When contracts are signed, budgets prepared and all the necessary paperwork (such as your trial protocol, CIP development, ICF, eCRF) has been submitted and approved by the relevant committees and authorities, your cardiology clinical trial is ready for execution.  

In other words, you’re ready to start including patients.

During the execution phase, we support you with the following clinical operations services:

Our clinical operations services

Clinical operations

clinical trial management Project managementClinical operations

Our dedicated clinical operations team supports you every step of the way, with your single centre study or your international multicentre trial. We’re experienced in site management, including site initiation visits, education and engagement.

Other clinical operations services include, but are not limited to: the coordination of study supplies (i.e. medication, medical devices), monitoring budget and timeline and organising regular trial meetings to ensure everybody involved stays up to date.

Need support from our clinical operations team?

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Clinical trail services Clinical MonitoringClinical monitoring

When hospitals start including patients into your trial, our experienced Clinical Research Associates (CRAs) can help with clinical monitoring.

Depending on the type of trial, we offer different clinical monitoring services: we provide source data verification (SDV), site management and risk based monitoring.

We ensure the protection of rights of all included patients and we check compliance with the trial protocol, Good Clinical Practice (GCP) and the relevant regulatory requirements.

When needed, we take corrective and preventative actions, so your trial continues to run smoothly.

Ask for our clinical monitoring package here

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Clinical trial services safety reportingSafety reporting

Serious Adverse Event (SAE) reporting

A SAE is an undesired serious medical event involving a patient, which is not necessarily associated with the treatment. All SAEs need to be reported, individually or annually to the ethics committee if indicated in the study protocol. Diagram is able to support SAE reporting, including Serious Adverse Reaction (SAR), Suspected Unexpected Serious Adverse Reaction (SUSAR) and Serious Adverse Device Effect (SADE) reporting.

Data Safety Monitoring Board (DSMB)

A DSMB is and independent committee of medical experts formed to monitor the safety of the patients during a trial. This can also be useful or deemed necessary by the ethical committee for trials other than with medicinal products. If a DSMB is established for a trial, Diagram arrange the DSMB meetings, including preparation of the DSMB charter, contracting, invitation of the DSMB members. Diagram is experienced in organising DSMB, safety committee, meetings for trials.

Clinical Event Committee (CEC)

A CEC is an independent committee of medical experts formed to review events obtained from patients who are participating in a clinical trial. The CEC members independently review events based on the CEC charter definitions ensuring assessment in a uniform manner. This centralized adjudication provides a standard, systematic and unbiased assessment of endpoints to determine whether they meet charter specific criteria.

Diagram is experienced in coordinating the entire adjudication process of events by a dedicated CEC. Hence, we prepare the event dossiers and organise the CEC meetings in order to adjudicate the events. We can organise face-to face meetings or remote adjudication by using our own web-based eDREAM system. The web-based system is user-friendly and can be used at any time. Up to 2019 we have organised the CEC for several trials. Diagram has their own network of cardiologists.

Data management

A successful and efficient clinical trial is defined by its results. However, before investigators and sponsors can reach to any final conclusions, the whole trial undergoes many different process including data management.

Query management

One of the key responsibilities of the participating investigators of each hospital is to make sure that the trial information is correct and all GCP regulations/requirements are met. Implementing effective query management contributes to the integrity of a trial database and helps investigators and their study staff to clean the database. A query refers to a database check used to solve discrepancies, empty fields and invalid values. Diagram has gained extensive experience in query management in the last two decades.

ATC/DDD coding

Diagram is experienced in using the Anatomical Therapeutic Chemical (ATC) as classification system and the Defined Daily Dose (DDD) as a unit of measure, endorsed by the World Heart Organisation (WHO). The ATC classification system categorises the active medical substances according to the organ/system on which they act and according to their therapeutic, pharmacologic and chemical properties. The ATC/DDD coding facilitates valid presentation of events at international level.

MedDRA classification

The International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) developed Medical Dictionary for Regulatory Activities (MedDRA) almost three decades ago. MedDRA is a specific standardised medical terminology to facilitate sharing of regulatory information internationally for medical products used by patients in clinical trials. Diagram is experienced in using the MedDRA classification.


A data management plan will be prepared when initiating a trial. This plan will be followed throughout the study, giving guidance to the data manager. Dependent on the requests of the project management team, investigator and sponsor overviews will be prepared including figures and tables in order to give an overview of the status of the trial.

Clinical trial services corelabImaging Corelab

Our Imaging Corelab is one of our key pillars to contribute to better and improved treatments for heart patients. We offer numerous affordable techniques to analyse medical image information:

Interested in our Imaging Corelab services?

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This trial execution phase ends with the last visit of your last participating patient.

Looking for clinical operations services?

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