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Questions and Answers

JAMA. 1990;264(16):2137-2140. doi:10.1001/jama.1990.03450160107042.
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The categories for response to a DATTA question are defined as follows: Established—this technology has been adequately evaluated and its (A) safety or (B) effectiveness is accepted as appropriate by the practicing medical community for the given indication in the specified patient population; promising— given current knowledge, the (A) safety or (B) effectiveness of this technology appears to be appropriate for the given indication in the specified patient population; as more experience and long-term follow-up are accumulated, this interim rating will change; investigational—there is no consensus on the (A) safety or (B) effectiveness of this technology to date, there is insufficient evidence to determine its appropriateness, or it warrants further study; use of this technology for the given indication in the specified patient population should be confined largely to research protocols; doubtful—given current knowledge, the (A) safety or (B) effectiveness of this technology appears to be inappropriate for the given indication in the specified patient population; as more experience and long-term follow-up are accumulated, this interim rating will change; and unacceptable—the (A) safety or (B) effectiveness of this technology is regarded by the practicing medical community as inappropriate for the given indication in the specified patient population.
For each question, any response category receiving 50% or more of the panel's votes was tested for a consensus by assuming that the DATTA panel is a sample from a broader population of experts. Using exact binomial probabilities, the likelihood of the observed vote was calculated if exactly 50% of the total population of experts support that response for that question. Hence, the null hypothesis is 50% of all experts support the response, and the alternative, onetailed, hypothesis is that more than 50% of all experts support the response. Rejection of the null hypothesis, and acceptance of the alternative, is interpreted as evidence of a majority opinion in the total population of experts, and a consensus is achieved. If no consensus was found, the categories were reorganized and reanalyzed. The definitions of "promising" and "established" include the concept of "appropriate," while the "doubtful" and "unacceptable" definitions include the concept of "inappropriate." The original five categories were thus, if necessary, reorganized into three categories, "appropriate," "investigational," and "inappropriate"; an analysis of any category with 50% or more of the vote was performed.
P values for the survey responses are as follows: question 1A, 26 "appropriate" responses out of 33, P<.001, consensus for "appropriate"; question 1B, 25 "appropriate" responses out of 33, P<.01, consensus for "appropriate." One respondent offered no opinion for questions 1A and 1B.
Canellos GP.  Chronic granulocytic leukemia . Med Clin North Am. 1976;60:1001-1018.
Gutterman JU, Fine S, Quesada J, et al.  Recombinant leukocyte A interferon: pharmacokinetics, single dose tolerance and biologic effects in cancer patients . Ann Intern Med. 1982;96:549-556.
Link to Article[[XSLOpenURL/10.7326/0003-4819-96-5-549]]
Verma DS, Spitzer G, Gutterman JU, Zander AR, McCredie KB, Dicke KA.  Human leukocytic interferon preparation blocks granulopoietic differentiation . Blood. 1979;54:1423-1427.
Williams CK, Svet-Moldavskaga I, Vilcek J, Ohnuma T, Holland JF.  Ibhibitory effects of human leukocyte and fibroblast interferons on normal and chronic myelogenous leukemic granulocytic progenitor cells . Oncology. 1981;38:356360.
Link to Article[[XSLOpenURL/10.1159/000225587]]
Neumann MA, Fauser AA.  Effect of interferon on pluripotent hemopoietic progenitors (CFU-GEMM) derived from human bone marrow . Exp Hematol. 1982;10:587-590.
Ozer H.  Biotherapy of chronic myelogenous leukemia with interferon . Semin Oncol. 1988;15:14-20.
Goldstein D, Laszlo J.  The role of interferon in cancer therapy: a current perspective . CA. 1988;38:258-277.
Link to Article[[XSLOpenURL/10.1017/S0009838800031505]]
Spiegel RJ.  The alpha interferons: clinical overview . Semin Oncol. 1987;14: 1-12.
Yoffe G, Blick M, Kantarjian M, Spitzer G, Gutterman JU, Talpaz M.  Molecular analysis of interferon-induced suppression of Philadelphia chromosome in patients with chronic myeloid leukemia . Blood. 1987;69:961-963.
Smyth JF.  Guidelines for the use of INTRON A (interferon alfa-2b) in clinical oncology: lessons from the laboratory . Cancer Treat Rev. 1988;15( (suppl A) ):3-6.
Reid LM, Minato N, Gresser I, Holland J, Kadish A, Bloom BR.  Influence of antimouse interferon serum on the growth and metastasis of tumor cells persistently infected with virus and of human prostatic tumors in nude mice . Proc Natl Acad Sci U S A. 1981;78:1171-1175.
Link to Article[[XSLOpenURL/10.1073/pnas.78.2.1171]]
Galvani DW, Owens W, Nethersell ABW, Cawley JC.  The beneficial effects of alpha IFN in CGL are probably not mediated by NK cells . Br J Haematol. 1989;71:233-237.
Link to Article[[XSLOpenURL/10.1111/j.1365-2141.1989.tb04260.x]]
Gresser I.  How does interferon inhibit tumor growth? Interferon. 1985;6:93-126.
Revel M, Kimchi A, Shulman L, et al.  Role of interferon-induced enzymes in the antiviral and antimitogenic effects of interferon . Ann N Y Acad Sci. 1980;350:459-472.
Link to Article[[XSLOpenURL/10.1111/nyas.1980.350.issue-1]]
Kirkwood JM, Ernstoff MS.  Interferons in the treatment of human cancer . J Clin Oncol. 1984;2:336-352.
Clemens M.  Interferons and oncogenes . Nature (London) . 1985;313:531532.
Link to Article[[XSLOpenURL/10.1038/313531a0]]
Goldstein D, Laszlo J.  Interferon therapy in cancer: from imaginon to interferon . Cancer Res. 1986;46:4315-4329.
Gauci L.  Management of cancer patients receiving interferon alfa-2a . Int J Cancer. 1987;1:21-30.
Link to Article[[XSLOpenURL/10.1002/(ISSN)1097-0215]]
Kantarjian HM, Smith TL, McCredie KB, Keating MJ, Walters RS, Talpaz M.  Chronic myelogenous leukemia: a multivariate analysis of the associations of patient characteristics and therapy with survival . Blood. 1985;66:1326-1335.
Talpaz M, Kantarjian HM, McCredie KB, Keating MJ, Trujillo J, Gutterman J.  Clinical investigation of human alpha interferon in chronic myelogenous leukemia . Blood. 1987;69:1280-1288.
Alimena G, Morra E, Lazzarino M, et al.  Treatment of Ph'-positive chronic myelogenous leukemia (CML) with recombinant interferon alfa-2b (INTRON A) . Cancer Treat Rev. 1988;15( (suppl A) ):21-26.
Link to Article[[XSLOpenURL/10.1016/0305-7372(88)90070-9]]
Niederle N, Kloke R, Wandl A, Opalka B, Schmidt CG.  Interferon alfa-2b in the treatment of chronic myelogenous leukemia . Semin Oncol. 1987;14:29-35.
Talpaz M, Kantarjian HM, Kurzrock R, Gutterman JU.  Therapy of chronic myelogenous leukemia: chemotherapy and interferons . Semin Hematol. 1988;25:62-73.
Talpaz M, Kantarjian H, Kurzrock R, Gutterman JU.  Clinical studies with interferons in Philadelphia positive chronic myelogenous leukemia . Bone Marrow Transplant. 1989;4( (suppl 1) ):63.
Talpaz M, Kantarjian HM, McCredie K, Trujillo JM, Keating MJ, Gutterman JU.  Hematologic remission and cytogenetic improvement induced by recombinant human interferon alpha-A in chronic myelogenous leukemia . N Engl J Med. 1986;314:1065-1069.
Link to Article[[XSLOpenURL/10.1056/NEJM198604243141701]]
Gastl G, Aubitzky W, Tilg H, et al.  Recombinant IFN-alpha-2 (RIFNalpha-2) for treatment of chronic myelogenous leukemia in benign and accelerated phase . J Interferon Res. 1987;7:737.
Ozer H, Dear K, Testa J, et al.  Prolonged administration of subcutaneous alfa interferon induces major clinical and complete cytogenetic remissions in untreated Philadelphia chromosome positive (PH + ) chronic myelogenous leukemia (CML) . ASCO Proc. 1990;9:C-21. Abstract 783.
Kantarjian HM, Talpaz M, Gutterman JU.  Chronic myelogenous leukemia—past, present and future . Hematol Pathol. 1988;2:91-120.
Bergsagel DE.  Interferon alfa-2b in the management of chronic granulocytic leukemia . Cancer Treat Rev. 1988;15(suppl A):15-20.
Guilhot F, Brizard A, Huret JK, Dreyfus B, Desmarest MC, Tanzer J.  Cytogenetic response in chronic myelocytic leukemia (CML) using recombinant alpha 2A interferon (A-IFN) plus hydroxyurea (HU): preliminary results . Blood. 1987;70( (suppl 1) ):230.
Kloke 0, Becher R, Niederle N.  Response to the combined administration of interferons alpha and gamma after failure of single interferon therapy in chronic myelogenous leukemia . Blut. 1987;55:453-458.
Link to Article[[XSLOpenURL/10.1007/BF00367463]]
Lee KH, Talpaz M, Rothberg JM, et al.  Concomitant administration of recombinant human interleukin-2 and recombinant interferon alpha-2A in cancer patients: a phase I study . J Clin Oncol. 1989;7:1726-1732.
Meyers JD, Flournoy N, Sanders JE, et al.  Prophylactic use of human leukocyte interferon after allogeneic marrow transplantation . Ann Intern Med. 1987;107:809-816.
Link to Article[[XSLOpenURL/10.7326/0003-4819-107-6-809]]
Newland AC, Jones L, Mir N, Slocombe GW.  Alpha 2 interferon in chronic myeloid leukemia following relapse post-allogeneic transplant . Br J Haematol. 1987;66:141-143.
DeCherney AH, Jones EE.  Ectopic pregnancy . Clinical Obstet Gynecol. 1985;28:365-370.
Link to Article[[XSLOpenURL/10.1097/00003081-198528020-00014]]
Madsen DE, Cavanagh D.  Hemorrhagic shock in the gynecologic patient . Clinical Obstet Gynecol. 1985;28:383-390.


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