A

Workshop Agenda

Sharing Clinical Research Data: An Institute of Medicine Workshop

October 4–5, 2012

National Academy of Sciences Building, Room 125
2101 Constitution Avenue, NW
Washington, DC 20418

Background:

Pharmaceutical companies, academic institutions, advocacy organizations, and government agencies such as the Food and Drug Administration and the National Institutes of Health have large quantities of clinical research data. Increased data sharing could facilitate scientific and public health advances, among other potential benefits to patients and society. Much of this information, however, is not transparent or shared beyond the data owner. More specifically, study results are not always published and where results are published, they typically only include summary-level data; participant-level data are privately held and rarely shared or revealed publicly.

This workshop will explore the benefits of and barriers to the sharing of clinical research data and will help identify strategies for enhancing the sharing both within and across sectors. To facilitate identification of key issues and potential solutions, the workshop will focus on data resulting from preplanned interventional studies of human subjects. While recognizing the importance of other data sources such as observational



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A Workshop Agenda Sharing Clinical Research Data: An Institute of Medicine Workshop October 4–5, 2012 National Academy of Sciences Building, Room 125 2101 Constitution Avenue, NW Washington, DC 20418 Background: Pharmaceutical companies, academic institutions, advocacy organi- zations, and government agencies such as the Food and Drug Admin- istration and the National Institutes of Health have large quantities of clinical research data. Increased data sharing could facilitate scientific and public health advances, among other potential benefits to patients and society. Much of this information, however, is not transparent or shared beyond the data owner. More specifically, study results are not always published and where results are published, they typically only include summary-level data; participant-level data are privately held and rarely shared or revealed publicly. This workshop will explore the benefits of and barriers to the sharing of clinical research data and will help identify strategies for enhancing the sharing both within and across sectors. To facilitate identification of key issues and potential solutions, the workshop will focus on data re- sulting from preplanned interventional studies of human subjects. While recognizing the importance of other data sources such as observational 85

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86 SHARING CLINICAL RESEARCH DATA studies and electronic health records, this focus was selected to encour- age concrete problem-solving discussions over the course of a day-and-a- half–long meeting. Models and projects that involve sharing of other types of data will be considered during the workshop to the extent that these models provide lessons and best practices applicable to sharing preplanned interventional clinical research data. The workshop is being jointly organized by the Institute of Medi- cine’s Forum on Drug Discovery, Development, and Translation; Forum on Neuroscience and Nervous System Disorders; National Cancer Policy Forum; and Roundtable on Translating Genomic-Based Research for Health. Meeting Objectives:  Examine the benefits of sharing of clinical research data, and specifically clinical trial data, from all sectors and among these sectors, including, for example: o Benefits to the research and development enterprise o Benefits to the analysis of safety and efficacy  Identify barriers and challenges to sharing clinical research data.  Explore strategies to address these barriers and challenges, in- cluding the identification of priority actions and “low-hanging fruit” opportunities.  Discuss strategies for using these potentially large datasets to fa- cilitate scientific and public health advances. October 4, 2012 Day One 8:30 a.m. Opening Remarks SHARON TERRY, Workshop Chair President and Chief Executive Officer Genetic Alliance

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APPENDIX A 87 SESSION I: BENEFITS OF SHARING CLINICAL RESEARCH DATA Session Objectives:  Provide an overview of the benefits of sharing clinical research data, specifically clinical trial data, and discuss advantages and disadvantages of sharing participant- versus summary-level data from individual trials as well as pooling data across multiple studies.  Consider examples of scientific success stories that illustrate what can be accomplished when clinical trial data are shared. 8:40 a.m. Background and Session Objectives WILLIAM POTTER, Session Co-Chair Co-Chair Emeritus Neuroscience Steering Committee Foundation for the National Institutes of Health (FNIH) Biomarkers Consortium DEBORAH ZARIN, Session Co-Chair Director, ClinicalTrials.gov National Library of Medicine National Institutes of Health 8:50 a.m. Fundamentals and Benefits of Sharing Participant- Level Clinical Trial Data ELIZABETH LODER Clinical Epidemiology Editor, BMJ 9:10 a.m. Pooling Data from Multiple Clinical Trials to Answer Big Questions ROBERT CALIFF Director, Duke Translational Medicine Institute Professor of Medicine Vice Chancellor for Clinical and Translational Research Duke University Medical Center

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88 SHARING CLINICAL RESEARCH DATA 9:30 a.m. Panel Discussion: Perspectives on the Benefits of Sharing Clinical Trial Data  Data sharing—what does it mean from your perspective?  Considering the benefits and risks of sharing clinical research data, how extensively should it be shared to maximize new knowledge and ultimately patient benefit? Panelists HARLAN KRUMHOLZ Harold H. Hines, Jr., Professor of Medicine and Epidemiology and Public Health Yale University School of Medicine MYLES AXTON Editor Nature Genetics JESSE BERLIN Vice President of Epidemiology Janssen Research & Development, LLC Panel Moderators WILLIAM POTTER, Session Co-Chair Co-Chair Emeritus Neuroscience Steering Committee FNIH Biomarkers Consortium DEBORAH ZARIN, Session Co-Chair Director, ClinicalTrials.gov National Library of Medicine National Institutes of Health 10:30 a.m. BREAK

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APPENDIX A 89 SESSION II: DATA-SHARING MODELS: DESIGN, BEST PRACTICES, AND LESSONS LEARNED Session Objectives:  Present examples, best practices, and lessons learned from pro- jects across the continuum of data-sharing opportunities (e.g., rapid publication of participant-level data, increased access to participant-level data for qualified researchers, or maximizing the use of clinical research data that are currently held in central- ized locations by requiring sharing or access to subsets of data).  Distill best practices and lessons learned that can be applied broadly to new projects to maximize the use of data from indi- vidual trials and/or data-pooling initiatives. 10:45 a.m. Background and Session Objectives JEFFREY NYE, Session Chair Vice President Neuroscience Innovation and Partnership Strategy Janssen Research & Development, LLC 10:55 a.m. The Limits of Summary Data Reporting: Lessons from ClinicalTrials.gov DEBORAH ZARIN Director, ClinicalTrials.gov National Library of Medicine National Institutes of Health 11:10 a.m. Models That Increase Access and Use of Data from Individual Clinical Trials The DataSphere Project CHARLES HUGH-JONES Vice President, Medical Affairs North America Sanofi Oncology, on behalf of the Life Sciences Consortium CEO Roundtable on Cancer

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90 SHARING CLINICAL RESEARCH DATA Yale/Medtronic Experience RICHARD KUNTZ Senior Vice President Chief Scientific, Clinical and Regulatory Officer Medtronic, Inc. 11:40 a.m. Models That Foster Pooling and Analysis of Data FNIH Biomarkers Consortium Adiponectin Project JOHN WAGNER Vice President, Clinical Pharmacology Merck & Co., Inc. Novel Methods Leading to New Medications in Depression and Schizophrenia (NEWMEDS) Consortium JONATHAN RABINOWITZ Academic Lead, NEWMEDS Work Package on Advanced Data Analysis Techniques Bar Ilan University 12:10 p.m. Series of Brief Presentations on Overcoming Challenges Facing Clinical Trial Data Sharing Challenge #1: Permissions JENNIFER GEETTER Partner McDermott Will & Emery Challenge #2: Techniques and Methodologies JOHN IOANNIDIS (via video conference) C.F. Rehnborg Chair in Disease Prevention Stanford University

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APPENDIX A 91 Challenge #3: Culture KELLY EDWARDS Acting Associate Dean, The Graduate School Associate Professor, Bioethics and Humanities University of Washington 12:40 p.m. Discussion among speakers, panelists, and audience Discussant:  Sally Okun, Health Data Integrity & Patient Safety, PatientsLikeMe Discussion Moderator JEFFREY NYE, Session Chair Vice President Neuroscience Innovation and Partnership Strategy Janssen Research & Development, LLC 1:00 p.m. LUNCH KEYNOTE CASE STUDY: DISTRIBUTED SYSTEMS FOR CLINICAL RESEARCH INFORMATION SHARING 1:30 p.m. RICHARD PLATT Professor and Chair Department of Population Medicine Harvard Pilgrim Health Care Institute and Harvard Medical School 1:50 p.m. Discussion with Speaker and Audience Discussion Moderator SHARON TERRY, Workshop Chair President and Chief Executive Officer Genetic Alliance

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92 SHARING CLINICAL RESEARCH DATA SESSION III: STANDARDIZATION AND GOVERNANCE Session Objectives:  Receive an update on recent legislative and regulatory language regarding standardization of clinical research data and discuss how stakeholders are designing and implementing data standard- ization plans in response.  Discuss the relative cost–benefit of data conversion of existing trial data versus building an infrastructure to improve data collec- tion and sharing moving forward.  Present case studies from data-sharing projects using different data standardization and governance models and consider lessons learned or best practices for the future. 2:00 p.m. Background and Session Objectives FRANK ROCKHOLD, Session Co-Chair Senior Vice President, Global Clinical Safety and Pharmacovigilance GlaxoSmithKline Pharmaceuticals Research and Development LYNN HUDSON, Session Co-Chair Chief Science Officer and Executive Director Coalition Against Major Diseases Critical Path Institute 2:10 p.m. PDUFA Update on Data Standards RON FITZMARTIN Senior Advisor, Office of Planning and Analysis Center for Drug Evaluation and Research U.S. Food and Drug Administration

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APPENDIX A 93 2:25 p.m. Standardization to Facilitate Data Sharing: Opportunities and Limitations CDISC Efforts to Support Clinical Research Data REBECCA KUSH President and Chief Executive Officer Clinical Data Interchange Standards Consortium HL7 Efforts to Support Clinical Care Data CHARLES JAFFE Chief Executive Officer Health Level 7 International Health Information Technology Perspective on Clinical Research Data Standards SACHIN JAIN Chief Medical Information and Innovation Officer Merck & Co., Inc. 3:10 p.m. Discussion with speakers and audience 3:30 p.m. BREAK 3:45 p.m. Cost–Benefit Analysis of Retrospective vs. Prospective Data Standardization VICKI SEYFERT-MARGOLIS Senior Advisor, Science Innovation and Policy Office of the Chief Scientist U.S. Food and Drug Administration 4:00 p.m. Case Studies: Standardization and Governance Models in Data Sharing

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94 SHARING CLINICAL RESEARCH DATA Critical Path Institute and Coalition Against Major Diseases Alzheimer’s Clinical Trial Database CAROLYN COMPTON President and Chief Executive Officer Critical Path Institute Translational Medicine Mart (tranSMART) ERIC PERAKSLIS Chief Information Officer and Chief Scientist, Informatics U.S. Food and Drug Administration 4:30 p.m. Panel Discussion  Catalog new data-sharing challenges not yet dis- cussed and provide suggestions for overcoming these challenges.  Given the data standardization and governance mod- els discussed, suggest a framework to guide the de- velopment of new data-sharing projects based on their purpose (e.g., regulatory approval with FDA, detecting safety signals, testing secondary hypothe- ses, etc.). Panelists LAURA LYMAN RODRIGUEZ Director Office of Policy, Communications and Education National Human Genome Research Institute MEREDITH NAHM Associate Director for Clinical Research Informatics Duke Translational Medicine Institute NEIL DE CRESCENZO Senior Vice President and General Manager Oracle Health Sciences

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APPENDIX A 95 MICHAEL CANTOR Senior Director Clinical Informatics and Innovation Pfizer Inc. Panel Moderators FRANK ROCKHOLD, Session Co-Chair Senior Vice President, Global Clinical Safety and Pharmacovigilance GlaxoSmithKline Pharmaceuticals Research and Development LYNN HUDSON, Session Co-Chair Chief Science Officer and Executive Director Coalition Against Major Diseases Critical Path Institute 5:30 p.m. Adjourn Day One October 5, 2012 Day Two 8:00 a.m. Opening Remarks SHARON TERRY, Workshop Chair President and Chief Executive Officer Genetic Alliance SESSION IV: INCENTIVIZING POLICY AND CULTURAL SHIFTS TO ENHANCE DATA SHARING Session Objectives:  Receive an update on clinical trial data transparency decisions in Europe.

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96 SHARING CLINICAL RESEARCH DATA  Explore current incentives for and against (i.e., benefits and risks of) data sharing within and across sectors and suggest mechanisms to encourage stakeholders to engage in a culture of data sharing.  Identify existing and potential strategies, including technology- based approaches, for protecting patient privacy and confidentiality while facilitating data sharing. 8:10 a.m. Background and Session Objectives ROBERT HARRINGTON, Session Chair Arthur L. Bloomfield Professor of Medicine Chair, Department of Medicine Stanford University 8:20 a.m. Clinical Trial Data Transparency: European Medicines Agency Perspective HANS-GEORG EICHLER Senior Medical Officer European Medicines Agency 8:40 a.m. Clinical Research Data Sharing Practices and Attitudes ANDREW VICKERS Attending Research Methodologist Department of Epidemiology and Biostatistics Memorial Sloan-Kettering Cancer Center 8:55 a.m. Overview of Data-Sharing Policies: Research Funders and Publishers STEVEN GOODMAN Associate Dean for Clinical and Translational Research Professor of Medicine & Health Research and Policy Stanford University School of Medicine 9:10 a.m. Series of Presentations: Incentives for Data Sharing Within and Across Sectors

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APPENDIX A 97 Academic Perspectives PETER DOSHI Postdoctoral Fellow Johns Hopkins University School of Medicine BETH KOZEL Instructor of Pediatrics Division of Genetics and Genomic Medicine St. Louis Children’s Hospital and Washington University School of Medicine Federal Research Funder Perspective JOSEPHINE BRIGGS Director, National Center for Complementary and Alternative Medicine Director, National Center for Advancing Translation Sciences, Division of Clinical Innovation National Institutes of Health 9:55 a.m. Discussion with speakers and audience 10:30 a.m. BREAK 10:45 a.m. Facilitating Patient Ownership of Clinical Trial Data: Technical Challenges and Opportunities JOHN WILBANKS Director Sage Bionetworks DEVEN MCGRAW Director, Health Privacy Project Center for Democracy and Technology 11:15 a.m. Discussion with speakers and audience

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98 SHARING CLINICAL RESEARCH DATA SESSION V: NEXT STEPS AND FUTURE DIRECTIONS Session Objectives:  Discuss key themes from the workshop.  Based on workshop presentations and discussions, identify po- tential next steps and priority actions for data-sharing stakehold- ers to take action.  Highlight potential opportunities and challenges that are current- ly on the horizon, but may become more salient as technology evolves and/or data sharing becomes more pervasive. 11:30 a.m. Background and Session Objectives SHARON TERRY, Workshop Chair President and Chief Executive Officer Genetic Alliance 11:40 a.m. Session Chair Reports (5 minutes per session) WILLIAM POTTER, Session I Co-Chair Co-Chair Emeritus Neuroscience Steering Committee FNIH Biomarkers Consortium DEBORAH ZARIN, Session I Co-Chair Director, ClinicalTrials.gov National Library of Medicine National Institutes of Health JEFFREY NYE, Session II Chair Vice President Neuroscience Innovation and Partnership Strategy Janssen Research & Development, LLC

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APPENDIX A 99 FRANK ROCKHOLD, Session III Co-Chair Senior Vice President Global Clinical Safety and Pharmacovigilance GlaxoSmithKline Pharmaceuticals Research and Development LYNN HUDSON, Session III Co-Chair Chief Science Officer and Executive Director Coalition Against Major Diseases, Critical Path Institute ROBERT HARRINGTON, Session IV Chair Arthur L. Bloomfield Professor of Medicine Chair, Department of Medicine Stanford University 12:00 p.m. Closing Discussion with Session Chairs, Panelists, and Audience Led by Workshop Chair JOSEPHINE BRIGGS Director, National Center for Complementary and Alternative Medicine Director, National Center for Advancing Translation Sciences, Division of Clinical Innovation National Institutes of Health MICHAEL ROSENBLATT Executive Vice President and Chief Medical Officer Merck & Co., Inc. JAY “MARTY” TENENBAUM Founder and Chair Cancer Commons JANET WOODCOCK Director, Center for Drug Evaluation and Research U.S. Food and Drug Administration 12:45 p.m. ADJOURN

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