Views of IRBs Concerning their Local Ecologies: Perceptions of Relationships, Systems, and Tensions between IRBs and their Institutions.

Robert Klitzman
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Abstract

Background: Research has generally examined institutional review boards (IRBs) in isolation, but critical questions arise of how these entities fit into the larger institutional contexts in which they operate and what the implications may be.

Methods: Semi-structured interviews were conducted with leaders of IRBs from among the top 240 institutions receiving funding from the National Institutes of Health.

Results: Interviewees felt that institutions may affect IRBs through both broad, indirect features (e.g., size, type of research, and culture of the institution), and more direct, IRB-related factors (e.g., amount of leadership and resource support for the IRB). Interviewees thought that institutional support of IRBs ranged from financial to non-financial, direct and indirect, and that these institutional factors can mold amounts of IRB staff and education, audits, and education of principal investigators (PIs), and tensions IRBs had to address. Respondents felt that these factors can in turn potentially affect IRB reviews of protocols and interactions with principle investigators (PIs). Within the complex systems of an institution, IRBs felt that PIs' experiences and complaints about the IRB to institutional leaders may also shape how the institution related to the IRB.

Conclusions: These data are the first to show how IRBs perceive themselves as working within the contexts of dynamic local institutional relationships and systems that pose challenges and tensions that can potentially affect critical aspects of IRB functioning. The findings have implications for practice, future research, and policy.

注册评审委员会对其当地生态环境的看法:对 IRB 与其机构之间的关系、系统和紧张关系的看法。
背景:研究一般都是孤立地研究机构审查委员会(IRBs),但对于这些实体如何融入其运作的更大机构环境以及可能产生的影响,却出现了一些关键问题:对接受美国国立卫生研究院资助的前 240 家机构中的 IRB 领导进行了半结构化访谈:受访者认为,机构可能会通过广泛、间接的特征(如规模、研究类型和机构文化)以及更直接、与 IRB 相关的因素(如对 IRB 的领导力和资源支持的数量)来影响 IRB。受访者认为,机构对 IRB 的支持包括资金和非资金支持、直接和间接支持,这些机构因素可能会影响 IRB 工作人员的数量、教育、审计、对主要研究者 (PI) 的教育,以及 IRB 必须应对的紧张局势。受访者认为,这些因素可能反过来影响到 IRB 对协议的审查以及与主要研究者 (PI) 的互动。在机构的复杂系统中,IRB 认为 PI 的经历和向机构领导投诉 IRB 的情况也可能会影响机构与 IRB 的关系:这些数据首次显示了 IRB 如何看待自己在动态的地方机构关系和系统背景下的工作,这些关系和系统带来的挑战和紧张可能会影响 IRB 运作的关键方面。这些发现对实践、未来研究和政策都有影响。
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