Benchmarking Protocol Deviations and Their Variation by Major Disease Categories

Ther Innov Regul Sci. 2022 Jul;56(4):632-636. doi: 10.1007/s43441-022-00401-4. Epub 2022 Apr 4.


Background: Little to no data exist quantifying and benchmarking the magnitude of protocol deviation experience.

Methods: Nearly two-dozen companies provided the Tufts Center for the Study of Drug Development (Tufts CSDD) with data on the design and the performance of 187 protocols.

Results: The results of this working group study show that phase II and III protocols have a mean total of 75 and 119 protocol deviations, respectively, involving nearly one-third of all patients enrolled in each clinical trial. Oncology clinical trials have the highest relative mean number of protocol deviations affecting more than 40% of patients enrolled in each trial. The number of endpoints, the number of procedures per visit, and the number of countries were modestly positively associated with and predictive of, the incidence of deviations per protocol. A strong positive relationship was shown between the number of investigative sites and the number of protocol deviations.

Conclusion: The results of this initial study provide useful measures that sponsor companies can use to benchmark their own protocol deviation experience, identify factors most associated with protocol deviations, and determine whether remediation is warranted.

Keywords: Protocol changes; Protocol design; Protocol deviations.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Benchmarking*
  • Humans