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Primary Care
CMECNE

The IRB Rules Are Changing – What to Expect in this Upcoming Version

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Learning Objectives and CME/Disclosure Information

This activity is intended for healthcare providers delivering care to women and their families.

After completing this activity, the participant should be better able to:

1. List the important changes in the HHS ‘Common Rule’
2. Explain the reasons for changes in the ‘Common Rule’

Estimated time to complete activity: 0.25 hours

Faculty:

Susan J. Gross, MD, FRCSC, FACOG, FACMG
President and CEO, The ObG Project

Disclosure of Conflicts of Interest

Postgraduate Institute for Medicine (PIM) requires faculty, planners, and others in control of educational content to disclose all their financial relationships with ineligible companies. All identified conflicts of interest (COI) are thoroughly vetted and mitigated according to PIM policy. PIM is committed to providing its learners with high quality accredited continuing education activities and related materials that promote improvements or quality in healthcare and not a specific proprietary business interest of an ineligible company.

The PIM planners and others have nothing to disclose. The OBG Project planners and others have nothing to disclose.

Faculty: Susan J. Gross, MD, receives consulting fees from Cradle Genomics, and has financial interest in The ObG Project, Inc.

Planners and Managers: The PIM planners and managers, Trace Hutchison, PharmD, Samantha Mattiucci, PharmD, CHCP, Judi Smelker-Mitchek, MBA, MSN, RN, and Jan Schultz, MSN, RN, CHCP have nothing to disclose.

Method of Participation and Request for Credit

Fees for participating and receiving CME credit for this activity are as posted on The ObG Project website. During the period from Dec 31 2017 through Dec 31 2019, participants must read the learning objectives and faculty disclosures and study the educational activity.

If you wish to receive acknowledgment for completing this activity, please complete the post-test and evaluation. Upon registering and successfully completing the post-test with a score of 100% and the activity evaluation, your certificate will be made available immediately.

For Pharmacists: Upon successfully completing the post-test with a score of 100% and the activity evaluation form, transcript information will be sent to the NABP CPE Monitor Service within 4 weeks.

Joint Accreditation Statement

In support of improving patient care, this activity has been planned and implemented by the Postgraduate Institute for Medicine and The ObG Project. Postgraduate Institute for Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

Physician Continuing Medical Education

Postgraduate Institute for Medicine designates this enduring material for a maximum of 0.25 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Continuing Nursing Education

The maximum number of hours awarded for this Continuing Nursing Education activity is 0.2 contact hours.

Read Disclaimer & Fine Print

SUMMARY:

A new version of the U.S. Department of Health and Human Services (HHS) Office for Human Research Protections (OHRP) “Common Rule”, governing federally funded human research, took effect January 21, 2019. This new guidance is the first update to the regulations since they were published in 1991. The FDA has issued guidance (October, 2018) to help provide direction, stating that it

…intends to undertake notice and comment rulemaking to harmonize, to the extent applicable, FDA’s regulations with the revised Common Rule. Because FDA has not revised its regulations, FDA is issuing this guidance to reduce confusion and burden associated with complying with two different sets of human subject protection regulations.

Consent Forms

Establishes new requirements regarding the information that must be given to prospective research subjects as part of the informed consent process.

  • A summary will now be required at the beginning of the consent document, with a concise explanation of the following elements
    • Consent sought for research and participation is voluntary
    • Purpose
    • Reasonable foreseeable risks
    • Benefits to participant or others that may be expected
    • Appropriate alternatives
  • The expectation is that the summary will not be more than a few pages in length
  • The final rule allows flexibility, such that consent summary may not be required if the actual consent document is relatively brief

Private Information and Biospecimens

Allows the use of broad consent (i.e., seeking prospective consent to unspecified future research) from a subject for storage, maintenance, and secondary research use of identifiable private information and identifiable biospecimens. Broad consent will be an optional alternative that an investigator may choose instead of, for example, conducting the research on nonidentified information and nonidentified biospecimens, having an institutional review board (IRB) waive the requirement for informed consent, or obtaining consent for a specific study.

  • A researcher may prospectively request a broad consent for unspecified future research from a subject to store, maintain and perform secondary research on identifiable private information and biospecimens
  • The pre-2018 rule that investigators can conduct research on biospecimens and data that had been stripped of all identifiers or coded without obtaining consent remains unchanged

New Exempt Categories

Establishes new exempt categories of research based on their risk profile. Under some of the new categories, exempt research would be required to undergo limited IRB review to ensure that there are adequate privacy safeguards for identifiable private information and identifiable biospecimens.

  • The purpose of these categories is to reduce regulatory burden and help IRBs concentrate on studies that are truly higher risk to participants
  • With the establishment of new categories, some exempt categories may require limited IRB review to ensure that there are appropriate privacy safeguards for identifiable private information
  • There is a new exempt category involving benign behavioral interventions with adult subjects
    • Benign behavioral interventions are brief in duration, harmless, painless, not physically invasive, not likely to have a significant adverse lasting impact on the subjects, and the investigator has no reason to think the subjects will find the interventions offensive or embarrassing
    • Participants must prospectively agree to the intervention and information collection
    • The research may not involve deception (unless subjects are prospectively informed that they will be misled)
    • While interventions and specimen collection is not allowed, collection of sensitive and identifiable data will be allowed
    • This section now includes most surveys, interviews and educational tests in adult research

Single IRB for Multi-Centered Studies

Creates a requirement for U.S.-based institutions engaged in cooperative research to use a single IRB for that portion of the research that takes place within the United States, with certain exceptions. This requirement becomes effective 3 years after publication of the final rule.

  • Any federal agency involved in research can determine whether a single IRB is appropriate
  • The goal of this change is to allow the IRB to better protect all the participants in a particular study, avoiding multiple IRBs getting involved with the same study

NOTE: The IFR does not delay the compliance date for the cooperative research provision of the revised Common Rule, which remains January 20, 2020

Elimination of Continuing Review for Exempt Research

Removes the requirement to conduct continuing review of ongoing research for studies that undergo expedited review and for studies that have completed study interventions and are merely analyzing study data or involve only observational follow up in conjunction with standard clinical care.

  • This change acknowledges the lower risk profile of studies that fall under expedited review, allowing IRBs to focus on higher risk research

KEY POINTS:

  • The Common Rule is established at the federal level
    • State and local IRBs may require additional protections
  • The main goal of the regulations is to protect research participants
  • The above is a summary of key highlights
    • For further detail see ‘Learn More – Primary Sources’

Learn More – Primary Sources:

Final Revisions to the Common Rule

Impact of Certain Provisions of the Revised Common Rule on FDA-Regulated Clinical Investigations

Federal Register: Federal Policy for the Protection of Human Subjects

The Common rule, Updated (NEJM)

What do revised U.S. rules mean for human research? (Science)

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This website is not intended to be a source for legal advice, and thus the reader should not rely on any information provided in this website as such. Readers should not consider the information provided to be an invitation for an attorney-client relationship, and should always seek the advice of competent counsel in the reader’s home jurisdiction. Provider may provide links to third party websites. These links are provided only as a convenience. Linked websites are not reviewed, controlled or examined by Provider and Provider is not responsible for the information, advertising, products, resources or other materials, of any linked site or any link contained in a linked site. The inclusion of any link does not imply endorsement by Provider. In addition, please be aware that your use of any linked site is subject to the terms and conditions applicable to that site. Please direct any questions regarding linked sites to the webmaster of that site.

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Computer System Requirements

OBG Project CME requires a modern web browser (Internet Explorer 10+, Mozilla Firefox, Apple Safari, Google Chrome, Microsoft Edge). Certain educational activities may require additional software to view multimedia, presentation, or printable versions of their content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Flash, Apple QuickTime, Adobe Acrobat, Microsoft PowerPoint, Windows Media Player, or Real Networks Real One Player.

Disclosure of Unlabeled Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Disclaimer

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information
presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

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