ethics committees, research

道德委员会,Research
  • 文章类型: Journal Article
    2019年,修订后的《共同规则》要求研究的知情同意书包括一份关于临床相关研究结果是否会返还给研究参与者的声明。虽然有关于返回结果的全国性讨论,这些文件没有提供有关机构审查委员会(IRB)应如何解决这一问题的具体指导。通过为期一年的IRB员工和领导层参与的过程,科学和生物伦理学教员,社区IRB成员,和其他人,印第安纳大学的人类研究保护计划创建了一个框架,为研究人员考虑返回的结果类型提供了明确的分类,提供知情同意文件的语言,并描述了IRB的活跃但有意限制的角色。在这篇文章中,我们将这个框架及其基本原理描述为其他大学的模型,更一般地说,作为平衡保护人类受试者的需要与限制研究人员和IRB负担的努力的模型。
    In 2019, the revised Common Rule required informed consent documents for research to include a statement about whether clinically relevant research results would be returned to research participants. While there are national discussions regarding the return of results, these do not provide specific guidance about how institutional review boards (IRBs) should address this issue. Through a year-long process involving IRB staff and leadership, science and bioethics faculty members, community IRB members, and others, Indiana University\'s human research protection program created a framework that offers a clear categorization of types of results for researchers to consider returning, provides language for informed consent documents, and describes an active but intentionally limited role for the IRB. In this article, we describe this framework and its rationale as a model for other universities and, more generally, as a model for balancing the need to protect human subjects with efforts to limit the burdens on researchers and the IRB.
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  • 文章类型: Journal Article
    难民和寻求庇护者可能会遇到与抵达前经历有关的挑战,移民后和移民安置期间的结构缺点,在参与研究时需要特别保护。目的是审查具有难民和寻求庇护者背景的人是否以及如何在国家和国际研究伦理准则中解决对特殊保护的需求。对灰色文献进行了系统的搜索。搜索产生了2187个文档,其中14个符合纳入标准。很少有准则针对弱势群体的具体道德考虑,更不用说有难民和寻求庇护者背景的人了。一项准则明确解决了难民和寻求庇护者的脆弱性。为了确保伦理委员会成员和研究人员考虑与这些团体进行研究的潜在挑战,准则可能需要补充难民和寻求庇护者特定的研究伦理框架。这样一个框架对于在研究中最佳地保护具有难民和寻求庇护者背景的人可能是必要的。
    Refugees and asylum seekers may experience challenges related to pre-arrival experiences, structural disadvantage after migration and during resettlement requiring the need for special protection when participating in research. The aim was to review if and how people with refugee and asylum seeker backgrounds have had their need for special protection addressed in national and international research ethics guidelines. A systematic search of grey literature was undertaken. The search yielded 2187 documents of which fourteen met the inclusion criteria. Few guidelines addressed specific ethical considerations for vulnerable groups much less people with refugee and asylum seeker backgrounds. One guideline explicitly addressed vulnerability for refugees and asylums seekers. To ensure members of ethics committees and researchers consider the potential challenges of conducting research with these groups, guidelines may need to be supplemented with a refugee and asylum seeker specific research ethics framework. Such a framework may be necessary to optimally protect people with refugee and asylum seeker backgrounds in research.
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  • 文章类型: Journal Article
    向学生讲授人类主题研究(HSR)的伦理学应成为学生研究教育的基本组成部分。在这篇文章中,我们分析了排名第一的文理学院(LAC)的机构审查委员会(IRB)网站,以检查由本科生进行的HSR框架。我们对美国50个排名最高的LAC进行的描述性定量分析表明,大多数IRB网站都提供有关本科生研究的信息,大多数包括关于学生的基于课堂的研究信息。我们对十个学院的子样本进行的定性内容分析IRB网站提供了有关他们如何告知和教育包括知情同意在内的问题的信息,并为包括研究顾问在内的学生突出了不同的资源。和纪律标准。最后,我们讨论了IRB对本科生的可及性的建议。
    Teaching students about the ethics of Human Subject Research (HSR) should be a fundamental component of students\' education about research. In this article, we analyze the Institutional Review Board (IRB) websites of top-ranked Liberal Arts Colleges (LACs) to examine their framing of HSR carried out by undergraduate students. Our descriptive quantitative analysis from 50 top-ranked LACs in the United States indicates that a majority of IRB websites provide information about undergraduate research, and most include information about students\' classroom-based research. Our qualitative content analysis of a subsample of ten colleges\' IRB websites provides information on how they inform and educate about issues including informed consent and highlight different resources for students including their research advisor, and disciplinary standards. We conclude by discussing recommendations for IRBs in their accessibility to undergraduates.
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  • 文章类型: Journal Article
    背景:尽管ECG是医学实践中的重要诊断工具,心电图解释能力被认为较差。包括对ECG的误解的诊断不准确会导致不适当的医学判断并导致负面的临床结果。不必要的医疗测试甚至死亡。尽管评估心电图解释技能很重要,目前没有公认的普遍性,心电图解释的标准化评估工具。当前的研究旨在(1)开发一组项目(ECG问题),以根据基于RAND/UCLA适当性方法(RAM)的过程,通过专家小组之间的共识评估医务人员的ECG解释能力,以及(2)分析测试集的项目参数和多维潜在因素,以开发评估工具。
    方法:本研究将分为两个步骤:(1)专家小组通过RAM后的共识过程选择ECG解释评估的问题项目;(2)横截面,基于网络的测试使用一组心电图问题。多学科专家小组将评估答案和适当性,并选择50个问题作为下一步。根据从医生招募的438名测试参与者的预测样本量收集的数据,护士,医学生和护理学生,和其他医疗保健专业人员,我们计划使用多维项目反应理论对项目参数和参与者表现进行统计分析.此外,我们将尝试检测ECG解释能力中可能的潜在因素.将根据提取的参数提出用于ECG解释的问题项的测试集。
    背景:这项研究的方案得到了爱媛大学医学研究生院机构审查委员会的批准(IRB编号:2209008)。我们将获得所有参与者的知情同意。研究结果将提交给同行评审的期刊发表。
    Although the ECG is an important diagnostic tool in medical practice, the competency of ECG interpretation is considered to be poor. Diagnostic inaccuracy involving the misinterpretation of ECG can lead to inappropriate medical judgements and cause negative clinical outcomes, unnecessary medical testing and even fatalities. Despite the importance of assessing ECG interpretation skills, there is currently no established universal, standardised assessment tool for ECG interpretation. The current study seeks to (1) develop a set of items (ECG questions) for estimating competency of ECG interpretation by medical personnel by consensus among expert panels following a process based on the RAND/UCLA Appropriateness Method (RAM) and (2) analyse item parameters and multidimensional latent factors of the test set to develop an assessment tool.
    This study will be conducted in two steps: (1) selection of question items for ECG interpretation assessment by expert panels via a consensus process following RAM and (2) cross-sectional, web-based testing using a set of ECG questions. A multidisciplinary panel of experts will evaluate the answers and appropriateness and select 50 questions as the next step. Based on data collected from a predicted sample size of 438 test participants recruited from physicians, nurses, medical and nursing students, and other healthcare professionals, we plan to statistically analyse item parameters and participant performance using multidimensional item response theory. Additionally, we will attempt to detect possible latent factors in the competency of ECG interpretation. A test set of question items for ECG interpretation will be proposed on the basis of the extracted parameters.
    The protocol of this study was approved by the Institutional Review Board of Ehime University Graduate School of Medicine (IRB number: 2209008). We will obtain informed consent from all participants. The findings will be submitted for publication in peer-reviewed journals.
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  • 文章类型: Editorial
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  • 文章类型: Journal Article
    研究方案的制定和临床试验的开展需要高质量的阿尔茨海默病临床试验的开发和鉴定的共识指导。
    与阿尔茨海默氏症协会联合召开了一个特设共识委员会,以制定共识建议。
    很容易达成共识,需要提供科学依据,审判登记,机构审查委员会的监督,利益冲突披露,资金来源披露,定义的试验人群,招聘资源,干预的定义,试验持续时间的规范,参与者参与的适当付款,风险收益披露作为同意过程的一部分,以及即使研究结果为阴性,也要求传播和/或发布试验结果。
    本共识指南应被证明对方案制定和临床试验的进行有用。并可能进一步为开发教育材料提供平台,这些材料可能有助于指导潜在的试验参与者和公众做出适当的临床试验参与决策。
    Consensus guidance for the development and identification of high-quality Alzheimer\'s disease clinical trials is needed for protocol development and conduct of clinical trials.
    An ad hoc consensus committee was convened in conjunction with the Alzheimer\'s Association to develop consensus recommendations.
    Consensus was readily reached for the need to provide scientific justification, registration of trials, institutional review board oversight, conflict of interest disclosure, funding source disclosure, defined trial population, recruitment resources, definition of the intervention, specification of trial duration, appropriate payment for participant engagement, risk-benefit disclosure as part of the consent process, and the requirement to disseminate and/or publish trial results even if the study is negative.
    This consensus guidance should prove useful for the protocol development and conduct of clinical trials, and may further provide a platform for the development of education materials that may help guide appropriate clinical trial participation decisions for potential trial participants and the general public.
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  • 文章类型: Journal Article
    目前,世界面临着前所未有的冠状病毒病(Covid-19)大流行爆发。病毒的新颖性质和非常高的感染率不仅增加了寻找疫苗或治疗方法的紧迫性,而且还导致了研究模式的巨大变化。因此,印度医学研究理事会制定了“Covid-19大流行期间生物医学和健康研究伦理委员会审查国家指南”,以在研究审查期间提供指导。这里,我们试图分析这些指南的优势和局限性,以评估在当前情况下研究过程中面临的独特伦理挑战是否得到充分识别和解决,以及这些指南是否考虑了研究伦理的基本价值观和原则.
    The world currently faces an unprecedented pandemic outbreak of coronavirus disease (Covid-19). The novel nature of the virus and very high infection rates have not only increased the urgency to find a vaccine or cure but have also led to drastic changes in the mode of conduct of research. Thus, the Indian Council of Medical Research has developed the \"National Guidelines for Ethics Committees Reviewing Biomedical & Health Research during Covid-19 Pandemic\" for guidance during the review of research. Here, we attempt to analyse the strengths and limitations of these guidelines to assess if the unique ethical challenges faced during research in the current situation are adequately identified and addressed and if foundational values and principles of research ethics have been taken into account in these guidelines.
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  • 文章类型: Journal Article
    预计2020-2021年与COVID-19相关的全球死亡人数将很高。开发和提供疫苗可能是结束大流行的最有可能的方法。如果有可能将此开发时间缩短数周或数月,这可能对减少死亡有重大影响.如果使用人类挑战方法,II期和III期试验的时间可能不会那么长,也就是说,接种后故意感染COVID-19的参与者。本文分析了支持和反对这种方法的论点,并为监管机构提供了建议的广泛指导方针,研究人员和伦理委员会在考虑这些问题时。结论是,在延迟至关重要的情况下,可以维持当前的道德标准,但仍然允许进行人体挑战试验。其含义是,监管机构和研究人员现在需要共同努力,设计健壮但简短的试验,并简化伦理批准程序,以便在提出试验申请时到位。
    Global fatalities related to COVID-19 are expected to be high in 2020-2021. Developing and delivering a vaccine may be the most likely way to end the pandemic. If it were possible to shorten this development time by weeks or months, this may have a significant effect on reducing deaths. Phase II and phase III trials could take less long to conduct if they used human challenge methods-that is, deliberately infecting participants with COVID-19 following inoculation. This article analyses arguments for and against such methods and provides suggested broad guidelines for regulators, researchers and ethics committees when considering these matters. It concludes that it may be possible to maintain current ethical standards yet still permit human challenge trials in a context where delay is critical. The implications are that regulators and researchers need to work together now to design robust but short trials and streamline ethics approval processes so that they are in place when applications for trials are made.
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  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    国际公认的原则是,应通过研究伦理委员会(RECs)的伦理审查,在与人类的研究中应用和执行伦理规范。这将REC置于保护参与者和行使其权利的系统的核心。在南非儿童研究的伦理法律框架中,同意有不同的方法。也就是说,《国家卫生法》第71条(第2003年第61号)(NHA)要求父母对儿童研究给予强制性同意,并将代理人同意的权限限制为父母和法定监护人。然而,由NHA第72条授权并由国家健康研究伦理委员会(NHREC)根据其任务授权发布的国家伦理准则(国家卫生部,2015)允许更细致的方法-即年龄较大的青少年的自我同意,只要满足某些条件,并在没有父母或法定监护人的情况下获得一系列父母替代品的同意。我们在其他地方认为,第71条中的同意方法具有不适当的限制性,并认为国家道德准则中认可的同意方法更有道理。选择批准道德准则允许的同意策略的REC实际上是选择不遵循第71条,这提出了一个问题,即对该REC可能产生的后果。本文通过责任追究的三个“线程”来研究RECs的法律责任:NHREC,主办REC的机构,和法院。我们得出的结论是:(i)如果REC根据国家道德准则而不是第71条允许的同意策略批准了儿童协议,则NHREC不太可能在面对投诉时对REC进行纪律处分-前提是REC在NHREC根据其第72条规定的国家道德准则中采取了行动,以制定国家规范和标准;(ii)如果REC在同意的指导中允许道德准则面对投诉,主办机构也不太可能对REC进行纪律处分-特别是如果该机构知道REC明确决定遵循NHA第72条授权的国家道德准则;(iii)只有在证明了几个要求苛刻的组成部分的情况下,REC才能由参与者根据违法行为提起诉讼(并承担损害赔偿责任),例如,参与者遭受的伤害直接来自REC批准该研究的特定同意策略的行为。此外,法院在确定REC的行为是否为民法责任的目的是不法行为时,很可能会参考国家道德准则。RECs不受其东道机构购买的保险的集体责任的保护。我们提出了一系列解决这一问题的建议。
    It is an internationally accepted principle that ethics norms should be applied and enforced in research with humans through ethics review by research ethics committees (RECs). This places RECs at the very heart of the system for protecting participants and enforcing their rights. In the South African ethical-legal framework for child research, there are divergent approaches to consent. That is, section 71 of the National Health Act (No. 61 of 2003) (NHA) requires mandatory parental consent for child research, and limits the authority for proxy consent to parents and legal guardians. However, national ethics guidelines authorised by section 72 of the NHA and issued by the National Health Research Ethics Council (NHREC) acting in terms of its mandate (National Department of Health, 2015) allow a more nuanced approach - i.e. self-consent by older adolescents, provided certain conditions are met, and consent by a range of parental substitutes where there are no available parents or legal guardians. We have argued elsewhere that the consent approach in section 71 is inappropriately restrictive and are of the view that the consent approach endorsed in national ethics guidelines is more defensible. An REC that elects to approve a consent strategy allowable in ethics guidelines is effectively electing to not follow section 71, which raises the question of what the consequences might be for that REC. This article examines the legal liability of RECs through three \'threads\' of accountability: the NHREC, the institutions hosting RECs, and the courts. We conclude that: (i) if an REC approves a child protocol with consent strategies allowable in terms of national ethics guidelinesbut not in terms of section 71, it is unlikely that the NHREC would discipline the REC in the face of a complaint - provided the REC acted within national ethics guidelines issued by the NHREC in terms of the latter\'s section 72 mandate to set national norms and standards; (ii) if an REC approves a consent approach allowed for in ethics guidance, it is also unlikely that the host institution would discipline the REC in the face of a complaint - especially if the institution is aware of the REC\'s explicit decision to follow national ethics guidelines that are authorised by section 72 of the NHA; and (iii) an REC could only be sued by a participant in terms of the law of delict (and be liable for damages) if several demanding components are proven, such as that the harm suffered by the participant resulted directly from the REC\'s actions in approving a particular consent strategy for that research. Furthermore, the court may well look to national ethics guidelines in making determinations about whether an REC\'s conduct was wrongful for the purposes of liability in civil law. RECs are protected from being collectively liable by insurance taken out by their host institutions. We make a series of recommendations to address this issue.
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