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In recent years, the oncologic community has been widely debating the high costs of new anti-cancer drugs, that put at risk the sustainability of the health care system. In a study published in BMJ in October 2017, Davis and colleagues analyzed clinical trials conducted with anti-cancer drugs approved by the European Medicines Agency between 2009 and 2013. The authors emphasized that most anti-cancer drugs have been approved without any evidence of an improvement in overall survival and/or in quality of life. However, the consciousness about the importance of "raising the bar" for treatment value has recently increased, not only in regulatory agencies, but also among medical oncologists and scientific societies. The frameworks designed by ASCO and ESMO to quantify treatment value have been firstly published in 2015, that is after the years analyzed by Davis and colleagues. We strongly hope that the same kind of analysis, if repeated for the subsequent 5 years, could document a trend of improved magnitude of benefit. This improvement would be particularly relevant, considering that the debate about the relevance of results obtained with anti-cancer drugs is necessarily going to grow. Let's go forward, but wisely….
This article was published in the following journal.
Name: Recenti progressi in medicina
To determine non-American Society for Clinical Pathology pathology- and laboratory-related Choosing Wisely recommendations that drive effective test utilization in the laboratory.
(i) To describe how aligned the 'Choosing Wisely' concept is with the medical culture among Brazilian cardiologists and (ii) to identify predictors for physicians' preference for avoiding wasteful car...
Several specialty societies participate in the Choosing Wisely (CW) campaign in an attempt to reduce waste in health care spending. We surveyed internal medicine (IM) residents with an objective of cl...
Despite the growing enthusiasm surrounding the Choosing Wisely® campaign, little is known regarding the evidence underlying these recommendations. We extracted references for all 320 recommendations ...
This is a randomized study intended to produce a reduction in ordering of inappropriate tests by general practitioners as determined by recommendations from the CRA's Choosing Wisely guide...
This pragmatic trial examines the uptake and effects of primary care clinician commitments to follow 3 Choosing Wisely® recommendations. The investigators hypothesize that pre-encounter i...
The goal of this study is to determine if training in both the forward and reverse modes on the ICARE (motor-assisted elliptical) contributes to improvements in gait and cardiorespiratory ...
Training of health care providers and structured LARC forward counseling may contribute to increased LARC uptake. The hypothesis to be tested is that by introducing LARC forward counsellin...
Clinicians' decisions to order potentially unnecessary services -- such as those targeted in the Choosing Wisely® campaign -- are often affected by their high-pressure practice environmen...
Malalignment of a bone in which its head and neck is rotated excessively forward or inward.
Automotive safety devices consisting of a bag designed to inflate upon collision and prevent passengers from pitching forward. (American Heritage Dictionary, 1982)
Moving a retruded mandible forward to a normal position. It is commonly performed for malocclusion and retrognathia. (From Jablonski's Dictionary of Dentistry, 1992)
Applies to the movements of the forearm in turning the palm forward or upward and when applied to the foot, a combination of adduction and inversion of the foot.
Deformities of the SPINE characterized by an exaggerated convexity of the vertebral column. The forward bending of the thoracic region usually is more than 40 degrees. This deformity sometimes is called round back or hunchback.
Cancer is not just one disease but many diseases. There are more than 100 different types of cancer. Most cancers are named for the organ or type of cell in which they start - for example, cancer that begins in the colon is called colon cancer; cancer th...
Clinical trials are a set of procedures in medical research conducted to allow safety (or more specifically, information about adverse drug reactions and adverse effects of other treatments) and efficacy data to be collected for health interventions (e.g...
Bladder Cancer Brain Cancer Breast Cancer Cancer Cervical Cancer Colorectal Head & Neck Cancers Hodgkin Lymphoma Leukemia Lung Cancer Melanoma Myeloma Ovarian Cancer Pancreatic Cancer ...