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|Issue 53||July 2012|
A Systematic Review: The Role of the Institutional Review Board in Managing Conflict of Interest
Ethical integrity in the conduct of healthcare research is essential for maintaining the public trust and support of such activities. Institutional Review Boards (IRB) play a critical role in maintaining the ethical integrity of research by reviewing research protocols to ensure safe and ethical treatment of participants, the provision of informed consent, and minimizing of conflicts of interest.
Investigators with the VA Evidence-based Synthesis Program at the West Los Angeles VA Medical Center conducted a review of the literature from January 1, 2000 to February 11, 2011, in order to describe the evidence regarding areas of interest in the ethical conduct of research. Specifically, the purpose of this review was to: catalog the literature on issues pertaining to IRBs; identify the issue with the greatest number of published studies -- conflict of interest policies -- which might inform VA policy; and assess the evidence regarding that issue. After reviewing more than 4,000 titles and abstracts, 116 references were determined to be appropriate for addressing the following key questions.
VA strives to provide, and patients have come to expect, a high standard of clinical care at all VA facilities. Veterans should expect similar ethical standards of research across all VA facilities. Research-informed policy can ensure that COI disclosure be made as standard as clinical care, while allowing local flexibility when it is justified. After ensuring uniform disclosure practices, the next step will be to provide national VA guidelines on managing COI for individuals (investigators) and IRBs. While preservation of local autonomy is important for providing insitutions with the flexibility they need, some system-wide principles would be useful to help local sites inform COI management decisions.
Of note, since many VA insitutions that conduct research have university affiliates, a potential complicating factor is the lack of harmony between VA COI policies and that of university affliates.
This report is a product of VA/HSR&D's Quality Enhancement Research Initiative's (QUERI) Evidence-Based Synthesis Program (ESP), which was established to provide timely and accurate synthesis of targeted healthcare topics of particular importance to VA managers and policymakers -- and to disseminate these reports throughout VA.
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This Management eBrief is a product of the HSR&D Evidence Synthesis Program (ESP). ESP is currently soliciting review topics from the broader VA community. Nominations will be accepted electronically using the online Topic Submission Form. If your topic is selected for a synthesis, you will be contacted by an ESP Center to refine the questions and determine a timeline for the report.
This Management e-Brief is provided to inform you about recent HSR&D findings that may be of interest. The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs. If you have any questions or comments about this Brief, please email CIDER. The Center for Information Dissemination and Education Resources (CIDER) is a VA HSR&D Resource Center charged with disseminating important HSR&D findings and information to policy makers, managers, clinicians, and researchers working to improve the health and care of Veterans.
This report is a product of the HSR&D Evidence-Based Synthesis Program (ESP), which was established to provide timely and accurate synthesis of targeted healthcare topics of particular importance to VA managers and policymakers - and to disseminate these reports throughout VA.
See all reports online.