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Mainous AG, Struelens MJ, Bao S. The importance of patients in conflict of interest declarations. Front Med (Lausanne) 2024; 11:1365067. [PMID: 38572157 PMCID: PMC10988291 DOI: 10.3389/fmed.2024.1365067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 03/11/2024] [Indexed: 04/05/2024] Open
Affiliation(s)
- Arch G Mainous
- Department of Health Services Research Management, and Policy, University of Florida, Gainesville, FL, United States
- Department of Community Health and Family Medicine, University of Florida, Gainesville, FL, United States
| | - Marc J Struelens
- Emeritus, Faculty of Medicine, Université libre de Bruxelles, Brussels, Belgium
| | - Shisan Bao
- Center for Laboratory and Simulation Training, School of Public Health, Center for Evidence-Based Medicine, Gansu University of Chinese Medicine, Lanzhou, Gansu, China
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2
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Gordon BG, Lowe AE, Kratochvil CJ. Rapid Review of Therapy Protocols for Public Health Emergencies. Ethics Hum Res 2024; 46:16-21. [PMID: 38446100 DOI: 10.1002/eahr.500203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2024]
Abstract
How research during a public health emergency is conducted is recognized as essential to the public health response to that emergency. Such research needs to undergo substantive and meaningful ethical review in a timely manner. Rapid ethical review may be accomplished through a number of mechanisms, including use of local rapid-response institutional review boards (IRBs). We describe use of such a model in the setting of the 2014 Ebola virus disease epidemic and the Rapid-Response IRB's subsequent transition to a multisite single IRB model during the current Covid-19 pandemic. The rapid-response review model is characterized by a small IRB with extensive use of alternate members with specific expertise and by close collaboration with the investigator in an iterative process.
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Affiliation(s)
- Bruce G Gordon
- Assistant vice-chancellor for regulatory affairs, and executive chairman of the IRBs at the University of Nebraska Medical Center
| | - Abigail E Lowe
- Assistant professor at the College of Allied Health Professions and a scholar at the Global Center for Health Security at the University of Nebraska Medical Center
| | - Christopher J Kratochvil
- Senior advisor and Distinguished Chair at the Global Center for Health Security, and vice chancellor of external relations at the University of Nebraska Medical Center
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3
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Bierer BE, Zarin DA, Gelinas L. Deprioritization of Ongoing Clinical Trials. Ethics Hum Res 2023; 45:27-33. [PMID: 37777980 DOI: 10.1002/eahr.500180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/03/2023]
Abstract
To be ethical, clinical trials must exhibit a favorable risk-benefit balance at the time of their initiation. However, in some cases, the expected value of a study decreases while the study is ongoing, due to developments outside of the study itself, such as findings from other studies or an otherwise shifting evidence base. While such situations are acknowledged in the research community, they have not received sufficient attention, given the high costs of uninformative studies, both in material and human capital. In addition, the Covid-19 pandemic has exposed serious shortcomings with current approaches to monitoring studies for continued relevance and value. In this article, with reference to a case study from the Covid-19 pandemic, we identify and describe the importance and challenge of ensuring that clinical trials continue to exhibit scientific relevance and value once initiated. We explore the ethical dynamics of these situations and identify unresolved issues. While more empirical work is needed to ensure that proposed solutions to the issues are evidence based, we offer some provisional considerations that amount to a framework for approaching these challenging situations.
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Affiliation(s)
- Barbara E Bierer
- Faculty director of the Multi-Regional Clinical Trials Center of the Brigham and Women's Hospital and Harvard, a senior physician at Brigham and Women's Hospital, and a professor of medicine at Harvard Medical School
| | - Deborah A Zarin
- Program director at the Multi-Regional Clinical Trials Center of the Brigham and Women's Hospital and Harvard
| | - Luke Gelinas
- Senior IRB chair director at Advarra and a senior advisor at the Multi-Regional Clinical Trials Center of Brigham and Women's Hospital and Harvard
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4
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Abstract
Much of precision medicine is driven by big health data research-the analysis of massive datasets representing the complex web of genetic, behavioral, environmental, and other factors that impact human well-being. There are some who point to the Common Rule, the regulation governing federally funded human subjects research, as a regulatory panacea for all types of big health data research. But how well does the Common Rule fit the regulatory needs of this type of research? This article suggests that harms that may arise from artificial intelligence and machine-learning technologies used in big health data research-and the increased likelihood that this research will affect public policy-mean it is time to consider whether the current human research regulations prohibit comprehensive, ethical review of big health data research that may result in group harm.
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Affiliation(s)
| | - Sara Meeder
- Director of Human Research Protections at Maimonides Medical Center
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5
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Dickert NW, Metz K, Deeds SI, Linke MJ, Mitchell AR, Speight CD, Adeoye OM. Getting the Most out of Consent: Patient-Centered Consent for an Acute Stroke Trial. Ethics Hum Res 2022; 44:33-40. [PMID: 35218601 DOI: 10.1002/eahr.500122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Informed consent for clinical trials in acute stroke is characterized by challenges related to urgency, cognitive impairment, and geographical separation. Context-appropriate approaches are needed for this setting. We conducted a mixed-methods project involving focus groups and interviews as well as collaboration with a patient advisory panel and a central institutional review board (CIRB) to design and implement a patient-driven consent process for a multicenter trial incorporating adaptive randomization. Remote consent was recognized as challenging but acceptable. Adaptive randomization was viewed positively, but significant potential for misunderstanding was appreciated. Collaboration between the patient advisory panel and the CIRB resulted in a shortened, more patient-centered consent form that was approved at all sites with few modifications. An information sheet was developed as a resource for patients and surrogates after enrollment. Collaboration between investigators, patient partners, and a CIRB can facilitate innovation and implementation of patient-centered, context-appropriate consent strategies.
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Affiliation(s)
- Neal W Dickert
- Associate professor in the Department of Medicine at the Emory University School of Medicine and in the Department of Epidemiology at the Emory University Rollins School of Public Health
| | - Kathleen Metz
- Resident in the Department of Emergency Medicine at Emory University School of Medicine
| | - S Iris Deeds
- Project manager in the Department of Emergency Medicine at the Washington University School of Medicine
| | - Michael J Linke
- Adjunct professor and IRB chair at the University of Cincinnati College of Medicine
| | - Andrea R Mitchell
- Senior research administrative coordinator in the Department of Medicine at the Emory University School of Medicine
| | - Candace D Speight
- Data analyst in the Department of Medicine at the Emory University School of Medicine
| | - Opeolu M Adeoye
- Professor and the chair of the Department of Emergency Medicine at the Washington University School of Medicine
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6
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Johnson AR, Rigtrup LM, VanBuren J, Rothwell E, Dean JM. An Approach to Reviewing Local Context for Exception from Informed Consent Trials Using a Single IRB. Ethics Hum Res 2021; 43:42-48. [PMID: 34751515 PMCID: PMC10353538 DOI: 10.1002/eahr.500109] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
In the context of emergency research, researchers can ask the institutional review board (IRB) to waive the regulatory requirement that individuals provide informed consent when enrolling in research studies. A requirement of the waiver of informed consent is that the reviewing IRB must review and approve a community consultation and public disclosure plan. It is critical that an IRB serving as the single IRB (sIRB) for multisite research be thoroughly versed in the local context concerns for each participating site to determine whether the site's community is being adequately consulted about the research in which individuals will be enrolled under an exception to the informed consent requirement. We designed an sIRB review model for evaluating site-specific community consultation plans that included a local evaluation and feedback step, and we piloted the model with a four-site, pediatric exception from informed consent (EFIC) clinical trial. We identified three key roles for the model: the sIRB, the investigators, and the representative of the institution's human research protection program (HRPP). We successfully collected the information and local input needed to evaluate each site's community consultation plan and applied the information to a thorough IRB review, despite the geographic distance between the study site and the sIRB.
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Affiliation(s)
- Ann R Johnson
- Director of the institutional review board and Human Research Protection Program at the University of Utah
| | - Lisa M Rigtrup
- Manager of the institutional review board at the University of Utah
| | - John VanBuren
- Associate professor and statistician in the Department of Pediatrics at the University of Utah
| | - Erin Rothwell
- Professor and social scientist in the Department of Obstetrics and Gynecology at the University of Utah
| | - J Michael Dean
- Professor and vice chairman for research in the Department of Pediatrics at the University of Utah
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7
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Seykora A, Coleman C, Rosenfeld SJ, Bierer BE, Lynch HF. Steps toward a System of IRB Precedent: Piloting Approaches to Summarizing IRB Decisions for Future Use. Ethics Hum Res 2021; 43:2-18. [PMID: 34676693 DOI: 10.1002/eahr.500106] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Institutional review boards (IRBs) have been criticized for inconsistency and lack of transparency in decision-making, problems that undermine both trust in their ability to protect human research participants and respect for their decisions among researchers. The absence of robust documentation of their decisions and the inability or unwillingness to share those decisions together represent a missed opportunity for IRBs to learn from one another and advance debates about challenging ethical issues. The concept of IRB precedent, modeled upon the system of legal precedent, has been proposed as a potential solution to these problems. In theory, an IRB faced with a review decision could look back at previous IRB decisions, either its own or those of other boards, made in similar studies or circumstances to guide the present decision. Some IRBs attempt this informally within their institution, but few examples of a structured system of IRB precedent have been described in the literature, and none has been widely adopted. This article describes a pilot project to summarize IRB decisions in a way that could facilitate their use as precedent by creating a documentation tool that meets four criteria-comprehensiveness, validity, searchability, and efficiency. Though this process turned out to be more challenging than expected, we identified key features of such a tool that holds promise for future development and could promote more consistent, robust IRB decision-making and advance discourse in human research ethics.
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Affiliation(s)
- Andrea Seykora
- Research compliance manager at Kaiser Permanente Northwest at the time of submission
| | | | | | - Barbara E Bierer
- Faculty director at the Multi-Regional Clinical Trials Center of Brigham and Women's Hospital and Harvard and a professor of medicine at Harvard Medical School and Brigham and Women's Hospital
| | - Holly Fernandez Lynch
- John Russell Dickson, MD, Presidential Assistant Professor of Medical Ethics at Perelman School of Medicine at the University of Pennsylvania
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8
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Goldstein PA. The ethics of quality improvement studies: do the needs of the many outweigh the needs of the few? Br J Anaesth 2021; 127:821-824. [PMID: 34620499 DOI: 10.1016/j.bja.2021.08.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 08/04/2021] [Accepted: 08/18/2021] [Indexed: 10/20/2022] Open
Abstract
Clinical research involving human subjects and quality improvement (QI) projects share a common goal of seeking to improve human health, whether by directly changing the standard of care (research) or by improving the process(es) by which that care is delivered (QI). Whether a QI project requires informed consent (written or oral) is a function of the risk-benefit analysis of the study; such a determination should not be at the sole discretion of the investigators, but should come from an appropriately constituted review board with expertise in the ethics of biomedical research.
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Affiliation(s)
- Peter A Goldstein
- Department of Anesthesiology, Weill Cornell Medicine, New York, NY, USA; Department of Medicine, Division of Medical Ethics, Weill Cornell Medicine, New York, NY, USA; Feil Family Brain & Mind Research Institute, Weill Cornell Medicine, New York, NY, USA.
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9
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Taylor HA, Porter KM, Paquette ET, McCormick JB, Tumilty E, Arnold JF, Spector-Bagdady K, Danis M, Brandt D, Shah J, Wilfond BS, Lee LM. Creating a Research Ethics Consultation Service: Issues to Consider. Ethics Hum Res 2021; 43:18-25. [PMID: 34496156 DOI: 10.1002/eahr.500101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
This article provides pragmatic advice for organizations interested in creating a research ethics consultation service (RECS). A robust RECS has the potential to build capacity among investigators to identify and consider the ethical issues they encounter while conducting their research. Determining whether to establish an RECS should begin with an institutional-needs assessment that includes three key questions: What are the current resources available to research teams to navigate ethical concerns that arise from their research? Is there a demand or perceived need for more resources? Is there institutional support (financial and otherwise) to establish and maintain an RECS? If this results in the decision to establish the consultation service, relevant institutional stakeholders must be identified and consulted, and personnel with the requisite skills recruited. The next step is to establish an RECS and build the infrastructure to process and respond to requests. The RECS's long-term sustainability will depend on a stable source of funding and a mechanism to receive constructive feedback to ensure that the service is meeting the institutional needs it set out to address.
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Affiliation(s)
- Holly A Taylor
- Research bioethicist in the Department of Bioethics at the Clinical Center at the National Institutes of Health
| | - Kathryn M Porter
- Research scientist at the Seattle Children's Hospital and Research Institute
| | - Erin Talati Paquette
- Assistant professor of pediatrics (critical care) at the Northwestern University Feinberg School of Medicine and Ann & Robert H. Lurie Children's Hospital of Chicago and an assistant professor of law (by courtesy) at the Northwestern University Pritzker School of Law
| | - Jennifer B McCormick
- Associate professor in the Department of Humanities in the College of Medicine at the Pennsylvania State University
| | - Emma Tumilty
- Bioethicist and lecturer at the School of Medicine in the Faculty of Health at Deakin University Waurn Ponds, Geelong, Australia
| | - Jason F Arnold
- Senior fellow of bioethics and health policy and the assistant director of the CTR fellowship program at the Institute of Human Values in Health Care at the Medical University of South Carolina
| | - Kayte Spector-Bagdady
- Associate director of the Center for Bioethics & Social Sciences in Medicine and an assistant professor of obstetrics and gynecology at the University of Michigan Medical School
| | - Marion Danis
- Head of the section on ethics and health policy in the Department of Bioethics at the Clinical Center of the National Institutes of Health
| | - Debra Brandt
- Research assistant professor in the Department of Obstetrics and Gynecology at the University of Iowa
| | - Jina Shah
- Senior director of patient safety and pharmacovigilance at Kite, a Gilead Sciences company, in Santa Monica, CA
| | - Benjamin S Wilfond
- Professor in the divisions of bioethics and palliative care and pulmonary and sleep medicine in the Department of Pediatrics at the Seattle Children's Hospital and Research Institute at the University of Washington School of Medicine
| | - Lisa M Lee
- Associate vice president for research and innovation, the director of scholarly integrity and research compliance, and a professor of population health sciences at Virginia Tech
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10
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Abstract
Human research protection programs (HRPP) generate an abundance of data on performance, capacity, and compliance. When used effectively, this information can be instrumental in helping HRPPs meet programmatic and institutional goals, demonstrate growth and success, and improve the HRPP overall. Metrics must be grounded in professional insight so that HRPPs can pair analytics with strategies for future action or improvement. The purpose of this paper is to demonstrate how high-performing HRPPs develop, adopt, and implement a metrics framework that benefits everyday operations and produces real-world results. Through a three-part thematic framework (of insight, data, and action) and by providing case examples and actionable strategies, this article will address how HRPPs iteratively develop and characterize their metrics, build a metrics framework that leverages both quantitative and qualitative data to validate outcomes, and activate human insight to produce meaningful communication, visualization, and dissemination of data.
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Affiliation(s)
- Kimberley Serpico
- Associate director of IRB operations in the Office of Regulatory Affairs and Research Compliance at the Harvard T.H. Chan School of Public Health at Harvard University
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11
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Mastroianni AC, Franceschini R, Wicks SL, Henry LM. The Pathway Forward: Insights on Factors that Facilitate Research with Pregnant Women. Ethics Hum Res 2021; 42:2-16. [PMID: 32672419 DOI: 10.1002/eahr.500058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The near-routine exclusion of pregnant women from clinical research has resulted in evidence gaps that endanger the health of pregnant women and their future offspring. Although existing literature documents numerous obstacles along the clinical trial pathway that can stymie research involving pregnant women, there is little guidance on how to facilitate such research. This qualitative study aims to fill that void by examining the experiences of individuals involved in conducting, approving, or overseeing research involving pregnant women at one academic institution. The study identifies factors throughout the clinical pathway-from protocol development, to IRB review, and ultimately trial execution-that likely contribute to the successful conduct of research with pregnant women. Attention to those factors, coupled with agreement among stakeholders that research with pregnant women should and can be done ethically and legally, is critical to shifting the narrative from "why we cannot" do such research to "how we can."
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Affiliation(s)
- Anna C Mastroianni
- Professor at the School of Law at the University of Washington and an associate director at the Institute for Public Health Genetics at the University of Washington
| | | | | | - Leslie Meltzer Henry
- Professor of law at the University of Maryland Carey School of Law and a member of the core faculty at the Johns Hopkins Berman Institute of Bioethics
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12
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Chisolm-Straker M, Nassisi D, Daya MR, Cook JNB, Wilets IF, Clesca C, Richardson LD. Exception From Informed Consent: How IRB Reviewers Assess Community Consultation and Public Disclosure. AJOB Empir Bioeth 2020; 12:24-32. [PMID: 32990501 DOI: 10.1080/23294515.2020.1818878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Exception from Informed Consent (EFIC) regulations detail specific circumstances in which Institutional Review Boards (IRB) can approve studies where obtaining informed consent is not possible prior to subject enrollment. To better understand how IRB members evaluate community consultation (CC) and public disclosure (PD) processes and results, semi-structured interviews of EFIC-experienced IRB members were conducted and analyzed using thematic analysis. Interviews with 11 IRB members revealed similar approaches to reviewing EFIC studies. Most use summaries of CC activities to determine community members' attitudes; none reported using specific criteria nor recalled any CC reviews that resulted in modifications to or denials of EFIC studies. Most interviewees thought metrics based on Community VOICES's domains (feasibility, participant selection, quality of communication, community perceptions, investigator/IRB perceptions) would be helpful. IRB members had similar experiences and concerns about reviewing EFIC studies. Development of metrics to assess CC processes may be useful to IRBs reviewing EFIC studies.
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Affiliation(s)
- Makini Chisolm-Straker
- Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Denise Nassisi
- Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Mohamud R Daya
- Department of Emergency Medicine, Oregon Health and Science University, Portland, Oregon, USA
| | - Jennifer N B Cook
- Department of Emergency Medicine, Oregon Health and Science University, Portland, Oregon, USA
| | - Ilene F Wilets
- Department of Environmental Health and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Cindy Clesca
- Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Lynne D Richardson
- Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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13
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Roberts MK, Fisher DM, Parker LE, Darnell D, Sugarman J, Carrithers J, Weinfurt K, Jurkovich G, Zatzick D. Ethical and Regulatory Concerns in Pragmatic Clinical Trial Monitoring and Oversight. Ethics Hum Res 2020; 42:29-37. [PMID: 32937035 DOI: 10.1002/eahr.500066] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The implementation of pragmatic clinical trials (PCTs) can be accompanied by unique regulatory challenges. In this paper, we describe the experience and management of regulatory noncompliance during a 25-site acute care PCT. During the trial, the study team conducted a comprehensive audit of all enrollment forms (informed consent and Health Insurance Portability and Accountability Act authorization forms) and related study documentation. A review of 997 participants' enrollment forms identified 138 (13.8%) that required reporting to the institutional review board due to noncompliance. To prevent subsequent noncompliance, the study team developed and introduced a revised participant tracking system, reviewed all enrollment documentation, and retrained sites regarding study procedures. Based on these experiences, we developed a set of recommendations for future PCTs to ensure both operational success and regulatory compliance.
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Affiliation(s)
- Michelle K Roberts
- Research coordinator of rehabilitation medicine at the University of Washington School of Medicine
| | - Dylan M Fisher
- Research study coordinator of psychiatry and behavioral sciences at the University of Washington School of Medicine
| | - Lea E Parker
- Doctoral student in the Department of Psychology at Drexel University
| | - Doyanne Darnell
- Assistant professor of psychiatry and behavioral sciences at the University of Washington School of Medicine
| | - Jeremy Sugarman
- Harvey M. Meyerhoff Professor of Bioethics and Medicine at the Berman Institute of Bioethics and at the School of Medicine at Johns Hopkins University
| | | | - Kevin Weinfurt
- Professor and vice chair of research in the Department of Population Health Sciences at the Duke University School of Medicine
| | - Gregory Jurkovich
- Professor and vice chairman and the Lloyd F. & Rosemargaret Donant chair in trauma medicine in the Department of Surgery at University of California Davis Health
| | - Douglas Zatzick
- Professor of psychiatry and behavioral sciences at the University of Washington School of Medicine
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14
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Abstract
The increased use of big data in the medical field has shifted the way in which biomedical research is designed and carried out. The novelty of techniques and methods brought by big data research brings new challenges to institutional review boards (IRBs). Yet it is unclear if IRBs should be the responsible oversight bodies for big data research and, if so, which criteria they should use. A large but heterogenous set of ethics guidelines and normative responses have emerged to address these issues. In this study, we conducted a scoping review of soft-law documents and guidelines with the aim of assessing ongoing normative efforts that are proliferating in this domain. We also synthesize a set of recurrent guidelines that could work as a baseline to create a harmonized process for big data research ethics.
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Affiliation(s)
- Agata Ferretti
- PhD candidate in Bioethics at the Health Ethics and Policy Lab, Swiss Federal Institute of Technology in Zurich
| | - Marcello Ienca
- Senior researcher at the Health Ethics and Policy Lab, Swiss Federal Institute of Technology in Zurich
| | - Samia Hurst
- Professor of medical ethics and director of the Institute for Ethics, History, and the Humanities & Department of Community Health and Medicine, University of Geneva, Switzerland
| | - Effy Vayena
- Professor of bioethics and director of the Health Ethics and Policy Lab, Swiss Federal Institute of Technology in Zurich
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15
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Khan MA, Barratt MS, Krugman SD, Serwint JR, Dumont-Driscoll M. Variability of the institutional review board process within a national research network. Clin Pediatr (Phila) 2014; 53:556-60. [PMID: 24658908 DOI: 10.1177/0009922814527504] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To determine the variability of the institutional review board (IRB) process for a minimal risk multicenter study. METHODS Participants included 24 Continuity Research Network (CORNET) sites of the Academic Pediatric Association that participated in a cross-sectional study. Each site obtained individual institutional IRB approval. An anonymous questionnaire went to site investigators about the IRB process at their institution. RESULTS Twenty-two of 24 sites (92%) responded. Preparation time ranged from 1 to 20 hours, mean of 7.1 hours. Individuals submitting ≤3 IRB applications/year required more time for completion than those submitting >3/year (P < .05). Thirteen of 22 (59%) study sites received approval with "exempt" status, and 6 (27%) approved as "expedited" studies. CONCLUSIONS IRB experiences were highly variable across study sites. These findings indicate that multicenter research projects should anticipate barriers to timely study implementation. Improved IRB standardization or centralization for multicenter clinical studies would facilitate this type of practice-based clinical research.
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