한국의 한 대학병원의 연구윤리심의위원회 심의에서 나타난 임상연구계획의 과학적, 윤리적 문제*

Abstract

With the increased number of clinical trials being conducted in South Korea, Institutional Review Boards (IRBs) have acquired greater significance. In human clinical trials, unscientific studies may be unethical in light of their potential for causing harm to participants. Therefore, IRBs should review both the scientific and the ethical issues of any research protocol. However, research into the IRB review process is lacking in Korea. This study examined the protocols for clinical trials under the review of the IRB at Seoul National University Hospital. In total 1,244 protocols (752 between 2004 and 2006; 492 in 2013) were analyzed. Of these 22.7% were approved, 64.2% underwent minor revision, and 12.6% underwent major revision. In total, 62.2% of these protocols raised scientific issues, and 47.0% raised ethical issues. Among the scientific issues, “unclear sample size calculation” occurred most frequently. “Subjects’ recruitment/inclusion criteria” was the most frequently cited ethical issue. A total of 67.0% had consent issues and 41.3% raised questions about the case report form. Compared to the period from 2004 to 2006, the prevalence of protocols with “unclear study design” and those that raised questions about “privacy/personal data” increased in 2013. While scientific issues were the most frequent among investigator-initiated trials, consent issues were the most frequent in sponsor-initiated trials. Although all issues were significantly associated with the approval decision, the approval rate of studies with ethical issues was lowest. These results provide a basis for the development of guidelines for researchers by identifying common issues in clinical protocols.