CITI Training Flashcard Example #20332

A subject participates in a drug study because treatment is available at no or reduced cost, and he could not otherwise afford it. This is an example of

A. Institutional vulnerability
B. Communicative vulnerability
C. Economic vulnerability
D. Social vulnerability

According to the authors, there are four common abuses that historically are described as giving rise to vulnerability . Which response below contains the correct four?

A. Coercion, undue influence, neglect and disrespect
B. Physical control, coercion, undue influence, and manipulation
C. Prejudice, physical control, manipulation and coercion
D. Physical control, coercion, undue influence and neglect

Identify the following groups that are protected in the federal regulations (45 CFR 46), specifically in Subparts B, C, and D with additional protections:

A. Pregnant women, prisoners, children
B. Prisoners, children, and older adults
C. Pregnant women, prisoners, and individuals who are economically disadvantaged
D. Children, prisoners, and individuals who are critically ill

Subjects with a serious illness may be at risk for exploitation since they may be desperate for a possible cure. This is an example of

A. Deferential vulnerability
B. Therapeutic misconception
C. Medical Vulnerability
D. Economic vulnerability

Which is an example of a situation where deferential vulnerability might be a factor?

A. A college professor recruiting among his students
B. An army medical officer recruiting subjects among lower ranks
C. A physician recruiting his patients
D. An employer recruiting among persons who directly report to him

In considering NBAC’s analytic approach, an otherwise competent person who is acutely ill might be considered at especially high risk of harm for:

A. Economic vulnerability
B. Communicative vulnerability
C. Situational cognitive vulnerability
D. Capacity-related cognitive vulnerability

When an IRB is reviewing a research study and they are considering if a potential subject population is vulnerable, they should consider:

A. Are there adequate resources to conduct the study?
B. Is there a power differential between researchers and subjects?
C. Are the research procedures greater than minimal risk of harm?
D. Has the researcher completed required training?

Which is true of inducements in research?

A. Like coercion, undue inducement is easy for IRBs to determine.
B. Offering $10 for an hour long research study constitutes undue inducement.
C. Inducements, like coercion, are always inappropriate, as they violate the ethical principle of respect for persons.
D. Inducements constitute an “undue influence” if they alter a potential subject’s decision-making processes, such that they do not appropriately weigh the risk-benefit relationship of the research.

NBAC proposed a concept of vulnerability in research based on features of potential subjects or of their situation. Which of the following was NOT included as possibly leading to vulnerability?

A. High risk for exploitation
B. High potential for individual benefit from participating in research
C. Difficulty providing voluntary, informed consent arising from limitations in decision-making capacity
D. Difficulty providing voluntary, informed consent arising from or situational circumstances

Which of the following brought increased public attention to the problems with the IRB system?

A. HHS Inspector General Report of 1998
B. 1983 Presidential Commission Report
C. “Shut Downs” by OHRP
D. Death of Jesse Gelsinger

Issued in 1974, 45 CFR 46 raised which of the following to regulatory status?

A. The 1974 National Research Act
B. The Nuremberg Code
C. Kefauver-Harris Drug Amendments to the Federal Food, Drug ; Cosmetics Act
D. US Public Health Service Policy

The National Research Act of 1974

A. Identified the basic ethical principles of human subjects research
B. Identified guidelines to ensure the ethical conduct of research.
C. Required that all federal agencies have the same regulations governing human subjects research.
D. Established the National Commission.

Informed consent is considered an application of which Belmont principle?

A. Non-maleficence
B. Beneficence
C. Respect for Persons
D. Justice

Which of the following concerns is related to the Belmont Principle of Justice:

A. Prisoners are not free to say no
B. Privacy and confidentiality concerns when research occurs in prisons
C. Prisoners participating in research that only benefits the larger society
D. Prisoners are not a representative sample of the general population

Which of the following was the result of the Beecher article?

A. An identification of basic ethical principles
B. Additional FDA regulations
C. Realization that ethical abuses are not limited to the Nazi regime
D. Multiple Congressional hearings

Which of the following is included in the Nuremberg Code:

A. Voluntary consent
B. Equitable selection of subjects
C. Additional Protection for vulnerable subjects
D. Confidentiality of data

A professor at Big State University is writing a biography about Bill Gates and conducting oral histories with all of Bill Gates’ friends, family members and business acquaintances. The researcher submits the research proposal to the institution’s IRB. What action can he expect by the IRB?

A. The IRB will not review this study because it does not involve an investigational new device.
B. The IRB will not review this study because it does not include human subjects as defined by the federal regulations.
C. The IRB will not review this study because it is not research as defined by the federal regulations.
D. The IRB will review this study because it includes human subjects and is considered research.

According to the federal regulations, human subjects are living human beings about whom an investigator obtains data through interaction or intervention with the individual or:

A. Identifiable private information.
B. De-identified private information.
C. Observations of public behavior.
D. Identifiable public information.

According to the federal regulations, which of the following studies meets the definition of research with human subjects?

A. An organization for women academics in engineering asks a federal agency to provide the number of women investigators funded by that agency to include in a report for its membership.
B. A university designs an in-house study to improve the mentoring of women students in its engineering department with the proposed outcome consisting of a report of recommendations for the department.
C. An experiment is proposed on the relationship between gender-related stereotypes in math and the subsequent performance by males and females on math tests.
D. A researcher receives anonymized data for secondary analysis from a survey about gender-related differences in stress levels conducted by a colleague at another university.

According to the federal regulations, which of the following studies meets the definition of research with human subjects?

A. A cognitive psychologist enrolls undergraduate students for a computer-based study about the effect of mood on problem solving behaviors.
B. Undergraduate students in a field methods class are assigned a research question and asked to interview another classmate, to be followed by a class discussion on interview techniques.
C. A researcher conducts a comparison of the comments made in a publicly available blog and the blogger’s comments on a similar topic in a weekly magazine.
D. A researcher sets up a meeting with the superintendent of a large and diverse public school system to get data about the ethnic composition of the school system and the number of students receiving free lunches.

According to the federal regulations, which of the following studies meets the definition of research with human subjects?

A. A developmental psychologist videotapes interactions between groups of toddlers and their care givers to determine which intervention methods most effectively manage aggression.
B. A researcher asks the director of a local free clinic about the number of patients in the last two years with newly diagnosed HIV/AIDS.
C. A researcher uses the Customs Office’s passenger lists for ships bringing immigrants to the US between1820-1845 to track the numbers of immigrants from certain ethnic groups.
D. A researcher conducts a linguistic study of comments posted on a local public blog.

A medical record is an example of:

A. Public behavior.
B. Public information.
C. Private information.
D. Private behavior.

According to the federal regulations, which of the following studies meets the definition of research with human subjects?

A. The collection of data, by a playground designer hired by the superintendent of schools, about the physical dimensions of school playgrounds, presence of fencing, and the kinds of equipment currently provided.
B. An analysis of aggregate data comparing statewide high school graduation rates provided by the State Department of Public Instruction, using county tax information.
C. A feasibility study for implementing a year-round school program, focusing on economic issues such a facilities utilization and transportation costs.
D. A study of twenty 4th grade classrooms in which researchers ask the schools to systematically vary the time of day reading is taught, and collect weekly assessments of reading comprehension for each child over a three-month period.

Census data (the final report as published by the Census Bureau) is an example of:

A. Private behavior.
B. Public behavior.
C. Private information.
D. Public information.

A subject in a clinical research trial experiences a serious, unanticipated adverse drug experience. How should the investigator proceed, with respect to the IRB, after the discovery of the adverse event occurrence?

A. Do not report the adverse drug experience to the IRB since it is a common adverse experience.
B. Report the adverse drug experience to the IRB only if there are several other occurrences.
C. Report the adverse drug experience in a timely manner, in keeping with the IRB’s policies and procedures, using the forms or the mechanism provided by the IRB.
D. Report the adverse drug experience as part of the continuing review report.

How long is an investigator required to keep consent documents, IRB correspondence, and research records?

A. Until data analysis is complete
B. For a minimum of three years after completion of the study
C. As long as the investigator is at that institution
D. Until the study is closed

Multiple Choice/Single Answer – Select only one answer

According to federal regulations, which of the following best describes when expedited review of a new, proposed study may be used by the IRB?

A. The study includes only research subjects that are healthy volunteers.
B. The study involves no more than minimal risk and meets one of the allowable categories of expedited review specified in federal regulations
C. The study does not require informed consent or survey instruments.
D. The study is required for a student research project

Amendments involving changes to IRB approved protocols do NOT need prior IRB approval if:

A. The investigator keeps careful records of all changes and includes them in the final report.
B. They are eligible for review using expedited procedures.
C. They only involve changes to the consent form.
D. The changes must be immediately implemented for the health and well being of the subject.

IRB continuing review of an approved protocol must:

A. Be conducted by a convened IRB.
B. Occur only when the level of risk changes.
C. Include copies of all signed consent forms.
D. Occur at least annually.

An elderly gentleman, whose wife is his legally authorized representative since his strokes several years ago, was recently diagnosed with lung cancer. He is eligible for a clinical trial using a new investigational drug that aims to treat lung cancer. He is able to express interest, shows a basic understanding of the nature of the trial, and gives his assent to participation. The subject’s wife is out of town on a business trip.

Which of the following is the most appropriate action to take for the investigator?

A. Exclude the man from the study.
B. Send a copy of the informed consent via facsimile to the subject’s wife. After she has had the opportunity to speak to the investigator, she can sign the informed consent and fax it back.
C. The investigator can go ahead and enroll the man without a signed consent.
D. Request the IRB meet and waive the requirement for a signed informed consent.

A general requirement for the informed consent is that no informed consent may include any exculpatory language. Exculpatory language is that which waives or appears to waive any of the subject’s legal rights or releases or appears to release those conducting the research from liability for negligence. Which of the following statements in a consent form is an example of exculpatory language?

A. I waive any possibility of compensation for injuries that I may receive as a result of participation in this research.
B. The investigator may stop you from participating in this research without your consent if you experience side effects that make your condition worse. If you become ill during the research, you may have to drop out.
C. Your participation in this research is voluntary. If you choose not to participate, or change your mind later, your decision will not affect your relationship with your doctor or your right to health care or other services that you may be eligible for.
D. In the event of any injury you may have related to this research, you will be given medical treatment.

A 46-year-old man is currently enrolled in a Phase 2 study of a drug for severe diabetic neuropathy. While the study is on going, a new drug becomes commercially available that may have equal or greater benefit to the subject. The investigator should do which of the following?

A. Withhold this new information to avoid confusing the subject with other treatment options or alternatives
B. Give the subject comprehensive information about the new drug, including its side effects. Discuss the pros and cons of both the investigational drug and the commercially available drug and then allow the subject to decide whether to withdraw from the research to take the new drug.
C. Do not tell the subject about the new drug since physicians have the right to try out new treatments with their patients
D. Tell the subject about the new drug but discourage him from switching treatments until the study is completed

The purpose of informed consent is:

A. To obtain a signature from a study subject in order to protect the investigator, the study staff and the institution.
B. To obtain a signature from a study subject in order to document his or her agreement to participate in research.
C. To provide a potential subject with appropriate information in an appropriate manner and allow that person to make an informed decision about participation in research.
D. To document the investigator’s participation in the consent process.

An investigator is confronted with a life-threatening situation that necessitates using a test article in a human subject who is unable to provide informed consent and there is no time to obtain consent from the individual’s legal representative and no alternative method or recognized therapy is available. Under the FDA regulations for using test articles, which of the following describes the best course of action for the investigator:

A. Do not use the test article until either the subject or the subject’s legal representative can give consent.
B. Use the test article without obtaining consent from the subject or the legal representative then notify the IRB.
C. The investigator and an independent physician agree that the situation necessitates the use of the test article. An exception or waiver for informed consent can be made under these circumstances. The IRB will be notified later.
D. Submit a research protocol to the IRB and justify an expedited review approval of the consent document so test article can be used immediately.

In a longitudinal study that will follow children from kindergarten through high school and will collect information about illegal activities, which of the following confidentiality procedures would protect against compelled disclosure of individually identifiable information?

A. Waiving documentation of consent.
B. Using pseudonyms in research reports.
C. Securing a Certificate of Confidentiality.
D. Using data encryption for stored files.

Data are made anonymous by

A. Keeping the key linking names to responses in a secure location.
B. Reporting data in aggregate form in publications resulting from the research.
C. Destroying all identifiers connected to the data.
D. Requiring all members of the research team to sign confidentiality agreements.

A researcher leaves a research file in her car while she attends a concert and her car is stolen. The file contains charts of aggregated numerical data from a research study with human subjects, but no other documents. The consent form said that no identifying information would be retained, and the researcher adhered to that component. Which of the following statements best characterizes what occurred?

A. The subjects’ privacy has been violated.
B. There was neither a violation of privacy nor a breach of confidentiality.
C. Confidentiality of the data has been breached.
D. There was both a violation of privacy and a breach of confidentiality.

When a focus group deals with a potentially sensitive topic, which of the following statements about providing confidentiality to focus group participants is correct?

A. Using pseudonyms in reports removes the concern about any confidences shared in the group.
B. If group participants sign confidentiality agreements, the researcher can guarantee confidentiality.
C. If group members know each other confidentiality is not an issue.
D. The researcher cannot control what participants repeat about others outside the group.

Which of the following constitutes both a breach of confidentiality (the research data have been disclosed, counter to the agreement between researcher and subjects) and a violation of subjects’ privacy (the right of the individuals to be protected against intrusion into their personal lives or affairs)?

A. A faculty member makes identifiable data about sexual behavior available to graduate students, although the subjects were assured that the data would be de-identified.
B. A researcher, who is a guest, audio-records conversations at a series of private dinner parties to assess gender roles, without informing participants.
C. A researcher asks cocaine users to provide names and contact information of other cocaine users
D. In order to eliminate the effect of observation on behavior, a researcher attends a support group and records interactions without informing the attendees.

In a longitudinal study that will follow children from kindergarten through high school and will collect information about illegal activities, which of the following confidentiality procedures would protect against compelled disclosure of individually identifiable information?

A. Securing a Certificate of Confidentiality.
B. Using pseudonyms in research reports.
C. Using data encryption for stored files.
D. Waiving documentation of consent.

A researcher wants to conduct a secondary analysis using a Centers for Disease Control and Prevention (CDC) database that was collected by the agency solely for surveillance purposes from 1996-2006. The researcher did not participate in the initial collection of the data. The database is publicly available. The database does not include any identifiers. The IRB makes a determination that the individuals whose records will be reviewed do not meet the federal definition of human subjects.

Which of the following considerations was relevant to the IRB’s determination that this activity does not constitute research with human subjects?

A. The researcher will not be interacting/intervening with subjects and the data has no identifiers.
B. The database reflects data collected originally for surveillance purposes.
C. The CDC is a federal agency.
D. The data was collected between 1996-2006.

As part of a research study, a physician plans to review medical records of the next 50 of her patients who require magnetic resonance imaging (MRI) scans for clinical treatment to explore factors related to patients requiring MRI scans. The physician will review the medical records, and write down the clinical indication for the scans, any existing injuries, current prescriptions, as well as other clinical data. The clinical indication for the scans and the other clinical data will be collected in the medical records for treatment purposes as part of standard clinical care. The physician will use a coding system to be able to identify the patient’s information; however, the “key” to the coding system will be stored separately from the data in a locked cabinet that only she will have access to. Which of the following is true?

A. The study is human subject research which is eligible for expedited review.
B. The research does not meet the federal definition of human subject C. The study is human subject research which must be reviewed by the full IRB.
D. The study is human subject research which is eligible for exemption.

An investigator obtains consent from subjects to review their medical records and HIV status. He plans to go back to the medical record, so the HIV status information is stored along with patient identifiers in a database that he keeps on his laptop computer. His laptop is stolen. This incident constitutes:

A. A breach of confidentiality.
B. An invasion of privacy.

When conducting research that involves collecting biological specimens for genetic testing, which of the following issues is the most important for the IRB to consider?

A. Ownership of biological specimens
B. Need for publication of results
C. Long term financial impact of results
D. Effects of findings on other family members

Identify which types of discrimination the Genetic Information Non-Discrimination Act (GINA) protects individuals from:

A. Long-term care insurance and religious discrimination
B. Health insurance and employment discrimination
C. Disability insurance and mortgage insurance
D. Gender discrimination

As of January 2015, the NIH expects investigators to obtain the informed (valid) consent of research participants in NIH -funded genetic research for broad research use of data and data sharing, even if the cell lines or specimens are:

A. De-Identified
B. From subjects under 18 years of age
C. From subjects over 18 years of age
D. Identifiable

Which choice best describes the purpose of most pharmacogenomic research?

A. To evaluate how different racial and ethnic groups respond to certain drugs or classes of drugs
B. To evaluate the association between individual genotypes and the safety and efficacy of a particular drug or class of drugs
C. To evaluate whether genetic testing can reduce the cost of pharmaceuticals
D. To evaluate how the genomes of infectious agents impact the efficacy of certain antibiotics

Investigator A has biological specimens that are coded and linked to identifiers of the source individuals. Investigator A provides the specimens to Investigator B but does not provide the individual identifiers. Investigator B agrees not to re-identify the source individuals. Is Investigator B’s research using the biospecimens human subjects research according to the definition of human subjects research in the federal regulations?

A. No, because Investigator B’s research does not involve interaction with humans.
B. Yes, because the specimens are from human subjects.
C. No, because Investigator B cannot readily ascertain the identity of the source individual and Investigator B has agreed not to attempt re-identification.
D. No, because Investigator B cannot readily ascertain the identity of the specimen sources.
E. Yes, because Investigator A retains the identifiers and therefore the specimens are identifiable.

Which of the following statements is accurate in determining subject risk involved in a genetic study:

A. All genetic studies should be considered greater than minimal risk
B. Understanding the risks involved in other genetic studies is critical in determining the risk involved in a new study
C. All genetic studies should be considered no more than minimal risk
D. Understanding the purpose and context of a specific study is critical in determining the risk involved

Which choice is the best definition of “genetic determinism?”

A. Genes are primarily responsible for human traits, including health, behavior, and disease
B. Genetic testing can determine appropriate treatments for certain health conditions
C. Genetic information about an individual can foster stigma and discrimination
D. Parents determine the nature of their children through the inheritance of genes

Under which of the following conditions is it appropriate to re-contact the individuals who provided biological specimens?

A. Original signed consent documents include provisions for recontacting subjects
B. Biological specimens need to be replenished
C. Subjects received financial compensation for participation in the study
D. Discovery of related clinical information requires contacting subjects for follow-up

Investigator A conducts research on emphysema using biospecimens from human subjects. The consent form indicates that the research will focus exclusively on emphysema. Investigator B wishes to use the biospecimens for research on lung cancer. Can Investigator B use the specimens for cancer research without re-consent if the specimens are de-identified?

A. Yes, because research with biospecimens is minimal risk.
B. Yes, if the biospecimens are de-identified then the research is no longer considered human subjects research.
C. No, because it would be unethical to conduct research that is not consistent with the consent form the subjects originally signed.
D. No, the original research subjects must be re-consented for the cancer research.

A researcher’s membership on an advisory board with an organization sponsoring research can create a COI because:

A. The research result could be flawed from missing data
B. The organization can have policies that affect the research
C. It may be difficult for the researcher to appear neutral, as the researcher may have an interest in the research’s success
D. The members of the advisory board know each other

The peer review process can create conflicts of interest because the choice of who reviews a potentially publishable project may show:

A. Their connections to the journal may yield some concern
B. There may be bias by the peer reviewer as to the area of research
C. The project has a limited scope
D. They are not informed of the area of work

An example of an institutional COI is:

A. An industry sponsor pays for the construction of a new research laboratory at the organization
B. One of the organization’s deans is the vice-chair of the organization’s IRB
C. The organization gives scholarships to some post-doctoral researchers
D. The organization’s president is a member of the board of trustees for a local non-profit organization that does not sponsor research at the organization

A researcher calls you stating that he plans to submit a proposal to the NIH for a human subjects research study. He wants to know at what point he and his study team must submit COI disclosures to comply with the PHS regulation.

A. Researchers must only submit COI disclosures if they have a significant financial interest related to the research
B. Not until a notice of award is received
C. Never — the PHS regulation does not require researchers to submit COI disclosures
D. No later than the time of proposal submission

An example of an individual financial COI is:

A. A researcher’s 10-year-old son wins a local science competition, the prize for which is a $5,000 scholarship to a workshop sponsored by a local company that sponsors one of the researcher’s ongoing projects.
B. A researcher’s wife holds equity in a publicly traded pharmaceutical company that is also the sponsor of the researcher’s study.
C. A researcher’s wife works at the same university as the researcher.
D. A researcher is considering buying stock in a publicly traded company that specializes in making and delivering hand tossed pizza.

The COI management plan aims to:

A. Address disclosure of COIs in multi-center research when a COI is disclosed
B. Reduce IRB review burden when a COI is disclosed
C. Eliminate all COIs in research when a COI is disclosed
D. Provide procedures or extras steps to be taken to minimize the risk of bias when a COI is disclosed

The PHS regulations about financial conflict of interests require which party to disclose significant financial conflicts of interest?

A. Organization
B. IRB Member
C. Researcher
D. Sponsor
E. Applicants submitting marketing applications for drugs, biologics, or devices

The FDA regulations governing disclosure of individual COIs require:

A. Organizations to disclose financial COIs to the FDA no later than the time of submission of the IND application
B. Applicants submitting marketing applications to disclose financial COIs of researchers who conducted clinical studies
C. Researchers to annually self-disclose financial COIs to the FDA
D. Sponsors to annually disclose to the FDA financial COIs of researchers who conducted clinical studies

What is the term for management controls that are built in to a research study (for example, independent data analysis)?

A.Objective controls
B.Inherent controls
C.Mandated controls
D.Required controls

During an Institutional Review Board (IRB) meeting, any IRB member who may have a potential COI with a study under review should:

A. Disclose their potential COI, but not answer any questions about the study
B. Disclose their potential COI and not participate in any action
C. Disclose their potential COI and may answer questions, but recuse themselves from voting
D. Leave the meeting immediately