WorldWideScience

Sample records for reliable cost-effective emission

  1. In search of cost-effective, reliable software

    International Nuclear Information System (INIS)

    Naser, J.A.; Bhatt, S.C.

    1992-01-01

    Considerable effort is ongoing to utilize the strengths of digital technology to upgrade and add functionality to existing systems and to develop solutions to problems in the nuclear industry. Acceptance of digital solutions requires verification and validation activities to ensure the reliability and acceptance of these solutions. EPRI has an ongoing effort to develop a methodology for verification and validation of digital control systems. Also, a joint project between the NRC and EPRI is developing a methodology for expert system verification and validation. To obtain a wider acceptance of digital system solutions and hence the utilization of verification and validation techniques, cost effective methods for design, development and verification and validation are needed. EPRI is leading an effort to develop methods for cost effective verification and validation for all types of software

  2. Emission Control Cost-Effectiveness of Alternative-Fuel Vehicles

    OpenAIRE

    Wang, Quanlu; Sperling, Daniel; Olmstead, Janis

    1993-01-01

    Although various legislation and regulations have been adopted to promote the use of alternative-fuel vehicles for curbing urban air pollution problems, there is a lack of systematic comparisons of emission control cost-effectiveness among various alternative-fuel vehicle types. In this paper, life-cycle emission reductions and life-cycle costs were estimated for passenger cars fueled with methanol, ethanol, liquified petroleum gas, compressed natural gas, and electricity. Vehicle emission es...

  3. Parts and Components Reliability Assessment: A Cost Effective Approach

    Science.gov (United States)

    Lee, Lydia

    2009-01-01

    System reliability assessment is a methodology which incorporates reliability analyses performed at parts and components level such as Reliability Prediction, Failure Modes and Effects Analysis (FMEA) and Fault Tree Analysis (FTA) to assess risks, perform design tradeoffs, and therefore, to ensure effective productivity and/or mission success. The system reliability is used to optimize the product design to accommodate today?s mandated budget, manpower, and schedule constraints. Stand ard based reliability assessment is an effective approach consisting of reliability predictions together with other reliability analyses for electronic, electrical, and electro-mechanical (EEE) complex parts and components of large systems based on failure rate estimates published by the United States (U.S.) military or commercial standards and handbooks. Many of these standards are globally accepted and recognized. The reliability assessment is especially useful during the initial stages when the system design is still in the development and hard failure data is not yet available or manufacturers are not contractually obliged by their customers to publish the reliability estimates/predictions for their parts and components. This paper presents a methodology to assess system reliability using parts and components reliability estimates to ensure effective productivity and/or mission success in an efficient manner, low cost, and tight schedule.

  4. Cost-effective solutions to maintaining smart grid reliability

    Science.gov (United States)

    Qin, Qiu

    As the aging power systems are increasingly working closer to the capacity and thermal limits, maintaining an sufficient reliability has been of great concern to the government agency, utility companies and users. This dissertation focuses on improving the reliability of transmission and distribution systems. Based on the wide area measurements, multiple model algorithms are developed to diagnose transmission line three-phase short to ground faults in the presence of protection misoperations. The multiple model algorithms utilize the electric network dynamics to provide prompt and reliable diagnosis outcomes. Computational complexity of the diagnosis algorithm is reduced by using a two-step heuristic. The multiple model algorithm is incorporated into a hybrid simulation framework, which consist of both continuous state simulation and discrete event simulation, to study the operation of transmission systems. With hybrid simulation, line switching strategy for enhancing the tolerance to protection misoperations is studied based on the concept of security index, which involves the faulted mode probability and stability coverage. Local measurements are used to track the generator state and faulty mode probabilities are calculated in the multiple model algorithms. FACTS devices are considered as controllers for the transmission system. The placement of FACTS devices into power systems is investigated with a criterion of maintaining a prescribed level of control reconfigurability. Control reconfigurability measures the small signal combined controllability and observability of a power system with an additional requirement on fault tolerance. For the distribution systems, a hierarchical framework, including a high level recloser allocation scheme and a low level recloser placement scheme, is presented. The impacts of recloser placement on the reliability indices is analyzed. Evaluation of reliability indices in the placement process is carried out via discrete event

  5. The Reliability, Impact, and Cost-Effectiveness of Value-Added Teacher Assessment Methods

    Science.gov (United States)

    Yeh, Stuart S.

    2012-01-01

    This article reviews evidence regarding the intertemporal reliability of teacher rankings based on value-added methods. Value-added methods exhibit low reliability, yet are broadly supported by prominent educational researchers and are increasingly being used to evaluate and fire teachers. The article then presents a cost-effectiveness analysis…

  6. Cost-effective control of SO2 emissions in Asia

    NARCIS (Netherlands)

    Cofala, J.; Amann, M.; Gyarfas, F.; Schoepp, F.; Boudri, J.C.; Hordijk, L.; Kroeze, C.; Li Junfeng,; Dai Lin, D.; Panwar, T.S.; Gupta, S.

    2004-01-01

    Despite recent efforts to limit the growth of SO2 emissions in Asia, the negative environmental effects of sulphur emissions are likely to further increase in the future. This paper presents an extension of the RAINS-Asia integrated assessment model for acidification in Asia with an optimisation

  7. Are renewables portfolio standards cost-effective emission abatement policy?

    Science.gov (United States)

    Dobesova, Katerina; Apt, Jay; Lave, Lester B

    2005-11-15

    Renewables portfolio standards (RPS) could be an important policy instrument for 3P and 4P control. We examine the costs of renewable power, accounting for the federal production tax credit, the market value of a renewable credit, and the value of producing electricity without emissions of SO2, NOx, mercury, and CO2. We focus on Texas, which has a large RPS and is the largest U.S. electricity producer and one of the largest emitters of pollutants and CO2. We estimate the private and social costs of wind generation in an RPS compared with the current cost of fossil generation, accounting for the pollution and CO2 emissions. We find that society paid about 5.7 cent/kWh more for wind power, counting the additional generation, transmission, intermittency, and other costs. The higher cost includes credits amounting to 1.1 cent/kWh in reduced SO2, NOx, and Hg emissions. These pollution reductions and lower CO2 emissions could be attained at about the same cost using pulverized coal (PC) or natural gas combined cycle (NGCC) plants with carbon capture and sequestration (CCS); the reductions could be obtained more cheaply with an integrated coal gasification combined cycle (IGCC) plant with CCS.

  8. Potential Cost-Effective Opportunities for Methane Emission Abatement

    Energy Technology Data Exchange (ETDEWEB)

    Warner, Ethan [Joint Inst. for Strategic Energy Analysis, Golden, CO (United States); Steinberg, Daniel [Joint Inst. for Strategic Energy Analysis, Golden, CO (United States); Hodson, Elke [U.S. Department of Energy, Washington, DC (United States); Heath, Garvin [Joint Inst. for Strategic Energy Analysis, Golden, CO (United States)

    2015-08-01

    The energy sector was responsible for approximately 84% of carbon dioxide equivalent (CO2e) greenhouse gas (GHG) emissions in the U.S. in 2012 (EPA 2014a). Methane is the second most important GHG, contributing 9% of total U.S. CO2e emissions. A large portion of those methane emissions result from energy production and use; the natural gas, coal, and oil industries produce approximately 39% of anthropogenic methane emissions in the U.S. As a result, fossil-fuel systems have been consistently identified as high priority sectors to contribute to U.S. GHG reduction goals (White House 2015). Only two studies have recently attempted to quantify the abatement potential and cost associated with the breadth of opportunities to reduce GHG emissions within natural gas, oil, and coal supply chains in the United States, namely the U.S. Environmental Protection Agency (EPA) (2013a) and ICF (2014). EPA, in its 2013 analysis, estimated the marginal cost of abatement for non-CO2 GHG emissions from the natural gas, oil, and coal supply chains for multiple regions globally, including the United States. Building on this work, ICF International (ICF) (2014) provided an update and re-analysis of the potential opportunities in U.S. natural gas and oil systems. In this report we synthesize these previously published estimates as well as incorporate additional data provided by ICF to provide a comprehensive national analysis of methane abatement opportunities and their associated costs across the natural gas, oil, and coal supply chains. Results are presented as a suite of marginal abatement cost curves (MACCs), which depict the total potential and cost of reducing emissions through different abatement measures. We report results by sector (natural gas, oil, and coal) and by supply chain segment - production, gathering and boosting, processing, transmission and storage, or distribution - to facilitate identification of which sectors and supply chain

  9. Cost-Effectiveness of Emission Reduction for the Indonesian Coal-Fired Power Plants

    NARCIS (Netherlands)

    Handayani, Kamia; Krozer, Yoram

    2014-01-01

    This paper presents the result of research on the cost-effectiveness of emission reduction in the selected coal-fired power plants (CFPPs) in Indonesia. The background of this research is the trend of more stringent environmental regulation regarding air emission from coal-fired power plants (CFPPs)

  10. Reliable cost effective technique for in situ ground stress measurements in deep gold mines.

    CSIR Research Space (South Africa)

    Stacey, TR

    1995-07-01

    Full Text Available on these requirements, an in situ stress measurement technique which will be practically applicable in the deep gold mines, has been developed conceptually. Referring to the figure on the following page, this method involves: • a borehole-based system, using... level mines have not been developed. 2 This is some of the background to the present SIMRAC research project, the title ofwhich is “Reliable cost effective technique for in-situ ground stress measurements in deep gold mines”. A copy of the research...

  11. Cost-effectiveness of feeding strategies to reduce greenhouse gas emissions from dairy farming

    NARCIS (Netherlands)

    Middelaar, van C.E.; Dijkstra, J.; Berentsen, P.B.M.; Boer, de I.J.M.

    2014-01-01

    The objective of this paper was to evaluate the cost-effectiveness of 3 feeding strategies to reduce enteric CH4 production in dairy cows by calculating the effect on labor income at the farm level and on greenhouse gas (GHG) emissions at the chain level (i.e., from production of farm inputs to the

  12. A Delphi study to establish national cost-effectiveness research priorities for positron emission tomography

    International Nuclear Information System (INIS)

    Robert, Glenn; Milne, Ruairidh

    1999-01-01

    Objective: This study aimed to determine the key cost-effectiveness research questions relating to positron emission tomography (PET) in the UK. Methods: A systematic literature review was conducted to establish the existing knowledge base relating to the cost-effectiveness of PET in the various conditions for which it has been proposed. A three-round postal Delphi study of relevant individuals was used to determine the key cost-effectiveness research questions relating to PET in the UK. The content and structure of the Delphi study was informed by the results of the literature review. Results: The most important cost-effectiveness research priorities for the National Health Service (NHS) relating to PET were in the clinical areas of lung cancer, breast cancer and the assessment of myocardial viability. Gamma camera PET using coincidence imaging was highlighted as a modality whose clinical role needed to be determined urgently. Conclusion: Underlying the cost-effectiveness research priorities which were established is the need for evidence that the use of the various PET modalities as a diagnostic technique will alter patient management as compared to existing diagnostic strategies. The findings of the project provide a contemporary overview of the potential role for PET in the NHS and will be relevant to other countries

  13. Integrated cost-effectiveness analysis of greenhouse gas emission abatement. The case of Finland

    Energy Technology Data Exchange (ETDEWEB)

    Lehtilae, A.; Tuhkanen, S. [VTT Energy, Espoo (Finland). Energy Systems

    1999-11-01

    In Finland greenhouse gas emissions are expected to increase during the next decades due to economic growth, particularly in the energy intensive industrial sectors. The role of these industries is very central in the national economy. The emission control according to the Kyoto Protocol will therefore be quite difficult and costly. The study analyses the cost-effectiveness of different technical options for reducing the emissions of carbon dioxide, methane, and nitrous oxide in Finland. The analysis is performed with the help of a comprehensive energy system model for Finland, which has been extended to cover all major sources of methane and nitrous oxide emissions in the energy sector, industry, waste management and agriculture. The focus being on technical options, no consideration is given to possible policy measures, emission trading or joint implementation in the study. Under the boundary conditions given for the development of the Finnish energy economy, cost-effective technical measures in the energy system include increases in the use of wood biomass, natural gas and wind energy, increases in the contribution of CHP to the power supply, and intensified energy conservation in all end-use sectors. Additional cost-effective measures are landfill gas recovery, utilisation of the combustible fraction of waste and catalytic conversion of N{sub 2}O in nitric acid production. With baseline assumptions, the direct annual costs of emission abatement are calculated to be about 2000 MFIM (330 M{epsilon}) in 2010. The marginal costs are estimated to be about 230 FIM (40 {epsilon}) per tonne of CO{sub 2}-equivalent in 2010. The cost curie derived from the analysis could be used in further analyses concerning emissions trading. (orig.) 109 refs. SIHTI Research Programme

  14. Cost-Effectiveness of Emissions Reduction through Vehicle Repair Compared to CNG Conversion.

    Science.gov (United States)

    Guenther, Paul L; Lesko, Jon M; Stedman, Donald H

    1996-10-01

    In return for a temporary waiver from converting five vehicles to operate on compressed natural gas (CNG) for the Denver Clean Fuels program, the University of Denver identified, tested, repaired, and retested nine employee commuter vehicles. The results of the study validated the concept that employer-based identification and repair programs can be carried out in a cost-effective way. On average, each repaired vehicle removed fifty times more carbon monoxide (CO) emissions from Denver air than each CNG conversion. The average cost of each repair was eight times less than the average cost of each conversion. The average fuel economy benefit from the repairs was enough to pay for the average cost of repairs in less than three years of normal driving. When the expected lifetimes of repairs and conversions are included, the targeted repair program appears to be over sixty times more cost-effective as a CO emissions reduction strategy than CNG conversion.

  15. Tradeable CO2 emission permits for cost-effective control of global warming

    International Nuclear Information System (INIS)

    Kosobud, R.F.; South, D.W.; Daly, T.A.; Quinn, K.G.

    1991-01-01

    Many current global warming mitigation policy proposals call for large, near-term reductions in CO 2 emissions, thereby entailing high initial carbon emission tax rates or permit prices. This paper claims that these high initial tax rates or permit prices are not cost-effective in achieving the desired degree of climate change control. A cost-effective permit system is proposed and described that, under certain assumptions, would allow markets to optimally lead permit prices along a gradually increasing trajectory over tie. This price path presents the Hotelling result and would ease the abrupt, inefficient, and costly adjustments imposed on the fossil fuel and other industries in current proposals. This finding is demonstrated using the Argonne Model, a linear programming energy- environmental-economic model that allows for intertemporal optimization of consumer energy well-being. 12 refs., 3 figs., 1 tab

  16. Improving cost-effectiveness and facilitating participation of developing countries in international emissions trading

    International Nuclear Information System (INIS)

    Bohm, P.

    2003-01-01

    Cost-effectiveness is a crucial requirement for meaningful agreements on international climate change policy. This is also borne out in the wording of the Framework Convention of Climate Change and, in particular, the Kyoto Protocol (KP), see UNFCCC (1992) and UN (1997). However, the KP - as it stands after COP7 in Marrakech - is not fully cost-effective, although it may eventually turn out to be the only politically feasible, 'most cost-effective', first step in international climate change policy. The successor to the COP7 version of the KP may be a renegotiated protocol, if the COP7 version fails to be ratified by enough countries to enter into force, or it may be the treaty to be designed for a second commitment period. Four dimensions in which cost-effectiveness may be improved in a treaty that succeeds the KP are discussed here. They all relate to international emissions trading (IET) which is likely to be the most significant instrument for attaining cost-effective reductions in aggregate greenhouse gas (GHG) emissions. It is important for a climate treaty to be able to attract as many developing countries to IET as possible and achieve this as soon as possible. This would have to occur at essentially no cost to them. Only with developing countries onboard can the world community get full access to their low-cost options for emission reductions. A first aspect to be discussed here is related to identifying a cost-effective approach to attain that goal (Section 1). Another aspect concerns the role of the Clean Development Mechanism (CDM) in this context (Section 2). A third issue is to evaluate the consequences for cost-effectiveness of introducing a Commitment Period Reserve to limit 'overselling' (Section 3). A final one deals with the increase in flexibility that would follow from allowing not only banking but also borrowing of Assigned Amount Units (AAUs) (Section 4). While the first two issues refer directly to developing countries, the last two will be

  17. The cost-effectiveness of methanol for reducing motor vehicle emissions and urban ozone

    International Nuclear Information System (INIS)

    Krupnick, A.J.; Walls, M.A.

    1992-01-01

    This article analyzes the costs and emissions characteristics of methanol vehicles. The cost-effectiveness of methanol - the cost per ton of reactive hydrocarbon emissions reduced - is calculated and compared to the cost-effectiveness of other hydrocarbon reduction strategies. Methanol is found to cost from $33,000 to nearly $60,000 per ton, while several other options are available for under $10,000 per ton. The cost per part-per-million reduction in peak ambient ozone levels is also computed for two cities, Houston and Philadelphia. Despite the greater improvement in ozone in Philadelphia than Houston, methanol is found to be more cost-effective in Houston. This result occurs because Houston's distribution and marketing costs are lower than Philadelphia's. The costs in both cities, however, are far higher than estimates of the benefits from acute health improvements. Finally, the reduction in ozone exposure in Los Angeles is estimated and the costs of the reduction compared with an estimate of acute health benefits. Again, the benefits fall far short of the costs. 51 refs., 5 tabs

  18. Coupling of CORINAIR Data to Cost-effective Emission Reduction Strategies Based on Critical Thresholds

    International Nuclear Information System (INIS)

    Johansson, M.; Guardans, R.; Lindstrom, M.

    1999-12-01

    This report summarizes the results of a workshop held by the participants in the EU/LIFE project: Coupling of CORINAIR data to cost-effective emission reduction strategies based on critical thresholds. The project participants include FEI, Filand, NERI, Denmark, CIEMAT, Spain, Lund Univ. Sweden. EMEP/MSC-W, UN/ECE/WGE/CCE and IIASA. The main objective of the project is to support national activities in assessing the spatial and temporal details of emissions of sulphur, nitrogen oxides, ammonium and volatile organic compounds and the impacts of acidification, eutrophication and ground level ozone. The reproject workshop enabled participants to report preliminary results of the two main tasks, emissions and impacts and to agree on common solutions for the final results. (Author) 11 refs

  19. Cost-effectiveness of feeding strategies to reduce greenhouse gas emissions from dairy farming.

    Science.gov (United States)

    Van Middelaar, C E; Dijkstra, J; Berentsen, P B M; De Boer, I J M

    2014-01-01

    The objective of this paper was to evaluate the cost-effectiveness of 3 feeding strategies to reduce enteric CH4 production in dairy cows by calculating the effect on labor income at the farm level and on greenhouse gas (GHG) emissions at the chain level (i.e., from production of farm inputs to the farm gate). Strategies included were (1) dietary supplementation of an extruded linseed product (56% linseed; 1kg/cow per day in summer and 2kg/cow per day in winter), (2) dietary supplementation of a nitrate source (75% nitrate; 1% of dry matter intake), and (3) reducing the maturity stage of grass and grass silage (grazing at 1,400 instead of 1,700kg of dry matter/ha and harvesting at 3,000 instead of 3,500kg of dry matter/ha). A dairy farm linear programing model was used to define an average Dutch dairy farm on sandy soil without a predefined feeding strategy (reference situation). Subsequently, 1 of the 3 feeding strategies was implemented and the model was optimized again to determine the new economically optimal farm situation. Enteric CH4 production in the reference situation and after implementing the strategies was calculated based on a mechanistic model for enteric CH4 and empirical formulas explaining the effect of fat and nitrate supplementation on enteric CH4 production. Other GHG emissions along the chain were calculated using life cycle assessment. Total GHG emissions in the reference situation added up to 840kg of CO2 equivalents (CO2e) per t of fat- and protein-corrected milk (FPCM) and yearly labor income of €42,605. Supplementation of the extruded linseed product reduced emissions by 9kg of CO2e/t of FPCM and labor income by €16,041; supplementation of the dietary nitrate source reduced emissions by 32kg of CO2e/t of FPCM and labor income by €5,463; reducing the maturity stage of grass and grass silage reduced emissions by 11kg of CO2e/t of FPCM and labor income by €463. Of the 3 strategies, reducing grass maturity was the most cost-effective

  20. [Emissions trading potential : achieving emission reductions in a cost-effective manner

    International Nuclear Information System (INIS)

    Fay, K.

    1998-01-01

    The issue of emissions trading as a viable tool to reduce greenhouse gas emissions by developed countries was discussed. The essence of this author's argument was that emissions trading alone will not solve the climate change problem and that the details of the program are hazy at best. In order to have any hope of meeting the emission reductions, it is essential to begin working out the details now, and to coordinate them with the Clean Development Mechanism (CDM) and Joint Implementation (JI) plan since all three of these flexibility mechanisms will be working in and among themselves, therefore they need to be consistent. Work on a general set of draft principles by the International Climate Change Partnership (ICCP), a coalition headquartered in Washington, DC, was summarized. Essentially, ICCP favors voluntary programs, incentives for participation, no quantitative limits on trading, no limits on sources and sinks. ICCP believes that trading should be allowed at the company level, and liability should not devolve on the buyer alone, rather, it should be negotiated between buyers and sellers. Credits for early action should also be tradable and most of all, the trading program should be simple to allow active participation by industry, and be free of bureaucratic impediments

  1. Can Water-Injected Turbomachines Provide Cost-Effective Emissions and Maintenance Reductions?

    Science.gov (United States)

    Hendricks, Robert C.; Daggett, David L.; Shouse, Dale T.; Roquemore, William M.; Brankovic, Andreja; Ryder, Robert C., Jr.

    2011-01-01

    An investigation has been performed to evaluate the effect of water injection on the performance of the Air Force Research Laboratory (AFRL, Wright-Patterson Air Force Base (WPAFB)) experimental trapped vortex combustor (TVC) over a range of fuel-to-air and water-to-fuel ratios. Performance is characterized by combustor exit quantities: temperature and emissions measurements using rakes, and overall pressure drop, from upstream plenum to combustor exit. Combustor visualization is performed using gray-scale and color still photographs and high-frame-rate videos. A parallel investigation evaluated the performance of a computational fluid dynamics (CFD) tool for the prediction of the reacting flow in a liquid fueled combustor (e.g., TVC) that uses water injection for control of pollutant emissions and turbine inlet temperature. Generally, reasonable agreement is found between data and NO(x) computations. Based on a study assessing the feasibility and performance impact of using water injection on a Boeing 747-400 aircraft to reduce NO(x) emissions during takeoff, retrofitting does not appear to be cost effective; however, an operator of a newly designed engine and airframe might be able to save up to 1.0 percent in operating costs. Other challenges of water injection will be discussed.

  2. A critical evaluation of deterministic methods in size optimisation of reliable and cost effective standalone hybrid renewable energy systems

    International Nuclear Information System (INIS)

    Maheri, Alireza

    2014-01-01

    cost-effective system cannot be quantified without employing probabilistic methods of analysis. It is also shown that deterministic cost analysis yields inaccurate results for all of the investigated configurations. - Graphical abstract: Deterministic size optimisation methods are unreliable in design of reliable and cost effective wind–PV–battery hybrid renewable systems irrespective of selected worst-case-scenarios and safety factors. - Highlights: • Deterministic design optimisation methods do not predict the cost of standalone HRES accurately. • Deterministic methods do not evaluate power reliability of standalone HRES directly. • Deterministic methods of design of HRES lead to solutions with unpredictable power reliability. • New robust design methods are required to be developed for standalone HRES

  3. Cost-effectiveness of reducing emissions from tropical deforestation, 2016-2050

    Science.gov (United States)

    Busch, Jonah; Engelmann, Jens

    2017-12-01

    Reducing tropical deforestation is potentially a large-scale and low-cost strategy for mitigating climate change. Yet previous efforts to project the cost-effectiveness of policies to reduce greenhouse gas emissions from future deforestation across the tropics were hampered by crude available data on historical forest loss. Here we use recently available satellite-based maps of annual forest loss between 2001-2012, along with information on topography, accessibility, protected status, potential agricultural revenue, and an observed inverted-U-shaped relationship between forest cover loss and forest cover, to project tropical deforestation from 2016-2050 under alternative policy scenarios and to construct new marginal abatement cost curves for reducing emissions from tropical deforestation. We project that without new forest conservation policies 289 million hectares of tropical forest will be cleared from 2016-2050, releasing 169 GtCO2. A carbon price of US20/tCO2 (50/tCO2) across tropical countries would avoid 41 GtCO2 (77 GtCO2) from 2016-2050. By comparison, we estimate that Brazil’s restrictive policies in the Amazon between 2004-2012 successfully decoupled potential agricultural revenue from deforestation and reduced deforestation by 47% below what would have otherwise occurred, preventing the emission of 5.2 GtCO2. All tropical countries enacting restrictive anti-deforestation policies as effective as those in the Brazilian Amazon between 2004-2012 would avoid 58 GtCO2 from 2016-2050.

  4. Cost-effectiveness of combustion turbines: recommendations for reliability, maintainability, supportability and maintenance requirements

    Energy Technology Data Exchange (ETDEWEB)

    Meuwisse, C.; Despujols, A. [Electricite de France, Research and Development Division, Chatou (France); Givaudan, B. [Electricite de France, Research and Development Division - SEPTEN, Villeurbanne (France); Lafage, L. [Electricite de France, Engineering and Construction Division - CNET, Paris (France)

    1998-12-31

    The profitability of combustion turbines intended for export is of extreme importance for Electricite de France. It is principally during the development phase of a project that one can ensure resect of two indissociable factors, essential to the per-kWh production cost: global operating costs and performance in terms of reliability and availability. The approach proposed here advocates the global acquisition of the installation and its logistic support. Generally applicable recommendations are given. They enable integrating in the future plant specifications all requirements relative to plant reliability, availability, maintainability and logistic support. They are structured according to type: expression of needs and management factors. (orig.) 4 refs.

  5. Cost-effectiveness of combustion turbines: recommendations for reliability, maintainability, supportability and maintenance requirements

    Energy Technology Data Exchange (ETDEWEB)

    Meuwisse, C; Despujols, A [Electricite de France, Research and Development Division, Chatou (France); Givaudan, B [Electricite de France, Research and Development Division - SEPTEN, Villeurbanne (France); Lafage, L [Electricite de France, Engineering and Construction Division - CNET, Paris (France)

    1999-12-31

    The profitability of combustion turbines intended for export is of extreme importance for Electricite de France. It is principally during the development phase of a project that one can ensure resect of two indissociable factors, essential to the per-kWh production cost: global operating costs and performance in terms of reliability and availability. The approach proposed here advocates the global acquisition of the installation and its logistic support. Generally applicable recommendations are given. They enable integrating in the future plant specifications all requirements relative to plant reliability, availability, maintainability and logistic support. They are structured according to type: expression of needs and management factors. (orig.) 4 refs.

  6. Reliability-oriented Design of a Cost-effective Active Capacitor

    DEFF Research Database (Denmark)

    Wang, Haoran; Wang, Huai

    2017-01-01

    This paper presents the reliability-oriented design of a two-terminal active capacitor proposed recently. The two-terminal active capacitor has the same level of convenience as a passive capacitor with reduced requirement of overall energy storage. In order to fully explore the potential...... of the proposed concept, a comprehensive design procedure is necessary to optimally sizing the key components of the active capacitor in terms of cost and reliability. Moreover, the inherent condition monitoring capability of the active capacitor is discussed by utilizing the existing feedback signals. A 500 W...

  7. Cost-effective and reliable design of a solar thermal power plant

    International Nuclear Information System (INIS)

    Aliabadi, A.A.; Wallace, J.S.

    2009-01-01

    A design study was conducted to evaluate the cost-effectiveness of solar thermal power generation in a 50 kWe power plant that could be used in a remote location. The system combines a solar collector-thermal storage system utilizing a heat transfer fluid and a simple Rankine cycle power generator utilizing R123 refrigerant. Evacuated tube solar collectors heat mineral oil and supply it to a thermal storage tank. A mineral oil to refrigerant heat exchanger generates superheated refrigerant vapor, which drives a radial turbogenerator. Supplemental natural gas firing maintains a constant thermal storage temperature irregardless of solar conditions enabling the system to produce a constant 50 kWe output. A simulation was carried out to predict the performance of the system in the hottest summer day and the coldest winter day for southern California solar conditions. A rigorous economic analysis was conducted. The system offers advantages over advanced solar thermal power plants by implementing simple fixed evacuated tube collectors, which are less prone to damage in harsh desert environment. Also, backed up by fossil fuel power generation, it is possible to obtain continued operation even during low insolation sky conditions and at night, a feature that stand-alone PV systems do not offer. (author)

  8. The cost-effectiveness of household photovoltaic systems in reducing greenhouse gas emissions in Australia: Linking subsidies with emission reductions

    International Nuclear Information System (INIS)

    Burtt, D.; Dargusch, P.

    2015-01-01

    Highlights: • Payback period for Australian household PV fell to four years in 2011 and 2012. • PV became attractive due to high feed-in tariffs and declining PV costs. • Cost was AU$200/t CO 2 e in 2010, expected to be AU$65 to AU$100/t CO 2 e by 2020. • PV resulted in greenhouse gas emissions reducing by 3.7 million t CO 2 e in 2013. • PV expected to reduce greenhouse gas emissions by 8 million t CO 2 e in 2020. - Abstract: This paper examines the cost-effectiveness of subsidies (feed-in tariffs and renewable energy credits) paid for by electricity consumers to support the uptake of roof top photovoltaic (PV) systems by households in Australia. We estimate annual payback periods, and then regress these against the actual uptake of household PV and associated emission reductions, creating a relationship not apparent in other research. Sensitivity analysis reveals that the declining cost of PV panels had most impact on PV uptake followed by feed-in tariffs, renewable energy credits and the increasing cost of household electricity tariffs. Our modelling shows that feed-in tariffs were higher than necessary to achieve the resultant levels of PV uptake and that the low cost of PV panels and comparatively high electricity tariffs are likely to result in a continuing strong uptake of household PV in Australia. Our modelling shows that subsidies peaked in 2011 and 2012, with payback periods of three to four years, having since increased to five to six years. Emission reduction costs are expected to reduce from over AU$200 per t CO 2 e in 2013 to between AU$65 and AU$100 per t CO 2 e in 2020. Household PV reduced Australia’s emissions by 3.7 million t CO 2 e in 2013 (1.7% of Australia’s total emissions) and is expected to reach eight million tonnes (3.7% of Australia’s total emissions) by 2020

  9. Nuclear power plants electrical retrofitting for cost effectiveness, reliability and operating efficiency

    International Nuclear Information System (INIS)

    Ciufu, L.; Popescu, M. O.

    2016-01-01

    In the context of continuous fast growing of the energy demand the current power plants retrofitting concept may represent an important step in the emission reduction, being able to offer in the same time a maximum operating efficiency. This desideratum can be obtained by implementing a rigorous energy management plan, based on an increased energy production capacity of non-pollutant electrical power plants and future-oriented frame on extending their lifetime operation. This management is focused on using state-of-art electronic, electrical and industrial control equipments, which can represent a real key factor. Thus, in this paper an analysis of the electrical system retrofitting is presented. As a part of this research the authors propose and simulate ambitious ways to upgrade actual control and command of the electrical operating systems, by promoting variable speed for large pumps and also computer software, as SCADA, for an intelligent control and monitoring of these studied processes. (authors)

  10. A conceptual framework for the evaluation of cost-effectiveness of projects to reduce GHG emissions and sequester carbon

    International Nuclear Information System (INIS)

    Sathaye, J.; Norgaard, R.; Makundi, W.

    1993-07-01

    This paper proposes a conceptual framework for evaluating the cost of projects to reduce atmospheric greenhouse gases (GHGs). The evaluation of cost-effectiveness should account for both the timing of carbon emissions and the damage caused by the atmospheric stock of carbon. We develop a conceptual basis to estimate the cost-effectiveness of projects in terms of the cost of reducing atmospheric carbon (CRAC) and other GHGs. CRAC accounts for the economic discount rate, alternative functional forms of the shadow price, the residence period of carbon in the atmosphere, and the multiple monetary benefits of projects. The last item is of particular importance to the developing countries

  11. Project-Based Emissions Trading. The Impact of Institutional Arrangements on Cost-Effectiveness

    International Nuclear Information System (INIS)

    Woerdman, E.; Van der Gaast, W.

    2001-01-01

    In this paper we demonstrate that the institutional arrangement (or: design) of Joint Implementation (JI) and the Clean Development Mechanism (CDM) has a decisive impact on their cost-effectiveness. We illustrate our arguments by statistically analyzing the costs from 94 Activities Implemented Jointly (AIJ) pilot phase projects as well as by adjusting these data on the basis of simple mathematical formulas. These calculations explicitly take into account the institutional differences between JI (sinks, no banking) and the CDM (banking, no sinks) under the Kyoto Protocol and also show the possible effects on credit costs of alternative design options. However, our numerical illustrations should be viewed with caution, because AIJ is only to a limited extent representative of potential future JI and CDM projects and because credit costs are not credit prices. Some of the main figures found in this study are: an average cost figure per unit of emission reduction for AIJ projects of 46 dollar per ton of carbon dioxide equivalent ($/Mg CO 2 -eq), an average potential JI credit cost figure which is lowered to 37 $/Mg CO 2 -eq by introducing banking and an average of 6 $/Mg CO 2 -eq per credit for potential low-cost CDM projects which includes sinks. However, at CoP6 in November 2000 in The Hague (The Netherlands), the Parties to the Framework Convention on Climate Change (FCCC) did not (yet) reach consensus on the institutional details of the project-based mechanisms, such as the possible arrangement of early JI action or the inclusion of sinks under the CDM. 55 refs

  12. Noninvasive Hemoglobin Monitoring: A Rapid, Reliable, and Cost-Effective Method Following Total Joint Replacement.

    Science.gov (United States)

    Martin, J Ryan; Camp, Christopher L; Stitz, Amber; Young, Ernest Y; Abdel, Matthew P; Taunton, Michael J; Trousdale, Robert T

    2016-03-02

    Noninvasive hemoglobin (nHgb) monitoring was initially introduced in the intensive care setting as a means of rapidly assessing Hgb values without performing a blood draw. We conducted a prospective analysis to compare reliability, cost, and patient preference between nHgb monitoring and invasive Hgb (iHgb) monitoring performed via a traditional blood draw. We enrolled 100 consecutive patients undergoing primary or revision total hip or total knee arthroplasty. On postoperative day 1, nHgb and iHgb values were obtained within thirty minutes of one another. iHgb and nHgb values, cost, patient satisfaction, and the duration of time required to obtain each reading were recorded. The concordance correlation coefficient (CCC) was utilized to evaluate the agreement of the two Hgb measurement methods. Paired t tests and Wilcoxon signed-rank tests were utilized to compare mean Hgb values, time, and pain for all readings. The mean Hgb values did not differ significantly between the two measurement methods: the mean iHgb value (and standard deviation) was 11.3 ± 1.4 g/dL (range, 8.2 to 14.3 g/dL), and the mean nHgb value was 11.5 ± 1.8 g/dL (range, 7.0 to 16.0 g/dL) (p = 0.11). The CCC between the two Hgb methods was 0.69. One hundred percent of the patients with an nHgb value of ≥ 10.5 g/dL had an iHgb value of >8.0 g/dL. The mean time to obtain an Hgb value was 0.9 minute for the nHgb method and 51.1 minutes for the iHgb method (p measurement, resulting in a savings of $26 per Hgb assessment when the noninvasive method is used. Noninvasive Hgb monitoring was found to be more efficient, less expensive, and preferred by patients compared with iHgb monitoring. Providers could consider screening total joint arthroplasty patients with nHgb monitoring and only order iHgb measurement if the nHgb value is protocol had been applied to the first blood draw in our 100 patients, approximately $2000 would have been saved. Extrapolated to the U.S. total joint arthroplasty practice

  13. An approach to demonstrating cost-effectiveness of diagnostic imaging modalities in Australia illustrated by positron emission tomography

    International Nuclear Information System (INIS)

    Miles, K.A.

    2001-01-01

    The aim of this study was to develop a framework in which the cost-effectiveness of new imaging technologies could be evaluated using data from other countries, while assessing the impact that any differences between the study populations and Australia may have upon the results. Publications reporting the cost-effectiveness or therapeutic impact of positron emission tomography (PET) were re-worked using Australian cost structures. PET was assigned a cost of $950. The effects of potential differences between the populations studied and the Australian population were evaluated by applying sensitivity analysis to those publications that describe decision tree methodology. The parameters included in the sensitivity analysis were disease prevalence and specificity of PET. The Australian cost savings per patient examined by PET were $505.50-$912.41 for investigation of solitary pulmonary nodules, $34.65-$360.03 for lung cancer staging, $550.08 for axillary staging of breast cancer, $230.75-$2301.27 for assessment of recurrent colorectal cancer and $300.24-$2069.65 for assessment of myocardial viability. Significant differences in disease prevalence and PET specificity could occur while the cost-effectiveness of PET was preserved. Decision tree sensitivity analysis can demonstrate the cost-effectiveness of diagnostic imaging modalities in Australia and provides indications that PET is cost-effective for a range of clinical indications. Copyright (2001) Blackwell Science Pty Ltd

  14. Cost-effective policy instruments for greenhouse gas emission reduction and fossil fuel substitution through bioenergy production in Austria

    International Nuclear Information System (INIS)

    Schmidt, Johannes; Leduc, Sylvain; Dotzauer, Erik; Schmid, Erwin

    2011-01-01

    Climate change mitigation and security of energy supply are important targets of Austrian energy policy. Bioenergy production based on resources from agriculture and forestry is an important option for attaining these targets. To increase the share of bioenergy in the energy supply, supporting policy instruments are necessary. The cost-effectiveness of these instruments in attaining policy targets depends on the availability of bioenergy technologies. Advanced technologies such as second-generation biofuels, biomass gasification for power production, and bioenergy with carbon capture and storage (BECCS) will likely change the performance of policy instruments. This article assesses the cost-effectiveness of energy policy instruments, considering new bioenergy technologies for the year 2030, with respect to greenhouse gas emission (GHG) reduction and fossil fuel substitution. Instruments that directly subsidize bioenergy are compared with instruments that aim at reducing GHG emissions. A spatially explicit modeling approach is used to account for biomass supply and energy distribution costs in Austria. Results indicate that a carbon tax performs cost-effectively with respect to both policy targets if BECCS is not available. However, the availability of BECCS creates a trade-off between GHG emission reduction and fossil fuel substitution. Biofuel blending obligations are costly in terms of attaining the policy targets. - Highlights: → Costs of energy policies and effects on reduction of CO 2 emissions and fossil fuel consumption. → Particular focus on new bioenergy production technologies such as second generation biofuels. → Spatially explicit techno-economic optimization model. → CO 2 tax: high costs for reducing fossil fuel consumption if carbon capture and storage is available. → Biofuel policy: no significant reductions in CO 2 emissions or fossil fuel consumption.

  15. Cost-Effective Reciprocating Engine Emissions Control and Monitoring for E&P Field and Gathering Engines

    Energy Technology Data Exchange (ETDEWEB)

    Kirby S. Chapman; Sarah R. Nuss-Warren

    2007-02-01

    The objective of this project is to identify, develop, test, and commercialize emissions control and monitoring technologies that can be implemented by exploration and production (E&P) operators to significantly lower the cost of environmental compliance and expedite project permitting. The project team takes considerable advantage of the emissions control research and development efforts and practices that have been underway in the gas pipeline industry for the last 12 years. These efforts and practices are expected to closely interface with the E&P industry to develop cost-effective options that apply to widely-used field and gathering engines, and which can be readily commercialized. The project is separated into two phases. Phase 1 work establishes an E&P industry liaison group, develops a frequency distribution of installed E&P field engines, and identifies and assesses commercially available and emerging engine emissions control and monitoring technologies. Current and expected E&P engine emissions and monitoring requirements are reviewed, and priority technologies are identified for further development. The identified promising technologies are tested on a laboratory engine to confirm their generic viability. In addition, a full-scale field test of prototype emissions controls will be conducted on at least ten representative field engine models with challenging emissions profiles. Emissions monitoring systems that are integrated with existing controls packages will be developed. Technology transfer/commercialization is expected to be implemented through compressor fleet leasing operators, engine component suppliers, the industry liaison group, and the Petroleum Technology Transfer Council. This topical report discusses work completed during Phase 1 of the project Cost Effective Reciprocating Engine Emissions Control and Monitoring for E&P Field and Gathering Engines. In this report information, data, and results are compiled and summarized from quarterly

  16. Design and implementation of a reliable and cost-effective cloud computing infrastructure: the INFN Napoli experience

    International Nuclear Information System (INIS)

    Capone, V; Esposito, R; Pardi, S; Taurino, F; Tortone, G

    2012-01-01

    Over the last few years we have seen an increasing number of services and applications needed to manage and maintain cloud computing facilities. This is particularly true for computing in high energy physics, which often requires complex configurations and distributed infrastructures. In this scenario a cost effective rationalization and consolidation strategy is the key to success in terms of scalability and reliability. In this work we describe an IaaS (Infrastructure as a Service) cloud computing system, with high availability and redundancy features, which is currently in production at INFN-Naples and ATLAS Tier-2 data centre. The main goal we intended to achieve was a simplified method to manage our computing resources and deliver reliable user services, reusing existing hardware without incurring heavy costs. A combined usage of virtualization and clustering technologies allowed us to consolidate our services on a small number of physical machines, reducing electric power costs. As a result of our efforts we developed a complete solution for data and computing centres that can be easily replicated using commodity hardware. Our architecture consists of 2 main subsystems: a clustered storage solution, built on top of disk servers running GlusterFS file system, and a virtual machines execution environment. GlusterFS is a network file system able to perform parallel writes on multiple disk servers, providing this way live replication of data. High availability is also achieved via a network configuration using redundant switches and multiple paths between hypervisor hosts and disk servers. We also developed a set of management scripts to easily perform basic system administration tasks such as automatic deployment of new virtual machines, adaptive scheduling of virtual machines on hypervisor hosts, live migration and automated restart in case of hypervisor failures.

  17. Design and implementation of a reliable and cost-effective cloud computing infrastructure: the INFN Napoli experience

    Science.gov (United States)

    Capone, V.; Esposito, R.; Pardi, S.; Taurino, F.; Tortone, G.

    2012-12-01

    Over the last few years we have seen an increasing number of services and applications needed to manage and maintain cloud computing facilities. This is particularly true for computing in high energy physics, which often requires complex configurations and distributed infrastructures. In this scenario a cost effective rationalization and consolidation strategy is the key to success in terms of scalability and reliability. In this work we describe an IaaS (Infrastructure as a Service) cloud computing system, with high availability and redundancy features, which is currently in production at INFN-Naples and ATLAS Tier-2 data centre. The main goal we intended to achieve was a simplified method to manage our computing resources and deliver reliable user services, reusing existing hardware without incurring heavy costs. A combined usage of virtualization and clustering technologies allowed us to consolidate our services on a small number of physical machines, reducing electric power costs. As a result of our efforts we developed a complete solution for data and computing centres that can be easily replicated using commodity hardware. Our architecture consists of 2 main subsystems: a clustered storage solution, built on top of disk servers running GlusterFS file system, and a virtual machines execution environment. GlusterFS is a network file system able to perform parallel writes on multiple disk servers, providing this way live replication of data. High availability is also achieved via a network configuration using redundant switches and multiple paths between hypervisor hosts and disk servers. We also developed a set of management scripts to easily perform basic system administration tasks such as automatic deployment of new virtual machines, adaptive scheduling of virtual machines on hypervisor hosts, live migration and automated restart in case of hypervisor failures.

  18. Modeling of Control Costs, Emissions, and Control Retrofits for Cost Effectiveness and Feasibility Analyses

    Science.gov (United States)

    Learn about EPA’s use of the Integrated Planning Model (IPM) to develop estimates of SO2 and NOx emission control costs, projections of futureemissions, and projections of capacity of future control retrofits, assuming controls on EGUs.

  19. COST EFFECTIVE CONTROL OF HEXAVALENT CHROMIUM AIR EMISSIONS FROM FUNCTIONAL CHROMIUM ELECTROPLATING

    Science.gov (United States)

    This paper will summrize thie pollution prevention (p2) method to control stack emissions from hard chromium plating operations performed by the USEPA's National Risk Management Research Laboratory (NRMRL) over the last four years. During literature research and user surveys, it...

  20. Cost-effective reduction of fine primary particulate matter emissions in Finland

    International Nuclear Information System (INIS)

    Karvosenoja, Niko; Klimont, Zbigniew; Tohka, Antti; Johansson, Matti

    2007-01-01

    Policies to reduce adverse health impacts of fine particulate matter (PM 2.5 ) require information on costs of abatement and associated costs. This paper explores the potential for cost-efficient control of anthropogenic primary PM 2.5 emissions in Finland. Based on a Kyoto-compliant energy projection, two emission control scenarios for 2020 were developed. 'Baseline' assumes implementation of PM controls in compliance with existing legislation. 'Reduction' assumes ambitious further reductions. Emissions for 2020 were estimated at 26 and 18.6 Gg a -1 for 'Baseline' and 'Reduction', respectively. The largest abatement potential, 3.0 Gg a -1 , was calculated for power plants and industrial combustion. The largest potential with marginal costs below 5000 Euro MG(PM 2.5 ) -1 was for domestic wood combustion, 1.7 Gg a -1 . For traffic the potential was estimated at 1.0 Gg a -1 , but was associated with high costs. The results from this paper are used in the policy-driven national integrated assessment modeling that explores cost-efficient reductions of the health impacts of PM

  1. Electric urban delivery trucks: energy use, greenhouse gas emissions, and cost-effectiveness.

    Science.gov (United States)

    Lee, Dong-Yeon; Thomas, Valerie M; Brown, Marilyn A

    2013-07-16

    We compare electric and diesel urban delivery trucks in terms of life-cycle energy consumption, greenhouse gas (GHG) emissions, and total cost of ownership (TCO). The relative benefits of electric trucks depend heavily on vehicle efficiency associated with drive cycle, diesel fuel price, travel demand, electric drive battery replacement and price, electricity generation and transmission efficiency, electric truck recharging infrastructure, and purchase price. For a drive cycle with frequent stops and low average speed such as the New York City Cycle (NYCC), electric trucks emit 42-61% less GHGs and consume 32-54% less energy than diesel trucks, depending upon vehicle efficiency cases. Over an array of possible conditions, the median TCO of electric trucks is 22% less than that of diesel trucks on the NYCC. For a drive cycle with less frequent stops and high average speed such as the City-Suburban Heavy Vehicle Cycle (CSHVC), electric trucks emit 19-43% less GHGs and consume 5-34% less energy, but cost 1% more than diesel counterparts. Considering current and projected U.S. regional electricity generation mixes, for the baseline case, the energy use and GHG emissions ratios of electric to diesel trucks range from 48 to 82% and 25 to 89%, respectively.

  2. Cost-Effective Reciprocating Engine Emissions Control and Monitoring for E&P Field and Gathering Engines

    Energy Technology Data Exchange (ETDEWEB)

    Kirby S. Chapman

    2004-01-01

    During the fourth reporting period, the project team investigated the Non-Selective Catalytic Reduction technologies that are in use on rich-burn four-stroke cycle engines. Several engines were instrumented and data collected to obtain a rich set of engine emissions and performance data. During the data collection, the performance of the catalyst under a variety of operating conditions was measured. This information will be necessary to specify a set of sensors that can then be used to reliably implement NSCRs as plausible technologies to reduce NOx emissions for four-stroke cycle engines used in the E&P industry. A complete summary all the technologies investigated to data is included in the report. For each technology, the summary includes a description of the process, the emission reduction that is to be expected, information on the cost of the technology, development status, practical considerations, compatibility with other air pollutant control technologies, and any references used to obtain the information.

  3. Reliable and cost effective design of intermetallic Ni2Si nanowires and direct characterization of its mechanical properties

    OpenAIRE

    Seung Zeon Han; Joonhee Kang; Sung-Dae Kim; Si-Young Choi; Hyung Giun Kim; Jehyun Lee; Kwangho Kim; Sung Hwan Lim; Byungchan Han

    2015-01-01

    We report that a single crystal Ni2Si nanowire (NW) of intermetallic compound can be reliably designed using simple three-step processes: casting a ternary Cu-Ni-Si alloy, nucleate and growth of Ni2Si NWs as embedded in the alloy matrix via designing discontinuous precipitation (DP) of Ni2Si nanoparticles and thermal aging, and finally chemical etching to decouple the Ni2Si NWs from the alloy matrix. By direct application of uniaxial tensile tests to the Ni2Si NW we characterize its mechanica...

  4. Reliable and cost effective design of intermetallic Ni2Si nanowires and direct characterization of its mechanical properties.

    Science.gov (United States)

    Han, Seung Zeon; Kang, Joonhee; Kim, Sung-Dae; Choi, Si-Young; Kim, Hyung Giun; Lee, Jehyun; Kim, Kwangho; Lim, Sung Hwan; Han, Byungchan

    2015-10-12

    We report that a single crystal Ni2Si nanowire (NW) of intermetallic compound can be reliably designed using simple three-step processes: casting a ternary Cu-Ni-Si alloy, nucleate and growth of Ni2Si NWs as embedded in the alloy matrix via designing discontinuous precipitation (DP) of Ni2Si nanoparticles and thermal aging, and finally chemical etching to decouple the Ni2Si NWs from the alloy matrix. By direct application of uniaxial tensile tests to the Ni2Si NW we characterize its mechanical properties, which were rarely reported in previous literatures. Using integrated studies of first principles density functional theory (DFT) calculations, high-resolution transmission electron microscopy (HRTEM), and energy-dispersive X-ray spectroscopy (EDX) we accurately validate the experimental measurements. Our results indicate that our simple three-step method enables to design brittle Ni2Si NW with high tensile strength of 3.0 GPa and elastic modulus of 60.6 GPa. We propose that the systematic methodology pursued in this paper significantly contributes to opening innovative processes to design various kinds of low dimensional nanomaterials leading to advancement of frontiers in nanotechnology and related industry sectors.

  5. 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Accuracy in the Staging of Non-Small Cell Lung Cancer: Review and Cost-Effectiveness

    International Nuclear Information System (INIS)

    Gómez León, Nieves; Escalona, Sofía; Bandrés, Beatriz; Belda, Cristobal; Callejo, Daniel; Blasco, Juan Antonio

    2014-01-01

    Aim of the performed clinical study was to compare the accuracy and cost-effectiveness of PET/CT in the staging of non-small cell lung cancer (NSCLC). Material and Methods. Cross-sectional and prospective study including 103 patients with histologically confirmed NSCLC. All patients were examined using PET/CT with intravenous contrast medium. Those with disease stage ≤IIB underwent surgery (n = 40). Disease stage was confirmed based on histology results, which were compared with those of PET/CT and positron emission tomography (PET) and computed tomography (CT) separately. 63 patients classified with ≥IIIA disease stage by PET/CT did not undergo surgery. The cost-effectiveness of PET/CT for disease classification was examined using a decision tree analysis. Results. Compared with histology, the accuracy of PET/CT for disease staging has a positive predictive value of 80%, a negative predictive value of 95%, a sensitivity of 94%, and a specificity of 82%. For PET alone, these values are 53%, 66%, 60%, and 50%, whereas for CT alone they are 68%, 86%, 76%, and 72%, respectively. Incremental cost-effectiveness of PET/CT over CT alone was €17,412 quality-adjusted life-year (QALY). Conclusion. In our clinical study, PET/CT using intravenous contrast medium was an accurate and cost-effective method for staging of patients with NSCLC

  6. 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Accuracy in the Staging of Non-Small Cell Lung Cancer: Review and Cost-Effectiveness

    International Nuclear Information System (INIS)

    Leon, N.G.; Bandrs, B.; Escalona, S.; Callejo, D.; Blasco, J.A.; Belda, C.; Blasco, J.A.

    2014-01-01

    Aim of the performed clinical study was to compare the accuracy and cost-effectiveness of PET/CT in the staging of non-small cell lung cancer (NSCLC). Material and Methods. Cross-sectional and prospective study including 103 patients with histologically confirmed NSCLC. All patients were examined using PET/CT with intravenous contrast medium. Those with disease stage ≤IIB underwent surgery (η=40). Disease stage was confirmed based on histology results, which were compared with those of PET/CT and positron emission tomography (PET) and computed tomography (CT) separately. 63 patients classified with ≥IIIA disease stage by PET/CT did not undergo surgery. The cost-effectiveness of PET/CT for disease classification was examined using a decision tree analysis. Results. Compared with histology, the accuracy of PET/CT for disease staging has a positive predictive value of 80%, a negative predictive value of 95%, a sensitivity of 94%, and a specificity of 82%. For PET alone, these values are 53%, 66%, 60%, and 50%, whereas for CT alone they are 68%, 86%, 76%, and 72%, respectively. Incremental cost-effectiveness of PET/CT over CT alone was €17,412 quality-adjusted life-year (QALY). Conclusion. In our clinical study, PET/CT using intravenous contrast medium was an accurate and cost-effective method for staging of patients with NSCLC

  7. Fairness and cost-effectiveness of CO2 emission reduction targets in the European Union member states. An analysis based on scenario studies

    International Nuclear Information System (INIS)

    Kram, T.; Ybema, J.R.; Vos, D.

    1997-06-01

    The Member States of the European Union (EU) have agreed upon a common position in the international negotiations on the limitation of greenhouse gas emissions. The total commitment of the EU is the result of differentiated emission targets for the individual Member States. In this study the results of 4 recent scenario studies on CO2 emission reduction are used to assess the fairness and the cost-effectiveness of the differentiated targets. Here, fairness is measured by the average cost per capita in a country to reach the emission target. Cost-effectiveness is based on the marginal cost of emission reduction. It is noted that there are limitations in the comparability of the country results. Further, the coverage of the EU Member States is not complete in all 4 studies. Robust conclusions could thus not be drawn for all countries. Nonetheless, there are strong indications that the efforts to achieve the emission reduction targets are not evenly distributed. Based on the results the countries can be divided into four groups with different burdens to achieve reduction of CO2 emissions: (a) countries that will probably be faced with above average burdens: Sweden, Italy and the Netherlands; (b) countries that will presumably be faced with above average burdens but for which limited information is available: Austria and Denmark; (c) countries that will probably be faced with average burdens or for which the relative efforts are indistinct: Germany, Portugal, Belgium, Finland and Luxembourg; and (d) countries that will probably be faced with below average burdens: United Kingdom, France, Spain, Ireland and Greece. 1 fig., 12 tabs., 6 refs

  8. Cost effectiveness comparison of certain transportation measures to mitigate greenhouse gas emissions in San Diego County, California

    International Nuclear Information System (INIS)

    Silva-Send, Nilmini; Anders, Scott; Narwold, Andrew

    2013-01-01

    California's overarching mandate to achieve 1990 levels of greenhouse gases (GHGs) in 2020 (AB 32, 2005), and the ensuing recent regulations (SB 375, CEQA updates) require local and regional governments to assess GHG mitigation policies, including on-road transportation. The regulations do not make cost-effectiveness a primary criteria for choosing measures but cost remains important to a variety of stakeholders. This communication summarizes results from GHG and cost analysis for seven actual San Diego County road transportation policies: telecommute, vanpools, a bicycle strategy, an increase in mass transit use, parking policies (parking pricing, preferred parking for electric vehicles), an increased local fuel tax and speed harmonization (signal re-timing, roundabouts). Net costs are calculated as the sum of direct costs and benefits to the administering agency, the employer and the individual. Net costs per metric ton GHG abated vary greatly across measures, from negative to high positive (more than US $1000). We find that local GHG cost cannot be sensibly compared to other carbon or GHG policy costs outside the local context for a variety of reasons, but especially because measures have not been adopted primarily for carbon or GHG abatement potential or on the basis of cost effectiveness

  9. Cost-Effective Reciprocating Engine Emissions Control and Monitoring for E&P Field and Gathering Engines

    Energy Technology Data Exchange (ETDEWEB)

    Keith Hohn; Sarah R. Nuss-Warren

    2011-08-31

    This final report describes a project intended to identify, develop, test, and commercialize emissions control and monitoring technologies that can be implemented by E&P operators to significantly lower their cost of environmental compliance and expedite project permitting. Technologies were installed and tested in controlled laboratory situations and then installed and tested on field engines based on the recommendations of an industry-based steering committee, analysis of installed horsepower, analysis of available emissions control and monitoring technologies, and review of technology and market gaps. The industry-recognized solution for lean-burn engines, a low-emissions-retrofit including increased airflow and pre-combustion chambers, was found to successfully control engine emissions of oxides of nitrogen (NO{sub X}) and carbon monoxide (CO). However, the standard non-selective catalytic reduction (NSCR) system recognized by the industry was found to be unable to consistently control both NO{sub X} and CO emissions. The standard NSCR system was observed to produce emissions levels that changed dramatically on a day-to-day or even hour-to-hour basis. Because difficulties with this system seemed to be the result of exhaust gas oxygen (EGO) sensors that produced identical output for very different exhaust gas conditions, models were developed to describe the behavior of the EGO sensor and an alternative, the universal exhaust gas oxygen (UEGO) sensor. Meanwhile, an integrated NSCR system using an advanced, signal-conditioned UEGO sensor was tested and found to control both NO{sub X} and CO emissions. In conjunction with this project, advanced monitoring technologies, such as Ion Sense, and improved sensors for emissions control, such as the AFM1000+ have been developed and commercialized.

  10. Feeding strategies and manure management for cost-effective mitigation of greenhouse gas emissions from dairy farms in Wisconsin.

    Science.gov (United States)

    Dutreuil, M; Wattiaux, M; Hardie, C A; Cabrera, V E

    2014-09-01

    Greenhouse gas (GHG) emissions from dairy farms are a major concern. Our objectives were to assess the effect of mitigation strategies on GHG emissions and net return to management on 3 distinct farm production systems of Wisconsin. A survey was conducted on 27 conventional farms, 30 grazing farms, and 69 organic farms. The data collected were used to characterize 3 feeding systems scaled to the average farm (85 cows and 127ha). The Integrated Farm System Model was used to simulate the economic and environmental impacts of altering feeding and manure management in those 3 farms. Results showed that incorporation of grazing practices for lactating cows in the conventional farm led to a 27.6% decrease in total GHG emissions [-0.16kg of CO2 equivalents (CO2eq)/kg of energy corrected milk (ECM)] and a 29.3% increase in net return to management (+$7,005/yr) when milk production was assumed constant. For the grazing and organic farms, decreasing the forage-to-concentrate ratio in the diet decreased GHG emissions when milk production was increased by 5 or 10%. The 5% increase in milk production was not sufficient to maintain the net return; however, the 10% increase in milk production increased net return in the organic farm but not on the grazing farm. A 13.7% decrease in GHG emissions (-0.08kg of CO2eq/kg of ECM) was observed on the conventional farm when incorporating manure the day of application and adding a 12-mo covered storage unit. However, those same changes led to a 6.1% (+0.04kg of CO2eq/kg of ECM) and a 6.9% (+0.06kg of CO2eq/kg of ECM) increase in GHG emissions in the grazing and the organic farms, respectively. For the 3 farms, manure management changes led to a decrease in net return to management. Simulation results suggested that the same feeding and manure management mitigation strategies led to different outcomes depending on the farm system, and furthermore, effective mitigation strategies were used to reduce GHG emissions while maintaining

  11. A Cost-effective and Emission-aware Power Management System for Ships with Integrated Full Electric Propulsion

    DEFF Research Database (Denmark)

    Kanellos, Fotis D.; Anvari-Moghaddam, Amjad; Guerrero, Josep M.

    2017-01-01

    The extensive exploitation of electric power in ships enables the development of more efficient and environmentally friendlier ships, as it allows for a more flexible ship power system operation and configuration. In this paper, an optimal power management method for ship electric power systems....... The proposed fuzzy-based particle swarm optimization (FPSO) algorithm aims at minimizing the operation cost, limiting the greenhouse gas (GHG) emissions and satisfying the technical and operational constraints of the ship....

  12. Individualized Positron Emission Tomography–Based Isotoxic Accelerated Radiation Therapy Is Cost-Effective Compared With Conventional Radiation Therapy: A Model-Based Evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Bongers, Mathilda L., E-mail: ml.bongers@vumc.nl [Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam (Netherlands); Coupé, Veerle M.H. [Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam (Netherlands); De Ruysscher, Dirk [Radiation Oncology University Hospitals Leuven/KU Leuven, Leuven (Belgium); Department of Radiation Oncology, GROW Research Institute, Maastricht University Medical Center, Maastricht (Netherlands); Oberije, Cary; Lambin, Philippe [Department of Radiation Oncology, GROW Research Institute, Maastricht University Medical Center, Maastricht (Netherlands); Uyl-de Groot, Cornelia A. [Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam (Netherlands); Institute for Medical Technology Assessment, Erasmus University Rotterdam, Rotterdam (Netherlands)

    2015-03-15

    Purpose: To evaluate long-term health effects, costs, and cost-effectiveness of positron emission tomography (PET)-based isotoxic accelerated radiation therapy treatment (PET-ART) compared with conventional fixed-dose CT-based radiation therapy treatment (CRT) in non-small cell lung cancer (NSCLC). Methods and Materials: Our analysis uses a validated decision model, based on data of 200 NSCLC patients with inoperable stage I-IIIB. Clinical outcomes, resource use, costs, and utilities were obtained from the Maastro Clinic and the literature. Primary model outcomes were the difference in life-years (LYs), quality-adjusted life-years (QALYs), costs, and the incremental cost-effectiveness and cost/utility ratio (ICER and ICUR) of PET-ART versus CRT. Model outcomes were obtained from averaging the predictions for 50,000 simulated patients. A probabilistic sensitivity analysis and scenario analyses were carried out. Results: The average incremental costs per patient of PET-ART were €569 (95% confidence interval [CI] €−5327-€6936) for 0.42 incremental LYs (95% CI 0.19-0.61) and 0.33 QALYs gained (95% CI 0.13-0.49). The base-case scenario resulted in an ICER of €1360 per LY gained and an ICUR of €1744 per QALY gained. The probabilistic analysis gave a 36% probability that PET-ART improves health outcomes at reduced costs and a 64% probability that PET-ART is more effective at slightly higher costs. Conclusion: On the basis of the available data, individualized PET-ART for NSCLC seems to be cost-effective compared with CRT.

  13. COST EFFECTIVE VOC EMISSION CONTROL STARTEGIES FOR MILITARY, AEROSPACE,AND INDUSTRIAL PAINT SPRAY BOOTH OPERATIONS: COMBINING IMPROVED VENTILATION SYSTEMS WITH INNOVATIVE, LOW COST EMISSION CONTROL TECHNOLOGIES

    Science.gov (United States)

    The paper describes a full-scale demonstration program in which several paint booths were modified for recirculation ventilation; the booth exhaust streams are vented to an innovative volatile organic compound (VOC) emission control system having extremely low operating costs. ...

  14. Cost effective method for valuation of impacts caused by greenhouse gases emissions for oil and gas companies; Metodo de custo-efetividade para avaliacao de impactos causados pelas emissoes de gases de efeito estufa em empresas de oleo e gas

    Energy Technology Data Exchange (ETDEWEB)

    Carneiro, Elisa Vieira [Petroleo Brasileiro S.A. (PETROBRAS), Rio de Janeiro, RJ (Brazil); Barros, Sergio Ricardo da Silveira [Universidade Federal Fluminense (LATEC/UFF), Niteroi, RJ (Brazil). Mestrado em Sistemas de Gestao

    2012-07-01

    The objective of this work is to apply the method of cost-effectiveness in economic evaluation of new investment projects, based on information about reducing greenhouse gases emissions. In the context of the commitment of companies with the Climate Change and Sustainability, this work is important and contributes to the oil and gas industry, because it integrates information on reducing emissions of greenhouse gases in negative Net Present Value (NPV) projects, helping the portfolio manager on decision making between alternative projects. In this article, examples are given of two investment projects, in which the cost effectiveness methodology is applied, considering the reduction of emission of greenhouse gases such as additional environmental benefit, or cost avoidance, in an adjusted model of the economic viability analysis of meritorious projects. (author)

  15. Exploring the comparative cost-effectiveness of economic incentive and command-and-control instruments, and of renewable energy technologies in PM10 emission control: A case study of Lima-Callao, Peru

    Science.gov (United States)

    Kroeger, Timm

    Much economic literature expounds the superior cost-effectiveness of economic incentive (EI) policies over command-and-control (CAC) ones, based on appealing theoretical arguments. However, one of the assumptions underlying much of this literature is that monitoring and enforcement (M&E) of policies are not only feasible, but essentially costless. In reality, M&E are never costless and sometimes infeasible, and, crucially, M&E requirements vary across policy types. Furthermore, in technical economic terms, cost-effectiveness is defined with respect to variable costs only; however, in choosing among policies, the objective generally is to identify that with the lowest total (variable plus fixed) cost per unit abatement, which in its own right may be termed cost-effective. The neglect of M&E and of fixed costs throws up the question of the validity of much of the policy advice that draws on the environmental economics literature for developing countries, where the institutional capacity for effective M&E often is strongly limited, and where creating this capacity will require considerable infrastructure investments. The limited institutional capacity also has led to the suggestion that in developing countries, conventional environmental policies, such as input or output taxes, emission charges, or standards, may be less cost-effective than non-conventional environmental policies, such as direct public provision of electricity from renewable sources, because the M&E capacity required for the implementation of non-conventional policies is often less stringent. I test the hypotheses of superior cost-effectiveness of EI over CAC and of non-conventional over conventional environmental policy instruments. The samples of pollution control policies used to test the hypotheses are drawn from a list of frequently recommended urban air pollution abatement measures for developing countries, plus two renewable energy sources. Both sets of environmental policy types are compared

  16. Reliability

    OpenAIRE

    Condon, David; Revelle, William

    2017-01-01

    Separating the signal in a test from the irrelevant noise is a challenge for all measurement. Low test reliability limits test validity, attenuates important relationships, and can lead to regression artifacts. Multiple approaches to the assessment and improvement of reliability are discussed. The advantages and disadvantages of several different approaches to reliability are considered. Practical advice on how to assess reliability using open source software is provided.

  17. Reduction of carbon dioxide emissions by modernisation or substitution of existing coal power stations in the EC and the resulting cost effect

    International Nuclear Information System (INIS)

    Folke, C.

    2000-01-01

    Trends in carbon dioxide emissions and cost of coal power stations are analyzed EC-wide. The data base derives from several generations of power stations for the period between 2000 and 2050 assuming several different substitution strategies. The reference scenario is one in which decisions on new power station types are made purely on the basis of short-term economic aspects (annual minimisation of the nominal cost). The method and the parameters used for calculating and analyzing carbon dioxide strategies in the context of this study are presented and explained [de

  18. RELIABILITY OF POSITRON EMISSION TOMOGRAPHY-COMPUTED TOMOGRAPHY IN EVALUATION OF TESTICULAR CARCINOMA PATIENTS.

    Science.gov (United States)

    Nikoletić, Katarina; Mihailović, Jasna; Matovina, Emil; Žeravica, Radmila; Srbovan, Dolores

    2015-01-01

    The study was aimed at assessing the reliability of 18F-fluorodeoxyglucose positron emission tomography-computed tomography scan in evaluation of testicular carcinoma patients. The study sample consisted of 26 scans performed in 23 patients with testicular carcinoma. According to the pathohistological finding, 14 patients had seminomas, 7 had nonseminomas and 2 patients had a mixed histological type. In 17 patients, the initial treatment was orchiectomy+chemotherapy, 2 patients had orchiectomy+chemotherapy+retroperitoneal lymph node dissection, 3 patients had orchiectomy only and one patient was treated with chemotherapy only. Abnormal computed tomography was the main cause for the oncologist to refer the patient to positron emission tomography-computed tomography scan (in 19 scans), magnetic resonance imaging abnormalities in 1 scan, high level oftumor markers in 3 and 3 scans were perforned for follow-up. Positron emission tomography-computed tomography imaging results were compared with histological results, other imaging modalities or the clinical follow-up of the patients. Positron emission tomography-computed tomography scans were positive in 6 and negative in 20 patients. In two patients, positron emission tomography-computed tomography was false positive. There were 20 negative positron emission omography-computed tomography scans perforned in 18 patients, one patient was lost for data analysis. Clinically stable disease was confirmed in 18 follow-up scans performed in 16 patients. The values of sensitivty, specificity, accuracy, and positive- and negative predictive value were 60%, 95%, 75%, 88% and 90.5%, respectively. A hgh negative predictive value obtained in our study (90.5%) suggests that there is a small possibility for a patient to have future relapse after normal positron emission tomography-computed tomography study. However, since the sensitivity and positive predictive value of the study ire rather low, there are limitations of positive

  19. Integrated approach for combining sustainability and safety into a RAM analysis, RAM2S (Reliability, Availability, Maintainability, Sustainability and Safety) towards greenhouse gases emission targets

    Energy Technology Data Exchange (ETDEWEB)

    Alvarenga, Tobias V. [Det Norske Veritas (DNV), Hovik, Oslo (Norway)

    2009-07-01

    This paper aims to present an approach to integrate sustainability and safety concerns on top of a typical RAM Analysis to support new enterprises to find alternatives to align themselves to the greenhouse gases emission targets, measured as CO{sub 2} (carbon dioxide) equivalent. This approach can be used to measure the impact of the potential CO{sub 2} equivalent emission levels mainly related to new enterprises with high CO{sub 2} content towards environment and production, as per example, the extraction of oil and gas from the Brazilian Pre-salt layers. In this sense, this integrated approach, combining Sustainability and Safety into a RAM analysis, RAM2S (Reliability, Availability, Maintainability, Sustainability and Safety), can be used to assess the impact of CO{sub 2} 'production' along the entire enterprise life-cycle, including the impact of possible facility shutdown due to emission restrictions limits, as well as due to the occurrence of additional failures modes related to CO{sub 2} corrosion capabilities. Thus, at the end, this integrated approach would allow companies to find out a more cost-effective alternative to adapt their business into the global warming reality, overcoming the inherent threats of greenhouse gases. (author)

  20. Controlling Healthcare Costs: Just Cost Effectiveness or "Just" Cost Effectiveness?

    Science.gov (United States)

    Fleck, Leonard M

    2018-04-01

    Meeting healthcare needs is a matter of social justice. Healthcare needs are virtually limitless; however, resources, such as money, for meeting those needs, are limited. How then should we (just and caring citizens and policymakers in such a society) decide which needs must be met as a matter of justice with those limited resources? One reasonable response would be that we should use cost effectiveness as our primary criterion for making those choices. This article argues instead that cost-effectiveness considerations must be constrained by considerations of healthcare justice. The goal of this article will be to provide a preliminary account of how we might distinguish just from unjust or insufficiently just applications of cost-effectiveness analysis to some healthcare rationing problems; specifically, problems related to extraordinarily expensive targeted cancer therapies. Unconstrained compassionate appeals for resources for the medically least well-off cancer patients will be neither just nor cost effective.

  1. Cost effectiveness analysis in radiopharmacy

    International Nuclear Information System (INIS)

    Carpentier, N.; Verbeke, S.; Ducloux, T.

    1999-01-01

    Objective: to evaluate the cost effectiveness of radiopharmaceuticals and their quality control. Materials and methods: this retrospective study was made in the Nuclear Medicine Department of the University Hospital of Limoges. Radiopharmaceutical costs were obtained with adding the price of the radiotracer, the materials, the equipments, the labour, the running expenses and the radioisotope. The costs of quality control were obtained with adding the price of labour, materials, equipments, running expenses and the cost of the quality control of 99m Tc eluate. Results: during 1998, 2106 radiopharmaceuticals were prepared in the Nuclear Medicine Department. The mean cost effectiveness of radiopharmaceutical was 1430 francs (846 to 4260). The mean cost effectiveness of quality control was 163 francs (84 to 343). The rise of the radiopharmaceutical cost induced by quality control was 11%. Conclusion: the technical methodology of quality control must be mastered to optimize the cost of this operation. (author)

  2. Custom LSI plus hybrid equals cost effectiveness

    Science.gov (United States)

    Friedman, S. N.

    The possibility to combine various technologies, such as Bi-Polar linear and CMOS/Digital makes it feasible to create systems with a tailored performance not available on a single monolithic circuit. The custom LSI 'BLOCK', especially if it is universal in nature, is proving to be a cost effective way for the developer to improve his product. The custom LSI represents a low price part in contrast to the discrete components it will replace. In addition, the hybrid assembly can realize a savings in labor as a result of the reduced parts handling and associated wire bonds. The possibility of the use of automated system manufacturing techniques leads to greater reliability as the human factor is partly eliminated. Attention is given to reliability predictions, cost considerations, and a product comparison study.

  3. A cost effective CO2 strategy

    DEFF Research Database (Denmark)

    , a scenario-part and a cost-benefit part. Air and sea modes are not analyzed. The model adopts a bottom-up approach to allow a detailed assessment of transport policy measures. Four generic areas of intervention were identified and the likely effect on CO2 emissions, socioeconomic efficiency and other...... are evaluated according to CO2 reduction potential and according to the ‘shadow price’ on a reduction of one ton CO2. The shadow price reflects the costs (and benefits) of the different measures. Comparing the measures it is possible to identify cost effective measures, but these measures are not necessarily...... by the Ministry of Transport, with the Technical University of Denmark as one of the main contributors. The CO2-strategy was to be based on the principle of cost-effectiveness. A model was set up to assist in the assessment. The model consists of a projection of CO2-emissions from road and rail modes from 2020...

  4. Are small-scale grid-connected photovoltaic systems a cost-effective policy for lowering electricity bills and reducing carbon emissions? A technical, economic, and carbon emission analysis

    International Nuclear Information System (INIS)

    McHenry, Mark P.

    2012-01-01

    This research discusses findings from technical simulations and economic models of 1 kW p and 3 kW p grid-connected photovoltaic (PV) systems supplying a rural home electricity load in parallel with the electricity network in Western Australia (WA). The technical simulations are based on electricity billing, consumption monitoring, an energy audit data, combined with 15 min interval load and PV system performance for commercially available technologies and balance of system components, using long-term meteorological input data. The economic modelling uses 2010 market prices for capital costs, operational costs, electricity tariffs, subsidies, and is based on discounted cash flow analyses which generate a final net present value (NPV) for each system against network electricity costs (in Australian dollars, AUD) over a 15 year investment horizon. The results suggest that current market prices generate a negative NPV (a net private loss), even with the current government subsidies, which lead to higher home electricity costs than conventional network electricity use. Additionally, the private costs of carbon emission mitigation (AUD tCO 2 -e −1 ) for the grid-connected PV system simulations and models were around AUD 600-700 tCO 2 -e −1 , a particularly expensive option when compared to existing large-scale renewable energy mitigation activities. - Highlights: ► Subsidised small-scale grid-connected PV systems can increase home electricity costs. ► Subsidies for private PV systems are provided by those who do not receive a benefit. ► Small-scale grid-connected PV systems result in very high costs of mitigation. ► Verifying actual mitigation from grid-connected small-scale systems is problematic. ► Maintain medium/large-scale grid-connected or small-scale off-grid system subsidies.

  5. Inspections - a cost effective approach

    International Nuclear Information System (INIS)

    Joseph, C.

    1981-01-01

    This paper describes a cost effective approach for inspections of Computerized Nuclear Materials Control and Accounting Systems (CNMCAS). Highlighted is the capability to conduct an inspection program via portable telephone terminals from off-site locations. The program can be applied to various materials management functions including materials control, quality assurance, and materials accounting. The system is designed to facilitate inspections by both external and internal groups

  6. Cost effectiveness of transportation fuels from biomass

    International Nuclear Information System (INIS)

    De Jager, D.; Faaij, A.P.C.; Troelstra, W.P.

    1998-06-01

    The aim of the study on the title subject was to investigate whether stimulation of the production and use of biofuels for transportation is worthwhile compared to the production of electricity from biomass. Several options are compared to each other and with reference technologies on the basis of the consumption or the avoided input of fossil fuels, emissions of greenhouse gases, specific costs and cost effectiveness. For each phase in the biomass conversion process (cultivation, pretreatment, transportation, conversion, distribution and final consumption) indicators were collected from the literature. Next to costs of the bioconversion routes attention is paid to other relevant aspects that are important for the introduction of the technological options in the Netherlands. 41 refs

  7. Hazard assessment of exhaust emissions - The next generation of fast and reliable tools for in vitro screening

    Science.gov (United States)

    Rothen-Rutishauser, B.

    2017-12-01

    Hazard assessment of exhaust emissions - The next generation of fast and reliable tools for in vitro screening Barbara Rothen-Rutishauser Adolphe Merkle Institute, University of Fribourg, Switzerland; barbara.rothen@unifr.ch Pollution by vehicles is a major problem for the environment due to the various components in the exhaust gasses that are emitted into the atmosphere. A large number of epidemiological studies demonstrate the profound impact of vehicle emissions upon human health [1-3]. Such studies however, are unable to attribute a given subset of emissions to a certain adverse effect, which renders decision making difficult. Standardized protocols for exhaust toxicity assessment are lacking and it relies in many aspects on epidemiological and in vivo studies (animals), which are very time and cost-intensive and suffer from considerable ethical issues. An overview about the current state of research and clinical aspects in the field, as well as about the development of sophisticated in vitro approaches mimicking the inhalation of airborne particles / exhaust for the toxicological testing of engine emissions will be provided. Data will be presented that show that the combination of an air-liquid exposure system and 3D lung-cell culture model offers an adequate tool for fast and reliable investigations of complete exhaust toxicity as well as the effects of particulate fraction [4,5]. This approach yields important results for novel and improved emission technologies in the early stages of product development. [1] Donaldson et al. Part Fibre Toxicol 2005, 2: 10. [2] Ghio et al. J Toxicol Environ Health B Crit Rev 2012, 15: 1-21. [3] Peters et al. Res Rep Health Eff Inst 2009, 5-77. [4] Bisig et al. Emiss Control Sci Technol 2015, 1: 237-246. [5] Steiner et al. Atmos Environ 2013, 81: 380-388.

  8. Acid rain abatement in Belgium: lessons in cost-effectiveness studies

    International Nuclear Information System (INIS)

    Cuijpers, C.; Proost, S.

    1992-01-01

    In this paper a cost-effectiveness analysis is presented for combating emissions of acid precursors. The focus of concern is to reach the environmental quality goal at least cost. Two cost-effective approaches are elaborated. Firstly, the maximum allowable emission of each acid precursor seperately is allocated in a cost-effective way across the economic sectors. Secondly, the maximum allowable emissions of acid precursors are allocated in a cost-effective way across the three considered acid precursors as well as across the economic sectors. It is argued that not only the energy consumption but also the agricultural sector could play an important role in a cost-effective strategy by curtailing its ammonia emissions. 6 refs., 8 figs., 1 tab

  9. reliability reliability

    African Journals Online (AJOL)

    eobe

    Corresponding author, Tel: +234-703. RELIABILITY .... V , , given by the code of practice. However, checks must .... an optimization procedure over the failure domain F corresponding .... of Concrete Members based on Utility Theory,. Technical ...

  10. 2-[{sup 18}F]-fluoro-2-deoxy-D-glucose positron-emission tomography is cost-effective in the initial staging of non-small cell lung cancer patients in Brazil

    Energy Technology Data Exchange (ETDEWEB)

    Cerci, Juliano Julio, E-mail: cercijuliano@hotmail.com [PET-CT Center, Quanta - Diagnostico e Terapia, Curitiba, PR (Brazil); Instituto do Coracao (InCor) - Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo (HC-FMUSP), Sao Paulo, SP (Brazil); Takagaki, Teresa Yae [Universidade de Sao Paulo (USP), Sao Paulo, SP (Brazil); Trindade, Evelinda; Morgado, Roberta; Morabito, Fausto; Musolino, Rafael Silva; Meneghetti, Jose Claudio; Soares Junior, Jose [Instituto do Coracao (InCor) - Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo (HC-FMUSP), Sao Paulo, SP (Brazil)

    2012-07-15

    Objective: To evaluate the accuracy and cost-effectiveness of metabolic staging (MS) with FDG-PET as compared with the conventional staging (CS) strategy in the preoperative staging of non-small cell lung cancer (NSCLC). Materials And Methods: A total of 95 patients with initial diagnosis of NSCLC were staged before undergoing treatment. The MS and CS results were compared with regard to treatment definition and incidence of futile thoracotomies with both strategies. Results: Metabolic staging with FDG-PET upstaged 48.4% and down staged 5.3% of the patients, and would lead to change in the treatment of 41% of cases. Thoracotomy was considered as futile in 47% of the patients with CS, and in 19% of the patients with MS. The cost of futile thoracotomies in eight patients with MS was R$ 79,720, while in 31 patients with CS it would be R$ 308,915. Just such saving in costs would be more than enough to cover the costs of all FDG-PETs (R$ 126,350) or FDG-PET/CTs (R$ 193,515) for the 95 patients. Conclusion: The metabolic staging with FDG-PET is more accurate than CS in patients with NSCLC. Both FDG-PET and FDG-PET/CT are cost-effective methods and their utilization is economically justifiable in the Brazilian public health system. (author)

  11. Reliability of a positron emission tomography system (CTI: PT931/04-12)

    Energy Technology Data Exchange (ETDEWEB)

    Watanuki, Shoichi; Itoh, Masatoshi [Tohoku Univ., Sendai (Japan). Cyclotron and Radioisotope Center; Ishii, Keizo; Orihara, Hikonojyo [Tohoku Univ., Sendai (Japan). Graduate School of Engineering

    2002-05-01

    The maintenance data of a PET system (PT931/04-12 CTI Inc.) was analyzed to evaluate its reliability. We examined whether the initial performance for the system resolution and efficiency is kept. The reliability of the PET system was evaluated from the value of MTTF (mean time to failure) and MTBF (mean time between failures) for each part of the system obtained from the maintenance data for 13 years. The initial performance was kept for the resolution, but the efficiency decreased to 72% of the initial value. The 83% of the troubles of the system was for detector block (DB) and DB control module (BC). The MTTF of DB and BC were 2,733 and 3,314 days, and the MTBF of DB and BC per detector ring were 38 and 114 days. The MTBF of the system was 23 days. We found seasonal dependence for the number of troubles of DB and BC. This means that the trouble may be related the humidity. The reliability of the PET system strongly depends on the MTBF of DB and BC. The improvement in quality of these parts and optimization of the environment in operation may increase the reliability of the PET system. For the popularization of PET, it is effective to evaluate the reliability of the system and to show it to the users. (author)

  12. The cost - effective solar energy applications in Canada

    International Nuclear Information System (INIS)

    Pape, A.

    1999-01-01

    This paper outlines several cost-effective solar energy application in Canada, and estimates the GHG emission reduction potential for each. The applications include: (1) passive solar building design; (2) solar water heating applications; (3) solar photovoltaics for remote power; and (4) solar assisted space heating and cooling in industrial buildings. Each technology is briefly profiled in terms of functionality, cost characteristics, energy production characteristics and potential emission reduction benefits. Real-life examples of each application are also included. Finally, the paper concludes on the potential role of solar energy in the reduction of Canadian GHG emissions. (author)

  13. Reliability Study of Mechatronic Power Components Using Spectral Photon Emission Microscopy

    Directory of Open Access Journals (Sweden)

    N. Moultif

    2016-11-01

    Full Text Available In this paper, we present one of the most important failure analysis tools that permits the localizing and the identification of the failure mechanisms. It is a new spectral photon emission system, enabling to localize the failure, and quickly get the photon emission spectra that characterize the failure with high resolution. A diffraction grating is used as a spectrometer in the system. Application results on mechatronic power devices such as HEMT AlGaN/GAN and SiC MOSFETs are reported.

  14. Fast and reliable method for computing free-bound emission coefficients for hydrogenic ions

    Energy Technology Data Exchange (ETDEWEB)

    Sarmiento, A; Canto, J

    1985-12-01

    An approximate formula for the computation of the free-bound emission coefficient for hydrogenic ions is presented. The approximation is obtained through a manipulation of the (free-bound) Gaunt factor which intentionally distinguish the dependence on frequency from the dependence on temperature and ionic composition. Numerical tests indicate that the derived formula is very precise, fast and easy to use, making the calculation of the free-bound contribution from an ionized region of varying temperature and ionic composition a very simple and time-saving task.

  15. A fast and reliable method for computing free-bound emission coefficients for hydrogenic ions

    International Nuclear Information System (INIS)

    Sarmiento, A.; Canto, J.

    1985-01-01

    An approximate formula for the computation of the free-bound emission coefficient for hydrogenic ions is presented. The approximation is obtained through a manipulation of the (free-bound) Gaunt factor which intentionally distinguish the dependence on frequency from the dependence on temperature and ionic composition. Numerical tests indicate that the derived formula is very precise, fast and easy to use, making the calculation of the free-bound contribution from an ionized region of varying temperature and ionic composition a very simple and time-saving task. (author)

  16. Pursuing Photovoltaic Cost-Effectiveness

    DEFF Research Database (Denmark)

    Yang, Yongheng; Koutroulis, Eftichios; Sangwongwanich, Ariya

    2017-01-01

    loading of the power devices. However, its feasibility is challenged by the associated energy losses. An increase of the inverter lifetime and a reduction of the energy yield can alter the cost of energy, demanding an optimization of the power limitation. Therefore, aiming at minimizing the Levelized Cost...... be flexibly performed. As an advanced control strategy, the Absolute Active Power Control (AAPC) can effectively solve the overloading issues by limiting the maximum possible PV power to a certain level (i.e., the power limitation), and also benefit the inverter reliability due to the reduction in the thermal...... performance in terms of LCOE and energy production can be obtained by enabling the AAPC strategy, compared to the conventional PV inverter operating only in the maximum power point tracking mode. In the presented case study, the minimum of the LCOE is achieved for the PV system when the power limit...

  17. Tuition fees and sunk-cost effects

    NARCIS (Netherlands)

    Ketel, N.; Linde, J.; Oosterbeek, H.; van der Klaauw, B.

    2016-01-01

    This article reports on a field experiment testing for sunk-cost effects in an education setting. Students signing up for extra-curricular tutorial sessions randomly received a discount on the tuition fee. The sunk-cost effect predicts that students who pay more will attend more tutorial sessions,

  18. Cost-effectiveness thresholds: pros and cons.

    Science.gov (United States)

    Bertram, Melanie Y; Lauer, Jeremy A; De Joncheere, Kees; Edejer, Tessa; Hutubessy, Raymond; Kieny, Marie-Paule; Hill, Suzanne R

    2016-12-01

    Cost-effectiveness analysis is used to compare the costs and outcomes of alternative policy options. Each resulting cost-effectiveness ratio represents the magnitude of additional health gained per additional unit of resources spent. Cost-effectiveness thresholds allow cost-effectiveness ratios that represent good or very good value for money to be identified. In 2001, the World Health Organization's Commission on Macroeconomics in Health suggested cost-effectiveness thresholds based on multiples of a country's per-capita gross domestic product (GDP). In some contexts, in choosing which health interventions to fund and which not to fund, these thresholds have been used as decision rules. However, experience with the use of such GDP-based thresholds in decision-making processes at country level shows them to lack country specificity and this - in addition to uncertainty in the modelled cost-effectiveness ratios - can lead to the wrong decision on how to spend health-care resources. Cost-effectiveness information should be used alongside other considerations - e.g. budget impact and feasibility considerations - in a transparent decision-making process, rather than in isolation based on a single threshold value. Although cost-effectiveness ratios are undoubtedly informative in assessing value for money, countries should be encouraged to develop a context-specific process for decision-making that is supported by legislation, has stakeholder buy-in, for example the involvement of civil society organizations and patient groups, and is transparent, consistent and fair.

  19. A Departmental Cost-Effectiveness Model.

    Science.gov (United States)

    Holleman, Thomas, Jr.

    In establishing a departmental cost-effectiveness model, the traditional cost-effectiveness model was discussed and equipped with a distant and deflation equation for both benefits and costs. Next, the economics of costing was examined and program costing procedures developed. Then, the model construct was described as it was structured around the…

  20. Reliability of eye lens dosimetry in workers of a positron emission tomography radiopharmaceutical production facility

    International Nuclear Information System (INIS)

    Silva, Teógenes A. da; Guimarães, Margarete C.; Meireles, Leonardo S.; Teles, Luciana L.D.; Lacerda, Marco Aurélio S.

    2016-01-01

    A new regulatory statement was issued concerning the eye lens radiation protection of persons in planned exposures. A debate was raised on the adequacy of the dosimetric quantity and on its method of measurement. The aim of this work was to establish the individual monitoring procedure with the EYE-D™ holder and a MCP-N LiF:Mg,Cu,P thermoluminescent chip detector for measuring the personal dose equivalent H_p(3) in workers of a Positron Emission Tomography Radiopharmaceutical Production Facility. - Highlights: • New regulatory statement was issued concerning eye lens radiation protection. • The calibration procedure of dosimeters for measuring H_p(3) was studied on a slab and cylindrical phantoms. • H_p(3) measurements in workers in a radiopharmaceutical production facility were done.

  1. CT colonography and cost-effectiveness

    Energy Technology Data Exchange (ETDEWEB)

    Mavranezouli, Ifigeneia [University College London, National Collaborating Centre for Mental Health, Centre for Outcomes Research and Effectiveness, Sub-department of Clinical Health Psychology, London (United Kingdom); East, James E. [St Marks Hospital, Imperial College London, Wolfson Unit for Endoscopy, London (United Kingdom); Taylor, Stuart A. [University College Hospital, Specialist X-Ray, London (United Kingdom); University College Hospital, Department of Imaging, London (United Kingdom)

    2008-11-15

    CT colonography (CTC) is increasingly advocated as an effective initial screening tool for colorectal cancer. Nowadays, policy-makers are increasingly interested in cost-effectiveness issues. A number of studies assessing the cost-effectiveness of CTC have been published to date. The majority of findings indicate that CTC is probably not cost-effective when colonoscopy is available, but this conclusion is sensitive to a number of key parameters. This review discusses the findings of these studies, and considers those factors which most influence final conclusions, notably intervention costs, compliance rates, effectiveness of colonoscopy, and the assumed prevalence and natural history of diminutive advanced polyps. (orig.)

  2. CT colonography and cost-effectiveness

    International Nuclear Information System (INIS)

    Mavranezouli, Ifigeneia; East, James E.; Taylor, Stuart A.

    2008-01-01

    CT colonography (CTC) is increasingly advocated as an effective initial screening tool for colorectal cancer. Nowadays, policy-makers are increasingly interested in cost-effectiveness issues. A number of studies assessing the cost-effectiveness of CTC have been published to date. The majority of findings indicate that CTC is probably not cost-effective when colonoscopy is available, but this conclusion is sensitive to a number of key parameters. This review discusses the findings of these studies, and considers those factors which most influence final conclusions, notably intervention costs, compliance rates, effectiveness of colonoscopy, and the assumed prevalence and natural history of diminutive advanced polyps. (orig.)

  3. Cost effectiveness of radon mitigation in Canada

    International Nuclear Information System (INIS)

    Letourneau, E.G.; Krewski, D.; Zielinski, J.M.; McGregor, R.G.

    1992-01-01

    This paper examines the cost effectiveness of comprehensive strategies for reducing exposure to radon gas in indoor air in Canadian homes. The analysis is conducted within the context of a general framework for risk management programme evaluation which includes well-known evaluation techniques such as cost effectiveness and cost-benefit analyses as special cases. Based on this analysis, it is clear that any comprehensive programme to reduce exposure to environmental radon will be extremely expensive, and may not be justifiable in terms of health impact, particularly when considered in relation to other public health programmes. Testing of homes at the point of sale and installing sub-slab suction equipment to reduce exposure to indoor radon where necessary appears to be a relatively cost-effective radon mitigation strategy. In general, radon mitigation was found to be most cost effective in cities with relatively high levels of radon. (author)

  4. Green Infrastructure Siting and Cost Effectiveness Analysis

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — Parcel scale green infrastructure siting and cost effectiveness analysis. You can find more details at the project's website.

  5. Emissions Trading

    NARCIS (Netherlands)

    Woerdman, Edwin; Backhaus, Juergen

    2014-01-01

    Emissions trading is a market-based instrument to achieve environmental targets in a cost-effective way by allowing legal entities to buy and sell emission rights. The current international dissemination and intended linking of emissions trading schemes underlines the growing relevance of this

  6. Cost-effective unilateral climate policy design: Size Matters

    Energy Technology Data Exchange (ETDEWEB)

    Boehringer, Christoph; Fischer, Carolyn; Rosendahl, Knut Einar

    2011-07-01

    Given the bleak prospects for a global agreement on mitigating climate change, pressure for unilateral abatement is increasing. A major challenge is emissions leakage. Border carbon adjustments and output-based allocation of emissions allowances can increase effectiveness of unilateral action but introduce distortions of their own. We assess antileakage measures as a function of abatement coalition size. We first develop a partial equilibrium analytical framework to see how these instruments affect emissions within and outside the coalition. We then employ a computable general equilibrium model of international trade and energy use to assess the strategies as the coalition grows. We find that full border adjustments rank first in global cost-effectiveness, followed by import tariffs and output-based rebates. The differences across measures and their overall appeal decline as the abatement coalition grows. In terms of cost, the coalition countries prefer border carbon adjustments; countries outside the coalition prefer output-based rebates.(Author)

  7. Biosimilar medicines and cost-effectiveness

    Directory of Open Access Journals (Sweden)

    Steven Simoens

    2011-02-01

    Full Text Available Steven SimoensResearch Centre for Pharmaceutical Care and Pharmaco-economics, Faculty of Pharmaceutical Sciences, Katholieke Universiteit Leuven, Leuven, BelgiumAbstract: Given that biosimilars are agents that are similar but not identical to the reference biopharmaceutical, this study aims to introduce and describe specific issues related to the economic evaluation of biosimilars by focusing on the relative costs, relative effectiveness, and cost-effectiveness of biosimilars. Economic evaluation assesses the cost-effectiveness of a medicine by comparing the costs and outcomes of a medicine with those of a relevant comparator. The assessment of cost-effectiveness of a biosimilar is complicated by the fact that evidence needed to obtain marketing authorization from a registration authority does not always correspond to the data requirements of a reimbursement authority. In particular, this relates to the availability of adequately powered equivalence or noninferiority studies, the need for comparative data about the effectiveness in a real-world setting rather than the efficacy in a structured setting, and the use of health outcome measures instead of surrogate endpoints. As a biosimilar is likely to be less expensive than the comparator (eg, the reference biopharmaceutical, the assessment of the cost-effectiveness of a biosimilar depends on the relative effectiveness. If appropriately designed and powered clinical studies demonstrate equivalent effectiveness between a biosimilar and the comparator, then a cost-minimization analysis identifies the least expensive medicine. If there are differences in the effectiveness of a biosimilar and the comparator, other techniques of economic evaluation need to be employed, such as cost-effectiveness analysis or cost-utility analysis. Given that there may be uncertainty surrounding the long-term safety (ie, risk of immunogenicity and rare adverse events and effectiveness of a biosimilar, the cost-effectiveness

  8. Value of travel-time reliability, part II : a study of tradeoffs between travel reliability, congestion-mitigation strategies and emissions.

    Science.gov (United States)

    2012-09-01

    Capacity, demand, and vehicle based emissions reduction strategies are compared for several pollutants employing aggregate US : congestion and vehicle fleet condition data. We find that congestion mitigation does not inevitably lead to reduced emissi...

  9. Cost-effectiveness in the mitigation of green house gases

    International Nuclear Information System (INIS)

    Rey, Francisco Carlos

    2009-01-01

    This paper analyzes the cost-effectiveness in the mitigation of green house gases from solar, eolic and nuclear energy sources, concluding that nuclear is, not doubt, the mos efficient. On the other hand, nuclear is the unique source that can be installed without limit in magnitude and in the proximity of the demand, and is for all these reasons that several environmental referents in the world have changed their perception on this source and defend it as the unique actual alternative to fight against the emission of green house gases. (author) [es

  10. The carbon-budget approach to climate stabilization: Cost-effective subglobal versus global action

    OpenAIRE

    Eichner, Thomas; Pethig, Rüdiger

    2010-01-01

    Scientific expertise suggests that mitigating extreme world-wide climate change damages requires avoiding increases in the world mean temperature exceeding 2 degrees Celsius. To achieve the two degree target, the cumulated global emissions must not exceed some limit, the so-called global carbon budget. In a two-period two country general equilibrium model with a finite stock of fossil fuels we compare the cooperative cost-effective policy with the unilateral cost-effective policy of restricti...

  11. Cost-effectiveness analysis and innovation.

    Science.gov (United States)

    Jena, Anupam B; Philipson, Tomas J

    2008-09-01

    While cost-effectiveness (CE) analysis has provided a guide to allocating often scarce resources spent on medical technologies, less emphasis has been placed on the effect of such criteria on the behavior of innovators who make health care technologies available in the first place. A better understanding of the link between innovation and cost-effectiveness analysis is particularly important given the large role of technological change in the growth in health care spending and the growing interest of explicit use of CE thresholds in leading technology adoption in several Westernized countries. We analyze CE analysis in a standard market context, and stress that a technology's cost-effectiveness is closely related to the consumer surplus it generates. Improved CE therefore often clashes with interventions to stimulate producer surplus, such as patents. We derive the inconsistency between technology adoption based on CE analysis and economic efficiency. Indeed, static efficiency, dynamic efficiency, and improved patient health may all be induced by the cost-effectiveness of the technology being at its worst level. As producer appropriation of the social surplus of an innovation is central to the dynamic efficiency that should guide CE adoption criteria, we exemplify how appropriation can be inferred from existing CE estimates. For an illustrative sample of technologies considered, we find that the median technology has an appropriation of about 15%. To the extent that such incentives are deemed either too low or too high compared to dynamically efficient levels, CE thresholds may be appropriately raised or lowered to improve dynamic efficiency.

  12. Gedanken Experiments in Educational Cost Effectiveness

    Science.gov (United States)

    Brudner, Harvey J.

    1978-01-01

    Discusses the effectiveness of cost determining techniques in education. The areas discussed are: education and management; cost-effectiveness models; figures of merit determination; and the implications as they relate to the areas of audio-visual and computer educational technology. (Author/GA)

  13. Cost-effectiveness of colorectal cancer screening

    NARCIS (Netherlands)

    I. Lansdorp-Vogelaar (Iris); A.B. Knudsen (Amy); H. Brenner (Hermann)

    2011-01-01

    textabstractColorectal cancer is an important public health problem. Several screening methods have been shown to be effective in reducing colorectal cancer mortality. The objective of this review was to assess the cost-effectiveness of the different colorectal cancer screening methods and to

  14. The Interpersonal Sunk-Cost Effect.

    Science.gov (United States)

    Olivola, Christopher Y

    2018-05-01

    The sunk-cost fallacy-pursuing an inferior alternative merely because we have previously invested significant, but nonrecoverable, resources in it-represents a striking violation of rational decision making. Whereas theoretical accounts and empirical examinations of the sunk-cost effect have generally been based on the assumption that it is a purely intrapersonal phenomenon (i.e., solely driven by one's own past investments), the present research demonstrates that it is also an interpersonal effect (i.e., people will alter their choices in response to other people's past investments). Across eight experiments ( N = 6,076) covering diverse scenarios, I documented sunk-cost effects when the costs are borne by someone other than the decision maker. Moreover, the interpersonal sunk-cost effect is not moderated by social closeness or whether other people observe their sunk costs being "honored." These findings uncover a previously undocumented bias, reveal that the sunk-cost effect is a much broader phenomenon than previously thought, and pose interesting challenges for existing accounts of this fascinating human tendency.

  15. [Cost-effectiveness of addiction care].

    Science.gov (United States)

    Suijkerbuijk, A W M; van Gils, P F; Greeven, P G J; de Wit, G A

    2015-01-01

    A large number of interventions are available for the treatment of addiction. Professionals need to know about the effectiveness and cost-effectiveness of interventions so they can prioritise appropriate interventions for the treatment of addiction. To provide an overview of the scientific literature on the cost-effectiveness of addiction treatment for alcohol- and drug-abusers. We searched the databases Medline and Centre for Reviews and Dissemination. To be relevant for our study, articles had to focus on interventions in the health-care setting, have a Western context and have a health-related outcome measure such as quality adjusted life years (QALY). Twenty-nine studies met our inclusion criteria: 15 for alcohol and 14 for drugs. The studies on alcohol addiction related mainly to brief interventions. They proved to be cost-saving or had a favourable incremental cost-effectiveness ratio (ICER), remaining below the threshold of € 20,000 per QALY. The studies on drug addiction all involved pharmacotherapeutic interventions. In the case of 10 out of 14 interventions, the ICER was less than € 20,000 per QALY. Almost all of the interventions studied were cost-saving or cost-effective. Many studies consider only health-care costs. Additional research, for instance using a social cost-benefit analysis, could provide more details about the costs of addiction and about the impact that an intervention could have in these/the costs.

  16. Making choices in health: WHO guide to cost effectiveness analysis

    National Research Council Canada - National Science Library

    Tan Torres Edejer, Tessa

    2003-01-01

    ... . . . . . . . . . . . . . . . . . . . . . . . XXI PART ONE: METHODS COST-EFFECTIVENESS FOR GENERALIZED ANALYSIS 1. 2. What is Generalized Cost-Effectiveness Analysis? . . . . . . . . . . . . 3 Undertaking...

  17. Global warming and urban smog: The cost effectiveness of CAFE standards and alternative fuels

    International Nuclear Information System (INIS)

    Krupnick, A.J.; Walls, M.A.; Collins, C.T.

    1992-01-01

    This paper evaluates alternative transportation policies for reducing greenhouse gas emissions and ozone precursors. The net cost-effectiveness -- i.e., the cost per ton of greenhouse gas reduced, adjusted for ozone reduction benefits -- of substituting methanol, compressed natural gas (CNG), and reformulated gasoline for conventional gasoline is assessed and compared with the cost-effectiveness of raising the corporate average fuel economy (CAFE) standard to 38 miles per gallon. Computing this open-quotes netclose quotes cost-effectiveness is one way of measuring the joint environmental benefits that these alternatives provide. Greenhouse gas emissions are assessed over the entire fuel cycle and include not only carbon dioxide emissions, but also methane, carbon monoxide, and nitrous oxide emissions. In computing cost-effectiveness, we account for the so-called open-quotes rebound effectclose quotes -- the impact on vehicle-miles traveled of higher or lower fuel costs. CNG is found to be the most cost-effective of these alternatives, followed by increasing the CAFE standard, substituting methanol for gasoline, and substituting reformulated for conventional gasoline. Including the ozone reduction benefits does not change the rankings of the alternatives, but does make the alternative fuels look better relative to increasing the CAFE standard. Incorporating the rebound effect greatly changes the magnitude of the estimates but does not change the rankings of the alternatives. None of the alternatives look cost-effective should a carbon tax of $35 per ton be passes (the proposal in the Stark bill, H.R. 1086), and only CNG under optimistic assumptions looks cost-effective if a tax of $100 per ton of carbon is passed

  18. Cost-effectiveness of tubal patency tests.

    Science.gov (United States)

    Verhoeve, H R; Moolenaar, L M; Hompes, P; van der Veen, F; Mol, B W J

    2013-04-01

    Guidelines are not in agreement on the most effective diagnostic scenario for tubal patency testing; therefore, we evaluated the cost-effectiveness of invasive tubal testing in subfertile couples compared with no testing and treatment. Cost-effectiveness analysis. Decision analytic framework. Computer-simulated cohort of subfertile women. We evaluated six scenarios: (1) no tests and no treatment; (2) immediate treatment without tubal testing; (3) delayed treatment without tubal testing; (4) hysterosalpingogram (HSG), followed by immediate or delayed treatment, according to diagnosis (tailored treatment); (5) HSG and a diagnostic laparoscopy (DL) in case HSG does not prove tubal patency, followed by tailored treatment; and (6) DL followed by tailored treatment. Expected cumulative live births after 3 years. Secondary outcomes were cost per couple and the incremental cost-effectiveness ratio. For a 30-year-old woman with otherwise unexplained subfertility for 12 months, 3-year cumulative live birth rates were 51.8, 78.1, 78.4, 78.4, 78.6 and 78.4%, and costs per couple were €0, €6968, €5063, €5410, €5405 and €6163 for scenarios 1, 2, 3, 4, 5 and 6, respectively. The incremental cost-effectiveness ratios compared with scenario 1 (reference strategy), were €26,541, €19,046, €20,372, €20,150 and €23,184 for scenarios 2, 3, 4, 5 and 6, respectively. Sensitivity analysis showed the model to be robust over a wide range of values for the variables. The most cost-effective scenario is to perform no diagnostic tubal tests and to delay in vitro fertilisation (IVF) treatment for at least 12 months for women younger than 38 years old, and to perform no tubal tests and start immediate IVF treatment from the age of 39 years. If an invasive diagnostic test is planned, HSG followed by tailored treatment, or a DL if HSG shows no tubal patency, is more cost-effective than DL. © 2013 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2013

  19. Cost-effectiveness of the fenceline cow

    Energy Technology Data Exchange (ETDEWEB)

    Eichholz, G G; Lando, A V [Georgia Inst. of Tech., Atlanta (USA). School of Nuclear Engineering

    1979-07-01

    The grass-cow-milk pathway for /sup 131/I is one of the main contributers to estimated population dose from BWR's and PWR's. Such estimates assume a cow at the fenceline grazing for 12 months of the year. Reductions in the population dose would require a trade-off, based on cost-effectiveness criteria, between additions to the effluent treatment system, expanding the exclusion area, or raising the stack height. It is suggested that a more practical and more cost-effective means may be provided by redistribution of nearby dairy cattle (or goats), and that the plant operator buy these animals and/or contract with the land owner(s) to use the land for alternative crops. Even a subsidy to compensate the farmer for any financial losses entailed in these changes might be less expensive than alternative technical installations to lower iodine effluent levels. Figures are provided to illustrate these points.

  20. Cost-effectiveness of monitoring free flaps.

    Science.gov (United States)

    Subramaniam, Shiva; Sharp, David; Jardim, Christopher; Batstone, Martin D

    2016-06-01

    Methods of free flap monitoring have become more sophisticated and expensive. This study aims to determine the cost of free flap monitoring and examine its cost effectiveness. We examined a group of patients who had had free flaps to the head and neck over a two-year period, and combined these results with costs obtained from business managers and staff. There were 132 free flaps with a success rate of 99%. The cost of monitoring was Aus $193/flap. Clinical monitoring during this time period cost Aus$25 476 and did not lead to the salvage of any free flaps. Cost equivalence is reached between monitoring and not monitoring only at a failure rate of 15.8%. This is to our knowledge the first study to calculate the cost of clinical monitoring of free flaps, and to examine its cost-effectiveness. Copyright © 2016 The British Association of Oral and Maxillofacial Surgeons. All rights reserved.

  1. Making choices in health: WHO guide to cost effectiveness analysis

    National Research Council Canada - National Science Library

    Tan Torres Edejer, Tessa

    2003-01-01

    ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67 6. Uncertainty in cost-effectiveness analysis . . . . . . . . . . . . . . . . . . 73 7. 8. Policy uses of Generalized CEA...

  2. Cost-effectiveness Analysis with Influence Diagrams.

    Science.gov (United States)

    Arias, M; Díez, F J

    2015-01-01

    Cost-effectiveness analysis (CEA) is used increasingly in medicine to determine whether the health benefit of an intervention is worth the economic cost. Decision trees, the standard decision modeling technique for non-temporal domains, can only perform CEA for very small problems. To develop a method for CEA in problems involving several dozen variables. We explain how to build influence diagrams (IDs) that explicitly represent cost and effectiveness. We propose an algorithm for evaluating cost-effectiveness IDs directly, i.e., without expanding an equivalent decision tree. The evaluation of an ID returns a set of intervals for the willingness to pay - separated by cost-effectiveness thresholds - and, for each interval, the cost, the effectiveness, and the optimal intervention. The algorithm that evaluates the ID directly is in general much more efficient than the brute-force method, which is in turn more efficient than the expansion of an equivalent decision tree. Using OpenMarkov, an open-source software tool that implements this algorithm, we have been able to perform CEAs on several IDs whose equivalent decision trees contain millions of branches. IDs can perform CEA on large problems that cannot be analyzed with decision trees.

  3. Cost-effectiveness Analysis for Technology Acquisition.

    Science.gov (United States)

    Chakravarty, A; Naware, S S

    2008-01-01

    In a developing country with limited resources, it is important to utilize the total cost visibility approach over the entire life-cycle of the technology and then analyse alternative options for acquiring technology. The present study analysed cost-effectiveness of an "In-house" magnetic resonance imaging (MRI) scan facility of a large service hospital against outsourcing possibilities. Cost per unit scan was calculated by operating costing method and break-even volume was calculated. Then life-cycle cost analysis was performed to enable total cost visibility of the MRI scan in both "In-house" and "outsourcing of facility" configuration. Finally, cost-effectiveness analysis was performed to identify the more acceptable decision option. Total cost for performing unit MRI scan was found to be Rs 3,875 for scans without contrast and Rs 4,129 with contrast. On life-cycle cost analysis, net present value (NPV) of the "In-house" configuration was found to be Rs-(4,09,06,265) while that of "outsourcing of facility" configuration was Rs-(5,70,23,315). Subsequently, cost-effectiveness analysis across eight Figures of Merit showed the "In-house" facility to be the more acceptable option for the system. Every decision for acquiring high-end technology must be subjected to life-cycle cost analysis.

  4. Cost effectiveness of surveillance for GI cancers.

    Science.gov (United States)

    Omidvari, Amir-Houshang; Meester, Reinier G S; Lansdorp-Vogelaar, Iris

    2016-12-01

    Gastrointestinal (GI) diseases are among the leading causes of death in the world. To reduce the burden of GI diseases, surveillance is recommended for some diseases, including for patients with inflammatory bowel diseases, Barrett's oesophagus, precancerous gastric lesions, colorectal adenoma, and pancreatic neoplasms. This review aims to provide an overview of the evidence on cost-effectiveness of surveillance of individuals with GI conditions predisposing them to cancer, specifically focussing on the aforementioned conditions. We searched the literature and reviewed 21 studies. Despite heterogeneity of studies in terms of settings, study populations, surveillance strategies and outcomes, most reviewed studies suggested at least some surveillance of patients with these GI conditions to be cost-effective. For some high-risk conditions frequent surveillance with 3-month intervals was warranted, while for other conditions, surveillance may only be cost-effective every 10 years. Further studies based on more robust effectiveness evidence are needed to inform and optimise surveillance programmes for GI cancers. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. Is expanding Medicare coverage cost-effective?

    Directory of Open Access Journals (Sweden)

    Muennig Peter

    2005-03-01

    Full Text Available Abstract Background Proposals to expand Medicare coverage tend to be expensive, but the value of services purchased is not known. This study evaluates the efficiency of the average private supplemental insurance plan for Medicare recipients. Methods Data from the National Health Interview Survey, the National Death Index, and the Medical Expenditure Panel Survey were analyzed to estimate the costs, changes in life expectancy, and health-related quality of life gains associated with providing private supplemental insurance coverage for Medicare beneficiaries. Model inputs included socio-demographic, health, and health behavior characteristics. Parameter estimates from regression models were used to predict quality-adjusted life years (QALYs and costs associated with private supplemental insurance relative to Medicare only. Markov decision analysis modeling was then employed to calculate incremental cost-effectiveness ratios. Results Medicare supplemental insurance is associated with increased health care utilization, but the additional costs associated with this utilization are offset by gains in quality-adjusted life expectancy. The incremental cost-effectiveness of private supplemental insurance is approximately $24,000 per QALY gained relative to Medicare alone. Conclusion Supplemental insurance for Medicare beneficiaries is a good value, with an incremental cost-effectiveness ratio comparable to medical interventions commonly deemed worthwhile.

  6. Cost-effective framework for basic surgical skills training.

    Science.gov (United States)

    Jiang, Deng-Jin; Wen, Chan; Yang, Ai-Jun; Zhu, Zhi-Li; Lei, Yan; Lan, Yang-Jun; Huang, Qing-Yuan; Hou, Xiao-Yu

    2013-06-01

    The importance of basic surgical skills is entirely agreed among surgical educators. However, restricted by ethical issues, finance etc, the basic surgical skills training is increasingly challenged. Increasing cost gives an impetus to the development of cost-effective training models to meet the trainees' acquisition of basic surgical skills. In this situation, a cost-effective training framework was formed in our department and introduced here. Each five students were assigned to a 'training unit'. The training was implemented weekly for 18 weeks. The framework consisted of an early, a transitional, an integrative stage and a surgical skills competition. Corresponding training modules were selected and assembled scientifically at each stage. The modules comprised campus intranet databases, sponge benchtop, nonliving animal tissue, local dissection specimens and simulating reality operations. The training outcomes used direct observation of procedural skills as an assessment tool. The training data of 50 trainees who were randomly selected in each year from 2006 to 2011 year, were retrospectively analysed. An excellent and good rate of the surgical skills is from 82 to 88%, but there is no significant difference among 6 years (P > 0.05). The skills scores of the contestants are markedly higher than those of non-contestants (P < 0.05). The average training cost per trainee is about $21.85-34.08. The present training framework is reliable, feasible, repeatable and cost-effective. The skills competition can promote to improve the surgical skills level of trainees. © 2012 The Authors. ANZ Journal of Surgery © 2012 Royal Australasian College of Surgeons.

  7. [Incremental cost effectiveness of multifocal cataract surgery].

    Science.gov (United States)

    Pagel, N; Dick, H B; Krummenauer, F

    2007-02-01

    Supplementation of cataract patients with multifocal intraocular lenses involves an additional financial investment when compared to the corresponding monofocal supplementation, which usually is not funded by German health care insurers. In the context of recent resource allocation discussions, however, the cost effectiveness of multifocal cataract surgery could become an important rationale. Therefore an evidence-based estimation of its cost effectiveness was carried out. Three independent meta-analyses were implemented to estimate the gain in uncorrected near visual acuity and best corrected visual acuity (vision lines) as well as the predictability (fraction of patients without need for reading aids) of multifocal supplementation. Study reports published between 1995 and 2004 (English or German language) were screened for appropriate key words. Meta effects in visual gain and predictability were estimated by means and standard deviations of the reported effect measures. Cost data were estimated by German DRG rates and individual lens costs; the cost effectiveness of multifocal cataract surgery was then computed in terms of its marginal cost effectiveness ratio (MCER) for each clinical benefit endpoint; the incremental costs of multifocal versus monofocal cataract surgery were further estimated by means of their respective incremental cost effectiveness ratio (ICER). An independent meta-analysis estimated the complication profiles to be expected after monofocal and multifocal cataract surgery in order to evaluate expectable complication-associated additional costs of both procedures; the marginal and incremental cost effectiveness estimates were adjusted accordingly. A sensitivity analysis comprised cost variations of +/- 10 % and utility variations alongside the meta effect estimate's 95 % confidence intervals. Total direct costs from the health care insurer's perspective were estimated 3363 euro, associated with a visual meta benefit in best corrected visual

  8. Carbon footprint and cost-effectiveness of cataract surgery.

    Science.gov (United States)

    Venkatesh, Rengaraj; van Landingham, Suzanne W; Khodifad, Ashish M; Haripriya, Aravind; Thiel, Cassandra L; Ramulu, Pradeep; Robin, Alan L

    2016-01-01

    This article raises awareness about the cost-effectiveness and carbon footprint of various cataract surgery techniques, comparing their relative carbon emissions and expenses: manual small-incision cataract surgery (MSICS), phacoemulsification, and femtosecond laser-assisted cataract surgery. As the most commonly performed surgical procedure worldwide, cataract surgery contributes significantly to global climate change. The carbon footprint of a single phacoemulsification cataract surgery is estimated to be comparable to that of a typical person's life for 1 week. Phacoemulsification has been estimated to be between 1.4 and 4.7 times more expensive than MSICS; however, given the lower degree of postoperative astigmatism and other potential complications, phacoemulsification may still be preferable to MSICS in relatively resource-rich settings requiring high levels of visual function. Limited data are currently available regarding the environmental and financial impact of femtosecond laser-assisted cataract surgery; however, in its current form, it appears to be the least cost-effective option. Cataract surgery has a high value to patients. The relative environmental impact and cost of different types of cataract surgery should be considered as this treatment becomes even more broadly available globally and as new technologies are developed and implemented.

  9. Cost effective material control and accountability training

    International Nuclear Information System (INIS)

    Robichaux, J.J.; Shull, L.M.; Salizzoni, L.M.

    1995-01-01

    DOE Order 5630.15, ''Safeguards and Security Training Program'' is being implemented at the Savannah River Site within the Westinghouse Savannah River Company's material control and accountability program. This paper reviews the development of a material control and accountability task analysis, the development of specific material control and accountability courses, and the cost effective and innovative strategies employed to implement the training program. The paper also discusses how the site material control and accountability policies and procedures are incorporated into the Westinghouse Savannah River Company training program to ensure that personnel receive the most current information

  10. Cost benefit analysis cost effectiveness analysis

    International Nuclear Information System (INIS)

    Lombard, J.

    1986-09-01

    The comparison of various protection options in order to determine which is the best compromise between cost of protection and residual risk is the purpose of the ALARA procedure. The use of decision-aiding techniques is valuable as an aid to selection procedures. The purpose of this study is to introduce two rather simple and well known decision aiding techniques: the cost-effectiveness analysis and the cost-benefit analysis. These two techniques are relevant for the great part of ALARA decisions which need the use of a quantitative technique. The study is based on an hypothetical case of 10 protection options. Four methods are applied to the data

  11. The potential of urban tree plantings to be cost effective in carbon credit markets

    Science.gov (United States)

    M.R. McHale; E.G. McPherson; I.C. Burke

    2007-01-01

    Emission trading is considered to be an economically sensitive method for reducing the concentrations of greenhouse gases, particularly carbon dioxide, in the atmosphere. There has been debate about the viability of using urban tree plantings in these markets. The main concern is whether or not urban planting projects can be cost effective options for investors. We...

  12. Global warming and urban smog: Cost-effectiveness of CAFE standards and alternative fuels

    International Nuclear Information System (INIS)

    Krupnick, A.J.; Walls, M.A.; Collins, C.T.

    1993-01-01

    In this paper we estimate the cost-effectiveness, in terms of reducing greenhouse gas emissions, of increasing the corporate average fuel economy (CAFE) standard to 38 miles per gallon and substituting methanol, compressed natural gas (CNG), and reformulated gasoline for conventional gasoline. Greenhouse gas emissions are assessed over the entire fuel cycle and include carbon dioxide, methane, carbon monoxide, and nitrous oxide emissions. To account for joint environmental benefits, the cost per ton of greenhouse gas reduced is adjusted for reductions in volatile organic compound (VOC) emissions, an ozone precursor. CNG is found to be the most cost-effective of these alternatives, followed by increasing the CAFE standard, substituting methanol for gasoline, and substituting reformulated for conventional gasoline. Including the VOC benefits does not change the ranking of the alternatives, but does make the alternative fuels look better relative to increasing the CAFE standard. None of the alternatives look cost-effective should a carbon tax of $35 per ton be passed, and only CNG under optimistic assumptions looks cost-effective with a tax of $100 per ton of carbon. 35 refs., 4 figs., 6 tabs

  13. UK's climate change levy: cost effectiveness, competitiveness and environmental impacts

    International Nuclear Information System (INIS)

    Varma, Adarsh

    2003-01-01

    This paper intends to examine the cost effectiveness of UK's climate change levy (CCL), its implications on competitiveness of firms and the environmental impact. The paper briefly describes the levy and analyses it under the cannons of a good taxation policy. The economic implications of the levy are discussed with theoretical and empirical perspectives. Change in net exports, investment patterns and productivity and inclusion of compliance cost forms the basis for analysing the effect on competitiveness. It discusses the options available to firms to safeguard their competitiveness if it is adversely affected by the CCL. A description of the current scenario of the levy since its inception is also presented. The paper argues the need for a comprehensive policy involving the use of standards, emission trading as well as energy taxes to achieve emission and energy-use reductions. A focal point of this paper is to elucidate the pros and cons of the CCL (energy tax) with respect to an emission trading scheme

  14. A cost-effective climastrategy; En omkostningseffektiv klimastrategi

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2003-02-01

    As a consequence of the 1997 Kyoto Protocol and the subsequent 1998 EU Burden Sharing Agreement, Denmark is committed to reducing its average annual greenhouse gas emissions in the period 2008-2012 by 21% in relation to the basis year, 1990. Excess emissions in relation to the reduction commitments are expected to be 25 million tonnes CO{sub 2} equivalents per year, corresponding to approximately 30% of expected emissions in the period 2008-2012, if calculations are based on Denmark's legal commitment under the EU Burden Sharing Agreement, which is significantly more than previously estimated. The legal commitment is based on figures not corrected for the especially large import of electricity in the basis year, 1990. At the Council meeting in connection with ratification of the Kyoto Protocol on 4 March 2002, Denmark did however achieve agreement on a political declaration. According to the declaration, Denmark's claim for adjusted electricity imports for the basis year, 1990, will be considered when individual Member State reductions in tonnes are finally determined in 2006. If the claimed correction is fully taken account of, Danish excess emissions will be reduced by 5 million tonnes CO{sub 2} equivalents per year. Flexible mechanisms, i.e. trading in the so-called credits from CO{sub 2} reduction projects in developing countries and in Central and Eastern Europe as well as trading in CO{sub 2} quotas, may contribute to fulfilling Denmark's reduction commitments. This reflects the fact that greenhouse gas emissions are a global problem that must be solved by ensuring the most cost-effective reduction at global level. Furthermore, flexible mechanisms can contribute to developing the countries in question through the transfer of know-how and capital. (ba)

  15. On cost-effective communication network designing

    Science.gov (United States)

    Zhang, Guo-Qiang

    2010-02-01

    How to efficiently design a communication network is a paramount task for network designing and engineering. It is, however, not a single objective optimization process as perceived by most previous researches, i.e., to maximize its transmission capacity, but a multi-objective optimization process, with lowering its cost to be another important objective. These two objectives are often contradictive in that optimizing one objective may deteriorate the other. After a deep investigation of the impact that network topology, node capability scheme and routing algorithm as well as their interplays have on the two objectives, this letter presents a systematic approach to achieve a cost-effective design by carefully choosing the three designing aspects. Only when routing algorithm and node capability scheme are elegantly chosen can BA-like scale-free networks have the potential of achieving good tradeoff between the two objectives. Random networks, on the other hand, have the built-in character for a cost-effective design, especially when other aspects cannot be determined beforehand.

  16. Clinical evaluation based on cost-effectiveness

    International Nuclear Information System (INIS)

    Inoue, Takehiro; Inoue, Toshihiko

    1998-01-01

    We carried out two Phase III clinical trials using high dose rate (HDR) remote afterloading brachytherapy unit. We evaluated the clinical results based not only on the medical but also the economical standpoint. The first trial is the Phase III trial for cervical cancer treated with HDR or medium dose rate (MDR) intracavitary radiotherapy. The second one is the Phase III trial for tongue cancer treated with HDR or low dose rate (LDR) interstitial radiation. For cervical cancer, the survival rate of patients treated with HDR brachytherapy is the some as for LDR brachytherapy. The average total cost of treatment for the HDR group was 1.47 million yen, while that for the MDR group was 1.58 million yen. The average total admission days was 63. For tongue cancer, the local control rate of the HDR group is almost the same as that of the LDR groups. The average total cost for the HDR group was 780 thousand yen, and that for the LDR group was 830 thousand yen. The average total admission days was 34. According to the cost-effectiveness, HDR brachytherapy for cervical cancer has the same result as MDR, and HDR brachytherapy for tongue cancer has the same result as LDR. However, HDR can be treated without admission for patients who live near the hospital. HDR can be applied for these patients with less expense. We must be aware of not only the medical results but also the cost-effectiveness. (author)

  17. Deregulation and Nuclear Training: Cost Effective Alternatives

    International Nuclear Information System (INIS)

    Richard P. Coe; Patricia A. Lake

    2000-01-01

    Training is crucial to the success of any organization. It is also expensive, with some estimates exceeding $50 billion annually spent on training by U.S. corporations. Nuclear training, like that of many other highly technical organizations, is both crucial and costly. It is unlikely that the amount of training can be significantly reduced. If anything, current trends indicate that training needs will probably increase as the industry and workforce ages and changes. With the advent of energy deregulation in the United States, greater pressures will surface to make the costs of energy more cost-competitive. This in turn will drive businesses to more closely examine existing costs and find ways to do things in a more cost-effective way. The commercial nuclear industry will be no exception, and nuclear training will be equally affected. It is time for nuclear training and indeed the entire nuclear industry to begin using more aggressive techniques to reduce costs. This includes the need for nuclear training to find alternatives to traditional methods for the delivery of cost-effective high-quality training that meets regulatory requirements and produces well-qualified personnel capable of working in an efficient and safe manner. Computer-based and/or Web-based training are leading emerging technologies

  18. Cost-Effective Fuel Treatment Planning

    Science.gov (United States)

    Kreitler, J.; Thompson, M.; Vaillant, N.

    2014-12-01

    The cost of fighting large wildland fires in the western United States has grown dramatically over the past decade. This trend will likely continue with growth of the WUI into fire prone ecosystems, dangerous fuel conditions from decades of fire suppression, and a potentially increasing effect from prolonged drought and climate change. Fuel treatments are often considered the primary pre-fire mechanism to reduce the exposure of values at risk to wildland fire, and a growing suite of fire models and tools are employed to prioritize where treatments could mitigate wildland fire damages. Assessments using the likelihood and consequence of fire are critical because funds are insufficient to reduce risk on all lands needing treatment, therefore prioritization is required to maximize the effectiveness of fuel treatment budgets. Cost-effectiveness, doing the most good per dollar, would seem to be an important fuel treatment metric, yet studies or plans that prioritize fuel treatments using costs or cost-effectiveness measures are absent from the literature. Therefore, to explore the effect of using costs in fuel treatment planning we test four prioritization algorithms designed to reduce risk in a case study examining fuel treatments on the Sisters Ranger District of central Oregon. For benefits we model sediment retention and standing biomass, and measure the effectiveness of each algorithm by comparing the differences among treatment and no treat alternative scenarios. Our objective is to maximize the averted loss of net benefits subject to a representative fuel treatment budget. We model costs across the study landscape using the My Fuel Treatment Planner software, tree list data, local mill prices, and GIS-measured site characteristics. We use fire simulations to generate burn probabilities, and estimate fire intensity as conditional flame length at each pixel. Two prioritization algorithms target treatments based on cost-effectiveness and show improvements over those

  19. Advanced air staging techniques to improve fuel flexibility, reliability and emissions in fluidized bed co-combustion

    Energy Technology Data Exchange (ETDEWEB)

    Aamand, Lars-Erik; Leckner, Bo [Chalmers Technical Univ., Goeteborg (Sweden); Luecke, Karsten; Werther, Joachim [Technical Univ. of Hamburg-Harburg (Germany)

    2001-12-01

    A joint research project between the Technical University of Hamburg-Harburg and Chalmers Technical University. For operation under co-combustion the following results should be considered: The high ash content of the sewage sludge results in significantly increased ash flows. Although high alkali metal concentrations are found in the sewage sludge ash, no critical concentrations were reached and tendencies to fouling were not observed. The trace metal input rises with increased sludge fraction. However, emissions of metal compounds were well below legal limits. The trace metals tend to accumulate on the fly ash. In general, very low fuel nitrogen conversions to NO and N{sub 2}O of 2 - 4 % are achievable. With coal as a base fuel alternative air staging with secondary air supply after solids separation attains even lower NO emissions than normal staging without strongly affecting CO and SO{sub 2} emissions. Alternative staging also reduces N{sub 2}O emissions. An optimum for the excess air ratio in the riser of 1.05 was found for a total excess air ratio of 1.2. The higher the volatile content of the fuel is, the less effective the NO reduction due to air staging becomes. The measurements suggest that the optimum gas residence time regarding the emissions in CFB combustors is around 6 to 7 s. These times are achieved in commercial scale plants due to their large cyclones that perhaps partly can replace a large afterburner chamber. The circulating fluidized bed boiler can be operated in a very flexible way with various fuel mixtures up to an energy fraction of sludge of 25% without exceeding legal emission limits.

  20. Some Observations on Cost-Effectiveness Analysis in Education.

    Science.gov (United States)

    Geske, Terry G.

    1979-01-01

    The general nature of cost-effectiveness analysis is discussed, analytical frameworks for conducting cost-effectiveness studies are described, and some of the problems inherent in measuring educational costs and in assessing program effectiveness are addressed. (Author/IRT)

  1. OPCAB surgery is cost-effective for elderly patients

    DEFF Research Database (Denmark)

    Houlind, Kim Christian; Kjeldsen, Bo Juul; Madsen, Susanne Nørgaard

    2013-01-01

    To determine the cost-effective operative strategy for coronary artery bypass surgery in patients above 70 years.......To determine the cost-effective operative strategy for coronary artery bypass surgery in patients above 70 years....

  2. Understanding Cost-Effectiveness of Energy Efficiency Programs

    Science.gov (United States)

    Discusses the five standard tests used to assess the cost-effectiveness of energy efficiency, how states are using these tests, and how the tests can be used to determine the cost-effectiveness of energy efficiency measures.

  3. Design And Implementation Of Cost Effective Inverter

    Directory of Open Access Journals (Sweden)

    Niaz Morshedul Haque

    2017-10-01

    Full Text Available This paper deals with the design and construct of a 100 Watt 220 Volt and 50 Hz Inverter. The system is designed without any microcontroller and it has a cost-effective design architecture. The elementary purpose of this device is to transmute 12 V DC to 220 V AC. Snubber technology is used to diminish the reverse potential transients and excessive heat of transformer winding and transistor switches. Switching pulse generated by NE 555 timer circuit and comparator circuit was used to take signal strength input from its rear as well as from both sides for triggering the MOSFET switches. Another switch is used to invert pulse between two switching circuitries. A 5 volts regulator IC 7805 was used to supply fixed 5V for biasing the switching and amplifying circuitry.

  4. Cost-effective implementation of intelligent systems

    Science.gov (United States)

    Lum, Henry, Jr.; Heer, Ewald

    1990-01-01

    Significant advances have occurred during the last decade in knowledge-based engineering research and knowledge-based system (KBS) demonstrations and evaluations using integrated intelligent system technologies. Performance and simulation data obtained to date in real-time operational environments suggest that cost-effective utilization of intelligent system technologies can be realized. In this paper the rationale and potential benefits for typical examples of application projects that demonstrate an increase in productivity through the use of intelligent system technologies are discussed. These demonstration projects have provided an insight into additional technology needs and cultural barriers which are currently impeding the transition of the technology into operational environments. Proposed methods which addresses technology evolution and implementation are also discussed.

  5. Cost effective waste management through composting in Africa

    Energy Technology Data Exchange (ETDEWEB)

    Couth, R. [CRECHE, Centre for Environmental, Coastal and Hydrological Engineering, Civil Engineering Programme, School of Engineering, University of KwaZulu-Natal, Durban 4041 (South Africa); Trois, C., E-mail: troisc@ukzn.ac.za [CRECHE, Centre for Environmental, Coastal and Hydrological Engineering, Civil Engineering Programme, School of Engineering, University of KwaZulu-Natal, Durban 4041 (South Africa)

    2012-12-15

    Highlights: Black-Right-Pointing-Pointer The financial/social/institutional sustainability of waste management in Africa is analysed. Black-Right-Pointing-Pointer This note is a compendium of a study on the potential for GHG control via improved zero waste in Africa. Black-Right-Pointing-Pointer This study provides the framework for Local Authorities for realizing sustained GHG reductions. - Abstract: Greenhouse gas (GHG) emissions per person from urban waste management activities are greater in sub-Saharan African countries than in other developing countries, and are increasing as the population becomes more urbanised. Waste from urban areas across Africa is essentially dumped on the ground and there is little control over the resulting gas emissions. The clean development mechanism (CDM), from the 1997 Kyoto Protocol has been the vehicle to initiate projects to control GHG emissions in Africa. However, very few of these projects have been implemented and properly registered. A much more efficient and cost effective way to control GHG emissions from waste is to stabilise the waste via composting and to use the composted material as a soil improver/organic fertiliser or as a component of growing media. Compost can be produced by open windrow or in-vessel composting plants. This paper shows that passively aerated open windrows constitute an appropriate low-cost option for African countries. However, to provide an usable compost material it is recommended that waste is processed through a materials recovery facility (MRF) before being composted. The paper demonstrates that material and biological treatment (MBT) are viable in Africa where they are funded, e.g. CDM. However, they are unlikely to be instigated unless there is a replacement to the Kyoto Protocol, which ceases for Registration in December 2012.

  6. Cost effective waste management through composting in Africa

    International Nuclear Information System (INIS)

    Couth, R.; Trois, C.

    2012-01-01

    Highlights: ► The financial/social/institutional sustainability of waste management in Africa is analysed. ► This note is a compendium of a study on the potential for GHG control via improved zero waste in Africa. ► This study provides the framework for Local Authorities for realizing sustained GHG reductions. - Abstract: Greenhouse gas (GHG) emissions per person from urban waste management activities are greater in sub-Saharan African countries than in other developing countries, and are increasing as the population becomes more urbanised. Waste from urban areas across Africa is essentially dumped on the ground and there is little control over the resulting gas emissions. The clean development mechanism (CDM), from the 1997 Kyoto Protocol has been the vehicle to initiate projects to control GHG emissions in Africa. However, very few of these projects have been implemented and properly registered. A much more efficient and cost effective way to control GHG emissions from waste is to stabilise the waste via composting and to use the composted material as a soil improver/organic fertiliser or as a component of growing media. Compost can be produced by open windrow or in-vessel composting plants. This paper shows that passively aerated open windrows constitute an appropriate low-cost option for African countries. However, to provide an usable compost material it is recommended that waste is processed through a materials recovery facility (MRF) before being composted. The paper demonstrates that material and biological treatment (MBT) are viable in Africa where they are funded, e.g. CDM. However, they are unlikely to be instigated unless there is a replacement to the Kyoto Protocol, which ceases for Registration in December 2012.

  7. 10 CFR 455.63 - Cost-effectiveness testing.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 3 2010-01-01 2010-01-01 false Cost-effectiveness testing. 455.63 Section 455.63 Energy..., Hospitals, Units of Local Government, and Public Care Institutions § 455.63 Cost-effectiveness testing. (a... paragraph (a) of this section, if the State plan requires the cost effectiveness of an energy conservation...

  8. 10 CFR 436.18 - Measuring cost-effectiveness.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 3 2010-01-01 2010-01-01 false Measuring cost-effectiveness. 436.18 Section 436.18 Energy... Procedures for Life Cycle Cost Analyses § 436.18 Measuring cost-effectiveness. (a) In accordance with this section, each Federal agency shall measure cost-effectiveness by combining cost data established under...

  9. 42 CFR 457.1015 - Cost-effectiveness.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Cost-effectiveness. 457.1015 Section 457.1015... Waivers: General Provisions § 457.1015 Cost-effectiveness. (a) Definition. For purposes of this subpart... may demonstrate cost-effectiveness by comparing the cost of coverage for the family to the cost of...

  10. 49 CFR 639.21 - Determination of cost-effectiveness.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 7 2010-10-01 2010-10-01 false Determination of cost-effectiveness. 639.21... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION CAPITAL LEASES Cost-Effectiveness § 639.21 Determination of cost...-effectiveness comparison as described in this subpart, it may ask FTA to approve an alternate form of cost...

  11. Mercury emissions from flooded soils and sediments in Germany are an underestimated problem: challenges for reliable risk assessments and management strategies

    Directory of Open Access Journals (Sweden)

    Rinklebe J.

    2013-04-01

    Full Text Available Environmental pollution by mercury is a world-wide problem. Particularly floodplain ecosystems are frequently affected. One example is the Elbe River in Germany and its catchment areas; large amounts of Hg from a range of anthropogenic and geogenic sources have been accumulated in the soils of these floodplains. They serve as sink for Hg originating from the surface water of adjacent river. Today, the vastly elevated Hg contents of the floodplain soils at the Elbe River often exceed even the action values of the German Soil Conservation Law. This is especially important as Hg polluted areas at the Elbe River achieve several hundred square kilometres. Thus, authorities are coerced by law to conduct an appropriate risk assessment and to implement practical actions to eliminate or reduce environmental problems. A reliable risk assessment particularly with view to organisms (vegetation as green fodder and hay production, grazing and wild animals to avoid the transfer of Hg into the human food chain, requires an authentic determination of Hg fluxes and their dynamics since gaseous emissions from soil to atmosphere are an important pathway of Hg. However, reliable estimates of Hg fluxes from the highly polluted floodplain soils at the Elbe River and its tributaries, and its influencing factors are scarce. For this purpose, we have developed a new method to determine mercury emissions from soils at various sites. Our objectives were i to quantify seasonal variations of total gaseous mercury (TGM fluxes for floodplain soils at the Elbe River, ii to provide insights into physico-chemical processes regulating these TGM fluxes, and iii to quantify the impacts of the controlling factors soil temperature and soil water content on Hg volatilization from a typical contaminated floodplain soil within soil microcosm experiments under various controlled temperature and moisture conditions. Our study provides insight into TGM emissions from highly Hg

  12. Cost effectiveness of recycling: A systems model

    Energy Technology Data Exchange (ETDEWEB)

    Tonjes, David J., E-mail: david.tonjes@stonybrook.edu [Department of Technology and Society, College of Engineering and Applied Sciences, Stony Brook University, Stony Brook, NY 11794-3560 (United States); Waste Reduction and Management Institute, School of Marine and Atmospheric Sciences, Stony Brook University, Stony Brook, NY 11794-5000 (United States); Center for Bioenergy Research and Development, Advanced Energy Research and Technology Center, Stony Brook University, 1000 Innovation Rd., Stony Brook, NY 11794-6044 (United States); Mallikarjun, Sreekanth, E-mail: sreekanth.mallikarjun@stonybrook.edu [Department of Technology and Society, College of Engineering and Applied Sciences, Stony Brook University, Stony Brook, NY 11794-3560 (United States)

    2013-11-15

    Highlights: • Curbside collection of recyclables reduces overall system costs over a range of conditions. • When avoided costs for recyclables are large, even high collection costs are supported. • When avoided costs for recyclables are not great, there are reduced opportunities for savings. • For common waste compositions, maximizing curbside recyclables collection always saves money. - Abstract: Financial analytical models of waste management systems have often found that recycling costs exceed direct benefits, and in order to economically justify recycling activities, externalities such as household expenses or environmental impacts must be invoked. Certain more empirically based studies have also found that recycling is more expensive than disposal. Other work, both through models and surveys, have found differently. Here we present an empirical systems model, largely drawn from a suburban Long Island municipality. The model accounts for changes in distribution of effort as recycling tonnages displace disposal tonnages, and the seven different cases examined all show that curbside collection programs that manage up to between 31% and 37% of the waste stream should result in overall system savings. These savings accrue partially because of assumed cost differences in tip fees for recyclables and disposed wastes, and also because recycling can result in a more efficient, cost-effective collection program. These results imply that increases in recycling are justifiable due to cost-savings alone, not on more difficult to measure factors that may not impact program budgets.

  13. Cost-effectiveness analysis of microdose clinical trials in drug development.

    Science.gov (United States)

    Yamane, Naoe; Igarashi, Ataru; Kusama, Makiko; Maeda, Kazuya; Ikeda, Toshihiko; Sugiyama, Yuichi

    2013-01-01

    Microdose (MD) clinical trials have been introduced to obtain human pharmacokinetic data early in drug development. Here we assessed the cost-effectiveness of microdose integrated drug development in a hypothetical model, as there was no such quantitative research that weighed the additional effectiveness against the additional time and/or cost. First, we calculated the cost and effectiveness (i.e., success rate) of 3 types of MD integrated drug development strategies: liquid chromatography-tandem mass spectrometry, accelerator mass spectrometry, and positron emission tomography. Then, we analyzed the cost-effectiveness of 9 hypothetical scenarios where 100 drug candidates entering into a non-clinical toxicity study were selected by different methods as the conventional scenario without MD. In the base-case, where 70 drug candidates were selected without MD and 30 selected evenly by one of the three MD methods, incremental cost-effectiveness ratio per one additional drug approved was JPY 12.7 billion (US$ 0.159 billion), whereas the average cost-effectiveness ratio of the conventional strategy was JPY 24.4 billion, which we set as a threshold. Integrating MD in the conventional drug development was cost-effective in this model. This quantitative analytical model which allows various modifications according to each company's conditions, would be helpful for guiding decisions early in clinical development.

  14. The Kyoto Protocol Is Cost-effective

    Directory of Open Access Journals (Sweden)

    Marino Gatto

    2002-06-01

    Full Text Available Despite recent advances, there is a high degree of uncertainty concerning the climate change that would result from increasing atmospheric greenhouse gas concentrations. Also, opponents of the Kyoto Protocol raised the key objection that reducing emissions would impose an unacceptable economic burden on businesses and consumers. Based on an analysis of alternative scenarios for electricity generation in Italy, we show that if the costs in terms of damage to human health, material goods, agriculture, and the environment caused by greenhouse gas emissions are included in the balance, the economic argument against Kyoto is untenable. Most importantly, the argument holds true even if we exclude global external costs (those due to global warming, and account for local external costs only (such as those due to acidic precipitation and lung diseases resulting from air pollution.

  15. Reliability engineering

    International Nuclear Information System (INIS)

    Lee, Chi Woo; Kim, Sun Jin; Lee, Seung Woo; Jeong, Sang Yeong

    1993-08-01

    This book start what is reliability? such as origin of reliability problems, definition of reliability and reliability and use of reliability. It also deals with probability and calculation of reliability, reliability function and failure rate, probability distribution of reliability, assumption of MTBF, process of probability distribution, down time, maintainability and availability, break down maintenance and preventive maintenance design of reliability, design of reliability for prediction and statistics, reliability test, reliability data and design and management of reliability.

  16. Transit vehicle emissions program.

    Science.gov (United States)

    2013-08-01

    The evaluation, selection, and implementation of fuel and powertrain technology choices are critically important to accomplishing : the mission of providing safe, efficient, reliable, environmentally-conscious, and cost-effective public transportatio...

  17. Statin cost effectiveness in primary prevention: A systematic review of the recent cost-effectiveness literature in the United States

    Directory of Open Access Journals (Sweden)

    Mitchell Aaron P

    2012-07-01

    Full Text Available Abstract Background The literature on the cost-effectiveness of statin drugs in primary prevention of coronary heart disease is complex. The objective of this study is to compare the disparate results of recent cost-effectiveness analyses of statins. Findings We conducted a systematic review of the literature on statin cost-effectiveness. The four studies that met inclusion criteria reported varying conclusions about the cost-effectiveness of statin treatment, without a clear consensus as to whether statins are cost-effective for primary prevention. However, after accounting for each study’s assumptions about statin costs, we found substantial agreement among the studies. Studies that assumed statins to be more expensive found them to be less cost-effective, and vice-versa. Furthermore, treatment of low-risk groups became cost-effective as statins became less expensive. Conclusions Drug price is the primary determinant of statin cost-effectiveness within a given risk group. As more statin drugs become generic, patients at low risk for coronary disease may be treated cost-effectively. Though many factors must be weighed in any medical decision, from a cost-effectiveness perspective, statins may now be considered an appropriate therapy for many patients at low risk for heart disease.

  18. Cost-effectiveness, feed utilization and body composition of african ...

    African Journals Online (AJOL)

    Cost-effectiveness, feed utilization and body composition of african sharptooth catfish ( Clarias gariepinus , Burchell 1822) fingerlings fed locally formulated and commercial pelleted diets in tarpaulin tanks.

  19. Controlling air pollution from passenger ferries: cost-effectiveness of seven technological options.

    Science.gov (United States)

    Farrell, Alexander E; Corbett, James J; Winebrake, James J

    2002-12-01

    Continued interest in improving air quality in the United States along with renewed interest in the expansion of urban passenger ferry service has created concern about air pollution from ferry vessels. This paper presents a methodology for estimating the air pollution emissions from passenger ferries and the costs of emissions control strategies. The methodology is used to estimate the emissions and costs of retrofitting or re-powering ferries with seven technological options (combinations of propulsion and emission control systems) onto three vessels currently in service in San Francisco Bay. The technologies include improved engine design, cleaner fuels (including natural gas), and exhaust gas cleanup devices. The three vessels span a range of ages and technologies, from a 25-year-old monohull to a modern, high-speed catamaran built only four years ago. By looking at a range of technologies, vessel designs, and service conditions, a sense of the broader implications of controlling emissions from passenger ferries across a range of vessels and service profiles is provided. Tier 2-certified engines are the most cost-effective choice, but all options are cost-effective relative to other emission control strategies already in place in the transportation system.

  20. Cost-effectiveness of high-efficiency appliances in the U.S. residential sector: A case study

    International Nuclear Information System (INIS)

    McNeil, Michael A.; Bojda, Nicholas

    2012-01-01

    This paper presents an analysis of the cost-effectiveness of high-efficiency appliances in the U.S. residential sector using cost and efficiency data developed as part of the regulatory process of the U.S. Department of Energy's Appliances and Commercial Equipment Standards Program. These data are presented as a case study in the development of an ‘efficiency technology database’ which can be expanded and published as a resource to other researchers and policy makers seeking scenarios that optimize efficiency policies and forecast their likely impacts on energy demand and greenhouse gas emissions. The use of this data to evaluate cost-effectiveness according to a variety of metrics is demonstrated using the example of one refrigerator–freezer product class. Cost-effectiveness is then evaluated in terms of cost of conserved energy for refrigerators, room air conditioners, water heaters, cooking equipment, central air conditioners and gas furnaces. The resulting potential of cost-effective improvement ranges from 1% to 53% of energy savings, with a typical potential of 15–20%. - Highlights: ► We determined the potential for cost-effective efficiency for residential appliances. ► We cover 6 appliance groups using cost of conserved energy as a metric for cost-effectiveness. ► Data are source from the DOE's Appliance and Commercial Equipment Standards Program. ► Between 15% and 20% additional cost-effective efficiency improvement is possible.

  1. Cost effectiveness of haemophilia treatment : a cross-national assessment

    NARCIS (Netherlands)

    Lippert, B; Berger, K; Berntorp, E; Giangrande, P; van den Berg, M; Schramm, W; Siebert, U

    2005-01-01

    The aim of this study was to assess the incremental cost effectiveness of on-demand versus prophylactic haemophilia therapy in Germany, Sweden, the United Kingdom and The Netherlands from the third-party payers' perspective. Using a decision tree model, the cost effectiveness of on-demand versus

  2. Cost-effectiveness of antiplatelet drugs after percutaneous coronary intervention.

    Science.gov (United States)

    Wisløff, Torbjørn; Atar, Dan

    2016-01-01

    Clopidogrel has, for long time, been accepted as the standard treatment for patients who have undergone a percutaneous coronary intervention (PCI). The introduction of prasugrel-and more recently, ticagrelor-has introduced a decision-making problem for clinicians and governments worldwide: to use the cheaper clopidogrel or the more effective, and also more expensive prasugrel or ticagrelor. We aim to give helpful contributions to this debate by analysing the cost-effectiveness of clopidogrel, prasugrel, and ticagrelor compared with each other. We modified a previously developed Markov model of cardiac disease progression. In the model, we followed up cohorts of patients who have recently had a PCI until 100 years or death. Possible events are revascularization, bleeding, acute myocardial infarction, and death. Our analysis shows that ticagrelor is cost-effective in 77% of simulations at an incremental cost-effectiveness ratio of €7700 compared with clopidogrel. Ticagrelor was also cost-effective against prasugrel at a cost-effectiveness ratio of €7800. Given a Norwegian cost-effectiveness threshold of €70 000, both comparisons appear to be clearly cost-effective in favour of ticagrelor. Ticagrelor is cost-effective compared with both clopidogrel and prasugrel for patients who have undergone a PCI.

  3. Cost effectiveness of Tuberculosis Treatment from the Patients ...

    African Journals Online (AJOL)

    ... Directly Observed Treatment Short course is more cost effective from the patients' point of view. DOTS needs to be re-focused out of the hospitals and clinics and made community based in view of the increasing TB caseload occasioned by HI V/AIDS. Key Words: Cost effectiveness, Tuberculosis treatment, personal cost, ...

  4. Index method for analyzing cost effectiveness of drilling rigs

    Energy Technology Data Exchange (ETDEWEB)

    Batura, N P; Bocharov, V V

    1978-01-01

    The method for a complete analysis of the factors determining cost effectiveness of a drilling rig fleet is examined. The system of calculating production indexes from statistical reports is relatively simple and is not difficult to use for production organizations. The analytical results may be used to develop actual measures used to increase cost effectiveness of drilling operations.

  5. Cost-effectiveness of trachoma control in seven world regions.

    NARCIS (Netherlands)

    Baltussen, R.M.P.M.; Sylla, M.; Frick, K.D.; Mariotti, S.P.

    2005-01-01

    BACKGROUND/AIMS: The fight against blinding trachoma is being addressed with an integrated strategy of surgery, antibiotics, hygiene promotion, and environmental improvement-the SAFE strategy, but its cost-effectiveness is largely unknown. This paper estimates the cost effectiveness of surgery and

  6. The Cost-Effectiveness of NBPTS Teacher Certification

    Science.gov (United States)

    Yeh, Stuart S.

    2010-01-01

    A cost-effectiveness analysis of the National Board for Professional Teaching Standards (NBPTS) program suggests that Board certification is less cost-effective than a range of alternative approaches for raising student achievement, including comprehensive school reform, class size reduction, a 10% increase in per pupil expenditure, the use of…

  7. 10 CFR 436.13 - Presuming cost-effectiveness results.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 3 2010-01-01 2010-01-01 false Presuming cost-effectiveness results. 436.13 Section 436... Methodology and Procedures for Life Cycle Cost Analyses § 436.13 Presuming cost-effectiveness results. (a) If the investment and other costs for an energy or water conservation measure considered for retrofit to...

  8. Costs and cost-effectiveness of periviable care.

    Science.gov (United States)

    Caughey, Aaron B; Burchfield, David J

    2014-02-01

    With increasing concerns regarding rapidly expanding healthcare costs, cost-effectiveness analysis allows assessment of whether marginal gains from new technology are worth the increased costs. Particular methodologic issues related to cost and cost-effectiveness analysis in the area of neonatal and periviable care include how costs are estimated, such as the use of charges and whether long-term costs are included; the challenges of measuring utilities; and whether to use a maternal, neonatal, or dual perspective in such analyses. A number of studies over the past three decades have examined the costs and the cost-effectiveness of neonatal and periviable care. Broadly, while neonatal care is costly, it is also cost effective as it produces both life-years and quality-adjusted life-years (QALYs). However, as the gestational age of the neonate decreases, the costs increase and the cost-effectiveness threshold is harder to achieve. In the periviable range of gestational age (22-24 weeks of gestation), whether the care is cost effective is questionable and is dependent on the perspective. Understanding the methodology and salient issues of cost-effectiveness analysis is critical for researchers, editors, and clinicians to accurately interpret results of the growing body of cost-effectiveness studies related to the care of periviable pregnancies and neonates. Copyright © 2014 Elsevier Inc. All rights reserved.

  9. ORIGINAL ARTICLES Cost-effectiveness analysis for priority-setting ...

    African Journals Online (AJOL)

    health outcomes and wasted resources.4-5 It was found that the cost- effectiveness of South ... Priorities for Developing Countries Project was that emergency (and even some elective) ... to control air pollutants found that in South Africa the most cost- effective ..... outdoor air pollution in South Africa in 2000. S Afr Med J ...

  10. Cost-effective analysis of PET application in NSCLC

    International Nuclear Information System (INIS)

    Gu Aichun; Liu Jianjun; Sun Xiaoguang; Shi Yiping; Huang Gang

    2006-01-01

    Objective: To evaluate the cost-effectiveness of PET and CT application for diagnosis of non-small cell lung cancer (NSCLC) in China. Methods: Using decision analysis method the diagnostic efficiency of PET and CT for diagnosis of NSCLC in china was analysed. And also the value of cost for accurate diagnosis (CAD), cost for accurate staging (CAS) and cost for effective therapy (CAT) was calculated. Results: (1) For the accurate diagnosis, CT was much more cost-effective than PET. (2) For the accurate staging, CT was still more cost-effective than PET. (3) For the all over diagnostic and therapeutic cost, PET was more cost-effective than CT. (4) The priority of PET to CT was for the diagnosis of stage I NSCLC. Conclusion: For the management of NSCLC patient in China, CT is more cost-effective for screening, whereas PET for clinical staging and monitoring therapeutic effect. (authors)

  11. Developing Cost-Effective Field Assessments of Carbon Stocks in Human-Modified Tropical Forests.

    Science.gov (United States)

    Berenguer, Erika; Gardner, Toby A; Ferreira, Joice; Aragão, Luiz E O C; Camargo, Plínio B; Cerri, Carlos E; Durigan, Mariana; Oliveira Junior, Raimundo C; Vieira, Ima C G; Barlow, Jos

    2015-01-01

    Across the tropics, there is a growing financial investment in activities that aim to reduce emissions from deforestation and forest degradation, such as REDD+. However, most tropical countries lack on-the-ground capacity to conduct reliable and replicable assessments of forest carbon stocks, undermining their ability to secure long-term carbon finance for forest conservation programs. Clear guidance on how to reduce the monetary and time costs of field assessments of forest carbon can help tropical countries to overcome this capacity gap. Here we provide such guidance for cost-effective one-off field assessments of forest carbon stocks. We sampled a total of eight components from four different carbon pools (i.e. aboveground, dead wood, litter and soil) in 224 study plots distributed across two regions of eastern Amazon. For each component we estimated survey costs, contribution to total forest carbon stocks and sensitivity to disturbance. Sampling costs varied thirty-one-fold between the most expensive component, soil, and the least, leaf litter. Large live stems (≥10 cm DBH), which represented only 15% of the overall sampling costs, was by far the most important component to be assessed, as it stores the largest amount of carbon and is highly sensitive to disturbance. If large stems are not taxonomically identified, costs can be reduced by a further 51%, while incurring an error in aboveground carbon estimates of only 5% in primary forests, but 31% in secondary forests. For rapid assessments, necessary to help prioritize locations for carbon- conservation activities, sampling of stems ≥20cm DBH without taxonomic identification can predict with confidence (R2 = 0.85) whether an area is relatively carbon-rich or carbon-poor-an approach that is 74% cheaper than sampling and identifying all the stems ≥10cm DBH. We use these results to evaluate the reliability of forest carbon stock estimates provided by the IPCC and FAO when applied to human-modified forests

  12. Developing Cost-Effective Field Assessments of Carbon Stocks in Human-Modified Tropical Forests.

    Directory of Open Access Journals (Sweden)

    Erika Berenguer

    Full Text Available Across the tropics, there is a growing financial investment in activities that aim to reduce emissions from deforestation and forest degradation, such as REDD+. However, most tropical countries lack on-the-ground capacity to conduct reliable and replicable assessments of forest carbon stocks, undermining their ability to secure long-term carbon finance for forest conservation programs. Clear guidance on how to reduce the monetary and time costs of field assessments of forest carbon can help tropical countries to overcome this capacity gap. Here we provide such guidance for cost-effective one-off field assessments of forest carbon stocks. We sampled a total of eight components from four different carbon pools (i.e. aboveground, dead wood, litter and soil in 224 study plots distributed across two regions of eastern Amazon. For each component we estimated survey costs, contribution to total forest carbon stocks and sensitivity to disturbance. Sampling costs varied thirty-one-fold between the most expensive component, soil, and the least, leaf litter. Large live stems (≥10 cm DBH, which represented only 15% of the overall sampling costs, was by far the most important component to be assessed, as it stores the largest amount of carbon and is highly sensitive to disturbance. If large stems are not taxonomically identified, costs can be reduced by a further 51%, while incurring an error in aboveground carbon estimates of only 5% in primary forests, but 31% in secondary forests. For rapid assessments, necessary to help prioritize locations for carbon- conservation activities, sampling of stems ≥20cm DBH without taxonomic identification can predict with confidence (R2 = 0.85 whether an area is relatively carbon-rich or carbon-poor-an approach that is 74% cheaper than sampling and identifying all the stems ≥10cm DBH. We use these results to evaluate the reliability of forest carbon stock estimates provided by the IPCC and FAO when applied to human

  13. Can a Costly Intervention Be Cost-effective?

    Science.gov (United States)

    Foster, E. Michael; Jones, Damon

    2009-01-01

    Objectives To examine the cost-effectiveness of the Fast Track intervention, a multi-year, multi-component intervention designed to reduce violence among at-risk children. A previous report documented the favorable effect of intervention on the highest-risk group of ninth-graders diagnosed with conduct disorder, as well as self-reported delinquency. The current report addressed the cost-effectiveness of the intervention for these measures of program impact. Design Costs of the intervention were estimated using program budgets. Incremental cost-effectiveness ratios were computed to determine the cost per unit of improvement in the 3 outcomes measured in the 10th year of the study. Results Examination of the total sample showed that the intervention was not cost-effective at likely levels of policymakers' willingness to pay for the key outcomes. Subsequent analysis of those most at risk, however, showed that the intervention likely was cost-effective given specified willingness-to-pay criteria. Conclusions Results indicate that the intervention is cost-effective for the children at highest risk. From a policy standpoint, this finding is encouraging because such children are likely to generate higher costs for society over their lifetimes. However, substantial barriers to cost-effectiveness remain, such as the ability to effectively identify and recruit such higher-risk children in future implementations. PMID:17088509

  14. Cost-effectiveness of Chlamydia antibody tests in subfertile women.

    Science.gov (United States)

    Fiddelers, A A A; Land, J A; Voss, G; Kessels, A G H; Severens, J L

    2005-02-01

    For the evaluation of tubal function, Chlamydia antibody testing (CAT) has been introduced as a screening test. We compared six CAT screening strategies (five CAT tests and one combination of tests), with respect to their cost-effectiveness, by using IVF pregnancy rate as outcome measure. A decision analytic model was developed based on a source population of 1715 subfertile women. The model incorporates hysterosalpingography (HSG), laparoscopy and IVF. To calculate IVF pregnancy rates, costs, effects, cost-effectiveness and incremental costs per effect of the six different CAT screening strategies were determined. pELISA Medac turned out to be the most cost-effective CAT screening strategy (15 075 per IVF pregnancy), followed by MIF Anilabsystems (15 108). A combination of tests (pELISA Medac and MIF Anilabsystems; 15 127) did not improve the cost-effectiveness of the single strategies. Sensitivity analyses showed that the results are robust for changes in the baseline values of the model parameters. Only small differences were found between the screening strategies regarding the cost-effectiveness, although pELISA Medac was the most cost-effective strategy. Before introducing a particular CAT test into clinical practice, one should consider the effects and consequences of the entire screening strategy, instead of only the diagnostic accuracy of the test used.

  15. Cost-effectiveness and the socialization of health care.

    Science.gov (United States)

    Musgrove, P

    1995-01-01

    The more health care is socialized, the more cost-effectiveness is an appropriate criterion for expenditure. Utility-maximizing individuals, facing divisibility of health care purchases and declining marginal health gains, and complete information about probable health improvements, should buy health care according to its cost-effectiveness. Absent these features, individual health spending will not be cost-effective; and in any case, differences in personal utilities and risk aversion will not lead to the same ranking of health care interventions for everyone. Private insurance frees consumers from concern for cost, which undermines cost-effectiveness, but lets them emphasize effectiveness, which favors value for money. This is most important for costly and cost-effective interventions, especially for poor people. Cost-effectiveness is more appropriate and easier to achieve under second-party insurance. More complete socialization of health care, via public finance, can yield greater efficiency by making insurance compulsory. Cost-effectiveness is also more attractive when taxpayers subsidize others' care: needs (effectiveness) take precedence over wants (utility). The gain in effectiveness may be greater, and the welfare loss from Pareto non-optimality smaller, in poor countries than in rich ones.

  16. The Potential Cost-Effectiveness of Amblyopia Screening Programs

    Science.gov (United States)

    Rein, David B.; Wittenborn, John S.; Zhang, Xinzhi; Song, Michael; Saaddine, Jinan B.

    2013-01-01

    Background To estimate the incremental cost-effectiveness of amblyopia screening at preschool and kindergarten, we compared the costs and benefits of 3 amblyopia screening scenarios to no screening and to each other: (1) acuity/stereopsis (A/S) screening at kindergarten, (2) A/S screening at preschool and kindergarten, and (3) photoscreening at preschool and A/S screening at kindergarten. Methods We programmed a probabilistic microsimulation model of amblyopia natural history and response to treatment with screening costs and outcomes estimated from 2 state programs. We calculated the probability that no screening and each of the 3 interventions were most cost-effective per incremental quality-adjusted life year (QALY) gained and case avoided. Results Assuming a minimal 0.01 utility loss from monocular vision loss, no screening was most cost-effective with a willingness to pay (WTP) of less than $16,000 per QALY gained. A/S screening at kindergarten alone was most cost-effective between a WTP of $17,000 and $21,000. A/S screening at preschool and kindergarten was most cost-effective between a WTP of $22,000 and $75,000, and photoscreening at preschool and A/S screening at kindergarten was most cost-effective at a WTP greater than $75,000. Cost-effectiveness substantially improved when assuming a greater utility loss. All scenarios were cost-effective when assuming a WTP of $10,500 per case of amblyopia cured. Conclusions All 3 screening interventions evaluated are likely to be considered cost-effective relative to many other potential public health programs. The choice of screening option depends on budgetary resources and the value placed on monocular vision loss prevention by funding agencies. PMID:21877675

  17. Cost-effectiveness of reduction of off-site dose

    International Nuclear Information System (INIS)

    McGrath, J.J.; Macphee, R.; Arbeau, N.; Miskin, J.; Scott, C.K.; Winters, E.

    1988-03-01

    Since the early 1970's, nuclear power plants have been designed and operated with a target of not releasing more than one percent of the licensed limits (derived emission limits) in liquid and gaseous effluents. The AECB initiated this study of the cost-effectiveness of the reduction of off-site doses as part of a review to determine if further measures to reduce off-site doses might be reasonably achievable. Atlantic Nuclear has estimated the cost of existing technology options that can be applied for a further reduction of radioactive effluents from future CANDU nuclear power plants. Detritiation, filtration, ion exchange and evaporation are included in the assessment. The costs are presented in 1987 Canadian dollars, and include capital and operating costs for a reference 50 year plant life. Darlington NGS and Point Lepreau NGS are the reference nuclear power plant types and locations. The effect resulting from the hypothetical application of each technology has been calculated as the resulting reduction in world collective radiation dose detriment. The CSA N288.1 procedure was used for local pathway analysis and the global dispersion model developed by the NEA (OECD) group of experts was used for dose calculations. The reduction in the 'collective effective dose equivalent commitment' was assumed to exist for 10,000 years, the expected life-span of solid waste repositories. No attempt was made to model world population dynamics. The collective dose reductions were calculated for a nominal world population of 10 billion persons. The estimated cost and effect of applying the technology options are summarized in a tabular form for input to further consideration of 'reasonably achievable off-site dose levels'

  18. Global cost-effectiveness of GDM screening and management

    DEFF Research Database (Denmark)

    Weile, Louise K K; Kahn, James G; Marseille, Elliot

    2015-01-01

    a systematic search and abstraction of cost-effectiveness and cost-utility studies from 2002 to 2014. We standardized all findings to 2014 US dollars. We found that cost-effectiveness ratios varied widely. Most variation was found to be due to differences in geographic setting, diagnostic criteria...... and intervention approaches, and outcomes (e.g., inclusion or exclusion of long-term type 2 diabetes risk and associated costs). We concluded that incorporation of long-term benefits of GDM screening and treatment has huge impact on cost-effectiveness estimates. Based on the large methodological heterogeneity...

  19. Cost effectiveness analysis of indoor radon control measures

    International Nuclear Information System (INIS)

    Fujimoto, Kenzo

    1989-01-01

    The problem of radon 222 in buildings as a contributor to radiation exposure is described. Five different control methods and the dose reductions that would result from each are analysed. The annualized cost for each control measure was evaluated and the cost effectiveness of each control measure was calculated on the basis of dollars per person-sievert dose reduction. The use of unipolar ion generators for particle removal appears to be the most cost effective and the use of ceiling fans to increase air circulation the least cost effective. 3 figs., 1 tab

  20. Proposed Reliability/Cost Model

    Science.gov (United States)

    Delionback, L. M.

    1982-01-01

    New technique estimates cost of improvement in reliability for complex system. Model format/approach is dependent upon use of subsystem cost-estimating relationships (CER's) in devising cost-effective policy. Proposed methodology should have application in broad range of engineering management decisions.

  1. Reliability of low-frequency auditory stimulation studies associated with technetium-99m hexamethylpropylene amine oxime single-photon emission tomography

    Energy Technology Data Exchange (ETDEWEB)

    Le Saco, Y.; Turzo, A.; Guias, B.; Morin, P.P. (Centre Hospitalier Universitaire, 29 - Brest (France). Dept. of Nuclear Medicine); Jezequel, J. (Centre Hospitalier Universitaire, 29 - Brest (France). Dept. of Otorhinolaryngology); Robier, A. (Centre Hospitalier Universitaire, 37 - Tours (France). Dept. of Otorhinolaryngology); Baulieu, J.L. (Centre Hospitalier Universitaire, 37 - Tours (France). Dept. of Nuclear Medicine)

    1993-05-01

    Development of auditory stimulation tests associated with single-photon emission tomography (SPET) shows evidence of variations in perfusion related to the stimuli. Three brain SPET examinations with technetium-99m hexamethylpropylene amine oxime were performed on eight right-handed adults with normal hearing, the first one without stimulation and the other two associated with a 500-Hz/30-dB stimulation of the right ear. Temporal regions of interest covering auditory areas, as well as parietal ones (internal control), were drawn on three successive coronal slices. A cortico-cerebellar index R was calculated, and the variation in activity was defined for each subject using the ratio R[sub poststimulation] - R[sub prestimulation]/R[sub prest]u[sub mulation]. A significant increase in the temporal cortex count occurred in all subjects. This increase was bilateral, except for one subject in whom it was not significant on the right side. This result recurred during the second stimulation study. Overall the response of the left temporal cortex was stronger, although the asymmetry was not significant. The asymmetry repeated itself after each stimulation. The perfursion response is globally reliable in our study. We must ascertainhow sensitive this test is with regard to deaf adults and adults with normal hearing before extending its use to children. (orig.).

  2. Reliability of low-frequency auditory stimulation studies associated with technetium-99m hexamethylpropylene amine oxime single-photon emission tomography

    International Nuclear Information System (INIS)

    Le Saco, Y.; Turzo, A.; Guias, B.; Morin, P.P.; Jezequel, J.; Robier, A.; Baulieu, J.L.

    1993-01-01

    Development of auditory stimulation tests associated with single-photon emission tomography (SPET) shows evidence of variations in perfusion related to the stimuli. Three brain SPET examinations with technetium-99m hexamethylpropylene amine oxime were performed on eight right-handed adults with normal hearing, the first one without stimulation and the other two associated with a 500-Hz/30-dB stimulation of the right ear. Temporal regions of interest covering auditory areas, as well as parietal ones (internal control), were drawn on three successive coronal slices. A cortico-cerebellar index R was calculated, and the variation in activity was defined for each subject using the ratio R poststimulation - R prestimulation /R prest u mulation . A significant increase in the temporal cortex count occurred in all subjects. This increase was bilateral, except for one subject in whom it was not significant on the right side. This result recurred during the second stimulation study. Overall the response of the left temporal cortex was stronger, although the asymmetry was not significant. The asymmetry repeated itself after each stimulation. The perfursion response is globally reliable in our study. We must ascertainhow sensitive this test is with regard to deaf adults and adults with normal hearing before extending its use to children. (orig.)

  3. Use of cost-effective construction technologies in India to mitigate climate change

    Energy Technology Data Exchange (ETDEWEB)

    Sengupta, N. [Forum of Scientists, Engineers and Technologists, Kolkata (India)

    2008-01-10

    Concentration of greenhouse gases plays a major role in raising the earth's temperature. Carbon dioxide, produced from burning of fossil fuels, is the principle greenhouse gas and efforts are being made at international level to reduce its emission through adoption of energy-efficient technologies. The UN Conference on Environment and Development, 1992 made a significant development in this field by initiating the discussion on sustainable development under the Agenda 21. Cost-effective construction technologies can bring down the embodied energy level associated with production of building materials by lowering use of energy-consuming materials. This embodied energy is a crucial factor for sustainable construction practices and effective reduction of the same would contribute in mitigating global warming. The cost-effective construction technologies would emerge as the most acceptable case of sustainable technologies in India both in terms of cost and environment.

  4. A spreadsheet-based microcomputer application for determining cost-effectiveness of commercial lighting retrofit opportunities

    International Nuclear Information System (INIS)

    Spain, T.K.

    1992-01-01

    Lighting accounts for 20-25% of electricity use in the United States. With estimates of 50-70% potential reductions being made by energy engineers, lighting is a promising area for cost-effective energy conservation projects in commercial buildings. With an extensive array of alternatives available to replace or modify existing lighting systems, simple but effective calculation tools are needed to help energy auditors evaluate lighting retrofits. This paper describes a spreadsheet-based microcomputer application for determining the cost-effectiveness of commercial lighting retrofits. Developed to support walk-through energy audits conducted by the Industrial Energy Advisory Service (IdEAS), the spreadsheet provides essential comparative data for evaluating the payback of alternatives. The impact of alternatives on environmental emissions is calculated to help communicate external costs and sell the project, if appropriate. The methodology and calculations are fully documented to allow the user to duplicate the spreadsheet and modify it as needed

  5. Cost effectiveness of facility and home based HIV voluntary ...

    African Journals Online (AJOL)

    Cost effectiveness of facility and home based HIV voluntary counseling and ... Background: In Uganda, the main stay for provision of human immunodeficiency virus (HIV) voluntary counseling and testing (VCT) ... AJOL African Journals Online.

  6. Cost-effectiveness and radiation risk of breast cancer screening

    International Nuclear Information System (INIS)

    Rombach, J.J.

    1987-01-01

    Base cost effectiveness risk associated with radiological screening for tuberculosis and lung tumor the Government of Netherlands advised against mass screening. However, mass screening remains an important method in the case of breast cancer

  7. Bioinformatics tools for development of fast and cost effective simple ...

    African Journals Online (AJOL)

    Bioinformatics tools for development of fast and cost effective simple sequence repeat ... comparative mapping and exploration of functional genetic diversity in the ... Already, a number of computer programs have been implemented that aim at ...

  8. Costs and Cost-Effectiveness of Plasmodium vivax Control.

    Science.gov (United States)

    White, Michael T; Yeung, Shunmay; Patouillard, Edith; Cibulskis, Richard

    2016-12-28

    The continued success of efforts to reduce the global malaria burden will require sustained funding for interventions specifically targeting Plasmodium vivax The optimal use of limited financial resources necessitates cost and cost-effectiveness analyses of strategies for diagnosing and treating P. vivax and vector control tools. Herein, we review the existing published evidence on the costs and cost-effectiveness of interventions for controlling P. vivax, identifying nine studies focused on diagnosis and treatment and seven studies focused on vector control. Although many of the results from the much more extensive P. falciparum literature can be applied to P. vivax, it is not always possible to extrapolate results from P. falciparum-specific cost-effectiveness analyses. Notably, there is a need for additional studies to evaluate the potential cost-effectiveness of radical cure with primaquine for the prevention of P. vivax relapses with glucose-6-phosphate dehydrogenase testing. © The American Society of Tropical Medicine and Hygiene.

  9. Cost-effective conservation of an endangered frog under uncertainty.

    Science.gov (United States)

    Rose, Lucy E; Heard, Geoffrey W; Chee, Yung En; Wintle, Brendan A

    2016-04-01

    How should managers choose among conservation options when resources are scarce and there is uncertainty regarding the effectiveness of actions? Well-developed tools exist for prioritizing areas for one-time and binary actions (e.g., protect vs. not protect), but methods for prioritizing incremental or ongoing actions (such as habitat creation and maintenance) remain uncommon. We devised an approach that combines metapopulation viability and cost-effectiveness analyses to select among alternative conservation actions while accounting for uncertainty. In our study, cost-effectiveness is the ratio between the benefit of an action and its economic cost, where benefit is the change in metapopulation viability. We applied the approach to the case of the endangered growling grass frog (Litoria raniformis), which is threatened by urban development. We extended a Bayesian model to predict metapopulation viability under 9 urbanization and management scenarios and incorporated the full probability distribution of possible outcomes for each scenario into the cost-effectiveness analysis. This allowed us to discern between cost-effective alternatives that were robust to uncertainty and those with a relatively high risk of failure. We found a relatively high risk of extinction following urbanization if the only action was reservation of core habitat; habitat creation actions performed better than enhancement actions; and cost-effectiveness ranking changed depending on the consideration of uncertainty. Our results suggest that creation and maintenance of wetlands dedicated to L. raniformis is the only cost-effective action likely to result in a sufficiently low risk of extinction. To our knowledge we are the first study to use Bayesian metapopulation viability analysis to explicitly incorporate parametric and demographic uncertainty into a cost-effective evaluation of conservation actions. The approach offers guidance to decision makers aiming to achieve cost-effective

  10. Cost-effective treatment for the couple with infertility.

    Science.gov (United States)

    Van Voorhis, B J; Syrop, C H

    2000-12-01

    Although the evaluation of cost-effective approaches to infertility treatment remains in its infancy, several important principles have emerged from the initial studies in this field. Currently, in treating couples with infertility without tubal disease or severe male-factor infertility, the most cost-effective approach is to start with IUI or superovulation-IUI treatments before resorting to IVF procedures. The woman's age and number of sperm present for insemination are significant factors influencing cost-effectiveness. The influence of certain diagnoses on the cost-effectiveness of infertility treatments requires further study. Even when accounting for the costs associated with multiple gestations and premature deliveries, the cost of IVF decreases within the range of other cost-effective medical procedures and decreases to less than the willingness to pay for these procedures. Indeed, for patients with severe tubal disease, IVF has been found to be more cost-effective than surgical repair. The cost-effectiveness of IVF will likely improve as success rates show continued improvements over the course of time. In addition, usefulness of embryo selection and practices to reduce the likelihood of high-order multiple pregnancies, without reductions in pregnancy rates, will significantly impact cost-effectiveness. The exclusion of infertility treatments from insurance plans is unfortunate and accentuates the importance of physicians understanding the economics of infertility treatment with costs that are often passed directly to the patient. The erroneous economic policies and judgments that have led to inequities in access to infertility health care should not be tolerated.

  11. Assessing the cost-effectiveness of electric vehicles in European countries using integrated modeling

    International Nuclear Information System (INIS)

    Seixas, J.; Simões, S.; Dias, L.; Kanudia, A.; Fortes, P.; Gargiulo, M.

    2015-01-01

    Electric vehicles (EVs) are considered alternatives to internal combustion engines due to their energy efficiency and contribution to CO 2 mitigation. The adoption of EVs depends on consumer preferences, including cost, social status and driving habits, although it is agreed that current and expected costs play a major role. We use a partial equilibrium model that minimizes total energy system costs to assess whether EVs can be a cost-effective option for the consumers of each EU27 member state up to 2050, focusing on the impact of different vehicle investment costs and CO 2 mitigation targets. We found that for an EU-wide greenhouse gas emission reduction cap of 40% and 70% by 2050 vis-à-vis 1990 emissions, battery electric vehicles (BEVs) are cost-effective in the EU only by 2030 and only if their costs are 30% lower than currently expected. At the EU level, vehicle costs and the capability to deliver both short- and long-distance mobility are the main drivers of BEV deployment. Other drivers include each state’s national mobility patterns and the cost-effectiveness of alternative mitigation options, both in the transport sector, such as plug-in hybrid electric vehicles (PHEVs) or biofuels, and in other sectors, such as renewable electricity. - Highlights: • Electric vehicles were assessed through the minimization of the total energy systems costs. • EU climate policy targets could act as a major driver for PHEV adoption. • Battery EV is an option before 2030 if costs will drop by 30% from expected costs. • EV deployment varies per country depending on each energy system configuration. • Incentives at the country level should consider specific cost-effectiveness factors

  12. Electricity supply. Older plants' impact on reliability and air quality

    International Nuclear Information System (INIS)

    England-Joseph, Judy A.; Adams, Charles M.; Wood, David G.; Feehan, Daniel J.; Veal, Howard F.; Skeen, John H. III; Koenigs, Melvin J.; Lichtenfeld, David I.; Seretakis, Pauline J.

    1990-09-01

    Life extension of fossil fuel plants is a relatively recent phenomenon; thus, utilities have little experience to demonstrate the longer-term operating reliability of plants with an extended service life. While utility industry officials and government and industry studies express optimism that these plants will continue to operate reliably, the officials and the studies also caution that it is too soon to determine how pursuing life extension will affect the reliability of the nation's electricity supply. According to DOE, the number of fossil fuel generating units' 30 years old or older is expected to increase from about 2,500 in 1989 to roughly 3,700 in 1998, increasing such plants' share of overall generating capacity from 13 percent in 1989 to 27 percent in 1998. EPA estimates that with existing air quality requirements, fossil fuel plant emissions will increase steadily during the coming decade. Proposed acid rain control legislation, which would affect many plants that may have their service life extended, would require utilities to significantly reduce emissions by the year 2000 but would allow utilities flexibility in deciding how and where to achieve the reductions. If such legislation is enacted, utilities generally are expected to find reducing emissions from existing plants more cost-effective than replacing them and to continue extending plants' service life. Officials of DOE and utility organizations expressed concern, however, that EPA could decide, as it did for one plant in 1988, that alterations made in extending the service life of plants exempted from the Clean Air Act would result in increased emissions and thus cause the altered plants to lose their exemption. According to the officials, the additional costs of achieving the Clean Air Act's standards could discourage some life extension projects. However, such decisions by EPA could also reduce the nation's total power plant emissions by eliminating an existing incentive to retain exempt

  13. Reliability Engineering

    International Nuclear Information System (INIS)

    Lee, Sang Yong

    1992-07-01

    This book is about reliability engineering, which describes definition and importance of reliability, development of reliability engineering, failure rate and failure probability density function about types of it, CFR and index distribution, IFR and normal distribution and Weibull distribution, maintainability and movability, reliability test and reliability assumption in index distribution type, normal distribution type and Weibull distribution type, reliability sampling test, reliability of system, design of reliability and functionality failure analysis by FTA.

  14. Options for cost-effectively reducing atmospheric methane concentrations from anthropogenic biomass sources

    International Nuclear Information System (INIS)

    Roos, K.F.; Jacobs, C.; Orlic, M.

    1993-01-01

    Methane is a major greenhouse gas, second only to carbon dioxide in its contribution to future global warming. Methane concentrations have more than doubled over the last two centuries and continue to rise annually. These increases are largely correlated with increasing human populations. Methane emissions from human related activities currently account for about 70 percent of annual emissions. Of these human related emissions, biomass sources account for about 75 percent and non-biomass sources about 25 percent. Because methane has a shorter lifetime than other major greenhouse gases, efforts to reduce methane emissions may fairly quickly be translated into lower atmospheric concentrations of methane and lower levels of radiative forcing. This fairly quick response would have the benefit of slowing the rate of climate change and hence allow natural ecosystems more time to adapt. Importantly, methane may be cost-effectively reduced from a number of biomass and non-biomass sources in the United States and worldwide. Methane is a valuable fuel, not just a waste by-product, and often systems may be reconfigured to reap the fuel value of the methane and more than justify the necessary expenditures. Such options for reducing methane emission from biomass sources exist for landfills, livestock manures, and ruminant livestock, and have been implemented to varying degrees in countries around the world. However, there are a number of barriers that hinder the more widespread use of technologies, including institutional, financial, regulatory, informational, and other barriers. This paper describes an array of available options that may be cost-effectively implemented to reduce methane emissions from biomass sources. This paper also discusses a number of programs that have been developed in the United States and internationally to promote the implementation of these methane reduction options and overcome existing barriers

  15. Cost-effectiveness analysis of treatments for premenstrual dysphoric disorder.

    Science.gov (United States)

    Rendas-Baum, Regina; Yang, Min; Gricar, Joseph; Wallenstein, Gene V

    2010-01-01

    Premenstrual syndrome (PMS) is reported to affect between 13% and 31% of women. Between 3% and 8% of women are reported to meet criteria for the more severe form of PMS, premenstrual dysphoric disorder (PMDD). Although PMDD has received increased attention in recent years, the cost effectiveness of treatments for PMDD remains unknown. To evaluate the cost effectiveness of the four medications with a US FDA-approved indication for PMDD: fluoxetine, sertraline, paroxetine and drospirenone plus ethinyl estradiol (DRSP/EE). A decision-analytic model was used to evaluate both direct costs (medication and physician visits) and clinical outcomes (treatment success, failure and discontinuation). Medication costs were based on average wholesale prices of branded products; physician visit costs were obtained from a claims database study of PMDD patients and the Agency for Healthcare Research and Quality. Clinical outcome probabilities were derived from published clinical trials in PMDD. The incremental cost-effectiveness ratio (ICER) was calculated using the difference in costs and percentage of successfully treated patients at 6 months. Deterministic and probabilistic sensitivity analyses were used to assess the impact of uncertainty in parameter estimates. Threshold values where a change in the cost-effective strategy occurred were identified using a net benefit framework. Starting therapy with DRSP/EE dominated both sertraline and paroxetine, but not fluoxetine. The estimated ICER of initiating treatment with fluoxetine relative to DRSP/EE was $US4385 per treatment success (year 2007 values). Cost-effectiveness acceptability curves revealed that for ceiling ratios>or=$US3450 per treatment success, fluoxetine had the highest probability (>or=0.37) of being the most cost-effective treatment, relative to the other options. The cost-effectiveness acceptability frontier further indicated that DRSP/EE remained the option with the highest expected net monetary benefit for

  16. Analyses of Blood Bank Efficiency, Cost-Effectiveness and Quality

    Science.gov (United States)

    Lam, Hwai-Tai Chen

    In view of the increasing costs of hospital care, it is essential to investigate methods to improve the labor efficiency and the cost-effectiveness of the hospital technical core in order to control costs while maintaining the quality of care. This study was conducted to develop indices to measure efficiency, cost-effectiveness, and the quality of blood banks; to identify factors associated with efficiency, cost-effectiveness, and quality; and to generate strategies to improve blood bank labor efficiency and cost-effectiveness. Indices developed in this study for labor efficiency and cost-effectiveness were not affected by patient case mix and illness severity. Factors that were associated with labor efficiency were identified as managerial styles, and organizational designs that balance workload and labor resources. Medical directors' managerial involvement was not associated with labor efficiency, but their continuing education and specialty in blood bank were found to reduce the performance of unnecessary tests. Surprisingly, performing unnecessary tests had no association with labor efficiency. This suggested the existence of labor slack in blood banks. Cost -effectiveness was associated with workers' benefits, wages, and the production of high-end transfusion products by hospital-based donor rooms. Quality indices used in this study included autologous transfusion rates, platelet transfusion rates, and the check points available in an error-control system. Because the autologous transfusion rate was related to patient case mix, severity of illness, and possible inappropriate transfusion, it was not recommended to be used for quality index. Platelet-pheresis transfusion rates were associated with the transfusion preferences of the blood bank medical directors. The total number of check points in an error -control system was negatively associated with government ownership and workers' experience. Recommendations for improving labor efficiency and cost-effectiveness

  17. Cost-effectiveness analysis of sandhill crane habitat management

    Science.gov (United States)

    Kessler, Andrew C.; Merchant, James W.; Shultz, Steven D.; Allen, Craig R.

    2013-01-01

    Invasive species often threaten native wildlife populations and strain the budgets of agencies charged with wildlife management. We demonstrate the potential of cost-effectiveness analysis to improve the efficiency and value of efforts to enhance sandhill crane (Grus canadensis) roosting habitat. We focus on the central Platte River in Nebraska (USA), a region of international ecological importance for migrating avian species including sandhill cranes. Cost-effectiveness analysis is a valuation process designed to compare alternative actions based on the cost of achieving a pre-determined objective. We estimated costs for removal of invasive vegetation using geographic information system simulations and calculated benefits as the increase in area of sandhill crane roosting habitat. We generated cost effectiveness values for removing invasive vegetation on 7 land parcels and for the entire central Platte River to compare the cost-effectiveness of management at specific sites and for the central Platte River landscape. Median cost effectiveness values for the 7 land parcels evaluated suggest that costs for creating 1 additional hectare of sandhill crane roosting habitat totaled US $1,595. By contrast, we found that creating an additional hectare of sandhill crane roosting habitat could cost as much as US $12,010 for some areas in the central Platte River, indicating substantial cost savings can be achieved by using a cost effectiveness analysis to target specific land parcels for management. Cost-effectiveness analysis, used in conjunction with geographic information systems, can provide decision-makers with a new tool for identifying the most economically efficient allocation of resources to achieve habitat management goals.

  18. Intra-tumour 18F-FDG uptake heterogeneity decreases the reliability on target volume definition with positron emission tomography/computed tomography imaging.

    Science.gov (United States)

    Dong, Xinzhe; Wu, Peipei; Sun, Xiaorong; Li, Wenwu; Wan, Honglin; Yu, Jinming; Xing, Ligang

    2015-06-01

    This study aims to explore whether the intra-tumour (18) F-fluorodeoxyglucose (FDG) uptake heterogeneity affects the reliability of target volume definition with FDG positron emission tomography/computed tomography (PET/CT) imaging for nonsmall cell lung cancer (NSCLC) and squamous cell oesophageal cancer (SCEC). Patients with NSCLC (n = 50) or SCEC (n = 50) who received (18)F-FDG PET/CT scanning before treatments were included in this retrospective study. Intra-tumour FDG uptake heterogeneity was assessed by visual scoring, the coefficient of variation (COV) of the standardised uptake value (SUV) and the image texture feature (entropy). Tumour volumes (gross tumour volume (GTV)) were delineated on the CT images (GTV(CT)), the fused PET/CT images (GTV(PET-CT)) and the PET images, using a threshold at 40% SUV(max) (GTV(PET40%)) or the SUV cut-off value of 2.5 (GTV(PET2.5)). The correlation between the FDG uptake heterogeneity parameters and the differences in tumour volumes among GTV(CT), GTV(PET-CT), GTV(PET40%) and GTV(PET2.5) was analysed. For both NSCLC and SCEC, obvious correlations were found between uptake heterogeneity, SUV or tumour volumes. Three types of heterogeneity parameters were consistent and closely related to each other. Substantial differences between the four methods of GTV definition were found. The differences between the GTV correlated significantly with PET heterogeneity defined with the visual score, the COV or the textural feature-entropy for NSCLC and SCEC. In tumours with a high FDG uptake heterogeneity, a larger GTV delineation difference was found. Advance image segmentation algorithms dealing with tracer uptake heterogeneity should be incorporated into the treatment planning system. © 2015 The Royal Australian and New Zealand College of Radiologists.

  19. Intra-tumour 18F-FDG uptake heterogeneity decreases the reliability on target volume definition with positron emission tomography/computed tomography imaging

    International Nuclear Information System (INIS)

    Dong, Xinzhe; Wu, Peipei; Yu, Jinming; Xing, Ligang; Sun, Xiaorong; Li, Wenwu; Wan, Honglin

    2015-01-01

    This study aims to explore whether the intra-tumour 18 F-fluorodeoxyglucose (FDG) uptake heterogeneity affects the reliability of target volume definition with FDG positron emission tomography/computed tomography (PET/CT) imaging for nonsmall cell lung cancer (NSCLC) and squamous cell oesophageal cancer (SCEC). Patients with NSCLC (n = 50) or SCEC (n = 50) who received 18 F-FDG PET/CT scanning before treatments were included in this retrospective study. Intra-tumour FDG uptake heterogeneity was assessed by visual scoring, the coefficient of variation (COV) of the standardised uptake value (SUV) and the image texture feature (entropy). Tumour volumes (gross tumour volume (GTV) ) were delineated on the CT images (GTV CT ), the fused PET/CT images (GTV PET-CT ) and the PET images, using a threshold at 40% SUV max (GTV PET40% ) or the SUV cut-off value of 2.5 (GTV PET2.5 ). The correlation between the FDG uptake heterogeneity parameters and the differences in tumour volumes among GTV CT , GTV PET-CT , GTV PET40% and GTV PET2.5 was analysed. For both NSCLC and SCEC, obvious correlations were found between uptake heterogeneity, SUV or tumour volumes. Three types of heterogeneity parameters were consistent and closely related to each other. Substantial differences between the four methods of GTV definition were found. The differences between the GTV correlated significantly with PET heterogeneity defined with the visual score, the COV or the textural feature-entropy for NSCLC and SCEC. In tumours with a high FDG uptake heterogeneity, a larger GTV delineation difference was found. Advance image segmentation algorithms dealing with tracer uptake heterogeneity should be incorporated into the treatment planning system.

  20. Cost-effectiveness and pricing of antibacterial drugs.

    Science.gov (United States)

    Verhoef, Talitha I; Morris, Stephen

    2015-01-01

    Growing resistance to antibacterial agents has increased the need for the development of new drugs to treat bacterial infections. Given increasing pressure on limited health budgets, it is important to study the cost-effectiveness of these drugs, as well as their safety and efficacy, to find out whether or not they provide value for money and should be reimbursed. In this article, we systematically reviewed 38 cost-effectiveness analyses of new antibacterial agents. Most studies showed the new antibacterial drugs were cost-effective compared to older generation drugs. Drug pricing is a complicated process, involving different stakeholders, and has a large influence on cost-effectiveness. Value-based pricing is a method to determine the price of a drug at which it can be cost-effective. It is currently unclear what the influence of value-based pricing will be on the prices of new antibacterial agents, but an important factor will be the definition of 'value', which as well as the impact of the drug on patient health might also include other factors such as wider social impact and the health impact of disease. © 2015 The Authors. Chemical Biology & Drug Design Published by John Wiley & Sons Ltd.

  1. Cost effectiveness of the Dutch incentive for the environmental quality of power generation (MEP)

    International Nuclear Information System (INIS)

    Melgerd, R.

    2005-01-01

    This article relates to research on the cost effectiveness of the MEP scheme ('Milieukwaliteit Elektriciteitsproductie' or Environmental Quality of Electricity Generation), carried out as a graduation project at the Vrije Universiteit, Amsterdam, Netherlands. MEP subsidies are intended to promote investment in sustainable energy sources in the Netherlands by offering investors more certainty and a simpler structure than previous energy subsidies. The MEP also helps prevent Dutch taxpayers' money 'leaking' abroad to purchase sustainable electricity produced cheaper elsewhere. This makes the MEP measurably more effective than its predecessors. The scheme is moreover a step towards the effective deployment of state funds for the reduction of CO2 emission [nl

  2. A reliable and cost effective approach for radiographic monitoring in nutritional rickets.

    Science.gov (United States)

    Chatterjee, D; Gupta, V; Sharma, V; Sinha, B; Samanta, S

    2014-04-01

    Radiological scoring is particularly useful in rickets, where pre-treatment radiographical findings can reflect the disease severity and can be used to monitor the improvement. However, there is only a single radiographic scoring system for rickets developed by Thacher and, to the best of our knowledge, no study has evaluated radiographic changes in rickets based on this scoring system apart from the one done by Thacher himself. The main objective of this study is to compare and analyse the pre-treatment and post-treatment radiographic parameters in nutritional rickets with the help of Thacher's scoring technique. 176 patients with nutritional rickets were given a single intramuscular injection of vitamin D (600 000 IU) along with oral calcium (50 mg kg(-1)) and vitamin D (400 IU per day) until radiological resolution and followed for 1 year. Pre- and post-treatment radiological parameters were compared and analysed statistically based on Thacher's scoring system. Radiological resolution was complete by 6 months. Time for radiological resolution and initial radiological score were linearly associated on regression analysis. The distal ulna was the last to heal in most cases except when the initial score was 10, when distal femur was the last to heal. Thacher's scoring system can effectively monitor nutritional rickets. The formula derived through linear regression has prognostic significance. The distal femur is a better indicator in radiologically severe rickets and when resolution is delayed. Thacher's scoring is very useful for monitoring of rickets. The formula derived through linear regression can predict the expected time for radiological resolution.

  3. The Spin Move: A Reliable and Cost-Effective Gowning Technique for the 21st Century.

    Science.gov (United States)

    Ochiai, Derek H; Adib, Farshad

    2015-04-01

    Operating room efficiency (ORE) and utilization are considered one of the most crucial components of quality improvement in every hospital. We introduced a new gowning technique that could optimize ORE. The Spin Move quickly and efficiently wraps a surgical gown around the surgeon's body. This saves the operative time expended through the traditional gowning techniques. In the Spin Move, while the surgeon is approaching the scrub nurse, he or she uses the left heel as the fulcrum. The torque, which is generated by twisting the right leg around the left leg, helps the surgeon to close the gown as quickly and safely as possible. From 2003 to 2012, the Spin Move was performed in 1,725 consecutive procedures with no complication. The estimated average time was 5.3 and 7.8 seconds for the Spin Move and traditional gowning, respectively. The estimated time saving for the senior author during this period was 71.875 minutes. Approximately 20,000 orthopaedic surgeons practice in the United States. If this technique had been used, 23,958 hours could have been saved. The money saving could have been $14,374,800.00 (23,958 hours × $600/operating room hour) during the past 10 years. The Spin Move is easy to perform and reproducible. It saves operating room time and increases ORE.

  4. Simple, Reliable, and Cost-Effective Yeast Identification Scheme for the Clinical Laboratory

    OpenAIRE

    Koehler, Ann P.; Chu, Kai-Cheong; Houang, Elizabeth T. S.; Cheng, Augustine F. B.

    1999-01-01

    The appearance of colonies on the chromogenic medium CHROMagar Candida combined with observation of morphology on corn meal–Tween 80 agar was used for the identification of 353 clinical yeast isolates. The results were compared with those obtained with API yeast identification kits. The accuracy of identification and the turnaround time were equivalent for each method, and our cultural method was less expensive.

  5. Design of cost-effective M 25 grade of self compacting concrete

    International Nuclear Information System (INIS)

    Guru Jawahar, J.; Sashidhar, C.; Ramana Reddy, I.V.; Annie Peter, J.

    2013-01-01

    Highlights: ► Design of cost-effective M 25 grade of self compacting concrete is done. ► Mechanical properties of SCC compared with M 25 grade of conventional concrete. ► Effect of class F fly ash is studied on the SCC mechanical properties. ► Cost analysis is done between M 25 grade of CC and SCC. ► Recommendation of M 25 grade of SCC for normal building constructions. - Abstract: This investigation is mainly focused on the development of cost-effective normal strength M 25 grade of self compacting concrete (SCC) for the use of normal building constructions. Keeping in view of the normal strength, cost, quality and durability of SCC and greenhouse gas emissions, a combination type of SCC was developed with 35% replacement of cement with class F fly ash. This study recommended a SCC mix with moderate fines to obtain a cost-effective normal strength SCC for the normal building constructions. Studies also revealed that further reduction in fines content in SCC with the same replacement level of fly ash decreased the SCC strength and its performance. Cost analysis has been done between M 25 grade of SCC and conventional concrete (CC). Results shown that the SCC material cost is slightly higher than that of CC of the same strength class, but the savings in labour cost and construction time and quality of SCC would offset the SCC material cost and reduce the total life cycle cost of SCC

  6. Consumer cost effectiveness of CO2 mitigation policies in restructured electricity markets

    International Nuclear Information System (INIS)

    Moore, Jared; Apt, Jay

    2014-01-01

    We examine the cost of carbon dioxide mitigation to consumers in restructured USA markets under two policy instruments, a carbon price and a renewable portfolio standard (RPS). To estimate the effect of policies on market clearing prices, we constructed hourly economic dispatch models of the generators in PJM and in ERCOT. We find that the cost effectiveness of policies for consumers is strongly dependent on the price of natural gas and on the characteristics of the generators in the dispatch stack. If gas prices are low (∼$4/MMBTU), a technology-agnostic, rational consumer seeking to minimize costs would prefer a carbon price over an RPS in both regions. Expensive gas (∼$7/MMBTU) requires a high carbon price to induce fuel switching and this leads to wealth transfers from consumers to low carbon producers. The RPS may be more cost effective for consumers because the added energy supply lowers market clearing prices and reduces CO 2 emissions. We find that both policies have consequences in capacity markets and that the RPS can be more cost effective than a carbon price under certain circumstances: continued excess supply of capacity, retention of nuclear generators, and high natural gas prices. (letter)

  7. Attributes of system testing which promote cost-effectiveness

    International Nuclear Information System (INIS)

    Martin, L.C.

    1975-01-01

    A brief overview of conventional EMP testing activity examines attributes of overall systems tests which promote cost-effectiveness. The general framework represents an EMP-oriented systems test as a portion of a planned program to design, produce, and field system elements. As such, all so-called system tests should play appropriate cost-effective roles in this program, and the objective here is to disclose such roles. The intrinsic worth of such tests depends not only upon placing proper values on the outcomes, but also upon the possible eventual consequences of not doing tests. A relative worth measure is required. Attributes of EMP system testing over the range of potential activity which encompasses research and development, production, field handling, verification, evaluation, and others are reviewed and examined. Thus, the relative worth, in a cost-effective sense, is provided by relating such attributes to the overall program objectives so that values can be placed on the outcomes for tradeoff purposes

  8. Cost effectiveness and efficiency in assistive technology service delivery.

    Science.gov (United States)

    Warren, C G

    1993-01-01

    In order to develop and maintain a viable service delivery program, the realities of cost effectiveness and cost efficiency in providing assistive technology must be addressed. Cost effectiveness relates to value of the outcome compared to the expenditures. Cost efficiency analyzes how a provider uses available resources to supply goods and services. This paper describes how basic business principles of benefit/cost analysis can be used to determine cost effectiveness. In addition, basic accounting principles are used to illustrate methods of evaluating a program's cost efficiency. Service providers are encouraged to measure their own program's effectiveness and efficiency (and potential viability) in light of current trends. This paper is meant to serve as a catalyst for continued dialogue on this topic.

  9. Bayesian cost-effectiveness analysis with the R package BCEA

    CERN Document Server

    Baio, Gianluca; Heath, Anna

    2017-01-01

    The book provides a description of the process of health economic evaluation and modelling for cost-effectiveness analysis, particularly from the perspective of a Bayesian statistical approach. Some relevant theory and introductory concepts are presented using practical examples and two running case studies. The book also describes in detail how to perform health economic evaluations using the R package BCEA (Bayesian Cost-Effectiveness Analysis). BCEA can be used to post-process the results of a Bayesian cost-effectiveness model and perform advanced analyses producing standardised and highly customisable outputs. It presents all the features of the package, including its many functions and their practical application, as well as its user-friendly web interface. The book is a valuable resource for statisticians and practitioners working in the field of health economics wanting to simplify and standardise their workflow, for example in the preparation of dossiers in support of marketing authorisation, or acade...

  10. A Layered Decision Model for Cost-Effective System Security

    Energy Technology Data Exchange (ETDEWEB)

    Wei, Huaqiang; Alves-Foss, James; Soule, Terry; Pforsich, Hugh; Zhang, Du; Frincke, Deborah A.

    2008-10-01

    System security involves decisions in at least three areas: identification of well-defined security policies, selection of cost-effective defence strategies, and implementation of real-time defence tactics. Although choices made in each of these areas affect the others, existing decision models typically handle these three decision areas in isolation. There is no comprehensive tool that can integrate them to provide a single efficient model for safeguarding a network. In addition, there is no clear way to determine which particular combinations of defence decisions result in cost-effective solutions. To address these problems, this paper introduces a Layered Decision Model (LDM) for use in deciding how to address defence decisions based on their cost-effectiveness. To validate the LDM and illustrate how it is used, we used simulation to test model rationality and applied the LDM to the design of system security for an e-commercial business case.

  11. Application of reliability methods in Ontario Hydro

    International Nuclear Information System (INIS)

    Jeppesen, R.; Ravishankar, T.J.

    1985-01-01

    Ontario Hydro have established a reliability program in support of its substantial nuclear program. Application of the reliability program to achieve both production and safety goals is described. The value of such a reliability program is evident in the record of Ontario Hydro's operating nuclear stations. The factors which have contributed to the success of the reliability program are identified as line management's commitment to reliability; selective and judicious application of reliability methods; establishing performance goals and monitoring the in-service performance; and collection, distribution, review and utilization of performance information to facilitate cost-effective achievement of goals and improvements. (orig.)

  12. Field reliability of electronic systems

    International Nuclear Information System (INIS)

    Elm, T.

    1984-02-01

    This report investigates, through several examples from the field, the reliability of electronic units in a broader sense. That is, it treats not just random parts failure, but also inadequate reliability design and (externally and internally) induced failures. The report is not meant to be merely an indication of the state of the art for the reliability prediction methods we know, but also as a contribution to the investigation of man-machine interplay in the operation and repair of electronic equipment. The report firmly links electronics reliability to safety and risk analyses approaches with a broader, system oriented view of reliability prediction and with postfailure stress analysis. It is intended to reveal, in a qualitative manner, the existence of symptom and cause patterns. It provides a background for further investigations to identify the detailed mechanisms of the faults and the remedical actions and precautions for achieving cost effective reliability. (author)

  13. Cost-effectiveness of osteo-odonto keratoprosthesis in Singapore.

    Science.gov (United States)

    Dong, Di; Tan, Anna; Mehta, Jodhbir S; Tan, Donald; Finkelstein, Eric Andrew

    2014-01-01

    To determine the long-term cost-effectiveness of osteo-odonto keratoprosthesis (OOKP) relative to no treatment among patients with end-stage corneal and ocular surface diseases in Singapore. Cost-effectiveness analysis based on data from a retrospective cohort study. From a health system perspective, we calculated the incremental cost-effectiveness ratio of OOKP treatment relative to no treatment over a 30-year horizon, based on data from a cohort of 23 patients who underwent OOKP surgery between 2004 and 2009 at Singapore National Eye Centre. Preoperative and postoperative vision-related quality-of-life values were estimated from patients' visual outcomes and were used to calculate the gain in quality-adjusted life years (QALYs) resulting from OOKP treatment. Unsubsidized costs for surgery, consultations, examinations, medications, follow-up visits, and treatments for complications were retrieved from patients' bills to estimate the total costs associated with OOKP treatment. Sensitivity analyses were conducted to test the robustness of the model. Over a 30-year period, OOKP treatment, compared with no treatment, improved QALYs by 3.991 among patients with end-stage corneal and ocular surface diseases at an additional cost of S$67 840 (US$55 150), resulting in an incremental cost-effectiveness ratio of S$17 000/QALY (US$13 820/QALY). Based on commonly cited cost-effectiveness benchmarks, the OOKP is a cost-effective treatment for patients with end-stage corneal and ocular surface diseases. Copyright © 2014 Elsevier Inc. All rights reserved.

  14. Is individualized medicine more cost-effective? A systematic review.

    Science.gov (United States)

    Hatz, Maximilian H M; Schremser, Katharina; Rogowski, Wolf H

    2014-05-01

    Individualized medicine (IM) is a rapidly evolving field that is associated with both visions of more effective care at lower costs and fears of highly priced, low-value interventions. It is unclear which view is supported by the current evidence. Our objective was to systematically review the health economic evidence related to IM and to derive general statements on its cost-effectiveness. A literature search of MEDLINE database for English- and German-language studies was conducted. Cost-effectiveness and cost-utility studies for technologies meeting the MEDLINE medical subject headings (MeSH) definition of IM (genetically targeted interventions) were reviewed. This was followed by a standardized extraction of general study characteristics and cost-effectiveness results. Most of the 84 studies included in the synthesis were from the USA (n = 43, 51 %), cost-utility studies (n = 66, 79 %), and published since 2005 (n = 60, 71 %). The results ranged from dominant to dominated. The median value (cost-utility studies) was calculated to be rounded $US22,000 per quality-adjusted life year (QALY) gained (adjusted to $US, year 2008 values), which is equal to the rounded median cost-effectiveness in the peer-reviewed English-language literature according to a recent review. Many studies reported more than one strategy of IM with highly varying cost-effectiveness ratios. Generally, results differed according to test type, and tests for disease prognosis or screening appeared to be more favorable than tests to stratify patients by response or by risk of adverse effects. However, these results were not significant. Different definitions of IM could have been used. Quality assessment of the studies was restricted to analyzing transparency. IM neither seems to display superior cost-effectiveness than other types of medical interventions nor to be economically inferior. Instead, rather than 'whether' healthcare was individualized, the question of 'how' it was individualized was

  15. [Cost-effectiveness and affordability of strategy for preventing mother-to-child transmission of hepatitis B in China].

    Science.gov (United States)

    Lin, Y; Zhang, S X; Yang, P C; Cai, Y L; Zou, Y H

    2017-07-10

    Objective: To evaluate the cost effectiveness of nationwide prevention of mother to child transmission (PMTCT) strategy for hepatitis B, and estimate the willing to pay and budget impacts on the PMTCT. Methods: The decision analytic Markov model for the PMTCT was constructed and a birth cohort of Chinese infants born in 2013 was used to calculate the cost-effectiveness of the PMTCT among them compared with those receiving no intervention. The parameters in the model were obtained from literatures of national surveys or Meta-analysis. The costs, cases of HBV-related diseases and quality-adjusted life-years (QALYs) were obtained from the societal and payer perspectives, respectively. The incremental cost-effectiveness ratio (ICER) was used as measures of strategy optimization. One-way and probability sensitivity analysis were performed to explore the uncertainty of the primary results. In addition, cost-effectiveness acceptability curve and cost-effectiveness affordability curves were drawn to illustrate the cost effectiveness threshold and financial budget of the PMTCT strategy. Results: The lifetime cost for PMTCT strategy was 4 063.5 yuan (RMB) per carrier, which was 37 829.7 yuan (RMB) lower compared with those receiving no intervention. Due to the strategy, a total of 24.516 1 QALYs per person would be gained, which was higher than that in those receiving no intervention. From societal perspective, the ICER was -59 136.6 yuan (RMB) per additional QALYs gained, indicating that the PMTCT is cost effective. The results were reliable indicated by one-way, multi-way and probability sensitivity analyses. By the CEAC, the willing to pay was much lower than the cost-effectiveness threshold. From the affordability curve of the PMTCT strategy, the annual budget ranged from 590.4 million yuan (RMB) to 688.8 million yuan (RMB), which was lower than the financial ability. Based on the results of cost-effectiveness affordability curves, the higher annual budget was determined

  16. Cost-effectiveness analysis of computer-based assessment

    Directory of Open Access Journals (Sweden)

    Pauline Loewenberger

    2003-12-01

    Full Text Available The need for more cost-effective and pedagogically acceptable combinations of teaching and learning methods to sustain increasing student numbers means that the use of innovative methods, using technology, is accelerating. There is an expectation that economies of scale might provide greater cost-effectiveness whilst also enhancing student learning. The difficulties and complexities of these expectations are considered in this paper, which explores the challenges faced by those wishing to evaluate the costeffectiveness of computer-based assessment (CBA. The paper outlines the outcomes of a survey which attempted to gather information about the costs and benefits of CBA.

  17. Cost Effectiveness Analysis of Optimal Malaria Control Strategies in Kenya

    Directory of Open Access Journals (Sweden)

    Gabriel Otieno

    2016-03-01

    Full Text Available Malaria remains a leading cause of mortality and morbidity among the children under five and pregnant women in sub-Saharan Africa, but it is preventable and controllable provided current recommended interventions are properly implemented. Better utilization of malaria intervention strategies will ensure the gain for the value for money and producing health improvements in the most cost effective way. The purpose of the value for money drive is to develop a better understanding (and better articulation of costs and results so that more informed, evidence-based choices could be made. Cost effectiveness analysis is carried out to inform decision makers on how to determine where to allocate resources for malaria interventions. This study carries out cost effective analysis of one or all possible combinations of the optimal malaria control strategies (Insecticide Treated Bednets—ITNs, Treatment, Indoor Residual Spray—IRS and Intermittent Preventive Treatment for Pregnant Women—IPTp for the four different transmission settings in order to assess the extent to which the intervention strategies are beneficial and cost effective. For the four different transmission settings in Kenya the optimal solution for the 15 strategies and their associated effectiveness are computed. Cost-effective analysis using Incremental Cost Effectiveness Ratio (ICER was done after ranking the strategies in order of the increasing effectiveness (total infections averted. The findings shows that for the endemic regions the combination of ITNs, IRS, and IPTp was the most cost-effective of all the combined strategies developed in this study for malaria disease control and prevention; for the epidemic prone areas is the combination of the treatment and IRS; for seasonal areas is the use of ITNs plus treatment; and for the low risk areas is the use of treatment only. Malaria transmission in Kenya can be minimized through tailor-made intervention strategies for malaria control

  18. Skeletal traction and intramedullary nailing cost-effectiveness

    African Journals Online (AJOL)

    In the operative group 24 patients had union with one delayed union while in the traction group 12 patients had union, 9 with mal union and 4 delayed union. Conclusion: Intramedullary nailing is more cost-effective than skeletal traction. It met the dominant strategy, because it was significantly less costly than skeletal ...

  19. Cost Effectiveness of Premium Versus Regular Gasoline in MCPS Buses.

    Science.gov (United States)

    Baacke, Clifford M.; Frankel, Steven M.

    The primary question posed in this study is whether premium or regular gasoline is more cost effective for the Montgomery County Public School (MCPS) bus fleet, as a whole, when miles-per-gallon, cost-per-gallon, and repair costs associated with mileage are considered. On average, both miles-per-gallon, and repair costs-per-mile favor premium…

  20. Cost-effectiveness of varenicline for smoking cessation

    DEFF Research Database (Denmark)

    Keiding, Hans

    2009-01-01

    Smoking cessation therapies are among the most cost-effective preventive healthcare measures. Varenicline is a relatively new drug developed especially for this purpose, and it has been shown to achieve better quit rates than nicotine replacement therapies and the non-nicotine-based drug, bupropion...

  1. Pressure relieving support surfaces (PRESSURE) trial: cost effectiveness analysis.

    Science.gov (United States)

    Iglesias, Cynthia; Nixon, Jane; Cranny, Gillian; Nelson, E Andrea; Hawkins, Kim; Phillips, Angela; Torgerson, David; Mason, Su; Cullum, Nicky

    2006-06-17

    To assess the cost effectiveness of alternating pressure mattresses compared with alternating pressure overlays for the prevention of pressure ulcers in patients admitted to hospital. Cost effectiveness analysis carried out alongside the pressure relieving support surfaces (PRESSURE) trial; a multicentre UK based pragmatic randomised controlled trial. 11 hospitals in six UK NHS trusts. Intention to treat population comprising 1971 participants. Kaplan Meier estimates of restricted mean time to development of pressure ulcers and total costs for treatment in hospital. Alternating pressure mattresses were associated with lower overall costs (283.6 pounds sterling per patient on average, 95% confidence interval--377.59 pounds sterling to 976.79 pounds sterling) mainly due to reduced length of stay in hospital, and greater benefits (a delay in time to ulceration of 10.64 days on average,--24.40 to 3.09). The differences in health benefits and total costs for hospital stay between alternating pressure mattresses and alternating pressure overlays were not statistically significant; however, a cost effectiveness acceptability curve indicated that on average alternating pressure mattresses compared with alternating pressure overlays were associated with an 80% probability of being cost saving. Alternating pressure mattresses for the prevention of pressure ulcers are more likely to be cost effective and are more acceptable to patients than alternating pressure overlays.

  2. Cost-effectiveness of in vitro fertilization and embryo transfer

    NARCIS (Netherlands)

    Mol, B. W.; Bonsel, G. J.; Collins, J. A.; Wiegerinck, M. A.; van der Veen, F.; Bossuyt, P. M.

    2000-01-01

    OBJECTIVE: Economic analyses in reproductive medicine often fail to take into account the chances of treatment-independent conception. We compared the cost-effectiveness of several realistic strategies involving IVF using no treatment as the reference strategy. DESIGN: A decision tree was

  3. Cost-effectiveness of hysteroscopy screening for infertile women.

    Science.gov (United States)

    Kasius, Jenneke C; Eijkemans, René J C; Mol, Ben W J; Fauser, Bart C J M; Fatemi, Human M; Broekmans, Frank J M

    2013-06-01

    This study assessed the cost-effectiveness of office hysteroscopy screening prior to IVF. Therefore, the cost-effectiveness of two distinct strategies - hysteroscopy after two failed IVF cycles (Failedhyst) and routine hysteroscopy prior to IVF (Routinehyst) - was compared with the reference strategy of no hysteroscopy (Nohyst). When present, intrauterine pathology was treated during hysteroscopy. Two models were constructed and evaluated in a decision analysis. In model I, all patients had an increase in pregnancy rate after screening hysteroscopy prior to IVF; in model II, only patients with intrauterine pathology would benefit. For each strategy, the total costs and live birth rates after a total of three IVF cycles were assessed. For model I (all patients benefit from hysteroscopy), Routinehyst was always cost-effective compared with Nohyst or Failedhyst. For the Routinehyst strategy, a monetary profit would be obtained in the case where hysteroscopy would increase the live birth rate after IVF by ≥ 2.8%. In model II (only patients with pathology benefit from hysteroscopy), Routinehyst also dominated Failedhyst. However, hysteroscopy performance resulted in considerable costs. In conclusion, the application of a routine hysteroscopy prior to IVF could be cost-effective. However, randomized trials confirming the effectiveness of hysteroscopy are needed. Copyright © 2013 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  4. Construction of cost effective homebuilt spin coater for coating ...

    African Journals Online (AJOL)

    We report the construction of a cost effective and low power consumption spin coater from a direct current (DC) brushless motor. The DC mechanical component is widdely available in the central processing unit (CPU) cooler. This set up permits simple operation where the DC voltage can be controlled manually in order to ...

  5. Exploring cost-effective maize integrated weed management ...

    African Journals Online (AJOL)

    Several production constraints have led to low yields (< 2.5 t ha-1) in maize (Zea mays L.) inUganda, among which are weeds. This study investigated the most cost-effective integrated weedmanagement (IWM) approach in maize in eastern Uganda. An experiment was conducted atIkulwe station, Mayuge in 2011 and 2012 ...

  6. Cost-Effectiveness Analysis of Regorafenib for Metastatic Colorectal Cancer.

    Science.gov (United States)

    Goldstein, Daniel A; Ahmad, Bilal B; Chen, Qiushi; Ayer, Turgay; Howard, David H; Lipscomb, Joseph; El-Rayes, Bassel F; Flowers, Christopher R

    2015-11-10

    Regorafenib is a standard-care option for treatment-refractory metastatic colorectal cancer that increases median overall survival by 6 weeks compared with placebo. Given this small incremental clinical benefit, we evaluated the cost-effectiveness of regorafenib in the third-line setting for patients with metastatic colorectal cancer from the US payer perspective. We developed a Markov model to compare the cost and effectiveness of regorafenib with those of placebo in the third-line treatment of metastatic colorectal cancer. Health outcomes were measured in life-years and quality-adjusted life-years (QALYs). Drug costs were based on Medicare reimbursement rates in 2014. Model robustness was addressed in univariable and probabilistic sensitivity analyses. Regorafenib provided an additional 0.04 QALYs (0.13 life-years) at a cost of $40,000, resulting in an incremental cost-effectiveness ratio of $900,000 per QALY. The incremental cost-effectiveness ratio for regorafenib was > $550,000 per QALY in all of our univariable and probabilistic sensitivity analyses. Regorafenib provides minimal incremental benefit at high incremental cost per QALY in the third-line management of metastatic colorectal cancer. The cost-effectiveness of regorafenib could be improved by the use of value-based pricing. © 2015 by American Society of Clinical Oncology.

  7. Chain Risk Model for quantifying cost effectiveness of phytosanitary measures

    NARCIS (Netherlands)

    Benninga, J.; Hennen, W.H.G.J.; Schans, van de J.

    2010-01-01

    A Chain Risk Model (CRM) was developed for a cost effective assessment of phytosanitary measures. The CRM model can be applied to phytosanitary assessments of all agricultural product chains. In CRM, stages are connected by product volume flows with which pest infections can be spread from one stage

  8. Cost-effectiveness in Clostridium difficile treatment decision-making

    NARCIS (Netherlands)

    Nuijten, Mark J. C.; Keller, Josbert J.; Visser, Caroline E.; Redekop, Ken; Claassen, Eric; Speelman, Peter; Pronk, Marja H.

    2015-01-01

    To develop a framework for the clinical and health economic assessment for management of Clostridium difficile infection (CDI). CDI has vast economic consequences emphasizing the need for innovative and cost effective solutions, which were aim of this study. A guidance model was developed for

  9. A cost-effective Geographic Information Systems for Transportation ...

    African Journals Online (AJOL)

    A cost-effective Geographic Information Systems for Transportation (GIS-T) application for traffic congestion analyses in the Developing World. ... The PDF file you selected should load here if your Web browser has a PDF reader plug-in installed (for example, a recent version of Adobe Acrobat Reader). If you would like ...

  10. Final report: Compiled MPI. Cost-Effective Exascale Application Development

    Energy Technology Data Exchange (ETDEWEB)

    Gropp, William Douglas [Univ. of Illinois, Urbana-Champaign, IL (United States)

    2015-12-21

    This is the final report on Compiled MPI: Cost-Effective Exascale Application Development, and summarizes the results under this project. The project investigated runtime enviroments that improve the performance of MPI (Message-Passing Interface) programs; work at Illinois in the last period of this project looked at optimizing data access optimizations expressed with MPI datatypes.

  11. Impacts of optimum cost effective energy efficiency standards

    International Nuclear Information System (INIS)

    Brancic, A.B.; Peters, J.S.; Arch, M.

    1991-01-01

    Building Codes are increasingly required to be responsive to social and economic policy concerns. In 1990 the State of Connecticut passes An Act Concerning Global Warming, Public Act 90-219, which mandates the revision of the state building code to require that buildings and building elements be designed to provide optimum cost-effective energy efficiency over the useful life of the building. Further, such revision must meet the American Society of Heating, Refrigerating and Air Conditioning Engineers (ASHRAE) Standard 90.1 - 1989. As the largest electric energy supplier in Connecticut, Northeast Utilities (NU) sponsored a pilot study of the cost effectiveness of alternative building code standards for commercial construction. This paper reports on this study which analyzed design and construction means, building elements, incremental construction costs, and energy savings to determine the optimum cost-effective building code standard. Findings are that ASHRAE 90.1 results in 21% energy savings and alternative standards above it result in significant additional savings. Benefit/cost analysis showed that both are cost effective

  12. The Cost-Effectiveness of Raising Teacher Quality

    Science.gov (United States)

    Yeh, Stuart S.

    2009-01-01

    Econometric studies suggest that student achievement may be improved if high-performing teachers are substituted for low-performing teachers. Drawing upon a recent study linking teacher performance on licensure exams with gains in student achievement, an analysis was conducted to determine the cost-effectiveness of requiring teacher applicants to…

  13. A Cost-Effectiveness Analysis of Early Literacy Interventions

    Science.gov (United States)

    Simon, Jessica

    2011-01-01

    Success in early literacy activities is associated with improved educational outcomes, including reduced dropout risk, in-grade retention, and special education referrals. When considering programs that will work for a particular school and context; cost-effectiveness analysis may provide useful information for decision makers. The study…

  14. Cost-Effective Mass Production of Mono Bucket Foundations

    DEFF Research Database (Denmark)

    Gres, Szymon; Nielsen, Søren Andreas; Fejerskov, Morten

    2015-01-01

    for innovative and cost-effective design of Mono Bucket foundations. Established approach merges wind and wave load models, soil/structure interaction topics, structural optimization and installation/fabrication aspects, into software package with ability to perform optimal design of the individual foundations...

  15. Cost effectiveness studies of environmental technologies: Volume 1

    International Nuclear Information System (INIS)

    Silva, E.M.; Booth, S.R.

    1994-02-01

    This paper examines cost effectiveness studies of environmental technologies including the following: (1) In Situ Air Stripping, (2) Surface Towed Ordinance Locator System, (3) Ditch Witch Horizontal Boring Technology, (4) Direct Sampling Ion Trap Mass Spectrometer, (5) In Situ Vitrification, (6) Site Characterization and Analysis Penetrometer System, (7) In Situ Bioremediation, and (8) SEAMIST Membrane System Technology

  16. Improving cost-effectiveness of hypertension management at a ...

    African Journals Online (AJOL)

    Objectives. To describe the pattern of prescribing for hypertension at a community health centre (CHC) and to evaluate the impact of introducing treatment guidelines and restricting availability of less cost-effective antihypertensive drugs on prescribing patterns, costs of drug treatment and blood pressure (BP) control. Design ...

  17. Cost-effectiveness of hip protectors in frail institutionalized elderly

    NARCIS (Netherlands)

    van Schoor, N.M.; de Bruyne, M.C.; van der Roer, N.; Lommerse, E.; van Tulder, M.; Bouter, L.M.; Lips, P.T.A.M.

    2004-01-01

    A randomized controlled trial was performed to examine the cost-effectiveness of external hip protectors in the prevention of hip fractures. Since the hip protectors were not effective in preventing hip fractures in our study, the main objective became to examine whether the use of hip protectors

  18. Flipping the Calculus Classroom: A Cost-Effective Approach

    Science.gov (United States)

    Young, Andrea

    2015-01-01

    This article discusses a cost-effective approach to flipping the calculus classroom. In particular, the emphasis is on low-cost choices, both monetarily and with regards to faculty time, that make the daunting task of flipping a course manageable for a single instructor. Student feedback and overall impressions are also presented.

  19. Cost-effectiveness analysis of infant feeding strategies to prevent ...

    African Journals Online (AJOL)

    Changing feeding practices is beneficial, depending on context. Breastfeeding is dominant (less costly, more effective) in rural settings, whilst formula feeding is a dominant strategy in urban settings. Cost-effectiveness was most sensitive to proportion of women on lifelong antiretroviral therapy (ART) and infant mortality rate ...

  20. Cost-effectiveness of PET and PET/Computed Tomography

    DEFF Research Database (Denmark)

    Gerke, Oke; Hermansson, Ronnie; Hess, Søren

    2015-01-01

    measure by means of incremental cost-effectiveness ratios when considering the replacement of the standard regimen by a new diagnostic procedure. This article discusses economic assessments of PET and PET/computed tomography reported until mid-July 2014. Forty-seven studies on cancer and noncancer...

  1. Cost-Effectiveness Analysis of Unsafe Abortion and Alternative First ...

    African Journals Online (AJOL)

    To explore the policy implications of increasing access to safe abortion in Nigeria and Ghana, we developed a computer-based decision analytic model which simulates induced abortion and its potential complications in a cohort of women, and comparatively assessed the cost-effectiveness of unsafe abortion and three ...

  2. Design of cost effective antennas for instrumentation radars

    CSIR Research Space (South Africa)

    Botha, L

    2012-09-01

    Full Text Available The cost of antennas for instrumentation radars are determined by the development cost. By re-use of the reflector system cost effective antennas can be designed. The factors governing the design of such antennas are described here....

  3. Cost-Effectiveness Analysis of Family Planning Services Offered by ...

    African Journals Online (AJOL)

    USER

    Keywords: Mobile clinics; Staic clinic; Family planning; Cost-effectiveness. Résumé. Des analyses ... d'offrir plus de méthodes de longue durée d'action peut influer sur une décision politique entre ces options. Cliniques ... nurse and a driver9.

  4. Cost-effectiveness of controlling Salmonella in the pork chain

    NARCIS (Netherlands)

    Gaag, van der M.A.; Saatkamp, H.W.; Backus, G.B.C.; Beek, van P.; Huirne, R.B.M.

    2004-01-01

    Pork is one of the sources of food-borne salmonellosis in humans. In this paper, the cost-effectiveness of different control scenarios against Salmonella in the stages finishing, transport, lairage and slaughtering is explored. A stochastic simulation model was used for the epidemiological analysis

  5. How does cognitive dissonance influence the sunk cost effect?

    Directory of Open Access Journals (Sweden)

    Chung SH

    2018-03-01

    Full Text Available Shao-Hsi Chung,1 Kuo-Chih Cheng2 1Department of Business Administration, Meiho University, Pingtung, Taiwan; 2Department of Accounting, National Changhua University of Education, Changhua City, Taiwan Background: The sunk cost effect is the scenario when individuals are willing to continue to invest capital in a failing project. The purpose of this study was to explain such irrational behavior by exploring how sunk costs affect individuals’ willingness to continue investing in an unfavorable project and to understand the role of cognitive dissonance on the sunk cost effect. Methods: This study used an experimental questionnaire survey on managers of firms listed on the Taiwan Stock Exchange and Over-The-Counter. Results: The empirical results show that cognitive dissonance does not mediate the relationship between sunk costs and willingness to continue an unfavorable investment project. However, cognitive dissonance has a moderating effect, and only when the level of cognitive dissonance is high does the sunk cost have significantly positive impacts on willingness to continue on with an unfavorable investment. Conclusion: This study offers psychological mechanisms to explain the sunk cost effect based on the theory of cognitive dissonance, and it also provides some recommendations for corporate management. Keywords: sunk costs, sunk cost effect, cognitive dissonance, behavior, unfavorable investment

  6. Cost-effectiveness of telemonitoring of diabetic foot ulcer patients

    DEFF Research Database (Denmark)

    Fasterholdt, Iben; Gerstrøm, Marie; Rasmussen, Benjamin Schnack Brandt

    2016-01-01

    This study compared the cost-effectiveness of telemonitoring with standard monitoring for patients with diabetic foot ulcers. The economic evaluation was nested within a pragmatic randomised controlled trial. A total of 374 patients were randomised to either telemonitoring or standard monitoring...

  7. Cost-effectiveness of private umbilical cord blood banking.

    Science.gov (United States)

    Kaimal, Anjali J; Smith, Catherine C; Laros, Russell K; Caughey, Aaron B; Cheng, Yvonne W

    2009-10-01

    To investigate the cost-effectiveness of private umbilical cord blood banking. A decision-analytic model was designed comparing private umbilical cord blood banking with no umbilical cord blood banking. Baseline assumptions included a cost of $3,620 for umbilical cord blood banking and storage for 20 years, a 0.04% chance of requiring an autologous stem cell transplant, a 0.07% chance of a sibling requiring an allogenic stem cell transplant, and a 50% reduction in risk of graft-versus-host disease if a sibling uses banked umbilical cord blood. Private cord blood banking is not cost-effective because it cost an additional $1,374,246 per life-year gained. In sensitivity analysis, if the cost of umbilical cord blood banking is less than $262 or the likelihood of a child needing a stem cell transplant is greater than 1 in 110, private umbilical cord blood banking becomes cost-effective. Currently, private umbilical cord blood banking is cost-effective only for children with a very high likelihood of needing a stem cell transplant. Patients considering private blood banking should be informed of the remote likelihood that a unit will be used for a child or another family member. III.

  8. Protocol for cost effective detection of cassava mosaic virus ...

    African Journals Online (AJOL)

    Early detection of cassava mosaic disease (CMD) is an extremely important step in containing the spread of the disease in Africa. Many nucleic acid based detection tools have been developed for CMD diagnosis but although these methods are specific and sensitive for their target DNA, they are not fast, cost effective, can't ...

  9. Priority Setting, Cost-Effectiveness, and the Affordable Care Act.

    Science.gov (United States)

    Persad, Govind

    2015-01-01

    The Affordable Care Act (ACA) may be the most important health law statute in American history, yet much of the most prominent legal scholarship examining it has focused on the merits of the court challenges it has faced rather than delving into the details of its priority-setting provisions. In addition to providing an overview of the ACA's provisions concerning priority setting and their developing interpretations, this Article attempts to defend three substantive propositions. First, I argue that the ACA is neither uniformly hostile nor uniformly friendly to efforts to set priorities in ways that promote cost and quality. Second, I argue that the ACA does not take a single, unified approach to priority setting; rather, its guidance varies depending on the aspect of the healthcare system at issue (Patient Centered Outcomes Research Institute, Medicare, essential health benefits) and the factors being excluded from priority setting (age, disability, life expectancy). Third, I argue that cost-effectiveness can be achieved within the ACA's constraints, but that doing so will require adopting new approaches to cost-effectiveness and priority setting. By limiting the use of standard cost-effectiveness analysis, the ACA makes the need for workable rivals to cost-effectiveness analysis a pressing practical concern rather than a mere theoretical worry.

  10. Cost-effectiveness of infant pneumococcal vaccination in the Netherlands

    NARCIS (Netherlands)

    Vemer, P.; Postma, M.J.

    2013-01-01

    Objectives: The Dutch National Immunization Program offers the 10-valent pneumococcal conjugate vaccine (PCV10). Also licensed for use in the infant population is the 13-valent PCV (PCV13). To update cost-effectiveness (CE) estimates of PCV13 over PCV10, using current epidemiological and economic

  11. Cost-effectiveness of periconceptional supplementation of folic acid

    NARCIS (Netherlands)

    Postma, MJ; Londeman, J; Veenstra, M; de Walle, HEK; de Jong-van den Berg, LTW

    Background: Supplementation of folic acid prior to and in the beginning of pregnancy may prevent neural tube defects (NTDs) in newborns - such as spina bifida - and possibly other congenital malformations. Objective. To estimate cost effectiveness of periconceptional supplementation of folk: acid

  12. Cost-effectiveness of rotavirus vaccination in Turkey

    Directory of Open Access Journals (Sweden)

    Tulin Koksal

    2017-10-01

    Conclusion: At a cost per vaccine course of US$31.5 for monovalent and US$38 for pentavalent vaccine, routine RV vaccination could be potentially cost effective and also cost saving in Turkey. National RV vaccinations will play a significant role in preventing RV infections.

  13. Systemic cost-effectiveness analysis of food hazard reduction

    DEFF Research Database (Denmark)

    Jensen, Jørgen Dejgård; Lawson, Lartey Godwin; Lund, Mogens

    2015-01-01

    stage are considered. Cost analyses are conducted for different risk reduction targets and for three alternative scenarios concerning the acceptable range of interventions. Results demonstrate that using a system-wide policy approach to risk reduction can be more cost-effective than a policy focusing...

  14. Cost-effectiveness of pharmacological and psychosocial interventions for schizophrenia

    Directory of Open Access Journals (Sweden)

    Vos Theo

    2011-05-01

    Full Text Available Abstract Background Information on cost-effectiveness of interventions to treat schizophrenia can assist health policy decision making, particularly given the lack of health resources in developing countries like Thailand. This study aims to determine the optimal treatment package, including drug and non-drug interventions, for schizophrenia in Thailand. Methods A Markov model was used to evaluate the cost-effectiveness of typical antipsychotics, generic risperidone, olanzapine, clozapine and family interventions. Health outcomes were measured in disability adjusted life years. We evaluated intervention benefit by estimating a change in disease severity, taking into account potential side effects. Intervention costs included outpatient treatment costs, hospitalization costs as well as time and travel costs of patients and families. Uncertainty was evaluated using Monte Carlo simulation. A sensitivity analysis of the expected range cost of generic risperidone was undertaken. Results Generic risperidone is more cost-effective than typicals if it can be produced for less than 10 baht per 2 mg tablet. Risperidone was the cheapest treatment with higher drug costs offset by lower hospital costs in comparison to typicals. The most cost-effective combination of treatments was a combination of risperidone (dominant intervention. Adding family intervention has an incremental cost-effectiveness ratio of 1,900 baht/DALY with a 100% probability of a result less than a threshold for very cost-effective interventions of one times GDP or 110,000 baht per DALY. Treating the most severe one third of patients with clozapine instead of risperidone had an incremental cost-effectiveness ratio of 320,000 baht/DALY with just over 50% probability of a result below three times GDP per capita. Conclusions There are good economic arguments to recommend generic risperidone as first line treatment in combination with family intervention. As the uncertainty interval indicates

  15. Cost-effectiveness of pharmacological and psychosocial interventions for schizophrenia.

    Science.gov (United States)

    Phanthunane, Pudtan; Vos, Theo; Whiteford, Harvey; Bertram, Melanie

    2011-05-13

    Information on cost-effectiveness of interventions to treat schizophrenia can assist health policy decision making, particularly given the lack of health resources in developing countries like Thailand. This study aims to determine the optimal treatment package, including drug and non-drug interventions, for schizophrenia in Thailand. A Markov model was used to evaluate the cost-effectiveness of typical antipsychotics, generic risperidone, olanzapine, clozapine and family interventions. Health outcomes were measured in disability adjusted life years. We evaluated intervention benefit by estimating a change in disease severity, taking into account potential side effects. Intervention costs included outpatient treatment costs, hospitalization costs as well as time and travel costs of patients and families. Uncertainty was evaluated using Monte Carlo simulation. A sensitivity analysis of the expected range cost of generic risperidone was undertaken. Generic risperidone is more cost-effective than typicals if it can be produced for less than 10 baht per 2 mg tablet. Risperidone was the cheapest treatment with higher drug costs offset by lower hospital costs in comparison to typicals. The most cost-effective combination of treatments was a combination of risperidone (dominant intervention). Adding family intervention has an incremental cost-effectiveness ratio of 1,900 baht/DALY with a 100% probability of a result less than a threshold for very cost-effective interventions of one times GDP or 110,000 baht per DALY. Treating the most severe one third of patients with clozapine instead of risperidone had an incremental cost-effectiveness ratio of 320,000 baht/DALY with just over 50% probability of a result below three times GDP per capita. There are good economic arguments to recommend generic risperidone as first line treatment in combination with family intervention. As the uncertainty interval indicates the addition of clozapine may be dominated and there are serious

  16. Simulation of the cost-effectiveness of malaria vaccines

    Directory of Open Access Journals (Sweden)

    Tediosi Fabrizio

    2009-06-01

    Full Text Available Abstract Background A wide range of possible malaria vaccines is being considered and there is a need to identify which vaccines should be prioritized for clinical development. An important element of the information needed for this prioritization is a prediction of the cost-effectiveness of potential vaccines in the transmission settings in which they are likely to be deployed. This analysis needs to consider a range of delivery modalities to ensure that clinical development plans can be aligned with the most appropriate deployment strategies. Methods The simulations are based on a previously published individual-based stochastic model for the natural history and epidemiology of Plasmodium falciparum malaria. Three different vaccine types: pre-erythrocytic vaccines (PEV, blood stage vaccines (BSV, mosquito-stage transmission-blocking vaccines (MSTBV, and combinations of these, are considered each delivered via a range of delivery modalities (Expanded Programme of Immunization – EPI-, EPI with booster, and mass vaccination combined with EPI. The cost-effectiveness ratios presented are calculated for four health outcomes, for assumed vaccine prices of US$ 2 or US$ 10 per dose, projected over a 10-year period. Results The simulations suggest that PEV will be more cost-effective in low transmission settings, while BSV at higher transmission settings. Combinations of BSV and PEV are more efficient than PEV, especially in moderate to high transmission settings, while compared to BSV they are more cost-effective in moderate to low transmission settings. Combinations of MSTBV and PEV or PEV and BSV improve the effectiveness and the cost-effectiveness compared to PEV and BSV alone only when applied with EPI and mass vaccinations. Adding booster doses to the EPI is unlikely to be a cost-effective alternative to delivering vaccines via the EPI for any vaccine, while mass vaccination improves effectiveness, especially in low transmission settings, and is

  17. Cost-effectiveness of pharmacological and psychosocial interventions for schizophrenia

    Science.gov (United States)

    2011-01-01

    Background Information on cost-effectiveness of interventions to treat schizophrenia can assist health policy decision making, particularly given the lack of health resources in developing countries like Thailand. This study aims to determine the optimal treatment package, including drug and non-drug interventions, for schizophrenia in Thailand. Methods A Markov model was used to evaluate the cost-effectiveness of typical antipsychotics, generic risperidone, olanzapine, clozapine and family interventions. Health outcomes were measured in disability adjusted life years. We evaluated intervention benefit by estimating a change in disease severity, taking into account potential side effects. Intervention costs included outpatient treatment costs, hospitalization costs as well as time and travel costs of patients and families. Uncertainty was evaluated using Monte Carlo simulation. A sensitivity analysis of the expected range cost of generic risperidone was undertaken. Results Generic risperidone is more cost-effective than typicals if it can be produced for less than 10 baht per 2 mg tablet. Risperidone was the cheapest treatment with higher drug costs offset by lower hospital costs in comparison to typicals. The most cost-effective combination of treatments was a combination of risperidone (dominant intervention). Adding family intervention has an incremental cost-effectiveness ratio of 1,900 baht/DALY with a 100% probability of a result less than a threshold for very cost-effective interventions of one times GDP or 110,000 baht per DALY. Treating the most severe one third of patients with clozapine instead of risperidone had an incremental cost-effectiveness ratio of 320,000 baht/DALY with just over 50% probability of a result below three times GDP per capita. Conclusions There are good economic arguments to recommend generic risperidone as first line treatment in combination with family intervention. As the uncertainty interval indicates the addition of clozapine

  18. Cost-effectiveness of rotavirus vaccination in Albania.

    Science.gov (United States)

    Ahmeti, Albana; Preza, Iria; Simaku, Artan; Nelaj, Erida; Clark, Andrew David; Felix Garcia, Ana Gabriela; Lara, Carlos; Hoestlandt, Céline; Blau, Julia; Bino, Silvia

    2015-05-07

    Rotavirus vaccines have been introduced in several European countries but can represent a considerable cost, particularly for countries that do not qualify for any external financial support. This study aimed to evaluate the cost-effectiveness of introducing rotavirus vaccination into Albania's national immunization program and to inform national decision-making by improving national capacity to conduct economic evaluations of new vaccines. The TRIVAC model was used to assess vaccine impact and cost-effectiveness. The model estimated health and economic outcomes attributed to 10 successive vaccinated birth cohorts (2013-2022) from a government and societal perspective. Epidemiological and economic data used in the model were based on national cost studies, and surveillance data, as well as estimates from the scientific literature. Cost-effectiveness was estimated for both the monovalent (RV1) and pentavalent vaccines (RV5). A multivariate scenario analysis (SA) was performed to evaluate the uncertainty around the incremental cost-effectiveness ratios (ICERs). With 3% discounting of costs and health benefits over the period 2013-2022, rotavirus vaccination in Albania could avert 51,172 outpatient visits, 14,200 hospitalizations, 27 deaths, 950 disability-adjusted life-years (DALYs), and gain 801 life-years. When both vaccines were compared to no vaccination, the discounted cost per DALY averted was US$ 2008 for RV1 and US$ 5047 for RV5 from a government perspective. From the societal perspective the values were US$ 517 and US$ 3556, respectively. From both the perspectives, the introduction of rotavirus vaccine to the Albanian immunization schedule is either cost-effective or highly cost-effective for a range of plausible scenarios. In most scenarios, including the base-case scenario, the discounted cost per DALY averted was less than three times the gross domestic product (GDP) per capita. However, rotavirus vaccination was not cost-effective when rotavirus cases

  19. Cost-effectiveness of emergency contraception options over 1 year.

    Science.gov (United States)

    Bellows, Brandon K; Tak, Casey R; Sanders, Jessica N; Turok, David K; Schwarz, Eleanor B

    2018-05-01

    The copper intrauterine device is the most effective form of emergency contraception and can also provide long-term contraception. The levonorgestrel intrauterine device has also been studied in combination with oral levonorgestrel for women seeking emergency contraception. However, intrauterine devices have higher up-front costs than oral methods, such as ulipristal acetate and levonorgestrel. Health care payers and decision makers (eg, health care insurers, government programs) with financial constraints must determine if the increased effectiveness of intrauterine device emergency contraception methods are worth the additional costs. We sought to compare the cost-effectiveness of 4 emergency contraception strategies-ulipristal acetate, oral levonorgestrel, copper intrauterine device, and oral levonorgestrel plus same-day levonorgestrel intrauterine device-over 1 year from a US payer perspective. Costs (2017 US dollars) and pregnancies were estimated over 1 year using a Markov model of 1000 women seeking emergency contraception. Every 28-day cycle, the model estimated the predicted number of pregnancy outcomes (ie, live birth, ectopic pregnancy, spontaneous abortion, or induced abortion) resulting from emergency contraception failure and subsequent contraception use. Model inputs were derived from published literature and national sources. An emergency contraception strategy was considered cost-effective if the incremental cost-effectiveness ratio (ie, the cost to prevent 1 additional pregnancy) was less than the weighted average cost of pregnancy outcomes in the United States ($5167). The incremental cost-effectiveness ratios and probability of being the most cost-effective emergency contraception strategy were calculated from 1000 probabilistic model iterations. One-way sensitivity analyses were used to examine uncertainty in the cost of emergency contraception, subsequent contraception, and pregnancy outcomes as well as the model probabilities. In 1000 women

  20. Diesel vs. compressed natural gas for school buses: a cost-effectiveness evaluation of alternative fuels

    International Nuclear Information System (INIS)

    Cohen, J.T.

    2005-01-01

    Reducing emissions from school buses is a priority for both state and federal regulators. Two popular alternative technologies to conventional diesel (CD) are emission controlled diesel (ECD), defined here to be diesel buses equipped with continuously regenerating particle filters, and engines fueled by compressed natural gas (CNG). This paper uses a previously published model to quantify the impact of particulate matter (PM), oxides of nitrogen (NO x ), and sulfur dioxide (SO 2 ) emissions on population exposure to ozone and to primary and secondary PM, and to quantify the resulting health damages, expressed in terms of lost quality adjusted life years (QALYs). Resource costs include damages from greenhouse gas-induced climate change, vehicle procurement, infrastructure development, and operations. I find that ECD and CNG produce very similar reductions in health damages compared to CD, although CNG has a modest edge because it may have lower NO x emissions. However, ECD is far more cost effective ($400,000-900,000 cost per QALY saved) than CNG (around $4 million per QALY saved). The results are uncertain because the model used makes a series of simplifying assumptions and because emissions data and cost data for school buses are very limited

  1. Proposed reliability cost model

    Science.gov (United States)

    Delionback, L. M.

    1973-01-01

    The research investigations which were involved in the study include: cost analysis/allocation, reliability and product assurance, forecasting methodology, systems analysis, and model-building. This is a classic example of an interdisciplinary problem, since the model-building requirements include the need for understanding and communication between technical disciplines on one hand, and the financial/accounting skill categories on the other. The systems approach is utilized within this context to establish a clearer and more objective relationship between reliability assurance and the subcategories (or subelements) that provide, or reenforce, the reliability assurance for a system. Subcategories are further subdivided as illustrated by a tree diagram. The reliability assurance elements can be seen to be potential alternative strategies, or approaches, depending on the specific goals/objectives of the trade studies. The scope was limited to the establishment of a proposed reliability cost-model format. The model format/approach is dependent upon the use of a series of subsystem-oriented CER's and sometimes possible CTR's, in devising a suitable cost-effective policy.

  2. Cost-effectiveness of pneumococcal conjugate vaccination in Croatia.

    Science.gov (United States)

    Vučina, V Višekruna; Filipović, S Kurečić; Kožnjak, N; Stamenić, V; Clark, A D; Mounaud, B; Blau, J; Hoestlandt, C; Kaić, B

    2015-05-07

    Pneumococcus is a known cause of meningitis, pneumonia, sepsis, and acute otitis media in children and adults globally. Two new vaccines for children have the potential to prevent illness, disability, and death, but these vaccines are expensive. The Croatian Ministry of Health has considered introducing the vaccine in the past, but requires economic evidence to ensure that the limited funds available for health care will be used in the most effective way. Croatia appointed a multidisciplinary team of experts to evaluate the cost-effectiveness of introducing pneumococcal conjugate vaccination (PCV) into the national routine child immunization program. Both 10-valent and 13-valent PCV (PCV10 and PCV13) were compared to a scenario assuming no vaccination. The TRIVAC decision-support model was used to estimate cost-effectiveness over the period 2014-2033. We used national evidence on demographics, pneumococcal disease incidence and mortality, the age distribution of disease in children, health service utilization, vaccine coverage, vaccine timeliness, and serotype coverage. Vaccine effectiveness was based on evidence from the scientific literature. Detailed health care costs were not available from the Croatian Institute for Health Insurance at the time of the analysis so assumptions and World Health Organization (WHO) estimates for Croatia were used. We assumed a three-dose primary vaccination schedule, and an initial price of US$ 30 per dose for PCV10 and US$ 35 per dose for PCV13. We ran univariate sensitivity analyses and multivariate scenario analyses. Either vaccine is estimated to prevent approximately 100 hospital admissions and one death each year in children younger than five in Croatia. Compared to no vaccine, the discounted cost-effectiveness of either vaccine is estimated to be around US$ 69,000-77,000 per disability-adjusted life-years (DALYs) averted over the period 2014-2033 (from the government or societal perspective). Only two alternative scenarios

  3. Seasonal influenza vaccination for children in Thailand: a cost-effectiveness analysis.

    Science.gov (United States)

    Meeyai, Aronrag; Praditsitthikorn, Naiyana; Kotirum, Surachai; Kulpeng, Wantanee; Putthasri, Weerasak; Cooper, Ben S; Teerawattananon, Yot

    2015-05-01

    patterns between age groups. Vaccinating school-aged children with LAIV is likely to be cost-effective in Thailand in the short term, though the long-term consequences of such a policy cannot be reliably predicted given current knowledge of influenza epidemiology and immunology. Our work provides a coherent framework that can be used for similar analyses in other low- and middle-income countries.

  4. Cost-effectiveness of norovirus vaccination in children in Peru.

    Science.gov (United States)

    Mirelman, Andrew J; Ballard, Sarah Blythe; Saito, Mayuko; Kosek, Margaret N; Gilman, Robert H

    2015-06-17

    With candidate norovirus (NV) vaccines in a rapid phase of development, assessment of the potential economic value of vaccine implementation will be necessary to aid health officials in vaccine implementation decisions. To date, no evaluations have been performed to evaluate the benefit of adopting NV vaccines for use in the childhood immunization programs of low- and middle-income countries. We used a Markov decision model to evaluate the cost-effectiveness of adding a two-dose NV vaccine to Peru's routine childhood immunization schedule using two recent estimates of NV incidence, one for a peri-urban region and one for a jungle region of the country. Using the peri-urban NV incidence estimate, the annual cost of vaccination would be $13.0 million, offset by $2.6 million in treatment savings. Overall, this would result in 473 total DALYs averted; 526,245 diarrhea cases averted;153,735 outpatient visits averted; and 414 hospitalizations averted between birth and the fifth year of life. The incremental cost-effectiveness ratio would be $21,415 per DALY averted; $19.86 per diarrhea case; $68.23 per outpatient visit; and $26,298 per hospitalization. Using the higher jungle NV incidence rates provided a lower cost per DALY of $10,135. The incremental cost per DALY with per-urban NV incidence is greater than three times the 2012 GDP per capita of Peru but the estimate drops below this threshold using the incidence from the jungle setting. In addition to the impact of incidence, sensitivity analysis showed that vaccine price and efficacy play a strong role in determining the level of cost-effectiveness. The introduction of a NV vaccine would prevent many healthcare outcomes in the Peru and potentially be cost-effective in scenarios with high NV incidence. The vaccine cost-effectiveness model could also be applied to the evaluation of NV vaccine cost-effectiveness in other countries. In resource-poor settings, where NV incidence rates are expected to be higher. Published

  5. Cost-effectiveness of Bariatric Surgery in Adolescents With Obesity.

    Science.gov (United States)

    Klebanoff, Matthew J; Chhatwal, Jagpreet; Nudel, Jacob D; Corey, Kathleen E; Kaplan, Lee M; Hur, Chin

    2017-02-01

    Severe obesity affects 4% to 6% of US youth and is increasing in prevalence. Bariatric surgery for the treatment of adolescents with severe obesity is becoming more common, but data on cost-effectiveness are limited. To assess the cost-effectiveness of bariatric surgery for adolescents with obesity using recently published results from the Teen-Longitudinal Assessment of Bariatric Surgery study. A state-transition model was constructed to compare 2 strategies: no surgery and bariatric surgery. In the no surgery strategy, patients remained at their initial body mass index (calculated as weight in kilograms divided by height in meters squared) over time. In the bariatric surgery strategy, patients were subjected to risks of perioperative mortality and complications as well as initial morbidity but also experienced longer-term quality-of-life improvements associated with weight loss. Cohort demographic information-of the 228 patients included, the mean (SD) age was 17 (1.6) years, the mean (range) body mass index was 53 (34-88), and 171 (75.0%) were female-surgery-related outcomes, and base case time horizon (3 years) were based on data from the Teen-Longitudinal Assessment of Bariatric Surgery study. One-way and probabilistic sensitivity analyses were performed. Quality-adjusted life-years (QALYs), total costs (in US dollars adjusted to 2015-year values using the Consumer Price Index), and incremental cost-effectiveness ratios (ICERs). A willingness-to-pay threshold of $100 000 per QALY was used to assess cost-effectiveness. After 3 years, surgery led to a gain of 0.199 QALYs compared with no surgery at an incremental cost of $30 747, yielding an unfavorable ICER of $154 684 per QALY. When the clinical study results were extrapolated to 4 years, the ICER decreased to $114 078 per QALY and became cost-effective by 5 years with an ICER of $91 032 per QALY. Outcomes were robust in most 1-way and probabilistic sensitivity analyses. Bariatric surgery incurs

  6. Cost-effectiveness of a central venous catheter care bundle.

    Directory of Open Access Journals (Sweden)

    Kate A Halton

    Full Text Available BACKGROUND: A bundled approach to central venous catheter care is currently being promoted as an effective way of preventing catheter-related bloodstream infection (CR-BSI. Consumables used in the bundled approach are relatively inexpensive which may lead to the conclusion that the bundle is cost-effective. However, this fails to consider the nontrivial costs of the monitoring and education activities required to implement the bundle, or that alternative strategies are available to prevent CR-BSI. We evaluated the cost-effectiveness of a bundle to prevent CR-BSI in Australian intensive care patients. METHODS AND FINDINGS: A Markov decision model was used to evaluate the cost-effectiveness of the bundle relative to remaining with current practice (a non-bundled approach to catheter care and uncoated catheters, or use of antimicrobial catheters. We assumed the bundle reduced relative risk of CR-BSI to 0.34. Given uncertainty about the cost of the bundle, threshold analyses were used to determine the maximum cost at which the bundle remained cost-effective relative to the other approaches to infection control. Sensitivity analyses explored how this threshold alters under different assumptions about the economic value placed on bed-days and health benefits gained by preventing infection. If clinicians are prepared to use antimicrobial catheters, the bundle is cost-effective if national 18-month implementation costs are below $1.1 million. If antimicrobial catheters are not an option the bundle must cost less than $4.3 million. If decision makers are only interested in obtaining cash-savings for the unit, and place no economic value on either the bed-days or the health benefits gained through preventing infection, these cost thresholds are reduced by two-thirds. CONCLUSIONS: A catheter care bundle has the potential to be cost-effective in the Australian intensive care setting. Rather than anticipating cash-savings from this intervention, decision

  7. Life Cycle Assessment of Residential Heating and Cooling Systems in Minnesota A comprehensive analysis on life cycle greenhouse gas (GHG) emissions and cost-effectiveness of ground source heat pump (GSHP) systems compared to the conventional gas furnace and air conditioner system

    Science.gov (United States)

    Li, Mo

    Ground Source Heat Pump (GSHP) technologies for residential heating and cooling are often suggested as an effective means to curb energy consumption, reduce greenhouse gas (GHG) emissions and lower homeowners' heating and cooling costs. As such, numerous federal, state and utility-based incentives, most often in the forms of financial incentives, installation rebates, and loan programs, have been made available for these technologies. While GSHP technology for space heating and cooling is well understood, with widespread implementation across the U.S., research specific to the environmental and economic performance of these systems in cold climates, such as Minnesota, is limited. In this study, a comparative environmental life cycle assessment (LCA) is conducted of typical residential HVAC (Heating, Ventilation, and Air Conditioning) systems in Minnesota to investigate greenhouse gas (GHG) emissions for delivering 20 years of residential heating and cooling—maintaining indoor temperatures of 68°F (20°C) and 75°F (24°C) in Minnesota-specific heating and cooling seasons, respectively. Eight residential GSHP design scenarios (i.e. horizontal loop field, vertical loop field, high coefficient of performance, low coefficient of performance, hybrid natural gas heat back-up) and one conventional natural gas furnace and air conditioner system are assessed for GHG and life cycle economic costs. Life cycle GHG emissions were found to range between 1.09 × 105 kg CO2 eq. and 1.86 × 10 5 kg CO2 eq. Six of the eight GSHP technology scenarios had fewer carbon impacts than the conventional system. Only in cases of horizontal low-efficiency GSHP and hybrid, do results suggest increased GHGs. Life cycle costs and present value analyses suggest GSHP technologies can be cost competitive over their 20-year life, but that policy incentives may be required to reduce the high up-front capital costs of GSHPs and relatively long payback periods of more than 20 years. In addition

  8. Reliability of candida skin test in the evaluation of T-cell function in ...

    African Journals Online (AJOL)

    Ehab

    2017-01-23

    Jan 23, 2017 ... considered generally reliable under the age of 1 year.6 ... We sought to investigate the reliability of manually ... Conclusion: Candida intradermal test is a cost- effective ..... Ballow M. Historical perspectives in the diagnosis.

  9. Reliability and Characterization of High Voltage Power Capacitors

    Science.gov (United States)

    2014-03-01

    in a Faraday cage to minimize external noise. In addition, electron microscopy could also be performed to identify the change in trap concentration...military bases in the United States. Energy product reliability affects the sustainability and cost- effectiveness of these systems, which must be tested...Energy product reliability affects the sustainability and cost- effectiveness of these systems, which must be tested by outside entities to ensure

  10. Above Bonneville passage and propagation cost effectiveness analysis

    International Nuclear Information System (INIS)

    Paulsen, C.M.; Hyman, J.B.; Wernstedt, K.

    1993-05-01

    We have developed several models to evaluate the cost-effectiveness of alternative strategies to mitigate hydrosystem impacts on salmon and steelhead, and applied these models to areas of the Columbia River Basin. Our latest application evaluates the cost-effectiveness of proposed strategies that target mainstem survival (e.g., predator control, increases in water velocity) and subbasin propagation (e.g., habitat improvements, screening, hatchery production increases) for chinook salmon and steelhead stocks, in the portion of the Columbia Basin bounded by Bonneville, Chief Joseph, Dworshak, and Hells Canyon darns. At its core the analysis primarily considers financial cost and biological effectiveness, but we have included other attributes which may be of concern to the region

  11. [Cost-effectiveness of breast cancer screening policies in Mexico].

    Science.gov (United States)

    Valencia-Mendoza, Atanacio; Sánchez-González, Gilberto; Bautista-Arredondo, Sergio; Torres-Mejía, Gabriela; Bertozzi, Stefano M

    2009-01-01

    Generate cost-effectiveness information to allow policy makers optimize breast cancer (BC) policy in Mexico. We constructed a Markov model that incorporates four interrelated processes of the disease: the natural history; detection using mammography; treatment; and other competing-causes mortality, according to which 13 different strategies were modeled. Strategies (starting age, % of coverage, frequency in years)= (48, 25, 2), (40, 50, 2) and (40, 50, 1) constituted the optimal method for expanding the BC program, yielding 75.3, 116.4 and 171.1 thousand pesos per life-year saved, respectively. The strategies included in the optimal method for expanding the program produce a cost per life-year saved of less than two times the GNP per capita and hence are cost-effective according to WHO Commission on Macroeconomics and Health criteria.

  12. Above Bonneville Passage and Propagation Cost Effectiveness Analysis.

    Energy Technology Data Exchange (ETDEWEB)

    Paulsen, C.M.; Hyman, J.B.; Wernstedt, K.

    1993-05-01

    We have developed several models to evaluate the cost-effectiveness of alternative strategies to mitigate hydrosystem impacts on salmon and steelhead, and applied these models to areas of the Columbia River Basin. Our latest application evaluates the cost-effectiveness of proposed strategies that target mainstem survival (e.g., predator control, increases in water velocity) and subbasin propagation (e.g., habitat improvements, screening, hatchery production increases) for chinook salmon and steelhead stocks, in the portion of the Columbia Basin bounded by Bonneville, Chief Joseph, Dworshak, and Hells Canyon darns. At its core the analysis primarily considers financial cost and biological effectiveness, but we have included other attributes which may be of concern to the region.

  13. Privacy Enforcement in a Cost-Effective Smart Grid

    DEFF Research Database (Denmark)

    Mikkelsen, Søren Aagaard

    In this technical report we present the current state of the research conducted during the first part of the PhD period. The PhD thesis “Privacy Enforcement in a Cost-Effective Smart Grid” focuses on ensuring privacy when generating market for energy service providers that develop web services...... for the residential domain in the envisaged smart grid. The PhD project is funded and associated to the EU project “Energy Demand Aware Open Services for Smart Grid Intelligent Automation” (Smart HG) and therefore introduces the project on a system-level. Based on this, we present some of the integration, security...... and privacy challenges that emerge when designing a system architecture and infrastructure. The resulting architecture is a consumer-centric and agent-based design and uses open Internet-based communication protocols for enabling interoperability while being cost-effective. Finally, the PhD report present...

  14. Cost-effectiveness analysis of PET-CT-guided management for locally advanced head and neck cancer.

    Science.gov (United States)

    Smith, A F; Hall, P S; Hulme, C T; Dunn, J A; McConkey, C C; Rahman, J K; McCabe, C; Mehanna, H

    2017-11-01

    A recent large United Kingdom (UK) clinical trial demonstrated that positron-emission tomography-computed tomography (PET-CT)-guided administration of neck dissection (ND) in patients with advanced head and neck cancer after primary chemo-radiotherapy treatment produces similar survival outcomes to planned ND (standard care) and is cost-effective over a short-term horizon. Further assessment of long-term outcomes is required to inform a robust adoption decision. Here we present results of a lifetime cost-effectiveness analysis of PET-CT-guided management from a UK secondary care perspective. Initial 6-month cost and health outcomes were derived from trial data; subsequent incidence of recurrence and mortality was simulated using a de novo Markov model. Health benefit was measured in quality-adjusted life years (QALYs) and costs reported in 2015 British pounds. Model parameters were derived from trial data and published literature. Sensitivity analyses were conducted to assess the impact of uncertainty and broader National Health Service (NHS) and personal social services (PSS) costs on the results. PET-CT management produced an average per-person lifetime cost saving of £1485 and an additional 0.13 QALYs. At a £20,000 willingness-to-pay per additional QALY threshold, there was a 75% probability that PET-CT was cost-effective, and the results remained cost-effective over the majority of sensitivity analyses. When adopting a broader NHS and PSS perspective, PET-CT management produced an average saving of £700 and had an 81% probability of being cost-effective. This analysis indicates that PET-CT-guided management is cost-effective in the long-term and supports the case for wide-scale adoption. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. Impact and cost-effectiveness of rotavirus vaccination in Bangladesh.

    Science.gov (United States)

    Pecenka, Clint; Parashar, Umesh; Tate, Jacqueline E; Khan, Jahangir A M; Groman, Devin; Chacko, Stephen; Shamsuzzaman, Md; Clark, Andrew; Atherly, Deborah

    2017-07-13

    Diarrheal disease is a leading cause of child mortality globally, and rotavirus is responsible for more than a third of those deaths. Despite substantial decreases, the number of rotavirus deaths in children under five was 215,000 per year in 2013. Of these deaths, approximately 41% occurred in Asia and 3% of those in Bangladesh. While Bangladesh has yet to introduce rotavirus vaccination, the country applied for Gavi support and plans to introduce it in 2018. This analysis evaluates the impact and cost-effectiveness of rotavirus vaccination in Bangladesh and provides estimates of the costs of the vaccination program to help inform decision-makers and international partners. This analysis used Pan American Health Organization's TRIVAC model (version 2.0) to examine nationwide introduction of two-dose rotavirus vaccination in 2017, compared to no vaccination. Three mortality scenarios (low, high, and midpoint) were assessed. Benefits and costs were examined from the societal perspective over ten successive birth cohorts with a 3% discount rate. Model inputs were locally acquired and complemented by internationally validated estimates. Over ten years, rotavirus vaccination would prevent 4000 deaths, nearly 500,000 hospitalizations and 3 million outpatient visits in the base scenario. With a Gavi subsidy, cost/disability adjusted life year (DALY) ratios ranged from $58/DALY to $142/DALY averted. Without a Gavi subsidy and a vaccine price of $2.19 per dose, cost/DALY ratios ranged from $615/DALY to $1514/DALY averted. The discounted cost per DALY averted was less than the GDP per capita for nearly all scenarios considered, indicating that a routine rotavirus vaccination program is highly likely to be cost-effective. Even in a low mortality setting with no Gavi subsidy, rotavirus vaccination would be cost-effective. These estimates exclude the herd immunity benefits of vaccination, so represent a conservative estimate of the cost-effectiveness of rotavirus vaccination

  16. Cost-effectiveness of a pressure ulcer quality collaborative

    Directory of Open Access Journals (Sweden)

    Bal Roland

    2010-06-01

    Full Text Available Abstract Background A quality improvement collaborative (QIC in the Dutch long-term care sector (nursing homes, assisted living facilities, home care used evidence-based prevention methods to reduce the incidence and prevalence of pressure ulcers (PUs. The collaborative consisted of a core team of experts and 25 organizational project teams. Our aim was to determine its cost-effectiveness from a healthcare perspective. Methods We used a non-controlled pre-post design to establish the change in incidence and prevalence of PUs in 88 patients over the course of a year. Staff indexed data and prevention methods (activities, materials. Quality of life (Qol weights were assigned to the PU states. We assessed the costs of activities and materials in the project. A Markov model was built based on effectiveness and cost data, complemented with a probabilistic sensitivity analysis. To illustrate the results of longer term, three scenarios were created in which change in incidence and prevalence measures were (1 not sustained, (2 partially sustained, and (3 completely sustained. Results Incidence of PUs decreased from 15% to 4.5% for the 88 patients. Prevalence decreased from 38.6% to 22.7%. Average Quality of Life (Qol of patients increased by 0.02 Quality Adjusted Life Years (QALYs in two years; healthcare costs increased by €2000 per patient; the Incremental Cost-effectiveness Ratio (ICER was between 78,500 and 131,000 depending on whether the changes in incidence and prevalence of PU were sustained. Conclusions During the QIC PU incidence and prevalence significantly declined. When compared to standard PU care, the QIC was probably more costly and more effective in the short run, but its long-term cost-effectiveness is questionable. The QIC can only be cost-effective if the changes in incidence and prevalence of PU are sustained.

  17. Cost-effectiveness of a pressure ulcer quality collaborative.

    Science.gov (United States)

    Makai, Peter; Koopmanschap, Marc; Bal, Roland; Nieboer, Anna P

    2010-06-01

    A quality improvement collaborative (QIC) in the Dutch long-term care sector (nursing homes, assisted living facilities, home care) used evidence-based prevention methods to reduce the incidence and prevalence of pressure ulcers (PUs). The collaborative consisted of a core team of experts and 25 organizational project teams. Our aim was to determine its cost-effectiveness from a healthcare perspective. We used a non-controlled pre-post design to establish the change in incidence and prevalence of PUs in 88 patients over the course of a year. Staff indexed data and prevention methods (activities, materials). Quality of life (Qol) weights were assigned to the PU states. We assessed the costs of activities and materials in the project. A Markov model was built based on effectiveness and cost data, complemented with a probabilistic sensitivity analysis. To illustrate the results of longer term, three scenarios were created in which change in incidence and prevalence measures were (1) not sustained, (2) partially sustained, and (3) completely sustained. Incidence of PUs decreased from 15% to 4.5% for the 88 patients. Prevalence decreased from 38.6% to 22.7%. Average Quality of Life (Qol) of patients increased by 0.02 Quality Adjusted Life Years (QALY)s in two years; healthcare costs increased by euro2000 per patient; the Incremental Cost-effectiveness Ratio (ICER) was between 78,500 and 131,000 depending on whether the changes in incidence and prevalence of PU were sustained. During the QIC PU incidence and prevalence significantly declined. When compared to standard PU care, the QIC was probably more costly and more effective in the short run, but its long-term cost-effectiveness is questionable. The QIC can only be cost-effective if the changes in incidence and prevalence of PU are sustained.

  18. Cost-effectiveness of root caries preventive treatments.

    Science.gov (United States)

    Schwendicke, Falk; Göstemeyer, Gerd

    2017-01-01

    With a growing number of individuals retaining their teeth lifelong, often with periodontitis-induced root surface exposure, there is the need for cost-effective management strategies for root caries lesions. The present study aimed to assess the cost-effectiveness of root caries preventive treatments. Patients were simulated over 10 years using a Markov model. Four treatments were compared: No treatment, daily 225-800ppm fluoride rinses, chlorhexidine (CHX) varnish (2×/year), silver diamine fluoride (SDF) varnish (2×/year). Data from a systematic review were submitted to network meta-analysis for inferring relative efficacies of treatments. The health outcome was years of teeth being free of root caries. A mixed public-private payer perspective within 2016 German healthcare was taken, with costs being estimated from fee item catalogues or based on market prices. Populations with different numbers of teeth and tooth-level risks were modelled. Monte-Carlo microsimulations, univariate- and probabilistic sensitivity analyses were performed. In populations with 16 teeth at risk and low tooth-level risk for root caries, providing no preventive treatment was least costly, but also least effective (130 Euro, 144 years). SDF ranked next, being more costly (180 Euro), but also more effective (151 years). Payers willing to invest 8.30 Euro per root caries-free tooth-year found SDF most cost-effective. CHX varnish and fluoride rinse were not cost-effective. In populations with more teeth and high tooth-level risk, SDF was the most effective and least costly option. Root caries preventive treatments (like SDF) are effective and might even be cost-saving in high risk populations. Application of SDF can be recommended as a cost-saving treatment for prevention of root caries in patients with high risk of root caries. Copyright © 2016 Elsevier Ltd. All rights reserved.

  19. Cost-Effectiveness of a Clinical Childhood Obesity Intervention.

    Science.gov (United States)

    Sharifi, Mona; Franz, Calvin; Horan, Christine M; Giles, Catherine M; Long, Michael W; Ward, Zachary J; Resch, Stephen C; Marshall, Richard; Gortmaker, Steven L; Taveras, Elsie M

    2017-11-01

    To estimate the cost-effectiveness and population impact of the national implementation of the Study of Technology to Accelerate Research (STAR) intervention for childhood obesity. In the STAR cluster-randomized trial, 6- to 12-year-old children with obesity seen at pediatric practices with electronic health record (EHR)-based decision support for primary care providers and self-guided behavior-change support for parents had significantly smaller increases in BMI than children who received usual care. We used a microsimulation model of a national implementation of STAR from 2015 to 2025 among all pediatric primary care providers in the United States with fully functional EHRs to estimate cost, impact on obesity prevalence, and cost-effectiveness. The expected population reach of a 10-year national implementation is ∼2 million children, with intervention costs of $119 per child and $237 per BMI unit reduced. At 10 years, assuming maintenance of effect, the intervention is expected to avert 43 000 cases and 226 000 life-years with obesity at a net cost of $4085 per case and $774 per life-year with obesity averted. Limiting implementation to large practices and using higher estimates of EHR adoption improved both cost-effectiveness and reach, whereas decreasing the maintenance of the intervention's effect worsened the former. A childhood obesity intervention with electronic decision support for clinicians and self-guided behavior-change support for parents may be more cost-effective than previous clinical interventions. Effective and efficient interventions that target children with obesity are necessary and could work in synergy with population-level prevention strategies to accelerate progress in reducing obesity prevalence. Copyright © 2017 by the American Academy of Pediatrics.

  20. Cost-effectiveness of rotavirus vaccination in Kenya and Uganda.

    Science.gov (United States)

    Sigei, Charles; Odaga, John; Mvundura, Mercy; Madrid, Yvette; Clark, Andrew David

    2015-05-07

    Rotavirus vaccines have the potential to prevent a substantial amount of life-threatening gastroenteritis in young African children. This paper presents the results of prospective cost-effectiveness analyses for rotavirus vaccine introduction for Kenya and Uganda. In each country, a national consultant worked with a national technical working group to identify appropriate data and validate study results. Secondary data on demographics, disease burden, health utilization, and costs were used to populate the TRIVAC cost-effectiveness model. The baseline analysis assumed an initial vaccine price of $0.20 per dose, corresponding to Gavi, the Vaccine Alliance stipulated copay for low-income countries. The incremental cost-effectiveness of a 2-dose rotavirus vaccination schedule was evaluated for 20 successive birth cohorts from the government perspective in both countries, and from the societal perspective in Uganda. Between 2014 and 2033, rotavirus vaccination can avert approximately 60,935 and 216,454 undiscounted deaths and hospital admissions respectively in children under 5 years in Kenya. In Uganda, the respective number of undiscounted deaths and hospital admission averted is 70,236 and 329,779 between 2016 and 2035. Over the 20-year period, the discounted vaccine program costs are around US$ 80 million in Kenya and US$ 60 million in Uganda. Discounted government health service costs avoided are US$ 30 million in Kenya and US$ 10 million in Uganda (or US$ 18 million including household costs). The cost per disability-adjusted life-year (DALY) averted from a government perspective is US$ 38 in Kenya and US$ 34 in Uganda (US$ 29 from a societal perspective). Rotavirus vaccine introduction is highly cost-effective in both countries in a range of plausible 'what-if' scenarios. The involvement of national experts improves the quality of data used, is likely to increase acceptability of the results in decision-making, and can contribute to strengthened national

  1. COST EFFECTIVE AND HIGH RESOLUTION SUBSURFACE CHARACTERIZATION USING HYDRAULIC TOMOGRAPHY

    Science.gov (United States)

    2017-08-01

    objective of this project is to provide the DoD and its remediation contractors with the HT technology for delineating the spatial distribution of...STATEMENT Approved for public release; distribution is unlimited 13. SUPPLEMENTARY NOTES 14. ABSTRACT Hydraulic Tomography ( HT ) is a high-resolution...performance of subsurface remedial actions at environmental sites. The good technical performance and cost-effectiveness of HT have been demonstrated in

  2. Invisible Cost Effective Mechanics for Anterior Space Closure.

    Science.gov (United States)

    Jumle, Aatish Vinod; Bagrecha, Saurabh; Gharat, Ninad; Misal, Abhijit; Toshniwal, N G

    2015-01-01

    The shifting paradigm towards invisible orthodontic treatment and also awareness in patients has allured their focus towards the most esthetic treatment approach. Also the lingual treatment is proved successful and is very well accepted by the patients. The problem that persist is its high expenses, which is not affordable by all patients. This article is a effort to treat a simple Class I malocclusion with anterior spacing using a simple, esthetic, Cost effective approach with acceptable results when esthetics plays a priority role.

  3. A Cost-effectiveness Analysis of Early vs Late Tracheostomy.

    Science.gov (United States)

    Liu, C Carrie; Rudmik, Luke

    2016-10-01

    The timing of tracheostomy in critically ill patients requiring mechanical ventilation is controversial. An important consideration that is currently missing in the literature is an evaluation of the economic impact of an early tracheostomy strategy vs a late tracheostomy strategy. To evaluate the cost-effectiveness of the early tracheostomy strategy vs the late tracheostomy strategy. This economic analysis was performed using a decision tree model with a 90-day time horizon. The economic perspective was that of the US health care third-party payer. The primary outcome was the incremental cost per tracheostomy avoided. Probabilities were obtained from meta-analyses of randomized clinical trials. Costs were obtained from the published literature and the Healthcare Cost and Utilization Project database. A multivariate probabilistic sensitivity analysis was performed to account for uncertainty surrounding mean values used in the reference case. The reference case demonstrated that the cost of the late tracheostomy strategy was $45 943.81 for 0.36 of effectiveness. The cost of the early tracheostomy strategy was $31 979.12 for 0.19 of effectiveness. The incremental cost-effectiveness ratio for the late tracheostomy strategy compared with the early tracheostomy strategy was $82 145.24 per tracheostomy avoided. With a willingness-to-pay threshold of $50 000, the early tracheostomy strategy is cost-effective with 56% certainty. The adaptation of an early vs a late tracheostomy strategy depends on the priorities of the decision-maker. Up to a willingness-to-pay threshold of $80 000 per tracheostomy avoided, the early tracheostomy strategy has a higher probability of being the more cost-effective intervention.

  4. Cost effectiveness methodology for evaluating Korean international communication system alternatives.

    OpenAIRE

    Hwang, Tae Kyun.

    1987-01-01

    Approved for public release; distribution in unlimited. Cost and Effectiveness models are developed by using of cost-effectiveness technique for fiber optic cable and satellite communication media. The models are applied to the Korean international communication problem. Alternative selection is required since the two medias different in cost and effectiveness. The major difficulties encountered were data gathering and measuring the effectiveness of the Korean international ...

  5. Cost-effectiveness of the Norwegian breast cancer screening program.

    Science.gov (United States)

    van Luijt, P A; Heijnsdijk, E A M; de Koning, H J

    2017-02-15

    The Norwegian Breast Cancer Screening Programme (NBCSP) has a nation-wide coverage since 2005. All women aged 50-69 years are invited biennially for mammography screening. We evaluated breast cancer mortality reduction and performed a cost-effectiveness analysis, using our microsimulation model, calibrated to most recent data. The microsimulation model allows for the comparison of mortality and costs between a (hypothetical) situation without screening and a situation with screening. Breast cancer incidence in Norway had a steep increase in the early 1990s. We calibrated the model to simulate this increase and included recent costs for screening, diagnosis and treatment of breast cancer and travel and productivity loss. We estimate a 16% breast cancer mortality reduction for a cohort of women, invited to screening, followed over their complete lifetime. Cost-effectiveness is estimated at NOK 112,162 per QALY gained, when taking only direct medical costs into account (the cost of the buses, examinations, and invitations). We used a 3.5% annual discount rate. Cost-effectiveness estimates are substantially below the threshold of NOK 1,926,366 as recommended by the WHO guidelines. For the Norwegian population, which has been gradually exposed to screening, breast cancer mortality reduction for women exposed to screening is increasing and is estimated to rise to ∼30% in 2020 for women aged 55-80 years. The NBCSP is a highly cost-effective measure to reduce breast cancer specific mortality. We estimate a breast cancer specific mortality reduction of 16-30%, at the cost of 112,162 NOK per QALY gained. © 2016 UICC.

  6. Cost-effectiveness analysis of treatments for vertebral compression fractures.

    Science.gov (United States)

    Edidin, Avram A; Ong, Kevin L; Lau, Edmund; Schmier, Jordana K; Kemner, Jason E; Kurtz, Steven M

    2012-07-01

    Vertebral compression fractures (VCFs) can be treated by nonsurgical management or by minimally invasive surgical treatment including vertebroplasty and balloon kyphoplasty. The purpose of the present study was to characterize the cost to Medicare for treating VCF-diagnosed patients by nonsurgical management, vertebroplasty, or kyphoplasty. We hypothesized that surgical treatments for VCFs using vertebroplasty or kyphoplasty would be a cost-effective alternative to nonsurgical management for the Medicare patient population. Cost per life-year gained for VCF patients in the US Medicare population was compared between operated (kyphoplasty and vertebroplasty) and non-operated patients and between kyphoplasty and vertebroplasty patients, all as a function of patient age and gender. Life expectancy was estimated using a parametric Weibull survival model (adjusted for comorbidities) for 858 978 VCF patients in the 100% Medicare dataset (2005-2008). Median payer costs were identified for each treatment group for up to 3 years following VCF diagnosis, based on 67 018 VCF patients in the 5% Medicare dataset (2005-2008). A discount rate of 3% was used for the base case in the cost-effectiveness analysis, with 0% and 5% discount rates used in sensitivity analyses. After accounting for the differences in median costs and using a discount rate of 3%, the cost per life-year gained for kyphoplasty and vertebroplasty patients ranged from $US1863 to $US6687 and from $US2452 to $US13 543, respectively, compared with non-operated patients. The cost per life-year gained for kyphoplasty compared with vertebroplasty ranged from -$US4878 (cost saving) to $US2763. Among patients for whom surgical treatment was indicated, kyphoplasty was found to be cost effective, and perhaps even cost saving, compared with vertebroplasty. Even for the oldest patients (85 years of age and older), both interventions would be considered cost effective in terms of cost per life-year gained.

  7. Cost-effectiveness of screening for asymptomatic carotid atherosclerotic disease.

    Science.gov (United States)

    Derdeyn, C P; Powers, W J

    1996-11-01

    The value of screening for asymptomatic carotid stenosis has become an important issue with the recently reported beneficial effect of endarterectomy. The purpose of this study is to evaluate the cost-effectiveness of using Doppler ultrasound as a screening tool to select subjects for arteriography and subsequent surgery. A computer model was developed to simulate the cost-effectiveness of screening a cohort of 1000 men during a 20-year period. The primary outcome measure was incremental present-value dollar expenditures for screening and treatment per incremental present-value quality-adjusted life-year (QALY) saved. Estimates of disease prevalence and arteriographic and surgical complication rates were obtained from the literature. Probabilities of stroke and death with surgical and medical treatment were obtained from published clinical trials. Doppler ultrasound sensitivity and specificity were obtained through review of local experience. Estimates of costs were obtained from local Medicare reimbursement data. A one-time screening program of a population with a high prevalence (20%) of > or = 60% stenosis cost $35130 per incremental QALY gained. Decreased surgical benefit or increased annual discount rate was detrimental, resulting in lost QALYs. Annual screening cost $457773 per incremental QALY gained. In a low-prevalence (4%) population, one-time screening cost $52588 per QALY gained, while annual screening was detrimental. The cost-effectiveness of a one-time screening program for an asymptomatic population with a high prevalence of carotid stenosis may be cost-effective. Annual screening is detrimental. The most sensitive variables in this simulation model were long-term stroke risk reduction after surgery and annual discount rate for accumulated costs and QALYs.

  8. A Cost-Effectiveness Analysis Model for Evaluating and Planning Secondary Vocational Programs

    Science.gov (United States)

    Kim, Jin Eun

    1977-01-01

    This paper conceptualizes a cost-effectiveness analysis and describes a cost-effectiveness analysis model for secondary vocational programs. It generates three kinds of cost-effectiveness measures: program effectiveness, cost efficiency, and cost-effectiveness and/or performance ratio. (Author)

  9. Cost-Effectiveness of Secondary Screening Modalities for Hypertension

    Science.gov (United States)

    Wang, Y. Claire; Koval, Alisa M.; Nakamura, Miyabi; Newman, Jonathan D.; Schwartz, Joseph E.; Stone, Patricia W.

    2014-01-01

    Background Clinic-based blood pressure (CBP) has been the default approach for diagnosing hypertension, but patients may be misclassified due to masked hypertension (false negative) or “white coat” hypertension (false positive). The incorporation of other diagnostic modalities, such as home blood pressure monitoring (HBPM) and ambulatory blood pressure monitoring (ABPM), holds promise to improve diagnostic accuracy and subsequent treatment decisions. Method We reviewed the literature on the costs and cost-effectiveness of adding HBPM and ABPM into routine blood pressure screening in adults. We excluded letters, editorials, and studies of pregnant and/or pre-eclamptic patients, children, and patients with specific conditions (e.g. diabetes). Results We identified 14 original, English language studies that included cost outcomes and compared two or more modalities. ABPM was found to be cost-saving for diagnostic confirmation following an elevated CBP in 6 studies. Three of 4 studies found that adding HBPM to an elevated CBP was also cost-effective. Conclusion Existing evidence supports the cost-effectiveness of incorporating HBPM or ABPM following an initial CBP-based diagnosis of hypertension. Future research should focus on their implementation in clinical practice, long-term economic values, and potential roles in identifying masked hypertension. PMID:23263535

  10. Cost-effectiveness in Clostridium difficile treatment decision-making.

    Science.gov (United States)

    Nuijten, Mark Jc; Keller, Josbert J; Visser, Caroline E; Redekop, Ken; Claassen, Eric; Speelman, Peter; Pronk, Marja H

    2015-11-16

    To develop a framework for the clinical and health economic assessment for management of Clostridium difficile infection (CDI). CDI has vast economic consequences emphasizing the need for innovative and cost effective solutions, which were aim of this study. A guidance model was developed for coverage decisions and guideline development in CDI. The model included pharmacotherapy with oral metronidazole or oral vancomycin, which is the mainstay for pharmacological treatment of CDI and is recommended by most treatment guidelines. A design for a patient-based cost-effectiveness model was developed, which can be used to estimate the cost-effectiveness of current and future treatment strategies in CDI. Patient-based outcomes were extrapolated to the population by including factors like, e.g., person-to-person transmission, isolation precautions and closing and cleaning wards of hospitals. The proposed framework for a population-based CDI model may be used for clinical and health economic assessments of CDI guidelines and coverage decisions for emerging treatments for CDI.

  11. Cost-effective conservation planning: lessons from economics.

    Science.gov (United States)

    Duke, Joshua M; Dundas, Steven J; Messer, Kent D

    2013-08-15

    Economists advocate that the billions of public dollars spent on conservation be allocated to achieve the largest possible social benefit. This is "cost-effective conservation"-a process that incorporates both monetized benefits and costs. Though controversial, cost-effective conservation is poorly understood and rarely implemented by planners. Drawing from the largest publicly financed conservation programs in the United States, this paper seeks to improve the communication from economists to planners and to overcome resistance to cost-effective conservation. Fifteen practical lessons are distilled, including the negative implications of limiting selection with political constraints, using nonmonetized benefit measures or benefit indices, ignoring development risk, using incomplete cost measures, employing cost measures sequentially, and using benefit indices to capture costs. The paper highlights interrelationships between benefits and complications such as capitalization and intertemporal planning. The paper concludes by identifying the challenges at the research frontier, including incentive problems associated with adverse selection, additionality, and slippage. Copyright © 2013 Elsevier Ltd. All rights reserved.

  12. Cost-effectiveness of secondary screening modalities for hypertension.

    Science.gov (United States)

    Wang, Y Claire; Koval, Alisa M; Nakamura, Miyabi; Newman, Jonathan D; Schwartz, Joseph E; Stone, Patricia W

    2013-02-01

    Clinic-based blood pressure (CBP) has been the default approach for the diagnosis of hypertension, but patients may be misclassified because of masked hypertension (false negative) or 'white coat' hypertension (false positive). The incorporation of other diagnostic modalities, such as home blood pressure monitoring (HBPM) and ambulatory blood pressure monitoring (ABPM), holds promise to improve diagnostic accuracy and subsequent treatment decisions. We reviewed the literature on the costs and cost-effectiveness of adding HBPM and ABPM to routine blood pressure screening in adults. We excluded letters, editorials, and studies of pregnant and/or pre-eclamptic patients, children, and patients with specific conditions (e.g. diabetes). We identified 14 original, English language studies that included cost outcomes and compared two or more modalities. ABPM was found to be cost saving for diagnostic confirmation following an elevated CBP in six studies. Three of four studies found that adding HBPM to an elevated CBP was also cost-effective. Existing evidence supports the cost-effectiveness of incorporating HBPM or ABPM after an initial CBP-based diagnosis of hypertension. Future research should focus on their implementation in clinical practice, long-term economic values, and potential roles in identifying masked hypertension.

  13. The Canadian Government perspective on cost-effective regulation

    Energy Technology Data Exchange (ETDEWEB)

    Martin, J K; Iwankow, C [Treasury Board of Canada Secretariat, Ottawa, ON (Canada)

    1997-12-31

    Fiscal constraint, globalization of markets, and accelerated technological change have resulted in a new focus on the cost-effectiveness of government activities and, in turn, on methods of policy evaluation. An exploration of regulatory problems, and the use of regulation as a public policy instrument, reveals a commonalty of experience in all industrialized countries. This paper provides a brief synopsis of the Government of Canada`s perspective on cost-effective regulation. To understand cost-effective regulation, this paper examines the principles of regulatory reform which underlie the current strategy of the federal government (collaborative decision-making mechanisms., methods of clear policy evaluation, and well defined lines of accountability). It discusses the nature of, and rationale for, government regulation, the reasons for regulatory reform in the economy, and the principal aims of Canadian regulatory reform and regulatory policy assessment. It does so by specifically addressing the role of cost-benefit analysis in the process of regulatory assessment - a method which involves systematically identifying, and quantifying where possible, the social benefits and costs associated with alternative public policy actions - with a particular focus on regulation which affects the Canadian nuclear industry. (author). 51 refs.

  14. How does cognitive dissonance influence the sunk cost effect?

    Science.gov (United States)

    Chung, Shao-Hsi; Cheng, Kuo-Chih

    2018-01-01

    The sunk cost effect is the scenario when individuals are willing to continue to invest capital in a failing project. The purpose of this study was to explain such irrational behavior by exploring how sunk costs affect individuals' willingness to continue investing in an unfavorable project and to understand the role of cognitive dissonance on the sunk cost effect. This study used an experimental questionnaire survey on managers of firms listed on the Taiwan Stock Exchange and Over-The-Counter. The empirical results show that cognitive dissonance does not mediate the relationship between sunk costs and willingness to continue an unfavorable investment project. However, cognitive dissonance has a moderating effect, and only when the level of cognitive dissonance is high does the sunk cost have significantly positive impacts on willingness to continue on with an unfavorable investment. This study offers psychological mechanisms to explain the sunk cost effect based on the theory of cognitive dissonance, and it also provides some recommendations for corporate management.

  15. Cost-effectiveness analysis of optimal strategy for tumor treatment

    International Nuclear Information System (INIS)

    Pang, Liuyong; Zhao, Zhong; Song, Xinyu

    2016-01-01

    We propose and analyze an antitumor model with combined immunotherapy and chemotherapy. Firstly, we explore the treatment effects of single immunotherapy and single chemotherapy, respectively. Results indicate that neither immunotherapy nor chemotherapy alone are adequate to cure a tumor. Hence, we apply optimal theory to investigate how the combination of immunotherapy and chemotherapy should be implemented, for a certain time period, in order to reduce the number of tumor cells, while minimizing the implementation cost of the treatment strategy. Secondly, we establish the existence of the optimality system and use Pontryagin’s Maximum Principle to characterize the optimal levels of the two treatment measures. Furthermore, we calculate the incremental cost-effectiveness ratios to analyze the cost-effectiveness of all possible combinations of the two treatment measures. Finally, numerical results show that the combination of immunotherapy and chemotherapy is the most cost-effective strategy for tumor treatment, and able to eliminate the entire tumor with size 4.470 × 10"8 in a year.

  16. Cost-effectiveness of barium enemas performed by radiographers

    International Nuclear Information System (INIS)

    Brown, Lorraine; Desai, Sharad

    2002-01-01

    AIM: To assess the cost-effectiveness of barium enemas performed by radiographers compared to those performed by consultant radiologists. METHOD: Prospective study of 200 barium enemas carried out by a senior radiographer and a consultant radiologist. The sample was a consecutive sample of adult out-patients over a 3-month period, with no exclusion. The length of time of the enema and the numbers and grades of staff involved in the procedure were recorded. This was translated into staffing costs using the appropriate pay scales. RESULTS: The barium enemas performed by the superintendent radiographer were more cost-effective than those performed by the consultant radiologist (1406 pounds for 100 radiographer-performed barium enemas compared to 1787 pounds for 100 carried out by the consultant radiologist). CONCLUSION: In terms of staffing costs, radiographers performing barium enemas not only liberates radiologist time, it is also a cost-effective method of providing an out-patient barium enema service. Brown, L. and Desai, S. (2002)

  17. The Canadian Government perspective on cost-effective regulation

    International Nuclear Information System (INIS)

    Martin, J.K.; Iwankow, C.

    1996-01-01

    Fiscal constraint, globalization of markets, and accelerated technological change have resulted in a new focus on the cost-effectiveness of government activities and, in turn, on methods of policy evaluation. An exploration of regulatory problems, and the use of regulation as a public policy instrument, reveals a commonalty of experience in all industrialized countries. This paper provides a brief synopsis of the Government of Canada's perspective on cost-effective regulation. To understand cost-effective regulation, this paper examines the principles of regulatory reform which underlie the current strategy of the federal government (collaborative decision-making mechanisms., methods of clear policy evaluation, and well defined lines of accountability). It discusses the nature of, and rationale for, government regulation, the reasons for regulatory reform in the economy, and the principal aims of Canadian regulatory reform and regulatory policy assessment. It does so by specifically addressing the role of cost-benefit analysis in the process of regulatory assessment - a method which involves systematically identifying, and quantifying where possible, the social benefits and costs associated with alternative public policy actions - with a particular focus on regulation which affects the Canadian nuclear industry. (author). 51 refs

  18. Cost-effectiveness of open versus arthroscopic rotator cuff repair.

    Science.gov (United States)

    Adla, Deepthi N; Rowsell, Mark; Pandey, Radhakant

    2010-03-01

    Economic evaluation of surgical procedures is necessary in view of more expensive newer techniques emerging in an increasingly cost-conscious health care environment. This study compares the cost-effectiveness of open rotator cuff repair with arthroscopic repair for moderately size tears. This was a prospective study of 30 consecutive patients, of whom 15 had an arthroscopic repair and 15 had an open procedure. Clinical effectiveness was assessed using Oxford and Constant shoulder scores. Costs were estimated from departmental and hospital financial data. At last follow-up, no difference Oxford and Constant shoulder scores was noted between the 2 methods of repair. There was no significant difference between the groups in the cost of time in the operating theater, inpatient time, amount of postoperative analgesia, number of postoperative outpatient visits, physiotherapy costs, and time off work. The incremental cost of each arthroscopic rotator cuff repair was pound675 ($1248.75) more than the open procedure. This was mainly in the area of direct health care costs, instrumentation in particular. Health care policy makers are increasingly demanding evidence of cost-effectiveness of a procedure. This study showed both methods of repair provide equivalent clinical results. Open cuff repair is more cost-effective than arthroscopic repair and is likely to have lower cost-utility ratio. In addition, the tariff for the arthroscopic procedure in some health care systems is same as open repair. Copyright 2010 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

  19. Cost effectiveness of detritiating water with resin columns

    International Nuclear Information System (INIS)

    Drake, R.H.; Williams, D.S.

    1997-10-01

    There are technologies in use for cleaning up concentrated tritiated process water. These are not cost effective for tritiated water with low concentrations of tritium. There are currently no cost-effective technologies for cleaning up low-tritium-concentration tritiated water, such as most tritiated groundwater, spent fuel storage basin water, or underground storage tank water. Resin removal of tritium from tritiated water at low concentrations (near the order of magnitude of drinking water standard maximums) is being tested on TA-SO (Los Alamos National Laboratory's Liquid Radioactive Waste Treatment Facility) waste streams. There are good theoretical and test indications that this may be a technologically effective means of removing tritium from tritiated water. Because of likely engineering design similarity, it is reasonable to anticipate that a resin column system's costs will be similar to some common commercial water treatment systems. Thus, the potential cost effectiveness of a resin treatment system offers hope for treating tritiated water at affordable costs. The TA-50 resin treatment cost projection of $18 per 1,000 gallons is within the same order of magnitude as cost data for typical commercial groundwater cleanup projects. The prospective Los Alamos National Laboratory (LANL) resin treatment system at $18 per 1,000 gallons appears to have a likely cost advantage of at least an order of magnitude over the competing, developmental, water detritiation technologies

  20. Determinants of Change in the Cost-effectiveness Threshold.

    Science.gov (United States)

    Paulden, Mike; O'Mahony, James; McCabe, Christopher

    2017-02-01

    The cost-effectiveness threshold in health care systems with a constrained budget should be determined by the cost-effectiveness of displacing health care services to fund new interventions. Using comparative statics, we review some potential determinants of the threshold, including the budget for health care, the demand for existing health care interventions, the technical efficiency of existing interventions, and the development of new health technologies. We consider the anticipated direction of impact that would affect the threshold following a change in each of these determinants. Where the health care system is technically efficient, an increase in the health care budget unambiguously raises the threshold, whereas an increase in the demand for existing, non-marginal health interventions unambiguously lowers the threshold. Improvements in the technical efficiency of existing interventions may raise or lower the threshold, depending on the cause of the improvement in efficiency, whether the intervention is already funded, and, if so, whether it is marginal. New technologies may also raise or lower the threshold, depending on whether the new technology is a substitute for an existing technology and, again, whether the existing technology is marginal. Our analysis permits health economists and decision makers to assess if and in what direction the threshold may change over time. This matters, as threshold changes impact the cost-effectiveness of interventions that require decisions now but have costs and effects that fall in future periods.

  1. A cost-effectiveness analysis of shipboard telemedicine.

    Science.gov (United States)

    Stoloff, P H; Garcia, F E; Thomason, J E; Shia, D S

    1998-01-01

    The U.S. Navy is considering the installation of telemedicine equipment on more than 300 ships. Besides improving the quality of care, benefits would arise from avoiding medical evacuations (MEDEVACs) and returning patients to work more quickly. Because telemedicine has not yet been fully implemented by the Navy, we relied on projections of anticipated savings and costs, rather than actual expenditures, to determine cost-effectiveness. To determine the demand for telemedicine and the cost-effectiveness of various technologies (telephone and fax, e-mail and Internet, video teleconferencing (VTC), teleradiology, and diagnostic instruments), as well as their bandwidth requirements. A panel of Navy medical experts with telemedicine experience reviewed a representative sample of patient visits collected over a 1-year period and estimated the man-day savings and quality-of-care enhancements that might have occurred had telemedicine technologies been available. The savings from potentially avoiding MEDEVACs was estimated from a survey of ships' medical staff. These sample estimates were then projected to the medical workload of the entire fleet. Off-the-shelf telemedicine equipment prices were combined with installation, maintenance, training, and communication costs to obtain the lifecycle costs of the technology. If telemedicine were available to the fleet, ship medical staffs would initiate nearly 19, 000 consults in a year-7% of all patient visits. Telemedicine would enhance quality of care in two-thirds of these consults. Seventeen percent of the MEDEVACs would be preventable with telemedicine (representing 155,000 travel miles), with a savings of $4400 per MEDEVAC. If the ship's communication capabilities were available, e-mail and Internet and telephone and fax would be cost-effective on all ships (including small ships and submarines). Video teleconferencing would be cost-effective on large ships (aircraft carriers and amphibious) only. Teleradiology would be cost-effective

  2. Cost-effectiveness of hepatitis A vaccination in Indonesia

    Science.gov (United States)

    Suwantika, Auliya A; Beutels, Philippe; Postma, Maarten J

    2014-01-01

    Objective This study aims to assess the cost-effectiveness of hepatitis A immunization in Indonesia, including an explicit comparison between one-dose and two-dose vaccines. Methods An age-structured cohort model based on a decision tree was developed for the 2012 Indonesia birth cohort. Using the model, we made a comparison on the use of two-dose and one-dose vaccines. The model involved a 70-year time horizon with 1-month cycles for children less than 2 years old and annually thereafter. Monte Carlo simulations were used to examine the economic acceptability and affordability of the hepatitis A vaccination. Results Vaccination would save US$ 3 795 148 and US$ 2 892 920 from the societal perspective, for the two-dose and one-dose vaccine schedules, respectively, in the context of hepatitis A treatment. It also would save 8917 and 6614 discounted quality-adjusted-life-years (QALYs), respectively. With the vaccine price of US$ 3.21 per dose, the implementation of single dose vaccine would yield an incremental cost-effectiveness ratio (ICER) of US$ 4933 per QALY gained versus no vaccination, whereas the two-dose versus one-dose schedule would cost US$ 14 568 per QALY gained. Considering the 2012 gross-domestic-product (GDP) per capita in Indonesia of US$ 3557, the results indicate that hepatitis A vaccination would be a cost-effective intervention, both for the two-dose and one-dose vaccine schedules in isolation, but two-dose vaccination would no longer be cost-effective if one-dose vaccination is a feasible option. Vaccination would be 100% affordable at budgets of US$ 71 408 000 and US$ 37 690 000 for the implementation of the two-dose and one-dose vaccine schedules, respectively. Conclusions The implementation of hepatitis A vaccination in Indonesia would be a cost-effective health intervention under the market vaccine price. Given the budget limitations, the use of a one-dose-vaccine schedule would be more realistic to be applied than a two

  3. Cost-effectiveness analysis of rotavirus vaccination in Argentina.

    Science.gov (United States)

    Urueña, Analía; Pippo, Tomás; Betelu, María Sol; Virgilio, Federico; Hernández, Laura; Giglio, Norberto; Gentile, Ángela; Diosque, Máximo; Vizzotti, Carla

    2015-05-07

    Rotavirus is a leading cause of severe diarrhea in children under 5. In Argentina, the most affected regions are the Northeast and Northwest, where hospitalizations and deaths are more frequent. This study estimated the cost-effectiveness of adding either of the two licensed rotavirus vaccines to the routine immunization schedule. The integrated TRIVAC vaccine cost-effectiveness model from the Pan American Health Organization's ProVac Initiative (Version 2.0) was used to assess health benefits, costs savings, life-years gained (LYGs), DALYs averted, and cost/DALY averted of vaccinating 10 successive cohorts, from the health care system and societal perspectives. Two doses of monovalent (RV1) rotavirus vaccine and three doses of pentavalent (RV5) rotavirus vaccine were each compared to a scenario assuming no vaccination. The price/dose was US$ 7.50 and US$ 5.15 for RV1 and RV5, respectively. We ran both a national and sub-national analysis, discounting all costs and benefits 3% annually. Our base case results were compared to a range of alternative univariate and multivariate scenarios. The number of LYGs was 5962 and 6440 for RV1 and RV5, respectively. The cost/DALY averted when compared to no vaccination from the health care system and societal perspective was: US$ 3870 and US$ 1802 for RV1, and US$ 2414 and US$ 358 for RV5, respectively. Equivalent figures for the Northeast were US$ 1470 and US$ 636 for RV1, and US$ 913 and US$ 80 for RV5. Therefore, rotavirus vaccination was more cost-effective in the Northeast compared to the whole country; and, in the Northwest, health service's costs saved outweighed the cost of introducing the vaccine. Vaccination with either vaccine compared to no vaccination was highly cost-effective based on WHO guidelines and Argentina's 2011 per capita GDP of US$ 9090. Key variables influencing results were vaccine efficacy, annual loss of efficacy, relative coverage of deaths, vaccine price, and discount rate. Compared to no

  4. Cost effective reductions in the agricultural load of nitrogen to the Baltic Sea

    Energy Technology Data Exchange (ETDEWEB)

    Elofsson, K.

    1997-11-01

    To restore the health of the Baltic Sea, the Helsinki Commission, HELCOM, suggests that the nitrogen load should be reduced by 50%. The agricultural sector accounts for about 1/3 of the total load of nitrogen to the Baltic Sea, while point sources account for about 1/4. The remaining load reaches the Baltic as atmospheric deposition. The purpose of this study is to calculate cost effective reductions in the agricultural load of nitrogen to the Baltic Sea coastal waters. The Baltic Sea drainage basin is divided into 17 regions, which differ with respect to costs, leaching and nitrogen retention. For each region, cost functions are estimated for 11 nitrogen abatement measures in the agricultural sector. It is difficult to find reliable data on both costs and biological parameters for all regions included, and several assumptions are made to obtain the cost functions. In this paper the total cost of a 50% reduction of the nitrogen load from arable land is estimated to 11,700 million SEK per year. A decrease in the use of fertilizer nitrogen is the most important measure in a cost effective policy. Other measures included in the cost effective solution are changes in land-use and in manure management practices. If, instead, each country is required to reduce its load by 50%, the total cost will increase by nearly 60%. Three out of nine countries around the Baltic Sea would gain from separate reduction targets, while all others lose by such a policy. The results are sensitive to assumptions about the biological parameters and the shape of the cost functions for reductions in chemical fertilizer. 75 refs, 3 figs, 11 tabs

  5. Regional disparity and cost-effective SO2 pollution control in China: A case study in 5 mega-cities

    International Nuclear Information System (INIS)

    Kanada, Momoe; Dong, Liang; Fujita, Tsuyoshi; Fujii, Minoru; Inoue, Tsuyoshi; Hirano, Yujiro; Togawa, Takuya; Geng, Yong

    2013-01-01

    With rapid development, increasing sulfur dioxide (SO 2 ) emission becomes a key environmental issue in China. To respond to this challenge, the Chinese government established a top-down scheme to reduce its SO 2 emissions. However, regional disparity and the associated cost differences brought uncertainties to the policy effectiveness and efficiency. Few studies focus on this field. Therefore, this study tries to fill such a gap by investigating the differences of SO 2 emissions, reduction potential, and cost-effectiveness through use of the GAINS-China model in five mega-cities in China, namely, Beijing, Shanghai, Tianjin, Chongqing, and Hong Kong. A scenario analysis approach is employed, focusing on two technologies named flue gas desulfurization (FGD) and limestone injection (LINJ). Results demonstrated that a large SO 2 reduction potential exists, as well as a great disparity, among the five mega-cities. Chongqing had the largest reduction potential with lowest unit cost, while Beijng and Hong Kong showed the lowest reduction potential with higher unit cost. In Beijing and Shanghai, FGD and LINJ in the power generation sector had the larger reduction potential with the highest cost-effectiveness. However, in Chongqing, the industry sectors also had large reduction potentials. Finally, appropriate SO 2 control strategies and policies are raised by considering the local realities. - Highlights: • The cost-effectiveness of SO 2 control policy was analyzed in five mega-cities in China. • Reduction potential and cost-effectiveness were closely linked to regional disparity. • Beijing and Hong Kong showed lower reduction potential and higher marginal reduction cost. • Chongqing showed the largest reduction potential and the lowest marginal reduction cost

  6. Solitary pulmonary nodules: accuracy and cost-effectiveness of sodium iodide FDG-PET using Australian data

    International Nuclear Information System (INIS)

    Keith, C.J.; Miles, K.A.; Griffiths, M.R.; Wong, D.; Pitman, A.G.; Hicks, R.J.

    2002-01-01

    This study uses Australian data to confirm the accuracy of dedicated sodium iodide (NaI) fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) in evaluating indeterminate solitary pulmonary nodules (SPNs) and to determine the conditions under which PET could play a cost-effective role in this evaluation. Ninety-two patients from two Australian hospitals in different states underwent FDG-PET for evaluation of an SPN. Observed values for prior probability of malignancy and diagnostic accuracy of PET were applied to previously published decision tree models using published Australian health care costs. The accuracy of FDG-PET was 93% with a sensitivity of 92% and a specificity of 95%. The prior probability of malignancy (0.54), PET sensitivity and PET specificity indicated cost savings per patient of up to EUR 455 (A$ 774) based on a PET cost of EUR 706 (A$ 1,200). PET would remain cost-effective for levels of prior probability up to 0.8-0.9 and a PET cost of EUR 736-1,161 (A$ 1,252-A$ 1,974). It is concluded that NaI PET is accurate, cost saving and cost-effective for the characterisation of indeterminate pulmonary nodules in Australia. Comparison with previous reports from the United States confirms that FDG-PET can remain cost-effective despite population differences in medical costs, disease prevalence and PET diagnostic performance. (orig.)

  7. Solitary pulmonary nodules: Impact of quantitative contrast-enhanced CT on the cost-effectiveness of FDG-PET

    International Nuclear Information System (INIS)

    Comber, L.A.; Keith, C.J.; Griffiths, M.; Miles, K.A.

    2003-01-01

    AIM: To determine the impact of quantitative contrast-enhanced computed tomography (QECT) on the cost-effectiveness of diagnostic strategies for the assessment of solitary pulmonary nodules (SPNs). MATERIALS AND METHODS: Four diagnostic strategies were evaluated using decision tree analysis: conventional CT alone; conventional CT followed by QECT; conventional CT followed positron emission tomography (PET); and conventional CT followed by QECT and PET (QECT+PET). The average cost per patient, accuracy of management and incremental cost:accuracy ratio (ICAR) were determined for each strategy. Although baseline assumptions reflected the Australian setting, sensitivity analysis was used to extrapolate the results to the UK. RESULTS: At the baseline prevalence of malignancy (54%) and cost of PET relative to surgery (16%), the QECT strategy incurs the least cost ($5560/patient) but the QECT+PET strategy is the most cost-effective (ICAR $12059/patient). At reported levels of disease prevalence (68.5%) and cost of PET relative to surgery (29.9%) in the UK, the QECT strategy is the most cost-effective. CONCLUSION: QECT offers a cost-effective approach to evaluation of SPNs. Whether QECT is used alone or in combination with PET will depend upon local availability and regional values for prior probability of malignancy within SPNs and the cost of PET relative to surgery

  8. International lessons in new methods for grading and integrating cost effectiveness evidence into clinical practice guidelines

    DEFF Research Database (Denmark)

    Antioch, Kathryn M; Drummond, Michael F; Niessen, Louis W

    2017-01-01

    Economic evidence is influential in health technology assessment world-wide. Clinical Practice Guidelines (CPG) can enable economists to include economic information on health care provision. Application of economic evidence in CPGs, and its integration into clinical practice and national decisio......-of-life, budget impact, cost-effective ratios, net benefits and disparities in access and outcomes. Priority setting remains essential and trade-off decisions between policy criteria can be based on MCDA, both in evidence based clinical medicine and in health planning....... that scores that checklist for grading studies, when assessing economic evidence. Cost-effectiveness Analysis (CEA) thresholds, opportunity cost and willingness-to-pay (WTP) are crucial issues for decision rules in CEA generally, including end-of-life therapies. Limitations of inter-rater reliability......, logistics, innovation price, price sensitivity, substitutes and complements, WTP, absenteeism and presentism. Supply issues may include economies of scale, efficiency changes, and return on investment. Involved equity and efficiency measures may include cost-of-illness, disease burden, quality...

  9. Software reliability

    CERN Document Server

    Bendell, A

    1986-01-01

    Software Reliability reviews some fundamental issues of software reliability as well as the techniques, models, and metrics used to predict the reliability of software. Topics covered include fault avoidance, fault removal, and fault tolerance, along with statistical methods for the objective assessment of predictive accuracy. Development cost models and life-cycle cost models are also discussed. This book is divided into eight sections and begins with a chapter on adaptive modeling used to predict software reliability, followed by a discussion on failure rate in software reliability growth mo

  10. In vitro cost-effective methods to detect carbapenemases in Enterobacteriaceae

    Directory of Open Access Journals (Sweden)

    Varsha Gupta

    2018-01-01

    Full Text Available The rise in carbapenemases-producing organisms has challenged the scientific community. Infections caused by these bacteria have limited treatment options. There are various types such as Klebsiella pneumoniae carbapenemase (Ambler class A, metallo-beta-lactamases of VIM-type, IMP-type, NDM-type (Ambler class B, and OXA-48-types (Ambler class D. An efficient strategy for detection of carbapenemase producers is important to determine the appropriate therapeutic modalities. In this study, four methods - Carba NP test, modified Carba NP (MCNP test, carbapenem inactivation method (CIM test, and Rapidec Carba NP kit test were evaluated. We evaluated an in-house MCNP test to detect carbapenemase production using a single protocol which gave reliable results. Furthermore, CIM using routine antibiotic discs gives good results. Both these tests were found to be cost-effective.

  11. Cost-effective ERT technique for oil-in-water measurement for offshore hydrocyclone installations

    DEFF Research Database (Denmark)

    Durdevic, Petar; Hansen, Leif; Mai, Christian

    2015-01-01

    The goal of this paper is to introduce and design a cost-effective Oil-in-Water (OiW) measuring instrument, which will be investigated for its value in increasing the efficiency of a deoiling hydrocyclone. The technique investigated is based on Electrical Resistivity Tomography (ERT), which basic...... principle is to measure the resistivity of substances from multiple electrodes and from these measurements create a 2-D image of the oil and gas component in the water. This technique requires the measured components to have different electrical resistances, such as seawater which has a lower electrical...... resistance than hydrocarbon oil and gas. This work involves construction of a pilot plant, for testing the feasibility of ERT for OiW measurements, and further exploring if this measured signal can be applied as a reliable feedback signal in optimization of the hydrocyclone's efficiency. Different algorithms...

  12. Cost-Effective ERT Technique for Oil-in-Water Measurement for Offshore Hydrocyclone Installations

    DEFF Research Database (Denmark)

    Løhndorf, Petar Durdevic; Hansen, Leif; Mai, Christian

    2015-01-01

    The goal of this paper is to introduce and design a cost-effective Oil-in-Water (OiW) measuring instrument, which will be investigated for its value in increasing the efficiency of a deoiling hydrocyclone. The technique investigated is based on Electrical Resistivity Tomography (ERT), which basic...... principle is to measure the resistivity of substances from multiple electrodes and from these measurements create a 2-D image of the oil and gas component in the water. This technique requires the measured components to have different electrical resistances, such as seawater which has a lower electrical...... resistance than hydrocarbon oil and gas. This work involves construction of a pilot plant, for testing the feasibility of ERT for OiW measurements, and further exploring if this measured signal can be applied as a reliable feedback signal in optimization of the hydrocyclone's efficiency. Different algorithms...

  13. Training effectiveness vs. cost effectiveness: The next millennium challenge

    International Nuclear Information System (INIS)

    Coe, Richard P.

    2003-01-01

    With the advent of the new millennium and energy deregulation, organizations will be challenged to be cost competitive and profitable. Deregulation in the US energy industry will force utilities and, more specifically, commercial nuclear power production to unprecedented cost control measures. It will also renew the fires of debate about costs vs. safety. With personnel costs being the single largest expenditure for most organizations management will be faced with constant dilemmas of competition for scarce resources. Salaries, benefits and training costs will be under greater scrutiny. Training resources and programs will face increased pressure to be job related, based on conservative requirements and more cost effective than in the past. For nearly two decades the US National Academy for Nuclear Training (NANT) has developed and used industry-wide accreditation and evaluation standards based on the Systematic Approach to Training (SAT). This process assures that existing and emerging technical training is constantly reviewed and evaluated against standardized criteria to assure job relatedness and enhanced job performance. The process also requires management to approve, actively participate in and support the training of NPP personnel. Instructors must be highly skilled and well trained in the SAT process and various instructional strategies. The SAT process is grounded in five interlocking keystone steps; Analysis - Design - Development - Implementation - Evaluation (ADDIE). Evaluation of training is often said to be the most crucial and most difficult step. Here is where an organization determines if the training is effective and meeting the legitimate needs of all of the stakeholders. This QA/QC aspect of training must be an ongoing process involving management, instructors and the students. It is only through the discipline of an SAT based evaluation process that an organization can truly determine if the training is efficient, effective, cost effective and

  14. On the censored cost-effectiveness analysis using copula information

    Directory of Open Access Journals (Sweden)

    Charles Fontaine

    2017-02-01

    Full Text Available Abstract Background Information and theory beyond copula concepts are essential to understand the dependence relationship between several marginal covariates distributions. In a therapeutic trial data scheme, most of the time, censoring occurs. That could lead to a biased interpretation of the dependence relationship between marginal distributions. Furthermore, it could result in a biased inference of the joint probability distribution function. A particular case is the cost-effectiveness analysis (CEA, which has shown its utility in many medico-economic studies and where censoring often occurs. Methods This paper discusses a copula-based modeling of the joint density and an estimation method of the costs, and quality adjusted life years (QALY in a cost-effectiveness analysis in case of censoring. This method is not based on any linearity assumption on the inferred variables, but on a punctual estimation obtained from the marginal distributions together with their dependence link. Results Our results show that the proposed methodology keeps only the bias resulting statistical inference and don’t have anymore a bias based on a unverified linearity assumption. An acupuncture study for chronic headache in primary care was used to show the applicability of the method and the obtained ICER keeps in the confidence interval of the standard regression methodology. Conclusion For the cost-effectiveness literature, such a technique without any linearity assumption is a progress since it does not need the specification of a global linear regression model. Hence, the estimation of the a marginal distributions for each therapeutic arm, the concordance measures between these populations and the right copulas families is now sufficient to process to the whole CEA.

  15. Cost-effectiveness of minimally invasive sacroiliac joint fusion

    Science.gov (United States)

    Cher, Daniel J; Frasco, Melissa A; Arnold, Renée JG; Polly, David W

    2016-01-01

    Background Sacroiliac joint (SIJ) disorders are common in patients with chronic lower back pain. Minimally invasive surgical options have been shown to be effective for the treatment of chronic SIJ dysfunction. Objective To determine the cost-effectiveness of minimally invasive SIJ fusion. Methods Data from two prospective, multicenter, clinical trials were used to inform a Markov process cost-utility model to evaluate cumulative 5-year health quality and costs after minimally invasive SIJ fusion using triangular titanium implants or non-surgical treatment. The analysis was performed from a third-party perspective. The model specifically incorporated variation in resource utilization observed in the randomized trial. Multiple one-way and probabilistic sensitivity analyses were performed. Results SIJ fusion was associated with a gain of approximately 0.74 quality-adjusted life years (QALYs) at a cost of US$13,313 per QALY gained. In multiple one-way sensitivity analyses all scenarios resulted in an incremental cost-effectiveness ratio (ICER) <$26,000/QALY. Probabilistic analyses showed a high degree of certainty that the maximum ICER for SIJ fusion was less than commonly selected thresholds for acceptability (mean ICER =$13,687, 95% confidence interval $5,162–$28,085). SIJ fusion provided potential cost savings per QALY gained compared to non-surgical treatment after a treatment horizon of greater than 13 years. Conclusion Compared to traditional non-surgical treatments, SIJ fusion is a cost-effective, and, in the long term, cost-saving strategy for the treatment of SIJ dysfunction due to degenerative sacroiliitis or SIJ disruption. PMID:26719717

  16. The cost-effectiveness of rotavirus vaccination in Armenia.

    Science.gov (United States)

    Jit, Mark; Yuzbashyan, Ruzanna; Sahakyan, Gayane; Avagyan, Tigran; Mosina, Liudmila

    2011-11-08

    The cost-effectiveness of introducing infant rotavirus vaccination in Armenia in 2012 using Rotarix(R) was evaluated using a multiple birth cohort model. The model considered the cost and health implications of hospitalisations, primary health care consultations and episodes not leading to medical care in children under five years old. Rotavirus vaccination is expected to cost the Ministry of Health $220,000 in 2012, rising to $830,000 in 2016 following termination of GAVI co-financing, then declining to $260,000 in 2025 due to vaccine price maturity. It may reduce health care costs by $34,000 in the first year, rising to $180,000 by 2019. By 2025, vaccination may be close to cost saving to the Ministry of Health if the vaccine purchase price declines as expected. Once coverage has reached high levels, vaccination may prevent 25,000 cases, 3000 primary care consultations, 1000 hospitalisations and 8 deaths per birth cohort vaccinated. The cost per disability-adjusted life year (DALY) saved is estimated to be about $650 from the perspective of the Ministry of Health, $850 including costs accrued to both the Ministry and to GAVI, $820 from a societal perspective excluding indirect costs and $44 from a societal perspective including indirect costs. Since the gross domestic product per capita of Armenia in 2008 was $3800, rotavirus vaccination is likely to be regarded as "very cost-effective" from a WHO standpoint. Vaccination may still be "very cost-effective" if less favourable assumptions are used regarding vaccine price and disease incidence, as long as DALYs are not age-weighted. Copyright © 2011 Elsevier Ltd. All rights reserved.

  17. Cost-Effectiveness of the Freeze-All Policy.

    Science.gov (United States)

    Roque, Matheus; Valle, Marcello; Guimarães, Fernando; Sampaio, Marcos; Geber, Selmo

    2015-08-01

    To evaluate the cost-effectiveness of freeze-all cycles when compared to fresh embryo transfer. This was an observational study with a cost-effectiveness analysis. The analysis consisted of 530 intracytoplasmic sperm injection (ICSI) cycles in a private center in Brazil between January 2012 and December 2013. A total of 530 intracytoplasmic sperm injection (ICSI) cycles - 351 fresh embryo transfers and 179 freeze-all cycles - with a gonadotropin-releasing hormone (GnRH) antagonist protocol and day 3 embryo transfers. The pregnancy rate was 31.1% in the fresh group and 39.7% in the freeze-all group. We performed two scenario analyses for costs. In scenario 1, we included those costs associated with the ICSI cycle (monitoring during controlled ovarian stimulation [COS], oocyte retrieval, embryo transfer, IVF laboratory, and medical costs), embryo cryopreservation of supernumerary embryos, hormone measurements during COS and endometrial priming, medication use (during COS, endometrial priming, and luteal phase support), ultrasound scan for frozen- thawed embryo transfer (FET), obstetric ultrasounds, and miscarriage. The total cost (in USD) per pregnancy was statistically lower in the freeze-all cycles (19,156.73 ± 1,732.99) when compared to the fresh cycles (23,059.72 ± 2,347.02). Even in Scenario 2, when charging all of the patients in the freeze-all group for cryopreservation (regardless of supernumerary embryos) and for FET, the fresh cycles had a statistically significant increase in treatment costs per ongoing pregnancy. The results presented in this study suggest that the freeze-all policy is a cost-effective strategy when compared to fresh embryo transfer.

  18. Cost effectiveness of adopted quality requirements in hospital laboratories.

    Science.gov (United States)

    Hamza, Alneil; Ahmed-Abakur, Eltayib; Abugroun, Elsir; Bakhit, Siham; Holi, Mohamed

    2013-01-01

    The present study was designed in quasi-experiment to assess adoption of the essential clauses of particular clinical laboratory quality management requirements based on international organization for standardization (ISO 15189) in hospital laboratories and to evaluate the cost effectiveness of compliance to ISO 15189. The quality management intervention based on ISO 15189 was conceded through three phases; pre - intervention phase, Intervention phase and Post-intervention phase. In pre-intervention phase the compliance to ISO 15189 was 49% for study group vs. 47% for control group with P value 0.48, while the post intervention results displayed 54% vs. 79% for study group and control group respectively in compliance to ISO 15189 and statistically significant difference (P value 0.00) with effect size (Cohen's d) of (0.00) in pre-intervention phase and (0.99) in post - intervention phase. The annual average cost per-test for the study group and control group was 1.80 ± 0.25 vs. 1.97 ± 0.39, respectively with P value 0.39 whereas the post-intervention results showed that the annual average total costs per-test for study group and control group was 1.57 ± 0.23 vs 2.08 ± 0.38, P value 0.019 respectively, with cost-effectiveness ratio of (0.88) in pre -intervention phase and (0.52) in post-intervention phase. The planned adoption of quality management requirements (QMS) in clinical laboratories had great effect to increase the compliance percent with quality management system requirement, raise the average total cost effectiveness, and improve the analytical process capability of the testing procedure.

  19. Cost-effectiveness of pharmacotherapy to reduce obesity.

    Directory of Open Access Journals (Sweden)

    J Lennert Veerman

    Full Text Available AIMS: Obesity causes a high disease burden in Australia and across the world. We aimed to analyse the cost-effectiveness of weight reduction with pharmacotherapy in Australia, and to assess its potential to reduce the disease burden due to excess body weight. METHODS: We constructed a multi-state life-table based Markov model in Excel in which body weight influences the incidence of stroke, ischemic heart disease, hypertensive heart disease, diabetes mellitus, osteoarthritis, post-menopausal breast cancer, colon cancer, endometrial cancer and kidney cancer. We use data on effectiveness identified from PubMed searches, on mortality from Australian Bureau of Statistics, on disease costs from the Australian Institute of Health and Welfare, and on drug costs from the Department of Health and Ageing. We evaluate 1-year pharmacological interventions with sibutramine and orlistat targeting obese Australian adults free of obesity-related disease. We use a lifetime horizon for costs and health outcomes and a health sector perspective for costs. Incremental Cost-Effectiveness Ratios (ICERs below A$50 000 per Disability Adjusted Life Year (DALY averted are considered good value for money. RESULTS: The ICERs are A$130 000/DALY (95% uncertainty interval [UI] 93 000-180 000 for sibutramine and A$230 000/DALY (170 000-340 000 for orlistat. The interventions reduce the body weight-related disease burden at the population level by 0.2% and 0.1%, respectively. Modest weight loss during the interventions, rapid post-intervention weight regain and low adherence limit the health benefits. CONCLUSIONS: Treatment with sibutramine or orlistat is not cost-effective from an Australian health sector perspective and has a negligible impact on the total body weight-related disease burden.

  20. Cost-effective analysis of unilateral vestibular weakness investigation.

    Science.gov (United States)

    Gandolfi, Michele M; Reilly, Erin K; Galatioto, Jessica; Judson, Randy B; Kim, Ana H

    2015-02-01

    To evaluate the cost-effectiveness of obtaining a magnetic resonance imaging (MRI) in patients with abnormal electronystagmography (ENG) or videonystagmography (VNG) results. Retrospective chart review. Academic specialty center. Patients presenting with vertigo between January 1, 2010, and August 30, 2013. Patients who fit the following abnormal criteria were included in the study: unilateral caloric weakness (≥20%), abnormal ocular motor testing, and nystagmus on positional testing. Patients with abnormal findings who then underwent MRI with gadolinium were evaluated. Of the 1,996 charts reviewed, there were 1,358 patients who met the inclusion criteria. The average age of these patients was 62 years (12-94 yr). The male:female ratio was approximately 1:2. Of the 1,358 patients, 253 received an MRI with the following pathologies: four vestibular schwannomas, three subcortical/periventricular white matter changes suspicious for demyelinating disease, four acute cerebellar/posterior circulation infarct, two vertebral artery narrowing, one pseudomeningocele of internal auditory canal, and two white matter changes indicative of migraines. The positive detection rate on MRI was 5.5% based on MRI findings of treatable pathologies causing vertigo. Average cost of an MRI is $1,200, thereby making the average cost of identifying a patient with a positive MRI finding $15,180. In our study, those patients with a positive MRI had a constellation of symptoms and findings (asymmetric sensorineural hearing loss, tinnitus, vertigo, and abnormal ENG/VNG). Cost-effectiveness can be improved by ordering an MRI only when clinical examination and VNG point toward a central pathology. Clinical examination and appropriate testing should be factored when considering the cost-effectiveness of obtaining an MRI in patients with abnormal ENG/VNG findings.

  1. Design of a cost-effective laser spot tracker

    Science.gov (United States)

    Artan, Göktuǧ Gencehan; Sari, Hüseyin

    2017-05-01

    One of the most important aspects of guided systems is detection. The most convenient detection in the sense of precision can be achieved with a laser spot tracker. This study deals with a military grade, high performance and cost-effective laser spot tracker for a guided system. The aim is to develop a high field of view system that will detect a laser spot from a distance of 3 kilometers in which the target is designated from 3 kilometers with a laser. The study basically consists of the system design, modeling, producing and the conducting performance tests of the whole system.

  2. Preoperative localization of parathyroid adenomas is cost-effective

    International Nuclear Information System (INIS)

    Wilson, M.A.; Mack, E.; Rowe, B.; Perlman, S.B.

    1986-01-01

    The preoperative localization of parathyroid adenomas is cost-effective because it reduces anesthesia and surgery times. The technique is sensitive in single and double adenomas (90%), and some surgeons have modified their operative technique because of its introduction. The practical experience of one surgeon is presented, with similar patient subsets (n = 22) compared before and after use of a localization scan was instituted. The average operative time fell by 94%, from 2 hours 35 minutes to 1 hour 19 minutes. The reduction in operative time was possible because the surgeon did not seek to identify the remaining normal parathyroids when the scanned lesion was excised and proved to be the adenoma

  3. Cost effectiveness of a protocol using palivizumab in preterm infants

    Directory of Open Access Journals (Sweden)

    Yolanda Hernández-Gago

    2017-03-01

    Full Text Available Objective: The main objective was to evaluate the cost-effectiveness of protocol use of palivizumab in premature established by consensus in our Hospital comparing it based on the recommendations of various Scientific Societies. As a secondary objective risk factors and severity of hospitalized patients attending the established protocol in our Hospital were analyzed. Methods: The study period was 4 seasons with the expanded protocol (retrospective data versus 2 with restricted or agreed protocol (prospective data. The perspective of the study was the Health System, including the costs of hospitalization and palivizumab our center. The calculation of the effectiveness was determined with the admission rate of premature patients stratified by weeks of gestational age <29, <32; and <35. For the analysis of risk factors and severity in patients admitted seasons with the new protocol are collected prospectively clinical data and environmental and social factors. Results: In the range of gestational age <29 years old and <32 greater effectiveness of the extended protocol was not demonstrated against the consensus. Only more effective for EG <35 in the accumulated data and comparing seasons 12/13 and 08/09 to 13/14 for individual data was observed. This range has an associated incremental cost effectiveness ratio of € 53 250,07 (range: € 14 793,39 to € 90 446,47 for singles data and € 50 525,53 (€ 28 688.22 to € 211 575,65 for accumulated. The establishment of this protocol in our center meant an average saving per season € 169 911,51. A cost- effectiveness of the extended protocol appropriate relationship is found if the cost of palivizumab per patient was less than € 1 206,67 (calculated for maximum use of the vial and a higher rate of hospitalization of 9.21%. Children entering the season with the new protocol (season 12/13 and 13/14 are 63.4% in children under 3 months and 90% are term infants who do not belong to any population at

  4. Operating dedicated data centers – is it cost-effective?

    International Nuclear Information System (INIS)

    Ernst, M; Hogue, R; Hollowell, C; Strecker-Kellog, W; Wong, A; Zaytsev, A

    2014-01-01

    The advent of cloud computing centres such as Amazon's EC2 and Google's Computing Engine has elicited comparisons with dedicated computing clusters. Discussions on appropriate usage of cloud resources (both academic and commercial) and costs have ensued. This presentation discusses a detailed analysis of the costs of operating and maintaining the RACF (RHIC and ATLAS Computing Facility) compute cluster at Brookhaven National Lab and compares them with the cost of cloud computing resources under various usage scenarios. An extrapolation of likely future cost effectiveness of dedicated computing resources is also presented.

  5. Operating Dedicated Data Centers - Is It Cost-Effective?

    Science.gov (United States)

    Ernst, M.; Hogue, R.; Hollowell, C.; Strecker-Kellog, W.; Wong, A.; Zaytsev, A.

    2014-06-01

    The advent of cloud computing centres such as Amazon's EC2 and Google's Computing Engine has elicited comparisons with dedicated computing clusters. Discussions on appropriate usage of cloud resources (both academic and commercial) and costs have ensued. This presentation discusses a detailed analysis of the costs of operating and maintaining the RACF (RHIC and ATLAS Computing Facility) compute cluster at Brookhaven National Lab and compares them with the cost of cloud computing resources under various usage scenarios. An extrapolation of likely future cost effectiveness of dedicated computing resources is also presented.

  6. Cost-effectiveness in fall prevention for older women

    OpenAIRE

    Hektoen, Liv F.; Aas, Eline; Lurås, Hilde

    2009-01-01

    Artikkelen beskriver en studie hvor hensikten var å estimere kostnadseffekten av fallforebygging for hjemmeboende eldre kvinner i Norge. The aim of this study was to estimate the cost-effectiveness of implementing an exercise-based fall prevention programme for home-dwelling women in the 80-year age group in Norway. Methods: the impact of the home-based individual exercise programme on the number of falls is based on a New Zealand study. On the basis of the cost estimates and the estimate...

  7. Cost effective tools for soil organic carbon monitoring

    Science.gov (United States)

    Shepherd, Keith; Aynekulu, Ermias

    2013-04-01

    There is increasing demand for data on soil properties at fine spatial resolution to support management and planning decisions. Measurement of soil organic carbon has attracted much interest because (i) soil organic carbon is widely cited as a useful indicator of soil condition and (ii) of the importance of soil carbon in the global carbon cycle and climate mitigation strategies. However in considering soil measurement designs there has been insufficient attention given to careful analysis of the specific decisions that the measurements are meant to support and on what measurements have high information value for decision-making. As a result, much measurement effort may be wasted or focused on the wrong variables. A cost-effective measurement is one that reduces risk in decisions and does not cost more than the societal returns to additional evidence. A key uncertainty in measuring soil carbon as a soil condition indicator is what constitutes a good or bad level of carbon on a given soil. A measure of soil organic carbon concentration may have limited value for informing management decisions without the additional information required to interpret it, and so expending further efforts on improving measurements to increase precision may then have no value to improving the decision. Measuring soil carbon stock changes for carbon trading purposes requires high levels of measurement precision but there is still large uncertainty on whether the costs of measurement exceed the benefits. Since the largest cost component in soil monitoring is often travel to the field and physically sampling soils, it is generally cost-effective to meet multiple objectives by analysing a number of properties on a soil sample. Diffuse reflectance infrared spectroscopy is playing a key role in allowing multiple soil properties to be determined rapidly and at low cost. The method provides estimation of multiple soil properties (e.g. soil carbon, texture and mineralogy) in one measurement

  8. Dynamic modeling of cost-effectiveness of rotavirus vaccination, Kazakhstan.

    Science.gov (United States)

    Freiesleben de Blasio, Birgitte; Flem, Elmira; Latipov, Renat; Kuatbaeva, Ajnagul; Kristiansen, Ivar Sønbø

    2014-01-01

    The government of Kazakhstan, a middle-income country in Central Asia, is considering the introduction of rotavirus vaccination into its national immunization program. We performed a cost-effectiveness analysis of rotavirus vaccination spanning 20 years by using a synthesis of dynamic transmission models accounting for herd protection. We found that a vaccination program with 90% coverage would prevent ≈880 rotavirus deaths and save an average of 54,784 life-years for children vaccine cost at vaccination program costs would be entirely offset. To further evaluate efficacy of a vaccine program, benefits of indirect protection conferred by vaccination warrant further study.

  9. Cost-effectiveness studies as part of an ALARA program

    International Nuclear Information System (INIS)

    Baum, J.W.

    1986-01-01

    Recent studies of cost effectiveness of engineering modifications for dose reduction at nuclear power plants conducted at BNL will be considered in this report. Since each of these items has the potential for a 50% to 60% reduction in collective dose, it appears there is large potential for dose reduction from engineering type modifications. The question that must be answered for each plant is ''which modifications or improvements are required for optimization (ALARA). The purpose of this paper is to illustrate that quantified optimization need not be costly and can often be highly beneficial

  10. A compact cost-effective beamline for a PET Cyclotron

    International Nuclear Information System (INIS)

    Dehnel, M.P.; Jackle, P.; Roeder, M.; Stewart, T.; Theroux, J.; Brasile, J.P.; Sirot, P.; Buckley, K.R.; Bedue, M.

    2007-01-01

    Most commercial PET Cyclotrons have targets mounted on or near the main cyclotron vacuum chamber. There is often little or no system capability for centering or focusing the extracted beam on target to achieve maximum production. This paper describes the ion-optics, design and development of a compact cost-effective beamline comprised of low activation and radiation resistant materials. The beamline, complete with suitable diagnostic devices, permits the extracted proton beam to be centered (X-Y steering magnet), and focused (quadrupole doublet) on target eliminating unnecessary beamspill and ensuring high production

  11. Cost-effectiveness of minimally invasive sacroiliac joint fusion

    Directory of Open Access Journals (Sweden)

    Cher DJ

    2015-12-01

    Full Text Available Daniel J Cher,1 Melissa A Frasco,2 Renée JG Arnold,2,3 David W Polly4,5 1Clinical Affairs, SI-BONE, Inc., San Jose, CA, USA; 2Division of Health Economics and Outcomes Research, Quorum Consulting, Inc., San Francisco, CA, USA; 3Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA; 4Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN, USA; 5Department of Neurosurgery, University of Minnesota, Minneapolis, MN, USA Background: Sacroiliac joint (SIJ disorders are common in patients with chronic lower back pain. Minimally invasive surgical options have been shown to be effective for the treatment of chronic SIJ dysfunction. Objective: To determine the cost-effectiveness of minimally invasive SIJ fusion. Methods: Data from two prospective, multicenter, clinical trials were used to inform a Markov process cost-utility model to evaluate cumulative 5-year health quality and costs after minimally invasive SIJ fusion using triangular titanium implants or non-surgical treatment. The analysis was performed from a third-party perspective. The model specifically incorporated variation in resource utilization observed in the randomized trial. Multiple one-way and probabilistic sensitivity analyses were performed. Results: SIJ fusion was associated with a gain of approximately 0.74 quality-adjusted life years (QALYs at a cost of US$13,313 per QALY gained. In multiple one-way sensitivity analyses all scenarios resulted in an incremental cost-effectiveness ratio (ICER <$26,000/QALY. Probabilistic analyses showed a high degree of certainty that the maximum ICER for SIJ fusion was less than commonly selected thresholds for acceptability (mean ICER =$13,687, 95% confidence interval $5,162–$28,085. SIJ fusion provided potential cost savings per QALY gained compared to non-surgical treatment after a treatment horizon of greater than 13 years. Conclusion: Compared to traditional non-surgical treatments

  12. Cost effective treatment for wet FGD scrubber bleedoff

    Energy Technology Data Exchange (ETDEWEB)

    Janecek, K.F. [EIMCO Process Equipment Company, Salt Lake City, UT (United States); Kim, J.Y. [Samkook Corporation, Seoul (Korea, Democratic People`s Republic of)

    1994-12-31

    The dewatering of scrubber bleedoff gypsum is a thoroughly proven technology, whether for production of wallboard grade gypsum or environmentally responsible land fill. Careful review of the technology options will show which one is the most effective for the specific plant site. Likewise, a recipe for wastewater treatment for heavy metals removal can be found that will meet local regulatory limits. EIMCO has worldwide experience in FGD gypsum sludge dewatering and wastewater treatment. Contacting EIMCO can be the most important step toward a practical cost effective system for handling FGD scrubber bleed slurries.

  13. Cost Effective Polymer Solar Cells Research and Education

    Energy Technology Data Exchange (ETDEWEB)

    Sun, Sam-Shajing [Norfolk State Univ, Norfolk, VA (United States)

    2015-10-13

    The technical or research objective of this project is to investigate and develop new polymers and polymer based optoelectronic devices for potentially cost effective (or cost competitive), durable, lightweight, flexible, and high efficiency solar energy conversion applications. The educational objective of this project includes training of future generation scientists, particularly young, under-represented minority scientists, working in the areas related to the emerging organic/polymer based solar energy technologies and related optoelectronic devices. Graduate and undergraduate students will be directly involved in scientific research addressing issues related to the development of polymer based solar cell technology.

  14. Is aggressive treatment of traumatic brain injury cost-effective?

    Science.gov (United States)

    Whitmore, Robert G; Thawani, Jayesh P; Grady, M Sean; Levine, Joshua M; Sanborn, Matthew R; Stein, Sherman C

    2012-05-01

    The object of this study was to determine whether aggressive treatment of severe traumatic brain injury (TBI), including invasive intracranial monitoring and decompressive craniectomy, is cost-effective. A decision-analytical model was created to compare costs, outcomes, and cost-effectiveness of 3 strategies for treating a patient with severe TBI. The aggressive-care approach is compared with "routine care," in which Brain Trauma Foundation guidelines are not followed. A "comfort care" category, in which a single day in the ICU is followed by routine floor care, is included for comparison only. Probabilities of each treatment resulting in various Glasgow Outcome Scale (GOS) scores were obtained from the literature. The GOS scores were converted to quality-adjusted life years (QALYs), based on expected longevity and calculated quality of life associated with each GOS category. Estimated direct (acute and long-term medical care) and indirect (loss of productivity) costs were calculated from the perspective of society. Sensitivity analyses employed a 2D Monte Carlo simulation of 1000 trials, each with 1000 patients. The model was also used to estimate these values for patients 40, 60, and 80 years of age. For the average 20-year-old, aggressive care yields 11.7 (± 1.6 [SD]) QALYs, compared with routine care (10.0 ± 1.5 QALYs). This difference is highly significant (p care remains significantly better at all ages. When all costs are considered, aggressive care is also significantly less costly than routine care ($1,264,000 ± $118,000 vs $1,361,000 ± $107,000) for the average 20-year-old. Aggressive care remains significantly less costly until age 80, at which age it costs more than routine care. However, even in the 80-year-old, aggressive care is likely the more cost-effective approach. Comfort care is associated with poorer outcomes at all ages and with higher costs for all groups except 80-year-olds. When all the costs of severe TBI are considered, aggressive

  15. Modelling the cost effectiveness of antidepressant treatment in primary care.

    Science.gov (United States)

    Revicki, D A; Brown, R E; Palmer, W; Bakish, D; Rosser, W W; Anton, S F; Feeny, D

    1995-12-01

    The aim of this study was to estimate the cost effectiveness of nefazodone compared with imipramine or fluoxetine in treating women with major depressive disorder. Clinical decision analysis and a Markov state-transition model were used to estimate the lifetime health outcomes and medical costs of 3 antidepressant treatments. The model, which represents ideal primary care practice, compares treatment with nefazodone to treatment with either imipramine or fluoxetine. The economic analysis was based on the healthcare system of the Canadian province of Ontario, and considered only direct medical costs. Health outcomes were expressed as quality-adjusted life years (QALYs) and costs were in 1993 Canadian dollars ($Can; $Can1 = $US0.75, September 1995). Incremental cost-utility ratios were calculated comparing the relative lifetime discounted medical costs and QALYs associated with nefazodone with those of imipramine or fluoxetine. Data for constructing the model and estimating necessary parameters were derived from the medical literature, clinical trial data, and physician judgement. Data included information on: Ontario primary care physicians' clinical management of major depression; medical resource use and costs; probabilities of recurrence of depression; suicide rates; compliance rates; and health utilities. Estimates of utilities for depression-related hypothetical health states were obtained from patients with major depression (n = 70). Medical costs and QALYs were discounted to present value using a 5% rate. Sensitivity analyses tested the assumptions of the model by varying the discount rate, depression recurrence rates, compliance rates, and the duration of the model. The base case analysis found that nefazodone treatment costs $Can1447 less per patient than imipramine treatment (discounted lifetime medical costs were $Can50,664 vs $Can52,111) and increases the number of QALYs by 0.72 (13.90 vs 13.18). Nefazodone treatment costs $Can14 less than fluoxetine

  16. Comparison of methods to assess cost-effectiveness of CO2 policies for cars

    International Nuclear Information System (INIS)

    Van den Brink, R.M.M.; Annema, J.A.

    2007-01-01

    The purchase of smaller more fuel-efficient cars seems to have only advantages: the purchase results in less carbon dioxide (CO2) emissions and the purchaser spends less money on the car and the fuel. In spite of this a general trend in buying more fuel-efficient cars is hardly observable in the Netherlands. This report argues that the reason is that consumers value other things in cars (size, comfort, status) next to out-of-pocket money they have to spend on purchase, taxes and fuels. This report recommends to estimating cost-effectiveness of CO2 policies for cars with methods including benefit losses related to buying other cars - smaller, less comfortable - compared to the reference case. This approach results in more realistic cost estimates of CO2 policies compared to methods, which are limited to a 'narrow' - only out-of-pocket money - cost concept [nl

  17. Preoperative staging of lung cancer with PET/CT: cost-effectiveness evaluation alongside a randomized controlled trial

    DEFF Research Database (Denmark)

    Søgaard, Rikke; Fischer, Barbara Malene B; Mortensen, Jann

    2011-01-01

    PURPOSE: Positron emission tomography (PET)/CT has become a widely used technology for preoperative staging of non-small cell lung cancer (NSCLC). Two recent randomized controlled trials (RCT) have established its efficacy over conventional staging, but no studies have assessed its cost-effective......PURPOSE: Positron emission tomography (PET)/CT has become a widely used technology for preoperative staging of non-small cell lung cancer (NSCLC). Two recent randomized controlled trials (RCT) have established its efficacy over conventional staging, but no studies have assessed its cost......-effectiveness. The objective of this study was to assess the cost-effectiveness of PET/CT as an adjunct to conventional workup for preoperative staging of NSCLC. METHODS: The study was conducted alongside an RCT in which 189 patients were allocated to conventional staging (n = 91) or conventional staging + PET/CT (n = 98......) and followed for 1 year after which the numbers of futile thoracotomies in each group were monitored. A full health care sector perspective was adapted for costing resource use. The outcome parameter was defined as the number needed to treat (NNT)-here number of PET/CT scans needed-to avoid one futile...

  18. UK's climate change levy: cost effectiveness, competitiveness and environmental impacts

    Energy Technology Data Exchange (ETDEWEB)

    Varma, Adarsh [Hull Univ., School of Economic Studies, Hull (United Kingdom)

    2003-01-01

    This paper intends to examine the cost effectiveness of UK's climate change levy (CCL), its implications on competitiveness of firms and the environmental impact. The paper briefly describes the levy and analyses it under the canons of a good taxation policy. The economic implications of the levy are discussed with theoretical and empirical perspectives. Change in net exports, investment patterns and productivity and inclusion of compliance cost forms the basis for analysing the effect on competitiveness. It discusses the options available to firms to safeguard their competitiveness if it is adversely affected by the CCL. A description of the current scenario of the levy since its inception is also presented. The paper argues the need for a comprehensive policy involving the use of standards, emission trading as well as energy taxes to achieve emission and energy-use reductions. A focal point of this paper is to elucidate the pros and cons of the CCL (energy tax) with respect to an emission trading scheme. (Author)

  19. Human reliability

    International Nuclear Information System (INIS)

    Embrey, D.E.

    1987-01-01

    Concepts and techniques of human reliability have been developed and are used mostly in probabilistic risk assessment. For this, the major application of human reliability assessment has been to identify the human errors which have a significant effect on the overall safety of the system and to quantify the probability of their occurrence. Some of the major issues within human reliability studies are reviewed and it is shown how these are applied to the assessment of human failures in systems. This is done under the following headings; models of human performance used in human reliability assessment, the nature of human error, classification of errors in man-machine systems, practical aspects, human reliability modelling in complex situations, quantification and examination of human reliability, judgement based approaches, holistic techniques and decision analytic approaches. (UK)

  20. Reliability Calculations

    DEFF Research Database (Denmark)

    Petersen, Kurt Erling

    1986-01-01

    Risk and reliability analysis is increasingly being used in evaluations of plant safety and plant reliability. The analysis can be performed either during the design process or during the operation time, with the purpose to improve the safety or the reliability. Due to plant complexity and safety...... and availability requirements, sophisticated tools, which are flexible and efficient, are needed. Such tools have been developed in the last 20 years and they have to be continuously refined to meet the growing requirements. Two different areas of application were analysed. In structural reliability probabilistic...... approaches have been introduced in some cases for the calculation of the reliability of structures or components. A new computer program has been developed based upon numerical integration in several variables. In systems reliability Monte Carlo simulation programs are used especially in analysis of very...

  1. The concept of an ACEX(R) cost-effective first level surface detector trigger in the Pierre Auger Observatory

    International Nuclear Information System (INIS)

    Szadkowski, Z.

    2005-01-01

    The paper describes the new design of the first level trigger for the surface array in the Pierre Auger Observatory. The previous design was tested in a small test segment called Engineering Array (EA). It confirmed full functionality and reliability of the PLD approach. However, because of the high price of the chips available at that time, a new cost-effective design was developed. Altera ( R) offered cost-effective family, which allows reducing the total budget of the electronics without compromise in the functionality. The here described concept of a splitting of data processing into two sub-channels implemented into the parallel working chips, the chips synchronization and the automatization of internal processing management, together with the fully pipelined AHDL code became the framework for the further implementation in the environmental condition of the Argentinian pampa

  2. Cost-effectiveness criteria for marine oil spill preventive measures

    International Nuclear Information System (INIS)

    Vanem, Erik; Endresen, Oyvind; Skjong, Rolf

    2008-01-01

    Oil tanker accidents resulting in large quantities of oil spills and severe pollution have occurred in the past, leading to major public attention and an international focus on finding solutions for minimising the risks related to such events. This paper proposes a novel approach for evaluating measures for prevention and control of marine oil spills, based on considerations of oil spill risk and cost effectiveness. A cost model that incorporates all costs of a shipping accident has been established and oil tanker spill accidents have been further elaborated as a special case of such accidents. Utilising this model, novel implementation criteria, in terms of the Cost of Averting a Tonne of oil Spilt (CATS), for risk control options aiming at mitigating the environmental risk of accidental oil spills, are proposed. The paper presents a review of previous studies on the costs associated with oil spills from shipping, which is a function of many factors such as location of spill, spill amount, type of oil, etc. However, ships are designed for global trade, transporting different oil qualities. Therefore, globally applicable criteria must average over most of these factors, and the spill amount is the remaining factor that will be used to measure cost effectiveness against. A weighted, global average cleanup cost of USD 16,000/tonne of oil spilt has been calculated, considering the distribution of oil tanker traffic densities. Finally, the criteria are compared with some existing regulations for oil spill prevention, response and compensation (OPA 90)

  3. Selecting cost-effective areas for restoration of ecosystem services.

    Science.gov (United States)

    Adame, M F; Hermoso, V; Perhans, K; Lovelock, C E; Herrera-Silveira, J A

    2015-04-01

    Selection of areas for restoration should be based on cost-effectiveness analysis to attain the maximum benefit with a limited budget and overcome the traditional ad hoc allocation of funds for restoration projects. Restoration projects need to be planned on the basis of ecological knowledge and economic and social constraints. We devised a novel approach for selecting cost-effective areas for restoration on the basis of biodiversity and potential provision of 3 ecosystem services: carbon storage, water depuration, and coastal protection. We used Marxan, a spatial prioritization tool, to balance the provision of ecosystem services against the cost of restoration. We tested this approach in a mangrove ecosystem in the Caribbean. Our approach efficiently selected restoration areas that at low cost were compatible with biodiversity targets and that maximized the provision of one or more ecosystem services. Choosing areas for restoration of mangroves on the basis carbon storage potential, largely guaranteed the restoration of biodiversity and other ecosystem services. © 2014 Society for Conservation Biology.

  4. Dynamic Modeling of Cost-effectiveness of Rotavirus Vaccination, Kazakhstan

    Science.gov (United States)

    Flem, Elmira; Latipov, Renat; Kuatbaeva, Ajnagul; Kristiansen, Ivar Sønbø

    2014-01-01

    The government of Kazakhstan, a middle-income country in Central Asia, is considering the introduction of rotavirus vaccination into its national immunization program. We performed a cost-effectiveness analysis of rotavirus vaccination spanning 20 years by using a synthesis of dynamic transmission models accounting for herd protection. We found that a vaccination program with 90% coverage would prevent ≈880 rotavirus deaths and save an average of 54,784 life-years for children <5 years of age. Indirect protection accounted for 40% and 60% reduction in severe and mild rotavirus gastroenteritis, respectively. Cost per life year gained was US $18,044 from a societal perspective and US $23,892 from a health care perspective. Comparing the 2 key parameters of cost-effectiveness, mortality rates and vaccine cost at

  5. Designing cost effective water demand management programs in Australia.

    Science.gov (United States)

    White, S B; Fane, S A

    2002-01-01

    This paper describes recent experience with integrated resource planning (IRP) and the application of least cost planning (LCP) for the evaluation of demand management strategies in urban water. Two Australian case studies, Sydney and Northern New South Wales (NSW) are used in illustration. LCP can determine the most cost effective means of providing water services or alternatively the cheapest forms of water conservation. LCP contrasts to a traditional approach of evaluation which looks only at means of increasing supply. Detailed investigation of water usage, known as end-use analysis, is required for LCP. End-use analysis allows both rigorous demand forecasting, and the development and evaluation of conservation strategies. Strategies include education campaigns, increasing water use efficiency and promoting wastewater reuse or rainwater tanks. The optimal mix of conservation strategies and conventional capacity expansion is identified based on levelised unit cost. IRP uses LCP in the iterative process, evaluating and assessing options, investing in selected options, measuring the results, and then re-evaluating options. Key to this process is the design of cost effective demand management programs. IRP however includes a range of parameters beyond least economic cost in the planning process and program designs, including uncertainty, benefit partitioning and implementation considerations.

  6. Cost-effectiveness of minimally invasive sacroiliac joint fusion.

    Science.gov (United States)

    Cher, Daniel J; Frasco, Melissa A; Arnold, Renée Jg; Polly, David W

    2016-01-01

    Sacroiliac joint (SIJ) disorders are common in patients with chronic lower back pain. Minimally invasive surgical options have been shown to be effective for the treatment of chronic SIJ dysfunction. To determine the cost-effectiveness of minimally invasive SIJ fusion. Data from two prospective, multicenter, clinical trials were used to inform a Markov process cost-utility model to evaluate cumulative 5-year health quality and costs after minimally invasive SIJ fusion using triangular titanium implants or non-surgical treatment. The analysis was performed from a third-party perspective. The model specifically incorporated variation in resource utilization observed in the randomized trial. Multiple one-way and probabilistic sensitivity analyses were performed. SIJ fusion was associated with a gain of approximately 0.74 quality-adjusted life years (QALYs) at a cost of US$13,313 per QALY gained. In multiple one-way sensitivity analyses all scenarios resulted in an incremental cost-effectiveness ratio (ICER) dysfunction due to degenerative sacroiliitis or SIJ disruption.

  7. Simulating school closure policies for cost effective pandemic decision making

    Directory of Open Access Journals (Sweden)

    Araz Ozgur M

    2012-06-01

    Full Text Available Abstract Background Around the globe, school closures were used sporadically to mitigate the 2009 H1N1 influenza pandemic. However, such closures can detrimentally impact economic and social life. Methods Here, we couple a decision analytic approach with a mathematical model of influenza transmission to estimate the impact of school closures in terms of epidemiological and cost effectiveness. Our method assumes that the transmissibility and the severity of the disease are uncertain, and evaluates several closure and reopening strategies that cover a range of thresholds in school-aged prevalence (SAP and closure durations. Results Assuming a willingness to pay per quality adjusted life-year (QALY threshold equal to the US per capita GDP ($46,000, we found that the cost effectiveness of these strategies is highly dependent on the severity and on a willingness to pay per QALY. For severe pandemics, the preferred strategy couples the earliest closure trigger (0.5% SAP with the longest duration closure (24 weeks considered. For milder pandemics, the preferred strategies also involve the earliest closure trigger, but are shorter duration (12 weeks for low transmission rates and variable length for high transmission rates. Conclusions These findings highlight the importance of obtaining early estimates of pandemic severity and provide guidance to public health decision-makers for effectively tailoring school closures strategies in response to a newly emergent influenza pandemic.

  8. Cost effectiveness of reducing radon exposure in Spanish dwellings

    International Nuclear Information System (INIS)

    Colgan, P.A.; Gutierrez, J.

    1996-01-01

    Published information on the distribution of radon levels in Spanish single family dwellings is used to evaluate the cost-effectiveness of three different intervention scenarios: remediation of existing dwellings, radon proofing of all future dwellings and the targetting of areas with higher than average indoor radon concentrations. Analysis is carried out on the basis of a Reference Level of 400 Bq m -3 for the existing housing stock and 200 Bq m -3 for new dwellings. Certain assumptions are made about the effectiveness and durability of the measures applied and annualised costs are used to calculate the costs per lung cancer death averted. The results reveal that targetting future housing is a more cost-effective option than remediation of existing dwellings with radon concentrations above the Reference Level -the costs per lung cancer death averted are typically $145000. In high-risk areas, these costs can be considerably less, depending on the percentage of dwellings expected to exceed the Reference Level and the average savings in exposure as a result of the intervention. The costs of intervention to reduce lung cancer deaths following exposure to radon compare favourably with those of other health programmes in other countries. (Author)

  9. Cost-effectiveness assessment in outpatient sinonasal surgery.

    Science.gov (United States)

    Mortuaire, G; Theis, D; Fackeure, R; Chevalier, D; Gengler, I

    2018-02-01

    To assess the cost-effectiveness of outpatient sinonasal surgery in terms of clinical efficacy and control of expenses. A retrospective study was conducted from January 2014 to January 2016. Patients scheduled for outpatient sinonasal surgery were systematically included. Clinical data were extracted from surgical and anesthesiology computer files. The cost accounting methods applied in our institution were used to evaluate logistic and technical costs. The standardized hospital fees rating system based on hospital stay and severity in diagnosis-related groups (Groupes homogènes de séjours: GHS) was used to estimate institutional revenue. Over 2years, 927 outpatient surgical procedures were performed. The crossover rate to conventional hospital admission was 2.9%. In a day-1 telephone interview, 85% of patients were very satisfied with the procedure. All outpatient cases showed significantly lower costs than estimated for conventional management with overnight admission, while hospital revenue did not differ between the two. This study confirmed the efficacy of outpatient surgery in this indication. Lower costs could allow savings for the health system by readjusting the rating for the procedure. More precise assessment of cost-effectiveness will require more fine-grained studies based on micro costing at hospital level and assessment of impact on conventional surgical activity and post-discharge community care. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  10. Modelling Common Agricultural Policy-Water Framework Directive interactions and cost-effectiveness of measures to reduce nitrogen pollution.

    Science.gov (United States)

    Mouratiadou, Ioanna; Russell, Graham; Topp, Cairistiona; Louhichi, Kamel; Moran, Dominic

    2010-01-01

    Selecting cost-effective measures to regulate agricultural water pollution to conform to the Water Framework Directive presents multiple challenges. A bio-economic modelling approach is presented that has been used to explore the water quality and economic effects of the 2003 Common Agricultural Policy Reform and to assess the cost-effectiveness of input quotas and emission standards against nitrate leaching, in a representative case study catchment in Scotland. The approach combines a biophysical model (NDICEA) with a mathematical programming model (FSSIM-MP). The results indicate only small changes due to the Reform, with the main changes in farmers' decision making and the associated economic and water quality indicators depending on crop price changes, and suggest the use of target fertilisation in relation to crop and soil requirements, as opposed to measures targeting farm total or average nitrogen use.

  11. Cost-effective climate policy in a small country

    International Nuclear Information System (INIS)

    Hagem, C.

    1994-01-01

    Unilateral action to curb CO 2 emissions in a small country or a group of countries has only a limited effect on global CO 2 emissions. However, it could be a first step toward a broader climate treaty. So far, unilateral commitments have been aimed at reducing national consumption of fossil fuels. A country that produces and consumes fossil fuels can also infiuence the global CO 2 emissions by reducing its production. The estimated cost of reducing national CO 2 emissions in Norway, through a reduction infossil fuel consumption, is presented in a report from the Environmental Tax Committee (1992). In this paper, that cost is compared with an estimated cost of reducing fossil fuel production. The calculation reveals that it could be less costly to reduce the production than the consumption, given that the effect on global CO 2 emissions is identical. 23 refs., 4 tabs

  12. Program integration of predictive maintenance with reliability centered maintenance

    International Nuclear Information System (INIS)

    Strong, D.K. Jr; Wray, D.M.

    1990-01-01

    This paper addresses improving the safety and reliability of power plants in a cost-effective manner by integrating the recently developed reliability centered maintenance techniques with the traditional predictive maintenance techniques of nuclear power plants. The topics of the paper include a description of reliability centered maintenance (RCM), enhancing RCM with predictive maintenance, predictive maintenance programs, condition monitoring techniques, performance test techniques, the mid-Atlantic Reliability Centered Maintenance Users Group, test guides and the benefits of shared guide development

  13. Cost-effectiveness analysis in minimally invasive spine surgery.

    Science.gov (United States)

    Al-Khouja, Lutfi T; Baron, Eli M; Johnson, J Patrick; Kim, Terrence T; Drazin, Doniel

    2014-06-01

    Medical care has been evolving with the increased influence of a value-based health care system. As a result, more emphasis is being placed on ensuring cost-effectiveness and utility in the services provided to patients. This study looks at this development in respect to minimally invasive spine surgery (MISS) costs. A literature review using PubMed, the Cost-Effectiveness Analysis (CEA) Registry, and the National Health Service Economic Evaluation Database (NHS EED) was performed. Papers were included in the study if they reported costs associated with minimally invasive spine surgery (MISS). If there was no mention of cost, CEA, cost-utility analysis (CUA), quality-adjusted life year (QALY), quality, or outcomes mentioned, then the article was excluded. Fourteen studies reporting costs associated with MISS in 12,425 patients (3675 undergoing minimally invasive procedures and 8750 undergoing open procedures) were identified through PubMed, the CEA Registry, and NHS EED. The percent cost difference between minimally invasive and open approaches ranged from 2.54% to 33.68%-all indicating cost saving with a minimally invasive surgical approach. Average length of stay (LOS) for minimally invasive surgery ranged from 0.93 days to 5.1 days compared with 1.53 days to 12 days for an open approach. All studies reporting EBL reported lower volume loss in an MISS approach (range 10-392.5 ml) than in an open approach (range 55-535.5 ml). There are currently an insufficient number of studies published reporting the costs of MISS. Of the studies published, none have followed a standardized method of reporting and analyzing cost data. Preliminary findings analyzing the 14 studies showed both cost saving and better outcomes in MISS compared with an open approach. However, more Level I CEA/CUA studies including cost/QALY evaluations with specifics of the techniques utilized need to be reported in a standardized manner to make more accurate conclusions on the cost effectiveness of

  14. Cost-Effective Icy Bodies Exploration using Small Satellite Missions

    Science.gov (United States)

    Jonsson, Jonas; Mauro, David; Stupl, Jan; Nayak, Michael; Aziz, Jonathan; Cohen, Aaron; Colaprete, Anthony; Dono-Perez, Andres; Frost, Chad; Klamm, Benjamin; hide

    2015-01-01

    It has long been known that Saturn's moon Enceladus is expelling water-rich plumes into space, providing passing spacecraft with a window into what is hidden underneath its frozen crust. Recent discoveries indicate that similar events could also occur on other bodies in the solar system, such as Jupiter's moon Europa and the dwarf planet Ceres in the asteroid belt. These plumes provide a possible giant leap forward in the search for organics and assessing habitability beyond Earth, stepping stones toward the long-term goal of finding extraterrestrial life. The United States Congress recently requested mission designs to Europa, to fit within a cost cap of $1B, much less than previous mission designs' estimates. Here, innovative cost-effective small spacecraft designs for the deep-space exploration of these icy worlds, using new and emerging enabling technologies, and how to explore the outer solar system on a budget below the cost horizon of a flagship mission, are investigated. Science requirements, instruments selection, rendezvous trajectories, and spacecraft designs are some topics detailed. The mission concepts revolve around a comparably small-sized and low-cost Plume Chaser spacecraft, instrumented to characterize the vapor constituents encountered on its trajectory. In the event that a plume is not encountered, an ejecta plume can be artificially created by a companion spacecraft, the Plume Maker, on the target body at a location timed with the passage of the Plume Chaser spacecraft. Especially in the case of Ceres, such a mission could be a great complimentary mission to Dawn, as well as a possible future Europa Clipper mission. The comparably small volume of the spacecraft enables a launch to GTO as a secondary payload, providing multiple launch opportunities per year. Plume Maker's design is nearly identical to the Plume Chaser, and fits within the constraints for a secondary payload launch. The cost-effectiveness of small spacecraft missions enables the

  15. Cost-effectiveness of Rotavirus vaccination in Vietnam

    Directory of Open Access Journals (Sweden)

    Goldie Sue J

    2009-01-01

    Full Text Available Abstract Background Rotavirus is the most common cause of severe diarrhea leading to hospitalization or disease-specific death among young children. New rotavirus vaccines have recently been approved. Some previous studies have provided broad qualitative insights into the health and economic consequences of introducing the vaccines into low-income countries, representing several features of rotavirus infection, such as varying degrees of severity and age-dependency of clinical manifestation, in their model-based analyses. We extend this work to reflect additional features of rotavirus (e.g., the possibility of reinfection and varying degrees of partial immunity conferred by natural infection, and assess the influence of the features on the cost-effectiveness of rotavirus vaccination. Methods We developed a Markov model that reflects key features of rotavirus infection, using the most recent data available. We applied the model to the 2004 Vietnamese birth cohort and re-evaluated the cost-effectiveness (2004 US dollars per disability-adjusted life year [DALY] of rotavirus vaccination (Rotarix® compared to no vaccination, from both societal and health care system perspectives. We conducted univariate sensitivity analyses and also performed a probabilistic sensitivity analysis, based on Monte Carlo simulations drawing parameter values from the distributions assigned to key uncertain parameters. Results Rotavirus vaccination would not completely protect young children against rotavirus infection due to the partial nature of vaccine immunity, but would effectively reduce severe cases of rotavirus gastroenteritis (outpatient visits, hospitalizations, or deaths by about 67% over the first 5 years of life. Under base-case assumptions (94% coverage and $5 per dose, the incremental cost per DALY averted from vaccination compared to no vaccination would be $540 from the societal perspective and $550 from the health care system perspective. Conclusion

  16. Is Stacking Intervention Components Cost-Effective? An Analysis of the Incredible Years Program

    Science.gov (United States)

    Foster, E. Michael; Olchowski, Allison E.; Webster-Stratton, Carolyn H.

    2007-01-01

    The cost-effectiveness of delivering stacked multiple intervention components for children is compared to implementing single intervention by analyzing the Incredible Years Series program. The result suggests multiple intervention components are more cost-effective than single intervention components.

  17. Cost-Effectiveness Analysis of the Residential Provisions of the 2015 IECC for South Carolina

    Energy Technology Data Exchange (ETDEWEB)

    Mendon, Vrushali V. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Zhao, Mingjie [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Taylor, Zachary T. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Poehlman, Eric A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2016-02-15

    The 2015 IECC provides cost-effective savings for residential buildings in South Carolina. Moving to the 2015 IECC from the 2009 IECC base code is cost-effective for residential buildings in all climate zones in South Carolina.

  18. Cost-Effectiveness Analysis of the Residential Provisions of the 2015 IECC for Nebraska

    Energy Technology Data Exchange (ETDEWEB)

    Mendon, Vrushali V. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Zhao, Mingjie [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Taylor, Zachary T. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Poehlman, Eric A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2016-02-15

    The 2015 IECC provides cost-effective savings for residential buildings in Nebraska. Moving to the 2015 IECC from the 2009 IECC base code is cost-effective for residential buildings in all climate zones in Nebraska.

  19. Cost-Effectiveness Analysis of the Residential Provisions of the 2015 IECC for Wisconsin

    Energy Technology Data Exchange (ETDEWEB)

    Mendon, Vrushali V. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Zhao, Mingjie [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Taylor, Zachary T. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Poehlman, Eric A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2016-02-15

    The 2015 IECC provides cost-effective savings for residential buildings in Wisconsin. Moving to the 2015 IECC from the 2006 IECC base code is cost-effective for residential buildings in all climate zones in Wisconsin.

  20. Cost-Effectiveness Analysis of the Residential Provisions of the 2015 IECC for Pennsylvania

    Energy Technology Data Exchange (ETDEWEB)

    Mendon, Vrushali V. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Zhao, Mingjie [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Taylor, Zachary T. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Poehlman, Eric A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2016-02-15

    The 2015 IECC provides cost-effective savings for residential buildings in Pennsylvania. Moving to the 2015 IECC from the 2009 IECC base code is cost-effective for residential buildings in all climate zones in Pennsylvania.

  1. Cost-Effectiveness Analysis of the Residential Provisions of the 2015 IECC for Nevada

    Energy Technology Data Exchange (ETDEWEB)

    Mendon, Vrushali V. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Zhao, Mingjie [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Taylor, Zachary T. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Poehlman, Eric A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2016-02-15

    The 2015 IECC provides cost-effective savings for residential buildings in Nevada. Moving to the 2015 IECC from the 2012 IECC base code is cost-effective for residential buildings in all climate zones in Nevada.

  2. Cost-Effectiveness Analysis of the Residential Provisions of the 2015 IECC for Texas

    Energy Technology Data Exchange (ETDEWEB)

    Mendon, Vrushali V. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Zhao, Mingjie [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Taylor, Zachary T. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Poehlman, Eric A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2016-02-15

    The 2015 IECC provides cost-effective savings for residential buildings in Texas. Moving to the 2015 IECC from the 2009 IECC base code is cost-effective for residential buildings in all climate zones in Texas.

  3. Cost-Effectiveness Analysis of the Residential Provisions of the 2015 IECC for Oklahoma

    Energy Technology Data Exchange (ETDEWEB)

    Mendon, Vrushali V. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Zhao, Mingjie [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Taylor, Zachary T. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Poehlman, Eric A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2016-02-15

    The 2015 IECC provides cost-effective savings for residential buildings in Oklahoma. Moving to the 2015 IECC from the 2009 IECC base code is cost-effective for residential buildings in all climate zones in Oklahoma.

  4. Cost-Effectiveness Analysis of the Residential Provisions of the 2015 IECC for Missouri

    Energy Technology Data Exchange (ETDEWEB)

    Mendon, Vrushali V. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Zhao, Mingjie [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Taylor, Zachary T. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Poehlman, Eric A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2016-02-15

    The 2015 IECC provides cost-effective savings for residential buildings in Missouri. Moving to the 2015 IECC from the 2009 IECC base code is cost-effective for residential buildings in all climate zones in Missouri.

  5. Cost-Effectiveness Analysis of the Residential Provisions of the 2015 IECC for Rhode Island

    Energy Technology Data Exchange (ETDEWEB)

    Mendon, Vrushali V. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Zhao, Mingjie [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Taylor, Zachary T. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Poehlman, Eric A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2016-02-15

    The 2015 IECC provides cost-effective savings for residential buildings in Rhode Island. Moving to the 2015 IECC from the 2012 IECC base code is cost-effective for residential buildings in all climate zones in Rhode Island.

  6. Cost-Effectiveness Analysis of the Residential Provisions of the 2015 IECC for New Mexico

    Energy Technology Data Exchange (ETDEWEB)

    Mendon, Vrushali V. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Zhao, Mingjie [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Taylor, Zachary T. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Poehlman, Eric A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2016-02-15

    The 2015 IECC provides cost-effective savings for residential buildings in New Mexico. Moving to the 2015 IECC from the 2009 IECC base code is cost-effective for residential buildings in all climate zones in New Mexico.

  7. Cost-Effectiveness Analysis of the Residential Provisions of the 2015 IECC for North Dakota

    Energy Technology Data Exchange (ETDEWEB)

    Mendon, Vrushali V. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Zhao, Mingjie [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Taylor, Zachary T. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Poehlman, Eric A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2016-02-15

    The 2015 IECC provides cost-effective savings for residential buildings in North Dakota. Moving to the 2015 IECC from the 2009 IECC base code is cost-effective for residential buildings in all climate zones in North Dakota.

  8. Cost-Effectiveness Analysis of the Residential Provisions of the 2015 IECC for Ohio

    Energy Technology Data Exchange (ETDEWEB)

    Mendon, Vrushali V. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Zhao, Mingjie [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Taylor, Zachary T. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Poehlman, Eric A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2016-02-15

    The 2015 IECC provides cost-effective savings for residential buildings in Ohio. Moving to the 2015 IECC from the 2009 IECC base code is cost-effective for residential buildings in all climate zones in Ohio.

  9. Cost-Effectiveness Analysis of the Residential Provisions of the 2015 IECC for Massachusetts

    Energy Technology Data Exchange (ETDEWEB)

    Mendon, Vrushali V. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Zhao, Mingjie [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Taylor, Zachary T. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Poehlman, Eric A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2016-02-15

    The 2015 IECC provides cost-effective savings for residential buildings in Massachusetts. Moving to the 2015 IECC from the 2012 IECC base code is cost-effective for residential buildings in all climate zones in Massachusetts.

  10. Cost-Effectiveness Analysis of the Residential Provisions of the 2015 IECC for Vermont

    Energy Technology Data Exchange (ETDEWEB)

    Mendon, Vrushali V. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Zhao, Mingjie [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Taylor, Zachary T. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Poehlman, Eric A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2016-02-15

    The 2015 IECC provides cost-effective savings for residential buildings in Vermont. Moving to the 2015 IECC from the 2012 IECC base code is cost-effective for residential buildings in all climate zones in Vermont.

  11. Cost-Effectiveness Analysis of the Residential Provisions of the 2015 IECC for Mississippi

    Energy Technology Data Exchange (ETDEWEB)

    Mendon, Vrushali V. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Zhao, Mingjie [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Taylor, Zachary T. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Poehlman, Eric A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2016-02-15

    The 2015 IECC provides cost-effective savings for residential buildings in Mississippi. Moving to the 2015 IECC from the 2009 IECC base code is cost-effective for residential buildings in all climate zones in Mississippi.

  12. Cost-Effectiveness Analysis of the Residential Provisions of the 2015 IECC for Virginia

    Energy Technology Data Exchange (ETDEWEB)

    Mendon, Vrushali V. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Zhao, Mingjie [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Taylor, Zachary T. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Poehlman, Eric A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2016-02-15

    The 2015 IECC provides cost-effective savings for residential buildings in Virginia. Moving to the 2015 IECC from the 2012 IECC base code is cost-effective for residential buildings in all climate zones in Virginia.

  13. Cost-Effectiveness Analysis of the Residential Provisions of the 2015 IECC for Wyoming

    Energy Technology Data Exchange (ETDEWEB)

    Mendon, Vrushali V. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Zhao, Mingjie [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Taylor, Zachary T. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Poehlman, Eric A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2016-02-15

    The 2015 IECC provides cost-effective savings for residential buildings in Wyoming. Moving to the 2015 IECC from the 2009 IECC base code is cost-effective for residential buildings in all climate zones in Wyoming.

  14. Cost-Effectiveness Analysis of the Residential Provisions of the 2015 IECC for West Virginia

    Energy Technology Data Exchange (ETDEWEB)

    Mendon, Vrushali V. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Zhao, Mingjie [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Taylor, Zachary T. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Poehlman, Eric A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2016-02-15

    The 2015 IECC provides cost-effective savings for residential buildings in West Virginia. Moving to the 2015 IECC from the 2009 IECC base code is cost-effective for residential buildings in all climate zones in West Virginia.

  15. Cost-Effectiveness Analysis of the Residential Provisions of the 2015 IECC for Utah

    Energy Technology Data Exchange (ETDEWEB)

    Mendon, Vrushali V. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Zhao, Mingjie [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Taylor, Zachary T. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Poehlman, Eric A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2016-02-15

    The 2015 IECC provides cost-effective savings for residential buildings in Utah. Moving to the 2015 IECC from the 2012 Utah State Code base code is cost-effective for residential buildings in all climate zones in Utah.

  16. Cost-Effectiveness Analysis of the Residential Provisions of the 2015 IECC for Tennessee

    Energy Technology Data Exchange (ETDEWEB)

    Mendon, Vrushali V. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Zhao, Mingjie [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Taylor, Zachary T. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Poehlman, Eric A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2016-02-15

    The 2015 IECC provides cost-effective savings for residential buildings in Tennessee. Moving to the 2015 IECC from the 2006 IECC base code is cost-effective for residential buildings in all climate zones in Tennessee.

  17. Cost-Effectiveness Analysis of the Residential Provisions of the 2015 IECC for South Dakota

    Energy Technology Data Exchange (ETDEWEB)

    Mendon, Vrushali V. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Zhao, Mingjie [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Taylor, Zachary T. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Poehlman, Eric A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2016-02-15

    The 2015 IECC provides cost-effective savings for residential buildings in South Dakota. Moving to the 2015 IECC from the 2009 IECC base code is cost-effective for residential buildings in all climate zones in South Dakota.

  18. Cost-Effectiveness Analysis of the Residential Provisions of the 2015 IECC for Michigan

    Energy Technology Data Exchange (ETDEWEB)

    Mendon, Vrushali V. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Zhao, Mingjie [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Taylor, Zachary T. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Poehlman, Eric A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2016-02-15

    The 2015 IECC provides cost-effective savings for residential buildings in Michigan. Moving to the 2015 IECC from the 2009 IECC base code is cost-effective for residential buildings in all climate zones in Michigan.

  19. Cost-Effectiveness Analysis of the Residential Provisions of the 2015 IECC for Minnesota

    Energy Technology Data Exchange (ETDEWEB)

    Mendon, Vrushali V. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Zhao, Mingjie [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Taylor, Zachary T. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Poehlman, Eric A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2016-02-15

    The 2015 IECC provides cost-effective savings for residential buildings in Minnesota. Moving to the 2015 IECC from the 2012 IECC base code is cost-effective for residential buildings in all climate zones in Minnesota.

  20. Cost-Effectiveness Analysis of the Residential Provisions of the 2015 IECC for Montana

    Energy Technology Data Exchange (ETDEWEB)

    Mendon, Vrushali V. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Zhao, Mingjie [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Taylor, Zachary T. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Poehlman, Eric A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2016-02-15

    The 2015 IECC provides cost-effective savings for residential buildings in Montana. Moving to the 2015 IECC from the 2014 Montana State Code base code is cost-effective for residential buildings in all climate zones in Montana.

  1. Cost-Effectiveness Analysis of the Residential Provisions of the 2015 IECC for New York

    Energy Technology Data Exchange (ETDEWEB)

    Mendon, Vrushali V. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Zhao, Mingjie [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Taylor, Zachary T. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Poehlman, Eric A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2016-02-15

    The 2015 IECC provides cost-effective savings for residential buildings in New York. Moving to the 2015 IECC from the 2009 IECC base code is cost-effective for residential buildings in all climate zones in New York.

  2. Cost-Effectiveness Analysis of the Residential Provisions of the 2015 IECC for Alabama

    Energy Technology Data Exchange (ETDEWEB)

    Mendon, Vrushali V. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Zhao, Mingjie [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Taylor, Zachary T. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Poehlman, Eric A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2016-02-15

    The 2015 IECC provides cost-effective savings for residential buildings in Alabama. Moving to the 2015 IECC from the 2009 IECC base code is cost-effective for residential buildings in all climate zones in Alabama.

  3. Cost-Effectiveness Analysis of the Residential Provisions of the 2015 IECC for Louisiana

    Energy Technology Data Exchange (ETDEWEB)

    Mendon, Vrushali V. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Zhao, Mingjie [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Taylor, Zachary T. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Poehlman, Eric A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2016-02-15

    The 2015 IECC provides cost-effective savings for residential buildings in Louisiana. Moving to the 2015 IECC from the 2009 IECC base code is cost-effective for residential buildings in all climate zones in Louisiana.

  4. Cost-Effectiveness Analysis of the Residential Provisions of the 2015 IECC for Delaware

    Energy Technology Data Exchange (ETDEWEB)

    Mendon, Vrushali V. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Zhao, Mingjie [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Taylor, Zachary T. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Poehlman, Eric A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2016-02-15

    The 2015 IECC provides cost-effective savings for residential buildings in Delaware. Moving to the 2015 IECC from the 2012 IECC base code is cost-effective for residential buildings in all climate zones in Delaware.

  5. Cost-Effectiveness Analysis of the Residential Provisions of the 2015 IECC for Arizona

    Energy Technology Data Exchange (ETDEWEB)

    Mendon, Vrushali V. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Zhao, Mingjie [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Taylor, Zachary T. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Poehlman, Eric A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2016-02-15

    The 2015 IECC provides cost-effective savings for residential buildings in Arizona. Moving to the 2015 IECC from the 2009 IECC base code is cost-effective for residential buildings in all climate zones in Arizona.

  6. Cost-Effectiveness Analysis of the Residential Provisions of the 2015 IECC for Idaho

    Energy Technology Data Exchange (ETDEWEB)

    Mendon, Vrushali V. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Zhao, Mingjie [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Taylor, Zachary T. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Poehlman, Eric A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2016-02-15

    The 2015 IECC provides cost-effective savings for residential buildings in Idaho. Moving to the 2015 IECC from the 2015 Idaho State Code base code is cost-effective for residential buildings in all climate zones in Idaho.

  7. Cost-Effectiveness Analysis of the Residential Provisions of the 2015 IECC for Georgia

    Energy Technology Data Exchange (ETDEWEB)

    Mendon, Vrushali V. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Zhao, Mingjie [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Taylor, Zachary T. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Poehlman, Eric A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2016-02-15

    The 2015 IECC provides cost-effective savings for residential buildings in Georgia. Moving to the 2015 IECC from the 2011 Georgia State Code base code is cost-effective for residential buildings in all climate zones in Georgia.

  8. Cost-Effectiveness Analysis of the Residential Provisions of the 2015 IECC for Kansas

    Energy Technology Data Exchange (ETDEWEB)

    Mendon, Vrushali V. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Zhao, Mingjie [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Taylor, Zachary T. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Poehlman, Eric A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2016-02-15

    The 2015 IECC provides cost-effective savings for residential buildings in Kansas. Moving to the 2015 IECC from the 2009 IECC base code is cost-effective for residential buildings in all climate zones in Kansas.

  9. Cost-Effectiveness Analysis of the Residential Provisions of the 2015 IECC for Arkansas

    Energy Technology Data Exchange (ETDEWEB)

    Mendon, Vrushali V. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Zhao, Mingjie [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Taylor, Zachary T. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Poehlman, Eric A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2016-02-15

    The 2015 IECC provides cost-effective savings for residential buildings in Arkansas. Moving to the 2015 IECC from the 2009 IECC base code is cost-effective for residential buildings in all climate zones in Arkansas.

  10. Cost-Effectiveness Analysis of the Residential Provisions of the 2015 IECC for Florida

    Energy Technology Data Exchange (ETDEWEB)

    Mendon, Vrushali V. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Zhao, Mingjie [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Taylor, Zachary T. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Poehlman, Eric A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2016-02-15

    The 2015 IECC provides cost-effective savings for residential buildings in Florida. Moving to the 2015 IECC from the 2012 IECC base code is cost-effective for residential buildings in all climate zones in Florida.

  11. Cost-Effectiveness Analysis of the Residential Provisions of the 2015 IECC for Connecticut

    Energy Technology Data Exchange (ETDEWEB)

    Mendon, Vrushali V. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Zhao, Mingjie [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Taylor, Zachary T. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Poehlman, Eric A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2016-02-15

    The 2015 IECC provides cost-effective savings for residential buildings in Connecticut. Moving to the 2015 IECC from the 2009 IECC base code is cost-effective for residential buildings in all climate zones in Connecticut.

  12. Cost-Effectiveness Analysis of the Residential Provisions of the 2015 IECC for Colorado

    Energy Technology Data Exchange (ETDEWEB)

    Mendon, Vrushali V. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Zhao, Mingjie [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Taylor, Zachary T. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Poehlman, Eric A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2016-02-15

    The 2015 IECC provides cost-effective savings for residential buildings in Colorado. Moving to the 2015 IECC from the 2009 IECC base code is cost-effective for residential buildings in all climate zones in Colorado.

  13. Cost-Effectiveness Analysis of the Residential Provisions of the 2015 IECC for Hawaii

    Energy Technology Data Exchange (ETDEWEB)

    Mendon, Vrushali V. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Zhao, Mingjie [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Taylor, Zachary T. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Poehlman, Eric A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2016-02-15

    The 2015 IECC provides cost-effective savings for residential buildings in Hawaii. Moving to the 2015 IECC from the 2006 IECC base code is cost-effective for residential buildings in all climate zones in Hawaii.

  14. Cost-Effectiveness Analysis of the Residential Provisions of the 2015 IECC for Indiana

    Energy Technology Data Exchange (ETDEWEB)

    Mendon, Vrushali V.; Zhao, Mingjie; Taylor, Zachary T.; Poehlman, Eric A.

    2016-02-15

    The 2015 IECC provides cost-effective savings for residential buildings in Indiana. Moving to the 2015 IECC from the 2009 IECC base code is cost-effective for residential buildings in all climate zones in Indiana.

  15. Cost-Effectiveness Analysis of the Residential Provisions of the 2015 IECC for Illinois

    Energy Technology Data Exchange (ETDEWEB)

    Mendon, Vrushali V. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Zhao, Mingjie [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Taylor, Zachary T. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Poehlman, Eric A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2016-02-15

    The 2015 IECC provides cost-effective savings for residential buildings in Illinois. Moving to the 2015 IECC from the 2012 IECC base code is cost-effective for residential buildings in all climate zones in Illinois.

  16. Cost-Effectiveness Analysis of the Residential Provisions of the 2015 IECC for Maine

    Energy Technology Data Exchange (ETDEWEB)

    Mendon, Vrushali V. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Zhao, Mingjie [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Taylor, Zachary T. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Poehlman, Eric A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2016-02-15

    The 2015 IECC provides cost-effective savings for residential buildings in Maine. Moving to the 2015 IECC from the 2009 IECC base code is cost-effective for residential buildings in all climate zones in Maine.

  17. Cost-Effectiveness Analysis of the Residential Provisions of the 2015 IECC for Maryland

    Energy Technology Data Exchange (ETDEWEB)

    Mendon, Vrushali V. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Zhao, Mingjie [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Taylor, Zachary T. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Poehlman, Eric A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2016-02-15

    The 2015 IECC provides cost-effective savings for residential buildings in Maryland. Moving to the 2015 IECC from the 2012 IECC base code is cost-effective for residential buildings in all climate zones in Maryland.

  18. Cost-Effectiveness Analysis of the Residential Provisions of the 2015 IECC for Iowa

    Energy Technology Data Exchange (ETDEWEB)

    Mendon, Vrushali V. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Zhao, Mingjie [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Taylor, Zachary T. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Poehlman, Eric A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2016-02-15

    The 2015 IECC provides cost-effective savings for residential buildings in Iowa. Moving to the 2015 IECC from the 2014 Iowa State Code base code is cost-effective for residential buildings in all climate zones in Iowa.

  19. Cost-Effectiveness Analysis of the Residential Provisions of the 2015 IECC for Alaska

    Energy Technology Data Exchange (ETDEWEB)

    Mendon, Vrushali V. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Zhao, Mingjie [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Taylor, Zachary T. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Poehlman, Eric A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2016-02-15

    The 2015 IECC provides cost-effective savings for residential buildings in Alaska. Moving to the 2015 IECC from the 2009 IECC base code is cost-effective for residential buildings in all climate zones in Alaska.

  20. Cost-Effectiveness Analysis of the Residential Provisions of the 2015 IECC for Kentucky

    Energy Technology Data Exchange (ETDEWEB)

    Mendon, Vrushali V. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Zhao, Mingjie [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Taylor, Zachary T. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Poehlman, Eric A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2016-02-15

    The 2015 IECC provides cost-effective savings for residential buildings in Kentucky. Moving to the 2015 IECC from the 2009 IECC base code is cost-effective for residential buildings in all climate zones in Kentucky.

  1. Cost effectiveness and benefits of photovoltaics in the Gambia

    Energy Technology Data Exchange (ETDEWEB)

    Able-Thomas, U.; Hill, R.; O' Keefe, P.; Pearsall, N.M. (Northumbria Univ., Newcastle upon Tyne (United Kingdom))

    1994-08-01

    This paper discusses the socio-economic benefits that the Gambia has derived from photovoltaics (PV) and its future potential. Technical performance, reliability and cost estimates are assessed for some PV applications. (Author)

  2. Cost-effectiveness of antenatal screening for neonatal alloimmune thrombocytopenia

    DEFF Research Database (Denmark)

    Killie, M K; Kjeldsen-Kragh, J; Husebekk, A

    2007-01-01

    OBJECTIVES: To estimate the costs and health consequences of three different screening strategies for neonatal alloimmune thrombocytopenia (NAIT). DESIGN: Cost-utility analysis on the basis of a decision tree that incorporates the relevant strategies and outcomes. SETTING: Three health regions......-4 weeks before term. Severely thrombocytopenic newborn were transfused immediately with compatible platelets. MAIN OUTCOME MEASUREMENTS: Quality-adjusted life years (QALYs) and costs. RESULTS: Compared with no screening, a programme of screening and subsequent treatment would generate between 210 and 230...... additional QALYs among 100,000 pregnant women, and at the same time, reduce health care costs by approximately 1.7 million euros. The sensitivity analyses indicate that screening is cost effective or even cost saving within a wide range of probabilities and costs. CONCLUSION: Our calculations indicate...

  3. Cost-effective design of economic instruments in nutrition policy

    Directory of Open Access Journals (Sweden)

    Smed Sinne

    2007-04-01

    Full Text Available Abstract This paper addresses the potential for using economic regulation, e.g. taxes or subsidies, as instruments to combat the increasing problems of inappropriate diets, leading to health problems such as obesity, diabetes 2, cardiovascular diseases etc. in most countries. Such policy measures may be considered as alternatives or supplements to other regulation instruments, including information campaigns, bans or enhancement of technological solutions to the problems of obesity or related diseases. 7 different food tax and subsidy instruments or combinations of instruments are analysed quantitatively. The analyses demonstrate that the average cost-effectiveness with regard to changing the intake of selected nutritional variables can be improved by 10–30 per cent if taxes/subsidies are targeted against these nutrients, compared with targeting selected food categories. Finally, the paper raises a range of issues, which need to be investigated further, before firm conclusions about the suitability of economic instruments in nutrition policy can be drawn.

  4. Cost-effective design of economic instruments in nutrition policy

    DEFF Research Database (Denmark)

    Jensen, Jørgen Dejgård; Smed, Sinne

    2007-01-01

    This paper addresses the potential for using economic regulation, e.g. taxes or subsidies, as instruments to combat the increasing problems of inappropriate diets, leading to health problems such as obesity, diabetes 2, cardiovascular diseases etc. in most countries. Such policy measures may....... The analyses demonstrate that the average cost-effectiveness with regard to changing the intake of selected nutritional variables can be improved by 10–30 per cent if taxes/subsidies are targeted against these nutrients, compared with targeting selected food categories. Finally, the paper raises a range...... of issues, which need to be investigated further, before firm conclusions about the suitability of economic instruments in nutrition policy can be drawn....

  5. Cost-effectiveness analysis of radon remediation in schools

    International Nuclear Information System (INIS)

    Kennedy, C.A.; Gray, A.M.

    2000-01-01

    Indoor radon is an important source of radiation dosage in the general population and has been recognised as a world-wide environmental and public health challenge. Governments in many Western and Eastern European and North American countries are undertaking active radon-risk reduction policies, including the remediation of existing residential and work place building stocks (1). These endeavours include a priority of remediating school buildings. Epidemiological and technical radon research has produced information which has enabled attention to be turned to specific effectiveness and optimisation questions regarding radon identification and remediation programmes in buildings, including schools. Decision making about policy implementation has been an integral part of these programmes and questions have been raised about the economic implications of the regulations and optimisation strategies for workplace action level policy (2,3). (the action level applied to schools is 400 Bq m -3 ). No previous study has estimated the cost-effectiveness of a radon remediation programme for schools using the methodological framework now considered appropriate in the economic evaluation of health interventions. It is imperative that this should be done, in order that the resources required to obtain health gain from radon remediation in schools can be systematically compared with equivalent data for other health interventions and radon remediation programmes. In this study a cost-effectiveness analysis of radon remediation in schools was undertaken, using the best available national data and information from Northamptonshire on the costs and effectiveness of radon identification and remediation in schools, and the costs and health impact of lung cancer cases. A model based on data from Northamptonshire is presented (where 6.3% of residential stock is over 200 Bq m -3 ). The resultant cost-effectiveness ratio was pound 7,550 per life year gained in pound 1997. Results from the

  6. Development of a Cost Effective Power Generation System: An Overview

    Directory of Open Access Journals (Sweden)

    Shiv Prakash Bihari

    2016-03-01

    Full Text Available This paper presents an overview on development of cost effective power generation system and motivates for development of a model for hybrid system with wind to investigate the combined operation of wind with different sources to cater to wind’s stochastic nature for imbalance minimization and optimal operation. Development of model for trading power in competitive electricity market and development of strategies for trading in electricity markets (wind energy and reserves markets to investigate the effects of real time pricing tariffs on electricity market operation has been illustrated in this paper. Dynamic modelling related studies to investigate the wind generator’s kinetic energy for primary frequency support using simulink and simulation studies on doubly fed induction generator to study its capability during small disturbances / fluctuations on power system have been described.

  7. Cost effectiveness of rural development programme instruments in Denmark

    DEFF Research Database (Denmark)

    Jensen, J Dejgaard; Jakobsen, L; Madsen, B

    2011-01-01

    The objective of this study is to investigate the cost-effectiveness of selected instruments of the Danish Rural Development Programme 2007-2013, which constitutes the Danish implementation of the EU Rural Development Programme under Pillar Two of the Common Agricultural Policy. The Programme aims...... to support sustainable economic growth and income diversification in rural areas (and in particular in economically vulnerable areas). The study combines different datasets and simulation models at farm level (register data, Farm Accountancy Data, farm sector model, run-off models, etc.), municipality level...... (micro-based “National Accounts” for municipalities, municipality economic model) and national level (national economic model), which enables analysis at a fairly detailed geographical level and hence to evaluate the spatially distributed effects of the considered policy instruments, while at the same...

  8. Cost effectiveness of prostacyclins in pulmonary arterial hypertension.

    Science.gov (United States)

    Roman, Antonio; Barberà, Joan A; Escribano, Pilar; Sala, Maria L; Febrer, Laia; Oyagüez, Itziar; Sabater, Eliazar; Casado, Miguel A

    2012-05-01

    Pulmonary arterial hypertension (PAH) is considered an orphan disease. Prostacyclins are the keystone for PAH treatment. Choosing between the three available prostacyclin therapies could be complicated because there are no comparison studies, so the final decision must be driven by factors such as efficacy, administration route, safety profile and economic aspects. This study provides a cost-effectiveness and cost-utility comparison of initiating prostacyclin therapy with three different treatment alternatives (inhaled iloprost [ILO], intravenous epoprostenol [EPO] and subcutaneous treprostinil [TRE]) for patients with PAH. The goal of this work is to help physicians with their therapeutic decision-making. A Markov model was built to simulate a patient cohort with class III PAH according to the classification of the New York Heart Association (NYHA). Four health states corresponding with the NYHA classes plus death were allowed for patients in the model. Changing the treatment was possible when patients worsened from functional class III to IV. The time horizon was 3 years, allowing patients to transition between health states on a 12-week cycle basis. The study perspective was that of the National Health System (NHS) [only direct medical costs were included]. Unitary costs were obtained from the Drug Catalogue and e-Salud Database in 2009 and are given in euros (€). Data on health resources and treatment pathways were informed by a four-member expert panel. Efficacy was obtained from pivotal clinical trials of ILO, EPO and TRE, the latter used in Spain as a foreign medication. Utilities for each health state were obtained from the literature. The final efficacy measure was life-years gained (LYG), and utilities were used to obtain quality-adjusted life-years (QALYs). Costs and effects were discounted at a 3% rate. To check for the robustness of the results, sensitivity analyses were performed. At the end of the 3 years, in the base case of the deterministic

  9. The business value and cost-effectiveness of genomic medicine.

    Science.gov (United States)

    Crawford, James M; Aspinall, Mara G

    2012-05-01

    Genomic medicine offers the promise of more effective diagnosis and treatment of human diseases. Genome sequencing early in the course of disease may enable more timely and informed intervention, with reduced healthcare costs and improved long-term outcomes. However, genomic medicine strains current models for demonstrating value, challenging efforts to achieve fair payment for services delivered, both for laboratory diagnostics and for use of molecular information in clinical management. Current models of healthcare reform stipulate that care must be delivered at equal or lower cost, with better patient and population outcomes. To achieve demonstrated value, genomic medicine must overcome many uncertainties: the clinical relevance of genomic variation; potential variation in technical performance and/or computational analysis; management of massive information sets; and must have available clinical interventions that can be informed by genomic analysis, so as to attain more favorable cost management of healthcare delivery and demonstrate improvements in cost-effectiveness.

  10. Cost-effectiveness of hepatitis B vaccination of prison inmates.

    Science.gov (United States)

    Pisu, Maria; Meltzer, Martin Isaac; Lyerla, Rob

    2002-12-13

    The purpose of this paper is to determine the cost-effectiveness of vaccinating inmates against hepatitis B. From the prison perspective, vaccinating inmates at intake is not cost-saving. It could be economically beneficial when the cost of a vaccine dose is US dollars 30 per dose, or there is no prevalence of infection upon intake, or the costs of treating acute or chronic disease are about 70% higher than baseline costs, or the incidence of infection during and after custody were >1.6 and 50%, respectively. The health care system realizes net savings even when there is no incidence in prison, or there is no cost of chronic liver disease, or when only one dose of vaccine is administered. Thus, while prisons might not have economic incentives to implement hepatitis B vaccination programs, the health care system would benefit from allocating resources to them.

  11. Specialty-specific admission: a cost-effective intervention?

    LENUS (Irish Health Repository)

    Slattery, E

    2012-02-01

    INTRODUCTION: Cost effectiveness of healthcare has become an important component in its delivery. Current practices need to be assessed and measured for variations that may lead to financial savings. Speciality specific admission is known not only to lead improved clinical outcomes but also to lead important cost reductions. METHODS: All patients admitted to an Irish teaching hospital via the emergency department over a 2-year period with a gastroenterology (GI) related illness were included in this analysis.GI illness was classified using the Disease related grouping (DRG) system. Mean length of stay (LOS) and patient level costing (PLC) were calculated. Differences between DRGs with respect to speciality (i.e. specialist vs. non-specialist) were calculated for the five commonest DRGs. RESULTS: Significant variations in LOS and PLC were demonstrated in the DRGs. Mean LOS varied with increasing complexity, from 3.2 days for non-complex GI haemorrhage to 14.4 days for complex alcohol related cirrhosis as expected. A substantial difference in LOS within DRG groups was demonstrated by large standard deviations in the mean (up to 8.1 days in some groups) and was independent of complexity of cases. PLC also varied widely in both complex and non-complex cases with standard deviations of up to 17,342 noted. Specialty-specific admission was associated with shorter LOS for most GI admissions. CONCLUSION: Significant disparity exists for both LOS and PLC for most GI diagnoses. Specialty-specific admissions are associated with reduced LOS. Specialty-specific admission would appear to be cost-effective which may also lead to improved clinical outcomes.

  12. A Cost Effective System Design Approach for Critical Space Systems

    Science.gov (United States)

    Abbott, Larry Wayne; Cox, Gary; Nguyen, Hai

    2000-01-01

    NASA-JSC required an avionics platform capable of serving a wide range of applications in a cost-effective manner. In part, making the avionics platform cost effective means adhering to open standards and supporting the integration of COTS products with custom products. Inherently, operation in space requires low power, mass, and volume while retaining high performance, reconfigurability, scalability, and upgradability. The Universal Mini-Controller project is based on a modified PC/104-Plus architecture while maintaining full compatibility with standard COTS PC/104 products. The architecture consists of a library of building block modules, which can be mixed and matched to meet a specific application. A set of NASA developed core building blocks, processor card, analog input/output card, and a Mil-Std-1553 card, have been constructed to meet critical functions and unique interfaces. The design for the processor card is based on the PowerPC architecture. This architecture provides an excellent balance between power consumption and performance, and has an upgrade path to the forthcoming radiation hardened PowerPC processor. The processor card, which makes extensive use of surface mount technology, has a 166 MHz PowerPC 603e processor, 32 Mbytes of error detected and corrected RAM, 8 Mbytes of Flash, and I Mbytes of EPROM, on a single PC/104-Plus card. Similar densities have been achieved with the quad channel Mil-Std-1553 card and the analog input/output cards. The power management built into the processor and its peripheral chip allows the power and performance of the system to be adjusted to meet the requirements of the application, allowing another dimension to the flexibility of the Universal Mini-Controller. Unique mechanical packaging allows the Universal Mini-Controller to accommodate standard COTS and custom oversized PC/104-Plus cards. This mechanical packaging also provides thermal management via conductive cooling of COTS boards, which are typically

  13. Cost effectiveness of teratology counseling - the Motherisk experience.

    Science.gov (United States)

    Koren, Gideon; Bozzo, Pina

    2014-01-01

    While the benefits of evidence-based counseling to large numbers of women and physicians are intuitively evident, there is an urgent need to document that teratology counseling, in addition to improving the quality of life of women and families, also leads to cost saving. The objective of the present study was to calculate the cost effectiveness of the Motherisk Program, a large teratology information and counseling service at The Hospital for Sick Children and the University of Toronto. We analyzed data from the Motherisk Program on its 2012 activities in two domains: 1) Calculation of cost-saving in preventing unjustified pregnancy terminations; and 2) prevention of major birth defects. Cost of pregnancy termination and lifelong cost of specific birth defects were identified from primary literature and prorated for cost of living for the year 2013. Prevention of 255 pregnancy terminations per year led to cost savings of $516,630. The total estimated number of major malformations prevented by Motherisk counseling in 2012 was 8.41 cases at a total estimated cost of $9,032,492. With an estimated minimum annual prevention of 8 major malformations, and numerous unnecessary terminations of otherwise- wanted pregnancies, a cost saving of $10 million can be calculated. In 2013 the operating budget of Motherisk counseling totaled $640,000. Even based on the narrow range of activities for which we calculated cost, this service is highly cost- effective. Because most teratology counseling services are operating in a very similar method to Motherisk, it is fair to assume that these results, although dependent on the size of the service, are generalizable to other countries.

  14. Reducing Wildlife Damage with Cost-Effective Management Programmes.

    Directory of Open Access Journals (Sweden)

    Cheryl R Krull

    Full Text Available Limiting the impact of wildlife damage in a cost effective manner requires an understanding of how control inputs change the occurrence of damage through their effect on animal density. Despite this, there are few studies linking wildlife management (control, with changes in animal abundance and prevailing levels of wildlife damage. We use the impact and management of wild pigs as a case study to demonstrate this linkage. Ground disturbance by wild pigs has become a conservation issue of global concern because of its potential effects on successional changes in vegetation structure and composition, habitat for other species, and functional soil properties. In this study, we used a 3-year pig control programme (ground hunting undertaken in a temperate rainforest area of northern New Zealand to evaluate effects on pig abundance, and patterns and rates of ground disturbance and ground disturbance recovery and the cost effectiveness of differing control strategies. Control reduced pig densities by over a third of the estimated carrying capacity, but more than halved average prevailing ground disturbance. Rates of new ground disturbance accelerated with increasing pig density, while rates of ground disturbance recovery were not related to prevailing pig density. Stochastic simulation models based on the measured relationships between control, pig density and rate of ground disturbance and recovery indicated that control could reduce ground disturbance substantially. However, the rate at which prevailing ground disturbance was reduced diminished rapidly as more intense, and hence expensive, pig control regimes were simulated. The model produced in this study provides a framework that links conservation of indigenous ecological communities to control inputs through the reduction of wildlife damage and suggests that managers should consider carefully the marginal cost of higher investment in wildlife damage control, relative to its marginal conservation

  15. Cost-effectiveness in fall prevention for older women.

    Science.gov (United States)

    Hektoen, Liv F; Aas, Eline; Lurås, Hilde

    2009-08-01

    The aim of this study was to estimate the cost-effectiveness of implementing an exercise-based fall prevention programme for home-dwelling women in the > or = 80-year age group in Norway. The impact of the home-based individual exercise programme on the number of falls is based on a New Zealand study. On the basis of the cost estimates and the estimated reduction in the number of falls obtained with the chosen programme, we calculated the incremental costs and the incremental effect of the exercise programme as compared with no prevention. The calculation of the average healthcare cost of falling was based on assumptions regarding the distribution of fall injuries reported in the literature, four constructed representative case histories, assumptions regarding healthcare provision associated with the treatment of the specified cases, and estimated unit costs from Norwegian cost data. We calculated the average healthcare costs per fall for the first year. We found that the reduction in healthcare costs per individual for treating fall-related injuries was 1.85 times higher than the cost of implementing a fall prevention programme. The reduction in healthcare costs more than offset the cost of the prevention programme for women aged > or = 80 years living at home, which indicates that health authorities should increase their focus on prevention. The main intention of this article is to stipulate costs connected to falls among the elderly in a transparent way and visualize the whole cost picture. Cost-effectiveness analysis is a health policy tool that makes politicians and other makers of health policy conscious of this complexity.

  16. Cost effectiveness of a pentavalent rotavirus vaccine in Oman.

    Science.gov (United States)

    Al Awaidy, Salah Thabit; Gebremeskel, Berhanu G; Al Obeidani, Idris; Al Baqlani, Said; Haddadin, Wisam; O'Brien, Megan A

    2014-06-17

    Rotavirus gastroenteritis (RGE) is the leading cause of diarrhea in young children in Oman, incurring substantial healthcare and economic burden. We propose to formally assess the potential cost effectiveness of implementing universal vaccination with a pentavalent rotavirus vaccine (RV5) on reducing the health care burden and costs associated with rotavirus gastroenteritis (RGE) in Oman A Markov model was used to compare two birth cohorts, including children who were administered the RV5 vaccination versus those who were not, in a hypothetical group of 65,500 children followed for their first 5 years of life in Oman. The efficacy of the vaccine in reducing RGE-related hospitalizations, emergency department (ED) and office visits, and days of parental work loss for children receiving the vaccine was based on the results of the Rotavirus Efficacy and Safety Trial (REST). The outcome of interest was cost per quality-adjusted life year (QALY) gained from health care system and societal perspectives. A universal RV5 vaccination program is projected to reduce, hospitalizations, ED visits, outpatient visits and parental work days lost due to rotavirus infections by 89%, 80%, 67% and 74%, respectively. In the absence of RV5 vaccination, RGE-related societal costs are projected to be 2,023,038 Omani Rial (OMR) (5,259,899 United States dollars [USD]), including 1,338,977 OMR (3,481,340 USD) in direct medical costs. However, with the introduction of RV5, direct medical costs are projected to be 216,646 OMR (563,280 USD). Costs per QALY saved would be 1,140 OMR (2,964 USD) from the health care payer perspective. An RV5 vaccination program would be considered cost saving, from the societal perspective. Universal RV5 vaccination in Oman is likely to significantly reduce the health care burden and costs associated with rotavirus gastroenteritis and may be cost-effective from the payer perspective and cost saving from the societal perspective.

  17. Cost effective water treatment program in Heavy Water Plant (Manuguru)

    International Nuclear Information System (INIS)

    Mohapatra, C.; Prasada Rao, G.

    2002-01-01

    Water treatment technology is in a state of continuous evolution. The increasing urgency to conserve water and reduce pollution has in recent years produced an enormous demand for new chemical treatment programs and technologies. Heavy water plant (Manuguru) uses water as raw material (about 3000 m 3 /hr) and its treatment and management has benefited the plant in a significant way. It is a fact that if the water treatment is not proper, it can result in deposit formation and corrosion of metals, which can finally leads to production losses. Therefore, before selecting treatment program, complying w.r.t. quality requirements, safety and pollution aspects cost effectiveness shall be examined. The areas where significant benefits are derived, are raw water treatment using polyelectrolyte instead of inorganic coagulant (alum), change over of regenerant of cation exchangers from hydrochloric acid to sulfuric acid and in-house development of cooling water treatment formulation. The advantages and cost effectiveness of these treatments are discussed in detail. Further these treatments has helped the plant in achieving zero discharge and indirectly increased cost reduction of final product (heavy water); the dosage of 3 ppm of polyelectrolyte can replace 90 ppm alum at turbidity level of 300 NTU of raw water which has resulted in cost saving of Rs. 15-20 lakhs in a year beside other advantages; the change over of regenerant from HCl to H 2 SO 4 will result in cost saving of at least Rs.1.4 crore a year besides other advantages; the change over to proprietary formulation to in-house formulation in cooling water treatment has resulted in a saving about Rs.11 lakhs a year. To achieve the above objectives in a sustainable way the performance results are being monitored. (author)

  18. Cost-effectiveness of improving pediatric hospital care in Nicaragua.

    Science.gov (United States)

    Broughton, Edward I; Gomez, Ivonne; Nuñez, Oscar; Wong, Yudy

    2011-11-01

    To determine the costs and cost-effectiveness of an intervention to improve quality of care for children with diarrhea or pneumonia in 14 hospitals in Nicaragua, based on expenditure data and impact measures. Hospital length of stay (LOS) and deaths were abstracted from a random sample of 1294 clinical records completed at seven of the 14 participating hospitals before the intervention (2003) and 1505 records completed after two years of intervention implementation ("post-intervention"; 2006). Disability-adjusted life years (DALYs) were derived from outcome data. Hospitalization costs were calculated based on hospital and Ministry of Health records and private sector data. Intervention costs came from project accounting records. Decision-tree analysis was used to calculate incremental cost-effectiveness. Average LOS decreased from 3.87 and 4.23 days pre-intervention to 3.55 and 3.94 days post-intervention for diarrhea (P = 0.078) and pneumonia (P = 0.055), respectively. Case fatalities decreased from 45/10 000 and 34/10 000 pre-intervention to 30/10 000 and 27/10 000 post-intervention for diarrhea (P = 0.062) and pneumonia (P = 0.37), respectively. Average total hospitalization and antibiotic costs for both diagnoses were US$ 451 (95% credibility interval [CI]: US$ 419-US$ 482) pre-intervention and US$ 437 (95% CI: US$ 402-US$ 464) post-intervention. The intervention was cost-saving in terms of DALYs (95% CI: -US$ 522- US$ 32 per DALY averted) and cost US$ 21 per hospital day averted (95% CI: -US$ 45- US$ 204). After two years of intervention implementation, LOS and deaths for diarrhea decreased, along with LOS for pneumonia, with no increase in hospitalization costs. If these changes were entirely attributable to the intervention, it would be cost-saving.

  19. 77 FR 1743 - Discount Rates for Cost-Effectiveness Analysis of Federal Programs

    Science.gov (United States)

    2012-01-11

    ... OFFICE OF MANAGEMENT AND BUDGET Discount Rates for Cost-Effectiveness Analysis of Federal Programs... Appendix C are to be used for cost-effectiveness analysis, including lease-purchase analysis, as specified... (Revised December 2011) Discount Rates for Cost-Effectiveness, Lease Purchase, and Related Analyses...

  20. [Cost-effectiveness in Dutch mental health care: future because of ROM?

    NARCIS (Netherlands)

    Agthoven, M. van; Kolk, A. van der; Knegtering, H.; Delespaul, P.A.; Arends, J.; Jeurissen, P.P.T.; Krabbe, P.F.M.; Huijsman, R.; Luijk, R.; Beurs, E. de; Hakkaart-van Roijen, L.; Bruggeman, R.

    2015-01-01

    BACKGROUND: The document reporting Dutch mental health care negotiations for 2014 - 2017 calls for a cost decrease based on cost-effectiveness. Thanks to rom, the Dutch mental health care seems well prepared for cost-effectiveness research.
    AIM: Evaluate how valid cost-effectiveness research

  1. 76 FR 7881 - Discount Rates for Cost-Effectiveness Analysis of Federal Programs

    Science.gov (United States)

    2011-02-11

    ... OFFICE OF MANAGEMENT AND BUDGET Discount Rates for Cost-Effectiveness Analysis of Federal Programs... Appendix C are to be used for cost-effectiveness analysis, including lease-purchase analysis, as specified... (Revised December 2010) DISCOUNT RATES FOR COST-EFFECTIVENESS, LEASE PURCHASE, AND RELATED ANALYSES...

  2. 78 FR 6140 - Discount Rates for Cost-Effectiveness Analysis of Federal Programs

    Science.gov (United States)

    2013-01-29

    ... OFFICE OF MANAGEMENT AND BUDGET Discount Rates for Cost-Effectiveness Analysis of Federal Programs... in Appendix C are to be used for cost-effectiveness analysis, including lease-purchase analysis, as...) Discount Rates for Cost-Effectiveness, Lease Purchase, and Related Analyses Effective Dates. This appendix...

  3. Cost-Effectiveness Analysis in Practice: Interventions to Improve High School Completion

    Science.gov (United States)

    Hollands, Fiona; Bowden, A. Brooks; Belfield, Clive; Levin, Henry M.; Cheng, Henan; Shand, Robert; Pan, Yilin; Hanisch-Cerda, Barbara

    2014-01-01

    In this article, we perform cost-effectiveness analysis on interventions that improve the rate of high school completion. Using the What Works Clearinghouse to select effective interventions, we calculate cost-effectiveness ratios for five youth interventions. We document wide variation in cost-effectiveness ratios between programs and between…

  4. Comparing the Cost-Effectiveness of Simulation Modalities: A Case Study of Peripheral Intravenous Catheterization Training

    Science.gov (United States)

    Isaranuwatchai, Wanrudee; Brydges, Ryan; Carnahan, Heather; Backstein, David; Dubrowski, Adam

    2014-01-01

    While the ultimate goal of simulation training is to enhance learning, cost-effectiveness is a critical factor. Research that compares simulation training in terms of educational- and cost-effectiveness will lead to better-informed curricular decisions. Using previously published data we conducted a cost-effectiveness analysis of three…

  5. Costs, health effects and cost-effectiveness of alcohol and tobacco control strategies in Estonia.

    NARCIS (Netherlands)

    Lai, T.; Habicht, J.; Reinap, M.; Chisholm, D.; Baltussen, R.M.P.M.

    2007-01-01

    OBJECTIVE: To assess the population-level costs, effects and cost-effectiveness of different alcohol and tobacco control strategies in Estonia. DESIGN: A WHO cost-effectiveness modelling framework was used to estimate the total costs and effects of interventions. Costs were assessed in Estonian

  6. Reliability Engineering

    CERN Document Server

    Lazzaroni, Massimo

    2012-01-01

    This book gives a practical guide for designers and users in Information and Communication Technology context. In particular, in the first Section, the definition of the fundamental terms according to the international standards are given. Then, some theoretical concepts and reliability models are presented in Chapters 2 and 3: the aim is to evaluate performance for components and systems and reliability growth. Chapter 4, by introducing the laboratory tests, puts in evidence the reliability concept from the experimental point of view. In ICT context, the failure rate for a given system can be

  7. Reliability training

    Science.gov (United States)

    Lalli, Vincent R. (Editor); Malec, Henry A. (Editor); Dillard, Richard B.; Wong, Kam L.; Barber, Frank J.; Barina, Frank J.

    1992-01-01

    Discussed here is failure physics, the study of how products, hardware, software, and systems fail and what can be done about it. The intent is to impart useful information, to extend the limits of production capability, and to assist in achieving low cost reliable products. A review of reliability for the years 1940 to 2000 is given. Next, a review of mathematics is given as well as a description of what elements contribute to product failures. Basic reliability theory and the disciplines that allow us to control and eliminate failures are elucidated.

  8. Integrated reliability condition monitoring and maintenance of equipment

    CERN Document Server

    Osarenren, John

    2015-01-01

    Consider a Viable and Cost-Effective Platform for the Industries of the Future (IOF) Benefit from improved safety, performance, and product deliveries to your customers. Achieve a higher rate of equipment availability, performance, product quality, and reliability. Integrated Reliability: Condition Monitoring and Maintenance of Equipment incorporates reliable engineering and mathematical modeling to help you move toward sustainable development in reliability condition monitoring and maintenance. This text introduces a cost-effective integrated reliability growth monitor, integrated reliability degradation monitor, technological inheritance coefficient sensors, and a maintenance tool that supplies real-time information for predicting and preventing potential failures of manufacturing processes and equipment. The author highlights five key elements that are essential to any improvement program: improving overall equipment and part effectiveness, quality, and reliability; improving process performance with maint...

  9. Plasma metanephrines: a novel and cost-effective test for pheochromocytoma

    Directory of Open Access Journals (Sweden)

    G. Eisenhofer

    2000-10-01

    Full Text Available Pheochromocytomas are rare chromaffin cell tumors that nevertheless must be excluded in large numbers of patients who develop sustained or episodic hypertension as well as in many others with suggestive symptoms or with a familial history of pheochromocytoma. Diagnosis of pheochromocytoma depends importantly on biochemical evidence of excess catecholamine production by a tumor. Imperfect sensitivity and specificity of commonly available biochemical tests and the low incidence of the tumor among the tested population mean that considerable time and effort can be expended in confirming or ruling out pheochromocytoma in patients where the tumor is suspected. Measurements of plasma free metanephrines provide a superior test compared to other available tests for diagnosis of pheochromocytoma. In particular, the high sensitivity of plasma free metanephrines means that a normal test result reliably excludes all but the smallest of pheochromocytomas so that no other tests are necessary. Measurements of plasma free metanephrines, when systematically combined with other diagnostic procedures outlined in this review, provide a more efficient, reliable and cost-effective approach for diagnosis of pheochromocytoma than offered by previously available approaches.

  10. Alternative Strategies to Reduce Maternal Mortality in India: A Cost-Effectiveness Analysis

    Science.gov (United States)

    Goldie, Sue J.; Sweet, Steve; Carvalho, Natalie; Natchu, Uma Chandra Mouli; Hu, Delphine

    2010-01-01

    Background Approximately one-quarter of all pregnancy- and delivery-related maternal deaths worldwide occur in India. Taking into account the costs, feasibility, and operational complexity of alternative interventions, we estimate the clinical and population-level benefits associated with strategies to improve the safety of pregnancy and childbirth in India. Methods and Findings Country- and region-specific data were synthesized using a computer-based model that simulates the natural history of pregnancy (both planned and unintended) and pregnancy- and childbirth-associated complications in individual women; and considers delivery location, attendant, and facility level. Model outcomes included clinical events, population measures, costs, and cost-effectiveness ratios. Separate models were adapted to urban and rural India using survey-based data (e.g., unmet need for birth spacing/limiting, facility births, skilled birth attendants). Model validation compared projected maternal indicators with empiric data. Strategies consisted of improving coverage of effective interventions that could be provided individually or packaged as integrated services, could reduce the incidence of a complication or its case fatality rate, and could include improved logistics such as reliable transport to an appropriate referral facility as well as recognition of referral need and quality of care. Increasing family planning was the most effective individual intervention to reduce pregnancy-related mortality. If over the next 5 y the unmet need for spacing and limiting births was met, more than 150,000 maternal deaths would be prevented; more than US$1 billion saved; and at least one of every two abortion-related deaths averted. Still, reductions in maternal mortality reached a threshold (∼23%–35%) without including strategies that ensured reliable access to intrapartum and emergency obstetrical care (EmOC). An integrated and stepwise approach was identified that would ultimately

  11. Alternative strategies to reduce maternal mortality in India: a cost-effectiveness analysis.

    Directory of Open Access Journals (Sweden)

    Sue J Goldie

    2010-04-01

    Full Text Available BACKGROUND: Approximately one-quarter of all pregnancy- and delivery-related maternal deaths worldwide occur in India. Taking into account the costs, feasibility, and operational complexity of alternative interventions, we estimate the clinical and population-level benefits associated with strategies to improve the safety of pregnancy and childbirth in India. METHODS AND FINDINGS: Country- and region-specific data were synthesized using a computer-based model that simulates the natural history of pregnancy (both planned and unintended and pregnancy- and childbirth-associated complications in individual women; and considers delivery location, attendant, and facility level. Model outcomes included clinical events, population measures, costs, and cost-effectiveness ratios. Separate models were adapted to urban and rural India using survey-based data (e.g., unmet need for birth spacing/limiting, facility births, skilled birth attendants. Model validation compared projected maternal indicators with empiric data. Strategies consisted of improving coverage of effective interventions that could be provided individually or packaged as integrated services, could reduce the incidence of a complication or its case fatality rate, and could include improved logistics such as reliable transport to an appropriate referral facility as well as recognition of referral need and quality of care. Increasing family planning was the most effective individual intervention to reduce pregnancy-related mortality. If over the next 5 y the unmet need for spacing and limiting births was met, more than 150,000 maternal deaths would be prevented; more than US$1 billion saved; and at least one of every two abortion-related deaths averted. Still, reductions in maternal mortality reached a threshold ( approximately 23%-35% without including strategies that ensured reliable access to intrapartum and emergency obstetrical care (EmOC. An integrated and stepwise approach was

  12. Alternative strategies to reduce maternal mortality in India: a cost-effectiveness analysis.

    Science.gov (United States)

    Goldie, Sue J; Sweet, Steve; Carvalho, Natalie; Natchu, Uma Chandra Mouli; Hu, Delphine

    2010-04-20

    Approximately one-quarter of all pregnancy- and delivery-related maternal deaths worldwide occur in India. Taking into account the costs, feasibility, and operational complexity of alternative interventions, we estimate the clinical and population-level benefits associated with strategies to improve the safety of pregnancy and childbirth in India. Country- and region-specific data were synthesized using a computer-based model that simulates the natural history of pregnancy (both planned and unintended) and pregnancy- and childbirth-associated complications in individual women; and considers delivery location, attendant, and facility level. Model outcomes included clinical events, population measures, costs, and cost-effectiveness ratios. Separate models were adapted to urban and rural India using survey-based data (e.g., unmet need for birth spacing/limiting, facility births, skilled birth attendants). Model validation compared projected maternal indicators with empiric data. Strategies consisted of improving coverage of effective interventions that could be provided individually or packaged as integrated services, could reduce the incidence of a complication or its case fatality rate, and could include improved logistics such as reliable transport to an appropriate referral facility as well as recognition of referral need and quality of care. Increasing family planning was the most effective individual intervention to reduce pregnancy-related mortality. If over the next 5 y the unmet need for spacing and limiting births was met, more than 150,000 maternal deaths would be prevented; more than US$1 billion saved; and at least one of every two abortion-related deaths averted. Still, reductions in maternal mortality reached a threshold ( approximately 23%-35%) without including strategies that ensured reliable access to intrapartum and emergency obstetrical care (EmOC). An integrated and stepwise approach was identified that would ultimately prevent four of five

  13. RodPilotR - The Innovative and Cost-Effective Digital Control Rod Drive Control System for PWRs

    International Nuclear Information System (INIS)

    Baron, Clemens

    2008-01-01

    With RodPilot, AREVA NP offers an innovative and cost-effective system for controlling control rods in Pressurized Water Reactors. RodPilot controls the three operating coils of the control rod drive mechanism (lift, moveable gripper and stationary gripper coil). The rods are inserted into or withdrawn from the core as required by the Reactor Control System. The system combines modern components, state-of-the-art logic and a proven electronic control rod drive control principle to provide enhanced reliability and lower maintenance costs. (author)

  14. RodPilot{sup R} - The Innovative and Cost-Effective Digital Control Rod Drive Control System for PWRs

    Energy Technology Data Exchange (ETDEWEB)

    Baron, Clemens [AREVA NP GmbH, NLEE-G, Postfach 1199, 91001 Erlangen (Germany)

    2008-07-01

    With RodPilot, AREVA NP offers an innovative and cost-effective system for controlling control rods in Pressurized Water Reactors. RodPilot controls the three operating coils of the control rod drive mechanism (lift, moveable gripper and stationary gripper coil). The rods are inserted into or withdrawn from the core as required by the Reactor Control System. The system combines modern components, state-of-the-art logic and a proven electronic control rod drive control principle to provide enhanced reliability and lower maintenance costs. (author)

  15. Reliability aspects and facet damage in high-power emission from (AlGa)As cw laser diodes at room temperature

    International Nuclear Information System (INIS)

    Kressel, H.; Ladany, I.

    1975-01-01

    Factors are described that limit the optical power output from (AlGa)As laser diodes (lambda = 8100 to 8300 A) operating cw at room temperature with uncoated facets. Rapid laser ''catastrophic'' degradation due to facet damage (in contrast to ''bulk'' phenomena previously considered) has been found to occur as a result of excessive optical flux density at the facets. The diodes studied are capable of initial cw power emission values of 25 to 100 mW from one facet depending on their dimensions. Data are presented showing long-term constant-current operation at power levels below these maximum values. Preliminary data are also presented on devices utilizing dielectric facet coatings to minimize facet damage. (U.S.)

  16. Reliability calculations

    International Nuclear Information System (INIS)

    Petersen, K.E.

    1986-03-01

    Risk and reliability analysis is increasingly being used in evaluations of plant safety and plant reliability. The analysis can be performed either during the design process or during the operation time, with the purpose to improve the safety or the reliability. Due to plant complexity and safety and availability requirements, sophisticated tools, which are flexible and efficient, are needed. Such tools have been developed in the last 20 years and they have to be continuously refined to meet the growing requirements. Two different areas of application were analysed. In structural reliability probabilistic approaches have been introduced in some cases for the calculation of the reliability of structures or components. A new computer program has been developed based upon numerical integration in several variables. In systems reliability Monte Carlo simulation programs are used especially in analysis of very complex systems. In order to increase the applicability of the programs variance reduction techniques can be applied to speed up the calculation process. Variance reduction techniques have been studied and procedures for implementation of importance sampling are suggested. (author)

  17. TFTR CAMAC power supplies reliability

    International Nuclear Information System (INIS)

    Camp, R.A.; Bergin, W.

    1989-01-01

    Since the expected life of the Tokamak Fusion Test Reactor (TFTR) has been extended into the early 1990's, the issues of equipment wear-out, when to refurbish/replace, and the costs associated with these decisions, must be faced. The management of the maintenance of the TFTR Central Instrumentation, Control and Data Acquisition System (CICADA) power supplies within the CAMAC network is a case study of a set of systems to monitor repairable systems reliability, costs, and results of action. The CAMAC network is composed of approximately 500 racks, each with its own power supply. By using a simple reliability estimator on a coarse time interval, in conjunction with determining the root cause of individual failures, a cost effective repair and maintenance program has been realized. This paper describes the estimator, some of the specific causes for recurring failures and their correction, and the subsequent effects on the reliability estimator. By extension of this program the authors can assess the continued viability of CAMAC power supplies into the future, predicting wear-out and developing cost effective refurbishment/replacement policies. 4 refs., 3 figs., 1 tab

  18. Can Economic Model Transparency Improve Provider Interpretation of Cost-effectiveness Analysis? Evaluating Tradeoffs Presented by the Second Panel on Cost-effectiveness in Health and Medicine.

    Science.gov (United States)

    Padula, William V; McQueen, Robert Brett; Pronovost, Peter J

    2017-11-01

    The Second Panel on Cost-Effectiveness in Health and Medicine convened on December 7, 2016 at the National Academy of Medicine to disseminate their recommendations for conduct, methodological practices, and reporting of cost-effectiveness analyses (CEAs). Following its summary, panel proceedings included lengthy discussions including the field's struggle to disseminate findings efficiently through peer-reviewed literature to target audiences. With editors of several medical and outcomes research journals in attendance, there was consensus that findings of cost-effectiveness analyses do not effectively reach other researchers or health care providers. The audience members suggested several solutions including providing additional training to clinicians in cost-effectiveness research and requiring that cost-effectiveness models are made publicly available. However, there remains the questions of whether making economic modelers' work open-access through journals is fair under the defense that these models remain one's own intellectual property, or whether journals can properly manage the peer-review process specifically for cost-effectiveness analyses. In this article, we elaborate on these issues and provide some suggested solutions that may increase the dissemination and application of cost-effectiveness literature to reach its intended audiences and ultimately benefit the patient. Ultimately, it is our combined view as economic modelers and clinicians that cost-effectiveness results need to reach the clinician to improve the efficiency of medical practice, but that open-access models do not improve clinician access or interpretation of the economics of medicine.

  19. Modeling the cost-effectiveness of health care systems for alcohol use disorders: how implementation of eHealth interventions improves cost-effectiveness

    NARCIS (Netherlands)

    Smit, Filip; Lokkerbol, Joran; Riper, Heleen; Majo, Maria Cristina; Boon, Brigitte; Blankers, Matthijs

    2011-01-01

    Informing policy decisions about the cost-effectiveness of health care systems (ie, packages of clinical interventions) is probably best done using a modeling approach. To this end, an alcohol model (ALCMOD) was developed. The aim of ALCMOD is to estimate the cost-effectiveness of competing health

  20. Cost-effective hybrid RF/FSO backhaul solution for next generation wireless systems

    KAUST Repository

    Dahrouj, Hayssam

    2015-10-28

    The rapid pace of demand for mobile data services and the limited supply of capacity in the current wireless access networks infrastructure are leading network operators to increase the density of base station deployments to improve network performance. This densification, made possible by small-cell deployment, also brings a novel set of challenges, specifically related to the cost of ownership, in which backhaul is of primary concern. This article proposes a cost-effective hybrid RF/free-space optical (FSO) solution to combine the advantages of RF backhauls (low cost, NLOS applications) and FSO backhauls (high-rate, low latency). To first illustrate the cost advantages of the RF backhaul solution, the first part of this article presents a business case of NLOS wireless RF backhaul, which has a low cost of ownership as compared to other backhaul candidates. RF backhaul, however, is limited by latency problems. On the other side, an FSO solution, which offers better latency and higher data rate than RF backhauls, remains sensitive to weather and nature conditions (e.g., rain, fog). To combine RF and FSO advantages, the second part of this article proposes a lowcost hybrid RF/FSO solution, wherein base stations are connected to each other using either optical fiber or hybrid RF/FSO links. This part addresses the problem of minimizing the cost of backhaul planning under reliability, connectivity, and data rate constraints, and proposes choosing the appropriate cost-effective backhaul connection between BSs (i.e., either OF or hybrid RF/FSO) using graph theory techniques.

  1. Systems reliability/structural reliability

    International Nuclear Information System (INIS)

    Green, A.E.

    1980-01-01

    The question of reliability technology using quantified techniques is considered for systems and structures. Systems reliability analysis has progressed to a viable and proven methodology whereas this has yet to be fully achieved for large scale structures. Structural loading variants over the half-time of the plant are considered to be more difficult to analyse than for systems, even though a relatively crude model may be a necessary starting point. Various reliability characteristics and environmental conditions are considered which enter this problem. The rare event situation is briefly mentioned together with aspects of proof testing and normal and upset loading conditions. (orig.)

  2. City-scale analysis of water-related energy identifies more cost-effective solutions.

    Science.gov (United States)

    Lam, Ka Leung; Kenway, Steven J; Lant, Paul A

    2017-02-01

    Energy and greenhouse gas management in urban water systems typically focus on optimising within the direct system boundary of water utilities that covers the centralised water supply and wastewater treatment systems, despite a greater energy influence by the water end use. This work develops a cost curve of water-related energy management options from a city perspective for a hypothetical Australian city. It is compared with that from the water utility perspective. The curves are based on 18 water-related energy management options that have been implemented or evaluated in Australia. In the studied scenario, the cost-effective energy saving potential from a city perspective (292 GWh/year) is far more significant than that from a utility perspective (65 GWh/year). In some cases, for similar capital cost, if regional water planners invested in end use options instead of utility options, a greater energy saving potential at a greater cost-effectiveness could be achieved in urban water systems. For example, upgrading a wastewater treatment plant for biogas recovery at a capital cost of $27.2 million would save 31 GWh/year with a marginal cost saving of $63/MWh, while solar hot water system rebates at a cost of $28.6 million would save 67 GWh/year with a marginal cost saving of $111/MWh. Options related to hot water use such as water-efficient shower heads, water-efficient clothes washers and solar hot water system rebates are among the most cost-effective city-scale opportunities. This study demonstrates the use of cost curves to compare both utility and end use options in a consistent framework. It also illustrates that focusing solely on managing the energy use within the utility would miss substantial non-utility water-related energy saving opportunities. There is a need to broaden the conventional scope of cost curve analysis to include water-related energy and greenhouse gas at the water end use, and to value their management from a city perspective. This

  3. Cost-effectiveness of alternative management strategies for patients with solitary pulmonary nodules.

    Science.gov (United States)

    Gould, Michael K; Sanders, Gillian D; Barnett, Paul G; Rydzak, Chara E; Maclean, Courtney C; McClellan, Mark B; Owens, Douglas K

    2003-05-06

    Positron emission tomography (PET) with 18-fluorodeoxyglucose (FDG) is a potentially useful but expensive test to diagnose solitary pulmonary nodules. To evaluate the cost-effectiveness of strategies for pulmonary nodule diagnosis and to specifically compare strategies that did and did not include FDG-PET. Decision model. Accuracy and complications of diagnostic tests were estimated by using meta-analysis and literature review. Modeled survival was based on data from a large tumor registry. Cost estimates were derived from Medicare reimbursement and other sources. All adult patients with a new, noncalcified pulmonary nodule seen on chest radiograph. Patient lifetime. Societal. 40 clinically plausible combinations of 5 diagnostic interventions, including computed tomography, FDG-PET, transthoracic needle biopsy, surgery, and watchful waiting. Costs, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios. The cost-effectiveness of strategies depended critically on the pretest probability of malignancy. For patients with low pretest probability (26%), strategies that used FDG-PET selectively when computed tomography results were possibly malignant cost as little as 20 000 dollars per QALY gained. For patients with high pretest probability (79%), strategies that used FDG-PET selectively when computed tomography results were benign cost as little as 16 000 dollars per QALY gained. For patients with intermediate pretest probability (55%), FDG-PET strategies cost more than 220 000 dollars per QALY gained because they were more costly but only marginally more effective than computed tomography-based strategies. The choice of strategy also depended on the risk for surgical complications, the probability of nondiagnostic needle biopsy, the sensitivity of computed tomography, and patient preferences for time spent in watchful waiting. In probabilistic sensitivity analysis, FDG-PET strategies were cost saving or cost less than 100 000 dollars per QALY

  4. Cost-effectiveness of greenhouse gases mitigation measures in the European agro-forestry sector: a literature survey

    International Nuclear Information System (INIS)

    Povellato, Andrea; Bosello, Francesco; Giupponi, Carlo

    2007-01-01

    Over the last 20 years, climate change has become an increasing concern for scientists, public opinions and policy makers. Due to the pervasive nature of its impacts for many important aspects of human life, climate change is likely to influence and be influenced by the most diverse policy or management choices. This is particularly true for those interventions affecting agriculture and forestry: they are strongly dependent on climate phenomena, but also contribute to climate evolution being sources of and sinks for greenhouse gases (GHG). This paper offers a survey of the existing literature assessing cost-effectiveness and efficiency of greenhouse gas mitigation strategies or the effects of broader economic reforms in the agricultural and forestry sectors. The focus is mainly on European countries. Different methodological approaches, research questions addressed and results are examined. The main findings are that agriculture can potentially provide emissions reduction at a competitive cost, mainly with methane abatement, while carbon sequestration seems more cost-effective with appropriate forest management measures. Afforestation, cropland management and bioenergy are less economically viable measures due to competition with other land use. Mitigation policies should be carefully designed either to balance costs with expected benefits in terms of social welfare. Regional variability is one of the main drawbacks to fully assess the cost-effectiveness of different measures. Integration of models to take into account both social welfare and spatial heterogeneity seems to be the frontier of the next model generation

  5. Design for Reliability in Renewable Energy Systems

    DEFF Research Database (Denmark)

    Blaabjerg, Frede; Zhou, Dao; Sangwongwanich, Ariya

    2017-01-01

    Power electronics are widely used in renewable energy systems to achieve lower cost of energy, higher efficiency and high power density. At the same time, the high reliability of the power electronics products is demanded, in order to reduce the failure rates and ensure cost-effective operation...... of the renewable energy systems. This paper thus describes the basic concepts used in reliability engineering, and presents the status and future trends of Design for Reliability (DfR) in power electronics, which is currently undergoing a paradigm shift to a physics-of-failure approach. Two case studies of a 2 MW...

  6. Cost effective decommissioning and dismantling of nuclear power plants

    International Nuclear Information System (INIS)

    Wasinger, Karl

    2012-01-01

    As for any large and complex project, the basis for cost effective decommissioning and dismantling of nuclear power plants is established with the development of the project. Just as its construction, dismantling of a nuclear power plant is similarly demanding. Daily changing situations due to the progress of construction - in the present case progress of dismantling - result in significant logistical challenges for project managers and site supervisors. This will be aggravated by the fact that a considerable amount of the removed parts are contaminated or even activated. Hence, not only occupational health, safety and environmental protection is to be assured, employees, public and environment are to be adequately protected against the adverse effect of radioactive radiation as well. Work progress and not least expenses involved with the undertaking depend on adherence to the planned course of actions. Probably the most frequent cause of deviation from originally planned durations and costs of a project are disruptions in the flow of work. For being enabled to counteract in a timely and efficient manner, all required activities are to be comprehensively captured with the initial planning. The effect initial activities may have on subsequent works until completion must particularly be investigated. This is the more important the larger and more complex the project actually are. Comprehensive knowledge of all the matters which may affect the progress of the works is required in order to set up a suitable work break-down structure; such work break-down structure being indispensable for successful control and monitoring of the project. In building the related organizational structure of the project, all such stakeholders not being direct part of the project team but which may potentially affect the progress of the project are to be considered as well. Cost effective and lost time injury free dismantling of decommissioned nuclear power plants is based on implementing

  7. Critical Research for Cost-Effective Photoelectrochemical Production of Hydrogen

    Energy Technology Data Exchange (ETDEWEB)

    Xu, Liwei [Midwest Optoelectronics, LLC, Toledo, OH (United States); Deng, Xunming [Univ. of Toledo, OH (United States); Abken, Anka [Midwest Optoelectronics, LLC, Toledo, OH (United States); Cao, Xinmin [Midwest Optoelectronics, LLC, Toledo, OH (United States); Du, Wenhui [Midwest Optoelectronics, LLC, Toledo, OH (United States); Vijh, Aarohi [Xunlight Corporation, Toledo, OH (United States); Ingler, William [Univ. of Toledo, OH (United States); Chen, Changyong [Univ. of Toledo, OH (United States); Fan, Qihua [Univ. of Toledo, OH (United States); Collins, Robert [Univ. of Toledo, OH (United States); Compaan, Alvin [Univ. of Toledo, OH (United States); Yan, Yanfa [Univ. of Toledo, OH (United States); Giolando, Dean [Univ. of Toledo, OH (United States); Turner, John [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2014-10-29

    The objective of this project is to develop critical technologies required for cost-effective production of hydrogen from sunlight and water using a-Si triple junction solar cell based photo-electrodes. In this project, Midwest Optoelectronics, LLC (MWOE) and its collaborating organizations utilize triple junction a-Si thin film solar cells as the core element to fabricate photoelectrochemical (PEC) cells. Triple junction a-Si/a-SiGe/a-SiGe solar cell is an ideal material for making cost-effective PEC system which uses sun light to split water and generate hydrogen. It has the following key features: 1) It has an open circuit voltage (Voc ) of ~ 2.3V and has an operating voltage around 1.6V. This is ideal for water splitting. There is no need to add a bias voltage or to inter-connect more than one solar cell. 2) It is made by depositing a-Si/a-SiGe/aSi-Ge thin films on a conducting stainless steel substrate which can serve as an electrode. When we immerse the triple junction solar cells in an electrolyte and illuminate it under sunlight, the voltage is large enough to split the water, generating oxygen at the Si solar cell side (for SS/n-i-p/sunlight structure) and hydrogen at the back, which is stainless steel side. There is no need to use a counter electrode or to make any wire connection. 3) It is being produced in large rolls of 3ft wide and up to 5000 ft long stainless steel web in a 25MW roll-to-roll production machine. Therefore it can be produced at a very low cost. After several years of research with many different kinds of material, we have developed promising transparent, conducting and corrosion resistant (TCCR) coating material; we carried out extensive research on oxygen and hydrogen generation catalysts, developed methods to make PEC electrode from production-grade a-Si solar cells; we have designed and tested various PEC module cases and carried out extensive outdoor testing; we were able to obtain a solar to hydrogen conversion efficiency (STH

  8. Rapid, cost-effective liquid chromatograghic method for the ...

    African Journals Online (AJOL)

    GRACE

    2006-07-03

    Jul 3, 2006 ... The method was validated and used for pharmacokinetic studies. Key words: Metronidazole ... by the intrinsic analytical properties of the drug molecule ... In addition, such factors as sample size ... account, since these affect the reliability of the quantitation. ... phase and ion-pair high–performance liquid.

  9. CICS Region Virtualization for Cost Effective Application Development

    Science.gov (United States)

    Khan, Kamal Waris

    2012-01-01

    Mainframe is used for hosting large commercial databases, transaction servers and applications that require a greater degree of reliability, scalability and security. Customer Information Control System (CICS) is a mainframe software framework for implementing transaction services. It is designed for rapid, high-volume online processing. In order…

  10. The cost effectiveness of intracyctoplasmic sperm injection (ICSI).

    Science.gov (United States)

    Hollingsworth, Bruce; Harris, Anthony; Mortimer, Duncan

    2007-12-01

    To estimate the incremental cost effectiveness of ICSI, and total costs for the population of Australia. Treatment effects for three patient groups were drawn from a published systematic review and meta-analysis of trials comparing fertilisation outcomes for ICSI. Incremental costs derived from resource-based costing of ICSI and existing practice comparators for each patient group. Incremental cost per live birth for patients unsuited to IVF is estimated between A$8,500 and 13,400. For the subnormal semen indication, cost per live birth could be as low as A$3,600, but in the worst case scenario, there would just be additional incremental costs of A$600 per procedure. Multiplying out the additional costs of ICSI over the relevant target populations in Australia gives potential total financial implications of over A$31 million per annum. While there are additional benefits from ICSI procedure, particularly for those with subnormal sperm, the additional cost for the health care system is substantial.

  11. Scalable and cost-effective NGS genotyping in the cloud.

    Science.gov (United States)

    Souilmi, Yassine; Lancaster, Alex K; Jung, Jae-Yoon; Rizzo, Ettore; Hawkins, Jared B; Powles, Ryan; Amzazi, Saaïd; Ghazal, Hassan; Tonellato, Peter J; Wall, Dennis P

    2015-10-15

    While next-generation sequencing (NGS) costs have plummeted in recent years, cost and complexity of computation remain substantial barriers to the use of NGS in routine clinical care. The clinical potential of NGS will not be realized until robust and routine whole genome sequencing data can be accurately rendered to medically actionable reports within a time window of hours and at scales of economy in the 10's of dollars. We take a step towards addressing this challenge, by using COSMOS, a cloud-enabled workflow management system, to develop GenomeKey, an NGS whole genome analysis workflow. COSMOS implements complex workflows making optimal use of high-performance compute clusters. Here we show that the Amazon Web Service (AWS) implementation of GenomeKey via COSMOS provides a fast, scalable, and cost-effective analysis of both public benchmarking and large-scale heterogeneous clinical NGS datasets. Our systematic benchmarking reveals important new insights and considerations to produce clinical turn-around of whole genome analysis optimization and workflow management including strategic batching of individual genomes and efficient cluster resource configuration.

  12. Cost-effective practices in the blood service sector.

    Science.gov (United States)

    Katsaliaki, Korina

    2008-05-01

    The objective of this study is to recommend alternative policies, which are tested on a computer simulation model, towards a more cost-effective management of the blood supply chain in the UK. With the use of primary and secondary data from the National Blood Service (NBS) and the supplied hospitals, statistical analysis is conducted and a detailed discrete event simulation model of a vertical part of the UK supply chain of blood products is developed to test and identify good ordering, inventory and distribution practices. Fewer outdates, group substitutions, shortages and deliveries could be achieved by blood banks: holding stock of rare blood groups of red blood cells (RBC), having a second routine delivery per weekday, exercising a more insensitive ordering point for RBC, reducing the total crossmatch release period to less than 1.5 days, increasing the transfusion-to-crossmatch ratio to 70%, adhering to an age-based issuing of orders, holding RBC stock of a weighted average of approximately 4 days. The blood supply simulation model can offer useful pieces of advice to the stakeholders of the examined system which leads to cost reductions and increased safety. Moreover, it provides a great range of experimental capabilities in a risk-free environment.

  13. Cost effectiveness of open versus laparoscopic living-donor nephrectomy

    DEFF Research Database (Denmark)

    Hamidi, Vida; Andersen, Marit Helen; Oyen, Ole

    2009-01-01

    , and a consequent potential to increase the pool of kidney donors. However, the cost effectiveness of LLDN remains unknown. The aim of this study was to explore the health and cost consequences of replacing open-donor nephrectomy by LLDN. METHODS: Kidney donors were randomized to laparoscopic (n=63) or open surgery...... (n=59). We obtained data on operating time, personnel costs, length of stay, cost of analgesic, disposable instruments and complications, and indirect costs. Quality of life was captured before the operation and at 1, 6, and 12 months postdonation by means of short form-36. The scores were translated...... into utilities by means of Brazier's 6D algorithm. RESULTS: The cost per patient was U.S. $55,292 with laparoscopic and U.S. $29,886 with open surgery. The greatest cost difference was in costs attributed to complications (U.S. $33,162 vs. U.S. $4,573). The 1-year quality-adjusted life years (QALYs) were 0...

  14. A cost-effective simulation curriculum for preclinical endodontics.

    Science.gov (United States)

    Pileggi, Roberta; Glickman, Gerald N

    2004-02-01

    A challenge in contemporary dental education is to achieve a smooth transition from preclinical teaching environments to patient-care clinics in a cost-effective manner. The preclinical endodontic courses at The University of Texas, Dental Branch at Houston provide a unique learning environment that enables the student to perform endodontic treatment on extracted teeth in a typodont, and be involved in diagnosis and treatment-planning discussions. The specially designed stone typodont used has built-in radiographic capability, and is mounted at each chair in the clinic. During each preclinical session, students are assigned clinical cubicles and proper aseptic protocol is followed. Students are required to wear gloves, masks and eyewear, and place a rubber dam during treatment. Written self-assessment evaluations based upon prescribed criteria are utilised; feedback is given by faculty composed of both full-time endodontists and graduate students who periodically rotate and are calibrated on a regular basis. In the lecture phase, clinical case scenarios are presented to reinforce concepts of diagnosis and emergency care and to help integrate endodontics with other disciplines; a Socratic-like teaching style is established by the faculty facilitator to create an environment for developing critical-thinking and problem-solving skills. The overall feedback from graduating students has been very positive. Advantages of this format are an easier transition to patient management, a more keen interest in specialsation and a perceived increase in levels of confidence.

  15. Mobile liquid VR system: a cost effective alternative

    International Nuclear Information System (INIS)

    Soto, R.; Harkins, R.; HPD, Inc., Naperville, IL)

    1985-01-01

    The need for cost effective alternatives to treat large volumes of liquid radwaste has never been more evident. As part of a continuing effort to introduce such alternatives, HPD, Inc., and Chem-Nuclear Systems, Inc., have integrated two proven state-of-the-art technologies to offer a mobile liquid volume reduction system that satisfies nuclear industry requirements, with respect to liquid radwaste handling. This system optimizes proven technology by employing a crystallizer unit to concentrate the waste liquids to 50 weight percent solids, thereby reducing the volume to be solidified by factors of 40, while using only 20 percent of the energy required by conventional evaporative systems. In addition, the system employs a field proven cement solidification process which has been accepted in a Topical Report by the US NRC and which offers the highest waste to container volume ratios for stable waste forms in the industry. This volume reduction-solidification system is able to reduce over 7000 gallons of liquid waste per day to less than 30 cubic feet of 10CFR61 certified stable solidified waste for ultimate disposal or on-site storage. This document describes the GEODE System; its applicability; economics; volume reduction; scope of responsibility and experience. Major benefits include higher VR factors; assurance of continual regulatory compliance; and no capital investment

  16. COST-EFFECTIVE TARGET FABRICATION FOR INERTIAL FUSION ENERGY

    International Nuclear Information System (INIS)

    GOODIN, D.T; NOBILE, A; SCHROEN, D.G; MAXWELL, J.L; RICKMAN, W.S

    2004-03-01

    A central feature of an Inertial Fusion Energy (IFE) power plant is a target that has been compressed and heated to fusion conditions by the energy input of the driver. The IFE target fabrication programs are focusing on methods that will scale to mass production, and working closely with target designers to make material selections that will satisfy a wide range of required and desirable characteristics. Targets produced for current inertial confinement fusion experiments are estimated to cost about $2500 each. Design studies of cost-effective power production from laser and heavy-ion driven IFE have found a cost requirement of about $0.25-0.30 each. While four orders of magnitude cost reduction may seem at first to be nearly impossible, there are many factors that suggest this is achievable. This paper summarizes the paradigm shifts in target fabrication methodologies that will be needed to economically supply targets and presents the results of ''nth-of-a-kind'' plant layouts and concepts for IFE power plant fueling. Our engineering studies estimate the cost of the target supply in a fusion economy, and show that costs are within the range of commercial feasibility for laser-driven and for heavy ion driven IFE

  17. Cost-effectiveness evaluation of alternatives in environmental impact statements

    International Nuclear Information System (INIS)

    Weiser, A.L.

    1977-01-01

    Although it has been Federal government officials who have been accused in courts of law with mismanagement with regard to the consideration of alternatives in the environmental impact statement, the responsibility for systematically considering all alternatives to a proposed project remains with project decisionmakers in the Federal, state, or local levels of government and in industry. By applying the techniques of system cost-effectiveness analysis to the assessment of alternatives, it is believed that management will be able to clearly demonstrate that the selection of the proposed approach was neither arbitrary nor capricious. A rational approach to the assessment of alternatives should aid in meeting the mandates of environmental legislation and EIS guidelines, and it should eliminate the merit of any plaintiff's charge of mismanagement with regard to management's consideration of alternatives. Even though many interfaces between the proposed system and the environment cannot as yet be objectively quantified, application of CE techniques will demonstrate that a rigorous exploration and objective evaluation has been applied to the consideration of alternatives with respect to project objectives, financial conditions, and adverse environmental impacts

  18. Cost effectiveness of in situ bioremediation at Savannah River

    International Nuclear Information System (INIS)

    Saaty, R.P.; Showalter, W.E.; Booth, S.R.

    1995-01-01

    In situ bioremediation (ISBR) is an innovative new remediation technology for the removal of chlorinated solvents from contaminated soils and groundwater. The principal contaminant at the Savannah River Integrated Demonstration is tricloroethylene (TCE) a volatile organic compound (VOC). A 384-day test run at Savannah River, sponsored by the US Department of Energy (DOE), Office of Technology Development (EM-50), furnished information about the performance and applications of ISBR. In situ bioremediation, as tested, is based on two distinct processes occurring simultaneously; the physical process of in situ air stripping and the biological process of bioremediation. Both processes have the potential to remediate some amount of contamination. A quantity of VOCs, directly measured from the extracted airstream, was removed from the test area by the physical process of air stripping. The biological process is difficult to examine. However, the results of several tests performed at the SRID and independent numerical modeling determined that the biological process remediated an additional 40% above the physical process. Given these data, the cost effectiveness of this new technology can be evaluated

  19. Cost effectiveness of risk-based closures at UST sites

    International Nuclear Information System (INIS)

    Scruton, K.M.; Baker, J.N.

    1995-01-01

    Risk-based closures have been achieved at Underground Storage Tank (UST) sites throughout the country for a major transportation company. The risk-based closures were cost-effective because a streamlined risk-based approach was used instead of the generic baseline risk assessment approach. USEPA has recently provided guidance encouraging the use of risk-based methodology for achieving closure at UST sites. The risk-based approach used in achieving the site closures involved an identification of potential human and ecological receptors and exposure pathways, and a comparison of maximum onsite chemical concentrations to applicable or relevant and appropriate requirements (ARARs). The ARARs used in the evaluation included Federal and/or State Maximum Contaminant Levels (MCLs) for groundwater and risk-based screening levels for soils. If the maximum concentrations were above the screening levels, a baseline risk assessment was recommended. In several instances, however, the risk-based approach resulted in a regulatory agency acceptance of a ''no further action'' alternative at UST sites which did not pose a significant threat to human health and the environment. The cost of the streamlined risk-based approach is approximately $3,500, while a baseline risk assessment for the same UST site could cost up to $10,000 or more. The use of the streamlined risk-based approach has proven to be successful for achieving a ''no further action'' outcome for the client at a reasonable cost

  20. Human reliability

    International Nuclear Information System (INIS)

    Bubb, H.

    1992-01-01

    This book resulted from the activity of Task Force 4.2 - 'Human Reliability'. This group was established on February 27th, 1986, at the plenary meeting of the Technical Reliability Committee of VDI, within the framework of the joint committee of VDI on industrial systems technology - GIS. It is composed of representatives of industry, representatives of research institutes, of technical control boards and universities, whose job it is to study how man fits into the technical side of the world of work and to optimize this interaction. In a total of 17 sessions, information from the part of ergonomy dealing with human reliability in using technical systems at work was exchanged, and different methods for its evaluation were examined and analyzed. The outcome of this work was systematized and compiled in this book. (orig.) [de

  1. Microelectronics Reliability

    Science.gov (United States)

    2017-01-17

    inverters  connected in a chain. ................................................. 5  Figure 3  Typical graph showing frequency versus square root of...developing an experimental  reliability estimating methodology that could both illuminate the  lifetime  reliability of advanced devices,  circuits and...or  FIT of the device. In other words an accurate estimate of the device  lifetime  was found and thus the  reliability  that  can  be  conveniently

  2. A method for improving reliability and relevance of LCA reviews: the case of life-cycle greenhouse gas emissions of tap and bottled water.

    Science.gov (United States)

    Fantin, Valentina; Scalbi, Simona; Ottaviano, Giuseppe; Masoni, Paolo

    2014-04-01

    The purpose of this study is to propose a method for harmonising Life Cycle Assessment (LCA) literature studies on the same product or on different products fulfilling the same function for a reliable and meaningful comparison of their life-cycle environmental impacts. The method is divided in six main steps which aim to rationalize and quicken the efforts needed to carry out the comparison. The steps include: 1) a clear definition of the goal and scope of the review; 2) critical review of the references; 3) identification of significant parameters that have to be harmonised; 4) harmonisation of the parameters; 5) statistical analysis to support the comparison; 6) results and discussion. This approach was then applied to the comparative analysis of the published LCA studies on tap and bottled water production, focussing on Global Warming Potential (GWP) results, with the aim to identify the environmental preferable alternative. A statistical analysis with Wilcoxon's test confirmed that the difference between harmonised GWP values of tap and bottled water was significant. The results obtained from the comparison of the harmonised mean GWP results showed that tap water always has the best environmental performance, even in case of high energy-consuming technologies for drinking water treatments. The strength of the method is that it enables both performing a deep analysis of the LCA literature and obtaining more consistent comparisons across the published LCAs. For these reasons, it can be a valuable tool which provides useful information for both practitioners and decision makers. Finally, its application to the case study allowed both to supply a description of systems variability and to evaluate the importance of several key parameters for tap and bottled water production. The comparative review of LCA studies, with the inclusion of a statistical decision test, can validate and strengthen the final statements of the comparison. Copyright © 2014 Elsevier B.V. All

  3. EU-Type Carbon Emissions Trade and the Distributional Impact of Overlapping Emissions Taxes

    OpenAIRE

    Thomas Eichner; Rüdiger Pethig

    2009-01-01

    The European Union fulfills its emissions reductions commitments by means of an emissions trading scheme covering some part of each member state’s economy and by national emissions control in the rest of their economies. The member states also levy energy/emissions taxes overlapping with the trading scheme. Restricting our focus on cost-effective policies, this paper investigates the distributive consequences of increasing the overlapping emissions tax that is uniform across countries. For ...

  4. Effectiveness and cost effectiveness of counselling in primary care.

    Science.gov (United States)

    Bower, P; Rowland, N; Mellor, C l; Heywood, P; Godfrey, C; Hardy, R

    2002-01-01

    Counsellors are prevalent in primary care settings. However, there are concerns about the clinical and cost-effectiveness of the treatments they provide, compared with alternatives such as usual care from the general practitioner, medication or other psychological therapies. To assess the effectiveness and cost effectiveness of counselling in primary care by reviewing cost and outcome data in randomised controlled trials, controlled clinical trials and controlled patient preference trials of counselling interventions in primary care, for patients with psychological and psychosocial problems considered suitable for counselling. The original search strategy included electronic searching of databases (including the CCDAN Register of RCTs and CCTs) along with handsearching of a specialist journal. Published and unpublished sources (clinical trials, books, dissertations, agency reports etc.) were searched, and their reference lists scanned to uncover further controlled trials. Contact was made with subject experts and CCDAN members in order to uncover further trials. For the updated review, searches were restricted to those databases judged to be high yield in the first version of the review: MEDLINE, EMBASE, PSYCLIT and CINAHL, the Cochrane Controlled Trials register and the CCDAN trials register. All controlled trials comparing counselling in primary care with other treatments for patients with psychological and psychosocial problems considered suitable for counselling. Trials completed before the end of June 2001 were included in the review. Data were extracted using a standardised data extraction sheet. The relevant data were entered into the Review Manager software. Trials were quality rated, using CCDAN criteria, to assess the extent to which their design and conduct were likely to have prevented systematic error. Continuous measures of outcome were combined using standardised mean differences. An overall effect size was calculated for each outcome with 95

  5. Breast cancer screening; cost-effective in practice?

    International Nuclear Information System (INIS)

    Koning, Harry J. de

    2000-01-01

    The main aim of national breast screening is a reduction in breast cancer mortality. The data on the reduction in breast cancer mortality from three (of the five) Swedish trials in particular gave rise to the expectation that the Dutch programme of 2-yearly screening for women aged 50-70 would produce a 16% reduction in the total population. In all likelihood, many of the years of life gained as a result of screening are enjoyed in good health. According to its critics the actual benefit that can be achieved from the national breast cancer screening programmes is overstated. Considerable benefits have recently been demonstrated in England and Wales. However, the fall was so considerable in such a relatively short space of time that screening (started in 1987) was thought to only have played a small part. As far as the Dutch screening programme is concerned it is still too early to reach any conclusions about a possible reduction in mortality. The first short-term results of the screening are favourable and as good as (or better than) expectations. In Swedish regions where mammographic screening was introduced, a 19% reduction in breast cancer mortality can be estimated at population level, and recently a 20% reduction was presented in the UK. In countries where women are expected to make appointments for screening themselves, the attendance figures are significantly lower and the quality of the process as a whole is sometimes poorer. The benefits of breast cancer screening need to be carefully balanced against the burden to women and to the health care system. Mass breast screening requires many resources and will be a costly service. Cost-effectiveness of a breast cancer screening programme can be estimated using a computer model. Published cost-effectiveness ratios may differ tremendously, but are often the result of different types of calculation, time periods considered, including or excluding downstream cost. The approach of simulation and estimation is here

  6. The Cost-Effectiveness of Treatment Modalities for Ureteral Stones

    Directory of Open Access Journals (Sweden)

    Justin Ji-Yuen Siu MD

    2016-10-01

    Full Text Available Additional intervention and medical treatment of complications may follow the primary treatment of a ureteral stone. We investigated the cost of the treatment of ureteral stone(s within 45 days after initial intervention by means of retrospective analysis of the National Health Insurance Research Database of Taiwan. All patients of ages ≥20 years diagnosed with ureteral stone(s( International Classification of Diseases, Ninth Revision, Clinical Modification/ICD-9-CM: 592.1 from January 2001 to December 2011 were enrolled. We included a comorbidity code only if the diagnosis appeared in at least 2 separate claims in a patient’s record. Treatment modalities (code included extracorporeal shock-wave lithotripsy (SWL; 98.51, ureteroscopic lithotripsy (URSL; 56.31, percutaneous nephrolithotripsy (PNL; 55.04, (open ureterolithotomy (56.20, and laparoscopy (ie, laparoscopic ureterolithotomy; 54.21. There were 28 513 patients with ureteral stones (13 848 men and 14 665 women in the randomized sample of 1 million patients. The mean cost was 526.4 ± 724.1 United States Dollar (USD. The costs of treatment were significantly increased in patients with comorbidities. The costs of treatment among each primary treatment modalities were 1212.2 ± 627.3, 1146.7 ± 816.8, 2507.4 ± 1333.5, 1533.3 ± 1137.1, 2566.4 ± 2594.3, and 209.8 ± 473.2 USD in the SWL, URSL, PNL, (open ureterolithotomy, laparoscopy (laparoscopic ureterolithotomy, and conservative treatment group, respectively. In conclusion, URSL was more cost-effective than SWL and PNL as a primary treatment modality for ureteral stone(s when the possible additional costs within 45 days after the initial operation were included in the calculation.

  7. Chemistry of cost effective water treatment programme in HWP (Manuguru)

    International Nuclear Information System (INIS)

    Mohapatra, C.; Laxmana Prasad, K.

    2008-01-01

    In order to develop a water treatment programme following points must be kept in mind: Effectiveness to achieve desired water quality objectives; Compliance with regulatory requirements; Cost minimization; Safety; Easy operation and protection to equipments. Heavy Water Plant (Manuguru) laboratory has developed treatment programs to treat raw water and cooling water which satisfy the above requirements and has been in use for last several years successfully without any problem. These treatment programs have been given to other plants in Heavy Water Board for implementation. This paper describes the chemistry of the treatment program and cost minimization achieved. Further these treatments have helped the plant in achieving ΦZero Discharge and indirectly reduced the production cost. The chemistry parameters are monitored regularly to ascertain the effectiveness of these treatments. The areas where significant benefits derived are raw water treatment using polyelectrolyte instead of inorganic coagulant (alum), change over of regenerant of cation exchangers from hydrochloric acid to sulfuric acid and development of in-house cooling water treatment formulation. The advantages and cost effectiveness of these treatments are discussed in detail. Further these treatments helped the plant in achieving Zero discharge and indirectly reduced production cost of heavy water. The dosage of 3 ppm of polyelectrolyte can replace 90 ppm alum at turbidity level of 300 NTU of raw water which has resulted in cost saving of Rs. 15 - 20 Lakhs in a year besides other advantages. The changeover of regenerant from HCl to H 2 SO 4 will result in cost saving of at least Rs. 1.4 Crore a year along with other advantages. The change over of proprietary formulation to in-house formulation in cooling water treatment has resulted a saving about Rs. 11 Lakhs a year. To achieve the above objectives in a sustainable way the performance results are being monitored (author)

  8. The cost-effectiveness of public postsecondary education subsidies.

    Science.gov (United States)

    Muennig, P; Fahs, M

    2001-02-01

    Although educational attainment is a well-recognized covariate of health status, it is rarely thought of as a tool to be used to improve health. Since fewer than 40% of U.S. citizens have a college degree, it may be possible for the government to improve the health status of the population by assuming a larger burden of the cost of postsecondary education. This paper examines the costs and health effects of a government subsidy for public postsecondary education institutions. All high school graduates in 1997 were included in a decision analysis model as a hypothetical cohort. Data from the U.S. Department of Education, the World Health Organization, and the National Center for Health Statistics were used as model inputs. Results. Relative to the present educational system, a federal subsidy for public and private colleges equal to the amount now paid by students for tuition and living expenses would save $6,176 and avert 0.0018 of a disability-adjusted life-year (DALY) per person annually if enrollment increased 5%. The overall savings among 1997 high school graduates would be $17.1 billion and 4,992 DALYs would be averted per year relative to the present educational system. If enrollment increased by just 3%, $3,743 would be saved and 0.0011 DALYs would be averted per person. An enrollment increase of 7% would lead to savings of $8,610 and 0.0025 DALYs would be averted per person relative to the present educational system. If the government were to offer a full subsidy for college tuition at public universities, both lives and money would be saved, so long as enrollment levels increased. Providing a free postsecondary education for students attending public schools may be more cost-effective than most health investments. Copyright 2001 American Health Foundation and Academic Press.

  9. Chromogenic media for urine cultures can be cost-effective

    Directory of Open Access Journals (Sweden)

    Matjaž J. Retelj

    2007-03-01

    Full Text Available Background: Chromogenic media for diagnostic urinary bacteriology have several advantages over traditional media, such as cysteine-lactose-electrolyte deficient (CLED medium. Chromogenic media allow for easier recognition of mixed growth, save time, reduce workload and provide higher detection rates. However, the cost of chromogenic media is significantly higher compared to CLED and performance of chromogenic media varies depending on the manufacturer. In the present study, performance, turn-around time and cost of Uriselect4 chromogenic medium was compared to CLED.Methods: For performance analysis, 351 midstream urine (MSU samples from September 2005 to December 2005 were directly plated in parallel on Uriselect4 and CLED agar using the calibrated loop technique. Isolates on Uriselect4 were presumptively identified according to the product insert. For cost-effectiveness analysis, we included 1,972 consecutive MSU samples from May 2005 to July 2006. We compared the cost of required materials as well as technologists’ or specialists’ time for each medium examined.Results: No significant differences were found between the isolation rates of urinary pathogens on the studied media. The procedure using chromogenic media for uropathogens is slightly cheaper than the procedure using CLED, considering the proportion of bacteriuria positive samples (50.5 % and the distribution of taxa among isolates (namely Escherichia coli with 59.6 % observed in our laboratory. At the current isolation proportion in MSU samples processed in our laboratory, the average time to reporting results could be decreased by 0.3 days.Conclusions: Use of chromogenic media for urine investigations offers multiple advantages without increasing costs compared to procedures using CLED.

  10. Cost-effectiveness of routine imaging of suspected appendicitis.

    Science.gov (United States)

    D'Souza, N; Marsden, M; Bottomley, S; Nagarajah, N; Scutt, F; Toh, S

    2018-01-01

    Introduction The misdiagnosis of appendicitis and consequent removal of a normal appendix occurs in one in five patients in the UK. On the contrary, in healthcare systems with routine cross-sectional imaging of suspected appendicitis, the negative appendicectomy rate is around 5%. If we could reduce the rate in the UK to similar numbers, would this be cost effective? This study aimed to calculate the financial impact of negative appendicectomy at the Queen Alexandra Hospital and to explore whether a policy of routine imaging of such patients could reduce hospital costs. Materials and methods We performed a retrospective analysis of all appendicectomies over a 1-year period at our institution. Data were extracted on outcomes including appendix histology, operative time and length of stay to calculate the negative appendicectomy rate and to analyse costs. Results A total of 531 patients over 5 years of age had an appendicectomy. The negative appendicectomy rate was 22% (115/531). The additional financial costs of negative appendicectomy to the hospital during this period were £270,861. Universal imaging of all patients with right iliac fossa pain that could result in a 5% negative appendicectomy rate would cost between £67,200 and £165,600 per year but could save £33,896 (magnetic resonance imaging), £105,896 (computed tomography) or £132,296 (ultrasound) depending on imaging modality used. Conclusions Negative appendicectomy is still too frequent and results in additional financial burden to the health service. Routine imaging of patients with suspected appendicitis would not only reduce the negative appendicectomy rate but could lead to cost savings and a better service for our patients.

  11. Cost-effective greenhouse gas reduction of various bioenergies

    International Nuclear Information System (INIS)

    Dressler, Daniela; Engelmann, Karsten; Boeswirth, Tobias

    2016-01-01

    The overriding long-term goal, which is to be worked on and supported by the ExpRessBio expert group, is to reduce greenhouse gas emissions (GHG emissions) in consideration of other important environmental impacts in Bavaria. For this purpose, energy and material flows of agricultural and forestry production of biomass for the provision of raw materials for energy conversion and material use are analysed. Based on these analyses, recommendations for the optimization of the mentioned production chains are worked out. At the same time, an economic and business assessment of the investigated process chains is to be carried out at different levels so that the most sustainable use of agricultural and forestry resources in Bavaria can be ensured. [de

  12. Cost-Effectiveness of Florbetapir-PET in Alzheimer's Disease: A Spanish Societal Perspective.

    Science.gov (United States)

    Hornberger, John; Michalopoulos, Steven; Dai, Minghan; Andrade, Paula; Dilla, Tatiana; Happich, Michael

    2015-06-01

    The rising prevalence of Alzheimer's disease (AD), and other diseases associated with dementia, imposes significant burden to various stakeholders who care for the elderly. Management of AD is complicated by multiple factors including disease-specific features which make it difficult to diagnose accurately during milder stages. Florbetapir F18 positron emission tomography (florbetapir-PET) is an approved imaging tool used to capture beta-amyloid neuritic plaque density in brains of cognitively impaired adults undergoing evaluation for AD and other causes of cognitive impairment. It has the potential to help improve healthcare outcomes as it may help clinicians identify patients with AD early so that treatments are initiated when most effective. Evaluate the potential long-term clinical and economic outcomes of adopting florbetapir-PET--adjunctive to standard clinical evaluation (SCE)--versus SCE alone in the diagnostic assessment of cognitively impaired patients with suspected AD. A decision analysis with a ten-year time horizon was developed in compliance with Good Research Practices and CHEERS guidelines. The target population was comprised of Spanish patients who were undergoing initial assessment for cognitive impairment (Mini-Mental State Examination [MMSE] score=20). Diagnostic accuracy, rate of cognitive decline, effect of drugs on cognition and dwelling status, economic burden (direct and indirect costs), and quality of life (QoL) were based on relevant clinical studies and published literature. Scenario analysis was applied to explore outcomes under different conditions, which included: (i) use of florbetapir-PET earlier in disease progression (MMSE score=22); and (ii) the addition of fluorodeoxyglucose (FDG)-PET to SCE. Adjunctive florbetapir-PET increased quality-adjusted life years (QALYs) by 0.008 years and increased costs by 36 compared to SCE alone (incremental cost-effectiveness ratio [ICER], 4,769). Use of florbetapir-PET was dominant in alternate

  13. Cost effectiveness of GHG mitigation options and policy implication

    Energy Technology Data Exchange (ETDEWEB)

    Lim, K. S. [Korea Institute for Industrial Economics and Trade, Seoul (Korea, Republic of)

    1998-04-01

    This paper represents the summary findings and conclusions of several studies implemented about microeconomics and macroeconomics marginal costs of GHG abatement policies. Financial, economic, and, where possible, environmental microeconomics costs of reducing GHGs are estimated by a World Bank team. Six energy-related CO{sub 2} mitigation policy options are applied to estimate the macroeconomics costs of GHG emission reduction, the macroeconomics impacts on the Chinese economy. In terms of policy, conservation is a better option to cope with a restrictive mitigation constraint, assuming a developing country can achieve planned energy-saving targets. Without a CO{sub 2} emission constraint or with less restrictive CO{sub 2} emission constraints, however, the simulation results indicate that a conservation strategy may be less attractive than fuel substitution in a developing country, mainly due to the economic dampening effect of reduced production in the energy sectors. This finding suggests that an often-cited costless or negative-cost energy conservation policy may not be a better option when a less restrictive mitigation target is in force. This does not mean that the potential for energy efficiency improvements in a developing country is not worthwhile, but that the overall macroeconomics impacts should be considered before implementing the policy option. (author). 9 refs., 3 figs., 3 tabs.

  14. Nitrous Oxide Abatement Coupled with Biopolymer Production As a Model GHG Biorefinery for Cost-Effective Climate Change Mitigation.

    Science.gov (United States)

    Frutos, Osvaldo D; Cortes, Irene; Cantera, Sara; Arnaiz, Esther; Lebrero, Raquel; Muñoz, Raúl

    2017-06-06

    N 2 O represents ∼6% of the global greenhouse gas emission inventory and the most important O 3 -depleting substance emitted in this 21st century. Despite its environmental relevance, little attention has been given to cost-effective and environmentally friendly N 2 O abatement methods. Here we examined, the potential of a bubble column (BCR) and an internal loop airlift (ALR) bioreactors of 2.3 L for the abatement of N 2 O from a nitric acid plant emission. The process was based on the biological reduction of N 2 O by Paracoccus denitrificans using methanol as a carbon/electron source. Two nitrogen limiting strategies were also tested for the coproduction of poly(3-hydroxybutyrate-co-3-hydroxyvalerate) (PHBV) coupled with N 2 O reduction. High N 2 O removal efficiencies (REs) (≈87%) together with a low PHBV cell accumulation were observed in both bioreactors in excess of nitrogen. However, PHBV contents of 38-64% were recorded under N limiting conditions along with N 2 O-REs of ≈57% and ≈84% in the ALR and BCR, respectively. Fluorescence in situ hybridization analyses showed that P. denitrificans was dominant (>50%) after 6 months of experimentation. The successful abatement of N 2 O concomitant with PHBV accumulation confirmed the potential of integrating biorefinery concepts into biological gas treatment for a cost-effective GHG mitigation.

  15. Carbon emissions performance of commercial logging in East Kalimantan, Indonesia.

    Science.gov (United States)

    Griscom, Bronson; Ellis, Peter; Putz, Francis E

    2014-03-01

    Adoption of reduced-impact logging (RIL) methods could reduce CO2 emissions by 30-50% across at least 20% of remaining tropical forests. We developed two cost effective and robust indices for comparing the climate benefits (reduced CO2 emissions) due to RIL. The indices correct for variability in the volume of commercial timber among concessions. We determined that a correction for variability in terrain slope was not needed. We found that concessions certified by the Forest Stewardship Council (FSC, N = 3), when compared with noncertified concessions (N = 6), did not have lower overall CO2 emissions from logging activity (felling, skidding, and hauling). On the other hand, FSC certified concessions did have lower emissions from one type of logging impact (skidding), and we found evidence of a range of improved practices using other field metrics. One explanation of these results may be that FSC criteria and indicators, and associated RIL practices, were not designed to achieve overall emissions reductions. Also, commonly used field metrics are not reliable proxies for overall logging emissions performance. Furthermore, the simple distinction between certified and noncertified concessions does not fully represent the complex history of investments in improved logging practices. To clarify the relationship between RIL and emissions reductions, we propose the more explicit term 'RIL-C' to refer to the subset of RIL practices that can be defined by quantified thresholds and that result in measurable emissions reductions. If tropical forest certification is to be linked with CO2 emissions reductions, certification standards need to explicitly require RIL-C practices. © 2013 John Wiley & Sons Ltd.

  16. Cost-Effectiveness of Old and New Technologies for Aneuploidy Screening.

    Science.gov (United States)

    Sinkey, Rachel G; Odibo, Anthony O

    2016-06-01

    Cost-effectiveness analyses allow assessment of whether marginal gains from new technology are worth increased costs. Several studies have examined cost-effectiveness of Down syndrome (DS) screening and found it to be cost-effective. Noninvasive prenatal screening also appears to be cost-effective among high-risk women with respect to DS screening, but not for the general population. Chromosomal microarray (CMA) is a genetic sequencing method superior to but more expensive than karyotype. In light of CMAs greater ability to detect genetic abnormalities, it is cost-effective when used for prenatal diagnosis of an anomalous fetus. This article covers methodology and salient issues of cost-effectiveness. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Redefining reliability

    International Nuclear Information System (INIS)

    Paulson, S.L.

    1995-01-01

    Want to buy some reliability? The question would have been unthinkable in some markets served by the natural gas business even a few years ago, but in the new gas marketplace, industrial, commercial and even some residential customers have the opportunity to choose from among an array of options about the kind of natural gas service they need--and are willing to pay for. The complexities of this brave new world of restructuring and competition have sent the industry scrambling to find ways to educate and inform its customers about the increased responsibility they will have in determining the level of gas reliability they choose. This article discusses the new options and the new responsibilities of customers, the needed for continuous education, and MidAmerican Energy Company's experiment in direct marketing of natural gas

  18. Probabilistic Risk Assessment (PRA): A Practical and Cost Effective Approach

    Science.gov (United States)

    Lee, Lydia L.; Ingegneri, Antonino J.; Djam, Melody

    2006-01-01

    The Lunar Reconnaissance Orbiter (LRO) is the first mission of the Robotic Lunar Exploration Program (RLEP), a space exploration venture to the Moon, Mars and beyond. The LRO mission includes spacecraft developed by NASA Goddard Space Flight Center (GSFC) and seven instruments built by GSFC, Russia, and contractors across the nation. LRO is defined as a measurement mission, not a science mission. It emphasizes the overall objectives of obtaining data to facilitate returning mankind safely to the Moon in preparation for an eventual manned mission to Mars. As the first mission in response to the President's commitment of the journey of exploring the solar system and beyond: returning to the Moon in the next decade, then venturing further into the solar system, ultimately sending humans to Mars and beyond, LRO has high-visibility to the public but limited resources and a tight schedule. This paper demonstrates how NASA's Lunar Reconnaissance Orbiter Mission project office incorporated reliability analyses in assessing risks and performing design tradeoffs to ensure mission success. Risk assessment is performed using NASA Procedural Requirements (NPR) 8705.5 - Probabilistic Risk Assessment (PRA) Procedures for NASA Programs and Projects to formulate probabilistic risk assessment (PRA). As required, a limited scope PRA is being performed for the LRO project. The PRA is used to optimize the mission design within mandated budget, manpower, and schedule constraints. The technique that LRO project office uses to perform PRA relies on the application of a component failure database to quantify the potential mission success risks. To ensure mission success in an efficient manner, low cost and tight schedule, the traditional reliability analyses, such as reliability predictions, Failure Modes and Effects Analysis (FMEA), and Fault Tree Analysis (FTA), are used to perform PRA for the large system of LRO with more than 14,000 piece parts and over 120 purchased or contractor

  19. a Cost-Effective Method for Crack Detection and Measurement on Concrete Surface

    Science.gov (United States)

    Sarker, M. M.; Ali, T. A.; Abdelfatah, A.; Yehia, S.; Elaksher, A.

    2017-11-01

    Crack detection and measurement in the surface of concrete structures is currently carried out manually or through Non-Destructive Testing (NDT) such as imaging or scanning. The recent developments in depth (stereo) cameras have presented an opportunity for cost-effective, reliable crack detection and measurement. This study aimed at evaluating the feasibility of the new inexpensive depth camera (ZED) for crack detection and measurement. This depth camera with its lightweight and portable nature produces a 3D data file of the imaged surface. The ZED camera was utilized to image a concrete surface and the 3D file was processed to detect and analyse cracks. This article describes the outcome of the experiment carried out with the ZED camera as well as the processing tools used for crack detection and analysis. Crack properties that were also of interest were length, orientation, and width. The use of the ZED camera allowed for distinction between surface and concrete cracks. The ZED high-resolution capability and point cloud capture technology helped in generating a dense 3D data in low-lighting conditions. The results showed the ability of the ZED camera to capture the crack depth changes between surface (render) cracks, and crack that form in the concrete itself.

  20. A COST-EFFECTIVE METHOD FOR CRACK DETECTION AND MEASUREMENT ON CONCRETE SURFACE

    Directory of Open Access Journals (Sweden)

    M. M. Sarker

    2017-11-01

    Full Text Available Crack detection and measurement in the surface of concrete structures is currently carried out manually or through Non-Destructive Testing (NDT such as imaging or scanning. The recent developments in depth (stereo cameras have presented an opportunity for cost-effective, reliable crack detection and measurement. This study aimed at evaluating the feasibility of the new inexpensive depth camera (ZED for crack detection and measurement. This depth camera with its lightweight and portable nature produces a 3D data file of the imaged surface. The ZED camera was utilized to image a concrete surface and the 3D file was processed to detect and analyse cracks. This article describes the outcome of the experiment carried out with the ZED camera as well as the processing tools used for crack detection and analysis. Crack properties that were also of interest were length, orientation, and width. The use of the ZED camera allowed for distinction between surface and concrete cracks. The ZED high-resolution capability and point cloud capture technology helped in generating a dense 3D data in low-lighting conditions. The results showed the ability of the ZED camera to capture the crack depth changes between surface (render cracks, and crack that form in the concrete itself.

  1. A Cost Effective Multi-Spectral Scanner for Natural Gas Detection

    Energy Technology Data Exchange (ETDEWEB)

    Yudaya Sivathanu; Jongmook Lim; Vinoo Narayanan; Seonghyeon Park

    2005-12-07

    The objective of this project is to design, fabricate and demonstrate a cost effective, multi-spectral scanner for natural gas leak detection in transmission and distribution pipelines. During the first year of the project, a laboratory version of the multi-spectral scanner was designed, fabricated, and tested at EnUrga Inc. The multi-spectral scanner was also evaluated using a blind Department of Energy study at the Rocky Mountain Oilfield Testing Center. The performance of the scanner was inconsistent during the blind study. However, most of the leaks were outside the view of the multi-spectral scanner that was developed during the first year of the project. Therefore, a definite evaluation of the capability of the scanner was not obtained. Despite the results, sufficient number of plumes was detected fully confirming the feasibility of the multi-spectral scanner. During the second year, the optical design of the scanner was changed to improve the sensitivity of the system. Laboratory tests show that the system can reliably detect small leaks (20 SCFH) at 30 to 50 feet. A prototype scanner was built and evaluated during the second year of the project. Only laboratory evaluations were completed during the second year. The laboratory evaluations show the feasibility of using the scanner to determine natural gas pipeline leaks. Further field evaluations and optimization of the scanner are required before commercialization of the scanner can be initiated.

  2. Development of cost-effective Nb3Sn conductors for the next generation hadron colliders

    International Nuclear Information System (INIS)

    Scanlan, R.M.; Dietderich, D.R.; Zeitlin, B.A.

    2001-01-01

    Significant progress has been made in demonstrating that reliable, efficient high field dipole magnets can be made with Nb 3 Sn superconductors. A key factor in determining whether these magnets will be a cost-effective solution for the next generation hadron collider is the conductor cost. Consequently, DOE initiated a conductor development program to demonstrate that Nb 3 Sn can be improved to reach a cost/performance value of $1.50/kA-m at 12T, 4.2K. The first phase of this program was initiated in Jan 2000, with the goal of improving the key properties of interest for accelerator dipole magnets--high critical current density and low magnetization. New world record critical current densities have been reported recently, and it appears that significant potential exists for further improvement. Although new techniques for compensating for magnetization effects have reduced the requirements somewhat, techniques for lowering the effective filament size while maintaining these high Jc values are a program priority. The next phase of this program is focused on reducing the conductor cost through substitution of lower cost raw materials and through process improvements. The cost drivers for materials and fabrication have been identified, and projects are being initiated to demonstrate cost reductions

  3. Accounting for Cured Patients in Cost-Effectiveness Analysis.

    Science.gov (United States)

    Othus, Megan; Bansal, Aasthaa; Koepl, Lisel; Wagner, Samuel; Ramsey, Scott

    2017-04-01

    Economic evaluations often measure an intervention effect with mean overall survival (OS). Emerging types of cancer treatments offer the possibility of being "cured" in that patients can become long-term survivors whose risk of death is the same as that of a disease-free person. Describing cured and noncured patients with one shared mean value may provide a biased assessment of a therapy with a cured proportion. The purpose of this article is to explain how to incorporate the heterogeneity from cured patients into health economic evaluation. We analyzed clinical trial data from patients with advanced melanoma treated with ipilimumab (Ipi; n = 137) versus glycoprotein 100 (gp100; n = 136) with statistical methodology for mixture cure models. Both cured and noncured patients were subject to background mortality not related to cancer. When ignoring cured proportions, we found that patients treated with Ipi had an estimated mean OS that was 8 months longer than that of patients treated with gp100. Cure model analysis showed that the cured proportion drove this difference, with 21% cured on Ipi versus 6% cured on gp100. The mean OS among the noncured cohort patients was 10 and 9 months with Ipi and gp100, respectively. The mean OS among cured patients was 26 years on both arms. When ignoring cured proportions, we found that the incremental cost-effectiveness ratio (ICER) when comparing Ipi with gp100 was $324,000/quality-adjusted life-year (QALY) (95% confidence interval $254,000-$600,000). With a mixture cure model, the ICER when comparing Ipi with gp100 was $113,000/QALY (95% confidence interval $101,000-$154,000). This analysis supports using cure modeling in health economic evaluation in advanced melanoma. When a proportion of patients may be long-term survivors, using cure models may reduce bias in OS estimates and provide more accurate estimates of health economic measures, including QALYs and ICERs. Copyright © 2017 International Society for Pharmacoeconomics

  4. Cost-effectiveness analysis of algae energy production in the EU

    International Nuclear Information System (INIS)

    Kovacevic, Vujadin; Wesseler, Justus

    2010-01-01

    Today's society relies heavily on fossil fuels as a main energy source. Global energy demand increase, energy security and climate change are the main drivers of the transition towards alternative energy sources. This paper analyses algal biodiesel production for the EU road transportation and compares it to the fossil fuels and 1st generation biofuels. A cost-effectiveness analysis was used to aggregate private and external costs and derive the social cost of each fuel. The following externalities were internalized: emissions (GHG and non-GHG), food prices impact, pesticides/fertilizers use and security of supply. Currently the social cost of producing algal biodiesel at 52.3 EUR GJ -1 is higher than rapeseed biodiesel (36.0 EUR GJ -1 ) and fossil fuels (15.8 EUR GJ -1 ). Biotechnology development, high crude oil prices and high carbon value are the key features of the scenario where algal biodiesel outcompetes all other fuels. A substantial investment into the biotechnology sector and comprehensive environmental research and policy are required to make that scenario a reality. (author)

  5. Preoperative staging of lung cancer with PET/CT: cost-effectiveness evaluation alongside a randomized controlled trial

    International Nuclear Information System (INIS)

    Soegaard, Rikke; Fischer, Barbara Malene B.; Mortensen, Jann; Hoejgaard, Liselotte; Lassen, Ulrik

    2011-01-01

    Positron emission tomography (PET)/CT has become a widely used technology for preoperative staging of non-small cell lung cancer (NSCLC). Two recent randomized controlled trials (RCT) have established its efficacy over conventional staging, but no studies have assessed its cost-effectiveness. The objective of this study was to assess the cost-effectiveness of PET/CT as an adjunct to conventional workup for preoperative staging of NSCLC. The study was conducted alongside an RCT in which 189 patients were allocated to conventional staging (n = 91) or conventional staging + PET/CT (n = 98) and followed for 1 year after which the numbers of futile thoracotomies in each group were monitored. A full health care sector perspective was adapted for costing resource use. The outcome parameter was defined as the number needed to treat (NNT) - here number of PET/CT scans needed - to avoid one futile thoracotomy. All monetary estimates were inflated to 2010 EUR. The incremental cost of the PET/CT-based regimen was estimated at 3,927 EUR [95% confidence interval (CI) -3,331; 10,586] and the NNT at 4.92 (95% CI 3.00; 13.62). These resulted in an average incremental cost-effectiveness ratio of 19,314 EUR, which would be cost-effective at a probability of 0.90 given a willingness to pay of 50,000 EUR per avoided futile thoracotomy. When costs of comorbidity-related hospital services were excluded, the PET/CT regimen appeared dominant. Applying a full health care sector perspective, the cost-effectiveness of PET/CT for staging NSCLC seems to depend on the willingness to pay in order to avoid a futile thoracotomy. However, given that four outliers in terms of extreme comorbidity were all randomized to the PET/CT arm, there is uncertainty about the conclusion. When hospital costs of comorbidity were excluded, the PET/CT regimen was found to be both more accurate and cost saving. (orig.)

  6. Reliability metrics extraction for power electronics converter stressed by thermal cycles

    DEFF Research Database (Denmark)

    Ma, Ke; Choi, Uimin; Blaabjerg, Frede

    2017-01-01

    Due to the continuous demands for highly reliable and cost-effective power conversion, the quantified reliability performances of the power electronics converter are becoming emerging needs. The existing reliability modelling approaches for the power electronics converter mainly focuses on the pr...... performance of power electronics system. The final predicted results showed good accuracy with much more reliability information compared to the existing approaches, and the quantified reliability correlation to the mission profiles of converter is mathematically established....

  7. An Analysis of Failure Handling in Chameleon, A Framework for Supporting Cost-Effective Fault Tolerant Services

    Science.gov (United States)

    Haakensen, Erik Edward

    1998-01-01

    The desire for low-cost reliable computing is increasing. Most current fault tolerant computing solutions are not very flexible, i.e., they cannot adapt to reliability requirements of newly emerging applications in business, commerce, and manufacturing. It is important that users have a flexible, reliable platform to support both critical and noncritical applications. Chameleon, under development at the Center for Reliable and High-Performance Computing at the University of Illinois, is a software framework. for supporting cost-effective adaptable networked fault tolerant service. This thesis details a simulation of fault injection, detection, and recovery in Chameleon. The simulation was written in C++ using the DEPEND simulation library. The results obtained from the simulation included the amount of overhead incurred by the fault detection and recovery mechanisms supported by Chameleon. In addition, information about fault scenarios from which Chameleon cannot recover was gained. The results of the simulation showed that both critical and noncritical applications can be executed in the Chameleon environment with a fairly small amount of overhead. No single point of failure from which Chameleon could not recover was found. Chameleon was also found to be capable of recovering from several multiple failure scenarios.

  8. Cost-effectiveness analysis of diarrhoea management approaches in Nigeria: A decision analytical model.

    Directory of Open Access Journals (Sweden)

    Charles E Okafor

    2017-12-01

    Full Text Available Diarrhoea is a leading cause of death in Nigerian children under 5 years. Implementing the most cost-effective approach to diarrhoea management in Nigeria will help optimize health care resources allocation. This study evaluated the cost-effectiveness of various approaches to diarrhoea management namely: the 'no treatment' approach (NT; the preventive approach with rotavirus vaccine; the integrated management of childhood illness for diarrhoea approach (IMCI; and rotavirus vaccine plus integrated management of childhood illness for diarrhoea approach (rotavirus vaccine + IMCI.Markov cohort model conducted from the payer's perspective was used to calculate the cost-effectiveness of the four interventions. The markov model simulated a life cycle of 260 weeks for 33 million children under five years at risk of having diarrhoea (well state. Disability adjusted life years (DALYs averted was used to quantify clinical outcome. Incremental cost-effectiveness ratio (ICER served as measure of cost-effectiveness.Based on cost-effectiveness threshold of $2,177.99 (i.e. representing Nigerian GDP/capita, all the approaches were very cost-effective but rotavirus vaccine approach was dominated. While IMCI has the lowest ICER of $4.6/DALY averted, the addition of rotavirus vaccine was cost-effective with an ICER of $80.1/DALY averted. Rotavirus vaccine alone was less efficient in optimizing health care resource allocation.Rotavirus vaccine + IMCI approach was the most cost-effective approach to childhood diarrhoea management. Its awareness and practice should be promoted in Nigeria. Addition of rotavirus vaccine should be considered for inclusion in the national programme of immunization. Although our findings suggest that addition of rotavirus vaccine to IMCI for diarrhoea is cost-effective, there may be need for further vaccine demonstration studies or real life studies to establish the cost-effectiveness of the vaccine in Nigeria.

  9. Technology strategy for cost-effective drilling and intervention; Technology Target Areas; TTA4 - Cost effective drilling and intervention

    Energy Technology Data Exchange (ETDEWEB)

    2007-07-01

    The main goals of the OG21 initiative are to (1) develop new technology and knowledge to increase the value creation of Norwegian oil and gas resources and (2) enhance the export of Norwegian oil and gas technology. The OG21 Cost-effective Drilling and Intervention (CEDI) Technology Target Area (TTA) has identified some key strategic drilling and well intervention needs to help meet the goals of OG21. These key strategic drilling and well intervention needs are based on a review of present and anticipated future offshore-Norway drilling and well intervention conditions and the Norwegian drilling and well intervention industry. A gap analysis has been performed to assess the extent to which current drilling and well intervention research and development and other activities will meet the key strategic needs. Based on the identified strategic drilling and well intervention needs and the current industry res each and development and other activities, the most important technology areas for meeting the OG21 goals are: environment-friendly and low-cost exploration wells; low-cost methods for well intervention/sidetracks; faster and extended-reach drilling; deep water drilling, completion and intervention; offshore automated drilling; subsea and sub-ice drilling; drilling through basalt and tight carbonates; drilling and completion in salt formation. More specific goals for each area: reduce cost of exploration wells by 50%; reduce cost for well intervention/sidetracks by 50%; increase drilling efficiency by 40%; reduce drilling cost in deep water by 40 %; enable offshore automated drilling before 2012; enable automated drilling from seabed in 2020. Particular focus should be placed on developing new technology for low-cost exploration wells to stem the downward trends in the number of exploration wells drilled and the volume of discovered resources. The CEDI TTA has the following additional recommendations: The perceived gaps in addressing the key strategic drilling and

  10. Good practices for cost effective maintenance of nuclear power plants

    International Nuclear Information System (INIS)

    1997-02-01

    This publication is organized around five areas that were identified by the utilities and government organizations who contributed to this report as most important to them. They are: Increasing production through maintenance activities related to improved plant material condition, reduced duration of planned outages, use of on-line maintenance and reduced frequency of forced outages; reducing workload through avoiding unnecessary regulatory burden and using reliability centered maintenance and condition monitoring; improving maintenance processes through better planning and scheduling, use of information management systems, graduated work controls, and appropriate post-maintenance testing; improving productivity through better teamwork, greater sharing of resources, and better radiation management associated with maintenance; measuring performance of maintenance activities through such tools as performance measures and benchmarking. Figs, tabs

  11. International lessons in new methods for grading and integrating cost effectiveness evidence into clinical practice guidelines.

    Science.gov (United States)

    Antioch, Kathryn M; Drummond, Michael F; Niessen, Louis W; Vondeling, Hindrik

    2017-01-01

    Economic evidence is influential in health technology assessment world-wide. Clinical Practice Guidelines (CPG) can enable economists to include economic information on health care provision. Application of economic evidence in CPGs, and its integration into clinical practice and national decision making is hampered by objections from professions, paucity of economic evidence or lack of policy commitment. The use of state-of-art economic methodologies will improve this. Economic evidence can be graded by 'checklists' to establish the best evidence for decision making given methodological rigor. New economic evaluation checklists, Multi-Criteria Decision Analyses (MCDA) and other decision criteria enable health economists to impact on decision making world-wide. We analyse the methodologies for integrating economic evidence into CPG agencies globally, including the Agency of Health Research and Quality (AHRQ) in the USA, National Health and Medical Research Council (NHMRC) and Australian political reforms. The Guidelines and Economists Network International (GENI) Board members from Australia, UK, Canada and Denmark presented the findings at the conference of the International Health Economists Association (IHEA) and we report conclusions and developments since. The Consolidated Guidelines for the Reporting of Economic Evaluations (CHEERS) 24 item check list can be used by AHRQ, NHMRC, other CPG and health organisations, in conjunction with the Drummond ten-point check list and a questionnaire that scores that checklist for grading studies, when assessing economic evidence. Cost-effectiveness Analysis (CEA) thresholds, opportunity cost and willingness-to-pay (WTP) are crucial issues for decision rules in CEA generally, including end-of-life therapies. Limitations of inter-rater reliability in checklists can be addressed by including more than one assessor to reach a consensus, especially when impacting on treatment decisions. We identify priority areas to generate

  12. On the potential cost effectiveness of scientific audits.

    Science.gov (United States)

    Click, J L

    1989-09-01

    inefficient process for uncovering scientific fraud (5, 6, 9). Data from a survey of university scientists was also presented, indicating ". . . a reluctance to take prompt, corrective action not only when an investigator suspects another of misconduct but also should the investigator discover flaws in his or her own published reports-whether the flaws were the result of honest error or fraud"; (10). The uncritical acceptance by established scientists that the self-correcting process works compounds the problem. The Editor of Science has written that";. . . 99.9999 percent of reports are accurate and truthful. . ."; (8). If indeed only 0.0001% of published reports were inaccurate or untruthful, there would be little justification for scientific audits. However, congressional testimony from the National Institutes of Health (NIH) revealed that";. . . the NIH Director's office has handled an average of 15-20 allegations and reports of misconduct annually in its extramural programs, which supports the work of approximately 50,000 scientists"; (11). As I shall attempt to demonstrate, since NIH alone receives fraud-related complaints concerning the work of at least 0.03% of scientists it supports in other institutions, and since evidence indicates that the incidence of fraud is considerably greater than 0.03% (10, 12), the need to audit data is justifiable on the basis of being cost effective.

  13. Reliability engineering for nuclear and other high technology systems

    International Nuclear Information System (INIS)

    Lakner, A.A.; Anderson, R.T.

    1985-01-01

    This book is written for the reliability instructor, program manager, system engineer, design engineer, reliability engineer, nuclear regulator, probability risk assessment (PRA) analyst, general manager and others who are involved in system hardware acquisition, design and operation and are concerned with plant safety and operational cost-effectiveness. It provides criteria, guidelines and comprehensive engineering data affecting reliability; it covers the key aspects of system reliability as it relates to conceptual planning, cost tradeoff decisions, specification, contractor selection, design, test and plant acceptance and operation. It treats reliability as an integrated methodology, explicitly describing life cycle management techniques as well as the basic elements of a total hardware development program, including: reliability parameters and design improvement attributes, reliability testing, reliability engineering and control. It describes how these elements can be defined during procurement, and implemented during design and development to yield reliable equipment. (author)

  14. The clinician's guide to diagnostic imaging: Cost effective pathways

    International Nuclear Information System (INIS)

    Grossman, Z.D.; Chew, F.S.; Ellis, D.A.; Brigham, S.C.

    1987-01-01

    This book presents logical, step-by-step imaging sequences for 47 medical, surgical, and pediatric problems. Topics considered include breast cancer screening, acute spinal trauma, search for primary cancer of unknown origin, acute anuria, blunt chest trauma, new onset seizures, and spinal cord compression from metastases. Other chapters have been rewritten to enhance the clarity of presentation and to incorporate new techniques such as magnetic resonance imaging, dipyridamole stress testing, and single photon emission computed tomography. The book highlights the expanding role of CT in evaluation of thoracic and abdominal problems, the emergence of magnetic resonance imaging as a vital diagnostic tool for the central nervous system, and the clinical utility of many newly developed radiopharmaceuticals

  15. Wind power: cost effective generation for the 1990s

    Energy Technology Data Exchange (ETDEWEB)

    Pedersen, T [Vestas Wind Systems A/S (Denmark)

    1989-01-01

    Wind power plants have been installed all over the world, notably in California and Denmark. Commercially available wind turbines today are rated from 50 KW to 1 MW with emphasis on the 1 MW range. As the fuel is ''free'' generating costs are identical to the capital, operation and maintenance costs of the plant. An estimate of the unit price of wind power generated electricity in Denmark is comparable to that generated by a coal fired plant. The main environmental impacts of a wind farm are considered. These are visual impact, noise emission, use of (agricultural) space and the impact on wildlife, mainly birds. Finally the installation of a wind farm and its connection to the grid are described. (3 figures, 1 table). (UK)

  16. Cost-effective and compact wide-field fluorescent imaging on a cell-phone.

    Science.gov (United States)

    Zhu, Hongying; Yaglidere, Oguzhan; Su, Ting-Wei; Tseng, Derek; Ozcan, Aydogan

    2011-01-21

    We demonstrate wide-field fluorescent and darkfield imaging on a cell-phone with compact, light-weight and cost-effective optical components that are mechanically attached to the existing camera unit of the cell-phone. For this purpose, we used battery powered light-emitting diodes (LEDs) to pump the sample of interest from the side using butt-coupling, where the pump light was guided within the sample cuvette to uniformly excite the specimen. The fluorescent emission from the sample was then imaged using an additional lens that was positioned right in front of the existing lens of the cell-phone camera. Because the excitation occurs through guided waves that propagate perpendicular to our detection path, an inexpensive plastic colour filter was sufficient to create the dark-field background required for fluorescent imaging, without the need for a thin-film interference filter. We validate the performance of this platform by imaging various fluorescent micro-objects in 2 colours (i.e., red and green) over a large field-of-view (FOV) of ∼81 mm(2) with a raw spatial resolution of ∼20 μm. With additional digital processing of the captured cell-phone images, through the use of compressive sampling theory, we demonstrate ∼2 fold improvement in our resolving power, achieving ∼10 μm resolution without a trade-off in our FOV. Further, we also demonstrate darkfield imaging of non-fluorescent specimen using the same interface, where this time the scattered light from the objects is detected without the use of any filters. The capability of imaging a wide FOV would be exceedingly important to probe large sample volumes (e.g., >0.1 mL) of e.g., blood, urine, sputum or water, and for this end we also demonstrate fluorescent imaging of labeled white-blood cells from whole blood samples, as well as water-borne pathogenic protozoan parasites such as Giardia Lamblia cysts. Weighing only ∼28 g (∼1 ounce), this compact and cost-effective fluorescent imaging platform

  17. Cost-effectiveness of newborn screening for cystic fibrosis determined with real-life data

    NARCIS (Netherlands)

    van der Ploeg, C. P B; van den Akker-van Marle, M. E.; Vernooij-van Langen, A. M M; Elvers, L. H.; Gille, J. J P; Verkerk, P. H.; Dankert-Roelse, J. E.; Dankert-Roelse, J. E.; Vernooij-van Langen, A. M M; Loeber, J. G.; Elvers, L. H.; Triepels, R. H.; Gille, J. J P; Van der Ploeg, C. P B; van der Pal, S. M.; Dompeling, E.; Pals, G.; van den Akker van Marle, M. E.; Gulmans, V. A M; Oey-Spauwen, M. J W; Wijnands, Y. H H M; Castricum, L. M.; Arets, H. G M; van der Ent, C. K.; Tiddens, H. A W M; de Rijke, Y. B.; Yntema, J. B.

    2015-01-01

    Background: Previous cost-effectiveness studies using data from the literature showed that newborn screening for cystic fibrosis (NBSCF) is a good economic option with positive health effects and longer survival. Methods: We used primary data to compare cost-effectiveness of four screening

  18. Limitations of acceptability curves for presenting uncertainty in cost-effectiveness analysis

    NARCIS (Netherlands)

    Groot Koerkamp, Bas; Hunink, M. G. Myriam; Stijnen, Theo; Hammitt, James K.; Kuntz, Karen M.; Weinstein, Milton C.

    2007-01-01

    Clinical journals increasingly illustrate uncertainty about the cost and effect of health care interventions using cost-effectiveness acceptability curves (CEACs). CEACs present the probability that each competing alternative is optimal for a range of values of the cost-effectiveness threshold. The

  19. Identifying potentially cost effective chronic care programs for people with COPD

    NARCIS (Netherlands)

    L.M.G. Steuten (Lotte); K.M.M. Lemmens (Karin); A.P. Nieboer (Anna); H.J.M. Vrijhoef (Hubertus)

    2009-01-01

    textabstractObjective: To review published evidence regarding the cost effectiveness of multi-component COPD programs and to illustrate how potentially cost effective programs can be identified. Methods: Systematic search of Medline and Cochrane databases for evaluations of multicomponent disease

  20. Cost-Effectiveness of Management Training in the Informal Sector. Discussion Paper No. 101.

    Science.gov (United States)

    Nubler, Irmgard

    A research project in the Ivory Coast, Kenya, and Tanzania evaluated the cost effectiveness of management training seminars for women entrepreneurs in the informal sector. Women, a large and growing part of entrepreneurs, had less access to needed resources, skills, and information than men. Reasons for failure to study the cost effectiveness and…

  1. Cost-effectiveness of salpingotomy and salpingectomy in women with tubal pregnancy (a randomized controlled trial)

    NARCIS (Netherlands)

    Broekmans, FJM; Mol, F.; Mello, N.M.; Strandell, Annika; Strandell, Karin; Jurkovic, Davor; Ross, Jackie; Barnhart, K.; Yalcinkaya, Tamer; Verhoeve, H.R.; Graziosi, G.C.M.; Koks, Carolien A M; Klinte, Ingmar; Hogstrom, Lars; Janssen, Ineke; Kragt, Harry; Hoek, Annemieke; Trimbos-Kemper, Trudy; Willemsen, Wim; Ankum, W.M.; Mol, Benwillem; Wely, M.; van der Veen, Fulco; Hajenius, Petra J

    2015-01-01

    STUDY QUESTION: Is salpingotomy cost effective compared with salpingectomy in women with tubal pregnancy and a healthy contralateral tube? SUMMARY ANSWER: Salpingotomy is not cost effective over salpingectomy as a surgical procedure for tubal pregnancy, as its costs are higher without a better

  2. Manual on Cost-Effectiveness of Training Modalities in Population Education. Population Education Programme Service Series.

    Science.gov (United States)

    United Nations Educational, Scientific and Cultural Organization, Bangkok (Thailand). Principal Regional Office for Asia and the Pacific.

    This manual is the result of a regional training workshop on the cost-effectiveness of different training strategies in population education by Unesco in Kathmandu, Nepal, June 1-8, 1987. The purpose of the manual is to enable project staff to initiate studies to determine cost-effective training strategies in population growth control education.…

  3. Cost-Effectiveness Analysis of Early Reading Programs: A Demonstration with Recommendations for Future Research

    Science.gov (United States)

    Hollands, Fiona M.; Kieffer, Michael J.; Shand, Robert; Pan, Yilin; Cheng, Henan; Levin, Henry M.

    2016-01-01

    We review the value of cost-effectiveness analysis for evaluation and decision making with respect to educational programs and discuss its application to early reading interventions. We describe the conditions for a rigorous cost-effectiveness analysis and illustrate the challenges of applying the method in practice, providing examples of programs…

  4. The Treatment of Challenging Behaviour in Intellectual Disabilities: Cost-Effectiveness Analysis

    Science.gov (United States)

    Romeo, R.; Knapp, M.; Tyrer, P.; Crawford, M.; Oliver-Africano, P.

    2009-01-01

    Background: Antipsychotic drugs are used in the routine treatment of adults with intellectual disabilities (ID) and challenging behaviour in the UK despite limited evidence of their effectiveness. There is no evidence on their cost-effectiveness. Methods: The relative cost-effectiveness of risperidone, haloperidol and placebo in treating…

  5. Class Size Reduction or Rapid Formative Assessment?: A Comparison of Cost-Effectiveness

    Science.gov (United States)

    Yeh, Stuart S.

    2009-01-01

    The cost-effectiveness of class size reduction (CSR) was compared with the cost-effectiveness of rapid formative assessment, a promising alternative for raising student achievement. Drawing upon existing meta-analyses of the effects of student-teacher ratio, evaluations of CSR in Tennessee, California, and Wisconsin, and RAND cost estimates, CSR…

  6. Cost-Effectiveness Analysis of the Residential Provisions of the 2015 IECC for New Jersey

    Energy Technology Data Exchange (ETDEWEB)

    Mendon, Vrushali V. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Zhao, Mingjie [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Taylor, Zachary T. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Poehlman, Eric A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2016-02-15

    The 2015 IECC provides cost-effective savings for residential buildings in New Jersey. Moving to the 2015 IECC from the 2015 New Jersey State Code base code is cost-effective for residential buildings in all climate zones in New Jersey.

  7. Cost-Effectiveness Analysis of the Residential Provisions of the 2015 IECC for New Hampshire

    Energy Technology Data Exchange (ETDEWEB)

    Mendon, Vrushali V. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Zhao, Mingjie [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Taylor, Zachary T. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Poehlman, Eric A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2016-02-15

    The 2015 IECC provides cost-effective savings for residential buildings in New Hampshire. Moving to the 2015 IECC from the 2010 New Hampshire State Code base code is cost-effective for residential buildings in all climate zones in New Hampshire.

  8. Cost-Effectiveness Analysis of the Residential Provisions of the 2015 IECC for North Carolina

    Energy Technology Data Exchange (ETDEWEB)

    Mendon, Vrushali V. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Zhao, Mingjie [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Taylor, Zachary T. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Poehlman, Eric A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2016-02-15

    The 2015 IECC provides cost-effective savings for residential buildings in North Carolina. Moving to the 2015 IECC from the 2012 North Carolina State Code base code is cost-effective for residential buildings in all climate zones in North Carolina.

  9. Cost-effectiveness and radiological risk associated with mass chest screening

    International Nuclear Information System (INIS)

    Stieve, F.E.

    1987-01-01

    This report presents in summary the cost effectiveness and radiological risks associated with mass chest tuberculosis screening in major European countries. The state of tuberculosis in west Europe, the cost effectiveness of mass screening, international standards regarding radiation doses as well as the need for quality control are addressed

  10. The Cost-Effectiveness of Spinal Cord Stimulation for Complex Regional Pain Syndrome

    NARCIS (Netherlands)

    Kemler, Marius A.; Raphael, Jon H.; Bentley, Anthony; Taylor, Rod S.

    2010-01-01

    Objectives: Health-care policymakers and payers require cost-effectiveness evidence to inform their treatment funding decisions. The aims of this study were to assess the cost-effectiveness of the addition of spinal cord stimulation (SCS) compared with conventional management alone (CMM) in patients

  11. Cost-effectiveness and evidence-based policy : Steering on social Impact

    NARCIS (Netherlands)

    van Yperen, Tom

    2016-01-01

    Introduction - The cost-effectiveness of many services is unknown. Because the demand for services is growing, whereas budgets are cut, the issue how to enhance the cost-effectiveness of Child and Youth Care is urgent in day to day politics and practice. The NJi developed a working model that helps

  12. Cost-effectiveness of renal denervation therapy for the treatment of resistant hypertension in the Netherlands

    NARCIS (Netherlands)

    Henry, Thea L.; De Brouwer, Bonnie F E; Van Keep, Marjolijn M L; Blankestijn, Peter J.; Bots, Michiel L.; Koffijberg, Hendrik

    2015-01-01

    Objectives: Safety and efficacy data for catheter-based renal denervation (RDN) in the treatment of resistant hypertension have been used to estimate the cost-effectiveness of this approach. However, there are no Dutch-specific analyses. This study examined the cost-effectiveness of RDN from the

  13. Living renal donors: optimizing the imaging strategy--decision- and cost-effectiveness analysis

    NARCIS (Netherlands)

    Y.S. Liem (Ylian Serina); M.C.J.M. Kock (Marc); W. Weimar (Willem); K. Visser (Karen); M.G.M. Hunink (Myriam); J.N.M. IJzermans (Jan)

    2003-01-01

    textabstractPURPOSE: To determine the most cost-effective strategy for preoperative imaging performed in potential living renal donors. MATERIALS AND METHODS: In a decision-analytic model, the societal cost-effectiveness of digital subtraction angiography (DSA), gadolinium-enhanced

  14. Cost-effectiveness of HIV screening of blood donations in Accra (Ghana)

    NARCIS (Netherlands)

    van Hulst, Marinus; Sagoe, Kwamena W. C.; Vermande, Jacobien E.; van der Schaaf, Ido P.; Adriani, Willem P. A. van der Tuuk; Torpey, Kwasi; Ansah, Justina; Mingle, Julius A. A.; Smit Sibinga, Cees Th.; Postma, Maarten J.

    2008-01-01

    Objectives: Areas with high HIV-incidence rates compared to the developed world may benefit from additional testing in blood banks and may show more favorable cost-effectiveness ratios. We evaluated the cost-effectiveness of adding p24 antigen, mini pool nucleic acid amplification testing (MP-NAT),

  15. The integrated business information system: using automation to monitor cost-effectiveness of park operations

    Science.gov (United States)

    Dick Stanley; Bruce Jackson

    1995-01-01

    The cost-effectiveness of park operations is often neglected because information is laborious to compile. The information, however, is critical if we are to derive maximum benefit from scarce resources. This paper describes an automated system for calculating cost-effectiveness ratios with minimum effort using data from existing data bases.

  16. Cost-effectiveness analysis of cetuximab in treatment of metastatic colorectal cancer in Iranian pharmaceutical market

    Directory of Open Access Journals (Sweden)

    Majid Davari

    2015-01-01

    Conclusions: The FOLFOX regimen + cetuximab provides lower costs per additional life years gained (more cost-effective compared with its alternatives in the treatment of patients with unresectable metastatic CRC. However, according to the WHO indicator, none of the cetuximab regimens could be considered as cost effective for the Iranian health care market.

  17. At What Cost? Examining the Cost Effectiveness of a Universal Social-Emotional Learning Program

    Science.gov (United States)

    Hunter, Leah J.; DiPerna, James C.; Hart, Susan Crandall; Crowley, Max

    2018-01-01

    Although implementation of universal social-emotional learning programs is becoming more common in schools, few studies have examined the cost-effectiveness of such programs. As such, the purpose of this article is two fold. First, we provide an overview of cost-effectiveness methods for school-based programs, and second, we share results of a…

  18. Cost-effectiveness of cardiotocography plus ST analysis of the fetal electrocardiogram compared with cardiotocography only

    NARCIS (Netherlands)

    Vijgen, Sylvia M. C.; Westerhuis, Michelle E. M. H.; Opmeer, Brent C.; Visser, Gerard H. A.; Moons, Karl G. M.; Porath, Martina M.; Oei, Guid S.; van Geijn, Herman P.; Bolte, Antoinette C.; Willekes, Christine; Nijhuis, Jan G.; van Beek, Erik; Graziosi, Giuseppe C. M.; Schuitemaker, Nico W. E.; van Lith, Jan M. M.; van den Akker, Eline S. A.; Drogtrop, Addy P.; van Dessel, Hendrikus J. H. M.; Rijnders, Robbert J. P.; Oosterbaan, Herman P.; Mol, Ben Willem J.; Kwee, Anneke

    2011-01-01

    To assess the cost-effectiveness of addition of ST analysis of the fetal electrocardiogram (ECG; STAN) to cardiotocography (CTG) for fetal surveillance during labor compared with CTG only. Cost-effectiveness analysis based on a randomized clinical trial on ST analysis of the fetal ECG. Obstetric

  19. Cost effectiveness of MR imaging in the evaluation of focal lesions in the liver

    International Nuclear Information System (INIS)

    Cahill, P.T.; Goldberg, S.; Millerin, J.; Whalen, J.P.; Markisz, J.A.

    1986-01-01

    The authors evaluated the advantages of MR imaging over conventional imaging techniques with respect to clinical sensitivity, risk to patients, and cost-effectiveness. Patients were separated into four groups: cancer patients, those with incidental findings of liver lesions, those with questionable CT findings, and those with known hepatic hemangiomas that should be followed up. The determination of cost-effectiveness of MR imaging depended on the ability of CT to accurately distinguish between hemangiomas and metastases, as well as the cost of each examination. MR imaging at $400 per series was always cost-effective for the first three groups of patients. With a questionable rate of only 20%, MR imaging became cost-effective at an examination cost of $600. CT was cost-effective for the fourth group of patients in all instances. This analysis supports the use of MR imaging in the diagnosis of solitary liver lesions and for clinical evaluation of patients with cancer

  20. Issues in assessing the cost-effectiveness of coordinated DSM programs

    International Nuclear Information System (INIS)

    Hill, L.J.; Brown, M.A.

    1995-01-01

    Coordinated demand-side management (DSM) programs, co-administered by government agencies and electric and gas utilities, are likely to grow in importance in the coming years. Because of the unique features of these types of DSM programs, special care must be taken in assessing their cost-effectiveness. In this paper, we discuss these features, suggest how standard cost-effectiveness measures must be adapted to accommodate them, and show how important these adaptations are in assessing the cost-effectiveness of coordinated programs. At first, we use a least-cost, financial approach. The discussion indicates that failure to account properly for the special features of coordinated programs materially affects estimates of cost-effectiveness and, in extreme cases, may lead to rejection of otherwise cost-effective programs. Then extending the analysis to include economic factors, we speculate that most types of coordinated programs are more attractive than when evaluated on a financial basis. (author)