Variability in Ethics Review for Multicenter Protocols in Buenos Aires, Argentina. An Observational Study

It has been reported that significant variability in the ethics review process affects multisite studies. We analyzed 1,305 applications for multicenter studies (409 unique protocols), from 1^st January 2020 to 20^th September 2021. We examined the variability in the times to approval and the first observation and the variation in the level of risk assigned. The median [IQR] variabilities were 42.19 [15.23-82.36] days and 8.00 [3.12-16.68] days, for the times to approval and to the first observation, respectively. There was disagreement in the level of risk assigned by the Research Ethics Committee (REC) in 24.0% of cases. Independent predictors of variability included the number of REC members. In our study, we found substantial variability in the ethics review process among health research protocols. Also, we describe methods to readily measure the delays and the variations in the ethics review process.

Research in nursing education and the institutional review board/ethics committee

BACKGROUND

Institutional review board (IRB) or research ethics committee approval is intended to protect the rights of human subjects. Assurance that ethical standards are met is essential for educational research and quality improvement (QI) projects involving human subjects.

PURPOSE

The purposes were to describe the requirements of nursing journals for educational studies and QI projects related to education to be reviewed by an IRB or a research ethics committee and to identify the types of statements of approval or exemption to be included in manuscripts.

METHOD

The investigators employed an electronic survey sent to members of the International Academy of Nursing Editors list serve. Responses representing 64 nursing journals were received.

RESULTS

The majority of journals that publish academic educational studies (n = 32, 86.5%) always required IRB or other ethics committee review, and 17 (45.9%) required the same for QI projects related to education. An IRB or research ethics committee review was always required by journals for educational studies (n = 24, 88.9%) and for QI projects (n = 14, 51.9%) involving the professional development of nurses.

CONCLUSIONS

Educational studies that involve human subjects should be reviewed by an IRB or other type of research ethics committee before implementing the study. Any determination of exemption should be made by the IRB or research ethics committee, not by the investigator.

Challenges and Best Practices in Ethical Review of Human and Organizational Factors Studies in Health Technology: a Synthesis of Testimonies

OBJECTIVE

Human and Organizational Factors (HOF) studies in health technology involve human beings and thus require Institutional Review Board (IRB) approval. Yet HOF studies have specific constraints and methods that may not fit standard regulations and IRB practices. Gaining IRB approval may pose difficulties for HOF researchers. This paper aims to provide a first overview of HOF study challenges to get IRB review by exploring differences and best practices across different countries.

METHODS

HOF researchers were contacted by email to provide a testimony about their experience with IRB review and approval. Testimonies were thematically analyzed and synthesized to identify and discuss shared themes.

RESULTS

Researchers from seven European countries, Argentina, Canada, Australia, and the United States answered the call. Four themes emerged that indicate shared challenges in legislation, IRB inefficiencies and inconsistencies, general regulation and costs, and lack of HOF study knowledge by IRB members. We propose a model for IRB review of HOF studies based on best practices.

CONCLUSION

International criteria are needed that define low and high-risk HOF studies, to allow identification of studies that can undergo an expedited (or exempted) process from those that need full IRB review. Enhancing IRB processes in such a way would be beneficial to the conduct of HOF studies. Greater knowledge and promotion of HOF methods and evidence-based HOF study designs may support the evolving discipline. Based on these insights, training and guidance to IRB members may be developed to support them in ensuring that appropriate ethical issues for HOF studies are considered.