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  • 1
    In: Pharmaceutical Statistics, Wiley, Vol. 18, No. 6 ( 2019-11), p. 636-644
    Abstract: In confirmatory clinical trials, the prespecification of the primary analysis model is a universally accepted scientific principle to allow strict control of the type I error. Consequently, both the ICH E9 guideline and the European Medicines Agency (EMA) guideline on missing data in confirmatory clinical trials require that the primary analysis model is defined unambiguously. This requirement applies to mixed models for longitudinal data handling missing data implicitly. To evaluate the compliance with the EMA guideline, we evaluated the model specifications in those clinical study protocols from development phases II and III submitted between 2015 and 2018 to the Ethics Committee at Hannover Medical School under the German Medicinal Products Act, which planned to use a mixed model for longitudinal data in the confirmatory testing strategy. Overall, 39 trials from different types of sponsors and a wide range of therapeutic areas were evaluated. While nearly all protocols specify the fixed and random effects of the analysis model (95%), only 77% give the structure of the covariance matrix used for modeling the repeated measurements. Moreover, the testing method (36%), the estimation method (28%), the computation method (3%), and the fallback strategy (18%) are given by less than half the study protocols. Subgroup analyses indicate that these findings are universal and not specific to clinical trial phases or size of company. Altogether, our results show that guideline compliance is to various degrees poor and consequently, strict type I error rate control at the intended level is not guaranteed.
    Type of Medium: Online Resource
    ISSN: 1539-1604 , 1539-1612
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2019
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    detail.hit.zdb_id: 2163550-X
    SSG: 15,3
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  • 2
    Online Resource
    Online Resource
    Emerald ; 2016
    In:  Management Decision Vol. 54, No. 1 ( 2016-2-8), p. 194-221
    In: Management Decision, Emerald, Vol. 54, No. 1 ( 2016-2-8), p. 194-221
    Abstract: – The purpose of this paper is to propose a comprehensive methodology and a problem-specific model for the configuration of the optimal strategic supplier portfolio in terms of traditional, performance-related objectives and sustainability targets. Design/methodology/approach – To bridge the research gap, i.e., to align strategic supplier portfolio selection with corporate sustainability targets, a hybrid model of the analytic network process (ANP) and goal programming (GP) is developed. To validate the model, a case example is presented and managerial feedback is collected. Findings – By enabling the integration of sustainability targets into strategic supplier portfolio configuration, the hybrid ANP-GP model contributes to research in the area of sustainable supply chain management. Results indicate that simplifying the model by omitting one or more details may lead to unfortunate actions. Research limitations/implications – The model has been applied using a case example in the automotive industry. To strengthen the findings, it should be examined under other terms as well. Practical implications – Integrating economic, environmental, and social targets into strategic supplier portfolio configuration reduces supply risks and promotes the achievement of the sustainability goals of the purchasing company. Social implications – Strategic supplier selection counts among the decisions that have an impact on the environment and society for several years. Configuring economically rational, environmentally friendly, and socially responsible supplier bases supports worldwide efforts towards sustainable development. Originality/value – Although sustainable supplier selection has gained importance in recent years, this is the first time that a comprehensive model for the determination of the optimal strategic supplier portfolio in terms of performance-related objectives and sustainability targets has been proposed.
    Type of Medium: Online Resource
    ISSN: 0025-1747
    Language: English
    Publisher: Emerald
    Publication Date: 2016
    detail.hit.zdb_id: 2023018-7
    SSG: 3,2
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  • 3
    Online Resource
    Online Resource
    Georg Thieme Verlag KG ; 2022
    In:  RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren Vol. 194, No. 12 ( 2022-12), p. 1333-1345
    In: RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren, Georg Thieme Verlag KG, Vol. 194, No. 12 ( 2022-12), p. 1333-1345
    Abstract: Despite the high prevalence and mortality of lung cancer and proven effectiveness of low-dose computed tomography (LDCT) to reduce mortality, Germany still lacks a national screening program. The German Institute for Quality and Efficiency in Health Care (IQWiG) and the Federal Office for Radiation Protection (BfS) both published positive scientific evaluations recommending a quality-controlled national screening program. IQWiG underlined the importance of a clear risk definition, integrated smoking cessation programs, and quality assurance, highlighting the necessity of procedural optimization. In the HANSE study, former and current smokers aged 55–79 years are assessed for their lung cancer risk by the NELSON and PLCOM2012 risk scores. 5000 high-risk participants, defined as PLCOM2012 6-year risk ≥ 1.58 % or fulfilling NELSON risk inclusion criteria, will be screened by LDCT at baseline and after 12 months. Lung nodules are analyzed by a modified Lung-RADS 1.1 score of the HANSE study, and values of emphysema and coronary calcium are determined and randomly reported to the participants. 7100 low-risk participants serve as a control. All patients are followed-up for up to 10 years. The sensitivity and specificity of the two risk assessments and LDCT screening, effects of the randomized LDCT reporting, efficiency of lung nodule management, and several other factors are assessed to analyze the success and quality of the holistic screening program. The HANSE study is designed as a holistic lung cancer screening study in northern Germany to answer pressing questions for a successful implementation of an effective German lung cancer screening program. Citation Format
    Type of Medium: Online Resource
    ISSN: 1438-9029 , 1438-9010
    RVK:
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2022
    detail.hit.zdb_id: 2031079-1
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  • 4
    Online Resource
    Online Resource
    Wiley ; 2018
    In:  Statistics in Medicine Vol. 37, No. 8 ( 2018-04-15), p. 1402-1404
    In: Statistics in Medicine, Wiley, Vol. 37, No. 8 ( 2018-04-15), p. 1402-1404
    Type of Medium: Online Resource
    ISSN: 0277-6715 , 1097-0258
    URL: Issue
    RVK:
    Language: English
    Publisher: Wiley
    Publication Date: 2018
    detail.hit.zdb_id: 1491221-1
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  • 5
    In: Clinical Pharmacology & Therapeutics, Wiley, Vol. 108, No. 3 ( 2020-09), p. 653-660
    Abstract: The traditional drug development paradigm, consisting of sequential phases and randomized studies, has been challenged in oncology and hemato‐oncology. In the regulatory context, a number of new products have been authorized based on nonrandomized efficacy and safety data. We retrospectively analyzed the European public assessment reports for anticancer treatments authorized between 2010 and 2019 to describe the data behind such approvals. Twenty‐two initial marketing authorizations, mainly conditional, were identified. Fifty percent of the products had an orphan indication, and 77% had received previous scientific advice. Conclusions of clinical benefit were based on tumor responses, ranging between 15.8 and 88%. Our data shows that single‐arm clinical studies leading to positive regulatory outcomes share common methodological approaches and end points, mostly comparing the overall response rate with a fixed success threshold as the primary analysis. The clinical indications in these approvals are clustered in late‐line settings, hematological malignancies, and lung cancer. Our findings underline the need to reflect on the current practice, the methodological aspects, and end points in single‐arm studies, and develop specific regulatory guidance on nonrandomized and novel study designs.
    Type of Medium: Online Resource
    ISSN: 0009-9236 , 1532-6535
    RVK:
    Language: English
    Publisher: Wiley
    Publication Date: 2020
    detail.hit.zdb_id: 2040184-X
    SSG: 15,3
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  • 6
    In: Clinical Pharmacology & Therapeutics, Wiley, Vol. 111, No. 5 ( 2022-05), p. 1093-1102
    Abstract: The coronavirus disease 2019 (COVID‐19) pandemic has a major impact not only on public health and daily living, but also on clinical trials worldwide. To investigate the potential impact of the COVID‐19 pandemic on the initiation of clinical trials, we have descriptively analyzed the longitudinal change in phase II and III interventional clinical trials initiated in Europe and in the United States. Based on the public clinical trial register EU Clinical Trials Register and clinicaltrials.gov, we conducted (i) a yearly comparison of the number of initiated trials from 2010 to 2020 and (ii) a monthly comparison from January 2020 to February 2021 of the number of initiated trials. The analyses indicate that the COVID‐19 pandemic affected both the initiation of clinical trials overall and the initiation of non‐COVID‐19 trials. An increase in the overall numbers of clinical trials could be observed both in Europe and the United States in 2020 as compared with 2019. However, the number of non‐COVID‐19 trials initiated is reduced as compared with the previous decade, with a slightly larger relative decrease in the United States as compared to Europe. Additionally, the monthly trend for the initiation of non‐COVID‐19 trials differs between regions. In the United States, after a sharp decrease in April 2020, trial numbers reached the levels of 2019 from June 2020 onward. In Europe, the decrease was less pronounced, but trial numbers mainly remained below the 2019 average until February 2021.
    Type of Medium: Online Resource
    ISSN: 0009-9236 , 1532-6535
    URL: Issue
    RVK:
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 2040184-X
    SSG: 15,3
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  • 7
    Online Resource
    Online Resource
    Springer Science and Business Media LLC ; 2019
    In:  Trials Vol. 20, No. 1 ( 2019-12)
    In: Trials, Springer Science and Business Media LLC, Vol. 20, No. 1 ( 2019-12)
    Type of Medium: Online Resource
    ISSN: 1745-6215
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2019
    detail.hit.zdb_id: 2040523-6
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  • 8
    Online Resource
    Online Resource
    Springer Science and Business Media LLC ; 2017
    In:  Orphanet Journal of Rare Diseases Vol. 12, No. 1 ( 2017-12)
    In: Orphanet Journal of Rare Diseases, Springer Science and Business Media LLC, Vol. 12, No. 1 ( 2017-12)
    Type of Medium: Online Resource
    ISSN: 1750-1172
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2017
    detail.hit.zdb_id: 2225857-7
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  • 9
    In: Trials, Springer Science and Business Media LLC, Vol. 21, No. 1 ( 2020-12)
    Abstract: The standard therapy for patients suffering from sensorineural hearing loss is cochlear implantation. The insertion of the electrode array into the cochlea, with potential mechanical trauma and the presence of this foreign body inside the cochlea, may lead to free radical formation and reduced blood perfusion of the cochlea which can result in a loss of residual hearing. Studies have suggested that a particular combination of the antioxidants vitamins A, C and E as well as the vasodilator magnesium (together: ACEMg) may protect the residual hearing. Methods The potential protective effect of ACEMg on residual hearing preservation in cochlear implant (CI) patients was investigated in a single-centre, randomized, placebo-controlled, double-blind phase II clinical trial. CI candidates with some residual hearing in low frequencies receiving MED-EL implants of different FLEX electrode array lengths were treated with ACEMg tablets or placebo respectively 2 days preoperatively and up to 3 months postoperatively. The study objective was to demonstrate that ACEMg is more efficacious than placebo in preserving residual hearing during cochlear implantation by comparing the hearing loss (change in hearing thresholds at 500 Hz from baseline) 3 months after the first fitting between the two treatment groups and to investigate the treatments’ safety. Results Fifty-one patients were included in the study, which had to be terminated before the recruitment goal was reached because of IMP-resupply mismanagement of one partner. In the intention-to-treat population, 25 patients were treated with ACEMg and 24 patients with placebo. The mean hearing loss at 500 Hz was (± 15.84) 30.21 dB (placebo) or (± 17.56) 26.00 dB (ACEMg) 3 months after the initial fitting. Adjusting the postoperative hearing loss for the baseline residual hearing, planned electrode length and surgeon results in 8.01 dB reduced hearing loss in ACEMg-treated patients compared to placebo-treated ones. The safety analysis revealed that ACEMg was generally well-tolerated with adverse event frequencies below the placebo level. Conclusion This is the first clinical trial investigating a drug effect on residual hearing in CI patients. These first-in-man data may suggest that a perioperative oral administration of ACEMg is safe and may provide protection of residual hearing in CI patients. Trial registration EU Clinical Trial Register No. 2012-005002-22 . Registered on 6 December 2013. Funding: European Commission FP7-HEALTH-2012-INNOVATION-2.
    Type of Medium: Online Resource
    ISSN: 1745-6215
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2020
    detail.hit.zdb_id: 2040523-6
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  • 10
    In: Frontiers in Cardiovascular Medicine, Frontiers Media SA, Vol. 7 ( 2020-4-9)
    Type of Medium: Online Resource
    ISSN: 2297-055X
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2020
    detail.hit.zdb_id: 2781496-8
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