• Resuscitation · Feb 2019

    Randomized Controlled Trial Multicenter Study

    Variations in the application of exception from informed consent in a multicenter clinical trial.

    • Jestin N Carlson, Dana Zive, Denise Griffiths, Karen N Brown, Robert H Schmicker, Heather Herren, George Sopko, Sara DiFiore, Dixie Climer, Caroline Herdeman, Ahamed Idris, Graham Nichol, and Henry E Wang.
    • Department of Emergency Medicine, University of Pittsburgh, Pittsburgh, PA; Department of Emergency Medicine, Allegheny Health Network, Pittsburgh, PA. Electronic address: jcarlson@svhs.org.
    • Resuscitation. 2019 Feb 1; 135: 151-5.

    BackgroundException from infor med consent (EFIC) is allowed using federal regulations 21 CFR 50.24 and facilitates research on patients with critical conditions such as cardiac arrest. Little is known regarding the differences in the application of EFIC requirements such as community consultation (CC), public disclosure (PD) and patient notification. We sought to characterize variations in the fulfillment of EFIC requirements in a national multicenter clinical trial in the United States.MethodsWe determined the strategies for fulfillment of EFIC requirements at five regional coordinating centers of the Pragmatic Airway Resuscitation Trial (PART), a cluster-crossover randomized trial comparing airway devices in out-of-hospital cardiac arrest. We collected information from the including site demographics, how CC and PD were implemented, methods undertaken by the site investigative team to meet the local IRB's interpretation, and patient notification timing (post-enrollment). We analyzed the data using descriptive statistics.ResultsSites had multiple approaches to CC, including social media advertising, random digit dialing surveys, working with city officials, and websites with embedded surveys. All sites used more than one approach for conducting CC. Public Disclosure activities included press releases through various means, website documentation, and letters to community members and local officials. Time from CC to study approval ranged from 42 days to 253 days.ConclusionEFIC implementation varies across sites and highlight community and regional variation. Different EFIC approaches may be needed to effectively accomplish the goals of community consultation, public disclosure, and patient notification.Copyright © 2018 Elsevier B.V. All rights reserved.

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