Page 31 - Ethical Guidelines for Conducting Research Studies Involving Human Subjects
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10.1.5 Special Concerns

                                         10.1.5.1      Multicenter Trials

                                         A  multicenter  research  trial  is  a  clinical  trial  conducted  at
                                         more  than  one  medical  center  or  clinic.  Most  large  clinical
                                         trials, particularly Phase III trials, are conducted at several
                                         clinical  research  centers.  The  benefits  of  multicenter  trials
                                         include a larger number of participants, different geographic
                                         locations,  the  possibility  of  inclusion  of  a  wider  range  of
                                         population groups, and the ability to compare results among
                                         centers, all of which increase the generalizable  of the study.
                                         Ideally, these trials should be initiated at the same time at
                                         all the centers.

                                                i.     All  investigators  should  give  a  written
                                                acceptance  of  the  protocol.    The  protocol  may  be
                                                modified  to  suit  the  local  requirements,  as  well  as
                                                should  be  appropriately  approved  by  the  ethics
                                                committee of the host institutes/country.
                                                ii.    In  a  meaningful  multicenter  trial,  all  study
                                                sites should be conducted in the same way and should
                                                follow  standardized  procedures  and  evaluation
                                                criteria.  So,  meetings  should  be  arranged  at  the
                                                initial and intermediary stages of the trial to ensure
                                                consistent procedures at all centers.
                                                iii.   All research staff at the participating centers
                                                should  be  trained  to  familiarize  them  with  the
                                                uniform  procedures,  data  entry  in  the  case  record
                                                forms, ethics and GCP.
                                                iv.     For  recruitment,  evaluation/monitoring  of
                                                laboratory   procedures    and    conduct    of   trial,
                                                standardization of methods should be carried out.
                                                v.     If  necessary,  in  the  protocol  there  should  be
                                                monitoring  of  adherence  to  protocol  including
                                                measures  to  terminate  the  participation  of  some
                                                centers.  For  this  purpose  a  central  monitoring
                                                committee could be set up including ethics committee
                                                members.
                                                vi.    Specific  role  of  coordinators  and  monitors
                                                should be defined.
                                                vii.    According  to  WHO’s  “Operational  Guidelines
                                                for  the  Establishment  and  Functioning  of  Data  and
                                                Safety   Monitoring     Boards”,    centralized   data
                                                management and analysis should be planned.
                                                Viii.   Drafting  procedure  for  common  final  report
                                                and  publication  should  be  decided  at  the  outset.  No



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