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181. A Study of Interactions between Pharmaceutical Representatives and Ophthalmology Trainees. (PubMed)

A Study of Interactions between Pharmaceutical Representatives and Ophthalmology Trainees. To evaluate the behavior and attitudes among ophthalmology trainees toward pharmaceutical promotions.Questionnaire survey.A questionnaire on behavior and attitudes toward interactions with pharmaceutical representatives was distributed to 110 ophthalmology residency programs in the United States. Responses were collected and analyzed.One hundred and twenty-two responses were received. Most (87 (...) %) respondents reported seeing pharmaceutical representatives visiting their program at least once every 1 to 2 months. Most respondents reported having accepted gifts from them. Although only 26% of trainees have changed prescribing behavior based on information provided by pharmaceutical representatives, 77% did so because of available medicine samples. Trainees tended to consider their peers more susceptible than themselves to the influence of pharmaceutical promotions. When asked to rate their agreement

2009 American Journal of Ophthalmology

182. Prescribers and Pharmaceutical Representatives: Why Are We Still Meeting? (Full text)

Prescribers and Pharmaceutical Representatives: Why Are We Still Meeting? Research suggests that pharmaceutical marketing influences prescribing and may cause cognitive dissonance for prescribers. This work has primarily been with physicians and physician-trainees. Questions remain regarding why prescribers continue to meet with pharmaceutical representatives (PRs).To describe the reasons that prescribers from various health professions continue to interact with PRs despite growing evidence (...) interactions such that their own prescribing is not adversely impacted. Prescribers describe few specific strategies or policies for these interactions, and report that policies are not consistently implemented with all members of a clinic or institution. Some prescribers perceive an inherent contradiction between academic centers and national societies receiving money from pharmaceutical companies, and then recommending restriction at the level of the individual prescriber. Prescribers with different

2009 Journal of General Internal Medicine PubMed

183. Economic evaluations of pre- and post-exposure prophylaxis for HIV

represent value for money (22), and are intended to inform decisions (23). The measures used in economic evaluations are costs and outcomes (23). In any given health intervention, economic evaluation makes explicit the resources consumed (i.e. cost), as well as the outcomes (i.e. benefits and/or drawbacks) produced by the intervention (6). These costs and outcomes are evaluated relative to alternative strategies that can be used with the same available resources (6). Economic evaluation is defined (...) benefits in terms of the general impact on well-being, or “utilities”). A common measure of utility is the quality-adjusted life year (QALY), which combines the estimated quantity of life years that are gained or saved as a result of a health intervention, with some judgment as to the quality of those years (6). Cost-utility analysis is somewhat more sophisticated than cost-effectiveness analysis as it is able to compare very different health programs to one another, such as surgical, pharmaceutical

2019 Ontario HIV Treatment Network

184. Guidelines on Management of Dyspnea (Breathlessness) in Patients with Cancer

, benzodiazepines, and corticosteroids. For malignant pleural effusion it covers thoracentesis with drainage, and pleurodesis; diuretics are not recommended. Other guidelines specifically on malignant pleural effusion provide more detailed guidance on this topic and are discussed in a subsequent section of this evidence summary. It does not cover radiotherapy or other non-pharmaceutical approaches. The German S3 guideline on palliative care in incurable cancer [10] focuses on seven topics, including (...) ]. They indicate that oxygen is a treatment for hypoxemia, not breathlessness. Other treatments such as opioids or non-pharmaceutical treatments such as fan therapy should be used for dyspnea if the patient is non-hypoxemic. Palliative oxygen along with formal assessment of its effect may on occasion be considered by a specialist team for patients unresponsive to all other therapies. The NICE guideline [16] deals with care in the last days of life and is not specific to patients with cancer; however, patients

2019 Cancer Care Ontario

185. Programmatic management of latent tuberculosis infection in the European Union

of LTBI management. Representatives of the EU/EEA Member States and additional stakeholders in the field of TB were consulted by means of a modified Delphi approach, with three rounds. First, a questionnaire was sent out to collect opinions on LTBI management. The collected information served as input for the two subsequent interactive discussion rounds which were conducted during a workshop meeting. At the workshop, the experts discussed elements to be considered when introducing programmatic (...) . A comprehensive, deterministic TB transmission model for four European Union countries (the Netherlands, the Czech Republic, Portugal, and Spain) was developed. The model accounts for transmission within and between the general population and different target risk groups (i.e. migrants from TB high-endemic countries, homeless people, people who inject drugs, and prisoners.) The quantified model was used to predict the impact of different LTBI screening and treatment strategies in the four representative

2019 European Centre for Disease Prevention and Control - Public Health Guidance

186. France has delisted anti-dementia agents

HECK -The Informed Prescriber Translated from the Editorial in Med Check-TIP (in Japanese) Nov 2018 ; 18 (127) process, the board decided on the expulsion. Based on the minimum number stipulated by the Articles of Association, six board members are enough to run the board. However, if at least 13 members are needed as explained in Cochrane’s website (now it has been changed), the current board is illegitimate. Moreover, the current governing board does not represent the opinions of the entire (...) the criteria will be removed from the full membership list. Med Check-TIP fulfills it. Now it is clear that the information independent of pharmaceutical companies is reliable. What is important is not simply the transparency, but the fact that conflict of interest distorts scientific information. If conflict of interest is not eliminated, Cochrane will no longer be trusted by patients and medical professionals. We support the views of Dr. Gøtzsche and the ISDB Committee that the current board should

2019 Med Check - The Informed Prescriber

187. From innovation to implementation: team science two years on

From innovation to implementation: team science two years on From innovation to implementation: team science two years on February 2019The Academy of Medical Sciences is the independent body in the UK representing the diversity of medical science. Our mission is to promote medical science and its translation into benefits for society. The Academy’s elected Fellows are the United Kingdom’s leading medical scientists from hospitals, academia, industry and the public service. We work with them (...) to promote excellence, influence policy to improve health and wealth, nurture the next generation of medical researchers, link academia, industry and the NHS, seize international opportunities and encourage dialogue about the medical sciences. Opinions expressed in this report do not necessarily represent the views of all participants at the event, the Academy of Medical Sciences, or its Fellows. All web references were accessed in February 2019 This work is © The Academy of Medical Sciences

2019 Academy of Medical Sciences

188. Delivering novel therapies in the 21st century

months of dosing. Modelling indicates that a 60% reduction in mHTT in the cerebrospinal fluid represents a 70 – 85% reduction in brain mHTT in the cerebral cortex, and a 35 – 50% reduction in the caudate tissue. This mHTT reduction in cerebrospinal fluid is greater than that required to reverse symptoms in animal models, making RG6042 a promising therapeutic for treatment of Huntington’s disease. This is the first demonstration of ASO-mediated protein suppression in the CNS of patients (...) and rapid production of different product types. • High costs of scaling up can halt the manufacture process, but scaling solutions can be found in the chemical industry. “Manufacturing to order is likely to become the norm for novel therapies, rather than manufacturing to stock.” Dr Nicholas Medcalf, UKRI “Autologous therapies are the ultimate challenge, and their fantastic clinical results represent a paradigm shift.” Keith Thompson, Cell and Gene Therapy Catapult “Start-ups, biotechnology companies

2019 Academy of Medical Sciences

189. Horizon scanning: what's next for medical and health research?

Horizon scanning: what's next for medical and health research? Horizon Scanning – research and innovation to transform the health of society by 2048 Findings from a survey and series of workshops held in 2017/18 The Academy of Medical Sciences 2 The Academy of Medical Sciences The Academy of Medical Sciences is the independent body in the UK representing the diversity of medical science. Our mission is to promote medical science and its translation into benefits for society. The Academy’s (...) elected Fellows are the United Kingdom’s leading medical scientists from hospitals, academia, industry and the public service. We work with them to promote excellence, influence policy to improve health and wealth, nurture the next generation of medical researchers, link academia, industry and the NHS, seize international opportunities and encourage dialogue about the medical sciences. Opinions expressed in this report do not necessarily represent the views of all participants at the event

2019 Academy of Medical Sciences

190. Preoperative or Postoperative Therapy for the Management of Patients with Stage II or III Rectal Cancer

In general, the six RCTs included in this review were of high quality (See Appendix 1). None of the five trials that reported the source of funding was funded by pharmaceutical companies (5,6,20,28,31). Adequate randomization methods were described in five trials (5,6,20,28,31) and were not reported in one trial (29). Sauer et al (31) reported significantly more patients with tumours 5 cm or less from the anal verge in the preoperative therapy group compared with the postoperative therapy group (...) target sample size calculations and statistical power to detect a significant difference in outcome between treatment groups (9,16,19,22,25,26,29,32,33,35,37,39,40,45,46). Method of randomization was often not reported, particularly in older studies. Six studies also included patients with colon tumours or patients with stage I disease (22,27,29,30,35,37); therefore, data extracted for the purpose of this review represents subgroup analyses for these studies. It is likely that the majority

2019 Cancer Care Ontario

192. Individualised funding interventions to improve health and social care outcomes for people with a disability

to the latter, some control group participants were randomly assigned, some did not wish to leave traditional services, whilst others were on a waiting list to avail of individualised funding. Furthermore, the study designs were heavily influenced by country-specific, and changing economic and policy landscapes. Therefore, a narrative analysis of quantitative data was considered the approach which would best represent the results. Narrative systematic reviews serve several functions including reporting (...) titles originally identified, 7,158 were independently double screened based on ‘title / abstract’ and a subsequent 328 full-text articles were doubled screened. In total, 73 studies met the inclusion criteria and were included in the review, 66 (90%) of which were qualitative in nature. 10 The Campbell Collaboration | www.campbellcollaboration.org Quantitative Seven unique studies contained eligible quantitative data (including three mixed methods) and were included in the review, representing

2019 Campbell Collaboration

193. Health Care Support Workers Administering Inactivated Influenza, Shingles and Pneumococcal Vaccines for Adults and Live Attenuated Influenza Vaccine (LAIV) for Children

medical practice. London: GMC. Available at: www.gmc- uk.org/guidance/good_medical_practice.asp General Pharmaceutical Council (2017) Standards for pharmacy professionals. London: GPhC. Available at: www.pharmacyregulation. org/spp Health and Care Professions Council (2016) Standards of conduct, performance and ethics. London: HCPC. Available at: www.hcpc-uk. org/standards/standards-of-conduct- performance-and-ethics Human Medicines Regulations 2012. The Stationery Office. Available at: www (...) - for-doctors/delegation-and-referral NHS Wales. Developing Excellence in Healthcare: An NHS Wales Skills and Career Framework for Clinical Healthcare Support Workers. Online resource. Available at: www.nhswalesdevelopinghealthcare.com/ Royal College of Nursing. Medicines management. Online resource. Available at: www.rcn.org.uk/clinical-topics/medicines- management Royal Pharmaceutical Society (2018) Professional guidance on the safe and secure handling of medicines. London: RPS. Available

2019 Royal College of Nursing

194. Management of opioid use disorders: a national clinical practice guideline

structured literature searches as needed to address committee feedback. Differences in opinion or interpretation with regard to the guideline recommendations or the evidence review were resolved through facilitated discussions in regional committee teleconferences or direct communication. A final decision was reached for all cases without the need for arbi- tration. Following the two rounds of committee review, two inter- national experts and two organizations representing people affected by opioid use (...) disorders reviewed and provided input on the final draft. Management of competing interests This guideline was entirely funded through the CIHR-funded CRISM network and without pharmaceutical industry support. Competing interests were assessed using the Guidelines International Net- work’s Principles for Disclosure of Interests and Management of Conflicts in Guidelines. 15 No current or ongoing direct competing interests were disclosed by the 43 members of the review commit- tee or the four CRISM

2018 CPG Infobase

195. Simplified guideline for prescribing medical cannabinoids in primary care

Review Group performed a detailed systematic review of 4 clinical areas with the best evidence around cannabinoids: pain, nausea and vomiting, spasticity, and adverse events. Nine health professionals (2 generalist family physicians, 2 pain management–focused family physicians, 1 inner-city family physician, 1 neurologist, 1 oncologist, 1 nurse practitioner, and 1 pharmacist) and a patient representative comprised the Prescribing Guideline Committee (PGC), along with 2 nonvoting members (pharmacist (...) , and location to represent a variety of key stakeholders (particularly primary care) from across the country, as well as on the absence of financial conflicts of interest. ? Although cannabinoids have been promoted for an array of medical conditions, the evidence base is challenged by bias and a lack of high-level research. Two large evidence synopses suggested that only 3 conditions have an adequate volume of evidence to inform prescribing recommendations: chronic pain, nausea and vomiting, and spasticity

2018 CPG Infobase

196. Pharmacological management of migraine

month. This group of patients is very small and it was increasingly recognised that this definition did not represent the majority of patients with chronic headache evolving from episodic migraine. The majority of patients with chronic migraine have background headache with superimposed migraine attacks. A consensus statement was produced in 2007 with a new definition of chronic migraine and this has been used in all subsequent studies on chronic migraine. 16 Chronic migraine is now defined (...) of shared decision making with the patient, covering the diagnostic and treatment choices available. It is advised, however, that significant departures from the national guideline or any local guidelines derived from it should be documented in the patient’s medical records at the time the relevant decision is taken. 1.3.1 INFLUENCE OF FINANCIAL AND OTHER INTERESTS It has been recognised that financial interests in, or close working relationships with, pharmaceutical companies may have an influence

2018 SIGN

197. Management of stable angina

departures from the national guideline or any local guidelines derived from it should be documented in the patient’s medical records at the time the relevant decision is taken. 1.3.1 INFLUENCE OF FINANCIAL AND OTHER INTERESTS It has been recognised that financial interests in, or close working relationships with, pharmaceutical companies may have an influence on the interpretation of evidence from clinical studies. It is not possible to completely eliminate any possible bias from this source, nor even (...) Scientist, Healthcare Improvement Scotland Mr Gordon Sneddon Lay representative, Forfar Mr Iain Speirits Advanced Pharmacist, Clinical Cardiology, West Glasgow Ambulatory Care Hospital Dr John Stout General Practitioner, Peterhead Professor Vipin Zamvar Consultant Surgeon, Royal Infirmary of Edinburgh The membership of the guideline development group was confirmed following consultation with the member organisations of SIGN. All members of the guideline development group made declarations of interest

2018 SIGN

198. Antidepressants versus placebo for panic disorder in adults. (PubMed)

Antidepressants versus placebo for panic disorder in adults. Panic disorder is characterised by repeated, unexpected panic attacks, which represent a discrete period of fear or anxiety that has a rapid onset, reaches a peak within 10 minutes, and in which at least four of 13 characteristic symptoms are experienced, including racing heart, chest pain, sweating, shaking, dizziness, flushing, stomach churning, faintness and breathlessness. It is common in the general population with a lifetime (...) of this review.Limitations in results include funding of some studies by pharmaceutical companies, and only assessing short-term outcomes.Data from the present review will be included in a network meta-analysis of psychopharmacological treatment in panic disorder, which will hopefully provide further useful information on this issue.

2018 Cochrane

199. Canadian stroke best practice recommendations: secondary prevention of stroke, sixth edition practice guidelines

term are at increased risk for cardiovascular events over the long term. 3 Therefore, the opportunity to reduce the risk of recurrent strokes through aggres- sive vascular risk factor reduction e?orts represent a signi?cant opportunity to lower the total stroke burden. The Canadian Stroke Best Practice Recommendations have been developed to provide up-to-dateevidence-basedguidelinesfortheprevention and management of stroke, to promote optimal recov- ery and reintegration for people who have

2018 CPG Infobase

200. Systemic treatments for metastatic cutaneous melanoma. (PubMed)

with chemotherapy. In many cases, trials were sponsored by pharmaceutical companies producing the tested drug: this was especially true for new classes of drugs, such as immune checkpoint inhibitors and small-molecule targeted drugs.When compared to single agent chemotherapy, the combination of multiple chemotherapeutic agents (polychemotherapy) did not translate into significantly better survival (overall survival: HR 0.99, 95% CI 0.85 to 1.16, 6 studies, 594 participants; high-quality evidence; progression (...) as the common comparator and currently approved treatments for which high- to moderate-quality evidence of efficacy (as represented by treatment effect on progression-free survival) was available (based on the above results) for: biochemotherapy (with both interferon-alpha and interleukin-2); anti-CTLA4 monoclonal antibodies; anti-PD1 monoclonal antibodies; anti-CTLA4 plus anti-PD1 monoclonal antibodies; BRAF inhibitors; MEK inhibitors, and BRAF plus MEK inhibitors. Analysis (which included 19 RCTs and 7632

2018 Cochrane

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