Evidence map›Paper›PMID 42118422›Full record

ArticlePharmaceutical medicine2026

Evaluation of the Quality Decision-Making Practices Utilized by the Zambia Medicines Regulatory Authority Technical Committees.

Constance Sakala Chisha, Makomani Siyanga, Stephanie Leigh, Juan Lara, Stuart Walker

Abstract read
In one paragraph

Article in Pharmaceutical medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

5 authors.

Constance Sakala ChishaWITS Pharmacy Regulatory Science Hub, WITS Health Consortium, 31 Princess of Wales Terrace, Parktown, Johannesburg, 2193, South Africa.
Makomani SiyangaZambia Medicines Regulatory Authority, Lusaka, Zambia.
Stephanie LeighWITS Pharmacy Regulatory Science Hub, WITS Health Consortium, 31 Princess of Wales Terrace, Parktown, Johannesburg, 2193, South Africa. stephanie.leigh@wits.ac.za.ORCID 0000-0003-3945-9823
Juan LaraCentre for Innovation in Regulatory Science, 70. St Mary Axe, London, EC3A 8BE, UK.
Stuart WalkerWITS Pharmacy Regulatory Science Hub, WITS Health Consortium, 31 Princess of Wales Terrace, Parktown, Johannesburg, 2193, South Africa.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundA consistent and transparent approach is essential for quality decision-making in the review and approval of medicines. This is achieved through the use of a standard and well-defined framework, as the decisions made should not be influenced by any biases. While most National Medicines Regulatory Authorities (NMRAs) have designed frameworks to assess the quality of their decisions, many have not been implemented. A well-structured framework improves consistency and predictability in the decision-making process. The Quality of Decision-Making Orientation Scheme (QoDoS) has been widely adopted as a leading framework for this purpose. This study aimed to assess the decision-making processes of two technical committees operating within the Zambia Medicines Regulatory Authority (ZAMRA) using the QoDoS framework developed by the Centre for Innovation in Regulatory Science (CIRS); determine areas of improvement for routine assessment of quality of decision-making and its acceptability with respect to ZAMRA; and suggest ways of improving the lowest-scoring Quality Decision-Making Practices (QDMPs) and how these may be implemented into the decision-making framework to ensure consistency.

methodsThe framework was used to assess the quality of the decision-making process and subsequent implementation of the ten QDMPs. The study included five members from the Technical Committee for Human Medicines (TCHM) and seven members from the Technical Committee for Veterinary Medicines (TCVM) at ZAMRA, all responsible for recommending the approval or rejection of applications following scientific review. The validated QoDoS questionnaire was electronically distributed to the members, and data were analysed using descriptive statistics.

resultsAnalysis of the QDMPs across the 12 committee members indicated that both human and veterinary medicines technical committees generally perceived their individual and organizational decision-making practices as favourable. Favourable QDMPs included QDMP 2 (assigning clear roles and responsibilities of the stakeholders involved in the review and approval of medicines), QDMP 4 (evaluate both internal and external influences or biases), QDMP 6 (considering uncertainty), QDMP 7 (re-evaluate new information as it becomes available), QDMP 9, (ensure transparency and keep a record trail) and QDMP 10 (effective communication of the basis of the decision). However, areas for improvement were identified in QDMP 1 (systematic structured approach), QDMP 3 (decision criteria), QDMP 5 (alternatives) and QDMP 8 (impact analysis) within the TCVM, as well as in QDMP 3 and QDMP 8 within the TCHM.

conclusionThis study assessed committee members' perceptions of the implementation of QDMPs in the review and approval of medicines. It was demonstrated that most of the best QDMPs were implemented, except for four QDMPs that needed improvement, namely having a systematic structured approach, decision criteria, alternatives and impact analysis.

Indexed as

Decision MakingDrug ApprovalHumansZambia

Identifiers

PMID42118422
PMCPMC13219053

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

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.