Factors influencing turn-around time of ethics review in Tanzania:Assessment of protocol review systems by David Machaku 1, Mwanaidi Kafuye2, Renatha Joseph1, Paul Kazyoba1, Muhsin Aboud2
Main Article Content
Abstract
Ethics review of health research protocols is paramount for the protection of the rights, safety, and welfare of research participants. The review of protocols is done by designated committees called Research Ethics Committees (RECs). In Tanzania, the National Research Ethics Committee (NatHREC) processes a large volume of protocols every year. Although the turnaround time of ethics review has been identified as a concern for stakeholders involved in the review process, there is a lack of comprehensive research on the specific factors that influence the duration of the review process by examining the research protocols themselves. While the long review timelines have significant implications for the timely commencement of research activities, as well as questions regarding the capacity of research ethics committees (RECs), the existing literature does not adequately address this aspect.
The study aimed to assess the factors that influenced the turnaround time of ethics review
at the National Health Research Ethics Committee (NatHREC) for research protocols submitted
between January 2018 and August 2019. This specific time frame was chosen to capture a substantial sample of protocols and provide a comprehensive understanding of the factors affecting the review process during that period and also because during this period the REC employed two different review systems for protocol review. Several factors were identified as influencing the turnaround time of the ethics review process. Firstly, the review systems played a significant role as during the study period, the REC employed two different review systems; Precursor Protocol Review System (PPRs) and Improved Protocol Review System (IPRs) which proved to be more time-efficient. Secondly, the type of study being reviewed also had an influence on turnaround time as clinical trials had a longer review turnaround time than non-clinical trials. Additionally, the time taken for researchers to resubmit their protocols for review affected the overall turnaround time.
If researchers took longer to make necessary revisions, it would naturally extend the review process. By focusing on the NatHREC, which is a prominent and nationally recognized research ethics committee, the study aimed to explore the factors that are influential within a well-established and reputable review system. Understanding the specific factors that contribute to the turnaround time at this committee would provide valuable insights for other similar committees and research ethics bodies across the country. Overall, the study highlighted the importance of addressing factors that influence the turnaround time of the review process to improve the efficiency of the process. The findings suggest that implementing the IPRS can significantly reduce the time taken for ethics review, benefiting both researchers and research participants.
Downloads
Article Details
Section
References
Abbott, L., & Grady, C. (2011). A systematic review of the empirical literature evaluating IRBs: What
we know and what we still need to learn. Journal of Empirical Research on Human Research Ethics
(pp. 1984–1984).
Baldwin, J. R., Pingault, J. B., Schoeler, T., Sallis, H. M., & Munafò, M. R. (2022). Protecting against
researcher bias in secondary data analysis : challenges and potential solutions. European Journal of
Epidemiology, 37(1), 1–10. https://doi.org/10.1007/s10654-021-00839-0
Black, N., Van Rooyen, S., Godlee, F., Smith, R., & Evans, S. (1998). What makes a good reviewer and
a good review for a general medical journal? Journal of the American Medical Association, 280(3),
231–233. https://doi.org/10.1001/jama.280.3.231
Burmeister, E., & Aitken, L. M. (2012). Sample size: How many is enough? Australian Critical Care,
25(4), 271–274. https://doi.org/10.1016/j.aucc.2012.07.002
Cancer Research UK. (2022). Types of clinical trials _ (p. 4).
Chambers, J. D., Thorat, T., Wilkinson, C. L., & Neumann, P. J. (2017). Drugs cleared through the FDA’s
expedited review offer greater gains than drugs approved by conventional process. Health Affairs,
36(8), 1408–1415. https://doi.org/10.1377/hlthaff.2016.1541
Cho, K., Schunn, C. D., & Charney, D. (2006). Commenting on writing: Typology and perceived
helpfulness of comments from novice peer reviewers and subject matter experts. Written
Communication, 23(3), 260–294. https://doi.org/10.1177/0741088306289261
Cipriani, A., & Barbui, C. (2010). What is a clinical trial protocol? Epidemiologia e Psichiatria Sociale,
19(2), 116–117. https://doi.org/10.1017/s1121189x00000804
Clarke, D. L. (2014). Auditing the process of ethics approval for Master’s degrees at a South African
university. South African Journal of Bioethics and Law, 7(1), 23. https://doi.org/10.7196/sajbl.301
dLaerd Statistics. (2018). Spearman’s Rank-Order Correlation - A guide to when to use it, what it
does and what the assumptions are. In Lund Research LTD (pp. 1–2).
Emanuel, E. J., Wendler, D., Killen, J., & Grady, C. (2004). What makes clinical research in developing
countries ethical? The benchmarks of ethical research. Journal of Infectious Diseases, 189(5), 930–
937. https://doi.org/10.1086/381709
Gibbs Brown, J. (1998). OFFICE OF INSPECTOR GENERAL Institutional Review Boards: A Time for
Reform. https://oig.hhs.gov/oei/reports/oei-01-97-00193.pdf
Hirshon, J. M., Krugman, S. D., Witting, M. D., Furuno, J. P., Limcangco, M. R., Perisse, A. R., & Rasch,
E. K. (2002). Variability in institutional review board assessment of minimal-risk research. Academic
Emergency Medicine, 9(12), 1417–1420. https://doi.org/10.1197/aemj.9.12.1417
Howe, E. G. (2018). Balanced Ethics Review: A Guide for Institutional ReviewBoard Members.
Psychiatry (New York), 9(2), 2016. https://doi.org/10.1080/00332747.2018.1492854
Joppi, R., Bertele, V., Vannini, T., Garattini, S., & Banzi, R. (2020). Food and Drug Administration vs
European Medicines Agency: Review times and clinical evidence on novel drugs at the time of
approval. British Journal of Clinical Pharmacology, 86(1), 170–174. https://doi.org/10.1111/bcp.14130
Kashyap, S. (2023). What Causes Project Delay and How to Avoid Them with 6 Tips (p. 10).
https://www.proofhub.com/articles/project-delays
Kimmelman, J. (2004). Valuing risk: The ethical review of clinical trial safety. Kennedy Institute of
Ethics Journal, 14(4), 369–393. https://doi.org/10.1353/ken.2004.0041
Landau, P. (2023). What Is Resource Allocation? How to Allocate Resources for Projects (p. 6).
https://www.projectmanager.com/blog/resource-allocation
Liberti, L., Bujar, M., Breckenridge, A., Hoekman, J., McAuslane, N., Stolk, P., & Leufkens, H. (2017).
FDA facilitated regulatory pathways: Visualizing their characteristics, development, and
authorization timelines. Frontiers in Pharmacology, 8(APR), 1–6.
https://doi.org/10.3389/fphar.2017.00161
Lynch, H. F., Abdirisak, M., Bogia, M., & Clapp, J. (2020). Evaluating the Quality of Research Ethics
Review and Oversight : A Systematic Analysis of Quality Assessment Instruments Evaluating the
Quality of Research Ethics Review and Oversight : A Systematic Analysis of Quality Assessment
Instruments. AJOB Empirical Bioethics, 0(0), 1–15. https://doi.org/10.1080/23294515.2020.1798563
Mamotte, N., & Wassenaar, D. (2009). Ethics review in a developing country: a survey of South
African social scientists’ experiences. Journal of Empirical Research on Human Research Ethics :
JERHRE, 4(4), 69–78. https://doi.org/10.1525/jer.2009.4.4.69
Mrisho, M. (2021). Understanding constraints and enablers of turnaround time for ethics review :
The case of institutional review boards in Tanzania.
Ness, E. (2022). Protocol Development , Review and Approval Process Planning a Clinical Trial.
Center for Cancer Research National Cancer Institute, 84.
NIMR. (2014). STANDARD OPERATING PROCEDURES FOR THE NATIONAL INSTITUTE OF MEDICAL
RESEARCH. NIMR, 2, 94.
Nxumalo, B. C. (2017). An examination of timelinesss in the expedited ethics review process at the
University of KwaZulu-Natal, biomedical research ethics committee (Doctoral dissertation).1.
Nxumalo BC. An examination of timelinesss in the expedited ethics review process at th. University
of KwaZulu-Natal, 58.
Page, S. A., & Nyeboer, J. (2017). Improving the process of research ethics review. Research Integrity
and Peer Review, 2(1), 1–7. https://doi.org/10.1186/s41073-017-0038-7
TMDA. (2020). GUIDELINES FOR APPLICATION TO CONDUCT CLINICAL TRIALS IN TANZANIA.
63(March). chromeextension://efaidnbmnnnibpcajpcglclefindmkaj/https://www.tmda.go.tz/uploads/publications/en
1672900058-CLINICAL TRIAL GUIDELINES - 2020.pdf
TMDA. (2020). GUIDELINES FOR APPLICATION TO CONDUCT CLINICAL TRIALS IN TANZANIA. 63.
Toto, N., Douglas, E., Gmeiner, M., Barrett, L. K., Lindblad, R., Makhaza, L., Nedi, W., Phulusa, J.,
Quinnan, G. V, Sawyer, L. A., Thole, H., Voorhis, W. C. Van, & Tam, P. I. (2020). Conducting clinical
trials in sub-Saharan Africa : challenges and lessons learned from the Malawi Cryptosporidium
study. 1–8.
Tsoka-Gwegweni, J. M., & Wassenaar, D. R. (2014). Using the Emanuel et al. Framework to assess
ethical issues raised by a biomedical research ethics committee in South Africa. Journal of Empirical
Research on Human Research Ethics, 9(5), 36–45. https://doi.org/10.1177/1556264614553172
Wang, X., & Cheng, Z. (2020). Cross-Sectional Studies: Strengths, Weaknesses, and
Recommendations. Chest, 158(1), S65–S71. https://doi.org/10.1016/j.chest.2020.03.012
Weinger, M. B., Slagle, J., Jain, S., & Ordonez, N. (2003). Retrospective data collection and analytical
techniques for patient safety studies. Journal of Biomedical Informatics, 36(1–2), 106–119.
https://doi.org/10.1016/j.jbi.2003.08.002
Wolzt, M., Druml, C., Leitner, D., & Singer, E. A. (2009). Protocols in expedited review: Tackling the
workload of ethics committees. Intensive Care Medicine, 35(4), 613–615.