title: Ethical approval for research involving geographically dispersed subjects: unsuitability of the UK MREC/LREC system and relevance to uncommon genetic disorders.
abstract: OBJECTIVE
  To assess the process involved in obtaining ethical approval for a single-centre study involving geographically dispersed subjects with an uncommon genetic disorder.
  
  
  METHODS
  Observational data of the application process to 53 local research ethics committees (LRECs) throughout Wales, England and Scotland. The Multicentre Research Ethics Committee (MREC) for Wales had already granted approval.
  
  
  RESULTS
  Application to the 53 LRECs required 24,552 sheets of paper and took two months of the researcher's time. The median time taken for approval was 39 days with only seven (13%) of committees responding within the recommended 21 days. In at least nineteen cases (36%) a subcommittee considered the application. Thirty-three committees (62%) accepted the proposal without amendments but, of the remainder, four (8%) requested changes outside of the remit of LRECs.
  
  
  CONCLUSIONS
  Difficulties still exist with the system for obtaining ethical approval for studies involving a single centre but with patients at multiple sites, as is often required for genetic observational research. As such studies differ from true multicentre studies, it may be advantageous to develop a separate and specific process of application to ensure that resources are not unnecessarily expended in the quest for ethical approval.
authors.affiliation: Institute of Medical Genetics, University of Wales College of Medicine, Heath Park, Cardiff, Wales, UK.
authors.forename: J C
authors.initials: JC
authors.lastname: Lewis
authors.forename: S
authors.initials: S
authors.lastname: Tomkins
authors.forename: J R
authors.initials: JR
authors.lastname: Sampson
mesh_terms: D015331:Cohort Studies; D003657:Decision Making; D028744:Ethics Committees, Research / Q000458:organization & administration*; D036281:Genetic Research; D005838:Genotype; D005843:Geography; D006805:Human Experimentation; D006801:Humans; D010641:Phenotype; D012111:Residence Characteristics; D012941:Social Responsibility; D014402:Tuberous Sclerosis / Q000235:genetics*; D006113:United Kingdom