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Human subjects research includes any systematic investigation that is designed to develop or contribute to generalizeable (i.e., scholarly) knowledge and which uses living humans or identifiable information about living humans. Some examples of human subjects research projects conducted at the Brookwood Baptist Health are:
drug/device comparison trials
disease prevention studies
medical chart review studies
STANDARD DIAGNOSTIC OR THERAPEUTIC PROCEDURES
The distinction between research and treatment can be blurred in patient care settings, as well as in some educational and training settings. An established and accepted diagnostic or therapeutic procedure that is performed only for the benefit of a patient is generally not subject to IRB review. However, collection of data about a series of such procedures or treatments for dissemination or generalization does constitute research that requires IRB review. Additionally, if patient care or assignment to intervention is altered for research purposes in any way the activity must be submitted for IRB review. Also, a diagnostic procedure for research purposes that is added to a standard treatment requires IRB review.
INNOVATIVE PROCEDURES OR TREATMENTS
Innovations in diagnosis or therapy are not generally subject to IRB review if they are applied to a patient for the sole purpose of aiding that individual, although such innovations are governed by the appropriate professional ethics (e.g., obtaining informed consent). IRB review is required when a 'systematic investigation' of such innovations is considered. For example, if a physician plans to collect information about the innovation for scientific purposes or will repeat the innovation in other patients in order to compare it to standard treatment, the physician must receive prior IRB review.
EMERGENCY USE OF AN INVESTIGATIONAL DRUG OR DEVICE
Nothing in the Brookwood Baptist Health policies or Federal regulations is intended to limit the authority of a physician to provide emergency medical care for patients who need such care. The Brookwood Baptist Health Institutional Review Board review is not required for emergency use of a test article provided such emergency use is reported to the Institutional Review Board within five (5) working days of the emergency use. When emergency medical care is initiated, the patient may not be considered a research subject. Such emergency care may not be claimed as research, nor may any data regarding such care be included in any report of research activity.
A report on a single case does not usually require prior IRB approval because it does not usually meet the 'systematic investigation' criteria to be considered research. These are more akin to journalism than to research. However, these projects should follow the same guidelines for the protection of the subject's privacy, dignity, and welfare as they would if they required IRB review.
What is an Institutional Review Board?
An Institutional Review Board (IRB) is a local committee comprised of clinicians, administrative and support staff, and lay people who review all proposed Brookwood Baptist Health human subjects research to ensure that the safety and welfare of subjects are protected. There is one IRB committee at the Brookwood Baptist Health. The Institutional Review Board meets once per month and is supported by staff who are available for consultation on all human subjects research matters. Institutional Review Board staff also are available by appointment to pre-review any human subject research protocol submission to the Institutional Review Board.
Who is Eligible to be a Principal Investigator?
Brookwood Baptist Health clinicians, residents, nursing staff, and employees with .5 FTE status or more may serve as Principal Investigator on research protocols involving human subjects.
What Kind of Approval Do I Need to Begin My Human Subjects Research Study?
All human subjects research at the Brookwood Baptist Health is to be reviewed by the Institutional Review Board. Depending on the research interventions proposed, you will need Institutional Review Board approval or Exempt From Continuing Review status from the Institutional Review Board . The categories of research and their corresponding levels of review are described in WHAT LEVEL OF REVIEW DO I NEED? You also may need approval from other oversight committees, such as Radiation Safety Committee for protocols involving radiating the subject or Institutional Biosafety Committee for protocol involving genetic therapy and transfer.
How Do I Get Started?
Federal regulations divide human subjects research into three categories, each of which has a corresponding requirement for institutional approval or registration. For an explanation of each, see WHAT LEVEL OF REVIEW DO I NEED? Once you have determined the level of review required, you will need to submit an application for Institutional Review Board Review. What Do I Need in Order to Submit a Protocol for Institutional Review Board Review?
For all the categories for review, please refer to Appendix I: Submission Instructions.
EXEMPT FROM CONTINUING REVIEW STATUS
To apply for Exempt From Continuing Review Status you must complete and submit to the Institutional Review Board the NEW RESEARCH PROJECT APPLICATION for approval. Request Exempt From Continuing Review Status and include a brief abstract describing your research project. If you will be using a data collection instrument, such as a survey or questionnaire, please attach a copy. There are no submission deadlines for requests for Exempt From Continuing Review Status confirmation.
EXPEDITED REVIEW FOR NEW PROJECT
To apply for Expedited Review, you must submit one complete original copy of the NEW RESEARCH PROJECT application form, Expedited Application form, the Protocol and the Informed Consent document to the Institutional Review Board. There are no submission deadlines for expedited review, as they are conducted on a continuous basis. Print out these checklists to refer to when preparing your protocol:
"Protocol Preparation Checklist" (Appendix II): A list of information that the Institutional Review Board expects to find in a complete protocol.
"Consent Form Preparation Checklist" (Appendix III): Elements necessary for preparing consent for review.
FULL COMMITTEE REVIEW FOR NEW PROJECT
Print out these checklists to refer to when preparing your protocol:
· "Protocol Preparation Checklist" (Appendix II): A list of information that the Institutional Review Board committee expects to find in a complete protocol.
· "Consent Form Preparation Checklist" (Appendix III): Elements necessary for preparing consent for review.
Modifications to Approved Research
Changes in project scope, location, personnel, interventions, or inclusion/exclusion criteria must receive prior approval by the Institutional Review Board. To apply for a modification, you must submit an AMENDMENT TO A PREVIOUSLY APPROVED PROJECT form. Please consult the Institutional Review Board Coordinator to find out if committee deadlines will apply. This is dependent on whether the proposed modification will be reviewed on an Expedited or Full Committee basis.