A quickly realizable benefit of model-based drug development is in reducing uncertainty in risk/benefit, comprising individually of safety and effectiveness, two key attributes of a product evaluated for regulatory approval, marketing, and use. In this review, we investigate gaps and opportunities in using fundamental decision analytic principles in drug development and present a quantitative clinical pharmacology framework for the application of such aids for early clinical development decision making. We anticipate that implementation of such emerging tools will enable sufficient scientific understanding of the two attributes to facilitate the early termination of compounds with less than desirable risk/benefit profiles and continuance of compounds with acceptable risk/benefit profiles.
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http://dx.doi.org/10.1208/s12248-008-9074-z | DOI Listing |
J Neurol Sci
January 2025
The Gaffin Center for Neuro-Oncology, Sharett Institute of Oncology, Hadassah Medical Center, and Faculty of Medicine, The Hebrew University of Jerusalem, Israel. Electronic address:
Introduction: Herpes encephalitis is known to affect patients undergoing brain radiotherapy, but early diagnosis and treatment, the foremost determinants of disease outcome, remain challenging in this patient population. This can be due to attribution of symptoms to the brain tumor and radiation side effects, as well as patients' atypical clinical presentation. Here we sought to highlight pearls and pitfalls in the clinical course and diagnostic workup which may facilitate timely diagnosis and improve disease outcome.
View Article and Find Full Text PDFObstet Gynecol
January 2025
Medical Practice Evaluation Center, the Division of Infectious Disease, and the Division of Maternal Fetal Medicine, Massachusetts General Hospital, Boston, Massachusetts; the Department of Pediatrics, Centre Hospitalier Universitaire Sainte-Justine, University of Montreal, Montreal, Quebec, Canada; and the Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, New York.
The purpose of this review is to serve as an update on congenital cytomegalovirus (CMV) evaluation and management for obstetrician-gynecologists and to provide a framework for counseling birthing people at risk for or diagnosed with a primary CMV infection or reactivation or reinfection during pregnancy. A DNA virus, CMV is the most common congenital viral infection and the most common cause of nongenetic childhood hearing loss in the United States. The risk of congenital CMV infection from transplacental viral transfer depends on the gestational age at the time of maternal infection and whether the infection is primary or nonprimary.
View Article and Find Full Text PDFJ Am Acad Orthop Surg
December 2024
From the American Hip Institute Research Foundation (McCarroll and KuhnsDomb), Chicago, IL, and the American Hip Institute (KuhnsDomb), Chicago, IL.
Hip pain in active patients with early osteoarthritis can be quite debilitating, affecting mobility, quality of life, and overall well-being. Management of this patient population is challenging because arthroplasty implants inevitably have limited life expectancy while chondral damage can mitigate the benefits of arthroscopic or open hip preservation. A multifaceted, patient-specific approach to clinical decision making is crucial in this patient population, given their higher activity level and expectations compared with older cohorts.
View Article and Find Full Text PDFBiomol Biomed
January 2025
Department of Orthognathic Surgery and Maxillofacial Trauma, The Third Affiliated Hospital of Air Force Medical University, Xi'an, China.
Implant failure remains a significant challenge in oral implantology, necessitating a deeper understanding of its risk factors to improve treatment outcomes. This study aimed to enhance the clinical outcomes of oral implant restoration by investigating the factors contributing to implant failure in patients with partial dentition defects within two years of treatment. Additionally, the study sought to develop an early risk prediction model for implant failure.
View Article and Find Full Text PDFACS Sens
January 2025
Key Laboratory for Ultrafine Materials of Ministry of Education, School of Materials Science and Engineering, East China University of Science and Technology, Shanghai 200237, China.
It is crucial yet challenging to sensitively quantify low-abundance biomarkers in blood for early screening and diagnosis of various diseases. Herein, an analytical model of intra-mesopore immunoassay (IMIA) was proposed, which was competent to examine various biomarkers at the femtomolar level. The success is rooted in the design of an innovative superparamagnetic core-shell structure with FeO nanoparticles (NPs) at the core and hierarchically porous zeolitic imidazolate frameworks as a shell (FeO@HPZIF-8), achieved through a soft-template directed self-assembly coupled with confinement growth mechanism.
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