1. Clinical Trial Management
Systems
By
Nageswararao. Y
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2. Clinical Trial Systems – Key Application Areas
 Protocol Development
 Investigator/Site Selection and Trial Preparation
 Subject Identification and Enrollment
 Collection, Monitoring and Processing of Data
 Data Analysis and Reporting
 Safety and Adverse Event Reporting - Pharmacovigilance
 Submission for Review by Regulatory Authorities
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3. Clinical Trial Systems – Stakeholders
 Protocol Development –
 Principal Investigator
 Trial Sponsor
 Investigator/Site Selection and Trial Preparation
 Sites
 Trial Sponsor
 IRB
 Subject Identification and Enrollment
 Sites
 Collection, Monitoring and Processing of Data
 Trial Sponsor
 Sites
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4. Clinical Trial Systems – Stakeholders – Cont…
 Trial Management
 Trial Sponsor, Sites
 Data Analysis and Reporting
 Trial Sponsor
 Submission for Review by Regulatory Authorities
 Trial Sponsor to agency
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5. Clinical Trial Systems – Technology Usage
• Protocol Development –
– Word Processing software such as Word, Adobe
– Document Management Solutions such as Documentum for organizing
and standardizing the process of protocol development
– Protocol Authoring / Modeling tools
– Simulation software
• Investigator/Site Selection and Trial Preparation
– Excel Sheets
– In House Tracking systems to track receipt/ approvals of documents
– Internet based software systems
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6. Clinical Trial Systems – Technology Usage – Cont…
• Subject Identification and Enrollment
– Media Advertisements
– Databases from local hospitals -
– Call centers
– Publicly available subject data from organizations such as Center Watch
• Collection, Monitoring and Processing of Data
– Clinical Data Management Systems (Paper based)
– Electronic Data Capture
• First Generation EDC tools
– OCR and OMR (Post Marketing Trials)
– Remote Data Entry
– IVRS (Interactive Voice Response Systems)
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7. Clinical Trial Systems – Technology Usage – Cont…
• Second Generation EDC tools
– Integrated functionalities with much more clinical trial process
functionalities
– Extensive usage of internet
– Hybrid systems with 2 modes of operations, online and offline
– Enhanced IVRS
– ePRO systems
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8. Integrated CTMS
Regulatory Compliant
Study Site Staff
Management Management Management
Offline and Online Capability
Subject Contracts Data
Management Management Management
Secure
Document Patient Diary
Medical Coding
Management Integration
Adverse Supplies
Monitoring
Event Reporting Management
LAB Data External Interfaces Randomization
Data Standards
compatible
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9. Alternative Views of CTMS systems
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10. Clinical Trial Systems – Study Management
 A Program represents the top level in the
grouping hierarchy of studies. Program_DrugA
(Drug under Investigation)
 Typically a Program is matched to a drug
under investigation.
 Project maps to an indication or a
formulation of the drug. Project1 Project2 Project3
 Project is a collection of multiple studies.
 Assign multiple compounds to a program.
 Create a Program and the Projects Study1 Study2
associated with a Program
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11. Clinical Trial Systems – Study Management – Cont…
 Organizational Unit defines the sponsors of a study
 Sponsor A
 Sponsor B
 Geographical Regions can be added to a study and one of
them can be made as the Master geographical region
 United States (Master)
 India
 SriLanka
 Historical events may be one of two kinds: event recording
triggered by the system, or a user-defined event
 Creation of this study
 Creation of a study version
 Setting or changing the randomization access codes for a study
 Setting or changing the study status
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12. Clinical Trial Systems – Study Management – Cont…
 Set start and end dates for studies
 Set Study Objectives – A study can have more than one objective
 Set Enrollment Criteria – The list of criteria for including /
excluding a subject in a trial
 Set Termination Criteria – The reasons for terminating a subject
from a study
 Set Study Comment – Comments about the study
 Manage study design – One of the several clinical trial designs
available to conduct a clinical trial
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13. Clinical Trial Systems – Site/Investigator Management
• Create Sites
• Assign a site to a study
• Assign an investigator to a study site
• Link Patient positions to the site
• Maintain Investigator data
• Assign Treatments to a site
• Creating Strata and Randomization criteria
• Creating, Reviewing or Canceling blind breaks
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14. Clinical Trial Systems – Treatments/ Events and
Randomization
 Active Substances- Active substances are the New
chemical entities which are being investigated
 Active Drug- The drug currently under investigation
 Treatment Regimen (A systematic Plan)
 defining the details about a drug’s dosing a single regimen is created
 combinations of single regimens is a Combination Regimen
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15. Clinical Trial Systems – Treatments/ Events and
Randomization
 Timelines, Periods, Sub periods and Phases
 Strata and Randomization
 strata means groupings of patients that have common characteristics;
they are representations of particular expressions of factors.
 Randomization is the process of hiding patients’ treatments by
assigning treatment patterns to patient positions in an unpredictable
order
 Patient positions represent potential study participants
 Each factor describes a single characteristic, such as sex or age.
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16. Clinical Trial Systems – Data
Management
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17. Clinical Data Management
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18. Clinical Data Management
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19. Study Management – Adverse Events
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20. Clinical Trial Systems – Adverse Event Management
• Ability to enter and manage Adverse Events and Serious Adverse
Event.
• Manage Adverse Event Discrepancy
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21. Clinical Trial Systems – Oracle AERS
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22. Clinical Trial Systems – Patient Diary
• Get Quality of Life Questionnaires filled by patients.
• Scheduled and Unscheduled entries - Send reminders to subjects,
administer questionnaires, alert them for any invalid entries.
• Patient Compliance Tracking – Enables to track patient compliance by
using date time stamps, edit checks and automatic scheduled
reminders.
• Data can be secured and provide instant access to Investigators and
Sponsors on a 24/7 basis.
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23. Clinical Trial Systems – External data
 Import / Export data between clinical trial systems, AERS
systems, Financial and ERP systems
 Can be CDISC or non CDISC based data transfer
 Operational Data can be typically split into Admin, Study,
Subject, Audit trail sections
 LAB data can be transferred between LIMS and CTMS
 Adverse Event integration would happen with systems like
Oracle Clinical
 Contracts and other financial data can be transferred from
financial and ERP systems
 Inventory related information such as Supplies can be
integrated with manufacturing controls
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24. Clinical Trial Systems – External data – Cont…
• Randomization details could be integrated from IVRS based systems
• Contract details could also be retrieved from Document Management systems such
as Documentum, ERP systems or Financial systems
• Document management systems like Documentum and Adobe can be integrated
with CTMS easily.
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25. References
http://en.wikipedia.org/wiki/Clinical_Trial_Management_System
http://www.medicalnewstoday.com/articles/60535.php
http://www.microsoft.com/office/showcase/ctm/default.mspx
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26. Thank you
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