Led by imaging scientists, engineers, clinical developers, and regulatory experts with extensive experience, WCC has a dedicated team that serves as an extension of your team to ensure unmatched expediency from start to finish. Our own proven, in-house radiology expertise is complemented by experts from the world's most renowned medical institutions.
Our board-certified, in-house radiology staff has experience in multiple therapeutic areas along with extensive technology expertise for managing high-volume trials. We also have a strategic relationship with Massachusetts General Hospital (MGH), which we've maintained for more than 20 years, giving us unprecedented access to the best clinical talent in the world and more than 80 subspecialty-trained physicians.
Whether you choose from WCC's own board-certified, in-house radiology experts, subspecialty-trained physicians from MGH or your own independent reviewers, you will receive the expertise, scalability and resources necessary to manage large volumes of images and keep your trial on track.
Massachusetts General Hospital
Since its creation out of Massachusetts General Hospital Imaging (formerly the MGH Department of Radiology) in 1995, WCC has maintained a strategic relationship with the oldest and largest teaching hospital of Harvard Medical School. This access to the vast range of expertise in multiple subspecialties and modalities (including neuroradiology and nuclear medicine) allows us to provide our sponsors with the highest quality medical reads by leaders in many different disease states.
Global Technology Expertise
We draw our extensive global technology expertise and teleradiology capabilities from our parent company ProScan Imaging. As one of the world's most trusted and experienced radiology providers, ProScan enables us to manage virtually any volume of images for our trials, while evolving our service offerings and expanding our global reach as the imaging industry grows.
Through our cross-department relationship with MGH, we are able to draw from the best independent readers in the world for imaging studies and beyond by offering our sponsors access to subspecialty-trained physicians from across departments, who have world-class therapeutic expertise in multiple disease states. We also provide Endpoints Adjudication Committees (EACs) if multiple subspecialists are required. Whether it's a melanoma study that requires a radiologist, dermatologist and oncologist, or a vascular study that requires an arrhythmia specialist and stroke neurologist, WCC can leverage the expertise needed.
Our ProScan Connection
As a member of the ProScan family of companies, WCC leverages the infrastructure of a diagnostic teleradiology network that efficiently processes over 1,000 images per day from 350 sites worldwide using our proprietary WorldPRO technology. This advanced reach allows us to provide sponsors with access to global therapeutic expertise and the scalability to process any volume of images for radiology review and image archiving.
ProScan is a global leader in operating freestanding diagnostic imaging centers and owns and operates one of the most sophisticated image transmission networks in the world. All of ProScan's radiologists are fellowship-trained in at least one subspecialty and bring extensive experience in image interpretation. The ProScan team also provides a superior workflow born from decades of experience as the oldest privately-held teleradiology practice in the U.S., enabling us to offer an operational advantage for complex trials.
When it comes to reader review and data management, precision and control are of the utmost importance. Our scientific approach to imaging provides sponsors with the most accurate and reproducible datasets available. We provide access to operational metrics and clinical statistics every step of the way to improve the accuracy of the trial. Our advanced understanding of diagnostic statistics and variability testing metrics allow WCC to provide an unparalleled depth of understanding of trial data.
WCC's intensive training program starts with the selection of the review team and lead reviewer. Criteria are specified to measure the statistical proficiency of all readers prior to assignment and to set goals for performance.
We look at adjudication rates, apply our statistical approach and use tests such as kappa analysis with confidence intervals to test the performance of the team. To help maintain focus, we provide this data to the lead reviewer and the sponsor so potential issues can be recognized and corrected.
Our approach to retraining is adaptive with retraining being done periodically and on an "as needed" basis. When retraining is required, we select tough to interpret cases rather than randomly selected cases that allow us to better understand reader performance and hone reader skills.
Blinded Independent Central Reviews (BICRs) have the potential to minimize bias and increase the precision of trial data by utilizing multiple independent readers (in a multi-reader BICR). Currently, most multi-reader BICRs are performed primarily for radiological assessments. This is in part attributed to both an understanding of the variability associated with image interpretations and the growth of teleradiology, which allows multiple readers to make rapid assessments of imaging data with software that can automatically send discrepant reads to an adjudicator.
Reader Performance can be Improved
A carefully conducted multi-reader BICR may result in a decrease in inter-reader variability and thus increase the accuracy of the assessment. The inter-reader variability of a small team of independent reviewers can be honed through an iterative process of team training after testing with a focus on difficult cases (i.e., adjudicated cases).
Readers are only the sum of their precision and accuracy
Performance of readers can be explained by their precision and accuracy. When a BICR includes a cohesive team of board-certified, subspecialty-trained practicing physicians, you have the best chance of maximizing the accuracy of an assessment. When coupled with WCC's adaptive training and testing methodology, differences between reviewers are minimized to such a degree that the smallest discrepancies between treatments can be detected.
Precision Where You Need It
The BICR process allows you to add precision to different components of the assessment. For example, we usually recommend multi-reader BICR paradigms for primary endpoints or for complex assessments, whereas a single reader BICR paradigm should be sufficient for secondary endpoints. Regardless of the read paradigm, WCC can help titrate the cost value proposition for your BICR.
Simple Fact: BICRs can be Cost-Effective
Assuming both local evaluation and BICR readers have the same precision and accuracy, an increase in sample size (multi-reader BICR) will decrease variability and result in an increase in precision over the single local evaluation. A simulation model using a cancer study, in collaboration with Dr. Duan from Brown University, demonstrated that compared to local evaluations, BICR paradigms decreased overall trial costs and sample sizes. The effect was even greater if the precision and/or accuracy of BICR reviews were better than the site reviewers.
If data validity is not being actively monitored as it is collected, submissions are at risk. Discrepancies build on one another and the data drifts further and further off course if uncorrected. We proactively assess imaging data so potential issues can be identified and corrected as early as possible. Our regular status updates on every trial and intra- and inter- reader reliability testing allows us to report on the performance of readers and even help reduce the rate that errors occur.