Patient Participation in Clinical Trials Infographic

Venu Mallarapu:

Another “Eye Opener” of an infographic from Lily COI team. The data presented seems to indicate that 10% of the patients do not participate in the clinical trials. If only they saw the infographic published by this team in Decemeber that the patients on Placebo will also receieve the standard treatment, could they be swayed to join the trial? Interesting question, Isn’t it?

Originally posted on lillycoi:

In December, we published our first infographic. Our goal was to start a discussion around the question: “How often do patients receive placebos in cancer clinical trials?” After digging into the data from cancer trials registered on ClinicalTrials.gov, we found less than a 1 percent chance of a patient receiving a placebo alone on a cancer study. The majority of placebo-based trials adminster the placebo along with standard of care treatments. 

We received some great constructive feedback on the graphic from the patient advocacy and clinical research communities through our blog and Twitter. We appreciate those who asked clarifying questions and gave us suggestions for future infographics. Armed with their input, we went to work on our second infographic.

ppct-1 (2)

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Placebos in Cancer Clinical Research: An Infographic

Venu Mallarapu:

While Placebos have been in use in Clinical Trials for a long time, I always wondered about the fate of patients who would receive a Placebo rather than the actual drug. This Inforgraphic by Lilly COI team provided an insight into Cancer Clinical Research and the use of Placebos. Thought I’d share it. Personally, I feel we ought to leverage newer technology like Human Genomes and perform more targeted research to not only reduce the cost of clinical research but more importantly reduce the impact of a critically ill patient receiving a Placebo instead of teh actual treatment.

Originally posted on lillycoi:

Back in September, we spent some time looking into the overall use of infographics in the clinical research space for a blog post titled, “Using Infographics to Increase Understanding of Clinical Trials.” What we learned is that there is  a real opportunity to create more infographics that present information about clinical trials in a way that’s clear, concise and visually-appealing, and that helps answer some of patients’ most frequently asked questions.

So, we decided to take a stab at putting together an infographic of our own. The question we set out to answer: “How often do patients receive placebos in cancer clinical trials?”

lilly, placebo, clinical trials, cancer, infographic, medical research

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2013 in review

The WordPress.com stats helper monkeys prepared a 2013 annual report for this blog.

Here’s an excerpt:

A New York City subway train holds 1,200 people. This blog was viewed about 4,300 times in 2013. If it were a NYC subway train, it would take about 4 trips to carry that many people.

Click here to see the complete report.

Transition to Oracle Argus Safety – Key Considerations – Part 2

In my previous post titled “Transition to Oracle Argus Safety – Key Considerations – Part 1” I summarized the key considerations for Transition to Oracle Argus Safety. The Infographic included in the previous post, summarizes the considerations across the Business Process, Business Support and Application Support areas.

In this post, I will outline the considerations in Single Case Handling. This is one of the most resource intensive and critical functions of a safety organization. This is one function that cannot be interrupted, despite transition to a new tool/system, as it his many implications on the sponsor organization as well as on the patients.

  • Business Process Services:
    • Process Optimization: This is one of the aspects of the safety organization that will be impacted immediately. The business teams processing the cases would have reached their peak performance within the current environment.       Introducing Argus will impact the team as they have to learn new tool and also readjust to a process that most likely was reengineered
    • Case Receipt Automation: Many organizations would have automated the Case Intake process. The process of automation and any tools associated with it would have to be reengineered to leverage Argus’ Intake capabilities instead
    • QA, Metrics & Best Practices: The quality assurance of the single case processing, the performance metrics associated with it and the best practices established over the course of time will all be impacted and probably take a dip with the introduction of Argus. This has to do more with the change in itself rather than the functions/features/capabilities       of Argus tool
  • Business Support:
    • Access Management: The users need to be configured in the new system. Also, if any new users are being on boarded as part of consolidation then this will have to be accounted part as part of access management
    • Partner Support: The Safety organization will have established relationships with CRO partners. These partners need to be supported during the transition. This might also mean reengineering some of the Intake processes, tools and systems. If Argus Affiliate module is being leveraged for capturing AEs from the affiliates, this could add additional entity to the support organization from a configuration as well as help desk support perspective.
    • Report Distribution: The established channels of distribution of expedited reports to regulators will be impacted with the introduction of Argus. This might mean retesting any electronic E2B report submission channels. The review, approval and submission of reports may need to be configured using Argus and Argus Interchange modules.
  • Application Support:
    • Workflow Configuration: The Case Processing workflow need to be reconfigured. For large organizations this is usually a complex task as the automated routing of cases to the right groups/personnel is key to efficient processing. If a global consolidation is undertaken as part of the transition, this task would become even more complex.
    • E2B and Reconciliation: The established process and tools for collection and/or distribution of safety data/reports to/from partners should be reengineered with the inroduction of Argus. Also, the safety case reconsiliation that happens between the clinical and safety systems will be impacted and should be reengineered and automated to account for changes due to Argus
    • Distribution:  As mentioned in the Business Support, the reporting process will be reconfigured, which will necessitate a reengineering of distribution process.

In the next part, we will look at additional considerations from an Aggregate Reporting perspective.

Transition to Oracle Argus Safety – Key Considerations – Part 1

In the last three years, I have seen a lot of customers migrating, upgrading or switching to Oracle Argus Safety. In this context I thought I will share my 2 cents about some of the key considerations for the teams driving the transition.

Oracle’s Argus Safety Platform is evolving and will continue to evolve over the course of the years. We have come a long way from the erstwhile Relsys days of Argus 4.x to more recent Oracle’s 7.x releases. During this journey, a lot of customers who bought into the product may or may not have moved on to the new versions. This, combined with typical technology currency lethargy associated with Life Sciences organizations (for obvious reasons) has made it a very difficult transition for sponsors using Argus. The other category of customers include ones with either a custom application (typically home grown)  or one of the other safety suites (ARISg, AERS, Trace etc.). The transition for these customers is even more tedious as this may involve changes at multiple levels.

Irrespective of the source system, the transition is a long journey with various roadblocks along the way. In this context, I would like to highlight some key considerations for the team’s leading this transformation. The diagram below highlights the topics I consider as critical items, in my opinion:

Argus Transformation - Key COnsiderations

Argus Transformation – Key Considerations

If you consider the generic aspects (non-Safety) of a transition like this, one area that stands out is “Change Management”.  Also, the change should be managed across multiple functions of the organization. Based on my experience with typical organization setup, across multiple sponsors I have worked with, the most common layers are: Business Process Services, Business Support (Help Desk & Product Configuration can be combined in this category) and Application Support. Let’s look at key aspects, from a Change Management perspective for the above three layers below:

  • Business Process Services:
    • Process Re-Engineering: This is one of the most critical parts of the transition. More so, if the sponsor is moving from a non-Argus environment to Argus. Many a times customers try to configure their existing business process. Despite Argus being a configurable system, this may not yield optimum outcome. Therefore, process re-engineering is a critical activity to be undertaken.
    • Process Standardization: In the current world of mergers and acquisitions, it is not uncommon that an organization may have multiple safety systems. This might be the case across geographies (typically Japan). Hence, for organizations that desire a global Argus system (even though Argus Safety and Argus Japan are two modules in the Argus suite) it is essential that they consider standardization of processes. This will be particularly useful in being able to provide better support to the system and also simplifies the business process across the organization.
    • Global Compliance: While “One Size fits all” may not work. It is always good to think about global compliance needs when setting up the business processes, procedures and personnel. This is more relevant when Argus is chosen as the Global Drug Safety tool of choice
  • Business Support:
    • Learning Management: Many of the personnel in the safety organization would need training on Argus Safety. This may not only require product training but also process training, in the context of Argus.
    • Configuration Management: This in itself will be a huge exercise, not only to migrate configuration data from existing system but also to transform the configuration to fit into Argus. At times this might require additional training to the staff and/or setting up of a new team to handle Argus Business and System Configuration.
    • Known Errors and Work Arounds: Over a period of time the KEDB for the current system would have grown to a huge extent and might be leveraged to improve response times for any incidents. There should be plans made to reuse and or seed the new Known Error Database (KEDB) with some standard information that can be provided by either Oracle or other sources.
  • Application Support:
    • Sourcing Strategy: Argus skill set is required to effectively support the product. This may mean looking for a different vendor from the one that might be supporting the current system. This might be the case even if the system is currently being supported by the sponsor, using internal IT personnel.
    • Support Transition: This is one of the critical activities, if not done right, will not only sets back the entire transition but also may result in fines, if the AEs are not reported to regulators in time.
    • Operational Efficiency: The existing team will be operating at an optimum level. This may also be true in terms of tools and accelerators developed over a period of time by the current team. The transition will force the efficiency to take a hit. So, it is essential to account for this change and plan accordingly.

While the above items only correspond to the Change Management, I will post my thoughts on the remainder of the considerations in subsequent posts. As always, I will be happy to receive feedback and inputs from you.

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