Research vs. Public Health Practice Update: How to Assure a High Quality, Safe and Ethical Practice?

Scientific and clinical activities undertaken by public health agencies may be misconstrued as medical research. Most discusssions of regulatory oversight of medical research activities are focused on research activities undertaken either in the setting of clinical practice or in clinical trials in which healthy volunteers are enrolled. Little regulatory attention has been paid to differentiating those scientific activities at the core of public health practice from identical practices undertaken in the course of pursuing medical research. This gap has caused some degree of confusion and uncertainty for public health agencies at all levels of government, including the Federal sector. We will discuss how one can adjudicate and support activities common to public health and research investigations, including the question of if, when, and how institutional research review boards should become involved. We will also suggest management mechanisms to assure high quality and ethical public health practice.