I think the ethics board would also have a say on whether the trial continues if MSB don't follow DSMB recommendation. Only question is whether this trial had a centralized IRB or one for each site or a combination.
IRB would have to be kept in the loop of any DSMB decisions, imo.
Ann: Phase 3 Trial in COVID-19 ARDS Surpasses 50% Enrollment, page-157
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