The value of source data verification in a cancer clinical trial.

<h4>Background</h4>Source data verification (SDV) is a resource intensive method of quality assurance frequently used in clinical trials. There is no empirical evidence to suggest that SDV would impact on comparative treatment effect results from a clinical trial.<h4>Methods</h4...

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Main Authors: Catrin Tudur Smith, Deborah D Stocken, Janet Dunn, Trevor Cox, Paula Ghaneh, David Cunningham, John P Neoptolemos
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2012-01-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0051623&type=printable
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author Catrin Tudur Smith
Deborah D Stocken
Janet Dunn
Trevor Cox
Paula Ghaneh
David Cunningham
John P Neoptolemos
author_facet Catrin Tudur Smith
Deborah D Stocken
Janet Dunn
Trevor Cox
Paula Ghaneh
David Cunningham
John P Neoptolemos
author_sort Catrin Tudur Smith
collection DOAJ
description <h4>Background</h4>Source data verification (SDV) is a resource intensive method of quality assurance frequently used in clinical trials. There is no empirical evidence to suggest that SDV would impact on comparative treatment effect results from a clinical trial.<h4>Methods</h4>Data discrepancies and comparative treatment effects obtained following 100% SDV were compared to those based on data without SDV. Overall survival (OS) and Progression-free survival (PFS) were compared using Kaplan-Meier curves, log-rank tests and Cox models. Tumour response classifications and comparative treatment Odds Ratios (ORs) for the outcome objective response rate, and number of Serious Adverse Events (SAEs) were compared. OS estimates based on SDV data were compared against estimates obtained from centrally monitored data.<h4>Findings</h4>Data discrepancies were identified between different monitoring procedures for the majority of variables examined, with some variation in discrepancy rates. There were no systematic patterns to discrepancies and their impact was negligible on OS, the primary outcome of the trial (HR (95% CI): 1.18(0.99 to 1.41), p = 0.064 with 100% SDV; 1.18(0.99 to 1.42), p = 0.068 without SDV; 1.18(0.99 to 1.40), p = 0.073 with central monitoring). Results were similar for PFS. More extreme discrepancies were found for the subjective outcome overall objective response (OR (95% CI): 1.67(1.04 to 2.68), p = 0.03 with 100% SDV; 2.45(1.49 to 4.04), p = 0.0003 without any SDV) which was mostly due to differing CT scans.<h4>Interpretation</h4>Quality assurance methods used in clinical trials should be informed by empirical evidence. In this empirical comparison, SDV was expensive and identified random errors that made little impact on results and clinical conclusions of the trial. Central monitoring using an external data source was a more efficient approach for the primary outcome of OS. For the subjective outcome objective response, an independent blinded review committee and tracking system to monitor missing scan data could be more efficient than SDV.
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spelling doaj-art-b5e22a0909df4b099fd2051e3034cc622025-08-20T03:09:48ZengPublic Library of Science (PLoS)PLoS ONE1932-62032012-01-01712e5162310.1371/journal.pone.0051623The value of source data verification in a cancer clinical trial.Catrin Tudur SmithDeborah D StockenJanet DunnTrevor CoxPaula GhanehDavid CunninghamJohn P Neoptolemos<h4>Background</h4>Source data verification (SDV) is a resource intensive method of quality assurance frequently used in clinical trials. There is no empirical evidence to suggest that SDV would impact on comparative treatment effect results from a clinical trial.<h4>Methods</h4>Data discrepancies and comparative treatment effects obtained following 100% SDV were compared to those based on data without SDV. Overall survival (OS) and Progression-free survival (PFS) were compared using Kaplan-Meier curves, log-rank tests and Cox models. Tumour response classifications and comparative treatment Odds Ratios (ORs) for the outcome objective response rate, and number of Serious Adverse Events (SAEs) were compared. OS estimates based on SDV data were compared against estimates obtained from centrally monitored data.<h4>Findings</h4>Data discrepancies were identified between different monitoring procedures for the majority of variables examined, with some variation in discrepancy rates. There were no systematic patterns to discrepancies and their impact was negligible on OS, the primary outcome of the trial (HR (95% CI): 1.18(0.99 to 1.41), p = 0.064 with 100% SDV; 1.18(0.99 to 1.42), p = 0.068 without SDV; 1.18(0.99 to 1.40), p = 0.073 with central monitoring). Results were similar for PFS. More extreme discrepancies were found for the subjective outcome overall objective response (OR (95% CI): 1.67(1.04 to 2.68), p = 0.03 with 100% SDV; 2.45(1.49 to 4.04), p = 0.0003 without any SDV) which was mostly due to differing CT scans.<h4>Interpretation</h4>Quality assurance methods used in clinical trials should be informed by empirical evidence. In this empirical comparison, SDV was expensive and identified random errors that made little impact on results and clinical conclusions of the trial. Central monitoring using an external data source was a more efficient approach for the primary outcome of OS. For the subjective outcome objective response, an independent blinded review committee and tracking system to monitor missing scan data could be more efficient than SDV.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0051623&type=printable
spellingShingle Catrin Tudur Smith
Deborah D Stocken
Janet Dunn
Trevor Cox
Paula Ghaneh
David Cunningham
John P Neoptolemos
The value of source data verification in a cancer clinical trial.
PLoS ONE
title The value of source data verification in a cancer clinical trial.
title_full The value of source data verification in a cancer clinical trial.
title_fullStr The value of source data verification in a cancer clinical trial.
title_full_unstemmed The value of source data verification in a cancer clinical trial.
title_short The value of source data verification in a cancer clinical trial.
title_sort value of source data verification in a cancer clinical trial
url https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0051623&type=printable
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