Lessons from the United States for Research Ethics Oversight When we think about protecting research participants, most of us think about ethics committees. Researchers submit applications. Committees review them. Studies are approved, further information is requested, or they are declined. The system appears reassuringly simple. But recently, a story emerging from the United States has highlighted a question that few researchers, and even fewer members of the public, ever st

Quality improvement (QI) and audit activities are essential to a functioning health system. They allow services to reflect, adapt, and improve, often quickly and pragmatically. They are also one of the most misunderstood areas of research ethics.

A company commissions a research agency to test a new digital health product. Participants are recruited online and asked about their health behaviours, medication use, and attitudes toward treatment. They consent to take part. The data is anonymised. The findings will inform product strategy, and may later be presented externally. No ethics committee is involved. At first glance, this feels routine. It is, after all, “just market research”. But pause for a moment.

Ethics committees have traditionally relied on face-to-face meetings to review research applications. But as research volume increases and timelines tighten, this model is being challenged. Increasingly, committees are adopting asynchronous (or “rolling”) review processes, where applications are assessed independently and decisions are made without real-time meetings. So which approach is better?