ALL INDIA INSTITUTE OF MEDICAL SCIENCES, BIBINAGAR,

Hyderabad Metropolitan Region, TELANGANA - 508126

अखिलभारतीयआयुर्वि ज्ञानसंस्थान, बीबीनगर,
है दराबादमे ट्रोपोर्लट्नक्षे त्र,तेलंगाना – 508126

Standard Operating Procedure (SOP)

For
Institutional Ethics Committee
 Standard Operating Procedures (SOP)
for
Institutional Ethics Committee (IEC)
AIIMS Bibinagar, Hyderabad Metropolitan Region (HMR)
Telangana-508126

Version- 01

Date: 11/01/2021

SOP prepared by:Dr.Madhavi.E, Member Secretary, AIIMS Bibinagar

Approved by: Prof. Neeraj Agarwal, Dean, AIIMS Bibinagar

Prof.Vikas Bhatia, Director, AIIMS Bibinagar
Dr.Suryanaryan Raju , Chairperson, IEC, AIIMS Bibinagar

Contents:
1. Introduction
2. Objectives
3. Authority under which AIIMS BBN -IEC is constituted
4. Composition
5. Role &Responsibilities of AIIMS BBN-IEC
6. Quorum requirements
7. Convention and Conduct of AIIMS BBN-IEC meetings
8. Application procedures
9. Details of documents to be submitted for EC review
10. Details of documents to be included in the protocol
11. Review procedures
12. Review of research proposals involving vulnerable populations
13. Review of multicentric research
14. Independent consultant/Invited subject experts
15. Decision-making & Communication of decision
16. Record keeping and archiving of documents
17. Terms of reference
18. Administration and management
19. Web page for AIIMS BBN-IEC
20. Contact details
21. Annexures
Annexure1: template - Invitation letter to a member
Annexure 2: template -Consent letter from a member
Annexure3: Appointment order
Annexure 4: Application for initial review
Annexure 5: Continuing review /Annual report format
Annexure 6: Application /notification for amendments
Annexure 7: Protocol violation/deviation reporting form
Annexure 8: Serious Adverse event format (Biomedical Health research)
Annexure 9: Premature termination/suspension/discontinuation of study report format
Annexure 10: Application form for clinical trials
Annexure 11:Serious Adverse event format for clinical trials
Annexure 12: Study completion /Final report
Annexure 13: Participant information sheet (PIS)
Annexure 14: Informed consent
Annexure 15: Undertaking by the investigator
 1. Introduction:

AIIMS, Bibinagar is one of the apex healthcare institutes established in 2019 by the Ministry of
Health & Family Welfare, Government of India under the PMSSY with a mission to establish a
Centre of excellence in medical education and training andto provide a high-quality community and
patient-focused health care that is readily accessible, cost effective and meets the needs of the
communities and offer scientific research opportunities.

Bio medical research involves a number of ethical issues that need to be addressed. The Institutional
Human Ethics Committee (IHEC)/IEC plays an important role in guiding researchers in the ethical
aspects associated with the biomedical research.Apart from ethical issues,IEC will also review the
research proposals for the scientific relevance and risk involved in research. IEC functions as per the
ICMR National Ethical Guidelines for Biomedical and Health Research involving Human
Participant-2017 (ICMR National Ethical Guidelines).

2. Objectives:

The objective of this SOP is to maintain effective functioning of the IEC and to ensurequality and
technical excellence and consistent ethical review of all submitted biomedicalresearch proposals and
ongoing approved research studies involving human participants in accordancewith the ICMR
National Ethical Guidelines and New Drugs and Clinical Trials Rules 2019.

3. Authority under which IEC is constituted

AIIMS, Bibinagar IEC (AIIMSBBN-IEC) is an Institutional standing ethics committee which

functions independently. The Dean of Faculty in consultation with the Executive Director, AIIMS
Bibinagar will appoint the Chairperson and all the committee members, based on their qualifications,
competence and experience in reviewing and evaluating the scientific and ethical aspects of
biomedical research proposals. The tenure/ periodof IEC members will be for 3 years or till further
orders.

4. Composition:

Thenumber of members in anIEC may range from 7 to 15. The IEC will be multidisciplinary in
composition andindependent. As per the ICMR National Ethical Guidelines2017, AIIMS BBN-
IECshould have the following categories of members

 Chairperson – Non affiliated

 Member Secretary- Affiliated
 Basic medical scientist-Non-affiliated/affiliated
 Clinicians -Non-affiliated/affiliated
 Legal expert -Non-affiliated/affiliated
 Social Scientist /representative of NGO/Philosopher//ethicist/theologian-Non-
affiliated/affiliated
 Lay person from the community -Non-affiliated/affiliated
 5. Responsibilities of AIIMSBBN-IEC:

The main responsibility of AIIMSBBN- IEC is to review all types of research proposals involving
human participants with a view to safeguard the dignity, rights, safety and wellbeing of research
participants before approving the research proposals.
It should ascertain that allthe ethical principles of research suchas Autonomy, Beneficence, Non –
maleficence, Respect for Free and Informed Consent, Respect for Human Dignity, Respect for
Vulnerable Persons, Respect for Privacy and Confidentiality and Justice are taken care of in
planning, conducting and reporting of the proposed research.IEC will review each study proposal for
its both scientific and ethical review.

Members of IEC are expected to attended all IEC meetings and prior information should be provided
if a member is unable to attend meeting.
5.1 Responsibilities of each member is mentioned below

Member Responsibility
Chairperson • Conduct EC meetings and ensure active participation of all members during
meeting
• Ratify minutes of the previous meetings
•Seek COI declaration from members and ensure quorum and fair decision making.
• Handle complaints against researchers, EC members, conflict of interest issues and
requests for use of EC data, etc.
Member Organize an effective and efficient procedure for receiving,preparing, circulating and
Secretary maintaining each proposal forreview
• Schedule EC meetings, prepare the agenda and minutes
• Organize EC documentation, communication andarchiving
• Ensure training of EC secretariat and EC members
• Ensure SOPs are updated as and when required&adherence of EC functioning to
the SOPs
• Prepare for and respond to audits and inspections
• Ensure completeness of documentation at the time ofreceipt and timely inclusion in
agenda for EC review.
• Assess the need for expedited review/ exemption fromreview or full review.
Assess the need to obtain prior scientific review,invite independent consultant,
patient or communityrepresentatives.
• Ensure quorum during the meeting and record discussionsand decisions
Basic scientist Scientific and ethical review - emphasis on intervention, benefit-risk analysis,
research design, methodology and statistics, continuing review process, SAE,
protocol deviation, progress and completion report, drug safety and
pharmacodynamics in case of clinical trials
clinician Scientific review of protocols including review of the intervention, benefit-risk
analysis, research design, methodology, sample size, site of study and statistics
Ongoing review of the protocol (SAE, protocol deviation or violation, progress and
completion report)
Review medical care, facility and appropriateness of the principal investigator,
provision for medical care, management and compensation.
Thorough review of protocol, investigators brochure&all other protocol details
Legal expert Ethical review of the proposal, ICD along with translations, MoU, Clinical Trial
Agreement (CTA), regulatory approval, insurance document, other site approvals,
researcher’s undertaking, protocol specific other permissions (NAC-SCRT, HMSC
 etc) compliance with guidelines etc.
Social scientist/ Ethical review of the proposal, ICD along with the translations.
philosopher/ Assess impact on community involvement, socio–cultural context, religious
ethicist/theologian orphilosophical context, if any
Serve as a patient/participant/ societal / community representative and bring
inethical and societal concerns.
Lay person Ethical review of the proposal, ICD along with translation(s).
Evaluate benefits and risks from the participant’s perspective and opinewhether
benefits justify the risks.
Serve as a patient/participant/ community representative and bring in ethical
andsocietal concerns.
Assess on societal aspects if any.

Members are expected to show their full commitment, responsibility, respect for divergent opinions,
maintain confidentiality review proposals from bias and without any external influences.

All IEC members must be familiarized with guidelines related to research and ethics such as ICMR
National Ethical Guidelines2017, New Drugs and Clinical Trials Rules 2019, ICH-GCP guidelines.
When there is any change in SOP the same will be communicated to the members and
necessarytraining will be imparted.Record will be maintained regarding the training of members and
change in the SOP/guidelines.

Members are expected to declare conflicts of interest, if any, before commencement of the
meeting.IEC members should not take part in discussion or decision making on research proposals in
which they are PI or Co –investigators or if there are any other conflicts of interest.
The IEC has the rights torevoke its approval accorded to scientific study/clinical study protocol, and
further, it has torecord the reasons for doingso and communicate the same to the Investigator as well
as to the Licensing Authority/ other relevant stakeholders.

IEC may review progress of the approved studies periodically till the completion of the study
through periodic study progress report /internal audit reports.

The investigator is responsible for reporting all SAEs including hospitalization or prolongation of
hospitalization, clinical trial related injury or death, regardless of causal relationship to the EC within
24 hours ofknowledge. Reporting of SAE may be done through email or fax
communication(including on non-working days). A report on how the SAE was related to the
researchmust also be submitted within 14 days.SAEs must be reported for all trials and if applicable
timelines as specified by regulatorsto be followed (within 24 hours to the sponsor, EC and regulator,
if applicable, followedby a due analysis report in 14 days).

The IEC shall forward the report on anySAE(including, death), after due analysis, along with
itsopinion on the financial compensation, if any, to be paid by the sponsor or his representative, to
the Chairman of the Expert Committee constituted by the Licensing Authority.The copy of the report
has to be submitted the Licensing Authoritywithin twentyone calendar days of the occurrence of the
SAE.
.
6. Requirements for IEC Membership

Every EC member must:

 Provide anupdated CV with signature

 Consent letter
 Submit trainingcertificates on human research participant protection and good clinical
practice (GCP) guidelines
o If not trained must undergo training and submit training certificates within 6 months
of appointment (or as per institutional policy)
 Be willing to undergo training or update their skills/knowledge during their tenure
 Declare Conflict of Interest (COI)in accordance with the policy of the IEC, if applicable, at
the appropriate time
 Sign a confidentiality and conflict of interest agreement/s;
 Be willing to place her/his full name, profession and affiliation to the EC in the public
domain

7. Quorum requirements

 A minimum of five members must be present in the meeting room.

 The quorum should include both medical, non-medical or technical or/and non-technical
members.
 Minimum one non-affiliated member should be part of the quorum.
 Preferably the lay person should be part of the quorum.
 The quorum for reviewing regulatory clinical trials should be in accordance with current
New Drugs and Clinical Trials Rules 2019 requirements.
 No decision is valid without fulfilment of the quorum.

8. Convention and Conduct of IEC meetings

The Chairperson will conduct all meetings of the AIIMSBBN-IEC. In the absence of the Chairperson
an alternate Chairperson will be elected from the other members on the day of meeting (or
Chairperson should nominate a committee member as Acting Chairperson for that meeting) by the
members present, who will conduct the meeting. The alternate or acting chairperson should have the
powers of the chair person and should be non-affiliated person.The Member Secretary is responsible
for organizing the meetings, maintaining the records and communicating with all concerned.
Member Secretary will prepare the minutes of the meetings and get it approved by the Chairperson
and all the members. In the absence of Member Secretary alternate Member Secretary among the
members, will organize the IEC meeting.
All proposals will be received at least 3 weeks before the meeting and after initial scrutiny by
Member Secretary the proposals will be circulated to the IEC members.
The recommendations by the IEC will be communicated to all the PIs and guides/HODs in case of
student’s proposals
If required additional review meetings can also be conducted with a short notice period.
9. Application procedures

All proposals should be submitted to IEC on any working day 3 weeks in advance of scheduled
meetingin the prescribed application form along with relevant documents.

Eight (8) hard Copies soft copy of the proposal along with the application and documents in
prescribed format duly signed by the Principal Investigator (PI) and Co-investigators/ Collaborators /
should be submitted to IEC

Principle Investigators shall be forwarded their application to the Chairperson IEC, through Member
Secretary and the receipt of the application will be acknowledged bythe IEC office.

Every application will be allotted an IEC registration number to be used for all future
correspondenceand reference. The date of IEC meeting will be intimated to the PI to attend the
meeting and tomake a brief presentation of the proposal and to clarify the points raised by the
members.IEC can suggest for online meetings and virtual presentations of the investigators in special
situations such as COVID-19 pandemic, etc.

If revision is to bemade, the revised proposal in required number of copies should be submitted
within a stipulated periodof time as specified in the communication or before the next meeting.

All research proposals/clinical trials funded/sponsored by Pharmaceutical companies,

Agencies,Multinationals etc. will be charged an administrative fee/ processing fee of 5% of their
sanctioned budget. Waiver of these feesis permissible for non-funded studies, departmental studies,
and studies funded by organizations likeICMR, UGC, DST Government of India, State Science &
Technology Department, UNICEF,WHO, USAID, Non Profitable Organizations etc.

10. Details of documents to be submitted for EC review

a) Cover letter to the Member Secretary
b) Type of review requested
c) Application form for initial review
d) Permission of using copyrighted proforma/ questionnaire
e) A complete protocol
f) Approval of the project for Institute Scientific Committee
g) The correct version of the informed consent document (ICD) in English andthe local
language(s).
h) Case record form/questionnaire
i) Recruitment procedures: advertisement, notices (if applicable)
j) Patient instruction card, diary, etc. (if applicable)
k) Investigator’s brochure (as applicable for drug/biologicals/device trials)
l) Details of funding agency/sponsor and fund allocation (if applicable)
m) Brief curriculum vitae of all the study researchers
n) A statement on COI, if any
o) GCP training certificate (preferably within 5 years) of investigators (Sponsored clinical trials)
 p) Any other research ethics/other training evidence, if applicable as per EC SOP
q) List of ongoing research studies undertaken by the principal investigator (if applicable)
r) Undertaking with signatures of investigators
s) Regulatory permissions (as applicable)
t) Relevant administrative approvals (such as HMSC approval for International trials)
u) Institutional Committee for Stem Cell Research (IC-SCR) approval (if applicable)
v) MoU in case of studies involving collaboration with other institutions (if
applicable)
w) Clinical trial agreement between the sponsors, investigator and the head ofthe institution(s)
(if applicable)
x) Insurance policy (if applicable)

10. Details of documents to be included in the protocol

The protocol should include the following:

A. The first page carrying the title of the proposal with signatures of the investigators;
B. Brief summary/ lay summary of the protocol;
C. Background with rationale of why a human study is needed to answer the research question;
D. Justification of inclusion/exclusion of vulnerable populations;
E. Clear research objectives and end points/ outcome ;
F. Eligibility criteria and participant recruitment procedures;
G. Detailed description of the methodology of the proposed research, including sample size
(with justification), type of study design (observational, experimental, pilot, randomized,
blinded, etc.), types of data collection, intended intervention, dosages of drugs, route of
administration, duration of treatment and details of invasive procedures, if any;
H. Duration of the study;
I. Justification for use of placebo, benefit–risk assessment, plans to withdraw and rescue
medication. If standard therapies are to be withheld,
J. Procedure for seeking and obtaining written informed consent with a sample of the
patient/participant information sheet and informed consent forms in English
and local languages. Informed consent for storage of samples;assent; re-consent
K. Plan for statistical analysis of the study;
L. Plan to maintain the privacy and confidentiality of the study participants;
M. For research involving more than minimal risk, an account of managementof risk or injury;
Proposed compensation, reimbursement of incidental expenses and management
of research related injury/illness during and after research period and insurance policy
N. Provision of ancillary care for unrelated illness during the duration of research;
O. An account of storage and maintenance of all data collected during the trial; and
P. Plans for publication of results – positive or negative – while maintaining
confidentiality of personal information/ identity.
Q. Ethical considerations and safeguards for protection of participants
 11. Review procedures

I. The meeting of the IEC will be held periodically, unless otherwise specified by the member
secretary. Additional review meetings canalso be held with short notice as and when
required. Meetings will be planned in accordance with theneed of the work load.
II. The proposals should be sent to the IEC at least 3 weeks in advance of scheduled meeting.
III. The Member-Secretary with the support of the secretarial staff shall screen the proposals for
their completeness anddepending on the risk involved categorize them into three types,
namely, exemption from review,expedited review and full committee review.
IV. Decisions will be taken by consensus after discussion, and whenever needed voting will be
done.
V. The PI / Research Scholar will thenpresent the proposal in person in the meeting. When the
PI is not available due to unavoidable reasonsthe Co-PI will be allowed to present the
proposal.Researchers will be invited to offer clarifications on case to case basis,if needed
VI. The review discussions/ decisions will be charted down and the final minutes will be
approved by the Chairperson.
VII. After the IEC meeting, the decision of the IEC members regarding the discussed proposals to
obtained on the same day of the meeting.
VIII. The proceedings of the meeting will be video recorded with prior permission from all the
members attending the meeting.
IX. The type of EC review based on risk involved in the research, is categorized as follows

Type of risk Definition/description

Less than Probability of harm or discomfort anticipated in the research is nil or not
minimal risk expected. Research on anonymous or non-identified data/samples, data
available in the public domain, meta-analysis, etc
Minimal risk Probability of harm or discomfort anticipated in the research is not greater
thanthat ordinarily encountered in routine daily life activities of an average
healthyindividual or general population or during the performance of
routine tests whereoccurrence of serious harm or an adverse event (AE) is
unlikely.
Research involving routine questioning or history taking, observing,
physicalexamination, chest X-ray, obtaining body fluids without invasive
intervention,such as hair, saliva or urine samples, etc.
Minor increase Increment in probability of harm or discomfort is only a little more than
over minimal theminimal risk threshold.
risk or Low risk  Routine research on children and adolescents; Research on persons
incapable of giving consent
 Delaying or withholding a proven intervention or standard of care in a
control or placebo group during randomized trials;
 Use of minimally invasive procedures that might cause no more than
brief pain or tenderness, small bruises or scars, or very slight,
temporary distress, such as drawing a small sample of blood for testing;
 Trying a new diagnostic technique in pregnant and breastfeeding
women etc.
 Research should have a social value. Use of personal identifiable data
in research also imposes indirect risks.
 Social risks, psychological harm and discomfort may also fall in this
 category.
More than Probability of harm or discomfort anticipated in the research is invasive
minimal risk or and greaterthan minimal risk.
High risk Examples include research involving any interventional studyusing a drug,
device or invasive procedure such as lumbar puncture, lung or liver
biopsy, endoscopic procedure, intravenous sedation for diagnostic
procedures

IX. Types of reviews

11.1 Exemption from review
Proposals which present “less than minimal risk” fall under this category

Followingsituations may come under this “less than minimal risk” category:
Research on educational practices such as instructional strategies or effectiveness of or the
comparisonamong instructional techniques, curricula, or classroom management methods.
Exceptions:
1. When research on use of educational tests, survey or interview procedures, or observation of
publicbehaviour can identify the human participant directly or through identifiers, and the disclosure
ofinformation outside research could subject the participant to the risk of civil or criminal or
financialliability or psychosocial harm.
2. When interviews involve direct approach or access to private papers

11.2 Expedited Review

The proposals presenting “no more than minimal risk” to research participants may be subjected to
expeditedreview.

The Member- Secretary and the Chairperson of the IEC or designated member of the Committee
orSubcommittee of the IEC may do expedited review only if the protocols involve

1. Minor deviations from originally approved research protocol during the period of approval.
2. Revised proposal previously approved through full review by the IEC or continuing review of
approved proposals where there is no additional risk or activity is limited to data analysis.
3. Research activities that involve only procedures listed in one or more of the following categories
• Clinical studies of drugs and medical devices only when -
(1). Research is on already approved drugs except when studying drug interaction or
conducting trial on vulnerable population or
(2). Adverse Event (AE) or unexpected Adverse Drug Reaction (ADR) of minor nature is
reported.
(3). Research involving clinical materials (data, documents, records, or specimens) that have been
collected for non-research (clinical) purposes.
(4). When in emergency situations like serious outbreaks or disasters a full review of the research is
notpossible, prior written permission of IEC may be taken before use of the test intervention. Such
researchcan only be approved for pilot study or preliminary work to study the safety and efficacy of
theintervention and the same participants should not be included in the clinical trial that may
beinitiated later based on the findings of the pilot study.
a. Research on interventions in emergency situation
When proven prophylactic, diagnostic, and therapeutic methods do not exist or have been
ineffective, physicians may use new intervention as investigational drug (IND) / devices /
vaccine to provide emergency medical care to their patients in life threatening conditions.
Research in such instance of medical care could be allowed in patients -
i. When consent of person/ patient/ responsible relative or custodian/ team of designated
doctors for such an event is not possible. However, information about the intervention
be given to the relative/ legal guardian when available later;
ii. When the intervention has undergone testing for safety prior to its use in emergency
situations and sponsor has obtained prior approval of DCGI;
iii. Only if the local IEC reviews the protocol since institutional responsibility is of
paramountimportance in such instances.
iv. If Data SafetyMonitoring Board (DSMB) is constituted to review the data;

b. Research on disastermanagement
It may also be unethical sometimes not to do research during disaster. Disasterscreate vulnerable
persons and groups in society, particularly so in disadvantaged communities, andtherefore, the
following points need to be considered when reviewing such research:
i. Research planned to be conducted after a disaster should be essential, culturally sensitive and
specificin nature with possible application in future disaster situations.
ii. Disaster-affected community participation before and during the research is essential and its
representatives or advocates must be identified.
iii. Extra care must be taken to protect the privacy and confidentiality of participants and
communities.
iv. Protection must be ensured so that only minimal additional risk is imposed.
v. The research undertaken should provide direct or indirect benefits to the participants, the
disasteraffectedcommunity or future disaster- affected population and a priori agreement should be
reachedon this, whenever possible, between the community and the researcher.
vi. All international collaborative research in the disaster-affected area should be done with a
localpartner on equal partnership basis.
vii. Transfer of biological material, if any, should be as per Government rules taking care of
intellectualproperty rights issues.

(5). Expedited review may also be taken up for nationally relevant proposals requiring urgent review.

11.3Full Review
All research presenting with “more than minimal risk”, proposals/ protocols which do not qualify for
exemptedor expedited review and projects shall be subjected tofull review by all the members.
a) Research involving vulnerable populations, even if the risk is minimal;
b) Research with minor increase over minimal risk
c) Studies involving deception of participants;
d) Research proposals that have received exemption from review, or have undergone expedited
review/undergone subcommittee review should be ratified by the full committee, which has
 the right to reverse/or modify any decision taken by the subcommittee or expedited
committee;
e) Amendments of proposals/related documents (including but not limited to informed consent
documents, investigator’s brochure, advertisements, recruitment methods, case record forms
etc.) involving an altered risk;
f) Major deviations and violations in the protocol;
g) Any new information that emerges during the course of the research for deciding whether or
not to terminate the study in view of the altered benefit–risk assessment;
h) Research during emergencies and disasters either through an expedited review/ scheduled or
unscheduled full committee meetings. This may be decided by Member Secretary depending
on the urgency and need;
i) Prior approval of research on predictable emergencies or disasters before the actual crisis
occurs for implementation later when the actual emergency or disaster occurs.

12. Review of research proposals involving vulnerable population

Vulnerable persons are those individuals who are relatively or absolutely incapableof protecting their
own interests and providing valid informed consent. Include economically and socially
disadvantaged; children (up to 18 years);women in special situations;tribals and marginalized
communities;refugees, migrants, homeless, persons or populations in conflict zones, riot areas or
disastersituations;afflicted with mental illness and cognitively impaired individuals, differently abled
–mentally and physically disabled;terminally ill or are in search of new interventions having
exhausted all therapies;suffering from stigmatizing or rare diseases; orhave diminished autonomy
due to dependency or being under a hierarchical system and unduly influenced either by the
expectation of benefits or fear of retaliation in case ofrefusal to participate which may lead them to
give consent.

IECs should carefully determine the benefits and risks of the study and examine the justification
provided and risk minimization strategies
Additional safety measures should be strictly reviewed and approved by the IECs
.
IEC must ensure that the informed consent process should be well documented and recording of
assent in case of research studies involving children aged 7 to 18 years and reconsent, when
applicable.
Informed consent from vulnerable populations may be obtained from LAR (Legally authorized
representative)in presence of impartial witness after through explanation of risks and benefits,

.
13. Review of multicentric research

Multicentre research is conducted at more than one centre by different researchersusually following a
common protocol.
 All sites are required to obtain approval from their respective ECs, which would consider the
local needs and requirements of the populations being researched and safeguard the dignity,
rights, safety and well-being of the participants.
 The ECs/Secretariats of all participating sites should establish communication with one another
 If any EC does not grant approval for a study at a site the reasons must be shared with other ECs
and deliberated upon.
 The EC can suggest site-specific protocols and informed consent modifications as per local
needs.

 Separate review may be requested for studies with a higher degree of risk, clinical trials or
intervention studies where conduct may vary depending on the site or any other reason which
requires closer review and attention

 Common review for all participating sites in multicentric research - In order to save time, prevent
duplication of effort and streamline the reviewprocess, the ECs can decide to have one
designated main EC, the decisions ofwhich may be acceptable to other ECs.

 Common review process may be applied to researchinvolving low or minimal risk, survey or
multicentric studies using anonymizedsamples or data or those that are public health research
studies determined tohave low or minimal risk.

 The common review is applicable only for ECs in India. In case of international collaboration for
research and approval by a foreign institution, the local participating sites would be required to
obtain local ethical approval

14.Independent consultant/Invited subject experts

Subject experts will be called to provide special review for selected research proposals, if required.
They can give their opinion/specialized views but they do not take part during decision making by
IEC members.

15. Decision-making& Communication of decision

a. Members will discuss the various issues before arriving at a consensus decision. When consensus
is not arrived at, the decision will be made by voting procedure.
b. A member should withdraw from the meeting during the decision procedure concerning an
application where a conflict of interest arises and the sameshould be conveyedto theChairperson
prior to the review of the application and recorded in the minutes.
c. Decision will be made only in meetings where quorum is complete.
d. Only the members can make the decisions. The expert consultants (subject experts) will only
offer their opinions.
e. Decision may be to approve, reject, or revise the proposals. Specific suggestions for
modifications and reasons for modifications and reasons for rejection will be given.
f. In cases of conditional decisions, clear suggestions for revision and the procedure for having the
application revised will be specified.
g. Modified proposals will be reviewed by an expedited review through identified members.
h. Decision taken on the proposals will be communicated by the Member Secretary/secretariat in writing to
the PI / Research Scholar within two weeks after the meeting at which the decision was taken in the
specified format
i. IEC approval will be valid for one year or for the duration of the project whichever is less. Investigator
has to get his or her project re- approved after one year, where required.
j. The communication of the decision will include:
a. Name and address of IEC.
b. The date, place and time of decision.
c. The name and designation of the applicant.
d. Title of the research proposal reviewed.
e. The clear identification of protocol no., version no., date, amendment no., date.
f. Along with protocol, other documents reviewed- Clear description of these documents along with
Version No. and Date.
g. List of EC members who attended the meeting- clear description of their role, affiliation
and gender.
h. A clear statement of decision reached.
i. Any advice by the IEC to the applicant including the schedule / plan of ongoing review by the
AIIMS IEC
j. In case of conditional decision, any requirement by IEC, including suggestions for revision, and
the procedure for having the application re-reviewed.
k. In case of rejection of the proposal, reason(s) for the rejection will be clearly stated.
l. Signature of the member secretary with date

16. Record keeping and archiving of documents

All Research proposals (8 hard copies along with soft copy) along with the information and
documents submitted will be dated and filed
The documents will be archived for a minimum period of 3 years and for sponsored clinical trials for
5 years after completion/termination of the study.
IEC members should not retain any documents with them after the meeting is over.

List of documents to be filed and archived

1. Constitution of IEC
2. SOP
3. CV & consent of IEC members
4. IEC Registration
5. Honorarium details, Income and expenses
6. Agenda & minutes of the meetings
7. One copy of proposal
8. Copy of recommendations/decision communicated to applicant
9. Review reports, documents received during the follow up period and final reports of the study

17. Terms of reference

Terms of reference will be maintained in the office of IEC. This includes

A. MembershipRequirements
B. Terms of Appointment with reference to the duration of the term,
C. The policy for removal, replacement, resignation procedure,
D. Frequency of meetings, and
E. Payment of processing fee to the IEC for review, honorarium/ consultancy to the
members/ invited experts etc.

The SOPs will be updated periodically based on the changing requirements. The term of appointment
ofmembers could be extended for another term and a defined percentage (35 to 50%) of members
could be changedon regular basis. Preferably, IEC would appoint persons trained in bioethics or
persons familiar withethical guidelines and laws of the country.

18. Administration and management

AIIMS Bibinagar should have an office for the IEC which have adequate space, infrastructure and
staff to the EC for maintainingfull-time secretariat, safe archival of records and conduct of meeting.A
reasonable fee for review may be charged by the IEC to cover the expenses
related to optimal functioning in accordance to Institutional policies for industry sponsored
projects/funded projects. There should be provision for allocating reasonable amount of funds for
smooth functioningof the IEC. Honorarium of INR 5000/-per sitting will be paid by the institute to
the Non affiliated members attending the meeting

19. Web page for IEC: A dedicated webpage will be created and maintained for IEC. Details of
composition, SOP ,registration details, circulars/notifications related to IEC meetings and status of
submitted proposalsand ongoing projects, submission forms, guidelines and contact details will be
displayed on this page

20.Contact details:

Dr.Madhavi Eerike
Member Secretary, IEC, AIIMS, Bibinagar, Telangana-508126
Contact number: 9941476332
Email ID:[email protected]
Whatapp: 9941476332
 Letter head

Letter ref no:

From

The Dean
AIIMS, Bibinagar
Hyderabad Metropolitan Region
Telangana -508126

To

-------

Dear Sir/Madam

Greetings from AIIMS Bibinagar, Hyderabad

Sub:Invitation to be a member for Institutional Ethics Committee (IEC) of AIIMS Bibinagar,

Hyderabad

Based on your expertise in the field of medicine and research, you are cordially invited to be a
member of our IEC for a period of three years ortill further orders. I request you to kindly accept our
invitation and confirm the same at the earliest.

This is issued with approval of competent authority .

With Regards
From,

To

The Dean
AIIMS-Bibinagar
Hyderabad Metropolitan region
Telangana –508126

Sub: Consent to be a member of Institute Ethics Committee (IEC) - Reg.

Ref: Your Letter No: dated:

Dear Sir/Madam

With reference to your letter stated above, I hereby extend my willingness to become a member of IEC of
AIIMS Bibinagar. I shall regularly attend IEC meetings to review and give my unbiased opinion
regarding the ethical aspects of research proposals involving human participants.
.
I shall be willing for my name, profession and affiliation to be published.
I shall not participate in quorum decisions where there is a conflict of interest.
I shall maintain all the research project related information confidential and shall not share or reveal the
same to anyone other than project related personnel.

I herewith enclose my CV

Thanking you,

Yours sincerely,

Signature with date

Name of the Member
:
Address:

Telephone No: (Off) (Res)

email:
 Letter head

APPOINTMENT ORDER

Date:
Ref No:

Dr/ Mr. / Mrs.:

I am pleased to appoint you as the ------------ of the Institutional Ethics Committee (IEC) (Human
research) at All India Institute of Medical Sciences, Bibinagar (AIIMS-BBN) following the receipt of
your acceptance letter. The appointment shall be effective from --- for a period of _ year / months or till
further notice provided the following conditions are satisfied.

1. You should be willing to publicize your full name, profession & affiliation.
2. You are willing to record all reimbursement for work & expenses, if any, within or related to an
EC & make it available to the public upon request
1. You consent to sign confidentiality agreement between you & the IEC regarding meeting
deliberations, applications, information on research participants, & related matters.

Further, the renewal of your appointment will be by consensus & one-month notice on either side
will be necessary prior to resignation/ termination of appointment. Terms & Conditions regarding the
resignation procedure, disqualification procedures, replacement procedures etc. may be found in the
Standard Operating Procedures (SOPs) of IEC, AIIMS Bibinagar.

You will be paid a sum of INR/……../- per sitting as Honorarium for your services rendered towards
attending the IEC meetings at AIIMS-BBN as per the institutional norms.

We sincerely hope your association with IEC, AIIMS-BBN will be scientifically productive and
beneficial to the Institute & the community at large.

Signature with date

 Application for Initial review
A. Basic information

(a) Title of the study:

Acronym/Shorttitle,(Ifany):
(b) Name of Principal Investigator:
(c)Department:
(d) Date ofsubmission:
(e) Designation:
(f) Email id:

(g)Typeofreviewrequested:
Exemption fromreview Expedited review Full committee review

(h) Protocol number (Ifany): Version number:

(i)Details ofInvestigators:
Name Designation and Department and Address for
Qualification Institution communication
Principal Investigator/Guide

Co-investigator/student/fellow

(i) Number of studies where applicant isa:

i) PrincipalInvestigatorattimeofsubmission
ii) Co-Investigator at time ofsubmission:

(k)Durationofthestudy:

FUNDING DETAILS ANDBUDGET

(a) Total estimated budget for site:

At site
Overall.
(b)Self-funding Institutionalfunding Funding agency (Specify)
 SECTION B - RESEARCH RELATED INFORMATION
1. OVERVIEW OFRESEARCH
(a)Laysummary(within300words):

(b) objective of the study:

(c) Type of study:

BasicSciences  Clinical  CrossSectional 
Retrospective  Epidemiological/  CaseControl 
Prospective  PublicHealth Cohort 
Qualitative  Socio-behavioural  Systematic Review 
Quantitative  Biological samples/Data 
MixedMethod  Any others(Specify) 

(d) justification for conduct of this study:

1. METHODOLOGY
(a) Sample size/ number of participants
At site : total sample size
Control group / Study group
Justification for the sample size chosen (100 words); In case of qualitative study, mention the criteria
used for saturation

(b)Inclusion criteria:
(c) Exclusion criteria:
(d) Study design:
(e) Investigations specifically related to projects:

(f) Isthereanexternallaboratory/outsourcinginvolvedforinvestigations?Yes / No/ NA

(g) Howwasthescientificqualityofthestudyassessed?

Independent external review / Reviewbysponsor or Funder/Review within

PI’sinstitution/Reviewwithinmulti-centreresearch group/ Noreview

Date of the Review:

Research Comments of scientific committee/IRC, if any (100 words)
 SECTION C: PARTICIPANT RELATED INFORMATION
5.RECRUITMENT AND RESEARCHPARTICIPANTS

a. Type of participants in thestudy:

Healthyvolunteers Patients  Vulnerable persons/ Special groups
Others  (Specify)
Who will do the recruitment?
Participant recruitment methods used:
Posters/  TV/Radioads/ Patients/ Telephone 
leaflets/Letters Family/Friends 
Social 
Others  media/
(Specify) visiting hospitals
Institutionwebsite
(b) i. Will there be vulnerable persons / special groups involved? Yes  No  NA
ii. If yes, type of vulnerable persons / special groups

Children under18yrs  Pregnant orlactatingwomen

Differentlyabled(Mental/Physical)  Employees/Students/Nurses/Staff 

Elderly  Institutionalized Economically and socially disadvantaged 

Refugees/Migrants/Homeless  Terminally ill (stigmatized or rare diseases) 

Any other (Specify): 

iii. Provide justification for inclusion/exclusion

iv. Are there any additional safeguards to protect researchparticipants?

(c) Is there any reimbursement totheparticipants? Yes  No

If yes,Monetary Non-monetary Providedetails

d) Are there any incentives to the participants? Yes  No 

If yes,Monetary Non-monetary Providedetails

e) Arethereanyparticipantrecruitmentfees/incentivesforthestudyprovidedtothePI/Institution?
 If yes,Monetary Non-monetary Provide detailsYes  No

6. BENEFITS ANDRISKS
(a) i. Are there any anticipated physical/social/psychological discomforts/
risktoparticipants? Yes  No
If yes, categorize the level of risk:
Less thanMinimalrisk  Minimalrisk 
Minor increase over minimal risk or lowrisk  More than minimal risk orhighrisk
ii. Describe the risk management strategy:

What are the potential benefits from the study? For theparticipant Yes No If yes, Direct Indire
ct
For the society/community    
   
For improvement in science
   
Pleasedescribehowthebenefitsjustifytherisks

Areadverseeventsexpectedinthestudy?Yes  No NA 
a. Arereportingproceduresandmanagementstrategiesdescribedinthestudy? Yes  No 

b. If Yes, Specify

7.INFORMEDCONSENT
(a) Areyouseekingwaiverofconsent?Ifyes,pleasespecifyreasonsandskiptoitemno.8 Yes
 No

(b) VersionnumberanddateofParticipantInformationSheet(PIS):

VersionnumberanddateofInformedConsentForm(ICF):

Type of consent planned for:

Signedconsent  Verbal/Oralconsen  Witnessedconse  Audio- 

t nt Video(AV) 
consent
ConsentfromL  Forchildren <7yrs  Verbalassentfro  Writtenassentfro 
AR (If so, parental/LAR m minor (7-12 mminor (13-18
specify consent yrs) along with yrs) along with
fromwhom) parentalconsent parentalconsent

Other 
(specify)
d) Who will obtain the informedconsent?
PI/Co-I Nurse/Counselor  ResearchStaff  Other (Specify)
Anytoolstobeused
e) Participant Information Sheet (PIS) and Informed Consent Form(ICF)
English  Locallanguage  Other (Specify)
List the languages in which translations were done
Iftranslationhasnotbeendone in local language,pleasejustify

f) Providedetailsofconsentrequirementsforpreviouslystoredsamplesifusedinthestudy7

(g) Elements contained in the Participant Information Sheet(PIS) and Informed Consent Form

(ICF)

Simple language  Data/ Sample sharing  Compensation for study 

related injury
Risks and discomforts  Need to recontact  Statement that consent is 
voluntary
Alternatives to  Confidentiality  Commercialization/ Benefit 
participation sharing
Right to withdraw  Storage of samples  Statement that study 
involves research
Benefits  Return of research  Use of photographs/ 
results Identifying data
Purpose and procedure  Payment for  Contact information of PI 
participation and Member Secretary of
EC
Others(Specify) 

8.PAYMENT/COMPENSATION

(a) Whowillbearthecostsrelatedtoparticipationandprocedures?

PI  Institution  Sponsor  Otheragencies  (specify)

(a) Isthereaprovisionforfreetreatmentofresearchrelatedinjuries?Yes  NoN/A 

Ifyes,thenwhowillprovidethetreatment?
(b) Is there a provision for compensation of researchrelatedSAE?Ifyes,specify.
Yes  No N/A 
Sponsor Institutional/CorpusfundProjectgrant Insurance
(c) Is there any provision for medical treatment or management till the relatedness is
determined for injuryto the participantsduringthestudyperiod?Ifyes,specify.Yes
 NoN/A 
(e)Isthereaprovisionforancillarycareforunrelatedillnessduringthestudyperiod?Ifyes,pleasespecify
. Yes  No  N/A 

9. STORAGE ANDCONFIDENTIALITY

a. Identifying Information: Study Involves samples/data. Yes  No  NA IfYes, specify

Anonymous/Unidentified  Anonymized: Reversibly coded  Irreversibly coded
 Identifiable  If identifiers must be retained, what additional precautions will be
taken to ensure that access is limited /data is safeguarded? (e.g. data stored in a cabinet,
password protected computer etc.)
(b)Whowillbemaintainingthedatapertainingtothestudy?

(c)Wherewillthedatabeanalyzedandbywhom?
(d)Forhowlongwillthedatabestored?

(e)Doyouproposetousestoredsamples/datainfuturestudies?Yes  No  Maybe 
Ifyes,explainhowyoumightusestoredmaterial/datainthefuture?

SECTION D: OTHER ISSUES

10.PUBLICATION, BENEFIT SHARING AND IPRISSUES

a) Will the results of the study be reported and disseminated? If yes, specify.
Yes  No  NA 
b) Willyouinformparticipantsabouttheresultsofthestudy? YesNoNA
c) Are there any arrangements for continued provision of the intervention for participants,
if effective, once the studyhasfinished?Ifyesdescribeinbrief(Max50words) Yes  No
 NA 
d) Isthereanyplanforpostresearchbenefitsharingwithparticipants?Ifyes,specify Yes
 No  NA
e) Is there any commercial value or a plan to patent/IPR issues? If yes, please provide
details Yes  No  NA
f) Doyouhaveanyadditionalinformationtoaddinsupportoftheapplication,whichisnotinclud
edelsewherein the form? If yes,providedetails.Yes  No

SECTION E: DECLARATION AND CHECKLIST

11. DECLARATION (Please tick as applicable)
 I/We certify that the information provided in this application is complete and correct.
 I/We confirm that all investigators have approved the submitted version of proposal/related
documents.
 I/WeconfirmthatthisstudywillbeconductedinaccordancewiththelatestICMRNationalEthicalGuid
elines
forBiomedicalandHealthResearchInvolvingHumanParticipantsandotherapplicableregulationsan
dguide- lines.
 I/We confirm that this study will be conducted in accordance with the Drugs and Cosmetics Act
1940 and its Rules 1945 as amended from time to time, New drugs and Clinical Trial Rules
2019 GCP guidelines and other applicable regulations and guidelines.
 I/Wewillcomplywithallpoliciesandguidelinesoftheinstituteandaffiliated/collaboratinginstitution
swhere this study will beconducted.
 I/We will ensure that personnel performing this study are qualified, appropriately trained and
will adhere to the provisions of the IEC approved protocol.
 I/We declare that the expenditure in case of injury related to the study will be taken care of.
 I/We confirm that an undertaking of what will be done with the leftover samples is provided, if
applicable.
 I/We confirm that we shall submit any protocol amendments, adverse events report, significant
deviations from protocols, progress reports and a final report and also participate in any audit of
the study if needed.
 I/We confirm that we will maintain accurate and complete records of all aspects of the study.
 I/We will protect the privacy of participants and assure confidentiality of data and biological
samples.
 I/We hereby declare that I/any of the investigators, researchers and/or close relative(s), have no
conflict of interest (Financial/Non-Financial) with the sponsor(s) and outcome of study.
I/We have the following conflict of interest (PI/Co-I):

1.
2.
 I/We declare/confirm that all necessary government approvals will be obtained as per
requirements wherever applicable.
Name of PI:

Signature with date:

Name of Co-PI:

Signature with date:

Name of Guide:

Signature with date

Name of HOD:

Signature with date

Administrative requirements

Enclosu IEC
S. Items Yes No re No remar
N ks
o
1 Cover letter  
2 Brief CV of all Investigators  
3 Good Clinical Practice (GCP) training of investigators  
in last 3 years
4 Approval of scientific committee  
5 IEC clearance of other centers  
6 Agreement between collaborating partners  
7 MTA between collaborating partners  
8 Insurance policy/certificate  
Evidence of external laboratory credentials in case of  
9 an externally outsourced laboratory study QA/QC
certification
10 Copy of contract or agreement signed with the sponsor or  
donor agency
Provide all significant previous decisions (e.g. those
11 leading to a negative decision or modified protocol) by  
other ECs/Regulatory
authoritiesforproposedstudy(whetherinsamelocationore
lsewhere) and modification(s) toprotocol
Proposal related
12 Copyofthedetailedprotocol11  
13 InvestigatorsBrochure(Ifapplicablefordrug/biologicals/  
devicetrials)
Participant Information Sheet (PIS) and Participant  
14 Informed Consent Form (ICF)(English and translated)
15 Assent form for minors (12-18 years) (English and  
Translated)
Proforma/Questionnaire/CaseReportForms(CRF)/Inter  
16 viewguides/
GuidesforFocusedGroupDiscussions(FGDs)(Englishan
dtranslated)
17 Advertisement/material to recruit participants (fliers,  
posters etc)
Permission from governing authorities
Other permissions Requir Not Receive Appli
ed requir d ed dd/
ed mm/y
y
18 CTRI   
19 DCGI   
20 HMSC   
21 NAC-SCRT   
22 ICSCR   
23 RCGM   
24 BARC   
25 others (specify)
 Application Form for Exemption from Review

Title of study:

PrincipalInvestigator(Name,DesignationandAffiliation):

1. Choose reasons why exemption from ethics review is requested?

i. Research on data in the public domain/ systematic reviews ormeta-analyses 

ii. Observationofpublicbehavior/informationrecordedwithoutlinkedidentifiersanddisclosu 
re would not harm the interests of the observed person
iii. Quality control and quality assurance audits in the institution 
iv. Comparison among instructional techniques, curricula, or classroom management 
methods
v. Consumer acceptance studies related to taste and food quality 
vi.Publichealthprogrammesbygovernmentagencies 
vii. Any other (please specify in 100 words):

Signature of PI with date:

Comments of EC Secretariat:

Signature of Member Secretary with date:

 Continuing Review / Annual report format
Title of study:

PrincipalInvestigator(Name,DesignationandAffiliation):

1. Date of IEC approval

2. Validity of approval
3. Date of start of study
4. Proposed date of study completion
5. Period of continuing report from to
6. Does the study involve recruitment of participant s Yes  No 
(a) Ifyes,Totalnumberexpected: NumberScreened: Number Enrolled:.
Number Completed: Number on follow up
(b) Enrolment status – ongoing / completed/stopped
(c) ReportofDSMBYes  No NA
(d) Any other remark

(e) Haveanyparticipantswithdrawnfromthisstudysincethelastapproval? Yes  No NA

Ifyes,totalnumberwithdrawnandreasons:

7. Isthestudylikelytoextendbeyondthestatedperiod?Yes  No
Ifyes,pleaseprovidereasonsfortheextension.

8.
Havetherebeenanyamendmentsintheresearchprotocol/InformedConsentDocument(ICD)during
thepast approvalperiod?
IfNo,skiptoitemno.9Yes  No
(i) Ifyes,dateofapprovalforprotocolandICD:
(II)In case of amendments in the research protocol/ICD, was re-consent sought from
participants? Yes  No

Ifyes,when/how:

9. Is any new information available that changes the benefit - risk analysis of human
participants involved in this study?Yes  No
Ifyes,discussindetail:

10. Have any ethical concerns occurred duringthisperiod?

Yes  No
If yes, give details

11. Have any adverse events been noted since thelast review? Yes  No
Describe in brief:

12. (a)Have any SAE’s occurred sincelastreview?Yes  No

If yes, number ofSAE’s Type of SAE’s:
(b) Is the SAE related tothe study?Yes No
(c) Have you reported the SAE to EC? If no,statereasonsYes  No

13. Hastherebeenanyprotocoldeviations/violationsthatoccurredduringthisperiod?
If yes, number of deviations
b) Have you reported the deviations to EC? Yes  No
If no,statereasons
14. Incaseofmulticenterictrials, have reportsofoff-siteSAEsbeensubmittedtotheEC?Yes  No
 NA

15. Are there any publications or presentations during this period? If yesgivedetails.
Yes  No

Any other comments:

Signature of PI:

Application/Notification form for Amendments

1. Title of the study

2. IEC ref no:
3. PI – Name, Designation and Affiliation

4. Date of EC approval
5. Date of Start of study

6. Details of Amendments

Location in the
S.No Existing Proposed Reason
protocol/ICD
Provision Amendment

7. Impact on Benefit and risk analysis – Yes/No

If yes describe in brief

8. Is anyreconsentnecessary? Yes/No 
Ifyes,havenecessarychangesbeenmadeintheinformedconsent? Yes/No

9. Type of review requested foramendment:

Expedited review (No alteration in risktoparticipants) 

FullreviewbyEC(Thereisanincreasedalterationintherisktoparticipants) 
10. VersionnumberofamendedProtocol/Investigator’sbrochure/ICD:

Signature of PI:

Protocol Violation/Deviation Reporting Form (Reporting by case )

1. Title of the study
2. IEC ref no:
3. PI – Name, Designation and Affiliation

4. Date of EC approval
5. Date of Start of study
6. Participant ID

7. Total number of deviations /violations reported till date in the study:

8. Deviation/Violation identified by: Principal

Investigator/studyteam/ Sponsor/Monitor/SAESubCommittee/EC
9. Isthedeviationrelatedto(Ticktheappropriatebox):

Consenting  Sourcedocumentation 
Enrollment  Staff 
Laboratory assessment  Participantnon-compliance 
Investigational Product  Others(specify) 

Safety Reporting
10. Provide details of Deviation/Violation:

11. Corrective action taken by PI/Co-I:

12. Impact on (if any): Studyparticipant/Quality of data/

13. Areanychangestothestudy/protocolrequired? Yes/No

If yes, give details

14. Signature of PI with date

Serious Adverse Event Reporting Format (Biomedical HealthResearch)

1. Title of the study
2. IEC ref no:
3. PI – Name, Designation and Affiliation

4. Date of EC approval
5. Date of Start of study

6. Participant details:

Initials/ID
Age at the time of event
Gender : Male/Female
Weight (Kgs) :
Height (cms) :
7. Suspected SAE diagnosis
8. DateofonsetofSAE:
9. Describetheevent
10. Date of reporting SAE
11. Details of suspected intervention causing SAE
12. Report type:Initial/Follow-up/Final
13. If Follow-up report, state date initial report
14. HaveanysimilarSAEoccurredpreviouslyinthisstudy? Yes/NO
Ifyes,pleaseprovidedetails.
15. In caseofamulti-centricstudy,haveanyoftheotherstudysitesreportedsimilar SAEs ?
(Pleaselistnumberofcaseswithdetailsifavailable)
16.
TickwhicheverisapplicablefortheSAE:(KindlynotethatthisreferstotheInterventionbeingevalua
tedandNOT diseaseprocess)

A. Expectedevent/ Unexpected event

B. HospitalizationIncreased Hospital Stay Death Congenital anomaly/birth defects 

Persistent or significant disability/incapacityEvent requiring intervention (surgical or

medical) to prevent SAEEvent which poses threat to lifeOthers

17. Incaseofdeath,stateprobablecauseofdeath.
18. No permanent/significantfunctional/cosmetic impairment 
Permanent/significantfunctional/cosmeticimpairment NotApplicable 
19.
Describethemedicalmanagementprovidedforadversereaction(ifany)totheresearchparticipant.(In

cludeinformationonwhopaid,howmuchwaspaidandtowhom).

20. Provide details of compensation provided / to be provided to participants (Include information

on who pays, howmuch, and towhom

21. Outcome ofSAE

Fatal  Recovered 
Continuing  Unknown 
Recovering  Other(specify) 

22.
Provideanyotherrelevantinformationthatcanfacilitateassessmentofthecasesuchasmedicalhistory
23. ProvidedetailsaboutPI’sfinalassessmentofSAErelatednesstoresearch.

Signature of PI with date

 Premature Termination/Suspension/ Discontinuation Report Format

1. Title of the study

2. IEC ref no:
3. PI – Name, Designation and Affiliation

4. Date of EC approval
5. Date of Start of study
6. Date of last progress report submitted to EC
7. Date oftermination/suspension/discontinuation:
8. Reason for Termination/Suspension/Discontinuation
9. ActiontakenpostTermination/Suspension/Discontinuation(ifany):
10. Plansforpoststudyfollowup/withdrawal(ifany)
11. Details of study participants
Total number of participants to be recruited
Screened
Screen failures
Consent with drawn – reason
With drawn by PI- reason
Active on treatment / Completed treatment/ Participants on follow-up:
Participants lost to follow up
Number of drop outs
Reasons for each drop-out
Any other
12. Total number of SAEs reported till date in the study
13. Have any unexpected adverse events or outcomes observed in the study been reported to the
EC?Yes/No
14.Have there been participant complaints or feedback about the study?Yes/No
If yes provide details
15. Have there been any suggestions from the SAE Sub Committee?Yes/No
If yes have you implemented that suggestion?Yes/No

16.Do the procedures for withdrawal of enrolled participants take into account their rights and
welfare? Yes  No (e.g., making arrangements for medical care of research participants):
If Yes, provide details

Summary of results:

Signature of PI with date

 Application Form for Clinical Trials
1.Title of the study

2. PI details

3. Type of Clinical trial – Regulatory trial / Academic trial

CTRIregistrationnumber:

NABHaccreditationnumber:

ECregistrationnumber

4. Ifregulatorytrial,providestatusofCDSCOpermissionletter
Approved and letterattached/ Applied, under process/ Not applied(Statereason)

5. Tick all categories that apply to yourtrial

Phase-I  PhaseII 
PhaseIII  Phase IV or Post Marketing Surveillance

Investigational medicinal products  Investigational Newdrug 

Medical devices  New innovativeprocedure 
Drug/device combination  Bioavailability/Bioequivalencestudies 
Non-drug intervention  Repurposing an existingintervention 
Indian system of  Stemcells 
(AYUSH)medicinePhytopharmaceut  Approved drug for any newindication

 ornewrouteofadministration
ical drug
Others (specify)

6. Trial design of thestudy

I. Randomized  Factorial 
Non randomized  Stratified 
Parallel  Adaptive 
Cross-over  Comparisontrial 
Cluster  Superioritytrial 
Matched-pair  Non-inferioritytrial 
Others (specify)  Equivalencetrial 

II.If there is randomization, how will the participants be allocated to the control and study group(s)?

III. Describe the method of allocation concealment (blinding / masking), if applicable.

7. List the primary / secondary outcomes of the trial.

8. Is there a Contract Research Organization (CRO) /Site Management Organisation (SMO) / Any
other agency such as public relation/human resource? Yes  No 
If yes, Name and Contact details:

9. State how the CRO/SMO/agency will be involved in the conduct of the trial (tick all that apply)

Project management  Clinical and medicalmonitoring 

Regulatory affairs  Datamanagement 

Statistical support  Medicalwriting 

Site management  
Audits,qualitycontrol,qualityassuranc
10. Please provide the following details about
e the intervention being used in the protocol
I. Drug/s, device/s and/or biologics; Yes  No  NA 
Finance management  Recruitment andtraining 
if yes, provide regulatory approval details.
Administrative support  Others(specify) 
II. Already approved drugs or a combination of two or more drugs with new indications / change
in dosage form / route of administration. Yes  No  NA 

If yes, provide details.

III. Provide
contact details of who prepared and /or is manufacturing the drug/s, device/s and
biologics.

IV.Provide details of patent of the drug/s, device/s and biologics.

11. Describe in brief any preparatory work or site preparedness for the protocol?Yes  No  NA 

If yes, provide details

12. Is there an initial screening/use of existing database for participant selection?Yes No NAIf
Yes, provide details

13. Is there any anticipated incidence, frequency and duration of adverse events related to the
intervention?Yes  No  NA 

If yes, provide details of arrangements made to address them.

14. Does the study use a placebo?Yes  No  NA 

If yes, justify the use of the placebo and risks entailed to participants.

15. Will current standard of care be provided to the control arm in the study?Yes  No  NA 

If no, please justify.

16. Are there any plans to withdraw standard therapy during the study?Yes  No  NA 
If yes, please justify

17. Are there any rules to stop the protocol in case of any adverse events?.Yes  No  NA 

If yes, please specify

18. Does the study have a Data and Safety Monitoring Plan? Yes  No  NA 

If no, please justify.

16. Participant Information Sheet(PIS) and Informed Consent Form (ICF)

English Local language Other(Specify) 

(certified that local version (s) is/are a true translation of the English version andcan be easily
understood by the participants)

17. Involvement/consultation of statistician in the study design Yes  No  NA 

18. Is there any insurance coverage of the trial? If yes, provide details. Yes  No 

19. Is the PI registered with Medical Council of India (MCI) or the State Medical Council
registration?Yes  No 

Please provide details.

20. Is the PI trained in GCP in last 3 years? If yes, Please enclose certificate Yes  No 

Signature of PI with date

 Serious Adverse Event Reporting Format (Clinical trials)
Title of the study

PI details:

Participant details

Initials and Case No

Subject ID
Age at the time of event
Gender: Male/Female
Weight (Kgs)
Height (cms)
2. Report type: Initial  Follow-up  Final 

3. If Follow-up report, state date of Initial report

4. What was the assessment of relatedness to the trial in the initial report?

By PI – Related  By Sponsor – Related By EC –Related 

Unrelated  Unrelated  Unrelated 

5. Describe the event and specify suspected SAE diagnosis

6. Date of onset of SAE: Date of reporting:

7. Onset lag time after administration of intervention:

8. Location of SAE (Clinic/Ward/Home/Other)

9. Details of suspected study drug/device/investigational procedure causing SAE:

I. Suspect study drug (include generic name) device/intervention:

II. Indication(s) for which suspect study drug was prescribed or tested:

10. Route(s) of administration, daily dose and regimen, dosage form and strength

II. Therapy start date: Stop date:

11. Was study intervention discontinued due to event? Yes  No 

12. Do the reaction decline after stopping or reducing the dosage of the study drug / procedure?

Yes  No 

If yes, provide details about the reduced dose

13. Did the reaction reappear after reintroducing the study drug / procedure?Yes  No  NA 
If yes, provide details about the dose

14. Concomitant drugs history and lab investigations:

I. Concomitant drug (s) and date of administration:

II. Relevant test/laboratory data with dates:

III. Patient relevant history including pre-existing medical conditions (e.g. allergies, race,
pregnancy, smoking, alcohol use, hepatic/ renal dysfunction etc)

15. Have any similar SAE occurred previously in this study? Yes  No

If yes, please provide details

16. Seriousness of the SAE:

Death  Congenital anomaly 

Life threatening  Required intervention to prevent

Hospitalization-initial or prolonged  permanent impairment / damage 

Disability  Others (specify) 

17. Describe the medical management provided for adverse reaction (if any) to the research
participant. (Include infor- mation on who paid, how much was paid and to whom).

18. Outcome of SAE:

Fatal  Recovered 

Continuing  Unknown 

Recovering  Other (specify) 

19. Was the research participant continued on the trial? Yes  No  NA 

20. Provide details about PI’s final assessment of SAE relatedness to trial.

21. Has this information been communicated to sponsor/CRO/regulatory agencies?Yes  No 

22. Provide details if communicated (including date)

23.Does this report require any alteration in trial protocol? Yes  No 

24. Provide details of compensation provided / to be provided the participants (Include

information on who pays, how much, and to whom)

Signature of PI with date

 Study completion/Final report format

Title of study:

PI (Name, Designation and Affiliation):

Date of EC Approval:

Date of Start of Study:

Date of study completion:

Provide details of

a) Total no. of study participants approved by the EC for recruitment:

b) b) Total no. of study participants recruited:
c) Total number of participants withdrawn from the study (if any):

4. Describe in brief the publication/ presentation/dissemination plans of the study findings. (Also, mention if
both positive and negative results will be shared)-

5. Describe the main Ethical issues encountered in the study (if any):

6. State the number (if any) of Deviations/Violations/ Amendments made to the study protocol during the
study period

7. Describe in brief Plans for archival of records / Record Retention:

8. Is there a plan for post study follow-up –

9. Do you have plans for ensuring that the data from the study can be shared/ accessed easily?
10. Is there a plan for post study benefit sharing with the study participants?
11.Describe results (summary) with Conclusion:
12.Number of SAEs that occurred in the study
13. Have all SAEs been intimated to the EC:
14. Is medical management or compensation for SAE provided to the participants?
 INFORMED CONSENTDOCUMENT

Participant information sheet

(i) Statement that the study involves research and explanation of the purpose of the research. In
simple language

(ii) Expected duration of the participation of subject.

(iii) Description of the procedures to be followed, including all invasive procedures.

(iv) Description of any reasonably foreseeable risks or discomforts to the Subject.

(v) Description of any benefits to the participant or others reasonably expected from research. If no
benefit isexpected participants should be made aware of this.

(vi) Disclosure of specific appropriate alternative procedures or therapies available to the participant.

(vii) Statement describing the extent to which confidentiality of records identifying the participant
will bemaintained and who will have access to participant's medical records.

(viii) Trial treatment schedule and the probability for random assignment to each treatment (for
randomizedtrials).

(ix) Statement describing the financial compensation and the medical management as under:

(a) In case of an injury occurring to the subject during the clinical trial, free medical
management shall begiven as long as required or till such time it is established that the injury
is not related to the clinical trial,whichever is earlier.

(b) In the event of a trial related injury or death, the sponsor or his representative or the
investigator orcentre, as the case may be, in accordance with the rule 39, as the case may be,
shall provide financialcompensation for the injury or death.

(x)An explanation about whom to contact for trial related queries, rights of Subjects and in the event
of any injury.

(xi) The anticipated prorated payment, if any, to the participant for participating in the trial.

(xii) Responsibilities of subject on participation in the trial.

(xiii) Statement that participation is voluntary, that the subject can withdraw from the study at any
time and thatrefusal to participate will not involve any penalty or loss of benefits to which the subject
is otherwise entitled.

(xiv) Statement that there is a possibility of failure of investigational product to provide intended
therapeuticeffect.

(xv) Statement that in the case of placebo-controlled trial, the placebo administered to the subjects
shall not haveany therapeutic effect.
(xvi) Any other pertinent information.

Additional elements, which may be required:

(a)Statement of foreseeable circumstances under which the participation of the subject may be
terminated by theInvestigator without his or her consent.

(b)Additional costs to the participant that may result from participation in the study.

(c)The consequences of a participant's decision to withdraw from the research and procedures for
orderlytermination of participation by Subject.

(d)Statement that the Participant or participant's representative will be notified in a timely manner if
significant newfindings develop during the course of the research which may affect the participant's
willingness to continueparticipation will be provided.

(e). A statement that the particular treatment or procedure may involve risks to the participant (or to
the embryo orfoetus, if the participant is or may become pregnant), which are currently
unforeseeable.

(f) Approximate number of participants enrolled in the study.

 Informed consent form

Study Title:

Study Number:

Participant’s Initials: ________________________ Participant’s Name: _____________________

Date of Birth/Age: _________

Address of the Participant ___

Qualification _____________

Occupation: Student or Self-Employed or Service or Housewife or Others (Please click as

appropriate) .

Annual Income of the subject:

Name and address of the nominees and his relation to the subject (for the purpose of compensation in
case oftrial related death).

Place Initial box (Subject)

(i) I confirm that I have read and understood the information [ ]

Sheet dated ___________ for the above study and havehad the opportunity to ask questions.

(ii) I understand that my participation in the study is voluntary and [ ]

that I am free to withdraw at any time, without giving any reason,without my medical care or legal
rights being affected.

(iii) I understand that the Sponsor of the clinical trial, othersworking on the Sponsor's behalf, the
Ethics Committeeand the regulatory authorities will not need my permissionto look at my health
records both in respect of the currentstudy and any further research that may be conducted inrelation
to it, even if I withdraw from the trial.I agree to this access. However, I understand thatmy identity
will not be revealed in any informationreleased to third parties or published. [ ]

(iv) I agree not to restrict the use of any data or results that arisefrom this study provided such a use
is only for scientific purposes [ ]

(v) I agree to take part in the above study. [ ]

Signature (or Thumb impression) of the Subject/Legally Acceptable Representative:

Date: _____/ ____ /

Signatory’s Name: __________________________________________________

Signature of the Investigator: _____________ Date: ____ / ____ /

Study Investigator’s Name: ___ ___________________

Signature of the Witness ______________________________ Date: ____ / ____ /

Name of the Witness:________________________

UNDERTAKING BY THE INVESTIGATOR

1. Full name, address and title of the Principal Investigator (or Investigators when there is no
Principal Investigator).

2. Name and address of the medical college, hospital or other facility where the research will be
conducted:Education, training & experience that qualify the Investigator for the clinical trial (Attach
details includingMedical Council registration number, or any other statements of qualifications)

3. Name and address of all clinical laboratory facilities to be used in the study.

4. Name and address of the Ethics Committee that is responsible for approval and continuing review
of the study.

5. Names of the other members of the research team (Co-or sub-Investigators) who will be assisting
the Investigatorin the conduct of the investigations.

6. Protocol Title and Study number (if any) of the clinical trial to be conducted by the Investigator.

7. Commitments:

(i) I have reviewed the clinical protocol and agree that it contains all the necessary information to
conductthe study. I will not begin the study until all necessary ethics committee and regulatory
approvals have beenobtained. I inform that no work has been started for this research yet.

(ii) I agree to conduct the study in accordance with the current protocol. I will not implement any
deviationfrom or changes of the protocol without agreement by the Sponsor and prior review and
documented approval orfavourable opinion from the ethics committee of the amendment, except
where necessary to eliminate animmediate hazard to the trial subject or when the changes involved
are only logistical or administrative in nature.

(iii) I agree to personally conduct or supervise the clinical trial at my site.

(iv) I agree to inform all trial subject, that the drugs are being used for investigational purposes and I
willensure that the requirements relating to obtaining informed consent and ethics committee review
and approvalspecified in the New Drugs and Clinical Trials Rules, 2019 and Good Clinical Practices
guidelines are met.

(v) I agree to report to the Sponsor all adverse experiences that occur in the course of the
investigation(s)in accordance with the regulatory requirements and Good Clinical Practices
guidelines.

(vi) I have read and understood the information in the Investigator's brochure, including the potential
risksand side effects of the drug.

(vii) I agree to ensure that all associates, colleagues and employees assisting in the conduct of the
study aresuitably qualified and experienced and they have been informed about their obligations in
meeting theircommitments in the trial.
(viii) I agree to maintain adequate and accurate records and to make those records available for audit
orinspection by the Sponsor, ethics committee, Central Licencing Authority or their authorised
representatives, inaccordance with regulatory provisions and the Good Clinical Practices guidelines.
I will fully cooperate with anystudy related audit conducted by regulatory officials or authorised
representatives of the Sponsor.

(ix) I agree to promptly report to the ethics committee all changes in the clinical trial activities and
allunanticipated problems involving risks to human subjects or others.

(x) I agree to inform all serious adverse events to the Central Licencing Authority, sponsor as well as
theethics committee within twenty-four hours of their occurrence. In case, of failure to do so, I shall
furnish thereason for the delay to the satisfaction of the Central Licencing Authority along with the
report of the seriousadverse event.

(xi) The report of the serious adverse event, after due analysis, shall also be forwarded by me to the
CentralLicencing Authority, the Chairperson of the ethics committee and the Head of the institution
where the trial hasbeen conducted within fourteen days in accordance with the regulatory
requirements.

(xii) I will maintain confidentiality of the identification of all participating subjects and assure
security andconfidentiality of study data.

(xiii) I agree to comply with all other requirements, guidelines and statutory obligations as applicable
toclinical Investigators participating in clinical trials.

Signature of Investigator with date.