The relevance of real-world data for the evaluation of neuropathic pain treatments

Treatment of neuropathic pain (NP) is challenging. Interest in real-world evidence (RWE) for benefit-risk assessments of NP treatments increases given the paucity of drugs showing efficacy in randomized controlled trials and restricted labels of available medicines. To provide further context, a literature review regarding regulatory use of RWE and a clinical trial registry search for randomized controlled trials over the last 10 years was carried out. Taken together, and especially for available NP treatments, there is increasing support to consider RWE when evaluating their benefit-risk profile. Examples are provided in which RWE could be used effectively for updating the product label and informing treatment recommendations. Collected and analyzed according to state-of-the-art standards, RWE can inform treatment recommendations and product label decisions

Evaluation of Musical Creativity and Musical Metacreation Systems

The field of computational creativity, including musical metacreation, strives to develop artificial systems that are capable of demonstrating creative behavior or producing creative artefacts. But the claim of creativity is often assessed, subjectively only on the part of the researcher and not objectively at all. This article provides theoretical motivation for more systematic evaluation of musical metacreation and computationally creative systems and presents an overview of current methods used to assess human and machine creativity that may be adapted for this purpose. In order to highlight the need for a varied set of evaluation tools, a distinction is drawn among three types of creative systems: those that are purely generative, those that contain internal or external feedback, and those that are capable of reflection and self-reflection. To address the evaluation of each of these aspects, concrete examples of methods and techniques are suggested to help researchers (1) evaluate their systems' creative process and generated artefacts, and test their impact on the perceptual, cognitive, and affective states of the audience, and (2) build mechanisms for reflection into the creative system, including models of human perception and cognition, to endow creative systems with internal evaluative mechanisms to drive self-reflective processes. The first type of evaluation can be considered external to the creative system and may be employed by the researcher to both better understand the efficacy of their system and its impact and to incorporate feedback into the system. Here we take the stance that understanding human creativity can lend insight to computational approaches, and knowledge of how humans perceive creative systems and their output can be incorporated into artificial agents as feedback to provide a sense of how a creation will impact the audience. The second type centers around internal evaluation, in which the system is able to reason about its own behavior and generated output. We argue that creative behavior cannot occur without feedback and reflection by the creative/metacreative system itself. More rigorous empirical testing will allow computational and metacreative systems to become more creative by definition and can be used to demonstrate the impact and novelty of particular approaches

Diagnostic et prise en charge de la douleur neuropathique en médecine générale (étude prospective observationelle au moyen d'outils validés auprès de praticien de la région voironnaise)

La douleur neuropathique est devenue une priorité de santé publique du fait de sa fréquence, de son intensité et de son retentissement sur la qualité de vie. Le médecin généraliste est en première ligne pour le diagnostic et la mise en place de thérapeutiques adaptées. Nous avons réalisé une étude prospective sur 3 consultations chez 17 patients au cours d une consultation en médecine générale en observant l utilisation de l outil diagnostic DN4, l utilisation d auto questionnaires patients (SF12, HAD et NPSI) et la prise en charge de la douleur neuropathique par les médecins généralistes. Le DN4 a été jugé utile par la quasi-totalité des médecins qui pensent l utiliser dans leur pratique future, le retentissement direct de l utilisation du DN4 a été important, induisant une adaptation thérapeutique immédiate. Les auto questionnaires patients n ont pas semblé intégrés dans la pratique quotidienne. La prise en charge thérapeutique a été le plus souvent conformes aux recommandations d experts : monothérapie par tricyclique ou anticomitial en première intention notamment. Le retentissement sur l EVN et la satisfaction globale des patients de la prise en charge spécifique de la douleur a semblé très positif.Neuropathic pain is generally chronic en disabling and is very difficult to treat. The primary care physicians are very important in the strategy to diagnose and treat neuropathic pain. We conduce a prospective survey among 17 patients in the French general population during 3 consultations. We ve made observations on the use of the DN4 questionnaire, the prescriptions and the use of self questionnaires ( SF12, HAD, NPSI ). The DN4 questionnaire has been appreciated by primary care physicians who seem to use it in the future. The direct effect has been a good adaptation of the treatment for nearly all the patients. The self s questionnaires seem not to be efficient in our study for the primary physicians. The take care as been correct according to the french recommendations: tricylic agent or anti comitial in first line. The effect on EVN and satisfaction has been efficientGRENOBLE1-BU Médecine pharm. (385162101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Une lecture socioanthropologique de la douleur chronique sous le signe de l’aliénation sociale

International audienc

Une lecture socioanthropologique de la douleur chronique sous le signe de l’aliénation sociale

International audienc

Une lecture socioanthropologique de la douleur chronique sous le signe de l’aliénation sociale

International audienc

Étude descriptive de la migraine de l'enfant de 3 à 6 ans ayant fréquenté au moins une fois un service d'urgence pédiatrique dans l'île de la Réunion en 2005

LYON1-BU Santé (693882101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Topical pain management with the 5 lidocaine medicated plaster a review

Background: The topical 5 lidocaine medicated plaster is recommended as first-line treatment for localized peripheral neuropathic pain. Scope: In order to provide an overview of the efficacy and safety of the lidocaine plaster in the treatment of different neuropathic pain conditions, all efficacy and safety studies (randomized, controlled, or open-label with well described methodology), case reports, and pharmacological studies on the lidocaine plaster retrieved from a PubMed literature research (1960-March 2012) plus additional references identified from retrieved articles were included. Findings: The lidocaine plaster is efficacious in the treatment of neuropathic pain symptoms associated with previous herpes zoster infection. Results from a large open-label controlled study suggest that the lidocaine plaster could be at least as effective as systemic pregabalin in the treatment of postherpetic neuralgia and painful diabetic polyneuropathy. Open-label studies indicate efficacy in t