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MEETING MINUTES





Committee: Upper South B Regional Ethics Committee

Meeting date: 7 November 2011

Meeting venue: Sudima Hotel, cnr Memorial Avenue and Orchard Road, Christchurch

Dakota Room



Time Item of business

4.00pm 1. Welcome

2. Confirmation of minutes of meeting of 29 August 2011

3. Resubmissions of previously deferred applications (see over for details)

Nil

4. New applications for review (see over for details)

i. URB/11/11/039 – Magnus McGee

ii. URB/11/11/040– Raewyn Idoine

iii. URB/11/11/041– Dr Mary Livingston

iv. URB/11/11/042– Annette Finlay

v. URB/11/11/043 – Dr Melissa Copland

vi. URB/11/11/044 – Dr Sarah Gunningham

vii. URB/11/11/045 – Judene Edgar

viii. URB/11/11/046 – Selma Scott

5. General business

6. Amendments to approved applications

Nil

Meeting closes







Committee members: Patricia Costigan, Chair

Annette Finlay

Sarah Gunningham

Selma Scott

Judene Edgar

Magnus McGee

Raewyn Idoine

Mary Livingston

Melissa Copland

Apologies: None





Administrator(s): Diana Whipp









URB Minutes 7 November 2011

1. Welcome



 The Chair opened the meeting at 4.05pm and welcomed the Committee members.



 The Chair noted that the meeting was quorate, with 9 members present, and there was a

balanced representation of lay and non-lay members.



 The Committee noted and agreed the agenda for the meeting.



 Potential conflicts of interest declared:

 Dr Sarah Gunningham is the Principal Investigator for the submitted Tissue Bank study

URB/11/11/040.





2. Confirmation of previous minutes



 The minutes of the meeting of 29 August 2011 were confirmed subject to one amendment on

page 9: Dr Paparangi Reed is female and therefore reference to her needs to be changed to

‘she’.



3. Resubmissions of previously deferred applications

Nil



4. New applications for review



1. Ethics ref: URB/11/11/039

Title: A prospective randomised trial of Niti-S full covered vs double

layered oesophageal stents for malignant dysphagia



Principal Investigator: Dr Gary Lim

Main Site: Christchurch Hospital

Reviewer(s): Magnus McGee



locality Māori

Locality documentation received? assessment consultation

Part 4



Canterbury District Health Board Yes Yes Yes



Potential conflicts of interest

- No potential conflicts of interest were declared.



Discussion

The main points discussed by the Committee were as follows.



- The Committee is concerned about the efficacy of the use of stents. It appears that the

researcher has some prior knowledge on the efficacy of stents. The Committee notes that a 5

year retrospective study of oesophageal stent insertion for malignant dysphagia in Christchurch,

NZ. is in progress. The results to date of this study need to be provided to the Committee. The







URB Minutes 7 November 2011

2

Committee also requires clarification about the current criteria for deciding which stent is selected

at Christchurch Hospital.

- The Committee found the description of the sample size calculation to be inadequate. A detailed

description of the sample size calculation including a justification the expected design affect and

its standard deviation is required.

- On this basis, the Committee found that the application failed to meet the requirements for ethical

research as found in the Operational Standards for Ethics Committees, 2006. In particular the

relevant provisions found in section 2.4 Validity of Research Proposal number 57 (ii) and (iii).



Decision

Following this discussion, the Upper South B Regional Ethics Committee deferred the above study.



Point of contact for applicant

The Committee decided that the Administrator be available to be contacted by the applicant with any

questions arising from its decision on this application.







2. Ethics ref: URB/11/11/040

Title: Ang – 1/IL-29 as markers of cancer in patients with venous

thromboembolism



Principal Investigator: Dr Sarah Gunningham

Main Site: Christchurch Tissue Bank

Reviewer(s): Raewyn Idoine



locality Māori

Locality documentation received? assessment consultation

Part 4



Not applicable No No No



Potential conflicts of interest

Dr Sarah Gunningham is the Principal Investigator for the submitted Tissue Bank study

URB/11/11/040. Dr Gunningham left the room whilst the study was being considered.



Discussion

The main points discussed by the Committee were as follows.



- This is a straightforward and well written application.



Decision

Following this discussion, the Committee decided to approve the above study.



Point of contact for applicant

The Committee decided that the Administrator be available to be contacted by the applicant with any

questions arising from its decision on this application.







3. Ethics ref: URB/11/11/041

Title: Colorectal cancer (CRC) and chronic kidney disease − CRC

screening and early detection

Principal Investigator: Dr Nicholas B Cross







URB Minutes 7 November 2011

3

Main Site: Christchurch Hospital

Reviewer(s): Dr Mary Livingston



locality Māori

Locality documentation received? assessment consultation

Part 4



Christchurch Hospital Pending Pending Yes



Potential conflicts of interest

- No potential conflicts of interest were declared.



Discussion

The main points discussed by the Committee were as follows.



- The Committee is concerned that because of differences in health provisions the New Zealand

arm of the study will be quite different from the Australian arm and that combining the two data

sets might not be valid. The researcher needs to explain and justify why combining the two arms

would be appropriate.

- On this basis, the Committee found that the application failed to meet the requirements for ethical

research as found in the Operational Standards for Ethics Committees, 2006. In particular the

relevant provisions found in section 2.4 Validity of Research Proposal number 57 (iii).

- The Committee strongly encourages the researcher to attend the meeting if and when this

application is resubmitted.



Decision

Following this discussion, the Upper South B Regional Ethics Committee deferred the above study.



Other requests for the researcher to note for any future resubmission of the application



Application Form

- Please clarify the funding for the colonoscopies.

- The flow diagram stating 268 patients is inconsistent with the application form which refers to 100

patients.

- Please clarify whether this is a 5 or 7 year study.

- Please confirm whether the screening test laboratory is in New Zealand or Australia and the

reasons for this choice.



Information sheet

- An Information Sheet is required for the 60 people on the sub study.

- Health data must be stored for 10 years. This must be stated in the Information Sheet. For

studies that involve children, health data must be stored for 10 years after the youngest

participant has turned 16 years of age.

- Please amend your Statement of approval to read as follows:

This study has received ethical approval from the Upper South B Regional Ethics Committee,

ethics reference number URB/11/11/041.

Consent Form

- A Consent Form is required for the 60 people on the sub study.

- A number of co-investigators are mentioned in the Consent Form but they are not included on the

application form. Please include them in the application form.

- Please remove the declaration about being over 16 years of age as this is not relevant to this

study.



Locality Assessment Form

A locality assessment form is required for this study for each site.





URB Minutes 7 November 2011

4

Maori consultation

Written evidence of Maori consultation is required for this study.



Point of contact for applicant

The Committee decided that the Administrator be available to be contacted by the applicant with any

questions arising from its decision on this application.







4. Ethics ref: URB/11/11/042

Title: Efficacy and acceptability of chewing gum to reduce postoperative ileus, pain and

nausea after elective open abdominal surgery in a New Zealand context



Principal Investigator: Dr Katherine Hulme

Main Site: Wairau Hospital, NMDHB



Reviewer(s): Annette Finlay



locality Māori

Locality documentation received? assessment consultation

Part 4



Wairau Hospital, NMDHB

Yes Pending Yes



Potential conflicts of interest

- No potential conflicts of interest were declared.



Discussion

The main points discussed by the Committee were as follows.



- It appears that this study is similar to the work of the systematic review of the ‘Fitzgerald Review’.

The Committee did not find the application provided sufficient information to understand why this

additional study needed to be carried out.

- The requirement for a full power calculation for this study.

- The study cannot provide a New Zealand context if it is conducted in only one location.

- The definition of ileus versus post operative paralytic ileus was discussed.



Decision

Following this discussion, the Committee decided to approve this application subject to the

following conditions, which are to be checked by the Chairperson and Spokesperson.



Requirements



Application Form

It appears that this study is similar to the work of the systematic review of the ‘Fitzgerald Review’.

Therefore, please justify why this additional study is being done.



Please provide a full power calculation for this study explaining where the data has been taken from.



Please clarify whether the participant is chewing gum for 10 minutes 3 times a day or for 30 minutes

once per day and ensure that this information is consistent with the Information Sheet.









URB Minutes 7 November 2011

5

Short project title (lay title): use language that is readily understandable by laypersons. This title is

also to be used on the consent form and information sheet.



Information sheet

- For administrative clarity please include a footer on the Information Sheet with the full study title,

version number, and/or date (dd/mm/yy).

- Please amend your Statement of approval to read as follows:

This study has received ethical approval from the Upper South B Regional Ethics Committee,

ethics reference number URB/11/11/042.

Consent Form

For administrative clarity please include a footer on the Consent Form with the full study title, version

number, and/or date (dd/mm/yy).



Locality Assessment Form

- The first page of the Locality Assessment Form needs to be completed.



Maori consultation

- Written evidence of Maori consultation is required for this study.



Suggestion

Please consider asking the placebo group if they used chewing gum as part of the exit survey.



Point of contact for applicant

The Committee decided that the Administrator be available to be contacted by the applicant with any

questions arising from its decision on this application.







5. Ethics ref: URB/11/11/043 – CLOSED MEETING

Title: Protocol NP27945: A Two part Relative bioavailability Study

Between the Danoprevir Tablet Formulation 1, Danoprevir Tablet

Formulation 2, and the reference Phase 2 Tablet Formulation (Part

1) and Between the Ritonavir Test formulation 1, Ritonavir Test

Formulation 2, and the Reference Ritonavir Formulation Norvir ®

(Part 2) following Oral Administration to Healthy Subjects

Principal Investigator: Dr Richard Robson

Main Site: Christchurch Clinical Studies Trust

Reviewer(s): Dr Melissa Copland



locality Māori

Locality documentation received? assessment consultation

Part 4



Christchurch Clinical Studies Trust Yes Yes Yes



Potential conflicts of interest

- No potential conflicts of interest were declared.



Decision

In a closed meeting the Upper South B Regional Ethics Committee approved this application

subject to conditions.



Point of contact for applicant









URB Minutes 7 November 2011

6

The Committee decided that the Administrator be available to be contacted by the applicant with any

questions arising from its decision on this application.







6. Ethics ref: URB/11/11/044

Title: A Phase 3, Randomized, Double-Blind, Placebo-Controlled,

Parallel-Group Study to Assess the Safety and Efficacy of Two

Different Regimens of Mipomersen in Patients with Familial

Hypercholesterolemia and Inadequately Controlled Low-Density

Lipoprotein Cholesterol. Protocol Number: MIP03801011

Principal Investigator: Professor Russell Scott

Main Site: Diabetes Research Institute, 40 Stewart Street

Reviewer(s): Dr Sarah Gunningham



locality Māori

Locality documentation received? assessment consultation

Part 4



Diabetes Research Institute, 40 Stewart Street Yes Pending Yes



16 St Asaph Street Yes Pending Yes



Potential conflicts of interest

- No potential conflicts of interest were declared.



Discussion

The main points discussed by the Committee were as follows.



- Reimbursement for participants is unclear and may be insufficient.

- Additional information about blood samples, and withdrawal protocol from study needs to be

included in the Information Sheet and Consent Form.



Decision

Following this discussion, the Committee decided to approve this application subject to the

following conditions, which are to be checked by the Chairperson and Spokesperson.



Requirements



Application Form

A.9.2 Please clarify what reimbursement will be given to participants and include this information in

the Information Sheet.



Invitation Letter

- The invitation letter needs to include an explanation about how the participant has been

identified.

- The invitation letter should be prepared on the appropriate letterhead of the principal

investigator’s institution and the full address of the ‘Hagley Building’ given.



Information sheet

- No mention is made in the Information Sheet of the blood samples being sent to the USA for

analysis, the storage time for samples and the protocol for withdrawal from the study. Please

include this information in the Information Sheet and Consent Form.







URB Minutes 7 November 2011

7

- Please include another contact on the Information Sheet so that if Professor Scott is unavailable

there is an alternative contact for participants.

- Please amend your Statement of approval to read as follows:

This study has received ethical approval from the Upper South B Regional Ethics Committee,

ethics reference number URB/11/11/044.

Insurance Certificate

Please provide the Committee with amended insurance certificates which covers the full period of the

study.



Suggestion

The Committee recommends that an appropriate reimbursement be made to participants for this

study.



Point of contact for applicant

The Committee decided that the Administrator be available to be contacted by the applicant with any

questions arising from its decision on this application.







7. Ethics ref: URB/11/11/045

Title: WHY ARE NEUTROPHILS UNABLE TO KILL BACTERIA IN THE

AIRWAYS OF CHILDREN WITH CYSTIC FIBROSIS?



Principal Investigator: Dr Anthony J Kettle

Main Site: Christchurch Hospital, CDHB

Reviewer(s): Judene Edgar



locality Māori

Locality documentation received? assessment consultation

Part 4



Christchurch Hospital, CDHB Yes Yes Yes

Department of Pathology, University of Otago, No Yes Yes

Christchurch

Canterbury Scientific, Christchurch No Yes Yes



Dr Anthony Kettle attended the meeting.



Potential conflicts of interest

- No potential conflicts of interest were declared.



Discussion

The main points discussed by the Committee were as follows.



- This is a worthwhile study but some amendments are required on the Information Sheet and

Consent Form to make them age appropriate and easy to understand.



Decision

Following this discussion, the Committee decided to approve this application subject to the

following conditions, which are to be checked by the Chairperson and Spokesperson.



Requirements



Application Form

- No. 16 Consent: this should be answered with ‘No’ and not ‘Yes’. Please amend.





URB Minutes 7 November 2011

8

- Part 8: Please refer to the requirements for ‘Research with children’ on page 33 of the

Guidelines for the Completion of the National Application Form for Ethical Approval of a

Research Project (NAFG), and ‘Appendix 1: Guidelines for Health Research with Children’ on

pages 51 – 55 of the Operational Standard for Ethics Committees in particular the section on

‘Consent’ in paragraph 263, pages 53 - 54. In the event the child is competent to consent,

the form submitted with the application is appropriate. However, in the event that the

child is deemed not competent to consent, then parent/caregiver consent will be

necessary which should also include the child’s assent. The wording or clauses in pages 21

– 29 of the NAFG, ‘Pro forma for Consent Form’ may be helpful for use or adaption.



Information sheet

- Short project title (lay title): use language that is readily understandable by laypersons. This title

is also to be used on the consent form.

- The wording in the Information Sheet needs to be reviewed to ensure that technical terms and

words are written in lay language eg on page 2 replace the word ‘neutrophils’ with ’white blood

cells’.

- Please rewrite the Information Sheet in more age appropriate language.

- Page 1: Please remove the reference to chlorine bleach.

- Page 3: Please remove the first sentence at the top of page 3 ‘If students or health

……organisation’.

- All references to 50mls blood need to be changed to 20mls.

- Please amend your Statement of approval to read as follows:

This study has received ethical approval from the Upper South B Regional Ethics Committee,

ethics reference number URB/11/11/045.

Consent Form

- Please ensure that the Consent Form is age appropriate and the Consent Form needs to follow

the format of the pro forma template as found on page 20 of the guidelines for completion of the

National Application Form, found using the following link:

http://www.ethicscommittees.health.govt.nz/moh.nsf/pagescm/6771/$File/naf-guidelines-2009-v1-

3.doc



Point of contact for applicant

The Committee decided that the Administrator be available to be contacted by the applicant with any

questions arising from its decision on this application.







8. Ethics ref: URB/11/11/046

Title: Insomnia and Melatonin: A Polar Exploration





Principal Investigator: Wells Weymouth

Main Site: Gateway Antarctica

Reviewer(s): Selma Scott



locality Māori

Locality documentation received? assessment consultation

Part 4



Gateway Antarctica Yes No Yes



Wells Weymouth and Dr Gary Steel attended the meeting.



Potential conflicts of interest







URB Minutes 7 November 2011

9

- No potential conflicts of interest were declared.



Discussion

The main points discussed by the Committee were as follows.



- This study needs to meet the prescribing process in New Zealand.

- The Information Sheet and Consent Forms need to be reviewed.

- Maori consultation is required for this study.



Decision

Following this discussion, the Committee decided to approve this application subject to the

following conditions, which are to be checked by the Chairperson and Spokesperson.



Requirements



Application Form

Form A: the statutory declaration needs to be signed by the most senior registered health

professional ie prescribing physician.



Information sheet

- The Information Sheet needs to include that the drug taken is a prescription medicine and

confirm the process that will be used for this medicine to be prescribed for participants ie which

medical practitioner they will visit.

- Please combine the invitation sheet and the information sheet to avoid confusion.

- Please use wording appropriate for New Zealand.

- Please highlight, embolden or move the ‘Participants’ Rights’ statement to the first page of the

Information Sheet.

- “Compensation”: Please include with the appropriate ACC wording (as per the recommended

Guidelines) as follows:

‘In the unlikely event of a physical injury as a result of your participation in this study, you may

be covered by ACC under the Injury Prevention, Rehabilitation and Compensation Act. ACC

cover is not automatic and your case will need to be assessed by ACC according to the

provisions of the 2002 Injury Prevention Rehabilitation and Compensation Act. If your claim

is accepted by ACC, you still might not get any compensation. This depends on a number of

factors such as whether you are an earner or non-earner. ACC usually provides only partial

reimbursement of costs and expenses and there may be no lump sum compensation

payable. There is no cover for mental injury unless it is a result of physical injury. If you have

ACC cover, generally this will affect your right to sue the investigators.

If you have any questions about ACC, contact your nearest ACC office or the investigator.’

‘You are also advised to check whether participation in this study would affect any indemnity

cover you have or are considering, such as medical insurance, life insurance and

superannuation.’

- Please amend your Statement of approval to read as follows:

This study has received ethical approval from the Upper South B Regional Ethics Committee,

ethics reference number URB/11/11/046.For administrative clarity please include a footer on the

Information Sheet with the full study title, version number, and/or date (dd/mm/yy).

- Information sheets should be prepared on the appropriate letterhead of the principal

investigator’s institution.



Consent Form

- The authorisation needs to be become the Consent Form and the Consent Form needs to follow

the format of the pro forma template as found on page 20 of the guidelines for completion of the

National Application Form, found using the following link:

http://www.ethicscommittees.health.govt.nz/moh.nsf/pagescm/6771/$File/naf-guidelines-2009-v1-

3.doc





URB Minutes 7 November 2011

10

- Please include a statement about the recording of the actigraph during sleep.

- Please include the statement ‘I confirm that I am not pregnant’.



- Consent Forms should be prepared on the appropriate letterhead of the principal investigator’s

institution.



- For administrative clarity please include a footer on the Consent Form with the full study title,

version number, and/or date (dd/mm/yy).



Maori consultation

Written evidence of Maori consultation is required for this study.



Suggestion

You may wish to consider collecting data on people on medications that may affect sleep eg

sedatives, contraceptives,



Point of contact for applicant

The Committee decided that the Administrator be available to be contacted by the applicant with any

questions arising from its decision on this application.









URB Minutes 7 November 2011

11

5. General business



1. Dr Martin Than joined the meeting by phone to say thank you and farewell to committee

members, and the committee thanked Dr Martin Than for his contribution and work for the

committee and wished him well for the future. Dr Than has now transferred to the Upper

South A Regional Ethics Committee.



2. Upcoming changes to health and disability ethics committees: the Chairperson gave the

committee an update of the changes announced by the Government in September as part of

its recent response to an inquiry into New Zealand’s clinical trial environment undertaken by

Parliament’s Health Committee.



New SOPs and shorter, simpler application forms

The Government has directed the Ministry of Health to lead work on developing standard

operating procedures (SOPs) for HDECs. These SOPs will replace the current procedural

rules for HDECs, which are fragmented across a number of documents (including the

Operational Standard).



Consistent with the Government’s decisions, the SOPs will:



 clarify and reduce the scope of HDEC review expand access to the expedited review

pathway to include some clinical trials

 introduce timelines for full review (35 days) and expedited review (15 days)

 clarify when amendments to approved studies themselves require HDEC review

 reduce duplication by clarifying the role of HDECs with regard to peer review and local

governance issues.



These SOPs will be finalised by mid-January 2012, by which time shorter, simpler application

forms will also be developed. They will take effect from 1 July 2012.



The Ministry of Health has worked with HDEC Chairs to develop draft SOPs and application

forms. These are likely to be released to stakeholders for comment from December 2011.



Online applications

The Government has directed that applications for HDEC review be able to be made

electronically through the web by 1 July 2012. This will require that the Ministry purchase an

electronic information management system.



The Ministry of Health has released a Request for Proposal (RFP) to give effect to this

Government decision. This RFP, which has been posted on the Government Electronic

Tender Service, closes on Monday 10 October 2011.



Structural changes to HDECs

The number of HDECs will be reduced from seven to four, and their size from twelve to eight

members, as of 1 July 2012. The seven current HDECs will continue to operate normally until

this date.



The Ministry expects to make a call for applications for membership of the four HDECs in late

2011. This call will be publicised on the HDECs’ website.



3. A new member’s training and orientation day is being held in Wellington on 14 November

2011. Judene Edgar is attending.





URB Minutes 7 November 2011

12

6. Amendments to approved applications

Nil







Meeting closed: 6.55 pm.









Signed:……………………………………..Date………………………………









URB Minutes 7 November 2011

13



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