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Sunday, March 8, 2009

Open Source eClinical - Myths & Facts

I came across a blog / article posted by here that provides a Q&A with Ben Baumann of Akaza Research.  On reading the article, I feel obliged to respond to some of the comments made. 

First of all, I believe that Open Source based systems do provide a valid alternative to closed source products.  I have both developed, and used Open Source systems in the past. Both Open and Closed Source based systems are designed to create a financial return for the companies that develop and support them.  With the Open Source model, the revenue comes from support and consulting with the reduced cost of development shared across a number of organizations.   With Commercial software, revenue comes from licenses, support and consulting.  The cost of the development is higher, but, this cost is typically covered by the corresponding license revenue.

Back to the article. There are a few points that jump out at me as arguments for OpenClinica;

In addition to a full set of EDC and CDM features one might expect in such a system, OpenClinica has  built-in features that give users the ability to set-up their own studies.

Any EDC or CDM system worth their salt will provide functions that give users the ability to setup their own studies.  Good systems will also ensure that an absolute and clear separation is maintained between the configuration of the study and the tool itself. If the tool has to be modified in any way, then you have a validation nightmare each time you run a study.

In short, an organization can make a rapid and highly informed decision whether or not to use OpenClinica without having to go through lengthy vendor-biased demonstrations and negotiations, and rely on a vendor in order to get their studies configured appropriately.

Well... instead of going through a demonstration that presents the features of the product, the user really needs to start digging into the source code to gain a good understanding of what goes on. So, as a user you need to have a good understanding of fairly complex 3rd generation language programming.   To fully understand how a tool works takes some time. For large EDC or CDM systems I would put that estimate, for an experienced programmer, weeks if not months of detailed analysis. 

Enhanced validation. Validation can be much more thorough with open source software. Buying proprietary software is like buying a car with the  hood welded shut-you don’t know what’s really know going on behind the scenes. Open source provides the highest level of transparency making it possible to truly validate a system from end-to-end.

"Oh! so I need to validate the system myself?" Validation is complicated and expensive.  All systems in the eClinical world require that the development runs within a structured process. You generally need to maintain a trace-ability matrix that takes the software through a lifecycle from specification through to coding and on to completed and recorded testing.   As with InHouse systems, maintaining this will can be challenging

Typical eClinical systems split the code product, that is developed and validated, from the configuration of the product. That part is typically just 'tested'.  In the situation, you don't need to re-validate the software product following a configuration of the product for a particular deployment (i.e. Study).  The validation of a full EDC product might take 200 man days. The testing of a configuration might only take 10 days.   If you mix the configuration with changes to the core software product, you need to be very careful that you don't compromise the core product validation.

As I said at the start, open source solutions have a place in the eClinical business area.  They can be the right solution in certain circumstances, but, they are not always suitable.

2 comments:

Eco said...

Great post.

For me it is about a certain type of freedom. Do you want the freedom to host the product, to fork it (make new variants), to get your hands dirty in the code and to use it forever license free?

Sure you do. But do you want it at the price of having to host, maintain and validate the product youself?

For a certain type of organization (Universities) with an inexhaustible supply of top-notch but underpaid technical staff (Grad Students) this is a great deal!

But if you are BigPharma that means putting considerable investment into your IT and technical validation departments. Maybe not such a great deal.

Exactly as you say, both have their place but you are right to point out that Open Source != Free lunch!

joshuadf said...

I ran across this post and wanted to provide some feedback because I work at a university currently evaluating OpenClinica as a possible low-cost EDC solution. While I agree with most of your assessment, some EDC vendors do not allow users to set up their own studies. As far as I can tell, this is mostly because their software is too cumbersome for users to understand! Just to be clear, EDC software from major vendors like Medidata or PhaseForward is more user-friendly than OpenClinica.

I wish the comment about plentiful grad students was accurate. Unfortunately for us the real world is PIs on RO1 grants with maybe a couple thousand dollars budgeted for data management.