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多中心研究的综述:由多中心网络实施的围产期研究的特点和结果。

Review of multicenter studies by multiple institutional review boards: characteristics and outcomes for perinatal studies implemented by a multicenter network.

机构信息

Department of Obstetrics and Gynecology, University of Alabama at Birmingham School of Medicine, Birmingham, AL.

Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, TX.

出版信息

Am J Obstet Gynecol. 2015 Jan;212(1):110.e1-6. doi: 10.1016/j.ajog.2014.07.058. Epub 2014 Aug 1.

Abstract

OBJECTIVE

The objective of the study was to describe characteristics and outcomes of a review of multisite perinatal studies by individual institutional review boards (IRBs) and identify barriers and opportunities for streamlined IRB review.

STUDY DESIGN

We compared the review of 5 collaborative protocols by individual IRBs at National Perinatal Research Consortium centers from 2007 through 2012. Three randomized trials, 1 observational study, and 1 follow-up study of a trial were selected. IRB logs and communications were reviewed and abstracted by trained team members.

RESULTS

Seven or 8 IRBs reviewed each protocol. Monthly IRB meeting frequency varied from 1 to 6. Full board review was required by all IRBs for the primary trials but not by all for the observational protocols. The overall duration from submission to approval (P = .024) and number of stipulations (P = .007) differed across protocols but not across IRBs. However, times from submission-to-IRB review (P = .011) and IRB review-to-initial letter (P < .007) differed across sites. Both overall submission-to-approval and initial review-to-approval times increased with the increasing number of IRB review stipulations (both values P < .001). Significant delays (>60 days) were few and not consistent across IRBs or protocols. Most stipulations were stylistic or editorial modifications rather than regulatory requests. All protocols were approved without changes, and no more than 1 IRB meeting was needed at each site.

CONCLUSION

Findings confirm unnecessary duplication and variability and some similarities in IRB review processes and outcomes for multisite perinatal studies. This may help guide initiatives to streamline IRB review and reduce research delays and burdens.

摘要

目的

本研究旨在描述各机构审查委员会(IRB)对多中心围产期研究进行审查的特点和结果,并确定简化 IRB 审查的障碍和机会。

研究设计

我们比较了 2007 年至 2012 年国家围产医学研究联盟中心的 5 项合作方案,由各个 IRB 进行审查。选择了 3 项随机试验、1 项观察性研究和 1 项试验的随访研究。IRB 记录和交流由经过培训的团队成员进行审查和摘录。

结果

每个方案都有 7 或 8 个 IRB 进行审查。每月 IRB 会议的频率从 1 次到 6 次不等。所有 IRB 都要求对主要试验进行全委员会审查,但并非所有协议都要求对观察性方案进行全委员会审查。从提交到批准的总体时间(P =.024)和规定数量(P =.007)因方案而异,但不因 IRB 而异。然而,从提交到 IRB 审查(P =.011)和 IRB 审查到初始信(P <.007)的时间因站点而异。总体提交到批准的时间和初始审查到批准的时间都随着 IRB 审查规定数量的增加而增加(两者的 P 值均<.001)。很少有且不一致的重大延迟(超过 60 天)发生在各个 IRB 或方案中。大多数规定都是文体或编辑上的修改,而不是监管上的要求。所有方案均获得批准而无需修改,每个地点只需召开不超过 1 次 IRB 会议。

结论

研究结果证实,多中心围产期研究的 IRB 审查过程和结果存在不必要的重复和差异,同时也存在一些相似之处。这可能有助于指导简化 IRB 审查并减少研究延迟和负担的举措。

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