Myles Paul S, Tan Nicole
Department of Anaesthesia and Pain Management, Alfred Hospital, P. O. Box 315, Melbourne, Victoria 3181, Australia.
Anesthesiology. 2003 Nov;99(5):1209-13. doi: 10.1097/00000542-200311000-00030.
Ethical conduct in human research in anesthesia includes approval by an institutional review board (IRB) or ethics committee and informed consent. Evidence of these is sometimes lacking in journal publications.
The authors reviewed all publications involving human subjects in six leading anesthesia journals for the year 2001 (n = 1189). Rates of IRB approval and informed consent were examined and compared with potential predictors that included journal, type of publication, and patient demographics (age, sex, elective or emergency status). Rates were compared by use of chi-square and logistic regression.
The authors found that IRB approval was documented in 71% of publications and consent was obtained in 66% of publications. Significant variation in IRB approval and consent was found among journals (P < 0.0005) and according to type of publication (P < 0.0005). Because publication type affected rates of IRB approval and consent (trials > mechanistic studies > observational studies > case reports), an analysis restricted to prospective studies also found a significant difference in IRB approval and consent among journals (P < 0.0005).
This study suggests that rates of IRB approval and informed consent vary among publications in anesthesia journals. Clearer guidelines (and author adherence) for all types of publication are needed, both as a protection for research subjects and to maintain public trust in the process.
麻醉学人体研究中的伦理行为包括获得机构审查委员会(IRB)或伦理委员会的批准以及知情同意。而在期刊发表的文章中,有时缺乏这些方面的证据。
作者回顾了2001年六种主要麻醉学杂志上所有涉及人体受试者的出版物(n = 1189)。检查了IRB批准率和知情同意率,并与包括期刊、出版物类型以及患者人口统计学特征(年龄、性别、择期或急诊状态)等潜在预测因素进行比较。采用卡方检验和逻辑回归分析比较比率。
作者发现,71%的出版物记录了IRB批准,66%的出版物获得了知情同意。在不同期刊之间(P < 0.0005)以及根据出版物类型(P < 0.0005),IRB批准和知情同意情况存在显著差异。由于出版物类型影响IRB批准率和知情同意率(试验>机制研究>观察性研究>病例报告),仅对前瞻性研究进行的分析也发现不同期刊之间在IRB批准和知情同意方面存在显著差异(P < 0.0005)。
本研究表明,麻醉学杂志上不同出版物的IRB批准率和知情同意率有所不同。需要针对所有类型的出版物制定更明确的指南(并要求作者遵守),这既是为了保护研究对象,也是为了维持公众对该过程的信任。