Sharp Helen M, Orr Robert D
The University of Iowa, USA.
Am J Bioeth. 2004 Spring;4(2):W32-6. doi: 10.1162/152651604323097970.
Surveys and routine clinical procedures applied in research protocols are typically considered only minimally risky to participants. The apparent benign nature of "minimal risk" tasks increases the chance that investigators and Institutional Review Boards (IRBs) will overlook the probability that clinical tools will identify signs, symptoms, or definitive test results that are clinically-relevant to subjects' welfare. "Minimal risk" procedures may also pose a particular hazard to participants in clinical research by increasing the therapeutic misconception because the tasks mimic clinical care and are often conducted in clinical settings. Investigators should anticipate which measures could yield clinically-important findings and should describe explicit plans for data monitoring, disclosure, and follow-up. Protocols that include reliable and valid clinical measures should prompt a more detailed risk assessment by the IRB, even when the tasks meet the regulatory criteria for minimal physical, psychological, or emotional risk.
研究方案中应用的调查和常规临床程序通常被认为对参与者的风险极小。“最小风险”任务表面上的良性性质增加了调查人员和机构审查委员会(IRB)忽视临床工具识别与受试者福利相关的体征、症状或确定性检测结果的可能性。“最小风险”程序还可能因增加治疗误解而对临床研究参与者构成特殊危害,因为这些任务模仿临床护理且通常在临床环境中进行。研究人员应预测哪些措施可能产生具有临床重要性的发现,并应描述数据监测、披露和随访的明确计划。即使任务符合最低身体、心理或情感风险的监管标准,包含可靠且有效的临床测量的方案也应促使IRB进行更详细的风险评估。