39,601 research outputs found

    Exploring the Use of Cost-Benefit Analysis to Compare Pharmaceutical Treatments for Menorrhagia

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    Background: The extra-welfarist theoretical framework tends to focus on health-related quality of life, whilst the welfarist framework captures a wider notion of well-being. EQ-5D and SF-6D are commonly used to value outcomes in chronic conditions with episodic symptoms, such as heavy menstrual bleeding (clinically termed menorrhagia). Because of their narrow-health focus and the condition’s periodic nature these measures may be unsuitable. A viable alternative measure is willingness to pay (WTP) from the welfarist framework. Objective: We explore the use of WTP in a preliminary cost-benefit analysis comparing pharmaceutical treatments for menorrhagia. Methods: A cost-benefit analysis was carried out based on an outcome of WTP. The analysis is based in the UK primary care setting over a 24-month time period, with a partial societal perspective. Ninety-nine women completed a WTP exercise from the ex-ante (pre-treatment/condition) perspective. Maximum average WTP values were elicited for two pharmaceutical treatments, levonorgestrel-releasing intrauterine system (LNG-IUS) and oral treatment. Cost data were offset against WTP and the net present value derived for treatment. Qualitative information explaining the WTP values was also collected. Results: Oral treatment was indicated to be the most cost-beneficial intervention costing £107 less than LNG-IUS and generating £7 more benefits. The mean incremental net present value for oral treatment compared with LNG-IUS was £113. The use of the WTP approach was acceptable as very few protests and non-responses were observed. Conclusion: The preliminary cost-benefit analysis results recommend oral treatment as the first-line treatment for menorrhagia. The WTP approach is a feasible alternative to the conventional EQ-5D/SF-6D approaches and offers advantages by capturing benefits beyond health, which is particularly relevant in menorrhagia

    Simplifying HL7 Version 3 messages

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    Design and implementation of a secure and user-friendly broker platform supporting the end-to-end provisioning of e-homecare services

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    We designed a broker platform for e-homecare services using web service technology. The broker allows efficient data communication and guarantees quality requirements such as security, availability and cost-efficiency by dynamic selection of services, minimizing user interactions and simplifying authentication through a single user sign-on. A prototype was implemented, with several e-homecare services (alarm, telemonitoring, audio diary and video-chat). It was evaluated by patients with diabetes and multiple sclerosis. The patients found that the start-up time and overhead imposed by the platform was satisfactory. Having all e-homecare services integrated into a single application, which required only one login, resulted in a high quality of experience for the patients

    Towards a Unifying Process Framework for Services Knowledge Management

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    Activities concerned with the design, planning and execution of services are becoming increasingly complex. This is due to the involvement of many different stakeholders, the complexity of the service systems themselves, and the dynamic nature of their organizational and ICT environments. Service knowledge management helps share and reuse relevant knowledge among the different stakeholders, and therefore emerges as a critical factor to perform service activities with required efficiency and quality. Recent advances in knowledge management provide promising opportunities to support individual service activities within a single domain. Yet, sharing knowledge throughout the service life-cycle and across service domains is still very challenging. The source of service knowledge, its usage, update frequency, encoding and associated stakeholders may vary depending upon the service activity and the service domain. Based on a critical analysis of currently proposed frameworks, we argue that a process framework approach is beneficial for service knowledge management. To support our claim, we offer an abstract template and a typical service life-cycle that can be adopted to integrate heterogeneous service knowledge from diverse sources

    Exploring the Impact of Socio-Technical Core-Periphery Structures in Open Source Software Development

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    In this paper we apply the social network concept of core-periphery structure to the sociotechnical structure of a software development team. We propose a socio-technical pattern that can be used to locate emerging coordination problems in Open Source projects. With the help of our tool and method called TESNA, we demonstrate a method to monitor the socio-technical core-periphery movement in Open Source projects. We then study the impact of different core-periphery movements on Open Source projects. We conclude that a steady core-periphery shift towards the core is beneficial to the project, whereas shifts away from the core are clearly not good. Furthermore, oscillatory shifts towards and away from the core can be considered as an indication of the instability of the project. Such an analysis can provide developers with a good insight into the health of an Open Source project. Researchers can gain from the pattern theory, and from the method we use to study the core-periphery movements
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