Procedural Rules
(as amended
on January 16, 2004)
II
Membership
III Regulatory Canon
IV Submitting a Study Proposal to IMDEC
V Committee Procedure
VI Continuing Review
VII Fees
I Purpose
The
International Medical & Dental Ethics Commission (IMDEC) offers independent
ethical and legal reviews of drug, medical-device and other healthcare and
consumer-product studies on behalf of sponsors and investigators responsible
for carrying out such studies in the pharmaceutical, medical-device, healthcare
and consumer-product industries.
IMDEC’s primary
objective in conducting its reviews is to protect the rights and dignity of
those persons who volunteer to participate in clinical research. In seeking to
meet this objective, the commission takes special care to ensure that the
studies it reviews are carried out in conformity with all applicable national
and international rules and recommendations. With regard to drug and
medical-device studies, IMDEC is also guided in its decision making by the
consideration of whether the risks for individual volunteers associated with
participation in a clinical study are medically acceptable in light of the
study’s expected benefits for medical science.
IMDEC is
registered at the German Federal Institute for Drugs and Medical Devices
(Bundesinstitut für Arzneimittel und Medizinprodukte) and operates in
accordance with ICH Guidelines for Good Clinical Practice and U.S.
Food and Drug Administration Regulations.
IMDEC is also
registered under IRB Identifier IRB00002010 at the Office of Human
Research Protections of the U.S. Department of Health and Human Services.
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II Membership
- IMDEC’s membership comprises at
least 12 individuals from various countries and of diverse professional
and cultural backgrounds. The members include both medical and legal
experts of both sexes as well as laypersons of both sexes.
- Through the experience, expertise
and diversity of its members, IMDEC possesses the competence necessary to
review specific research activities, ascertain the acceptability of
proposed research in light of national and international regulations and
standards of professional practice, and safeguard the rights and welfare
of human subjects.
- To avoid conflicts of interest,
members who are themselves involved in the carrying out of a clinical
study may not participate – beyond the supplying of information – in the
review of the same clinical study.
- IMDEC may solicit the advice of
appropriately qualified referees. While such referees may participate at
committee meetings, they may not vote on specific study proposals.
- All members active in the review of
study proposals are sworn to secrecy.
- Committee meetings are led by the
committee chairperson. The chairperson may be represented by another
committee member who assumes the role of acting chairperson. The
chairperson is appointed for a period of two years. At the end of this
period, it is the responsibility of the remaining committee members to
either reappoint the chairperson or to appoint a replacement.
- It is open to any interested
individual to submit an application in writing to IMDEC to become a
committee member. New member appointments are made with an eye to
maintaining the committee’s independence, expertise, interdisciplinary
nature and cultural balance. Members are appointed for a period of two
years by the chairperson in consultation with the existing committee
members. Reappointment is regarded as desirable for the sake of continuity.
- Committee members are remunerated
for their work. This remuneration corresponds to that of experts appointed
by the courts.
- In the interest of maintaining
independence, the role of IMDEC’s management and ownership is restricted
to the provision of basic administrative support and basic resources such
as an office, a conference room, computer equipment and filing space.
Those persons responsible for managing IMDEC’s business affairs and any of
IMDEC’s owners may not function as committee members.
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III Regulatory Canon
IMDEC reviews
study proposals in accordance with the following regulatory documents.
- Declaration of Helsinki
- ICH Guidelines for Good Clinical
Practice
- U.S. Food and Drug Administration
Regulations
- German Drug Law
- German Medical Device Law
- EN-540
- European Cosmetic, Toiletry and
Perfumery Association (COLIPA) Guidelines
- Cosmetic, Toiletry and Fragrance
Association (CTFA) Safety Testing Guidelines
- The Belmont Report
- Health Insurance Portability and
Accountability Act (HIPAA Privacy Rule)
- ISO 14155 Clinical Investigation of
Medical Devices for Human Subjects
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IV Submitting a Study Proposal to IMDEC
- The study sponsor or the study
investigator submits a copy of all required documentation in English or
German to IMDEC by mail, fax or e-mail. The required documentation
includes:
·
A short
written request for commission review (1 copy)
·
Study
protocol (6 copies)
·
Test-subject
information sheets and informed-consent form (6 copies)
·
Investigator’s
brochure (if not previously made available to the commission) (3 copies)
·
Principal
investigator’s CV (1 copy)
·
Other
investigators’ CVs (for multicenter studies; may be submitted after initial
request) (1 copy)
·
List of
proposed study centers (1 copy)
·
Description
of subject recruitment procedures including information about compensation as
well as any advertisements used for recruiting purposes (1 copy)
·
Verification
of insurance coverage or copy of CE-certificate (1 copy)
·
Case
report forms (may be submitted after initial request for review) (2 copies)
·
If
applicable, a statement justifying the use of any vulnerable subject
populations (6 copies)
·
If
applicable, a statement outlining special informed consent procedures used for
study subjects (e.g., foreign nationals) who show signs of insufficient
language comprehension (6 copies)
- Requests for review may be
supplemented or withdrawn.
- As a rule, research proposals are
reviewed within 9 days of their receipt (on condition that all relevant
documentation has indeed been received).
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V Committee Procedure
- Meetings take place every Tuesday
evening. Ad hoc meetings may also be arranged.
- With ample time in advance of
committee meetings, study materials are made available to at least five
committee members and one alternate.
- Each committee member slated to
participate at the next meeting examines all documents received and drafts
notes for the purpose of more effective discussion.
- At least five committee members (at
these two of these physicians) take part in person at the committee
meeting. A quorum is five members.
- Each study proposal is discussed
from ethical and legal points of view, with discussion culminating in a
vote on the study proposal’s acceptability. While IMDEC endeavors to reach
unanimous decisions, a simple majority is deemed sufficient to issue an
opinion. In the case of ties, the vote of the chairperson is decisive.
- Minutes are kept for each meeting.
These minutes specify: place; date; time of day; members present; subject
of review; result of review; and specific voting tally.
- The result of committee review
shall declare one of the following:
a) approval
b) conditional approval
c) approval denied
d) decision postponed
- Notice of the committee’s decision
is sent by fax or e-mail to the sponsor or investigator on the day
following the committee meeting.
- An official certificate of review
containing the committee’s decision, the signatures of the individual
members present as well as any dissenting opinions is sent by mail.
- As a rule, IMDEC drafts its
certificates of review in English and in German.
- In the case of (7b), final approval
is granted as soon as the sponsor or investigator demonstrates that the
conditions have been met. Alternatively, the sponsor may request that the
decision be reconsidered. Decisions are reconsidered only upon
presentation of a thorough justification for not accepting the conditions.
- Committee decisions may be
postponed. Postponement is deemed necessary whenever important matters
must be clarified through further consultation with the sponsor or the
investigator or through the submission of additional documents.
- All study documents are maintained
in the commission’s archives for a period of at least four years.
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VI Continuing Review
- At the time of its initial review,
the committee will arrive at a decision as to whether the study at hand is
subject to interim reporting. This decision is largely based on the type
of risk assessed during the review, the proposed enrollment procedures for
the study and the proposed length of the study.
- If the committee determines that
the study is subject to interim reporting, it will notify the
investigator/sponsor of this fact on its certificate of review. This
notification will specify the content of the required reporting and the
deadlines by which such reports are to be submitted to the commission.
- In order to ensure that
investigators/sponsors comply with interim reporting requirements, the
committee maintains a practice of sending reminders to the
investigator/sponsor. These reminders clearly indicate that failure to
report in a timely manner will result in the expiration of the
commission’s approval.
- While the content of interim
reporting may be more narrowly circumscribed, the commission usually
requires the submission of a protocol summary and a status report on the
progress of research, including (i) the number of additional enrollments,
(ii) a summary of any adverse events or unanticipated problems involving
risks to subjects, (iii) the number of subject withdrawals and any
associated complaints about the research, (iv) a summary of any relevant
recent literature, clinical findings, amendments or modifications to the
research since the last review and (v) a copy of the current informed consent
document.
- Interim reports are handled by the
committee chairperson or a substitute according to an expedited review
procedure. The chairperson may decide to pass on such reports to the full
committee for review at its next scheduled meeting.
- Amendments to the study protocol should be
presented to IMDEC for approval before their implementation, except
when their implementation is necessary to eliminate immediate hazards
to the subjects or when they involve only logistical or administrative
aspects of the trial (e.g., change of monitors, telephone numbers, etc.).
- Amendments are handled by the
committee chairperson or a substitute according to an expedited review
procedure. The chairperson may decide to pass on such amendments to the
full committee for review at its next scheduled meeting.
- Significant new clinical findings and all study-related events
(especially serious adverse events) that could have a bearing on
the health and safety of trial subjects are to be reported without delay
to IMDEC in writing. These are handled by the committee chairperson or a
substitute according to an expedited review procedure. If time permits,
they may be passed on for full committee review.
- The committee may conduct on-site
inspections. The committee may also withdraw its approval should it come
to have compelling evidence that a study is not being conducted in
accordance with good clinical practice or in accordance with any
conditions it may have set before issuing its approval.
- A brief final report should be sent
to IMDEC upon study completion.
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VII Fees
The commission
receives a fee for its services in order to cover operating costs and the
compensation of its members. The fee for the review of a clinical study
proposal ranges from € 1,100 to € 3,500 plus the applicable value added tax.
The fee for the review of study amendments, unexpected adverse events and new
clinical findings ranges from € 100 to € 300 plus the applicable value added
tax. In exceptional cases, the fees mentioned may be raised or lowered.
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