Roberts Laura Weiss, Dunn Laura B, Green Hammond Katherine A, Warner Teddy D
Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA.
Schizophr Bull. 2006 Jan;32(1):153-8. doi: 10.1093/schbul/sbi055. Epub 2005 Sep 15.
Federal regulations governing human research suggest that potential harms and discomforts of research be considered in relation to the risks normally encountered in daily life or in routine examinations. No data regarding relative risks of research exist for persons with schizophrenia. We surveyed psychiatrists (N = 68) to assess their perceptions of the risk associated with 12 research procedures in 2 categories, that is, evaluation- and intervention-type procedures. Psychiatrists were asked to rate "risks compared to usual daily risks" for people with schizophrenia and, separately, for healthy people. For healthy research volunteers, psychiatrists rated 2 of 5 evaluation procedures and none of the intervention procedures as posing fewer risks than daily life. One evaluation procedure and 2 intervention procedures were rated as similar to daily risks for healthy research volunteers. For volunteers with schizophrenia, psychiatrists rated 4 of the 5 evaluation procedures and 1 intervention procedure as conferring less risk than everyday life. For 1 of 5 evaluation procedures and 5 of 7 intervention procedures, the risks associated with the procedures were centered close to the benchmark for those faced every day by persons with schizophrenia. Psychiatrists in this study viewed research procedure risks as closer to the daily risks encountered by persons with schizophrenia than by healthy persons. Because federal regulations benchmark research studies as "minimal risk" if they are analogous to the usual risks of everyday life, this finding may have important implications for the evaluation of psychiatric protocols.
管理人体研究的联邦法规表明,研究中的潜在危害和不适应与日常生活或常规检查中通常遇到的风险相权衡。目前尚无关于精神分裂症患者研究相对风险的数据。我们对68名精神科医生进行了调查,以评估他们对两类12种研究程序(即评估型和干预型程序)相关风险的看法。我们要求精神科医生分别对精神分裂症患者和健康人的“与日常风险相比的风险”进行评分。对于健康的研究志愿者,精神科医生认为5种评估程序中的2种以及干预程序中没有一种的风险低于日常生活风险。有一种评估程序和两种干预程序被认为与健康研究志愿者的日常风险相似。对于精神分裂症志愿者,精神科医生认为5种评估程序中的4种和1种干预程序的风险低于日常生活风险。对于5种评估程序中的1种和7种干预程序中的5种,这些程序相关的风险集中在接近精神分裂症患者每天面临的基准风险水平。本研究中的精神科医生认为研究程序风险更接近精神分裂症患者而非健康人的日常风险。由于联邦法规将与日常生活常见风险类似的研究界定为“最低风险”,这一发现可能对精神科研究方案的评估具有重要意义。