Professional Societies Research Articles

Parkinson's Disease Psychosis and the Marketing of Pimavanserin.

In 2016, Nuplazid (pimavanserin) became the first FDA-approved treatment for Parkinson's Disease Psychosis (PDP). We explored the possibility that PDP was a term created to market Nuplazid. We examined trends in perceptions of psychosis in Parkinson's disease from the 1990s to 2020 through MEDLINE search term frequency, neurology textbooks, guidance from professional societies, Acadia annual reports, sponsored websites, and a sponsored meeting held by the National Institutes of Health (NIH). We analyzed continuing medical education (CME) activities on PDP and analyzed the connection between payments by the manufacturer of pimavanserin and prescriptions. Our analysis of nine sponsored CME activities reveals misleading themes, including: PDP is common, progressive, and not always drug-induced; there is no such thing as a benign hallucination, and psychotic symptoms always worsen; PDP increases mortality; and competing treatments are ineffective or dangerous while pimavanserin is safe and effective for treating PDP. Industry-sponsored CME was used to disseminate inaccurate and misleading marketing messages on psychosis related to Parkinson's disease. Some professional societies and some textbooks also resisted the PDP label. Reframing PDP as a unique condition is a typical example of condition branding. The establishment of PDP expanded the use of pimavanserin and is likely to have resulted in many avoidable deaths.

How the Milan System for Reporting Salivary Gland Cytopathology works in cytopathology practice: Meta-analysis of prospective studies and comparison with retrospective studies.

The Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) is widely accepted and endorsed by professional societies. Although several studies focusing on the MSRSGC have been published, few have been prospective studies. The objective of this study was to evaluate the effectiveness of the MSRSGC in cytopathology practice. A comprehensive literature search was conducted to identify all prospective studies on the MSRSGC. The risk of malignancy (ROM), risk of neoplasm, and diagnostic accuracy for each diagnostic category were calculated. Data were tabulated in Microsoft Excel, and analyses were performed with the Open Meta-Analyst program. Seven prospective and seven retrospective studies were identified. The total number of fine-needle aspirations (FNAs) was 1587 in the prospective studies and 1764 in the retrospective studies. The ROM values for the nondiagnostic, nonneoplastic, atypia of undetermined significance, benign neoplasm, salivary gland neoplasm of uncertain malignant potential, suspicious for malignancy, and malignant categories in prospective versus retrospective studies were 21.0% versus 26.6%, 9.4% versus 8.1%, 34.9% versus 39.6%, 2.4% versus 2.1%, 36.6% versus 31.2%, 86.0% versus 66.0%, and 97.0% versus 96.7%, respectively. Sensitivities, specificities, and diagnostic odds ratios were 83.1% (95% confidence interval [CI], 71.1%-90.8%) versus 89.1% (95% CI, 83.6%-92.9%), 98.4% (95% CI, 96.6%-99.3%) versus 94.9% (95% CI, 91.9%-96.9%), and 310.7 (95% CI, 121.2-796.6) versus 218.8 (95% CI, 107.3-438.1). This meta-analysis indicated that the MSRSGC works well in FNA cytopathology practice and improves diagnostic accuracy in all diagnostic categories. The ROMs of prospective studies were in concordance with the MSRSGC reference values.

Validation of the predictive value of BDNF -87 methylation for antidepressant treatment success in severely depressed patients—a randomized rater-blinded trial

BackgroundBrain-derived neurotrophic factor (BDNF) is essential for antidepressant treatment of major depressive disorder (MDD). Our repeated studies suggest that DNA methylation of a specific CpG site in the promoter region of exon IV of the BDNF gene (CpG -87) might be predictive of the efficacy of monoaminergic antidepressants such as selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and others. This trial aims to evaluate whether knowing the biomarker is non-inferior to treatment-as-usual (TAU) regarding remission rates while exhibiting significantly fewer adverse events (AE).MethodsThe BDNF trial is a prospective, randomized, rater-blinded diagnostic study conducted at five university hospitals in Germany. The study’s main hypothesis is that {1} knowing the methylation status of CpG -87 is non-inferior to not knowing it with respect to the remission rate while it significantly reduces the AE rate in patients experiencing at least one AE. The baseline assessment will occur upon hospitalization and a follow-up assessment on day 49 (± 3). A telephone follow-up will be conducted on day 70 (± 3). A total of 256 patients will be recruited, and methylation will be evaluated in all participants. They will be randomly assigned to either the marker or the TAU group. In the marker group, the methylation results will be shared with both the patient and their treating physician. In the TAU group, neither the patients nor their treating physicians will receive the marker status. The primary endpoints include the rate of patients achieving remission on day 49 (± 3), defined as a score of ≤ 10 on the Hamilton Depression Rating Scale (HDRS-24), and the occurrence of AE.Ethics and disseminationThe trial protocol has received approval from the Institutional Review Boards at the five participating universities. This trial holds significance in generating valuable data on a predictive biomarker for antidepressant treatment in patients with MDD. The findings will be shared with study participants, disseminated through professional society meetings, and published in peer-reviewed journals.Trial registrationGerman Clinical Trial Register DRKS00032503. Registered on 17 August 2023.

Pulmonary Rehabilitation: A Look Back, a Look Forward.

Pulmonary rehabilitation (PR) is a comprehensive approach to the management of patients with chronic lung disease that encompasses exercise, education, and psychosocial support. The development of PR programs began in the mid-20th century with the appreciation that exercise provided real benefit in chronic lung disease and that effective disease management involved patient education focused on medications, lifestyle changes, and lifelong regular exercise. Initially PR was primarily facility-based, but today PR is extending into the home with telemedicine, and this is encouraging a real partnership of patients and professionals supporting self-management. The evidence base supporting PR as a safe and effective modality has grown exponentially over the last 4 decades, and PR is strongly endorsed by virtually all the major professional societies. Importantly, PR has also clearly been shown to be cost-effective. Challenges remain, however. Access is still very limited for a variety of reason (logistics, financial, patient motivation) that need to be addressed. More focused and personalized exercise programs and monitoring strategies that encourage a patient's lifetime commitment to the principles of PR need to be developed and refined. The opportunity to really impact important clinical outcomes exists with PR, and this needs to be exploited.

Practice Patterns and Barriers to Vascular Genetic Testing Among Vascular Surgeons

Engaging patients living with or at risk of aortic dissection via the Aortic Dissection Collaborative, physician education in vascular genetics was identified as a research priority. We surveyed vascular surgeons to characterize practice patterns, motivations, and barriers regarding aortopathy genetic testing. An anonymous 27-question survey was distributed on social media platforms between November and December 2022. Domains included demographics, vascular genetic education, testing attitudes and utilization, and experience in treating patients with genetic vascular aortopathies. The analysis included summary statistics and unpaired t-test to compare responses by interest in incorporating testing and practice type. A total of 171 vascular surgeons from 15 countries responded to the survey (23% trainees). Over half received vascular genetics education during training (59%), and most (86%) were interested in incorporating genetic testing into their practice. Academic surgeons were more likely to have cared for a patient with a known genetic aortopathy over the past year than surgeons in hospital-based and private practices (83% vs. 56% vs. 27%; P<0.01), to have ever made a referral to a medical geneticist (78% vs. 51% vs. 9%; P<0.01), and have access to genetic counselors or geneticists (66% vs. 46% vs. 0%; P<0.01). Barriers to genetic testing were rated as more significant by surgeons in nonacademic practices, with top barriers being insurance coverage of testing, cost of genetic testing, and access to genetic counselors. Evidence-based professional society guidelines were the strongest rated motivating factor for testing incorporation among respondents. Vascular surgeon attitudes are not major barriers to incorporating genetic testing for patients with aortopathies; however, practical challenges regarding genetic testing and counseling are barriers to implementation especially for vascular surgeons in nonacademic practices. Future efforts should focus on evidence-based society guidelines, continuing medical education to increase adoption, and facilitating access to genetic counseling.

Toward the elimination of hepatitis B: networking to promote the prevention of vertical transmission of hepatitis B virus through population-based interventions and multidisciplinary groups in Africa.

The WHO African Region had 81 million people with chronic hepatitis B in 2019, which remains a silent killer. Hepatitis B virus (HBV), hepatitis delta virus (HDV), and HIV can be transmitted from the mother to child. If the HBV infection is acquired at infancy, it may lead to chronic hepatitis B in 90% of the cases. WHO reports that 6.4 million children under 5 years live with chronic hepatitis B infection worldwide. The prevention of mother-to-child transmission (PMTCT) of HBV is therefore critical in the global elimination strategy of viral hepatitis as we take lessons from PMTCT of HIV programs in Africa. We sought to create a network of multidisciplinary professional and civil society volunteers with the vision to promote cost-effective, country-driven initiatives to prevent the MTCT of HBV in Africa. In 2018, the Mother-Infant Cohort Hepatitis B Network (MICHep B Network) with members from Cameroon, Zimbabwe, and the United Kingdom and later from Chad, Gabon, and Central African Republic was created. The long-term objectives of the network are to organize capacity-building and networking workshops, create awareness among pregnant women, their partners, and the community, promote the operational research on MTCT of HBV, and extend the network activities to other African countries. The Network organized in Cameroon, two "Knowledge, Attitude and Practice" (KAP) surveys, one in-depth interview of 45 health care workers which revealed a high acceptability of the hepatitis B vaccine by families, two in-person workshops in 2018 and 2019, and one virtual in 2021 with over 190 participants, as well as two workshops on grant writing, bioethics, and biostatistics of 30 postgraduate students. Two HBV seroprevalence studies in pregnant women were conducted in Cameroon and Zimbabwe, in which a prevalence of 5.8% and 2.7%, respectively, was reported. The results and recommendations from the MICHep B Network activities could be implemented in countries of the MICHep B Network and beyond, with the goal of providing free birth dose vaccine against hepatitis B in Africa.

Tracing the Academic Lineage of Richard J. Goldstein

Abstract Richard J. Goldstein was a distinguished figure in both scientific and engineering research, who served in several important professional societies and was honored with fellowships and appointments to numerous domestic and international academies. His global impact is further felt through the distinguished students he mentored during his highly productive academic career and who have subsequently achieved success in academia, research, and industry. However, to many, Goldstein's most profound and personal impact was as an esteemed educator, thesis advisor, and mentor. The heartfelt gratitude expressed by these students and colleagues attests to his profound influence in their lives. This brief article endeavors to delve into Goldstein's academic genealogy, a history of groundbreaking contributors spanning over six centuries, which also bears witness to the evolution of the present-day fields of thermodynamics and heat and mass transfer. Richard J. Goldstein's academic lineage traces back through two primary branches: (i) an astronomy/physics branch and (ii) a mathematics/physics branch. The astronomy/physics branch commences its journey from the venerable Nicolaus Copernicus, whose revolutionary contributions laid the foundation for seminal research in the field of astronomy. The mathematics/physics branch is anchored by eminent figures such as the Bernoulli brothers, Leonhard Euler, Jean d'Alembert, and Pierre-Simon Laplace. Presented in this article predominantly in the form of a directed graph, this succinct academic lineage illustrates the historical roots of Goldstein's intellectual heritage, a journey incorporating key figures greatly revered by the contemporary thermodynamics and heat transfer research community.

Fertility education on Instagram: advertisements vs. educational content analysis for posts in Bahasa (Indonesian language).

As one of Indonesia's major social media platforms, Instagram provides abundant information, including fertility topics. However, fertility information in Bahasa (Indonesian language) had never been mapped before. This study aims to determine the prevalence, authorship, and types of fertility-related information in Bahasa shared on Instagram using hashtag and content analysis. Additional outcomes included a comparison of post content stratified by author type (healthcare providers vs. non-healthcare providers). Five hashtags comprising fertility terms in Bahasa (Indonesian language) were derived. Content analysis was performed on the top 100 posts for each hashtag to determine the authorship and content type. The contents posted by healthcare providers were analyzed and compared to those published by non-healthcare providers. Our search yielded 3883000 posts for the five most popular hashtags. The three most popular hashtags were 'promil', 'program hamil' and 'bayitabung'. Authorship of the top posts for each hashtag was predominantly by for-profit healthcare institutions (27.6%), followed by commercial alternative/herbal medicine (20.2%), patients (20%), physicians (11.8%), allied health professionals (3.2%), professional societies (0.8%), and others (16.4%). Of these posts, 35.4% were advertisements, 28% were related to patient experience, and 18% were educational. Healthcare provider groups were more likely to author educational posts than advertisements, while non-healthcare providers were more likely to post content for commercial purposes (P < 0.001). Fertility-related posts were dominated by for-profit healthcare institutions and alternative/herbal medicines for commercial purposes. The physician group authored more of the educational content. There is plenty of room for optimal utilization of social platforms as educational media.

Implementation of high sensitivity troponin into routine clinical practice - results of the extended CARdiac MArkers guideline uptake in Europe group (CARMAGUE) survey

BackgroundMeasurement of cardiac troponin (cTn) by a high sensitivity method is now the recommended strategy for the detection of myocardial injury. An international survey was undertaken to assess how this has been implemented. MethodsA questionnaire based around 14 domains on cardiac biomarkers was distributed electronically with the aid of professional societies accessed by a web link within the invitation. Results were returned electronically then extracted into a relational database for analysis. ResultsResponses were obtained from 663 laboratories across 76 countries ranging from 1 to 69 largest country. The majority of responses (79.6%) came from the European area. Responses were grouped into broad geographic areas for analysis. Most responses came from hospitals providing a local and regional service of which the majority provided angioplasty. cTn measurement was the dominant biomarker. The majority of laboratories include creatine kinase (CK) in their cardiac profile and approximately 50% also offer the MB isoenzyme of CK. The majority of laboratories (91.9%) measure cTn by a high sensitivity method. Sex specific reference ranges were typically implemented for cardiac troponin I but not for cardiac troponin T. The preferred unit of measurement was nanograms/L. A structured decision-making pathway utilising high sensitivity cTn measurement was used by 83.3% of laboratories who responded. Single sample rule out is common but the majority used serial sampling strategy based on measurement on admission and three hours. ConclusionsMeasurement of cTn by a high sensitivity method is now well established internationally, the use of rapid diagnostic protocols lags behind.

The Making of Psychiatrists in Japan

Abstract Background: Like in most countries in the world, Japan has its own system of how a medical graduate becomes a psychiatrist. Methods: The authors, young Japanese psychiatrists, describe what they have personally been through the education and training before becoming full-fledged psychiatrists who can treat patients with psychiatric diseases. All those personal experiences are validated with related documents. Results: In Japan, the pathway to become psychiatrists involves a rigorous process starting with a competitive entrance to medical school, followed by a six-year educational curriculum influenced by international accreditation standards. After graduating from medical schools, physicians receive a two-year junior residency training, which briefly introduces them to psychiatry, influencing some to specialize in the field. Specialization requires further training and certification, facilitated by the Japanese Society of Psychiatry and Neurology (JSPN) and the Ministry of Health, Labor, and Welfare, encompassing various psychiatric settings and disorders. Beyond initial certification, there are continuous professional development opportunities, including advanced specializations and educational programs supported by professional societies such as the JSPN and the Japan Young Psychiatrists Organization. Conclusion: This system ensures a comprehensive and structured approach to psychiatric education and specialization in Japan, offering a wide range of opportunities for aspiring psychiatrists.

How good is ChatGPT at answering patients’ questions related to early detection of oral (mouth) cancer?

ObjectivesTo examine the quality, reliability, readability, and usefulness of ChatGPT in promoting oral cancer early detection. Study design108 patients-oriented questions about oral cancer early detection were compiled from expert panel, professional societies, and web-based tools. Questions were categorized into four topic domains and ChatGPT 3.5 was asked each question independently. ChatGPT answers were evaluated regarding quality, readability, actionability, and usefulness using. Two experienced reviewers independently assessed each response. ResultsQuestions related to clinical appearance constituted 36.1% (n=39) of the total questions. ChatGPT provided “very useful” responses to the majority of questions (75%; n=81). The mean Global Quality Score was 4.24 ±1.3 out of 5. The mean reliability score was 23.17 ± 9.87 out of 25. The mean understandability score was 76.6% ±25.9 out of 100, while the mean actionability score was 47.3% ± 18.9 out of 100. The mean FKS reading ease score was 38.4%± 29.9, while the mean SMOG index readability score was 11.65 ± 8.4. No misleading information was identified among ChatGPT responses. ConclusionChatGPT is an attractive and potentially useful resource for informing patients about early detection of oral cancer. Nevertheless, concerns do exist about readability and actionability of the offered information.

Society of Sensory Professionals

Society of Sensory Professionals

Наукова, міжнародна і громадська діяльність товариства у 2023 році

Information on the main results of the activities of the Public Union “Ukrainian Society of Geodesy and Cartography (GS “USGC”)” and the Western Geodetic Society of USGC (WGS USGC) in the difficult conditions of the military state. The main focus is on the professional protection of the country’s geodetic industry, the holding of the Geoforum-2023 MNTC and the support of other MNTCs, the participation of the Society’s delegation in the INTERGEO world congress in Berlin, in the work of the CLGE Assembly in Romania, cooperation with FIG CLGE and professional public societies of various countries, publication of regular issues of the professional journal of HRT, marking of important events in the country, industry, society, collectives, in the life of specialists in Ukraine and abroad, etc.

Breakdown of gender representation in leadership of professional gynecologic specialty societies worldwide

Breakdown of gender representation in leadership of professional gynecologic specialty societies worldwide

191 Online Multi-media Teaching Modules are Effective for Surgical Education in Electrodiagnostic Interpretation

INTRODUCTION: Though electrodiagnostic studies are the gold standard for diagnosing nerve injuries, most surgeons are not trained to interpret these studies, and therefore typically rely on interpretation from a non-surgical electrodiagnostician. This discrepancy between interpretation and treatment of nerve injuries can lead to suboptimal surgical planning and patient outcomes. METHODS: Hand surgeons at various stages of training were recruited from professional surgical societies. All surgeons completed an educational module, which consisted of a pre-intervention knowledge assessment, an educational video, and a post-intervention assessment. The educational video was a 45-minute lecture on electrodiagnostic indications for nerve injury and included either traditional PowerPoint or Prezi formatting. Participants were randomized into receiving one of the two video formats. A retention assessment, including surgeon satisfaction and feedback, was administered at three-months after initial evaluation. RESULTS: Sixty-three surgeons completed the pre-intervention knowledge assessment, educational video, and post-intervention assessment, 30 of whom underwent the three-month retention assessment. The average assessment score improved by 2 points between pre- and post-intervention (12-point scale, p &lt; 0.001). The majority of participants responded that the educational video was a “perfect” length (81%), was engaging (86%), improved their knowledge (86%), and that they would incorporate the information into their clinical practice (86%). Seventy-two percent of the surgeons preferred the online teaching module compared to a traditional in-person conference presentation. There was no significant difference in assessment performance and surgeon satisfaction between Prezi and PowerPoint formatting (p &gt; 0.05). CONCLUSIONS: Our results demonstrate the feasibility and efficacy of an online educational module to support continuing professional development in nerve injury surgery, irrespective of the presentation style (i.e., Prezi vs. PowerPoint). This study highlights the potential behind online educational content and provides a framework for future multimedia modules for surgical education.

The World’s Most Troublesome Weed: Water Hyacinth and the Development of Wetland Science

Water Hyacinth (Eichhornia crassipes (Mart.) Solms) is a large free-floating plant (up to 1 m tall) that can become established from seed and vegetative fragments. Vegetative growth is by stolons, creating floating mats of interconnected plants. Originally from South America, it reached the United States in the 1880s and, by the 1890s, had become a severe problem in Florida rivers. When large floating mats of Water Hyacinth began interfering with steamboat navigation on the St. Johns River and other rivers, various control measures were investigated to destroy or remove it, including mechanical harvesting, primitive herbicides, and physical barriers (booms). None proved completely effective. None of the numerous attempts to turn Water Hyacinth into salable commodities has been commercially viable. The lack of any permanent solution to Water Hyacinth infestations forced local governments in Florida to hire stafto deal with infestations in their jurisdictions. Eventually, the number of people working on Water Hyacinth control increased significantly, resulting in the establishment of the Hyacinth Control Society in 1961 to facilitate the exchange of information on how best to manage it. This Society was the first American professional society whose members were dedicated to protecting and managing wetlands.

Application of End-Tidal CO2 Monitoring to ICU Management.

Waveform capnography is a noninvasive measurement of ventilation and perfusion commonly employed in the prehospital setting. It is easy to apply, and modern cardiac monitors are equipped with the necessary ports and capability to display results. Despite its ease of use, end-tidal CO2 monitoring has not yet achieved widespread adoption within the hospital setting. It is routinely used in the emergency department and by anesthesiologists, but its application could support ICU management in critically ill patients. Its use is routinely supported by multiple professional societies, and it has been recommended as a requirement in all cardiac arrests. Careful analysis of the waveform and expired carbon dioxide can guide therapy for patients experiencing respiratory emergencies, hemodynamic compromise, metabolic acidosis, and shock due to trauma, hypovolemia, or sepsis. Use of capnography throughout the hospital could improve patient outcomes and prevent unidentified deterioration.

ChatGPT accurately performs genetic counseling for gynecologic cancers

ObjectiveArtificial Intelligence (AI) systems such as ChatGPT can take medical examinations and counsel patients regarding medical diagnosis. We aim to quantify the accuracy of the ChatGPT V3.4 in answering commonly asked questions pertaining to genetic testing and counseling for gynecologic cancers. MethodsForty questions were formulated in conjunction with gynecologic oncologists and adapted from professional society guidelines and ChatGPT version 3.5 was queried, the version that is readily available to the public. The two categories of questions were genetic counseling guidelines and questions pertaining to specific genetic disorders. The answers were scored by two attending Gynecologic Oncologists according to the following scale: 1) correct and comprehensive, 2) correct but not comprehensive, 3) some correct, some incorrect, and 4) completely incorrect. Scoring discrepancies were resolved by additional third reviewer. The proportion of responses earning each score were calculated overall and within each question category. ResultsChatGPT provided correct and comprehensive answers to 33/40 (82.5%) questions, correct but not comprehensive answers to 6/40 (15%) questions, partially incorrect answers to 1/40 (2.5%) questions, and completely incorrect answers to 0/40 (0%) questions. The genetic counseling category of questions had the highest proportion of answers that were both correct and comprehensive with ChatGPT answering all 20/20 questions with 100% accuracy and were comprehensive in responses. ChatGPT performed equally in the specific genetic disorders category, with 88.2% (15/17) and 66.6% (2/3) correct and comprehensive answers to questions pertaining to hereditary breast and ovarian cancer and Lynch syndrome questions respectively. ConclusionChatGPT accurately answers questions about genetic syndromes, genetic testing, and counseling in majority of the studied questions. These data suggest this powerful tool can be utilized as a patient resource for genetic counseling questions, though more data input from gynecologic oncologists would be needed to educate patients on genetic syndromes.

Six country vignettes: Strengthening radiotherapy and theranostics

BackgroundFor cancer patient populations worldwide, the synchronous scale-up of diagnostics and treatments yields meaningful gains in survival and quality of life. Among advanced cancer therapies, radiotherapy (RT) and theranostics are key to achieving practical, high-quality, and personalized precision medicine - targeting disease manifestations of individual patients and broad populations, alike. Aiming to learn from one another across different world regions, the six country vignettes presented here depict both challenges and victories in de novo establishment or improvement of RT and theranostics infrastructure. MethodsThe International Atomic Energy Agency (IAEA) convened global RT and theranostics experts from diverse world regions and contexts to identify relevant challenges and report progress in their own six countries: Belgium, Brazil, Costa Rica, Jordan, Mongolia, and South Africa. These accounts are collated, compared, and contrasted herein. ResultsCommon challenges persist which could be more strategically assessed and addressed. A quantifiable discrepancy entails personnel. The estimated radiation oncologists (ROs), nuclear medicine physicians (NMPs), and medical physicists (MPs for RT and nuclear medicine) per million inhabitants in the six collective countries respectively range between 2.69–38.00 ROs, 1.00–26.00 NMPs, and 0.30–3.45 MPs (Table 1), reflecting country-to-country inequities which largely match World Bank country-income stratifications. ConclusionEstablished goals for RT and nuclear medicine advancement worldwide have proven elusive. The pace of progress could be hastened by enhanced approaches such as more sustainably phased implementation; better multinational networking to share lessons learned; routine quality and safety audits; as well as capacity building employing innovative, resource-sparing, cutting-edge technologic approaches.Bodies such as ministries of health, professional societies, and the IAEA shall serve critical roles in convening and coordinating more innovative RT and theranostics translational research, including expanding nuanced global database metrics to inform, reach, and potentiate milestones most meaningfully. Policy SummaryAligned with WHO 25×25 NCDs target; WHA70.12 and WHA76.5 resolutions.

R WE ready for reimbursement? A round up of developments in real-world evidence relating to health technology assessment: part 15.

In this latest update we discuss real-world evidence (RWE) guidance from the leading oncology professional societies, the American Society of Clinical Oncology and the European Society for Medical Oncology, and the PRINCIPLED practical guide on the design and analysis of causal RWE studies.