2251
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Affiliation(s)
- Benjamin Druss
- Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
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2252
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Affiliation(s)
- Xiangzhong Yang
- Center for Regenerative Biology, University of Connecticut Storrs, Connecticut 06269-4243, USA
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2253
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Affiliation(s)
- Kenneth Chien
- University of California, San Diego, Institute of Molecular Medicine, Salk Institute, UCSD Institute of Molecular Medicine, La Jolla, California, 92093, USA
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2254
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Bian ZX, Yang XR. [Standardized clinical research is the key for joining of Chinese medicine into mainstream medicine]. Zhongguo Zhong Xi Yi Jie He Za Zhi 2004; 24:359-61. [PMID: 15143728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
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2255
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2256
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2257
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Tuñón T, García-Bragado F, Caballero MC, Guerrero D, Manubens JM. Banco de tejidos neurológicos destinados a la investigación en neurociencias: Una realidad en Navarra. An Sist Sanit Navar 2004; 27:73-6. [PMID: 15146207 DOI: 10.4321/s1137-66272004000100008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- T Tuñón
- Servicio de Anatomía Patológica, Hospital de Navarra, Pamplona
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2258
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2259
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2260
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Wilson M. Getting a fix on good governance. J Med Ethics 2004; 30:232. [PMID: 15082826 PMCID: PMC1733839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
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2261
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Carneiro PCA. Avaliação de trabalho científico. Rev Assoc Med Bras (1992) 2004; 50:125; author reply 125. [PMID: 15286857 DOI: 10.1590/s0104-42302004000200024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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2262
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2263
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2264
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Saracci R. [Scientific research in Italy: as before, worse than before]. Epidemiol Prev 2004; 28:69-70. [PMID: 15291381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
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2265
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2266
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2267
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Delgado Rodríguez M, Llorca Díaz J. [Longitudinal studies: concepts and particularities]. Rev Esp Salud Publica 2004; 78:141-8. [PMID: 15199793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023] Open
Abstract
In this review the definition of "longitudinal study" is analysed. Most current textbooks on epidemiology do not define a longitudinal study, whereas statistical textbooks do. It is more common to talk about longitudinal data than about longitudinal studies. A longitudinal study implies the existence of repeated measurements (more than two) across follow-up. According to these ideas, a longitudinal study can be considered a subtype of cohort study that, in contrast with life-table cohort studies, allows inference to the subject level, to analyze changes in variables (exposures and outcomes) and transitions among different health states. The characteristics of this design force to paid special attention to quality control during data collection, losses during follow-up, and missing data in some measurements. The statistical analysis should take repeated measures into account, and it is what finally gives the longitudinal character to a study with repeated measurements.
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2268
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Affiliation(s)
- Ray Wu
- Liberty Hyde Bailey, Department of Molecular Biology and Genetics, Cornell University, Ithaca, New York 14853, USA
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2269
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Rousseau RF, Gee AP. [Impact of regulations on translational research in cell and gene therapy: the American experience]. Bull Cancer 2004; 91:239-47. [PMID: 15171048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
The increasing utilization of cell and gene therapy in the treatment of human diseases, particularly cancers, has led lawmakers to institute stringent rules to regulate this new area of medicine and optimally protect patients. Cell and gene therapy centers, often located within academic institutions, are becoming subject to rules previously applied only to pharmaceutical companies. Based on the US experience, we review here the regulations that currently regulate or are being proposed to cover cell and gene therapy centers. We describe the principles of good manufacturing practices, quality assurance and quality control and accreditation. Finally, we discuss the future of cell and gene therapy in the context of the increasingly rigorous regulatory environment implemented in the US.
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Affiliation(s)
- Raphaël F Rousseau
- Center for Cell and Gene Therapy, Baylor College of Medicine, 6621 Fannin, MC 3-3320, Houston, Texas 77030, USA.
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2270
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Abstract
Much animal research into potential treatments for humans is wasted because it is poorly conducted and not evaluated through systematic reviews
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Affiliation(s)
- Pandora Pound
- Department of Social Medicine, University of Bristol, Bristol BS8 2PR
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2271
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Bartlett T. Ecstasy agonistes: a retracted study on a controversial substance raises questions about the reliability of government-sponsored research on drugs. Chron High Educ 2004; 50:A14-6. [PMID: 15287142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
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2272
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2273
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2274
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Emanuel EJ, Wendler D, Killen J, Grady C. What makes clinical research in developing countries ethical? The benchmarks of ethical research. J Infect Dis 2004; 189:930-7. [PMID: 14976611 DOI: 10.1086/381709] [Citation(s) in RCA: 467] [Impact Index Per Article: 23.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2003] [Accepted: 09/02/2003] [Indexed: 11/04/2022] Open
Affiliation(s)
- Ezekiel J Emanuel
- Department of Clinical Bioethics, Warren G. Magnuson Clinical Center, National Institutes of Health, Bethesda, Maryland 20892-1156, USA.
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2275
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Abstract
BACKGROUND Studies of diagnostic accuracy are subject to different sources of bias and variation than studies that evaluate the effectiveness of an intervention. Little is known about the effects of these sources of bias and variation. PURPOSE To summarize the evidence on factors that can lead to bias or variation in the results of diagnostic accuracy studies. DATA SOURCES MEDLINE, EMBASE, and BIOSIS, and the methodologic databases of the Centre for Reviews and Dissemination and the Cochrane Collaboration. Methodologic experts in diagnostic tests were contacted. STUDY SELECTION Studies that investigated the effects of bias and variation on measures of test performance were eligible for inclusion, which was assessed by one reviewer and checked by a second reviewer. Discrepancies were resolved through discussion. DATA EXTRACTION Data extraction was conducted by one reviewer and checked by a second reviewer. DATA SYNTHESIS The best-documented effects of bias and variation were found for demographic features, disease prevalence and severity, partial verification bias, clinical review bias, and observer and instrument variation. For other sources, such as distorted selection of participants, absent or inappropriate reference standard, differential verification bias, and review bias, the amount of evidence was limited. Evidence was lacking for other features, including incorporation bias, treatment paradox, arbitrary choice of threshold value, and dropouts. CONCLUSIONS Many issues in the design and conduct of diagnostic accuracy studies can lead to bias or variation; however, the empirical evidence about the size and effect of these issues is limited.
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2276
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Ferris LE, Singer PA, Naylor CD. Better governance in academic health sciences centres: moving beyond the Olivieri/Apotex Affair in Toronto. J Med Ethics 2004; 30:25-29. [PMID: 14872067 PMCID: PMC1757127 DOI: 10.1136/jme.2003.005181] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
The Toronto experience suggests that there may be several general lessons for academic health sciences complexes to learn from the Olivieri/Apotex affair (OAA) regarding the ethics, independence, and integrity of clinical research sponsored by for profit enterprises. From a local perspective, the OAA occurred when there already was a focus on the complex and changing relationships among the University of Toronto, its medical school, the fully affiliated teaching hospitals, and off campus faculty because of intertwined interests and responsibilities. The OAA became a catalyst that accelerated various systemic reforms, particularly concerning academic/industry relations. In this article, the evolving governance framework for the Toronto academic health sciences complex is reviewed and these policy and process reforms discussed. These reforms have created collaborative activity among research ethics boards and contract research offices of the partner institutions, and allowed the joint university/hospital ethics centre to play a role in governance and policy, while respecting the missions and mandates of the involved institutions. Although few of the policies are dramatically innovative, what is arguably novel is the elaboration of an overarching governance framework that aims to move ethics to a central focus in the academic complex. Time alone will tell how sustainable and effective these changes are.
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Affiliation(s)
- L E Ferris
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
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2277
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Abstract
This article describes how a small but vocal group of biomedical scientists propagates the views that either HIV is not the cause of AIDS, or that it does not exist at all. When these views were rejected by mainstream science, this group took its views and arguments into the public domain, actively campaigning via newspapers, radio, and television to make its views known to the lay public. I describe some of the harmful consequences of the group's activities, and ask two distinct ethical questions: what moral obligations do scientists who hold such minority views have with regard to a scientifically untrained lay audience, and what moral obligations do mainstream newspapers and government politicians have when it comes to such views. The latter question will be asked because the "dissidents" succeeded for a number of years in convincing the South African government of the soundness of their views. The consequences of their stance affected millions of HIV infected South Africans severely.
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Affiliation(s)
- U Schüklenk
- Division of Bioethics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
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2278
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2279
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Abstract
CONTEXT Federal regulations allow children in the United States to be enrolled in clinical research only when the institutional review board (IRB) determines that the risks are minimal or a minor increase over minimal, or that the research offers a prospect of direct benefit. Despite this reliance on IRBs, no data exist on how IRBs apply the risk and benefit categories for pediatric research. OBJECTIVE To determine how IRB chairpersons apply the federal risk and benefit categories for pediatric research. DESIGN, SETTING, AND PARTICIPANTS Telephone survey, conducted between May and August 2002 of 188 randomly selected chairpersons of IRBs in the Unites States. The survey consisted of 21 questions to assess the application of federal risk standards to research procedures, whether certain interventions offer a prospect of direct benefit to participating children, and the extent to which IRBs use the federal definition of minimal risk when categorizing the risks of research procedures in children. MAIN OUTCOME MEASURES Responses regarding categorization of the risk level and direct benefits of pediatric research procedures. RESULTS A single blood draw was the only procedure categorized as minimal risk by a majority (152 or 81%) of the 188 respondents. An electromyogram was categorized as minimal or a minor increase over minimal risk by 100 (53%) and as more than a minor increase over minimal risk by 77 (41%). Allergy skin testing was categorized as minimal risk by 43 IRB chairpersons (23%), a minor increase over minimal risk by 81 (43%), and more than a minor increase over minimal risk by 51 (27%). Regarding benefits, 113 chairpersons (60%) considered added psychological counseling to be a direct benefit, while participant payment was considered a direct benefit by 10% (n = 19). CONCLUSIONS Application of the federal risk and benefit categories for pediatric research by IRB chairpersons is variable and sometimes contradicted by the available data on risks and the regulations themselves. To protect children from excessive risks while allowing appropriate research, IRB chairpersons need guidance on applying the federal risk and benefit categories and also need data on the risks children face in daily life and during routine physical or psychological tests.
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Affiliation(s)
- Seema Shah
- Department of Clinical Bioethics, National Institutes of Health, Bethesda, Md 20892, USA
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2280
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Roberts LW, Warner TD, Brody JL, Nguyen K, Roberts BB. What is ethically important in clinical research? A preliminary study of attitudes of 73 psychiatric faculty and residents. Schizophr Bull 2004; 29:607-13. [PMID: 14609253 DOI: 10.1093/oxfordjournals.schbul.a007032] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
The ethical caliber of psychiatric research ultimately rests upon the shoulders of psychiatric clinicians and investigators who perform protocols and are directly responsible for the welfare of study volunteers. Little is known, however, about ethically relevant attitudes of psychiatrists toward human research. Working as part of a larger study, we surveyed all psychiatry faculty and residents at one institution in 1999 regarding the relative importance of 12 elements in the ethical conduct of human research. Responses of 73 participants were analyzed, and three factors emerged: Safeguards and Scientific Merit, Investigator Integrity and Relationship, and Patient Benefit. Safeguards and Scientific Merit, as a set, were the most salient considerations for both psychiatry faculty and residents. We found that residents placed greater importance on all factors and nearly every element than did faculty. Future research is needed to clarify the understanding of the perspectives and priorities of different stakeholders involved in human studies.
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Affiliation(s)
- Laura Weiss Roberts
- Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee 53226, USA.
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2281
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Abstract
The introduction in the UK of the Calman Registrar training scheme envisaged seamless progression from Senior House Officer (SHO) grade through to Consultancy. Within this framework research was acknowledged to be a valuable (but optional) part of the training programme, as laid out by the 'Orange Guide' to Specialist Registrar (SpR) Training [A Guide to Specialist Registrar Training 1998; HM Press]. Time is provided for this activity within the SpR training scheme, but it is becoming increasingly evident that the majority of formal research (towards post graduate degrees) is being carried out by so-called 'gap' SHO's in order to gain entry into Higher Surgical Training (HST) programmes [Ann R Coll Surg Engng 81 (1999) 182], [Br J Plast Surg 55 (2002) 463-468]. With this in mind, a survey of all Plastic Surgery SHO's in the UK was undertaken to assess the extent of clinical research undertaken by individuals, and the perceived need for formal research for career progression.
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Affiliation(s)
- A H F MacQuillan
- The RAFT Institute of Plastic Surgery, Mount Vernon Hospital, Rickmansworth Road, Northwood, Middlesex HA6 2RN, UK.
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2282
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2283
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Abstract
Inflexible use of evidence hierarchies confuses practitioners and irritates researchers. So how can we improve the way we assess research?
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Affiliation(s)
- Paul Glasziou
- Department of Primary Health Care, University of Oxford, Oxford OX3 7LF.
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2284
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2285
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Albertazzi P. Academic medicine: time for reinvention: Hogwarts may be a useful analogy for improvement. BMJ 2004; 328:46-7; discussion 49. [PMID: 14703551 PMCID: PMC314242 DOI: 10.1136/bmj.328.7430.46-c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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2286
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Lim MWK. Academic medicine: time for reinvention: shorter training and shortage of doctors detrimentally affect research. BMJ 2004; 328:48; discussion 49. [PMID: 14703559 PMCID: PMC314246 DOI: 10.1136/bmj.328.7430.48-b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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2287
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2288
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2289
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Connell DG. Academic medicine: time for reinvention: what really matters? BMJ 2004; 328:47; discussion 49. [PMID: 14703557 PMCID: PMC313913 DOI: 10.1136/bmj.328.7430.47] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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2290
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Awofeso N. Academic medicine: time for reinvention: encourage overseas based researchers to return to improve academic medicine in the developing world. BMJ 2004; 328:47-8; author reply 49. [PMID: 14703556 PMCID: PMC314244 DOI: 10.1136/bmj.328.7430.47-b] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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2291
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Galvanising mental health research in low-and middle-income countries: role of scientific journals. Epidemiol Psichiatr Soc 2004; 13:66-9. [PMID: 15248395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
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2292
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Uhari M. [Research of psychotherapy is clinical research]. Duodecim 2004; 120:2617-8. [PMID: 15656419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Affiliation(s)
- Matti Uhari
- OYS:n lastentautien klinikka, Oulun yliopisto.
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2293
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Comisión de Criopreservación de Muestras Biológicas. [Crypreservation of biological samples unit]. An Sist Sanit Navar 2004; 27:77-85. [PMID: 15146208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
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2294
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Affiliation(s)
- Aurelio Tobías
- Departamento de Estadística y Econometría, Universidad Carlos III de Madrid, 28903 Getafe, Madrid 126, Spain.
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2295
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2296
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2297
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Pedraza Muriel V. Investigación en atención primaria de salud. Premisas básicas. Aten Primaria 2004; 34:318-22. [PMID: 15491525 PMCID: PMC7668818 DOI: 10.1016/s0212-6567(04)79502-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
- V. Pedraza Muriel
- Correspondencia: Departamento de Radiología y Medicina Física. Facultad de Medicina. Avda. de Madrid, 11. 18012 Granada. España
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2298
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Abstract
Bauer, Taub, and Parsi's review of an international sample of standards on informed consent, confidentiality, commercialization, and quality of research in tissue banking reveals that no clear national or international consensus exists for these issues. The authors' response to the lack of uniformity in the meaning, scope, and ethical significance of the policies they examined is to call for the creation of uniform ethical guidelines. This raises questions about whether harmonization should consist of voluntary international standards or international regulations that include an official oversight mechanism and sanctions for noncompliance, and about who should participate in the harmonization process. Moreover, the normative assumptions and political dynamics that shape global policymaking need to be addressed. This commentary explores the policy implications and normative questions raised by the idea of international ethical guidelines for the use of biotechnologies and biotechnological resources such as stored samples of human tissue.
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2299
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2300
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Baeyens AJ. Impact of the European Clinical Trials Directive on academic clinical research. Med Law 2004; 23:103-110. [PMID: 15163079] [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] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
With the adoption of the Clinical Trials Directive it was Europe's intention to make the performance of multi-national clinical trials in Europe easier through the harmonization of the regulatory procedures. As the Directive was mainly conceived to facilitate the performance of multi-national clinical trials to develop new drugs, it is to be determined to what extent academic clinical trials will be concerned by the Directive and more importantly what will be its impact on daily academic clinical research. Contrary to several national regulations the scope of the Directive is very large only excluding non-interventional trials. This implies that most of the academic clinical trials will be concerned by the Directive. Besides the handling of the regulatory procedures in the different countries, issues related to insurance, labeling requirements and provision of the investigational medical products will expose the academic sponsor to additional administrative and financial challenges that will have to be handled appropriately, as the academic sponsors will be controlled by Inspectors regarding their compliance with the new regulations to come.
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Affiliation(s)
- A J Baeyens
- European Organisation for Research and Treatment of Cancer, Brussels
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