1
|
Fey MF, O'Reilly S, Awada AH, Crowley J, Gelmon KA. Diligent use of MedDRA terminology and preferred term selection in safety reports of clinical trials. Curr Opin Oncol 2024; 36:418-420. [PMID: 39106404 DOI: 10.1097/cco.0000000000001056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2024]
Affiliation(s)
- Martin F Fey
- Former Chairman of the Department of Medical Oncology, Inselspital and University of Bern, Bern, Switzerland
| | - Seamus O'Reilly
- Consultant Medical Oncologist, University College Cork, Cork, Ireland
| | - Ahmad H Awada
- Medical Oncologist, Institut Jules Bordet, Université Libre de Bruxelles, Bruxelles, Belgium
| | - John Crowley
- CRAB Cancer Research and Biostatistics, Seattle, Washington, USA
| | - Karen A Gelmon
- University of British Columbia Faculty of Medicine, 2775 Laurel Street, Vancouver, British Columbia, Canada
| |
Collapse
|
2
|
Harvey H, Carroll H, Murphy V, Ballot J, O'Grady M, O'Hare D, Lawler G, Bennett E, Connolly M, Noone E, Kelly MG, Bazin A, Daly A, Mulroe E, McDermott R, O'Reilly S. The Impact of a National Cyberattack Affecting Clinical Trials: The Cancer Trials Ireland Experience. JCO Clin Cancer Inform 2023; 7:e2200149. [PMID: 37053539 PMCID: PMC10281450 DOI: 10.1200/cci.22.00149] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 12/18/2022] [Accepted: 02/22/2023] [Indexed: 04/15/2023] Open
Abstract
PURPOSE Cyberattacks are increasing in health care and cause immediate disruption to patient care, have a lasting impact, and compromise scientific integrity of affected clinical trials. On the May 14, 2021, the Irish health service was the victim of a nationwide ransomware attack. Patient care was disrupted across 4,000 locations, including 18 cancer clinical trials units associated with Cancer Trials Ireland (CTI). This report analyses the impact of the cyberattack on the organization and proposes steps to mitigate the impact of future cyberattacks. METHODS A questionnaire was distributed to the units within the CTI group; this examined key performance indicators for a period of 4 weeks before, during, and after the attack, and was supplemented by minutes of weekly conference call with CTI units to facilitate information sharing, accelerate mitigation, and support affected units. A total of 10 responses were returned, from three private and seven public hospitals. RESULTS The effect of the attack on referrals and enrollment to trials was marked, resulting in a drop of 85% in referrals and 55% in recruitment before recovery. Radiology, radiotherapy, and laboratory systems are heavily reliant on information technology systems. Access to all was affected. Lack of preparedness was highlighted as a significant issue. Of the sites surveyed, two had a preparedness plan in place before the attack, both of these being private institutions. Of the eight institutions where no plan was in place, three now have or are putting a plan in place, whereas no plan is in place at the five remaining sites. CONCLUSION The cyberattack had a dramatic and sustained impact on trial conduct and accrual. Increased cybermaturity needs to be embedded in clinical trial logistics and the units conducting them.
Collapse
Affiliation(s)
- Harry Harvey
- UCC Cancer Trials Group, Cork University Hospital, Cork, Ireland
| | - Hailey Carroll
- UCC Cancer Trials Group, Cork University Hospital, Cork, Ireland
| | | | - Jo Ballot
- St Vincents University Hospital, Dublin, Ireland
| | | | - Debra O'Hare
- UCC Cancer Trials Group, Cork University Hospital, Cork, Ireland
| | - Gavin Lawler
- Irish Research Radiation Oncology Group, Dublin, Ireland
| | - Erica Bennett
- Bon Secours Radiotherapy Centre in association with UPMC Hillman Cancer Center, Cork, Ireland
| | | | - Emma Noone
- St Lukes Radiation Oncology Trials Unit, Dublin, Ireland
| | | | | | | | | | | | - Seamus O'Reilly
- UCC Cancer Trials Group, Cork University Hospital, Cork, Ireland
- Cancer Trials Ireland, Dublin, Ireland
| |
Collapse
|
3
|
O'Reilly S, Kathryn Carroll H, Murray D, Burke L, McCarthy T, O'Connor R, Kilty C, Lynch S, Feighan J, Cloherty M, Fitzpatrick P, Falvey K, Murphy V, Jane O'Leary M, Gregg S, Young L, McAuliffe E, Hegarty J, Gavin A, Lawler M, Kavanagh P, Spillane S, McWade T, Heffron M, Ryan K, Kelly PJ, Murphy A, Corrigan M, Redmond HP, Redmond P, Walsh PM, Tierney P, Zhang M, Bennett K, Mullooly M. Impact of the COVID-19 pandemic on cancer care in Ireland - Perspectives from a COVID-19 and Cancer Working Group. J Cancer Policy 2023; 36:100414. [PMID: 36841473 PMCID: PMC9951610 DOI: 10.1016/j.jcpo.2023.100414] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 02/17/2023] [Indexed: 02/27/2023]
Abstract
Upon the COVID-19 pandemic onset in Ireland, cancer service disruptions occurred due to prioritisation of COVID-19 related care, redeployment of staff, initial pausing of screening, diagnostic, medical and surgical oncology procedures, staff shortages due to COVID-19 infection and impacts on the physical and mental health of cancer healthcare workers. This was coupled with reluctance among people with symptoms suspicious for cancer to attend for clinical evaluation, due to concerns of contracting the virus. This was further compounded by a cyber-attack on national health service IT systems on May 14th 2021. The Irish Cancer Society, a national cancer charity with a role in advocacy, research and patient supports, convened a multi-disciplinary stakeholder group (COVID-19 and Cancer Working Group) to reflect on and understand the impact of the pandemic on cancer patients and services in Ireland, and discuss potential mitigation strategies. Perspectives on experiences were gathered across domains including timeliness of data acquisition and its conversion into intelligence, and the resourcing of cancer care to address cancer service impacts. The group highlighted aspects for future research to understand the long-term pandemic impact on cancer outcomes, while also highlighting potential strategies to support cancer services, build resilience and address delayed diagnosis. Additional measures include the need for cancer workforce recruitment and retention, increased mental health supports for both patients and oncology professionals, improvements to public health messaging, a near real-time multimodal national cancer database, and robust digital and physical infrastructure to mitigate impacts of the current pandemic and future challenges to cancer care systems.
Collapse
Affiliation(s)
- Seamus O'Reilly
- Department of Medical Oncology, Cork University Hospital and Cancer Research@UCC, University College Cork, Cork, Ireland; Cancer Trials Ireland, Dublin, Ireland.
| | - Hailey Kathryn Carroll
- Department of Medical Oncology, Cork University Hospital and Cancer Research@UCC, University College Cork, Cork, Ireland
| | - Deirdre Murray
- School of Public Health, University College Cork, Cork, Ireland; National Cancer Registry Ireland, Cork, Ireland
| | - Louise Burke
- Department of Pathology, Cork University Hospital and University College Cork, Cork, Ireland
| | | | | | | | - Sonya Lynch
- PPI Contributor c/o Cancer Research, UCC University College Cork, T12 DCA4 Cork, Ireland
| | - Jennifer Feighan
- Irish Nutrition & Dietetic Institute, Airfield Estate, Overend Ave, Dundrum, Dublin, Ireland
| | - Maeve Cloherty
- Department of Medical Oncology, Cork University Hospital and Cancer Research@UCC, University College Cork, Cork, Ireland
| | - Patricia Fitzpatrick
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland; National Screening Service, Dublin, Ireland
| | | | | | - Mary Jane O'Leary
- Palliative Medicine, Marymount University Hospital and Hospice, Cork, Ireland
| | - Sophie Gregg
- Palliative Medicine, Marymount University Hospital and Hospice, Cork, Ireland
| | - Leonie Young
- Endocrine Oncology Research Group, Department of Surgery, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Eilish McAuliffe
- UCD IRIS Centre, School of Nursing, Midwifery and Health Systems, University College Dublin, Ireland
| | | | - Anna Gavin
- Northern Ireland Cancer Registry, Queens University Belfast, Belfast, UK
| | - Mark Lawler
- Faculty of Medicine, Health and Life Sciences, Patrick G Johnston Centre for Cancer Research, Queen's University Belfast, Northern Ireland, UK; DATA-CAN, the UK's Health Data Research Hub for Cancer, UK
| | - Paul Kavanagh
- National Health Intelligence Unit, Strategy and Research, Jervis House, Jervis St, Health Service Executive, Dublin 1, Ireland
| | - Susan Spillane
- Health Information and Quality Authority, Dublin, Ireland
| | - Terry McWade
- Royal College of Physicians of Ireland, Dublin, Ireland
| | | | - Karen Ryan
- Department of Palliative Medicine, Mater Misericordiae University Hospital and St Francis Hospice Dublin, Ireland
| | - Paul J Kelly
- Bon Secours Radiotherapy Centre, Bon Secours, Cork, Ireland; UPMC Hillman Cancer Centre, Cork, Ireland
| | - Aileen Murphy
- Department of Economics, Cork University Business School, University College Cork, Cork, Ireland
| | - Mark Corrigan
- Department of Breast Surgery, Cork University Hospital, Cork, Ireland
| | - H Paul Redmond
- Department of Breast Surgery, Cork University Hospital, Cork, Ireland
| | - Patrick Redmond
- Department of General Practice, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | | | | | - Mengyang Zhang
- School of Population Health, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Kathleen Bennett
- School of Population Health, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Maeve Mullooly
- School of Population Health, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| |
Collapse
|
4
|
Abu Jawdeh EG, Hunt CE, Eichenwald E, Corwin MJ, McEntire B, Heeren T, Crowell LM, Ikponmwonba C, Saroufim A, Kerr S. Adverse effects of COVID-19 pandemic on a multicenter randomized controlled trial. J Perinatol 2022; 43:653-658. [PMID: 36581761 PMCID: PMC9798371 DOI: 10.1038/s41372-022-01592-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 12/12/2022] [Accepted: 12/16/2022] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Describe the effects of the COVID-19 pandemic on subject enrollment in a multicenter randomized controlled trial. STUDY DESIGN We assessed the number of eligible infants approached and consented for enrollment over five separate epochs including baseline, peak pandemic, and gradual but incomplete recovery. RESULT The pandemic had a major effect on ability to approach parents for consent. Parents approached dropped from 95.4% baseline to 13.1% in the peak pandemic epoch and has not recovered to baseline even in the just-completed post-pandemic epoch (84.9%). Despite the decrease in subjects approached, there was no significant change in the overall consent rate for the study CONCLUSION: The pandemic has significantly limited ability to approach parents of eligible infants for consent, with only partial recovery. Opportunities for interactions of investigators and study coordinators with parents continue to present challenges limiting full recovery.
Collapse
Affiliation(s)
- Elie G. Abu Jawdeh
- grid.266539.d0000 0004 1936 8438University of Kentucky, Lexington, KY USA
| | - Carl E. Hunt
- grid.265436.00000 0001 0421 5525Uniformed Services University, Bethesda, MD USA
| | - Eric Eichenwald
- grid.239552.a0000 0001 0680 8770Children’s Hospital of Philadelphia and University of Pennsylvania, Philadelphia, PA USA
| | | | | | - Timothy Heeren
- grid.189504.10000 0004 1936 7558Boston University, Boston, MA USA
| | - Lisa M. Crowell
- grid.189504.10000 0004 1936 7558Boston University, Boston, MA USA
| | | | - Ariana Saroufim
- grid.189504.10000 0004 1936 7558Boston University, Boston, MA USA
| | - Stephen Kerr
- grid.189504.10000 0004 1936 7558Boston University, Boston, MA USA
| | | |
Collapse
|
6
|
Abstract
PURPOSE OF REVIEW The COVID-19 pandemic posed several challenges to cancer research including halting of trials, reduced recruitment and protocol violations related to inflexible processes followed in clinical trials. Researchers adopted innovative measures to mitigate these problems and continue studies without compromising their quality. This review collates these adaptations that could well continue after the pandemic. RECENT FINDINGS The COVID-19 pandemic forced researchers globally to adopt innovative measures to overcome the challenges of the pandemic. These included protocol amendments to adjust to the pandemic and travel restrictions, and increased use of digital technologies. 'Virtual' clinical trials were conducted increasingly with adaptations in ethics and regulatory approvals, patient recruitment and consenting, study interventions and delivery of study medications, trial assessments, and monitoring. Many of these adaptations are safe and feasible, without compromising study quality and data integrity. Although these may not be universally applicable in all types of research, they bring many benefits including more diverse patient participation, less burden on patients for study procedures and reduced resources to conduct trials. SUMMARY The COVID-19 pandemic has affected cancer research adversely; however, learnings from the pandemic and adaptations from researchers are likely to improve the efficiency of clinical research beyond the pandemic.
Collapse
Affiliation(s)
| | - C.S. Pramesh
- Department of Surgical Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| |
Collapse
|