238 results
Search Results
2. Patterns of Clinical Trial Eligibility Criteria
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Milian, Krystyna, ten Teije, Annette, Bucur, Anca, van Harmelen, Frank, Hutchison, David, Series editor, Kanade, Takeo, Series editor, Kittler, Josef, Series editor, Kleinberg, Jon M., Series editor, Mattern, Friedemann, Series editor, Mitchell, John C., Series editor, Naor, Moni, Series editor, Nierstrasz, Oscar, Series editor, Pandu Rangan, C., Series editor, Steffen, Bernhard, Series editor, Sudan, Madhu, Series editor, Terzopoulos, Demetri, Series editor, Tygar, Doug, Series editor, Vardi, Moshe Y., Series editor, Weikum, Gerhard, Series editor, Goebel, Randy, editor, Siekmann, Jörg, editor, Wahlster, Wolfgang, editor, Riaño, David, editor, ten Teije, Annette, editor, and Miksch, Silvia, editor
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- 2012
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3. Poverty-alleviation programs in Tunisia: selection processes and targeting performance indicators at the regional level
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Nasri, Khaled
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- 2022
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4. Defining and quantifying population-level need for children's palliative care: findings from a rapid scoping review.
- Author
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Delamere, Tara, Balfe, Joanne, Fraser, Lorna K., Sheaf, Greg, and Smith, Samantha
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MEDICAL information storage & retrieval systems ,PALLIATIVE treatment ,RESEARCH funding ,POPULATION health ,HEALTH ,CINAHL database ,INFORMATION resources ,DESCRIPTIVE statistics ,SYSTEMATIC reviews ,MEDLINE ,LITERATURE reviews ,MEDICAL databases ,MEDICAL needs assessment ,NEEDS assessment ,PSYCHOLOGY information storage & retrieval systems - Abstract
Background: The number of children who require palliative care has been estimated to be as high as 21 million globally. Delivering effective children's palliative care (CPC) services requires accurate population-level information on current and future CPC need, but quantifying need is hampered by challenges in defining the population in need, and by limited available data. The objective of this paper is to summarise how population-level CPC need is defined, and quantified, in the literature. Methods: Scoping review performed in line with Joanna Briggs Institute methodology for scoping reviews and PRISMA-ScR guidelines. Six online databases (CINAHL, Cochrane Library, EMBASE, Medline, PsycINFO, and Web of Science), and grey literature, were searched. Inclusion criteria: literature published in English; 2008–2023 (Oct); including children aged 0–19 years; focused on defining and/or quantifying population-level need for palliative care. Results: Three thousand five hundred seventy-eight titles and abstracts initially reviewed, of which, 176 full-text studies were assessed for eligibility. Overall, 51 met the inclusion criteria for this scoping review. No universal agreement identified on how CPC need was defined in population-level policy and planning discussions. In practice, four key definitions of CPC need were found to be commonly applied in quantifying population-level need: (1) ACT/RCPCH (Association for Children with Life-Threatening or Terminal Conditions and their Families, and the Royal College of Paediatrics and Child Health) groups; (2) The 'Directory' of Life-Limiting Conditions; (3) 'List of Life-Limiting Conditions'; and (4) 'Complex Chronic Conditions'. In most cases, variations in data availability drove the methods used to quantify population-level CPC need and only a small proportion of articles incorporated measures of complexity of CPC need. Conclusion: Overall, greater consistency in how CPC need is defined for policy and planning at a population-level is important, but with sufficient flexibility to allow for regional variations in epidemiology, demographics, and service availability. Improvements in routine data collection of a wide range of care complexity factors could facilitate estimation of population-level CPC need and ensure greater alignment with how need for CPC is defined at the individual-level in the clinical setting. [ABSTRACT FROM AUTHOR]
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- 2024
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5. Inquiring into youth homelessness
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Fopp, Rodney and Ellis, Bob
- Published
- 1995
6. Does the addition of non-approved inclusion and exclusion criteria for rtPA impact treatment rates? Findings in Australia, the UK, and the USA
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Sandy Middleton, Dame Caroline Watkins, Elizabeth McInnes, Andrei V. Alexandrov, Elizabeth Lightbody, Anne W. Alexandrov, Victoria Swatzell, Fern Cudlip, Louise E. Craig, Helen Hamilton, Simeon Dale, Dominique A Cadilhac, and Sheeba Philip
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medicine.medical_specialty ,thrombolysis ,medicine.medical_treatment ,Computed tomography ,B700 ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Ischaemic stroke ,medicine ,survey ,Recombinant tissue plasminogen activator ,Original Paper ,medicine.diagnostic_test ,business.industry ,Stroke scale ,eligibility criteria ,Thrombolysis ,Inclusion and exclusion criteria ,recombinant tissue plasminogen activator ,Surgery ,Neurology (clinical) ,Cardiology and Cardiovascular Medicine ,business ,030217 neurology & neurosurgery - Abstract
Background: Strict criteria for recombinant tissue plasminogen activator (rtPA) eligibility are stipulated on licences for use in ischaemic stroke; however, practitioners may also add non-standard rtPA criteria. We examined eligibility criteria variation in 3 English-speaking countries including use of non-standard criteria, in relation to rtPA treatment rates. Methods: Surveys were mailed to 566 eligible hospitals in Australia (AUS), the UK, and the USA. Criteria were pre-classified as standard (approved indication and contraindications) or non-standard (approved warning or researcher “decoy”). Percentage for criterion selection was calculated/compared; linear regression was used to assess the association between use of non-standard criteria and rtPA treatment rates, and to identify factors associated with addition of non-standard criteria. Results: Response rates were 74% AUS, 65% UK, and 68% USA; mean rtPA treatment rates were 8.7% AUS, 12.7% UK, and 8.7% USA. Median percentage of non-standard inclusions was 33% (all 3 countries) and included National Institutes of Health Stroke Scale (NIHSS) scores > 4, computed tomography (CT) angiography documented occlusion, and favourable CT perfusion. Median percentage of non-standard exclusions was 25% AUS, 28% UK, and 60% USA, and included depressed consciousness, NIHSS > 25, and use of antihypertensive infusions. No AUS or UK sites selected 100% of standard exclusions. Conclusions: Non-standard criteria for rtPA eligibility were evident in all three countries and could, in part, explain comparably low use of rtPA. Differences in the use of standard criteria may signify practitioner intolerance for those derived from original efficacy studies that are no longer relevant.
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- 2019
7. Web-Based Information Infrastructure Increases the Interrater Reliability of Medical Coders: Quasi-Experimental Study
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Varghese, Julian, Sandmann, Sarah, and Dugas, Martin
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Original Paper ,Internet ,Non-Randomized Controlled Trials as Topic ,Clinical Coding ,Humans ,Reproducibility of Results ,eligibility criteria ,Unified Medical Language System ,health information interoperability ,Natural Language Processing - Abstract
Background Medical coding is essential for standardized communication and integration of clinical data. The Unified Medical Language System by the National Library of Medicine is the largest clinical terminology system for medical coders and Natural Language Processing tools. However, the abundance of ambiguous codes leads to low rates of uniform coding among different coders. Objective The objective of our study was to measure uniform coding among different medical experts in terms of interrater reliability and analyze the effect on interrater reliability using an expert- and Web-based code suggestion system. Methods We conducted a quasi-experimental study in which 6 medical experts coded 602 medical items from structured quality assurance forms or free-text eligibility criteria of 20 different clinical trials. The medical item content was selected on the basis of mortality-leading diseases according to World Health Organization data. The intervention comprised using a semiautomatic code suggestion tool that is linked to a European information infrastructure providing a large medical text corpus of >300,000 medical form items with expert-assigned semantic codes. Krippendorff alpha (Kalpha) with bootstrap analysis was used for the interrater reliability analysis, and coding times were measured before and after the intervention. Results The intervention improved interrater reliability in structured quality assurance form items (from Kalpha=0.50, 95% CI 0.43-0.57 to Kalpha=0.62 95% CI 0.55-0.69) and free-text eligibility criteria (from Kalpha=0.19, 95% CI 0.14-0.24 to Kalpha=0.43, 95% CI 0.37-0.50) while preserving or slightly reducing the mean coding time per item for all 6 coders. Regardless of the intervention, precoordination and structured items were associated with significantly high interrater reliability, but the proportion of items that were precoordinated significantly increased after intervention (eligibility criteria: OR 4.92, 95% CI 2.78-8.72; quality assurance: OR 1.96, 95% CI 1.19-3.25). Conclusions The Web-based code suggestion mechanism improved interrater reliability toward moderate or even substantial intercoder agreement. Precoordination and the use of structured versus free-text data elements are key drivers of higher interrater reliability.
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- 2018
8. Eligibility criteria in systematic reviews published in prominent medical journals: a methodological review.
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McCrae, Niall and Purssell, Edward
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META-analysis ,SYSTEMATIC reviews ,EVIDENCE-based medicine ,PERIODICAL articles ,IMPACT factor (Citation analysis) - Abstract
Rationale and aim Clear and logical eligibility criteria are fundamental to the design and conduct of a systematic review. This methodological review examined the quality of reporting and application of eligibility criteria in systematic reviews published in three leading medical journals. Methods All systematic reviews in the BMJ, JAMA and T he L ancet in the years 2013 and 2014 were extracted. These were assessed using a refined version of a checklist previously designed by the authors. Results A total of 113 papers were eligible, of which 65 were in BMJ, 17 in T he L ancet and 31 in JAMA. Although a generally high level of reporting was found, eligibility criteria were often problematic. In 67% of papers, eligibility was specified after the search sources or terms. Unjustified time restrictions were used in 21% of reviews, and unpublished or unspecified data in 27%. Inconsistency between journals was apparent in the requirements for systematic reviews. Conclusions The quality of reviews in these leading medical journals was high; however, there were issues that reduce the clarity and replicability of the review process. As well as providing a useful checklist, this methodological review informs the continued development of standards for systematic reviews. [ABSTRACT FROM AUTHOR]
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- 2015
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9. An Ensemble Learning Strategy for Eligibility Criteria Text Classification for Clinical Trial Recruitment: Algorithm Development and Validation
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Kun Zeng, Yingying Qu, Yibin Xu, and Zhiwei Pan
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020205 medical informatics ,Computer science ,Computer applications to medicine. Medical informatics ,R858-859.7 ,Health Informatics ,02 engineering and technology ,Eligibility criteria ,Machine learning ,computer.software_genre ,03 medical and health sciences ,Class imbalance ,0302 clinical medicine ,Health Information Management ,Ensemble learning ,0202 electrical engineering, electronic engineering, information engineering ,030212 general & internal medicine ,Macro ,Original Paper ,Recall ,business.industry ,Deep learning ,Clinical trial ,Text classification ,Artificial intelligence ,Gradient boosting ,business ,Encoder ,computer - Abstract
Background Eligibility criteria are the main strategy for screening appropriate participants for clinical trials. Automatic analysis of clinical trial eligibility criteria by digital screening, leveraging natural language processing techniques, can improve recruitment efficiency and reduce the costs involved in promoting clinical research. Objective We aimed to create a natural language processing model to automatically classify clinical trial eligibility criteria. Methods We proposed a classifier for short text eligibility criteria based on ensemble learning, where a set of pretrained models was integrated. The pretrained models included state-of-the-art deep learning methods for training and classification, including Bidirectional Encoder Representations from Transformers (BERT), XLNet, and A Robustly Optimized BERT Pretraining Approach (RoBERTa). The classification results by the integrated models were combined as new features for training a Light Gradient Boosting Machine (LightGBM) model for eligibility criteria classification. Results Our proposed method obtained an accuracy of 0.846, a precision of 0.803, and a recall of 0.817 on a standard data set from a shared task of an international conference. The macro F1 value was 0.807, outperforming the state-of-the-art baseline methods on the shared task. Conclusions We designed a model for screening short text classification criteria for clinical trials based on multimodel ensemble learning. Through experiments, we concluded that performance was improved significantly with a model ensemble compared to a single model. The introduction of focal loss could reduce the impact of class imbalance to achieve better performance.
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- 2020
10. El Salvador Financial Sector Assessment Program Update : Public Banks
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International Monetary Fund and World Bank
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RESERVE REQUIREMENTS ,NATIONAL TREASURY ,PUBLIC BANK ,PENSION FUNDS ,PRIVATE INVESTMENT ,LONG-TERM FUNDING ,CREDIT GUARANTEE ,DEPOSIT ,EXTERNALITIES ,EMPLOYMENT ,LOAN DEFAULTS ,FINANCIAL SECTOR ASSESSMENT ,UNEMPLOYMENT ,RECESSION ,FEDERAL RESERVE ,LIQUIDATIONS ,CREDIT ANALYSIS ,BANK LOAN ,LENDER OF LAST RESORT ,FINANCIAL INTERMEDIARIES ,LOAN APPLICATIONS ,RETURNS ,COLLATERAL ,PENSION ,FINANCIAL MARKET ,NON-PERFORMING LOANS ,CREDIT CONSTRAINED FIRMS ,CREDIT LINES ,FINANCIAL SYSTEMS ,EQUITY INVESTMENTS ,DEVELOPMENT BANKS ,FARMERS ,FINANCIAL AUTHORITIES ,RETAIL BANKS ,MORTGAGE ,FINANCIAL MARKETS ,LONG TERM FINANCING ,NPL ,ACCOUNTING TREATMENT ,EMERGING ECONOMIES ,CREDIT RISKS ,DEPOSITS ,INSTITUTIONAL CAPACITY ,ISSUANCES ,CREDITORS ,GUARANTOR ,STATE OWNED BANKS ,ADMINISTRATIVE COSTS ,CORPORATE GOVERNANCE ,BUSINESS STRATEGIES ,PRIVATE FINANCIAL SECTOR ,INTEREST EXPENSE ,BALANCE SHEET ,LEGAL CONSTRAINTS ,MONETARY POLICY ,SMALL BANK ,FOREIGN BANKS ,PRIVATE EQUITY ,DIRECT FINANCING ,LIQUIDITY ,CREDIT LIMITS ,INTEREST RATES ,CREDIT RISK ,MARKET FAILURE ,LOAN SIZE ,GUARANTEE SCHEMES ,RESERVE ACCOUNTS ,FINANCIAL SERVICES ,PROFITABILITY ,CONVERTIBLE DEBENTURES ,LOAN PORTFOLIO ,DISBURSEMENTS ,MICROCREDIT ,INVESTMENT PROJECTS ,EMPLOYEE ,FINANCIAL SUSTAINABILITY ,BANKRUPTCY ,COOPERATIVE BANKS ,LENDERS ,LENDER ,CONSOLIDATION ,RETURN ON ASSETS ,DERIVATIVES ,CAPITAL MARKETS ,COLLECTION PROCESSES ,CREDIT PROCESS ,CREDIT PROVISION ,FINANCIAL SYSTEM ,LEGAL PROVISIONS ,BUSINESS PLAN ,FINANCIAL INSTITUTIONS ,EQUIPMENT ,TELECOMMUNICATIONS ,BANKING SERVICES ,DIVERSIFICATION ,CREDIT PORTFOLIO ,BANKS ,CREDIT GUARANTEES ,STUDENT LOANS ,DEBT FINANCING ,LOAN ,MUTUAL FUNDS ,BANK CREDIT ,FINANCIAL DEVELOPMENT ,STATE INTERVENTION ,GUARANTEE FUNDS ,SECURITIES ,MARKET INTEREST RATE ,MICROFINANCE ,ACCESS TO CAPITAL ,MARKET FAILURES ,CREDIT HISTORY ,CENTRAL BANKS ,COOPERATIVES ,DEVELOPMENT BANK ,SUBSIDIARY ,HOUSING ,LOW INTEREST RATES ,CAPITALIZATION ,FINANCIAL PERFORMANCE ,RETURN ON EQUITY ,CORRUPTION ,LENDING PORTFOLIO ,ECONOMIES OF SCALE ,FINANCIAL LIABILITIES ,PRIVATE CREDITORS ,SOCIAL CAPITAL ,FINANCIAL PLAYERS ,PUBLIC BANKS ,SMALL LOANS ,TRANSACTION COST ,PRIVATIZATIONS ,ACCOUNTABILITY ,FISCAL LOSSES ,RISK WEIGHTED ASSETS ,CREDIT ENHANCEMENTS ,NET INTEREST MARGIN ,BANKING SYSTEM ,ECONOMIC GROWTH ,OPERATING EXPENSES ,PENSION FUND ,GROSS DOMESTIC PRODUCT ,INTERMEDIARY BANKS ,BRANCH NETWORK ,TRANSACTION COSTS ,OUTSTANDING LOAN ,MATURITIES ,TECHNICAL ASSISTANCE ,RISK AVERSION ,EARNING ASSETS ,PRIVATE COMMERCIAL BANKS ,TIER 1 CAPITAL ,MANDATES ,PARTIAL CREDIT ,ASSET QUALITY ,FINANCIAL CRISIS ,LONG-TERM CAPITAL ,AUDITING ,PLEDGE COLLATERAL ,GOVERNANCE STANDARDS ,RISK MANAGEMENT ,SECURITIES ISSUANCE ,COMMERCIAL PAPER ,CREDIT INSTITUTIONS ,GUARANTEE FUND ,SOLVENCY ,FUNDING SOURCE ,CREDIT PROCESSES ,BORROWER ,INTERNATIONAL MARKETS ,GUARANTIES ,LONG-TERM FINANCE ,DEBT ,ASYMMETRIC INFORMATION ,BANKING SECTOR ,NON-PERFORMING LOAN ,CAPITAL ADEQUACY ,CREDITS ,FINANCIAL PRODUCTS ,ACCESS TO FINANCE ,RETURN ,MARKET DISCIPLINE ,FACTORING ,CAPITAL MARKET ,COLLATERAL REQUIREMENTS ,CREDIT CRUNCH ,NATIONAL CREDIT ,CREDIBILITY ,FOREIGN EXCHANGE ,PRIVATE BANKS ,INSURED DEPOSITS ,BUSINESS PLANS ,LINES OF CREDIT ,ACCOUNTING ,FINANCES ,COMMERCIAL BANK ,INTEREST RATE CEILINGS ,MARKET DEVELOPMENT ,BANK FINANCING ,DIRECT CREDIT ,PRUDENTIAL REGULATION ,FINANCIAL STABILITY ,INSURANCE ,SOCIAL DEVELOPMENT ,TREASURY ,AGRICULTURAL SECTOR ,INTERNATIONAL BANKS ,FINANCIAL INSTITUTION ,MARKET INTEREST RATES ,ACCESS TO CREDIT ,INTERNATIONAL BANK ,MONETARY FUND ,EQUITY FUNDS ,INVESTMENT BANK ,AGRICULTURAL PRODUCTS ,LINE OF CREDITS ,CAPITAL FINANCE ,ELIGIBILITY CRITERIA ,BLUE CHIP ,INTEREST INCOME ,LEVY ,LIQUID ASSETS ,SUBSIDIARIES ,TRUST FUNDS ,CREDIT ORIGINATION ,INTEREST RATE ,OPERATING COSTS - Abstract
The global financial crisis and ensuing credit crunch has revived the discussion on the role of public sector in the financial system around the world and in El Salvador, authorities have announced plans to step up their activities. A clearly defined strategy for the public banks, focused on complementing private sector activity, is necessary as their activities expand to improve access to finance and diversify the sources of funding. Any process of growth needs to accompany by improvement in risk management processes, governance arrangements and enhanced supervision. Going forward, the two public retail banks should increase their specialization in different market segments. The development bank role can be enhanced while maintaining its second tier status. To make the guarantee funds effective, in addition to scale their size, several operational features need to be improved.
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- 2010
11. Research Methodology
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Gani, Mohammad Osman, Faroque, Anisur R., Takahashi, Yoshi, Gani, Mohammad Osman, Faroque, Anisur R., and Takahashi, Yoshi
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- 2023
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12. Review of the Performance Metrics for Natural Language Systems for Clinical Trials Matching.
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Jeongeun Kim and Quintana, Yuri
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Natural Language Processing (NLP) has been adopted widely in clinical trial matching for its ability to process unstructured text hat is often found in electronic health records. Despite the rise n the new tools that use NLP to match patients to eligible clinical rials, the comparison of these tools is difficult due to the lack of consistency in how these tools are evaluated. The ground truth or eference that the tools use to assess results varies, making it difficult to compare the robustness of the tools against each other. This paper alarms the lack of definition and consistency of ground truth data used to evaluate such tools and suggests two ways to define a gold standard for the ground truth in small and arge-scale studies. [ABSTRACT FROM AUTHOR]
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- 2022
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13. DEFINING ELIGIBILITY CRITERIA FOR FUNDING POLICIES AROUND IN VITRO FERTILIZATION.
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Menon, Devidas, Nardelli, Alexa A., Motan, Tarek, Klein, Kristin, and Stafinski, Tania
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Objectives: This review aims to assess the state of the science around the potential impact of certain patient characteristics on the safety and effectiveness of in vitro fertilization (IVF).Methods: Following Cochrane Collaboration guidelines and the PRISMA statement, a comprehensive systematic review of reviews and recent primary studies examining the impact of paternal age and maternal age, smoking, and body mass index (BMI) on the safety and effectiveness of IVF was performed. Papers, published between January 2007 and June 2014, were independently reviewed and critically appraised by two researchers using published quality assessment tools for reviews and primary studies. Due to heterogeneity across papers (different study designs and patient selection criteria), a qualitative analysis of extracted information was performed.Results: Seventeen papers (ten systematic reviews and seven primary studies) were included. They comprised evidence from retrospective observational studies in which maternal age, BMI, and smoking status were explored as part of secondary analyses of larger studies. The majority of papers found that the likelihood of achieving a pregnancy was lower among women who were >40 years, had a BMI ≥ 25 and smoked. Advanced maternal age and BMI were also associated with higher rates of preterm birth and low birth weight.Conclusions: Based on available evidence, it may be appropriate to consider "maternal age" and "morbid obesity" in public funding policies that aim to maximize the effectiveness of IVF. However, given inconsistencies in the effect of smoking across different pregnancy-related outcomes, support for incorporating it into funding conditions appears weak. [ABSTRACT FROM AUTHOR]- Published
- 2015
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14. Review of the Performance Metrics for Natural Language Systems for Clinical Trials Matching.
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Jeongeun Kim and Quintana, Yuri
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STATISTICS ,CLINICAL trials ,NATURAL language processing ,RESEARCH methodology ,PATIENT selection ,CONFERENCES & conventions ,MACHINE learning ,ELIGIBILITY (Social aspects) ,LITERATURE reviews ,DATA analysis - Abstract
Natural Language Processing (NLP) has been adopted widely in clinical trial matching for its ability to process unstructured text that is often found in electronic health records. Despite the rise in the new tools that use NLP to match patients to eligible clinical trials, the comparison of these tools is difficult due to the lack of consistency in how these tools are evaluated. The ground truth or reference that the tools use to assess results varies, making it difficult to compare the robustness of the tools against each other. This paper alarms the lack of definition and consistency of ground truth data used to evaluate such tools and suggests two ways to define a gold standard for the ground truth in small and large-scale studies. [ABSTRACT FROM AUTHOR]
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- 2021
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15. Public Assistance Eligibility and the Well-Being of Poor People in China.
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Chan, Chak Kwan and Lei, Jie
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PUBLIC welfare ,POOR people ,WELL-being ,QUALITY of life ,ELIGIBILITY (Social aspects) ,STIGMATIZATION - Abstract
This study adopted content analysis to examine policy papers concerning the eligibility requirements of the Minimum Living Standard Scheme (MLSS) in China's 31 capital cities. It was found that local officials not only assess applicants’ assets and incomes, but also their living space, quality of home decoration, possession of luxury goods, leisure activities, and behavior. The local governments’ use of a lifestyle assessment approach is caused by financial constraints and the lack of an effective mechanism to check applicants’ incomes. The lifestyle approach leads to regional inequalities in accessing public assistance, because some of the terms, which define the quality of life, are too ambiguous. The lifestyle approach, which requires applicants to live in very poor living conditions and also demonstrate their hardship to local officials, will be a barrier preventing poor people from being integrated into their communities. This study suggests that the key words and terms in the policy documents need to be clearly explained and similar criteria should also be adopted across different regions. It also proposes that the gap between MLSS eligibility criteria in the policy papers and their actual implementation requires further study in order to understand the impact of special local factors and the quality of life of poor people in China. [ABSTRACT FROM AUTHOR]
- Published
- 2018
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16. Defining and quantifying population-level need for children’s palliative care: findings from a rapid scoping review
- Author
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Tara Delamere, Joanne Balfe, Lorna K. Fraser, Greg Sheaf, and Samantha Smith
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Palliative care ,Children ,Need ,Eligibility criteria ,Life-limiting conditions ,Life-threatening conditions ,Special situations and conditions ,RC952-1245 - Abstract
Abstract Background The number of children who require palliative care has been estimated to be as high as 21 million globally. Delivering effective children’s palliative care (CPC) services requires accurate population-level information on current and future CPC need, but quantifying need is hampered by challenges in defining the population in need, and by limited available data. The objective of this paper is to summarise how population-level CPC need is defined, and quantified, in the literature. Methods Scoping review performed in line with Joanna Briggs Institute methodology for scoping reviews and PRISMA-ScR guidelines. Six online databases (CINAHL, Cochrane Library, EMBASE, Medline, PsycINFO, and Web of Science), and grey literature, were searched. Inclusion criteria: literature published in English; 2008–2023 (Oct); including children aged 0–19 years; focused on defining and/or quantifying population-level need for palliative care. Results Three thousand five hundred seventy-eight titles and abstracts initially reviewed, of which, 176 full-text studies were assessed for eligibility. Overall, 51 met the inclusion criteria for this scoping review. No universal agreement identified on how CPC need was defined in population-level policy and planning discussions. In practice, four key definitions of CPC need were found to be commonly applied in quantifying population-level need: (1) ACT/RCPCH (Association for Children with Life-Threatening or Terminal Conditions and their Families, and the Royal College of Paediatrics and Child Health) groups; (2) The ‘Directory’ of Life-Limiting Conditions; (3) ‘List of Life-Limiting Conditions’; and (4) ‘Complex Chronic Conditions’. In most cases, variations in data availability drove the methods used to quantify population-level CPC need and only a small proportion of articles incorporated measures of complexity of CPC need. Conclusion Overall, greater consistency in how CPC need is defined for policy and planning at a population-level is important, but with sufficient flexibility to allow for regional variations in epidemiology, demographics, and service availability. Improvements in routine data collection of a wide range of care complexity factors could facilitate estimation of population-level CPC need and ensure greater alignment with how need for CPC is defined at the individual-level in the clinical setting.
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- 2024
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17. Meta-analysis of Pregnancy Events in Biomedical HIV Prevention Trials in Sub-Saharan Africa: Implications for Gender Transformative Trials
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Lorenzetti, Lara, Dinh, Nhi, Whitcomb, Cason, Martinez, Andres, Chatani, Manju, Lievense, Breanne, Nhamo, Definate, Slack, Catherine, Eley, Natalie, and MacQueen, Kathleen
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- 2024
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18. Exclusion of older patients from randomized clinical trials in Parkinson’s disease
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Kłosowska, Danuta, Fiszer, Urszula, Dulski, Jarosław, Górski, Andrzej, and Borysowski, Jan
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- 2024
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19. Eligibility and Readiness Criteria for Sex Reassignment Surgery: Recommendations for Revision of the WPATH Standards of Care.
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De Cuypere, Griet and Vercruysse, Herman
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GENDER affirmation surgery ,STANDARDS of care (Gender transition) ,GUIDELINES ,FOLLOW-up studies (Medicine) ,EVIDENCE-based medicine - Abstract
In a review of the literature on follow-up studies of sex reassignment surgery (SRS) with regard to regret, suicide, and prognosis, this article evaluates the eligibility and readiness criteria of the WPATH Standards of Care—Sixth Version. Because the literature shows a lack of high-quality follow-up studies on large numbers of operated transsexuals, it offers no evidence-based research above evidence Level B or Level C. Nevertheless, our review allows us to conclude that most of the eligibility criteria are evidence-based. Although psychiatric co-morbidity is consistently mentioned in the literature as a negative predictive factor, it is barely addressed in the eligibility and readiness criteria for SRS. Therefore this paper suggests some changes and a shift in emphasis in the eligibility and readiness criteria of the Standards of Care. [ABSTRACT FROM AUTHOR]
- Published
- 2009
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20. Transparency in Cognitive Training Meta-analyses: A Meta-review
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Sandoval-Lentisco, Alejandro, López-Nicolás, Rubén, Tortajada, Miriam, López-López, José Antonio, and Sánchez-Meca, Julio
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- 2024
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21. NHS funded fertility treatment – a national service in name only?
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O'donnell, Claire, Manché, Marioth, Kingsland, Charles, Haddad, Nabil, and Brickwood, Paul
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MEDICAL care ,FERTILITY ,NATIONAL service ,CHILDLESSNESS ,HEALTH facilities ,HEALTH ,FINANCE - Abstract
Abstract The variable nature of NHS provision of fertility services has again been highlighted by the response of commissioners to the recent guidance from the National Institute of Clinical Excellence. This paper describes an evidence-based model for policy aimed at minimising inequity across one Strategic Health Authority. The paper highlights the difficulties resulting from the current Department of Health guidance on targeting those in greatest need. A different way of describing this group is proposed, namely, defining childlessness in terms of parental status alone. This is clear to both patient and clinician at the outset, not subject to variable interpretation and because it is quantifiable for any given population, facilitates the commissioning of a level of service provision that reflects expressed need. A clinical audit suggests that the annual incidence of fertility problems prompting attendance at secondary care clinics is similar to levels observed nearly 20 years ago, at around 98 per 10,000 of the fertile population (proxy denominator, women aged 25  –  39). Our model further indicates that, for the more complex treatments, if both partners were required to be childless and treatments were to be delivered within 12  –  18 months of listing, commissioners would need to fund treatment for around 15  –  20 patients per 10,000 of the fertile population. If only one partner was required to be childless this figure would rise by 15  –  20%. We argue that despite the clinical guidelines, fertility treatments will remain a ‘postcode lottery’ unless central government addresses the priority to be given to fertility treatment on a national basis. [ABSTRACT FROM AUTHOR]
- Published
- 2005
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22. Medicaid 1915(c) Home and Community-Based Services Waivers: A National Survey of Eligibility Criteria, Caps, and Waiting Lists.
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Kitchener, Martin, Ng, Terence, and Harrington, Charlene
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COMMUNITY health services ,MEDICAL care costs ,MEDICAID ,HEALTH policy ,STATE governments - Abstract
With 43 states reporting budget deficits in 2002, there is increasing interest in the cost controls methods that state governments use on the 229 Medicaid home and community-based services (HCBS) waiver programs which, in 2001, provided services to more than 830,000 persons and cost more than $14.2 billion. This paper reports findings from a national survey of all waiver programs regarding cost containment strategies used in 2002. Responses from 76 percent of all waivers show that 57 percent used some type of financial cap, 33 percent used more restrictive financial eligibility criteria than for institutional services, and the vast majority of states limited the number of waiver slots available. Overall, the waiver programs reported that 157,640 persons were on waiting lists in 2002. These findings provide an important basis for comparison between states because the use of these strategies may restrict individuals' choice of services and result in unnecessary institutionalization. [ABSTRACT FROM AUTHOR]
- Published
- 2004
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23. Eligibility screening in evidence synthesis of environmental management topics.
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Frampton, Geoff K., Livoreil, Barbara, and Petrokofsky, Gillian
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ENVIRONMENTAL management ,ENVIRONMENTAL research ,ENVIRONMENTAL standards - Abstract
The eligibility screening step of a systematic review or systematic map (sometimes referred to as 'study selection', 'evidence selection' or 'inclusion screening') determines the scope of the evidence that may answer the review or map question. Eligibility screening involves the development, testing and application of eligibility criteria (inclusion and exclusion criteria) by an evidence synthesis review team, based on methods pre-specified in the review or map protocol. Some parts of the process require judgement, meaning that consistent and transparent reporting of the eligibility criteria and the process for applying them are essential in order to reduce the risk of introducing errors or bias. The existing Collaboration for Environmental Evidence (CEE) Guidelines for Systematic Reviews in Environmental Management (version 4.2, March 2013) give relatively limited guidance on how to conduct eligibility screening. In this paper we provide more in-depth information on good practice methods for this step of evidence synthesis, based on a critical consideration of existing guidance and current practice. Our aim is to provide recommendations to support those conducting CEE systematic reviews or systematic maps for environmental management questions; however, the methods we describe are generic and should be broadly applicable across a wide range of environmental research topics. [ABSTRACT FROM AUTHOR]
- Published
- 2017
- Full Text
- View/download PDF
24. Correlating eligibility criteria generalizability and adverse events using Big Data for patients and clinical trials.
- Author
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Sen, Anando, Ryan, Patrick B., Goldstein, Andrew, Chakrabarti, Shreya, Wang, Shuang, Koski, Eileen, and Weng, Chunhua
- Subjects
BIG data ,ADVERSE health care events ,ELECTRONIC health records ,STATISTICAL correlation ,RANDOMIZED controlled trials - Abstract
Randomized controlled trials can benefit from proactive assessment of how well their participant selection strategies during the design of eligibility criteria can influence the study generalizability. In this paper, we present a quantitative metric called generalizability index for study traits 2.0 (GIST 2.0) to assess the a priori generalizability (based on population representativeness) of a clinical trial by accounting for the dependencies among multiple eligibility criteria. The metric was evaluated on 16 sepsis trials identified from ClinicalTrials.gov, with their adverse event reports extracted from the trial results sections. The correlation between GIST scores and adverse events was analyzed. We found that the GIST 2.0 score was significantly correlated with total adverse events and serious adverse events (weighted correlation coefficients of 0.825 and 0.709, respectively, with P < 0.01). This study exemplifies the promising use of Big Data in electronic health records and ClinicalTrials.gov for optimizing eligibility criteria design for clinical studies. [ABSTRACT FROM AUTHOR]
- Published
- 2017
- Full Text
- View/download PDF
25. Avaliação dos Critérios de Elegibilidade do Programa Territórios da Cidadania.
- Author
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Andrade, Pedro Gomes, Mercedes Strauch, Julia Celia, and Ferreira, Gustavo
- Abstract
Copyright of Revista de Economia e Sociologia Rural is the property of Sociedade Brasileira de Economia e Sociologia Rural and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2016
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- View/download PDF
26. Eligibility Criteria and Entitlements: Defining Need for NHS Continuing Care.
- Author
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South, Jane
- Subjects
HOME care services ,HEALTH facilities ,LONG-term care facilities ,MEDICAL needs assessment - Abstract
The 1995 guidance HSG(95)8 "NHS Responsibilities for Meeting Continuing Health Care Needs" required health authorities to develop local policies and eligibility criteria for a range of continuing care services. The role of criteria in defining health need, and the potential effect on open-ended rights to NHS care, need to be considered in light of the prior erosion of rights associated with changes in continuing care provision. This paper examines whether the development of eligibility criteria has led to a loss of entitlements to NHS care. Analysis of empirical evidence from a study of the policies and criteria of six health authorities found that criteria for fully funded care were generally well defined and restricted access to those with very intense and specialist needs, thereby constituting a loss of rights. In contrast, the criteria for community-based services left eligibility dependent on professional discretion but often failed to clarify the relationship between individual need and levels of service provision. The research found that resource limits are likely to remain a factor in the allocation of services and this will affect the status of the criteria as potential entitlements. [ABSTRACT FROM AUTHOR]
- Published
- 1999
- Full Text
- View/download PDF
27. Real-World Data for Planning Eligibility Criteria and Enhancing Recruitment: Recommendations from the Clinical Trials Transformation Initiative.
- Author
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Evans, Scott R., Paraoan, Dianne, Perlmutter, Jane, Raman, Sudha R., Sheehan, John J., and Hallinan, Zachary P.
- Subjects
EXPERIMENTAL design ,CLINICAL trials ,HUMAN research subjects ,PATIENT selection ,ACQUISITION of data ,DECISION making ,ELECTRONIC health records - Abstract
The growing availability of real-world data (RWD) creates opportunities for new evidence generation and improved efficiency across the research enterprise. To varying degrees, sponsors now regularly use RWD to make data-driven decisions about trial feasibility, based on assessment of eligibility criteria for planned clinical trials. Increasingly, RWD are being used to support targeted, timely, and personalized outreach to potential trial participants that may improve the efficiency and effectiveness of the recruitment process. This paper highlights recommendations and resources, including specific case studies, developed by the Clinical Trials Transformation Initiative (CTTI) for applying RWD to planning eligibility criteria and recruiting for clinical trials. Developed through a multi-stakeholder, consensus- and evidence-driven process, these actionable tools support researchers in (1) determining whether RWD are fit for purpose with respect to study planning and recruitment, (2) engaging cross-functional teams in the use of RWD for study planning and recruitment, and (3) understanding patient and site needs to develop successful and patient-centric approaches to RWD-supported recruitment. Future considerations for the use of RWD are explored, including ensuring full patient understanding of data use and developing global datasets. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
28. Guidelines for the Reporting of Treatment Trials for Alcohol Use Disorders.
- Author
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Witkiewitz, Katie, Finney, John W., Harris, Alex H. S., Kivlahan, Daniel R., and Kranzler, Henry R.
- Subjects
ALCOHOL-induced disorders ,CLINICAL trials ,EXPERIMENTAL design ,MEDICAL cooperation ,MEDICAL protocols ,RESEARCH ,RESEARCH funding ,STATISTICAL sampling ,PATIENT participation ,SYSTEMATIC reviews ,SAMPLE size (Statistics) ,ELIGIBILITY (Social aspects) ,DATA analysis ,RANDOMIZED controlled trials ,CLINICAL trial registries ,HUMAN research subjects ,PATIENT selection ,THERAPEUTICS - Abstract
Background The primary goals in conducting clinical trials of treatments for alcohol use disorders ( AUDs) are to identify efficacious treatments and determine which treatments are most efficacious for which patients. Accurate reporting of study design features and results is imperative to enable readers of research reports to evaluate to what extent a study has achieved these goals. Guidance on quality of clinical trial reporting has evolved substantially over the past 2 decades, primarily through the publication and widespread adoption of the Consolidated Standards of Reporting Trials statement. However, there is room to improve the adoption of those standards in reporting the design and findings of treatment trials for AUD. Methods This paper provides a narrative review of guidance on reporting quality in AUD treatment trials. Results Despite improvements in the reporting of results of treatment trials for AUD over the past 2 decades, many published reports provide insufficient information on design or methods. Conclusions The reporting of alcohol treatment trial design, analysis, and results requires improvement in 4 primary areas: (i) trial registration, (ii) procedures for recruitment and retention, (iii) procedures for randomization and intervention design considerations, and (iv) statistical methods used to assess treatment efficacy. Improvements in these areas and the adoption of reporting standards by authors, reviewers, and editors are critical to an accurate assessment of the reliability and validity of treatment effects. Continued developments in this area are needed to move AUD treatment research forward via systematic reviews and meta-analyses that maximize the utility of completed studies. [ABSTRACT FROM AUTHOR]
- Published
- 2015
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- View/download PDF
29. Recommendations for the Design and Analysis of Treatment Trials for Alcohol Use Disorders.
- Author
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Witkiewitz, Katie, Finney, John W., Harris, Alex H.S., Kivlahan, Daniel R., and Kranzler, Henry R.
- Subjects
ALCOHOL-induced disorders ,BEHAVIOR modification ,EXPERIMENTAL design ,RESEARCH funding ,STATISTICAL sampling ,STATISTICS ,TIME ,PATIENT participation ,SYSTEMATIC reviews ,ELIGIBILITY (Social aspects) ,DATA analysis ,RANDOMIZED controlled trials ,HUMAN research subjects ,THERAPEUTICS - Abstract
Background Over the past 60 years, the view that 'alcoholism' is a disease for which the only acceptable goal of treatment is abstinence has given way to the recognition that alcohol use disorders ( AUDs) occur on a continuum of severity, for which a variety of treatment options are appropriate. However, because the available treatments for AUDs are not effective for everyone, more research is needed to develop novel and more efficacious treatments to address the range of AUD severity in diverse populations. Here we offer recommendations for the design and analysis of alcohol treatment trials, with a specific focus on the careful conduct of randomized clinical trials of medications and nonpharmacological interventions for AUDs. Methods This paper provides a narrative review of the quality of published clinical trials and recommendations for the optimal design and analysis of treatment trials for AUDs. Results Despite considerable improvements in the design of alcohol clinical trials over the past 2 decades, many studies of AUD treatments have used faulty design features and statistical methods that are known to produce biased estimates of treatment efficacy. Conclusions The published statistical and methodological literatures provide clear guidance on methods to improve clinical trial design and analysis. Consistent use of state-of-the-art design features and analytic approaches will enhance the internal and external validity of treatment trials for AUDs across the spectrum of severity. The ultimate result of this attention to methodological rigor is that better treatment options will be identified for patients with an AUD. [ABSTRACT FROM AUTHOR]
- Published
- 2015
- Full Text
- View/download PDF
30. Determining eligibility for long-term care--lessons from Germany.
- Author
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Büscher, Andreas, Wingenfeld, Klaus, and Schaeffer, Doris
- Subjects
LONG-term care insurance ,LONG-term health care ,NURSING care facilities ,HEALTH insurance - Abstract
Objectives: This paper addresses recent steps for reforming the eligibility criteria of the German long-term care insurance that have been initiated to overcome shortcomings in the current system. Methods: Based on findings of a survey of international long-term care systems, assessment tools and the relevant literature on care needs a new tool for determining eligibility in the German long-term care insurance was developed. Results: The new tool for determining long-term care eligibility broadens the understanding of what 'dependency on nursing care' implies for the person affected. The assessment results in a degree of dependency from personal help provided by formal or informal caregivers. This degree of dependency can be used for determining eligibility for and the amount of long-term care benefits. Discussion: The broader understanding of 'dependency on nursing care' and the new tool are important steps to adapt the German long-term care insurance to the challenges of the demographic and societal changes in the future. [ABSTRACT FROM AUTHOR]
- Published
- 2011
31. Fair Access to Care Services (FACS): implementation in the mental health context of the UK.
- Author
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Cestari, L., Munroe, M., Evans, S., Smith, A., and Huxley, P.
- Subjects
ADULT care services ,MENTAL health care teams ,COMMUNITY health services ,HEALTH services accessibility ,MENTAL health & society - Abstract
Since April 2003, all adults requiring social care services must have an assessment to determine their eligibility, which is set within the four-level framework of Fair Access to Care Services [FACS; LAC (2002)13]. This paper examines the implementation of FACS by community mental health teams in eight sites in mental health partnership trusts, and one in a mental health and social care trust in the UK. Twenty-eight respondents (managers within trusts and social services departments) participated in in-depth qualitative interviews, which were undertaken between August 2004 and February 2005. The interviews covered: consultation with users and partner organisations; training and briefings for staff; FACS thresholds; integration of FACS and the Care Programme Approach; and the impact of implementing FACS on budgetary arrangements between health and social care. Using the framework analysis approach to analyse data, it was found that FACS implementation in mental health services has been somewhat haphazard, and has identified real differences between health and social care approaches to eligibility determination, assessment and priorities. In particular, the type and amount of consultation, training and induction into FACS was variable, and in some cases, unacceptably poor. While FACS may have reduced variability between authorities, the exercise of professional judgement in the operation of FACS and the lack of high-quality preventative services remain as potential sources of inequity within the system. The authors conclude that FACS has revealed and reinforced a growing separation rather than an integration of mental health and social care ideas and practices, at least in the participating sites. [ABSTRACT FROM AUTHOR]
- Published
- 2006
- Full Text
- View/download PDF
32. Effective matching of patients to clinical trials using entity extraction and neural re-ranking.
- Author
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Kusa, Wojciech, Mendoza, Óscar E., Knoth, Petr, Pasi, Gabriella, and Hanbury, Allan
- Abstract
Clinical trials (CTs) often fail due to inadequate patient recruitment. Finding eligible patients involves comparing the patient's information with the CT eligibility criteria. Automated patient matching offers the promise of improving the process, yet the main difficulties of CT retrieval lie in the semantic complexity of matching unstructured patient descriptions with semi-structured, multi-field CT documents and in capturing the meaning of negation coming from the eligibility criteria. This paper tackles the challenges of CT retrieval by presenting an approach that addresses the patient-to-trials paradigm. Our approach involves two key components in a pipeline-based model: (i) a data enrichment technique for enhancing both queries and documents during the first retrieval stage, and (ii) a novel re-ranking schema that uses a Transformer network in a setup adapted to this task by leveraging the structure of the CT documents. We use named entity recognition and negation detection in both patient description and the eligibility section of CTs. We further classify patient descriptions and CT eligibility criteria into current, past, and family medical conditions. This extracted information is used to boost the importance of disease and drug mentions in both query and index for lexical retrieval. Furthermore, we propose a two-step training schema for the Transformer network used to re-rank the results from the lexical retrieval. The first step focuses on matching patient information with the descriptive sections of trials, while the second step aims to determine eligibility by matching patient information with the criteria section. Our findings indicate that the inclusion criteria section of the CT has a great influence on the relevance score in lexical models, and that the enrichment techniques for queries and documents improve the retrieval of relevant trials. The re-ranking strategy, based on our training schema, consistently enhances CT retrieval and shows improved performance by 15% in terms of precision at retrieving eligible trials. The results of our experiments suggest the benefit of making use of extracted entities. Moreover, our proposed re-ranking schema shows promising effectiveness compared to larger neural models, even with limited training data. These findings offer valuable insights for improving methods for retrieval of clinical documents. [Display omitted] • We conduct several experiments for the patient-to-trial matching retrieval problem. • Inclusion criteria section has the biggest influence on the score in lexical models. • Query and document enrichment techniques improve retrieval of relevant trials. • Age and gender-based filtering helped remove 26% ineligible trials. • Novel training strategy for re-ranking further increases retrieval effectiveness. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
33. Eligibility criteria in clinical trials in breast cancer: a cohort study.
- Author
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Szlezinger, Katarzyna, Pogoda, Katarzyna, Jagiełło-Gruszfeld, Agnieszka, Kłosowska, Danuta, Górski, Andrzej, and Borysowski, Jan
- Subjects
CLINICAL trials ,BREAST cancer ,COHORT analysis ,OLDER patients ,OLDER people - Abstract
Background: Breast cancer (BC) is the most common cancer type in women. The purpose of this study was to assess the eligibility criteria in recent clinical trials in BC, especially those that can limit the enrollment of older patients as well as those with comorbidities and poor performance status. Methods: Data on clinical trials in BC were extracted from ClinicalTrials.gov. Co-primary outcomes were proportions of trials with different types of the eligibility criteria. Associations between trial characteristics and the presence of certain types of these criteria (binary variable) were determined with univariate and multivariate logistic regression. Results: Our analysis included 522 trials of systemic anticancer treatments started between 2020 and 2022. Upper age limits, strict exclusion criteria pertaining to comorbidities, and those referring to inadequate performance status of the patient were used in 204 (39%), 404 (77%), and 360 (69%) trials, respectively. Overall, 493 trials (94%) had at least one of these criteria. The odds of the presence of each type of the exclusion criteria were significantly associated with investigational site location and trial phase. We also showed that the odds of the upper age limits and the exclusion criteria involving the performance status were significantly higher in the cohort of recent trials compared with cohort of 309 trials started between 2010 and 2012 (39% vs 19% and 69% vs 46%, respectively; p < 0.001 for univariate and multivariate analysis in both comparisons). The proportion of trials with strict exclusion criteria was comparable between the two cohorts (p > 0.05). Only three of recent trials (1%) enrolled solely patients aged 65 or 70 and older. Conclusions: Many recent clinical trials in BC exclude large groups of patients, especially older adults, individuals with different comorbidities, and those with poor performance status. Careful modification of some of the eligibility criteria in these trials should be considered to allow investigators to assess the benefits and harms of investigational treatments in participants with characteristics typically encountered in clinical practice. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
34. Time for a reform of the Zois scholarships
- Author
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Mirt Nagy
- Subjects
scholarships for talented ,Zois scholarship ,scholarship act ,eligibility criteria ,promoting the development of talent ,Psychology ,BF1-990 - Abstract
The paper presents a history of development of scholarships for young talents in Slovenia. Through recent years the eligibility criteria to obtain the scholarship has changed as policy and certain characteristics have been reformed. The paper argues about stricter criteria that were implemented in recently reformed Scholarship policy act. The discussion includes a proposal for necessary improvements within the system of Zois scholarships. The described changes would assign the Zois scholarship a greater role in promoting the students’ career development during and after their educational process.
- Published
- 2016
- Full Text
- View/download PDF
35. State Variation Regarding Other Health Impairment Eligibility Criteria for Attention Deficit Hyperactivity Disorder
- Author
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Briesch, Amy M., Waldron, Felicia M., and Beneville, Margaret A.
- Published
- 2023
- Full Text
- View/download PDF
36. More efficient and inclusive time-to-event trials with covariate adjustment: a simulation study.
- Author
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Momal, Raphaëlle, Li, Honghao, Trichelair, Paul, Blum, Michael G. B., and Balazard, Félix
- Subjects
STATISTICAL power analysis ,SAMPLE size (Statistics) ,HEPATOCELLULAR carcinoma ,METASTASIS ,CLINICAL trials - Abstract
Adjustment for prognostic covariates increases the statistical power of randomized trials. The factors influencing the increase of power are well-known for trials with continuous outcomes. Here, we study which factors influence power and sample size requirements in time-to-event trials. We consider both parametric simulations and simulations derived from the Cancer Genome Atlas (TCGA) cohort of hepatocellular carcinoma (HCC) patients to assess how sample size requirements are reduced with covariate adjustment. Simulations demonstrate that the benefit of covariate adjustment increases with the prognostic performance of the adjustment covariate (C-index) and with the cumulative incidence of the event in the trial. For a covariate that has an intermediate prognostic performance (C-index=0.65), the reduction of sample size varies from 3.1% when cumulative incidence is of 10% to 29.1% when the cumulative incidence is of 90%. Broadening eligibility criteria usually reduces statistical power while our simulations show that it can be maintained with adequate covariate adjustment. In a simulation of adjuvant trials in HCC, we find that the number of patients screened for eligibility can be divided by 2.4 when broadening eligibility criteria. Last, we find that the Cox-Snell R C S 2 is a conservative estimation of the reduction in sample size requirements provided by covariate adjustment. Overall, more systematic adjustment for prognostic covariates leads to more efficient and inclusive clinical trials especially when cumulative incidence is large as in metastatic and advanced cancers. Code and results are available at https://github.com/owkin/CovadjustSim. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
37. An Assessment of Program Eligibility Among Participants in Day Reporting Centers.
- Author
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Mowbray, Orion, Fatehi, Mariam, Robinson, Michael A., Skinner, Jeffery, Risler, Ed, and Dias, Clarissa
- Subjects
PROPENSITY score matching ,COMMUNITIES - Abstract
Day reporting centers (DRCs) vary considerably in how participant eligibility is determined and to date, there is little to no knowledge whether criteria for DRC eligibly are appropriately applied in program entrance. This study examines a statewide sample of individuals in community supervision settings and compares DRC eligibility criteria between DRC and non-DRC participants to examine differences between DRC participants and non-participants. Using a propensity score matched sample of 1,554 participants, study findings suggest that DRC participants show higher risk, need, and responsivity factors, consistent with the DRC programing model. These results suggest many individuals appear to be appropriately matched to DRCs, which may in turn, may influence their likelihood of program success, among other factors. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
38. Feasibility of Using Oncology-Specific Electronic Health Record (EHR) Data to Emulate Clinical Trial Eligibility Criteria †.
- Author
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Wilson, Thomas W., Dye, Joseph T., Spark, Sarah, Robert, Nicholas J., Espirito, Janet L., and Amirian, E. Susan
- Subjects
ONCOLOGY ,ELECTRONIC health records ,CLINICAL trials ,COMORBIDITY - Abstract
We examined eligibility criteria from recent oncology clinical trials to see whether real-world data (RWD) from electronic health records (EHRs) could be used to create external control groups for clinical trials. Trials were identified from the Aggregate Analysis of ClinicalTrials.gov database; the selected trials were for oncology drugs approved by the FDA in 2020. Verbatim text from trial inclusion and exclusion criteria was qualitatively assessed by an expert panel to determine if criteria could be ascertained from structured and unstructured EHR data. Identified criteria were categorized (cancer-related, comorbidity-related, demographic, functional status, and trial operations) and subcategorized. Among 53 identified trials, 20 met the requirements for study inclusion, which included 463 eligibility criteria. Percentages of criteria by category were as follows: cancer-related factors (46%), comorbidities (20%), functional status (18%), trial operations (14%), and demographics (2%). For 18 of the 20 trials, 80% of the eligibility criteria could be ascertained with RWD; for 4 of the 20, it was 100%. When trial operation-specific criteria were excluded, all 20 met the 100% threshold. Our study indicates that both structured and unstructured data from community-based oncology-specific EHRs can be used for determining patient eligibility for external control arms for clinical trials. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
39. A consensus conference report on defining the eligibility criteria for pediatric palliative care in Italy
- Author
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Jankovic, Momcilo, De Zen, Lucia, Pellegatta, Federico, Lazzarin, Pierina, Bertolotti, Marina, Manfredini, Luca, Aprea, Antonino, Memo, Luigi, Del Vecchio, Antonio, Agostiniani, Rino, and Benini, Franca
- Published
- 2019
- Full Text
- View/download PDF
40. Hemochromatosis and blood donation.
- Author
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Braseth, Turid Aarhus, Hervig, Tor, and Rosvik, Anne Synnove
- Subjects
- *
HEMOCHROMATOSIS , *BLOOD collection , *BLOOD banks , *BLOOD donors , *PATIENTS , *SAFETY - Abstract
The voluntary, unpaid, altruistic blood donor is a cornerstone of current transfusion medicine. The complexity of medical and ethical issues related to blood donation and hemochromatosis has led to a large number of studies related to the safety of the hemochromatosis donor and the quality of the blood components produced from these donations. The issue of accepting persons with HC as blood donors is diverting, both in Europe and worldwide and without joint guidelines. A questionnaire-based study was performed and mailed to all 25 blood bank leaders in Norway. Descriptive analysis was used to evaluate the data. Eight of 22 blood banks strictly followed national guidelines concerning persons with hemochromatosis. Other blood banks make local adjustments. 16 of 22 responding blood banks accept hemochromatosis donors and five do not, and one answered partly yes. The reasons the blood bank leaders supported the acceptance of hemochromatosis donors differ. Based on published papers and the present questionnaire, we believe that a clear definition of the “hemochromatosis donor” and guidelines with more detailed information on an acceptable donation regime would be important to overcome the weak points in blood donor eligibility criteria. [ABSTRACT FROM AUTHOR]
- Published
- 2017
- Full Text
- View/download PDF
41. Voluntary Assisted Dying in Australia—Key Similarities and Points of Difference Concerning Eligibility Criteria in the Individual State Legislation
- Author
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Okninski, Michaela Estelle
- Published
- 2023
- Full Text
- View/download PDF
42. Taxpayer Information: Options Exist to Enable Data Sharing Between IRS and USCIS but Each Presents Challenges: GAO-06-100.
- Subjects
TAXPAYER compliance ,TAXATION ,PUBLIC finance ,EMIGRATION & immigration ,STATISTICAL matching - Abstract
In 2000, federal agencies estimated they saved at least $900 million annually through data sharing initiatives. The Internal Revenue Service (IRS) can use data from taxpayers and third parties to better ensure taxpayers meet their obligations. Likewise, Congress has authorized certain agencies access to taxpayer information collected by IRS to better determine benefit eligibility. In July 2004, we reported that data sharing between IRS and the United States Citizenship and Immigration Services (USCIS) has the potential to improve tax compliance as well as immigration eligibility decisions (GAO-04-972T). For this report, GAO determined (1) the potential benefits of data matching, and (2) the options and associated challenges. Data sharing can help improve (1) tax compliance if businesses applying to sponsor immigrant workers are required to meet tax filing and payment requirements, and (2) the accuracy and timeliness of USCIS's immigration eligibility decisions if it obtained tax data from IRS to help ensure business sponsors meet eligibility criteria. As of December 2003, IRS databases showed 18,942 businesses (5 percent) applying to sponsor immigrant workers had $5.6 billion in unpaid assessments. Of this amount, businesses were not in installment agreements with IRS or otherwise making payments on $3.7 billion. If future business sponsors owe taxes and are required to meet their tax obligations, they would need to make arrangements with the IRS to come into compliance. Although USCIS officials acknowledge that no explicit prohibition exists in immigration laws against conditioning approval of employer applications on their tax compliance, USCIS officials said a statutory change is preferable because they have legal concerns about USCIS's authority to issue such a regulation absent specific authority. IRS data can help USCIS make more accurate eligibility decisions by better identifying businesses that may not have met eligibility criteria due to having unpaid assessments or not filing returns. In our nationwide selection, 67,949 of 413,723 (16 percent) business sponsors were in IRS's nonfiler database at the time of their application. A variety of options is available to IRS and USCIS for establishing and implementing data sharing. An applicant-initiated data-sharing arrangement could be implemented under existing Internal Revenue Code authority through taxpayer consent, whereby taxpayers authorize IRS to disclose their information. USCIS then could verify applicant-provided data by obtaining tax returns or tax transcripts. Treasury guidance suggests a small-scale pilot using consents as a way to make the business case for continued access to taxpayer information. In general, the more that data sharing could be done electronically, the more efficient the data sharing could be. However, achieving electronic data sharing may take longer than paper-based processes due to legal, technological, and cost challenges. Further, if business sponsors need to come into compliance, net tax collections might not increase if collecting their taxes displaces other IRS work. Establishing user fees to cover data-sharing costs could be a way to fund data sharing, but IRS lacks the authority to collect and retain a user fee to cover compliance-related costs associated with data sharing. [ABSTRACT FROM AUTHOR]
- Published
- 2005
43. A comparative study of pre-trained language models for named entity recognition in clinical trial eligibility criteria from multiple corpora.
- Author
-
Li, Jianfu, Wei, Qiang, Ghiasvand, Omid, Chen, Miao, Lobanov, Victor, Weng, Chunhua, and Xu, Hua
- Abstract
Background: Clinical trial protocols are the foundation for advancing medical sciences, however, the extraction of accurate and meaningful information from the original clinical trials is very challenging due to the complex and unstructured texts of such documents. Named entity recognition (NER) is a fundamental and necessary step to process and standardize the unstructured text in clinical trials using Natural Language Processing (NLP) techniques.Methods: In this study we fine-tuned pre-trained language models to support the NER task on clinical trial eligibility criteria. We systematically investigated four pre-trained contextual embedding models for the biomedical domain (i.e., BioBERT, BlueBERT, PubMedBERT, and SciBERT) and two models for the open domains (BERT and SpanBERT), for NER tasks using three existing clinical trial eligibility criteria corpora. In addition, we also investigated the feasibility of data augmentation approaches and evaluated their performance.Results: Our evaluation results using tenfold cross-validation show that domain-specific transformer models achieved better performance than the general transformer models, with the best performance obtained by the PubMedBERT model (F1-scores of 0.715, 0.836, and 0.622 for the three corpora respectively). The data augmentation results show that it is feasible to leverage additional corpora to improve NER performance.Conclusions: Findings from this study not only demonstrate the importance of contextual embeddings trained from domain-specific corpora, but also shed lights on the benefits of leveraging multiple data sources for the challenging NER task in clinical trial eligibility criteria text. [ABSTRACT FROM AUTHOR]- Published
- 2022
- Full Text
- View/download PDF
44. The Ontology of Clinical Research (OCRe): An informatics foundation for the science of clinical research.
- Author
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Sim, Ida, Tu, Samson W., Carini, Simona, Lehmann, Harold P., Pollock, Brad H., Peleg, Mor, and Wittkowski, Knut M.
- Abstract
To date, the scientific process for generating, interpreting, and applying knowledge has received less informatics attention than operational processes for conducting clinical studies. The activities of these scientific processes – the science of clinical research – are centered on the study protocol, which is the abstract representation of the scientific design of a clinical study. The Ontology of Clinical Research (OCRe) is an OWL 2 model of the entities and relationships of study design protocols for the purpose of computationally supporting the design and analysis of human studies. OCRe’s modeling is independent of any specific study design or clinical domain. It includes a study design typology and a specialized module called ERGO Annotation for capturing the meaning of eligibility criteria. In this paper, we describe the key informatics use cases of each phase of a study’s scientific lifecycle, present OCRe and the principles behind its modeling, and describe applications of OCRe and associated technologies to a range of clinical research use cases. OCRe captures the central semantics that underlies the scientific processes of clinical research and can serve as an informatics foundation for supporting the entire range of knowledge activities that constitute the science of clinical research. [ABSTRACT FROM AUTHOR]
- Published
- 2014
- Full Text
- View/download PDF
45. Seek and Ye Shall Find: How Search Requirements Affect Job Finding Rates of Older Workers.
- Author
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Hullegie, Patrick and Ours, Jan
- Subjects
JOB hunting ,EMPLOYMENT of older people ,UNEMPLOYMENT insurance ,AGE & employment - Abstract
Unemployment insurance recipients in the Netherlands were for many years exempted from the requirement to actively search for a job after they reached the age of 57.5. We study how this exemption affected the job finding rates of the recipients involved. Our results indicate that the job finding rate starts to fall just prior to the removal of the search requirement at age 57.5. In addition we find a large negative effect on job finding rates of the actual removal of the search requirement at age 57.5. Apparently, even for persons with seemingly poor job prospects search requirements have a positive effect on finding rates. [ABSTRACT FROM AUTHOR]
- Published
- 2014
- Full Text
- View/download PDF
46. National Representation without Citizenship: the Special Case of Rugby
- Author
-
Reiche Danyel
- Subjects
citizenship ,eligibility criteria ,rugby league ,rugby union ,residence ,sports governance ,Political science - Abstract
This article is a case study of one of the few sports, rugby, that does not link national representation exclusively to citizenship. It discusses who may represent a country in major events and under which conditions. It analyses the consequences of the rules on different stakeholders; and discusses why the residency rule in particular is subject to much controversy. The author has conducted case studies of the 2019 rugby union and 2017 rugby league men’s World Cups. Academic literature, international news-papers, and rugby-specific websites were reviewed. Other than secondary sources, the researcher also collected primary data through interviews. The interviewees included representatives of Rugby League International Federation and World Rugby. This research reveals that national representation without citizenship is widespread in both codes of rugby. It has also shown that the effects of the eligibility criteria go beyond simplistic rich/poor and center/periphery models. This article argues that the rational for the eligibility criteria is the limited global spread of rugby league and rugby union. Without those lenient rules it would be difficult to organize international competitions.
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- 2021
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47. Randomized clinical trials and real life studies: Comparison of baseline characteristics of patients in oral target therapies for renal cell carcinoma.
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Lasala, Ruggero, Santoleri, Fiorenzo, Romagnoli, Alessia, Musicco, Felice, Abrate, Paolo, and Costantini, Alberto
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RENAL cell carcinoma ,ORAL drug administration ,MANN Whitney U Test ,RANDOMIZED controlled trials ,CANCER patients ,CHI-squared test ,DESCRIPTIVE statistics - Abstract
Introduction: Pivotal Randomized Controlled Trials (RCTs) constitute scientific evidence in support of therapeutic choices when a drug is authorized in the market. In RCTs, patients are selected in a rigorous manner, in order to avoid bias that may influence efficacy assessments. Therefore, patients who take the drug in Real Life Studies (RLSs) are not the same as those participating in RCTs, which, in turn, leads to low data transferability from RCTs to RLS. The objective of this study was to evaluate the differences between RCTs and RLS, in terms of patient baseline characteristics. Materials and Methods: Our study includes all oral target therapies for RCC (Renal Cell Carcinoma) marketed in Europe before March 31, 2019. For each treatment, we considered both RCTs and RLSs, the former gathered from Summary of Product Characteristics published on the European Medicine Agency (EMA) website, and the latter yielded by our search in relevant literature. For each drug considered, we then compared the baseline characteristics of patients included in the RCT samples with those of the samples included in the RLSs using the Chi-squared and Mann-Whitney tests. Results: We considered six medicines, for a total of 9 pivotal RCTs and 31 RLSs. RCTs reported the same type of patient baseline characteristics, whereas RLSs are more varied in reporting. Some patient baseline characteristics (metastases, previous treatments, etc.) were significantly different between RCTs and RLs. Other characteristics, such as ECOG Performance Status, brain metastases, and comorbidities, liver and kidney failure, are comprised in exclusion criteria of RCTs, though are included in RLS. Discussion and Conclusion: While evaluating equal treatments for the same indications, RCTs and RLSs do not always assess patients with the same characteristics. It would be necessary to produce evidence from RLSs so as to have an idea of treatment effectiveness in patients groups that are not eligible or underrepresented in RCTs. [ABSTRACT FROM AUTHOR]
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- 2022
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48. Awareness of, Willingness to Take PrEP and Its Actual Use Among Belgian MSM at High Risk of HIV Infection: Secondary Analysis of the Belgian European MSM Internet Survey
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Buffel, Veerle, Reyniers, Thijs, Masquillier, Caroline, Thunissen, Estrelle, Nöstlinger, Christiana, Laga, Marie, Wouters, Edwin, Berghe, Wim Vanden, Deblonde, Jessika, and Vuylsteke, Bea
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- 2022
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49. The Electronic Healthcare Record for Clinical Research (EHR4CR) information model and terminology.
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Mantas, John, Andersen, Stig Kjær, Mazzoleni, Maria Christina, Blobel, Bernd, Quaglini, Silvana, Moen, Anne, Ouagne, David, Hussain, Sajjad, Sadou, Eric, Jaulent, Marie-Christine, and Daniel, Christel
- Abstract
A major barrier to repurposing routinely collected data for clinical research is the heterogeneity of healthcare information systems. Electronic Healthcare Record for Clinical Research (EHR4CR) is a European platform designed to improve the efficiency of conducting clinical trials. In this paper, we propose an initial architecture of the EHR4CR Semantic Interoperability Framework. We used a model-driven engineering approach to build a reference HL7-based multidimensional model bound to a set of reference clinical terminologies acting as a global as view model. We then conducted an evaluation of its expressiveness for patient eligibility. The EHR4CR information model consists in one fact table dedicated to clinical statement and 4 dimensions. The EHR4CR terminology integrates reference terminologies used in patient care (e.g LOINC, ICD-10, SNOMED CT, etc). We used the Object Constraint Language (OCL) to represent patterns of eligibility criteria as constraints on the EHR4CR model to be further transformed in SQL statements executed on different clinical data warehouses. [ABSTRACT FROM AUTHOR]
- Published
- 2012
50. Re‐engineering the medical assessment of blood donors in South Africa: The balance between supply and safety.
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Rapodile, Thabiso, Mitchel, Josephine, Swanevelder, Ronel, Murphy, Edward L., and van den Berg, Karin
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BLOOD donors ,MEDICAL needs assessment ,NUCLEIC acid amplification techniques ,NEEDLESTICK injuries ,LOGISTIC regression analysis - Abstract
Background: The balance between ensuring blood donor and recipient safety while maintaining a sufficient blood supply can be affected by excessive deferral of blood donors. In 2018, a biannual regulatory review of donor eligibility criteria provided the South African National Blood Service (SANBS) the opportunity to review the existing criteria. Changes to these criteria were implemented in April 2019 after an extensive review. Study Design and Methods: We conducted a cross‐sectional study of SANBS whole‐blood donor presentations to determine the impact of the changed donor eligibility criteria on deferrals and blood safety. We compared donor presentations, deferrals, and HIV‐positive cases for the 12‐month period (April 2019–March 2020) after the implementation of the updated donor eligibility criteria to those of the previous year. Results: Of the 2,112,917 donor presentations, 51.1% (1079506) occurred in the post‐implementation study period. Overall, deferrals decreased from 18.6% to 14.5%, whereas HIV‐positive donations increased by 0.03%. A multivariable logistic regression analysis adjusted for sex, age, geographical location, donor, and clinic type showed significantly lower odds of deferral (OR 0.70; 95% CI: 0.69–0.70) and greater odds of HIV‐positive cases in the study period than those in the control period (OR 1.17; 95% CI: 1.10–1.25). Conclusion: We confirmed that the change in donor eligibility criteria was associated with a decrease in deferrals and an increase in the country's blood supply. The impact of the increased number of HIV‐positive donations on blood safety in a country performing individual donation nucleic acid amplification testing requires further investigation. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
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