Conducting research using the emergency exception from informed consent: The Public Access Defibrillation (PAD) Trial experience

Vincent N. Mosesso, Lawrence H. Brown, H. Leon Greene, Terri A. Schmidt, Tom P. Aufderheide, Michael R. Sayre, Shannon W. Stephens, Andrew Travers, Richard A. Craven, Myron L. Weisfeldt

Research output: Contribution to journalArticlepeer-review

76 Scopus citations


Background: The Public Access Defibrillation (PAD) Trial, a prospective, multicenter, randomized clinical trial comparing two prehospital resuscitation strategies, was conducted under the regulations for exception from informed consent (21CFR50.24) in 24 communities in North America. These regulations place additional requirements for human subject protection on investigators and Institutional Review Boards (IRBs), including conducting community consultation (CC) and public disclosure (PD). Objective: To describe the IRB approval process at study sites and the number and types of community consultation and public disclosure activities conducted. Methods: The 24 study sites in the United States and Canada submitted IRB applications, CC and PD plans, and a structured report on IRB process and investigator perceptions to the Clinical Trial Center at the University of Washington. Results: The primary IRBs for all 24 trial sites and a total of 101 IRBs approved the study. The median interval from submission to approval was 108 days (IQR 43-196), and the mean number of revisions was two (range 0-7). Investigators conducted nearly 12,000 activities to achieve CC and PD; activities varied greatly from site to site in both type and quantity. Conclusion: The length of time to obtain IRB approval and the extent of community consultation and public disclosure varied greatly among trial sites in meeting the current regulations for conducting emergency research with exception from informed consent. This suggests that more specific guidance may be useful and that determination of effective strategies for community consultation and public disclosure is needed.

Original languageEnglish (US)
Pages (from-to)29-36
Number of pages8
Issue number1
StatePublished - Apr 2004
Externally publishedYes


  • Automated external defibrillator (AED)
  • Cardiac arrest
  • Cardiopulmonary resuscitation (CPR)
  • Desfibrilhação automática externa (AED)
  • Ethics
  • Human experimentation: clinical trials
  • Informed consent
  • Paragem cardíaca

ASJC Scopus subject areas

  • Emergency Medicine
  • Emergency
  • Cardiology and Cardiovascular Medicine


Dive into the research topics of 'Conducting research using the emergency exception from informed consent: The Public Access Defibrillation (PAD) Trial experience'. Together they form a unique fingerprint.

Cite this