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Multi-modal cancer screening tests: hype or hope?


Paul Pharoah, MD, PhD

A variety of technologies have been developed in recent years that enable the detection of multiple different site-specific cancers using a single blood test.  These multi-modal tests have been promoted as possible tests for the early detection of cancer that could be used in people without symptoms of cancer as a cancer screening test.  While these tests are promising there are several potential problems with their application in a screening setting. I will use the ‘Galleri’ test developed by Grail to illustrate both the potential of these tests and to outline the potential problems and the questions that will need to be answered before they can be used in clinical practice.

Multi-modal cancer screening tests: hype or hope? 

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Detecting problematic RCTs


Jack Wilkinson, PhD

Systematic reviews of health interventions synthesise evidence from all RCTs addressing a particular research question, and are considered very high-quality evidence. Unfortunately, it has become clear that some RCTs included in systematic reviews are not authentic and may have been entirely fabricated. We call trials subject to data falsification, fabrication, or other serious research integrity issues “problematic studies”, and recent examples can be found amongst studies included in systematic reviews of ivermectin for the treatment of COVID-19. However, there is no consensus around how to identify these problematic studies when undertaking a systematic review, and often no checks are performed at all.

In the first half of this talk, I will present the NIHR-funded INSPECT-SR project, which aims to develop a tool for identifying and excluding problematic RCTs from systematic reviews. The project will combine empirical evidence and consensus science approaches to develop a tool, which will then be refined through testing. I will outline the project, deliver interim results, and provide information about how to participate in the development of the tool.

In the second half of the talk, I will describe some of the analytic methods which are employed to assess the authenticity of RCT datasets.

Developing a tool for detecting problematic RCTs in health systematic reviews: the INSPECT-SR project
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Why Retractions Are On The Rise -- And Why There Should Be Many More


Ivan Oransky, MD

Retractions -- the nuclear option of scientific correction -- have grown more than 100-fold in the past 20 years. Why? And is that good news, or bad news? We'll discuss fake data, paper mills, as well as ways forward.

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De-escalation in Cancer Care


Kevin Knopf, MD

De-escalation implies readjusting cancer care to that which is appropriate for optimal patient outcome. This talk reviews how and why cancer care has escalated over time as well as how this can be harmful for patients and society. This talk discusses de-escalation efforts in surgery, imaging, radiation oncology, and chemotherapy and how these efforts can preserve outcome and improve health equity.

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Reading Clinical Studies


 Nathan I Cherny MBBS, FRACP, FRCP

Prof Nathan Cherny presents an approach to the systematic critical evaluation of clinical studies to identify  some of the common issues that bias the outcomes of clinical research in oncology. 

The talk will highlight issues related to:

1.      surrogate endpoints and their predictive reliability for true clinical benefit

2.      study design and implementation issues that may exaggerate overall survival

3.      issues related post hoc and subgroup analyses and the important distinction between confirmatory and conjectural findings

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Background reading:

Evolve or die: the urgent need to streamline RCTs


There is an urgent need to develop comprehensive guidelines based on the scientific principles underlying randomized, controlled trials that focus on those aspects that really matter for both generating reliable findings and ensuring patient safety, and that take advantage of technological advances to increase the scope of randomized evidence. Such guidelines would be relevant not only for the various phases of clinical development that lead to regulatory approval of new interventions (with reduction of wasteful practices allowing more new treatments to become available) but also for non-commercial randomized trials of existing treatments (making more such trials affordable leading to better patient care and improved public health).

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Now we finally have the evidence: but can we trust the data?

19 April 2023 4pm BST

Ben Mol, MD, PhD

Trustworthiness of medical publications can depend on either good faith or verifiable data. In recent years, it has increasingly become apparent that good faith alone is not enough, with estimates of fabricated research being 30% of published randomised clinical trials. I will discuss the role of authors and their institutes, peer review pre-and post publication and the role of publishers in this problem.

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Methodological Review Boards

11 May 2023 17:00 BST

Daniel Lakens, PhD

Should scientists be allowed to perform studies that are a waste of time? If it is clear from the outset that the methods they use will not be able to answer the question they are asking, should they be told to redesign their study or adjust their research question? Methodological review boards provide one way to check the methodological quality of studies before data collection. Collaboratively performed methodological review can help to improve research practices and prevent research waste.

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If God Doesn't Play Dice, Should Doctors?

18 May 2023 5pm BST

David Healy, MD

This talk presents a new history and analysis of Randomized Controlled Trials (RCTs) making the case that while these can be very helpful, at present they are being fetished and we now face medical scenarios that will require a restoration of faith in clinical judgement rather than more RCTs.

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Pharma’s key opinion leaders — Epistemic corruption in medical science

8 June 2023 5pm BST

Sergio Sismondo, PhD

In its efforts to more effectively market its products, the pharmaceutical industry often turns to ‘key opinion leaders’ (KOLs) to disseminate scientific information. This presentation documents some uses of KOLs in pharmaceutical companies’ marketing efforts. This contributes to a situation in which companies with well-defined and narrow interests have substantial influence over how medical knowledge is produced, circulated and consumed.

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How research integrity and open science hang together


Lex Bouter, PhD

The trustworthiness of research findings is threatened when researchers don’t do their utmost best to get it right and engage in questionable research practices or worse. By adopting open science practices, research becomes transparent and accountable. Only then it is possible to verify whether trust in research findings is justified. The magnitude of the issue will be explored, as well as why researchers regularly engage in behaviours that harm the validity and trustworthiness of their work.

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Malignant Pharmacoeconomics: innovation and sustainability

31 August 2023

Nathan Cherny

The very high cost of new cancer medicines is threatening the sustainability of cancer care and is harming health care systems and patients. This talk explores the global economic factors underlying this phenomenon addressing critical questions like “Is this the cost of innovation or exploitative profiteering?”  and exploring global public health initiatives to address this problem.

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Why Better Outcomes Cost Less

September 14, 2023 5pm BST

Pramod John, PhD

Why can't we say 'No' to high prices and low quality for drugs? The United States, which accounts for only 4% of the world’s population, spends as much on drugs as the rest of the world combined (96%). Despite this, health outcomes in the US are often worse than those in developing countries. Economic inefficiencies of the healthcare system are the main drivers of these poor results. By focusing on outcomes and taking a common-sense approach, significant cost savings can be achieved.

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Industry funding of patient organisations in the UK

28 September, 2023

Arianna Gentilini

Iva Parvanova

Patient organisations play an important role in the development, regulatory review and adoption of new drugs. Given the increasingly important role of these organisations, it is vital to understand their financial ties with pharmaceutical companies. This seminar will present the findings from an analysis of the financial ties between the pharmaceutical industry and patient organisations in the United Kingdom in 2020. The authors develop a methodology to determine the concordance between commercial interests of pharmaceutical companies and disease areas supported by patient organisations. They also analyse funding patterns based on the prevalence of the conditions supported by the patient organization.

Gentilini A, Parvanova I - Industry funding of patient organisations in the UK: a retrospective study of commercial determinants, funding concentration and disease prevalence, BMJ Open (Original Research)

Parvanova I, Gentilini A,  Cushing J, Naci H - Safeguarding NICE from patient groups’ conflicts of interest, BMJ (Opinion)

Das S, Ungoed-Thomas J - Revealed: drug firms funding UK patient groups that lobby for NHS approval of medicines, The Guardian (Media Coverage)

Open consultation - Disclosure of industry payments to the healthcare sector (Consultation closes at 11:59pm on 16 October 2023)

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High prices and dirty tricks: the evolution of the pharmaceutical industry

October 19, 2023 5pm BST

Billy Kenber

The investigative journalist, Billy Kenber, who exposed a billion-pound British price-hiking scandal discusses his book Sick Money, which tells the story of how finance took over the pharmaceutical industry and the damaging consequences for access to medicines and research priorities. He discusses the cultural shifts and scientific challenges which have driven an initially public spirited industry’s transformation into treating drugs as nothing more than financial assets.
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Reporting of Nordic registered clinical trials

November 30, 2023 5pm GMT

Gustav Nilsonne, MD, PhD

The results of hundreds of clinical trials involving patients in Denmark, Sweden, Norway, Finland and Iceland have not been made public.
Gustav Nilsonne presents his research into the problem, which included 2,113 registered trials completed 2016-2019. Overall, about one quarter were reported within a year, half by two years, and just over three quarters were reported at the end of follow-up.
The presentation is followed by a discussion with experienced transparency advocates on how to use these data to campaign for positive change. All participants in the webinar are invited to share their suggestions and ideas.

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