Evidence map›Paper›PMID 19591576›Full record

ArticleThe Journal of infectious diseases2009

Misclassification of drug failure in Plasmodium falciparum clinical trials in southeast Asia.

Jonathan J Juliano, Frederic Ariey, Rithy Sem, Noppadon Tangpukdee, Srivicha Krudsood, Carol Olson, Sornchai Looareesuwan, William O Rogers, Chansuda Wongsrichanalai, Steven R Meshnick

Abstract read
In one paragraph

Article in The Journal of infectious diseases, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

20 citing papers in PubMed.

  1. Adherence to Mass Drug Administration with Dihydroartemisinin-Piperaquine andThe American journal of tropical medicine and hygiene · 2020
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Jonathan J JulianoDivision of Infectious Diseases, School of Medicine, Department of Epidemiology, University of North Carolina, Chapel Hill, NC 27599, USA.
Frederic Ariey
Rithy Sem
Noppadon Tangpukdee
Srivicha Krudsood
Carol Olson
Sornchai Looareesuwan
William O Rogers
Chansuda Wongsrichanalai
Steven R Meshnick

Funding

UNC Clinical Translation Science Award-K12 Scholars Program (KL2)KL2RR025746 · NCRR · UNIV OF NORTH CAROLINA CHAPEL HILL · PI RUNGE, MARSCHALL S. · 2008 to 2011
$9.0M
INFECTIOUS DISEASE PATHOGENESIS TRAININGT32AI007151 · NIAID · UNIV OF NORTH CAROLINA CHAPEL HILL · PI JULIANO, JONATHAN J · 1985 to 2024
$5.5M
Prevalence and fitness of drug resistant minority variant mutations in PlasmodiumR21AI076785 · NIAID · UNIV OF NORTH CAROLINA CHAPEL HILL · PI MESHNICK, STEVEN RICHARD · 2008 to 2009
$404k
NCRR NIH HHS KL2 RR025746NCRR NIH HHS KL2RR025746NIAID NIH HHS 1R21AI076785NIAID NIH HHS 5 T32 AI07151-29NIAID NIH HHS R21 AI076785NIAID NIH HHS T32 AI007151
6 · The paper itself

Abstract

Most trials of antimalarials occur in areas in which reinfections are possible. For Plasmodium falciparum, reinfections are distinguished from recrudescences by polymerase chain reaction analysis of 3 polymorphic genes. However, the validity of this approach has never been rigorously tested. We tested for misclassification in 6 patients from clinical trials in Thailand and Cambodia who were classified as being reinfected by the standard polymerase chain reaction protocol. Using heteroduplex tracking assays and direct DNA sequencing, we found that 5 (83%) of 6 patients were misclassified. Misclassification in this manner overestimates the efficacy of antimalarials and delays the recognition of decreasing therapeutic efficacy, thus delaying potential changes in policy.

Indexed as

AnimalsAntimalarialsCambodiaDNA, ProtozoanGenetic MarkersGenetic VariationGenotypeMalaria, FalciparumPlasmodium falciparumPolymerase Chain ReactionProtozoan ProteinsRecurrenceThailandTreatment FailureAntimalarialsDNA, ProtozoanGenetic MarkersProtozoan Proteins

Identifiers

PMID19591576
PMCPMC2761972

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.