Category Archives: Clintrial

Clinical Trials – Computerized Systems

The Food and Drug Administration (FDA) established the Bioresearch Monitoring (BIMO) program of inspections and audits to monitor the conduct and reporting of clinical trials to ensure that data from these clinical trials meet the highest standards of quality and integrity and conform to FDA’s regulations.

Computerized systems used in clinical trials refer to the creation, modification, maintenance, archiving, retrieving or transmitting clinical data intended for submission to the Food and Drug Administration (FDA).

Key Definitions:

Audit Trail: a secure, computer-generated, time-stamped electronic record that allows reconstructions of the data course of events relating to the creation, modification, and deletion of an electronic record.

Certified Copy: it is a copy of the original information that has been verified, as an exact copy having all of the same attributes and information as the original. It must have a dated signature.

Computerized System: it is the computer hardware, software, and associated documents (i.e manuals) that create, modify, maintain, archive, retrieve, or transmit in digital form information related to the conduct of a clinical trial.

Electronic Case Report Form (e-CRF): designed to record information required by the clinical trial protocol to be reported to the sponsor on each trial subject.

Electronic Patient Diary: an electronic record into which a subject participating in a clinical trial directly entrees observations or directly responds to an evaluation checklist or questionnaire

Electronic Record: a combination of text, graphics, data, audio, pictorial, or any other information representation in digital form that is created, modified, maintained, archived, retrieved or distributed by a computer system.

Electronic Signature: a computer data compilation of any symbol or series of symbols, executed, adopted, or authorized by an individual to be legally binding equivalent of the individual’s handwritten signature.

Software Validation: verification and validation is the process of checking that a software system meets specifications and that it fulfills its intended purpose. For these guidelines, the design level validation is that portion of the software validation that takes place in parts of the software life cycle before the software is delivered to the end-user.

Source Documents: original documents and records including, but not limited to, hospital records, clinical and office charts, laboratory notes, memoranda, subjects’ diaries or evaluation checklists, pharmacy dispensing records, recorded data from automated instruments,copies or transcriptions certified after verification as being accurate and complete, microfiches,photographic negatives, microfilm or magnetic media, x-rays, subject files, and records kept at the pharmacy, at the laboratories, and at medico-technical departments involved in the clinical trial.

Principles:

Security measures should be in place to prevent unauthorized access to the data and to the computerized system.

1-Identify at which steps a computerized system will be used to create, modify, maintain, archive, retrieve, or transmit data.

2-Documentation should identify what software and, if known, what hardware is to be used in computerized systems that create, modify, maintain, archive, retrieve, or transmit data. This document should be retained as part of the study records.

3-Source documents should be retained to enable reconstruction and evaluation of the trial.

4-When original observations are entered directly into a computerized system, the electronic record is the source document.

5-The design of a computerized system should ensure that all applicable regulatory requirements for recordkeeping and record retention in clinical trials are met with the same degree of confidence as is provided with paper systems.

6-Clinical investigators should retain either the original or a certified copy of all source documents sent to a sponsor or contract research organization, including query resolution correspondence.

7-Any change to a record required to be maintained should not obscure the original information. The record should clearly indicate that a change was made and clearly provide a means to locate and read the prior information.

8-Change to the data are stored on electronic media will always require an audit trail, in accordance with 21 CRF 11,.10(e). It should include who made the changes, when, and why they were made.

9-The FDA may inspect all records that are intended to support submissions to the Agency, regardless of how they were created or maintained.

10-Data should be retrievable in such a fashion that all information regarding each individual subject in a study is attributable to that subject.

11-Computerized systems should be designed so that all requirements assigned to these systems in a study protocol are satisfied and to preclude errors in data creation, modification, maintenance, archiving, retrieval or transmission.

As we read in this blog about guidance for the industry around computerized systems revolts around data quality and data integrity. The users or people using the data from these systems should have confidence that the data are no less reliable than data in paper form.

In the next blog, we will cover audits and inspections, data entry into this computerized system, security and electronic signatures as a way of certifying the data.

Source:

CFR 11 and ICH

FDA.com

 

 

 

How the Pharmaceutical Industry became into existence?

The Birth of the Pharmaceutical Industry can be traced back to 1850 – 1875 where the first “authentic” drug was developed by extracting agents from plants.

In those years, there were also developed the microbial theory of disease, medicines and homoeopathy patent and there heavy use of powerful purgatives and cathartics medicines.

By 1875, the Drug Development becomes a science and the first synthetic drug was introduced. By 1900, vaccines and antitoxins form the basis of the new pharmaceutical industry.

From 1900 to 1925, began what is now known as the pharmaceutical century. The U.S. Pure Food and Drugs Act was passed (known today as the FDA) and the development of hormonal and chemotherapy was introduced.

After 1925, it began what is known today as the Antibiotic and Regulatory Era. Vitamins, antimalarials, anticarcinogenic compounds and anti-infectives discoveries were made. The FDA gains independence as a regulatory agency and is given compliance responsibility.

From 1950 thru 1975, a new generation of the drug became apparent. Vaccines for polio became mandatory, oral contraceptives appears on the market and cardiovascular therapies.

Also, an amendment to the Federal Food Drug and Cosmetic Act of 1938 Act was signed by President Kennedy to ensure that consumers will not be the victims of unsafe and ineffective medications. Additional information about this Act can be read here: Kefauver-Harris Amendments

The Globalization of the Pharmaceuticals industry started from 1975 thru 2000. New drugs therapies, new antiviral drugs, and the development of new drugs by biotechnology companies were in global high demand.

By 2000, over 2.8 million people participated in over 50,000 clinical trials and more research and development funding was increased.

R&D Expenditures by Body System

R&D Expenditures

Cost (Billions) Body System
7.0 Central Nervous System
6.0 Cancer, endocrine and metabolic
4.5 Cardiovascular
3.5 Infectious Disease
2.5 Biological and vaccines
5.3 Other

Current Trends in the Industry since the late 2000s

Biotechnology Medicines
Drug Intervention Targets
Vaccines

 

Role of Generic Drugs
Generic drugs account for over 47% of prescription drugs in the market in which 43 major prescription drugs come off patent by 2005.

What does this mean for pharmaceutical drugs?
Between 40% – 60% of sales are lost to the generic brand within the two years of coming off patent.

Factors that will impact the R&D future:

  • There has been over 40 mergers and acquisitions since 1985
    • Sanofi and Synthelabo
    • Zeneca and Astra
    • Monsanto and Pharmacia
    • Roche and Genentech
  • Employment grew at a 3% rate per year

Total Drug Development Time (Years)

Summary:
On average, it takes at least ten years for a new medicine to complete the journey from initial discovery to the marketplace, with clinical trials alone taking six to seven years on average. The average cost to research and develop each successful drug is estimated to be $2.6 billion.

Pharmaceutical Regulation

In 1902, about 10 children die after receiving a vaccine shot. The BIOLOGICS CONTROL ACT was passed to ensure purity and safety of serums, vaccines and similar products used to prevent or treat diseases in humans.

In 1906, “The Great American Fraud” reveals patent medicines laced with addictive drugs, toxic additive and alcohol.

In 1912, Public outcry over the sales of “snake venom” and other wonder cures.  The SHERLEY AMEND was passed to prohibit labelling medicines with false therapeutic claims intended to defraud the purchaser.

In 1927, the government forms a separate law enforcement agency called the Food, Drug and Insecticide Agency.

In 1937, about 107 people, including many children die after drinking a syrup called Elixir of Sulfanilamide. Due to safety concerns, The Federal, Food, Drug and Cosmetic Act (1938) was passed as the first attempt to regulate cosmetics and medical devices.

In 1962, the sleeping pill “Thalidomide“, developed what is known today as Grunenthal Pharmaceutical in Germany, resulted in thousands of birth defects in Western Europe. The KEFAUVER-HARRIS Drug Amend was passed to ensure drug efficacy and greater drug safety.

In 1983, the ORPHAN DRUG Act was passed enabling the FDA to promote research and marketing of drugs needed for treatment of rare diseases. This year there as an outbreak of HIV / AIDS cases.

In 1988, The FOOD and DRUG ADMINISTRATION ACT were established as the FDA under the Department of Health and Human Services.

In 1992, the pharmaceutical industry complained that life-saving drugs were being reviewed too slowly by the FDA. The PRESCRIPTION DRUG USER FEE ACT (PDUFA) is made into law.

Source:

Image: Courtesy of Google image

FDA website

Private information for college researched in the 2000s.

Becoming a Data Scientist {EDC Developer + Statistical Expert + Data Manager}

At an early age, I was drawn to computers. I did well in math; I love science and I started enjoying programming when my stepfather gave me a small computer to program games. This was my real experience with programming. I think the programming language was Basic. The computer had some built-in games and basic math problems in it but you could also play around with ‘Basic‘ codes and create your own.

Then I went to a technical school and into college where you take basic classes in information system /technology and took courses in telecommunication management.  Most of the courses were around IP, PBX and Network Administration.  As part of that curriculum, I took a basic programming course and VB.net. I really like that since it has a visual interface (drag and drop to create the interface) and when you click a button you create an event so I like the design aspect of it (I am known to be very creative) then I started to design for people (website design and development, small databases). A lot better than working in telecommunications. I thought VB was a great first language to learn. Later I took a Microsoft Access database development class and we learn database design (relational) and found out I was really good at that.

Before I graduated, I was already working for a well known pharmaceutical company as a database analyst within their data management and biometrics team. They really like what I did with their clinical operations data (investigator data – you know the one that now we need CTMS systems for nowadays). So this was a confirmation that ‘databases’ was my passion. I love designing it, managing and maintaining it.

During my early years in this industry, I spent a lot of time writing SQL codes and SAS programs.  We pulled the messy data (back in those years we used the Clintrial Oracle backend system) and very problem solving oriented. A business question was asked and we would go using either SQL or SAS and go into this messy database and figure it out the answer. I really enjoyed that.

In recent years, I take data from a {EDC} system then write scripts to summarize the data for reporting and put into a data warehouse and then I use a product called ‘IBM Cognos’, which points to the data warehouse to build those reports and worked with different users across different departments (a lot of different audiences for the data) with a lot of different interesting data in there. I have spent time using APIs to extract data via Web Services (usually in XML-ODM format) and generate useful reports in SAS or Excel XML.

People think that being a data analyst is just sitting around a computer screen and crunching data. A lot of it is design-oriented, people-oriented, and problem-solving. So when people ask a question, I get to dive into the data and figure it out the answer.

Next step is to get into predictive analytics and do more data mining and data forecasting.

Are you still excited about becoming a data scientist?

You can start by reading my blog about programming languages you should learn here!

Other tools and programming languages you should learn: Anaconda, R Programming, Python, Business Intelligence Software like Tableau, Big Data Analytics with Hadoop, create new representations of the data using HTML and CSS (for example when you use APIs, XML to extract data from third-party sources).

Anayansi, MPM, an EDC Developer Consultant and clinical programmer for the Pharmaceutical, Biotech, and Medical Device industry with more than 18 years of experience.

Available for short-term contracts or ad-hoc requests.  See my contact page for more details or contact me.

Fair Use Notice: Images/logos/graphics on this page contains some copyrighted material whose use has not been authorized by the copyright owners. We believe that this not-for-profit, educational, and/or criticism or commentary use on the Web constitutes a fair use of the copyrighted material (as provided for in section 107 of the US Copyright Law).

ICH is coming to Town – European Medicines Agency (EMA)

The International Conference on Harmonization (ICH)  is involved in promoting public health, improve efficiency of new drug development and registration process among other objectives. In order to accomplish this, ICH has developed and implemented harmonized guidelines and standards, also known as ICH6.

ICH Steps

Over 50 guidelines on technical requirements on:
Quality, Safety and Efficacy
Efficacy – 14 topics/17 guidelines
Safety – 8 topics/16 guidelines
Quality – 9 topics/23 guidelines

  • Maintenance of ICH Controlled Terminology Lists
  • Medical dictionary for adverse event reporting and coding
    of clinical trial data (MedDRA)
  • Electronic Standards for the Transfer of Regulatory
    Information
  • Common Technical Document (CTD & eCTD)

The European Medicines Agency (EMA) is a decentralised body of the EU. EMA is responsible for centralised procedure and co-ordination of EU network + plays a role in stimulating innovation and research in the pharmaceutical sector.

EMA is not an FDA for Europe

EMA responsibility does not include:

  • Evaluation of all medicines in the EU
  • Research/development of medicines
  • Clinical trial approval
  • Medical devices
  • EU healthcare policies
EMA Regulatory Process

 

 

Conclusion: ICH-GCP guidelines brought forth public awareness that there was a need to control and regulate clinical trials dealing with drugs and human subjects.

ICH main goal is to provide a unified standard for the European Union (EU), Japan and the United States to facilitate the mutual acceptance of clinical data by the regulatory authorities in these jurisdictions.

Source:

Guidelines on good clinical practice (European Community and within the ICH regions)  – https://ec.europa.eu/

Presentation – ICH and EU regulatory – www.ema.europa.eu

 

Recommended Posts:

https://edcdeveloper.wordpress.com/2015/05/11/are-you-practicing-gcp/

https://edcdeveloper.wordpress.com/2011/11/17/21-cfr-part-11-cheat-sheet-for-the-edc-developer/

Fair Use Notice: Images/logos/graphics on this page contains some copyrighted material whose use has not been authorized by the copyright owners. We believe that this not-for-profit, educational, and/or criticism or commentary use on the Web constitutes a fair use of the copyrighted material (as provided for in section 107 of the US Copyright Law).

Top 3 Posts at (EDC Developer)

Fist, I would like to thank everyone who has read articles posted at {EDC} Developer. Especially, my colegas and friends from India. The highest reading and hits have come from people living in India.

New to the industry? Want to get in as clinical data manager or clinical programmer? Looking for a particular topic or an answer to a question? check the contact me section.

Here are the top most searched articles this past few months:

1- Data Management: Queries in Clinical Trials

2- How to document the testing done on the edit checks?

3- Why use JReview for your Clinical Trials?

Others most read articles:

Role of Project Management and the Project Manager in Clinical Data Management

4 Programming Languages You Should Learn Right Now (eClinical Speaking)

Data Management Plan in Clinical Trials

For the search term used to find {EDC} Developer:

1-types of edit checks in clinical data management

2-Rave programming

3- pharmaceutical terminology list

4-seeking rave training (better source is mdsol.com)

5- edc programmer

6-central design tips and tricks

Thank you for reading!

What Is In A Name Besides Letters?

Disclaimer: This is based on a fictional story in this fictional world.

Deciding on a name for your company or product is among the first steps an entrepreneur takes. Entrepreneurs often angst over the perfect name for their EDC tool. That name is a break or make deal for many. Your users will either identify with it or completely turn the other way and use your competitor’s EDC system.

It seems straightforward. Who wouldn’t want to stand out?

A rose by any other name is still a rose…

Let’s look at some Mythological names for several {EDC} systems.

  1. Medidata Rave: “Rave” at first thought, it is not an unique name. The traditional meaning of ‘Rave’ was to show signs of madness or delirium (rave. (n.d.). The American Heritage® Dictionary of Idioms by Christine Ammer) but most recent and contemporary meaning is ‘wild party’. For many of us, during the college years, we associated the word ‘Rave’ with underground parties, fun, entertainment and much more. I have been to several White Sensation parties here in Europe. Rave is my favorite name by far.
  2. Cmed Timaeus: Timaeus resonates with ‘Amadeus’. You know, the famous ‘Mozart’, Austrian composer, widely recognized as one of the greatest composers in the history of Western music. If you were born near the 80’s music era then this music video will come to mind.
  3. RDC: In contracts, RDC is “running down” clause, provides coverage for legal liability of either the shipper or the common carrier for claims arising out of collisions. Oracle RDC stands for ‘Remote data capture’. It is easy to remember and catchy.
  4. InForm: Is it ‘information forward’? Information in the form? InForm has been around for several years now. It started becoming popular in the 90s. There has been several modifications and upgrades but the name has stayed the same. It is now part of a group of systems own by Oracle.
  5. OpenClinica: I believe this name refers to the ‘open’ source capability of this tool. Open-source software (OSS) is computer software with its source code made available with a license in which the copyright holder provides the rights to study, change and distribute the software to anyone and for any purpose. (St. Laurent, Andrew M. (2008). Understanding Open Source and Free Software Licensing. O’Reilly Media. p. 4. ). I believe some users may confuse this name with Oracle Clinical, another popular CDM system.
  6. ClinCase: In computer science, CASE tools can be used for simple operations such as routine coding from an appropriately detailed design in a specific programming language, or for more complex tasks such as incorporating an expert system to enforce design rules and eliminate software defects and redundancies before the coding phase. (“CASE”. Encyclopædia Britannica. Encyclopædia Britannica Online). I personally has not used this tool but was asked recently so I added it to the fictious name list.
  7. RedCap: This is a catchy name as well. It can infer many meanings. Cap for capital letters, the cap or ceiling placed on mortgage rates, to protect or to seal? the hat that you wear, a member of the military police. Some further research, wikipedia has the following description of ‘redcap’: Redcaps are said to murder travellers who stray into their homes and dye their hats with their victims’ blood (from which they get their name) (Briggs, Katherine M. (1967). The Fairies in English Tradition and Literature. London: University of Chicago Press. p. 57) Regardless of definition, it is still a creative name.

You want a name that your employees and customers will want to say

Should You File For a Trademark? Here is some information about trademarks.

Having a brandable business name is one of the reason for the growth of business. Every EDC system is different and choosing the right name is key on getting the attention your {EDC} tool deserves.

One final reminder. When searching the list of fictitious names (also called “doing business as,” or DBAs) for your county and looking for names in your “class” (or industry) on the U.S. Patent and Trademark Office website (www.uspto.gov), be sure to look up variations on spellings, too, because names that sound alike can’t be registered in the same class. Also check Register.com to see which Internet domain names remain available.

what happens when you find out that your {EDC} name is also the name of another business in a different city/state? Keep it simple, as short as possible (check domain availability) and don’t play too much with spelling alternatives.

What is your favorite {EDC} name? Can a name make or break your chances of business success?

Comments? Join us at {EDC Developer}

Anayansi Gamboa, MPM, an EDC Developer Consultant and clinical programmer for the Pharmaceutical and Biotech industry with more than 13 years of experience.

Available for short-term contracts or ad-hoc requests. See my specialties section (Oracle, SQL Server, EDC Inform, EDC Rave, OpenClinica, SAS and other CDM tools)

 

Credit: The title of this article was an inspiration from a recent readingKate Of Gaia With Michael McCracken – What Is In A Name Besides Letters.” What an eye opening that was.

Fair Use Notice: This blog/article/video contains some copyrighted material whose use has not been authorized by the copyright owners. We believe that this not-for-profit, educational, and/or criticism or commentary use on the Web constitutes a fair use of the copyrighted material (as provided for in section 107 of the US Copyright Law).

If you wish to use this copyrighted material for purposes that go beyond fair use, you must obtain permission from the copyright owner. Fair Use notwithstanding we will immediately comply with any copyright owner who wants their material removed or modified, wants us to link to their website or wants us to add their photo.

Disclaimer: The EDC Developer blog is “one man’s opinion”. Anything that is said on the report is either opinion, criticism, information or commentary. If making any type of investment or legal decision it would be wise to contact or consult a professional before making that decision.

Disclaimer:De inhoud van deze columns weerspiegelen niet per definitie de mening van {EDC Developer}.

 

 

Your Strongest Characteristics

The reason I am writing is that I am looking for a new challenge and I felt we might have some areas for discussion, or at least you might be able to point me in the right direction.

My services basically represent a low-cost alternative to the traditional consultancy companies, which usually demand high prices for their services. My services are always the right partner for you – no matter if you are looking for an interim solution due to personnel shortage in your company, if you demand creative and unconventional solutions or if your project requires up-to-date knowledge – direct cost savings.

My current work and skills:

I’m currently working on several initiatives but there is always room for new challenges. I hold a project management degree and several certifications in different fields.

 My style?

I’m a quick-learner, flexible to change, achievement oriented and proactive.

 What you will gain from working with me:

  • Clarity on what you want
  • Tools and approaches for getting it
  • Insight into your patterns that work and roadblocks that don’t
  • An ability to see options and take action, in other words, results.

 What you can expect from me:

Honesty, straightforward yet sensitive advice and confidentiality.

Are these the kinds of skills you look for in a project leader?

Comments? Join us at {EDC Developer}

Anayansi Gamboa, MPM, an EDC Developer Consultant and clinical programmer for the Pharmaceutical and Biotech industry with more than 13 years of experience.

Available for short-term contracts or ad-hoc requests. See my specialties section (Oracle, SQL Server, EDC Inform, EDC Rave, OpenClinica, SAS and other CDM tools)

As the 3 C’s of life states: Choices, Chances and Changes- you must make a choice to take a chance or your life will never change. I continually seek to implement means of improving processes to reduce cycle time and decrease work effort.

Subscribe to my blog’s RSS feed and email newsletter to get immediate updates on latest news, articles, and tips. I am available on LinkedIn. Connect with me there for technical discussions.

Where in the World is Ana?

First, I want to say thank you for reading my blog, connecting with me on LinkedIn or following whenever I go [thank you NSA].

Many of you, for months, have asked me if I was going to write more articles related to clinical trials. For sometime now, I have taking time-off from this EDC blog and concentrated on some other projects of equal importance. I will share some new insights and information as I get myself back on track.

So what is a girl who has a master’s degree in project management and computer networks doing as a programmer? It’s not that I didn’t like project management, per se. And entering in the IT network business years ago was quite difficult for girls like me in a world dominated by men. It’s basically that I didn’t find myself with the same passion for project management or computer networks that I have for programming and technology in general.

Because I am so interested in technology and programming, I tend to spend a lot more time than my peers in learning new technologies, and enhancing my existing skills. Many of my co-workers and ex-collega (Dutch) have commented on their admiration that my skill level is as high as it is, and that I am able to learn new technologies so quickly. But beyond just learning new technologies and APIs, I’m passionate about becoming a better overall programmer. Reason why in the last few months, I spent time learning IOs development (iPhone and Android apps). I am actually working on an app to ‘hack’ into my own car. 🙂 Well, not exactly. I want to be able to open my car and do some other basic command (like opening the garage door) using an APP.

Given my degree in project management, it should be clear that I have useful skills beyond the programming world. In fact, having a project management background has helped me interface with various groups in various organizations in which I’ve worked.

I have installed, maintained, and designed numerous relational databases and small networks. As a freelancer, I have worked in projects doing data analysis, project support and computer training.

Now you know a little about me personally. If you think I might be the type of developer you’re looking for, feel free to browse my resume and contact me.

Anayansi Gamboa
Resume / CV .

Comments? Join us at {EDC Developer}

P.S. I will be releasing some training videos / training material for several EDC tools in the near future including tips and best practices. Price has not been setup yet. All training will be web-based, password protected. If you wish to consult with me for a face-to-face training or on-site training, please contact me to discuss further.

Fair Use Notice: This video contains some copyrighted material whose use has not been authorized by the copyright owners. We believe that this not-for-profit, educational, and/or criticism or commentary use on the Web constitutes a fair use of the copyrighted material (as provided for in section 107 of the US Copyright Law. If you wish to use this copyrighted material for purposes that go beyond fair use, you must obtain permission from the copyright owner. Fair Use notwithstanding we will immediately comply with any copyright owner who wants their material removed or modified, wants us to link to their website or wants us to add their photo.

Disclaimer: The EDC Developer blog is “one man’s opinion”. Anything that is said on the report is either opinion, criticism, information or commentary, If making any type of investment or legal decision it would be wise to contact or consult a professional before making that decision.

Disclaimer:De inhoud van deze columns weerspiegelen niet per definitie de mening van {EDC Developer}.

Disclaimer: The legal entity on this blog is registered as Doing Business As (DBA) – Trade Name – Fictitious Name – Assumed Name as “GAMBOA”.

Professional Timeline – Clinical Programmer

Professional Timeline

Curriculum Vitae
CV

 

anayansi gamboa