Elizabeth Clearfield, Benjamin Kim, Sarah Ford, Nathan T Connell, Maria E Santaella, Michelle Lavin, Manon E L Degenaar-Dujardin, Emily Ayoub, Veronica H Flood, Dawn Rotellini, Mark W Skinner, Paula James
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引用次数: 0
摘要
导言:冯-威廉氏病(VWD)的治疗方案正在不断扩大。核心结果集(COS)是针对特定病症的每项临床试验所使用的最低限度的商定结果集,它为哪些结果是最重要的测量结果提供了指导,以确保为各种利益相关者收集必要的数据,并能对不同产品和试验进行比较:方法:采用改良的德尔菲共识流程,对一长串潜在结果进行压缩/优先排序。在三轮德尔菲讨论中,多方利益相关者小组(患者、临床医生、制药公司代表、HTA 组织、支付方和政府组织代表)对每项结果的评分从 1 分(不重要,不纳入 COS)到 9 分(必须纳入)不等。根据预先确定的标准对结果进行剔除或保留;其中包括一项提高患者优先级的特别规定。德尔菲第二轮结束后,召开了一次面对面的共识会议:结果:39 位小组成员参加了会议。预防性治疗的最终 COS 包括 18 项结果,其中 7 项属于为妇女、女童和有月经可能的人选择的特殊子集。最终的围手术期分支 COS 共有 11 项结果。有六项结果与两个 COS 重叠:VWD核心COS代表了因子和非因子VWD疗法临床试验结果的共识清单。这些结果将在产品的整个生命周期中发挥作用,从临床开发到监管和市场准入阶段,再到患者-提供者决策。
A core outcome set for prophylaxis and perioperative treatment of von Willebrand disease: The coreVWD initiative.
Introduction: Treatment options are expanding for von Willebrand disease (VWD). A core outcome set (COS)-a minimum set of agreed-upon outcomes to be used in every clinical trial for a given condition-provides guidance on which outcomes are most important to measure to ensure necessary data is collected for a variety of stakeholders and enable comparison across products and trials.
Aim: coreVWD aimed to develop a COS for trials for prophylaxis and perioperative treatments for VWD.
Methods: A modified Delphi consensus process was used to condense/prioritize a long list of potential outcomes. Over three Delphi rounds, a multi-stakeholder panel (patients, clinicians, pharmaceutical company representatives, HTA organizations, payer, and government organization representatives) rated each outcome from 1 (not important to include in a COS) to 9 (essential to include). Outcomes were eliminated or retained based on pre-determined criteria; a special provision to elevate patient priorities was included. An in-person consensus meeting was held after Delphi round 2.
Results: Thirty-nine panellists participated. The final COS for prophylaxis treatment included 18 outcomes, seven of which are part of a special subset selected for women, girls and people with the potential to menstruate. There were 11 outcomes in the final perioperative branch COS. Six outcomes overlapped both COS.
Conclusions: The coreVWD COS represents a consensus list of outcomes for clinical trials for both factor and non-factor VWD therapies. These outcomes will be useful across the lifecycle of a product, from clinical development through regulatory and market access phases and into patient-provider decision-making.
期刊介绍:
Haemophilia is an international journal dedicated to the exchange of information regarding the comprehensive care of haemophilia. The Journal contains review articles, original scientific papers and case reports related to haemophilia care, with frequent supplements. Subjects covered include:
clotting factor deficiencies, both inherited and acquired: haemophilia A, B, von Willebrand''s disease, deficiencies of factor V, VII, X and XI
replacement therapy for clotting factor deficiencies
component therapy in the developing world
transfusion transmitted disease
haemophilia care and paediatrics, orthopaedics, gynaecology and obstetrics
nursing
laboratory diagnosis
carrier detection
psycho-social concerns
economic issues
audit
inherited platelet disorders.