BACKGROUND: The concept of risk assessment for clinical trials has been discussed before, but no comprehensive structured procedure leading to risk-adapted quality management has been published so far. Such a procedure is of particular interest for noncommercial trials in order to optimally use the sparse resources. PURPOSE: To provide a structured procedure for risk analysis in clinical trials. To propose strategies for on-site monitoring adapted to the risks identified. RESULTS: The risk analysis refers to the risk of noncompliance with the main objectives of Good Clinical Practice. It takes into account risks of the study intervention compared to the risks a patient would run if treated outside a protocol as well as further potential risks regarding patient safety, patient rights, or the credibility of results. The risk analysis is based on detailed questionnaires, which are used to draw up (a) an on-site monitoring strategy recommendation, (b) a list of trial-specific tasks to be covered by on-site monitoring, and (c) a specification of further quality management measures e.g., central monitoring measures. The resulting risk-adapted monitoring strategies focus on the trial's critical aspects, and differ in terms of the recommended extent of on-site activities. LIMITATIONS: The effectiveness of the proposed risk analysis and risk-adapted monitoring has not yet been confirmed. However, the ADAMON project (prospective cluster-randomised study of trial-specific adapted strategies for on-site monitoring in combination with additional quality management measures) has been started in Germany to investigate whether a trial-specific, risk-adapted, reduced on-site monitoring strategy is as effective as an intensive monitoring strategy with regard to the occurrence of serious or critical audit findings. Twelve clinical trials planning to recruit more than 3200 patients participate in this investigation. CONCLUSIONS: Our proposal will provide sponsor-investigators and other noncommercial sponsors with an instrument that may facilitate risk analysis and the implementation of targeted quality management measures.
BACKGROUND: The concept of risk assessment for clinical trials has been discussed before, but no comprehensive structured procedure leading to risk-adapted quality management has been published so far. Such a procedure is of particular interest for noncommercial trials in order to optimally use the sparse resources. PURPOSE: To provide a structured procedure for risk analysis in clinical trials. To propose strategies for on-site monitoring adapted to the risks identified. RESULTS: The risk analysis refers to the risk of noncompliance with the main objectives of Good Clinical Practice. It takes into account risks of the study intervention compared to the risks a patient would run if treated outside a protocol as well as further potential risks regarding patient safety, patient rights, or the credibility of results. The risk analysis is based on detailed questionnaires, which are used to draw up (a) an on-site monitoring strategy recommendation, (b) a list of trial-specific tasks to be covered by on-site monitoring, and (c) a specification of further quality management measures e.g., central monitoring measures. The resulting risk-adapted monitoring strategies focus on the trial's critical aspects, and differ in terms of the recommended extent of on-site activities. LIMITATIONS: The effectiveness of the proposed risk analysis and risk-adapted monitoring has not yet been confirmed. However, the ADAMON project (prospective cluster-randomised study of trial-specific adapted strategies for on-site monitoring in combination with additional quality management measures) has been started in Germany to investigate whether a trial-specific, risk-adapted, reduced on-site monitoring strategy is as effective as an intensive monitoring strategy with regard to the occurrence of serious or critical audit findings. Twelve clinical trials planning to recruit more than 3200 patients participate in this investigation. CONCLUSIONS: Our proposal will provide sponsor-investigators and other noncommercial sponsors with an instrument that may facilitate risk analysis and the implementation of targeted quality management measures.
Authors: Katherine Huppler Hullsiek; Jonathan M Kagan; Nicole Engen; Jesper Grarup; Fleur Hudson; Eileen T Denning; Catherine Carey; David Courtney-Rodgers; Elizabeth B Finley; Per O Jansson; Mary T Pearson; Dwight E Peavy; Waldo H Belloso Journal: Ther Innov Regul Sci Date: 2015-03-01 Impact factor: 1.778
Authors: Clare E Hastings; Cheryl A Fisher; Margaret A McCabe; J Allison; D Brassil; M Offenhartz; S Browning; E DeCandia; R Medina; J Duer-Hefele; K McClary; N Mullen; M Ottosen; S Britt; T Sanchez; V Turbini Journal: Nurs Outlook Date: 2011-12-14 Impact factor: 3.250
Authors: Thorsten Löffler; Christoph M Seiler; Inga Rossion; Thomas Kijak; Oliver Thomusch; Renè Hodina; Matthias Krüger; Thomas Simon; Thomas Bruckner; Meinhard Kieser; Markus W Büchler; Jürgen Weitz Journal: Trials Date: 2011-02-08 Impact factor: 2.279
Authors: Christian Gluud; Christine Kubiak; Kate Whitfield; Jane Byrne; Karl-Heinz Huemer; Steffen Thirstrup; Christian Libersa; Béatrice Barraud; Xina Grählert; Gabriele Dreier; Sebastian Geismann; Wolfgang Kuchinke; Zsuza Temesvari; Gyorgy Blasko; Gabriella Kardos; Timothy O'Brien; Margaret Cooney; Siobhan Gaynor; Arrigo Schieppati; Fernando de Andres; Nuria Sanz; German Kreis; Charlotte Asker-Hagelberg; Hanna Johansson; Sue Bourne; Adeeba Asghar; Jean-Marc Husson; Jacques Demotes-Mainard Journal: Trials Date: 2012-03-27 Impact factor: 2.279