Treat-to-target in systemic lupus erythematosus: recommendations from an international task force.

The principle of treating-to-target has been successfully applied to many diseases outside rheumatology and more recently to rheumatoid arthritis. Identifying appropriate therapeutic targets and pursuing these systematically has led to improved care for patients with these diseases and useful guidance for healthcare providers and administrators. Thus, an initiative to evaluate possible therapeutic targets and develop treat-to-target guidance was believed to be highly appropriate in the management of systemic lupus erythematosus (SLE) patients as well. Specialists in rheumatology, nephrology, dermatology, internal medicine and clinical immunology, and a patient representative, contributed to this initiative. The majority convened on three occasions in 2012-2013. Twelve topics of critical importance were identified and a systematic literature review was performed. The results were condensed and reformulated as recommendations, discussed, modified and voted upon. The finalised bullet points were analysed for degree of agreement among the task force. The Oxford Centre level of evidence (LoE, corresponding to the research questions) and grade of recommendation (GoR) were determined for each recommendation. The 12 systematic literature searches and their summaries led to 11 recommendations. Prominent features of these recommendations are targeting remission, preventing damage and improving quality of life. LoE and GoR of the recommendations were variable but agreement was >0.9 in each case. An extensive research agenda was identified, and four overarching principles were also agreed upon. Treat-to-target-in-SLE (T2T/SLE) recommendations were developed by a large task force of multispecialty experts and a patient representative. It is anticipated that 'treating-to-target' can and will be applicable to the care of patients with SLE

Socia movenments and the transformation of american health care

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Supplemental Appendix for "Gender Equity and Due Process in Campus Sexual Assault Adjudication Procedures"

Title IX prohibits sex discrimination in federally funded education programs. In 2011, the Department of Education under President Obama issued a Dear Colleague Letter (DCL) advising schools of their obligation to protect Title IX rights by more effectively responding to campus sexual assault. Many observers hoped that this would promote gender equity. Yet it also generated a backlash, as critics charged schools with stripping accused students of due process rights in campus adjudication procedures. We conducted content analysis of the 2016–17 sexual misconduct policies of 381 American colleges and universities to analyze how well adjudication procedures created in response to the DCL attended to both gender equity and due process requirements. The state of adjudication at this pivotal moment provides an empirical baseline from which to assess equity in university sexual misconduct procedures. We found that most school procedures for investigating and adjudicating complaints of sexual misconduct included hybrid models that incorporated due process protections while acknowledging (but often not fully meeting) Title IX obligations. To our knowledge, this is the only large-scale national study of how schools have reconciled Title IX and due process rights in adjudication procedures.Supplemental Tables Survey Question