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Gieber L, Muturi-Kioi V, Malhotra S, Sitlani A. Clinical and Regulatory Challenges and Opportunities for Monoclonal Antibodies in Low- and Middle-Income Countries: Lessons from COVID-19 and Beyond. Pharmaceut Med 2023; 37:203-214. [PMID: 37115494 PMCID: PMC10141866 DOI: 10.1007/s40290-023-00473-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2023] [Indexed: 04/29/2023]
Abstract
Monoclonal antibodies are an effective and growing class of pharmaceuticals for the treatment and prevention of a broad range of non-communicable and infectious diseases; however, most low- and middle-income countries have limited access to these innovative products. Many factors contribute to the global inequity of access to these products; however, in this report, we focus on clinical and regulatory complexities as further highlighted by the coronavirus disease 2019 pandemic. Despite a higher prevalence of many diseases in low- and middle-income countries, only 12% of clinical trials for monoclonal antibodies are conducted in these countries. Additionally, only a fraction of the available monoclonal antibodies in the USA and European Union are authorized for use in low- and middle-income countries. Through learnings from desk research and global symposia with international partners, we present recommendations to harmonize processes and facilitate regional and international collaborations for more rapid approval of fit-for-purpose innovative monoclonal antibodies and biosimilars in low- and middle-income countries.
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Affiliation(s)
- Lisa Gieber
- IAVI, 125 Broad St, 9th Floor, New York, NY, 10004, USA
| | - Vincent Muturi-Kioi
- IAVI, The Address, 11th Floor Muthangari Drive, P.O. Box 340 KNH, Nairobi, Kenya, 00202
| | | | - Ayesha Sitlani
- IAVI, 125 Broad St, 9th Floor, New York, NY, 10004, USA.
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2
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Selvarajah S, Corona Maioli S, Deivanayagam TA, de Morais Sato P, Devakumar D, Kim SS, Wells JC, Yoseph M, Abubakar I, Paradies Y. Racism, xenophobia, and discrimination: mapping pathways to health outcomes. Lancet 2022; 400:2109-2124. [PMID: 36502849 DOI: 10.1016/s0140-6736(22)02484-9] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 10/06/2022] [Accepted: 11/28/2022] [Indexed: 12/13/2022]
Abstract
Despite being globally pervasive, racism, xenophobia, and discrimination are not universally recognised determinants of health. We challenge widespread beliefs related to the inevitability of increased mortality and morbidity associated with particular ethnicities and minoritised groups. In refuting that racial categories have a genetic basis and acknowledging that socioeconomic factors offer incomplete explanations in understanding these health disparities, we examine the pathways by which discrimination based on caste, ethnicity, Indigeneity, migratory status, race, religion, and skin colour affect health. Discrimination based on these categories, although having many unique historical and cultural contexts, operates in the same way, with overlapping pathways and health effects. We synthesise how such discrimination affects health systems, spatial determination, and communities, and how these processes manifest at the individual level, across the life course, and intergenerationally. We explore how individuals respond to and internalise these complex mechanisms psychologically, behaviourally, and physiologically. The evidence shows that racism, xenophobia, and discrimination affect a range of health outcomes across all ages around the world, and remain embedded within the universal challenges we face, from COVID-19 to the climate emergency.
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Affiliation(s)
- Sujitha Selvarajah
- Institute for Global Health, University College London, London, UK; St George's Hospital NHS Foundation Trust, London, UK.
| | | | - Thilagawathi Abi Deivanayagam
- Institute for Global Health, University College London, London, UK; Lancaster Medical School, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | | | - Delan Devakumar
- Institute for Global Health, University College London, London, UK
| | - Seung-Sup Kim
- Department of Environmental Health Sciences, Seoul National University, Seoul, South Korea
| | - Jonathan C Wells
- University College London Great Ormond Street Institute of Child Health, London, UK
| | - Marcella Yoseph
- Global Mental Health, London School of Hygiene & Tropical Medicine, London, UK; Sir Ketumile Masire Teaching Hospital, University of Botswana, Gaborone, Botswana
| | - Ibrahim Abubakar
- Institute for Global Health, University College London, London, UK
| | - Yin Paradies
- Alfred Deakin Institute for Citizenship and Globalisation, Deakin University, Melbourne VIC, Australia
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3
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Bai Y, Du J. Measuring the impact of health research data in terms of data citations by scientific publications. Scientometrics 2022; 127:6881-6893. [PMCID: PMC9661461 DOI: 10.1007/s11192-022-04559-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 10/10/2022] [Indexed: 11/16/2022]
Abstract
Health is a representative domain data-driven research since health research data are growingly generated at a massive scale. There is an intuitive logic that the degree to which disease burden and the number of data resources align. In order to figure out disease-specific data sharing and reuse level, we took the number of data records and their citations in the scientific literature in the Data Citation Index platform as approximate indicators. The results indicated that only a small percentage (7.5%) of health data records had received documented citations by scientific publications. We find the level of data sharing and reuse varies across diseases. Our study suggested that the more socioeconomic burden and the more research funding, the more likely scientific data for diseases will be produced and made available. But such a correlation could not be observed for the activity of data reuse. Secondary reuse of scientific data is a complex behavior.
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Affiliation(s)
- Yongmei Bai
- grid.11135.370000 0001 2256 9319Institute of Medical Technology, Peking University Health Science Center, Peking University, No. 38 Xueyuan Road, Beijing, China ,grid.11135.370000 0001 2256 9319National Institute of Health Data Science, Peking University, No. 38 Xueyuan Road, Beijing, China
| | - Jian Du
- grid.11135.370000 0001 2256 9319National Institute of Health Data Science, Peking University, No. 38 Xueyuan Road, Beijing, China
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4
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Barrenho E, Halmai R, Miraldo M, Tzintzun I, Raïs Ali S, Toulemon L, Dupont JCK, Rochaix L. Inequities in cancer drug development in terms of unmet medical need. Soc Sci Med 2022; 302:114953. [PMID: 35489114 DOI: 10.1016/j.socscimed.2022.114953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 02/28/2022] [Accepted: 03/26/2022] [Indexed: 10/18/2022]
Abstract
This study measures inequality and inequity in the distribution of clinical trials on cancer drug development between 1996 and 2016, comparing the number of clinical trials with cancer need, proxied by prevalence, incidence, or survival rates for both rare and non-rare cancers. We leverage a unique global database of clinical trials activity and costs between 1996 and 2016, constructed for 227 different cancer types to measure for rare and non-rare cancers: i) inequalities and inequity of clinical trial activity, considering all trials as well as split by R&D stage; ii) inequalities and inequity in R&D investment proxied by trial enrollment and duration; iii) evolution of inequity over time. Inequalities are measured with concentration curves and indices and inequities measured with the health inequity index. We find four important results. First, we show pro-low need inequity across cancer types for both rare and non-rare cancers, for all need proxies. Second, we show inequity differs across R&D stages and between rare and non-rare cancers. The distribution of clinical trials for non-rare cancers disproportionately favors low-need non-rare cancers from earlier to later stages of R&D, whilst for rare cancers this only occurs in Phase 2 trials. Third, inequity analyses in R&D investment show that only trial enrollment for rare cancers and trial duration for non-rare cancers are disproportionately concentrated among low-need cancers. Finally, while pro-low need inequity has persisted between 1996 and 2016 for non-rare cancers, it has faded for rare cancers post-EU orphan drugs' legislation.
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Affiliation(s)
- Eliana Barrenho
- Department of Economics and Public Policy, Business School, Imperial College London, UK; Organisation for Economic Co-operation and Development (OECD), France.
| | - Réka Halmai
- Hospinnomics (PSE-Ecole d'Economie de Paris, Assistance Publique des Hôpitaux de Paris-AP-HP), France.
| | - Marisa Miraldo
- Department of Economics and Public Policy, Business School, Imperial College London, UK; Centre for Health Economics and Policy Innovation (CHEPI), Imperial College London, UK.
| | - Iván Tzintzun
- Hospinnomics (PSE-Ecole d'Economie de Paris, Assistance Publique des Hôpitaux de Paris-AP-HP), France.
| | - Setti Raïs Ali
- Hospinnomics (PSE-Ecole d'Economie de Paris, Assistance Publique des Hôpitaux de Paris-AP-HP), France.
| | - Léa Toulemon
- Hospinnomics (PSE-Ecole d'Economie de Paris, Assistance Publique des Hôpitaux de Paris-AP-HP), France; Institut des Politiques Publiques, PSE-Ecole d'Economie de Paris, France.
| | - Jean-Claude K Dupont
- Hospinnomics (PSE-Ecole d'Economie de Paris, Assistance Publique des Hôpitaux de Paris-AP-HP), France; Centre de Recherche des Cordeliers, Sorbonne Université, Université de Paris, Inserm, Laboratoire ETREs, F-75006, Paris, France.
| | - Lise Rochaix
- Hospinnomics (PSE-Ecole d'Economie de Paris, Assistance Publique des Hôpitaux de Paris-AP-HP), France; Université Paris 1 Panthéon-Sorbonne, Paris-Jourdan Sciences économiques (UMR 8545), Paris, France.
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Campbell F, Salam S, Sutton A, Jayasooriya SM, Mitchell C, Amabebe E, Balen J, Gillespie BM, Parris K, Soma-Pillay P, Chauke L, Narice B, Anumba DO. Interventions for the prevention of spontaneous preterm birth: a scoping review of systematic reviews. BMJ Open 2022; 12:e052576. [PMID: 35568487 PMCID: PMC9109033 DOI: 10.1136/bmjopen-2021-052576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 04/04/2022] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Globally, 11% of babies are born preterm each year. Preterm birth (PTB) is a leading cause of neonatal death and under-five mortality and morbidity, with lifelong sequelae in those who survive. PTB disproportionately impacts low/middle-income countries (LMICs) where the burden is highest. OBJECTIVES This scoping review sought to the evidence for interventions that reduce the risk of PTB, focusing on the evidence from LMICs and describing how context is considered in evidence synthesis. DESIGN We conducted a scoping review, to describe this wide topic area. We searched five electronic databases (2009-2020) and contacted experts to identify relevant systematic reviews of interventions to reduce the risk of PTB. We included published systematic reviews that examined the effectiveness of interventions and their effect on reducing the risk of PTB. Data were extracted and is described narratively. RESULTS 139 published systematic reviews were included in the review. Interventions were categorised as primary or secondary. The interventions where the results showed a greater effect size and consistency across review findings included treatment of syphilis and vaginal candidiasis, vitamin D supplementation and cervical cerclage. Included in the 139 reviews were 1372 unique primary source studies. 28% primary studies were undertaken in LMIC contexts and only 4.5% undertaken in a low-income country (LIC) Only 10.8% of the reviews sought to explore the impact of context on findings, and 19.4% reviews did not report the settings or the primary studies. CONCLUSION This scoping review highlights the lack of research evidence derived from contexts where the burden of PTB globally is greatest. The lack of rigour in addressing contextual applicability within systematic review methods is also highlighted. This presents a risk of inappropriate and unsafe recommendations for practice within these contexts. It also highlights a need for primary research, developing and testing interventions in LIC settings.
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Affiliation(s)
| | - Shumona Salam
- Department of Oncology and Metabolism, The University of Sheffield, Sheffield, UK
| | | | | | - Caroline Mitchell
- Academic Unit of Primary Medical Care, The University of Sheffield, Sheffield, UK
| | - Emmanuel Amabebe
- Department of Oncology and Metabolism, The University of Sheffield, Sheffield, UK
| | - Julie Balen
- ScHARR, The University of Sheffield, Sheffield, UK
| | - Bronwen M Gillespie
- Department of Oncology and Metabolism, The University of Sheffield, Sheffield, UK
| | - Kerry Parris
- Department of Oncology and Metabolism, The University of Sheffield, Sheffield, UK
| | - Priya Soma-Pillay
- Steve Biko Academic Hospital, University of Pretoria, Pretoria, South Africa
| | - Lawrence Chauke
- Department of Obstetrics and Gynaecology, University of Witwatersrand, Johannesburg, South Africa
| | - Brenda Narice
- Department of Oncology and Metabolism, The University of Sheffield, Sheffield, UK
| | - Dilichukwu O Anumba
- Department of Oncology and Metabolism, The University of Sheffield, Sheffield, UK
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Antequera A, Stallings E, Henry RS, Lopez-Alcalde J, Runnels V, Tudiver S, Tugwell P, Welch V. Sex and Gender Appraisal Tool-Systematic Reviews-2 and Participation-To-Prevalence Ratio assessed to whom the evidence applies in sepsis reviews. J Clin Epidemiol 2021; 142:119-132. [PMID: 34763038 DOI: 10.1016/j.jclinepi.2021.11.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 10/08/2021] [Accepted: 11/03/2021] [Indexed: 12/22/2022]
Abstract
OBJECTIVES To revise a sex and gender appraisal tool for systematic reviews (SGAT-SR) and apply it to Cochrane sepsis reviews. STUDY DESIGN AND SETTING The revision process was informed by existing literature on sex, gender, intersectionality, and feedback from an expert advisory board. We revised the items to consider additional factors associated with health inequities and appraised sex and gender considerations using the SGAT-SR-2 and female Participation-to-Prevalence Ratio (PPR) in Cochrane sepsis reviews. RESULTS SGAT-SR-2 consists of 19 questions appraising the review's sections and use of the terms sex and gender. amongst 71 SRs assessed, 50.7% included at least one tool item, the most frequent being the number of participants by sex or gender at included study-level (24/71 reviews). Only four reviews provided disaggregated data for the full set of included trials, while two considered other equity-related factors. Reviews rarely appraised possible similarities and differences across sex and gender. In half of a subset of reviews, female participants were under-represented relative to their share of the sepsis population (PPR<0.8). CONCLUSION The SGAT-SR-2 tool and the PPR can support the design and appraisal of systematic reviews to assess sex and gender considerations, address to whom evidence applies, and determine future research needs.
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Affiliation(s)
- A Antequera
- Biomedical Research Institute Sant Pau, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
| | - E Stallings
- Clinical Biostatistics Unit, Instituto Ramón y Cajal de Investigación Sanitaria, Madrid, Spain. CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - R S Henry
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada; Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - J Lopez-Alcalde
- Clinical Biostatistics Unit, Instituto Ramón y Cajal de Investigación Sanitaria, Madrid, Spain. CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Institute for Complementary and Integrative Medicine, University Hospital Zurich and University of Zurich, Zurich, Switzerland; Universidad Francisco de Vitoria, Pozuelo de Alarcón, Spain
| | - V Runnels
- University of Ottawa, Ottawa, Ontario, Canada
| | - S Tudiver
- Researcher/Consultant - Gender and Health, Ottawa, Ontario, Canada
| | - P Tugwell
- Department of Medicine, and School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; WHO Collaborating Centre for Knowledge Translation and Health Technology Assessment in Health Equity, Bruyère Research Institute, Ottawa, Ontario, Canada
| | - V Welch
- Bruyère Research Institute, University of Ottawa, Ottawa, Ontario, Canada; School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
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Marshall IJ, L'Esperance V, Marshall R, Thomas J, Noel-Storr A, Soboczenski F, Nye B, Nenkova A, Wallace BC. State of the evidence: a survey of global disparities in clinical trials. BMJ Glob Health 2021; 6:bmjgh-2020-004145. [PMID: 33402333 PMCID: PMC7786802 DOI: 10.1136/bmjgh-2020-004145] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 11/12/2020] [Accepted: 11/16/2020] [Indexed: 12/14/2022] Open
Abstract
Introduction Ideally, health conditions causing the greatest global disease burden should attract increased research attention. We conducted a comprehensive global study investigating the number of randomised controlled trials (RCTs) published on different health conditions, and how this compares with the global disease burden that they impose. Methods We use machine learning to monitor PubMed daily, and find and analyse RCT reports. We assessed RCTs investigating the leading causes of morbidity and mortality from the Global Burden of Disease study. Using regression models, we compared numbers of actual RCTs in different health conditions to numbers predicted from their global disease burden (disability-adjusted life years (DALYs)). We investigated whether RCT numbers differed for conditions disproportionately affecting countries with lower socioeconomic development. Results We estimate 463 000 articles describing RCTs (95% prediction interval 439 000 to 485 000) were published from 1990 to July 2020. RCTs recruited a median of 72 participants (IQR 32–195). 82% of RCTs were conducted by researchers in the top fifth of countries by socio-economic development. As DALYs increased for a particular health condition by 10%, the number of RCTs in the same year increased by 5% (3.2%–6.9%), but the association was weak (adjusted R2=0.13). Conditions disproportionately affecting countries with lower socioeconomic development, including respiratory infections and tuberculosis (7000 RCTs below predicted) and enteric infections (9700 RCTs below predicted), appear relatively under-researched for their disease burden. Each 10% shift in DALYs towards countries with low and middle socioeconomic development was associated with a 4% reduction in RCTs (3.7%–4.9%). These disparities have not changed substantially over time. Conclusion Research priorities are not well optimised to reduce the global burden of disease. Most RCTs are produced by highly developed countries, and the health needs of these countries have been, on average, favoured.
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Affiliation(s)
- Iain James Marshall
- School of Population Health and Environmental Sciences, King's College London, London, UK
| | - Veline L'Esperance
- School of Population Health and Environmental Sciences, King's College London, London, UK
| | | | - James Thomas
- EPPI-Centre, Department of Social Science, UCL, London, UK
| | | | - Frank Soboczenski
- School of Population Health and Environmental Sciences, King's College London, London, UK
| | - Benjamin Nye
- Khoury College of Computer Sciences, Northeastern University, Boston, Massachusetts, USA
| | - Ani Nenkova
- Computer and Information Science, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Byron C Wallace
- Khoury College of Computer Sciences, Northeastern University, Boston, Massachusetts, USA
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Park JJH, Grais RF, Taljaard M, Nakimuli-Mpungu E, Jehan F, Nachega JB, Ford N, Xavier D, Kengne AP, Ashorn P, Socias ME, Bhutta ZA, Mills EJ. Urgently seeking efficiency and sustainability of clinical trials in global health. Lancet Glob Health 2021; 9:e681-e690. [PMID: 33865473 PMCID: PMC8424133 DOI: 10.1016/s2214-109x(20)30539-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 12/07/2020] [Accepted: 12/10/2020] [Indexed: 12/22/2022]
Abstract
This paper shows the scale of global health research and the context in which we frame the subsequent papers in the Series. In this Series paper, we provide a historical perspective on clinical trial research by revisiting the 1948 streptomycin trial for pulmonary tuberculosis, which was the first documented randomised clinical trial in the English language, and we discuss its close connection with global health. We describe the current state of clinical trial research globally by providing an overview of clinical trials that have been registered in the WHO International Clinical Trial Registry since 2010. We discuss challenges with current trial planning and designs that are often used in clinical trial research undertaken in low-income and middle-income countries, as an overview of the global health trials landscape. Finally, we discuss the importance of collaborative work in global health research towards generating sustainable and culturally appropriate research environments.
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Affiliation(s)
- Jay J H Park
- Department of Experimental Medicine, University of British Columbia, Vancouver, BC, Canada
| | | | - Monica Taljaard
- Clinical Epidemiology Program, Ottawa Hospital Research Institute and School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | | | - Fyezah Jehan
- Department of Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Jean B Nachega
- Department of Medicine and Center for Infectious Diseases, Stellenbosch University, Cape Town, South Africa; Department of Epidemiology and Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Epidemiology and Department of Infectious Diseases and Microbiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA
| | - Nathan Ford
- Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Denis Xavier
- Department of Pharmacology and Division of Clinical Research, St John's Medical College, Bangalore, India
| | - Andre P Kengne
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Per Ashorn
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Maria Eugenia Socias
- Fundación Huésped, Buenos Aires, Argentina; British Columbia Centre for Substance Use, Vancouver, BC, Canada; Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Zulfiqar A Bhutta
- Centre for Global Child Health, Hospital for Sick Children, Toronto, ON, Canada; Institute of Global Health and Development, and Center of Excellence in Women and Child Health, Aga Khan University, Karachi, Pakistan
| | - Edward J Mills
- School of Public Health, University of Rwanda, Kigali, Rwanda; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada; Cytel, Vancouver, BC, Canada.
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Lamy JB. A data science approach to drug safety: Semantic and visual mining of adverse drug events from clinical trials of pain treatments. Artif Intell Med 2021; 115:102074. [PMID: 34001324 DOI: 10.1016/j.artmed.2021.102074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 01/21/2021] [Accepted: 04/07/2021] [Indexed: 10/21/2022]
Abstract
Clinical trials are the basis of Evidence-Based Medicine. Trial results are reviewed by experts and consensus panels for producing meta-analyses and clinical practice guidelines. However, reviewing these results is a long and tedious task, hence the meta-analyses and guidelines are not updated each time a new trial is published. Moreover, the independence of experts may be difficult to appraise. On the contrary, in many other domains, including medical risk analysis, the advent of data science, big data and visual analytics allowed moving from expert-based to fact-based knowledge. Since 12 years, many trial results are publicly available online in trial registries. Nevertheless, data science methods have not yet been applied widely to trial data. In this paper, we present a platform for analyzing the safety events reported during clinical trials and published in trial registries. This platform is based on an ontological model including 582 trials on pain treatments, and uses semantic web technologies for querying this dataset at various levels of granularity. It also relies on a 26-dimensional flower glyph for the visualization of the Adverse Drug Events (ADE) rates in 13 categories and 2 levels of seriousness. We illustrate the interest of this platform through several use cases and we were able to find back conclusions that were initially found during meta-analyses. The platform was presented to four experts in drug safety, and is publicly available online, with the ontology of pain treatment ADE.
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Affiliation(s)
- Jean-Baptiste Lamy
- Université Sorbonne Paris Nord, LIMICS, Sorbonne Université, INSERM, UMR 1142, F-93000 Bobigny, France; Laboratoire de Recherche en Informatique, CNRS/Université Paris-Sud/Université Paris-Saclay, Orsay, France.
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10
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Coordination and planning of clinical research on a national and global level. Fertil Steril 2021; 113:1100-1106. [PMID: 32482245 DOI: 10.1016/j.fertnstert.2020.04.032] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 04/14/2020] [Accepted: 04/14/2020] [Indexed: 12/11/2022]
Abstract
In reproductive medicine, the needs and desires of infertility patients drive future research, with the most important outcome being live birth of a baby. Large, multicenter, randomized clinical trials are considered the best research tool to evaluate the effectiveness of medical interventions, but they can often take a long time to find definitive answers. Advances in individual participant data (IPD) and network meta-analysis have enabled research questions to be answered more quickly, but better planning could streamline this process further. To harmonize research findings that are taking place globally in this way, it is crucial that the same outcomes are collected in clinical trials conducted in reproductive medicine. Furthermore, the conduct of clinical trials often requires collaboration on an international scale; however, individual countries have their own processes for research prioritization and delivery. We describe the perspective of high- and low-resourced settings and industry as well as the mechanisms of prioritization and coordination that are in place in different settings. In addition, we discuss the importance of the patient perspective, which can help shape the research question, clinical trial design, and the logistical operations of trial delivery. The need for increased global collaboration and coalitions within and between stakeholders is evident for the research community to accelerate advances and maximize benefits in reproductive medicine.
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11
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Do national funding organizations properly address the diseases with the highest burden?: Observations from China and the UK. Scientometrics 2020. [DOI: 10.1007/s11192-020-03572-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Catalá-López F, Aleixandre-Benavent R, Caulley L, Hutton B, Tabarés-Seisdedos R, Moher D, Alonso-Arroyo A. Global mapping of randomised trials related articles published in high-impact-factor medical journals: a cross-sectional analysis. Trials 2020; 21:34. [PMID: 31910857 PMCID: PMC6947860 DOI: 10.1186/s13063-019-3944-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 11/29/2019] [Indexed: 12/12/2022] Open
Abstract
Background Randomised controlled trials (RCTs) provide the most reliable information to inform clinical practice and patient care. We aimed to map global clinical research publication activity through RCT-related articles in high-impact-factor medical journals over the past five decades. Methods We conducted a cross-sectional analysis of articles published in the highest ranked medical journals with an impact factor > 10 (according to Journal Citation Reports published in 2017). We searched PubMed/MEDLINE (from inception to December 31, 2017) for all RCT-related articles (e.g. primary RCTs, secondary analyses and methodology papers) published in high-impact-factor medical journals. For each included article, raw metadata were abstracted from the Web of Science. A process of standardization was conducted to unify the different terms and grammatical variants and to remove typographical, transcription and/or indexing errors. Descriptive analyses were conducted (including the number of articles, citations, most prolific authors, countries, journals, funding sources and keywords). Network analyses of collaborations between countries and co-words are presented. Results We included 39,305 articles (for the period 1965–2017) published in forty journals. The Lancet (n = 3593; 9.1%), the Journal of Clinical Oncology (n = 3343; 8.5%) and The New England Journal of Medicine (n = 3275 articles; 8.3%) published the largest number of RCTs. A total of 154 countries were involved in the production of articles. The global productivity ranking was led by the United States (n = 18,393 articles), followed by the United Kingdom (n = 8028 articles), Canada (n = 4548 articles) and Germany (n = 4415 articles). Seventeen authors who had published 100 or more articles were identified; the most prolific authors were affiliated with Duke University (United States), Harvard University (United States) and McMaster University (Canada). The main funding institutions were the National Institutes of Health (United States), Hoffmann-La Roche (Switzerland), Pfizer (United States), Merck Sharp & Dohme (United States) and Novartis (Switzerland). The 100 most cited RCTs were published in nine journals, led by The New England Journal of Medicine (n = 78 articles), The Lancet (n = 9 articles) and JAMA (n = 7 articles). These landmark contributions focused on novel methodological approaches (e.g. the “Bland-Altman method”) and trials on the management of chronic conditions (e.g. diabetes control, hormone replacement therapy in postmenopausal women, multiple therapies for diverse cancers, cardiovascular therapies such as lipid-lowering statins, antihypertensive medications, and antiplatelet and antithrombotic therapy). Conclusions Our analysis identified authors, countries, funding institutions, landmark contributions and high-impact-factor medical journals publishing RCTs. Over the last 50 years, publication production in leading medical journals has increased, with Western countries leading in research but with low- and middle-income countries showing very limited representation.
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Affiliation(s)
- Ferrán Catalá-López
- Department of Health Planning and Economics, National School of Public Health, Institute of Health Carlos III, Madrid, Spain. .,Department of Medicine, University of Valencia/INCLIVA Health Research Institute and CIBERSAM, Valencia, Spain. .,Clinical Epidemiology Program, Ottawa Hospital Research Institute (OHRI), Ottawa, Ontario, Canada.
| | - Rafael Aleixandre-Benavent
- Ingenio-Spanish National Research Council (CSIC) and Universitat Politècnica de Valencia (UPV), Valencia, Spain.,Information and Social and Health Research Unit (UISYS), University of Valencia and Spanish National Research Council (CSIC), Valencia, Spain
| | - Lisa Caulley
- Clinical Epidemiology Program, Ottawa Hospital Research Institute (OHRI), Ottawa, Ontario, Canada.,Ear, Nose and Throat Department, Guy's Hospital, London, UK.,Department of Clinical Epidemiology, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Brian Hutton
- Clinical Epidemiology Program, Ottawa Hospital Research Institute (OHRI), Ottawa, Ontario, Canada.,School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Rafael Tabarés-Seisdedos
- Department of Medicine, University of Valencia/INCLIVA Health Research Institute and CIBERSAM, Valencia, Spain
| | - David Moher
- Clinical Epidemiology Program, Ottawa Hospital Research Institute (OHRI), Ottawa, Ontario, Canada.,School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Adolfo Alonso-Arroyo
- Information and Social and Health Research Unit (UISYS), University of Valencia and Spanish National Research Council (CSIC), Valencia, Spain.,Department of History of Science and Documentation, University of Valencia, Valencia, Spain
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Hazo JB, Brunn M, Wykes T, McDaid D, Dorsey M, Demotes-Mainard J, van der Feltz-Cornelis CM, Wahlbeck K, Knappe S, Meyer-Lindenberg A, Obradors-Tarragó C, Haro JM, Leboyer M, Chevreul K. European mental health research resources: Picture and recommendations of the ROAMER project. Eur Neuropsychopharmacol 2019; 29:179-194. [PMID: 30579654 DOI: 10.1016/j.euroneuro.2018.11.1111] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 11/13/2018] [Accepted: 11/15/2018] [Indexed: 11/29/2022]
Abstract
As part of the Roamer project, we sought to have a picture of the available mental health research (MHR) funding, capacity-building and infrastructures resources and to establish consensus-based recommendations that would allow an increase of European MHR resources and enable better use and accessibility to them. The methods fell into three sections (i) a review of the literature, (ii) a mental health-related keywords search within the Cordis®, On-Course® and Meril® databases which contain information on European research funding, training and infrastructures. These reviews provided an overview that was presented to (iii) two experts workshops with 28 participants drawn from academic which identified gaps and produced recommendations. The literature review illustrates the debates in the scientific community on funding, training and infrastructures. The database searches estimated the fraction of health research resources available for mental health. Eight overarching goals for MHR resources were identified by the workshops; each of them was carried out with several practical recommendations. Resources for MHR are scarce considering the burden of mental disorders, the high rate of return of MHR and the under-investment of the field. The recommendations are urgently warranted to increase resources and their optimal access and use.
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Affiliation(s)
- Jean-Baptiste Hazo
- ECEVE, UMRS 1123, Université Paris Diderot, Sorbonne Paris Cité, INSERM, Paris, France; AP-HP, URC-Eco, DHU PePSY, F-75 004 Paris, France; Fondation FondaMental, French Scientific Foundation, Créteil, France; World Health Organization Collaborating Centre for Research and Training in Mental Health, CCOMS, Lille 59260, Hellemmes, France.
| | - Matthias Brunn
- ECEVE, UMRS 1123, Université Paris Diderot, Sorbonne Paris Cité, INSERM, Paris, France; AP-HP, URC-Eco, DHU PePSY, F-75 004 Paris, France; Fondation FondaMental, French Scientific Foundation, Créteil, France
| | - Til Wykes
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, South London and Maudsley NHS Foundation Trust, UK
| | - David McDaid
- PSSRU, London School of Economics and Political Science, London, UK
| | - Maya Dorsey
- ECEVE, UMRS 1123, Université Paris Diderot, Sorbonne Paris Cité, INSERM, Paris, France; AP-HP, URC-Eco, DHU PePSY, F-75 004 Paris, France; Fondation FondaMental, French Scientific Foundation, Créteil, France
| | | | - Christina M van der Feltz-Cornelis
- Department of Health Sciences, MHARG, University of York, York, United Kingdom; Tranzo Department, Tilburg University, Tilburg, The Netherlands
| | | | - Susanne Knappe
- Institut für Klinische Psychologie und Psychotherapie, Behaviorale Epidemiologie & Center for Clinical Epidemiology and Longitudinal Studies, Technische Universität Dresden, Chemnitzer Str. 46, 01187 Dresden, Germany
| | - Andreas Meyer-Lindenberg
- Medical Faculty Mannheim, Central Institute of Mental Health, University of Heidelberg, 68159 Mannheim, Germany
| | | | - Josep Maria Haro
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain; Institut de Recerca Sant Joan de Déu, Sant Boi de llobregat, Universitat de Barcelona, Barcelona, Spain
| | - Marion Leboyer
- Fondation FondaMental, French Scientific Foundation, Créteil, France; AP-HP, Department of Psychiatry of Mondor Hospital, DHU PePSY, Paris-Est-Créteil University (UPEC), Créteil, France; INSERM, U955, Translational Psychiatry, Créteil, France
| | - Karine Chevreul
- ECEVE, UMRS 1123, Université Paris Diderot, Sorbonne Paris Cité, INSERM, Paris, France; AP-HP, URC-Eco, DHU PePSY, F-75 004 Paris, France
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15
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David Sackett Young Investigator Award. J Clin Epidemiol 2019. [DOI: 10.1016/j.jclinepi.2019.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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16
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Translating clinical trials into improved real-world management of pain: convergence of translational, population-based, and primary care research. Pain 2019; 161:36-42. [PMID: 31433350 DOI: 10.1097/j.pain.0000000000001684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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17
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Beyeler N, Fewer S, Yotebieng M, Yamey G. Improving resource mobilisation for global health R&D: a role for coordination platforms? BMJ Glob Health 2019; 4:e001209. [PMID: 30899563 PMCID: PMC6407558 DOI: 10.1136/bmjgh-2018-001209] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 11/26/2018] [Accepted: 12/13/2018] [Indexed: 11/23/2022] Open
Abstract
Achieving many of the health targets in the Sustainable Development Goals will not be possible without increased financing for global health research and development (R&D). Yet financing for neglected disease product development fell from 2009-2015, with the exception of a one-time injection of Ebola funding. An important cause of the global health R&D funding gap is lack of coordination across R&D initiatives. In particular, existing initiatives lack robust priority-setting processes and transparency about investment decisions. Low-income countries (LICs) and middle-income countries (MICs) are also often excluded from global investment initiatives and priority-setting discussions, leading to limited investment by these countries. An overarching global health R&D coordination platform is one promising response to these challenges. This analysis examines the essential functions such a platform must play, how it should be structured to maximise effectiveness and investment strategies for diversifying potential investors, with an emphasis on building LIC and MIC engagement. Our analysis suggests that a coordination platform should have four key functions: building consensus on R&D priorities; facilitating information sharing about past and future investments; building in accountability mechanisms to track R&D spending against investment targets and curating a portfolio of prioritised projects alongside mechanisms to link funders to these projects. Several design features are likely to increase the platform’s success: public ownership and management; separation of coordination and financing functions; inclusion of multiple diseases; coordination across global and national efforts; development of an international R&D ‘roadmap’ and a strategy for the financial sustainability of the platform’s secretariat.
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Affiliation(s)
- Naomi Beyeler
- Evidence to Policy Initiative, Global Health Group, Institute for Global Health Sciences, University of California, San Francisco, California, USA
| | - Sara Fewer
- Evidence to Policy Initiative, Global Health Group, Institute for Global Health Sciences, University of California, San Francisco, California, USA
| | - Marcel Yotebieng
- Division of Epidemiology, Ohio State University, Columbus, Ohio, USA
| | - Gavin Yamey
- Center for Policy Impact in Global Health, Duke Global Health Institute, Duke University, Durham, North Carolina, USA
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Viguera-Guerra I, Ruano J, Aguilar-Luque M, Gay-Mimbrera J, Montilla A, Fernández-Rueda JL, Fernández-Chaichio J, Sanz-Cabanillas JL, Gómez-Arias PJ, Vélez García-Nieto A, Gómez-Garcia F, Isla-Tejera B. Evolution of international collaborative research efforts to develop non-Cochrane systematic reviews. PLoS One 2019; 14:e0211919. [PMID: 30811451 PMCID: PMC6392271 DOI: 10.1371/journal.pone.0211919] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 01/22/2019] [Indexed: 01/28/2023] Open
Abstract
This research-on-research study describes efforts to develop non-Cochrane systematic reviews (SRs) by analyzing demographical and time-course collaborations between international institutions using protocols registered in the International Prospective Register of Systematic Reviews (PROSPERO) or published in scientific journals. We have published an a priori protocol to develop this study. Protocols published in scientific journals were searched using the MEDLINE and Embase databases; the query terms "Systematic review" [Title] AND "protocol" [Title] were searched from February 2011 to December 2017. Protocols registered at PROSPERO during the same period were obtained by web scraping all non-Cochrane records with a Python script. After excluding protocols that had a fulfillment or duplication rate of less than 90%, they were classified as published "only in PROSPERO", "only in journals", or in "journals and PROSPERO". Results of data and metadata extraction using text mining processes were curated by two reviewers. These Datasets and R scripts are freely available to facilitate reproducibility. We obtained 20,814 protocols of non-Cochrane SRs. While "unique protocols" by reviewers' institutions from 60 countries were the most frequent, a median of 6 (2-150) institutions from 130 different countries were involved in the preparation of "collaborative protocols". The highest Ranked countries involved in overall protocol production were the UK, the U.S., Australia, Brazil, China, Canada, the Netherlands, Germany, and Italy. Most protocols were registered only in PROSPERO. However, the number of protocols published in scientific journals (924) or in both PROSPERO and journals (807) has increased over the last three years. Syst Rev and BMJ Open published more than half of the total protocols. While the more productive countries were involved in "unique" and "collaborative protocols", less productive countries only participated in "collaborative protocols" that were mainly published in PROSPERO. Our results suggest that, although most countries were involved in solitary production of protocols for non-Cochrane SRs during the study period, it would be useful to develop new strategies to promote international collaborations, especially with less productive countries.
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Affiliation(s)
- Isabel Viguera-Guerra
- Agencia de Evaluación de Tecnologías Sanitarias de Andalucía (AETSA), Sevilla, Spain
- Instituto Maimonides de Investigación Biomédica de Córdoba (IMIBIC)/Reina Sofía University Hospital/University of Córdoba, Cordoba, Spain
| | - Juan Ruano
- Instituto Maimonides de Investigación Biomédica de Córdoba (IMIBIC)/Reina Sofía University Hospital/University of Córdoba, Cordoba, Spain
- Department of Dermatology, Reina Sofía University, Hospital, Córdoba, Spain
- * E-mail:
| | - Macarena Aguilar-Luque
- Instituto Maimonides de Investigación Biomédica de Córdoba (IMIBIC)/Reina Sofía University Hospital/University of Córdoba, Cordoba, Spain
| | - Jesús Gay-Mimbrera
- Instituto Maimonides de Investigación Biomédica de Córdoba (IMIBIC)/Reina Sofía University Hospital/University of Córdoba, Cordoba, Spain
| | - Ana Montilla
- School of Medicine, University of Cordoba, Córdoba, Spain
| | - Jose Luis Fernández-Rueda
- Instituto Maimonides de Investigación Biomédica de Córdoba (IMIBIC)/Reina Sofía University Hospital/University of Córdoba, Cordoba, Spain
| | - José Fernández-Chaichio
- Instituto Maimonides de Investigación Biomédica de Córdoba (IMIBIC)/Reina Sofía University Hospital/University of Córdoba, Cordoba, Spain
| | - Juan Luis Sanz-Cabanillas
- Instituto Maimonides de Investigación Biomédica de Córdoba (IMIBIC)/Reina Sofía University Hospital/University of Córdoba, Cordoba, Spain
- Department of Dermatology, Reina Sofía University, Hospital, Córdoba, Spain
| | - Pedro Jesús Gómez-Arias
- Instituto Maimonides de Investigación Biomédica de Córdoba (IMIBIC)/Reina Sofía University Hospital/University of Córdoba, Cordoba, Spain
- Department of Dermatology, Reina Sofía University, Hospital, Córdoba, Spain
| | - Antonio Vélez García-Nieto
- Instituto Maimonides de Investigación Biomédica de Córdoba (IMIBIC)/Reina Sofía University Hospital/University of Córdoba, Cordoba, Spain
- Department of Dermatology, Reina Sofía University, Hospital, Córdoba, Spain
| | - Francisco Gómez-Garcia
- Instituto Maimonides de Investigación Biomédica de Córdoba (IMIBIC)/Reina Sofía University Hospital/University of Córdoba, Cordoba, Spain
- Department of Dermatology, Reina Sofía University, Hospital, Córdoba, Spain
| | - Beatriz Isla-Tejera
- Instituto Maimonides de Investigación Biomédica de Córdoba (IMIBIC)/Reina Sofía University Hospital/University of Córdoba, Cordoba, Spain
- Department of Pharmacy, Reina Sofía University Hospital, Córdoba, Spain
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