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JCO Early Release, published online ahead of print Oct 19 2009
Journal of Clinical Oncology, 10.1200/JCO.2009.23.2470

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Received March 25, 2009
Accepted July 20, 2009

Costs and Benefits of the National Cancer Institute Central Institutional Review Board

Todd H. Wagner,* Christine Murray, Jacquelyn Goldberg, Jeanne M. Adler, and Jeffrey Abrams

From the Veterans Affairs Palo Alto Health Care System and Department of Health Research and Policy, Stanford University School of Medicine, Menlo Park, CA; Central Institutional Review Board Initiative; Clinical Investigations Branch; and the Cancer Therapy Evaluation Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute, Bethesda MD.

* To whom correspondence should be addressed. E-mail: todd.wagner{at}va.gov

Purpose: In 2001, the National Cancer Institute (NCI) formed the Central Institutional Review Board (CIRB) to conduct a single human subjects review for its multisite phase III oncology trials. The goal of this study was to assess whether NCI's CIRB was associated with lower effort, time, and cost in processing adult phase III oncology trials.

Methods: We conducted an observational study and compared sites affiliated with the NCI CIRB to unaffiliated sites that used their local IRB for review. Oncology research staff and IRB staff were surveyed to understand effort and timing. Response rates were 60% and 42%, respectively. Analysis of these survey data yielded information on effort, timing, and costs. We combined these data with CIRB operational data to determine the net savings of the CIRB using a societal perspective.

Results: CIRB affiliation was associated with faster reviews (33.9 calendar days faster on average), and 6.1 fewer hours of research staff effort. CIRB affiliation was associated with a savings of $717 per initial review. The estimated cost of running the CIRB was $161,000 per month. The CIRB yielded a net cost of approximately $55,000 per month from a societal perspective. Whether the CIRB results in higher or lower quality reviews was not assessed because there is no standard definition of review quality.

Conclusion: The CIRB was associated with decreases in investigator and IRB staff effort and faster protocol reviews, although savings would be higher if institutions used the CIRB as intended.


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Copyright © 2009 by the American Society of Clinical Oncology, Online ISSN: 1527-7755. Print ISSN: 0732-183X
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