title: Central institutional review board review for an academic trial network.
abstract: OBJECTIVE
  Translating discoveries into therapeutics is often delayed by lengthy start-up periods for multicenter clinical trials. One cause of delay can be multiple institutional review board (IRB) reviews of the same protocol.
  
  
  METHODS
  When developing the Network for Excellence in Neuroscience Clinical Trials (NeuroNEXT; hereafter, NN), the National Institute of Neurological Disorders and Stroke (NINDS) established a central IRB (CIRB) based at Massachusetts General Hospital, the academic medical center that received the NN clinical coordinating center grant. The 25 NN sites, located at U.S. academic institutions, agreed to required CIRB use for NN trials.
  
  
  RESULTS
  To delineate roles and establish legal relationships between the NN sites and the CIRB, the CIRB executed reliance agreements with the sites and their affiliates that hold federalwide assurance for the protection of human subjects (FWA); this took, on average, 84 days. The first NN protocol reviewed by the CIRB achieved full approval to allow participant enrollment within 56 days and went from grant award to the first patient visit in less than four months. The authors describe anticipated challenges related to institutional oversight responsibilities versus regulatory CIRB review as well as unanticipated challenges related to working with complex organizations that include multiple FWA-holding affiliates.
  
  
  CONCLUSIONS
  The authors anticipate that CIRB use will decrease NN trial start-up time and thus promote efficient trial implementation. They plan to collect data on timelines and costs associated with CIRB use. The NINDS plans to promote CIRB use in future initiatives.
authors.affiliation: Dr. Kaufmann is director, Division of Clinical Innovation, National Center for Advancing Translational Sciences, and former director, Office of Clinical Research, National Institute for Neurological Disorders and Stroke, Bethesda, Maryland. Dr. O'Rourke is director, Human Research Affairs, and director, Partners Human Embryonic Stem Cell Research Oversight, Partners HealthCare, Boston, Massachusetts.
authors.forename: Petra
authors.initials: P
authors.lastname: Kaufmann
authors.forename: P Pearl
authors.initials: PP
authors.lastname: O'Rourke
mesh_terms: D000046:Academic Medical Centers; D035843:Biomedical Research / Q000458:organization & administration*; D002986:Clinical Trials as Topic; D028744:Ethics Committees, Research / Q000458:organization & administration*; D006801:Humans; D017146:Models, Organizational; D014481:United States