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An Audit of Protocol Deviations Submitted to an Institutional Ethics Committee of a Tertiary Care Hospital

机译:提交三级医院机构伦理委员会的方案偏差审核

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摘要

Protocol deviations (PDs) may jeopardize safety, rights, and welfare of subjects and data integrity. There is scarce literature and no guidelines for Institutional Ethics Committees (IECs) to process PD reports. The PD reports submitted to IECs from Jan 2011 to August 2014 were analyzed retrospectively. Types of studies reporting PDs, category and type of PDs, PD rate per participant, time of reporting PD since its occurrence and corrective actions stated by principal investigator (PI) for major deviations were noted. Out of 447 PDs from 73/1387 total studies received during study period, 402 were from 126 pharma studies. Investigator initiated studies and dissertations reported negligible PDs. Median number of PDs was 4 per protocol. Out of 447 PDs, 304 were related to study procedure, 87, 47 and 9 were from safety, informed consent document (ICD) and eligibility category respectively. The most common reason for PDs was incomplete ICD (22/47). Maximum study procedure related PDs were due to patient visiting outside window period (126/304). Thirty five of 87 PDs were due to missed safety assessment. The overall PD reporting rate per participant was 0.08. In 90% of reports, date of occurrence of PD was not specified. The median delay for reporting PDs after occurrence was 94 days. PDs classified as Major were 73% (323/447). The most common corrective actions stated by PI were participant counseling (85/323) and caution in future (70/323). The study findings emphasize the need for GCP training at regular interval of study team members. IEC have to be vigilant and visit sites frequently, take initiative and formulate guidelines regarding PD reporting.
机译:协议偏差(PD)可能危害受试者的安全性,权利和福祉以及数据完整性。缺乏文献,也没有机构道德委员会(IEC)处理PD报告的指南。对2011年1月至2014年8月提交IEC的PD报告进行了回顾性分析。记录了报告PD的研究类型,PD的类别和类型,每位参与者的PD率,PD发生以来的报告时间以及主要研究者(PI)提出的针对主要偏差的纠正措施。在研究期间接受的73/1387项研究中的447个PD中,有402个来自126个药物研究。研究人员发起的研究和论文报道的PD可以忽略不计。每个协议的PD中位数为4。在447个PD中,有304个与研究程序有关,其中87、47和9个分别来自安全性,知情同意文件(ICD)和资格类别。 PD的最常见原因是ICD不完整(22/47)。与研究程序相关的最大PD数是由于患者在窗口期之外访问(126/304)。 87个PD中有35个是由于未进行安全评估而导致的。每个参与者的整体PD报告率为0.08。在90%的报告中,未指定PD的发生日期。发生PD后报告PD的中位延迟为94天。被分类为专业的PD为73%(323/447)。 PI提出的最常见的纠正措施是参与者咨询(85/323)和将来的谨慎(70/323)。研究结果强调需要定期对研究团队成员进行GCP培训。 IEC必须保持警惕并经常走访现场,采取主动行动并制定有关PD报告的准则。

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