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Characterizing and Communicating Uncertainty in the Assessment of Benefits and Risks of Pharmaceutical Products: Workshop Summary - Institute of Medicine December 19, 2014 PDF  BOOKS
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Characterizing and Communicating Uncertainty in the Assessment of Benefits and Risks of Pharmaceutical Products: Workshop Summary
Author: Institute of Medicine
Year: December 19, 2014
Format: PDF
File size: PDF 3.3 MB
Language: English



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Despite the extensive body of evidence that informs regulatory decisions on pharmaceutical products, significant uncertainties persist. These uncertainties include the underlying variability in human biology factors associated with the chemistry of a drug and limitations in the research and clinical trial process itself, which may limit the generalizability of results. As a result, regulatory reviewers are consistently required to draw conclusions about a drug's safety and efficacy from imperfect data. Efforts are underway within the drug development community to enhance the evaluation and communication of the benefits and risks associated with pharmaceutical products, aimed at increasing the predictability, transparency, and efficiency of pharmaceutical regulatory decision-making. Effectively communicating regulatory decisions necessarily includes explaining the impact of uncertainty on decision-making.
Несмотря на обширное количество доказательств, которые служат основой для нормативных решений в отношении фармацевтических продуктов, сохраняются значительные неопределенности. Эти неопределенности включают в себя основную изменчивость факторов биологии человека, связанных с химией лекарственного средства, и ограничения в самом процессе исследований и клинических испытаний, которые могут ограничивать обобщаемость результатов. В результате регуляторные рецензенты постоянно должны делать выводы о безопасности и эффективности препарата на основе несовершенных данных. В рамках сообщества разработчиков лекарств предпринимаются усилия по улучшению оценки и информирования о преимуществах и рисках, связанных с фармацевтическими продуктами, направленные на повышение предсказуемости, прозрачности и эффективности принятия фармацевтических нормативных решений. Эффективное информирование о нормативных решениях обязательно включает объяснение влияния неопределенности на принятие решений.
Malgré un grand nombre de preuves qui servent de base aux décisions réglementaires concernant les produits pharmaceutiques, d'importantes incertitudes subsistent. Ces incertitudes comprennent la variabilité sous-jacente des facteurs de la biologie humaine associés à la chimie du médicament et les limites du processus de recherche et d'essai clinique lui-même qui peuvent limiter la généralisation des résultats. En conséquence, les évaluateurs réglementaires doivent constamment tirer des conclusions sur l'innocuité et l'efficacité du médicament sur la base de données imparfaites. Au sein de la communauté des développeurs de médicaments, des efforts sont déployés pour améliorer l'évaluation et la communication des avantages et des risques associés aux produits pharmaceutiques afin d'améliorer la prévisibilité, la transparence et l'efficacité de la prise de décisions réglementaires pharmaceutiques. La communication efficace des décisions réglementaires comprend nécessairement une explication de l'effet de l'incertitude sur la prise de décisions.
A pesar de la vasta cantidad de pruebas que sirven de base para las decisiones regulatorias sobre productos farmacéuticos, persisten importantes incertidumbres. Estas incertidumbres incluyen la variabilidad subyacente de los factores de la biología humana relacionados con la química del medicamento y limitaciones en el propio proceso de investigación y ensayo clínico que pueden limitar la generalidad de los resultados. Como resultado, los revisores reguladores deben constantemente extraer conclusiones sobre la seguridad y eficacia del fármaco basadas en datos imperfectos. Dentro de la comunidad de desarrolladores de medicamentos, se están realizando esfuerzos para mejorar la evaluación y la información sobre los beneficios y riesgos de los productos farmacéuticos, con el fin de mejorar la previsibilidad, la transparencia y la eficacia de las decisiones normativas farmacéuticas. La comunicación eficaz de las decisiones normativas incluye necesariamente una explicación del impacto de la incertidumbre en la toma de decisiones.
Apesar do vasto número de provas que servem de base para decisões regulatórias sobre produtos farmacêuticos, ainda há incertezas significativas. Essas incertezas incluem a principal variabilidade dos fatores da biologia humana associados à química do medicamento e as limitações no próprio processo de pesquisa e ensaio clínico que podem limitar a generalidade dos resultados. Como resultado, os revisores regulatórios devem constantemente tirar conclusões sobre a segurança e eficácia do medicamento com base em dados imperfeitos. A comunidade de desenvolvedores de medicamentos tem se esforçado para melhorar a avaliação e informar sobre os benefícios e riscos associados aos produtos farmacêuticos, visando a aumentar a previsibilidade, a transparência e a eficácia das decisões regulatórias farmacêuticas. A informação eficaz sobre as decisões regulatórias inclui necessariamente uma explicação para o impacto da incerteza na tomada de decisões.
Nonostante l'ampia quantità di prove che costituiscono la base per le normative sui prodotti farmaceutici, restano molte incertezze. Queste incertezze includono la principale variabilità dei fattori di biologia umana associati alla chimica del medicinale e le limitazioni nel processo di ricerca e sperimentazione clinica che possono limitare la generalizzazione dei risultati. Di conseguenza, i revisori regolatori devono continuamente trarre conclusioni sulla sicurezza e l'efficacia del farmaco sulla base di dati imperfetti. La comunità di sviluppatori di farmaci sta cercando di migliorare la valutazione e la sensibilizzazione sui vantaggi e i rischi associati ai prodotti farmaceutici per migliorare la prevedibilità, la trasparenza e l'efficacia delle normative farmaceutiche. L'informazione efficace sulle soluzioni normative include necessariamente una spiegazione dell'impatto dell'incertezza decisionale.
Trotz der umfangreichen Evidenz, die als Grundlage für regulatorische Entscheidungen bei Arzneimitteln dient, bestehen nach wie vor erhebliche Unsicherheiten. Zu diesen Unsicherheiten gehören die zugrunde liegende Variabilität humanbiologischer Faktoren im Zusammenhang mit der Arzneimittelchemie und Einschränkungen im Forschungs- und klinischen Studienprozess selbst, die die Verallgemeinerbarkeit der Ergebnisse einschränken können. Infolgedessen müssen regulatorische Gutachter aufgrund unvollkommener Daten ständig Rückschlüsse auf die cherheit und Wirksamkeit des Arzneimittels ziehen. Innerhalb der Gemeinschaft der Arzneimittelentwickler werden Anstrengungen unternommen, um die Bewertung und Kommunikation der mit pharmazeutischen Produkten verbundenen Vorteile und Risiken zu verbessern, um die Vorhersehbarkeit, Transparenz und Effizienz pharmazeutischer Regulierungsentscheidungen zu verbessern. Die effektive Kommunikation regulatorischer Entscheidungen beinhaltet notwendigerweise eine Erklärung der Auswirkungen von Unsicherheit auf die Entscheidungsfindung.
למרות גוף הראיות הנרחב שמהווה את הבסיס להחלטות רגולטוריות בנוגע למוצרי תרופות, אי ודאות זו כוללת את השונות הבסיסית של גורמי הביולוגיה האנושית הקשורים לכימיה של תרופות ומגבלות בתהליך המחקר והניסוי הקליני עצמו שעשויות להגביל את ההכללות של התוצאות. כתוצאה מכך, סוקרים רגולטוריים חייבים להסיק כל הזמן מסקנות לגבי הבטיחות והיעילות של התרופה בהתבסס על נתונים לא מושלמים. בתוך קהילת פיתוח התרופות, נעשים מאמצים לשפר את ההערכה והתקשורת של היתרונות והסיכונים הקשורים למוצרי תרופות, שמטרתם לשפר את יכולת החיזוי, השקיפות והיעילות של קבלת החלטות רגולטוריות תרופתיות. תקשורת אפקטיבית של החלטות רגולטוריות כרוכה בהכרח בהסבר ההשפעה של אי ודאות על קבלת החלטות.''
Farmasötik ürünlerle ilgili düzenleyici kararların temelini oluşturan kapsamlı kanıtlara rağmen, önemli belirsizlikler devam etmektedir. Bu belirsizlikler, ilaç kimyası ile ilişkili insan biyolojisi faktörlerinin altta yatan değişkenliğini ve sonuçların genelleştirilebilirliğini sınırlayabilecek araştırma ve klinik araştırma sürecindeki sınırlamaları içerir. Sonuç olarak, düzenleyici gözden geçirenler, kusurlu verilere dayanarak ilacın güvenliği ve etkinliği hakkında sürekli olarak sonuç çıkarmalıdır. İlaç geliştirme topluluğu içinde, farmasötik düzenleyici karar vermenin öngörülebilirliğini, şeffaflığını ve verimliliğini artırmayı amaçlayan farmasötik ürünlerle ilgili faydaların ve risklerin değerlendirilmesini ve iletişimini iyileştirme çabaları devam etmektedir. Düzenleyici kararların etkili bir şekilde iletilmesi, belirsizliğin karar verme üzerindeki etkisinin açıklanmasını gerektirir.
على الرغم من مجموعة الأدلة الواسعة التي تشكل الأساس للقرارات التنظيمية المتعلقة بالمنتجات الصيدلانية، لا تزال هناك شكوك كبيرة. تشمل أوجه عدم اليقين هذه التباين الأساسي لعوامل البيولوجيا البشرية المرتبطة بكيمياء الأدوية والقيود في عملية البحث والتجارب السريرية نفسها التي قد تحد من قابلية تعميم النتائج. نتيجة لذلك، يجب على المراجعين التنظيميين استخلاص استنتاجات باستمرار حول سلامة وفعالية الدواء بناءً على بيانات غير كاملة. وفي أوساط تطوير الأدوية، تبذل جهود لتحسين تقييم المنافع والمخاطر المرتبطة بالمنتجات الصيدلانية والإبلاغ عنها، بهدف تحسين القدرة على التنبؤ بالشفافية والكفاءة في اتخاذ القرارات التنظيمية المتعلقة بالمستحضرات الصيدلانية. وينطوي الإبلاغ الفعال بالقرارات التنظيمية بالضرورة على شرح أثر عدم اليقين على عملية صنع القرار.
제약 제품에 관한 규제 결정의 기초를 형성하는 광범위한 증거에도 불구하고 상당한 불확실성이 남아 있습니다. 이러한 불확실성에는 약물 화학과 관련된 인간 생물학 요인의 근본적인 변동성 및 결과의 일반성을 제한 할 수있는 연구 및 임상 시험 과정 자체의 한계가 포함됩니다. 결과적으로 규제 검토자는 불완전한 데이터를 기반으로 약물의 안전성과 효능에 대한 결론을 지속적으로 도출해야합니다. 약물 개발 커뮤니티 내에서 제약 규제 의사 결정의 예측 가능성, 투명성 및 효율성 향상을 목표로 제약 제품과 관련된 이점과 위험의 평가 및 커뮤니케이션을 개선하기위한 노력이 진행 중입니다. 규제 결정의 효과적인 의사 소통에는 반드시 불확실성이 의사 결정에 미치는 영향을 설명하는 것이
盡管有大量證據作為藥品監管決策的基礎,但仍存在相當大的不確定性。這些不確定性包括與藥物化學相關的人類生物學因素的主要變異性,以及研究和臨床試驗過程本身的局限性,這可能會限制結果的可推廣性。結果,監管審查員必須不斷根據不完善的數據得出有關藥物安全性和有效性的結論。藥品開發界正在努力改進對藥品效益和風險的評估和宣傳,以提高藥品管理決策的可預測性、透明度和效率。對監管決策的有效溝通必然包括解釋不確定性對決策的影響。

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