Ethical integrity in the conduct of health care research is essential for maintaining the public trust and support of such activities. Institutional Review Boards (IRBs) play a critical role in maintaining the ethical integrity of research by reviewing research protocols to ensure, among other things, that research participants receive safe and ethical treatment and provide informed consent, and that the potential for a conflict of interest is minimized. The purpose of this review was to catalog the literature on issues pertaining to IRBs, to identify the issue with the greatest number of published studies which might inform VA policy, and to assess the evidence regarding that issue, which were conflict of interest policies and the activities of the IRB.