PP94 Pandemic Preparedness: EUnetHTA COVID-19 Rapid Response With “Rolling Collaborative Reviews (RCR)”

2021 ◽  
Vol 37 (S1) ◽  
pp. 18-18
Author(s):  
Claudia Wild ◽  
Julia Mayer-Ferbas ◽  
Anne Willemsen
Keyword(s):  
Public Health ◽  
Meta Analysis ◽  
Safety Data ◽  
Policy Support ◽  
European Medicines Agency ◽  
Sources Of Information ◽  
Pandemic Preparedness ◽  
Clinical Trial Registries ◽  
High Level ◽  
Initial List

IntroductionPotential therapies and interventions for COVID-19 are emerging and developing rapidly. In a response to this public health emergency, the European Network for Health Technology Assessment (EUnetHTA) aims to support health policy in preparation for evidence-based purchasing. To monitor the emerging evidence, a new EUnetHTA product was created: Rolling Collaborative Reviews (RCRs).MethodsRCRs are living documents that are descriptive in nature, updated monthly, and centrally coordinated. They are based on the following three sources of information: (i) published randomized controlled trials (RCTs) presented as a summary of efficacy and safety data (synthesized for a network meta-analysis conducted by the Department of Epidemiology Lazio Regional Health Service, Italy); (ii) published prospective observational studies for safety results, provided by the Map of COVID-19 Evidence conducted by the Norwegian Institute of Public Health, Norway; and (iii) RCTs registered in clinical trial registries (ClinicalTrials.gov, EudraCT Register, and the ISRCTN registry). Additionally, detailed stopping and starting rules were defined.ResultsAs of November 2020, 14 RCRs were ongoing. From the initial list of RCRs, one was suspended due to lacking effectiveness and two moved on to rapid collaborative reviews due to European Medicines Agency approvals. Four RCRs are updated on a bimonthly basis due to a lack of high-quality evidence, and five new RCRs will be started because of promising clinical studies.ConclusionsRCRs can be a means of providing timely and continuous policy support, but they require a high level of coordinated effort.

scholarly journals Systematic review and meta-analysis assessing the knowledge and use of the female condom among Nigerians

2021 ◽  
Vol 21 (3) ◽  
pp. 1362-1374
Author(s):  
Philemon Dauda Shallie ◽  
Firoza Haffejee
Keyword(s):  
Undergraduate Students ◽  
Meta Analysis ◽  
Female Condom ◽  
Critical Component ◽  
Sources Of Information ◽  
Sexually Transmitted ◽  
Unintended Pregnancies ◽  
Comprehensive Information ◽  
Significant Difference ◽  
High Level

Background: The female condom (FC) is a critical component in a comprehensive and sustainable approach to prevent HIV, other sexually transmitted infections and unintended pregnancies. Objectives: This review provides comprehensive information about Nigerian’s knowledge and use of FC. Methods: We screened search output, evaluated study eligibility, and extracted data in duplicate. Data from similar studies were combined in a meta-analysis. Results: There was a significantly (p < 0.0001) high-level of awareness amongst the respondents. However, the use of the FC was very low at 5.5% among female respondents. There was a significant (p < 0.0001) difference between FC awareness and use. The main reasons for FC use were prevention of unintended pregnancy (55%) and STIs/HIV (31%). We observed a significant difference between reasons of non-use of the FC [F (5, 13) = 5.195, P = 0.0077]. Furthermore, there were significant differences between the sources of information on FC [F (3, 8) = 32.89, P < 0.0001]. Conclusion: Despite the high levels of awareness, especially among the female respondents, the use of the FC has remained extremely low even among the young, educated undergraduate students. There is aneed for robust and consistent advocacy to make the FC available and affordable. Keywords: Female condom; women; men; awareness; use; Nigeria.

scholarly journals Modafinil/armodafinil in obstructive sleep apnoea: a systematic review and meta-analysis

2016 ◽  
Vol 47 (5) ◽  
pp. 1420-1428 ◽  
Author(s):  
Julia L. Chapman ◽  
Andrew Vakulin ◽  
Jan Hedner ◽  
Brendon J. Yee ◽  
Nathaniel S. Marshall
Keyword(s):  
Adverse Events ◽  
Obstructive Sleep Apnoea ◽  
Meta Analysis ◽  
Safety Data ◽  
Sleep Apnoea ◽  
European Medicines Agency ◽  
Controlled Trials ◽  
Serious Adverse Events ◽  
Obstructive Sleep ◽  
Randomised Controlled

Modafinil is used internationally to treat residual sleepiness despite continuous positive airway pressure in obstructive sleep apnoea (res-OSA). In 2011, the European Medicines Agency removed the indication based on an unfavourable risk–benefit profile in two trials for efficacy and all accumulated safety data. We performed a meta-analysis of all randomised controlled trials of modafinil (or armodafinil) in res-OSA to quantify efficacy and safety.We systematically searched and assessed studies from major databases, conferences and trials registries to find randomised, placebo-controlled trials of modafinil/armodafinil for ≥2 weeks in adult res-OSA treating sleepiness.We analysed 10 of the 232 articles identified that met inclusion criteria (1466 patients). Modafinil/armodafinil improved the Epworth Sleepiness Scale score (2.2 points, 95% CI 1.5–2.9) and the Maintenance of Wakefulness Test over placebo (3 min, 95% CI 2.1–3.8 min). Modafinil/armodafinil tripled adverse events and doubled adverse events leading to withdrawal but did not increase serious adverse events (hospitalisations or death).Modafinil and armodafinil improve subjective and objective daytime sleepiness in res-OSA. We believe our analysis is a fairer analysis of the risk–benefit profile of this indication. Clinicians may want to use this data to balance the risks and benefits on a case-by-case basis with their patients.

Developmental Disorders in Canada

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Sarah Palmeter
Keyword(s):  
Public Health ◽  
Developmental Disorders ◽  
Health Agency ◽  
The Public ◽  
Age Of Diagnosis ◽  
High Level ◽  
Project Objectives ◽  
Disability Severity ◽  
Occupational Function ◽  
Improve Health

In the completion of my practicum at the Public Health Agency of Canada (PHAC) this summer, I worked to develop a surveillance knowledge product to support the national surveillance of developmental disorders. This project used Statistics Canada’s 2017 Canadian Survey on Disability to investigate the burden of developmental disorders in Canada. Developmental disorders are conditions with onset in the developmental period. They are associated with developmental deficits and impairments of personal, social, academic, and occupational function. The project objectives are to estimate the prevalence of developmental disorders in Canadians 15 years of age or older, overall and by age and sex, as well as report on the age of diagnosis, disability severity, and disability co-occurrence in those with developmental disorders. The majority of the analysis has been completed and preliminary results completed, which cannot be released prior to PHAC publication. Although not highly prevalent, developmental disorders are associated with a high level of disability in young Canadians. Early detection and interventions have been shown to improve health and social outcomes among affected individuals. Understanding the burden of developmental disorders in Canada is essential to the development of public health policies and services.

Japanese-language videos on YouTube as a source of public health information for COVID-19 (Preprint)

2020 ◽  
Author(s):  
Takeo Yasu
Keyword(s):  
Public Health ◽  
Health Information ◽  
Scientific Evidence ◽  
The State ◽  
Video Content ◽  
Sources Of Information ◽  
State Of Emergency ◽  
Public Health Information ◽  
Youtube Videos ◽  
Spread Of Infection

BACKGROUND Serious public health problems, such as the COVID-19 pandemic, can cause an infodemic. Sources of information that may cause an infodemic include social networking services; YouTube, which consists of content created and uploaded by individuals, is one such source. OBJECTIVE To survey the content and changes in YouTube videos that present public health information about COVID-19 in Japan. METHODS We surveyed YouTube content regarding public health information pertaining to COVID-19 in Japan. YouTube searches were performed on March 6, 2020 (before the state of emergency), April 14 (during the state of emergency), and May 27 (after the state of emergency was lifted), with 136, 113, and 140 sample videos evaluated, respectively. The main outcome measures were: (1) The total number of views for each video, (2) video content, and (3) the usefulness of the video. RESULTS In the 100 most viewed YouTube videos during the three periods, the number of videos on public health information in March was significantly higher than in May (p = .02). Of the 331 unique videos, 9.1% (n = 30) were released by healthcare professionals. Useful videos providing public health information about the prevention of the spread of infection comprised only 13.0% of the sample but were viewed significantly more often than not useful videos (p = .006). CONCLUSIONS Individuals need to take care when obtaining information from YouTube before or early in a pandemic, during which time scientific evidence is scarce.

Pandemic Disease, Public Health, and Ethics

2019 ◽  
pp. 796-811 ◽  
Author(s):  
Maxwell Smith ◽  
Ross Upshur
Keyword(s):  
Public Health ◽  
Ethical Issues ◽  
Ethical Challenges ◽  
Pandemic Preparedness ◽  
Scarce Resources ◽  
Ethical Frameworks ◽  
Health Measures ◽  
Care Workers ◽  
The Face ◽  
Conducting Research

Infectious disease pandemics raise significant and novel ethical challenges to the organization and practice of public health. This chapter provides an overview of the salient ethical issues involved in preparing for and responding to pandemic disease, including those arising from deploying restrictive public health measures to contain and curb the spread of disease (e.g., isolation and quarantine), setting priorities for the allocation of scarce resources, health care workers’ duty to care in the face of heightened risk of infection, conducting research during pandemics, and the global governance of preventing and responding to pandemic disease. It also outlines ethical guidance from prominent ethical frameworks that have been developed to address these ethical issues and concludes by discussing some pressing challenges that must be addressed if ethical reflection is to make a meaningful difference in pandemic preparedness and response.

scholarly journals Low versus high level of physical resemblance in simulation for the acquisition of basic surgical skill: a meta-analysis

2021 ◽  
pp. bmjstel-2020-000797
Author(s):  
Fabrizio Consorti ◽  
Gianmarco Panzera
Keyword(s):  
Undergraduate Students ◽  
Scoring System ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Surgical Skill ◽  
Undergraduate Medical Students ◽  
Study Selection ◽  
High Level ◽  
Physical Resemblance

BackgroundMany studies explored the use of simulation in basic surgical education, with a variety of devices, contexts and outcomes, with sometimes contradictory results.ObjectivesThe objectives of this meta-analysis were to focus the effect that the level of physical resemblance in a simulation has on the development of basic surgical skill in undergraduate medical students and to provide a foundation for the design and implementation of a simulation, with respect to its effectiveness and alignment with the learning outcomes.Study selectionWe searched PubMed and Scopus database for comparative randomised studies between simulations with a different level of resemblance. The result was synthesised as the standardised mean difference, under a random effect model.FindingsWe selected 12 out of 2091 retrieved studies, reporting on 373 undergraduate students (mean of subjects 15.54±6.89). The outcomes were the performance of simple skills and the time to complete a task. Two studies reported a scoring system; seven studies reported time for a task; and three studies reported both. The total number of measures included in the meta-analysis was 456 for score and 504 for time. The pooled effect size did not show any significant advantage in a simulation of a high level of physical resemblance over a lower level, both for the scoring system (−0.19, 95% CI −0.44 to 0.06) and for time (−0.14, 95% CI −0.54 to 0.27).ConclusionSimulations with a low level of physical resemblance showed the same effect as the simulation using a higher level of resemblance on the development of basic surgical skills in undergraduate students.

scholarly journals The Safety of COVID-19 Vaccinations—We Should Rethink the Policy

Vaccines ◽  
2021 ◽  
Vol 9 (7) ◽  
pp. 693
Author(s):  
Harald Walach ◽  
Rainer J. Klement ◽  
Wouter Aukema
Keyword(s):  
Side Effects ◽  
Confidence Interval ◽  
Field Study ◽  
Adverse Reactions ◽  
Safety Data ◽  
European Medicines Agency ◽  
Point Estimate ◽  
Drug Reactions ◽  
Vaccination Policy ◽  
Risks And Benefits

Background: COVID-19 vaccines have had expedited reviews without sufficient safety data. We wanted to compare risks and benefits. Method: We calculated the number needed to vaccinate (NNTV) from a large Israeli field study to prevent one death. We accessed the Adverse Drug Reactions (ADR) database of the European Medicines Agency and of the Dutch National Register (lareb.nl) to extract the number of cases reporting severe side effects and the number of cases with fatal side effects. Result: The NNTV is between 200–700 to prevent one case of COVID-19 for the mRNA vaccine marketed by Pfizer, while the NNTV to prevent one death is between 9000 and 50,000 (95% confidence interval), with 16,000 as a point estimate. The number of cases experiencing adverse reactions has been reported to be 700 per 100,000 vaccinations. Currently, we see 16 serious side effects per 100,000 vaccinations, and the number of fatal side effects is at 4.11/100,000 vaccinations. For three deaths prevented by vaccination we have to accept two inflicted by vaccination. Conclusions: This lack of clear benefit should cause governments to rethink their vaccination policy.

scholarly journals Vaccination knowledge, attitudes and practices in patients with HIV: a cross-sectional survey

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
S Rousset ◽  
G Voglino ◽  
E Boietti ◽  
A Corradi ◽  
M R Gualano ◽  
...  
Keyword(s):  
Public Health ◽  
Infectious Diseases ◽  
Health System ◽  
Vaccination Coverage ◽  
Public Health System ◽  
Cross Sectional Survey ◽  
Hiv Patients ◽  
Cross Sectional ◽  
Contagion Risk ◽  
High Level

Abstract Background Infectious diseases are more common and severe in patients with HIV, which show different response to vaccines and a diminished protection. It is therefore very important to assess knowledge and attitudes towards vaccination in people with HIV, since precise vaccination coverage and vaccine hesitancy are not well established in this subgroup of patients. Methods A sample of 119 patients with HIV completed a cross-sectional survey. Patients were recruited during their routine medical examination at the infectious diseases clinic in Turin. The survey explored these main areas: demographics and history of HIV infection, vaccination history, attitudes towards vaccination, confidence in the public health system, contagion risk and disease seriousness perception. In this preliminary phase descriptive analysis were conducted. Results Preliminary data show that mean age of the participants was 49.51 years, 80% were males. The median of HIV infection duration was 10 years, while the median of the lymphocyte count was 762.50 cells/mm3. The disease with the highest vaccination coverage was tetanus (88.7%), considered a serious or very serious disease by 85.6% of the participants, despite low or very low contagion risk perception (84.1%). The disease with the lowest vaccination coverage was Herpes Zoster (7.3%), despite high or very high seriousness perception (70%). Furthermore, 99.1% of the participants showed high or very high confidence toward public health system professionals, and the majority of them (59.5%) stated that vaccines are more useful for the community than for the single person. Conclusions Vaccination coverage is still not fully satisfactory regarding diseases considered infrequent or mild. Considering the high level of confidence toward the public health system that has emerged, it is necessary to implement informative and operative strategies about vaccination for European HIV patients, which are particularly at risk regarding infectious diseases. Key messages Vaccination coverage and risk perception in HIV patients is not satisfactory for many diseases and an effort to implement informative strategies in Europe is needed. The role of vaccination in preventing infectious diseases in HIV patients should be recognized and strengthened by relying on the high level of confidence toward European public health systems.

scholarly journals Leveraging artificial intelligence for pandemic preparedness and response: a scoping review to identify key use cases

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Ania Syrowatka ◽  
Masha Kuznetsova ◽  
Ava Alsubai ◽  
Adam L. Beckman ◽  
Paul A. Bain ◽  
...  
Keyword(s):  
Public Health ◽  
Artificial Intelligence ◽  
Real Time ◽  
Scoping Review ◽  
Grey Literature ◽  
Use Cases ◽  
Outbreak Detection ◽  
Response To Treatment ◽  
Pandemic Preparedness ◽  
Modeling Approaches

AbstractArtificial intelligence (AI) represents a valuable tool that could be widely used to inform clinical and public health decision-making to effectively manage the impacts of a pandemic. The objective of this scoping review was to identify the key use cases for involving AI for pandemic preparedness and response from the peer-reviewed, preprint, and grey literature. The data synthesis had two parts: an in-depth review of studies that leveraged machine learning (ML) techniques and a limited review of studies that applied traditional modeling approaches. ML applications from the in-depth review were categorized into use cases related to public health and clinical practice, and narratively synthesized. One hundred eighty-three articles met the inclusion criteria for the in-depth review. Six key use cases were identified: forecasting infectious disease dynamics and effects of interventions; surveillance and outbreak detection; real-time monitoring of adherence to public health recommendations; real-time detection of influenza-like illness; triage and timely diagnosis of infections; and prognosis of illness and response to treatment. Data sources and types of ML that were useful varied by use case. The search identified 1167 articles that reported on traditional modeling approaches, which highlighted additional areas where ML could be leveraged for improving the accuracy of estimations or projections. Important ML-based solutions have been developed in response to pandemics, and particularly for COVID-19 but few were optimized for practical application early in the pandemic. These findings can support policymakers, clinicians, and other stakeholders in prioritizing research and development to support operationalization of AI for future pandemics.

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