Who Is the Research Subject in Cluster Randomized Trials in Health Research?
McRae, Andrew D
Grimshaw, Jeremy M
Brehaut, Jamie C
Eccles, Martin P
Trials 2011 July 26; 12: 183
This article is part of a series of papers examining ethical issues in cluster randomized trials (CRTs) in health research. In the introductory paper in this series, we set out six areas of inquiry that must be addressed if the CRT is to be set on a firm ethical foundation. This paper addresses the first of the questions posed, namely, who is the research subject in a CRT in health research? The identification of human research subjects is logically prior to the application of protections as set out in research ethics and regulation. Aspects of CRT design, including the fact that in a single study the units of randomization, experimentation, and observation may differ, complicate the identification of human research subjects. But the proper identification of human research subjects is important if they are to be protected from harm and exploitation, and if research ethics committees are to review CRTs efficiently.We examine the research ethics literature and international regulations to identify the core features of human research subjects, and then unify these features under a single, comprehensive definition of human research subject. We define a human research subject as any person whose interests may be compromised as a result of interventions in a research study. Individuals are only human research subjects in CRTs if: (1) they are directly intervened upon by investigators; (2) they interact with investigators; (3) they are deliberately intervened upon via a manipulation of their environment that may compromise their interests; or (4) their identifiable private information is used to generate data. Individuals who are indirectly affected by CRT study interventions, including patients of healthcare providers participating in knowledge translation CRTs, are not human research subjects unless at least one of these conditions is met.
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Binik, Ariella; Weijer, Charles; McRae, Andrew D; Grimshaw, Jeremy M; Boruch, Robert; Brehaut, Jamie C; Donner, Allan; Eccles, Martin P; Saginur, Raphael; Taljaard, Monica; Zwarenstein, Merrick (2011-05-11)This article is part of a series of papers examining ethical issues in cluster randomized trials (CRTs) in health research. In the introductory paper in this series, Weijer and colleagues set out six areas of inquiry that ...
Weijer, Charles; Grimshaw, Jeremy M; Taljaard, Monica; Binik, Ariella; Boruch, Robert; Brehaut, Jamie C; Donner, Allan; Eccles, Martin P; Gallo, Antonio; McRae, Andrew D; Saginur, Raphael; Zwarenstein, Merrick (2011-04-20)The cluster randomized trial (CRT) is used increasingly in knowledge translation research, quality improvement research, community based intervention studies, public health research, and research in developing countries. ...
Inadequate Reporting of Research Ethics Review and Informed Consent in Cluster Randomised Trials: Review of Random Sample of Published Trials Taljaard, Monica; McRae, Andrew D; Weijer, Charles; Bennett, Carol; Dixon, Stephanie; Taleban, Julia; Skea, Zoe; Eccles, Martin P; Brehaut, Jamie C; Donner, Allan; Saginur, Raphael; Boruch, Robert F; Grimshaw, Jeremy M (2011-05-11)To investigate the extent to which authors of cluster randomised trials adhered to two basic requirements of the World Medical Association's Declaration of Helsinki and the International Committee of Medical Journal Editors' ...