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Sample records for economic evaluation diagnosis

  1. 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.

  2. 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.

  3. 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)

  4. [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

  5. 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

  6. 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

  7. 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.

  8. 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.

  9. 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...

  10. 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.

  11. 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

  12. 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.

  13. 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.

  14. 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.

  15. 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.

  16. 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

  17. 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.

  18. 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...

  19. 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.

  20. 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.

  1. 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.)

  2. 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

  3. 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.

  4. 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.

  5. 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.

  6. 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.

  7. 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

  8. 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

  9. 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.

  10. 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

  11. 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.

  12. 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)

  13. [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.

  14. 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

  15. 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...

  16. 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.

  17. 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

  18. 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

  19. 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.

  20. 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

  1. 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

  2. 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

  3. 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.

  4. 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

  5. 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

  6. 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.

  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. 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.

  11. [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.

  12. 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.)

  13. 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.

  14. 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...

  15. 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.

  16. 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.

  17. 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

  18. 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.

  19. 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.

  20. 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

  1. 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

  2. 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.

  3. 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.

  4. 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...

  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. 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.

  7. 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

  8. 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.

  9. 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.

  10. 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

  11. 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.

  12. 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.

  13. 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

  14. 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.

  15. 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.

  16. 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

  17. 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...

  18. 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

  19. 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.

  20. 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

  1. 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

  2. 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

  3. 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.)

  4. 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

  5. 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.

  6. 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

  7. 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.

  8. 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

  9. 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.

  10. 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

  11. 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.

  12. 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.

  13. 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)

  14. 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.

  15. 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

  16. 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

  17. 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

  18. 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...

  19. 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...

  20. 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.

  1. 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

  2. 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.)

  3. 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

  4. 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.

  5. 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.

  6. 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.

  7. 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.

  8. 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

  9. 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)

  10. [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.

  11. 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

  12. 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.

  13. What is the impact of antenatal diagnosis on long-term outlook?

    Energy Technology Data Exchange (ETDEWEB)

    Garel, Laurent [CHU Ste-Justine, Department of Medical Imaging, Montreal (Canada)

    2008-06-15

    Congential malformations result in very significant consequences in paediatrics; more than 20% of infant mortality, more than 30% of paediatric ICU admissions, and one-third of overall admissions in the paediatric age group are linked to congential malformations. Health economics and antenatal diagnosis. Key issues yet to be addressed include: 1. Clarification of the objectives for screening for birth defects: Is it to detect cases or to prevent the birth of affected fetuses? 2. The establishment of the trade-of between resources allocated to screening and those allocated to help families and disabled children. 3. The value of a child born with structural or chromosomal defects compared with miscarriage of a normal fetus following amniocentesis. Apart from the ethical debates related to prenatal screening (variable expertise, rationing of resources, eugenics), the economic evaluations of antenatal diagnosis espouse the hypothesis and value judgment of the health commissioners. Indeed, prenatal screening and antenatal diagnosis carry high political and social stakes that make evidence-based evaluation of their impact more difficult than in any field in medicine. (orig.)

  14. Diagnosis in the Enterprise Management System

    Directory of Open Access Journals (Sweden)

    Skrynkovskyy Ruslan M.

    2016-08-01

    Full Text Available The aim of the article is to define the role and place of the diagnosis management system in the structure of the task system of the enterprise diagnosis. There suggested the essence of the concept of «diagnosis of the enterprise», which is understood as the process of identification, analysis and evaluation of the enterprise state and trends in its changes (changes of the state on the basis of relevant business indicators in order to develop recommendations on the elimination of problematic points and weaknesses in the functioning of the enterprise to ensure a qualitatively new level of its development and formation of prospects with consideration to the consequences of violation of the legislation in the field of economics and enterprise management and law (legal responsibility for the violation of the labor law, tax law, law on protection of economic competition, law on trade secret, etc.. It was found that the diagnosis in the system of enterprise management: 1 is a structural component (or a partial diagnosis task in a group of private diagnosis tasks in the system of diagnosis task of the enterprise activity; 2 as a sub-function of the control function (as a general function of management includes such components as: assessment (identification of key features, characteristics, parameters (indexes, indicators, properties; analysis (a thorough study of the structure, dynamics, trends, etc.; identification (involves determination of deviations of parameters from the criteria and/or standards, formulation of diagnosis. Prospects for further research in this direction are the development of methods for quantitative assessment of the effectiveness of the management system with the purpose of its introducing in practical activities of enterprises, namely in the processes of decision-making.

  15. 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.

  16. 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.

  17. 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)

  18. 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.

  19. 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

  20. 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.

  1. [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.

  2. 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...

  3. 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.

  4. 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.

  5. 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

  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. 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....

  8. 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.

  9. 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.

  10. 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

  11. 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.

  12. 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

  13. 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

  14. 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

  15. 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.

  16. 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.

  17. 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.

  18. 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 ...

  19. [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.

  20. 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.

  1. 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...

  2. 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

  3. 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.

  4. 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

  5. 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.

  6. 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

  7. 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.

  8. 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

  9. 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

  10. 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.

  11. 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.

  12. 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)

  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. 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

  15. Bibliometric trends of health economic evaluation in Sub-Saharan Africa.

    Science.gov (United States)

    Hernandez-Villafuerte, Karla; Li, Ryan; Hofman, Karen J

    2016-08-24

    Collaboration between Sub-Saharan African researchers is important for the generation and transfer of health technology assessment (HTA) evidence, in order to support priority-setting in health. The objective of this analysis was to evaluate collaboration patterns between countries. We conducted a rapid evidence assessment that included a random sample of health economic evaluations carried out in 20 countries (Angola, Botswana, Congo, Lesotho, Madagascar, Malawi, Mauritius, Mozambique, Namibia, Seychelles, South Africa, Swaziland, Tanzania, Zambia, Zimbabwe, Ghana, Kenya, Nigeria, Ethiopia, Uganda). We conducted bibliometric network analysis based on all first authors with a Sub-Saharan African academic affiliation and their co-authored publications ("network-articles"). Then we produced a connection map of collaboration patterns among Sub-Saharan African researchers, reflecting the number of network-articles and the country of affiliation of the main co-authors. The sample of 119 economic evaluations mostly related to treatments of communicable diseases, in particular HIV/AIDS (42/119, 35.29 %) and malaria (26/119, 21.85 %). The 39 first authors from Sub-Saharan African institutions together co-authored 729 network-articles. The network analysis showed weak collaboration between health economic researchers in Sub-Saharan Africa, with researchers being more likely to collaborate with Europe and North America than with other African countries. South Africa stood out as producing the highest number of health economic evaluations and collaborations. The development and evaluation of HTA research networks in Sub-Saharan Africa should be supported, with South Africa central to any such efforts. Organizations and institutions from high income countries interested in supporting priority setting in Sub-Saharan Africa should include promoting collaboration as part of their agendas, in order to take advantage of the potential transferability of results and methods of the

  16. 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.)

  17. 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.

  18. 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.

  19. 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.

  20. 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...

  1. Public health economics: a systematic review of guidance for the economic evaluation of public health interventions and discussion of key methodological issues.

    Science.gov (United States)

    Edwards, Rhiannon Tudor; Charles, Joanna Mary; Lloyd-Williams, Huw

    2013-10-24

    If Public Health is the science and art of how society collectively aims to improve health, and reduce inequalities in health, then Public Health Economics is the science and art of supporting decision making as to how society can use its available resources to best meet these objectives and minimise opportunity cost. A systematic review of published guidance for the economic evaluation of public health interventions within this broad public policy paradigm was conducted. Electronic databases and organisation websites were searched using a 22 year time horizon (1990-2012). References of papers were hand searched for additional papers for inclusion. Government reports or peer-reviewed published papers were included if they; referred to the methods of economic evaluation of public health interventions, identified key challenges of conducting economic evaluations of public health interventions or made recommendations for conducting economic evaluations of public health interventions. Guidance was divided into three categories UK guidance, international guidance and observations or guidance provided by individual commentators in the field of public health economics. An assessment of the theoretical frameworks underpinning the guidance was made and served as a rationale for categorising the papers. We identified 5 international guidance documents, 7 UK guidance documents and 4 documents by individual commentators. The papers reviewed identify the main methodological challenges that face analysts when conducting such evaluations. There is a consensus within the guidance that wider social and environmental costs and benefits should be looked at due to the complex nature of public health. This was reflected in the theoretical underpinning as the majority of guidance was categorised as extra-welfarist. In this novel review we argue that health economics may have come full circle from its roots in broad public policy economics. We may find it useful to think in this broader

  2. 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

  3. 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.

  4. 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

  5. Finding the economics in economic entomology.

    Science.gov (United States)

    Onstad, David W; Knolhoff, Lisa M

    2009-02-01

    To recommend new pest management tactics and strategies to farmers and policy makers, economic entomologists must evaluate the economics of biologically reasonable approaches. We collected data to determine how frequently these economic evaluations occur. We discovered from our survey of entomological journals representing the discipline of economic entomology that papers published since 1972 include economic evaluations of pest management tactics. At least 85% of these analyses were performed by entomologists and not economists. Much of the research on economic evaluations is performed without special funds granted by agencies separate from the authors' institutions. In the United States, USDA competitive grants supported 20% of the economic evaluations published since 2000. However, only approximately 12% of the projects funded since 2000 by three sections of the USDA (Crops at Risk, Risk Avoidance and Mitigation Program, and Pest Management Alternatives Program) resulted in publications concerning economic evaluations. If the purpose of economic entomology is to ultimately determine the value of different kinds of tactics, the discipline may need to take steps to enhance the research that supports these evaluations.

  6. 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.

  7. 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

  8. 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

  9. 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

  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. 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.

  12. 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

  13. 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

  14. 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.

  15. 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.

  16. 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

  17. Economical evaluation of mineral reserves. Economicheskaya otsenka minerae'nykh resursov

    Energy Technology Data Exchange (ETDEWEB)

    Astakhov, A S

    1981-01-01

    An approach to the evaluation of mineral resources is presented which takes into account a number of interrelated economical, technological and social aspects. The basic pattern of man and environment interaction in the process of mineral resources recovery is analyzed. Various approaches to classification of mineral resources are presented. Problems related to the development of a criterion and a system of factors characteristic for particular aspects of mineral resources management are discussed in detail. A dynamic approach to the economical evaluation of mineral reserves based on the form, magnitude, and the moment of time when the compensation of damage caused by the loss of resources in question becomes necessary, is presented. The influence of typical technical restrictions on the capacity of mining enterprises and the succession of the development of a field is discussed. Dynamic aspects of the evaluation of promising mineral reserves as a limited and nonreproducible natural resource is studied in detail. Actual methods and the state of current studies in the field of the economical evaluation of mineral deposits in the USSR, the CMEA countries and in capitalistic countries are presented.

  18. 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...

  19. 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.

  20. 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.

  1. 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.

  2. Public health economics: a systematic review of guidance for the economic evaluation of public health interventions and discussion of key methodological issues

    Science.gov (United States)

    2013-01-01

    Background If Public Health is the science and art of how society collectively aims to improve health, and reduce inequalities in health, then Public Health Economics is the science and art of supporting decision making as to how society can use its available resources to best meet these objectives and minimise opportunity cost. A systematic review of published guidance for the economic evaluation of public health interventions within this broad public policy paradigm was conducted. Methods Electronic databases and organisation websites were searched using a 22 year time horizon (1990–2012). References of papers were hand searched for additional papers for inclusion. Government reports or peer-reviewed published papers were included if they; referred to the methods of economic evaluation of public health interventions, identified key challenges of conducting economic evaluations of public health interventions or made recommendations for conducting economic evaluations of public health interventions. Guidance was divided into three categories UK guidance, international guidance and observations or guidance provided by individual commentators in the field of public health economics. An assessment of the theoretical frameworks underpinning the guidance was made and served as a rationale for categorising the papers. Results We identified 5 international guidance documents, 7 UK guidance documents and 4 documents by individual commentators. The papers reviewed identify the main methodological challenges that face analysts when conducting such evaluations. There is a consensus within the guidance that wider social and environmental costs and benefits should be looked at due to the complex nature of public health. This was reflected in the theoretical underpinning as the majority of guidance was categorised as extra-welfarist. Conclusions In this novel review we argue that health economics may have come full circle from its roots in broad public policy economics. We may

  3. [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.

  4. 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

  5. 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

  6. 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.

  7. 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

  8. 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

  9. 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)

  10. 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

  11. Study protocol of an economic evaluation of an extended implementation strategy for the treatment of low back pain in general practice: a cluster randomised controlled trial.

    Science.gov (United States)

    Jensen, Cathrine Elgaard; Riis, Allan; Pedersen, Kjeld Møller; Jensen, Martin Bach; Petersen, Karin Dam

    2014-10-08

    In Denmark, guidelines on low back pain management are currently being implemented; in association with this, a clinical trial is conducted. A health economic evaluation is carried out alongside the clinical trial to assess the cost-effectiveness of an extended implementation strategy to increase the general practitioners' adherence to the guidelines. In addition to usual dissemination, the extended implementation strategy is composed of visits from a guideline facilitator, stratification tools, and feedback on guideline adherence. The aim of this paper is to provide the considerations on the design of the health economic evaluation. 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 will be enrolled. The economic evaluation comprises both a cost-effectiveness analyses and a cost-utility analysis. Effectiveness measures include referral to secondary care, health-related quality of life measured by EQ-5D-5L, and disability measured by the Roland Morris disability questionnaire. Cost measures 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. It is expected that the extended implementation strategy will reduce the number of patients referred to secondary care. It is hypothesised that the additional upfront cost of extended implementation will be counterbalanced by improvements in clinical practice and patient-related outcomes, thereby rendering the extended implementation strategy cost-effective. ClinicalTrials.gov: NCT01699256.

  12. 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.

  13. 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

  14. 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

  15. Electrical machines diagnosis

    CERN Document Server

    Trigeassou, Jean-Claude

    2013-01-01

    Monitoring and diagnosis of electrical machine faults is a scientific and economic issue which is motivated by objectives for reliability and serviceability in electrical drives.This book provides a survey of the techniques used to detect the faults occurring in electrical drives: electrical, thermal and mechanical faults of the electrical machine, faults of the static converter and faults of the energy storage unit.Diagnosis of faults occurring in electrical drives is an essential part of a global monitoring system used to improve reliability and serviceability. This diagnosis is perf

  16. 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)

  17. 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.

  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 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...

  20. 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

  1. 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

  2. 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.

  3. Using whole disease modeling to inform resource allocation decisions: economic evaluation of a clinical guideline for colorectal cancer using a single model.

    Science.gov (United States)

    Tappenden, Paul; Chilcott, Jim; Brennan, Alan; Squires, Hazel; Glynne-Jones, Rob; Tappenden, Janine

    2013-06-01

    To assess the feasibility and value of simulating whole disease and treatment pathways within a single model to provide a common economic basis for informing resource allocation decisions. A patient-level simulation model was developed with the intention of being capable of evaluating multiple topics within National Institute for Health and Clinical Excellence's colorectal cancer clinical guideline. The model simulates disease and treatment pathways from preclinical disease through to detection, diagnosis, adjuvant/neoadjuvant treatments, follow-up, curative/palliative treatments for metastases, supportive care, and eventual death. The model parameters were informed by meta-analyses, randomized trials, observational studies, health utility studies, audit data, costing sources, and expert opinion. Unobservable natural history parameters were calibrated against external data using Bayesian Markov chain Monte Carlo methods. Economic analysis was undertaken using conventional cost-utility decision rules within each guideline topic and constrained maximization rules across multiple topics. Under usual processes for guideline development, piecewise economic modeling would have been used to evaluate between one and three topics. The Whole Disease Model was capable of evaluating 11 of 15 guideline topics, ranging from alternative diagnostic technologies through to treatments for metastatic disease. The constrained maximization analysis identified a configuration of colorectal services that is expected to maximize quality-adjusted life-year gains without exceeding current expenditure levels. This study indicates that Whole Disease Model development is feasible and can allow for the economic analysis of most interventions across a disease service within a consistent conceptual and mathematical infrastructure. This disease-level modeling approach may be of particular value in providing an economic basis to support other clinical guidelines. Copyright © 2013 International

  4. 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

  5. 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

  6. 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.

  7. 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

  8. 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

  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. 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.

  11. 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.

  12. 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

  13. 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

  14. 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.

  15. 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

  16. 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.

  17. 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...

  18. 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.

  19. 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.

  20. 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.

  1. 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

  2. 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)

  3. 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…

  4. 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.

  5. 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)

  6. 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.)

  7. 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 ...

  8. 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 ...

  9. Economic evaluation for first-line anti-hypertensive medicines: applications for the Philippines

    Directory of Open Access Journals (Sweden)

    Geroy Lester Sam Araneta

    2012-12-01

    Full Text Available Abstract Background Medicines to control hypertension, a leading cause of morbidity and mortality, are a major component of health expenditures in the Philippines. This study aims to review economic studies for first line anti-hypertensive medical treatment without co-morbidities; and discuss practical, informational and policy implications on the use of economic evaluation in the Philippines. Methods A systematic literature review was performed using the following databases: MEDLINE, EMBASE, BIOSIS, PubMed, The Cochrane Library, Health Economics Evaluations Database (HEED and the Centre for Reviews and Dissemination – NHS NICE. Six existing economic analytical frameworks were reviewed and one framework for critical appraisal was developed. Results Out of 1336 searched articles, 12 fulfilled the inclusion criteria. The studies were summarized according to their background characteristics (year, journal, intervention and comparators, objective/study question, target audience, economic study type, study population, setting and country and source of funding/conflict of interest and technical characteristics (perspective, time horizon, methodology/modeling, search strategy for parameters, costs, effectiveness measures, discounting, assumptions and biases, results, cost-effectiveness ratio, endpoints, sensitivity analysis, generalizability, strengths and limitations, conclusions, implications and feasibility and recommendations. The studies represented different countries, perspectives and stakeholders. Conclusions Diuretics were the most cost-effective drug class for first-line treatment of hypertension without co-morbidities. Although the Philippine Health Insurance Corporation may apply the recommendations given in previous studies (i.e. to subsidize diuretics, ACE inhibitors and calcium channel blockers, it is uncertain how much public funding is justified. There is an information gap on clinical data (transition probabilities, relative risks

  10. Economic evidence for the clinical management of major depressive disorder: a systematic review and quality appraisal of economic evaluations alongside randomised controlled trials.

    Science.gov (United States)

    Karyotaki, E; Tordrup, D; Buntrock, C; Bertollini, R; Cuijpers, P

    2017-10-01

    The aim of this systematic review of economic evaluations alongside randomised controlled trials (RCTs) was to provide a comprehensive overview of the evidence concerning cost-effectiveness analyses of common treatment options for major depression. An existing database was used to identify studies reporting cost-effectiveness results from RCTs. This database has been developed by a systematic literature search in the bibliographic databases of PubMed, PsychINFO, Embase and Cochrane library from database inception to December 2014. We evaluated the quality of economic evaluations using a 10-item short version of the Drummond checklist. Results were synthesised narratively. The risk of bias of the included RCTs was assessed, based on the Cochrane risk of bias assessment tool. Fourteen RCTs were included from the 5580 articles screened on titles and abstracts. The methodological quality of the health economic evaluations was relatively high and the majority of the included RCTs had low risk of bias in most of Cochrane items except blinding of participants and personnel. Cognitive behavioural therapy was examined in seven trials as part of a variety of treatment protocols and seems cost-effective compared with pharmacotherapy in the long-term. However cost-effectiveness results for the combination of psychotherapy with pharmacotherapy are conflicting and should be interpreted with caution due to limited comparability between the examined trials. For several treatments, only a single economic evaluation was reported as part of a clinical trial. This was the case for comparisons between different classes of antidepressants, for several types of psychotherapy (behavioural activation, occupational therapy, interpersonal psychotherapy, short-term psychotherapy, psychodynamic psychotherapy, rational emotive behavioural therapy, solution focused therapy), and for transcranial magnetic stimulation v. electroconvulsive therapy. The limited evidence base for these interventions

  11. 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

  12. 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)

  13. 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...

  14. 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.

  15. 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.)

  16. 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)

  17. 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

  18. 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.

  19. 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 ...

  20. 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.

  1. 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...

  2. 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.)

  3. 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...

  4. 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...

  5. 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

  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. A reference case for economic evaluations in osteoarthritis: an expert consensus article from the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO).

    Science.gov (United States)

    Hiligsmann, Mickaël; Cooper, Cyrus; Guillemin, Francis; Hochberg, Marc C; Tugwell, Peter; Arden, Nigel; Berenbaum, Francis; Boers, Maarten; Boonen, Annelies; Branco, Jaime C; Maria-Luisa, Brandi; Bruyère, Olivier; Gasparik, Andrea; Kanis, John A; Kvien, Tore K; Martel-Pelletier, Johanne; Pelletier, Jean-Pierre; Pinedo-Villanueva, Rafael; Pinto, Daniel; Reiter-Niesert, Susanne; Rizzoli, René; Rovati, Lucio C; Severens, Johan L; Silverman, Stuart; Reginster, Jean-Yves

    2014-12-01

    General recommendations for a reference case for economic studies in rheumatic diseases were published in 2002 in an initiative to improve the comparability of cost-effectiveness studies in the field. Since then, economic evaluations in osteoarthritis (OA) continue to show considerable heterogeneity in methodological approach. To develop a reference case specific for economic studies in OA, including the standard optimal care, with which to judge new pharmacologic and non-pharmacologic interventions. Four subgroups of an ESCEO expert working group on economic assessments (13 experts representing diverse aspects of clinical research and/or economic evaluations) were charged with producing lists of recommendations that would potentially improve the comparability of economic analyses in OA: outcome measures, comparators, costs and methodology. These proposals were discussed and refined during a face-to-face meeting in 2013. They are presented here in the format of the recommendations of the recently published Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement, so that an initiative on economic analysis methodology might be consolidated with an initiative on reporting standards. Overall, three distinct reference cases are proposed, one for each hand, knee and hip OA; with diagnostic variations in the first two, giving rise to different treatment options: interphalangeal or thumb-based disease for hand OA and the presence or absence of joint malalignment for knee OA. A set of management strategies is proposed, which should be further evaluated to help establish a consensus on the "standard optimal care" in each proposed reference case. The recommendations on outcome measures, cost itemisation and methodological approaches are also provided. The ESCEO group proposes a set of disease-specific recommendations on the conduct and reporting of economic evaluations in OA that could help the standardisation and comparability of studies that evaluate

  8. 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)

  9. 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

  10. 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...

  11. Evaluation and Characterization of Health Economics and Outcomes Research in SAARC Nations.

    Science.gov (United States)

    Mehta, Manthan; Nerurkar, Rajan

    2018-05-01

    To identify, evaluate, and characterize the variety, quality, and intent of the health economics and outcomes research studies being conducted in SAARC (South Asian Association for Regional Cooperation) nations. Studies published in English language between 1990 and 2015 were retrieved from Medline databases using relevant search strategies. Studies were independently reviewed as per Cochrane methodology and information on the type of research and outcomes were extracted. Quality of reporting was assessed. Of the 2638 studies screened from eight SAARC nations, a total of 179 were included for review (India = 140; Bangladesh = 12; Sri Lanka = 8; Pakistan = 7; Afghanistan = 5; Nepal = 4; Bhutan = 2; Maldives = 1). The broad study categories were cost-effectiveness analyses (CEAs = 76 studies), cost analyses (35 studies), and burden of illness (BOI=26 studies). The outcomes evaluated were direct costs, indirect costs, and incremental cost-effectiveness ratio (ICER), quality-adjusted life-years (QALYs), and disability-adjusted life-years (DALYs). Cost of medicines, consultation and hospital charges, and monitoring costs were assessed as direct medical costs along with non-direct medical costs such as travel and food for patients and caregivers. The components of indirect costs were loss of income of patients and caregivers and loss of productivity. Quality of life (QoL) was assessed in 48 studies. The most commonly used instrument for assessing QoL was the WHO-Quality of Life BREF (WHOQOL-BREF) questionnaire (76%). The Quality of Health Economic Studies (QHES) score was used for quality assessment of full economic studies (44 studies). The mean QHES score was 43.76. This review identifies various patterns of health economic studies in eight SAARC nations. The quality of economic evaluation studies for health care in India, Bangladesh, Sri Lanka, Pakistan, Afghanistan, Nepal, Bhutan, and Maldives needs improvement. There is a need to generate the capacity of researchers

  12. 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.

  13. Revolution then evolution: the advance of health economic evaluation in Australia.

    Science.gov (United States)

    Lopert, Ruth; Viney, Rosalie

    2014-01-01

    All governments face immense challenges in providing affordable healthcare for their citizens, and the diffusion of novel health technologies is a key driver of growth in expenditure for many. Although important methodological and process variations exist around the world, health economic evaluation is increasingly seen as an important tool to support decision-making around the introduction of new health technologies, interventions and programmes in countries of varying stages of economic development. In Australia, the assessment of the comparative cost-effectiveness of new medicines proposed for subsidy under the country's national drug subsidy programme, the Pharmaceutical Benefits Scheme, was introduced in the late 1980s and became mandatory in 1993, making Australia the first country to introduce such a requirement nationally. Since then the use of health economic evaluation has expanded and been applied to support decision-making across a broader range of health technologies, as well as to programmes in public health. Copyright © 2014. Published by Elsevier GmbH.

  14. 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

  15. 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.)

  16. Valuing Our Communities: Ethical Considerations for Economic Evaluation of Community-Based Prevention.

    Science.gov (United States)

    Crowley, Max; Jones, Damon

    2017-12-01

    Restricted public budgets and increasing efforts to link the impact of community interventions to public savings have increased the use of economic evaluation. While this type of evaluation can be important for program planning, it also raises important ethical issues about how we value the time of local stakeholders who support community interventions. In particular, researchers navigate issues of scientific accuracy, institutional inequality, and research utility in their pursuit of even basic cost estimates. We provide an example of how we confronted these issues when estimating the costs of a large-scale community-based intervention. Principles for valuing community members' time and conducting economic evaluations of community programs are discussed. © Society for Community Research and Action 2017.

  17. [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.

  18. 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

  19. 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.

  20. The impact of economic evaluation on quality management in spine surgery.

    Science.gov (United States)

    Boos, Norbert

    2009-08-01

    Health care expenditures are substantially increasing within the last two decades prompting the imperative need for economic evaluations in health care. Historically, economic evaluations in health care have been carried out by four approaches: (1) the human-capital approach (HCA), (2) cost-effectiveness analysis (CEA), (3) cost-utility analysis (CUA) and (4) cost-benefit analysis (CBA). While the HCA cannot be recommended because of methodological shortcomings, CEA and CUA have been used frequently in healthcare. In CEA, costs are measured in monetary terms and health effects are measured in a non-monetary unit, e.g. number of successfully treated patients. In an attempt to develop an effectiveness measure that incorporates effects on both quantity and quality of life, so-called Quality Adjusted Life Years (QUALYs) were introduced. Contingent valuation surveys are used in cost-benefit analyses (CBA) to elicit the consumer's monetary valuations for program benefits by applying the willingness-to-pay approach. A distinguished feature of CBA is that costs and benefits are expressed in the same units of value, i.e. money. Only recently, economic evaluations have started to explore various spinal interventions particularly the very expensive fusion operations. While most of the studies used CEA or CUA approaches, CBAs are still rare. Most studies fail to show that sophisticated spinal interventions are more cost-effective than conventional treatments. In spite of the lack of therapeutic or cost-effectiveness for most spinal surgeries, there is rapidly growing spinal implant market demonstrating market imperfection and information asymmetry. A change can only be anticipated when physicians start to focus on the improvement of health care quality as documented by outcome research and economic evaluations of cost-effectiveness and net benefits.

  1. Model‐based economic evaluations in smoking cessation and their transferability to new contexts: a systematic review

    Science.gov (United States)

    Berg, Marrit L.; Cheung, Kei Long; Hiligsmann, Mickaël; Evers, Silvia; de Kinderen, Reina J. A.; Kulchaitanaroaj, Puttarin

    2017-01-01

    Abstract Aims To identify different types of models used in economic evaluations of smoking cessation, analyse the quality of the included models examining their attributes and ascertain their transferability to a new context. Methods A systematic review of the literature on the economic evaluation of smoking cessation interventions published between 1996 and April 2015, identified via Medline, EMBASE, National Health Service (NHS) Economic Evaluation Database (NHS EED), Health Technology Assessment (HTA). The checklist‐based quality of the included studies and transferability scores was based on the European Network of Health Economic Evaluation Databases (EURONHEED) criteria. Studies that were not in smoking cessation, not original research, not a model‐based economic evaluation, that did not consider adult population and not from a high‐income country were excluded. Findings Among the 64 economic evaluations included in the review, the state‐transition Markov model was the most frequently used method (n = 30/64), with quality adjusted life years (QALY) being the most frequently used outcome measure in a life‐time horizon. A small number of the included studies (13 of 64) were eligible for EURONHEED transferability checklist. The overall transferability scores ranged from 0.50 to 0.97, with an average score of 0.75. The average score per section was 0.69 (range = 0.35–0.92). The relative transferability of the studies could not be established due to a limitation present in the EURONHEED method. Conclusion All existing economic evaluations in smoking cessation lack in one or more key study attributes necessary to be fully transferable to a new context. PMID:28060453

  2. Model-based economic evaluations in smoking cessation and their transferability to new contexts: a systematic review.

    Science.gov (United States)

    Berg, Marrit L; Cheung, Kei Long; Hiligsmann, Mickaël; Evers, Silvia; de Kinderen, Reina J A; Kulchaitanaroaj, Puttarin; Pokhrel, Subhash

    2017-06-01

    To identify different types of models used in economic evaluations of smoking cessation, analyse the quality of the included models examining their attributes and ascertain their transferability to a new context. A systematic review of the literature on the economic evaluation of smoking cessation interventions published between 1996 and April 2015, identified via Medline, EMBASE, National Health Service (NHS) Economic Evaluation Database (NHS EED), Health Technology Assessment (HTA). The checklist-based quality of the included studies and transferability scores was based on the European Network of Health Economic Evaluation Databases (EURONHEED) criteria. Studies that were not in smoking cessation, not original research, not a model-based economic evaluation, that did not consider adult population and not from a high-income country were excluded. Among the 64 economic evaluations included in the review, the state-transition Markov model was the most frequently used method (n = 30/64), with quality adjusted life years (QALY) being the most frequently used outcome measure in a life-time horizon. A small number of the included studies (13 of 64) were eligible for EURONHEED transferability checklist. The overall transferability scores ranged from 0.50 to 0.97, with an average score of 0.75. The average score per section was 0.69 (range = 0.35-0.92). The relative transferability of the studies could not be established due to a limitation present in the EURONHEED method. All existing economic evaluations in smoking cessation lack in one or more key study attributes necessary to be fully transferable to a new context. © 2017 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.

  3. 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

  4. Economic evaluation of seawater desalination by using SMART in the MENA

    International Nuclear Information System (INIS)

    Lee, Hyo Sung; Roh, Myung Sub

    2013-01-01

    This paper show the economic evaluation of seawater desalination in the MENA(Middle East and North Africa) by using nuclear source. Especially the evaluation of economics is performed based on comparing the SMART(System integrated Modular Advanced Reactor) developed in Korea with general Combined Cycle Gas Turbine. Taken the economic analysis together, the most important issues for economic feasibility are the management of the construction cost. SMART have a competitive when the construction cost is 3,000$/kWe. Thus plan for the management of the target construction cost will be reflected in the design process like a notion of modularity and mass production methods. Another way is the design optimization of SMART and facility of desalination in a view of the mechanical properties. In other words, it is a way to design improvements for eliminating or sharing of duplicate functions between SMART and desalination facility and maximization the efficiency of energy use. Finally, construction cost can be rationalized by reduce the construction lead time. The potential weakness of SMART is the long construction lead time as compared with alternative. Moreover considering the SMART is suitable for the country which is expected to have the most rapid economic growth in the near future, the construction lead time should be shorten. Managing these concepts to reduce the construction cost is enough to compensate for a disadvantage in power cost and water cost comparing with combined cycle

  5. Economic evaluation of seawater desalination by using SMART in the MENA

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Hyo Sung; Roh, Myung Sub [KEPCO International Nuclear Graduate School, Ulsan (Korea, Republic of)

    2013-10-15

    This paper show the economic evaluation of seawater desalination in the MENA(Middle East and North Africa) by using nuclear source. Especially the evaluation of economics is performed based on comparing the SMART(System integrated Modular Advanced Reactor) developed in Korea with general Combined Cycle Gas Turbine. Taken the economic analysis together, the most important issues for economic feasibility are the management of the construction cost. SMART have a competitive when the construction cost is 3,000$/kWe. Thus plan for the management of the target construction cost will be reflected in the design process like a notion of modularity and mass production methods. Another way is the design optimization of SMART and facility of desalination in a view of the mechanical properties. In other words, it is a way to design improvements for eliminating or sharing of duplicate functions between SMART and desalination facility and maximization the efficiency of energy use. Finally, construction cost can be rationalized by reduce the construction lead time. The potential weakness of SMART is the long construction lead time as compared with alternative. Moreover considering the SMART is suitable for the country which is expected to have the most rapid economic growth in the near future, the construction lead time should be shorten. Managing these concepts to reduce the construction cost is enough to compensate for a disadvantage in power cost and water cost comparing with combined cycle.

  6. 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.

  7. 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.

  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. 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.

  10. 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…

  11. 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.

  12. Technical and economic evaluation of selected technologies of the Landfill Characterization System

    Energy Technology Data Exchange (ETDEWEB)

    Floran, R.J.

    1993-12-31

    In 1992 and 1993, numerous innovative and emerging technologies for characterizing metal and mixed waste contaminants and their migration beneath landfills in and environments were field tested at Sandia`s Chemical Waste Landfill. Many of these technologies are being evaluated as part of the Landfill Characterization System (LCS). The LCS emphasizes minimally intrusive technologies and downhole sensors that strive to be cheaper, better, safer and faster than conventional methods. Major aims of the LCS are to demonstrate, test and evaluate these technologies, and determine whether substantial cost saving over traditional baseline methods can be realized. To achieve these goals, the LCS uses an integrated systems approach that stresses the application of complementary and compatible technologies. Successful field demonstrations combined with favorable economics, will greatly assist the commercialization of these technologies to the private sector and to Environmental Restoration groups throughout the DOE Complex. In this paper, a technical and economic evaluation of selected technologies that comprise the LCS is presented. Because sampling and analysis is the most costly part of a characterization effort, the economic evaluation presented here focuses specifically on these activities. LCS technologies discussed include the ``Smart Sampling Methodology`` and two field screening analytical methods, stripping voltammetry and x-ray fluorescence.

  13. 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

  14. 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.

  15. 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 ...

  16. Diagnosis and Change or Change and Diagnosis.

    Science.gov (United States)

    Cammann, Cortlandt

    Organizational consultation is often viewed as a four-stage process: entry, diagnosis, intervention, and evaluation. A fifth stage, preparation of organizations to conduct diagnosis and change, is frequently neglected. In the preparation stage, organizational consultants must deal with resistance by creating conditions for the consideration of the…

  17. 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.

  18. Tapering off benzodiazepines in long-term users : an economic evaluation

    NARCIS (Netherlands)

    Oude Voshaar, Richard C; Krabbe, Paul F M; Gorgels, Wim J M J; Adang, Eddy M M; van Balkom, Anton J L M; van de Lisdonk, Eloy H; Zitman, Frans G

    2006-01-01

    BACKGROUND: Discontinuation of benzodiazepine usage has never been evaluated in economic terms. This study aimed to compare the relative costs and outcomes of tapering off long-term benzodiazepine use combined with group cognitive behavioural therapy (TO+CBT), tapering off alone (TOA) and usual

  19. 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.

  20. Economic and Ecological Evaluation of Land Use Change: Evidence from Karelia

    Directory of Open Access Journals (Sweden)

    Anton Sergeevich Strokov

    2017-06-01

    Full Text Available Land use change and a shift in economic activity often bring to unpredictable consequences for local ecosystems. There is a necessity of making preliminary evaluation and analysis of comparing the different types of economic and ecological transformation, including cost and benefit analysis, not only for business and local population, but for the whole environment. We give an example of a particular animal husbandry farm in Karelia and show how potential change in economic specialization can be effective on a 10 years horizon. Among other land use types, we chose peat mining and wetland conservation. Each type of activities was complexly evaluated with different types of costs and benefits. In the paper, we use a method of land use change evaluation including the value of ecosystem services. The monetary values of ecosystem services are given with the respect to foreign analogues and taking into account local realities and prices. Our results have shown that the most beneficial for the society and the environment is wetland conservation, due to their berries picking service, which are highly appreciated on the market, and due to low costs for the third parties, since wetlands contain regulative and refinery services for local ecosystems. As a contrary peat mining is a profitable business, but pollutes the environment because of carbon emissions into the atmosphere. The current specialization for animal husbandry is neither an optimal solution because of low profitability of the chosen farm. The results of the research can be used for optimization in regional politics in the sphere of agriculture and environment economics in order to protect the ecological balance between human activities and nature.

  1. Economic evaluation (quantitative for Mung bean (Vigna radiata production in the Kamin Region, Sadat Shahr, Fars province

    Directory of Open Access Journals (Sweden)

    Mahmood Reza Sadikhani

    2016-11-01

    Full Text Available Although one of the biggest disadvantages of an economic evaluation, is volatility of price and instability of economic conditions, But for land use planning, economic considerations play a key role in land use and making decision. Cost is an important factor that encourage farmers to grow special crop. Thus, in addition to the qualitative and quantitative evaluation, Land Suitability can be based on net or gross profit per unit area of land to be assessed in economic terms. The economic evaluation is based on net income or gross income from the land. The purpose of this study was to assess the economic evaluation for part of Saadat Shahr (Kamin region for Mung bean (Vigna radiata. 8 drilled profiles in order to see the profiles were chosen and after collecting data on real output, the variable cost of producing the product and the critical values and estimated gross profit are calculated and land suitability classes were determined. The results showed that one unit has a moderate suitability (S2 and two units have suitable classes (S1 from separate units.

  2. Evaluating quantity and quality of literature focusing on health economics and pharmacoeconomics in Gulf Cooperation Council countries.

    Science.gov (United States)

    Eljilany, Islam; El-Dahiyat, Faris; Curley, Louise Elizabeth; Babar, Zaheer-Ud-Din

    2018-05-30

    The importance of pharmacoeconomics and health economics has been augmented. It has the potential to provide evidence to aid in optimal decision-making in the funding of cost-effective medicines and services in Gulf Cooperation Council countries (G.C.C). To evaluate the quality and quantity of health economic researches published until the end of 2017 in G.C.C. and to identify the factors that affect the quality of studies. Studies were included according to predefined inclusion and exclusion criteria. The quantity was recorded, and the quality was assessed using the Quality of Health Economic Studies (QHES) instrument. Forty-nine studies were included. The mean (SD) quality score of all studies was 57.83 (25.05), and a high number of reviewed studies (47%) were evaluated as either poor or extremely poor quality. The factors that affect the quality of studies with statistical significance were, the type and method of economic evaluation, the economic outcome was the objective of the research, author`s background, the perspective of the study, health intervention and source of funding. The use of economic evaluation studies in G.C.C was limited. Different factors that affect the quality of articles such as performing a full economic evaluation and choosing societal perspective were identified. Strategies to improve the quality of future studies were recommended.

  3. 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...

  4. 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,…

  5. 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)

  6. 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.

  7. 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

  8. 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...

  9. Economic evaluations of pharmacogenetic approaches in infectious diseases: a review of current approaches and evaluation of critical aspects affecting their quality

    Directory of Open Access Journals (Sweden)

    Paolo Meoni

    2013-11-01

    Full Text Available Pharmacogenetics holds great potential for improving the effectiveness of treatment modalities in infectious diseases by taking into account the genetic determinants of both the host and infectious agents’ individuality. Better utilization of resources and improved therapeutic efficiency are the expected outcomes of personalized medicine using pharmacogenetic and pharmacogenomics information made available by technological advances. However, there has been growing concern in the clinical community regarding the evaluation of the true benefits of these approaches. This perception is partly due to the limited number and perceived poor quality of economic evaluations in this field, and initiatives aimed at harmonizing and communicating strategies improving the quality of these studies and their acceptance by the clinical community are greatly needed. This paper reviews current literature of economic evaluations of pharmacogenetics interventions guiding pharmacotherapy in infectious diseases. PubMed and the NHS Centre for Reviews and Dissemination databases were searched using a combination of five broad research terms related to pharmacogenetic approaches, and papers relative to economic evaluations of pharmacogenetic interventions in infectious diseases retained for further analysis. Using these criteria, a total of 14 papers were included in this review. The area of economic evaluation of pharmacogenetic interventions in infectious diseases remains understudied and would benefit from greater harmonization. The main weaknesses of evaluations reviewed in this paper seem to be represented by poor evidence of pharmacogenetic marker validation, inconsistencies in the selection of costs and utility included in the economic models and the choice of sensitivity analysis. All these factors limit the overall transparency of the studies, greater acceptance of their results and applicability to diverse and possibly resourcelimited environments where these

  10. Economic evaluation and the Jordan Rational Drug List: an exploratory study of national-level priority setting.

    Science.gov (United States)

    Lafi, Rania; Robinson, Suzanne; Williams, Iestyn

    2012-01-01

    To explore the extent of and barriers to the use of economic evaluation in compiling the Jordan Rational Drug List in the health care system of Jordan. The research reported in this article involved a case study of the Jordan Rational Drug List. Data collection methods included semi-structured interviews with decision makers and analysis of secondary documentary sources. The case study was supplemented by additional interviews with a small number of Jordanian academics involved in the production of economic evaluation. The research found that there was no formal requirement for cost-effectiveness information submitted as part of the decision-making process for the inclusion of new technologies on the Jordan Rational Drug List. Both decision makers and academics suggested that economic evidence was not influential in formulary decisions. This is unusual for national formulary bodies. The study identified a number of barriers that prevent substantive and routine use of economic evaluation. While some of these echo findings of previous studies, others-notably the extent to which the sectional interests of clinical groups and commercial (pharmaceutical) industry exert undue influence over decision making-more obviously result from the specific Jordanian context. Economic evaluation was not found to be influential in the Jordan Rational Drug List. Recommendations for improvement include enhancing capacity in relation to generating, accessing, and/or applying health economic analysis to priority setting decisions. There is a further need to incentivize the use of economic evaluation, and this requires that organizational and structural impediments be removed. Copyright © 2012 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  11. The Integration of Socio-Economic Indicators in the CASBEE-UD Evaluation System: A Case Study

    Directory of Open Access Journals (Sweden)

    Francesco Cappai

    2018-03-01

    Full Text Available The use of tools to measure the degree of sustainability of cities is the approach that receives the most attention in developed countries. However, studies of evaluation tools at the neighborhood level reveal that there are many weaknesses in the most widely-used evaluation systems (LEED-ND, BREEAM Communities, CASBEE-UD. There are ambiguities and gaps in weighting and in scoring and in most cases, there is no mechanism for local adaptability and participation. The purpose of this study is to provide an overview of the current situation by highlighting the strengths and weaknesses of these evaluation tools in order to integrate social and economic aspects for the improvement of the CASBEE-UD (neighborhood level evaluation tool. The selection of socio-economic aspects was made through the use of a multi criteria Analysis Hierarchical Process (AHP and a Geographic Integration System (GIS. The results of this case study indicate that most evaluation tools need to be revised because most do not include socio-economic aspects. We have demonstrated that applying the CASBEE-UD assessment tool integrated with socio-economic aspects to four boroughs in the City of Montreal can measure success by addressing the objectives of sustainable development.

  12. Evaluation of technological and economic standard of the mining industry. [USSR

    Energy Technology Data Exchange (ETDEWEB)

    Evdokimov, F.I.; Nekhaev, S.A.; Laptev, I.V.

    1983-02-01

    In order to assure constant growth in coal production, as stipulated in the five-year plan, an evaluation scheme has been devised. The technological and economic standard is judged by indicators such as productivity, self sufficiency, capital write-off and investment, as well as factors such as working conditions, financial incentives, health services, and absenteeism. The method of canonical analysis yields expressions for technological and economic factors, and a coefficient for the utilization of resources. Relationship of these coefficients and factors is demonstrated graphically.

  13. 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

  14. 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 ...

  15. Diagnosis of Diversification Processes at an Enterprise

    Directory of Open Access Journals (Sweden)

    Skrynkovskyy Ruslan M.

    2017-06-01

    Full Text Available The aim of the article is formation and development of theoretical and methodological basis for diagnosing diversification processes at an enterprise in the context and on the basis of theory and practice of economics and enterprise management. It is found that: 1 one of the most common ways of development of an enterprise is diversification, which contributes to effective implementation of its development strategy and formation of its prospects; 2 diagnosis of diversification processes at an enterprise is a targeted evaluation of its state, trends and development prospects associated with identification of new spheres (branches of activities and penetration into them, development of new production technologies and markets, expansion of the range of products (goods, which is most conducive to effective realization of competitive advantages of an enterprise with the purpose of maximization of its incomes received from all directions of its activity and minimization of expected risks. It is determined that the key business indicators of the diagnostic system are indicators that reflect the level of diversification of an enterprise’s activities: the absolute level of diversification; the transformed concentration index; the Berry index / the Herfindahl-Hirschman index; the concentration ratio of the sphere of activity (branch according to the descending (or increasing principle; the entropy index; the Atton index; the index of diversification; the level of risk. The prospect for further scientific and practical research in this area is development of a multi-criteria system for diagnosing the activities of enterprises, taking into account diagnosis of diversification processes at an enterprise as a partial diagnostic purpose of the system of partial diagnostic purposes of the multi-criteria system of economic diagnosis of an enterprise.

  16. 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...

  17. A macro-economic and sectoral evaluation of carbon taxation in France

    International Nuclear Information System (INIS)

    Callonnec, Gael; Reynes, Frederic; Yeddir-Tamsamani, Yasser

    2011-01-01

    This paper evaluates the macro-economic and sectoral impact of a carbon tax in France using the Three-ME model that combines two important features: (1) The model has a detailed industrial structure and detailed description of the French tax system, particularly the taxation applied to energy. (2) It has the main properties of the neo-Keynesian models because it takes into account the slow process adjustment of prices and quantifies. Our results show under certain conditions the possibility of a double economic and environmental dividends resulting from carbon taxation, for both the short and long term. Carbon tax. Neo-Keynesian macro-economic model. Sectoral analysis. Initially published in 'Revue de l'OFCE / Debats et politiques' No. 120

  18. 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.

  19. 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

  20. Comprehensive evaluation of environmental and economic benefits of China's urban underground transportation construction projects.

    Science.gov (United States)

    Yang, Xiaobin; Chen, Zhilong; Guo, Dongjun

    2015-07-01

    Urban underground transportation projects are introduced to address problems of scarce green land and traffic pollution. As construction of urban underground transportation is still in its infancy, there is no definite quantitative measurement on whether the construction is beneficial and what influences it will place on the region in China. This study intends to construct a comprehensive evaluation method for evaluating social, economic and environmental benefits of urban underground transportation projects and proposes the concept, role and principle for evaluation of environmental and economic benefits. It figures out relationship between the environment and factors of city development. It also summarizes three relevant factors, including transportation, biophysics and social economy, and works out indicators to evaluate the influence of urban underground transportation construction. Based on Contingent Valuation Method (CVM), Cost of Illness Approach (CIA), Human Capital Approach (HCA), this paper constructs 13 monetization calculation models for social, economic and environmental benefits in response to seven aspects, namely, reducing noise pollution and air pollution, using land efficiently, improving traffic safety, reducing traffic congestion, saving shipping time and minimizing transportation costs.

  1. Handling value added tax (VAT) in economic evaluations: should prices include VAT?

    Science.gov (United States)

    Bech, Mickael; Christiansen, Terkel; Gyrd-Hansen, Dorte

    2006-01-01

    In health economic evaluations, value added tax is commonly treated as a transfer payment. Following this argument, resources are valued equal to their net-of-tax prices in economic evaluations applying a societal perspective. In this article we argue that if there is the possibility that a new healthcare intervention may expand the healthcare budget, the social cost of input factors should be the gross-of-tax prices and not the net-of-tax prices. The rising interest in cost-benefit analysis and the use of absolute thresholds, net benefit estimates and acceptability curves in cost-effectiveness analysis makes this argument highly relevant for an appropriate use of these tools in prioritisation.

  2. THE PRACTICE OF EVALUATING THE ECONOMIC EFFICIENCY OF THE INNOVATIVE PROJECT

    Directory of Open Access Journals (Sweden)

    I. A. Vorobiev

    2013-01-01

    Full Text Available At the present stage of development of the society of scientific and technical activities is the most important factor in the intensification of production and the growth of its economic performance. It is therefore important now gets to determine the effectiveness of research and development activities, improving the measurement methods of economic evaluation of innovative projects and innovation. For informed decision-making requires a deep study and objective assessment of the real situation. This is due to changes in economic relations between the producers and consumers of scientific and technical products. Earlier in this activity involved only state scientific institution and the enterprise, then now they are gradually joining financial institutions, commercial and non-profit organizations. The adoption of innovative solutions should be preceded by thorough and comprehensive analysis of the economic feasibility of the innovative project. In this paper we propose to consider how business is costing innovative projects and determine their effectiveness for the enterprise business hotel.

  3. 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.

  4. Fuzzy logic approach for energetic and economic evaluation of hydroelectric projects

    International Nuclear Information System (INIS)

    Iliev, Atanas M.

    2003-01-01

    A mathematical model for energetic and economic evaluation of hydroelectric projects is developed. The main advantage of the proposed methodology is that the model considers uncertainty and vagueness which appears during the decision making process. Due to modeling of variables that are non statistical in their character, fuzzy logic approach is fully incorporated in the model. The first step in energetic evaluation of the hydro power projects is determination of the characteristic of the efficiency of the units to be installed in hydro power plants. For this purpose the model which uses the best characteristics of Artificial Network Fuzzy Inference System (ANFIS) is applied. The method is tested on real systems: HPP Tikves- the power plant in operation and HPP Kozjak - the power plant in construction. The results obtained from practical implementation show that the proposed approach gives superior results than classical polynomial approximation. The model for determining the consumption characteristic of hydro power plant is developed by Sugeno Fuzzy Logic System with polynomials in the consequent part of the rules. Model takes into account the variable gross head of HPP, as well as, the number of units which will be in operation for given output. Modeling of the gross head and power output are performed by expert's design membership functions. This model is practically applied on HPP Tikves for determination of the consumption characteristic for several gross head. The plausible yearly production of electricity from hydro power project, which is important for estimation of the benefit from the project, is calculated by mixed fuzzy-statistical model. hi this approach fuzzy set of the inflow is constructed according to the statistical parameters. The calculation of the production of electricity is realized for a several hydrological conditions which are described by linguistic variables. Finally, Mamdani Fuzzy Inference System with fuzzy number in consequent part

  5. 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

  6. [Economic evaluation on breast cancer screening in mainland China: a systematic review].

    Science.gov (United States)

    Wang, L; Shi, J F; Huang, H Y; Zhu, J; Li, J; Fang, Y; Dai, M

    2016-12-10

    Objective: To gather available evidence related to the economic evaluation on breast cancer screening in mainland China and to provide reference for further research. Methods: A systematic review was conducted to identify articles in PubMed and three Chinese databases (CNKI, Wanfang and VIP) during 1995-2015. Data related to descriptive characteristics, rates on participation and detection for population-based studies, methods for model-based studies, types of economic evaluation and results, were extracted. A Consolidated Health Economic Evaluation Reporting Standards (CHEERS) was used to assess the reporting quality of included studies. Results: Of the 356 records searched in the databases, 13 studies (all published between 2012 and 2015) were included in the current paper involving 11 population-based studies and 3 model-based evaluations (1 study using both methods). Age of the participants who started to be engaged in the screening program ranged from 18 to 45 years old, but terminated at the age of 59 years or older. The screening modalities included single-used clinical breast examination, mammography and ultrasound or combined applications. Study persepectives were described in 7 studies, with 5 from the healthcare providers, and 2 from societal angles. Only 5 studies discounted cost or effectiveness. Out of 11 papers, 9 showed the results on cost-effectiveness analysis (CEA) that reporting the cost per breast cancer detection, with median as 145.0 thousand Chinese Yuan (CNY), ranging from 49.7 thousand to 2 293.0 thousand CNY. From 4 papers with results of cost-utility analysis (CUA), the cost per quality adjusted life year (QALY) gained or cost per disability adjusted life year (DALY) averted, were evaluated. The incremental cost-effectiveness ratio (ICER) was from 2.9 thousand to 270.7 thousand CNY (GDP per capita of China was CNY 49.3 thousand in 2015). In 13 studies, the quality of reporting varied, with an average score of 14.5 (range: 9.5-21.0). In

  7. 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...

  8. Some aspects of the economics of fast reactor fuel cycle evaluation

    International Nuclear Information System (INIS)

    Sweet, C.

    1982-01-01

    The economics of Fast Reactor Fuel Cycles is a subject marked by a more than usual degree of uncertainty. An evaluation of the future costs and benefits is therefore a necessarily tentative exercise, and the proposed paper will be written within the limitations imposed by the present state of knowledge. It will be no less limited by the present ''state of the art'', which while contingent on the availability of information, is primarily to do with questions of economic method and conception as applied to this field of study. (author)

  9. Economic Evaluation of Pollination Services Comparing Coffee Landscapes in Ecuador and Indonesia

    Directory of Open Access Journals (Sweden)

    Roland Olschewski

    2006-06-01

    Full Text Available 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 in Indonesia and an area of high human impact with little remaining forest in Ecuador. We evaluated bee pollination for different forest-destruction scenarios, where coffee yields depend on forests to provide nesting sites for bees. We used two novel approaches. First, we examined how coffee net revenues depend on the pollination services of adjacent forests by considering berry weight in addition to fruit set, thereby providing a comprehensive evaluation. Second, we determined the net welfare effects of land-use changes, including the fact that former forestland is normally used for alternative crops. In both regions, crop revenues exceeded coffee pollination values, generating incentives to convert forests, even if owners would be compensated for pollination services. The promotion of certified "biodiversity-friendly" coffee is a feasible option to maintain shade-coffee systems. This is of special importance in high-impact areas where only small forest fragments remain. We conclude that a comprehensive economic analysis is necessary to adequately evaluate rainforest preservation for the enhancement of ecosystem services, such as pollination.

  10. 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.

  11. 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.

  12. 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

  13. 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

  14. 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

  15. Economic evaluation of small modular nuclear reactors and the complications of regulatory fee structures

    International Nuclear Information System (INIS)

    Vegel, Benjamin; Quinn, Jason C.

    2017-01-01

    Carbon emission concerns and volatility in fossil fuel resources have renewed world-wide interest in nuclear energy as a solution to growing energy demands. Several large nuclear reactors are currently under construction in the United States, representing the first new construction in over 30 years. Small Modular Reactors (SMRs) have been in design for many years and offer potential technical and economic advantages compared with traditionally larger reactors. Current SMR capital and operational expenses have a wide range of uncertainty. This work evaluates the potential for SMRs in the US, develops a robust techno-economic assessment of SMRs, and leverages the model to evaluate US regulatory fees structures. Modeling includes capital expenses of a factory facility and capital and operational expenses with multiple scenarios explored through a component-level capital cost model. Policy regarding the licensing and regulation of SMRs is under development with proposed annual US regulatory fees evaluated through the developed techno-economic model. Results show regulatory fees are a potential barrier to the economic viability of SMRs with an alternate fee structure proposed and evaluated. The proposed fee structure is based on the re-distribution of fees for all nuclear reactors under a single structure based on reactor thermal power rating. - Highlights: • Potential demand for new small modular nuclear power in the US is established. • Capital costs are broken down on component level and include factory production. • US regulatory fees structures are evaluated, results show potential barrier. • An additional fee structure is proposed and compared with current US fee structures.

  16. The Economics of Colon Cancer.

    Science.gov (United States)

    Orangio, Guy R

    2018-04-01

    The economic burden of cancer on the national health expenditure is billions of dollars. The economic cost is measured on direct and indirect medical costs, which vary depending on stage at diagnosis, patient age, type of medical services, and site of service. Costs vary by region, physician behavior, and patient preferences. When analyzing the economic burden of survivors of colon cancer, we cannot forget the societal burden. Post-acute care and readmissions are major economic burdens. People with colon cancer have to be followed for their lifetime. Economic models are being studied to give cost-effective solutions to this problem. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. 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)

  18. 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.

  19. 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.

  20. Underestimated uncertainties. Hospital-at-home for COPD exacerbations and methodological issues in the economic evaluation of healthcare

    NARCIS (Netherlands)

    L.M.A. Goossens (Lucas)

    2013-01-01

    textabstractEconomic evaluation has been defined as `the comparative analysis of alternative courses of action in terms of both their costs and consequences’. In an economic evaluation in healthcare, two or more interventions are compared in terms of costs and health outcomes. This results in

  1. 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.

  2. 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

  3. 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

  4. 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.

  5. [Evaluation of comprehensive capacity of resources and environments in Poyang Lake Eco-economic Zone].

    Science.gov (United States)

    Song, Yan-Chun; Yu, Dan

    2014-10-01

    With the development of the society and economy, the contradictions among population, resources and environment are increasingly worse. As a result, the capacity of resources and environment becomes one of the focal issues for many countries and regions. Through investigating and analyzing the present situation and the existing problems of resources and environment in Poyang Lake Eco-economic Zone, seven factors were chosen as the evaluation criterion layer, namely, land resources, water resources, biological resources, mineral resources, ecological-geological environment, water environment and atmospheric environment. Based on the single factor evaluation results and with the county as the evaluation unit, the comprehensive capacity of resources and environment was evaluated by using the state space method in Poyang Lake Eco-economic Zone. The results showed that it boasted abundant biological resources, quality atmosphere and water environment, and relatively stable geological environment, while restricted by land resource, water resource and mineral resource. Currently, although the comprehensive capacity of the resources and environments in Poyang Lake Eco-economic Zone was not overloaded as a whole, it has been the case in some counties/districts. State space model, with clear indication and high accuracy, could serve as another approach to evaluating comprehensive capacity of regional resources and environment.

  6. Economic evaluation of bone stimulation modalities: A systematic review of the literature

    Directory of Open Access Journals (Sweden)

    Button Melissa

    2009-01-01

    Full Text Available Various bone stimulation modalities are commonly used in treatment of fresh fractures and nonunions; however, the effectiveness and efficiency of these modalities remain uncertain. A systematic review of trials evaluating the clinical and economical outcomes of ultrasounds, electrical stimulation, and extracorporeal sound waves on fracture healing was conducted. We searched four electronic databases for economic evaluations that assessed bone stimulation modalities using ultrasound therapy, electrical stimulation, or extracorporeal shock waves. In addition, we searched the references and related articles of eligible studies, and a content expert was contacted. Information on the clinical and economical outcomes of patients was independently extracted by reviewers. Fourteen studies met the inclusion criteria; therefore, very limited research was found on the cost associated with treatments and the corresponding outcomes. The data available focus primarily on the efficacy of newly introduced treatment methods for bone growth, but failed to incorporate the costs of implementing such treatments. One economic analysis was identified that assessed different treatment paths using ultrasound. A total cost savings of 24-40% per patient occurred when ultrasound was used for fresh fractures and nonunions (grade C recommendation. The results suggest that the ultrasound is a viable alternative for bone stimulation; however, the impacts of the other modalities are left unknown due to the lack of research available. Methodological limitations leave the overall economic and clinical impact of these modalities uncertain. Large, prospective, randomized controlled trials that include cost-effectiveness analyses are needed to further define the clinical effectiveness and financial burden associated with bone stimulation modalities.

  7. Economic evaluation of bone stimulation modalities: A systematic review of the literature.

    Science.gov (United States)

    Button, Melissa L; Sprague, Sheila; Gharsaa, Osama; Latouche, Sandra; Bhandari, Mohit

    2009-04-01

    Various bone stimulation modalities are commonly used in treatment of fresh fractures and nonunions; however, the effectiveness and efficiency of these modalities remain uncertain. A systematic review of trials evaluating the clinical and economical outcomes of ultrasounds, electrical stimulation, and extracorporeal sound waves on fracture healing was conducted. We searched four electronic databases for economic evaluations that assessed bone stimulation modalities using ultrasound therapy, electrical stimulation, or extracorporeal shock waves. In addition, we searched the references and related articles of eligible studies, and a content expert was contacted. Information on the clinical and economical outcomes of patients was independently extracted by reviewers. Fourteen studies met the inclusion criteria; therefore, very limited research was found on the cost associated with treatments and the corresponding outcomes. The data available focus primarily on the efficacy of newly introduced treatment methods for bone growth, but failed to incorporate the costs of implementing such treatments. One economic analysis was identified that assessed different treatment paths using ultrasound. A total cost savings of 24-40% per patient occurred when ultrasound was used for fresh fractures and nonunions (grade C recommendation). The results suggest that the ultrasound is a viable alternative for bone stimulation; however, the impacts of the other modalities are left unknown due to the lack of research available. Methodological limitations leave the overall economic and clinical impact of these modalities uncertain. Large, prospective, randomized controlled trials that include cost-effectiveness analyses are needed to further define the clinical effectiveness and financial burden associated with bone stimulation modalities.

  8. 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.

  9. 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.

  10. Thermal paint production: the techno-economic evaluation of muscovite as insulating additive.

    Directory of Open Access Journals (Sweden)

    Gabriela Fernandes Ribas

    2016-09-01

    Full Text Available Muscovite is known by its thermal and electrical insulating properties. Based on this, it was hypothesized that its addition on paints should increase the thermal resistance. The use of muscovite as mineral insulating is pointed out as advantageous due to its low cost compared to other materials used for this purpose, such as the ceramic microsphere. The use of a low cost material could open the access to the medium and low income families, implying two aspects: the life quality increase by thermal comfort and the increase of energy saving. Thus, this part of the population could open a new market to thermal paints. Aiming to contribute to this issue, this work evaluated the thermal insulation performance of commercial paints containing muscovite additions and determined the economic evaluation for its industrial production. The thermal paint was formulated by adding 10%, 20% and 40% of muscovite to the commercial paint. This was applied on steel reinforced mortar boards. Thermal insulation tests were carried out in bench scale using an adapted box. The economic evaluation of the industrial production of muscovite-based thermal paint was conducted, considering the Brazilian economic market in this activity. The results showed its ability as an insulating agent due to a reduction of 0.667 °C/mm board by the addition of 40% muscovite. The economic analysis also demonstrated the feasibility of the thermal paint industrial production. The payback is favorable to 5 years when compared to the Selic short-term lending rate, with 21.53% of internal rate return and a net present value of US$ 15,085.76.

  11. Comparison of economic evaluation methodology for the nuclear plant lifetime extension

    International Nuclear Information System (INIS)

    Song, T. H.; Jung, I. S.

    2003-01-01

    In connection with economic evaluation of NPP lifetime management, there are lots of methodologies such as present worth calculation, Levelized Unit Energy Cost (LUEC) calculation, and market benefit comparison methodology. In this paper, economic evaluation of NPP lifetime management was carried out by using these three methodologies, and the results of each was compared with the other methodologies. With these three methodologies, break even points of investment cost related to life extension of nuclear power plant were calculated. It was turned out to be as a analysis result that LUEC is more conservative than present worth calculation and that benefit comparison is more conservative than LUEC, which means that Market Benefit Comparison is the most conservative methodology, and which means base load demand of the future would be far more important than any other factors such as capacity factor, investment cost of life extension, and performance of replacing power plant

  12. 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.

  13. 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.

  14. 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)

  15. Economic Evaluations for the Carbon Dioxide-involved Production of High-value Chemicals

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Ji Hyun; Lee, Dong Woog; Jang, Se Gyu; Kwak, No-Sang; Lee, In Young; Jang, Kyung Ryoung; Shim, Jae-Goo [KEPCO Research Institute, Daejon (Korea, Republic of); Choi, Jong Shin [Korea East-West Power Co. LTD, Seoul (Korea, Republic of)

    2014-06-15

    Economic evaluation of the manufacturing technology of high-value chemicals through the carbonation reaction of carbon dioxide contained in the flue gas was performed, and analysis of the IRR (Internal Rate of Return) and whole profit along the production plan of the final product was conducted. Through a carbonation reaction with sodium hydroxide that is generated from electrolysis and by using carbon dioxide in the combustion gas that is generated in the power plant, it is possible to get a high value products such as sodium bicarbonate compound and also to reduce the carbon dioxide emission simultaneously. The IRR (Internal Rate of Return) and NPV (Net Present Value) methods were used for the economic evaluation of the process which could handle carbon dioxide of 100 tons per day in the period of the 20 years of plant operation. The results of economic evaluation showed that the IRR of baseline case of technology was 67.2% and the profit that obtained during the whole operation period (20 years) was 346,922 million won based on NPV value. When considering ETS due to the emissions trading enforcement that will be activated in 2015, the NPV was improved to a 6,000 million won. Based on this results, it could be concluded that this CO2 carbonation technology is an cost-effective technology option for the reduction of greenhouse gas.

  16. Economic Evaluations for the Carbon Dioxide-involved Production of High-value Chemicals

    International Nuclear Information System (INIS)

    Lee, Ji Hyun; Lee, Dong Woog; Jang, Se Gyu; Kwak, No-Sang; Lee, In Young; Jang, Kyung Ryoung; Shim, Jae-Goo; Choi, Jong Shin

    2014-01-01

    Economic evaluation of the manufacturing technology of high-value chemicals through the carbonation reaction of carbon dioxide contained in the flue gas was performed, and analysis of the IRR (Internal Rate of Return) and whole profit along the production plan of the final product was conducted. Through a carbonation reaction with sodium hydroxide that is generated from electrolysis and by using carbon dioxide in the combustion gas that is generated in the power plant, it is possible to get a high value products such as sodium bicarbonate compound and also to reduce the carbon dioxide emission simultaneously. The IRR (Internal Rate of Return) and NPV (Net Present Value) methods were used for the economic evaluation of the process which could handle carbon dioxide of 100 tons per day in the period of the 20 years of plant operation. The results of economic evaluation showed that the IRR of baseline case of technology was 67.2% and the profit that obtained during the whole operation period (20 years) was 346,922 million won based on NPV value. When considering ETS due to the emissions trading enforcement that will be activated in 2015, the NPV was improved to a 6,000 million won. Based on this results, it could be concluded that this CO2 carbonation technology is an cost-effective technology option for the reduction of greenhouse gas

  17. 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

  18. 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…

  19. Stakeholders' perception on including broader economic impact of vaccines in economic evaluations in low and middle income countries: a mixed methods study.

    Science.gov (United States)

    van der Putten, Ingeborg M; Evers, Silvia M A A; Deogaonkar, Rohan; Jit, Mark; Hutubessy, Raymond C W

    2015-04-10

    Current health economic evaluation guidelines mainly concentrate on immediate health gains and cost savings for the individual involved in the intervention. However, it has been argued that these guidelines are too narrow to capture the full impact of vaccination in low and middle income countries. The inclusion of broader economic impact of vaccines (BEIV) has therefore been proposed. Some examples of these are productivity-related gains, macro-economic impact, and different externalities. Despite their potency, the extent to which such benefits can and should be incorporated into economic evaluations of vaccination is still unclear. This mixed methods study aims to assess the relevance of BEIV to different stakeholders involved in the vaccine introduction decision making process. In this mixed method study an internet based survey was sent to attendees of the New and Underutilized Vaccines Initiative meeting in Montreux, Switzerland in 2011. Additionally, semi-structured interviews of 15 minutes each were conducted during the meeting. Study participants included decision makers, experts and funders of vaccines and immunization programs in low and middle income countries. Descriptive analysis of the survey, along with identification of common themes and factors extracted from the interviews and open survey questions was undertaken. Evidence on macro-economic impact, burden of disease and ecological effects were perceived as being most valuable towards aiding decision making for vaccine introduction by the 26 survey respondents. The 14 interviewees highlighted the importance of burden of disease and different types of indirect effects. Furthermore, some new interpretations of BEIVs were discussed, such as the potential negative impact of wastage during immunization programs and the idea of using vaccines as a platform for delivering other types of health interventions. Interviewees also highlighted the importance of using a broader perspective in connection to

  20. 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.

  1. Economic Evaluation of SMART Deployment in the MENA Region using DEEP 5..0

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Han-Ok; Lee, Man-Ki; Zee, Sung-Kyun; Kim, Young-In; Kim, Keung Koo [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2014-10-15

    Some countries have officially announced that the development of atomic energy is essential to meet the growing nation's requirements for energy to generate electricity, produce desalination water, and reduce reliance on depleting hydrocarbon resources. SMART (system-integrated modular advanced reactor) is a small-sized advanced integral reactor with a rated thermal power of 330 MW. It can produce 100 MW of electricity, or 90 MW of electricity and 40,000 tons of desalinated water concurrently, which is sufficient for 100,000 residents. It is an integral type reactor with a sensible mixture of proven technologies and advanced design features. SMART aims at achieving enhanced safety and improved economics; the enhancement of safety and reliability is realized by incorporating inherent safety-improving features and reliable passive safety systems. The improvement in the economics is achieved through a system simplification, component modularization, reduction of construction time, and high plant availability. The standard design approval assures the safety of the SMART system. The economics of SMART are evaluated for the deployment in MENA region in this study. DEEP 5.0 software was selected for the economic evaluation of SMART plant. By using the collected technical and economic data as the input data into DEEP program, the power and water costs are calculated. Electric power and fresh water production costs for the case of SMART deployment at the MENA region is evaluated using the DEEP 5.0 software in this study. Technical input data are prepared on the basis of the local environmental conditions of the MENA region. The results show that the SMART plant can supply 94 MWe to an external grid system with 40,000 m{sup 3}/d of fresh water. The power and water costs are calculated for the various specific construction costs.

  2. Economic Evaluation of SMART Deployment in the MENA Region using DEEP 5..0

    International Nuclear Information System (INIS)

    Kang, Han-Ok; Lee, Man-Ki; Zee, Sung-Kyun; Kim, Young-In; Kim, Keung Koo

    2014-01-01

    Some countries have officially announced that the development of atomic energy is essential to meet the growing nation's requirements for energy to generate electricity, produce desalination water, and reduce reliance on depleting hydrocarbon resources. SMART (system-integrated modular advanced reactor) is a small-sized advanced integral reactor with a rated thermal power of 330 MW. It can produce 100 MW of electricity, or 90 MW of electricity and 40,000 tons of desalinated water concurrently, which is sufficient for 100,000 residents. It is an integral type reactor with a sensible mixture of proven technologies and advanced design features. SMART aims at achieving enhanced safety and improved economics; the enhancement of safety and reliability is realized by incorporating inherent safety-improving features and reliable passive safety systems. The improvement in the economics is achieved through a system simplification, component modularization, reduction of construction time, and high plant availability. The standard design approval assures the safety of the SMART system. The economics of SMART are evaluated for the deployment in MENA region in this study. DEEP 5.0 software was selected for the economic evaluation of SMART plant. By using the collected technical and economic data as the input data into DEEP program, the power and water costs are calculated. Electric power and fresh water production costs for the case of SMART deployment at the MENA region is evaluated using the DEEP 5.0 software in this study. Technical input data are prepared on the basis of the local environmental conditions of the MENA region. The results show that the SMART plant can supply 94 MWe to an external grid system with 40,000 m 3 /d of fresh water. The power and water costs are calculated for the various specific construction costs

  3. Methodology for the economic evaluation of cogeneration/desalination options: A user's manual

    International Nuclear Information System (INIS)

    1997-01-01

    The Methodology for the Economic Evaluation of Cogeneration/Desalination Options is suitable for economic evaluations and screening analyses of various desalination and energy source options. The methodology, based on the spreadsheet, includes simplified models of several types of nuclear/fossil power plants, nuclear/fossil heat sources, and both distillation and membrane desalination plants. Current cost and performance data have already been incorporated so that the spreadsheet can be quickly adapted to analyze a large variety of options with very little new input data required. The spreadsheet output includes the levelized cost of water and power, breakdowns of cost components, energy consumption and net saleable power for each selected option. Specific power plants can be modeled by adjustment of input data including design power, power cycle parameters and costs

  4. Evaluating β-convergence of the Socio-Economic Development of Ukraine’s Regions

    Directory of Open Access Journals (Sweden)

    Kyzym Mykola O.

    2016-08-01

    Full Text Available The article is devoted to evaluating β-convergence of the socio-economic development of Ukraine’s regions. The essence and theoretical basis of evaluation of σ- and β-convergence is studied. The neoclassical theory of growth of R. Solow that serves as a basis for models of β-convergence is considered. The essence and features of evaluation of the absolute (unconditional and conditional β-convergence is examined. The existing empirical researches of the economic development of countries and their regions with the use of convergence models are analyzed and it is found that: the theory of convergent-divergent development of countries and their regions is sufficiently developed; there are certain studies aimed at evaluation and analysis of the convergence of regional development in Ukraine, but there is no comprehensive study that comprises the building of all the above types of β-convergence models for the period covering the years before and after the crisis of 2008–2009. A scheme of the investigation of the convergence process in regions of Ukraine is proposed, and on this basis the evaluation of β-convergence for Ukraine’s regions is conducted with the use of four types of models: the Barro and Sala-i-Martin model, the Baumol model, the Solow-Swan model, the Cuadrado-Roura model. On the basis of the study it has been found that for the peripheral regions the presence of convergence of their social and economic development is determined by the share of services in the gross regional product to a greater extent and availability of mineral resources to a less extent, but the given result is obtained only with the use of the Barro Sala-i-Martin model, for the other models the condition of β-convergence is not met.

  5. Development, evaluation, and laboratory validation of immunoassays for the diagnosis of equine infectious anemia (EIA) using recombinant protein produced from a synthetic p26 gene of EIA virus.

    Science.gov (United States)

    Singha, Harisankar; Goyal, Sachin K; Malik, Praveen; Khurana, Sandip K; Singh, Raj K

    2013-12-01

    Equine infectious anemia (EIA)-a retroviral disease caused by equine infectious anemia virus (EIAV)-is a chronic, debilitating disease of horses, mules, and donkeys. EIAV infection has been reported worldwide and is recognized as pathogen of significant economic importance to the horse industry. This disease falls under regulatory control program in many countries including India. Control of EIA is based on identification of inapparent carriers by detection of antibodies to EIAV in serologic tests and "Stamping Out" policy. The current internationally accepted test for diagnosis of EIA is the agar gel immune-diffusion test (AGID), which detects antibodies to the major gag gene (p26) product. The objective of this study was to develop recombinant p26 based in-house immunoassays [enzyme linked immunosorbent assays (ELISA), and AGID] for EIA diagnosis. The synthetic p26 gene of EIAV was expressed in Escherichia coli and diagnostic potential of recombinant p26 protein were evaluated in ELISA and AGID on 7,150 and 1,200 equine serum samples, respectively, and compared with commercial standard AGID kit. The relative sensitivity and specificity of the newly developed ELISA were 100 and 98.6 %, respectively. Whereas, relative sensitivity and specificity of the newly developed AGID were in complete agreement in respect to commercial AGID kit. Here, we have reported the validation of an ELISA and AGID on large number of equine serum samples using recombinant p26 protein produced from synthetic gene which does not require handling of pathogenic EIAV. Since the indigenously developed reagents would be economical than commercial diagnostic kit, the rp26 based-immunoassays could be adopted for the sero-diagnosis and control of EIA in India.

  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. Including adverse drug events in economic evaluations of anti-tumour necrosis factor-α drugs for adult rheumatoid arthritis: a systematic review of economic decision analytic models.

    Science.gov (United States)

    Heather, Eleanor M; Payne, Katherine; Harrison, Mark; Symmons, Deborah P M

    2014-02-01

    Anti-tumour necrosis factor-α drugs (anti-TNFs) have revolutionised the treatment of rheumatoid arthritis (RA). More effective than standard non-biological disease-modifying anti-rheumatic drugs (nbDMARDs), anti-TNFs are also substantially more expensive. Consequently, a number of model-based economic evaluations have been conducted to establish the relative cost-effectiveness of anti-TNFs. However, anti-TNFs are associated with an increased risk of adverse drug events (ADEs) such as serious infections relative to nbDMARDs. Such ADEs will likely impact on both the costs and consequences of anti-TNFs, for example, through hospitalisations and forced withdrawal from treatment. The aim of this review was to identify and critically appraise if, and how, ADEs have been incorporated into model-based cost-effectiveness analyses of anti-TNFs for adult patients with RA. A systematic literature review was performed. Electronic databases (Ovid MEDLINE; Ovid EMBASE; Web of Science; NHS Economic Evaluations Database) were searched for literature published between January 1990 and October 2013 using electronic search strategies. The reference lists of retrieved studies were also hand searched. In addition, the National Institute for Health and Care Excellence technology appraisals were searched to identify economic models used to inform UK healthcare decision making. Only full economic evaluations that had used an economic model to evaluate biological DMARDs (bDMARDs) (including anti-TNFs) for adult patients with RA and had incorporated the direct costs and/or consequences of ADEs were critically appraised. To be included, studies also had to be available as a full text in English. Data extracted included general study characteristics and information concerning the methods used to incorporate ADEs and any associated assumptions made. The extracted data were synthesised using a tabular and narrative format. A total of 43 model-based economic evaluations of bDMARDs for adult RA

  9. 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.)

  10. 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.

  11. Childhood and adulthood socio-economic position and midlife depressive and anxiety disorders.

    Science.gov (United States)

    Stansfeld, Stephen A; Clark, Charlotte; Rodgers, Bryan; Caldwell, Tanya; Power, Chris

    2008-02-01

    This paper investigates how childhood socio-economic position influences the risk for midlife depressive and anxiety disorders at 45 years of age, assessed by the Clinical Interview Schedule in 9377 participants of the 1958 British Birth Cohort. Socio-economic position was measured by Registrar General Social Class in childhood and adulthood. The association of paternal manual socio-economic position with any diagnosis at 45 years of age was accounted for after adjustment for adult socio-economic position. Manual socio-economic position in women at 42 years of age was associated with midlife depressive disorder and any diagnosis; these associations were diminished by adjustment for childhood psychological disorders. Effects of childhood socio-economic position on adult depressive disorders may be mediated through adult socio-economic position.

  12. 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.

  13. 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,

  14. Systematic mapping review about costs and economic evaluations of skin conditions and diseases in the aged.

    Science.gov (United States)

    Lichterfeld-Kottner, Andrea; Hahnel, Elisabeth; Blume-Peytavi, Ulrike; Kottner, Jan

    2017-02-01

    Skin conditions and dermatological diseases associated with advanced age (e.g. fungal infection, dry skin and itch) receive increasingly attention in clinical practice and research. Cost and economic evaluations are important sources to inform priority setting and ressource allocation decisions in healthcare. The economics of skin conditions in aged populations has not been systematically reviewed so far. The aim of this mapping review was to summarize the economic evidence of selected skin conditions in the aged (65 + years). A mapping literature review and evidence summary was conducted. Searches were conducted in data bases Medline and Embase via OVID. Cinahl was searched using EBSCO. References lists of potential eligible studies, reviews, guidelines or other sources were screened for additional literature. For evaluation of methodological quality of full economic analyses the Consensus on Health Economic Criteria (CHEC) checklist was used. Database searches resulted in 1388 records. A total of 270 articles were read in full-text. Thirty-five publications were finally included in the data analysis reporting 38 economic analyses. Ten cost of illness analyses and 26 cost-effectiveness analyses reporting about pressure ulcers, skin tears, pressure ulcers, incontinence associated dermatitis and intertrigo/contact dermatitis/candidiasis treatment and prevention and onychomycosis testing were identified. Limited evidence indicated that low air loss beds were more cost effective than standard beds for prevention of pressure ulcers. Standardized skin care regimens seem to lower the incidence of pressure ulcers, skin tears and IAD but a cost saving effect was not always observed. Findings of this mapping review indicate that there is a paucity of high quality evidence regarding the economic impact of age-associated skin conditions and diseases. Substantial heterogeneity in terms of study design, evaluation perspective, time period, and way of cost estimation was

  15. Emergy evaluation of water utilization benefits in water-ecological-economic system based on water cycle process

    Science.gov (United States)

    Guo, X.; Wu, Z.; Lv, C.

    2017-12-01

    The water utilization benefits are formed by the material flow, energy flow, information flow and value stream in the whole water cycle process, and reflected along with the material circulation of inner system. But most of traditional water utilization benefits evaluation are based on the macro level, only consider the whole material input and output and energy conversion relation, and lack the characterization of water utilization benefits accompanying with water cycle process from the formation mechanism. In addition, most studies are from the perspective of economics, only pay attention to the whole economic output and sewage treatment economic investment, but neglect the ecological function benefits of water cycle, Therefore, from the perspective of internal material circulation in the whole system, taking water cycle process as the process of material circulation and energy flow, the circulation and flow process of water and other ecological environment, social economic elements were described, and the composition of water utilization positive and negative benefits in water-ecological-economic system was explored, and the performance of each benefit was analyzed. On this basis, the emergy calculation method of each benefit was proposed by emergy quantitative analysis technique, which can realize the unified measurement and evaluation of water utilization benefits in water-ecological-economic system. Then, taking Zhengzhou city as an example, the corresponding benefits of different water cycle links were calculated quantitatively by emergy method, and the results showed that the emergy evaluation method of water utilization benefits can unify the ecosystem and the economic system, achieve uniform quantitative analysis, and measure the true value of natural resources and human economic activities comprehensively.

  16. Energetic, exergetic, economic and environmental evaluations of geothermal district heating systems: An application

    International Nuclear Information System (INIS)

    Keçebaş, Ali

    2013-01-01

    Highlights: ► Applying exergy, economic, environment and sustainability analyses to the GDHSs. ► Assessing energy and exergy efficiencies, economic and environmental impacts. ► Calculating the energy and exergy efficiencies of 34.86% and 48.78%, respectively. ► Proposing GDHSs as the most economic heating system. ► Providing a significant contribution towards reducing the emissions of air pollution. - Abstract: This study deals with an energetic and exergetic analysis as well as economic and environmental evaluations of Afyon geothermal district heating system (AGDHS) in Afyon, Turkey. In the analysis, actual system data are used to assess the district heating system performance, energy and exergy efficiencies, specific exergy index, exergetic improvement potential and exergy losses. And, for economic and environmental evaluations, actual data are obtained from the Technical Departments. The energy and exergy flow diagrams are clearly drawn to illustrate how much destructions/losses take place in addition to the inputs and outputs. For system performance analysis and improvement, both energy and exergy efficiencies of the overall AGDHS are determined to be 34.86% and 48.78%, respectively. The efficiency improvements in heat and power systems can help achieving energy security in an environmentally acceptable way by reducing the emissions that might otherwise occur. Present application has shown that in Turkey, geothermal energy is much cheaper than the other energy sources, like fossil fuels, and makes a significant contribution towards reducing the emissions of air pollution.

  17. 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.

  18. Economic evaluation of HIV pre-exposure prophylaxis strategies: protocol for a methodological systematic review and quantitative synthesis.

    Science.gov (United States)

    Thavorn, Kednapa; Kugathasan, Howsikan; Tan, Darrell H S; Moqueet, Nasheed; Baral, Stefan D; Skidmore, Becky; MacFadden, Derek; Simkin, Anna; Mishra, Sharmistha

    2018-03-15

    Pre-exposure prophylaxis (PrEP) with antiretrovirals is an efficacious and effective intervention to decrease the risk of HIV (human immunodeficiency virus) acquisition. Yet drug and delivery costs prohibit access in many jurisdictions. In the absence of guidelines for the synthesis of economic evaluations, we developed a protocol for a systematic review of economic evaluation studies for PrEP by drawing on best practices in systematic reviews and the conduct and reporting of economic evaluations. We aim to estimate the incremental cost per health outcome of PrEP compared with placebo, no PrEP, or other HIV prevention strategies; assess the methodological variability in, and quality of, economic evaluations of PrEP; estimate the incremental cost per health outcome of different PrEP implementation strategies; and quantify the potential sources of heterogeneity in outcomes. We will systematically search electronic databases (MEDLINE, Embase) and the gray literature. We will include economic evaluation studies that assess both costs and health outcomes of PrEP in HIV-uninfected individuals, without restricting language or year of publication. Two reviewers will independently screen studies using predefined inclusion criteria, extract data, and assess methodological quality using the Philips checklist, Second Panel on the Cost-effectiveness of Health and Medicines, and the International Society for Pharmacoeconomics and Outcomes Research recommendations. Outcomes of interest include incremental costs and outcomes in natural units or utilities, cost-effectiveness ratios, and net monetary benefit. We will perform descriptive and quantitative syntheses using sensitivity analyses of outcomes by population subgroups, HIV epidemic settings, study designs, baseline intervention contexts, key parameter inputs and assumptions, type of outcomes, economic perspectives, and willingness to pay values. Findings will guide future economic evaluation of PrEP strategies in terms of

  19. 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...

  20. EXPRESSION OF THE TRANSPORT SECTOR OPERATIONAL EFFICIENCY EVALUATION METHODOLOGY (TRENDS AT DIFFERENT STAGES OF THE ECONOMIC CYCLE

    Directory of Open Access Journals (Sweden)

    Deimena KIYAK

    2017-12-01

    Full Text Available It is important to evaluate the impact of economic fluctuations on the transport sector operational efficiency, since such an analysis is a source of economic information which contributes to the identification of the sector's potential and advantages, the establishment of the risky areas of activity, and the exploration of the opportunities to increase its effectiveness. The aim of the study was to apply mathematical evaluation methods to the exploration of the operational efficiency of the Lithuanian transport sector companies and, based on the outcomes, to validate the opportunity of predicting a potential change of the economic cycle. The operational efficiency of the Lithuanian transport sector was analysed in the context of the cyclical national economy, and not in individual economic boom or recession periods, as that allowed for more detailed evaluation of the specific activities of the sector and its impact on Lithuanian economy. To achieve the aim, three different stages of the economic cycle in Lithuania were identified, and calculations were made during them. Based on the aggregate financial data, four different economic efficiency indicators were developed that reflected the efficiency level of the entire transport sector, and the sensitivity of the transport sector to economic fluctuations was identified. The comparison of the changes in the transport sector and in Lithuanian economy made it obvious that the level of the sector's operational efficiency could be regarded as a leading indicator of the economic cycle.

  1. Methodological variation in economic evaluations conducted in low- and middle-income countries: information for reference case development.

    Science.gov (United States)

    Santatiwongchai, Benjarin; Chantarastapornchit, Varit; Wilkinson, Thomas; Thiboonboon, Kittiphong; Rattanavipapong, Waranya; Walker, Damian G; Chalkidou, Kalipso; Teerawattananon, Yot

    2015-01-01

    Information generated from economic evaluation is increasingly being used to inform health resource allocation decisions globally, including in low- and middle- income countries. However, a crucial consideration for users of the information at a policy level, e.g. funding agencies, is whether the studies are comparable, provide sufficient detail to inform policy decision making, and incorporate inputs from data sources that are reliable and relevant to the context. This review was conducted to inform a methodological standardisation workstream at the Bill and Melinda Gates Foundation (BMGF) and assesses BMGF-funded cost-per-DALY economic evaluations in four programme areas (malaria, tuberculosis, HIV/AIDS and vaccines) in terms of variation in methodology, use of evidence, and quality of reporting. The findings suggest that there is room for improvement in the three areas of assessment, and support the case for the introduction of a standardised methodology or reference case by the BMGF. The findings are also instructive for all institutions that fund economic evaluations in LMICs and who have a desire to improve the ability of economic evaluations to inform resource allocation decisions.

  2. Quality Assessment of Economic Evaluations of Suicide and Self-Harm Interventions

    DEFF Research Database (Denmark)

    Madsen, Lizell Bustamante; Eddleston, Michael; Hansen, Kristian Schultz

    2018-01-01

    Background: Death following self-harm constitutes a major global public health challenge and there is an urgent need for governments to implement cost-effective, national suicide prevention strategies. Aim: To conduct a systematic review and quality appraisal of the economic evaluations...... of interventions aimed at preventing suicidal behavior. Method: A systematic literature search was performed in several literature databases to identify relevant articles published from 2003 to 2016. Drummond's 10-item appraisal tool was used to assess the methodological quality of the included studies. Results....... The discussion of suicide and self-harm prevention should be as nuanced as possible, including health economics along with cultural, social, and political aspects....

  3. 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.

  4. Methods Used in Economic Evaluations of Chronic Kidney Disease Testing — A Systematic Review

    Science.gov (United States)

    Sutton, Andrew J.; Breheny, Katie; Deeks, Jon; Khunti, Kamlesh; Sharpe, Claire; Ottridge, Ryan S.; Stevens, Paul E.; Cockwell, Paul; Kalra, Philp A.; Lamb, Edmund J.

    2015-01-01

    Background The prevalence of chronic kidney disease (CKD) is high in general populations around the world. Targeted testing and screening for CKD are often conducted to help identify individuals that may benefit from treatment to ameliorate or prevent their disease progression. Aims This systematic review examines the methods used in economic evaluations of testing and screening in CKD, with a particular focus on whether test accuracy has been considered, and how analysis has incorporated issues that may be important to the patient, such as the impact of testing on quality of life and the costs they incur. Methods Articles that described model-based economic evaluations of patient testing interventions focused on CKD were identified through the searching of electronic databases and the hand searching of the bibliographies of the included studies. Results The initial electronic searches identified 2,671 papers of which 21 were included in the final review. Eighteen studies focused on proteinuria, three evaluated glomerular filtration rate testing and one included both tests. The full impact of inaccurate test results was frequently not considered in economic evaluations in this setting as a societal perspective was rarely adopted. The impact of false positive tests on patients in terms of the costs incurred in re-attending for repeat testing, and the anxiety associated with a positive test was almost always overlooked. In one study where the impact of a false positive test on patient quality of life was examined in sensitivity analysis, it had a significant impact on the conclusions drawn from the model. Conclusion Future economic evaluations of kidney function testing should examine testing and monitoring pathways from the perspective of patients, to ensure that issues that are important to patients, such as the possibility of inaccurate test results, are properly considered in the analysis. PMID:26465773

  5. Could combined sleep and pain evaluation be useful in the diagnosis of disorders of consciousness (DOC)? Preliminary findings.

    Science.gov (United States)

    Aricò, Irene; Naro, Antonino; Pisani, Laura Rosa; Leo, Antonino; Muscarà, Nunzio; De Salvo, Simona; Silvestri, Rosalia; Bramanti, Placido; Calabrò, Rocco Salvatore

    2016-01-01

    The diagnosis of Disorders of Consciousness (DOC) is still challenging. Indeed, ~ 40% of patients in vegetative state (VS) are misdiagnosed, suggesting the need of more appropriate diagnostic tools. Emerging data are showing that EEG, including sleep structure evaluation and multimodal evoked potential recording could be helpful in DOC diagnosis. Moreover, pain perception evaluation could further increase diagnosis accuracy in such individuals. Fourteen individuals with DOC, due to severe brain injury, were enrolled and admitted to the Intensive Neurorehabilitation Unit of the Research Institute. All patients were evaluated by means of the Coma Recovery Scale-Revised, a 24(hh)-polysomnography and a Laser Evoked Potential (LEP) paradigm. Clinically-defined patients in Minimally Consciousness State showed a more preserved sleep structure, physiologic hypnic figures and preserved REM/NREM sleep distribution than subjects in VS. LEP showed increased latencies and reduced amplitudes and were also detectable in patients with more structured sleep. The data support previous findings concerning the importance of sleep study in DOC diagnosis, with more specific neurophysiological paradigms. Interestingly, the findings shed some light on the possible correlations among global brain connectivity, sleep structure and pain perception, which are related to the activity of the wide thalamo-cortical and cortico-cortical networks underlying consciousness.

  6. 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

  7. 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)

  8. Made in Denmark 2014 - Evaluation of Spectator Experience and Tourism Economic Impacts

    DEFF Research Database (Denmark)

    Toft, Henrik; Zahle Østergaard, Mads

    2015-01-01

    This report is a translation of the impact analysis of the golf tournament, Made in Denmark, which was held in August 2014. The content of the report is divided into two sub-parts. The first part is an analysis of the spectator experience and how well the experience of being at this event was ass...... was asssessed by the spectators. The second part is a tourism economic impact analysis which purpose is to analyse, evaluate and assess the economic impact this event had on the local area where it was held....

  9. 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.

  10. Diagnosis change in voice-disordered patients evaluated by primary care and/or otolaryngology: a longitudinal study.

    Science.gov (United States)

    Cohen, Seth M; Dinan, Michaela A; Roy, Nelson; Kim, Jaewhan; Courey, Mark

    2014-01-01

    Accurate diagnosis of a voice disorder is an essential first step toward its appropriate treatment. We examined differences in laryngeal diagnosis over time in outpatients evaluated by primary care physicians (PCPs) and/or otolaryngologists. Retrospective analysis of data from a large, national administrative US claims database. Patients with laryngeal disorders based on International Classification of Diseases, Ninth Revision, Clinical Modification codes from January 1, 2004, to December 31, 2008, with at least 2 outpatient visits by a PCP and/or otolaryngologist and continuously enrolled for 12 months were included. The initial and final laryngeal diagnoses were tabulated. Of approximately 55 million individuals, 29,501 met inclusion criteria. More than half the patients in the PCP to otolaryngology group and one-third of the otolaryngology to otolaryngology group had different laryngeal diagnoses over time. Three-fourths of patients with an initial acute laryngitis diagnosis in the PCP to otolaryngology group and half of the otolaryngology to otolaryngology group had a different final laryngeal diagnosis. Of patients with a final laryngeal cancer diagnosis, one-fourth of the otolaryngology to otolaryngology group had an initial diagnosis of nonspecific dysphonia, and one-fifth of the PCP to otolaryngology group had an initial diagnosis of acute laryngitis. Differential diagnosis of voice disorders often evolves over time. The impact on treatment and health care utilization are important areas of future study.

  11. 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

  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. 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.

  14. 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.)

  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. Economic evaluation of indirect use activities in a private natural heritage reserve

    Directory of Open Access Journals (Sweden)

    Keila Lima Sanches

    2011-06-01

    Full Text Available This study aimed to evaluate the economic viability of indirect use activities as developed in a private natural heritage reserve (RPPN. Activities developed in the RPPN include Adventure Tourism and an Ecological Trail. Data were obtained relating to annual number of people visiting the reserve, prices paid to participate in activities, cost of land, maintenance costs and labor costs. Economic criteria used include Net Present Value (VPL and Equivalent Periodic Benefit (BPE. In the 1996-2008 period the number of visitors increased by 6% a year, and the average annual number of visitors to the RPPN was 8,889. It was concluded that indirect use activities in the RPPN are economically viable and can coexist with other direct soil use activities such as eucalyptus cultivation.

  17. Economical evaluation on gas turbine high temperature reactor 300 (GTHTR300)

    International Nuclear Information System (INIS)

    Takei, Masanobu; Kosugiyama, Shinichi; Mouri, Tomoaki; Katanishi, Shoji; Kunitomi, Kazuhiko

    2006-01-01

    Japan Atomic Energy Research Institute (JAERI) has been developing a graphite moderate and helium cooled High Temperature Gas-cooled Reactor (HTGR) with gas turbine, the GTHTR300 based on experience gained in development and operations of the High Temperature Engineering Test Reactor (HTTR) in JAERI. The GTHTR300 is a simplified and economical power plant with a high level of safety characteristics and a high plant efficiency of approximately 46%. Cost evaluation for plant construction and power generation is studied in order to clarify the economical feasibility of the GTHTR300. The construction cost is estimated to be about 200 thousands Yen/kWe. The power generation cost is estimated to be about 3.8 Yen/kWh by the conditions of 90% load factor and 3% discount rate. The economical feasibility of the GTHTR300 is certified. The present study is entrusted from Ministry of Education, Culture, Sports, Science and Technology of Japan. (author)

  18. Evaluation of the Technical-Economic Potential of Particle- Reinforced Aluminum Matrix Composites and Electrochemical Machining

    International Nuclear Information System (INIS)

    Schubert, A; Hackert-Oschätzchen, M; Lehnert, N; Götze, U; Herold, F; Schmidt, A; Meichsner, G

    2016-01-01

    Compared to conventional cutting, the processing of materials by electrochemical machining offers some technical advantages like high surface quality, no thermal or mechanical impact on the work piece and preservation of the microstructure of the work piece material. From the economic point of view, the possibility of process parallelization and the absence of any process-related tool wear are mentionable advantages of electrochemical machining. In this study, based on experimental results, it will be evaluated to what extent the electrochemical machining is technically and economically suitable for the finish-machining of particle- reinforced aluminum matrix composites (AMCs). Initial studies showed that electrochemical machining - in contrast to other machining processes - has the potential to fulfil demanding requirements regarding precision and surface quality of products or components especially when applied to AMCs. In addition, the investigations show that processing of AMCs by electrochemical machining requires less energy than the electrochemical machining of stainless steel. Therefore, an evaluation of electrochemically machined AMCs - compared to stainless steel - from a technical and an economic perspective will be presented in this paper. The results show the potential of electro-chemically machined AMCs and contribute to the enhancement of instruments for technical-economic evaluations as well as a comprehensive innovation control. (paper)

  19. Virtual microscopy: an evaluation of its validity and diagnostic performance in routine histologic diagnosis of skin tumors

    DEFF Research Database (Denmark)

    Nielsen, Patricia Switten; Lindebjerg, Jan; Rasmussen, Jan

    2010-01-01

    Digitization of histologic slides is associated with many advantages, and its use in routine diagnosis holds great promise. Nevertheless, few articles evaluate virtual microscopy in routine settings. This study is an evaluation of the validity and diagnostic performance of virtual microscopy...... in routine histologic diagnosis of skin tumors. Our aim is to investigate whether conventional microscopy of skin tumors can be replaced by virtual microscopy. Ninety-six skin tumors and skin-tumor-like changes were consecutively gathered over a 1-week period. Specimens were routinely processed, and digital...... slides were captured on Mirax Scan (Carl Zeiss MicroImaging, Göttingen, Germany). Four pathologists evaluated the 96 virtual slides and the associated 96 conventional slides twice with intermediate time intervals of at least 3 weeks. Virtual slides that caused difficulties were reevaluated to identify...

  20. An economic evaluation of alternative biofuel deployment scenarios in the USA

    Directory of Open Access Journals (Sweden)

    Gbadebo Oladosu

    2017-05-01

    Full Text Available Energy market conditions have shifted dramatically since the USA renewable fuel standards (RFS1 in 2005; RFS2 in 2007 were enacted. The USA has transitioned from an increasing dependence on oil imports to abundant domestic oil production. In addition, increases in the use of ethanol, the main biofuel currently produced in the USA, is now limited by the blend wall constraint. Given this, the current study evaluates alternative biofuel deployment scenarios in the USA, accounting for changes in market conditions. The analysis is performed with a general equilibrium model that reflects the structure of the USA biofuel market as the transition to advanced biofuels begins. Results suggest that ethanol consumption would increase, albeit slowly, if current biofuel deployment rates of about 10% are maintained as persistently lower oil prices lead to a gradual increase in the consumption of liquid transportation fuels. Without the blend wall constraint, this study finds that the overall economic impact of a full implementation of the USA RFS2 policy is largely neutral before 2022. However, the economic impacts become slightly negative under the blend wall constraint since more expensive bio-hydrocarbons are needed to meet the RFS2 mandates. Results for a scenario with reduced advanced biofuel deployment based on current policy plans show near neutral economic impacts up to 2027. This scenario is also consistent with another scenario where the volume of bio-hydrocarbons deployed is reduced to adjust for its higher cost and energy content relative to deploying the mandated RFS2 advanced biofuel volumes as ethanol. The important role of technological change is demonstrated under pioneer and accelerated technology scenarios, with the latter leading to neutral or positive economic effects up to 2023 under most blend wall scenarios. All scenarios evaluated in this study are found to have positive long-term benefits for the USA economy.

  1. 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)

  2. Socio-economic differences and health seeking behaviour for the diagnosis and treatment of malaria: a case study of four local government areas operating the Bamako initiative programme in south-east Nigeria

    Directory of Open Access Journals (Sweden)

    Onwujekwe Obinna E

    2004-06-01

    Full Text Available Abstract Background Malaria is one of the leading causes of mortality and morbidity in Nigeria. It is not known how user fees introduced under the Bamako Initiative (BI system affect healthcare seeking among different socio-economic groups in Nigeria for diagnosis and treatment of malaria. Reliable information is needed to initiate new policy thrusts to protect the poor from the adverse effect of user fees. Methods Structured questionnaires were used to collect information from 1594 female household primary care givers or household head on their socio-economic and demographic status and use of malaria diagnosis and treatment services. Principal components analysis was used to create a socio-economic status index which was decomposed into quartiles and chi-square for trends was used to calculate for any statistical difference. Results The study showed that self diagnosis was the commonest form of diagnosis by the respondents. This was followed by diagnosis through laboratory tests, community health workers, family members and traditional healers. The initial choice of care for malaria was a visit to the patent medicine dealers for most respondents. This was followed by visit to the government hospitals, the BI health centres, traditional medicine healers, private clinics, community health workers and does nothing at home. Furthermore, the private health facilities were the initial choice of treatment for the majority with a decline among those choosing them as a second source of care and an increase in the utilization of public health facilities as a second choice of care. Self diagnosis was practiced more by the poorer households while the least poor used the patent medicine dealers and community health workers less often for diagnosis of malaria. The least poor groups had a higher probability of seeking treatment at the BI health centres (creating equity problem in BI, hospitals, and private clinics and in using laboratory procedures. The least

  3. 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.

  4. Proceduralism and its role in economic evaluation and priority setting in health.

    Science.gov (United States)

    Jan, Stephen

    2014-05-01

    This paper provides a critical overview of Gavin Mooney's proceduralist approach to economic evaluation and priority setting in health. Proceduralism is the notion that the social value attached to alternative courses of action should be determined not only by outcomes, but also processes. Mooney's brand of proceduralism was unique and couched within a broader critique of 'neo-liberal' economics. It operated on a number of levels. At the micro level of the individual program, he pioneered the notion that 'process utility' could be valued and measured within economic evaluation. At a macro level, he developed a framework in which the social objective of equity was defined by procedural justice in which communitarian values were used as the basis for judging how resources should be allocated across the health system. Finally, he applied the notion of procedural justice to further our understanding of the political economy of resource allocation; highlighting how fairness in decision making processes can overcome the sometimes intractable zero-sum resource allocation problem. In summary, his contributions to this field have set the stage for innovative programs of research to help in developing health policies and programs that are both in alignment with community values and implementable. Copyright © 2014 Elsevier Ltd. All rights reserved.

  5. [Ecosystem service value and its aplication in evaluation of eco-economic harmonious development].

    Science.gov (United States)

    Wu, Jian-zhai; Li, Bo; Zhang, Xin-shi

    2007-11-01

    Based on the data of land use/cover and by using eco-economic harmony index (EEH) this paper studied the spatiotemporal characteristics of ecosystem service value on the northern slope of Tianshan Mountains, and evaluated the harmony degree of eco-economic development in the region. The results showed that the total ecosystem service value on the northern slope of Tianshan Mountains was increased from 319.93 x 10(8) yuan in 1989 to 321.26 x 10(8) yuan in 2000, with a net increment of 0.42%. The regional eco-economic development was overall at a low harmony level, being higher in eastern part than in middle and western parts, among which, eight counties had a positive value of EEH and their eco-economic development was harmonious, while seven counties had a negative value of EEH and their eco-economic development was inharmonic. The eco-economic development in the region was at the margin of harmony, and thus, more attention should be paid to strengthen the protection of eco-environment and promote the harmonious development of eco-economy to have a sustainable development.

  6. 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

  7. Evidence used in model-based economic evaluations for evaluating pharmacogenetic and pharmacogenomic tests: a systematic review protocol.

    Science.gov (United States)

    Peters, Jaime L; Cooper, Chris; Buchanan, James

    2015-11-11

    Decision models can be used to conduct economic evaluations of new pharmacogenetic and pharmacogenomic tests to ensure they offer value for money to healthcare systems. These models require a great deal of evidence, yet research suggests the evidence used is diverse and of uncertain quality. By conducting a systematic review, we aim to investigate the test-related evidence used to inform decision models developed for the economic evaluation of genetic tests. We will search electronic databases including MEDLINE, EMBASE and NHS EEDs to identify model-based economic evaluations of pharmacogenetic and pharmacogenomic tests. The search will not be limited by language or date. Title and abstract screening will be conducted independently by 2 reviewers, with screening of full texts and data extraction conducted by 1 reviewer, and checked by another. Characteristics of the decision problem, the decision model and the test evidence used to inform the model will be extracted. Specifically, we will identify the reported evidence sources for the test-related evidence used, describe the study design and how the evidence was identified. A checklist developed specifically for decision analytic models will be used to critically appraise the models described in these studies. Variations in the test evidence used in the decision models will be explored across the included studies, and we will identify gaps in the evidence in terms of both quantity and quality. The findings of this work will be disseminated via a peer-reviewed journal publication and at national and international conferences. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  8. 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....

  9. A systematic review of modelling approaches in economic evaluations of health interventions for drug and alcohol problems.

    Science.gov (United States)

    Hoang, Van Phuong; Shanahan, Marian; Shukla, Nagesh; Perez, Pascal; Farrell, Michael; Ritter, Alison

    2016-04-13

    The overarching goal of health policies is to maximize health and societal benefits. Economic evaluations can play a vital role in assessing whether or not such benefits occur. This paper reviews the application of modelling techniques in economic evaluations of drug and alcohol interventions with regard to (i) modelling paradigms themselves; (ii) perspectives of costs and benefits and (iii) time frame. Papers that use modelling approaches for economic evaluations of drug and alcohol interventions were identified by carrying out searches of major databases. Thirty eight papers met the inclusion criteria. Overall, the cohort Markov models remain the most popular approach, followed by decision trees, Individual based model and System dynamics model (SD). Most of the papers adopted a long term time frame to reflect the long term costs and benefits of health interventions. However, it was fairly common among the reviewed papers to adopt a narrow perspective that only takes into account costs and benefits borne by the health care sector. This review paper informs policy makers about the availability of modelling techniques that can be used to enhance the quality of economic evaluations for drug and alcohol treatment interventions.

  10. Methodological variation in economic evaluations conducted in low- and middle-income countries: information for reference case development.

    Directory of Open Access Journals (Sweden)

    Benjarin Santatiwongchai

    Full Text Available Information generated from economic evaluation is increasingly being used to inform health resource allocation decisions globally, including in low- and middle- income countries. However, a crucial consideration for users of the information at a policy level, e.g. funding agencies, is whether the studies are comparable, provide sufficient detail to inform policy decision making, and incorporate inputs from data sources that are reliable and relevant to the context. This review was conducted to inform a methodological standardisation workstream at the Bill and Melinda Gates Foundation (BMGF and assesses BMGF-funded cost-per-DALY economic evaluations in four programme areas (malaria, tuberculosis, HIV/AIDS and vaccines in terms of variation in methodology, use of evidence, and quality of reporting. The findings suggest that there is room for improvement in the three areas of assessment, and support the case for the introduction of a standardised methodology or reference case by the BMGF. The findings are also instructive for all institutions that fund economic evaluations in LMICs and who have a desire to improve the ability of economic evaluations to inform resource allocation decisions.

  11. 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)

  12. 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

  13. The use of economic evaluations in NHS decision-making: a review and empirical investigation.

    Science.gov (United States)

    Williams, I; McIver, S; Moore, D; Bryan, S

    2008-04-01

    To determine the extent to which health economic information is used in health policy decision-making in the UK, and to consider factors associated with the utilisation of such research findings. Major electronic databases were searched up to 2004. A systematic review of existing reviews on the use of economic evaluations in policy decision-making, of health and non-health literature on the use of economic analyses in policy making and of studies identifying actual or perceived barriers to the use of economic evaluations was undertaken. Five UK case studies of committees from four local and one national organisation [the Technology Appraisal Committee of the National Institute for Health and Clinical Excellence (NICE)] were conducted. Local case studies were augmented by documentary analysis of new technology request forms and by workshop discussions with members of local decision-making committees. The systematic review demonstrated few previous systematic reviews of evidence in the area. At the local level in the NHS, it was an exception for economic evaluation to inform technology coverage decisions. Local decision-making focused primarily on evidence of clinical benefit and cost implications. And whilst information on implementation was frequently requested, cost-effectiveness information was rarely accessed. A number of features of the decision-making environment appeared to militate against emphasis on cost-effectiveness analysis. Constraints on the capacity to generate, access and interpret information, led to a minor role for cost-effectiveness analysis in the local decision-making process. At the national policy level in the UK, economic analysis was found to be highly integrated into NICE's technology appraisal programme. Attitudes to economic evaluation varied between committee members with some significant disagreement and extraneous factors diluted the health economics analysis available to the committee. There was strong evidence of an ordinal

  14. Diagnosis of vulvovaginitis: comparison of clinical and microbiological diagnosis.

    Science.gov (United States)

    Esim Buyukbayrak, Esra; Kars, Bulent; Karsidag, Ayse Yasemin Karageyim; Karadeniz, Bernan Ilkay; Kaymaz, Ozge; Gencer, Serap; Pirimoglu, Zehra Meltem; Unal, Orhan; Turan, Mehmet Cem

    2010-11-01

    The purpose of the present study was to compare the current diagnostic clinical and laboratory approaches to women with vulvovaginal discharge complaint. The secondary outcomes were to determine the prevalence of infections in our setting and to look for the relation between vulvovaginal infections and predisposing factors if present. Premenopausal women applying to our gynecology outpatient clinic with vaginal discharge complaint were enrolled prospectively into the study. Each patient evaluated clinically with direct observation of vaginal secretions, wet mount examination, whiff test, vaginal pH testing and chlamydia rapid antigen test. Each patient also evaluated microbiologically with vaginal discharge culture and gram staining. Clinical diagnosis was compared with the microbiological diagnosis (the gold standard). Diagnostic accuracy was measured with sensitivity, specificity, positive (ppv) and negative predictive values (npv). 460 patients were included in the study. 89.8% of patients received a clinical diagnosis whereas only 36% of them had microbiological diagnosis. The sensitivity, specificity, ppv, npv of clinical diagnosis over microbiological culture results were 95, 13, 38, 82%, respectively. The most commonly encountered microorganisms by culture were Candida species (17.4%) and Gardnerella vaginalis (10.2%). Clinically, the most commonly made diagnoses were mixed infection (34.1%), bacterial vaginosis (32.4%) and fungal infection (14.1%). Symptoms did not predict laboratory results. Predisposing factors (DM, vaginal douching practice, presence of IUD and usage of oral contraceptive pills) were not found to be statistically important influencing factors for vaginal infections. Clinical diagnosis based on combining symptoms with office-based testing improves diagnostic accuracy but is insufficient. The most effective approach also incorporates laboratory testing as an adjunct when a diagnosis is in question or treatment is failing.

  15. 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.

  16. Techno-economic evaluation of a solar powered water desalination plant

    International Nuclear Information System (INIS)

    Fiorenza, G.; Sharma, V.K.; Braccio, G.

    2003-01-01

    Water desalination technologies and their possible coupling with solar energy have been evaluated. The topic is of particular interest, especially for countries located within the Southern Mediterranean belt, generally characterized with vast arid and isolated areas having practically no access to electric power from the national grid. Economic factors being one of the main barriers to diffusion of solar devices so far, an attempt has been made to estimate the water production cost for two different seawater desalination systems: reverse osmosis and multiple effect, powered by a solar thermal and a photovoltaic field, respectively. The results obtained for plants of capacity varying between 500 and 5000 m 3 /d have been compared to results concerning a conventional desalination system. In addition, the influences of various parameters, such as depreciation factor, economic incentives, PV modules cost and oil price, have also been considered

  17. Angra 3 - economic and financial evaluation of the enterprise; Angra 3 - avaliacao economico-financeira do empreendimento

    Energy Technology Data Exchange (ETDEWEB)

    Andrade, Ronaldo Barata de [ELETROBRAS Termonuclear S.A. (ELETRONUCLEAR), Rio de Janeiro, RJ (Brazil)]. E-mail: rbarata@eletronuclear.gov.br

    2006-07-01

    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)

  18. Diagnosis of thyroid diseases. The diagnosis value of the various methods of examination

    Energy Technology Data Exchange (ETDEWEB)

    Pfannenstiel, P [Stiftung Deutsche Klinik fuer Diagnostik, Wiesbaden (Germany, F.R.). Fachbereich Nuklearmedizin

    1980-03-01

    The recommendations of the thyroid section of the Deutsche Gesellschaft fuer Endokrinologie take account of practical requirements and serve as a basis for assessing the indications of the various diagnostic methods in view of their value, expenditure, and hazards. Progress in methodology and recent scientific findings have been taken into account as well as economic aspects and the available equipment. In spite of all the possibilities offered by modern laboratory diagnosis, the diagnosis and theory of thyroid diseases should always depend on a special anamnesis and a physical examination of the patient. The measured values must agree with the patient's complaints and with clinical findings. In diagnoses involving several steps, one should always start with simple in-vitro techniques in order to spare the patient stress. Functional diagnosis of thyroid diseases are supplemented by thyroid scintiscanning with short-lived radionuclides and by thyroid cytology. Experience and precise knowledge help to 'save expense and radiation'. Of course, uncertain diagnoses and untypical findings require a more extensive use of diagnostic means than diagnosis that are more or less clinically proved.

  19. Evaluation of Effect of Global Economic Meltdown on Capital Market Performance

    Directory of Open Access Journals (Sweden)

    ONAOLAPO ADEKUNLE RAHMAN

    2013-07-01

    Full Text Available The recent financial crisis that loomed the global economy was considered more inclusive than any other period of financial turmoil in the past 60 years. This paper evaluates the implications of the global economic meltdown on the Nigerian Capital Market Performance using the market capitalization of the Nigerian Stock Exchange as a major indicator. When the global economic meltdown came, it poses a recession on the Market Capitalization and the volume of share index of the Nation. This study depends entirely on secondary data in form of annual aggregate time series data of Market capitalization (dependent variable, exchange rate, interest rate, inflation rate, market share index with Dummy variable to represent the period of economic crisis. Ordinary least square of multiple regressions was used to analyze the data into econometric model while F-statistics was used to test for the formulated hypothesis. This study depicts that the global economic meltdown has a negative effect on the Capital Market Performance. It was therefore recommended that the Federal government and the regulatory agencies (CBN, NSE, SEC etc. should come up with intervention and fiscal policies that will suppress these effects and jumpstart the capital market and that the policies should be properly implemented and monitored.

  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. [Evaluation of the standard application of Delphi in the diagnosis of chronic obstructive pulmonary disease caused by occupational irritant chemicals].

    Science.gov (United States)

    Zhao, L; Yan, Y J

    2017-11-20

    Objective: To investigate the problems encountered in the application of the standard (hereinafter referred to as standard) for the diagnosis of chronic obstructive pulmonary disease caused by occu-pational irritant chemicals, to provide reference for the revision of the new standard, to reduce the number of missed patients in occupational COPD, and to get rid of the working environment of those who suffer from chronic respiratory diseases due to long-term exposure to poisons., slowing the progression of the disease. Methods: Using Delphi (Delphi) Expert research method, after the senior experts to demonstrate, to under-stand the GBZ 237-2011 "occupational irritant chemicals to the diagnosis of chronic obstructive pulmonary dis-ease" standard evaluation of the system encountered problems, to seek expert advice, The problems encoun-tered during the clinical implementation of the standards promulgated in 2011 are presented. Results: Through the Delphi Expert investigation method, it is found that experts agree on the content evaluation and implemen-tation evaluation in the standard, but the operational evaluation of the standard is disputed. According to the clinical experience, the experts believe that the range of occupational irritant gases should be expanded, and the operation of the problem of smoking, seniority determination and occupational contact history should be challenged during the diagnosis. Conclusions: Since the promulgation in 2011 of the criteria for the diagnosis of chronic obstructive pulmonary disease caused by occupational stimulant chemicals, there have been some problems in the implementation process, which have caused many occupationally exposed to irritating gases to suffer from "occupational chronic respiratory Diseases" without a definitive diagnosis.

  2. 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

  3. Psycho-social and Economic Evaluation of Onchocerciasis: A Literature Review

    Directory of Open Access Journals (Sweden)

    Laura Moya Alonso

    2009-02-01

    Full Text Available Background: Onchocerciasis or river blindness is a chronic parasitic disease caused by the filarial nematode Onchocerca Volvulus. It occurs in 38 countries in the world, including Africa, Latin America and the Arabian Peninsula. The infection predominantly causes visual impairment and blindness and skin disease. Objectives: The aim of this project is to review the literature on the psycho-social and economic consequences of onchocerciasis in endemic areas. Economic evaluation studies on onchocerciasis and its control programmes were also reviewed. Methods: Electronic searches of PUBMED and Google were made. In addition, the Cochrane Library and WHO website were searched. Different types of economic analysis were reviewed to quantify the relationship between the programme costs and impacts. Results: Eighty papers were identified from different sources, most of which are quantitative studies or literature reviews, and only two were clinical trials. Onchocerciasis has severe socio-economic and psychological consequences. The stigma associated with the disease may reduce marital prospects among affected individuals, disrupt social relationships and cause loss of self-confidence. Also among agricultural workers onchocerciasis has been associated with increased time away from work and reduced productivity, leading to lower income. Discussion: Most of the papers analysed were cross-sectional studies based on data collection through questionnaires. Although there is an increasing number of published papers about the importance of the psycho-social and economic perspective of onchocerciasis, further research is still necessary to quantify and control its consequences. Conclusion: Onchocerciasis is still a serious problem in poor countries. Infected people face physical disability and social stigma that can dramatically reduce the quality of life and land productivity. Control programmes, though costly, have been very successful and cost

  4. Systematic review of economic evaluations of preparedness strategies and interventions against influenza pandemics.

    Science.gov (United States)

    Pérez Velasco, Román; Praditsitthikorn, Naiyana; Wichmann, Kamonthip; Mohara, Adun; Kotirum, Surachai; Tantivess, Sripen; Vallenas, Constanza; Harmanci, Hande; Teerawattananon, Yot

    2012-01-01

    Although public health guidelines have implications for resource allocation, these issues were not explicitly considered in previous WHO pandemic preparedness and response guidance. In order to ensure a thorough and informed revision of this guidance following the H1N1 2009 pandemic, a systematic review of published and unpublished economic evaluations of preparedness strategies and interventions against influenza pandemics was conducted. The search was performed in September 2011 using 10 electronic databases, 2 internet search engines, reference list screening, cited reference searching, and direct communication with relevant authors. Full and partial economic evaluations considering both costs and outcomes were included. Conversely, reviews, editorials, and studies on economic impact or complications were excluded. Studies were selected by 2 independent reviewers. 44 studies were included. Although most complied with the cost effectiveness guidelines, the quality of evidence was limited. However, the data sources used were of higher quality in economic evaluations conducted after the 2009 H1N1 pandemic. Vaccination and drug regimens were varied. Pharmaceutical plus non-pharmaceutical interventions are relatively cost effective in comparison to vaccines and/or antivirals alone. Pharmaceutical interventions vary from cost saving to high cost effectiveness ratios. According to ceiling thresholds (Gross National Income per capita), the reduction of non-essential contacts and the use of pharmaceutical prophylaxis plus the closure of schools are amongst the cost effective strategies for all countries. However, quarantine for household contacts is not cost effective even for low and middle income countries. The available evidence is generally inconclusive regarding the cost effectiveness of preparedness strategies and interventions against influenza pandemics. Studies on their effectiveness and cost effectiveness should be readily implemented in forthcoming events that

  5. Systematic review of economic evaluations of preparedness strategies and interventions against influenza pandemics.

    Directory of Open Access Journals (Sweden)

    Román Pérez Velasco

    Full Text Available BACKGROUND: Although public health guidelines have implications for resource allocation, these issues were not explicitly considered in previous WHO pandemic preparedness and response guidance. In order to ensure a thorough and informed revision of this guidance following the H1N1 2009 pandemic, a systematic review of published and unpublished economic evaluations of preparedness strategies and interventions against influenza pandemics was conducted. METHODS: The search was performed in September 2011 using 10 electronic databases, 2 internet search engines, reference list screening, cited reference searching, and direct communication with relevant authors. Full and partial economic evaluations considering both costs and outcomes were included. Conversely, reviews, editorials, and studies on economic impact or complications were excluded. Studies were selected by 2 independent reviewers. RESULTS: 44 studies were included. Although most complied with the cost effectiveness guidelines, the quality of evidence was limited. However, the data sources used were of higher quality in economic evaluations conducted after the 2009 H1N1 pandemic. Vaccination and drug regimens were varied. Pharmaceutical plus non-pharmaceutical interventions are relatively cost effective in comparison to vaccines and/or antivirals alone. Pharmaceutical interventions vary from cost saving to high cost effectiveness ratios. According to ceiling thresholds (Gross National Income per capita, the reduction of non-essential contacts and the use of pharmaceutical prophylaxis plus the closure of schools are amongst the cost effective strategies for all countries. However, quarantine for household contacts is not cost effective even for low and middle income countries. CONCLUSION: The available evidence is generally inconclusive regarding the cost effectiveness of preparedness strategies and interventions against influenza pandemics. Studies on their effectiveness and cost

  6. Economic evaluation of the anti-stigma social marketing campaign in England 2009-2011.

    Science.gov (United States)

    Evans-Lacko, Sara; Henderson, Claire; Thornicroft, Graham; McCrone, Paul

    2013-04-01

    Evidence on the economic impact of social marketing anti-stigma campaigns in relation to people with mental illness is limited. To describe the economic impact of the Time to Change (TTC) anti-stigma social marketing campaign, including the potential effects on the wider economy. Data collected for the evaluation of TTC were combined with the social marketing campaign expenditure data to investigate differences in knowledge, attitudes and behaviour in relation to campaign awareness. To evaluate the return on investment, we applied a decision model that estimated the impact on employment for people with depression. Based on average national social marketing campaign costs, the economic benefits outweighed costs even if the campaign resulted in only 1% more people with depression accessing services and gaining employment if they experienced a health improvement. The cost per person with improved intended behaviour was at most £ 4 if we assume the campaign was responsible for 50% of the change. Costs associated with improved knowledge and attitudes, however, were more variable. The findings suggest that the TTC anti-stigma social marketing campaign is a potentially cost-effective and low-cost intervention for reducing the impact of stigma on people with mental health problems.

  7. Numerical model for thermoeconomic diagnosis in commercial transcritical/subcritical booster refrigeration systems

    DEFF Research Database (Denmark)

    Ommen, Torben; Elmegaard, Brian

    2012-01-01

    cycle supplying refrigerant for evaporators in both chilled and frozen display cases. In the paper, thermoeconomic theory is used to establish the cost of cooling at each individual temperature level based on operating costs.With a high amount of operating systems, faulty operation becomes an economic......, and environmental, interest. A general solution for evaluation of these systems is considered, with the objective to reduce cost and power consumption of malfunctioning equipment in operation. An analysis of the use of thermoeconomic diagnosis methods is required, as these methods may prove applicable...

  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 on the eco-economic benefits of small watershed in Beijing mountainous area: a case of Yanqi River watershed].

    Science.gov (United States)

    Xiao, Hui-Jie; Wei, Zi-Gang; Wang, Qing; Zhu, Xiao-Bo

    2012-12-01

    Based on the theory of harmonious development of ecological economy, a total of 13 evaluation indices were selected from the ecological, economic, and social sub-systems of Yanqi River watershed in Huairou District of Beijing. The selected evaluation indices were normalized by using trapezoid functions, and the weights of the evaluation indices were determined by analytic hierarchy process. Then, the eco-economic benefits of the watershed were evaluated with weighted composite index method. From 2004 to 2011, the ecological, economic, and social benefits of Yanqi River watershed all had somewhat increase, among which, ecological benefit increased most, with the value changed from 0.210 in 2004 to 0.255 in 2011 and an increment of 21.5%. The eco-economic benefits of the watershed increased from 0.734 in 2004 to 0.840 in 2011, with an increment of 14.2%. At present, the watershed reached the stage of advanced ecosystem, being in beneficial circulation and harmonious development of ecology, economy, and society.

  10. Operational safety performance and economical efficiency evaluation for nuclear power plants

    International Nuclear Information System (INIS)

    Liu Yachun; Zou Shuliang

    2012-01-01

    The economical efficiency of nuclear power includes a series of environmental parameters, for example, cleanliness. Nuclear security is the precondition and guarantee for its economy, and both are the direct embodiment of the social benefits of nuclear power. Through analyzing the supervision and management system on the effective operation of nuclear power plants, which has been put forward by the International Atomic Energy Agency (IAEA), the World Association of Nuclear Operators (WANO), the U.S. Nuclear Regulatory Commission (NRC), and other organizations, a set of indexs on the safety performance and economical efficiency of nuclear power are explored and established; Based on data envelopment analysis, a DEA approach is employed to evaluate the efficiency of the operation performance of several nuclear power plants, Some primary conclusion are achieved on the basis of analyzing the threshold parameter's sensitivity and relativity which affected operational performance. To address the conflicts between certain security and economical indicators, a multi-objective programming model is established, where top priority is given to nuclear safety, and the investment behavior of nuclear power plant is thereby optimized. (authors)

  11. [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.

  12. 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.

  13. Economic evaluation of reliability-centred maintenance (RCM): an electricity transmission industry perspective

    International Nuclear Information System (INIS)

    Bowler, D.J.; Primrose, P.L.; Leonard, R.

    1995-01-01

    Traditional approaches to appraising the introduction of reliability centred maintenance (RCM) are shown to exhibit severe limitations. In particular, the economic implications surrounding its adoption are repeatedly mis-stated, with the consequence that organisations may be investing in unprofitable RCM ventures. Previously quoted benefits are examined and, contrary to established opinion, it is shown that these 'generalised' statements, once redeemed, are able to be quantified. The paper then proceeds to describe a financial methodology, developed by NGC and UMIST, by which the introduction of RCM can be evaluated. Moreover, it shows that, by regarding RCM as an investment decision, rather than an 'act of faith', the economic viability of a potential application can be determined before vital resources are committed. Finally, it is demonstrated that when the methodology is applied within the context of the electricity transmission industry, the economic case underlying the adoption of RCM can be realistically appraised. (author)

  14. Evaluation of environmental impact produced by different economic activities with the global pollution index.

    Science.gov (United States)

    Zaharia, Carmen

    2012-07-01

    The paper analyses the environment pollution state in different case studies of economic activities (i.e. co-generation electric and thermal power production, iron profile manufacturing, cement processing, waste landfilling, and wood furniture manufacturing), evaluating mainly the environmental cumulative impacts (e.g. cumulative impact against the health of the environment and different life forms). The status of the environment (air, water resources, soil, and noise) is analysed with respect to discharges such as gaseous discharges in the air, final effluents discharged in natural receiving basins or sewerage system, and discharges onto the soil together with the principal pollutants expressed by different environmental indicators corresponding to each specific productive activity. The alternative methodology of global pollution index (I (GP)*) for quantification of environmental impacts is applied. Environmental data analysis permits the identification of potential impact, prediction of significant impact, and evaluation of cumulative impact on a commensurate scale by evaluation scores (ES(i)) for discharge quality, and global effect to the environment pollution state by calculation of the global pollution index (I (GP)*). The I (GP)* values for each productive unit (i.e. 1.664-2.414) correspond to an 'environment modified by industrial/economic activity within admissible limits, having potential of generating discomfort effects'. The evaluation results are significant in view of future development of each productive unit and sustain the economic production in terms of environment protection with respect to a preventive environment protection scheme and continuous measures of pollution control.

  15. 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.

  16. Economic evaluations of Haemophilus influenzae type b (Hib) vaccine: a systematic review.

    Science.gov (United States)

    Chongmelaxme, Bunchai; Hammanee, Maythika; Phooaphirak, Wariya; Kotirum, Surachai; Hutubessy, Raymond; Chaiyakunapruk, Nathorn

    2017-10-01

    The World Health Organization (WHO) recommends the use of Haemophilus influenzae type b (Hib) conjugate vaccines, but China and Thailand have not used Hib vaccination in their national immunization programs. This systematic review aimed to update published economic evaluations of Hib vaccinations and to determine factors that potentially affected their cost-effectiveness. Searches were performed from the inception until December 2015 using 13 databases: CAB direct; CEA registry; EconLit; EMBASE; E-library; NHSEED; PAHO; POPLINE; PubMed; Redalyc project; RePEc; SciELO; and WHOLIS. Reference lists of relevant studies and grey literature were also searched. Full economic evaluations of Hib vaccination with results of costs and outcomes were included. The WHO checklist was used to evaluate the quality of the included studies. Data from eligible studies were extracted using a standardized data collection form. Out of 830 articles, 27 were included. Almost half of the studies (12/27) were conducted in high-income countries. Twelve studies (12/27) investigated the Hib vaccine as an addition to the existing vaccination program. Most studies (17/27) examined a 3-dose schedule of Hib vaccine. Nineteen studies (19/27) reported the model used, where all were decision tree models. Most of the studies (23/27) demonstrated an economic value of Hib vaccination programs, key influential parameters being incidence rates of Hib disease and vaccine price. Hib vaccination programs are mostly found to be cost-effective across geographic regions and country income levels, and Hib vaccination is recommended for inclusion into all national immunization programs. The findings are expected to support policy-makers for making decisions on allocating limited resources of the Hib vaccination program effectively.

  17. Economic evaluation of environmental externalities in China’s coal-fired power generation

    International Nuclear Information System (INIS)

    Zhao, Xiaoli; Cai, Qiong; Ma, Chunbo; Hu, Yanan; Luo, Kaiyan; Li, William

    2017-01-01

    Serious environmental externalities exist in China’s power industry. Environmental economics theory suggests that the evaluation of environmental externality is the basis of designing an efficient regulation. The purposes of this study are: (1) to identify Chinese respondents’ preferences for green development of electric power industry and the socio-economic characteristics behind them; (2) to investigate the different attitudes of the respondents towards pollution and CO_2 reduction; (3) to quantitatively evaluate the environmental cost of China’s coal-fired power generation. Based on the method of choice experiments (CE) and the 411 questionnaires with 2466 data points, we found that Chinese respondents prefer PM2.5, SO_2 and NO_x reduction to CO_2 reduction and that the environment cost of coal-fired power plants in China is 0.30 yuan per kWh. In addition, we found that the socio-economic characteristics of income, education, gender, and environmental awareness have significant impacts on respondents’ choices. These findings indicate that the environmental cost of coal-fired power generation is a significant factor that requires great consideration in the formulation of electric power development policies. In addition, importance should also be attached to the implementation of green power price policy and enhancement of environmental protection awareness. - Highlights: • Chinese respondents have willingness to pay premium for green development. • The environment cost of coal-fired power plants in China is 0.30 yuan/kwh. • Chinese respondents prefer PM2.5, SO_2 and NO_x reduction to CO_2 reduction. • Environmental awareness has significant impacts on respondents’ preferences. • Income, education and gender affect the evaluation results.

  18. The economic burden of brain metastasis among lung cancer patients in the United States.

    Science.gov (United States)

    Guérin, A; Sasane, M; Dea, K; Zhang, J; Culver, K; Nitulescu, R; Wu, E Q; Macalalad, A R

    2016-01-01

    Brain metastases among lung cancer patients can impair cognitive and functional ability, complicate care, and reduce survival. This study focuses on the economic burden of brain metastasis in lung cancer-direct healthcare costs to payers and indirect costs to patients, payers, and employers-in the US. Retrospective study using claims data from over 60 self-insured Fortune 500 companies across all US census regions (January 1999-March 2013). Adult, non-elderly lung cancer patients with brain metastasis were evaluated over two study periods: (1) pre-diagnosis (≤30 days prior to first observed lung cancer diagnosis to ≤30 days prior to first-observed brain metastasis diagnosis) and (2) post-diagnosis (≤30 days prior to first observed brain metastasis diagnosis to end of continuous eligibility or observation). Healthcare costs to payers and resource utilization, salary loss to patients, disability payouts for payers, and productivity loss to employers. A total of 132 patients were followed for a median of 8.4 and 6.6 months in the pre- and post-diagnosis periods, respectively. At diagnosis of brain metastasis, 21.2% of patients were on leave of absence and 6.1% on long-term disability leave. Substantial differences were observed in the pre- vs post-diagnosis periods. Specifically, patients incurred much greater healthcare utilization in the post-diagnosis period, resulting in $25,579 higher medical costs per-patient-per-6-months (PPP6M). During this period, patients missed significantly more work days, generating an incremental burden of $2853 PPP6M in salary loss for patients, $2557 PPP6M in disability payments for payers, and $4570 PPP6M in productivity loss for employers. Type of primary lung cancer and extent of brain metastasis could not be assessed in the data. The analysis was also limited to patients with comprehensive disability coverage. Development of brain metastasis among lung cancer patients is associated with a substantial economic burden to payers

  19. 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.

  20. Virtual chromoendoscopy for the real-time assessment of colorectal polyps in vivo: a systematic review and economic evaluation.

    Science.gov (United States)

    Picot, Joanna; Rose, Micah; Cooper, Keith; Pickett, Karen; Lord, Joanne; Harris, Petra; Whyte, Sophie; Böhning, Dankmar; Shepherd, Jonathan

    2017-12-01

    Current clinical practice is to remove a colorectal polyp detected during colonoscopy and determine whether it is an adenoma or hyperplastic by histopathology. Identifying adenomas is important because they may eventually become cancerous if untreated, whereas hyperplastic polyps do not usually develop into cancer, and a surveillance interval is set based on the number and size of adenomas found. Virtual chromoendoscopy (VCE) (an electronic endoscopic imaging technique) could be used by the endoscopist under strictly controlled conditions for real-time optical diagnosis of diminutive (≤ 5 mm) colorectal polyps to replace histopathological diagnosis. To assess the clinical effectiveness and cost-effectiveness of the VCE technologies narrow-band imaging (NBI), flexible spectral imaging colour enhancement (FICE) and i-scan for the characterisation and management of diminutive (≤ 5 mm) colorectal polyps using high-definition (HD) systems without magnification. Systematic review and economic analysis. People undergoing colonoscopy for screening or surveillance or to investigate symptoms suggestive of colorectal cancer. NBI, FICE and i-scan. Diagnostic accuracy, recommended surveillance intervals, health-related quality of life (HRQoL), adverse effects, incidence of colorectal cancer, mortality and cost-effectiveness of VCE compared with histopathology. Electronic bibliographic databases including MEDLINE, EMBASE, The Cochrane Library and Database of Abstracts of Reviews of Effects were searched for published English-language studies from inception to June 2016. Bibliographies of related papers, systematic reviews and company information were screened and experts were contacted to identify additional evidence. Systematic reviews of test accuracy and economic evaluations were undertaken in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Meta-analyses were conducted, where possible, to inform the independent

  1. Economic evaluation of dual purpose desalination plants by fuel type in Korea

    International Nuclear Information System (INIS)

    Seung-Su, Kim; Man-Ki, Lee

    2007-01-01

    In light of the recent rapid increase in the fossil fuel prices it is meaningful to evaluate the impact of these price changes in the economics of dual-purpose desalination projects producing electricity and fresh water simultaneously. The price of crude oil and LNG (Liquefied Natural Gas) has increased by about 200% and 100% during the past three or four years. The uranium price has also increased by nearly 500% during the same period. The purpose of this paper is to analyze and compare the economics of SMART (System-integrated Modular Advanced ReacTor) which is being developed as a small size PWR type and the LNG Combine Cycle coupled with MED (Multi-Effect Distillation) which are being acknowledged as promising energy sources for the future in Korea. The methods of analysis used in this paper are the lifetime leveled cost method for the power and water cost calculation and the power credit method for the total cost allocation. DEEP (Devaluation Economic Evaluation Program) developed by IAEA was used to perform an economic comparison between the two dual-purpose desalination projects. From the results of the analysis it is found that the desalination by SMART-MED is much superior to that of LNG CC-MED under the current economic and technical situations. It is also shown that the relative superiority of SMART-MED to LNG CC-MED will be maintained even in case where an increase in the uranium price and the SMART construction cost would reach a maximum in the sensitivity analysis. In the case that the discount rate declines to 5% per year, the relative attractiveness of SMART-MED which is a capital intensive plant will be enhanced when compared to that for a 7% discount rate. In addition to this, it is thought that a nuclear energy source will be favored much more than now in the field of desalination if the regulations for the emission of greenhouse gases are to be strengthened. (authors)

  2. 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...

  3. 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

  4. 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.

  5. 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)

  6. A economic evaluation system software on in-situ leaching mining sandstone uranium deposits

    International Nuclear Information System (INIS)

    Yao Yixuan; Su Xuebin; Xie Weixing; Que Weimin

    2001-01-01

    The author presents the study results of applying computer technology to evaluate quantitatively the technical-economic feasibility of in-situ leaching mining sandstone uranium deposits. A computer system software have been developed. Under specifying deposit conditions and given production size per year, the application of the software will generate total capital and mine life operating costs as well as solve for the movable and static financial assessment targets through discounted cash flow analysis. According to the characters of two kinds of sandstone uranium deposits, a data bases of economic and technique parameters of in-situ leaching have been designed. Also the system software can be used to study the economic value of deposits and to optimize the key project parameters. Its features, data input method and demand, main functions, structure and operating environments are described

  7. 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...

  8. Evaluation of correct diagnosis of referral patients to skin clinic by family physicians: A needs assessment for UME,CME

    Directory of Open Access Journals (Sweden)

    A Ramezanpour

    2009-08-01

    Full Text Available Background and purpose: It has been demonstrated that the level of welfare and improvement of nations is evaluated by the progress and achievement of their health service networks. The specialization of therapeutic approaches is one of the practical and effective ways to accomplish this goal. The health system savants believe that the family physician guideline is the redeemer of health system section. This study is aimed, to evaluate the accuracy of diagnosis of the dermatologic disease of referred patients by family physician in Zanjan Valiasr hospital in year 2008.Methods: This descriptive and cross-sectional study was done on 173 cases of referred patients from village family physician to dermatologic clinic. After correct diagnosis by dermatologist data including age, sex, family physician diagnosis and dermatologist diagnosis were recorded on data forms and then analyzed by Chi-square test.Results: From 173 referred patients, 76 cases (43.9% were male, 49 cases (28.3% were under 15 years old, 73 cases (42.2% were between 15-30 years old, and rest were more than 30 years old. 28 cases (16.1% have been referred with correct diagnosis.Conclusion: The level of accurate diagnosis by family physicians was law, which can be due to non-familiarity with common local skin disease and lack of enough instruction and education before starting the family physician project. We recommended that before starting this project, specialist workshop be prepared for family physicians.key words: Family Physician, Skin Diseases, Needs Assessment

  9. ECONOMIC MODEL FOR EVALUATION OF INTEGRAL COMPETITIVENESS OF AUTOMOTIVE ENTERPRISES (AE

    Directory of Open Access Journals (Sweden)

    A. F. Zubritsky

    2010-01-01

    Full Text Available The paper considers problems pertaining to evaluation of competitiveness of automotive enterprises in the field of international consignments. An economic model for determination of the integral AE competitiveness is proposed in the paper and the model permits to substitute an expert estimation in respect of some factors by their qualitative calculation on the basis of data on enterprise activity in the international consignment market.

  10. 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.

  11. Recommendations for reporting economic evaluations of haemophilia prophylaxis: a nominal groups consensus statement on behalf of the Economics Expert Working Group of The International Prophylaxis Study Group.

    Science.gov (United States)

    Nicholson, A; Berger, K; Bohn, R; Carcao, M; Fischer, K; Gringeri, A; Hoots, K; Mantovani, L; Schramm, W; van Hout, B A; Willan, A R; Feldman, B M

    2008-01-01

    The need for clearly reported studies evaluating the cost of prophylaxis and its overall outcomes has been recommended from previous literature. To establish minimal ''core standards'' that can be followed when conducting and reporting economic evaluations of hemophilia prophylaxis. Ten members of the IPSG Economic Analysis Working Group participated in a consensus process using the Nominal Groups Technique (NGT). The following topics relating to the economic analysis of prophylaxis studies were addressed; Whose perspective should be taken? Which is the best methodological approach? Is micro- or macro-costing the best costing strategy? What information must be presented about costs and outcomes in order to facilitate local and international interpretation? The group suggests studies on the economic impact of prophylaxis should be viewed from a societal perspective and be reported using a Cost Utility Analysis (CUA) (with consideration of also reporting Cost Benefit Analysis [CBA]). All costs that exceed $500 should be used to measure the costs of prophylaxis (macro strategy) including items such as clotting factor costs, hospitalizations, surgical procedures, productivity loss and number of days lost from school or work. Generic and disease specific quality of lífe and utility measures should be used to report the outcomes of the study. The IPSG has suggested minimal core standards to be applied to the reporting of economic evaluations of hemophilia prophylaxis. Standardized reporting will facilitate the comparison of studies and will allow for more rational policy decisions and treatment choices.

  12. Health economic evaluations of medical devices in the People's Republic of China: A systematic literature review.

    Science.gov (United States)

    Zhang, Rongrong; Modaresi, Farhang; Borisenko, Oleg

    2015-01-01

    The objective of this study is to identify and review the methodological quality of health economic evaluations of medical devices performed in the People's Republic of China. To our knowledge, no such investigations have been performed to date. A systematic literature review involving searches of Medline, Medline In-Process, the National Health Service Economic Evaluation Database, the Cost-Effectiveness Analysis Registry of the Tufts Medical Center, and the Wanfang Database was performed. The search spanned the period from 1990 to 2013. Studies on health economic evaluations of medical devices, in-vitro diagnostics, procedures, and the use of medical devices in Chinese health care settings were included. Full-text articles and conference abstracts in English and Chinese were included. Fifty-seven publications were included, 26 (46%) of which were in English and 31 (54%) of which were in Chinese. The included publications covered a wide range of clinical areas, such as surgery (n=23, 40%), screening (n=9, 16%), imaging use (n=6, 11%), kidney intervention (n=4, 7%), and nine other technological areas. Most of the studies (n=31, 54%) were cost analyses. Among the others, 13 (50%) studies used modeling, and another 13 (50%) were within-trial evaluations. Among studies that used modeling, eleven (85%) conducted sensitivity analyses, six of which had one-way sensitivity analysis, whereas one conducted both one-way and two-way sensitivity analyses; four of these eleven modeling-based analyses included probabilistic sensitivity analyses. The incremental cost-effectiveness ratio was reported in ten (18%) studies, eight of which were screening studies. The remaining two modeling studies were in areas of imaging and oncology. This study indicates that there are major limitations and deficiencies in the health economic evaluations on medical devices performed in the People's Republic of China. Further efforts are required from different stakeholders - academic, governmental

  13. THE PRODUCTION AND EVALUATION OF THREE COMPUTER-BASED ECONOMICS GAMES FOR THE SIXTH GRADE. FINAL REPORT.

    Science.gov (United States)

    WING, RICHARD L.; AND OTHERS

    THE PURPOSE OF THE EXPERIMENT WAS TO PRODUCE AND EVALUATE 3 COMPUTER-BASED ECONOMICS GAMES AS A METHOD OF INDIVIDUALIZING INSTRUCTION FOR GRADE 6 STUDENTS. 26 EXPERIMENTAL SUBJECTS PLAYED 2 ECONOMICS GAMES, WHILE A CONTROL GROUP RECEIVED CONVENTIONAL INSTRUCTION ON SIMILAR MATERIAL. IN THE SUMERIAN GAME, STUDENTS SEATED AT THE TYPEWRITER TERMINALS…

  14. The economical contracting management in Agricultural Cooperatives: tools for evaluating their performance.

    Directory of Open Access Journals (Sweden)

    Rafael Enrique Viña Echevarría

    2014-06-01

    Full Text Available The economic and management contracts involve strategic actions, legal and operational purposes that make possible to convert the goal of an organization on results that express the fulfillment of the mandates and satisfies customers on the basis of the duties and obligations set out in the negotiating document. This article aims to get inside into the performance evaluation of the management of the recruitment of Agricultural Cooperatives and to reflex about the insufficiencies evidenced in this process. To which we developed a theoretical valuation and economic procurement praxiological showing a group of deficiencies that have impacted in the contracts management The study was able to obtain, process, analyze, interpret and argue the problems associated with economic contracting and justify the need to propose a system of indicators to assess recruitment management Agricultural Cooperatives in the province of Sancti Spiritus, the results revealed the ineffectiveness of the process and the negative impact on the productive base.

  15. Economic evaluations of interventions to manage hyperphosphataemia in adult haemodialysis patients: A systematic review.

    Science.gov (United States)

    Rizk, Rana; Hiligsmann, Mickaël; Karavetian, Mirey; Evers, Silvia Maa

    2016-03-01

    Managing hyperphosphataemia in haemodialysis patients is resource-intensive. A search for cost-effective interventions in this field is needed to inform decisions on the allocation of healthcare resources. NHSEED, MEDLINE, EMBASE and CINAHL were searched for full economic evaluations of hyperphosphataemia-managing interventions in adult haemodialysis patients, published between 2004 and 2014, in English, French, Dutch or German. Incremental cost-effectiveness ratios of the interventions were up-rated to 2013US$ using Purchasing Power Parity conversion rates and Consumer Price Indices. The quality of included studies was assessed using the Extended Consensus on Health Economic Criteria List. Twelve out of the 1681 retrieved records fulfilled the inclusion criteria. They reported only on one aspect of hyperphosphataemia management, which is the use of phosphate binders (calcium-based and calcium-free, in first-line and sequential use). No economic evaluations of other phosphorus-lowering interventions were found. The included articles derived from five countries and most of them were funded by pharmaceutical companies. The incremental cost-effectiveness ratios of phosphate binders ranged between US$11 461 and US$157 760 per quality-adjusted life-year gained. Calcium-based binders (especially calcium acetate) appear to be the optimal cost-effective first- and second-line therapy in prevalent patients, while the calcium-free binder, lanthanum carbonate, might provide good value for money, as second-line therapy, in incident patients. The studies' overall quality was suboptimal. Drawing firm conclusions was not possible due to the quality heterogeneity and inconsistent results. Future high-quality economic evaluations are needed to confirm the findings of this review and to address other interventions to manage hyperphosphataemia in this population. © 2015 Asian Pacific Society of Nephrology.

  16. A systematic and critical review of model-based economic evaluations of pharmacotherapeutics in patients with bipolar disorder.

    Science.gov (United States)

    Mohiuddin, Syed

    2014-08-01

    Bipolar disorder (BD) is a chronic and relapsing mental illness with a considerable health-related and economic burden. The primary goal of pharmacotherapeutics for BD is to improve patients' well-being. The use of decision-analytic models is key in assessing the added value of the pharmacotherapeutics aimed at treating the illness, but concerns have been expressed about the appropriateness of different modelling techniques and about the transparency in the reporting of economic evaluations. This paper aimed to identify and critically appraise published model-based economic evaluations of pharmacotherapeutics in BD patients. A systematic review combining common terms for BD and economic evaluation was conducted in MEDLINE, EMBASE, PSYCINFO and ECONLIT. Studies identified were summarised and critically appraised in terms of the use of modelling technique, model structure and data sources. Considering the prognosis and management of BD, the possible benefits and limitations of each modelling technique are discussed. Fourteen studies were identified using model-based economic evaluations of pharmacotherapeutics in BD patients. Of these 14 studies, nine used Markov, three used discrete-event simulation (DES) and two used decision-tree models. Most of the studies (n = 11) did not include the rationale for the choice of modelling technique undertaken. Half of the studies did not include the risk of mortality. Surprisingly, no study considered the risk of having a mixed bipolar episode. This review identified various modelling issues that could potentially reduce the comparability of one pharmacotherapeutic intervention with another. Better use and reporting of the modelling techniques in the future studies are essential. DES modelling appears to be a flexible and comprehensive technique for evaluating the comparability of BD treatment options because of its greater flexibility of depicting the disease progression over time. However, depending on the research question

  17. 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)

  18. 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

  19. Agro-energy supply chain planning: a procedure to evaluate economic, energy and environmental sustainability

    Directory of Open Access Journals (Sweden)

    Fabrizio Ginaldi

    2012-07-01

    Full Text Available The increasing demand for energy and expected shortage in the medium term, solicit innovative energy strategies to fulfill the increasing gap between demand-supply. For this purpose it is important to evaluate the potential supply of the energy crops and finding the areas of EU where it is most convenient. This paper proposes an agro-energy supply chain approach to planning the biofuel supply chain at a regional level. The proposed methodology is the result of an interdisciplinary team work and is aimed to evaluate the potential supply of land for the energy production and the efficiency of the processing plants considering simultaneously economic, energy and environmental targets. The crop simulation, on the basis of this approach, takes into account environmental and agricultural variables (soil, climate, crop, agronomic technique that affect yields, energy and economic costs of the agricultural phase. The use of the Dijkstra’s algorithm allows minimizing the biomass transport path from farm to collecting points and the processing plant, to reduce both the transport cost and the energy consumption. Finally, a global sustainability index (ACSI, Agro-energy Chain Sustainability Index is computed combining economic, energy and environmental aspects to evaluate the sustainability of the Agroenergy supply chain (AESC on the territory. The empirical part consists in a pilot study applied to the whole plain of Friuli Venezia Giulia (FVG a region situated in the North-Eastern part of Italy covering about 161,300 ha. The simulation has been applied to the maize cultivation using three different technologies (different levels of irrigation and nitrogen fertilization: low, medium and high input. The higher input technologies allow to achieve higher crop yields, but affect negatively both the economic and energy balances. Low input levels provides, on the average, the most favourable energy and economic balances. ACSI indicates that low inputs levels

  20. 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

  1. Study of a simplified method of evaluating the economic maintenance importance of components in nuclear power plant system

    International Nuclear Information System (INIS)

    Aoki, Takayuki; Takagi, Toshiyuki; Kodama, Noriko

    2014-01-01

    Safety risk importance of components in nuclear power plants has been evaluated based on the probabilistic risk assessment and used for the decisions in various plant managements. But economic risk importance of the components has not been discussed very much. Therefore, this paper discusses risk importance of the components from the viewpoint of plant economic efficiency and proposes a simplified evaluation method of the economic risk importance (or economic maintenance importance). As a result of consideration, the followings were obtained. (1) A unit cost of power generation is selected as a performance indicator and can be related to a failure rate of components in nuclear power plant which is a result of maintenance. (2) The economic maintenance importance has to major factors, i.e. repair cost at component failure and production loss associated with plant outage due to component failure. (3) The developed method enables easy understanding of economic impacts of plant shutdown or power reduction due to component failures on the plane which adopts the repair cost in vertical axis and the production loss in horizontal axis. (author)

  2. EMBIO - The Danish Energy Agency's model for economic and environmental evaluation of bio-fuels. Appendix

    International Nuclear Information System (INIS)

    1997-01-01

    A methodological concept is established for a life-cycle based model which can be used for socio- and private economic and environmental assessment of automotive bio-fuels. The calculation method must be able to calculate socio-economic, energy, environmental, and other consequences by alternative productions and uses of bio-fuels. The main emphasis in the development of the model has been put on the relation between CO 2 reduction and economics. The appendix presents details of the model used for evaluating two specific projects: 'Bio-diesel in the Lemvig area (Denmark), rape seeds as energy crops'; 'Ethanol in the green bio-refining plant'. The results from the use of the model are presented and sensitivity analyses of the model results are performed. Furthermore, a number of background information is presented to be used in relation to the model for evaluating alternative production methods and uses of bio-fuels. Primarily Danish and other European sources of information are selected. (LN)

  3. Does the medical diagnosis of occupational asthma coincide with the legal diagnosis?

    Science.gov (United States)

    Çelebi Sözener, Zeynep; Aydın, Ömür; Demirel, Yavuz Selim; Soyyiğit, Şadan; Çerçi, Pamir; Kendirlinan, Reşat; Bavbek, Sevim; Çelik, Gülfem Elif; Misirligil, Zeynep; Sin, Betül Ayşe; Keleşoğlu, Arif; Mungan, Dilşad

    2017-11-01

    The incidence of occupational asthma (OA) is increasing worldwide. In this study, we first aimed to document the rate of diagnosis of OA among patients who were referred to our clinic from the Social Security Institution and the factors that affected diagnosis; secondly, we aimed to assess the consistency of the medical and legal diagnoses. The study involved 132 consecutive patients who were referred to our clinic for the evaluation of OA between 2010 and 2015. Detailed workplace history, the tools used in the diagnosis such as peak expiratory flow (PEF) monitoring and bronchial provocation tests, and the final medical diagnosis were recorded from case files. Asthma was diagnosed in 75% (n = 99) of the patients. Among them, 22.2% were diagnosed as having OA. The diagnosis was confirmed by serial PEF measurements, non-specific bronchial hyperreactivity assessment or both of the tests both at work and off-work periods. OA diagnosis was mostly established in active workers (72.7%). The legal diagnosis period was completed in 54.5% of these 22 patients, and 50% (n = 11) were officially diagnosed as having OA with a 91.6% concordance with medical diagnosis. This study verifies the importance of diagnosing asthma correctly as a first step in the evaluation of OA. Diagnostic tests other than specific provocation tests could be preferential in patients who still work in the same field. We believe that cooperation with the patient's occupational physician and adequate recognition of the work environment will improve the consistency of legal and medical diagnoses.

  4. CO2 emission reduction policies in the greek residential sector: a methodological framework for their economic evaluation

    International Nuclear Information System (INIS)

    Mirasgedis, S.; Georgopoulou, E.; Sarafidis, Y.; Balaras, C.; Gaglia, A.; Lalas, D.P.

    2004-01-01

    This paper outlines a methodological framework for the economic evaluation of CO 2 emissions abatement policies and measures in the residential sector, taking into consideration both economic and social costs/benefits. The approach includes two stages: first, the measures under consideration are evaluated on the basis of a cost effectiveness analysis, which takes into account only the related net financial costs, thus highlighting win-win actions (i.e. measures presenting an economic benefit for end users without the provision of any economic subsidies or other similar policies); and second, the measures are re-evaluated using an integrated cost benefit analysis (where both the private and external costs/benefits are taken into account). The economic performance of the measures examined incorporates the effects of a variety of parameters, such as the region's climate, size and age of buildings, etc., which significantly affect the resulting ranking. The implementation of this framework in the Greek residential sector identified and prioritized a significant emissions reduction potential, which could be achieved with win-win measures and/or interventions that present a net social benefit. Measures with negative economic cost but positive net social benefit for the majority of the buildings examined include: (i) regular inspection of central heating boilers, (ii) use of thermostats in central heating boilers, (iii) sealing of openings, (iv) installation of solar collectors for hot water etc. The monetization of environmental benefits is shown to provide a powerful tool for highlighting priority actions in the context of a climate change mitigation policy

  5. 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.

  6. 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.

  7. [Age 89 years, depression, fall with pelvic fracture, severe confusion - serotonin syndrome : Differential diagnosis, importance of CYP450 and economic considerations].

    Science.gov (United States)

    Weinrebe, W; Moutaouakil, A; Risz, K; Martin, M; Jeckelmann, K; Goetz, S

    2017-04-18

    A case study of an 89-year-old patient is reported, who was admitted to hospital because of immobility due to pain. After the cause of the pain could initially be clarified and treated, the further clinical course in this very old woman showed an alarming symptom complex of agitation, confusion and cognitive deterioration, which took on grave forms. The work-up of this case showed a typical constellation of pain and depression in old age; however, the pharmaceutical treatment in this case is not atypical and could lead to a severe serotonin syndrome. The interaction, diagnostics, differential diagnosis, pharmacological, functional, codification and economic aspects of the course of the disease are discussed.

  8. [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.

  9. 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.

  10. Systematic Review and Quality Appraisal of Economic Evaluation Publications in Dentistry.

    Science.gov (United States)

    Tonmukayakul, U; Calache, H; Clark, R; Wasiak, J; Faggion, C M

    2015-10-01

    Economic evaluation (EE) studies have been undertaken in dentistry since the late 20th century because economic data provide additional information to policy makers to develop guidelines and set future direction for oral health services. The objectives of this study were to assess the methodological quality of EEs in oral health. Electronic searching of Ovid MEDLINE, the Cochrane Library, and the NHS Economic Evaluation Database from 1975 to 2013 were undertaken to identify publications that include costs and outcomes in dentistry. Relevant reference lists were also searched for additional studies. Studies were retrieved and reviewed independently for inclusion by 3 authors. Furthermore, to appraise the EE methods, 1 author applied the Drummond 10-item (13-criteria) checklist tool to each study. Of the 114 publications identified, 79 studies were considered full EE and 35 partial. Twenty-eight studies (30%) were published between the years 2011 and 2013. Sixty-four (53%) studies focused on dental caries prevention or treatment. Median appraisal scores calculated for full and partial EE studies were 11 and 9 out of 13, respectively. Quality assessment scores showed that the quality of partial EE studies published after 2000 significantly improved (P = 0.02) compared to those published before 2000. Significant quality improvement was not found in full EE studies. Common methodological limitations were identified: absence of sensitivity analysis, discounting, and insufficient information on how costs and outcomes were measured and valued. EE studies in dentistry increased over the last 40 y in both quantity and quality, but a number of publications failed to satisfy some components of standard EE research methods, such as sensitivity analysis and discounting. © International & American Associations for Dental Research 2015.

  11. 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

  12. An analysis of the influence of framework aspects on the study design of health economic modeling evaluations.

    Science.gov (United States)

    Gurtner, Sebastian

    2013-04-01

    Research and practical guidelines have many implications for how to structure a health economic study. A major focus in recent decades has been the quality of health economic research. In practice, the factors influencing a study design are not limited to the quest for quality. Moreover, the framework of the study is important. This research addresses three major questions related to these framework aspects. First, we want to know whether the design of health economic studies has changed over time. Second, we want to know how the subject of a study, whether it is a process or product innovation, influences the parameters of the study design. Third, one of the most important questions we will answer is whether and how the study's source of funding has an impact on the design of the research. To answer these questions, a total of 234 health economic studies were analyzed using a correspondence analysis and a logistic regression analysis. All three categories of framework factors have an influence on the aspects of the study design. Health economic studies have evolved over time, leading to the use of more advanced methods like complex sensitivity analyses. Additionally, the patient's point of view has increased in importance. The evaluation of product innovations has focused more on utility concepts. On the other hand, the source of funding may influence only a few aspects of the study design, such as the use of evaluation methods, the source of data, and the use of certain utility measures. The most important trends in health care, such as the emphasis on the patients' point of view, become increasingly established in health economic evaluations with the passage of time. Although methodological challenges remain, modern information and communication technologies provide a basis for increasing the complexity and quality of health economic studies if used frequently.

  13. Production forecasting and economic evaluation of horizontal wells completed in natural fractured reservoirs

    International Nuclear Information System (INIS)

    Evans, R. D.

    1996-01-01

    A technique for optimizing recovery of hydrocarbons from naturally fractured reservoirs using horizontal well technology was proposed. The technique combines inflow performance analysis, production forecasting and economic considerations, and is based on material balance analysis and linear approximations of reservoir fluid properties as functions of reservoir pressure. An economic evaluation model accounting for the time value of cash flow, interest and inflation rates, is part of the package. Examples of using the technique have been demonstrated. The method is also applied to a gas well producing from a horizontal wellbore intersecting discrete natural fractures. 11 refs., 2 tabs,. 10 figs

  14. Economic evaluation of vaccines : specificities and future challenges illustrated by recent European examples

    NARCIS (Netherlands)

    Postma, M.J.; Westra, T.A.; Quilici, S.; Largeron, N.

    2013-01-01

    This study reviews the current challenges in the economic evaluation of vaccines with a focus on European countries. In particular, the type of clinical evidence generally available, the impact of discounting for time preference and the use of modeling to derive valid cost-effectiveness assessments

  15. Economic evaluation of vaccines : specificities and future challenges illustrated by recent European examples

    NARCIS (Netherlands)

    Postma, Maarten J; Westra, Tjalke A; Quilici, Sibilia; Largeron, Nathalie

    This study reviews the current challenges in the economic evaluation of vaccines with a focus on European countries. In particular, the type of clinical evidence generally available, the impact of discounting for time preference and the use of modeling to derive valid cost-effectiveness assessments

  16. Review of economic evaluations of mask and respirator use for protection against respiratory infection transmission.

    Science.gov (United States)

    Mukerji, Shohini; MacIntyre, C Raina; Newall, Anthony T

    2015-10-13

    There has been increasing debate surrounding mask and respirator interventions to control respiratory infection transmission in both healthcare and community settings. As decision makers are considering the recommendations they should evaluate how to provide the most efficient protection strategies with minimum costs. The aim of this review is to identify and evaluate the existing economic evaluation literature in this area and to offer advice on how future evaluations on this topic should be conducted. We searched the Scopus database for all literature on economic evaluation of mask or respirator use to control respiratory infection transmission. Reference lists from the identified studies were also manually searched. Seven studies met our inclusion criteria from the initial 806 studies identified by the search strategy and our manual search. Five studies considered interventions for seasonal and/or pandemic influenza, with one also considering SARS (Severe Acute Respiratory Syndrome). The other two studies focussed on tuberculosis transmission control interventions. The settings and methodologies of the studies varied greatly. No low-middle income settings were identified. Only one of the reviewed studies cited clinical evidence to inform their mask/respirator intervention effectiveness parameters. Mask and respirator interventions were generally reported by the study authors to be cost saving or cost-effective when compared to no intervention or other control measures, however the evaluations had important limitations. Given the large cost differential between masks and respirators, there is a need for more comprehensive economic evaluations to compare the relative costs and benefits of these interventions in situations and settings where alternative options are potentially applicable. There are at present insufficient well conducted cost-effectiveness studies to inform decision-makers on the value for money of alternative mask/respirator options.

  17. Conceptual design and economic evaluation about the coupling of high power PWRs and desalination system

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Sang Ho; Chang, Soon Heung [Korea Advanced Institute of Science and Technology, Daejeon (Korea, Republic of); Kim, Hyeon Min; Heo, Gyun Young [Kyung Hee Univ., Yongin (Korea, Republic of)

    2012-03-15

    Both electricity and fresh water become basic human needs in modern days. This paper describes the coupling methods of high power pressurized water reactors and desalination system, and evaluates the economics of coupling systems. OPR1000 designed by Korea was chosen for the reference reactor. Because MED (Mulct-Effect Distillation) with TVC (Thermal Vapor Compressor) have been evaluated as an effective desalination system for high power reactors, it was used for the reference desalination method in simulation. In order to simulate the secondary circuit of PWRs with heat exchangers for MED-TVC, PEPSE program which is normally used for performance evaluation of power system efficiencies was used. The coupling of OPR1000 and desalination systems were set under the restriction it had to make as small changes as possible. From the results PEPSE simulation, the economics of the coupling systems were calculates using equations form DEEP4.0 (Desalination Economic Evaluation Program) which was developed by IAEA because Deep simulates just two simple couplings which are back pressure and condensation/extraction. In the secondary circuit simulation seven coupling cases were set and outlet powers to heat exchanger for desalination were varied to be dependent on the thermohydraulic conditions on each part. The results of changed electrical power generation were calculated with the thermal outputs for desalination. It is concluded that two coupling method using the steam from high-pressure turbine have high performance and are economical among the simulated cases. The first one is to add a heat exchanger on the branch from high-pressure turbine into moisture separator and the other is on the branch into feedwater heating parts. It proves desalination plants can be added to current high power PWRs.

  18. Integrating social justice concerns into economic evaluation for healthcare and public health: A systematic review.

    Science.gov (United States)

    Dukhanin, Vadim; Searle, Alexandra; Zwerling, Alice; Dowdy, David W; Taylor, Holly A; Merritt, Maria W

    2018-02-01

    Social justice is the moral imperative to avoid and remediate unfair distributions of societal disadvantage. In priority setting in healthcare and public health, social justice reaches beyond fairness in the distribution of health outcomes and economic impacts to encompass fairness in the distribution of policy impacts upon other dimensions of well-being. There is an emerging awareness of the need for economic evaluation to integrate all such concerns. We performed a systematic review (1) to describe methodological solutions suitable for integrating social justice concerns into economic evaluation, and (2) to describe the challenges that those solutions face. To be included, publications must have captured fairness considerations that (a) involve cross-dimensional subjective personal life experience and (b) can be manifested at the level of subpopulations. We identified relevant publications using an electronic search in EMBASE, PubMed, EconLit, PsycInfo, Philosopher's Index, and Scopus, including publications available in English in the past 20 years. Two reviewers independently appraised candidate publications, extracted data, and synthesized findings in narrative form. Out of 2388 publications reviewed, 26 were included. Solutions sought either to incorporate relevant fairness considerations directly into economic evaluation or to report them alongside cost-effectiveness measures. The majority of reviewed solutions, if adapted to integrate social justice concerns, would require their explicit quantification. Four broad challenges related to the implementation of these solutions were identified: clarifying the normative basis; measuring and determining the relative importance of criteria representing that basis; combining the criteria; and evaluating trade-offs. All included solutions must grapple with an inherent tension: they must either face the normative and operational challenges of quantifying social justice concerns or accede to offering incomplete policy

  19. Burden of disease and economic evaluation of healthcare interventions: are we investigating what really matters?

    Science.gov (United States)

    Catalá-López, Ferrán; García-Altés, Anna; Alvarez-Martín, Elena; Gènova-Maleras, Ricard; Morant-Ginestar, Consuelo; Parada, Antoni

    2011-04-13

    The allocation of limited available healthcare resources demands an agreed rational allocation principle and the consequent priority setting. We assessed the association between economic evaluations of healthcare interventions published in Spain (1983-2008) and the disease burden in the population. Electronic databases (e.g., PubMed/MEDLINE, SCOPUS, ISI Web of Knowledge, CRD, IME, IBECS) and reports from health technology assessment agencies were systematically reviewed. For each article, multiple variables were recorded such as: year and journal of publication, type of study, health intervention targetted, perspective of analysis, type of costs and sources of information, first author's affiliation, explicit recommendations aimed at decision-making, and the main disease cause to which the intervention was addressed. The following disease burden measures were calculated: years of life lost (YLLs), years lived with disability (YLDs), disability-adjusted life years (DALYs), and mortality by cause. Correlation and linear regression models were fitted. Four hundred and seventy-seven economic evaluations were identified. Cardiovascular diseases (15.7%), infectious diseases (15.3%), malignant neoplasms (13.2%), and neuropsychiatric diseases (9.6%) were the conditions most commonly addressed. Accidents and injuries, congenital anomalies, oral conditions, nutritional deficiencies and other neoplasms were the categories with a lowest number of studies (0.6% for each of them). For the main disease categories (n = 20), a correlation was seen with: mortality 0.67 (p = 0.001), DALYs 0.63 (p = 0.003), YLLs 0.54 (p = 0.014), and YLDs 0.51 (p = 0.018). By disease sub-categories (n = 51), the correlations were generally low and non statistically significant. Examining discrepancies between economic evaluations in particular diseases and the overall burden of disease helps shed light on whether there are potentially over- and under-investigated areas. The approach taken could help

  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. Energetic and economical evaluation of the geothermal water desalination by distillation; Evaluation energeco-economique du procede de dessalement de l'eau geothermale par distillation

    Energy Technology Data Exchange (ETDEWEB)

    Nasfi, N.; Hajji, N.; Benali, S.; Jeday, M.R. [Ecole Nationale d' Ingenieurs de Gabes, Lab. d' Energetique et d' Ingenierie, Gabes (Tunisia)

    2001-07-01

    This study is devoted to the energetic and economical performance of desalination units by geothermal water distillation, without and with vapor mechanical compression. The process and its block diagram are described. The obtained results allow the evaluation of the more economical process. (A.L.B.)

  2. Evaluation of pulse oximeter derived photoplethysmographic signals for obstructive sleep apnea diagnosis.

    Science.gov (United States)

    Li, Yan; Gao, He; Ma, Yan

    2017-05-01

    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.Consecutive out-patients with suspect OSA completed a PPG monitoring simultaneous with an overnight in-lab standard PSG. Forty-nine OSA patients (38 males, age 43.5 ± 16.9 years, BMI 26.9 ± 0.5 kg/m) were included in this study. Automated analyses were based on PPG and oximetry signals only. The PPG calculated measures were compared with PSG derived measures for agreement tests.Respiratory events index derived from PPG significantly correlated with PSG-derived apnea-hypopnea index (r = 0.935, P oximeter system with PPG recording can be used for the diagnosis or screening of OSA in high risk population.

  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. 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.

  5. Economic support to patients in HIV and TB grants in rounds 7 and 10 from the global fund to fight AIDS, tuberculosis and malaria.

    Directory of Open Access Journals (Sweden)

    Linda M Richter

    Full Text Available People with TB and/or HIV frequently experience severe economic barriers to health care, including out-of-pocket expenses related to diagnosis and treatment, as well as indirect costs due to loss of income. These barriers can both aggravate economic hardship and prevent or delay diagnosis, treatment and successful outcome, leading to increased transmission, morbidity and mortality. WHO, UNAIDS and the ILO argue that economic support of various kinds is essential to enable vulnerable people to protect themselves from infection, avoid delayed diagnosis and treatment, overcome barriers to adherence, and avert destitution. This paper analyses successful country proposals to the Global Fund to Fight AIDS, Tuberculosis and Malaria that include economic support in Rounds 7 and 10; 36 and 20 HIV and TB grants in Round 7 and 32 and 26, respectively, in Round 10. Of these, up to 84 percent included direct or indirect economic support for beneficiaries, although the amount constituted a very small proportion of the total grant. In TB grants, the objectives of economic support were generally clearly stated, and focused on mechanisms to improve treatment uptake and adherence, and the case was most clearly made for MDR-TB patients. In HIV grants, the objectives were much broader in scope, including mitigation of adverse economic and social effects of HIV and its treatment on both patients and families. The analysis shows that economic support is on the radar for countries developing Global Fund proposals, and a wide range of economic support activities are in place. In order to move forward in this area, the wealth of country experience that exists needs to be collated, assessed and disseminated. In addition to trials, operational research and programme evaluations, more precise guidance to countries is needed to inform evidence-based decision about activities that are cost-effective, affordable and feasible.

  6. Non-invasive spectroscopic techniques in the diagnosis of non-melanoma skin cancer

    Science.gov (United States)

    Drakaki, E.; Sianoudis, IA; Zois, EN; Makropoulou, M.; Serafetinides, AA; Dessinioti, C.; Stefanaki, E.; Stratigos, AJ; Antoniou, C.; Katsambas, A.; Christofidou, E.

    2017-11-01

    The number of non-melanoma skin cancers is increasing worldwide and has become an important health and economic issue. Early detection and treatment of skin cancer can significantly improve patient outcome. Therefore there is an increase in the demand for proper management and effective non-invasive diagnostic modalities in order to avoid relapses or unnecessary treatments. Although the gold standard of diagnosis for non-melanoma skin cancers is biopsy followed by histopathology evaluation, optical non-invasive diagnostic tools have obtained increased attention. Emerging non-invasive or minimal invasive techniques with possible application in the diagnosis of non-melanoma skin cancers include high-definition optical coherence tomography, fluorescence spectroscopy, oblique incidence diffuse reflectance spectrometry among others spectroscopic techniques. Our findings establish how those spectrometric techniques can be used to more rapidly and easily diagnose skin cancer in an accurate and automated manner in the clinic.

  7. Economic evaluation and market analysis for natural gas utilization. Topical report

    International Nuclear Information System (INIS)

    Hackworth, J.H.; Koch, R.W.; Rezaiyan, A.J.

    1995-04-01

    During the past decade, the U.S. has experienced a surplus gas supply. Future prospects are brightening because of increased estimates of the potential size of undiscovered gas reserves. At the same time, U.S. oil reserves and production have steadily declined, while oil imports have steadily increased. Reducing volume growth of crude oil imports was a key objective of the Energy Policy Act of 1992. Natural gas could be an important alternative energy source to liquid products derived from crude oil to help meet market demand. The purpose of this study was to (1) analyze three energy markets to determine whether greater use could be made of natural gas or its derivatives and (2) determine whether those products could be provided on an economically competitive basis. The following three markets were targeted for possible increases in gas use: transportation fuels, power generation, and chemical feedstock. Gas-derived products that could potentially compete in these three markets were identified, and the economics of the processes for producing those products were evaluated. The processes considered covered the range from commercial to those in early stages of process development. The analysis also evaluated the use of both high-quality natural gas and lower-quality gases containing CO 2 and N 2 levels above normal pipeline quality standards

  8. 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)

  9. 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

  10. 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.

  11. CT diagnosis of hepatic alveolar echinococcosis and evaluation after albendazole chemotherapy

    International Nuclear Information System (INIS)

    Wu Jingquan; Liu Yuehan; Wang Xiaogen

    1998-01-01

    Purpose: To analyze the CT features and evaluate albendazole chemotherapy of hepatic alveolar echinococcosis with computed tomography (CT). Methods: Twenty-one patients of hepatic alveolar echincoccosis were diagnosed by epidemiological, clinical, serological tests, and studied with US and CT. Twenty patients were followed up by CT scanning from 1 to 9 years (mean 3.9 years) after albendazole chemotherapy. Results: CT scanning of liver before treatment displayed heterogeneous hypodense lesions, with irregular, obscure contour and calcifications According to CT features, the hepatic lesions were divided into 3 forms: solid mass in 7 cases, pseudocyst in 6 cases and mixed in 8 cases. Three patients had contrast study. The hepatic lesions were not markedly enhanced, but the lesions were seen more clearly and appeared more extensive. In follow-up examination of 20 cases, 4 were apparently cured, 5 improved, 5 stabilized, and 6 cases remained pseudocyst. Conclusion: CT scanning was of value not only for diagnosis of hepatic alveolar echinococcosis, but also useful in evaluation of chemotherapeutic efficacy

  12. The International Decision Support Initiative Reference Case for Economic Evaluation: An Aid to Thought.

    Science.gov (United States)

    Wilkinson, Thomas; Sculpher, Mark J; Claxton, Karl; Revill, Paul; Briggs, Andrew; Cairns, John A; Teerawattananon, Yot; Asfaw, Elias; Lopert, Ruth; Culyer, Anthony J; Walker, Damian G

    2016-12-01

    Policymakers in high-, low-, and middle-income countries alike face challenging choices about resource allocation in health. Economic evaluation can be useful in providing decision makers with the best evidence of the anticipated benefits of new investments, as well as their expected opportunity costs-the benefits forgone of the options not chosen. To guide the decisions of health systems effectively, it is important that the methods of economic evaluation are founded on clear principles, are applied systematically, and are appropriate to the decision problems they seek to inform. The Bill and Melinda Gates Foundation, a major funder of economic evaluations of health technologies in low- and middle-income countries (LMICs), commissioned a "reference case" through the International Decision Support Initiative (iDSI) to guide future evaluations, and improve both the consistency and usefulness to decision makers. The iDSI Reference Case draws on previous insights from the World Health Organization, the US Panel on Cost-Effectiveness in Health Care, and the UK National Institute for Health and Care Excellence. Comprising 11 key principles, each accompanied by methodological specifications and reporting standards, the iDSI Reference Case also serves as a means of identifying priorities for methods research, and can be used as a framework for capacity building and technical assistance in LMICs. The iDSI Reference Case is an aid to thought, not a substitute for it, and should not be followed slavishly without regard to context, culture, or history. This article presents the iDSI Reference Case and discusses the rationale, approach, components, and application in LMICs. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  13. Establishment of Passive Energy Conservation Measure and Economic Evaluation of Fenestration System in Nonresidential Building of Korea

    Directory of Open Access Journals (Sweden)

    Bo-Eun Choi

    2017-01-01

    Full Text Available ECO2 (building energy efficiency rating program and passive energy conservation measures (ECMs were established as a basic study for targeted methodologies and decision support systems development in Korea to meet national regulations. The primary energy consumption and economic evaluation of nonresidential buildings was performed. Passive ECMs were classified as planning and performance elements. The planning elements are the window-to-wall ratio (WWR and horizontal shading angle. The performance elements are the thermal transmittance (U-value of the walls, roof, and floor and the U-value and solar heat gain coefficient (SHGC of windows. This study focused on the window-to-wall ratio and the U-value and solar heat gain coefficient of windows. An economic efficiency database for the constructed alternatives was built; the target building was set and the Passive ECM List for the target building was derived. The energy consumption evaluation and economic evaluation were performed for each of the constructed alternatives, and a methodology for guiding energy efficiency decisions was proposed based on the performance evaluation results, and the optimal Passive ECM List for the target building was derived.

  14. 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

  15. A techno-economic evaluation of a biomass energy conversion park

    Energy Technology Data Exchange (ETDEWEB)

    Van Dael, M.; Van Passel, S.; Witters, N. [Centre for Environmental Sciences, Hasselt University, Agoralaan Gebouw D, 3590 Diepenbeek (Belgium); Pelkmans, L.; Guisson, R. [VITO, Boeretang 200, 2400 Mol (Belgium); Reumermann, P. [BTG Biomass Technology Group, Josink Esweg 34, 7545 PN Enschede (Netherlands); Marquez Luzardo, N. [School of Life Sciences and Environmental Technology, Avans Hogeschool, Hogeschoollaan 1, 4800 RA Breda (Netherlands); Broeze, J. [Agrotechnology and Food Sciences Group, Wageningen University, Bomenweg 2, 6703 HD Wageningen (Netherlands)

    2013-04-15

    Biomass as a renewable energy source has many advantages and is therefore recognized as one of the main renewable energy sources to be deployed in order to attain the target of 20% renewable energy use of final energy consumption by 2020 in Europe. In this paper the concept of a biomass Energy Conversion Park (ECP) is introduced. A biomass ECP can be defined as a synergetic, multi-dimensional biomass conversion site with a highly integrated set of conversion technologies in which a multitude of regionally available biomass (residue) sources are converted into energy and materials. A techno-economic assessment is performed on a case study in the Netherlands to illustrate the concept and to comparatively assess the highly integrated system with two mono-dimensional models. The three evaluated models consist of (1) digestion of the organic fraction of municipal solid waste, (2) co-digestion of manure and co-substrates, and (3) integration. From a socio-economic point of view it can be concluded that it is economically and energetically more interesting to invest in the integrated model than in two separate models. The integration is economically feasible and environmental benefits can be realized. For example, the integrated model allows the implementation of a co-digester. Unmanaged manure would otherwise represent a constant pollution risk. However, from an investor's standpoint one should firstly invest in the municipal solid waste digester since the net present value (NPV) of this mono-dimensional model is higher than that of the multi-dimensional model. A sensitivity analysis is performed to identify the most influencing parameters. Our results are of interest for companies involved in the conversion of biomass. The conclusions are useful for policy makers when deciding on policy instruments concerning manure processing or biogas production.

  16. Life-cycle evaluation of nitrogen-use in rice-farming systems: implications for economically-optimal nitrogen rates

    Directory of Open Access Journals (Sweden)

    Y. Xia

    2011-11-01

    Full Text Available Nitrogen (N fertilizer plays an important role in agricultural systems in terms of food yield. However, N application rates (NARs are often overestimated over the rice (Oryza sativa L. growing season in the Taihu Lake region of China. This is largely because negative externalities are not entirely included when evaluating economically-optimal nitrogen rate (EONR, such as only individual N losses are taken into account, or the inventory flows of reactive N have been limited solely to the farming process when evaluating environmental and economic effects of N fertilizer. This study integrates important material and energy flows resulting from N use into a rice agricultural inventory that constitutes the hub of the life-cycle assessment (LCA method. An economic evaluation is used to determine an environmental and economic NAR for the Taihu Lake region. The analysis reveals that production and exploitation processes consume the largest proportion of resources, accounting for 77.2 % and 22.3 % of total resources, respectively. Regarding environmental impact, global warming creates the highest cost with contributions stemming mostly from fertilizer production and farming processes. Farming process incurs the biggest environmental impact of the three environmental impact categories considered, whereas transportation has a much smaller effect. When taking account of resource consumption and environmental cost, the marginal benefit of 1 kg rice would decrease from 2.4 to only 1.05 yuan. Accordingly, our current EONR has been evaluated at 187 kg N ha−1 for a single rice-growing season. This could enhance profitability, as well as reduce the N losses associated with rice growing.

  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 area-wide pest management program to control asian tiger mosquito in New Jersey

    Science.gov (United States)

    Area-wide pest management (AWPM) is recommended to control urban mosquitoes, such as Aedes albopictus, which limit outdoor activities. While several evaluations of effectiveness exist, information on costs is lacking. Economic evaluation of such a program is important to help inform policy makers an...

  19. 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.

  20. Process Simulation and Techno-Economic Evaluation of Alternative Biorefinery Scenarios

    Science.gov (United States)

    Aizpurua Gonzalez, Carlos Ernesto

    A biorefinery is a complex processing facility that uses sustainably produced biomass as feedstock to generate biofuels and chemical products using a wide variety of alternative conversion pathways. The alternative conversion pathways can be generally classified as either biochemical or thermochemical conversion. A biorefinery is commonly based on a core biomass conversion technology (pretreatment, hydrolysis, pyrolysis, etc.) followed by secondary processing stages that determine the specific product, and its recovery. In this study, techno-economic analysis of several different lignocellulosic biomass conversion pathways have been performed. First, a novel biochemical conversion, which used electron beam and steam explosion pretreatments for ethanol production was evaluated. This evaluation include both laboratory work and process modeling. Encouraging experimental results are obtained that showed the biomass had enhanced reactivity to the enzyme hydrolysis. The total sugar recovery for the hardwood species was 72% using 5 FPU/g enzyme dosage. The combination of electron beam and steam explosion provides an improvement in sugar conversion of more than 20% compared to steam explosion alone. This combination of pretreatments was modeled along with a novel ethanol dehydration process that is based on vapor permeation membranes. The economic feasibility of this novel pretreatment-dehydration technology was evaluated and compared with the dilute acid process proposed by NREL in 2011. Overall, the pretreatment-dehydration technology process produces the same ethanol yields (81 gal/bdton). However, the economics of this novel process does not look promising since the minimum ethanol selling price (MESP) to generate an internal rate of return of 10% is of 3.09 /gal, compared to 2.28 /gal for the base case. To enhance the economic potential of a biorefinery, the isolation of value-added co-products was incorporated into the base dilute acid biorefinery process. In this

  1. Evaluation of socio-economic effects of R and D results at Japan Atomic Energy Research Institute. 2. Socio-economic evaluation of the basic research at JAERI

    International Nuclear Information System (INIS)

    2003-11-01

    The Japan Atomic Energy Research Institute (JAERI), as a core organization devoted to comprehensive nuclear energy research, has steadily promoted various types of research and development (R and D) studies since its establishment in June 1956. Research activities are aimed at performing (1) R and D for nuclear energy, (2) the utilization and application of radiation-based technologies, and (3) the establishment of basic and fundamental research in the nuclear field. Last year, the socio-economic effects on items (1) and (2) were qualitatively and quantitatively evaluated. The quantitative evaluation of item (3) from the viewpoint of a socio-economic effect, however, calls for a different concept and methodology than previously used cost-benefit approach. Achievements obtained from the activities conducted over the last 10 years implied that socio-economics in basic research funded by the public could contribute to the (1) increase in useful intellectual stocks, (2) upbringing of highly skilled college graduates, (3) construction of new scientific facilities and creation of methodologies, (4) stimulation and promotion of social interrelations by networking, (5) increase of one's ability to solve scientific problems, and (6) establishment of venture companies. In this study, we focused on item (4) for the analysis because it assumed that the external economic effect has a link with the socio-economic effects accompanying the networking formation. For the criteria of socio-economic effects we assume that the external effect becomes significant in proportion to the width of networking and/or the magnitude of cooperation measured by numbers of co-writing studies between JAERI and the research bodies, namely private and governmental sectors and universities. Taking these criteria into consideration, the subsequent four items are prepared for quantitative study. They are (1) to clarify the basic research fields where JAERI has been established a significant effort to

  2. Opportunity cost in the economic evaluation of da Vinci robotic assisted surgery.

    Science.gov (United States)

    Fuertes-Guiró, Fernando; Girabent-Farrés, Montserrat; Viteri-Velasco, Eduardo

    2016-04-01

    This study aims to demonstrate the importance of the opportunity cost in using da Vinci robotic surgery, assisted by a comprehensive review of the literature to determine the differences in the total cost of surgery and operative time in traditional laparoscopic surgery and da Vinci robotic surgery. We identified the studies comparing the use of traditional laparoscopic surgery with robotics during the period 2002-2012 in the electronic economic evaluation databases, and another electronic search was performed for publications by Spanish hospitals in the same period to calculate the opportunity cost. A meta-analysis of response variables considering the total cost of the intervention and surgical time was completed using the items selected in the first revision, and their differences were analyzed. We then calculated the opportunity cost represented by these time differences using the data obtained from the studies in the second review of the literature. Nine items were selected in the first review and three in the second. Traditional laparoscopic surgery has a lower cost than the da Vinci (p < 0.00001). Robotic surgery takes longer (8.0-65.5 min) than traditional surgery (p < 0.00001), and this difference represents an average opportunity cost for robot use of € 489.98, with a unit cost factor/time which varies according to the pathology dealt with, from € 8.2 to 18.7/min. The opportunity cost is a quantity that must be included in the total cost of using a surgical technology within an economic cost analysis in the context of an economic evaluation.

  3. A FINANCIAL AND ECONOMIC ACTIVITIES EFFECTIVENESS EVALUATION AS A CONDITION OF CORPORATE MANAGEMENT DECISIONS MAKING

    Directory of Open Access Journals (Sweden)

    Nataliia Bieliaieva

    2017-09-01

    Full Text Available The purpose of the paper is to substantiate, on the real figures, the need for enterprise’s financial and economic activities analysis as a condition of management decisions making to achieve the success of the company. Methodology. The research is based on a comparison and analysis of data from the organization top management. So using matrix analysis in the paper, the financial and economic activities effectiveness is evaluated. Based on these calculations, it is possible to make conclusions about the necessity of an identified management decisions regarding the future activity of the company. Results. Daily managers of various function levels accept hundreds and thousands of decisions regarding seemingly slight problems of the organization in general. At the same time, every such a decision, especially relating to the activity of the whole structure, should be clearly justified. Such a need stems from the fact that every decision leads to certain consequences. If there is a need to make a decision relating to the future of the enterprise (e.g., embodiment, reorganization, etc., it should be based on the data of the entire structure. And that is generally very difficult to do. Many factors complicate the possibility of comprehensive evaluation of the company’s activity. At the same time, analysis of basic indicators will provide the specialist with some directions according to which the priority of the analysis can be indicated and appropriate management decision can be made. Practical implications. It is built an effectiveness matrix of financial and economic activities of the enterprise. Analysis of financial and economic activities makes it possible to design necessary strategic and tactical plan for the enterprise development, revealing its reserves of production efficiency increasing. So the aim of the paper is the assessment of the effectiveness of financial and economic activities of the company on the base of matrix analysis as a

  4. Methodology for the economic evaluation of the strategies for spent fuel

    International Nuclear Information System (INIS)

    Zouain, D.M.

    1981-08-01

    A methodology for the economic evaluation of the spent fuel and a comparative analysis of the various available strategies for its treatment, is developed. For the realization of the proposed studies a computer program METACIR was developed, which incorporates the necessary computational methodology, and it was performed a analysis of the present situation and future tendencies of the stages that constitute a PWR nuclear fuel cycle. According to the obtained results, the eternal disposal of the spent fuel is less advantageous than the reprocessing and recycle options; between the last options, the uranium recycle in PWR's is the most attractive until nearly the end of the 1990's, when the uranium and plutonium recycle in LMFBR's becomes the most convenient. The economic value of the spent fuel varies with the reactor discharge date, being considered a onus during the 1980's, and a bonus only in the next decade. (Author) [pt

  5. 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

  6. 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

  7. 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

  8. 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.

  9. 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

  10. Scale interactions in economics: application to the evaluation of the economic damages of climatic change and of extreme events; Interactions d'echelles en economie: application a l'evaluation des dommages economiques du changement climatique et des evenements extremes

    Energy Technology Data Exchange (ETDEWEB)

    Hallegatte, S

    2005-06-15

    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.)

  11. Standardisation of costs: the Dutch Manual for Costing in economic evaluations.

    Science.gov (United States)

    Oostenbrink, Jan B; Koopmanschap, Marc A; Rutten, Frans F H

    2002-01-01

    The lack of a uniform costing methodology is often considered a weakness of economic evaluations that hinders the interpretation and comparison of studies. Standardisation is therefore an important topic within the methodology of economic evaluations and in national guidelines that formulate the formal requirements for studies to be considered when deciding on the reimbursement of new medical therapies. Recently, the Dutch Manual for Costing: Methods and Standard Costs for Economic Evaluations in Health Care (further referred to as "the manual") has been published, in addition to the Dutch guidelines for pharmacoeconomic research. The objectives of this article are to describe the main content of the manual and to discuss some key issues of the manual in relation to the standardisation of costs. The manual introduces a six-step procedure for costing. These steps concern: the scope of the study;the choice of cost categories;the identification of units;the measurement of resource use;the monetary valuation of units; andthe calculation of unit costs. Each step consists of a number of choices and these together define the approach taken. In addition to a description of the costing process, five key issues regarding the standardisation of costs are distinguished. These are the use of basic principles, methods for measurement and valuation, standard costs (average prices of healthcare services), standard values (values that can be used within unit cost calculations), and the reporting of outcomes. The use of the basic principles, standard values and minimal requirements for reporting outcomes, as defined in the manual, are obligatory in studies that support submissions to acquire reimbursement for new pharmaceuticals. Whether to use standard costs, and the choice of a particular method to measure or value costs, is left mainly to the investigator, depending on the specific study setting. In conclusion, several instruments are available to increase standardisation in

  12. Health economic assessment: a methodological primer.

    Science.gov (United States)

    Simoens, Steven

    2009-12-01

    This review article aims to provide an introduction to the methodology of health economic assessment of a health technology. Attention is paid to defining the fundamental concepts and terms that are relevant to health economic assessments. The article describes the methodology underlying a cost study (identification, measurement and valuation of resource use, calculation of costs), an economic evaluation (type of economic evaluation, the cost-effectiveness plane, trial- and model-based economic evaluation, discounting, sensitivity analysis, incremental analysis), and a budget impact analysis. Key references are provided for those readers who wish a more advanced understanding of health economic assessments.

  13. Health Economic Assessment: A Methodological Primer

    Directory of Open Access Journals (Sweden)

    Steven Simoens

    2009-11-01

    Full Text Available This review article aims to provide an introduction to the methodology of health economic assessment of a health technology. Attention is paid to defining the fundamental concepts and terms that are relevant to health economic assessments. The article describes the methodology underlying a cost study (identification, measurement and valuation of resource use, calculation of costs, an economic evaluation (type of economic evaluation, the cost-effectiveness plane, trial- and model-based economic evaluation, discounting, sensitivity analysis, incremental analysis, and a budget impact analysis. Key references are provided for those readers who wish a more advanced understanding of health economic assessments.

  14. Value for money of changing healthcare services? Economic evaluation of quality improvement

    Science.gov (United States)

    Severens, J

    2003-01-01

    

 There are many instances of perceived or real inefficiencies in health service delivery. Both healthcare providers and policy makers need to know the impact and cost of applying strategies to change the behaviour of individuals or organisations. Quality improvement or implementation research is concerned with evaluating the methods of behavioural change. Addressing inefficiencies in healthcare services raises a series of issues, beginning with how inefficiency itself should be defined. The basic concepts of cost analysis and economic evaluations are explained and a model for working through the economic issues of quality improvement is discussed. This model combines the costs and benefits of corrected inefficiency with the costs and degree of behavioural change achieved by a quality improvement method in the policy maker's locality. It shows why it may not always be cost effective for policy makers to address suboptimal behaviour. Both the interpretation of quality improvement research findings and their local application need careful consideration. The limited availability of applicable quality improvement research may make it difficult to provide robust advice on the value for money of many behavioural quality improvement strategies. PMID:14532369

  15. DIAGNOSIS OF FINANCIAL POSITION BY BALANCE SHEET ANALYSIS - CASE STUDY

    OpenAIRE

    Hada Teodor; Marginean Radu

    2013-01-01

    This study aims to elucidate and to exemplify an important technique for assessing the economic entities, namely the fundamental analysis of the balance sheet, in several significant aspects. The analysis of financial data reported in the balance sheet are, for an economic entity, the basis of a principle diagnosis by determining specific indicators of economic and financial analysis. This analysis aims to provide an insight into the companyâ€(tm)s financial position. The stated aim of this s...

  16. Diagnosis and pathology of endocrine diseases

    International Nuclear Information System (INIS)

    Shriver, B.D.

    1988-01-01

    This book contains 22 papers under the headings of Diagnosis and Pathology of endocrine diseases. Topics covered include: Laboratory tests in the diagnosis and management of thyroid disorders, Pathology of thyroid diseases, Diagnosis of adrenourtical disease, Radiologic techniques in evaluating endocrine disorders; and the Pituitary and adrenal glands

  17. Diagnosis and pathology of endocrine diseases

    Energy Technology Data Exchange (ETDEWEB)

    Shriver, B.D.

    1988-01-01

    This book contains 22 papers under the headings of Diagnosis and Pathology of endocrine diseases. Topics covered include: Laboratory tests in the diagnosis and management of thyroid disorders, Pathology of thyroid diseases, Diagnosis of adrenourtical disease, Radiologic techniques in evaluating endocrine disorders; and the Pituitary and adrenal glands.

  18. 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.

  19. Stakeholders' Perspectives About and Priorities for Economic Evaluation of Health and Safety Programs in Healthcare.

    Science.gov (United States)

    Tompa, Emile; de Boer, Henriette; Macdonald, Sara; Alamgir, Hasanat; Koehoorn, Mieke; Guzman, Jaime

    2016-04-01

    This study identified and prioritized resources and outcomes that should be considered in more comprehensive and scientifically rigorous health and safety economic evaluations according to healthcare sector stakeholders. A literature review and stakeholder interviews identified candidate resources and outcomes and then a Delphi panel ranked them. According to the panel, the top five resources were (a) health and safety staff time; (b) training workers; (c) program planning, promotion, and evaluation costs; (d) equipment purchases and upgrades; and (e) administration costs. The top five outcomes were (a) number of injuries, illnesses, and general sickness absences; (b) safety climate; (c) days lost due to injuries, illnesses, and general sickness absences; (d) job satisfaction and engagement; and (e) quality of care and patient safety. These findings emphasize stakeholders' stated priorities and are useful as a benchmark for assessing the quality of health and safety economic evaluations and the comprehensiveness of these findings. © 2016 The Author(s).

  20. Recurrent outbreaks of lumpy skin disease and its economic impact ...

    African Journals Online (AJOL)

    Lumpy skin disease (LSD) is an acute, severe and economically important transboundary disease of cattle caused by LSD virus (LSDV). Suspected outbreaks of LSD are frequently reported in Nigeria, but laboratory diagnosis is seldom carried out and the economic impact of the disease is unknown. This study investigated ...