Application of Multi-Criteria Decision Analysis (MCDA) to Prioritize Real-World Evidence Studies for Health Technology Management: Outcomes and Lessons Learned by the Canadian Real-World Evidence for Value of Cancer Drugs (CanREValue) Collaboration.

Multi-criteria decision analysis (MCDA) is a value assessment tool designed to help support complex decision-making by incorporating multiple factors and perspectives in a transparent, structured approach. We developed an MCDA rating tool, consisting of seven criteria evaluating the importance and feasibility of conducting potential real-world evidence (RWE) studies aimed at addressing uncertainties stemming from initial cancer drug funding recommendations. In collaboration with the Canadian Agency for Drugs and Technologies in Health's Provincial Advisory Group, a validation exercise was conducted to further evaluate the application of the rating tool using RWE proposals varying in complexity.

Development of a Multi-Criteria Decision Analysis Rating Tool to Prioritize Real-World Evidence Questions for the Canadian Real-World Evidence for Value of Cancer Drugs (CanREValue) Collaboration.

The Canadian Real-world Evidence for Value of Cancer Drugs (CanREValue) collaboration developed an MCDA rating tool to assess and prioritize potential post-market real-world evidence (RWE) questions/uncertainties emerging from public drug funding decisions in Canada. In collaboration with a group of multidisciplinary stakeholders from across Canada, the rating tool was developed following a three-step process: (1) selection of criteria to assess the importance and feasibility of an RWE question; (2) development of rating scales, application of weights and calculating aggregate scores; and (3) validation testing. An initial MCDA rating tool was developed, composed of seven criteria, divided into two groups.

Building a National Reassessment Process for Oncology Drugs: Lessons Learned by the Canadian Real-World Evidence for Value of Cancer Drugs (CanREValue) Collaboration through a Simulated Reassessment Exercise.

The CanREValue Collaboration established the Reassessment & Uptake Working Group to develop a preliminary process to reassess funded cancer drugs in Canada. A simulated exercise was conducted to evaluate the proposed reassessment process using a real-world case. We invited 32 attendees including representatives from Health Canada and Health Technology Assessment (HTA) agencies, along with payers, clinicians, academics, and patient representatives.

A Retrospective Review of Chemotherapy for Patients with Small Bowel Adenocarcinoma in British Columbia.

Small bowel adenocarcinoma (SBA) is associated with a poor prognosis. It is an uncommon malignancy and therefore difficult to study. Randomized phase III trials are not available to guide best approaches.

Capacity planning and appointment scheduling for new patient oncology consults.

To ensure that patients receive timely access to care, it has become increasingly important to use existing care provider capacity as efficiently as possible and to make informed capacity planning decisions. To support this decision-making process at a regional cancer center in British Columbia (Canada), we undertook a simulation and optimization based study that investigated the simultaneous impact of the available number of new patient consultation slots, appointment scheduling policies and oncologist specialization configurations on the timeliness of patient access to care and physician workload. The key contribution of this paper is the methodological framework it provides to decision makers who manage specialty clinics to ensure that they are using their resources efficiently and making informed strategic short- and mid-term capacity planning decisions for new patient demand.

Influence of nurse navigation on wait times for breast cancer care in a Canadian regional cancer center.

Background: The wait times for breast cancer care in our region do not meet acceptable benchmarks. We implemented the Interior Breast Rapid Access Investigation and Diagnosis (IB-RAPID) nurse navigation program to address this issue.

Methods: The IB-RAPID prospective database was reviewed for patients entering the program between April 1, 2011 and April 30, 2012 (2011/2012 cohort), and was compared with patients from the same area in 2010.

Gender influences on children's selective trust of adult testimony.

Do children tend to trust same-sex adults when learning new information? A sample of 325 4- to 7-year-olds completed two tasks. The testimony task pitted previous reliability against the sex of the informant. Children first viewed clips of a man and a woman naming familiar objects (neutral, feminine, or masculine) to establish prior accuracy.

Randomized phase II study comparing two schedules of everolimus in patients with recurrent/metastatic breast cancer: NCIC Clinical Trials Group IND.163.

Purpose: To evaluate the safety and efficacy of oral everolimus, a mammalian target of rapamycin (mTOR) inhibitor, in two different schedules in minimally pretreated patients with metastatic breast cancer and to explore for possible biologic correlates of response.

Patients And Methods: Patients who received no or one prior chemotherapy regimen for metastatic breast cancer were entered onto this multicenter, noncomparative, randomized phase II study of everolimus 10 mg daily versus 70 mg weekly; the multinomial end points of response and progression were evaluated at 8 weeks. A two-stage accrual design was used, with 15 evaluable patients in each schedule in stage 1.

Boys will be boys; cows will be cows: children's essentialist reasoning about gender categories and animal species.

Two studies (N = 456) compared the development of concepts of animal species and human gender, using a switched-at-birth reasoning task. Younger children (5- and 6-year-olds) treated animal species and human gender as equivalent; they made similar levels of category-based inferences and endorsed similar explanations for development in these 2 domains. In contrast, 10-year-olds and adults treated gender and species concepts as distinct from one another.

A prospective, non-randomised phase 1-2 trial of VACOP-B with filgrastim support for HIV-related non-Hodgkin's lymphoma.

Non-Hodgkin's lymphoma (NHL) remains an important complication of associated HIV infection despite advances in antiretroviral therapy (ART), and the optimum chemotherapy regimen for this disease remains to be defined. A dose-escalation trial was performed to determine the maximum tolerated doses of etoposide and doxorubicin as part of the 12-week VACOP-B regimen, supported by filgrastim (r-metHuG-CSF). Patients with aggressive histology HIV-related NHL who were previously untreated with chemotherapy, and who had no active opportunistic infection were eligible for the study.

Phase II randomized study of ISIS 3521 and ISIS 5132 in patients with locally advanced or metastatic colorectal cancer: a National Cancer Institute of Canada clinical trials group study.

Background: Because treatment of metastatic colon cancer is noncurative, new treatments are needed. This trial evaluated the antitumor effects of two targeted anticancer agents: (a) ISIS 3521, an antisense inhibitor of the protein kinase C alpha; and (b) ISIS 5132, an antisense inhibitor of c-raf kinase in patients untreated previously with recurrent or metastatic colorectal carcinoma.

Patients And Methods: All patients had colorectal adenocarcinoma with measurable disease and no prior chemotherapy for metastatic disease.