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1 EXPEDITED OR FULL BOARD REVIEW APPLICATION Review Categories EXPEDITED REVIEW: Mid‐level reviews for research activities that present minimal risk to the human subjects. Note, however, that qualifying as one of the listed procedures does NOT automatically qualify as being “minimal risk,” and you may therefore need to undergo a more in‐depth review. Projects using subjects from “vulnerable populations” usually do not qualify for Expedited Review. Additional caveats are discussed in the CITI training, and in 45 CFR 46.100, 21 CFR 56.110, and related materials. The list of activities eligible for Expedited Review follows. Activity 1: Clinical studies of drugs and/or medical devices for which no new FDA application, approval, and/or clearance is required. Examples: Research on drugs for which an investigational new drug application (21 CFR Part 312) is not required. NOTE: Research on marketed drugs that significantly increases the risks or decreases the acceptability of the risks associated with the use of the product is not eligible for expedited review. Research on medical devices for which (i) an investigational device exemption application (21 CFR Part 812) is not required; or (ii) the medical device cleared/approved for marketing and the medical device is being used in accordance with its cleared/approved labeling. Activity 2: Collection of blood samples by finger stick, heel stick, ear stick or venipuncture, provided the activity meets the CFR‐specified criteria for subject health, frequency of collection, and amount of blood collected in a given time frame as follows: from healthy, non‐pregnant adults who weigh at least 110 pounds. For these participants, the amounts drawn may not exceed 550 ml in an 8 week period and collection may not occur more frequently than 2 times per week; or from other adults and children considering the age, weight, and health of the participants, the collection procedure, the amount of blood to be collected, and the frequency with which it will be collected. For these participants, the amount drawn may not exceed the lesser of 50 ml or 3 ml per kg in an 8‐week period and collection may not occur more frequently than 2 times per week. Activity 3: Prospective collection of biological specimens for research by non‐invasive means. Examples: Hair and nail clippings in a non‐disfiguring manner; deciduous teeth at time of exfoliation or if routine patient care indicates a need for extraction; permanent teeth if routine patient care indicates a need for extraction; excreta and external secretions; uncannulated saliva collected either in an unstimulated fashion or stimulated by chewing gumbase or wax or by applying a dilute citric solution to the tongue; placenta removal at delivery; amniotic fluid obtained at the time of rupture of the membrane before or during labor; supragingival and subgingival dental plaque and calculus, provided the collection procedure is not more invasive than routine
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EXPEDITED OR FULL BOARD REVIEW APPLICATION

Review Categories

EXPEDITED REVIEW: Mid‐level reviews for research activities that present minimal risk to the human subjects. Note, however, that qualifying as one of the listed procedures does NOT automatically qualify as being “minimal risk,” and you may therefore need to undergo a more in‐depth review. Projects using subjects from “vulnerable populations” usually do not qualify for Expedited Review. Additional caveats are discussed in the CITI training, and in 45 CFR 46.100, 21 CFR 56.110, and related materials. The list of activities eligible for Expedited Review follows. 

Activity 1: Clinical studies of drugs and/or medical devices for which no new FDA application, approval, and/or clearance is required. Examples:  

Research on drugs for which an investigational new drug application (21 CFR Part 312) is not

required.

NOTE: Research on marketed drugs that significantly increases the risks or decreases the 

acceptability of the risks associated with the use of the product is not eligible for expedited 

review. 

Research on medical devices for which (i) an investigational device exemption application (21

CFR Part 812) is not required; or (ii) the medical device cleared/approved for marketing and

the medical device is being used in accordance with its cleared/approved labeling.

Activity 2: Collection of blood samples by finger stick, heel stick, ear stick or venipuncture, provided the activity meets the CFR‐specified criteria for subject health, frequency of collection, and amount of blood collected in a given time frame as follows: 

• from healthy, non‐pregnant adults who weigh at least 110 pounds.  For these participants, the

amounts drawn may not exceed 550 ml in an 8 week period and collection may not occur more

frequently than 2 times per week; or

• from other adults and children considering the age, weight, and health of the participants, the

collection procedure, the amount of blood to be collected, and the frequency with which it will

be collected.  For these participants, the amount drawn may not exceed the lesser of 50 ml or 3

ml per kg in an 8‐week period and collection may not occur more frequently than 2 times per

week.

Activity 3: Prospective collection of biological specimens for research by non‐invasive means. Examples: 

Hair and nail clippings in a non‐disfiguring manner; deciduous teeth at time of exfoliation or if

routine patient care indicates a need for extraction; permanent teeth if routine patient care

indicates a need for extraction; excreta and external secretions; uncannulated saliva collected

either in an unstimulated fashion or stimulated by chewing gumbase or wax or by applying a

dilute citric solution to the tongue; placenta removal at delivery; amniotic fluid obtained at the

time of rupture of the membrane before or during labor; supragingival and subgingival dental

plaque and calculus, provided the collection procedure is not more invasive than routine

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prophylactic scaling of the teeth and the process is accomplished in accordance with accepted 

prophylactic techniques; muscosal and skin cells collected by buccal scraping or swab, skin swab, 

or mouth washings; and sputum collected after saline mist nebulization 

Activity 4: Collection of routine clinical data through non‐invasive procedures typically employed in clinical practice.  

NOTE: Procedures involving x‐rays or microwaves are excluded from eligibility for 

Expedited Review.  

Examples: physical sensors that are applied either to the surface of the body or at a distance and

do not involve input of significant amounts of energy into the subject or an invasion of the

subject’s privacy; weighing or testing sensory acuity; magnetic resonance imaging;

electrocardiography, electroencephalograph, thermography, detection of naturally occurring

radioactivity, electroretinoraphy, ultrasound, diagnostic infrared imaging, Doppler blood flow,

and echocardiography; moderate exercise muscular strength testing, body composition

assessment, and flexibility testing where appropriate given the age, weight, and health of the

individual.

Activity 5: Research involving existing materials that were originally collected solely for non‐research purposes (e.g., medical treatment or diagnosis). 

NOTE: Some research in this category may be exempt from the HHS regulations for the 

protection of human participants.  45 CFR 46.101(b)(4).  This listing refers only to 

research that is not exempt. 

Activity 6: Collection of data from voice, video, digital or image recordings. 

Activity 7: Research on individual or group characteristics or behavior.  

Examples: research on perception, cognition, motivation, identity, language, communication,

cultural beliefs or practices, and social behavior or research employing survey, interview, oral

history, focus group, program evaluation, human factors evaluation, or quality assurance

methodologies.

NOTE: Some research in this category may be exempt from the HHS regulations for the 

protection of human participants.  45 CFR 46.101(b)(2) and (b)(3).  This listing refers only 

to research that is not exempt. 

Activity 8: Review of “Renewal” applications for research previously approved by the HSC, provided:  

the research is permanently closed to the enrollment of new subjects, all research interventions

have been completed, and the only research activity remaining is long‐term follow‐up;

no new subjects have been enrolled and no additional risks identified; or

the remaining activities are limited to research analysis.

Activity 9: Continuing review of research, which not conducted under an investigational new drug application or investigational device exemption where categories two (2) through eight (8) do not apply but the IRB has determined and documented at a convened meeting that the research involves no greater than minimal risk and no additional risks have been identified. 

FULL BOARD REVIEW: Any research or training project involving the use of human participants, which does not fall into an exempt or expedited review category, must be submitted for full board IRB review.  Research involving more than minimal risk requires full board review. 

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Population Screening Questions

Answer Key 

Population Screening Questions Answer Required Yes No

Will the research include minors (under age 18)? 

Will the research include prisoners?  

Will the research include populations vulnerable to coercion or undue influence?  

Will the research include cognitively impaired individuals?  

Will the research include individuals who are legally blind or physically cannot talk or write?  

Will the research include economically disadvantaged individuals?  

Will the research include educationally disadvantaged individuals? 

Will the research include individuals with AIDS/HIV? 

Does the research include individuals who are terminally ill? 

NOTE: The questions above represent a list of commonly defined ‘Vulnerable Populations.’ The Federal Regulations does not present an exhaustive list of vulnerable populations, but rather vulnerability is based upon ability to consent, risk and reward in the study, potential for coercion, and choice of subjects. 

Did you answer ‘Yes’ to any of the ‘Population Screening Questions’?  Yes  No 

If you answered YES to any of the Population Screening Questions, your application does not qualify for expedited review; it must be a full board review.  

What type of review are you seeking? Answer Required Expedited Review 

Full Board Review 

If you answered YES to any of the Population Screening Questions, your application does not qualify for expedited review; your

application must be a full board review. 

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SECTION A: General Information

OVERVIEW Answer Required 

1. Title of Protocol:

2. Anticipated Start Date: Anticipated End Date: 

INVESTIGATORS Answer Required 

3. Principal Investigator (PI) (Please refer to the Human Subjects policy on PI Roles & Responsibilities.

Graduate Students PI’s must have a Faculty member/Administrator as a Co‐PI. Undergraduate Students

cannot be PI’s.)

Name:

Status:

Telephone:

Institutional Email:

Department:

CITI Training Number:        CITI Training required prior to application submission.

CITI Training Completed:    Social & Behavioral Research    Biomedical Research

Roles and responsibilities in this study:

4. Co‐Investigator(s)

Name:

Status:

Telephone:

Institutional Email:

Department:

CITI Training Number: CITI Training required prior to application submission. 

CITI Training Completed: Social & Behavioral Research    Biomedical Research 

Roles and responsibilities in this study:

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Name: 

Status: 

Telephone: 

Institutional Email: 

Department: 

CITI Training Number:    CITI Training required prior to application submission. 

CITI Training Completed:  Social & Behavioral Research    Biomedical Research 

Roles and responsibilities in this study: 

Name: 

Status: 

Telephone: 

Institutional Email: 

Department: 

CITI Training Number:    CITI Training required prior to application submission. 

CITI Training Completed:  Social & Behavioral Research    Biomedical Research 

Roles and responsibilities in this study: 

5. Is this proposal supported in whole or in part by a grant or contract? Answer Required

No 

Yes 

Sponsors Name: 

PI on Grant: 

Grant Title/Contract: 

Project Period:  From  to 

Office of Sponsored Programs Proposal Number:  

Grant Project Summary Attached 

6. Has this protocol previously been considered by Colorado Mesa University IRB? Answer Required

No 

Yes 

IRB Number: 

Date Approved:  

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SECTION B: Research Details

OVERVIEW 7. Provide a summary of the purpose of your project.  Include information about the background and

rationale for the study and goal(s) of the proposed study.  Use language understood by a person

unfamiliar with this area of research.  Specific jargon should be avoided or explicitly explained.

Answer Required

8. What is your research question? State your hypothesis. Answer Required

9. What will you do with the results of your study (e.g. contributing to generalizable knowledge, publishing,

sharing at conference, etc.)?  If this project is only for internal evaluation or to complete a class

assignment, IRB may not be required.  Please contact the Office of Sponsored Programs for additional

information. Answer Required

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PARTICIPANT POPULATION 10. Provide a description of the participant population.  Describe the characteristics applicable to your

research, such as gender, age ranges, ethnic background and health status.

11. Will your research involve vulnerable populations, such as children or adolescents under the age of 18,

pregnant women, prisoners or cognitively, economically, or educationally impaired participants?

(Vulnerability is based upon ability to consent, risk and reward in the study, potential for coercion, and

choice of subjects.) Answer Required

No 

Yes: If yes, describe additional safeguards planned to protect the rights and welfare of this 

population(s). 

12. Will you be recruiting students from a class that you teach? Answer Required

No 

Yes: If yes, explain why this population is necessary to the study, and how you will ensure 

participants do not feel coerced to participate.  Coercion is a significant concern. 

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13. Will you be recruiting employees who report to you? Answer Required 

No 

Yes: If yes, explain why this population is necessary to the study, and how you will ensure 

participants do not feel coerced to participate.  Coercion is a significant concern. 

           

 

 

 

 

14. Indicate any exclusion criteria for participants.  

 

 

 

 

 

 

15. Approximately how many participants are needed to complete your study and what is your rationale for 

your sample size? 

           

 

 

 

 

 

RECRUITMENT 16. Describe the recruitment process.  Include how, where, when and who will contact potential research 

participants. 

           

 

 

 

 

 

 

 

 

 

 

 

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17. Attach all applicable recruitment materials. (Check all that apply.)

Recruitment Scripts 

Letter/Cover Letter 

Flyers   

Advertisements 

Recruitment Emails 

Other:    

18. Are you directly emailing or mailing participants?

No 

Yes: If yes, how are you obtaining emails and/or mailing addresses? 

METHODS OF DATA COLLECTION 19. Attach copies of all data collection tools to be used. (Check all that apply.)

Questionnaire/Survey   

Interviews (attach questions, interview script) 

Observations 

Focus Groups 

Reviewing Medical / Education Records 

Videotaping 

Photographing 

Audiotaping 

Using Direct Quotes 

Deception 

Other:      

20. List all biomedical procedures that apply to your research (e.g., Physical activity, Body Mass Index,

Collection of blood samples, X‐rays, Anthropomorphic evaluations, etc.):

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21. If applicable, describe the procedure being performed already for diagnostic or treatment purpose.

22. Where will the study take place? (i.e., explain where you are distributing surveys, conducting interviews,

etc.) Answer Required

23. Does your study include plans to recruit participants from or collect data at an external site? (i.e., off

Colorado Mesa University campus. For example, an elementary school, hospital, etc.) Answer Required

No 

Yes: If YES, indicate the external site(s) and you must attach an acknowledgement (letter or 

email) indicating you have permission to use their facility and personnel.   

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24. Provide a description of the research methods for data collection that will be employed. For example,

what are participants going to do?  Provide a step‐by‐step description of each procedure, including the

frequency and duration of each procedure. If analyzing existing data, describe steps taken to obtain and

analyze data.  Answer Required

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INFORMED CONSENT 25. Are you requesting an alteration or waiver to any informed consent requirements, including

documentation of informed consent (signed consent)? Answer Required

No: If NO, skip to question 26. 

Yes: If YES, complete the section below.  

INDICATE THE TYPE OF WAIVER YOU ARE REQUESTING 

I am requesting to waive the required documentation of informed consent (i.e. waive 

obtaining the signature for anonymous internet‐based survey, telephone survey, 

mailed survey, etc.). Check the box next to the condition that best fits your research 

study.  

Condition 1: The consent form is the only record linking the subject to the 

research, and the principal risk would be potential harm resulting from a breach 

of confidentiality. Each participant will be given the choice whether or not to 

sign, OR 

Condition 2: The research present no more than minimal risk and involves no 

procedures where written consent is normally required outside of the research 

context.  

Provide a justification based on the selected condition above. 

I am requesting to waive or alter the required elements of the informed consent 

process. 

Explain why the research involves no more than minimal risk to the participants.  

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Explain why the waiver / alteration will not adversely affect the rights and 

welfare of subjects.  

 

 

 

 

 

 

Explain why the research could not practicably be carried out without the 

waiver / alteration.  

 

 

 

 

 

 

If applicable, explain how additional information will be provided to subjects.  

 

 

 

 

  

26. Describe the consent process.  Describe how, when and where the informed consent process will take 

place and who will obtain informed consent. (Do not answer, “See attached consent form,” as this does 

not describe the process of obtaining informed consent.)   

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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27. If the participants are not able to give legal consent (e.g., minors), explain how parent / guardian assent 

will be secured.   

 

           

 

 

 

 

28. The consent document must contain all required elements of consent.  Please refer to the IRB policy on 

Informed Consent Options, Processes and Documentation. (Check all that apply.)  

  Which of the following will you use to present the consent process?  Please attach the following: 

Not applicable (existing data or specimens) 

Debriefing script 

Informed consent – oral script, online, unsigned  

Informed consent – form 

Assent (Participants under 18) – form  

Assent (Participants under 18) – oral script, online, unsigned 

Parental permission – form 

Parental permission – oral script, online, unsigned 

Translated consent/assent – form(s), script(s), etc. 

Other – Please explain:   

 

 

29. Into what languages will these documents be translated?  (A copy of the English and translated consent 

documents must be submitted for IRB review.) 

 

 

30. If your research involves collecting a combination of demographic data (e.g., a combination of gender, 

age, race, and ethnicity) that may make a participant identifiable, you must inform the participants the 

following:  

“For this research project, the researchers are requesting demographic information.  

Due to the make‐up of certain populations, the combined answers to these questions 

may make an individual person identifiable.  The researchers will make every effort to 

protect your confidentiality.  However, if you are uncomfortable answering any of these 

questions, you may leave them blank.”  

If applicable, indicate where and how participants will be informed of this. 

 

 

 

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PRIVACY Privacy refers to persons during data collection.  It is the control over the extent, timing, and 

circumstances of sharing oneself (physically, behaviorally, or intellectually) with others (e.g., 

surveys are completed in the privacy of their own home; interviews will be done in a location of 

their choosing where it is unlikely they will be overheard). 

31. Describe the provisions to protect the privacy of the participants during the data collection procedures.

CONFIDENTIALITY Confidentiality refers to how DATA is handled after collection.  It is the treatment of information 

already revealed and states that there is an expectation that it will not be divulged to others in 

ways that are inconsistent with the understanding of the original disclosure without permission 

(e.g., data is secured on a password‐protected computer or locked file cabinet, data is de‐

identified or coded, only the researchers have access to the data). 

32. Indicate how the investigator will receive and record the research data.  Research related records must

be retained for at least three years after the research has been completed (per federal regulations).

(Check all that apply.)

Identifiable data not collected. 

Identifiable data will be received and recorded by investigators. 

Coded data received and investigators will not have access to a code key. 

Coded data received and investigators will have access to a code key. 

Other – Please explain:   

33. Provide details as to how you plan to protect the data while on site and during travel. (e.g., from data

collection site back to data storage site). Answer Required

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34. Describe how you will maintain the data once it has been collected, including measures to protect the 

identity of the participants (if applicable) and their responses. Answer Required 

 

 

 

 

 

 

 

           

      

 

35. Where will you store the data? Answer Required  

 

 

           

 

36. Who will have access to the data? Answer Required 

 

 

 

 

37. In what format will the data be stored (e.g., paper, electronic, etc.)? Answer Required 

           

 

 

 

RISKS 38. Describe all known anticipated psychological, physical, sociological, financial, and economic risk to 

participants (e.g., loss of confidentiality, emotional stress or discomfort, physical injury or discomfort, 

etc.). Answer Required 

 

 

 

 

 

 

 

 

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39. Describe how you will minimize these risks and their impact to the participant. Answer Required

40. Describe your plan for an emergency situation. Answer Required

BENEFITS 41. Describe the potential benefits of this research to participants (if any) as well as the potential broader

benefits to society. Answer Required

INCENTIVES 42. Will participants receive compensation or other incentives (e.g., gift certificates, extra credit, etc.) to

participate in the research study? Answer Required

No 

Yes: If YES, describe the incentive, including the amount and timing of payment.  If offering extra 

credit, an equal alternative must be provided. 

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SECTION C: Reminder Checklist

1. Have you completed the correct protocol form for your research project (i.e., Exempt, Expedited or

Full Review)?

Yes   No  

2. Have you reviewed the protocol form to ensure that it is properly and accurately completed?

Yes   No  

3. Have you attached all of the required documents (e.g., consent, script, survey, etc.)?

Yes  No 

4. Have all Investigators completed the required CITI training?

Yes  No 

SECTION D: Investigator Assurance and Acknowledgement

PRINCIPAL INVESTIGATOR

1. As Principal Investigator, I understand the proposed study cannot begin until the Colorado Mesa

University IRB has provided a letter of approval. Answer Required

Yes    No 

2. As Principal Investigator, I understand that only I can submit the protocol application and its

associated documents. Answer Required

Yes  No 

3. The protocol form and all supporting documents have been proofed for typos and grammatical errors.

Answer Required

Yes  No 

I certify that the information I provided in the Request for IRB Review is correct and complete. I also 

pledge that I will not change any of the procedures, forms, or protocols used in this study without first 

seeking review and approval from the Institutional Review Board. Answer Required 

_________________________________________  ___________________ 

Name / Signature of Principal Investigator  Date 

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CO-INVESTIGATOR(S) I certify that the information I provided in the Request for IRB Review is correct and complete. I also 

pledge that I will not change any of the procedures, forms, or protocols used in this study without first 

seeking review and approval from the Institutional Review Board. 

_________________________________________  ___________________ 

Name / Signature of Co‐Investigator  Date 

_________________________________________  ___________________ 

Name / Signature of Co‐Investigator  Date 

_________________________________________  ___________________ 

Name / Signature of Co‐Investigator  Date 

OFFICIAL OFFICE USE ONLY 

Date Received:          Notes: 

Protocol Number: 

Reviewer:  

Date Reviewed:   

Revised: June 2019   

All fields marked as ‘Answer Required’ must be completed before you can submit a protocol to the Colorado Mesa University IRB. 


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