Study Start Up

The purpose of the Study Start Up stop is to create and implement the Trial plans to ensure all the necessary elements are ready to conduct the trial. This includes:

  • performing a feasibility study to identify appropriate sites / site types
  • selecting the PI(s) and sub-investgators, including any virtual research sites
  • preparing the contracts and agreements that will be needed for the Clinical Trial,
  • preparing and submitting the required Ethics and Regulatory filings, including any patient facing recruitment documents or messages, including the ICF
  • configuring and testing the DCT System, or platform
  • identifying the supplies needed for the trial
  • defining workflows for supplies to be available for trial visits, aligned to DCT options defined in the protocol
  • identifying vendors to provide both technology and/or services for the trial and how their processes
    • identifying which sites and or site-types (e.g. mobile research unit, pharmacy based unit, mobile nursing, etc) will participate in the trial and in what ways
    • ensuring the sites are prepared with supplies and trained staff, including plans to support PI Oversight of any assessments done at an alternate location, and
  • developing/documenting how the trial will be monitored.

 

Prior to the trial starting, two gating events must occur:

  • study specific DCT System configuration must be on-line ("live")
  • the trial must be approved by ethics and regulatory bodies
DTRA_Tubestop Icons-04

Description

Study start up in clinical trials is the process of preparing and launching a clinical trial. In a decentralized trial, additional considerations are needed to ensure the trial can be conducted in locations other than a traditional clinical trial site, using technology and or services to enhance patient access and convenience. 


DCT-specific Considerations/Inputs

Clinical trials require robust plans for site selection, data management, data monitoring, safety oversight and protocol compliance. DCTs require all of these, and there may be additional plans needed to ensure appropriate site and alternative site selection and training, as well as PI oversight of activities performed at locations other than a traditional brick and mortar site.

Per the FDA draft DCT guidance: DCTs generally include specific plans to facilitate the decentralization of the trial. These plans should include, as appropriate, the use of local health care facilities, local HCPs, and local clinical laboratory facilities;visits to trial participants’ homes; and direct distribution of the IP to trial participants at their locations. Specific issues related to the feasibility, design, implementation, or analysis of a DCT should be discussed early with the relevant FDA review divisions. Appropriate training, oversight, and up-front risk assessment and management will be key to implementing a DCT successfully.


Tools


Regulatory Documents

FDA/U.S.

U.S. FDA Final Guidance Document: Conducting Clinical Trials With Decentralized Elements Guidance for Industry, Investigators, and Other Interested Parties - September 2024

View

Europe/EMA

European Medicines Agency Recommendation Paper on Decentralised Element in Clinical Trials Version 01, 13 December 2022

View

The Danish Medicines Agency’s guidance on the implementation of decentralized elements in clinical trials with medicinal products

View

Guidance on the Management of Clinical Trials During the COVID-19 (Coronavirus) Pandemic

View

Reference Documents

CTTI Recommendations: Decentralized Clinical Trials

View