eCFR — Code of Federal Regulations ELECTRONIC CODE OF FEDERAL REGULATIONS e-CFR data is current as of May 21, 2020 Title 21 → Chapter I → Subchapter A → Part 50 Title 21: Food and Drugs PART...

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Review the DHHS and FDA regulations in the attached materials, and list the regulations you regard as material to addressing waiver of consent in learning health care systems generally, or in "usual care" or comparative effectiveness research in particular.




eCFR — Code of Federal Regulations ELECTRONIC CODE OF FEDERAL REGULATIONS e-CFR data is current as of May 21, 2020 Title 21 → Chapter I → Subchapter A → Part 50 Title 21: Food and Drugs PART 50—PROTECTION OF HUMAN SUBJECTS Contents Subpart A—General Provisions §50.1 Scope. §50.3 Definitions. Subpart B—Informed Consent of Human Subjects §50.20 General requirements for informed consent. §50.23 Exception from general requirements. §50.24 Exception from informed consent requirements for emergency research. §50.25 Elements of informed consent. §50.27 Documentation of informed consent. Subpart C [Reserved] Subpart D—Additional Safeguards for Children in Clinical Investigations §50.50 IRB duties. §50.51 Clinical investigations not involving greater than minimal risk. §50.52 Clinical investigations involving greater than minimal risk but presenting the prospect of direct benefit to individual subjects. §50.53 Clinical investigations involving greater than minimal risk and no prospect of direct benefit to individual subjects, but likely to yield generalizable knowledge about the subjects' disorder or condition. §50.54 Clinical investigations not otherwise approvable that present an opportunity to understand, prevent, or alleviate a serious problem affecting the health or welfare of children. §50.55 Requirements for permission by parents or guardians and for assent by children. §50.56 Wards. AUTHORITY: 21 U.S.C 321, 343, 346, 346a, 348, 350a, 350b, 352, 353, 355, 360, 360c-360f, 360h-360j, 371, 379e, 381; 42 U.S.C. 216, 241, 262, 263b-263n. SOURCE: 45 FR 36390, May 30, 1980, unless otherwise noted. return arrow Back to Top Subpart A—General Provisions return arrow Back to Top §50.1 Scope. (a) This part applies to all clinical investigations regulated by the Food and Drug Administration under sections 505(i) and 520(g) of the Federal Food, Drug, and Cosmetic Act, as well as clinical investigations that support applications for research or marketing permits for products regulated by the Food and Drug Administration, including foods, including dietary supplements, that bear a nutrient content claim or a health claim, infant formulas, food and color additives, drugs for human use, medical devices for human use, biological products for human use, and electronic products. Additional specific obligations and commitments of, and standards of conduct for, persons who sponsor or monitor clinical investigations involving particular test articles may also be found in other parts (e.g., parts 312 and 812). Compliance with these parts is intended to protect the rights and safety of subjects involved in investigations filed with the Food and Drug Administration pursuant to sections 403, 406, 409, 412, 413, 502, 503, 505, 510, 513-516, 518-520, 721, and 801 of the Federal Food, Drug, and Cosmetic Act and sections 351 and 354-360F of the Public Health Service Act. (b) References in this part to regulatory sections of the Code of Federal Regulations are to chapter I of title 21, unless otherwise noted. eCFR — Code of Federal Regulations https://gov.ecfr.io/cgi-bin/text-idx?SID=e06a655844034e62da6... 1 of 12 5/26/20, 1:27 PM [45 FR 36390, May 30, 1980; 46 FR 8979, Jan. 27, 1981, as amended at 63 FR 26697, May 13, 1998; 64 FR 399, Jan. 5, 1999; 66 FR 20597, Apr. 24, 2001] return arrow Back to Top §50.3 Definitions. As used in this part: (a) Act means the Federal Food, Drug, and Cosmetic Act, as amended (secs. 201-902, 52 Stat. 1040 et seq. as amended (21 U.S.C. 321-392)). (b) Application for research or marketing permit includes: (1) A color additive petition, described in part 71. (2) A food additive petition, described in parts 171 and 571. (3) Data and information about a substance submitted as part of the procedures for establishing that the substance is generally recognized as safe for use that results or may reasonably be expected to result, directly or indirectly, in its becoming a component or otherwise affecting the characteristics of any food, described in §§170.30 and 570.30. (4) Data and information about a food additive submitted as part of the procedures for food additives permitted to be used on an interim basis pending additional study, described in §180.1. (5) Data and information about a substance submitted as part of the procedures for establishing a tolerance for unavoidable contaminants in food and food-packaging materials, described in section 406 of the act. (6) An investigational new drug application, described in part 312 of this chapter. (7) A new drug application, described in part 314. (8) Data and information about the bioavailability or bioequivalence of drugs for human use submitted as part of the procedures for issuing, amending, or repealing a bioequivalence requirement, described in part 320. (9) Data and information about an over-the-counter drug for human use submitted as part of the procedures for classifying these drugs as generally recognized as safe and effective and not misbranded, described in part 330. (10) Data and information about a prescription drug for human use submitted as part of the procedures for classifying these drugs as generally recognized as safe and effective and not misbranded, described in this chapter. (11) [Reserved] (12) An application for a biologics license, described in part 601 of this chapter. (13) Data and information about a biological product submitted as part of the procedures for determining that licensed biological products are safe and effective and not misbranded, described in part 601. (14) Data and information about an in vitro diagnostic product submitted as part of the procedures for establishing, amending, or repealing a standard for these products, described in part 809. (15) An Application for an Investigational Device Exemption, described in part 812. (16) Data and information about a medical device submitted as part of the procedures for classifying these devices, described in section 513. (17) Data and information about a medical device submitted as part of the procedures for establishing, amending, or repealing a standard for these devices, described in section 514. (18) An application for premarket approval of a medical device, described in section 515. (19) A product development protocol for a medical device, described in section 515. (20) Data and information about an electronic product submitted as part of the procedures for establishing, amending, or repealing a standard for these products, described in section 358 of the Public Health Service Act. (21) Data and information about an electronic product submitted as part of the procedures for obtaining a variance from any electronic product performance standard, as described in §1010.4. (22) Data and information about an electronic product submitted as part of the procedures for granting, amending, or eCFR — Code of Federal Regulations https://gov.ecfr.io/cgi-bin/text-idx?SID=e06a655844034e62da6... 2 of 12 5/26/20, 1:27 PM extending an exemption from a radiation safety performance standard, as described in §1010.5. (23) Data and information about a clinical study of an infant formula when submitted as part of an infant formula notification under section 412(c) of the Federal Food, Drug, and Cosmetic Act. (24) Data and information submitted in a petition for a nutrient content claim, described in §101.69 of this chapter, or for a health claim, described in §101.70 of this chapter. (25) Data and information from investigations involving children submitted in a new dietary ingredient notification, described in §190.6 of this chapter. (c) Clinical investigation means any experiment that involves a test article and one or more human subjects and that either is subject to requirements for prior submission to the Food and Drug Administration under section 505(i) or 520(g) of the act, or is not subject to requirements for prior submission to the Food and Drug Administration under these sections of the act, but the results of which are intended to be submitted later to, or held for inspection by, the Food and Drug Administration as part of an application for a research or marketing permit. The term does not include experiments that are subject to the provisions of part 58 of this chapter, regarding nonclinical laboratory studies. (d) Investigator means an individual who actually conducts a clinical investigation, i.e., under whose immediate direction the test article is administered or dispensed to, or used involving, a subject, or, in the event of an investigation conducted by a team of individuals, is the responsible leader of that team. (e) Sponsor means a person who initiates a clinical investigation, but who does not actually conduct the investigation, i.e., the test article is administered or dispensed to or used involving, a subject under the immediate direction of another individual. A person other than an individual (e.g., corporation or agency) that uses one or more of its own employees to conduct a clinical investigation it has initiated is considered to be a sponsor (not a sponsor-investigator), and the employees are considered to be investigators. (f) Sponsor-investigator means an individual who both initiates and actually conducts, alone or with others, a clinical investigation, i.e., under whose immediate direction the test article is administered or dispensed to, or used involving, a subject. The term does not include any person other than an individual, e.g., corporation or agency. (g) Human subject means an individual who is or becomes a participant in research, either as a recipient of the test article or as a control. A subject may be either a healthy human or a patient. (h) Institution means any public or private entity or agency (including Federal, State, and other agencies). The word facility as used in section 520(g) of the act is deemed to be synonymous with the term institution for purposes of this part. (i) Institutional review board (IRB) means any board, committee, or other group formally designated by an institution to review biomedical research involving humans as subjects, to approve the initiation of and conduct periodic review of such research. The term has the same meaning as the phrase institutional review committee as used in section 520(g) of the act. (j) Test article means any drug (including a biological product for human use), medical device for human use, human food additive, color additive, electronic product, or any other article subject to regulation under the act or under sections 351 and 354-360F of the Public Health Service Act (42 U.S.C. 262 and 263b-263n). (k) Minimal risk means that the probability and magnitude of harm or discomfort anticipated in the research are not greater in and of themselves than those ordinarily encountered in daily life or during the performance of routine physical or psychological examinations or tests. (l) Legally authorized representative means an
Answered Same DayFeb 16, 2022

Answer To: eCFR — Code of Federal Regulations ELECTRONIC CODE OF FEDERAL REGULATIONS e-CFR data is current as...

Garima answered on Feb 17 2022
104 Votes
Review the DHHS and FDA regulations in the attached materials, and list the regulations you regard as material to addressing waiver of consent in learning health care systems generally, or in "usual care" or comparative effectiveness research in particular.
The common rule (Basic HHS Policy Subpart A of 45 CFR part 46) has been successfully adopted and implemented by several US federal agencies which gives certain guidelines for protection of human subjects in the research. One of the guidelines is requiring informed consent by the research investigator.
Under the revised federal common rule for the protection of human subjects (Basic HHS Policy Subpart A of 45 CFR part 46) (https://www.hhs.gov/ohrp/regulations-and-policy/regulations/45-cfr-46/index.html), IRB (Institutional Review Board), can approve changes required in waiving informed consent procedure. This includes,
(a) Entirely waving off the requirement(s) to get informed consent.
(b) Modifying some or all of the components of informed consent form.
(c) Waving off the requirement to get the document signed for informed consent form.
Regulatory Criteria for informed consent waver according to 45 CFR 46.116: Common Rule
Under certain specific circumstances, for example, research that involves no more than minimal risk, institutional review board may accept a request to waive off certain components or all the elements of informed consent form. Such research projects either involve minimal risk or ancillary analysis of already existing data or research in which some kind of deception is involved such as behavior analysis. According to the guidelines 46.116(f)(1)(2)(3) (HHS Policy, 2018), following are the situations under which certain or all the components of informed consent form are waved off.
(a) Research studies in which there is minimal risk or no more than minimal harm such as drawing of blood from a needle, surveys, forms, interviews etc.
(b) If the waiver of informed consent form does not interfere with the welfare and rights of the participants.
(c) In cases of deception research or behavorial analysis, where informing the...
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