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Trials
Published in: Trials 1/2011

Open Access 01-12-2011 | Research

Who is the research subject in cluster randomized trials in health research?

Authors: Andrew D McRae, Charles Weijer, Ariella Binik, Angela White, Jeremy M Grimshaw, Robert Boruch, Jamie C Brehaut, Allan Donner, Martin P Eccles, Raphael Saginur, Merrick Zwarenstein, Monica Taljaard

Published in: Trials | Issue 1/2011

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Abstract

This article is part of a series of papers examining ethical issues in cluster randomized trials (CRTs) in health research. In the introductory paper in this series, we set out six areas of inquiry that must be addressed if the CRT is to be set on a firm ethical foundation. This paper addresses the first of the questions posed, namely, who is the research subject in a CRT in health research? The identification of human research subjects is logically prior to the application of protections as set out in research ethics and regulation. Aspects of CRT design, including the fact that in a single study the units of randomization, experimentation, and observation may differ, complicate the identification of human research subjects. But the proper identification of human research subjects is important if they are to be protected from harm and exploitation, and if research ethics committees are to review CRTs efficiently.
We examine the research ethics literature and international regulations to identify the core features of human research subjects, and then unify these features under a single, comprehensive definition of human research subject. We define a human research subject as any person whose interests may be compromised as a result of interventions in a research study. Individuals are only human research subjects in CRTs if: (1) they are directly intervened upon by investigators; (2) they interact with investigators; (3) they are deliberately intervened upon via a manipulation of their environment that may compromise their interests; or (4) their identifiable private information is used to generate data. Individuals who are indirectly affected by CRT study interventions, including patients of healthcare providers participating in knowledge translation CRTs, are not human research subjects unless at least one of these conditions is met.
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Metadata
Title
Who is the research subject in cluster randomized trials in health research?
Authors
Andrew D McRae
Charles Weijer
Ariella Binik
Angela White
Jeremy M Grimshaw
Robert Boruch
Jamie C Brehaut
Allan Donner
Martin P Eccles
Raphael Saginur
Merrick Zwarenstein
Monica Taljaard
Publication date
01-12-2011
Publisher
BioMed Central
Published in
Trials / Issue 1/2011
Electronic ISSN: 1745-6215
DOI
https://doi.org/10.1186/1745-6215-12-183

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