The role of the clinical research coordinator--data manager--in oncology clinical trials

A training protocol compliance of 13% was observed in a research study of clinical research professionals

OBJECTIVE

We attempted to conduct a randomized controlled trial of three different informed consent training formats to evaluate their effectiveness. We recruited 503 clinical research professionals, who received $50 for participation. Incidental findings showed unexpectedly low rates of compliance with completing the study training protocols, resulting in insufficient statistical power to test our original hypotheses. In this report, we conducted a secondary analysis of the data in which we characterize and evaluate the observed low compliance. This involved using literature on average reading times, speed-reading times, and video play speeds to calculate the timeframes required to complete the three training formats.

RESULTS

Only 13% of participants completed the training in a reasonable timeframe. Furthermore, only 46% of participants completed the training in the minimum possible timeframe. These findings lead us to ask whether online research training is effective, since no training can be effective if participants do not actually complete the training. Given extensive requirements for educational training among clinical research professionals, we feel the burden of proof is on training programs to demonstrate that they have positive effects.

Navigating the challenges of clinical trial professionals in the healthcare sector

Clinical trials (CTs) are essential for medical advancements but face significant challenges, particularly in professional training and role clarity. Principal investigators, clinical research coordinators (CRCs), nurses, clinical trial pharmacists, and monitors are key players. Each faces unique challenges, such as maintaining protocol compliance, managing investigational products, and ensuring data integrity. Clinical trials' complexity and evolving nature demand specialized and ongoing training for these professionals. Addressing these challenges requires clear role delineation, continuous professional development, and supportive workplace environments to improve retention and trial outcomes. Enhanced training programs and a collaborative approach are essential for the successful conduct of clinical trials and the advancement of medical research.

A cross-sectional survey on principal investigators' clinical research knowledge in Japan

Principal investigators (PIs) play a key role in clinical research, and must thus understand the role of clinical research support staff to conduct successful and appropriate clinical research. This study evaluates clinical research capabilities by examining the clinical research knowledge of PIs and clinical research support staff. The participants of this cross-sectional study were academic researchers and clinical research support staff from Japanese universities and research institutions. The participants comprised of 54 respondents, among whom 36 were PIs (physicians) and 18 were clinical research support staff. A self-administered electronic survey was created and evaluated by experts, with 50 knowledge items. Mann-Whitney U tests were used to determine the significance of the differences in knowledge between clinical research support staff and PIs. We compared the correct answer rate of clinical research support staff and PIs for each knowledge category and observed that the clinical research support staff scored significantly higher than the PIs in all aspects of clinical research knowledge sections, including total score. Our findings showed that PIs did not have the same amount of clinical research knowledge as the clinical research support staff. Clinical research knowledge is essential for investigators, especially PIs, to protect patients and promote medical breakthroughs. Thus, more accessible clinical research education and mandatory knowledge testing will allow PIs to lead successful clinical research and further the level of medical research in Japan.

What does a department need to get involved in clinical trials?

Clinical trials are conducted to evaluate the usefulness of a drug, medical treatment, surgical intervention, radiological procedure, behavioral intervention, or preventive health care strategy. Clinical trials are challenging, time-consuming, and need careful planning and execution. There are certain requirements for an academic unit to be ready for conducting quality research, especially clinical trials. These include logistical concerns, infrastructure, appropriately trained human resources, conformity with ethical compliances and regulatory compliances as per the laws governing the respective geographical regions. Infrastructure requirements include research division space, robust data archival system, archival of imaging data, laboratory services, information technology division and facilities for the appropriate consenting process. Human resources such as principal investigators, data managers, clinical research assistants and biostatisticians are needed to execute the clinical trial as per the study design. Adherence to ethical and regulatory standards; during the conduct of the clinical trial are imperative. Strict compliance with prevailing governing laws in the country is a prerequisite for a department to get involved in clinical trials. The department also needs to put in place an institutional ethics committee; the composition of which is often governed by regulatory laws. The ethical aspects of the trial undergo a formal scrutiny by an Institute ethics committee that ensures quality care to the patient, and safeguards the patient's rights and privileges. The academic unit of any department forms the core for possible research and pursuit of clinical trials. A department with rich clinical experience and expertise in the filed aids in the execution of quality research. The academic department must consider grant writing and multiple center collaborative research projects in due course of time to further enhance the quality of clinical trials and research output.

Awareness of Clinical Research Coordinators Toward Ethics and Protection of Clinical Trial Patients

PURPOSE

Clinical research coordinators (CRCs) play an important role in the protection of clinical trial participants and maintenance of ethical standards. However, limited data are available on the ethical cognition of CRCs. Understanding the knowledge, attitude, and practices (KAP) of CRCs toward ethics is essential to protect study participants and improve their compliance.

METHODS

We conducted a descriptive, cross-sectional, quantitative study at 20 hospitals in Anhui province of China. A self-administered questionnaire was completed by 435 CRCs conducting clinical trials.

RESULTS

The good knowledge, positive attitude, and good practice rates were 55.2%, 59.3%, and 79.5% respectively. Most CRCs (99.1%) were aware of the participants' rights. Only 127 (29.2%) and 140 (32.2%) CRCs were aware of measures to protect participants' rights and ethical guidelines regarding trials, respectively. In total, 59.6% of CRCs stated that ethical review might delay the start of a clinical trial. Marital status (odds ratio [OR] 0.47, 95% confidence interval [CI] 0.27-0.83), CRC work experience (OR 0.11, 95% CI 0.02-0.75), and educational background (OR 0.31, 95% CI 0.13-0.76) affected the knowledge of CRCs regarding ethics.

CONCLUSIONS

Some deficiencies were observed in the ethical knowledge and behavior of CRCs. Interventions to improve the ethical training of CRCs regarding study participant protection, international guidelines, and the role of ethical committees are essential when conducting clinical trials. Validated instruments should be constructed to assess the effectiveness of ethical training and measure the KAP of CRCs toward ethics.

The appearance and increase in the quantity and proportion of the clinical research coordinator's service fee in drug clinical trial research fund and its impact on trial quality

Objective

The changes of absolute value and relative value of clinical research coordinator service fee and its influence on the quality of drug clinical trial were analyzed.

Methods

This study compared the amount and structural changes of drug clinical trial costs in before 3 years and after 3 years of self-examination and inspection initiated by the China Food and Drug Administration, identified the increase number and composition of each individual cost of a clinical trial research funds which including clinical research coordinator service fee, investigator labor fee, subjects examination fee, subjects traffic subsidy, documents management fee, drug management fee, etc.

Result

The most significant appearance of increase in volume and proportion was the clinical research coordinator service fee. From the initial few to the global multicenter tumor drug clinical trials RMB31,624 or 34.92% of the proportion and domestic multicenter tumor drug clinical trials RMB16,500, accounted for 33.74%.

Discussion

It has become common for more money to be spent on clinical trials to be accompanied by improved quality, but the occurrence and continuous increase of clinical research coordinator service fee were divided into two aspects, On the one hand, the quality of clinical trials was promoted by the large amount of low-skill trivial work undertaken by clinical research coordinator; on the other hand, the quality of clinical trials was undermined by the fact that clinical research coordinator did too much treatment evaluation work that should have been done by the investigator.

Conclusion

The clinical research coordinators’ access standards, pre-employment training and examination, job and performance evaluation, in addition to the SMO specification management and avoiding malicious competition between the industry, are important factors in the quality assurance of drug clinical trials.

The Children's Oncology Group Adolescent and Young Adult Responsible Investigator Network: A New Model for Addressing Site-Level Factors Impacting Clinical Trial Enrollment

Purpose: In the Children's Oncology Group (COG), there is precedent for scientific committees designating institutional Responsible Investigators (RIs) to promote clinical trial enrollment and coordinate related research activities. In response to low enrollment of adolescents and young adults (AYAs) on COG clinical trials, the COG AYA RI Network was established. Leveraging this network, we undertook an initiative to identify site-level factors influencing AYA enrollment. Methods: The overarching goal of the AYA RI Network is to increase AYA enrollment onto COG trials. At each site, RIs highlight AYA disparities, facilitate activation of relevant trials, improve recruitment processes, and expand interactions with medical oncologists. Through a series of monthly national webinars and workshops, participating RIs reported local barriers and facilitators enrolling AYAs. A mixed-methods approach was utilized to determine major themes of factors affecting site-level enrollment. Results: For this report, there were 145 participating RIs representing 122 demographically and geographically diverse sites. There were 13 interactive webinars and 3 symposia involving 25 speakers focused on addressing enrollment barriers. Major thematic categories for site-level barriers were (1) Lack of available trials; (2) Poor communication between pediatric and medical oncology; (3) Logistical constraints to accessing trials; and (4) Need for leadership support, sufficient resources and appropriate policies. Conclusion: The COG AYA RI Network has identified multiple site-level barriers impeding AYA clinical trial enrollment and represents a novel model for developing and implementing appropriate solutions through a nationally coordinated strategy.

Knowledge and use of recruitment support tools among study coordinators at an academic medical center: The Novel Approaches to Recruitment Planning Study

Background

Study coordinators play an essential role on study teams; however, there remains a paucity of research on the supports and services they need to effectively recruit and retain study participants.

Methods

A cross-sectional survey was conducted with 147 study coordinators from a large academic medical center. Survey items assessed barriers and facilitators to recruitment and retention, anxiety about reaching enrollment numbers, confidence for talking to potential study participants about research involvement, awareness and use of CTSA resources, and PI involvement with recruitment planning.

Results

Significant associations were found between anxiety about reaching target enrollment numbers and whether the study coordinator was the primary person responsible for developing a recruitment strategy. Three years or more serving as a study coordinator and levels of anxiety for reaching enrollment numbers was also significant.

Conclusion

More institutional level supports and formal training opportunities are needed to enhance study coordinators’ effectiveness to recruit participants.

Research nurses in New Zealand intensive care units: A qualitative descriptive study

BACKGROUND

This study explored the role of the research nurse in New Zealand (NZ) Level III intensive care units (ICU). Little was known about this role in NZ prior to this study.

OBJECTIVES

To describe the role and responsibilities of NZ ICU research nurses.

METHODOLOGY

A qualitative, descriptive approach, using semi structured interviews was used.

RESULTS

The study was conducted in six Level III ICUs throughout NZ that employed a research nurse. Interviews were conducted with research nurses (n = 11), principal investigators (n = 6) and nurse managers (n = 6), and the findings were triangulated. The views across all ICUs and stakeholders were generally similar, with differences only being in some operational areas. This study found that the primary role of the research nurse was trial management, where they coordinated all elements of trial conduct. Almost half of the research nurses were involved in trial design through their positions on management committees. Research nurses also played a vital role in patient and trial advocacy, and they bridged the knowledge gap by bringing research to staff nurses, patients and their families. The majority of research nurses reported to a nursing line manager, and had an informal accountability to the PI.

CONCLUSION

The role of NZ ICU research nurses is similar to their international counterparts. This study provides clarity about the research nurse role and showcases their key contribution in ensuring that NZ ICUs undertake high quality research, thus contributing to potential improvements for future patients' outcomes.

Present Status and Perspectives on Future Roles of Japanese Clinical Research Coordinators

Background

The new Clinical Trials Act that recently came into effect in Japan emphasizes the reliability of investigator-initiated clinical trials. Although Japanese clinical research coordinators have been mainly engaged in operational roles in industry-initiated clinical trials for drug approval (registration trials), broadening their contribution to cover more types of clinical research may lead to quality improvement of clinical research. To ultimately establish a clinical research infrastructure that meets the needs of the new era of Clinical Trials Act, here we gathered basic information on how clinical research coordinators might make such contributions.

Methods

We conducted a survey using self-reporting questionnaires in clinical research-related personnel to examine present status and the perspectives toward broader contribution of clinical research coordinators. The study participants were attendee of group discussion of a clinical research-related meeting in Shikoku area of Japan held in August 2017.

Results

Among 88 participants, 69 responded (response rate: 78.4%) and 68 respondents (98.6%) were engaged in support and management of clinical research. The main area of involvement was industry-initiated registration trials (48, 69.7%), and main roles of involvement were cooperators who plays roles under the guidance of investigators (41, 59.5%). When divided by occupation into clinical research coordinators (n = 41) and other clinical research-related personnel (n = 28), approximately half of the respondents in each group replied positively to wanting broader involvement of clinical research coordinators as a clinical research professional.

Conclusion

The present study revealed that about half of the clinical research coordinators and other clinical research-related personnel view a broadening of involvement of clinical research coordinators in research activities positively. Accordingly, a structured practical program aimed at encouraging such involvement may help to expand and strengthen their contribution into the future. Whether greater involvement of clinical research coordinators in clinical research will help to ensure the reliability of investigator-initiated clinical research warrants further study.

A SOA-Based Platform to Support Clinical Data Sharing

The eSource Data Interchange Group, part of the Clinical Data Interchange Standards Consortium, proposed five scenarios to guide stakeholders in the development of solutions for the capture of eSource data. The fifth scenario was subdivided into four tiers to adapt the functionality of electronic health records to support clinical research. In order to develop a system belonging to the "Interoperable" Tier, the authors decided to adopt the service-oriented architecture paradigm to support technical interoperability, Health Level Seven Version 3 messages combined with LOINC (Logical Observation Identifiers Names and Codes) vocabulary to ensure semantic interoperability, and Healthcare Services Specification Project standards to provide process interoperability. The developed architecture enhances the integration between patient-care practice and medical research, allowing clinical data sharing between two hospital information systems and four clinical data management systems/clinical registries. The core is formed by a set of standardized cloud services connected through standardized interfaces, involving client applications. The system was approved by a medical staff, since it reduces the workload for the management of clinical trials. Although this architecture can realize the "Interoperable" Tier, the current solution actually covers the "Connected" Tier, due to local hospital policy restrictions.

The Critical Role of the Clinical Research Coordinator for Clinical Trials: A Survey in Oncology

Introduction

Access to innovative medicine requires proper evidence from clinical trials with the growing demand of qualified and experienced personnel. The clinical research coordinator (CRC) plays an important role in the conduction of research activities and provides a strong support to the research team. In Italy, this role is not recognized at any institutional level and its professional outline is still indefinite. Several national associations (Associazione Italiana di Oncologia Medica, Collegio Italiano dei Primari Oncologi Medici Ospedalieri, Gruppo Italiano Data Manager) are committed to promoting the enhancement and recognition of the professional status of CRCs, underlining their role as fundamental.

Methods

A web survey, proposed by the AIOM CRC Working Group, was submitted to 319 Italian oncology sites with items focusing on the organization of sites, the research activities, the staff composition, and the presence of coordinators and the multidisciplinary team.

Results

A total of 115 sites (35.9%) responded to the web survey. Clinical studies were carried out at 88.7% of the investigated sites, and coordinators were on staff at 75.5% of the active investigational sites. Interestingly, there was a direct association between the number of clinical studies and the number of coordinators, whose contribution to the research activities is believed to be essential for trial conduct in 82.4% of cases. Most sites retain that the quality of clinical research has absolutely improved (83.3%) after the implementation of a coordinator as member of the team.

Conclusions

Given the constant growth of the number of clinical trials performed at Italian oncology sites, the CRC proves to be an essential component of the research team. However, there is an urgent need to institute the professional role alongside the need to standardize the training of coordinators to establish the minimum requirements enhanced by qualifying courses.

The Role of a Burn Research Coordinator: A Guide for Novice Coordinators

As health-care complexity and costs increase, evidence-based research has become essential to the advancement of burn care. Multicenter trials involve procedures, regulations, and guidelines that require meticulous attention to details and strict adherence to compliance issues. Taking on a large, multicenter trial can be a daunting task for a new burn research coordinator. The purpose of this article is to provide a resource for new burn research coordinators in multicenter clinical trial planning, especially in the field of burns. The burn research coordinator must possess organizational and multitasking skills, attention to detail, professionalism, initiative, and motivation. The burn research coordinator must exercise five principles of practice: compliance, confidentiality, consistency and correctness, and collaboration. Compliance assures subject safety, study integrity, and burn center reputation. Confidentiality is essential, especially when handling sensitive health information. Maintaining subject privacy through secure links and destruction of linked data in a timely matter protects the subjects and complies with the regulations of many governing bodies. Consistency and correctness minimize human errors through continuous data validation and self-auditing and peer auditing. Collaboration between the Principal Investigator/burn research coordinator and all departments involved in the study maintains the study focus and allows for enforcement of procedures. Preparing a budget confirms adequate compensation for work done by the research team and can be broken down into the following five steps: protocol review, calculation of initial payment, establishment of indirect costs, calculation of direct costs, and budget negotiation. Over time, one becomes familiar with the details involved with study success. Advocating for subject safety and protocol adherence are of highest priority. Study design is the most important element that dictates the success of the study. Anticipating the direct and indirect costs of a particular trial assures that the study can be completed with adequate allotment for staff time, laboratory costs, and supplies. Regular communication with the Principal Investigator, clinical staff, and consultants is vital for study completion. An essential contributor to burn research and the advancement of burn care, the burn research coordinator must balance many study-related tasks. Through the practice of compliance, confidentiality, and organization/planning, the burn research coordinator can ensure proper study management. These recommendations may assist new burn research coordinators in their practice.

Are Leadership and Management Essential for Good Research? An Interview Study of Genetic Researchers

Principal investigators are responsible for a myriad of leadership and management activities in their work. The practices they use to navigate these responsibilities ultimately influence the quality and integrity of research. However, leadership and management roles in research have received scant empirical examination. Semi-structured interviews with 32 National Institutes of Health (NIH)-funded genetic researchers revealed that they considered leadership and management essential for effective research, but their scientific training inadequately prepared them. We also report management practices that the researchers described using in their labs, as well as their perceptions of a proposed intervention to enhance laboratory leadership. These findings suggest best practices for the research community, future directions for scientific training, and implications for research on leadership and management in science.

Serious adverse events and compensation in registration trials: a review of data from a Japanese university hospital

Background

Clinical trials leading to regulatory approval, or registration trials, play a central role in the development of drugs and medical devices. The contribution of support staff, such as the clinical research coordinator (CRC) and administrative officers, in registration trials is now widely recognized. Attending to serious adverse events is an important duty of the CRC and investigators alike, and managing these complications and compensation constitutes a key responsibility. We retrospectively examined the frequency of serious adverse events and compensation events reported from 2007 through 2011 at Tokushima University Hospital, an academic hospital in rural Japan. We present herein the results of our analysis.

Results

Over the five-year period, 284 subjects participating in 106 registration trials experienced a total of 43 serious adverse events, and eight compensation events were documented. Among the serious adverse events, 35 (81.4%) were considered not related to the investigational drug, and 17 (39.5%) resulted in withdrawal of the study drug. Patients with malignant diseases experienced serious adverse events significantly more frequently compared to those with non-malignant diseases (28.3% versus 8.2%, respectively; P < 0.01).

Conclusions

The CRC should be vigilant for serious adverse events in oncology clinical trials due to the generally higher frequency of these complications in subjects with malignancy. However, on an individual basis, the CRC may be seldom involved in the process for compensating serious adverse events. Therefore, the CRC’s ability to share such experiences may serve as an opportunity for educating clinical trial support staff at the study site as well as those at other sites. However, further study is warranted to determine the role of the clinical trial support staff in optimizing methods for managing adverse events requiring compensation in registration trials.

Using software to elicit user needs for clinical research visit scheduling

User needs understanding is critical for developing useful and usable clinical research decision support. Existing methods largely depend on self-reporting and often fail to elicit implicit or fine-grained user needs. We hypothesized that functional software would address this problem by presenting to users existing technology while simultaneously encouraging users to optimize workflow. Using clinical research visit scheduling as an example, we used a piece of software under development that was called IMPACT to reveal user needs iteratively. The identified user needs explained why most clinical research coordinators still rely on paper to schedule clinical research visits. The common user needs themes such as information completeness for software to be useful may generalize to other clinical decision support. This paper contributes valuable firsthand knowledge about user needs for decision support for clinical research visit scheduling among clinical research coordinators and a generalizable methodology for collecting and analyzing software usage data to inform user needs elicitation.

Facilitating accrual to cancer control and supportive care trials: the clinical research associate perspective

Background

Accrual to Cancer Control and Supportive Care (CCL) studies can be challenging. Our objective was to identify facilitators and perceived barriers to successful Children’s Oncology Group (COG) CCL accrual from the clinical research associate (CRA) perspective.

Methods

A survey was developed that focused on the following features from the institutional perspective: (1) Components of successful accrual; (2) Barriers to accrual; (3) Institutional changes that could enhance accrual; and (4) How COG could facilitate accrual. The survey was distributed to the lead CRA at each COG site with at least 2 CCL accruals within the previous year. The written responses were classified into themes and sub-themes.

Results

57 sites in the United States (n = 52) and Canada (n = 5) were contacted; 34 (60%) responded. The four major themes were: (1) Staff presence and dynamics; (2) Logistics including adequate numbers of eligible patients; (3) Interests and priorities; and (4) Resources. Suggestions for improvement began at the study design/conception stage, and included ongoing training/support and increased reimbursement or credit for successful CCL enrollment.

Conclusions

The comments resulted in suggestions to facilitate CCL trials in the future. Soliciting input from key team members in the clinical trials process is important to maximizing accrual rates.

Job analysis of clinical research coordinators using the DACUM process

PURPOSE

This study was done to analyze the job of clinical research coordinators (CRCs).

METHODS

Through the "developing a curriculum (DACUM)" workshop, the definition of CRCs' role was described and CRCs' duties and tasks were identified. Finally, the developed duties and tasks were validated for importance, difficulty, and frequency.

RESULTS

A CRC is defined as the one who coordinates and performs tasks related to clinical research/trials among investigators, participants, and sponsors according to the Good Clinical Practice at institutions conducting clinical trials. Twelve duties and 78 tasks were identified on the DACUM chart which represented the importance, difficulty, and frequency of tasks represented as A, B, and C respectively. Based on determinant coefficient (DC) of the task, the highest ranked task was confirming the eligibility of participants for research (DC=8.03) and the lowest was inventory management for clinical study materials (3.95).

CONCLUSION

In this study, the job of a CRC was analyzed through the DACUM process and it was found that CRCs were doing various duties and tasks. Based on these results, it is suggested that it is necessary to develop CRC education programs considering the career ladder of CRCs.

A worldwide investigation of critical care research coordinators' self-reported role and professional development priorities: the winner survey

AIMS AND OBJECTIVES

To describe the self-reported role and professional development priorities of research coordinators in different regions of the world.

BACKGROUND

Research coordinators employed in critical care settings provide clinical and technical expertise in the development, conduct and completion of clinical research studies. Knowledge of this specialised role is well established in some parts of the world, yet emerging in others.

DESIGN

Descriptive exploratory study involving research coordinators outside of Australia and New Zealand.

METHOD

An anonymous, structured, multiple-choice, web-based questionnaire conducted between April-May 2011.

RESULTS

There were 80 respondents from North America (61%), Europe (29%) and Latin America (10%). The majority of respondents performed data collection and obtained informed consent, and half had presented study findings at conferences or wrote scholarly articles, despite a greater willingness to do so. Requisite skills for the research coordinator role included clinical research knowledge, creative problem solving and the ability to identify/resolve ethical questions. 'Best' reported aspects of the role were promotion of evidence-based clinical practice, intellectual stimulation and autonomy. 'Worst' aspects included heavy workload, lack of funding and recognition.

CONCLUSION

Research coordinators working in critical care settings collect data, require clinical research knowledge and problem-solving skills and are interested in, but have less confidence in, dissemination of research findings. They feel isolated with a lack of support and inadequate remuneration for the effort and time required to maintain the high standards of their role. This is outweighed by the satisfaction derived from promoting the research process and autonomy. Further observational studies aimed at clarifying and advancing the role of the research coordinator is warranted.

RELEVANCE TO CLINICAL PRACTICE

This study offers insight into the global roles and responsibilities as reported by research coordinators employed in critical care settings.

The Feasibility, Perceived Satisfaction, and Value of Using Synchronous Webinars to Educate Clinical Research Professionals on Reporting Adverse Events in Clinical Trials

Clinical research professionals are faced with decreased funding and increased workloads; innovative methods of professional development programs are necessary to accommodate these factors. This study evaluated the feasibility, perceived satisfaction, and value of using webinars to educate clinical research professionals on reporting adverse events commonly experienced in pediatric oncology clinical trials. The setting incorporated synchronous web-based educational technology. Constructivist learning provides the theoretical framework for this study. Participants evaluated the professional development program at 2 time points: (a) at the conclusion and (b) 4 to 6 weeks afterward, using survey method. Synchronous webinars were both economical and effective in educating clinical research professionals across institutional sites. Participants reported exceptionally high levels of satisfaction with the accessibility, scope, quality, and interactivity of the professional development program. The vast majority of participants reported that the education would assist with reporting adverse events in pediatric oncology clinical trials and this perception persisted into clinical practice. Although the results of this study were intended to guide future educational efforts of the Children’s Oncology Group, they may also apply to other cooperative groups.

Intensive Care Research Coordinators in Australia and New Zealand: a cross-sectional survey of demographics, responsibilities, job satisfaction and importance

INTRODUCTION

The achievement of successful clinical research projects depends on multiple team members including Research Coordinators (RCs), who are the link between the researcher and the trial participants. The RCs main responsibility is to ensure that all research is conducted according to the appropriate protocols, regulations and guidelines.

AIM

Description of demographics, the role and associated responsibilities and assessment of items of importance to, and satisfaction with, various job related items.

METHOD

An observational web-based cross-sectional study of RCs working in Intensive Care Units (ICU) across Australia and New Zealand.

RESULTS

Fifty-six participants completed the survey. Forty percent had more than 6 years experience in ICU research and one-third held a Masters Degree. Most respondents performed research related tasks including ethics submission, patient screening, education and data collection. Autonomy and work hours were the most satisfying job characteristics reported and aspects relating to autonomy were most important for the RCs. Inadequate remuneration was of great concern to the participants.

CONCLUSION

Research Coordinators in Australia and New Zealand have many and varied roles with a significant workload. Unfortunately, the RCs do not feel their employers are adequately remunerating the demand on their time and efforts. The results indicate that RCs enjoy high levels of satisfaction with general conditions and facets of their work and its environment and they remain passionate about their role in the ICU setting.

The intensive care research coordinator position in Australia and New Zealand: Self-perception of professional development priorities and "best" and "worst" aspects of the position. A cross-sectional web-based study

BACKGROUND

Many intensive care units (ICU) research coordinators (RCs) work in isolation with limited access to professional development and peer support.

AIMS

(1) To map professional development priorities and "best" and "worst" aspects of the ICU RC role. (2) To compare results of "best" and "worst" aspects to a similar 2004 study.

METHODS

On-line study conducted from July 2009 to October 2009. Respondents scored 26 individual items related to professional development and described in free text "best" and "worst" aspects.

RESULTS

56 RCs participated. Maintaining high ethical standards for the research participant was ranked the highest priority. RCs had considerable interest but less confidence in completing own research. The "best" and "worst" aspects exposed three thematic clusters: work conditions; work environment; work role. Most often recorded notations were Work Conditions for "best" and work environment for "worst" aspects.

CONCLUSION

RCs judge adherence to international research guidelines the most important pre-requisite for the position and wish involvement in research design and dissemination. With little change from 2004, inadequate peer support and unsatisfactory employment conditions constituted most of the "worst" aspects. Autonomy and working in the ICU team are the "best" aspects of the role in addition to the intellectual stimulation of research.

Collaborative Staffing Model for Multiple Sites: Reducing the challenges of study coordination in complex, multi-site clinical trials

The implementation of complex, multi-site clinical trials presents challenges that make recruitment efforts, participant follow-up, and organization of staff critical to the success of the overall outcome. This article describes a unique staffing model utilized by the TODAY (Treatment Options for type 2 Diabetes in Adolescents and Youth) study, an NIH (National Institutes of Health) sponsored trial designed to explore treatment options for type 2 diabetes in youth. At each study center, the program coordinator (PC) and diabetes educator (DE) work together to implement the study protocol. A staffing model that provides this type of mutual support for two key members of the study team may decrease the burden customarily encountered solely by the PC in complex trials, and furthermore allows for cross-coverage and flexibility. To determine the degree of overlap and task sharing between the PC and DE across study sites, a self-administered survey was distributed to all PCs and DEs. Survey results as well as specific examples demonstrating an effective collaborative approach by front-line study personnel in managing various challenges encountered in study implementation are included.

Conducting chemoprevention clinical trials: challenges and solutions

The clinical trials investigative team faces a number of challenges during the execution of a chemoprevention protocol that often depend on the phase of the trial. Phase II chemoprevention trials test promising agents for biomarker modulation in cohorts of 30 to 200 participants at greater than average risk of the cancer being studied who meet strict eligibility criteria. By contrast, phase III trials test agents for their efficacy in cancer prevention in thousands of participants who are generally healthy or may be at slightly elevated risk. Consideration must be given to accruing a very large cohort or a smaller but relatively rare group of participants, and to maintaining vigilance over the toxicity profile of the agent, which may be taken for a lengthy period of time. Additional considerations include clear communication to the participants of the risks and benefits associated with participating on the trial, as well as the need for their long-term commitment. In light of the layer of complexities that chemoprevention research adds to clinical trials, one or more team members need a unique set of skills and knowledge, beyond understanding the scientific aspects of the trial.

A comparative method of evaluating quality of international clinical studies in China: Analysis of site visit reports of the Clinical Research Operations and Monitoring Center

Due to the extremely competitive market, the pharmaceutical industry has been conducting clinical drug studies in emerging markets such as Russia, India and China, and submits data for new drug approval. But whether or not they follow the International Conference on Harmonization (ICH) and Good Clinical Practice (GCP) guidelines remains a critical concern to FDA. Site visit reports of the Comprehensive International Program of Research on AIDS (CIPRA), an international research program on HIV/AIDS sponsored by the US National Institutes of Health, were pulled out to compare the studies of the China CIPRA program and the US studies for GCP adherence. To compare adherence, GCP data were abstracted from the reports and transcribed into an assessment tool, which recorded GCP activities. The frequency distribution for the responses to each individual item was examined. The generalized linear model was used to assess the adherence differences between the China CIPRA studies and US studies. In addition, a multinomial generalized linear regression model with GEE analysis was conducted on the assessment of the overall GCP performance using the variables - group (China vs. US) and three level of GCP adherence. The GCP adherence data of the two groups were similar in distribution pattern. The difference of the protocol adherence area was statistically significant between the two groups (p=0.0425). Specifically, the China group had less "failure to perform study procedures or to obtain authorization to deviate" than the US group (13(81.25%) vs. 8(47.06%, p=0.0488)). There was no significant difference (p=1.0000) on the overall GCP performance between the two groups (China vs. US), for three level of GCP adherence. As a preliminary study, our results showed that the China CIPRA program was at least equivalent to the US studies in overall from ICH/GCP perspective.

Problems with registration-directed clinical trials for lung cancer in Japan

New anticancer agents against lung cancer are needed because efficacy of chemotherapy is limited. The long time required, low quality, and considerable costs of registration-directed clinical trials in Japan ("Chiken") have been pointed out. The quality of 24 phase I and 41 phase II trials of an anticancer drug for lung cancer were analyzed according to the approval year of the drug. The human resources and infrastructure to support oncology clinical practice and clinical trials were compared between Japan and the USA. A maximum tolerated dose was not defined in any of seven phase I trials before 1989, and was determined in two of six trials between 1989 and 1996 and in seven of 10 trials thereafter. Before 1989, 29 (20%) of 142 patients registered in two trials were ineligible, and the number of ineligible patients was not reported in the five trials. Sample size calculations were not performed in any of seven phase II trials before 1989 and were performed in only four of 10 trials between 1989 and 1996 and in all 23 trials conducted thereafter. The shortage of human resources, including medical oncologists, oncology nurse practitioners and clinical research coordinators, is serious and acute. The infrastructure to support clinical trials also remains insufficient in Japan. In conclusion, registration-directed clinical trials of anticancer agents have advanced significantly during last three decades but remain unsatisfactory. The development of infrastructure and human resources is an urgent task to ensure high-quality clinical trials without unnecessary delays.

The best and worst aspects of the ICU research coordinator role

BACKGROUND

The Research Coordinator (RC) role is a relative new addition to staffing profiles in Australasian Intensive Care Units (ICUs). The RC plays a pivotal role in conducting ethically and scientifically sound research. There have been anecdotal reports of the RC role in various speciality areas. However, limited research has been undertaken into the role, and only one study has been published from the intensive care setting.

AIM

To evaluate which factors the RC found to be the best and worst attributes of the role.

METHODS

A cross-sectional web-based cohort study was conducted in 2004 collecting free text information from RCs in ICUs in Australia and New Zealand.

RESULTS

Forty-nine participants (71%) completed the study with 273 entries into the two categories of 'best' (60%) and 'worst' (40%) aspects of the role. We identified four thematic clusters in both categories: (1) 'How the job was structured' (2) 'The worth of the job' (3) 'What the work involves' and (4) 'Who I work with'. Both categories received proportionally the same number of responses in each theme with (1) the most frequent and (4) the least number of entries.

CONCLUSION

There is much variation between RCs in almost every descriptor of the role. The Australasian Intensive Care RC values autonomy, respect and intellectual stimulation with the scope for extending the role to suit the individual and finds isolation, under-recognition and workload, often not sufficiently compensated, to be the worst aspects of the position.

Information-seeking behavior and use of information resources by clinical research coordinators

PURPOSE

The study sought to understand the literature searching experiences and skills of clinical research coordinators at a large academic medical center.

SETTING/PARTICIPANTS/RESOURCES

The Health Sciences Library System, University of Pittsburgh, conducted a survey of clinical research coordinators at the University of Pittsburgh and the University of Pittsburgh Medical Center to solicit their perceived use and knowledge of the library's electronic resources.

BRIEF DESCRIPTION

The University of Pittsburgh Institutional Review Board (IRB) is a "high volume IRB" that monitors human subject research at both the University of Pittsburgh and the University of Pittsburgh Medical Center. More than 3,500 human research studies and clinical trials are active at any given time. Many studies entail more than minimal risk to human subjects, with the majority evaluating or including a drug or medical device. Clinical research coordinators are involved in most of these studies or trials. Their roles and responsibilities focus on managing many aspects of the study or clinical trial. As a first step in understanding the literature searching experiences and skills of these research coordinators, baseline data were gathered from this group in November 2004.

RESULTS/OUTCOME

The data from this survey indicate that clinical research coordinators are a population who would benefit from training by academic medical center librarians in how to use electronic library resources and services.

EVALUATION METHOD

A Web-based survey solicited participants' information (gender, education, job title) and role in the IRB process (job responsibilities, number studies they manage). The majority of the survey questions focused on the use of specific electronic library resources, the type of information wanted, and the types of problems encountered.

Modeling clinical trials workflow in community practice settings

Clinical research is vital to the translation of biomedical knowledge into standard clinical practice. Efforts are underway under the NIH Roadmap initiative to re-engineer the national research enterprise to sustain the rapid pace of innovation in the biomedical domain. As part of these efforts, we have embarked on an empirical evaluation of clinical research workflow in community practice settings. The reasons for this focus are three-fold. First, there is an increasing tendency by trial sponsors to conduct clinical trials in community, rather than academic, settings. Second, understanding workflow is critical to developing re-engineering strategies. Third, workflow associated with the conduct of clinical research in community practices have received virtually no attention in the scientific literature. In this paper, we describe a pilot study using time-motion observations, to determine the workflow of clinical research coordinators, the tools they use to conduct the constituent activities of those workflows, and their ultimate outcomes. The preliminary findings provide insights and understanding of clinical research workflow in community practice settings - knowledge that may significantly impact the way in which information technology based re-engineering can be deployed in such an environment.