Elsevier

The Lancet

Volume 365, Issue 9460, 19–25 February 2005, Pages 711-722
The Lancet

Clinical Trials
A proposed charter for clinical trial data monitoring committees: helping them to do their job well

https://doi.org/10.1016/S0140-6736(05)17965-3Get rights and content

Summary

Formal monitoring of data from randomised controlled trials (RCTs) is becoming more common. Wide variation exists in the structure and organisation of data monitoring committees (DMCs), with little guidance on how they should operate. We used various strategies to consider the behavioural, procedural, and organisational aspects of data monitoring in RCTs: systematic reviews of DMCs and small group processes in decision making; surveys of reports of RCTs, recently completed and ongoing RCTs, and the policies of major organisations connected with RCTs; detailed case studies of four DMCs that faced difficult decisions; and interviews with experienced DMC members. The findings aided the development of a template for a charter for DMCs. We summarise the findings and outline the key considerations at every stage of the data monitoring process. Widespread use of a charter for the structure and organisation of DMCs would promote a systematic and transparent approach, and enable them to operate more effectively and efficiently.

Section snippets

Research strategy

The DAMOCLES study used several complementary strategies to study behavioural and organisational aspects of DMCs and procedural issues of interim analyses. These are described fully elsewhere.5 In brief, we used systematic reviews of published work on DMCs and on small group processes in decision-making; surveys of reports of RCTs, of recently completed and ongoing RCTs, and of the policies of major organisations connected with RCTs; detailed case studies of four DMCs in which difficult

The charter

Full details of the systematic review, the results of the surveys, and the systematic review of small group processes in decision making have been reported elsewhere.5, 6, 7, 8, 9 Here we present the proposed DMC charter (see end of article) with short summaries of the key points contributing to each of the charter's ten sections. From the review of published work and the cross-sectional surveys, we could see that various names and descriptors are used to describe the data monitoring process.

Comment

The DAMOCLES study used a combination of research strategies to consider the behavioural, procedural, and organisational aspects of data monitoring in RCTs. The study drew on a wide range of work, from publications directly addressing the working of DMCs to psychological research on processes that aid small group decision making. The surveys provided empirical evidence of previous and current DMC practices, and the interviews and case studies provided valuable insights into the factors

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