RESEARCH ETHICS. Evidence gaps and ethical review of multicenter studies.

RESEARCH ETHICS. Evidence gaps and ethical review of multicenter studies.
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研究伦理。

DOI:
10.1126/science.aac4872
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发表时间:
2015
期刊:
Science (New York, N.Y.)
影响因子:
--
通讯作者:
Ehrhardt,Stephan
Ehrhardt,Stephan
中科院分区:
--
文献类型:
--
作者:
Ervin,Ann-Margret;Taylor,HollyA;Meinert,CurtisL;Ehrhardt,Stephan

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大型、多中心临床研究是循证预防和医疗保健的支柱。多中心研究的伦理审查通常由每个参与机构的机构审查委员会(IRB)进行。然而,IRB 对法规的解释存在差异很常见,并且可能会产生伦理和科学影响 (1, 2)。美国最近颁布的指令旨在通过单一的中央记录IRB (CIRB) 进行伦理审查,从而减轻行政负担并加快多中心研究的速度。然而,道德审查的质量绝不能受到影响。我们描述了美国当前的伦理审查模式,并确定了在制定此类政策之前必须解决的研究差距。多中心研究旨在加快参与者的招募速度,但受到当前审查流程的阻碍。不同 IRB 提出的修改研究程序和同意书的请求可能会阻止受影响中心的参与,或需要向所有参与中心的 IRB 重新提交。排除临床中心或修改程序可能会不平等地分配研究的利益和负担。
Large, multicenter clinical studies are the backbone of evidence-based prevention and healthcare. Ethical review of multicenter research is usually conducted by the institutional review board (IRB) of each participating institution. However, variation in interpretation of regulations by IRBs is common and can have ethical and scientific implications (1, 2). Recent mandates in the United States aim to reduce the administrative burden and to expedite multicenter research by conducting ethical review with a single, central IRB of record (CIRB). Yet the quality of ethical review must not suffer. We characterize current models of ethical review in the United States and identify research gaps that must be addressed before such policies are instituted.Multicenter studies are designed to expedite participant enrollment but are hampered by the current review process. Requests from disparate IRBs to modify study procedures and consent forms may prevent participation of affected centers or require resubmissions to IRBs of all participating centers. Exclusion of clinical centers or modifications to procedures may unequally distribute the benefits and burdens of research.
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