In addition, we note that the RCTs are all single center studies. Extrapolation of the data from these RCTs to the general population may be limited. Many of these trials have been conducted in areas of the United States with the most advanced COVID-19 cases and pandemic burden, and there is a need for all the research to be done in a timely manner in different regions of the world. There is a call for more multi-center studies to contribute to a higher level of evidence for COVID-19 treatment.
We note that the National Institute of Health, Food and Drug Administration, and European Medicines Agency clinical trial database includes a total of 132 studies to date, and at least 70 are in the enrollment phase. However, the number of RCTs to date is still very low ( 2 ) and the number of patients enrolled in these studies is small. The US Food and Drug Administration (FDA) has issued a guidance document for sponsors of clinical trials involving COVID-19 treatments . As an example, in the RCT by Zhao et al (2020) , the authors reported that they had randomized 377 patients in each arm. However, RCT data are being published at a much slower pace than other health conditions ( 6 ), and the number of trials is likely to increase as international investigators and trial sponsors seek to accelerate drug evaluation. The authors of this guideline recommend that a registry be established to allow for the collection of data on patients affected by COVID-19, who may be enrolled in future trials. Registry data should be made available to the public for public health purposes and quality improvement initiatives.
Finally, in light of the novel coronavirus outbreak, a number of patients and health professionals have requested that we provide an update on the best and most up-to-date recommendations regarding the use of hydroxychloroquine and azithromycin for COVID-19. At the time of initial publication, hydroxychloroquine and azithromycin were recommended as potential treatments for hospitalized patients with COVID-19. While both hydroxychloroquine and azithromycin have proven efficacy for the treatment of malaria, there is no convincing evidence of their efficacy for COVID-19. Unfortunately, the large observational studies that evaluated these agents in patients with COVID-19 were severely limited by methodological flaws that led to numerous potential biases (e.g., hydroxychloroquine , azithromycin , macrolides , ribavirin , immune-stimulating therapies , lopinavir/ritonavir , chloroquine/hydroxychloroquine ).
Peer Group Questions – Think about the size of the private equity firm and the industry you are applying to. How did the firm decide to go with that size? Can you think of a situation where a firm would consider a different size? What kind of questions would you ask to determine whether a particular size or industry is right for you?
To decide which one should you opt for, one needs to look at the business as a whole. Doing so will give a better understanding of how the business functions, how profitable it is, how the management team is doing and what problems it might face in the future. It also helps to determine if there are any other reasons as to why you should or shouldn’t be interested in the company. Companies with a higher ROE are considered more attractive as well as have a higher Return on invested capital (ROIC). This helps determine if you need to invest in the company. 827ec27edc