This peer-reviewed white paper analyzes more than 270,000 ECGs from oncology trials to compare site-based ECG machine measurements with centralized core lab readings. The findings demonstrate substantial discrepancies in QTc measurements, particularly near protocol decision thresholds, leading to unnecessary patient exclusions or treatment interruptions. The authors show that automated ECG algorithms frequently overestimate QTc prolongation, while centralized expert review improves precision, consistency, and patient safety. The paper underscores the importance of centralized ECG interpretation in oncology trials, where QTc-based decisions directly affect enrollment and dosing. Overall, the study supports centralized ECG reading as a best practice to improve data integrity, trial efficienc

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