Research ethics

研究伦理
  • 文章类型: Journal Article
    组织工程是一个多学科领域,结合了细胞生物学的原理,生物工程,材料科学,药物和手术,以创造功能和可行的生物制品,可用于修复或替换人体内受损或患病的组织。组织工程的复杂性会影响将该领域的科学发现有效转化为可扩展的临床方法的前景,从而使患者受益。组织挑战可能在组织工程的临床转化中起关键作用,以造福患者。
    为了深入了解组织工程的组织方面,这些方面可能会阻碍有效的临床翻译,我们进行了一项针对膝关节软骨工程组织移植物的组织工程多部位转化项目的回顾性定性病例研究。我们使用一组不同的方法收集定性数据:半结构化访谈,文献研究和视听内容分析。
    我们的研究确定了与组织工程中首次人体试验相关的各种挑战,特别涉及:后勤和沟通;研究参与者招募;临床医生和医学生参与;研究管理;和监管。
    虽然不能直接推广到其他类型的先进疗法或一般的再生医学,我们的研究结果为组织障碍提供了有价值的见解,这些障碍可能会阻碍组织工程领域的有效临床转化.
    UNASSIGNED: Tissue engineering is a multidisciplinary field that combines principles from cell biology, bioengineering, material sciences, medicine and surgery to create functional and viable bioproducts that can be used to repair or replace damaged or diseased tissues in the human body. The complexity of tissue engineering can affect the prospects of efficiently translating scientific discoveries in the field into scalable clinical approaches that could benefit patients. Organizational challenges may play a key role in the clinical translation of tissue engineering for the benefit of patients.
    UNASSIGNED: To gain insight into the organizational aspects of tissue engineering that may create impediments to efficient clinical translation, we conducted a retrospective qualitative case study of one tissue engineering multi-site translational project on knee cartilage engineered tissue grafts. We collected qualitative data using a set of different methods: semi-structured interviews, documentary research and audio-visual content analysis.
    UNASSIGNED: Our study identified various challenges associated to first-in-human trials in tissue engineering particularly related to: logistics and communication; research participant recruitment; clinician and medical student participation; study management; and regulation.
    UNASSIGNED: While not directly generalizable to other types of advanced therapies or to regenerative medicine in general, our results offer valuable insights into organizational barriers that may prevent efficient clinical translation in the field of tissue engineering.
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  • 文章类型: Journal Article
    从单站点健康研究转向多站点健康研究,实现了一系列研究益处,包括更快地招募更大和更多样化的样本;增加统计能力,更严格,概括性,和外部可靠性;以及影响政策和临床实践的可能性增加。然而,与单中心研究相比,机构审查委员会(IRB)对多中心研究的伦理审查提出了具体挑战,由于要求适用于多个本地IRB,增加了研究负担,可能危及研究过程的完整性或抑制多站点研究的发展。单一集中式IRB的选择可能会提供更清晰的,更加一致和有效的审查过程。本研究通过爱尔兰老龄化纵向研究的智力残疾补充(IDS-TILDA),提供了15年来与爱尔兰多个地点的IRB接触的案例报告和评论。它通过前四波考察了IDS-TILDA的道德审查过程。虽然48个IRB中的大多数在13周内获得了道德批准,六个IRB花了21-47周的时间批准,导致数据收集延迟长达11个月。尽管有额外的审查时间,本研究方案无需改变.因此,该过程的一个关键影响是在少数组织中开始数据收集的延迟,并减少对一个组织的研究参与。具有多个IRB的道德审查过程增加了过程的复杂性,由于增加了官僚作风,并且需要在48个IRB之间进行更大的沟通,大大增加了审查过程的资源承诺。大多数IRB的相对较快批准部分是纵向研究在多次浪潮中与组织建立关系的结果。其他健康研究可能不会产生这种好处,这支持了对多站点健康研究的单一IRB系统的呼吁。
    A shift from single to multi-site health studies enabled a range of research benefits including faster recruitment of larger and more diverse samples; increased statistical power, greater rigour, generalisability, and external reliability; and increased likelihood of impacting policy and clinical practice. However, ethical review of multi-site studies by Institutional Review Boards (IRBs) raises specific challenges compared with single site studies, with requirements to apply to multiple local IRBs increasing the burden on research, possibly endangering the integrity of the research process or inhibiting development of multi-site studies. The option of a single centralised IRB may offer a clearer, more consistent and efficient review process. This study presents a case report and commentary from 15 years engaging with IRBs in multiple sites in Ireland by the Intellectual Disability Supplement to the Irish Longitudinal Study on Ageing (IDS-TILDA). It examines the ethics review process for IDS-TILDA through its first four waves. While the majority of 48 IRBs granted ethical approval within 13 weeks, six IRBs took 21-47 weeks to approve, leading to delays in data collection of up to 11 months. Despite additional review time, no changes were required to the study protocol. Therefore, a critical impact of the process was the delay in starting data collection within a small number of organisations, and reduced involvement in the study for one organisation. The ethical review process with multiple IRBs increased the degree of complexity of the process, with added bureaucracy and far greater communication required across 48 IRBs, substantially adding to the resource commitment for the review process. The relatively quick approval from the majority of IRBs was partially a result of the longitudinal study building relationships with organisations throughout multiple waves. That other health studies may not accrue this benefit supports calls for a single IRB system for multi-site health studies.
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  • 文章类型: Journal Article
    本案例分析了专业知识,潜在的利益冲突,编辑的客观性,作者,以及参与2022年生育问题特刊的同行审稿人,怀孕,和心理健康。收集了有关资格的数据,组织隶属关系,以及六篇论文作者之间的关系,三位客座编辑,和十二位同行评审员。两篇文章被发现作者之间存在未公开的利益冲突,一个编辑,以及与反堕胎倡导和游说团体有关联的多个同行评审员,表明客观性受损。这种缺乏透明度破坏了同行审查过程,并导致有偏见的研究和虚假信息扩散。我们的研究受到几个因素的限制,包括:难以收集同行评审数据,可能缺失的隶属关系,和一个没有比较的小样本。虽然这是一个特刊的案例研究,我们确实有提高诚信的建议。
    This case study analyzes the expertise, potential conflicts of interest, and objectivity of editors, authors, and peer reviewers involved in a 2022 special journal issue on fertility, pregnancy, and mental health. Data were collected on qualifications, organizational affiliations, and relationships among six papers\' authors, three guest editors, and twelve peer reviewers. Two articles were found to have undisclosed conflicts of interest between authors, an editor, and multiple peer reviewers affiliated with anti-abortion advocacy and lobbying groups, indicating compromised objectivity. This lack of transparency undermines the peer review process and enables biased research and disinformation proliferation.Our study is limited by a few factors including: difficulty collecting peer reviewer data, potentially missing affiliations, and a small sample without comparisons. While this is a case study of one special issue, we do have suggestions for increasing integrity.
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  • 文章类型: Journal Article
    伦理价值-对一些学者来说,在研究伦理学领域,为试验患者提供试验后访问(PTA)的必要性受到了极大的关注。虽然没有达成共识,很明显,在某些审判环境中,各种因素使PTA特别合适。我们概述了迷幻临床试验的非典型方面,这些试验支持在该领域的研究中引入PTA的情况。包括迷幻药的更广泛的法律地位,研究人员-治疗师/参与者关系的性质,以及整个治疗过程的延长时限。正如人们越来越理解的那样,迷幻药辅助心理治疗的功效与药物本身一样,主要受食外学因素和文化治疗容器的驱动。因此,我们还主张将注意力从审判后的获取转向涵盖审判后护理其他要素的更广泛概念。我们提供了一些可能适用于迷幻药临床试验的潜在试验后护理规定的概述。尽管世界医学协会的赫尔辛基宣言呼吁研究人员,赞助商,和政府为审判后的准入做出规定,在已经受到高资源需求和重大官僚负担限制的迷幻试验中,这种规定可能感到不切实际或遥不可及。我们展示了如何将审判后的规定视为研究过程的一个组成部分,和研究经费的适当目的地,将有助于发展合法化后迷幻药生态系统所需的基础设施。
    The ethical value-and to some scholars, necessity-of providing trial patients with post-trial access (PTA) to an investigational drug has been subject to significant attention in the field of research ethics. Although no consensus has emerged, it seems clear that, in some trial contexts, various factors make PTA particularly appropriate. We outline the atypical aspects of psychedelic clinical trials that support the case for introducing the provision of PTA within research in this field, including the broader legal status of psychedelics, the nature of the researcher-therapist/participant relationship, and the extended time-frame of the full therapeutic process. As is increasingly understood, the efficacy of psychedelic-assisted psychotherapy is driven as much by extrapharmacological elements and the cultural therapeutic container as by the drug itself. As such, we also advocate for a refocusing of attention from post-trial access to a broader concept encompassing other elements of post-trial care. We provide an overview of some of the potential post-trial care provisions that may be appropriate in psychedelic clinical trials. Although the World Medical Association\'s Declaration of Helsinki calls on researchers, sponsors, and governments to make provisions for post-trial access, such provision may feel impracticable or out-of-reach within psychedelic trials that are already constrained by a high resource demand and significant bureaucratic burden. We show how conceiving of post-trial provision as an integral site of the research process, and an appropriate destination for research funding, will serve to develop the infrastructure necessary for the post-legalisation psychedelic medicine ecosystem.
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  • 文章类型: Journal Article
    在疾病暴发期间进行研究可能在道德上具有挑战性,2014-2016年西非埃博拉疫情和COVID-19大流行证明了这一点。然而,在疾病爆发期间进行研究时,很少有实证研究来了解不同利益相关者对道德问题的看法和观点。进行这项初步研究是为了实证探索非洲公共卫生研究利益相关者对非洲传染病暴发期间研究伦理问题的看法。我们对参加2019年3月13日至15日在亚的斯亚贝巴举行的国际复发和新兴传染病国际会议(ICREID)的330名参与者进行了在线调查。埃塞俄比亚就2014年埃博拉疫情中经历的各种研究伦理复杂性发表了意见。研究结果揭示了在几个伦理主题上的一些分歧观点,包括:在暴发中使用未注册干预措施的伦理;可接受的研究设计;伦理审查过程;风险收益评估;排除孕妇和儿童;以及生物学样本和数据共享。大多数(76.3%)的受访者认为,在缺乏可用的标准治疗或预防方法的情况下,如果有强有力的科学依据和有利的风险-收益比,那么使用研究性干预措施在伦理上是合理的.关于高病死率暴发期间的常规安慰剂对照试验,认为这种不道德的受访者是认为这种设计在道德上是合理的受访者的三倍以上。我们感到有些惊讶的是,大多数(近60%)的受访者对在暴发期间将孕妇和儿童排除在临床试验中感到满意。所有受访者都同意在爆发期间优先考虑知情同意进行研究。根据我们的发现,需要研究伦理指导,以使研究利益相关方能够处理在新出现的疾病暴发期间进行研究时出现的伦理复杂性,特别是关于使用实验性干预措施;安慰剂试验设计;纳入或合理排除孕妇和儿童;以及生物样本/数据共享.研究结果将用于正在进行的努力,以开发以非洲为中心的协商和连贯的框架,以支持对非洲未来新出现的传染病暴发进行研究的道德行为。
    Conducting research during disease outbreaks can be ethically challenging as evidenced in the 2014-2016 Ebola outbreak in West Africa and COVID-19 pandemic. Yet, there has been little empirical research conducted for understanding the views and perspectives of different stakeholders regarding ethical issues in conducting research during disease outbreaks. This preliminary study was conducted to empirically explore African public health research stakeholders\' views about research ethics issues during infectious disease outbreaks in Africa. We conducted an online survey of 330 participants attending the International Conference on Re-emerging and Emerging Infectious Disease (ICREID) meeting that took place from 13-15 March 2019 in Addis Ababa, Ethiopia to elicit their views on various research ethics complexities experienced in the 2014 Ebola outbreak. Study results revealed some divergent views on several ethical themes including: ethics of using unregistered interventions in outbreaks; acceptable study design; ethics review processes; risks-benefit assessment; exclusion of pregnant women and children; and biological sample and data sharing. Majority (76.3%) of respondents felt that in the absence of available standard treatments or prevention modalities, the use of investigational interventions can be ethically justifiable if there is a strong scientific rationale and favorable risk-benefit ratio. Regarding conventional placebo-controlled trials during outbreaks with high case fatality rates, respondents that considered this unethical were more than three times those that felt such design were ethically justifiable. We were somewhat surprised that a majority (almost 60%) of respondents were satisfied with the exclusion of pregnant women and children in clinical trials during outbreaks. All respondents concurred with the prioritization of informed consent for research during an outbreak. Based on our findings, research ethics guidance is needed to equip research stakeholders in dealing with ethical complexities arising in the conduct of research during emerging disease outbreaks-especially regarding using experimental interventions; placebo trial design; inclusion or justified exclusion of pregnant women and children; and biological sample/data sharing. The findings will be used in ongoing efforts of developing a consultative and coherent African-centric framework to support ethical conduct of research for future emerging infectious disease outbreaks in Africa.
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  • 文章类型: Journal Article
    涉及人类的生物医学研究的好处是公认的,以及符合国际科学和伦理标准的需要。当人体研究涉及辐射成像程序或放射治疗时,从放射防护的角度来看,应提供额外的专家审查水平。国际辐射防护委员会(ICRP)的相关出版物现在已有三十年的历史,目前正在进行更新。
本文旨在引发关于如何评估辐射剂量风险和研究收益的讨论,使用诊断放射学的案例研究,涉及对没有直接益处的志愿者。Further,本文提供了目前正在考虑审查和修订的关键概念的理解,如剂量限制和新的研究方法在地平线上,包括放射生物学和流行病学。分析重新审视了ICRP出版物62中描述的观点,并考虑了放射保护伦理和医学研究伦理的最新进展。 .
    The benefits of biomedical research involving humans are well recognised, along with the need for conformity to international standards of science and ethics. When human research involves radiation imaging procedures or radiotherapy, an extra level of expert review should be provided from the point of view of radiological protection. The relevant publication of the International Commission for Radiological Protection (ICRP) is now three decades old and is currently undergoing an update. This paper aims to provoke discussions on how the risks of radiation dose and the benefits of research should be assessed, using a case study of diagnostic radiology involving volunteers for whom there is no direct benefit. Further, the paper provides the current understanding of key concepts being considered for review and revision-such as the dose constraint and the novel research methods on the horizon, including radiation biology and epidemiology. The analysis revisits the perspectives described in the ICRP Publication 62, and considers the recent progress in both radiological protection ethics and medical research ethics.
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  • 文章类型: Case Reports
    2012年的Menlo报告是一群计算机科学家的努力,美国政府的资助者,律师为信息和通信技术(ICT)研究制定了道德准则。在这里,我们将门洛作为我们所谓的道德治理的案例进行研究,发现此过程检查了过去的争议,并吸收了现有的网络,以将日常的道德实践与道德作为一种治理形式联系起来。要创建Menlo报告,作者和资助者依靠现有的拼凑工作,可用资源,这显著影响了报告的内容和影响。报告作者受到前瞻性和前瞻性目标的激励:实现新的数据共享以及解决过去的争议及其对该领域研究机构的影响。作者还努力应对哪些道德框架是合适的不确定性,并决定将许多网络数据归类为人类受试者数据。最后,《门洛报告》的作者试图通过对当地研究社区的呼吁以及对联邦规则制定采取步骤来注册多个现有的治理网络。门洛报告作为如何研究道德治理的案例研究:关注资源,适应,和拼花,并且专注于过程试图修复的不确定性,以及该过程揭示的新的不确定性,这将成为未来道德工作的场所。
    The 2012 Menlo Report was an effort in which a group of computer scientists, US government funders, and lawyers produced ethics guidelines for research in information and communications technology (ICT). Here we study Menlo as a case of what we call ethics governance in the making, finding that this process examines past controversies and enrols existing networks to connect the everyday practice of ethics with ethics as a form of governance. To create the Menlo Report, authors and funders relied on bricolage work with existing, available resources, which significantly shaped both the report\'s contents and impacts. Report authors were motivated by both forward- and backward-looking goals: enabling new data-sharing as well as addressing past controversies and their implications for the field\'s body of research. Authors also grappled with uncertainty about which ethical frameworks were appropriate and made the decision to classify much network data as human subjects data. Finally, the Menlo Report authors attempted to enrol multiple existing networks in governance through appeals to local research communities as well as taking steps towards federal rulemaking. The Menlo Report serves as a case study in how to study ethics governance in the making: with attention to resources, adaptation, and bricolage, and with a focus on both the uncertainties the process tries to repair, as well as the new uncertainties the process uncovers, which will become the site of future ethics work.
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  • 文章类型: Journal Article
    在学术和科学出版中,作者从属关系的披露可以说是一种关键但却鲜为人知且基本上不受管制的现象。首先,本文认为,从属关系归因实践受到误解和误用的困扰。第二,这表明大学,研究机构和出版商应紧急进行对话,以明确定义期望并促进最佳实践。第三,它引入了从属关系贡献声明,作为提高准确性的具体举措,透明度,和问责制。
    Author affiliation disclosures are arguably a critical yet poorly understood and largely unregulated phenomenon in scholarly and scientific publishing. First, this paper argues that affiliation attribution practices are burdened by misunderstandings and misuses. Second, it suggests that universities, research institutions and publishers should urgently engage in a conversation aimed at clearly defining expectations and promoting best practices. Third, it introduces affiliation contribution statements as a concrete initiative in the direction of increased accuracy, transparency, and accountability.
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  • 文章类型: Journal Article
    许多寻求治愈艾滋病毒的研究必须要求参与者中断其抗逆转录病毒治疗。在这种情况下,是否允许在研究中加入安慰剂组?我们解释了为什么这样做是科学和道德上的必要性,比想象中更良性。
    Many studies that seek to cure HIV must ask participants to interrupt their antiretroviral treatment. In such circumstances, is it permissible to include a placebo group in the study? We explain why doing so is a scientific and an ethical necessity, and more benign than imagined.
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  • 文章类型: Journal Article
    公平纳入研究对象对于确保急性后遗症COVID-19(PASC)研究结果使社会所有成员受益是必要的。科学家应该对代表影响疾病的临床相关因素的广泛个体样本进行研究。没有人口的多样性和社会及环境的多变性,研究产出不太可能适用于不同的人群,因此会增加健康差距。本叙事文献综述和伦理分析的目的是将公平的选择标准应用于PASC研究。我们简要强调翻译研究中公平选择主题的重要性,然后确定PASC的特征,以及PASC的研究,这阻碍了研究参与者的公平包容。我们将证明,确定一个足够和有代表性的样本不仅仅是确保更大的多样性;公平需要对风险进行更广泛的评估,负担,以及代表性不足的人群特有的福利。我们提供建议,以确保在PASC研究中公平选择主题,并促进所有个人的积极健康结果。包括最脆弱的人。
    Fair inclusion of research subjects is necessary to ensure that post-acute sequelae COVID-19 (PASC) research results benefit all members of society. Scientists should conduct research on a broad sample of individuals who represent clinically relevant factors influencing a disease. Without demographic diversity and sociological and environmental variability, research outputs are less likely to apply to different populations and would thus increase health disparities. The goal of this narrative literature review and ethical analysis is to apply fair selection criteria to PASC research studies. We briefly highlight the importance of fair subject selection in translational research and then identify features of PASC, as well as PASC research, that hinder fair inclusion of research participants. We will demonstrate that determining an adequate and representative sample is not simply a matter of ensuring greater diversity; rather, fairness requires a broader evaluation of risks, burdens, and benefits specific to underrepresented populations. We provide recommendations to ensure fair subject selection in PASC research and promote translation toward positive health outcomes for all individuals, including the most vulnerable.
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