orientation for new clinical research coordinators · 2018-05-03 · overall agenda for orientation...
TRANSCRIPT
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ORIENTATION FOR NEW CLINICAL RESEARCH
COORDINATORS
Presented by
NC TraCS InstituteUNC Office of Clinical Trials
UNC Network for Research Professionals
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Overall Agenda for Orientation• Module 1:
Introduction to Clinical Research, Education, and IRB• Module 2:
Informed Consent, Documentation and GCP, and Study Start up
• Module 3: Contracting, ClinicalTrials.gov, and Drug/ Device Policies, Conflict of Interest Policy
• Module 4: Recruitment, Preparing Industry & NIH Grant Budgets, Accounting, Billing Coverage Analysis
• Module 5:Essential Documents, From CDA to Study Close Out
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ESSENTIAL (REGULATORY) DOCUMENTS
Valorie BuchholzAssociate Director for Clinical Trial Quality AssuranceOffice of Clinical Trials
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Mornings in the Regulatory World
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What Types of Trials Should Meet GCP Guidelines?
• FDA Regulated Trials
• Federally funded (NIH) TrialsRequirement as of January, 2017
“A quality research site complies with the ICH Good Clinical Practice guidelines, the accepted international ethical and scientific quality standards for designing, conducting, recording, and reporting trials
involving human participants.”
American Society of Clinical Oncology Statement on Minimum Standards and Exemplary Attributes of Clinical Trial Sites; R. Zion et al; Journal of Clinical Oncology; April 7, 2008
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What are Essential Documents?
ICH defines Essential Documents as:
the documents which individually and collectively permit the evaluation of the conduct of a trial and the quality of the data produced
(ICH GCP E6 (R2) 8.1)
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GCP Essential Documents Guidance
• Categorizes documents into 3 sections
• Defines whether the sponsor, site or both are responsible for maintenance of the documents
• Reminder – If your investigator holds and IND or IDE, he/she also has sponsor responsibilities
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BEFORE STUDY IS INITIATED:
Investigative Site Sponsor/Funding Agency
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IND trials –1572 Statement of InvestigatorIDE Trials –Investigator Agreement
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Documentation for Investigators and Sub-
Investigators
Curriculum Vitae
• Documents qualifications and eligibility to conduct trial
Licensure
• Documents eligibility to provide medical supervision of subjects
Certifications
• Documents qualifications to perform tasks as delegated
GCP 2.8, 4.1.1, 4.1.5
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AND MORE……
APPROVAL DOCUMENTS
• Institutional Review Board
• Regulatory Authorities• Protocol Review
Committee• Institutional Biosafety
Committee• Scientific Review
Committee
AGREEMENTS
• Site and Sponsor• Site and CRO• Financial Aspects
• Disclosure Forms (FDA)
GCP 3.4, 4.5.1, 8.2.4, 8.2.9
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AND MORE……
Lab
Info
Normal Ranges
CLIA
CAP
CV of Medical Director
GCP 8.2.11
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JUST A FEW MORE……
• Investigational Product Shipping and Accountability Records• Applicable for both Drugs and Devices
• Procedures for Decoding Blinded Trials− used in case of emergency – doesn’t break blind for others
• Study Initiation Report− Document questions asked during SIV!
GCP 8.2.13, 8.2.14, 8.2.15, 8.2.17, 8.2.20
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READY, SET, GO!Documents updated during the study
1572 /InvestigatorAgreement
Only required by FDA if a new protocol is added
to the IND and the Investigator is
participating OR a new investigator is added
Investigator’s Brochures
Normal values to lab
ranges
Laboratory Accreditations (CLIA/CAP)
UPDATE
GCP 8.2.11-12, 8.3.1, 8.3.6
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Update
IRB renewals /
modifications
Regulatory Authorities
Biosafety CommitteeProtocol Review
Committee
CV’s / Licensures / Certifications
for New Investigators
GCP 8.3.2-5
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ADD
LOGS
DELEGATION OF
AUTHORITYLOG /
SIGNATURESHEET
SCREENINGLOG
SUBJECTENROLL-
MENTLOG
SUBJECTID CODE
LIST
TRAINING
LOGSProtocol
IBEquipment
CRF Completio
n / Correction
RETAINED
BODYFLUID
/ TISSU
ESAMPLES
GCP 4.1.5, 4.2.4, 8.3.20-22,
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INCLUDELetters
Meeting Notes
Telephone Calls
Memos to File
REL
EVA
NT
CO
MM
UN
ICAT
ION
S
GCP 8.3.11
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SAFETYSERIOUS ADVERSE
EVENTS• Report to sponsor and IRB
UNANTICIPATED / UNEXPECTED
ADVERSE EVENTS• Report to Sponsor and IRB
SAFETYINFORMATION /
REPORTS• Sponsors Notify Sites
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STUDY COMPLETION LogsInvestigational Product AccountabilitySubject Identification Code
Final Close-out monitoring report Includes where site documents will be stored
Termination of study with IRBClinical Study Report
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Inspections and Essential Documents
Sponsors and other regulatory agencies look to these documents as part of their processes to confirm the validity of the conduct of the trial and
the data collected
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Record Retention RequirementsDepends on the Type of Trial
• FDA: 21CFR312.62 (IND) OR 21CFR812.140 (IDE)
• Contracts with Funding Source
• Institutional Policies: http://library.unc.edu/wp-content/uploads/2016/06/unc_ret_sched.pdf
(see Section 6 – Grants and Research Records)
Pediatric Studies – UNC Healthcare Policy?
GCP 5.5.12
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TAKE AWAY POINTS
Organized
Consistent
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For Additional Information
http://www.ich.org/products/guidelines/efficacy/article/efficacy-guidelines.html
http://www.fda.gov/downloads/drugs/guidancecomplianceregulatoryinformation/guidances/ucm073122.pdf
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FROM CDA TO STUDY CLOSUREPanel Members:
Christine NelsonVal Buchholz
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Objectives• Review the steps for successful clinical trial
implementation beginning with first sponsor contact through study closure
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So it begins…
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Site Survey
•Site information form•Site Qualification form•Site Feasibility form•Sponsors and CROs track turn around times
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CDA
•CDA must be submitted via CRMS•Cannot be signed by PI•Quick turn around•Not every CDA results in receiving a protocol
•Sponsors and CROs track turn around times
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CRMS• Protocol – final or draft?
• May just send protocol until you are selected as a site • May send someone out to do site qualification visit
• Draft ICF• Draft CTA• Draft Budget• Investigator brochure• Pharmacy manual • Lab manual
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Feasibility• Conduct a preliminary feasibility assessment
• Read the draft ICF• Read the protocol
• Potential enrollment • Study schedule (practical, reasonable)• Study duration• Non-routine care items • Imaging • Pharmacy• Lab/specimens • Resources (study coordinator, data manager, 24/7)• Adequate staffing• Training requirements • Special vendor requirements
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Budget• Billing Coverage Analysis
• Spreadsheet from CRMS• Deemed and Qualified• Epic Billing calendar
• Funding source (federal or industry) • Consistent approach• Ensure start up fees are sufficient and invoiced• Standardized fees • Screen fails • Monitoring visits • Monthly invoicing• IDS
• CTRC
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CTA• Submit CTA to OIC via CRMS, direct link to ALICE
• Complete review request form (RRF)• Contract manager assigned• Only the assigned contract manager negotiates the CTA• Open communication with your contract manager• The CTA can be negotiated while you negotiate your
budget• Once budget has been finalized with sponsor we can
execute the CTA
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IRB• Submit when you are sure the PI wants to participate• UNC local IRB or Central IRB• ICF and contract must be consistent in respect to subject
injury, stipends and what has been promised for free to the subjects
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CTA and IRB • IRB Approval • ICF and CTA must be consistent • OCT will check but you should also check• If inconsistent the ICF will need to be revised
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Ramses• eIPF• Internal budget• Need an account
• Set up after all compliance checks are completed by OCT• Sent to OSR for final PS project ID assignment
• COI• Individual• Institutional
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CTA/ICF checked for Consistency
eIPF completed in Ramses
Account Number Assigned
Conflict of Interest eForm
completed
Study Information is pushed to EPIC
via CRMS
Billing Calendar
Built in Epic
CTA Executed
CTA Executed
Prepare for/Enroll Subjects
Enrollment Complete
Site Initiation
Visit
Study Closure
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Study Start Up• When can I enroll! Its been months and I am already
tired…
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Mornings in the Regulatory World
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What Types of Trials Should Meet GCP Guidelines?
• FDA Regulated Trials
• Federally funded (NIH) TrialsRequirement as of January, 2017
“A quality research site complies with the ICH Good Clinical Practice guidelines, the accepted international ethical and scientific quality standards for designing, conducting, recording, and reporting trials
involving human participants.”
American Society of Clinical Oncology Statement on Minimum Standards and Exemplary Attributes of Clinical Trial Sites; R. Zion et al; Journal of Clinical Oncology; April 7, 2008
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What are Essential Documents?
ICH defines Essential Documents as:
The documents which individually and collectively permit the evaluation of the conduct
of a trial and the quality of the data produced
(ICH GCP E6 (R2) 8.1)
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BEFORE STUDY IS INITIATED:
Investigative Site Sponsor/Funding Agency
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Documentation for Investigators and Sub-
Investigators
Curriculum Vitae
• Documents qualifications and eligibility to conduct trial
Licensure
• Documents eligibility to provide medical supervision of subjects
Certifications
• Documents qualifications to perform tasks as delegated
GCP 2.8, 4.1.1, 4.1.5
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AND MORE……
APPROVAL DOCUMENTS
• Institutional Review Board
• Regulatory Authorities• Protocol Review
Committee• Institutional Biosafety
Committee• Scientific Review
Committee
AGREEMENTS
• Site and Sponsor/Funding Agency
• Site and CRO• Financial Aspects
• Disclosure Forms (FDA)
GCP 3.4, 4.5.1, 8.2.4, 8.2.9
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AND MORE……
Lab
Info
Normal Ranges
CLIA
CAP
CV of Medical Director
GCP 8.2.11
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JUST A FEW MORE……
• Investigational Product Shipping and Accountability Records• Applicable for both Drugs and Devices
• Procedures for Decoding Blinded Trials− used in case of emergency – doesn’t break blind for others
• Study Initiation Report− Document questions asked during SIV!
GCP 8.2.13, 8.2.14, 8.2.15, 8.2.17, 8.2.20
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Include:
LOGS
DELEGATIONOF
AUTHORITYLOG /
SIGNATURESHEET
SCREENINGLOG
SUBJECTENROLL-
MENTLOG
SUBJECTID CODE
LIST
TRAININGLOGS
ProtocolIB
EquipmentCRF
Completion / Correction
OTHERLOGS
GCP 4.1.5, 4.2.4, 8.3.20-22,
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Study Start Up
• SIV – Site Initiation Visit• Study supplies • CRMS – Clinical Research Management System (OnCore for
Oncology studies)• Epic • IDS – Investigational Drug Services at UNC Healthcare• Subject binders• Source documents• Study visit checklist
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Study Conduct• Enroll your first subject
• Inclusion/exclusion criteria• ICF
• Documentation of the informed consent process
• Maintenance of Essential Documents
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Documents updated during the study
1572 /InvestigatorAgreement
Only required by FDA if a new protocol is added
to the IND and the Investigator is
participating OR a new investigator is added
Investigator’s Brochures
Normal values to lab
ranges
Laboratory Accreditations (CLIA/CAP)
UPDATE
GCP 8.2.11-12, 8.3.1, 8.3.6
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Update
IRB renewals /
modifications
Regulatory Authorities
Biosafety CommitteeProtocol Review
Committee
CV’s / Licensures / Certifications
for New Investigators
GCP 8.3.2-5
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INCLUDELetters
Meeting Notes
Telephone Calls
Memos to File
REL
EVA
NT
CO
MM
UN
ICAT
ION
S
GCP 8.3.11
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Ongoing conduct of study• Study visit checklists• Case report forms • Epic Billing review • Investigational product accountability• SAE/AE reporting• Monitor Access• Annual IRB renewal• Amendments• Modifications • Deviations
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STUDY COMPLETION / CLOSE OUT
All study subjects completeData lock / IRB closureLogsInvestigational Product AccountabilitySubject Identification Code
Final Close-out monitoring report Includes where site documents will be stored
Clinical Study ReportPack up the records Pat yourself on the back
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Record Retention RequirementsDepends on the Type of Trial
• FDA: 21CFR312.62 (IND) OR 21CFR812.140 (IDE)
• Contracts with Funding Source
• Institutional Policies: http://library.unc.edu/wp-content/uploads/2016/06/unc_ret_sched.pdf
(see Section 6 – Grants and Research Records)
Pediatric Studies – UNC Healthcare Policy?
GCP 5.5.12
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Audits –FDA or Sponsor• Who do you call?
• Hint – its not Ghost Busters!
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Inspections and Essential Documents
Sponsors and other regulatory agencies look to these documents as part of their processes to confirm the validity of the conduct of the trial and
the data collected
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TAKE AWAY POINTS
Organized
Consistent
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ENTER NEXT Training
November XX, 2017, 12 noon –1:30pm
Brinkhous-Bullitt Bldg, Room 219