Clinical trials are a fundamental part of clinical research that support the development of new medicines or uses of existing medicines. Well-designed and conducted clinical trials help answer key questions in healthcare and drug development. Their results are essential for evidence-based healthcare decisions. Trials with inadequate design and/or poorly conducted trials may place participant safety at risk, yield inadequate or unreliable results and are unethical. They waste resources and the efforts and time of investigators and participants.
The Principles of GCP are designed to be flexible and applicable to a broad range of clinical trials. This guideline, along with ICH E8(R1), encourages thoughtful consideration and planning to address specific and potentially unique aspects of an individual clinical trial. This includes evaluation of trial characteristics, such as the design elements, the investigational product being evaluated, the medical condition being addressed, the characteristics of the participants, the setting in which the clinical trial is being conducted, and the type of data being collected. Careful consideration of factors relevant to ensuring trial quality is needed for each clinical trial.
The principles are intended to support efficient approaches to trial design and conduct. For example, digital health technologies, such as wearables and sensors, may expand the possible approaches to trial conduct. Such technologies can be incorporated into existing healthcare infrastructures and enable the use of a variety of relevant data sources in clinical trials. This will aid in keeping clinical trial conduct in line with advancing science and technological developments. The use of technology in the conduct of clinical trials should be adapted to fit the participant characteristics and the particular trial design. This guideline is intended to be media neutral to enable the use of different technologies.
The design and conduct of the clinical trial may be supported by obtaining the perspectives of interested parties, such as patients and their communities, patient advocacy groups and healthcare professionals. Their input can help to reduce unnecessary complexity, improve feasibility and increase the likelihood of meaningful trial outcomes. The use of innovative trial designs and technologies may enable the inclusion of a wider and more diverse population of participants and thereby broaden the applicability of trial outcomes.
Clinical trials should be designed to protect the rights, safety and well-being of participants and assure the reliability of results. Quality by design should be implemented to identify the factors (i.e., data and processes) that are critical to ensuring trial quality and the risks that threaten the integrity of those factors and ultimately the reliability of the trial results. Clinical trial processes and risk mitigation strategies implemented to support the conduct of the trial should be proportionate to the importance of the data being collected and the risks to trial participant safety and the reliability of trial results. Trial designs should be operationally feasible and avoid unnecessary complexity.
The overarching principles provide a flexible framework for clinical trial conduct. They are structured to provide guidance throughout the life cycle of the clinical trial. These principles are applicable to trials involving human participants. The principles are interdependent and should be considered in their totality to assure ethical trial conduct and reliable results.