Metadata
Content: Key requirements and steps in the IRB approval process
Length: One hour
Purpose: How-to guide on navigating the IRB approval process
Learning goals:
Developed by: Elisabeth O’Toole
Key sources: Draws heavily on presentations by Freida Siregar, of Evidence for Policy Design (EPoD) (presented at NH RST 2017) and Lindsey Shaughnessy of IPA (presented at NH RST 2017)
Delivered by: Laura Feeney
Reviewed by: Stephanie Lin; Laura Feeney
Last edited on/by: 10/20/21, Jessica Sashihara, Fatima Vakil, Noreen Giga
Knowledge Assessment Questions
For which changes do you need to submit a modification? Select all that apply.
New study personnel CORRECT
Change in sample size CORRECT
Non-adherence to study protocol
Updated eligibility requirements CORRECT
Change in intervention CORRECT
Next calendar year begins
Informed consent cannot contain language that is: (select all that apply)
Coercive CORRECT
Specific
Undue influence CORRECT
Exculpatory CORRECT
Jargon CORRECT
Explanatory
"If you choose not to participate in this research study, you will no longer receive any medical care.” Assuming medical care is otherwise provided to all individuals, this language is:
Coercive CORRECT
Undue influence
Exculpatory
Jargon
An IRB only needs to review research if there is face-to-face interaction between researcher staff and human subjects.
True
False CORRECT
If research is exempt from IRB review, no application to the IRB is required.
True
False CORRECT
Audience questions and comments, 2018 – IRB, Laura
Audience questions and comments, + session notes, 2019 – IRB, Laura. Laura’s post-RST responses in bold.
How involved have you been with the Institutional Review Board review process?
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Add any questions you hope we answer about IRBs throughout the presentation to the chat!
Institutional Review Boards (IRB)
Noreen Giga, Jess Sashihara, Fatima Vakil
J-PAL North America
J-PAL Research Staff Training USA 2021
Outline
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Outline
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Why is IRB approval necessary?
Ethics | Protect human subjects from harm. |
Required by university | Maintain federal funding for university; maintain PI status at university. |
Required by funders | Many funders (incl. J-PAL) require IRB approval prior to establishing awards. |
Required by journals | Journals may request the IRB protocol numbers or consent documents. |
J-PAL Research Protocol: Minimum Must Do | All PIs should obtain IRB approval from their host institution, or another authorized body, and follow ALL protocols and procedures as agreed to in that IRB approval. |
Research Protocols
The Common Rule & IRBs: Origins
1947 | Nuremburg Code – created as a result of Nazis’ human experimentation |
1974 | Department of Health & Human Services publishes basic regulations governing the protection of human subjects |
1974 | National Research Act – created National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. Creates Institutional Review Boards to ensure compliance |
1979 | Commission published “Ethical Principles and Guidelines for the Protection of Human Subjects of Research,” also known as the Belmont Report. |
Belmont Principles of research ethics
Beneficence
Respect for persons
Justice
The Common Rule & IRBs: Origins
1970s-80s | HHS revised and expanded its regulations, codified at 45 CFR 46, subparts A through D |
1991 | 14 Federal departments and agencies joined HHS in adopting rules for the protection of human subjects: the Federal Policy for the Protection of Human Subjects, or the “Common Rule.” |
The Common Rule & IRBs: Today
“I. The Rational of Modernizing the Common Rule.” January 2017. Federal Register, Rules and Regulations. 82(12) https://www.govinfo.gov/content/pkg/FR-2017-01-19/pdf/2017-01058.pdf
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2017 | Common Rule was updated for the first time since 1991 |
January 21, 2019 | Revised Common Rule went into effect for studies first approved on or after this date
|
International Context
(Always check with you host institution!)
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Institutional Review Boards
The Institutional Review Board
A group designated by an institution (e.g., a university or non-profit) to approve, monitor, and review research involving human subjects to assure appropriate steps are taken to protect the rights and welfare of those subjects in compliance with the Common Rule
This Photo by Unknown Author is licensed under CC BY
Who is on the IRB?
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MIT IRB Committee members
Adam Berinsky
Mitsui Professor of Political Science, Director of the MIT Political Experiments Research Lab
Ife Ademolu-Odeneye
Undergraduate student studying Mathematics with Computer Science
Jon P. Daries
Senior Research Analyst, Office of the Provost
Dr. Arolyn Conwill
Postdoctoral Associate, Institute for Medical Engineering and Science
Dr. Daniel Debowy
Psychiatrist, MIT Medical department
Kate Doria
Senior Data Analyst, Office of the Provost
Evelina Fedorenko
Associate Professor, Department of Brain and Cognitive Sciences
Kelly Flannigan
Review Specialist, Office of Research Subject Protection, Broad Institute for biomedical and genomic research
Angela Fowler-Brown
Medical Doctor, Family Medicine, MIT Medical Department
Michael Kane
Community Representative, Physician, Internal Medicine
Drazen Prelec
Professor of Management, Sloan School of Management
Robert Randolph
Chaplain to the Institute, Office of the Dean for Student Life
Catherine Ricciardi
Nurse Manager, MIT Clinical Research Center
Haley Schilling
Graduate Student, Linguistics & Philosophy
Peter C. Scott
Community Representative
Edward Wack
Asst. Division Head, Homeland Protection and Air Traffic Control, MIT Lincoln Laboratory
What do IRBs review?
Human Subjects
+
Research
Human Subjects Research
Scope of IRB review
Human subjects: living individuals about whom an investigator…
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See Human Subjects Decision Chart 1: “Is an Activity Human Subjects Research Covered by 45 CFR Part 46?”
Scope of IRB review
IRBs review research: a systematic investigation, including research development, testing, and evaluation, designed to develop or contribute to generalizable knowledge.
* ”Electronic Code of Federal Regulations” §46.104 Exempt research.
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Scope of IRB review: Research vs practice
“Practice” is different from “research”
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Research vs practice: The two extremes
In evaluation of Vietnam war: lottery draft was not subject to ethical approval, as researchers did not implement nor have a say in decision-making over the draft process
When a researcher invents and test new vaccine on humans, the “program” (vaccine) is part of research
Practice ≠ Research
Practice = Research
Research vs practice: Complicated middle ground
Practice ≈ Research
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You are developing a study on health insurance. You want to interview Dr. Yasmina, a policymaker, to learn about the current regulation. Do you need to submit an IRB to do this interview?
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Following every Research Staff Training, we survey the participants to understand what they think should be improved. Do we need IRB approval?
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You want to run a pilot where you will be test-driving the survey tools and intervention. Do you need to submit an IRB?
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Outline
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Key documents for IRB approval
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IRB forms at MIT: https://couhes.mit.edu/forms-templates
IRB forms at Harvard: https://cuhs.harvard.edu/forms
IRB forms at IFMR: IFMR IRB Google Drive folder
Research protocol: A chance to think through all aspects of the research design
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Informed consent
Not just a form
It’s a process
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Informed consent
Not just a form
It’s a process
Help someone make a decision about participation.
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Informed consent
Requirements for Informed Consent:
Informed consent CANNOT include language that is:
Requirements for Informed Consent, or waivers or alterations to the documentation or gathering of informed consent, are outlined by the Common Rule in section 116 and 117.
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Research Ethics
Discuss:
You provide ongoing training & support to survey enumerators on how to collect informed consent. You learn that some enumerators are skipping over parts of the consent process because they think it’s too long and participants are losing interest. What should you do? How do you advise enumerators to collect informed consent?
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Informed consent & participant data
You must tell people what will happen to their data in the future
When using identifiable private information, you must include one of two statements describing future research:
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Informed consent – (waiver of)
In order for there to be a waiver, the IRB must find and document that:
See Human Subjects Decision Chart 13: “When Can Informed Consent Be Waived or Altered Under 45 CFR 46.116(f)?”
Discuss:
Have you gotten a waiver of some or all parts of consent?
Tell us about it!
Why was it necessary? What justification did you provide? Did you have any difficulty getting the approval?
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Outline
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IRB process
Initial application & approval
Before starting any human subjects research activities.
Amendments
Before changing almost anything: team members, sample size, surveys, consent forms, donors
Reportable new information (RNI)
In the case of non-compliance, adverse events, added risk, etc.
Continuing review
Frequency varies; some studies require annual review and renewal.
Study closure
All study interventions and study activities are complete, AND
no one is working with identified data.
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Make sure to save ample time for IRB approval.
See Human Subjects Decision Chart 11: “Is Continuing Review Required Under 45 CFR 46.109(f)?”
IRB Lifecycle - example
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Submit: 10/16/20
Approval: 3/2/21
*able to start research activity*
Ask questions to IRB in preparation for submission
Four rounds of questions from IRB and responses from the team
While waiting to hear back - submit a change form indicating a slight design shift
Amendments & reportable new information
Human Subjects trainings for all new staff conducting enrollment
IRB Lifecycle - example
Inquiries from IRB
Amendments
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Full Board | Greater than minimal risk; e.g. studies involving sensitive data. Reviewed by convened IRB committee. |
Expedited | No more than minimal risk and falls under one of nine expedited categories. Reviewed by IRB Chair / designee. |
Exempt (with Limited Review) | No more than minimal risk and falls under one of eight exempt categories. Might have private, identifiable information. Reviewed by IRB Chair/designee. |
Exempt (without Limited Review) | No more than minimal risk and falls under one of eight exempt categories. Does not have private, identifiable information. Reviewed by IRB Chair / designee / staff / automated system. |
Not Human Subjects Research | Doesn’t meet federal definition or is coded (de-identified) data. Reviewed by IRB staff (or researcher determination). |
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Full Board | Greater than minimal risk; e.g. studies involving sensitive data. Reviewed by convened IRB committee. |
Expedited | No more than minimal risk and falls under one of nine expedited categories. Reviewed by IRB Chair / designee. |
Exempt (with Limited Review) | No more than minimal risk and falls under one of 8 exempt categories. Might have private, identifiable information. Reviewed by IRB Chair/designee. |
Exempt (without Limited Review) | No more than minimal risk and falls under one of eight exempt categories. Does not have private, identifiable information. Reviewed by IRB Chair / designee / staff / automated system. |
Not Human Subjects Research | Doesn’t meet federal definition or is coded (de-identified) data. Reviewed by IRB staff (or researcher determination). |
See Human Subjects Decision Chart 2: “Is the Research Involving Human Subjects Eligible for Exemption Under 45 CFR 46.104(d)?”
An aside on “minimal risk”
Minimal risk means that the probability and magnitude of harm or discomfort anticipated in the research are not greater than those ordinarily encountered in daily life or during routine physical or psychological examinations or tests.
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Full Board | Greater than minimal risk; e.g. studies involving sensitive data. Reviewed by convened IRB committee. |
Expedited | No more than minimal risk and falls under one of nine expedited categories. Reviewed by IRB Chair / designee. |
Exempt (with Limited Review) | No more than minimal risk and falls under one of 8 exempt categories. Might have private, identifiable information. Reviewed by IRB Chair/designee. |
Exempt (without Limited Review) | No more than minimal risk and falls under one of 8 exempt categories. Does not have private, identifiable information. Reviewed by IRB Chair / designee / staff / automated system. |
Not Human Subjects Research | Doesn’t meet federal definition or is coded (de-identified) data. Reviewed by IRB staff (or researcher determination). |
Limited review & new exemptions
Hicks, Lorna. “Final Rule Material: Changes to Exempt Determination Process.” CITI Program. https://about.citiprogram.org/wp-content/uploads/2018/07/Final-Rule-Material-Changes-to-Exempt-Determination-Process.pdf
“Limited IRB Review.” KUNC. http://www.kumc.edu/Documents/hrpp/Topical%20Guidance/KUMC%20Guidance%20on%20Limited%20IRB%20Review.pdf
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Streamlining exempt apps
If you need your IRB application approved very quickly, what kind of application do you submit?
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You don’t yet have any IRB approvals on a study. You think the study might be exempt. What do you do?
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See Project Management for how to talk to your PI about this topic!
What are your responsibilities?
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What are your responsibilities?
Continuing Review: Typically happens once a year. You will want to start this process at least 6-8 weeks before IRB expires. Any delays in continuing review could impact study.
Modifications: Typically happen throughout the course of the project. Modifications include adding new research personnel and any updates to study protocol.
Reportable new information: Should be submitted as soon as new information is identified. Provide as much detail on the event as possible. Avoid study jargon that the IRB won’t understand. Be prepared to follow up with additional information and protocols.
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IRB roles and responsibilities (example)
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Draft updates
RA
Review updates
Submit
RM
Approve submission
IRB Contact
Share events and changes
Field Staff
Oversee activities & submission
PI
Tips for navigating IRBs
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Tips for navigating IRBs (II)
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Tips for navigating IRBs (III) - submitting RNIs
Reportable New Information is one of the ways that you will communicate with your IRB. This process will vary by institution - so make sure you check with your PI and IRB coordinator!
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In your IRB application, you said you were going to survey 6,000 patients. You cannot find 500 patients and end up surveying 5,500 patients. Do you need to submit a modification?
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Your IRB application has just been approved, but the questionnaire that was submitted missed a key question: “How many cigarettes did you smoke in the last week?” You add the question back in. Do you need to make a modification?
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You are working on a study involving children. You are about to launch your intervention and your implementing partner thinks it’s better to target 1st graders instead of 3rd graders. Your PIs agree. Do you need to submit a modification?
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You recently found out that some of your study tablets went missing that may contain PII. What do you do?
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Where is IRB approval needed?
At every site where human subjects research occurs. This includes:
Institutional Authorization Agreement (IAA)
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IRB settings
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Imagine that Raj Chetty (Harvard) and Amy Finkelstein (MIT) have a study involving human subjects in India, run through IFMR. Raj wants to cede IRB review to MIT. Where is IRB approval needed?
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Outline
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Limitations of IRBs
🡪 don’t outsource your ethics
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IRB Response to COVID-19
IRB guidance for COVID-19, in general, was:
IRBs and institutions are now beginning to allow in-person research to resume
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Questions? Comments?
Thank you!
Credits
References
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References: Common Rule revisions
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References: Research Ethics Committees outside the US and international frameworks
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University IRB Policies for COVID-19
For reference, links to various university IRB policies relating to COVID, to give a sense of the types of policies across institutions. Check your own institution’s policies.
Resuming Research Links
For reference, links to various university IRB policies relating to COVID – ramping up / resuming in-person research, to give a sense of the types of policies across institutions. Check your own institution’s policies.