现实世界的证据,以告知监管决策:一个范围审查
Marieke S Jansen1, Olaf M Dekkers1,2,3, Saskia le Cessie1,4
1Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.
Clinical pharmacology and therapeutics
|February 23, 2024
概括
现实世界的证据 (RWE) 对监管决策至关重要,其必要性受到流行病学,利益风险评估,可行性和道德考虑等因素的影响. 这些因素的累积影响决定了RWE在决策过程中的重要作用.
科学领域:
- 健康科学 卫生科学 卫生科学
- 监管科学 监管科学
- 基于证据的医学基于证据的医学.
背景情况:
- 现实世界证据 (RWE) 在监管决策过程中越来越突出.
- 监管机构将RWE视为相关的程度受众因素的影响.
- 了解这些因素是优化RWE在药物和生物干预评估中的使用的关键.
研究的目的:
- 系统地识别和分类使现实世界证据 (RWE) 成为必要或可取的因素,以告知监管决策.
- 提供影响监管机构接受和使用RWE的考虑因素的全面概述.
主要方法:
- 采用了一个范围审查方法,系统地搜索主要的文献数据库 (PubMed,Embase,Emcare,科学网,Cochrane图书馆).
- 纳入标准集中在文章讨论影响RWE必要性/可取性的因素在欧洲,北美或全球的人类药理/生物干预的监管决策.
- 包括118篇文章,导致确定了两个主要主题和六个子主题.
主要成果:
- 两个主要主题出现了:"RWE可解决的问题" (包括流行病学和益处风险评估) 和"上下文因素" (包括可行性,伦理考虑,证据限制和疾病/治疗特点).
- 总共确定了43个不同的因素,影响了监管决策中对RWE的需求.
- 虽然个别因素可能并不总是需要RWE,但它们的综合影响可以确定RWE是必不可少的.
结论:
- 在监管决策中,RWE的必要性和可取性是由复杂的因素相互作用决定的.
- 这些因素涵盖了RWE可以回答的问题类型以及影响其应用的各种上下文因素.
- 本次审查强调了要有效地将RWE纳入监管评估所需的细微考虑.
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