Clinical Research
Off-shoring: A Country Attractiveness Index for Clinical Trials
By Mark P. Mathieu For many years, pharmaceutical companies have been off-shoring manufacturing operations to lower-cost countries. Healthy margins and strong risk aversion have afforded pharmaceutical companies the luxury of staying close to home, for all but manufacturing activities. As financial pressures increase, pharmaceutical executives are finding that going offshore is not only less risky than it once was, but also too attractive to ignore. Read More
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By Ann Neuer
January 5, 2009 | The much anticipated convergence of data between clinical trials and electronic health records (EHR) is heading toward reality with the recent formation of the EHR Clinical Research Value Case Workgroup. Convened in November by the American National Standards Institute (ANSI), the workgroup is a cross-section of experts from industry, academia, standards organizations, and government who have come together to identify priorities for the harmonization of technical standards needed to ensure the interoperability of EHRs and global clinical research applications.
“It’s a neutral group of stakeholder representatives that will set priorities for interoperability specification development in the clinical research space,” says Rebecca Kush, president and CEO of the Clinical Data Interchange Standards Consortium (CDISC) and co-chair of this initiative.
Kush explains that when the workgroup held its first meeting in November, she and fellow co-chair Gregory Downing, director of the Initiative on Personalized Health Care at the Department of Health and Human Services (HHS), came prepared with five suggested priorities. By the end of that session, however, one key priority, known as the value case, emerged—to identify a core (common) set of data fields that could be exchanged between EHRs and systems that support clinical research. “This refers to a set of data fields found in EHRs that would have application to international research studies, such as demographic data. This information could be collected once in the EHR and could then populate a case report form for a clinical research study,” Kush remarks. With this value case creating a foundation, future priorities are expected to take shape around EHRs for purposes of patient recruitment, adverse event reporting, pharmacovigilance, and pharmacogenomics.
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| Rebecca Kush |
In order for the information to flow effectively, standards must be identified, and this is where it gets complicated. For some time, the clinical research sector had been anxious to become part of the multiple federal forays into expanding information technology in health care, such as the Healthcare Information Technology Standards Panel (HITSP), which reports to HHS; the American Health Information Community (AHIC), which set priorities for HITSP and terminated in November; and the AHIC Successor, currently in the midst of developing its governance, and whose funding as a public-private partnership is uncertain. Downing, who opened the door for the clinical research presentation to AHIC in July, says that the connecting of research with federal efforts is critical at this time to avoid the development of divergent and disparate standards that will inhibit the compatibility of EHRs with clinical research platforms. “A number of organizations, such as CDISC and Health Level 7 (HL7) have already developed standards, so we should leverage them instead of re-inventing the wheel,” says Downing.And things are moving forward within the workgroup. The value case is currently being written by a contractor for HHS, with input from the workgroup. An initial draft of the value case is expected in early January, to be followed by a mid-January conference call to seek comments from members of the workgroup. “By early February, we’re hoping to have this finished so it can be sent to HITSP, which will form technical committees to select the standards that support this value case and they will write up the interoperability specifications,” Kush explains.
One of the key issues is the dire need for funding if the work is to continue. There is no federal funding to support this project, and it is unknown if the new administration will fund this work. The workgroup hopes there will be a “glide path” for this work when the AHIC Successor is established. In the interim, ANSI and Kush are looking to stakeholders for financial support. She estimates that $250,000 to $300,000 is needed from public and private-sector sources for ANSI to be able to contract with HITSP for the development of the interoperability specifications. “We cannot go forward in February with the HITSP work without money. In this economy, we need a lot of contributors and people in clinical research, personalized medicine, pharmacogenomics, anyone who would ever want to use EHR data for their studies should contribute,” Kush comments.
This story first appeared in eCliniqua, one of Bio-IT World’s free eNewsletters. Subscribe here.
Rethinking Clinical Trials Data Integration There is a gap between the need for data integration and fully integrated systems. To find out why, SAS and Pharmaceutical Executive conducted confidential telephone interviews with senior pharmaceutical executives and CROs. This article discusses recommendations on how to achieve optimal clinical data integration, based on those interviews.
eClinical Trial Technologies Revolutionizing Clinical Development Efficiency This Bio-IT World BriefingON report, sponsored by ClearTrial, presents a selection of recent stories from Bio•IT World and sister publication, eCliniqua, that illustrate how new technologies and approaches can have a profound impact on the management and execution of clinical trials.
Remote Data Capture:Acquisition and Analysis See why Electronic Data Capture (EDC) is gaining traction in the pharmaceutical
clinical trials arena. Today approximately half of all clinical trials are conducted
electronically, and the figure is rapidly rising. Report includes contributions from
Oracle Health Sciences, Pfizer, PPD, and C3i.
Bio-IT World & CHI
Impact of the 1000 Genomes Project on the Next Wave of Pharmacogenomic Discovery
Interview with M. Eileen Dolan, Ph.D., Professor, Medicine, University of Chicago and Speaker at Next-Generation Sequencing Data Management, September 27-29, 2010, Providence, RI
The 1000 Genomes Project aims to provide detailed genetic variation data on >1000 genomes from worldwide populations using the next-generation sequencing technologies. Some of the samples utilized for the 1000 Genomes Project are the International Hap-Map samples that are composed of lymphoblastoid cell lines (LCLs) derived from individuals of different world populations. The detailed map of human genetic variation promised by the 1000 Genomes project will allow a more in-depth analysis of the contribution of genetic variation to drug response. Future studies utilizing this new resource can greatly enhance our understanding of the genetic basis of drug response and other complex traits.
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