many jurisdictions they have the capacity to grant consent waivers when research is judged to be of particular value. However, several different terms are used to refer to this value (including public interest, public benefit, public good and social value), indicating a lack of conceptual clarity regarding the appropriate test for access to health data for research without consent. In this paper we do three things. First we describe the current confusion and instability in terminology relating to public interest in the context of consent waivers. Second we argue for harmonisation of terminology on the grounds of clarity, transparency and consistency. Third we argue that the term 'public interest' best reflects the normative work required to justify consent waivers because it is the broadest of the competing terms. 'Public interest' contains within its scope positive and negative implications of a study, as well as welfare, justice and rights considerations. In making this argument, we explain the normative basis for consent waivers, and provide a starting place for further discussion about the precise conditions in which a given study can be said to advance the public interest. Ipsos MORI study found that: … the public would be broadly happy with administrative data linking for research projects provided (1) Those projects have social value, broadly defined. (2) Data are de-identified. (3) Data are kept secure. (4) Businesses are not able to access the data for profit.
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Affiliation(s)
- Angela Ballantyne
- Centre for Biomedical Ethics, Yong Loo Lin School of Medicine, National University Singapore, Singapore
| | - G Owen Schaefer
- Centre for Biomedical Ethics, Yong Loo Lin School of Medicine, National University Singapore, Singapore
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Bozorghadad S, Newton IG, Perez AW, Makary MS, Keller EJ. Research Ethics in IR: The Intersection Between Care and Progress. J Vasc Interv Radiol 2020; 31:846-848. [PMID: 32359529 DOI: 10.1016/j.jvir.2020.02.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 02/08/2020] [Accepted: 02/14/2020] [Indexed: 11/15/2022] Open
Affiliation(s)
| | - Isabel G Newton
- Department of Radiology, Division of Vascular and Interventional Radiology, University of California San Diego, San Diego, California
| | - Andrew W Perez
- Department of Radiology, Division of Vascular and Interventional Radiology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Mina S Makary
- Department of Radiology, Division of Vascular and Interventional Radiology, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Eric J Keller
- Department of Radiology, Division of Vascular and Interventional Radiology, Stanford University, 300 Pasteur Drive, H3630, Stanford, CA 94305.
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The New 2019 Institutional Review Board Common Rule Update: Implications for Plastic Surgery Research. Plast Reconstr Surg 2020; 145:1323-1330. [PMID: 32332559 DOI: 10.1097/prs.0000000000006752] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Clinical research remains at the forefront of academic practice and evidence-based medicine. Unfortunately, history has shown that human subjects are vulnerable to experimentation without regard for their own dignity and informed decision-making. Subsequently, it is vital for research institutes to uphold safeguards and ethical conscientiousness toward human subjects. The establishment of federal regulations and the development of institutional review boards have set guidance on these processes. On January 21, 2019, final revisions to the Federal Policy for the Protection of Human Subjects (the "Common Rule") went into effect. The purpose of this article is to review changes to the Common Rule and discuss their impact on plastic surgery research.
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Commentary on The Effect of Postoperative Telephone Calls on Patient Satisfaction and Scar Satisfaction Following Mohs Micrographic Surgery. Dermatol Surg 2019; 45:1465-1466. [PMID: 31188148 DOI: 10.1097/dss.0000000000001968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Freed MC, Novak LA, Killgore WDS, Rauch SAM, Koehlmoos TP, Ginsberg JP, Krupnick JL, Rizzo AS, Andrews A, Engel CC. IRB and Research Regulatory Delays Within the Military Health System: Do They Really Matter? And If So, Why and for Whom? THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2016; 16:30-37. [PMID: 27366845 DOI: 10.1080/15265161.2016.1187212] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Institutional review board (IRB) delays may hinder the successful completion of federally funded research in the U.S. military. When this happens, time-sensitive, mission-relevant questions go unanswered. Research participants face unnecessary burdens and risks if delays squeeze recruitment timelines, resulting in inadequate sample sizes for definitive analyses. More broadly, military members are exposed to untested or undertested interventions, implemented by well-intentioned leaders who bypass the research process altogether. To illustrate, we offer two case examples. We posit that IRB delays often appear in the service of managing institutional risk, rather than protecting research participants. Regulators may see more risk associated with moving quickly than risk related to delay, choosing to err on the side of bureaucracy. The authors of this article, all of whom are military-funded researchers, government stakeholders, and/or human subject protection experts, offer feasible recommendations to improve the IRB system and, ultimately, research within military, veteran, and civilian populations.
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Affiliation(s)
- Michael C Freed
- a Deployment Health Clinical Center, Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury and Uniformed Services University of the Health Sciences
| | - Laura A Novak
- b Deployment Health Clinical Center, Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury
| | | | - Sheila A M Rauch
- d Emory University School of Medicine and Atlanta VA Medical Center
| | - Tracey P Koehlmoos
- e Headquarters, U.S. Marine Corps and Uniformed Services University of the Health Sciences
| | - J P Ginsberg
- f William Jennings Bryan Dorn VA Medical Center and University of South Carolina School of Medicine
| | | | - Albert Skip Rizzo
- h University of Southern California Institute for Creative Technologies
| | - Anne Andrews
- i Headquarters, Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury and National Institute of Standards and Technology
| | - Charles C Engel
- j Uniformed Services University of the Health Sciences and RAND Corporation
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McEvenue G, Hofer SOP, Lista F, Ahmad J. Performing Ethical Research as a Plastic Surgeon in Private Practice: The Institutional Review Board. Aesthet Surg J 2016; 36:508-14. [PMID: 26792910 DOI: 10.1093/asj/sjv263] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2015] [Indexed: 11/12/2022] Open
Affiliation(s)
- Giancarlo McEvenue
- From the Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada. Dr Lista is Breast Section Co-editor for Aesthetic Surgery Journal (ASJ). Dr Ahmad is My Way Section Editor for ASJ
| | - Stefan O P Hofer
- From the Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada. Dr Lista is Breast Section Co-editor for Aesthetic Surgery Journal (ASJ). Dr Ahmad is My Way Section Editor for ASJ
| | - Frank Lista
- From the Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada. Dr Lista is Breast Section Co-editor for Aesthetic Surgery Journal (ASJ). Dr Ahmad is My Way Section Editor for ASJ
| | - Jamil Ahmad
- From the Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada. Dr Lista is Breast Section Co-editor for Aesthetic Surgery Journal (ASJ). Dr Ahmad is My Way Section Editor for ASJ
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Zawati MH, Junker A, Knoppers BM, Rahimzadeh V. Streamlining review of research involving humans: Canadian models. J Med Genet 2015; 52:566-9. [PMID: 26041760 DOI: 10.1136/jmedgenet-2014-102640] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Accepted: 05/10/2015] [Indexed: 11/03/2022]
Affiliation(s)
- Ma'n H Zawati
- Faculty of Medicine, Department of Human Genetics, Centre of Genomics and Policy, McGill University, Montreal, Quebec, Canada
| | - Anne Junker
- Faculty of Medicine, Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Bartha Maria Knoppers
- Faculty of Medicine, Department of Human Genetics, Centre of Genomics and Policy, McGill University, Montreal, Quebec, Canada
| | - Vasiliki Rahimzadeh
- Faculty of Medicine, Department of Human Genetics, Centre of Genomics and Policy, McGill University, Montreal, Quebec, Canada
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