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Jones P.W.,St George's, University of London | Small M.,REAL WORLD
Respiratory Medicine | Year: 2014

GOLD proposed a COPD assessment framework focussed on symptoms measured by the COPD Assessment Test™ (CAT) or the mMRC and on exacerbation risk based on poor lung function (FEV1 <50%) or a history of ≥2 exacerbations in the previous year. This analysis examined the characteristics of COPD patients recruited from routine clinical settings and classified using the GOLD framework. 1041 European COPD patients (38.5% from primary care) from the Adelphi Respiratory Disease Specific Programme with information on CAT, mMRC, spirometry and exacerbation history in the previous year were analysed. Their mean age was 64.9 ± 9.9 years and mean FEV1 was 62.5 ± 17.8% predicted; 80% were in GOLD 2 spirometric grade or milder. CAT and mMRC cut points identified different groups of patients; using CAT, the composition was: Group A 9.3%, Group B 48.5%, Group C 0.7% and Group D 41.5%. 80% were classified as high risk based on exacerbation history and 25% of patients in a low risk category (GOLD A and B) had 1 exacerbation in the previous year. The incidence of diabetes, hypertension and hyperlipidaemia rose with worsening GOLD group (all p < 0.0001); diabetes GOLD A 4%, GOLD B 16%, GOLD D 29%; hypertension GOLD A 38%, GOLD B 55%, GOLD D 65%; hyperlipidaemia GOLD A 13%, GOLD B 30%, GOLD D 37%. In patients seen in routine clinical settings, 25% of GOLD low risk patients had one exacerbation per year and the incidence of cardio-vascular and metabolic diseases increases with worsening GOLD group. © 2013 The Authors. Published by Elsevier Ltd. All rights reserved.

Agency: GTR | Branch: Innovate UK | Program: | Phase: Collaborative Research & Development | Award Amount: 346.23K | Year: 2014

A new broadcast format has emerged from the rapid expansion of online video. Channel creators are building a new economy around making short form editorial video which they publish on video platforms like YouTube attracting significant numbers of viewers to their video channels and generating significant advertising revenues. This represents a licensing opportunity for the music industry who make substantial revenues from the use of commercial music in terrestrial and satellite broadcast markets. But due to the complex world of commercial music licensing, high-quality published music is rarely used and lower quality royalty free music is used in its place. This results in lower quality and lower impact videos being produced to the frustration of Channel Creators on the one hand, who want to produce broadcast quality content that attracts the highest advertising revenue and artists and composers for whom this currently represents a lost opportunity. By partnering with labels, publishers and video networks this project will create an online music service that supplies professional channel creators with sync-music licenses while compensating artists and composers.

Vestbo J.,University of Southern Denmark | Vestbo J.,University of Manchester | Vogelmeier C.,Universitatsklinikum Giessen und Marburg | Small M.,REAL WORLD | Higgins V.,REAL WORLD
Respiratory Medicine | Year: 2014

Study objectives The aim of this analysis was to understand the implications of the GOLD 2011 multidimensional system for the assessment and management of COPD, using data from a real-world observational study. Methods Data were drawn from the Adelphi Respiratory Disease Specific Programme, a cross-sectional survey of consulting patients in five European countries and in the US undertaken between June and September 2011. Patients were classified using both the GOLD 2010 and revised GOLD 2011 criteria, and profiled with regards to demographics, disease characteristics and treatment patterns. Results Information on 3813 COPD patients was collected. Disease characteristics showed a general tendency to worsen in parallel with worsening of symptoms. When comparing dual versus single risk criteria, the inclusion of exacerbation history resulted in an increase in the number of patients in high risk groups. The highest proportions of patients receiving inhaled corticosteroids (ICS) were in group D. However, a considerable proportion of patients in low risk groups were receiving ICS/long-acting β2 agonists. Conclusions Our analysis confirmed the relationship between higher symptomatic burden, increased airflow limitation and exacerbation, and further illustrated the importance of including exacerbation history in the assessment of COPD to identify patients at high risk. As based on data from current clinical practice, this study also highlighted the frequent and potentially inappropriate use of ICS and bronchodilators in patients at low risk of experiencing exacerbations. © 2014 Elsevier Ltd. All rights reserved.

Kay S.,REAL WORLD | Ferreira A.,Novartis
Ophthalmic Epidemiology | Year: 2014

Purpose: To develop a mapping algorithm for the estimation of EQ-5D-based utility scores from observed 25-item National Eye Institute Visual Functioning Questionnaire (NEI VFQ-25) scores, a disease-specific, patient-reported outcome measure used in several retinal disorders to evaluate vision-specific functioning. Methods: The dataset comprised 951 paired EQ-5D/NEI VFQ-25 observations from 344 patients in RESTORE, a 12-month, randomized, double-blind trial in individuals with visual impairment due to diabetic macular edema. EQ-5D index scores (utilities) were calculated based on the UK tariff. We evaluated 11 models using predictor sets based on the NEI VFQ-25 subscales to estimate utility as a function of NEI VFQ-25 score, based on four modeling techniques. Model performance was assessed by 10-fold cross-validation comparing root mean squared error (RMSE), mean absolute error (MAE) and correlation with EQ-5D score (Pearson and Spearman correlation coefficients). Results: Mapping results were similar across all techniques and predictor sets. The reverse two-part generalized estimating equation model used fewest predictors and had the best predictive performance (RMSE 0.200, MAE 0.140). Predicted and original EQ-5D values were not strongly correlated (squared Spearman correlation coefficient, 0.34). Conclusions: Although mapping disease-specific instruments to EQ-5D utilities is a preferred method by some reimbursement bodies, finding an appropriate mapping equation is not straightforward. In this study, mapping NEI VFQ-25 scores to EQ-5D utilities provided low predictive power, independent of the modeling methodology applied, suggesting an inability of the EQ-5D to discriminate vision-related activities, and highlighting that mapping exercises may lead to inaccurate utility values that do not represent patients' preferences. © 2014 Informa Healthcare USA, Inc. All rights reserved: reproduction in whole or part not permitted.

Iyer S.,Pfizer | Roughley A.,REAL WORLD | Rider A.,REAL WORLD | Taylor-Stokes G.,REAL WORLD
Supportive Care in Cancer | Year: 2014

Purpose: Disease symptom management in patients with advanced non-small cell lung cancer (NSCLC) is a critical aspect of therapy. The main objective of our study was to assess patient-reported outcomes and the degree of concordance between physician and patient perceptions of symptom severity in advanced NSCLC in the USA. Methods: Patients with advanced (stage IIIB/IV) NSCLC (N = 450) were recruited in a nationwide (USA) lung cancer study. Patients and their oncologists completed patient and physician versions of the Lung Cancer Symptom Scale (LCSS). Patient-reported lung cancer-specific quality of life was assessed with the Functional Assessment of Cancer Therapy - Lung (FACT-L). Concordance was assessed using the kappa-statistic. Regression analysis was performed with FACT-L total score as the dependent variable and patient-reported LCSS symptom scores as predictors. Results: A high proportion of patients experienced lung cancer symptoms: fatigue (100 %), loss of appetite (97 %), shortness of breath (95 %), cough (93 %), pain (92 %), and blood in sputum (63 %). Concordance between physician and patients was lowest for loss of appetite (kappa 0.1701) and greatest for hemoptysis (kappa 0.4586). Loss of appetite (β = -0.204; p < 0.001), cough (β = -0.145; p < 0.01), pain (β = -0.265; p < 0.001), and shortness of breath (β = -0.145; p < 0.01) were found to be significant predictors of the quality of life. Conclusions: Symptom burden in patients with advanced NSCLC is high and has a negative impact on the quality of life. Patient-reported outcomes data could help optimize disease outcomes and therapy management in NSCLC. © 2013 Springer-Verlag Berlin Heidelberg.

Iyer S.,Pfizer | Taylor-Stokes G.,REAL WORLD | Roughley A.,REAL WORLD
Lung Cancer | Year: 2013

Background: To assess patient reported symptom burden and impact on disease specific health related quality of life (HRQOL) in advanced non-small cell lung cancer (NSCLC) patients. Methods: Patients with advanced (stage IIIB/IV) NSCLC in France (n=613) and Germany (n=600) were recruited into a multicenter, patient record-based cross-sectional study. Patient reported symptoms using the Lung Cancer Symptom Scale, which assesses fatigue, loss of appetite, shortness of breath, cough, pain and blood in sputum on a 0-100 visual analog scale. Disease specific and generic HRQOL were assessed using the Functional Assessment of Cancer Therapy-Lung (FACT-L) and the EuroQol five-dimensional questionnaire (EQ-5D) respectively. A multivariate regression analysis was performed with total FACT-L score as the dependent variable and symptom scores as predictors. Age, gender, stage and performance status were used as control variables. Results: Majority of the patients were male (67%), Caucasian (93%) with an average age of 63 years. Fatigue, loss of appetite, shortness of breath, cough and pain were reported by ≥90% of patients. The mean health utility index score was found to be 0.58 and the mean general health status score was 58.0. Fatigue (β=-0.122; p<0.001), loss of appetite (β=-0.170; p<0.001), pain (β=-0.145; p<0.001), shortness of breath (β=-0.118; p<0.001) were found to be significant predictors of lung cancer specific quality of life as measured by the FACT-L total score. Conclusion: Fatigue, loss of appetite, shortness of breath and pain have a significant negative impact on patient reported disease specific HRQOL in advanced NSCLC patients. © 2013 Elsevier Ireland Ltd.

Agency: GTR | Branch: Innovate UK | Program: | Phase: Collaborative Research & Development | Award Amount: 171.59K | Year: 2015

DRW is marketing a simple, robust point-of-care nucleic acid diagnostic platform, called SAMBA, which allows complex, high-performance tests to be carried out in remote, resource-limited settings in developing countries and primary care settings in developed countries. The first SAMBA tests are for HIV: one to measure HIV viral load for treatment monitoring and one to detect HIV in infants in order to initiate early treatment. Due to WHO recommendation for viral load monitoring and early infant diagnosis in sub-Saharan Africa, the market in the developing world alone will grow to $1 billion/annum by 2017. To meet demand, DRW must automate its test cartridge manufacture to allow a production scale of 1.5 million tests/annum. DRW proposes and requests funding for developing production processes that are appropriate for high-speed assembly and 100% inspection, to produce SAMBA tests for the developed and developing world market.

Agency: GTR | Branch: Innovate UK | Program: | Phase: Small Business Research Initiative | Award Amount: 349.95K | Year: 2012

The objective of this project is to develop a new cost effectiveness tool (the tool), which can be used by health commissioners and providers to assess the costs and benefits of introducing the point-of-care (POC) Chlamydia Rapid Test. Developing this tool will require: (1) the development of an appropriate dynamic mathematical model (the model) that captures the dynamics of Chlamydia transmission; (2) the collection of information on both: (a) behaviour of tested individuals in different settings to refine and test the proposed model and (b) changes in care pathways and associated costs and savings by using the POC Chlamydia Rapid Test. The tool will allow health commissioners and providers to populate the model with location specific data to generate outputs specific to a single clinic, health authority or regions.

Journal of Comparative Effectiveness Research | Year: 2014

The intense competition that accompanied the growth of internet-based companies ushered in the era of 'big data characterized by major innovations in processing of very large amounts of data and the application of advanced analytics including data mining and machine learning. Healthcare is on the cusp of its own era of big data, catalyzed by the changing regulatory and competitive environments, fueled by growing adoption of electronic health records, as well as efforts to integrate medical claims, electronic health records and other novel data sources. Applying the lessons from big data pioneers will require healthcare and life science organizations to make investments in new hardware and software, as well as in individuals with different skills. For life science companies, this will impact the entire pharmaceutical value chain from early research to postcommercialization support. More generally, this will revolutionize comparative effectiveness research. © 2014 Future Medicine Ltd.

News Article | February 20, 2017

Real World Training (, the world’s largest QuickBooks training company, today announced support for QuickBooks 2017, the most up-to-date version of the QuickBooks desktop edition. All of Real World Training's live classes and online webinars will now teach students how to use this latest version of QuickBooks. QuickBooks is the world’s leading accounting software, with an estimated 29 million small businesses using the software. “We are the only training company endorsed by Intuit, the makers of QuickBooks. Because of our special relationship with Intuit, we’ve been given early access to the 2017 version,” says David O’Brien, President of Real World Training. “That means we can quickly update our classes to highlight the new features.” QuickBooks 2017 includes a number of new features, including a much improved search capability, the ability to schedule reports to be sent by email, plus new notifications telling users if they have payments waiting for bank deposit, and the ability to easily see credit cards charges that have been reconciled. Real World Training has taught over 1.5 million people how to use QuickBooks in both its desktop and online editions. The company teaches more than 40 live in-person classroom seminars each month in cities across the U.S. In addition, the company offers a live, online webinar twice each month for students who cannot attend a live class, or who prefer to learn online. A full schedule of their classroom seminars is available at About Real World Training Real World Training is the world's largest QuickBooks training company and has trained over 1.5 million people since its founding in 1992. Real Word Training offers the only QuickBooks training endorsed by Intuit, the maker of QuickBooks software. Real World Training's classes have a 99% approval rating and come with a money-back guarantee. For more information, visit Real World Training's website at or call (800) 564-2688.

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