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Carreras MJ, Renedo-Miró B, Valdivia C, Tomás-Guillén E, Farriols A, Mañós L, Vidal J, Alcalde M, De la Paz I, Jiménez-Lozano I, Palacio-Lacambra ME, Sabaté N, Felip E, Garralda E, Garau M, Gorgas MQ, Monterde J, Tabernero J. Drug Cost Avoidance Resulting from Participation in Clinical Trials: A 10-Year Retrospective Analysis of Cancer Patients with Solid Tumors. Cancers (Basel) 2024; 16:1529. [PMID: 38672610 PMCID: PMC11048575 DOI: 10.3390/cancers16081529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 04/13/2024] [Accepted: 04/15/2024] [Indexed: 04/28/2024] Open
Abstract
The objective of this single-center retrospective study was to describe the clinical characteristics of adult patients with solid tumors enrolled in cancer clinical trials over a 10-year period (2010-2019) and to assess drug cost avoidance (DCA) associated with sponsors' contributions. The sponsors' contribution to pharmaceutical expenditure was calculated according to the actual price (for each year) of pharmaceutical specialties that the Vall d'Hebron University Hospital (HUVH) would have had to bear in the absence of sponsorship. A total of 2930 clinical trials were conducted with 10,488 participants. There were 140 trials in 2010 and 459 in 2019 (228% increase). Clinical trials of high complexity phase I and basket trials accounted for 34.3% of all trials. There has been a large variation in the pattern of clinical research over the study period, whereas, in 2010, targeted therapy accounted for 79.4% of expenditure and cytotoxic drugs for 20.6%; in 2019, immunotherapy accounted for 68.4%, targeted therapy for 24.4%, and cytotoxic drugs for only 7.1%. A total of four hundred twenty-one different antineoplastic agents were used, the variability of which increased from forty-seven agents in 2010, with only seven of them accounting for 92.8% of the overall pharmaceutical expenditure) to three hundred seventeen different antineoplastic agents in 2019, with thirty-three of them accounting for 90.6% of the overall expenditure. The overall expenditure on antineoplastic drugs in clinical care patients not included in clinical trials was EUR 120,396,096. The total cost of antineoplastic drugs supplied by sponsors in a clinical trial setting was EUR 107,306,084, with a potential DCA of EUR 92,662,609. Overall, clinical trials provide not only the best context for the progress of clinical research and healthcare but also create opportunities for reducing cancer care costs.
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Affiliation(s)
- Maria-Josep Carreras
- Pharmacy Department, Vall d’Hebron University Hospital, E-08035 Barcelona, Spain (L.M.); (J.V.); (M.A.); (I.D.l.P.); (I.J.-L.); (M.-E.P.-L.); (N.S.); (M.-Q.G.)
| | - Berta Renedo-Miró
- Pharmacy Department, Vall d’Hebron University Hospital, E-08035 Barcelona, Spain (L.M.); (J.V.); (M.A.); (I.D.l.P.); (I.J.-L.); (M.-E.P.-L.); (N.S.); (M.-Q.G.)
| | - Carolina Valdivia
- Pharmacy Department, Vall d’Hebron University Hospital, E-08035 Barcelona, Spain (L.M.); (J.V.); (M.A.); (I.D.l.P.); (I.J.-L.); (M.-E.P.-L.); (N.S.); (M.-Q.G.)
| | - Elena Tomás-Guillén
- Asserta Global Healthcare Solutions, Sant Quirze del Vallés, E-08192 Barcelona, Spain
| | - Anna Farriols
- Pharmacy Department, Vall d’Hebron University Hospital, E-08035 Barcelona, Spain (L.M.); (J.V.); (M.A.); (I.D.l.P.); (I.J.-L.); (M.-E.P.-L.); (N.S.); (M.-Q.G.)
| | - Laura Mañós
- Pharmacy Department, Vall d’Hebron University Hospital, E-08035 Barcelona, Spain (L.M.); (J.V.); (M.A.); (I.D.l.P.); (I.J.-L.); (M.-E.P.-L.); (N.S.); (M.-Q.G.)
| | - Jana Vidal
- Pharmacy Department, Vall d’Hebron University Hospital, E-08035 Barcelona, Spain (L.M.); (J.V.); (M.A.); (I.D.l.P.); (I.J.-L.); (M.-E.P.-L.); (N.S.); (M.-Q.G.)
| | - María Alcalde
- Pharmacy Department, Vall d’Hebron University Hospital, E-08035 Barcelona, Spain (L.M.); (J.V.); (M.A.); (I.D.l.P.); (I.J.-L.); (M.-E.P.-L.); (N.S.); (M.-Q.G.)
| | - Isabel De la Paz
- Pharmacy Department, Vall d’Hebron University Hospital, E-08035 Barcelona, Spain (L.M.); (J.V.); (M.A.); (I.D.l.P.); (I.J.-L.); (M.-E.P.-L.); (N.S.); (M.-Q.G.)
| | - Inés Jiménez-Lozano
- Pharmacy Department, Vall d’Hebron University Hospital, E-08035 Barcelona, Spain (L.M.); (J.V.); (M.A.); (I.D.l.P.); (I.J.-L.); (M.-E.P.-L.); (N.S.); (M.-Q.G.)
| | - Maria-Eugenia Palacio-Lacambra
- Pharmacy Department, Vall d’Hebron University Hospital, E-08035 Barcelona, Spain (L.M.); (J.V.); (M.A.); (I.D.l.P.); (I.J.-L.); (M.-E.P.-L.); (N.S.); (M.-Q.G.)
| | - Nuria Sabaté
- Pharmacy Department, Vall d’Hebron University Hospital, E-08035 Barcelona, Spain (L.M.); (J.V.); (M.A.); (I.D.l.P.); (I.J.-L.); (M.-E.P.-L.); (N.S.); (M.-Q.G.)
| | - Enriqueta Felip
- Medical Oncology Department, Vall d’Hebron University Hospital, Vall d’Hebron Institute of Oncology (VHIO), E-08035 Barcelona, Spain; (E.F.); (E.G.); (J.T.)
| | - Elena Garralda
- Medical Oncology Department, Vall d’Hebron University Hospital, Vall d’Hebron Institute of Oncology (VHIO), E-08035 Barcelona, Spain; (E.F.); (E.G.); (J.T.)
| | - Margarita Garau
- Pharmacy Department, Vall d’Hebron University Hospital, E-08035 Barcelona, Spain (L.M.); (J.V.); (M.A.); (I.D.l.P.); (I.J.-L.); (M.-E.P.-L.); (N.S.); (M.-Q.G.)
| | - Maria-Queralt Gorgas
- Pharmacy Department, Vall d’Hebron University Hospital, E-08035 Barcelona, Spain (L.M.); (J.V.); (M.A.); (I.D.l.P.); (I.J.-L.); (M.-E.P.-L.); (N.S.); (M.-Q.G.)
| | - Josep Monterde
- Asserta Global Healthcare Solutions, Sant Quirze del Vallés, E-08192 Barcelona, Spain
| | - Josep Tabernero
- Medical Oncology Department, Vall d’Hebron University Hospital, Vall d’Hebron Institute of Oncology (VHIO), E-08035 Barcelona, Spain; (E.F.); (E.G.); (J.T.)
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Silja Viergutz HK, Cambra-Rufino L, Apple M, Heithoff A, Lindahl G, Capolongo S, Brambilla A. Benchmarking Relevance for Hospital Design and Planning: An International Web-Based Survey. HERD 2024:19375867241239324. [PMID: 38591575 DOI: 10.1177/19375867241239324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
Abstract
OBJECTIVE The study aims to investigate what design practitioners and healthcare facility managers deem as important benchmarking metrics worldwide, investigating country differences in benchmarking usage and which metrics are prioritized. BACKGROUND Benchmarking is a regular practice in the healthcare sector, both for clinical and managerial aspects to compare, measure, and improve standardized processes. However, limited knowledge is available about benchmarking procedures in hospital planning, design, and construction. METHODS A web-based survey was designed, revised, and pilot-tested in five countries; it was adjusted according to local experts' suggestions and submitted globally via SoSci multilingual platform to persons involved in hospital design, research, construction, and facility management. It was composed of closed questions on 5-point Likert-type scale ranking frequency or importance and open-ended questions divided into six sections. Two hundred and eighty full responses have been collected. Statistical analysis was performed via PowerBI and R-Studio, while qualitative analysis was performed via MAXQDA. RESULTS The findings reported allow for both specific insights per each country or category as well as enabling general considerations of a practice that is becoming always more international with 30%-50% of respondents working in the international context. The evaluation of the survey highlights the most important benchmarks, among others. For example, for respondents from the top five countries (Sweden, Spain, Germany, Italy, and the United States), the most important metric for benchmark comparability is whether the project was new construction, new construction attached to an existing hospital, or interior renovation. Construction date, client type (public vs. private), and country of location were also generally rated as the most important metrics by respondents. Other metrics that were consistently rated as important globally included inpatient unit layout, walking distances, number of floors, and whether all patient rooms are private. Space-related metrics are considered very important elements in the design and planning of healthcare facilities worldwide. Regarding cost-related metrics, all countries consider the ratio construction cost per building gross area as the most important. CONCLUSIONS Benchmarking emerges as a relevant tool for hospital design and planning as it can support efficiency, standardization, and confidence; currently, benchmarking is still underutilized due to the challenge of international comparison, access to data outside each specific company, and variation design metrics nationally. Benchmarking strategies should be further investigated to support knowledge exchange and to ensure reliable and comparable information globally.
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Affiliation(s)
| | | | | | | | - Goran Lindahl
- Department of Architecture and Civil Engineering (ACE), Center for Healthcare Architecture, Chalmers University of Technology, Goteborg, Sweden
| | - Stefano Capolongo
- Design & Health Lab, Department of Architecture, Built Environment and Construction Engineering (DABC), Politecnico di Milano, Italy
| | - Andrea Brambilla
- Design & Health Lab, Department of Architecture, Built Environment and Construction Engineering (DABC), Politecnico di Milano, Italy
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Cheng SL, Tsai SJ, Bai YM, Ko CH, Hsu CW, Yang FC, Tsai CK, Tu YK, Yang SN, Tseng PT, Hsu TW, Liang CS, Su KP. Comparisons of Quality, Correctness, and Similarity Between ChatGPT-Generated and Human-Written Abstracts for Basic Research: Cross-Sectional Study. J Med Internet Res 2023; 25:e51229. [PMID: 38145486 PMCID: PMC10760418 DOI: 10.2196/51229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 10/17/2023] [Accepted: 11/20/2023] [Indexed: 12/26/2023] Open
Abstract
BACKGROUND ChatGPT may act as a research assistant to help organize the direction of thinking and summarize research findings. However, few studies have examined the quality, similarity (abstracts being similar to the original one), and accuracy of the abstracts generated by ChatGPT when researchers provide full-text basic research papers. OBJECTIVE We aimed to assess the applicability of an artificial intelligence (AI) model in generating abstracts for basic preclinical research. METHODS We selected 30 basic research papers from Nature, Genome Biology, and Biological Psychiatry. Excluding abstracts, we inputted the full text into ChatPDF, an application of a language model based on ChatGPT, and we prompted it to generate abstracts with the same style as used in the original papers. A total of 8 experts were invited to evaluate the quality of these abstracts (based on a Likert scale of 0-10) and identify which abstracts were generated by ChatPDF, using a blind approach. These abstracts were also evaluated for their similarity to the original abstracts and the accuracy of the AI content. RESULTS The quality of ChatGPT-generated abstracts was lower than that of the actual abstracts (10-point Likert scale: mean 4.72, SD 2.09 vs mean 8.09, SD 1.03; P<.001). The difference in quality was significant in the unstructured format (mean difference -4.33; 95% CI -4.79 to -3.86; P<.001) but minimal in the 4-subheading structured format (mean difference -2.33; 95% CI -2.79 to -1.86). Among the 30 ChatGPT-generated abstracts, 3 showed wrong conclusions, and 10 were identified as AI content. The mean percentage of similarity between the original and the generated abstracts was not high (2.10%-4.40%). The blinded reviewers achieved a 93% (224/240) accuracy rate in guessing which abstracts were written using ChatGPT. CONCLUSIONS Using ChatGPT to generate a scientific abstract may not lead to issues of similarity when using real full texts written by humans. However, the quality of the ChatGPT-generated abstracts was suboptimal, and their accuracy was not 100%.
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Affiliation(s)
- Shu-Li Cheng
- Department of Nursing, Mackay Medical College, Taipei, Taiwan
| | - Shih-Jen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Ya-Mei Bai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Chih-Hung Ko
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Department of Psychiatry, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Psychiatry, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chih-Wei Hsu
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Fu-Chi Yang
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chia-Kuang Tsai
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Yu-Kang Tu
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
- Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
| | - Szu-Nian Yang
- Department of Psychiatry, Tri-service Hospital, Beitou branch, Taipei, Taiwan
- Department of Psychiatry, Armed Forces Taoyuan General Hospital, Taoyuan, Taiwan
- Graduate Institute of Health and Welfare Policy, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Ping-Tao Tseng
- Institute of Biomedical Sciences, Institute of Precision Medicine, National Sun Yat-sen University, Kaohsiung, Taiwan
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan
- Prospect Clinic for Otorhinolaryngology and Neurology, Kaohsiung, Taiwan
| | - Tien-Wei Hsu
- Department of Psychiatry, E-Da Dachang Hospital, I-Shou University, Kaohsiung, Taiwan
- Department of Psychiatry, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Chih-Sung Liang
- Department of Psychiatry, Tri-service Hospital, Beitou branch, Taipei, Taiwan
- Department of Psychiatry, National Defense Medical Center, Taipei, Taiwan
| | - Kuan-Pin Su
- College of Medicine, China Medical University, Taichung, Taiwan
- Mind-Body Interface Laboratory, China Medical University and Hospital, Taichung, Taiwan
- An-Nan Hospital, China Medical University, Tainan, Taiwan
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Sahu PK, Benjamin LA, Singh Aswal G, Williams-Persad A. ChatGPT in research and health professions education: challenges, opportunities, and future directions. Postgrad Med J 2023; 100:50-55. [PMID: 37819738 DOI: 10.1093/postmj/qgad090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 09/15/2023] [Indexed: 10/13/2023]
Abstract
ChatGPT was launched by OpenAI in November 2022 and within 2 months it became popular across a wide range of industrial, social, and intellectual contexts including healthcare education. This article reviews the impact of ChatGPT on research and health professions education by identifying the challenges and opportunities in these fields. Additionally, it aims to provide future directions to mitigate the challenges and maximize the benefits of this technology in health professions education. ChatGPT has the potential to revolutionize the field of research and health professions education. However, there is a need to address ethical concerns and limitations such as lack of real-time data, data inaccuracies, biases, plagiarism, and copyright infringement before its implementation. Future research can highlight the ways to mitigate these challenges; establish guidelines and policies; and explore how effectively ChatGPT and other AI tools can be used in the field of research and healthcare professions education.
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Affiliation(s)
- Pradeep Kumar Sahu
- Centre For Medical Sciences Education, Faculty of Medical Sciences, The University of the West Indies, St Augustine, Trinidad and Tobago
| | - Lisa A Benjamin
- Department of Basic Veterinary Sciences, School of Veterinary Medicine, Faculty of Medical Sciences, The University of the West Indies, St Augustine, Trinidad and Tobago
| | - Gunjan Singh Aswal
- Department of Restorative Dentistry, School of Dentistry, Faculty of Medical Sciences, The University of the West Indies, St Augustine Trinidad and Tobago
| | - Arlene Williams-Persad
- Department of Paraclinical Sciences, Faculty of Medical Sciences, The University of the West Indies St. Augustine, Trinidad and Tobago West Indies
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Chaufan C. Is Covid-19 "vaccine uptake" in postsecondary education a "problem"? A critical policy inquiry. Health (London) 2023:13634593231204169. [PMID: 37968946 DOI: 10.1177/13634593231204169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2023]
Abstract
Since the launch of the Covid-19 global vaccination campaign, postsecondary institutions have strongly promoted vaccination, often through mandates, and the academic literature has identified "vaccine uptake" among postsecondary students as a problem deserving monitoring, research, and intervention. However, with the admission that vaccines do not stop viral spread, that older-age and co-morbidities are major determinants of poor outcomes, and that many vaccine side effects disproportionately affect the young, it cannot be assumed that a risk-benefit analysis favors vaccinating postsecondary students. Drawing from critical policy studies, I appraise the literature on Covid-19 vaccine uptake in postsecondary education. I find that this literature reflects the "scientific consensus," hardly acknowledging contradictory medical evidence, ignoring coercive elements underlying "vaccine acceptance," and neglecting ethical tensions built into the very design of vaccination policies. I discuss potential explanations for my findings, and their implications for academia's role in society in the COVID-19 era and beyond.
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Hoffmann JM, Blümle A, Grossmann R, Yau H, Lang B, Bradbury C. Toward a global harmonization of service infrastructure in academic clinical trial units: an international survey. Front Med (Lausanne) 2023; 10:1252352. [PMID: 37901403 PMCID: PMC10602721 DOI: 10.3389/fmed.2023.1252352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 09/25/2023] [Indexed: 10/31/2023] Open
Abstract
Background Clinicians around the world perform clinical research in addition to their high workload. To meet the demands of high quality Investigator Initiated Trials (IITs), Clinical Trial Units (CTUs) (as part of Academic Research Institutions) are implemented worldwide. CTUs increasingly hold a key position in facilitating the international mutual acceptance of clinical research data by promoting clinical research practices and infrastructure according to international standards. Aim In this project, we aimed to identify services that established and internationally operating CTUs - members of the International Clinical Trial Center Network (ICN) - consider most important to ensure the smooth processing of a clinical trial while meeting international standards. We thereby aim to drive international harmonization by providing emerging and growing CTUs with a resource for informed service range set-up. Methods Following the AMEE Guide, we developed a questionnaire, addressing the perceived importance of different CTU services. Survey participants were senior representatives of CTUs and part of the ICN with long-term experience in their field and institution. Results Services concerning quality and coordination of a research project were considered to be most essential, i.e., Quality management, Monitoring and Project management, followed by Regulatory & Legal affairs, Education & Training, and Data management. Operative services for conducting a research project, i.e., Study Nurse with patient contact and Study Nurse without patient contact, were considered to be least important. Conclusion To balance the range of services offered while meeting high international standards of clinical research, emerging CTUs should focus on offering (quality) management services and expertise in regulatory and legal affairs. Additionally, education and training services are required to ensure clinicians are well trained on GCP and legislation. CTUs should evaluate whether the expertise and resources are available to offer operative services.
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Affiliation(s)
- Jean-Marc Hoffmann
- Clinical Trials Center, University of Zurich and University Hospital Zurich, Zurich, Switzerland
| | - Anette Blümle
- Clinical Trials Unit, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Regina Grossmann
- Clinical Trials Center, University of Zurich and University Hospital Zurich, Zurich, Switzerland
| | - Henry Yau
- Clinical Trials Centre, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Britta Lang
- Clinical Trials Unit, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Cedric Bradbury
- Clinical Trials Unit, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
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Lebowitz AJ. The Sendai Framework Eight Years On: Whither the "Science-Policy Interface"? Disaster Med Public Health Prep 2023; 17:e501. [PMID: 37795804 DOI: 10.1017/dmp.2023.163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023]
Abstract
This short commentary is a general analysis of the current state of the knowledge-policy relationship in the disaster field. This "science-policy interface" was described as fundamental in the 2015 UN Sendai Framework. However, midway to the 2030 deadline, there have been concerns from both the UN and academia about the lack of policy compared to research production. This suggests that barriers to this relationship may exist. To explain these, recent scholarship on factors influencing the general relationship between knowledge and policy is examined. Aspects of the "shape" of disaster research and its effect on policy creation are also examined, and a new direction is proposed. How the UN's initial approach plausibly did not support this interface is also explained; however, more recent advocacy suggests that the organization has taken a new approach that may prove effective. Overall, a debate within the disaster field about its role in policy creation may be necessary.
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Hogervorst E, Haskell-Ramsay C, Jadavji NM. Editorial: Women in nutrition and brain health. Front Nutr 2023; 10:1229751. [PMID: 37781130 PMCID: PMC10534978 DOI: 10.3389/fnut.2023.1229751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 08/31/2023] [Indexed: 10/03/2023] Open
Affiliation(s)
- Eef Hogervorst
- National Centre for Sport and Exercise Medicine (NCSEM), Loughborough University, Loughborough, United Kingdom
| | | | - Nafisa M. Jadavji
- Department of Biomedical Sciences, College of Graduate Studies, College of Veterinary Medicine, College of Osteopathic Medicine, Midwestern University, Glendale, AZ, United States
- Department of Child Health, College of Medicine Phoenix, University of Arizona, Phoenix, AZ, United States
- Department of Neuroscience, Carleton University, Ottawa, ON, Canada
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Lee JJ, Korndorffer JR, Knowlton LM, Choi J. An Open-Source Curriculum to Teach Practical Academic Research Skills. Ann Surg Open 2023; 4:e329. [PMID: 37746596 PMCID: PMC10513130 DOI: 10.1097/as9.0000000000000329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 07/29/2023] [Indexed: 09/26/2023] Open
Abstract
Academic productivity is important for career advancement, yet not all trainees have access to structured research programs. Without formal teaching, acquiring practical skills for research can be challenging. A comprehensive research course that teaches practical skills to translate ideas into publications could accelerate trainees' productivity and liberate faculty mentors' time. We share our experience designing and teaching "A Practical Introduction to Academic Research", a course that teaches practical skills including building productive habits, recognizing common statistical pitfalls, writing cover letters, succinct manuscripts, responding to reviewers, and delivering effective presentations. We share open-source educational material used during the Winter 2022 iteration to facilitate curriculum adoption at peer institutions.
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Affiliation(s)
- Jonathan J. Lee
- From the Stanford University School of Medicine, Stanford, CA
| | | | | | - Jeff Choi
- Department of Surgery, Stanford University, Stanford, CA
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Wykoff R, Dixon RE. We Welcome Findings from Further Afield. J Appalach Health 2023; 5:1-5. [PMID: 38023115 PMCID: PMC10629887 DOI: 10.13023/jah.0501.01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
For the past five years, the Journal of Appalachian Health has published timely, high-quality research from within Appalachia. We also welcome submissions from those working outside of Appalachia who produce quality research of direct relevance to our region.
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Datti A. Academic drug discovery in an age of research abundance, and the curious case of chemical screens toward drug repositioning. Drug Discov Today 2023; 28:103522. [PMID: 36764576 DOI: 10.1016/j.drudis.2023.103522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 01/31/2023] [Accepted: 02/02/2023] [Indexed: 02/11/2023]
Abstract
High-throughput screening (HTS) is a vaunted technology in drug discovery, and drug repositioning a celebrated strategy with famous examples of successful stories; however, repositioned drugs have primarily resulted from serendipitous observations, retrospective studies, and pharmacological analyses as opposed to experimental routes. This observation points to a methodological paradox, considering that academic laboratories of the post-genomic era have benefited from unprecedented technological progress, and a facilitated access to powerful resources that, historically, were a prerogative of the pharma industry. This disconnect is exacerbated by financial, practical, and regulatory complexities affecting drug repositioning; however, the pivotal significance of stringent and rigorous data is what unconditionally sits at the crossroad of go/no-go decisions concerning the therapeutic significance, or predictive validity, of selected drugs. Here, I propose a visionary approach, to which I assigned the term labsourcing, to dramatically enhance efficiency and clinical relevance of academic drug screens and, ultimately, generate contextual and reproducible data for correct interpretations and reliable selection of drug candidates. The overall concept implies intra- and intermural aggregation of expertise (e.g., assay development, cell biology, statistics, bioinformatics) to perform multiple bioassays, under multiple conditions and readouts, using a common screening collection. Advantages of high input screens can be manifold: (i) to tackle discrepancies that may arise from the screens of libraries of variable size and content and assay types and conditions too narrow in scope; (ii) the opportunity to generate massive amounts of data applicable for multiple publications and funding requests; (iii) the educational benefits for students and post-docs collegially exposed to long-term programs; and (iv) the opportunity to democratize research and recruit small labs that could not otherwise join screening programs due to costs, timelines, and risks.
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Affiliation(s)
- Alessandro Datti
- Department of Agricultural, Food, and Environmental Sciences, University of Perugia, Borgo XX Giugno, 74, 06121 Perugia, Italy.
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Quesada S, Bini M, Lebreton C, Ray-Coquard I. Update on new treatments for rare ovarian tumours. Curr Opin Obstet Gynecol 2023; 35:27-33. [PMID: 36440753 PMCID: PMC9788923 DOI: 10.1097/gco.0000000000000836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE OF REVIEW In spite of their rarity when considered individually, the sum of all rare ovarian tumours (ROT) represent almost half of all ovarian malignancies. As such, their appropriate inclusion within dedicated clinical trials is essential for enhanced management. RECENT FINDINGS Supported by institutional expert national (e.g. TMRG) and international (e.g. ESGO) networks and owing to national (e.g. ARCAGY-GINECO) and international (e.g. ENGOT) collaborations dedicated to clinical research, the last few years have shown increased number of clinical trials dedicated to ROT. These either were based on specific molecular features of ROT (e.g. expression of oestrogen receptors for low-grade serous ovarian carcinomas and anastrazole evaluation in the PARAGON trial) or on the evaluation of innovative therapies (e.g. pembrolizumab within the ROT cohort from the AcSé Pembrolizumab multicentric basket trial). Furthermore, recent years have also shown the advent of randomized clinical trials. For instance, the ALIENOR trial positioned weekly paclitaxel as a new option for relapsed sex cord-stromal tumours, while the GOG281/LOGS trial raised trametinib as a new standard-of-care option for recurrent low-grade serous carcinomas. SUMMARY The last few years have exhibited a paradigm shift towards the possibility to develop dedicated trials for ROT, owing to international collaborations supported by institutional networks. Current trials, molecular-driven and based on innovative designs, are highly promising, as they may bring ROT management towards more personalized medicine.
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Affiliation(s)
- Stanislas Quesada
- Centre Léon Bérard, Lyon, France
- Institut régional du Cancer de Montpellier, Montpellier, France
| | - Marta Bini
- Centre Léon Bérard, Lyon, France
- Instituto Nazionale dei Tumori, Milan, Italy
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13
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Hjorhöy LG, Thomsen TG, Beck M. Physical Environment as a Tool in Caring for the Hospitalized Patient: A Qualitative Study of Nurses' Experiences in Hospitals. HERD 2022; 15:143-153. [PMID: 35437044 DOI: 10.1177/19375867221092150] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To explore how nurses experience the physical environment when caring for hospitalized patients. BACKGROUND The physical environment as part of nursing is already an embedded understanding in the earliest nursing theory. In today's hospitals, the impact of the physical environment is important for both patients and nurses. Patients' well-being is linked to the physical environment, which can produce both negative and positive emotions. Nurses' work environment is affected by the physical one, which affects practice, communication, and teamwork. METHODS This study used a qualitative design to explore nurses' experiences of the physical environment in nursing. The study complied with the Consolidated Criteria for Reporting Qualitative Research (COREQ). Individual interviews were conducted with nine nurses working in somatic hospital units. Data collection, analysis, and interpretation consisted of individual semi-structured interviews and meaning condensation as described by Kvale and Brinkmann. RESULTS Three themes were identified: (1) providing a place to belong, (2) offering a protective sensory shield, and (3) balancing clinical needs with the patients' personal needs. CONCLUSIONS Involvement of the physical environment in nursing provides an opportunity for nurses to offer the hospitalized patient a place to belong. However, the physical environment is important for nurses to maintain accessibility with, and visualization of the patient. It is a careful balancing act carried out in practice without further verbalization in nursing.
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Affiliation(s)
- Liv Gølnitz Hjorhöy
- Department of Neurology, Zealand University Hospital, Roskilde, Region Zealand, Denmark
| | - Thora Grothe Thomsen
- Department of Otorhinolaryngology, Zealand University Hospital, Køge, Region Zealand, Denmark.,Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Malene Beck
- Department of Neurology, Zealand University Hospital, Roskilde, Region Zealand, Denmark.,Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
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14
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Facile R, Muhlbradt EE, Gong M, Li Q, Popat V, Pétavy F, Cornet R, Ruan Y, Koide D, Saito TI, Hume S, Rockhold F, Bao W, Dubman S, Jauregui Wurst B. Use of Clinical Data Interchange Standards Consortium (CDISC) Standards for Real-world Data: Expert Perspectives From a Qualitative Delphi Survey. JMIR Med Inform 2022; 10:e30363. [PMID: 35084343 PMCID: PMC8832264 DOI: 10.2196/30363] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 09/17/2021] [Accepted: 10/09/2021] [Indexed: 01/16/2023] Open
Abstract
Background Real-world data (RWD) and real-world evidence (RWE) are playing increasingly important roles in clinical research and health care decision-making. To leverage RWD and generate reliable RWE, data should be well defined and structured in a way that is semantically interoperable and consistent across stakeholders. The adoption of data standards is one of the cornerstones supporting high-quality evidence for the development of clinical medicine and therapeutics. Clinical Data Interchange Standards Consortium (CDISC) data standards are mature, globally recognized, and heavily used by the pharmaceutical industry for regulatory submissions. The CDISC RWD Connect Initiative aims to better understand the barriers to implementing CDISC standards for RWD and to identify the tools and guidance needed to more easily implement them. Objective The aim of this study is to understand the barriers to implementing CDISC standards for RWD and to identify the tools and guidance that may be needed to implement CDISC standards more easily for this purpose. Methods We conducted a qualitative Delphi survey involving an expert advisory board with multiple key stakeholders, with 3 rounds of input and review. Results Overall, 66 experts participated in round 1, 56 in round 2, and 49 in round 3 of the Delphi survey. Their inputs were collected and analyzed, culminating in group statements. It was widely agreed that the standardization of RWD is highly necessary, and the primary focus should be on its ability to improve data sharing and the quality of RWE. The priorities for RWD standardization included electronic health records, such as data shared using Health Level 7 Fast Health care Interoperability Resources (FHIR), and the data stemming from observational studies. With different standardization efforts already underway in these areas, a gap analysis should be performed to identify the areas where synergies and efficiencies are possible and then collaborate with stakeholders to create or extend existing mappings between CDISC and other standards, controlled terminologies, and models to represent data originating across different sources. Conclusions There are many ongoing data standardization efforts around human health data–related activities, each with different definitions, levels of granularity, and purpose. Among these, CDISC has been successful in standardizing clinical trial-based data for regulation worldwide. However, the complexity of the CDISC standards and the fact that they were developed for different purposes, combined with the lack of awareness and incentives to use a new standard and insufficient training and implementation support, are significant barriers to setting up the use of CDISC standards for RWD. The collection and dissemination of use cases, development of tools and support systems for the RWD community, and collaboration with other standards development organizations are potential steps forward. Using CDISC will help link clinical trial data and RWD and promote innovation in health data science.
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Affiliation(s)
- Rhonda Facile
- Clinical Data Interchange Standards Consortium, Austin, TX, United States
| | | | - Mengchun Gong
- Digital Health China Technologies, Bejing, China.,Institute of Health Management, Southern Medical University, Guangzhou, China
| | - Qingna Li
- Institute of Clinical Pharmacology, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China.,Key Laboratory for Clinical Research and Evaluation of Traditional Chinese Medicine of National Medical Products Administration, Beijing, China.,National Clinical Research Center for Chinese Medicine Cardiology, Beijing, China
| | - Vaishali Popat
- Food and Drug Administration, Center for Drug Evaluation Research, Silver Spring, MD, United States
| | - Frank Pétavy
- European Medicines Agency, Amsterdam, Netherlands
| | - Ronald Cornet
- Department of Medical Informatics, Amsterdam Public Health Research Institute, Amsterdam University Medical Centers - University of Amsterdam, Amsterdam, Netherlands
| | | | - Daisuke Koide
- Department of Biostatistics & Bioinformatics, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Toshiki I Saito
- National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Sam Hume
- Clinical Data Interchange Standards Consortium, Austin, TX, United States
| | - Frank Rockhold
- Duke Clinical Research Institute, Duke University Medical Center, Durham, NC, United States
| | - Wenjun Bao
- JMP Life Sciences, SAS Institute Inc, Cary, NC, United States
| | - Sue Dubman
- Clinical Data Interchange Standards Consortium, Austin, TX, United States
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15
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Shandhi MMH, Goldsack JC, Ryan K, Bennion A, Kotla AV, Feng A, Jiang Y, Wang WK, Hurst T, Patena J, Carini S, Chung J, Dunn J. Recent Academic Research on Clinically Relevant Digital Measures: Systematic Review. J Med Internet Res 2021; 23:e29875. [PMID: 34524089 PMCID: PMC8482196 DOI: 10.2196/29875] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 07/02/2021] [Accepted: 08/12/2021] [Indexed: 01/16/2023] Open
Abstract
Background Digital clinical measures collected via various digital sensing technologies such as smartphones, smartwatches, wearables, ingestibles, and implantables are increasingly used by individuals and clinicians to capture health outcomes or behavioral and physiological characteristics of individuals. Although academia is taking an active role in evaluating digital sensing products, academic contributions to advancing the safe, effective, ethical, and equitable use of digital clinical measures are poorly characterized. Objective We performed a systematic review to characterize the nature of academic research on digital clinical measures and to compare and contrast the types of sensors used and the sources of funding support for specific subareas of this research. Methods We conducted a PubMed search using a range of search terms to retrieve peer-reviewed articles reporting US-led academic research on digital clinical measures between January 2019 and February 2021. We screened each publication against specific inclusion and exclusion criteria. We then identified and categorized research studies based on the types of academic research, sensors used, and funding sources. Finally, we compared and contrasted the funding support for these specific subareas of research and sensor types. Results The search retrieved 4240 articles of interest. Following the screening, 295 articles remained for data extraction and categorization. The top five research subareas included operations research (research analysis; n=225, 76%), analytical validation (n=173, 59%), usability and utility (data visualization; n=123, 42%), verification (n=93, 32%), and clinical validation (n=83, 28%). The three most underrepresented areas of research into digital clinical measures were ethics (n=0, 0%), security (n=1, 0.5%), and data rights and governance (n=1, 0.5%). Movement and activity trackers were the most commonly studied sensor type, and physiological (mechanical) sensors were the least frequently studied. We found that government agencies are providing the most funding for research on digital clinical measures (n=192, 65%), followed by independent foundations (n=109, 37%) and industries (n=56, 19%), with the remaining 12% (n=36) of these studies completely unfunded. Conclusions Specific subareas of academic research related to digital clinical measures are not keeping pace with the rapid expansion and adoption of digital sensing products. An integrated and coordinated effort is required across academia, academic partners, and academic funders to establish the field of digital clinical measures as an evidence-based field worthy of our trust.
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Affiliation(s)
| | | | - Kyle Ryan
- Big Ideas Lab, Department of Biomedical Engineering, Duke University, Durham, NC, United States
| | - Alexandra Bennion
- Big Ideas Lab, Department of Biomedical Engineering, Duke University, Durham, NC, United States
| | - Aditya V Kotla
- Big Ideas Lab, Department of Biomedical Engineering, Duke University, Durham, NC, United States
| | - Alina Feng
- Big Ideas Lab, Department of Biomedical Engineering, Duke University, Durham, NC, United States
| | - Yihang Jiang
- Department of Biomedical Engineering, Duke University, Durham, NC, United States
| | - Will Ke Wang
- Department of Biomedical Engineering, Duke University, Durham, NC, United States
| | - Tina Hurst
- Activinsights Ltd, Cambridgeshire, United Kingdom
| | - John Patena
- Brown-Lifespan Center for Digital Health, Brown University, Providence, RI, United States
| | - Simona Carini
- Division of General Internal Medicine, University of California, San Francisco, CA, United States
| | - Jeanne Chung
- Digital Medicine Society, Boston, MA, United States
| | - Jessilyn Dunn
- Department of Biomedical Engineering, Duke University, Durham, NC, United States.,Department of Biostatistics & Bioinformatics, Duke University, Durham, NC, United States
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16
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White E, Ahn S, Miner T, Longo W, Yoo P. Where Are They Now? Charting Careers for 32 Years of New England Surgical Society Podium Presentation Winners. R I Med J (2013) 2021; 104:30-32. [PMID: 34044434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND The New England Surgical Society (NESS) has been a pillar of the regional medical community since 1916, founded to promote surgical knowledge sharing across a small but diverse geographical region. Annual podium awards recognize high-quality research by surgical trainees. DESIGN We described trends among 81 research abstracts and career trajectories for their trainee authors (1987-present). RESULTS Among abstracts, 80.2% were clinical research, 12.3% basic science, and 7.4% education. 87.6% resulted in publications. Awardees represented 19 institutions and were predominantly residents (74.0%), with the remainder being fellows and students. 71.4% are now practicing attendings in 14 surgical subspecialties while 18.2% remain in surgical training. 44.2% currently reside in New England. CONCLUSION NESS attracts a range of high-quality research and winners demonstrate a range of successful careers with a propensity for academic surgery. Findings of low attrition and many currently living in New England highlight the value of regional conferences for strengthening local professional connections.
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Affiliation(s)
| | | | - Thomas Miner
- Associate Professor of Surgery and Chief of Surgical Oncology at The Warren Alpert Medical School of Brown University
| | - Walter Longo
- Professor of Colon & Rectal Surgery at Yale University and Past President of the New England Surgical Society
| | - Peter Yoo
- Associate Professor of Surgery and Program Director of the General Surgery Residency at Yale University
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17
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Abstract
Background The number of publications is widely used as a measure of academic productivity in the field of orthopaedics. How “productive” a physician is has a great influence on consideration for employment, compensation, and promotions. Predictors of potential high-output researchers would be of value to the orthopaedic department and university leadership for new faculty evaluation. Methods The study population included orthopaedic faculty from the top 10 orthopaedic institutions in the United States. Their names and the number of publications at each point in their training (medical school, residency, and fellowship) and early career (first five and 10 years following fellowship) along with a total number of publications to date were collected by using PubMed. Results Strong correlations were seen between publications during total training and publications output in the first five years following fellowship (rs=0.717, P<0.0001). However, no significant correlations were found comparing publications during each stage of training and the first 10 years following fellowship. A moderate positive correlation was found when comparing publications during medical school and residency output (rs=0.401, P<0.0001). Conclusions The data presented here may be utilized by department chairs during the evaluation of faculty and candidates to not interpret the number of publications during training and early career as a gauge of research interest and potential for future publications. Program directors may also use the only moderate correlation between publications in medical school and residency when evaluating applications as support of a more holistic review of applicants to determine research interest.
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Affiliation(s)
- Madison L Goss
- Orthopaedics and Rehabilitation, Penn State Health Milton S. Hershey Medical Center, Hershey, USA
| | - Sarah McNutt
- Neurosurgery, Penn State Health Milton S. Hershey Medical Center, Hershey, USA
| | - Jesse E Bible
- Orthopaedics and Rehabilitation, Penn State Health Milton S. Hershey Medical Center, Hershey, USA
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18
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Abraham A, Gille D, Puhan MA, ter Riet G, von Wyl V. Defining Core Competencies for Epidemiologists in Academic Settings to Tackle Tomorrow's Health Research Challenges: A Structured, Multinational Effort. Am J Epidemiol 2021; 190:343-352. [PMID: 33106866 PMCID: PMC7935742 DOI: 10.1093/aje/kwaa209] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 12/04/2019] [Revised: 09/21/2020] [Accepted: 10/01/2020] [Indexed: 12/18/2022] Open
Abstract
Only a few efforts have been made to define core competencies for epidemiologists working in academic settings. Here we describe a multinational effort to define competencies for epidemiologists, who are increasingly facing emerging and potentially disruptive technological and societal health trends in academic research. During a 1.5-year period (2017–2019), we followed an iterative process that aimed to be inclusive and multinational to reflect the various perspectives of a diverse group of epidemiologists. Competencies were developed by a consortium in a consensus-oriented process that spanned 3 main activities: 2 in-person interactive meetings held in Amsterdam, the Netherlands, and Zurich, Switzerland, and an online survey. In total, 93 meeting participants from 16 countries and 173 respondents from 19 countries contributed to the development of 31 competencies. These 31 competencies included 14 on “developing a scientific question” and “study planning,” 12 on “study conduct and analysis,” 3 on “overarching competencies,” and 2 on “communication and translation.” The process described here provides a consensus-based framework for defining and adapting the field. It should initiate a continuous process of thinking about competencies and the implications for teaching epidemiology to ensure that epidemiologists working in academic settings are well prepared for today’s and tomorrow’s health research.
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Affiliation(s)
| | | | - Milo A Puhan
- Correspondence to Prof. Dr. Milo A. Puhan, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Hirschengraben 84, Room HRS G29, 8001 Zurich, Switzerland (e-mail: )
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19
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Abstract
OBJECTIVE Research was conducted to evaluate the correlation between design hypotheses and performance outcomes in single-occupancy patient rooms. BACKGROUND Health environments host complex interactions between patients and clinicians, and patient rooms offer a unique lens to understanding the impact of design on interactions and outcomes. This places importance on articulating, measuring, and assessing design hypotheses. This study of documented strategies and measured outcomes in patient room design investigates the relationship between design variables and clinical interactions. METHODS Design hypotheses were identified for the strategic approach to four key elements of patient room design: the room configuration, charting location, personal protective equipment (PPE) supply, and mobile supply cart. Researchers collected observational data from existing and newly constructed patient rooms in order to evaluate performance outcomes related to design hypotheses. RESULTS Observation data supported hypotheses behind three of the four design components and revealed greater insight into how design variables impacted interactions in patient rooms. CONCLUSIONS The study identified a distinction between "fixed" design elements, such as the configuration of the patient room, and "dynamic" elements such as the design of the mobile cart. This was more prevalent in evaluating the use of supply carts and PPE cabinets, which may be more influenced by training, while the room configuration and charting location require little training to benefit both clinicians and patients. This study points to the value of research that evaluates correlations between design hypotheses and outcomes in healthcare design.
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Affiliation(s)
- Valerie Greer
- School of Architecture, 14434The University of Utah, Salt Lake City, UT, USA
| | | | - Josephine Hsu
- Sam Fox School of Design and Visual Arts, 7548Washington University in St. Louis, MO, USA
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20
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Carthey J. Participatory Design, Project Clients, and Healthcare User Groups. HERD 2020; 14:96-108. [PMID: 32806927 DOI: 10.1177/1937586720948462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AIM This study is the third in a series of investigations that explored the role of project user groups and how they impact on the design of a healthcare facility. Previous studies focused on a wide range of users, whereas this study sought the views of project clients. BACKGROUND The "project client" represents the organization responsible for the procurement of a healthcare facility. "Users" will work in or "use" that building. With the input of project clients, this research focused on the user group process required for Australian and New Zealand publicly funded healthcare projects. It sought lessons to improve the process for future projects. METHODS Previous research findings, and an expanded literature review examining participatory design, were used to develop questions for semistructured interviews with selected project clients. Responses were transcribed and analyzed in terms of themes and subthemes using reflexive thematic analysis to develop a narrative that reports and discusses the findings. RESULTS Although not all are recognized, many stakeholders influence design decisions. No history, rationale, terms of reference, or evaluations of the user group process were found, suggesting that although it is a "given," the process could be enhanced. Useful suggestions for improving the user group process are offered. CONCLUSIONS Evaluating the user group process, and learning from alternative approaches, may improve its outcomes. A project charter and terms of reference would support more effective decision making, while best practice guidelines and education for user group participants should be considered.
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Affiliation(s)
- Jane Carthey
- 346230Faculty of Creative Industries, Queensland University of Technology, Queensland, Australia
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21
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Abstract
Objectives: The objective of the research was to study the visitors’ experiences of
different healthcare environment designs of intensive care unit (ICU)
patient rooms. Background: The healthcare environment may seem frightening and overwhelming in times
when life-threatening conditions affect a family member or close friend and
individuals visit the patient in an ICU. A two-bed patient room was
refurbished to enhance the well-being of patients and their families
according to the principles of evidence-based design (EBD). No prior
research has used the Person-centred Climate Questionnaire—Family version
(PCQ-F) or the semantic environment description (SMB) in the ICU
setting. Methods: A sample of 99 visitors to critically ill patients admitted to a
multidisciplinary ICU completed a questionnaire; 69 visited one of the two
control rooms, while 30 visited the intervention room. Results: For the dimension of everydayness in the PCQ-F, a significantly better
experience was expressed for the intervention room (p <
.030); the dimension regarding the ward climate general was also perceived
as higher in the intervention room (p < .004). The
factors of pleasantness (p < .019), and complexity
(p < 0.049), showed significant differences favoring
the intervention room in the SMB, with borderline significance on the modern
factor (p < .061). Conclusion: Designing and implementing an enriched healthcare environment in the ICU
setting increases person-centered care in relation to the patients’
visitors. This could lead to better outcomes for the visitors, for example,
decreasing post-traumatic stress disorder symptoms, but this needs further
investigations.
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Affiliation(s)
- Fredrika Sundberg
- Faculty of Caring Science, Work Life and Social Welfare, 1802University of Borås, Sweden
| | - Isabell Fridh
- Faculty of Caring Science, Work Life and Social Welfare, 1802University of Borås, Sweden
| | - Berit Lindahl
- Faculty of Caring Science, Work Life and Social Welfare, 1802University of Borås, Sweden
| | - Ingemar Kåreholt
- Institute of Gerontology, School of Health and Welfare, 4161Jönköping University, Sweden
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22
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Makowski N, Ciplea AM, Ali M, Burdman I, Bartel A, Burckhardt BB; LENA Consortium. A comprehensive quality control system suitable for academic research: application in a pediatric study. Bioanalysis 2020; 12:319-33. [PMID: 32129082 DOI: 10.4155/bio-2019-0242] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Aim:
Clinical research in pediatrics is progressively initiated by academia. As the reliability of pharmacodynamic measures is closely linked to the quality of bioanalytical data, bioanalytical quality assurance is crucial. However, clear guidance on comprehensive bioanalytical quality monitoring in the academic environment is lacking.
Methods & results:
By applying regulatory guidelines, international recommendations and scientific discussions, a five-step quality control system for monitoring the bioanalysis of aldosterone by immunoassay was developed. It comprised performance qualification, calibration curve evaluation, analysis of the intra- and inter-run performance via quality control samples, incurred sample reanalysis and external quality assessment by interlaboratory testing. A total of 55 out of 70 runs were qualified for the quantification of aldosterone in the study sample enabling the evaluation of 954 pediatric samples and demonstrating reliability over the 29-month bioanalysis period.
Conclusion:
The bioanalytical quality control system successfully monitored the aldosterone assay performance and proved its applicability in the academic environment.
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23
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Coppens DG, Gardarsdottir H, van den Bogert CA, De Bruin ML, Leufkens HG, Hoekman J. Publication rates and reported results in a cohort of gene- and cell-based therapy trials. Regen Med 2020; 15:1215-1227. [PMID: 32103712 DOI: 10.2217/rme-2019-0066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Aim: We investigated publication rates and reported results for gene- and cell-based therapy trials. Materials & methods: In a cohort of Institutional Review Board (IRB)-authorized trials during 2007-2017 in the Netherlands (n = 105), we examine publication rates and reported results in scientific papers and conference abstracts as well as associations with the occurrence of trial characteristics. Results: The publication rate for scientific papers was 27% and 17% for conference abstracts (median survival time: 1050 days). Academic hospitals published more in scientific papers whereas private sponsors published more in conference abstracts. Manufacturing protocols were underreported compared with clinical outcomes. Most publications reported positive results (78%). Conclusion: Publication rates are currently suboptimal indicating a need for enhanced knowledge sharing to stimulate gene- and cell-based therapy development.
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Affiliation(s)
- Delphi Gm Coppens
- Division of Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands
| | - Helga Gardarsdottir
- Division of Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands.,Department of Clinical Pharmacy, Division Laboratories, Pharmacy & Biomedical Genetics, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Cornelis A van den Bogert
- Division of Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands
| | - Marie L De Bruin
- Division of Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands.,Copenhagen Centre for Regulatory Science, University of Copenhagen, Copenhagen, Denmark
| | - Hubert Gm Leufkens
- Division of Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands
| | - Jarno Hoekman
- Division of Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands.,Innovation Studies Group, Faculty of Geosciences, Utrecht University, Utrecht, The Netherlands
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Abstract
AIM User group consultation is more effective when participants work toward commonly agreed goals and objectives. To understand how they set these goals, this research explored how "user group" participants from diverse professional discipline backgrounds define the concepts of "design quality" and "project success," and their connection on a healthcare facility design project. BACKGROUND User group consultation is often time-consuming, frustrating, and expensive. Rarely are design quality or project success clearly defined, nor is the connection between them communicated well either in the literature or by project clients. METHOD Using an online survey, respondents were asked to rank frameworks of components for design quality and project success in order of importance and to indicate how they believed their project clients would assess the same items. They were asked about the connection between the terms, and how well each was achieved on their healthcare projects, both from their personal and their client's point of view. RESULTS Design quality and project success were personally valued highly by respondents, with a strong connection seen between the concepts. By contrast, respondents perceived their clients saw the connection as less important. Functionality was essential to all, especially clinicians, but designers and other consultants demonstrated a broader perspective on all design outcomes. CONCLUSIONS Healthcare designers should take the lead on project teams in defining design quality and its connection to project success as part of setting clear goals and objectives for more effective user group consultation.
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Affiliation(s)
- Jane Carthey
- Faculty of Creative Industries, Queensland University of Technology, Brisbane, Australia
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25
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Cardone C, Martinelli E, Troiani T, Sforza V, Avallone A, Nappi A, Montesarchio V, Andreozzi F, Biglietto M, Calabrese F, Bordonaro R, Cordio S, Bregni G, Febbraro A, Garcia-Carbonero R, Feliu J, Cervantes A, Ciardiello F. Exploratory findings from a prematurely closed international, multicentre, academic trial: RAVELLO, a phase III study of regorafenib versus placebo as maintenance therapy after first-line treatment in RAS wild-type metastatic colorectal cancer. ESMO Open 2019; 4:e000519. [PMID: 31555481 PMCID: PMC6735666 DOI: 10.1136/esmoopen-2019-000519] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 05/20/2019] [Accepted: 05/22/2019] [Indexed: 01/07/2023] Open
Abstract
Background In patients with RAS wild-type (WT) metastatic colorectal cancer (mCRC), the role of maintenance therapy after first-line treatment with chemotherapy plus antiepidermal growth factor receptor (EGFR) monoclonal antibodies (MoAb) is still an object of debate. Methods We assessed the efficacy and safety of regorafenib as a switch maintenance strategy after upfront 5-fluorouracil-based chemotherapy plus an anti-EGFR MoAb in patients with RAS WT mCRC. RAVELLO was a phase III, international, double-blind, placebo-controlled, academic trial. The primary endpoint was progression-free survival (PFS). Secondary endpoints included overall survival and toxicity. Regorafenib or placebo were administered daily for 3 weeks of 4-week cycle until disease progression or unacceptable toxicity, up to 24 months. Results The study was stopped prematurely due to slow accrual and lack of funding after the randomisation of 21 patients: 11 in the regorafenib arm and 10 in the placebo arm. The small sample size precludes any statistical analysis. Toxicity was acceptable and consistent with the known regorafenib safety profile. Median PFS was similar in the two arms. However, a subgroup of patients treated with regorafenib experienced a remarkably long PFS. Three patients were progression free at 9 months in the regorafenib arm versus one patient in the placebo arm, whereas at 12 months two regorafenib-treated patients were still progression free versus none in the placebo arm. Conclusion RAVELLO trial demonstrated that growing financial and bureaucratic hurdles affect the feasibility of independent academic research. Although stopped prematurely and within the limited sample size, RAVELLO suggests that regorafenib has not a major activity in maintenance setting after upfront chemotherapy and anti-EGFR MoAb. However, a subgroup of patients experienced a remarkable long PFS, indicating that a better refinement of the patient population would help to identify subjects that might benefit from a regorafenib personalised approach in the switch maintenance setting.
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Affiliation(s)
- Claudia Cardone
- Department of Precision Medicine, Università degli Studi della Campania Luigi Vanvitelli, Napoli, Campania, Italy
| | - Erika Martinelli
- Department of Precision Medicine, Università degli Studi della Campania Luigi Vanvitelli, Napoli, Campania, Italy
| | - Teresa Troiani
- Department of Precision Medicine, Università degli Studi della Campania Luigi Vanvitelli, Napoli, Campania, Italy
| | - Vincenzo Sforza
- Department of Precision Medicine, Università degli Studi della Campania Luigi Vanvitelli, Napoli, Campania, Italy
| | - Antonio Avallone
- Department of Experimental Medicine, Istituto Nazionale Tumori IRCCS Fondazione Pascale, Napoli, Italy
| | - Anna Nappi
- Department of Experimental Medicine, Istituto Nazionale Tumori IRCCS Fondazione Pascale, Napoli, Italy
| | | | - Francesca Andreozzi
- Azienda Ospedaliera dei Colli, Medical Oncology, Monaldi Hospital, Napoli, Italy
| | - Maria Biglietto
- Medical Oncology, Antonio Cardarelli Hospital, Napoli, Italy
| | | | - Roberto Bordonaro
- Medical Oncology, National Specialist Hospital Garibaldi, Catania, Italy
| | - Stefano Cordio
- Medical Oncology, National Specialist Hospital Garibaldi, Catania, Italy
| | | | - Antonio Febbraro
- Medical Oncology, Hospital Sacro Cuore di Gesù, Fatebenefratelli, Benevento, Italy
| | - Rocio Garcia-Carbonero
- Medical Oncology, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), UCM, CNIO, CIBERONC, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Jaime Feliu
- CIBERONC, Medical Oncology, Hospital Universitario La Paz, Madrid, Spain
| | - Andrés Cervantes
- CIBERONC, Medical Oncology, Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain
| | - Fortunato Ciardiello
- Department of Precision Medicine, Università degli Studi della Campania Luigi Vanvitelli, Napoli, Campania, Italy
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Abstract
AIM This Australian research explores how "user group" participants from diverse professional discipline backgrounds understand, define, perform their roles, and assess the outcomes of the healthcare design process. BACKGROUND Part of the design process in Australia and New Zealand, the purpose of interdisciplinary user group consultation is to design the best healthcare facilities possible within the parameters set by project clients and funding bodies. METHOD An online survey was used to explore how user group participants viewed the process, including how well informed they felt they were about their role/s in it, its success in achieving specific outcomes for their project, and how they felt their project client, owner, or funding body assessed these same issues. It included both closed and open-ended questions, and data were then analyzed using an interpretative methodology by an architect researcher based in practice. RESULTS Emergent issues identified include governance of the process, knowledge asymmetries between participants, missed opportunities for innovation, composition and workloads of user groups, and the quality of resources available to guide the process. CONCLUSIONS The interdisciplinary user group process could be improved, and future research will look at how drawing on participatory design methods used in sectors such as urban planning may support the development of new techniques for conducting user groups.
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Affiliation(s)
- Jane Carthey
- Faculty of Creative Industries, Queensland University of Technology, Brisbane, Queensland, Australia
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Abstract
We quantify the impact of scientific grant funding at the National Institutes of Health (NIH) on patenting by pharmaceutical and biotechnology firms. Our paper makes two contributions. First, we use newly constructed bibliometric data to develop a method for flexibly linking specific grant expenditures to private-sector innovations. Second, we take advantage of idiosyncratic rigidities in the rules governing NIH peer review to generate exogenous variation in funding across research areas. Our results show that NIH funding spurs the development of private-sector patents: a $10 million boost in NIH funding leads to a net increase of 2.3 patents. Though valuing patents is difficult, we report a range of estimates for the private value of these patents using different approaches.
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Favier R, Crépin S. The reporting of harms in publications on randomized controlled trials funded by the "Programme Hospitalier de Recherche Clinique," a French academic funding scheme. Clin Trials 2018; 15:257-267. [PMID: 29498543 DOI: 10.1177/1740774518760565] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND/AIMS Accurate information on harms arising from medical interventions is essential for assessing benefit-risk ratios. Since 2004, there has been an extension of the Consolidated Standards of Reporting Trials statement for reporting harms data in publications on randomized clinical trials. The objective of our study was to assess the quality of this reporting from academic randomized clinical trials on drugs. METHODS We searched for articles on randomized clinical trials funded between 2004 and 2008 by the "Programme Hospitalier de Recherche Clinique." We included all published randomized clinical trials that assessed drugs. Harm-related data were extracted and compared with the Consolidated Standards of Reporting Trials Harms extension, and the space in the articles devoted to harms data was measured. RESULTS In total, 37 randomized clinical trials met the inclusion criteria. The median harm score was 9/18. In 73.0% of the randomized clinical trials, the reporting of adverse events was selective. Less than 50% of articles provided information on reasons for drug discontinuation that were related to adverse events. The score and the space allocated to harms were higher in antineoplastic and immunomodulating drugs randomized clinical trials, while the median proportion of the space in the results section allocated to harms was 16.8%. In 67.6% of the articles, the space allocated to the authors' list and affiliations was greater than the space in the results section allocated to descriptions of harms. No significant improvement in the score or the space allocation was observed during the study period. CONCLUSION Reporting of harms in French academic drug randomized clinical trials is suboptimal; moreover, this shortcoming is a critical barrier to evaluating the benefit-risk ratio of drug randomized clinical trials. Thus, the authors should be encouraged to adhere to the Consolidated Standards of Reporting Trials Harms extension.
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Affiliation(s)
- Romain Favier
- Service de Pharmacologie, Toxicologie et Pharmacovigilance, CHU de Limoges, France
| | - Sabrina Crépin
- Service de Pharmacologie, Toxicologie et Pharmacovigilance, CHU de Limoges, France
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Negrouk A, Lacombe D, Cardoso F, Morin F, Carrasco E, Maurel J, Maibach R, Aranda E, Marais R, Stahel RA. Safeguarding the future of independent, academic clinical cancer research in Europe for the benefit of patients. ESMO Open 2017; 2:e000187. [PMID: 29021919 PMCID: PMC5634488 DOI: 10.1136/esmoopen-2017-000187] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Revised: 06/27/2017] [Accepted: 06/27/2017] [Indexed: 12/14/2022] Open
Abstract
Cancer is a complex disease that is constantly evolving. It is now the most common cause of death in Europe after cardiovascular diseases. There are inequalities among European countries, potentially unsustainable healthcare systems impacting quality of cancer care and increasing number of patients with cancer with rare conditions. Clinical and translational research are the backbone in establishing scientific advances as novel treatments and advancing progress to the benefit of patients. Commercially sponsored clinical trials are responsible for developing new medicines that can treat various disease areas, including cancer. It is important to note, however, that these clinical trials only assess the viability of compounds that are chosen by a commercial entity that funds the entire process. By their design and focus, these trials need to fulfil commercial interests and market expectations, which do not always coincide with patients' needs. As soon or even before novel treatments and compounds obtain formal market authorisation, academia will take these existing and new medicines to further conduct research in order to optimise their use, develop new combinations and with a strong focus on the patients and their needs. Established standard of care most commonly relies on clinical cancer research stemming from non-commercial entities, cooperative groups or academic clinical research. This article provides a consensus on the definition of academic research, illustrates its added value and suggests and calls to European Union institutions to support this type of research for the benefit of patients.
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Affiliation(s)
- Anastassia Negrouk
- International Policy Office, European Organisation for Research and Treatment of Cancer (EORTC),Headquarters, Brussels, Belgium
| | - Denis Lacombe
- Director General, European Organisation for Research and Treatment of Cancer (EORTC), Brussels, Belgium
| | | | - Franck Morin
- French Cooperative Thoracic Intergroup (IFCT) – Groupes Cooperateurs en Oncologie (GCO), Paris, France
| | - Eva Carrasco
- Grupo Español de Investigación en Cáncer de Mama (GEICAM), Scientific Director and CEO, Madrid, Spain
| | - Joan Maurel
- Grupo Espanol Multidisciplinar en Cancer Digestivo (GEMCAD), Medical OncologyDepartment, Hospital Clínic, Translational Genomics and Targeted Therapeuticsin Solid Tumors Group, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Rudolf Maibach
- International Breast Cancer Study Group (IBCSG) Coordinating Center, Bern, Switzerland
| | - Enrique Aranda
- Spanish Cooperative Group for the Treatment of Digestive Tumors (TTD), Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), InstitutoSanitario de Investigación Biomédica de Córdoba (IMIBIC), Medical OncologyDepartment, Hospital Universitario Reina Sofía, Córdoba, Spain
| | - Richard Marais
- European Association for Cancer Research (EACR), Department of Molecular Oncology at the University of Manchester and Directorof the Cancer Research UK Manchester Institute, Manchester, UK
| | - Rolf A Stahel
- European Society for Medical Oncology (ESMO), Clinic of Oncology,University Hospital, Zürich, Zurich, Switzerland
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Tan L, Hong M, Albert TW. Improving Student Commitment to Healthcare-Related Design Practice by Improving the Studio Learning Experience. HERD 2017. [PMID: 28627299 DOI: 10.1177/1937586717713733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE This case study explores the influence of the healthcare design studio experience on students' short-term professional goals as measured through rates of healthcare-related certification and internship/employment. BACKGROUND The value and relevance of interior design is evident in the healthcare design sector. However, interior design students may not perceive this value if it is not communicated through their design education. Students' experience in the design studio plays a crucial role in determining career choices, and students may be more committed to career goals when there is clear connection between major coursework and professional practice. METHOD The authors compared healthcare-related certification and internship/employment levels between two student cohorts in a capstone undergraduate interior design healthcare design studio course. The first cohort was led by the existing curriculum. The second cohort was led by the revised curriculum that specifically aimed at encouraging students to commit to healthcare-related design practice. RESULTS When measured at 3 months from graduation, the second cohort, led by the revised curriculum, saw a 30% increase in Evidence-based Design Accreditation and Certification exam pass rates and a 40% increase in healthcare-related internship/employment. CONCLUSION The challenge of interior design education is to instill in emerging professionals not only professional competence but also those professional attitudes that will make them better prepared to design spaces that improve quality of life, particularly in healthcare environments. The results exceeded the project goals, and so this could be considered a promising practice for courses focused on healthcare design education.
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Affiliation(s)
| | - Miyoung Hong
- 2 University of Nebraska-Lincoln, Lincoln, NE, USA
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Edwards MA, Roy S. Academic Research in the 21st Century: Maintaining Scientific Integrity in a Climate of Perverse Incentives and Hypercompetition. Environ Eng Sci 2017; 34:51-61. [PMID: 28115824 PMCID: PMC5206685 DOI: 10.1089/ees.2016.0223] [Citation(s) in RCA: 171] [Impact Index Per Article: 24.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Accepted: 08/18/2016] [Indexed: 05/10/2023]
Abstract
Over the last 50 years, we argue that incentives for academic scientists have become increasingly perverse in terms of competition for research funding, development of quantitative metrics to measure performance, and a changing business model for higher education itself. Furthermore, decreased discretionary funding at the federal and state level is creating a hypercompetitive environment between government agencies (e.g., EPA, NIH, CDC), for scientists in these agencies, and for academics seeking funding from all sources-the combination of perverse incentives and decreased funding increases pressures that can lead to unethical behavior. If a critical mass of scientists become untrustworthy, a tipping point is possible in which the scientific enterprise itself becomes inherently corrupt and public trust is lost, risking a new dark age with devastating consequences to humanity. Academia and federal agencies should better support science as a public good, and incentivize altruistic and ethical outcomes, while de-emphasizing output.
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Affiliation(s)
- Marc A. Edwards
- Corresponding author: Department of Civil and Environmental Engineering, Virginia Tech, 407 Durham Hall, 1145 Perry Street, Blacksburg, VA 24061. Phone: (540) 231-7236; Fax: (540) 231-7532; E-mail:
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Kobayashi L, Gosbee JW, Merck DL. Development and Application of a Clinical Microsystem Simulation Methodology for Human Factors-Based Research of Alarm Fatigue. HERD 2016; 10:91-104. [PMID: 27815527 DOI: 10.1177/1937586716673829] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES (1) To develop a clinical microsystem simulation methodology for alarm fatigue research with a human factors engineering (HFE) assessment framework and (2) to explore its application to the comparative examination of different approaches to patient monitoring and provider notification. BACKGROUND Problems with the design, implementation, and real-world use of patient monitoring systems result in alarm fatigue. A multidisciplinary team is developing an open-source tool kit to promote bedside informatics research and mitigate alarm fatigue. METHOD Simulation, HFE, and computer science experts created a novel simulation methodology to study alarm fatigue. Featuring multiple interconnected simulated patient scenarios with scripted timeline, "distractor" patient care tasks, and triggered true and false alarms, the methodology incorporated objective metrics to assess provider and system performance. Developed materials were implemented during institutional review board-approved study sessions that assessed and compared an experimental multiparametric alerting system with a standard monitor telemetry system for subject response, use characteristics, and end-user feedback. RESULTS A four-patient simulation setup featuring objective metrics for participant task-related performance and response to alarms was developed along with accompanying structured HFE assessment (questionnaire and interview) for monitor systems use testing. Two pilot and four study sessions with individual nurse subjects elicited true alarm and false alarm responses (including diversion from assigned tasks) as well as nonresponses to true alarms. In-simulation observation and subject questionnaires were used to test the experimental system's approach to suppressing false alarms and alerting providers. CONCLUSIONS A novel investigative methodology applied simulation and HFE techniques to replicate and study alarm fatigue in controlled settings for systems assessment and experimental research purposes.
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Affiliation(s)
- Leo Kobayashi
- 1 Department of Emergency Medicine, Alpert Medical School of Brown University, Providence, RI, USA.,2 Lifespan Medical Simulation Center, Providence, RI, USA
| | - John W Gosbee
- 3 Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA.,4 Red Forest Consulting, Ann Arbor, MI, USA
| | - Derek L Merck
- 5 Department of Diagnostic Imaging, Alpert Medical School of Brown University, Providence, RI, USA
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Abstract
Academic research is essential to bring disruptive innovation on medical devices market because the risk-taking is too high for companies and their investors. Performing clinical trials is essential to technical files but no one wants to accept responsibility for implanted off-label devices. The paper explains the academic process for innovation. We see that academic research depends, at the end, on the motivation of companies to develop a product. The key to innovation stands in the early collaboration between the surgeons, the research teams and the companies in a project. Innovation is a good idea supported by the expertise of the right people at the right moment. In orthopaedics, we need, more than ever, to stay focused on the patient benefits.
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Affiliation(s)
- Aurélien Courvoisier
- a Department of Pediatric Orthopedics , Grenoble University Hospital, Grenoble Alpes University, TIMC - IMAG - SPM , Grenoble , France
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Miller AD. Evolving from academic to academic entrepreneur: overcoming barriers to scientific progress and finance. Future Med Chem 2016; 8:1157-62. [PMID: 27476702 DOI: 10.4155/fmc-2016-0100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The overall goal of my career as an academic chemist has always been the design and creation of advanced therapeutics and diagnostics that address unmet medical need in the management of chronic diseases. Realising this goal has been an immensely difficult process involving multidisciplinary problem-driven research at the chemistry-biology-medicine interfaces. With success in the laboratory, I started seriously to question the value of remaining an academic whose career is spent in the pursuit of knowledge and understanding alone without making any significant effort to translate knowledge and understanding gained into products of genuine utility for public benefit. Therefore, I elected by choice to become an academic entrepreneur, seeking opportunities wherever possible for the translation of the best of my personal and collaborative academic research work into potentially valuable and useful products. This choice has brought with it many unexpected difficulties and challenges. Nevertheless, progress bas been made and sufficient learnt to suggest that this would be an appropriate moment to take stock and provide some personal reflections on what it takes to design and create advanced therapeutics and diagnostics in the laboratory then seek to develop, innovate and translate the best towards market.
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Köhler L, Karlberg I. How to create and terminate a school of public health. Scand J Public Health 2015; 43:12-7. [PMID: 26311792 DOI: 10.1177/1403494814568589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The famous preamble to the Constitution of the World Health Organization (WHO) from 1948, stating that health is not only the absence of disease, has been one of the most influential political statements of our time. The follow-up, reaching a position where health is viewed as instrumental to a good life and not as a goal in itself, as set out in the Ottawa Charter of 1986, has likewise been of the utmost importance for the global development of public health, as well as developing the concept of health promotion. The focus on public health sparked by the WHO was paralleled by expansion of the academic interest in the topic, beginning in the USA and successively adopted around the world. In the Nordic countries the pioneering of an academic platform for public health studies and research began in 1953. This was later followed by a stepwise expansion to a full academic institution with postgraduate studies, work-related training, research and development. From the start, the resultant institution called the Nordic School of Public Health (NHV) was a joint Nordic project financed by the Nordic governments. The NHV became a leader in public health studies in Nordic countries and also a role model for the development of an academic community. A large campus and a select and erudite staff, together with thousands of students, paved the way for the NHV having a major impact on public health policy in Nordic countries. One effect of this was increasing awareness of the need for systematic policy supporting public health research and, with this, the founding of institutions of public health in all of the separate Nordic countries. Ironically, the impact made by the NHV in spreading the idea of public health as an important part of academic study has made the NHV superfluous. It is true that courses and programmes in public health are now available at most universities in the five Nordic countries, but they are directed at young students fresh from high school. There is no institution that offers a broad and high-quality postgraduate education and training in public health, adapted to the special needs of mid-career professionals in a multi-professional and internordic setting. With the NHV closing, a research institute focusing public health in a Nordic context will disappear, as will an internationally leading School of Public Health, a centre of excellence and relevance in public health, which has evaluated, assessed and promoted the goals and evaluated the success of the Nordic welfare societies.
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Abstract
OBJECTIVE Designers can and should play a critical role in shaping a holistic healthcare experience by creating empathetic design solutions that foster a culture of care for patients, families, and staff. Using narrative inquiry as a design tool, this case study shares strategies for promoting empathy. BACKGROUND Designing for patient-centered care infuses empathy into the creative process. Narrative inquiry offers a methodology to think about and create empathetic design that enhances awareness, responsiveness, and accountability. METHODS This article shares discoveries from a studio on empathetic design within an outpatient cancer care center. The studio engaged students in narrative techniques throughout the design process by incorporating aural, visual, and written storytelling. Benchmarking, observations, and interviews were merged with data drawn from scholarly evidence-based design literature reviews. RESULTS Using an empathy-focused design process not only motivated students to be more engaged in the project but facilitated the generation of fresh and original ideas. Design solutions were innovative and impactful in supporting the whole person. Similarities as well as differences defined empathetic cancer care across projects and embodied concepts of design empowerment, design for the whole person, and design for healing. CONCLUSIONS By becoming more conscious of empathy, those who create healthcare environments can better connect holistically to the user to take an experiential approach to design. Explicitly developing a mind-set that raises empathy to the forefront of the design process offers a breakthrough in design thinking that bridges the gap between what might be defined as "good design" and patient-centered care.
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Abstract
BACKGROUND Few methods have been defined for evaluating the individual and collective impacts of academic research centers. In this project, with input from injury center directors, we systematically defined indicators to assess the progress and contributions of individual Injury Control Research Centers (ICRCs) and, ultimately, to monitor progress of the overall injury center program. METHOD We used several methods of deriving a list of recommended priority and supplemental indicators. This included published literature review, telephone interviews with selected federal agency staff, an e-mail survey of injury center directors, an e-mail survey of staff at the Centers for Disease Control and Prevention, a two-stage Delphi process (e-mailed), and an in-person focus group with injury center directors. We derived the final indicators from an analysis of ratings of potential indicators by center directors and CDC staff. We also examined qualitative responses to open-ended items that address conceptual and implementation issues. RESULTS All currently funded ICRCs participated in at least one part of the process, resulting in a list of 27 primary indicators (some with subcomponents), 31 supplemental indicators, and multiple suggestions for using the indicators. CONCLUSION Our results support an approach that combines standardized definitions and quantifiable indicators with qualitative reporting, which allows consideration of center distinctions and priorities. The center directors urged caution in using the indicators, given funding constraints and recognition of unique institutional environments. While focused on injury research centers, we suggest these indicators also may be useful to academic research centers of other types.
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Affiliation(s)
- Carol Runyan
- 1 Society for the Advancement of Violence and Injury Research (SAVIR), USA
- 2 Department of Epidemiology, Colorado School of Public Health, Aurora, CO, USA
- 3 Pediatric Injury Prevention, Education and Research (PIPER) Program, University of Colorado-Denver, Denver, CO, USA
| | - Mariana Garrettson
- 1 Society for the Advancement of Violence and Injury Research (SAVIR), USA
- 4 University of North Carolina Injury Prevention Research Center, Chapel Hill, NC, USA
| | - Sue Lin Yee
- 5 National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Matos G, Tufik S, Andersen ML. Challenges in translating academic research into therapeutic advancement. Front Neurol 2013; 4:123. [PMID: 24027554 PMCID: PMC3760065 DOI: 10.3389/fneur.2013.00123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Accepted: 08/18/2013] [Indexed: 12/24/2022] Open
Affiliation(s)
- Gabriela Matos
- Departamento de Psicobiologia, Universidade Federal de São Paulo , São Paulo, Brazil
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Deagle G. Nurturing research in a family medicine department. Can Fam Physician 1989; 35:879-882. [PMID: 21249036 PMCID: PMC2280820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
In order to encourage research, one must maintain the initial enthusiasm of residents for exploring the questions that arise during their early experience. Once they begin to study these questions, an academic department can help further by teaching skills in literature review, data analysis, and presentation of data. Once established, these support programs can assist faculty members to carry on their own research as well.
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