Skip to main content

Advertisement

Log in

The Role of an Independent Statistical Analysis Center in the Institutes of Health Model

  • Published:
Drug information journal : DIJ / Drug Information Association Aims and scope Submit manuscript

Abstract

During the past four decades, the randomized clinical trial has evolved as a major research methodology for the rigorous evaluation of new medical interventions and therapies. The role of statistics in clinical trial methodology and the organizational structure of clinical trials have also evolved. More recently, there has been a shift in the funding of clinical trials, from the public (eg, National Institutes of Health, or NIH) to the private (pharmaceutical and device industries) sectOK This paper describes an Industry-Modified NIH Model for the conduct of industry-sponsored clinical trials that involves a distinct statistical analysis center (SAC) and data management centeer, as opposed to the single unit, or coordinating center, utilized in most NIH-sponsored trials. The role of the SAC in support of the monitoring activities of an independent data monitoring committee (IDMC) is described in detail. Since the Greenberg Report was published in 1967, the number of multicenter confirmatory clinical trials that have an IDMC has steadily increased, and the recent International Conjerence on Harmonisation (ICH) E9 regulatory guideline on clinical trials supports this trend, This manuscript provides explicit guidance regarding the activities of an independent SAC for industry-sponsored clinical trials based on our experiences as a SAC for a number of such trials. Activities discussed include protocol development, drafting of written operuting procedures for an IDMC and summary notes of its meetings, and preparation of an interim analysis plan and interim analysis reports.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Heart Special Project Committee. Organization, review and administration of cooperative studies (Greenberg Report): A report from the heart special project committee to the National Advisory Council, May 1967. Control Clin Trials 1988;9:137–148.

    Article  Google Scholar 

  2. Friedman L. The NHLBI model: A 25 year history. Stat Med. 1992;12:425–431.

    Article  Google Scholar 

  3. International Conference on Harmonisation. E9 Statistical Principles for Clinical Trials. Federal Register. September 1998.

    Google Scholar 

  4. National Institutes of Health. Interim Report on the NIH Director’s Panel on Clinical Research, December 1996. December 1996. National Institute of Health. <http://www.nih.gov/news/crp/>.

    Google Scholar 

  5. Meinert CL. Clinical Trials. Design, Conduct, and Analysis. New York: Oxford University Press; 1986.

    Book  Google Scholar 

  6. Metoprolol in Acute Myocardial Infarction (MIAMI) Trial Research Group. Patients and Methods. Am J Card 1985;56(14):3G–9G.

    Article  Google Scholar 

  7. Packer M, Carver J, Rodeheffer R, et al. Effect of oral milrinone on mortality in severe chronic heart failure. PROMISE Study Research Group. N Engl J Med. 1991;325:1468–1475.

    Article  CAS  Google Scholar 

  8. Packer M, O’Connor C, Ghali J, et al. Prospective Randomized Amlodipine Survival Evaluation (PRAISE) Study Group. Effect of amlodipine on morbidity and mortality in severe chronic heart failure. N Engl J Med. 1996;335:1107–1113.

    Article  CAS  Google Scholar 

  9. Coumadin Aspirin Reinfarction Study (CARS) Investigators. Randomized double-blind trial of fixed low dose warfarin with aspirin after myocardial infarction. Lancet. 1997; 350 (9075):389–396.

    Article  Google Scholar 

  10. Cohn JN, Goldstein SO, Greenberg BH, et al. A dose-dependent increase in mortality with Vesnari-none among patients with severe heart failure. N Engl J Med. 1998;339:1810–1816.

    Article  CAS  Google Scholar 

  11. MERIT-HF Study Group. Effect of metoprolol CR/ XL in chronic heart failure: Metoprolol CR/XL Randomized Intervention Trial in Congestive Heart Failure (MERIT-HF). Lancet. 1999;353:2001–2007.

    Article  Google Scholar 

  12. O’Neill WW, et al. for the EXCITE Trial Investigators. Long-term treatment with a platelet glycoprotein-receptor antagonist after percutaneous coronary revascularization. N Engl J Med. 2000;342:1316–1324.

    Article  Google Scholar 

  13. Sloan EP, Koenigsberg M, Gens D, Cipolle M, Runge J, Mallory MN, Rodman G. Diaspirin cross-linked hemoglobin (DCLHb) in the treatment of severe traumatic hemorrhagic shock. JAMA. 1999;282: 1857–1864.

    Article  CAS  Google Scholar 

  14. Ellenberg SS, Geller NL, Simon R, et al., eds. Proceedings of “Practical Issues in Data Monitoring of Clinical Trials,” Bethesda, Maryland, U.S.A., January 27–28, 1992. Stat Med. 1993;12(5/6):415–616.

    Article  Google Scholar 

  15. Fleming TR, DeMets DL. Monitoring of clinical trials: Issues and recommendations. Control Clin Trials. 1993;14:183–197.

    Article  CAS  Google Scholar 

  16. DeMets DL, Fleming TR, Whitley RJ, et al. The Data and Safety Monitoring Board and Acquired Immune Deficiency Syndrome (AIDS) clinical trials. Control Clin Trials. 1995;16:408–421.

    Article  CAS  Google Scholar 

  17. DeMets DL. Data and Safety Monitoring Boards. In: Armitage P, Colton T, eds. Encyclopedia of Bio-statistics. New York: Wiley; 1998.

    Google Scholar 

  18. DeMets DL. Principles of Data and Safety Monitoring Boards. In: Hennekens CH, ed. Clinical Trials in Cardiovascular Disease. Philadelphia: WB Saunders Co.; 1998.

    Google Scholar 

  19. Gangnon R, Roecker E, Cook T. Sequential monitoring of multiple endpoints in clinical trials. Control Clin Trials. 1999;20:355.

    Google Scholar 

  20. Hawkins BS. Data monitoring committees for multi-center clinical trails sponsored by the National Institutes of Health. I: Roles and membership of data monitoring committees sponsored by the National Eye Institute. Control Clin Trials. 1991;12:424–437.

    Article  CAS  Google Scholar 

  21. Meinert CL, et al. Clinical trials and treatment effects monitoring, comments and rejoinder. Control Clin Trials. 1998;19:515–543.

    Article  CAS  Google Scholar 

  22. Ellenberg, SS, Myers MW, Blackwelder WC. The use of external monitoring committees in clinical trials of the national institute of allergy and infectious diseases. Stat Med. 1993;12:461–467.

    Article  CAS  Google Scholar 

  23. Ferguson JR. Biomedical research and insider trading. N Engl J Med. 1997;337(9):631–634.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Fisher, M.R., Roecker, E.B. & DeMets, D.L. The Role of an Independent Statistical Analysis Center in the Institutes of Health Model. Ther Innov Regul Sci 35, 115–129 (2001). https://doi.org/10.1177/009286150103500113

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1177/009286150103500113

Key Words

Navigation