jag009
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NJ,
2013-08-19 22:40
(3899 d 09:48 ago)

Posting: # 11308
Views: 7,594
 

 I thought I have seen everything [Study As­sess­ment]

Hi all,

Apparently not...

Question. If a study requires partial AUC at early phase of the plasma concentration-time curve, is it acceptable to implement in the protocol "Subject will be removed from the study if more than x blood draws cannot be collected within x min of schedule time during post-dose 0.5, 1.0, 1.5, 2.0, 2.5, 3.0, 3.5, 4 hours?"

Given the fact that the variability of PAUC can be high, can the above be implemented at all? I know it probably doesn't happen but...
Obvious with the above example, the subject will be dropped out if he/she misses the 4 hr sample since PAUC0-4 requires 4 hour timepoint.

My answer to my questio? "As long as you state it in the protocol" Why I asked? Tada, some CRO managed to screw up some early timepoint collection by as much as 35mins! :no:

Thanks

John


Edit: Category changed. [Helmut]
Helmut
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Vienna, Austria,
2013-08-20 17:43
(3898 d 14:45 ago)

@ jag009
Posting: # 11322
Views: 6,182
 

 I thought I have seen everything

Hi John,

❝ Apparently not...


Otherwise it would be boring, isn’t it?

❝ Question. If a study requires partial AUC at early phase of the plasma concentration-time curve, is it acceptable to implement in the protocol "Subject will be removed from the study if more than x blood draws cannot be collected within x min of schedule time during post-dose 0.5, 1.0, 1.5, 2.0, 2.5, 3.0, 3.5, 4 hours?"


Maybe; actually no qualified opinion. ;-)

❝ Given the fact that the variability of PAUC can be high, can the above be implemented at all?


Again – maybe. You will loose power what you terribly need for this metric…

❝ Obvious with the above example, the subject will be dropped out if he/she misses the 4 hr sample since PAUC0-4 requires 4 hour timepoint.


❝ […] Tada, some CRO managed to screw up some early timepoint collection by as much as 35mins!


That’s a fucking lot! What happened? Normaly time deviations outside an “allowance window” stated in the protocol must be not only documented as such but also a comment in the CRF should be given justifiying the event. 35min?!

BTW, if you ask Phoenix/WinNonlin for partial AUCs (and sampling wasn’t performed exactly at the cut-off time point) an interpolation between two adjacent time points (before/after) is used; linear if C2 ≥ C1 and log/linear if C2 < C1. Makes sense, IMHO.

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jag009
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NJ,
2013-08-20 20:09
(3898 d 12:19 ago)

@ Helmut
Posting: # 11323
Views: 5,990
 

 I thought I have seen everything

Hi Helmut!

❝ ❝ […] Tada, some CRO managed to screw up some early timepoint collection by as much as 35mins!


❝ That’s a fucking lot! What happened? Normaly time deviations outside an “allowance window” stated in the protocol must be not only documented as such but also a comment in the CRF should be given justifiying the event. 35min?!


4 out of 30 subjects had this fiasco. Get this one --> Sampling time at 3.5 and 4.0 hour... They were late 35 mins for the 3.5 (meaning it crossed over into the 4 hr timepoint). They then draw a 4 hr timepint sample with a delay of 11 mins (It's obvious why, they didn't want to miss collecting a sample!!!)So now I have a 3.5hr sample with a +35min deviation and a 4 hr with a +11min deviation!!! what should I use for PAUC0-4??????

Reason for deviation? Couldn't get blood from sites of puncture! 35mins!???? how many time did they poke on the subjects arm(s)!!!!!
I wouldn't have gone ballistic if the reason was "Subject went into hiding somewhere in the dosing area"
Helmut
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Vienna, Austria,
2013-08-20 20:16
(3898 d 12:12 ago)

@ jag009
Posting: # 11325
Views: 6,015
 

 Gimme some data!

Hi John!

❝ 4 out of 30 subjects had this fiasco.


Very strange, indeed!

❝ So now I have a 3.5hr sample with a +35min deviation and a 4 hr with a +11min deviation!!! what should I use for PAUC0-4??????


If you want you can post the time course of this subject (scheduled & actual times, concentrations). Let’s see.

❝ Reason for deviation? Couldn't get blood from sites of puncture! 35mins!???? how many time did they poke on the subjects arm(s)!!!!!


Do you believe in this “reason”?

❝ I wouldn't have gone ballistic if the reason was "Subject went into hiding somewhere in the dosing area"


:-D

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jag009
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NJ,
2013-08-20 20:19
(3898 d 12:08 ago)

@ Helmut
Posting: # 11326
Views: 5,987
 

 Gimme some data!

Hi Helmut,

❝ If you want you can post the time course of this subject (scheduled & actual times, concentrations). Let’s see.


Study is in progress with period 1 completed... Will update.

❝ ❝ Reason for deviation? Couldn't get blood from sites of puncture! 35mins!???? how many time did they poke on the subjects arm(s)!!!!!

❝ Do you believe in this “reason”?


What can I do?

❝ ❝ I wouldn't have gone ballistic if the reason was "Subject went into hiding somewhere in the dosing area"


Playing hide and seek with the person holding needle...

John
Helmut
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Vienna, Austria,
2013-08-20 20:34
(3898 d 11:54 ago)

@ jag009
Posting: # 11327
Views: 6,046
 

 Gimme some data!

Hi John,

❝ ❝ ❝ Reason for deviation? Couldn't get blood from sites of puncture! 35mins!???? how many time did they poke on the subjects arm(s)!!!!!

❝ ❝ Do you believe in this “reason”?


❝ What can I do?


Likely nothing. If you audit the site now, which answer do you expect? Even if they come up with something (relying on their memory “Oops, I remember it was just five minutes late, not 35. Sorry!”) – will it be more credible than was written (GCP…) in the CRF? Fishy.
Whenever possible monitor at least the first period of all studies.

Dif-tor heh smusma 🖖🏼 Довге життя Україна! [image]
Helmut Schütz
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The quality of responses received is directly proportional to the quality of the question asked. 🚮
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jag009
★★★

NJ,
2013-08-20 21:54
(3898 d 10:34 ago)

@ Helmut
Posting: # 11330
Views: 5,926
 

 Gimme some data!

Hi Helmut,

❝ Likely nothing. If you audit the site now, which answer do you expect? Even if they come up with something (relying on their memory “Oops, I remember it was just five minutes late, not 35. Sorry!”) – will it be more credible than was written (GCP…) in the CRF? Fishy.

❝ Whenever possible monitor at least the first period of all studies.


The joke of the day... My monitor was there but left after 3 hours because she was satisfied with the performance observed during her stay (-1 day upto 3 hour post-dose draw). :no:
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