THE CLINICAL RESEARCH TEAM: ROLES AND RESPONSIBILITIES
Clinical research is a cooperative effort by a team of professionals and other staff. The goals of the team include the protection of patients who have voluntarily agreed to participate in the trial, and a commitment to the integrity of the data generated in the trial. These goals are achieved by a relatively small group of people, facing common and sometimes unique challenges in large, complex institutions. It is wonder that clinical research can be accomplished in such settings!
Summary/overview of roles and responsibilities
http://clinicaltrial.vc.ons.org/file_depot/0-10000000/0-10000/3367/folder/14779/Roles_of_the_Research_Team1.pdf
http://jop.ascopubs.org/content/7/3/188.full.pdf
Study research teams may have many members or responsibilities may be distributed among a small number of members. Although teams vary in composition, some of the common responsibilities are listed below:
Principal Investigator (PI):
· Ultimate responsibility and oversight of trial in a particular organization. In some cases, the same person may be the overall lead for the clinical trial across all institutions
· Delegation of tasks to appropriately trained staff. Ensure staff education
· Implement ethical research consistent with the Belmont Report http://www.hhs.gov/ohrp/humansubjects/guidance/belmont.html
· Comply with Federal Regulations http://www.fda.gov/ScienceResearch/SpecialTopics/RunningClinicalTrials/ucm155713.html
· Ensure that all research protocols are submitted to the institution’s IRB for approval and comply with the IRB mandates http://www.fda.gov/aboutfda/centersoffices/officeofmedicalproductsandtobacco/cder/ucm164171.htm
· Ensure that research is carried out in according to the protocol with IRB changes
· Ensure informed consent of all research participants by appropriate staff and documentation of the consenting process http://www.fda.gov/regulatoryinformation/guidances/ucm126431.htm
· Report on the progress of the research to the IRB, including continuing reviews, unanticipated events, and serious adverse events. Report adverse events to sponsor and FDA as appropriate
http://www.hhs.gov/ohrp/policy/advevntguid.html
http://www.fda.gov/downloads/RegulatoryInformation/Guidances/UCM126572.pdf
· Familiarity with contents of the Investigator Brochure (risks of investigational agent to study participants)
· Maintains Form 1572 (agreement to provide information to the sponsor and to comply with FDA regulations) http://www.fda.gov/downloads/RegulatoryInformation/Guidances/UCM214282.pdf
· Ensures records are maintained for at least 3 years past the completion of all research activities.
The responsibilities of the clinical investigator:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3051859/pdf/jop124.pdf
Sub-Investigator: Other investigators on the Form 1572 and under the direction of the PI
· Familiarity with the research protocol
· Implement and comply with the protocol as written with IRB changes
· Participate in Informed Consent process and documentation
· Participate in timely reporting of adverse events and unanticipated events to the IRB and sponsor
Clinical Trial Nurse (CTN): Coordinates the clinical trial and patient care
· Maintain patient safety and trial integrity
· Participate in the advancement of science in oncology (evidence-based practice)
· Provide education to participants and caregivers, and colleagues
· Help research participants navigate the protocol and the system
· Ensure ongoing participant informed consent
· Facilitate communication and coordination across systems
· Identify strategies for accomplishing requirements of the protocol
· Collaborate with Investigators to evaluate patients for potential clinical trial participation and eligibility
· Identify trends in side effects and participant management strategies. In collaboration with the PI, ensure reporting of unanticipated/adverse events.
The Domain of Clinical Research Nursing:
Clinical research nurse taxonomy developed at the NIH and based on a role delineation study. The domain of clinical research nursing is divided into the following dimensions, each dimension defined by certain activities: clinical practice, study management, care coordination and continuity, human subject protection, and contributing to science.
http://www.cc.nih.gov/nursing/crn/DOP_document.pdf
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3304543/
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3304545/
The Oncology Nursing Society Oncology Clinical Trials Nurse Competencies (2010)
http://www.ons.org/media/ons/docs/publications/ctncompetencies.pdf
Study Manager: Supervises the research program
· Oversees quality assurance activities
· Supervises research staff (regulatory coordinator, study coordinator and data manager), and advocates for additional staff
· Supervises research staff training and evaluation
· Supervises budgeting activities
· Supervises audit of affiliate sites
· In collaboration with the PI, ensures that all investigator responsibilities are met
Regulatory Coordinator: Maintains regulatory activities
· Submits new protocols to the IRB
· Supervises and/or completes required IRB and sponsor reports
· Maintains communication among the study staff, the sponsor and the IRB
· Submits safety data
· Maintains files relating to communication with the IRB and sponsor
· Maintains Form 1572, current Investigator licenses and CVs
Study Coordinator: Assists in the implementation of clinical trial
· In collaboration with CTN, maintains participant calendars and schedules
· Assists Regulatory Coordinator as needed
· In collaboration with CTN, ensures that all protocol requirements are accomplished as outlined the written document (tests, scans, blood samples, questionnaires, etc)
Data Manager:
· Organizes records and source documents
· Tracks completion of the case report forms (CRF)
· Maintains and validates data entry in the CRF system
· Manages discrepancies in data entered in CRF system
Staff Nurse:
· Ensures knowledge of and access to the research protocol
· Is aware of resources for questions and concerns
· Administers investigational drugs
· Monitors participants for adverse effects to the study agent
Research Pharmacist: Maintains drug supply
· Maintains adequate supply of study medication
· Maintains drug accountability
· Acts as consultant to research staff regarding drug interactions and study medications
Study Participant:
· Expresses agreement to participate in the requirements of the study
· Expresses agreement to participate in the accurate administration of the study medication
· Agrees to communicate with the study team regarding adverse events (which may or may not be related to the study medication)