How do institutions determine which studies will use the Agreement?

How is it determined what specific research study(ies) will be ceded under the Agreement?

Each Participating Institution, in consultation with other involved Participating Institutions as needed, makes a determination whether a research study(ies) is appropriate for ceded review. No Participating Institution involved in the research is required to participate in the ceded review. If one or more involved Participating Institutions declines to participate in the ceded review, the other institutions may still participate in it.