Faculty Collaboration Database

Conducting research using the emergency exception from informed consent: the Public Access Defibrillation (PAD) Trial experience. Resuscitation 2004 Apr;61(1):29-36

Date

04/15/2004

Pubmed ID

15081178

DOI

10.1016/j.resuscitation.2003.11.016

Scopus ID

2-s2.0-11144355628 (requires institutional sign-in at Scopus site)   84 Citations

Abstract

BACKGROUND: The Public Access Defibrillation (PAD) Trial, a prospective, multicenter, randomized clinical trial comparing two prehospital resuscitation strategies, was conducted under the regulations for exception from informed consent (21CFR50.24) in 24 communities in North America. These regulations place additional requirements for human subject protection on investigators and Institutional Review Boards (IRBs), including conducting community consultation (CC) and public disclosure (PD).

OBJECTIVE: To describe the IRB approval process at study sites and the number and types of community consultation and public disclosure activities conducted.

METHODS: The 24 study sites in the United States and Canada submitted IRB applications, CC and PD plans, and a structured report on IRB process and investigator perceptions to the Clinical Trial Center at the University of Washington.

RESULTS: The primary IRBs for all 24 trial sites and a total of 101 IRBs approved the study. The median interval from submission to approval was 108 days (IQR 43-196), and the mean number of revisions was two (range 0-7). Investigators conducted nearly 12,000 activities to achieve CC and PD; activities varied greatly from site to site in both type and quantity.

CONCLUSION: The length of time to obtain IRB approval and the extent of community consultation and public disclosure varied greatly among trial sites in meeting the current regulations for conducting emergency research with exception from informed consent. This suggests that more specific guidance may be useful and that determination of effective strategies for community consultation and public disclosure is needed.

Author List

Mosesso VN Jr, Brown LH, Greene HL, Schmidt TA, Aufderheide TP, Sayre MR, Stephens SW, Travers A, Craven RA, Weisfeldt ML, PAD Trial Investigators

Author

Tom P. Aufderheide MD Professor in the Emergency Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Cardiopulmonary Resuscitation
Community-Institutional Relations
Disclosure
Electric Countershock
Emergencies
Emergency Medical Services
Ethics Committees, Research
Health Services Accessibility
Heart Arrest
Humans
Informed Consent
Referral and Consultation
Research
Resuscitation