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IRB workshop.mp4

May 13, 2022
  • 00:05Sometimes the HP, so the human
  • 00:08research protection program and the
  • 00:10name Irbs are used interchangeably,
  • 00:12and I just want to make sure that
  • 00:13you will like at the end of my
  • 00:15quick presentation you will know the
  • 00:17difference and you will be able to
  • 00:19distinguish between the different roles.
  • 00:22Human research Protection program is
  • 00:24part of a larger office of Research
  • 00:27administration and the human Research
  • 00:30Protection Program is providing
  • 00:32administrative support to a few groups.
  • 00:35It's not just the Arab, although they yell.
  • 00:39Arab is the largest group.
  • 00:41We have 19 different panels.
  • 00:42At the end you will,
  • 00:44you will see a list of all of them.
  • 00:47We provide support to greedy active
  • 00:49drug research committee and.
  • 00:51Investigational drug committee.
  • 00:53So these are studies that involve or at
  • 00:57pet center that involve radioactive drug,
  • 01:00and that's actually one of the
  • 01:03committees that we run as well.
  • 01:05In addition,
  • 01:06we also provide support to institutional
  • 01:08conflict of interest Committee,
  • 01:09so it's one of our committees
  • 01:11that we schedule meetings for.
  • 01:13We have policies and procedures in place,
  • 01:15so that's part of our office, too.
  • 01:18In addition to that.
  • 01:20So these are the committees that we run.
  • 01:22In addition to this,
  • 01:23we work very closely with
  • 01:25different bodies within Yale,
  • 01:27so any ancillary committee that
  • 01:29is that needs to review research
  • 01:32and we have about 20 of them.
  • 01:35We have workflows in place,
  • 01:37so we work closely to make sure that
  • 01:39we know how the information travels
  • 01:41from that committee to the Arab.
  • 01:44We work very closely with Yale
  • 01:47Center for Clinical Investigations
  • 01:48at Yale with conflict of Interest
  • 01:51Office Office of sponsored.
  • 01:52Projects we work very closely to make
  • 01:55sure that grants actually match and
  • 01:57contracts match the protocol and the
  • 01:59consent language, and vice versa.
  • 02:02So that's a large umbrella of what we do.
  • 02:06I will focus mostly on the Arab.
  • 02:09I know you can't see it very well,
  • 02:11but that's on top.
  • 02:12It says the nitpicking Arab,
  • 02:14that's, I understand.
  • 02:15That's how often people think about
  • 02:17the Arabs that they're always there to
  • 02:20find something that is wrong or get back to.
  • 02:23Go back to you on and ask for
  • 02:25revisions and clarifications,
  • 02:27but in reality the IRB.
  • 02:29So that's institutional review boards
  • 02:31is there to protect the rights and
  • 02:33welfare of research participants.
  • 02:35So when you look at the regulations,
  • 02:37that's what the mission of the IRB is,
  • 02:40and I included some text from FDA guidance,
  • 02:44for example,
  • 02:45because it's like nicely described of
  • 02:47what it is that IRB is supposed to do.
  • 02:50The RB meets that mission so protects
  • 02:52the rights and welfare of research
  • 02:55participants by reviewing the
  • 02:57documents that you need to submit,
  • 02:59and they look through those
  • 03:02documents to make determinations
  • 03:03about very specific things.
  • 03:06So if you actually ever
  • 03:07attend any of our meetings,
  • 03:09our reviewers have checklists in place.
  • 03:12There are, based on the regulations.
  • 03:14So, for example,
  • 03:15when they look at the consent
  • 03:17or the consent process,
  • 03:19they need to make sure that.
  • 03:20All of the elements that the regulations
  • 03:23describe that the consent needs to have or
  • 03:26there if they're looking at your protocol
  • 03:29and how you're going to obtain consent,
  • 03:31they need to make sure that what you're
  • 03:34describing actually matches the regulations.
  • 03:36They look at the data
  • 03:38safety monitoring plans.
  • 03:39That's why we ask you to always
  • 03:41include that in your protocol.
  • 03:43There is an approval criterion that
  • 03:46talks about confidentiality of data.
  • 03:48That's why our protocols and our protocol.
  • 03:51I would be submission forms.
  • 03:52Ask specific questions about
  • 03:54confidentiality so everything that the
  • 03:57IRB asks for is based in regulations.
  • 04:00It's a highly regulated business.
  • 04:03In addition to this,
  • 04:04we need to make sure as an IRB
  • 04:07that the approval criteria are met.
  • 04:10But if you doing research in other countries,
  • 04:13for example or in other states
  • 04:16that the local regulations,
  • 04:18the local policies and procedures.
  • 04:21Were followed as well.
  • 04:23But when do you actually need
  • 04:25to even worry about the Arab?
  • 04:28So in general,
  • 04:29the IRB reviews research
  • 04:32involving human subjects,
  • 04:33so if it's not research that
  • 04:35involves human subjects,
  • 04:36I will be does not have to reveal it.
  • 04:39I know that different institutions may
  • 04:42have additional policies in place,
  • 04:44so for example they will say you,
  • 04:47even if you are doing a
  • 04:50quality improvement project,
  • 04:51you still need to come to the
  • 04:53Arab for the determination.
  • 04:54The rule in the regulation is
  • 04:57if it's human subjects research,
  • 04:59IRB needs to review it,
  • 05:01and so I underlined the terms
  • 05:04that are based in regulations,
  • 05:06research and human subjects.
  • 05:09Anytime you create a project
  • 05:12and submit it for review,
  • 05:14this is how we think about it
  • 05:16and this is how we always tell
  • 05:18our investigators to think about
  • 05:20the projects too.
  • 05:21The first question and they need to be
  • 05:24asked in order is does your project
  • 05:27fit the regulatory definition of research?
  • 05:30Because it's again research
  • 05:31is a regulatory definition.
  • 05:33I I will go through that definition
  • 05:35in a second.
  • 05:36If you say no,
  • 05:38what I'm doing is actually not research.
  • 05:40It doesn't fit the regulatory
  • 05:42definition of research.
  • 05:43You do not need to come to the Arab,
  • 05:45so there is no submission that is expected.
  • 05:49Sometimes you will get questions
  • 05:50from a publisher or from your
  • 05:52colleague that will to that will
  • 05:54prompt you to submit something to
  • 05:56their be to get their determination
  • 05:58that what you're doing is not
  • 05:59research and we will not reject it.
  • 06:01We'll give you that determination,
  • 06:03but there is no expectation at
  • 06:05Yale that you need to have it.
  • 06:07But if you say yes,
  • 06:08what I'm doing is research that
  • 06:10fits that definition that the next
  • 06:13question that you need to ask is
  • 06:15does it involve human subjects.
  • 06:17Human subjects is a regulatory.
  • 06:19Definition I will go through it
  • 06:21in a second as well.
  • 06:23If you say no,
  • 06:24I'm doing research by doesn't
  • 06:26involve human subjects.
  • 06:27You don't have to come to the IRB either,
  • 06:29but if you say yes, I'm doing research.
  • 06:32It involves human subjects.
  • 06:33Then you know that you need to submit
  • 06:36something to our office for some
  • 06:38determination and I will talk about
  • 06:40what those determinations might be like.
  • 06:43Different levels of review.
  • 06:44But let's start with the first one.
  • 06:46Is it research?
  • 06:48I included a citation to the regulatory
  • 06:51to the regulation, so it's 45.
  • 06:54Code of federal regulations.
  • 06:55You can put it in Google,
  • 06:57you'll you'll find that rights
  • 06:58and I shorten it a little bit,
  • 07:01but research is a systematic investigation
  • 07:03that will need to generalizable knowledge.
  • 07:07I underlined the keywords here.
  • 07:09The systematic investigation and
  • 07:11the generalizable knowledge because
  • 07:14certain projects sound like research,
  • 07:16but they are not because they do not
  • 07:18produce or they're not intended to
  • 07:21contribute to generalizable knowledge.
  • 07:23A perfect example of something
  • 07:24that may seem like research.
  • 07:26Is not a journalistic activity,
  • 07:29so we have students who may want
  • 07:32to publish a or write an article.
  • 07:34Talk to people about their experiences for
  • 07:38for in order to for a journalistic activity.
  • 07:42That's not research,
  • 07:43even if you're talking to
  • 07:45people and collecting data about
  • 07:46them program evaluation.
  • 07:47So if you get a contract in place
  • 07:51from a program that is taking place
  • 07:54regardless of your activities.
  • 07:56And somebody asks you to evaluate
  • 07:58how successful it is,
  • 07:59whether it works or not,
  • 08:01just for that purpose of that
  • 08:03of that project of that program,
  • 08:05we would say this is not research.
  • 08:06IRB review is not required.
  • 08:09And the case study will say this
  • 08:11is not research because you don't
  • 08:14have enough data from sufficient
  • 08:16number of individuals to lead
  • 08:18to generalizable knowledge.
  • 08:19You don't need to obtain IRB approval.
  • 08:23I know that a natural question is how many?
  • 08:28How many individuals would constitute
  • 08:32research like a case study?
  • 08:33Is it just one or two?
  • 08:35Or if I have five people that I
  • 08:36want to write about or publish,
  • 08:38is that research?
  • 08:39We always go back to the investigator
  • 08:42and ask that questions like how many
  • 08:45people do you need to yield meaningful data.
  • 08:49One person generally will say you
  • 08:50can publish you as you need to
  • 08:52ask for permission.
  • 08:53Whether you can use that person's data,
  • 08:56but that's not a research.
  • 08:58There are certain activities
  • 09:00preparatory to research,
  • 09:01so if you're going to look
  • 09:03at medical records,
  • 09:04for example to see whether you
  • 09:06even have sufficient population
  • 09:08to pull from that activity.
  • 09:09Self is not considered research.
  • 09:11You just cannot write any identifiers down.
  • 09:14So you cannot remove any Phi
  • 09:16from a HIPAA covered entity,
  • 09:18but that activity itself is not research.
  • 09:21Another example,
  • 09:22and that's where the Gray area happens
  • 09:25is a quality improvement project.
  • 09:27We say that called the improvement
  • 09:30project is evaluation of how
  • 09:32something works or you you put an
  • 09:35intervention in place and then you
  • 09:37check how it works in a very specific
  • 09:41setting so your the the purpose of
  • 09:43that activity is not to take it and
  • 09:46generalizable to other other hospitals.
  • 09:48For example,
  • 09:49other healthcare operations
  • 09:50you can publish
  • 09:52about it. You can say this is
  • 09:54what we did in our hospital,
  • 09:56but you just have to call it call
  • 09:58improvement project. And not research.
  • 09:59And then you do not need IRB
  • 10:01approval or review or approval.
  • 10:03We have certain checklists in place
  • 10:05that you can use to see whether or
  • 10:08not your project fits that definition,
  • 10:10but if it turns out that it is and it's
  • 10:12very clear that it's quality improvement,
  • 10:14you do not have to submit anything to the RB.
  • 10:16You can. If you want to,
  • 10:18but but you don't have to.
  • 10:20So that was the first question,
  • 10:21is it research?
  • 10:22Is it a systematic investigation that
  • 10:25will lead to generalizable knowledge?
  • 10:27If you say no?
  • 10:29As I said, no IRB review is required,
  • 10:32but if you say yes,
  • 10:33the next question is does
  • 10:36it involve human subjects?
  • 10:38That's a regulatory definition.
  • 10:39A human subject is a living individual
  • 10:42about whom you're going to obtain data,
  • 10:45either through interaction with that
  • 10:47person or interaction with their private,
  • 10:50identifiable information.
  • 10:51I underlined the key elements here.
  • 10:56Sometimes we go back and forth
  • 10:58with some of our investigators
  • 10:59because they submit proposals and
  • 11:01then it turns out that the data
  • 11:04they're obtaining or the tissue that
  • 11:06they're working with is actually.
  • 11:08From diseased individuals and
  • 11:09then it turns out well,
  • 11:11this is this is research,
  • 11:12but it doesn't involve human
  • 11:14subject because the person needs
  • 11:16to be living needs to be alive
  • 11:18for IRB regulations to to apply.
  • 11:22So what type of studies would not
  • 11:25constitute human subjects research?
  • 11:27If you're talking to people and
  • 11:30you're asking questions about
  • 11:32policies and procedures in place,
  • 11:35you asking about a makeup of a hospital,
  • 11:37for example,
  • 11:38like how many people are working here,
  • 11:40what is your policy on how
  • 11:42you deal with this situation?
  • 11:45Even though you're doing research
  • 11:46and you're talking to people,
  • 11:48you're not obtaining information
  • 11:50about people, but rather things.
  • 11:52We would say it's research
  • 11:54doesn't involve human subjects.
  • 11:56You don't have to come to the Arab.
  • 11:58The example that I just gave.
  • 12:00If you obtaining information
  • 12:02about deceased individuals,
  • 12:04HIPAA regulations may apply,
  • 12:05but it's not human subjects research,
  • 12:08so you do not require higher
  • 12:10be review or approval.
  • 12:12Or if you are getting a large data
  • 12:15set with deidentified data that you
  • 12:18cannot readily ascertain who the person is,
  • 12:21who that data belongs to.
  • 12:22We would say it's researching
  • 12:24doesn't involve human subjects.
  • 12:26You don't have to submit anything
  • 12:27to the Arab.
  • 12:31So that's it is that research
  • 12:33doesn't involve human subjects.
  • 12:35If you said yes, yes,
  • 12:36that means that she have to
  • 12:38submit something to the Arab.
  • 12:39Now the submission is required,
  • 12:41and when it comes through to us,
  • 12:43we need to make determination
  • 12:45about the level of review.
  • 12:47So this shows how a
  • 12:49stringent level of review is.
  • 12:52We have exemption determinations
  • 12:54then if that doesn't.
  • 12:56If your submission doesn't fit the
  • 12:58exemption determination or any categories,
  • 13:01I will explain that in a second.
  • 13:03Then you will go to expedited review
  • 13:04and if it doesn't fit the expedited
  • 13:07review categories then we send it
  • 13:09to full board and that's where all
  • 13:11those panels that you will see at the
  • 13:13end come into a place because that's
  • 13:16the panel that will review the submission.
  • 13:18So let's start with the exemption.
  • 13:21If you start reading the regulations
  • 13:23about human subjects research,
  • 13:25that's the 45 CFR 46.
  • 13:28The way they start is by saying these
  • 13:32regulations apply to all human subjects.
  • 13:34Research,
  • 13:35except these categories,
  • 13:36and there are eight categories,
  • 13:38so exemption,
  • 13:40determination or exempt research means
  • 13:42that the regulations don't apply to
  • 13:46those research involving human subjects.
  • 13:49There are eight determination.
  • 13:50There are eight different categories.
  • 13:52Most institutions,
  • 13:53including Yale,
  • 13:54is only using six of them,
  • 13:57and the reason for it is that the
  • 14:00two the exemption determinations that
  • 14:02are described in the regulations.
  • 14:05Don't have any guidance that the
  • 14:07the agencies federal agencies
  • 14:09didn't give us much guidance
  • 14:11about how to put it in operation,
  • 14:14so it has to do with repositories
  • 14:17and using data from repositories
  • 14:19for people who provided the broad
  • 14:22consent to use their data for future,
  • 14:24it's very difficult to put it in practice,
  • 14:27so we decided that at Yale and
  • 14:29again as many other institutions,
  • 14:31we only going to use 6 categories
  • 14:34of exempt research.
  • 14:35So it has to be a minimal risk study
  • 14:38that fits in one of those six categories.
  • 14:41There is a concept of limited IRB review.
  • 14:45Two of those categories my my
  • 14:49involve sensitive information.
  • 14:51So for example you are talking to
  • 14:53people and asking them questions
  • 14:55and writing down identifiable
  • 14:57information so their name but
  • 14:59the topic is quite sensitive.
  • 15:01So if somebody if somebody learned
  • 15:04that information that actually
  • 15:05may put people at risk for,
  • 15:07there might be some legal or precautions.
  • 15:09Or maybe there is risk to their harm.
  • 15:11Reputation in those cases IRB needs to
  • 15:14review it for one approval criterion
  • 15:17and that has to do with confidentiality.
  • 15:21Examples of research that could be exempt.
  • 15:25I listed just a few of them,
  • 15:27but it's usually talking about
  • 15:29surveys or interviews, focus groups,
  • 15:32observations of public behavior.
  • 15:34I actually underline the public because
  • 15:38you cannot propose going into church,
  • 15:40for example, to observe people's behavior.
  • 15:45There we would say that it's there
  • 15:47is an expectation of privacy,
  • 15:48so we would not issue.
  • 15:50Exemption determination would actually
  • 15:51send it to the next level of review.
  • 15:54If you're doing research
  • 15:56on educational techniques,
  • 15:57you want to introduce two different
  • 16:00ways of teaching and material
  • 16:01to to different classrooms and
  • 16:03then then compare the results.
  • 16:05That could be an exempt determination.
  • 16:08Research we have a benign
  • 16:11intervention behavioral intervention,
  • 16:12so you're asking people to.
  • 16:15Play a video game and then you ask
  • 16:17them questions about that video game.
  • 16:19Those types of research studies
  • 16:21would go through would received
  • 16:23an exemption determination,
  • 16:25so even though it's called exempt from the
  • 16:28IRB reviewer exempt from the regulations,
  • 16:30you still have to come to the
  • 16:33AB to get that determination.
  • 16:36So that's so that's exempt that
  • 16:38that's that's exempt research.
  • 16:39I think.
  • 16:39I wanted to add something else to to this,
  • 16:42but it just escaped me.
  • 16:43It's in your best interest to know
  • 16:46whether your study could be exempt or not,
  • 16:49because the submission to the
  • 16:51Arab to receive an exemption
  • 16:53determination is very simple.
  • 16:54It's just one form that you
  • 16:56complete submitted and the
  • 16:58turn around time is very quick,
  • 17:00so why you do not need to know
  • 17:02the difference between the
  • 17:03expedited and full board,
  • 17:05it's in your best interest to know whether
  • 17:07you're study would qualify for exempt.
  • 17:09Office or not,
  • 17:10because there is just fewer
  • 17:12documents that you need to fill out.
  • 17:14OK, we said the first level is exempt.
  • 17:17Research has to be minimal risk.
  • 17:18Study fit into certain definition.
  • 17:21Certain category.
  • 17:22If you study does not fit
  • 17:24in any of those categories,
  • 17:26the next level is expedited.
  • 17:28Expedited review is a misleading
  • 17:30name because it has nothing to
  • 17:32do with how fast it's done.
  • 17:34It has to do with who can actually review it.
  • 17:38The regulation states either
  • 17:39the chair or a designee,
  • 17:42which means that our regulatory
  • 17:44analyst in the office majority of
  • 17:47them are very experienced and they
  • 17:49got this designation from the Chair
  • 17:52to review research studies via
  • 17:55expedited review and so it has to
  • 17:57the study needs to be of minimal
  • 18:00risk and fit one of the categories.
  • 18:02I included a list here so you can
  • 18:04click on it and we'll take you to the
  • 18:06page that describes all the categories.
  • 18:08Or if it's already an approved study and
  • 18:11you're proposing a minor modification to it,
  • 18:14an expedited review procedural kick in too,
  • 18:17so it's only one person can review
  • 18:19it if that person will say, well,
  • 18:22the study doesn't actually fit
  • 18:24approval criteria,
  • 18:25it will have to go to a full board,
  • 18:28or the reviewer will ask
  • 18:29you to make some revisions.
  • 18:31And if you say no,
  • 18:32I really want to keep it that way.
  • 18:33They cannot disapprove the study,
  • 18:36so only a full board can disapprove research.
  • 18:39So if the research your proposal
  • 18:42does not fit exempts criteria,
  • 18:44it does not feel expedited
  • 18:47fit expedited criteria,
  • 18:49or if the reviewer.
  • 18:52It says that it doesn't fit approval
  • 18:54criteria and wants to send it to board.
  • 18:57That's when your study will
  • 18:58be sent to full board review.
  • 19:00Both actually take similar time to review,
  • 19:03so there is no much difference.
  • 19:05When I look at the metrics of
  • 19:07how fast it takes. And again you
  • 19:09don't need to know the difference.
  • 19:11You're not requesting expedited versus
  • 19:13fulbert review when you submission comes in,
  • 19:15that's where it's triaged
  • 19:17to that appropriate level.
  • 19:19So let me walk you through
  • 19:21quickly the submission process
  • 19:23when study comes to Yale IRB,
  • 19:25I am not going to talk
  • 19:27about our system in detail.
  • 19:29If you want me to come back and to
  • 19:30give you training on the system,
  • 19:32I'm happy to do so.
  • 19:33We have monthly trainings as well
  • 19:35so you can come to one of those
  • 19:37trainings and and we will train you
  • 19:39on how to use electronic system.
  • 19:42What I will say is that when studies
  • 19:45created in electronic IRB system,
  • 19:47we refer to as. Iris IRB.
  • 19:50It goes through different States
  • 19:52and the first state is preview.
  • 19:55Preview is the moment where HRPP analysts,
  • 20:00so they're not from.
  • 20:01They're not representing IRB,
  • 20:02they're representing the HRPP
  • 20:04or looking at your submission,
  • 20:07and there are reviewing it to
  • 20:09make sure that you compliant
  • 20:10with institutional requirements.
  • 20:12So if they ask you for clarifications,
  • 20:15they're usually about.
  • 20:16Maybe you didn't.
  • 20:18Usually about institutional requirements,
  • 20:19so they're looking at your
  • 20:21training they're looking at.
  • 20:22At the conflict of interest disclosures,
  • 20:25they're going to look at whether or
  • 20:27not you have all the other ancillary
  • 20:29approvals that might be applicable,
  • 20:31or if you didn't submit it correctly,
  • 20:33they were going to ask for it too.
  • 20:35But once the preview is completed,
  • 20:38so the institutional review is completed,
  • 20:40that's when the study moves
  • 20:42to the Arab review.
  • 20:43And if you get questions from the
  • 20:45RB that's about approval criteria.
  • 20:48So IRB review is very focused.
  • 20:50They're all looking at does your study fit?
  • 20:53The approval criteria are as
  • 20:55described in the regulations.
  • 20:58What are the institutional requirements?
  • 21:00I only included a few of them
  • 21:02and that's people.
  • 21:03How how people would start with.
  • 21:04So the first thing that we always
  • 21:06look at this institutional review
  • 21:08stage is whether or not you can
  • 21:10serve as the principal investigator.
  • 21:13Faculty Handbook has very specific
  • 21:15criteria of who can and cannot
  • 21:18serve as the principal investigator
  • 21:20Pi on the sponsor project and
  • 21:23our office adopted those rules.
  • 21:25So if your appointment at Yale.
  • 21:27Doesn't fit that criteria.
  • 21:29We will either look for special
  • 21:31permission to serve as the investigate
  • 21:33Pi as the principal investigator.
  • 21:35There are different ways of getting it,
  • 21:37or if you consider a trainee,
  • 21:39we're going to ask you to identify
  • 21:42a faculty advisor.
  • 21:43Have the faculty advisor to
  • 21:45complete that station that they take
  • 21:47responsibility for your research,
  • 21:49and upload it in our system.
  • 21:52Another thing that we look for,
  • 21:54and actually this is number one
  • 21:55reason why we send submissions.
  • 21:57Back right at the first stop
  • 22:00is the training requirements.
  • 22:02If you're from a HIPAA covered
  • 22:04entity entity and and you are,
  • 22:06you need to have a HIPAA training.
  • 22:08You need to have human subjects
  • 22:10protection training taken within
  • 22:11the last three years, and in addition,
  • 22:14if your study fits the NIH criteria for
  • 22:19clinical research for clinical trial,
  • 22:23you also need to have good
  • 22:25clinical practice training.
  • 22:26So it's not just you.
  • 22:28As a principal investigator,
  • 22:29it's every single person that
  • 22:31is listed on your study.
  • 22:32So if somebody doesn't have the training,
  • 22:34we'll send it back to you so that
  • 22:37you can either take the person
  • 22:39off the study or we submit with
  • 22:41the full training completed.
  • 22:43We going to look for conflict of
  • 22:46interest disclosures for for anybody
  • 22:48who is listed as an investigator.
  • 22:50So if your π or investigator,
  • 22:52we're going to make sure that you
  • 22:54have disclosures on file with the COI
  • 22:57office we're going to review that.
  • 22:58Disclosure to see whether there is
  • 23:01any significant financial interest
  • 23:03that is related to the study,
  • 23:04and if there is,
  • 23:05will inform the IRB to say oh,
  • 23:07you need to review this disclosure
  • 23:10because there might be conflict of interest.
  • 23:13Some studies require ancillary
  • 23:15committee review and approval.
  • 23:18As I said earlier,
  • 23:19there were about 20 of them.
  • 23:21For example,
  • 23:22if you're doing research with minors,
  • 23:24there is pediatric Protocol Review
  • 23:26committee that will need to review it.
  • 23:28If you doing research with.
  • 23:32What is it that research with
  • 23:34oncology patients there is a
  • 23:36committee that reviews it.
  • 23:37So if there is something that it was
  • 23:39a applicable ancillary committee,
  • 23:41we're going to look at this to make
  • 23:43sure that you already have the.
  • 23:46Approval in place or sometimes
  • 23:47we use our system to communicate
  • 23:49with that ancillary committee.
  • 23:51So we're going to initiate that as well.
  • 23:54We're also going to look at
  • 23:56the necessary documents.
  • 23:57I include that links to the
  • 23:59training and COI disclosures.
  • 24:01So if you get the slides and if you need it,
  • 24:03you can just click on them
  • 24:04and we'll take you there.
  • 24:06So what are the necessary documents?
  • 24:08There are quite a few of them.
  • 24:10You always need to have a
  • 24:11protocol unless you have.
  • 24:12Unless it's an exempt request,
  • 24:15then instead of protocol.
  • 24:16Going to use exemption request
  • 24:18and again it's much much shorter.
  • 24:20Yale doesn't have a very
  • 24:22specific form for a protocol.
  • 24:25I will go through it in a second.
  • 24:26You always need to have an IRB submission
  • 24:29form because there are certain things
  • 24:30that wouldn't be in a protocol.
  • 24:32There will be an IRB submission form that's
  • 24:35a document available in Iris IRB library.
  • 24:37So in our system,
  • 24:38because we are doing research
  • 24:40during pandemic,
  • 24:41we still have a form called safety
  • 24:43protocol during pandemic.
  • 24:44That's just one.
  • 24:46Page document that just describes
  • 24:48how we're going to protect your participants,
  • 24:51but also stuff that works with
  • 24:53you or or third party.
  • 24:55Anybody who can come into contact
  • 24:57with you during this research to
  • 24:59make sure that we're not exposing
  • 25:01people to unnecessary risk.
  • 25:02If you're obtaining consents,
  • 25:04you're not asking for a waiver of consent,
  • 25:08we're going to look at the
  • 25:10consent script or the document.
  • 25:11Or if you asking for a waiver of consent,
  • 25:14that something that you would ask in
  • 25:16either be submission form any measures
  • 25:18created for the purposes of the study,
  • 25:21we need to be uploaded.
  • 25:22If you're doing international research,
  • 25:24we're going to look for their
  • 25:26specific checklist that we require.
  • 25:28There is letters of support from local
  • 25:30like NGOs that will help you with that.
  • 25:32Research and if you need to have
  • 25:35special permission, we're going to
  • 25:37look for those documents as well.
  • 25:39As I said earlier,
  • 25:41Yale does not require a specific
  • 25:43protocol template.
  • 25:44If you come.
  • 25:45If you come from a different
  • 25:48institution and you had a temple like
  • 25:50to using at a different institution,
  • 25:51you can use that as well,
  • 25:53as long as has all of
  • 25:55those required elements,
  • 25:57we have a subscription to protocol builder,
  • 25:59which is a software.
  • 26:00There was a link on our website
  • 26:02I included here too that will
  • 26:04help you build the protocol
  • 26:06by asking specific questions.
  • 26:08We have some word.
  • 26:09Portions of the templates from
  • 26:11protocol builder in our library
  • 26:12you can use that as well and
  • 26:14there are some other tools that
  • 26:16included here that you can you.
  • 26:18You may actually like some of
  • 26:20those protocol templates too.
  • 26:22In terms of consent,
  • 26:24if you're very familiar with regulations,
  • 26:26you can definitely just
  • 26:28draft your own consent.
  • 26:29Just make sure that all of
  • 26:31the elements are included.
  • 26:32We created templates for
  • 26:35your for our investigators,
  • 26:37so if this is not externally sponsored study,
  • 26:40you have to draft consent.
  • 26:41You can go to the consent form
  • 26:44section in our library in the system,
  • 26:46and there are some templates available for
  • 26:48you already has all the required elements.
  • 26:51Just asked you to fill in.
  • 26:52Certain pieces of information.
  • 26:54If you working with colleagues
  • 26:56from a different institution and
  • 26:58they are sponsoring the study.
  • 27:00So they wrote the protocol,
  • 27:01they wrote the templates or if
  • 27:03you working with a sponsor.
  • 27:04So somebody already gave you a template,
  • 27:06use those.
  • 27:07Don't don't try to copy everything
  • 27:09and move it into like a yell version.
  • 27:11Use the templates that you were given.
  • 27:14There is a document called consent
  • 27:16Glossary in the consent section
  • 27:19that includes all of the required.
  • 27:22Language that we want to see
  • 27:24in consent forms.
  • 27:25Like if your study is taking
  • 27:27place at PET Center,
  • 27:29Pet Center has language that needs to go in.
  • 27:31We also included certain paragraphs
  • 27:33that we know our IRB likes to see,
  • 27:37so that's a preferred language
  • 27:39that was previously approved for
  • 27:41like risks of certain procedures.
  • 27:43So just make sure that it matches.
  • 27:45Go through that document and see
  • 27:47if you need to use any of this,
  • 27:50but don't try to copy and paste it.
  • 27:53Let me talk very quickly about external Irbs,
  • 27:56because almost 50% of our studies
  • 27:58that are externally sponsored
  • 28:00actually go to external Irbs.
  • 28:02So Yale IRB is the IRB of record for Yale,
  • 28:07but we have agreements with other
  • 28:09IRB's from other institutions we
  • 28:12have agreements with a commercial
  • 28:14certain commercial IRB's.
  • 28:15There are some some studies or networks
  • 28:18of studies that it's actually requirement
  • 28:21that if you're doing research.
  • 28:23Is part of stroke net.
  • 28:24We have to go through a very specific
  • 28:27IRB so we have those agreements as well.
  • 28:30Or sometimes maybe you have a a colleague
  • 28:33that you want to work with and now the
  • 28:35regulations actually require a single IRB.
  • 28:37If it's multi site research and
  • 28:40that colleague is going through
  • 28:41his or her institution,
  • 28:43we will be able to enter into agreement
  • 28:45with that institutions that we can
  • 28:47see the review to the IRB as well.
  • 28:49So if you ever asked from someone,
  • 28:52does Yale.
  • 28:52Need to review or enter into
  • 28:55reliance agreement with other Irbs.
  • 28:57The answer is yes.
  • 28:58We we work with Irbs all the time.
  • 29:01But even if you go to a different IRB,
  • 29:05that institutional review that I just
  • 29:07described earlier about the training,
  • 29:09the making sure that you have the COI
  • 29:12disclosures still needs to happen
  • 29:14because it's the institutional review.
  • 29:17So even if you want to go to an external IRB,
  • 29:20you still have to submit something
  • 29:22in our system will do that review of
  • 29:25institutional compliance or compliance
  • 29:27with institutional requirements.
  • 29:28We'll check whether we have a
  • 29:30reliance agreement in place.
  • 29:32If not,
  • 29:32we'll establish one and then we'll
  • 29:34write a letter saying that you're
  • 29:36OK to go to that external IRB and
  • 29:39submit your proposal to the other IRB.
  • 29:42We just need to keep track of those
  • 29:44studies in our system after you
  • 29:47get approval from the external IRB,
  • 29:49you still need to make sure that
  • 29:50our system is updated with all the
  • 29:52approval letters and up to date so you
  • 29:55don't have to submit all the modifications,
  • 29:57but you need to keep the most recent
  • 30:00approval letter for the study in our system.
  • 30:03But all the modifications continuing
  • 30:05reviews go directly to the external IRB.
  • 30:07It's just that young needs to
  • 30:09keep track of all those studies
  • 30:10because we are as an institution,
  • 30:12we are responsible for them.
  • 30:15I included a list of some of our
  • 30:18individuals in our office so that
  • 30:21you may work with most of our office
  • 30:23is of course at this point remote,
  • 30:25but we have our offices are 25 science park,
  • 30:28so if you wanted to meet with
  • 30:30someone in person,
  • 30:31you can schedule a meeting.
  • 30:32We'll meet you there included
  • 30:34the names of all the assistant
  • 30:37directors and advisors within the
  • 30:39office and names of the managers.
  • 30:42Because I expect I suspect that you
  • 30:44will probably go directly to a manager.
  • 30:46If you have questions about yeah.
  • 30:48Irby or your protocol,
  • 30:50these are the people that you will be
  • 30:52working with and sometimes if they don't,
  • 30:55they cannot answer your question.
  • 30:56They're going to triage or
  • 30:57to somebody on their teams,
  • 30:59like a regulatory analyst that can.
  • 31:01That can answer the question if you ever
  • 31:03need to have like a general question,
  • 31:06you can send it to HR Pate l.edu.
  • 31:09We check those emails daily and their
  • 31:11triage to someone who is on call that day.
  • 31:14So every day there is a different person.
  • 31:17And we'll get back to you.
  • 31:18Or you can leave a message,
  • 31:19but I think email is nice because then
  • 31:21you can see that information in writing.
  • 31:24This is a list that included the
  • 31:26link to our panel information,
  • 31:28but this is the list of all of our
  • 31:31panels and when they meet and who serves
  • 31:34as the chair and the vice chair so you
  • 31:36can see what what's panels, we have.
  • 31:39Some of them are very specialized.
  • 31:41You don't request a review by specific
  • 31:43IRB we sent when your study comes in.
  • 31:47They were we we have like very
  • 31:49specific schedule so we send your
  • 31:51study to the next available IRB.
  • 31:53If it's Pi initiated we send it
  • 31:55to the we give ourselves two weeks
  • 31:57to work through your protocol,
  • 31:59but everything else goes to the
  • 32:01next available so that it's just
  • 32:03a week waiting time.
  • 32:04OK, so this is what I had.