title: Quality assurance of ethical issues and regulatory aspects relating to good clinical practices in the HELENA Cross-Sectional Study.
abstract: BACKGROUND
  Research involving humans is regulated by regulatory authorities through their specific requirements and controls. The Healthy Life Style in Europe by Nutrition in Adolescence Cross-Sectional Study (HELENA-CSS) is a multicenter biomedical research study of adolescents in several representative European cities, which requires satisfying medico-regulatory requirements including Independent Ethics Committee (IEC) approval and agreement by the national or local regulatory authorities. To achieve a high level of quality assurance relating to ethical issues, we followed the good clinical practices (GCP) described at the International Conference on Harmonisation (ICH), which we adapted to the national and local situations of each of the 11 participating cities in 10 European countries.
  
  
  OBJECTIVE
  The main objective of the HELENA-CSS is to evaluate reliable and comparable data of nutritional habits and lifestyle in a representative sample of European adolescents. The aim of this paper is to present the methods relating to the ethical and regulatory issues of this study and to describe the current state of the medico-regulatory requirements involved in conducting this kind of study in each country.
  
  
  METHODS
  Following the GCP-ICH guidelines, a protocol describing the HELENA-CSS was written and approved by all partners. In the pilot study, a case report form adapted to the study objectives and its manual of operation was constructed and used by all partners. All information letters to adolescents and their parents and consent forms were first written in English, then translated into the local language, and adapted to each local situation. All documents were then checked centrally for any deviation and corrected if required. An operation manual relating to ethical issues and other medico-regulatory requirements was also developed. This paper presents the current status of the medico-regulatory requirements from each HELENA-CSS participant country.
  
  
  RESULTS
  Before the beginning of the study, most centers had satisfied the medico-regulatory requirements of IEC approval and agreement with other national or local regulatory authorities/organizations. For a few centers, some problems were detected and corrective actions were taken to improve missing information to reach a high level of quality assurance of ethical issues.
  
  
  CONCLUSIONS
  The GCP-ICH guidelines about nontherapeutic biomedical research are interpreted and applied differently across Europe. This study shows that high-quality nontherapeutic biomedical research can address the ethical issues included in the GCP-ICH regulations and can be harmonized among the HELENA European partners.
authors.affiliation: EA-3925, Lille 2 Law and Health University Faculty of Medicine, Lille, France. l-beghin@chru-lille.fr
authors.forename: L
authors.initials: L
authors.lastname: Béghin
authors.forename: M
authors.initials: M
authors.lastname: Castera
authors.forename: Y
authors.initials: Y
authors.lastname: Manios
authors.forename: C C
authors.initials: CC
authors.lastname: Gilbert
authors.forename: M
authors.initials: M
authors.lastname: Kersting
authors.forename: S
authors.initials: S
authors.lastname: De Henauw
authors.forename: A
authors.initials: A
authors.lastname: Kafatos
authors.forename: F
authors.initials: F
authors.lastname: Gottrand
authors.forename: D
authors.initials: D
authors.lastname: Molnar
authors.forename: M
authors.initials: M
authors.lastname: Sjöström
authors.forename: C
authors.initials: C
authors.lastname: Leclercq
authors.forename: K
authors.initials: K
authors.lastname: Widhalm
authors.forename: M I
authors.initials: MI
authors.lastname: Mesana
authors.forename: L A
authors.initials: LA
authors.lastname: Moreno
authors.forename: C
authors.initials: C
authors.lastname: Libersa
mesh_terms: D000293:Adolescent; D002985:Clinical Protocols; D003430:Cross-Sectional Studies; D028744:Ethics Committees, Research / Q000331:legislation & jurisprudence; D032984:Ethics, Research; D005060:Europe; D005260:Female; D017408:Guidelines as Topic; D006801:Humans; D008297:Male; D015337:Multicenter Studies as Topic / Q000941:ethics*; D011785:Quality Assurance, Health Care / Q000941:ethics*; D016032:Randomized Controlled Trials as Topic / Q000941:ethics*