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HOVON 104 AL AMYLOIDOSIS Clinical trial protocol version 7, 27 November 2012<br />

<br />

Reason for end <strong>of</strong> protocol treatment.<br />

Each CRF page will be identified by a pre-printed trial number, <strong>and</strong> a combination <strong>of</strong> patient <strong>study</strong><br />

number (assigned at registration), hospital name to be filled out before completing the form.<br />

The CRF will be completed on site by the local investigator or an authorized staff member. Each page<br />

must be dated <strong>and</strong> signed by the local investigator upon completion. All CRF entries must be based<br />

on source documents. The CRF <strong>and</strong> written instructions for completing the CRF will be provided by<br />

the HOVON Data Center.<br />

Copies <strong>of</strong> the CRF will be kept on site. The original CRF pages must be sent to the HOVON Data<br />

Center at the requested time points. How <strong>and</strong> when to send in forms is described in detail in the CRF<br />

header <strong>and</strong> the CRF instructions.<br />

All data from the CRF will be entered into the <strong>study</strong> database by the HOVON Data Center.<br />

Country specific addition for GERMANY:<br />

On the <strong>study</strong> specific case report forms the complete birth date will be asked for. In Germany only the<br />

entry <strong>of</strong> the year <strong>of</strong> birth is allowed according to data protection. Therefore spaces for day <strong>and</strong> month<br />

on the CRF-pages will be crossed out <strong>and</strong> only the year will be entered.<br />

16.2 Data quality assurance<br />

Steps to be taken to ensure the accuracy <strong>and</strong> reliability <strong>of</strong> data include the selection <strong>of</strong> qualified<br />

investigators <strong>and</strong> appropriate <strong>study</strong> centers, review <strong>of</strong> protocol procedures with the investigator before<br />

the <strong>study</strong>, <strong>and</strong> site visits by the sponsor.<br />

Data collected on the CRF will be verified for accuracy. If necessary, queries will be sent to the<br />

investigational site to clarify the data on the CRF. The investigator should answer data queries within<br />

the specified time line.<br />

16.3 Monitoring<br />

The sponsor will perform on-site monitoring visits to verify that the rights <strong>and</strong> well-being <strong>of</strong> patients<br />

are protected, the reported trial data are accurate, complete, <strong>and</strong> verifiable from source documents<br />

<strong>and</strong> the conduct <strong>of</strong> the trial is in compliance with the currently approved protocol/amendment(s), with<br />

GCP, <strong>and</strong> with the applicable regulatory requirement(s). Monitoring visits will take place according to<br />

the <strong>study</strong> specific monitoring plan.<br />

Direct access to source documentation (medical records) must be allowed for the purpose <strong>of</strong> verifying<br />

that the data recorded in the CRF are consistent with the original source data. The sponsor expects<br />

that during monitoring visits the relevant investigational staff will be available, the source<br />

Page 46 <strong>of</strong> 75 EudraCT-No: 2010-021445-42

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