bluuebunny/crossref_metadata_2025_split huggingface dataset:
Once bitten, twice shy? Lessons learned from an experiment to liberalize price regulations for dental care
Authors:   ADVOCATE Consortium, Trescher Anna-Lena , Listl Stefan , van der Galien Onno , Gabel Frank , Kalmus Olivier 
Published: December 2019

AbstractIn 2012, The Netherlands established the so-called “free market experiment”, which allowed providers of dental care to set the prices for their dental services themselves. The introduction of market mechanisms is intended to improve the quality of care and to contribute to cost containment, but increasing health expenditures for citizens have been observed in this context. Using large-volume health insurance claims data and exploiting the 2012 experiment in Dutch dental care, we identified the effects of a liberalization of service prices. Using pooled regression with individual fixed effects, we analyzed changes in utilization patterns of prevention-oriented dental services in response to the experiment as well as the elasticities in demand in response to variations in out-of-pocket (OOP) prices. We found substantial increases in prices and patients’ OOP contributions for dental services following the liberalization with differences in increases between types of services. In response to the experiment, the proportion of treatment sessions containing preventive-oriented services decreased significantly by 3.4% among adults and by 5.3% for children and adolescents. Estimates of short-run price elasticities of demand for different services point towards differences in price sensitivity. One potential explanation for the observed variations in prices and utilization could be different extents of asymmetric information for first-stage and follow-on services. Price liberalization seems to have affected the composition of treatment sessions towards a decreasing use of preventive services, suggesting a shift in the reason for seeing a dental care provider from a regular-preventive perspective to a symptom-based restorative approach.
The early detection of and rapid response (EDRR) to invasive species: a conceptual framework and federal capacities assessment
Authors: Reaser Jamie K. , Burgiel Stanley W. , Kirkey Jason , Brantley Kelsey A. , Veatch Sarah D. , Burgos-Rodríguez Jhoset 
Published: December 2019

AbstractGlobalization necessitates that we address the negative externalities of international trade and transport, including biological invasion. The US government defines invasive species to mean, “with regard to a particular ecosystem, a non-native organism whose introduction causes, or is likely to cause, economic or environmental harm, or harm to human, animal, or plant health.” Here we address the role of early detection of and rapid response to invasive species (EDRR) in minimizing the impact of invasive species on US interests. We provide a review of EDRR’s usage as a federal policy and planning term, introduce a new conceptual framework for EDRR, and assess US federal capacities for enacting well-coordinated EDRR. Developing a national EDRR program is a worthwhile goal; our assessment nonetheless indicates that the federal government and its partners need to overcome substantial conceptual, institutional, and operational challenges that include establishing clear and consistent terminology use, strategically identifying and communicating agency functions, improving interagency budgeting, facilitating the application of emerging technologies and other resources to support EDRR, and making information relevant to EDRR preparedness and implementation more readily accessible. This paper is the first in a special issue of Biological Invasions that includes 12 complementary papers intended to inform the development and implementation of a national EDRR program.
Lessons in Casual Sex: Narratives of Young Swedish Women
Authors: Tholander Michael , Tour Ninni 
Published: December 2019

AbstractThis study focuses on the narratives of four young Swedish women who were interviewed about their experiences of heterosexual casual sex. The analyses are based on a phenomenological approach and provide insight into a highly complex sexual practice, which the participants often portray as having lacked transparent communication, balance of power, and satisfying sex—three key dimensions of an everyday “sexual democracy.” However, the participants also claim to have dealt with these problematic issues, hence pointing to the socializing role that early sexual experiences have for young women. Thus, if the participants’ own perspectives of events are accepted, sexual empowerment might best be understood as individually colored, experience-based, developmental processes rather than as something that is brought about primarily through collective, formal sex education.
Controllable drilling parameter optimization for roller cone and polycrystalline diamond bits
Authors: Darwesh Ali K. , Rasmussen Thorkild M. , Al-Ansari Nadhir 
Published: December 2019

AbstractOil well drilling data from 23 oil wells in northern Iraq are analyzed and optimized controllable drilling parameters are found. The most widely used Bourgoyne and Young (BY) penetration rate model have been chosen for roller cone bits, and parameters were extracted to adjust for other bit types. In this regard, the collected data from real drilling operation have initially been averaged in short clusters based on changes in both lithology and bottom hole assemblies. The averaging was performed to overcome the issues related to noisy data negative effect and the lithological homogeneity assumption. Second, the Dmitriy Belozerov modifications for polycrystalline diamond bits compacts have been utilized to correct the model to the bit weight. The drilling formulas were used to calculate other required parameters for the BYM. Third, threshold weight for each cluster was determined through the relationship between bit weight and depth instead of the usual Drill of Test. Fourth, coefficients of the BYM were calculated for each cluster using multilinear regression. Fifth, a new model was developed to find the optimum drill string rotation based on changes in torque and bit diameter with depth. The above-developed approach has been implemented successfully on 23 oil wells field data to find optimum penetration rate, weight on bit and string rotation.
Boosting High-Rate Zinc-Storage Performance by the Rational Design of Mn2O3 Nanoporous Architecture Cathode
Authors: Feng Danyang , Gao Tu-Nan , Zhang Ling , Guo Bingkun , Song Shuyan , Qiao Zhen-An , Dai Sheng 
Published: December 2019

AbstractManganese oxides are regarded as one of the most promising cathode materials in rechargeable aqueous Zn-ion batteries (ZIBs) because of the low price and high security. However, the practical application of Mn2O3 in ZIBs is still plagued by the low specific capacity and poor rate capability. Herein, highly crystalline Mn2O3 materials with interconnected mesostructures and controllable pore sizes are obtained via a ligand-assisted self-assembly process and used as high-performance electrode materials for reversible aqueous ZIBs. The coordination degree between Mn2+ and citric acid ligand plays a crucial role in the formation of the mesostructure, and the pore sizes can be easily tuned from 3.2 to 7.3 nm. Ascribed to the unique feature of nanoporous architectures, excellent zinc-storage performance can be achieved in ZIBs during charge/discharge processes. The Mn2O3 electrode exhibits high reversible capacity (233 mAh g−1 at 0.3 A g−1), superior rate capability (162 mAh g−1 retains at 3.08 A g−1) and remarkable cycling durability over 3000 cycles at a high current rate of 3.08 A g−1. Moreover, the corresponding electrode reaction mechanism is studied in depth according to a series of analytical methods. These results suggest that rational design of the nanoporous architecture for electrode materials can effectively improve the battery performance.
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Monistic Argumentation
Authors: Bosley Richard 
Published: December 2019

On those occasions on which one gives an interpretation of a work both scanty in remains and obscure in meaning I would take it to be appropriate to insist that one's task is not to argue that one's interpretation is certainly correct but rather to argue that it is probably correct. It is accordingly not my task to argue that it is not possible that other interpretations of Parmenides’ Way of Truth are correct. Nor do I increase the likelihood of my own by decreasing that of theirs.I seek to give an interpretation which is rich enough to disclose the springs of monism. I am primarily concerned to show how we may understand those arguments which leave us with the conclusion that there is only one thing to know.
OP16 Assessing The Viability Of Medical Equipment Procurement In Hospital
Authors: Avdeyev Andrey , Benberin Valeriy , Shanazarov Nasrulla , Kudaibergenova Maigul , Kaptagayeva Aigul , Hailey David , Zhumagali Yenglik , Magzumova Raushan , Makalkina Larissa 
Published: December 2019

IntroductionABC-VEN analysis is an easy method of clinical and economic analysis on the costs of drug coverage and an important tool for monitoring and ensuring the rational use of medicines. However, this methodology is difficult to apply in assessing the viability of medical equipment procurement (MEP) in hospital. Using a combined model of ABC analysis and Multiple criteria decision analysis (MCDA) may be more appropriate to apply to MEP.MethodsWe created five standardized criteria, which present the main results of assessment of the viability of MEP for implementing new health technologies (HTs). These criteria address the following: 1) Novelty/innovation; 2) Comparative clinical effectiveness and safety; 3) Relevance (demand); 4) Economic effectiveness; and 5) Payback period. Based on these criteria we determine the threshold values of priority for MEP: 1) High priority; 2) Medium priority; 3) Low priority.ResultsUsing the ABC model and five standardized criteria, we analyzed all proposals from the Hospital units for implementing new HTs connected with MEP for 2018. In total, proposals contained 11 items of ME, among them three items were in group A (27%), two items were in group B (18%), and six items were in group C (55%). All items were high priority for procurement with the exception of one item from group B with medium priority. Items with low priority were not revealed which can be considered as a direct indicator of the operational effectiveness of Hospital-based HTA Unit. Excluding ME with a medium priority from the procurement plan would reduce Hospital costs by 13.5 percent.ConclusionsCombined ABC and MCDA analysis in the process of assessment the viability of MEP can give the opportunity to make comparative assessment of different types of ME based on standardized criteria; determine the priority for procurement of new ME; and avoid the influence of subjective factors of the managerial decision-making process in hospital.
OP21 Enhancing Capability: Patient Impact In Ultra-Orphan Conditions
Authors: Tonkinson Amanda , Livingstone Heidi , Upadhyaya Sheela , Leng Gillian 
Published: December 2019

IntroductionWritten evidence is submitted to the National Institute for Heath and Care Excellence (NICE) by patient organisations for all ultra-orphan evaluations. To enhance the capability of patient involvement at NICE and to further develop understanding of how patient generated evidence and input in ultra-orphan conditions can support the Health Technology Assessment (HTA) agencies beyond 2020, the Public Involvement Programme systematically reviews the impact the evidence has on committee decision making.MethodsThis study captured data from September 2017 to August 2018 for seven ultra-orphan evaluations. A paper questionnaire was given to each committee member to complete for each evaluation and entered in to an online system for analysis. Findings were used to inform the committee views which were highlighted in feedback letters to the patient groups. The questions included: how much impact and what sort of impact the patients had; both qualitative and quantitative data; and, a specific question on clarification of quality of life dataResultsWe obtained 83 responses showing the submissions: had a moderately high or high impact; gave the committee particular insight into quality of life data not provided elsewhere; provided new evidence; interpret the data from other sources; and, demonstrated consistency with other sourcesConclusionsPatient evidence is particularly useful for ultra-orphan conditions where other forms of evidence are limited. Patients can provide a unique insight into the burden of disease, the patient population, any updates of treatments and the impact on patient and carers. They provide real life data to the committee including information that standard Quality Adjusted Life Years measures do not. Evidence varied by condition with impact themes highlighting the effects on patient and carers including fear, stress and anxiety. The examples are recorded, updated annually and will be shared with national patient groups and offered internationally through the HTAi Interest Group on Patient and Citizen Involvement.
OP27 Engaging Patients: The EuroCAB Programme
Authors: Houyez François , Camp Rob 
Published: December 2019

IntroductionWhen developing a health technology that requires clinical studies, developers institute working relations with clinical investigators. In certain diseases areas, patients' representatives create their own advisory boards, which proved their utility in the early 90s, in particular for the development of products to treat HIV infection. Inspired by this model, where patients with a same disease join and meet with relevant developers and discuss all aspects of the research, the European Organisation for Rare Diseases (EURORDIS) proposes a new programme of such Community Advisory Boards for Rare Diseases (CAB).MethodsFor this programme, EURORDIS invites developers to sign a Charter of principles when engaging with patients, and provides guidelines on CABs, together with a mentoring programme for patients’ networks that are less experienced with the development and the evaluation of health technologies. CABs are driven by patients who set their agenda, who sign a Memorandum of Understanding with each developer, and who organise the sessions. Sessions typically last for two to four days during which different meetings with different developers can take place, or trainings. All meetings can take place under confidentiality arrangements, and minutes are written to keep track and to follow-up with all points discussed. Participants and agendas are made publicResultsAs of 2018, four CABs exist and operate (for tuberous sclerosis complex, for scleroderma, for cystic fibrosis, for Duchenne muscular dystrophy) and 18 others are in discussion with many due to start in 2019. Topics discussed cover the target population, the study feasibility, the endpoints including patient reported outcomes, the comparator choice and/or the acceptance of a placebo controlled trial, the quality of life, the practical aspects of the trials, and the identification of previously unknown or unmet patient needs/preferences. For products which are more advanced in their life-cycle, discussions can also cover compassionate use, pricing policy, relative efficacy etc.ConclusionsThis represents a well-structured programme for the engagement of patients, where collective thinking and exchange between different patients ensure high quality dialogue with developers and can inform HTA also.
OP44 Robot-Assisted Surgery: Joint HTA To Inform Australian Policy And Funding
Authors: Fennessy Paul , Clements Vanessa , Hibbitt Olivia 
Published: December 2019

IntroductionRobot-Assisted Surgery (RAS) has been available in Australia since 2003. There are 50 da Vinci RAS systems in Australia (18 in NSW and 12 in Victoria) with most in the private hospital sector. In Australia the capital cost of a da Vinci RAS system is up to AUD 4 million (USD 2.8 million), which excludes annual maintenance fees of AUD 250,000 (USD 175,000) and consumable costs of AUD 3,500 (USD 2,450) for each procedure.MethodsThe NSW Ministry of Health and Victorian Department of Health and Human Services commissioned a health technology assessment (HTA) to explore the benefits, risks and economic implications of surgical robotics, which involved a review of the peer reviewed literature, a cost benefit analysis of public sector patients who received RAS and broad stakeholder consultation to document current perspectives on RAS applications.ResultsRAS is as safe and effective as other surgical modalities when performed by sufficiently skilled surgeons, although evidence generally comes from small studies with limited follow-up time and few studies report long term mortality, morbidity or patient-reported outcomes. Comparative benefits of RAS are uncertain as most studies conclude little or no difference in procedure related or functional outcomes. While RAS reduces length of stay, which offers patient and health system benefits, this is insufficient to fully offset high capital and consumable costs currently charged to Australian providers. Government and clinical stakeholders identified that establishing an RAS service requires consideration of important factors, including: i) Governance is critical; ii) Higher case volumes may improve financial viability; and iii) a need for state-wide/national standards for surgeon training and credentialing.ConclusionsRAS is as safe and effective as other modalities when performed by skilled surgeons. However, uncertainty remains around long-term outcomes and clinical and cost effectiveness. An accredited training program, monitoring and evaluation will be critical to ensure outcomes data inform ongoing evidence assessment and government policy and investment.
OP49 MAIC-ing Use Of Trials? Study Of Matching-Adjusted Indirect Comparisons
Authors: Leahy Joy , Walsh Cathal 
Published: December 2019

IntroductionWhen conducting a Network Meta-Analysis (NMA) for a Health Technology Assessment (HTA), the submitting company typically will have access to Individual Patient Data (IPD) from their own trials, but only aggregate data (AgD) for the comparator. In this case, they can re-weight the IPD so that the covariate characteristics in the IPD trials match that of the AgD trials, using the increasingly popular method of Matching-Adjusted Indirect Comparison (MAIC).MethodsWe carried out a simulation study to investigate this method in a Bayesian setting. We simulated three IPD trials comparing treatments A and B (AB-IPD trials), and one aggregate data trial comparing treatments B and C (BC-AgD trial). We investigated two options of weighting covariates: 1. all three studies are weighted separately to match the BC-AgD trial (MAIC Separate Trials). 2. patients are weighted across all three IPD studies to match the BC-AgD trial, but the NMA still considers each trial separately (MAIC Pooled Trials). We compared the results of the MAIC to a standard NMA and a mixed IPD/AgD NMA. We applied these methods to a network of treatments for multiple myeloma.ResultsMAIC can provide more accurate estimates of the relative treatment effects than a standard NMA in the BC-AgD trial population. However, MAIC may decrease the accuracy of the relative treatment effects in the overall population. Treatment rankings were unchanged when applying MAIC to the multiple myeloma network.ConclusionsMAIC is beneficial as a sensitivity analysis to demonstrate that results hold across patient populations. If there is a difference in relative treatment effects attributable to population imbalances, then it is useful to be able to quantify this difference. However, we recommend using either a standard NMA or a mixed IPD/AgD NMA for the base case analysis, given the potential bias that can arise in an MAIC.
OP75 Facts And Values In Health Technology Assessment: The Case Of Non-Invasive Prenatal Testing
Authors: Bloemen Bart , Jansen Maarten , Rijke Wouter , Oortwijn Wija , Vanderwilt Gert 
Published: December 2019

IntroductionHealth Technology Assessment (HTA) is where facts and values meet: the evidence that is considered relevant to the assessment of a technology depends on the value framework used. In the context of the European project VALIDATE (Values in doing assessments of healthcare technologies), we assessed to what extent this interplay between facts and values is acknowledged in HTA reports on non-invasive prenatal testing (NIPT). Our aim is to gain a better understanding of this fact-value relationship, and to contribute to the development of capacity for ethical analyses in HTA.MethodsFive reviewers independently analyzed HTA reports on NIPT, obtained from the National Institute for Health Research (NIHR) HTA database, by answering a structured questionnaire on: (i) arguments, values, and conclusions; (ii) relations between values and collected evidence; (iii) operationalizations of the values involved. Ethical argumentation was analyzed using the method of specifying norms. This method holds that for general, abstract ethical principles to reach concrete cases, principles need to be specified in such a way as to achieve maximal coherence between different value commitments and practice. The results of the analysis were discussed in joint meetings to arrive at a consensus on interpretation.ResultsOur results show that the pivotal role of values in defining what counts as relevant evidence and why, is rarely acknowledged. The same holds for the importance of specifying values as a means to achieve greater coherence between the use of healthcare technologies and a range of values.ConclusionsThere is ample room for improvement in clarifying the role of values in HTA: they can serve to explain and justify what evidence is considered relevant to the assessment of a healthcare technology. Recognizing that abstract values need specification in order to reach concrete cases opens up new opportunities for exploring in what way values are affected by healthcare technologies.