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1.
PLoS One ; 16(3): e0248128, 2021.
Article in English | MEDLINE | ID: covidwho-1575679

ABSTRACT

BACKGROUND: The COVID-19 pandemic remains a significant global threat. However, despite urgent need, there remains uncertainty surrounding best practices for pharmaceutical interventions to treat COVID-19. In particular, conflicting evidence has emerged surrounding the use of hydroxychloroquine and azithromycin, alone or in combination, for COVID-19. The COVID-19 Evidence Accelerator convened by the Reagan-Udall Foundation for the FDA, in collaboration with Friends of Cancer Research, assembled experts from the health systems research, regulatory science, data science, and epidemiology to participate in a large parallel analysis of different data sets to further explore the effectiveness of these treatments. METHODS: Electronic health record (EHR) and claims data were extracted from seven separate databases. Parallel analyses were undertaken on data extracted from each source. Each analysis examined time to mortality in hospitalized patients treated with hydroxychloroquine, azithromycin, and the two in combination as compared to patients not treated with either drug. Cox proportional hazards models were used, and propensity score methods were undertaken to adjust for confounding. Frequencies of adverse events in each treatment group were also examined. RESULTS: Neither hydroxychloroquine nor azithromycin, alone or in combination, were significantly associated with time to mortality among hospitalized COVID-19 patients. No treatment groups appeared to have an elevated risk of adverse events. CONCLUSION: Administration of hydroxychloroquine, azithromycin, and their combination appeared to have no effect on time to mortality in hospitalized COVID-19 patients. Continued research is needed to clarify best practices surrounding treatment of COVID-19.


Subject(s)
Antiviral Agents/therapeutic use , Azithromycin/therapeutic use , COVID-19/drug therapy , Hydroxychloroquine/therapeutic use , Pandemics/prevention & control , Data Management/methods , Drug Therapy, Combination/methods , Female , Hospitalization , Humans , Male , SARS-CoV-2/drug effects
2.
J Natl Compr Canc Netw ; 19(4): 378-384, 2021 04.
Article in English | MEDLINE | ID: covidwho-1436323

ABSTRACT

The 21st Century Cures Act (Cures Act), signed into law in 2016, was designed to advance new therapies by modernizing clinical trials, funding research initiatives, and accelerating the development and use of health information technology. To analyze the current issues in cancer care related to the implementation and impact of the Cures Act, NCCN convened a multistakeholder working group. Participants discussed the legislation's impact on the oncology community since enactment and identified the remaining gaps and challenges as experienced by stakeholders. In June 2020, the policy recommendations of the working group were presented at the virtual NCCN Policy Summit: Accelerating Advances in Cancer Care Research: A Lookback at the 21st Century Cures Act in 2020. The summit consisted of informative discussions and a multistakeholder panel to explore the recommendations and the future of the Cures Act. This article explores identified policy recommendations from the NCCN Working Group and the NCCN Policy Summit, and analyzes opportunities to advance innovative cancer care and patient access to data.


Subject(s)
Biomedical Research/trends , Neoplasms , Humans , Neoplasms/therapy
3.
Journal of the American Planning Association ; : 1-15, 2021.
Article in English | Academic Search Complete | ID: covidwho-1279966

ABSTRACT

Millions of North Americans stopped riding public transit in response to COVID-19. We treat this crisis as a natural experiment to illustrate the importance of public transit in riders’ abilities to access essential destinations. We measured the impacts of riders forgoing transit through a survey of transportation barriers completed by more than 4,000 transit riders in Toronto and Vancouver (Canada). We used Heckman selection models to predict six dimensions of transport disadvantage and transport-related social exclusions captured in our survey. We then complemented model results with an analysis of survey comments describing barriers that individuals faced. Lack of access to alternative modes is the strongest predictor of a former rider experiencing transport disadvantage, particularly neighborhood walkability and vehicle ownership. Groups at risk of transport disadvantage before COVID-19, particularly women and people in poorer health, were also more likely to report difficulties while avoiding public transit. Barriers described by respondents included former supports no longer offering rides, gendered household car use dynamics, and lack of culturally specific or specialized amenities within walking distance.Policymakers should plan for a level of redundancy in transportation systems that enables residents to access essential destinations when unexpected service losses occur. Designing communities that enable residents to walk to those essential destinations will help reduce the burdens faced by transit riders during crises that render transit unfeasible. At the same time, planners championing active travel as an alternative to transit during such crises also need to devise solutions for former transit riders for whom active travel is ill suited, for example, due to physical challenges with carrying groceries or needing to chaperone children. [ABSTRACT FROM AUTHOR] Copyright of Journal of the American Planning Association is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

4.
Non-conventional in English | Homeland Security Digital Library, Grey literature | ID: grc-740473

ABSTRACT

From the Executive Summary: Hundreds of therapeutics are in preclinical or clinical development for treating COVID-19 [coronavirus disease 2019] patients. But as of May 2020, so far none have demonstrated effectiveness sufficient to warrant approval for general use, although one antiviral drug (remdesivir) has shown sufficient impact in ongoing clinical trials to support an authorization for emergency use. This is a reflection of the complexity, time, costs, and uncertainties associated with developing therapeutics - a process that not only encompasses preclinical evaluation and clinical trials to demonstrate safety and effectiveness, but also manufacturing at pandemic scale, and sufficient payment to enable appropriate and effective access. [...] Policy attention has understandably focused on the development of vaccines as the path to recovery. But even with these unprecedented actions, the widespread availability of effective vaccines remains many months away, if not longer. To reduce the impact of the pandemic in the meantime, intensive effort is also needed to accelerate therapeutics development to help prevent infections, reduce their severity, and mitigate or prevent further outbreak waves.COVID-19 (Disease);Therapeutics;Public health

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