Updated results from the international phase III ALTTO trial (BIG 2-06/Alliance N063D).

Aim: To present the pre-specified analyses of >5-years follow-up of the Phase III ALTTO trial.

Patients And Methods: 8381 patients with stage I-III HER2 positive breast cancer randomised to chemotherapy plus 1-year of trastuzumab (T), oral lapatinib (L; no longer evaluated), trastuzumab followed by lapatinib (T→L), and lapatinib + trastuzumab (L+T). The primary endpoint was disease-free survival (DFS).

Difficulties arising in reimbursement recommendations on new medicines due to inadequate reporting of population adjustment indirect comparison methods.

Indirect treatment comparisons are useful to estimate relative treatment effects when head-to-head studies are not conducted. Statisticians at the National Centre for Pharmacoeconomics Ireland (NCPE) and Scottish Medicines Consortium (SMC) assess the clinical and cost-effectiveness of new medicines as part of multidisciplinary teams. We describe some shared observations on areas where reporting of population-adjustment indirect comparison methods is causing uncertainty in our recommendations to decision-making committees when assessing reimbursement of medicines.

Acquired transverse myelopathy in children in the United Kingdom--a 2 year prospective study.

Aims: To define the incidence, describe presentation, management and outcome and identify prognostic factors in Acquired Transverse Myelopathy (ATM) in children under 16 years.

Methods: A prospective population-based surveillance study, involving all consultant paediatric neurologists in the United Kingdom from 1 July 2002 to 30 June 2004.

Results And Discussion: Response rate was 91%, and 60 children were reported, of whom 41 were included.

Evaluation of severe infection and survival after splenectomy.

Purpose: Splenectomized patients are known to be at risk of severe infection, but the extent of risk is unclear. We evaluated the incidence of severe infection and survival in 1648 splenectomized patients.

Methods: Patients who underwent splenectomy between 1988 and 1999 in Scotland were identified through the Scottish hospital discharge records (SMR01) and then linked to the death certificate data recorded by the General Register Office in Scotland to obtain clinical and demographical information.

Influenza and pneumococcal vaccination in Scottish nursing homes: coverage, policies and reasons for receipt and non-receipt of vaccine.

A national survey was carried out to determine the coverage of influenza and pneumococcal vaccines, policies, reasons for receipt, non-receipt of vaccine and strategies to improve vaccine coverage in Scottish nursing homes. Of the 550 nursing homes, 72% (394) participated in the study. Overall coverage was 85% for influenza vaccine in 2001-2002 season and 11% for pneumococcal vaccine in the last 5-year period.