Marketing authorization procedures for advanced cancer drugs: exploring the views of patients, oncologists, healthcare decision makers and citizens in France

International audienceBackground. The past decades have seen advances in cancer treatments in terms of toxicity and side effects but progress in the treatment of advanced cancer has been modest. New drugs have emerged improving progression free survival but with little impact on overall survival, raising questions about the criteria on which to base decisions to grant marketing authorizations and about the authorization procedure itself. For decisions to be fair, transparent and accountable, it is necessary to consider the views of those with relevant expertise and experience. Methods. We conducted a Q-study to explore the views of a range of stakeholders in France, involving: 54 patients (18 months after diagnosis); 50 members of the general population; 27 oncologists; 19 healthcare decision makers; and 2 individuals from the pharmaceutical industry. Results. Three viewpoints emerged, focussing on different dimensions entitled: 1) ‘Quality of life (QoL), opportunity cost and participative democracy’; 2)‘QoL and patient-centeredness’; and 3) ‘Length of life’. Respondents from all groups were associated with each viewpoint, except for healthcare decision makers, who were only associated with the first one. Conclusion. Our results highlight plurality in the views of stakeholders, emphasize the need for transparency in decision making processes, and illustrate the importance of a re-evaluation of treatments for all 3 viewpoints. In the context of advanced cancer, our results suggest that QoL should be more prominent amongst authorization criteria, as it is a concern for 2 of the 3 viewpoints

Physiolytics at the workplace : Affordances and constraints of wearables use from an employee’s perspective

Wearables paired with data analytics and machine learning algorithms which measure physiological (and other) parameters are slowly finding their way into our workplace. Several studies have reported positive effects from using such “physiolytics” devices and purported the notion that it may lead to significant workplace safety improvements or to increased awareness among employees concerning unhealthy work practices and other job-related health and well-being issues. At the same time, physiolytics may cause an over-dependency on technology and create new constraints on privacy, individuality, and personal freedom. While it is easy to understand why organizations are implementing physiolytics, it remains unclear what employees think about using wearables at their workplace. Using an affordance theory lens, we, therefore, explore the mental models of employees who are faced with the introduction of physiolytics as part of corporate wellness or security programs. We identify five distinct user types each of which characterizes a specific viewpoint on physiolytics at the workplace: the freedom-loving, the individualist, the cynical, the tech-independent, and the balancer. Our findings allow for better understanding the wider implications and possible user responses to the introduction of wearable technologies in occupational settings and address the need for opening up the “user black box” in IS use research

Alcohol-related affordances and group subjectivities: a Q-Methodology study

Aims: An Ecological approach to alcohol behaviour focuses on understanding individual–environment transactions, rather than on cognitive antecedents of behaviour. Meaning exists in the interdependence of individuals and their environments, in terms of affordances. Through subjective experience, this study focussed on group viewpoints related to alcohol-related affordances, or opportunities to consume alcohol in shared drinking environments. Methods: Forty students with a range of self-reported drinking behaviours participated in a Q-Methodology study, ranking 60 statements along a symmetrical grid. This varied concourse of alcohol-related affordances was obtained from a previous observation study within licenced premises and a photo-elicitation interview study with drinkers. Findings: Factor analysis and post-sort interviews revealed four subjective perspectives held by groups about their drinking behaviour: 13 participants were aware of contextual influences, but autonomous in their drinking choices; 12 participants were conscious of influences and compliant to their effects; six participants were unaware of influences, but unanimous with their peers; two participants were concerned about acting appropriately in a context by taking up canonical affordances. Conclusions: Grouping subjectivities from a varied concourse of affordances can reveal subjective experience in relation to drinking environments and alcohol behaviour. This conceptual approach for understanding drinking behaviour should be studied further