Researchers' perceptions of US Defense Health Agency Institutional Review Board performance

The US Defense Health Agency (DHA) maintains five Institutional Review Boards (IRBs) within the Office of Human Research Protection Human Research Protection Program (HRPP) to oversee the research portfolio. DHA researchers completed the IRB Researcher Assessment Tool (IRB-RAT) to share their perceptions of IRB performance and identify areas where future process improvement efforts can be focused.

This study was a cross-sectional programme evaluation and IRB determination was received. Participants were asked to complete the IRB-RAT. The primary outcome was the performance gap score, calculated for each item as Actual minus Ideal. Linear mixed-effects models were used to analyse responses and to evaluate institutional variability.

An electronic invitation to complete the IRB-RAT was sent to 5960 registered DHA Electronic IRB system (EIRB) users between May and October 2025. Of those, 473 responded. Analysis identified the most important Ideal characteristics as (Q1) timeliness, (Q4) providing complete explanations for changes and (Q25) not using its power to suppress research. The largest performance gap scores were (Q1) timeliness, (Q24) being an ally rather than a hurdle and (Q15) accountability for errors or delays. Items identified for process improvement were (Q1) timeliness, (Q4) providing complete explanations for changes, (Q24) being an ally rather than a hurdle and (Q22) understanding and acting within their scope of function. There were significant differences across the five IRBs. Performance was not uniform across the DHA.

The IRB-RAT effectively captured respondents' perceptions of DHA IRB performance. Timeliness was a universal concern and improvements within IRB scope of function and providing explanations for changes should help minimise delays. Additional work is needed to understand why DHA researchers view the IRB as a hurdle, not an ally. The DHA IRBs must harmonise best practices across the five IRBs and develop future process improvement projects to address researchers' concerns.