Office of Research IntegrityOffice of Research Integrity
Institutional Review Board
Human Subject Protections
Human Subjects
Defined:– An individual about whom an investigator,
whether professional or student, conducting research obtains
• data through intervention or interaction with the individual or
• identifiable private information
Research
Defined:– A systematic investigation (i.e. gathering and
analysis of information) designed to develop or contribute to generalizable knowledge
Historical Ethical Violations The Willowbrook Hepatitis Study
– (1963-1966) – New York – Conducted on mentally retarded,
institutionalized children– Involved systematically infecting the children
with hepatitis– Parents were coerced into consenting
The Brooklyn Jewish Chronic Disease Cancer Study– (1963)– Indigent, elderly subjects were injected with
live cancer cells without their consent
The Stanford Prison Experiment– (1971)– A psychology study of how ordinary people,
college students, can behave in aggressive and dehumanizing ways based on the situation
– Subjects were divided into two groups, “guards” and “prisoners”; the guards were allowed to inflict escalating levels of pain and humiliation on the “prisoners” over an extended period of time which resulted in extreme psychological stress
Tuskegee Syphilis Study– (1932-1972)– US Public Health Service– 400 poor, rural, southern African American
males– Penicillin was accepted as the treatment for
syphilis in 1943, it was deliberately withheld– “Sometimes, with the best of intentions,
scientists, public officials and others, involved in working for the benefit of us all, forget that people are people"
Nazi Medical War Crimes– “Medical experiments” were performed on
thousands of concentration camp prisoners, and included deadly studies and tortures
– In December 1946, 23 physicians and administrators were indicted before the War Crimes Tribunal at Nuremberg, and 16 found guilty in the August 1947 verdict
– Judges included a section called “Permissible Medical Experiments,” now known as the Nuremberg Code
Historical Guidelines
Broad ethical guidelines that assist scientists, subjects and society in understanding the ethical issues related to human subject research
These historical guidelines have evolved since the 1940's and serve as a framework for current regulations
Historical Documents The Nuremberg Code, 1947
– Legal responsibilities– (written by lawyers)
• http://ohsr.od.nih.gov/nuremberg.php3
The Declaration of Helsinki, 1964– Ethical responsibilities– (written by physicians)
• http://www.dvincitbt.com/ohsrsite/guidelines/helsinki.html
The Belmont Report, 1979– Separation of research from practice– (written by physicians)
• http://ohsr.od.nih.gov/mpa/belmont.php3
Nuremberg Code
10-point policy for ethical constraints obligatory on anyone designing and conducting clinical research studies
Established the right of persons to choose whether to participate in research
Declared fundamental and sacred dignity of human subjects who participate in research
Declaration of Helsinki
Internationally recognized document which addresses research personnel conduct and other fundamental principles for experimentation involving humans
Established human subject protection through presumption of investigator integrity and ethical behavior
Belmont Report
Ethical Principals
– Respect for Persons
– Beneficence
– Justice
Applications
– Informed Consent
– Risks and Benefits
– Selection of Subjects
Elements of the Informed Consent Document
Study involves research– Purpose, duration,
procedures, experimental
Risks/discomforts Benefits Alternative treatments Confidentiality
Compensation for injury
Contact Person– Rights as subject– Research related
injury– Research in general
Participation is voluntary
Additional Consent Elementsas Appropriate
Additional costs to subject
Number of subjects in study
Consequences of subject’s decision to withdraw
Conveyance of significant new findings
Investigator termination of subject
Unforeseeable risk to subject, fetus or embryo
The Informed Consent Should . . . .
Give subjects all the information that they may need to make a decision. The information
should be factual, complete, and accurate Ensure that subjects understand the information
– Should be written at an 8th grade reading level
Give subjects an opportunity to consider participation in the study on an initial and ongoing basis
It is important to understand that the informed consent is a process of communication that occurs between the subject and the researcher (s) throughout the study
It is not merely written information or a signature on a page
Child Assent
Parents must give consent for their children to participate, but the children must assent to participate.– Assent is an affirmative action on the part the
child indicating willingness to participate– A child is a person who has not attained the
legal age of consent, 18 years in the state of Georgia
The child assent form must include the same elements as the consent form, but must be written at the appropriate age level for comprehension
The average age when assent can be given is generally age 6 and above
Ages 6-10: verbal assent must be obtained and documented by the researcher
Ages 11-17: This age group must sign a separate assent document
The template for a model consent form can be found on our website– http://www.gsu.edu/irb
Institutional Review Board(IRB)
Defined:
Any board, committee, or other group formally designated by an institution to review, to approve the initiation of, and to conduct periodic review of research involving human subjects
45 CFR 46
What Requires IRB Review?
Any University research that uses humans, human tissue, surveys of human subjects or human subject’s records requires IRB review, irrespective of the funding source
Scope of Review
IRB review and approval is required for any research involving human subjects that:
Is conducted by University faculty, staff or students
Is performed on University property Is performed with or involves the use of
facilities or equipment belonging to the University
More . . . .
Satisfies a requirement imposed by the University for a degree program or for completion of a course of study
Is certified by a dean or department head to satisfy an obligation of a faculty appointment at the University, including clinical or adjunct appointments
What is Subject to Review? Research conducted
by “affiliated faculty” Research projects in
which the researcher is a consultant
Research conducted in courses
Research conducted by students
Research as pilot or feasibility stage
Research conducted at another institution by GSU personnel
Research in foreign countries
Research involving secondary use of data
Research using “waste and “extra” material
Submitting a Proposal New Projects
– Complete the IRB application electronically via IRBWise and route appropriately for signatures
– Necessary documents can be uploaded within IRBWise:
• Interview instrument (s) ● Informed consent (s)
• Survey instrument (s) ● Recruitment flyer
• Audio visual material ● Newspaper Ad
For Continuing Projects– Completed Renewal Application
electronically via IRBWise and route appropriately for signature
– Upload all necessary documents
• Informed consents and/or assents (clean copy)
• Any revised materials to include:
• Audio visual material ● Recruitment flyer
• Survey instrument (s) ● Newspaper Ad
• Interview instrument (s)
Review and Approval Process Exempt Protocols:
– Reviewed by Compliance Staff
– Verified by IRB Chairman
– Process takes about 72 hours
Expedited Protocols:– Reviewed by:
• Compliance Staff
• IRB Member
• IRB Chairman
– Review process takes approximately two weeks
Full Board Protocols:– Reviewed and acted upon at regularly
scheduled monthly IRB meeting
Protocol Approval
Protocols can be voted:– Approved– Approved, pending modifications: requires
modifications be made to protocol before approval is obtained
– Deferred: requires major modifications and will be reviewed again after revisions are made
– Disapproved: extensive modifications and complete resubmission required
Approved Protocols Expedited and Full Board protocols must
be reviewed and renewed to continue on an annual basis
Federal regulations require the IRB to review continuing research at intervals appropriate to degree of risk, but not less than once annually
If you have contact with subjects or are analyzing data, you are required to maintain current IRB approval
Investigators are sent reminder notices approximately 45-60 days prior to the expiration date of the IRB approval
A lapse in approval mandates that the research cease
It is the ultimate responsibility of the investigator to ensure the renewal application is completed and received by the IRB for review and approval in a timely manner
When the Research is Complete . . .
Exempt Study . . . – Email notification
Expedited Study . . . – Study Closure Report
Full Board Study . . . – Study Closure Report
Meeting Dates and Deadlines
Protocols requiring Full committee review must be submitted no later than the 2nd Monday of each month
Protocols requiring Expedited or Exempt review may be submitted at any time
Additional Information
Susan Vogtner, BBA, Compliance Specialist
404-463-0674 Shelia White, PhD, CIP, Compliance Officer
404-651-4689