title: [Local approval procedures act as a brake on RCTs].
abstract: Large multicentre randomised controlled trials (RCTs) in the Netherlands are increasingly being impeded by major differences between local approval procedures. However, no national agenda exists as yet to improve this situation. The existence of major local differences in processing time and documentation required has been reported previously but little is known about the costs incurred and whether or not specific certifications and research contracts are mandatory. The current study evaluated these aspects of local procedures for obtaining approval of two oncological multicentre RCTs.
  
  
  
  Retrospective, descriptive.
  
  
  
  All local procedures for obtaining approval of two randomised clinical trials were evaluated: the CAIRO5 and CHARISMA trials initiated by the Dutch Colorectal Cancer Group (DCCG). We objectified time between approval by the Medical Ethics Review Committee (METC) and final approval by the Board of Directors (RvB), the type and number of documents needed, and costs charged.
  
  
  
  The median time interval between the approval by the Medical Ethics Review Committee and the approval by the Board of Directors was 90 days (range 4-312). The number of documents required per centre ranged from 6-20. The costs charged ranged from € 0-€ 1750, and amounted to € 8575 for all procedures combined. No costs were charged by the majority of the centres.
  
  
  
  The approval procedures for multicentre clinical trials in the Netherlands demonstrate major differences. Processing times, documentation required and costs are unpredictable; greater uniformity is highly desirable in this context.
authors.affiliation: Erasmus MC Kankerinstituut, afd. Chirurgische Oncologie, Rotterdam.
authors.forename: E P
authors.initials: EP
authors.lastname: van der Stok
authors.forename: J
authors.initials: J
authors.lastname: Huiskens
authors.forename: B
authors.initials: B
authors.lastname: Hemmes
authors.forename: D J
authors.initials: DJ
authors.lastname: Grünhagen
authors.forename: T M
authors.initials: TM
authors.lastname: van Gulik
authors.forename: C
authors.initials: C
authors.lastname: Verhoef
authors.forename: C J A
authors.initials: CJ
authors.lastname: Punt
mesh_terms: D026724:Ethical Review; D028744:Ethics Committees, Research; D006801:Humans; D009426:Netherlands; D016032:Randomized Controlled Trials as Topic / Q000191:economics; D012189:Retrospective Studies