Primary Ethical Concern in E-Research Comparing NSAID Gastric Symptoms
The primary ethical problem with e-research comparing gastric symptoms of NSAIDs is that informed consent may not be taken correctly (Option B). This represents the most fundamental breach of research ethics principles in online health studies.
Why Informed Consent is the Critical Issue
The Journal of Medical Internet Research found that only 1 out of 119 online health studies actually sought informed consent from participants, demonstrating widespread failure in this fundamental ethical requirement 1. This is particularly problematic because:
- The online format makes it impossible to verify participant identity, comprehension of risks, or voluntary participation 1
- 73.9% of online health studies made no mention of ethical considerations, and only 12.6% sought IRB review 1
- Researchers often incorrectly assume online platforms constitute "public space" and therefore don't require traditional consent processes, which is ethically problematic when dealing with vulnerable populations 1
Why Other Options Are Secondary Concerns
Data Collection (Option A)
While data gathering can be challenging in e-research, this is a logistical problem, not an ethical one. The SPIRIT-PRO Extension guidelines address data collection methods but frame these as methodological considerations rather than primary ethical violations 2.
Patient Privacy (Option C)
Privacy concerns exist but are secondary to consent issues. The Journal of Medical Internet Research found that 27.7% of online health studies contained identifying information, but privacy can be technically protected through anonymization 1. Unlike consent, privacy breaches can be prevented through proper technical safeguards.
Medication Discontinuation (Option D)
This is not a specific ethical problem unique to e-research. In any NSAID study (online or traditional), patients retain the right to discontinue medication. Guidelines emphasize that patients should be monitored for concerning symptoms during PRO data collection 2, but this applies equally to all research formats.
Common Pitfalls in Online Research Ethics
- Assuming that publicly accessible online data doesn't require consent - this is ethically incorrect, especially when studying health conditions 1
- Failing to establish clear pathways for monitoring concerning PRO responses - protocols should state whether and how data will be monitored during the study 2
- Not providing alternative support mechanisms (e.g., 24-hour helpline) for participants reporting adverse symptoms 2