How ontologies can help NPIs research and practice: challenges, limits and promises?

International audienc

A need of integrative and comprehensive health intervention ontology for intervention research

International audienceCongress organisation: Public Health Research Institute (IReSP), Alliance for life sciences and health (Aviesan), National Research Agency on AIDS and viral hepatitis (ANRS), National Cancer Institute (INCa). Integrated and Comprehensive Health Interventions (ICHIs), also called Non Pharmacological Interventions (NPIs), have become essential solutions to improve health, quality of life and, often, life expectancy. Recent studies have also highlighted the positive social and economic impact. "ICHIs are non-invasive methods of care (programs, products or services) whose efficacy in improving the health and quality of life of human beings has been proven. Their effects on health and quality of life markers are observable (with measured risks and benefits beyond mere user opinions) and can be linked to identify biological and/or psychological processes. They can also have a positive impact on health behaviours and socio-economic indicators” (CEPS Platform, 2016). Many authors (e.g., Ioannidis, 2015) and health authorities argue that what has been brought forth is merely proof of concept (e.g., French Health Authority, 2011). They note the lack of a consensus paradigm of validation and surveillance, such as the standards in drug development. They highlight the methodology problems due to rapid obsolescence of ICHI using a digital solution (e.g., Mobile Apps). As a result, policy makers and health decision-makers remain skeptical of the impact of ICHIs. These key players are encouraging innovators to come forward with additional evidence for the efficacy and the cost/effectiveness of ICHIs in order to improve their visibility, and, ultimately, to garner more substantive private and public financial support for them. ICHIs need to be compared and optimized, as well as targeted to the right health problem at the right time. The first step will be to develop a collaborative top-down strategy to identify and classify these health interventions. The communication presents our strategy supported by French State, Occitanie Region, and Montpellier Metropole. The CEPS Platform: An European Academic Platform Dedicated to Research Methodology For NPIs / Universities of Montpellier, France / www.cepsplatform.e

A need of integrative and comprehensive health intervention ontology for intervention research

International audienceCongress organisation: Public Health Research Institute (IReSP), Alliance for life sciences and health (Aviesan), National Research Agency on AIDS and viral hepatitis (ANRS), National Cancer Institute (INCa). Integrated and Comprehensive Health Interventions (ICHIs), also called Non Pharmacological Interventions (NPIs), have become essential solutions to improve health, quality of life and, often, life expectancy. Recent studies have also highlighted the positive social and economic impact. "ICHIs are non-invasive methods of care (programs, products or services) whose efficacy in improving the health and quality of life of human beings has been proven. Their effects on health and quality of life markers are observable (with measured risks and benefits beyond mere user opinions) and can be linked to identify biological and/or psychological processes. They can also have a positive impact on health behaviours and socio-economic indicators” (CEPS Platform, 2016). Many authors (e.g., Ioannidis, 2015) and health authorities argue that what has been brought forth is merely proof of concept (e.g., French Health Authority, 2011). They note the lack of a consensus paradigm of validation and surveillance, such as the standards in drug development. They highlight the methodology problems due to rapid obsolescence of ICHI using a digital solution (e.g., Mobile Apps). As a result, policy makers and health decision-makers remain skeptical of the impact of ICHIs. These key players are encouraging innovators to come forward with additional evidence for the efficacy and the cost/effectiveness of ICHIs in order to improve their visibility, and, ultimately, to garner more substantive private and public financial support for them. ICHIs need to be compared and optimized, as well as targeted to the right health problem at the right time. The first step will be to develop a collaborative top-down strategy to identify and classify these health interventions. The communication presents our strategy supported by French State, Occitanie Region, and Montpellier Metropole. The CEPS Platform: An European Academic Platform Dedicated to Research Methodology For NPIs / Universities of Montpellier, France / www.cepsplatform.e

De la définition des interventions non médicamenteuses à leur ontologie

Article disponible en ligne à l'adresse : http://hdl.handle.net/2042/65114International audienceLa multiplication des interventions non médicamenteuses (INM) et des doutes résiduels de leur efficacité imposent aujourd’hui de ne plus se cantonner à leur appellation générale et disciplinaire (psychothérapie, thérapie manuelle, complément alimentaire, activité physique adaptée, solution e-santé…) mais d’accéder à leur véritable contenu. Décrite de manière précise, chaque INM pourra être mieux évaluée par la science, surveillée par les professionnels et expliquée au patient. Pour ce faire, il est nécessaire de construire une modélisation de l’ensemble des connaissances scientifiques et d’usage sous la forme d’une ontologie informatique. Cette ontologie des INM facilitera les recherches bibliographiques, les statistiques d’usage et l’amélioration des bonnes pratiques. Une première version de cette classification internationale évolutive est disponible sur le site Internet de la Plateforme universitaire CEPS en accès libre

Characteristics of Anaplastic Oligodendrogliomas Short-Term Survivors: A POLA Network Study

Abstract Background Anaplastic oligodendrogliomas IDH-mutant and 1p/19q codeleted (AO) occasionally have a poor outcome. Herein we aimed at analyzing their characteristics. Methods We retrospectively analyzed the characteristics of 44 AO patients with a cancer-specific survival <5 years (short-term survivors, STS) and compared them with those of 146 AO patients with a survival ≥5 years (classical survivors, CS) included in the POLA network. Results Compared to CS, STS were older (P = .0001), less frequently presented with isolated seizures (P < .0001), more frequently presented with cognitive dysfunction (P < .0001), had larger tumors (P = .= .003), a higher proliferative index (P = .= .0003), and a higher number of chromosomal arm abnormalities (P = .= .02). Regarding treatment, STS less frequently underwent a surgical resection than CS (P = .= .0001) and were more frequently treated with chemotherapy alone (P = .= .009) or with radiotherapy plus temozolomide (P = .= .05). Characteristics independently associated with STS in multivariate analysis were cognitive dysfunction, a number of mitosis > 8, and the absence of tumor resection. Based on cognitive dysfunction, type of surgery, and number of mitosis, patients could be classified into groups of standard (18%) and high (62%) risk of <5 year survival. Conclusion The present study suggests that although STS poor outcome appears to largely result from a more advanced disease at diagnosis, surgical resection may be particularly important in this population

Temozolomide and Radiotherapy versus Radiotherapy Alone in Patients with Glioblastoma, IDH -wildtype: Post Hoc Analysis of the EORTC Randomized Phase III CATNON Trial

In a post hoc analysis of the CATNON trial (NCT00626990), we explored whether adding temozolomide to radiotherapy improves outcome in patients with IDH1/2 wildtype (wt) anaplastic astrocytomas with molecular features of glioblastoma [redesignated as glioblastoma, isocitrate dehydrogenase–wildtype (IDH-wt) in the 2021 World Health Organization (WHO) classification of central nervous system tumors]. Patients and Methods: From the randomized phase III CATNON study examining the addition of adjuvant and concurrent temozolomide to radiotherapy in anaplastic astrocytomas, we selected a subgroup of IDH1/2wt and H3F3Awt tumors with presence of TERT promoter mutations and/or EGFR amplifications and/or combined gain of chromosome 7 and loss of chromosome 10. Molecular abnormalities including MGMT promoter methylation status were determined by next-generation sequencing, DNA methylation profiling, and SNaPshot analysis. Results: Of the 751 patients entered in the CATNON study, 670 had fully molecularly characterized tumors. A total of 159 of these tumors met the WHO 2021 molecular criteria for glioblastoma, IDH-wt. Of these patients, 47 received radiotherapy only and 112 received a combination of radiotherapy and temozolomide. There was no added effect of temozolomide on either overall survival [HR, 1.19; 95% confidence interval (CI), 0.82–1.71] or progression-free survival (HR, 0.87; 95% CI, 0.61–1.24). MGMT promoter methylation was prognostic for overall survival, but was not predictive for outcome to temozolomide treatment either with respect to overall survival or progression-free survival. Conclusions: In this cohort of patients with glioblastoma, IDH-wt temozolomide treatment did not add benefit beyond that observed from radiotherapy, regardless of MGMT promoter status. These findings require a new well-powered prospective clinical study to explore the efficacy of temozolomide treatment in this patient population

La Plateforme CEPS : une structure universitaire de réflexion sur l’évaluation des interventions non médicamenteuses (INM)

National audienceLes Interventions Non Médicamenteuses (INM) sont devenues des solutions incontournables pour améliorer la qualité de vie et la santé. Elles présentent dans certains cas un impact positif sur la durée de vie et des bénéfices sociaux et économiques. Leur usage augmente sans cesse. Une plateforme universitaire collaborative basée à Montpellier, la Plateforme CEPS, réfléchit aux manières de les évaluer. Cet article présente plus en détail ses activités