Barriers to multisite research in Canada: Experiences from a minimal risk COVID-19 study

The ability to provide timely evidence-informed health care depends on high quality clinical research that responds to current needs and health crises. Canadian researchers doing many types of research have faced significant challenges obtaining timely research ethics board and institutional approv­als for research causing premature termination of studies, study delays, wasted resources and, crucially, missed opportunities to improve clinical care and outcomes. To illustrate such challenges, we refer to the minimal risk, multisite observational study we are currently conduct­ing, examining the long-term respiratory health effects of COVID-19. As a COVID-19 research study, it was pur­portedly prioritized for review; however we experienced long delays in study approval. Three main factors contributed: lengthy and repetitive REB review processes, discrepancies in REB and institutional requirements, and multidepartment approval requirements. Delays in research study approval impede new knowledge and, ultimately, improvements in patient care and health. This in itself, represents an ethical dilemma that we can no longer ignore.