Clinical end points for drug treatment trials in BCR-ABL1-negative classic myeloproliferative neoplasms: consensus statements from European LeukemiaNET (ELN) and Internation Working Group-Myeloproliferative Neoplasms Research and Treatment (IWG-MRT)

The discovery of somatic mutations, primarily JAK2V617F and CALR, in classic BCR-ABL1-negative myeloproliferative neoplasms (MPNs) has generated interest in the development of molecularly targeted therapies, whose accurate assessment requires a standardized framework. A working group, comprised of members from European LeukemiaNet (ELN) and International Working Group for MPN Research and Treatment (IWG-MRT), prepared consensus-based recommendations regarding trial design, patient selection and definition of relevant end points. Accordingly, a response able to capture the long-term effect of the drug should be selected as the end point of phase II trials aimed at developing new drugs for MPNs. A time-to-event, such as overall survival, or progression-free survival or both, as co-primary end points, should measure efficacy in phase III studies. New drugs should be tested for preventing disease progression in myelofibrosis patients with early disease in randomized studies, and a time to event, such as progression-free or event-free survival should be the primary end point. Phase III trials aimed at preventing vascular events in polycythemia vera and essential thrombocythemia should be based on a selection of the target population based on new prognostic factors, including JAK2 mutation. In conclusion, we recommended a format for clinical trials in MPNs that facilitates communication between academic investigators, regulatory agencies and drug companies.

European Union Biomedical Research Law and Policy and Citizen Science

In this chapter I focus on the EU's emerging biomedical research law and policy and examine the development of citizen science in this setting. The chapter argues that while what the analysis reveals might not be specific to the EU, attention to this organisation underlines important but often overlooked aspects of citizen science. That is, citizen science is (being) made less about promoting substantive involvement by citizens in the fashioning of biomedical trajectories and their empowerment as participants that pursue aims defined by themselves rather than others. Instead citizen science is underpinned by a more longstanding EU level approach to participation in science-based issues that sees it being harnessed, shaped and directed towards supporting the production and legitimation of organisational identity and sociotechnical order (in this case the EU’s). Within biomedical research law and policy citizen science might therefore be expected to support market-optimised biomedical futures and a dynamic internal market and economy. Citizen science is thereby implicated in the delineation of the boundaries of responsibility and accountability (and blame) for the (non-)realisation of public health priorities and objectives. In this way law and policy on participation and citizen science might support current research trajectories that do not serve all health needs.

BESTUFS policy and research recommendations IV: environmental zones in European cities, accommodating the needs of passenger and freight transport in cities, and BESTUFS Project recommendations

Recommendations report produced as part of the EC-funded BESTUFS project on urban freight transport.

Superior outcome of women with stage I/II cutaneous melanoma: pooled analysis of four European Organisation for Research and Treatment of Cancer phase III trials.

PURPOSE: Several studies observed a female advantage in the prognosis of cutaneous melanoma, for which behavioral factors or an underlying biologic mechanism might be responsible. Using complete and reliable follow-up data from four phase III trials of the European Organisation for Research and Treatment of Cancer (EORTC) Melanoma Group, we explored the female advantage across multiple end points and in relation to other important prognostic indicators. PATIENTS AND METHODS: Patients diagnosed with localized melanoma were included in EORTC adjuvant treatment trials 18832, 18871, 18952, and 18961 and randomly assigned during the period of 1984 to 2005. Cox proportional hazard models were used to calculate hazard ratios (HRs) and 95% CIs for women compared with men, adjusted for age, Breslow thickness, body site, ulceration, performed lymph node dissection, and treatment. RESULTS: A total of 2,672 patients with stage I/II melanoma were included. Women had a highly consistent and independent advantage in overall survival (adjusted HR, 0.70; 95% CI, 0.59 to 0.83), disease-specific survival (adjusted HR, 0.74; 95% CI, 0.62 to 0.88), time to lymph node metastasis (adjusted HR, 0.70; 95% CI, 0.51 to 0.96), and time to distant metastasis (adjusted HR, 0.69; 95% CI, 0.59 to 0.81). Subgroup analysis showed that the female advantage was consistent across all prognostic subgroups (with the possible exception of head and neck melanomas) and in pre- and postmenopausal age groups. CONCLUSION: Women have a consistent and independent relative advantage in all aspects of the progression of localized melanoma of approximately 30%, most likely caused by an underlying biologic sex difference.

Revised definitions of invasive fungal disease from the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG) Consensus Group.

BACKGROUND: Invasive fungal diseases are important causes of morbidity and mortality. Clarity and uniformity in defining these infections are important factors in improving the quality of clinical studies. A standard set of definitions strengthens the consistency and reproducibility of such studies. METHODS: After the introduction of the original European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG) Consensus Group definitions, advances in diagnostic technology and the recognition of areas in need of improvement led to a revision of this document. The revision process started with a meeting of participants in 2003, to decide on the process and to draft the proposal. This was followed by several rounds of consultation until a final draft was approved in 2005. This was made available for 6 months to allow public comment, and then the manuscript was prepared and approved. RESULTS: The revised definitions retain the original classifications of "proven," "probable," and "possible" invasive fungal disease, but the definition of "probable" has been expanded, whereas the scope of the category "possible" has been diminished. The category of proven invasive fungal disease can apply to any patient, regardless of whether the patient is immunocompromised, whereas the probable and possible categories are proposed for immunocompromised patients only. CONCLUSIONS: These revised definitions of invasive fungal disease are intended to advance clinical and epidemiological research and may serve as a useful model for defining other infections in high-risk patients.

Defining responses to therapy and study outcomes in clinical trials of invasive fungal diseases: Mycoses Study Group and European Organization for Research and Treatment of Cancer consensus criteria.

Invasive fungal diseases (IFDs) have become major causes of morbidity and mortality among highly immunocompromised patients. Authoritative consensus criteria to diagnose IFD have been useful in establishing eligibility criteria for antifungal trials. There is an important need for generation of consensus definitions of outcomes of IFD that will form a standard for evaluating treatment success and failure in clinical trials. Therefore, an expert international panel consisting of the Mycoses Study Group and the European Organization for Research and Treatment of Cancer was convened to propose guidelines for assessing treatment responses in clinical trials of IFDs and for defining study outcomes. Major fungal diseases that are discussed include invasive disease due to Candida species, Aspergillus species and other molds, Cryptococcus neoformans, Histoplasma capsulatum, and Coccidioides immitis. We also discuss potential pitfalls in assessing outcome, such as conflicting clinical, radiological, and/or mycological data and gaps in knowledge.

Identification of quality in educational research publications : the european educational research quality indicators (EERQI) project

Resumen basado en el de la publicación

Predictors of knowledge creation performance. A quantitative qualitative comparative study of European doctorandi

Aquesta tesi forma part d'un projecte destinat a predir el rendiment acadèmic dels estudiants de doctorat portat a terme per l'INSOC (International Network on Social Capital and Performance). El grup de recerca INSOC està format per les universitats de Girona (Espanya), Ljubljana (Eslovènia), Giessen (Alemanya) i Ghent (Bèlgica). El primer objectiu d'aquesta tesi és desenvolupar anàlisis quantitatius comparatius sobre el rendiment acadèmic dels estudiants de doctorat entre Espanya, Eslovènia i Alemanya a partir dels resultats individuals del rendiment acadèmic obtinguts de cada una de les universitats. La naturalesa internacional del grup de recerca implica la recerca comparativa. Vam utilitzar variables personal, actitudinals i de xarxa per predir el rendiment. El segon objectiu d'aquesta tesi és entendre de manera qualitativa perquè les variables de xarxa no ajuden quantitativament a predir el rendiment a la universitat de Girona (Espanya). En el capítol 1, definim conceptes relacionats amb el rendiment i donam un llistat de cada una de les variables independents (variables de xarxa, personals i actitudinals), resumint la lliteratura. Finalment, explicam com s'organitzen els estudis de doctorat a cada un dels diferents països. A partir d'aquestes definicions teòriques, en els pròxims capítols, primer presentarem els qüestionaris utilitzats a Espanya, Eslovènia i Alemanya per mesurar aquests diferents tipus de variables. Després, compararem les variables que són relevants per predir el rendiment dels estudiants de doctorat a cada país. Després d'això, fixarem diferents models de regressió per predir el rendiment entre països. En tots aquests models les variables de xarxa fallen a predir el rendiment a la Universitat de Girona. Finalment, utilitzem estudis qualitatius per entendre aquests resultats inesperats. En el capítol 2, expliquem com hem dissenyat i conduït els qüestionaris en els diferents països amb l'objectiu d'explicar el rendiment dels estudiants de doctorat obtinguts a Espanya, Eslovènia i Alemanya. En el capítol 3, cream indicadors comparables però apareixen problemes de comparabilitat en preguntes particulars a Espanya, Eslovènia i Alemanya. En aquest capítol expliquem com utilitzem les variables dels tres països per crear indicadors comparables. Aquest pas és molt important perquè el principal objectiu del grup de recerca INSOC és comparar el rendiment dels estudiants de doctorat entre els diferents països. En el capítol 4 comparem models de regressió obtinguts de predir el rendiment dels estudiants de doctorat a les universitats de Girona (Espanya) i Eslovènia. Les variables són característiques dels grups de recerca dels estudiants de doctorat enteses com una xarxa social egocèntrica, característiques personals i actitudinals dels estudiants de doctorat i algunes carecterístiques dels directors. Vam trobar que les variables de xarxa egocèntriques no predien el rendiment a la Universitat de Girona. En el capítol 5, comparem dades eslovenes, espanyoles i alemnayes, seguint la metodologia del capítol 4. Concluïm que el cas alemany és molt diferent. El poder predictiu de les variables de xarxa no millora. En el capítol 6 el grup de recerca dels estudiants de doctorat és entès com una xarxa duocèntrica (Coromina et al., 2008), amb l'objectiu d'obtendre informació de la relació mútua entre els estudiants i els seus directors i els contactes d'ambdós amb els altres de la xarxa. La inclusió de la xarxa duocèntrica no millora el poder predictiu del model de regressió utilitzant les variales egocèntriques de xarxa. El capítol 7 pretèn entendre perquè les variables de xarxa no predeixen el rendiment a la Universitat de Girona. Utilitzem el mètode mixte, esperant que l'estudi qualitatiu pugui cobrir les raons de perquè la qualitat de la xarxa falla en la qualitat del treball dels estudiants. Per recollir dades per l'estudi qualitatiu utilitzem entrevistes en profunditat.