It is common for international and UK Life Science companies to use specific medical terms and acronyms. For those in this industry some terms are second nature, but for others they are not! Barlow Robbins has produced a glossary of terms in order to help navigate some of the most commonly used terms.
Adverse Drug Reaction or ADR
In clinical trials: all adverse or unusual noxious and unintended responses to a medicinal product related to any dose or doses so that a causal relationship between a medicinal product and an adverse reaction is at least a reasonable possibility, i.e. the relationship cannot be ruled out.
Regarding marketed medicinal products: a response to a drug which is noxious and unintended and which occurs at usual doses normally used for therapy of diseases, for modification of physiological function or diagnosis.
Adverse Event or AE
Any untoward medical occurrence in a patient or clinical investigation subject administered a pharmaceutical product. An AE can therefore be any unfavourable and unintended sign (including an abnormal laboratory finding), symptom, or disease temporally associated with the use of a medicinal (or investigational) product, whether or not related to the medicinal (or investigational) product.
Amendment to the protocol
See Protocol Amendment.
Applicable Regulatory Requirement(s)
Any law(s) and regulation(s) addressing the conduct of clinical trials of investigational products.
Active pharmaceutical ingredient
Approval (in relation to Institutional Review Boards)
The affirmative decision of the IRB that the clinical trial has been reviewed and may be conducted at the institution site within the constraints set forth by the IRB, the institution, Good Clinical Practice, and the applicable regulatory requirements.
A systematic and independent examination of trial related activities and documents to determine whether the evaluated trial related activities were conducted, and the data were recorded, analysed and accurately reported according to the protocol, sponsor’s standard operating procedures, Good Clinical Practice, and the applicable regulatory requirement(s).
A declaration of confirmation by the auditor that an audit has taken place.
A written evaluation by the sponsor’s auditor of the results of the audit.
Documentation that allows reconstruction of the course of events.
BID or b.i.d.
Means twice a day (Latin: bis indie).
A procedure in which one or more parties to the trial are kept unaware of the treatment assignment(s). Single-blinding usually refers to the subject(s) being unaware, and double-blinding usually refers to the subject(s), investigator(s), monitor, and, in some cases, data analyst(s) being unaware of the treatment assignment(s).
Case Report Form (also CRF)
A printed, optical, or electronic document designed to record all of the protocol required information to be reported to the sponsor on each trial subject.
Means centrally authorised products (i.e. in the EU).
Clinical Trial/Clinical Study
Any investigation in human subjects intended to discover or verify the clinical, pharmacological and/or other pharmacodynamic effects of an investigational product(s), and/or to identify any adverse reactions to an investigational product(s), and/or to study absorption, distribution, metabolism, and excretion of an investigational product(s) with the object of ascertaining its safety and/or efficacy. The terms clinical trial and clinical study are synonymous.
Clinical Trial/Study Report
A written description of a trial/study of any therapeutic, prophylactic, or diagnostic agent conducted in human subjects, in which the clinical and statistical description, presentations, and analyses are fully integrated into a single report (see the ICH Guideline for Structure and Content of Clinical Study Reports).
Clinical trial authorisation.
Means the committee for Medicinal Products for Human Use.
An investigational or marketed product (i.e., active control), or placebo, used as a reference in a clinical trial.
Compliance (in relation to trials)
Adherence to all the trial-related requirements, Good Clinical Practice (GCP) requirements, and the applicable regulatory requirements.
Prevention of disclosure, to other than authorized individuals, of a sponsor’s proprietary information or of a subject’s identity.
A written, dated, and signed agreement between two or more involved parties that sets out any arrangements on delegation and distribution of tasks and obligations and, if appropriate, on financial matters. The protocol may serve as the basis of a contract.
A committee that a sponsor may organize to coordinate the conduct of a multicentre trial.
An investigator assigned the responsibility for the coordination of investigators at different centres participating in a multicentre trial.
Contract Research Organization or CRO
A person or an organization (commercial, academic, or other) contracted by the sponsor to perform one or more of a sponsor’s trial-related duties and functions.
Means clinical trial regulations in particular the EU Clinical Trials Regulation (EU 536/2014).
Permission to examine, analyse, verify, and reproduce any records and reports that are important to evaluation of a clinical trial. Any party (e.g., domestic and foreign regulatory authorities, sponsor’s monitors and auditors) with direct access should take all reasonable precautions within the constraints of the applicable regulatory requirement(s) to maintain the confidentiality of subjects’ identities and sponsor’s proprietary information.
All records, in any form (including, but not limited to, written, electronic, magnetic, and optical records, and scans, x-rays, and electrocardiograms) that describe or record the methods, conduct, and/or results of a trial, the factors affecting a trial, and the actions taken.
Means the EU medicines regulatory network.
Documents which individually and collectively permit evaluation of the conduct of a study and the quality of the data produced (see further: Essential Documents for the Conduct of a Clinical Trial).
GCP or Good Clinical Practice (or cGMP) (current Good Manufacturing Practices)
A standard for the design, conduct, performance, monitoring, auditing, recording, analyses, and reporting of clinical trials that provides assurance that the data and reported results are credible and accurate, and that the rights, integrity, and confidentiality of trial subjects are protected. GMP is the equivalent standard for the manufacturing equivalent.
A person, who is independent of the trial, who cannot be unfairly influenced by people involved with the trial, who attends the informed consent process if the subject or the subject’s legally acceptable representative cannot read, and who reads the informed consent form and any other written information supplied to the subject.
IDMC or Independent Data Monitoring Committee
In relation to Data and Safety: Monitoring Board, Monitoring Committee, Data Monitoring Committee) An independent data-monitoring committee that may be established by the sponsor to assess at intervals the progress of a clinical trial, the safety data, and the critical efficacy endpoints, and to recommend to the sponsor whether to continue, modify, or stop a trial.
IEC or Independent Ethics Committee
An independent body (a review board or a committee, institutional, regional, national, or supranational), constituted of medical professionals and non-medical members, whose responsibility it is to ensure the protection of the rights, safety and well-being of human subjects involved in a trial and to provide public assurance of that protection, by, among other things, reviewing and approving / providing favourable opinion on, the trial protocol, the suitability of the investigator(s), facilities, and the methods and material to be used in obtaining and documenting informed consent of the trial subjects. The legal status, composition, function, operations and regulatory requirements pertaining to Independent Ethics Committees may differ among countries, but should allow the Independent Ethics Committee to act in agreement with GCP.
A process by which a subject voluntarily confirms his or her willingness to participate in a particular trial, after having been informed of all aspects of the trial that are relevant to the subject’s decision to participate. Informed consent is documented by means of a written, signed and dated informed consent form.
The act by a regulatory authority(ies) of conducting an official review of documents, facilities, records, and any other resources that are deemed by the authority(ies) to be related to the clinical trial and that may be located at the site of the trial, at the sponsor’s and/or contract research organization’s (CRO’s) facilities, or at other establishments deemed appropriate by the regulatory authority(ies).
Commonly a university or college but can include any public or private entity or agency or medical facility where research or clinical trials are conducted.
IRB or Institutional Review Board
An independent body constituted of medical, scientific, and non-scientific members, whose responsibility is to ensure the protection of the rights, safety and well-being of human subjects involved in a trial by, among other things, reviewing, approving, and providing continuing review of trial protocol and amendments and of the methods and material to be used in obtaining and documenting informed consent of the trial subjects.
Interim Clinical Trial/Study Report
A report of intermediate results and their evaluation based on analyses performed during the course of a trial.
Means an investigational medical product.
Means an investigational medical device.
Investigational Medical Product
A pharmaceutical form of an active ingredient or placebo being tested or used as a reference in a clinical trial, including a product with a marketing authorization when used or assembled (formulated or packaged) in a way different from the approved form, or when used for an unapproved indication, or when used to gain further information about an approved use.
A person responsible for the conduct of the clinical trial at a trial site. If a trial is conducted by a team of individuals at a trial site, the investigator is the responsible leader of the team and may be called the principal investigator. (See also Sub investigator).
In an artificial environment such as a test tube, in order for samples to be tested.
In vitro diagnostics
Testing of in vitro samples.
A compilation of the clinical and nonclinical data on the investigational product(s) which is relevant to the study of the investigational product(s) in human subjects.
Means an individual project addendum.
Legally Acceptable Representative
An individual or juridical or other body authorized under applicable law to consent, on behalf of a prospective subject, to the subject’s participation in the clinical trial.
MIA or Manufacturer’s Licence
A licence to lawfully manufacture medical products.
Marketing Authorisation Holder (also MAHs)
Usually a reference to EU central system authority but can also mean authorisation by MHRA.
Means Medicines and Healthcare products Regulatory Agency being the medical regulator in the UK.
Material safety data sheet (see SDs).
The act of overseeing the progress of a clinical trial, and of ensuring that it is conducted, recorded, and reported in accordance with the protocol, Standard Operating Procedures (SOPs), Good Clinical Practice (GCP), and the applicable regulatory requirement(s).
A written report from the monitor to the sponsor after each site visit and/or other trial-related communication according to the sponsor’s SOPs.
A clinical trial conducted according to a single protocol but at more than one site, and therefore, carried out by more than one investigator.
Means national Institute for Biological Standards and Control.
Biomedical studies not performed on human subjects.
Means official Control Authority Batch Release.
Opinion (in relation to Independent Ethics Committee)
The judgement and/or the advice provided by an Independent Ethics Committee or IEC.
Original Medical Record
See Source Documents.
Means a drug used to combat rare diseases.
OOS or Out of Specification
Means analytical results that do not comply with pre-determined acceptance criteria.
OOT or Out of Trend
Means analytical results that do not follow the expected trend. The result is not necessarily Out of Specification but is not the expected data point.
The practice of monitoring the safety and/or effects of medical drugs after they have been licenced for use particularly to identify and evaluate previously unreported adverse reactions.
Post authorisation safety study.
A document that describes the objective(s), design, methodology, statistical considerations, and organization of a trial. The protocol usually also gives the background and rationale for the trial, but these could be provided in other protocol referenced documents. Throughout the ICH GCP Guidelines the term protocol refers to protocol and protocol amendments.
A written description of a change(s) to or formal clarification of a protocol.
Means a product specification file.
Product safety data sheet (see SDS).
Means periodic safety update reports.
QP or Qualified Person
In respect of the right to manufacture products in the UK or directly imported into the UK.
QA or Quality Assurance
All those planned and systematic actions that are established to ensure that the trial is performed and the data are generated, documented (recorded), and reported in compliance with Good Clinical Practice and the applicable regulatory requirement(s). Also QA can mean the agreement (quality agreement) between parties setting out responsibilities regarding services performance including cGMP.
QC or Quality Control
The operational techniques and activities undertaken within the quality assurance system to verify that the requirements for quality of the trial-related activities have been fulfilled.
Q.D. or q.d.
Means daily dose (Latin: quaque die), also sometimes used is the phrase OD.
The process of assigning trial subjects to treatment or control groups using an element of chance to determine the assignments in order to reduce bias.
Bodies having the power to regulate. In the ICH GCP guidelines the expression Regulatory Authorities includes the authorities that review submitted clinical data and those that conduct inspections. These bodies are sometimes referred to as competent authorities.
Means a responsible Person for Import.
Safety Data Sheets or SDS
SDS are key documents in the safe supply, handling and use of chemicals for medical use. They should help to ensure that those who use chemicals in the workplace do so safely without risk of harm to users or the environment. SDSs are required by the REACH Regulation. They list health and safety information on chemicals and chemical compounds and their use (also MSDS and PSDS).
SAE or Serious Adverse Event or Serious ADR or Serious Adverse Drug Reaction
Any untoward medical occurrence that at any dose of a drug:
- results in death,
- is life-threatening,
- requires inpatient hospitalization or prolongation of existing hospitalization,
- results in persistent or significant disability/incapacity,
- or creates a congenital anomaly/birth defect
(see the ICH Guideline for Clinical Safety Data Management: Definitions and Standards for Expedited Reporting).
All information in original records and certified copies of original records of clinical findings, observations, or other activities in a clinical trial necessary for the reconstruction and evaluation of the trial. Source data are contained in source documents (original records or certified copies).
Original documents, data, and records (e.g., hospital records, clinical and office charts, laboratory notes, memoranda, subjects’ diaries or evaluation checklists, pharmacy dispensing records, recorded data from automated instruments, copies or transcriptions certified after verification as being accurate copies, microfiches, photographic negatives, microfilm or magnetic media, x-rays, subject files, and records kept at the pharmacy, at the laboratories and at medico-technical departments involved in the clinical trial).
An individual, company, institution, or organization which takes responsibility for the initiation, management, and/or financing of a clinical trial.
An individual who both initiates and conducts, alone or with others, a clinical trial, and under whose immediate direction the investigational product is administered to, dispensed to, or used by a subject. The term does not include any person other than an individual (e.g., it does not include a corporation or an agency). The obligations of a sponsor-investigator include both those of a sponsor and those of an investigator.
SOPs or Standard Operating Procedures
Detailed, written instructions to achieve uniformity of the performance of a specific function: can also mean sponsor’s standard operating procedures.
Any individual member of the clinical trial team designated and supervised by the investigator at a trial site to perform critical trial-related procedures and/or to make important trial-related decisions (e.g., associates, residents, research fellows). See also Investigator.
An individual who participates in a clinical trial, either as a recipient of the investigational product(s) or as a control.
Subject Identification Code
A unique identifier assigned by the investigator to each trial subject to protect the subject’s identity and used in lieu of the subject’s name when the investigator reports adverse events and/or other trial related data.
SPC or Supplementary Protection Certificate
Extends patent protection for medicinal products.
The location(s) where trial-related activities are actually conducted.
Unexpected Adverse Drug Reaction
An adverse reaction, the nature or severity of which is not consistent with the applicable product information (e.g., Investigator’s Brochure for an unapproved investigational product or package insert/summary of product characteristics for an approved product) (see the ICH Guideline for Clinical Safety Data Management: Definitions and Standards for Expedited Reporting).
Individuals whose willingness to volunteer in a clinical trial may be unduly influenced by the expectation, whether justified or not, of benefits associated with participation, or of a retaliatory response from senior members of a hierarchy in case of refusal to participate. Examples are members of a group with a hierarchical structure, such as medical, pharmacy, dental, and nursing students, subordinate hospital and laboratory personnel, employees of the pharmaceutical industry, members of the armed forces, and persons kept in detention. Other vulnerable subjects include patients with incurable diseases, persons in nursing homes, unemployed or impoverished persons, patients in emergency situations, ethnic minority groups, homeless persons, nomads, refugees, minors, and those incapable of giving consent.
Well-being (of the trial subjects)
The physical and mental integrity of the subjects participating in a clinical trial.