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A descriptive study of new drug approvals during 2017-2021 and disease morbidity and mortality patterns in India. 印度 2017-2021 年新药批准情况及疾病发病率和死亡率模式的描述性研究。
Q2 Medicine Pub Date : 2024-04-01 Epub Date: 2023-09-25 DOI: 10.4103/picr.picr_109_23
Urvashi Gupta, Ashwin Kamath, Priyanka Kamath

Aim: Studies show the presence of a mismatch between drug research and disease burden. A study conducted in the European Union found that new drug development was restricted to certain diseases. A study of biosimilar approvals in India found that 87% of drugs were for treating noncommunicable diseases. This study aimed to determine the new drugs approved in India from 2017 to 2021 and the top ten causes of morbidity and mortality and detect the presence of any discordance between these.

Methods: A descriptive study was conducted using data on new drug approvals accessed from the Central Drugs Standard Control Organization website. The top ten causes of mortality and morbidity in India from 2015 to 2019 were identified from the Global Burden of Diseases database. Descriptive statistics were used to compare the drug approvals and the leading diseases.

Results: One hundred twenty-six drugs were approved during the study period. Antineoplastic drugs constituted 19.84% of the approvals, antimicrobials 18.25%, and cardiovascular drugs 9.52%. Ischemic heart disease and chronic obstructive pulmonary disease were the two leading causes of morbidity and mortality. Diarrheal diseases, lower respiratory tract infection, and drug-susceptible tuberculosis were among the top ten causes. Ten antibacterials, including four antitubercular drugs, were approved during this period. Two drugs were approved for rare diseases.

Conclusion: Our study showed that the drugs approved were largely in line with the prevalent disease burden, and there was no significant discordance observed. Some diseases, such as ischemic stroke/intracranial hemorrhage, require further efforts in bringing forth newer pharmacotherapy options.

目的:研究表明,药物研究与疾病负担之间存在不匹配。在欧盟进行的一项研究发现,新药开发仅限于某些疾病。对印度生物仿制药批准情况的研究发现,87%的药物用于治疗非传染性疾病。本研究旨在确定2017年至2021年印度批准的新药以及十大发病和死亡原因,并检测这两者之间是否存在任何不一致:利用从中央药品标准控制组织网站获取的新药批准数据进行了描述性研究。从全球疾病负担数据库中确定了 2015 年至 2019 年印度十大死亡和发病原因。使用描述性统计来比较药物批准情况和主要疾病:研究期间批准了 126 种药物。抗肿瘤药物占获批药物的 19.84%,抗菌药物占 18.25%,心血管药物占 9.52%。缺血性心脏病和慢性阻塞性肺病是发病和死亡的两大主要原因。腹泻病、下呼吸道感染和药物敏感性结核病位列十大病因。在此期间,包括四种抗结核药物在内的十种抗菌药物获得批准。有两种药物被批准用于治疗罕见疾病:我们的研究表明,批准的药物与流行病负担基本一致,没有发现明显的不一致。一些疾病,如缺血性中风/颅内出血,需要进一步努力推出更新的药物治疗方案。
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引用次数: 0
Impact of education on knowledge and attitude related to pharmacovigilance and reporting of adverse drug reactions among community pharmacists in Yemen: A pre- and postinterventional study 教育对也门社区药剂师药物警戒和报告药物不良反应相关知识和态度的影响:干预前后研究
Q2 Medicine Pub Date : 2024-04-01 DOI: 10.4103/picr.picr_160_23
Khalifah Abdulwahid, Nur Aizati Athirah Daud, Y. Al-Worafi, Mohamed Azmi Ahmad Hassali
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引用次数: 0
Artificial intelligence in pharmacovigilance – Opportunities and challenges 人工智能在药物警戒领域的应用--机遇与挑战
Q2 Medicine Pub Date : 2024-03-27 DOI: 10.4103/picr.picr_290_23
Mira Kirankumar Desai
Pharmacovigilance (PV) is a data-driven process to identify medicine safety issues at the earliest by processing suspected adverse event (AE) reports and extraction of health data. The PV case processing cycle starts with data collection, data entry, initial checking completeness and validity, coding, medical assessment for causality, expectedness, severity, and seriousness, subsequently submitting report, quality checking followed by data storage and maintenance. This requires a workforce and technical expertise and therefore, is expensive and time-consuming. There has been exponential growth in the number of suspected AE reports in the PV database due to smart collection and reporting of individual case safety reports, widening the base by increased awareness and participation by health-care professionals and patients. Processing of the enormous volume and variety of data, making its sensible use and separating “needles from haystack,” is a challenge for key stakeholders such as pharmaceutical firms, regulatory authorities, medical and PV experts, and National Pharmacovigilance Program managers. Artificial intelligence (AI) in health care has been very impressive in specialties that rely heavily on the interpretation of medical images. Similarly, there has been a growing interest to adopt AI tools to complement and automate the PV process. The advanced technology can certainly complement the routine, repetitive, manual task of case processing, and boost efficiency; however, its implementation across the PV lifecycle and practical impact raises several questions and challenges. Full automation of PV system is a double-edged sword and needs to consider two aspects – people and processes. The focus should be a collaborative approach of technical expertise (people) combined with intelligent technology (processes) to augment human talent that meets the objective of the PV system and benefit all stakeholders. AI technology should enhance human intelligence rather than substitute human experts. What is important is to emphasize and ensure that AI brings more benefits to PV rather than challenges. This review describes the benefits and the outstanding scientific, technological, and policy issues, and the maturity of AI tools for full automation in the context to the Indian health-care system.
药物警戒(PV)是一个以数据为驱动的过程,通过处理可疑不良事件(AE)报告和提取健康数据,尽早发现药品安全问题。药物警戒案例处理周期始于数据收集、数据录入、初步检查完整性和有效性、编码、因果关系、预期性、严重性和严重程度的医学评估、随后提交报告、质量检查以及数据存储和维护。这需要大量人力和专业技术知识,因此既昂贵又耗时。由于个人病例安全报告的智能收集和报告,PV 数据库中疑似 AE 报告的数量呈指数级增长,医疗保健专业人员和患者的意识和参与程度提高,从而扩大了基础。对于制药公司、监管机构、医疗和 PV 专家以及国家药物警戒项目管理人员等主要利益相关者来说,如何处理数量庞大、种类繁多的数据、合理利用这些数据并将其从 "大海捞针 "中分离出来是一项挑战。医疗保健领域的人工智能(AI)在严重依赖医学影像解读的专业领域表现抢眼。同样,人们对采用人工智能工具来补充和自动化 PV 流程的兴趣也在不断增长。先进的技术当然可以补充病例处理过程中的常规、重复和人工任务,并提高效率;然而,在整个病例处理生命周期中实施这种技术并产生实际影响,却提出了一些问题和挑战。光伏系统的完全自动化是一把双刃剑,需要考虑两个方面--人员和流程。重点应该是将专业技术(人员)与智能技术(流程)相结合的协作方法,以增强人的才能,从而实现光伏系统的目标,并使所有利益相关者受益。人工智能技术应增强人类智慧,而不是取代人类专家。重要的是要强调并确保人工智能能为光伏行业带来更多益处,而不是挑战。本综述介绍了印度医疗保健系统的优势和突出的科学、技术和政策问题,以及人工智能工具在实现完全自动化方面的成熟度。
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引用次数: 0
Exploring the bioethical implications of using artificial intelligence in writing research proposals 探索使用人工智能撰写研究提案的生物伦理影响
Q2 Medicine Pub Date : 2024-02-26 DOI: 10.4103/picr.picr_226_23
S. Shivananda, V. Doddawad, C. S. Vidya, J. Chandrakala
Artificial intelligence (AI) has great potential to assist researchers in writing research proposals, by generating hypotheses, identifying literature, and suggesting methods for data collection and analysis. However, the use of AI in research proposal writing raises important bioethical implications, including the unintentional propagation of bias and questions about the role of human expertise and judgment in the research process. This paper explores the ethical implications of using AI in research proposal writing and proposes guidelines for the responsible and ethical use of AI in this context. The paper will review the potential benefits and challenges associated with using AI in research proposal writing, discuss the role of human expertise and judgment, and propose guidelines for promoting transparency and accountability in developing and using AI systems. Ultimately, addressing the bioethical issues related to AI in research proposal writing will require ongoing dialogue and collaboration between stakeholders, as well as a commitment to transparency, accountability, and ethical principles.
人工智能(AI)在协助研究人员撰写研究计划书方面有着巨大的潜力,它可以生成假设、识别文献并提出数据收集和分析的方法。然而,在撰写研究计划书时使用人工智能会产生重要的生物伦理影响,包括无意中传播偏见,以及对人类专业知识和判断在研究过程中的作用提出质疑。本文探讨了在研究计划书撰写中使用人工智能的伦理影响,并提出了在此背景下负责任地、合乎伦理地使用人工智能的指导原则。本文将回顾在撰写研究计划书时使用人工智能可能带来的益处和挑战,讨论人类专业知识和判断力的作用,并提出在开发和使用人工智能系统时提高透明度和问责制的指导方针。最终,要解决研究计划书撰写中与人工智能相关的生物伦理问题,需要利益相关者之间持续不断的对话与合作,以及对透明度、问责制和伦理原则的承诺。
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引用次数: 0
Procalcitonin-guided antimicrobial stewardship in critically ill patients with sepsis: A pre– post interventional study 脓毒症重症患者在降钙素原指导下的抗菌药物管理:干预前干预后研究
Q2 Medicine Pub Date : 2024-02-26 DOI: 10.4103/picr.picr_298_23
Philip Mathew, S. Vargese, Litha Mary Mathew, Alice David, J. Saji, Ann Mariam Varghese
Injudicious usage of antibiotics has led to the emergence of antibiotic resistance which is a major health-care problem in developing countries such as India. Our aim was to show how antibiotic therapy based on serial procalcitonin (PCT) assay can help in antibiotic de-escalation in septic patients. A pre–post interventional study was conducted among 300 septic patients admitted to an intensive care unit (ICU). All septic patients admitted 2 months before and 2 months after the introduction of monitoring of PCT were included and they were divided into Group P (with PCT monitoring) and Group C (without PCT monitoring). The proportion of patients for whom antimicrobials were de-escalated, the average time taken to de-escalate antimicrobials, and the average duration of ICU stay were compared. Proportions and averages with standard deviations were calculated to describe the data. A test of proportions was done to compare the proportion de-escalated and a Student’s t-test was done to compare the average duration of antibiotic therapy. The proportion of patients in whom de-escalation of antimicrobials was done was 125 (83.33%) in Group P as compared to 92 (61.33%) in Group C. The time taken to de-escalate was 3.04 ± 0.83 days (95% confidence interval [CI] 2.89–3.18) in Group P compared to 4.7 ± 1.4 days (CI 4.41–4.98) in Group C. The duration of ICU stay was also less in Group P - 3.08 ± 0.91 days (CI 3.08–3.38) as compared to Group C - 5.16 ± 2.17 days (4.80–5.51). Serial PCT assay-based antimicrobial therapy helped to wean patients with sepsis off antimicrobials earlier thus reducing the duration of ICU stay.
抗生素的滥用导致了抗生素耐药性的出现,这是印度等发展中国家的一个主要医疗保健问题。我们的目的是说明基于系列降钙素原 (PCT) 检测的抗生素疗法如何帮助脓毒症患者降低抗生素耐药性。 我们在重症监护室(ICU)收治的 300 名脓毒症患者中开展了一项干预前-干预后研究。所有在引入 PCT 监测前 2 个月和引入 PCT 监测后 2 个月入院的脓毒症患者都被纳入其中,并被分为 P 组(有 PCT 监测)和 C 组(无 PCT 监测)。比较了不再使用抗菌药物的患者比例、不再使用抗菌药物所需的平均时间以及重症监护病房的平均住院时间。通过计算比例、平均值和标准差来描述数据。采用比例检验比较停用抗菌药物的比例,采用学生 t 检验比较抗生素治疗的平均持续时间。 P组患者中使用抗菌药物的比例为125人(83.33%),C组为92人(61.33%)。P 组的重症监护室住院时间为 3.08 ± 0.91 天(CI 3.08-3.38),而 C 组为 5.16 ± 2.17 天(4.80-5.51)。 基于 PCT 检测的系列抗菌疗法有助于脓毒症患者尽早停用抗菌药物,从而缩短重症监护室的住院时间。
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引用次数: 0
Ethical considerations for real-world evidence studies 真实世界证据研究的伦理考虑因素
Q2 Medicine Pub Date : 2024-02-22 DOI: 10.4103/picr.picr_256_23
Arun Bhatt
Real-world evidence (RWE) studies are conducted on patient’s data primarily collected for monitoring of health status of patients. The use of real-world data to generate evidence in academic research or for regulatory submission raises a variety of ethical issues such as privacy, confidentiality, data protection, data de-identification, data sharing, scientific design of study, and informed consent requirements. The investigators–researchers and sponsors should adhere to current standards of ethics whilst planning and conduct of RWE studies. The ethics committees should consider ethical issues specific to RWE studies before approval.
真实世界证据(RWE)研究是以患者数据为基础进行的,主要是为了监测患者的健康状况。在学术研究或提交监管申请时,使用真实世界数据生成证据会引发各种伦理问题,如隐私、保密、数据保护、数据去标识化、数据共享、研究的科学设计和知情同意要求等。在规划和开展 RWE 研究时,研究者和赞助商应遵守现行的伦理标准。伦理委员会在批准研究之前,应考虑到 RWE 研究特有的伦理问题。
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引用次数: 0
Onsite serious adverse events reporting: Seven-year experience of the institutional ethics committee of a tertiary care hospital 现场严重不良事件报告:一家三级医院伦理委员会的七年经验
Q2 Medicine Pub Date : 2024-02-03 DOI: 10.4103/picr.picr_213_23
Y. Shetty, Prajakta D. Auti, Y. Aithal
Over the years, Indian regulations have undergone numerous amendments, including stringent reporting deadlines, relatedness requirements, and compensation obligations for serious adverse event (SAE). A historic change, new drugs and trial rules-2019, was proposed on March 19, 2019. The purpose of the study was to ascertain whether various stakeholders were reporting in accordance with the evolving SAE criteria. Data were retrieved after the Ethics Committee’s approval between August 2014 and December 2021. Data gathered before March 19, 2019, were categorized as “BEFORE” data, while the remaining data were categorized as “AFTER.” Utilizing causality, on-site SAE reporting, and the ethics committee review procedure, we evaluated the compliance. The data were evaluated using descriptive statistics, and the Chi-square or Mann–Whitney tests were used to compare the “BEFORE” and “AFTER” groups. A total of 77 SAEs were reported in 26 clinical trials, where most clinical trials were phase III. Endocrine projects made up 9/26 (34.61%). In the cardiology studies, the greatest SAE distribution was 21 SAEs/89 participants (23.59%) with approximately 48% of these being vascular. The “AFTER” group noticed a decrease in the total number and length of SAE subcommittee meetings. In the “AFTER” group, there was a significantly higher median number of agenda items/meetings (8 [4.5–10.75]) (P < 0.0001). The median interval between the onset of SAE and the first reporting date, however, was just 1 day (interquartile range: 1–5 days). In nondeath SAEs, there was no significant difference in the compensation paid. In the “AFTER” group, there were no discrepancies in reporting SAE. There is acceptable adherence to SAE reporting criteria.
多年来,印度的法规经历了多次修订,包括严格的报告期限、关联性要求和严重不良事件(SAE)的赔偿义务。2019 年 3 月 19 日,印度提出了一项历史性变革--《新药和试验规则-2019》。本研究旨在确定各利益相关方是否按照不断变化的 SAE 标准进行报告。 2014年8月至2021年12月期间的数据在伦理委员会批准后进行了检索。2019 年 3 月 19 日之前收集的数据被归类为 "前 "数据,其余数据被归类为 "后 "数据。利用因果关系、现场 SAE 报告和伦理委员会审查程序,我们对合规性进行了评估。我们使用描述性统计对数据进行评估,并使用卡方检验或曼-惠特尼检验对 "前 "组和 "后 "组进行比较。 26 项临床试验共报告了 77 例 SAE,其中大多数临床试验为 III 期临床试验。内分泌项目占 9/26(34.61%)。在心脏病学研究中,SAE 分布最广的是 21 例/89 名参与者(23.59%),其中约 48% 是血管性的。AFTER "组注意到,SAE小组委员会会议的总数和时间长度均有所减少。在 "AFTER "组中,议程项目/会议的中位数明显增加(8 [4.5-10.75])(P < 0.0001)。然而,SAE 发生与首次报告日期之间的中位间隔仅为 1 天(四分位数间距:1-5 天)。在非死亡 SAE 中,支付的赔偿金没有显著差异。在 "AFTER "组中,报告 SAE 的时间没有差异。 对 SAE 报告标准的遵守情况可以接受。
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引用次数: 0
Onsite serious adverse events reporting: Seven-year experience of the institutional ethics committee of a tertiary care hospital 现场严重不良事件报告:一家三级医院伦理委员会的七年经验
Q2 Medicine Pub Date : 2024-02-03 DOI: 10.4103/picr.picr_213_23
Y. Shetty, Prajakta D. Auti, Y. Aithal
Over the years, Indian regulations have undergone numerous amendments, including stringent reporting deadlines, relatedness requirements, and compensation obligations for serious adverse event (SAE). A historic change, new drugs and trial rules-2019, was proposed on March 19, 2019. The purpose of the study was to ascertain whether various stakeholders were reporting in accordance with the evolving SAE criteria. Data were retrieved after the Ethics Committee’s approval between August 2014 and December 2021. Data gathered before March 19, 2019, were categorized as “BEFORE” data, while the remaining data were categorized as “AFTER.” Utilizing causality, on-site SAE reporting, and the ethics committee review procedure, we evaluated the compliance. The data were evaluated using descriptive statistics, and the Chi-square or Mann–Whitney tests were used to compare the “BEFORE” and “AFTER” groups. A total of 77 SAEs were reported in 26 clinical trials, where most clinical trials were phase III. Endocrine projects made up 9/26 (34.61%). In the cardiology studies, the greatest SAE distribution was 21 SAEs/89 participants (23.59%) with approximately 48% of these being vascular. The “AFTER” group noticed a decrease in the total number and length of SAE subcommittee meetings. In the “AFTER” group, there was a significantly higher median number of agenda items/meetings (8 [4.5–10.75]) (P < 0.0001). The median interval between the onset of SAE and the first reporting date, however, was just 1 day (interquartile range: 1–5 days). In nondeath SAEs, there was no significant difference in the compensation paid. In the “AFTER” group, there were no discrepancies in reporting SAE. There is acceptable adherence to SAE reporting criteria.
多年来,印度的法规经历了多次修订,包括严格的报告期限、关联性要求和严重不良事件(SAE)的赔偿义务。2019 年 3 月 19 日,印度提出了一项历史性变革--《新药和试验规则-2019》。本研究旨在确定各利益相关方是否按照不断变化的 SAE 标准进行报告。 2014年8月至2021年12月期间的数据在伦理委员会批准后进行了检索。2019 年 3 月 19 日之前收集的数据被归类为 "前 "数据,其余数据被归类为 "后 "数据。利用因果关系、现场 SAE 报告和伦理委员会审查程序,我们对合规性进行了评估。我们使用描述性统计对数据进行评估,并使用卡方检验或曼-惠特尼检验对 "前 "组和 "后 "组进行比较。 26 项临床试验共报告了 77 例 SAE,其中大多数临床试验为 III 期临床试验。内分泌项目占 9/26(34.61%)。在心脏病学研究中,SAE 分布最广的是 21 例/89 名参与者(23.59%),其中约 48% 是血管性的。AFTER "组注意到,SAE小组委员会会议的总数和时间长度均有所减少。在 "AFTER "组中,议程项目/会议的中位数明显增加(8 [4.5-10.75])(P < 0.0001)。然而,SAE 发生与首次报告日期之间的中位间隔仅为 1 天(四分位数间距:1-5 天)。在非死亡 SAE 中,支付的赔偿金没有显著差异。在 "AFTER "组中,报告 SAE 的时间没有差异。 对 SAE 报告标准的遵守情况可以接受。
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引用次数: 0
Effectiveness of partial COVID-19 vaccination on the outcome of hospitalized COVID-19 patients during the second pandemic in India. 在印度第二次大流行期间,COVID-19 部分疫苗接种对 COVID-19 住院病人的疗效。
Q2 Medicine Pub Date : 2024-01-01 Epub Date: 2024-01-09 DOI: 10.4103/picr.picr_48_23
Sajal De, Dibakar Sahu, Diksha Mahilang, Ranganath T Ganga, Ajoy Kumar Behera
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引用次数: 0
Challenges of assessing educational intervention in type 1 diabetes mellitus. 评估 1 型糖尿病教育干预措施的挑战。
Q2 Medicine Pub Date : 2024-01-01 Epub Date: 2024-01-09 DOI: 10.4103/picr.picr_331_23
Deepa Chodankar
{"title":"Challenges of assessing educational intervention in type 1 diabetes mellitus.","authors":"Deepa Chodankar","doi":"10.4103/picr.picr_331_23","DOIUrl":"10.4103/picr.picr_331_23","url":null,"abstract":"","PeriodicalId":20015,"journal":{"name":"Perspectives in Clinical Research","volume":"15 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10810053/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139572523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Perspectives in Clinical Research
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