Inconsistencies and time delays in site-specific research approvals hinder collaborative clinical research in Australia

Intern Med J. 2016 Sep;46(9):1023-9. doi: 10.1111/imj.13191.

Abstract

Background/aim: The aim of this study was to describe the time and documentation needed to gain ethics and governance approvals in Australian states with and without a centralised ethical review system.

Methods: This is a prospective descriptive study undertaken between February 2012 and March 2015. Paediatric and adult hospitals (n = 67) in Australian states were approached to allow the review of their medical records. Participants included 15- to 24-year-olds diagnosed with cancer between 2008 and 2012. The main outcomes measures were time (weeks) to approval for ethics and governance and the number and type of documents submitted.

Results: Centralised ethics approval processes were used in five states, with approval taking between 2 and 18 weeks. One state did not use a centralised process, with ethics approval taking a median of 4.5 weeks (range: 0-15) per site. In four states using a centralised ethics process, 33 governance applications were submitted, with 20 requiring a site clinician listed as an investigator. Governance applications required the submission of 11 documents on average, including a Site-Specific Assessment form. Thirty-two governance applications required original signatures from a median of 3.5 (range: 1-10) non-research persons, which took a median of 5 weeks (range: 0-15) to obtain. Governance approval took a median of 6 weeks (range: 1-45). Twelve research study agreements were needed, each taking a median of 7.5 weeks (range: 1-20) to finalise.

Conclusion: The benefits of centralised ethics review systems have not been realised due to duplicative, inflexible governance processes. A system that allowed the recognition of prior ethical approval and low-risk applications was more efficient than a central ethics and site-specific governance process.

Keywords: adolescents and young adults; cancer; ethical review; multi-centre research; research governance.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Australia
  • Biomedical Research / ethics*
  • Cooperative Behavior
  • Ethical Review / standards*
  • Ethics Committees, Research / organization & administration*
  • Hospitals / ethics*
  • Humans
  • Prospective Studies
  • Time Factors
  • Young Adult