Knowledge, Awareness, and Attitudes about Research Ethics among Dental Faculty in the Middle East: A Pilot Study

Perceptions of the Research Integrity Climate in Egyptian Universities: A Survey Among Academic Researchers

Problem: Investigations regarding perceptions of the institutional research integrity climate in the Arab Middle East remain underexplored. Subjects: We surveyed faculty from three Egyptian universities. Method: We utilized the Survey of Organizational Research Climate (SOuRCe) tool, which incorporates seven subscales that measure different aspects of the research integrity climate. Responses were obtained from a 5-point Likert scale. Findings: Of the 228 participants, the subscales 'Regulatory Quality' and '[Lack of] Integrity Inhibitors' received the highest mean scores, whereas the lowest scores pertained to 'Departmental Expectations,' 'Integrity Socialization,' and 'Responsible Conduct of Research´ indicating areas in need of improvement. Conclusions: Academic leaders should set fairer expectations for research and funding for their researchers, ensure junior researchers are socialized into research integrity practices, and promote effective RCR training and availability of RCR policies. We identify specific targeted interventions to enhance the research integrity climate within these institutions.

Study on good clinical practices among researchers in a tertiary healthcare institute in India

BACKGROUND

Good clinical practice (GCP) is put in place to protect human participants in clinical trials as well as to ensure the quality of research. Non-adherence to these guidelines can produce research that may not meet the standards set by the scientific community. Therefore, it must be ensured that researchers are well-versed in the GCP. But not much is known about the knowledge and practices of the GCP in the medical colleges of North India.

AIM

To assess the knowledge and practices of researchers about GCP and analyze these with respect to the demographics of participants.

METHODS

This is a cross-sectional study. A self-structured questionnaire about GCP, after expert validations, was circulated among researchers, at a tertiary healthcare institute, All India Institute of Medical Sciences (AIIMS), Rishikesh. A total of 59 individuals, who were selected by universal sampling, participated in the study. All healthcare workers who have been investigators of Institutional Ethics Committee-approved research projects, except residents and faculty, and are still a part of the institute have been included in the study. The study was approved by the Institutional Ethics Committee of AIIMS, Rishikesh. We used descriptive analysis and the Chi-squared test to analyze data. P value < 0.05 was considered significant.

RESULTS

Out of 59 participants, only 11 (18.6%) were certified for GCP. Most of the participants (64.4%) had "Average" knowledge, 33.9% had "Good" knowledge and 1.7% had "Poor" knowledge. Only 49% of participants had satisfactory practices related to GCP. There was a significant difference in the knowledge based on the current academic position for the items assessing knowledge of institutional review board (P = 0.010), confidentiality & privacy (P = 0.011), and participant safety & adverse events (P < 0.001). There was also a significant difference in knowledge of research misconduct (P = 0.024) and participant safety & adverse events (P = 0.011) based on certification of GCP. There was a notable difference in the practices related to recruitment & retention on the basis of current academic position (P < 0.001) and certification of GCP (P = 0.023). We also observed a considerable difference between the knowledge and practices of GCP among the participants (P = 0.013).

CONCLUSION

Participants have basic knowledge of GCP but show a lack thereof in certain domains of GCP. This can be addressed by holding training sessions focusing on these particular domains.

Development and validation of a tool to assess researchers' knowledge of human subjects' rights and their attitudes toward research ethics education in Saudi Arabia

BACKGROUND

Researchers must adhere to ethical and scientific standards in their research involving human subjects; therefore, their knowledge of human subjects' rights is essential. A tool to measure the extent of this knowledge is necessary to ensure that studies with participants are conducted ethically and to enhance research integrity. Currently, no validated instrument is available for such an assessment. Therefore, the primary purpose of this study is to develop a reliable and valid instrument to assess researchers' knowledge of human subjects' rights in clinical settings, as well as a reliable and valid measure of their attitudes toward clinical research ethics education in Saudi Arabia.

METHODS

The current study involves the development of a questionnaire about the rights of human subjects in research and the researchers' attitudes toward research ethics education. The content was developed based on an extensive review of research ethics guidelines. A panel of experts tested the questionnaire for face validity (n = 5) and content validity (n = 8). The reliability of the questionnaire was established by a split-half reliability coefficient and item analysis among a sample (n = 301) of clinical researchers.

RESULTS

Face validity demonstrated that the questionnaire was quick to complete and easy to answer. The global content validity indices (S-CVIs) were greater than 0.78 for all questionnaire sections; the split-half reliability coefficient was 0.755 for knowledge items; Cronbach's alpha was 0.77 for researchers' attitudes, showing good internal consistency. The difficulty index ranged from 12.0% to 98.7% for all knowledge items. Most questions were at an acceptable level of reliability and discrimination criteria. The final version of the questionnaire contained 89 items, distributed as 15 questions on demographic and professional characteristics, 64 questions items on knowledge, and 10 items on attitudes.

CONCLUSIONS

The questionnaire is a valid and reliable tool to assess biomedical researchers' knowledge of human subjects' rights and their attitudes toward research ethics education. This instrument could help address the gap in researchers' knowledge of the rights and facilitate the development of educational intervention programs to set appropriate learning objectives.

A Survey Study on Knowledge and Attitude Toward the Ethics Committee and Research Ethical Practices Among Researchers From Kuwait

The integrity of research findings and the safety of participants who voluntarily consent to participate in research studies must be assured through ethical approaches. Additionally, ethical guidelines and the ethics committee protect participants from unfair practices by the research team. Therefore, this study aims to assess the knowledge and attitudes toward the ethics committee and research ethical practices among the researchers of a diabetes institute in Kuwait. An anonymous survey was conducted through an online questionnaire using Microsoft Forms. The study had a response rate of 86%. Among the 55 participants in this study, 43 (78%) had ethics training. Researchers involved in more than four research projects were shown to have a much higher awareness of the ethics committee and its role than researchers involved in no projects. Approximately 90% of researchers had training in research ethics and were knowledgeable about informed consent forms and assent, as well as additional protections for vulnerable populations. Ninety-eight percent of respondents were of the view that an ethics committee was necessary. Our study concluded that most of the researchers at the institute were aware of the role of the ethics committee, and ethical principles. However, we recommend that continuous and customized training on research ethics should be provided.

Awareness and Perception About Research Ethics and Misconduct Among the Teaching Staff of Health Colleges, Jazan University, Saudi Arabia

BACKGROUND

Despite adopting biomedical research ethics rules, regulations, and statements, unethical behavior is pervasive and frequently reported. This study assessed the perception and awareness of research Ethics and Misconduct among the Teaching Staff of Health Colleges at Jazan University, southwest Saudi Arabia.

PURPOSE

This research aimed to assess the awareness and perception of research ethics and misconduct among the teaching staff of the health colleges at Jazan University in southwest Saudi Arabia.

METHODS

Observational cross-sectional study targeted 424 faculty members randomly chosen from health-related colleges at Jazan University. A structured questionnaire was used to collect data using a web-based survey.

RESULTS

The overall level of knowledge about medical ethics indicated that more than half of respondents (57.8%) had a good level of knowledge, 23.4% had a fair level of knowledge, and only 18.4% had poor knowledge. The Saudi National Committee on Bioethics was only known by 49.5% of the study participants. In addition, just 48.3% of respondents knew Saudi Arabia's national standards of ethics and principles for conducting scientific research. The knowledge of research ethics was found to be significantly (P<0.05) higher in participants with higher academic positions, such as professors, MD degree holders, and participants with more extensive work experience. About 48.2% reported that the severity of penalties for scientific misconduct would highly affect scientific integrity, and 74.3% found that their understanding of rules and procedures related to scientific misconduct has a very high effect on scientific integrity. Poor knowledge of research ethics is typically associated with an individual's academic job title, as "lecturer" showed a lower level of knowledge in comparison to other job titles. Even though about 50% of participants in the study had a good understanding of research ethics, it's crucial to ensure that all faculty members have a universal understanding. Therefore, it's essential to implement an appropriate research ethics training program.

Knowledge and attitudes of Chinese medical postgraduates toward research ethics and research ethics committees: a cross-sectional study

BACKGROUND

Research ethics provides the ethical standards for conducting sound and safe research. The field of medical research in China is rapidly growing and facing various ethical challenges. However, in China, little empirical research has been conducted on the knowledge and attitudes of medical postgraduates toward research ethics and RECs. It is critical for medical postgraduates to develop a proper knowledge of research ethics at the beginning of their careers. The purpose of this study was to assess the knowledge and attitudes of medical postgraduates toward research ethics and RECs.

METHODS

This cross-sectional study was conducted from May to July 2021 at a medical school and two affiliated hospitals in south-central China. The instrument of the study was an online survey that was distributed via WeChat.

RESULTS

We found that only 46.7% were familiar with the ethical guidelines for research with human subjects. In addition, 63.2% of participants were familiar with the RECs that reviewed their research, and 90.7% perceived RECs as helpful. However, only 36.8% were fully aware of the functions of RECs. In the meantime, 30.7% believed that review by an REC would delay research and make it more difficult for researchers. Furthermore, most participants (94.9%) believed that a course on research ethics should be mandatory for medical postgraduates. Finally, 27.4% of the respondents considered the fabrication of some data or results to be acceptable.

CONCLUSION

This paper serves to suggest that research ethics education should be prioritized in medical ethics curriculum, and course syllabi or teaching methods should be revised to provide medical postgraduates with a deeper understanding of the principles, regulations, and specifics of research ethics. We also recommend that RECs provide diverse approaches in their review procedure to facilitate the understanding of medical postgraduates of the functions and processes of RECs and to enhance their awareness of research integrity.

Awareness of Clinical Research Coordinators Toward Ethics and Protection of Clinical Trial Patients

PURPOSE

Clinical research coordinators (CRCs) play an important role in the protection of clinical trial participants and maintenance of ethical standards. However, limited data are available on the ethical cognition of CRCs. Understanding the knowledge, attitude, and practices (KAP) of CRCs toward ethics is essential to protect study participants and improve their compliance.

METHODS

We conducted a descriptive, cross-sectional, quantitative study at 20 hospitals in Anhui province of China. A self-administered questionnaire was completed by 435 CRCs conducting clinical trials.

RESULTS

The good knowledge, positive attitude, and good practice rates were 55.2%, 59.3%, and 79.5% respectively. Most CRCs (99.1%) were aware of the participants' rights. Only 127 (29.2%) and 140 (32.2%) CRCs were aware of measures to protect participants' rights and ethical guidelines regarding trials, respectively. In total, 59.6% of CRCs stated that ethical review might delay the start of a clinical trial. Marital status (odds ratio [OR] 0.47, 95% confidence interval [CI] 0.27-0.83), CRC work experience (OR 0.11, 95% CI 0.02-0.75), and educational background (OR 0.31, 95% CI 0.13-0.76) affected the knowledge of CRCs regarding ethics.

CONCLUSIONS

Some deficiencies were observed in the ethical knowledge and behavior of CRCs. Interventions to improve the ethical training of CRCs regarding study participant protection, international guidelines, and the role of ethical committees are essential when conducting clinical trials. Validated instruments should be constructed to assess the effectiveness of ethical training and measure the KAP of CRCs toward ethics.

Nurses' awareness and adherence with national ethical guidelines for research in North India

BACKGROUND

A large number of nurse researchers do not adhere to ethical standards while performing the research. Moreover, there is far less data on knowledge of existing national ethical guidelines. This study was, therefore, done to assess awareness and adherence to current national ethical guidelines among nursing students and faculty members.

METHODS

A cross-sectional descriptive study was done among nursing faculty members and theses carried out by postgraduate nursing students between 2012 and 2017. Using the convenience sampling technique, seven states of North India were selected. In each of the selected seven states, one government and one private nursing college was selected. Thus, a sample of 14 nursing colleges was selected. Then, using simple random sampling, a total of 140 nursing faculty members and 280 postgraduate nursing theses were selected from all the chosen institutes to be part of the study. Data analysis was done using descriptive statistics.

ETHICAL CONSIDERATIONS

The study has been approved by the institutional ethical committee (ECR/737/Inst/UK/2018/RR-18). In addition, written permission from the head of each nursing institute was obtained before conducting the study. After participants read the Participation Information Sheet, they were asked for written informed consent before data collection. Confidentiality of the information and anonymity of the participants were maintained throughout the study.

RESULTS

The majority (81.8%) of the participants were females. It was found that compared to private nurses, government college nurses were more adhered to the research guidelines on research project approval (68.6% vs 22.1%), informed consent guidelines (74.3% vs 25%), providing patient information sheets (55.7% vs 10%), maintaining information confidentiality (82.9% vs 72.1%), maintaining anonymity (76.4% vs 22.9%) and obtaining custodian permission (97.8 vs 89.3%). It was also shown that nurses were more aware of the informed consent process domain (4.3 ± 0.3) followed by the general ethical principles domain (3.8 ± 0.8).

CONCLUSION

Government college nurses adhered more to the research guidelines as compared to those employed in private settings. Most of the faculty members were not part of any clinical trials and had no research ethics training at all. Therefore, it is needed to provide an instructional programme to raise awareness of the research ethical standards.

Implementation of an educational program to promote research ethics in undergraduate medical students

Background:

MBBS students lack training in research ethics which is crucial when they enter clinical practice and venture into clinical research in future. This study was planned to implement an educational module to build concepts in research ethics

Objective:

To assess the change in the knowledge and attitude of medical students towards research ethics.

Methods:

The study was initiated after obtaining institutional ethics committee approval. It was an interventional study, conducted on 2nd MBBS students (N=130) subjected to an educational program which comprised of three modules viz., theme lectures, educational visits and small group case based learning. A prevalidated questionnaire(35 items), was administered at baseline and at the end of 3 modules, to assess the change in the knowledge gained and in the attitude towards ethics in animal and human research. Feedback was obtained from students and faculty to assess the outcome of this program.

Results:

On analyzing the knowledge gained post intervention in 130 students, it was observed that in the post test for the items on ethics committee- need and composition, principles of research ethics was answered correctly by more number of students, which was statistically significant. The statistically significant positive change was observed for attitude of these students towards both animal and human research ethics. Case based discussions provided better understanding of ethical practices and its importance in conducting research as responded by majority students and faculty.

Conclusions:

Educational program on research ethics enhanced learning and brought about the positive attitudinal change. Majority students’ and faculty appreciated the program and considered it as relevant for undergraduate training.

Perceptions of Challenges Affecting Research Ethics Committees’ Members at Medical and Health Science Colleges in Omani and Jordanian Universities

In recent years there has been an increase in research conducted in the Middle East, with a corresponding increase in the challenges faced by members of the Research Ethics Committees (RECs). This study compares the structures of Omani and Jordanian RECs and investigates the perceptions of the challenges affecting the work of the REC members in Oman and Jordan. A convenience sample of 34 Omani and 66 Jordanian participants from 21 universities was recruited in this cross-sectional study. Almost 70% disagreed that the members of RECs are unqualified, providing comments without justification; half believed that members have limited experience in research, and almost three-quarters that they have different opinions regarding some ethical issues. No significant differences were found between Omani and Jordanian REC members regarding their perception of the challenges, except for the perception that reviewing proposals is a time-consuming task (p = 0.048) and that multi-REC centres are less available (p = 0.026). The regression model showed that there were significantly more male members of Jordanian RECs, and that Jordanian members were less likely to receive formal training. In conclusion, the current structure of RECs and the challenges faced by members need to be re-evaluated by decision makers to improve the overall quality of research activities, and to ensure that current REC members’ practices adhere to international standards.

Knowledge, Awareness, Attitudes, and Practices towards Research Ethics and Research Ethics Committees among Myanmar Post-graduate Students

Health research has increased during the last decade, which has enhanced the importance of research ethics. However, little is known regarding the knowledge, awareness, attitudes, and practices of investigators in Myanmar. To assess awareness, knowledge, and attitudes of post-graduates regarding research ethics and research ethics committees (RECs) and their informed consent practices and to determine the association between their responses and certain independent factors. We conducted a cross-sectional study using a questionnaire that was distributed to a convenience sample of post-graduates at the Defence Services Medical Academy in Myanmar. We used descriptive, t test, and chi-square statistics to analyze the data. Significance was set at p < 0.05. We obtained surveys from 204 participants, which included 177 MSc and 27 PhDs of whom 63.6% had performed research and 86.5% had prior ethics training. Regarding awareness, 92.2% were aware of an REC at their academy, but only 47.1% were "fully aware" of the functions of an REC and only 52.9% stated they were familiar with ethical principles that govern human subject research. More than 90% thought that research involving human subjects should be submitted to an REC and that post-graduates should have training on research ethics. However, several of their attitudes were sub-optimal; for example, 20.2% said that informed consent is only necessary from the community leader of a village rather than from the individual, 32.8% agreed it is acceptable to fabricate research data, and 33.0% believed that ethical review of research should be restricted to international collaborative research. Calculated mean total attitude scores were statistically significantly higher in post-graduates with PhDs compared with those with MSc and higher in those with knowledge of research ethics principles compared with those lacking such knowledge. Significant gaps exist among post-graduates regarding their knowledge, awareness, and attitudes regarding research ethics and RECs. We recommend that post-graduates receive further training in research ethics to ensure the ethical conduct of research. Further studies should be performed to determine the generalizability of our findings to other institutions in Myanmar.

Assessing training needs in health research ethics: a case study from the University of Zambia School of Medicine

In many settings, and perhaps especially in low-middle income countries, training institutions do not adequately prepare their students for the ethical challenges that confront them in professional life. We conducted a survey to assess the training needs in research ethics among the faculty at the University of Zambia, School of Medicine (UNZASoM) using a structured questionnaire distributed to faculty members in January 2015. The study was approved by the University of Zambia Biomedical Research Ethics Committee. Seventy-five faculty members of various ranks completed the questionnaire. It was found that 31% of the faculty had not received any research ethics training. Of those who had received training, most of them had received it through short workshops of five days or less (57.4%, n = 31), while only 27.7% received ethics training as a component of an academic degree and 22.2% obtained it through electronic web-based courses. While most faculty (70.7%) reported being well-prepared to guide their students in developing a research methods section of a research protocol, only 25.3% felt they were well-prepared to guide on ethical considerations. This study has demonstrated gaps in research ethics training among faculty members at UNZASoM. Mandatory instruction in research ethics among faculty and students is recommended.

Knowledge and attitudes of physicians toward research ethics and scientific misconduct in Lebanon

Background

Despite the implementation of codes and declarations of medical research ethics, unethical behavior is still reported among researchers. Most of the medical faculties have included topics related to medical research ethics and developed ethical committees; yet, in some cases, unethical behaviors are still observed, and many obstacles are still conferring to applying these guidelines.

Methods

This cross-sectional questionnaire-based study was conducted by interviewing randomly selected 331 Lebanese physicians across Lebanon, to assess their awareness, knowledge and attitudes on practice regarding international and national research ethics guidelines (Lebanese decrees/Laws and CNRS chart of ethics) and scientific misconduct and misbehaviors.

Results

Our results revealed that although majority of participants declared familiar with ethical principles governing research that involves human subjects (79.5%), the overall mean score achieved on their knowledge questions was 46%. Only 27.4% are aware of the presence of the Lebanese National Consultative Committee on Ethics (LNCCE), with only half of them aware of its functions and only 25.7% know about the charter of ethics and guiding principles of scientific research in Lebanon. Significant higher levels of research ethics knowledge were recorded among Ph.D. degree-holding subjects, higher university positions as in professors, research ethics trainings-attendees, and physicians with prior research experience. A significant correlation was observed between knowledge of research ethics principles and positive attitudes toward research ethics principles. Noteworthy, we found that more than one third of participants have reported witnessing scientific misconduct and misbehaviors at some period of their careers.

Conclusions

The presence of low mean awareness levels regarding research ethical principles among the study population of physicians and high levels of perception of scientific misconduct raises concern on the importance of implementing proper training for physicians on research ethics.

The understanding of research ethics at health sciences schools in Jordan: a cross-sectional study

BACKGROUND

Research ethics is required for high-quality research that positively influences society. There is limited understanding of research ethics in Middle Eastern countries including Jordan. Here, we aim to investigate the level of understanding of research ethics principles among health sciences faculty members in Jordan.

METHODS

This is a cross sectional study where faculty members from the University of Jordan were surveyed for their knowledge and, attitude of research ethics principles. The study was conducted in the period between July 2016 to July 2017 using a customized-design questionnaire involving demographic data and participants' contributions toward research, and assessment of participants' knowledge, belief and attitude towards research ethics. Different question-formats have been used including multiple-choice, yes or no, and a four point Likert-type questions. Obtained responses were tabulated according to gender, academic-rank, and knowledge about research ethics principles.

RESULTS

The study had a response rate of 51%. Among the 137 participants of this study, most (96%) were involved in human and animal research, yet, only 2/3 had prior training in research ethics. Moreover, 91% believed that investigators should have training in research ethics and 87% believed that there should be a mandatory postgraduate course on that. The average correct scores for correct understanding of researchers towards research ethics was 62%. Yet, there were some misconceptions about the major ethical principles as only 43% identified them correctly. Additionally, the role of research ethics committees was not well understood by most of the respondents.

CONCLUSIONS

Although there is acceptable knowledge about research ethics, discrepancies in understanding in research ethics principles seems to exist. There is a large support for further training in responsible conduct of research by faculty in health sciences in Jordan. Thus, such training should be required by universities to address this knowledge gap in order to improve research quality and its impact on society.

Awareness of Jordanian Investigators About the Importance of Ethics Review Committees: A Pilot Study

Protection of study participants is an integral function of the Institutional Review Board (IRB). Recently, great efforts were dedicated to enhance investigators' awareness of ethical principles in conducting human research and to implement reviewing committees' standards in Jordan to ensure the transparency, versatility, and responsibility in handling human subjects research in the country. The aim of the current study is to evaluate the awareness and attitudes of healthcare investigators in Jordan towards the structure and importance of IRBs. A questionnaire was distributed to 200 investigators and graduate students from the Jordan University of Science and Technology. The majority of the responses indicated positive knowledge towards core ethics guidelines and the importance of IRBs. This includes beneficence, confidentiality, informed consent, and treating participants with respect. In addition, the majority of participants (> 82%) agreed on the importance of the IRB for ensuring the rights, safety, and well-being of the research subjects. Moreover, the majority of participants (> 80%) agreed that the IRB members should be trained on ethics regulations in conducting research and declare any conflict of interest with the investigators. On the other hand, about 30% of participants believed that being reviewed by the IRB would delay research and make it more difficult for the researcher. Jordanian investigators have good awareness of and knowledge about research ethics and the importance of IRBs, though more education is needed.

Knowledge, Attitudes, and Practice Regarding Research Ethics Committees Among Health Care Faculty at Two Public Universities in Jordan

Human research at Jordanian universities is increasing. This descriptive cross-sectional survey assessed knowledge, attitudes, and practices concerning the procedures and review process of research ethics committees (RECs) among faculty in health sciences in two major Jordanian universities. Most faculty reported having no training in research ethics in their current institutions. Although knowledge of RECs' roles and functions was adequate, deficiencies were found regarding the advisory and monitoring roles for RECs raised in this survey. Faculty expressed concerns about levels of ethical training for members of RECs and potential conflicts of interest and bias in review process. RECs should provide ethics training for faculty, and future research should examine the functioning of the RECs in Jordan and other Middle Eastern countries.

Knowledge, awareness, and attitudes about research ethics committees and informed consent among resident doctors

Background: Medical research involving humans is now common all over the world. Medical doctors and residents are increasingly involved in such research. As part of their training requirements, medical residents in many institutions have to be involved, to different degrees, in human research projects. Methods: In this study, knowledge, awareness, and attitudes of resident doctors toward research ethics committees (REC) and informed consent (IC) processes were evaluated. For that purpose, a sample of 209 medical residents of different years from a major teaching hospital was surveyed. Results: Results showed that resident doctors had minimal knowledge of major ethical guidelines such as the Declaration of Helsinki and Belmont Report. However, more than half of respondents in this study had general knowledge of REC. Additionally, the majority of participants believed that there is a need for REC in each research conducting institution, and that training is also needed for REC members. Moreover, 82.7% of participants thought that investigators should have some training in research ethics. Finally, the current study showed that 60.3%-88.7% of participants were aware of IC requirements in clinical research. Conclusion: Although many residents showed good knowledge and positive attitudes regarding certain aspects related to REC and IC, others need improvement.

Clinical trials in dentistry in India: Analysis from trial registry

Introduction:

Evidence-based practice requires clinical trials to be performed. In India, if any clinical trial has to be performed, it has to be registered with clinical trial registry of India. Studies have shown that the report of clinical trials is poor in dentistry. Hence, the present study has been conducted to assess the type and trends of clinical trials being undertaken in dentistry in India over a span of 6 years.

Methodology:

All the clinical trials which were registered with the Central Trial Registry of India (CTRI) (www.ctri.nic.in) from January 1, 2007 to March 3, 2014 were evaluated using the keyword “dental.” Following information were collected for each of the clinical trials obtained from the search; number of centres (single center/multicentric), type of the institution undertaking the research (government/private/combined), study (observational/interventional), study design (randomized/single blinded/double-blinded), type of health condition, type of participants (healthy/patients), sponsors (academia/commercial), phase of clinical trial (Phase 1/2/3/4), publication details (published/not published), whether it was a postgraduate thesis or not and prospective or retrospective registration of clinical trials, methodological quality (method of randomization, allocation concealment). Descriptive statistics was used for analysis of various categories. Trend analysis was done to assess the changes over a period of time.

Results:

The search yielded a total of 84 trials of which majority of them were single centered. Considering the study design more than half of the registered clinical trials were double-blinded (47/84 [56%]). With regard to the place of conducting a trial, most of the trials were planned to be performed in private hospitals (56/84 [66.7%]). Most (79/84, 94.1%) of the clinical trials were interventional while only 5/84 (5.9%) were observational. Majority (65/84, 77.4%) of the registered clinical trials were recruiting patients while the rest were being done in healthy participants. From 2011, some of the postgraduate thesis trials had also been registered (2011-8; 2012-8; 2013-13; 2014-6). Inadequacy in reporting the method of randomization and allocation concealment was observed in 37/67 (55.2%) and 31/67 (46.2%) clinical trials respectively. A considerable number of postgraduate theses was also registered with CTRI in dentistry and majority of the clinical trials despite being completed are not yet published.

Conclusion:

The number of clinical trials in dentistry are low in India, and more focus should be placed by dental investigators regarding the reporting standards. Furthermore, researchers and trial sponsors should aim at publication of the research findings so that it is made publically available for use. A clear-cut need exists for an increase in both the quantity and quality of clinical trials in dentistry.

Knowledge, Attitudes and Practice about Research Ethics among Dental Faculty in the North India

BACKGROUND

Research activities in dentistry are increased greatly in India during the recent decade, but there is limited of information about the knowledge and attitude of dental faculty for research ethics. To assess the knowledge and attitudes of dental faculty of North India regarding research ethics.

MATERIALS AND METHODS

Through convenience sampling, a questionnaire was sent either via printed copies or E-mails to 1240 dental faculty, while protecting confidentiality and anonymity of all the participants.

RESULTS

Our response rate was 76% (942). Majority (>90%) are aware of ethical committee but have poor knowledge (8-35%) about various ethical guidelines laid down at international level; however almost 20% believe that research ethics committees would delay research. A large number of researchers (78%) want some training in research ethics. There is fair knowledge about informed consent among researchers.

CONCLUSIONS

We conclude that ethical norms should be strictly followed by giving due respect to confidentiality or privacy of research participants to achieve the goal of minimal risks and maximum benefits to patients and there is need of training to researchers and students to make them aware about various research principles.

An Insight Into Research Ethics among Dental Professionals in A Dental Institute, India- A Pilot Study

BACKGROUND

Research activities are increasing in all the fields of medicine including dentistry but there is dearth of information about the knowledge, attitude and behaviour of dental professionals for ethical principles in research, especially in the developing countries like India.

OBJECTIVE

To assess knowledge, attitude and behaviour among dental professionals pertaining to research ethics.

MATERIALS AND METHODS

A self-administered, close ended questionnaire survey with cross-sectional design was conducted in a private dental institute in India. All the house-surgeons, post-graduate students and the faculty of the same institute were included for the assessment of the knowledge, attitude and behaviour regarding research ethics using a 24, 8 and 8 items.

RESULTS

A total of 213 of 230 dental professionals participated (response rate of 92.6%). Mean knowledge, attitude and behaviour scores were 43.3%, 82.5% and 46.37%, respectively. Significant correlations were observed of age and gender with the attitude about the research ethics among study subjects (χ(2)=14.383, p=0.006 and χ(2)=7.769, p=0.021, respectively).

CONCLUSION

Participants had favorable attitude towards research ethics, but their knowledge and behaviour needs considerable improvements. The age and gender were associated with attitude. The present pilot study highlights the need for further nationwide study and development of research ethics curriculum in detail for dental education in India.

Enhancing Research Ethics Review Systems in Egypt: The Focus of an International Training Program Informed by an Ecological Developmental Approach to Enhancing Research Ethics Capacity

Recently, training programs in research ethics have been established to enhance individual and institutional capacity in research ethics in the developing world. However, commentators have expressed concern that the efforts of these training programs have placed 'too great an emphasis on guidelines and research ethics review', which will have limited effect on ensuring ethical conduct in research. What is needed instead is a culture of ethical conduct supported by national and institutional commitment to ethical practices that are reinforced by upstream enabling conditions (strong civil society, public accountability, and trust in basic transactional processes), which are in turn influenced by developmental conditions (basic freedoms of political freedoms, economic facilities, social opportunities, transparency guarantees, and protective security). Examining this more inclusive understanding of the determinants of ethical conduct enhances at once both an appreciation of the limitations of current efforts of training programs in research ethics and an understanding of what additional training elements are needed to enable trainees to facilitate national and institutional policy changes that enhance research practices. We apply this developmental model to a training program focused in Egypt to describe examples of such additional training activities.

A mixed-methods study on perceptions towards use of Rapid Ethical Assessment to improve informed consent processes for health research in a low-income setting

Background

Rapid Ethical Assessment (REA) is a form of rapid ethnographic assessment conducted at the beginning of research project to guide the consent process with the objective of reconciling universal ethical guidance with specific research contexts. The current study is conducted to assess the perceived relevance of introducing REA as a mainstream tool in Ethiopia.

Methods

Mixed methods research using a sequential explanatory approach was conducted from July to September 2012, including 241 cross-sectional, self-administered and 19 qualitative, in-depth interviews among health researchers and regulators including ethics committee members in Ethiopian health research institutions and universities.

Results

In their evaluation of the consent process, only 40.2% thought that the consent process and information given were adequately understood by study participants; 84.6% claimed they were not satisfied with the current consent process and 85.5% thought the best interests of study participants were not adequately considered. Commonly mentioned consent-related problems included lack of clarity (48.1%), inadequate information (34%), language barriers (28.2%), cultural differences (27.4%), undue expectations (26.6%) and power imbalances (20.7%). About 95.4% believed that consent should be contextualized to the study setting and 39.4% thought REA would be an appropriate approach to improve the perceived problems. Qualitative findings helped to further explore the gaps identified in the quantitative findings and to map-out concerns related to the current research consent process in Ethiopia. Suggestions included, conducting REA during the pre-test (pilot) phase of studies when applicable. The need for clear guidance for researchers on issues such as when and how to apply the REA tools was stressed.

Conclusion

The study findings clearly indicated that there are perceived to be correctable gaps in the consent process of medical research in Ethiopia. REA is considered relevant by researchers and stakeholders to address these gaps. Exploring further the feasibility and applicability of REA is recommended.

Enhancing research ethics capacity in the Middle East: experience and challenges of a Fogarty-sponsored training program

We describe the research ethics capacity needs of the countries from the Middle East region. Against this background, we relate the experience of an international training program focused on providing long-term training in research ethics to individuals from low and middle-income countries in the Middle East area. We describe our pedagogical approach to training, program changes to address challenges faced, and accomplishments of trainees. Many former trainees developed research ethics curricula in their home institutions, established or enhanced their institutions' research ethics committees, provided leadership to national research ethics systems, and conducted research in research ethics. Based on our analysis, we make recommendations for how trainees can further address current regional research ethics needs in the Middle East and conduct future research. This paper is part of a collection of papers analyzing the Fogarty International Center's International Research Ethics Education and Curriculum Development program.

Perspectives of Egyptian research ethics committees regarding their effective functioning

The recent increase in research in the Middle East has been associated with the establishment of research ethics committees (RECs). Our aim was to obtain perspectives of RECs regarding the challenges that impede their effective functioning. We conducted in-depth interviews using a semi-structured interview guide. We transcribed and analyzed the interviews to uncover major themes and subthemes. We identified the following themes: membership composition; training needs of members; availability of human and capital resources; role of the national government; concerns with the informed consent process; government scrutiny of research; investigator-related issues; and concerns with transfer of biological samples to other countries. Our interview study revealed several barriers that need to be considered by appropriate stakeholders to enhance adequate functioning of RECs.

Reporting of Ethical Considerations Associated with Clinical Trials Published in Iranian Dental Journals between 2001 and 2011

BACKGROUND

Ethical consideration is a basic requirement for design of randomized clinical trials. The purpose of this study was to assess whether reports of Iranian dental clinical trials complied with the requirements of the ethical principles of human research.

METHODS

In this retrospective observational study electronic search was performed to identify all dental clinical trials published between 2001 and 2011. Each trial report was assessed for inclusion of a statement that 17 items about research ethics.

RESULTS

Totally 242 papers were identified, of which 15.3%, stated that ethical approval had been obtained and 50.4% of the trial reports indicated that informed consent had been obtained. The mean ethical score for the mentioned studies was 7/68 out of 17.

CONCLUSIONS

Most Iranian dental clinical trial reports failed to consider important ethical principles. The reporting of the ethical issues associated with these trials could be improved further not only by the instructions to authors, but also by Journal editors refusing to publish trials that do not comply.