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Blockchain technology has disclosed unprecedented opportunities in the healthcare sector by unlocking the true value of interoperability. Specifically, the striking features of blockchain technology, such as data provenance, transparency, decentralized transaction validation, and immutability, can help to compensate for stringent data management issues (e.g., patient recruitment, persistent monitoring, data management, and data analytics and accurate reporting) in clinical trials (CTs). Although several research studies show that blockchain solutions help to improve patient retention, data integrity, privacy and ensure CTs compliance with regulatory policies, a comprehensive survey on this topic is lacking. In this survey, we provide insights into the adoption of blockchain technology in CTs. We categorize and classify the literature by devising a meticulous taxonomy of the decentralized tasks of CT and practices based on indispensable parameters. Furthermore, we provide insights on works in progress toward deploying blockchain solutions in CTs. Finally, we identify and discuss several challenges that hinder the successful implementation of blockchain technologies in CTs. [ABSTRACT FROM AUTHOR]

Background: Clinical Trials (CTs) help in testing and validating the safety and efficacy of newly discovered drugs on specific patient population cohorts. However, these trials usually experience many challenges, such as extensive time frames, high financial cost, regulatory and administrative barriers, and insufficient workforce. In addition, CTs face several data management challenges pertaining to protocol compliance, patient enrollment, transparency, traceability, data integrity, and selective reporting. Blockchain can potentially address such challenges because of its intrinsic features and properties. Although existing literature broadly discusses the applicability of blockchain-based solutions for CTs, only a few studies present their working proof-of-concept.Methods: We propose a blockchain-based framework for CT data management, using Ethereum smart contracts, which employs IPFS as the file storage system to automate processes and information exchange among CT stakeholders. CT documents stored in the IPFS are difficult to tamper with as they are given unique cryptographic hashes. We present algorithms that capture various stages of CT data management. We develop the Ethereum smart contract using Remix IDE that is validated under different scenarios.Results: The proposed framework results are advantageous to all stakeholders ensuring transparency, data integrity, and protocol compliance. Although the proposed solution is tested on the Ethereum blockchain platform, it can be deployed in private blockchain networks using their native smart contract technologies. We make our smart contract code publicly available on Github.Conclusions: We conclude that the proposed framework can be highly effective in ensuring that the trial abides by the protocol and the functions are executed only by the stakeholders who are given permission. It also assures data integrity and promotes transparency and traceability of information among stakeholders. [ABSTRACT FROM AUTHOR]

The sudden development of the COVID-19 pandemic has exposed the limitations in modern healthcare systems to handle public health emergencies. It is evident that adopting innovative technologies such as blockchain can help in effective planning operations and resource deployments. Blockchain technology can play an important role in the healthcare sector, such as improved clinical trial data management by reducing delays in regulatory approvals, and streamline the communication between diverse stakeholders of the supply chain, etc. Moreover, the spread of misinformation has intensely increased during the outbreak, and existing platforms lack the ability to validate the authenticity of data, leading to public panic and irrational behavior. Thus, developing a blockchain-based tracking system is important to ensure that the information received by the public and government agencies is reliable and trustworthy. In this paper, we review various blockchain applications and opportunities in combating the COVID-19 pandemic and develop a tracking system for the COVID-19 data collected from various external sources. We propose, implement, and evaluate a blockchain-based system using Ethereum smart contracts and oracles to track reported data related to the number of new cases, deaths, and recovered cases obtained from trusted sources. We present detailed algorithms that capture the interactions between stakeholders in the network. We present security analysis and the cost incurred by the stakeholders, and we highlight the challenges and future directions of our work. Our work demonstrates that the proposed solution is economically feasible and ensures data integrity, security, transparency, data traceability among stakeholders. [ABSTRACT FROM AUTHOR]