bluuebunny/crossref_metadata_2025_split huggingface dataset:
Invasive species watch lists: guidance for development, communication, and application
Authors: Reaser Jamie K. , Frey Mark , Meyers N. Marshall 
Published: December 2019

AbstractA watch list is a list of invasive species to be prioritized for surveillance, reporting, and other possible responses in order to reduce the risk of impact to valued assets. Watch lists are basic, yet multi-functional tools for the early detection of and rapid response to invasive species. There is, however, a need to substantially improve watch list standardization, accessibility, and associated communication strategies. We provide guidance to achieve these aims, including an overview of guiding principles and a list of questions to consider when one develops, communicates, and applies invasive species watch lists. Our guidance is intended to support invasive species watch lists development and application globally.
Objectivity and Perspectival Content
Authors: Kölbel Max 
Published: December 2019

AbstractWhat is objectivity? What would it take to have objective representations and do we (humans) have what it takes? This paper aims to contribute to answering these questions. To this end, it isolates one relevant sense of objectivity and proposes a generalization of standard frameworks of representational content in order to engage with the question in a way that is rhetorically fair. Armed with a general conception of perspectival content, taken from the literature on centred orde secontent, the paper articulates one necessary condition for objective representation: the possession of objective concepts and therefore objective contents. Two ways of meeting (or approximately meeting) this condition are discussed in an exploratory way.
“Spotting the signs” of trafficking recruitment online: exploring the characteristics of advertisements targeted at migrant job-seekers
Authors: Volodko Ada , Cockbain Ella , Kleinberg Bennett 
Published: December 2019

AbstractDespite considerable concern about how human trafficking offenders may use the Internet to recruit their victims, arrange logistics or advertise services, the Internet-trafficking nexus remains unclear. This study explored the prevalence and correlates of a set of commonly-used indicators of labour trafficking in online job advertisements. Taking a case study approach, we focused on a major Lithuanian website aimed at people seeking work abroad. We examined a snapshot of job advertisements (n = 430), assessing both their general characteristics (e.g. industry, destination country) and the presence of trafficking indicators. The vast majority (98.4%) contained at least one indicator, suggesting certain "indicators" may in fact be commonplace characteristics of this labour market. Inferential statistical tests revealed significant but weak relationships between the advertisements’ characteristics and the number and nature of indicators present. While there may be value in screening job advertisements to identify potential labour trafficking and exploitation, additional information is needed to ascertain actual labour trafficking. We conclude with an outlook on automated approaches to identifying cases of possible trafficking and a discussion of the benefits and ethical concerns of a data science-driven approach.
A new approach for satisfactory pensions with no guarantees
Authors: Boado-Penas M. Carmen , Eisenberg Julia , Helmert Axel , Krühner Paul 
Published: December 2019

AbstractThe increase in longevity, the ultra-low interest rates and the guarantees associated to pension benefits have put significant strain on the pension industry. Consequently, insurers need to be in a financially sound position while offering satisfactory benefits to participants. In this paper, we propose a pension design that goes beyond the idea of annuity pools and unit-linked insurance products. The purpose is to replace traditional guarantees with low volatility, mainly achieved by collective smoothing algorithms and an adequate asset management. With the aim of offering security to the insured, we discuss the optimisation of some key variables of the proposed pension product to target both a satisfactory level of the initial pension and stable pension payments over time. By combining such well-known products as unit-linked and annuities, we show that it is possible to design a pension product with both high-expected return and low risk for the policyholder. However, differently than in the classical unit-linked framework, we do not allow the individuals to choose the underlying funds. Instead, the funds are under the surveillance of an insurance company’s professional risk management, which induces better informed decisions.
OP15 Use Of Digital Health Information Among HIV Populations In Uganda
Authors: Nabaggala Maria , Kiragga Agnes , Naggirinya Naggirinya Agnes , Oseku Elizabeth , Akirana Josephine , Oyat Phillip , Pattery Theresa , Ratanshi Rosalind 
Published: December 2019

IntroductionCellphones can be used to support treatment and disseminate health information. Literature has shown an unmet need for information for people living with human immunodeficiency virus (PLHIV) and others affected by the epidemic. The World Health Organization (WHO) emphasizes the incorporation of cellphones as a tool to support HIV adherence and information dissemination. We sought to assess rates of utilization of health information provided through the Call for Life Uganda (CFLU) platform among HIV-positive individuals.MethodsCFLU uses the Mobile Technology for Community Health (MoTeCH) software Call for Life™ developed by Janssen and adapted to the Uganda setting in collaboration with Infectious Diseases Institute (IDI). It offers daily pill reminder calls/sms, health info tips; symptom reporting and clinic appointment reminders. CFLU was used in a randomized control trial (RCT) undertaken to improve outcomes in HIV patients providing information categorized into Antiretroviral therapy (ART) and adherence, positive living, general health, pregnancy, breast-feeding, and sexuality. We used data from the RCT between August 2016 to June 2018 to generate frequency distributions and gender differences regarding utilization of health information.ResultsFrom a total of 300 respondents receiving the CFLU intervention, a majority were: females (70%), aged 16 to 35 years (62%), married (74.7%), had attained secondary and higher education (57.3%); and employed (67.7%). Overall, 255/300 (85%) utilized at least one of the health-tips categories. Participants utilized mostly general health information 211/300 (70%); followed ARTs and adherence 173/300 (57.7%); pregnancy and breast-feeding 137/300 (45.7%), sexuality 113/300 (37.7%), and positive living 98/300 (32.7%). Gender differences were noted regarding ARTs and adherence utilization with higher percentage of females to males (61% vs 50%) and for sexuality, a higher percentage of males to females (41.6% vs 33.3%, p < 0.05).ConclusionsThe findings indicate that when availed with platforms for health-related information, PLHIV populations will utilize them mostly for adherence. We recommend increased incorporation of such technologies to disseminate information in this key population.
OP31 HTA And Patients’ Preferences: Starting A Discrete Choice Experiment
Authors: Poder Thomas , Beffarat Marion , Benkhalti Maria , Dagenais Pierre , Ladouceur Ginette 
Published: December 2019

IntroductionHospital-based health technology assessment (HB-HTA) needs to consider all relevant data to help decision-making, including patients’ preferences. In this study, we comprehensively describe the process of identification, refinement and selection of attributes and levels for a discrete choice experiment (DCE).MethodsA mixed-methods design was used to identify attributes and levels explaining low back pain (LBP) patients’ choice for a non-surgical treatment. This design combined a systematic literature review with a patients’ focus group, one-on-one interactions with experts and patients, and discussions with stakeholder committee members. Following the patient's focus group, ranking exercises were conducted. A consensus about the attributes and levels was researched during discussions with committee members.ResultsThe literature review yielded 40 attributes to consider in patients’ treatment choice. During the focus group, one additional attribute emerged. The ranking exercises allowed selecting eight attributes for the DCE. These eight attributes and their levels were discussed and validated by the committee members who helped reframe two levels in one of the attributes and delete one attribute. The final seven attributes were: treatment modality, pain reduction, onset of treatment efficacy, duration of efficacy, difficulty in daily living activities, sleep problem, and knowledge about their body and pain.ConclusionsThis study is one of the few to comprehensively describe the selection process of attributes and levels for a DCE. This may help ensure transparency and judge the quality of the decision-making process. In the context of a HB-HTA unit, this strengthens the legitimacy to perform a DCE to better inform decision-makers in a patient-centered care approach.
OP45 Biological Drugs And Rheumatoid Arthritis In Brazil: An Overview
Authors: Mega Tacila , Santos Vania Canuto , Silva Rondineli 
Published: December 2019

IntroductionThe Brazilian Unified Health System (SUS) is known worldwide for ensuring universal assistance to citizens, which includes the supply of medicines free of charge. Biological drugs consume about 40 percent of the public budget for pharmaceutical services in the SUS and Rheumatoid Arthritis (RA) is the largest consumer of these resources, serving about 110,000 patients. Since 2002 there has been a clinical guideline for the care of patients with rheumatoid arthritis in Brazil, currently providing 10 biological drugs for treatment of RA. The objective of this study is to present data about the provision, expenditure and profile of users of biological drugs for rheumatoid arthritis in SUS.MethodsRetrospective and exploratory study, using administrative data regarding the purchase and consumption of biological drugs Infliximab, Etanercept, Adalimumab, Rituximab, Abatacept (intravenous and subcutaneous), Tocilizumab, Golimumab and Certolizumab pegol for the treatment of RA between 2012 and 2017 in SUS.ResultsThere was an expenditure of approximately USD 421.7 million from the Brazilian Ministry of Health with the supply of about 2 million pharmaceutical units of biological drugs for treatment of rheumatoid arthritis, 79 percent of them destined for female users and 89.2 percent for the 40-69 age group. The M05.8 and M.06.0 codes of the International Classification of Diseases (ICD-10) were the most prevalent among the arthritic population served. Adalimumab and Etanercept accounted for 68.3 percent of total expenditure. A reduction in the use of these medicines were observed after the availability of new drugs for the treatment of the disease between 2014 and 2017.ConclusionsBrazil is one of the largest consumers of biological medicines in the world. The use of real-life data allows monitoring trends and costs of the use of these drugs as well as changes with the entry of new therapies and biosimilar medicines.
OP47 Need For New Thrombectomy Centers? A Practical Decision Framework
Authors: Nicolae Maria Vutcovici , Boothroyd Lucy , Azzi Leila , Lambert Laurie , de Guise Michèle 
Published: December 2019

IntroductionStroke is a major contributor to mortality, disability and long-term use of healthcare services. As for all chrono-dependant conditions, clinical results are associated with timely access to appropriate care. Thrombectomy (EVT) is an effective treatment for large vessel occlusions, but can only be provided in highly-specialized centers by experienced personnel. We sought to develop a framework to aid decision-making on the appropriateness of opening new EVT centers in Québec, Canada.MethodsData sources included provincial administrative healthcare databases, population density statistics, field evaluation of Québec's four existing EVT care networks, and literature review concerning structural and performance criteria for EVT centers. We consulted EVT clinical teams, interdisciplinary stroke experts, patients, professional association representatives, healthcare managers and decision-makers.ResultsAccess to EVT is suboptimal in all 17 regions of Québec, with virtually no access in remote areas. Results of key performance indicators indicated favorable treatment delays after arrival at the EVT center. However, door-to-needle and door-in-door-out times were long for patients transferred from non-EVT centers. High use of ambulances indicated the potential to transport patients to the most appropriate center. In light of ‘real world’ results and other sources of information, the need for a new EVT center should consider the following criteria: sub-optimal EVT access within the region; transport time to an existing EVT center >1 hour; expected patient volume within 2 hours of transport; impact on volume of existing programs; availability of long-term financial support; availability of a critical mass of neurointerventionists, vascular neurologists, and neurosurgeons; demonstrated quality of stroke care; and, presence of a stroke unit.ConclusionsThe triangulation of literature, clinician experience and the Québec context enriched the evaluation process. Furthermore, this facilitated the development of a framework that was broadly applicable across regions to the real-world setting of decision-making in a complex system of care.
OP56 Are Therapeutic Positioning Reports Driving Pharmaceutical Reimbursement Outcomes In Spain?
Authors: Dacosta Raquel Fernandez , Berardi Andrea , Macaulay Richard 
Published: December 2019

IntroductionFollowing marketing authorization in Spain, new medicines are assessed by the Inter-Ministerial Pricing Commission for Pharmaceuticals (CIPM), which provides reimbursement recommendations with a maximum ex-factory price. However, there are 17 autonomous regions, which can make distinct reimbursement decisions. To drive consistency, the Spanish Agency for Medicines and Health Products has issued national Therapeutic Positioning Reports (TPRs) for new medicines since 2012. Since November 2017, CIPM recommendations have been published monthly, giving the opportunity to analyze the impact of TPRs on the speed and outcome of CIPM decisions, which this research evaluates.MethodsPublicly-available CIPM and TRP decisions were identified from www.msssi.gob.es and www.aemps.gob.es, respectively. Marketing authorization dates were identified from www.ema.europa.eu or www.aemps.gob.es (10 March 2007-11 February 2018). Pearson's chi-squared and Mann-Whitney U statistical tests were performed using R.ResultsOne hundred and ninety-three drug-indication pairings with an associated TPR were identified. The majority (62% [120/193]) were recommended as alternative treatment options with only 19 percent (36/193) deemed to be superior and 19 percent (37/193) not recommended. One hundred and eight CIPM recommendations were identified across seven monthly reports, issued a mean of 12.2 months after market approval, 59 percent (64/108) were positive and 41 percent (44/108) were negative recommendations. There were 34 drug-indication pairings with both CIPM and TPR recommendations available. Of these, 24 percent, 56 percent and 21 percent had TPR outcomes of ‘superior’, ‘alternative’ and ‘not recommended’, respectively and 71 percent and 29 percent had positive and negative CIPM outcomes. Drug-indication pairings with ‘negative’ TPRs were significantly more likely to have negative CIPMs than those with either ‘alternative’ or ‘superior’ TPRs (71% vs. 19%, respectively, χ2 = 5.16, p = 0.02) and were more likely to experience significantly longer delays to CIPM recommendation (23.9 vs. 13.5 months, respectively, U = 50, p = 0.03).ConclusionsDrug-indication pairings with ‘positive’ and ‘alterative’ TPR outcomes are associated with significantly better and faster CIPM recommendations than those with ‘not recommended’ TPR outcomes
OP74 Stoma Cover Use By Fully Laryngectomized Patients
Authors: Deblois Simon , L'Espérance Sylvain , Coulombe Martin , Lepanto Luigi , Rhainds Marc 
Published: December 2019

IntroductionThe use of stoma covers has been a common clinical practice for laryngectomized patients for several years. In the province of Québec, Canada, laryngectomized patients can obtain stoma covers through a dedicated program providing them with medical supplies and voice re-education services. For many years, the program's supply has included cloth and/or foam covers, but the supply of Heat and Moisture Exchangers (HME) has been limited. Two hospital-based HTA units joined their expertise to assess the opportunity of providing HMEs to more patients, depending on their clinical characteristics.MethodsTheir joined assessment rested on a systematic review (SR) and a field assessment. The systematic review aimed at assessing the efficacy, clinical effectiveness and safety of various types of stoma covers. The field inquiries intended to assess the perceptions of clinicians and managers towards stoma covers in clinical practice.ResultsWe included 27 studies in the SR. Most of them appraised the clinical effectiveness or safety of HME filters. Their methodological quality was very low with potential conflicts of interest whereas many studies were financed by the industry. The heterogeneity of study designs, expected outcomes and paucity of comparative studies prevented the pooling of results. Industry sponsorship appeared to be an important issue, since 17 of the included studies were sponsored. The SR did not provide conclusive evidence concerning the efficacy, clinical effectiveness and safety of the various types of stoma covers. The field inquiries intended to assess the perceptions of clinicians and managers towards stoma covers in clinical practice. It showed that industry representatives are quite active in clinical settings, promoting their products. Clinicians’ opinions and preferences were coherent with the systematic review main observations: in a context where the quality of the evidence is low, clinicians’ recommendations of stoma protectors for laryngectomies are mainly based on their professional experience and academic training.ConclusionsFuture research of high methodological quality would strengthen the evidence concerning the relative efficacy and safety of different stoma protectors. These studies would help define evidence-based allocation criteria and set parameters so that the choice of a stoma protector is best adapted to a laryngectomized patients’ condition.
OP77 Nudging In Non-Invasive Prenatal Testing: Ethical Guidance
Authors: Stanak Michal 
Published: December 2019

IntroductionNon-Invasive Prenatal Testing (NIPT) has already established itself in many European countries (either via public or private institutions) as an option at hand that pregnant women can choose. Based on mother's blood, NIPT claims to “quasi-diagnose” among other things the presence of chromosomal abnormalities caused by an aneuploidy of a chromosome (such as Trisomy 13, 18, and 21). Apart from normative issues concerning the question of “whether to fund NIPT by universal coverage”, NIPT gives rise also to normative issues concerning the question of “how to put NIPT into practice” – the analysis of which is the goal of this study.MethodsComplemented by a hand search, we have conducted a systematic literature search in Ovid MEDLINE and PsycINFO for combinations of NIPT and nudging, NIPT and participation, and NIPT and ethics. Screening was based on content analysis of titles, abstracts, and articles. Writing of the study is in progress.ResultsWe identified 83 references of which 39 were included. The main instance of nudging (or also of unintentional choice design) was the use of default bias (the application or reduction of friction cost/hassle factor) that influenced the turnout to NIPT. In establishing NIPT in universal coverage systems, further potential biases identified were the use of authority bias, bandwagon effect, sunk-cost bias, and framing effect. The core ethical challenges with nudging in NIPT derive from the lack of transparency of the methods applied and the challenge of paternalism.ConclusionsAlong the line of accountability for reasonableness, four specific recommendations are suggested as the ethical guidance to using of the tool of nudging in NIPT: (i) decision makers should recognize that some choice design is inevitable, (ii) nudging should be done transparently, (iii) rationales for nudging should be publicly accessible. (iv) revision procedures should be put in place.
OP79 Improving Public Understanding Of Scottish Medicines Consortium Advice
Authors: Dickson Jennifer , Taylor Louise , McCormack Jackie , Downes Noreen , Lockhart Lindsay , Walker Laura 
Published: December 2019

IntroductionTransparency of processes and decision making is important to the Scottish Medicines Consortium (SMC). An independent review of access to new medicines in Scotland in 2016 recommended that SMC should review its communication of decisions with a view to achieving greater transparency. SMC therefore began to develop plain English summaries of advice on each new medicine.MethodsA multi-stakeholder approach was adopted to develop the summary documents, with patient groups involved. Firstly, a review of communications for the public from other HTA organizations was conducted. The public involvement team then held a workshop to find out what patient groups felt would be important to include when explaining SMC decisions to patients and the public. The process was also informed by reviewing examples of good practice from other parts of NHSScotland, including patient versions of Scottish Intercollegiate Guidelines Network (SIGN) clinical guidelines. Exemplar documents were then developed and feedback sought from the Public Involvement Network Advisory Group.ResultsA format was developed for the SMC ‘Decision Explained’ summaries consisting of a question and answer format for each medicine decision in a two page document. The summaries were piloted internally over a six month period, during which the development process and layout were finalized. Since September 2018 these summaries have been published on the website alongside the technical advice.ConclusionsPartnership working between SMC and patient groups has helped to develop a new way of communicating SMC's decisions to patients and the public in a clear way, helping to improve transparency and understanding. Evaluation of the summaries will be undertaken from six months of publication.