Author: Davy Baele, Team Leader – CDM Programming
In the competitive landscape of clinical research, midsize Contract Research Organizations (CROs) often find themselves overshadowed by the success stories of large pharmaceutical companies. These giants leverage fully controlled standardized metadata repositories and vast proprietary clinical data to train in-house AI tools, optimizing their data management processes. However, this narrative is changing. A midsize CRO, through clever design, well-defined standards, and easily obtainable AI, can revolutionize its data management processes and streamlined operations.
The Vision: Creating a Robust and Flexible Metadata Repository
The journey began with a vision: to create a metadata repository that could rival those of the larger players in the industry. The goal was to build a system that was not only robust but also flexible, capable of adapting to the unique needs of the organization. IDDI, a midsize CRO, set out to achieve this by leveraging standards, expertise, and artificial intelligence (AI).
Building Around Standards: The Foundation of the Repository
At the heart of IDDI’s metadata repository is a library of CDASH-driven compliant Case Report Forms (CRFs). CDASH, or Clinical Data Acquisition Standards Harmonization, provides a standardized approach to data collection in clinical trials, ensuring consistency and reliability across studies. Each CRF included in the repository is associated with a comprehensive set of specifications:
EDC Specifications: Electronic Data Capture (EDC) systems are essential for collecting and managing clinical trial data. The repository includes detailed EDC specifications for each CRF, ensuring that data is captured accurately and efficiently.
SDTM Mapping Code: The Study Data Tabulation Model (SDTM) is a standard for organizing clinical trial data. Each CRF is linked with SDTM mapping code, facilitating the transformation of collected data into the SDTM format.
SDTM Specifications and Annotations: To ensure complete and accurate data submission, the repository includes SDTM specifications and annotations for each CRF. These provide detailed instructions on how to map collected data to the SDTM format, including any necessary annotations.
Leveraging AI for Efficiency: The Role of Artificial Intelligence
AI plays a crucial role in developing the underlying SDTM. Standard forms and their associated specifications serve as training data for an AI engine, which predicts SDTM annotations for CRF items not explicitly present in the repository. This process unfolds in several steps:
Training the AI Engine: The AI engine is trained using existing standard forms and specifications. This enables it to recognize patterns and make accurate predictions about SDTM annotations.
Validation by Experts: Once the AI engine generates predictions, these are validated by SDTM experts. This step ensures the accuracy and reliability of the predictions, maintaining high data quality standards.
Automation and Code Generation: Validated metadata is fed into automated SDTM annotations and code generators. This automates a significant portion of the data management process, reducing manual effort and increasing efficiency.
Continuous Learning: Released materials are added to the metadata repository and become new training data for future CRF development. This continuous learning process ensures that the AI engine evolves and improves over time, becoming more accurate and efficient.
Efficiency Gains: Realizing the Benefits
By distilling all CRF design activities into a central repository, IDDI achieved significant efficiency gains. Future activities benefit from the work already done, reducing setup costs for both EDC and SDTM. This approach also ensures that the organization is not restricted to a single set of sponsor preferences, providing flexibility and adaptability.
Key Efficiency Gains Include:
Reduced Setup Costs: Standardizing and centralizing CRF design reduces the time and resources required to set up new studies. This leads to significant cost savings and allows the organization to take on more projects.
Improved Data Management: A centralized repository ensures consistency and accuracy in data management processes. This reduces the risk of errors and improves the quality of the data collected.
Enhanced AI Capabilities: With each new study, the AI engine learns and improves. This leads to more accurate predictions and further automation, continuously enhancing efficiency.
The Potential for Further Improvement:
Even with these significant efficiency gains, there is ample potential for further improvement through AI. Future developments could focus on more advanced inferences and automation in SDTM processes, as well as improvements in CRF design.
Areas for Future Improvement:
Advanced AI Inferences: As the AI engine continues to learn, it could be trained to make more complex inferences about SDTM annotations. This would further reduce the need for manual intervention and increase the speed and accuracy of data management processes.
Enhanced CRF Design: AI could also be used to enhance the design of CRFs, making them more user-friendly and efficient. This could include optimizing the layout and structure of CRFs to improve data collection and reduce the burden on study participants.
Conclusion: A Blueprint for Midsize CROs
The story of IDDI demonstrates that midsize CROs can actively benefit from an implementation-based metadata repository. By automating and standardizing the harvest of precious metadata, these organizations can leverage easily obtainable AI tools for significant efficiency gains. This approach levels the playing field, allowing midsize CROs to compete with larger players in the industry.
Key Takeaways:
Leverage Standards: Building a metadata repository around established standards like CDASH and SDTM ensures consistency and reliability.
Utilize AI: AI can significantly enhance efficiency by automating complex data management processes and continuously learning from new data.
Centralize and Standardize: Centralizing and standardizing CRF design activities in a metadata repository reduces setup costs and improves data management efficiency.
Continuous Improvement: The metadata repository and AI engine should be continuously updated and improved to maintain high standards and adapt to new challenges.
By following this blueprint, midsize CROs can streamline their data management processes, improve efficiency, and compete effectively in the clinical research landscape. The journey of IDDI is a testament to the power of clever design, well-defined standards, and the strategic use of AI in transforming clinical data management.