Use of Research Evidence: Social Services Portfolio

The William T. Grant Foundation intends that the emerging research evidence from its Use of Research Evidence (URE) portfolio be useful to those engaged in these (and other) diverse efforts. But broad and meaningful use of research evidence will require conversations that extend beyond researchers and expert forums. Indeed, URE findings suggest that policymakers and practitioners should not be viewed simply as "end users" of research evidence. To provide insight into how URE studies and the resulting evidence could be most relevant and useful to them, policymakers and practitioners at all levels in the social services system must have a voice in these conversations. This paper is intended to foster and inform dialogue among researchers, policymakers, and practitioners by reflecting on the Foundation's social services URE portfolio from the perspective of policy and practice and by identifying potential opportunities for the next generation of studies and considerations for those undertaking that work

Big Data and the Internet of Things

Advances in sensing and computing capabilities are making it possible to embed increasing computing power in small devices. This has enabled the sensing devices not just to passively capture data at very high resolution but also to take sophisticated actions in response. Combined with advances in communication, this is resulting in an ecosystem of highly interconnected devices referred to as the Internet of Things - IoT. In conjunction, the advances in machine learning have allowed building models on this ever increasing amounts of data. Consequently, devices all the way from heavy assets such as aircraft engines to wearables such as health monitors can all now not only generate massive amounts of data but can draw back on aggregate analytics to "improve" their performance over time. Big data analytics has been identified as a key enabler for the IoT. In this chapter, we discuss various avenues of the IoT where big data analytics either is already making a significant impact or is on the cusp of doing so. We also discuss social implications and areas of concern.Comment: 33 pages. draft of upcoming book chapter in Japkowicz and Stefanowski (eds.) Big Data Analysis: New algorithms for a new society, Springer Series on Studies in Big Data, to appea

Evaluating Value-Based Frameworks Used for Relapsed or Refractory Multiple Myeloma Regimens: ICER Report, ASCO Value Framework, and NCCN Evidence Blocks

BACKGROUND: With the continuous rise in costs for oncology drugs, the Institute for Clinical and Economic Review (ICER), the American Society of Clinical Oncology (ASCO) and the National Comprehensive Cancer Network (NCCN) have developed value-based frameworks (VBFs) to assist stakeholders in formulary and treatment decisionmaking. While emerging VBFs have the potential to significantly impact therapeutic options for patients, it is important to understand the differences associated with those VBFs within a therapeutic area. OBJECTIVE: To compare ICER, ASCO, and NCCN VBFs across three therapeutic options for relapsed or refractory multiple myeloma (RRMM). METHODS: The values of carfilzomib (CFZ), elotuzumab (ELO), and ixazomib (IX) were generated using ICER, ASCO, and NCCN VBFs. Those regimens, used for second or third line treatment of RRMM, were chosen because they share a common comparator in clinical trials, lenalidomide + dexamethasone (LEN + DEX). The ICER 2016 report of treatment options for RRMM was used to obtain results of the comparative clinical effectiveness and the cost effectiveness analysis for those regimens compared to LEN + DEX. ASCO’s 2016 VBF, which incorporates clinical benefit, toxicity and bonus points was used to generate a net health benefit (NHB) score without a scale along with the drug wholesale acquisition cost (WAC) for each regimen compared to LEN + DEX. The NCCN VBF uses a score ranging from 1 to 5, with 1 as the least favorable and 5 as the most favorable, for each of five evidence blocks: efficacy, safety, quality, consistency, and affordability. The 2016 Multiple Myeloma NCCN evidence blocks was used to obtain the value of CFZ, ELO, and IX. RESULTS: The ICER VBF suggested with moderate certainty that CFZ, ELO, and IX provide a better NHB in patients with RRMM compared to LEN + DEX. Second-line and third-line treatment costs per QALY for CFZ, ELO, and IX were $199,982,$427,607 and $433,794, and$238,560, $481,244, and$484,582, respectively. The ASCO VBF generated a total NHB of 28.8, 23.7 and 23.0 with a monthly WAC of $17,364,$16,032 and $20,607 for CFZ, ELO, and IX, respectively. The monthly cost of LEN + DEX was$11,616. The NCCN VBF had an efficacy score of 5, 3, and 4 for CFZ, ELO, IX, respectively. Safety, quality, consistency, and affordability scores of 3, 4, 4, and 1, respectively, were the same across regimens. CONCLUSIONS: ICER, ASCO and NCCN VBFs suggest CFZ may be the most valued treatment out of the three regimens. However, their applicability in stakeholder’s decision-making remains unclear due to uncertainty and challenges associated with them. SPONSORSHIP: None.https://jdc.jefferson.edu/jcphposters/1012/thumbnail.jp

Assessing and enhancing quality through outcomes-based continuing professional development (CPD): a review of current practice

Numerous professional bodies have questioned whether traditional input-based continuing professional development (CPD) schemes are effective at measuring genuine learning and improving practice performance and patient health. The most commonly used type of long-established CPD activities, such as conferences, lectures and symposia, have been found to have a limited effect on improving practitioner competence and performance, and no significant effect on patient health outcomes. Additionally, it is thought that the impact of many CPD activities is reduced when they are undertaken in isolation outside of a defined structure of directed learning. In contrast, CPD activities which are interactive, encourage reflection on practice, provide opportunities to practice skills, involve multiple exposures, help practitioners to identify between current performance and a standard to be achieved, and are focused on outcomes, are the most effective at improving practice and patient health outcomes

On the role of Prognostics and Health Management in advanced maintenance systems

The advanced use of the Information and Communication Technologies is evolving the way that systems are managed and maintained. A great number of techniques and methods have emerged in the light of these advances allowing to have an accurate and knowledge about the systems’ condition evolution and remaining useful life. The advances are recognized as outcomes of an innovative discipline, nowadays discussed under the term of Prognostics and Health Management (PHM). In order to analyze how maintenance will change by using PHM, a conceptual model is proposed built upon three views. The model highlights: (i) how PHM may impact the definition of maintenance policies; (ii) how PHM fits within the Condition Based Maintenance (CBM) and (iii) how PHM can be integrated into Reliability Centered Maintenance (RCM) programs. The conceptual model is the research finding of this review note and helps to discuss the role of PHM in advanced maintenance systems.EU Framework Programme Horizon 2020, 645733 - Sustain-Owner - H2020-MSCA-RISE-201

Freshwater ecosystem services in mining regions : modelling options for policy development support

The ecosystem services (ES) approach offers an integrated perspective of social-ecological systems, suitable for holistic assessments of mining impacts. Yet for ES models to be policy-relevant, methodological consensus in mining contexts is needed. We review articles assessing ES in mining areas focusing on freshwater components and policy support potential. Twenty-six articles were analysed concerning (i) methodological complexity (data types, number of parameters, processes and ecosystem-human integration level) and (ii) potential applicability for policy development (communication of uncertainties, scenario simulation, stakeholder participation and management recommendations). Articles illustrate mining impacts on ES through valuation exercises mostly. However, the lack of ground-and surface-water measurements, as well as insufficient representation of the connectivity among soil, water and humans, leave room for improvements. Inclusion of mining-specific environmental stressors models, increasing resolution of topographies, determination of baseline ES patterns and inclusion of multi-stakeholder perspectives are advantageous for policy support. We argue that achieving more holistic assessments exhorts practitioners to aim for high social-ecological connectivity using mechanistic models where possible and using inductive methods only where necessary. Due to data constraints, cause-effect networks might be the most feasible and best solution. Thus, a policy-oriented framework is proposed, in which data science is directed to environmental modelling for analysis of mining impacts on water ES

Curriculum renewal for interprofessional education in health

In this preface we comment on four matters that we think bode well for the future of interprofessional education in Australia. First, there is a growing articulation, nationally and globally, as to the importance of interprofessional education and its contribution to the development of interprofessional and collaborative health practices. These practices are increasingly recognised as central to delivering effective, efficient, safe and sustainable health services. Second, there is a rapidly growing interest and institutional engagement with interprofessional education as part of pre-registration health professional education. This has changed substantially in recent years. Whilst beyond the scope of our current studies, the need for similar developments in continuing professional development (CPD) for health professionals was a consistent topic in our stakeholder consultations. Third, we observe what might be termed a threshold effect occurring in the area of interprofessional education. Projects that address matters relating to IPE are now far more numerous, visible and discussed in terms of their aggregate outcomes. The impact of this momentum is visible across the higher education sector. Finally, we believe that effective collaboration is a critical mediating process through which the rich resources of disciplinary knowledge and capability are joined to add value to existing health service provision. We trust the conceptual and practical contributions and resources presented and discussed in this report contribute to these developments.Office of Learning and Teaching Australi