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Benns HJ, Storch M, Falco JA, Fisher FR, Tamaki F, Alves E, Wincott CJ, Milne R, Wiedemar N, Craven G, Baragaña B, Wyllie S, Baum J, Baldwin GS, Weerapana E, Tate EW, Child MA. CRISPR-based oligo recombineering prioritizes apicomplexan cysteines for drug discovery. Nat Microbiol 2022; 7:1891-1905. [PMID: 36266336 PMCID: PMC9613468 DOI: 10.1038/s41564-022-01249-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 09/09/2022] [Indexed: 11/30/2022]
Abstract
Nucleophilic amino acids are important in covalent drug development yet underutilized as anti-microbial targets. Chemoproteomic technologies have been developed to mine chemically accessible residues via their intrinsic reactivity towards electrophilic probes but cannot discern which chemically reactive sites contribute to protein function and should therefore be prioritized for drug discovery. To address this, we have developed a CRISPR-based oligo recombineering (CORe) platform to support the rapid identification, functional prioritization and rational targeting of chemically reactive sites in haploid systems. Our approach couples protein sequence and function with biological fitness of live cells. Here we profile the electrophile sensitivity of proteinogenic cysteines in the eukaryotic pathogen Toxoplasma gondii and prioritize functional sites using CORe. Electrophile-sensitive cysteines decorating the ribosome were found to be critical for parasite growth, with target-based screening identifying a parasite-selective anti-malarial lead molecule and validating the apicomplexan translation machinery as a target for ongoing covalent ligand development.
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Affiliation(s)
- H J Benns
- Department of Life Sciences, Imperial College London, London, UK
- Department of Chemistry, Imperial College London, London, UK
| | - M Storch
- London Biofoundry, Imperial College Translation & Innovation Hub, London, UK
| | - J A Falco
- Department of Chemistry, Boston College, Boston, MA, USA
| | - F R Fisher
- Department of Life Sciences, Imperial College London, London, UK
| | - F Tamaki
- Wellcome Centre for Anti-Infectives Research, School of Life Sciences, University of Dundee, Dundee, UK
| | - E Alves
- Department of Life Sciences, Imperial College London, London, UK
| | - C J Wincott
- Department of Life Sciences, Imperial College London, London, UK
| | - R Milne
- Wellcome Centre for Anti-Infectives Research, School of Life Sciences, University of Dundee, Dundee, UK
| | - N Wiedemar
- Wellcome Centre for Anti-Infectives Research, School of Life Sciences, University of Dundee, Dundee, UK
| | - G Craven
- Department of Chemistry, Imperial College London, London, UK
| | - B Baragaña
- Wellcome Centre for Anti-Infectives Research, School of Life Sciences, University of Dundee, Dundee, UK
| | - S Wyllie
- Wellcome Centre for Anti-Infectives Research, School of Life Sciences, University of Dundee, Dundee, UK
| | - J Baum
- Department of Life Sciences, Imperial College London, London, UK
- School of Biomedical Sciences, UNSW, Sydney, NSW, Australia
| | - G S Baldwin
- Department of Life Sciences, Imperial College London, London, UK
| | - E Weerapana
- Department of Chemistry, Boston College, Boston, MA, USA
| | - E W Tate
- Department of Chemistry, Imperial College London, London, UK.
| | - M A Child
- Department of Life Sciences, Imperial College London, London, UK.
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Ong W, Finn N, Marvelde LT, Hornby C, Milne R, Hanna G, Pitson G, Elsaleh H, Millar J, Foroudi F. Radiotherapy Utilization in a Population-Based Cohort of Cancer Patients Diagnosed in Victoria, Australia from 2013 to 2017. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.2478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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3
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Ong W, Foroudi F, Milne R, Millar J. PH-0523: Palliative radiotherapy for bone metastases at the end of life: an Australian population-based study. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00545-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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4
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Gregory S, Bunnik EM, Callado AB, Carrie I, De Boer C, Duffus J, Fauria K, Forster S, Gove D, Knezevic I, Laquidain A, Pennetier D, Saunders S, Sparks S, Rice J, Ritchie CW, Milne R. Involving research participants in a pan-European research initiative: the EPAD participant panel experience. Res Involv Engagem 2020; 6:62. [PMID: 33088590 PMCID: PMC7566117 DOI: 10.1186/s40900-020-00236-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 10/01/2020] [Indexed: 05/13/2023]
Abstract
BACKGROUND Including participants in patient and public involvement activities is increasingly acknowledged as a key pillar of successful research activity. Such activities can influence recruitment and retention, as well as researcher experience and contribute to decision making in research studies. However, there are few established methodologies of how to set up and manage participant involvement activities. Further, there is little discussion of how to do so when dealing with collaborative projects that run across countries and operate in multiple linguistic and regulatory contexts. METHODS In this paper we describe the set-up, running and experiences of the EPAD participant panel. The EPAD study was a pan-European cohort study with the aim to understand risks for developing Alzheimer's disease and build a readiness cohort for Phase 2 clinical trials. Due to the longitudinal nature of this study, combined with the enrolment of healthy volunteers and those with mild cognitive impairments, the EPAD team highlighted participant involvement as crucial to the success of this project. The EPAD project employed a nested model, with local panels meeting in England, France, Scotland, Spain and The Netherlands, and feeding into a central study panel. The local panels were governed by terms of reference which were adaptable to local needs. RESULTS The impact of the panels has been widespread, and varies from feedback on documentation, to supporting with design of media materials and representation of the project at national and international meetings. CONCLUSIONS The EPAD panels have contributed to the success of the project and the model established is easily transferable to other disease areas investigating healthy or at-risk populations.
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Affiliation(s)
- S. Gregory
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - E. M. Bunnik
- Department of Medical Ethics and Philosophy of Medicine, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - A. B. Callado
- BarcelonaBeta Brain Research Center, Pasqual Maragall Fundation, Barcelona, Spain
| | - I. Carrie
- Centre de Recherche Clinique du Gérontopôle, Toulouse University Hospital, Toulouse, France
| | - C. De Boer
- VUmc Alzheimercentrum, Amsterdam, The Netherlands
| | - J. Duffus
- Participant panel member, Barcelona, Spain
| | - K. Fauria
- BarcelonaBeta Brain Research Center, Pasqual Maragall Fundation, Barcelona, Spain
| | - S. Forster
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - D. Gove
- Alzheimer Europe, Luxembourg, Luxembourg
| | - I. Knezevic
- BarcelonaBeta Brain Research Center, Pasqual Maragall Fundation, Barcelona, Spain
| | | | - D. Pennetier
- Centre de Recherche Clinique du Gérontopôle, Toulouse University Hospital, Toulouse, France
| | - S. Saunders
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - S. Sparks
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - J. Rice
- Participant panel member, Barcelona, Spain
| | - C. W. Ritchie
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - R. Milne
- Institute of Public Health, University of Cambridge, Cambridge, UK
- Society and Ethics Research, Wellcome Genome Campus, Hinxton, UK
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Milne R, Bunnik E, Tromp K, Bemelmans S, Badger S, Gove D, Maman M, Schermer M, Truyen L, Brayne C, Richard E. Ethical Issues in the Development of Readiness Cohorts in Alzheimer's Disease Research. J Prev Alzheimers Dis 2018; 4:125-131. [PMID: 29186282 DOI: 10.14283/jpad.2017.5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
There is growing interest in the development of novel approaches to secondary prevention trials in Alzheimer's disease to facilitate screening and recruitment of research participants and to reduce the time and costs associated with clinical trials. Several international research collaborations are setting up research infrastructures that link existing research cohorts, studies or patient registries to establish 'trial-ready' or 'readiness' cohorts. From these cohorts, individuals are recruited into clinical trial platforms. In setting up such research infrastructures, researchers must make ethically challenging design decisions in at least three areas: re-contacting participants in existing research studies, obtaining informed consent for participation in a readiness cohort, and disclosure of Alzheimer's disease-related biomarkers. These ethical considerations have been examined by a dedicated workgroup within the European Prevention of Alzheimer's Dementia (EPAD) project, a trans-European longitudinal cohort and adaptive proof-of-concept clinical trial platform. This paper offers recommendations for the ethical management of re-contact, informed consent and risk disclosure which may be of value to other research collaborations in the process of developing readiness cohorts for prevention trials in Alzheimer's disease and other disease areas.
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Affiliation(s)
- R Milne
- Richard Milne, PhD, Institute of Public Health, University of Cambridge, 2 Wort's Causeway Cambridge, UK, CB1 8RN, , 0044 (0)1223 761912
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Hoffmann T, Glasziou P, Boutron I, Milne R, Perera R, Moher D, Altman D, Barbour V, Macdonald H, Johnston M, Lamb S, Dixon-Woods M, McCulloch P, Wyatt J, Chan AW, Michie S. Die TIDieR Checkliste und Anleitung – ein Instrument für eine verbesserte Interventionsbeschreibung und Replikation. Gesundheitswesen 2018; 78:e174. [DOI: 10.1055/s-0037-1600948] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- T. Hoffmann
- Centre for Research in Evidence Based Practice, Faculty of Health Sciences and Medicine, Bond University, Queensland, Australia, 4229
| | - P. Glasziou
- Centre for Research in Evidence Based Practice, Faculty of Health Sciences and Medicine, Bond University, Queensland, Australia, 4229
| | - I. Boutron
- INSERMU738, Université Paris Descartes-Sorbonne Paris Cité, Paris, France
| | - R. Milne
- Wessex Institute, University of Southampton, Southampton, UK
| | - R. Perera
- Department of Primary Care Health Sciences, University of Oxford, UK
| | - D. Moher
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - D. Altman
- Centre for Statistics in Medicine, University of Oxford, UK
| | | | | | - M. Johnston
- Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
| | - S. Lamb
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, Oxford, UK
| | - M. Dixon-Woods
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - P. McCulloch
- Nuffield Department of Surgical Science, University of Oxford, Oxford, UK
| | - J. Wyatt
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - A.-W. Chan
- Women’s College Research Institute, University of Toronto, Toronto, Canada
| | - S. Michie
- Centre for Outcomes Research and Effectiveness, Department of Clinical, Educational and Health Psychology, University College London, London, UK
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Williams-Wietzikoski C, McLaughlin S, Deng W, Milne R, Frenkel L. Enrichment of HIV proviral DNA from mononuclear leukocytes for next-generation sequencing of integration sites. J Virus Erad 2017. [DOI: 10.1016/s2055-6640(20)30617-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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8
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Eng L, Liu S, Zhang Q, Farzanfar D, Milne R, Yeung S, Brown C, Howell D, Xu W, Goldstein D, Jones J, Selby P, Giuliani M, Liu G. Cancer patient attitudes and preferences towards smoking status assessment. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx388.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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9
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Hoffmann TC, Glasziou PP, Boutron I, Milne R, Perera R, Moher D, Altman DG, Barbour V, Macdonald H, Johnston M, Lamb SE, Dixon-Woods M, McCulloch P, Wyatt JC, Chan AW, Michie S. [Better Reporting of Interventions: Template for Intervention Description and Replication (TIDieR) Checklist and Guide]. Gesundheitswesen 2016; 78:175-88. [PMID: 26824401 DOI: 10.1055/s-0041-111066] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Without a complete published description of interventions, clinicians and patients cannot reliably implement interventions that are shown to be useful, and other researchers cannot replicate or build on research findings. The quality of description of interventions in publications, however, is remarkably poor. To improve the completeness of reporting, and ultimately the replicability, of interventions, an international group of experts and stakeholders developed the Template for Intervention Description and Replication (TIDieR) checklist and guide. The process involved a literature review for relevant checklists and research, a Delphi survey of an international panel of experts to guide item selection, and a face-to-face panel meeting. The resultant 12-item TIDieR checklist (brief name, why, what (materials), what (procedure), who intervened, how, where, when and how much, tailoring, modifications, how well (planned), how well (actually carried out)) is an extension of the CONSORT 2010 statement (item 5) and the SPIRIT 2013 statement (item 11). While the emphasis of the checklist is on trials, the guidance is intended to apply across all evaluative study designs. This paper presents the TIDieR checklist and guide, with a detailed explanation of each item, and examples of good reporting. The TIDieR checklist and guide should improve the reporting of interventions and make it easier for authors to structure the accounts of their interventions, reviewers and editors to assess the descriptions, and readers to use the information.
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Affiliation(s)
- T C Hoffmann
- Centre for Research in Evidence Based Practice, Faculty of Health Sciences and Medicine, Bond University, Queensland, Australia, 4229
| | - P P Glasziou
- Centre for Research in Evidence Based Practice, Faculty of Health Sciences and Medicine, Bond University, Queensland, Australia, 4229
| | - I Boutron
- INSERMU738, Université Paris Descartes-Sorbonne Paris Cité, Paris, France
| | - R Milne
- Wessex Institute, University of Southampton, Southampton, UK
| | - R Perera
- Department of Primary Care Health Sciences, University of Oxford, UK
| | - D Moher
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - D G Altman
- Centre for Statistics in Medicine, University of Oxford, UK
| | | | | | - M Johnston
- Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
| | - S E Lamb
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, Oxford, UK
| | - M Dixon-Woods
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - P McCulloch
- Nuffield Department of Surgical Science, University of Oxford, Oxford, UK
| | - J C Wyatt
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - A-W Chan
- Women's College Research Institute, University of Toronto, Toronto, Canada
| | - S Michie
- Centre for Outcomes Research and Effectiveness, Department of Clinical, Educational and Health Psychology, University College London, London, UK
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Giuliani M, Milne R, Kwan J, Alibhai S, Howell D, Waddell T, Abdelmutti N, Liu G, Jones J, Catton P, Puts M. Identification of Unmet Survivorship Needs in Primary Lung Cancer Patients: A High Burden for Younger Patients. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.2089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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11
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Abstract
OBJECTIVE To assess the clinical relevance and newsworthiness of the UK National Institute for Health Research (NIHR) Health Technology Assessment (HTA) Programme funded reports. STUDY DESIGN Retrospective cohort study. SETTING The cohort included 311 NIHR HTA Programme funded reports publishing in HTA in the period 1 January 2007-31 December 2012. The McMaster Online Rating of Evidence (MORE) system independently identified the clinical relevance and newsworthiness of NIHR HTA publications and non-NIHR HTA publications. The MORE system involves over 4000 physicians rating publications on a scale of relevance (the extent to which articles are relevant to practice) and a scale of newsworthiness (the extent to which articles contain news or something clinicians are unlikely to know). MAIN OUTCOME MEASURES The proportion of reports published in HTA meeting MORE inclusion criteria and mean average relevance and newsworthiness ratings were calculated and compared with publications from the same studies publishing outside HTA and non-NIHR HTA funded publications. RESULTS 286/311 (92.0%) of NIHR HTA reports were assessed by MORE, of which 192 (67.1%) passed MORE criteria. The average clinical relevance rating for NIHR HTA reports was 5.48, statistically higher than the 5.32 rating for non-NIHR HTA publications (mean difference=0.16, 95% CI 0.04 to 0.29, p=0.01). Average newsworthiness ratings were similar between NIHR HTA reports and non-NIHR HTA publications (4.75 and 4.70, respectively; mean difference=0.05, 95% CI -0.18 to 0.07, p=0.402). NIHR HTA-funded original research reports were statistically higher for newsworthiness than reviews (5.05 compared with 4.64) (mean difference=0.41, 95% CI 0.18 to 0.64, p=0.001). CONCLUSIONS Funding research of clinical relevance is important in maximising the value of research investment. The NIHR HTA Programme is successful in funding projects that generate outputs of clinical relevance.
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Affiliation(s)
- D Wright
- National Institute for Health Research, Evaluation, Trials and Studies Coordinating Centre (NETSCC), University of Southampton, Southampton, Hampshire, UK
| | - A Young
- National Institute for Health Research, Evaluation, Trials and Studies Coordinating Centre (NETSCC), University of Southampton, Southampton, Hampshire, UK
| | - E Iserman
- Department of Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, Ontario, Canada
| | - R Maeso
- National Institute for Health Research, Evaluation, Trials and Studies Coordinating Centre (NETSCC), University of Southampton, Southampton, Hampshire, UK
| | - S Turner
- National Institute for Health Research, Evaluation, Trials and Studies Coordinating Centre (NETSCC), University of Southampton, Southampton, Hampshire, UK
| | - R B Haynes
- Department of Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, Ontario, Canada
| | - R Milne
- Wessex Institute, University of Southampton, Southampton, Hampshire, UK
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12
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Milne R, La Vecchia C, Van Steen K, Hahn S, Buchholz M, Costello E, Esposito I, Hoheisel JD, Lange B, Lopez-Bigas N, Michalski CW, Real FX, Brand A, Malats N. EU Pancreas: an integrated European platform for pancreas cancer research--from basic science to clinical and public health interventions for a rare disease. Public Health Genomics 2014; 16:305-12. [PMID: 24503591 DOI: 10.1159/000355937] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Large-scale international collaboration is essential to decipher relevant information in the context of omics-scale interrogations in cancer research. This is even more important for rare and fatal diseases like pancreas cancer (PC). METHODS The COST Action BM1204 is a unique platform to facilitate the collaboration of a broad range of European and international PC multidisciplinary research groups in order to: (1) integrate knowledge and experience in a multidisciplinary way 'from cell to society', (2) promote the application of uniform study tools and protocols, (3) foster their optimal use by early-stage researchers, (4) enhance the mobility and training of researchers, and (5) disseminate the results produced to the broader society. RESULTS This Action will develop novel interdisciplinary tools for collaborative research to improve our understanding of PC and its prevention, diagnosis and treatment. It also aims to answer questions related to the etiology, early detection, evidence-based and personalized treatment, and health management for PC. Furthermore, the Action will contribute to new insights into PC personalized medicine and beyond as well as to the understanding of complex and rare diseases taking PC as a best practice example. The Action aims at attracting young scholars across a range of disciplines in collaboration with more experienced researchers and enhancing active European participation in the international scenario of PC research. CONCLUSION The ultimate aim is to foster PC research in Europe and to coordinate this effort with other international initiatives to reduce disease mortality.
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Affiliation(s)
- R Milne
- Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
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Giuliani M, Gillan C, Milne R, Uchino M, Millar B, Catton P. EP-1800: Determining an imaging literacy curriculum for radiation oncologists: An international Delphi study. Radiother Oncol 2014. [DOI: 10.1016/s0167-8140(15)31918-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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14
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Turner S, Wright D, Maeso R, Cook A, Milne R. Publication rate for funded studies from a major UK health research funder: a cohort study. BMJ Open 2013; 3:e002521. [PMID: 23645914 PMCID: PMC3646183 DOI: 10.1136/bmjopen-2012-002521] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2013] [Revised: 04/09/2013] [Accepted: 04/09/2013] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES This study aimed to investigate what percentage of National Institute for Health Research (NIHR) Health Technology Assessment (HTA) Programme-funded projects have published their final reports in the programme's journal HTA and to explore reasons for non-publication. DESIGN Retrospective cohort study. SETTING Failure to publish findings from research is a significant area of research waste. It has previously been suggested that potentially over 50% of studies funded are never published. PARTICIPANTS All NIHR HTA projects with a planned submission date for their final report for publication in the journal series on or before 9 December 2011 were included. PRIMARY AND SECONDARY OUTCOME MEASURES The projects were classified according to the type of research, whether they had been published or not; if not yet published, whether they would be published in the future or not. The reasons for non-publication were investigated. RESULTS 628 projects were included: 582 (92.7%) had published a monograph; 19 (3%) were expected to publish a monograph; 13 (2.1%) were discontinued studies and would not publish; 12 (1.9%) submitted a report which did not lead to a publication as a monograph; and two (0.3%) did not submit a report. Overall, 95.7% of HTA studies either have published or will publish a monograph: 94% for those commissioned in 2002 or before and 98% for those commissioned after 2002. Of the 27 projects for which there will be no report, the majority (21) were commissioned in 2002 or before. Reasons why projects failed to complete included failure to recruit; issues concerning the organisation where the research was taking place; drug licensing issues; staffing issues; and access to data. CONCLUSIONS The percentage of HTA projects for which a monograph is published is high. The advantages of funding organisations requiring publication in their own journal include avoidance of publication bias and research waste.
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Affiliation(s)
- S Turner
- National Institute for Health Research, Evaluation, Trials and Studies Coordinating Centre (NETSCC), University of Southampton, Southampton, Hampshire, UK
| | - D Wright
- National Institute for Health Research, Evaluation, Trials and Studies Coordinating Centre (NETSCC), University of Southampton, Southampton, Hampshire, UK
| | - R Maeso
- National Institute for Health Research, Evaluation, Trials and Studies Coordinating Centre (NETSCC), University of Southampton, Southampton, Hampshire, UK
| | - A Cook
- Wessex Institute, University of Southampton, Southampton, Hampshire, UK
| | - R Milne
- Wessex Institute, University of Southampton, Southampton, Hampshire, UK
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French J, Ghoussaini M, Edwards S, Meyer K, Michailidou K, Ahmed S, Khan S, Maranian M, O’Reilly M, Hillman K, Betts J, Carroll T, Bailey P, Dicks E, Beesley J, Tyrer J, Maia AT, Beck A, Knoblauch N, Chen C, Kraft P, Barnes D, González-Neira A, Alonso M, Herrero D, Tessier D, Vincent D, Bacot F, Luccarini C, Baynes C, Conroy D, Dennis J, Bolla M, Wang Q, Hopper J, Southey M, Schmidt M, Broeks A, Verhoef S, Cornelissen S, Muir K, Lophatananon A, Stewart-Brown S, Siriwanarangsan P, Fasching P, Loehberg C, Ekici A, Beckmann M, Peto J, dos Santos Silva I, Johnson N, Aitken Z, Sawyer E, Tomlinson I, Kerin M, Miller N, Marme F, Schneeweiss A, Sohn C, Burwinkel B, Guénel P, Truong T, Laurent-Puig P, Menegaux F, Bojesen S, Nordestgaard B, Nielsen S, Flyger H, Milne R, Zamora M, Arias Perez J, Benitez J, Anton-Culver H, Brenner H, Müller H, Arndt V, Stegmaier C, Meindl A, Lichtner P, Schmutzler R, Engel C, Brauch H, Hamann U, Justenhoven C, Aaltonen K, Heikkilä P, Aittomäki K, Blomqvist C, Matsuo K, Ito H, Iwata H, Sueta A, Bogdanova N, Antonenkova N, Dörk T, Lindblom A, Margolin S, Mannermaa A, Kataja V, Kosma VM, Hartikainen J, Wu A, Tseng CC, Van Den Berg D, Stram D, Lambrechts D, Peeters S, Smeets A, Floris G, Chang-Claude J, Rudolph A, Nickels S, Flesch-Janys D, Radice P, Peterlongo P, Bonanni B, Sardella D, Couch F, Wang X, Pankratz V, Lee A, Giles G, Severi G, Baglietto L, Haiman C, Henderson B, Schumacher F, Le Marchand L, Simard J, Goldberg M, Labrèche F, Dumont M, Teo S, Yip C, Ng CH, Vithana E, Kristensen V, Zheng W, Deming-Halverson S, Shrubsole M, Long J, Winqvist R, Pylkäs K, Jukkola-Vuorinen A, Grip M, Andrulis I, Knight J, Glendon G, Mulligan A, Devilee P, Seynaeve C, García-Closas M, Figueroa J, Chanock S, Lissowska J, Czene K, Klevebring D, Schoof N, Hooning M, Martens J, Collée J, Tilanus-Linthorst M, Hall P, Li J, Liu J, Humphreys K, Shu XO, Lu W, Gao YT, Cai H, Cox A, Balasubramanian S, Blot W, Signorello L, Cai Q, Pharoah P, Healey C, Shah M, Pooley K, Kang D, Yoo KY, Noh DY, Hartman M, Miao H, Sng JH, Sim X, Jakubowska A, Lubinski J, Jaworska-Bieniek K, Durda K, Sangrajrang S, Gaborieau V, McKay J, Toland A, Ambrosone C, Yannoukakos D, Godwin A, Shen CY, Hsiung CN, Wu PE, Chen ST, Swerdlow A, Ashworth A, Orr N, Schoemaker M, Ponder B, Nevanlinna H, Brown M, Chenevix-Trench G, Easton D, Dunning A. Functional variants at the 11q13 risk locus for breast cancer regulate cyclin D1 expression through long-range enhancers. Am J Hum Genet 2013; 92:489-503. [PMID: 23540573 PMCID: PMC3617380 DOI: 10.1016/j.ajhg.2013.01.002] [Citation(s) in RCA: 154] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2012] [Revised: 12/21/2012] [Accepted: 01/03/2013] [Indexed: 10/27/2022] Open
Abstract
Analysis of 4,405 variants in 89,050 European subjects from 41 case-control studies identified three independent association signals for estrogen-receptor-positive tumors at 11q13. The strongest signal maps to a transcriptional enhancer element in which the G allele of the best candidate causative variant rs554219 increases risk of breast cancer, reduces both binding of ELK4 transcription factor and luciferase activity in reporter assays, and may be associated with low cyclin D1 protein levels in tumors. Another candidate variant, rs78540526, lies in the same enhancer element. Risk association signal 2, rs75915166, creates a GATA3 binding site within a silencer element. Chromatin conformation studies demonstrate that these enhancer and silencer elements interact with each other and with their likely target gene, CCND1.
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MESH Headings
- Binding Sites
- Breast Neoplasms/genetics
- Case-Control Studies
- Cell Line, Tumor
- Chromatin/chemistry
- Chromatin/genetics
- Chromatin Immunoprecipitation
- Chromosomes, Human, Pair 11/genetics
- Cyclin D1/genetics
- Cyclin D1/metabolism
- Electrophoretic Mobility Shift Assay
- Enhancer Elements, Genetic/genetics
- Female
- GATA3 Transcription Factor/antagonists & inhibitors
- GATA3 Transcription Factor/genetics
- GATA3 Transcription Factor/metabolism
- Gene Expression Regulation, Neoplastic
- Humans
- Luciferases/metabolism
- Polymorphism, Single Nucleotide/genetics
- Promoter Regions, Genetic/genetics
- RNA, Messenger/genetics
- RNA, Small Interfering/genetics
- Real-Time Polymerase Chain Reaction
- Reverse Transcriptase Polymerase Chain Reaction
- Silencer Elements, Transcriptional/genetics
- ets-Domain Protein Elk-4/antagonists & inhibitors
- ets-Domain Protein Elk-4/genetics
- ets-Domain Protein Elk-4/metabolism
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Affiliation(s)
- Juliet D. French
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Queensland 4072, Australia
| | - Maya Ghoussaini
- Department of Oncology, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge CB1 8RN, UK
| | - Stacey L. Edwards
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Queensland 4072, Australia
| | - Kerstin B. Meyer
- Cancer Research UK Cambridge Research Institute, Li Ka Shing Centre, Cambridge CB2 0RE, UK
| | - Kyriaki Michailidou
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge CB1 8RN, UK
| | - Shahana Ahmed
- Department of Oncology, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge CB1 8RN, UK
| | - Sofia Khan
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Central Hospital, Helsinki 00029, Finland
| | - Mel J. Maranian
- Department of Oncology, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge CB1 8RN, UK
| | - Martin O’Reilly
- Cancer Research UK Cambridge Research Institute, Li Ka Shing Centre, Cambridge CB2 0RE, UK
| | - Kristine M. Hillman
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Queensland 4072, Australia
| | - Joshua A. Betts
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Queensland 4072, Australia
| | - Thomas Carroll
- Cancer Research UK Cambridge Research Institute, Li Ka Shing Centre, Cambridge CB2 0RE, UK
| | - Peter J. Bailey
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Queensland 4072, Australia
| | - Ed Dicks
- Department of Oncology, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge CB1 8RN, UK
| | - Jonathan Beesley
- Department of Genetics, Queensland Institute of Medical Research, Brisbane, Queensland 4029, Australia
| | - Jonathan Tyrer
- Department of Oncology, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge CB1 8RN, UK
| | - Ana-Teresa Maia
- Cancer Research UK Cambridge Research Institute, Li Ka Shing Centre, Cambridge CB2 0RE, UK
| | - Andrew Beck
- Harvard Medical School and Department of Pathology, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA
| | - Nicholas W. Knoblauch
- Harvard Medical School and Department of Pathology, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA
| | - Constance Chen
- Department of Epidemiology, Harvard School of Public Health, Boston, MA 02215, USA
| | - Peter Kraft
- Department of Epidemiology, Harvard School of Public Health, Boston, MA 02215, USA
- Department of Biostatistics, Harvard School of Public Health, Boston, MA 02215, USA
| | - Daniel Barnes
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge CB1 8RN, UK
| | - Anna González-Neira
- Human Genotyping-CEGEN Unit, Human Cancer Genetics Program, Spanish National Cancer Research Centre (CNIO), Madrid 28029, Spain
| | - M. Rosario Alonso
- Human Genotyping-CEGEN Unit, Human Cancer Genetics Program, Spanish National Cancer Research Centre (CNIO), Madrid 28029, Spain
| | - Daniel Herrero
- Human Genotyping-CEGEN Unit, Human Cancer Genetics Program, Spanish National Cancer Research Centre (CNIO), Madrid 28029, Spain
| | - Daniel C. Tessier
- Centre d’innovation Génome Québec et Université McGill, Montréal, QC H3A 0G1, Canada
| | - Daniel Vincent
- Centre d’innovation Génome Québec et Université McGill, Montréal, QC H3A 0G1, Canada
| | - Francois Bacot
- Centre d’innovation Génome Québec et Université McGill, Montréal, QC H3A 0G1, Canada
| | - Craig Luccarini
- Department of Oncology, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge CB1 8RN, UK
| | - Caroline Baynes
- Department of Oncology, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge CB1 8RN, UK
| | - Don Conroy
- Department of Oncology, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge CB1 8RN, UK
| | - Joe Dennis
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge CB1 8RN, UK
| | - Manjeet K. Bolla
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge CB1 8RN, UK
| | - Qin Wang
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge CB1 8RN, UK
| | - John L. Hopper
- Centre for Molecular, Environmental, Genetic, and Analytic Epidemiology, The University of Melbourne, Melbourne, Victoria 3010, Australia
| | - Melissa C. Southey
- Genetic Epidemiology Laboratory, Department of Pathology, The University of Melbourne, Melbourne, Victoria 3010, Australia
| | - Marjanka K. Schmidt
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, 1066 CX Amsterdam, the Netherlands
- Division of Molecular Pathology, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, 1066 CX Amsterdam, the Netherlands
| | - Annegien Broeks
- Division of Molecular Pathology, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, 1066 CX Amsterdam, the Netherlands
| | - Senno Verhoef
- Family Cancer Clinic, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, 1066 CX Amsterdam, the Netherlands
| | - Sten Cornelissen
- Division of Molecular Pathology, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, 1066 CX Amsterdam, the Netherlands
| | - Kenneth Muir
- Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK
| | | | | | | | - Peter A. Fasching
- Department of Medicine, Division of Hematology and Oncology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA 90095, USA
- University Breast Center Franconia, Department of Gynecology and Obstetrics, University Hospital Erlangen, 91054 Erlangen, Germany
| | - Christian R. Loehberg
- University Breast Center Franconia, Department of Gynecology and Obstetrics, University Hospital Erlangen, 91054 Erlangen, Germany
| | - Arif B. Ekici
- Institute of Human Genetics, Friedrich Alexander University Erlangen-Nuremberg, 91054 Erlangen, Germany
| | - Matthias W. Beckmann
- University Breast Center Franconia, Department of Gynecology and Obstetrics, University Hospital Erlangen, 91054 Erlangen, Germany
| | - Julian Peto
- Non-communicable Disease Epidemiology Department, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
| | - Isabel dos Santos Silva
- Non-communicable Disease Epidemiology Department, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
| | - Nichola Johnson
- Breakthrough Breast Cancer Research Centre, The Institute of Cancer Research, London SW3 6JB, UK
| | - Zoe Aitken
- Non-communicable Disease Epidemiology Department, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
| | - Elinor J. Sawyer
- Division of Cancer Studies, NIHR Comprehensive Biomedical Research Centre, Guy’s & St. Thomas’ NHS Foundation Trust in partnership with King’s College London, London SE1 9RT, UK
| | - Ian Tomlinson
- Welcome Trust Centre for Human Genetics and Oxford Biomedical Research Centre, University of Oxford, Oxford OX3 7BN, UK
| | - Michael J. Kerin
- Surgery, Clinical Science Institute, Galway University Hospital and National University of Ireland, Galway, Ireland
| | - Nicola Miller
- Surgery, Clinical Science Institute, Galway University Hospital and National University of Ireland, Galway, Ireland
| | - Frederik Marme
- Department of Obstetrics and Gynecology, University of Heidelberg, 69115 Heidelberg, Germany
- National Center for Tumor Diseases, University of Heidelberg, 69120 Heidelberg, Germany
| | - Andreas Schneeweiss
- Department of Obstetrics and Gynecology, University of Heidelberg, 69115 Heidelberg, Germany
- National Center for Tumor Diseases, University of Heidelberg, 69120 Heidelberg, Germany
| | - Christof Sohn
- Department of Obstetrics and Gynecology, University of Heidelberg, 69115 Heidelberg, Germany
| | - Barbara Burwinkel
- Department of Obstetrics and Gynecology, University of Heidelberg, 69115 Heidelberg, Germany
- Molecular Epidemiology Group, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | - Pascal Guénel
- INSERM (National Institute of Health and Medical Research), CESP (Center for Research in Epidemiology and Population Health), U1018, Environmental Epidemiology of Cancer Team, 94807 Villejuif, France
- University Paris-Sud, UMRS 1018, 94807 Villejuif, France
| | - Thérèse Truong
- INSERM (National Institute of Health and Medical Research), CESP (Center for Research in Epidemiology and Population Health), U1018, Environmental Epidemiology of Cancer Team, 94807 Villejuif, France
- University Paris-Sud, UMRS 1018, 94807 Villejuif, France
| | - Pierre Laurent-Puig
- Université Paris Sorbonne Cité, UMR-S775 INSERM, 75270 Paris Cedex 06, France
| | - Florence Menegaux
- INSERM (National Institute of Health and Medical Research), CESP (Center for Research in Epidemiology and Population Health), U1018, Environmental Epidemiology of Cancer Team, 94807 Villejuif, France
- University Paris-Sud, UMRS 1018, 94807 Villejuif, France
| | - Stig E. Bojesen
- Copenhagen General Population Study, Herlev Hospital, Copenhagen University Hospital, University of Copenhagen, Copenhagen, 2730 Herlev, Denmark
- Department of Clinical Biochemistry, Herlev Hospital, Copenhagen University Hospital, University of Copenhagen, Copenhagen, 2730 Herlev, Denmark
| | - Børge G. Nordestgaard
- Copenhagen General Population Study, Herlev Hospital, Copenhagen University Hospital, University of Copenhagen, Copenhagen, 2730 Herlev, Denmark
- Department of Clinical Biochemistry, Herlev Hospital, Copenhagen University Hospital, University of Copenhagen, Copenhagen, 2730 Herlev, Denmark
| | - Sune F. Nielsen
- Copenhagen General Population Study, Herlev Hospital, Copenhagen University Hospital, University of Copenhagen, Copenhagen, 2730 Herlev, Denmark
- Department of Clinical Biochemistry, Herlev Hospital, Copenhagen University Hospital, University of Copenhagen, Copenhagen, 2730 Herlev, Denmark
| | - Henrik Flyger
- Department of Breast Surgery, Herlev Hospital, Copenhagen University Hospital, Copenhagen, 2730 Herlev, Denmark
| | - Roger L. Milne
- Genetic & Molecular Epidemiology Group, Human Cancer Genetics Program, Spanish National Cancer Research Centre (CNIO), Madrid 28029, Spain
| | - M. Pilar Zamora
- Servicio de Oncología Médica, Hospital Universitario La Paz, Madrid 28046, Spain
| | | | - Javier Benitez
- Human Genotyping-CEGEN Unit, Human Cancer Genetics Program, Spanish National Cancer Research Centre (CNIO), Madrid 28029, Spain
- Centro de Investigación en Red de Enfermedades Raras (CIBERER), Madrid 28029, Spain
| | - Hoda Anton-Culver
- Department of Epidemiology, University of California, Irvine, Irvine, CA 92697, USA
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | - Heiko Müller
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | - Volker Arndt
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | | | - Alfons Meindl
- Division of Gynaecology and Obstetrics, Technische Universität München, 81675 Munich, Germany
| | - Peter Lichtner
- Institute of Human Genetics, Helmholtz Zentrum München - German Research Center for Environmental Health, 85764 Neuherberg, Germany
| | - Rita K. Schmutzler
- Division of Molecular Gyneco-Oncology, Department of Gynaecology and Obstetrics, University Cologne, 50931 Cologne, Germany
| | - Christoph Engel
- Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, 04107 Leipzig, Germany
| | - Hiltrud Brauch
- Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology, 70376 Stuttgart, Germany
- University of Tübingen, 72074 Tübingen, Germany
| | - Ute Hamann
- Molecular Genetics of Breast Cancer, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | - Christina Justenhoven
- Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology, 70376 Stuttgart, Germany
- University of Tübingen, 72074 Tübingen, Germany
| | - The GENICA Network
- Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology, 70376 Stuttgart, Germany
- University of Tübingen, 72074 Tübingen, Germany
- Molecular Genetics of Breast Cancer, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
- Department of Internal Medicine, Evangelische Kliniken Bonn gGmbH, Johanniter Krankenhaus, 53113 Bonn, Germany
- Institute and Outpatient Clinic of Occupational Medicine, Saarland University Medical Center and Saarland University Faculty of Medicine, 66421 Homburg, Germany
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance (IPA), 44789 Bochum, Germany
- Institute of Pathology, Medical Faculty of the University of Bonn, 53123 Bonn, Germany
| | - Kirsimari Aaltonen
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Central Hospital, Helsinki 00029, Finland
- Department of Clinical Genetics, University of Helsinki and Helsinki University Central Hospital, Helsinki, 00029, Finland
| | - Päivi Heikkilä
- Department of Pathology, University of Helsinki and Helsinki University Central Hospital, Helsinki, 00029, Finland
| | - Kristiina Aittomäki
- Department of Clinical Genetics, University of Helsinki and Helsinki University Central Hospital, Helsinki, 00029, Finland
| | - Carl Blomqvist
- Department of Oncology, University of Helsinki and Helsinki University Central Hospital, Helsinki, 00029, Finland
| | - Keitaro Matsuo
- Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya 464-8681, Japan
| | - Hidemi Ito
- Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya 464-8681, Japan
| | - Hiroji Iwata
- Department of Breast Oncology, Aichi Cancer Center Hospital, Nagoya 464-8681, Japan
| | - Aiko Sueta
- Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya 464-8681, Japan
| | - Natalia V. Bogdanova
- Department of Obstetrics and Gynaecology, Hannover Medical School, 30625 Hannover, Germany
- Department of Radiation Oncology, Hannover Medical School, 30625 Hannover, Germany
| | - Natalia N. Antonenkova
- N.N. Alexandrov Research Institute of Oncology and Medical Radiology, 223040 Minsk, Belarus
| | - Thilo Dörk
- Department of Obstetrics and Gynaecology, Hannover Medical School, 30625 Hannover, Germany
| | - Annika Lindblom
- Department of Molecular Medicine and Surgery, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Sara Margolin
- Department of Oncology-Pathology, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Arto Mannermaa
- Imaging Center, Department of Clinical Pathology, Kuopio University Hospital, 70211 Kuopio, Finland
- School of Medicine, Institute of Clinical Medicine, Pathology and Forensic Medicine, Biocenter Kuopio, Cancer Center of Eastern Finland, University of Eastern Finland, 70211 Kuopio, Finland
| | - Vesa Kataja
- School of Medicine, Institute of Clinical Medicine, Pathology and Forensic Medicine, Biocenter Kuopio, Cancer Center of Eastern Finland, University of Eastern Finland, 70211 Kuopio, Finland
- Cancer Center, Kuopio University Hospital, 70211 Kuopio, Finland
| | - Veli-Matti Kosma
- Imaging Center, Department of Clinical Pathology, Kuopio University Hospital, 70211 Kuopio, Finland
- School of Medicine, Institute of Clinical Medicine, Pathology and Forensic Medicine, Biocenter Kuopio, Cancer Center of Eastern Finland, University of Eastern Finland, 70211 Kuopio, Finland
| | - Jaana M. Hartikainen
- Imaging Center, Department of Clinical Pathology, Kuopio University Hospital, 70211 Kuopio, Finland
- School of Medicine, Institute of Clinical Medicine, Pathology and Forensic Medicine, Biocenter Kuopio, Cancer Center of Eastern Finland, University of Eastern Finland, 70211 Kuopio, Finland
| | | | - Anna H. Wu
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90089, USA
| | - Chiu-chen Tseng
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90089, USA
| | - David Van Den Berg
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90089, USA
| | - Daniel O. Stram
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90089, USA
| | - Diether Lambrechts
- Laboratory for Translational Genetics, Department of Oncology, University of Leuven, 3000 Leuven, Belgium
- Vesalius Research Center (VRC), VIB, 3000 Leuven, Belgium
| | - Stephanie Peeters
- Multidisciplinary Breast Center, University Hospital Leuven and KU Leuven, 3000 Leuven, Belgium
| | - Ann Smeets
- Multidisciplinary Breast Center, University Hospital Leuven and KU Leuven, 3000 Leuven, Belgium
| | - Giuseppe Floris
- Multidisciplinary Breast Center, University Hospital Leuven and KU Leuven, 3000 Leuven, Belgium
| | - Jenny Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | - Anja Rudolph
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | - Stefan Nickels
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | - Dieter Flesch-Janys
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
- Department of Cancer Epidemiology/Clinical Cancer Registry and Institute for Medical Biometrics and Epidemiology, University Clinic Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Paolo Radice
- Unit of Molecular Bases of Genetic Risk and Genetic Testing, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale Tumori (INT), 20133 Milan, Italy
- IFOM, Fondazione Istituto FIRC di Oncologia Molecolare, 20139 Milan, Italy
| | - Paolo Peterlongo
- Unit of Molecular Bases of Genetic Risk and Genetic Testing, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale Tumori (INT), 20133 Milan, Italy
- IFOM, Fondazione Istituto FIRC di Oncologia Molecolare, 20139 Milan, Italy
| | - Bernardo Bonanni
- Division of Cancer Prevention and Genetics, Istituto Europeo di Oncologia, 20141 Milan, Italy
| | - Domenico Sardella
- IFOM, Fondazione Istituto FIRC di Oncologia Molecolare, 20139 Milan, Italy
| | - Fergus J. Couch
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA
| | - Xianshu Wang
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA
| | - Vernon S. Pankratz
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN 55905, USA
| | - Adam Lee
- Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, MN 55905, USA
| | - Graham G. Giles
- Centre for Molecular, Environmental, Genetic, and Analytic Epidemiology, The University of Melbourne, Melbourne, Victoria 3010, Australia
- Cancer Epidemiology Centre, The Cancer Council Victoria, Melbourne, Victoria 3053, Australia
| | - Gianluca Severi
- Centre for Molecular, Environmental, Genetic, and Analytic Epidemiology, The University of Melbourne, Melbourne, Victoria 3010, Australia
- Cancer Epidemiology Centre, The Cancer Council Victoria, Melbourne, Victoria 3053, Australia
| | - Laura Baglietto
- Centre for Molecular, Environmental, Genetic, and Analytic Epidemiology, The University of Melbourne, Melbourne, Victoria 3010, Australia
- Cancer Epidemiology Centre, The Cancer Council Victoria, Melbourne, Victoria 3053, Australia
| | - Christopher A. Haiman
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90089, USA
| | - Brian E. Henderson
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90089, USA
| | - Fredrick Schumacher
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90089, USA
| | - Loic Le Marchand
- Epidemiology Program, Cancer Research Center, University of Hawaii, Honolulu, HI 96813, USA
| | - Jacques Simard
- Cancer Genomics Laboratory, Centre Hospitalier Universitaire de Québec and Laval University, Québec City, QC G1V 4G2, Canada
| | - Mark S. Goldberg
- Department of Medicine, McGill University, Montreal, QC H3A 1A1, Canada
- Division of Clinical Epidemiology, McGill University Health Centre, Royal Victoria Hospital, Montreal, QC H3A 1A1, Canada
| | - France Labrèche
- Département de médecine sociale et préventive, Département de santé environnementale et santé au travail, Université de Montréal, Montreal, QC H3A 3C2, Canada
| | - Martine Dumont
- Cancer Genomics Laboratory, Centre Hospitalier Universitaire de Québec and Laval University, Québec City, QC G1V 4G2, Canada
| | - Soo Hwang Teo
- Cancer Research Initiatives Foundation, Sime Darby Medical Centre, Subang Jaya, 47500 Selangor, Malaysia
- Breast Cancer Research Unit, University Malaya Cancer Research Institute, Faculty of Medicine, University Malaya, 50603 Kuala Lumpur, Malaysia
| | - Cheng Har Yip
- Breast Cancer Research Unit, University Malaya Cancer Research Institute, Faculty of Medicine, University Malaya, 50603 Kuala Lumpur, Malaysia
| | - Char-Hong Ng
- Breast Cancer Research Unit, University Malaya Cancer Research Institute, Faculty of Medicine, University Malaya, 50603 Kuala Lumpur, Malaysia
| | | | - Vessela Kristensen
- Department of Genetics, Institute for Cancer Research, Oslo University Hospital, Radiumhospitalet, 0310 Oslo, Norway
- Faculty of Medicine (Faculty Division Ahus), University of Oslo, 0318 Oslo, Norway
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN 37203, USA
| | - Sandra Deming-Halverson
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN 37203, USA
| | - Martha Shrubsole
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN 37203, USA
| | - Jirong Long
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN 37203, USA
| | - Robert Winqvist
- Laboratory of Cancer Genetics and Tumor Biology, Department of Clinical Genetics and Biocenter Oulu, University of Oulu, Oulu University Hospital, 90014 Oulu, Finland
| | - Katri Pylkäs
- Laboratory of Cancer Genetics and Tumor Biology, Department of Clinical Genetics and Biocenter Oulu, University of Oulu, Oulu University Hospital, 90014 Oulu, Finland
| | - Arja Jukkola-Vuorinen
- Department of Oncology, Oulu University Hospital, University of Oulu, 90014 Oulu, Finland
| | - Mervi Grip
- Department of Surgery, Oulu University Hospital, University of Oulu, 90014 Oulu, Finland
| | - Irene L. Andrulis
- Department of Molecular Genetics, University of Toronto, Toronto, ON M5S 1A8, Canada
- Ontario Cancer Genetics Network, Samuel Lunenfeld Research Institute, Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada
| | - Julia A. Knight
- Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada
- Prosserman Centre for Health Research, Samuel Lunenfeld Research Institute, Mount Sinai Hospital, Toronto, ON M5T 3L9, Canada
| | - Gord Glendon
- Ontario Cancer Genetics Network, Samuel Lunenfeld Research Institute, Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada
| | - Anna Marie Mulligan
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A8, Canada
- Laboratory Medicine Program, University Health Network, 200 Elizabeth Street, Toronto, ON M5G 2C4, Canada
| | - Peter Devilee
- Department of Human Genetics & Department of Pathology, Leiden University Medical Center, 2300 RC Leiden, the Netherlands
| | - Caroline Seynaeve
- Family Cancer Clinic, Department of Medical Oncology, Erasmus MC-Daniel den Hoed Cancer Center, 3075 EA Rotterdam, the Netherlands
- Department of Medical Oncology, Erasmus University Medical Center, 3075 EA Rotterdam, the Netherlands
| | - Montserrat García-Closas
- Breakthrough Breast Cancer Research Centre, The Institute of Cancer Research, London SW3 6JB, UK
- Division of Genetics and Epidemiology, Institute of Cancer Research and Breakthrough Breast Cancer Research Centre, London SM2 5NG, UK
- Division of Breast Cancer Research, The Institute of Cancer Research, London SW3 6JB, UK
| | - Jonine Figueroa
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD 20892, USA
| | - Stephen J. Chanock
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD 20892, USA
| | - Jolanta Lissowska
- Department of Cancer Epidemiology and Prevention, M. Sklodowska-Curie Memorial Cancer Center & Institute of Oncology, 02-781 Warsaw, Poland
| | - Kamila Czene
- Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm 17 177, Sweden
| | - Daniel Klevebring
- Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm 17 177, Sweden
| | - Nils Schoof
- Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm 17 177, Sweden
| | - Maartje J. Hooning
- Department of Medical Oncology, Erasmus University Medical Center, 3075 EA Rotterdam, the Netherlands
| | - John W.M. Martens
- Department of Medical Oncology, Erasmus University Medical Center, 3075 EA Rotterdam, the Netherlands
| | - J. Margriet Collée
- Department of Clinical Genetics, Erasmus University Medical Center, 3008 AE Rotterdam, the Netherlands
| | | | - Per Hall
- Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm 17 177, Sweden
| | - Jingmei Li
- Human Genetics Division, Genome Institute of Singapore, Singapore 138672, Singapore
| | - Jianjun Liu
- Human Genetics Division, Genome Institute of Singapore, Singapore 138672, Singapore
| | - Keith Humphreys
- Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm 17 177, Sweden
| | - Xiao-Ou Shu
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN 37203, USA
| | - Wei Lu
- Shanghai Center for Disease Control and Prevention, Shanghai 200336, China
| | - Yu-Tang Gao
- Department of Epidemiology, Shanghai Cancer Institute, Shanghai 200032, China
| | - Hui Cai
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN 37203, USA
| | - Angela Cox
- CRUK/YCR Sheffield Cancer Research Centre, Department of Oncology, University of Sheffield, Sheffield S10 2RX, UK
| | - Sabapathy P. Balasubramanian
- CRUK/YCR Sheffield Cancer Research Centre, Department of Oncology, University of Sheffield, Sheffield S10 2RX, UK
| | - William Blot
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN 37203, USA
- International Epidemiology Institute, Rockville, MD 20850, USA
| | - Lisa B. Signorello
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN 37203, USA
- International Epidemiology Institute, Rockville, MD 20850, USA
| | - Qiuyin Cai
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN 37203, USA
| | - Paul D.P. Pharoah
- Department of Oncology, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge CB1 8RN, UK
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge CB1 8RN, UK
| | - Catherine S. Healey
- Department of Oncology, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge CB1 8RN, UK
| | - Mitul Shah
- Department of Oncology, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge CB1 8RN, UK
| | - Karen A. Pooley
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge CB1 8RN, UK
| | - Daehee Kang
- Seoul National University College of Medicine, Seoul 110-799, Korea
| | - Keun-Young Yoo
- Seoul National University College of Medicine, Seoul 110-799, Korea
| | - Dong-Young Noh
- Seoul National University College of Medicine, Seoul 110-799, Korea
| | - Mikael Hartman
- Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore 117597, Singapore
| | - Hui Miao
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore 117597, Singapore
| | - Jen-Hwei Sng
- Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
| | - Xueling Sim
- Centre for Molecular Epidemiology, National University of Singapore, Singapore 117597, Singapore
| | - Anna Jakubowska
- Department of Genetics and Pathology, Pomeranian Medical University, u. Polabska 4, 70-115 Szczecin, Poland
| | - Jan Lubinski
- Department of Genetics and Pathology, Pomeranian Medical University, u. Polabska 4, 70-115 Szczecin, Poland
| | - Katarzyna Jaworska-Bieniek
- Department of Genetics and Pathology, Pomeranian Medical University, u. Polabska 4, 70-115 Szczecin, Poland
- Postgraduate School of Molecular Medicine, Warsaw Medical University, ul. Żwirki i Wigury 61, 02-091 Warsaw, Poland
| | - Katarzyna Durda
- Department of Genetics and Pathology, Pomeranian Medical University, u. Polabska 4, 70-115 Szczecin, Poland
| | | | - Valerie Gaborieau
- International Agency for Research on Cancer, 69372 Lyon Cedex 08, France
| | - James McKay
- International Agency for Research on Cancer, 69372 Lyon Cedex 08, France
| | - Amanda E. Toland
- Department of Molecular Virology, Immunology and Medical Genetics, Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210, USA
| | - Christine B. Ambrosone
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, NY 14263, USA
| | - Drakoulis Yannoukakos
- Molecular Diagnostics Laboratory, IRRP, National Centre for Scientific Research “Demokritos,” Athens 15310, Greece
| | - Andrew K. Godwin
- Department of Pathology and Laboratory Medicine, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - Chen-Yang Shen
- Colleague of Public Health, China Medical University, Taichong 40402, Taiwan, ROC
- Institute of Biomedical Sciences, Academia Sinica, Taipei 115, Taiwan, ROC
| | - Chia-Ni Hsiung
- Institute of Biomedical Sciences, Academia Sinica, Taipei 115, Taiwan, ROC
| | - Pei-Ei Wu
- Taiwan Biobank, Institute of Biomedical Sciences, Academia Sinica, Taipei 115, Taiwan, ROC
| | - Shou-Tung Chen
- Department of Surgery, Changhua Christian Hospital, Changhua City, Changhua county 500, Taiwan, ROC
| | - Anthony Swerdlow
- Division of Genetics and Epidemiology, Institute of Cancer Research and Breakthrough Breast Cancer Research Centre, London SM2 5NG, UK
- Division of Breast Cancer Research, The Institute of Cancer Research, London SW3 6JB, UK
| | - Alan Ashworth
- Breakthrough Breast Cancer Research Centre, The Institute of Cancer Research, London SW3 6JB, UK
| | - Nick Orr
- Breakthrough Breast Cancer Research Centre, The Institute of Cancer Research, London SW3 6JB, UK
- Division of Breast Cancer Research, The Institute of Cancer Research, London SW3 6JB, UK
| | - Minouk J. Schoemaker
- Division of Genetics and Epidemiology, Institute of Cancer Research and Breakthrough Breast Cancer Research Centre, London SM2 5NG, UK
| | - Bruce A.J. Ponder
- Cancer Research UK Cambridge Research Institute, Li Ka Shing Centre, Cambridge CB2 0RE, UK
| | - Heli Nevanlinna
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Central Hospital, Helsinki 00029, Finland
| | - Melissa A. Brown
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Queensland 4072, Australia
| | - Georgia Chenevix-Trench
- Department of Genetics, Queensland Institute of Medical Research, Brisbane, Queensland 4029, Australia
| | - Douglas F. Easton
- Department of Oncology, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge CB1 8RN, UK
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge CB1 8RN, UK
| | - Alison M. Dunning
- Department of Oncology, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge CB1 8RN, UK
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Abstract
The diversity of ericoid mycorrhizal fungi isolated from Rhododendron decorum Franch. in Yunnan, southwestern China, was examined for the first time. In total 300 hair-root samples were collected from 13 R. decorum individuals in two adjacent wild population sites and one cultivated population site. Two hundred eighteen slow-growing isolates were obtained; the ability of some to form ericoid mycorrhiza was tested in vitro. One hundred twenty-five isolates formed hyphal structures morphologically corresponding to ericoid mycorrhiza, and these were determined by morphological and molecular means to belong to 12 fungal species. There were hardly any differences in species among the three sampled populations. The sequences of several isolates were similar to those of Oidiodendron maius and ericoid mycorrhizal fungi from Helotiales, accounting respectively for 18.4% and 24.8% of the total culturable ericoid mycorrhizal fungi assemblage. Dark septate endophytes were detected in the sampled hair roots by microscopy.
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Affiliation(s)
- W Tian
- Kunming Institute of Botany, Chinese Academy of Sciences, Kunming, Yunnan, China
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17
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Lickliter JD, Francesconi AB, Smith G, Burge M, Coulthard A, Rose S, Griffin M, Milne R, McCarron J, Yeadon T, Wilks A, Cubitt A, Wyld DK, Vasey PA. Phase I trial of CYT997, a novel cytotoxic and vascular-disrupting agent. Br J Cancer 2010; 103:597-606. [PMID: 20733579 PMCID: PMC2938266 DOI: 10.1038/sj.bjc.6605841] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Background: CYT997 is a novel microtubule inhibitor and vascular-disrupting agent with marked preclinical anti-tumour activity. Methods: This phase I dose-escalation study assessed the safety, tolerability, pharmacokinetics and pharmacodynamics of CYT997 administered by continuous intravenous infusion over 24 h every 3 weeks to patients with advanced solid tumours. Results: Thirty-one patients received CYT997 over 12 dose levels (7–358 mg m−2). Doses up to 202 mg m−2 were well tolerated. Dose-limiting toxicities were observed at 269 and 358 mg m−2, consisting of grade 3 prolonged corrected QT interval in two patients and grade 3 hypoxia and grade 4 dyspnea in one patient. All toxicities were reversible. The pharmacokinetics of CYT997 were linear over the entire dose range. Dynamic contrast-enhanced magnetic resonance imaging scans showed significant changes in tumour Ktrans values consistent with vascular disruption in 7 out of 11 evaluable patients treated at CYT997 doses of ⩾65 mg m−2. Moreover, plasma levels of von Willebrand factor and caspase-cleaved cytokeratin-18 increased post-treatment at higher dose levels. Among 22 patients evaluable for response, 18 achieved stable disease for >2 cycles. Conclusions: CYT997 was well tolerated at doses that were associated with pharmacodynamic evidence of vascular disruption in tumours.
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Affiliation(s)
- J D Lickliter
- Department of Medical Oncology, Royal Brisbane and Women's Hospital, Herston 4029, Queensland, Australia.
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18
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Chase D, Rosten C, Turner S, Hicks N, Milne R. Development of a toolkit and glossary to aid in the adaptation of health technology assessment (HTA) reports for use in different contexts. Health Technol Assess 2009; 13:1-142, iii. [PMID: 19958718 DOI: 10.3310/hta13590] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- D Chase
- NIHR Evaluation, Trials and Studies Coordinating Centre, Health Technology Assessment, Southampton, UK
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19
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Kiely BE, Jenkins MA, McKinley JM, Friedlander ML, Weideman PC, Milne R, McLachlan S, Hopper JL, Phillips K. Contralateral risk-reducing mastectomy in BRCA1/2 mutation carriers and other high-risk women in the Kathleen Cuningham Foundation Consortium for Research into Familial Breast Cancer (kConFab). J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.1509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
1509 Background: Contralateral risk-reducing mastectomy (CRRM) reduces contralateral breast cancer (BC) risk by up to 97%. Few studies have examined the prevalence and predictors of CRRM in BC patients at high familial risk of a second primary BC. Methods: Participants were women with unilateral BC and a strong family history of the disease, including BRCA1 and BRCA2 mutation carriers. Data were collected by interview, self-administered questionnaire, and review of pathology and surgical reports. Associations between having CRRM and potential predictors were assessed using multivariate logistic regression. Results: Of 1018 study participants (median follow-up 5.5 years), 154 (15%) underwent CRRM. The median time from initial BC to CRRM was 1 year. More likely to undergo CRRM were women who were younger at the time of their BC diagnosis (odds ratio [OR] = 0.94 per year of age, p < 0.001), those diagnosed more recently (OR = 1.16 per calendar year, p < 0.001), those who underwent mastectomy rather than breast conservation as their initial definitive BC treatment (OR = 5.2, p < 0.001) and those who underwent risk-reducing salpingo-oophorectomy (OR = 3.4, p < 0.001). BRCA1/2 mutation status and tumor characteristics were not independently associated with CRRM uptake. A contralateral BC event occurred in 177 (20.5%) of the 864 women who did not have CRRM, compared with one chest wall event (0.6%) in the 154 women post-CRRM. Conclusions: Younger women with more recently diagnosed BC treated with mastectomy were most likely to elect CRRM. BRCA1/2 mutation status and the competing risk of BC recurrence and death did not appear to influence decision making. No significant financial relationships to disclose.
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Affiliation(s)
- B. E. Kiely
- Peter MacCallum Cancer Centre, Melbourne, Australia; The University of Melbourne, Melbourne, Australia; Prince of Wales Hospital, Sydney, Australia; Spanish National Cancer Research Centre, Madrid, Spain; St Vincent's Hospital, Melbourne, Australia
| | - M. A. Jenkins
- Peter MacCallum Cancer Centre, Melbourne, Australia; The University of Melbourne, Melbourne, Australia; Prince of Wales Hospital, Sydney, Australia; Spanish National Cancer Research Centre, Madrid, Spain; St Vincent's Hospital, Melbourne, Australia
| | - J. M. McKinley
- Peter MacCallum Cancer Centre, Melbourne, Australia; The University of Melbourne, Melbourne, Australia; Prince of Wales Hospital, Sydney, Australia; Spanish National Cancer Research Centre, Madrid, Spain; St Vincent's Hospital, Melbourne, Australia
| | - M. L. Friedlander
- Peter MacCallum Cancer Centre, Melbourne, Australia; The University of Melbourne, Melbourne, Australia; Prince of Wales Hospital, Sydney, Australia; Spanish National Cancer Research Centre, Madrid, Spain; St Vincent's Hospital, Melbourne, Australia
| | - P. C. Weideman
- Peter MacCallum Cancer Centre, Melbourne, Australia; The University of Melbourne, Melbourne, Australia; Prince of Wales Hospital, Sydney, Australia; Spanish National Cancer Research Centre, Madrid, Spain; St Vincent's Hospital, Melbourne, Australia
| | - R. Milne
- Peter MacCallum Cancer Centre, Melbourne, Australia; The University of Melbourne, Melbourne, Australia; Prince of Wales Hospital, Sydney, Australia; Spanish National Cancer Research Centre, Madrid, Spain; St Vincent's Hospital, Melbourne, Australia
| | - S. McLachlan
- Peter MacCallum Cancer Centre, Melbourne, Australia; The University of Melbourne, Melbourne, Australia; Prince of Wales Hospital, Sydney, Australia; Spanish National Cancer Research Centre, Madrid, Spain; St Vincent's Hospital, Melbourne, Australia
| | - J. L. Hopper
- Peter MacCallum Cancer Centre, Melbourne, Australia; The University of Melbourne, Melbourne, Australia; Prince of Wales Hospital, Sydney, Australia; Spanish National Cancer Research Centre, Madrid, Spain; St Vincent's Hospital, Melbourne, Australia
| | - K. Phillips
- Peter MacCallum Cancer Centre, Melbourne, Australia; The University of Melbourne, Melbourne, Australia; Prince of Wales Hospital, Sydney, Australia; Spanish National Cancer Research Centre, Madrid, Spain; St Vincent's Hospital, Melbourne, Australia
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20
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Goodwin P, Phillips K, West D, Ennis M, Hopper J, John EM, O'Malley F, Milne R, Andrulis I, Friedlander M, Longacre T. Prognosis in BRCA1, BRCA2 associated breast cancer (BC): a prospective Breast Cancer Family Registry (BCFR) international population-based cohort study. Cancer Res 2009. [DOI: 10.1158/0008-5472.sabcs-2072] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Abstract #2072
Hereditary BC occurs at a younger age and is associated with more adverse tumor-related features than sporadic breast cancer (BC) (defined here as BC in those with no 1st or 2nd degree family history of breast or ovarian cancer). Using pre-specified criteria, we assembled a population-based cohort of newly diagnosed BC at 3 centers: Ontario, Canada (1996-98), San Francisco Bay area, USA (1995-2000), Melbourne/Sydney, Australia (1991-1998). Medical information was obtained from medical records; women were followed prospectively for recurrence, new cancers and death. Pathology data were obtained from central review or pathology reports. BRCA1 and BRCA2 mutation testing was performed on 77% and 70% of cases, respectively (sporadic BC cases were not tested at 2 centers). Hereditary and sporadic BC cases were compared using Cox proportional hazards (stratified by center). 3215 eligible cases were enrolled in the BCFR, with a mean age at diagnosis of 46.9 years. Median follow-up was 7.61 years; 565 women had distant recurrences and 547 died. There were 92 cases with BRCA1 and 72 with BRCA2 mutations; 1549 (48.2%) had sporadic BC; the remainder had familial BC as defined above. BRCA1 mutations were associated with young age, estrogen and progesterone receptor (ER and PgR) negativity and high grade; BRCA2 mutations were associated with node positivity and high grade. Distant disease-free survival (DDFS) and overall survival (OS) did not differ significantly between BRCA1 carriers and sporadic cases in univariate or multivariate analyses. DDFS and OS were worse in BRCA2 carriers than in sporadic cases (HR 1.6, p=0.04 and HR 1.8, p=0.01, respectively) in univariate analyses but not in multivariate analyses (DDFS HR 1.0, p=0.98; OS HR 1.13, p=0.61). The small group of BRCA2 carriers who did not receive adjuvant chemotherapy had a significantly worse OS (multivariate HR 3.63, p = 0.005). Furthermore, BRCA2 carriers who received adjuvant tamoxifen had significantly worse OS than women with sporadic BC (HR=2.0, p=0.03). We conclude that BRCA1 and BRCA2 mutations do not independently impact DDFS or OS. Significantly worse outcomes were seen in BRCA2 carrier subgroups defined by adjuvant treatment; this requires further investigation and may have implications for clinical practice.
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 2072.
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Affiliation(s)
- P Goodwin
- 1 Samuel Lunenfeld Research Institute, Mount Sinai Hospital, Toronto, Canada
| | - K Phillips
- 2 Peter MacCallum Cancer Center, Melbourne, Australia
| | - D West
- 3 Northern California Cancer Center, Fremont
- 4 Stanford University School of Medicine, Stanford
| | - M Ennis
- 5 9227 Kennedy Road, Markham, Canada
| | - J Hopper
- 6 The University of Melbourne, Melbourne, Australia
| | - EM John
- 3 Northern California Cancer Center, Fremont
- 4 Stanford University School of Medicine, Stanford
| | | | - R Milne
- 8 Spanish National Cancer Research Office, Madrid, Spain
| | - I Andrulis
- 9 Ontario Cancer Genetics Network, Cancer Care Ontario, Toronto, ON, Canada
| | | | - T Longacre
- 8 Spanish National Cancer Research Office, Madrid, Spain
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21
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Morcillo-Suarez C, Alegre J, Sangros R, Gazave E, de Cid R, Milne R, Amigo J, Ferrer-Admetlla A, Moreno-Estrada A, Gardner M, Casals F, Perez-Lezaun A, Comas D, Bosch E, Calafell F, Bertranpetit J, Navarro A. SNP analysis to results (SNPator): a web-based environment oriented to statistical genomics analyses upon SNP data. Bioinformatics 2008; 24:1643-4. [DOI: 10.1093/bioinformatics/btn241] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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22
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Sutton MA, Nemitz E, Erisman JW, Beier C, Bahl KB, Cellier P, de Vries W, Cotrufo F, Skiba U, Di Marco C, Jones S, Laville P, Soussana JF, Loubet B, Twigg M, Famulari D, Whitehead J, Gallagher MW, Neftel A, Flechard CR, Herrmann B, Calanca PL, Schjoerring JK, Daemmgen U, Horvath L, Tang YS, Emmett BA, Tietema A, Peñuelas J, Kesik M, Brueggemann N, Pilegaard K, Vesala T, Campbell CL, Olesen JE, Dragosits U, Theobald MR, Levy P, Mobbs DC, Milne R, Viovy N, Vuichard N, Smith JU, Smith P, Bergamaschi P, Fowler D, Reis S. Challenges in quantifying biosphere-atmosphere exchange of nitrogen species. Environ Pollut 2007; 150:125-39. [PMID: 17604887 DOI: 10.1016/j.envpol.2007.04.014] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2006] [Revised: 02/19/2007] [Accepted: 04/15/2007] [Indexed: 05/16/2023]
Abstract
Recent research in nitrogen exchange with the atmosphere has separated research communities according to N form. The integrated perspective needed to quantify the net effect of N on greenhouse-gas balance is being addressed by the NitroEurope Integrated Project (NEU). Recent advances have depended on improved methodologies, while ongoing challenges include gas-aerosol interactions, organic nitrogen and N(2) fluxes. The NEU strategy applies a 3-tier Flux Network together with a Manipulation Network of global-change experiments, linked by common protocols to facilitate model application. Substantial progress has been made in modelling N fluxes, especially for N(2)O, NO and bi-directional NH(3) exchange. Landscape analysis represents an emerging challenge to address the spatial interactions between farms, fields, ecosystems, catchments and air dispersion/deposition. European up-scaling of N fluxes is highly uncertain and a key priority is for better data on agricultural practices. Finally, attention is needed to develop N flux verification procedures to assess compliance with international protocols.
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Affiliation(s)
- M A Sutton
- Centre for Ecology and Hydrology, Edinburgh Research Station, Bush Estate, Penicuik, EH26 0QB, UK.
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23
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Abstract
BACKGROUND Idiopathic short stature (ISS) refers to children who are very short compared with their peers for unknown or hereditary reasons. Recombinant human growth hormone (GH) has been used to increase growth and final height in children with ISS. OBJECTIVES To assess the effects of recombinant human GH on short-term growth and final height in children with ISS. SEARCH STRATEGY Studies were obtained from computerised searches of MEDLINE, EMBASE, The Cochrane Library, Science Citation Index, BIOSIS and Current Controlled Trials. Article reference lists were assessed for trials and experts and pharmaceutical companies were contacted. SELECTION CRITERIA Randomised controlled trials were included if they were carried out in children with ISS with normal GH secretion. GH had to be administered for a minimum of six months and be compared with placebo or no treatment. A growth or height outcome measure had to be assessed. DATA COLLECTION AND ANALYSIS Two reviewers assessed studies for inclusion criteria and for methodological quality. Data were extracted by one reviewer and checked by a second. The primary outcome was final height and secondary outcomes included short term growth, health related quality of life and adverse effects. To estimate summary treatment effects, data were pooled, when appropriate using a random effects model. MAIN RESULTS Ten RCTs were included. One trial reported near final height in girls and found that girls treated with GH were 7.5 cm taller than untreated controls (GH group, 155.3 cm +/- 6.4; control, 147.8 cm +/- 2.6; P = 0.003); another trial which reported adult height standard deviation score found that children treated with GH were 3.7 cm taller than children in a placebo-treated group (95% confidence intervals 0.03 to 1.10; P < 0.04). The other trials reported short term outcomes. Results suggest that short-term height gains can range from none to approximately 0.7 SD over one year. One study reported health related quality of life and showed no significant improvement in GH treated children compared with those in the control group, whilst another found no significant evidence that GH treatment impacts psychological adaptation or self-perception in children with ISS. No serious adverse effects of treatment were reported. AUTHORS' CONCLUSIONS GH therapy can increase short-term growth and improve (near) final height. Increases in height are such that treated individuals remain relatively short when compared with peers of normal stature. Large, multicentre RCTs are required which should focus on final height and address quality of life and cost issues.
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Affiliation(s)
- J Bryant
- University of Southampton, Wessex Institute for Health Research and Development, Mailpoint 728, Biomedical Sciences Building, Bassett Crescent East, Southampton, Hants, UK, SO16 7PX.
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Abstract
BACKGROUND Turner syndrome (TS) affects about one in 1500 to 2500 live-born females. One of the most prevalent and salient features of the syndrome is extremely short stature. Untreated women are approximately 20 to 21 cm shorter than normal women within their respective populations. Recombinant human growth hormone (hGH) has been used to increase growth and final height in girls who have Turner syndrome. OBJECTIVES To assess the effects of recombinant growth hormone in children and adolescents with TS. SEARCH STRATEGY MEDLINE, EMBASE, The Cochrane Library, LILACS, BIOSIS, Science Citation Index and reference lists were used to identify relevant trials. SELECTION CRITERIA Randomised controlled trials were included if they were carried out in children with TS before achieving final height. Growth hormone had to be administered for a minimum of six months and compared with a placebo or no treatment control condition. DATA COLLECTION AND ANALYSIS Two reviewers assessed studies for inclusion criteria and for methodological quality. The primary outcomes were final height and growth. Secondary outcomes included bone age, quality of life, cognitive performance, and adverse effects. MAIN RESULTS Four RCTs that included 365 participants after one year of treatment were included. Only one trial reported final height in 61 treated women to be 148 cm and 141 cm in 43 untreated women (mean difference (MD) seven cm, 95% CI 6 to 8). Short-term growth velocity was greater in treated than untreated girls after one year (two trials, MD three cm per year, 95% CI 2 to 4) and after two years (one trial, MD two cm per year, 95% CI 1 to 2.3). Skeletal maturity was not accelerated by treatment with recombinant growth hormone (hGH). Adverse effects were minimally reported. AUTHORS' CONCLUSIONS Recombinant human growth hormone (hGH) doses between 0.3 to 0.375 mg/kg/wk increase short-term growth in girls with Turner syndrome by approximately three (two) cm in the first (second) year of treatment. Treatment in one trial increased final height by approximately six cm over an untreated control group. Despite this increase, the final height of treated women was still outside the normal range. Additional trials of the effects of hGH carried out with control groups until final height is achieved would allow better informed decisions about whether the benefits of hGH treatment outweigh the requirement of treatment over several years at considerable cost.
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25
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Abstract
BACKGROUND Despite widespread debate on the merits of different models of anaesthesia care delivery, there are few published data on the relative safety and effectiveness of different anaesthesia providers. METHOD We conducted a systematic search for, and critical appraisal of, primary research comparing safety and effectiveness of different anaesthetic providers. RESULTS Our search of Medline, EMBASE, CINAHL, and HMIC for material published between 1990 and April 2003 yielded four articles of relevance to the question. The studies used a variety of methodologies and all had potential confounding factors limiting the validity of the results. CONCLUSIONS In view of the paucity of high-level primary evidence in this area, it is not possible to draw a conclusion regarding differences in patient safety as a function of provider type. There are difficulties in classifying events as "anaesthesia-related", and also in the variable definitions of "supervision" and "anaesthesia care team". We suggest that existing attempts to show differences in outcome might usefully be complemented by studies examining measures of anaesthetic process.
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Affiliation(s)
- A F Smith
- Department of Anaesthesia, Royal Lancaster Infirmary, Lancaster, UK.
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Oliver S, Clarke-Jones L, Rees R, Milne R, Buchanan P, Gabbay J, Gyte G, Oakley A, Stein K. Involving consumers in research and development agenda setting for the NHS: developing an evidence-based approach. Health Technol Assess 2004; 8:1-148, III-IV. [PMID: 15080866 DOI: 10.3310/hta8150] [Citation(s) in RCA: 208] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES To look at the processes and outcomes of identification and prioritisation in both national and regional R&D programmes in health and elsewhere, drawing on experiences of success and failure. Also to identify the barriers to, and facilitators of, meaningful participation by consumers in research identification and prioritisation. DATA SOURCES Electronic databases and interviews with UK consumers and research programme managers. REVIEW METHODS A framework was devised for examining the diverse ways of involving consumers in research. It identified key distinguishing features as: the types of consumers involved; whether consumers or researchers initiated the involvement; the degree of consumer involvement (consultation, collaboration or consumer control); forums for communication (e.g. committees, surveys, focus groups); methods for decision-making; and the practicalities for implementation. Context (institutional, geographical and historical setting) and underpinning theories were considered as important variables for analysing examples of consumer involvement. This innovative framework was then applied to the review data from reports selected for inclusion and interviews. RESULTS The study found 286 documents explicitly mentioning consumer involvement in identifying or prioritising research topics. Of these, 91 were general discussions, some of which included a theoretical analysis or a critique of research agendas from a consumer perspective, 160 reported specific efforts to include consumers in identifying or prioritising research topics and a further 51 reported consumers identifying or prioritising research topics in the course of other work. Detailed reports of 87 specific examples were identified. Most of this literature was descriptive reports by researchers who were key actors in involving consumers. A few reports were written by consumer participants. Fewer still were by independent researchers. Our conclusions are therefore not based on rigorous research, but implications for policy are drawn from individual reports and comparative analyses. CONCLUSIONS Productive methods for involving consumers require appropriate skills, resources and time to develop and follow appropriate working practices. The more that consumers are involved in determining how this is to be done, the more research programmes will learn from consumers and about how to work with them. Further success might be expected if research programmes embarking on collaborations approach well-networked consumers and provide them with information, resources and support to empower them in key roles for consulting their peers and prioritising topics. To be worthwhile, consultations should engage consumer groups directly and repeatedly in facilitated debate; when discussing health services research, more resources and time are required if consumers are drawn from groups whose main focus of interest is not health. These barriers can largely be overcome with good leadership, purposeful outreach to consumers, investing time and effort in good communication, training and support and thereby building good working relationships and building on experience. Organised consumer groups capable of identifying research priorities also need to find ways of introducing their ideas into research programmes. Further research is suggested to develop and evaluate different training methods, information and education and other support for consumers and those wishing to involve them; to address the barriers to consumers' ideas influencing research agendas; and to carry out prospective comparative studies of different methods for involving consumers. Research about collective decision-making would also be further advanced by addressing the processes and outcomes of consensus development that involves consumers.
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Affiliation(s)
- S Oliver
- Social Science Research Unit, Institute of Education, London, UK
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Bryant J, Loveman E, Chase D, Mihaylova B, Cave C, Gerard K, Milne R. Clinical effectiveness and cost-effectiveness of growth hormone in adults in relation to impact on quality of life: a systematic review and economic evaluation. Health Technol Assess 2003; 6:1-106. [PMID: 12583817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2023] Open
Affiliation(s)
- J Bryant
- Southampton Health Technology Assessments Centre, Wessex Institute for Health Research and Development, University of Southampton, UK
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Bryant J, Cave C, Mihaylova B, Chase D, McIntyre L, Gerard K, Milne R. Clinical effectiveness and cost-effectiveness of growth hormone in children: a systematic review and economic evaluation. Health Technol Assess 2003; 6:1-168. [PMID: 12433316 DOI: 10.3310/hta6180] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- J Bryant
- Southampton Health Technology Assessments Centre, Wessex Institute for Health Research and Development, University of Southampton, Southampton SO16 7PX, UK
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Abstract
BACKGROUND Idiopathic short stature (ISS) refers to children who are very short compared with their peers for unknown or hereditary reasons. Recombinant human growth hormone has been used to increase growth and final height in children with idiopathic short stature. OBJECTIVES To assess the effects of recombinant human growth hormone on short-term growth and final height in children with idiopathic short stature. SEARCH STRATEGY Randomised controlled trials (RCTs) were sought by searching The Cochrane Central Register of Controlled Trials (CENTRAL), Medline, Embase, PubMed, Science Citation Index, BIOSIS and Current Controlled Trials (date of last search 10 December 2002). Article reference lists were assessed for trials and experts and pharmaceutical companies were contacted. SELECTION CRITERIA Randomised controlled trials were included if they were carried out in children with ISS with normal growth hormone secretion. Growth hormone (GH) had to be administered for a minimum of six months and be compared with placebo or no treatment. A growth or height outcome measure had to be assessed. DATA COLLECTION AND ANALYSIS Two reviewers assessed studies for inclusion criteria and for methodological quality. Data were extracted by one reviewer and checked by a second. The primary outcome was final height and secondary outcomes included short term growth, health related quality of life and adverse effects. To estimate summary treatment effects, data were pooled, when appropriate using a random effects model. MAIN RESULTS Nine randomised controlled trials were included. One trial reported near final height in girls and found that girls treated with growth hormone were 7.5 cm taller than untreated controls (GH group, 155.3 cm +/- 6.4; control, 147.8 cm +/- 2.6; p = 0.003). The other trials reported short term outcomes. Results suggest that short-term height gains can range from none to approximately 0.7 SD over one year. One study reported health related quality of life and showed no significant improvement in growth hormone treated children compared with those in the control group. No serious adverse effects of treatment have been reported. REVIEWER'S CONCLUSIONS Results suggest that growth hormone therapy can increase short-term growth and improve (near) final height. Increases in height are such that treated individuals remain relatively short when compared with peers of normal stature. Further research in the form of large, multicentre RCTs are required. These should focus on final height, which is the best outcome for assessing the effects of growth hormone, and address quality of life and cost issues.
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Affiliation(s)
- J Bryant
- Wessex Institute for Health Research and Development, University of Southampton, Mailpoint 728, Biomedical Sciences Building, Bassett Crescent East, Southampton, Hants, UK, SO16 7PX
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Abstract
BACKGROUND Turner syndrome (TS) affects about one in 1,500 to 2,500 live-born females. One of the most prevalent and salient features of the syndrome is extremely short stature. Untreated women are approximately 20-21 cm shorter than normal women within their respective populations. Recombinant human growth hormone (hGH) has been used to increase growth and final height in women who have Turner syndrome. OBJECTIVES To assess the effects of recombinant growth hormone on short-term growth and final height in children and adolescents with Turner syndrome. SEARCH STRATEGY Published and unpublished randomised-controlled trials (RCTs) were sought by searching the Cochrane Central Register of Controlled Trials (Central) (2002, Issue 3), Medline (1981 to July 2002), Embase (1980 to June 2002), PubMed (search 30 July, 2002 for entries in last 180 days), Science Citation Index (search 30 July, 2002), BIOSIS (search 30 July, 2002) and Current Controlled Trials (search 30 July, 2002). Article reference lists were assessed for trials and experts and pharmaceutical companies were contacted. SELECTION CRITERIA Randomised controlled trials were included if they were carried out in children with Turner Syndrome before achieving final height. Growth hormone had to be administered for a minimum of six months and compared with a placebo or no treatment control condition. A growth or height outcome measure must have been assessed. In addition, in the context of a growth assessment other outcomes reflecting psychological adjustment were also included. DATA COLLECTION AND ANALYSIS Two reviewers assessed studies for inclusion criteria and for methodological quality. Data were extracted by one reviewer and checked by a second. The main outcomes were final height (in cm or standard deviation score), growth (in velocity or velocity standard deviation score). Additional outcomes included bone age, quality of life, cognitive performance, and adverse effects. To estimate summary treatment effects, data were pooled using a random effects model (when data were sufficient and appropriate to combine) with calculation of weighted mean differences (WMD) for continuous outcomes. MAIN RESULTS Four RCTs that included 211 participants after one year of treatment were included. These were described in six publications. Three studies were included in the analyses of growth outcomes (one study did not report any data). Only one trial reported results on final height. This trial reported that average final height in 40 treated women was 146.2 cm and 141.4 cm in 29 untreated women (mean difference (MD) 4.8 cm, 95% CI 2.2 to 7.4). Short-term growth velocity was greater in treated than untreated girls after one year (two trials, weighted mean difference (WMD) 3.3 cm/yr, 95% CI 2.4 to 4.3) after 18 months (one trial, MD 2.6 cm/yr, 95% CI 2.1 to 3.1) and after two years (one trial, MD 1.8 cm/yr, 95% CI 1.3 to 2.3). Results were similar when reported as growth velocity standard deviation scores. Skeletal maturity was not accelerated by treatment with recombinant growth hormone (hGH). Bone age divided by chronological age was approximately one in both treated and untreated groups in one trial after both one and two years of treatment. One trial selectively reported psychological outcomes that suggested that psychological adjustment was better in girls treated with hGH, but selective reporting leaves these results in some doubt. Adverse effects were minimally reported. There is little evidence of serious short-term adverse effects in these trials, but they are underpowered to detect rare adverse effects. REVIEWER'S CONCLUSIONS Recombinant human growth hormone (hGH) doses between 0.3 - 0.375 mg/kg/wk increase short-term growth in girls with Turner Syndrome (TS) by approximately 3 cm in the first year of treatment and by approximately 2 cm per year after 2 years of treatment. There is little evidence on the effects of hGH on final height. Treatment in one trial increased final height by approximately 5 cm over an untreated control group. Despite this increase, the fated control group. Despite this increase, the final height of treated women was still outside the normal range (more than two standard deviations below the normal population mean). Additional trials of the effects of hGH carried out with control groups until final height is achieved would allow better informed decisions about whether the benefits of hGH treatment outweigh the requirement of treatment over several years at considerable cost.
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Affiliation(s)
- C B Cave
- Wessex Institute for Health Research and Development, University of Southampton, Bassett Crescent East, Mailpoint 728, Biomedical Sciences Building, Southampton, UK, SO16 7PX
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Bryant J, Loveman E, Chase D, Mihaylova B, Cave C, Gerard K, Milne R. The clinical effectiveness and cost effectiveness of the use of human growth hormones in adults. Health Technol Assess 2002. [DOI: 10.3310/hta6190] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- J Bryant
- Southampton Health Technology Assessments Centre,Wessex Institute for Health Research and Development, University of Southampton, UK
| | - E Loveman
- Southampton Health Technology Assessments Centre,Wessex Institute for Health Research and Development, University of Southampton, UK
| | - D Chase
- Health Care Research Unit, University of Southampton, UK
| | - B Mihaylova
- Health Care Research Unit, University of Southampton, UK
| | - C Cave
- Southampton Health Technology Assessments Centre,Wessex Institute for Health Research and Development, University of Southampton, UK
| | - K Gerard
- Health Care Research Unit, University of Southampton, UK
| | - R Milne
- Southampton Health Technology Assessments Centre,Wessex Institute for Health Research and Development, University of Southampton, UK
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Bryant J, Loveman E, Cave C, Chase D, Milne R. Endocrinology trial design: adverse event reporting in randomised controlled trials of recombinant human GH in GH-deficient adults. J Endocrinol 2002; 175:545-52. [PMID: 12429052 DOI: 10.1677/joe.0.1750545] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
We have evaluated the reporting of withdrawals due to adverse effects and specific adverse effects in randomised controlled trials of recombinant human GH in adults. A systematic review was carried out of randomised controlled trials of the clinical effectiveness of recombinant human GH in adults with GH deficiency in relation to impact on quality of life. Trials were identified from searching electronic databases, bibliographies of related articles and consulting experts. There was reporting of withdrawals due to adverse effects and specific adverse effects. Rates of oedema and arthralgia were reported in included trials. Seventeen randomised controlled trials, published between 1990 and 1999, met the inclusion criteria for the review. Nine trials reported data on the effectiveness of GH on quality of life in adults. Only five trials (29%) reported both withdrawals from the study because of adverse events and specific adverse events with numbers per study arm and per type. Six further trials (35%) reported either withdrawal details or specific adverse event details or partial data on specific adverse events. Six trials (35%), however, did not report information on either withdrawals or specific adverse events. Ten of the 17 studies (59%) reported the number of patients who withdrew from the study due to adverse events per study arm and type of adverse event per study arm. Seven of the 17 trials (41%) reported the number of specific adverse events per study arm and six (35%) reported the type per study arm. The reporting of adverse events in randomised controlled trials of GH is variable and not consistent across trials. It is not possible to assess the impact that adverse events may have had on unblinding patients, and therefore the extent to which the effects of GH may have been overestimated. Therefore those conducting endocrinology trials in the future need to pay attention to the reporting of withdrawals due to adverse events and specific adverse events.
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Affiliation(s)
- J Bryant
- Southampton Health Technology Assessment Centre, Wessex Institute for Health Research and Development, University Of Southampton, Bassett Crescent East, UK.
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Abstract
BACKGROUND Deficiencies and lack of standardisation of the management of acute pancreatitis in the UK have been reported. National UK guidelines for the management of acute pancreatitis were published in 1998. However, implementation of national guidelines in other areas has been patchy, suggesting that evaluation of the uptake of the pancreatitis guidelines would be appropriate. AIM Identification of current practice in the management of acute pancreatitis as reported by consultant surgeons, in order to determine how effectively the UK guidelines have been introduced into practice. METHODS A questionnaire was posted to 1,072 full members of the Association of Surgeons of Great Britain and Ireland. It consisted of 13 questions that aimed to identify the surgeon's practice in the management of patients with acute pancreatitis in relation to key points in the UK guidelines. We compared the practice of hepatobiliary and pancreatic (HBP) vs. non-HBP specialists, and teaching vs. non-teaching hospital surgeons using the chi(2) test. RESULTS Of 538 responses (50%), 519 were from consultant surgeons. 59 did not look after patients with acute pancreatitis and 89 (17%) had a HBP interest. There were differences between the recommendations in the guidelines and reported practice, particularly in the use of critical care resources and referral to specialist units. Of consultants looking after acute pancreatitis 371 (72%) were non-HBP specialists. There were significant overall differences between the practice of HBP specialists and non-specialists: in severity assessment (Glasgow and C-reactive protein vs. Ranson criteria); indication and timing of requesting computed tomography (routinely at 7-10 days vs. when clinically indicated); nutritional support (enteral feeding vs. no support), and in common bile duct assessment prior to cholecystectomy (intra-operative cholangiography vs. endoscopic retrograde cholangiopancreatography). There was no significant difference between practice in teaching and non-teaching hospitals. CONCLUSION Implementation of national guidelines for the management of acute pancreatitis was greater in the practice of HBP specialists than non-specialists. This has implications for the rationale of creating guidelines, and for the strategies associated with their introduction.
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Affiliation(s)
- Emad A H Aly
- Pancreas and Biliary Research Group, University Surgical Unit, Southampton General Hospital, UK
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Abstract
OBJECTIVE To review the effectiveness of implantable cardioverter-defibrillators (ICDs) in the management of risk factors for sudden cardiac death. DESIGN Systematic review of randomised controlled trials identified from searching eight electronic databases, bibliographies of relevant studies, and consulting experts. MAIN OUTCOME MEASURES Absolute and relative reduction in mortality. RESULTS Seven trials met the inclusion criteria. These showed changes in absolute risk of total mortality ranging from +1.7% to -22.8% (relative risk reductions -7% to +54%). Estimated benefits from ICD treatment compared with conventional drug treatment at three years were 0.23 to 0.80 additional years of life. CONCLUSIONS Evidence suggests that ICDs reduce total mortality in particular subgroups of patients at high risk of ventricular arrhythmias. The optimal strategy for identifying the patients who could benefit most is not clearly established. Ongoing trials into the treatment of cardiac failure with ICDs may provide further evidence about subgroups in whom ICDs are most cost effective.
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Affiliation(s)
- J Parkes
- University of Southampton, Southampton, UK.
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Nicol MJ, Nichol MJ, Manoharan H, Marfell-Jones MJ, Meha-Hoerara K, Milne R, O'Connell M, Olliver J, Teekman B. Issues in adolescent health: a challenge for nursing. Contemp Nurse 2002; 12:155-63. [PMID: 12188150 DOI: 10.5172/conu.12.2.155] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The young people of today are the greatest investment we as adults have in our future. The care and nurturing we afford the adolescent is just as important as that which we afford to children or the elderly. Although most adolescents have a preoccupation with their bodies, they do not always engage in activities that will protect and develop them. Adolescents are often exposed to peer pressure, the effects of which may impact negatively on their behaviour and their health. Many adolescent health and behavioural issues evolve from developmental changes and can manifest in a confrontational attitude toward society, parents and others. They are hormonally 'fully charged', and their adolescent sexuality can have enormous effects on their future physical, psychosocial, moral and sexual development. Nurses have a pivotal role to play in ensuring children and adolescents learn the facts relating to the consequences of engaging in unhealthy behaviour and lifestyle. Nurses must also encourage parents to model and reinforce good health practices, such as serving balanced and nutritious meals at regular times and planning positive family activities. In this paper we review some of the salient issues in adolescent health today.
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Affiliation(s)
- M J Nicol
- Division of Nursing, Universal College of Learning, Palmerston North, New Zealand
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Dinnes J, Cave C, Huang S, Milne R. A rapid and systematic review of the effectiveness of temozolomide for the treatment of recurrent malignant glioma. Br J Cancer 2002; 86:501-5. [PMID: 11870527 PMCID: PMC2375282 DOI: 10.1038/sj.bjc.6600135] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2001] [Revised: 11/21/2001] [Accepted: 11/21/2001] [Indexed: 11/08/2022] Open
Abstract
A rapid and systematic review of the effectiveness and cost-effectiveness of temozolomide in the treatment of recurrent malignant glioma was commissioned by the NHS HTA Programme on behalf of NICE. The full report has been published elsewhere. This paper summarizes the results for the effectiveness of temozolomide in people with recurrent glioblastoma multiforme and anaplastic astrocytoma. The review was conducted using standard systematic review methodology involving a systematic literature search, quality assessment of included studies with systematic data extraction and data synthesis. One randomized controlled trial and four uncontrolled studies were identified for inclusion. The key results were that temozolomide may increase progression-free survival but has no significant impact on overall length of survival. The main effect from temozolomide may have been in those patients who had not received any prior chemotherapy regimens, however further randomized controlled trials are required to confirm this suggestion. Temozolomide appears to produce few serious adverse effects and may also have a positive impact on health-related quality of life. Overall the evidence-base is weak and few strong conclusions can be drawn regarding the effectiveness of temozolomide. Large, well-designed randomized controlled trails conducted in a wider patient population are needed.
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Affiliation(s)
- J Dinnes
- Southampton Health Technology Assessment Centre, Wessex Institute for Health Research and Development, University of Southampton, Mailpoint 728, Boldrewood, Southampton SO16 7PX, UK.
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Abstract
Apolipoprotein D (apoD), a 169 amino acid member of the lipocalin family, is thought to be a transporter of small, hydrophobic ligands. A panel of 10 anti-apoD monoclonal antibodies (mAbs) was prepared and characterized in order to define apoD structure-function relationships. An apoD epitope map was constructed based on reactivity of the mAbs with apoD fragments. Three mAbs react with epitopes between apoD residues 7-78, seven mAbs with epitopes between residues 128-169, one mAb recognizes an epitope that straddles residues 99-102 and one mAb is specific for an epitope composed of non-contiguous apoD residues. Several pairs of mAbs whose respective epitopes are widely separated in apoD primary structure can compete for binding to immobilized apoD. This would be consistent with the compact beta-barrel tertiary structure that apoD is thought to adopt. None of the mAbs block the interaction of apoD with pregnenolone, a putative physiological ligand for apoD.
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Affiliation(s)
- L Terrisse
- Département des Sciences Biologiques, Université du Québec à Montréal, Québec, Canada
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Abstract
Cholesteryl ester transfer protein (CETP) plays a pivotal role in the reverse transport of cholesterol and in the remodeling of circulating lipoproteins. While plasma and adipose tissue levels of CETP are affected by a variety of metabolic conditions, the extent of the effects of dietary factors, other than high cholesterol feeding, are not well understood. To further explore this paradigm, male Golden Syrian hamsters were fed for 4 weeks with a 60%-enriched fructose diet (F) and were compared to a matched group of animals fed with a normal chow diet (N). After feeding for 4 weeks, plasma insulin concentrations were lower in animals fed fructose than in control animals (F: 3.3+/-0.8 vs N: 7.4+/-1.9 ng/mL; p<0.03), but there was no significant difference in plasma glucose concentrations between the two groups (F: 138+/-7 vs N: 148+/-10 mg/dL; p>0.05). Fructose-fed animals showed significant increases in plasma triglyceride (F: 269+/-22 vs N: 165+/-22 mg/dL; p<0.01) and plasma cholesterol (F: 150+/-10 vs N: 113+/-6 mg/dL; p<0.02) concentrations compared with control animals. Total CETP activity and immunoreactive mass were higher in the plasma of fructose-fed animals that in that of controls (F: 1036+/-70 vs N: 826+/-43 pmol/h/mL, p<0.04 and F: 24.5+/-3.1 vs N: 37.5+/-4.3 AU, p<0.02, respectively). Adipose tissue CETP mRNA levels, assessed by the very sensitive ribonuclease protection assay, were 53% higher in fructose-fed animals than in controls (F: 14.1+/-2.0 vs N: 9.2+/-1.0 AU over a rRNA control; p<0.04). Adipose tissue CETP activity and immunoreactive mass also showed a statistically significant increase in the fructose-fed hamsters compared with those fed a normal diet (p<0.04). In conclusion, fructose feeding in Syrian hamsters induces a mixed dyslipidemia. These metabolic changes are accompanied by a significant increase in CETP levels, both in plasma and in adipose tissue. This phenomenon suggests that the increase in the expression of adipose tissue CETP may be caused either by the ambient hypercholesterolemia resulting from fructose feeding or by an attenuation of a possible inhibitory effect of plasma insulin concentrations on the expression of adipose tissue CETP in this feeding paradigm.
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Affiliation(s)
- P Rémillard
- Department of Medicine, Université de Sherbrooke, Québec, Canada
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Booth-Clibborn N, Milne R, Oliver S. Searching for high-quality evidence to prepare patient information. Health Info Libr J 2001; 18:75-82. [PMID: 11780736 DOI: 10.1046/j.1365-2532.2001.00323.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVES To help those preparing patient information by developing a search protocol for finding evidence on treatments that would maximize rigour, relevance and completeness. To apply the search protocol in one example area, 'early breast cancer'. METHODS Development--a multidisciplinary group listed evidence sources and assigned them to 'rigour of methods' bandings and also assessed their completeness. A search protocol was made by ranking evidence sources by rigour and then by completeness. Application-the protocol was used to search for information on treatments for early breast cancer. RESULTS Eighteen evidence sources provided details of their methods. Thirteen sources were assigned to Band A ('key source') and two sources to Band B ('some doubt about rigour but nevertheless useful'). The 15 Band A and B sources were ordered into a search protocol and used to identify 24 pieces of evidence about early breast cancer. Ten reviews were excluded (as irrelevant), leaving 14 useful pieces of evidence-based information to help inform patient information. CONCLUSIONS Those preparing patient information on treatments for early breast cancer would find 14 pieces of useful evidence. It remains to be seen how far these pieces of evidence would answer questions that patients might pose about treatments.
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Affiliation(s)
- N Booth-Clibborn
- National Horizon Scanning Centre, Department of Public Health and Epidemiology, University of Birmingham, UK.
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Bryant J, Clegg A, Milne R. Systematic review of immunomodulatory drugs for the treatment of people with multiple sclerosis: Is there good quality evidence on effectiveness and cost? J Neurol Neurosurg Psychiatry 2001; 70:574-9. [PMID: 11309449 PMCID: PMC1737368 DOI: 10.1136/jnnp.70.5.574] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To review the clinical effectiveness and costs of a range of disease modifying drugs in multiple sclerosis. Drugs included are azathioprine, cladribine, cyclophosphamide, intravenous immunoglobulin, methotrexate, and mitoxantrone. METHODS Electronic databases and bibliographies of related papers were searched for randomised controlled trials (RCTs) and systematic reviews, and experts and pharmaceutical companies were contacted for further information. Inclusion and quality criteria were assessed, data extraction undertaken by one reviewer and checked by a second reviewer, with discrepancies being resolved through discussion. Costs were obtained and cost-effectiveness papers sought. RESULTS Seventeen studies met the inclusion criteria for the review. Evidence for the clinical effectiveness of the drugs showed some reductions in relapse rates and/or progression to disability for people with MS, although benefits may be lessened by wide ranging side effects. Annual drug costs/patient are estimated to range from 60 pounds to 10200 pounds. No cost effectiveness studies were found. CONCLUSION Evidence for the effectiveness of these drugs in multiple sclerosis is problematic because there are few good quality trials for each drug. Trials often have methodological limitations and use different treatment regimes, patient groups, and outcome measures. Well conducted trials using outcome measures with clinical significance for groups of patients with different types of multiple sclerosis and long term follow up are needed if the evidence base of treatment for the disease is to be improved.
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Affiliation(s)
- J Bryant
- Wessex Institute for Health Research and Development, University of Southampton, Biomedical Sciences Building (Mailpoint 728), Bassett Crescent East, Southampton SO16 7PX, UK.
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Abstract
OBJECTIVES To describe the methods used for involving consumers in a needs-led health research programme, and to discuss facilitators, barriers and goals. DESIGN In a short action research pilot study, we involved consumers in all stages of the Health Technology Assessment (HTA) Programme: identifying and prioritizing research topics; commissioning and reporting research; and communicating openly about the programme. We drew on the experience of campaigning, self-help and patients' representative groups, national charities, health information services, consumer researchers and journalists for various tasks. We explored consumer literature as a potential source for research questions, and as a route for disseminating research findings. These innovations were complemented by training, one-to-one support and discussion. A reflective approach included interviews with consumers, co-ordinating staff, external observers and other programme contributors, document analysis and multidisciplinary discussion (including consumers) amongst programme contributors. RESULTS When seeking research topics, face-to-face discussion with a consumer group was more productive than scanning consumer research reports or contacting consumer health information services. Consumers were willing and able to play active roles as panel members in refining and prioritizing topics, and in commenting on research plans and reports. Training programmes for consumer involvement in service planning were readily adapted for a research programme. Challenges to be overcome were cultural divides, language barriers and a need for skill development amongst consumers and others. Involving consumers highlighted a need for support and training for all contributors to the programme. CONCLUSIONS Consumers made unique contributions to the HTA Programme. Their involvement exposed processes which needed further thought and development. Consumer involvement benefited from the National Co-ordinating Centre for Health Technology Assessment (NCCHTA) staff being comfortable with innovation, participative development and team learning. Neither recruitment nor research capacity were insurmountable challenges, but ongoing effort is required if consumer involvement is to be sustained.
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Affiliation(s)
- S Oliver
- Social Science Research Unit, University of London, Institute of Education, London, UK.
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Abstract
OBJECTIVE To evaluate the effectiveness and cost effectiveness of methylphenidate in the treatment of children with hyperkinetic disorder as defined using ICD-10 criteria. DESIGN Comprehensive literature review and cost utility analysis comparing methylphenidate treatment with placebo. Costs and effects were estimated from a NHS perspective according to the methodology developed by the previous South and West Development and Evaluation Committee. The number of Quality Adjusted Life Years (QALYs) gained was estimated by using the Index of Health Related Quality of Life to model treatment effects. RESULTS Evidence from good and medium quality randomized controlled trials shows benefits of methylphenidate over weeks and months respectively. Evidence beyond 6 months is poorer and it is uncertain whether effects of methylphenidate persist into adolescence and adulthood. Methylphenidate is of reasonable cost-effectiveness when considering short- and medium- term benefits with an estimated cost per QALY of 7 pounds 400 to 9 pounds 200 at 1997 prices. CONCLUSIONS Short-term treatment of hyperkinetic children with methylphenidate is effective and cost effective.
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Affiliation(s)
- A Gilmore
- ECOHOST, London School of Hygiene and Tropical Medicine, UK.
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Li J, Turnidge J, Milne R, Nation RL, Coulthard K. In vitro pharmacodynamic properties of colistin and colistin methanesulfonate against Pseudomonas aeruginosa isolates from patients with cystic fibrosis. Antimicrob Agents Chemother 2001; 45:781-5. [PMID: 11181360 PMCID: PMC90373 DOI: 10.1128/aac.45.3.781-785.2001] [Citation(s) in RCA: 178] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The in vitro pharmacodynamic properties of colistin and colistin methanesulfonate were investigated by studying the MICs, time-kill kinetics, and postantibiotic effect (PAE) against mucoid and nonmucoid strains of Pseudomonas aeruginosa isolated from patients with cystic fibrosis. Twenty-three clinical strains, including multiresistant strains, and one type strain were selected for MIC determination. Eleven strains were resistant; MICs for these strains were >128 mg/liter. For the susceptible strains, MICs of colistin ranged from 1 to 4 mg/liter, while the MICs of colistin methanesulfonate were significantly higher and ranged from 4 to 16 mg/liter. The time-kill kinetics were investigated with three strains at drug concentrations ranging from 0.5 to 64 times the MIC. Colistin showed extremely rapid killing, resulting in complete elimination at the highest concentrations within 5 min, while colistin methanesulfonate killed more slowly, requiring a concentration of 16 times the MIC to achieve complete killing within 24 h. Colistin exhibited a significant PAE of 2 to 3 h at 16 times the MIC against the three strains after 15 min of exposure. For colistin methanesulfonate, PAEs were shorter at the concentrations tested. Colistin methanesulfonate had lower overall bactericidal and postantibiotic activities than colistin, even when adjusted for differences in MICs. Our data suggest that doses of colistin methanesulfonate higher than the recommended 2 to 3 mg/kg of body weight every 12 h may be required for the effective treatment of P. aeruginosa infections in cystic fibrosis patients.
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Affiliation(s)
- J Li
- Centre for Pharmaceutical Research, University of South Australia, Adelaide, South Australia, Australia
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Parkes J, Bryant J, Milne R. Implantable cardioverter defibrillators: arrhythmias. A rapid and systematic review. Health Technol Assess 2001; 4:1-69. [PMID: 11086270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023] Open
Abstract
UNLABELLED PROPOSED SERVICE: The service proposed is the use of implantable cardioverter defibrillators (ICDs) in the management of risk factors leading to sudden cardiac death (SCD). ICDs are similar in size to a pacemaker and are intended to prevent death due to life-threatening ventricular tachyarrhythmias. EPIDEMIOLOGY AND BACKGROUND SCD occurs in approximately 100,000 people annually in the UK and is usually due to ventricular tachyarrhythmia. Increasing numbers of people are surviving a first episode of ventricular tachyarrhythmia and are at high risk of further episodes. Standard treatments for those at high risk have been anti-arrhythmic drugs, catheter ablation or surgery and, increasingly, vasodilating beta-blockers. METHODS Electronic databases were searched for the period 1980-99. In addition, bibliographies of related papers were assessed for relevant studies, and experts were contacted to identify additional published and unpublished references. Studies were included if they were systematic reviews, meta-analyses or randomised controlled trials (RCTs) comparing ICDs with conventional therapy in people at high risk of SCD. NUMBER AND QUALITY OF STUDIES AND DIRECTION OF EVIDENCE Seven RCTs on effectiveness the majority of which were of good quality, eight cost-effectiveness analyses most of which were older studies and based on non-UK data, and two good-quality literature reviews one of which was a critical appraisal of the literature of effectiveness and cost-effectiveness of ICD therapy, and the other a review of the cost-effectiveness of ICD therapy. These showed changes in absolute risk of total mortality ranging from an increase of 1.7% to a reduction of 22.8% (relative risk reductions of -7% to +54%). SUMMARY OF BENEFITS Estimated benefits from RCT data are 0.23-0.8 additional years of life with ICD therapy compared with anti-arrhythmic drug therapy. COSTS Unit cost of ICDs (based on 1999/2000 prices), ranges from pound 12,500 to pound 22,000. Total discounted costs for 3 years range from pound 20,000 to pound 29,000. COST-EFFECTIVENESS: Cost-effectiveness estimates in the literature identified range from $11,000 to $146,000 per life-year saved. Using UK cost data from three hospitals and trial survival data from one RCT, the estimate of cost-effectiveness from this review ranges between pound 20,250 and pound 87,000 per life-year saved. COST-UTILITY: Cost per quality-adjusted life-year is estimated by the authors of this review at pound 21,300 to pound 108,800 (using survival data from one trial and quality-of-life indices derived from clinical opinion). These figures remain speculative until quality-of-life data from ongoing trials are available to inform future UK cost-effectiveness/utility analyses. IMPLICATIONS If implemented for indications supported by evidence from RCTs, ICDs may cost the NHS in excess of pound 24 million per annum. FUTURE RESEARCH Future research should include the use of British Pacing and Electrophysiological Group registries to assess the use of different types of ICD and current service provision.
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Affiliation(s)
- J Parkes
- University of Southampton, Southampton, UK
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Chase D, Milne R, Stein K, Stevens A. What are the relative merits of the sources used to identify potential research priorities for the NHS HTA programme? Int J Technol Assess Health Care 2001; 16:743-50. [PMID: 11028130 DOI: 10.1017/s0266462300102028] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The NHS Health Technology Assessment (HTA) Programme runs an annual process of identifying suggestions for health technology assessment. The objective of this paper is to describe and evaluate the relative importance of the different sources used by the program in 1998 to identify potential priorities. There were four different sources: a) a widespread consultation of healthcare commissioners, providers and consumers; b) research recommendations from systematic reviews; c) reconsidering previous research priorities which had not been taken forward for funding; and d) horizon scanning. Collectively, the four sources generated just over 1,100 HTA suggestions. By far the largest source of suggestions and priorities was the widespread consultation. However, the success rate of this source, in terms of being commissioned, was low. Research recommendations from systematic reviews provided the second largest source of priorities and the best success rate of all sources. Value was found from different sources for different healthcare areas.
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Milne R, Clegg A, Bryant J. Drug treatment of multiple sclerosis. Clinical review was unsystematic. BMJ 2001; 322:299. [PMID: 11157552 PMCID: PMC1119535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
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Abstract
BACKGROUND Critical appraisal is the process of assessing and interpreting evidence by systematically considering its validity, results and relevance to an individual's work. Within the last decade critical appraisal has been added as a topic to many medical school and UK Royal College curricula, and several continuing professional development ventures have been funded to provide further training. OBJECTIVES To assess the effects of teaching critical appraisal skills to health professionals, on the process of care, patient outcomes and knowledge of health professionals. SEARCH STRATEGY We searched The Cochrane Library (to Issue 2 2000), MEDLINE (1966 to 1997), EMBASE (1980 to 1997), Eric (1966 to 1997), Cinahl (1982 to 1997), Lisa (1976 to 1997), Sigle (1980 to 1997), Science Citation Index (1981 to 1997), PsycLit (1974 to 1997), the world-wide-web, and reference lists of articles. We also contacted major medical education centres. SELECTION CRITERIA Randomised trials, controlled clinical trials, controlled before and after studies and interrupted time series analyses of educational interventions teaching critical appraisal to health professionals. The outcomes were: process of care; patient mortality, quality of life, and satisfaction; and health professional knowledge/awareness based upon objective, standardised, validated instruments. DATA COLLECTION AND ANALYSIS Two reviewers independently extracted data and three reviewers independently assessed study quality. MAIN RESULTS One USA hospital-based randomised trial was included involving 44 doctors. The outcome assessed was critical appraisal knowledge. Process of care, patient health or attitude/awareness outcomes were not assessed. Critical appraisal teaching was reported to have resulted in a 25% improvement (adjusted figure) in critical appraisal knowledge in the intervention group compared to a 6% improvement in the control group, which was statistically significant (p=0.02). REVIEWER'S CONCLUSIONS There is evidence that critical appraisal teaching has positive effects on participants' knowledge, but as only one study met the inclusion criteria the validity of drawing general conclusions about the effects of teaching critical appraisal is debatable. There are large gaps in the evidence as to whether teaching critical appraisal impacts on decision-making or patient outcomes. It is also unclear whether the size of benefit seen is large enough to be of practical significance, or whether this varies according to participant background or teaching method. The evidence supporting all outcomes is weakened by the generally poorly designed, executed and reported studies that we found.
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Affiliation(s)
- J Parkes
- Health Care Research Unit South Academic Block, Southampton General Hospital, Tremona Road, Southampton, Hampshire, UK, SO16 6YD.
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