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Bai I, Doshi P, Herder M. How to use the regulatory data from Health Canada for secondary analyses on new drugs, biologics and vaccines. BMJ Evid Based Med 2024; 29:187-193. [PMID: 37898504 PMCID: PMC11137451 DOI: 10.1136/bmjebm-2023-112475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/11/2023] [Indexed: 10/30/2023]
Abstract
Incorporating clinical data held by national health product regulatory authorities into secondary analyses such as systematic reviews can help combat publication bias and selective outcome reporting, in turn, supporting more evidence-based decisions regarding the prescribing of drugs, biologics and vaccines. Owing to recent changes in Canadian law, Health Canada has begun to make clinical information-whether it has been previously published or not-publicly available through its 'Public Release of Clinical Information' (PRCI) online database. We provide guidance about how to access and use regulatory data obtained through the PRCI database for the purpose of conducting drug and biologic secondary analyses.
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Affiliation(s)
- Isaac Bai
- Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Peter Doshi
- Department of Practice, Sciences, and Health Outcomes Research, School of Pharmacy, University of Maryland, Baltimore, Maryland, USA
| | - Matthew Herder
- Health Law Institute, Schulich School of Law, Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Pharmacology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
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Oxman AD, Chalmers I, Dahlgren A. Key concepts for informed health choices: 1.4. Trust based on the source of a claim alone can be misleading. J R Soc Med 2022; 115:479-481. [PMID: 36349971 PMCID: PMC9747893 DOI: 10.1177/01410768221135537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- A D Oxman
- Centre for Epidemic Interventions Research, Norwegian Institute of Public Health, 0213 Oslo, Norway
| | - I Chalmers
- Centre for Evidence-Based Medicine, University of Oxford, OX2 6GG, UK
| | - A Dahlgren
- Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway
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Alves CPDL, Costa GGD. Transparência e integridade em pesquisa: dos problemas às potenciais soluções. REVISTA BRASILEIRA DE GERIATRIA E GERONTOLOGIA 2021. [DOI: 10.1590/1981-22562021024.210239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Chirac P. Defending transparency at European drug regulator. BMJ 2020; 368:m10. [PMID: 31915125 DOI: 10.1136/bmj.m10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Cheng HY, Chen WC, Chou YJ, Huang ASE, Huang WT. Containing influenza outbreaks with antiviral use in long-term care facilities in Taiwan, 2008-2014. Influenza Other Respir Viruses 2018; 12:287-292. [PMID: 29341490 PMCID: PMC5820419 DOI: 10.1111/irv.12536] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2017] [Indexed: 11/28/2022] Open
Abstract
Backgrounds Influenza can spread rapidly in long‐term care facilities (LTCFs), and residents are usually at higher risk for influenza infections. Objective Our study aimed to evaluate the effectiveness of antiviral interventions on outbreak control. Methods Taiwan Centers for Disease Control used a syndromic surveillance system to monitor outbreaks in LTCFs. Local public health authorities verified those outbreaks and logged reports to the Epidemic Investigation Report Files Management System (EIRFMS). We conducted a retrospective cohort study by reviewing EIRFMS reports of influenza outbreaks in LTCFs during 2008‐2014. An influenza outbreak was defined as 3 or more cases of influenza‐like illness occurring within a 48‐hours period with ≥1 case of real‐time RT‐PCR‐confirmed influenza in the same LTCF. Antiviral interventions included providing antiviral treatment for patients and antiviral prophylaxis for contacts during outbreaks. Results Of 102 influenza outbreaks, median days from onset of the first patient to outbreak notification was 4 (range 0‐22). Median attack rate was 24% (range 2.2%‐100%). Median influenza vaccination coverage among residents was 81% (range 0%‐100%); 43% occurred during the summer months. Even though antiviral treatment was provided in 87% of the outbreaks, antiviral prophylaxis was implemented in only 40%. Starting antiviral treatment within 2 days of outbreak onset was associated with keeping attack rates at <25% (OR 0.29, 95% CI: 0.12‐0.71). Conclusions Early initiation of antiviral treatment may reduce the magnitude of influenza outbreaks. Clinicians should identify patients with influenza and start antiviral use early to prevent large outbreaks in LTCFs.
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Affiliation(s)
- Hao-Yuan Cheng
- Epidemic Intelligence Center, Taiwan Centers for Disease Control, Taipei, Taiwan
| | - Wan-Chin Chen
- Office of Preventive Medicine, Taiwan Centers for Disease Control, Taipei, Taiwan
| | - Yu-Ju Chou
- Office of Preventive Medicine, Taiwan Centers for Disease Control, Taipei, Taiwan
| | - Angela Song-En Huang
- Division of Acute Infectious Diseases, Taiwan Centers for Disease Control, Taipei, Taiwan
| | - Wan-Ting Huang
- Office of Preventive Medicine, Taiwan Centers for Disease Control, Taipei, Taiwan
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Broes S, Lacombe D, Verlinden M, Huys I. Sharing human samples and patient data: Opening Pandora’s box. J Cancer Policy 2017. [DOI: 10.1016/j.jcpo.2017.07.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Systematic review finds that study data not published in full text articles have unclear impact on meta-analyses results in medical research. PLoS One 2017; 12:e0176210. [PMID: 28441452 PMCID: PMC5404772 DOI: 10.1371/journal.pone.0176210] [Citation(s) in RCA: 112] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Accepted: 04/06/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND A meta-analysis as part of a systematic review aims to provide a thorough, comprehensive and unbiased statistical summary of data from the literature. However, relevant study results could be missing from a meta-analysis because of selective publication and inadequate dissemination. If missing outcome data differ systematically from published ones, a meta-analysis will be biased with an inaccurate assessment of the intervention effect. As part of the EU-funded OPEN project (www.open-project.eu) we conducted a systematic review that assessed whether the inclusion of data that were not published at all and/or published only in the grey literature influences pooled effect estimates in meta-analyses and leads to different interpretation. METHODS AND FINDINGS Systematic review of published literature (methodological research projects). Four bibliographic databases were searched up to February 2016 without restriction of publication year or language. Methodological research projects were considered eligible for inclusion if they reviewed a cohort of meta-analyses which (i) compared pooled effect estimates of meta-analyses of health care interventions according to publication status of data or (ii) examined whether the inclusion of unpublished or grey literature data impacts the result of a meta-analysis. Seven methodological research projects including 187 meta-analyses comparing pooled treatment effect estimates according to different publication status were identified. Two research projects showed that published data showed larger pooled treatment effects in favour of the intervention than unpublished or grey literature data (Ratio of ORs 1.15, 95% CI 1.04-1.28 and 1.34, 95% CI 1.09-1.66). In the remaining research projects pooled effect estimates and/or overall findings were not significantly changed by the inclusion of unpublished and/or grey literature data. The precision of the pooled estimate was increased with narrower 95% confidence interval. CONCLUSIONS Although we may anticipate that systematic reviews and meta-analyses not including unpublished or grey literature study results are likely to overestimate the treatment effects, current empirical research shows that this is only the case in a minority of reviews. Therefore, currently, a meta-analyst should particularly consider time, effort and costs when adding such data to their analysis. Future research is needed to identify which reviews may benefit most from including unpublished or grey data.
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Affiliation(s)
- Tom Jefferson
- a Honorary Research Fellow, Centre for Evidence Based Medicine , Oxford OX2 6GG
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Penttinen P, Catchpole M. ECDC expert opinion on efficacy and effectiveness of neuraminidase inhibitors published for public consultation. Influenza Other Respir Viruses 2016; 10:152-3. [PMID: 26889767 PMCID: PMC4814868 DOI: 10.1111/irv.12377] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Björnmalm M, Faria M, Caruso F. Increasing the Impact of Materials in and beyond Bio-Nano Science. J Am Chem Soc 2016; 138:13449-13456. [PMID: 27672703 DOI: 10.1021/jacs.6b08673] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
This is an exciting time for the field of bio-nano science: enormous progress has been made in recent years, especially in academic research, and materials developed and studied in this area are poised to make a substantial impact in real-world applications. Herein, we discuss ways to leverage the strengths of the field, current limitations, and valuable lessons learned from neighboring fields that can be adopted to accelerate scientific discovery and translational research in bio-nano science. We identify and discuss five interconnected topics: (i) the advantages of cumulative research; (ii) the necessity of aligning projects with research priorities; (iii) the value of transparent science; (iv) the opportunities presented by "dark data"; and (v) the importance of establishing bio-nano standards.
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Affiliation(s)
- Mattias Björnmalm
- ARC Centre of Excellence in Convergent Bio-Nano Science and Technology, and Department of Chemical and Biomolecular Engineering, The University of Melbourne , Parkville, Victoria 3010, Australia
| | - Matthew Faria
- ARC Centre of Excellence in Convergent Bio-Nano Science and Technology, and Department of Chemical and Biomolecular Engineering, The University of Melbourne , Parkville, Victoria 3010, Australia
| | - Frank Caruso
- ARC Centre of Excellence in Convergent Bio-Nano Science and Technology, and Department of Chemical and Biomolecular Engineering, The University of Melbourne , Parkville, Victoria 3010, Australia
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Kreutziger J, Wenzel V. [German Resuscitation Register : lots of quality management at low cost]. Anaesthesist 2015; 63:467-9. [PMID: 24851835 DOI: 10.1007/s00101-014-2334-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- J Kreutziger
- Univ.-Klinik für Anästhesie und Intensivmedizin, Medizinische Universität Innsbruck, Anichstr. 35, 6020, Innsbruck, Österreich
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Pansieri C, Pandolfini C, Bonati M. The evolution in registration of clinical trials: a chronicle of the historical calls and current initiatives promoting transparency. Eur J Clin Pharmacol 2015; 71:1159-64. [PMID: 26242226 DOI: 10.1007/s00228-015-1897-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2015] [Accepted: 06/29/2015] [Indexed: 01/28/2023]
Abstract
PURPOSE Quality of care is strongly influenced by evidence-based medicine, a large part of which is based on results obtained from clinical trials. If trials are conducted in secret, patient safety is at risk. Several mandates-legal, editorial, financial, and ethical-have tried to influence the disclosure of clinical trials, first by encouraging registration in publicly accessible registers and, second, by calling for the publication of results. Not all these initiatives have reached high rates of compliance, but the succession of national and international events over a few years gave an important boost to information disclosure. This article provides a chronicle of the succession of the events, from the historical calls to the recent EMA policy and WHO statement, and public consultations requested by the NIH, and the HHS, which will inevitably change the international panorama. The path of these new policies is moving towards more supervised clinical research. Individual scientific institutions can also contribute, at the local level, to such an ethical endeavor as is improving research transparency, by disclosing information on the trials coordinated by their own researchers. RESULTS The way is long and complex, but, if everyone contributes there could be a prompt, worldwide diffusion of the findings of clinical trials, and therefore a more possible evidenced-based medicine.
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Affiliation(s)
- Claudia Pansieri
- Department of Public Health, Laboratory for Mother and Child Health, IRCCS-Istituto di Ricerche Farmacologiche "Mario Negri", Via La Masa 19, 20156, Milan, Italy
| | - Chiara Pandolfini
- Department of Public Health, Laboratory for Mother and Child Health, IRCCS-Istituto di Ricerche Farmacologiche "Mario Negri", Via La Masa 19, 20156, Milan, Italy
| | - Maurizio Bonati
- Department of Public Health, Laboratory for Mother and Child Health, IRCCS-Istituto di Ricerche Farmacologiche "Mario Negri", Via La Masa 19, 20156, Milan, Italy.
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Developments in the treatment of severe influenza: lessons from the pandemic of 2009 and new prospects for therapy. Curr Opin Infect Dis 2015; 27:560-5. [PMID: 25333476 DOI: 10.1097/qco.0000000000000113] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
PURPOSE OF REVIEW Cases of severe influenza may occur during seasonal epidemics, following sporadic zoonotic influenza A transmission from animal reservoirs or on a massive scale with the unpredictable emergence of a new pandemic influenza strain. Clinical experience identifies unmet medical need for additional therapies for influenza, in particular to treat severely unwell adults and children. During and following the pandemic of 2009, a wealth of data from hospitalized cases of influenza from many different countries accumulated and are now starting to emerge. Observational clinical data provide information about the efficacy of existing antiviral drugs in severely ill patients. The development pipeline for new therapies contains several promising agents which are focussed on a range of viral targets, and opens the possibility of combination antiviral therapy for the first time, which may be especially useful in clinically challenging cases. Advances in immunological methods and recombinant protein engineering support the potential for use of immunomodulating therapies as adjuncts in treatment of severe influenza. RECENT FINDINGS The main themes are the importance of treating severe influenza early, considering multiple therapy options and the relevance of observational clinical data to treatment of severely ill and risk groups. SUMMARY Clinicians, who may have only seen the media headlines following discussion of reviews which deal with randomized controlled trials of neuraminidase inhibitor drug use in mild uncomplicated influenza in the community, may be hesitant to prescribe these drugs. Observational data arising from treatment of severely ill individuals support use of these drugs early in illness and show improvement in outcomes associated with drug use.
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Leo J, Lacasse JR. Wikipedia vs Peer-Reviewed Medical Literature for Information About the 10 Most Costly Medical Conditions–II. J Osteopath Med 2014; 114:761-4. [DOI: 10.7556/jaoa.2014.147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Jonathan Leo
- Lincoln Memorial University-DeBusk College of Osteopathic Medicine, Harrogate , Tennessee
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