ethics committees, research

道德委员会,Research
  • 文章类型: Journal Article
    许多国家考虑对社会的长期影响。
    Many countries consider long-term implications for society.
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  • 文章类型: Journal Article
    对多中心研究的单一IRB(sIRB)审查的主要关注,正如现在联邦政策所要求的那样,sIRB在审查中是否以及如何考虑当地情况。虽然已经提出了几种类型的本地背景考虑因素,对于地方背景审查的目标和内容,负责对人类受试者研究进行伦理监督的人之间没有共同的协议,sIRB审查可能不合适的研究类型。通过对已发表奖学金的范围审查,公众意见,和联邦指导文件,我们为本地背景审查确定了五个假设目标:保护本地参与者的权利和福利;确保遵守适用法律和政策;评估可行性;提高研究质量;促进程序正义。虽然各种内容被提议是相关的,它主要分为四个领域:人口/参与者级别的特征;研究者和研究团队的特征;机构级别的特征;以及州和地方法律.排除在sIRB要求之外的拟议特征反映了基于保护和效率的关切。这些发现可以为正在进行的努力提供信息,以评估强制sIRB审查的政策的影响,以及这些政策的例外情况何时可能是适当的。
    A leading concern about single IRB (sIRB) review for multisite studies, as is now required by federal policies, is whether and how sIRBs consider local context in their review. While several types of local context considerations have been proposed, there is no shared agreement among those charged with the ethics oversight of human subjects research as to the goals and content of local context review, nor the types of research studies for which sIRB review might be inappropriate. Through a scoping review of published scholarship, public comments, and federal guidance documents, we identified five assumed goals for local context review: protecting the rights and welfare of local participants; ensuring compliance with applicable laws and policies; assessing feasibility; promoting the quality of research; and promoting procedural justice. While a variety of content was proposed to be relevant, it was largely grouped into four domains: population/participant-level characteristics; investigator and research team characteristics; institution-level characteristics; and state and local laws. Proposed characteristics for exclusion from sIRB requirements reflected both protection- and efficiency-based concerns. These findings can inform ongoing efforts to assess the implications of policies mandating sIRB review, and when exceptions to those policies might be appropriate.
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  • 文章类型: Journal Article
    在常规临床实践中,使用患者报告的结果指标(PROM)越来越普遍。作为量化症状和健康状况的工具,PROM在将医疗保健重点放在对患者重要的结果方面发挥着重要作用。PROM数据的用途很多,从临床护理到基于调查的研究和质量改进。识别这些用例之间的界限对于机构审查委员会(IRB)来说可能是一个挑战。在这篇文章中,我们提供了一个框架来分类三个主要的PROM用例(临床护理,人体研究,和质量改进),并讨论每个必要的IRB监督水平(如果有)。IRB工作人员最重要的考虑因素之一是PROM是否主要用于临床护理,因此不构成人类受试者研究。我们讨论了主要为临床护理实施的PROM的特点,重点关注:数据平台;调查位置;问卷长度;患者接口;和临床医生接口。我们还讨论了IRB对涉及在临床护理过程中收集的PROM数据的二次使用的项目的监督,涵盖人类学科研究和质量改进。该框架为IRB工作人员以及在常规临床实践中使用PROM作为沟通辅助工具的临床医生提供了实用指导。
    The use of patient-reported outcome measures (PROMs) is increasingly common in routine clinical practice. As tools to quantify symptoms and health status, PROMs play an important role in focusing health care on outcomes that matter to patients. The uses of PROM data are myriad, ranging from clinical care to survey-based research and quality improvement. Discerning the boundaries between these use cases can be challenging for institutional review boards (IRBs). In this article, we provide a framework for classifying the three primary PROM use cases (clinical care, human subjects research, and quality improvement) and discuss the level of IRB oversight (if any) necessary for each. One of the most important considerations for IRB staff is whether PROMs are being used primarily for clinical care and thus do not constitute human subjects research. We discuss characteristics of PROMs implemented primarily for clinical care, focusing on: data platform; survey location; questionnaire length; patient interface; and clinician interface. We also discuss IRB oversight of projects involving the secondary use of PROM data that were collected during the course of clinical care, which span human subjects research and quality improvement. This framework provides practical guidance for IRB staff as well as clinicians who use PROMs as communication aids in routine clinical practice.
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  • 文章类型: Journal Article
    在线参与者招募(“众包”)平台越来越多地用于研究。虽然这样的平台可以快速提供大样本的访问,随之而来的是对数据质量的担忧。研究人员已经研究并证明了减少众包平台低质量数据流行的方法,但这样做的方法通常涉及拒绝工作和/或拒绝向参与者付款,这可能会带来道德困境。我们以副教授和两位机构审查委员会(IRB)董事的身份撰写本文,以提供对参与者/工人和研究人员竞争利益的观点,并提出一份我们认为可能支持工人机构的步骤清单。平台和减少对他们造成不公平后果的情况,同时使研究人员能够明确拒绝低质量的工作,否则这些工作可能会降低他们的研究产生真实结果的可能性。我们进一步鼓励,在学术界和IRB之间明确讨论这些问题。
    Online participant recruitment (\"crowdsourcing\") platforms are increasingly being used for research studies. While such platforms can rapidly provide access to large samples, there are concomitant concerns around data quality. Researchers have studied and demonstrated means to reduce the prevalence of low-quality data from crowdsourcing platforms, but approaches to doing so often involve rejecting work and/or denying payment to participants, which can pose ethical dilemmas. We write this essay as an associate professor and two institutional review board (IRB) directors to provide a perspective on the competing interests of participants/workers and researchers and to propose a checklist of steps that we believe may support workers\' agency on the platform and lessen instances of unfair consequences to them while enabling researchers to definitively reject lower-quality work that might otherwise reduce the likelihood of their studies producing true results. We encourage further, explicit discussion of these issues among academics and among IRBs.
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  • 文章类型: Journal Article
    本文考察了研究设计的伦理和研究的启动(例如,招募参与者)涉及难民参与者。我们的目标是为研究人员和IRB成员提供一套道德考虑和务实的建议,以解决以难民为中心的研究中的挑战,因为它是为IRB审查而开发和准备的。我们讨论了挑战,包括如何定义和识别难民;他们之前的脆弱性,during,以及影响其研究参与的重新安置;招募;同意做法,包括同意和无人陪伴的未成年人;和利益冲突。国际机构提供的道德指导和监管监督,联邦政府,和IRB对于加强对参与者的保护很重要。我们描述了需要额外的道德指导和意识,如果不是由美国国立卫生研究院(NIH)伦理研究指导原则指导的对难民人口的特殊保护。
    This article examines the ethics of research design and the initiation of a study (e.g., recruitment of participants) involving refugee participants. We aim to equip investigators and members of IRBs with a set of ethical considerations and pragmatic recommendations to address challenges in refugee-focused research as it is developed and prepared for IRB review. We discuss challenges including how refugees are being defined and identified; their vulnerabilities before, during, and following resettlement that impacts their research participation; recruitment; consent practices including assent and unaccompanied minors; and conflicts of interest. Ethical guidance and regulatory oversight provided by international bodies, federal governments, and IRBs are important for enforcing the protection of participants. We describe the need for additional ethical guidance and awareness, if not special protections for refugee populations as guided by the National Institutes of Health (NIH) Guiding Principles for Ethical Research.
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  • 文章类型: Letter
    暂无摘要。
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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
    所有涉及人类受试者的生命科学和医学研究都必须遵守《赫尔辛基宣言》和相关法律和准则。此外,它的科学和道德适用性必须由一个精通研究性质和内容的委员会审查。在进行涉及人类受试者的研究时,不遵守这些要求是严重违反日本法律的行为,指导方针,和当地法规,因此,在日本医学院(NMS)基金会及其附属机构内成立了几个道德委员会和机构审查委员会。调查人员必须及时了解伦理审查过程的最新发展,并确保他们提议开展的任何项目在研究开始之前都经过适当的伦理审查。为了帮助研究人员和NMS基金会的其他工作人员及时了解这些进展,本报告概述了NMS目前对涉及人类受试者的研究的伦理审查过程。
    All life science and medical research involving human subjects must be conducted in compliance with the Declaration of Helsinki and the relevant laws and guidelines. Additionally, its scientific and ethical suitability must be reviewed by a committee well versed in the nature and content of the research. Failure to comply with these requirements when conducting research involving human subjects is a serious violation of Japanese laws, guidelines, and local regulations, so several ethics committees and institutional review boards have been established within the Nippon Medical School (NMS) Foundation and its affiliated institutions. It is essential for investigators to keep up to date with the latest developments in the ethical review process and to ensure that any projects they propose to embark on are subjected to an appropriate ethical review before the research is initiated. To help researchers and other staff affiliated with the NMS Foundation keep abreast of these developments, this report outlines NMS\'s current ethical review processes for research involving human subjects.
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