RT Journal A1 Lantos J T1 IT is time to professionalize institutional review boards JF Archives of Pediatrics & Adolescent Medicine JO Archives of Pediatrics & Adolescent Medicine YR 2009 FD December 1 VO 163 IS 12 SP 1163 OP 1164 DO 10.1001/archpediatrics.2009.225 UL http://dx.doi.org/10.1001/archpediatrics.2009.225 AB The study by Finch et al1 about inconsistent and lengthy institutional review board (IRB) reviews of a minimal risk protocol should surprise nobody. Previous studies have shown that IRBs are inefficient,2 inconsistent,3 idiosyncratic,4 and often ineffective.5 They spend much of their time monitoring low-risk protocols6 or inadequately wordsmithing informed consent forms7 and sometimes approving protocols that should not be approved.8 While IRB oversight of low-risk protocols is scrupulous, oversight of high-risk innovations may not take place at all. Such innovations may not be conceptualized as research and so are able to be introduced into clinical medicine without IRB approval.9 Why do we put up with such a dysfunctional system of regulation?