CTTI to Launch New Embedding Trials Feasibility Assessment Tool

CTTI will host a free public webinar on Thursday, Feb. 29 at 12:00 p.m. EST to unveil a new tool for assessing the feasibility of embedding clinical trial elements into clinical practice.  

The webinar will include a welcome from Sara Calvert; a project overview from Lindsay Kehoe; a panel discussion that will focus on stakeholder perspectives related to the practical use of the tool; and an opportunity for you to help CTTI optimize its use. 

Embedding elements of clinical trials, such as patient identification, informed consent, and
data acquisition, into routine care reduces duplication of trial and care activities and promotes the
development of a learning health care system. This can naturally lead to better decision-making,
treatment options, and outcomes for patients. 

However, integrating interventional clinical trials into clinical practice is complex, and operational direction is needed. Supporting recently released recommendations, CTTI created a new tool that aims to aid sponsors involved in early planning and design of a clinical trial by providing insight into site readiness and feasibility of integrating trials into clinical practice. 

Register for the free 60-minute webinar. 

CTTI Holds Meeting to Discuss Strategies for Advancing the Use and Acceptance of Disease Progression Modeling (DPM) in Clinical Trial Design & Decision Making

The Clinical Trials Transformation Initiative (CTTI) held a multi-stakeholder expert meeting on March 6 to discuss strategies for advancing the use and acceptance of disease progression modeling (DPM) in clinical trial design and decision making. Meeting attendees discussed DPM and its current applications; explored opportunities, barriers, and best practices for advancing the use of DPM in clinical trial decision making; and proposed relevant metrics for monitoring and evaluating the recognition, value, and consistent use of DPM. CTTI will be using the ideas generated during this meeting and collecting case examples of DPM application in order to identify and catalog examples of how DPM can provide value for clinical trials – with the ultimate goal of developing and disseminating recommendations that address DPM best practices. 

The maturity and potential impact of model-informed drug development (MIDD) is recognized, but knowledge sharing and clear regulatory expectations are needed to realize its widespread use. FDA’s paired meeting program and the Fit-for-Purpose initiative are examples of programs that foster engagement and transparent communication but additional communication and pre-competitive collaboration is needed between the modeling industry, regulatory agencies, and the clinical community to advance consistent application of MIDD. 

During the meeting, attributes that allow for a successful application of DPM in a given context were discussed, leveraging the results from the CTTI DPM project team scoping review and expert panel presentations.  

  • Meeting attendees also discussed essential next steps for advancing the recognition,
    value, and use of DPM approaches, including the need to:
    ► Establish best practices and provide illustrative case examples.
    ► Develop a common language for disease progression modeling.
    ► Highlight the value and impact of DPM for a variety of stakeholders.
    ► Facilitate communication across stakeholders.
    ► Create metrics to monitor the changes in DPM acceptance and use within organizations and across the clinical trials enterprise (CTE). 

Overall, meeting attendees highlighted that the benefit of CTE-wide adoption of DPM would be faster, higher-quality drug development programs, and more diverse clinical trials. 

Disease Progression Modeling Expert Meeting

MEETING OBJECTIVES:

  • Discuss disease progression modeling (DPM) and its current applications 
  • Explore opportunities, barriers, and best practices for advancing the use of disease progression modeling to aid in decision making 
  • Brainstorm relevant metrics to monitor and evaluate the recognition, value and consistent use of disease progression modeling  

Meeting Location: Mayflower Hotel, Washington, D.C.

Meeting Summary

Meeting Agenda

List of Meeting Attendees

Full Presentation Set            

Meeting Materials:

The views and opinions expressed in this presentation are those of the individual presenter and should not be attributed to the Clinical Trials Transformation Initiative, or any organization with which the presenter is employed or affiliated.

CTTI Publication Investigates Use of Preventive Statins among Older Patients with Cardiovascular Disease

A new CTTI publication, published in the Journal of the American Geriatrics Society, investigates the use of preventive, high-intensity statins among patients 75 and older diagnosed with atherosclerotic cardiovascular disease (ASCVD). The study, which used pharmacy and medical claims data from a commercial health plan, found substantial underuse of statins among insured ASCVD patients. Less than half of older adults with ASCVD, who are at the highest risk of vascular events like heart attack or stroke, are taking statins. Only a minority of older patients are taking high-intensity statins, and very few are taking non-statin ASCVD treatments. Notably, women and patients who had a diagnosis of cerebrovascular disease (CeVD) or peripheral arterial disease (PAD) were less likely to be prescribed a statin. This paper was based on exploratory work done by CTTI with Duke and HealthCore to assess patient use of ASCVD therapies, with a focus on high-intensity statins, to identify areas where future clinical trials and/or quality improvement initiatives can be targeted to address treatment gaps between clinical practice and guideline recommendations. 

Recording Now Available: CTTI Webinar Unveiling New Recommendations on Embedding Clinical Trials into Clinical Practice

A recording of CTTI’s December 15 webinar unveiling the new recommendations on embedding clinical trials into clinical practice is now available. 

The one-hour webinar includes a welcome from Sally Okun, CTTI Executive Director; a keynote
presentation from Robert M. Califf, U.S. Food & Drug Administration; a project overview from Matthew Roe, AstraZeneca; and a panel discussion moderated by Lindsay Kehoe, CTTI Senior Project Manager. The panel discussion, which focused on stakeholder perspectives related to the
integration of the new recommendations, included: Sam Bozzette, National Institutes of Health;
Lara Jehi, Cleveland Clinic; Holly Robertson, Medidata; and Alandra Weaver, Crohn’s & Colitis
Foundation. 

The goal of creating these recommendations for embedding elements of clinical trials into care is to reduce trial inefficiencies and enable faster, more representative, evidence generation that improves patient care. The recommendations were developed for trials of drugs, devices, and biologics in close collaboration with stakeholders across the clinical trials enterprise. The first phase involved gathering input through qualitative, in-depth interviews with designers and implementers of interventional clinical trials that are embedded into clinical practice. The recommendations were drafted and refined with input from a multi-stakeholder project team and through Expert Meetings. 

View the slide deck to read more. 

CTTI Unveils New Recommendations for Embedding Clinical Trials into Clinical Practice

 

 

CTTI today released new recommendations for embedding clinical trials into clinical practice. The goal is to have care inform research and research inform care, which will enable higher quality, more efficient, and more representative evidence for care. When clinical trials have elements embedded into health care delivery, the trials are more accessible to patients, can be conducted in close alignment with clinical workflows, and may use existing infrastructure and data sources for research. This is in contrast to the status quo where research data is collected separately from a clinical care setting, and may therefore produce results that do not reflect the real-world performance of medical products in the populations that will use them.

“We hope that by creating these recommendations for embedding elements of clinical trials into clinical practice, we can reduce trial inefficiencies and enable faster, more representative, evidence generation that improves patient care,” said Lindsay Kehoe, CTTI Senior Project Manager. “Higher quality, safer, more efficient care benefits everyone.”

The case for embedding elements of clinical trials into clinical practice is clear: we have inadequate evidence for care, lack of representativeness of most Americans and health care settings, and an underperforming emergency response mechanism for national health crises. By facilitating the integration of randomized, interventional trial elements into clinical care, we may create efficiencies that help provide much needed evidence faster. Elements that can be embedded include eligibility and patient identification, informed consent, randomization, intervention, trial data acquisition, and evidence integration.

The recommendations were developed for trials of drugs, devices, and biologics in close collaboration with stakeholders across the clinical trials enterprise. The first phase involved gathering input through qualitative, in-depth interviews with designers and implementers of interventional clinical trials that are embedded into clinical practice. The recommendations were drafted and refined with input from a multi-stakeholder project team and through Expert Meetings.

More information on the Trials in Clinical Practice project can be found on CTTI’s website.