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  • 學位論文

台灣與美國新藥臨床試驗查核缺失對應知識庫建構及運用

Developing Good Clinical Practice Inspection Knowledge Base for Comparison of Inspection Deficiency between Taiwan and United States

指導教授 : 劉建財
共同指導教授 : 何善台

摘要


全球臨床試驗環境及報告審查規定快速變遷且日益複雜,新藥臨床試驗必須瞭解藥品生產和臨床研究的活動在國內外擴張對於監管機構使用標準的需要,以通過不同地區實施新藥臨床試驗查核規範及不同查核缺失標準,因此提供不同地區新藥臨床試驗查核缺失的對應資訊查詢,將成為瞭解不同地區的重要資料。本研究目的為探討台灣與美國試驗主持人新藥臨床試驗查核缺失項目的對應,以建置新藥臨床試驗查核缺失對應知識庫,提供查詢查核缺失的知識平台。藉由台灣與美國查核缺失對應,分析台灣2001-2011年新藥臨床試驗查核缺失在美國查核缺失碼分佈情況,作為未來與美國查核缺失交流的重要資訊。 研究結果顯示,台灣38項試驗主持人查核項目與美國FDA 20項查核缺失碼可完成對應並完成建置台灣與美國新藥臨床試驗查核缺失知識庫。而台灣333件和美國2948件GCP查核之缺失在與美國查核缺失碼分析得知因查核程序及缺失分類的不同,台灣在對應前查核缺失在「受試驗者資料」(58.6%)之分佈比率較高;但與美國查核缺失碼對應後則以「不健全的藥品權責」(23.2%)缺失分佈比率較高,而美國方面則見於「未按實驗計畫書執行」缺失分佈比率較高(38.0%)。 藉此查核缺失對應知識庫建立,幫助我們瞭解台灣及美國臨床試驗查核缺失分類及分佈,未來可利用此方式延伸探討與不同地區如歐盟及日本的查核缺失對應,有助於國際間瞭解台灣新藥臨床試驗查核及提供我國藥政單位於新藥臨床試驗查核政策規畫的參考。

並列摘要


The purpose of this study was to build up a knowledge base of deficiency items of clinical trials between Taiwan and USA and to understand it distribution based on the Clinical Investigator Inspection Deficiency Codes of U.S. FDA GCP. Through correlating Taiwan FDA (TFDA) GCP inspection checklist items with the FDA Clinical Investigator Inspection Deficiency Codes, we built up a TFDA-FDA GCP inspection knowledge base to analyze the distribution of the GCP inspection defieiency from 2001 to 2011 in Taiwan based on U.S. FDA Deficiencies. Applying GCP inspection knowledge base to Analysis deficiencies from FDA Clinical Investigator Inspection Deficiencies Code, Comparing the deficiency between TFDA 333 routine GCP inspection report and FDA 2948 routine GCP inspection deficiency, we found out that "Inadequate drug accountability" in TFDA is ranked as top with 23.2%. Wherever the FDA found out that "Failure to follow investigational plan" is ranked as top with 38.0%. Setting up a knowledge base, we can not only effectively map those inspection deficiency items of clinical trials in Taiwan to those in U.S., but also use this approach to compare GCP deficiency differences between TFDA and FDA. Moreover, the knowledge base will be able to indicate the implementation quality of GCP inspection and to enhance internationalization of GCP inspection in Taiwan.

參考文獻


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