Auditing of clinical research ethics in a children's and women's academic hospital.
OBJECTIVE
Canadian and international guidelines for research ethics practices have advocated that research ethics boards (REBs) should implement mechanisms to review and monitor human research. Despite this, few Canadian REBs fulfil this expectation. The objective of this report is to summarize the results of 6 audits of clinical research ethics conducted between 1992 and 2000 in a children's and women's academic hospital in Canada in an effort to guide other academic centres planning a similar process.


METHODS
Research audits were conducted by members of a research audit review committee made up of REB volunteers. With use of random and selective processes, approximately 10% of research protocols were audited through interviews with research investigators and research coordinators and by sampling research records. Predetermined criteria were used to assess evidence of good record keeping, data monitoring, adherence to protocol, consents and the recording of adverse events during the research study. An estimate of time required to undertake an audit was made by recall of participants and records.


RESULTS
Thirty-five research studies were reviewed including 16 multicentre clinical trials and 19 single-site clinical studies. Review of record keeping and research practice revealed some deficiencies: researchers failed to maintain original authorization (7%) or renewal documentation (9%); there was 1 instance of improper storage of medication; in 5% of 174 participants for whom consent was reviewed, an outdated consent form had been used, and in 4% the signature of the enrolee was not properly shown. Other deficiencies in consent documentation occurred in less than 2% of cases. Nineteen recommendations were made with respect to deficiencies and process issues. A total of 9 to 20 person-hours are required to review each protocol in a typical audit of this type.


CONCLUSIONS
Information from research audits has been useful to develop educational programs to correct deficiencies identified through the audits. The research audit is a valuable tool in improving research ethics performance but requires considerable resources.
Department of Pediatrics, Dalhousie University, Halifax, NS. robert.bortolussi@iwk.nshealth.ca
Robert
R
Bortolussi
Diann
D
Nicholson
D035843:Biomedical Research; D002986:Clinical Trials as Topic; D006776:Hospitals, Pediatric / Q000458:organization & administration*; D006782:Hospitals, Special / Q000458:organization & administration*; D006784:Hospitals, Teaching / Q000458:organization & administration*; D008330:Management Audit; D009674:Nova Scotia; D016387:Women's Health