Respiratory Syncytial Virus (RSV) remains a significant cause of respiratory illness, particularly in vulnerable populations. For this project, our client sought support in updating a previously conducted systematic literature review (SLR) to capture the most recent evidence on an RSV preventive intervention, in preparation for a health technology assessment (HTA) submission.

Building on the client’s existing SLR framework, we executed comprehensive database searches across PubMed, Embase, Cochrane Library, INAHTA, ClinicalTrials.gov, and WHO ICTRP, complemented by a targeted grey literature search across nine scientific conferences. Following deduplication, we prepared structured screening files and conducted dual Level 1 (title/abstract) screening of approximately 900 records, followed by full-text procurement and Level 2 screening of approximately 30 articles. Data extraction was completed for approximately 10 eligible studies using a client-provided template, ensuring consistency with prior submissions and HTA requirements.

Therapy area: Infectious Diseases, Respiratory (RSV Prevention)

Diffuse Large B-Cell Lymphoma (DLBCL) is one of the most aggressive forms of non-Hodgkin Lymphoma. Our client sought support in conducting a targeted literature review to identify and extract evidence from clinical trials published in the last decade that reported survival outcomes stratified by response status.

We performed Level 1 (Title & Abstract) screening of around 900 records, followed by full-text procurement of included articles and Level 2 (full-text) screening of around 650 by applying detailed inclusion/exclusion criteria.

Data extraction was completed for around 60 eligible studies capturing response and survival outcomes.

Therapy Area: Hematology, Oncology

Non-Small Cell Lung Cancer (NSCLC) accounts for the majority of lung cancer cases worldwide and remains a leading cause of cancer-related mortality. With the growing importance of targeted therapies for specific mutations in NSCLC patients, our client sought to conduct a systematic literature review (SLR) to assess the efficacy and safety of a specific small molecule that targets BRAF mutations in locally advanced and metastatic NSCLC.

We conducted literature searches across PubMed, Embase, INAHTA, Cochrane Library, ClinicalTrials.gov, and WHO ICTRP. The review process included Level 1 screening of around 500 records, followed by Level 2 screening of around 80 full texts. Data extraction (DE) and quality assessment (QA) were performed for around 20 articles. Key deliverables included a PRISMA 2020 flow diagram and structured screening and DE/QA outputs.

Therapy area: Oncology, Lung Cancer

Evidence generation is essential to build robust clinical and economic value stories in healthcare. For this project, our client sought support in extracting data from a predefined set of articles and classifying evidence levels for both clinical and economic endpoints.
We extracted data from the provided article list and organized it into two consolidated outputs: clinical and economic evidence. Each study was classified by level of evidence, and risk-of-bias (RoB) assessments were conducted using appropriate tools tailored to clinical studies, including Cochrane RoB v2.0, ROBINS-I, JBI checklist, and ROBIS. A consolidated Quality Assessment form was also delivered in Excel to ensure transparent reporting of clinical evidence.
This structured approach provided the client with comprehensive, quality-checked evidence tables that strengthened the integration of both clinical and economic perspectives for informed decision-making.

Therapy area: Hematology, Oncology

Prostate cancer continues to be a critical focus in oncology research, with growing attention on understanding patient symptoms and related clinical endpoints. For this project, our client sought support in systematically screening evidence on symptom-related outcomes in prostate cancer patients.
We reviewed approximately 2,500 articles during L1 screening, followed by Level 2 screening of around 900 full texts for detailed information on symptoms and symptom-related endpoints, with quality checks applied at each stage. Key deliverables included the screening outputs, and documentation of procured full-texts.

Therapy area: Oncology, Prostate Cancer

Hematologic malignancies often require complex treatment strategies, with prognosis influenced by eligibility for hematopoietic stem cell transplant (HSCT). Our client sought to update a previously conducted systematic literature review to capture additional evidence about HSCT eligibility.

We conducted data extraction of approximately 200 records, including randomized controlled trials with one arm of interest, single-arm trials, and observational studies. Data extraction was focused on interventions of interest in the overall population, with subgroup results by HSCT eligibility to strengthen existing evidence for clinical and strategic decision-making.

Therapy area: Hematology, Oncology

Indolent systemic mastocytosis (ISM), advanced systemic mastocytosis (ASM), and gastrointestinal stromal tumors (GIST) are rare but complex conditions, often driven by mutations in the KIT and PDGFRA pathways. Our client sought to systematically review the clinical evidence on safety and efficacy across these three indications.

For this project, we screened approximately 500 records and 200 full texts across each indications. We also developed separate PRISMA 2020 flow diagrams for ISM, ASM, and GIST to support condition-specific evidence synthesis.

Therapy area: Oncology, Rare Diseases

Next-Generation Sequencing (NGS) plays a pivotal role in biomarker-driven oncology by enabling testing of multiple gene variants and streamlining access to targeted treatments. Our client sought to conduct a targeted literature review (TLR) to assess the cost-effectiveness of NGS compared to conventional testing strategies. For this project, we performed structured literature search in PubMed, Embase, and EBSCO databases. We then screened over 2000 records and 50 full-texts, prepared the template for data extraction, and extracted data from around 20 studies.

Therapy area: Oncology, Diagnostics

Myelodysplastic syndrome (MDS) is a group of hematologic malignancies requiring timely and effective treatment to improve prognosis and quality of life. Our clients sought to conduct a systematic literature review (SLR) to evaluate clinical and economic outcomes of therapies used in newly diagnosed high risk MDS patients. We searched databases including but not limited to PubMed, EMBASE, MEDLINE and Cochrane Library. For clinical SLR, we screened approximately 9000 records, 1000 full-texts and extracted data from 30 studies while for economic SLR, we screened ~3500 records, 100 full-texts and extracted data from 25 studies. We also conducted quality assessment for both domains. 

Therapy area: Oncology

Understanding placebo remission rates can help in interpreting trial results and benchmarking for efficacy and safety of advanced therapies in Ulcerative Colitis (UC) and Crohn’s Disease (CD). Our client sought to conduct a two systematic literature reviews (SLR) of clinical trials of advanced therapies for UC and CD. We conducted a comprehensive database search from PubMed, EMBASE, MEDLINE and Cochrane Library. For UC we screened approximately 3500 records, 600 full-texts and extracted data from 40 studies whereas for CD SLR we screened 700 records, 100 full-texts and extracted data from 20 studies. We also carried out the quality assessment for each extracted study.  

Therapy area: Autoimmune 

Early stage non-small cell lung cancer (NSCLC) presents a unique clinical landscape with evolving therapies and distinct gaps in care. Understanding the unmet needs to inform future treatments and clinical decision making is important.

Our client sought to conduct a targeted literature review (TLR) to assess unmet needs in stage I NSCLC to support value communication and strategic planning. The review process included screening of approximately 2500 record, 300 full-texts and extracted data from 30 studies along with their quality assessments for clinical and economic outcomes.

Therapy area: Oncology

Retained surgical items (RSIs) are serious complications that occur during operative procedures leading to increased morbidity and healthcare costs with extended hospital stays however, they are preventable. Technologies to prevent RSIs are critical to enhance patient safety and surgical outcomes.

Our client sought to conduct targeted literature review (TLR) to evaluate available technologies designed to reduce foreign body retention risk during surgeries. We searched major databases including PubMed, EMBASE, MEDLINE and Cochrane Library, screening approximately 400 records, 60 full-texts and extracted data from 30 studies for quality assessment.

Therapy area: Surgery

Osteoporosis in postmenopausal women is a significant public health concern that elevates risk of fracture. We had previously supported our client in the HTA submission for the inclusion of an antiresorptive therapy in the UK NHS. As new evidence emerges, our client sought to update the previous evidence we generated in three systematic literature reviews (SLRs) focusing on clinical effectiveness, economic outcomes and humanistic outcomes.

We conducted updated literature search across databases from PubMed, MEDLINE, Cochrane Library and HTA websites. For clinical SLR update, we screened approximately 200 records, 25 full-text articles and extracted data from 10 studies. The economic SLR update involved 1200 record screening, 25 full text articles and extracted data from 3 studies. The humanistic SLR update included screening of 150 records, 30 full-texts and extracted data from 5 studies. We also conducted quality appraisal across all domains. We also supported with network meta-analysis (NMA), cost-effectiveness (CE) modelling aligned with HTA requirements.

Therapy area: Endocrinology, Metabolic, Bone health

Type 1 Diabetes Mellitus (T1DM) is caused by autoimmune destruction of pancreatic beta cells requiring lifelong insulin therapy, accounting for 5-10% of all diabetes cases. Optimizing long-acting insulin regimens is important for minimizing adverse events, managing glycemic control and improving patient outcomes.

Our client sought to systematically review randomized clinical trials (RCTs) and synthesize evidence comparing two long-acting insulin analogs in T1DM patients. We conducted a comprehensive search across PubMed, EMBASE, Cochrane Library, ANZCTR, ClinicalTrials.gov and WHO ICTRP, screening approximately 1000 records, 85 full-texts and extracting data from ~50 studies for quality appraisal.

Therapy area: Metabolic, Diabetology

Programmed cell death protein-1 (PD-1) is a cell surface receptor on certain T and B cell subtypes that has a role in immune-mediated killing of certain cancer cells. It has been observed that inhibiting PD-1 can result in increased killing of cancer cells, and thus, PD-1 inhibitors have been investigated as targeted therapy for various cancers. One such PD-1 inhibitor has been shown to have activity against several cancers, including Merkel cell carcinoma, urothelial carcinoma, and renal cell carcinoma, and has already been approved by the USFDA for these indications. Our client was interested in understanding the efficacy, safety, cost-effectiveness, and impact on the quality of life of this PD-1 inhibitor molecule in different types of cancer. For this project, we assisted our client by screening and abstracting relevant articles from nearly 550 records over two rounds of screening. We also were involved in data extraction and quality assessment from over 50 records.
Therapy area: Oncology

Neovascular Age-Related Macular Degeneration (nAMD) is a progressive ocular disease characterized by the abnormal growth of new blood vessels in the choroid, leading to retinal damage and central vision loss. This pathological neovascularization results in leakage, hemorrhage and fibrosis which ultimately disrupts the macula along with the central portion of the retina responsible for detailed vision. Agents targeting VEGF (vascular endothelial growth factor) administered intravitreally have revolutionized the treatment of nAMD. Our client wanted to understand the efficacy and safety of different anti-VEGF medications used in the management of nAMD. To address this, we conducted a comprehensive data extraction and risk of bias assessment of over 70 studies. This project stood out by the large number of linked publications that some of the included studies had. We extracted data pertaining to efficacy, safety, and tolerability, and also performed risk of bias assessment for all the included articles.
Therapy area: Therapy Area: Ophthalmology

Coronary artery disease (CAD) is a leading cause of death worldwide. When plaque buildup narrows a coronary artery, restricting blood flow to the heart, stenting offers a minimally invasive solution to restore blood flow and prevent heart attacks. However, choosing the optimal stent type for each patient is crucial to maximize the clinical benefit. Our client wanted to compare the clinical performance of various stent devices. To achieve this, we performed data extraction from over 60 relevant studies focusing on patient-centric clinical outcomes like Amputation-Free Survival (AFS) and freedom from Clinically-Driven Target Lesion Revascularization (CD-TLR).
Therapy area: Cardiovascular

Robotic surgery utilizes advanced robotic systems to perform minimally invasive procedures with high precision, flexibility, and control. Staplers in robotic surgery are essential tools that enable surgeons to efficiently cut and staple tissues simultaneously, enhancing surgical outcomes and reducing recovery times. Our client wanted to evaluate the impact of using different types of surgical staplers in various robotic surgeries. In this project, we performed data extraction on over 110 studies identified through a prior literature review. This analysis helped our client develop an understanding surrounding the usage of their staplers in different robotic surgeries, potential advantages, and factors influencing the choice of their staplers over their competitors.
Therapy area: Robotic Surgery

Multivessel coronary artery disease (MVD) occurs when there is luminal stenosis of at least 70% in at least two major coronary arteries. It is estimated to occur in 45% to 88% of men with angina, and has around 3-times higher mortality hazard compared to single vessel disease. Optimal revascularization strategy for MVD using either percutaneous coronary intervention (PCI) or coronary arterial bypass grafting (CABG) often depends on the complexity of coronary anatomy, patient comorbidities, operator experience, and patient preferences/ expectations. Our client aimed to update the understanding of the latest research to optimize treatment strategies for MVD. In this project, we extracted data from nearly 50 records based on a data extraction template provided to us by the client, helping our client to draw insights on the factors affecting treatment strategies for MVD.
Therapy area: Cardiolog

Non-muscle invasive bladder cancer (NMIBC) is a malignancy of the urothelial cells in the urinary bladder that has not yet infiltrated the muscular wall. NMIBC is the most common type of bladder cancer and is classified as a non-organ-confined disease. Despite being non-invasive, NMIBC carries a high risk of recurrence and progression to muscle-invasive disease, highlighting the need for close monitoring and potential adjuvant treatment strategies. Selecting the most effective treatment requires understanding not only established options but also how they perform in real-world settings. Our client was interested to understand the treatment landscape of NMIBC in the real-world setting. To achieve this, we assisted our client by screening around 200 records followed by data extraction from around 20 records with a focus on treatment types, effectiveness, safety, and patient characteristics.
Therapy area: Oncology, Urology

Multiple myeloma (MM) is a spectrum of related disorders associated with clonal proliferation of plasma cells within bone marrow leading to the accumulation of monoclonal paraproteins (M-proteins) with incomplete immunoglobulin chains. Patients with MM not only suffer from the detrimental effects of the accumulated M-proteins in various organ systems, but also experience bone destruction and the resulting pathologic fractures. Treatment options depend on the specific disorder and the stage of illness, and usually include watchful waiting, surgery when feasible, hematopoietic cell transplant, radiation therapy, and chemotherapy. Our client wanted to assess the outcomes of various available treatment strategies for MM with an intention to understand the optimum treatment strategy. For this project, we performed screening of 500 records followed by data extraction of nearly 200 records, focusing on treatment efficacy, safety, and impact on the patient’s quality of life.
Therapy area: Oncology, Hematology

Graft-versus-Host Disease (GvHD) is a serious complication that can occur after a hematopoietic stem cell transplantation, where the grafted immunocompetent donated cells recognize the host tissues as ‘foreign’ and mount an immunological attack. This attack typically occurs within the first 100 days after the transplant, and the damage can be seen in various organs, including the skin, gastrointestinal tract, liver, and lungs. GVHD can be acute or chronic, each with distinct clinical presentations and management strategies. Our client was particularly interested in understanding the economic burden of GvHD, and the current treatment landscape. We assisted our client by screening nearly 50 records to identify the records with the most relevant information, and data extraction from around 10 records.
Therapy area: Hematology, Immunology

Acute myeloid leukemia (AML) is a highly aggressive hematological malignancy characterized by the clonal expansion of immature myeloid precursors in the bone marrow, leading to disruption of normal hematopoiesis. This uncontrolled proliferation results in cytopenias, increased risk of infections, and bleeding complications. Heterogeneity in the underlying genetic mutations and cytogenetic abnormalities in AML necessitates a personalized and multimodality treatment approach. Selecting optimal treatment regimens requires a nuanced understanding of the therapeutic landscape, encompassing established therapies, emerging targeted agents, as well as the efficacy, safety, long-term toxicities, and cost-effectiveness of these treatment options in real-world settings. Our client wanted to navigate this complex landscape of AML treatment through a multifaceted analysis. To assist our client, we screened around 400 records to identify the studies containing the most relevant information, followed by data extraction of 100 records using the data extraction grid shared by the client.
Therapy area: Oncology, Hematology

Myelodysplastic syndromes (MDS) represent a heterogeneous group of clonal hematopoietic stem cell malignancies characterized by ineffective hematopoiesis, cytopenias, and a concerning predisposition to evolve into acute myeloid leukemia (AML). The intricate pathogenesis of MDS involves a multifaceted interplay between genetic and epigenetic alterations within hematopoietic stem and progenitor cells (HSPCs). These aberrations disrupt normal differentiation pathways, escalate apoptosis (programmed cell death), and ultimately culminate in bone marrow failure. Our client was interested in assessing the outcomes associated with the established therapies as well as evolving treatment strategies for MDS, with an emphasis on real-world effectiveness and safety profiles. To address this, we meticulously screened over 300 records to identify relevant publications encompassing both interventional trials and real-world evidence sources. From this initial screening, we performed data extraction from nearly 150 records.
Therapy area: Hematology

Multiple myeloma (MM) is a cancer of plasma cells originating in the bone marrow. Different stages of MM include “Refractory myeloma” which is non-responsive to therapy or progresses within 60 days of the last line of therapy; “Relapsed myeloma” in which previously treated myeloma progresses after prior therapy and requires new therapy; and “Relapsed and refractory multiple myeloma (RRMM)” is disease that is nonresponsive to the chosen line of therapy in patients who had achieved a minimal response or better at some point previously in their disease. Our client aimed to understand how different drugs impact RRMM patients, especially surrounding clinical efficacy of the drugs (survival and response rates), their impact on the quality of life, and their economic outcomes, in both controlled as well as real-world settings. To address this requirement, we screened around 600 records to identify the most relevant publications, and extracted data from nearly 200 records.
Therapy area: Oncology, Hematology

Non-small cell lung cancer (NSCLC) represents the most prevalent form of lung cancer, accounting for approximately 80-85% of all lung cancer diagnoses. While targeted therapies have revolutionized first-line treatment for advanced/ metastatic NSCLC, patients often experience disease progression, necessitating subsequent treatment lines (2L+). Our client wanted to explore the landscape of evidence surrounding the efficacy and safety of FDA/EMA-approved 2L+ therapies for this patient population, drawing insights from clinical trial data. In this project, we extracted data from nearly 100 records with a focus on safety, survival, and response outcomes.
Therapy area: Oncology

A significant proportion of patients suffering from type 2 diabetes mellitus (T2DM) eventually experience insufficient glycemic control with oral antidiabetic drugs and require insulin therapy. Various types of insulin are available, including rapid-acting, short-acting, intermediate-acting, and long-acting formulations, each tailored to different glycemic needs and patient lifestyles. Insulin can be administered in different strategies, such as basal, basal-bolus, twice-daily, split-mixed, etc. Our client wanted to perform a comparative efficacy and safety assessment of dual-action basal insulin medications in managing uncontrolled T2DM in patients who have already failed previous anti-diabetic therapies. We assisted our client by doing the data extraction of 20 records using the data extraction sheet provided by the client.
Therapy area: Metabolic, Diabetology

Psoriasis is a chronic autoimmune inflammatory disease that affects millions of people worldwide. Moderate-to-severe plaque psoriasis (PsO) manifests as thick, red, scaly plaques that can significantly impact patients’ quality of life. Tumor necrosis factor inhibitors (TNFi) have revolutionized PsO treatment, demonstrating remarkable efficacy. However, with the expiration of patents on some TNFi drugs, biosimilars have emerged as a potentially cost-effective alternative. Our client was interested in investigating the landscape of evidence surrounding the relative efficacy and safety of TNFi and biosimilars for patients with moderate-to-severe PsO in clinical trials. In this project, we helped our client to perform data extraction of around 150 records using the data extraction grid provided by the client.
Therapy area: Dermatology

Interstitial pulmonary fibrosis (IPF) is a chronic, progressive lung disease characterized by the thickening and scarring of lung tissue, leading to a decline in lung function. The exact cause of IPF is unknown, and its symptoms, which include shortness of breath and a persistent dry cough, typically worsen over time. Understanding the burden of IPF is crucial for developing effective management strategies and improving patient outcomes. Our client wanted to explore the epidemiologic, clinical, humanistic, and economic burden of IPF. For this project, we assisted our client in gathering relevant data by screening of nearly 10,000 records over two stages to identify the most relevant records containing the information of interest.
Therapy area: Respiratory

Major Depressive Disorder (MDD) is a mood disorder marked by a persistent (at least 2 weeks) low mood and loss of pleasure. Neurotransmitters like serotonin and norepinephrine are likely involved, and prominent risk factors include genes and environmental influences. Symptoms can include sleep problems, weight changes, fatigue, trouble thinking, and suicidal thoughts. Our client needed a deeper understanding of how different treatments for MDD impacted the lives of the patients. To achieve this, we performed data extraction from over 80 relevant studies that focused on the influence of various available interventions on economic burden, quality of life, suicidal ideation, anxiety, self-harm risk, and mortality.
Therapy area: Psychiatry

Narcolepsy, a neurological disorder marked by persistent daytime sleepiness and unpredictable episodes of sudden sleep onset, significantly disrupts daily activities for those affected. Managing this condition involves a multifaceted approach, combining pharmacological, behavioral, and immunotherapy options. Addressing our client’s interest in understanding the efficacy and safety of the available narcolepsy medications, and the impact in patient’s quality of life and other outcomes, we conducted a comprehensive analysis, extracting data from 150 articles using a predefined grid for this project.
Therapy area: Neurology

Plaque psoriasis is a chronic skin condition characterized by the presence of thick, red, and scaly patches on the skin, and can impact the patient’s quality of life, especially those who have moderate-to-severe form of the disease. In fact, these individuals often experience more extensive skin involvement compared to the mild form, with the plaques covering a larger percentage of their body surface area. Managing this condition typically involves topical and systemic treatments to alleviate symptoms and minimize daily life impact.

Our client was interested in summarizing the published data on the effectiveness, safety and Quality of life outcomes of approved biologics and their biosimilars for adults with chronic moderate-to-severe plaque psoriasis within real-world studies. For this project, we extracted data from 200 articles using a pre-specified data extraction grid.
Therapy area: Dermatology

Multiple myeloma (MM) is a hematologic malignancy characterized by abnormal clonal B-cell growth in the bone marrow, resulting in various complications such as hypercalcemia, renal impairment, anemia, bone fractures, and increased susceptibility to infections. One particularly challenging phase of the disease is known as relapsed or refractory multiple myeloma (RRMM). RRMM is defined as a condition where the disease continues to advance despite attempts at salvage therapy or within 60 days of the last treatment, even in patients who initially showed at least a minimal response to treatment. An even more formidable subset within RRMM is referred to as triple class refractory (TCR) MM. TCR MM signifies disease progression after receiving treatment with a proteasome inhibitor, an immunomodulatory drug, and a CD-38 antibody.

Our client was interested in gathering evidence about the clinical, humanistic, and economic outcomes of systemic pharmacological anti-cancer therapies when used in the management of RRMM. In addition to clinical trial evidence, our client was also interested in gathering evidence from published real-world evidence (RWE) studies. For this project, we screened over 400 articles for relevant records and extracted data from over 60 articles using a pre-specified data extraction grid.
Therapy area: Oncology

Acute myeloid leukemia (AML) is distinguished by an uncontrolled proliferation of myeloid blasts within the bloodstream, bone marrow, and possibly other tissues. Symptoms of AML may include fatiguability, easy bruising and bleeding, shortness of breath, and increased risk of infection. AML can occasionally spread to skin, brain, or gums. Being an acute leukemia, AML is characterized by rapid progression, and if left untreated, is typically fatal within weeks or months.

Our client was interested in compiling comprehensive evidence encompassing clinical, economic, and humanistic outcomes surrounding newly diagnosed AML treated with non-intensive chemotherapy This information was intended to bolster future health technology assessment (HTA) submissions for a novel product to treat AML. For this project, we conducted a rigorous two-level screening of around 11,000 articles, based on the eligibility criteria drafted by the client and and identified the records that contained the most relevant information pertaining to the objectives of the review.
Therapy area: Oncology

Metastatic Castration-Resistant Prostate Cancer (mCRPC) is a highly aggressive manifestation of prostate cancer. In this advanced stage, cancer cells exhibit a remarkable capacity to proliferate and metastasize, even when hormonal therapy is no longer effective, posing significant management challenges. mCRPC is frequently linked with reduced survival rates, as it tends to progress rapidly and develop resistance to conventional treatment modalities. Ongoing research endeavors are dedicated to pioneering novel therapies and targeted interventions aimed at enhancing the prognosis and overall quality of life for individuals grappling with this formidable and insidious disease. With a focus on early detection, personalized treatment strategies, and the continual advancement of medical science, there is a glimmer of hope in the battle against mCRPC, offering optimism to those confronted by this complex condition.

Our client was interested in generating a comprehensive evidence base surrounding clinical, economic, and humanistic outcomes of adult patients with mCRPC. For this project, we conducted screening of around 4,000 articles across two levels and extracted relevant data from over 100 records, using the data extraction template shared by the client.
Therapy area: Oncology

Diffuse Large B-Cell Lymphoma (DLBCL) stands as the most prevalent subtype of Non-Hodgkin Lymphoma (NHL), comprising approximately 31% of newly diagnosed cases. This aggressive form of lymphoma originates in B cells, a type of white blood cell responsible for immune response regulation. DLBCL is characterized by its rapid growth and can manifest in various parts of the body, including the lymph nodes, spleen, and bone marrow. Prompt diagnosis and treatment are crucial, as the condition can progress swiftly. Advances in medical research and therapy options continue to improve outcomes for DLBCL patients, underscoring the importance of ongoing research in the field.

Our client was interested in generating evidence surrounding clinical, humanistic, and economic outcomes for stem cell therapy-ineligible DLBCL patients beyond second-line therapy. For this project, we conducted a rigorous screening of around 11,000 articles across two levels at break-neck speed and extracted relevant data from approximately 200 records using the data extraction template shared by the client.
Therapy area: Oncolog

Gastroparesis is a chronic disorder due to weak peristalsis of the stomach muscles, characterized by delayed stomach emptying without a blockage, and usually presents with nausea, heartburn, vomiting, early satiety, and boating sensation. Cyclic vomiting syndrome (CVS) is a rare gastrointestinal disorder characterized by recurrent episodes of severe vomiting that occur at regular intervals, typically with symptom-free periods in between; the underlying cause of CVS is not fully understood, but it is thought to be related to abnormal functioning of the nervous system and gastrointestinal tract.

Our client was interested to generate evidence surrounding epidemiology, treatment patterns, and economic burden of gastroparesis and CVS. For this project, we extracted data from over 50 articles in the extraction template provided by the client.
Therapy area: Gynaecology

Uterine fibroids (UFs) are the most common benign tumors in women, affecting up to 70–80% of women by the age of 50. The symptoms of these monoclonal tumors that originate from uterine smooth muscle include abnormal uterine bleeding, including heavy menstrual bleeding leading to anemia, pelvic pain, reproductive dysfunction, and obstetric complications. UFs are also associated with significant impact on the quality of life.

Conventional management options for UFs include hysterectomy, uterus-sparing interventions such as myomectomy, endometrial/ radiofrequency ablation, and uterine artery embolization. Medical management is usually preferred by women who desire future pregnancy, and include gonadotropin antagonists such as relugolix, progestin modulators such as mifepristone and ulipristal, and certain off-label medications. Nevertheless, medical management of UFs still remain an unmet need.

Our client was interested in updating an existing three-volume systematic literature review surrounding the clinical outcomes, humanistic outcomes, and economic impact of different treatment options for UFs, following the NICE template. For this project, we provided end-to-end support, beginning from executing search strategy, preparing screening sheets, screening over 800 records over 2 rounds including published articles, conference abstracts, and clinical trial records, preparing data extraction template, extracting data from around 20 records, performing quality assessment, and updating the three SLR reports including rectifying a few inconsistencies.
Therapy area: Gynaecology

Hematopoietic stem cell transplant (HSCT) is often performed as a treatment modality for cancers involving blood or bone marrow, including multiple myelomas and various forms of leukemias. One of the complications following HSCT is thrombotic microangiopathy (TMA), in which there is endothelial injury due to multiple factors, leading to microangiopathic hemolytic anemia, intravascular platelet activation, and formation of thrombi within the microcirculation. HSCT-TMA is associated with end-organ injury involving kidney, lungs, and gastro-intestinal tract among others, primarily due to ischemia and activation of complement cascade.

Our client was interested to understand the mortality, survival, and other long-term outcomes among patients with HSCT-TMA. For this project, we performed literature screening of nearly 1400 articles over 2 rounds and identified the records that contained the most relevant information pertaining to the objectives of the review.
Therapy area: Oncology, Hematology

Non-Hodgkin lymphoma (NHL) can arise from both hematopoietic and lymphoid tissues (typically in the bone marrow), including B, T, and natural killer cells. Within B-cell NHL (B-NHL), there are several subtypes, including DLBCL (diffuse large B-cell lymphoma), FL (follicular lymphoma), MCL (mantle cell lymphoma), MZL (marginal zone lymphoma), SLL (small lymphocytic lymphoma), PMBCL (primary mediastinal B-cell lymphoma), and HGBCL (high-grade B-cell lymphoma), to name a few. Treatment of B-NHL includes traditional chemotherapy and immunotherapy regimens; various newer treatment modalities including CAR-T therapy, small molecules and bispecific antibodies are in various phases of development.

Our client was interested to understand the adverse event profile of all available treatment modalities for B-NHL, stratified by the subtypes of B-NHL, to update an existing systematic literature review. For this project, we performed screening of over 2400 articles through two levels. We also performed preliminary data extraction from around 100 records and full data extraction from around 30 records using the data extraction template shared by the client.
Therapy area: Oncology, Hematology

Sjögren’s syndrome is a female-predominant systemic autoimmune rheumatic disease characterized by ‘sicca symptoms’ involving symptoms due to dryness most often involving the eyes and mouth, that develops as a result of inflammation of the lacrimal and salivary glands. Extra-glandular manifestations of Sjögren’s syndrome may include the joints, skin, lungs, gastrointestinal (GI) tract, nervous system, and kidneys. Sjögren’s syndrome is also the second most common rheumatic autoimmune disorder, and is traditionally classified as primary or secondary, depending on the absence or presence of other major autoimmune diseases.

Our client was interested in exploring the epidemiology, clinical, economic, and humanistic Burden of illness in patients with Sjögren’s syndrome. For this project, we assisted our client by extracting data pertaining to epidemiology from over 120 articles using the data extraction template provided by the client.
Therapy area: Rheumatology

Multiple myeloma (MM), also known as plasma cell myeloma, is a neoplasm involving plasma cells, and is associated with substantial morbidity and mortality resulting from end organ damage, such as renal impairment, anemia, hypercalcemia, and lytic bony lesions. Treatment for MM has evolved from therapies such as autologous stem cell transplant in the 1980s, the IMIDs (including thalidomide and lenalidomide) and proteasome inhibitors in the 1990s and 2000s, and has more recently included monoclonal antibodies (daratumumab and elotuzumab) and histone deacetylating agents (panobinostat). All said, MM is still considered treatable, but generally incurable.

Our client was interested in understanding the clinical, economic, and humanistic burden of MM, and safety profile of available treatment options, in the real-world setting across the world. For this project, we assisted our client in gathering relevant data by screening through over 1500 articles (including nearly 250 conference abstracts/ posters). We also extracted data from over 60 relevant records pertaining to the disease burden of relapsed and refractory MM, in the data extraction template shared by the client.
Therapy area: Oncology, hematology

Antipsychotic drugs are the mainstay in the management of schizophrenia, but are associated with challenges such as unpleasant adverse effects and poor adherence rates, also stemming from the disbelief on the patients’ side of having an illness (which is common in schizophrenia). To overcome these challenges, long-acting injectable (LAI) antipsychotic drugs were developed: these can be administered at intervals of 2 to 4 weeks or even longer. The LAI versions of second-generation antipsychotics (SGA) have been associated with reduced relapse rates and reduced hospitalization outcomes.

Out client was interested to perform a network meta-analysis of LAI-SGAs vs other SGAs with a focus on outcomes related to hospitalization. For this project, we evaluated nearly 3600 records over 2 rounds of screening to identify the most relevant records that contained the outcomes of interest for performing the NMA.
Therapy area: Psychiatry

Left untreated, chronic kidney disease (CKD) can result in complications such as hypertension, cardiovascular disease (including left ventricular hypertrophy, diastolic and systolic dysfunction, valvular disease, dysrhythmias, and heart failure), anemia, mineral bone disorder, salt and water retention, electrolyte disorders including metabolic acidosis, and uremic symptoms including anorexia, fatigue, cachexia, pruritus, nausea, restless leg syndrome, sleep disturbances, and sexual dysfunction.

Our client was interested to understand the epidemiology, economic, clinical, and humanistic burdens of CKD and its different stages, including patients with ESRD (end-stage renal disease), renal transplant recipients, and CKD patients undergoing dialysis. For this project, we evaluated around 3900 records over 2 rounds of screening and identified the records containing the most relevant information.
Therapy area: Nephrology

Lung transplant has been shown to improve the health-related quality of life (HRQoL) among patients with end-stage lung disease arising from various conditions. However, development of chronic lung allograft dysfunction (CLAD) can considerably affect the HRQoL. Two subtypes of CLAD have been defined: the obstructive form, Bronchiolitis Obliterans Syndrome (BOS), and the restrictive form, Restrictive Allograft Syndrome (RAS).

Our client was interested in evaluating the humanistic outcomes pertaining to CLAD, BOS, and RAS. For this project, we extracted data from around 20 full texts identified by the client in a detailed data extraction template shared by the client.
Therapy area: Pulmonology, Transplantation medicine

Vasomotor symptoms (VMS), also referred to as hot flashes, hot flushes, and night sweats, are the hallmark symptoms of menopause. The occurrence of VMS is common in midlife women; emerging data suggest that VMS may also persist into old age for some women. The frequency and severity of VMS vary widely among women, and as a result, VMS significantly impacts the lives of perimenopausal, menopausal, and postmenopausal women. Though hormonal therapy is used for VMS management, usage of hormonal therapy is also associated with considerable amount of risk.

Our client was interested to characterize the burden and unmet need resulting from VMS in perimenopausal, menopausal, and postmenopausal women, and to describe the impact of VMS on fatigue, anxiety and depression among all women residing in the USA. For this project, we evaluated over 4,400 records over 2 rounds of screening and identified the most suitable records to inform two different SLRs about VMS.
Therapy area: Endocrinology, Women’s health

Janus kinase inhibitors (JAKis) are being investigated for their efficacy and safety in the management of several autoimmune disorders, including rheumatoid arthritis (RA), atopic dermatitis (AD), ankylosing spondylitis (AS), non-radiographic axial spondyloarthritis (nr-AxSpa), Crohn’s disease (CD), ulcerative colitis (UC), and psoriatic arthritis (PsA).

Our client was interested in compiling evidence about the safety of a certain second-generation JAKi when used in the management of the autoimmune conditions mentioned above. Specifically, since direct head-to-head comparisons of this molecule with other comparators are scarce, our client wanted to focus on extracting data from published indirect treatment comparisons (ITCs) such as network meta-analyses (NMAs). For this project, we simultaneously extracted data from 35 NMAs that were obtained from a previous targeted literature review (TLR), and also performed a fresh screening of around 3500 abstracts over 2 levels to identify 5 additional NMAs for data extraction.

Impressed by the quality of work that we delivered in identifying and extracting data from ITCs, the client expanded the initial scope of work to include meta-analyses as well. For this expanded scope of work, we screened through around 1500 records that we had excluded in the previous rounds of screening, and identified around 30 meta-analyses that contained relevant information; we also extracted data from these 30 records.
Therapy area: Rheumatology

Janus kinase inhibitors (JAK inhibitors or Jakinibs) are immune modulating medications that act by interfering with the JAK-STAT signalling pathway in lymphocytes by inhibiting the activity of enzymes belonging to the Janus kinase family (JAK1, JAK2, JAK3, TYK2). Jakinibs have been used in the treatment of inflammatory arthritides such as rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis, and various other conditions including atopic dermatitis, Crohn’s disease, and myelofibrosis. Our client was interested to understand the pattern of usage of various approved Jakinibs in different conditions. For this project, we extracted relevant data from 82 articles into a data extraction grid shared by the client.
Therapy area: Multiple

Dilated Cardiomyopathy (DCM) is a condition affecting the heart muscle in which one or both ventricles undergo enlargement and dilation, resulting in impaired contractility, leading to a left ventricular ejection fraction (LVEF) of < 40%. Some forms of DCM have genetic predisposition, with common associated mutations observed in the ‘cardiomyopathy genes’, namely MYH7 (β myosin heavy chain), MYBPC3 (myosin binding protein C), and TTN (titin).

Our client was interested to explore the incidence and prevalence of genetic DCM worldwide, with special interest in the epidemiology of genetic DCM in the USA, and epidemiology of mutations in the cardiomyopathy genes. For this project, we screened through nearly 1250 records to identify the articles containing the most relevant information of interest. We also extracted data from around 50 records using the data extraction template shared by the client.
Therapy area: Cardiology

Psoriatic arthritis (PsA) is a chronic inflammatory arthritis that is found in about 20% of patients having psoriasis. Out of the 5 clinical subtypes of PsA, the asymmetric oligoarticular pattern is the most frequent, the others being polyarticular arthritis, distal arthritis, arthritis mutilans, and spondyloarthritis patterns. PsA is associated with considerable financial and psychological burden. With a significant progress in understanding of the disease pathogenesis, various new therapies have emerged or are in the pipeline for PsA.

Our client wanted to have an in-depth understanding of the epidemiology, medical and clinical burden, risk factors, financial burden, healthcare resource utilization, humanistic burden, and unmet needs in PsA. For this project that was split up into three sub-projects, we screened nearly 7,000 articles from a list shared by the client to identify the most suitable records with relevant information for further data mining.
Therapy area: Rheumatology

Janus activated kinases (JAKs) are cytoplasmic tyrosine kinases that are thought to be involved in the pathogenesis of several inflammatory and autoimmune disorders. As a result, JAK inhibitors are important therapeutic targets for management of autoimmune diseases. In the context of recently observed concerns about the safety of one of the JAK inhibitors, our client wanted to have a comprehensive understanding of the safety of these agents from previously reported studies, specially related to laboratory values. For this project, we performed data curation and abstraction from almost 1000 articles and selected the studies that contained the most relevant safety information.
Therapy area: Immune system

In oncology, Kaplan-Meier (KM) curves are extensively used for survival estimates of different treatment modalities. KM curves give a graphical understanding of different types of survival, including overall survival, progression-free survival, disease-free survival, etc. The information obtained from KM curves are used for secondary analyses, including meta-analyses and development of pharmacoeconomic models. Our client was interested in converting the information in KM curves obtained from different studies about breast cancer into digital format. For this project, we digitized almost 250 KM curves and generated coordinates of the curves in CSV format.
Therapy area: Oncology

Infection by human papilloma virus (HPV) can cause genital warts, which can progress to cervical, vulvar, and vaginal cancers. Different vaccines – bivalent, quadrivalent, and nonavalent – have a protective role against HPV-induced genital cancer. Our client wanted to evaluate vaccine effectiveness of all the 3 types of vaccine in preventing HPV infection. For this project, we curated around 2500 papers over 2 rounds of screening, based on the eligibility criteria drafted by the client and identified most relevant records containing the information of interest.
Therapy area: Oncology, Vaccines

Our client was interested in constructing a dynamic population model of human papilloma virus (HPV) infection and impact of vaccination. For this project, we identified model inputs by curating over 5000 potentially relevant papers through 2 rounds of screening and identified relevant articles containing information about rates of disease progression and regression, death, detection, cure, and recurrence of HPV in vaccinated and unvaccinated individuals. We also extracted data for informing the model inputs from around 150 RCTs and RWE studies, based on extraction template provided by the client.
Therapy area: Oncology

Infection by human papilloma virus (HPV) can cause genital warts, which can progress to cervical, vulvar, and vaginal cancers. Our client was interested to understand the natural history of HPV infection affecting different locations in the body. For this project, we extracted data from 26 articles based on the data extraction grid shared by the client.
Therapy area: Oncology

Atopic dermatitis (AD), or atopic eczema, is characterized by chronic, relapsing pruritic skin lesions that generally develop in early childhood, usually between 3 and 6 months of age. AD is the most common inflammatory skin condition of childhood, and around 60% of patients develop eczematous lesions in the first year of life. Treatment options include topical agents such as corticosteroids, calcineurin inhibitors, and crisaborole; systemic immunosuppressants are given off-label, and emerging therapies include topical lipoxin, omalizumab, dupilumab, nemolizumab, and barcitinib. Our client was interested to understand the safety and efficacy of various treatment options for infant AD. For this project we screened over 850 articles and selected the most appropriate articles containing the information of interest.
Therapy area: Dermatology, Pediatric Medicine

Narcolepsy is a neurological disorder involving dysregulated sleep-wake cycles, specially involving REM (rapid eye movement) phase, that results in excessive daytime sleepiness (EDS). Currently there is no medication that can bring about a satisfactory improvement in narcolepsy, and as a result the medication adherence of the available treatment options is often low. Our client was interested to understand the efficacy, safety, and improvements in patient-reported outcomes such as quality of life, work productivity, attention, and global impression of change, that have been reported in literature with the available treatment modalities. For this project, we abstracted around 700 research articles over 2 rounds of screening and selected the most relevant papers that contain the required information. Therapy area: Neurology

Spinal muscular atrophy (SMA) is a rare disorder of the neuromuscular system, in which there is progressive loss of motor neurons and associated muscle wasting. SMA is due to abnormal SMN (survival motor neuron) protein, which in turn is due to a mutation in the SMN1 gene. There are 5 subtypes of SMA. There are huge variations in the natural history and treatment outcomes of SMA. Our client was interested to know the natural history of SMA, as well as the efficacy, safety, quality of life, economic burden, and health state utilities of various treatment options of SMA. For this project, we curated over 2000 articles over two levels of screening to identify the most relevant studies containing the information of interest to the client.
Therapy Area: Neurology

Non-Small Cell Lung Cancer (NSCLC) is the most common type of lung cancer accounting for approximately 85% of all lung cancers, and is often associated with a poor treatment outcome and high mortality. Treatment options for NSCLC include surgery, radiofrequency ablation, radiation therapy, chemotherapy, and immunotherapy. The presence of certain mutations in NSCLC enables treatment with drugs targeting the mutations. We assisted our client in generating evidence surrounding efficacy and safety of available treatment options that target advanced NSCLC variants which carry mutations in the BRAF gene, including conventional non-targeted therapy as well as targeted therapy, from the Canadian perspective, by performing data abstraction and curation through screening of around 1100 papers through 2 levels of screening, and identified 11 eligible papers from which we extracted relevant data.
Therapy area: Oncology

Various immunotherapy options are now available for the management of non-small cell lung cancer (NSCLC). Our client was interested in exploring the clinical effectiveness of a specific monoclonal antibody for the immunotherapy (both mono and in combination) of advanced NSCLC. For this project, we assisted our client in evidence synthesis by screening around 1950 papers over 2 levels of screening, and subsequently extracted data from 194 studies. We also assisted in updating this SLR in the next year with by performing data abstraction from over 2000 new papers and extracting data from 92 studies.
Therapy area: Oncology

Different treatment options are available for the management of non-small cell lung cancer (NSCLC), such as chemotherapy, radiotherapy, immunotherapy, and surgery. Frequently, many modalities are delivered in combination. Our client was interested to evaluate the efficacy and safety of a monoclonal antibody in combination with radiotherapy in patients with advanced NSCLC. In this project, we extracted data from around 100 studies based on the data extraction grid shared by the client.
Therapy area: Oncology

Two main types of lung cancer are non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). Both these types differ in terms of epidemiology, natural history, treatment, and prognosis. For a project, we helped our client in collating evidence on the epidemiology, humanistic and economic burden, treatment patterns, and clinical outcomes among patients with advanced stages of both NSCLC and SCLC without any specific mutations of interest, who had received at least one session of check-point inhibitor (CPI) therapy or platinum-based therapy as a part of another project. We identified relevant studies by performing data abstraction from over 3800 records over 2 levels of screening.
Therapy area: Oncology

For protection against disease caused by Streptococcus pneumoniae (pneumococcus), available vaccine options include polysaccharide vaccines (where pneumococcal capsular polysaccharides are used) and the more popular pneumococcal conjugate vaccines (PCVs, where pneumococcal antigens are conjugated onto another protein component to enhance antibody response). Two of the most popular PCVs are PCV7 and PCV13, which use antigens from 7 and 13 serotypes of pneumococcus respectively. Our client was interested to understand the clinical efficacy, real-world effectiveness, and impact of both these PCVs among children with otitis media, and among with children at a high risk of developing pneumococcal disease. For both these projects, we cumulatively examined over 2400 articles over 2 rounds of screening each, to identify a total of 75 full texts which contained the most relevant information that the client was interested in. We also performed data extraction from these 75 papers using the data extraction grid provided by the client.
Therapy area: Infectious diseases, Vaccines

Alopecia areata (AA) is a form of non-scarring hair loss that presents with patchy areas of alopecia. It usually affects the scalp, and is associated with significant loss of quality of life (QoL). Various treatment options are available for AA, including topical, intralesional, and systemic therapies. Our client was interested to generate current evidence surrounding the prevalence, treatment options, QoL, economic aspects, guidelines, and unmet needs of AA. For this project, we prepared the PubMed search strategy, performed data abstraction and selected the most appropriate studies from around 500 papers in two rounds of screening, and also performed data extraction from around 90 most relevant papers using the data extraction grid that we prepared based on client needs. As a follow-up to the same project, we identified articles containing information about etiology, risk factors, molecular pathogenesis pathway, and clinical signs of AA by screening through around 600 papers through two rounds of screening.
Therapy area: Dermatology

Alpha-1 antitrypsin (AAT) is a glycoprotein produced by the liver hepatocytes (and in smaller quantities by other cells in the body), and is essential for the normal functioning of liver and lungs. Genetic absence of the protein, which is termed AAT deficiency, leads to uninhibited activity of the enzyme trypsin, causing extensive tissue breakdown; this can lead to complications in the lung (such as COPD) and liver (such as cirrhosis). Our client was interested to understand the natural history of AAT deficiency and its associated hepatic and pulmonary complications, especially surrounding prevalence, incidence, progression, diagnostic features, comorbidities, disease outcomes, and risk factors. For this project, we screened close to 3400 articles over two rounds of screening, and after identifying the 70 most relevant papers containing information that the client was looking for, we also extracted data following the data extraction grid shared by the client.
Therapy area: Metabolic

Acute-on-Chronic Liver Failure (ACLF) is a life-threatening medical condition with high mortality rates. The “Acute-on-Chronic” designation refers to patients’ clinical presentation of hepatic degeneration on top of pre-existing chronic liver disease. However, it has been felt that there is a lack of consensus surrounding the term ACLF, because there are multiple definitions for the term provided by multiple associations and organizations. Our client was interested to understand the similarities and differences across these ACLF definitions, and for this project we assisted our client by performing a comprehensive assessment of the definitions and extracting data pertaining to these definitions from 41 full texts based on the data extraction grid shared by the client.
Therapy area: Gastroenterology

Ulcerative colitis (UC) is an inflammatory disorder involving large intestine in which there is formation of inflammatory ulcers in colon and rectum, that is common in North America and Europe. Many treatment options are available, but definitive treatment of non-responding cases of UC generally require surgical management. Our client was interested to develop evidence surrounding epidemiology, clinical, humanistic, and economic burden, and management options of UC. For this project, we performed data abstraction of nearly 3000 articles over two rounds of screening and identified the articles with the most relevant information pertaining to the objectives of the targeted literature review, using criteria given by the client. We also extracted data from 83 studies based on the data extraction grid shared by the client.
Therapy area: Gastrointestinal

Refractory follicular lymphoma (RFL) and marginal zone lymphoma (MZL) are two subsets of non-Hodgkin lymphomas affecting B cells. Both these types of lymphomas are rare conditions, and are often viewed as orphan diseases. For the same reason, despite contributing to a significant burden on the healthcare systems around the world, the evidence surrounding the epidemiology, clinical features, and management outcomes of these two conditions are far from complete. Our client was interested to understand the clinical, humanistic, and economic burden, treatment patterns, and epidemiology of RFL and MZL. For this project, we performed data extraction from 30 full texts and 16 study abstracts shared with us by the client, and populated the data extraction grid that was shared with us.
Therapy area: Oncology

As a part of post-menopausal physiology, most women suffer from a menopause-related vasomotor symptoms (MR-VMS), including hot flashes and night sweats. While mild episodes of MR-VMS subside without treatment, moderate to severe episodes often require treatment. Most frequently prescribed therapy for MR-VMS is hormonal replacement therapy (HRT), while non-hormonal therapies are also available. Our client was interested to understand the efficacy of various available treatment modalities (HRT and non-HRT) for MR-VMS from published randomized controlled trials. For this project, we performed data abstraction of over 2700 articles over two rounds of screening and selected the most relevant papers containing the information of interest to the client. We also performed data extraction from 71 articles pertaining to clinical efficacy and patient-reported outcomes of various therapies.
Therapy area: Endocrinology

Fibrosis of the liver occurs following healing of any injury to the liver, and there is replacement of healthy hepatic tissue with fibrous tissue or scar. Advanced stage of hepatic fibrosis is called cirrhosis, and is associated with significant morbidity and mortality. The important causes of hepatic fibrosis include viral hepatitis, alcoholic liver disease, non-alcoholic steatohepatitis (NASH), biliary obstruction, autoimmune hepatitis, etc. Our client was interested to study the association between the stage of liver fibrosis and clinical, quality of life, and economic outcomes in Hepatitis B, Hepatitis C, and NASH through a targeted literature review. For this project, we extracted data from 38 studies identified by the client and shared the information in the prescribed format, which was used by the client to prepare a study report.
Therapy area: Gastrointestinal, Hepatology

There are different options for the diagnosis and assessment of hepatic fibrosis: some are invasive, some are non-inavsive. Each has its own set of merits and demerits. Our client was interested in comparing the outcomes of using traditional histological assessment of liver fibrosis with non-invasive assessment options such as biomarkers and sonography. For this project, we extracted data from 24 articles based on the data extraction grid shared by the client.
Therapy area: Gastrointestinal, Hepatology

Triple Negative Breast Cancer (TNBC) is a subtype of breast cancer that based on immunohistochemistry (IHC) is estrogen receptor (ER) negative, progesterone receptor (PR) negative and human epidermal growth factor receptor 2 (HER2) negative. Our client wanted to explore the efficacy and safety of available treatment options for managing TNBC. For this project, we abstracted around 3000 records through 2 levels of screening based on eligibility criteria shared by the client, and identified the most relevant articles for evidence synthesis.
Therapy area: Oncology

Locally advanced breast cancer (LABC) is a subset of breast cancer characterized by the most advanced breast tumours in the absence of distant metastasis. Multimodality treatment involving surgery, chemotherapy, and radiotherapy in combination with hormonal and targeted therapy as required, can significantly improve outcomes in patients with LABC. Our client was interested in evaluating the efficacy and safety of 2nd line or later treatments of LABC. For this project, we abstracted around 1000 records through 2 levels of screening to identify the most relevant articles for evidence synthesis, and also extracted data from 14 studies.
Therapy area: Oncology

Breast cancer among premenopausal women often presents at more advanced stages, and has less favourable prognosis than among postmenopausal women. Despite this, premenopausal breast cancer is an under-represented population in clinical trials. Our client was interested to understand the efficacy and safety of available treatment options for the management of advanced HR+, HER2- breast cancer among pre-menopausal women. For this project, we abstracted around 560 records through 2 levels of screening to identify the most relevant articles for evidence synthesis, and also extracted data from 5 studies.
Therapy area: Oncology

Breast cancer is among the most frequent cancers among women, and is associated with a considerable amount of clinical, humanistic, and economic burden. There are multiple forms and variants of breast cancer. Our client was interested to understand the patient-reported outcomes in addition to clinical efficacy and safety of all available treatment options for managing HER2+ or HER2+/HR+ breast cancer, especially in advanced, inoperable, or metastatic stages. For this project, we abstracted around 6000 records through 2 levels of screening to identify the most relevant articles for evidence synthesis, based on the eligibility criteria shared by the client. Therapy area: Oncology

Triple-negative breast cancer (TNBC) accounts for 10-20% of all breast cancers. It is more commonly diagnosed in younger women and often has a less favourable prognosis compared with other breast cancer subtypes. Our client was interested to compile evidence on the humanistic burden of metastatic TNBC. For this project, we abstracted around 1000 records through 2 levels of screening to identify the most relevant articles for evidence synthesis, and also extracted data from 6 studies. Therapy area: Oncology

Human epidermal growth factor receptor 2 (HER2) is overexpressed in around 20–30% of breast cancer tumors: such cancers are often more aggressive, have higher recurrence rates, and are associated with an increased mortality. However, the availability of the HER2 receptor blocker trastuzumab to standard of care chemotherapy in clinical trials has improved outcomes for early stage as well as metastatic HER2 positive breast cancer. Our client was interested to understand the epidemiology, humanistic, economic, and clinical burden of HER2+ breast cancer. For this project, we searched and screened around 670 papers and conference abstracts to identify the most relevant records for evidence synthesis, based on eligibility criteria shared by the client.
Therapy area: Oncology

Streptococcus pneumoniae, also known as pneumococcus, is a gram-positive bacterium that is the major cause of community-acquired pneumonia, and also causes other serious infections such as meningitis, sepsis, and a host of invasive pneumococcal infections including otitis, bronchitis, conjunctivitis, osteomyelitis, endocarditis and cellulitis, to name a few. Routine childhood vaccination through polyvalent pneumococcal vaccines (PCV-7 and PCV-13) to prevent pneumococcal infections are recommended by the WHO, but are not incorporated in all countries yet. Our client was interested in understanding the clinical efficacy of PCV-7 and PCV-13 among children with otitis media (OM), both in clinical trial and in real-world settings, and to explore how vaccine use impacted the incidence of OM among previously healthy children. For this project, we performed data abstraction and curation of more than 650 articles through two levels of screening and identified the most relevant papers for data extraction. For a different review, we helped our client to compile evidence on the immunogenicity and clinical efficacy of PCV-7 and PCV-13 among children at high-risk of developing pneumococcal infections, in both clinical trial and real-world settings, and the impact of vaccine use on the incidence of all-cause invasive pneumococcal disease in this population, by abstracting nearly 1750 articles through 2 levels of screening, identifying the most relevant papers for data extraction.
Therapy area: Infectious diseases, Vaccines

Hemophilias are a group of inherited disorders of blood clotting wherein the coagulation cascade following injury becomes abnormal due to low amounts of clotting factors such as factor VIII (hemophilia A), factor IX (hemophilia B), and so on. While current management largely involves replacing the missing clotting factors, non-factor therapies (such as monoclonal antibodies and RNA interfaces) and gene therapy are being studied as possible therapeutic options for these disorders. Our client was interested to compile evidence surrounding the efficacy, safety, and patient-reported outcomes of factor replacement therapies and various non-factor therapies (excluding plasma derivatives and supportive therapies) for both hemophilia A and hemophilia B, in terms of bleeding rates and other surrogate markers. For this project, we screened over 2550 articles concerning both the disorders over 2 rounds of screening, based on eligibility criteria shared by the client, and identified the most relevant articles for data extraction, quality assessment, and report preparation.
Therapy area: Hematology

The COVID-19 pandemic has been the major healthcare crisis that the world has witnessed in the recent years. Along with healthcare crisis, the COVID-19 pandemic was also associated with huge economic burdens. Our client was interested to conduct a systematic literature review pertaining to studies reporting the economic burden of COVID-19. For this project, we performed data extraction from a total of 48 papers identified by the client, using the data extraction grid provided to us. The data we extracted was used by the client to prepare a comprehensive study report about the economic burden of COVID-19. For a different project, we also extracted data pertaining to economic burden of COVID-19 (including direct medical costs, direct non-medical costs, indirect costs, and healthcare-related utilities) from 28 studies identified by the client.
Therapy area: Infectious diseases; COVID-19

Gastroparesis is a chronic disorder characterised by delayed stomach emptying without a blockage, and presenting features include nausea, heartburn, vomiting, early satiety, and boating sensation. The condition is associated with loss of quality of life, patient suffering, and economic burden resulting from reduced productivity and absenteeism. Our client was interested to generate evidence surrounding epidemiology, humanistic and economic burden, and efficacy of available treatment options for gastroparesis. For this project, we performed data abstraction and curation of over 1600 potential articles through two levels of screening and selected the most relevant papers for data extraction.
Therapy area: Gastrointestinal

Gastroparesis is a collection of symptoms of nausea and vomiting associated with bloating and early satiety plus or minus upper abdominal pain, caused by delayed gastric emptying in the absence of mechanical obstruction. Different modalities are available for the diagnosis of gastroparesis, including CT, MRI, gastric emptying studies, and scintigraphy. Our client wanted to compare two diagnostic modalities used in gastroparesis evaluation, namely GEBT (gastric emptying breath test) and scintigraphy, with respect to both diagnostic parameters and patient-reported outcomes. For this project we performed data abstraction and curation of over 1200 potential articles through two levels of screening and extracted data from 53 most relevant papers. We were also involved in the subsequent updating of this systematic review by screening through over 300 articles and extracting data from 15 new articles.
Therapy area: Gastrointestinal

Chemotherapy-induced nausea and vomiting (CINV) is a common and debilitating side effect of cancer treatment, that is associated with a loss of appetite, leading to reduced oral intake of food and water, which further worsens the patient’s health. While numerous antiemetic agents are available, CINV continues to be an unresolved adverse effect of chemotherapy for many patients. Our client was interested to evaluate the epidemiology, humanistic and economic burden, and efficacy of various available treatment options for CINV. For this project, we screened over 1000 articles through 2 levels of screening, based on the eligibility criteria as shared by the client, and identified the most relevant papers for data extraction.
Therapy area: Oncology

Acute kidney injury (AKI) is a sudden decrease in renal function, and is common among hospitalized patients. Patients who develop AKI are at an increased risk of developing chronic kidney injury. ‘Prolonged AKI’ is a less studied variant of AKI, wherein the kidney injury lasts more than 3 days. Our client wanted to understand the economic burden of prolonged AKI, compared to AKI that resolves more quickly. For this project, we screened over 2750 articles through 2 levels of screening and identified 40 most relevant papers that suited the eligibility criteria as shared by the client. We also performed data extraction from these 40 papers, the contents of which was used by the client to develop a targeted literature review report.
Therapy area: Renal

Treatment options for advanced, metastatic, and ‘unresectable’ cancer of the exocrine pancreas are limited, and are often associated with poor treatment outcomes in terms of survival and quality of life. Our client wanted to generate evidence pertaining to efficacy and safety of various treatment options, including conventional chemotherapy and immunotherapy, with special emphasis on survival (overall, and progression-free), treatment outcomes (disease control rate, duration of response, overall response rate, and other parameters), and safety (adverse effects, rate of and discontinuation of medication). We performed 2 levels of article screening, and also performed data extraction and quality assessment from the eligible studies for this project using criteria shared by the client.
Therapy area: Oncology

Acute myeloid leukemia (AML) is a cancer involving myeloid blood cells in which rapidly proliferating cancerous cells interfere with various normal functions of the body, including normal blood production. As an acute cancer, the condition rapidly progresses, and is fatal within few months if left untreated. AML is associated with huge clinical, humanistic, and economic burden and loss of quality of life among patients and their caregivers. Our client was interested to compare the health economic implications of AML from the perspective of four countries – Canada, Sweden, France, and USA – with respect to health economics, resource use, and impact on health utilities. We performed data extraction from a total of 55 studies pertaining to economic evaluation and resource utilization, which was used by the client to generate a detailed study report.
Therapy area: Oncology

Pemphigus is a group of autoimmune disorders affecting the skin and mucous membrane that leads to blistering lesions of the affected region. Severe forms of pemphigus can result in opportunistic infections, which can lead to significant complications including death. Current treatment of pemphigus involves immune suppression through corticosteroids and other drugs, which are associated with their own complications. Our client was interested to develop an overview of the pemphigus market, including epidemiology, clinical, humanistic, and economic burden of the disease, and the merits and demerits of the existing treatment options. For this project, we assisted our client by performing data extraction of around 120 relevant papers shared with us by the client, which was used by the client to develop a document to support market access activity of a new drug being developed for pemphigus treatment.
Therapy area: Dermatology

Disease-modifying therapy involving drugs such as glatiramer acetate, dimethyl fumarate, fingolimod, interferon-beta preparations, natalizumab, and mitoxantrone, is the mainstay of treatment of relapsing multiple sclerosis. Our client was interested to evaluate the safety and efficacy of different treatment options for relapsing multiple sclerosis. For this project, we performed data abstraction and curation through two levels of screening of over 2400 potential articles and selected the most relevant papers for data extraction. Therapy area: Neurology

Disease-modifying therapy involving drugs such as glatiramer acetate, dimethyl fumarate, fingolimod, interferon-beta preparations, natalizumab, and mitoxantrone, is the mainstay of treatment of relapsing multiple sclerosis. Our client was interested to evaluate the safety and efficacy of different treatment options for relapsing multiple sclerosis. For this project, we performed data abstraction and curation through two levels of screening of over 2400 potential articles and selected the most relevant papers for data extraction.
Therapy area: Neurology

Secondary progressive multiple sclerosis is a variant of MS in which there is a gradual neurologic deterioration after an initial relapsing-remitting course. Superimposed relapses can sometimes be observed in the clinical course of this condition. Our client wanted to compile evidence surrounding the safety and efficacy of different treatment options for secondary progressive multiple sclerosis. For this project, we performed data abstraction and curation of around 750 articles through 2 rounds of screening for identifying the most relevant studies for evidence synthesis.
Therapy area: Neurology

Post-operative gastrointestinal dysfunction (POGD), also referred to as post-operative ileus, is a common condition seen immediately after surgery with complex and multifactorial pathology. The condition is associated with increased patient suffering and cost of care. Our client was interested to generate evidence surrounding epidemiology, humanistic and economic burden, and efficacy of available treatment options for POGD. We assisted our client in performing data abstraction and curation through two levels of screening of over 450 potential articles and selected the most relevant papers for data extraction. In a separate project concerning the same condition, we evaluated nearly 1000 papers for eligibility as per criteria shared by the client.
Therapy area: Gastrointestinal

Advanced endometrial cancer is generally associated with poor prognosis due to lack of effective treatment options which can prolong survival and achieve significant disease control. Our client was interested to compile information pertaining to the epidemiological burden of advanced endometrial cancer, treatment guidelines for the condition, the efficacy and safety profile of available treatment options for the condition, and the real-world treatment patterns for the cancer. For this project, we performed data extraction from 23 records identified by the client as containing essential information for preparing a comprehensive report. We also critically assessed the methodological quality of 53 papers identified by the client using the appropriate tool. The information that we shared with the client was used to generate a report that would support preparation of a narrative value of a two-drug combination that was being developed for launch in few global markets.
Therapy area: Oncology

Chronic insomnia is associated with several physical and mental consequences, which are further responsible for loss of productivity, absenteeism, and healthcare costs. While several drugs belonging to different pharmacological classes are available for management of the condition, all of these are associated with safety concerns. Our client was interested to generate evidence surrounding efficacy and safety of all available treatment option for chronic insomnia, which would be used to support market access activities surrounding a novel drug under development for the condition. For this project, we assisted our client with data abstraction and curation through which we identified the most relevant papers for data extraction, using the criteria shared with us by the client.
Therapy area: Neurology

Plaque psoriasis is a chronic, inflammatory, multi-system disease characterised by flaky, itchy, scaly skin and associated with numerous systemic complications. Effective medications for this condition include conventional drugs, and biologics, which are both more efficacious as well as more expensive. Our client was in the process of commercializing a new biologic for this condition, and wanted to generate evidence pertaining to the efficacy and safety of the existing treatment options for this condition by means of a systematic literature review and network meta-analysis. For this project, we assisted our client with data curation through two rounds of screening of all possibly relevant papers shared with us by the client, and identified the most relevant papers for data extraction and quality assessment, which was used by the client for HTA submission purposes.
Therapy area: Dermatology

Varicella (chicken pox) is a vaccine-preventable infectious condition caused due to infection by varicella zoster virus. Even though varicella symptoms are mild, systemic complications are often described with relation to varicella. Our client wanted to prepare a comprehensive compilation of complications due to varicella, with a special emphasis on duration, rate of occurrence, and symptoms. For this project, we assisted the client with data curation through which 130 eligible records were identified from an initial pool of over 2000 records. We also performed data extraction, and quality assessment of the included records, and also prepared a comprehensive study report of the entire systematic literature review.
Therapy area: infectious diseases

Selection of proper device for delivering inhalational drug for treating chronic obstructive pulmonary disease (COPD) is essential to ensure optimal treatment outcomes. Device selection, ease of use, familiarity, and availability are known to affect the disease progression, and even when a drug with proven efficacy is used with improper device, the disease is known to worsen. Our client wanted to update a previously prepared TLR surrounding the value of pressurised metered dose inhalers (pMDIs) in COPD and include patients with asthma as well. We updated the search strategy, screened around hits for the most relevant articles over two rounds, and extracted data from over 250 eligible papers, which helped the client to prepare a project report.
Therapy area: Respiratory

Long-acting medications often tend to have poor medication adherence rates, especially if the route of administration is not oral, because of poor patient satisfaction and treatment experience. The resulting poor medication adherence can lead to poor treatment outcomes and worsening of the disease. Our client was interested to explore the role of factors such as route of administration, dosing frequency, patient convenience, and patient satisfaction on adherence to certain long-acting medications on specific indications such as hyperlipidemia, osteoporosis, psoriasis, alcohol dependence, and schizophrenia. We screened around 3800 abstracts for identifying the most relevant sources of information, based on the eligibility criteria provided to us by the client.
Therapy area: Metabolic, Orthopedics, Dermatology, Psychiatry, Substance abuse

Pompe disease is a subtype of glycogen storage disease (type II), in which there are mutations in the gene coding for acid alpha-glucosidase (GAA), the enzyme that breaks down glycogen in acidic milieu of the lysosome, resulting in a severe metabolic myopathy. Our client wanted to generate evidence surrounding the humanistic burden of GSD type II (Pompe disease), along with the clinical effectiveness and pharmacoeconomic considerations of enzyme replacement therapy for Pompe disease, which would be used for HTA submissions for NICE. For this project, we identified the most relevant papers for data extraction through two rounds of screening of nearly 2000 papers, using the criteria shared with us by the client.
Therapy area: Metabolic

Delayed graft function (DGF) is a severe form of acute kidney injury resulting from an ischemia and reperfusion injury. It is a common complication following renal transplantation from a deceased donor. DGF is associated with a significant clinical and economic burden, and is a significant determinant of long-term success after renal transplantation. Our client was interested to systematically review the available literature concerning the clinical, humanistic, and economic burden of DGF following renal transplantation, specially in the last 15 years. For this study, we extracted data from 91 articles based on guidelines and data extraction grid shared with us by the client, the findings of which was used by the client to generate a detailed study report.
Therapy area: Transplantation medicine, Renal

Chronic kidney disease (CKD), also called chronic kidney failure, describes the gradual loss of kidney function. Chronic kidney disease can progress to end-stage kidney failure, which is fatal without artificial filtering (dialysis) or a kidney transplant. Our client wanted to conduct a targeted literature review of burden of disease, epidemiology, treatment patterns, guidelines, and current trial designs and data on competitors on published SLRs and meta-analyses (MAs). A search strategy was developed using EMBASE Search Strategy (via OvidSP), Medline Search Strategy (via OvidSP), and subsequently identified the most relevant papers from around 3,800 articles over 2 rounds screening.
Therapy area: Renal