title: [Role of Institutional Review Boards for multi-centre studies in national health services research - a cross-sectional study of the effort to obtain secondary ethical approvals for the DACAPO study].
abstract: BACKGROUND
  Health services research (HSR) is of fundamental importance for the continuous improvement of preventive, diagnostic or therapeutic measures. The conduct of multi-centre HSR studies requires that ethical approval by Institutional review boards (IRB's) is obtained. We documented the effort, the complexity and the man power necessary to obtain secondary ethical approval for a national HSR in Germany ("Surviving the Acute Respiratory Distress Syndrome" [DACAPO-study]).
  
  
  METHODS
  Having obtained a primary ethical approval by the IRB of Regensburg University, the time, correspondence, necessity for amendments, corrections, or additional costs by 34 IRB's for 64 participating study centers was documented.
  
  
  RESULTS
  The complete obtainment was found to be time consuming and associated with a high workload and man power. A time span of seven month was needed to receive votes from all IRB's. The median time span was 25,5 days (25 %/75 % percentile 13 and 42 days, respectively). Requirements in terms of corrections or amendments were inhomogeneous and frequent changes were necessary. There were additional fees for secondary votes of 4328,40 €. Total costs for the study center Regensburg were 21.193,40 € (2,6 % of the grant volume).
  
  
  CONCLUSIONS
  Obtaining all ethical approvals for a multi-centre observational HSR study in Germany is complex and time consuming. Various and inhomogeneous formalities may delay the plan and realization of HSR. A Homogenization and simplification of the procedure of ethics votes should be discussed.
authors.affiliation: Klinik für Anästhesiologie, Universitätsklinikum Regensburg.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Blecha
authors.affiliation: Klinik für Anästhesiologie, Universitätsklinikum Regensburg.
authors.forename: Kathrin
authors.initials: K
authors.lastname: Thomann-Hackner
authors.affiliation: Medizinische Soziologie, Institut für Epidemiologie und Präventivmedizin, Universität Regensburg.
authors.forename: Susanne
authors.initials: S
authors.lastname: Brandstetter
authors.affiliation: Medizinische Soziologie, Institut für Epidemiologie und Präventivmedizin, Universität Regensburg.
authors.forename: Frank
authors.initials: F
authors.lastname: Dodoo-Schittko
authors.affiliation: Medizinische Soziologie, Institut für Epidemiologie und Präventivmedizin, Universität Regensburg.
authors.forename: Philipp
authors.initials: P
authors.lastname: Seboek
authors.affiliation: Medizinische Soziologie, Institut für Epidemiologie und Präventivmedizin, Universität Regensburg.
authors.forename: Christian
authors.initials: C
authors.lastname: Apfelbacher
authors.affiliation: Klinik für Anästhesiologie, Universitätsklinikum Regensburg.
authors.forename: Bernhard M
authors.initials: BM
authors.lastname: Graf
authors.affiliation: Klinik für Anästhesiologie, Universitätsklinikum Regensburg.
authors.forename: Thomas
authors.initials: T
authors.lastname: Bein
mesh_terms: D003430:Cross-Sectional Studies; D028744:Ethics Committees, Research / Q000191:economics / Q000941:ethics / Q000592:standards; D005858:Germany; D006302:Health Services Research / Q000191:economics / Q000941:ethics; D006801:Humans; D015337:Multicenter Studies as Topic / Q000191:economics / Q000941:ethics; D009313:National Health Programs