The present disclosure relates to computing, and more particularly, to systems and methods for clinical study data acquisition and quality control.
A clinical trial (also referred to as a “clinical study” and/or a “research study”) involves conducting investigative research using human subjects (also referred to as “participants” and/or “study participants”). A clinical trial may be conducted according to a predetermined research protocol, which may be set forth in a protocol document that describes the objective(s), design, methodology, statistical considerations, and organization of the trial. Clinical trials are designed to investigate questions about biomedical or behavioral interventions, such as treatments (e.g. novel vaccines, drugs, dietary choices, dietary supplements, and medical devices, or other products, treatment techniques or methodologies, and the like) and interventions. Clinical trials may generate data on safety and efficacy. In some circumstances, clinical trials may only be conducted after they have received health authority/ethics committee approval in the country where approval of the therapy is sought.
Useful Definitions:
Sponsor—A clinical trial sponsor may be an individual, company, institution, organization, or other entity that takes responsibility for the initiation, management, and/or financing of a clinical trial, e.g.: a pharmaceutical or medical device company or any company who has developed whatever medical innovation is being put through a clinical trial.
CRO/Contract Research Organization—A company that runs clinical trials on behalf of Sponsors; basically, outsourced clinical operations teams. A single CRO may have many sponsors as customers and may be running one or more trials for each sponsor.
CRA/Clinical Research Associate/Monitor—This person either works directly for the Sponsor or CRO. Their responsibility is to make sure Sites working for the Sponsor or CRO have submitted all appropriate documents and data. They also perform Site visits to do site selection and training, making sure each Site understands the Study Protocol.
Site/Research Site/Research Center—A hospital, clinic, or other location that has been contracted by the Sponsor or CRO to participate in the Study. It is their responsibility to enroll subjects at their Site into the study, follow the Study Protocol, and provide data and source documents to the Sponsor or CRO.
PI/Principal Investigator—The supervising medical doctor at a site. Their responsibilities may include seeing subjects, generating source documents, and review records for clinical significance.
Study Coordinator/Research Coordinator—A study coordinator may refer to one or more administrative staff members at a participating research site. A study coordinator may, for example, be responsible for taking source documents, extracting source data, and transcribing or otherwise loading the source data into CRFs. The person(s) at the site who runs the study there, they are often very busy enrolling subjects into the study and collecting study documents, making sure the PI has signed appropriate records, etc. Sometimes they are also involved in seeing subjects and directly generate source documents. They work with the monitor to make sure all the monitor's queries about the study documents are resolved.
Subjects—Participants in the study. Given clinical trials are medical research and not treatment, people enrolled in clinical trials at the sites are referred to as “Subjects” and not “Patients”.
IRB/Institutional Review Board—Each site either has a centralized or local ethics committee that reviews the Study Protocol and approves it before it can be put into practice at the Site(s) they represent. Their goal is to protect Subjects.
Study Protocol—The plan created by the Sponsor or CRO that outlines the study design, such as who should participate in the trial (inclusion and exclusion criteria) and the objective(s), design, methodology, statistical considerations, and organization of the trial.
Source Document(s)—Source documents may refer to original documents, data and records (including copies or transcriptions certified after verification as being accurate and complete, such as microfiches, photographic negatives, microfilm or magnetic media). Source documents may include hospital records; clinical and office charts; laboratory notes; memoranda; subjects' diaries of evaluation; checklists; pharmacy dispensing records; recorded data from automated instruments; x-ray films; participant/patient files; records kept at pharmacies, laboratories, and medico-technical departments involved in the clinical trial; papers, electronic records, and the like. They are the origin of data about the study.
Source Data—All information in original records and certified copies of original records of clinical findings, observations, or other activities (in a clinical investigation) used for the reconstruction and evaluation of the trial. Source data are contained in source documents (original records or certified copies).
Certified Copy—A copy (paper or electronic) of original information that has been verified, as indicated by a dated signature, as an exact copy, having all the same attributes and information as the original. Certified Copies are considered equivalent to Source Documents for the purpose of Source Data Verification.
Subject Binder—A subject binder may refer to a collection of source documents and other source data for an individual participant in a clinical trial (EMR & non-EMR source documents, such as questionnaires, external lab results, or research-related evaluations that may not be part of standard of care). A participant's subject binder may also contain other documents, such as checklists or worksheets, or participant informed consent forms or HIPAA authorizations for that participant. A site's set of records and Source Documents pertaining to a specific Subject for a specific Study. This is what monitors will access when they come on-site to do SDV. Today, often a physical 3-ring binder (or multiple binders).
Regulatory Binders—A site's set of records and the Study Protocol (and any revisions to that protocol) pertaining to a specific Study. Today, often a physical 3-ring binder (or multiple binders).
EHR/Electronic Health Record/EMR/Electronic Medical Record—An EHR system may refer to an electronic platform that contains individual electronic health records for patients and may be maintained by healthcare organizations and institutions. For example, a typical EHR system may include data corresponding to patients' medical history, diagnoses, treatment plans, immunization dates, allergies, radiology images, pharmacy records, and laboratory and test results. EHRs can be used by healthcare institutions to integrate real-time electronic healthcare information from medical devices and different health care providers involved in the care of patients. A site-specific system for patient records, owned by the Site. Sometimes, this data is pertinent to the study and included as Source Documents, however not all EHR data is applicable to the study and EHR access is tightly controlled. Also, as each site has their own EHR configuration, the data generated from one site's EHR is often inconsistent in structure with the data generated from another site's EHR. As a result of these issues, this data is today often printed and filed into a Subject Binder.
EDC/Electronic Data Capture—A study-specific system to house all Study data, owned and/or controlled by the study Sponsor or CRO. Study Coordinators transcribe data from Source Documents into the EDC, then Monitors check the EDC data against the Source Document Data in the process of SDV to ensure the accuracy of that transcription.
Optical character recognition/OCR—may refer to technology used to identify and/or convert images of typed, handwritten, printed text, and the like to machine-readable text.
Case Report Form/CRF—a printed, optical, or electronic document (sometimes referred to as an “eCRF” when electronic) designed to record protocol-related study data (also referred to as “clinical data”) to be reported to the sponsor on each trial subject. Simple versions of a CRF may consist of a spreadsheet or database. Study data in a CRF may be analyzed by the sponsor, sponsor representatives, and/or a regulatory agency (e.g. the United States Food and Drug Administration) to determine the efficacy and safety of the subject being evaluated during the clinical trial (such as a drug, device, or other investigational product or intervention being evaluated. Study data entered in a case report form may be transcribed, or interpreted, from source documents and source data gathered from evaluations or other interactions with study participants.
SDV/Source Data Verification—the monitoring process that a CRA performs to check that fields in the EDC match the original Source Documents stored in the Subject Binder.
Query—A query may refer to marking (or flagging) a data element, e.g. in a CRF, for notification and/or action, for example because the data element's value seems statistically unlikely (such as being outside of a predetermined reference range), is inconsistent with a corresponding source element value, does not make sense in the context of other data values (for example, a participant's cholesterol total having a value is less than the sum of the participant's LDL level and HDL level values). If a transcription error is found by a Monitor doing SDV, they query the originating site to correct. Monitors are never allowed to make corrections, only query the site for resolution.
Clinical Trial Overview
Clinical trials can vary in size and cost, and can involve multiple research centers spread across wide geographic areas working independently. A clinical trial may be sponsored by a governmental organization or a pharmaceutical, biotechnology or medical device company. Certain functions necessary to the clinical trial, such as monitoring and lab work, may be managed by a third party, such as a CRO or a central laboratory.
Clinical trials of new drugs, for example, may be administered by a CRO hired by the trial sponsor. The trial sponsor may provide the drug being tested as well as medical oversight, while the CRO is contracted to perform all the administrative work during a clinical trial. The CRO may recruit, train, and supply participating sites, coordinate study administration and data collection, monitor participating research centers for compliance with the clinical protocol, audit research data, and ensure the trial sponsor receives research data collected from the research center.
At a participating research site, one or more research personnel, e.g. a research coordinator (also referred to as a study coordinator), may do most of the work in conducting the clinical trial. The research coordinator's job may include some or all of the following: working with the research site's IRB to obtain initial and ongoing permission to conduct the trial; assisting with administrative matters relating to the trial, identifying eligible patients; attempting to obtain consent for the identified eligible patients to participate in the trial; administering study treatment(s) to participants in the trial; obtaining source documents and/or source data relating to the trial; transcribing data; filing and/or archiving patient source documents and data; maintaining and updating study records, the sponsor, and/or the CRO.
A single clinical trial may cost hundreds of millions of dollars and a significant portion (often over 20%) of the cost may be incurred by monitoring the trial. As used herein, “monitoring” refers to the process of overseeing the progress of a clinical trial to ensure that it is conducted, recorded, and reported in accordance with the research protocol, standard operating procedures (SOPs), good clinical practice (GCP) standards, any applicable regulatory requirement(s), and the like. Monitoring tasks may be performed by a study monitor (also referred to as a clinical monitor, a clinical research monitor, a clinical research associate, a study site monitor, and/or a quality specialist). A significant portion of effort and cost of monitoring a clinical trial may be spent having study monitors traveling to and from research sites in order to manually verify trial data obtained by an onsite study coordinator via the use of the aforementioned physical 3-ring subject binders.
A conventional manual workflow for clinical trial data collection and monitoring may include:
The detailed description that follows is represented largely in terms of processes and symbolic representations of operations by conventional computer components, including a processor, memory storage devices for the processor, connected display devices and input devices. Furthermore, these processes and operations may utilize conventional computer components in a heterogeneous distributed computing environment, including remote file servers, computer servers, and/or memory storage devices. Each of these conventional distributed computing components is accessible by the processor via a communication network, which may include, but is not limited to, the Internet.
The phrases “in one embodiment,” “in various embodiments,” “in some embodiments,” and the like are used repeatedly. Such phrases do not necessarily refer to the same embodiment. The terms “comprising,” “having,” and “including” are synonymous, unless the context dictates otherwise.
Various systems and methods embodying the present inventive concept are now described in detail with reference to the accompanying drawings. However, there is no intent to limit the scope of the inventive concept to the embodiments described herein. On the contrary, the intent is to provide a written description of embodiments that enable any person skilled in the art to make and use the described embodiments, as well as all alternatives, modifications, and equivalents encompassed by the inventive concept. The inventive concept underlying the present methods and systems relates to obtaining study data from source data or documents and the verification of transcribed study data against associated source data or documents, certain aspects of which are specifically defined by the Claims below. In various alternate embodiments, additional devices, may be added to, or combined with, the illustrated devices, and various illustrated devices may be combined into one or more other devices, without departing from the scope of the inventive concept.
Example Network Topology of an Exemplary Clinical Trial Data Acquisition and Quality Control Systems and Methods
The client/server-based research study data acquisition and quality control system illustrated in
As is explained in more detail below, each of research study coordinator client devices 200A-B may be in the possession of and operated by a research coordinator (not shown) who may be an employee of a research site or facility (not shown) participating in a study conducted by the research study sponsor entity and/or CRO. Similarly, each of study monitor client devices 400A-B may in the possession of, and operated by, a clinical research assistant (“CRA”) (not shown) who may be an employee of the research study sponsor entity and/or CRO.
In these and other embodiments, a research coordinator client device 200, such as research coordinator client devices 200A-B, and/or a study monitor client device 300, such as study monitor client devices 300A-B, may be computing devices having form factors including general-purpose computers (including “desktop,” “laptop,” “notebook,” “tablet” computers, or the like); mobile phones; wearable computing devices (including watches, glasses, or the like); or the like. For simplified exemplary purposes, research study coordinator client devices 200A-B are depicted as having the form factor of laptop computers. The primary functional components of an exemplary, form-factor-independent research coordinator client device 200 are described below in reference to
In various embodiments, front-end server 400A and trial data processing server 1300 (as well as research study sponsor server 110) may be networked computing devices generally capable of accepting requests over network 103, e.g. from research coordinator client device 200, each other, various databases, and/or other networked computing devices (not shown), and providing responses accordingly. The primary functional components of an exemplary server 400, such as front-end server 400A, are described below in reference to
For the purposes of the present example, two research coordinator client devices 200 and two study monitor client devices 300 are shown, i.e. research coordinator client devices 200A-B and study monitor client devices 300A-B. In other embodiments, there may be many more research coordinator devices 200 and/or study monitor client devices 300.
Additionally, a research site EHR server 115, study monitor client devices 300A-B, front-end server 400A, and trial data processing server 1300 may be in data communication with network 103. An EHR database 118 may be in data communication with research site EHR server 115.
EHR server 115 and EHR database 118 may be operated in support of an EHR system (not shown). In various embodiments, the EHR system may be operated by a research site or may be operated independently of the research site. In various embodiments, EHR database 118 may contain source data for a clinical trial. EHR server 115 may provide the source data to trial data processing server 1300.
In various embodiments, a EHR server 115 may be a networked computing device generally capable of accepting requests over network 103, e.g. from trial data processing server 1300 and/or other networked computing devices (not shown), and providing responses accordingly.
Exemplary Research Coordinator Client Device
Referring to
As shown in
Research coordinator client device 200 may also include a network interface 210 for connecting to a network such as network 103, one or more optional user input device(s) 213, e.g. an alphanumeric keyboard, keypad, a mouse or other pointing device, a touchscreen, and/or a microphone, (or a user input port for connecting an external user input device), an optional display 215 (or a display port for connecting an external display device), an optional optical scanner 218 (or an accessory port for connecting an external optical scanner), an optional global-positioning-system (“GPS”) unit 220 (or an accessory port for connecting an external GPS device), and the like, all interconnected along with the network interface 210 via bus 208.
Memory 205 of exemplary research coordinator client device 200 may store program code, executable by central processing unit 203, corresponding to an operating system 223, as well as program code corresponding to various software applications, such as a browser application 225, a research study data acquisition and quality control application 228, and other software applications (not shown). Operating system 223 and various software applications may be loaded into memory 205 via network interface 210 or via a computer-readable storage medium 230, such as a hard-disk drive, a solid-state drive, an optical disc, a removable memory card, and/or the like.
Browser application 225 is a software application for retrieving, presenting, and traversing information resources on a network, such as network 103. Although browser application 225 may be primarily intended to use the World Wide Web, it may also be used to access information resources provided by remote servers in private networks. An information resource may be a web page, an image, a video, a document, or other piece of content and may be identified by a Uniform Resource Identifier (URI/URL) on network 103. An information resource may also provide browser application 225 executable program code for web applications, i.e. a software application that runs in and is rendered by browser application 225.
In operation, operating system 223 manages the hardware and software resources of research coordinator client device 200 and provides common services and memory allocation for various software applications, such as research study data acquisition and quality control application 228. For hardware functions such as network communications via network interface 210, receiving data via input 213, outputting data via optional display 215, and allocation of memory 205 for various software applications, such as research study data acquisition and quality control application 228, operating system 223 acts as an intermediary between software executing on the client device and the device's hardware.
For example, operating system 223 may cause a representation of available software applications, such as browser application 225 and research study data acquisition and quality control application 228, to be presented to a user of research coordinator client device 200 via display 215. If research coordinator client device 200 obtains an indication from a user, e.g. via user input 213, a desire to use research study data acquisition and quality control application 228, operating system 223 may instantiate a research study data acquisition and quality control application process (not shown), i.e. cause central processing unit 203 to begin executing the executable instructions of the research coordinator application and allocate a portion of memory 205 for its use.
In the case of a web application, browser application 225 may act as an intermediary between a software service operating on a remote server and the operating system 223. For example, a software service equivalent of research study data acquisition and quality control application 228 may be executing on front-end server 400A.
Although an exemplary research coordinator client device 200 has been described with hardware components that generally conforms to conventional general-purpose computing devices, a research coordinator client device may be any of a substantial number of devices capable of communicating with network 103 and executing instructions for performing research study data acquisition and quality control application 228.
Exemplary Study Monitor Client Device
Referring to
Central processing unit 303 is an electronic circuit designed to carry out instructions of a computer program, e.g. obtained from memory 305, by performing the basic arithmetic, logical, control and input/output (I/O) operations specified by the program's instructions. Memory 305 generally comprises some or all of random access memory (RAM), read-only memory (ROM), and/or a permanent mass storage device, such as a disk drive, flash memory, or the like. Bus 308 is a communication system that transfers data between components within study monitor client device 300, and encompasses any related hardware components (wire, optical fiber, etc.) and software, including communication protocols.
Study monitor client device 300 may also include a network interface 310 for connecting to a network such as network 103, one or more optional user input device(s) 313, e.g. an alphanumeric keyboard, keypad, a mouse or other pointing device, a touchscreen, and/or a microphone (or a user input port for connecting an external user input device), an optional display 315 (or a display-port for connecting an external display device), and the like, all interconnected along with the network interface 310 via bus 308.
Memory 305 of study monitor client device 300 may store program code, executable by central processing unit 303, corresponding to an operating system 320, as well as program code corresponding to various software applications, such as a browser application 323, research study data access application 325, and the like. Operating system 320 and various software applications, such as research study data access application 325, may be loaded into memory 305 via network interface 310 or via a computer-readable storage medium 330, such as a hard-disk drive, a solid-state drive, an optical disc, a removable memory card, and/or the like.
In operation, operating system 320 manages the hardware and software resources of study monitor client device 300 and provides common services and memory allocation for various software applications, such as research study data access application 325. For hardware functions such as network communications via network interface 310, receiving data via input 313, outputting data via optional display 315, and allocation of memory 305 for various software applications, such as research study data access application 325, operating system 320 acts as an intermediary between software executing on the study monitor client device and the device's hardware. For example, operating system 320 may cause a representation of available software applications, such as browser application 323 and research study data access application 325, to be presented to a user of client device 300 via display 315. If study monitor client device 300 obtains an indication from a user, e.g. via user input 313, a desire to use research study data access application 325, operating system 320 may instantiate a research study data access application process (not shown), i.e. cause central processing unit 303 to begin executing the executable instructions of the browser application and allocate a portion of memory 305 for its use.
Browser application 323 may be similar to browser application 225, described above. In the case of a web application, browser application 323 may act as an intermediary between a software service operating on a remote server and the operating system 320. For example, a software service equivalent of research study data access 325 may be executing on front-end server 400A.
Although an exemplary remote event/venue client device 300 has been described that generally conforms to conventional general-purpose computing devices, a remote event/venue client device may be any of a substantial number of devices capable of communicating with network 103 and executing instructions for performing browser application 323.
Exemplary Server
Referring now to
Central processing unit 403 is an electronic circuit designed to carry out instructions of a computer program, e.g. obtained from memory 405, by performing the basic arithmetic, logical, control and input/output (I/O) operations specified by the program's instructions. Memory 405 may generally include some or all of random access memory (RAM), read-only memory (ROM), and/or a permanent mass storage device, such as a disk drive, flash memory, or the like. Bus 408 is communication system that transfers data between components within exemplary server 400, and includes any related hardware components (wire, optical fiber, etc.) and software, including communication protocols.
Server 400 may also include a network interface 410 for connecting to a network such as network 103, one or more optional user input device(s) 413, e.g. an alphanumeric keyboard, keypad, a mouse or other pointing device, a touchscreen, and/or a microphone (or a user input port for connecting an external user input device), and/or an optional display 415 (or a display port for connecting an external display device), both interconnected along with the network interface 410 via bus 408.
Memory 405 may store an operating system 420 and program code for various software services 423. For example, front-end server 400A may include executable instructions for performing user session management service 423A (indicated by dotted lines) and trial data processing server 1300 may include executable instructions for performing trial data processing service 1323.
Program code for these and other such software services, such as a software services (not shown) equivalent to research study data acquisition and quality control application 228 or research study data access application 325, may be loaded into memory 405 from a non-transient computer-readable storage medium 430 using a drive mechanism (not shown) associated with the non-transient computer-readable storage medium, such as, but not limited to, a DVD/CD-ROM drive, memory card, or the like. Software components may also be loaded into memory 404 via the network interface 410. A server 400 may also communicate via bus 408 with a database (not shown), such as admin database 105 and/or trial data database 125, or other local or remote data store.
Although an exemplary server 400 has been described having hardware components that generally conform to a conventional general-purpose computing device, a server may be any of a substantial number of devices capable of communicating with network 103 and executing instructions for performing user session management service 423A and/or trial data processing service 1323.
Referring now to
Central processing unit 1303 is an electronic circuit designed to carry out instructions of a computer program, e.g. obtained from memory 1305, by performing the basic arithmetic, logical, control and input/output (I/O) operations specified by the program's instructions. Memory 1305 may generally include some or all of random access memory (RAM), read-only memory (ROM), and/or a permanent mass storage device, such as a disk drive, flash memory, or the like. Bus 1308 is communication system that transfers data between components within exemplary server 1300, and includes any related hardware components (wire, optical fiber, etc.) and software, including communication protocols.
Trial data processing server 1300 may also include a network interface 1310 for connecting to a network such as network 103, one or more optional user input device(s) 1313, e.g. an alphanumeric keyboard, keypad, a mouse or other pointing device, a touchscreen, and/or a microphone, (or a user input port for connecting an external user input device) and/or an optional display 1315 (or a display port for connecting an external display device), both interconnected along with the network interface 1310 via bus 1308.
Memory 1305 may store an operating system 1320 and program code for various software services and data storage. For example, trial data processing server 1300 may include executable instructions for performing trial data processing service 1323.
In one example embodiment, the trial data database 125 includes remotely accessible digital “binder” information for source data. The trial data database 125 would contain all of the source data for each participant in a clinical trial as well as relevant pieces of metadata (e.g.: tags, notes, and the like) that explain the participant's association with the trial. Some of the data that would be considered part of the subject binder can include, but are not limited to, the following:
Trial data processing server 1300 would store the source data from the subject binder in a universally accessible location. As long as a user has credentials to access the trial data processing server 1300 and an internet connection, he or she can access the data in the subject binder from anywhere in the world.
In some embodiments, access to source data is restricted via business roles of users. In a physical setting, a research coordinator who had access to a physical subject binder for a particular participant would have access to all of the participant's data unless another person managing the trial manually sorted through the files first. In trial data processing server 1300, the research coordinators can be configured with a specific level of authorization, ensuring that the research coordinate can only view (and edit, when appropriate) source or clinical data which he or she has been granted access.
Program code for these and other such software services, such as a software services (not shown) equivalent to research study data acquisition and quality control application 228 or research study data access application 325, may be loaded into memory 1305 from a non-transient computer-readable storage medium 1330 using a drive mechanism (not shown) associated with the non-transient computer-readable storage medium, such as, but not limited to, a DVD/CD-ROM drive, memory card, or the like. Software components may also be loaded into memory 13013 via the network interface 1310. A server 1300 may also communicate via bus 1308 with a remote database (not shown), or other local or remote data store.
Although an exemplary server 400 has been described having hardware components that generally conform to a conventional general-purpose computing device, a server may be any of a substantial number of devices capable of communicating with network 103 and executing instructions for performing user session management service 423A and/or trial data processing service 1323.
In some embodiments, a server 400 may comprise one or more replicated and/or distributed physical or logical devices. In some embodiments, one or more of front-end server 400A and trial data processing server 1300 may be embodied by the same physical device.
Research Study Data Acquisition via the Present Systems and Methods
Referring generally to
In accordance with certain aspects of the present methods and systems, after identifying a source document, such as a medical record, patient intake form, questionnaire, or the like (in paper, digital, or other form), containing data relevant to a particular research study/clinical trial (“study data”), a research coordinator may transcribe the study data from the source document to a case report form specific to the research study.
In some embodiments, research study data acquisition and quality control application 228 may provide a user interface via display 215 having options for selectively (i) identifying a particular research study/clinical trial to associate with provided study data, (ii) identifying and accessing source data files containing study data stored locally on research coordinator client device 200, such as in memory 205 or in computer-readable storage medium 230, or stored remotely via network interface 210 and/or (iii) manually entering study data via user input 213. Research study data acquisition and quality control application 228 may further, e.g. upon selection of a particular research study/clinical trial and a source document, e.g. via user input 213, provide a digital copy of the selected source data file and a case report form associated with the selected research study/clinical trial, e.g. via display 215.
Upon selection of a source document, e.g. via user input 213, research study data acquisition and quality control application 228 may access the file, analyze the file, and attempt to identify and extract the relevant study data without additional input from the research coordinator. If research study data acquisition and quality control application 228 is unable to successfully identify and extract the relevant study data, additional input from the research coordinator may be obtained. For example, research study data acquisition and quality control application 228 may cause a representation of the file and an editable study data form to be displayed via display 215. The research coordinator may then manually copy the relevant study data from the representation of the file to the fillable study data form, e.g. via user input 213. If research study data acquisition and quality control application 228 is able to successfully identify and extract the relevant study data, the research study data acquisition and quality control application may still cause a representation of the file and an editable study data form to be displayed via display 215, thereby allowing the research coordinator to selectively validate the research study data identified and extracted by research study data acquisition and quality control application 228.
Research study data acquisition and quality control application 228 may interact with an EMR application (not shown), e.g. operating on 200 or another device in data communication with 200 via network 103, to obtain source documents. For example, research study data acquisition and quality control application 228 may present a list or directory of medical records stored in files accessible through the EMR application to the research coordinator via display 215 and the research coordinator may selectively indicate which medical records contain the desired study data, e.g. via user input 213. As above, research study data acquisition and quality control application 228 may then access the corresponding file, analyze the file, and attempt to identify and extract the relevant study data without additional input from the research coordinator. If research study data acquisition and quality control application 228 is unable to successfully identify and extract the relevant study data, additional input from the research coordinator may be obtained. For example, research study data acquisition and quality control application 228 may cause a representation of the file and an editable study data form to be displayed via display 215. The research coordinator may then manually copy the relevant study data from the representation of the file to the fillable study data form, e.g. via user input 213. If research study data acquisition and quality control application 228 is able to successfully identify and extract the relevant study data, the research study data acquisition and quality control application may still cause a representation of the file and an editable study data form to be displayed via display 215, thereby allowing the research coordinator to selectively check the study data identified and extracted by research study data acquisition and quality control application 228 for accuracy.
In accordance with certain embodiments, research study data acquisition and quality control application 228 may compare the source document to one or more predefined source document templates and provide mapping data indicating where in the source document the research study data acquisition and quality control application expects to find study data, e.g. via an overlay on the copy of the selected source data file being displayed or via providing a cropped image of that area. A research coordinator may then utilize the mapping coordinates to locate and identify the relevant study data from the copy of the source document and manually transcribe the source data into the case report form, or verify that the data already transcribed is correct or determine that the transcribed data is incorrect.
In accordance with other embodiments, research study data acquisition and quality control application 228 may compare the copy of the source document to predefined document templates to identify expected location of study data in the source document using predefined document templates, extract potential study data from the identified locations, and automatically transcribe the potential study data into the case report form. A research coordinator may then manually review the case report form to ensure the potential study data is actually study data and accurately reflects the data contained in the source document and edit the case report form, if necessary.
In accordance with other embodiments, research study data acquisition and quality control application 228 may analyze a plurality of source documents to identify potential study data without the use of predefined document templates, extract the potential study data, transcribe the potential study data to a case report form, analyze the potential study data for indications of invalidity (e.g. corrupted, fraudulent, or incorrectly identified data), and flag such indications, if any, for manual review by a research coordinator.
In conjunction with obtaining study data, such as in one or more of the manners described above, additional study metadata may be obtained and associated with the study data, such as an identifier associated with the research coordinator (an “RSC identifier”), an identifier associated the research site (a “site identifier”), the research study (a “study identifier”), the time and date the study data was initially recorded (“a data-recorded timestamp”), the time and date the data was obtained by research study data acquisition and quality control application 228 (a “data-entered timestamp”), an indication whether the underlying source of the study data (e.g. a case report form) was manually reviewed by a research coordinator (a “manual review flag”), an indication of how much time was spent manually reviewing the source of the study data (a “manual review value”), and/or the like. Research study data acquisition and quality control application 228 may then cause the study data, a copy of the underlying source of the study data (e.g. a digital copy of a case report form), and the associated metadata to be provided to trial data processing service 1323, for example via exemplary series of communications 500, described below in reference to
In accordance with other aspects of some embodiments, trial data processing service 1323 may, upon obtaining new study data and associated metadata, e.g. from an instantiation of research study data acquisition and quality control application 228, as described above: (i) determine which research study the data is associated with, e.g. via a study identifier provided with the study data; (ii) access research study records associated with the study identifier, e.g. stored in trial data database 125; (iii) validate the newly obtained research study data (e.g., via a case record validation routine 700 illustrated in
Trial data processing service 1323 may provide study data updates to instantiations of research study data access application 325, e.g. operating on a study monitor client device 300, such as study monitor client device 300A-B. Such study data updates may be provided responsively upon request from research study data access application 325 and/or automatically at certain time intervals or when new study data is obtained by trial data processing service 1323. For example, the study data records associated with a particular study identifier may contain one or more associated study monitor identifiers, corresponding to study monitors assigned to the research study associated with the study identifier, and associated contact information (such as an email address). When a study monitor access research study data access application 325, research study data access application 325 may provide a notification to trial data processing service 1323, the notification including the monitor identifier associated with the study monitor. trial data processing service 1323 may then determine if an update should be provided, e.g. by looking up trial identifiers associated with the monitor identifier and searching for updated study data associated with the trial identifier that has been provided since the most recent update associated with the monitor identifier, and proceed accordingly. Such study data updates may include specific study data, associated metadata, cumulative summaries of study data, and/or links (e.g. URIs) to network locations where such specific study data and/or cumulative summaries may be accessed.
Research Study Data Quality Control via the Present Systems and Methods
Still referring generally to
In certain embodiments, trial data processing service 1323 may analyze source documents, identify potential trial data within the source document, analyze the potential trial data, compare the potential trial data to the corresponding trial data contained in the associated case report form, and calculate a transcription confidence level representing an assessment of the accuracy of the trial data with respect to the underlying source data. If the transcription confidence level is below a pre-defined threshold value, e.g. less than 97%, or if the transcription is selected as part of a random sample, the trial data processing service 1323 may flag the trial data for manual validation, e.g. by a study monitor. If the transcription confidence level is above the pre-defined threshold value, or not selected as part of a sample, the trial data processing service 1323 may proceed with automated validation, the system will be allowed to validate the data on behalf of the end user.
For example, research study records associated with a particular trial identifier may include predetermined data ranges for study data. Upon obtaining new study data, trial data processing service 1323 may compare the obtained study data to the predetermined data ranges for the study data and, if the study data is outside the predetermined data range, the trial data processing service may flag the study data for further follow up/investigation.
Manual review of such flagged study data may reveal an error in the original data collection process (e.g. a transcription or OCR error between the original medical record and the case report form), an error in the data acquisition process (e.g. a transcription or OCR error between the case report form and the study data provided to trial data processing service 1323), or a data outlier (e.g. the study data is accurate but outside the predetermined range). In the latter case, the result of the manual review of the study data may override the automated validation result. In the former cases, a notification may be provided to the research coordinator responsible for the flagged study data so the flagged study data may be updated and re-validated.
In accordance with certain aspects of some embodiments, the study monitor may cause research study data access application 325 to obtain study data updates relating to research study data associated with one or more research studies/clinical trials. As noted above, such study data updates may include specific study data, associated metadata, cumulative summaries of study data, and/or links (e.g. URIs) to network locations where such specific study data and/or cumulative summaries may be accessed. For example, research study data access application 325 may provide a user interface via display 315 having options for selectively identifying and accessing research study records, e.g. stored in trial data database 125, associated with a particular study identifier. Upon selection of one or more research study records, either through manual selection by the study monitor via user input 313 or automatic selection by research study data access application 325 or trial data processing service 1323, research study data access application 325 and trial data processing service 1323 may cooperatively cause a selection of the study data associated with the trial identifier as well as a copy of the underlying source data to be presented via display 315. The study monitor may then selectively provide an indication of whether the study data accurately reflects the underlying source data. If the study monitor determines the study data does not accurately reflect the underlying source data, research study data access application 325 may provide options for flagging the discrepancy for investigation. Trial data processing service 1323 may then prepare a validation-fail notification and provide the validation-fail notification to the research coordinator associated with the study data.
First Exemplary Series of Communications
Study monitor client device 200A may obtain 503 clinical trial data, e.g. via user input 213 in response to a prompt provided via display 215.
Study monitor client device 200A may provide front-end server 400A with a corresponding update clinical trial data request 505. Update clinical trial data request 505 may include user identifying information corresponding to a user of study monitor client device 200A (a monitor identifier), e.g. via an alphanumeric identifier associated with a site monitor; identifying information corresponding to a particular clinical trial (a trial identifier); a current location of study monitor client device 200A; clinical trial data, metadata; and the like.
Front-end server 400A may process 508 update clinical trial data request 505. For example, front-end server 400A may obtain additional metadata relating to the trial identifier from admin database 105 and/or other sources.
Front-end server 400A may provide trial data processing server 1300 with a corresponding internal clinical trial update request 510. Internal clinical trial data update request 510 may include data obtained from study monitor client device 200A via update clinical trial data request 505 and via processing 508 the update clinical trial data request by front-end server 400A.
Trial data processing server 1300 may process 513 internal clinical trial data update request 510. For example, trial data processing server 1300 may validate study data obtained from study monitor client device 200A, identify and flag questionable data, and update related clinical trial data records, e.g. in trial data database 125.
Trial data processing server 1300 may then provide an internal clinical trial data update response 515 to front-end server 400A.
Front-end server 400A may then process 518 internal clinical trial data update response 515, e.g. by determining which research coordinator client device (see
Front-end server 400A may then provide an update clinical trial data response 520 to study monitor client device 200A. Update clinical trial data response 520 may include queries corresponding to flagged data points, confirmation of the successful upload of the trial data contained in update clinical trial data request 505, error messages, and/or the like.
Study monitor client device 200A may then process 523 update clinical trial data response 520, for example by rendering information provided in the update clinical trial data response via display 215.
Second Exemplary Series of Communications
Research coordinator client device 300A may process 603 an external request for a status update on a clinical trial, e.g. obtained via user input 313 in response to a prompt provided via display 315.
Research coordinator client device 300A may provide front-end server 400A with a corresponding clinical trial status request 608. Clinical trial status request 608 may include user identifying information corresponding to a user of research coordinator client device 300A (a coordinator identifier), e.g. via an alphanumeric identifier associated with a research coordinator; identifying information corresponding to a particular clinical trial (a trial identifier); and the like.
Front-end server 400A may process 610 clinical trial status request 608. For example, front-end server 400A may obtain metadata relating to clinical trial status request 608 from admin database.
Front-end server 400A may provide trial data processing server 1300 with a corresponding internal clinical trial status request 613. Internal clinical trial status request 613 may include data obtained from research coordinator client device 300A via clinical trial update request 608 and via processing 610 the clinical trial update request by front-end server 400A.
Trial data processing server 1300 may process 615 internal clinical trial status request 613 and provide trial status summary data, and/or the like.
Trial data processing server 1300 may then provide an internal clinical trial status response 618 to front-end server 400A, e.g. including the trial status summary data.
Front-end server 400A may process 620 internal clinical trial status response 618. For example, front-end server 400A reformat the trial status summary data based on preference data associated with the coordinator identifier provided in clinical trial status request 608.
Front-end server 400A may then provide a clinical trial status response 623 to research coordinator client device 300A, e.g. including the formatted trial status summary data.
Research study coordinator client device 300A may then process 625 clinical trial status response 623, for example by rendering the trial status summary data via display 215.
In order for the trial data processing server 1300 to assist monitors in reviewing case record files, the case record files are automatically compared to research study source data. In one embodiment, the source data (or possible certified copies of the source data) is converted into a machine-readable format (e.g., via voice recognition, optical character recognition, EHR ingestion, and the like).
While automatic case record validation routine 700 is shown flagging case record values as valid/invalid or out-of-bounds, many more possible flags or metatags may be applied in alternate embodiments. For example, a monitor may request that certain value ranges for particular types of source data values be flagged as “of interest” or “clinically significant” to thereby speed the review of the case records while the monitor may be engaged with reviewing other materials, sites, and/or subjects.
When a monitor is reviewing case records for accuracy and information of interest, it behooves them to have the more relevant case record data values prioritized for review. And if inaccuracies are found, having the ability to query for updates to the case record data value(s) and/or source data values because monitors do not have permission to modify case record data values or source data values themselves.
By allowing the monitor to quickly focus on the case record data values that have been automatically identified as mismatched and/or of interest, the monitor is able to quickly determine which queries are necessary.
In some embodiments, the monitor may be presented with and/or control a confidence level that they wish to apply to automatically identified mismatches and/or items of interest. For example, if an OCR scan of a source data returns a confidence value of the OCR operation, the monitor may choose to only see OCR value within a certain confidence value range.
In block 913 the source data field's source data value is compared to the case record data field' case record data value. Next, in decision block 915, if a determination is made that the source data value does not correspond to the case record data value, unmatched result is the returned in return block 989. On the other hand, if the source data value and the case record data value correspond, then a determination is made in decision block 920 if the source data value falls within a potentially clinically significant range. If the source value falls within the potentially clinically significant range, then in block 925 the case record (and possibly the case record data value) is tagged as potentially clinically significant and processing continues to block 930. If, in decision block 920 the source data value is determined not to be within a potentially clinically significant range processing continues to decision block 930 where determination is made whether the source data value is outside and predetermined bounds. If the source data value is outside of predetermined bounds then processing continues to return block 994 where a value of outside predetermined bounds is returned. Ultimately, if in decision block 930 it is determined that the source data value is not outside a predetermined range then processing proceeds to return block 999 where is a validated result is returned.
While an example case record field and/or case record value validation subroutine has been shown with example tests, other tests/validations/comparisons/reviews options may be present in other embodiments. For example, in some embodiments, there may be statistical testing for fraudulent or fabricated data.
Although specific embodiments have been illustrated and described herein, it will be appreciated by those of ordinary skill in the art that alternate and/or equivalent implementations may be substituted for the specific embodiments shown and described without departing from the scope of the present disclosure. For example, in some embodiments, instead of or in addition to the assisted data verification routine process described in verification routine 700 (see
This application is related to, and claims the benefit of, U.S. Provisional Patent Application 62/344,355, entitled “Client/Server-Based Research Study Data Acquisition and Quality Control Systems and Methods” and filed on Jun. 1, 2016 under Attorney Docket No. INVI-2016001Z, the entire disclosure of which, including the Appendices, is hereby incorporated by reference for all purposes. This application is related to, and claims the benefit of, U.S. Provisional Patent Application 62/360,032, entitled “Client/Server-Based Research Study Data Acquisition and Quality Control Systems and Methods” and filed on Jul. 8, 2016 under Attorney Docket No. INVI-2016001Z2, the entire disclosure of which, including the Appendices, is hereby incorporated by reference for all purposes.
Number | Date | Country | |
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62360032 | Jul 2016 | US | |
62344335 | Jun 2016 | US |