Download or read book Evidence Synthesis and Meta analysis for Drug Safety written by Council for International Organizations of Medical Sciences (CIOMS) and published by World Health Organization. This book was released on 2016 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: At any point in the drug development process, systematic reviews and meta-analysis can provide important information to guide the future path of the development program and any actions that might be needed in the post-marketing setting. This report gives the rationale for why and when a meta-analysis should be considered, all in the context of regulatory decision-making, and the tasks, data collection, and analyses that need to be carried out to inform those decisions. There is increasing demand by decision-makers in health care, the bio-pharmaceutical industry, and society at large to have access to the best available evidence on benefits and risks of medicinal products. The best strategy will take an overview of all the evidence and where it is possible and sensible, combine the evidence and summarize the results. For efficacy, the outcomes generally use the same or very similar predefined events for each of the trials to be included. Most regulatory guidance and many Cochrane Collaboration reviews have usually given more attention to assessment of benefits, while issues around combining evidence on harms have not been as well-covered. However, the (inevitably) unplanned nature of the data on safety makes the process more difficult. Combining evidence on adverse events (AEs), where these were not the focus of the original studies, is more challenging than combining evidence on pre-specified benefits. This focus on AEs represents the main contribution of the current CIOMS X report. The goal of the CIOMS X report is to provide principles on appropriate application of meta-analysis in assessing safety of pharmaceutical products to inform regulatory decision-making. This report is about meta-analysis in this narrow area, but the present report should also provide conceptually helpful points to consider for a wider range of applications, such as vaccines, medical devices, veterinary medicines or even products that are combinations of medicinal products and medical devices. Although some of the content of this report describes highly technical statistical concepts and methods (in particular Chapter 4), the ambition of the working group has been to make it comprehensible to non-statisticians for its use in clinical epidemiology and regulatory science. To that end, Chapters 3 and 4, which contain the main technical statistical aspects of the appropriate design, analysis and reporting of a meta-analysis of safety data are followed by Chapter 5 with a thought process for evaluating the findings of a meta-analysis and how to communicate these.

Download or read book Finding What Works in Health Care written by Institute of Medicine and published by National Academies Press. This book was released on 2011-07-20 with total page 267 pages. Available in PDF, EPUB and Kindle. Book excerpt: Healthcare decision makers in search of reliable information that compares health interventions increasingly turn to systematic reviews for the best summary of the evidence. Systematic reviews identify, select, assess, and synthesize the findings of similar but separate studies, and can help clarify what is known and not known about the potential benefits and harms of drugs, devices, and other healthcare services. Systematic reviews can be helpful for clinicians who want to integrate research findings into their daily practices, for patients to make well-informed choices about their own care, for professional medical societies and other organizations that develop clinical practice guidelines. Too often systematic reviews are of uncertain or poor quality. There are no universally accepted standards for developing systematic reviews leading to variability in how conflicts of interest and biases are handled, how evidence is appraised, and the overall scientific rigor of the process. In Finding What Works in Health Care the Institute of Medicine (IOM) recommends 21 standards for developing high-quality systematic reviews of comparative effectiveness research. The standards address the entire systematic review process from the initial steps of formulating the topic and building the review team to producing a detailed final report that synthesizes what the evidence shows and where knowledge gaps remain. Finding What Works in Health Care also proposes a framework for improving the quality of the science underpinning systematic reviews. This book will serve as a vital resource for both sponsors and producers of systematic reviews of comparative effectiveness research.

Download or read book Cochrane Handbook for Systematic Reviews of Interventions written by Julian P. T. Higgins and published by Wiley. This book was released on 2008-11-24 with total page 672 pages. Available in PDF, EPUB and Kindle. Book excerpt: Healthcare providers, consumers, researchers and policy makers are inundated with unmanageable amounts of information, including evidence from healthcare research. It has become impossible for all to have the time and resources to find, appraise and interpret this evidence and incorporate it into healthcare decisions. Cochrane Reviews respond to this challenge by identifying, appraising and synthesizing research-based evidence and presenting it in a standardized format, published in The Cochrane Library (www.thecochranelibrary.com). The Cochrane Handbook for Systematic Reviews of Interventions contains methodological guidance for the preparation and maintenance of Cochrane intervention reviews. Written in a clear and accessible format, it is the essential manual for all those preparing, maintaining and reading Cochrane reviews. Many of the principles and methods described here are appropriate for systematic reviews applied to other types of research and to systematic reviews of interventions undertaken by others. It is hoped therefore that this book will be invaluable to all those who want to understand the role of systematic reviews, critically appraise published reviews or perform reviews themselves.

Download or read book An Exploration of Evidence Synthesis Methods for Adverse Events written by Fiona Claire Warren and published by . This book was released on 2010 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Adverse events following the use of medical interventions are a major source of concern for patients, healthcare professionals and pharmaceutical companies. Therefore, evidence synthesis of potential adverse events are very important in determining whether an association exists, and the strength of such an association. It is also desirable to be able to quantitatively balance potential harms against the benefits of the intervention. However, standard statistical techniques for meta-analysis are often unsuitable when applied to datasets where the primary intervention is an adverse event. A review of standard meta-analysis methods, including Bayesian methods, is conducted. The specific challenges of meta-analysis in relation to adverse events datasets are described, with some of the main areas of contention being sparsity of events, subgroup analysis, class effects with regard to drug interventions, and issues related to time factors within the individual studies. Methods used in existing meta-analyses where the primary outcome is an adverse event have also been reviewed; this demonstrates the methods already used in this field and highlights some of their limitations, and where the methods could be extended. In the light of the reviews of methods and previous meta-analyses, four case-studies are performed. The first uses data from GlaxoSmithKline to investigate a potential relationship between paroxetine and suicidality, using many of the standard methods for comparison purposes. The second uses individual patient data for a time-to-event analysis of anti-TNF drugs used for rheumatoid arthritis. This clinical example is extended by the use of Mixed Treatment Comparisons for within-class comparisons, and to assess the effect of dose. Finally, a harm-benefits model is used to assess the interplay of risk of endometrial cancer against breast cancer recurrence for tamoxifen users. These models present novel ways of analysing adverse events data and demonstrate some of the difficulties in their use.

Download or read book Quantitative Drug Safety and Benefit Risk Evaluation written by William Wang and published by CRC Press. This book was released on 2021-12-30 with total page 347 pages. Available in PDF, EPUB and Kindle. Book excerpt: Quantitative Methodologies and Process for Safety Monitoring and Ongoing Benefit Risk Evaluation provides a comprehensive coverage on safety monitoring methodologies, covering both global trends and regional initiatives. Pharmacovigilance has traditionally focused on the handling of individual adverse event reports however recently there had been a shift towards aggregate analysis to better understand the scope of product risks. Written to be accessible not only to statisticians but also to safety scientists with a quantitative interest, this book aims to bridge the gap in knowledge between medical and statistical fields creating a truly multi-disciplinary approach that is very much needed for 21st century safety evaluation.

Download or read book Statistical Methods for Drug Safety written by Robert D. Gibbons and published by CRC Press. This book was released on 2015-07-28 with total page 297 pages. Available in PDF, EPUB and Kindle. Book excerpt: Explore Important Tools for High-Quality Work in Pharmaceutical SafetyStatistical Methods for Drug Safety presents a wide variety of statistical approaches for analyzing pharmacoepidemiologic data. It covers both commonly used techniques, such as proportional reporting ratios for the analysis of spontaneous adverse event reports, and newer approach

Download or read book Evidence Synthesis for Decision Making in Healthcare written by Nicky J. Welton and published by John Wiley & Sons. This book was released on 2012-04-12 with total page 296 pages. Available in PDF, EPUB and Kindle. Book excerpt: In the evaluation of healthcare, rigorous methods of quantitative assessment are necessary to establish interventions that are both effective and cost-effective. Usually a single study will not fully address these issues and it is desirable to synthesize evidence from multiple sources. This book aims to provide a practical guide to evidence synthesis for the purpose of decision making, starting with a simple single parameter model, where all studies estimate the same quantity (pairwise meta-analysis) and progressing to more complex multi-parameter structures (including meta-regression, mixed treatment comparisons, Markov models of disease progression, and epidemiology models). A comprehensive, coherent framework is adopted and estimated using Bayesian methods. Key features: A coherent approach to evidence synthesis from multiple sources. Focus is given to Bayesian methods for evidence synthesis that can be integrated within cost-effectiveness analyses in a probabilistic framework using Markov Chain Monte Carlo simulation. Provides methods to statistically combine evidence from a range of evidence structures. Emphasizes the importance of model critique and checking for evidence consistency. Presents numerous worked examples, exercises and solutions drawn from a variety of medical disciplines throughout the book. WinBUGS code is provided for all examples. Evidence Synthesis for Decision Making in Healthcare is intended for health economists, decision modelers, statisticians and others involved in evidence synthesis, health technology assessment, and economic evaluation of health technologies.

Download or read book Systematic Reviews in Health Care written by Matthias Egger and published by John Wiley & Sons. This book was released on 2008-04-15 with total page 512 pages. Available in PDF, EPUB and Kindle. Book excerpt: The second edition of this best-selling book has been thoroughly revised and expanded to reflect the significant changes and advances made in systematic reviewing. New features include discussion on the rationale, meta-analyses of prognostic and diagnostic studies and software, and the use of systematic reviews in practice.

Download or read book Umbrella Reviews written by Giuseppe Biondi-Zoccai and published by Springer. This book was released on 2016-02-03 with total page 390 pages. Available in PDF, EPUB and Kindle. Book excerpt: ​This book is an ideal guide to umbrella reviews, overviews of reviews, and meta-epidemiologic studies for evidence synthesis. Research is conducted at different levels: primary research consists of original studies while secondary research comprises qualitative reviews, systematic reviews, and meta-analyses. Recently, a novel further level of research has been introduced, based on the analysis and pooling of reviews and meta-analysis. This book is the first to focus solely on this new type of research design, which permits a comprehensive and powerful synthesis of scientific evidence in medicine as well as in many other fields in order to inform decision-making. All aspects are covered, including review design and registration, the searching, abstracting, appraisal, and synthesis of evidence, the appraisal of moderators and confounders, and state of the art reporting. Case studies in a range of medical specialties are then presented. The hands-on approach of the book, written by a multinational team of experts, will enable the reader to interpret and independently conduct umbrella reviews.

Download or read book Textbook of Pharmacoepidemiology written by Brian L. Strom and published by John Wiley & Sons. This book was released on 2013-05-13 with total page 756 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Textbook of Pharmacoepidemiology provides a streamlined text for evaluating the safety and effectiveness of medicines. It includes a brief introduction to pharmacoepidemiology as well as sections on data sources, methodology and applications. Each chapter includes key points, case studies and essential references. One-step resource to gain understanding of the subject of pharmacoepidemiology at an affordable price Gives a perspective on the subject from academia, pharmaceutical industry and regulatory agencies Designed for students with basic knowledge of epidemiology and public health Includes many case studies to illustrate pharmacoepidemiology in real clinical setting

Download or read book Quantitative Drug Safety and Benefit Risk Evaluation written by William Wang and published by CRC Press. This book was released on 2021-12-30 with total page 402 pages. Available in PDF, EPUB and Kindle. Book excerpt: Quantitative Methodologies and Process for Safety Monitoring and Ongoing Benefit Risk Evaluation provides a comprehensive coverage on safety monitoring methodologies, covering both global trends and regional initiatives. Pharmacovigilance has traditionally focused on the handling of individual adverse event reports however recently there had been a shift towards aggregate analysis to better understand the scope of product risks. Written to be accessible not only to statisticians but also to safety scientists with a quantitative interest, this book aims to bridge the gap in knowledge between medical and statistical fields creating a truly multi-disciplinary approach that is very much needed for 21st century safety evaluation.

Download or read book Real World Evidence in Drug Development and Evaluation written by Harry Yang and published by CRC Press. This book was released on 2021-01-11 with total page 191 pages. Available in PDF, EPUB and Kindle. Book excerpt: Real-world evidence (RWE) has been at the forefront of pharmaceutical innovations. It plays an important role in transforming drug development from a process aimed at meeting regulatory expectations to an operating model that leverages data from disparate sources to aid business, regulatory, and healthcare decision making. Despite its many benefits, there is no single book systematically covering the latest development in the field. Written specifically for pharmaceutical practitioners, Real-World Evidence in Drug Development and Evaluation, presents a wide range of RWE applications throughout the lifecycle of drug product development. With contributions from experienced researchers in the pharmaceutical industry, the book discusses at length RWE opportunities, challenges, and solutions. Features Provides the first book and a single source of information on RWE in drug development Covers a broad array of topics on outcomes- and value-based RWE assessments Demonstrates proper Bayesian application and causal inference for real-world data (RWD) Presents real-world use cases to illustrate the use of advanced analytics and statistical methods to generate insights Offers a balanced discussion of practical RWE issues at hand and technical solutions suitable for practitioners with limited data science expertise

Download or read book Effective Care of the Newborn Infant written by John C. Sinclair and published by . This book was released on 1992 with total page 714 pages. Available in PDF, EPUB and Kindle. Book excerpt: This companion volume to the highly acclaimed Effective Care in Pregnancy and Childbirth (OUP 1989, edited by Iain Chalmers et al.) evaluates the care of newborn infants. Medical research has produced an explosion of new knowledge concerning the causes, diagnosis, prognosis, treatment and prevention of diseases of the newborn infant. As the pace of therapeutic innovation quickens, there is an increasing need for efficient access to information concerning the probable effects of therapy. This book meets the urgent demand for a systematic summary of the best available evidence concerning the expected outcomes of therapeutic decisions in neonatology. This revolutionary work consists fundamentally of quantitative reviews of randomized trials of alternative courses of action. It contains some 2000 new analyses of data from the clinical trials literature, representing the vast majority of randomized trials in neonatology. The result is the first systematic review of evidence from randomized clinical trials in this field and an explicit dissection of the research data supporting, or in some cases not supporting, clinical management of the newborn. This book will interest pediatricians, especially neonatologists; obstetricians, especially maternal-fetal medicine specialists; family practitioners; and epidemiologists.

Download or read book Network Meta Analysis for Decision Making written by Sofia Dias and published by John Wiley & Sons. This book was released on 2018-03-19 with total page 484 pages. Available in PDF, EPUB and Kindle. Book excerpt: A practical guide to network meta-analysis with examples and code In the evaluation of healthcare, rigorous methods of quantitative assessment are necessary to establish which interventions are effective and cost-effective. Often a single study will not provide the answers and it is desirable to synthesise evidence from multiple sources, usually randomised controlled trials. This book takes an approach to evidence synthesis that is specifically intended for decision making when there are two or more treatment alternatives being evaluated, and assumes that the purpose of every synthesis is to answer the question "for this pre-identified population of patients, which treatment is 'best'?" A comprehensive, coherent framework for network meta-analysis (mixed treatment comparisons) is adopted and estimated using Bayesian Markov Chain Monte Carlo methods implemented in the freely available software WinBUGS. Each chapter contains worked examples, exercises, solutions and code that may be adapted by readers to apply to their own analyses. This book can be used as an introduction to evidence synthesis and network meta-analysis, its key properties and policy implications. Examples and advanced methods are also presented for the more experienced reader. Methods used throughout this book can be applied consistently: model critique and checking for evidence consistency are emphasised. Methods are based on technical support documents produced for NICE Decision Support Unit, which support the NICE Methods of Technology Appraisal. Code presented is also the basis for the code used by the ISPOR Task Force on Indirect Comparisons. Includes extensive carefully worked examples, with thorough explanations of how to set out data for use in WinBUGS and how to interpret the output. Network Meta-Analysis for Decision Making will be of interest to decision makers, medical statisticians, health economists, and anyone involved in Health Technology Assessment including the pharmaceutical industry.

Download or read book Improving Healthcare Quality in Europe Characteristics Effectiveness and Implementation of Different Strategies written by OECD and published by OECD Publishing. This book was released on 2019-10-17 with total page 447 pages. Available in PDF, EPUB and Kindle. Book excerpt: This volume, developed by the Observatory together with OECD, provides an overall conceptual framework for understanding and applying strategies aimed at improving quality of care. Crucially, it summarizes available evidence on different quality strategies and provides recommendations for their implementation. This book is intended to help policy-makers to understand concepts of quality and to support them to evaluate single strategies and combinations of strategies.

Download or read book Bayesian Approaches to Clinical Trials and Health Care Evaluation written by David J. Spiegelhalter and published by John Wiley & Sons. This book was released on 2004-01-16 with total page 416 pages. Available in PDF, EPUB and Kindle. Book excerpt: READ ALL ABOUT IT! David Spiegelhalter has recently joined the ranks of Isaac Newton, Charles Darwin and Stephen Hawking by becoming a fellow of the Royal Society. Originating from the Medical Research Council’s biostatistics unit, David has played a leading role in the Bristol heart surgery and Harold Shipman inquiries. Order a copy of this author’s comprehensive text TODAY! The Bayesian approach involves synthesising data and judgement in order to reach conclusions about unknown quantities and make predictions. Bayesian methods have become increasingly popular in recent years, notably in medical research, and although there are a number of books on Bayesian analysis, few cover clinical trials and biostatistical applications in any detail. Bayesian Approaches to Clinical Trials and Health-Care Evaluation provides a valuable overview of this rapidly evolving field, including basic Bayesian ideas, prior distributions, clinical trials, observational studies, evidence synthesis and cost-effectiveness analysis. Covers a broad array of essential topics, building from the basics to more advanced techniques. Illustrated throughout by detailed case studies and worked examples Includes exercises in all chapters Accessible to anyone with a basic knowledge of statistics Authors are at the forefront of research into Bayesian methods in medical research Accompanied by a Web site featuring data sets and worked examples using Excel and WinBUGS - the most widely used Bayesian modelling package Bayesian Approaches to Clinical Trials and Health-Care Evaluation is suitable for students and researchers in medical statistics, statisticians in the pharmaceutical industry, and anyone involved in conducting clinical trials and assessment of health-care technology.

Download or read book Synthesizing Qualitative Evidence written by and published by . This book was released on 2011 with total page 79 pages. Available in PDF, EPUB and Kindle. Book excerpt: "Practitioners and patients are called upon to make numerous health care decisions and, in doing so, need to weigh various types of information before taking action. This information comes from a myriad of sources, including the results of well-designed research; information related to the preferences of patients/clients and their relevant others; the practitioner{u2019}s own experiences; and the nature and norms of the setting and culture in which the care is being delivered. Methods to synthesize qualitative evidence are now emerging and this text examines the methodological bases to qualitative synthesis and describes the processes involved in the conduct of a rigorous synthesis of qualitative evidence, with a particular focus on Meta-Aggregation."--[source inconnue].