UC DAVIS OFFICE OF RESEARCH IRB Submission Miles McFann IRB Administration Outreach, Training, and Education Smallpox Vaccination Objectives Explain the history of Institutional Review Boards (IRBs) Define “Research” and “Minimal Risk” Describe the IRB review categories and regulatory criteria for approval Discuss the IRB application process Discuss tips for success 3 History of Human Research Protection Nuremberg Code (1947) Created the first principles of: • Informed Consent • Proper formulated scientific experimentation • Beneficence towards participants History of Human Research Protection (cont.) Declaration of Helsinki (1964) Created by the World Medical Association Further focus on clinical research Considered the cornerstone document of human research ethics History of Human Research Protection (cont.) Belmont Report (1978) Established three fundamental ethical principles: • Respect for Persons • Beneficence • Justice Institutional Review Board (IRB) UC Davis IRB Administration Federalwide Assurance #00004557 Approve/modify/disapprove research protocols involving human subjects Protect rights and welfare of human subjects Multi-campus collaborative review and agreements Education and training Administration and record-keeping The Common Rule 45 CFR 46 (Public Welfare) Research FDA Definition: Clinical Investigation: An experiment involving a test article and control when the results must meet requirements for prior submission to the FDA or are intended to be later submitted to or held for inspection by the FDA OHRP Definition: Research: A systematic investigation, including research development, testing and evaluation, designed to develop or contribute to generalizable knowledge. 9 What is a Human Subject? A living individual about whom an investigator (professional or student) conducting research obtains: data through intervention or interaction with the individual, or identifiable private information. 45 CFR 46.102(f) UCD is “engaged” in human subject research when: 1.If UC Davis is the grant recipient; 2. If for purposes of human subject research: (a) Data about subjects through intervention or interaction; (b) Identifiable private information (c) Informed consent from a research subject 11 Definition of Minimal Risk (45 CFR 46.102(i)) Risk encountered in your daily life…… Types of IRB Review Determinations not requiring IRB review Exempt Expedited Review Full Board Review Exempt Review Must be minimal risk research Fits one of six categories Review is typically conducted by a designated IRB member Exempt Review Categories 1. Research conducted in established or commonly accepted educational settings, involving normal educational practices. 1. Research involving the use of educational tests (cognitive, diagnostic, aptitude, achievement), survey procedures, interview procedures or observation of public behavior. 1. Research involving the use of educational tests, survey procedures, interview procedures, or observation of public behavior that is not exempt under paragraph (b)(2) of this section. (Public Official) 1. Research involving the collection or study of existing data that subjects cannot be identified, directly or through identifiers linked to the subjects. 2. Research and demonstration projects which are conducted by or subject to the approval of Dept. or Agency heads. 3. Taste and food quality evaluation and consumer acceptance studies. Expedited Review Must be minimal risk Rigor same as full committee review, but only one IRB member reviews the project Fits one or more of the nine categories Expedited Review Categories 1. Clinical studies where an IND or IDE is not required 2. Blood Collection 3. Prospective collection of biological specimens for research purposes by noninvasive means 4. Collection of data through noninvasive procedures routinely employed in clinical practice 5. Research involving materials that have been collected for any purpose 6. Collection of data via audio/visual recordings made for research purposes 7. Research employing survey, interview, oral history, focus group, program evaluation, human factors evaluation, or quality assurance methodologies 8. Continuing review of a study previously reviewed by a convened IRB and meets three categories. 9. Continuing review of research, where categories (2) through (8) do not apply but the IRB has determined and documented at a convened meeting that the research involves no greater than Minimal Risk. Full Committee Review Any study which does not meet the Exemption or Expedited Criteria A full quorum is assembled Decision is rendered by a majority of the assembled quorum No member with a conflict of interest can participate in the decision All members participate in the discussion and comments How does the IRB figure this all out? WORKSHEET: Human Research Determination NUMBER HRP-310 Answer: Worksheets HRP-310 Human Research Determination HRP-311 Engagement Determination HRP-312 Exemption Determination DATE 0/0/0000 PAGE 1 of 1 The purpose of this worksheet is to provide support for individuals in determining whether an activity is Human Research or how it is regulated. This worksheet is to be used. It does not need to be completed or retained. START Is activity “Human Research” as defined by DHHS? Yes Yes Is activity “Human Research” as defined by FDA? “Human Research” under DHHS and FDA No Is activity “Human Research” as defined by FDA? No Yes “Human Research” under DHHS only “Human Research” under FDA only No NOT “Human Research” 1 Research as Defined by DHHS Regulationsi (Check if “Yes”.) Is the activity an investigation? (Investigation: A searching inquiry for facts; detailed or careful examination.) Is the investigation systematic? (Systematic: Having or involving a system, method, or plan.) Is the systematic investigation designed to develop or contribute to knowledge? (Designed: observable behaviors used to develop or contribute to knowledge. Develop: to form the basis for a future contribution. Contribute: to result in. Knowledge: truths, facts, information.) Is the knowledge the systematic investigation is designed to develop or contribute generalizable? (Generalizable: Universally or widely applicable.) 2 Human Subject Under DHHS Regulations (Check if “Yes”.) Is the investigator conducting the Research gathering data about living individuals? 3 Human Subject Under DHHS Regulations (Check if “Yes”.) Will the investigator gather that data through either of the following mechanisms (specify which mechanism(s) apply): Physical procedures or manipulations of those individuals or their environment for research purposes (“intervention”). Communication or interpersonal contact with the individuals. ("interaction”). 4 Human Subject Under DHHS Regulations (Check if “Yes”) Will the investigator gather data that is either? Specify which category(s) apply if yes: The data are about behavior that occurs in a context in which an individual can reasonably expect that no observation or recording is taking place (i.e. “Private information”). Individuals have provided the data for specific purposes in which the individuals can reasonably expect that it will NOT be made public, such as a medical record (i.e. “Private information”). Can the individuals’ identities be readily ascertained or associated with the information by the investigator (i.e. “Identifiable information”)? If all items are checked under 1, 2, and 3 or 1, 2, and 4, the activity is Human Research under DHHS regulations. 5 Human Research Under FDA Regulations (Check if “Yes”) Does the activity involve any of the following? (Check all that apply) In the United States: The use of a drugii in one or more persons other than use of an approved drug in the course of medical practice iii. In the United States: The use of a deviceiv in one or more persons that evaluates the safety or effectiveness of that device. Data regarding subjects or control subjects submitted to or held for inspection by FDA v. Data regarding the use of a device on human specimens (identified or unidentified) submitted to or held for inspection by FDAvi. If “Yes”, the activity is Human Research under FDA regulations. If the activity is Human Research under DHHS regulations or under FDA regulations, it is Human Research under organizational policy. 6 HRP-313 Eligibility for Review Using the Expedited Procedure Engagement Determination (Complete if the activity is Human Research. (Check if “Yes”) The organization is engaged in Human Research. Use WORKSHEET: Engagement Determination (HRP-311)) Criteria for Approval of Research 1. Risks to subjects are minimized by using procedures, which are consistent with sound research design and which do not unnecessarily expose subjects to risk. 2. Risks to subjects are minimized by using procedures already being performed on the subjects for other purposes. 3. Risks to subjects are reasonable in relation to anticipated benefits, if any, to subjects, and the importance of the knowledge that may reasonably be expected to result. 4. Selection of subjects is equitable. 5. The research plan makes adequate provision for monitoring the data collected to ensure the safety of subjects. Criteria for Approval of Research (cont.) 6. There are adequate provisions to protect the privacy of subjects. 7. There are adequate provisions to maintain the confidentiality of data. 8. Additional safeguards have been included in the study to protect the rights and welfare of subjects vulnerable to coercion or undue influence. (“N/A” if no vulnerable subjects) 9. The informed consent process is adequate. 10. The documentation of informed consent is adequate. How Do Researchers Meet These Regulations? IRB Documents (Available on the IRB Website) Human Research Protection Program Plan (HRP-101) Investigator Manual(HRP-103) Application Forms Initial (HRP-211) Continuing Review Progress Report (HRP-212) Modification (HRP-213) Reportable New Information Form (HRP-214) Template Protocol (HRP-503) Template Consent Document (HRP-502) SOPs on consent process and documentation (HRP-90, HRP-91) 23 Basic Elements of Informed Consent (45 CFR 46.116(a)) The 8 Necessities 1. Research Description 2. Risks 3. Benefits 4. Alternatives 5. Confidentiality 6. Compensation 7. Contacts 8. Voluntary participation and withdrawal California Health and Safety Code Section 24170 Impact on Informed Consent States that subjects in a “medical experiment” must sign a consent form California’s definition of “medical experiment”; (a) The severance or penetration or damaging of tissues of a human subject or the use of a drug or device, as defined in Section 109920 or 109925, electromagnetic radiation, heat or cold, or a biological substance or organism, in or upon a human subject in the practice or research of medicine in a manner not reasonably related to maintaining or improving the health of the subject or otherwise directly benefiting the subject. (b) The investigational use of a drug or device as provided in Sections 111590 and 111595. (c) Withholding medical treatment from a human subject for any purpose other than maintenance or improvement of the health of the subject Alteration or Waiver of Informed Consent (45 CFR 46.116 (d)) What criteria need to be met? Consent Form Common Mistakes Information in the Consent Form is not consistent with the Protocol Utilization of medical jargon Not fully identifying risks Consent Form is not a HIPAA Authorization form 27 My protocol is ready, what do I do now? 28 Submit the Protocol IRB Submission Forms Application for Initial Review (HRP-211) Administrative Approvals (HRP-226) The following forms, if applicable: Sponsor Fee Form Qualifying Clinical Trials Form INITIAL SUBMISSION REVIEW REQUEST FOR INFO PI RESPONSE REVIEW APPROVAL ACCEPT w/CHANGES MEETS REQUEST Yeah, it’s approved! Anything else? Investigator Responsibilities after Approval Protect human subjects. Ensure all personnel comply with protocol requirements and determinations of IRB. Avoid undue influence in enrolling subjects. Ensure that informed consent is adequate and understandable to subjects. Report new information as stated within HRP-214, Reportable New Information Form. Submit changes in research to IRB for approval prior to implementation. 32 Submitting to the IRB Forms research.ucdavis.edu/gt/f Guidance research.ucdavis.edu/f/gt Standard Operating Procedures research.ucdavis.edu/gt/irb-sop eDocs research.ucdavis.edu/gt/edocs IRB Certification (CITI) research.ucdavis.edu/c/cs/hrp/r es/roe Additional Resources Contact the IRB Staff research.ucdavis.edu/a/cu/contact-irba Subscribe to our Listserv research.ucdavis.edu/r/ls Advisories research.ucdavis.edu/c/cs/hrp/a References Regulatory Agencies www.hhs.gov/ohrp www.fda.gov UC Davis IRB www.research.ucdavis.edu/c/cs/hrp Belmont Report www. hhs.gov/ohrp/humansubjects/guidance/belmont.html Download applications and forms from our website to ensure you have the latest version. Gather all signatures prior to submission. Place version dates on your documents at initial submission and only change them when updating the document. Utilize and follow the Protocol and Consent Form Template instructions when creating your application and forms. Attach all relevant documentation. If it is listed on HRP-211 and applicable to your research, submit it. Have your research staff complete their human subject research certification (CITI and GCP training) prior to submission. Respond to the IRB in a timely manner. Follow all UCDHS regulations. When in doubt, contact us! Input? Suggestions? Feedback? Miles McFann mtmcfann@ucdavis.edu 916-703-9156 40