title: A review finds that multicenter studies face substantial challenges but strategies exist to achieve Institutional Review Board approval.
abstract: OBJECTIVE
  To characterize the impact of multiple Institutional Review Board (IRB) reviews on multicenter observational research studies, and identify strategies for overcoming the identified challenges.
  
  
  METHODS
  Using PubMed, we identified empirical studies, anecdotal reports, and opinion pieces addressing the process of obtaining initial IRB approval for multicenter clinical trials and observational studies. We also reviewed relevant information from federal and other national sources.
  
  
  RESULTS
  A total of 40 peer-reviewed articles were synthesized, plus six reports from commissions or other key sources. These sources identified numerous challenges that researchers may encounter when multicenter studies undergo review by multiple IRBs, such as added time for initial review and approval and different requirements across IRBs. Strategies to alleviate these challenges include planning to accommodate multiple reviews and determining upfront whether certain variations to study protocols are tolerable across sites. Many researchers and commissions have proposed comprehensive reforms, such as centralized review for multicenter projects.
  
  
  CONCLUSIONS
  Policy-makers, researchers, and IRBs should convene to specifically discuss optimal approaches for multicenter review. However, until structural changes are implemented, observational researchers should develop and implement strategic plans for obtaining IRB approval in multicenter studies, including adopting models successfully employed by clinical trials.
authors.affiliation: Group Health Cooperative Center for Health Studies, 1730 Minor Avenue, Suite 1600, Seattle, WA 98101, USA. greene.sm@ghc.org
authors.forename: Sarah M
authors.initials: SM
authors.lastname: Greene
authors.forename: Ann M
authors.initials: AM
authors.lastname: Geiger
mesh_terms: D015340:Epidemiologic Research Design; D028744:Ethics Committees, Research / Q000592:standards*; D006801:Humans; D015337:Multicenter Studies as Topic / Q000941:ethics / Q000592:standards; D017712:Peer Review, Research / Q000592:standards*