2. Accreditation – the formal recognition by an independent body,
generally known as an accreditation body, that the certification body
operates according to standards.
Accreditation- process to improve the quality of ethical research.
a) Institute ethics committees
b) Principal investigators
c) Centers desirous of carrying out clinical trials.
INTRODUCTION
4. highest possible standards and protections
assurance of quality
improves efficiency, effectiveness
Government recognition
5. sole non-governmental organization in USA, which was established to promote accreditation as a way
to improve the quality of research and protect research participants.
6.
7. OBJECTIVE: EC is adequately qualified, experienced, and
knowledgeable in ethical issues and applicable rules and regulations for
conduct of clinical trials ensuring scientific integrity and protection of
subject rights, safety and wellbeing.
OUTCOME:
1. EC competently assesses risk and scientific validity of trials.
2. EC has appropriate measures to ensure protection of subject rights,
safety and wellbeing.
3. There shall be transparency in EC functioning and procedures are
followed for all essential activities.
8. 1.1 Authority for formation of Ethics Committee
1.2 Standard Operating Procedures (SOPs)
1.3 Ethics Committee Composition
1.4 Protection of subject rights, safety and wellbeing
1.5 Administrative support
1.6 Review Process
1.7 Decision making and post meeting activities
1.8 Monitoring
1.9 Self-Assessment
1.10 Record keeping and archival
9. OBJECTIVE: Investigators are adequately qualified, experienced and knowledgeable
in trial processes, ethical issues and applicable rules and regulations for conduct of
clinical trials ensuring data integrity and protection of subject rights, safety and
wellbeing.
OUTCOME:
1. Clinical trial conduct is ethical and in compliance with the applicable rules and
regulations.
2. There are appropriate measures to ensure protection of subject rights, safety and
wellbeing.
3. There is transparency in the conduct of clinical trials and documented procedures
are followed by the investigators/relevant site staff for all essential activities.
10. 2.1 Qualification, Experience and Training
2.2 Compliance to standard operations procedures (SOPs)
2.3 Protection of subject rights, safety and wellbeing
2.4 Informed consent process
2.5 Safety Reporting and Management
2.6 Clinical Trial documents and materials
2.7 Clinical Trial Conduct
11. OBJECTIVE: Clinical Trial Sites shall have adequate infrastructure, facilities,
documented procedures and oversight mechanism to support clinical trial conduct as
per applicable rules and regulations ensuring trial integrity and protection of subject
rights, safety and wellbeing.
OUTCOME:
1. Clinical Trial conduct must be ethical and in compliance with the applicable rules
and regulations.
2. There are appropriate measures to ensure protection of subject rights, safety and
wellbeing.
3. There is transparency in the conduct of Clinical Trials and documented procedures
are available and followed by accredited investigators associated with the clinical
trial site.
4. There is an oversight mechanism by the Clinical Trial Site to maintain the ethical
and quality standards.
12. 3.1 Responsibility of management for the Clinical Trial Site(s)
3.2 Qualification, Experience and Training
3.3 Site SOPs and documented procedures
3.4 Protection of subject rights, safety and wellbeing
3.5 Clinical Trial materials, documentation and IT systems
3.6 Clinical Trial Oversight
action or process of officially recognizing someone or something as being qualified to perform a particular activity.
CT gives confidence to volunteers – subjected to any unijustified and hazardous trials
confidence to regulatory body and govt – trials is well run and it will ensure both ethical and scientific integrity.
CT – conducted at sites – accredited in all 3 areas. Illegal by DCGI.
An Expert Committee under the Chairmanship of Prof. Ranjit Roy Chaudhury was constituted by the Ministry of Health & Family Welfare to formulate policy and guidelines for approval of new drugs, clinical trials and banning of drugs. One of the recommendations of the committee was that clinical trial should be conducted only at accredited sites by accredited investigator under the supervision of accredited Ethics Committees.
Benefits for Subjects: biggest beneficiary among all the stakeholders. Accreditation of EC- high quality of care and safety to subjects. Rights and welfare of the subjects are respected and protected.
Benefits for Sites : Accreditation stimulates continuous improvement. It helps sites in demonstrating commitment to quality care. It also provides assurance to other stakeholders that all the procedures carried out at the site(s) are in compliance to regulatory guidelines and standard.
Benefits for regulatory bodies: Accreditation provides access to reliable and certified information on facilities, infrastructure and process followed in conducting clinical trials. It provides assurance and a sense of satisfaction to regulatory bodies that all the procedures and process of carrying out research are in accordance with laid principles as per schedule Y, GCP guidelines and other applicable regulatory requirements
Benefits for Site Staff: The staff at the Sites are benefitted a lot as it provides continuous learning, good working environment. It improves overall professional development of an Investigator, research professionals & nursing staff
The initial accreditation period is three years. After that you apply for reaccreditation. Thereafter, the accreditation period is five years.
Kasturba Medical College and Hospital, Manipal [KMC], and Manipal Hospital Bangalore [MHB]
*Both Independent Ethics Committee for BA/BE studies and Institutional EC for clinical trials
IECs are presently being registered by the Indian Council of Medical Research (ICMR).
. Within each Domain are Standards, and for each Standard there are Elements that provide more specificity for the Standard. For each Element, there are essential requirements that all Organizations must follow.
SOPs for Ethics Committees- Composition, Declaration of conflict of interest and confidentiality agreement, Frequency of ethics committee meetings, SOPs for protocol submission and review of protocol, SOPs for documentation and archival of records.
Composition – multidisciplinary, Roles and responsibilities of members are well defined
1.4 Rights and responsibility of subject are documented, Confidentiality and privacy of subjects is protected. Compensation for injury
1.6 trial related documents. Informed consent document, assent form, and translations.
Investigator follows documented procedures i.e SOPs for clinical trial conduct.
2.1 Criteria for qualifications of an investigator to qualify for accreditation ; Should have a medical degree registered with the MCI. training in Good Clinical Practice, well-versed with principles and procedures of informed consent process, clear understanding of ethical issues,
Availability of the general facilities and equipment, Diagnostics facilities, storage and inventory management of investigational product
3.2 The Clinical Trial Site follows documented procedures to ensure that investigators and relevant site staff is qualified and knowledgeable about applicable rules and regulations.
Full Accreditation: An Organization placed in this category meets all the Accreditation Standards. Full Accreditation for three years
Qualified Accreditation: meets almost all the Accreditation Standards and the Issues that need to be corrected are minor. if the issues get resolved then Full Accreditation for the remainder of the period of accreditation
Accreditation-Pending: The Council on Accreditation may place an Organization in the Accreditation-Pending category when the Organization does not meet the criteria for Full or Qualified Accreditation but the council thinks that organization is willing to take corrective actions within reasonable period of time. Has to submit an Improvement Plan seven months
Accreditation Withheld: An Organization placed in this category does not meet a enough number of Accreditation Standards and the Accreditation Council believes that the Organization will not commit to undertake corrective action.
Before the end of its then-current accreditation period, an Organization must reapply for reaccreditation. The Council on Accreditation may place the applicant in one of four categories.
Reaccreditation-Pending: The Council on Accreditation places an Organization in the Reaccreditation-Pending category until it decides whether to award Full Accreditation, place the Organization on Probation, or to Revoke Accreditation. does not meet the criteria for Full Accreditation. Council believes the Organization is able and willing to commit
Probation; The Council on Accreditation places an Organization on probation when the Organization does not meet the criteria for Full Accreditation and cannot make changes within a reasonable time period, usually three months.
Accreditation Revoked: The Council on Accreditation may revoke accreditation when an Organization does not meet the criteria for Full Accreditation, and the Council believes the Organization has demonstrated an inability or unwillingness to take effective corrective action.