Chayanin Pratoomsoot

The effects of metformin on ovarian cancer: a systematic review.

Objective The potential therapeutic effects of metformin on several cancers were reported. However, the evidence of the effects of metformin on ovarian cancer is still limited and inconclusive. This systematic review and meta-analysis study aims to summarize the existing evidence of the therapeutic effects of metformin on ovarian cancer. Methods We performed systematic searches using electronic databases including PubMed and EMBASE until December 2012. Key words included “metformin” AND (“ovarian cancer” OR “ovary tumor”). All human studies assessing the effects of metformin on ovarian cancer were eligible for inclusion. All articles were reviewed independently by 2 authors with a standardized approach for the purpose of study, study design, patient characteristics, exposure, and outcomes. The data were pooled using a random-effects model. Results Of 190 studies retrieved, only 3 observational studies and 1 report of 2 randomized controlled trials were included. Among those studies, 2 reported the effects of metformin on survival outcomes of ovarian cancer, whereas the other 2 reported the effects of metformin on ovarian cancer prevention. The findings of studies reporting the effects on survival outcomes indicated that metformin may prolong overall, disease-specific, and progression-free survival in ovarian cancer patients. The results of studies reporting the effects of metformin on ovarian cancer prevention were meta-analyzed. It indicated that metformin tended to decrease occurrence of ovarian cancer among diabetic patients with the pooled odds ratio of 0.57 (95% confidence interval, 0.16–1.99). Conclusions Our findings showed the potential therapeutic effects of metformin on survival outcomes of ovarian cancer and ovarian cancer prevention. However, most of the evidence was observational studies. There is a call for further well-conducted controlled clinical trials to confirm the effects of metformin on ovarian cancer survival and ovarian cancer prevention.

Healthcare Databases in Thailand and Japan: Potential Sources for Health Technology Assessment Research

Background Health technology assessment (HTA) has been continuously used for value-based healthcare decisions over the last decade. Healthcare databases represent an important source of information for HTA, which has seen a surge in use in Western countries. Although HTA agencies have been established in Asia-Pacific region, application and understanding of healthcare databases for HTA is rather limited. Thus, we reviewed existing databases to assess their potential for HTA in Thailand where HTA has been used officially and Japan where HTA is going to be officially introduced. Method Existing healthcare databases in Thailand and Japan were compiled and reviewed. Databases’ characteristics e.g. name of database, host, scope/objective, time/sample size, design, data collection method, population/sample, and variables were described. Databases were assessed for its potential HTA use in terms of safety/efficacy/effectiveness, social/ethical, organization/professional, economic, and epidemiological domains. Request route for each database was also provided. Results Forty databases– 20 from Thailand and 20 from Japan—were included. These comprised of national censuses, surveys, registries, administrative data, and claimed databases. All databases were potentially used for epidemiological studies. In addition, data on mortality, morbidity, disability, adverse events, quality of life, service/technology utilization, length of stay, and economics were also found in some databases. However, access to patient-level data was limited since information about the databases was not available on public sources. Conclusion Our findings have shown that existing databases provided valuable information for HTA research with limitation on accessibility. Mutual dialogue on healthcare database development and usage for HTA among Asia-Pacific region is needed.

Quality of Reporting of Randomised Controlled Trials of Herbal Interventions in ASEAN Plus Six Countries: A Systematic Review

Background Many randomised controlled trials (RCTs) of herbal interventions have been conducted in the ASEAN Communities. Good quality reporting of RCTs is essential for assessing clinical significance. Given the importance ASEAN placed on herbal medicines, the reporting quality of RCTs of herbal interventions among the ASEAN Communities deserved a special attention. Objectives To systematically review the quality of reporting of RCTs of herbal interventions conducted in the ASEAN Plus Six Countries. Methods Searches were performed using PubMed, EMBASE, The Cochrane Library, and Allied and Complementary Medicine (AMED), from inception through October 2013. These were limited to studies specific to humans and RCTs. Herbal species search terms were based on those listed in the National List of Essential Medicines [NLEM (Thailand, 2011)]. Studies conducted in the ASEAN Plus Six Countries, published in English were included. Results Seventy-one articles were identified. Thirty (42.25%) RCTs were from ASEAN Countries, whereas 41 RCTs (57.75%) were from Plus Six Group. Adherence to the recommended CONSORT checklist items for reporting of RCTs of herbal interventions among ASEAN Plus Six Countries ranged from 0% to 97.18%. Less than a quarter of the RCTs (18.31%) reported information on standardisation of the herbal products. However, the scope of our interventions of interest was limited to those developed from 20 herbal species listed in the NLEM of Thailand. Conclusions The present study highlights the need to improve reporting quality of RCTs of herbal interventions across ASEAN Plus Six Communities.

Prognostic predictors for ambulation in children with cerebral palsy: a systematic review and meta-analysis of observational studies

Abstract Purpose: The purpose of this study is to investigate the prognostic predictors for ambulation in children with cerebral palsy using meta-analysis of observational studies. Method: Electronic searches were conducted in PubMed, SCOPUS, CINAHL, ProQuest, Ovid, Wiley InterScience, and ScienceDirect databases from their start dates to December 2015. Results: Of the 1123 identified articles, 12 met the inclusion criteria for qualitative synthesis, eight of which were deemed appropriate for meta-analysis. Qualitative synthesis found that the type of cerebral palsy, early motor milestones, primitive reflexes and postural reactions, absence of visual impairment, absence of intellectual disability, absence of epilepsy or seizure, and ability to feed self were indicated as potential predictors for ambulation. Meta-analysis detected four significant prognostic predictors for ambulation: sitting independently at 2 years, absence of visual impairment, absence of intellectual disability, and absence of epilepsy or seizure. Conclusion: These prognostic predictors should be taken into consideration in therapeutic plans and rehabilitation goals, especially sitting independently before the age of 2 years. Implications for rehabilitation The meta-analysis supports strong evidence that sitting independently at 2 years of age, absence of visual impairment, absence of intellectual disability, and absence of epilepsy or seizure are positive predictors for ambulation in children with cerebral palsy. The therapeutic plans and rehabilitation goals should be considered cautiously for these predictors, especially sitting independently before the age of two years.

1715Oseltamivir use in an Influenza Outbreak: Linking Pharmacology to Pharmacoeconomics

Wu DBC1, Chaiyakunapruk N1,2,3,4, Pratoomsoot C5, Lee KKC1, Chong HY1, Nelson RE6, Smith PF7, Kirkpatrick C8, Kamal MA9, Nieforth K7, Dall G7, Toovey S10, Kong DCM8, Kamauu A11, Rayner CR7 1School of Pharmacy, Monash University, Sunway, Malaysia ,2 Center of Pharmaceutical Outcomes Research (CPOR), Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Thailand, 3 School of Pharmacy, University of Wisconsin, Madison, USA, 4 School of Population Health, University of Queensland, Brisbane, Australia, 5Faculty of Public Health, Naresuan University, Thailand, 6University of Utah, Salt Lake City, UT, 7 d3 Medicine LLC, 8Monash University, Melbourne, Australia, 9Hoffman-La Roche, Inc., Nutley, NJ, 10Royal Free and University College Medical School, London, UK, 11Anolinx LLC, Salt Lake City

1063Estimating Health Outcomes of Antiviral Use in Influenza (flu) Outbreaks by Linking PK/PD and Epidemiology via Transmission Dynamic Model: A Novel Approach

Outbreaks by Linking PK/PD and Epidemiology via Transmission Dynamic Model: A Novel Approach Patrick Smith, PharmD; Carl Kirkpatrick, PhD; Craig Rayner, PharmD MBA; Keith Nieforth, PharmD; Georgina Dall, PharmD; Stephen Toovey, MD PhD; David Kong, PhD; David Wu, PhD; Nathorn Chaiyakunapruk, PharmD PhD; Kenneth Lee, PhD; Chayanin Pratoomsoot; Huey Chong Yi; Aaron Kamauu, MD MSMPH; Richard E. Nelson, PhD; Mohamed Kamal, PharmD PhD; D3 Medicine, Parsippany, NJ; Pharmacy Practice, Monash University, Parkville, Australia; Pegasus Research, Bottmingen, Switzerland; Monash University, Selangor, Malaysia; Anolinx, Murray, UT; Internal Medicine, University of Utah, Salt Lake City, UT; Roche, New York, NY