What real-time data and Risk-based monitoring mean for your CRO

A widely neglected factor in cost-effective risk-based clinical trial monitoring is availability and accessibility of data.

RBM methods used by a central clinical trial  monitoring operation that receives stale data (any data from patients that is more than a day old is stale) are ineffective. Every day that goes by without having updated data from patients, devices and investigators reduces the relevance and efficacy of remote monitoring.

Real-time data is a sine-que-non for RBM.

Sponsors and Contract research organizations (CROs) should therefore approach real-time data and risk-based monitoring (RBM) as 2 closely related priorities for executing clinical trials. Use of modern data technologies for real-time data collection and remote risk-based monitoring will reduce non-value added rework, people and paper in clinical trials and help speed up time to statistical report.

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Implementing an EDC to take advantage of risk-based monitoring

Clinical trial monitoring is 30-40% of your project costs.    At least half of that cost is manual work and SDV activities which can be eliminated with use of modern technologies like electronic source documents and remote risk-based monitoring.

In this post, we take a look at how you can automate routine data management activities and eliminate costly manual labor of your study monitors.  In order to eliminate costly people and paper processing, we need to  implement a strategy of “management by exception” or as the FDA calls it “remote risk-based monitoring“.

For the benefit of connected medical device developers who  are new to clinical trial operations and data management,  or new to electronic data capture (EDC) for clinical studies; this post starts with an introduction to FDA guidance on remote risk-based monitoring and goes on to provide some practical suggestions for using your EDC system within a remote risk-based monitoring plan for your connected medical device study.

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Homeostasis and medical device clinical trials

medical device clinical trials

Danny talks about how to strike a good balance between people and technology for monitoring medical device clinical trials.

Are real-time alerts too much of a good thing for monitoring your study? Maybe real-time alerts for patient compliance in medtech studies is just a fad – a fad just like WhatsApp.

I had a conversation with my friend John who has worked for years in digital technologies in the public education space. With over a billion people on social media, John was concerned that the human element is getting trashed.

My answer to him was – “No way”. People, both individually and collectively after they go through a change (especially a big technology change) they tend to return to a state of homeostasis.

The homeostasis of information

Stop for a moment and consider how much of your data sharing and private messaging interaction is digital and how much is paper and then ask yourself why clinical trial compliance monitoring is still dependent upon paper interactions.

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The great ripoff of SDV in medical device studies

medical device clinical trials

Question

Are you still doing 100% SDV in your medical device clinical trial?

Here are some facts from medical device clinical trials:

30% of your study budget is for monitoring and 50% of monitoring is for SDV

For a $1M study – you are spending $150k for SDV.

What do you get for your $150K?

Check the EDC and see what percent of  the data was updated due to SDV activity.   A study we did with 20 medical device studies shows that it is less than 1/3 of 1% for connected medical devices using ePRO ( the endpoint/patient compliance data is collected electronically).

Your return on investment was $525.

What does Risk-Based Monitoring mean for CROs?

It basically means a golden opportunity to shake-down the customer.

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