bluuebunny/crossref_metadata_2025 huggingface dataset:
Olympe de Gouges versus Rousseau: Happiness, Primitive Societies, and the Theater
Authors: BERGÈS SANDRINE
Published: January 2019

InLe Bonheur Primitif(1789), Olympe de Gouges takes on Rousseau's account of the evolution of human society in his first twoDiscourses, and she argues that primitive human beings were not only happy, but also capable of virtue. I argue that in that text, Gouges offers a contribution to the eighteenth-century debate on human progress that is distinct from Rousseau's in that it takes seriously the contribution of women and families to human happiness and progress. I show how the concept of emulation plays an important role in Gouges's analysis, both in her account of primitive societies and of the theater, and argue that she uses it to bridge the gap between primitive happiness and future progress.
Du Pont Turns 150: Corporate Culture as Public Culture
Authors: CURRIE TAYLOR ALEXANDRA
Published: January 2019

This article details the ways in which the executives of Du Pont used the chemical company’s 150th-anniversary festivities in 1952 and its associated sponsored media as an opportunity to explicitly link the history of the company with the history of the nation. This was an attempt to legitimatize the company’s existence and its ultraconservative worldview, espouse free trade, and fight antitrust litigation. This article explores the conflation of private and public history in Du Pont-sponsored anniversary materials to illustrate how corporate public relations meant for private corporate consumption reverberated into a shared American public culture.
Return- and hitting-time distributions of small sets in infinite measure preserving systems
Authors: RECHBERGER SIMON , ZWEIMÜLLER ROLAND
Published: January 2019

We study convergence of return- and hitting-time distributions of small sets$E_{k}$with$\unicode[STIX]{x1D707}(E_{k})\rightarrow 0$in recurrent ergodic dynamical systems preserving an infinite measure$\unicode[STIX]{x1D707}$. Some properties which are easy in finite measure situations break down in this null-recurrent set-up. However, in the presence of a uniform set$Y$with wandering rate regularly varying of index$1-\unicode[STIX]{x1D6FC}$with$\unicode[STIX]{x1D6FC}\in (0,1]$, there is a scaling function suitable for all subsets of$Y$. In this case, we show that return distributions for the$E_{k}$converge if and only if the corresponding hitting-time distributions do, and we derive an explicit relation between the two limit laws. Some consequences of this result are discussed. In particular, this leads to improved sufficient conditions for convergence to${\mathcal{E}}^{1/\unicode[STIX]{x1D6FC}}{\mathcal{G}}_{\unicode[STIX]{x1D6FC}}$, where${\mathcal{E}}$and${\mathcal{G}}_{\unicode[STIX]{x1D6FC}}$are independent random variables, with${\mathcal{E}}$exponentially distributed and${\mathcal{G}}_{\unicode[STIX]{x1D6FC}}$following the one-sided stable law of order$\unicode[STIX]{x1D6FC}$(and${\mathcal{G}}_{1}:=1$). The same principle also reveals the limit laws (different from the above) which occur at hyperbolic periodic points of prototypical null-recurrent interval maps. We also derive similar results for the barely recurrent$\unicode[STIX]{x1D6FC}=0$case.
Using a Probabilistic Model to Assist Merging of Large-Scale Administrative Records
Authors: ENAMORADO TED , FIFIELD BENJAMIN , IMAI KOSUKE
Published: January 2019

Since most social science research relies on multiple data sources, merging data sets is an essential part of researchers’ workflow. Unfortunately, a unique identifier that unambiguously links records is often unavailable, and data may contain missing and inaccurate information. These problems are severe especially when merging large-scale administrative records. We develop a fast and scalable algorithm to implement a canonical model of probabilistic record linkage that has many advantages over deterministic methods frequently used by social scientists. The proposed methodology efficiently handles millions of observations while accounting for missing data and measurement error, incorporating auxiliary information, and adjusting for uncertainty about merging in post-merge analyses. We conduct comprehensive simulation studies to evaluate the performance of our algorithm in realistic scenarios. We also apply our methodology to merging campaign contribution records, survey data, and nationwide voter files. An open-source software package is available for implementing the proposed methodology.
The elongation of very long-chain fatty acid 6 gene product catalyses elongation ofn-13 : 0 andn-15 : 0 odd-chain SFA in human cells
Authors: Wang Zhen , Wang Dong Hao , Goykhman Yuliya , Yan Yuanyuan , Lawrence Peter , Kothapalli Kumar S. D. , Brenna J. Thomas
Published: January 2019

Normal odd-chain SFA (OCSFA), particularly tridecanoic acid (n-13 : 0), pentadecanoic acid (n-15 : 0) and heptadecanoic acid (n-17 : 0), are normal components of dairy products, beef and seafood. The ratio ofn-15 : 0:n-17 : 0 in ruminant foods (dairy products and beef) is 2:1, while in seafood and human tissues it is 1:2, and their appearance in plasma is often used as a marker for ruminant fat intake. Human elongases encoded by elongation of very long-chain fatty acid (ELOVL)1, ELOVL3, ELOVL6 and ELOVL7 catalyse biosynthesis of the dominant even-chain SFA; however, there are no reports of elongase function on OCSFA. ELOVL transfected MCF7 cells were treated withn-13 : 0,n-15 : 0 orn-17 : 0 (80 µm) and products analysed. ELOVL6 catalysed elongation ofn-13 : 0→n-15 : 0 andn-15 : 0→n-17 : 0; and ELOVL7 had modest activity towardn-15 : 0 (n-15 : 0→n-17 : 0). No elongation activity was detected forn-17 : 0→n-19 : 0. Our data expand ELOVL specificity to OCSFA, providing the first molecular evidence demonstrating ELOVL6 as the major elongase acting on OCSFAn-13 : 0 andn-15 : 0 fatty acids. Studies of food intake relying on OCSFA as a biomarker should consider endogenous human metabolism when relying on OCSFA ratios to indicate specific food intake.
Rewriting theReich: German Women Journalists as Transnational Mediators for Germany's Rehabilitation
Authors: Barton Deborah
Published: January 2019

This article looks at the transnational impact of two diaries written by the female German journalists Ruth Andreas-Friedrich and Ursula von Kardorff, whose journals shed light on German wartime experiences, resistance activities, and, to a lesser extent, the press. In the postwar years, both journalists sought to influence (West) Germany's relationship with its former enemies, in particular the United States. In their autobiographical writing, they presented both an image of Germany as a victim of Nazism, as well as an early acknowledgment of German crimes. In this way, they achieved a balanced narrative that received a positive reception from American and German audiences. Though the ways in which Friedrich and Kardorff presented aspects of journalism and everyday life in the Third Reich were not unique, their dual identity as women and journalists underlay their ability to act as “legitimate” mediators for Germany's rehabilitation. Western allied occupation authorities and overseas audiences viewed them, in contrast to men, as largely apolitical because they were women, and as objective witnesses because they were journalists. Through their autobiographical writings, both journalists situated themselves among the predominantly male US and German elites devoted to developing amicable relations between the two countries via soft-power diplomacy.
East Germany's Red Woodstock: The 1973 Festival between the “Carnivalesque” and the Everyday
Authors: White Katharine
Published: January 2019

Scholars often depict the 1973 World Festival of Youth and Students—or, more colloquially, the Red Woodstock—as a momentary “departure” or “break” from everyday life, when the German Democratic Republic (GDR) briefly opened its borders to the youth of the world. Similarly, they suggest that, when the festival's nine days of festivities came to an end, the “pathos of revolution” disappeared just as quickly as it had come about, resulting in a return to the restraints of everyday life behind the “Iron Curtain.” By contrast, this article reconsiders the festival's significance by adopting an analytical framework from postsocialist theorists. In doing so, it reconceptualizes the Red Woodstock as a moment of globalized influences and youth engagement that not only reflected shifting societal norms, but also the East German state's commitment to international socialist solidarity. Soviet theorist Mikhail Bakhtin’s work on the “upside-down” nature of the carnival, as well as on society’s “grotesque body,” is useful in this regard, as it sets in sharp relief the extent to which one of the East German state’s greatest challenges resulted from its own embrace of international socialism. This was the case as young people from the GDR and beyond transformed the East German capital through a subtle appropriation, transformation, and even subversion of the state-generated discourse on international solidarity, in ways that had a lasting effect during the late socialist period.
Discussion Forum: The Vanishing Nineteenth Century in European History?
Authors: Hagemann Karen , Lässig Simone
Published: January 2019

This forum explores from multiple perspectives the often stated impression that the nineteenth century is “vanishing” from German and European history. It asks how one can explain this trend, what consequences it has for the development of historiography and public historical knowledge, if and why the nineteenth century matters for the present, and what the future of nineteenth-century history might be. Fourteen experts on different regions and historiographical approaches to European history from the United States and Germany discuss these questions. We sought contributors from these two countries in order to illuminate differences in the historical profession on either side of the Atlantic, and are sure that a broader regional comparison would point to more varieties in the state of historical research on the nineteenth century.
«Leur aveuglement est systématique». Rôles de la cécité dans la critique et la construction des systèmes au XVIIIesiècle
Authors: CHOTTIN MARION
Published: January 2019

Cet article étudie les rapports que l’idée de système, au siècle des Lumières, entretient avec la cécité et constate que celle-ci constitue aussi bien une arme employée pour disqualifier les métaphysiques du XVIIesiècle, qu’un lieu où la pensée peut se constituer, voire se systématiser à distance du dogmatisme. Les Lumières françaises exploitent l’usage métaphorique de la cécité et plongent les systématiques dans les ténèbres de l’ignorance. Mais, avec Diderot, elles montrent aussi que la philosophie est au sens propre une affaire de cécité, pour le pire comme le meilleur.
Diderot, l’éclectisme et l’histoire de l’esprit humain
Authors: RIOUX-BEAULNE MITIA
Published: January 2019

Les interprétations habituelles de l’article «Éclectisme» de l’Encyclopédiemettent l’accent sur l’idée que Diderot y annonce le programme de la philosophie moderne, dont il se ferait par le fait même un illustre représentant et l’un des promoteurs. Dans cet article, j’essaie de compléter cette interprétation en montrant que l’article est également porteur d’une réflexion de premier plan sur l’histoire de la philosophie, sur les effets de continuité dans sa pratique et, conséquemment, sur ce qui est proprement constitutif du discours philosophique lui-même, tant sur le plan méthodologique qu’en ce qui concerne son positionnement politique.
Jeffrey Kahn, Federalism, Democratization, and the Rule of Law in Russia.
London: Oxford University Press, 2002, 300 pp.
Authors: Konitzer-Smirnov Andrew
Published: January 2019

Like the declarations of the newly empowered republican elites in Jeffrey Kahn's text, murky notions of federalism, democracy, sovereignty and the rule of law mar current debates about Russian federalism. Lacking some foundational understanding of these concepts as applied to the Russian context, analysts neither agree on the nature of the problems nor the potential means to resolve them and analyses frequently degenerate into subjective judgments about the intentions of political actors involved in the institution-building process. Jeffrey Kahn's Federalism, Democratization, and the Rule of Law in Russia comes the closest of any currently available work to providing a framework for discussions of Russian federal reform by tracing the development of contemporary Russian federalism and attempting to place it within a carefully constructed federal typology. In this respect, this work is essential reading for anyone interested in issues of federalism and post-Soviet Russia.
Conference of Ukrainian Scholars in Urbana, Illinois
Authors: Kuk Zenon M.
Published: January 2019

On June 24-28, 1982 the Conference on Ukrainian Literature in the Twentieth Century took place at the University of Illinois at Urbana-Champaign, Levis Faculty Center. The conference was sponsored by the Summer Research Laboratory on Russia and Eastern Europe, University of Illinois, Urbana-Champaign and the Shevchenko Scientific Society, Inc., New York.
‘The only real magic’: enchantment and disenchantment in music's modernist ordinary
Authors: Loeffler Zachary
Published: January 2019

This essay tracks a predominant fantasy of music in global liberal-capitalist culture: music as ‘the only real magic’. Although discussion of music's ‘magic’ has been characterized as a vestige of Romanticism, I argue that it became a cornerstone of ordinary/everyday music discourse circa 1900, around the time that sociologists defined modernity as mostly bereft of magic and configured the aesthetic as its remaining stronghold. Juxtaposing claims of magic in ordinary music discourse with a coeval archive of these ‘disenchantment’ narratives, I trace music's institutionalization as magic in the historical moment from around 1900 to the present. This history reveals that music remains commonly experienced as ‘the only real magic’ insofar as it offers deeply ameliorative forms of affective connection felt to be scarce in other domains. Accordingly, it indicates the immense healing power that music has accrued particularly over the last century while also adumbrating the conditions of scarcity from which this potency has emerged.
Sample magic: (conjuring) phonographic ghosts and meta-illusions in contemporary hip-hop production
Authors: Exarchos Michail
Published: January 2019

Sampling has been criticised as ‘a mixture of time-travel and seance’, ‘the musical art of ghost co-ordination and ghost arrangement’, and a process that ‘doubles (recording's) inherent supernaturalism’ (Reynolds, S., 2012,Retromania: Pop Culture's Addiction to its Own Past, London, Faber and Faber, pp. 313–14). Yet out of all the sample-based music forms, hip-hop receives the lion's share of attention in popular music literature; critics are puzzled by its appeal, scholars identify a plethora of problems in its function, and practitioners and audiences alike are mesmerised by its effect. Rap producers attribute an inherent ‘magic’ to working with past phonographic samples and fans appear spellbound by the resulting ‘supernatural’ collage. The author examines the music's unique recipe of phonographic juxtaposition, exploring the conditions of this ascribed ‘magic’, investigating gaps in perception between emotional and intellectual effect and deciphering parallels in the practice and vocabulary mobilised against a range of genres in performance magic.
OP14 The 2017 Health Technology Assessment International Asia Policy Forum: The Perspective Of Industry Members
Authors: Patel Parashar , Trowman Rebecca
Published: January 2019

Introduction:

The fifth Health Technology Assessment International (HTAi) Asia Policy Forum (APF) was held in Beijing, November 2017. The topic of the meeting was ‘Universal Health Care in the Asia Region: Overcoming the Barriers using HTA and Real World Data’. This presentation will focus on the use of real world data (RWD) as a mechanism of informing HTA in the Asia region – from the perspective of industry that were represented at the APF.

Methods:

The 2017 HTAi APF had senior representatives from 11 pharmaceutical and medical device companies active in the region. A keynote presentation was delivered that explored the findings of the background paper and survey, and there were guided breakout group discussions.

Results:

RWD is needed in all stages of the life cycle of a product; however, of greatest importance to industry is RWD to develop value propositions, inform HTA assessments, gauge market need and demonstrate where a new technology sits within an established clinical pathway. Although the HTA agencies present at the APF stated that RWD is available in the Asia region, this was not reflected by industry members who had limited awareness and access. Key concerns raised included whether this RWD is available for public use (and what caveats will be placed around its release), the quality of the data, whether it is longitudinal, and if it includes costs.

Conclusions:

There is a clear difference in the perspective of RWD between industry and HTA agencies in the Asia region. It is possible that this difference is driven by the apparent lack of publicly available data in the region and industry members comparing the use of RWD in Asia with the use in higher-income countries. This can be improved with clearer definitions, increased dialogue and multi-stakeholder collaboration in the region.
OP46 Redefining Mental Health Services For Youth: Evidence To Action
Authors: Ly Angela , Tremblay Gilbert A. , Beauchamp Sylvie
Published: January 2019

Introduction:

Current organization of mental health services in Canada imposes a rupture during youth transition to adulthood, when severe mental health disorders start appearing. This can have a major impact on youth recovery and social integration. A health technology assessment (HTA) was initiated to evaluate the efficacy of programs that simultaneously target adolescents and young adults to support decision making.

Methods:

A systematic review of systematic reviews was conducted. Four databases were searched (MEDLINE, Embase, Applied Social Sciences Index and Abstracts, and CINAHL) for articles published between 2000 and 2017. Article selection and quality assessment (ROBIS tool) were performed and inter-rater agreement was measured. To be included, the systematic review had to study specialized models or programs serving both adolescents and young adults. An analytical framework was constructed based on the categorization of performance measures for early intervention and the five dimensions of recovery. Group and individual interviews were conducted to collect contextual and experiential data.

Results:

A total of 1,054 references were identified. After applying the selection criteria, five systematic reviews were selected. The majority of programs identified were developed for early psychosis. This HTA did not identify specialized programs for other types of mental illness or at-risk youth. Evidence on early interventions for psychosis is emerging in regards to their efficacy in improving functional and clinical recovery. However, evidence has yet to be established for their impact on access. Contextual and experiential data from our organization validated and completed the scientific findings. Facilitating and constraining factors in the implementation of a person-centered care model and inter-agency collaboration were identified.

Conclusions:

Services targeting at-risk youth should be developed as part of a continuum of care that is adapted to clinical stages so that all youths living with psychological distress can be treated, regardless of diagnosis or age. These services may draw inspiration from models of early intervention for psychosis. Recommendations from this HTA are currently being put into action in the West Island of Montreal.
OP61 Net Value Of Treating Hepatitis C With Newly Available Direct-Acting Antivirals
Authors: Bloom David E. , Khoury Alexander , Srinivasan V.
Published: January 2019

Introduction:

Recently developed direct-acting antiviral (DAA) treatments for hepatitis C virus (HCV) are groundbreaking in their high efficacy across disease genotypes and lack of severe side effects. This study used a cost-of-illness (COI) approach to estimate the net value conferred by one of these novel drug combinations, sofosbuvir and velpatasir (SOF/VEL), recently licensed for generic manufacture in India.

Methods:

This study considered COI from lifetime earnings lost due to disability and premature death from HCV infection. Risk of death and disability in future years was calculated using a Markov state-transition model with parameters determined from the literature. The future earnings of sampled patients were predicted using an empirical earnings model, with coefficients determined from India Human Development Survey data. Costs to both the patient and secondarily infected individuals were considered.

Results:

Preliminary results suggested that curing individuals diagnosed with chronic HCV in India would preserve INR 3.7 million (USD 55,750) in earnings per person. For non-cirrhotic (NC) and compensated cirrhotic (CC) individuals, the expected benefits associated with preventing secondary infections were worth between one and forty-one percent of the value of benefits conferred to the diagnosed individuals (depending on sex and extent of liver damage). Treating decompensated cirrhotic (DC) individuals with DAAs alone offered minimal earnings benefits because these individuals will likely remain disabled and unable to work without a liver transplant. Expected net benefits of treatment were substantial for NC and CC patients, ranging from INR 640,349 (USD 9,531) for NC women to INR 10.7 million (USD 158,968) for CC men. The cost of treatment for DC individuals exceeded the expected earnings benefits.

Conclusions:

For average NC and CC individuals, the cost of treatment with SOF/VEL is offset by the benefits of increased future productivity. Increased earnings are not sufficient to offset the cost of treatment for DC individuals, but treatment may still be justified on the basis of the intrinsic value of health improvements and other treatment benefits.
OP66 Tumor Profiling Tests In Early Breast Cancer: A Systematic Review
Authors: Harnan Susan , Cooper Katy , Stevens John , Wong Ruth , Tappenden Paul , Bessey Alice , Ward Sue , Rafia Rachid , Stein Rob , Brown Janet
Published: January 2019

Introduction:

Tumor profiling tests can help to identify whether women with breast cancer need chemotherapy due to their risk of relapse, and some may be able to predict benefit from chemotherapy. We focused on four genetic tests: Oncotype DX (O-DX), MammaPrint (MMP), EndoPredict and Prosigna, and one immunohistochemistry test, IHC4, for the National Institute of Health and Care Excellence as part of their Diagnostic Appraisal Programme.

Methods:

A systematic review was undertaken, including searching of nine databases in February 2017 plus other sources including a previous review published in 2013. The review included studies assessing clinical effectiveness of the five tumor profiling tests, with or without clinicopathological factors, to guide decisions about adjuvant chemotherapy in people with ER-positive, HER-2 negative, Stage I-II cancer with 0 to 3 positive lymph nodes (LN). The PROBAST tool and Cochrane risk of bias tools were used to assess risk of bias.

Results:

A total of 153 studies were included; the strength of evidence base for individual tests was varied. Results suggest all tests are prognostic for risk of relapse, though results were more varied in LN positive (+) patients than in LN negative (0) patients. Evidence was limited about whether tests can predict benefit from chemotherapy (available for MMP and O-DX only). Studies that assessed the impact of the tests on clinical decisions indicate that the net change in chemotherapy recommendations or decisions pre-/post-test ranged from an increase of one percent to a decrease of 23 percent among UK studies, and a decrease of zero percent to 64 percent across European studies.

Conclusions:

The studies included in the review suggest that all of the tests can provide prognostic information on the risk of relapse; however results were more varied in LN+ patients than in LN0 patients. There is limited and varying evidence for prediction of chemotherapy benefit.
OP87 Nitrous Oxide As Sedation Regimen In Children—How To Assess Safety?
Authors: Pike Eva , Hafstad Elisabeth , Tjelle Torunn Elisabeth
Published: January 2019

Introduction:

Children who undergo short, painful procedures at hospitals are given different kinds of pain relief (analgesics), often in combination with drugs for relaxation (sedatives). Nitrous oxide (NO) is a drug administered for pain relief and relaxation, it is applied by inhalation and its effects are analgesic, anxiolytic and sedative. It is used in several countries, but is not normally used as a sedation method for children in Norwegian hospitals, although widely used in maternity wards during labor. Our aim was to evaluate the effectiveness and safety of this sedation regimen in children. However, we also wanted to assess safety for health personnel after repetitive or long-term exposure.

Methods:

We performed a systematic review on effectiveness and safety of nitrous oxide for sedation in children. For evidence on efficacy and safety in children, only randomized controlled trials (RCT) were included. For safety of health personnel we also accepted other study designs. For all endpoints, we presented the evidence in summary of finding tables.

Results:

We retrieved twenty-two randomized controlled trials on the effectiveness or safety in children undergoing sedation with nitrous oxide. Outcomes were hospital procedure satisfaction or characteristics, and pain relief. Safety was reported as acute adverse events. None of the RCTs reported evidence on safety for health personnel. We are currently exploring different ways to systematically assess safety for health personnel within the form of an HTA otherwise designed for a different population.

Conclusions:

Assessing safety of new technologies, methods or procedures through HTAs is a crucial point. However, assessing the long-term safety of the health personnel should also be included, but evidence will often not be retrieved through literature search designed for the patient group, and long-term safety data is in general difficult to retrieve for exposure to a novel technology. We will discuss our approach to this challenge.
OP88 Reduction Of Biologics In Rheumatoid Arthritis: A Systematic Review
Authors: Vasconcelos Leticia , Silva Marcus , Galvao Tais
Published: January 2019

Introduction:

Reduction of biologics after reaching low disease activity rheumatoid arthritis has been tested in clinical trials. The aim of this systematic review is to assess the effectiveness and safety of the reduction of biologics drugs in patients with rheumatoid arthritis in low disease activity.

Methods:

The protocol of this review is registered at PROSPERO (CRD42017069080). We searched MEDLINE, Embase, Scopus and The Cochrane Library for randomized controlled trials that reduced or spaced the dose of biologics in patients at low disease activity or remission state compared with maintenance. Two researchers selected studies, extracted the data, and assessed the risk of bias of the studies. Random effects meta-analyses by DerSimonian & Laird method were calculated considering intention to treat analysis to obtain the standardized mean difference (SMD) or relative risk (RR) and 95 percent confidence interval (CI). Quality of evidence will be assessed by the Grading of Recommendations, Assessment, Development and Evaluation (GRADE).

Results:

From 725 retrieved records, seven studies were included. Compared to regular doses, reduction of biologics significantly increased the health assessment quality (SMD = 0.20; 95% CI: 0.04 0.37; I2 = 3.5%). No difference was observed for low disease activity (RR = 0.83; 95% CI: 0.68, 1.03; I2= 71.3), serious and non-serious adverse events; disease activity scores; patient global assessment and radiographic progression.

Conclusions:

Preliminary results show no differences in clinically relevant outcomes from reduction of biologics compared to regular doses. As a limited number of studies is available, the certainty of evidence is limited and need to be monitored to better inform patients and clinicians.
OP112 Stakeholder Views As Evidence For NICE's Public Involvement Review
Authors: Thomas Lizzie , Livingstone Heidi , Kastoryano Chloe , Leng Gillian , Thomas Victoria
Published: January 2019

Introduction:

The National Institute for Health and Care Excellence (NICE) strategic review of its public involvement offer included a survey with stakeholders to explore how NICE can continue to deliver high quality, meaningful public involvement in a rapidly-changing environment.

Methods:

NICE staff, committee lay members, and an external academic ran the project and designed an online survey. The survey was open for two weeks. A purposive sample, recruited through various communication channels, was invited to participate. The sample comprised: (i) external individuals involved in NICE work, (ii) NICE committee and Board members, (iii) NICE staff. The survey included qualitative and quantitative questions, covering the ‘who’, ‘when’, ‘how’ and ‘what’ of NICE's public involvement approaches.

Results:

The survey yielded 684 responses, which were stratified by stakeholder type. Overall the responses indicated that: (i) the suggested stages for involvement are all important, but on a sliding scale: ‘defining outcomes guidance should consider’ is most important, and ‘helping committee chair recruitment’ is least important; (ii) different perspectives are needed such as individual treatment or care decisions should incorporate views of directly affected people, and population-based public health decisions need the views of citizens. Quality improvement suggestions included: (i) seeking feedback on people's experiences of care, using clear, structured approaches including focus groups, interviews, surveys, social media; (ii) increasing communications about NICE's work, specifically about involvement opportunities and use of patient evidence; (iii) using data on people's experiences equally with academic evidence; (iv) providing education and training on involvement to NICE staff and the general public; and, (v) partnership working with other organizations to enhance engagement. A focus group with key stakeholders used the survey findings to shape the subsequent public consultation document.

Conclusions:

There was consensus that public involvement is necessary throughout guidance development; however, the type of person involved and nature of participation should vary across the development stages. Project challenges included managing diametrically opposing views, and the associated implications for engagement.
OP120 Rapid Qualitative Reviews: A Scoping Review Of Guidance And Examples
Authors: Campbell Fiona , Weeks Laura , Booth Andrew , Kaunelis David , Smith Andrea
Published: January 2019

Introduction:

Decision-makers are increasingly recognizing the usefulness of qualitative research to inform patient-centered policy decisions, and are accordingly increasingly demanding qualitative evidence as part of health technology assessment (HTA). In the context of tight HTA timelines, a new form of evidence synthesis has emerged—rapid qualitative reviews. The need for rapidity requires either an increase in resources or, more commonly, a compromise in rigor, yet guidance on appropriate compromises for qualitative reviews is lacking.

Methods:

In order to inform de novo guidance, we conducted a systematic scoping review to identify existing guidance and published examples of rapid qualitative reviews. We searched Medline and CINAHL using medical subject headings and keywords related to “rapid reviews” and “qualitative” research, and screened the 1,771 resultant citations independently in duplicate. Additionally, we searched the grey literature and solicited examples from our contacts and other evidence-synthesis organizations. We summarized included guidance and reviews using the Search, AppraisaL, Synthesis, Analysis (SALSA) framework to identify abbreviations in the review process.

Results:

We found no guidance documents specific to rapid qualitative reviews. We found one published peer-reviewed rapid qualitative review, and several more (>10; grey literature search in process) through our organizational contacts. While methods to abbreviate the process are poorly reported, an abbreviated literature search (years and databases searched) and the use of a single reviewer appear common.

Conclusions:

A number of agencies are producing rapid qualitative reviews, however our review identifies the urgent need to develop and explore methods for the synthesis of qualitative research that balance rapidity and rigor.
OP136 Full Texts Versus Conference Abstract Data: How Does The Message Change?
Authors: Varley-Campbell Jo , Cooper Chris , Coelho Helen , Dodman Sophie , Barnish Max , Mujica-Mota Ruben , Hyde Christopher , Hoyle Martin
Published: January 2019

Introduction:

High quality evidence for test accuracy can be scarce. We assessed the test accuracy of two tests (Actim Partus and PartoSure) for the prediction of preterm birth. Twenty published full-text papers were included whilst conference abstracts were excluded. Since systematic reviews of diagnostic tests on other topics may need to rely on data from conference abstracts, we test whether the findings of our review would change with conference abstracts included.

Methods:

Conference citations previously excluded (n=108) were re-screened for inclusion using the following criteria: i) the diagnostic test was Actim Partus or PartoSure ii) test accuracy data of preterm delivery within seven days was reported iii) the population was women with signs/symptoms of preterm labor with intact membranes. Relevant test accuracy data were extracted and used to calculate sensitivity and specificity. Pooled sensitivity and specificity for each test were run using data from full-text papers and conference abstracts combined. These values were compared with the pooled sensitivities and specificities produced for the systematic review using full-text papers only.

Results:

Preliminary pooled sensitivities of the sixteen full-text Actim Partus studies and sixteen full-texts and two abstracts were 0.77 (95% confidence interval (CI) 0.68, 0.83) and 0.76 (95% CI 0.69, 0.83) respectively whilst pooled specificities were 0.81 (95% CI 0.76, 0.85).and 0.80 (95% CI 0.75, 0.84) respectively. Preliminary, pooled sensitivities of the four full-text PartoSure studies and four full-texts and three abstracts were 0.83 (95% CI 0.61, 0.94) and 0.82 (95% CI 0.65, 0.92), respectively, whilst pooled specificities were 0.95 (95% CI 0.89, 0.98) and 0.96 (95% CI 0.94, 0.97), respectively.

Conclusions:

Our findings suggest that the test accuracy results would not alter substantially with the inclusion of conference abstracts. However, work is ongoing to investigate how the assessment of heterogeneity and risk of bias across studies would alter given the difficulties associated with limited methodological reporting from conference abstracts.
OP152 Level Of Agreement In EUnetHTA Joint Action 3 Early Dialogues
Authors: Fernandez Judith , Guilhaume Chantal , Galbraith Margaret , Meyer François , Belorgey Chantal , Thuillez Christian , d'Andon Anne
Published: January 2019

Introduction:

A recent article reported a high level of commonality across European Health Technology Assessment bodies’ (HTABs) positions in former parallel scientific advice procedure. Since 2017, the EUnetHTA joint action 3 (JA3) offers a new early dialogue process involving a higher number of European HTABs. The present analysis aims to describe if the JA3 process modified the level of agreement across HTABs.

Methods:

A descriptive analysis of the written recommendations provided during every JA3 early dialogues coordinated by the French National Authority for Health (HAS) until November 2017 was conducted. The level of commonality for each HTAB position identified was assessed globally and by domain (population, comparator, outcomes, study design and health economics) and classified as follows: “full agreement” if all HTABs had the same position, “partial agreement” if more than half HTABs had the same position and “disagreement” in all other cases.

Results:

Four JA3 early dialogues were performed until November 2017: two in oncology, one in neurology and one in metabolic disorders. Between five and nine HTABs from eleven European countries participated. A total of forty-six positions were identified in these four early dialogues: ten on population, five on comparator, fifteen on outcomes, four on study design and twelve on health economics. Of the forty-six positions, full agreement was reached for twenty-eight positions, partial agreement for seventeen positions and only one disagreement was observed. The level of full agreements was highest for questions on comparators (five out of five) and population (nine out of ten) and lower for questions on health economics (six out of 12).

Conclusions:

Although the JA3 process substantially increased the number of HTABs participating in the early dialogues, this descriptive analysis suggests that the level of agreement remains very high. This may be facilitated by the high level of dialogue and coordination between HTAB ensured by the EUnetHTA process.
OP175 A National Perspective On Criteria And Methods For Resource Allocation
Authors: Roy Mathieu , Déry Véronique , Ganache Isabelle , Gagné Véronique , de Langavant Ghislaine Cleret
Published: January 2019

Introduction:

Decisions about which health and social services to include in the publicly funded services basket are complex. Several criteria need to be taken into account in decision-making (DM), as well as ethical, economic and organizational issues. Nowadays a global consensus supports the view that citizens’ values and preferences must guide DM. To elicit these values and concerns regarding publicly funded services, the Quebec Health and Welfare Commissioner recently conducted a vast public consultation on the population viewpoints. Parts of this consultation targeted criteria for DM, approaches to assess new or current services and perspectives on appropriateness of care.

Methods:

Various consultation methods were used in complementary steps: a representative population survey (n=1850), six regional focus groups (n=62), a call for briefs (n=52) for groups that wished to share their views, consultation meetings (n=35) with diverse stakeholders and a call for personal accounts (n=2633). It also held five deliberation sessions (18 citizens and 9 experts) over the course of the project on major related issues.

Results:

The need to ensure the appropriateness of covered services was one of the strongest themes emerging from the consultation. Citizens want that the appropriateness evaluation be carried out under certain conditions: transparently, in explicit DM processes, using criteria that are clear and adaptable according to the disease or problem. The whole evaluation process needs to be well documented, showing clearly the data used and rejected, so that they can understand the decision and see on what basis it is supported. Among the usual criteria for DM, those related to cost are less valued whereas others are considered incomplete.

Conclusions:

Citizens have clear viewpoints and expectations regarding DM criteria and processes for resource allocation. Decision-makers must take them into account to ensure that the basket of insured services is representative of social values and preferences.
PP05 Developing Equity In Remote Locations Through Telediagnosis
Authors: Galvan Pedro , Velazquez Miguel , Rivas Ronald , Benitez Gualberto , Ortellado Jose , Barrios Antonio , Hilario Enrique
Published: January 2019

Introduction:

Clinical background: Until recently, populations living in remote areas did not have access to specialist care and quality diagnostic services and thus depended on the low response capacity of their local health system. Subsequently, there were equity issues between urban and rural populations. Therefore it was considered telediagnosis applications should be directed towards developing better equity in the provision of services in remote locations without access to specialists. This study has evaluated the results of a new telemedicine system in remote public hospitals in Paraguay, in order to show how the response capacity of the local integrated health service delivery networks has been improved by providing access to tertiary level diagnostic services by specialists. Objective: This study aims to evaluate the utility of telemedicine as a tool for developing better equity in the provision of services in remote locations.

Methods:

This was a descriptive study, where the results of using telemedicine for diagnosis in remote public hospitals were evaluated as a tool to improve access to diagnostic services countrywide between 2014–2017. For these purposes, type and frequency of pathology diagnosed was determined.

Results:

A total of 311,562 telediagnoses were performed in fifty-seven hospitals. The 191,435 electrocardiogram diagnosis performed in the fifty-five hospitals were mainly normal (62.1%), unspecified arrhythmias (12.5%), and sinus bradycardia (10.4%). Also 115,924 teletomography tests were performed in twelve hospitals, where 54.4 percent corresponded to head as a consequence of accidents (motorcycles) and cerebrovascular diseases, 13.8 percent to chest, and the rest the other anatomical regions. Regarding the 4,184 electroencephalogram tests performed, antecedents of seizure (54.3%), evolutionary controls (14.0%), and headache (11.5%), were mainly diagnosed. The nineteen ultrasound studies corresponded to prenatal controls.

Conclusions:

Despite the results of the telediagnosis implemented in the public health to develop better equity in the provision of services in remote locations, a widespread use-assessment should be analyzed before this tool is adopted.
PP41 Toward Rules For Stakeholders’ Involvement In Regional Health Technology Assessment Units
Authors: Roy Mathieu , Déry Véronique , Dagenais Pierre
Published: January 2019

Introduction:

Health services users must participate in health technology assessment (HTA) activities. Users, caregivers, and citizens have the practical experience of healthcare and social services. HTA outputs are more useful when values and preferences of patients, caregivers, and citizens are taken into account. Despite this, the best methods of stakeholders’ involvement, timing for doing so, selection of participants, and the type of users to recruit depending of methods and contexts remain unspecified. Herein, an involvement policy has been developed to formalize the participation of users, caregivers and citizens in the services offering of a regional HTA unit.

Methods:

A steering committee composed of stakeholders (i.e. user, caregiver, citizen, User Experience Service representative, manager, provincial HTA body representative, HTA unit members) was constituted to discuss user involvement in a regional HTA unit. A preliminary vision statement emerged from this committee, and included objectives and principles for users, caregivers, and citizens participation. This statement was deliberated using a Delphi consensus method. Three rounds of deliberations were needed to reach a strong consensus.

Results:

Four objectives and four principles that should underlie the development of an involvement policy reached consensus. Participants agreed that users, caregivers, and citizens should: i) propose principles of involvement for each HTA projects; ii) co-realize evaluations with HTA professionals; iii) contribute to evaluation processes; and, iv) be involved in some management decisions of regional HTA units. Four principles to formalize users, caregivers and citizens’ involvement in regional HTA units also emerged. These principles were about utility and feasibility of involvement as well as ethical and methodological considerations.

Conclusions:

Users, caregivers, and citizens must participate in the activities of regional HTA units. Each of them have different roles and can contribute to evaluation processes. Their involvement in HTA activities is warranted for co-producing better evaluation more adapted to users’ needs in healthcare and social services.
PP44 Effectiveness Of Insulin Glargine Versus Detemir In Type 1 Diabetes
Authors: Silva Thales , Fernandes Almeida Paulo Henrique Ribeiro , Araújo Vânia , Guerra Augusto , Acurcio Francisco , Alvares Juliana , Godman Brian , de Lemos Livia Pires
Published: January 2019

Introduction:

The use of long-acting insulin analogues have been reported in patients with type 1 diabetes mellitus who exhibit important oscillations of their daily blood glucose, although the therapeutic benefits are lacking. The aim of this study was to evaluate the effectiveness and safety of the insulin analogue glargine compared detemir to support health decision-making.

Methods:

We performed a systematic review with meta-analysis of observational studies (cohort and registry), available in the MEDLINE (Pubmed), Latin American and Caribbean Health Sciences (LILACS), EMBASE and Cochrane Library databases (accessed August 2017), including research in the electronic journal Diabetes Care and gray literature. Several combinations of terms were used, including disease terms, interventions and type of study. The results evaluated were: glycated hemoglobin; weight gain; occurrence of severe hypoglycemia; total insulin dose; and, fasting capillary glycemia. Methodological quality was assessed using the Newcastle scale. The meta-analyses were performed in Review Manager® 5.2 software using a random effects model. Protocol number CRD42017054925 (International Prospective Register of Ongoing Systematic Reviews).

Results:

A total of 705 publications, eight cohort studies were included. The quality of included studies was classified as high. In the meta-analysis, the results for episodes of severe hypoglycemia (p = 0.002), measurements of fasting capillary glycemia (p = 0.01), and weight gain (p = 0.001) were favorable for detemir. The glycated hemoglobin endpoint (p = 0.49, heterogeneity = 89 percent) revealed high heterogeneity and no statistically significant difference between groups, showing no difference between the interventions for glycemic control.

Conclusions:

Although some results are favorable to detemir, it was not possible to identify significant differences in effectiveness and safety between the two analogues evaluated, requiring new long term studies and better quality of methodological studies.