Published in

Wiley, Academic Emergency Medicine: A Global Journal of Emergency Care, 2(30), p. 133-138, 2023

DOI: 10.1111/acem.14645

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A Census of Clinical Trials Conducted Under the US Exception from Informed Consent Rule

Journal article published in 2022 by Krista L. Snyder, Jon F. Merz ORCID
This paper was not found in any repository, but could be made available legally by the author.
This paper was not found in any repository, but could be made available legally by the author.

Full text: Unavailable

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Postprint: archiving restricted
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Abstract

AbstractBackgroundThe exception from informed consent (EFIC) rule was adopted in 1996, permitting waiver of informed consent for certain emergency research, including trials funded by the U.S. government. The rule requires prospective consent from patients or their legally authorized representative(s) (LAR) if practicable. For those enrolled without consent, the patient or their LAR must be given an opportunity to opt out from continued participation at the earliest opportunity. We sought to census the trials conducted under the EFIC rule to facilitate research to better understand how the rule is being used.MethodsWe conducted a multipronged search to identify all trials conducted under the EFIC rule, drawing on reviews, database searches, examination of the FDA's docket, posting an inquiry on the institutional review board forum, and email requests to lead authors of all published EFIC trials and related review articles. We describe the trials, when they were started and completed, and whether they were terminated early.ResultsWe identified a total of 110 trials as of the end of April 2022: 78 complete, 13 recruiting, seven registered onclinicaltrials.govbut not yet recruiting, five trials that were abandoned before enrolling any subjects, and seven trials in early planning. Nine of the 78 completed trials were pilot or feasibility trials. Of 69 completed full trials, 30 (43.5%) were terminated early. The most common reason for early termination was futility (15 trials, 25.0%) followed by poor recruitment (10 trials, 14.5%). The rate of conduct of trials has been remarkably constant since 2001, with roughly 18 trials started in each 5‐year period.ConclusionsWe have compiled a census of trials conducted under the U.S. FDA's EFIC rule, the availability of which we hope will stimulate further in‐depth data collection and analysis of this set of trials.