Performing Ethical Research as a Plastic Surgeon in Private Practice: The Institutional Review Board

Plastic surgery as a specialty has embraced evidence-based medicine.1,2 With innovation at their core, plastic surgeons are striving to increase the levels of evidence in their specialty. This paradigm shift to evidence-based medicine has the potential to improve quality of care and patient safety in areas traditionally lacking evidence such as aesthetic surgery. Aesthetic surgery however is often performed in nontraditional settings for research such as private offices and ambulatory surgery centers independent of larger institutions. Many jurisdictions have medical professional society as well as healthcare government regulated oversight and regulations to safeguard patient safety and maintain standards of clinical care in such independent healthcare facilities. However, no readily identifiable systems to safeguard ethical conduct of research in these same facilities is generally present. Regardless of the location, all human research must be reviewed and approved by an Institutional Review Board (IRB) prior to study initiation. Unfortunately, private facilities typically do not have easy access to an IRB, making approval and oversight difficult to obtain. Obtaining an IRB for plastic surgeons in private practice is often a convoluted process and creates an obstacle in producing research and, in turn, improving the standards of care in aesthetic surgery. Several options exist for ethics board approval after determining whether the study requires it. This article will outline the function of an IRB, when one is required, and the IRB options that are available. In doing so, we hope to clarify some of the issues surrounding the IRB for plastic surgeons in private practice. An IRB, also known in Canada as a Research Ethics Board (REB), is a committee charged with approving, monitoring, and reviewing biomedical research involving human subjects.3 An IRB's goal is to protect the rights and welfare of research subjects. Researchers submit their study protocol and … Corresponding Author: Dr Jamil Ahmad, The Plastic Surgery Clinic, 1421 Hurontario Street, Mississauga, Ontario, Canada L5G 3H5. E-mail: drahmad{at}theplasticsurgeryclinic.com

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