Journal of Biopharmaceutical Statistics, 19: 1168–1171, 2009 Copyright © Taylor & Francis Group, LLC ISSN: 1054-3406 print/1520-5711 online DOI: 10.1080/10543400903244288
BOOK REVIEW
Downloaded By: [Marcel Dekker] At: 17:18 30 December 2009
Data and Safety Monitoring Committees in Clinical Trials, by J. Herson, Boca Raton, FL: Chapman & Hall/CRC, 2009, ISBN 978-1-4200-7037-8, xviii + 173 pp., $89.95.
This book is the most recent addition to a group of texts addressing monitoring of interim data and Data Monitoring Committee (DMC) processes and practices. This set was basically empty at the start of this decade, but reflecting the increased importance of this aspect of current clinical trial practice, it now includes several members, starting with the landmark work by Ellenberg et al. (2002), as well as a number of other entries (e.g., DeMets et al., 2006; Moyé, 2006) and regulatory guidance documents (CHMP, 2006; FDA, 2006). As mentioned at the start of the preface, the focus of this book is on best practices, i.e., on setting up and implementing appropriate processes for DMC activities, and on proper behavior and execution of those processes by the parties involved. The key parties are the DMC members themselves, sponsor trial operations personnel, and personnel from the Data Analysis Center (DAC) providing results to the DMC (other roles in the process addressed to a lesser extent include Steering Committees, Institutional Review Boards [IRBs], investigators, and regulatory agencies). The text specifically focuses on safety monitoring by the DMC, i.e., ensuring patient safety by periodic monitoring of safety data, particularly examining for trends in serious adverse events. Other familiar DMC roles, such as decision making associated with group sequential schemes allowing early stopping for efficacy, or for making futility judgments, are not directly addressed here, apart from some brief discussions of how a DMC might in some circumstances take riskbenefit considerations into account. The target audience includes those who might serve in any of the key roles just mentioned, particularly those who may be undertaking such a role for the first time, or who at least are not highly experienced in the role in which they are serving. This book is lively and readable and has somewhat of an informal tone, no doubt heavily advised by the author’s substantial experience as a biostatistical consultant and a member of many DMCs. It gives much emphasis to real-world complications, subtleties, and “glitches” where practical realities may deviate a bit from the ideal or the anticipated. These are somewhat inevitable in DMC work, as there is a “moving target” aspect to accruing interim data; the amount of information reviewed by a DMC at an interim time point generally was not planned to be definitive for the main research questions of the study, and can be subject to various types of biasing influences as the DMC attempts to separate signal from noise. The different parties 1168