Industry spotlight
BEST PRACTICES FROM CTTI
“CTTI suggests considering more intensive monitoring early in the process to identify any unanticipated technical issues that require resolution before they compromise the study when digital technologies are used for data capture.”
TOOLKIT FROM TRANSCELERATE
TransCelerate: Toolkit can help you gather patient feedback on study schedules, visit burden, outcome relevance, etc., ensuring that the chosen sDHT and endpoints align with patient preferences.
PUBLICATION
“We offer considerations for academic researchers, drug developers, and patient advocacy organizations on the design and deployment of BYOD models in clinical research. These considerations address: (1) early identification and engagement with internal and external stakeholders; (2) study design including informed consent and recruitment strategies; (3) outcome, endpoint, and technology selection; (4) data management including compliance and data monitoring; (5) statistical considerations to meet regulatory requirements. We believe that this article acts as a primer, providing insights into study design and operational requirements to ensure the successful implementation of BYOD clinical studies.”
PUBLICATION
Mobile technologies offer the potential to reduce the costs of conducting clinical trials by collecting high-quality information on health outcomes in real-world settings that are relevant to patients and clinicians. However, widespread use of mobile technologies in clinical trials has been impeded by their perceived challenges. To advance solutions to these challenges, the Clinical Trials Transformation Initiative (CTTI) has issued best practices and realistic approaches that clinical trial sponsors can now use. These include CTTI recommendations on technology selection; data collection, analysis, and interpretation; data management; protocol design and execution; and US Food and Drug Administration submission and inspection. The scientific principles underpinning the clinical trials enterprise continue to apply to studies using mobile technologies. These recommendations provide a framework for including mobile technologies in clinical trials that can lead to more efficient assessment of new therapies for patients. (Abstract)
BEST PRACTICES BY TRANSCELERATE
Risk-Based Monitoring (RBM) initiative, which offers a more efficient and effective alternative to traditional, resource-intensive clinical trial monitoring. The initiative provides a comprehensive methodology that focuses on identifying and mitigating risks that are critical to patient safety and data integrity. By concentrating resources on areas of highest risk, RBM aims to improve the quality of clinical trials, enhance patient safety, and increase the efficiency of drug development. The program provides a suite of tools and resources to help sponsors and research sites implement this modern approach. recommends KRIs be visible to both sponsor and CRO in a shared tool.
CTTI Considerations for Advancing the Use of Digital Technologies for Data Capture & Improved Clinical Trials
DHT selection should be guided by the trial’s scientific goals, unmet needs, and potential to reduce participant burden.
Verification ensures the DHT accurately measures physical parameters, while validation confirms it reliably captures the desired clinical outcomes.
Conducting feasibility studies is essential to identify potential usability or compliance issues before full trial implementation.
Clear communication, training, and support plans for participants and sites are critical to the success of DHT-enabled trials.
Operational challenges, including DHT malfunctions, must be anticipated with robust management and mitigation plans.
Recommendations
Define Measurement Goals: Identify the scientific and patient-centered needs driving the decision to use DHTs.
Specification-Driven Selection: Tailor DHT selection based on technical performance, trial needs, and participant preferences, collaborating with manufacturers for transparency.
Verify and Validate Technologies: Conduct both verification and validation processes in controlled and real-world settings, focusing on the target population.
Pilot Feasibility Studies: Test the DHT in small-scale studies to assess usability, compliance, and real-world functionality.
Operational Planning: Develop detailed standard operating procedures (SOPs) for managing DHTs, addressing potential malfunctions, and supporting participants.
Regulatory Considerations
Regulatory status should not solely determine DHT selection; instead, focus on its fit-for-purpose performance in the trial context.
Maintain transparency with manufacturers to document DHT performance characteristics and limitations for regulatory submissions.
Validate endpoints and DHT data to meet evidentiary standards required by regulatory agencies.
Ensure clear roles and responsibilities for managing DHTs to align with regulatory compliance requirements.
Address interoperability, data privacy, and security concerns to adhere to ethical and legal standards in clinical trials.
Some summaries are generated with the help of a large language model; always view the linked primary source of a resource you are interested in.
Patient Protocol Engagement toolkit
Clinical trial protocols designed without patient input often result in a high participant burden and a poor patient experience, leading to challenges in trial enrollment, adherence, and retention.
A lack of early patient engagement can lead to study designs that are not feasible, collect data on outcomes that aren’t meaningful to patients, and require costly protocol amendments later in the process.
Many sponsors and research teams lack a structured, systematic process and standardized tools for effectively planning and executing patient engagement activities.
Meaningful patient partnerships can lead to research of greater quality and relevance, as patients provide unique insights into living with their condition and the practicality of trial procedures.
Recommendations
Adopt a structured toolkit and systematic process to plan patient engagement, define objectives, select appropriate methods, and apply learnings to the protocol.
Engage with patients and caregivers as early as possible in the protocol development lifecycle to ensure their insights can meaningfully influence the study design.
Carefully select diverse patient partners based on criteria like their disease experience, and choose appropriate engagement methods (e.g., advisory boards, focus groups, surveys) to meet defined goals.
Use provided guides, templates, and visual aids to facilitate clear communication, manage expectations, and effectively gather, assess, and implement patient feedback.
Regulatory Considerations
Patient engagement in trial design is strongly encouraged by global regulatory bodies, including the U.S. Food and Drug Administration (FDA).
These activities align with regulatory initiatives like the FDA’s Patient-Focused Drug Development (PFDD) guidance, which emphasizes collecting data that reflects patient experiences, needs, and priorities.
Incorporating patient feedback helps ensure that a clinical trial is designed to capture meaningful endpoints and outcomes, which supports subsequent regulatory and Health Technology Assessment (HTA) review.
Some summaries are generated with the help of a large language model; always view the linked primary source of a resource you are interested in.
Considerations for Conducting Bring Your Own “Device” (BYOD) Clinical Studies
Limited use of BYOD in clinical trials and evolving regulatory guidance.
Potential biases due to participant preselection based on technology access and literacy.
Challenges in technology availability for generating study endpoints.
Recommendations
Ensure appropriate technology selection to meet study objectives.
Address potential biases in study population and data variability.
Implement mitigation strategies like provisioned technologies to avoid digital divide.
Develop a comprehensive statistical analysis plan for BYOD data.
Engage stakeholders early in the study design process.
Regulatory Considerations
Manage interactions with regulatory authorities on trial design and approval.
Prepare evidence dossiers for novel assessments via digital health technology.
Ensure compliance with guidelines like those from the Agency for Health Research and Quality.
Some summaries are generated with the help of a large language model; always view the linked primary source of a resource you are interested in.
Advancing the Use of Mobile Technologies in Clinical Trials: Recommendations from the Clinical Trials Transformation Initiative
Widespread use of mobile technologies in clinical trials is impeded by perceived challenges.
Scientific and technical challenges affect decision-making around using mobile technology for data capture.
Concerns include choosing appropriate technology, data collection and analysis, ensuring data authenticity, and designing protocols.
Recommendations
Use CTTI’s framework for mobile technology selection to assist sponsors.
Conduct feasibility studies prior to launching trials.
Engage with regulatory authorities early to discuss endpoint appropriateness and validation processes.
Secure data generated by mobile technologies using recommended practical approaches.
Optimize data quality to minimize variability and ensure robust conclusions.
Regulatory Considerations
Engage with the FDA early in the trial design process.
Ensure data integrity and security throughout the data life cycle.
Maintain open dialogue with regulatory authorities regarding trial-specific strategies for data collection and sharing.
Some summaries are generated with the help of a large language model; always view the linked primary source of a resource you are interested in.
Risk Based Monitoring
Traditional on-site monitoring, which often involves 100% source data verification, is not the most effective way to ensure data quality and can divert resources from more critical activities. A risk-based approach allows for the early identification of potential issues, enabling proactive risk mitigation and improved trial oversight. The successful implementation of RBM requires a cultural shift within organizations, moving from a reactive to a proactive mindset. Collaboration among sponsors, CROs, and sites is essential for the effective adoption of RBM methodologies.
Recommendations
Sponsors should adopt a systematic, risk-based approach to monitoring that is tailored to the specific risks of their clinical trial. This includes conducting a thorough risk assessment during the planning phase to identify critical data and processes. The use of centralized monitoring and advanced analytics should be a core component of any RBM strategy to detect unusual patterns or trends in the data. Training for all stakeholders, including site staff and monitors, is crucial for the successful implementation of RBM.
Regulatory Considerations
Global regulatory agencies, including the FDA, EMA, and Japan’s PMDA, have issued guidance that supports and encourages the use of risk-based approaches to monitoring clinical trials. Regulatory submissions should include a description of the RBM methodology used in the trial and a justification for the approach taken. The adoption of RBM is consistent with Good Clinical Practice (GCP) principles, which emphasize a focus on patient safety and data quality.
Some summaries are generated with the help of a large language model; always view the linked primary source of a resource you are interested in.
For reference: review the relevant regulatory guidances
Regulatory spotlight
Features essential guidance, publications, and communications from regulatory bodies relevant to this section. Use these resources to inform your regulatory strategy and ensure compliance.