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      Benefit–Risk Monitoring of Vaccines Using an Interactive Dashboard: A Methodological Proposal from the ADVANCE Project

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          Abstract

          Introduction

          New vaccines are launched based on their benefit–risk (B/R) profile anticipated from clinical development. Proactive post-marketing surveillance is necessary to assess whether the vaccination uptake and the B/R profile are as expected and, ultimately, whether further public health or regulatory actions are needed. There are several, typically not integrated, facets of post-marketing vaccine surveillance: the surveillance of vaccination coverage, vaccine safety, effectiveness and impact.

          Objective

          With this work, we aim to assess the feasibility and added value of using an interactive dashboard as a potential methodology for near real-time monitoring of vaccine coverage and pre-specified health benefits and risks of vaccines.

          Methods

          We developed a web application with an interactive dashboard for B/R monitoring. The dashboard is demonstrated using simulated electronic healthcare record data mimicking the introduction of rotavirus vaccination in the UK. The interactive dashboard allows end users to select certain parameters, including expected vaccine effectiveness, age groups, and time periods and allows calculation of the incremental net health benefit (INHB) as well as the incremental benefit–risk ratio (IBRR) for different sets of preference weights. We assessed the potential added value of the dashboard by user testing amongst a range of stakeholders experienced in the post-marketing monitoring of vaccines.

          Results

          The dashboard was successfully implemented and demonstrated. The feedback from the potential end users was generally positive, although reluctance to using composite B/R measures was expressed.

          Conclusion

          The use of interactive dashboards for B/R monitoring is promising and received support from various stakeholders. In future research, the use of such an interactive dashboard will be further tested with real-life data as opposed to simulated data.

          Electronic supplementary material

          The online version of this article (10.1007/s40264-018-0658-y) contains supplementary material, which is available to authorized users.

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          Most cited references20

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          Giving Patients' Preferences a Voice in Medical Treatment Life Cycle: The PREFER Public-Private Project.

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            Balancing benefit and risk of medicines: a systematic review and classification of available methodologies.

            The need for formal and structured approaches for benefit-risk assessment of medicines is increasing, as is the complexity of the scientific questions addressed before making decisions on the benefit-risk balance of medicines. We systematically collected, appraised and classified available benefit-risk methodologies to facilitate and inform their future use. A systematic review of publications identified benefit-risk assessment methodologies. Methodologies were appraised on their fundamental principles, features, graphical representations, assessability and accessibility. We created a taxonomy of methodologies to facilitate understanding and choice. We identified 49 methodologies, critically appraised and classified them into four categories: frameworks, metrics, estimation techniques and utility survey techniques. Eight frameworks describe qualitative steps in benefit-risk assessment and eight quantify benefit-risk balance. Nine metric indices include threshold indices to measure either benefit or risk; health indices measure quality-of-life over time; and trade-off indices integrate benefits and risks. Six estimation techniques support benefit-risk modelling and evidence synthesis. Four utility survey techniques elicit robust value preferences from relevant stakeholders to the benefit-risk decisions. Methodologies to help benefit-risk assessments of medicines are diverse and each is associated with different limitations and strengths. There is not a 'one-size-fits-all' method, and a combination of methods may be needed for each benefit-risk assessment. The taxonomy introduced herein may guide choice of adequate methodologies. Finally, we recommend 13 of 49 methodologies for further appraisal for use in the real-life benefit-risk assessment of medicines. Copyright © 2014 John Wiley & Sons, Ltd.
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              The risk of intussusception following monovalent rotavirus vaccination in England: A self-controlled case-series evaluation.

              To investigate the risk of intussusception after monovalent rotavirus vaccine (RV1) given to infants aged 2 and 3 months in England.
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                Author and article information

                Contributors
                + 32-485 789657 , Kaatje.Bollaerts@p-95.com
                Journal
                Drug Saf
                Drug Saf
                Drug Safety
                Springer International Publishing (Cham )
                0114-5916
                1179-1942
                26 March 2018
                26 March 2018
                2018
                : 41
                : 8
                : 775-786
                Affiliations
                [1 ]P95 Pharmacovigilance and Epidemiology Services, Koning Leopold III laan 1, 3001 Leuven, Belgium
                [2 ]GRID grid.57981.32, Medicines and Healthcare products Regulatory Agency, ; Buckingham Palace Road 151, London, SW1W 9SZ United Kingdom
                [3 ]ISNI 0000 0000 8800 7493, GRID grid.410513.2, Worldwide Research and Development, , Pfizer Inc, ; East 42nd St 235, New York City, NY 10017 NY USA
                [4 ]GRID grid.425090.a, GlaxoSmithKline Vaccines, ; Avenue Fleming 20, 1300 Wavre, Belgium
                Author information
                http://orcid.org/0000-0001-7704-0527
                Article
                658
                10.1007/s40264-018-0658-y
                6061437
                29582392
                e96fcd37-8719-4427-844b-5adac3fb07c6
                © The Author(s) 2018

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/), which permits any noncommercial use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

                History
                Funding
                Funded by: IMI
                Award ID: n° 115557
                Categories
                Original Research Article
                Custom metadata
                © Springer Nature Switzerland AG 2018

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