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Isere EE, Omorogbe NE. Quality Management in Clinical and Public Health Research: A Panacea for Minimising and Eliminating Protocol Deviations in Research Operations. Niger Med J 2024; 65:367-375. [PMID: 39022564 PMCID: PMC11249487 DOI: 10.60787/nmj-v65i3-421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2024] Open
Abstract
A quality management system for clinical and public health research operations is indispensable because it ensures the integrity and reliability of research outcomes. By implementing a robust quality management practice in research implementation and operation, research teams can uphold the highest standard of research conduct, thereby enhancing the credibility and trustworthiness of research findings. This paper elucidates the significance and role of a quality management system in clinical and public health research operations and its efficacy in minimising and eliminating protocol deviations and highlights the key steps in setting up a quality management system for research operations.
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Affiliation(s)
- Elvis Efe Isere
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, University of Ibadan, Nigeria
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Loo VC, Kim S, Johnson LM, Kay H, Yi A, Chen J, Asmar-Abdien LO. Preventing Potential Patient Harm Through Clinical Content Interventions During Oncology Clinical Trial Implementation. J Patient Saf 2023; 19:460-464. [PMID: 37616191 PMCID: PMC10545059 DOI: 10.1097/pts.0000000000001154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/26/2023]
Abstract
OBJECTIVES Clinical trial documents are complex and may have inconsistencies, leading to potential site implementation errors and may compromise participant safety. This study characterizes the frequency and type of administrative and potential patient safety interventions (PPSIs) made during the review of oncology trial documents for clinical trial implementation by centralized clinical content specialists. METHODS A dedicated group of centralized clinical content specialists reviewed trial documents, including the protocol, laboratory manual, and pharmacy/cellular therapy manual, and collected intervention data over a 1-year period. Each trial was categorized by study phase and sponsor type, and multiple interventions could be identified per trial. Interventions were deemed administrative or PPSIs, with PPSIs further subcategorized as medication, laboratory, procedure related, or other. RESULTS Of 585 clinical trials reviewed, 269 (46%) required intervention(s). Among 1001 interventions, 171 (17.1%) were PPSIs. Most PPSIs were medication related (45.6%), with drug dosing interventions most frequently identified (53.8%). Phase 1 trials had the highest proportion of PPSIs (0.35:1) and administrative interventions (2:1) per trial compared with all other phases. Investigator-initiated trials saw the highest proportion of PPSIs per trial (0.44:1) of all sponsor types. CONCLUSIONS This study demonstrates a gap in patient safety when assessing trial documents for clinical trial implementation. One solution to address this gap is the utilization of a centralized team of clinical specialists to preemptively review trial documents, thereby enhancing patient safety during clinical trial conduct.
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Affiliation(s)
- Vivian C. Loo
- From the Departments of Protocol Content Administration
| | - Sarah Kim
- From the Departments of Protocol Content Administration
| | | | - Howard Kay
- From the Departments of Protocol Content Administration
| | - Annie Yi
- From the Departments of Protocol Content Administration
| | - Jason Chen
- Pharmacy, City of Hope, Duarte, California
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Kulkarni U, Vaswani R, Guthigar M, Bhat N, Sonde L. Unreported protocol deviations - The tip of the research-berg. Perspect Clin Res 2023; 14:68-74. [PMID: 37325575 PMCID: PMC10267994 DOI: 10.4103/picr.picr_235_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 12/23/2021] [Accepted: 02/24/2022] [Indexed: 12/24/2022] Open
Abstract
Introduction Failure to stay within an ethics committee (EC)-approved protocol limits is termed protocol deviation or violation (PD/PV), depending on the seriousness of the transgression and its attendant risks and/or harms. PD/PVs arise in the post-approval phase of the research and are often missed. Current guidelines expect ECs to detect, report and recommend suitable actions such that research participants' risks and harms are mitigated, to the extent possible. Objective Yenepoya Ethics Committee-1 conducted an internal audit of ongoing postgraduate dissertations involving human participants to assess the occurrence of PD/PVs. Materials and Methods 54 out of 80 postgraduates responded to our request for filling out a self-reported checklist. These responses were followed up with physical verification of the protocol-related documents. Results Protocol transgressions were classified as non-compliance (administrative issues), protocol deviations (minor transgressions with minimal or less than minimal increase in attendant risk to participants) and protocol violations (serious transgressions with more than minimal increase in attendant risk to participants). The non-compliances included non-reporting for audit and non-reporting of PDs. Protocol deviations included non-conformance to EC validity, sample size, approved methodology, informed consent process and documentation and suboptimal data storage. No protocol violations were observed. Conclusion We report PD/PVs from these 54 protocols - with our assessment on the negative impact it may have on scientific validity, harm to participants, EC functioning and credibility of the institution - in the hope that our readers appreciate this important aspect of the post-approval process in the functioning of an EC.
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Affiliation(s)
- Uma Kulkarni
- Professor, Ophthalmology, Yenepoya Medical College, Additional Faculty Centre for Ethics, Mangalore, Karnataka, India
| | - Ravi Vaswani
- Professor, Internal Medicine, Yenepoya Medical College, Additional Faculty, Centre for Ethics, Mangalore, Karnataka, India
| | - Mohammed Guthigar
- Associate Professor and Head, Medical Social Work Department, Pharmacology, Yenepoya Medical College, Mangalore, Karnataka, India
| | - Nagapati Bhat
- Associate Professor, Pharmacology, Yenepoya Medical College, Mangalore, Karnataka, India
| | - Laxminarayan Sonde
- Associate Professor, Public Health Dentistry, Yenepoya Dental College, Yenepoya Ethics Committee-1 and Affiliated to Yenepoya (Deemed to be University), Mangalore, Karnataka, India
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Chodankar D. Impact of protocol deviations on the clinical study. Perspect Clin Res 2023; 14:47-48. [PMID: 37325573 PMCID: PMC10267991 DOI: 10.4103/picr.picr_69_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 03/15/2023] [Indexed: 06/17/2023] Open
Affiliation(s)
- Deepa Chodankar
- Heading GENESIS Unit, Clinical Study Unit, Sanofi, Mumbai, India
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Mackay K, Bernstein D, Glocker B, Kamnitsas K, Taylor A. A Review of the Metrics Used to Assess Auto-Contouring Systems in Radiotherapy. Clin Oncol (R Coll Radiol) 2023; 35:354-369. [PMID: 36803407 DOI: 10.1016/j.clon.2023.01.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 12/05/2022] [Accepted: 01/23/2023] [Indexed: 02/01/2023]
Abstract
Auto-contouring could revolutionise future planning of radiotherapy treatment. The lack of consensus on how to assess and validate auto-contouring systems currently limits clinical use. This review formally quantifies the assessment metrics used in studies published during one calendar year and assesses the need for standardised practice. A PubMed literature search was undertaken for papers evaluating radiotherapy auto-contouring published during 2021. Papers were assessed for types of metric and the methodology used to generate ground-truth comparators. Our PubMed search identified 212 studies, of which 117 met the criteria for clinical review. Geometric assessment metrics were used in 116 of 117 studies (99.1%). This includes the Dice Similarity Coefficient used in 113 (96.6%) studies. Clinically relevant metrics, such as qualitative, dosimetric and time-saving metrics, were less frequently used in 22 (18.8%), 27 (23.1%) and 18 (15.4%) of 117 studies, respectively. There was heterogeneity within each category of metric. Over 90 different names for geometric measures were used. Methods for qualitative assessment were different in all but two papers. Variation existed in the methods used to generate radiotherapy plans for dosimetric assessment. Consideration of editing time was only given in 11 (9.4%) papers. A single manual contour as a ground-truth comparator was used in 65 (55.6%) studies. Only 31 (26.5%) studies compared auto-contours to usual inter- and/or intra-observer variation. In conclusion, significant variation exists in how research papers currently assess the accuracy of automatically generated contours. Geometric measures are the most popular, however their clinical utility is unknown. There is heterogeneity in the methods used to perform clinical assessment. Considering the different stages of system implementation may provide a framework to decide the most appropriate metrics. This analysis supports the need for a consensus on the clinical implementation of auto-contouring.
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Affiliation(s)
- K Mackay
- The Institute of Cancer Research, London, UK; The Royal Marsden Hospital, London, UK.
| | - D Bernstein
- The Institute of Cancer Research, London, UK; The Royal Marsden Hospital, London, UK
| | - B Glocker
- Department of Computing, Imperial College London, South Kensington Campus, London, UK
| | - K Kamnitsas
- Department of Computing, Imperial College London, South Kensington Campus, London, UK; Department of Engineering Science, University of Oxford, Oxford, UK
| | - A Taylor
- The Institute of Cancer Research, London, UK; The Royal Marsden Hospital, London, UK
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Rauh S, Johnson BS, Bowers A, Tritz D, Vassar BM. A review of reproducible and transparent research practices in urology publications from 2014 to2018. BMC Urol 2022; 22:102. [PMID: 35820886 PMCID: PMC9277815 DOI: 10.1186/s12894-022-01059-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 07/07/2022] [Indexed: 11/10/2022] Open
Abstract
Background Reproducibility is essential for the integrity of scientific research. Reproducibility is measured by the ability of different investigators to replicate the outcomes of an original publication using the same materials and procedures. Unfortunately, reproducibility is not currently a standard being met by most scientific research. Methods For this review, we sampled 300 publications in the field of urology to assess for 14 indicators of reproducibility including material availability, raw data availability, analysis script availability, pre-registration information, links to protocols, and if the publication was available free to the public. Publications were also assessed for statements about conflicts of interest and funding sources. Results Of the 300 sample publications, 171 contained empirical data available for analysis of reproducibility. Of the 171 articles with empirical data to analyze, 0.58% provided links to protocols, 4.09% provided access to raw data, 3.09% provided access to materials, and 4.68% were pre-registered. None of the studies provided analysis scripts. Our review is cross-sectional in nature, including only PubMed indexed journals-published in English-and within a finite time period. Thus, our results should be interpreted in light of these considerations. Conclusion Current urology research does not consistently provide the components needed to reproduce original studies. Collaborative efforts from investigators and journal editors are needed to improve research quality while minimizing waste and patient risk. Supplementary Information The online version contains supplementary material available at 10.1186/s12894-022-01059-8.
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Affiliation(s)
- Shelby Rauh
- Oklahoma State University Center for Health Sciences, 1111 W 17th St., Tulsa, OK, 74107, USA.
| | - Bradley S Johnson
- Oklahoma State University Center for Health Sciences, 1111 W 17th St., Tulsa, OK, 74107, USA
| | - Aaron Bowers
- Oklahoma State University Center for Health Sciences, 1111 W 17th St., Tulsa, OK, 74107, USA
| | - Daniel Tritz
- Oklahoma State University Center for Health Sciences, 1111 W 17th St., Tulsa, OK, 74107, USA
| | - Benjamin Matthew Vassar
- Oklahoma State University Center for Health Sciences, 1111 W 17th St., Tulsa, OK, 74107, USA
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Ward L, Nault D, Cramer H, Moonaz S. Development of the CLARIFY (CheckList stAndardising the Reporting of Interventions For Yoga) guidelines: a Delphi study. BMJ Open 2022; 12:e054585. [PMID: 35105638 PMCID: PMC8804643 DOI: 10.1136/bmjopen-2021-054585] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND The use of yoga as a therapeutic modality is increasing; however, a lack of transparent intervention reporting is restricting the dissemination and implementation of yoga research into clinical and community practice. The aim of this study was to develop a yoga-specific reporting guideline as an extension to existing reporting guidelines for randomised controlled trials, observational studies and case reports. METHODS Recognised international stakeholders in the design and conduct of yoga research were invited to contribute to the electronic Delphi survey. A four-round Delphi was conducted, whereby panellists rated selected items for their importance in the inclusion of yoga reporting guidelines, according to a 5-step Likert scale. A priori consensus for item inclusion was agreement of items as 'Very important' or 'Extremely important' by ≥80% of panellists. Non-consensus items were forwarded to subsequent rounds for re-rating. RESULTS 53 experts in yoga research from 11 countries, primarily identifying as researchers (50%), allied health professionals (18.8%) and yoga professionals (12.5%), consented to participate in the Delphi. Of these, 48 completed Round 1 (91%), 43 completed Round 2 (81%), 39 completed Round 3 (74%) and 32 completed Round 4 (60%). Panellists reached consensus for inclusion on 21 items, grouped under 10 domains reflective of more generic intervention-based guidelines. CONCLUSIONS The consensus-based 21-item CLARIFY (CheckList stAndardising the Reporting of Interventions For Yoga) checklist provides a minimum reporting template for researchers across a range of methodology designs. Use of these yoga-specific guidelines, in conjunction with the CLARIFY explanation and elaboration guidelines, will standardise the minimum level of detail required for transparent yoga intervention, facilitating the replication, dissemination and implementation of yoga research. Ongoing research will assess the uptake and impact of CLARIFY, to ensure these guidelines retain their relevance to the internationally growing field of yoga research.
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Affiliation(s)
- Lesley Ward
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle upon Tyne, UK
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Daryl Nault
- Department of Integrative Health Research, Maryland University of Integrative Health, Laurel, Maryland, USA
| | - Holger Cramer
- Department of Internal and Integrative Medicine, Evang, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Steffany Moonaz
- Department of Integrative Health Research, Maryland University of Integrative Health, Laurel, Maryland, USA
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Kamioka H, Origasa H, Kitayuguchi J, Tsutani K. Compliance of Clinical Trial Protocols for Foods with Function Claims (FFC) in Japan: Consistency between Clinical Trial Registrations and Published Reports. Nutrients 2021; 14:nu14010081. [PMID: 35010956 PMCID: PMC8746435 DOI: 10.3390/nu14010081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 12/21/2021] [Accepted: 12/23/2021] [Indexed: 11/16/2022] Open
Abstract
Background: A new type of foods with a health claims notification system, the Foods with Function Claims (FFC), was introduced in Japan in April 2015. This cross-sectional study sought to clarify compliance of clinical trial protocols reported as the scientific basis of efficacy in the FFC system. Methods: All articles based on clinical trials published on the Consumer Affairs Agency website from 1 July 2018 to 30 June 2021 were reviewed. Items assessed included first author characteristics (for-profit or academia), journal name, year published, journal impact factor in 2020, article language, name of clinical trial registration (CTR), and seven compliance items (Title: T, Participant: P, Intervention: I, Comparison: C, Outcome: O, Study design: S, and Institutional Review Board, IRB). Among studies that conducted CTR, consistency with these seven compliance items was evaluated. Results: Out of 136 studies that met all inclusion criteria, 103 (76%) performed CTR, and CTR was either not performed or not specified for 33 (24%). Compliance between the protocol and the text was high (≥96%) for items P and S, but considerably lower for items T, I, C, O, and IRB (52%, 15%, 13%, 69%, and 27%, respectively). Furthermore, 43% of protocols did not include functional ingredients or food names in items T or I. The total score was 3.7 ± 1.1 pts (out of 7). Conclusions: Some CTs had no protocol registration, and even registered protocols were suboptimal in transparency. In addition to selective reporting, a new problem identified was that the content of the intervention (test food) was intentionally concealed.
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Affiliation(s)
- Hiroharu Kamioka
- Faculty of Regional Environment Science, Tokyo University of Agriculture, 1-1-1 Sakuragaoka, Setagaya-ku, Tokyo 156-8502, Japan
- Correspondence:
| | - Hideki Origasa
- Division of Biostatistics and Clinical Epidemiology, School of Medicine, University of Toyama, 2630 Sugiya, Toyama 930-0194, Japan;
| | - Jun Kitayuguchi
- Physical Education and Medicine Research Center Unnan, 328 Uji, Unnan City 699-1105, Japan;
| | - Kiichiro Tsutani
- Facult of Health Sciences, Tokyo Ariake Medical and Health Sciences University, 2-9-1 Ariake, Kouto-ku, Tokyo 135-0063, Japan;
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Cha E, Elguindi S, Onochie I, Gorovets D, Deasy JO, Zelefsky M, Gillespie EF. Clinical implementation of deep learning contour autosegmentation for prostate radiotherapy. Radiother Oncol 2021; 159:1-7. [DOI: 10.1016/j.radonc.2021.02.040] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 01/29/2021] [Accepted: 02/24/2021] [Indexed: 12/17/2022]
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Gooden MJ, Norato G, Martin SB, Nath A, Reoma L. Reducing Events of Noncompliance in Neurology Human Subjects Research: the Effect of Human Subjects Research Protection Training and Site Initiation Visits. Neurotherapeutics 2021; 18:859-865. [PMID: 33475954 PMCID: PMC8423976 DOI: 10.1007/s13311-020-01003-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/28/2020] [Indexed: 11/29/2022] Open
Abstract
In an effort to minimize protocol noncompliance in neurological research studies that can potentially compromise patient safety, delay completion of the study, and result in premature termination and added costs, we determined the effect of investigator trainings and site initiation visits (SIVs) on the occurrence of noncompliance events. Results of protocol audits conducted at the National Institute of Neurological Disorders and Stroke from 2003 to 2019 on 97 research protocols were retrospectively analyzed. Based on the depth of auditing and provision of investigator research training, audit data were separated into four arms: 1) Early Period, 2003 to 2012; 2) Middle Period, 2013 to 2016; and Late Period, 2017 to 2019, further divided into 3) Late Period without SIVs; and 4) Late Period with SIVs. Events of noncompliance were classified by the type of protocol deviation, the category, and the cause. In total, 952 events occurred across 1080 participants. Protocols audited during the Middle Period, compared to the Early Period, showed a decrease in the percentage of protocols with at least 1 noncompliance event. Protocols with SIVs had a further decrease in major, minor, procedural, eligibility, and policy events. Additionally, protocols audited during the Early Period had on average 0.46 major deviations per participant, compared to 0.26 events in protocols audited during the Middle Period, and 0.08 events in protocols audited during the Late Period with SIVs. Protocol deviations and noncompliance events in neurological clinical trials can be reduced by targeted investigator trainings and SIVs. These measures have major impacts on the integrity, safety, and effectiveness of human subjects research in neurology.
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Affiliation(s)
- Matthew J Gooden
- Clinical Trials Unit, National Institute of Neurological Disorders and Stroke, National Institutes of Health, 10 Center Drive, Building 10, Room 2A23, Bethesda, MD, 20814, USA
| | - Gina Norato
- Clinical Trials Unit, National Institute of Neurological Disorders and Stroke, National Institutes of Health, 10 Center Drive, Building 10, Room 2A23, Bethesda, MD, 20814, USA
| | - Sandra B Martin
- Clinical Trials Unit, National Institute of Neurological Disorders and Stroke, National Institutes of Health, 10 Center Drive, Building 10, Room 2A23, Bethesda, MD, 20814, USA
| | - Avindra Nath
- Section of Infections of the Nervous System, National Institute of Neurological Disorders and Stroke, National Institutes of Health, 10 Center Drive, Building 10, Room 7C103, Bethesda, MD, 20814, USA
| | - Lauren Reoma
- Clinical Trials Unit, National Institute of Neurological Disorders and Stroke, National Institutes of Health, 10 Center Drive, Building 10, Room 2A23, Bethesda, MD, 20814, USA.
- Section of Infections of the Nervous System, National Institute of Neurological Disorders and Stroke, National Institutes of Health, 10 Center Drive, Building 10, Room 7C103, Bethesda, MD, 20814, USA.
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Richard E, Reddy B. Text Classification for Clinical Trial Operations: Evaluation and Comparison of Natural Language Processing Techniques. Ther Innov Regul Sci 2020; 55:447-453. [PMID: 33125616 DOI: 10.1007/s43441-020-00236-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 10/16/2020] [Indexed: 11/28/2022]
Abstract
The ability to detect patterns and trends across protocol deviations (PDs) is key to ensure high data quality and sufficient oversight of patient safety. In clinical trial operations, some business processes and work instructions limit efficient protocol deviation trending because a majority of protocol deviations are left unclassified. When this occurs, it restricts clinical teams from determining systemic issues or signals in the data. The unstructured text in protocol deviation descriptions is an important component of trial operation knowledge. Natural language processing (NLP) can make protocol deviation descriptions more accessible and can support information extraction and trending analysis. This paper reviews how the natural language processing techniques of Term-Frequency Inverse-Document-Frequency (TF-IDF) combined with the supervised machine learning model of Support Vector Machines (SVM) and word embedding approaches such as word2vec can be used to categorize/label protocol deviations across multiple therapeutic areas. NLP is a key tool that will lead to more data driven decisions in clinical trial operations.
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Affiliation(s)
- Emma Richard
- Janssen Research & Development, LLC, 1400 McKean Rd, Spring House, PA, 19477, USA.
| | - Bhargava Reddy
- Janssen Research & Development, LLC, 1400 McKean Rd, Spring House, PA, 19477, USA
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Kumuthini J, Chimenti M, Nahnsen S, Peltzer A, Meraba R, McFadyen R, Wells G, Taylor D, Maienschein-Cline M, Li JL, Thimmapuram J, Murthy-Karuturi R, Zass L. Ten simple rules for providing effective bioinformatics research support. PLoS Comput Biol 2020; 16:e1007531. [PMID: 32214318 PMCID: PMC7098546 DOI: 10.1371/journal.pcbi.1007531] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Life scientists are increasingly turning to high-throughput sequencing technologies in their research programs, owing to the enormous potential of these methods. In a parallel manner, the number of core facilities that provide bioinformatics support are also increasing. Notably, the generation of complex large datasets has necessitated the development of bioinformatics support core facilities that aid laboratory scientists with cost-effective and efficient data management, analysis, and interpretation. In this article, we address the challenges-related to communication, good laboratory practice, and data handling-that may be encountered in core support facilities when providing bioinformatics support, drawing on our own experiences working as support bioinformaticians on multidisciplinary research projects. Most importantly, the article proposes a list of guidelines that outline how these challenges can be preemptively avoided and effectively managed to increase the value of outputs to the end user, covering the entire research project lifecycle, including experimental design, data analysis, and management (i.e., sharing and storage). In addition, we highlight the importance of clear and transparent communication, comprehensive preparation, appropriate handling of samples and data using monitoring systems, and the employment of appropriate tools and standard operating procedures to provide effective bioinformatics support.
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Affiliation(s)
- Judit Kumuthini
- H3ABioNet, Centre for Proteomic and Genomic Research, Cape Town, South Africa
| | - Michael Chimenti
- Iowa Institute of Human Genetics, Bioinformatics Division, Carver College of Medicine, University of Iowa, Iowa City, United States of America
| | - Sven Nahnsen
- Quantitative Biology Centre, Eberhard Karls University of Tübingen, Tübingen, Baden-Württemberg, Germany
| | - Alexander Peltzer
- Quantitative Biology Centre, Eberhard Karls University of Tübingen, Tübingen, Baden-Württemberg, Germany
| | - Rebone Meraba
- H3ABioNet, Centre for Proteomic and Genomic Research, Cape Town, South Africa
| | - Ross McFadyen
- H3ABioNet, Centre for Proteomic and Genomic Research, Cape Town, South Africa
| | - Gordon Wells
- H3ABioNet, Centre for Proteomic and Genomic Research, Cape Town, South Africa
| | - Deanne Taylor
- Department of Biomedical and Health Informatics, The Children’s Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Mark Maienschein-Cline
- Research Informatics Core, University of Illinois at Chicago, Chicago, Illinois, United States of America
| | - Jian-Liang Li
- Integrative Bioinformatics Support Group, National Institute of Environmental Health Sciences, Durham, North Carolina, United States of America
| | - Jyothi Thimmapuram
- Bioinformatics Core, Purdue University, West Lafayette, Indiana, United States of America
| | - Radha Murthy-Karuturi
- Department of Computational Sciences, The Jackson Laboratory for Genomic Medicine, Farmington, Connecticut, United States of America
| | - Lyndon Zass
- H3ABioNet, Centre for Proteomic and Genomic Research, Cape Town, South Africa
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den Boer MC, Martherus T, Houtlosser M, Root L, Witlox RSGM, Te Pas AB. Improving the Quality of Provided Care: Lessons Learned From Auditing Neonatal Stabilization. Front Pediatr 2020; 8:560. [PMID: 33042913 PMCID: PMC7525009 DOI: 10.3389/fped.2020.00560] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 07/31/2020] [Indexed: 12/21/2022] Open
Abstract
Video and physiological parameter recording of neonatal stabilization was implemented at the Neonatal Intensive Care Unit (NICU) of the Leiden University Medical Center. In order to improve documentation and the quality of care provided during neonatal transition, we implemented weekly plenary audits reviewing recordings of neonatal stabilization in 2014. In audits, provided care is reviewed, discussing, among others, mask technique, compliance to the prevailing local guideline, and clinical decision making and alternative treatment options. In this perspective, we argue that auditing neonatal stabilization is a valuable tool to improve patient safety and the quality of care provided during neonatal stabilization. We, therefore, report lessons learned and areas for improvement that could be identified and addressed during audits conducted at our NICU. Important areas for improvement were guideline compliance, documentation, the usage of medical devices, the conduct of delivery room studies, and clinical decision making. By reporting our experiences, we hope to encourage other NICUs to also implement regular audit meetings, fitting to their improvement needs.
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Affiliation(s)
- Maria C den Boer
- Division of Neonatology, Leiden University Medical Center, Leiden, Netherlands.,Department of Medical Ethics and Health Law, Leiden University Medical Center, Leiden, Netherlands
| | - Tessa Martherus
- Division of Neonatology, Leiden University Medical Center, Leiden, Netherlands
| | - Mirjam Houtlosser
- Department of Medical Ethics and Health Law, Leiden University Medical Center, Leiden, Netherlands
| | - Laura Root
- Division of Neonatology, Leiden University Medical Center, Leiden, Netherlands
| | - Ruben S G M Witlox
- Division of Neonatology, Leiden University Medical Center, Leiden, Netherlands
| | - Arjan B Te Pas
- Division of Neonatology, Leiden University Medical Center, Leiden, Netherlands
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McNally GA, Hrnicek AK, Barr H. Clinical Trial Amendments: Development of a Process for Consistent Implementation
. Clin J Oncol Nurs 2018; 21:627-628. [PMID: 28945727 DOI: 10.1188/17.cjon.627-628] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Clinical trials are responsible for the advancements made in cancer care. An interdepartmental work group at a major academic cancer hospital developed a process for the consistent communication and implementation of clinical trial amendments. This process ensures improved patient safety, as well as high-quality research.
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Affiliation(s)
- Gretchen A McNally
- Ohio State University Comprehensive Cancer Center-Arthur G. James Cancer Hospital and Richard J. Solove Research Institute
| | - Amanda K Hrnicek
- Ohio State University Comprehensive Cancer Center-Arthur G. James Cancer Hospital and Richard J. Solove Research Institute
| | - Hallie Barr
- Ohio State University Comprehensive Cancer Center-Arthur G. James Cancer Hospital and Richard J. Solove Research Institute
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Kohara N, Kaneko M, Narukawa M. Investigation of the Study Characteristics Affecting Clinical Trial Quality Using the Protocol Deviations Leading to Exclusion of Subjects From the Per Protocol Set Data in Studies for New Drug Application: A Retrospective Analysis. Ther Innov Regul Sci 2018; 53:45-51. [PMID: 29714591 DOI: 10.1177/2168479017751402] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The concept of the risk-based approach has been introduced as an effort to secure the quality of clinical trials. In the risk-based approach, identification and evaluation of risk in advance are considered important. For recently completed clinical trials, we investigated the relationship between study characteristics and protocol deviations leading to the exclusion of subjects from Per Protocol Set (PPS) efficacy analysis. METHODS New drugs approved in Japan in the fiscal year 2014-2015 were targeted in the research. The reasons for excluding subjects from the PPS efficacy analysis were described in 102 trials out of 492 in the summary of new drug application documents, which was publicly disclosed after the drug's regulatory approval. The author extracted these reasons along with the numbers of the cases and the study characteristics of each clinical trial. Then, the direct comparison, univariate regression analysis, and multivariate regression analysis was carried out based on the exclusion rate. RESULT The study characteristics for which exclusion of subjects from the PPS efficacy analysis were frequently observed was multiregional clinical trials in study region; inhalant and external use in administration route; Anti-infective for systemic use; Respiratory system, Dermatologicals, and Nervous system in therapeutic drug under the Anatomical Therapeutic Chemical Classification. In the multivariate regression analysis, the clinical trial variables of inhalant, Respiratory system, or Dermatologicals were selected as study characteristics leading to a higher exclusion rate. CONCLUSIONS The characteristics of the clinical trial that is likely to cause protocol deviations that will affect efficacy analysis were suggested. These studies should be considered for specific attention and priority observation in the trial protocol or its monitoring plan and execution, such as a clear description of inclusion/exclusion criteria in the protocol, development of training materials to site staff, and/or trial subjects as specific risk-alleviating measures.
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Affiliation(s)
- Norihito Kohara
- 1 Division of Pharmaceutical Medicine, Kitasato University Graduate School of Pharmaceutical Sciences, Tokyo, Japan
| | - Masayuki Kaneko
- 1 Division of Pharmaceutical Medicine, Kitasato University Graduate School of Pharmaceutical Sciences, Tokyo, Japan
| | - Mamoru Narukawa
- 1 Division of Pharmaceutical Medicine, Kitasato University Graduate School of Pharmaceutical Sciences, Tokyo, Japan
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