This case study presents the application of Xcellerate® Central Monitoring (XCM) in clinical trial oversight, focusing on its role in identifying data anomalies and safety risks. It outlines three specific instances where medical review teams utilized XCM to enhance data integrity and compliance. The first example discusses Fortrea's use of XCM to efficiently evaluate blood eosinophil counts in a respiratory study, revealing trends that traditional monitoring methods could not achieve in a timely manner. The second example highlights how XCM facilitated medical and safety data reviews, enabling medical monitors to conduct cohort-based analyses and detect early safety signals. The third instance describes the identification of missing data in a non-small cell lung cancer study, where XCM helped improve data completeness for accurate safety assessments. Overall, the case study illustrates how XCM transforms clinical trial oversight into proactive quality management.