ethics committees, research

道德委员会,Research
  • 文章类型: Journal Article
    背景:研究引用了包括阿拉伯国家在内的世界许多地区的研究伦理委员会面临的缺点和挑战。本文介绍了与研究伦理委员会(REC)主席进行定性深入访谈的结果,以探讨他们对他们在工作中面临的挑战以及对涉及人群的研究的监督的看法。
    方法:对六个国家的生物医学和/或社会行为研究伦理委员会的主席(n=11)进行了虚拟深入访谈,转录,编码并接受重复主题的主题分析。
    结果:两组反复出现的主题阻碍了委员会的工作,并对研究应用的质量提出了担忧:(1)程序和委员会层面的挑战,例如繁重的工作量,成员资格的变化,阻碍官僚程序,成员过度劳累,以及在审查过程中交叉的社会文化价值观;(2)研究人员在应用研究伦理和研究方法方面的能力不一致。
    结论:REC椅子的叙述对于阐明调查中未发现的经验和问题很重要,增加对该地区有影响的知识体系,以及世界其他地区的低收入和中等收入国家(LMICs)。国际研究合作可以从这些发现中受益。
    BACKGROUND: Research cites shortcomings and challenges facing research ethics committees in many regions across the world including Arab countries. This paper presents findings from qualitative in-depth interviews with research ethics committee (REC) chairs to explore their views on the challenges they face in their work with the oversight of research involving human populations.
    METHODS: Virtual in-depth interviews were conducted with chairs (n = 11) from both biomedical and/or social-behavioral research ethics committees in six countries, transcribed, coded and subject to thematic analysis for recurring themes.
    RESULTS: Two sets of recurring themes impede the work of the committees and pose concerns for the quality of the research applications: (1) procedures and committee level challenges such as heavy workload, variations in member qualification, impeding bureaucratic procedures, member overwork, and intersecting socio-cultural values in the review process; (2) inconsistencies in the researchers\' competence in both applied research ethics and research methodology as revealed by their applications.
    CONCLUSIONS: Narratives of REC chairs are important to shed light on experiences and issues that are not captured in surveys, adding to the body of knowledge with implications for the region, and low- and middle-income countries (LMICs) in other parts of the world. International research collaborations could benefit from the findings.
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  • 文章类型: Journal Article
    这项研究确定了澳大利亚人信任人类研究伦理委员会(HREC)批准使用基因组数据的情况-未经明确同意-并考虑了基因组数据共享设置的影响。和应答者属性,公众信任。调查结果(N=3013)显示,某些情况比其他情况更有利于公众信任,当未来的研究有益时,当隐私得到保护时,豁免得到认可,但在其他情况下获得的支持较少。尽管如此,结果表明,态度受到的影响超过这些具体情况,使用不同的数据共享设置,和参与者属性,影响观点。最终,这项研究提出了与澳大利亚授权放弃同意时使用HREC标准相关的问题和担忧.
    This research identifies the circumstances in which Human Research Ethics Committees (HRECs) are trusted by Australians to approve the use of genomic data - without express consent - and considers the impact of genomic data sharing settings, and respondent attributes, on public trust. Survey results (N = 3013) show some circumstances are more conducive to public trust than others, with waivers endorsed when future research is beneficial and when privacy is protected, but receiving less support in other instances. Still, results imply attitudes are influenced by more than these specific circumstances, with different data sharing settings, and participant attributes, affecting views. Ultimately, this research raises questions and concerns in relation to the criteria HRECs use when authorising waivers of consent in Australia.
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  • 文章类型: Letter
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  • 文章类型: Journal Article
    背景:Q-CEP(巴西国家研究伦理委员会(Conep))是一个全国性的项目,由巴西国家研究伦理委员会(Conep)之间的合作产生,卫生部和医院MoinhosdeVento(HMV)。它的制定是为了巩固CEP/Conep系统所有成员对人类研究进行伦理审查的政策,巴西国家机构审查委员会制度。因此,这项研究的目的是报告Q-CEP项目的经验和结果。
    方法:观察性,回顾性研究包括来自Q-CEP的数据,从访问该国所有机构研究伦理委员会(RECs)中获得。Q-CEP实施的行动是两步过程的一部分:(i)对每个REC进行培训访问;(ii)开发与研究道德评估有关的战略主题的远程学习模块。本文提供的数据涵盖第一步(培训访问),由Q-CEP定义为项目的诊断阶段。对于像巴西这样一个社会和经济不平等的国家来说,这是一个特别重要的阶段;需要对现实的准确描述来为质量改进策略的规划提供信息。
    结果:在2019-2021年,Q-CEP访问了832个REC,培训了11,197人。该样本涵盖了该国几乎所有活跃的REC;只有4个(0.5%)未进行评估。在评估的94个项目中,62%的人没有达到至少80%的目标,大约1/4(26%)的人低于50%的目标。该过程的诊断阶段揭示了REC在道德审查中的不足之处。对知情同意书的分析表明,只有131个REC(15.74%)符合。REC在其报告中对未决问题的描述符合19.33%(n=161)。超过一半的区域经济共同体也认为行政和业务方面不足。
    结论:总体而言,巴西RECs在运营的几个方面表现出较差的合规性,在道德评估和其他过程中,这证明了额外的培训。Q-CEP项目是巴西卫生部推动的质量改进政策的一部分。在该项目的诊断步骤中获得的数据为世界上最大的研究伦理评估系统之一的资格和巩固做出了贡献。
    BACKGROUND: Q-CEP (Qualificação dos Comitês de Ética em Pesquisa que compõem o Sistema CEP/Conep) is a nationwide project resulting from a partnership between the Brazilian National Research Ethics Commission (Conep), the Ministry of Health and Hospital Moinhos de Vento (HMV). It was developed to consolidate policy for ethical review of research with human beings in all members of the CEP/Conep System, Brazil\'s national system of institutional review boards. The aim of this study was therefore to report on the experience and results of the Q-CEP project.
    METHODS: An observational, retrospective study includes data from the Q-CEP, obtained from visits to all the institutional research ethics committees (RECs) in the country. The actions implemented by Q-CEP were part of a two-step process: (i) training visits to each REC; (ii) development of distance learning modules on strategic topics pertaining to research ethics evaluation. The data presented herein cover step one (training visits), defined by Q-CEP as the diagnostic stage of the project. For a country with social and economics inequalities such as Brazil, this is a particularly important stage; an accurate picture of reality is needed to inform planning of quality improvement strategies.
    RESULTS: In 2019-2021, Q-CEP visited 832 RECs and trained 11,197 people. This sample covered almost all active RECs in the country; only 4 (0.5%) were not evaluated. Of the 94 items evaluated, 62% did not reach the target of at least 80% compliance and around 1/4 (26%) were below 50% compliance. The diagnostic stage of the process revealed inadequacies on the part of the RECs in their ethical reviews. The analysis of informed consent forms showed compliance in only 131 RECs (15.74%). The description of pending issues made by RECs in their reports was compliant in 19.33% (n = 161). Administrative and operational aspects were also considered inadequate by more than half of the RECs.
    CONCLUSIONS: Overall, Brazilian RECs showed poor compliance in several aspects of their operation, both in ethics evaluation and in other processes, which justifies additional training. The Q-CEP project is part of a quality improvement policy promoted by the Brazilian Ministry of Health. The data obtained in the diagnostic step of the project have contributed to the qualification and consolidation of one of the world\'s largest research ethics evaluation systems.
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  • 文章类型: Journal Article
    背景:基因研究可以产生与研究目标无关的信息,但可能与研究参与者的临床或个人兴趣有关。有一个新兴但有争议的责任返回一些遗传研究结果,然而,关于基因组研究人员和非洲大陆其他人的观点几乎没有证据。
    方法:我们进行了一项大陆调查,以征求研究人员的观点,科学政策制定者和研究伦理委员会成员对非洲基因组学研究中个体遗传研究成果的反馈。
    结果:共有110人参加了调查,收到了51份完整调查和59份不完整调查。使用描述性分析总结数据。总的来说,我们的受访者认为,临床上可行的个人基因研究结果应该返回给研究参与者,显然是因为参与者有权了解他们的健康状况,这也可能是研究参与得到认可的一种手段。尽管如此,需要就如何在非洲基因组学研究中返回个体遗传研究结果制定精确的指导。
    结论:参与者应获得可以促进更健康生活方式的信息;只有临床上可行的结果才应返回,参与者应获得与他们的健康直接相关的所有重要信息。然而,详细的指导方针应该告知应该退回什么。H3Africa指南规定,研究人员反馈一般研究结果通常被认为是良好的做法,但是对于个体基因组研究结果是否也应该反馈,目前尚无共识。关于个人反馈什么结果的决定,如果有的话,非常具有挑战性,具体的背景对于做出适当的决定很重要。
    BACKGROUND: Genetic research can yield information that is unrelated to the study\'s objectives but may be of clinical or personal interest to study participants. There is an emerging but controversial responsibility to return some genetic research results, however there is little evidence available about the views of genomic researchers and others on the African continent.
    METHODS: We conducted a continental survey to solicit perspectives of researchers, science policy makers and research ethics committee members on the feedback of individual genetic research findings in African genomics research.
    RESULTS: A total of 110 persons participated in the survey with 51 complete and 59 incomplete surveys received. Data was summarised using descriptive analysis. Overall, our respondents believed that individual genetic research results that are clinically actionable should be returned to study participants apparently because participants have a right to know things about their health, and it might also be a means for research participation to be recognized. Nonetheless, there is a need for development of precise guidance on how to return individual genetic research findings in African genomics research.
    CONCLUSIONS: Participants should receive information that could promote a healthier lifestyle; only clinically actionable findings should be returned, and participants should receive all important information that is directly relevant to their health. Nevertheless, detailed guidelines should inform what ought to be returned. H3Africa guidelines stipulate that it is generally considered good practice for researchers to feedback general study results, but there is no consensus about whether individual genomic study results should also be fed back. The decision on what individual results to feedback, if any, is very challenging and the specific context is important to make an appropriate determination.
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  • 文章类型: Journal Article
    背景:阻碍数据共享成功的几个因素——模糊或零散的监管环境,相互冲突的机构/研究人员利益和不同水平的数据科学相关的专业知识就是其中之一。鉴于数字技术和人工智能(AI)带来的独特挑战,传统的道德监督机制和做法可能无法很好地保证充分的研究监督。数据密集型研究提出了新的,在非洲研究环境中特别相关的语境伦理和法律挑战。然而,没有进行实证研究来探索这些挑战。
    方法:我们通过在2022年6月至2023年2月之间进行20次半结构化在线访谈,探索了REC成员对数据共享的看法和经验。使用有目的的采样和滚雪球,我们招募了撒哈拉以南非洲(SSA)的代表。我们逐字抄录,并使用Atlas对数据进行主题分析。tiV22。
    结果:确定了三个主要主题:(i)审查数据共享协议的经验,(二)对数据传输工具的看法和(三)道德,数据共享的法律和社会挑战。出现了几个子主题:(i。a)审查数据共享协议的频率和方法,(i.b)实际/技术挑战,(i.c)培训,(ii)a)数据传输工具的理想结构,(ii)b)数据传输工具的关键要素,(ii)c)实施水平,(ii)D)制定和审查数据传输协议(DTA)的关键利益相关者,(iii)a)机密性和匿名性,(iii)b)同意,(iii)C)监管框架,和(iii.d)污名化和歧视。
    结论:我们的结果表明REC成员的感知存在差异,对数据保护法的存在的认识不够理想,并且一致表示需要进行REC成员培训。为了促进SSA内部和跨SSA的有效数据共享,纳入道德准则,需要与相关利益攸关方和实地专家协商,制定法律和社会要素,以及REC成员在审查数据密集型协议方面的培训认证。
    BACKGROUND: Several factors thwart successful data sharing-ambiguous or fragmented regulatory landscapes, conflicting institutional/researcher interests and varying levels of data science-related expertise are among these. Traditional ethics oversight mechanisms and practices may not be well placed to guarantee adequate research oversight given the unique challenges presented by digital technologies and artificial intelligence (AI). Data-intensive research has raised new, contextual ethics and legal challenges that are particularly relevant in an African research setting. Yet, no empirical research has been conducted to explore these challenges.
    METHODS: We explored REC members\' views and experiences on data sharing by conducting 20 semi-structured interviews online between June 2022 and February 2023. Using purposive sampling and snowballing, we recruited representatives across sub-Saharan Africa (SSA). We transcribed verbatim and thematically analysed the data with Atlas.ti V22.
    RESULTS: Three dominant themes were identified: (i) experiences in reviewing data sharing protocols, (ii) perceptions of data transfer tools and (iii) ethical, legal and social challenges of data sharing. Several sub-themes emerged as: (i.a) frequency of and approaches used in reviewing data sharing protocols, (i.b) practical/technical challenges, (i.c) training, (ii.a) ideal structure of data transfer tools, (ii.b) key elements of data transfer tools, (ii.c) implementation level, (ii.d) key stakeholders in developing and reviewing a data transfer agreement (DTA), (iii.a) confidentiality and anonymity, (iii.b) consent, (iii.c) regulatory frameworks, and (iii.d) stigmatisation and discrimination.
    CONCLUSIONS: Our results indicated variability in REC members\' perceptions, suboptimal awareness of the existence of data protection laws and a unanimously expressed need for REC member training. To promote efficient data sharing within and across SSA, guidelines that incorporate ethical, legal and social elements need to be developed in consultation with relevant stakeholders and field experts, along with the training accreditation of REC members in the review of data-intensive protocols.
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  • 文章类型: Journal Article
    背景:在这项研究中,我们研究了埃及新临床试验法的伦理含义,采用伊曼纽尔等人提出的伦理框架。并将其与各种国家和超国家法律进行比较。作为埃及,这一分析至关重要,被认为是一个高增长的医药市场,已经成为临床试验的一个有吸引力的地点,在一个拥有强大的医疗保健基础设施和主要是初治患者的人口大国中,提供对生物伦理法规的伦理实施的见解。
    方法:我们对埃及法律与瑞典和法国的法规进行了比较分析,包括欧盟临床试验条例,考虑伦理人类主题研究标准,并采用定向方法进行定性内容分析,以考察法律法规。这项研究涉及广泛的同行审查,频繁的汇报情况,并与具有相关国际法律专业知识的法律专家合作,以确保对法律进行严格的分析和解释。
    结果:关于七个不同原则(社会和科学价值,科学有效性,公平选择参与者,风险收益比,独立审查,知情同意和对参与者的尊重)埃及,法国,和欧盟法规有可比的分数。具体原则(社会价值、科学价值,和公平选择参与者)由于某些法规体现了“隐含”原则而不是明确陈述的原则,因此直接识别具有挑战性。
    结论:分析强调了埃及与国际公认的道德原则的一致性,正如伊曼纽尔等人概述的那样。,通过与法语的比较,瑞典语,和欧盟法规,强调埃及迫切需要不断完善其道德法规,以保障参与者的保护和研究诚信。确定的关键问题包括在研究中澄清和规范社会价值概念的必要性,除了对道德审查委员会的专业知识和公正性的担忧之外,指出了加强埃及及其他地区研究伦理的更广泛议程。
    BACKGROUND: In this study, we examined the ethical implications of Egypt\'s new clinical trial law, employing the ethical framework proposed by Emanuel et al. and comparing it to various national and supranational laws. This analysis is crucial as Egypt, considered a high-growth pharmaceutical market, has become an attractive location for clinical trials, offering insights into the ethical implementation of bioethical regulations in a large population country with a robust healthcare infrastructure and predominantly treatment-naïve patients.
    METHODS: We conducted a comparative analysis of Egyptian law with regulations from Sweden and France, including the EU Clinical Trials Regulation, considering ethical human subject research criteria, and used a directed approach to qualitative content analysis to examine the laws and regulations. This study involved extensive peer scrutiny, frequent debriefing sessions, and collaboration with legal experts with relevant international legal expertise to ensure rigorous analysis and interpretation of the laws.
    RESULTS: On the rating of the seven different principles (social and scientific values, scientific validity, fair selection of participants, risk-benefit ratio, independent review, informed consent and respect for participants) Egypt, France, and EU regulations had comparable scores. Specific principles (Social Value, Scientific Value, and Fair selection of participants) were challenging to directly identify due to certain regulations embodying \'implicit\' principles more than explicitly stated ones.
    CONCLUSIONS: The analysis underscores Egypt\'s alignment with internationally recognized ethical principles, as outlined by Emanuel et al., through its comparison with French, Swedish, and EU regulations, emphasizing the critical need for Egypt to continuously refine its ethical regulations to safeguard participant protection and research integrity. Key issues identified include the necessity to clarify and standardize the concept of social value in research, alongside concerns regarding the expertise and impartiality of ethical review boards, pointing towards a broader agenda for enhancing research ethics in Egypt and beyond.
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  • 文章类型: Editorial
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  • 文章类型: Journal Article
    迫切需要增加对COVID-19及其预防策略的了解,治疗,和缓解。研究企业的所有参与者,包括机构审查委员会,有道德义务保护参与者,并确保从此类研究中获得的好处不与大流行前指导研究人员的核心原则相冲突。在这次审查中,我们讨论了围绕临床试验启动和实施的伦理问题,专注于新型COVID-19治疗剂,疫苗,或者生物样本研究,使用自治原则,仁慈,和正义。我们讨论了管理与进行临床试验相关的实际挑战的策略,强调维护研究参与者的权利和福利。
    There is an urgent need for increased understanding of COVID-19 and strategies for its prevention, treatment, and mitigation. All participants in the research enterprise, including institutional review boards, have an ethical duty to protect participants and ensure that the benefits gained from such research do not conflict with the core principles that guided researchers prior to the pandemic. In this review, we discuss the ethical issues surrounding initiation and conduct of clinical trials, focusing on novel COVID-19 therapeutic, vaccine, or biospecimen research, using the principles of autonomy, beneficence, and justice. We discuss strategies to manage the practical challenges associated with the conduct of clinical trials, with an emphasis on maintaining the rights and welfare of research participants.
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  • 文章类型: Journal Article
    背景:研究全球健康问题需要国际多学科团队。这种多学科和多元文化主义在不同国家背景下坚持一套道德原则方面带来了挑战。我们的卫生系统应对暴力侵害妇女行为(VAW)小组包括欧洲高收入国家(HIC)的两所大学和中低收入国家(LMICs)的四所大学。这项研究旨在调查专业和政策观点的类型,的原因,以及针对卫生系统应对VAW的全球研究项目的伦理批准阶段特有的伦理挑战的解决方案。
    方法:我们使用了伦理关系网络模型,框架方法,和READ方法分析定性半结构化访谈(n=18)和政策文件(n=27)。在2021年3月至7月,我们从五个伙伴国家招募了研究人员和研究伦理委员会(REC)成员的目的性样本。受访者在研究伦理方面张贴了政策和指导方针,包括VAW。
    结果:我们开发了三个主题和八个子主题,总结了三个背景因素中的道德挑战。该小组的全球性质导致了HIC和LMIC之间的权力和资源失衡以及不同的REC规则。卫生服务中主要研究的位置强调了大学REC和卫生当局之间的不同规则。各国之间对VAW和研究参与者的脆弱性有不同的概念性,一些LMIC区域经济共同体的方法和主题专长有限。这些因素威胁到研究的及时交付,并对研究人员及其与RECs和HIC资助者的关系产生负面影响。大多数研究人员对官僚主义者感到沮丧和沮丧,不协调,漫长的审批过程。与会者建议在HIC和LMIC之间重新分配权力和资源,让LMIC代表参与制定资助议程,更好地协调区域经济共同体和卫生当局,加强VAW研究中的伦理能力。
    结论:全球卫生系统应对VAW研究的伦理批准过程应在合作伙伴之间更加协调,HIC和LMIC之间的功率分配相等,研究人员和REC。虽然这些目标中的一些可以通过对REC和研究人员的教育来实现,权力不平衡和不同的规则应该在体制上解决,国家,和国际水平。其中三位作者也是研究参与者,这有可能在研究结果中引入偏见。然而,严格的反身性做法缓解了这一点。这种内部观点也是一种优势,因为它使我们能够获得并做出更细微的理解,以提高调查结果的可信度。它还有助于减轻不平等的权力动态。
    BACKGROUND: Studying global health problems requires international multidisciplinary teams. Such multidisciplinarity and multiculturalism create challenges in adhering to a set of ethical principles across different country contexts. Our group on health system responses to violence against women (VAW) included two universities in a European high-income country (HIC) and four universities in low-and middle-income countries (LMICs). This study aimed to investigate professional and policy perspectives on the types, causes of, and solutions to ethical challenges specific to the ethics approval stage of the global research projects on health system responses to VAW.
    METHODS: We used the Network of Ethical Relationships model, framework method, and READ approach to analyse qualitative semi-structured interviews (n = 18) and policy documents (n = 27). In March-July 2021, we recruited a purposive sample of researchers and members of Research Ethics Committees (RECs) from the five partner countries. Interviewees signposted policies and guidelines on research ethics, including VAW.
    RESULTS: We developed three themes with eight subthemes summarising ethical challenges across three contextual factors. The global nature of the group contributed towards power and resource imbalance between HIC and LMICs and differing RECs\' rules. Location of the primary studies within health services highlighted differing rules between university RECs and health authorities. There were diverse conceptualisations of VAW and vulnerability of research participants between countries and limited methodological and topic expertise in some LMIC RECs. These factors threatened the timely delivery of studies and had a negative impact on researchers and their relationships with RECs and HIC funders. Most researchers felt frustrated and demotivated by the bureaucratised, uncoordinated, and lengthy approval process. Participants suggested redistributing power and resources between HICs and LMICs, involving LMIC representatives in developing funding agendas, better coordination between RECs and health authorities and capacity strengthening on ethics in VAW research.
    CONCLUSIONS: The process of ethics approval for global research on health system responses to VAW should be more coordinated across partners, with equal power distribution between HICs and LMICs, researchers and RECs. While some of these objectives can be achieved through education for RECs and researchers, the power imbalance and differing rules should be addressed at the institutional, national, and international levels. Three of the authors were also research participants, which had potential to introduce bias into the findings. However, rigorous reflexivity practices mitigated against this. This insider perspective was also a strength, as it allowed us to access and contribute to more nuanced understandings to enhance the credibility of the findings. It also helped to mitigate against unequal power dynamics.
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