Digital Public Defence: Tone Westergren

Cand. pharm. Tone Westergren at Institute of Clinical Medicine will be defending the thesis “Reporting of adverse effects in clinical trials, systematic reviews, and guidelines. How events are lost along the evidence chain” for the degree of PhD (Philosophiae Doctor).

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Photo: Laila Bruun, OUS

The public defence will be held as a video conference over Zoom.

The defence will follow regular procedure as far as possible, hence it will be open to the public and the audience can ask ex auditorio questions when invited to do so.

Click here to participate in the public defence

Download Zoom here

Due to copyright reasons, an electronic copy of the thesis must be ordered from the faculty. In order for the faculty to have time to process the order, it must be received by the faculty no later than 2 days prior to the public defence. Orders received later than 2 days before the defence will not be processed. Inquiries regarding the thesis after the public defence must be addressed to the candidate.

Digital Trial Lecture – time and place

See Digital Trial Lecture.

Adjudication committee

  • First opponent: Professor Gert Jan van der Wilt, Radboud University Medical Centre
  • Second opponent: Professor Anne Gerd Granås, Norwegian Centre for E-health Research
  • Third member and chair of the evaluation committee: Researcher Vigdis Vindenes, University of Oslo

Chair of the Defence

Associate Professor Susanne Dudman, University of Oslo

Principal Supervisor

Associate Professor Marianne Klemp, University of Oslo


Knowledge about adverse effects of a medication is essential to assess treatment benefits versus risks. Several researchers have found that not all adverse effects are included when results from clinical trials are published. Consequently, evaluations of risk profiles may result in conflicting conclusions. Differences in what is counted as an adverse effect, and what is mentioned in publications, may influence the risk assessments that are presented to doctors and patients. The researchers found that adverse effects observed in clinical trials are not always presented in study publications or reflected in systematic reviews and guidelines.

The aims of this thesis were to assess how adverse effects in clinical trials are identified and communicated, and how adverse effects are described in therapy guidelines. The researchers addressed two model areas: Risk of gastrointestinal bleeding due to corticosteroid therapy, and risk of adverse effects from antidepressants in children and adolescents.

The researchers found that use of corticosteroids was associated with increased risk of gastrointestinal bleeding in hospitalized patients. There were few cases of gastrointestinal bleeding in ambulant patients. What was counted as a gastrointestinal bleeding differed considerably between trials. Many trial publications did not fulfil all international criteria for reporting of harms.

Risk of adverse effects from antidepressants in children and adolescents has not been extensively studied. The researchers found that adverse effects from treatment in a pivotal trial had been incompletely reported. The publications on adverse effects focused on suicidality, and did not describe other adverse reactions for treatment lasting more than 12 weeks.

Therapy guidelines on depression in children and adolescents mention adverse effects to a varying degree. All the assessed guidelines mentioned risk of suicidality, but many guidelines did not mention other types of adverse effects.

Additional information

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Published Nov. 11, 2021 11:28 AM - Last modified Nov. 24, 2021 9:53 AM