Dr Gary Allen
AHRECS Senior Consultant

Over the last decade, AHRECS has worked with institutions of various types, size and maturity.  The project brief often refers to fixing or implementing proportional review.  When you drill down, the work item will generally owe its origins to calls from researchers, the research ethics review body, the research office and the institution’s executive.  They might all use the words proportional review or perhaps expedited review, but are they really talking about the same thing?

A casual glance at the NHMRC’s annual activity report shows many institutions are conducting reviews outside their HREC.  So why are researchers still calling for change?

While cases like the Racist bus driver, Laughing at the Disabled and the Sexual health survey cases do raise questions about the (mis)use of triggers for review outside an HREC, there remains an apparent tension between the meanings that different stake-holders have of proportional review.

For institutions, proportional review is often understood to include:

• From the date of application, how long does it take to get a review outcome to the applicants.
• that the length of the application form is determined by the specifics of an individual project.
• the review process allows the review body to move quickly through ‘low risk’ and ‘low ethical sensitivity’ projects leaving more time for more contentious work.

Within that frame proportional review can be achieved by committees meeting relatively often, everyone using a smart form and a good structuring of the research ethics committee’s business.

But for researchers the term ‘proportional review’ often means:

• Not having a form with questions they struggle to relate to their research design.
• The review body including members who understand their (sub)discipline and methodology.
• The reviewers being aware of relevant good practice
• The objective of the review is to provide useful and constructive feedback.

What we understand researchers look for in proportional review arrangements are the following:

• A short and tight form where answers can be as expansive as necessary, guided by clear and useful help text.
• The reviewers are different from the main committee and include persons with a background in qualitative, participatory and iterative designs that are relevant to their research.
• The triggers between different review pathways, e.g. previously reviewed projects, not more than negligible risk, not more than low risk should be clear, predictable, transparent and consistently applied.

Within this frame, a researcher is unlikely to be satisfied with the review of their research by the ordinary committee or the use of the same form as for full HREC reviews.  In such circumstances, they are likely to perceive (even if that perception is inaccurate) that they are being forced to use a process intended for higher risk biomedical research.

One of the advantages of a discernibly separate process is that it is easier to stress to reviewers to adopt a proportional approach to their reflections and that an important part of their role is the facilitation of ethically sound research.

This post may be cited as:
Allen, G. (03 June 2020) How we interpret the words ‘proportional review’ Research Ethics Monthly. Retrieved from: https://ahrecs.com/human-research-ethics/how-we-interpret-the-words-proportional-review