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Oral Mucositis
Author Bios
Introduction
Etiology of Oral Mucositis
Prevalence
Diagnosis
Treatment
Biological Mechanisms of Mucositis
Assessment Scale
Clinical Trial Design
Population Selection and Randomization
Data Collection and Assessment Measures
Currently selected section: Quality Control Techniques
Anaysis and Presentation
Conclusion


Chapter 17: Oral Mucositis: Clinical Trial Design for Mucositis: Quality Control Techniques
        

Quality control techniques to be used in this study include:

  • Using clear definitions of pain;
  • Staff training sessions on how to collect data and encourage patient compliance; and
  • Making extra measures to insure that patients are filling out the dairies daily.

Data from all the centers should be evaluated at the beginning of each chemotherapy cycle to insure consistency in data collection from patient diaries and that patients are being weighed. This study relies heavily on patient cooperation in filling out their daily logs. Emphasizing the need for patients to fill the log every day will be crucial.

The following are important steps in obtaining high-quality data in a mucositis related study:

  • Have a solid protocol design and investigator's manual;
  • Clearly define all key words;
  • Train all investigators and evaluators in assessment of pain and mucositis, in use of the VAS scale, and in how to instruct patients on study procedures and the diary;
  • Regularly monitor raw data to insure that entries are complete and correct;
  • Review mucositis assessments weekly to determine whether the mucositis grades between the 2 scales, WHO and OMAS, are consistent. (For instance, an OMAS ulceration grade of 1 or above must mean a WHO grade of at least a 2. If mucositis grades are inconsistent, the data are unreliable.); and
  • Make corrections and clarifications immediately.

If the study involves multiple sites, special attention must be given to staff training. A formal training session, preferably by the same instructor, should be given at each site. Evaluators should be calibrated to allow for accurate inter-rater reliability. In addition, mucositis assessments should be performed at around the same time of day, with proper lighting of the same type at each site, and the number of evaluators should be limited to minimize error between raters.

 

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