Dean of the Faculty

IRB Policies, Procedures, and Review Guidelines

 
This Web site provides the College’s policies, procedures and review guidelines on research involving human subjects as well as the forms necessary for obtaining approval from Amherst’s Institutional Review Board (IRB).

If you are conducting a research project using human subjects, you will need to obtain approval of the IRB prior to collecting data. The purpose of this policy is to provide a single, comprehensive standard of protection for human subjects of research conducted by students, staff, faculty, or visiting researchers at Amherst College. The intent is to assure that investigators do not unduly put at risk or harm humans who are the subjects of research, and that the subjects of such research are aware of their rights as defined in Title 45, part 46 of the Code of Federal Regulations. IRB approval must precede commencement of any work involving human subjects.

Amherst College Policies

Amherst College is committed to safeguarding the welfare, rights, and privacy of all persons who participate as subjects in research projects conducted under its auspices, and to ensuring that the subjects of such research are aware of their rights and the protections available to them. These safeguards derive from the following ethical principles, which were first articulated in the Belmont Report issued by the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research in 1979: 

Respect for Persons: Recognition of the personal dignity and autonomy of individuals and special protection of those persons with diminished autonomy or particular vulnerabilities, including prisoners, children, those who are mentally or cognitively disabled, pregnant women, or economically or educationally disadvantaged persons. Human subjects should enter into research voluntarily and with adequate information about the research project and the potential consequences of participation in the study. 

Beneficence: The obligation to protect persons from harm by maximizing anticipated benefits and minimizing possible risks. Possible risks to human subjects should be weighed against possible benefits to the subjects, as well as against the possible improvement of knowledge. 

Justice: Fairness in the distribution of research benefits and burdens. In selecting human subjects for research, investigators should ensure that no group of participants is either consistently selected to participate in research, or consistently deprived of the opportunity to do so. 

The procedures for review adhere to the regulations of the Department of Health and Human Services, 45 CFR 46, as amended and published in the Federal Register on June 18, 1991. In addition, the IRB has repeatedly consulted Protecting Human Subjects: Institutional Review Guidebook (1993) – prepared by the Office for Human Research Protections (OHRP) of the National Institutes of Health – which you can view or download via http://www.hhs.gov/ohrp/irb/irb_preface.htm. Last but not least, Amherst College’s IRB would like to acknowledge assistance received from colleagues at the Office for Human Research Protections, Bryn Mawr College, Middlebury College, University of Massachusetts at Amherst, University of Southern California, and Wellesley College.

See the research misconduct policy for federally funded research here.

The Institutional Review Board 

The  IRB is the body charged with reviewing, prior to its commencement, all research, whether funded or not, involving human subjects conducted under the auspices of Amherst College by its faculty members, students, or staff, as well as research by outside investigators using Amherst College students, personnel, or facilities.

Research is defined in the Code of Federal Regulations (CFR) as “systematic investigation, including research development, testing, and evaluation, designed to develop or contribute to generalized knowledge” (45 CFR 46.102d). Research subject to review thus includes, but is not limited to, pilot studies; class projects aimed for publication; master’s theses; Ph.D. dissertations; co-supervised work; independent research; and senior theses, whether such research takes place on or off the Amherst College campus, including work done outside of the United States. 

Members of the IRB are appointed by Amherst College’s Committee of Six and should represent a wide range of academic disciplines. The College’s Dean of the Faculty appoints the chair of the committee. An investigator can be a member of the IRB, however, the investigator-as-member cannot participate in the review and approval process for any project in which he or she has a present or potential conflict of interest.  Where the investigator-member has a conflicting interest, he or she is present only to provide information requested by the IRB. You can view the criteria for IRB membership – as stipulated in 45 CFR 46.107 – via http://www.hhs.gov/ohrp/humansubjects/guidance/45cfr46.htm#46.107

Please visit the Dean of the Faculty's Committee page to view the Human Subjects Committee current voting and alternate members of the College’s IRB.

Amherst College’s IRB is registered with, and has an approved Federal Wide Assurance (FWA00012514) from the Office for Human Research Protections.

The IRB Review Process (Overview)

Application. Faculty members, staff members, or students who are planning research projects involving human subjects are responsible for beginning the review process by submitting the Request for Approval of Human Subjects Research forms to Deb Bishop in the Office of the Dean of the Faculty (see Submitting a Request for Approval for Human Subjects Research section below). After processing the proposal, she will forward it to the Initial Reviewer, a member of the IRB who has been designated by the IRB to oversee initial reviews at the College.

Review. The Initial Reviewer assigns the proposal to one of three categories: Level I: Exempt (no foreseeable risk), Level II: Expedited Review (minimal risk), and Level III: Full Board Review (more than minimal risk and protected subjects). If the Initial Reviewer wishes to submit his or her own proposal to the IRB, it is sent to the Expedited Reviewer.  If the Expedited Reviewer submits his or her own proposal to the IRB, it is not eligible for expedited review.

It is expected that most research projects may well fall into the Exempt category. Research in this category requires no further review beyond the initial review level. Those proposals the Initial Reviewer decides require Expedited Review will be forwarded to the Expedited Reviewer, a member of the IRB who has been designated by the committee’s chair to conduct expedited reviews. Proposals judged by the Initial Reviewer to require Full review will be forwarded to the chair of the IRB committee, and the IRB as a whole will perform the review. All research proposals evaluated by the Initial Reviewer, the Expedited Reviewer, or the full IRB committee are done so with regard to the degree of “risk,” if any, to human subjects.

If a research proposal is determined by the Initial Reviewer to involve minimal risk (defined in Expedited Review Part A.4), he or she will send the proposal to the Expedited Reviewer for Expedited Review. The proposed research must involve no more than minimal risk, and the involvement of human subjects must fall under one or more of the categories specified under Expedited Review. Full Committee Review is required when the procedures of the research present more than minimal risk to the subject and/or fall into one or more of the categories specified under Full Committee Review. 

Outcomes. There are four possible outcomes to a review:

Approved: No further action is required from the investigator prior to initiating the study.

Approved if Designated Changes are Made: The investigator may initiate the study after requested changes are made, and the IRB receives these revisions and notifies the investigator that he or she may proceed. 

Revise and Resubmit: More extensive changes are required before the study may begin. Additional information must be submitted to the IRB prior to approval.

Denied: The proposed research, because of the level of risk involved, cannot be initiated. 

Expiration and Renewal. Research approved by the IRB that is continuing must be re-reviewed on an annual basis by the IRB. The Initial Reviewer will determine whether a Full or Expedited Review is required for re-review.

Categories of Review

All research, including that which the investigator believes falls into the Exempt category, must be submitted to the Initial Reviewer for confirmation of the relevant review category. The criteria used to determine the categories of review are described below.

Please note that according to OHRP, oral history projects are excluded from IRB review.  However, the treatment of participants in oral history projects must conform to the standards of the Oral History Association and/or other professional organizations in the field. 

●  Exempt

Part A (all items must apply)

1. The research does not involve as subjects prisoners, fetuses, pregnant women, the seriously ill, or mentally or cognitively compromised adults.

2. The research does not involve the collection or recording of behavior which, if known outside the research, could reasonably place subjects at risk of criminal or civil liability or be damaging to the subject’s financial standing, employability, or reputation.

 3. The research does not involve the collection of information regarding sensitive aspects of subjects’ behavior (e.g., drug or alcohol use, illegal conduct, sexual behavior).

4. The research does not involve subjects under the age of 18 (except as they are participating in projects that fall under categories 1, 3, 4, and/or 5 in Part B). Category B 2 studies that include minors should be submitted for expedited review.

5. The research does not involve deception.

6. The procedures of this research are generally free of foreseeable risk to the subject.

7. The research does not require a waiver from informed consent procedures. 

Part B (at least one item should apply)

1. Research conducted in established or commonly accepted educational settings and involving normal educational practices (e.g., research on regular and special education instructional strategies, research on instructional techniques, curricula, or classroom management methods).

2. Research involving the use of educational tests (cognitive, diagnostic, aptitude, achievement), survey procedures, interview procedures or observation of public behavior, where information is recorded anonymously (i.e., so that the human subject cannot be identified, directly or indirectly through identifiers linked to the subject). All survey/interview/observational research in which elected or appointed public officials or candidates for public office serve as subjects is Exempt, whether or not data collection is anonymous.

3. Research involving the collection or study of existing data, documents, records, pathological specimens, or diagnostic specimens. These sources must be either publicly available or the information must be recorded anonymously (i.e., in such a manner that subjects cannot be identified, directly or through identifiers linked to the subject).

4. Research (including demonstration projects) conducted by or subject to the approval of federal department or agency heads, and designed to study, evaluate, or otherwise examine (i) public benefit or service programs (e.g., social security, welfare, etc.); (ii) procedures for obtaining benefits or services under those programs; (iii) possible changes in or alternatives to those programs or procedures; or (iv) possible changes in methods or levels of payment for benefits or services under those programs.

5. Research involving taste or food quality evaluations or consumer acceptance studies, where the tested products are wholesome foods without additives, or foods which contain additives at or below levels found to be safe by the FDA or approved by the EPA of the Food Safety and Inspection Service of the U.S. Department of Agriculture.

●  Expedited Review

Part A (all items must apply) 

1. The research does not involve as subjects prisoners, fetuses, pregnant women, the seriously ill, or mentally or cognitively compromised adults.

2. The research does not involve the collection or recording of behavior which, if known outside the research, could reasonably place the subjects at risk of criminal or civil liability or be damaging to the subject’s financial standing, employability, or reputation.

3. The research does not involve the collection of information regarding sensitive aspects of the subjects’ behavior (e.g., drug or alcohol use, illegal conduct, sexual behavior).

4. The procedures of this research present no more than minimal risk to the subject. (Minimal risk means that the probability and magnitude of harm or discomfort anticipated in the proposed research are not greater than those ordinarily encountered in daily life or during the performance of routine physical or psychological examinations or tests.) 

Part B (at least one item should apply) 

1. Research involving existing identifiable data, documents, records, or biological specimens (including pathological or diagnostic specimens), where these materials, in their entirety, have been collected prior to the research for a purpose other than the proposed research. These sources are not publicly available and, although confidentiality will be strictly maintained, information will not be recorded anonymously (e.g., use will be made of audio or-videotapes, names will be recorded, even if they are not directly associated with the data).

2. Collection of data through use of the following procedures: a) non-invasive procedures routinely employed in clinical practice and not involving exposure to electromagnetic exposure to electromagnetic radiation outside the visible range (i.e., not involving x-rays, microwaves, etc); b) 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; c) weighing, testing sensory acuity, electrocardiography, electroencephalography, thermography, detection of naturally occurring radioactivity, electroretinography, echography, sonography, ultrasound, magnetic resonance imaging (MRI), diagnostic infrared imaging, doppler blood flow, and echocardiography; d) moderate exercise, muscular strength testing, body composition assessment, and flexibility testing involving healthy subjects.

3. Collection of data from voice, video, or image recordings made for research purposes where identification of the subjects and/or their responses would not reasonably place them at risk of criminal or civil liability or be damaging to the subjects’ financial standing, employability, or reputation.

4. Research on individual or group characteristics or behavior (including but not limited to research involving perception, cognition, surveys, interviews, and focus groups) as follows:

a) Involving adults, where (i) the research does not involve stress to subjects, and (ii) identification of the subjects and/or their responses would not reasonably place them at risk of criminal or civil liability or be damaging to the subjects’ financial standing, employability, or reputation;

b) Involving children, where (i) the research involves neither stress to subjects nor sensitive information about themselves, or their family; (ii) no alteration or waiver of regulatory requirements for parental permission has been proposed; and (iii) identification of the subjects and/or their responses would not reasonably place them or their family members at risk of criminal or civil liability or be damaging to the financial standing, employability, or reputation of themselves or their family members.

5. Research involving the use of educational tests (cognitive, diagnostic, aptitude, achievement), survey procedures, interview procedures, or observation of public behavior. Although confidentiality will be strictly maintained, information will not be recorded anonymously (e.g., use will be made of audio or videotapes, names will be recorded, even if they are not directly associated with the data).

6. Research that involves deception. Deception must be scientifically justified and de-briefing procedures must be outlined in detail.

7. Prospective collection for research purposes of biological specimens; research on drugs or devices for which an investigational new drug exemption or an investigational device exemption is not required; collection of blood samples by finger stick or venipuncture.

8. Research previously approved by the convened IRB as follows: (a) where (i) the research is permanently closed to the enrollment of new subjects; (ii) all subjects have completed all research-related interventions; and (iii) the research remains active only for long-term follow-up of subjects; or (b) where the research remains active only for the purposes of data analysis; or (c) where the IRB has determined that the research involves no greater than minimal risk and no additional risks have been identified; (d) where no subjects have been enrolled and no additional risks have been identified.

●  Full Committee Review

If ANY of these apply:

1. The research involves prisoners, fetuses, pregnant women, the seriously ill, or mentally or cognitively compromised adults as subjects. 

2. The research involves the collection or recording of behavior which, if known outside the research, could reasonably place the subjects at risk of criminal or civil liability or be damaging to the subjects’ financial standing, employability, or reputation.

3. The research involves the collection of information regarding sensitive aspects of the subjects’ behavior (e.g., drug or alcohol use, illegal conduct, sexual behavior).

4. The procedures of the research involve more than minimal risk to the subject (where more than minimal risk means that the probability and magnitude of harm or discomfort anticipated in the proposed research is greater than that ordinarily encountered in daily life or during the performance of routine physical or psychological examinations or tests).

5. Any research which does not fall into any of the categories explicitly identified as qualifying for Exempt or Expedited status. 

6. Any research being proposed by investigators outside Amherst College.

Components of Informed Consent

Subjects must have sufficient information to make an informed decision to participate in the research study. If subjects cannot give informed consent, it must be obtained from their legal representatives. For example, when subjects are minors (under eighteen) or when they are mentally incapacitated, legal representatives are required.  Consent requests should be either clearly written or orally conveyed in a manner understandable to subjects, using language that is non-technical.  Scientific, technical, or medical terms should be plainly defined.

Assent

Children (those under 18) should be given an explanation - at a level appropriate to the child's age, maturity, experience, and condition - of the procedures to be used, their meaning to the child in terms of discomfort and inconvenience, and the general purpose of the research. Children should be asked if they wish to participate in the research or not. Mere failure to object on the part of the child should not, in the absence of affirmative agreement, be construed as assent. In the proposal, the investigator should indicate: 1) how assent will be obtained (what the investigator will say to the child and whether or not the child's parent(s) or guardian(s) will be present); 2) how assent will be documented. The child may either sign a very brief assent form or verbally indicate a willingness to participate.

Circumstances in Which a Written Consent Form May Not Be Required

In all research involving human beings, respondents must be made aware of the nature and purpose of the research, of the voluntary character of their participation, of the benefits and Risks – if any – they may incur as a result of participation, and of the ways in which their privacy will be protected. The method by which informed consent is obtained, however, differs according to the type of research in question. In many cases, the use of informed consent forms, signed by respondents, is the best means of obtaining consent. This is particularly true in biomedical or clinical research, or in social scientific research that utilizes similar formats. However, this method may be impossible to utilize in some types of social-scientific and humanistic investigations, especially in research of the “participant-observation” type involving the researcher’s immersion in the everyday life of a community. In research of this sort, knowledge is typically gained through the give and take of ordinary conversation, often casual and in unstructured situations, and by observing activities and interactions in their living context. In such cases, the Institutional Review Board may authorize oral informed consent—by which is meant consent obtained orally without the use of written forms—under the following conditions: 1) that the research involves no more than minimal risk to respondents, 2) that the substitution of an oral format will not harm respondents, 3) that the research could not be carried out without the substitution, and that 4) where appropriate, respondents will be provided additional information after their participation. Oral consent will also be allowed in research requiring the used of telephone interviews, provided that the aforementioned conditions obtain. In addition, oral consent will be authorized in cases in which a breach of confidentiality might be dangerous to respondents and the consent form is the only the only link between the respondent and the research. However, whether consent documents are used or not, researchers have an obligation to ensure that respondents understand the purpose and nature of the research.

Some research requires the use of mailed or emailed questionnaires. In such cases, a mailed or emailed response will itself be regarded as evidence of informed consent, provided that the questionnaire clearly explains the purpose and nature of the research.

Submitting a Request for Approval for Human Subjects Research

Submit one signed copy of your Request for Approval for Human Subjects Research to Deb Bishop in the Dean of the Faculty’s office and submit an electronic, PDF version to djbishop@amherstedu . This includes the following:

  • Description of Project and Procedures
  • Acknowledgment of Ethical Concerns for Student Researchers or Participant Observers
  • Consent Form
  • Completion-of-training certificate

College Records

The College keeps records of all original human subjects research, including request forms, IRB decisions, and copies of any research documents (informed consent forms, questionnaires, interview scripts, stress protocols, behavioral manipulation protocols, drug protocols, non-FDA device protocols, debriefing forms, etc.). The Description of Project and Procedures Form is signed by the researcher and co-signed by a faculty sponsor if the PI is a student. The aforementioned documentation constitutes the full College records of any project approved by the committee.

Review Outcomes

For proposals reviewed by the IRB, a letter will be sent to the investigator by the IRB chair, indicating one of four possible outcomes:

  1. Approved: A protocol that has been approved by the IRB requires no further action from the investigator prior to initiating the study. If the study should extend beyond twelve months, the investigator should send a letter to the IRB chair, informing her/him of the current status of the project, any changes in the protocol, and whether any adverse events have occurred.
  2. Approved if Designated Changes are Made: A protocol that has been approved by the IRB on the condition that designated changes are made by the investigator and given to the IRB prior to initiating the study. If the study should extend beyond twelve months, the investigator should send a letter to the IRB chair, informing her/him of the current status of the project, any changes in the protocol, and whether any adverse events have occurred.
  3. Revise and Resubmit: A protocol that has been deferred by the IRB usually requires that additional information be submitted to the IRB prior to approval. A revised application should be submitted to the IRB clarifying the issues involved or providing the requested documentation. The IRB will review the revised application at its next meeting.
  4. Denial: A protocol that has been denied approval by the IRB cannot be initiated by the investigator. The reasons for the denial are provided in writing. The investigator will be given the opportunity to respond either in writing or in person at the next meeting of the IRB.

Appeals

In the event that an application is denied because the Institutional Review Board feels the risks outweigh the benefits of the research, and the investigator disagrees with the committee’s disapproval decision, the researcher may appeal the decision by re-submitting the same application form and: 1) a letter of appeal presenting the researcher’s arguments for approval; and 2) any other pertinent information in support of the appeal. The letter should be directed to the Chair of the Institutional Review Board and mailed with enclosures to Deb Bishop, Office of the Dean of the Faculty, Converse Hall. Applications submitted for appeal will be considered by the full IRB at the next scheduled meeting date. The final decision of the IRB will be stated in writing to the investigator. If the proposal is not approved, the research cannot be conducted.

Progress and Incident Reporting

Approval of a human subject research proposal is good for one year, unless the project has acceptable but potential risk in which case approval is given for a six-month period. If the project will continue beyond the approval period, principal investigators are required to resubmit documents for review prior to the expiration date of the initial approval. These documents should include a status report of the project to date including:

  • The number of subjects accrued.
  • Summary of adverse events and any unanticipated problems involving risks to subjects or others and withdrawal of subjects from the research or complaints about the research since the last review;
  • Summary of any relevant amendments or modifications to the research since the last review;
  • Other relevant information, especially information about risks associated with the research; and
  • Copy of the current informed consent document and any newly proposed consent document.

In the initial approval letter, principal investigators are asked to promptly report any unanticipated problems or adverse effects of the research to the Institutional Review Board.

The IRB must be notified if adverse events occur and what actions the investigator has taken to respond.

Data collection involving human subjects that extends beyond one year must be re-reviewed, and re-approval granted, by the Initial Reviewer if the status of the research is exempt, or by the IRB if the status of the research is Expedited or requires Full IRB review.

Changes in the procedures of collecting data from human subjects must be re-reviewed and approved by the Initial Reviewer and/or the IRB.

Research Conducted Outside of the United States

Research conducted outside of the United Sates by Amherst faculty members, students, or staff must be reviewed in accordance with Amherst College IRB review procedures. Such research must also conform to the standards for research involving human subjects of the host country. Collaboration with colleagues at a local institution in the host country often provides a good method for ensuring compliance with host country law and human subject conventions in research.

Outside Investigators Wishing to Use Amherst College Students as Subjects

Outside investigators who wish to use Amherst College students as subjects must send a formal request and a proposal to the Dean of the Faculty.  The Dean will consult with the relevant department(s).  If the request is approved by the Dean and the department, the investigator should download the Request for Approval of Human Subjects Research forms, fill them out, sign them, and email a PDF of the forms to Deb Bishop in the Dean of the Faculty’s office. The materials will be forwarded to the IRB for a Full Review.

Research Conducted at Off-Campus Sites with Their Own Human Subjects Committees

If some portion of the research is conducted at another institution, that institution must also review and approve the research protocol. The Amherst College IRB will normally request some evidence of review and agreement from the host institution. If the host institution does not have a Human Subjects Review Committee, a letter on institutional letterhead signed by an official of the host institution agreeing to permit access to the study population will be required.

Training

Amherst requires all IRB members, designated reviewers, and principal investigators (faculty members and students) to complete human subjects training. It is also important for investigators who receive external funding to always check the awarding agency’s training requirements.

A copy of the certification of completion from one of the following three online training modules must be submitted to the IRB. For either online option, (option A, B, or C), individuals register online, complete the module, and print a certification of completion. The training is free of charge when only the certificate of completion is requested.

Option A

The Office for Human Research Protections (OHRP) of the U. S. Department of Health and Human Services provides free online Human Subject Assurance Training at http://ohrp-ed.od.nih.gov/CBTs/Assurance/login.asp

Specifically, three training modules are offered at the OHRP site: (1) HHS Regulations and Institutional Responsibilities; (2) Investigator Responsibilities and Informed Consent; and (3) Human Research Protections Program. Though all are recommended, only Module 2 (Investigator Responsibilities and Informed Consent) is required.

Option B

The National Institutes of Health free training module on Human Participant Protections Education for Research Teams is available online at http://cme.cancer.gov/clinicaltrials/learning/humanparticipant-protections.asp.

Option C

The Collaborative Institutional Training Initiative (CITI) course in the Responsible Conduct of Research (RCR). The course is located at: https://www.citiprogram.org

Useful Web Links

The Belmont Report
http://www.hhs.gov/ohrp/humansubjects/guidance/belmont.htm

Declaration of Helsinki
http://www.wma.net/e/policy/b3.htm

Nuremberg Code
http://ohsr.od.nih.gov/guidelines/nuremberg.html

Office for Human Research Protections, U.S. Dept. of Health and Human Services
http://www.hhs.gov/ohrp/

Office of Research Integrity, U.S. Dept. of Health and Human Services
http://ori.dhhs.gov/international/websites/index.shtml

Protection of Human Subjects, Federal Guidelines
http://www.hhs.gov/ohrp/humansubjects/guidance/45cfr46.htm

President’s Council on Bioethics
http://www.bioethics.gov/

Information on Ethnographic Research (University of Pennsylvania)
http://www.sas.upenn.edu/anthro/CPIA/methods.html

Jesse’s Intent
http://www.primr.org/uploadedFiles/PRIMR_Site_Home/Resource_Center/Useful_Links/Jesse_s_Intent.pdf

Links to Disciplinary Professional Organizations’ Statements of Ethics

American Anthropological Association
http://www.aaanet.org/committees/ethics/ethcode.htm

American Political Science Association
http://www.apsanet.org/

American Psychological Association
http://www.apa.org/ethics/homepage.html

American Sociological Association
http://www.asanet.org/

American Statistical Association
http://www.amstat.org/about/ethicalguidelines.cfm

Association of American Geographers
http://www.aag.org/Publications/EthicsStatement.html

Association of Internet Researchers
http://www.aoir.org/reports/ethics.pdf

Society for Applied Anthropology
http://www.sfaa.net/sfaaethic.html

Society for Neuroscience
http://www.sfn.org/index.cfm?pagename=home

Society for Research in Child Development
http://www.srcd.org/about.html#standards

Tuskegee University National Center for Bioethics
http://www.tuskegee.edu/Global/category.asp?C=35026

GLOSSARY OF TERMS
(Source: IRB Guidebook)
http://www.hhs.gov/ohrp/irb/irb_glossary.htm

ABUSE-LIABLE:  Pharmacological substances that have the potential for creating abusive dependency. Abuse-liable substances can include both illicit drugs (e.g., heroine) and licit drugs (e.g., methamphetamines).

ADAMHA: Alcohol, Drug Abuse, and Mental Health Administration; reorganized in October 1992 as the Substance Abuse and Mental Health Services Administration (SAMHSA). ADAMHA included the National Institute of Mental Health (NIMH), the National Institute on Alcohol Abuse and Alcoholism (NIAAA), the National Institute on Drug Abuse (NIDA), the Office for Substance Abuse Prevention (OSAP), and the Office for Treatment Intervention (OTI). NIMH, NIAAA, and NIDA are now part of the National Institutes of Health (NIH). (See also: SAMHSA.)

ADJUVANT THERAPY: Therapy provided to enhance the effect of a primary therapy; auxiliary therapy.

ADVERSE EFFECT: An undesirable and unintended, although not necessarily unexpected, result of therapy or other intervention (e.g., headache following spinal tap or intestinal bleeding associated with aspirin therapy).

ASSENT: Agreement by an individual not competent to give legally valid informed consent (e.g., a child or cognitively impaired person) to participate in research.

ASSURANCE: A formal written, binding commitment that is submitted to a federal agency in which an institution promises to comply with applicable regulations governing research with human subjects and stipulates the procedures through which compliance will be achieved [45 CFR 46.103].

AUTHORIZED INSTITUTIONAL OFFICIAL: An officer of an institution with the authority to speak for and legally commit the institution to adherence to the requirements of the federal regulations regarding the involvement of human subjects in biomedical and behavioral research.

AUTONOMY: Personal capacity to consider alternatives, make choices, and act without undue influence or interference of others.

AUTOPSY: Examination by dissection of the body of an individual to determine cause of death and other medically relevant facts.

BELMONT REPORT: A statement of basic ethical principles governing research involving human subjects issued by the National Commission for the Protection of Human Subjects in 1978.

BENEFICENCE: An ethical principle discussed in the Belmont Report that entails an obligation to protect persons from harm. The principle of beneficence can be expressed in two general rules: (1) do not harm; and (2) protect from harm by maximizing possible benefits and minimizing possible risks of harm.

BENEFIT: A valued or desired outcome; an advantage.

BIOLOGIC: Any therapeutic serum, toxin, anti-toxin, or analogous microbial product applicable to the prevention, treatment, or cure of diseases or injuries.

BLIND STUDY DESIGNS: See: Masked Study Designs; Double-Masked Design; and Single-Masked Design.

CADAVER: The body of a deceased person.

CASE-CONTROL STUDY: A study comparing persons with a given condition or disease (the cases) and persons without the condition or disease (the controls) with respect to antecedent factors. (See also: Retrospective Studies.)

CAT SCAN: Abbreviation for Computerized Axial Tomography, an X-ray technique for producing images of internal bodily structures through the assistance of a computer.

CHILDREN: Persons who have not attained the legal age for consent to treatment or procedures involved in the research, as determined under the applicable law of the jurisdiction in which the research will be conducted [45 CFR 46.401(a)].

CDC: Centers for Disease Control and Prevention; an agency within the Public Health Service, Department of Health and Human Services.

CLASS I, II, III DEVICES: Classification by the Food and Drug Administration of medical devices according to potential risks or hazards.

CLINICAL TRIAL: A controlled study involving human subjects, designed to evaluate prospectively the safety and effectiveness of new drugs or devices or of behavioral interventions.

COGNITIVELY IMPAIRED: Having either a psychiatric disorder (e.g., psychosis, neurosis, personality or behavior disorders, or dementia) or a developmental disorder (e.g., mental retardation) that affects cognitive or emotional functions to the extent that capacity for judgment and reasoning is significantly diminished. Others, including persons under the influence of or dependent on drugs or alcohol, those suffering from degenerative diseases affecting the brain, terminally ill patients, and persons with severely disabling physical handicaps, may also be compromised in their ability to make decisions in their best interests.

COHORT: A group of subjects initially identified as having one or more characteristics in common who are followed over time. In social science research, this term may refer to any group of persons who are born at about the same time and share common historical or cultural experiences.

COMPENSATION: Payment or medical care provided to subjects injured in research; does not refer to payment (remuneration) for participation in research. (Compare: Remuneration.)

COMPETENCE: Technically, a legal term, used to denote capacity to act on one's own behalf; the ability to understand information presented, to appreciate the consequences of acting (or not acting) on that information, and to make a choice. (See also: Incompetence, Incapacity.)

CONFIDENTIALITY: Pertains to the treatment of information that an individual has disclosed in a relationship of trust and with the expectation that it will not be divulged to others without permission in ways that are inconsistent with the understanding of the original disclosure.

CONSENT: See: Informed Consent.

CONTRACT: An agreement; as used here, an agreement that a specific research activity will be performed at the request, and under the direction, of the agency providing the funds. Research performed under contract is more closely controlled by the agency than research performed under a grant. (Compare: Grant.)

CONTROL (SUBJECTS) or CONTROLS: Subject(s) used for comparison who are not given a treatment under study or who do not have a given condition, background, or risk factor that is the object of study. Control conditions may be concurrent (occurring more or less simultaneously with the condition under study) or historical (preceding the condition under study). When the present condition of subjects is compared with their own condition on a prior regimen or treatment, the study is considered historically controlled.

CONTRAINDICATED: Disadvantageous, perhaps dangerous; a treatment that should not be used in certain individuals or conditions due to risks (e.g., a drug may be contraindicated for pregnant women and persons with high blood pressure).

CORRELATION COEFFICIENT: A statistical index of the degree of relationship between two variables. Values of correlation coefficients range from -1.00 through zero to +1.00. A correlation coefficient of 0.00 indicates no relationship between the variables. Correlations approaching -1.00 or +1.00 indicate strong relationships between the variables. However, causal inferences about the relationship between two variables can never be made on the basis of correlation coefficients, no matter how strong a relationship is indicated.

CROSS-OVER DESIGN: A type of clinical trial in which each subject experiences, at different times, both the experimental and control therapy. For example, half of the subjects might be randomly assigned first to the control group and then to the experimental intervention, while the other half would have the sequence reversed.

DATA AND SAFETY MONITORING BOARD: A committee of scientists, physicians, statisticians, and others that collects and analyzes data during the course of a clinical trial to monitor for adverse effects and other trends (such as an indication that one treatment is significantly better than another, particularly when one arm of the trial involves a placebo control) that would warrant modification or termination of the trial or notification of subjects about new information that might affect their willingness to continue in the trial.

DEAD FETUS: An expelled or delivered fetus that exhibits no heartbeat, spontaneous respiratory activity, spontaneous movement of voluntary muscles, or pulsation of the umbilical cord (if still attached) [45 CFR 46.203(f)]. Generally, some organs, tissues, and cells (referred to collectively as fetal tissue) remain alive for varying periods of time after the total organism is dead.

DEBRIEFING: Giving subjects previously undisclosed information about the research project following completion of their participation in research. (Note that this usage, which occurs within the behavioral sciences, departs from standard English, in which debriefing is obtaining rather than imparting information.)

DECLARATION OF HELSINKI: A code of ethics for clinical research approved by the World Medical Association in 1964 and widely adopted by medical associations in various countries. It was revised in 1975 and 1989.

DEPENDENT VARIABLES: The outcomes that are measured in an experiment. Dependent variables are expected to change as a result of an experimental manipulation of the independent variable(s).

DESCRIPTIVE STUDY: Any study that is not truly experimental (e.g., quasi-experimental studies, correlational studies, record reviews, case histories, and observational studies).

DEVICE (MEDICAL): See: Medical Device.

DHEW: A federal agency: U.S. Department of Health, Education and Welfare; reorganized in 1980 as the Department of Health and Human Services (DHHS) and the Department of Education.

DHHS: A federal agency: U.S. Department of Health and Human Services; formerly the Department of Health, Education and Welfare (DHEW).

DIAGNOSTIC (PROCEDURE): Tests used to identify a disorder or disease in a living person.

DOUBLE-MASKED DESIGN: A study design in which neither the investigators nor the subjects know the treatment group assignments of individual subjects. Sometimes referred to as "double-blind."

DRUG: Any chemical compound that may be used on or administered to humans as an aid in the diagnosis, treatment, cure, mitigation, or prevention of disease or other abnormal conditions.

EMANCIPATED MINOR: A legal status conferred upon persons who have not yet attained the age of legal competency as defined by state law (for such purposes as consenting to medical care), but who are entitled to treatment as if they had by virtue of assuming adult responsibilities such as being self-supporting and not living at home, marriage, or procreation. (See also: Mature Minor.)

EMBRYO: Early stages of a developing organism, broadly used to refer to stages immediately following fertilization of an egg through implantation and very early pregnancy (i.e., from conception to the eighth week of pregnancy). (See also: Fetus.)

EPIDEMIOLOGY: A scientific discipline that studies the factors determining the causes, frequency, and distribution of diseases in a community or given population.

EQUITABLE: Fair or just; used in the context of selection of subjects to indicate that the benefits and burdens of research are fairly distributed [45 CFR 46.111(a)(3)].

ETHICS ADVISORY BOARD: An interdisciplinary group that advises the Secretary, HHS, on general policy matters and on research proposals (or classes of proposals) that pose ethical problems.

ETHNOGRAPHIC RESEARCH: Ethnography is the study of people and their culture. Ethnographic research, also called fieldwork, involves observation of and interaction with the persons or group being studied in the group's own environment, often for long periods of time. (See also: Fieldwork.)

EXPANDED AVAILABILITY: Policy and procedure that permits individuals who have serious or life-threatening diseases for which there are no alternative therapies to have access to investigational drugs and devices that may be beneficial to them. Examples of expanded availability mechanisms include Treatment INDs, Parallel Track, and open study protocols.

EXPEDITED REVIEW: Review of proposed research by the IRB chair or a designated voting member or group of voting members rather than by the entire IRB. Federal rules permit expedited review for certain kinds of research involving no more than minimal risk and for minor changes in approved research [Federal Policy 45 CFR 46.110].

EXPERIMENTAL: Term often used to denote a therapy (drug, device, procedure) that is unproven or not yet scientifically validated with respect to safety and efficacy. A procedure may be considered "experimental" without necessarily being part of a formal study (research) to evaluate its usefulness. (See also: Research.)

EXPERIMENTAL STUDY: A true experimental study is one in which subjects are randomly assigned to groups that experience carefully controlled interventions manipulated by the experimenter according to a strict logic allowing causal inference about the effects of the interventions under investigation. (See also: Quasi-Experimental Study).

FALSE NEGATIVE: When a test wrongly shows an effect or condition to be absent (e.g., that a woman is not pregnant when, in fact, she is).

FALSE POSITIVE: When a test wrongly shows an effect or condition to be present (e.g. that is woman is pregnant when, in fact, she is not).

FDA: Food and Drug Administration; an agency of the federal government established by Congress in 1912 and presently part of the Department of Health and Human Services.

FEDERAL POLICY (THE): The federal policy that provides regulations for the involvement of human subjects in research. The Policy applies to all research involving human subjects conducted, supported, or otherwise subject to regulation by any federal department or agency that takes appropriate administrative action to make the Policy applicable to such research. Currently, sixteen federal agencies have adopted the Federal Policy. (Also known as the "Common Rule.")

FETAL MATERIAL: The placenta, amniotic fluid, fetal membranes, and umbilical cord.

FETUS: The product of conception from the time of implantation until delivery. If the delivered or expelled fetus is viable, it is designated an infant [45 CFR 46.203(c)]. The term "fetus" generally refers to later phases of development; the term "embryo" is usually used for earlier phases of development. (See also: Embryo.)

FIELDWORK: Behavioral, social, or anthropological research involving the study of persons or groups in their own environment and without manipulation for research purposes (distinguished from laboratory or controlled settings). (See also: Ethnographic Research.)

510(K) DEVICE: A medical device that is considered substantially equivalent to a device that was or is being legally marketed. A sponsor planning to market such a device must submit notification to the FDA 90 days in advance of placing the device on the market. If the FDA concurs with the sponsor, the device may then be marketed. 510(k) is the section of the Food, Drug and Cosmetic Act that describes premarket notification; hence the designation "510(k) device."

FULL BOARD REVIEW: Review of proposed research at a convened meeting at which a majority of the membership of the IRB are present, including at least one member whose primary concerns are in nonscientific areas. For the research to be approved, it must receive the approval of a majority of those members present at the meeting [45 CFR 46.108].

GENE THERAPY: The treatment of genetic disease accomplished by altering the genetic structure of either somatic (nonreproductive) or germline (reproductive) cells.

GENERAL ASSURANCE: Obsolete term, previously used to denote an institutional assurance covering multiple research projects. (See also: Assurance.)

GENERAL CONTROLS: Certain FDA statutory provisions designed to control the safety of marketed drugs and devices. The general controls include provisions on adulteration, misbranding, banned devices, good manufacturing practices, notification and record keeping, and other sections of the Medical Device Amendments to the Food, Drug and Cosmetic Act [21 U.S. Code 360(c) (Food, Drug and Cosmetic Act 513)].

GENETIC SCREENING: Tests to identify persons who have an inherited predisposition to a certain phenotype or who are at risk of producing offspring with inherited diseases or disorders.

GENOTYPE: The genetic constitution of an individual.

GRANT: Financial support provided for research study designed and proposed by the principal investigator(s). The granting agency exercises no direct control over the conduct of approved research supported by a grant. (Compare: Contract.)

GUARDIAN: An individual who is authorized under applicable state or local law to give permission on behalf of a child to general medical care [45 CFR 46.402(3)].

HELSINKI DECLARATION: See: Declaration of Helsinki.

HISTORICAL CONTROLS: Control subjects (followed at some time in the past or for whom data are available through records) who are used for comparison with subjects being treated concurrently. The study is considered historically controlled when the present condition of subjects is compared with their own condition on a prior regimen or treatment.

HUMAN IN VITRO FERTILIZATION: Any fertilization involving human sperm and ova that occurs outside the human body.

HUMAN SUBJECTS: Individuals whose physiologic or behavioral characteristics and responses are the object of study in a research project. Under the federal regulations, human subjects are defined as: living individual(s) about whom an investigator conducting research obtains: (1) data through intervention or interaction with the individual; or (2) identifiable private information [45 CFR 46.102(f)].

IDE: See: Investigational Device Exemptions.

INCAPACITY: Refers to a person's mental status and means inability to understand information presented, to appreciate the consequences of acting (or not acting) on that information, and to make a choice. Often used as a synonym for incompetence. (See also: Incompetence.)

INCOMPETENCE: Technically, a legal term meaning inability to manage one's own affairs. Often used as a synonym for incapacity. (See also: Incapacity.)

IND: See: Investigational New Drug.

INDEPENDENT VARIABLES The conditions of an experiment that are systematically manipulated by the investigator.

INFORMED CONSENT: A person's voluntary agreement, based upon adequate knowledge and understanding of relevant information, to participate in research or to undergo a diagnostic, therapeutic, or preventive procedure. In giving informed consent, subjects may not waive or appear to waive any of their legal rights, or release or appear to release the investigator, the sponsor, the institution or agents thereof from liability for negligence [45 CFR 46.116; 21 CFR 50.20 and 50.25].

INSTITUTION: (1) Any public or private entity or agency (including federal, state, and local agencies) [45 CFR 46.102(b)].

INSTITUTION: (2) A residential facility that provides food, shelter, and professional services (including treatment, skilled nursing, intermediate or long-term care, and custodial or residential care). Examples include general, mental, or chronic disease hospitals; inpatient community mental health centers; halfway houses and nursing homes; alcohol and drug addiction treatment centers; homes for the aged or dependent, residential schools for the mentally or physically handicapped; and homes for dependent and neglected children.

INSTITUTIONAL REVIEW BOARD: A specially constituted review body established or designated by an entity to protect the welfare of human subjects recruited to participate in biomedical or behavioral research [45 CFR 46.102(g); 45 CFR 46.108; 45 CFR 46.109].

INSTITUTIONALIZED: Confined, either voluntarily or involuntarily (e.g., a hospital, prison, or nursing home).

INSTITUTIONALIZED COGNITIVELY IMPAIRED: Persons who are confined, either voluntarily or involuntarily, in a facility for the care of the mentally or otherwise disabled (e.g., a psychiatric hospital, home, or school for the retarded).

INVESTIGATIONAL DEVICE EXEMPTIONS (IDE): Exemptions from certain regulations found in the Medical Device Amendments that allow shipment of unapproved devices for use in clinical investigations [21 CFR 812.20].

INVESTIGATIONAL NEW DRUG OR DEVICE: A drug or device permitted by FDA to be tested in humans but not yet determined to be safe and effective for a particular use in the general population and not yet licensed for marketing.

INVESTIGATOR: In clinical trials, an individual who actually conducts an investigation [21 CFR 312.3]. Any interventions (e.g., drugs) involved in the study are administered to subjects under the immediate direction of the investigator. (See also: Principal Investigator.)

IN VITRO: Literally, "in glass" or "test tube;" used to refer to processes that are carried out outside the living body, usually in the laboratory, as distinguished from in vivo.

IN VIVO: Literally, "in the living body;" processes, such as the absorption of a drug by the human body, carried out in the living body rather than in a laboratory (in vitro).

IRB: See: Institutional Review Board.

JUSTICE: An ethical principle discussed in the Belmont Report requiring fairness in distribution of burdens and benefits; often expressed in terms of treating persons of similar circumstances or characteristics similarly.

LACTATION: The period of time during which a woman is providing her breast milk to an infant or child.

LEGALLY AUTHORIZED REPRESENTATIVE: A person authorized either by statute or by court appointment to make decisions on behalf of another person. In human subjects research, an individual or judicial or other body authorized under applicable law to consent on behalf of a prospective subject to the subject's participation in the procedure(s) involved in the research [45 CFR 46.102(c)].

LOD SCORE: An expression of the probability that a gene and a marker are linked.

LONGITUDINAL STUDY: A study designed to follow subjects forward through time.

MASKED STUDY DESIGNS: Study designs comparing two or more interventions in which either the investigators, the subjects, or some combination thereof do not know the treatment group assignments of individual subjects. Sometimes called "blind" study designs. (See also: Double-Masked Design; Single-Masked Design.)

MATURE MINOR: Someone who has not reached adulthood (as defined by state law) but who may be treated as an adult for certain purposes (e.g., consenting to medical care). Note that a mature minor is not necessarily an emancipated minor. (See also: Emancipated Minor.)

MEDICAL DEVICE: A diagnostic or therapeutic article that does not achieve any of its principal intended purpose through chemical action within or on the body. Such devices include diagnostic test kits, crutches, electrodes, pacemakers, arterial grafts, intraocular lenses, and orthopedic pins or other orthopedic equipment.

MEDICAL DEVICE AMENDMENTS (MDA): Amendments to the Federal Food, Drug and Cosmetic Act passed in 1976 to regulate the distribution of medical devices and diagnostic products.

MENTALLY DISABLED: See: Cognitively Impaired.

METABOLISM (OF A DRUG): The manner in which a drug is acted upon (taken up, converted to other substances, and excreted) by various organs of the body.

MINIMAL RISK: A risk is minimal where the probability and magnitude of harm or discomfort anticipated in the proposed research are not greater, in and of themselves, than those ordinarily encountered in daily life or during the performance of routine physical or psychological examinations or tests [45 CFR 46.102(i)]. For example, the risk of drawing a small amount of blood from a healthy individual for research purposes is no greater than the risk of doing so as part of routine physical examination.

The definition of minimal risk for research involving prisoners differs somewhat from that given for noninstitutionalized adults. [See 45 CFR 46.303(d) and Guidebook Chapter 6, Section E, "Prisoners."]

MONITORING: The collection and analysis of data as the project progresses to assure the appropriateness of the research, its design and subject protections.

NATIONAL COMMISSION: National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. An interdisciplinary advisory body, established by Congressional legislation in 1974, which was in existence until 1978, and which issued a series of reports and recommendations on ethical issues in research and medicine, many of which are now embodied in federal regulations.

NDA: See: New Drug Application.

NEW DRUG APPLICATION: Request for FDA approval to market a new drug.

NIAAA: National Institute on Alcohol Abuse and Alcoholism; an institute in NIH.

NIDA: National Institute on Drug Abuse; an institute in NIH.

NIH: National Institutes of Health: a federal agency within the Public Health Service, DHHS, comprising 21 institutes and centers. It is responsible for carrying out and supporting biomedical and behavioral research.

NIMH: National Institute of Mental Health; an institute in NIH.

NONAFFILIATED MEMBER: Member of an Institutional Review Board who has no ties to the parent institution, its staff, or faculty. This individual is usually from the local community (e.g., minister, business person, attorney, teacher, homemaker).

NONSIGNIFICANT RISK DEVICE: An investigational medical device that does not present significant risk to the patient. (See also: Significant Risk Device.)

NONTHERAPEUTIC RESEARCH: Research that has no likelihood or intent of producing a diagnostic, preventive, or therapeutic benefit to the current subjects, although it may benefit subjects with a similar condition in the future.

NONVIABLE FETUS: An expelled or delivered fetus which, although it is living, cannot possibly survive to the point of sustaining life independently, even with the support of available medical therapy [45 CFR 46.203 (d) and (e)]. Although it may be presumed that an expelled or delivered fetus is nonviable at a gestational age less than 20 weeks and weight less than 500 grams [Federal Register 40 (August 8, 1975): 33552], a specific determination as to viability must be made by a physician in each instance. (See also: Viable Infant.)

NORMAL VOLUNTEERS: Volunteer subjects used to study normal physiology and behavior or who do not have the condition under study in a particular protocol, used as comparisons with subjects who do have the condition. "Normal" may not mean normal in all respects. For example, patients with broken legs (if not on medication that will affect the results) may serve as normal volunteers in studies of metabolism, cognitive development, and the like. Similarly, patients with heart disease but without diabetes may be the "normals" in a study of diabetes complicated by heart disease.

NULL HYPOTHESIS: The proposition, to be tested statistically, that the experimental intervention has "no effect," meaning that the treatment and control groups will not differ as a result of the intervention. Investigators usually hope that the data will demonstrate some effect from the intervention, thereby allowing the investigator to reject the null hypothesis.

NUREMBERG CODE: A code of research ethics developed during the trials of Nazi war criminals following World War II and widely adopted as a standard during the 1950s and 1960s for protecting human subjects.

OFFICE FOR PROTECTION FROM RESEARCH RISKS (OPRR): The office within the National Institutes of Health, an agency of the Public Health Service, Department of Health and Human Services, responsible for implementing DHHS regulations (45 CFR Part 46) governing research involving human subjects.

OPEN DESIGN: An experimental design in which both the investigator(s) and the subjects know the treatment group(s) to which subjects are assigned.

OPRR: See: Office for Protection from Research Risks.

PATERNALISM: Making decisions for others against or apart from their wishes with the intent of doing them good.

PERMISSION: The agreement of parent(s) or guardian to the participation of their child or ward in research [45 CFR 46.402(c)].

PHARMACOLOGY: The scientific discipline that studies the action of drugs on living systems (animals or human beings).

PHASE 1, 2, 3, 4 DRUG TRIALS: Different stages of testing drugs in humans, from first application in humans (Phase 1) through limited and broad clinical tests (Phase 3), to postmarketing studies (Phase 4).

PHASE 1 DRUG TRIAL: Phase 1 trials include the initial introduction of an investigational new drug into humans. These studies are typically conducted with healthy volunteers; sometimes, where the drug is intended for use in patients with a particular disease, however, such patients may participate as subjects. Phase 1 trials are designed to determine the metabolic and pharmacological actions of the drug in humans, the side effects associated with increasing doses (to establish a safe dose range), and, if possible, to gain early evidence of effectiveness; they are typically closely monitored. The ultimate goal of Phase 1 trials is to obtain sufficient information about the drug's pharmacokinetics and pharmacological effects to permit the design of well-controlled, sufficiently valid Phase 2 studies. Other examples of Phase 1 studies include studies of drug metabolism, structure-activity relationships, and mechanisms of actions in humans, as well as studies in which investigational drugs are used as research tools to explore biological phenomena or disease processes. The total number of subjects involved in Phase 1 investigations is generally in the range of 20-80.

PHASE 2 DRUG TRIAL: Phase 2 trials include controlled clinical studies conducted to evaluate the drug's effectiveness for a particular indication in patients with the disease or condition under study, and to determine the common short-term side effects and risks associated with the drug. These studies are typically well-controlled, closely monitored, and conducted with a relatively small number of patients, usually involving no more than several hundred subjects.

PHASE 3 DRUG TRIAL: Phase 3 trials involve the administration of a new drug to a larger number of patients in different clinical settings to determine its safety, efficacy, and appropriate dosage. They are performed after preliminary evidence of effectiveness has been obtained, and are intended to gather necessary additional information about effectiveness and safety for evaluating the overall benefit-risk relationship of the drug, and to provide and adequate basis for physician labeling. In Phase 3 studies, the drug is used the way it would be administered when marketed. When these studies are completed and the sponsor believes that the drug is safe and effective under specific conditions, the sponsor applies to the FDA for approval to market the drug. Phase 3 trials usually involve several hundred to several thousand patient-subjects.

PHASE 4 DRUG TRIAL: Concurrent with marketing approval, FDA may seek agreement from the sponsor to conduct certain postmarketing (Phase 4) studies to delineate additional information about the drug's risks, benefits, and optimal use. These studies could include, but would not be limited to, studying different doses or schedules of administration than were used in Phase 2 studies, use of the drug in other patient populations or other stages of the disease, or use of the drug over a longer period of time [21 CFR §312.85].

PHENOTYPE: The physical manifestation of a gene function.

PHS: Public Health Service. Part of the U.S. Department of Health and Human Services, it includes FDA, NIH, CDC, SAMHSA, and HRSA.

PLACEBO: A chemically inert substance given in the guise of medicine for its psychologically suggestive effect; used in controlled clinical trials to determine whether improvement and side effects may reflect imagination or anticipation rather than actual power of a drug.

POSTAMENDMENTS DEVICES: Medical devices marketed after enactment of the 1976 Medical Device Amendments.

PREAMENDMENTS DEVICES: Medical devices marketed before enactment of the 1976 Medical Device Amendments.

PRECLINICAL INVESTIGATIONS: Laboratory and animal studies designed to test the mechanisms, safety, and efficacy of an intervention prior to its applications to humans.

PREDICATE DEVICES: Currently legally marketed devices to which new devices may be found substantially equivalent under the 510(k) process.

PREGNANCY: The period of time from confirmation of implantation of a fertilized egg within the uterus until the fetus has entirely left the uterus (i.e., has been delivered). Implantation is confirmed through a presumptive sign of pregnancy such as missed menses or a positive pregnancy test [45 CFR 46.203(b)]. This "confirmation" may be in error, but, for research purposes, investigators would presume that a living fetus was present until evidence to the contrary was clear. Although fertilization occurs a week or more before implantation, the current inability to detect the fertilization event or the presence of a newly fertilized egg makes a definition of pregnancy based on implantation necessary.

PREMARKET APPROVAL: Process of scientific and regulatory review by the FDA to ensure the safety and effectiveness of Class III devices.

PRESIDENT'S COMMISSION: President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research. An interdisciplinary advisory group, established by congressional legislation in 1978, which was in existence until 1983, and which issued reports on ethical problems in health care and in research involving human subjects.

PRINCIPAL INVESTIGATOR: The scientist or scholar with primary responsibility for the design and conduct of a research project. (See also: Investigator)

PRISONER: An individual involuntarily confined in a penal institution, including persons: (1) sentenced under a criminal or civil statue; (2) detained pending arraignment, trial, or sentencing; and (3) detained in other facilities (e.g., for drug detoxification or treatment of alcoholism) under statutes or commitment procedures providing such alternatives to criminal prosecution or incarceration in a penal institution [45 CFR 46.303(c)].

PRIVACY: Control over the extent, timing, and circumstances of sharing oneself (physically, behaviorally, or intellectually) with others.

PROBAND: The person whose case serves as the stimulus for the study of other members of the family to identify the possible genetic factors involved in a given disease, condition, or characteristic.

PROPHYLACTIC: Preventive or protective; a drug, vaccine, regimen, or device designed to prevent, or provide protection against, a given disease or disorder.

PROSPECTIVE STUDIES: Studies designed to observe outcomes or events that occur subsequent to the identification of the group of subjects to be studied. Prospective studies need not involve manipulation or intervention but may be purely observational or involve only the collection of data.

PROTOCOL: The formal design or plan of an experiment or research activity; specifically, the plan submitted to an IRB for review and to an agency for research support. The protocol includes a description of the research design or methodology to be employed, the eligibility requirements for prospective subjects and controls, the treatment regimen(s), and the proposed methods of analysis that will be performed on the collected data.

PURITY: The relative absence of extraneous matter in a drug or vaccine that may or may not be harmful to the recipient or deleterious to the product.

QUASI-EXPERIMENTAL STUDY: A study that is similar to a true experimental study except that it lacks random assignments of subjects to treatment groups. (See also: Experimental Study.)

RADIOACTIVE DRUG: Any substance defined as a drug in §201(b)(1) of the Federal Food, Drug and Cosmetic Act that exhibits spontaneous disintegration of unstable nuclei with the emission of nuclear particles or photons [21 CFR 310.3(n)]. Included are any nonradioactive reagent kit or nuclide generator that is intended to be used in the preparation of a radioactive drug and "radioactive biological products," as defined in 21 CFR 600.3(ee). Drugs such as carbon-containing compounds or potassium-containing salts containing trace quantities of naturally occurring radionuclides are not considered radioactive drugs.

RADIOACTIVE DRUG RESEARCH COMMITTEE (RDRC): An institutional committee responsible for the use of radioactive drugs in human subjects for research purposes. Research involving human subjects that proposes to use radioactive drugs must meet various FDA requirements, including limitations on the pharmacological dose and the radiation dose. Furthermore, the exposure to radiation must be justified by the quality of the study and the importance of the information it seeks to obtain. The committee is also responsible for continuing review of the drug use to ensure that the research continues to comply with FDA requirements, including reporting obligations. The committee must include experts in nuclear medicine and the use of radioactive drugs, as well as other medical and scientific members [21 CFR 36.1].

RADIOPAQUE CONTRAST AGENTS: Materials that stop or attenuate radiation that is passed through the body, creating an outline on film of the organ(s) being examined. Contrast agents, sometimes called "dyes," do not contain radioisotopes. When such agents are used, exposure to radiation results only from the X-ray equipment used in the examination. The chemical structure of radiopaque contrast agents can produce a variety of adverse reactions, some of which may be severe – and possibly even life-threatening – in certain individuals.

RADIOPHARMACEUTICALS: Drugs (compounds or materials) that may be labeled or tagged with a radioisotope. These materials are largely physiological or subpharmacological in action, and, in many cases, function much like materials found in the body. The principal risk associated with these materials is the consequent radiation exposure to the body or to specific organ systems when they are injected into the body.

RANDOM, RANDOM ASSIGNMENT, RANDOMIZATION, RANDOMIZED: Assignment of subjects to different treatments, interventions, or conditions according to chance rather than systematically (e.g., as dictated by the standard or usual response to their condition, history, or prognosis, or according to demographic characteristics). Random assignment of subjects to conditions is an essential element of experimental research because it makes more likely the probability that differences observed between subject groups are the result of the experimental intervention.

RECOMBINANT DNA TECHNOLOGY: "The ability to chop up DNA, the stuff of which genes are made, and move the pieces, [which] permits the direct examination of the human genome," and the identification of the genetic components of a wide variety of disorders [Holtzman (1989), p. 1]. Recombinant DNA technology is also used to develop diagnostic screens and tests, as well as drugs and biologics for treating diseases with genetic components (see Guidebook Chapter 5, Section H, "Human Genetic Research."

REM: Acronym for Roentgen Equivalent in Man; the unit of measurement for a dose of an ionizing radiation that produces the same biological effect as a unit of absorbed does (1 rad) of ordinary X-rays. One millirem is equal to 1/1000 of a rem.

REMISSION: A period in which the signs and symptoms of a disease are diminished or in abeyance. The term "remission" is used when one cannot say with confidence that the disease has been cured.

REMUNERATION: Payment for participation in research. (NOTE: It is wise to confine use of the term "compensation" to payment or provision of care for research-related injuries.) (Compare: Compensation.)

RESEARCH: A systematic investigation (i.e., the gathering and analysis of information) designed to develop or contribute to generalizable knowledge [45 CFR 46.102(d)].

RESPECT FOR PERSONS: An ethical principle discussed in the Belmont Report requiring that individual autonomy be respected and that persons with diminished autonomy be protected.

RETROSPECTIVE STUDIES: Research conducted by reviewing records from the past (e.g., birth and death certificates, medical records, school records, or employment records) or by obtaining information about past events elicited through interviews or surveys. Case control studies are an example of this type of research.

REVIEW (OF RESEARCH): The concurrent oversight of research on a periodic basis by an IRB. In addition to the at least annual reviews mandated by the federal regulations, reviews may, if deemed appropriate, also be conducted on a continuous or periodic basis [45 CFR 46.108(e)].

RISK: The probability of harm or injury (physical, psychological, social, or economic) occurring as a result of participation in a research study. Both the probability and magnitude of possible harm may vary from minimal to significant. Federal regulations define only "minimal risk." (See also: Minimal Risk.)

SAMHSA: Substance Abuse and Mental Health Services Administration; includes the Center for Substance Abuse Prevention, the Center for Substance Abuse Treatment and the Center on Mental Health Services. Previously the Alcohol, Drug Abuse, and Mental Health Administration (ADAMHA). (See also: ADAMHA.)

SCIENTIFIC REVIEW GROUP: A group of highly regarded experts in a given field, convened by NIH to advise NIH on the scientific merit of applications for research grants and contracts. Scientific review groups are also required to review the ethical aspects of proposed involvement of human subjects. Various kinds of scientific review groups exist, and are known by different names in different institutes of the NIH (e.g., Study Sections, Initial Review Groups, Contract Review Committees, or Technical Evaluation Committees).

SECRETARY: A U.S. Cabinet Officer. In the context of DHHS-conducted or -supported research, usually refers to the Secretary of Health and Human Services.

SIGNIFICANT RISK DEVICE: An investigational medical device that presents a potential for serious risk to the health, safety, or welfare of the subject.

SINGLE-MASKED DESIGN: Typically, a study design in which the investigator, but not the subject, knows the identity of the treatment assignment. Occasionally the subject, but not the investigator, knows the assignment. Sometimes called "single-blind design."

SITE VISIT: A visit by agency officials, representatives, or consultants to the location of a research activity to assess the adequacy of IRB protection of human subjects or the capability of personnel to conduct the research.

SOCIAL EXPERIMENTATION: Systematic manipulation of, or experimentation in, social or economic systems; used in planning public policy.

SPONSOR (OF A DRUG TRIAL): A person or entity that initiates a clinical investigation of a drug, and usually the drug manufacturer or research institution that developed the drug. The sponsor does not actually conduct the investigation, but rather distributes the new drug to investigators and physicians for clinical trials. The drug is administered to subjects under the immediate direction of an investigator who is not also a sponsor. A clinical investigator may, however, serve as a sponsor-investigator. The sponsor assumes responsibility for investigating the new drug, including responsibility for compliance with applicable laws and regulations. The sponsor, for example, is responsible for obtaining FDA approval to conduct a trial and for reporting the results of the trial to the FDA.

SPONSOR--INVESTIGATOR: An individual who both initiates and actually conducts, alone or with others, a clinical investigation. Corporations, agencies, or other institutions do not qualify as sponsor-investigators.

STATISTICAL SIGNIFICANCE: A determination of the probability of obtaining the particular distribution of the data on the assumption that the null hypothesis is true. Or, more simply put, the probability of coming to a false positive conclusion. [See McLarty (1987), p. 2.] If the probability is less than or equal to a predetermined value (e.g., 0.05 or 0.01), then the null hypothesis is rejected at that significance level (0.05 or 0.01).

STERILITY: (1) The absence of viable contaminating microorganisms; aseptic state.

STERILITY: (2) The inability to procreate; the inability to conceive or induce conception.

STUDY SECTION: See: Scientific Review Group.

SUBJECTS (HUMAN): See: Human Subjects.

SURVEYS: Studies designed to obtain information from a large number of respondents through written questionnaires, telephone interviews, door-to-door canvassing, or similar procedures.

THERAPEUTIC INTENT: The research physician's intent to provide some benefit to improving a subject's condition (e.g., prolongation of life, shrinkage of tumor, or improved quality of life, even though cure or dramatic improvement cannot necessarily be effected.) This term is sometimes associated with Phase 1 drug studies in which potentially toxic drugs are given to an individual with the hope of inducing some improvement in the patient's condition as well as assessing the safety and pharmacology of a drug.

THERAPY: Treatment intended and expected to alleviate a disease or disorder.

UNIFORM ANATOMICAL GIFT ACT: Legislation adopted by all 50 States and the District of Columbia that indicates procedures for donation of all or part of a decedent's body for such activities as medical education, scientific research, and organ transplantation.

VACCINE: A biologic product generally made from an infectious agent or its components a virus, bacterium, or other microorganism – that is killed (inactive) or live-attenuated (active, although weakened). Vaccines may also be biochemically synthesized or made through recombinant DNA techniques.

VARIABLE (NOUN): An element or factor that the research is designed to study, either as an experimental intervention or a possible outcome (or factor affecting the outcome) of that intervention.

VIABLE INFANT: When referring to a delivered or expelled fetus, the term "viable infant" means likely to survive to the point of sustaining life independently, given the benefit of available medical therapy [45 CFR 46.203(d)]. This judgment is made by a physician. In accordance with DHHS regulations, the Secretary, HHS, may publish guidelines to assist in the determination of viability. Such guidelines were published in 1975, and specify an estimated gestational age of 20 weeks or more and a body weight of 500 grams or more as indices of fetal viability [Federal Register 40 (August 8, 1975): 33552]. These indices depend on the state of present technology and may be revised periodically. (See also: Nonviable Fetus.)

VOLUNTARY: Free of coercion, duress, or undue inducement. Used in the research context to refer to a subject's decision to participate (or to continue to participate) in a research activity.

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