Were the results of cast due to drug packaging error?

Were the results of cast due to drug packaging error?

272 Abstracts .46 TRACKING, ACCESSING, AND REPORTING ON EDIT QUERIES Paul B. Connor, M. Marvin Newhouse, and Stephen C. Grubb The Wllmer Ophthalmolo...

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272

Abstracts .46 TRACKING, ACCESSING, AND REPORTING ON EDIT QUERIES

Paul B. Connor, M. Marvin Newhouse, and Stephen C. Grubb The Wllmer Ophthalmological Institute The Johns Hopkins University Baltimore, Maryland A system for tracking, accessing, and reporting on edit-system generated queries has been developed for the Collaborative Ocular Melanoma Study (COMS) In the past we have spoken about an edit system that allows custom-written, logical cond~bons and messages whde prowd~ng complex editing capabilities and easy maintenance of edit specM~cat~onfiles However, we have found that w~th more chn~cal centers, more forms, and longer follow-up we need a system w~th sophisticated tracking and reporting capab~ht~es We have ~mplemented a system ~nwhich a umque ~dent~fier~sgenerated and stored along w~th ~nformat~on about each edit query Using this stored ~nformat~onthe system allows correcbon of queried data ~tems using a fast, direct-access algorithm, determ~nabon of the status of edit queries at any point ~nt~me, recording of the source of the error when an edit query ~s resolved, re-editing of records w~thout regenerating prewously confirmed edit queries, automatic regenerabon of outstanding edit queries, and tabulation of errors detected and resolved by form, ~tem, and source of error We present the design features of th~s system and provide examples of ~ts benefits

47 WERE THE RESULTS OF CAST DUE TO DRUG PACKAGING ERROR? Clair Haakenson, Loretta A. Malone, Mary Jo Gillespie, Ruth McBride, and Surena Khatir VA Medlca/ Center A/buquerque, New Mexico The Cardiac Arrhythm~a Suppression Trial (CAST) ~s a double-bhnd, placebo-controlled thai evaluating whether suppression of asymptomat~c or mddly symptomatic arrhythm~as ~s beneficial CAST ~s sponsored by the National Heart, Lung and Blood Insbtute using a Coordlnabng Center ~n Seattle (Umvers~ty of Washington) and a Drug D~stnbut~onCenter (DDC) ~nAlbuquerque (VA Cooperabve Studies Program Chmcal Research Pharmacy Coordinat~ng Center) Three ant~arrhythm~adrugs were chosen for use ~nCAST Active and placebo forms were obtained by the DDC from the manufacturers, repackaged into smaller units, and d~stnbuted to part~c~pabngcenters Recently two of the treatments were dropped, w~th mortahty rates greatly exceeding those of placebo controls Among possible explanations for these dramatic and unexpected results was that a drug packaging error may have occurred either at the manufacturing plants or DDC. To rule out th~s possibility, DDC accountability records, packaging procedures, and samphng programs were carefully examined The following were noted" 1. Quahtabve analys~s of one p~ll from every CAST bottle d~spensed ~n October 1988 (551 bottles) revealed no errors 2 330 bottles selected from drugs returned by parbc~pat~ngcenters and analyzed by manufacturers to test DDC packaging accuracy, revealed no errors 3 All samples analyzed during the study ~n the drug stab~hty program had been found satisfactory 4. Physical inventories and calculated ~nventor~es,frequently compared at DDC, had always balanced 5 DDC receipt records matched those of the manufacturers 6 The DDC and manufacturers observe FDA's Good Manufactunng Practices G~ven these findings, we determined that a packaging error had not occurred in CAST We d~scuss these and other considerations for Coordinating Centers relying on ~ndustry or other groups to perform drug packaging and d~str~but~on.