Maximizing the Value of Real-World Data and Real-World Evidence to Accelerate Healthcare Transformation in China: Summary of External Advisory Committee Meetings.

Use of real-world data (RWD) is gaining wide attention. To bridge the gap between diverse healthcare stakeholders and to leverage the impact of Chinese real-world evidence (RWE) globally, a multi-stakeholder External Advisory Committee (EAC) and EAC meetings were initiated, aiming to elucidate the current and evolving RWD landscape in China, articulate the values of RWE in ensuring Chinese patients' equitable access to affordable medicines and solutions, and identify strategic opportunities and partnerships for expansion of RWE generation in China. Chinese and international experts who are clinicians and academic researchers were selected as EAC members based on their professional background and familiarity with RWD/RWE. Three EAC meetings were held quarterly in 2023. Various topics were presented and discussed for insights and suggestions. Nine experts from China, one from South Korea, and two from Europe were selected as EAC members and attended these meetings. Experts' presentations were summarized by theme, including the RWD landscape and RWE enablement in China, as well as global development of a patient-centric ecosystem. Experts' insights and suggestions on maximizing the RWD/RWE value to accelerate healthcare transformation in China were collected. We concluded that though data access, sharing, and quality are still challenging, RWD is developing to support evidence generation in the medicinal product lifecycle, inform clinical practice, and empower patient management in China. RWD/RWE creates value, accelerates healthcare transformation, and improves patient outcomes. Fostering a patient-centric ecosystem across healthcare stakeholders and maintaining global partnerships and collaboration are essential for unlocking the power of RWD/RWE.

Plaque burden assessment and attenuation measurement of carotid atherosclerotic plaque using virtual monoenergetic images in comparison to conventional polyenergetic images from dual-layer spectral detector CT.

PURPOSE: To compare virtual monoenergetic images (VMIs) with conventional polyenergetic images (PI) of Dual-layer spectral detector CT angiography (DLCTA) in plaque burden assessment and attenuation measurement of carotid atherosclerotic plaques. METHODS: Supra-aortic DLCTA imaging of thirty patients (8 female, mean ages 63.1 ±â€¯7.5 years) were respectively reviewed. Lumen area, wall area, and calcified area of plaques were outlined and recorded. Normalized wall index (NWI) was calculated for plaque burden and compared between PI and different VMIs. The attenuation of the non-calcified, calcified area of the plaques, sternocleidomastoid muscle (SCM), as well as Z effective values were measured and compared. RESULTS: Fifty carotid plaques (27 left, 23 right) of thirty patients were analyzed. The average values of lumen, wall, calcified areas and NWI on PI were 34.50 ±â€¯20.57mm2, 47.61 ±â€¯19.94 mm2, 5.25 mm2 (1.35- 51.86 mm2), and 0.59 ±â€¯0.16 respectively. No significant difference was found in the lumen area (p = 0.314), wall area (p = 0.600), and NWI (p = 0.980) between different VMIs and PI. A significant difference was found in the calcified area between VMIs and PI (p = 0.009). Attenuations of non-calcified and calcified components in carotid plaques were comparable to PI for 50-120 keV (all: p > 0.05) and 60-120 keVs (all p > 0.05), respectively. Z Effective values for non-calcified, calcified and SCM were 7.67 ±â€¯0.42, 11.70 ±â€¯1.22, and 7.45 ±â€¯0.12, respectively. CONCLUSIONS: Carotid plaque burden assessment was comparable between PI and VMIs at 40-120 keVs. Attenuations of non-calcified components in carotid plaques were comparable to PI for 50-120 keV VMIs of DLCTA. VMIs might provide more information on carotid plaque features.

[Risk assessment for malaria elimination in P. R. China].

OBJECTIVE: To identify the risk area in China during the malaria elimination process, and provide the evidence for promotion of the national malaria elimination programme and implementation of elimination strategy. METHODS: Data collection was conducted in 24 endemic provinces in 2010, including data of transmission capacity, potential risk of malaria transmission and the capacity of health professional team at county level. Quantitative assessment of the malaria transmission risk as well as the capacity of health facilities were conducted based on the calculation of malaria transmission risk index (MTI) and health facilities capacity index (CI). ArcGIS 10.0 was used to develop the risk map based on the outcome of quantitative assessment. RESULTS: The data of transmission capacity, potential risk of transmission and the capacity of health professional team were collected from 2147 counties in 24 provinces. Based on MTI and CI calculated for each county, statistic results showed that about 40% of the counties were under the average level of both MTI and CI. The relationship among potential risk of transmission, the capacity of health professional team and malaria incidence were analyzed in three dimensions, and four types were categorized among 2147 counties. Type I (super-high risk area) counties (20) distributed in Yunnan (9), Guangxi (5), Henan (1), Hunan (1), Hebei (1), Sichuan (1), Chongqing (1), and Tibet (1). 17 counties were classified into type II (high risk area) area, distributed in Yunnan (3), Guangxi (2), Guizhou (2), Shaanxi (2), Guangdong (1), Jiangxi (1), Hubei (1), Sichuan (1), Gansu (1), Hebei (1), Fujian (1) and Tibet (1). A total of 170 type III (moderate risk area) counties distributed in 19 provinces including Yunnan (15), Guizhou (14), Hebei (14), Sichuan (13), Shanxi (10), Guangxi (9), Hunan (9), Anhui (9), Jiangsu (9), Shaanxi (9), Shandong (9), Chongqing (8), Gansu (8), Jiangxi (7), Henan (7), Fujian (6), Guangdong (5), Hubei (5), and Zhejiang (4). 1940 type IV (low risk area) counties distributed in 24 provinces. CONCLUSION: The distribution of four types of risk area for malaria elimination is identified in China.

[Analysis report of the national technique competition for diagnosis of parasitic diseases in 2012: I. Capability analysis of Plasmodium detection].

OBJECTIVE: To analyze the result of the national technique competition for diagnosis of parasitic diseases in 2012, so as to understand the capability of detection on Plasmodium parasites among professionals from institutes for disease control and prevention at different levels. METHODS: Four professionals from institution were selected as contestants (age < or = 45 and at least two contestants from county-level institution). The content of the competition included making thick and thin blood slides of Plasmodium (3 slides in 30 min, 10 scores as full marks and 6 as passing score) and identification of species and number with microscopy (5 slides, 8 min per slide, 30 scores as full marks and 18 as passing score). All contestants were grouped by gender, age, professional title, level of institution, classification according to malaria endemicity, geographical location and economic development of the province. Their scores were statistically analyzed by SPSS 16.0 software. RESULTS: The average score of blood smear making test in 120 contestants from 30 provinces was 8.7, the highest was 10 and the lowest was 5.8, 118 (98.3%) contestants passed the test. The average score of blood smear reading was 16.0, the highest was 29 and the lowest was 0, 52 (43.3%) contestants passed the test. There were no significant differences for the scores among genders, ages (< or = 30, 31-40, > 40), professional titles (junior, intermediate and senior), institution levels (provincial, municipal or county level) (P > 0.05). However, there was a significant difference among provinces with different malaria endemicity, geographical location and development status (P < 0.05). For the blood slide-making and film-reading, scores of contestants from malaria endemic provinces including Class I (9.29 +/- 0.41, 18.17 +/- 6.42), Class II (8.92 +/- 0.79, 18.31 +/- 6.94) and Class III (8.61 +/- 0.89, 15.63 +/- 7.52) were higher than those from non-endemic provinces (7.95 +/- 1.00, 10.19 +/- 7.01) (P < 0.01). Scores of contestants from southern provinces (9.16 +/- 0.61, 18.82 +/- 6.78) were significantly higher than that from northern ones (8.30 +/- 0.99, 13.23 +/- 7.45) (P < 0.01). The film-reading scores were significantly higher in those from eastern provinces (18.20 +/- 6.88) than those from western (13.39 +/- 7.60) (P < 0.05), while no significant difference was found in blood slide-making (P > 0.05). CONCLUSION: The capability of malaria parasite detection is imbalanced.

Meteorological factors-based spatio-temporal mapping and predicting malaria in central China.

Despite significant reductions in the overall burden of malaria in the 20th century, this disease still represents a significant public health problem in China, especially in central areas. Understanding the spatio-temporal distribution of malaria is essential in the planning and implementing of effective control measures. In this study, normalized meteorological factors were incorporated in spatio-temporal models. Seven models were established in WinBUGS software by using Bayesian hierarchical models and Markov Chain Monte Carlo methods. M1, M2, and M3 modeled separate meteorological factors, and M3, which modeled rainfall performed better than M1 and M2, which modeled average temperature and relative humidity, respectively. M7 was the best fitting models on the basis of based on deviance information criterion and predicting errors. The results showed that the way rainfall influencing malaria incidence was different from other factors, which could be interpreted as rainfall having a greater influence than other factors.