Prognosis research strategy (PROGRESS) 1: a framework for researching clinical outcomes.

The PROGRESS series (www.progress-partnership.org) sets out a framework of four interlinked prognosis research themes and provides examples from several disease fields to show why evidence from prognosis research is crucial to inform all points in the translation of biomedical and health related research into better patient outcomes. Recommendations are made in each of the four papers to improve current research standards What is prognosis research? Prognosis research seeks to understand and improve future outcomes in people with a given disease or health condition. However, there is increasing evidence that prognosis research standards need to be improved Why is prognosis research important? More people now live with disease and conditions that impair health than at any other time in history; prognosis research provides crucial evidence for translating findings from the laboratory to humans, and from clinical research to clinical practice This first article introduces the framework of four interlinked prognosis research themes and then focuses on the first of the themes - fundamental prognosis research, studies that aim to describe and explain future outcomes in relation to current diagnostic and treatment practices, often in relation to quality of care Fundamental prognosis research provides evidence informing healthcare and public health policy, the design and interpretation of randomised trials, and the impact of diagnostic tests on future outcome. It can inform new definitions of disease, may identify unanticipated benefits or harms of interventions, and clarify where new interventions are required to improve prognosis

Prognosis research strategy (PROGRESS) 4: Stratified medicine research

In patients with a particular disease or health condition, stratified medicine seeks to identify thosewho will have the most clinical benefit or least harm from a specific treatment. In this article, thefourth in the PROGRESS series, the authors discuss why prognosis research should form acornerstone of stratified medicine, especially in regard to the identification of factors that predictindividual treatment respons

A note on certificate path verification in next generation mobile communications

Certificate-based authentication of parties provides a powerful means for verifying claimed identities, since communicating partners do not have to exchange secrets in advance for authentication. This is especially valuable for roaming scenarios in mobile communications. When dealing with certificates, one must cope with the verification of complete certificate paths for security reasons. In mobile communications, there exist special conditions for this verification work. Mobile devices may have limited capacity for computation and mobile communication links may have limited bandwidth. In this paper, we propose to apply PKI servers -such as implemented at FhG-SIT- that allow the delegation of certificate path validation in order to speed up verification. Furthermore, we propose a special structure for PKI components and specific cooperation models that force certificate paths to be short. Additionally, we deal with the problem of users who do not have Internet, access during the authentication phase. We explain how we have solved this problem and show a gap in existing standards

Discovery of prognostic factors: a genome-wide association study of survival among people with breast cancer, and replication in 15 studies (Mid-figure forest plot based on example plots in [4].

<p>Path element adapted from Chart 7.1 in the Cooksey report (2006) <a href="http://bit.ly/Ro27rL" target="_blank">http://bit.ly/Ro27rL</a> (made available for use and re-use through the Open Government License).</p

Tumour grade as a prognostic factor in breast cancer.

<p>Kaplan-Meier curves for disease-free survival for three groups of breast cancer patients defined by tumour grade status (1, 2, or 3). Curves are derived from 246 breast cancer patients treated with tamoxifen who had 94 recurrences or deaths over a possible 7 years of follow-up (reproduced with published data relating to Schumacher et al <a href="http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001380#pmed.1001380-Schumacher1" target="_blank">[1]</a>). The distinct curves, significant log rank result, and hazard ratio estimates suggests tumour grade is a prognostic factor, as it identifies three groups of patients with a different average prognosis.</p

Evaluation of whether homocysteine is a prognostic factor, and whether modifying it improves clinical outcome in patients with coronary disease (drawn from data in [35]).

<p>Path element adapted from Chart 7.1 in the Cooksey report (2006) <a href="http://bit.ly/Ro27rL" target="_blank">http://bit.ly/Ro27rL</a> (made available for use and re-use through the Open Government License).</p

Elements to consider including in registration, protocols, reporting, and data sharing^a.

a<p>Stages mirror the structure of research publications; registration tends to have fewer elements.</p>b<p>Overlap with WHO Trial Registration Dataset v1.2.1. and ClinicalTrials.gov.</p

Illustration of the timing of prognosis study registration, protocol publication, data sharing, and reporting.

<p>Illustration of the timing of prognosis study registration, protocol publication, data sharing, and reporting.</p

Potential benefits of study registration, protocol publication, better study reporting, and data sharing of prognosis research studies.

<p>Potential benefits of study registration, protocol publication, better study reporting, and data sharing of prognosis research studies.</p