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Serious adverse event reporting in investigator‐initiated clinical trials
Author(s) -
Wallace Sophie,
Myles Paul S,
Zeps Nikolajs,
Zalcberg John R
Publication year - 2016
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/mja15.01007
Subject(s) - clinical trial , adverse effect , medicine , data monitoring committee , ethics committee , good clinical practice , workload , research ethics , medical emergency , patient safety , clinical research , alternative medicine , family medicine , intensive care medicine , health care , pharmacology , pathology , psychiatry , public administration , political science , computer science , economics , economic growth , operating system
Summary Reporting adverse events (AEs) and serious AEs (SAEs) are practical steps to ensure safety for volunteers and patients in medical research involving medications, treatments and devices. However, the burden and cost of reporting should be proportionate with the public health benefit of this information. Unfortunately, in Australia there is clear evidence of ever‐increasing requirements from sponsors and ethics committees to report AEs and SAEs unnecessarily, leading to a decrease in the uptake of research, particularly less well funded investigator‐initiated trials. We believe that individual AE reports to ethics committees serve no useful purpose, because in most cases the study group identity (drug exposure) is not known in studies with blinded treatment arms and their value is limited. Pragmatic, investigator‐initiated Phase IV clinical trials of post‐marketed drugs or devices are needed to understand their role in everyday clinical practice. In this setting, the workload and costs of systematic, complete reporting of all AEs and SAEs (independent of whether these are treatment‐related) is wasteful, and mostly unnecessary. A trial data safety and monitoring committee is in the unique position of being able to review safety information according to the blinded treatment arms of the study. This enables safety data to be analysed appropriately and a summary report provided to the trial steering committee, principal investigators and the relevant ethics committees in a meaningful way. Defined trial endpoints do not need to be reported as safety events (because they are being properly monitored and analysed).