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针对住院 COVID-19 患者的治疗方法的适应性、平台试验:知情同意书省略了一些重要的信息要素。

Adaptive, platform trials assessing therapies for hospitalized COVID-19 patients: Informed consent forms omitted a few important elements of information.

机构信息

Epidemiology Unit, Health Research Institute-Fundación Jiménez Díaz University Hospital, Universidad Autónoma de Madrid, Madrid, Spain.

Centre for Biomedical Ethics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.

出版信息

J Glob Health. 2023 May 12;13:06019. doi: 10.7189/jogh.13.06019.

DOI:10.7189/jogh.13.06019
PMID:37166268
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10173897/
Abstract

BACKGROUND

The information provided to participants of adaptive platform trials assessing therapies for COVID-19 inpatients is unknown. We aim to evaluate it by reviewing participant information sheets/informed consent forms (PIS/ICFs).

METHODS

We searched the Cochrane COVID-19 Study Register and ClinicalTrials.gov (28 March 2022) to identify non-industry-sponsored adaptive platform phase 2+ trials with publicly available protocols and PIS/ICFs, selecting versions closest to the initial one. We assessed the elements of information included in the Good Clinical Practice guidelines and the Declaration of Helsinki as present, absent, or deficient (incompletely described).

RESULTS

We included PIS/ICFs of 11 trials (ACCORD-2, ACTIV-1IM, Bari-SolidAct, CATALYST, Discovery, HEAL-COVID, ITAC, RECOVERY, REMAP-COVID, Solidarity and TACTIC-R), which were 4-32 pages long (median (md) = 11). Between two and 11 (md = 6) of the 25 different elements of information assessed were omitted or deficiently described in the PIS/ICFs of the 11 trials. Information about providing trial results, investigators' conflicts of interest, post-study provisions, payment to and anticipated expenses for participants, number of participants, and on whether participants will receive new information that could impact their decision on staying in the trial, were omitted or deficiently described in at least five PIS/ICFs.

CONCLUSIONS

Investigators failed to include a few important elements of information in the trial's PIS/ICF deemed relevant by international standards. In protocols of future trials, investigators should explain why elements of information specified in the Good Clinical Practice guidelines and/or by the Declaration of Helsinki were omitted from the PIS/ICFs.

摘要

背景

尚不清楚用于评估 COVID-19 住院患者治疗方法的适应性平台试验参与者所获得的信息。我们旨在通过审查参与者信息表/知情同意书(PIS/ICF)来评估这些信息。

方法

我们检索了 Cochrane COVID-19 研究注册库和 ClinicalTrials.gov(2022 年 3 月 28 日),以确定具有公开协议和 PIS/ICF 的非工业赞助的适应性平台 2 期+试验,并选择与初始版本最接近的版本。我们评估了纳入的 Good Clinical Practice 指南和赫尔辛基宣言的信息要素是否存在、缺失或不完整(描述不完整)。

结果

我们纳入了 11 项试验的 PIS/ICF(ACCORD-2、ACTIV-1IM、Bari-SolidAct、CATALYST、Discovery、HEAL-COVID、ITAC、RECOVERY、REMAP-COVID、Solidarity 和 TACTIC-R),其 PIS/ICF 的长度为 4-32 页(中位数[md]=11)。在 11 项试验的 PIS/ICF 中,有 25 个不同的信息要素中,有 2-11 个(md=6)被省略或描述不完整。关于提供试验结果、研究者的利益冲突、研究后规定、向参与者支付的费用和预期费用、参与者人数,以及参与者是否会收到可能影响其继续参与试验决定的新信息等信息,在至少 5 份 PIS/ICF 中被省略或描述不完整。

结论

研究者在试验的 PIS/ICF 中未纳入国际标准认为相关的一些重要信息要素。在未来试验的方案中,研究者应解释为何 Good Clinical Practice 指南和/或赫尔辛基宣言中规定的信息要素被从 PIS/ICF 中省略。

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