title: Ethics review of pediatric multi-center drug trials.
abstract: The assessment of safety and efficacy of therapeutics for children and adolescents requires the use of multi-centered designs. However, the need to obtain ethical approval from multiple independent research ethics boards (REBs) presents as a challenge to investigators and sponsors who must consider local requirements while ensuring that the protection of human subjects is consistent across sites. In pediatrics, this requirement is complicated by pediatric-specific ethical concerns such as the acquisition of assent and consent and the need for pediatric expertise to assess the scholarly merit of the proposed research. Efforts to tackle these challenges have focused on the process of ethics review, which will improve efficiency. In addition to improving process, we suggest further research to fill gaps in the evidence base for recommendations and decisions made by REBs, specifically their effectiveness to protect human subjects. Evidence gathered will contribute to the successful development, adoption and implementation of harmonized guidance to apply ethics principles in order to protect children through research rather than from research.
authors.affiliation: Child Health Evaluative Sciences CHES, The Hospital for Sick Children, University of Toronto, 555 University Ave, Toronto, ON, M5G 1X8, Canada, allison.needham@sickkids.ca.
authors.forename: Allison C
authors.initials: AC
authors.lastname: Needham
authors.forename: Mufiza Z
authors.initials: MZ
authors.lastname: Kapadia
authors.forename: Martin
authors.initials: M
authors.lastname: Offringa
mesh_terms: D002648:Child; D064420:Drug-Related Side Effects and Adverse Reactions / Q000517:prevention & control; D006801:Humans; D015337:Multicenter Studies as Topic / Q000941:ethics*; D010372:Pediatrics / Q000941:ethics*; D012107:Research Design