A central institutional review board for multi-institutional trials

These are difficult times for the nation's system of protection for human subjects in research.1–10 On the basis of a series of reports, the Office of the Inspector General of the Department of Health and Human Services concluded that institutional review boards (IRBs) are now forced to “review too much, too quickly, with too little expertise,” and with inadequate resources.6 One consequence is that there is minimal, often perfunctory, review of ongoing research. In addition, IRB members have become disillusioned as a result of both public criticism concerning the perceived failures of the boards and the increasing amount of . . .