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Implementing Clinical Trials
The general steps involved with starting up a clinical trial are summarized here. Note that the particular sequence of the steps may vary according to individual requirements, and some steps may occur concurrently. Jump to any section by clicking on the arrow corresponding to the step you wish to learn more about.
If you wish to conduct clinical trials pertaining to cancer, please visit the Clinical Trials Office of MCW's Cancer Center for information on available services and support for interventional cancer trials.
Step 1. Identify Protocol
Protocols can come from various sources. Investigators can develop or draft their own protocols or they can pursue the option of becoming a local PI on a regional, national, or global trial. Pharmaceutical companies, Cooperative groups, and Clinical Trial Consortiums are all avenues by which clinical trials can be opened locally at MCW.
Step 2. Sign Confidentiality Agreement (CDA)
If you decide to open a trial through a Pharmaceutical company, you most likely will need to complete a Confidentiality Disclosure Agreement (CDA) before the sponsor will release the protocol document to you and your staff. The CDA should always pass through the Office of Grants & Contracts (GCO) to ensure the language is appropriate for the investigator to sign; often, the language requires some level of editing before signature.
The Medical College of Wisconsin maintains a corporate policy Contract Requirements for Sponsored Human Research (RS.GC.040) which is available on the College’s intranet site. If you have access to InfoScope, review this policy by searching for keywords “contract requirements” and select the link to this policy.
Step 3. Assess Feasibility
Before you can fully commit to a research project, feasibility must be assessed. Determine the logistics needed within your department and others, such as Radiology, Cardiology, Dynacare, etc. The following questions should be considered as part of the assessment process:
Does your department/clinic have the qualified staff, equipment, and time to run the trial?
Do you need/have a clinical research coordinator or assistant?
Do you have a qualified staff member to do the IRB submission?
Who will do the data entry and fill out the case report forms?
How will you recruit subjects?
What other departments will be involved in the trial?
Does your protocol require CT or MRI scans?
Feasibility issues involving other departments must go through OCRICC (Office of Clinical Research and Innovative Care Compliance). Sometimes feasibility is assessed via a sponsor survey; other times through a simple, independent examination by the investigator.
Step 4. Review with Departmental Committees/Groups
Departments often have their own committees that review clinical trials prior to making a final decision about opening them, such as a Scientific Review Committee, Faculty Disease Group, Data Safety Monitoring Board, etc. Sometimes the review group consists of formally appointed members; other times the trial must simply be discussed among other physicians within the department. Consult with your department Administrator or colleagues within your department to learn what steps to take for departmental review.
Step 5. Identify Funding
Sponsored clinical trials include funding. However, if you are opening an investigator initiated trial, you will likely need funding to support the trial. Therefore, it is important to assess the cost of running a trial and seek adequate funding. We recommend visiting the Finding Funding section in Research Resources for current opportunities, links to funding agencies, and resources available to assist you in your search for funding.
Step 6. Develop/Finalize Budget
Applications for funding are submitted via eBridge in the form of a Funding Proposal and routed through the Office of Grants & Contracts (GCO). Your study will not be IRB approved until funding is awarded. There are several sources of support to assist you with the submission process:
Step 7. Obtain Approvals
You must receive IRB approval prior to beginning any research activities. Your study may also require approval from ancillary committees, depending on the nature of the research to be conducted: e.g. Radiation Safety Committee, Institutional Biosafety Committee, MRI Safety Committee.
The approval process is conducted via eBridge, the College’s online mechanism for submitting protocols. Your department may have a designated person or persons who can assist you in completing the eBridge IRB application, known as a SmartForm. Research Systems Training also has services for assisting you with your submission process.
We recommend reviewing What is eBridge? and Working with Human Subjects within the Obtaining Approvals section of Research Resources. Within Obtaining Approvals you will also find information on how to obtain approval for Working with Radioactive Material, Working with MRIs, Working with Biologicals, etc.
OCRICC (Office of Clinical Research and Innovative Care Compliance)
Most clinical trials utilize Froedtert Hospital (FH) resources - staff, facilities, equipment, etc. - in one way or another. To ensure that FH has the staff, equipment, and other resources to successfully handle the trial, OCRICC must formally approve your protocol before consenting any patients on a clinical trial. The OCRICC application is usually submitted at the same time as the IRB submission, with approval granted approximately three business days after IRB approval.