Skip to main content
Log in

Of Straws, Camels, Research Regulation, and IRBs

  • Regulatory Science: Review Article
  • Published:
Therapeutic Innovation & Regulatory Science Aims and scope Submit manuscript

Abstract

Institutional review boards (IRBs) have become beleaguered by a growth in responsibilities related to research oversight in the past several decades. A number of regulatory bodies have appeared in response to these novel and complex responsibilities, seeking to respond to among other issues, conflicts of interest, new technologies, and the potential misuse of research findings. Here, we examine several examples of these novel regulatory bodies as well as a number of concerns related to them that have been largely unacknowledged. Evidence suggests that there can be disharmony and conflicts between these regulatory bodies and IRBs, a lack of clarity with regard to their roles and responsibilities, as well as shortcomings within these entities that, at times, look a lot like the worries that have long been raised in relation to IRBs. We offer a brief discussion of how some of these concerns might be ameliorated, either through a significant restructuring of the system of research oversight, or perhaps through smaller changes to these regulatory bodies.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Stark L, Greene JA. Clinical trials, healthy controls, and the birth of the IRB. N Engl J Med. 2016;375:1013–1015.

    PubMed  Google Scholar 

  2. Grady C. Institutional review boards: purpose and challenges. Chest J. 2015;148:1148–1155.

    Google Scholar 

  3. US Food and Drug Administration. Institutional Review Boards, FDA 21 CFR Part 56. 2017.

  4. US Department of Health and Human Services. Federal Policy for the Protection of Human Subjects (“Common Rule”). DHHS version. 2014;45.

  5. Gilbert S. Trials and tribulations. Hastings Cent Rep. 2008;38:14–18.

    PubMed  Google Scholar 

  6. Moses H 3rd, Matheson DM, Cairns-Smith S, George BP, Palisch C, Dorsey ER. The anatomy of medical research: US and international comparisons. JAMA. 2015;313:174–189.

    CAS  PubMed  Google Scholar 

  7. King CST, Bivens KM, Pumroy E, Rauch S, Koerber A. IRB problems and solutions in health communication research. Health Commun. 2018;33:907–916.

    PubMed  Google Scholar 

  8. Musoba GD, Jacob SA, Robinson LJ. The Institutional Review Board (IRB) and Faculty: does the IRB challenge faculty professionalism in the social sciences? Qual Rep. 2014;19:1.

    Google Scholar 

  9. Noorani T, Charlesworth A, Kite A, McDermont M. Participatory research and the medicalization of research ethics processes. Soc Legal Stud. 2017;26:378–400.

    Google Scholar 

  10. Keith-Spiegel P, Koocher G, Tabachnick B. What scientists want from their research ethics committee. J Empir Res Hum Res Ethics. 2006;1:67–82.

    PubMed  Google Scholar 

  11. Gunsalus C, Bruner EM, Burbules NC, et al. Mission creep in the IRB world. Science. 2006;312:1441–1441.

    CAS  PubMed  Google Scholar 

  12. Resnik DB. Dual-use review and the IRB. J Clin Res Best Pract. 2010;6.

  13. Emanuel EJ, Wood A, Fleischman A, et al. Oversight of human participants research: identifying problems to evaluate reform proposals. Ann Intern Med. 2004;141:282–291.

    PubMed  Google Scholar 

  14. Lemmens T, Freedman B. Ethics review for sale? Conflict of interest and commercial research review boards. Milbank Q. 2000;78:547–584.

    CAS  PubMed  PubMed Central  Google Scholar 

  15. Tsan MF, Nguyen Y. Effectiveness of human research protection program performance measurements. J Empir Res Hum Res Ethics. 2017;12:217–228.

    PubMed  Google Scholar 

  16. Thomson JJ, Elgin C, Hyman DA, Rubin PE, Knight J. Research on human subjects: academic freedom and the institutional review board. Academe. 2006;92:95–100.

    Google Scholar 

  17. Hyman DA. Institutional review boards: is this the least worst we can do? Northwestern Univ Law Rev. 2007;101.

  18. Abbott L, Grady C. A systematic review of the empirical literature evaluating IRBs: what we know and what we still need to learn. J Empir Res Hum Res Ethics. 2011;6:3–19.

    PubMed  PubMed Central  Google Scholar 

  19. Emanuel EJ, Wood A, Fleischman A, et al. Oversight of human participants research: identifying problems to evaluate reform proposals. Ann Intern Med. 2004;141:282–291.

    PubMed  Google Scholar 

  20. Klitzman R. The Ethics Police? The Struggle to Make Human Research Safe. New York, NY: Oxford University Press; 2015.

    Google Scholar 

  21. Johnson ME, Brems C, Bergman AL, Mills ME, Eldridge GD. Knowledge of federal regulations for mental health research involving prisoners. AJOB Empir Bioeth. 2015;6:12–18.

    PubMed  Google Scholar 

  22. Mhaskar R, Pathak EB, Wieten S, Guterbock TM, Kumar A, Djulbegovic B. Those responsible for approving research studies have poor knowledge of research study design: a knowledge assessment of institutional review board members. Acta Inform Med. 2015;23:196–201.

    PubMed  PubMed Central  Google Scholar 

  23. Khan MA, Barratt MS, Krugman SD, Serwint JR, Dumont-Driscoll M. Variability of the institutional review board process within a national research network. Clin Pediatr (Phila). 2014;53:556–560.

    Google Scholar 

  24. Hirshon JM, Krugman SD, Witting MD, et al. Variability in institutional review board assessment of minimal-risk research. Acad Emerg Med. 2002;9:1417–1420.

    PubMed  Google Scholar 

  25. Shah S, Whittle A, Wilfond B, Gensler G, Wendler D. How do institutional review boards apply the federal risk and benefit standards for pediatric research? JAMA. 2004;291:476–482.

    CAS  PubMed  Google Scholar 

  26. Cohen IG, Lynch HF. Human Subjects Research Regulation: Perspectives on the Future. Cambridge, MA: MIT Press; 2014.

    Google Scholar 

  27. Whitney SN, Alcser K, Schneider CE, McCullough LB, McGuire AL, Volk RJ. Principal investigator views of the IRB system. Int J Med Sci. 2008;5:68.

    PubMed  PubMed Central  Google Scholar 

  28. Mueller JH, Furedy JJ. Reviewing for risk: what’s the evidence that it works? APS Observer. 2001;14.

  29. Nicholls SG, Hayes TP, Brehaut JC, et al. A scoping review of empirical research relating to quality and effectiveness of research ethics review. PLoS One. 2015;10:e0133639.

    PubMed  PubMed Central  Google Scholar 

  30. Silberman G, Kahn KL. Burdens on research imposed by institutional review boards: the state of the evidence and its implications for regulatory reform. Milbank Q. 2011;89:599–627.

    PubMed  PubMed Central  Google Scholar 

  31. Freedman RS, McKinney R. Is conflict of interest becoming a challenge for institution-based institutional review boards? Clin Cancer Res. 2013;19:4034–4039.

    PubMed  Google Scholar 

  32. US Department of Health and Human Services. Responsibility of Applicants for Promoting Objectivity in Research 42 CFR Parts 50. 2000.

  33. US Department of Health and Human Services. Responsible Prospective Contractors, 42 CFR Part 94. 2011.

  34. US Food and Drug Administration. Financial Disclosure by Clinical Investigators, FDA 21 CFR Part 54. 2017.

  35. Shabani M, Dove ES, Murtagh M, Knoppers BM, Borry P. Oversight of genomic data sharing: what roles for ethics and data access committees? Biopreserv Biobank. 2017;15:469–474.

    PubMed  Google Scholar 

  36. Shabani M, Borry P, “You want the right amount of oversight”: interviews with data access committee members and experts on genomic data access. Genet Med. 2016;18:892.

    CAS  PubMed  Google Scholar 

  37. National Institutes of Health. NIH Genomic Data Sharing Policy. 2014.

  38. Eckstein L. Building a more connected DSMB: better integrating ethics review and safety monitoring. Account Res. 2015;22:81–105.

    PubMed  Google Scholar 

  39. Greenberg B. Organization, revew, and administration of cooperative studies (Greenberg report)—a report from the Heart Special Project Committee to the National Advisory. Control Clin Trials. 1988;9:137–148.

    Google Scholar 

  40. Calis KA, Archdeacon P, Bain R, et al. Recommendations for data monitoring committees from the Clinical Trials Transformation Initiative. Clin Trials. 2017:1740774517707743.

  41. US Food and Drug Administration. Guidance for clinical trial sponsors: establishment and operation of clinical trial data monitoring committees. OMB Control. 2006(0910–0581).

  42. National Institutes of Health. NIH Policy for Data and Safety Monitoring. 1998.

  43. US Department of Health and Human Services. United States Government Policy for Institutional Oversight of Life Sciences Dual Use Research of Concern. 2014.

  44. Council NR. Guidelines for Human Embryonic Stem Cell Research. Washington, DC: National Academies Press; 2005.

    Google Scholar 

  45. Greely HT. Assessing ESCROs: yesterday and tomorrow. Am J Bioeth. 2013;13:44–52.

    PubMed  Google Scholar 

  46. US Department of Health and Human Services. Standards for privacy of individually identifiable health information. Final Rule, 45 CFR Parts 160, and 164. Code of Federal Regulations. 2010.

  47. National Institutes of Health. Privacy boards and the HIPAA privacy rule. Washington, DC: US Department of Health and Human Services, 2003.

    Google Scholar 

  48. Research & Development (R&D) Committees. Veterans Health Administration Handbook 1200.01. June 16, 2009.

  49. Knopman D, Alford E, Tate K, Long M, Khachaturian AS. Patients come from populations and populations contain patients. A two-stage scientific and ethics review: the next adaptation for single institutional review boards. Alzheimers Dement. 2017;13:940–946.

    PubMed  Google Scholar 

  50. Suleiman OH, Fejka R, Houn F, Walsh M. The radioactive drug research committee: background and retrospective study of reported research data (1975–2004). J Nucl Med. 2006;47:1220–1226.

    PubMed  Google Scholar 

  51. US Food and Drug Administration. Prescription drugs for human use generally recognized as safe and effective and not misbranded: drugs used in research. FDA 21 CFR Part 361. 2017.

  52. University of Pittsburgh. Radiation Safety Committees. Radiation Safety Office 2009; http://www.radsafe.pitt.edu/about/radiation-safety-committees.php. Accessed July 3, 2017.

  53. Riley M. IOM RAC workshop panelist comments. Hum Gene Ther. 2014;25:27–30.

    Google Scholar 

  54. Wivel NA. Historical perspectives pertaining to the NIH recombinant DNA advisory committee. Hum Gene Ther. 2014;25:19–24.

    CAS  PubMed  PubMed Central  Google Scholar 

  55. Wendler D, Belsky L, Thompson KM, Emanuel EJ. Quantifying the federal minimal risk standard: implications for pediatric research without a prospect of direct benefit. JAMA. 2005;294:826–832.

    CAS  PubMed  Google Scholar 

  56. Boyd EA, Lipton S, Bero LA. Implementation of financial disclosure policies to manage conflicts of interest. Health Aff (Millwood). 2004;23:206–214.

    Google Scholar 

  57. Weinfurt KP, Friedman JY, Dinan MA, et al. Disclosing conflicts of interest in clinical research: views of institutional review boards, conflict of interest committees, and investigators. J Law Med Ethics. 2006;34:581–591.

    PubMed  PubMed Central  Google Scholar 

  58. Dinan MA, Weinfurt KP, Friedman JY, et al. Comparison of conflict of interest policies and reported practices in academic medical centers in the United States. Account Res. 2006;13:325–342.

    PubMed  PubMed Central  Google Scholar 

  59. Boyd EA, Cho MK, Bero LA. Financial conflict-of-interest policies in clinical research: issues for clinical investigators. Acad Med. 2003;78:769–774.

    PubMed  Google Scholar 

  60. Gostin LO, Altevogt BM, Pope AM. Future oversight of recombinant dna research: recommendations of an Institute of Medicine committee. JAMA. 2014;311:671–672.

    CAS  PubMed  Google Scholar 

  61. Taylor HA, Chaisson L, Sugarman J. Enhancing communication among data monitoring committees and institutional review boards. Clin Trials. 2008;5:277–282.

    PubMed  Google Scholar 

  62. Tereskerz PM, Guterbock TM, Kermer DA, Moreno JD. An opinion and practice survey on the structure and management of data and safety monitoring boards. Account Res. 2011;18:1–30.

    PubMed  Google Scholar 

  63. Simpson CL, Goldenberg AJ, Culverhouse R, et al. Practical barriers and ethical challenges in genetic data sharing. Int J Environ Res Public Health. 2014;11:8383–8398.

    PubMed  PubMed Central  Google Scholar 

  64. Lilford RJ, Braunholtz D, Edwards S, Stevens A. Monitoring clinical trials—interim data should be publicly available. BMJ. 2001;323:441.

    CAS  PubMed  PubMed Central  Google Scholar 

  65. DeMets DL, Fost N, Powers M. An institutional review board dilemma: responsible for safety monitoring but not in control. Clin Trials. 2006;3:142–148.

    PubMed  Google Scholar 

  66. Baylis F, Scott Robert J. Human embryonic stem cell research: an argument for national research review. Account Res. 2006;13:207–224.

    PubMed  Google Scholar 

  67. Redman BK, Caplan AL. Limited reproducibility of research findings: implications for the welfare of research participants and considerations for institutional review boards. IRB. 2016;9.

  68. Harris R. Rigor Mortis: How Sloppy Science Creates Worthless Cures, Crushes Hope, and Wastes Billions. New York, NY: Basic Books; 2017.

    Google Scholar 

  69. Caplan AL. Off the RAC. Hum Gene Ther. 2013;25:17–18.

    Google Scholar 

  70. Becker G. The “H5N1 publication case” and its conclusions. Acta Biochim Pol. 2012;59:441–443.

    CAS  PubMed  Google Scholar 

  71. Brady SL, Mohaupt TH, Kaufman RA. A comprehensive risk assessment method for pediatric patients undergoing research examinations using ionizing radiation: how we answered the institutional review board. AJR Am J Roentgenol. 2015;204:W510–W518.

    PubMed  Google Scholar 

  72. Levine RJ. Institutional review boards: a crisis in confidence. Ann Intern Med. 2001;134:161–163.

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Phoebe Friesen PhD.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Friesen, P., Redman, B. & Caplan, A. Of Straws, Camels, Research Regulation, and IRBs. Ther Innov Regul Sci 53, 526–534 (2019). https://doi.org/10.1177/2168479018783740

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1177/2168479018783740

Keywords

Navigation