Address correspondence to Jennifer L. Gold, B.Sc., B.C.L., LL.B., 203 Park Drive, Suite 214, Boston, MA 02215. Jennifer L. Gold and Carolyn S. Dewa, Ph.D., M.P.H., are with the Health Systems Research and Consulting Unit, Center for Addiction and Mental Health, Toronto. Jennifer L. Gold, is also with the McGill University Faculty of Law and is currently an M.P.H. student at the Harvard School of Public Health. Carolyn S. Dewa, Ph.D., M.P.H., is also with the Department of Psychiatry, University of Toronto.
Institutional Review Boards and Multisite Studies in Health Services Research: Is There a Better Way?
Version of Record online: 21 JAN 2005
Health Services Research
Volume 40, Issue 1, pages 291–308, February 2005
How to Cite
Gold, J. L. and Dewa, C. S. (2005), Institutional Review Boards and Multisite Studies in Health Services Research: Is There a Better Way?. Health Services Research, 40: 291–308. doi: 10.1111/j.1475-6773.2005.00354.x
- Issue online: 21 JAN 2005
- Version of Record online: 21 JAN 2005
- Institution review boards (IRBs);
- multisite research;
Objective. The following paper examines the issue of whether the current system for ethics review of multisite health services research protocols is adequate, or whether there exist alternative methods that should be considered.
Principal Findings. (1) Investigators at different sites in a multisite project often have very different experiences with respect to the requirements and requests of the review board. Other problems include the waste of time and resources spent on document preparation for review boards, and delays in the commencement of research activities. (2) There are several possible reasons why there is variability in ethics review. These include the absence of standardized forms, differences in the background and experiences of board members, the influence of institutional or professional culture, and regional thinking. (3) Given the limited benefits derived from the variability in recommendations of multiple boards and the numerous problems encountered in seeking ethics approval from multiple boards suggest that some sort of reform is in order.
Conclusions. The increasing number of multisite, health services research studies calls for a centralized system of ethics review. The local review model is simply not conducive to multisite studies, and jeopardizes the integrity of the research process. Centralized multisite review boards, together with standardized documents and procedure, electronic access to documentation, and training for board members are all possible solutions. Changes to the current system are necessary not only to facilitate the conduct of multisite research, but also to preserve the integrity of the ethics approval process in general.