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Term of the Day

Natural history study

A natural history study is a preplanned observational study intended to track the course of a disease over time, identifying demographic, genetic, environmental and other variables that correlate with its development and outcomes in the absence of intervention, or under standard of care. Designs may be retrospective (chart review of existing records) or prospective (longitudinal follow-up of a cohort or registry).

Natural history data is particularly important in rare and paediatric diseases, where randomised placebo-controlled trials may be infeasible or unethical. The FDA (guidance on rare disease natural history studies, 2019) and the EMA accept well-designed natural history studies to define endpoints and biomarkers, identify patient subgroups, estimate sample sizes and, in some cases, serve as external or historical control arms for single-arm trials supporting orphan products.

Because they are non-interventional, natural history studies fall outside the CTR and are governed by national law (for example France's MR-003 or MR-004 reference methodologies) and by the GDPR. They typically involve secondary use of medical records, long-term follow-up, genetic data and small populations in which anonymisation is rarely achievable, so pseudonymisation, a DPIA and a robust research legal basis under Art. 9(2)(j) are essential. Registries maintained by patient organisations or academic consortia raise additional questions of joint controllership and data access governance.

R

Right of rectification

The right of rectification is the right of the data subject to obtain from the controller, without undue delay, the rectification of inaccurate personal data concerning him or her and, taking into account the purposes of the processing, to have incomplete personal data completed, including by means of providing a supplementary statement (Art. 16 GDPR). It is the individual-rights counterpart of the accuracy principle in Art. 5(1)(d), and the controller must notify recipients of any rectification under Art. 19.

Rectification concerns matters of fact. Where the data records an opinion, diagnosis or assessment, the right does not entitle the individual to have the professional judgement changed, but it does allow a supplementary statement recording their disagreement. Requests must be answered within one month (Art. 12(3)), free of charge, and refusals must be reasoned with information on the right to complain to a supervisory authority.

In health and clinical research, rectification operates within data integrity constraints. A patient can require correction of an incorrect date of birth or medication list in their medical record; the correction is made through a documented amendment that preserves the original entry and the audit trail, as required by medical record legislation and by GCP (ALCOA+). In a clinical trial, corrections flow from the source document at the site to the eCRF via a data query, so the sponsor and site need an agreed procedure for participant requests. Where Member State law implements the Art. 89(2) research derogation, rectification may be limited if it would seriously impair research objectives, but simply overwriting historical trial data is never acceptable.

How should a study team handle a request to correct inaccurate personal data?

Check the disputed information and correct inaccuracies without undue delay, taking account of the processing purpose. Record the correction through the study’s controlled process so that relevant systems are consistent. A rectification request should not be dismissed merely because the information is in a trial database; assess any applicable limitation specifically.