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Sample records for economic evaluation diagnosis

  1. Prerequisite programs at schools: diagnosis and economic evaluation.

    Science.gov (United States)

    Lockis, Victor R; Cruz, Adriano G; Walter, Eduardo H M; Faria, Jose A F; Granato, Daniel; Sant'Ana, Anderson S

    2011-02-01

    In this study, 20 Brazilian public schools have been assessed regarding good manufacturing practices and standard sanitation operating procedures implementation. We used a checklist comprised of 10 parts (facilities and installations, water supply, equipments and tools, pest control, waste management, personal hygiene, sanitation, storage, documentation, and training), making a total of 69 questions. The implementing modification cost to the found nonconformities was also determined so that it could work with technical data as a based decision-making prioritization. The average nonconformity percentage at schools concerning to prerequisite program was 36%, from which 66% of them own inadequate installations, 65% waste management, 44% regarding documentation, and 35% water supply and sanitation. The initial estimated cost for changing has been U.S.$24,438 and monthly investments of 1.55% on the currently needed invested values. This would result in U.S.$0.015 increase on each served meal cost over the investment replacement within a year. Thus, we have concluded that such modifications are economically feasible and will be considered on technical requirements when prerequisite program implementation priorities are established.

  2. [Economic evaluation od the value of early diagnosis and management of hypothyroidism in hypercholesterolemia].

    Science.gov (United States)

    Lenne, X; Allenet, B; Laurent, P; Lebrun, T; Wemeau, J L

    1999-11-01

    The aim of the study was to assess the economic consequences of the early screening and management for overt hypothyrodism in elderly women suffering from hypercholesterolaemia. A cost analysis was performed using screening decision tree followed by a Markov model, targeted on an hypothetical cohort of elderly women (i.e. > or = 55 years of age) suffering from hypercholesterolaemia. Two arms were compared, "no diagnosis", patients being treated by lipid lowering drugs in the long run, "diagnosis", patients being screened for thyroid disturbance and proposed adequate correction by hormone treatment. Relevant clinical data introduced into the model were obtained from published data and from experts. At the end of the initial diagnostic, patients could enter three different health states: euthyroidism, subclinical hypothyroidism or overt hypothyroidism. During 30 years, patients were assumed to be seen each year by a general practitioner for clinical examination and cholesterol dosage, plus, according to the health state evolution, TSH and T4 screening. In the baseline analysis, euthyroidian patients who had a inexplicable degradation of hypercholesterolaemia control were tested for TSH and, if abnormal, T4 serum; for subclinical hypothyroidian patients, TSH and T4 were measured every year. The direct costs taken into account were concerning medical supervision, drug treatment and biologic exams. Costs were analysed from the societal perspective and were expressed in 1998 French Francs (FF) with an accounting rate of 5% by year. A sensitivity analysis was also performed. The total cost at 30-year was equal to 25,006 F for "diagnosis" strategy, to 24,390 F for "no diagnosis" strategy. The incremental cost of the first strategy decreased according to the time horizon. It was 6.8% at 5-year and 2.5% at 30-year. Results were sensitive to variation in response rate of hypercholesterolaemic patients to hormone treatment of hypothyroidism (0.25 in base-case). The investment

  3. Health-economic evaluation of magnetic resonance imaging before biopsy for diagnosis of prostate cancer

    International Nuclear Information System (INIS)

    Stadlbauer, A.; Salomonowitz, E.; Bernt, R.; Plas, E.; Strunk, G.; Eberhardt, K.

    2011-01-01

    The aim of this study was the health-economic analysis of MR imaging in the diagnostics of suspicious prostate carcinoma (PCa) before execution of a first biopsy. The health-economic analysis included four steps: modeling, determination of probabilities, evaluation, and sensitivity analyses. We performed an effectiveness analysis from the patient perspective as well as a cost-effectiveness and a cost-utility analysis from the health insurance perspective for Austria and Germany. The effectiveness and cost-effectiveness analysis used a hypothetical cohort of 100 000 patients. The result parameters were number of biopsies, number of detected PCa, and monetary costs. For the cost-efficiency analysis, the result parameters, quality-adjusted life years (QALYs) and costs, were calculated for an individual patient. The efficiency analysis showed that MRI before a first biopsy can prevent ca. 64 000 unnecessary biopsies/ 100 000 patients. The diagnostic efficiency was higher by a factor of 1.7. Due to MRI, eight PCas were additionally detected. From a health insurance perspective, MRI was not cost-effective. Extra costs of ca. 42 m. Euro per 100 000 patients and of 650 Euro per prevented biopsy were calculated. The costs per detected PCa were increased by 1395 Euro. The attainable QALYs were a little higher for the MRI alternative, which was therefore not dominated. Our results do not permit a clear recommendation for or against the application of MRI in the diagnostics of PCa. From the patient perspective, it is to be endorsed due to the higher medical efficiency. However, it is connected with higher health insurance costs. (orig.)

  4. The Diagnosis of Urinary Tract Infection in Young Children (DUTY) Study Clinical Rule: Economic Evaluation.

    Science.gov (United States)

    Hollingworth, William; Busby, John; Butler, Christopher C; O'Brien, Kathryn; Sterne, Jonathan A C; Hood, Kerenza; Little, Paul; Lawton, Michael; Birnie, Kate; Thomas-Jones, Emma; Harman, Kim; Hay, Alastair D

    2017-04-01

    To estimate the cost-effectiveness of a two-step clinical rule using symptoms, signs and dipstick testing to guide the diagnosis and antibiotic treatment of urinary tract infection (UTI) in acutely unwell young children presenting to primary care. Decision analytic model synthesising data from a multicentre, prospective cohort study (DUTY) and the wider literature to estimate the short-term and lifetime costs and healthcare outcomes (symptomatic days, recurrent UTI, quality adjusted life years) of eight diagnostic strategies. We compared GP clinical judgement with three strategies based on a 'coefficient score' combining seven symptoms and signs independently associated with UTI and four strategies based on weighted scores according to the presence/absence of five symptoms and signs. We compared dipstick testing versus laboratory culture in children at intermediate risk of UTI. Sampling, culture and antibiotic costs were lowest in high-specificity DUTY strategies (£1.22 and £1.08) compared to clinical judgement (£1.99). These strategies also approximately halved urine sampling (4.8% versus 9.1% in clinical judgement) without reducing sensitivity (58.2% versus 56.4%). Outcomes were very similar across all diagnostic strategies. High-specificity DUTY strategies were more cost-effective than clinical judgement in the short- (iNMB = £0.78 and £0.84) and long-term (iNMB =£2.31 and £2.50). Dipstick tests had poorer cost-effectiveness than laboratory culture in children at intermediate risk of UTI (iNMB = £-1.41). Compared to GPs' clinical judgement, high specificity clinical rules from the DUTY study could substantially reduce urine sampling, achieving lower costs and equivalent patient outcomes. Dipstick testing children for UTI is not cost-effective. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  5. Evaluation of economic and performance outcomes associated with the number of treatments after an initial diagnosis of bovine respiratory disease in commercial feeder cattle.

    Science.gov (United States)

    Cernicchiaro, Natalia; White, Brad J; Renter, David G; Babcock, Abram H

    2013-02-01

    To evaluate associations between economic and performance outcomes with the number of treatments after an initial diagnosis of bovine respiratory disease (BRD) in commercial feedlot cattle. 212,867 cattle arriving in a Midwestern feedlot between 2001 and 2006. An economic model was created to estimate net returns. Generalized linear mixed models were used to determine associations between the frequency of BRD treatments and other demographic variables with economic and performance outcomes. Net returns decreased with increasing number of treatments for BRD. However, the magnitude depended on the season during which cattle arrived at the feedlot, with significantly higher returns for cattle arriving during fall and summer than for cattle arriving during winter and spring. For fall arrivals, there were higher mean net returns for cattle that were never treated ($39.41) than for cattle treated once ($29.49), twice ($16.56), or ≥ 3 times (-$33.00). For summer arrivals, there were higher least squares mean net returns for cattle that were never treated ($31.83) than for cattle treated once ($20.22), twice ($6.37), or ≥ 3 times ($-42.56). Carcass traits pertaining to weight and quality grade were deemed responsible for differences in net returns among cattle receiving different numbers of treatments after an initial diagnosis of BRD. Differences in economic net returns and performance outcomes for feedlot cattle were determined on the basis of number of treatments after an initial diagnosis of BRD; the analysis accounted for the season of arrival, sex, and weight class.

  6. Economic bid evaluation

    International Nuclear Information System (INIS)

    Bode, T.

    1975-01-01

    When it is intended to install a new nuclear power station, the usual procedure is to invite for tenders. In due course, bids will be received from various manufacturers, out of which the most favourable one is then to be selected. Appraisal is concluded in the Economic Bid Evaluation, the purpose of which is to define the economically most favourable bid by comparing overall costs and benefits of the various alternatives. Thus, Economic Bid Evaluation is a most important instrument for deciding on award of contract. (orig.) [de

  7. MICE or NICE? An economic evaluation of clinical decision rules in the diagnosis of heart failure in primary care.

    Science.gov (United States)

    Monahan, Mark; Barton, Pelham; Taylor, Clare J; Roalfe, Andrea K; Hobbs, F D Richard; Cowie, Martin; Davis, Russell; Deeks, Jon; Mant, Jonathan; McCahon, Deborah; McDonagh, Theresa; Sutton, George; Tait, Lynda

    2017-08-15

    Detection and treatment of heart failure (HF) can improve quality of life and reduce premature mortality. However, symptoms such as breathlessness are common in primary care, have a variety of causes and not all patients require cardiac imaging. In systems where healthcare resources are limited, ensuring those patients who are likely to have HF undergo appropriate and timely investigation is vital. A decision tree was developed to assess the cost-effectiveness of using the MICE (Male, Infarction, Crepitations, Edema) decision rule compared to other diagnostic strategies to identify HF patients presenting to primary care. Data from REFER (REFer for EchocaRdiogram), a HF diagnostic accuracy study, was used to determine which patients received the correct diagnosis decision. The model adopted a UK National Health Service (NHS) perspective. The current recommended National Institute for Health and Care Excellence (NICE) guidelines for identifying patients with HF was the most cost-effective option with a cost of £4400 per quality adjusted life year (QALY) gained compared to a "do nothing" strategy. That is, patients presenting with symptoms suggestive of HF should be referred straight for echocardiography if they had a history of myocardial infarction or if their NT-proBNP level was ≥400pg/ml. The MICE rule was more expensive and less effective than the other comparators. Base-case results were robust to sensitivity analyses. This represents the first cost-utility analysis comparing HF diagnostic strategies for symptomatic patients. Current guidelines in England were the most cost-effective option for identifying patients for confirmatory HF diagnosis. The low number of HF with Reduced Ejection Fraction patients (12%) in the REFER patient population limited the benefits of early detection. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  8. Discounting in Economic Evaluations.

    Science.gov (United States)

    Attema, Arthur E; Brouwer, Werner B F; Claxton, Karl

    2018-05-19

    Appropriate discounting rules in economic evaluations have received considerable attention in the literature and in national guidelines for economic evaluations. Rightfully so, as discounting can be quite influential on the outcomes of economic evaluations. The most prominent controversies regarding discounting involve the basis for and height of the discount rate, whether costs and effects should be discounted at the same rate, and whether discount rates should decline or stay constant over time. Moreover, the choice for discount rules depends on the decision context one adopts as the most relevant. In this article, we review these issues and debates, and describe and discuss the current discounting recommendations of the countries publishing their national guidelines. We finish the article by proposing a research agenda.

  9. Economic evaluation manual

    Energy Technology Data Exchange (ETDEWEB)

    1975-09-01

    An economic analysis on oil or gas property is generally accompanied by a reservoir analysis which predicts the reserves and the performance of the reservoir, recommends the optimum economic method with which to recover the reserves, and through a performance prediction indicates a time schedule for future investments and income. The requirements for a reservoir evaluation are as follows: (1) good reservoir data; (2) oil in place; (3) reservoir energy, both primary and secondary; and (4) reserve calculation and performance predictions for giving both production schedule and selection of secondary recovery mechanisms. Given the above reservoir evaluation parameters, the following are requirements for a complete economic analysis: (1) lease exploration and purchase costs; (2) capital investments schedule dependent upon a reservoir performance prediction; and (3) factors affecting net income such as anticipated selling price of oil and gas and the availability of a market, operating costs and working interest, royalty schedule, depreciation methods, depletion methods and tax schedule. (71 refs.)

  10. An economic evaluation of positron emission tomography (PET) and positron emission tomography/computed tomography (PET/CT) for the diagnosis of breast cancer recurrence.

    Science.gov (United States)

    Auguste, P; Barton, P; Hyde, C; Roberts, T E

    2011-04-01

    To review the published economic studies that have evaluated positron emission tomography/computed tomography (PET/CT) in the treatment of recurrent breast cancer, and to develop and carry out a model-based economic evaluation to investigate the relative cost-effectiveness of PET/CT to detect breast cancer recurrence compared with conventional work-up. A systematic review of economic and diagnostic evidence for PET/CT in diagnosis of breast cancer recurrence. The original databases searched include MEDLINE (Ovid) (1950 to week 5 May 2009), EMBASE (Ovid) (1980 to 2009 week 22) and the NHS Economic Evaluation Database. An updated search was conducted for each database from May 2009 to week 4 April 2010. A decision tree was developed in TREEAGE software (TreeAge Software Inc., Williamstown, MA, USA). The relevant data on accuracy, sensitivity and specificity of each diagnostic test were linked in the model, to costs and the primary outcome measure, cost per quality-adjusted life-year (QALY). The model estimated the mean cost associated with each diagnostic procedure and assumed that patients entering the model were aged 50-75 years. The results of the cost-effectiveness analysis are presented in terms of the incremental cost-effectiveness ratios (ICERs). The ICER for the strategy of PET compared with conventional work-up was estimated at £29,300 per QALY; the ICER for PET/CT compared with PET was £ 31,000 per QALY; and the ICER for PET/CT combined with conventional work-up versus PET/CT was £ 42,100. Clearly, for each additional diagnostic test that is added to PET, the more expensive the package becomes, but also the more effective it becomes in terms of QALYs gained. The probabilistic sensitivity analysis shows that at a willingness-to-pay threshold of £ 20,000 per QALY, conventional work-up is the preferred option. Only data from indirect comparisons are available from the accuracy review, and there is some uncertainty about whether the data defining the

  11. Economic evaluation of reprocessing

    International Nuclear Information System (INIS)

    1979-02-01

    This paper presents a progress report of work undertaken relevant to the economic evaluation of reprocessing. It sets out the assumptions to be made for the preparation of the economic ''phase diagram'' - a plot of fast reactor premium against uranium (U 3 O 8 ) price. The paper discusses the assumptions to be made in respect of present worth methodology, LWR fuel logistics, U 3 O 8 price, enrichment tails, plutonium values, fast reactor premium and proposes a set of reference costs to be used for the preparation of the phase diagram

  12. Health-economic evaluation of magnetic resonance imaging before biopsy for diagnosis of prostate cancer; Gesundheitsoekonomische Evaluation einer Magnetresonanzbildgebung vor Biopsie zur Diagnose von Prostatakarzinomen

    Energy Technology Data Exchange (ETDEWEB)

    Stadlbauer, A.; Salomonowitz, E. [Landesklinikum St. Poelten (Austria). Zentrales Inst. fuer Radiologie, Diagnostik und Interventionelle Therapie; Bernt, R. [Hanusch Krankenhaus, Vienna (Austria). Zentralroentgeninst.; Plas, E. [Hanusch Krankenhaus, Vienna (Austria). Abt. fuer Urologie; Strunk, G. [Technische Univ. Dortmund (Germany). Wirtschaftswissenschaft und Oekonomische Bildung; Eberhardt, K. [Krankenhaus Schloss Werneck, Werneck (Germany). MRT-Kompetenzzentrum

    2011-10-15

    The aim of this study was the health-economic analysis of MR imaging in the diagnostics of suspicious prostate carcinoma (PCa) before execution of a first biopsy. The health-economic analysis included four steps: modeling, determination of probabilities, evaluation, and sensitivity analyses. We performed an effectiveness analysis from the patient perspective as well as a cost-effectiveness and a cost-utility analysis from the health insurance perspective for Austria and Germany. The effectiveness and cost-effectiveness analysis used a hypothetical cohort of 100 000 patients. The result parameters were number of biopsies, number of detected PCa, and monetary costs. For the cost-efficiency analysis, the result parameters, quality-adjusted life years (QALYs) and costs, were calculated for an individual patient. The efficiency analysis showed that MRI before a first biopsy can prevent ca. 64 000 unnecessary biopsies/ 100 000 patients. The diagnostic efficiency was higher by a factor of 1.7. Due to MRI, eight PCas were additionally detected. From a health insurance perspective, MRI was not cost-effective. Extra costs of ca. 42 m. Euro per 100 000 patients and of 650 Euro per prevented biopsy were calculated. The costs per detected PCa were increased by 1395 Euro. The attainable QALYs were a little higher for the MRI alternative, which was therefore not dominated. Our results do not permit a clear recommendation for or against the application of MRI in the diagnostics of PCa. From the patient perspective, it is to be endorsed due to the higher medical efficiency. However, it is connected with higher health insurance costs. (orig.)

  13. Social environmental and economic evaluation diagnosis through application of MADSA (Social and Environmental Evaluation Matrix) customization; Diagnostico de desempenho socioambiental e economico por meio da customizacao da MADSA (Matriz para Avaliacao de Desempenho Socioambiental)

    Energy Technology Data Exchange (ETDEWEB)

    Ziliotto, Marco Aurelio B.; Villa, Alessandra T.; Padilha, Simone L. Vieira; Canaverde, Patricia Margue [Instituto ECOPLAN, General Carneiro, PR (Brazil); Sanqueta, Carlos Roberto [Universidade Federal do Parana (UFPR), Curitiba, PR (Brazil)

    2004-07-01

    The present paper reports a social, environment and economic diagnosis in an oil and energy organization, in the enlargement of its plant. Attending to some previous requirements made by this company, the diagnosis was accomplished making use of an innovative evaluation tool called MADSA{sup R} (Social and Environmental Evaluation Matrix). Through the customization of this tool, it was possible to evaluate, systematically, the performance of the engaged companies hired by the organization to implement its enterprise, based on proposed actions in QSMS - Quality, Safety, Environment and Health. The performance evaluation was supported by the employees', the organization, its clients' and the local community perception. MADSA{sup R} methodology made it possible to measure the accomplished gain through proposed actions. The development of a performance indicator allowed the comparison between achieved results and accomplished investments. It was concluded that MADSA{sup R} provided subsidies to elaborate an action plan to improve the organization achievements, since it was able to represent the strategy of the organization, to guide and standardize actions, to identify and quantify points to be made better of. (author)

  14. Economic evaluation of reprocessing

    International Nuclear Information System (INIS)

    1978-11-01

    This discussion paper first identifies the main factors which influence the economic assessment of reprocessing. It proposes the use of a diagram - the so-called ''phase diagram'' - which plots the fast reactor premium against the price of uranium. The diagram delineates areas where the once-through fuel cycle, thermal recycle and fast reactor will be the preferred choice from micro-economic considerations. The paper then goes on to consider the circumstances under which a country may or may not wish to introduce thermal recycle or fast reactors. Finally, a procedure for further discussion on economic considerations with WG4 is proposed

  15. Health Economic Evaluation of Telehealthcare

    DEFF Research Database (Denmark)

    Udsen, Flemming Witt

    for decision making meant to inform adaptation of the health economic evaluation approach. Based on developments in realist evaluation and experiences with conducting the evaluation of TeleCare North, four principles for health economic evaluation of complex telehealthcare interventions is outlined in order....... The results from the TeleCare North trial were used directly in a national decision to implement the telehealthcare solution to patients with severe COPD in Denmark and lead to considerable debate nationally. This debate could be viewed as an actual account of the usefulness of health economic evaluation...

  16. Optical coherence tomography for the diagnosis, monitoring and guiding of treatment for neovascular age-related macular degeneration: a systematic review and economic evaluation.

    Science.gov (United States)

    Mowatt, Graham; Hernández, Rodolfo; Castillo, Mayret; Lois, Noemi; Elders, Andrew; Fraser, Cynthia; Aremu, Olatunde; Amoaku, Winfried; Burr, Jennifer; Lotery, Andrew; Ramsay, Craig; Azuara-Blanco, Augusto

    2014-12-01

    Age-related macular degeneration is the most common cause of sight impairment in the UK. In neovascular age-related macular degeneration (nAMD), vision worsens rapidly (over weeks) due to abnormal blood vessels developing that leak fluid and blood at the macula. To determine the optimal role of optical coherence tomography (OCT) in diagnosing people newly presenting with suspected nAMD and monitoring those previously diagnosed with the disease. Databases searched: MEDLINE (1946 to March 2013), MEDLINE In-Process & Other Non-Indexed Citations (March 2013), EMBASE (1988 to March 2013), Biosciences Information Service (1995 to March 2013), Science Citation Index (1995 to March 2013), The Cochrane Library (Issue 2 2013), Database of Abstracts of Reviews of Effects (inception to March 2013), Medion (inception to March 2013), Health Technology Assessment database (inception to March 2013). Types of studies: direct/indirect studies reporting diagnostic outcomes. time domain optical coherence tomography (TD-OCT) or spectral domain optical coherence tomography (SD-OCT). clinical evaluation, visual acuity, Amsler grid, colour fundus photographs, infrared reflectance, red-free images/blue reflectance, fundus autofluorescence imaging, indocyanine green angiography, preferential hyperacuity perimetry, microperimetry. Reference standard: fundus fluorescein angiography (FFA). Risk of bias was assessed using quality assessment of diagnostic accuracy studies, version 2. Meta-analysis models were fitted using hierarchical summary receiver operating characteristic curves. A Markov model was developed (65-year-old cohort, nAMD prevalence 70%), with nine strategies for diagnosis and/or monitoring, and cost-utility analysis conducted. NHS and Personal Social Services perspective was adopted. Costs (2011/12 prices) and quality-adjusted life-years (QALYs) were discounted (3.5%). Deterministic and probabilistic sensitivity analyses were performed. In pooled estimates of diagnostic studies

  17. Economic evaluation of reprocessing

    International Nuclear Information System (INIS)

    This paper, which also appears as an Appendix to the Final Working Group 4 report, considers the economics of the four basic options available in nuclear programmes namely: the once-through cycle; reprocessing with uranium recycle and plutonium storage; reprocessing with both uranium and plutonium recycle; and the fast reactor. These options are represented by four separate areas on a ''phase diagram'' showing the relationship between relative generating costs and uranium ore price. The basic algebra defining each component of electricity cost is given for each option. The diagram can take different forms depending upon the relative magnitudes of the costs of reprocessing and MOX fuel fabrication and whether the once-through fuel cycle is acceptable or not on grounds other than strictly economic, i.e. environmental grounds. The shortcomings of this form of presentation are also identified

  18. Presentation of economic evaluation results.

    Science.gov (United States)

    Chaikledkaew, Usa

    2014-05-01

    The first HTA guidelines for Thailand included a chapter outlining a set of guidelines on how best to report the findings of health economic evaluations, based on a review of best practice and existing guidelines on the presentation of economic evaluation results from around the world. In this second edition of HTA guidelines for Thailand, the recommendations build on the first edition by using a case study to illustrate how the guidelines can be applied in a real research context. The guidelines propose that all reporting include ten key elements: defining the scope of the study, selection of comparator(s), defining the type of economic evaluation, measurement of costs, measurement of clinical effects, handling time in economic evaluation studies, handling uncertainty and sensitivity analysis, presentation of the results, discussion of the results, and disclosure of funding and authors conflict of interest.

  19. Economic evaluation of KALIMER

    Energy Technology Data Exchange (ETDEWEB)

    Moon, Kee Hwan

    1997-01-01

    The main results of this study are as follows. To estimate the economic feasibility of KALIMER, the cost estimate model has been developed by using MS Excel software. Two scenarios were considered in this study. Scenario-A is composed of KALIMER options, which have FC1B (first commercial plant with 1 block), FC3B (first commercial plant with 3 blocks), NOAK1B (Nth-of-a-kind plant with 1 block), NOAK3B(Nth-of-a-kind plant with 3 blocks). The size of each block is 333 MWe. Scenario-B is comprised of PWR options, which have existing PWRs and new concepts of advanced PWR (APWR) in order to compare with KALIMER options. According to the results, the specific capital cost ($/kWe) and the levelized busbar cost (mills/kWh) for the NOAK3B option are 11% and 12% lower than that of FC3B option, respectively. These results from learning effects, scaling factors and some reductions of material and labor requirements for the NOAK3B option. And the levelized capital cost of NOAK3B option is 17%, 6% lower than that of existing PWR and APWR option, respectively. These results form shorten of construction times and labor requirements, modularization and design simplications etc. Therefore, decision and policy maker related to KALIMER development must note through the results of this study that multi-blocks design concept for its commercial plant should be considered to get the economy of scale effects. KALIMER has high competitiveness comparing to the existing PWRs and APWR. Therefore, it should be considered as a power supply option in the future in Korea. (author). 7 refs., 17 tabs., 7 figs.

  20. Economic evaluation of KALIMER

    International Nuclear Information System (INIS)

    Moon, Kee Hwan.

    1997-01-01

    The main results of this study are as follows. To estimate the economic feasibility of KALIMER, the cost estimate model has been developed by using MS Excel software. Two scenarios were considered in this study. Scenario-A is composed of KALIMER options, which have FC1B (first commercial plant with 1 block), FC3B (first commercial plant with 3 blocks), NOAK1B (Nth-of-a-kind plant with 1 block), NOAK3B(Nth-of-a-kind plant with 3 blocks). The size of each block is 333 MWe. Scenario-B is comprised of PWR options, which have existing PWRs and new concepts of advanced PWR (APWR) in order to compare with KALIMER options. According to the results, the specific capital cost ($/kWe) and the levelized busbar cost (mills/kWh) for the NOAK3B option are 11% and 12% lower than that of FC3B option, respectively. These results from learning effects, scaling factors and some reductions of material and labor requirements for the NOAK3B option. And the levelized capital cost of NOAK3B option is 17%, 6% lower than that of existing PWR and APWR option, respectively. These results form shorten of construction times and labor requirements, modularization and design simplications etc. Therefore, decision and policy maker related to KALIMER development must note through the results of this study that multi-blocks design concept for its commercial plant should be considered to get the economy of scale effects. KALIMER has high competitiveness comparing to the existing PWRs and APWR. Therefore, it should be considered as a power supply option in the future in Korea. (author). 7 refs., 17 tabs., 7 figs

  1. Health economic evaluation in Greece.

    Science.gov (United States)

    Rovithis, Dimitrios

    2006-01-01

    There is a growing volume of literature on health economic evaluation, with this form of analysis becoming increasingly influential at the decision-making level worldwide. The purpose of this study was to review the current state of health economic evaluation in Greece, with a view to uncovering reasons why its use in this country is limited. A search of the NHS Economic Evaluation Database was undertaken. The search included cost, cost-of-illness, cost-minimization, cost-effectiveness, cost-consequences, cost-utility, and cost-benefit analyses and was narrowed only to Greek authors undertaking solo or joint health economic evaluation in Greece. The search revealed that, in Greece, very little health economic evaluation has been undertaken. The main reason for the lack of interest is that the current chaotic healthcare system structure and financing does not provide the appropriate incentives to stimulate a powerful interest in this type of research. This condition is a result of the lack of a long-term national health policy and the hesitation of the present and past Greek governments to date to proceed to large-scale reforms because of political considerations. The Greek governments have also been content with the good health indicators being achieved. Even if it is accepted that good health prevails in Greece, slower economic growth rates, an ageing population, and the continuous immigration will place increasing pressure on healthcare resources and will necessitate a more rational use of these resources. Health economic evaluation, by weighing benefits against costs, therefore, has an important role to play.

  2. Economic evaluation of fast breeders

    International Nuclear Information System (INIS)

    Vieider, G.

    1979-03-01

    In order to clarify discrepancies between different contributions to INFCE SG-5A concerning economic assessments of FBRs an independent evaluation is performed with assumptions typical for the current views in Europe and USA. As a result bounding cases are shown for the influence of the natural uranium price on the permitted FBR-capital cost premium for break-even with LWRs

  3. Public health interventions: evaluating the economic evaluations

    Directory of Open Access Journals (Sweden)

    Martin Forster

    2013-10-01

    Full Text Available Recent years have witnessed much progress in the incorporation of economic considerations into the evaluation of public health interventions. In England, the Centre for Public Health Excellence within the National Institute for Health and Care Excellence works to develop guidance for preventing illness and assessing which public health interventions are most effective and provide best value for money...

  4. Health economic evaluation in England.

    Science.gov (United States)

    Raftery, James

    2014-01-01

    The 2010 National Health Service Constitution for England specified rights and responsibilities, including health economic evaluation for the National Institute for Health and Care Excellence (NICE) and the Joint Committee on Vaccinations and Immunisations. The National Screening Committee and the Health Protection Agency also provide advice to the Government based on health economic evaluation. Each agency largely follows the methods specified by NICE. To distinguish the methods from neoclassical economics they have been termed "extra-welfarist". Key differences include measurement and valuation of both benefits (QALYs) and costs (healthcare related). Policy on discounting has also changed over time and by agency. The debate over having NICE's methods align more closely with neoclassical economics has been prominent in the ongoing development of "value based pricing". The political unacceptability of some decisions has led to special funding for technologies not recommended by NICE. These include the 2002 Multiple Sclerosis Risk Sharing Scheme and the 2010 Cancer Drugs Fund as well as special arrangements for technologies linked to the end of life and for innovation. Since 2009 Patient Access Schemes have made price reductions possible which sometimes enables drugs to meet NICE's cost-effectiveness thresholds. As a result, the National Health Service in England has denied few technologies on grounds of cost-effectiveness. Copyright © 2014. Published by Elsevier GmbH.

  5. Costing bias in economic evaluations.

    Science.gov (United States)

    Frappier, Julie; Tremblay, Gabriel; Charny, Mark; Cloutier, L Martin

    2015-01-01

    Determining the cost-effectiveness of healthcare interventions is key to the decision-making process in healthcare. Cost comparisons are used to demonstrate the economic value of treatment options, to evaluate the impact on the insurer budget, and are often used as a key criterion in treatment comparison and comparative effectiveness; however, little guidance is available to researchers for establishing the costing of clinical events and resource utilization. Different costing methods exist, and the choice of underlying assumptions appears to have a significant impact on the results of the costing analysis. This editorial describes the importance of the choice of the costing technique and it's potential impact on the relative cost of treatment options. This editorial also calls for a more efficient approach to healthcare intervention costing in order to ensure the use of consistent costing in the decision-making process.

  6. Economic and Financial Diagnosis - Fundamental Method in Management Accounting

    Directory of Open Access Journals (Sweden)

    Riana Iren RADU

    2012-11-01

    Full Text Available The purpose of the „financial analysis - financial diagnosis phrase is to characterize in a more relevant and more conservative manner the company situation, in order to develop, based on optimal decisions for the establishment and use of resources” . Analysis of company's financial position at a time, usually at the end of the year, permits to assess the size and development of heritage, and making judgments on how to achieve financial balance. In this paper an analysis is made based on diagnostic key economic and financial indicators, calculated using information from the balance sheet and profit and loss account in the period 2006-2011 to Navrom Company Galati, to can measurable effects of the economic crisis on the company.

  7. Health economic evaluation: important principles and methodology.

    Science.gov (United States)

    Rudmik, Luke; Drummond, Michael

    2013-06-01

    To discuss health economic evaluation and improve the understanding of common methodology. This article discusses the methodology for the following types of economic evaluations: cost-minimization, cost-effectiveness, cost-utility, cost-benefit, and economic modeling. Topics include health-state utility measures, the quality-adjusted life year (QALY), uncertainty analysis, discounting, decision tree analysis, and Markov modeling. Economic evaluation is the comparative analysis of alternative courses of action in terms of both their costs and consequences. With increasing health care expenditure and limited resources, it is important for physicians to consider the economic impact of their interventions. Understanding common methodology involved in health economic evaluation will improve critical appraisal of the literature and optimize future economic evaluations. Copyright © 2012 The American Laryngological, Rhinological and Otological Society, Inc.

  8. Economic evaluation of CISM : a pilot study

    DEFF Research Database (Denmark)

    Vogt, Joachim

    2004-01-01

    air traffic controllers, critical incident stress management, CISM, critical incidents, critical incident stress, cost-benefit-analysis, economic evaluation, efficiency, return on investment......air traffic controllers, critical incident stress management, CISM, critical incidents, critical incident stress, cost-benefit-analysis, economic evaluation, efficiency, return on investment...

  9. Unpaid work in health economic evaluations.

    Science.gov (United States)

    Krol, Marieke; Brouwer, Werner

    2015-11-01

    Given its societal importance, unpaid work should be included in economic evaluations of health care technology aiming to take a societal perspective. However, in practice this does not often appear to be the case. This paper provides an overview of the current place of unpaid work in economic evaluations in theory and in practice. It does so first by summarizing recommendations regarding the inclusion of unpaid labor reported in health economic textbooks and national guidelines for economic evaluations. In total, three prominent health economic text-books were studied and 28 national health economic guidelines. The paper, moreover, provides an overview of the instruments available to measure lost unpaid labor and reports on a review of the place of unpaid labor in applied economic evaluations in the area of rheumatoid arthritis. The review was conducted by examining methodology of evaluations published between 1 March 2008 and 1 March 2013. The results of this study show that little guidance is offered regarding the inclusion of unpaid labor in economic evaluations in textbooks and guidelines. The review identified five productivity costs instruments including questions about unpaid work and 33 economic evaluations of treatments for rheumatoid arthritis of which only one included unpaid work. The results indicate that unpaid work is rarely included in applied economic evaluations of treatments for rheumatoid arthritis, despite this disease expecting to be associated with lost unpaid work. Given the strong effects of certain diseases and treatments on the ability to perform unpaid work, unpaid work currently receives less attention in economic evaluations than it deserves. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. ECONOMIC THEORY OF LOBBYING: EVALUATION OF ECONOMIC EFFICIENCY

    Directory of Open Access Journals (Sweden)

    Павел Александрович Толстых

    2013-04-01

    Full Text Available In this article the author continues to analyze lobbying with regards to economic paradigm. [The author has started discussing lobbying in terms of economic theory in the article Politico-economic theory of lobbying / / Historical, philosophical, political and legal sciences, culture and art. Theory and practice. Tambov: Gramota, 2013. No 1. Part 2. p. 177-189.] Researcher evaluates the cost effectiveness of the lobbying function. Lobbying is understood as activity of specifically authorized employees of corporations and lobbying firms representing their interests, trade associations. This activity is aimed at improving the profitability of integrated and sustainable business development by representing  long-term, comfortable, predictable system of relationships with the relevant field-specific political stakeholders of the federal and regional levels. The article presents an in-depth analysis of economic concepts of lobbying function.DOI: http://dx.doi.org/10.12731/2218-7405-2013-1-3

  11. ECONOMIC THEORY OF LOBBYING: EVALUATION OF ECONOMIC EFFICIENCY

    Directory of Open Access Journals (Sweden)

    Tolstyh Pavel Aleksandrovich

    2013-01-01

    Full Text Available In this article the author continues to analyze lobbying with regards to economic paradigm. [The author has started discussing lobbying in terms of economic theory in the article Politico-economic theory of lobbying / / Historical, philosophical, political and legal sciences, culture and art. Theory and practice. Tambov: Gramota, 2013. No 1. Part 2. p. 177-189.] Researcher evaluates the cost effectiveness of the lobbying function. Lobbying is understood as activity of specifically authorized employees of corporations and lobbying firms representing their interests, trade associations. This activity is aimed at improving the profitability of integrated and sustainable business development by representing long-term, comfortable, predictable system of relationships with the relevant field-specific political stakeholders of the federal and regional levels. The article presents an in-depth analysis of economic concepts of lobbying function.

  12. Economic consequences of over-diagnosis of threatened preterm labor.

    Science.gov (United States)

    Coloma, Marta; Kang, Fatima; Vallejo-Torres, Laura; Díaz, Paloma; Méndez, Yurena; Álvarez de la Rosa, Margarita

    2018-05-01

    To investigate whether adherence to a cervical length-based protocol can reduce both unnecessary admissions and the socioeconomic costs associated with inappropriately admitted patients. The present retrospective observational study included women admitted for threatened preterm labor (TPL) at 24-34 weeks of pregnancy to a tertiary hospital in the Canary Islands, 2009-2014. Data were reviewed from all patients admitted for TPL. Those with a long cervix (>25 mm) were classified as "inappropriate admissions", and both the economic burden based on diagnosis-related group (DRG) and the social costs associated with sick leave for these women were calculated. During the 6-year study period, 430 women were admitted for TPL. The rate of inappropriate hospital admissions was 45% in the first year, but was reduced to 23% in the final year (P2099. The total annual costs from inappropriate admission (both social security sick leave costs and hospital costs) were estimated to be up to €571 047.37 during the 6-year study period, and reduced from €60 420.76 in 2009 to €29 998.04 in 2014. Reductions in inappropriate admissions from applying cervical length-based management protocol could reduce healthcare costs without increasing the incidence of premature delivery. © 2018 International Federation of Gynecology and Obstetrics.

  13. Economic evaluation of integrated care: an introduction

    Directory of Open Access Journals (Sweden)

    Hindrik Vondeling

    2004-03-01

    Full Text Available Background: Integrated care has emerged in a variety of forms in industrialised countries during the past decade. It is generally assumed that these new arrangements result in increased effectiveness and quality of care, while being cost-effective or even cost-saving at the same time. However, systematic evaluation, including an evaluation of the relative costs and benefits of these arrangements, has largely been lacking. Objectives: To stimulate fruitful dialogue and debate about the need for economic evaluation in integrated care, and to outline possibilities for undertaking economic appraisal studies in this relatively new field. Theory: Key concepts, including e.g. scarcity and opportunity costs, are introduced, followed by a brief overview of the most common methods used in economic evaluation of health care programmes. Then a number of issues that seem particularly relevant for economic evaluation of integrated care arrangements are addressed in more detail, illustrated with examples from the literature. Conclusion and discussion: There is a need for well-designed economic evaluation studies of integrated care arrangements, in particular in order to support decision making on the long-term financing of these programmes. Although relatively few studies have been done to date, the field is challenging from a methodological point of view, offering analysts a wealth of opportunities. Guidance to realise these opportunities is provided by the general principles for economic evaluation, which can be tailored to the requirements of this particular field.

  14. Belgian guidelines for economic evaluations: second edition.

    Science.gov (United States)

    Thiry, Nancy; Neyt, Mattias; Van De Sande, Stefaan; Cleemput, Irina

    2014-12-01

    The aim of this study was to present the updated methodological guidelines for economic evaluations of healthcare interventions (drugs, medical devices, and other interventions) in Belgium. The update of the guidelines was performed by three Belgian health economists following feedback from users of the former guidelines and personal experience. The updated guidelines were discussed with a multidisciplinary team consisting of other health economists, assessors of reimbursement request files, representatives of Belgian databases and representatives of the drugs and medical devices industry. The final document was validated by three external validators that were not involved in the previous discussions. The guidelines give methodological guidance for the following components of an economic evaluation: literature review, perspective of the evaluation, definition of the target population, choice of the comparator, analytic technique and study design, calculation of costs, valuation of outcomes, definition of the time horizon, modeling, handling uncertainty and discounting. We present a reference case that can be considered as the minimal requirement for Belgian economic evaluations of health interventions. These guidelines will improve the methodological quality, transparency and uniformity of the economic evaluations performed in Belgium. The guidelines will also provide support to the researchers and assessors performing or evaluating economic evaluations.

  15. Chronic diarrhea. Diagnosis and clinical evaluation

    International Nuclear Information System (INIS)

    Pineda O, Luis F; Otero R, William; Arbelaez M, Victor

    2004-01-01

    Chronic diarrhea is a syndrome of great clinical complexity, which is frequently encountered by general physicians, internists and gastroenterologists. Differential diagnosis is very broad and sometime finding the precise cause can be difficult, expensive and frustration. Literature published about this topic lack, in general, adequate controlled studies and for this reason recommendations for diagnostic evaluation and treatment are based upon series of cases, experience of the institutions or expert opinion and not on reasonable evidence. On the other hand, many of the classical diagnostic tests that have survived until now were designed over physiologic foundations and have not been validated extensively with the precision of a clinical test. This limits its acceptance, application and standardization in the daily practice. There is not a general agreement about diagnosis and treatment of chronic diarrhea and many of the experts divert recommendation about their recommendations. The purpose of this paper is to define some general guidelines about the clinical evaluation of patients with chronic diarrhea that lead us to a rational approach based upon clinical trials and the appropriate use of the many different tests

  16. Utilities' nuclear fuel economic evaluation methods

    International Nuclear Information System (INIS)

    Sonz, L.A.

    1987-01-01

    This paper presents the typical perceptions, methods, considerations, and procedures used by an operating electric utility in the economic evaluation of nuclear fuel preparation and utilization scenarios. The means given are probably not an exclusive review of those available, but are the author's recollection of systems employed to select and recommend preferable courses of action. Economic evaluation of proposed nuclear fuel scenarios is an important, but not exclusive, means of deciding on corporate action. If the economic evaluation is performed and coordinated with the other corporate considerations, such as technical and operational ability, electrical system operations management, tax effects, capital management, rates impact, etc., then the resultant recommendation may be employed to the benefit of the customers and, consequently, to the corporation

  17. Conducting systematic reviews of economic evaluations.

    Science.gov (United States)

    Gomersall, Judith Streak; Jadotte, Yuri Tertilus; Xue, Yifan; Lockwood, Suzi; Riddle, Dru; Preda, Alin

    2015-09-01

    In 2012, a working group was established to review and enhance the Joanna Briggs Institute (JBI) guidance for conducting systematic review of evidence from economic evaluations addressing a question(s) about health intervention cost-effectiveness. The objective is to present the outcomes of the working group. The group conducted three activities to inform the new guidance: review of literature on the utility/futility of systematic reviews of economic evaluations and consideration of its implications for updating the existing methodology; assessment of the critical appraisal tool in the existing guidance against criteria that promotes validity in economic evaluation research and two other commonly used tools; and a workshop. The debate in the literature on the limitations/value of systematic review of economic evidence cautions that systematic reviews of economic evaluation evidence are unlikely to generate one size fits all answers to questions about the cost-effectiveness of interventions and their comparators. Informed by this finding, the working group adjusted the framing of the objectives definition in the existing JBI methodology. The shift is away from defining the objective as to determine one cost-effectiveness measure toward summarizing study estimates of cost-effectiveness and informed by consideration of the included study characteristics (patient, setting, intervention component, etc.), identifying conditions conducive to lowering costs and maximizing health benefits. The existing critical appraisal tool was included in the new guidance. The new guidance includes the recommendation that a tool designed specifically for the purpose of appraising model-based studies be used together with the generic appraisal tool for economic evaluations assessment to evaluate model-based evaluations. The guidance produced by the group offers reviewers guidance for each step of the systematic review process, which are the same steps followed in JBI reviews of other

  18. National Economic Conditions and Patient Insurance Status Predict Prostate Cancer Diagnosis Rates and Management Decisions.

    Science.gov (United States)

    Weiner, Adam B; Conti, Rena M; Eggener, Scott E

    2016-05-01

    The recent Great Recession from December 2007 to June 2009 presents a unique opportunity to examine whether the incidence of nonpalpable prostate cancer decreases while conservative management for nonpalpable prostate cancer increases during periods of national economic hardship. We derived rates of national monthly diagnosis and conservative management for screen detected, nonpalpable prostate cancer and patient level insurance status from the SEER (Surveillance, Epidemiology and End Results) database from 2004 to 2011. We derived monthly statistics on national unemployment rates, inflation, median household income and S&P 500® closing values from government sources. Using linear and logistic multivariable regression we measured the correlation of national macroeconomic conditions with prostate cancer diagnosis and treatment patterns. We evaluated patient level predictors of conservative management to determine whether being insured by Medicaid or uninsured increased the use of conservative management. Diagnosis rates correlated positively with the S&P 500 monthly close (coefficient 24.90, 95% CI 6.29-43.50, p = 0.009). Conservative management correlated negatively with median household income (coefficient -49.13, 95% CI -69.29--28.98, p management compared to that in men with private insurance. As indicated by a significant interaction term being diagnosed during the Great Recession increased the Medicaid insurance predictive value of conservative management (OR 1.30, 95% CI 1.02-1.68, p = 0.037). National economic hardship was associated with decreased diagnosis rates of nonpalpable prostate cancer and increased conservative management. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  19. THE RELEVANCE OF THE PERFORMANCE INDICATORS IN ECONOMIC AND FINANCIAL DIAGNOSIS

    Directory of Open Access Journals (Sweden)

    MIRELA MONEA

    2011-01-01

    Full Text Available Each company must achieve the objectives to reach performance in order to survive on the market. The paper aims to present the concept of performance as is seen in economic literature, to discuss the relevance of the main performances indicators on economic and financial diagnosis, to answer the question what are the main indicators which reflect economic or financial performances: profit, profitability ratios, economic added value, investments return, liquidity, cash-flows, resources efficiency, productivity, others.

  20. Understanding the essentials of economic evaluation.

    Science.gov (United States)

    Schmid, G P

    1995-01-01

    Economic evaluation (EE) answers the following simple question: "From which course of action do we get the most value for our money?" We ask this question because resources are always limited, i.e., we never have enough money to do all the things we would like to do. Three types of economic evaluations are used: cost-effectiveness analysis, cost-utility analysis, and cost-benefit analysis. Although all involve a monetary and outcome comparison of two or more courses of action, the methodologies and outcomes of each type vary, making each one particularly suited for specific and different indications. Although the performance of an EE may be complex, its concept is intuitively simple. Understanding the basic elements of economic analysis is more and more important to all health-care providers because health-care policy makers at all levels are increasingly using EE for allocating resources.

  1. Economic assessment of preeclampsia : Screening, diagnosis, treatment options, and long term outcomes, a systematic review

    NARCIS (Netherlands)

    Zakiyah, N.; Van Asselt, A.; Baker, P.; Postma, M.J.

    2014-01-01

    Objectives: To provide a comprehensive overview of the existing evidence on the health economics of screening, diagnosis, and treatment options in preeclampsia. Methods: A systematic literature search was undertaken using three electronic databases (MEDLINE, Embase, Cochrane) to identify all English

  2. Economic assessment of preeclampsia : Screening, diagnosis, treatment options, and long term outcomes - A systematic review

    NARCIS (Netherlands)

    Zakiyah, Neily; Van Asselt, Antoinette D.; Baker, Philip N.; Postma, Maarten J.

    OBJECTIVES: Provide a comprehensive overview of the existing evidence on the health economics of screening, diagnosis, and treatment options in preeclampsia. METHODS: A systematic literature search was undertaken using three electronic databases (MEDLINE, Embase, Cochrane) to identify all English

  3. Engineering economic evaluations of trash segregation alternatives

    International Nuclear Information System (INIS)

    Collins, H.E.

    1987-01-01

    Health physicists are becoming increasingly involved in the selection of equipment to segregate a contaminated trash from clean trash in the effort to reduce low level waste disposal costs. Although well qualified to evaluate the technical merits of different equipment, health physicists also need to be aware of the elements of economic comparisons of different alternatives that meet all technical requirements

  4. Socio-economic project evaluation in practice

    International Nuclear Information System (INIS)

    Larsen, A.

    1995-01-01

    The theoretical basis for a socio-economic project evaluation can be doubtful and specific analyses can involve quite essential uncertainty. Among serious theoretical problems of the energy sector there should be named the price distortions, due to various taxes. The choice of the presumed calculation interest can be difficult, due to the extremely long-range energy-political planning. (EG) 10 refs

  5. Economic evaluation of reprocessing - Indicative Belgian position

    International Nuclear Information System (INIS)

    1979-05-01

    This paper, which also appears as an Appendix to the final Working Group 4 report, forms part of the overall economic evaluation of reprocessing. The indicative national position and illustrative ''phase diagram'' for Belgium is presented. Other factors which influence the Belgian viewpoint and which are not included on the phase diagram are given

  6. Economic evaluations of homeopathy: a review.

    Science.gov (United States)

    Viksveen, Petter; Dymitr, Zofia; Simoens, Steven

    2014-03-01

    Economic evaluations of commonly used complementary and alternative medicine (CAM) therapies such as homeopathy are needed to contribute to the evidence base on which policy makers, clinicians, health-care payers, as well as patients base their health-care decisions in an era of constrained resources. To review and assess existing economic evaluations of homeopathy. Literature search was made to retrieve relevant publications using AMED, the Cochrane Library, CRD (DARE, NHS EED, HTA), EMBASE, MEDLINE, and the journal Homeopathy (former British Homoeopathic Journal). A hand search of relevant publications was carried out. Homeopathy researchers were contacted. Identified publications were independently assessed by two authors. Fifteen relevant articles reported on 14 economic evaluations of homeopathy. Thirteen studies reported numbers of patients: a total of 3,500 patients received homeopathic treatment (median 97, interquartile range 48-268), and 10 studies reported on control group participants (median 57, IQR 40-362). Eight out of 14 studies found improvements in patients' health together with cost savings. Four studies found that improvements in homeopathy patients were at least as good as in control group patients, at comparable costs. Two studies found improvements similar to conventional treatment, but at higher costs. Studies were highly heterogeneous and had several methodological weaknesses. Although the identified evidence of the costs and potential benefits of homeopathy seemed promising, studies were highly heterogeneous and had several methodological weaknesses. It is therefore not possible to draw firm conclusions based on existing economic evaluations of homeopathy. Recommendations for future research are presented.

  7. Common methodological flaws in economic evaluations.

    Science.gov (United States)

    Drummond, Michael; Sculpher, Mark

    2005-07-01

    Economic evaluations are increasingly being used by those bodies such as government agencies and managed care groups that make decisions about the reimbursement of health technologies. However, several reviews of economic evaluations point to numerous deficiencies in the methodology of studies or the failure to follow published methodological guidelines. This article, written for healthcare decision-makers and other users of economic evaluations, outlines the common methodological flaws in studies, focussing on those issues that are likely to be most important when deciding on the reimbursement, or guidance for use, of health technologies. The main flaws discussed are: (i) omission of important costs or benefits; (ii) inappropriate selection of alternatives for comparison; (iii) problems in making indirect comparisons; (iv) inadequate representation of the effectiveness data; (v) inappropriate extrapolation beyond the period observed in clinical studies; (vi) excessive use of assumptions rather than data; (vii) inadequate characterization of uncertainty; (viii) problems in aggregation of results; (ix) reporting of average cost-effectiveness ratios; (x) lack of consideration of generalizability issues; and (xi) selective reporting of findings. In each case examples are given from the literature and guidance is offered on how to detect flaws in economic evaluations.

  8. An economic evaluation of solar radiation management

    Energy Technology Data Exchange (ETDEWEB)

    Aaheim, Asbjørn; Romstad, Bård; Wei, Taoyuan [CICERO — Center for International Climate and Environmental Research Oslo (Norway); Kristjánsson, Jón Egill; Muri, Helene [Department of Geosciences, University of Oslo (Norway); Niemeier, Ulrike; Schmidt, Hauke [Max Planck Institute for Meteorology, Hamburg (Germany)

    2015-11-01

    Economic evaluations of solar radiation management (SRM) usually assume that the temperature will be stabilized, with no economic impacts of climate change, but with possible side-effects. We know from experiments with climate models, however, that unlike emission control the spatial and temporal distributions of temperature, precipitation and wind conditions will change. Hence, SRM may have economic consequences under a stabilization of global mean temperature even if side-effects other than those related to the climatic responses are disregarded. This paper addresses the economic impacts of implementing two SRM technologies; stratospheric sulfur injection and marine cloud brightening. By the use of a computable general equilibrium model, we estimate the economic impacts of climatic responses based on the results from two earth system models, MPI-ESM and NorESM. We find that under a moderately increasing greenhouse-gas concentration path, RCP4.5, the economic benefits of implementing climate engineering are small, and may become negative. Global GDP increases in three of the four experiments and all experiments include regions where the benefits from climate engineering are negative.

  9. An economic evaluation of solar radiation management

    International Nuclear Information System (INIS)

    Aaheim, Asbjørn; Romstad, Bård; Wei, Taoyuan; Kristjánsson, Jón Egill; Muri, Helene; Niemeier, Ulrike; Schmidt, Hauke

    2015-01-01

    Economic evaluations of solar radiation management (SRM) usually assume that the temperature will be stabilized, with no economic impacts of climate change, but with possible side-effects. We know from experiments with climate models, however, that unlike emission control the spatial and temporal distributions of temperature, precipitation and wind conditions will change. Hence, SRM may have economic consequences under a stabilization of global mean temperature even if side-effects other than those related to the climatic responses are disregarded. This paper addresses the economic impacts of implementing two SRM technologies; stratospheric sulfur injection and marine cloud brightening. By the use of a computable general equilibrium model, we estimate the economic impacts of climatic responses based on the results from two earth system models, MPI-ESM and NorESM. We find that under a moderately increasing greenhouse-gas concentration path, RCP4.5, the economic benefits of implementing climate engineering are small, and may become negative. Global GDP increases in three of the four experiments and all experiments include regions where the benefits from climate engineering are negative

  10. Genetic testing in the European Union: does economic evaluation matter?

    Science.gov (United States)

    Antoñanzas, Fernando; Rodríguez-Ibeas, R; Hutter, M F; Lorente, R; Juárez, C; Pinillos, M

    2012-10-01

    We review the published economic evaluation studies applied to genetic technologies in the EU to know the main diseases addressed by these studies, the ways the studies were conducted and to assess the efficiency of these new technologies. The final aim of this review was to understand the possibilities of the economic evaluations performed up to date as a tool to contribute to decision making in this area. We have reviewed a set of articles found in several databases until March 2010. Literature searches were made in the following databases: PubMed; Euronheed; Centre for Reviews and Dissemination of the University of York-Health Technology Assessment, Database of Abstracts of Reviews of Effects, NHS Economic Evaluation Database; and Scopus. The algorithm was "(screening or diagnosis) and genetic and (cost or economic) and (country EU27)". We included studies if they met the following criteria: (1) a genetic technology was analysed; (2) human DNA must be tested for; (3) the analysis was a real economic evaluation or a cost study, and (4) the articles had to be related to any EU Member State. We initially found 3,559 papers on genetic testing but only 92 articles of economic analysis referred to a wide range of genetic diseases matched the inclusion criteria. The most studied diseases were as follows: cystic fibrosis (12), breast and ovarian cancer (8), hereditary hemochromatosis (6), Down's syndrome (7), colorectal cancer (5), familial hypercholesterolaemia (5), prostate cancer (4), and thrombophilia (4). Genetic tests were mostly used for screening purposes, and cost-effectiveness analysis is the most common type of economic study. The analysed gene technologies are deemed to be efficient for some specific population groups and screening algorithms according to the values of their cost-effectiveness ratios that were below the commonly accepted threshold of 30,000€. Economic evaluation of genetic technologies matters but the number of published studies is still

  11. Economic value evaluation in disease management programs.

    Science.gov (United States)

    Magnezi, Racheli; Reicher, Sima; Shani, Mordechai

    2008-05-01

    Chronic disease management has been a rapidly growing entity in the 21st century as a strategy for managing chronic illnesses in large populations. However, experience has shown that disease management programs have not been able to demonstrate their financial value. The objectives of disease management programs are to create quality benchmarks, such as principles and guidelines, and to establish a uniform set of metrics and a standardized methodology for evaluating them. In order to illuminate the essence of disease management and its components, as well as the complexity and the problematic nature of performing economic calculations of their profitability and value, we collected data from several reports that dealt with the economic intervention of disease management programs. The disease management economic evaluation is composed of a series of steps, including the following major categories: data/information technology, information generation, assessment/recommendations, actionable customer plans, and program assessment/reassessment. We demonstrate the elements necessary for economic analysis. Disease management is one of the most innovative tools in the managed care environment and is still in the process of being defined. Therefore, objectives should include the creation of quality measures, such as principles and guidelines, and the establishment of a uniform set of metrics and a standardized methodology for evaluating them.

  12. Techno-Economic, Sustainability & Environmental Impact Diagnosis (TESED) Framework

    DEFF Research Database (Denmark)

    Loureiro da Costa Lira Gargalo, Carina; Carvalho, Ana; Matos, Henrique A.

    2014-01-01

    that truly sustainable design alternatives can befound.This work proposes a framework,called ‘Techno-Economic Sustainability Environmental Impact Diagnosis’ (TESED) that allows users to assess chemical/biochemical processes in a product oriented analysis.TESED is asystematic and generic approach that can......Nowadays, companies are looking for new sustainable design alternatives that improve their original processes.To assesst he best designalternative, economic aspects have been the preferred indicators. However, environmental and social concerns should also be included in the decision process so...

  13. Clinical evaluation of ischemic heart diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Kamei, Fumio [Sendai Railway Hospital (Japan)

    1983-09-01

    Attempt were made to detect the existence of myocardial ischemia by means of both radiographic and scintigraphic techniques. Firstly, a new polygraph was especially designed for selecting the arbitrary phases in a cardiac cycle at which the corresponding radiogram should be synchronously obtained. A comparative investigation on the difference between end-systolic and-diastolic cardiac transverse diameters revealed a remarkable difference of 3.6% in normal subjects and 0.6% in patients with ischemic heart disease. These data indicating the difference of overall heart size was reflected in local dyskinesis documentation of recently developed techniques. For daily clinical purposes, radiography of the chest based on synchronously selected phases would contribute to accurate diagnosis and treatment of heart disease. Secondly, scintigraphic display using intravenously injected thallium-201 was clinically applied. For detection of ischemia, comparative study was performed of initial image relative to selective coronary cineangiography and stress scintigraphy. The former indicated a good correlation of 90%, whereas the latter served to enhance sensitivity. Sequential images (initial and delayed) facilitated the distinction of normal, necrotic, and ischemic areas. Scintigram was used for objective evaluation of coronary dilator (dilazep), either at immediate or follow-up stage. In the same way, it was also possible to indicate the effectiveness of sublingually given nitroglycerin by myocardial scintigram, where by significant increase of uptake was observed 20 minutes after administration. Rehabilitation after acute heart disease was discussed, especially on the peripheral effect. Ratio of the thigh muscle to myocardium shown in this study was useful for objective evaluation. Another preliminary study is to separate normal coronary arteries from myocardial necrosis.

  14. Clinical evaluation of ischemic heart diagnosis

    International Nuclear Information System (INIS)

    Kamei, Fumio

    1983-01-01

    Attempt were made to detect the existence of myocardial ischemia by means of both radiographic and scintigraphic techniques. Firstly, a new polygraph was especially designed for selecting the arbitrary phases in a cardiac cycle at which the corresponding radiogram should be synchronously obtained. A comparative investigation on the difference between end-systolic and-diastolic cardiac transverse diameters revealed a remarkable difference of 3.6% in normal subjects and 0.6% in patients with ischemic heart disease. These data indicating the difference of overall heart size was reflected in local dyskinesis documentation of recently developed techniques. For daily clinical purposes, radiography of the chest based on synchronously selected phases would contribute to accurate diagnosis and treatment of heart disease. Secondly, scintigraphic display using intravenously injected thallium-201 was clinically applied. For detection of ischemia, comparative study was performed of initial image relative to selective coronary cineangiography and stress scintigraphy. The former indicated a good correlation of 90%, whereas the latter served to enhnace sensitivity. Sequential images (initial and delayed) facilitated the distinction of normal, necrotic, and ischemic areas. Scintigram was used for objective evaluation of coronary dilator (dilazep), either at immediate or follow-up stage. In the same way, it was also possible to indicate the effectiveness of sublingually given nitroglycerin by myocardial scintigram, where by significant increase of uptake was observed 20 minutes after administration. Rehabilitation after acute heart disease was discussed, especially on the peripheral effect. Ratio of the thigh muscle to myocardium shown in this study was useful fer objective evaluation. Another preliminary study is to separate normal coronary arteries from myocardial necrosis. (J.P.N.)

  15. Economic framework for information system evaluation

    International Nuclear Information System (INIS)

    King, D.W.; Roderer, N.K.

    1979-01-01

    In the evaluation of complex information systems, it is useful to work within a generalized economic framework. This framework is based on consideration of four evaluation levels, including those associated with the overall system, system functions, products and services, and activities. Measures of cost and output can be defined at each level, with output measures related to volume of activity, performance, effectiveness, and benefit. The description of this framework includes definitions of the terminology used. Examples of the application of the framework to specific information system evaluations are also given. 4 figures

  16. Economic evaluation of nuclear plant project

    International Nuclear Information System (INIS)

    Tolba, Adel.

    1988-01-01

    The present work is an attempt to prepare a ''fair price'' estimate to serve as bench mark in the course of economic evaluation of bids to construct nuclear power plants. The methodology of determining the present value of all capital investment is used. Running costs of nuclear fuel, operation, and maintenance are also determined. As a result, levelized energy cost is calculated. Sensitivity analysis for different parameters has been conducted, and the results of which are included in this paper

  17. Economic evaluation of reprocessing. Indicative Netherlands position

    International Nuclear Information System (INIS)

    1979-05-01

    The paper, which also appears as an Appendix to the final Working Group 4 report, forms part of the overall economic evaluation of reprocessing. The indicative national position and illustrative ''phase diagram'' for the Netherlands is presented. Two alternative scenarios have been assumed for the variation of uranium price in the future; a 2% per annum price rise and a 5% per annum price rise

  18. Pre-eclampsia Diagnosis and Treatment Options: A Review of Published Economic Assessments.

    Science.gov (United States)

    Zakiyah, Neily; Postma, Maarten J; Baker, Philip N; van Asselt, Antoinette D I

    2015-10-01

    Pre-eclampsia is a pregnancy complication affecting both mother and fetus. Although there is no proven effective method to prevent pre-eclampsia, early identification of women at risk of pre-eclampsia could enhance appropriate application of antenatal care, management and treatment. Very little is known about the cost effectiveness of these and other tests for pre-eclampsia, mainly because there is no clear treatment path. The aim of this study was to provide a comprehensive overview of the existing evidence on the health economics of screening, diagnosis and treatment options in pre-eclampsia. We searched three electronic databases (PubMed, EMBASE and the Cochrane Library) for studies on screening, diagnosis, treatment or prevention of pre-eclampsia, published between 1994 and 2014. Only full papers written in English containing complete economic assessments in pre-eclampsia were included. From an initial total of 138 references, six papers fulfilled the inclusion criteria. Three studies were on the cost effectiveness of treatment of pre-eclampsia, two of which evaluated magnesium sulphate for prevention of seizures and the third evaluated the cost effectiveness of induction of labour versus expectant monitoring. The other three studies were aimed at screening and diagnosis, in combination with subsequent preventive measures. The two studies on magnesium sulphate were equivocal on the cost effectiveness in non-severe cases, and the other study suggested that induction of labour in term pre-eclampsia was more cost effective than expectant monitoring. The screening studies were quite diverse in their objectives as well as in their conclusions. One study concluded that screening is probably not worthwhile, while two other studies stated that in certain scenarios it may be cost effective to screen all pregnant women and prophylactically treat those who are found to be at high risk of developing pre-eclampsia. This study is the first to provide a comprehensive overview

  19. On the Economic Evaluation of Volatility Forecasts

    DEFF Research Database (Denmark)

    Voev, Valeri

    We analyze the applicability of economic criteria for volatility forecast evaluation based on unconditional measures of portfolio performance. The main theoretical finding is that such unconditional measures generally fail to rank conditional forecasts correctly due to the presence of a bias term...... driven by the variability of the conditional mean and portfolio weights. Simulations and a small empirical study suggest that the bias can be empirically substantial and lead to distortions in forecast evaluation. An important implication is that forecasting superiority of models using high frequency...

  20. A Neuro Solution for Economic Diagnosis and Prediction

    Directory of Open Access Journals (Sweden)

    Nicolae Morariu

    2013-07-01

    Full Text Available The paper present a solution for the economic activity evolution diagnostic and prediction by means of a set of indicators. Starting from the indicators set, there is defined a measure on the patterns set, measure representing a scalar value that characterizes the activity analyzed at each time moment. A pattern is defined by the values of the indicators set at a given time. Over the classes set obtained by means of the classification and recognition techniques is defined a relation that allows the representation of the evolution from negative evolution towards positive evolution. For the diagnostic and prediction the following tools are used: pattern recognition and multilayer perceptron implemented in the REFORME software written by the author and the results of the experiment obtained with this software for macroeconomic diagnostic and prediction during the years 2005-2012 for diagnostic and 2013-2014 for prediction. Keywords: pattern recognition, neural network, multilayer perceptron, indicators, diagnostic, prediction.

  1. Economic evaluation of reprocessing - Indicative Canadian position

    International Nuclear Information System (INIS)

    1979-05-01

    This paper, which also appears as an Appendix to the final Working Group 4 report, forms part of the overall economic evaluation of reprocessing. The indicative national position and illustrative ''phase diagram'' for Canada is presented. Three fuel cycles are considered. (1) CANDU operating on the natural uranium, once-through fuel cycle. (2) CANDU operating with low enrichment (1.2%) once-through fuel cycle. (3) CANDU operating with recycle of plutonium and depleted uranium which has been extracted from spent CANDU natural uranium fuel. The diagrams show that reprocessing and recycle of fuel can be used to reduce further the sensitivity of CANDU fuelling costs to increasing uranium ore price

  2. Desalination Economic Evaluation Program (DEEP). User's manual

    International Nuclear Information System (INIS)

    2000-01-01

    DEEP (formerly named ''Co-generation and Desalination Economic Evaluation'' Spreadsheet, CDEE) has been developed originally by General Atomics under contract, and has been used in the IAEA's feasibility studies. For further confidence in the software, it was validated in March 1998. After that, a user friendly version has been issued under the name of DEEP at the end of 1998. DEEP output includes the levelised cost of water and power, a breakdown of cost components, energy consumption and net saleable power for each selected option. Specific power plants can be modelled by adjustment of input data including design power, power cycle parameters and costs

  3. Economic Evaluation and Impact Analysis of SMART

    International Nuclear Information System (INIS)

    Jeong, K. H.; Kim, J. H.; Boo, K. D.; Park, S. B.

    2010-07-01

    The objective of this study is to analyze the economic value and contribution to the national economy of the SMART project. This study tries to evaluate three kinds of values of the project separately; national economy contribution, the financial cost-benefit analysis and intangible social benefit of the project. The research methods are Net Present Valuation (NPT) for the first analysis, Input-Output (IO) model for the second analysis and Contingent Valuation Method(CVM) for the last analysis. This study tries to answer for the following questions: (1) how much does the project affect on Korean national economy in area of construction, electricity generation and export? (2) what is the financial cost - benefit assessment of the SMART project which is of the most interest to the private sector constructing the reactor? (3) how much is the project's intangible social gains in that it brings Korea's scientific development in area of nuclear generation and improves Korea's global standing? Main Results of Research are (1) Domestic Construction and Electricity Generation of the 1st Reactor A. Contribution to the National Economy Production inducing effect by the domestic construction and generation of the 1st reactor amounts to 1,801 ∼2,059 billion won, value added inducing effect amounts to 789∼919 billion won, and employment inducing effect amounts to 11,015∼12, 856 men. B. Financial Cost-Benefit Assessment Financial cost - benefit of the domestic construction and generation of the 1st reactor turns out to be economically non-profitable from the point of view of private companies participating the project, by having economic loss over all scenarios of construction costs. C. Combining Financial Cost-Benefit Assessment and Contribution to the National Economy's Value-Added Combining financial cost - benefit and value added inducing effect of the domestic construction and generation of the 1st reactor turns out to be economically valid from the point of view of

  4. Operational Contract Support: Economic Impact Evaluation and Measures of Effectiveness

    Science.gov (United States)

    2017-12-01

    NAVAL POSTGRADUATE SCHOOL MONTEREY, CALIFORNIA MBA PROFESSIONAL REPORT OPERATIONAL CONTRACT SUPPORT: ECONOMIC IMPACT EVALUATION AND MEASURES...DATES COVERED MBA professional report 4. TITLE AND SUBTITLE OPERATIONAL CONTRACT SUPPORT: ECONOMIC IMPACT EVALUATION AND MEASURES OF EFFECTIVENESS 5...evaluation, expeditionary economics , operational contract support, measure of effectiveness 15. NUMBER OF PAGES 89 16. PRICE CODE 17. SECURITY

  5. ECONOMIC EVALUATION OF CO2 SEQUESTRATION TECHNOLOGIES

    Energy Technology Data Exchange (ETDEWEB)

    Bert R. Bock; Richard G. Rhudy; David E. Nichols

    2001-07-01

    In order to plan for potential CO{sub 2} mitigation mandates, utilities need better information on CO{sub 2} mitigation options, especially carbon sequestration options that involve non-utility operations. One of the major difficulties in evaluating CO{sub 2} sequestration technologies and practices, both geologic storage of captured CO{sub 2} and storage in biological sinks, is obtaining consistent, transparent, accurate, and comparable economics. This project is comparing the economics of major technologies and practices under development for CO{sub 2} sequestration, including captured CO{sub 2} storage options such as active oil reservoirs, depleted oil and gas reservoirs, deep aquifers, coal beds, and oceans, as well as the enhancement of biological sinks such as forests and croplands. An international group of experts has been assembled to compare on a consistent basis the economics of this diverse array of CO{sub 2} sequestration options. Designs and data collection are nearly complete for each of the CO{sub 2} sequestration options being compared. Initial spreadsheet development has begun on concepts involving storage of captured CO{sub 2}. No significant problems have been encountered, but some additional outside expertise will be accessed to supplement the team's expertise in the areas of life cycle analysis, oil and gas exploration and production, and comparing CO{sub 2} sequestration options that differ in timing and permanence of CO{sub 2} sequestration. Plans for the next reporting period are to complete data collection and a first approximation of the spreadsheet. We expect to complete this project on time and on budget.

  6. Ultrasound diagnosis and evaluation of fetal tumors.

    Science.gov (United States)

    Kurjak, A; Zalud, I; Jurković, D; Alfirević, Z; Tomić, K

    1989-01-01

    Fetal tumors represent a rare and heterogeneous group of abnormalities. A significant proportion of them can now be diagnosed by using modern high resolution ultrasonic equipment. During 15 years there were 57 fetal tumours detected prenatally. Hygroma colli is the most frequent fetal tumor. It should be emphasized that cystic hygroma generally carries poor prognosis, and after an early diagnosis, termination of pregnancy is most logical approach. Contrary to the general opinion our own experience showed that there are cases in which prognosis could be much better as illustrated with our 4 cases. All of the treated fetuses, after surgical resection, had normal development and are now on the age of 5, 4, 3 and 2 years of life. An ovarian cyst can be suspected if a fluid-filled structure is visualized next to a fetal kidney and female external genitalia are recognizable. The ultrasound finding suggestive of an ovarian cyst is that of a pelvic cystic or complex mass in a female fetus with normal kidneys and urinary bladder and a normal gastrointestinal tract. In most cases, the normal course of fetal ovarian cyst is a spontaneous intrauterine or postnatal involution. Prenatal diagnosis improves neonatal outcome by allowing an appropriate choice of the optimal time, mode and place of delivery in order to avoid accidental and unexpected intrapartum and postnatal complications. The management of a fetus affected by an ovarian cyst depends on the size and on the echo-pattern of the cyst. It remains unclear whether in utero puncture of the cyst and evacuation of its content should be justified in cases of particularly large ovarian cyst. In our opinion intrauterine procedure can be attempted in the presence of large cyst fulfilling the fetal abdomen. We have treated actively two cases of large ovarian cysts by ultrasonically guided puncture before delivery and both fetuses underwent surgery later without complications. If properly performed puncture of the cyst seems to be

  7. Handling time in economic evaluation studies.

    Science.gov (United States)

    Permsuwan, Unchalee; Guntawongwan, Kansinee; Buddhawongsa, Piyaluk

    2014-05-01

    The discount rates and time horizons used in a health technology assessment (HTA) can have a significant impact on the results, and thus the prioritization of technologies. Therefore, it is important that clear guidance be provided on the appropriate discount rates for cost and health effect and appropriate time horizons. In this paper we conduct a review of relevant case studies and guidelines and provide guidance for all researchers conducting economic evaluations of health technologies in the Thai context. A uniform discount rate of 3% is recommended for both costs and health effects in base case analyses. A sensitivity analysis should also be conducted, with a discount range of 0-6%. For technologies where the effects are likely to sustain for at least 30y ears, a rate of 4% for costs and 2% for health effects is recommended. The time horizon should be long enough to capture the full costs and effects of the programs.

  8. Solar energy system economic evaluation: Fern Tunkhannock, Tunkhannock, Pennsylvania

    Science.gov (United States)

    1980-01-01

    The economic performance of an Operational Test Site (OTS) is described. The long term economic performance of the system at its installation site and extrapolation to four additional selected locations to demonstrate the viability of the design over a broad range of environmental and economic conditions is reported. Topics discussed are: system description, study approach, economic analysis and system optimization, and technical and economical results of analysis. Data for the economic analysis are generated through evaluation of the OTS. The simulation is based on the technical results of the seasonal report simulation. In addition localized and standard economic parameters are used for economic analysis.

  9. Methodology for evaluation of economic security of industrial enterprises

    OpenAIRE

    Kopytko Marta Ivanovna

    2014-01-01

    This paper investigates the features of evaluation of ensuring economic security of industrial enterprises and the algorithm of complex evaluation of the economic security of industrial enterprises over time and the system of criteria and their limit values ​​and the dynamics of change to determine the level of economic security industrial enterprise in terms of its components.

  10. Simulation of electric power conservation strategies: model of economic evaluation

    International Nuclear Information System (INIS)

    Pinhel, A.C.C.

    1992-01-01

    A methodology for the economic evaluation model for energy conservation programs to be executed by the National Program of Electric Power Conservation is presented. From data as: forecasting of conserved energy, tariffs, energy costs and budget, the model calculates the economic indexes for the programs, allowing the evaluation of economic impacts in the electric sector. (C.G.C.)

  11. Welfare Evaluation and the Economic Impacts of Climate Change on ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Welfare Evaluation and the Economic Impacts of Climate Change on Water Supply ... In a context of positive economic growth, demand for water is expected to ... Socially equitable climate action is essential to strengthen the resilience of all ...

  12. Economic evaluation of bids for nuclear power plants

    International Nuclear Information System (INIS)

    1976-01-01

    The purpose of the guidebook is to assist an organisation responsible for a nuclear power project in evaluating and establishing an economic order of merit among competing bids. An approximate overall time schedule for a first nuclear power plant project is provided. A schematic outline of technical bid evaluation is given. The basic procedure of economic bid evaluation is outlined, e.g. evaluation of the present worth of all cost items of plant capital investment, of the nuclear cycle, of O and M costs (operation and maintenance costs), and of economic corrections. All these cost items are evaluated for the economic life of the plant and corrected for escalation where applicable

  13. Evaluation of laboratory diagnosis for cutaneous tuberculosis

    Directory of Open Access Journals (Sweden)

    Ilhan Afsar

    2016-01-01

    Full Text Available Background and Aim: Cutaneous tuberculosis (CTB is still difficult to diagnose due to its varied clinical presentation and limitations of diagnostic methods. The aim of this study was to evaluate the results of diagnostic laboratory tests available for CTB. Materials and Methods: Twenty-six skin biopsy specimens belonging to clinically suspected cases of CTB were studied retrospectively. The specimens were divided into two portions, one part processed for histopathological evaluation and the other was used for microscopy and inoculation for the isolation of mycobacteria. Polymerase chain reaction (PCR technique was applied to 14 of 26 specimens to detect Mycobacterium tuberculosis complex (MTBC DNA. Results: Of the 26 biopsy specimens, 11 were confirmed as CTB by identification of MTBC in culture and/or histopathologic affirmation. Of these, four were lupus vulgaris, four were TB verrucosa cutis, one was scrofuloderma, one was primary inoculation TB, and one was periorifical CTB. Culture for mycobacteria was positive for five (45.45% specimens, while histopathologic affirmation was obtained in ten (90.90% specimens. Acid-fast Bacilli were not demonstrated in any of the specimens on microscopic examination. The PCR was found to be applied to six of the 11 specimens diagnosed as CTB and was positive in two specimens (33.3%, which were positive for growth in culture and histopathological correlation. Conclusion: The recovery rate of MTBC from biopsy specimens was found to be satisfactory for CTB with histopathological correlation, but the combination of culture with a rapid method, PCR, may improve the diagnostic rate.

  14. Economic evaluations in pain management: principles and methods.

    Science.gov (United States)

    Asche, Carl V; Seal, Brian; Jackson, Kenneth C; Oderda, Gary M

    2006-01-01

    This paper describes how investigators may design, conduct, and report economic evaluations of pharmacotherapy for pain and symptom management. Because economic evaluation of therapeutic interventions is becoming increasingly important, there is a need for guidance on how economic evaluations can be optimally conducted. The steps required to conduct an economic evaluation are described to provide this guidance. Economic evaluations require two or more therapeutic interventions to be compared in relation to costs and effects. There are five types of economic evaluations, based on analysis of: (1) cost-effectiveness, (2) cost-utility, (3) cost-minimization, (4) cost-consequence, and (5) cost-benefit analyses. The six required steps are: identify the perspective of the study; identify the alternatives that will be compared; identify the relevant costs and effects; determine how to collect the cost and effect data; determine how to perform calculation for cost and effects data; and determine the manner in which to depict the results and draw comparisons.

  15. Improving early cycle economic evaluation of diagnostic technologies

    NARCIS (Netherlands)

    Steuten, Lotte Maria Gertruda; Ramsey, Scott D.

    2014-01-01

    The rapidly increasing range and expense of new diagnostics, compels consideration of a different, more proactive approach to health economic evaluation of diagnostic technologies. Early cycle economic evaluation is a decision analytic approach to evaluate technologies in development so as to

  16. Diagnosis and evaluation of gastric cancer by positron emission tomography

    Science.gov (United States)

    Wu, Chen-Xi; Zhu, Zhao-Hui

    2014-01-01

    Gastric cancer is the second leading cause of cancer mortality worldwide. The diagnosis of gastric cancer has been significantly improved with the broad availability of gastrointestinal endoscopy. Effective technologies for accurate staging and quantitative evaluation are still in demand to merit reasonable treatment and better prognosis for the patients presented with advanced disease. Preoperative staging using conventional imaging tools, such as computed tomography (CT) and endoscopic ultrasonography, is inadequate. Positron emission tomography (PET), using 18F-fluorodeoxyglucose (FDG) as a tracer and integrating CT for anatomic localization, holds a promise to detect unsuspected metastasis and has been extensively used in a variety of malignancies. However, the value of FDG PET/CT in diagnosis and evaluation of gastric cancer is still controversial. This article reviews the current literature in diagnosis, staging, response evaluation, and relapse monitoring of gastric cancer, and discusses the current understanding, improvement, and future prospects in this area. PMID:24782610

  17. Towards a Framework for Evaluating and Comparing Diagnosis Algorithms

    Science.gov (United States)

    Kurtoglu, Tolga; Narasimhan, Sriram; Poll, Scott; Garcia,David; Kuhn, Lukas; deKleer, Johan; vanGemund, Arjan; Feldman, Alexander

    2009-01-01

    Diagnostic inference involves the detection of anomalous system behavior and the identification of its cause, possibly down to a failed unit or to a parameter of a failed unit. Traditional approaches to solving this problem include expert/rule-based, model-based, and data-driven methods. Each approach (and various techniques within each approach) use different representations of the knowledge required to perform the diagnosis. The sensor data is expected to be combined with these internal representations to produce the diagnosis result. In spite of the availability of various diagnosis technologies, there have been only minimal efforts to develop a standardized software framework to run, evaluate, and compare different diagnosis technologies on the same system. This paper presents a framework that defines a standardized representation of the system knowledge, the sensor data, and the form of the diagnosis results and provides a run-time architecture that can execute diagnosis algorithms, send sensor data to the algorithms at appropriate time steps from a variety of sources (including the actual physical system), and collect resulting diagnoses. We also define a set of metrics that can be used to evaluate and compare the performance of the algorithms, and provide software to calculate the metrics.

  18. Introduction course on the economical evaluation of energy projects

    International Nuclear Information System (INIS)

    Jansen, J.C.

    1992-06-01

    A theoretical course on the financial and economical evaluation of energy projects is presented. The course was organized by the Banque Mondiale in Bujumbura, Burundi, from 11 to 16 November 1991. Subsequently attention is paid to the basics of economic analysis, the financial and the economical analysis of an investment project, and finally the prices of energy products. 4 figs., 13 refs

  19. Economic evaluation of reprocessing - Indicative German position

    International Nuclear Information System (INIS)

    1979-05-01

    This paper, which also appears as an Appendix to the final Working Group 4 report, forms part of the overall economic assessment of reprocessing. The indicative national position and illustrative ''phase diagram'' for the Federal Republic of Germany is presented. Advantages to be gained from the recycling of plutonium in thermal reactors are identified and it is concluded that many of these are not explicitly taken into account in the ''phase diagram''. Under the conditions pertaining in the Federal Republic of Germany thermal recycle will be economic under present day uranium prices. On the other hand the fast breeder reactor might become commercially economic around the year 2000

  20. Evaluation of economic rent of hydropower projects

    International Nuclear Information System (INIS)

    Shrestha, Ram M.; Abeygunawardana, A.M.A.K.

    2009-01-01

    Existing studies have mostly estimated the ex post economic rent of hydropower for the hydroelectric system of a province or a country as a whole and have ignored the site- or project-specific variations in the economic rent of hydropower plants. Further, most of the existing studies have used simplified methods to calculate the rent ex post. This paper presents a rigorous methodology for estimation of site-specific (i.e., project specific) economic rent of hydropower ex ante. It applies the methodology in the case of a hydropower project and analyzes the sensitivity of the rent to variations in some key parameters.

  1. Economic evaluation of reprocessing. Indicative UK position

    International Nuclear Information System (INIS)

    1979-05-01

    This paper, which also appears as an Appendix to the final Working Group 4 report, forms part of the overall economic assessment of reprocessing. The indicative national position and illustrative ''phase diagram'' for the United Kingdom is presented. Under conditions pertaining in the United Kingdom the diagram suggests that: if uranium prices rise rapidly the fast reactor would become economic in the decade 1990-2000, if uranium prices rise more slowly, the fast reactor would become economic in the decade 2000-2010

  2. [Basic principles and methodological considerations of health economic evaluations].

    Science.gov (United States)

    Loza, Cesar; Castillo-Portilla, Manuel; Rojas, José Luis; Huayanay, Leandro

    2011-01-01

    Health Economics is an essential instrument for health management, and economic evaluations can be considered as tools assisting the decision-making process for the allocation of resources in health. Currently, economic evaluations are increasingly being used worldwide, thus encouraging evidence-based decision-making and seeking efficient and rational alternatives within the framework of health services activities. In this review, we present an overview and define the basic types of economic evaluations, with emphasis on complete Economic Evaluations (EE). In addition, we review key concepts regarding the perspectives from which EE can be conducted, the types of costs that can be considered, the time horizon, discounting, assessment of uncertainty and decision rules. Finally, we describe concepts about the extrapolation and spread of economic evaluations in health.

  3. Economic evaluation of coalbed methane production in China

    International Nuclear Information System (INIS)

    Luo Dongkun; Dai Youjin

    2009-01-01

    Roaring natural gas demand, energy security and environment protection concerns coupled with stringent emission reduction requirement have made China's abundant coalbed methane (CBM) resource an increasingly valuable energy source. However, not all of China's CBM resource is economic to develop under current technological condition and economic situation. In order to locate the CBM resource with economic viability to develop in China, economic evaluation of CBM production is conducted by applying net present value (NPV) method. The results indicate that more than half of CBM resource in China is economic to develop. It shows that CBM price, production rate and operating costs are the three major factors with most impact on the economic viability of the CBM development in target areas in China. The result also demonstrates that the economic limit production is roughly 1200 cubic meters per day. These economic evaluation results provide important information for both CBM companies and China government.

  4. Dental health economics and diagnosis related groups/casemix in Indonesian dentistry

    Directory of Open Access Journals (Sweden)

    Ronnie Rivany

    2009-12-01

    Full Text Available Background: Dental Health Economics is a branch of transdiciplinary science that refers to the Economic and Public Health science. On the other hand, in other developed countries, Diagnosis Related Groups (DRG’s /Casemix has been used as a basic in creating the same perception between providers, patients and insurance companies in many aspects such as health planning, healthcare financing and quality assurance. Purpose: The objective of this review is to propose a new paradigm of economics to be applied in Indonesian Dentistry. Reviews: The Dental Health Economics should be considered as an important aspect in Indonesian Dentistry, which is used to determine the dental treatment fee based on unit cost, cost containment, and cost recovery rate analysis. Referring to Australian Refined Diagnosis Related Group, health care industry in Indonesia has starting to try a more structured way in grouping disease pattern in order to come up with more precise health care services to their patients. The on going development of Indonesian DRG’s is meant to confirm the disease pattern and partition. Conclusion: The development of Indonesian DRG’s concept, especially the Dental & Oral Disorders, needs a new paradigm, so the practitioners and academics could group and calculate the unit cost from each dental treatment according to the Indonesian DRG version (INA-DRG’s.

  5. New York State Technical & Economic MAGLEV Evaluation

    Science.gov (United States)

    1991-06-01

    The New York State Energy Research and Development Authority, with the : assistance of the Departments of Transportation, Economic Development, Environmental Conservation, and the New York State Thruway Authority, is undertaking a comprehensive, syst...

  6. Economic evaluation of reprocessing. Indicative US position

    International Nuclear Information System (INIS)

    1979-05-01

    This paper, which also appears as an Appendix to the final Working Group 4 report, forms part of the overall economic assessment of reprocessing. The indicative national position and illustrative ''phase diagram'' for the United States is presented. The prospective costs of nuclear power are given for four equilibrium modes of LWR operation: once-through, 15% and 25% improved once-through and thermal recycle. For a particular representative choice of fuel cycle parameters the economic cross over at which thermal recycle becomes economic relative to a 15% improved once-through cycle is above 100/lb U 3 O 8 . Thus the US believes that for the next several decades there is no economic incentive for thermal recycle. As a planning guide the US considers that the fast reactor will not become commercialised in the US before the year 2020

  7. The use of economic evaluation in CAM: an introductory framework.

    Science.gov (United States)

    Ford, Emily; Solomon, Daniela; Adams, Jon; Graves, Nicholas

    2010-11-11

    For CAM to feature prominently in health care decision-making there is a need to expand the evidence-base and to further incorporate economic evaluation into research priorities.In a world of scarce health care resources and an emphasis on efficiency and clinical efficacy, CAM, as indeed do all other treatments, requires rigorous evaluation to be considered in budget decision-making. Economic evaluation provides the tools to measure the costs and health consequences of CAM interventions and thereby inform decision making. This article offers CAM researchers an introductory framework for understanding, undertaking and disseminating economic evaluation. The types of economic evaluation available for the study of CAM are discussed, and decision modelling is introduced as a method for economic evaluation with much potential for use in CAM. Two types of decision models are introduced, decision trees and Markov models, along with a worked example of how each method is used to examine costs and health consequences. This is followed by a discussion of how this information is used by decision makers. Undoubtedly, economic evaluation methods form an important part of health care decision making. Without formal training it can seem a daunting task to consider economic evaluation, however, multidisciplinary teams provide an opportunity for health economists, CAM practitioners and other interested researchers, to work together to further develop the economic evaluation of CAM.

  8. The use of economic evaluation in CAM: an introductory framework

    Science.gov (United States)

    2010-01-01

    Background For CAM to feature prominently in health care decision-making there is a need to expand the evidence-base and to further incorporate economic evaluation into research priorities. In a world of scarce health care resources and an emphasis on efficiency and clinical efficacy, CAM, as indeed do all other treatments, requires rigorous evaluation to be considered in budget decision-making. Methods Economic evaluation provides the tools to measure the costs and health consequences of CAM interventions and thereby inform decision making. This article offers CAM researchers an introductory framework for understanding, undertaking and disseminating economic evaluation. The types of economic evaluation available for the study of CAM are discussed, and decision modelling is introduced as a method for economic evaluation with much potential for use in CAM. Two types of decision models are introduced, decision trees and Markov models, along with a worked example of how each method is used to examine costs and health consequences. This is followed by a discussion of how this information is used by decision makers. Conclusions Undoubtedly, economic evaluation methods form an important part of health care decision making. Without formal training it can seem a daunting task to consider economic evaluation, however, multidisciplinary teams provide an opportunity for health economists, CAM practitioners and other interested researchers, to work together to further develop the economic evaluation of CAM. PMID:21067622

  9. The use of economic evaluation in CAM: an introductory framework

    Directory of Open Access Journals (Sweden)

    Adams Jon

    2010-11-01

    Full Text Available Abstract Background For CAM to feature prominently in health care decision-making there is a need to expand the evidence-base and to further incorporate economic evaluation into research priorities. In a world of scarce health care resources and an emphasis on efficiency and clinical efficacy, CAM, as indeed do all other treatments, requires rigorous evaluation to be considered in budget decision-making. Methods Economic evaluation provides the tools to measure the costs and health consequences of CAM interventions and thereby inform decision making. This article offers CAM researchers an introductory framework for understanding, undertaking and disseminating economic evaluation. The types of economic evaluation available for the study of CAM are discussed, and decision modelling is introduced as a method for economic evaluation with much potential for use in CAM. Two types of decision models are introduced, decision trees and Markov models, along with a worked example of how each method is used to examine costs and health consequences. This is followed by a discussion of how this information is used by decision makers. Conclusions Undoubtedly, economic evaluation methods form an important part of health care decision making. Without formal training it can seem a daunting task to consider economic evaluation, however, multidisciplinary teams provide an opportunity for health economists, CAM practitioners and other interested researchers, to work together to further develop the economic evaluation of CAM.

  10. Environmental Economics And Policy: Course Evaluation Survey

    Directory of Open Access Journals (Sweden)

    Petr Šauer

    2013-09-01

    Full Text Available The main objective of this paper is to outline the educational aspects of environmental economics referring to an example of a course taught at The University of Economics, Prague. A quantitative survey among students was conducted to describe their perceptions of the environmental topics and the diverse components of the course. This learners’ perspective is compared with students’ examination results and their level of activity in seminars. One of the main questions asked in this text is: do students interested in economic policy and regional economics consider the environmental orientation of the course important? And if yes what aspects of the course do they value, what benefits do they get from the course, what are their learning strategies and what role does this play with regards to students’ concern for environmental issues? Probably the most important finding of the research is the students’ advocacy of environmental economics as a beneficial part of curriculum both by those clustered as ‘environmentalists’ and ‘non-environmentalists’ (or even ‘anti-environmentalists’. Students appreciate having a chance to participate actively in the course. A well balanced proportion of lectures and seminars with enough space for deep discussion seem to be crucial for retaining students’ interest. The data doesn’t equip us with sufficient information to construct regression models with reasonable predictive power concerning exam results. A challenge for further research is to work with a better informed analysis of students’ learning strategies.

  11. Economic evaluation of preconcentration of uranium ores

    International Nuclear Information System (INIS)

    1981-04-01

    The economics of two options for the preconcentration of low-grade uranium ores prior to hydrochloric acid leaching were studied. The first option uses flotation followed by wet high-intensity magnetic separation. The second option omits the flotation step. In each case it was assumed that most of the pyrite in the ore would be recovered by froth flotation, dewatered, and roasted to produce sulphuric acid and a calcine suitable for acid leaching. Savings in operating costs from preconcentration are offset by the value of uranium losses. However, a capital saving of approximately 6 million dollars is indicated for each preconcentration option. As a result of the capital saving, preconcentration appears to be economically attractive when combined with hydrochloric acid leaching. There appears to be no economic advantage to preconcentration in combination with sulphuric acid leaching of the ore

  12. Economic evaluation of intermediate operations in oak stands

    Science.gov (United States)

    Henry H. Webster; John C., Jr. Meadows

    1971-01-01

    Economic evaluation of forest-management opportunities is a vital ingredient of effective forestry programs. Choices among management opportunities are necessary because opportunities inevitably exceed funds available, and they are important because opportunities commonly range from highly productive to decidedly unproductive. Economic evaluation in oak stands shows a...

  13. Preliminary economic evaluation of the Alkox process

    International Nuclear Information System (INIS)

    Silva, L.J.; Lilga, M.A.; Camaioni, D.M.; Snowden, L.J.

    1991-09-01

    A new chemical process has been invented at Battelle Pacific Northwest Laboratories for converting alkanes to alcohols. This new chemistry has been named the ''Alkox Process.'' Pacific Northwest Laboratory prepared a preliminary economic analysis for converting cyclohexane to cyclohexanol, which may be one of the most attractive applications of the Alkox process. A process flow scheme and a material balance were prepared to support rough equipment sizing and costing. The results from the economic analysis are presented in the non-proprietary section of this report. The process details, including the flow diagram and material balance, are contained in separate section of this report that is proprietary to Battelle. 7 refs., 4 tabs

  14. Economic evaluation of a coal fired boiler

    International Nuclear Information System (INIS)

    Briem, J.J.

    1983-01-01

    This paper provides basic information on boiler economics which will assist steam users in analyzing the feasibility of using coal to generate steam - in either new or existing facilities. The information presented covers boilers ranging in size from 10,000 to 100,000 pounds per hour steaming capacity

  15. Economics of residue harvest: Regional partnership evaluation

    Science.gov (United States)

    Economic analyses on the viability of corn (Zea mays, L.) stover harvest for bioenergy production have largely been based on simulation modeling. While some studies have utilized field research data, most field-based analyses have included a limited number of sites and a narrow geographic distributi...

  16. Economic evaluation of tokamak power plants

    International Nuclear Information System (INIS)

    Reid, R.L.; Steiner, D.

    1977-01-01

    This study reports the impact of plasma operating characteristics, engineering options, and technology on the capital cost trends of tokamak power plants. Tokamak power systems are compared to other advanced energy systems and found to be economically competitive. A three-phase strategy for demonstrating commercial feasibility of fusion power, based on a common-site multiple-unit concept, is presented

  17. Economic evaluation of investment in electricity conservation

    International Nuclear Information System (INIS)

    Becker, Nir; Fishman, Yaron; Lavee, Doron

    2008-01-01

    The paper presents an economic study of the potential for energy conservation in Israel. We analyze energy conservation policies targeted at the household sector, focusing on the economic feasibility of scrapping old household electrical appliances, and considering the effect of such policies at both the household and the macro-economic level. The results of our analysis show that the appliance that provides the most potential conservation is the air conditioner (used for both heating and cooling). A scrapping program for old air conditioners passes a cost benefit analysis (CBA) even when external benefits are excluded from the calculation. When external benefits are included, scrapping programs for both washing machines and dishwashers pass the test as well. According to our findings, the annual economic benefit of a program involving the scrapping of 100,000 air conditioners, 45,000 washing machines and 15,000 dishwashers per annum over 10 years ranges from 246 million New Israeli Shekels (NIS) in the first year of implementation to 693 million in the tenth year. Most of the savings are derived from the scrapping of air conditioners

  18. Economic evaluation of vaccines in Canada: A systematic review.

    Science.gov (United States)

    Chit, Ayman; Lee, Jason K H; Shim, Minsup; Nguyen, Van Hai; Grootendorst, Paul; Wu, Jianhong; Van Exan, Robert; Langley, Joanne M

    2016-05-03

    Economic evaluations should form part of the basis for public health decision making on new vaccine programs. While Canada's national immunization advisory committee does not systematically include economic evaluations in immunization decision making, there is increasing interest in adopting them. We therefore sought to examine the extent and quality of economic evaluations of vaccines in Canada. We conducted a systematic review of economic evaluations of vaccines in Canada to determine and summarize: comprehensiveness across jurisdictions, studied vaccines, funding sources, study designs, research quality, and changes over time. Searches in multiple databases were conducted using the terms "vaccine," "economics" and "Canada." Descriptive data from eligible manuscripts was abstracted and three authors independently evaluated manuscript quality using a 7-point Likert-type scale scoring tool based on criteria from the International Society for Pharmacoeconomics and Outcomes Research (ISPOR). 42/175 articles met the search criteria. Of these, Canada-wide studies were most common (25/42), while provincial studies largely focused on the three populous provinces of Ontario, Quebec and British Columbia. The most common funding source was industry (17/42), followed by government (7/42). 38 studies used mathematical models estimating expected economic benefit while 4 studies examined post-hoc data on established programs. Studies covered 10 diseases, with 28/42 addressing pediatric vaccines. Many studies considered cost-utility (22/42) and the majority of these studies reported favorable economic results (16/22). The mean quality score was 5.9/7 and was consistent over publication date, funding sources, and disease areas. We observed diverse approaches to evaluate vaccine economics in Canada. Given the increased complexity of economic studies evaluating vaccines and the impact of results on public health practice, Canada needs improved, transparent and consistent processes

  19. Evaluation of CT findings for diagnosis of pleural effusions

    International Nuclear Information System (INIS)

    Arenas-Jimenez, J.; Alonso-Charterina, S.; Fernandez-Latorre, F.; Gil-Sanchez, S.; Sanchez-Paya, J.; Lloret-Llorens, M.

    2000-01-01

    Computed tomography studies are usually used to assess patients with pleural effusions, and radiologists should be aware of the significance of different CT findings for the diagnosis of the effusion. The purpose of this study was to evaluate CT findings for etiological diagnosis of pleural effusions. Contrast-enhanced CT of the chest of 211 patients with pleural effusion of definite diagnosis were evaluated. The CT images were evaluated for the presence and extent of pleural effusion, thickening or nodules, extrapleural fat and other changes in the mediastinum or lung. The CT scans were read by two independent observers and correlation between them was evaluated. Comparison of CT findings between benign and malignant effusions, between exudates and transudates, and between empyemas and the other parapneumonic effusions were carried out. Kappa values for most CT findings were >0.85. Loculation, pleural thickening, pleural nodules, and extrapleural fat of increased density were only present in exudative effusions. Multiple pleural nodules and nodular pleural thickening were the only pleural findings limited to malignant pleural effusions. The signs were also more frequently seen in empyemas than in other parapneumonic effusions. Computed tomography findings can help to distinguish between transudates and exudates. Although there is some overlap between benign and malignant pleural effusions, pleural nodules and nodular pleural thickening were present almost exclusively in the latter. Although differences between CT findings of empyemas and the other parapneumonic effusions exist, there is no finding which can definitely differentiate between them. (orig.)

  20. Acknowledging patient heterogeneity in economic evaluation : a systematic literature review.

    Science.gov (United States)

    Grutters, Janneke P C; Sculpher, Mark; Briggs, Andrew H; Severens, Johan L; Candel, Math J; Stahl, James E; De Ruysscher, Dirk; Boer, Albert; Ramaekers, Bram L T; Joore, Manuela A

    2013-02-01

    Patient heterogeneity is the part of variability that can be explained by certain patient characteristics (e.g. age, disease stage). Population reimbursement decisions that acknowledge patient heterogeneity could potentially save money and increase population health. To date, however, economic evaluations pay only limited attention to patient heterogeneity. The objective of the present paper is to provide a comprehensive overview of the current knowledge regarding patient heterogeneity within economic evaluation of healthcare programmes. A systematic literature review was performed to identify methodological papers on the topic of patient heterogeneity in economic evaluation. Data were obtained using a keyword search of the PubMed database and manual searches. Handbooks were also included. Relevant data were extracted regarding potential sources of patient heterogeneity, in which of the input parameters of an economic evaluation these occur, methods to acknowledge patient heterogeneity and specific concerns associated with this acknowledgement. A total of 20 articles and five handbooks were included. The relevant sources of patient heterogeneity (demographics, preferences and clinical characteristics) and the input parameters where they occurred (baseline risk, treatment effect, health state utility and resource utilization) were combined in a framework. Methods were derived for the design, analysis and presentation phases of an economic evaluation. Concerns related mainly to the danger of false-positive results and equity issues. By systematically reviewing current knowledge regarding patient heterogeneity within economic evaluations of healthcare programmes, we provide guidance for future economic evaluations. Guidance is provided on which sources of patient heterogeneity to consider, how to acknowledge them in economic evaluation and potential concerns. The improved acknowledgement of patient heterogeneity in future economic evaluations may well improve the

  1. Antenatal Hydronephrosis: Differential Diagnosis, Evaluation, and Treatment Options

    Science.gov (United States)

    Herndon, C.D. Anthony

    2006-01-01

    The diagnosis, evaluation and management of antenatal hydronephrosis has undergone a two stage paradigm shift since the advent of prenatal ultrasonography in the early 1980s. Initially the identification of a large number of asymptomatic infants appeared to afford the surgeon the opportunity for preemptive intervention. However, it has now become apparent that antenatal hydronephrosis (AH) is far more difficult to interpret thanoriginally perceived. The initial enthusiasm for surgery has now been replaced by a much more conservative approach to ureteropelvic junction(UPJ) obstruction, multi-cystic dysplastic kidney(MCDK), vesicoureteral reflux and the non-refluxing megaureter. This review will highlight the postnatal evaluation of AH and include an overview of the Society for Fetal Urology grading system for hydronephrosis. The differential diagnosis and treatment options for UPJ obstruction, vesicoureteral reflux, MCDK, duplication anomalies, megaureter, and posterior urethral valves will be discussed. PMID:17619702

  2. Assessing sufficient capability: A new approach to economic evaluation.

    Science.gov (United States)

    Mitchell, Paul Mark; Roberts, Tracy E; Barton, Pelham M; Coast, Joanna

    2015-08-01

    Amartya Sen's capability approach has been discussed widely in the health economics discipline. Although measures have been developed to assess capability in economic evaluation, there has been much less attention paid to the decision rules that might be applied alongside. Here, new methods, drawing on the multidimensional poverty and health economics literature, are developed for conducting economic evaluation within the capability approach and focusing on an objective of achieving "sufficient capability". This objective more closely reflects the concern with equity that pervades the capability approach and the method has the advantage of retaining the longitudinal aspect of estimating outcome that is associated with quality-adjusted life years (QALYs), whilst also drawing on notions of shortfall associated with assessments of poverty. Economic evaluation from this perspective is illustrated in an osteoarthritis patient group undergoing joint replacement, with capability wellbeing assessed using ICECAP-O. Recommendations for taking the sufficient capability approach forward are provided. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. Economical evaluation of electricity generation considering externalities

    International Nuclear Information System (INIS)

    El-Kordy, M.N.; Badr, M.A.; Abed, K.A.; Ibrahim, Said M.A.

    2002-01-01

    The economics of renewable energy are the largest barrier to renewable penetration. Nevertheless, the strong desire to reduce environmental emissions is considered a great support for renewable energy sources. In this paper, a full analysis for the cost of the kWh of electricity generated from different systems actually used in Egypt is presented. Also renewable energy systems are proposed and their costs are analyzed. The analysis considers the external cost of emissions from different generating systems. A proposed large scale PV plant of 3.3 MW, and a wind farm 11.25 MW grid connected at different sites are investigated. A life cycle cost analysis for each system was performed using the present value criterion. The comparison results showed that wind energy generation has the lowest cost, followed by a combined cycle-natural gas fired system. A photovoltaic system still uses comparatively expensive technology for electricity generation; even when external costs are considered the capital cost of photovoltaic needs to be reduced by about 60% in order to be economically competitive. (Author)

  4. Payment and economic evaluation of integrated care

    Directory of Open Access Journals (Sweden)

    Apostolos Tsiachristas

    2015-04-01

    Full Text Available Chronic diseases have an increasingly negative impact on (1 population health by increasing morbidity and mortality, (2 society by increasing health inequalities and burden to informal caregivers, and (3 economy by requiring enormous financial resources and jeopardising macro-economic development (e.g. consumption, capital accumulation, labour productivity and labour supply. Integrated care is the most promising concept in redesigning care to tackle the increasing threat of chronic diseases. Several European countries have experimented with models for integrating care, most frequently in the form of disease management programmes. These models were often supported by payment schemes to provide financial incentives to health care providers for implementing integrated care. This thesis aimed to investigate these payment schemes and assess their impact, explore the variability in costs of disease management programmes, and determine the costs and effects of disease management programmes.

  5. Economic evaluation of laser enrichment plant

    International Nuclear Information System (INIS)

    Arisawa, Takashi; Shiba, Koreyuki

    1983-08-01

    Operational characteristics of Laser Enrichment Plant are described based on the data available at present. And its economy is also discussed from the view point of investment and energy consumption. In the procedure of this estimation, the composition of the plant is firstly considered, secondly each component is designed, and thirdly the production cost of each component is estimated. Then the sensitivity of the component cost on the plant cost is analysed, which leads to the optimization of the product cost and the determination of the economic plant size, etc. The results shows that the power cost of the electric gun occupies the large majority of the total power cost, and that the capital cost of laser devices occupies most of the total capital cost. (author)

  6. Economic evaluation of fast reactor fuel cycling

    International Nuclear Information System (INIS)

    Hu Ping; Zhao Fuyu; Yan Zhou; Li Chong

    2012-01-01

    Economic calculation and analysis of two kinds of nuclear fuel cycle are conducted by check off method, based on the nuclear fuel cycling process and model for fast reactor power plant, and comparison is carried out for the economy of fast reactor fuel cycle and PWR once-through fuel cycle. Calculated based on the current price level, the economy of PWR one-through fuel cycle is better than that of the fast reactor fuel cycle. However, in the long term considering the rising of the natural uranium's price and the development of the post treatment technology for nuclear fuels, the cost of the fast reactor fuel cycle is expected to match or lower than that of the PWR once-through fuel cycle. (authors)

  7. Evaluating the economics of biodiesel in Africa

    International Nuclear Information System (INIS)

    Mulugetta, Yacob

    2009-01-01

    Road transport in Sub-Saharan Africa is expected to rise in the coming years. Paradoxically, this expansion is occurring at a time when oil prices have reached new heights. Unstable oil prices do indeed increase the vulnerability of importers. However, it also presents them with a unique opportunity to explore promising technical options to help reduce their over-reliance on imported petroleum fuels. This paper takes a closer look at the potential for biodiesel, with an emphasis on fuels produced from oil palm, castor oil and jatropha in Ghana, Kenya and Tanzania, respectively. The paper provides an economic appraisal of biodiesels from these feedstocks, and sets the context for further discussions on biofuels in Africa. (author)

  8. An economic analysis methodology for project evaluation and programming.

    Science.gov (United States)

    2013-08-01

    Economic analysis is a critical component of a comprehensive project or program evaluation methodology that considers all key : quantitative and qualitative impacts of highway investments. It allows highway agencies to identify, quantify, and value t...

  9. Economic evaluation of coal deposits. Ekonomicheskaya otsenka ugolinykh mestorozhdenii

    Energy Technology Data Exchange (ETDEWEB)

    Raikhel' , B L

    1979-01-01

    A presentation is made of theoretical problems, methods, and criteria for the economic evaluation of coal deposits. An examination is made of factors which influence the formation of magnitudes that are utilized in economic evaluations as well as problems whose solution requires the consideration of the economic evaluation of coal deposits (evaluation of useful mineral losses, substantiation for the extraction of reserves under various conditions, sectioning off reserves to an operating mine, the completeness of reserve extraction, and technico-economic substantiation for quality). Extensive experience in planning is summarized and data are illustrated by examples. The book is intended for engineering-technical personnel of enterprises, organizations, planning, and scientific-research institutes of the coal industry as well as geological organizations. 29 references, 27 tables.

  10. [Decision modeling for economic evaluation of health technologies].

    Science.gov (United States)

    de Soárez, Patrícia Coelho; Soares, Marta Oliveira; Novaes, Hillegonda Maria Dutilh

    2014-10-01

    Most economic evaluations that participate in decision-making processes for incorporation and financing of technologies of health systems use decision models to assess the costs and benefits of the compared strategies. Despite the large number of economic evaluations conducted in Brazil, there is a pressing need to conduct an in-depth methodological study of the types of decision models and their applicability in our setting. The objective of this literature review is to contribute to the knowledge and use of decision models in the national context of economic evaluations of health technologies. This article presents general definitions about models and concerns with their use; it describes the main models: decision trees, Markov chains, micro-simulation, simulation of discrete and dynamic events; it discusses the elements involved in the choice of model; and exemplifies the models addressed in national economic evaluation studies of diagnostic and therapeutic preventive technologies and health programs.

  11. Realization of economic evaluation expert system for uranium mine project

    International Nuclear Information System (INIS)

    Wang Haifeng

    1993-01-01

    By studying the EVALUATOR, economic evaluation expert system of uranium mine project, the theoretical fundamentals of expert system, principle of inference mechanism, implementation of knowledge base, realization of explanation mechanism, acquisition of domain knowledge and representation of knowledge were described, especially the subjective Bayes approach for inexact reasoning problem used in EVALUATOR was discussed in detail

  12. Solar energy system economic evaluation for Seeco Lincoln, Lincoln, Nebraska

    Science.gov (United States)

    1980-01-01

    The economic analysis of the solar energy system that was installed at Lincoln, Nebraska is developed for this and four other sites typical of a wide range of environmental and economic conditions in the continental United States. This analysis is accomplished based on the technical and economic models in the f chart design procedure with inputs based on the characteristics of the installed system and local conditions. The results are expressed in terms of the economic parameters of present worth of system cost over projected twenty year life: life cycle savings, year of positive savings and year of payback for the optimized solar energy system at each of the analysis sites. The sensitivity of the economic evaluation to uncertainties in constituent system and economic variables is also investigated.

  13. Solar energy system economic evaluation: IBM System 4, Clinton, Mississippi

    Science.gov (United States)

    1980-01-01

    An economic analysis of the solar energy system was developed for five sites, typical of a wide range of environmental and economic conditions in the continental United States. The analysis was based on the technical and economic models in the F-chart design procedure, with inputs based on the characteristic of the installed system and local conditions. The results are of the economic parameters of present worth of system cost over a 20 year time span: life cycle savings, year of positive savings and year of payback for the optimized solar energy system at each of the analysis sites. The sensitivity of the economic evaluation to uncertainties in constituent system and economic variables is also investigated.

  14. Ultrasound diagnosis and evaluation of plantar heel pain.

    Science.gov (United States)

    Argerakis, Nicholas G; Positano, Rock G; Positano, Rock C J; Boccio, Ashley K; Adler, Ronald S; Saboeiro, Gregory R; Dines, Joshua S

    2015-03-01

    One of the most common causes of heel pain is plantar fasciitis; however, there are other pathologic disorders that can mimic the symptoms and clinical presentation of this disorder. The purpose of this study was to retrospectively review the prevalence of various pathologic disorders on ultrasound in patients with proximal plantar heel pain. The medical records and diagnostic ultrasound reports of patients presenting with plantar heel pain between March 1, 2006, and March 31, 2007, were reviewed retrospectively, and the prevalence of various etiologies was collected. The inclusion criteria were based on their clinical presentation of plantar fasciitis or previous diagnosis of plantar fasciitis from an unknown source. Ultrasound evaluation was then performed to confirm the clinical diagnosis. We examined 175 feet of 143 patients (62 males and 81 females; age range, 16-79 years). Plantar fibromas were present in 90 feet (51%). Plantar fasciitis was diagnosed in 128 feet (73%). Coexistent plantar fibroma and plantar fascial thickening was found in 63 feet (36%). Of the 47 feet that were negative for plantar fasciitis on ultrasound, 27 (57%) revealed the presence of plantar fibroma. Diagnostic ultrasound can effectively and safely identify the prevalence of various etiologies of heel pain. The high prevalence of plantar fibromas and plantar fascial tears cannot be determined by clinical examination alone, and, therefore, ultrasound evaluation should be performed for confirmation of diagnosis.

  15. [Evaluation of economic forest ecosystem services in China].

    Science.gov (United States)

    Wang, Bing; Lu, Shao-Wei

    2009-02-01

    This paper quantitatively evaluated the economic forest ecosystem services in the provinces of China in 2003, based on the long-term and continuous observations of economic forest ecosystems in this country, the sixth China national forest resources inventory data, and the price parameter data from the authorities in the world, and by applying the law of market value, the method of substitution of the expenses, and the law of the shadow project. The results showed that in 2003, the total value of economic forest ecosystem services in China was 11763.39 x 10(8) yuan, and the total value of the products from economic forests occupied 19.3% of the total ecosystem services value, which indicated that the economic forests not only provided society direct products, but also exhibited enormous eco-economic value. The service value of the functions of economic forests was in the order of water storage > C fixation and O2 release > biodiversity conservation > erosion control > air quality purification > nutrient cycle. The spatial pattern of economic forest ecosystem services in the provinces of China had the same trend with the spatial distribution of water and heat resources and biodiversity. To understand the differences of economic forest ecosystem services in the provinces of China was of significance in alternating the irrational arrangement of our present forestry production, diminishing the abuses of forest management, and establishing high grade, high efficient, and modernized economic forests.

  16. Pressure ulcers management: an economic evaluation.

    Science.gov (United States)

    Foglia, E; Restelli, U; Napoletano, A M; Coclite, D; Porazzi, E; Bonfanti, M; Croce, D

    2012-03-01

    Pressure ulcer management represents a growing problem for medical and social health care systems all over the world, particularly in European Union countries where the incidence of pressure ulcers in older persons (> 60 years of age) is predicted to rise. The aim of this study was to provide evidence for the lower impact on economic resources of using advanced dressings for the treatment of pressure ulcers with respect to conventional simple dressings. Two different models of analysis, derived from Activity Based Costing and Health Technology Assessment, were used to measure, over a 30-day period, the direct costs incurred by pressure ulcer treatment for community-residing patients receiving integrated home care. Although the mean cost per home care visit was higher in the advanced dressings patient group than in the simple dressings patient one (E 22.31 versus E 16.03), analysis of the data revealed that the cost of using advanced dressings was lower due to fewer home care visits (22 versus 11). The results underline the fact that decision-makers need to improve their understanding of the advantages of taking a long-term view with regards to the purchase and use of materials. This could produce considerable savings of resources in addition to improving treatment efficacy for the benefit of patients and the health care system.

  17. Economic evaluation of the Blanket Comparison and Selection Study

    International Nuclear Information System (INIS)

    Waganer, L.M.

    1985-01-01

    The economic impact of employing the highly ranked blankets in the Blanket Comparison and Selection Study (BCSS) was evaluated in the context of both a tokamak and a tandem mirror power reactor (TMR). The economic evaluation criterion was determined to be the cost of electricity. The influencing factors that were considered are the direct cost of the blankets and related systems; the annual cost of blanket replacement; and the performance of the blanket, heat transfer, and energy conversion systems. The technical and cost bases for comparison were those of the STARFIRE and Mirror Advanced Reactor Study conceptual design power plants. The economic evaluation results indicated that the nitrate-salt-cooled blanket concept is an economically attractive concept for either reactor type. The water-cooled, solid breeder blanket is attractive for the tokamak and somewhat less attractive for the TMR. The helium-cooled, liquidlithium breeder blanket is the least economically desirable of higher ranked concepts. The remaining self-cooled liquid-metal and the helium-cooled blanket concepts represent moderately attractive concepts from an economic standpoint. These results are not in concert with those found in the other BCSS evaluation areas (engineering feasibility, safety, and research and development (R and D) requirements). The blankets faring well economically had generally lower cost components, lower pumping power requirements, and good power production capability. On the other hand, helium- and lithium-cooled systems were preferred from the standpoints of safety, engineering feasibility, and R and D requirements

  18. Economic hardship of minority and non-minority cancer survivors 1 year after diagnosis: another long-term effect of cancer?

    Science.gov (United States)

    Pisu, Maria; Kenzik, Kelly M; Oster, Robert A; Drentea, Patricia; Ashing, Kimlin T; Fouad, Mona; Martin, Michelle Y

    2015-04-15

    Current literature suggests that racial/ethnic minority survivors may be more likely than whites to experience economic hardship after a cancer diagnosis; however, little is known about such hardship. Patients with lung cancer (LC) and colorectal cancer (CRC) participating in the Cancer Care Outcomes Research and Surveillance (CanCORS) Consortium were surveyed approximately 4 months (baseline) and 12 months (follow-up) after diagnosis. Economic hardship at follow-up was present if participants 1) indicated difficulty living on household income; and/or 2) for the following 2 months, anticipated experiencing hardships (inadequate housing, food, or medical attention) or reducing living standards to the bare necessities of life. The authors tested whether African Americans (AAs) and Hispanics were more likely than whites to experience economic hardship controlling for sex, age, education, marital status, cancer stage, treatment, and economic status at baseline (income, prescription drug coverage). Of 3432 survivors (39.7% with LC, 60.3% with CRC), 14% were AA, 7% were Hispanic, and 79% were white. AAs and Hispanics had lower education and income than whites. Approximately 68% of AAs, 58% of Hispanics, and 44.5% of whites reported economic hardship. In LC survivors, the Hispanic-white disparity was not significant in unadjusted or adjusted analyses, and the AA-white disparity was explained by baseline economic status. In CRC survivors, the Hispanic-white disparity was explained by baseline economic status, and the AA-white disparity was not explained by the variables that were included in the model. Economic hardship was evident in almost 1 in 2 cancer survivors 1 year after diagnosis, especially AAs. Research should evaluate and address risk factors and their impact on survival and survivorship outcomes. © 2015 American Cancer Society.

  19. Importance of Economic Evaluation in Health Care: An Indian Perspective.

    Science.gov (United States)

    Dang, Amit; Likhar, Nishkarsh; Alok, Utkarsh

    2016-05-01

    Health economic studies provide information to decision makers for efficient use of available resources for maximizing health benefits. Economic evaluation is one part of health economics, and it is a tool for comparing costs and consequences of different interventions. Health technology assessment is a technique for economic evaluation that is well adapted by developed countries. The traditional classification of economic evaluation includes cost-minimization, cost-effectiveness analysis, cost-utility analysis, and cost-benefit analysis. There has been uncertainty in the conduct of such economic evaluations in India, due to some hesitancy with respect to the adoption of their guidelines. The biggest challenge in this evolutionary method is lack of understanding of methods in current use by all those involved in the provision and purchasing of health care. In some countries, different methods of economic evaluation have been adopted for decision making, most commonly to address the question of public subsidies for the purchase of medicines. There is limited evidence on the impact of health insurance on the health and economic well-being of beneficiaries in developing countries. India is currently pursuing several strategies to improve health services for its population, including investing in government-provided services as well as purchasing services from public and private providers through various schemes. Prospects for future growth and development in this field are required in India because rapid health care inflation, increasing rates of chronic conditions, aging population, and increasing technology diffusion will require greater economic efficiency into health care systems. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  20. ECONOMIC EVALUATION OF BEEKEEPING IN KARLOVACKA COUNTY

    Directory of Open Access Journals (Sweden)

    Janja Kezić

    2009-03-01

    Full Text Available Beekeeping in Croatia has a long tradition. There are favourable climate and vegetation conditions for development of beekeeping in Croatia. The number of registered beekeepers in Croatia is 3.404 with total of 313.978 beehives. Most of them are part–time beekeepers (53 %, hobby beekeepers comprise 37 % and professional beekeepers represent the smallest part with 11 % [3]. Beekeeping production is mainly organized on family farms [5]. Karlovačka county, in the cental part of Croatia, was chosen to analyse the economic attributes of beekeeping. The number of beekeepers in Karlovačka county in 2007. was 179 with total of 17.636 beehives [3]. Beekeepers were interviewed during the regular meeting of the Beekeepers Association. Forty–five beekeepers were interviewed which is a representative sample of beekeepers in Karlovacka county. Beekeepers were categorized as hobby beekeepers (<60, part–time (61–150 and professional beekeepers (>151 based on the number of beehives. There are 56 % of hobby beekeepers, 31 % of part–time beekeepers and 13 % are professional beekeepers. Fixed assets in beekeeping consist of equipment, beehives and vehicles used in beekeeping (trucks, trailers, personal car. Hobby beekeepers generate 5.031,55 € of total income per year with 52 average beehives per beekeeper. They achieve the highiest selling price an average of 3,20 € per kilo for their honey. Part–time beekeepers generate 9.875,74 € total income per year. The average number of beehives per part–time beekeeper is 110 and they achieve a selling price of 2,69 € per kilo. Professional beekeepers generate 26.681,36 € total income per year with an average number of 329 beehives per beekeeper. Their actual selling price, on average, is 2,07 €.

  1. To evaluate the efficacy of ultrasonography compared to clinical diagnosis, radiography and histopathological findings in the diagnosis of maxillofacial swellings

    Energy Technology Data Exchange (ETDEWEB)

    Pallagatti, Shambulingappa, E-mail: dr.shambulingappa@gmail.com [Department of Oral Medicine and Radiology, M.M. College of Dental Sciences and Research, Mullana, Ambala, Haryana (India); Sheikh, Soheyl; Puri, Nidhi; Mittal, Amit; Singh, Balwinder [Department of Oral Medicine and Radiology, M.M. College of Dental Sciences and Research, Mullana, Ambala, Haryana (India)

    2012-08-15

    Aim: To evaluate the efficacy of Ultrasonography compared to clinical diagnosis, radiography and histopathological findings in the diagnosis of maxillofacial swellings. Material and methods: The study was conducted on forty-five patients with maxillofacial swellings. The clinical diagnosis, radiographic diagnosis and ultrasonographic diagnosis were made which was compared to the histopathological diagnosis. The maxillofacial swellings included cystic lesions, benign swellings, malignant swellings, lymphadenopathies and abscesses and space infections. Results: The diagnostic accuracy and contingency coefficient was evaluated considering histopathology as gold standard. The diagnostic accuracy of ultrasound was found to be 92.30% in the diagnosis of cystic lesions, 87.5% in benign tumors, 81.8% in malignant tumors, 100% in lymphadenopathies and 90% in space infections and abscesses. The contingency coefficient of 0.934 was obtained when ultrasonography was compared to the histopathology, which was highly significant. Similar significant results were obtained comparing ultrasonography with clinical diagnosis (0.895) and radiographic diagnosis (0.889). Conclusion: Ultrasonography provides accurate imaging of the head and neck region and provides information about the nature of the lesion, its extent, and relationship with the surrounding structures. As the conventional and digital radiography enable the diagnosis of the presence of the disease, but do not give any indication of its nature. So, together with clinical and histopathological examinations, real time ultrasound imaging works out as a valuable adjunct in the diagnosis of orofacial swellings.

  2. Economic evaluation of spondyloarthritis: economic impact of diagnostic delay in Italy.

    Science.gov (United States)

    Mennini, Francesco S; Viti, Raffaella; Marcellusi, Andrea; Sciattella, Paolo; Viapiana, Ombretta; Rossini, Maurizio

    2018-01-01

    Spondyloarthritis (SpA) is a disease that normally affects the axial skeleton. It progressively leads to overall stiffness up to severe postural deformity of rachis and functional impotence. The objective of the study was to quantify, through an economic model, the impact of specialized testing and pharmacological treatments carried out by the National Health Service (NHS) in normal clinical practice, before the patient is diagnosed with SpA in Italy. In line with the analysis objective, the chosen perspective is that of the NHS. The study was conducted by analyzing the Health Search Database - IMS Health Longitudinal Patient Database, from which newly diagnosed SpA patients were identified over the period 1 January 2007 to 31 December 2013. The use of specialist health care services and pharmacological treatments provided to the patients before the final SpA diagnosis were estimated. Through a retrospective analysis of the Health Search Database, 1,084 subjects (aged 25-45 years) were identified. These patients produced an expense of approximately €153,000 in the 3 years prior to a confirmed SpA diagnosis, in terms of specialist check-ups and drugs, presumably not appropriately used due to a lack of diagnosis. If we assume that the Health Search Database is a representative sample of the Italian population, it may be estimated that, in the 3 years prior to SpA diagnosis, over €5.4 million was largely unduly spent in Italy to examine and manage 38,232 newly diagnosed SpA patients, between 2010 and 2013. The costs due to the delay in SpA diagnosis were quantified for the first time in Italy. For this reason, this work represents a contribution for national and regional decision makers to understand the current clinical practice and the economic consequences of a diagnostic delay in the short and medium term.

  3. [Systematic economic assessment and quality evaluation for traditional Chinese medicines].

    Science.gov (United States)

    Sun, Xiao; Guo, Li-ping; Shang, Hong-cai; Ren, Ming; Lei, Xiang

    2015-05-01

    To learn about the economic studies on traditional Chinese medicines in domestic literatures, in order to analyze the current economic assessment of traditional Chinese medicines and explore the existing problems. Efforts were made to search CNKI, VIP, Wanfang database and CBM by computer and include all literatures about economic assessment of traditional Chinese medicines published on professional domestic journals in the systematic assessment and quality evaluation. Finally, 50 articles were included in the study, and the systematic assessment and quality evaluation were made for them in terms of titles, year, authors' identity, expense source, disease type, study perspective, study design type, study target, study target source, time limit, cost calculation, effect indicator, analytical technique and sensitivity analysis. The finally quality score was 0.74, which is very low. The results of the study showed insufficient studies on economics of traditional Chinese medicines, short study duration and simple evaluation methods, which will be solved through unremitting efforts in the future.

  4. Economic evaluation in patient safety: a literature review of methods.

    Science.gov (United States)

    de Rezende, Bruna Alves; Or, Zeynep; Com-Ruelle, Laure; Michel, Philippe

    2012-06-01

    Patient safety practices, targeting organisational changes for improving patient safety, are implemented worldwide but their costs are rarely evaluated. This paper provides a review of the methods used in economic evaluation of such practices. International medical and economics databases were searched for peer-reviewed publications on economic evaluations of patient safety between 2000 and 2010 in English and French. This was complemented by a manual search of the reference lists of relevant papers. Grey literature was excluded. Studies were described using a standardised template and assessed independently by two researchers according to six quality criteria. 33 articles were reviewed that were representative of different patient safety domains, data types and evaluation methods. 18 estimated the economic burden of adverse events, 3 measured the costs of patient safety practices and 12 provided complete economic evaluations. Healthcare-associated infections were the most common subject of evaluation, followed by medication-related errors and all types of adverse events. Of these, 10 were selected that had adequately fulfilled one or several key quality criteria for illustration. This review shows that full cost-benefit/utility evaluations are rarely completed as they are resource intensive and often require unavailable data; some overcome these difficulties by performing stochastic modelling and by using secondary sources. Low methodological transparency can be a problem for building evidence from available economic evaluations. Investing in the economic design and reporting of studies with more emphasis on defining study perspectives, data collection and methodological choices could be helpful for strengthening our knowledge base on practices for improving patient safety.

  5. Economic evaluation of the integrated SMART desalination plant

    Energy Technology Data Exchange (ETDEWEB)

    Hwang, Young Dong; Lee, Man Kye; Yeo, Ji Won; Kim, Hee Chul; Chang, Moon Hee

    2001-04-01

    In this study, an economic evaluation methodology of the integrated SMART desalination plant was established and the economic evaluation of SMART was performed. The plant economics was evaluated with electricity generation costs calculated using approximate estimates of SMART cost data and the result was compared with the result calculated using the SMART design data and estimated bulk materials. In addition, a series of sensitivity studies on the power generation cost was performed for the main economic parameters of SMART Power credit method was used for the economic analysis of the integrated SMART desalination plant. Power credit method is a widely used economic analysis method for the cogeneration plant when the major portion of the energy is used for the electricity generation. In the case of using SMART fot power generation only, the result shows that the electricity generation cost of SMART is higher than that of the alternative power options. However, it can be competitive with the other power options in the limited cases, especially with the gas fired combined plant. In addition, an economic analysis of the integrated SMART desalination plant coupled with MED was performed. The calculated water production cost is in the range of 0.56 approx. 0.88($/m{sup 3}) for the plant availability of 80% or higher, which is close to the study results presented by the various other countries. This indicates that SMART can be considered as a competitive choice for desalination among various alternative energy sources.

  6. Economic evaluation of the integrated SMART desalination plant

    International Nuclear Information System (INIS)

    Hwang, Young Dong; Lee, Man Kye; Yeo, Ji Won; Kim, Hee Chul; Chang, Moon Hee

    2001-04-01

    In this study, an economic evaluation methodology of the integrated SMART desalination plant was established and the economic evaluation of SMART was performed. The plant economics was evaluated with electricity generation costs calculated using approximate estimates of SMART cost data and the result was compared with the result calculated using the SMART design data and estimated bulk materials. In addition, a series of sensitivity studies on the power generation cost was performed for the main economic parameters of SMART Power credit method was used for the economic analysis of the integrated SMART desalination plant. Power credit method is a widely used economic analysis method for the cogeneration plant when the major portion of the energy is used for the electricity generation. In the case of using SMART fot power generation only, the result shows that the electricity generation cost of SMART is higher than that of the alternative power options. However, it can be competitive with the other power options in the limited cases, especially with the gas fired combined plant. In addition, an economic analysis of the integrated SMART desalination plant coupled with MED was performed. The calculated water production cost is in the range of 0.56 approx. 0.88($/m 3 ) for the plant availability of 80% or higher, which is close to the study results presented by the various other countries. This indicates that SMART can be considered as a competitive choice for desalination among various alternative energy sources

  7. Improving early cycle economic evaluation of diagnostic technologies.

    Science.gov (United States)

    Steuten, Lotte M G; Ramsey, Scott D

    2014-08-01

    The rapidly increasing range and expense of new diagnostics, compels consideration of a different, more proactive approach to health economic evaluation of diagnostic technologies. Early cycle economic evaluation is a decision analytic approach to evaluate technologies in development so as to increase the return on investment as well as patient and societal impact. This paper describes examples of 'early cycle economic evaluations' as applied to diagnostic technologies and highlights challenges in its real-time application. It shows that especially in the field of diagnostics, with rapid technological developments and a changing regulatory climate, early cycle economic evaluation can have a guiding role to improve the efficiency of the diagnostics innovation process. In the next five years the attention will move beyond the methodological and analytic challenges of early cycle economic evaluation towards the challenge of effectively applying it to improve diagnostic research and development and patient value. Future work in this area should therefore be 'strong on principles and soft on metrics', that is, the metrics that resonate most clearly with the various decision makers in this field.

  8. The Development Evaluation of Economic Zones in China

    Science.gov (United States)

    Shi, Hong-Bo; Zhang, Zhe; Zhai, Yuming; Chen, Quan; Wang, Jiangtao

    2018-01-01

    After the Chinese reform and opening up, the construction of economic zones, such as Special Economic Zones, Hi-tech Zones and Bonded Zones, has played an irreplaceable role in China’s economic development. Currently, against the background of Chinese economic transition, research on development evaluation of economic zones has become popular and necessary. Similar research usually focuses on one specific field, and the methods that are used to evaluate it are simple. This research aims to analyse the development evaluation of zones by synthesis. A new hybrid multiple criteria decision making (MCDM) model that combines the DEMATEL technique and the DANP method is proposed. After establishing the evaluation criterion system and acquiring data, the influential weights of dimensions and criteria can be calculated, which will be a guide for forming measures of development. Shandong Peninsula Blue Economic Zone is used in the empirical case analysis. The results show that Transportation Conditions, Industrial Structure and Business Climate are the main influencing criteria and measures based on these criteria are proposed. PMID:29301304

  9. Evaluating the economic impact of casino liberalization in Macao.

    Science.gov (United States)

    Zheng, Victor; Hung, Eva P W

    2012-09-01

    This paper aims to evaluate the economic impact after Macao decided to liberalize its gaming industry. By analysing both objective data of official statistics and subjective data of the perceptions of quality of life, we painted a picture of mixed blessings. Although objective indicators showed strong economic growth in terms of a rise in per capita GDP and public revenue as well as a decline in unemployment rate, subjective indicators revealed that local residents were less than optimistic about their own employment outlook and did not perceive any improvement in their overall economic situation. While casino liberalization brought forth tremendous economic gain, the general population did not subjectively feel the benefits. An integrative analysis of both objective and subjective indicators would therefore allow us to look closer how residents' lives in the micro-level could have been adversely affected by the prosperous economic outlook at the macro-level.

  10. Solar energy system economic evaluation for Solaron Akron, Akron, Ohio

    Science.gov (United States)

    1980-01-01

    The economic analysis of the solar energy system that was installed at Akron, Ohio is developed for this and four other sites typical of a wide range of environmental and economic conditions. The analysis is accomplished based on the technical and economic models in the f chart design procedure with inputs based on the characteristics of the installed parameters of present worth of system cost over a projected twenty year life: life cycle savings, year of positive savings and year of payback for the optimized solar energy system at each of the analysis sites. The sensitivity of the economic evaluation to uncertainties in constituent system and economic variables is also investigated. Results show that only in Albuquerque, New Mexico, where insolation is 1828 Btu/sq ft/day and the conventional energy cost is high, is this solar energy system marginally profitable.

  11. A Survey on Economic-driven Evaluations of Information Technology

    NARCIS (Netherlands)

    Mutschler, B.B.; Zarvic, N.; Reichert, M.U.

    2007-01-01

    The economic-driven evaluation of information technology (IT) has become an important instrument in the management of IT projects. Numerous approaches have been developed to quantify the costs of an IT investment and its assumed profit, to evaluate its impact on business process performance, and to

  12. Economic Evaluation pf Antibacterial Usage in Ear, Nose and Throat ...

    African Journals Online (AJOL)

    Purpose: To carry out economic evaluation of antibacterial usage for Ear, Nose and Throat infections in a tertiary health care facility in Nigeria. Methods: Antibacterial utilisation evaluation was carried out retrospectively over one year period by reviewing 122 case notes containing 182 prescriptions of patient with Ear Nose ...

  13. Conceptual Framework of Economic Evaluation on SMRs

    International Nuclear Information System (INIS)

    Cho, Jin Sam; Kim, Jee Young; Kim, Chang Hoon

    2010-01-01

    Korea Atomic Energy Research Institute(KAERI) launched a project to develop an integral reactor in 1996. The reactor called as System Integrated Modular Advanced Reactor(SMART) which is a kind of small modular reactors (SMRs). Since the early 1990s, there has been renewed interest in the development and application of small and medium sized integral reactors. 2009 assessment by the IAEA under its Innovative Nuclear Power Reactor and Fuel Cycle (INPRO) program concluded that there could be 96 SMRs in operation around the world by 2030 in its 'high' case, and 43 units in the 'low' case, none of them in the USA. The reason of the increased demand mostly comes from the fact that SMRs are thought to be more suitable for developing countries with small electrical grid capacity, insufficient infrastructure and limited investment capability than developed ones. However, it has disadvantage in the point of scale of economy. So, it should be compared the amount of this advantage and disadvantage which differ from the circumstances of the countries. In this work, conceptual framework was built up for suitable evaluation model of SMRs to be utilized in the future detailed study

  14. Feasibility Study on Nuclear Propulsion Ship according to Economic Evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Gil, Youngmi; Yoo, Seongjin; Oh, June; Byun, Yoonchul; Woo, Ilguk [Daewoo Shipbuilding and Marine Engineering Co., Ltd, Seoul (Korea, Republic of); Kim, Jiho; Choi, Suhn [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2013-05-15

    The use of nuclear ships has been extending to the icebreaker, the deep-water exploration ship, and the floating nuclear power plant. Prior to developing the new ship, the relevant regulations need to be considered. In this study, we reviewed the nuclear ship-related regulations. In addition, economic value is one of the most important factors which should be considered in the pre-design phase. To evaluate the economics of the nuclear ship, we calculated Capital Expenditure (abbreviated as CAPEX) and Operation Expenditure (abbreviated as OPEX) for various types of ships. We reviewed the nuclear ship-related regulations and evaluated the economics of the nuclear ship compared to the diesel ship. The calculation result shows that economic feasibility of the nuclear ship depends on the oil price as well as the cost of the nuclear reactor.

  15. ECOGEN - Soil ecological and economic evaluation of genetically modified crops

    DEFF Research Database (Denmark)

    Krogh, P. H

    2007-01-01

    ECOGEN is a project funded by the EU under the 6th Framework Programme. Based on results obtained from soil biodiversity studies and economic evaluations, ECOGEN assessed the impact on soil organisms of different agricultural management practices, including those involving genetically modified (GM...... Policy were then evaluated. These two major factors - ecological and economic - were then integrated into decision support models for predicting the overall consequences of introducing GM crops into an agricultural system. Bt-maize line MON 810, resistant to a widespread insect pest called the European...... and economic results were integrated into a decision support model to facilitate the assessment of the impact of various cropping systems on soil quality and economics. In conclusion, the ECOGEN results indicate no difference of biological relevance in the impact on soil organisms between Bt-maize line MON 810...

  16. The economic evaluation of pharmacotherapies for Parkinson's disease.

    Science.gov (United States)

    Coyle, D; Barbeau, M; Guttman, M; Baladi, J-F

    2003-06-01

    As well as the significant clinical effects of Parkinson's disease (PD), the disease places a high economic burden on society. Given the scarcity of health care resources, it is becoming increasingly necessary to demonstrate that new therapies for PD provide value for money in comparison with other potential interventions. This paper outlines the basic techniques of cost-effectiveness analysis and its application to PD. These techniques are illustrated by a recent economic evaluation of entacapone for use in Canada.

  17. The economics of Language Policy: An Introduction to Evaluation Work

    OpenAIRE

    Grin, François; Vaillancourt, François

    2015-01-01

    This chapter presents some of the main empirical methods used by economists who since the 1970s have contributed to the elaboration of language policies. This specific focus is the result of the theme of this book; it is more restrictive than discussions on the economics of language of the economics of language policy evaluation. Furthermore, this leads us to emphasize practice-oriented research using quantitative data, in which economists have addressed questions such as: "How much does it c...

  18. Economic evaluation of municipal solid waste recycling in Yazd:

    OpenAIRE

    Eslami H; Mokhtari M; Eslami Dost Z; Barzegar Khanghah MR; Ranjbar Ezzatabadi M

    2017-01-01

    Background and aims: In every urban waste management plan, recycling and reuse is considered as an economic pattern. This study aimed to economic evaluation of municipal solid waste recycling in Yazd by cost-benefit analysis in 2015. Methods: This research is a descriptive–analytic study which in the data about quality and quantity of municipal solid waste in Yazd city were collected through the sampling and physical analysis and the data about total income and costs from the implementatio...

  19. Clinical evaluation of echography in diagnosis of thyroid disease

    International Nuclear Information System (INIS)

    Fritzsche, H.; Braendle, J.

    1983-01-01

    In 63 patients echography of thyroid was performed additionally to case history, palpation, scintigraphy and hormone tests for evaluating clinical significance of this method. The benefit of this technique is rapid measurement of thyroid size, demonstration of nodules in palpable diffuse goiters and differentiating of solid or cystic nodules of the thyroid. For diagnosis of autonomous areas in the thyroid scintigrahy remains the method of choice. Also there is no correlation of ultrasound findings and thyroid function. In routine diagnostic procedure of thyroid disease echography may replace scintigraphy only in diffuse goiter and if radionuclide imaging is not possible. Nevertheless ultrasonic evaluation of the thyroid is an important additional method in diagnostic of thyroid diseases. (Author)

  20. Health economic evaluations in orthodontics: a systematic review.

    Science.gov (United States)

    Sollenius, Ola; Petrén, Sofia; Björnsson, Liselotte; Norlund, Anders; Bondemark, Lars

    2016-06-01

    Economic evaluation is assuming increasing importance as an integral component of health services research. To conduct a systematic review of the literature and assess the evidence from studies presenting orthodontic treatment outcomes and the related costs. The literature review was conducted in four steps, according to Goodman's model, in order to identify all studies evaluating economic aspects of orthodontic interventions. The search covered the databases Medline, Cinahl, Cochrane, Embase, Google Scholar, National Health Service Economic Evaluation Database, and SCOPUS, for the period from 1966 to September 2014. The inclusion criteria were as follows: randomized controlled trials or controlled clinical trials comparing at least two different orthodontic interventions, evaluation of both economic and orthodontic outcomes, and study populations of all ages. The quality of each included study was assessed as limited, moderate, or high. The overall evidence was assessed according to the GRADE system (The Grading of Recommendations Assessment, Development and Evaluation). The applied terms for searches yielded 1838 studies, of which 989 were excluded as duplicates. Application of the inclusion and exclusion criteria identified 26 eligible studies for which the full-text versions were retrieved and scrutinized. At the final analysis, eight studies remained. Three studies were based on cost-effectiveness analyses and the other five on cost-minimization analysis. Two of the cost-minimization studies included a societal perspective, i.e. the sum of direct and indirect costs. The aims of most of the studies varied widely and of studies comparing equivalent treatment methods, few were of sufficiently high study quality. Thus, the literature to date provides an inadequate evidence base for economic aspects of orthodontic treatment. This systematic review disclosed that few orthodontic studies have presented both economic and clinical outcomes. There is currently

  1. Evaluation of computer-aided detection and diagnosis systems.

    Science.gov (United States)

    Petrick, Nicholas; Sahiner, Berkman; Armato, Samuel G; Bert, Alberto; Correale, Loredana; Delsanto, Silvia; Freedman, Matthew T; Fryd, David; Gur, David; Hadjiiski, Lubomir; Huo, Zhimin; Jiang, Yulei; Morra, Lia; Paquerault, Sophie; Raykar, Vikas; Samuelson, Frank; Summers, Ronald M; Tourassi, Georgia; Yoshida, Hiroyuki; Zheng, Bin; Zhou, Chuan; Chan, Heang-Ping

    2013-08-01

    Computer-aided detection and diagnosis (CAD) systems are increasingly being used as an aid by clinicians for detection and interpretation of diseases. Computer-aided detection systems mark regions of an image that may reveal specific abnormalities and are used to alert clinicians to these regions during image interpretation. Computer-aided diagnosis systems provide an assessment of a disease using image-based information alone or in combination with other relevant diagnostic data and are used by clinicians as a decision support in developing their diagnoses. While CAD systems are commercially available, standardized approaches for evaluating and reporting their performance have not yet been fully formalized in the literature or in a standardization effort. This deficiency has led to difficulty in the comparison of CAD devices and in understanding how the reported performance might translate into clinical practice. To address these important issues, the American Association of Physicists in Medicine (AAPM) formed the Computer Aided Detection in Diagnostic Imaging Subcommittee (CADSC), in part, to develop recommendations on approaches for assessing CAD system performance. The purpose of this paper is to convey the opinions of the AAPM CADSC members and to stimulate the development of consensus approaches and "best practices" for evaluating CAD systems. Both the assessment of a standalone CAD system and the evaluation of the impact of CAD on end-users are discussed. It is hoped that awareness of these important evaluation elements and the CADSC recommendations will lead to further development of structured guidelines for CAD performance assessment. Proper assessment of CAD system performance is expected to increase the understanding of a CAD system's effectiveness and limitations, which is expected to stimulate further research and development efforts on CAD technologies, reduce problems due to improper use, and eventually improve the utility and efficacy of CAD in

  2. [Principles of health economic evaluation for use by caregivers].

    Science.gov (United States)

    Derumeaux-Burel, Hélène; Derancourt, Christian; Rambhojan, Christine; Branchard, Olivier; Hayes, Nathalie; Bénard, Antoine

    2017-01-01

    The aim of health economic evaluation is to maximize health gains from limited resources. By definition, health economic evaluation is comparative, based on average costs and outcomes of compared interventions. Incremental costs and outcomes are used to calculate the cost-effectiveness ratio, which represents the average incremental cost per gained unit of effectiveness (i.e.: a year of life) with the evaluated intervention compared to the reference. The health economic rationale applies to all health domains. We cannot spend collective resources (health insurance) without asking ourselves about their potential alternative uses. This reasoning is useful to caregivers for understanding resources allocation decisions and healthcare recommandations. Caregivers should grab this field of expertise because they are central in this strategic reflection for defining the future French healthcare landscape. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  3. Economic evaluation of private power production under uncertainties

    Energy Technology Data Exchange (ETDEWEB)

    Weiguo Xing; Wu, F.F. [University of Hong Kong (China). Centre for Electrical Energy Systems

    2003-02-01

    Private power production is becoming an increasingly important source of electricity generation. In developing countries, build-operate-transfer (BOT) arrangement has emerged as a dominant form of private investment. Pricing private power production at its avoided cost is the breakeven point for the utility in economic evaluation, and uncertainties must be taken into account. In this paper, an approach of calculating the breakeven cost to the utility of a BOT power plant whose contract lasts for 10-25 years is proposed. The proposed approach requires the computation of production costs from long-term generation expansion planning (GEP) under future uncertainties. To facilitate the inclusion of constraints introduced by BOT plants in GEP and uncertainties, a genetic algorithm method is utilized in GEP. The breakeven cost is a useful measure in the economic evaluation of BOT power plants. An example is presented to illustrate the economic evaluation of BOT plants using the concept of breakeven cost.(author)

  4. Productivity costs in economic evaluations: past, present, future.

    Science.gov (United States)

    Krol, Marieke; Brouwer, Werner; Rutten, Frans

    2013-07-01

    Productivity costs occur when the productivity of individuals is affected by illness, treatment, disability or premature death. The objective of this paper was to review past and current developments related to the inclusion, identification, measurement and valuation of productivity costs in economic evaluations. The main debates in the theory and practice of economic evaluations of health technologies described in this review have centred on the questions of whether and how to include productivity costs, especially productivity costs related to paid work. The past few decades have seen important progress in this area. There are important sources of productivity costs other than absenteeism (e.g. presenteeism and multiplier effects in co-workers), but their exact influence on costs remains unclear. Different measurement instruments have been developed over the years, but which instrument provides the most accurate estimates has not been established. Several valuation approaches have been proposed. While empirical research suggests that productivity costs are best included in the cost side of the cost-effectiveness ratio, the jury is still out regarding whether the human capital approach or the friction cost approach is the most appropriate valuation method to do so. Despite the progress and the substantial amount of scientific research, a consensus has not been reached on either the inclusion of productivity costs in economic evaluations or the methods used to produce productivity cost estimates. Such a lack of consensus has likely contributed to ignoring productivity costs in actual economic evaluations and is reflected in variations in national health economic guidelines. Further research is needed to lessen the controversy regarding the estimation of health-related productivity costs. More standardization would increase the comparability and credibility of economic evaluations taking a societal perspective.

  5. Study on Economic Evaluation of Nuclear Power Plant's SSC

    International Nuclear Information System (INIS)

    Yun, Eun-Sub; Park, Young-Sheop

    2007-01-01

    As the operating year of nuclear power plant increases, more improvement plans on degraded SSCs(Structure, System, and Component) are suggested. Because of safety concern, the maintenance and replacing cost of nuclear power plant's SSCs are usually high and it can be a burden to financial control. To satisfy both safety and economic problems, systematic and efficient plans are needed. For this reason, KHNP is now developing the LTAM (Long Term Asset Management) program to establish the long term improvement plans for SSCs, from safety and economic point of views. Actually LTAM program is one of the steps of INPO ER (Equipment Reliability) process. In USA, EPRI (Electric Power Research Institute) has developed the LCM (Life Cycle Management) program and it was applied to some nuclear power plants. In this program, several alternatives are candidated. Then, economic evaluation is applied to each alternative. The result of economic evaluation affects to the final alternative decision. In this study, EPRI's economic evaluation method is reviewed

  6. Evaluation of computed tomography in the diagnosis of liver diseases

    Energy Technology Data Exchange (ETDEWEB)

    Kato, K; Takayama, T; Katada, N; Nishimura, D; Shibata, T [Kamo Hospital, Toyota, Aichi (Japan)

    1980-10-01

    In order to evaluate computed tomography (CT) in the diagnosis of liver disease, 90 cases of diffuse parenchymal diseases and 37 cases of mass lesions were examined with a GE 8800 CT scanner. Abnormal CT findings in liver cirrhosis were characterized by splenomegaly, uneven liver margin and asites. Atrophy of right lobe and enlargement of left lobe could not be easily recognized on CT scan, compared with nuclear imaging. CT values of the liver were decreased and the ratios of CT values of the liver to those of the spleen were less than 0.9 in all cases with fatty liver. Jaundice in acute viral hepatitis can be easily differentiated from obstructive jaundice on CT scan because of observing no dilatation of intrahepatic bile duct. CT was superior in detecting space-occupying lesions to nuclear imaging and was more specific in that it was able to differentiate cystic from solid lesions. However, it was almost impossible to make a histological diagnosis of solid lesions even on CT scan.

  7. Evaluation of computed tomography in the diagnosis of liver diseases

    International Nuclear Information System (INIS)

    Kato, Katsumoto; Takayama, Tetsuo; Katada, Naoyuki; Nishimura, Daisaku; Shibata, Tokimune

    1980-01-01

    In order to evaluate computed tomography (CT) in the diagnosis of liver disease, 90 cases of diffuse parenchymal diseases and 37 cases of mass lesions were examined with GE 8800 CT scanner. Abnormal CT findings in liver cirrhosis were characterized by splenomegaly, uneven liver margin and asites. Atrophy of right lobe and enlargement of left lobe could not be easily recognized on CT scan, compared with nuclear imaging. CT values of the liver were decreased and the ratios of CT values of the liver to those of the spleen were less than 0.9 in all cases with fatty liver. Jaundice in acute viral hepatitis can be easily differentiated from obstructive jaundice on CT scan because of observing no dilatation of intrahepatic bile duct. CT was superior in detecting space-occupying lesions to nuclear imaging and was more specific in that it was able to differentiate cystic from solid lesions. However, it was almost impossible to make a histological diagnosis of solid lesions even on CT scan. (author)

  8. Evaluation of nested PCR in diagnosis of fungal rhinosinusitis.

    Science.gov (United States)

    Badiee, Parisa; Gandomi, Behrooz; Sabz, Gholamabbass; Khodami, Bijan; Choopanizadeh, Maral; Jafarian, Hadis

    2015-02-01

    Given the importance of rapid diagnosis for fungal rhinosinusitis, this study aimed to evaluate the use of nested PCR to identify Aspergillus and Mucor species in clinical samples from patients with suspected fungal rhinosinusitis. Functional endoscopic sinus surgery specimens were collected from 98 patients with rhinosinusitis from 2012 to 2013. All samples were ground and cultured on sabouraud dextrose agar. The isolated fungi were identified based on their macroscopic and microscopic features. Fungal DNA was extracted from the tissue samples and nested PCR was performed with two sets of primers for Mucor and Aspergillus. Direct microscopic showed that 5.1% contained fungal components and 9.2% exhibited growth of fungi in culture. The most common agents isolated were Aspergillus fumigatus (n= 3), Aspergillus flavus (n=2), Penicillium sp (n=3) and Alternaria sp. (n=1). Mucor sp. was identified in the pathology smear from 1 patient. Positive results for fungal rhinosinusitis were obtained for a total of 10.2% by culture or pathology smear. Positive PCR results were obtained in 72 samples for Aspergillus and 31 samples for Mucor. Our results suggest that endoscopic sinus surgery specimens are not suitable for nested PCR, probably because of the accumulation of fungi that contaminate the environmental air. This drawback is a limiting factor for diagnosis with nasal cavity specimens. Therefore, molecular methods and conventional culture techniques are helpful complementary diagnostic methods to detect fungal rhinosinusitis and determine appropriate management for these patients.

  9. Evaluation of MODS Culture in the Diagnosis of Pulmonary Tuberculosis

    Directory of Open Access Journals (Sweden)

    Z Aminzadeh

    2012-05-01

    Full Text Available

    Background and Objectives

    Culture of M. tuberculosis is the golden standard for the diagnosis of TB which is a much more sensitive test than Smear examination. There is a strong need to use the new assays in order to speed up diagnostic methods. The aim of this research was to determine the evaluation of Microscopic Observation Drug Susceptibility culture in pulmonary tuberculosis in comparison with Ziehl-Neelsen stain and Lowenstein-Jensen culture of sputum.

     

    Methods

    The research method was a Cross-sectional (diagnostic test and the technique was observational-interview type. If the patient's history revealed clinical criteria compatible with TB and the infectious specialist’s judgment was that of "TB suspected case, the patient was considered a pulmonary TB suspect. Then, in addition to sputum Ziehl-Neelsen stain and culture for Lowenstein-Jensen, we carried out MODS culture as well.

     

    Results

    100 patients (48 male, 52 female with mean age of 52.9 ± 21.83 were evaluated. During sputum examination, 40% were Ziehl-Neelsen stain positive while 30% had positive sputum culture for Mycobacterium Tuberculosis in Lowenstein-Jensen and 47% had positive MODS culture. In comparison with sputum smear and Lowenstein-Jensen culture, MODS had a sensitivity of 82.5% and 86%, specificity of 77% and 70%, positive predictive value of 70% and 55%, negative predictive value of 86% and 92%, respectively.

     

    Conclusion

    MODS culture demonstrated faster recovery and higher negative predictive value than by Lowenstein-Jensen method; it could be a simple and rapid method in the diagnosis of pulmonary tuberculosis.

  10. Economic evaluation in stratified medicine: methodological issues and challenges

    Directory of Open Access Journals (Sweden)

    Hans-Joerg eFugel

    2016-05-01

    Full Text Available Background: Stratified Medicine (SM is becoming a practical reality with the targeting of medicines by using a biomarker or genetic-based diagnostic to identify the eligible patient sub-population. Like any healthcare intervention, SM interventions have costs and consequences that must be considered by reimbursement authorities with limited resources. Methodological standards and guidelines exist for economic evaluations in clinical pharmacology and are an important component for health technology assessments (HTAs in many countries. However, these guidelines have initially been developed for traditional pharmaceuticals and not for complex interventions with multiple components. This raises the issue as to whether these guidelines are adequate to SM interventions or whether new specific guidance and methodology is needed to avoid inconsistencies and contradictory findings when assessing economic value in SM.Objective: This article describes specific methodological challenges when conducting health economic (HE evaluations for SM interventions and outlines potential modifications necessary to existing evaluation guidelines /principles that would promote consistent economic evaluations for SM.Results/Conclusions: Specific methodological aspects for SM comprise considerations on the choice of comparator, measuring effectiveness and outcomes, appropriate modelling structure and the scope of sensitivity analyses. Although current HE methodology can be applied for SM, greater complexity requires further methodology development and modifications in the guidelines.

  11. The added value of thorough economic evaluation of telemedicine networks.

    Science.gov (United States)

    Le Goff-Pronost, Myriam; Sicotte, Claude

    2010-02-01

    This paper proposes a thorough framework for the economic evaluation of telemedicine networks. A standard cost analysis methodology was used as the initial base, similar to the evaluation method currently being applied to telemedicine, and to which we suggest adding subsequent stages that enhance the scope and sophistication of the analytical methodology. We completed the methodology with a longitudinal and stakeholder analysis, followed by the calculation of a break-even threshold, a calculation of the economic outcome based on net present value (NPV), an estimate of the social gain through external effects, and an assessment of the probability of social benefits. In order to illustrate the advantages, constraints and limitations of the proposed framework, we tested it in a paediatric cardiology tele-expertise network. The results demonstrate that the project threshold was not reached after the 4 years of the study. Also, the calculation of the project's NPV remained negative. However, the additional analytical steps of the proposed framework allowed us to highlight alternatives that can make this service economically viable. These included: use over an extended period of time, extending the network to other telemedicine specialties, or including it in the services offered by other community hospitals. In sum, the results presented here demonstrate the usefulness of an economic evaluation framework as a way of offering decision makers the tools they need to make comprehensive evaluations of telemedicine networks.

  12. The use of modeling in the economic evaluation of vaccines

    NARCIS (Netherlands)

    Bos, Jasper M; Alphen, Loek van; Postma, Maarten J

    2002-01-01

    As a consequence of the increased role of pharmacoeconomics in policy-making, economic evaluations are performed at more and more early stages in the development of a therapeutic. This implies the development of models to assess the future impact of an intervention and to account for the level of

  13. Economic evaluation of influenza vaccination : Assessment for The Netherlands

    NARCIS (Netherlands)

    Postma, Maarten J.; Bos, Jasper M.; Van Gennep, Mark; Jager, Johannes C.; Baltussen, Rob; Sprenger, Marc J.W.

    1999-01-01

    Objective: The objective of this study was to determine the costs associated with influenza and the cost effectiveness (net costs per life-year gained) of influenza vaccination in The Netherlands. Design and setting: The economic evaluation comprised a cost-of-illness assessment and a

  14. Performance, Carcass Evaluation And Economics Of Production Of ...

    African Journals Online (AJOL)

    An eight-weeks feeding trial involving 162,8-week old goldline cockerel birds was carried out in a completely randomized design to evaluate the performance, carcass characteristics and economics of production of cockerels fed whole cassava plant meal (WCPM). Diet 1 was maize based and served as the control, diet 2 ...

  15. Economic evaluation of soil fertility management in groundnut fields ...

    African Journals Online (AJOL)

    This paper provides the economic evaluation of soil fertility replenishing technologies (use of inorganic fertilizers, organic manure, and rhizobium inoculant) that were tested and recommended. Data on groundnut technologies used, yields, resource availability and use, and farmers' characteristics were collected through ...

  16. Writing, Evaluating and Assessing Data Response Items in Economics.

    Science.gov (United States)

    Trotman-Dickenson, D. I.

    1989-01-01

    Describes some of the problems in writing data response items in economics for use by A Level and General Certificate of Secondary Education (GCSE) students. Examines the experience of two series of workshops on writing items, evaluating them and assessing responses from schools. Offers suggestions for producing packages of data response items as…

  17. Feasibility and economic evaluation of low-cost evaporative cooling ...

    African Journals Online (AJOL)

    Feasibility and economic evaluation of low-cost evaporative cooling system in fruit and vegetables storage. ... on fruit and vegetables quality during harvesting, transportation, storage and marketing. ... The coolers were found to be effective in maintaining micro-environmental conditions for ... AJOL African Journals Online.

  18. nutritional and economic evaluation of Moringa oleifera leaf meal as ...

    African Journals Online (AJOL)

    nutritional and economic evaluation of Moringa oleifera leaf meal as a dietary supplement in West African Dwarf goats. ... South African Journal of Animal Science ... Moringa oleifera leaves may have the potential to enhance nutritional status, growth performance, and health of ruminant animals when used as part of their ...

  19. Design and techno economic evaluation of biomass gasifier for ...

    African Journals Online (AJOL)

    This paper addresses the design, performance and economic evaluation of biomass based open core downdraft gasifier for industrial process heat application. The gasifier is having feed rate as 90 kg h-1 and producing about 850 MJ h-1 of heat. The gasifier has been installed in M/S Phosphate India Pvt. Limited, Udaipur ...

  20. Disease specific methods for economic evaluations of breast cancer therapies

    NARCIS (Netherlands)

    Frederix, G.W.J.

    2013-01-01

    Cost-effectiveness analyses (CEAs) are widely considered to be helpful tools for making informative decisions in a resource constrained environment. Since the introduction of economic evaluations in reimbursement submissions in Australia as a formal requirement in 1993, CEAs have become widespread

  1. Evaluating economic costs and benefits of climate resilient livelihood strategies

    Directory of Open Access Journals (Sweden)

    S. Liu

    2016-01-01

    Full Text Available A major challenge for international development is to assist the poorest regions to achieve development targets while taking climate change into account. Such ‘climate resilient development’ (CRD must identify and implement adaptation strategies for improving livelihoods while also being cost-effective. While the idea that climate resilience and development goals should be compatible is often discussed, empirical evaluations of the economic impacts of actual CRD investments are practically non-existent. This paper outlines a framework to evaluate economic returns to CRD and applies it in two adaptation strategies trialed in Nusa Tenggara Barat Province, eastern Indonesia. The evaluation framework is composed of three models: a household benefit cost model, a diffusion model, and a regional benefit cost model. The models draw upon the impact evaluation, technology diffusion, and risk assessment literatures, respectively. The analyzes are based on expert opinion and locally-derived information, and hence can be applied in data-poor situations typical of developing countries. Our results explore economic costs and benefits at the household and regional scale, and we identify key input variables that greatly influence the economic returns of the strategies. These variables should therefore be a focus of ongoing investment. We also discuss how the framework is more generally applicable, its limitations including challenges in accounting for less tangible social and ecosystem service benefits, potentially leading to the underestimation of impacts, and how the approach should be complemented by qualitative methods.

  2. Evaluation of Demographic Variables and Socio-economic Status ...

    African Journals Online (AJOL)

    This study evaluated the demographic variables and socio-economic status on the prevalence of health hazards amongst residents of Akure North Local Government, Ondo State, Nigeria. The study was a descriptive research design of the survey type. The population for this study was estimated to be 131,587 residents.

  3. A framework for including family health spillovers in economic evaluation

    NARCIS (Netherlands)

    H. Al-Janabi (Hareth); N.J.A. van Exel (Job); W.B.F. Brouwer (Werner); J. Coast (Joanna)

    2016-01-01

    textabstractHealth care interventions may affect the health of patients' family networks. It has been suggested that these health spillovers? should be included in economic evaluation, but there is not a systematic method for doing this. In this article, we develop a framework for including health

  4. Economic evaluation of information technology applications on dairy farms

    OpenAIRE

    Asseldonk, van, M.A.P.M.

    1999-01-01

    The research described in this thesis focused on the economic evaluation of information technology (IT) applications on dairy farms in order to support investment decisions. The evaluation included a normative (deductive) approach and an empirical (positive) approach. The normative approach predicted potential benefits from a theoretical model of the investment, and investigated how farmers should deal with the applications. The empirical approach observed the actual effects of the i...

  5. Evaluation of endourological tools to improve the diagnosis and therapy of ureteral tumors – from model development to clinical application

    Directory of Open Access Journals (Sweden)

    Wagner D.

    2015-09-01

    Full Text Available Adequate diagnosis of upper urinary tract (UUT tumors is essential for successful local treatment. Organsparing approaches are technically difficult and require consistent further development. Appropriate models for investigating new diagnostic and therapeutic methods are not yet available. This study demonstrates the incorporation of a fresh sample model into five different test levels (I-V for improving the diagnosis and therapy of ureteral tumors. In these test levels, new diagnostic and ablation techniques are evaluated for feasibility, application safety, efficacy and accuracy. An assessment of their suitability for broad preclinical and clinical application also took economic aspects into account.

  6. Economic evaluation of bids for nuclear power plants. 1999 edition

    International Nuclear Information System (INIS)

    2000-01-01

    The introduction of a nuclear power plant (NPP) in a country is a major undertaking for all entities involved. The necessary planning work and co-ordination of the different fields of interest, from the point of view of governments, authorities, industries, universities and of the general public, must be done on a long term basis. This IAEA report may help support the work of the utility in the bidding process, especially in the economic bid evaluation. The different methods, aspects and parameters described should be regarded as a guide. The report's target criterion of lowest levelised discounted electricity generation costs (LDEGC) is a very useful and practical way of ranking bids. In view of the huge investment needed, the owner's country must be fully committed to a nuclear programme. A nuclear programme also requires a guarantee of long term financing, which implies the provision of local and foreign contributions. The necessary staff for all of the various areas of a nuclear programme must be recruited and trained. Within the planning phase, the bid invitation specification (BIS) has to be prepared and sent out in order to receive bids for the scope of supply and services desired by the owner. The evaluation of the bids received from the suppliers in response to the BIS is a huge and long-term task. The evaluation process should lead to the selection of the best bidder and at least to the final decision on the partners constructing the NPP. The responsibility for the entire bidding process lies with the plant owner. For technology transfer, two requirements need to be satisfied: the owner needs a well established and experienced engineering capability, and the supplier must be ready to transfer the agreed technology in such a way as to support the project goals. During the bid evaluation process, all aspects of the technical, financial and contractual approaches must be considered. Nowadays, political, socioeconomic and public acceptance aspects play a

  7. Evaluation of fusion study from socio-economic aspects

    International Nuclear Information System (INIS)

    Konishi, S.; Okano, K.; Ogawa, Y.; Nagumo, S.; Tokimatsu, K.; Tobita, K.

    2005-01-01

    A fusion research project was evaluated from the aspects of socio-economics and its possible economic benefit. Research project itself has large economic impacts and it appears in a different way in different time. Four categories were identified as such mechanisms; direct economic effect by purchase and employment, the growth of local community and its economy, an improvement of technical capability of the industry stimulated by the development, and fusion energy supply under environmental constraints. Industrial effects were analysed from actual R and D program and found to yield considerable economic outcome, although contribution by the research itself is far smaller than that required for industry before actual commercial products can be produced. Economic value of fusion energy could be huge, but appears several decades future, and should be reduced by discount rate and success probability. Its value is more important as a part of environmental policy. Value of the fusion research at present age cannot be estimated as actual benefit, but as the effectiveness in the policy, or benefit for public that is now regarded as a kind of Externality

  8. Analysis of the economic burden of diagnosis and treatment of tuberculosis patients in rural China.

    Science.gov (United States)

    Pan, H-Q; Bele, S; Feng, Y; Qiu, S-S; Lü, J-Q; Tang, S-W; Shen, H-B; Wang, J-M; Zhu, L-M

    2013-12-01

    A county in Jiangsu Province, China. To estimate the costs of the diagnosis and treatment of tuberculosis (TB) from the patient's perspective and to identify determinants of the patient's financial burden. In a cross-sectional survey, we interviewed 316 patients diagnosed from January 2010 to May 2011 who had already completed their anti-tuberculosis treatment. The financial burden on TB patients included out-of-pocket costs and productivity losses. The average per capita total out-of-pocket cost was 3024.0 Chinese yuan (CNY), with a median cost of 1086 CNY (interquartile range [IQR] 480-2456). Mean out-of-pocket medical and non-medical costs were respectively 2565.7 CNY and 458.3 CNY. Productivity lost by patients and family members was 2615.2 CNY (median 500, IQR 250-2025). Factors associated with out-of-pocket costs and productivity losses included hospitalisation, adverse drug reactions, cost of drugs to 'protect' the liver, cost of second-line anti-tuberculosis drugs and diagnostic delay. Although the government of China has implemented a 'free TB service policy', the economic burden on patients is still heavy. More patient-centred interventions are essential to reduce the financial burden on patients.

  9. MRI diagnosis and preoperative evaluation for hepatic hilar tumor

    International Nuclear Information System (INIS)

    Liu Yulin; Kong xiangquan; Xu Haibo; Xiao Xuehong; Liu Dingxi; Peng Zhenjun

    2004-01-01

    Objective: To investigate the value of the all-in-one MR scanning in the diagnosis and preoperative evaluation of hepatic hilar tumor. Methods: Forty-two cases of hepatic hilar tumors were examined with a 1.5 T superconductive MR system, including hepatocellular carcinoma (HCC, n=12), hilar cholangiocarcinoma (HC, n=22), and hilar metastasis (n=8). Besides the precontrast MRI and MRCP, all cases underwent consecutive dynamic contrast-enhanced MR scanning. The whole liver dynamic contrast-enhanced MR was performed with the first bolus injection of Gd-DTPA (10 ml), and 15 minutes later, 3D DCE MRA was performed with additional injection of Gd-DTPA (15-20 ml) (0.15-0.20 mmol/kg). The contrast time-signal curve of liver and tumor was drawn, and arterial and portal venous phase images were reconstructed with MIP. MR appearances were compared with surgical findings and pathology. Results: Consecutive DCE scanning was successfully performed in all cases. The contrast time-signal curve of HCC showed type I and II (10/12, 83.3%), and the curve of HC showed type III and IV (21/22, 95.4%), whereas the curve of metastasis was various. The difference of tumor peak transit time (PT) between HCC group and HC group was significant (P<0.05). The vascular invasion in HCC group appeared as arterial-portal vein fistula (2/12, 16.7%), portal vein infiltration (3/24, 12.5%), and occlusion by tumor thrombosis (4/24, 16.7%). However, the vascular invasion in HC group showed spiral artery (5/22, 22.7%), portal vein infiltration (5/44, 11.4%), portal vein central narrowing (8/44, 18.2%) and occlusion (11/44, 25.0%). All metastasis had no vascular invasion expect one gall bladder carcinoma with right portal vein infiltration. The accuracy of preoperative evaluation with MRI in HCC group and HC group was 83.3% (10/12) and 86.4% (19/22), respectively. The accuracy of preoperative evaluation in all hilar tumors was 78.6% (33/42). Conclusion: Consecutive DCE was a safe and useful technique in MR

  10. Thermo economical evaluation of retrofitting strategies in air conditioning systems

    Energy Technology Data Exchange (ETDEWEB)

    Tribess, Arlindo; Fiorelli, Flavio Augusto Sanzogo; Hernandez Neto, Alberto [Sao Paulo Univ., SP (Brazil). Escola Politecnica. Dept. de Engenharia Mecanica]. E-mail: atribess@usp.br; fiorelli@usp.br; ahneto@usp.br

    2000-07-01

    In a building project, several subsystems are designed, among them the air conditioning system. Electrical energy consumption profiles show that this subsystem is responsible for 40 to 50% of total consumption in a commercial building. Besides the study of technical aspects that should be considered in order to assure the thermal comfort of the occupants as well the temperature and humidity conditions for an efficient equipment operation, an economical evaluation of this subsystem should be also made. In retrofit projects, the economical aspect is also critical for such projects in order to assure bigger efficiency in an economically attractive way. This paper analyses some strategies that might be adopted in retrofitting an air conditioning system installed in a commercial building with mixed occupation. By mixed we mean that some floors have a typical office occupation profile and other floors are mainly occupied by electronic equipment. This analysis includes both technical and economical evaluation. The proposed solutions performance are compared to the old system, which allows to verify the retrofitting impact in energy consumption reduction and its economical feasibility. (author)

  11. Theoretical and methodological basis for the formation and evaluation of the level of the economic system's strategic economic potential

    Directory of Open Access Journals (Sweden)

    Kljushin Vladislav Vladimirovich

    2014-12-01

    Full Text Available The current level of business activity of socio-economic systems of different scale and insufficient to increase their overall potential. To solve this problem, the first priority is the effective management of their strategic and economic potential. Managerial decision-making about the use of economic resources strategic socio-economic systems requires the development of a methodology to identify and evaluate strategic and economic potential.

  12. Evaluation of Health Economics in Radiation Oncology: A Systematic Review

    Energy Technology Data Exchange (ETDEWEB)

    Nguyen, Timothy K.; Goodman, Chris D. [Department of Radiation Oncology, London Regional Cancer Program, London, Ontario (Canada); Boldt, R. Gabriel [London Health Sciences Centre, London, Ontario (Canada); Warner, Andrew; Palma, David A. [Department of Radiation Oncology, London Regional Cancer Program, London, Ontario (Canada); Rodrigues, George B. [Department of Radiation Oncology, London Regional Cancer Program, London, Ontario (Canada); Department of Epidemiology and Biostatistics, Western University, London, Ontario (Canada); Lock, Michael I. [Department of Radiation Oncology, London Regional Cancer Program, London, Ontario (Canada); Mishra, Mark V. [Department of Radiation Oncology, University of Maryland, Baltimore, Maryland (United States); Zaric, Gregory S. [Department of Epidemiology and Biostatistics, Western University, London, Ontario (Canada); Ivey Business School, Western University, London, Ontario (Canada); Louie, Alexander V., E-mail: Dr.alexlouie@gmail.com [Department of Radiation Oncology, London Regional Cancer Program, London, Ontario (Canada); Department of Epidemiology and Biostatistics, Western University, London, Ontario (Canada)

    2016-04-01

    Purpose: Despite the rising costs in radiation oncology, the impact of health economics research on radiation therapy practice analysis patterns is unclear. We performed a systematic review of cost-effectiveness analyses (CEAs) and cost-utility analyses (CUAs) to identify trends in reporting quality in the radiation oncology literature over time. Methods and Materials: A systematic review of radiation oncology economic evaluations up to 2014 was performed, using MEDLINE and EMBASE databases. The Consolidated Health Economic Evaluation Reporting Standards guideline informed data abstraction variables including study demographics, economic parameters, and methodological details. Tufts Medical Center CEA registry quality scores provided a basis for qualitative assessment of included studies. Studies were stratified by 3 time periods (1995-2004, 2005-2009, and 2010-2014). The Cochran-Armitage trend test and linear trend test were used to identify trends over time. Results: In total, 102 articles were selected for final review. Most studies were in the context of a model (61%) or clinical trial (28%). Many studies lacked a conflict of interest (COI) statement (67%), a sponsorship statement (48%), a reported study time horizon (35%), and the use of discounting (29%). There was a significant increase over time in the reporting of a COI statement (P<.001), health care payer perspective (P=.019), sensitivity analyses using multivariate (P=.043) or probabilistic methods (P=.011), incremental cost-effectiveness threshold (P<.001), secondary source utility weights (P=.010), and cost effectiveness acceptability curves (P=.049). There was a trend toward improvement in Tuft scores over time (P=.065). Conclusions: Recent reports demonstrate improved reporting rates in economic evaluations; however, there remains significant room for improvement as reporting rates are still suboptimal. As fiscal pressures rise, we will rely on economic assessments to guide our practice decisions

  13. Evaluation of Health Economics in Radiation Oncology: A Systematic Review

    International Nuclear Information System (INIS)

    Nguyen, Timothy K.; Goodman, Chris D.; Boldt, R. Gabriel; Warner, Andrew; Palma, David A.; Rodrigues, George B.; Lock, Michael I.; Mishra, Mark V.; Zaric, Gregory S.; Louie, Alexander V.

    2016-01-01

    Purpose: Despite the rising costs in radiation oncology, the impact of health economics research on radiation therapy practice analysis patterns is unclear. We performed a systematic review of cost-effectiveness analyses (CEAs) and cost-utility analyses (CUAs) to identify trends in reporting quality in the radiation oncology literature over time. Methods and Materials: A systematic review of radiation oncology economic evaluations up to 2014 was performed, using MEDLINE and EMBASE databases. The Consolidated Health Economic Evaluation Reporting Standards guideline informed data abstraction variables including study demographics, economic parameters, and methodological details. Tufts Medical Center CEA registry quality scores provided a basis for qualitative assessment of included studies. Studies were stratified by 3 time periods (1995-2004, 2005-2009, and 2010-2014). The Cochran-Armitage trend test and linear trend test were used to identify trends over time. Results: In total, 102 articles were selected for final review. Most studies were in the context of a model (61%) or clinical trial (28%). Many studies lacked a conflict of interest (COI) statement (67%), a sponsorship statement (48%), a reported study time horizon (35%), and the use of discounting (29%). There was a significant increase over time in the reporting of a COI statement (P<.001), health care payer perspective (P=.019), sensitivity analyses using multivariate (P=.043) or probabilistic methods (P=.011), incremental cost-effectiveness threshold (P<.001), secondary source utility weights (P=.010), and cost effectiveness acceptability curves (P=.049). There was a trend toward improvement in Tuft scores over time (P=.065). Conclusions: Recent reports demonstrate improved reporting rates in economic evaluations; however, there remains significant room for improvement as reporting rates are still suboptimal. As fiscal pressures rise, we will rely on economic assessments to guide our practice decisions

  14. Vacuum boilers developed heating surfaces technic and economic efficiency evaluation

    Science.gov (United States)

    Slobodina, E. N.; Mikhailov, A. G.; Semenov, B. A.

    2018-01-01

    The vacuum boilers as manufacturing proto types application analysis was carried out, the possible directions for the heating surfaces development are identified with a view to improving the energy efficiency. Economic characteristics to evaluate the vacuum boilers application efficiency (Net Discounted Income (NDI), Internal Rate of Return (IRR), Profitability Index (PI) and Payback Period) are represented. The given type boilers application technic and economic efficiency criteria were established. NDI changing curves depending on the finning coefficient and operating pressure were obtained as a result of the conducted calculation studies.

  15. Integrated Emergy and Economic Evaluation of Lotus-Root ...

    Science.gov (United States)

    Lotus (Neumbo nucifera, Gaertn) is the most important aquatic vegetable in China, with a cultivation history of over 3000 years. The emergy, energy, material, and money flows of three lotus root cultivation modes in Wanqingsha, Nansha District, Guangzhou, China were examined using Energy Systems Language models and emergy evaluation to better understand their ecological and economic characteristics on multiple spatial and temporal scales. The natural resource foundations, economic characteristics and sustainability of these modes were evaluated and compared. The results showed that although all three modes were highly dependent on purchased emergy inputs, their potential impacts as measured by the local (ELRL) and global (ELRW) environmental loading ratios were less than 1.2 and 0.7, respectively. The lotus-fish mode was the most sustainable with its emergy index of sustainable development (EISD) 2.09 and 2.13 times that of the pure lotus and lotus-shrimp modes, respectively. All three lotus-root production modes had superior economic viability, since their Output/Input ratio ranged from 2.56 to 4.95. The results indicated that agricultural systems may have different environmental impacts and sustainability characteristics at different spatial and temporal scales, and that these impacts and characteristics can be simultaneously explored using integrated emergy and economic evaluations. This study provides some major new insights about agriculture and its potenti

  16. Angra 3 - economic and financial evaluation of the enterprise

    International Nuclear Information System (INIS)

    Andrade, Ronaldo Barata de

    2006-01-01

    This paper presents an updated economic-financial evaluation of Angra 3 Nuclear Power Plant project and estimates the lowest power tariff value at which power potentially made available may be commercialized and yet ensures the project a profitability level agreeable to the interests of economic agents and shareholders. According to the project evaluation practice, Angra 3 power generation was considered separately from ELETRONUCLEAR operating plants (Angra 1 and Angra 2), thus preventing result distortions bound to occur if the economic-financial variables of the new project were analyzed associated with financial commitments and commercialization conditions resulting from the project implementation process and the generated power commercialization conditions, respectively. For this evaluation different technical and economic scenarios were devised, and the theory of Capital Asset Pricing Model (CAPM) for Own Capital cost and that of Weighted Average Cost of Capital (WACC) were used in addition to the forecast of the Statement of Results and Free Cash flow of Shareholders throughout the power plant life, which is the estimate basis for the lowest power tariff value and the Internal Return Rate (IRR) of the project. (author)

  17. An example of economical evaluation of stratiform uranium ore deposit

    International Nuclear Information System (INIS)

    Miyata, Hatsuho; Tabuchi, Akihiro; Ushijima, Kenichi.

    1992-01-01

    The Power Reactor and Nuclear Fuel Development corp. has carried out the business of uranium resource investigation and exploration in foreign countries aiming at securing uranium resources. If there is the possibility of economically developing the discovered uranium deposit, it is transferred to a Japanese private enterprise. In this paper, among the economical evaluation works that were carried out for the uranium deposits discovered by the Corp., the example of the initial economical evaluation for a stratiform uranium deposit carried out recently is reported. The deposit is located at the depth of 50 m - 70 m, and is a stratiform deposit having the extension of 4000 m x 1000 m. The boring investigation of about 350 holes was carried out for it. The estimation of the amount of uranium was done, and the production plan was made considering the scale of production, the characteristics of the ore, the circumstances of the site and so on. Based on the production plan, the initial expenses and the operation expenses were calculated. The design of the optimal pit which affects most the profitability and the economical evaluation were carried out. (K.I.)

  18. Role of Ultrasonography in Diagnosis and Evaluation of Dengue Fever

    Directory of Open Access Journals (Sweden)

    Harshavardhan Nagolu

    2017-10-01

    Full Text Available Introduction: Dengue Fever (DF is endemic to Southeast Asian region and poses a major public health problem with increasing incidence of epidemics over the past few years. Aim: This study intends to evaluate ultrasonographic findings in patients with DF during an epidemic in south India and their accuracy in diagnosis. Materials and Methods: This is a prospective observational study performed in tertiary care hospital in Tirupati, Andhra Pradesh, India. A total 310 patients seropositive for dengue, referred to Radiology department for sonography were screened for ascites, gall bladder wall thickening, pleural effusion, pericardial effusion, hepatomegaly and splenomegaly. These findings were correlated with patient demographics, serological tests for dengue and platelet count. Results: Mean age of the study population was 48.9 years. The male: female ratio was 1.46:1. Total 302 patients (97.4% had at least one positive ultrasound finding supportive of DF. Ascites (93% was the most common finding, followed by right pleural effusion (78.7%, gall bladder wall thickening (64.8%, left and bilateral pleural effusion (64.1%, splenomegaly (42.6% and hepatomegaly (28.0%. Patients were classified into four groups based on degree of thrombocytopenia. Ascites was the most common finding in all the groups of patients. Gall bladder wall thickening was seen in 63.2%, 70.5%, 73.0% and 27.7% in four groups respectively. Ascites was the most sensitive finding, while gall bladder wall thickening was the most specific finding. This study showed statistically significant correlation of ultrasound findings with platelet counts (p=0.00001. No statistically significant correlation was noted between age group of the patients and sonographic findings (p=0.908. Conclusion: Constellation of sonographic findings like ascites, gall bladder wall thickening, pleural effusion, hepatomegaly and splenomegaly, when used together, are Useful not only in early diagnosis of the

  19. Systematic overview of economic evaluations of health-related rehabilitation.

    Science.gov (United States)

    Howard-Wilsher, Stephanie; Irvine, Lisa; Fan, Hong; Shakespeare, Tom; Suhrcke, Marc; Horton, Simon; Poland, Fiona; Hooper, Lee; Song, Fujian

    2016-01-01

    Health related rehabilitation is instrumental in improving functioning and promoting participation by people with disabilities. To make clinical and policy decisions about health-related rehabilitation, resource allocation and cost issues need to be considered. To provide an overview of systematic reviews (SRs) on economic evaluations of health-related rehabilitation. We searched multiple databases to identify relevant SRs of economic evaluations of health-related rehabilitation. Review quality was assessed by AMSTAR checklist. We included 64 SRs, most of which included economic evaluations alongside randomized controlled trials (RCTs). The review quality was low to moderate (AMSTAR score 5-8) in 35, and high (score 9-11) in 29 of the included SRs. The included SRs addressed various health conditions, including spinal or other pain conditions (n = 14), age-related problems (11), stroke (7), musculoskeletal disorders (6), heart diseases (4), pulmonary (3), mental health problems (3), and injury (3). Physiotherapy was the most commonly evaluated rehabilitation intervention in the included SRs (n = 24). Other commonly evaluated interventions included multidisciplinary programmes (14); behavioral, educational or psychological interventions (11); home-based interventions (11); complementary therapy (6); self-management (6); and occupational therapy (4). Although the available evidence is often described as limited, inconsistent or inconclusive, some rehabilitation interventions were cost-effective or showed cost-saving in a variety of disability conditions. Available evidence comes predominantly from high income countries, therefore economic evaluations of health-related rehabilitation are urgently required in less resourced settings. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  20. Solar energy system economic evaluation: Contemporary Newman, Georgia

    Science.gov (United States)

    1980-01-01

    An economic evaluation of performance of the solar energy system (based on life cycle costs versus energy savings) for five cities considered to be representative of a broad range of environmental and economic conditions in the United States is discussed. The considered life cycle costs are: hardware, installation, maintenance, and operating costs for the solar unique components of the total system. The total system takes into consideration long term average environmental conditions, loads, fuel costs, and other economic factors applicable in each of five cities. Selection criteria are based on availability of long term weather data, heating degree days, cold water supply temperature, solar insolation, utility rates, market potential, and type of solar system.

  1. Evaluation of the economic and financial management in Mexican microenterprises

    Directory of Open Access Journals (Sweden)

    Malena Portal Boza

    2016-10-01

    Full Text Available The exhibit features Mexican microenterprises today give evidence of the problems that they face in terms of managing their activities, where the role of economic-financial elements is perceived. Although the issue has been addressed in previous studies the contribution of this study is to evaluate in an integrated manner the level of economic and financial management (GEF in micro and impact on business results. To do an index is constructed from indicators synthetic methodology using the principal components factor analysis, accompanied by linear regression exercises. The results confirm the presence of elements of GEF in micro studied. Moreover, it was found that the extent to which GEF elements are incorporated in its activities, the impact on their business results will be positive. These observations constitute the prelude to the creation of public policies seeking to establish improvement strategies for such companies, besides that fosters future research for analysis but by sectors of economic activity.

  2. Economic evaluation of emergency obstetric care training: a systematic review.

    Science.gov (United States)

    Banke-Thomas, Aduragbemi; Wilson-Jones, Megan; Madaj, Barbara; van den Broek, Nynke

    2017-12-04

    Training healthcare providers in Emergency Obstetric Care (EmOC) has been shown to be effective in improving their capacity to provide this critical care package for mothers and babies. However, little is known about the costs and cost-effectiveness of such training. Understanding costs and cost-effectiveness is essential in guaranteeing value-for-money in healthcare spending. This study systematically reviewed the available literature on cost and cost-effectiveness of EmOC trainings. Peer-reviewed and grey literature was searched for relevant papers published after 1990. Studies were included if they described an economic evaluation of EmOC training and the training cost data were available. Two reviewers independently searched, screened, and selected studies that met the inclusion criteria, with disagreements resolved by a third reviewer. Quality of studies was assessed using the Consolidated Health Economic Evaluation Reporting Standards statement. For comparability, all costs in local currency were converted to International dollar (I$) equivalents using purchasing power parity conversion factors. The cost per training per participant was calculated. Narrative synthesis was used to summarise the available evidence on cost effectiveness. Fourteen studies (five full and nine partial economic evaluations) met the inclusion criteria. All five and two of the nine partial economic evaluations were of high quality. The majority of studies (13/14) were from low- and middle-income countries. Training equipment, per diems and resource person allowance were the most expensive components. Cost of training per person per day ranged from I$33 to I$90 when accommodation was required and from I$5 to I$21 when training was facility-based. Cost-effectiveness of training was assessed in 5 studies with differing measures of effectiveness (knowledge, skills, procedure cost and lives saved) making comparison difficult. Economic evaluations of EmOC training are limited. There is a

  3. 201Thallium SPECT, accuracy in astrocytoma diagnosis and treatment evaluation

    International Nuclear Information System (INIS)

    Kaellen, K.

    1999-10-01

    The aims of the studies included in this thesis were: - to investigate the reliability of 201 Thallium single photon emission computed tomography. Tl SPECT for preoperative diagnosis and histological staging of malignant astrocytomas in comparison with CT; - to develop a method for quantification of cerebral thallium uptake, and to evaluate the quantitative measurement in comparison with CT, for astrocytoma treatment follow-up purposes; - to compare quantitative Tl SPECT and proton magnetic resonance spectroscopy (H-MRS) with conventional MR imaging for astrocytoma monitoring, and to evaluate associations between change of morphological tumour characteristics during treatment and changes of cerebral thallium uptake and metabolic ratios. Results and conclusions: - High TI-index, calculated as a ratio comparing tumour uptake to uptake in the contralateral hemisphere, is an indicator of highly malignant astrocytoma. Differentiation between the high-grade astrocytomas, the low-grade astrocytomas, and infectious lesions is only partial, with an overlap of Tl-indexes between these groups. High-grade astrocytomas that do not show contrast enhancement on CT, and astrocytomas with central necrosis and moderate ring-enhancement, tend to be underestimated when evaluated by Tl-index calculation. Tl SPECT is not a reliable method for non-invasive tumour staging among the group of highly malignant astrocytomas. - Quantification of cerebral TI-uptake, defining the volume of viable tumour tissue, is a new method for astrocytoma chemotherapy monitoring. Results suggest that the method provides prognostic information, and information of treatment efficacy, at an earlier stage than CT. - We did not find a higher accuracy of quantitative Tl SPECT than of MR for monitoring purposes and our results indicated that treatment induced MR changes were interrelated with TI-uptake variations. - Multi-voxel H-MRS was difficult to apply for astrocytoma treatment monitoring, due to the anatomical

  4. Economic and environmental evaluation of investment projects of biogas plants

    International Nuclear Information System (INIS)

    Guzmán Marrero, Elizabeth; Guzmán Chinea, Jesús Manuel; Mata Varela, Milagros C.; Pérez González, Yanet

    2015-01-01

    The economic evaluation of the implementation and use of renewable energy is an issue of paramount importance and has been approached from different perspectives by different authors in different countries. Biogas technology has its own characteristics that make it more complex analysis involved not only in this case the energy aspect but there is also a significant impact on health assessment difficult, fertilization, soil improvement, animal feed and improved conditions of life. The capital budgeting, in conjunction with the planning process, is a key economic tool for decision making and in turn represents an ongoing challenge for the agricultural sector. It is a necessity of our country, together with the entire world, potentiate the action to correct management of organic waste generated in intensive pig farming, to contribute to the reduction of environmental impacts that this work causes. Studies in this area show the shortcomings that exist in Cuban law established for the evaluation of investment projects, both in its structure and in its cycle, without taking into account important elements such as risk analysis. This research evaluates the economic and financial feasibility of an investment project, including a social and environmental assessment of the same financial justification for the inclusion of risk analysis in the evaluation process (full text)

  5. Economic evaluation, human immunodeficiency virus infection and screening: a review and critical appraisal of economic studies.

    Science.gov (United States)

    Dibosa-Osadolor, Onome; Roberts, Tracy

    2010-07-01

    The aim of this study was to review, systematically and critically, evidence used to derive estimates of cost-effectiveness of human immunodeficiency virus (HIV) screening. A systematic review was conducted. Searched were three main electronic bibliographic databases from 1993 to 2008 using key words including HIV, mass screening, HAART, economic evaluation, cost-effectiveness analysis, modeling. We included studies of sexually transmitted HIV infection in both sexes, including studies comparing diagnostic testing protocols and partner notification. Outcomes included were cases of HIV infection detected, deterioration to the AIDS state, secondary transmission of HIV, the quality-adjusted life-years/survival, costs, and cost-effectiveness of HIV screening. Eighty-four papers were identified; ten of which were formal economic evaluations, one cost study, three effectiveness studies, and three systematic reviews of HIV prevention programs. The predominant assertion was that HIV screening is cost-effective; methodological problems, such as the preponderance of static models which are inappropriate for infectious diseases, varying perspectives from which the studies were analyzed, and arbitrary threshold incremental cost-effectiveness ratio levels, limited the validity of these findings, and their usefulness in informing health policy decisions. The majority of published economic evaluations are based on inappropriate static models. This flaw renders the results of these studies as inconclusive and the purported cost-effectiveness of HIV screening debatable. The results of this review could form a basis for consideration of further research and analysis by health economists into the cost-effectiveness of HIV screening.

  6. Economic evaluation of closure cap barrier materials study

    Energy Technology Data Exchange (ETDEWEB)

    Serrato, M.G.; Bhutani, J.S.; Mead, S.M.

    1993-09-01

    Volume II of the Economic Evaluation of the Closure Cap Barrier Materials, Revision I contains detailed cost estimates for closure cap barrier materials. The cost estimates incorporate the life cycle costs for a generic hazardous waste seepage basin closure cap under the RCRA Post Closure Period of thirty years. The economic evaluation assessed six barrier material categories. Each of these categories consists of several composite cover system configurations, which were used to develop individual cost estimates. The information contained in this report is not intended to be used as a cost estimating manual. This information provides the decision makers with the ability to screen barrier materials, cover system configurations, and identify cost-effective materials for further consideration.

  7. New approaches to the economic evaluation of fusion research

    International Nuclear Information System (INIS)

    Hazelrigg, G.A.; Lietzke, K.R.

    1978-01-01

    The economic evaluation of fusion research to date has focussed on the benefits of essentially unlimited energy for future generations. In this paper it is shown that energy research in general, and fusion research in particular, also provides benefits in the short term, benefitting us today as well as future generations. Short-term benefits are the result of two distinct aspects of fusion research. First, fusion research provides information for decision making on both the continuing fusion research efforts and on other energy research programs. Second, fusion research provides an expectation of a future energy source thereby promoting accelerated consumption of existing fossil fuels today. Both short-term benefits can be quantitatively evaluated and both are quite substantial. Together, these short-term benefits form the primary economic rationale for fusion research

  8. Economic evaluation of closure cap barrier materials study

    International Nuclear Information System (INIS)

    Serrato, M.G.; Bhutani, J.S.; Mead, S.M.

    1993-09-01

    Volume II of the Economic Evaluation of the Closure Cap Barrier Materials, Revision I contains detailed cost estimates for closure cap barrier materials. The cost estimates incorporate the life cycle costs for a generic hazardous waste seepage basin closure cap under the RCRA Post Closure Period of thirty years. The economic evaluation assessed six barrier material categories. Each of these categories consists of several composite cover system configurations, which were used to develop individual cost estimates. The information contained in this report is not intended to be used as a cost estimating manual. This information provides the decision makers with the ability to screen barrier materials, cover system configurations, and identify cost-effective materials for further consideration

  9. Monetary conversion factors for economic evaluations of substance use disorders.

    Science.gov (United States)

    McCollister, Kathryn; Yang, Xuan; Sayed, Bisma; French, Michael T; Leff, Jared A; Schackman, Bruce R

    2017-10-01

    Estimating the economic consequences of substance use disorders (SUDs) is important for evaluating existing programs and new interventions. Policy makers in particular must weigh program effectiveness with scalability and sustainability considerations in deciding which programs to fund with limited resources. This study provides a comprehensive list of monetary conversion factors for a broad range of consequences, services, and outcomes, which can be used in economic evaluations of SUD interventions (primarily in the United States), including common co-occurring conditions such as HCV and HIV. Economic measures were selected from standardized clinical assessment instruments that are used in randomized clinical trials and other research studies (e.g., quasi-experimental community-based projects) to evaluate the impact of SUD interventions. National datasets were also reviewed for additional SUD-related consequences, services, and outcomes. Monetary conversion factors were identified through a comprehensive literature review of published articles as well as targeted searches of other sources such as government reports. Eight service/consequence/outcome domains were identified containing more than sixty monetizable measures of medical and behavioral health services, laboratory services, SUD treatment, social services, productivity outcomes, disability outcomes, criminal activity and criminal justice services, and infectious diseases consequences. Unit-specific monetary conversion factors are reported, along with upper and lower bound estimates, whenever possible. Having an updated and standardized source of monetary conversion factors will facilitate and improve future economic evaluations of interventions targeting SUDs and other risky behaviors. This exercise should be repeated periodically as new sources of data become available to maintain the timeliness, comprehensiveness, and quality of these estimates. Copyright © 2017 The Authors. Published by Elsevier Inc

  10. The conceptual design and economic evaluation of utility scale SMES

    International Nuclear Information System (INIS)

    Masuda, M.

    1986-01-01

    The paper reports the result of current Japanese activities in designing and evaluating the economic feasibility of utility Superconducting Magnetic Energy Storage (SMES). The 5 GWh/1 GW is proposed as a relevant unit of SMES in the year 2000. More than 20 companies, several universities and two national laboratories joined in a task force to study this technology. After three year's assessment, the conclusion on utility scale SMES is that no unresolvable technologies have been found and commercialization potential exists

  11. Economic evaluation method of new facilities for uranium ore processing

    International Nuclear Information System (INIS)

    Hebert, J.P.

    1986-01-01

    The importance of economic evaluation in feasibility studies is underlined. Notions of discounting are recalled. Profits of a project are analyzed. Studies can be relatively simple for a first estimation if investment cost and production cost are available because profits of a new production unit or savings obtained by a new investment are determined. But for integrated projects mine-plant the studies are complex especially for complete exploitation account [fr

  12. Use of economic evaluation guidelines: 2 years' experience in Canada.

    Science.gov (United States)

    Baladi, J F; Menon, D; Otten, N

    1998-05-01

    Considerable effort has been expended in recent years in the development of methodology guidelines for economic evaluation of pharmaceutical products, driven in part by the desire to improve the rigour and quality of economic evaluations and to help decision making. Canada was one of the first countries to develop such guidelines and to encourage their use. This paper examines the extent to which the economic evaluations that were submitted to the Canadian Coordinating Office for Health Technology Assessment in the last two years adhered to Canadian guidelines. The analytic technique employed by twelve studies as well as the comparator used, the perspective taken, the outcome measure selected, the cost items that were taken into consideration and the extent of sensitivity analyses that were performed are reviewed in this paper. It can be concluded that although studies have been of variable quality, the majority of them were well presented, complete and transparent, due in part to the guidelines. Except for the perspective of the analysis, guidelines were, in many respects, adhered to and did not restrict investigators to specific methodologies or specific techniques. They were also instrumental in ensuring a minimum set of standards.

  13. A Framework for Including Family Health Spillovers in Economic Evaluation.

    Science.gov (United States)

    Al-Janabi, Hareth; van Exel, Job; Brouwer, Werner; Coast, Joanna

    2016-02-01

    Health care interventions may affect the health of patients' family networks. It has been suggested that these "health spillovers" should be included in economic evaluation, but there is not a systematic method for doing this. In this article, we develop a framework for including health spillovers in economic evaluation. We focus on extra-welfarist economic evaluations where the objective is to maximize health benefits from a health care budget (the "health care perspective"). Our framework involves adapting the conventional cost-effectiveness decision rule to include 2 multiplier effects to internalize the spillover effects. These multiplier effects express the ratio of total health effects (for patients and their family networks) to patient health effects. One multiplier effect is specified for health benefit generated from providing a new intervention, one for health benefit displaced by funding this intervention. We show that using multiplier effects to internalize health spillovers could change the optimal funding decisions and generate additional health benefits to society. © The Author(s) 2015.

  14. Evaluation of economical at a uranium enrichment demonstration plant

    International Nuclear Information System (INIS)

    Sugitsue, Noritake

    2001-01-01

    In this report, the economy of technical achievement apply in the uranium enrichment demonstration plant is evaluated. From the evaluation, it can be concluded that the expected purpose was achieved because there was a definite economic prospect to commercial plant. The benefit analysis of thirteen years operation of the uranium enrichment demonstration plant also provides a financial aspect of the uranium enrichment business. Therefore, the performance, price and reliability of the centrifuge is an important factor in the uranium enrichment business. And the continuous development of a centrifuge while considering balance with the development cost is necessary for the business in the future. (author)

  15. An introduction to economic analysis in medicine - the basics of methology and chosen trems. Examples of results of evaluation in nuclear medicine

    International Nuclear Information System (INIS)

    Brockhuis, B.M.; Lass, P.

    2002-01-01

    This article overviews the basics terms and methodology of economic analysis in health care. The most important forms of economic analysis: cost-effectiveness, cost-utility and cost-minimisation analysis and aims of their application are presented. Particular emphasis is put on economic evaluation in nuclear medicine, e.g. FDG-PET v. thoracotomy in lung cancer diagnosis, radioiodine therapy v. antithyroid drugs in hyperthyroidism and technetium-99m-MIBI breast imaging v. biopsy in nonpalpable breast abnormalities. (author)

  16. Transferability of economic evaluations of medical technologies: a new technology for orthopedic surgery

    NARCIS (Netherlands)

    Steuten, Lotte Maria Gertruda; Vallejo-Torres, Laura; Young, Terry; Buxton, Martin

    2008-01-01

    Transferring results of economic evaluations across countries or jurisdictions can potentially save scarce evaluation resources while helping to make market access and reimbursement decisions in a timely fashion. This article points out why transferring results of economic evaluations is

  17. Biochemical Benefits, Diagnosis, and Clinical Risks Evaluation of Kratom

    Directory of Open Access Journals (Sweden)

    Dimy Fluyau

    2017-04-01

    Full Text Available BackgroundKratom (Mitragyna speciosa is a tropical tree with a long history of traditional use in parts of Africa and Southeast Asia. Kratom is also known as Thom, Thang, and Biak. Its leaves and the teas brewed from them have long been used by people in that region to manage pain and opioid withdrawal and to stave off fatigue. Kratom is actually consumed throughout the world for its stimulant effects and as an opioid substitute (in form of tea, chewed, smoked, or ingested in capsules. Some case reports have associated kratom exposure with psychosis, seizures, intrahepatic cholestasis, other medical conditions, and deaths. The clinical manifestations of kratom effects are not well defined and the clinical studies are limited. Data research suggest that both stimulant and sedative dose-dependent effects do exist, in addition to antinociceptive, antidepressant activity, anxiolytic-like effects, and anorectic effects, but a growing concern for the drug’s effects and safety of use has resulted in national and international attention primarily due to an increase in hospital visits and deaths in several countries that are believed to have been caused by extracts of the plant. There is a dearth of double blind controlled studies. In this study, we aim to use existing literature to clarify both benefits and risks of kratom as well as its diagnosis evaluation as kratom misuse is an emerging trend in the Western world.MethodsLiterature review using databases such as Embase, Medline, PubMed, Cochrane Library, and Mendeley from 2007 to 2017 were evaluated by all authors to analyze current state on benefits, risks, and diagnosis evaluation of kratom (M. speciosa.ResultsData analysis suggested that kratom possesses some benefits such as stimulant and sedative effects as wells as antinociceptive effects. It seems to inhibit pro-inflammatory mediator release and vascular permeability and can enhance immunity. In addition, it may be an antidepressant and

  18. Evaluation of undrilled prospects. Sensitivity to economic and geological factors

    International Nuclear Information System (INIS)

    Hermanrud, C.; Abrahamsen, K.; Vollset, J.; Nordahl, S.; Jourdan, C.

    1996-01-01

    Economic prospect evaluation at an early stage involves personnel with different skills, such as geoscientists, reservoir engineers, construction engineers and economists. Data are transferred between these groups of people who often have only a vague understanding of the accuracy of the data they receive. This lack of communication naturally limits the correctness of the results. To improve this communication, the complete process of prospect evaluation (including both geological and economical aspects) has been followed here in order to show the different data sets that are transferred and to comment upon their accuracy. Although this paper is based entirely on Statoil's methodology, it is nevertheless believed to be of general relevance. In Statoil's methodology, prospect volumes calculated by geoscientists are given as likelihood distributions. Post-drilling examination of such volume distributions show that historically they have been too optimistic. However, historical prospect risking has correctly identified the most important risk factors and has been able to separate low-risk from high-risk prospects in a satisfactory manner. The number of appraisal wells that are needed before the development of a field can be decided upon is often crucial to the economic evaluations. This number, however, is usually underestimated during the early stages of exploration, probably because data limitations mask reservoir heterogeneities. Reservoir performance is of utmost importance to early economic calculations as it influences both the drilling costs and the production of hydrocarbons vs. time. Of course, reservoir productivity is highly uncertain when judged prior to drilling the first well. Historical data show that reserve estimates of producing fields tend to be upgraded as reservoir depletion proceeds, although several fields have had their reserve estimates downgraded shortly after production start-up. The operational and investment costs are not generally

  19. Economic evaluation of multilateral nuclear fuel cycle approach

    International Nuclear Information System (INIS)

    Takashima, Ryuta; Kuno, Yusuke; Omoto, Akira; Tanaka, Satoru

    2011-01-01

    Recently previous works have shown that multilateral nuclear fuel cycle approach has benefits not only of non-proliferation but also of cost effectiveness. This is because for most facilities in nuclear fuel cycle, there exist economies of scale, which has a significant impact on the costs of nuclear fuel cycle. Therefore, the evaluation of economic rationality is required as one of the evaluation factors for the multilateral nuclear fuel cycle approach. In this study, we consider some options with respect to multilateral approaches to nuclear fuel cycle in Asian-Pacific region countries that are proposed by the University of Tokyo. In particular, the following factors are embedded into each type: A) no involvement of assurance of services, B) provision of assurance of services including construction of new facility, without transfer of ownership, and C) provision of assurance of service including construction of new joint facilities with ownership transfer of facilities to multilateral nuclear fuel cycle approach. We show the overnight costs taking into account install and operation of nuclear fuel cycle facilities for each option. The economic parameter values such as uranium price, scale factor, and market output expansion influences the total cost for each option. Thus, we show how these parameter values and economic risks affect the total overnight costs for each option. Additionally, the international facilities could increase the risk of transportation for nuclear material compared to national facilities. We discuss the potential effects of this transportation risk on the costs for each option. (author)

  20. Economic evaluation of interventions designed to reduce Clostridium difficile infection.

    Science.gov (United States)

    Brain, David; Yakob, Laith; Barnett, Adrian; Riley, Thomas; Clements, Archie; Halton, Kate; Graves, Nicholas

    2018-01-01

    Healthcare decision-makers are increasingly expected to balance increasing demand for health services with a finite budget. The role of economic evaluation in healthcare is increasing and this research provides decision-makers with new information about the management of Clostridium difficile infection, from an economic perspective. A model-based economic evaluation was undertaken to identify the most cost-effective healthcare intervention relating to the reduction of Clostridium difficile transmission. Efficacy evidence was synthesised from the literature and was used to inform the effectiveness of both bundled approaches and stand-alone interventions, where appropriate intervention combinations were coupled together. Changes in health outcomes were estimated by combining information about intervention effectiveness and its subsequent impact on quality of life. A bundled approach of improving hand hygiene and environmental cleaning produces the best combination of increased health benefits and cost-savings. It has the highest mean net monetary benefit when compared to all other interventions. This intervention remains the optimal decision under different clinical circumstances, such as when mortality rate and patient length of stay are increased. Bundled interventions offered the best opportunity for health improvements. These findings provide healthcare decision-makers with novel information about the allocation of scarce resources relating to Clostridium difficile. If investments are not made in interventions that clearly yield gains in health outcomes, the allocation and use of scarce healthcare resources is inappropriate and improvements in health outcomes will be forgone.

  1. Economic evaluation of interventions designed to reduce Clostridium difficile infection.

    Directory of Open Access Journals (Sweden)

    David Brain

    Full Text Available Healthcare decision-makers are increasingly expected to balance increasing demand for health services with a finite budget. The role of economic evaluation in healthcare is increasing and this research provides decision-makers with new information about the management of Clostridium difficile infection, from an economic perspective.A model-based economic evaluation was undertaken to identify the most cost-effective healthcare intervention relating to the reduction of Clostridium difficile transmission. Efficacy evidence was synthesised from the literature and was used to inform the effectiveness of both bundled approaches and stand-alone interventions, where appropriate intervention combinations were coupled together. Changes in health outcomes were estimated by combining information about intervention effectiveness and its subsequent impact on quality of life.A bundled approach of improving hand hygiene and environmental cleaning produces the best combination of increased health benefits and cost-savings. It has the highest mean net monetary benefit when compared to all other interventions. This intervention remains the optimal decision under different clinical circumstances, such as when mortality rate and patient length of stay are increased. Bundled interventions offered the best opportunity for health improvements.These findings provide healthcare decision-makers with novel information about the allocation of scarce resources relating to Clostridium difficile. If investments are not made in interventions that clearly yield gains in health outcomes, the allocation and use of scarce healthcare resources is inappropriate and improvements in health outcomes will be forgone.

  2. Evaluation of economics of spent fuel storage techniques

    International Nuclear Information System (INIS)

    Yamaji, Kenji; Nagano, Koji

    1988-01-01

    Various spent fuel storage techniques are evaluated in terms of required costs. The unit storage cost for each spent fuel storage scenario is calculated based on the total cost required for the scenario including capital expenditure, operation cost, maintenance cost and transport cost. Intermediate storage may be performed in relatively small facilities in the plant or in independent large-scale facilities installed away from the plant. Dry casks or water pools are assumed to be used in in-plant storage facilities while vaults may also be employed in independent facilities. Evaluation is made for these different cases. In in-plant facilities, dry cask storage is found to be more economical in all cases than water pool storage, especially when large-sized casks are employed. In independent facilities, on the other hand, the use of vaults is the most desirable because the required capital expenditure is the lowest due to the effect of scale economics. Dry cask storage is less expensive than water pool storage also in independent facilities. The annual discount rate has relatively small influence on the unit cost for storage. An estimated unit cost for storage in independent storage facilities is shown separately for facilities with a capacity of 1,000 tons, 3,000 tons or 5,000 tons. The report also outlines the economics of spent fuel storage in overseas facilities (Finland, Sweden and U.S.A.). (Nogami, K.)

  3. Economic evaluation of radiation processing in urban solid wastes treatment

    Science.gov (United States)

    Carassiti, F.; Lacquaniti, L.; Liuzzo, G.

    During the last few years, quite a number of studies have been done, or are still in course, on disinfection of urban liquid wastes by means of ionizing radiations. The experience gained by SANDIA pilot plant of irradiation on dried sewage sludge, together with the recently presented conceptual design of another plant handling granular solids, characterized by high efficiency and simple running, have shown the possibility of extending this process to the treatment of urban solid wastes. As a matter of fact, the problems connected to the pathogenic aspects of sludge handling are often similar to those met during the disposal of urban solid wastes. This is even more so in the case of their reuse in agriculture and zootechny. The present paper introduces the results of an analysis carried out in order to evaluate the economical advantage of inserting irradiation treatment in some process scheme for management of urban solid wastes. Taking as an example a comprehensive pattern of urban solid wastes management which has been analysed and estimated economically in previous works, we first evaluated the extra capital and operational costs due to the irradiation and then analysed economical justification, taking into account the increasing commercial value of the by-products.

  4. [Performance of self-help groups and their economic evaluation].

    Science.gov (United States)

    Engelhardt, H D; Trojan, A; Nickel, S

    2009-01-01

    Hoffmann von Fallersleben is quoted with the sentence "Self-help is worthwhile, because it does not demand anything from others". This sounds catchy; it is, however, wrong: Self-help groups ask for support, particularly for financial resources for the work of either individual, highly organized self-help associations or for general support of self-help groups via local contact and information centers ("contact points for self-help groups"). With this request for economic "investments" in self-help, the question arises whether this is profitable for the country, the local authority or the social health insurance. In principle, the initial answer to this is: yes, the work of self-help groups is worthwhile for a single person, but also for the larger community, as various kinds of services are provided by self-help groups and organizations. Despite many surveys of members or co-operation partners which show positive effects of self-help groups, the question remains whether services of self-help groups can be measured and economically evaluated. The socio- political question regarding funding is closely connected to the idea of an economic evaluation of self-help groups. The aim of this article is to summarize and discuss which empiric approaches and findings are available on this subject. The monetary value for the work done per member of self-help groups and year lies between approximately 700 and 900 EUR.

  5. Economic evaluation of I and C modernization approach in NPPs

    International Nuclear Information System (INIS)

    Kang, Hyeon Tae; Sung, Chan Ho; Lee, Jae Ki

    2009-01-01

    Utilities have recently been debating the respective pros and cons of implementation of a multi-phase modernization during several normal outages versus a single major modernization implementation during a prolonged outage. We have studied these approaches and have been developing the basic design of NPPs I and C modernization since early 2008. As part of this study, analyses of the NPPs I and C systems were conducted and the need for upgrading the systems was raised. One of the primary concerns regarding the system modernization is a cost-benefit implementation, which will influence the modernization approach. From this viewpoint, the I and C modernization must consider economic factors such as I and C vendor cost, architecture engineering cost, installation cost, utility cost, and other transition costs such as training and procedure development. This paper presents a comparison study of economical aspects including cost evaluation between the aforementioned modernization implementations and suggests a solution for the I and C modernization approach. (author)

  6. Economic evaluation of losses: technique and use of data

    Energy Technology Data Exchange (ETDEWEB)

    Robinson, T.K.; Drury, A.K.

    1992-01-01

    The paper reviews a major energy company's experience of the evaluation of the economic effects of accidents, discusses techniques for measurement and gives examples of current management use of the data. In 1988, British Petroleum carried out a pilot study at one of its coal mines in Illinois to investigate the direct cost of losses due to accidents to people, plant and equipment. It was found that the costs of losses were large (and in the case of the oil related studies the potential for loss was very large) and relatively easy to measure. However the use of the data to assist the effective management of operations required careful consideration. The paper concludes that measurement of the economic effect of accidents could be helpful to coal mining operations, but the correct organisational environment must be in place first. 3 figs., 6 tabs.

  7. Economical evaluation of damaged vacuum insulation panels in buildings

    Science.gov (United States)

    Kim, Y. M.; Lee, H. Y.; Choi, G. S.; Kang, J. S.

    2015-12-01

    In Korea, thermal insulation standard of buildings have been tightened annually to satisfy the passive house standard from the year 2009. The current domestic policies about disseminating green buildings are progressively conducted. All buildings should be the zero energy building in the year 2025, obligatorily. The method is applied to one of the key technologies for high-performance insulation for zero energy building. The vacuum insulation panel is an excellent high performance insulation. But thermal performance of damaged vacuum insulation panels is reduced significantly. In this paper, the thermal performance of damaged vacuum insulation panels was compared and analyzed. The measurement result of thermal performance depends on the core material type. The insulation of building envelope is usually selected by economic feasibility. To evaluate the economic feasibility of VIPs, the operation cost was analyzed by simulation according to the types and damaged ratio of VIPs

  8. Energy-, environmental and economic evaluation of energy crops utilization

    International Nuclear Information System (INIS)

    1994-06-01

    This preliminary project is prepared in order to clarify the economic possibilities and rentability of energy crops. Examples of energy crop resource potential, environmental and economic consequences are calculated on the basis of existing data. Utilization of annual and perennial crops is evaluated with regard to the usual following of agricultural areas, and to the traditional power generation in a coal-fueled plant. Two technological options are discussed: one based on energy crop fuels supplementing the conventional coal fuel, and the other based on a separate biomass-fueled boiler, connected to the conventional coal-fueled unit. Implementation of the main project,following the preliminary one will permit to estimate the future prospects and strategies of energy crop utilization as a profitable energy resource. (EG)

  9. Economic evaluations of personalized medicine: existing challenges and current developments

    Directory of Open Access Journals (Sweden)

    Shabaruddin FH

    2015-06-01

    Full Text Available Fatiha H Shabaruddin,1 Nigel D Fleeman,2 Katherine Payne3 1Department of Pharmacy, University of Malaya, Kuala Lumpur, Malaysia; 2Liverpool Reviews and Implementation Group (LRiG, University of Liverpool, Liverpool, UK; 3Institute of Population Health, The University of Manchester, Manchester, UK Abstract: Personalized medicine, with the aim of safely, effectively, and cost-effectively targeting treatment to a prespecified patient population, has always been a long-time goal within health care. It is often argued that personalizing treatment will inevitably improve clinical outcomes for patients and help achieve more effective use of health care resources. Demand is increasing for demonstrable evidence of clinical and cost-effectiveness to support the use of personalized medicine in health care. This paper begins with an overview of the existing challenges in conducting economic evaluations of genetics- and genomics-targeted technologies, as an example of personalized medicine. Our paper illustrates the complexity of the challenges faced by these technologies by highlighting the variations in the issues faced by diagnostic tests for somatic variations, generally referring to genetic variation in a tumor, and germline variations, generally referring to inherited genetic variation in enzymes involved in drug metabolic pathways. These tests are typically aimed at stratifying patient populations into subgroups on the basis of clinical effectiveness (response or safety (avoidance of adverse events. The paper summarizes the data requirements for economic evaluations of genetics and genomics-based technologies while outlining that the main challenges relating to data requirements revolve around the availability and quality of existing data. We conclude by discussing current developments aimed to address the challenges of assessing the cost-effectiveness of genetics and genomics-based technologies, which revolve around two central issues that are

  10. Systematic Review of Health Economic Evaluations of Diagnostic Tests in Brazil: How accurate are the results?

    Science.gov (United States)

    Oliveira, Maria Regina Fernandes; Leandro, Roseli; Decimoni, Tassia Cristina; Rozman, Luciana Martins; Novaes, Hillegonda Maria Dutilh; De Soárez, Patrícia Coelho

    2017-08-01

    The aim of this study is to identify and characterize the health economic evaluations (HEEs) of diagnostic tests conducted in Brazil, in terms of their adherence to international guidelines for reporting economic studies and specific questions in test accuracy reports. We systematically searched multiple databases, selecting partial and full HEEs of diagnostic tests, published between 1980 and 2013. Two independent reviewers screened articles for relevance and extracted the data. We performed a qualitative narrative synthesis. Forty-three articles were reviewed. The most frequently studied diagnostic tests were laboratory tests (37.2%) and imaging tests (32.6%). Most were non-invasive tests (51.2%) and were performed in the adult population (48.8%). The intended purposes of the technologies evaluated were mostly diagnostic (69.8%), but diagnosis and treatment and screening, diagnosis, and treatment accounted for 25.6% and 4.7%, respectively. Of the reviewed studies, 12.5% described the methods used to estimate the quantities of resources, 33.3% reported the discount rate applied, and 29.2% listed the type of sensitivity analysis performed. Among the 12 cost-effectiveness analyses, only two studies (17%) referred to the application of formal methods to check the quality of the accuracy studies that provided support for the economic model. The existing Brazilian literature on the HEEs of diagnostic tests exhibited reasonably good performance. However, the following points still require improvement: 1) the methods used to estimate resource quantities and unit costs, 2) the discount rate, 3) descriptions of sensitivity analysis methods, 4) reporting of conflicts of interest, 5) evaluations of the quality of the accuracy studies considered in the cost-effectiveness models, and 6) the incorporation of accuracy measures into sensitivity analyses.

  11. Influence of production circumstances and economic evaluation criteria on economic comparison of breeds and breed-crosses.

    NARCIS (Netherlands)

    Kahi, A.K.; Koskey, I.S.; Cardoso, V.L.; Arendonk, van J.A.M.

    1998-01-01

    The ranking of genotypes (i.e., breeds and breed crosses) for economic performance depends on the production circumstances of the herd and the criteria for economic evaluation. In this study, the effects of evaluation criteria and production circumstance are quantified using data from the literature

  12. Evaluation as institution: a contractarian argument for needs-based economic evaluation.

    Science.gov (United States)

    Rogowski, Wolf H

    2018-06-13

    There is a gap between health economic evaluation methods and the value judgments of coverage decision makers, at least in Germany. Measuring preference satisfaction has been claimed to be inappropriate for allocating health care resources, e.g. because it disregards medical need. The existing methods oriented at medical need have been claimed to disregard non-consequentialist fairness concerns. The aim of this article is to propose a new, contractarian argument for justifying needs-based economic evaluation. It is based on consent rather than maximization of some impersonal unit of value to accommodate the fairness concerns. This conceptual paper draws upon contractarian ethics and constitution economics to show how economic evaluation can be viewed as an institution to overcome societal conflicts in the allocation of scarce health care resources. For this, the problem of allocating scarce health care resources in a society is reconstructed as a social dilemma. Both disadvantaged patients and affluent healthy individuals can be argued to share interests in a societal contract to provide technologies which ameliorate medical need, based on progressive funding. The use of needs-based economic evaluation methods for coverage determination can be interpreted as institutions for conflict resolution as far as they use consented criteria to ensure the social contract's sustainability and avoid implicit rationing or unaffordable contribution rates. This justifies the use of needs-based evaluation methods by Pareto-superiority and consent (rather than by some needs-based value function per se). The view of economic evaluation presented here may help account for fairness concerns in the further development of evaluation methods. This is because it directs the attention away from determining some unit of value to be maximized towards determining those persons who are most likely not to consent and meeting their concerns. Following this direction in methods development is

  13. EVALUATION OF BARTIN CITY ECONOMIC CONSTRUCT WITH DIGITALIZED SWOT ANALYSIS

    Directory of Open Access Journals (Sweden)

    NERMİN ÇELİK

    2013-06-01

    Full Text Available In this study, firstly besides weakness and strengths of Bartın economy, threats and opportunities were presented by means of SWOT analysis. Secondly obtained findings were evaluated in comparative way and priority weights of each one were calculated by means of Analytic Hierarchy Process (AHP which is an evaluation approach with multiple criteria. Finally, the weak aspects were taken attention on the basis of quantitative findings and the alternative strategies towards to economic development of the city were presented. The weakest side of the city is high unemployment ratio and immigration problem, the most strength side of the city is the using for trading of Bartın port. Besides preparing that study as a first for Bartın city which is within the Encouragement Law, offering the solutions by evaluating the current and potential situations can be described as original sides of this study.

  14. Evaluation the potential economic impacts of Taiwanese biomass energy production

    International Nuclear Information System (INIS)

    Chen, Chi-Chung; McCarl, Bruce; Chang, Ching-Cheng; Tso, Chunto

    2011-01-01

    The Taiwanese rice paddy land set-aside program diverts a substantial land area. Given today's high energy prices and interests in energy security, that set-aside area could be converted to produce bioenergy feedstocks. This study evaluates the economic and environmental impacts of such a policy change using a Taiwanese agricultural sector model. The results show that such a strategy provides increased farm revenue, increased rural employment, increased energy sufficiency and reduced greenhouse gas emissions but also increased government expenditures. These outcomes indicate that the agricultural sector could play a positive role by producing renewable energy. -- Highlights: → This paper evaluates the economic and environmental impacts of converting set-aside area to produce bioenergy feedstocks. → Taiwanese agricultural sector model is built and applied to evaluate such impacts. → The empirical results show that producing bioenergy using set-aside area could provide increased farm revenue, increased rural employment, increased energy sufficiency and reduced greenhouse gas emissions but also increased government expenditures. → Agricultural sector in Taiwan could play a positive role by producing renewable energy.

  15. Cost of illness and economic evaluation in rare diseases.

    Science.gov (United States)

    López-Bastida, Julio; Oliva-Moreno, Juan

    2010-01-01

    Rare diseases are a major cause of morbidity and mortality in high income countries and have major repercussions on individuals and health care systems. This chapter examines the health economy of rare diseases from two different perspectives: firstly, the study of the economic impact of rare diseases (Cost of Illness studies); and, secondly, cost-effectiveness evaluation, which evaluates both the costs and results of the health care technologies applied in rare diseases. From the point of view of economics, health resource allocation is based on the principle of scarcity, as there are not - and never will be- sufficient resources for all worthy objectives. Hence, policy makers should balance costs and health outcomes. Rare diseases may well represent a significant societal burden that should rightly receive appropriate prioritisation of health care resources. As new and seemingly expensive health care technologies are developed for rare diseases, it will become increasingly important to evaluate potential and real impact of these new technologies in both dimensions: social costs and health outcomes.

  16. The impact of cancer drug wastage on economic evaluations.

    Science.gov (United States)

    Truong, Judy; Cheung, Matthew C; Mai, Helen; Letargo, Jessa; Chambers, Alexandra; Sabharwal, Mona; Trudeau, Maureen E; Chan, Kelvin K W

    2017-09-15

    The objective of this study was to determine the impact of modeling cancer drug wastage in economic evaluations because wastage can result from single-dose vials on account of body surface area- or weight-based dosing. Intravenous chemotherapy drugs were identified from the pan-Canadian Oncology Drug Review (pCODR) program as of January 2015. Economic evaluations performed by drug manufacturers and pCODR were reviewed. Cost-effectiveness analyses and budget impact analyses were conducted for no-wastage and maximum-wastage scenarios (ie, the entire unused portion of the vial was discarded at each infusion). Sensitivity analyses were performed for a range of body surface areas and weights. Twelve drugs used for 17 indications were analyzed. Wastage was reported (ie, assumptions were explicit) in 71% of the models and was incorporated into 53% by manufacturers; this resulted in a mean incremental cost-effectiveness ratio increase of 6.1% (range, 1.3%-14.6%). pCODR reported and incorporated wastage for 59% of the models, and this resulted in a mean incremental cost-effectiveness ratio increase of 15.0% (range, 2.6%-48.2%). In the maximum-wastage scenario, there was a mean increase in the incremental cost-effectiveness ratio of 24.0% (range, 0.0%-97.2%), a mean increase in the 3-year total incremental budget costs of 26.0% (range, 0.0%-83.1%), and an increase in the 3-year total incremental drug budget cost of approximately CaD $102 million nationally. Changing the mean body surface area or body weight caused 45% of the drugs to have a change in the vial size and/or quantity, and this resulted in increased drug costs. Cancer drug wastage can increase drug costs but is not uniformly modeled in economic evaluations. Cancer 2017;123:3583-90. © 2017 American Cancer Society. © 2017 American Cancer Society.

  17. Technical and economic evaluation of nuclear seawater desalination systems

    International Nuclear Information System (INIS)

    Grechko, A.G.; Romenkov, A.A.; Shishkin, V.A.

    1998-01-01

    The IAEA Cogeneration/Desalination Cost Model spreadsheets were used for the economic evaluation of sea water desalination plants coupled with small and medium size nuclear reactors developed in RDIPE. The results of calculations have shown that the cost of potable water is equal to or even below 1$/m 3 . This is very close to similar indices of the best fossil driven desalination plants. For remote and difficult-to-access regions, where the transportation share contributes significantly to the product water cost at fossil plants, the nuclear power sources of these reactor types are cost-efficient and can successfully compete with fossil power sources. (author)

  18. Economic evaluation of algae biodiesel based on meta-analyses

    Science.gov (United States)

    Zhang, Yongli; Liu, Xiaowei; White, Mark A.; Colosi, Lisa M.

    2017-08-01

    The objective of this study is to elucidate the economic viability of algae-to-energy systems at a large scale, by developing a meta-analysis of five previously published economic evaluations of systems producing algae biodiesel. Data from original studies were harmonised into a standardised framework using financial and technical assumptions. Results suggest that the selling price of algae biodiesel under the base case would be 5.00-10.31/gal, higher than the selected benchmarks: 3.77/gal for petroleum diesel, and 4.21/gal for commercial biodiesel (B100) from conventional vegetable oil or animal fat. However, the projected selling price of algal biodiesel (2.76-4.92/gal), following anticipated improvements, would be competitive. A scenario-based sensitivity analysis reveals that the price of algae biodiesel is most sensitive to algae biomass productivity, algae oil content, and algae cultivation cost. This indicates that the improvements in the yield, quality, and cost of algae feedstock could be the key factors to make algae-derived biodiesel economically viable.

  19. Systematic Review of Health Economic Impact Evaluations of Risk Prediction Models : Stop Developing, Start Evaluating

    NARCIS (Netherlands)

    van Giessen, Anoukh; Peters, Jaime; Wilcher, Britni; Hyde, Chris; Moons, Carl; de Wit, Ardine; Koffijberg, Erik

    2017-01-01

    Background: Although health economic evaluations (HEEs) are increasingly common for therapeutic interventions, they appear to be rare for the use of risk prediction models (PMs). Objectives: To evaluate the current state of HEEs of PMs by performing a comprehensive systematic review. Methods: Four

  20. Evaluation of modified Dennis parasitological technique for diagnosis of bovine fascioliasis.

    Science.gov (United States)

    Correa, Stefanya; Martínez, Yudy Liceth; López, Jessika Lissethe; Velásquez, Luz Elena

    2016-02-23

    Bovine fascioliasis causes important economic losses, estimated at COP$ 12,483 billion per year; its prevalence is 25% in dairy cattle. Parasitological techniques are required for it diagnosis. The Dennis technique, modified in 2002, is the one used in Colombia, but its sensitivity, specificity and validity are not known.  To evaluate the validity and performance of the modified Dennis technique for diagnosis of bovine fascioliasis using as reference test the observation of parasites in the liver.  We conducted a diagnostic evaluation study. We selected a convenience sample of discarded bovines sacrificed between March and June, 2013, in Frigocolanta for the study. We collected 25 g of feces from each animal and their liver and bile ducts were examined for Fasciola hepatica. The sensitivity, specificity, predictive positive value, predictive negative value, and validity index were calculated with 95% confidence intervals. The post-mortem evaluation was used as the gold standard.  We analyzed 180 bovines. The sensitivity and specificity of the modified Dennis technique were 73.2% (95% CI=58.4% - 87.9%) and 84.2% (95% CI= 77.7% - 90.6%), respectively. The positive predictive value was 57.7% (95% CI= 43.3% - 72.1%) and the negative one 91.4% (95% CI= 86.2% - 96.6%). The prevalence of bovine fascioliasis was 22.8% (95% CI= 16.4% - 29.2%).  The validity and the performance of the modified Dennis technique were higher than those of the traditional one, which makes it a good screening test for diagnosing fascioliasis for population and prevalence studies and during animal health campaigns.

  1. Evaluating Behavioral Economic Models of Heavy Drinking Among College Students.

    Science.gov (United States)

    Acuff, Samuel F; Soltis, Kathryn E; Dennhardt, Ashley A; Berlin, Kristoffer S; Murphy, James G

    2018-05-14

    Heavy drinking among college students is a significant public health concern that can lead to profound social and health consequences, including alcohol use disorder. Behavioral economics posits that low future orientation and high valuation of alcohol (alcohol demand) combined with deficits in alternative reinforcement increase the likelihood of alcohol misuse (Bickel et al., 2011). Despite this, no study has examined the incremental utility of all three variables simultaneously in a comprehensive model METHOD: The current study uses structural equation modeling to test the associations between behavioral economic variables - alcohol demand (latent), future orientation (measured with a delay discounting task and the Consideration of Future Consequences (CFC) scale), and proportionate substance-related reinforcement - and alcohol consumption and problems among 393 heavy drinking college students. Two models are tested: 1) an iteration of the reinforcer pathology model that includes an interaction between future orientation and alcohol demand; and 2) an alternative model evaluating the interconnectedness of behavioral economic variables in predicting problematic alcohol use RESULTS: The interaction effects in model 1 were nonsignificant. Model 2 suggests that greater alcohol demand and proportionate substance-related reinforcement is associated with greater alcohol consumption and problems. Further, CFC was associated with alcohol-related problems and lower proportionate substance-related reinforcement but was not significantly associated with alcohol consumption or alcohol demand. Finally, greater proportionate substance-related reinforcement was associated with greater alcohol demand CONCLUSIONS: Our results support the validity of the behavioral economic reinforcer pathology model as applied to young adult heavy drinking. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  2. Economic evaluation studies in reproductive medicine: a systematic review of methodologic quality

    NARCIS (Netherlands)

    Moolenaar, Lobke M.; Vijgen, Sylvia M. C.; Hompes, Peter; van der Veen, Fulco; Mol, Ben Willem J.; Opmeer, Brent C.

    2013-01-01

    To evaluate the methodologic quality of economic analyses published in the field of reproductive medicine. Systematic review. Centers for reproductive care. Infertility patients. We performed a Medline search to identify economic evaluation studies in reproductive medicine. We included studies that

  3. The revised Canadian Guidelines for the Economic Evaluation of Pharmaceuticals.

    Science.gov (United States)

    Glennie, J L; Torrance, G W; Baladi, J F; Berka, C; Hubbard, E; Menon, D; Otten, N; Rivière, M

    1999-05-01

    The first edition of the Guidelines for Economic Evaluation of Pharmaceuticals: Canada was published in November 1994. At that time, the Canadian Coordinating Office for Health Technology Assessment (CCOHTA) was assigned the task of maintaining and regularly updating the Canadian Guidelines. Since their introduction, a great deal of experience has been gained with the practical application of the guidelines. Their role has also evolved over time, from being a framework for pharmacoeconomic research to the point where a wide variety of decision-makers use economic evaluations based on the principles set out in the guidelines as a means of facilitating their formulary decisions. In addition, methodologies in certain areas (and the body of related research literature in general) have developed considerably over time. Given these changes in the science and the experience gained, CCOHTA convened a multi-disciplinary committee to address the need for revisions to the guidelines. The underlying principles of the review process were to keep the guidance nature of the document, to focus on the needs of 'doers' (so as to meet the information needs of 'users') and to provide information and advice in areas of controversy, with sound direction in areas of general agreement. The purpose of this review is three-fold: (i) to outline the process which lead to the revision of the Canadian Guidelines; (ii) to describe the major changes made to the second edition of this document; and (iii) to consider the 'next steps' as they relate to the impact of such guidelines and the measurement of outcomes related to economic assessments of pharmaceuticals in general.

  4. Improved fuel design economics - a new evaluation tool

    International Nuclear Information System (INIS)

    Aboudara, J.L.

    1987-01-01

    Advanced fuel design technology is now beginning to be implemented with new reload regions for large pressurized water reactors. Until recently there has not been an integrated computer modeling product that would allow easy assessment of the economics of various advanced fuel design alternatives now available to utilities. The Fuel Cycle Scoping System (FCSS) was designed to fill this need. The FCSS is a personnel computer (PC) software package that is used to evaluate alternative strategies for supplying and using nuclear fuel in nuclear power reactors. The FCSS is an extremely flexible package that permits evaluation of in-core and out-of-core fuel management strategy options. For each strategy option, unit and reactor operating assumptions and assumptions for uranium supply, conversion, enrichment, fabrication, and spent fuel disposal can be made

  5. Estimating costs in the economic evaluation of medical technologies.

    Science.gov (United States)

    Luce, B R; Elixhauser, A

    1990-01-01

    The complexities and nuances of evaluating the costs associated with providing medical technologies are often underestimated by analysts engaged in economic evaluations. This article describes the theoretical underpinnings of cost estimation, emphasizing the importance of accounting for opportunity costs and marginal costs. The various types of costs that should be considered in an analysis are described; a listing of specific cost elements may provide a helpful guide to analysis. The process of identifying and estimating costs is detailed, and practical recommendations for handling the challenges of cost estimation are provided. The roles of sensitivity analysis and discounting are characterized, as are determinants of the types of costs to include in an analysis. Finally, common problems facing the analyst are enumerated with suggestions for managing these problems.

  6. EVALUATION OF THE PRECISION OF CLINICAL DIAGNOSIS IN PULPOPATHIES

    Directory of Open Access Journals (Sweden)

    Raluca Mihaela Rosca

    2011-09-01

    Full Text Available Most clinicians universally acknowledge the difficulty of establishing a precise clinical diagnosis of the pathological status of the pulpal-dentinary organ, considering both the diversity of the etiological factors and especially the different histopatological forms that may characterize the same lesion. The aim of the present investigation is to identify and quantify the precision of the presumtive diagnosis established on the basis of clinical data and of paraclinical exams, comparatively with the results of the morphopathological work, which establishes the final diagnosis. There have been analyzed 45 teeth, 43 of which with various inflammatory pulpal problems, and 2 clinically-healthy teeth, extracted from orthodontic reasons. Taking advantage of the fact that, along with the development of the treatment, the dental pulp was also available, after its taking over, the surgical piece was prepared and microscopically examined, which permitted an undisputable morphopathological dignosis. To attain scientifically valid results, both the clinically and the morphopathologically obtained results were statistically interpreted by the non-parametric Wilcoxon test. If, from a clinical perspective, most of the cases were classified as mild hyperemia and partially serous acute pulpitis, the morphopathological examination viewed them as irreversible pulpitis, with major supurative and necrotic modifications. The actual diagnosis means cannot establish whether the pulpitis is a serous, a purulent or a combined manifestation in the various pulp sections.

  7. Evaluating Peripheral Vascular Injuries: Is Color Doppler Enough for Diagnosis?

    Directory of Open Access Journals (Sweden)

    Mohd Lateef Wani

    2014-03-01

    Full Text Available Background:: Vascular injury poses a serious threat to limb and life. Thus, diagnosis should be made immediately with minimally invasive methods. Doppler is a good aid in diagnosis of vascular injury. Methods:: The present prospective study was conducted on 150 patients who presented with soft signs (the signs which are suggestive but not confirmatory of vascular injury. They were subjected to color Doppler examination before exploration. The patients with the features of vascular injury on color Doppler were subjected to exploration. On the other hand, those who had normal Doppler were subjected to CT- angiography. Then, the findings of the exploration were matched with those of color Doppler. The data were analyzed using the SPSS statistical software. Results:: Out of the 150 Doppler examinations, 110 (73.33% were reported as positive, while 40 were reported as negative for vascular injury. These were subjected to CT-angiography and seven of them had the features of vascular injury on CT-angiography. All the patients with positive Doppler or CT angiography findings were subjected to exploration. Doppler had a sensitivity of 94% and specificity of 82.5% in diagnosis of vascular injury using Binary classification test. Conclusions:: Color Doppler is an easily available, reliable, and handy method of diagnosing a vascular injury. It has a very high sensitivity and specificity in diagnosis of vascular injuries.

  8. Study protocol of an economic evaluation of an enhanced implementation strategy for the treatment of low back pain in general practice

    DEFF Research Database (Denmark)

    Jensen, Cathrine; Riis, Allan; Pedersen, Kjeld Møller

    2014-01-01

    on the design of the health economic evaluation. Methods/design: The economic evaluation is carried out alongside a cluster randomised controlled trial consisting of 60 general practices in the North Denmark Region. An expected 1,200 patients between the age of 18 and 65 years with a low back pain diagnosis...... include all relevant additional costs of the extended implementation strategy compared to usual implementation. The economic evaluation will be performed from both a societal perspective and a health sector perspective with a 12-month time horizon. Discussion: It is expected that the extended...

  9. Evaluation of telemedicine systems for impacted third molars diagnosis

    Directory of Open Access Journals (Sweden)

    Duka Miloš

    2009-01-01

    Full Text Available Background/Aim. In the last twenty years significant advances have been made in the fields of information and telecommunication technology in health care applications, with a positive impact on the health care practice. The need for remote diagnosis and planning of interventions is of special importance in military health care, and health management of immobile persons, and those with special needs. In cases such as these, availability of specialist health care is mainly limited by geographic and financial factors. The aim of this study was to investigate practical usability of telemedicine approaches in everyday management of oral surgery patients in terms of reliability of established diagnosis and indications for oral surgery treatment of the third molars. Methods. Our experimental randomized study enrolled 432 randomly selected patients of both genders, aged 20 to 87 years, undergoing panoramic radiography for some reason in the Centre for Dental Radiography in Belgrade. In addition to radiography, photographs of the face and mouth cavity were taken. These images were uploaded to the web server specially dedicated to the study purposes, and then transmitted to teledentists, i.e. oral surgeons, who made remote diagnoses. Diagnostic agreement was determined by way of the Cohen's kappa coefficient, and diagnostic sensitivity (SE, specificity (SP, and effectiveness (EFF were also established. Statistical significance was determined and comparisons performed by using the z-test, and testing of non-parametric characteristics by using the McNemar's χ2 test for p = 0.05 significance cut-off. Results. The results obtained by analyzed images and diagnostic assessment of the clinical diagnosis (kappa = 0.99, SE = 99%, SP = 99%, EFF = 99%, for 95% CI indicate an almost complete diagnostic agreement. The differences in diagnosis were not statistically significant. Conclusion. Diagnostic assessment of the clinical diagnosis of impacted or semi

  10. The methodological quality of economic evaluation studies in obstetrics and gynecology: a systematic review

    NARCIS (Netherlands)

    Vijgen, Sylvia M. C.; Opmeer, Brent C.; Mol, Ben Willem J.

    2013-01-01

    We evaluated the methodological quality of economic evaluation studies in the field of obstetrics and gynecology published in the last decade. A MEDLINE search was performed to find economic evaluation studies in obstetrics and gynecology from the years 1997 through 2009. We included full economic

  11. Evaluation of Outcome- Prenatal Diagnosis Indication and Results Suitability in Families Referred to our Laboratory For Prenatal Diagnosis

    Directory of Open Access Journals (Sweden)

    Ayşegül Türkyılmaz

    2007-01-01

    Full Text Available Since our aim is to establish the importance, necessity and concept of prenatal diagnosis in our region and supply routine service at a stage which we admit as a transitional period for application, all of the materials of amniocentesis, cordocentesis and corion villi sample referred to laboratories were evaluated without refusal.When we examined prenatal diagnoses of these specimens, we found Down Risk (according to triple test result in 164 specimens (%34, fetal anomaly risk in 122 (%25, advanced age in 69 (%14 poor-obstetric anamnesis in 27(%5, Down Syndrome- infant history in 20 (%4, family request in 17, and habitual abortus (%3 etc. in specimens. Lymphocyte Culture prepared in duplicate for each specimen and chromosome were obtained from total of ten slides for each specimen. Slides were stained with Giemsa Banding Technic (GTG Banding. Total (10x481 4810 slides were evaluated for diagnosis.There were no false positive and false negative results.

  12. Experimental and economical evaluation of a novel biogas digester

    International Nuclear Information System (INIS)

    Rajendran, Karthik; Aslanzadeh, Solmaz; Johansson, Fredrik; Taherzadeh, Mohammad J.

    2013-01-01

    Highlights: • Textile biogas digester was tested with synthetic nutrients and MSW. • Economical evaluation was made with replacement of LPG and kerosene. • The investment is positive until the price of fuel goes down. • Sensitivity analysis was performed to check the stability of the digester. - Abstract: Many developing countries face an energy demand to satisfy the daily needs of the people. Household biogas digesters are among the interesting solutions to meet the energy demands for cooking and lighting, and at the same time taking care of the kitchen wastes. In this study, a novel textile-based biogas digester was developed. The digester was evaluated for biogas production from a synthetic nutrient and an organic fraction of municipal solid waste (OFMSW) as substrates for more than a year. The obtained biogas productivity in both experiments was 570 L/kgVS/day, which indicates that the digester is as efficient in handling of OFMSW as the synthetic nutrients. Based on the obtained biogas production data, the techno-economic evaluation and sensitivity analysis for the process were performed, replacing LPG and kerosene consumption with biogas in households. A 2-m 3 digester can supply the fuel needed for cooking for a family of 4–6 people. The sum of investment and 15-years operational costs of this digester was 656 USD, which can be compared with 1455 USD for subsidized-LPG and 975 USD for kerosene, respectively. The results from the sensitivity analysis show that it was a positive investment, unless the price of kerosene goes down to less than 0.18 USD/L

  13. Ecological and economic evaluation of biogas from intercrops

    Energy Technology Data Exchange (ETDEWEB)

    Niemetz, Nora; Kettl, Karl-Heinz [Graz Univ. of Technology (Austria). Inst. for Process and Particle Engineering

    2012-12-01

    Biogas made from main crops (e.g., corn) is commonly used for producing electricity and heat. Nevertheless, the production of energy from monocultures is highly unsustainable and not truly renewable. Since neither monocultures nor food competition are desirable, intercrops can be used to increase the yield per hectare instead of leaving agricultural fields unplanted for soil regeneration. The extra biomass can be used for biogas production. In a case study, the economic as well as the ecological feasibility of biogas production using intercrops, cattle manure, grass and corn silage as feedstocks for fermenters was analyzed. The set-up for the case study included different feedstock combinations as well as spatial distributions of substrate supply and heat demand for modeling and optimization. Using the process network synthesis, an optimum structure was generated representing the most economical technology constellation which included transport of substrates, heat and biogas (when applicable). The ecological evaluation was carried out by using the sustainable process index method. The application of both methodologies to different scenarios allowed a constellation to be found which is economically feasible while entailing low ecological pressure. It is demonstrated that the production of intercrops for producing biogas has so far not been regarded as a viable option by the farmers due to a variety of barriers. Sensitization is needed to emphasize that planting intercrops holds many advantages like positive effects on soil regeneration and raised nitrogen fixation, as well as increased biomass output per hectare and, last but not least, it allows the production of energy without conflicts between food and energy production. (orig.)

  14. A technical and economic evaluation of wood conversion processes

    Energy Technology Data Exchange (ETDEWEB)

    Douglas, L J

    1990-08-08

    A technical and economic evaluation of the Iogen wood-to-ethanol bioconversion process was carried out using a computer simulation model based on an engineering analysis of the process. The model was used to run sensitivity analyses for the process and to estimate the parameters with significant economic impact and promise for future improvement to process economics. The most important parameters were then used in Monte Carlo simulations to estimate the potential for future improvements and to assess the commercial potential of the process. Finally, the process was subjected to second-law analysis, in which its thermodynamic efficiency was assessed in terms of lost work potential. The Iogen process is a highly optimized process using state-of-the-art enzymatic hydrolysis with steam explosion pretreatment; lactose sugar from cheese whey is used as the carbon source for enzyme production. The base case design would use 1000 tonnes/d of aspen wood and would produce 91 Ml/y of ethanol. Assuming no value for byproducts, the break-even price for ethanol would be 45-70{cents}/l, depending on the financing method employed. If byproduct credit is added for lignin and molasses, the required ethanol selling price would drop to 30-50{cents}/l. Forecasts for future technology improvements show that it is possible to construct scenarios where the ethanol price could be as low as 10-20{cents}/l including byproduct credits. Potential improvements to the process include reduced enzyme production cost; xylose fermentation to ethanol; lower-cost feedstock; and substitution of wood sugars for lactose. 48 refs., 39 figs., 21 tabs.

  15. ECONOMIC EVALUATION OF CO2 SEQUESTRATION TECHNOLOGIES; SEMIANNUAL

    International Nuclear Information System (INIS)

    Bert R. Bock; Richard G. Rhudy; David E. Nichols

    2001-01-01

    In order to plan for potential CO(sub 2) mitigation mandates, utilities need better information on CO(sub 2) mitigation options, especially carbon sequestration options that involve non-utility operations. One of the major difficulties in evaluating CO(sub 2) sequestration technologies and practices, both geologic storage of captured CO(sub 2) and storage in biological sinks, is obtaining consistent, transparent, accurate, and comparable economics. This project is comparing the economics of major technologies and practices under development for CO(sub 2) sequestration, including captured CO(sub 2) storage options such as active oil reservoirs, depleted oil and gas reservoirs, deep aquifers, coal beds, and oceans, as well as the enhancement of biological sinks such as forests and croplands. An international group of experts has been assembled to compare on a consistent basis the economics of this diverse array of CO(sub 2) sequestration options. Designs and data collection are nearly complete for each of the CO(sub 2) sequestration options being compared. Initial spreadsheet development has begun on concepts involving storage of captured CO(sub 2). No significant problems have been encountered, but some additional outside expertise will be accessed to supplement the team's expertise in the areas of life cycle analysis, oil and gas exploration and production, and comparing CO(sub 2) sequestration options that differ in timing and permanence of CO(sub 2) sequestration. Plans for the next reporting period are to complete data collection and a first approximation of the spreadsheet. We expect to complete this project on time and on budget

  16. [Measurement and health economic evaluation of informal care].

    Science.gov (United States)

    Zrubka, Zsombor

    2017-09-01

    Informal care is non-financed care outside the realm of formal healthcare, which represents an increasing challenge for aging societies. Informal care has frequently been neglected in health economic analyses, while in recent years its coverage has increased considerably in the international scientific literature. This review summarizes the methodology of the health-economic assessment of informal care, including the objective and subjective metrics of caregiver burden, its financial and non-financial valuation and practical applications, with special emphasis on the introduction of care-related quality of life instruments (e.g. Care Related Quality of Life - CarerQoL instrument). Care-related quality of life is a different entity from health-related quality of life, the two cannot be combined, so their joint evaluation requires multi-criteria decision analysis methods. Therefore, it is important to determine the societal preferences of care-related quality of life versus health-related quality of life, and map the relationship of care-related quality of life with time. The local validation of tools measuring care-related quality of life, its more widespread practical application and the analysis of its effect on decision making are also important part of the future research agenda. Orv Hetil. 2017; 158(35): 1363-1372.

  17. Economic evaluation of occupational safety preventive measures in a hospital.

    Science.gov (United States)

    Ramos, Delfina G; Arezes, Pedro M; Afonso, Paulo

    2015-01-01

    When an organization performs an integrated analysis of risks through its Occupational Health and Safety Management System, several steps are suggested to address the implications of the identified risks. Namely, the organization should make a detailed analysis of the monetary impact for the organization of each of the preventive measures considered. However, it is also important to perform an analysis of the impact of each measure on society (externalities). The aim of this paper is to present a case study related to the application of the proposed economic evaluation methodology. An analysis of the work accidents in a hospital has been made. Three of the major types of accidents have been selected: needle stings, falls and excessive strain. Following the risk assessment, some preventive measures have been designed. Subsequently, the Benefit/Cost ratio (B/C) of these measures has been calculated, both in financial terms (from the organization's perspective) and in economic terms (including the benefits for the worker and for the Society). While the financial ratio is only advantageous in some cases, when the externalities are taken into account, the B/C ratio increases significantly. It is important to consider external benefits to make decisions concerning the implementation of preventive measures in Occupational Health and Safety projects.

  18. Operative and economic evaluation of a 'Laser Printer Multimodality' System

    International Nuclear Information System (INIS)

    Battaglia, G.; Moscatelli, G.; Maroldi, R.; Chiesa, A.

    1991-01-01

    The increasing application of digital techniques to diagnostic imaging is causing significant changes in several related activities, such as a reproduction of digital images on film. In the Department of Diagnostic Imaging of the University of Brescia, about 70% of the whole of images are produced by digital techniques; at present, most of these images are reproduced on film with a Multimodality System interfacing CT, MR, DSA, and DR units with a single laser printer. Our analysis evaluates the operative and economics aspects of image reproduction, by comparing the 'single cassette' multiformat Camera and the Laser Printer Multimodality SAystem. Our results point out the advantages obtained by reproducing images with a Laser Printer Multimodality System: outstanding quality, reproduction of multiple originals, and marked reduction in the time needed for both image archiving and film handling. The Laser Printer Multimodality System allows over 5 hours/day to be saved -that is to say the working day of an operator, who can be thus shifted to other functions. The important economic aspect of the reproduction of digital images on film proves the Laser Printer Multimodality System to have some advantage over Cameras

  19. Routine magnetic resonance imaging for idiopathic olfactory loss: a modeling-based economic evaluation.

    Science.gov (United States)

    Rudmik, Luke; Smith, Kristine A; Soler, Zachary M; Schlosser, Rodney J; Smith, Timothy L

    2014-10-01

    Idiopathic olfactory loss is a common clinical scenario encountered by otolaryngologists. While trying to allocate limited health care resources appropriately, the decision to obtain a magnetic resonance imaging (MRI) scan to investigate for a rare intracranial abnormality can be difficult. To evaluate the cost-effectiveness of ordering routine MRI in patients with idiopathic olfactory loss. We performed a modeling-based economic evaluation with a time horizon of less than 1 year. Patients included in the analysis had idiopathic olfactory loss defined by no preceding viral illness or head trauma and negative findings of a physical examination and nasal endoscopy. Routine MRI vs no-imaging strategies. We developed a decision tree economic model from the societal perspective. Effectiveness, probability, and cost data were obtained from the published literature. Litigation rates and costs related to a missed diagnosis were obtained from the Physicians Insurers Association of America. A univariate threshold analysis and multivariate probabilistic sensitivity analysis were performed to quantify the degree of certainty in the economic conclusion of the reference case. The comparative groups included those who underwent routine MRI of the brain with contrast alone and those who underwent no brain imaging. The primary outcome was the cost per correct diagnosis of idiopathic olfactory loss. The mean (SD) cost for the MRI strategy totaled $2400.00 ($1717.54) and was effective 100% of the time, whereas the mean (SD) cost for the no-imaging strategy totaled $86.61 ($107.40) and was effective 98% of the time. The incremental cost-effectiveness ratio for the MRI strategy compared with the no-imaging strategy was $115 669.50, which is higher than most acceptable willingness-to-pay thresholds. The threshold analysis demonstrated that when the probability of having a treatable intracranial disease process reached 7.9%, the incremental cost-effectiveness ratio for MRI vs no

  20. Comparative economic evaluation of environmental impact of different cogeneration technologies

    International Nuclear Information System (INIS)

    Patrascu, Roxana; Athanasovici, Victor; Raducanu, Cristian; Minciuc, Eduard; Bitir-Istrate, Ioan

    2004-01-01

    Cogeneration is one of the most powerful technologies for reduction of environmental pollution along with renewable energies. At the Kyoto Conference cogeneration has been identified as being the most important measure for reducing emissions of greenhouse effect gases. It has also been mentioned that cogeneration has a potential of reducing pollution with about 180 million tones per year. In order to promote new cogeneration technologies and evaluate the existing ones it is necessary to know and to be able to quantify in economical terms the environmental issues. When comparing different cogeneration technologies: steam turbine (TA), gas turbine (TG), internal combustion engine (MT), in order to choose the best one, the final decision implies an economic factor, which is even more important if it includes the environmental issues. The environmental impact of different cogeneration technologies is quantified using different criteria: depletion of non-renewable natural resources, eutrofisation, greenhouse effect, acidification etc. Environmental analysis using these criteria can be made using the 'impact with impact' methodology or the global one. The results of such an analysis cannot be quantified economically directly. Therefore there is a need of internalisation of ecological effects within the costs of produced energy: electricity and heat. In the energy production sector the externalizations represent the indirect effects on the environment. They can be materialised within different types of environmental impact: - Different buildings of mines, power plants etc; - Fuel losses during transportation and processing; - Effect of emissions in the air, water and soil. Introduction of the environmental impact costs in the energy price is called internalisation and it can be made using the direct and indirect methods. The paper discusses aspects regarding the emissions of cogeneration systems, the eco-taxes - method of 'internalisation' of environmental

  1. Methods for Health Economic Evaluation of Vaccines and Immunization Decision Frameworks : A Consensus Framework from a European Vaccine Economics Community

    NARCIS (Netherlands)

    Ultsch, Bernhard; Damm, Oliver; Beutels, Philippe; Bilcke, Joke; Brueggenjuergen, Bernd; Gerber-Grote, Andreas; Greiner, Wolfgang; Hanquet, Germaine; Hutubessy, Raymond; Jit, Mark; Knol, Mirjam; von Kries, Ruediger; Kuhlmann, Alexander; Levy-Bruhl, Daniel; Perleth, Matthias; Postma, Maarten; Salo, Heini; Siebert, Uwe; Wasem, Jurgen; Wichmann, Ole

    Incremental cost-effectiveness and cost-utility analyses [health economic evaluations (HEEs)] of vaccines are routinely considered in decision making on immunization in various industrialized countries. While guidelines advocating more standardization of such HEEs (mainly for curative drugs) exist,

  2. Health economic evaluation in lumbar spinal fusion: a systematic literature review anno 2005

    DEFF Research Database (Denmark)

    Soegaard, Rikke; Christensen, Finn B

    2006-01-01

    in clinical practice are present, economic evaluation is needed in order to facilitate the decision-makers' budget allocations. NHS Economic Evaluation Database, MEDLINE, EMBASE and Cochrane Library were searched. Two independent reviewers (one clinical content expert and one economic content expert) applied...... that the clinical effects are statistically synonymous, it does not support the use of high-cost techniques. There is a great potential for improvement of methodological quality in economic evaluations of lumbar spinal fusion and further research is imperative....

  3. Economic evaluation of volume reduction for Defense transuranic waste

    International Nuclear Information System (INIS)

    Brown, C.M.

    1982-03-01

    The economics of volume reduction of retrievably stored and newly generated DOE transuranic wastes are evaluated by comparing the costs of reduction of the wastes with the savings possible in transportation and disposal. A general approach to the comparison of TRU waste volume reduction costs and cost savings is developed, an initial set of cost data is established, conclusions to support selecting technologies and facilities for the disposal of DOE transuranic waste are developed. Section I outlines the analysis which considers seven types of volume reduction from incineration and compaction of combustibles to compaction, size reduction, shredding, melting, and decontamination of metals. The study considers the volume reduction of contact-handled, newly generated and retrievably stored DOE transuranic wastes. Section II of this report describes the analytical approach, assumptions, and flow of waste material through sites. Section III presents the waste inventories, disposal and transportation savings, and volume reduction techniques and costs. Section IV contains the results and conclusions of the study. The major conclusions drawn from the study are: For DOE sites with a small amount of waste requiring disposal ( 3 /year) the cost of volume reduction is greater than the transportation and disposal savings from volume reduction provided the waste requires little additional preparation to meet transportation and disposal criteria. Wastes that do not meet these criteria require site specific economic analysis outside the general evaluations of this study. For Idaho National Engineering Laboratory, incineration and metal shredding are cost-effective, provided a facility is to be constructed as a consequence of repackaging the fraction of stored waste which may require repackaging and immobilizing chemical process waste to meet disposal criteria

  4. Economic Evaluation of Pediatric Telemedicine Consultations to Rural Emergency Departments.

    Science.gov (United States)

    Yang, Nikki H; Dharmar, Madan; Yoo, Byung-Kwang; Leigh, J Paul; Kuppermann, Nathan; Romano, Patrick S; Nesbitt, Thomas S; Marcin, James P

    2015-08-01

    Comprehensive economic evaluations have not been conducted on telemedicine consultations to children in rural emergency departments (EDs). We conducted an economic evaluation to estimate the cost, effectiveness, and return on investment (ROI) of telemedicine consultations provided to health care providers of acutely ill and injured children in rural EDs compared with telephone consultations from a health care payer prospective. We built a decision model with parameters from primary programmatic data, national data, and the literature. We performed a base-case cost-effectiveness analysis (CEA), a probabilistic CEA with Monte Carlo simulation, and ROI estimation when CEA suggested cost-saving. The CEA was based on program effectiveness, derived from transfer decisions following telemedicine and telephone consultations. The average cost for a telemedicine consultation was $3641 per child/ED/year in 2013 US dollars. Telemedicine consultations resulted in 31% fewer patient transfers compared with telephone consultations and a cost reduction of $4662 per child/ED/year. Our probabilistic CEA demonstrated telemedicine consultations were less costly than telephone consultations in 57% of simulation iterations. The ROI was calculated to be 1.28 ($4662/$3641) from the base-case analysis and estimated to be 1.96 from the probabilistic analysis, suggesting a $1.96 return for each dollar invested in telemedicine. Treating 10 acutely ill and injured children at each rural ED with telemedicine resulted in an annual cost-savings of $46,620 per ED. Telephone and telemedicine consultations were not randomly assigned, potentially resulting in biased results. From a health care payer perspective, telemedicine consultations to health care providers of acutely ill and injured children presenting to rural EDs are cost-saving (base-case and more than half of Monte Carlo simulation iterations) or cost-effective compared with telephone consultations. © The Author(s) 2015.

  5. Economic evaluation of CO2 pipeline transport in China

    International Nuclear Information System (INIS)

    Zhang Dongjie; Wang Zhe; Sun Jining; Zhang Lili; Li Zheng

    2012-01-01

    Highlights: ► We build a static hydrodynamic model of CO 2 pipeline for CCS application. ► We study the impact on pressure drop of pipeline by viscosity, density and elevation. ► We point out that density has a bigger impact on pressure drop than viscosity. ► We suggest dense phase transport is preferred than supercritical state. ► We present cost-optimal pipeline diameters for different flowrates and distances. - Abstract: Carbon capture and sequestration (CCS) is an important option for CO 2 mitigation and an optimized CO 2 pipeline transport system is necessary for large scale CCS implementation. In the present work, a hydrodynamic model for CO 2 pipeline transport was built up and the hydrodynamic performances of CO 2 pipeline as well as the impacts of multiple factors on pressure drop behavior along the pipeline were studied. Based on the model, an economic model was established to optimize the CO 2 pipeline transport system economically and to evaluate the unit transport cost of CO 2 pipeline in China. The hydrodynamic model results show that pipe diameter, soil temperature, and pipeline elevation change have significant influence on the pressure drop behavior of CO 2 in the pipeline. The design of pipeline system, including pipeline diameter and number of boosters etc., was optimized to achieve a lowest unit CO 2 transport cost. In regarding to the unit cost, when the transport flow rate and distance are between 1–5 MtCO 2 /year and 100–500 km, respectively, the unit CO 2 transport cost mainly lies between 0.1–0.6 RMB/(tCO 2 km) and electricity consumption cost of the pipeline inlet compressor was found to take more than 60% of the total cost. The present work provides reference for CO 2 transport pipeline design and for feasibility evaluation of potential CCS projects in China.

  6. Smoking, health-related quality of life and economic evaluation.

    Science.gov (United States)

    López-Nicolás, Ángel; Trapero-Bertran, Marta; Muñoz, Celia

    2018-06-01

    The economic evaluation of tobacco control policies requires the adoption of assumptions about the impact of changes in smoking status on health-related quality of life (HRQoL). Estimates for such impacts are necessary for different populations. This paper aims to test whether smoking status has an independent effect on HRQoL over and above the effect derived from the increased likelihood of suffering a tobacco related disease, and to calculate utility values for the Spanish population. Using data from the Spanish Encuesta Nacional de Salud of 2011-12, we estimate statistical models for HRQoL as measured by the EQ-5D-5L instrument as a function of smoking status. We include a comprehensive set of controls for biological, clinical, lifestyle and socioeconomic characteristics. Smoking status has an independent, statistically significant effect on HRQoL. However, the size of the effect is small. The typical smoking related diseases, such as lung cancer, are associated with a reduction in HRQoL about 5 times larger than the difference between current smokers and never smokers. Attributing substantive HRQoL gains to quitting smoking as well as accounting for the concomitant HRQoL gain derived from a smaller likelihood of contracting tobacco related diseases might lead to an overestimation of the benefits of tobacco control policies. Nonetheless, the relatively large drops in HRQoL associated with being diagnosed with diseases that might be causally linked to tobacco suggest that such diseases should not be omitted from the economic evaluations of tobacco control policies.

  7. Discounting in the economic evaluation of health care interventions.

    Science.gov (United States)

    Krahn, M; Gafni, A

    1993-05-01

    Do economic theories that underlie discounting have specific implications for program evaluation in health? In this study, both the contemporary practice and the theoretical foundations of discounting are reviewed. The social discount rate controversy is considered, and the two major concepts (i.e., opportunity cost and time preference) involved in the formulation of a social discount rate are outlined. Also described are the arguments for discounting proposed by thinkers in non-economic disciplines. Finally, the implications of choosing a discount rate for evaluation of individual health care programs are considered. It is argued that the conventional practice of discounting all health care programs at a rate of 5% may not consistently reflect societal or individual preference. Specific recommendations arising from this paper are: 1) given the considerable disagreement at the theoretical level as to the appropriate social discount rate, analysts should be specific about what theoretical approach underlies their choice of rate, especially when the analytic result is sensitive to the discount rate; 2) the discount rate chosen should be appropriate for the perspective of the analysis (social vs. individual vs. institutional, etc.); 3) when appropriate, measures should be taken to avoid double discounting, because some health related outcome measures already incorporate individuals' time preference; and 4) it is suggested that the political process may serve as the appropriate means of reflecting social values in the choice of a discount rate. In addition, the authors argue that a consensus conference approach, with political participation, offers a flexible, pragmatic, and explicit way of synthesizing the empirical, normative, and ethical considerations that underlie choice of a discount rate.

  8. Evaluation of the diagnosis for hypertrophic cardiomyopathy (HCM) with SPECT

    International Nuclear Information System (INIS)

    Li Jiaxiu

    1992-01-01

    A heart phantom-7070 was used to measure the wall thickness of cardiac chambers. Two methods were employed: (1) profile curve measurement, (2) calculation of the thickness of cardiac walls. 9 normal cases and 13 patients with hypertrophic cardiomyopathy were studied using 99m Tc-CDI SPECT. 4 patterns were obtained: (1) Local hypertrophy of ventricular septum; (2) The predominant hypertrophy localized in left ventricular lateral wall; (3) Markedly hypertrophied septum and also involving left ventricular walls, especially the apical region; (4) Markedly hypertrophied papillary muscles with perfusion defects in the left wall and septum. These results suggest that myocardial SPECT is a promising and noninvasive method for the diagnosis of HCM

  9. Solar energy system economic evaluation for Wormser Columbia, South Carolina

    Science.gov (United States)

    1980-01-01

    The Solar Energy System is not economically beneficial under the assumed economic conditions at the sites considered. Economic benefits from this system depend on decreasing the initial investment and the continued increase in the cost of conventional energy. Decreasing the cost depends on favorable tax treatment and continuing development of solar energy technology. Fuel cost would have to increase drastically while the cost of the system would have to remain constant or decrease for the system to become economically feasible.

  10. [Economic and organizational evaluation of an imaging network (PACS)].

    Science.gov (United States)

    Charvet-Protat, S; Thoral, F

    1998-12-01

    Over the last twenty years, imaging modalities featuring new image production methods (ultrasound, nuclear magnetic resonance, etc.) have appeared on the market. Nevertheless, conventional radiology still accounts for 70% of the image examinations carried out in most western countries, including France. The conventional radiological image is in the process of evolving from analog to digital form. Digitalization of radiology means that image acquisition, archiving and distribution functions that were previously carried out by hand can now be automated using a Picture Archiving and Communication System. Decision-makers are having to decide whether or not to promote the development of PACS which, while they considerably modernize the way in which images are managed, also require heavy capital outlays. A critical appraisal of the literature allowed us to evaluate the relative cost and the efficiency of these image networks in comparison with film-based archiving and communication systems. It is clear from the economic evaluation that a PACS strategy involves greater costs than a film system. While PACS systems do generate savings on film and on storage space and obviate the need for certain staff, these savings do not offset the extra equipment and maintenance costs. This situation is likely to persist for some years yet, even when future price reductions are taken into account. The objective of this new radiological information management method is to improve organizational efficiency and hospital productivity. However, the economic evaluations that have been published to date are cost studies which do not take the efficiency criterion into account. A number of potential organizational benefits such as the fact that medical decisions can be made more quickly or that the average length of hospital stays can be reduced, are often claimed for PACS. However, for methodological reasons, these results cannot be generalised to cover all PACS. It is difficult to compare PACS

  11. Economic evaluation of targeted cancer interventions: critical review and recommendations.

    Science.gov (United States)

    Elkin, Elena B; Marshall, Deborah A; Kulin, Nathalie A; Ferrusi, Ilia L; Hassett, Michael J; Ladabaum, Uri; Phillips, Kathryn A

    2011-10-01

    Scientific advances have improved our ability to target cancer interventions to individuals who will benefit most and spare the risks and costs to those who will derive little benefit or even be harmed. Several approaches are currently used for targeting interventions for cancer risk reduction, screening, and treatment, including risk prediction algorithms for identifying high-risk subgroups and diagnostic tests for tumor markers and germline genetic mutations. Economic evaluation can inform decisions about the use of targeted interventions, which may be more costly than traditional strategies. However, assessing the impact of a targeted intervention on costs and health outcomes requires explicit consideration of the method of targeting. In this study, we describe the importance of this principle by reviewing published cost-effectiveness analyses of targeted interventions in breast cancer. Few studies we identified explicitly evaluated the relationships among the method of targeting, the accuracy of the targeting test, and outcomes of the targeted intervention. Those that did found that characteristics of targeting tests had a substantial impact on outcomes. We posit that the method of targeting and the outcomes of a targeted intervention are inextricably linked and recommend that cost-effectiveness analyses of targeted interventions explicitly consider costs and outcomes of the method of targeting.

  12. The Use of Economic Evaluation to Inform Newborn Screening Policy Decisions: The Washington State Experience.

    Science.gov (United States)

    Grosse, Scott D; Thompson, John D; Ding, Yao; Glass, Michael

    2016-06-01

    Newborn screening not only saves lives but can also yield net societal economic benefit, in addition to benefits such as improved quality of life to affected individuals and families. Calculations of net economic benefit from newborn screening include the monetary equivalent of avoided deaths and reductions in costs of care for complications associated with late-diagnosed individuals minus the additional costs of screening, diagnosis, and treatment associated with prompt diagnosis. Since 2001 the Washington State Department of Health has successfully implemented an approach to conducting evidence-based economic evaluations of disorders proposed for addition to the state-mandated newborn screening panel. Economic evaluations can inform policy decisions on the expansion of newborn screening panels. This article documents the use of cost-benefit models in Washington State as part of the rule-making process that resulted in the implementation of screening for medium-chain acyl-CoA dehydrogenase (MCAD) deficiency and 4 other metabolic disorders in 2004, cystic fibrosis (CF) in 2006, 15 other metabolic disorders in 2008, and severe combined immune deficiency (SCID) in 2014. We reviewed Washington State Department of Health internal reports and spreadsheet models of expected net societal benefit of adding disorders to the state newborn screening panel. We summarize the assumptions and findings for 2 models (MCAD and CF) and discuss them in relation to findings in the peer-reviewed literature. The MCAD model projected a benefit-cost ratio of 3.4 to 1 based on assumptions of a 20.0 percentage point reduction in infant mortality and a 13.9 percentage point reduction in serious developmental disability. The CF model projected a benefit-cost ratio of 4.0-5.4 to 1 for a discount rate of 3%-4% and a plausible range of 1-2 percentage point reductions in deaths up to age 10 years. The Washington State cost-benefit models of newborn screening were broadly consistent with peer

  13. Parathyromatosis: critical diagnosis regarding surgery and pathologic evaluation.

    Science.gov (United States)

    Aksoy-Altinboga, Ayşegül; Akder Sari, Ayşegül; Rezanko, Türkan; Haciyanli, Mehmet; Orgen Calli, Aylin

    2012-04-01

    Parathyromatosis, in which several nodules of hyperfunctioning parathyroid tissue form in the neck and mediastinum, is a rare cause of recurrent hyperparathyroidism. However, there are some theories regarding the origin of parathyromatosis, and seeding after rupture of the parathyroid gland capsule during surgical removal of a parathyroid lesions is the most regarded one. Herein, we report a 41-year-old man who presented with multiple parathyroid nodules in and around the left thyroid lobe 5 years after parathyroid surgery for secondary hyperparathyroidism that was finally diagnosed as parathyromatosis. We discuss the differential diagnosis of parathyromatosis from other parathyroid tumors, particularly from parathyroid carcinoma, which is important in the management of a suspected lesion.

  14. About Face: Evaluating and Managing Tactile Impairment at the Time of Autism Diagnosis

    OpenAIRE

    Silva, Louisa M. T.; Schalock, Mark; Gabrielsen, Kristen R.

    2015-01-01

    Evaluation for sensory impairment is a routine part of autism diagnosis. Sensory impairment of hearing, vision, or touch results in developmental delay and must be addressed before delay can resolve. Recent studies confirm that tactile impairment is present in autism and can be effectively treated with a tactile stimulation protocol. The research suggests a change in management at the time of autism diagnosis to include evaluation and treatment of tactile impairment. Here we validate screenin...

  15. [Clinical effectiveness and economical evaluation of preventive vaccination].

    Science.gov (United States)

    Vaz Carneiro, António; Belo, Ana Isabel; Gouveia, Miguel; Costa, João; Borges, Margarida

    2011-01-01

    The value of mass vaccination as a preventive measure for infectious diseases is one of the most important advances of modern Medicine. The impact on incidence of several infectious diseases, until recently responsible for significant morbidity and mortality at world level, is well proved in a series of high quality epidemiological studies. In this scientific review we aimed firstly to briefly resume the history of mass vaccination and its scientists, responsible for synthesis and marketing of these drugs. In second place we present a group of a few disease preventable by vaccines as well as the Portuguese National Vaccination Plan and its benefits. In third place we identified groups of subjects in which a well structured vaccination plan is particularly important, as well as the correspondent diseases to be covered by vaccination. Fourthly, we discussed the ethical considerations of vaccination, and its tensions between subject autonomy and society advantages in com pulsive programs. Fifthly, we analyzed clinical effectiveness of vaccines through the concept of herd immunity, clinical evaluation of immune response to vaccines and some examples of systematic reviews on three relevant diseases (influenza, meningococcal and pneumococcal infections). In sixth place we discussed vaccine safety presenting monitoring methods of vaccination risks, as well as discussing the public myths concerning vaccines. Finally we present a economic analysis of preventive vaccination with a review of some published literature on specific diseases. We conclude that mass vaccination is a efficacious preventive measure, as well as a economic rational choice, and that this public health intervention should be a pillar of a modern preventive system.

  16. A systematic review of economic evaluations of cardiac rehabilitation

    Directory of Open Access Journals (Sweden)

    Wong Wai

    2012-08-01

    Full Text Available Abstract Background Cardiac rehabilitation (CR, a multidisciplinary program consisting of exercise, risk factor modification and psychosocial intervention, forms an integral part of managing patients after myocardial infarction (MI, revascularization surgery and percutaneous coronary interventions, as well as patients with heart failure (HF. This systematic review seeks to examine the cost-effectiveness of CR for patients with MI or HF and inform policy makers in Singapore on published cost-effectiveness studies on CR. Methods Electronic databases (EMBASE, MEDLINE, NHS EED, PEDro, CINAHL were searched from inception to May 2010 for published economic studies. Additional references were identified through searching bibliographies of included studies. Two independent reviewers selected eligible publications based on the inclusion/exclusion criteria. Quality assessment of economic evaluations was undertaken using Drummond’s checklist. Results A total of 22 articles were selected for review. However five articles were further excluded because they were cost-minimization analyses, whilst one included patients with stroke. Of the final 16 articles, one article addressed both centre-based cardiac rehabilitation versus no rehabilitation, as well as home-based cardiac rehabilitation versus no rehabilitation. Therefore, nine studies compared cost-effectiveness between centre-based supervised CR and no CR; three studies examined that between centre- and home based CR; one between inpatient and outpatient CR; and four between home-based CR and no CR. These studies were characterized by differences in the study perspectives, economic study designs and time frames, as well as variability in clinical data and assumptions made on costs. Overall, the studies suggested that: (1 supervised centre-based CR was highly cost-effective and the dominant strategy when compared to no CR; (2 home-based CR was no different from centre-based CR; (3 no difference existed

  17. Evaluation of water resource economics within the Pasco Basin, Washington

    International Nuclear Information System (INIS)

    Leaming, G.F.

    1981-01-01

    The Columbia River basalt beneath the Hanford Site in south-central Washington is being considered for possible use as a terminal repository medium for high-level nuclear waste. Such underground storage would require that the facility be contiguous to at least a portion of the ambient groundwater system of the Pasco Basin. This report attempts to evaluate the economic factors and conditions related to the water resources of the Pasco Basin and the probable economic effects associated with selected hypothetical changes in local water demand and supply as a basis for eventual selection of credible water supply alternatives and more detailed analyses of the consequences of such alternative selection. It is most likely that total demand for water for consumptive uses in the Pasco Basin will increase from nearly 2.0 million acre-feet per year in 1980 to almost 2.8 million acre-feet in 2010, with total demand slightly more than 3.6 million acre-feet per year in 2080. The Columbia River and other surface streams constitute the source of more than 99 percent of the water available each year for all uses, both consumptive and non-consumptive, in the Pasco Basin. It is estimated that pumped groundwater accounted for 3 percent of the value of all water supplied to consumers of water in the Pasco Basin in 1980. Groundwater's share of the total cost is proportionately higher than groundwater's share of total use because it is generally more costly to acquire than is surface water and the value of water is considered equivalent to its cost of acquisition. Because groundwater represents such a small part of the total water supply and demand within the Pasco Basin, it is concluded that if the development of a nuclear waste repository on the Hanford Site were to result in changes in the groundwater supply during the next 100 years, the economic impact on the overall water supply picture for the entire basin would be insignificant

  18. Economic development evaluation based on science and patents

    Science.gov (United States)

    Jokanović, Bojana; Lalic, Bojan; Milovančević, Miloš; Simeunović, Nenad; Marković, Dusan

    2017-09-01

    Economic development could be achieved through many factors. Science and technology factors could influence economic development drastically. Therefore the main aim in this study was to apply computational intelligence methodology, artificial neural network approach, for economic development estimation based on different science and technology factors. Since economic analyzing could be very challenging task because of high nonlinearity, in this study was applied computational intelligence methodology, artificial neural network approach, to estimate the economic development based on different science and technology factors. As economic development measure, gross domestic product (GDP) was used. As the science and technology factors, patents in different field were used. It was found that the patents in electrical engineering field have the highest influence on the economic development or the GDP.

  19. Diagnosis and Tests: Evaluating a Fall or Risk of Falling

    Science.gov (United States)

    ... as a physical therapist, who can evaluate your fall risk. If your healthcare provider concludes that you are ... to check for things that can impact your fall risk, such as electrolyte balance and the possibility of ...

  20. Evaluation of pancreatic scintigram in the diagnosis of pancreatic diseases

    International Nuclear Information System (INIS)

    Takai, Yukihiro; Ueda, Noriyuki; Takasago, Noritsugu; Minemoto, Hiromasa; Namiki, Masayoshi

    1981-01-01

    The classification of accumulative patterns with the pancreatic scintigram findings of chronic pancreatitis and carcinoma of the pancreas were compared with endoscopic retrograde pancreatography (ERP) findings and Pancreozymin-Secretin test (P-S test). I) The frequency of pancreatic cancer was 93%, whilst, the chronic pancreatitis was 88% in the abnormal pancreatic scintigram. II) In the scintigram the type II (localyzed defect shadows) of pancreatic cancer was comparatively high and it is proportional to evidence. derived from ERP. Localized diagnostic certainty is helpful, although the two tests are related. The P-S test is only restricted to the carcinoma of head, whilst, scintigram is more useful to detect the carcinoma of the body and tail of the pancreas. III) As for the chronic pancreatitis, there are various accumulative patterns. This is resemblance to that of ERP findings, but in the P-S normal test, it showed discrepancy in part of the result. Particularly, in the type I (slightly generalized low uptake with density silhouette) and type II. Therefore in order to obtain an accurate diagnosis, it is essential to have both the P-S test and scintigram. (author)

  1. Differential diagnosis in the sonographic evaluation of adrenal metastases

    International Nuclear Information System (INIS)

    Ferrari, F.; Fagioli Zucchi, A.; Saloni, E.; Terrosi Vagnoli, P.; Disanto, A.

    1989-01-01

    The sonographic detection of adrenal masses in patients with neoplasms, especially neoplasms of the lung, can be related to the presence of both metastases and adenomas. In order to assess the benign/malignant nature of the such lesions, the adrenal glands of 43 patients with neoplasms (36 of them lung cancers) were studied with sonography (US) and fine needle aspiration biopsy (FNAB): in all, 58 masses were seen (28 monolateral and 15 bilateral). Six lesions (13%) presented with cytological features of benignancy, and on US they appeared as hypoechoic (as compared to the liver), round masses, with regular margins, ranging in size from 1.2 cm to 3.4 cm (average: 2.6 cm). In the remaining 34 patients (80%), cellular material with features of malignancy was obtained with FNAB. The US appearence of these metastases was heterogenous, with the same echogenicity as the liver, and average size >3 cm. On the basis of data obtained, the limit of 3 cm (if we consider the average dimension), corresponds to the threshold of benignancy, as well as the monolateral and hypoechoic appearence of the lesion. To sum up, the use of FNAB should be limited to those lesions which present with typical adenomatous features and for borderline lesions, while the diagnosis of metastases is sufficiently accurate (p 3 cm

  2. Differential diagnosis in the sonographic evaluation of adrenal metastases

    Energy Technology Data Exchange (ETDEWEB)

    Ferrari, F; Fagioli Zucchi, A; Saloni, E; Terrosi Vagnoli, P [Siena Univ. (Italy). Ist. di Scienze Eidologiche e Radiologiche; Disanto, A [Siena Univ. (Italy). Ist. di Anatomia Patologica

    1989-01-01

    The sonographic detection of adrenal masses in patients with neoplasms, especially neoplasms of the lung, can be related to the presence of both metastases and adenomas. In order to assess the benign/malignant nature of the such lesions, the adrenal glands of 43 patients with neoplasms (36 of them lung cancers) were studied with sonography (US) and fine needle aspiration biopsy (FNAB): in all, 58 masses were seen (28 monolateral and 15 bilateral). Six lesions (13%) presented with cytological features of benignancy, and on US they appeared as hypoechoic (as compared to the liver), round masses, with regular margins, ranging in size from 1.2 cm to 3.4 cm (average: 2.6 cm). In the remaining 34 patients (80%), cellular material with features of malignancy was obtained with FNAB. The US appearence of these metastases was heterogenous, with the same echogenicity as the liver, and average size >3 cm. On the basis of data obtained, the limit of 3 cm (if we consider the average dimension), corresponds to the threshold of benignancy, as well as the monolateral and hypoechoic appearence of the lesion. To sum up, the use of FNAB should be limited to those lesions which present with typical adenomatous features and for borderline lesions, while the diagnosis of metastases is sufficiently accurate (p<0.001) in case of bilateral or isoechoic lesions >3 cm.

  3. A Study on the Evaluation of Life and Development of Diagnosis System of Generator

    Energy Technology Data Exchange (ETDEWEB)

    Ji, P.S.; Ju, Y.H.; Park, J.J.; Kim, H.D. [Korea Electric Power Research Insitute, Taejeon (Korea, Republic of); Kim, Y.J.; Kim, J.B.; Hwang, D.H. [Korea Electrotechnology Research Institute, Changweon (Korea, Republic of)

    1997-12-31

    The following Research and Development activities have been performed by KEPRI and KERI for the safe and realiable operation of generators. They can also help to establish the economical scheduling for commissioning and to extend the lives of generators. (1) The optimal diagnosis system and techniques which can be applied to a generator while running are developed. (2) The novel criterion for degradation of stator winding insulation is established. (3) The database for stator winding diagnosis and development of expert system for life assessment is built. (author). 86 refs., 239 figs., 86 tabs.

  4. Economic evaluation of the restriction in the use piroxicam in Spain.

    Science.gov (United States)

    Maciá Martínez, Miguel-Ángel

    2015-01-01

    A retrospective economic evaluation was performed on the restriction of the use of piroxicam in Spain, a non-steroidal anti-inflammatory drug, with a proven higher risk of serious gastrointestinal complications compared to other non-steroidal anti-inflammatory drugs with the objective of putting the relevance of these activities into context. A retrospective cost-effectiveness analysis and a budget impact analysis were performed. Costs and cases of serious gastrointestinal complications were compared in the non-intervention (use of piroxicam) and the intervention scenarios (use of other non-steroidal anti-inflammatory drugs). The cost of serious gastrointestinal complications was obtained from the Diagnosis Related Groups and the cost of non-steroidal anti-inflammatory drugs from usage data in the Spanish national health system. The risk of serious gastrointestinal complications was obtained from epidemiological studies. The regulatory intervention was the dominant option. In that sense, 0.81 euros per treated patient were saved, 2.75 cases of serious gastrointestinal complications were avoided per 10,000 patients and 578,608 euros were saved in total in Spain in the first year following the intervention. It is possible to perform complete economical evaluations on pharmacovigilance actions. The intervention performed by the Spanish Agency for Medicines and Medical Devices, AEMPS on piroxicam not only achieved the objective of preventing adverse drug reactions but also resulted in significant economical savings even under conservative assumptions. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

  5. Evaluation of four immunoassays for diagnosis of brucellosis in Cuba

    International Nuclear Information System (INIS)

    Peraza, C.; Valdes, O.; Fonseca, N.; Garcia, M.; Alvarez, M.; Izquierdo, D.L.

    1998-01-01

    Four immunoassays (two indirect and two competitive ones) were evaluated by samples from areas free of disease, free by vaccination and affected areas using as reference techniques the Bengal Rose Tests, the Antigen in Buffered Plate Tests and the Complement Fixation Reaction Test. The evaluated samples demonstrated that the competitive assays (ELISAC-1 and ELISAC-2) detected less false positives than the indirect ones (ELISAI-1 and ELISAI-2). Of the competitive ELISAS, version 2 presented better sensitivity and specificity results in affected areas for 95% confidence: 80.9 - 96.9% and 97.5 - 99.4% respectively with positive predictive value in the range of 76 to 94% and negative predictive one between 98.1 and 99.7%. It was concluded that this assay can be used for brucellosis control because it gives higher assurance than the other evaluated immunoassays and it can discriminate infected from vaccinated animals. (author)

  6. Evaluating the Performance of South African Economics Departments

    OpenAIRE

    John Luiz

    2009-01-01

    Over the past decade economics departments in South Africa have seen major changes and a certain level of disruption. Much of this can be attributed to the integration of our discipline into the global arena after a period of academic isolation. This paper presents a survey of economics departments and covers everything from staff profiles and qualifications, to curricula, and research output. This paper indicates that there has been some improvement in the state of economics at South African...

  7. Solar energy system economic evaluation for Colt Pueblo, Pueblo, Colorado

    Science.gov (United States)

    1980-01-01

    The Solar Energy System is not economically beneficial under the assumed economic conditions at Pueblo, Colorado; Yosemite, California; Albuquerque, New Mexico; Fort Worth, Texas; and Washington, D.C. Economic benefits from this system depend on decreasing the initial investment and the continued increase in the cost of conventional energy. Decreasing the cost depends on favorable tax treatment and continuing development of solar energy technology. Fuel cost would have to increase drastically while the cost of the system would have to remain constant or decrease for the system to become economically feasible.

  8. An Economic Evaluation of Binary Cycle Geothermal Electricity Production

    National Research Council Canada - National Science Library

    Fitzgerald, Crissie

    2003-01-01

    .... Variables such as well flow rate, geothermal gradient and electricity prices were varied to study their influence on the economic payback period for binary cycle geothermal electricity production...

  9. A Systematic Review of Economic Evaluations of Pacemaker Telemonitoring Systems.

    Science.gov (United States)

    López-Villegas, Antonio; Catalán-Matamoros, Daniel; Martín-Saborido, Carlos; Villegas-Tripiana, Irene; Robles-Musso, Emilio

    2016-02-01

    Over the last decade, telemedicine applied to pacemaker monitoring has undergone extraordinary growth. It is not known if telemonitoring is more or less efficient than conventional monitoring. The aim of this study was to carry out a systematic review analyzing the available evidence on resource use and health outcomes in both follow-up modalities. We searched 11 databases and included studies published up until November 2014. The inclusion criteria were: a) experimental or observational design; b) studies based on complete economic evaluations; c) patients with pacemakers, and d) telemonitoring compared with conventional hospital monitoring. Seven studies met the inclusion criteria, providing information on 2852 patients, with a mean age of 81 years. The main indication for device implantation was atrioventricular block. With telemonitoring, cardiovascular events were detected and treated 2 months earlier than with conventional monitoring, thus reducing length of hospital stay by 34% and reducing routine and emergency hospital visits as well. There were no significant intergroup differences in perceived quality of life or number of adverse events. The cost of telemonitoring was 60% lower than that of conventional hospital monitoring. Compared with conventional monitoring, cardiovascular events were detected earlier and the number or hospitalizations and hospital visits was reduced with pacemaker telemonitoring. In addition, the costs associated with follow-up were lower with telemonitoring. Copyright © 2015 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  10. Economic evaluation of human papillomavirus vaccination in the United Kingdom.

    Science.gov (United States)

    Jit, Mark; Choi, Yoon Hong; Edmunds, W John

    2008-07-17

    To assess the cost effectiveness of routine vaccination of 12 year old schoolgirls against human papillomavirus infection in the United Kingdom. Economic evaluation. UK. Population Schoolgirls aged 12 or older. Costs, quality adjusted life years (QALYs), and incremental cost effectiveness ratios for a range of vaccination options. Vaccinating 12 year old schoolgirls with a quadrivalent vaccine at 80% coverage is likely to be cost effective at a willingness to pay threshold of pound30,000 (euro37,700; $59,163) per QALY gained, if the average duration of protection from the vaccine is more than 10 years. Implementing a catch-up campaign of girls up to age 18 is likely to be cost effective. Vaccination of boys is unlikely to be cost effective. A bivalent vaccine with the same efficacy against human papillomavirus types 16 and 18 costing pound13- pound21 less per dose (depending on the duration of vaccine protection) may be as cost effective as the quadrivalent vaccine although less effective as it does not prevent anogenital warts. Routine vaccination of 12 year old schoolgirls combined with an initial catch-up campaign up to age 18 is likely to be cost effective in the UK. The results are robust to uncertainty in many parameters and processes. A key influential variable is the duration of vaccine protection.

  11. CITRICULTURE ECONOMIC AND FINANCIAL EVALUATION UNDER CONDITIONS OF UNCERTAINTY

    Directory of Open Access Journals (Sweden)

    DANILO SIMÕES

    2015-12-01

    Full Text Available ABSTRACT The citriculture consists in several environmental risks, as weather changes and pests, and also consists in considerable financial risk, mainly due to the period ofreturn on the initial investment. This study was motivated by the need to assess the risks of a business activity such as citriculture. Our objective was to build a stochastic simulation model to achieve the economic and financial analysis of an orange producer in the Midwest region of the state of Sao Paulo, under conditions of uncertainty. The parameters used were the Net Present Value (NPV, the Modified Internal Rate of Return(MIRR, and the Discounted Payback. To evaluate the risk conditions we built a probabilistic model of pseudorandom numbers generated with Monte Carlo method. The results showed that the activity analyzed provides a risk of 42.8% to reach a NPV negative; however, the yield assessed by MIRR was 7.7%, higher than the yield from the reapplication of the positive cash flows. The financial investment pays itself after the fourteenth year of activity.

  12. Evaluating Post-Earthquake Building Safety Using Economical MEMS Seismometers.

    Science.gov (United States)

    Hsu, Ting-Yu; Yin, Ren-Cheng; Wu, Yih-Min

    2018-05-05

    The earthquake early warning (EEW)-research group at National Taiwan University has been developing a microelectromechanical system-based accelerometer called “P-Alert”, designed for issuing EEWs. The main advantage of P-Alert is that it is a relatively economical seismometer. However, because of the expensive nature of commercial hardware for structural health monitoring (SHM) systems, the application of SHM to buildings remains limited. To determine the performance of P-Alert for evaluating post-earthquake building safety, we conducted a series of steel-frame shaking table tests with incremental damage. We used the fragility curves of different damage levels and the interstory drift ratios (calculated by the measured acceleration of each story using double integration and a filter) to gauge the potential damage levels. We concluded that the acceptable detection of damage for an entire building is possible. With improvements to the synchronization of the P-Alert sensors, we also anticipate a damage localization feature for the stories of a building.

  13. Economic evaluation of nuclear reactor operation utilizing power effect

    International Nuclear Information System (INIS)

    Budinsky, M.; Mydliar, J.

    1988-01-01

    The operation of a reactor at the so-called power effect may substantially increase the burnup of fuel to be removed. The aim of the evaluation of such reactor operation is the optimal determination of the time over which the yield of the higher use of fuel exceeds economic losses resulting from the increased share of constant expenditure of the price of generated kWh of electric power which ensues from such operation. A mathematical model is presented for such evaluation of reactor operation with regard to benefits for the national economy which is the basis of the ESTER 2 computer program. The calculations show that the prices of generated and delivered kWh are minimally 2% less than the prices of generated power without the power effect use. The minimum ranges in the interval of 30 to 50 days. The dependence of the price of generated and delivered kWh from the point of view of the operator of the power plant as well as the component of fuel price of generated kWh will not reach the minimum even after 50 days of operation. From the operating and physical points of view the duration of power effect is not expected to exceed 20 to 30 days which means that from the point of view of the national economy the price of generated and delivered kWh will be 1.6 to 2% less and the fuel component of the price of the generated kWh will be 3 to 4.5% lower. (Z.M.). 5 figs., 3 refs

  14. Desalination Economic Evaluation Program (DEEP-3.0). User's manual

    International Nuclear Information System (INIS)

    2006-01-01

    DEEP is a Desalination Economic Evaluation Program developed by the International Atomic Energy Agency (IAEA) and made freely available for download, under a license agreement (www.iaea.org/nucleardesalination). The program is based on linked Microsoft Excel spreadsheets and can be useful for evaluating desalination strategies by calculating estimates of technical performance and costs for various alternative energy and desalination technology configurations. Desalination technology options modelled, include multi-stage flashing (MSF), multi-effect distillation (MED), reverse osmosis (RO) and hybrid options (RO-MSF, RO-MED) while energy source options include nuclear, fossil, renewables and grid electricity (stand-alone RO). Version 3 of DEEP (DEEP 3.0) features important changes from previous versions, including upgrades in thermal and membrane performance and costing models, the coupling configuration matrix and the user interface. Changes in the thermal performance model include a revision of the gain output ratio (GOR) calculation and its generalization to include thermal vapour compression effects. Since energy costs continue to represent an important fraction of seawater desalination costs, the lost shaft work model has been generalized to properly account for both backpressure and extraction systems. For RO systems, changes include improved modelling of system recovery, feed pressure and permeate salinity, taking into account temperature, feed salinity and fouling correction factors. The upgrade to the coupling technology configuration matrix includes a re-categorization of the energy sources to follow turbine design (steam vs. gas) and cogeneration features (dual-purpose vs. heat-only). In addition, cost data has also been updated to reflect current practice and the user interface has been refurbished and made user-friendlier

  15. TDmat--Mathematics Diagnosis Evaluation Test for Engineering Sciences Students

    Science.gov (United States)

    Pinto, J. S.; Oliveira, M. P.; Anjo, A. B.; Pais, S. I. Vieira; Isidro, R. O.; Silva, M. H.

    2007-01-01

    Since 1989, the Mathematics Education Project (PmatE--Projecto Matematica Ensino) has developed several strategies to improve the success of students in Mathematics. The most important of these are mathematical games for all grades above primary school. The online evaluation of Mathematics subjects is one of PmatE's goals. The implementation of an…

  16. Evaluation of PCR for diagnosis of visceral leishmaniasis

    NARCIS (Netherlands)

    Osman, O. F.; Oskam, L.; Zijlstra, E. E.; Kroon, N. C.; Schoone, G. J.; Khalil, E. T.; El-Hassan, A. M.; Kager, P. A.

    1997-01-01

    An evaluation of Leishmania PCR was performed with bone marrow, lymph node, and blood samples from 492 patients, 60 positive controls, and 90 negative controls. Results were compared with microscopy results for Giemsa-stained smears. PCR and microscopy of lymph node and bone marrow aspirates from

  17. Biochemical evaluation of phenylketonuria (PKU: from diagnosis to treatment

    Directory of Open Access Journals (Sweden)

    Leticia Belmont-Martínez

    2014-07-01

    Besides periodical Phe and Tyr testing, biochemical follow-up includes the measurement of necessary elements that guarantee normal physical and intellectual development such as selenium, zinc, B12 vitamin, folates, iron and long chain fatty acids. Clinical context is as important as biochemical status so periodic evaluation of nutritional, medical, social and psychological aspects should be included.

  18. Economic evaluation of nurse practitioner and clinical nurse specialist roles: A methodological review.

    Science.gov (United States)

    Lopatina, Elena; Donald, Faith; DiCenso, Alba; Martin-Misener, Ruth; Kilpatrick, Kelley; Bryant-Lukosius, Denise; Carter, Nancy; Reid, Kim; Marshall, Deborah A

    2017-07-01

    Advanced practice nurses (e.g., nurse practitioners and clinical nurse specialists) have been introduced internationally to increase access to high quality care and to tackle increasing health care expenditures. While randomised controlled trials and systematic reviews have demonstrated the effectiveness of nurse practitioner and clinical nurse specialist roles, their cost-effectiveness has been challenged. The poor quality of economic evaluations of these roles to date raises the question of whether current economic evaluation guidelines are adequate when examining their cost-effectiveness. To examine whether current guidelines for economic evaluation are appropriate for economic evaluations of nurse practitioner and clinical nurse specialist roles. Our methodological review was informed by a qualitative synthesis of four sources of information: 1) narrative review of literature reviews and discussion papers on economic evaluation of advanced practice nursing roles; 2) quality assessment of economic evaluations of nurse practitioner and clinical nurse specialist roles alongside randomised controlled trials; 3) review of guidelines for economic evaluation; and, 4) input from an expert panel. The narrative literature review revealed several challenges in economic evaluations of advanced practice nursing roles (e.g., complexity of the roles, variability in models and practice settings where the roles are implemented, and impact on outcomes that are difficult to measure). The quality assessment of economic evaluations of nurse practitioner and clinical nurse specialist roles alongside randomised controlled trials identified methodological limitations of these studies. When we applied the Guidelines for the Economic Evaluation of Health Technologies: Canada to the identified challenges and limitations, discussed those with experts and qualitatively synthesized all findings, we concluded that standard guidelines for economic evaluation are appropriate for economic

  19. Economic evaluations and Randomized trials in spinal disorders: Principles and methods

    DEFF Research Database (Denmark)

    Korthals-de Bos, I; Van Tulder, M; Van Dieten, H

    2004-01-01

    Study Design. Descriptive methodologic recommendations. Objective. To help researchers designing, conducting, and reporting economic evaluations in the field of back and neck pain. Summary of Background Data. Economic evaluations of both existing and new therapeutic interventions are becoming...... increasingly important. There is a need to improve the methods of economic evaluations in the field of spinal disorders. Materials and Methods. To improve the methods of economic evaluations in the field of spinal disorders, this article describes the various steps in an economic evaluation, using as example...... a study on the cost-effectiveness of manual therapy, physiotherapy, and usual care provided by the general practitioner for patients with neck pain. Results. An economic evaluation is a study in which two or more interventions are systematically compared with regard to both costs and effects...

  20. Economics.

    Science.gov (United States)

    Palley, Paul D; Parcero, Miriam E

    2016-10-01

    A review of literature in the calendar year 2015 dedicated to environmental policies and sustainable development, and economic policies. This review is divided into these sections: sustainable development, irrigation, ecosystems and water management, climate change and disaster risk management, economic growth, water supply policies, water consumption, water price regulation, and water price valuation.

  1. Applying the AHP in Health Economic Evaluations of New Technology.

    NARCIS (Netherlands)

    Hummel, J. Marjan; Steuten, Lotte Maria Gertruda; Groothuis-Oudshoorn, Catharina Gerarda Maria; IJzerman, Maarten Joost

    2011-01-01

    Much research in health care is devoted to health economical modelling. Even though the Analytic Hierarchy Process (AHP) is increasingly being applied in health care, its value to health economical modelling is still unrecognized. We explored the value of using AHP-derived results in a health

  2. Models of economic geography : dynamics, estimation and policy evaluation

    NARCIS (Netherlands)

    Knaap, Thijs

    2004-01-01

    In this thesis we look at economic geography models from a number of angles. We started by placing the theory in a context of preceding theories, both earlier work on spatial economics and other children of the monopolistic competition ‘revolution.’ Next, we looked at the theoretical properties of

  3. Economic evaluation of safety measures for transport companies

    NARCIS (Netherlands)

    Rietveld, Piet; Rienstra, Sytze A.

    1998-01-01

    Measures to reduce material damage within companies may both increase the business economic performance of the company and traffic safety in general. In this paper the notion of whether such measures are economically feasible is investigated. Results are presented of a series of interviews

  4. Timely and complete publication of economic evaluations alongside randomized controlled trials.

    Science.gov (United States)

    Thorn, Joanna C; Noble, Sian M; Hollingworth, William

    2013-01-01

    Little is known about the extent and nature of publication bias in economic evaluations. Our objective was to determine whether economic evaluations are subject to publication bias by considering whether economic data are as likely to be reported, and reported as promptly, as effectiveness data. Trials that intended to conduct an economic analysis and ended before 2008 were identified in the International Standard Randomised Controlled Trial Number (ISRCTN) register; a random sample of 100 trials was retrieved. Fifty comparator trials were randomly drawn from those not identified as intending to conduct an economic study. The trial start and end dates, estimated sample size and funder type were extracted. For trials planning economic evaluations, effectiveness and economic publications were sought; publication dates and journal impact factors were extracted. Effectiveness abstracts were assessed for whether they reached a firm conclusion that one intervention was most effective. Primary investigators were contacted about reasons for non-publication of results, or reasons for differential publication strategies for effectiveness and economic results. Trials planning an economic study were more likely to be funded by government (p = 0.01) and larger (p = 0.003) than other trials. The trials planning an economic evaluation had a mean of 6.5 (range 2.7-13.2) years since the trial end in which to publish their results. Effectiveness results were reported by 70 %, while only 43 % published economic evaluations (p economic results included the intervention being ineffective, and staffing issues. Funding source, time since trial end and length of study were not associated with a higher probability of publishing the economic evaluation. However, studies that were small or of unknown size were significantly less likely to publish economic evaluations than large studies (p journal impact factor was 1.6 points higher for effectiveness publications than for the

  5. Socio-economic evaluation of selected biogas technologies

    Energy Technology Data Exchange (ETDEWEB)

    Moeller, F.; Martinsen, L.

    2013-05-15

    Financial and welfare economic analyses are conducted of 15 different biogas production scenarios that vary in terms of plant size and type of input. All considered scenarios lead to welfare economic losses. Overall welfare economic GHG reduction costs seem to increase with increasing crop/crop material share of input, and although the costs vary significantly across scenarios they are quite high for all scenarios. The financial analyses suggest that biogas production generally will be financially profitable for the agricultural sector and local CHP facilities but unprofitable for the biogas plants and the State. Seen from a policy perspective the results highlights the importance of designing regulatory instruments in a way that create incentives for private actors to engage in welfare economically desirable biogas production activities while discouraging the expansion of welfare economically undesirable activities. (Author)

  6. What is the economic evidence for mHealth? A systematic review of economic evaluations of mHealth solutions.

    Science.gov (United States)

    Iribarren, Sarah J; Cato, Kenrick; Falzon, Louise; Stone, Patricia W

    2017-01-01

    Mobile health (mHealth) is often reputed to be cost-effective or cost-saving. Despite optimism, the strength of the evidence supporting this assertion has been limited. In this systematic review the body of evidence related to economic evaluations of mHealth interventions is assessed and summarized. Seven electronic bibliographic databases, grey literature, and relevant references were searched. Eligibility criteria included original articles, comparison of costs and consequences of interventions (one categorized as a primary mHealth intervention or mHealth intervention as a component of other interventions), health and economic outcomes and published in English. Full economic evaluations were appraised using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist and The PRISMA guidelines were followed. Searches identified 5902 results, of which 318 were examined at full text, and 39 were included in this review. The 39 studies spanned 19 countries, most of which were conducted in upper and upper-middle income countries (34, 87.2%). Primary mHealth interventions (35, 89.7%), behavior change communication type interventions (e.g., improve attendance rates, medication adherence) (27, 69.2%), and short messaging system (SMS) as the mHealth function (e.g., used to send reminders, information, provide support, conduct surveys or collect data) (22, 56.4%) were most frequent; the most frequent disease or condition focuses were outpatient clinic attendance, cardiovascular disease, and diabetes. The average percent of CHEERS checklist items reported was 79.6% (range 47.62-100, STD 14.18) and the top quartile reported 91.3-100%. In 29 studies (74.3%), researchers reported that the mHealth intervention was cost-effective, economically beneficial, or cost saving at base case. Findings highlight a growing body of economic evidence for mHealth interventions. Although all studies included a comparison of intervention effectiveness of a health

  7. Evaluation of ultrasound in the diagnosis of parotid gland masses

    Directory of Open Access Journals (Sweden)

    Parotid gland

    1999-08-01

    Full Text Available In order to evaluate accuracy and usefulness of sonography and choose it as preliminary investigation method in pathologic processes of parotid gland, 50 patients were studied in duration of 16 months. The lesions were evaluated with ultrasound and sonographic images were obtained before surgery and then were compared with pathologic results after surgery. All lesions were detected with sonography. This method could differentiate intraglandular from extraglandular lesions with accuracy of 100%. Except one case of lipomatosis which was hyperechoic, all other lesions of parotid gland were hypoechoic. All lesions with sharp and well-defined borders were benign whereas malignant processes had ill-defined borders. The results obtained show that sonography is a reliable diagnostic method to differentiate benign from malignant lesions and it has a high diagnostic value to detect warthin's tumor, plemorphic adenoma, Sjogren's syndrome and lipomatosis. Presence of calcification in a parotid mass of young patient with high probabye is related to cavernous hemangioma.

  8. Evaluating a decision making system for cardiovascular dysautonomias diagnosis.

    Science.gov (United States)

    Idri, Ali; Kadi, Ilham

    2016-01-01

    Autonomic nervous system (ANS) is the part of the nervous system that is involved in homeostasis of the whole body functions. A malfunction in this system can lead to a cardiovascular dysautonomias. Hence, a set of dynamic tests are adopted in ANS units to diagnose and treat patients with cardiovascular dysautonomias. The purpose of this study is to develop and evaluate a decision tree based cardiovascular dysautonomias prediction system on a dataset collected from the ANS unit of the Moroccan university hospital Avicenne. We collected a dataset of 263 records from the ANS unit of the Avicenne hospital. This dataset was split into three subsets: training set (123 records), test set (55 records) and validation set (85 records). C4.5 decision tree algorithm was used in this study to develop the prediction system. Moreover, Java Enterprise Edition platform was used to implement a prototype of the developed system which was deployed in the Avicenne ANS unit so as to be clinically validated. The performance of the decision tree-based prediction system was evaluated by means of the error rate criterion. The error rates were measured for each classifier and have achieved an average value of 1.46, 2.24 and 0.89 % in training, test, and validation sets respectively. The results obtained were encouraging but further replicated studies are still needed to be performed in order to confirm the findings of this study.

  9. Neural Networks and Fault Probability Evaluation for Diagnosis Issues

    Science.gov (United States)

    Lefebvre, Dimitri; Guersi, Noureddine

    2014-01-01

    This paper presents a new FDI technique for fault detection and isolation in unknown nonlinear systems. The objective of the research is to construct and analyze residuals by means of artificial intelligence and probabilistic methods. Artificial neural networks are first used for modeling issues. Neural networks models are designed for learning the fault-free and the faulty behaviors of the considered systems. Once the residuals generated, an evaluation using probabilistic criteria is applied to them to determine what is the most likely fault among a set of candidate faults. The study also includes a comparison between the contributions of these tools and their limitations, particularly through the establishment of quantitative indicators to assess their performance. According to the computation of a confidence factor, the proposed method is suitable to evaluate the reliability of the FDI decision. The approach is applied to detect and isolate 19 fault candidates in the DAMADICS benchmark. The results obtained with the proposed scheme are compared with the results obtained according to a usual thresholding method. PMID:25132845

  10. CT diagnosis in the evaluation of vertebral trauma

    International Nuclear Information System (INIS)

    Emori, Takumi; Kadoya, Satoru; Nakamura, Tsutomu; Ito, Shotaro; Kwak, Ryungchan

    1984-01-01

    The diagnostic capability of the CT scan of the vertebral trauma and a comparison with the results of a routine roentgenogram and tomogram were studied in 11 patients. In total, there were 15 fractured vertebrae: 3 in the upper cervical, 3 in the lower cervical, and 9 in the thoracic and thoraco-lumbar vertebrae. In the detailed evaluation of the vertebral fractures, CT provided more information than plain films in all 15 fractured vertebrae, with a better visualization of the spinal bony details, particularly at the upper cervical, thoracic, and thoraco-lumbar levels, where the interpretation of the spinal abnormalities is usually difficult because of adjacent structures such as the skull and thorax. Only CT was able to demonstrate impingements on the vertebral canal by bony fragments. Post-traumatic syringomyelia was incidentally demonstrated in one patient on a plain CT. In 6 patients, conventional tomography was done, but no additional information with regard to spinal instability and spinal-cord compression was obtained. The usage of sagittal tomography was also limited, because it required a change in the patient's position, which might worsen the neurological deficits. On the other hand, a plain roentgenogram and conventional tomography were superior in the evaluation of spinal malalignment and fractures running horizontally. In summary, both plain roentgenograms and CT images provided detailed information about vertebral injury, whereas conventional tomography is judged to be inferior and not always necessary. Based on these results, our new diagnostic and therapeutic approaches using CT for the vertebral injuries were presented. (author)

  11. Method of levelized discounted costs applied in economic evaluation of nuclear power plant project

    International Nuclear Information System (INIS)

    Tian Li; Wang Yongqing; Liu Jingquan; Guo Jilin; Liu Wei

    2000-01-01

    The main methods of economic evaluation of bid which are in common use are introduced. The characteristics of levelized discounted cost method and its application are presented. The method of levelized discounted cost is applied to the cost calculation of a 200 MW nuclear heating reactor economic evaluation. The results indicate that the method of levelized discounted costs is simple, feasible and which is considered most suitable for the economic evaluation of various case. The method is suggested which is used in the national economic evaluation

  12. Economic Evaluation of Teledentistry in Cleft Lip and Palate Patients.

    Science.gov (United States)

    Teoh, Jonathan; Hsueh, Arthur; Mariño, Rodrigo; Manton, David; Hallett, Kerrod

    2018-06-01

    To assess the use of Teledentistry (TD) in delivering specialist dental services at the Royal Children's Hospital (RCH) for rural and regional patients and to conduct an economic evaluation by building a decision model to estimate the costs and effectiveness of Teledental consultations compared with standard consultations at the RCH. A model-based analysis was conducted to determine the potential costs of implementing TD at the RCH. The outcome measure was timely consultations (whether the patient presented within an appropriate time according to the recommended schedule). Dental records at the RCH of those who presented for orthodontic or pediatric dental consultations were assessed. A cost-effectiveness analysis (CEA), comparing TD with the traditional method of consultation, was conducted. One-way sensitivity analysis was performed to test the robustness of the results. Results and Materials: A total of 367 TD appropriate consultations were identified, of which 241 were timely (65.7%). The mean cost of a RCH consultation was A$431.29, with the mean TD consult costing A$294.35. This represents a cost saving of A$136.95 per appointment. The CEA found TD to be a dominant option, with cost savings of A$3,160.81 for every additional timely consult. The model indicated that 36.7 days of clinic time may be freed up at the RCH to treat other patients and expand capacity. These results were robust when performing one-way sensitivity analysis. When taking a societal perspective, the implementation of TD is likely to be a cost-effective alternative compared with the standard practice of face-to-face consultation at the RCH.

  13. Economic evaluation of neutral streams and of river construction methods

    International Nuclear Information System (INIS)

    Donat, M.

    1998-12-01

    There are no current markets for the management and restoration of natural streams. However, economic elements tend to play an increasingly important role when it comes to decisions about river management activities. Although preference structures of market consumers can be analyzed using prices, there are several short-comings in using this technique for goods with no or an insufficient market. This is especially true for 'natural streams'. The non-existence of market prices for goods or their parts does not mean that they do not have a value or that there is no preference structure for them. After an introductory discussion of ethical and value issues, specific methods for evaluating and analyzing the willingness-to-pay for natural streams and theirs restoration are developed further. Using direct interview techniques, locals in three different watersheds in Upper Austria are ask for their preferences and social pricing of natural streams and river management options. The areas the interviews were conducted in, represent a watershed dominated by intensive agricultural and residential uses, another watershed typical for a rural community and a third representing a watershed of a relatively pristine river of the Northern Alpine limestone range mainly used by forestry and tourism. Demographic data, eco-morphological stream characteristics and preferences of the interviewed about elements of a natural stream, user and non-user values were linked and analyzed. The results of a personal interviewing technique conducted in these watersheds showed to be capable to capture the preference structure in small watersheds and may offer some help for decision-making concerning river management issues. (author)

  14. To Design and Evaluate a 12th Grade Course in the Principles of Economics; Final Report.

    Science.gov (United States)

    Wiggins, Suzanne E.; Sperling, John G.

    Reported is the design, development, and evaluation of a one-semester course on the principles of economics for twelfth grade students. The course is intended to develop students' capacity for economic reasoning through economic theory and empirical research. To do this, teaching materials and innovative techniques for teacher training were…

  15. Evaluation of the usefulness and validity of imaging diagnosis for acute abdomen

    International Nuclear Information System (INIS)

    Sakai, Takehiro; Sudo, Yasuhiro

    2007-01-01

    We retrospectively evaluated the usefulness and validity of imaging diagnosis for acute abdomens. Sixty-one patients who had complained of acute abdominal pain upon hospital admittance were and divided into four groups according to the diagnostic imaging modalities that were used: X-ray alone (X-P group, n=11), ultrasonography (US group, n=12), computed tomography (CT group, n=14), and both ultrasonography and CT (US/CT group, n=24). The diagnosis made at the time of admission was also evaluated, and the patients were divided into three groups and analyzed statistically: bowel obstructions (bowel obstruction group, n=20), acute appendicitis or other diseases necessitating a differential diagnosis (appendicitis group, n=35), and perforations of the digestive tract (perforation group, n=6). X-ray and CT examinations were useful for making a diagnosis in the bowel obstruction and perforation groups. Ultrasonography was regarded as important in the appendicitis group. The accuracy of the diagnosis made upon admission was 95.0% in the bowel obstruction group, 88.6 % in the appendicitis group, and 100 % in the perforation group. Although a prospective evaluation is necessary, CT appears to be useful for diagnosing bowel obstructions and perforations of the digestive tract. Although ultrasonography is useful for diagnosing acute appendicitis, CT is recommended in patients in whom a differential diagnosis is difficult to obtain. (author)

  16. Clinical Evaluation of Tumor Markers for Diagnosis in Patients with Non-small Cell Lung Cancer in China.

    Science.gov (United States)

    Ma, Li; Xie, Xiao-Wei; Wang, Hai-Yan; Ma, Ling-Yun; Wen, Zhong-Guang

    2015-01-01

    To evaluate the value of combined detection of serum carcinoembryonic antigen (CEA), cytokeratin 19 fragment (CYFRA21-1), and carbohydrateantigen 125 (CA125) for the clinical diagnosis of non- small cell lung cancer (NSCLC). Serum CEA, CYFRA21-1 and CA125 were assessed in 140 patients with NSCLC, 90 patients with benign lung disease and 90 normal control subjects, and differences of expression were compared in each group, and joint effects of these tumor markers in the diagnosis of NSCLC were analyzed. Serum CEA, CYFRA21-1 and CA125 in patients with NSCLC were significantly higher than those with benign lung disease and normal controls (PCEA, CYFRA21-1 and CA125 were 49.45%, 59.67%, and 44.87% respectively. As expected, combinations of these tumor markers improved their sensitivity for NSCLC. The combined detection of CEA+CYFRA21-1 was the most cost-effective combination which had higher sensitivity and specificity in NSCLC. Elevation of serum CEA and CYFRA21-1 was significantly associated with pathological types (PCEA, CYFRA21-1 and CA125 was significantly associated with TNM staging (PCEA, CYFRA21-1 and CA125 is of diagnostic value in the diagnosis of lung cancer, and a joint detection of these three tumor markers, could greatly improve the sensitivity of diagnosis on NSCLC. Combined detection of CEA+CYFRA21-1 proved to be the most economic and practical strategy in diagnosis of NSCLC, which can be used to screen the high-risk group.

  17. Economism

    Directory of Open Access Journals (Sweden)

    P. Simons

    2010-07-01

    Full Text Available Modern society is characterised not only by a fascination with scientific technology as a means of solving all problems, especially those that stand in the way of material progress (technicism, but also by an obsessive interest in everything that has to do with money (economism or mammonism. The article discusses the relationship between technicism and economism, on the basis of their relationship to utilitarian thinking: the quest for the greatest happiness for the greatest number of people. Recent major studies of neo-liberalism (seen as an intensification of utilitarianism by Laval and Dardot are used as reference to the development of utilitarianism. It is suggested that the western view of the world, as expressed in economism and technicism, with a utilitarian ethics, features three absolutisations: those of theoretical thinking, technology and economics. In a second part, the article draws on the framework of reformational philosophy to suggest an approach that, in principle, is not marred by such absolutisations.

  18. Economic evaluation and Applications of the Policy Analysis Matrix ...

    African Journals Online (AJOL)

    use

    2011-12-07

    Dec 7, 2011 ... By using benefit to costs index, internal rate of return, net ... city has no relative advantage, but intercropping system can increase the economic benefits and ... traditional farmers have reasons of technological, socio- logical ...

  19. Models of economic geography: dynamics, estimation and policy evaluation

    OpenAIRE

    Knaap, Thijs

    2004-01-01

    In this thesis we look at economic geography models from a number of angles. We started by placing the theory in a context of preceding theories, both earlier work on spatial economics and other children of the monopolistic competition ‘revolution.’ Next, we looked at the theoretical properties of these models, especially when we allow firms to have different demand functions for intermediate goods. We estimated the model using a dataset on US states, and computed a number of counterfactuals....

  20. Economic evaluation of reprocessing and thermal reactor recycle

    International Nuclear Information System (INIS)

    Marshall, W.

    This paper provides a summing up of the discussions on economic aspects in WG4. These discussions also took account of the strategic, ecological and public acceptance factors intimately involved. Tentative conclusions are put forward as a basis for discussion. Reprocessing may take place for reasons other than just strictly economic ones. The decisions facing various countries are rationalized by considering their reactions to the range of possible uranium prices and fast reactor costs in the future

  1. Exchange-rate regimes and economic growth: An empirical evaluation

    OpenAIRE

    Simón Sosvilla-Rivero; María del Carmen Ramos-Herrera

    2014-01-01

    Based on a dataset of 123 economies, this paper empirically investigates the relation between exchange-rate regimes and economic growth. We find that growth performance is best under intermediate exchange rate regimes, while the smallest growth rates are associated with flexible exchange rates. Nevertheless, this conclusion is tempered when we analyze the countries by income level: even though countries that adopt intermediate exchange-rate regimes are characterized by higher economic growth,...

  2. Diagnosis, Evaluation and Treatment of Pulmonary Arterial Hypertension in Children

    Science.gov (United States)

    Frank, Benjamin S.

    2018-01-01

    Pulmonary Hypertension (PH), the syndrome of elevated pressure in the pulmonary arteries, is associated with significant morbidity and mortality for affected children. PH is associated with a wide variety of potential underlying causes, including cardiac, pulmonary, hematologic and rheumatologic abnormalities. Regardless of the cause, for many patients the natural history of PH involves progressive elevation in pulmonary arterial resistance and pressure, right ventricular dysfunction, and eventually heart failure. In recent years, a number of pulmonary arterial hypertension (PAH)-targeted therapies have become available to reduce pulmonary artery pressure and improve outcome. A growing body of evidence in both the adult and pediatric literature demonstrates enhanced quality of life, functional status, and survival among treated patients. This review provides a description of select etiologies of PH seen in pediatrics and an update on the most recent data pertaining to evaluation and management of children with PH/PAH. The available evidence for specific classes of PAH-targeted therapies in pediatrics is additionally discussed. PMID:29570688

  3. Health-economic evaluation in implant trials: design considerations.

    Science.gov (United States)

    Alt, Volker; Pavlidis, Theodoros; Szalay, Gabor; Heiss, Christian; Schnettler, Reinhard

    2009-01-01

    In today's world, demonstration of the safety, efficacy, and quality of a new treatment strategy is no longer sufficient in many countries for market entry and reimbursement in the public healthcare system. This implies that new implants in orthopedic and orthopedic trauma surgery not only must be shown to lead to better medical outcome compared with the standard of care implant, but also must be shown to exhibit "good value" for the money for the public health-care system based on sound economic data from health-economic studies. The purpose of this article is to elucidate a framework for health-economic aspects alongside implant trials, with the assumption that the new implant is more costly but potentially better than the control implant. Cost-effectiveness, cost-utility, and cost-benefit studies are suitable for the assessment of the health-economic value of a new implant. The following criteria should be considered for a health-economic study design in the context with an implant: i) it should state medical benefits of the new implant compared with the control implant; ii) it should precise the type of health economic study; iii) it should define the methodological approach, perspective of the study, and types of costs; iv) if necessary, it should state discount costs and/benefits; and v) a sound sensitivity analysis should be included. Furthermore, close cooperation between researchers, clinicians, and health economists is essential.

  4. Economic Evaluation of Climate Change Impacts and Adaptation in Italy

    International Nuclear Information System (INIS)

    Gambarelli, G.; Goria, A.

    2004-07-01

    The paper deals with the social and economic dimensions of climate change impacts and adaptation in Italy. The ultimate aim of the paper is to provide policy makers and experts with a conceptual framework, as well as methodological and operational tools for dealing with climate change impacts and adaptation from an economic perspective. In order to do so, first a conceptual and theoretical framework of the economic assessment of climate change impacts is presented and the state of the art about impact assessment studies is briefly analysed. Then, the Italian case is taken into account, by underlying the main impacts and adaptation challenges that are likely to be implied by climate change in the next decades. The analysis of the Italian case is particularly addressed through the description of the methodology and results of two case studies. The first one, dealing mainly with impact assessment, is carried out at the national level and is part of a EC funded project on Weather Impacts on Natural, Social and Economic Systems (WISE). The second one is carried out at the local level and focuses on sea level rise impacts and adaptation in a plane south of Rome. The two case studies allow to propose simple and flexible methodologies for the economic impact assessment and the economic valuation of adaptation strategies

  5. The Social Effects of the Economic Transformation in India (An Attempt at Measurement and Evaluation

    Directory of Open Access Journals (Sweden)

    Bywalec Grzegorz

    2017-03-01

    Full Text Available One of significant and, at the same time, challenging research problems in Economics is measuring the social effect of economic growth (development. Economic growth should never be treated a goal per se. It is rational provided that it brings effects such as, generally speaking, an improvement in the standard of living. However, this is not always the case. Social sciences, including Economics, have not developed any uniform methods of measuring and evaluating such effects yet.

  6. Validation of laughter for diagnosis and evaluation of depression.

    Science.gov (United States)

    Navarro, J; del Moral, R; Alonso, M F; Loste, P; Garcia-Campayo, J; Lahoz-Beltra, R; Marijuán, P C

    2014-05-01

    In the medical field, laughter has been studied for its beneficial effects on health and as a therapeutic method to prevent and treat major medical diseases. However, very few works, if any, have explored the predictive potential of laughter and its potential use as a diagnostic tool. We registered laughs of depressed patients (n=30) and healthy controls (n=20), in total 934 laughs (517 from patients and 417 from controls). All patients were tested by the Hamilton Depression Rating Scale (HDRS). The processing was made in Matlab, with calculation of 8 variables per laugh plosive. General and discriminant analysis distinguished patients, controls, gender, and the association between laughter and HDRS test. Depressed patients and healthy controls differed significantly on the type of laughter, with 88% efficacy. According to the Hamilton scale, 85.47% of the samples were correctly classified in males, and 66.17% in women, suggesting a tight relationship between laughter and the depressed condition. (i) The compilation of humorous videos created to evoke laughter implied quite variable chances of laughter production. (ii) Some laughing subjects might not feel comfortable when recording. (iii) Evaluation of laughter episodes depended on personal inspection of the records. (iv) Sample size was relatively small and may not be representative of the general population afflicted by depression. Laughter may be applied as a diagnostic tool in the onset and evolution of depression and, potentially, of neuropsychiatric pathologies. The sound structures of laughter reveal the underlying emotional and mood states in interpersonal relationships. Copyright © 2014 Elsevier B.V. All rights reserved.

  7. Inadequate Diagnostic Evaluation in Young Patients Registered with a Diagnosis of Dementia

    DEFF Research Database (Denmark)

    Salem, Lise Cronberg; Andersen, Birgitte Bo; Nielsen, T Rune

    2014-01-01

    BACKGROUND: Establishing a diagnosis of dementia in young patients may be complex and have significant implications for the patient. The aim of this study was to evaluate the quality of the diagnostic work-up in young patients diagnosed with dementia in the clinical routine. METHODS: Two hundred...... patients were randomly selected from 891 patients aged ≤65 years registered with a diagnosis of dementia for the first time in 2008 in Danish hospitals, and 159 medical records were available for review. Three raters evaluated their medical records for the completeness of the diagnostic work-up on which...... the diagnosis of dementia had been based, using evidence-based guidelines for the diagnostic evaluation of dementia as reference standards. RESULTS: According to the rater review, only 111 (70%) patients met the clinical criteria for dementia. An acceptable diagnostic work-up including all items of recommended...

  8. Fault diagnosis and performance evaluation for high current LIA based on radial basis function neural network

    International Nuclear Information System (INIS)

    Yang Xinglin; Wang Huacen; Chen Nan; Dai Wenhua; Li Jin

    2006-01-01

    High current linear induction accelerator (LIA) is a complicated experimental physics device. It is difficult to evaluate and predict its performance. this paper presents a method which combines wavelet packet transform and radial basis function (RBF) neural network to build fault diagnosis and performance evaluation in order to improve reliability of high current LIA. The signal characteristics vectors which are extracted based on energy parameters of wavelet packet transform can well present the temporal and steady features of pulsed power signal, and reduce data dimensions effectively. The fault diagnosis system for accelerating cell and the trend classification system for the beam current based on RBF networks can perform fault diagnosis and evaluation, and provide predictive information for precise maintenance of high current LIA. (authors)

  9. Cost-benefit evaluation of systematic radiological diagnosis of congenital dislocated hip

    International Nuclear Information System (INIS)

    Faure, C.; Schmit, P.; Salvat, D.

    1984-01-01

    The interest of radiological mass screening of congential dislocated hip is still debated. We have tried to evaluate the cost-benefit ratio of radiological detection at the age of 3-4 months, taking into account the socio-economic cost and radiation risk. Assuming a frequency of this disorder of 1% the average cost of treatment of one case detected by X-ray screening at the age of 3-4 months, including the price of X-ray examinations of 99 normal babies is 23.374 FF. The average cost of treatment of a case detected at walking-age, i.e. after 9 months, is 84.230 FF. The cost-benefit ratio is 3.6. In countries where the frequency reaches 2% the cost benefit ratio is 4.57. It also appears from our study that the irradiation of the patient is much smaller when the diagnosis is made earlier. Comparing the slight irradiation delivered to normal infants by this mass screening to the heavy irradiation received by a few individuals whose treatment is started after 9 months, the calculated risk of leukemia or of genetic disorder for the whole population still favours a systematic X-ray film of the pelvis at age 3-4 months. However, if it were decided to make obligatory this mass radiological detection programme during the fourth month of life, this would necessitate a serious effort to train all radiologists to obtain adequate films with the best radiation protection. (orig.)

  10. Economical evaluation on spent fuel storage technology away from reactor

    International Nuclear Information System (INIS)

    Itoh, Chihiro; Nagano, Koji; Saegusa, Toshiari

    2000-01-01

    Concerning the spent fuel storage away from reactor, economical comparison was carried out between metal cask and water pool storage technology. The economic index was defined by levelized cost (Unit storage cost) calculated on the assumption that the storage cost is paid at the receipt of the spent fuel at the storage facility. It is found that the cask storage is economical for small and large storage capacity. Unit storage cost of pool storage, however, is getting close to that of cask storage in case of storage capacity of 10,000 ton. Then, the unit storage cost is converted to power generation cost using data of the burn up of the fuel, etc. The cost is obtained as yen 0.09/kWh and yen 0. 15/kWh for cask storage and pool storage, respectively in case of the capacity of 5,000 tonU and the cooling time of 5 years. (author)

  11. Economic Evaluation of Dual-Level-Residence Solar-Energy System

    Science.gov (United States)

    1982-01-01

    105-page report is one in a series of economic evaluations of different solar-energy installations. Using study results, an optimal collector area is chosen that minimizes life-cycle costs. From this optimal size thermal and economic performance is evaluated.

  12. Methodologies for environmental, micro- and macro-economic evaluation of bioenergy systems

    NARCIS (Netherlands)

    Broek, R. van den; Wijk, A. van

    2006-01-01

    An overview is given of methodologies used for evaluation of bioenergy systems on envoronmental, micro- and macro-economic spects. To evaluate micro-economic impacts net present value and annualised cost calculation are used. For environmental impacts, methods used are: qualitative studies, energy

  13. Study Concerning the Measure of Using Accounting, Economical and Administrative Evaluation in Practice

    Directory of Open Access Journals (Sweden)

    Dreghiciu Andreea Elena

    2017-01-01

    Starting from the purpose for which the evaluation is requested, this can be accountingevaluation, administrative evaluation and respectively economical – financial evaluation. Thepurpose of accounting evaluation is to elaborate financial reports, and administrative, economicaland financial evaluations have the purpose of determining the market value for different reasons.

  14. Evaluating transfer capability of economic-driven power markets

    DEFF Research Database (Denmark)

    Xu, Zhao

    2007-01-01

    in the present economic-driven electricity markets. A mathematical model of a multi-objective optimization (MOOP) technique has been adopted and presented here for transfer capability studies; which can be helpful for power system planning and operation procedures. The newly-developed algorithm is being tested......The on-going restructuring of electric power utilities poses great challenges for power system engineers to plan and operate power systems as economical and reliable as possible. This paper discusses an important issue, which has been usually neglected, when quantifying active power transfer levels...

  15. Economic evaluation of health promotion interventions for older people: do applied economic studies meet the methodological challenges?

    Science.gov (United States)

    Huter, Kai; Dubas-Jakóbczyk, Katarzyna; Kocot, Ewa; Kissimova-Skarbek, Katarzyna; Rothgang, Heinz

    2018-01-01

    In the light of demographic developments health promotion interventions for older people are gaining importance. In addition to methodological challenges arising from the economic evaluation of health promotion interventions in general, there are specific methodological problems for the particular target group of older people. There are especially four main methodological challenges that are discussed in the literature. They concern measurement and valuation of informal caregiving, accounting for productivity costs, effects of unrelated cost in added life years and the inclusion of 'beyond-health' benefits. This paper focuses on the question whether and to what extent specific methodological requirements are actually met in applied health economic evaluations. Following a systematic review of pertinent health economic evaluations, the included studies are analysed on the basis of four assessment criteria that are derived from methodological debates on the economic evaluation of health promotion interventions in general and economic evaluations targeting older people in particular. Of the 37 studies included in the systematic review, only very few include cost and outcome categories discussed as being of specific relevance to the assessment of health promotion interventions for older people. The few studies that consider these aspects use very heterogeneous methods, thus there is no common methodological standard. There is a strong need for the development of guidelines to achieve better comparability and to include cost categories and outcomes that are relevant for older people. Disregarding these methodological obstacles could implicitly lead to discrimination against the elderly in terms of health promotion and disease prevention and, hence, an age-based rationing of public health care.

  16. FBI fingerprint identification automation study. AIDS 3 evaluation report. Volume 4: Economic feasibility

    Science.gov (United States)

    Mulhall, B. D. L.

    1980-01-01

    The results of the economic analysis of the AIDS 3 system design are presented. AIDS 3 evaluated a set of economic feasibility measures including life cycle cost, implementation cost, annual operating expenditures and annual capital expenditures. The economic feasibility of AIDS 3 was determined by comparing the evaluated measures with the same measures, where applicable, evaluated for the current system. A set of future work load scenarios was constructed using JPL's environmental evaluation study of the fingerprint identification system. AIDS 3 and the current system were evaluated for each of the economic feasibility measures for each of the work load scenarios. They were compared for a set of performance measures, including response time and accuracy, and for a set of cost/benefit ratios, including cost per transaction and cost per technical search. Benefit measures related to the economic feasibility of the system are also presented, including the required number of employees and the required employee skill mix.

  17. Methodological Challenges to Economic Evaluations of Vaccines: Is a Common Approach Still Possible?

    Science.gov (United States)

    Jit, Mark; Hutubessy, Raymond

    2016-06-01

    Economic evaluation of vaccination is a key tool to inform effective spending on vaccines. However, many evaluations have been criticised for failing to capture features of vaccines which are relevant to decision makers. These include broader societal benefits (such as improved educational achievement, economic growth and political stability), reduced health disparities, medical innovation, reduced hospital beds pressures, greater peace of mind and synergies in economic benefits with non-vaccine interventions. Also, the fiscal implications of vaccination programmes are not always made explicit. Alternative methodological frameworks have been proposed to better capture these benefits. However, any broadening of the methodology for economic evaluation must also involve evaluations of non-vaccine interventions, and hence may not always benefit vaccines given a fixed health-care budget. The scope of an economic evaluation must consider the budget from which vaccines are funded, and the decision-maker's stated aims for that spending to achieve.

  18. A brief history of economic evaluation for human papillomavirus vaccination policy.

    Science.gov (United States)

    Beutels, Philippe; Jit, Mark

    2010-09-01

    This commentary discusses key issues for health economic evaluation and modelling, applied to human papillomavirus (HPV) vaccine programs. We outline some of the specific features of HPV disease and vaccination, and associated policy questions in light of a literature search for economic evaluations on HPV vaccination. We observe that some policy questions could not be reliably addressed by many of the 43 published economic evaluations we found. Despite this, policy making on universal HPV vaccination followed shortly after vaccine licensure in many developed countries, so the role economic evaluation played in informing these decisions (pre-dating 2008) seems to have been fairly limited. For more recent decisions, however, economic evaluation is likely to have been used more widely and more intensively. We expect future cost-effectiveness analyses to be more instrumental in policy making regarding vaccines covering more HPV types, therapeutic HPV vaccines, and novel diagnostic tests for biomarkers of HPV infection and disease integrated with cervical screening programs.

  19. Evaluation of Computer-Assisted Instruction in Principles of Economics.

    Science.gov (United States)

    Coates, Dennis; Humphreys, Brad R.

    2001-01-01

    Assesses the effectiveness of supplementary Web-based materials and activities in traditional introductory college economics courses. Results suggest that faculty should focus more on developing self-test quizzes and effective bulletin board discussion projects as opposed to generating online content related to text or lecture notes. (Author/LRW)

  20. Expert system for economic evaluation of technological projects

    Directory of Open Access Journals (Sweden)

    Bohumil Hlavenka

    2001-01-01

    Full Text Available Apart from the technical level, a basic tool for decision-making and realization of the technical innovation project is also its economic effectiveness. It is assessed by comparing expenses and effects with respect to all-society interests and standards valid in a relevant period for the areas of technology, economy, ecology, safety of work, etc.

  1. Incorporating risk in the economic evaluation of road infrastructure projects

    CSIR Research Space (South Africa)

    Schutte, IC

    2009-05-26

    Full Text Available credibility to the process and ensure strategic decisions that are more defendable. In this study, a prosedure for incorporating risk is suggested. It involves the identification of inputs critical to the economic success of the project, the quantification...

  2. Principles of economic evaluation of uranium resources in Canada

    International Nuclear Information System (INIS)

    Ruzicka, V.

    1998-01-01

    The uranium resources of Canada occur in deposits associated with unconformities in Proterozoic basins and adjacent areas. Classification of the resources is based on the confidence in the estimates and on their economic viability. The system is fully compatible with IAEA/NEA classified systems. The methods of estimating and classifying the Canadian resources is described. (author)

  3. Home Economics/Health Grades 6-12. Program Evaluation.

    Science.gov (United States)

    Des Moines Public Schools, IA. Teaching and Learning Div.

    Home economics programs are offered to students in grades 6-12 in the Des Moines INdependent Community School District (Iowa). Programs at the middle school level are exploratory, leading to occupational training in family and consumer science, child care, food service, and textile and fashion arts at the high school level. Health education…

  4. 192 inventory and economic evaluation of seedling species in ...

    African Journals Online (AJOL)

    2010-09-02

    Sep 2, 2010 ... and Rate of Return on Investment (RORI) were adapted for economic analysis. The result revealed ..... that goes to the employees and material input suppliers. Thus ... and ecological wellbeing of the people in the area. In fact ...

  5. Ecological and economic evaluation of Dutch egg production systems.

    NARCIS (Netherlands)

    Dekker, S.E.M.; Boer, de I.J.M.; Vermeij, I.; Aarnink, A.J.A.; Groot Koerkamp, P.W.G.

    2011-01-01

    The upcoming ban on battery cages in the European Union is expected to cause a shift in husbandry systems from predominantly battery cages to enriched cages and loose housing systems, such as barn, free range and organic systems. To gain insight into ecological and economic consequences of such a

  6. An economic evaluation of the economics of the Rancho Seco nuclear reactor

    Energy Technology Data Exchange (ETDEWEB)

    Craig, P P [California Univ., Davis, CA (USA). Dept. of Applied Science; Marcus, W B [JBS Energy, Inc., Broderick, CA (USA)

    1991-03-01

    Escalating costs of operating reactors may make it economically advantageous to close them down and purchase small, cheap technologies such as combined-cycle systems. We examine the arguments pro and con for the Rancho Seco nuclear reactor, owned by the Sacramento Municipal Utility District (SMUD) and now permanently shut-down. We conclude that if the reactor could be run no better than it has run in the past, there was no clear advantage to continued operation. Optimistic scenarios show a net advantage to running it, and pessimistic scenarios show a net disadvantage. The total range of plausible costs is narrow; the financial impact of either choice on consumers would have been small. The analysis suggests that decisions on whether to close down existing reactors are highly case specific, but that strong economic arguments for shut-down can exist if reactor performance is poor and/or if maintenance expenses are high. (author).

  7. An economic evaluation of the economics of the Rancho Seco nuclear reactor

    International Nuclear Information System (INIS)

    Craig, P.P.

    1991-01-01

    Escalating costs of operating reactors may make it economically advantageous to close them down and purchase small, cheap technologies such as combined-cycle systems. We examine the arguments pro and con for the Rancho Seco nuclear reactor, owned by the Sacramento Municipal Utility District (SMUD) and now permanently shut-down. We conclude that if the reactor could be run no better than it has run in the past, there was no clear advantage to continued operation. Optimistic scenarios show a net advantage to running it, and pessimistic scenarios show a net disadvantage. The total range of plausible costs is narrow; the financial impact of either choice on consumers would have been small. The analysis suggests that decisions on whether to close down existing reactors are highly case specific, but that strong economic arguments for shut-down can exist if reactor performance is poor and/or if maintenance expenses are high. (author)

  8. Use of economic evaluation in decision making: evidence and recommendations for improvement.

    Science.gov (United States)

    Simoens, Steven

    2010-10-22

    Information about the value for money of a medicine as derived from an economic evaluation can be used for decision-making purposes by policy makers, healthcare payers, healthcare professionals and pharmaceutical companies. This article illustrates the use of economic evaluation by decision makers and formulates a number of recommendations to enhance the use of such evaluations for decision-making purposes. Over the last decades, there has been a substantial increase in the number of economic evaluations assessing the value for money of medicines. Economic evaluation is used by policy makers and healthcare payers to inform medicine pricing/reimbursement decisions in more and more countries. It is a suitable tool to evaluate medicines and to present information about their value for money to decision makers in a familiar format. In order to fully exploit the use of economic evaluation for decision-making purposes, researchers need to take care to conduct such economic evaluations according to methodologically sound principles. Additionally, researchers need to take into account the decision-making context. They need to identify the various objectives that decision makers pursue and discuss how decision makers can use study findings to attain these objectives. These issues require further attention from researchers, policy makers, healthcare payers, healthcare professionals and pharmaceutical companies with a view to optimizing the use of economic evaluation in decision making.

  9. Scale interactions in economics: application to the evaluation of the economic damages of climatic change and of extreme events

    International Nuclear Information System (INIS)

    Hallegatte, S.

    2005-06-01

    Growth models, which neglect economic disequilibria, considered as temporary, are in general used to evaluate the damaging effects generated by climatic change. This work shows, through a series of modeling experiences, the importance of disequilibria and of endogenous variability of economy in the evaluation of damages due to extreme events and climatic change. It demonstrates the impossibility to separate the evaluation of damages from the representation of growth and of economic dynamics: the comfort losses will depend on both the nature and intensity of impacts and on the dynamics and situation of the economy to which they will apply. Thus, the uncertainties about the damaging effects of future climatic changes come from both scientific uncertainties and from uncertainties about the future organization of our economies. (J.S.)

  10. The scope of costs in alcohol studies: Cost-of-illness studies differ from economic evaluations

    Directory of Open Access Journals (Sweden)

    Tariq Luqman

    2010-07-01

    Full Text Available Abstract Background Alcohol abuse results in problems on various levels in society. In terms of health, alcohol abuse is not only an important risk factor for chronic disease, but it is also related to injuries. Social harms which can be related to drinking include interpersonal problems, work problems, violent and other crimes. The scope of societal costs related to alcohol abuse in principle should be the same for both economic evaluations and cost-of-illness studies. In general, economic evaluations report a small part of all societal costs. To determine the cost- effectiveness of an intervention it is necessary that all costs and benefits are included. The purpose of this study is to describe and quantify the difference in societal costs incorporated in economic evaluations and cost-of-illness studies on alcohol abuse. Method To investigate the economic costs attributable to alcohol in cost-of-illness studies we used the results of a recent systematic review (June 2009. We performed a PubMed search to identify economic evaluations on alcohol interventions. Only economic evaluations in which two or more interventions were compared from a societal perspective were included. The proportion of health care costs and the proportion of societal costs were estimated in both type of studies. Results The proportion of healthcare costs in cost-of-illness studies was 17% and the proportion of societal costs 83%. In economic evaluations, the proportion of healthcare costs was 57%, and the proportion of societal costs was 43%. Conclusions The costs included in economic evaluations performed from a societal perspective do not correspond with those included in cost-of-illness studies. Economic evaluations on alcohol abuse underreport true societal cost of alcohol abuse. When considering implementation of alcohol abuse interventions, policy makers should take into account that economic evaluations from the societal perspective might underestimate the total

  11. The scope of costs in alcohol studies: Cost-of-illness studies differ from economic evaluations.

    Science.gov (United States)

    van Gils, Paul F; Hamberg-van Reenen, Heleen H; van den Berg, Matthijs; Tariq, Luqman; de Wit, G Ardine

    2010-07-06

    Alcohol abuse results in problems on various levels in society. In terms of health, alcohol abuse is not only an important risk factor for chronic disease, but it is also related to injuries. Social harms which can be related to drinking include interpersonal problems, work problems, violent and other crimes. The scope of societal costs related to alcohol abuse in principle should be the same for both economic evaluations and cost-of-illness studies. In general, economic evaluations report a small part of all societal costs. To determine the cost- effectiveness of an intervention it is necessary that all costs and benefits are included. The purpose of this study is to describe and quantify the difference in societal costs incorporated in economic evaluations and cost-of-illness studies on alcohol abuse. To investigate the economic costs attributable to alcohol in cost-of-illness studies we used the results of a recent systematic review (June 2009). We performed a PubMed search to identify economic evaluations on alcohol interventions. Only economic evaluations in which two or more interventions were compared from a societal perspective were included. The proportion of health care costs and the proportion of societal costs were estimated in both type of studies. The proportion of healthcare costs in cost-of-illness studies was 17% and the proportion of societal costs 83%. In economic evaluations, the proportion of healthcare costs was 57%, and the proportion of societal costs was 43%. The costs included in economic evaluations performed from a societal perspective do not correspond with those included in cost-of-illness studies. Economic evaluations on alcohol abuse underreport true societal cost of alcohol abuse. When considering implementation of alcohol abuse interventions, policy makers should take into account that economic evaluations from the societal perspective might underestimate the total effects and costs of interventions.

  12. Evaluation of a simple and rapid dipstick assay for the diagnosis of typhoid fever in Indonesia

    NARCIS (Netherlands)

    Gasem, M. Hussein; Smits, Henk L.; Goris, Marga G. A.; Dolmans, Wil M. V.

    2002-01-01

    To support the clinical diagnosis of typhoid fever in Indonesia, where most hospitals and health centres have no facilities for culture, a rapid dipstick assay for the detection of Salmonella typhi-specific IgM antibodies was evaluated on serum samples from 127 patients clinically suspected of

  13. Evaluation of a new commercial assay for diagnosis of pulmonary and nonpulmonary tuberculosis

    DEFF Research Database (Denmark)

    Johansen, I S; Thomsen, V Ø; Johansen, A

    2002-01-01

    A new commercial assay for the diagnosis of tuberculosis, the BDProbeTec ET Direct Detection assay (Becton Dickinson, USA), was evaluated using 351 respiratory and 372 nonrespiratory specimens. The results were compared to detection of Mycobacterium tuberculosis complex (MTC) by conventional...

  14. Economic evaluation of HTRs as applied to an oil industry

    International Nuclear Information System (INIS)

    Djokolelono, M.; Soedibjo, R.; Padmosoebroto, S.

    1989-01-01

    General design requirement pertinent to the applied oil field is presented. Economic calculation of HTRs application in the enhanced oil recovery was performed. It includes the consideration of the current structure as practised so far in the oil industry in Indonesia. Sensitivity studies were done to enlighten the influence of uncertainties related to the HTRs, i.e. capital costs, oil prices, depreciations, investment credits, domestic obligation, financing terms. (author). 3 refs, 4 figs

  15. Welfare Evaluation and the Economic Impacts of Climate Change on ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    This research will aim to study from an interdisciplinary perspective the economic and social impact of changes in water availability and quality due to climate ... Dans le cadre de ce projet, on étudiera les efforts déployés par le secteur privé pour améliorer la conformité aux lois contre la corruption en Amérique latine.

  16. Mapping Ecosystem Services: An Integrated Biophysical and Economic Evaluation

    OpenAIRE

    Hayha, T.

    2014-01-01

    Forests provide a wide range of ecosystem services, from timber and non-wood products (provisioning services) to carbon sequestration, hydrogeological protection (regulating services), and recreation and aesthetic experiences (cultural services). Nonmarketed forest ecosystem services tend to be undervalued due to the lack of a market price and a clear understanding of their vital support to socio-economic systems. Ecosystem services are interlinked, and therefore the optimization of one typol...

  17. Transferability of economic evaluations of medical technologies: a new technology for orthopedic surgery.

    Science.gov (United States)

    Steuten, Lotte; Vallejo-Torres, Laura; Young, Terry; Buxton, Martin

    2008-05-01

    Transferring results of economic evaluations across countries or jurisdictions can potentially save scarce evaluation resources while helping to make market access and reimbursement decisions in a timely fashion. This article points out why transferring results of economic evaluations is particularly important in the field of medical technologies. It then provides an overview of factors that are previously identified in the literature as affecting transferability of economic evaluations, as well as methods for transferring results in a scientifically sound way. As the current literature almost exclusively relates to transferability of pharmacoeconomic evaluations, this article highlights those factors and methodologies that are of particular relevance to transferring medical technology assessments. Considering the state-of-the-art literature and a worked, real life, example of transferring an economic evaluation of a product used in orthopedic surgery, we provide recommendations for future work in this important area of medical technology assessment.

  18. Nuclear versus fossil power plants: evolution of economic evaluation techniques

    International Nuclear Information System (INIS)

    Thuesen, G.J.

    1975-01-01

    The purpose of this presentation is to document the evolution of methods used by an electric utility for comparing the economic attractiveness of nuclear versus fossil electric power generation. This process of change is examined as it took place within the Georgia Power Company (GPC), a company spending in the neighborhood of half a billion dollars annually for capital improvements. This study provides a look at the variety of richness of information that can be made available through the application of different methods of economic analysis. In addition, the varied presentations used to disclose relationships between alternatives furnish evidence as to the effectiveness of providing pertinent information in a simple, meaningful manner. It had been generally accepted throughout GPC that nuclear power was economically desirable as an alternative for the production of base-load power. With inflation increasing, its advantage over fossil power appeared to be significantly increasing as the large operating costs of fossil generation seemed to be more vulnerable to inflation than the costs of operating a nuclear facility. An early indication that the company should reevaluate this position was the experience gained with the installation of their first nuclear plant. Here, actual total costs were exceeding their original construction estimates by a factor of two. Thus the question arose ''Does the high capital cost of nuclear generation offset its operating advantages when compared to similar-sized coal-burning plants.'' To answer this question, additional analyses were undertaken

  19. ECONOMIC EVALUATION OF Eucalyptus grandis PLANTATION FOR CELLULOSE PRODUCTION

    Directory of Open Access Journals (Sweden)

    Antonio Donizette de Oliveira

    2008-03-01

    Full Text Available The aims of this research were: to analyze the economic feasibility of planting eucalyptus for producing wood pulp,considering various site index and two spacings; to analyze the economic effects regarding the profitability of the forest activity indifferent distances from the industry and changes on discount rate, wood price, transportation costs, minimum profitable diameter oflogs and the length of the logs. A biometric model for making wood volume prognosis was developed, using data of a trial ofEucalyptus grandis stands 19 and 103 months old. The prognosis started at the age zero, considering logs of 2.5 and 6.0 m of lenghtand the minimum diameter varying from 4 to 10 cm, in intervals of 2 cm. Net Present Worth (NPW was used as the economic decisioncriterium, considering an infinite horizon. The main conclusions were: reducing the minimum profitable diameter and the length ofthe logs are good strategies to increase wood utilization and profit; plantations located in less productive lands are economicallyunfeasible; the cost of transportation has significant effect on the profitability of the forest activity and must be analyzed carefully atthe moment of defining the location of new plantations; small variations on wood sales price may cause big alterations on theprofitability of the forest activity, suggesting that the improvement of the wood quality together with other decisions that may increasewood price are alternatives that may render the plantations in less productive areas profitable.

  20. The value of imaging examinations in diagnosis and curative effect evaluation of breast cancer

    International Nuclear Information System (INIS)

    Xia Xiaotian; Zhang Yongxue

    2010-01-01

    Breast cancer is a serious impact on women's physical and mental health and a life-threatening common disease. Imaging examinations have great significances in diagnosing and evaluating curative effect on breast cancer. This article aims to introduce and comprehensive the value of diagnosis and curative effect evaluation of breast cancer in the context of imaging examinations (ultrasonography, mammography, breast CT, breast MRI, breast 99 Tc m -MIBI imaging, PET, PET-CT, etc). (authors)

  1. Implementing economic evaluation in simulation-based medical education: challenges and opportunities.

    Science.gov (United States)

    Lin, Yiqun; Cheng, Adam; Hecker, Kent; Grant, Vincent; Currie, Gillian R

    2018-02-01

    Simulation-based medical education (SBME) is now ubiquitous at all levels of medical training. Given the substantial resources needed for SBME, economic evaluation of simulation-based programmes or curricula is required to demonstrate whether improvement in trainee performance (knowledge, skills and attitudes) and health outcomes justifies the cost of investment. Current literature evaluating SBME fails to provide consistent and interpretable information on the relative costs and benefits of alternatives. Economic evaluation is widely applied in health care, but is relatively scarce in medical education. Therefore, in this paper, using a focus on SBME, we define economic evaluation, describe the key components, and discuss the challenges associated with conducting an economic evaluation of medical education interventions. As a way forward to the rigorous and state of the art application of economic evaluation in medical education, we outline the steps to gather the necessary information to conduct an economic evaluation of simulation-based education programmes and curricula, and describe the main approaches to conducting an economic evaluation. A properly conducted economic evaluation can help stakeholders (i.e., programme directors, policy makers and curriculum designers) to determine the optimal use of resources in selecting the modality or method of assessment in simulation. It also helps inform broader decision making about allocation of scarce resources within an educational programme, as well as between education and clinical care. Economic evaluation in medical education research is still in its infancy, and there is significant potential for state-of-the-art application of these methods in this area. © 2017 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

  2. Application evaluation of MR diffusion weighted imaging in the diagnosis and differential diagnosis of early prostate cancer

    International Nuclear Information System (INIS)

    Shen Junkang; Lu Yanli; Yang Yi; Zhao Wenlu; Jiang Zhen; Zhang Caiyuan; Ma Qi; Zhang Yongsheng; Shan Yuxi

    2014-01-01

    Objective: To evaluate the value of diffusion weighted imaging (DWI) in the diagnosis and differential diagnosis of early prostate cancer. Methods: The data of 106 patients [35 with early prostate cancer (PCa), 55 with benign prostatic hyperplasia (BPH) and 16 with prostatitis] were retrospectively analyzed, who underwent T 2 WI, DWI, and T 2 WI + DWI examination and all patients were confirmed by pathology. The data obtained from T 2 WI, DWI, and a combination of T 2 WI and DWI were scored and compared with pathological findings. The receiver operating characteristic (ROC) curves were analyzed for the area under the curve (Az) using Z test. Specificities, sensitivities and accuracies of the three protocols to diagnose PCa were evaluated. The ADC values of each prostate lesion were measured and compared with ANOVA test. Results: DWI missed 7 in 35 early prostate cancer, misdiagnosed 2 in 55 BPH, and 11 in 16 prostatitis. The Az values of T 2 WI, DWI, and T 2 WI + DWI for the detection of early prostate cancer were 0.846, 0.874, and 0.947, respectively. There was significant differences between T 2 WI + DWI and T 2 WI alone (Z=3.262, P=0.001), and between T 2 WI + DWI and DWI alone (Z=2.402, P=0.016). There was no significant difference between T 2 WI alone and DWI alone (Z=0.630, P=0.528). The sensitivities, specificities, and accuracies of T 2 WI, DWI, and a combination of T 2 WI and DWI for the detection of early prostate cancer were 51.43% (18/35), 80.00% (28/35), and 85.71% (30/35); 90.14% (64/71), 81.69% (58/71), and 88.73% (63/71); 77.36% (82/106), 81.13% (86/106), and 87.74% (93/106) respectively. The ADC values for detecting early PCa, BPH, and prostatitis were (723 ± 183) ×10 -3 , (1 381 ± 117) × 10 -3 , and (957 ± 175) × 10 -3 mm 2 /s.These ADC values showed statistical significance (F=131.94, P<0.01) among the three groups and also reached statistical significance between each two groups. Conclusions: DWI is valuable in detecting early prostate

  3. Evaluating the quality and use of economic data in decisions about essential medicines.

    Science.gov (United States)

    Moucheraud, Corrina; Wirtz, Veronika J; Reich, Michael R

    2015-10-01

    To evaluate the quality of economic data provided in applications to the World Health Organization (WHO) Model List of Essential Medicines and to evaluate the role of these data in decision-making by the expert committee that considers the applications. We analysed applications submitted to the WHO Expert Committee on the Selection and Use of Essential Medicines between 2002 and 2013. The completeness of data on the price and cost-effectiveness of medicines was extracted from application documents and coded using a four-point scale. We recorded whether or not the expert committee discussed economic information and the outcomes of each application. Associations between the completeness of economic data and application outcomes were assessed using χ 2 tests. The expert committee received 134 applications. Only eight applications (6%) included complete price data and economic evaluation data. Many applicants omitted or misinterpreted the economic evaluation section of the application form. Despite the lack of economic data, all applications were reviewed by the committee. There was no significant association between the completeness of economic information and application outcomes. The expert committee tried to address information gaps in applications by further review and analysis of data related to the application. The World Health Organization should revise the instructions to applicants on economic data requirements; develop new mechanisms to assist applicants in completing the application process; and define methods for the use of economic data in decision-making.

  4. Economic evaluation of integrated new technologies for health and social care: Suggestions for policy makers, users and evaluators.

    Science.gov (United States)

    Wildman, John; McMeekin, Peter; Grieve, Eleanor; Briggs, Andrew

    2016-11-01

    With an ageing population there is a move towards the use of assisted living technologies (ALTs) to provide social care and health care services, and to improve service processes. These technologies are at the forefront of the integration of health and social care. However, economic evaluations of ALTs, and indeed economic evaluations of any interventions providing both health benefits and benefits beyond health are complex. This paper considers the challenges faced by evaluators and presents a method of economic evaluation for use with interventions where traditional methods may not be suitable for informing funders and decision makers. We propose a method, combining economic evaluation techniques, that can accommodate health outcomes and outcomes beyond health through the use of a common numeraire. Such economic evaluations can benefit both the public and private sector, firstly by ensuring the efficient allocation of resources. And secondly, by providing information for individuals who, in the market for ALTs, face consumption decisions that are infrequent and for which there may be no other sources of information. We consider these issues in the welfarist, extra-welfarist and capabilities frameworks, which we link to attributes in an individual production model. This approach allows for the valuation of the health component of any such intervention and the valuation of key social care attributes and processes. Finally, we present a set of considerations for evaluators highlighting the key issues that need to be considered in this type of economic evaluation. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

  5. Diagnostic and economic evaluation of new biomarkers for Alzheimer’s disease: the research protocol of a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Handels Ron LH

    2012-08-01

    Full Text Available Abstract Background New research criteria for the diagnosis of Alzheimer’s disease (AD have recently been developed to enable an early diagnosis of AD pathophysiology by relying on emerging biomarkers. To enable efficient allocation of health care resources, evidence is needed to support decision makers on the adoption of emerging biomarkers in clinical practice. The research goals are to 1 assess the diagnostic test accuracy of current clinical diagnostic work-up and emerging biomarkers in MRI, PET and CSF, 2 perform a cost-consequence analysis and 3 assess long-term cost-effectiveness by an economic model. Methods/design In a cohort design 241 consecutive patients suspected of having a primary neurodegenerative disease are approached in four academic memory clinics and followed for two years. Clinical data and data on quality of life, costs and emerging biomarkers are gathered. Diagnostic test accuracy is determined by relating the clinical practice and new research criteria diagnoses to a reference diagnosis. The clinical practice diagnosis at baseline is reflected by a consensus procedure among experts using clinical information only (no biomarkers. The diagnosis based on the new research criteria is reflected by decision rules that combine clinical and biomarker information. The reference diagnosis is determined by a consensus procedure among experts based on clinical information on the course of symptoms over a two-year time period. A decision analytic model is built combining available evidence from different resources among which (accuracy results from the study, literature and expert opinion to assess long-term cost-effectiveness of the emerging biomarkers. Discussion Several other multi-centre trials study the relative value of new biomarkers for early evaluation of AD and related disorders. The uniqueness of this study is the assessment of resource utilization and quality of life to enable an economic evaluation. The study results

  6. A multi-method evaluation of a training course on dual diagnosis.

    LENUS (Irish Health Repository)

    Rani, S

    2012-08-01

    A training course on dual diagnosis was developed within the Irish forensic mental health service, to bridge the gap in the lack of training on dual diagnosis in Ireland. The course was designed for service providers within mental health and addiction services. Twenty participants involving nursing, social work, police and social welfare disciplines attended the first training course. A mixed methodology research design was adapted to describe participants\\' evaluation of the training course. Data were collected using multiple methods: pre- and post-test, daily evaluation and focus group interviews. Quantitative data were analysed using the spss Version 16.0 and qualitative data were analysed thematically. Findings from the pre- and post-test suggest an increase in participants\\' knowledge of dual diagnosis and an increase in confidence in conducting groups. Daily evaluation indicates that the course content largely met participants\\' needs. Finally, three themes emerged from the focus group interview: increased confidence, the training course\\/teaching methods and personal\\/organizational challenges. This study implies that service providers within mental health and addiction services benefit from inter-professional, needs and skills based courses incorporating a variety of teaching methods. The way forward for future dual diagnosis training course developments would be working in partnership with service users and carers.

  7. What is the complementary role of ultrasound evaluation in the diagnosis of acute appendicitis after CT?

    Energy Technology Data Exchange (ETDEWEB)

    Jang, Kyung Mi [Department of Radiology, Hallym University Sacred Heart Hospital, Anyang (Korea, Republic of); Lee, Kwanseop [Department of Radiology, Hallym University Sacred Heart Hospital, Anyang (Korea, Republic of)], E-mail: kwanseop@hallym.or.kr; Kim, Min-Jeong; Yoon, Hoi Soo; Jeon, Eui Yong; Koh, Sung Hye [Department of Radiology, Hallym University Sacred Heart Hospital, Anyang (Korea, Republic of); Min, Kwangseon [Department of Pathology, Hallym University Sacred Heart Hospital, Anyang (Korea, Republic of); Choi, Dongil [Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (Korea, Republic of)

    2010-04-15

    The objective of our study was to estimate the complementary role of ultrasound evaluation in the diagnosis of acute appendicitis after abdominoplevic CT. A total of 104 patients initially underwent abdominopelvic CT before appendix US due to acute abdominal pain. All CT examinations were evaluated retrospectively for the presence of acute appendicitis. The findings of appendix on CT were classified into five categories (definite appendicitis, probably appendicitis, equivocal CT findings for diagnosis of appendicitis, probably not appendicitis, and normal looking appendix). Appendix US images and their radiologic reports were also evaluated retrospectively. Then, CT and US findings were correlated with clinical or pathologic diagnosis. Three all patients with definite appendicitis initially on CT again showed US findings of appendicitis. In the 32 patients of probably appendicitis on CT, US showed normal looking appendix in seven patients (21.8%, 7 of 32) who improved with medical treatment and discharged. In the 16 patients of equivocal CT findings for diagnosis of appendicitis, US showed appendicitis in seven patients (43.8%, 7 of 16) and normal looking appendix in nine patients. In the 12 patients of probably not appendicitis on CT, US showed acute appendicitis in two patients (16.7%, 2 of 12). In the 41 patients of normal looking appendix on CT, US showed acute appendicitis in five patients (12.2%, 5 of 41). US reevaluation enables us to avoid misdiagnosis of appendicitis on CT and improve diagnostic accuracy of acute appendicitis.

  8. Economic evaluation of five curing processes for wood coatings

    International Nuclear Information System (INIS)

    Martinez M, I.

    1996-01-01

    In this work we study the economic feasibility of five methods for curing coatings over sheet wood products. Each year, Mexico is producing more than 40 millions of square meters of wood panels, but the demand is of the range of 58 millions of square meters of this product. Two millions are expended after they are coated, and 38 millions without coating, they are coated artisanilly when they are used to make pieces of furniture. The technical characteristics and the costs involved in each one of five methods of curing, are described. Investments involved with each method are processed to establish: fixed costs, variable costs, equilibrium point, and others. Initial investment, coasts and revenues are processed to determine the income statement pro-form, the projected statement of change in financial position, the projected working capital, the projected balance sheet, the cash-flow, and some economical and financial indicators for each one of the five curing methods. With this information, the internal rate of return (IRR) is determined, and used to compare the economic worth of each of the five methods. The five methods are profitable, because all they have a IRR greater than the opportunity cost of capital (15%) of projects with similar characteristics. Despite, with each one of the five methods, the capital invested is recoverable, and profits can be obtained; curing by ultraviolet light or by electron beam, let recover the investment in less than two years, require fewer dollars for investment, and have a IRR of 135% and 111% respectively. Besides ultraviolet light or electron beam curing processes, pollute less with volatile solvents, use the energy efficiently, have greater production rate, and the coating obtained have better quality than with the other three methods. (Author)

  9. An Optimization Study on Syngas Production and Economic Evaluation

    Directory of Open Access Journals (Sweden)

    Qasim Faraz

    2016-01-01

    Full Text Available Syngas production in Gas-to-liquid (GTL process is focused in past by several researchers to increase the production with minimal capital and operating costs. In this study, syngas production process is simulated and optimized to increase its production and the economic analysis is studied for the proposed optimized process. Aspen HYSYS v8.4 is used for all process simulation work in this article. A new configuration is rigorously simulated while using auto-thermal reforming. Results exhibit a tremendous rise in production of syngas.

  10. The development of the Hydrogen Economic Evaluation Program (HEEP)

    International Nuclear Information System (INIS)

    Khamis, I.

    2010-01-01

    The International Atomic Energy Agency (IAEA) is developing software to perform economic analysis related to hydrogen production. The software is expected to analyse the economics of the four most promising processes for hydrogen production. These processes are: high and low temperature electrolysis, thermochemical processes including the S-I process, conventional electrolysis and steam reforming. The IAEA HEEP software is expected to be used for comparative studies between nuclear and fossil energy sources. Therefore, typical conventional methods are also to be included in HEEP to enable comparison with nuclear hydrogen production. The HEEP models will be based on some economic and technical data, and on cost modelling. Modelling will include various aspects of hydrogen economy including storage, transport and distribution with options to eliminate or include specific details as required by the users. Development of HEEP is based on the IAEA's successful programme during the development of DEEP. This IAEA DEEP software has been distributed free of charge to more than 500 scientists/engineers and researchers from 50 countries interested in cost estimation of desalination plants using nuclear/fossil energy sources. DEEP is not a design code. A number of member states engaged in nuclear desalination activities in their countries have used DEEP for conducting feasibility studies for establishing large nuclear desalination projects based on different nuclear reactors types and desalination processes. HEEP is expected to be similar to the IAEA software DEEP which is being used to perform economic analysis and feasibility studies related to nuclear desalination in the IAEA and other member states. It is expected that HEEP will have similar architecture to DEEP but with the possibility of easy update and future expansion. Various major processes and technologies are to be incorporated in the HEEP programme as the basis for modelling the performance and cost

  11. Fermentative production of butyric acid from wheat straw: Economic evaluation

    DEFF Research Database (Denmark)

    Baroi, G. N.; Gavala, Hariklia N.; Westermann, P.

    2017-01-01

    2014) at 3.50 and 3.95 $ per kg product (for S1 and S2 respectively) and a plant capacity of 10,000 tonnes indicated an internal rate of return of 14.92% and 12.42% and payback time of 4.28 and 4.70 years for S1 and S2 respectively. Sensitivity analysis showed that under the assumptions of the present......The economic feasibility of biochemical conversion of wheat straw to butyric acid was studied in this work. Basic process steps included physicochemical pretreatment, enzymatic hydrolysis and saccharification, fermentation with in-situ acids separation by electrodialysis and product purification...

  12. Solar energy system economic evaluation for IBM System 3, Glendo, Wyoming

    Science.gov (United States)

    1980-01-01

    This analysis was based on the technical and economic models in f-chart design procedures with inputs based on the characteristics of the parameters of present worth of system cost over a projected twenty year life: life cycle savings, year of positive savings, and year of payback for the optimized solar energy system at each of the analysis sites. The sensitivity of the economic evaluation to uncertainties in constituent system and economic variables was also investigated.

  13. Bio-economic evaluation of implementing trawl fishing gear with different selectivity

    DEFF Research Database (Denmark)

    Grønbæk Kronbak, Lone; Nielsen, J. Rasmus; Jørgensen, Ole A.

    2009-01-01

    The paper develops a biological-economic evaluation tool to analyse the consequences for trawl fishers of implementing more selective fishing technologies. This is done by merging a dynamic biological population model and an economic cost-benefit evaluation framework to describe the consequences...... with a baseline. The results from the evaluation are indicators for the consequences on ecological and economic levels. The results show that implementation of different selective fishing gear in the Kattegat and Skagerrak mixed trawl fisheries generally implies a trade off over time between rebuilding the stocks...... for the fish stocks, fishermen and society. The bio-economic evaluation is applied to the case of the Danish trawl fishery in Kattegat and Skagerrak, which experiences a high level of discards and byratches of several species. Four different kinds of selectivity scenarios are evaluated in comparison...

  14. Bio-economic evaluation of implementing trawl fishing gear with different selectivity

    DEFF Research Database (Denmark)

    Kronbak, Lone Grønbæk; Nielsen, J. Rasmus; Jørgensen, Ole A.

    2009-01-01

    The paper develops a biological-economic evaluation tool to analyse the consequences for trawl fishers of implementing more selective fishing technologies. This is done by merging a dynamic biological population model and an economic cost-benefit evaluation framework to describe the consequences...... with a baseline. The results from the evaluation are indicators for the consequences on ecological and economic levels. The results show that implementation of different selective fishing gear in the Kattegat and Skagerrak mixed trawl fisheries generally implies a trade off over time between rebuilding the stocks...... for the fish stocks, fishermen and society. The bio-economic evaluation is applied to the case of the Danish trawl fishery in Kattegat and Skagerrak, which experiences a high level of discards and bycatches of several species. Four different kinds of selectivity scenarios are evaluated in comparison...

  15. Evaluation of whole blood IFNgamma test using PPD and recombinant antigen challenge for diagnosis of pulmonary and extra-pulmonary tuberculosis.

    Science.gov (United States)

    Kalantri, Yatiraj; Hemvani, Nanda; Chitnis, D S

    2009-06-01

    Quantiferon TB gold (QFT-G) with recombinant antigen cocktail is well evaluated for diagnosis of pulmonary tuberculosis (PTB). However, diagnosis of extra-pulmonary tuberculosis (EPTB) is more difficult due to limitations of conventional techniques. This study compares recombinant antigens based QFT-G and low cost PPD based interferon test for the diagnosis of PTB and EPTB. IFNgamma release, with recombinant antigens and PPD, was assayed by ELISA from 140 cases of EPTB, 100 cases of PTB along with acid fast bacillus (AFB) detection, AFB culture on LJ and MGIT BACTEC. Sensitivity and specificity for QFT-G recombinant antigens was 84.29% and 96%, while for PPD based interferon was 70% and 84% for EPTB group. The sensitivity was far superior to AFB smear and culture for both the antigens. Nine samples were identified as non-tubercular mycobacteria (NTM) in the EPTB group and all were negative for QFT-G, but six of them were positive for PPD based test. Results of the study show that QFT-G using recombinant antigen is sensitive and specific for both PTB and EPTB diagnosis. The PPD based test is economic and offers comparable performance for PTB and EPTB diagnosis and also useful for diagnosis of NTM.

  16. Evaluation of accuracy and interobserver agreement of MR cholangiography for diagnosis of cholelithiasis

    International Nuclear Information System (INIS)

    Park, Sung Won; Baek, Seung Yon; Kang, Byung Chul; Rhee, Chung Sik

    2001-01-01

    To assess the accuracy of MR cholangiography(MRC) in the diagnosis of cholelithiasis, and to determine interobserver agreement. Between March and September 1999, 43 consecutive patients with biliary obstruction [24 men and 19 women aged 25-85 (mean, 58) years] underwent MRC using the single-shot fast spin-echo technique. Heavily T2-weighted source images(axial and coronal) 3-5 mm thick and 12 projection images with 15- degree rotation and 5-cm thickness were obtained. All images were reviewed blindly and independently by two radiologists specialized in the interpretation of abdominal imaging information. Choledocholithiasis was evaluated in eight segments of the intrahepatic duct(IHD), extrahepatic duct(EHD) and gall bladder lumen. Final diagnosis was established on the basis of operative (n=31) and other radiological (n=12) findings. The sensitivity, specificity and accuracy of the MRC findings were assessed, and using kappa measurement (cross-table analysis, SPSS Windows for 8.0), interobserver agreement was determined. Thirty of the 43 patients, had choledocholithiasis (IHD stones in 7 cases, EHD stones in 15, and GB stones in 18). For radiologist 1, sensitivity, specificity and accuracy were 86%, 100% and 98%, respectively, in the diagnosis of IHD stones; 100%, 89% and 93%, respectively, in the diagnosis of EHD stones; and 81%, 96% and 91%, respectively, in the diagnosis of GB stones. For radiologist 2, the corresponding figures were 86%, 94% and 93% (1HD stones);87%, 89% and 88% (EHD stones); and 81%, 86% and 84% (GB stones). Interobserver agreement for the diagnosis of choledocholithiasis was excellent in all cases. The kappa mesurement was 0.91 for 1HD stones, 0.77 for EHD stones, and 0.70 for GB stones. MRC is an excellent imaging modality for the diagnosis of choledocholithiasis, and inter observer agreement was also excellent

  17. Thermo-economic evaluation of ORCs for various working fluids

    International Nuclear Information System (INIS)

    Garg, Pardeep; Orosz, Matthew S.; Kumar, Pramod

    2016-01-01

    An inclusive component-level technical and economic assessment procedure for the general design and operating strategy of Organic Rankine Cycles (ORC) for use across major application categories (waste heat recovery, solar thermal, geothermal) and sub-MW scales can be an important tool for leveraging the cost-effective deployment of low and medium temperature power cycles. Previous analyses and design approaches tended to focus on thermodynamic efficiency rather than financial performance. To bridge this gap, a general thermo-economic optimization of sub 500 kWe ORCs is developed using a 7-dimensional design space with minimum investment cost per unit of nameplate electricity production as an objective function. Parameters used include working fluid, heat source temperature, pinch in condenser, boiler (HEX) and regenerator, expander inlet pressure and air cooled condenser area. Optimized power block configurations are presented for the application of ORCs with waste or “free” heat sources and solar heat input for power scales of 5, 50 and 500 kWe to facilitate rapid selection of design parameters across a wide range of thermal regimes. While R152a yields the lowest cost ORCs in the case of the former, isopentane is found to be more cost effective in the latter case for heat source temperatures between 125 and 275 °C.

  18. CHART in lung cancer: Economic evaluation and incentives for implementation

    International Nuclear Information System (INIS)

    Lievens, Yolande; Kesteloot, Katrien; Bogaert, Walter van den

    2005-01-01

    Background and purpose: To investigate the financial consequences and the impact on daily implementation of CHART in lung cancer. Patients and methods: A cost-effectiveness and cost-utility analysis were performed using Markov models, comparing the early and delayed costs and effects of CHART for NSCLC over a 4-year time span from a societal viewpoint. The outcome estimates were based on the CHART literature, the cost estimates on the standard practice of the Leuven University Hospitals, the radiotherapy costs being derived from an activity-based costing (ABC) programme developed in the department. Results: The additional societal cost per life-year gained was EURO 9164, the incremental cost per quality-adjusted life-year EURO 11,576. Sensitivity analyses confirmed the robustness of these results, the incremental cost-utility ratio remaining well under 20,000 EURO /QALY in all tested circumstances. The threshold analyses found the results of the study to be sensitive to the cost of CHART and to the quality of life after treatment. More specifically, standard treatment would become the optimal treatment if CHART would have a higher cost or would result in more long-term side effects. Conclusion: CHART should not be denied to patients with NSCLC on the basis of clinical or economic arguments. Other factors such as socio-economical, institutional, practical departmental and physician-bound barriers most probably explain the lack of implementation into daily practice

  19. An approach to evaluating the economic impact of emissions trading

    International Nuclear Information System (INIS)

    Lieu, S.; Johnson, S.L.; Dabirian, S.

    1993-01-01

    The command-and-control system to air quality controls is a mixture of technology-forcing standards for existing sources and offset for new sources. More stringent controls are required to achieve the ambient air quality standards in non-attainment urban areas which have been conformed with burgeoning economic growth. Due to the economy of scale and locale of polluting sources, some sources can implement these controls in a more cost-effective manner than others. In order to minimize the control costs of regulated sources, trading of emissions has been stipulated and has occurred among power plants to curb acid rain at the national level. Southern California is currently embarking on the trading of oxides of nitrogen, reactive organic compounds, and oxides of sulfur among existing and new stationary sources. New economic opportunities for entrepreneurs with advances control technology will arise under emissions trading. Trading will also result in the redistribution of emissions geographically and across industries. Through the linkage of a linear-programming trading model, a regional econometric model, and an urban airshed model, the impact of trading on the Southern California economy can thus be examined. This paper describes a framework which can be used to compare and contrast RECLAIM with the command-and-control system; and discusses a few issues which may arise in a trading market and how these issues can be dealt with are also examined

  20. Evaluating the Air Quality, Climate and Economic Impacts of ...

    Science.gov (United States)

    Anaerobic digestion is a natural biological process in which microorganisms break down organic materials in the absence of oxygen. When anaerobic microbes metabolize organic waste – i.e., the carbon-based remains of plants, animals and their waste products, e.g. animal manure, sewage sludge and food waste – they produce biogas. Biogas consists mainly of methane and carbon dioxide and can be used as a renewable energy fuel in a variety of applications. The impacts of biogas generation and utilization processes differ, depending on the source material (e.g., sewage, manure, food processing waste, municipal solid waste) and end uses (e.g., on-site electricity generation, conversion to a vehicle fuel, injection into the natural gas pipeline, etc.). Organic waste managers and regulators alike lack sufficient information about the overall environmental and economic performance of available biogas management technologies. A more complete understanding of the environmental and economic performance of biogas-to-energy technologies will assist state and local governments, regulators, and potential project developers in identifying geographically appropriate and cost-effective biogas management options.The backdrop for this research was California. The state has unique air quality challenges due to the combination of meteorology and topography, population growth and the pollution burden associated with mobile sources. However, with the strengthening of National Ambient

  1. Economic evaluation of GPS technology in Serbian agriculture

    Directory of Open Access Journals (Sweden)

    Marković Dragan

    2013-01-01

    Full Text Available This paper examined the level of savings in the application of the most modern technical systems for satellite guidance and control over performing agricultural operations throughout the season. The exemplary property was Agricultural Corporation Belgrade (PKB, which covers about 21.000 hectares of arable land. The effects of plot shape and direction of movement of tractor-attachment units in calculating the savings from reduced overlapping of adjacent passes were studied. The analysis was carried out of savings per crop (maize, wheat, soybean, sugar beet and alfalfa and the operations for each crop separately, based on the manufacturing technology applied to an exemplary property. Detailed data are shown only for wheat and barley. Comparing the achieved level of savings, the application of guidance for the type of the most economically viable operations was found as well as the needed equipment level of guidance devices and management. In particular, the analysis involved the functional dependence of the economic savings in fuel and inputs for the operations such as mineral fertilizers distribution and chemical plant protection. Tabulated are the data estimates for the degree of anticipated savings for operations related to the five analyzed crops.

  2. A Characteristics Approach to the Evaluation of Economics Software Packages.

    Science.gov (United States)

    Lumsden, Keith; Scott, Alex

    1988-01-01

    Utilizes Bloom's Taxonomy to identify elements of teacher and student interest. Depicts the way in which these interests are developed into characteristics for use in analytically evaluating software. Illustrates the use of this evaluating technique by appraising the much used software package "Running the British Economy." (KO)

  3. Economic Evaluations of Pathology Tests, 2010-2015: A Scoping Review.

    Science.gov (United States)

    Watts, Rory D; Li, Ian W; Geelhoed, Elizabeth A; Sanfilippo, Frank M; St John, Andrew

    2017-09-01

    Concerns about pathology testing such as the value provided by new tests and the potential for inappropriate utilization have led to a greater need to assess costs and benefits. Economic evaluations are a formal method of analyzing costs and benefits, yet for pathology tests, questions remain about the scope and quality of the economic evidence. To describe the extent and quality of published evidence provided by economic evaluations of pathology tests from 2010 to 2015. Economic evaluations relating to pathology tests from 2010 to 2015 were reviewed. Eight databases were searched for published studies, and details recorded for the country, clinical focus, type of testing, and consideration of sensitivity, specificity, and false test results. The reporting quality of studies was assessed using the Consolidated Health Economic Evaluation Reporting Standards checklist and cost-effectiveness ratios were analyzed for publication bias. We found 356 economic evaluations of pathology tests, most of which regarded developed countries. The most common economic evaluations were cost-utility analyses and the most common clinical focus was infectious diseases. More than half of the studies considered sensitivity and specificity, but few studies considered the impact of false test results. The average Consolidated Health Economic Evaluation Reporting Standards checklist score was 17 out of 24. Cost-utility ratios were commonly less than $10,000/quality-adjusted life-year or more than $200,000/quality-adjusted life-year. The number of economic evaluations of pathology tests has increased in recent years, but the rate of increase has plateaued. Furthermore, the quality of studies in the past 5 years was highly variable, and there is some question of publication bias in reporting cost-effectiveness ratios. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  4. EVALUATION METHODS USED FOR TANGIBLE ASSETS BY ECONOMIC ENTITIES

    Directory of Open Access Journals (Sweden)

    Csongor CSŐSZ

    2014-06-01

    Full Text Available At many entities the net asset value is influenced by the evaluation methods applied for tangible assets, because the value of intangible assets and financial assets is small in most cases. The objective of this paper is to analyze the differences between the procedures / methods of evaluation applied by micro and small entities and medium and large entities for tangible assets in Romania and Hungary. Furthermore, we analyze the differences between the procedures / methods of evaluation applied by micro and small entities in Romania and Hungary, respectively the differences between medium and large entities regarding de evaluation methods for tangible assets in Romania and Hungary. For this empirical study the questionnaire is used – as research technique, and to demonstrate the significant differences between the evaluation methods we used the Kolmogorov – Smirnov Z test.

  5. [Application evaluation of multi-parametric MRI in the diagnosis and differential diagnosis of early prostate cancer and prostatitis].

    Science.gov (United States)

    Li, P; Huang, Y; Li, Y; Cai, L; Ji, G H; Zheng, Y; Chen, Z Q

    2016-10-11

    Objective: To evaluate the value of multi-parametric MRI (Mp-MRI) in the diagnosis and differential diagnosis of early prostate cancer(PCa) in the peripheral zone(PZ) and low T 2 WI signal intensity of prostatitis. Methods: A total of 40 patients with PZ early PCa and 37 with prostatitis of hypointense T 2 WI signal in PZ were retrospectively analyzed, which were collected from the General Hospital of Ningxia Medical University from Janurary 2009 to June 2015, who underwent T 2 WI, DWI, and DCE-MRI examination and all patients were confirmed by pathology. All the data was transferred to GE Advanced Workstation AW4.3, the indexes divided into cancerous and prostatitis regions were calculated by Functool2 of signal intensity-time(SI-T) curve and ADC value, to calcuate the time to minimum(T max ), the whole enhancment degree (SI max ). ROC cure was used to determine the cutoff value for PCa detection with the ADC value. Result: On T 2 WI, 57.5% of PCa (23/40) showed focal nodular homogeneous low signal intensity, 70.3% of prostatitis(26/37) showed diffuse inhomogeneous low signal intensity. DCE-MRI, the distribution of curve types for malignant tumors was type Ⅰ 2.5%(1/40), typeⅡ32.5%(13/40) and type Ⅲ 65.0% (26/40). While the numbers for prostatitis was type Ⅰ 16.2%(6/37) , type Ⅱ 56.8% (21/37) and type Ⅲ 27.0% (10/37)respectively.The patterns of curve types in malignant lesions were different from benign lesions significantly(χ 2 =12.32, P prostatitis regions were (17.96±2.91)s, 1.76%±0.23% and (21.19±3.59)s, 1.53%±0.18%, respectively ( t =5.37, 6.10; P prostatitis regions were (0.95±0.13)×10 -3 mm 2 /s and (1.12±0.13)×10 -3 mm 2 /s, respectively ( t =7.10, P prostatitis from early PCa.

  6. Evaluation of older adults hospitalized with a diagnosis of failure to thrive.

    Science.gov (United States)

    Kumeliauskas, Linas; Fruetel, Karen; Holroyd-Leduc, Jayna M

    2013-01-01

    older adults are sometimes hospitalized with the admission diagnosis of failure to thrive (FTT), often because they are not felt safe to be discharged back to their current living arrangement. It is unclear if this diagnosis indicates primarily a social admission or suggests an acute medical deterioration. The objective of this study was to explore the level of acuity and medical investigations commonly conducted among older hospitalized adults with a diagnosis of FTT. We conducted a retrospective cohort study at three hospitals in Calgary, Alberta. Data were extracted from the electronic medical records of the 603 admissions of patients 65 years or older with a diagnosis of FTT between January 2010 and January 2011. Markers of medical acuity were evaluated. The vast majority of patients had short hospital stays. Specialist physicians were consulted for 323 cases (54%). Allied health-care professionals were consulted in 151 cases (25%). While in hospital, patients underwent extensive investigations, including CT scans, ultrasounds, and echo-cardiograms. Many patients received IV fluids (71%) and IV antibiotics (35%). The data suggest that acute illnesses, and not social factors, were the primary reason for admission among those given a diagnosis of FTT.

  7. STATISTICAL EVALUATION OF THE IMPACT OF ECONOMIC FACTORS ON SOCIO-DEMOGRAPHICS OF THE COUNTRY

    Directory of Open Access Journals (Sweden)

    O. Evseenko

    2014-04-01

    Full Text Available In theory made a case the necessity of modeling economic and demographic indicators. The influences of economic, social and environmental indicators on social and demographic factors of development country are researeched. Given statistical evaluation of relationships based on correlation and regression analysis method.

  8. Using Multiple-Choice Questions to Evaluate In-Depth Learning of Economics

    Science.gov (United States)

    Buckles, Stephen; Siegfried, John J.

    2006-01-01

    Multiple-choice questions are the basis of a significant portion of assessment in introductory economics courses. However, these questions, as found in course assessments, test banks, and textbooks, often fail to evaluate students' abilities to use and apply economic analysis. The authors conclude that multiple-choice questions can be used to…

  9. Evaluation of the Stress Adjustment and Adaptation Model among Families Reporting Economic Pressure

    Science.gov (United States)

    Vandsburger, Etty; Biggerstaff, Marilyn A.

    2004-01-01

    This research evaluates the Stress Adjustment and Adaptation Model (double ABCX model) examining the effects resiliency resources on family functioning when families experience economic pressure. Families (N = 128) with incomes at or below the poverty line from a rural area of a southern state completed measures of perceived economic pressure,…

  10. 24 CFR 570.209 - Guidelines for evaluating and selecting economic development projects.

    Science.gov (United States)

    2010-04-01

    ..., where the recreational benefit to users or members clearly outweighs employment or other benefits to low... DEVELOPMENT BLOCK GRANTS Eligible Activities § 570.209 Guidelines for evaluating and selecting economic... activities to be carried out for economic development purposes. Specifically, these guidelines are applicable...

  11. Economic evaluations of hepatitis A vaccination in middle-income countries

    NARCIS (Netherlands)

    Suwantika, Auliya A; Yegenoglu, Selen; Riewpaiboon, Arthorn; Tu, Hong-Anh T; Postma, Maarten J

    2013-01-01

    Economic evaluations of hepatitis A vaccination are important to assist national and international policy makers in different jurisdictions on making effective decisions. Up to now, a comprehensive review of the potential health and economic benefits on hepatitis A vaccination in middle-income

  12. SCIENTOMETRY AND EVALUATION OF THE RESULTS OF ECONOMIC SCIENTIFIC RESEARCH

    Directory of Open Access Journals (Sweden)

    Ana-Lucia RISTEA

    2017-04-01

    Full Text Available Starting from the necessity of a continuous and demanding evaluation, capable of linking the results obtained with the human, material and financial resources, allocated and periodically setting the position of the national research relative to the world level, the evaluation of the relevance of the publications must be carried out from the positions and requirements of new disciplines: Scientometry. Scientometry is intended to help substantiate the evaluation of research activity and decision-making on its development, the science policy as a whole.

  13. Economic evaluation of the industrial solar production of lime

    International Nuclear Information System (INIS)

    Meier, Anton; Gremaud, Nicolas; Steinfeld, Aldo

    2005-01-01

    The use of concentrated solar energy in place of fossil fuels for driving the endothermic calcination reaction CaCO 3 → CaO + CO 2 at above 1300 K has the potential of reducing CO 2 emissions by 20% in a state-of-the-art lime plant and up to 40% in a conventional cement plant. An economic assessment for an industrial solar calcination plant with 25 MW th solar input indicates that the cost of solar produced lime ranges between 128 and 157 $/t, about twice the current selling price of conventional lime. The solar production of high purity lime for special sectors in the chemical and pharmaceutical industry might be competitive with conventional fossil fuel based calcination processes at current fuel prices

  14. Testing and economical evaluation of U(IV) in Purex

    International Nuclear Information System (INIS)

    Hoisington, J.E.; Hsu, T.C.

    1983-01-01

    The use of uranous nitrate, U(IV), as a plutonium reductant in the Purex solvent extraction process could significantly reduce the waste generation at the Savannah River Plant. The current reductant is a ferrous sulfamate (FS)/hydroxylamine nitrate (HAN) mixture. The iron and sulfate in the FS are major contributors to waste generation. The U(IV) reductant oxidizes to U(VI) producing no waste. The Savannah River Laboratory has developed an efficient electrochemical cell for U(IV) production and has demonstrated the effectiveness of U(IV) as a plutonium reductant. Plant tests and economic analyses are currently being conducted to determine the cost effectiveness of U(IV) implementation. The results of recent studies are presented

  15. Use of the partial farm budget technique to predict the economic impact of the flock management decision to use B-mode ultrasonographic pregnancy diagnosis.

    Science.gov (United States)

    Sprecher, D J; Ley, W B; Whittier, W D; Bowen, J M; Thatcher, C D; Pelzer, K D; Moore, J M

    1989-07-15

    A computer spreadsheet was developed to predict the economic impact of a management decision to use B-mode ultrasonographic ovine pregnancy diagnosis. The spreadsheet design and spreadsheet cell formulas are provided. The program used the partial farm budget technique to calculate net return (NR) or cash flow changes that resulted from the decision to use ultrasonography. Using the program, either simple pregnancy diagnosis or pregnancy diagnosis with the ability to determine singleton or multiple pregnancies may be compared with no flock ultrasonographic pregnancy diagnosis. A wide range of user-selected regional variables are used to calculate the cash flow changes associated with the ultrasonography decisions. A variable may be altered through a range of values to conduct a sensitivity analysis of predicted NR. Example sensitivity analyses are included for flock conception rate, veterinary ultrasound fee, and the price of corn. Variables that influence the number of cull animals and the cost of ultrasonography have the greatest impact on predicted NR. Because the determination of singleton or multiple pregnancies is more time consuming, its economic practicality in comparison with simple pregnancy diagnosis is questionable. The value of feed saved by identifying and separately feeding ewes with singleton pregnancies is not offset by the increased ultrasonography cost.

  16. Techno-economical evaluation of protein extraction for microalgae biorefinery

    Science.gov (United States)

    Sari, Y. W.; Sanders, J. P. M.; Bruins, M. E.

    2016-01-01

    Due to scarcity of fossil feedstocks, there is an increasing demand for biobased fuels. Microalgae are considered as promising biobased feedstocks. However, microalgae based fuels are not yet produced at large scale at present. Applying biorefinery, not only for oil, but also for other components, such as carbohydrates and protein, may lead to the sustainable and economical microalgae-based fuels. This paper discusses two relatively mild conditions for microalgal protein extraction, based on alkali and enzymes. Green microalgae (Chlorella fusca) with and without prior lipid removal were used as feedstocks. Under mild conditions, more protein could be extracted using proteases, with the highest yields for microalgae meal (without lipids). The data on protein extraction yields were used to calculate the costs for producing 1 ton of microalgal protein. The processing cost for the alkaline method was € 2448 /ton protein. Enzymatic method performed better from an economic point of view with € 1367 /ton protein on processing costs. However, this is still far from industrially feasible. For both extraction methods, biomass cost per ton of produced product were high. A higher protein extraction yield can partially solve this problem, lowering processing cost to €620 and 1180 /ton protein product, using alkali and enzyme, respectively. Although alkaline method has lower processing cost, optimization appears to be better achievable using enzymes. If the enzymatic method can be optimized by lowering the amount of alkali added, leading to processing cost of € 633/ton protein product. Higher revenue can be generated when the residue after protein extraction can be sold as fuel, or better as a highly digestible feed for cattle.

  17. Economic evaluation of system concepts for biowaste fermentation

    International Nuclear Information System (INIS)

    Barchmann, Tino; Rensberg, Nadja

    2015-01-01

    Currently, the utilization of biowaste from separate waste collection as well as industrial organic waste and waste from the food industry are of little significance for biogas generation in Germany. Nevertheless, the number of biogas plants that exclusively or predominantly digest biowaste and organic waste continues to grow. With regard to the biogas plants that have come into operation since 2012 as well as plants that are still under construction or in planning, it becomes apparent that the utilization of biowaste and green waste from separate collection for biogas generation plays an increasingly important role. By the end of 2014, about 140 plants generating biogas from organic waste digestion have been in operation. 83 of these plants use municipal biowaste from separate waste collection. According to the DBFZ database, 68 biogas plants are digestion plants that exclusively or predominantly use biowaste under the terms of paragraph 27a Renewable Energy Sources Act of 2012/ paragraph 45 Renewable Energy Sources Act of 2014. Due to the introduction of direct marketing and flexibility premium of renewable energy by the Renewable Energy Act 2012 (EEG 2012), incentives were created to favour a more demand-oriented power supply from biogas plants. The decision for such an operational mode depends on on-site conversion units on the economic outcome of the plants throughout the whole operating time. From an economic perspective, a duplication of the installed electrical capacity seems to be the most beneficial option for a transition to a demand-driven operation mode of an average biogas model plant under the current legal framework (EEG 2012).

  18. Prospective evaluation of yield of endoscopic ultrasonography in the etiological diagnosis of "idiopathic" acute pancreatitis

    Directory of Open Access Journals (Sweden)

    Narendra S Choudhary

    2016-01-01

    Full Text Available Background: Etiology of acute pancreatitis (AP remains idiopathic in 30% of patients. Endoscopic ultrasound (EUS has been shown to increase the diagnostic yield in patients with idiopathic AP (IAP. Aim: The aim of this study was to evaluate the role of EUS in achieving etiological diagnosis in patients with IAP. Materials and Methods: Consecutive 192 patients with IAP were evaluated prospectively with EUS over a period of 2 years. Patients who had no etiological diagnosis for AP after detailed history, clinical examination, laboratory investigations, and magnetic resonance cholangiopancreatography were included in the study. Results: The mean age of patients was 34.6 ± 12 and male:female ratio was 2.1:1. Of these, 135 patients had gallbladder intact (Group A and 57 patients had undergone cholecystectomy (Group B. In Group A, EUS identified a possible cause in 79 (58.5% patients; microlithiasis (n = 48, chronic pancreatitis (CP (n = 23, common bile duct (CBD and gallbladder stone (n = 3, pancreatic divisum (n = 3, small pancreatic tumor (n = 1, and anomalous pancreaticobiliary junction (n = 1. In Group B, EUS yielded diagnosis in 28 (49.1% patients; CP (n = 22, ascariasis (n = 3, CBD stone (n = 2, and pancreatic divisum (n = 1. Overall EUS helped in achieving etiological diagnosis in 107 (55.1% of patients with IAP. The presence of intact gallbladder showed a tendency for increased diagnostic yield (P = 0.06. Conclusion: EUS is a useful modality to establish the diagnosis in IAP and this technique should be incorporated in the evaluation of IAP.

  19. Consolidated Health Economic Evaluation Reporting Standards (CHEERS)--explanation and elaboration: a report of the ISPOR Health Economic Evaluation Publication Guidelines Good Reporting Practices Task Force.

    Science.gov (United States)

    Husereau, Don; Drummond, Michael; Petrou, Stavros; Carswell, Chris; Moher, David; Greenberg, Dan; Augustovski, Federico; Briggs, Andrew H; Mauskopf, Josephine; Loder, Elizabeth

    2013-01-01

    Economic evaluations of health interventions pose a particular challenge for reporting because substantial information must be conveyed to allow scrutiny of study findings. Despite a growth in published reports, existing reporting guidelines are not widely adopted. There is also a need to consolidate and update existing guidelines and promote their use in a user-friendly manner. A checklist is one way to help authors, editors, and peer reviewers use guidelines to improve reporting. The task force's overall goal was to provide recommendations to optimize the reporting of health economic evaluations. The Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement is an attempt to consolidate and update previous health economic evaluation guidelines into one current, useful reporting guidance. The CHEERS Elaboration and Explanation Report of the ISPOR Health Economic Evaluation Publication Guidelines Good Reporting Practices Task Force facilitates the use of the CHEERS statement by providing examples and explanations for each recommendation. The primary audiences for the CHEERS statement are researchers reporting economic evaluations and the editors and peer reviewers assessing them for publication. The need for new reporting guidance was identified by a survey of medical editors. Previously published checklists or guidance documents related to reporting economic evaluations were identified from a systematic review and subsequent survey of task force members. A list of possible items from these efforts was created. A two-round, modified Delphi Panel with representatives from academia, clinical practice, industry, and government, as well as the editorial community, was used to identify a minimum set of items important for reporting from the larger list. Out of 44 candidate items, 24 items and accompanying recommendations were developed, with some specific recommendations for single study-based and model-based economic evaluations. The final

  20. Economic evaluation of occupational health and safety programmes in health care.

    Science.gov (United States)

    Guzman, J; Tompa, E; Koehoorn, M; de Boer, H; Macdonald, S; Alamgir, H

    2015-10-01

    Evidence-based resource allocation in the public health care sector requires reliable economic evaluations that are different from those needed in the commercial sector. To describe a framework for conducting economic evaluations of occupational health and safety (OHS) programmes in health care developed with sector stakeholders. To define key resources and outcomes to be considered in economic evaluations of OHS programmes and to integrate these into a comprehensive framework. Participatory action research supported by mixed qualitative and quantitative methods, including a multi-stakeholder working group, 25 key informant interviews, a 41-member Delphi panel and structured nominal group discussions. We found three resources had top priority: OHS staff time, training the workers and programme planning, promotion and evaluation. Similarly, five outcomes had top priority: number of injuries, safety climate, job satisfaction, quality of care and work days lost. The resulting framework was built around seven principles of good practice that stakeholders can use to assist them in conducting economic evaluations of OHS programmes. Use of a framework resulting from this participatory action research approach may increase the quality of economic evaluations of OHS programmes and facilitate programme comparisons for evidence-based resource allocation decisions. The principles may be applicable to other service sectors funded from general taxes and more broadly to economic evaluations of OHS programmes in general. © The Author 2015. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  1. Measuring value for money: a scoping review on economic evaluation of health information systems.

    Science.gov (United States)

    Bassi, Jesdeep; Lau, Francis

    2013-01-01

    To explore how key components of economic evaluations have been included in evaluations of health information systems (HIS), to determine the state of knowledge on value for money for HIS, and provide guidance for future evaluations. We searched databases, previously collected papers, and references for relevant papers published from January 2000 to June 2012. For selection, papers had to: be a primary study; involve a computerized system for health information processing, decision support, or management reporting; and include an economic evaluation. Data on study design and economic evaluation methods were extracted and analyzed. Forty-two papers were selected and 33 were deemed high quality (scores ≥ 8/10) for further analysis. These included 12 economic analyses, five input cost analyses, and 16 cost-related outcome analyses. For HIS types, there were seven primary care electronic medical records, six computerized provider order entry systems, five medication management systems, five immunization information systems, four institutional information systems, three disease management systems, two clinical documentation systems, and one health information exchange network. In terms of value for money, 23 papers reported positive findings, eight were inconclusive, and two were negative. We found a wide range of economic evaluation papers that were based on different assumptions, methods, and metrics. There is some evidence of value for money in selected healthcare organizations and HIS types. However, caution is needed when generalizing these findings. Better reporting of economic evaluation studies is needed to compare findings and build on the existing evidence base we identified.

  2. Teaching community diagnosis to medical students: evaluation of a case study approach.

    Science.gov (United States)

    Bair, C W

    1980-01-01

    A unique case study approach to training medical students in community diagnosis techniques was initiated at the Medical College of Ohio at Toledo. This paper describes the five elements of this teaching method: preliminary specification of target community and data base; group problem-solving requirement; specification of desired output; defined performance objectives; and regularly scheduled time for analysis. Experience with the case study method over two years was evaluated to identify specific strengths and weaknesses. The identified strengths include use of limited educational time to introduce community health problems, development of experience in a collegial team work setting, and specific awareness of the types of data useful to the analysis of community health service problems. Negative evaluations suggested that the method was not conducive to the development of skills in three areas: ability to establish the relative importance of health problems in communities; ability to identify an appropriate health system response to a community health problem from feasible alternatives; and ability to anticipate the community impact of health program modifications or improvements. Potential explanations for these deficiencies include: need for increased didactic support in the classroom for particular skill areas; need to establish a direct field experience in community diagnosis; inappropriateness of the data base used for evaluation of particular skills; and the probability that quantitative analysis, as used in this evaluation, may not be sufficient in and of itself to measure the outcome of a community diagnosis experience.

  3. About Face: Evaluating and Managing Tactile Impairment at the Time of Autism Diagnosis

    Directory of Open Access Journals (Sweden)

    Louisa M. T. Silva

    2015-01-01

    Full Text Available Evaluation for sensory impairment is a routine part of autism diagnosis. Sensory impairment of hearing, vision, or touch results in developmental delay and must be addressed before delay can resolve. Recent studies confirm that tactile impairment is present in autism and can be effectively treated with a tactile stimulation protocol. The research suggests a change in management at the time of autism diagnosis to include evaluation and treatment of tactile impairment. Here we validate screening and management tool for tactile impairment, the Autism Touch and Self-Regulation Checklist, in 404 typical and autistic preschool children. The tool assesses tactile impairment by location and severity. Autistic children were distinguished by mixed pain and numbness on multiple areas including the face and mouth (F=412.1 (1,402;p<.000. Oral-facial tactile impairment interferes with the tactile stimulus to orienting. We hypothesized that oral-facial tactile impairment and difficulty orienting are predictive of ASD and that severity of tactile impairment is predictive of severity of ASD. Questions evaluating oral-facial and orienting responses correctly predicted 91% of the autism group. Severity of tactile impairment correctly predicted 81% of mild versus severe ASD. Results underscore the importance of evaluating and treating tactile impairment at the time of autism diagnosis.

  4. Evaluating a mobile application for improving clinical laboratory test ordering and diagnosis.

    Science.gov (United States)

    Meyer, Ashley N D; Thompson, Pamela J; Khanna, Arushi; Desai, Samir; Mathews, Benji K; Yousef, Elham; Kusnoor, Anita V; Singh, Hardeep

    2018-04-20

    Mobile applications for improving diagnostic decision making often lack clinical evaluation. We evaluated if a mobile application improves generalist physicians' appropriate laboratory test ordering and diagnosis decisions and assessed if physicians perceive it as useful for learning. In an experimental, vignette study, physicians diagnosed 8 patient vignettes with normal prothrombin times (PT) and abnormal partial thromboplastin times (PTT). Physicians made test ordering and diagnosis decisions for 4 vignettes using each resource: a mobile app, PTT Advisor, developed by the Centers for Disease Control and Prevention (CDC)'s Clinical Laboratory Integration into Healthcare Collaborative (CLIHC); and usual clinical decision support. Then, physicians answered questions regarding their perceptions of the app's usefulness for diagnostic decision making and learning using a modified Kirkpatrick Training Evaluation Framework. Data from 368 vignettes solved by 46 physicians at 7 US health care institutions show advantages for using PTT Advisor over usual clinical decision support on test ordering and diagnostic decision accuracy (82.6 vs 70.2% correct; P < .001), confidence in decisions (7.5 vs 6.3 out of 10; P < .001), and vignette completion time (3:02 vs 3:53 min.; P = .06). Physicians reported positive perceptions of the app's potential for improved clinical decision making, and recommended it be used to address broader diagnostic challenges. A mobile app, PTT Advisor, may contribute to better test ordering and diagnosis, serve as a learning tool for diagnostic evaluation of certain clinical disorders, and improve patient outcomes. Similar methods could be useful for evaluating apps aimed at improving testing and diagnosis for other conditions.

  5. Economic Evaluation Methodology Review on KAERI's Recent Projects

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Jin Sam; Kim, Jee Young [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2012-05-15

    In technology utilization, economics evaluation is helpful to R and D program managers by giving them economic information needed to improve the usefulness of their projects. Moreover it can help them to communicate to others participants keeping all of them value-oriented minded through the whole development process. In this context, KAERI(Korea Atomic Energy Research Institute) has been performed economic evaluation on recent some projects. So, in this study, it has been made brief reviews on KAERI's economic evaluation methodology to its recent some projects of which evaluation we engage in, especially PEFP(Proton Engineering frontier Project) and SMART(Small Medium advanced ReacTor): Methodology comparison and their pros and cons

  6. Evaluation of the feasibility, economic impact, and effectiveness of underground nuclear power plants. Final technical report

    International Nuclear Information System (INIS)

    1978-05-01

    Information on underground nuclear power plants is presented concerning underground nuclear power plant concepts; public health impacts; technical feasibility of underground concepts; economic impacts of underground construction; and evaluation of related issues

  7. Economic evaluations of occupational health interventions from a corporate perspective - A systematic review of methodological quality

    NARCIS (Netherlands)

    Uegaki, K.; Bruijne, M.C. de; Lambeek, L.; Anema, J.R.; Beek, A.J. van der; Mechelen, W. van; Tulder, M.W. van

    2010-01-01

    Objective: Using a standardized quality criteria list, we appraised the methodological quality of economic evaluations of occupational safety and health (OSH) interventions conducted from a corporate perspective. Methods: The primary literature search was conducted in Medline and Embase.

  8. The discount rate in the economic evaluation of prevention: a thought experiment

    NARCIS (Netherlands)

    L.G.A. Bonneux (Luc); E. Birnie (Erwin)

    2001-01-01

    textabstractOBJECTIVES: In the standard economic model of evaluation, constant discount rates devalue the long term health benefits of prevention strongly. This study shows that it is unlikely that this reflects societal preference. DESIGN: A thought experiment in a

  9. State of health economic evaluation research in Saudi Arabia: a review.

    Science.gov (United States)

    Al-Aqeel, Sinaa A

    2012-01-01

    If evaluation of economic evidence is to be used increasingly in Saudi Arabia, a review of the published literature would be useful to inform policy decision-makers of the current state of research and plan future research agendas. The purpose of this paper is to provide a critical review of the state of health economic evaluation research within the Saudi context with regard to the number, characteristics, and quality of published articles. A literature search was conducted on May 8, 2011 to identify health economic articles pertaining to Saudi Arabia in the PubMed, Embase, and EconLit databases, using the following terms alone or in combination: "cost*", "economics", "health economics", "cost-effectiveness", "cost-benefit", "cost minimization", "cost utility analysis", and "Saudi". Reference lists of the articles identified were also searched for further articles. The tables of contents of the Saudi Pharmaceutical Journal and the Saudi Medical Journal were reviewed for the previous 5 years. The search identified 535 citations. Based on a reading of abstracts and titles, 477 papers were excluded. Upon reviewing the full text of the remaining 58 papers, 43 were excluded. Fifteen papers were included. Ten were categorized as full economic evaluations and five as partial economic evaluations. These articles were published between 1997 and 2010. The majority of the studies identified did not clearly state the perspective of their evaluation. There are many concerns about the methods used to collect outcome and costs data. Only one study used some sort of sensitivity analysis to assess the effects of uncertainty on the robustness of its conclusions. This review highlights major flaws in the design, analysis, and reporting of the identified economic analyses. Such deficiencies mean that the local economic evidence available to decision-makers is not very useful. Thus, building research capability in health economics is warranted.

  10. Economic evaluations and randomized trials in spinal disorders: principles and methods.

    Science.gov (United States)

    Korthals-de Bos, Ingeborg; van Tulder, Maurits; van Dieten, Hiske; Bouter, Lex

    2004-02-15

    Descriptive methodologic recommendations. To help researchers designing, conducting, and reporting economic evaluations in the field of back and neck pain. Economic evaluations of both existing and new therapeutic interventions are becoming increasingly important. There is a need to improve the methods of economic evaluations in the field of spinal disorders. To improve the methods of economic evaluations in the field of spinal disorders, this article describes the various steps in an economic evaluation, using as example a study on the cost-effectiveness of manual therapy, physiotherapy, and usual care provided by the general practitioner for patients with neck pain. An economic evaluation is a study in which two or more interventions are systematically compared with regard to both costs and effects. There are four types of economic evaluations, based on analysis of: (1) cost-effectiveness, (2) cost-utility, (3) cost-minimization, and (4) cost-benefit. The cost-utility analysis is a special case of cost-effectiveness analysis. The first step in all these economic evaluations is to identify the perspective of the study. The choice of the perspective will have consequences for the identification of costs and effects. Secondly, the alternatives that will be compared should be identified. Thirdly, the relevant costs and effects should be identified. Economic evaluations are usually performed from a societal perspective and include consequently direct health care costs, direct nonhealth care costs, and indirect costs. Fourthly, effect data are collected by means of questionnaires or interviews, and relevant cost data with regard to effect measures and health care utilization, work absenteeism, travel expenses, use of over-the-counter medication, and help from family and friends, are collected by means of cost diaries, questionnaires, or (telephone) interviews. Fifthly, real costs are calculated, or the costs are estimated on the basis of real costs, guideline prices

  11. An Evaluation of the Economic Theoretical Potential of the Rural Environment Mismanged During 1956-2010

    OpenAIRE

    Florentin Gabriel Niculescu

    2015-01-01

    Under the context of the essential role and growing importance of the rural environment in the development of a country, we focus on evaluating the economic theoretical potential of the rural environment that we consider to have been mismanaged during 1956-2010. For this purpose, in this paper we define, describe and explain the main concepts, as to be able to evaluate the economic potential of the rural development and further contribute to its improvement. The study focuses on the correlati...

  12. Pharmaceutical priority setting and the use of health economic evaluations: a systematic literature review.

    Science.gov (United States)

    Erntoft, Sandra

    2011-06-01

    To investigate which factors and criteria are used in priority setting of pharmaceuticals, in what contexts health economic evaluations are used, and barriers to the use of health economic evaluations at micro, meso, and macro health-care levels. The search for empirical articles was based on the MeSH index (Medical Substance Heading), including the search terms "economic evaluation," "cost-effectiveness analysis," "cost-utility analysis," "cost-benefit analysis," "pharmacoeconomic," AND "drug cost(s)," AND "eligibility determination," AND "decision-making," AND "rationing," AND formulary. The following databases were searched: PubMed, EconLit, Cochrane, Web of Science, CINAHL, and PsycINFO. More than 3100 studies were identified, 31 of which were included in this review. The use of health economic evaluations at all three health-care levels was investigated in three countries (United States [US], United Kingdom [UK], and Sweden). Postal and telephone survey methods dominated (n = 17) followed by interviews (n = 13), document analysis (n = 10), and observations of group deliberations (n = 9). The cost-effectiveness criterion was most important at the macro level. A number of contextual uses of health economic evaluations were identified, including importantly the legitimizing of decisions, structuring the priority-setting process, and requesting additional budgets to finance expensive pharmaceuticals. Factors that seem to support the increased use of health economic evaluations are well-developed frameworks for evaluations, the presence of health economic skills, and an explicit priority-setting process. Differences in how economic evaluations are used at macro, meso, and micro levels are attributed to differences in the preconditions at each level. Copyright © 2011 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  13. Evaluation of the usefulness of computed tomography on diagnosis and management of acute abdomen

    International Nuclear Information System (INIS)

    Sakai, Takehiro; Yagihashi, Nobuo; Osawa, Tadaharu; Harada, Osamu; Ito, Hiroyuki

    2007-01-01

    We evaluated the usefulness of computed tomography (CT) in diagnosing and managing acute abdomen. Subjects were 91 patients admitted complaining of acute abdominal pain and divided into two groups-those undergoing CT within 24 hours of admission (emergency CT group, n=70), those without CT (Non-CT group, n=21). The emergency CT group was subdivided into those with bowel obstruction (bowel obstruction group, n=29), those with acute appendicitis and other diseases necessitating differential diagnosis (appendicitis group, n=36), those with perforation of the digestive tract (perforation group, n=4), and other disease (n=1). We evaluated the accuracy of admission diagnosis retrospectively in each group. The final diagnosis of the bowel obstruction group was adhesive bowel obstruction in 16, colon cancer in 5, external hernia in 3 and other in 5. That in the appendicitis group was acute appendicitis in 25, colonic diverticulitis in 3, pelvic inflammatory disease in 3, ovarian hemorrhage in 2 and other in 5. The origin of perforation in the perforation group was upper digestive tract in 2 and lower digestive tract in 2. The sensitivity, specificity and accuracy of admission diagnosis in the emergency CT group was 91.1, 100 and 91.4%, respectively. The accuracy of admission diagnosis was 96.5% in the bowel obstruction group, 88.9% in the appendicitis group and 75.9% in the perforation group. Patients who could not be diagnosed precisely consisted of 6 patients in the emergency CT group. Those who could not be diagnosed precisely included 3 with pericecal abscess, 1 with acute appendicitis, 1 with stercoral perforation of the sigmoid colon and 1 with impacted bezoar in the small intestine. Evaluated retrospectively, 4 patients were able to be diagnosed by CT on admission. In diagnosis of acute abdomen, CT was useful in differential diagnosis of bowel obstruction and acute appendicitis, detection of fine free air, and determine of perforated sites. Emergency CT was thus

  14. Standardized evaluation of algorithms for computer-aided diagnosis of dementia based on structural MRI

    DEFF Research Database (Denmark)

    Bron, Esther E.; Smits, Marion; van der Flier, Wiesje M.

    2015-01-01

    algorithms based on a clinically representative multi-center data set. Using clinical practice as the starting point, the goal was to reproduce the clinical diagnosis. Therefore, we evaluated algorithms for multi-class classification of three diagnostic groups: patients with probable Alzheimer's disease...... of aging). The best performing algorithm yielded an accuracy of 63.0% and an area under the receiver-operating-characteristic curve (AUC) of 78.8%. In general, the best performances were achieved using feature extraction based on voxel-based morphometry or a combination of features that included volume......Abstract Algorithms for computer-aided diagnosis of dementia based on structural MRI have demonstrated high performance in the literature, but are difficult to compare as different data sets and methodology were used for evaluation. In addition, it is unclear how the algorithms would perform...

  15. Economic evaluation of three surgical interventions for menorrhagia.

    Science.gov (United States)

    Fernandez, Hervé; Kobelt, Giséla; Gervaise, Amélie

    2003-03-01

    The study was carried out to compare the overall effectiveness and direct economic costs of vaginal hysterectomy (VH), endometrial ablation (EA) and thermo-coagulation (TC) for the treatment menorrhagia. We treated 50, 50 and 47 women with menorrhagia (>150 points on the Higham pictorial chart) by VH, EA and TC respectively. The patients were treated consecutively by the same surgeon and the choice between the three procedures depended on the desire of the patients. Resource utilization for the interventions was collected retrospectively from the hospital charts. A study questionnaire was mailed to the patients 24-36 months after the primary surgery. Patients who reported that they had undergone a second procedure or who were still menorrhagic were considered as treatment failures. As expected, the failure rate was lowest for VH. The total cost (without re-intervention for persistent menorrhagia) was 5315 Euros for VH, 1098 Euros for EA and 921 Euros for TC. The total cost with re-intervention was calculated based on therapeutic strategies used in 2001 and estimated at 5321 Euros for VH, 1263 Euros for EA and 1320 Euros for TC. The two out-patient procedures are very comparable in terms of success rates and costs. Choices will depend on budgeting considerations, surgeon skill and patient preference. The results may give guidance to investment decisions.

  16. Evaluation of Computer-Assisted Instruction in Principles of Economics

    Directory of Open Access Journals (Sweden)

    Dennis Coates

    2001-04-01

    Full Text Available Despite increasing use, little is known about the effectiveness of web-based instructional material. This study assesses the effectiveness of supplementary web-based materials and activities in introductory economics courses. We have collected data on 66 students from three principles sections that describe demographic characteristics, use of web-based instructional resources, and performance on graded quizzes and examinations. We use this data to statistically assess the effectiveness of the web-based material. Student utilization of web-based material was extensive. Students frequently used on-line practice quizzes and accessed the web-based material often. A sizable fraction of the students actively posted and read threaded discussions on the course bulletin board. The statistical analysis shows that both on-line computer graded practice quizzes and posting to the class bulletin board are positively correlated with student performance on the quizzes and exams, but use of web-based content and passive reading of bulletin board posts ("lurking" is not. These results suggest that faculty should focus more on developing self-test quizzes and effective bulletin board discussion projects and less on generating on-line content.

  17. Scoliosis circa 2000: radiologic imaging perspective. Pt. 1. Diagnosis and pretreatment evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Oestreich, A.E. [Radiology Department, Children`s Hospital Medical Center, Cincinnati, OH (United States); Young, L.W. [Department of Pediatric Radiology, Loma Linda University Children`s Hospital, CA (United States); Young Poussaint, T. [Department of Radiology, Children`s Hospital, Boston, MA (United States)

    1998-11-01

    Plain film imaging remains important for the diagnosis and surveillance of scoliosis, as well as for the detection of complications after surgery. Advances in CT and MR imaging have greatly improved the ability to detect or confirming nonidiopathic causes of scoliosis, including abnormalities within the spinal canal. Three-dimensional thinking has become more important in evaluating and understanding scoliosis. (orig.) With 11 figs., 3 tabs., 75 refs.

  18. Evaluation of pulse oximeter derived photoplethysmographic signals for obstructive sleep apnea diagnosis

    OpenAIRE

    Li, Yan; Gao, He; Ma, Yan

    2017-01-01

    Abstract High prevalence of obstructive sleep apnea (OSA) has increased the demands for more convenient and accessible diagnostic devices other than standard in-lab polysomnography (PSG). Despite the increasing utility of photoplethysmograph (PPG), it remains understudied in underserved populations. This study aimed to evaluate the reliability of a standard pulse oximeter system with an automated analysis based on the PPG signal for the diagnosis of OSA, as compared with PSG derived measures....

  19. Techno-economic evaluation of various electric energy supply for rural areas Pakistan

    International Nuclear Information System (INIS)

    Nagdev, A.J.; Samo, S.R.

    1994-01-01

    A diagnostic study was carried out to evaluate the techno-economic viability of various electric supply sources for electrification of rural areas in Pakistan in present socio-economic conditions. The important influencing factors considered were: social needs, electric requirement and availability of energy resources. The electric requirements of model rural village were established at 20431 kw h per year. Prudent evaluations reveal that hydroelectric, photovoltaic and diesel systems are better options than an electric grid extension of more than 2 km. In order to become an economically meritorious energy source, photovoltaic system should attain cost level Rs. 100 per watt-peak of installed system. (author)

  20. An Evaluation of the Economic Theoretical Potential of the Rural Environment Mismanged During 1956-2010

    Directory of Open Access Journals (Sweden)

    Florentin Gabriel Niculescu

    2015-09-01

    Full Text Available Under the context of the essential role and growing importance of the rural environment in the development of a country, we focus on evaluating the economic theoretical potential of the rural environment that we consider to have been mismanaged during 1956-2010. For this purpose, in this paper we define, describe and explain the main concepts, as to be able to evaluate the economic potential of the rural development and further contribute to its improvement. The study focuses on the correlations between the population of working age, occupancy, unemployment and the wasted economic potential, putting forward a new concept, statistically valid, demographic named the absolute able overpopulation.

  1. Evaluation of economic traits in progenies of Nigerian heavy ...

    African Journals Online (AJOL)

    Genetic evaluation of egg production and biometrical traits of the first filial generation of the Nigerian heavy ecotype chicken was carried out. Heritability and genetic correlations between the traits were estimated using the mixed model least squares and maximum likelihood computer programme of Harvey. Results show an ...

  2. Techno-economic evaluation of broadband access technologies

    DEFF Research Database (Denmark)

    Sigurdsson, Halldór Matthias; Skouby, Knud Erik

    2005-01-01

    Broadband for all is an essential element in the EU policy concerning the future of ICT-based society. The overall purpose of this paper is to present a model for evaluation of different broadband access technologies and to present some preliminary results based on the model that has been carried...

  3. Economic evaluations of pharmacist-managed services in people with diabetes mellitus: a systematic review.

    Science.gov (United States)

    Wang, Y; Yeo, Q Q; Ko, Y

    2016-04-01

    To review and evaluate the most recent literature on the economic outcomes of pharmacist-managed services in people with diabetes. The global prevalence of diabetes is increasing. Although pharmacist-managed services have been shown to improve people's health outcomes, the economic impact of these programmes remains unclear. A systematic review was conducted of six databases. Study inclusion criteria were: (1) original research; (2) evaluation of pharmacist-managed services in people with diabetes; (3) an economic evaluation; (4) English-language publication; and (5) full-text, published between January 2006 and December 2014. The quality of the full economic evaluations reviewed was evaluated using the Consolidated Health Economic Evaluation Reporting Standards checklist. A total of 2204 articles were screened and 25 studies were selected. These studies were conducted in a community pharmacy (n = 10), a clinic- /hospital-based outpatient facility (n = 8), or others. Pharmacist-managed services included targeted education (n = 24), general pharmacotherapeutic monitoring (n = 21), health screening or laboratory testing services (n = 9), immunization services (n = 2) and pharmacokinetic monitoring (n = 1). Compared with usual care, pharmacist-managed services resulted in cost savings that varied from $7 to $65,000 ($8 to $85,000 in 2014 US dollars) per person per year, and generated higher quality-adjusted life years with lower costs. Benefit-to-cost ratios ranged from 1:1 to 8.5:1. Among the 25 studies reviewed, 11 were full economic evaluations of moderate quality. Pharmacist-managed services had a positive return in terms of economic viability. With the expanding role of pharmacists in the healthcare sector, alongside increasing health expenditure, future economic studies of high quality are needed to investigate the cost-effectiveness of these services. © 2015 Diabetes UK.

  4. Economic evaluation of environmental impacts of open cast mining project - an approach

    International Nuclear Information System (INIS)

    Maiti, S.K.; Pathak, K.

    1998-01-01

    Economic valuation of environmental attributes are pragmatic approach to evaluating the impacts and it helps decision makers to arrive at objective decisions on the basis of cost benefit ratio. For determining the physical impact and its quantification, four evaluation methods, namely-market price method, surrogate market price, survey based and cost based approaches are generally used. The present paper reviews the importance of environmental evaluation of impacts of mining and also reviews a few suitable methodologies that could be effectively used for economic evaluation of environmental impacts in open cast mining projects. (author)

  5. Trial-based economic evaluations in occupational health: principles, methods, and recommendations.

    Science.gov (United States)

    van Dongen, Johanna M; van Wier, Marieke F; Tompa, Emile; Bongers, Paulien M; van der Beek, Allard J; van Tulder, Maurits W; Bosmans, Judith E

    2014-06-01

    To allocate available resources as efficiently as possible, decision makers need information on the relative economic merits of occupational health and safety (OHS) interventions. Economic evaluations can provide this information by comparing the costs and consequences of alternatives. Nevertheless, only a few of the studies that consider the effectiveness of OHS interventions take the extra step of considering their resource implications. Moreover, the methodological quality of those that do is generally poor. Therefore, this study aims to help occupational health researchers conduct high-quality trial-based economic evaluations by discussing the theory and methodology that underlie them, and by providing recommendations for good practice regarding their design, analysis, and reporting. This study also helps consumers of this literature with understanding and critically appraising trial-based economic evaluations of OHS interventions.

  6. Performing Economic Evaluation of Integrated Care: Highway to Hell or Stairway to Heaven?

    Science.gov (United States)

    Stein, K. Viktoria; Evers, Silvia; Rutten-van Mölken, Maureen

    2016-01-01

    Health economists are increasingly interested in integrated care in order to support decision-makers to find cost-effective solutions able to tackle the threat that chronic diseases pose on population health and health and social care budgets. However, economic evaluation in integrated care is still in its early years, facing several difficulties. The aim of this paper is to describe the unique nature of integrated care as a topic for economic evaluation, explore the obstacles to perform economic evaluation, discuss methods and techniques that can be used to address them, and set the basis to develop a research agenda for health economics in integrated care. The paper joins the voices that call health economists to pay more attention to integrated care and argues that there should be no more time wasted for doing it. PMID:28316543

  7. Economic Evaluation of the Production Magnesium Oxide Nanoparticles via Liquid-Phase Route

    Science.gov (United States)

    Nandiyanto, A. B. D.; Fariansyah, R.; Ramadhan, M. F.; Abdullah, A. G.; Widiaty, I.

    2018-02-01

    The purpose of this study was to evaluate the production of magnesium oxide (MgO) nanoparticles. The evaluation was done in two perspectives: engineering and economic evaluation. The engineering perspective concerned about the analysis of the production rate based on the available apparatuses and raw materials, completed with mass balance calculation. The economic analysis was conducted based on several economic parameters: gross profit margin (GPM), internal return rate (IRR), payback period (PBP), cumulative net present value (CNPV), break even point (BEP), and profit to investment (PI). The engineering perspective showed that the production of MgO is feasibly done in small scale industry. This is verified by the potential production using current available apparatuses and raw materials in the market. Economic analysis obtained that the present project is profitable. But, for some cases, further studies must be done to get the present production process is attractive for investor.

  8. THE ECONOMIC EVALUATION METHOD OF LAND RESOURCES OF AGRARIAN NOMINATION WITH THEIR REGIONAL REPRODUCTION PECULIARITIES

    Directory of Open Access Journals (Sweden)

    R.Sh. Shafeyev

    2009-03-01

    Full Text Available Peculiarities of land market formation and peculiarities of its function in modern (up-to-date environment are covered in this article. The objective necessity of governmental regulation is shown. In authors opinion the economic regulation of land market is the most important part of the system. Economic regulation mechanism is realized in correlation with economic land evaluation. Cadastre evaluation that is applied today does not reflect the true land value, but it is used as a basis for the land rent rat estimation and the initial selling price. The alternative way of land resource evaluation that is offered in the article reflects the change of country economic situation more real and is able to influence objectively on the land relations regulation decision making process.

  9. Using the Delphi technique in economic evaluation: time to revisit the oracle?

    Science.gov (United States)

    Simoens, S

    2006-12-01

    Although the Delphi technique has been commonly used as a data source in medical and health services research, its application in economic evaluation of medicines has been more limited. The aim of this study was to describe the methodology of the Delphi technique, to present a case for using the technique in economic evaluation, and to provide recommendations to improve such use. The literature was accessed through MEDLINE focusing on studies discussing the methodology of the Delphi technique and economic evaluations of medicines using the Delphi technique. The Delphi technique can be used to provide estimates of health care resources required and to modify such estimates when making inter-country comparisons. The Delphi technique can also contribute to mapping the treatment process under investigation, to identifying the appropriate comparator to be used, and to ensuring that the economic evaluation estimates cost-effectiveness rather than cost-efficacy. Ideally, economic evaluations of medicines should be based on real-patient data. In the absence of such data, evaluations need to incorporate the best evidence available by employing approaches such as the Delphi technique. Evaluations based on this approach should state the limitations, and explore the impact of the associated uncertainty in the results.

  10. A systematic review of economic evaluations of health and health-related interventions in Bangladesh

    Directory of Open Access Journals (Sweden)

    Koehlmoos Tracey P

    2011-07-01

    Full Text Available Abstract Background Economic evaluation is used for effective resource allocation in health sector. Accumulated knowledge about economic evaluation of health programs in Bangladesh is not currently available. While a number of economic evaluation studies have been performed in Bangladesh, no systematic investigation of the studies has been done to our knowledge. The aim of this current study is to systematically review the published articles in peer-reviewed journals on economic evaluation of health and health-related interventions in Bangladesh. Methods Literature searches was carried out during November-December 2008 with a combination of key words, MeSH terms and other free text terms as suitable for the purpose. A comprehensive search strategy was developed to search Medline by the PubMed interface. The first specific interest was mapping the articles considering the areas of exploration by economic evaluation and the second interest was to scrutiny the methodological quality of studies. The methodological quality of economic evaluation of all articles has been scrutinized against the checklist developed by Evers Silvia and associates. Result Of 1784 potential articles 12 were accepted for inclusion. Ten studies described the competing alternatives clearly and only two articles stated the perspective of their articles clearly. All studies included direct cost, incurred by the providers. Only one study included the cost of community donated resources and volunteer costs. Two studies calculated the incremental cost effectiveness ratio (ICER. Six of the studies applied some sort of sensitivity analysis. Two of the studies discussed financial affordability of expected implementers and four studies discussed the issue of generalizability for application in different context. Conclusion Very few economic evaluation studies in Bangladesh are found in different areas of health and health-related interventions, which does not provide a strong basis

  11. A systematic review of economic evaluations of health and health-related interventions in Bangladesh

    Science.gov (United States)

    2011-01-01

    Background Economic evaluation is used for effective resource allocation in health sector. Accumulated knowledge about economic evaluation of health programs in Bangladesh is not currently available. While a number of economic evaluation studies have been performed in Bangladesh, no systematic investigation of the studies has been done to our knowledge. The aim of this current study is to systematically review the published articles in peer-reviewed journals on economic evaluation of health and health-related interventions in Bangladesh. Methods Literature searches was carried out during November-December 2008 with a combination of key words, MeSH terms and other free text terms as suitable for the purpose. A comprehensive search strategy was developed to search Medline by the PubMed interface. The first specific interest was mapping the articles considering the areas of exploration by economic evaluation and the second interest was to scrutiny the methodological quality of studies. The methodological quality of economic evaluation of all articles has been scrutinized against the checklist developed by Evers Silvia and associates. Result Of 1784 potential articles 12 were accepted for inclusion. Ten studies described the competing alternatives clearly and only two articles stated the perspective of their articles clearly. All studies included direct cost, incurred by the providers. Only one study included the cost of community donated resources and volunteer costs. Two studies calculated the incremental cost effectiveness ratio (ICER). Six of the studies applied some sort of sensitivity analysis. Two of the studies discussed financial affordability of expected implementers and four studies discussed the issue of generalizability for application in different context. Conclusion Very few economic evaluation studies in Bangladesh are found in different areas of health and health-related interventions, which does not provide a strong basis of knowledge in the area. The

  12. A review of typhoid fever transmission dynamic models and economic evaluations of vaccination.

    Science.gov (United States)

    Watson, Conall H; Edmunds, W John

    2015-06-19

    Despite a recommendation by the World Health Organization (WHO) that typhoid vaccines be considered for the control of endemic disease and outbreaks, programmatic use remains limited. Transmission models and economic evaluation may be informative in decision making about vaccine programme introductions and their role alongside other control measures. A literature search found few typhoid transmission models or economic evaluations relative to analyses of other infectious diseases of similar or lower health burden. Modelling suggests vaccines alone are unlikely to eliminate endemic disease in the short to medium term without measures to reduce transmission from asymptomatic carriage. The single identified data-fitted transmission model of typhoid vaccination suggests vaccines can reduce disease burden substantially when introduced programmatically but that indirect protection depends on the relative contribution of carriage to transmission in a given setting. This is an important source of epidemiological uncertainty, alongside the extent and nature of natural immunity. Economic evaluations suggest that typhoid vaccination can be cost-saving to health services if incidence is extremely high and cost-effective in other high-incidence situations, when compared to WHO norms. Targeting vaccination to the highest incidence age-groups is likely to improve cost-effectiveness substantially. Economic perspective and vaccine costs substantially affect estimates, with disease incidence, case-fatality rates, and vaccine efficacy over time also important determinants of cost-effectiveness and sources of uncertainty. Static economic models may under-estimate benefits of typhoid vaccination by omitting indirect protection. Typhoid fever transmission models currently require per-setting epidemiological parameterisation to inform their use in economic evaluation, which may limit their generalisability. We found no economic evaluation based on transmission dynamic modelling, and no

  13. A systematic review of economic evaluations of treatments for patients with epilepsy.

    Science.gov (United States)

    Wijnen, Ben F M; van Mastrigt, Ghislaine A P G; Evers, Silvia M A A; Gershuni, Olga; Lambrechts, Danielle A J E; Majoie, Marian H J M; Postulart, Debby; Aldenkamp, Bert A P; de Kinderen, Reina J A

    2017-05-01

    The increasing number of treatment options and the high costs associated with epilepsy have fostered the development of economic evaluations in epilepsy. It is important to examine the availability and quality of these economic evaluations and to identify potential research gaps. As well as looking at both pharmacologic (antiepileptic drugs [AEDs]) and nonpharmacologic (e.g., epilepsy surgery, ketogenic diet, vagus nerve stimulation) therapies, this review examines the methodologic quality of the full economic evaluations included. Literature search was performed in MEDLINE, EMBASE, NHS Economic Evaluation Database (NHS EED), Econlit, Web of Science, and CEA Registry. In addition, Cochrane Reviews, Cochrane DARE and Cochrane Health Technology Assessment Databases were used. To identify relevant studies, predefined clinical search strategies were combined with a search filter designed to identify health economic studies. Specific search strategies were devised for the following topics: (1) AEDs, (2) patients with cognitive deficits, (3) elderly patients, (4) epilepsy surgery, (5) ketogenic diet, (6) vagus nerve stimulation, and (7) treatment of (non)convulsive status epilepticus. A total of 40 publications were included in this review, 29 (73%) of which were articles about pharmacologic interventions. Mean quality score of all articles on the Consensus Health Economic Criteria (CHEC)-extended was 81.8%, the lowest quality score being 21.05%, whereas five studies had a score of 100%. Looking at the Consolidated Health Economic Evaluation Reporting Standards (CHEERS), the average quality score was 77.0%, the lowest being 22.7%, and four studies rated as 100%. There was a substantial difference in methodology in all included articles, which hampered the attempt to combine information meaningfully. Overall, the methodologic quality was acceptable; however, some studies performed significantly worse than others. The heterogeneity between the studies stresses the need to

  14. Economic evaluation of epinephrine auto-injectors for peanut allergy.

    Science.gov (United States)

    Shaker, Marcus; Bean, Katherine; Verdi, Marylee

    2017-08-01

    Three commercial epinephrine auto-injectors were available in the United States in the summer of 2016: EpiPen, Adrenaclick, and epinephrine injection, USP auto-injector. To describe the variation in pharmacy costs among epinephrine auto-injector devices in New England and evaluate the additional expense associated with incremental auto-injector costs. Decision analysis software was used to evaluate costs of the most and least expensive epinephrine auto-injector devices for children with peanut allergy. To evaluate regional variation in epinephrine auto-injector costs, a random sample of New England national and corporate pharmacies was compared with a convenience sample of pharmacies from 10 Canadian provinces. Assuming prescriptions written for 2 double epinephrine packs each year (home and school), the mean costs of food allergy over the 20-year model horizon totaled $58,667 (95% confidence interval [CI] $57,745-$59,588) when EpiPen was prescribed and $45,588 (95% CI $44,873-$46,304) when epinephrine injection, USP auto-injector was prescribed. No effectiveness differences were evident between groups, with 17.19 (95% CI 17.11-17.27) quality-adjusted life years accruing for each subject. The incremental cost per episode of anaphylaxis treated with epinephrine over the model horizon was $12,576 for EpiPen vs epinephrine injection, USP auto-injector. EpiPen costs were lowest at Canadian pharmacies ($96, 95% CI $85-$107). There was price consistency between corporate and independent pharmacies throughout New England by device brand, with the epinephrine injection, USP auto-injector being the most affordable device. Cost differences among epinephrine auto-injectors were significant. More expensive auto-injector brands did not appear to provide incremental benefit. Copyright © 2017 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  15. Micro economic evaluations of transferal tariffs and income framework

    International Nuclear Information System (INIS)

    Wangensteen, Ivar; Groenli, Helle

    2000-01-01

    The report discusses conditions of transferral tariffs as micro economic measures in the income-regulating frameworks of today. The process from aim to implementation of the tariff measures is described and the conditions as the tariff goal, segmenting of the customers and their price sensitivity are discussed. The report deals specifically with construction grants and connection fees. Connection fees are proposed as measures in order to influence dimensioning, while construction grants may be suitable in certain conditions for influencing the localisation. These measures would have different effects on the network companies' incomes and costs also due to the accounting regulations. A selection of tariff measures is proposed that illuminate the problems of the network companies. ''How shall the present income frames be distributed among the customers in order to stimulate the reduction of the costs and an increase of the income framework.'' The tariff measures are illustrated by specific numeric examples and the influence on incomes and costs are discussed. Examples of tariff measures are: Do not use the connection fee but rather the construction grant or increase the firm power part, only use the energy part, effect part or the firm power part. Solely altering of the tariff parts may result in the following: 1) Altering the firm power part: An increase would give a more stable yearly profit. 2) Altering of the energy part: An increase would promote a reduced consumption and thereby negatively influence a possible increase in the income frames. An increase may on the other hand reduce the costs of loss and delay investments. 3) Altering of the effect part: An increase would promote reduced maximal effects, lower the costs of loss and delay investments. 4) Reducing the connection fee would increase the maximum construction grant that could be applied for. This would result in a larger part of the construction costs could be covered within the income frames and would

  16. Evaluation of economic efficiency of process improvement in food packaging

    Directory of Open Access Journals (Sweden)

    Jana Hron

    2012-01-01

    Full Text Available In general, we make gains in process by the three fundamental ways. First, we define or redefine our process in a strategic sense. Second, once defined or redefined, we commence process operations and use process control methods to target and stabilize our process. Third, we use process improvement methods, as described in this paper, along with process control to fully exploit our process management and/or technology. Process improvement is focused primarily in our subprocesses and sub-subprocesses. Process leverage is the key to process improvement initiatives. This means that small improvements of the basic manufacturing operations can have (with the assumption of mass repetition of the operation a big impact on the functioning of the whole production unit. The complexity within even small organizations, in people, products, and processes, creates significant challenges in effectively and efficiently using these initiatives tools. In this paper we are going to place process purposes in the foreground and initiatives and tools in the background as facilitator to help accomplish process purpose. Initiatives and tools are not the ends we are seeking; result/outcomes in physical, economics, timeliness, and customer service performance matter. In the paper process boundaries (in a generic sense are set by our process purpose and our process definition. Process improvement is initiated within our existing process boundaries. For example, in a fast-food restaurant, if we define our cooking process around a frying technology, then we provide process improvements within our frying technology. On the other hand, if we are considering changing to a broiling technology, then we are likely faced with extensive change, impacting our external customers, and a process redefinition may be required. The result / aim of the paper are based on the example of the process improving of a food packaging quality. Specifically, the integration of two approaches

  17. ECONOMIC EVALUATION OF CO2 STORAGE AND SINK ENHANCEMENT OPTIONS

    Energy Technology Data Exchange (ETDEWEB)

    Bert Bock; Richard Rhudy; Howard Herzog; Michael Klett; John Davison; Danial G. De La Torre Ugarte; Dale Simbeck

    2003-02-01

    This project developed life-cycle costs for the major technologies and practices under development for CO{sub 2} storage and sink enhancement. The technologies evaluated included options for storing captured CO{sub 2} in active oil reservoirs, depleted oil and gas reservoirs, deep aquifers, coal beds, and oceans, as well as the enhancement of carbon sequestration in forests and croplands. The capture costs for a nominal 500 MW{sub e} integrated gasification combined cycle plant from an earlier study were combined with the storage costs from this study to allow comparison among capture and storage approaches as well as sink enhancements.

  18. Energetic and economic evaluations on hydrogen storage technologies

    Energy Technology Data Exchange (ETDEWEB)

    Arca, S.; Di Profio, P.; Germani, R. [Perugia Univ., Perugia (Italy). Centro di Eccellenza Materiali Innovativi Nanostrutturati, Dip. Chimica; Savelli, G.; Cotana, F.; Rossi, F.; Amantini, M. [Universita degli Studi di Perugia, Perugia (Italy). Dipartimento di Ingegneria Industriale, Sezione di Fisica Tecnica

    2008-07-01

    With the development of the hydrogen economy and fuel cell vehicles, a major technological issue has emerged regarding the storage and delivery of large amounts of hydrogen. Several hydrogen storage methodologies are available while other technologies are being developed aside from the classical compression and liquefaction of hydrogen. A novel technology is also in rapid process, which is based on clathrate hydrates of hydrogen. The features and performances of available storage systems were evaluated in an effort to determine the best technology throughout the hydrogen chain. For each of the storage solutions presented, the key parameters were compared. These key parameters included interaction energy between hydrogen and support; real and practical storage capacity; and specific energy consumption. The paper presented the study methods and discussed hydrogen storage technologies using compressed hydrogen; metal hydrides; liquefied hydrogen; carbon nanotubes; ammonia; and gas hydrates. Carbon dioxide emissions were also evaluated for each storage system analyzed. The paper also presented the worst scenario. It was concluded that a technology based on clathrate hydrates of hydrogen, while being far from optimized, was highly competitive with the classical approaches. 21 refs., 9 figs.

  19. Optimizing chronic disease management mega-analysis: economic evaluation.

    Science.gov (United States)

    2013-01-01

    As Ontario's population ages, chronic diseases are becoming increasingly common. There is growing interest in services and care models designed to optimize the management of chronic disease. To evaluate the cost-effectiveness and expected budget impact of interventions in chronic disease cohorts evaluated as part of the Optimizing Chronic Disease Management mega-analysis. Sector-specific costs, disease incidence, and mortality were calculated for each condition using administrative databases from the Institute for Clinical Evaluative Sciences. Intervention outcomes were based on literature identified in the evidence-based analyses. Quality-of-life and disease prevalence data were obtained from the literature. Analyses were restricted to interventions that showed significant benefit for resource use or mortality from the evidence-based analyses. An Ontario cohort of patients with each chronic disease was constructed and followed over 5 years (2006-2011). A phase-based approach was used to estimate costs across all sectors of the health care system. Utility values identified in the literature and effect estimates for resource use and mortality obtained from the evidence-based analyses were applied to calculate incremental costs and quality-adjusted life-years (QALYs). Given uncertainty about how many patients would benefit from each intervention, a system-wide budget impact was not determined. Instead, the difference in lifetime cost between an individual-administered intervention and no intervention was presented. Of 70 potential cost-effectiveness analyses, 8 met our inclusion criteria. All were found to result in QALY gains and cost savings compared with usual care. The models were robust to the majority of sensitivity analyses undertaken, but due to structural limitations and time constraints, few sensitivity analyses were conducted. Incremental cost savings per patient who received intervention ranged between $15 per diabetic patient with specialized nursing to

  20. Evaluation of the economic burden of leprosy among migrant and resident patients in Guangdong Province, China.

    Science.gov (United States)

    Xiong, Mingzhou; Li, Ming; Zheng, Daocheng; Wang, Xiaohua; Su, Ting; Chen, Yongfeng; Yang, Bin

    2017-12-11

    A lot of time and money was needed during the diagnosis and treatment process of leprosy, the delayed leprosy would also impair the labor capability of patients as well, and these put a heavy burden for the leprosy patients. The migrant leprosy patient is a special group and need more concern. Our goal was to assess the economic burden of leprosy on migrant and resident patient populations in Guangdong province, China. We conducted a population-based cross-sectional survey from February to July of 2016. A self-designed questionnaire was administered to leprosy patients who: (1) had registered in Leprosy Management Information System in China (LEPMIS) by the end of February 2016, (2) had received multiple drug treatment (MDT) drugs at a local leprosy control institution for three consecutive months or had had at least one physical check in the past half year, and (3) were willing to take part in the investigation and give informed written consent. Demographic characteristics, Financial and disease information, and costs before and after leprosy diagnosis were collected and compared using t-test and χ2 test. A total of 254 participants completed the questionnaires, including 168 males and 86 females. Migrants and residents accounted for 33.9% and 66.1% of patients, respectively. Among migrant patients, the median cost before diagnosis was $131.6 (39.2-450.9), the median yearly cost of leprosy treatment after diagnosis was $300.6 (158.4-868.5), and the median yearly cost of leprosy complications was $69.5 (11-178.4). In comparison, among residents the median yearly costs were $152.4 (30.7-770.9) pre-diagnosis, $309.7 (103.2-1016.7) after diagnosis, and $91.9 (32.6-303.1) for leprosy complications. Base on this, we determined that the median yearly total expense after diagnosis amounted to 15% of migrant and 38% of resident patients' annual income. Leprosy places a heavy economic burden on both migrant and resident leprosy patients and governmental policies and

  1. Comparison of economic evaluation methodology between levelized method and the evaluation system in China

    International Nuclear Information System (INIS)

    Zhang Shengli

    2005-01-01

    Different methodology would bring different results. This paper includes an introduction of levelized discounted generation cost methodology as well as that of Chinese system, respectively. In general, there have two key indices in Chinese evaluation system, they are generation cost and electricity sales price to the grid. This paper contains a description of cost breakdown and calculation procedure for each index. Comparison between these two methods and the primary differences are also included. For the first time, equations for calculating generation cost and selling price to the grid based on Chinese system have been derived, and its accuracy has been shown through running the special computer program. The two systems are quite different in many aspects. Firstly, levelized generation cost is always calculated with discounted method that excluded in Chinese system. Secondly, levelized generation cost is a single and constant value that would not change over the economic life while generation cost in Chinese system is estimated on a year by year base. Thirdly, the makeup of generation cost in Chinese system is different from that of levelized system since taxes and dividend share removed. Finally, the electricity sales price in Chinese system is more similar to levelized generation cost. (authors)

  2. Social Intuition and Social Information in Physical Child Abuse Evaluation and Diagnosis.

    Science.gov (United States)

    Keenan, Heather T; Cook, Lawrence J; Olson, Lenora M; Bardsley, Tyler; Campbell, Kristine A

    2017-11-01

    Poor and minority children with injuries concerning for abuse are evaluated and diagnosed for abuse differentially. We hypothesized that 2 steps in the decision-making process would influence evaluation and diagnosis: social intuition from meeting the family and objective social information associated with child abuse risk. Between 2009 and 2013, 32 child abuse pediatricians (CAPs) submitted 730 child abuse consultations including original medical evaluations and diagnoses. CAPs evaluated and diagnosed each other's cases. Comparisons of evaluations and diagnoses were made by levels of social understanding available to the CAP: meeting the family (social intuition and information), reading the case (social information), and reading the case without social information. Evaluations were compared with a consensus gold standard by using logistic regression modeling adjusting for child and CAP characteristics. Diagnostic categories were compared by level of social understanding and diagnostic certainty by using contingency tables. CAPs without access to social intuition were approximately twice as likely to perform gold standard evaluations for neurotrauma and long bone fracture compared with CAPs who met families. Diagnostic agreement fell from 73.3% (95% confidence interval [CI]: 70.1%-76.5%) when social information was present to 66.5% (95% CI: 63.1%-70.0%) when social information was restricted. In cases with less certainty, agreement dropped to 51.3% (95% CI: 46.0%-56.7%). Social intuition and information play a role in the physical child abuse decision-making process, which may contribute to differential diagnosis. Simple interventions including decision tools, check lists, and peer review may structure evaluations to ensure children's equal treatment. Copyright © 2017 by the American Academy of Pediatrics.

  3. Evaluation of clinical value of combined tumor markers detection in diagnosis of lung cancer

    International Nuclear Information System (INIS)

    Zhang Guangming; Deng Shouzhen; Wang Yun; Xu Lianqin; He Wanting; Gao Quan; Lin Xiangtong

    2002-01-01

    To evaluate clinical value of single or combined tumor marker detection CY21-1, CEA, CA15-3 and SCC in the diagnosis of lung cancer. There was retrospective analysis of 87 lung cancer inpatients, all of them was confirmed by pathology. Results showed: (1) Sensitivity of CY21-1, CEA, CA15-3 and SCC by single detection in diagnosing lung cancer was 59.8%, 39.1%, 44.8%, 18.4%, respectively. (2) Sensitivity of group I (CY21-1 + CEA) was 78.2%; sensitivity of group II (CY21-1 + CEA + CA15-3) was 88.5%; sensitivity of group III (CY21-1 + CEA + CA15-3 + SCC) was the same as group II. In the diagnosis of lung cancer, the combined detection with CY21-1, CEA, CA15-3 was an ideal selective combination

  4. Evaluation of the Effect of Consultant Characteristics on Telemedicine Diagnosis and Treatment

    Directory of Open Access Journals (Sweden)

    Ann B. Bynum

    2011-01-01

    Full Text Available This study examined teleconsultants' specialty, practice setting, type of employment, years and training in telemedicine to evaluate the effect of these characteristics on diagnoses and treatment. A postuse survey was conducted during 1998–2003 (n=454 consultations in the University of Arkansas for Medical Sciences' Rural Hospital, Telehealth Project. There were 61 consultants who conducted the teleconsultations. The teleconsultants established a diagnosis in 121 consultations and reported a change in diagnoses in 29 consultations. The consultants established a treatment plan in 219 consultations and reported a change in the treatment plan in 100 consultations. Dermatologists were significantly more likely to establish (P<.01 and change (P=.005 the diagnosis and to establish a treatment plan (P=.03, when compared to all other specialties. Teleconsultants who were self-employed were significantly more likely to change the treatment plan (P=.012. The findings suggest that teleconsultants' characteristics can affect diagnoses and treatment in telemedicine.

  5. Evaluation of economic impact of climatic change on agro-forestry systems

    Directory of Open Access Journals (Sweden)

    Vittorio Gallerani

    Full Text Available Climate change has a strong influence on agro-forestry systems. Present estimations evisage that changes in climate patterns and extreme events connected to climate change will have greater impacts in the future. This paper seeks to illustrate the articulation of the problems concerning the economic evaluation of climate change, with particularly attention to open problems and future lines of research. Research on this topic, though using methods and approaches consolidated in the disciplines of resource economics and evaluation, still have several open problems, particularly in the field of multidisciplinary studies of the man-environmental relations, policy evaluation and development of decision support systems for decision makers.

  6. Integrated Emergy and Economic Evaluation of Tea Production Chains in Anxi, China

    Science.gov (United States)

    Emergy and economic methods were used to evaluate and compare tea production systems in Anxi, China. Tea production was classified into three phases, i.e., the nursery, the plantation and tea processing, and each phase was evaluated. The results showed that the nursery subsystems...

  7. The economic evaluation of a Participatory Ergonomics programme to prevent low back and neck pain

    NARCIS (Netherlands)

    Driessen, M.; Bosmans, J.; Proper, K.; Anema, J.; Bongers, P.; Beek, A. van der

    2012-01-01

    This study was an economic evaluation conducted alongside a cluster randomised controlled trial with a follow-up of 12 months. The aim was to evaluate the cost-effectiveness and cost-benefit of the Stay@Work Participatory Ergonomics programme (PE) compared to a control group (no PE). In total, 37

  8. Evaluating Effective Teaching in College Level Economics Using Student Ratings of Instruction: A Factor Analytic Approach

    Science.gov (United States)

    Agbetsiafa, Douglas

    2010-01-01

    This paper explores the factors that affect students' evaluation of economic instruction using a sample of 1300 completed rating instruments at a comprehensive four-year mid-western public university. The study uses factor analysis to determine the validity and reliability of the evaluation instrument in assessing instructor or course…

  9. Economic gains stimulate negative evaluations of corporate sustainability initiatives

    Science.gov (United States)

    Makov, Tamar; Newman, George E.

    2016-09-01

    In recent years, many organizations have sought to align their financial goals with environmental ones by identifying strategies that maximize profits while minimizing environmental impacts. Examples of this `win-win' approach can be found across a wide range of industries, from encouraging the reuse of hotel towels, to the construction of energy efficient buildings, to the large-scale initiatives of multi-national corporations. Although win-win strategies are generally thought to reflect positively on the organizations that employ them, here we find that people tend to respond negatively to the notion of profiting from environmental initiatives. In fact, observers may evaluate environmental win-wins less favourably than profit-seeking strategies that have no environmental benefits. The present studies suggest that how those initiatives are communicated to the general public may be of central importance. Therefore, organizations would benefit from carefully crafting the discourse around their win-win initiatives to ensure that they avoid this type of backlash.

  10. Evaluation of an advanced physical diagnosis course using consumer preferences methods: the nominal group technique.

    Science.gov (United States)

    Coker, Joshua; Castiglioni, Analia; Kraemer, Ryan R; Massie, F Stanford; Morris, Jason L; Rodriguez, Martin; Russell, Stephen W; Shaneyfelt, Terrance; Willett, Lisa L; Estrada, Carlos A

    2014-03-01

    Current evaluation tools of medical school courses are limited by the scope of questions asked and may not fully engage the student to think on areas to improve. The authors sought to explore whether a technique to study consumer preferences would elicit specific and prioritized information for course evaluation from medical students. Using the nominal group technique (4 sessions), 12 senior medical students prioritized and weighed expectations and topics learned in a 100-hour advanced physical diagnosis course (4-week course; February 2012). Students weighted their top 3 responses (top = 3, middle = 2 and bottom = 1). Before the course, 12 students identified 23 topics they expected to learn; the top 3 were review sensitivity/specificity and high-yield techniques (percentage of total weight, 18.5%), improving diagnosis (13.8%) and reinforce usual and less well-known techniques (13.8%). After the course, students generated 22 topics learned; the top 3 were practice and reinforce advanced maneuvers (25.4%), gaining confidence (22.5%) and learn the evidence (16.9%). The authors observed no differences in the priority of responses before and after the course (P = 0.07). In a physical diagnosis course, medical students elicited specific and prioritized information using the nominal group technique. The course met student expectations regarding education of the evidence-based physical examination, building skills and confidence on the proper techniques and maneuvers and experiential learning. The novel use for curriculum evaluation may be used to evaluate other courses-especially comprehensive and multicomponent courses.

  11. Economic Evaluations of Strategies to Prevent Hospital-Acquired Pressure Injuries.

    Science.gov (United States)

    Ocampo, Wrechelle; Cheung, Amanda; Baylis, Barry; Clayden, Nancy; Conly, John M; Ghali, William A; Ho, Chester H; Kaufman, Jaime; Stelfox, Henry T; Hogan, David B

    2017-07-01

    To provide information from a review of literature about economic evaluations of preventive strategies for pressure injuries (PIs). This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. After participating in this educational activity, the participant should be better able to:1. Identify the purpose and methods used for this study.2. Compare costs and effectiveness related to preventative strategies for PIs. BACKGROUND: Pressure injuries (PIs) are a common and resource-intensive challenge for acute care hospitals worldwide. While a number of preventive strategies have the potential to reduce the cost of hospital-acquired PIs, it is unclear what approach is the most effective. The authors performed a narrative review of the literature on economic evaluations of preventive strategies to survey current findings and identify important factors in economic assessments. Ovid, MEDLINE, NHS Economic Evaluation Databases, and the Cochrane Database of Systematic ReviewsSELECTION CRITERIA: Potentially relevant original research articles and systematic reviews were considered. Selection criteria included articles that were written in English, provided data on cost or economic evaluations of preventive strategies of PIs in acute care, and published between January 2004 and September 2015. Data were abstracted from the articles using a standardized approach to evaluate how the items on the Consolidated Health Economic Evaluation Reporting Standards checklist were addressed. The searches identified 192 references. Thirty-three original articles were chosen for full-text reviews. Nineteen of these articles provided clear descriptions of interventions, study methods, and outcomes considered. Limitations in the available literature prevent firm conclusions from being reached about the relative economic merits of the various approaches to the prevention of PIs. The authors' review

  12. A systematic review and overview of health economic evaluations of emergency laparotomy

    Directory of Open Access Journals (Sweden)

    Sohail Bampoe

    2017-11-01

    Full Text Available Abstract Background Little is known about the economic impact of emergency laparotomy (EL surgery in healthcare systems around the world. The aim of this systematic review is to describe the primary resource utilisation, healthcare economic and societal costs of EL in adults in different countries. Methods MEDLINE, EMBASE, ISI Web of Knowledge, Cochrane Central Register Controlled Trials, Cochrane Database of Systematic Reviews and CINAHL were searched for full and partial economic analyses of EL published between 1 January 1991 and 31 December 2015. Quality of studies was assessed using the Consensus on Health Economic Criteria (CHEC checklist. Results Sixteen studies were included from a range of countries. One study was a full economic analysis. Fifteen studies were partial economic evaluations. These studies revealed that emergency abdominal surgery is expensive compared to similar elective surgery when comparing primary resource utilisation costs, with an important societal impact. Most contemporaneous studies indicate that in-hospital costs for EL are in excess of US$10,000 per patient episode, rising substantially when societal costs are considered. Discussion EL is a high-risk and costly procedure with a disproportionate financial burden for healthcare providers, relative to national funding provisions and wider societal cost impact. There is substantial heterogeneity in the methodologies and quality of published economic evaluations of EL; therefore, the true economic costs of EL are yet to be fully defined. Future research should focus on developing strategies to embed health economic evaluations within national programmes aiming to improve EL care, including developing the required measures and infrastructure. Conclusions Emergency laparotomy is expensive, with a significant cost burden to healthcare and systems and society worldwide. Novel strategies for reducing this econmic burden should urgently be explored if greater access to

  13. A systematic review and overview of health economic evaluations of emergency laparotomy.

    Science.gov (United States)

    Bampoe, Sohail; Odor, Peter M; Ramani Moonesinghe, S; Dickinson, Matthew

    2017-01-01

    Little is known about the economic impact of emergency laparotomy (EL) surgery in healthcare systems around the world. The aim of this systematic review is to describe the primary resource utilisation, healthcare economic and societal costs of EL in adults in different countries. MEDLINE, EMBASE, ISI Web of Knowledge, Cochrane Central Register Controlled Trials, Cochrane Database of Systematic Reviews and CINAHL were searched for full and partial economic analyses of EL published between 1 January 1991 and 31 December 2015. Quality of studies was assessed using the Consensus on Health Economic Criteria (CHEC) checklist. Sixteen studies were included from a range of countries. One study was a full economic analysis. Fifteen studies were partial economic evaluations. These studies revealed that emergency abdominal surgery is expensive compared to similar elective surgery when comparing primary resource utilisation costs, with an important societal impact. Most contemporaneous studies indicate that in-hospital costs for EL are in excess of US$10,000 per patient episode, rising substantially when societal costs are considered. EL is a high-risk and costly procedure with a disproportionate financial burden for healthcare providers, relative to national funding provisions and wider societal cost impact. There is substantial heterogeneity in the methodologies and quality of published economic evaluations of EL; therefore, the true economic costs of EL are yet to be fully defined. Future research should focus on developing strategies to embed health economic evaluations within national programmes aiming to improve EL care, including developing the required measures and infrastructure. Emergency laparotomy is expensive, with a significant cost burden to healthcare and systems and society worldwide. Novel strategies for reducing this econmic burden should urgently be explored if greater access to this type of surgery is to be pursued as a global health target. PROSPERO

  14. Economic Evaluation for Energy Business Using Real Options Pricing Method

    Energy Technology Data Exchange (ETDEWEB)

    Yun, W.C. [Korea Energy Economics Institute, Euiwang (Korea)

    2001-11-01

    Recently, facing the new era of restructuring, privatization, and liberalization the energy industry in the world is changing rapidly, and thus the uncertain factors tend to increase. This would imply that energy-related business is now confronted with new market risks as well as the simple price risks. The traditional investment valuation method using the concept of net present value (NPV) or internal rate of revenue (IRR) might not incorporate the managerial alternatives which enable managers to respond flexibly to the changes in business environment. This study pointed out the problems of the traditional discounted cash flow (DCF) method when evaluating a certain capital investment in energy industry. As an alternative, the real option pricing method (ROPM) was proposed, which is widely adopted in the field of profit projection for the venture business. In addition, when applying to energy sector the feasibility of ROPM was discussed, and the frameworks and major results of previous related studies were described. For those using the ROPM in real business, I explained the detailed procedures and solutions of ROPM, and introduced the log-transformed binomial model which provides a more efficient solution. In order to verify the usefulness of the ROPM, this study performed an empirical analysis for a virtual construction and operation project of power plant. And, the results from the ROPM was compared to those from the traditional DCF method. Based on the empirical results, the values of various investment opportunities were shown to be high. Therefore, the project not justified in terms of traditional DCF would turn into the project with a positive gross project value, properly reflecting managerial flexibilities inherent in the original project. (author). 58 refs., 32 figs., 33 tabs.

  15. Economic evaluation of treatments for chronic hepatitis B

    Directory of Open Access Journals (Sweden)

    Astrid Wiens

    Full Text Available The aim of this study was to conduct a cost-utility study of adefovir, entecavir, interferon alpha, pegylated interferon alpha, lamivudine and tenofovir for chronic hepatitis B in the context of Brazilian Public Health Care System. A systematic review was carried out for efficacy and safety. Another review was performed to collect utility data and transition probabilities between health states. A Markov model was developed in a time horizon of 40 years with annual cycles for three groups of: HBeAg positive, HBeAg negative, and all patients. These strategies were compared to a fourth group that received no treatment. Discount rates of 5% were applied and sensitivity analyses were performed. Tenofovir offered the best cost-utility ratio for the three evaluated models: U$397, U$385 and U$384 (per QALY, respectively, for HBeAg positive, negative, and all patients. All other strategies were completely dominated because they showed higher costs and lower effectiveness than tenofovir. The sequence of cost-utility in the three models was: tenofovir, entecavir, lamivudine, adefovir, telbivudine, pegylated interferon alpha, and interferon alpha. In the sensitivity analysis, adefovir showed lower cost-utility than telbivudine in some situations. The study has some limitations, primarily related to the creation of scenarios and modeling. In this study, tenofovir presented the best cost-utility ratio. The results obtained in this study will be valuable in decision-making and in the review of the clinical protocol, mainly involving the allocation of available resources for health care.

  16. Herpes zoster vaccine: A health economic evaluation for Switzerland.

    Science.gov (United States)

    Blank, Patricia R; Ademi, Zanfina; Lu, Xiaoyan; Szucs, Thomas D; Schwenkglenks, Matthias

    2017-07-03

    Herpes zoster (HZ) or "shingles" results from a reactivation of the varicella zoster virus (VZV) acquired during primary infection (chickenpox) and surviving in the dorsal root ganglia. In about 20% of cases, a complication occurs, known as post-herpetic neuralgia (PHN). A live attenuated vaccine against VZV is available for the prevention of HZ and subsequent PHN. The present study aims to update an earlier evaluation estimating the cost-effectiveness of the HZ vaccine from a Swiss third party payer perspective. It takes into account updated vaccine prices, a different age cohort, latest clinical data and burden of illness data. A Markov model was developed to simulate the lifetime consequences of vaccinating 15% of the Swiss population aged 65-79 y. Information from sentinel data, official statistics and published literature were used. Endpoints assessed were number of HZ and PHN cases, quality-adjusted life years (QALYs), costs of hospitalizations, consultations and prescriptions. Based on a vaccine price of CHF 162, the vaccination strategy accrued additional costs of CHF 17,720,087 and gained 594 QALYs. The incremental cost-effectiveness ratio (ICER) was CHF 29,814 per QALY gained. Sensitivity analyses showed that the results were most sensitive to epidemiological inputs, utility values, discount rates, duration of vaccine efficacy, and vaccine price. Probabilistic sensitivity analyses indicated a more than 99% chance that the ICER was below 40,000 CHF per QALY. Findings were in line with existing cost-effectiveness analyses of HZ vaccination. This updated study supports the value of an HZ vaccination strategy targeting the Swiss population aged 65-79 y.

  17. Economic evaluation of routine infant rotavirus immunisation program in Japan.

    Science.gov (United States)

    Hoshi, Shu-Ling; Kondo, Masahide; Okubo, Ichiro

    2017-05-04

    Two rotavirus vaccines are currently available in Japan. We estimated the incremental cost-effectiveness ratio (ICER) of routine infant rotavirus immunisation program without defining which vaccine to be evaluated, which reflects the current deliberation at the Health Science Council in charge of Immunisation and Vaccine established by the Ministry of Health, Labor and Welfare of Japan. Three ICERs were estimated, one from payers' perspective and 2 from societal perspective depending on the scenarios to uptake vaccines. The health statuses following the birth cohort were as follows: not infected by rotavirus, asymptomatic infection, outpatients after infection, hospitalised after infection, developing encephalitis/encephalopathy followed by recovery, sequelae, and death. Costs of per course of vaccination was ¥30,000 (US$283; US$1 = ¥106). The model runs for 60 months with one month cycle. From payers' perspective, estimated ICERs were ¥6,877,000 (US$64,877) per QALY. From societal perspective, immunisation program turns out to be cost-saving for 75% simultaneous vaccination scenario, while it is at ¥337,000 (US$3,179) per QALY gained with vaccine alone scenario. The probability of rotavirus immunisation program to be under ¥5,000,000 (US$47,170) per QALY was at 19.8%, 40.7%, and 75.6% when costs per course of vaccination were set at ¥30,000 (US$283), ¥25,000 (US$236), and ¥20,000 (US$189), respectively. Rotavirus immunisation program has a potential to be cost-effective from payers' perspective and even cost-saving from societal perspective in Japan, however, caution should be taken with regard to the interpretation of the results as cost-effectiveness is critically dependent on vaccination costs.

  18. Considering consumer choice in the economic evaluation of mandatory health programmes: a review.

    Science.gov (United States)

    Parkinson, Bonny; Goodall, Stephen

    2011-08-01

    Governments are increasing their focus on mandatory public health programmes following positive economic evaluations of their impact. This review aims to examine whether loss of consumer choice should be included in economic evaluations of mandatory health programmes (MHP). A systematic literature review was conducted to identify economic evaluations of MHP, whether they discuss the impact on consumer choice and any methodological limitations. Overall 39 economic evaluations were identified, of which 10 discussed the loss of consumer choice and 6 attempted to place a value on the loss of consumer choice. Methodological limitations included: measuring the marginal cost of compliance, unavailability of price elasticity estimates, the impact of income effects, double counting health impacts, biased willingness-to-pay responses, and "protest" responses. Overall it was found that the inclusion of the loss of consumer choice rarely impacted on the final outcome of the study. The impact of MHP on the loss of consumer choice has largely been ignored in economic evaluations. Its importance remains uncertain due to its infrequent inclusion and significant methodological limitations. Further research regarding which methodology is best for valuing the loss of consumer choice and whether it is important to the final implementation decision is warranted. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  19. Economic Evaluation of Pollination Services Comparing Coffee Landscapes in Ecuador and Indonesia

    OpenAIRE

    Roland Olschewski; Teja Tscharntke; Pablo C. Benítez; Stefan Schwarze; Alexandra-Maria Klein

    2006-01-01

    Biodiversity conservation through land-use systems on private land is becoming a pressing environmental policy issue. Agroforestry, such as shade-coffee production, contributes to biodiversity conservation. However, falling coffee prices force many coffee growers to convert their sites into economically more attractive land uses. We performed an economic evaluation of coffee pollination by bees in two distinct tropical regions: an area of low human impact with forests neighboring agroforestry...

  20. The scope of costs in alcohol studies: Cost-of-illness studies differ from economic evaluations

    OpenAIRE

    van Gils, Paul F; Hamberg-van Reenen, Heleen H; van den Berg, Matthijs; Tariq, Luqman; de Wit, G Ardine

    2010-01-01

    Abstract Background Alcohol abuse results in problems on various levels in society. In terms of health, alcohol abuse is not only an important risk factor for chronic disease, but it is also related to injuries. Social harms which can be related to drinking include interpersonal problems, work problems, violent and other crimes. The scope of societal costs related to alcohol abuse in principle should be the same for both economic evaluations and cost-of-illness studies. In general, economic e...

  1. Basis for the evaluation of economic benefits from using modules for the development of radiation technology

    International Nuclear Information System (INIS)

    Kodyukov, V.M.; Purtova, M.I.; Smirnova, Z.M.; Semenova, T.D.

    1976-01-01

    A method is discussed for calculating the economic effect obtained by introduction of a designing principle involving standardized units and blocks of various radiation equipment. The method was based on a comparison of the technological and economic factors that could be obtained by using the said principle with similar factors not involving the aggregate principle (used previously in designing various instruments and installations). The formulae are sited for estimating the economy involved in designing and manufacturing aggregated complexes (AC) of the subsystems involved in an aggregated system of instrument making (ASIM) and for evaluating the additional economic effect resulting from reduced AC development time

  2. Economic evaluation of seizures associated with solitary cysticercus granuloma.

    Science.gov (United States)

    Murthy, J M K; Rajshekar, G

    2007-01-01

    Patients with solitary cysticercus granuloma (SCG) develop acute symptomatic seizures because of the inflammatory response of the brain and the seizures are self-limiting. Thus seizure disorder associated with SCG provides a good model to study the total cost of illness (COI). COI of new-onset seizures associated with SCG was studied in 59 consecutive patients registered at the epilepsy clinic. Direct treatment-related costs and indirect costs, man-days lost and wages lost were evaluated. The relative cost was calculated as the percentage of per capita gross national product (GNP) at current prices for the year 1997-1998. The total COI, for treating seizure disorder associated with SCG per the period of CT resolution of the lesion per patient was INR 7273.7 (US$ 174.66, I$ 943.16) and he/she would be spending 50.9% of per capita GNP The direct cost per patient was INR 5916 (US$ 137.14, 41.4% of per capita GNP). If the patient had received only AEDs for the period of resolution of CT lesion, the cost would be INR 5702.48 (US$132.2, 40% of per capita GNP). The extra expenditure on albendazole and steroid was INR 213.72 (US$ 4.95), 3.6% of the total direct cost and 20.7% of the medication cost. Indirect cost (average wage loss) per patient was INR 1312.7 (US$ 30.42) and it accounted for 9% of per capita GNP. The one-time expenditure at present costs (adjusted for inflation) to the nation to treat all the prevalence cases is to the tune of INR 1.184 billion (US$ 2.605) and 0.0037% of GNP. This study suggests that seizure disorder associated with SCG, a potentially preventable disorder, is a good model to study the total COI. The one-time expenditure at present costs to the nation to treat all the prevalence cases of seizure disorder associated with SCG is to the tune of INR 1.184 billion (US$ 2.605 million) and 0.0037% of GNP.

  3. Economic evaluation of pneumococcal conjugate vaccination in The Gambia.

    Science.gov (United States)

    Kim, Sun-Young; Lee, Gene; Goldie, Sue J

    2010-09-03

    . Assuming a cost-effectiveness threshold of three times GDP per capita, all PCVs examined would be cost-effective at the tentative Advance Market Commitment (AMC) price of $3.5 per dose. Because the cost-effectiveness of a PCV program could be affected by potential serotype replacement or herd immunity effects that may not be known until after a large scale introduction, type-specific surveillance and iterative evaluation will be critical.

  4. Economic evaluation of pneumococcal conjugate vaccination in The Gambia

    Directory of Open Access Journals (Sweden)

    Kim Sun-Young

    2010-09-01

    pneumococcal diseases caused by S. pneumoniae in The Gambia. Assuming a cost-effectiveness threshold of three times GDP per capita, all PCVs examined would be cost-effective at the tentative Advance Market Commitment (AMC price of $3.5 per dose. Because the cost-effectiveness of a PCV program could be affected by potential serotype replacement or herd immunity effects that may not be known until after a large scale introduction, type-specific surveillance and iterative evaluation will be critical.

  5. Economic evaluation studies in nuclear medicine. A methodological review of the literature

    International Nuclear Information System (INIS)

    Gambhir, S.S.; Schwimmer, J.

    2000-01-01

    The growing need for evaluation of the utility of new nuclear medicine technologies has spawned a few economic studies ranging from preliminary indications of cost savings to complete decision analysis models incorporating costs and quality of life. The objective of the current study was to evaluate the methodological quality of economic analyses of nuclear medicine procedures which targeted cost-effectiveness or cost-utility issues published in the medical literature during the years 1985-1999. A computerized literature search was used to identify original investigations from the medical literature which included an economic analysis of a nuclear medicine procedure. Each economic analysis article was evaluated by two independent reviewers for adherence to ten accepted methodological criteria. Of the 29 articles meeting the search criteria, only six (21%) conformed to all ten methodological criteria. Published economic analyses of nuclear medicine procedures usually do not meet accepted methodological standards and could be significantly improved to achieve overall better quality relative to similar analyses in the literature from other medical fields. Continued improvement in the number and quality of economic studies is critically needed for the future competitiveness of nuclear medicine studies

  6. Environmental and economic evaluation of the Massachusetts Smoke-Free Workplace Law.

    Science.gov (United States)

    Alpert, Hillel R; Carpenter, Carrie M; Travers, Mark J; Connolly, Gregory N

    2007-08-01

    An environmental and economic evaluation of the smoke-free law in Massachusetts provides a broad appreciation of how a state-wide smoking ban affects the health of patrons and workers as well as the industries that are commonly concerned about the effects of smoking bans on business. The aim of this study is to evaluate environmental and economic effects of the statewide Massachusetts statewide Smoke-Free Workplace Law. Before and after the smoking ban, air quality testing was conducted in a sample (n = 27) of hospitality venues and state-wide economic changes were assessed. Compliance, in terms of patronage was measured by person-counts. Environmental outcomes were respirable suspended particles (RSP) less than 2.5 microns in diameter (PM2.5). Economic outcomes were meals tax collections, employment in the food services and drinking places and accommodations industries. On average, levels of respirable suspended particles (RSPs) less than 2.5 microns in diameter (PM2.5) decreased 93% in these venues after the Massachusetts Smoke-free Workplace Law went into effect. No statistically significant changes were observed among the economic indicators. This evaluation demonstrates that the state-wide Massachusetts law has effectively improved indoor air quality in a sample of Massachusetts venues and has not negatively affected several economic indicators.

  7. Challenges in economic evaluation of new drugs: experience with rituximab in Hungary.

    Science.gov (United States)

    Brodszky, Valentin; Orlewska, Ewa; Pentek, Martha; Karpati, Krisztian; Skoupa, Jana; Gulacsi, Laszlo

    2010-01-01

    Implementation of a new therapy into clinical practice is a complex process. Various countries have different requirements for information but most often focus on economic evaluation, which often plays a stronger role in healthcare decision making than does clinical evidence. To identify all potential challenges in economic evaluation, the case of a new biological drug, rituximab, used to treat rheumatoid arthritis, has been taken as an example. We present methods and results of economic assessment, highlighting the specific issues that should be considered in countries with economic and health care conditions similar to those of Hungary. In principle, economic evaluation requires data on characteristics of target population, disease progression, treatment impact, preferences, resource utilization and unit prices. Treatment effect/relative risk reduction and clinical practice patterns (resource use) may be more generalizable, whereas prices and baseline risk need to be jurisdiction specific. In order to address issues of transferability, investments need to be made in the collection of epidemiological and demographic data, plus data on clinical practice patterns, resource use, costs and health state valuation. In Hungary this problem has been solved through conducting a well designed 255 patient cross-sectional study. The Hungarian example shows that there should be more investment in data collection for those parameters that are thought to differ most from place to place. Owing to the similarities between Central and Eastern Europe countries in health care systems, clinical practice patterns and economic indicators, they may be able to develop partnerships to develop relevant regional databases and registries.

  8. Systematic review of economic evaluation analyses of available vaccines in Spain from 1990 to 2012.

    Science.gov (United States)

    Cortés, Isabel; Pérez-Camarero, Santiago; Del Llano, Juan; Peña, Luz María; Hidalgo-Vega, Alvaro

    2013-08-02

    The objective of this survey was to describe the evolution of economic evaluation studies on vaccines available in Spain. We conducted a systematic review of the economic evaluations published by Spanish researchers in major bibliographic databases available online from 1990 to 2012. For all references identified, we limited them to full economic evaluation carried out in Spanish vaccine programs. The following variables were analyzed: type of study, year of publication, vaccine evaluated, the herd immunity and the main methodological aspects proposed by international guidelines. The type of vaccines studied were Hepatitis A and B, Rotavirus, Influenza, Varicella, Tetanus, Measles, Human papillomavirus, Streptococcus pneumoniae infection and Neisseria meningitides serogroup C infection. A total of 34 references was included in the study. The number of economic evaluations has been increasing over the years by 86%. For many of the vaccines there were no economic evaluations, while others such as the vaccine against S. pneumoniae infection took up most of the studies. The non-vaccinated comparison was the most used strategy. The cost-effectiveness model was selected in 60% of cases. The most common health outcome was "cost per case prevented" and in 82% of the studies did not consider herd immunity. The results showed a cost-effectiveness ratio which was below breakeven. It is clear that the existence of a huge gap in this kind of work compared to other countries. Although the quality of the work discussed here was significant, we found many areas which could be improved. The reviewed literature exposed the great benefit of vaccination for society by analysing the health outcomes achieved for decades since its implementation. However, the evidence on the efficiency and effectiveness vaccination is not very high, and there are few studies about economic evaluation. Copyright © 2013 Elsevier Ltd. All rights reserved.

  9. What is the quality of economic evaluations of non-drug therapies? A systematic review and critical appraisal of economic evaluations of radiotherapy for cancer.

    Science.gov (United States)

    Barbieri, M; Weatherly, H L A; Ara, R; Basarir, H; Sculpher, M; Adams, R; Ahmed, H; Coles, C; Guerrero-Urbano, T; Nutting, C; Powell, M

    2014-10-01

    Breast, cervical and colorectal cancers are the three most frequent cancers in women, while lung, prostate and colorectal cancers are the most frequent in men. Much attention has been given to the economic evaluation of pharmaceuticals for treatment of cancer by the National Institute for Health and Care Excellence (NICE) in the UK and similar authorities internationally, while economic analysis developed for other types of anti-cancer interventions, including radiotherapy and surgery, are less common. Our objective was to review methods used in published cost-effectiveness studies evaluating radiotherapy for breast, cervical, colorectal, head and neck and prostate cancer, and to compare the economic evaluation methods applied with those defined in the guidelines used by the NICE technology appraisal programme. A systematic search of seven databases (MEDLINE, EMBASE, CDSR, NHSEED, HTA, DARE, EconLit) as well as research registers, the NICE website and conference proceedings was conducted in July 2012. Only economic evaluations of radiotherapy interventions in individuals diagnosed with cancer that included quality-adjusted life-years (QALYs) or life-years (LYs) were included. Included studies were appraised on the basis of satisfying essential, preferred and UK-specific methods requirements, building on the NICE Reference Case for economic evaluations and on other methods guidelines. A total of 29 studies satisfied the inclusion criteria (breast 14, colorectal 2, prostate 10, cervical 0, head and neck 3). Only two studies were conducted in the UK (13 in the USA). Among essential methods criteria, the main issue was that only three (10%) of the studies used clinical-effectiveness estimates identified through systematic review of the literature. Similarly, only eight (28%) studies sourced health-related quality-of-life data directly from patients with the condition of interest. Other essential criteria (e.g. clear description of comparators, patient group indication

  10. Evaluation of the contribution of radiological imaging to the final diagnosis in medical case reports

    International Nuclear Information System (INIS)

    Wiesinger, Isabel; Scharf, Gregor; Platz, Natascha; Dendl, Lena M.; Stroszczynski, Christian; Schreyer, Andreas G.; Pawlik, Michael T.

    2015-01-01

    To evaluate the clinical value and impact of radiological imaging in published medial case reports. We analysed 671 consecutively published case reports of a peer-reviewed medical journal for case reports. The general use of radiological imaging as well as the specific imaging modality used in each case (ultrasound, x-ray, fluoroscopy, CT, MRI) was documented, and most importantly the 'final problem solver', i.e. the diagnostic modality giving the final clue to the patient's diagnosis, was identified. In 511 of 671 (76.1 %) analysed case reports at least one radiological modality was used in the diagnostic cascade. In 28.6 % of all cases the final diagnosis was achieved by radiological imaging. All other cases were solved by the patient's history and physical examination (15.2 %), histology (12.4 %), and blood analysis (9.6 %). When radiology was the 'final problem solver', it was mainly CT (51.6 %) and MRI (30.6 %). In 52.2 % of the case reports the radiological image was included in the article. In case reports published in a prominent general medical journal radiological imaging is an important key player in the diagnostic process. In many cases, it is also the diagnostic tool which ultimately leads to determining the final diagnosis. (orig.)

  11. Evaluation of clinical and serological findings for diagnosis of cutaneous anthrax infection after an outbreak.

    Science.gov (United States)

    Gulseren, Duygu; Süzük-Yıldız, Serap; Çelebi, Bekir; Kılıç, Selçuk

    2017-09-01

    Anthrax, caused by the bacterium Bacillus anthracis, is one of the oldest documented infectious diseases in both livestock and humans. We aimed to evaluate clinical findings and risk factors of patients with cutaneous anthrax infection and report anti-lethal factor (LF) IgG and anti-protective antigen (PA) IgG titers in the serologic diagnosis of disease. In this study, serum samples of 18 cutaneous anthrax patients were collected and anti-LF IgG and anti-PA IgG titers were measured by enzyme-linked immunosorbent assay (ELISA). Twelve (67%) males and 6 (33%) females, with a mean age of 36.06 ± 16.58 years were included in the study. Risk factors identified in the patient population studied were slaughtering (28%), flaying (56%), chopping meat (67%), burying diseased animal corpses (17%) and milking (6%) livestock. Black eschar formation (94%), pruritus (78%) and painful lymphadenopathy (61%) were first three common clinical signs and symptoms, respectively. Fourteen (78%) patients produced a positive IgG response against PA, 11 (61%) patients produced against LF. Three (17%) patients had no response to either antigen. A detailed history of contact with sick animals or animal products along with clinical findings should be taken at the first step for the diagnosis of cutaneous anthrax infection. Serologic detection of anti-LF IgG and anti-PA IgG with ELISA may be useful auxillary method for establishing the diagnosis.

  12. Evaluation of the contribution of radiological imaging to the final diagnosis in medical case reports

    Energy Technology Data Exchange (ETDEWEB)

    Wiesinger, Isabel; Scharf, Gregor; Platz, Natascha; Dendl, Lena M.; Stroszczynski, Christian; Schreyer, Andreas G. [University Hospital Regensburg, Institute of Radiology, Regensburg (Germany); Pawlik, Michael T. [Intensive Care and Emergency Medicine, Institute of Anaesthesiology, Regensburg (Germany)

    2015-05-01

    To evaluate the clinical value and impact of radiological imaging in published medial case reports. We analysed 671 consecutively published case reports of a peer-reviewed medical journal for case reports. The general use of radiological imaging as well as the specific imaging modality used in each case (ultrasound, x-ray, fluoroscopy, CT, MRI) was documented, and most importantly the 'final problem solver', i.e. the diagnostic modality giving the final clue to the patient's diagnosis, was identified. In 511 of 671 (76.1 %) analysed case reports at least one radiological modality was used in the diagnostic cascade. In 28.6 % of all cases the final diagnosis was achieved by radiological imaging. All other cases were solved by the patient's history and physical examination (15.2 %), histology (12.4 %), and blood analysis (9.6 %). When radiology was the 'final problem solver', it was mainly CT (51.6 %) and MRI (30.6 %). In 52.2 % of the case reports the radiological image was included in the article. In case reports published in a prominent general medical journal radiological imaging is an important key player in the diagnostic process. In many cases, it is also the diagnostic tool which ultimately leads to determining the final diagnosis. (orig.)

  13. HRCT in the evaluation and diagnosis of the early/active pulmonary tuberculosis

    International Nuclear Information System (INIS)

    Tan Gao; Liu Xueguo; Zhang Qingwen; Wang Ying; Li Zhanjun; Zhang Cuiyun; Wang Jian; He Yanli; Hong Guobin

    2003-01-01

    Objective: To evaluate the HRCT findings of early/active pulmonary tuberculosis before and after antituberculous chemotherapy. Methods: One hundred tuberculous patients were studied prospectively and they were divided into 2 groups according to the history. The diagnosis of early active pulmonary tuberculosis was based on positive acid-fast bacilli in sputum (75 patients) and changes on serial radiographs obtained during treatment (25 patients). The correlation between pathology and imaging was done in the lungs from the cadavers of five other patients who died of pulmonary tuberculosis. Results: Comparing with the presence of other HRCT findings, the presence of centrilobular lesions (93.0%), tree-in-bud appearance (76.0%), and wall thickening of bronchioles (70.0%) were most common signs in both the first group consisting of 66 patients with newly diagnosed pulmonary tuberculosis and the second group consisting of 34 patients with recent reactivation of pulmonary tuberculosis at examination by HRCT, and there was significant difference between the presence of those signs and other signs (P<0.001). Conclusion: Centrilobular lesion appeared to be the most commonly seen characteristic HRCT features of early active tuberculosis, and it may be helpful to the diagnosis and (or ) differential diagnosis if combined with other commonly seen characteristic HRCT features as well as clinical information

  14. Evaluation of the diagnosis on staging of the bladder cancers by contrast-enhanced ultrasound

    International Nuclear Information System (INIS)

    Gao Yong; Xu Haiyan; Huan Haiming; Chen Yane

    2010-01-01

    Objective: To study the value of the staging of the bladder cancers with the contrast-enhanced ultrasound. Methods: After rapid injection of the contrast agent SonoVue through the elbow vein, the staging of images was completed in 18 cases of bladder cancer. Results: The results of contrast-enhanced ultrasound were compared with post-operative pathological analysis, the rate of accuracy of diagnosis on T1, T2, T3 and T4 stage was 100%, 80%, 83% and 100% respectively. The accuracy made by new methods higher than those of other imaging examinations in T1 stage; the other stages were similar to those of other imaging examinations. Conclusion: The evaluation of Contrast-enhanced ultrasound on the staging of the bladder cancer is higher than that of the conventional ultrasound examination, while the observation of blood flow in the tumor can make accurate diagnosis and differential diagnosis, this method can be complement each other with CT and MRI to improve the rate of accuracy on the staging of bladder cancer. (authors)

  15. Methods of international health technology assessment agencies for economic evaluations--a comparative analysis.

    Science.gov (United States)

    Mathes, Tim; Jacobs, Esther; Morfeld, Jana-Carina; Pieper, Dawid

    2013-09-30

    The number of Health Technology Assessment (HTA) agencies increases. One component of HTAs are economic aspects. To incorporate economic aspects commonly economic evaluations are performed. A convergence of recommendations for methods of health economic evaluations between international HTA agencies would facilitate the adaption of results to different settings and avoid unnecessary expense. A first step in this direction is a detailed analysis of existing similarities and differences in recommendations to identify potential for harmonization. The objective is to provide an overview and comparison of the methodological recommendations of international HTA agencies for economic evaluations. The webpages of 127 international HTA agencies were searched for guidelines containing recommendations on methods for the preparation of economic evaluations. Additionally, the HTA agencies were requested information on methods for economic evaluations. Recommendations of the included guidelines were extracted in standardized tables according to 13 methodological aspects. All process steps were performed independently by two reviewers. Finally 25 publications of 14 HTA agencies were included in the analysis. Methods for economic evaluations vary widely. The greatest accordance could be found for the type of analysis and comparator. Cost-utility-analyses or cost-effectiveness-analyses are recommended. The comparator should continuously be usual care. Again the greatest differences were shown in the recommendations on the measurement/sources of effects, discounting and in the analysis of sensitivity. The main difference regarding effects is the focus either on efficacy or effectiveness. Recommended discounting rates range from 1.5%-5% for effects and 3%-5% for costs whereby it is mostly recommended to use the same rate for costs and effects. With respect to the analysis of sensitivity the main difference is that oftentimes the probabilistic or deterministic approach is recommended

  16. Do economic evaluation studies inform effective healthcare resource allocation in Iran? A critical review of the literature

    Science.gov (United States)

    2014-01-01

    To aid informed health sector decision-making, data from sufficient high quality economic evaluations must be available to policy makers. To date, no known study has analysed the quantity and quality of available Iranian economic evaluation studies. This study aimed to assess the quantity, quality and targeting of economic evaluation studies conducted in the Iranian context. The study systematically reviewed full economic evaluation studies (n = 30) published between 1999 and 2012 in international and local journals. The findings of the review indicate that although the literature on economic evaluation in Iran is growing, these evaluations were of poor quality and suffer from several major methodological flaws. Furthermore, the review reveals that economic evaluation studies have not addressed the major health problems in Iran. While the availability of evidence is no guarantee that it will be used to aid decision-making, the absence of evidence will certainly preclude its use. Considering the deficiencies in the data identified by this review, current economic evaluations cannot be a useful source of information for decision makers in Iran. To improve the quality and overall usefulness of economic evaluations we would recommend; 1) developing clear national guidelines for the conduct of economic evaluations, 2) highlighting priority areas where information from such studies would be most useful and 3) training researchers and policy makers in the calculation and use of economic evaluation data. PMID:25050084

  17. [Clinical application evaluation of Guidelines for Diagnosis and Treatment of Internal Diseases in Traditional Chinese Medicine].

    Science.gov (United States)

    Han, Xue-Jie; Liu, Meng-Yu; Lian, Zhi-Hua; Wang, Li-Ying; Shi, Nan-Nan; Zhao, Jun

    2017-09-01

    To evaluate the applicability and clinical applications of Guidelines for Diagnosis and Treatment of Internal Diseases in Traditional Chinese Medicine, so as to provide the basis for the revision of the guidelines. This study was completed by the research and promotion base for traditional Chinese medicine(TCM) standard. The methods of applicability evaluation and application evaluation were used in the study. The questionnaires were filled out to evaluate applicability of the guideline, including doctor's familiarity with the guideline,the quality of the guideline, applicable conditions and clinical applications. The prospective case study analysis method was used to evaluate application of the guideline, including evaluation of clinical application compliance and application results(such as clinical effects, safety and economy). There were two parts in the guideline, which were TCM guideline and Western medicine guideline. The results of applicability evaluation showed that there were no obvious differences between TCM guideline and Western medicine guideline in doctor's familiarity with guideline(85.43%, 84.57%) and the use of the guideline(52.10%, 54.47%); the guidelines with good quality, and higher scores in the scope of application and the use of the term rationality(91.94%, 93.35%); the rationality scores of relevant contents in syndrome differentiation and treatment were more than 75%; the applicable conditions were better, and the safety score was the the highest. The comprehensive applicability evaluation showed that the proportion of the application of TCM guideline and Western medicine guideline were 77.73%, 75.46%, respectively. The results of application evaluation showed that there was high degree coincidence between the guideline with its clinical application; except for "other treatment" and "recuperation and prevention" in TCM, other items got high scores which were more than 90%; in the evaluation of application effects, safety of the guideline

  18. Economic evaluation in the context of rare diseases: is it possible?

    Science.gov (United States)

    Silva, Everton Nunes da; Sousa, Tanara Rosângela Vieira

    2015-03-01

    This study analyzes the available evidence on the adequacy of economic evaluation for decision-making on the incorporation or exclusion of technologies for rare diseases. The authors conducted a structured literature review in MEDLINE via PubMed, CRD, LILACS, SciELO, and Google Scholar (gray literature). Economic evaluation studies had their origins in Welfare Economics, in which individuals maximize their utilities based on allocative efficiency. There is no widely accepted criterion in the literature to weigh the expected utilities, in the sense of assigning more weight to individuals with greater health needs. Thus, economic evaluation studies do not usually weigh utilities asymmetrically (that is, everyone is treated equally, which in Brazil is also a Constitutional principle). Healthcare systems have ratified the use of economic evaluation as the main tool to assist decision-making. However, this approach does not rule out the use of other methodologies to complement cost-effectiveness studies, such as Person Trade-Off and Rule of Rescue.

  19. Economic evaluation and cost of interventions for cerebral palsy: a systematic review.

    Science.gov (United States)

    Shih, Sophy T F; Tonmukayakul, Utsana; Imms, Christine; Reddihough, Dinah; Graham, H Kerr; Cox, Liz; Carter, Rob

    2018-06-01

    Economic appraisal can help guide policy-making for purchasing decisions, and treatment and management algorithms for health interventions. We conducted a systematic review of economic studies in cerebral palsy (CP) to inform future research. Economic studies published since 1970 were identified from seven databases. Two reviewers independently screened abstracts and extracted data following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Any discrepancies were resolved by discussion. Of 980 identified references, 115 were included for full-text assessment. Thirteen articles met standard criteria for a full economic evaluation, two as partial economic evaluations, and 18 as cost studies. Six were full economic evaluations alongside clinical studies or randomized controlled trials, whereas seven involved modelling simulations. The economic case for administration of magnesium sulfate for imminent preterm birth is compelling, achieving both health gain and cost savings. Current literature suggests intrathecal baclofen therapy and botulinum toxin injection are cost-effective, but stronger evidence for long-term effects is needed. Lifestyle and web-based interventions are inexpensive, but broader measurement of outcomes is required. Prevention of CP would avoid significant economic burden. Some treatments and interventions have been shown to be cost-effective, although stronger evidence of clinical effectiveness is needed. What this paper adds Cost-effectiveness evidence shows prevention is the most significant strategy. Some treatments are cost-effective, but stronger evidence for long-term effectiveness is required. Comparison of treatment costs is challenging owing to variations in methodologies and varying clinical indications. © 2018 Mac Keith Press.

  20. Prospective evaluation of three rapid diagnostic tests for diagnosis of human leptospirosis.

    Directory of Open Access Journals (Sweden)

    Marga G A Goris

    Full Text Available BACKGROUND: Diagnosis of leptospirosis by the microscopic agglutination test (MAT or by culture is confined to specialized laboratories. Although ELISA techniques are more common, they still require laboratory facilities. Rapid Diagnostic Tests (RDTs can be used for easy point-of-care diagnosis. This study aims to evaluate the diagnostic performance of the RDTs LeptoTek Dri Dot, LeptoTek Lateral Flow, and Leptocheck-WB, prospectively. METHODOLOGY: During 2001 to 2012, one or two of the RDTs at the same time have been applied prior to routine diagnostics (MAT, ELISA and culture on serum specimens from participants sent in for leptospirosis diagnosis. The case definition was based on MAT, ELISA and culture results. Participants not fulfilling the case definition were considered not to have leptospirosis. The diagnostic accuracy was determined based on the 1(st submitted sample and paired samples, either in an overall analysis or stratified according to days post onset of illness. RESULTS: The overall sensitivity and specificity for the LeptoTek Dri Dot was 75% respectively 96%, for the LeptoTek Lateral Flow 78% respectively 95%, and for the Leptocheck-WB 78% respectively 98%. Based on the 1(st submitted sample the sensitivity was low (51% for LeptoTek Dri Dot, 69% for LeptoTek Lateral Flow, and 55% for Leptocheck-WB, but substantially increased when the results of paired samples were combined, although accompanied by a lower specificity (82% respectively 91% for LeptoTek Dri Dot, 86% respectively 84% for LeptoTek Lateral Flow, and 80% respectively 93% for Leptocheck-WB. CONCLUSIONS: All three tests present antibody tests contributing to the diagnosis of leptospirosis, thus supporting clinical suspicion and contributing to awareness. Since the overall sensitivity of the tested RDTs did not exceed 80%, one should be cautious to rely only on an RDT result, and confirmation by reference tests is strongly recommended.

  1. Psoriasis treatment and management - a systematic review of full economic evaluations.

    Science.gov (United States)

    Hamilton, M P; Ntais, D; Griffiths, C E M; Davies, L M

    2015-03-01

    Psoriasis frequently requires lifetime control and current therapies vary significantly in price. High-quality economic evaluations are necessary to determine if higher-cost treatments are value for money. This review aims to identify the cost-effectiveness of psoriasis care (whether more expensive interventions are associated with savings in health care and psoriasis management and/or improve patients' health); assess the level of uncertainty and transferability of this evidence to policy and practice; and, identify future research needs. Searches of electronic databases Embase, MEDLINE and NHS EED for full economic evaluations were conducted in January 2012 (updated April 2014). Included articles were screened, selected and critically appraised using predefined inclusion criteria and data extraction forms: 1355 articles were identified; 37 papers reporting 71 comparisons met the inclusion criteria. Treatments evaluated were systemic (n = 45), topical (n = 22), phototherapies (n = 14) and combination (n = 4). Despite a significant number of recent economic evaluations, the cost-effectiveness of all therapies remains unclear. This uncertainty arises from a diversity in settings, perspective and design. Economic evaluations were constrained by limited availability of high-quality short- and long-term head-to-head comparisons of the effectiveness, safety and adherence of different interventions. The economic evidence is dominated by comparisons of interventions to placebo, with implicit comparisons of different therapies. There is a lack of evaluations of service model innovations to deliver complex packages of care for psoriasis. Primary and secondary integrated clinical and economic research is needed to address the limitations and to identify patient preferences and barriers/facilitators to treatment. © 2014 British Association of Dermatologists.

  2. Economics and the evaluation of publicly funded energy R and D

    Energy Technology Data Exchange (ETDEWEB)

    Jones, D.W.; Paik, I.K.

    1998-10-19

    There are three major areas in which economics can contribute to the evaluation of federal R and D: assessment of net benefits, ex ante expected as well as ex post realized; tailoring of R and D portfolios to policy goals; and guiding the contractual organization of R and D production. Additionally, evaluation of R and D and scientific activity tend to be distinctly retrospective, principally because of the long lags between the initial production activity and the observability of consequences. Extending the purview of economic evaluation of R and D, they find ample opportunity for evaluation that can inform current R and D management practice. The conduct of R and D is organized through a series of explicit and implicit contracts designed to elicit long-term commitments by some agents while attempting to limit the commitment by others. It is natural to consider the efficiency with which R and D is conducted as a subject for economic inquiry, although in practice such inquiries generally are restricted to accounting exercises. In evaluating the efficiency with which R and D is done, the current ordinary practice is to look at labor rates and equipment and materials prices while considering quantities of those items as the principal instrument variables in an optimization problem (the authors conceptualization, not that of the typical review of an R and D project). The authors recommend the contractual structure and other elements of the incentive structure (pay and promotion) of R and D production as prime focal points for managerially useful economic evaluation. Non-economic motivations for funding public R and D, including energy R and D, are well known. The US will consider spending several billion dollars on an international space station, partly if not largely, to fund the peaceful employment of scientists from the Former Soviet Union. Nonetheless, it will be useful to understand the economics of the R and D programs even if other considerations play important

  3. Diagnostic tests and algorithms used in the investigation of haematuria: systematic reviews and economic evaluation.

    Science.gov (United States)

    Rodgers, M; Nixon, J; Hempel, S; Aho, T; Kelly, J; Neal, D; Duffy, S; Ritchie, G; Kleijnen, J; Westwood, M

    2006-06-01

    To determine the most effective diagnostic strategy for the investigation of microscopic and macroscopic haematuria in adults. Electronic databases from inception to October 2003, updated in August 2004. A systematic review was undertaken according to published guidelines. Decision analytic modelling was undertaken, based on the findings of the review, expert opinion and additional information from the literature, to assess the relative cost-effectiveness of plausible alternative tests that are part of diagnostic algorithms for haematuria. A total of 118 studies met the inclusion criteria. No studies that evaluated the effectiveness of diagnostic algorithms for haematuria or the effectiveness of screening for haematuria or investigating its underlying cause were identified. Eighteen out of 19 identified studies evaluated dipstick tests and data from these suggested that these are moderately useful in establishing the presence of, but cannot be used to rule out, haematuria. Six studies using haematuria as a test for the presence of a disease indicated that the detection of microhaematuria cannot alone be considered a useful test either to rule in or rule out the presence of a significant underlying pathology (urinary calculi or bladder cancer). Forty-eight of 80 studies addressed methods to localise the source of bleeding (renal or lower urinary tract). The methods and thresholds described in these studies varied greatly, precluding any estimate of a 'best performance' threshold that could be applied across patient groups. However, studies of red blood cell morphology that used a cut-off value of 80% dysmorphic cells for glomerular disease reported consistently high specificities (potentially useful in ruling in a renal cause for haematuria). The reported sensitivities were generally low. Twenty-eight studies included data on the accuracy of laboratory tests (tumour markers, cytology) for the diagnosis of bladder cancer. The majority of tumour marker studies

  4. Systemic arterial hypertension: etiologic diagnosis and evaluation of the effects on the kidneys and heart through nuclear medicine

    International Nuclear Information System (INIS)

    Martins, L.R.F.; Marioni Filho, H.

    1986-01-01

    Etiological diagnosis and evaluation of the effects on the kidneys and heart in systemic arterial hypertension through the nuclear medicine are presented. Different kinds of radioisotopes are used. (L.M.J.) [pt

  5. Evaluating the economic benefits of nonmotorized transportation : case studies and methods for the nonmotorized transportation pilot program communities.

    Science.gov (United States)

    2015-03-01

    This report examines potential methods for evaluating the economic benefits from nonmotorized transportation investments. The variety of potential economic benefits of bicycle and pedestrian infrastructure and programming investments discussed includ...

  6. Sensitivity analysis of technological, economic and sustainability evaluation of power plants using the analytic hierarchy process

    International Nuclear Information System (INIS)

    Chatzimouratidis, Athanasios I.; Pilavachi, Petros A.

    2009-01-01

    Technological, economic and sustainability evaluation of power plants by use of the analytic hierarchy process and nine end node criteria for a reference scenario based on subjective criteria weighting has been presented in a previous paper by authors. However, criteria weight variations may substantially modify overall evaluations and rankings of power plants. The current paper presents a sensitivity analysis with four alternative scenarios (sets of criteria weights) compared with the reference scenario. The results show that priority to 'technology and sustainability' favors renewable energy power plants, while priority to 'economic' criteria favors mainly nuclear power plants and less the four types of fossil fuel power plant

  7. An evaluation of technical and economic capacity of farmers of Rural Production Cooperatives. Case Study: Neishabour

    Directory of Open Access Journals (Sweden)

    Maryam Hadizadeh Bazaz

    2017-01-01

    Full Text Available The main objective of this article is to investigate the impact of cooperatives on the technical and economical empowering of farmers and agricultural development in the villages of Neishabour. The method of this research is analytical – descriptive and it has been carried out in 2013.  The statistical society is composed of 4685 members and non-members of cooperatives in twenty villages of Neishabour. The sample size via the Cochran formula and stratified sampling technique has been calculated to be 252.  Data collection has been performed through documentation and field study. For data analysis, the SPSS software package and the T-Student Test have been employed. The results of statistical analysis based on 13 economic indicators revealed that the average economic stability of the members is 2.64 which is slightly higher than 2.47; that is the average economic stability of non-members. Independent samples T-Test results between members and non-members revealed that the probability value is 0.004 which indicates that there exists a significant difference between average economic stability of members and non-members. The T-Test results with hypothetical mean of 3 and 4 showed that the majority of indicators are less than the average. Therefore, the impact of cooperatives in economic development is evaluated to be below the average limit and cooperatives could not play an important role in increasing the economic empowerment of farmers.

  8. Evaluation of different parasitological techniques in the diagnosis of canine helminthiasis

    Directory of Open Access Journals (Sweden)

    Marcelle Temporim Novaes

    2015-12-01

    Full Text Available ABSTRACT. Novaes M.T. & Martins I.V.F. [Evaluation of different parasitological techniques in the diagnosis of canine helminthiasis.] Avaliação de diferentes técnicas parasitológicas no diagnóstico de helmintoses caninas. Revista Brasileira de Medicina Veterinária, 37(Supl.1:71-76, 2015. Laboratório de Parasitologia, Hospital Veterinário, Universidade Federal do Espírito Santo, Rua Alto Universitário, s/n, Guararema, Alegre, ES 29500-000, Brasil. E-mail: marcelle_temporim@hotmail.com Were collected 100 fecal samples from dogs from August 2014 to April 2015 from the Zoonosis Control Center (CCZ of Cachoeiro de Itapemirim-ES. These were sent to the laboratory of Parasitology of the Veterinary Hospital of UFES, and analyzed in duplicate by the techniques of Kato-Katz, Hoffman, TF-Test Modified/Dog and Willis in order to evaluate the technique that present higher sensitivity, convenience and lower expenses with materials for parasitological diagnosis. Statistical analysis was performed using Fisher’s exact test and kappa the 5% significance level. Together they showed up 68 positive samples, 31, 34, 26 and 62 for technical Kato-Katz, Hoffman, TF-Test and Willis respectively. The results showed that the use of Willis technique should be adopted as the standard for egg Ancylostoma spp., since the techniques Kato-Katz, Hoffman and TF-Test showed a low sensitivity for diagnosis of this parasite, and technic of Hoffman should be used as standard for Toxocara spp. In relation to convenience and lower expenses, Willis technique, should be preferred, because the runtime and the microscope slide reading is fast, requiring only the use of a supersaturated solution.

  9. Diagnosis of thyroid lymphoma and follow-up evaluation using Ga-67 scintigraphy

    International Nuclear Information System (INIS)

    Nishiyama, Yoshihiro; Yamamoto, Yuka; Yokoe, Koiku; Satoh, Katashi; Ohkawa, Motoomi

    2003-01-01

    A strong association between malignant lymphoma and Hashimoto's thyroiditis has frequently been reported. However, it is difficult to detect the lymphomatous transformation of Hashimoto's thyroiditis in the early stage. The purpose of the present study was to examine the usefulness of 67 Ga scintigraphy in the diagnosis and evaluation of the therapeutic effects during follow-up, in patients with a suspected diagnosis of primary thyroid lymphoma. Twenty-five patients who were suspected of having primary thyroid lymphoma and had undergone 67 Ga scintigraphy were studied. 67 Ga planar scintigraphy was performed 72 hours after injection of 67 Ga-citrate. The degree and pattern of 67 Ga accumulation were graded visually. Histopathology on biopsy examination revealed thyroid lymphoma in 17 and Hashimoto's thyroiditis in 8 patients. Abnormal accumulation of 67 Ga in the thyroid was seen in all of the 17 thyroid lymphoma cases with additional mediastinal and abdominal involvement in one. Fifteen of 17 thyroid lymphoma patients also underwent 67 Ga scintigraphy 2-4 weeks after chemotherapy and/or radiotherapy. All 15 patients showed diminishing 67 Ga accumulation and a good clinical course. In one patient with local recurrence, abnormal accumulation could be depicted by follow-up scintigraphy. However, diffuse or enlarged accumulation in the thyroid was seen in all of the 8 Hashimoto's thyroiditis cases. The degree of abnormal accumulation in the thyroid in clinically active phase thyroiditis was more intense than that in the chronic phase thyroiditis. 67 Ga scintigraphy was helpful to confirm the diagnosis of thyroid lymphoma and to evaluate the therapeutic effects during follow-up. However, 67 Ga scintigraphy may not always distinguish thyroid lymphoma from Hashimoto's thyroiditis, especially the active phase of the disease. (author)

  10. Economic Evaluation of the Juvenile Drug Court/Reclaiming Futures (JDC/RF) Model.

    Science.gov (United States)

    McCollister, Kathryn; Baumer, Pamela; Davis, Monica; Greene, Alison; Stevens, Sally; Dennis, Michael

    2018-07-01

    Juvenile drug court (JDC) programs are an increasingly popular option for rehabilitating juvenile offenders with substance problems, but research has found inconsistent evidence regarding their effectiveness and economic impact. While assessing client outcomes such as reduced substance use and delinquency is necessary to gauge program effectiveness, a more comprehensive understanding of program success and sustainability can be attained by examining program costs and economic benefits. As part of the National Cross-Site Evaluation of JDC and Reclaiming Futures (RF), an economic analysis of five JDC/RF programs was conducted from a multisystem and multiagency perspective. The study highlights the direct and indirect costs of JDC/RF and the savings generated from reduced health problems, illegal activity, and missed school days. Results include the average (per participant) cost of JDC/RF, the total economic benefits per JDC/RF participant, and the net savings of JDC/RF relative to standard JDC.

  11. Public health policy decisions on medical innovations: what role can early economic evaluation play?

    Science.gov (United States)

    Hartz, Susanne; John, Jürgen

    2009-02-01

    Our contribution aims to explore the different ways in which early economic data can inform public health policy decisions on new medical technologies. A literature research was conducted to detect methodological contributions covering the health policy perspective. Early economic data on new technologies can support public health policy decisions in several ways. Embedded in horizon scanning and HTA activities, it adds to monitoring and assessment of innovations. It can play a role in the control of technology diffusion by informing coverage and reimbursement decisions as well as the direct public promotion of healthcare technologies, leading to increased efficiency. Major problems include the uncertainty related to economic data at early stages as well as the timing of the evaluation of an innovation. Decision-makers can benefit from the information supplied by early economic data, but the actual use in practice is difficult to determine. Further empirical evidence should be gathered, while the use could be promoted by further standardization.

  12. Brazilian Alcohol Program (Proalcool): economic re-evaluation and demand adjustments

    International Nuclear Information System (INIS)

    Motta, R.S. da; Rocha Ferreira, L. da

    1987-01-01

    The aim of this paper is to discuss the economic impact on the Brazilian National Alcohol Programme caused by changes in the energy scenery, in view of recent oil price fall in the international market, and evaluate the necessary adjustments of the Programme according to the new Brazilian economic reality. The economic analysis concludes that the alcohol production, considering current production capacity and its investments, could be economically feasible at international oil prices near US$ 30.00. Excluding investments, its feasibility would be between US$ 18.00 and US$ 20.00 per equivalent oil barrel. Based on these conclusions, proposals for adjusting the PROALCOOL are discussed, including alternative pricing, fiscal and credit policies to control the alcohol-fuel demand. (author)

  13. Evaluation and diagnosis of the hair loss patient: part II. Trichoscopic and laboratory evaluations.

    Science.gov (United States)

    Mubki, Thamer; Rudnicka, Lidia; Olszewska, Malgorzata; Shapiro, Jerry

    2014-09-01

    The use of trichoscopy for evaluating a number of hair and scalp disorders is gaining popularity. It is a simple and noninvasive in vivo tool for visualizing hair shafts and the scalp. Recently, alopecias have been classified according to their trichoscopic findings. The second part of this 2-part continuing medical education article reviews recent advances in this field and describes a systematic approach for using the differential diagnostic findings of trichoscopy in alopecia. Copyright © 2014 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

  14. Modeling companion diagnostics in economic evaluations of targeted oncology therapies: systematic review and methodological checklist.

    Science.gov (United States)

    Doble, Brett; Tan, Marcus; Harris, Anthony; Lorgelly, Paula

    2015-02-01

    The successful use of a targeted therapy is intrinsically linked to the ability of a companion diagnostic to correctly identify patients most likely to benefit from treatment. The aim of this study was to review the characteristics of companion diagnostics that are of importance for inclusion in an economic evaluation. Approaches for including these characteristics in model-based economic evaluations are compared with the intent to describe best practice methods. Five databases and government agency websites were searched to identify model-based economic evaluations comparing a companion diagnostic and subsequent treatment strategy to another alternative treatment strategy with model parameters for the sensitivity and specificity of the companion diagnostic (primary synthesis). Economic evaluations that limited model parameters for the companion diagnostic to only its cost were also identified (secondary synthesis). Quality was assessed using the Quality of Health Economic Studies instrument. 30 studies were included in the review (primary synthesis n = 12; secondary synthesis n = 18). Incremental cost-effectiveness ratios may be lower when the only parameter for the companion diagnostic included in a model is the cost of testing. Incorporating the test's accuracy in addition to its cost may be a more appropriate methodological approach. Altering the prevalence of the genetic biomarker, specific population tested, type of test, test accuracy and timing/sequence of multiple tests can all impact overall model results. The impact of altering a test's threshold for positivity is unknown as it was not addressed in any of the included studies. Additional quality criteria as outlined in our methodological checklist should be considered due to the shortcomings of standard quality assessment tools in differentiating studies that incorporate important test-related characteristics and those that do not. There is a need to refine methods for incorporating the characteristics

  15. [Reasearch progress in health economic evaluation of colorectal cancer screening in China].

    Science.gov (United States)

    Huang, Huiyao; Shi, Jufang; Dai, Min

    2015-08-01

    Burden of colorectal cancer is rising in China. More attention and financial input have been paid to it by central government that colorectal cancer screening program has been carried out recently in many areas in China. Diversity of screening strategies and limited health resources render selecting the best strategy in a population-wide program a challenging task that economy was also required to be considered except safety and efficacy. To provide a reference for the subsequent further economic evaluation, here we reviewed the evidence available on the economic evaluation of colorectal cancer screening in China. Meanwhile, information related to screening strategies, participation and mid-term efficacy of screening, information and results on economic evaluation were extracted and summarized. Three of the four studies finally included evaluated strategies combining immunochemical fecel occult blood test (iFOBT) with high-risk factor questionnaire as initial screening, colonoscopy as diagnostic screening. There was a consensus regarding the efficacy and effectiveness of screening compared to no screening. Whereas the lack and poor comparability between studies, multi-perspective and multi-phase economic evaluation of colorectal cancer screening is needed, relying on current population-based screening program to conduct a comprehensive cost accounting.

  16. Methods for Health Economic Evaluation of Vaccines and Immunization Decision Frameworks: A Consensus Framework from a European Vaccine Economics Community.

    Science.gov (United States)

    Ultsch, Bernhard; Damm, Oliver; Beutels, Philippe; Bilcke, Joke; Brüggenjürgen, Bernd; Gerber-Grote, Andreas; Greiner, Wolfgang; Hanquet, Germaine; Hutubessy, Raymond; Jit, Mark; Knol, Mirjam; von Kries, Rüdiger; Kuhlmann, Alexander; Levy-Bruhl, Daniel; Perleth, Matthias; Postma, Maarten; Salo, Heini; Siebert, Uwe; Wasem, Jürgen; Wichmann, Ole

    2016-03-01

    Incremental cost-effectiveness and cost-utility analyses [health economic evaluations (HEEs)] of vaccines are routinely considered in decision making on immunization in various industrialized countries. While guidelines advocating more standardization of such HEEs (mainly for curative drugs) exist, several immunization-specific aspects (e.g. indirect effects or discounting approach) are still a subject of debate within the scientific community. The objective of this study was to develop a consensus framework for HEEs of vaccines to support the development of national guidelines in Europe. A systematic literature review was conducted to identify prevailing issues related to HEEs of vaccines. Furthermore, European experts in the field of health economics and immunization decision making were nominated and asked to select relevant aspects for discussion. Based on this, a workshop was held with these experts. Aspects on 'mathematical modelling', 'health economics' and 'decision making' were debated in group-work sessions (GWS) to formulate recommendations and/or--if applicable--to state 'pros' and 'contras'. A total of 13 different aspects were identified for modelling and HEE: model selection, time horizon of models, natural disease history, measures of vaccine-induced protection, duration of vaccine-induced protection, indirect effects apart from herd protection, target population, model calibration and validation, handling uncertainty, discounting, health-related quality of life, cost components, and perspectives. For decision making, there were four aspects regarding the purpose and the integration of HEEs of vaccines in decision making as well as the variation of parameters within uncertainty analyses and the reporting of results from HEEs. For each aspect, background information and an expert consensus were formulated. There was consensus that when HEEs are used to prioritize healthcare funding, this should be done in a consistent way across all interventions

  17. A Systematic Review of the State of Economic Evaluation for Health Care in India.

    Science.gov (United States)

    Prinja, Shankar; Chauhan, Akashdeep Singh; Angell, Blake; Gupta, Indrani; Jan, Stephen

    2015-12-01

    Economic evaluations are one of the important tools in policy making for rational allocation of resources. Given the very low public investment in the health sector in India, it is critical that resources are used wisely on interventions proven to yield best results. Hence, we undertook this study to assess the extent and quality of evidence for economic evaluation of health-care interventions and programmes in India. A comprehensive search was conducted to search for published full economic evaluations pertaining to India and addressing a health-related intervention or programme. PubMed, Scopus, Embase, ScienceDirect, and York CRD database and websites of important research agencies were identified to search for economic evaluations published from January 1980 to the middle of November 2014. Two researchers independently assessed the quality of the studies based on Drummond and modelling checklist. Out of a total of 5013 articles enlisted after literature search, a total of 104 met the inclusion criteria for this systematic review. The majority of these papers were cost-effectiveness studies (64%), led by a clinician or public-health professional (77%), using decision analysis-based methods (59%), published in an international journal (80%) and addressing communicable diseases (58%). In addition, 42% were funded by an international funding agency or UN/bilateral aid agency, and 30% focussed on pharmaceuticals. The average quality score of these full economic evaluations was 65.1%. The major limitation was the inability to address uncertainties involved in modelling as only about one-third of the studies assessed modelling structural uncertainties (33%), or ran sub-group analyses to account for heterogeneity (36.5%) or analysed methodological uncertainty (32%). The existing literature on economic evaluations in India is inadequate to feed into sound policy making. There is an urgent need to generate awareness within the government of how economic evaluation can

  18. Concepts of ‘personalization’ in personalized medicine: implications for economic evaluation

    Science.gov (United States)

    Rogowski, Wolf; Payne, Katherine; Schnell-Inderst, Petra; Manca, Andrea; Rochau, Ursula; Jahn, Beate; Alagoz, Oguzhan; Leidl, Reiner; Siebert, Uwe

    2015-01-01

    Context This paper assesses if, and how, existing methods for economic evaluation are applicable to the evaluation of PM and if not, where extension to methods may be required. Method Structured workshop with a pre-defined group of experts (n=47), run using a modified nominal group technique. Workshop findings were recorded using extensive note taking and summarised using thematic data analysis. The workshop was complemented by structured literature searches. Results The key finding emerging from the workshop, using an economic perspective, was that two distinct, but linked, interpretations of the concept of PM exist (personalization by ‘physiology’ or ‘preferences’). These interpretations involve specific challenges for the design and conduct of economic evaluations. Existing evaluative (extra-welfarist) frameworks were generally considered appropriate for evaluating PM. When ‘personalization’ is viewed as using physiological biomarkers, challenges include: representing complex care pathways; representing spill-over effects; meeting data requirements such as evidence on heterogeneity; choosing appropriate time horizons for the value of further research in uncertainty analysis. When viewed as tailoring medicine to patient preferences, further work is needed regarding: revealed preferences, e.g. treatment (non)adherence; stated preferences, e.g. risk interpretation and attitude; consideration of heterogeneity in preferences; and the appropriate framework (welfarism vs. extra-welfarism) to incorporate non-health benefits. Conclusion Ideally, economic evaluations should take account of both interpretations of PM and consider physiology and preferences. It is important for decision makers to be cognizant of the issues involved with the economic evaluation of PM to appropriately interpret the evidence and target future research funding. PMID:25249200

  19. Evaluation of the Sepsis Flow Chip assay for the diagnosis of blood infections.

    Science.gov (United States)

    Galiana, Antonio; Coy, Javier; Gimeno, Adelina; Guzman, Noemi Marco; Rosales, Francisco; Merino, Esperanza; Royo, Gloria; Rodríguez, Juan Carlos

    2017-01-01

    Blood infections are serious complex conditions that generally require rapid diagnosis and treatment. The big challenge is to reduce the time necessary to make a diagnosis with current clinical microbiological methods so as to improve the treatment given to patients. In this study, we assess for the first time the Sepsis Flow Chip assay, which is a novel diagnostic assay for simultaneous rapid-detection of the vast majority of bloodstream pathogens, including Gram-positive and Gram-negative bacteria and fungi, in the same assay, and for the detection of most common antibiotic resistance genes. The SFC assay is based on multiplex PCR and low density DNA arrays. Positive blood cultures from 202 consecutive bacteremia patients were analyzed by SFC assay and the results were compared with the results obtained by the gold standard methodology used in clinical microbiology diagnostic laboratories (EUCAST guidelines). SFC assay overall sensitivity and specificity for bacterial identification were 93.3% and 100% respectively and sensitivity and specificity for the identification of antibiotic genetic resistance determinants were 93.6% and 100% respectively. This is the first evaluation of SFC assay in clinical samples. This new method appears to be very promising by combining the high number of distinct pathogens and genetic resistance determinants identified in a single assay. Further investigations should be done to evaluate the usefulness of this assay in combination with clinical multidisciplinary groups (stewardship), in order for the results to be applied appropriately to the management of patients`infectious processes.

  20. MR Cholangiography: Axial TSE-T2 Sequence Evaluation in the Diagnosis of Choledocholithiasis

    International Nuclear Information System (INIS)

    Alustiza, J. M.; Gervas, C.; Garcia, E.; Recondo, J. A.

    2003-01-01

    To evaluate diagnostic precision of the axial TSE-T2 sequence in the diagnosis of choledocholithiasis. Retrospective analysis of all those MR cholangiography studies performed in our center between January 1998 and June 1999 which were later subjected to conventional cholangiography (intraoperative) as a golden standard. A total of 39 patients was studied. Imaging parameters of the sequence evaluated, fat-suppressed TSE-T2 in the axial plane, were as follows: TE 100 ms, TR 1.800 ms, turbo factor 23 FOV 375 mm, NSA 4, 228 x 256 matrix, respiratory compensation, number of slices 35, slice thickness 3 mm, contiguous slices, scan duration 5'4''. Without having been informed as to the cholangiography result, two radiologists independently analyzed this sequence in order to determine the presence of choledocholithiasis. Their results were latter compared with those of the conventional cholangiography. The sensitivity, specificity and agreement between results were all calculated. 21 patients had choledocholithiasis. The analyzed sequence presented sensitivity 81%, specificity 89%, and agreement between radiologists 98%, Kappa index 0.949. The axial sequence TSE-T2 is reliable for choledocholithiasis diagnosis. (Author) 9 refs

  1. Diagnosis to Evaluate the Degree of the Customer’s Orientation in Cuban Enterprises.

    Directory of Open Access Journals (Sweden)

    Mirya Valdivia Hernández

    2013-09-01

    Full Text Available In the enterprise world of today, the organizations that occupy privileged places in the market, offer their products in the proper place and moment, with competitive prices and the appropriate quality at minimum possible cost. The use of quality as a strategic weapon implies the development of an organizational culture through out the enterprise parts, guided to obtain a final product or service that not only satisfies the customers´ expectations, but enhances them. The customers´ orientation and quality management has been object of different theories and enterprises focuses, which through their evolution have converged to the costumer. In this work it is proposed the implementation of a Procedure, scientifically validated, to evaluate the costumer’s orientation, to contribute to improve the Quality Management in the Cuban enterprises. In the diagnosis procedure the customers´ criteria are identified, the degree of the costumer’s orientation is evaluated and the incidences that influence on the quality management are analyzed. Some actions were proposed based on the diagnosis´ results to the possible causes solution.

  2. Evaluation of an indirect elisa for the diagnosis of bovine brucellosis in Patagonia, Argentina

    International Nuclear Information System (INIS)

    Uzal, F.A.; Carrasco, E.A.; Robles, C.A.; Echaide, S.

    1998-01-01

    Control and eradication of bovine brucellosis is usually based on the serological detection of antibodies. In Argentina, the Rose Bengal test (RB) and the Buffered Plate antigen test (BPA) are the two screening test officially recognized, while the 2-mercaptoethanol test (2ME) and the Tube Agglutination test (SAT) are the confirmatory assays currently in use. In order to improve the serological diagnosis of bovine brucellosis in Patagonia, Argentina, an indirect ELISA kit produced by the Joint FAO/IAEA Division was evaluated. Sera from negative non-vaccinated, negative but vaccinated and positive animals were tested by all the above techniques. The specificity of the I-ELISA (99.6% and 99.7%) was similar to that of the BPA, RB, 2ME and Complement Fixation test (CF) when used to test sera from non-vaccinated, negative and vaccinated, negative animals, respectively. The sensitivity of the I-ELISA (98%) was higher than the BPA test (96%) and the CF test (95,2%). The I-ELISA kit evaluated in this study was thought to be a valuable tool for the diagnosis of bovine brucellosis in Patagonia region where little epidemiological information is available about this disease and where large numbers of sera should be tested to obtain such information. (author)

  3. [Early diagnosis and prognosis evaluation of Bell palsy with blink reflex ].

    Science.gov (United States)

    Xie, Dan-dan; Li, Xiao-song; Liu, Yuan-yuan

    2014-11-01

    To determine the value of blink reflex in early diagnosis and prognosis evaluation of Bell palsy. Blink reflex and facial nerve conduction were examined in 58 patients with Bell palsy within one week after symptom onset. The patients without response of R1 , R2 and R2 ' waves were classified as complete efferent retardarce (Group A, 30 cases), and those with response of R1 , R2 and R2 ' waves were classified as incomplete efferent anomalies (Group B, 28 cases). The clinical outcomes after three months of systemic therapy were evaluated using the House-Blackmann (H-B) scale. Efferent anomalies of blink reflex occurred in ail of the 58 patients. Abnormal results of facial nerve conduction appeared in 23 (39. 7%) patients. The three months therapy was effective in 93% patients in Group B and 70% patients in Group A (PBell palsy.

  4. Evaluation of imaging methods in the diagnosis of urolithiasis: review of the literature

    International Nuclear Information System (INIS)

    Freitas, Ricardo Miguel Costa de; Silva, Luciana Costa; Santos, Jovita Lane Soares; Tavares Junior, Wilson Campos

    2004-01-01

    The aim of this study is to compare helical computed tomography with imaging studies currently used to evaluate patients with acute low back pain. In addition, we briefly review the pathophysiology of urolithiasis. The literature published in the last 30 years was reviewed, and the following methods were discussed: plain abdominal radiographs, intravenous pyelography, ultrasound of the urinary tract, and helical computed tomography. Helical computed tomography showed high sensitivity and specificity for detecting urolithiasis, virtually showing all stones, except in patients receiving indinavir. The accuracy of plain abdominal radiographs associated with ultrasound was similar to helical computed tomography, although the latter showed superiority as an isolated method. Data from literature suggest that whenever helical computed tomography is available, it is helpful in the evaluation of low back pain and also allows differential diagnosis between conditions that mimic the symptoms of urolithiasis.(author)

  5. Early economic evaluation of emerging health technologies: protocol of a systematic review

    Science.gov (United States)

    2014-01-01

    Background The concept of early health technology assessment, discussed well over a decade, has now been collaboratively implemented by industry, government, and academia to select and expedite the development of emerging technologies that may address the needs of patients and health systems. Early economic evaluation is essential to assess the value of emerging technologies, but empirical data to inform the current practice of early evaluation is limited. We propose a systematic review of early economic evaluation studies in order to better understand the current practice. Methods/design This protocol describes a systematic review of economic evaluation studies of regulated health technologies in which the evaluation is conducted prior to regulatory approval and when the technology effectiveness is not well established. Included studies must report an economic evaluation, defined as the comparative analysis of alternatives with respect to their associated costs and health consequences, and must evaluate some regulated health technology such as pharmaceuticals, biologics, high-risk medical devices, or biomarkers. We will conduct the literature search on multiple databases, including MEDLINE, EMBASE, the Centre for Reviews and Dissemination Databases, and EconLit. Additional citations will be identified via scanning reference lists and author searching. We suspect that many early economic evaluation studies are unpublished, especially those conducted for internal use only. Additionally, we use a chain-referral sampling approach to identify authors of unpublished studies who work in technology discovery and development, starting out with our contact lists and authors who published relevant studies. Citation screening and full-text review will be conducted by pairs of reviewers. Abstracted data will include those related to the decision context and decision problem of the early evaluation, evaluation methods (e.g., data sources, methods, and assumptions used to

  6. An educational method for evaluating the resistance to the treatment in the diagnosis of dyscalculia

    Directory of Open Access Journals (Sweden)

    Giampaolo Chiappini

    2016-04-01

    Full Text Available In this paper a didactical method that has been proven effective for evaluating the “resistance to the treatment” of the student is presented. This parameter is essential for distinguishing the learning difficulties in mathematics from the learning disorder of dyscalculia. The method is based on GimmeFive, an application that has been designed to develop skills in mental calculation of multi-digit additions and subtractions. In this paper we present the results of two experiments conducted with groups of students respectively with learning difficulties in mathematics and dyscalculia. These experiments allowed to show the effectiveness of the didactical method in the evaluation of the resistance to the treatment and to discuss the features that make it adequate for the evaluation of the learning disorder. An educational method for evaluating the resistance to the treatment in the diagnosis of dyscalculiaIn questo lavoro viene presentato un metodo didattico che si è dimostrato efficace per valutare la resistenza al trattamento dello studente che è uno dei parametri fondamentali per distinguere la difficoltà di apprendimento in matematica dal disturbo di apprendimento noto come discalculia. Il metodo si basa sull’uso dell’applicazione GimmeFive che è stata progettata per sviluppare competenze nel calcolo mentale di addizioni e sottrazioni a più cifre. In questo lavoro vengono presentati risultati di due sperimentazioni condotte con gruppi di studenti rispettivamente con difficoltà di apprendimento e con diagnosi di discalculia. Queste sperimentazioni hanno consentito di mostrare l’efficacia del metodo didattico nella valutazione della resistenza al trattamento e di discutere le caratteristiche che lo rendono adeguato per la valutazione del disturbo di apprendimento.

  7. Sociodemographic and economic factors are associated with weight gain between before and after cancer diagnosis: results from the prospective population-based NutriNet-Santé cohort.

    Science.gov (United States)

    Fassier, Philippine; Zelek, Laurent; Bachmann, Patrick; Touillaud, Marina; Druesne-Pecollo, Nathalie; Partula, Valentin; Hercberg, Serge; Galan, Pilar; Cohen, Patrice; Hoarau, Hélène; Latino-Martel, Paule; Srour, Bernard; Gonzalez, Rebeca; Deschasaux, Mélanie; Touvier, Mathilde

    2017-08-15

    While many cancer patients are affected by weight loss, others tend to gain weight, which may impact prognosis and risk of recurrence and of second cancer. The aim of this prospective study was to investigate weight variation between before and after cancer diagnosis and socio-demographic, economic, lifestyle and clinical factors associated with moderate-to-severe weight gain. 1051 incident cases of first primary cancer were diagnosed in the NutriNet-Santé cohort between 2009 and 2015. Weight was prospectively collected every 6 months since subjects' inclusion (i.e. an average of 2y before diagnosis). Mean weights before and after cancer diagnosis were compared with paired Student's t-test. Factors associated with moderate-to-severe weight gain (≥5% of initial weight) were investigated by age and sex-adjusted logistic regression. Weight loss was observed in men (-3.54±4.39kg in those who lost weight, p=0.0002) and in colorectal cancer patients (-3.94±4.40kg, p=0.001). Weight gain was observed in breast and skin cancers (2.83±3.21kg, p=0.04, and 2.96±2.75kg, p=0.04 respectively). Women (OR=1.75[1.06-2.87],p=0.03), younger patients (2.44[1.51-3.70],pgain weight. In breast cancer patients, induced menopause was associated with weight gain (OR=4.12[1.76-9.67]), but no association was detected for tumor characteristics or treatments. This large prospective cohort provided original results on weight variation between before and after cancer diagnosis, highlighting different weight trajectories. Socio-demographic and economic factors appeared to influence the risk of weight gain, illustrating social inequalities in health.

  8. Software Integration of Life Cycle Assessment and Economic Analysis for Process Evaluation

    DEFF Research Database (Denmark)

    Kalakula, Sawitree; Malakula, Pomthong; Siemanonda, Kitipat

    2013-01-01

    This study is focused on the sustainable process design of bioethanol production from cassava rhizome. The study includes: process simulation, sustainability analysis, economic evaluation and life cycle assessment (LCA). A steady state process simulation if performed to generate a base case design...... of the bioethanol conversion process using cassava rhizome as a feedstock. The sustainability analysis is performed to analyze the relevant indicators in sustainability metrics, to definedesign/retrofit targets for process improvements. Economic analysis is performed to evaluate the profitability of the process........ Also, simultaneously with sustainability analysis, the life cycle impact on environment associated with bioethanol production is performed. Finally, candidate alternative designs are generated and compared with the base case design in terms of LCA, economics, waste, energy usage and enviromental impact...

  9. Economic evaluation of energy saving measures in a common type of Greek building

    International Nuclear Information System (INIS)

    Nikolaidis, Yiannis; Pilavachi, Petros A.; Chletsis, Alexandros

    2009-01-01

    This paper deals with the economic analysis and evaluation of various energy saving measures in the building sector, focusing on a domestic detached house in Greece, i.e. in a typical Mediterranean climate. In order to detect the energy saving measures that, in addition to energy benefits, can also provide economic profits, the study examines the following measures: all kinds of insulation; upgrading of the heating system; use of thermal solar systems; upgrading of lighting; upgrading of electric appliances; upgrading of the cooling system. The economic evaluation methods used for ranking the energy saving measures are the Net Present Value, the Internal Rate of Return, the Savings to Investment Ratio and the Depreciated Payback Period. It has been found that amongst the most effective energy saving methods are the upgrading of lighting, the insulation of the roof of the building and the installation of an automatic temperature control system.

  10. Evaluation of the performance of diagnosis-related groups and similar casemix systems: methodological issues.

    Science.gov (United States)

    Palmer, G; Reid, B

    2001-05-01

    With the increasing recognition and application of casemix for managing and financing healthcare resources, the evaluation of alternative versions of systems such as diagnosis-related groups (DRGs) has been afforded high priority by governments and researchers in many countries. Outside the United States, an important issue has been the perceived need to produce local versions, and to establish whether or not these perform more effectively than the US-based classifications. A discussion of casemix evaluation criteria highlights the large number of measures that may be used, the rationale and assumptions underlying each measure, and the problems in interpreting the results. A review of recent evaluation studies from a number of countries indicates that considerable emphasis has been placed on the predictive validity criterion, as measured by the R2 statistic. However, the interpretation of the findings has been affected greatly by the methods used, especially the treatment and definition of outlier cases. Furthermore, the extent to which other evaluation criteria have been addressed has varied widely. In the absence of minimum evaluation standards, it is not possible to draw clear-cut conclusions about the superiority of one version of a casemix system over another, the need for a local adaptation, or the further development of an existing version. Without the evidence provided by properly designed studies, policy-makers and managers may place undue reliance on subjective judgments and the views of the most influential, but not necessarily best informed, healthcare interest groups.

  11. EVALUATION OF SMALL BUSINESS INFLUENCE ON THE ECONOMIC DEVELOPMENT OF THE REGION

    Directory of Open Access Journals (Sweden)

    Olena Zvarych

    2017-12-01

    Full Text Available The purpose of the paper is to study the role and assess the small business development influence on the economic development of the region. Methods. Theoretical and methodological foundations of the research draw up the scientists’ works on the problems of economic development of the regions. During the scientific research, a complex of such methods was used: generalization and scientific abstraction – in order to specify the conceptualcategorical instrument and identify characteristics of the small business; monographic – in case of highlighting the scientists’ views on the investigated problems; comparative analysis – when identifying features of small business influence on the economic development of the region; mathematical modelling in economics – to develop the methodology for the evaluation of small business development influence on the economic development of the region. Results. Special aspects of small business functioning as a factor of the economic development of the region that accommodates economic growth, the improvement of the product quality and social indicators of development, formation of the middle class, decrease of the unemployment rate, increase of the population living standards are researched. The ambiguity of approaches to the small business definition is established, the characteristic feature of which, in most cases, is the number of employees. However, the small business is distinguished for industrial enterprises and service-oriented companies, based on the structure of management, and also taking into account the self-regulation of small enterprises or their relations to the large enterprises or industrial group of companies. It is established that criteria for the evaluation of the efficiency of small business enterprises can be: increase in the entrepreneurship development rates, minimization of material and social losses of the society, increasing the share of small business in GDP formation

  12. Economic impact of an ultrasonographic contrast agent on the diagnosis and initial management of patients with suspected renal artery stenosis

    International Nuclear Information System (INIS)

    Levesque, J.; Lacourciere, Y.; Onrot, J.M.

    2002-01-01

    To determine resource use in the diagnosis and management of Canadian hypertensive patients with suspected renal artery stenosis and to estimate the impact of diagnosis with contrast-enhanced duplex Doppler ultrasonography (US) on resource use. Seventy-eight patients with suspected renal artery stenosis underwent usual diagnostic tests (captopril-enhanced renal scintigraphy or duplex Doppler US) and contrast-enhanced US. A management pathway ('planned') describing the medical resources required for further patient care was outlined on the basis of results from each test (separately), and a modified management pathway ('recommended'), which considered data from both diagnostic methods, was also outlined. Medical resources and productivity losses were assessed prospectively for a 3-month period after patients underwent both tests ('actual' management pathway). With usual diagnostic methods, 14 (18%) of the tests were inconclusive, whereas only 1 (1%) of the enhanced US examinations was inconclusive; the cost-efficacy ratio was $422 and $343 per successful diagnosis, respectively. Further management costs for patients with an inconclusive diagnosis were estimated at $6370 after the usual diagnostic tests, but only $1278 with enhanced US. Although the costs of the planned and recommended management pathways were similar ($227 and $294 per patient respectively), the proportion of patients requiring further resources was lower with enhanced US (56% v. 46%). Three-month actual management costs ranged from $121 to $1605 per patient (mean $360). Diagnostic tests and surgical procedures were the major cost drivers in all pathways, and costs wore highest for patients in whom stenosis was diagnosed. For patients with suspected renal artery stenosis, contrast-enhanced US had a higher diagnostic success rate than usual diagnostic methods and afforded savings through lower administrative costs and lower medical resource consumption for patients whose diagnosis was unclear after

  13. EVALUATION OF ECONOMIC EFFICIENCY PERTAINING TO USAGE OF AUTOMOTIVE TRANSPORT FACILITIES WHILE EXECUTING INTERNATIONAL CARGO TRANSPORTATION

    Directory of Open Access Journals (Sweden)

    R. B. Ivut

    2010-01-01

    Full Text Available The paper presents a methodology for evaluation of economic efficiency pertaining to usage of automotive transport facilities while executing international cargo transportation on the basis of average internal norm calculation of automotive operational profitability of a specific model under conditions which are typical for the given market by an average carrier.

  14. Economic evaluation of vaccines: Considerations on evidence, discounting, models and futures challenges

    NARCIS (Netherlands)

    Postma, M.; Largeron, N.; Annemans, L.

    2012-01-01

    OBJECTIVES: During the last decade, with the arrival of new innovative vaccines, there was a huge increase in the number of papers on economic evaluation of vaccination programmes. Our study had a 3-fold objective: 1) Appraise available methodological papers dealing with specificities of vaccines in

  15. Developing guidelines for good practice in the economic evaluation of occupational safety and health interventions

    NARCIS (Netherlands)

    Tompa, Emile; Verbeek, Jos; van Tulder, Maurits; de Boer, Angela

    2010-01-01

    One of the objectives of a recently held workshop in Amsterdam, the Netherlands, was to advance methods for the economic evaluation of occupational safety and health (OSH) interventions at the corporate and societal level. Drawing from that workshop, we discuss issues to consider when developing

  16. Evaluating the Air Quality, Climate Change, and Economic Impacts of Biogas Management Technologies

    Science.gov (United States)

    This is an abstract for a presentation that describes a project to evaluate economic and environmental performance of several biogas management technologies. It will analyze various criteria air pollutants, greenhouse gas emissions, and costs associated with the use of biogas. Th...

  17. Modelling and economic evaluation of forest biome shifts under climate change in Southwest Germany

    Science.gov (United States)

    Marc Hanewinkel; Susan Hummel; Dominik. Cullmann

    2010-01-01

    We evaluated the economic effects of a predicted shift from Norway spruce (Picea abies) to European beech (Fagus sylvatica) for a forest area of 1.3 million ha in southwest Germany. The shift was modelled with a generalized linear model (GLM) by using presence/absence data from the National Forest Inventory in Baden-Wurttemberg...

  18. A preliminary economic evaluation of percutaneous neuromuscular electrical stimulation in the treatment of hemiplegic shoulder pain

    NARCIS (Netherlands)

    van Til, Janine Astrid; Renzenbrink, Gerbert J.; Groothuis-Oudshoorn, Catharina Gerarda Maria; IJzerman, Maarten Joost

    Objective. The objective of this study was to compare the cost-effectiveness of various treatment modalities for hemiplegic shoulder pain. Design. A stage II economic evaluation. Main outcome measures. Incremental cost effectiveness ratio of P-NMES, compared to slings and anti-inflammatory

  19. Learning Online: A Case Study Exploring Student Perceptions and Experience of a Course in Economic Evaluation

    Science.gov (United States)

    Skordis-Worrall, Jolene; Haghparast-Bidgoli, Hassan; Batura, Neha; Hughes, Jane

    2015-01-01

    This study explored the perceptions and experiences of a group of students enrolled in an online course in Economic Evaluation. A mixed methods approach was adopted for the data collection, and thematic analysis was used to synthesize the data collected and highlight key findings. The participants identified several positive and negative perceived…

  20. Cultural, Social, and Economic Capital Constructs in International Assessments: An Evaluation Using Exploratory Structural Equation Modeling

    Science.gov (United States)

    Caro, Daniel H.; Sandoval-Hernández, Andrés; Lüdtke, Oliver

    2014-01-01

    The article employs exploratory structural equation modeling (ESEM) to evaluate constructs of economic, cultural, and social capital in international large-scale assessment (LSA) data from the Progress in International Reading Literacy Study (PIRLS) 2006 and the Programme for International Student Assessment (PISA) 2009. ESEM integrates the…