Single institutional review board (IRB) review of multisite research increased in frequency over a decade ago with a proliferation of master IRB reliance agreements supporting statewide and regional consortia and disease- and population-specific networks. Although successful, the increasing number of agreements presented significant challenges and illuminated potential benefits of a single, nationwide agreement. Anticipated changes in federal regulations highlighted the need to systematize and simplify IRB reliance. To address these challenges, the NIH National Center for Advancing Translational Sciences funded a project to establish a national IRB reliance network that would support national adoption of single IRB (sIRB) review. The Streamlined, Multisite, Accelerated Resources for Trials (SMART) IRB Platform launched in July 2016 to facilitate dissemination, adoption, and implementation of a collaboratively developed master IRB reliance agreement and supportive tools and resources. More than 580 institutions have joined SMART IRB's Master Common Reciprocal Institutional Review Board Authorization Agreement and begun using the SMART IRB platform to support sIRB arrangements. Here, we describe the tenets of the agreement and operational benefits and challenges of its use. SMART IRB's early success affirms the utility of collaborative, flexible, and centralized approaches to supporting sIRB review while highlighting the need for further national harmonization.
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http://dx.doi.org/10.1017/cts.2019.394 | DOI Listing |
BMC Glob Public Health
January 2025
Health Economics and Epidemiology Research Office, Department of Internal Medicine, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa.
Background: Under South Africa's Universal Test and Treat (UTT) policy, CD4 counts are no longer required to determine HIV treatment eligibility. However, CD4 count at presentation remains an important marker of disease progression. We assessed whether CD4 testing declined in the UTT era and, if so, by how much.
View Article and Find Full Text PDFJ Cardiothorac Surg
December 2024
University Teaching Hospital of Kigali, Kigali, Rwanda.
Background: While the number of cardiac surgery programs in sub-Saharan Africa are increasing, it is still insufficient. With only 0.08 pediatric cardiac surgeons per million people, few cardiac centers routinely perform pediatric cardiac surgery.
View Article and Find Full Text PDFBMC Med Educ
December 2024
Department of Community Dentistry, Dow International Dental College, Dow University of Health Sciences Karachi, Karachi, Pakistan.
Background: Medical education in resource-constrained settings such as Pakistan faces significant challenges, including large class sizes, limited resources, and reliance on traditional teacher-centered pedagogies. These factors hinder effective learning and fail to equip students with the critical thinking and practical skills essential for modern medical practice. Educators play a fundamental role in shaping student experiences but often struggle to adopt student-centred methodologies due to insufficient training, resource limitations, and institutional constraints.
View Article and Find Full Text PDFBMC Health Serv Res
December 2024
College of Social Work, Florida State University, Tallahassee, USA.
Background: Lack of trust is a critical issue in healthcare that contributes to the growing disparities in access and utilization of health among minoritized and disadvantaged populations in the U.S. This study explored how lack of trust affects Ethiopian immigrant women's (EIW) primary healthcare (PHC) experience and the personal and structural factors exacerbating the problem.
View Article and Find Full Text PDFJ Clin Transl Sci
May 2024
Southwest National Pediatric Device Innovation Consortium (SWPDC), Houston, TX, USA.
Introduction: Pediatric medical devices lag behind adult devices due to economic barriers, smaller patient populations, changing anatomy and physiology of patients, regulatory hurdles, and especially difficulties in executing clinical trials. We investigated the requirements, challenges, associated timeline, and costs of conducting a multi-site pivotal clinical trial for a Class II pediatric physiologic monitoring device.
Methods: This case study focused on the negotiation of clinical trial agreements (CTAs), budgets, and Institutional Review Board (IRB) processing times for a pediatric device trial.
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