• Sebastian Blecha, Kathrin Thomann-Hackner, Susanne Brandstetter, Frank Dodoo-Schittko, Philipp Seboek, Christian Apfelbacher, Bernhard M Graf, and Thomas Bein.
• Klinik für Anästhesiologie, Universitätsklinikum Regensburg.
• Dtsch. Med. Wochenschr. 2015 Sep 1; 140 (18): e186-93.

BackgroundHealth services research (HSR) is of fundamental importance for the continuous improvement of preventive, diagnostic or therapeutic measures. The conduct of multi-centre HSR studies requires that ethical approval by Institutional review boards (IRB's) is obtained. We documented the effort, the complexity and the man power necessary to obtain secondary ethical approval for a national HSR in Germany ("Surviving the Acute Respiratory Distress Syndrome" [DACAPO-study]).MethodsHaving obtained a primary ethical approval by the IRB of Regensburg University, the time, correspondence, necessity for amendments, corrections, or additional costs by 34 IRB's for 64 participating study centers was documented.ResultsThe complete obtainment was found to be time consuming and associated with a high workload and man power. A time span of seven month was needed to receive votes from all IRB's. The median time span was 25,5 days (25 %/75 % percentile 13 and 42 days, respectively). Requirements in terms of corrections or amendments were inhomogeneous and frequent changes were necessary. There were additional fees for secondary votes of 4328,40 €. Total costs for the study center Regensburg were 21.193,40 € (2,6 % of the grant volume).ConclusionObtaining all ethical approvals for a multi-centre observational HSR study in Germany is complex and time consuming. Various and inhomogeneous formalities may delay the plan and realization of HSR. A Homogenization and simplification of the procedure of ethics votes should be discussed.© Georg Thieme Verlag KG Stuttgart · New York.

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