VP39 The Alphabet Lottery? How NICE Outcomes Vary By Appraisal Committee

2019 ◽  
Vol 35 (S1) ◽  
pp. 86-86
Author(s):  
Richard Macaulay ◽  
Lok Wan Liu ◽  
Cornelia Roibu ◽  
Andrea Berardi
Keyword(s):  
Cost Effectiveness ◽  
The Other ◽  
Appraisal Committee ◽  
Technology Appraisal ◽  
The Public ◽  
Chi Squared ◽  
C 50 ◽  
To Receive ◽  
Disciplinary Group ◽  
53 C 55

IntroductionNICE (National Institute for Health and Care Excellence) makes recommendations on the public reimbursement of medicines based on their clinical- and cost-effectiveness. The recommendation is made by an Appraisal Committee (comprising a multi-disciplinary group of independent experts) as part of a technology appraisal. There are four Appraisal Committees (A,B,C,D); this research investigates whether appraisal outcomes vary by committee.MethodsAll publicly-available Final Appraisal Determinations from NICE Single Technology Appraisals (STA) were screened (01/10/2009-14/11/2018) and key data were extracted. Homogeneity in rates of acceptance or rejection across the committees was assessed using Chi-squared tests.ResultsThe Appraisal Committee was identified for 298 technologies, 56% (168/298) of which were ‘recommended’. The number of technologies assessed by each committee was similar (A:79, B:62, C:91, D:66). However, STAs conducted by Committee D were significantly less likely to receive ‘recommended’ outcomes (A:68% [54/79], B:65% [40/62], C:53% [48/91], D:39% [26/66]; p < 0.01). STAs for oncology indications had higher ’not recommended’ outcomes than those for non-oncology indications (25% vs. 9%). The lower ‘recommendation’ rates for committee D persisted across oncology (A:60%, B:83%, C:50%, D:38%; p = 0.01) and non-oncology indications (A:73%, B:53%, C:55%, D:40%; p < 0.01). However, STAs conducted by Committee D were significantly more likely to receive ‘optimized’ recommendations (A:16%, B:21%, C:33%, D: 36%; p < 0.01) and when considering the rates of ‘recommended’ and ‘optimized’ outcomes compared to ‘only in research’ and ‘not recommended’ outcomes, no significant differences were found (A:85%, B: 85%, C:86%, D:76%; p = 0.27).ConclusionsSTAs undertaken by NICE Appraisal Committee D was associated with a significantly lower rate of ‘recommended’ outcomes but tended to an ‘optimized’ recommendation significantly more than the other committees. Further research is needed to determine if this reflects any deviation in uniform implementation of NICE methodology between Committees.

scholarly journals Potential Autoimmunity of SARS CoV-2 Nucleic Acid-based Vaccination: What Should We Know?

2021 ◽  
Author(s):  
Mina Kelleni
Keyword(s):  
Nucleic Acid ◽  
The Other ◽  
Spike Protein ◽  
Vulnerable Groups ◽  
Right To Know ◽  
Benefit Ratio ◽  
The Public ◽  
To Receive ◽  
Personalized Risk

mRNA based and adenovirus vectored vaccines, types of nucleic acid-based vaccination, were first ever or first commercially ever approved for the public, respectively. However, these new types possess a potential risk to induce auto-immune diseases more possibly in the short yet potentially the long term as well. On the other hand, all SARS CoV-2 types of vaccines, depending on the spike protein immunogenicity, including the conventional ones might increase the likelihood of COVID-19 severity upon re-infection through antibody dependent enhancement. Thus, a moral, legal, and constitutional public right to know and decide basing on a personalized risk benefit ratio must be secured. In this manuscript, we analyze the theoretical autoimmunity potential of SARS CoV-2 adenovirus vectored vaccines, after we have previously discussed the same potential for mRNA-based ones. Further, we explore the vulnerable groups of vaccines recipients who are generally more liable to develop autoimmune diseases and how might these groups modify the risk if decided to receive the vaccines.

scholarly journals Potential Autoimmunity or Antibody Dependent COVID-19 Enhancement of SARS CoV-2 Vaccination or Convalescent Plasma: A Moral, Legal and Constitutional Right to Know.

2021 ◽  
Author(s):  
Mina Kelleni
Keyword(s):  
The Other ◽  
Spike Protein ◽  
Vulnerable Groups ◽  
Right To Know ◽  
Benefit Ratio ◽  
The Public ◽  
Constitutional Right ◽  
To Receive ◽  
Personalized Risk

mRNA based and adenovirus vectored vaccines, types of nucleic acid-based vaccination, were first ever or first commercially ever approved for the public, respectively. However, these new types possess a potential risk to induce auto-immune diseases more possibly in the short yet potentially the long term as well. On the other hand, all SARS CoV-2 types of vaccines, depending on the spike protein immunogenicity, especially the conventional inactivated ones might increase the likelihood of COVID-19 severity upon re-infection through antibody dependent enhancement which might also reason for some of the serious adverse effects encountered with administration of convalescent plasma to COVID-19 patients. Thus, a moral, legal, and constitutional public right to know and decide basing on a personalized risk benefit ratio must be secured. In this manuscript, we analyze the theoretical autoimmunity potential of SARS CoV-2 adenovirus vectored vaccines, after we have previously discussed the same potential for mRNA-based ones. Further, we explore the vulnerable groups of vaccines recipients who are generally more liable to develop autoimmune diseases and how might these groups modify the risk if decided to receive the vaccines.

VP63 National Institute For Health And Care Excellence (NICE) Technology Appraisal Patient Expert Feedback: 15 month analysis

2017 ◽  
Vol 33 (S1) ◽  
pp. 177-178
Author(s):  
Chloe Kastoryano ◽  
Lizzie Thomas ◽  
Heidi Livingstone ◽  
Gillian Leng
Keyword(s):  
Online Survey ◽  
Patient Involvement ◽  
Public Involvement ◽  
Appraisal Committee ◽  
Technology Appraisal ◽  
Committee Meeting ◽  
The Public ◽  
Formal Policy ◽  
Quantitative Results ◽  
Patient Expert

INTRODUCTION:The National Institute for Health and Care Excellence (NICE) has a formal policy stating patients, carers and citizens are involved throughout each Health Technology Assessment (HTA). One key way patient/carer organizations are involved is by nominating patient experts to participate in appraisal committee meetings.A NICE 2014 report (1) on Patient Experts experiences identified a need to routinely survey Patient Experts. This has been ongoing since October 2015. This study highlights key findings, including new recommendations and whether previous concerns have been addressed.METHODS:We refined the 2012 survey to be routinely sent to all patient experts that attended a NICE technology appraisal committee meeting. Between October 2015 and December 2016 this online survey was sent to eighty-eight patient experts. After analysis the findings were compared to the previous report to identify whether concerns have been addressed and whether new recommendations should be considered.RESULTS:There was a response rate of 47 percent (n = 41). Quantitative results and qualitative quotes demonstrate that patient experience varies widely. Key findings from the new data revealed that patient experts feel supported by the Public Involvement Programme, however would welcome more opportunities to speak. Notable improvements since 2012 include favourable opinions of support documents and the Chair more regularly introducing themselves to the patient expert before the meeting. Some experts still find the paperwork cumbersome and find the meetings very technical.CONCLUSIONS:Progress has been made since 2012, but further improvements could facilitate even more effective patient involvement. We continue to routinely measure experiences to identify and address evolving issues. Some tensions remain between NICE's remit and processes, and patients expectations of these. The findings, although specific to NICE, hopefully can feed into other patient involvement developments in the wider HTA ecosystem.

Global Economic Crisis of 2008-2009: Sources and Roots

2009 ◽  
pp. 18-31
Author(s):  
G. Rapoport ◽  
A. Guerts
Keyword(s):  
Oil And Gas ◽  
Trade Deficit ◽  
Developed Countries ◽  
The Other ◽  
Energy Resources ◽  
Market Mechanisms ◽  
Production Output ◽  
The One ◽  
To Receive ◽  
Partial Destruction

In the article the global crisis of 2008-2009 is considered as superposition of a few regional crises that occurred simultaneously but for different reasons. However, they have something in common: developed countries tend to maintain a strong level of social security without increasing the real production output. On the one hand, this policy has resulted in trade deficit and partial destruction of market mechanisms. On the other hand, it has clashed with the desire of several oil and gas exporting countries to receive an exclusive price for their energy resources.

Analisa Wacana Pemberitaan Kasus Korupsi E-KTP Pada Media Kompas.com Terhadap Pembentukan Opini Publik

2019 ◽  
Vol 4 (1) ◽  
pp. 1-19
Author(s):  
Neri Widya Ramailis ◽  
Dede Nopendri
Keyword(s):  
Mass Media ◽  
Social Control ◽  
The Other ◽  
Main Function ◽  
General Knowledge ◽  
Visual Method ◽  
The Public ◽  
The Media ◽  
Private Entrepreneurs

Discourse is a series of sentences that relate and connect one proposition with the other propositions to from a unity. The main function of the news is not to warn, instruct, and make the public stunned, the main function of the news is to inform and then it is upto the public to utilize the news. There are two ways for the news to be useful to the public, the first to effort news as general knowledge and the second to effort the news a tool of social control. E-Ktp corruption cases are one of the biggest corruption cases that occurered in Indonesia. Therefore, many mass media reported heavilly on E-Ktp corruption cases, one of which was the kompas.com. furthermore, to find out how the writer gets the source the writer gets the source of data and information the writer uses the criminology visual method and then analyzes it using criminology newsmaking theory. However, the results of this study illustrate that the aspect highlighted are those of actors suspected of being involved in E-Ktp corruption cases. Where the media only emphasizes one institution, namely the people’s representative council, even though in this case the involved parties are not only the legislature but case the involved parties are not only the legislature but also from various institutions such as the interior ministry, state-owned enterprises, and private entrepreneurs. In the aspect of media projection Kompas.com make the bulk of the news about E- Ktp corruption cases as news headline and a tranding topic.

MUNDANE MIRACLES IN AWADH. ENCOUNTERS WITH THE REVEALED AND THE HIDDEN

2020 ◽  
pp. 130-140
Author(s):  
Maxim B. Demchenko ◽  
Keyword(s):  
The Other ◽  
Local People ◽  
Natural Phenomena ◽  
Mughal Empire ◽  
The Public ◽  
British Raj ◽  
The Subject ◽  
Other World ◽  
Better Than

The sphere of the unknown, supernatural and miraculous is one of the most popular subjects for everyday discussions in Ayodhya – the last of the provinces of the Mughal Empire, which entered the British Raj in 1859, and in the distant past – the space of many legendary and mythological events. Mostly they concern encounters with inhabitants of the “other world” – spirits, ghosts, jinns as well as miraculous healings following magic rituals or meetings with the so-called saints of different religions (Hindu sadhus, Sufi dervishes),with incomprehensible and frightening natural phenomena. According to the author’s observations ideas of the unknown in Avadh are codified and structured in Avadh better than in other parts of India. Local people can clearly define if they witness a bhut or a jinn and whether the disease is caused by some witchcraft or other reasons. Perhaps that is due to the presence in the holy town of a persistent tradition of katha, the public presentation of plots from the Ramayana epic in both the narrative and poetic as well as performative forms. But are the events and phenomena in question a miracle for the Avadhvasis, residents of Ayodhya and its environs, or are they so commonplace that they do not surprise or fascinate? That exactly is the subject of the essay, written on the basis of materials collected by the author in Ayodhya during the period of 2010 – 2019. The author would like to express his appreciation to Mr. Alok Sharma (Faizabad) for his advice and cooperation.

State of Fashion: Searching for the New Luxury

APRIA Journal ◽  
2020 ◽  
Vol 1 (1) ◽  
pp. 11-16
Author(s):  
José Teunissen
Keyword(s):  
Twentieth Century ◽  
Daily Life ◽  
Life Cycles ◽  
The Other ◽  
Century Model ◽  
Cocktail Party ◽  
The Public ◽  
Other Hand ◽  
The One

In the last few years, it has often been said that the current fashion system is outdated, still operating by a twentieth-century model that celebrates the individualism of the 'star designer'. In I- D, Sarah Mower recently stated that for the last twenty years, fashion has been at a cocktail party and has completely lost any connection with the public and daily life. On the one hand, designers and big brands experience the enormous pressure to produce new collections at an ever higher pace, leaving less room for reflection, contemplation, and innovation. On the other hand, there is the continuous race to produce at even lower costs and implement more rapid life cycles, resulting in disastrous consequences for society and the environment.

Public Administration’s Dyslexia: Appreciating the Strengths of its Disabilities

Public Voices ◽  
2016 ◽  
Vol 8 (1) ◽  
pp. 61
Author(s):  
Pamela A Gibson
Keyword(s):  
Public Administration ◽  
The Other ◽  
The Public

To have a dis/ability opens the possibilities for seeing (understanding) something different because of difference in the disabled’s lens or worldview. Public administration is awash in self-doubt, discomfort and confusion. As it struggles with setting, moving and removing academic boundaries of the discipline, public administration reveals its own dyslexia. The disabling of public administration offers a view from the balcony (or orchestra pit) granting a greater appreciation of ‘the other’ in the public administration student, public administration theory and public administration practices. The dyslexic individual and institution can suffer and celebrate contradiction, paradox, irony, and other delimiting arenas of learning without resistance. Successful learning and understanding can come not in spite of but because of apparent disabilities.

Designing for Dissemination in Chronic Disease Prevention and Management

2017 ◽  
Author(s):  
Neville Owen ◽  
Ana Goode ◽  
Takemi Sugiyama ◽  
Mohammad Javad Koohsari ◽  
Genevieve Healy ◽  
...  
Keyword(s):  
Physical Activity ◽  
Chronic Disease ◽  
Cost Effectiveness ◽  
Health Behavior Change ◽  
The Other ◽  
Research Quality ◽  
Policy Initiatives ◽  
Rigorous Study ◽  
Behavior Change Program

This chapter emphasizes the need for research that is designed and implemented explicitly with dissemination in mind. This is illustrated in relation to environmental and policy initiatives to influence physical activity through active transport, and through the example of initiatives to reduce workplace sitting. The other element of this chapter, the broad-reach intervention-dissemination case study of a health behavior-change program, highlights the need to maintain key elements of research quality in designing for dissemination, to the extent that is practically possible: a rigorous study design; the systematic tracking of implementation and related costs; and, the conduct of dose-response, maintenance and cost-effectiveness analyses. These examples of designing for dissemination illustrate not only the exciting opportunities for real-world dissemination research, but also the resourcefulness and commitment required for success.

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