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How to Make Wise Post-Production Changes to Oracle Clinical/Remote Data Capture Studies

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It is not uncommon to make changes to a study after subjects have enrolled. If you use Oracle Clinical/Remote Data Capture (OC/RDC) to manage your clinical data, then you know that making those changes can be quite easy. However, even the simplest change could result in unforeseen consequences with the potential to undermine your study. That’s why it’s critical to perform a thorough risk analysis before making any changes.

In this webinar, Perficient’s Tammy Dutkin, director of clinical data management and EDC, discussed the process of evaluating and executing post-production changes in OC/RDC.

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How to Make Wise Post-Production Changes to Oracle Clinical/Remote Data Capture Studies

  1. 1. HOW TO MAKE WISE POST-PRODUCTION CHANGES TO ORACLE CLINICAL/RDC STUDIES
  2. 2. 2 ABOUT PERFICIENT Perficient is a leading information technology and management consulting firm serving clients throughout North America. We help clients implement digital experience, business optimization, and industry solutions that cultivate and captivate customers, drive efficiency and productivity, integrate business processes, improve productivity, reduce costs, and create a more agile enterprise.
  3. 3. 3 Founded in 1997 Public, NASDAQ: PRFT 2014 revenue $456 million Major market locations: Allentown, Atlanta, Ann Arbor, Boston, Charlotte, Chicago, Cincinnati, Columbus, Dallas, Denver, Detroit, Fairfax, Houston, Indianapolis, Lafayette, Milwaukee, Minneapolis, New York City, Northern California, Oxford (UK), Southern California, St. Louis, Toronto Global delivery centers in China and India >2,600 colleagues Dedicated solution practices ~90% repeat business rate Alliance partnerships with major technology vendors Multiple vendor/industry technology and growth awards PERFICIENT PROFILE
  4. 4. 4 OUR SOLUTIONS PORTFOLIO Business Process Management Customer Relationship Management Enterprise Performance Management Enterprise Information Solutions Enterprise Resource Planning Experience Design Portal / Collaboration Content Management Information Management Mobile BUSINESSSOLUTIONS 50+PARTNERS Safety / PV Clinical Data Management Electronic Data Capture Medical Coding Clinical Data Warehousing Clinical Data Analytics Clinical Trial Management Healthcare Data Warehousing Healthcare Analytics CLINICAL/HEALTHCAREIT Consulting Implementation Integration Migration Upgrade Managed Services Private Cloud Hosting Validation Study Setup Project Management Application Development Software Licensing Application Support Staff Augmentation Training SERVICES
  5. 5. 5 DATA MANAGEMENT SERVICES Implementation Services Manage implementations and upgrades of OC/RDC/TMS and data browsing tools Process Re-engineering Data Management Standard Operating Procedures, Guidelines development CDISC and CDASH implementations Training OC/RDC/TMS training for all levels of Sponsor and Site Users Data Management Rescue studies and Project Management, Study build services
  6. 6. 6 WELCOME / INTRODUCTION Tammy Dutkin Director of Clinical Data Management & EDC, Perficient • 20+ years of clinical research and data management experience • Previously SVP at DSP Clinical Research and VP at Advanced Clinical
  7. 7. 7 AGENDA • Intro to post-production changes • Warnings • Process • Things to consider/impact analysis • DCM changes • Migrating form versions • DCI form local study settings • Visit changes • DCI book changes • Summary
  8. 8. 8 INTRO TO POST-PRODUCTION CHANGES Post-Production Changes NOT uncommon – CRFs are final – Patients have been enrolled / data collected – Data entered into OC – Etc. Reasons for changes: – Protocol amendment – CRF modifications – Changes to working processes or requirements – Etc.
  9. 9. 9 WARNINGS • Document what you intend to do and the impact of those changes • Get approval BEFORE you do anything. Any error here can have HUGE impacts • Create things provisionally and TEST, TEST, TEST before you activate. If you can’t test (e.g. new form version) then have someone else double check your work – A good way to test is to clone your production data into a test database. Many of the changes you may need to make, you will not be able to test in your production study • Activate and confirm the changes rolled out as expected (check old data, new data, procedures, extracts, discrepancies) • Document and close any loops
  10. 10. 10 PROCESS
  11. 11. 11 THINGS TO CONSIDER / IMPACT ANALYSIS Before making any changes: 1. Assess the impact the change is going to make on: – Your overall study objectives – Your study timelines – Patient data already entered in the study (including how much data) – How many discrepancies might fire due to this change and how will those discrepancies be handled? – Current study set up (e.g. procedures that may be impacted, extract views that may need to be updated) – Verification and Approval statuses (retained or revoked) – Documentation that may need to be updated (e.g. annotations, change documentation) 2. Assess the options available for changing the database – Can the issue be handled with a convention or note to file other than a database change? – Does the change need to be applied to only new data or to both new and old data? – Is the database change even possible?
  12. 12. 12 THINGS TO CONSIDER / IMPACT ANALYSIS 3. Evaluate the risk associated with the change – Will it require system downtime? – How will the change be communicated to affected parties? – Is there a risk of losing or corrupting data? 4. What is the cost of the change? – How much resource time will be spent on the change? 5. Is the benefit worth the impact/risk/costs? WARNING: Changes that appear (and are) simple to make in OC may have far-reaching impacts – Think about & ask the right questions to ascertain all the potential impacts – All the potential impacts and subsequent tasks/changes should be included on the Impact Analysis BEFORE any changes are made
  13. 13. 13 DCM CHANGES • Updating a DVG • Adding a DCM question • Removing a DCM question • Minor updates to labels, question order, header
  14. 14. 14 DCM CHANGES – DVG UPDATES • Things to consider if adding a DVG choice: – Is there data already entered for that question? • What do you want to happen with that data? • Do you want the sites to re-evaluate their selection for the question or do you want those forms to stay on the old version? (If so, you may need to add a validation to prompt the sites to do this.) • How many discrepancies (univariate, multivariate, etc.) are going to fire due to the change? How will these be handled? – How many characters long is the new choice? Do you need to increase the question length? If so, don’t forget to update the views. – How is the data displayed on the form? LOV? Checkboxes? LOV DVG changes do not require a Form Layout change. – Does this impact default repeat values or default responses?
  15. 15. 15 DCM CHANGES – DVG UPDATES • Things to consider if removing a DVG choice… – Is there data already entered for that question for the DVG choice being removed? • What do you want to happen with that data? • Keep in mind that removing a selection that was chosen previously may result in discrepancies firing. – How is the data displayed on the form? LOV? Checkboxes? LOV DVG changes do not require a Form Layout change. – Does this impact any default repeat values or default responses? – Does it impact any procedures?
  16. 16. 16 DCM CHANGES – DVG UPDATES Steps to updating a DVG (assuming all patients will be using the new DVG): 1. Create new version of the DVG 2. Update the DVG version in the DCM 3. Uncheck the Available checkmark for Graphic Layout, if needed 4. Select SpecialGraphic LayoutUpdate DVG from DVG Definition, Edit layout if needed
  17. 17. 17 DCM CHANGES – DVG UPDATES Steps to updating a DVG: 5. Recheck Available (note: if this is a LOV DVG, nothing further is needed) 6. Go to DCIGenerate Provisional Layout, Edit Layout 7. Generate Provisional DCI Form 8. Activate (note if there is no data entered in the current active layout, can just delete or edit the original layout without creating a new version). All new patients will have the new version of the layout, unless something other than “Current” is selected in the DCI book constraints. 9. Migrate Form Version by Book, using the original book, all patients with data will move to the new form – check the test box and confirm and then run again with test box unchecked Note: Can schedule this off hours – will skip records if they are open by a user. See log.
  18. 18. 18 DCM CHANGES – DVG UPDATES - EXAMPLE Example: An additional Race code of “AMERICAN INDIAN” is needed for DEMOGRAPHICS
  19. 19. 19 DCM CHANGES – DVG UPDATES - EXAMPLE 1. Create new version of the DVG a. First add the new choices to the base DVG b. Next create new subset, renumber as needed and activate
  20. 20. 20 DCM CHANGES – DVG UPDATES - EXAMPLE 2. Update DCM with the new DVG 3. Uncheck Available for DCM Graphic Layout. 4. Update DVG definition and Edit layout as needed
  21. 21. 21 DCM CHANGES – DVG UPDATES - EXAMPLE 5. Recheck that layout is Available 6. Go to DCIGenerate Provisional Layout, Edit Layout 7. Generate Provisional DCI Form 8. Activate (this will retire the old Form Version)
  22. 22. 22 DCM CHANGES – DVG UPDATES - EXAMPLE Now for all new data entered, the new form version will appear… Previously entered data will appear as the old form version until you migrate the data…
  23. 23. 23 DCM CHANGES – ADDING A QUESTION • Things to consider if adding a question: – Is there data already entered for that DCM? • What do you want to happen with those eCRFs? • Do you want the new question to appear on previously entered eCRFs? • Do you want the sites to have to go back and enter that question? • Keep in mind that if you decide to create a new DCM subset, the old data will not “migrate” to that new DCM. It will have to stay in the old form. – Update all documentation (e.g. annotations) – Check for new validations or derivations that may be needed
  24. 24. 24 DCM CHANGES – ADDING A QUESTION Adding DCM questions (assuming you are not creating a new DCM or a new DCM subset) 1. Add new question to DCM 2. Graphic Layout will automatically change to Not Available 3. Select SpecialGraphic LayoutEdit and edit as needed 4. Mark Graphic Layout as Available 5. Go to DCIGenerate Provisional Layout, Edit Layout (if no data entered, edit the current layout) 6. Generate Provisional DCI Form 7. Activate layout 8. Migrate Form Version by Book (If you want some patients to stay on the old version of the form, you can do so by changing the constraints in the assigned DCI book.)
  25. 25. 25 DCM CHANGES – REMOVING A QUESTION • Things to consider if removing a question: – Is there data already entered for that question? • What do you want to happen with that data? • Do you want the data available for the sites to view/modify? – You cannot mark the question as not collected in study, only as not collected in subset – Did you want the previously entered data present in the extract views? – Update all documentation (e.g. annotations) – Is that question used as a trigger question? – Is that question used in any derivations/validations that may need to be reprogrammed? – Note: If you mark a question as Not collected in Subset, until you migrate the form, it will appear on the form in RDC but will be non- enterable.
  26. 26. 26 DCM CHANGES – REMOVING A QUESTION Removing DCM questions (assuming you are not creating a new DCM or a new DCM subset) 1. Mark the question as Not Collected in Subset 2. Graphic Layout will automatically change to Not Available 3. Select SpecialGraphic LayoutEdit and edit as needed 4. Mark Graphic Layout as Available 5. Go to DCIGenerate Provisional Layout, Edit Layout (if no data entered, edit the current layout) 6. Generate Provisional DCI Form 7. Activate layout 8. Migrate Form Version by Book
  27. 27. 27 MIGRATING VERSION FORMS • You can only have one active DCI Form Version • When a new Form Version is activated, all new eCRFs will use that new Form Version • If no data has been entered for an active form, the active form should be made Provisional, Edited, and Re-Activated • Previously entered eCRFs will use the old form until data is migrated from the old form to the new form (unless you have assigned a preferred version of that DCI as a constraint in the assigned DCI book) • Depending on your FLT, the eCRF form version being used may not be readily transparent. So be careful in not migrating your old data to the new form! It is possible to add the Form Version to a FLT. • If you don’t want to migrate your old data to the new form, you can create a new DCM or DCM subset and a new DCI or you can add a constraint to the assigned DCI book to point to a specific form version • Migration is done using Definition  DCIs  Migrate Form Version by Book
  28. 28. 28 MIGRATING VERSION FORMS The option to retain/reverse can be set in the DCI Form Local Study Settings (Note: The choices for Reason are found in a Installation Reference Codelist)
  29. 29. 29 DCI FORM LOCAL STUDY SETTINGS
  30. 30. 30 USING A RETIRED FORM VERSION DCIs Enhanced DCI Book  Constraints
  31. 31. 31 VISIT CHANGES • Updating a CPE Name – Can update name of CPE and it applies it across all subjects no matter if data is entered or not (automatically updates all records and DCI Book) – Even if someone is logged in while the change is happening, it updates everything with no errors • Adding additional CPEs – May have issues if study is a flex study with interval rules – If you aren’t going to include some visits, you can mark them as optional • Removing a CPE – Can’t delete visits from the Enhanced DCI books. Visits without any DCIs will not appear (unless data was previously entered). If data was entered, that visit will always appear for those subjects even if you change their assigned DCI Book or delete that data – Can’t delete Events from a study that has data
  32. 32. 32 VISIT CHANGES - EXAMPLE • Updating a CPE Name - Visit of FOLLOWUP needs to be changed to FOLLOWUP 1 and the Visit No. updated to 100.
  33. 33. 33 VISIT CHANGES - EXAMPLE When the CPE is updated, the Navigator then looks like this
  34. 34. 34 DCI BOOK CHANGES • Updating a DCI Book – Can’t delete visits from the Enhanced DCI books. Visits without any DCIs will not appear (unless data was previously entered). – Adding a New Form or Removing a Form • This can be done within the current DCI book, but you may run into issues with renumbering the book pages or with DCI/Interval Rules and then the action cannot be easily undone • Better to create a new DCI book when adding or removing forms. • Make sure to take into account new or affected procedures with the change – Create new DCI book, make updates, renumber Book pages (if needed), Validate DCI book, resolve any errors, make active. Assign the new DCI book as needed. Recalculate expectedness as needed. • Creating a new DCI Book – The process to assign a new DCI book to individual patients is time consuming. Plan accordingly! – A batch session must be run after DCI book re-assignments in order to recalculate expectedness.
  35. 35. 35 DCI BOOK CHANGES - EXAMPLE Adding a New Form to a New Visit in the existing DCI Book – Change needed to collect Lab results at a new Visit (Visit 2) 1. Add the new Visit to the Event Schedule 2. Made the DCI book provisional 3. For VISIT 2, added the new DCI book page of LABORATORY
  36. 36. 36 DCI BOOK CHANGES - EXAMPLE 4. Renumber book pages
  37. 37. 37 DCI BOOK CHANGES - EXAMPLE 5. Validate DCI Book and View Validation Results to confirm there are no errors. Re-Activate your DCI book.
  38. 38. 38 DCI BOOK CHANGES - EXAMPLE Migration is not needed as no form-level changes were made. The new visit and new form will be available to all subjects assigned to that DCI book immediately. (Note: Users who are already logged into the system while the change is being made, may need to logout and log back in to see the change.)
  39. 39. 39 SUMMARY Changes that appear (& are) simple to make in OC, may have far- reaching impacts – Think about/ask the right questions to ascertain all the potential impacts – All the potential impacts and subsequent tasks / changes should be included on the Impact Analysis BEFORE any changes are made
  40. 40. 40 QUESTIONS?
  41. 41. 41 CONNECT WITH US • Tammy.Dutkin@perficient.com • LifeSciencesInfo@perficient.com • +1 919 462 6395 (U.S. Sales) • +44 (0) 1865 910200 (U.K. Sales) • Blogs.perficient.com/lifesciences • LinkedIn.com/company/Perficient • Twitter.com/Perficient_LS • Facebook.com/Perficient
  42. 42. 42 THANK YOU

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