ICH E6(R3) monitoring framework: Annex 1, Section 3.11.4 in practice
Explain the monitoring requirements of ICH E6(R3) Annex 1, Section 3.11.4, including the proportionality principle, monitoring strategy documentation, and how risk assessment drives monitoring intensity and focus areas.
The document on the table
Picture the scene. A coordinator sits in a conference room at the study site during a site initiation visit. The CRA from the sponsor's contract research organization has just walked through the protocol, the electronic data capture system, and the investigational product handling procedures. Now the CRA opens a new document and places it on the table: the monitoring plan.