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Record W2046426458 · doi:10.1038/clpt.2011.345

Adaptive Licensing: Taking the Next Step in the Evolution of Drug Approval

2012· review· en· W2046426458 on OpenAlexaff
H-G Eichler, Kenneth A. Oye, L G Baird, Éric Abadie, Jeffrey S. Brown, Chester Lee Drum, John G. Ferguson, S Garner, Peter K. Honig, Mathias Hukkelhoven, John C. W. Lim, Robyn Lim, Murray Lumpkin, G L Neil, Brian O’Rourke, Edmund J. Pezalla, D Shoda, Vicki Seyfert‐Margolis, Ellen V. Sigal, J. Sobotka, Derek S. Tan, T F Unger, Gigi Hirsch

Bibliographic record

VenueClinical Pharmacology & Therapeutics · 2012
Typereview
Languageen
FieldEconomics, Econometrics and Finance
TopicHealth Systems, Economic Evaluations, Quality of Life
Canadian institutionsCanadian Agency for Drugs and Technologies in HealthHealth Canada
Fundersnot available
KeywordsTransformative learningLegislatureClinical pharmacologyEngineering ethicsAction (physics)Drug approvalManagement scienceComputer scienceRisk analysis (engineering)MedicinePsychologyPolitical scienceDrugPharmacologyLawEngineering

Abstract

fetched live from OpenAlex

Traditional drug licensing approaches are based on binary decisions. At the moment of licensing, an experimental therapy is presumptively transformed into a fully vetted, safe, efficacious therapy. By contrast, adaptive licensing (AL) approaches are based on stepwise learning under conditions of acknowledged uncertainty, with iterative phases of data gathering and regulatory evaluation. This approach allows approval to align more closely with patient needs for timely access to new technologies and for data to inform medical decisions. The concept of AL embraces a range of perspectives. Some see AL as an evolutionary step, extending elements that are now in place. Others envision a transformative framework that may require legislative action before implementation. This article summarizes recent AL proposals; discusses how proposals might be translated into practice, with illustrations in different therapeutic areas; and identifies unresolved issues to inform decisions on the design and implementation of AL.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.

metaresearch head score (Codex)0.032
metaresearch head score (Gemma)0.044
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesMetaresearch
Consensus categoriesnone
DomainCandidate signal: Methods · Consensus signal: none
Study designCandidate signal: Not applicable · Consensus signal: none
GenreCandidate signal: Review · Consensus signal: Review
Teacher disagreement score0.968
Threshold uncertainty score0.168

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0320.044
Meta-epidemiology (narrow)0.0010.001
Meta-epidemiology (broad)0.0010.001
Bibliometrics0.0020.002
Science and technology studies0.0010.013
Scholarly communication0.0070.018
Open science0.0020.004
Research integrity0.0080.010
Insufficient payload (model declined to judge)0.0040.001

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.798
GPT teacher head0.581
Teacher spread0.218 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

Study designNot applicable
DomainMethods
GenreReview

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations270
Published2012
Admission routes1
Has abstractyes

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