21 CFR 50 Flashcards

1
Q

What is 21 CFR Part 50?

A

A federal regulation that outlines the requirements for obtaining informed consent from human subjects participating in clinical research.

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2
Q

Who is responsible for obtaining informed consent from research subjects in accordance with 21 CFR Part 50?

A

The investigator or their designated representative is responsible for obtaining informed consent.

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3
Q

What is the primary purpose of informed consent under 21 CFR Part 50?

A

The primary purpose of informed consent is to ensure that research subjects are fully informed about the study, its risks and benefits, and voluntarily agree to participate.

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4
Q

What are the 8 basic elements of informed consent?

A

1) A statement that the study involves research, an explanation of the purposes of the research and the expected duration of the subject’s participation, a description of the procedures to be followed, and identification of any procedures that are experimental
2) A description of any reasonably foreseeable risks or discomforts to the subject
3) A description of any benefits to the subject or to others which may reasonably be expected from the research
4) A disclosure of appropriate alternative procedures or courses of treatment, if any, that might be advantageous to the subject
5) A statement describing the extent, if any, to which confidentiality of records identifying the subject will be maintained
6) For research involving more than minimal risk, an explanation as to whether any compensation or any medical treatments are available if injury occurs and, if so, what they consist of or where further information may be obtained
7) An explanation of whom to contact for answers to pertinent questions about the research and research subjects’ rights, and whom to contact in the event of a research-related injury to the subject
8) A statement that participation is voluntary, refusal to participate will involve no penalty or loss of benefits to which the subject is otherwise entitled, and the subject may discontinue participation at any time without penalty or loss of benefits to which the subject is otherwise entitled.

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5
Q

When can informed consent be waived or altered under 21 CFR Part 50.20?

A

The IRB may waive or alter the requirements if the research involves no more than minimal risk, the waiver will not adversely affect the rights and welfare of subjects, and obtaining informed consent is impracticable.

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6
Q

What are the requirements for obtaining the informed consent of children participating in research under 21 CFR Part 50?

A

Informed consent from children requires both parental/guardian permission and the child’s assent, depending on their age and maturity.

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7
Q

How should informed consent be documented under 21 CFR Part 50?

A

Informed consent should be documented by a written, signed consent form, and a copy must be provided to the subject.

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8
Q

What is “comprehension” in the context of informed consent under 21 CFR Part 50?

A

Comprehension refers to the subject’s ability to understand the information presented during the informed consent process.

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9
Q

What are the consequences of not obtaining proper informed consent under 21 CFR Part 50?

A

Failure to obtain proper informed consent can result in regulatory violations, invalidation of study data, and harm to research subjects.

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10
Q

How often must informed consent be renewed according to 21 CFR Part 50?

A

Informed consent should be periodically reviewed and re-obtained if there are changes to the study, risks, or benefits.

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11
Q

What is the title of 21 CFR Part 50?

A

Protection of Human Subjects

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12
Q

According to 21 CFR Part 50, what is informed consent?

A

Informed consent is the voluntary agreement, documented by written, signed, and dated consent, of a subject to participate in research after understanding the purpose, risks, and potential benefits.

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13
Q

What are the basic elements that must be included in the informed consent form, as outlined in 21 CFR Part 50?

A

A statement that the study involves research
Explanation of the purpose, duration, and procedures
Description of foreseeable risks or discomforts
Description of any benefits
Disclosure of alternative procedures or treatments
Explanation of the voluntary nature of participation
Statement about confidentiality

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14
Q

What is the role of the Institutional Review Board (IRB) in relation to 21 CFR Part 50?

A

The IRB is responsible for reviewing and approving the informed consent process and ensuring that it meets the requirements outlined in 21 CFR Part 50.

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15
Q

How does 21 CFR Part 50 address the inclusion of vulnerable populations in research?

A

It emphasizes the need for additional protections for vulnerable populations, such as children, prisoners, and individuals with impaired decision-making capacity.

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16
Q

Explain the concept of “assent” in the context of 21 CFR Part 50.

A

Assent is the agreement of a minor child to participate in research. While not a legally binding consent like that of an adult, it involves the child’s affirmative agreement to participate to the extent they are able.

17
Q

What steps must be taken to inform communities and the public about the use of exception from informed consent under 21 CFR Part 50.24?

A

Community consultation and public disclosure must occur, involving public meetings, information distribution, and engagement with community representatives.

18
Q

What documentation does 21 CFR Part 50.27 require regarding informed consent?

A

The regulation requires the retention of signed consent forms, a copy given to the subject, and documentation of the consent process in the research records.

19
Q

How long must records of informed consent be retained according to 21 CFR Part 50.53?

A

Records must be retained for at least three years after the completion of the research.

20
Q

According to 21 CFR Part 50.20, what is the concept of “retrospective informed consent”?

A

Retrospective informed consent involves obtaining consent from subjects after they have participated in all or some of the research. This is subject to specific conditions outlined in the regulation.

21
Q

Describe the conditions under which 21 CFR Part 50.24 allows an exception from informed consent for emergency research.

A

Exception is allowed if the intervention is necessary to address a life-threatening situation, no standard treatments are available, there is insufficient time to obtain informed consent, and certain community notification and public disclosure requirements are met.

22
Q

According to 21 CFR Part 50, what is the role of a legally authorized representative in providing informed consent for a child’s participation in research?

A

The legally authorized representative provides permission, and assent from the child is also sought if they are capable of providing it.

23
Q

Explain the considerations outlined in 21 CFR Part 50.55 regarding pediatric research involving greater than minimal risk.

A

The regulation emphasizes that the research must hold the prospect of direct benefit to the individual child subjects, or the research must be a minor increase over minimal risk with the potential for a significant benefit to society.

24
Q

How does 21 CFR Part 50.54 address the informed consent requirements for subjects in foreign countries participating in clinical investigations?

A

The regulation requires that informed consent is obtained in accordance with the laws and regulations of the foreign country and in a manner consistent with 21 CFR Part 50.

25
Q

According to 21 CFR Part 50.27, how does the regulation address the use of a short form of informed consent for non-English-speaking subjects?

A

A short form, written in a language understandable to the subject, is used along with a witness and an impartial third party translator.

26
Q

Describe the additional safeguards and requirements outlined in 45 CFR Part 46 Subpart C for biomedical and behavioral research involving prisoners.

A

These include detailed provisions for obtaining informed consent, additional criteria for IRB approval, and restrictions on compensation and incentives for prisoners.

27
Q

According to 45 CFR Part 46, how does the regulation address the role of an advocate for a prisoner subject?

A

An advocate must be appointed to represent the prisoner’s interests if the IRB determines that the prisoner is incapable of providing informed consent.

28
Q

How does 21 CFR Part 50.23 address the informed consent requirements for clinical investigations involving medical devices?

A

Informed consent must include a statement that the device is being used for investigational purposes and a description of any reasonably foreseeable risks or discomforts.

29
Q

According to 21 CFR Part 50.23, what information must be provided in the informed consent process for device investigations with significant risk?

A

Detailed information must be provided about the device and the significance of the investigation, including alternative procedures or treatments and the potential benefits and risks.

30
Q

What is the title of 21 CFR Part 50?

A

PROTECTION OF HUMAN SUBJECTS

31
Q

What are the subparts/titles of 21 CFR Part 50?

A

Subpart A- General Provisions
Subpart B- Informed Consent of Human Subjects
Subpart D- Additional Safeguards for Children in Clinical Investigations