What Can One University Do?

A few weeks ago, a correspondent asked me what reforms individual universities can implement while awaiting systemic, regulatory reform. It's an excellent question, so here's a roundup from material previously covered on the blog.

No university has adopted all of these measures, and at least one of these measures has not been adopted by any. But most of them are in place already, and there's no reason they can't spread.

Dingwall Links Ethics Review to University "Command and Control"

Robert Dingwall argues that ethics regulation is just one part of a corporate model that threatens innovative research in universities.

[Dingwall, Robert. “How Did We Ever Get into This Mess? The Rise of Ethical Regulation in the Social Sciences.” Studies in Qualitative Methodology 12 (2012): 3–26. doi:10.1108/S1042-3192(2012)0000012004.]

U of Michigan Reports Some Progress

The University of Michigan has released the results of a 2009 survey of investigator experiences in human research. The survey suggests that matters have improved somewhat since the university launched its HRPP Policy Innovation and Demonstration Initiative in 2007, but that more work remains to be done.

[Survey Research Center, Institute for Social Research, University of Michigan, "2009 Follow-Up Survey of Investigator Experiences in Human Research," December 2010. h/t: Human Research Protections Blog.]

Ohio State Restricts LGBTQ Research, Ponders Reforms

Two Ohio State University professors, James Sanders and Christine Ballengee-Morris, complain about IRBs' impacts on research and teaching in their fields and report on efforts at reform.

[James H. Sanders III and Christine Ballengee-Morris, "Troubling the IRB: Institutional Review Boards' Impact on Art Educators Conducting Social Science Research Involving Human Subjects," Studies in Art Education: A Journal of Issues and Research in Art Education 49 (2008): 311-327. Yes, it's two years old, but I just found out about it recently.]

Many of the complaints are familiar enough. The authors--one in arts policy, the other in art education--lament biomedical models, delays in approvals, and "lengthy boiler-plate consent forms." Yet the article advances the conversation about IRBs in two interesting ways.

First, the article highlights the difficulty of getting IRB approval to study lesbian, gay, bisexual, transgender, and queer self-identified youth. The authors would like to know "how LGBTQ students experience the World Wide Web, art and culture, and their self-image, or how they establish resilient behaviors." But, they find, "Conservative IRB interpretations of federal regulations requiring parental consent of all human subjects under 18, may have failed to protect the rights and welfare of LGBTQ adolescent research participants, and further dissuade researchers from studying all but (safe) consenting adult heterosexual subjects."

Second, the article describes reform efforts at Ohio State. Advised by colleagues to "be intentionally vague . . . speak in generalities, or simply not tell what we were actually doing," the authors did consider "lying to a repressive and controlling body that claims to care about human subjects' protections and then denies autonomy or voice to those living with repression." Instead, they joined 160 faculty members to petition their Office of Research to reconsider its policies.

The result was the issuance in 2007 of the Report of the IRB Working Group for Research in the Social and Behavioral Sciences." That report offers a number of constructive suggestions. For example,

• Relaxing the requirement that all changes to a protocol be reported to the IRB, even if they "have absolutely no material impact on a human subject's participation in a study."
  
• Accepting that interviewers cannot foresee in advance all the topics they may raise in a conversation.
  
• Informing investigators about their right to appeal decisions to the IRB chair, the full board, or the institutional official.
  
• Listing approved protocols, so researchers do not have to reinvent the wheel when submitting their own projects.
  

The 2007 report ends with a strong call for IRB policy to be shaped by the faculty. It specifically recommends the active participation of the University Research Committee, which is comprised mostly of regular facutly:

It is also important that there be continuing transparency and communication of IRB policy and procedure development among the faculty, the Office of Research, the IRB Policy Committee, and ORRP [Office of Responsible Research Practices]. To ensure that such consideration and implementation occurs, we recommend that an ad-hoc subcommittee of the University Research Committee be appointed for this purpose. This subcommittee should receive regular reports from the IRB Policy Committee regarding the development of new policies related to the Working Group's recommendations and suggestions, and from the ORRP staff regarding progress in staffing, website development, and electronic submission procedures.

In the longer term, it is important for the University Research Committee to participate actively in the human subject protection program at Ohio State, and to assess and suggest additional improvements to the operations of ORRP and the IRB. We strongly encourage the University Research Committee to set up a means to do so.

As of their writing, however, Sanders and Ballengee-Morris had yet to see improvement:

In short, one is required to think through every possible contingency and clearly communicate how such contingencies would be addressed. While the process itself strengthens the research design, the unreasonableness of some alternative scenarios posed by those unfamiliar with the researchers' field of study have been stifling. In response, many students and colleagues have chosen to change methods or abandon their research problems, rather than be subjected to this arduous, frustrating, and at times, humiliating process.

Texas's All-Star IRB Report

In February 2008, the University of Texas System formed an IRB Task Force to examine ways to improve IRB operations throughout the UT System. In April 2009, that task force issued its report: "IRB TASK FORCE REPORT: Trust, Integrity, and Responsibility in the Conduct of Human Subjects Research."

I recently obtained a copy of that report. While it has not previously been posted on the web, a University of Texas official assured me that a final policy report like this is public information under Texas law. So to make this important public document freely available, I have posted a copy on my website. (See link above.)

The report offers an exceptionally thorough and thoughtful consideration of how IRBs should work at great research universities. While some of its recommendations may be inapplicable to univerisities that are not part of larger systems or do not operate a medical campus, many of the task force's procedures and recommendations offer a model for others. I salute all those who were involved in the report's preparation.

In particular, I commend the following elements of the UT task force and its report.

Procedures

The UT system carefully set up the task force in a way that would build respect for its findings. In particular, it managed to:

1. Represent Multiple Disciplines

UT included task force members "representing a variety of academic disciplines," among them SACRHP member Lisa Leiden. (3, 24) It also sought help from a range of consultants, including such "national experts" Tina Gunsalus; John Heldens, Moira Keene, Dan Nelson, Ivor Pritchard, and Marjorie Speers. (8)

2. Include Stakeholders

At each UT campus, the task force solicited comments from university officials, IRB chairs, investigators, and other interested parties. (8)

3. Allow Adequate Time

The UT task force completed its deliberations over the course of a year, from February 2008 to February 2009, then released its report in April 2009. A report with so broad a scope cannot be rushed.

Recommendations

Careful investigation led to thoughtful recommendations. The report suggests that the UT system:

1. Employ Faculty Expertise

The UT report recognizes that researchers are often expert in a particular area of human subjects research, and it recommends that faculty experts be identified to prepare standards for specific types of research (e.g., research involving subjects with impaired capacity, internet research) and to consult on individual projects as needed. (10)

2. Utilize Flexibility and Empirical Evidence

The report recommends that the university encourage IRB staff to provide "an efficient level of regulatory review compatible with adequate protection of human subjects," rather than the most stringent level of review. In particular, it suggests that IRB staff and members employ empirical evidence when determining risk, by consulting experts or scholarly literature. (11) The report also suggests that IRBs rely strongly on experts when determining the scientific soundness of a proposal. (14)

3. Uncheck the Box

The UT report notes that, according to Speers, fewer than 50 percent of AAHRP accredited institutions check all the box on their federal-wide assurances, and that it is "primarily the major research universities that are considering unchecking the box," thus maximizing their flexibility in handling projects not directly funded by a Common Rule agency. (12) (More on this in an upcoming post.)

4. Diversify the IRB

The UT report recommends that "Institutional Officials should ensure that the institution's disciplines are well represented in the IRB." (18)

5. Provide IRB Oversight

The UT report recommends that institutions "consider the implementation of a research ombudsperson to increase the opportunity for rapid resolution of issues involving human subjects research." (21) It also suggests an ongoing "IRB Advisory Group" to implement recommendations and assist with human subject policy issues. (23)

6. Define Key Terms

The UT Report includes definitions of key terms. Among other things, these definitions make clear that information-gathering interviews, service surveys, and classroom activities may not meet the definition of human subjects research, and that biography and oral history interviews do not meet that definition. (27) As I mentioned earlier, this recommendation has already led to the deregulation of oral history at the University of Texas at Austin.

7. Explore Alternatives

The report include an appendix on "alternative IRB models," based on the November 2006 "National Conference on Alternative IRB Models." While it is promising that the task force is willing to consider such alternatives, I would have liked it to pick up on that conference's call for "further exploration" of models for social and behavioral research. The University of Pennsylvania policy on research in the sociobehavioral sciences might be such a model.

Goal

Most importantly, the UT task force understood the IRB problem as something larger than an administrative challenge. While it explored ways to increase IRB "effectiveness, efficiency, and productivity," it went beyond such managerial concerns to probe big questions about "IRB authority, mission, and functions," the "unnecessary obstruction of research and lapses of effective human subject protection," and best practices from the available literature. (8)

The task force hoped to foster a "culture of conscience" rather than a "culture of compliance," and it understood that conscience cannot be dictated from above. (20) If other universities also seek to promote a culture of conscience, they must give a voice to all those involved with human subjects research.

Brown Pledges IRB Reform

The Brown Daily Herald reports "a series of reforms" at Brown University, intended to "streamline Institutional Review Board procedures." (Sydney Ember, "Reform in the Works for Research Review Board," 13 November 2009.)

The process started in 2007, when Brown faculty complained that IRB operations were inhibiting research, especially by undergraduates. Brown's Research Advisory Board convened a four-person, ad hoc subcommittee to investigate. That subcommittee released a draft report, "Undergraduate Research in the Social Sciences and the Institutional Review Board at Brown" in January 2009.

The January 2009 Report

The draft report found:

Many faculty members from the social sciences report some aspect of the IRB to be or to have been a burden, and a significant fraction feel that IRB practices are having or have had some dampening effect on the quality or availability of undergraduate research opportunities. There is the widely held belief that many social science projects typically consisting of interviews or surveys, have a low intrinsic risk. Most faculty members, however, do recognize the existence of some risk, depending on the nature of the activity, and the need for some type of oversight. Many faculty members believe that the formal and rigidly structured IRB process is not an optimal way to oversee and regulate undergraduate work, due to variable levels of organization, knowledge, and professionalism among the undergraduates, and the special time constraints associated with the undergraduate senior year.

The subcommittee offered three policy options:

A. "Brown adopts IRB review as the standard procedure for undergraduate theses and non-classroom projects dealing with human subjects."

B. "Continue the current system, but clarify several points and communicate the policy more explicitly to avoid faculty and student confusion."

C. "Adopt and communicate a policy in which non-federally-funded undergraduate work is not subject to IRB review, but rather to some other educational and oversight system tailored for undergraduates, to be defined."

It recommended Option B "as the best near-term solution," while keeping C open as a longer-term option.

Brown's Faculty Executive Committee (FEC) received the draft report at its January 2009 meeting. According to the minutes of that meeting, "The FEC was disappointed that the report did not address some of the larger issues. It appears that the definition of research is getting broader so that the IRB has their hand in every aspect of research." As far as I can tell, the report has still not been finalized.

Changes Since January 2009

According to the Daily Herald story, the university's Research Protections Office (RPO) claims that it has implemented many of the recommendations in the report, primarily by updating its website. Since many of the pages on that website are undated, it's hard to know how many have been changed since the release of the draft report in January.

Some of the report's recommendations do seem to have been implemented. For example, the report called for the prominent placement of the information that faculty advisors get to decide whether an undergraduate project needs IRB review. That information is now indeed prominently displayed.

In contrast, the report specifically objected to the assertion that "obvious examples of dissemination [and therefore generalizability] are publication in a scholarly journal, presentation at a professional conference, or placement of a report in a library." It recommended the deletion of the references to conferences and libraries, but as of today, they remain on the RPO website. Given that this was one of the most concrete, immediate proposals of the subcommittee, I suggest that the Daily Herald may have been premature in its announcement of reform.

Erroneous Assertions

Not mentioned in the faculty report are three significant misstatements about federal regulations in the RPO's document, Frequently Asked Questions.

1. "Federal Regulations are clear that it is not up to the investigator alone to determine if a project is exempt."

Federal regulations specify no such thing, as recently reiterated by OHRP.

2. "In certain situations, all involving no more than minimal risk, the IRB can waive the requirement that you obtain the participant's signature on the consent form."

In fact, 45 CFR 46.117(c)(1) also allows IRBs to waive the signature requirement when "the only record linking the subject and the research would be the consent document and the principal risk would be potential harm resulting from a breach of confidentiality." This is true even when the risk is greater than minimal.

3. "As long as your research involves collecting data or information from or about living individuals, you need to have it reviewed by the IRB."

This would put reading a newspaper under the jurisdiction the IRB. Brown's RPO doesn't really believe this, but it hasn't been careful with its explanations.

Unfinished Business

It's great that a Brown faculty committee has taken a look at IRB operations, and that the administration has made some changes in response. But the report indeed failed to address some of the big issues at stake, and the administration has failed to implement some of the minor reforms suggested ten months ago. This case suggests the difficulty of restoring the principle of faculty governance when it comes to social science research.