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随机对照心血管研究的试验后监测:提交的方案、同意书和伦理委员会的作用。

Post-trial period surveillance for randomised controlled cardiovascular studies: submitted protocols, consent forms and the role of the ethics board.

机构信息

Division of Cardiology, University of Toronto, Toronto, Canada.

出版信息

J Med Ethics. 2011 Dec;37(12):762-5. doi: 10.1136/jme.2011.043349. Epub 2011 Jun 23.

Abstract

BACKGROUND

The post-trial period is the time period after the end of study drug administration. It is unclear whether post-trial arrangements for patient surveillance are routinely included in study protocols and consents, and whether research ethics boards (REB) consider the post-trial period.

OBJECTIVES

The objective was to determine whether trial protocols and consent forms reviewed by the REB describe procedures for post-trial period surveillance.

METHODS

An observational study of protocols of randomised trials of chronic therapies for cardiac conditions, approved by the REB of two academic institutions affiliated with the University of Toronto in Canada (University Health Network and Mount Sinai Hospital) from 1995 to 2007. Plans for patient surveillance in the post-trial period described in the protocol or in the consent form before and after REB approval were recorded.

RESULTS

42 studies were identified including 18 heart failure and 15 coronary artery disease trials. Only four studies planned a clinical visit after trial termination, and an additional three planned a telephone contact after trial completion. Five trials submitted consent forms to the REB with a discussion of the post-trial period.

CONCLUSIONS

The majority of protocols and consent forms did not discuss plans for post-trial period surveillance. The post-trial period and the REB approval process could be improved by systematic follow-up being described in the protocol and consent form. The small number of trial protocols evaluated in the study may impair the degree to which the results can be generalised.

摘要

背景

试验后时期是指研究药物给药结束后的时间段。目前尚不清楚患者监测的试验后安排是否通常包含在研究方案和知情同意书中,以及研究伦理委员会(REB)是否考虑试验后时期。

目的

目的是确定审查的试验方案和知情同意书是否描述了试验后监测期的程序。

方法

对加拿大安大略省多伦多大学两所附属医院(大学健康网络和西奈山医院)的 1995 年至 2007 年期间的心脏疾病慢性治疗的随机试验的 REB 批准的方案进行了观察性研究。记录方案或知情同意书中在 REB 批准前后描述的试验后患者监测计划。

结果

确定了 42 项研究,包括 18 项心力衰竭试验和 15 项冠状动脉疾病试验。只有四项研究计划在试验结束后进行临床访视,另外三项研究计划在试验完成后进行电话联系。有五份试验知情同意书提交给了 REB,并讨论了试验后期间的问题。

结论

大多数方案和知情同意书没有讨论试验后监测计划。通过在方案和知情同意书中描述系统的随访,可以改进试验后时期和 REB 审批流程。本研究评估的试验方案数量较少,可能会影响研究结果的推广程度。

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