Few data are available on guidelines used by research organizations to make decisions about paying subjects.

To analyze existing guidance regarding payment of research subjects and to identify common characteristics and areas for further research.

Descriptive content analysis of policies.

Written policies and rules of thumb about paying subjects from 32 U.S. research organizations.

Of 32 organizations, 37.5% had written guidelines about paying subjects; all but 1 reported having rules of thumb. Few (18.8%) were able to provide a confident estimate of the proportion of studies that pay subjects. Organizations reported that investigators and institutional review boards make payment decisions and that both healthy and ill subjects in some studies are paid for their time (87%), for inconvenience (84%), for travel (68%), as incentive (58%), or for incurring risk (32%). Most organizations require that payment be prorated (84%) and described in the consent document (94%).

Most organizations pay some research subjects, but few have written policies on payment. Because investigators and institutional review boards make payment decisions with little specific guidance, standards vary.