Medical Device Clinical Trials

ISBN-13: 9780470602256 / Angielski / Twarda / 2010 / 272 str.

Salah Abdel-aleem

Opis

Clinical trials tasks and activities are widely diverse and require certain skill sets to both plan and execute. This book provides professionals in the field of clinical research with valuable information on the challenging issues of the design, execution, and management of clinical trials, and how to resolve these issues effectively. It discusses key obstacles such as challenges to patient recruitment, investigator and study site selection, and dealing with compliance issues. Through practical examples, professionals working with medical device clinical trials will discover the appropriate steps to take.

Spis treści

List of Abbreviations.

Preface.

Acknowledgments.

1. Challenges to the Design of Clinical Study.

Development of Clinical SOPs.

Selection of Study Patients, Investigators, and Study Sites.

Definition of Enrolled Subjects in a Clinical Study.

Definition of the Investigational Device System.

Research Contract Challenges.

Review of Literature.

Challenges to the Design of the Study Protocol, Statistical Analysis Plan (SAP), and Selection of Study Endpoints.

Masking or Blinding.

Primary and Secondary Outcomes.

Selection of Study Endpoints.

Differences between the Primary Endpoint in FDA and CE Mark Studies.

SAP and Study Endpoints.

Components of the SAP for Clinical Trials.

Roles and Responsibilities of the Clinical Personnel in Completing the Study Protocol.

Changing the Primary Outcome during the Conduct of the Study.

Definition of Primary and Secondary Endpoints.

Combined "Composite" Endpoints.

Surrogate Endpoints.

Reducing the Study s Sample Size.

Statistical Terms to Define Endpoint Measurements.

Reporting Results of Clinical Trials.

Superiority and Equivalence Trials.

Subgroup Analysis.

Challenges to ICF.

Risk/Benefit Analysis.

2. Challenges to Managing the Study.

Enhancing Patient Enrollment by Relaxation of Study Criteria.

Compliance with the Study Protocol.

Challenges Associated with Data Accuracy and Completeness.

Data Analysis.

Data Integrity.

Criteria for Using Meta–Analysis Studies.

Who Should have Access to Clinical Trial Records.

Managing Study Data and Quality Assurance.

Missing Data Analysis.

Examination of Data across Study Sites.

Challenges to Adverse Event Reporting.

Adverse Event Coding Systems.

Protocol Deviation Report.

Adverse Event Reporting in Final Study Clinical Report.

Difference between the US and EU Definitions and Reporting of Adverse Events.

Adverse Event Reporting Challenges.

Minimization of Bias in Clinical Trials.

3. Selection of Historic Controls.

Types of Control Group in Medical Device Clinical Trials.

Purpose of Control Group.

Use of Placebo Control.

Advantages of Randomized Control Clinical Trials.

Disadvantages of Randomized Control Clinical Trials.

Commonly Used Pivotal Designs.

Definition of Historic Control.

Objective Performance Criteria (OPC).

Examples of Clinical Studies with Historic Controls.

LACI Clinical Study.

Left Ventricular Assist Devices.

Summary of Clinical Studies.

Summary of Recommendations for Historic Control.

4. Fraud and Misconduct in Clinical Trials.

Fraud and Misconduct in Clinical Trials.

Warning Signs of Fraud.

Tips for Detecting Serious Misconduct.

False Claims Act.

Fraud Prevention.

Policy on Handling Complaints of Misconduct.

Reporting Research Misconduct.

Bioresearch Monitoring Information System (BMIS).

5. Challenges to the Regulation of Medical Device.

Determination of 510(K) Devices.

510(K) "Substantial Equivalence Decision Making Process".

Determination of Nonsignificant Risk Devices (NSR).

Similarities and Differences between Medical Device and Drug Regulations in Clinical Trials.

Definitions of Drugs and Devices.

Combination Products.

FDA Sponsor Meetings.

BIMO Inspection.

Investigator–Initiated Clinical Trials.

6. Challenges of Global Clinical Studies and the CE Mark Process.

Global Trial Considerations.

Global Harmonization Task Force Challenges.

FDA Recommendations on Acceptance of Foreign Clinical Sites.

Operational Tips on Conductance of Global Clinical Trials.

CE Mark Process and Challenges.

International Standard ISO 14155.

Differences between FDA and CE Mark Clinical Trials.

Challenges to CE Mark Studies.

7. Challenging FDA PMA Cases.

PMA P970029 (TMR 2000 Holmium Laser System).

PMA P040012 Carotid Stenting for Treating Carotid Disease.

Historic Control Assumptions.

Use of Angiographic Late Loss as Primary Endpoint in Drug–Eluting Stent PMA P070015 (Xience V DES).

8. Bioethics in Clinical Research.

Bioethical Challenges in Clinical Studies.

Good Clinical Practice for the Investigator.

WHO Principles of GCP.

Guidelines and Ethical Principles.

IRB Review Process.

Glossary of Clinical, CE Mark, and Statistical Terms.

References.

Index.

O autorze

SALAH M. ABDEL–ALEEM, PhD, is Senior Manager of Clinical Operations at Proteus Biomedical, Inc., a medical device and pharmaceutical company that develops therapies for cardiovascular and diabetic diseases.¿He has over twenty years of experience in academic and corporate settings and has performed clinical research tasks and activities, such as the development of clinical standard operating procedures, clinical protocols, case report forms, clinical study forms, and investigator brochures for various academic and corporate settings. Dr. Abdel–aleem is the author of Design, Execution, and Management of Medical Device Clinical Trials, also published by Wiley.

Blurb

An in–depth and insightful presentation on dealing effectively with the challenges of clinical trials

Clinical trials tasks and activities are widely diverse and require specific skill sets including excellent communication and management skills as well as the ability to develop different clinical scientific documents for successful planning and execution. The Design and Management of Medical Device Clinical Trials: Strategies and Challenges provides readers with valuable information on overcoming obstacles in these three vital stages of clinical trials. Focusing primarily on medical device clinical trials, the author discusses common challenges, such as investigator and study site selection, slow study enrollment, study endpoint determination, handling compliance issues, missing data analysis, and protocol deviations.

Rather than delve too far into statistical theory, the book outlines only the essential quantitative methods that need to be understood when working hands–on with clinical trial data and research.¿Through practical examples, common issues that arise in the development and implementation of clinical trials are discussed including:

• The selection of historic controls over active control groups in clinical trials

• Challenges to the regulations of medical devices, such as 510 K determination, determination of significant and non–significant risk devices, and similarities and differences of regulations between drugs and medical devices

• Ways to identify and avoid fraud and misconduct in clinical trials

• Obstacles encountered with the CE Mark process and global clinical trials

• Challenges associated with high–profile FDA PMA cases where unconventional endpoints were used as the primary objectives of these studies

The Design and Management of Medical Device Clinical Trials: Strategies and Challenges is a valuable book for courses on biostatistics, epidemiology, and clinical research methods at the upper–undergraduate and graduate level. It is also an excellent reference for professionals in any area of clinical research who would like to learn more about working with medical device clinical trials and drug and biologics trials.