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Harnessing the Power of Quality Assurance Data: Can We Use Statistical Modeling for Quality Risk Assessment of Clinical Trials?

ABSTRACT: BACKGROUND:The increasing number of clinical trials and their complexity make it challenging to detect and identify clinical quality issues timely. Despite extensive sponsor audit programs and monitoring activities, issues related to data integrity, safety, sponsor oversight and patient consent have recurring audit and inspection findings. Recent developments in data management and IT systems allow statistical modeling to provide insights to clinical Quality Assurance (QA) professionals to help mitigate some of the key clinical quality issues more holistically and efficiently. METHODS:We used findings from a curated data set from Roche/Genentech operational and quality assurance study data, covering a span of 8 years (2011-2018) and grouped them into 5 clinical impact factor categories, for which we modeled the risk with a logistic regression using hand crafted features. RESULTS:We were able to train 5 interpretable, cross-validated models with several distinguished risk factors, many of which confirmed field observations of our quality professionals. Our models were able to reliably predict a decrease in risk by 12-44%, with 2-8 coefficients each, despite a low signal-to-noise ratio in our data set. CONCLUSION:We proposed a modeling strategy that could provide insights to clinical QA professionals to help them mitigate key clinical quality issues (e.g., safety, consent, data integrity) in a more sustained data-driven way, thus turning the traditional reactive approach to a more proactive monitoring and alerting approach. Also, we are calling for cross-sponsors collaborations and data sharing to improve and further validate the use of statistical models in clinical QA.

SUBMITTER: Koneswarakantha B

PROVIDER: S-EPMC7458946 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature

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Harnessing the Power of Quality Assurance Data: Can We Use Statistical Modeling for Quality Risk Assessment of Clinical Trials?

Koneswarakantha Björn B Ménard Timothé T Rolo Donato D Barmaz Yves Y Bowling Rich R

Therapeutic innovation & regulatory science 20200330 5

<h4>Background</h4>The increasing number of clinical trials and their complexity make it challenging to detect and identify clinical quality issues timely. Despite extensive sponsor audit programs and monitoring activities, issues related to data integrity, safety, sponsor oversight and patient consent have recurring audit and inspection findings. Recent developments in data management and IT systems allow statistical modeling to provide insights to clinical Quality Assurance (QA) professionals ...[more]

PMID: 32865805

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Project description:INTRODUCTION:Adverse event (AE) under-reporting has been a recurrent issue raised during health authorities Good Clinical Practices (GCP) inspections and audits. Moreover, safety under-reporting poses a risk to patient safety and data integrity. The current clinical Quality Assurance (QA) practices used to detect AE under-reporting rely heavily on investigator site and study audits. Yet several sponsors and institutions have had repeated findings related to safety reporting, and this has led to delays in regulatory submissions. Recent developments in data management and IT systems allow data scientists to apply techniques such as machine learning to detect AE under-reporting in an automated fashion. OBJECTIVE:In this project, we developed a predictive model that enables Roche/Genentech Quality Program Leads oversight of AE reporting at the program, study, site, and patient level. This project was part of a broader effort at Roche/Genentech Product Development Quality to apply advanced analytics to augment and complement traditional clinical QA approaches. METHOD:We used a curated data set from 104 completed Roche/Genentech sponsored clinical studies to train a machine learning model to predict the expected number of AEs. Our final model used 54 features built on patient (e.g., demographics, vitals) and study attributes (e.g., molecule class, disease area). RESULTS:In order to evaluate model performance, we tested how well it would detect simulated test cases based on data not used for model training. For relevant simulation scenarios of 25%, 50%, and 75% under-reporting on the site level, our model scored an area under the curve (AUC) of the receiver operating characteristic (ROC) curve of 0.62, 0.79, and 0.92, respectively. CONCLUSION:The model has been deployed to evaluate safety reporting performance in a set of ongoing studies in the form of a QA/dashboard cockpit available to Roche Quality Program Leads. Applicability and production performance will be assessed over the next 12-24 months in which we will develop a validation strategy to fully integrate our model into Roche QA processes.

Dataset Information

Harnessing the Power of Quality Assurance Data: Can We Use Statistical Modeling for Quality Risk Assessment of Clinical Trials?

Publications

Harnessing the Power of Quality Assurance Data: Can We Use Statistical Modeling for Quality Risk Assessment of Clinical Trials?

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