Smischney Nathan J, Pannu Jasleen, Hinds Richard F, McCormick Jennifer B
Department of Anesthesiology and Perioperative Medicine, Division of Critical Care Medicine, Mayo Clinic, Rochester, MN, United States.
Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, United States.
JMIR Res Protoc. 2018 May 2;7(5):e10062. doi: 10.2196/10062.
Emergent use research-research involving human subjects that have a life-threatening medical condition and who are unlikely to provide informed consent-in critical illness is fraught with challenges related to obtaining informed consent. Per federal regulations, to meet criteria to conduct such trials, the investigators have to seek community consultations. Effective ways of obtaining this consultation remains ill-defined.
We sought to describe methods, interpretations, and our experiences of conducting community consultation in a planned emergent use randomized controlled trial.
As part of a planned emergent use clinical trial in our study, community consultation consisted of four focus groups sessions with members from the community in which the clinical trial was conducted. Three focus group sessions were conducted with members who had an affiliation to Mayo Clinic, and the other focus group session was conducted with non-Mayo affiliation members. The feedback from the focus group sessions led to the creation of the public notification plan. The public was notified of the trial through community meetings as well as social media.
As compared to community meetings, focus group sessions resulted in greater attendance with more interactive discussions. Moreover, focus group sessions resulted in greater in-depth conversations leading to institutional acceptance of the clinical trial under study.
Exception from informed consent can be acceptable to the community. Focus groups provided better participation and valuable interactive insight as compared to community meetings in our study. This could serve as a valuable guide for investigators pursuing exception from informed consent in their research studies.
紧急使用研究——涉及患有危及生命的医疗状况且不太可能提供知情同意的人类受试者的研究——在危重病领域充满了与获得知情同意相关的挑战。根据联邦法规,为了符合进行此类试验的标准,研究人员必须寻求社区咨询。获得这种咨询的有效方法仍不明确。
我们试图描述在一项计划中的紧急使用随机对照试验中进行社区咨询的方法、解读和我们的经验。
作为我们研究中一项计划中的紧急使用临床试验的一部分,社区咨询包括与开展临床试验所在社区的成员进行四次焦点小组会议。三次焦点小组会议是与隶属于梅奥诊所的成员进行的,另一次焦点小组会议是与非梅奥附属成员进行的。焦点小组会议的反馈促成了公共通知计划的制定。通过社区会议以及社交媒体向公众通报了该试验。
与社区会议相比,焦点小组会议的参与度更高,讨论更具互动性。此外,焦点小组会议促成了更深入的对话,导致该研究中的临床试验获得机构认可。
社区可能会接受免除知情同意。在我们的研究中,与社区会议相比,焦点小组提供了更好的参与度和有价值的互动见解。这可以为在研究中寻求免除知情同意的研究人员提供有价值的指导。