FEASIBILITY ASSESSMENT: CORNERSTONE OF SUCCESSFUL CLINICAL TRIAL PLANNING
|
|
- Winifred Walker
- 6 years ago
- Views:
Transcription
1 FEASIBILITY ASSESSMENT: CORNERSTONE OF SUCCESSFUL CLINICAL TRIAL PLANNING VERONIKA FEKETE, MD MANAGER FEASIBILITY RESEARCH AND PATIENT RECRUITMENT SERVICES, PSI CRO 1
2 WHAT CAN GO WRONG WITH A CLINICAL TRIAL >90% of all clinical trials are delayed due to over-ambitious timelines and difficulty with patient enrollment. Roughly 70% of all trials are delayed from one to six months due to patient enrollment problems. 30% of PIs under-enroll in a given trial. Estimated 20% of PIs fail to enroll a single patient. Delays in the drug development process cost pharmaceutical companies billions of dollars per year. IF A CLINICAL TRIAL IS NOT WELL PLANNED IT WILL FAIL! 2
3 WHAT IS A FEASIBILITY STUDY? An analysis of the ability to complete a project successfully, taking into account technological, economic, legal, operational and scheduling factors. A feasibility study allow project managers to investigate the possible negative and positive outcomes of a project before investing too much time and money. Investopedia 3
4 WHAT FEASIBILITY ASSESSMENT SHOULD DEPICT 4
5 FEASIBILITY ASSESSMENT YEARS AGO Doctor House, could you please tell me how many AML patients are seen on your Moon annually? 50 up to 60 But we need AML patients with red hair only. Can you please tell us how many of your AML patients have red hair? 30 up to 40 5
6 ENROLLMENT PROJECTIONS 15 YEARS AGO AND NOW Investigator projections (p/site/month) Proposed screening rate (p/site/month) Proposed enrollment rate (p/site/month) PI SR ER NSCLC study with stage IIIb, IV patients who progressed on previous platinum-based regimen 6
7 WHAT HAS CHANGED IN ONCOLOGY TRIALS? Number of clinical trials Number of targeted therapies Number of unique procedures Number of eligible patients Longer trial duration Newly approved drugs Challenging environment for oncology trials 7
8 CASE STUDY #1: 2 ND -LINE NSCLC Comparison of pemetrexed + study drug vs. pemetrexed + placebo Eligible patients must be naive to pemetrexed Projected enrollment rate (patients/site/month) Germany 0.3 Italy 0.3 Czech Republic 0.3 Hungary 0.3 Russia 0.4 Achieved enrollment rate (patients/site/month) Reason: changes in 1 st -line treatment to pemetrexed + cisplatin combination 8
9 % of NSCLC patients treated with pemetrexed in 1 st line 1 ST -LINE PEMETREXED USE IN NSCLC IN % 60% 40% 20% 0% 9
10 AND IN 2014 Pemetrexed is routinely used in 1 st -line US Germany, France, Italy Spain, Belgium, UK Czech Republic, Hungary, Poland, Lithuania Pemetrexed is not routinely used in 1 st -line Estonia, Latvia, Romania Belarus, Russia, Georgia, Serbia, Ukraine Brazil, Mexico Chile, Peru, Argentina Israel 10
11 WHAT TO FOCUS ON DURING THE FEASIBILITY ASSESSMENT? Medical and clinical feasibility Standards of care Diagnostics methods routinely used? Investigators/patient motivation/benefit Study design Eligibility criteria Logistical feasibility Sample delivery timelines Imaging requirements Access to specific equipment (e.g. freezer, centrifuge, IMRT, etc.) Regulatory feasibility 11
12 FEASIBILITY HURDLES You have 3 days to deliver the RFP What do investigators think about the study? Commit to your projections but eligibility will change But do not contact any sites! 12
13 FEASIBILITY ASSESSMENT REQUIRES MULTIDISCIPLINARY INPUT Feasibility team Supported by highly professional experts with different background Feasibility specialist Medical expert Laboratory expert Regulatory expert Imaging expert 13
14 FEASIBILITY ASSESSMENT PROCESS 2 d a y s Protocol review by multidisciplinary experts Identification of key study challenges Comparison with in-house experience Comparison with industry experience Identification of site requirements and site profile 2 w e e k s Feasibility planning Communication with investigators Data analysis Scenario and feasibility report Challenges identified by investigators 14
15 WHAT FEASIBILITY CAN OFTEN PROVIDE? Clear and bright Lots of details Jumbled mess More questions than answers Studio with plaster head - Picasso 15
16 FEASIBILITY REPORT OFTEN LOOKS LIKE Attractive projection Blurred detail Understandable parameters The Path Monet 16
17 WHAT FACTORS AFFECT REAL ENROLLMENT? Finance Competition Regulatory Logistics Investigators projections Staff workload Benefit for patients 17
18 METHODOLOGY OF CALCULATING ENROLLMENT RATES Monthly availability of potential study candidates Investigator screening projections Complexity of early-phase studies (multiple assessments, heavy schedule) Indirectly competing trials consuming site staff time and resources Directly competing trials enrolling patients with the required indications Screening projections Screen failure rate Start up timelines Site Performance Factor Site Initiation Factor Effective enrollment rates 18
19 FEASIBILITY ASSESSMENT IS SCIENCE - ALWAYS MEASURE WHAT YOU DISCOVER Feasibility data must be verified: Over time With reality With all parties involved 19
20 CASE STUDY #2: NEWLY DIAGNOSED MULTIPLE MYELOMA TRIAL Study design: Newly diagnosed multiple myeloma not eligible for stem cell transplant Comparator: bortezomib + melphalan + prednisolone Feasibility assessment confirmed the study feasibility in all regions 20
21 VERIFY FEASIBILITY WITH REALITY Projections underestimated Enrollment target reached Screened (planned) Enrolled (planned) Screened Enrolled Multiple myeloma patients were provided with comparator, modern drug not yet available for all patients 21
22 CASE STUDY #3: NSCLC 2 nd line NSCLC patients IMPs: A novel radiopharmaceutical imaging agent for SPECT Targeted therapy Feasibility assessment conducted in the US, Western Europe, Central and Eastern Europe and Latin America 22
23 CHALLENGES Regulatory questions Coordination Reporting imaging results Standards of care Imaging requirements Patient transportation Patient availability 23
24 FEASIBILITY FOCUS In-house experts SPECT Radioactive labeling Result reporting CT experience Capacity Imaging Medical Regulatory Logistics Site Patient availability Standards of care Feasibility expert 24
25 VERIFY WITH REALITY Screened (planned) Enrolled (planned) Screened Enrolled 25
26 CONCLUSIONS Feasibility assessment is a complicated and multi-stage process Increasing complexity of studies requires in-depth scientific analysis of potential challenges that takes time Involvement of a multidisciplinary team is recommended at an early stage 26
27 Thank you! Questions? Feasibility specialist 27
28 THANK YOU! 28
Summary of Results for Laypersons
What was the Study Called? Summary of Results for Laypersons A Randomized, Double-blind, Parallel-group, Placebo- and Active-controlled, Multicenter Study to Evaluate the Efficacy, Safety and Tolerability
More informationReady for a CRO That Values Performance Over Promises? CHALLENGE. At Clinipace, it s personal.
Ready for a CRO That Values Performance Over Promises? CHALLENGE At Clinipace, it s personal. Who We Are At Clinipace, It s Personal. We Will PROVE IT. With us, you get the A team. We deliver a level of
More informationDesign and Analysis of a Cancer Prevention Trial: Plans and Results. Matthew Somerville 09 November 2009
Design and Analysis of a Cancer Prevention Trial: Plans and Results Matthew Somerville 09 November 2009 Overview Objective: Review the planned analyses for a large prostate cancer prevention study and
More informationAccess to treatment and disease burden
Access to treatment and disease burden Robert Flisiak Department of Infectious Diseases and Hepatology Medical University in Białystok, Poland Moulin de Vernègues, 27-29 August 2015 Disclosures Advisor
More informationWorld Health Organization Regional Office for Europe Surveillance of measles and rubella Data as of 15 March 2006
World Health Organization Regional Office for Europe Surveillance of measles and rubella Data as of 15 March 2006 WHO Regional Office for Europe Vaccine-preventable Diseases and Immunization programme,
More informationConducting Successful Oncology Clinical Trials in Asia Pacific: PharmaNet experience using Case Studies
Conducting Successful Oncology Clinical Trials in Asia Pacific: PharmaNet experience using Case Studies Emily Tan Executive Director Asia Pacific PharmaNet Conducting Successful Oncology Clinical Trials
More informationWhat can be done against XDR-TB?
What can be done against XDR-TB? Dr Matteo Zignol Stop TB Dep. World Health Organization Geneva 16 th Swiss Symposium on tuberculosis Münchenwiler, 22 March 2007 XDR-TB Extensive Drug Resistance XDR =
More informationAlcohol-related harm in Europe and the WHO policy response
Alcohol-related harm in Europe and the WHO policy response Lars Moller Programme Manager World Health Organization Regional Office for Europe Date of presentation NCD global monitoring framework: alcohol-related
More informationXDR-TB Extensively Drug-Resistant Tuberculosis. What, Where, How and Action Steps
XDR-TB Extensively Drug-Resistant Tuberculosis What, Where, How and Action Steps The boundaries and names shown and the designations used on this map do not imply the expression of any opinion whatsoever
More informationWCPT COUNTRY PROFILE December 2017 HUNGARY
WCPT COUNTRY PROFILE December 2017 HUNGARY HUNGARY NUMBERS WCPT Members Practising physical therapists 727 Total number of physical therapist members in your member organisation 4,000 Total number of practising
More informationInequalities in health: challenges and opportunities in Europe Dr Zsuzsanna Jakab WHO Regional Director for Europe
Inequalities in health: challenges and opportunities in Europe Dr Zsuzsanna Jakab WHO Regional Director for Europe 21st Congress of the European Association of Dental Public Health 1 October 2016 Budapest
More informationWCPT COUNTRY PROFILE December 2017 SERBIA
WCPT COUNTRY PROFILE December 2017 SERBIA SERBIA NUMBERS WCPT Members Practising physical therapists 622 Total number of physical therapist members in your member organisation 3,323 Total number of practising
More informationWCPT COUNTRY PROFILE December 2017 SWEDEN
WCPT COUNTRY PROFILE December 2017 SWEDEN SWEDEN NUMBERS WCPT Members Practising physical therapists 11,043 Total number of physical therapist members in your member organisation 17,906 Total number of
More informationPharmaceutical, Medical and Health-related Government and Regulatory bodies around the world.
1 International International Conference on Harmonization (ICH) World Health Organization (WHO) 2 Argentina National Administration of Drugs, Food and medical Technology. Australia s Department of health
More informationOverall survival: 1 st line therapy
1 3 Overall survival: 1 st line therapy 2-year OS phase III studies mm Prices per month of oncology medicin Bloomberg Business weekly 26 Feb 2015 Presented By Veena Shankaran at 2016 ASCO Annual Meeting
More informationSmokefree Policies in Europe: Are we there yet?
Smokefree Policies in Europe: Are we there yet? 14 April 2015, 9:00 10:30am Rue de l Industrie 24, 1040 Brussels Permanent Partners: Temporary Partners: The research for the SFP Smokefree Map was partially
More informationKey issues for HIV testing and
Key issues for HIV testing and counselling in Europe Martin C Donoghoe Programme Manager HIV/AIDS, STI &Viral Hepatitis Programme WHO Europe Key issues for HIV testing & counselling in Europe HIV epidemics
More informationReflecting on ten years of progress in the fight against AIDS, TB and malaria
Reflecting on ten years of progress in the fight against AIDS, TB and malaria Michel Kazatchkine UN Secretary General s Special Envoy on HIV/AIDS in Eastern Europe and central Asia Ten years of progress:
More informationNational Institute on Alcohol Abuse and Alcoholism. Environmental Approaches
Environmental Approaches Consumption of 10+ and 21+ Drinks on an Occasion At Least Once in the Past Year, 2013 30 25 20 15 10+ drinks 15 25 10+ drinks 16 25 10 5 0 21+ drinks 3 2 21+ drinks 18-20 21-24
More informationKenneth W. Mahaffey, MD and Keith AA Fox, MB ChB
Once-daily oral direct factor Xa inhibition Compared with vitamin K antagonism for prevention of stroke and Embolism Trial in Atrial Fibrillation Kenneth W. Mahaffey, MD and Keith AA Fox, MB ChB on behalf
More informationTerms and Conditions. VISA Global Customer Assistance Services
Terms and Conditions VISA Global Customer Assistance Services Visa Global Customer Assistance Services (VGCAS) 1 The Visa Global Customer Assistance Services are co-ordinated by the Global Assistance Centre
More informationWELLNESS COACHING. Wellness & Personal Fitness Solution Providers
WELLNESS COACHING Wellness & Personal Fitness Solution Providers Introducing Ourselves... We are Personal Wellness Coaches 2 We help people look and feel better by: - Educating on proper nutrition (80%)
More informationMARKET NEWS for pig meat
MARKET NEWS for pig meat Market analysis 7 January 2019 Week 2 MARKET SITUATION Europe: Trading in legs is at slightly falling prices this week. For other cuts, trading is more or less at unchanged prices.
More informationThe Spanish Society of Medical Oncology: objectives, structure and history
The Spanish Society of Medical Oncology: objectives, structure and history The Spanish Society of Medical Oncology (SEOM) brings together Spanish specialists who are dedicated solely to fighting cancer
More informationOncology Clinical Trials in Emerging Regions A Trend Analysis
Oncology Clinical Trials in Emerging Regions A Trend Analysis W H I T E P A P E R Toll Free Number: 1-888-987-2691 1 Cancer represents considerable unmet medical need and has been leading cause of death
More informationAlcohol in Europe and Brief Intervention. Dr Lars Møller Programme Manager World Health Organization Regional Office for Europe
Alcohol in Europe and Brief Intervention Dr Lars Møller Programme Manager World Health Organization Regional Office for Europe Global risk factors ranked by attributable burden of disease 2010 (GBD, Lancet,
More informationEUROPEAN AEROSOL PRODUCTION
Introduction EUROPEAN AEROSOL PRODUCTION 2017 EU European production Market share Production by segment Worldwide production / FEA, 2018. 1 INTRODUCTION More than 5.7 billion over 16 billion units globally
More informationTEDDY. Teddy Network of Excellence. Annagrazia ALTAVILLA. Ph.D. Sciences Ethics LL.M. Health Law. diterranée
Teddy Network of Excellence Annagrazia ALTAVILLA TEDDY Task-force in Europe for Drug Development for the Young Ph.D. Sciences Ethics LL.M. Health Law Associated Senior Lecturer Université de la MéditerranM
More informationBurden and cost of alcohol, tobacco and illegal drugs globally and in Europe
Burden and cost of alcohol, tobacco and illegal drugs globally and in Europe Jürgen Rehm 1-4 Kevin D. Shield 1,2,3 1) Centre for Addiction and Mental Health, Toronto, Canada 2) University of Toronto, Canada
More informationFOURIER STUDY GREYLOCK PRESS: CTS PRODUCT SAMPLE - FOURIER YES. Did the study achieve its main objective?
FOURIER STUDY Did the study achieve its main objective? 2 15% 1 5% 9.8% YES FOURIER compared Repatha with placebo in patients who were taking a statin and had hardening or narrowing of the arteries and
More informationMARKET NEWS for pig meat
MARKET NEWS for pig meat Market analysis 26 November 2018 Week 48 MARKET SITUATION Europe: Trading in legs is at slightly increasing or unchanged prices this week. Trading in other cuts is at unchanged
More informationGlobal EHS Resource Center
Global EHS Resource Center Understand environmental and workplace safety requirements that affect your global operations. 800.372.1033 bna.com/gelw Global EHS Resource Center This comprehensive research
More informationMen & Health Work. Difference can make a difference Steve Boorman & Ian Banks RSPH Academy 2013
Men & Health Promotion @ Work Difference can make a difference Steve Boorman & Ian Banks RSPH Academy 2013 Difference can make a Difference Mens health: State of mens health Use of services Role of the
More informationLEBANON. WCPT COUNTRY PROFILE December 2018
LEBANON WCPT COUNTRY PROFILE December 2018 LEBANON NUMBERS 1600 1400 1200 1000 800 600 400 200 0 Physical therapists in the country Members in MO 1,480 1,480 Total PTs in country 800000 700000 600000 500000
More informationFinnish international trade 2017 Figures and diagrams. Finnish Customs Statistics
Finnish international trade 217 Figures and diagrams Finnish Customs Statistics IMPORTS, EXPORTS AND TRADE BALANCE 199-217 Billion e 7 6 5 4 3 2 1-1 9 91 92 93 94 95 96 97 98 99 1 2 3 4 5 6 7 8 9 1 11
More informationMARKET NEWS for pig meat
MARKET NEWS for pig meat Market analysis 17 September 2018 Week 38 MARKET SITUATION Europe: Trading in fresh legs is at slightly falling prices this week. Trading in other cuts is at largely unchanged
More informationMedia Release. Inaugural study reveals that more than one in four women in European and Central Asian prisons locked up for drug offences
Media Release Embargoed 00.01 CET Monday 12 th March 2012 Inaugural study reveals that more than one in four women in European and Central Asian prisons locked up for drug offences Up to 70 percent of
More informationFinnish international trade 2017 Figures and diagrams. Finnish Customs Statistics
Finnish international trade 217 Figures and diagrams Finnish Customs Statistics IMPORTS, EXPORTS AND TRADE BALANCE 199-217 Billion e 7 6 5 4 3 2 1-1 9 91 92 93 94 95 96 97 98 99 1 2 3 4 5 6 7 8 9 1 11
More informationTable 6.1 Summary information for colorectal cancer in Ireland,
6 Colorectal cancer 6.1 Summary Colorectal cancer is the second most common cancer in Ireland (excluding non-melanoma skin cancer). It accounts for 12% of all malignant neoplasia in females and 15% in
More informationSummary of Results for Laypersons
What was the Study Called? Summary of Results for Laypersons A Multicenter, Three Arm, Randomized, Open Label Clinical Study to Compare Renal Function in Liver Transplant Recipients Receiving an Immunosuppressive
More informationDENMARK. WCPT COUNTRY PROFILE December 2018
DENMARK WCPT COUNTRY PROFILE December 2018 DENMARK NUMBERS 14000 12000 10000 8000 6000 4000 2000 0 Physical therapists in the country Members in MO 11,720 12,975 Total PTs in country 800000 700000 600000
More informationTHE CARE WE PROMISE FACTS AND FIGURES 2017
THE CARE WE PROMISE FACTS AND FIGURES 2017 2 SOS CHILDREN S VILLAGES INTERNATIONAL WHERE WE WORK Facts and Figures 2017 205 58 79 families and transit 31 Foster homes 162 8 3 173 214 2 115 159 136 148
More informationEuropean status report on alcohol and health Leadership, awareness and commitment
European status report on alcohol and health 2014 Leadership, awareness and commitment Leadership, awareness and commitment Background Strong leadership from national and local governments is essential
More informationEuropean Status report on Alcohol and Health
European Status report on Alcohol and Health Dr Lars Moller Regional Advisor a.i. WHO Regional Office for Europe Main killers in the WHO European Region Source: Preventing chronic diseases. A vital investment.
More informationPROMOTION AND PROTECTION OF ALL HUMAN RIGHTS, CIVIL, POLITICAL, ECONOMIC, SOCIAL AND CULTURAL RIGHTS, INCLUDING THE RIGHT TO DEVELOPMENT
UNITED NATIONS A General Assembly Distr. LIMITED A/HRC/11/L.16 16 June 2009 Original: ENGLISH HUMAN RIGHTS COUNCIL Eleventh session Agenda item 3 PROMOTION AND PROTECTION OF ALL HUMAN RIGHTS, CIVIL, POLITICAL,
More informationGERMANY. WCPT COUNTRY PROFILE December 2018
GERMANY WCPT COUNTRY PROFILE December 2018 GERMANY NUMBERS 160000 140000 120000 100000 80000 60000 40000 20000 0 Physical therapists in the country Members in MO 21,502 136,000 Total PTs in country 800000
More informationA report on the epidemiology of selected vaccine-preventable diseases in the European Region 30% 20% 10%
% of reported measles cases WHO EpiBrief A report on the epidemiology of selected vaccine-preventable diseases in the European Region No. /17 This issue of WHO EpiBrief provides an overview of selected
More informationCND UNGASS FOLLOW UP
CND UNGASS FOLLOW UP INCB follow-up activities on Chapter 2. Operational recommendations on ensuring the availability of and access to controlled substances exclusively for medical and scientific purposes,
More informationAlcohol Prevention Day
Alcohol Prevention Day Rome, 16 May 2018 Hana Horka Policy Officer, Unit C4 Health Determinants and International Relations European Commission DG Health and Food Safety (SANTE) Alcohol consumption in
More informationPrimary and secondary prevention of sudden cardiac death in emerging economies
Primary and secondary prevention of sudden cardiac death in emerging economies Béla Merkely MD, PhD, DSc, FESC Heart Center Semmelweis University Budapest Common risk factors for sudden cardiac death Increasing
More informationThe worldwide overview: updated (2005-6) meta-analyses of hormonal treatment trials
The worldwide overview: updated (2005-6) meta-analyses of hormonal treatment trials Richard Gray, for the Early Breast Cancer Trialists Collaborative Group (EBCTCG) Main questions, 2005-6 1) 5 years of
More informationOncology Treatment Network Structure in Russia and its Impact on the Success of Oncology Clinical Studies
Oncology Treatment Network Structure in Russia and its Impact on the Success of Oncology Clinical Studies Julia Kondakov Director Business Development, Accell Clinical Research 2016 Case Study: Setting
More informationPARALLELISM AND THE LEGITIMACY GAP 1. Appendix A. Country Information
PARALLELISM AND THE LEGITIMACY GAP 1 Appendix A Country Information PARALLELISM AND THE LEGITIMACY GAP 2 Table A.1 Sample size by country 2006 2008 2010 Austria 2405 2255 0 Belgium 1798 1760 1704 Bulgaria
More informationTable 7.1 Summary information for lung cancer in Ireland,
7 Lung cancer 7.1 Summary Lung cancer is the third most common cancer in Ireland, accounting for 15% of cancers in men and 9% in women, if non-melanoma skin cancer is excluded (table 7.1). Each year, approximately
More informationThe cancer burden in the European Union and the European Region: the current situation and a way forward
The cancer burden in the European Union and the European Region: the current situation and a way forward Presented by Zsuzsanna Jakab WHO Regional Director for Europe Informal Meeting of Health Ministers
More informationWELLNESS COACHING. Wellness & Personal Fitness Solution Providers NZ & Australia
WELLNESS COACHING Wellness & Personal Fitness Solution Providers NZ & Australia Introducing Ourselves... We are Personal Wellness Coaches 2 We help people look and feel better by: - Educating on proper
More informationDrug resistance TB in People Living with HIV: research questions and priorities.
Drug resistance TB in People Living with HIV: research questions and priorities. Haileyesus Getahun, MD, PhD. Stop TB Department World Health Organisation Geneva, Switzerland Outline of presentation Definition
More informationQ1 What age are you?
Q1 What age are you? Answered: 504 Skipped: 0 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 4.56% 23 3.77% 19 4.56% 23 6.15% 31 3.97% 20 6.55% 33 5.95% 30 6.75% 34 6.35% 32 4.37% 22 6.75% 34 5.56%
More informationSubtype Review. Lymphoma einformation Project (LeIP) Mantle Cell Lymphoma
Subtype Review Mantle Cell Lymphoma Worldwide Network of Lymphoma Patient Groups Lymphoma einformation Project (LeIP) Working together, we can change the lymphoma landscape and achieve more for patients.
More informationICMART. International Council of Medical Acupuncture and Related Techniques
ICMART International Council of Medical Acupuncture and Related Techniques Headquarters Louisenstrasse 15-17 / Loewengasse 1 61348 Bad Homburg Germany tel +49 6172 21038 fax +49 6172 599800 www.icmart.org
More informationALCOHOL CONSUMPTION IN EUROPE; TRADITIONS, GENERATIONS, CULTURE AND POLICY
ALCOHOL CONSUMPTION IN EUROPE; TRADITIONS, GENERATIONS, CULTURE AND POLICY JACEK MOSKALEWICZ INSTITUTE OF PSCHIATRY AND NEUROLOGY WARSAW, POLAND THIRD EUROPEAN CONFERENCE ON ALCOHOL AND LAW ENFORCEMENT,
More informationWhere we stand in EFORT
Where we stand in EFORT Engaging with the new EU regulatory landscape for medical devices. Challenges & opportunities Brussel, Belgium April 6, 2018 Per Kjaersgaard-Andersen Associate Professor Section
More informationThe Global Summit of Women 2009 Santiago, Chile May 14-16
The Global Summit of Women 2009 Santiago, Chile May 14-16 Presentation on Combating Violence Against Women By Susan Arnot Heaney, Global Director, Corporate Responsibility, Avon Products, Inc. (USA) Public
More informationThe Current Status of Cardiac Electrophysiology in ESC Member Countries J. Brugada, P. Vardas, C. Wolpert
Albania. Algeria. Armenia. Austria. Belarus. Belgium. Bosnia & Herzegovina. Bulgaria. Croatia. Cyprus. Czech Republic Denmark. Egypt. Estonia. Finland. Former Yugoslav Republic of Macedonia. France. Georgia.
More informationMARKET NEWS for pig meat
MARKET NEWS for pig meat Market analysis 10 December Week 50 MARKET SITUATION Europe: Trading in legs is at slightly falling prices. As regards other cuts trade is at unchanged prices. UK: Prices are reported
More informationUndetectable = Untransmittable. Mariah Wilberg Communications Specialist
Undetectable = Untransmittable Mariah Wilberg Communications Specialist Undetectable=Untransmittable PLWH who get and stay undetectable have effectively no risk of transmitting HIV to their sex partners
More informationMARKET NEWS for pig meat
MARKET NEWS for pig meat Market analysis 17 December 2018 Week 51 MARKET SITUATION Europe: Trading in legs and other cuts is at unchanged or slightly falling prices. UK: Prices are reported as stable.
More informationDevelopment of Palliative Care services in different countries
Development of Palliative Care services in different countries Nicoleta Mitrea EONS leadership summit, 2017 Disclosure speaker Do you have any interest to declare? No, I don t have any interest to declare.
More informationOverview of drug-induced deaths in Europe - What does the data tell us?
Overview of drug-induced deaths in Europe - What does the data tell us? João Matias, Isabelle Giraudon, Julián Vicente EMCDDA expert group on the key-indicator Drug-related deaths and mortality among drug
More informationSummary of Results for Laypersons
What was the Study Called? Summary of Results for Laypersons A Multicenter, Four Arm, Randomized, Open Label Clinical Study Investigating Optimized Dosing in a Prograf -/Advagraf -Based Immunosuppressive
More informationIs there a relationship between Countries' Human Development Index (HDI) level and the incidence of tuberculosis?
Is there a relationship between Countries' Human Development Index (HDI) level and the incidence of tuberculosis? Introduction Tuberculosis is a serious disease caused by the bacterium Mycobacterium tuberculosis.
More informationMARKET NEWS for pig meat
MARKET NEWS for pig meat Market analysis 24th September 2018 Week 39 MARKET SITUATION Europe: Trading in fresh legs and other cuts is at unchanged prices. UK: Prices are reported as stable. Sales activity
More informationXDR and MDR TB Urgent Research Priorities. Gerald Friedland MD Yale School of Medicine Nelson R Mandela School of Medicine
XDR and MDR TB Urgent Research Priorities Gerald Friedland MD Yale School of Medicine Nelson R Mandela School of Medicine The Year of MDR XDR TB CDC, WHO report on global XDR TB XDR TB defined Global distribution
More information11 Melanoma of the skin
11 Melanoma of the skin 11.1 Summary Melanoma of the skin is the ninth most common cancer in Ireland, accounting for 2.4 of all malignant neoplasia in men and 4.2 in women, if non-melanoma skin cancers
More informationTable 9.1 Summary information for stomach cancer in Ireland,
9 Stomach cancer 9.1 Summary Stomach cancer ranks seventh in terms of the most common cancers in Ireland, accounting for 4.1% of all malignant neoplasia in men and 2.8% in women, when non-melanoma skin
More informationEngagement in language assessment / Regions of Europe
Summary table: Engagement in language / Regions of This table lists the statistically significant differences in the engagement in activities by the respondents from different s of : If the word or appears
More informationThis work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 United States License.
The State of Cardiovascular Disease in the Kyrgyz Republic Ryskul B. Kydyralieva The National Center of Cardiology and Internal Medicine named after academician M.Mirrahimov at Ministry of Health of the
More informationColorectal Cancer Screening State of the art in Eastern Europe. Mārcis Leja Prague, September 27, 2017
Colorectal Cancer Screening State of the art in Eastern Europe Mārcis Leja Prague, September 27, 2017 The borders of Eastern Europe? EU Urals Bering Sea 2 3 4 CRC screening programs in EU in 2016 Cancer
More informationHighlighting in the WHO European Region: measles outbreaks rubella surveillance acute flaccid paralysis surveillance
No. 17 (September 2011) A monthly publication on vaccine preventable diseases and immunization data and analysis Issue 15, April 2011 Highlighting in the WHO European Region: measles outbreaks rubella
More informationMeasles and rubella monitoring January 2015
Measles and rubella monitoring January 215 Reporting on January December 214 surveillance data and epidemic intelligence data to the end of January 215 Main developments Measles During the 12-month period
More informationHighlighting in the WHO European Region: Summary. No. 21(February 2012)
No. 21(February 2012) Issue 15, April 2011 A monthly publication on vaccine preventable diseases and immunization data and analysis Highlighting in the WHO European Region: Update on measles in the European
More informationMARKET NEWS for pig meat
MARKET NEWS for pig meat Market analysis 7 May Week 19 MARKET SITUATION Europe: Trading in fresh legs is at falling prices. As regards other cuts, trading is largely at unchanged prices. Growing demand
More informationGrown-up congenital heart disease care throughout Europe
Grown-up congenital heart disease care throughout Europe P. Moons, F. Meijboom, H. Baumgartner, P.T. Trindade, E. Huyghe, H. Kaemmerer on behalf of the ESC Working Group on Grown-up Congenital Heart Disease
More informationAcademic Research in LA
Academic Research in LA Dr. Carlos H. Barrios Faculdade de Medicina, PUCRS Instituto do Câncer, HMD LACOG, Latin American Cooperative Oncology Group Porto Alegre, Brasil 36% improvement Age-Adjusted Male
More informationGlobal Terephthalic Acid (PTA) Market Study ( )
Global Terephthalic Acid (PTA) Market Study (2014 2025) Table of Contents 1. INTRODUCTION 1.1. Introduction to Terephthalic Acid Market Product Description Properties Industry Structure Value Chain Market
More informationMonthly measles and rubella monitoring report
SURVEILLANCE REPORT Monthly measles and rubella monitoring report December 2018 Period covered: 1 November 2017 to 31 October 2018 Introduction This monitoring report is based on measles and rubella data
More informationBiology Report. Is there a relationship between Countries' Human Development Index (HDI) level and the incidence of tuberculosis?
Biology Report Is there a relationship between Countries' Human Development Index (HDI) level and the incidence of tuberculosis? Introduction Tuberculosis is a serious disease caused by the bacterium Mycobacterium
More informationOF ALCOHOLIC DRINKS. Suggested Tasks:
Lesson 1 HISTORY, SCOPE AND NATURE OF ALCOHOLIC DRINKS Beer and wine are very much a part of modern day culture but their use evolved many centuries ago. In fact, the crudest type of alcoholic drinks made
More informationSafety Requirements for Long Term Operation or Ageing Aspects and for Design, Construction and Operation of New Nuclear Power Plants
Safety Requirements for Long Term Operation or Ageing Aspects and for Design, Construction and Operation of New Nuclear Power Plants ENSREG Conference, Brussels, 29 June 2015 Dr. Hans Wanner, WENRA Chairman
More informationSperm donation Oocyte donation. Hong Kong þ Guideline þ þ Hungary þ þ þ þ Israel þ þ þ þ Italy þ þ þ. Germany þ þ þ þ Greece þ þ þ þ
CHAPTER 8: Donation Although there has been a reduction in the use of donor sperm because of ICSI and the impact of the removal of anonymity in some countries (1), sperm donation is still used and has
More informationCautious upturn in CESEE: haunted by the spectre of uncertainty
Wiener Institut für Internationale Wirtschaftsvergleiche The Vienna Institute for International Economic Studies wiiw.ac.at Press conference, 16 March 217 New wiiw forecast for Central, East and Southeast
More informationAnimal health situation of OIE Member Countries in Europe 1 st semester 2012 (and previous)
Animal health situation of OIE Member Countries in Europe 1 st semester 2012 (and previous) 25 th Conference of the OIE Regional Commission for Europe 17 th to 21 st September 2012, Fleesensee Germany
More informationCost of Disorders of the Brain in Europe Gustavsson et al. Cost of disorders of the brain in Europe Eur. Neuropsych. (2011) 21,
Cost of Disorders of the Brain in Europe 2010 Gustavsson et al. Cost of disorders of the brain in Europe 2010. Eur. Neuropsych. (2011) 21, 718-779 Steering Committee Prof Jes Olesen 1 Prof Bengt Jönsson
More information