The criteria used by key decision makers in Australia to judge the academic quality of NTROs
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ABSTRACT:
SUBMITTER: McKee A
PROVIDER: S-EPMC8280536 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Innate immunity represents the first line of defence against invading pathogens. It consists of an initial inflammatory response that recruits white blood cells to the site of infection in an effort to destroy and eliminate the pathogen. Some pathogens replicate within host cells, and cell death by apoptosis is an important effector mechanism to remove the replication niche for such microbes. However, some microbes have evolved evasive strategies to block apoptosis, and in these cases host cells may employ further countermeasures, including an inflammatory form of cell death know as necroptosis. This review aims to highlight the importance of the RIP kinase family in controlling these various defence strategies. RIP1 is initially discussed as a key component of death receptor signalling and in the context of dictating whether a cell triggers a pathway of pro-inflammatory gene expression or cell death by apoptosis. The molecular and functional interplay of RIP1 and RIP3 is described, especially with respect to mediating necroptosis and as key mediators of inflammation. The function of RIP2, with particular emphasis on its role in NOD signalling, is also explored. Special attention is given to emphasizing the physiological and pathophysiological contexts for these various functions of RIP kinases.
| S-EPMC4291486 | biostudies-other
Project description:BackgroundIn rationing decisions in health, many criteria like costs, effectiveness, equity and feasibility concerns play a role. These criteria stem from different disciplines that all aim to inform health care rationing decisions, but a single underlying concept that incorporates all criteria does not yet exist. Therefore, we aim to develop a conceptual mapping of criteria, based on the World Health Organization's Health Systems Performance and Health Systems Building Blocks frameworks. This map can be an aid to decision makers to identify the relevant criteria for priority setting in their specific context.MethodsWe made an inventory of all possible criteria for priority setting on the basis of literature review. We categorized the criteria according to both health system frameworks that spell out a country's health system goals and input. We reason that the criteria that decision makers use in priority setting exercises are a direct manifestation of this.ResultsOur map includes thirty-one criteria that are distributed among five categories that reflect the goals of a health system (i.e. to improve level of health, fair distribution of health, responsiveness, social & financial risk protection and efficiency) and leadership/governance one category that reflects feasibiliy based on the health system building blocks (i.e. service delivery, health care workforce , information, medical products, vaccines & technologies, financing and).ConclusionsThis conceptual mapping of criteria, based on well-established health system frameworks, will further develop the field of priority setting by assisting decision makers in the identification of multiple criteria for selection of health interventions.
| S-EPMC3565954 | biostudies-literature
Project description:CONTEXT:Relationships between researchers and decision-makers have demonstrated positive potential to influence research, policy and practice. Over time, interest in better understanding the relationships between the two parties has grown as demonstrated by a plethora of studies globally. However, what remains elusive is the evolution of these vital relationships and what can be learned from them with respect to advancing evidence-informed decision-making. We therefore explored the nuances around the initiation, maintenance and dissolution of academic-government relationships. METHODS:We conducted in-depth interviews with 52 faculty at one school of public health and 24 government decision-makers at city, state, federal and global levels. Interviews were transcribed and coded deductively and inductively using Atlas.Ti. Responses across codes and respondents were extracted into an Excel matrix and compared in order to identify key themes. FINDINGS:Eight key drivers to engagement were identified, namely (1) decision-maker research needs, (2) learning, (3) access to resources, (4) student opportunities, (5) capacity strengthening, (6) strategic positioning, (7) institutional conditionalities, and (8) funder conditionalities. There were several elements that enabled initiation of relationships, including the role of faculty members in the decision-making process, individual attributes and reputation, institutional reputation, social capital, and the role of funders. Maintenance of partnerships was dependent on factors such as synergistic collaboration (i.e. both benefit), mutual trust, contractual issues and funding. Dissolution of relationships resulted from champions changing/leaving positions, engagement in transactional relationships, or limited mutual trust and respect. CONCLUSIONS:As universities and government agencies establish relationships and utilise opportunities to share ideas, envision change together, and leverage their collaborations to use evidence to inform decision-making, a new modus operandi becomes possible. Embracing the individual, institutional, networked and systems dynamics of relationships can lead to new practices, alternate approaches and transformative change. Government agencies, schools of public health and higher education institutions more broadly, should pay deliberate attention to identifying and managing the various drivers, enablers and disablers for relationship initiation and resilience in order to promote more evidence-informed decision-making.
| S-EPMC7011533 | biostudies-literature
Project description:Indicators can help decision-makers evaluate interventions in a complex, multi-sectoral injury system. We aimed to create indicators for road safety, seniors falls, and 'all-injuries' to inform and evaluate injury prevention initiatives in British Columbia, Canada. The indicator development process involved a five-stage mixed methodology approach, including an environmental scan of existing indicators, generating expert consensus, selection of decision-makers and conducting a survey, selection of final indicators, and specification of indicators. An Indicator Reference Group (IRG) reviewed the list of indicators retrieved in the environmental scan and selected candidate indicators through expert consensus based on importance, modifiability, acceptance, and practicality. Key decision-makers (n = 561) were invited to rank each indicator in terms of importance and actionability (online survey). The IRG applied inclusion criteria and thresholds to survey responses from decision-makers, which resulted in the selection of 47 road safety, 18 seniors falls, and 33 all-injury indicators. After grouping "like" indicators, a final list of 23 road safety, 8 seniors falls, and 13 all-injury indicators were specified. By considering both decision-maker ranking and expert opinion, we anticipate improved injury system performance through advocacy, accountability, and evidence-based resource allocation in priority areas. Our indicators will inform a data management framework for whole-system reporting to drive policy and funding for provincial injury prevention improvement.
| S-EPMC8621597 | biostudies-literature
Project description:BACKGROUND:Knowledge of what the pharmaceutical industry emphasizes when assessing trial sites during site selection is sparse. A better understanding of this issue can improve the collaboration on clinical trials and increase knowledge of how to attract and retain industry-sponsored trials. Accordingly, we investigated which site-related qualities multinational biopharmaceutical companies and clinical research organizations (CROs) find most important during site selection. METHODS:An online survey among decision-makers for trial site selection in the Nordic countries employed at multinational biopharmaceutical companies and CROs was conducted. The respondents' experiences with and perceptions of site selection were addressed to evaluate the relative importance of site-related qualities. We included up to four respondents per company, representing different geographic regions. Descriptive statistics were used to summarize findings. RESULTS:Of 49 eligible companies, 20 biopharmaceutical companies and 23 CROs participated. In total, 83 responses were analyzed (estimated response rate 78%). A relative importance of site-related qualities was identified: For example, 88% (binomial 95% confidence interval [CI] ±7%) preferred reaching enrollment goals at trial sites in their region 10% quicker rather than cutting the costs at all sites by 20%. Likewise, 42% (CI ±11%) of the respondents preferred that trial sites were best at having the first patients ready for inclusion right after site initiation visit compared to having good data entry, documentation, and reporting practice (25% [CI ±9%]), easily reachable site personnel and backup (23% [CI ±9%]), fast contractual procedure times (6% [CI ±5%]), a key opinion leader associated with the site (3% [CI ±4%]), and updated equipment and facilities (1% [CI ±2%]). In total, 75% [CI ±9%] agreed that their company would be interested in cooperating with an inexperienced trial site if the site had access to a large patient population and 52% [CI ±11%] had experienced that their company selected an inexperienced trial site in favor of an experienced site due to a higher level of interest and commitment. CONCLUSIONS:This study indicates that recruitment-related factors are pivotal to the pharmaceutical industry when assessing trial sites during site selection. Data quality-related factors seem highly valued especially in early phase trials whereas costs and investigator's publication track record are less important. Experience in conducting clinical trials is not imperative. However, this applies primarily to late phase trials.
| S-EPMC6907246 | biostudies-literature
Project description:In densely populated areas, surface waters are affected by many sources of pollution. Besides classical pollutants like nutrients and organic matter that lead to eutrophication, micropollutants from various point- and non-point sources are getting more attention by water quality managers. For cost-effective management an integrated assessment is needed that takes into account all relevant pollutants and all sources of pollution within a catchment. Due to the difficulty of identifying and quantifying sources of pollution and the need for considering long-term changes in boundary conditions, typically substantial uncertainty exists about the consequences of potential management alternatives to improve surface water quality. We therefore need integrated assessment methods that are able to deal with multiple objectives and account for various sources of uncertainty. This paper aims to contribute to integrated, prospective water management by combining a) multi-criteria decision support methods to structure the decision process and quantify preferences, b) integrated water quality modelling to predict consequences of management alternatives accounting for uncertainty, and c) scenario planning to consider uncertainty from potential future climate and socio-economic developments, to evaluate the future cost-effectiveness of water quality management alternatives at the catchment scale. It aims to demonstrate the usefulness of multi-attribute value functions for water quality assessment to i) propagate uncertainties throughout the entire assessment procedure, ii) facilitate the aggregation of multiple objectives while avoiding discretization errors when using categories for sub-objectives, iii) transparently communicate the results. We show how to use such multi-attribute value functions for model-based decision support in water quality management. We showcase the procedure for the Mönchaltorfer Aa catchment on the Swiss Plateau. We evaluate ten different water quality management alternatives, including current practice, that tackle macro- and micropollutants from a wide spectrum of agricultural and urban sources. We evaluate costs and water quality effects of the alternatives under four different socio-economic scenarios for the horizon 2050 under present and future climate projections and visualize their uncertainty. While the performance of alternatives is catchment specific, the methods can be transferred to other places and other management situations. Results confirm the need for cross-sectoral coordination of different management actions and interdisciplinary collaboration to support the development of prospective strategies to improve water quality.
| S-EPMC6549934 | biostudies-literature
Project description:BackgroundThe objective of this study was to develop a rating tool for policy makers to prioritize breast cancer interventions in low- and middle- income countries (LMICs), based on a simple multi-criteria decision analysis (MCDA) approach. The definition and identification of criteria play a key role in MCDA, and our rating tool could be used as part of a broader priority setting exercise in a local setting. This tool may contribute to a more transparent priority-setting process and fairer decision-making in future breast cancer policy development.MethodsFirst, an expert panel (n = 5) discussed key considerations for tool development. A literature review followed to inventory all relevant criteria and construct an initial set of criteria. A Delphi study was then performed and questionnaires used to discuss a final list of criteria with clear definitions and potential scoring scales. For this Delphi study, multiple breast cancer policy and priority-setting experts from different LMICs were selected and invited by the World Health Organization. Fifteen international experts participated in all three Delphi rounds to assess and evaluate each criterion.ResultsThis study resulted in a preliminary rating tool for assessing breast cancer interventions in LMICs. The tool consists of 10 carefully crafted criteria (effectiveness, quality of the evidence, magnitude of individual health impact, acceptability, cost-effectiveness, technical complexity, affordability, safety, geographical coverage, and accessibility), with clear definitions and potential scoring scales.ConclusionsThis study describes the development of a rating tool to assess breast cancer interventions in LMICs. Our tool can offer supporting knowledge for the use or development of rating tools as part of a broader (MCDA based) priority setting exercise in local settings. Further steps for improving the tool are proposed and should lead to its useful adoption in LMICs.
| S-EPMC4031156 | biostudies-literature
Project description:BackgroundDuring wildfire smoke episodes, school and childcare facility staff and those who support them rely upon air quality data to inform activity decisions. Where ambient regulatory monitor data is sparse, low-cost sensors can help inform local outdoor activity decisions, and provide indoor air quality data. However, there is no established protocol for air quality decision-makers to use sensor data for schools and childcare facilities. To develop practical, effective toolkits to guide the use of sensors in school and childcare settings, it is essential to understand the perspectives of the potential end-users of such toolkit materials.MethodsWe conducted 15 semi-structured interviews with school, childcare, local health jurisdiction, air quality, and school district personnel regarding sensor use for wildfire smoke response. Interviews included sharing PM2.5 data collected at schools during wildfire smoke. Interviews were transcribed and transcripts were coded using a codebook developed both a priori and amended as additional themes emerged.ResultsThree major themes were identified by organizing complementary codes together: (1) Low-cost sensors are useful despite data quality limitations, (2) Low-cost sensor data can inform decision-making to protect children in school and childcare settings, and (3) There are feasibility and public perception-related barriers to using low-cost sensors.ConclusionsInterview responses provided practical implications for toolkit development, including demonstrating a need for toolkits that allow a variety of sensor preferences. In addition, participants expected to have a wide range of available time for monitoring, budget for sensors, and decision-making types. Finally, interview responses revealed a need for toolkits to address sensor uses outside of activity decisions, especially assessment of ventilation and filtration.
| S-EPMC10626666 | biostudies-literature
Project description:Sea-level rise (SLR) is not just a future trend; it is occurring now in most coastal regions across the globe. It thus impacts not only long-range planning in coastal environments, but also emergency preparedness. Its inevitability and irreversibility on long time scales, in addition to its spatial non-uniformity, uncertain magnitude and timing, and capacity to drive non-stationarity in coastal flooding on planning and engineering timescales, create unique challenges for coastal risk-management decision processes. This review assesses past United States federal efforts to synthesize evolving SLR science in support of coastal risk management. In particular, it outlines the: (1) evolution in global SLR scenarios to those using a risk-based perspective that also considers low-probability but high-consequence outcomes, (2) regionalization of the global scenarios, and (3) use of probabilistic approaches. It also describes efforts to further contextualize regional scenarios by combining local mean sea-level changes with extreme water level projections. Finally, it offers perspectives on key issues relevant to the future uptake, interpretation, and application of sea-level change scenarios in decision-making. These perspectives have utility for efforts to craft standards and guidance for preparedness and resilience measures to reduce the risk of coastal flooding and other impacts related to SLR.
| S-EPMC7359874 | biostudies-literature
Project description:BackgroundMigraine is the world's second most common disabling disorder, affecting 15% of UK adults and costing the UK over £1.5 billion per year. Several costly new drugs have been approved by National Institute for Health and Care Excellence.AimTo assess the cost-effectiveness of drugs used to treat adults with chronic migraine.MethodsWe did a systematic review of placebo-controlled trials of preventive drugs for chronic migraine. We then assessed the cost-effectiveness of the currently prescribable drugs included in the review: Onabotulinum toxin A (BTA), Eptinezumab (100mg or 300mg), Fremanezumab (monthly or quarterly dose), Galcanezumab or Topiramate, each compared to placebo, and we evaluated them jointly. We developed a Markov (state-transition) model with a three-month cycle length to estimate the costs and quality-adjusted life years (QALYs) for the different medications from a UK NHS and Personal Social Services perspective. We used a two-year time horizon with a starting age of 30 years for the patient cohort. We estimated transition probabilities based on monthly headache days using a network meta-analysis (NMA) developed by us, and from published literature. We obtained costs from published sources and applied discount rates of 3.5% to both costs and outcomes.ResultsDeterministic results suggest Topiramate was the least costly option and generated slightly more QALYs than the placebo, whereas Eptinezumab 300mg was the more costly option and generated the most QALYs. After excluding dominated options, the incremental cost-effectiveness ratio (ICER) between BTA and Topiramate was £68,000 per QALY gained and the ICER between Eptinezumab 300mg and BTA was not within plausible cost-effectiveness thresholds. The cost-effectiveness acceptability frontier showed that Topiramate is the most cost-effective medication for any amount the decision maker is willing-to-pay per QALY.ConclusionsAmong the various prophylactic medications for managing chronic migraine, only Topiramate was within typical cost-effectiveness threshold ranges. Further research is needed, ideally an economic evaluation alongside a randomised trial, to compare these newer, expensive CGRP MAbs with the cheaper oral medications.
| S-EPMC10696771 | biostudies-literature