Acad Med. 2018 Mar 6. doi: 10.1097/ACM.0000000000002206. [Epub ahead of print]

Why Public Comments Matter: The Case of the National Institutes of Health Policy on Single Institutional Review Board Review of Multicenter Studies.

Ervin AM1, Taylor HA, Ehrhardt S, Meinert CL.

Author information

1

A.M. Ervin is assistant scientist, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland. H.A. Taylor is associate professor, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health and Johns Hopkins Berman Institute of Bioethics, Baltimore, Maryland. S. Ehrhardt is associate professor, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland. C.L. Meinert is professor, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.

Abstract

PURPOSE:

In 2014, the National Institutes of Health (NIH) requested public comments on a draft policy requiring NIH-funded, U.S.-based investigators to use a single institutional review board (sIRB) for ethical review of multicenter studies. The authors conducted a directed content analysis and qualitative summary of the comments and discuss how they shaped the final policy.

METHOD:

Two reviewers independently assessed support for the policy from a review of comments responding to the draft policy in 2016. A reviewer conducted an open text review to identify prespecified and additional comment themes. A second researcher reviewed 20% of the comments; discrepancies were resolved through discussion.

RESULTS:

The NIH received 167 comments: 65% (108/167) supportive of the policy, 23% (38/167) not supportive, and 12% (21/167) not indicating support. Clarifications or changes to the policy were suggested in 102/167 comments (61%). Criteria for selecting sIRBs were addressed in 32/102 comments (31%). Also addressed were IRB responsibilities (39/102; 38%), cost (27/102; 26%), the role of local IRBs (14/102; 14%), and allowable policy exceptions (19/102; 19%). The NIH further clarified or provided additional guidance for selection criteria, IRB responsibilities, and cost in the final policy (June 2016). Local IRB reviews and exemptions guidance were unchanged.

CONCLUSIONS:

In this case study, public comments were effective in shaping policy as the NIH modified provisions or planned supplemental guidance in response to comments. Yet critical knowledge gaps remain and empirical data are necessary. The NIH is considering mechanisms to support the establishment of best practices for sIRB implementation.