Cost-effectiveness analysis of pharmaceutical treatment options in the first-line management of major depressive disorder in Belgium

The objective of this study was to assess the cost effectiveness of commonly used antidepressants as first-line treatment of major depressive disorder (MDD) in Belgium. The model structure was based on a decision tree developed by the Swedish TLV (TandvAyenrds- och lakemedelsformAyennsverket) and adapted to the Belgium healthcare setting, using primary local data on the patterns of treatment and following KCE [Federal Knowledge Center (Federaal Kenniscentrum voor de Gezondheidszorg)] recommendations. Comparators were escitalopram, citalopram, fluoxetine, paroxetine, sertraline, duloxetine, venlafaxine, and mirtazapine. In the model, patients not achieving remission or relapsing after remission on the assessed treatment moved to a second therapeutic step (titration, switch, add-on, or transfer to a specialist). In case of failure in the second step or following a suicide attempt, patients were assumed to be referred to secondary care. The time horizon was 1 year and the analysis was conducted from the National Institute for Health and Disability Insurance (NIHDI; national health insurance) and societal perspectives. Remission rates were obtained from the TLV network meta-analysis and risk of relapse, efficacy following therapeutic change, risk of suicide attempts and related death, utilities, costs (2012), and resources were derived from the published literature and expert opinion. The effect of uncertainty in model parameters was estimated through scenario analyses and a probabilistic sensitivity analysis (PSA). In the base-case analysis, escitalopram was identified as the optimal strategy: it dominated all other treatments except venlafaxine from the NIHDI perspective, against which it was cost effective with an incremental cost-effectiveness ratio of a,not sign6,352 per quality-adjusted life-year (QALY). Escitalopram also dominated all other treatments from the societal perspective. At a threshold of a,not sign30,000 per QALY and from the NIHDI perspective, the PSA showed that the probability of escitalopram being identified as the optimal strategy ranged from 61 % (vs. venlafaxine) to 100 % (vs. fluoxetine). Escitalopram was associated with the highest probability of being the optimal treatment from the NIHDI and societal perspectives. This analysis, based on new Belgian clinical practice data and following KCE requirements, provides additional information that may be used to guide the choice of treatments in the management of MDD in Belgium

Enhancing the forensic comparison process of common trace materials through the development of practical and systematic methods

An ongoing advancement in forensic trace evidence has driven the development of new and objective methods for comparing various materials. While many standard guides have been published for use in trace laboratories, different areas require a more comprehensive understanding of error rates and an urgent need for harmonizing methods of examination and interpretation. Two critical areas are the forensic examination of physical fits and the comparison of spectral data, which depend highly on the examiner’s judgment. The long-term goal of this study is to advance and modernize the comparative process of physical fit examinations and spectral interpretation. This goal is fulfilled through several avenues: 1) improvement of quantitative-based methods for various trace materials, 2) scrutiny of the methods through interlaboratory exercises, and 3) addressing fundamental aspects of the discipline using large experimental datasets, computational algorithms, and statistical analysis. A substantial new body of knowledge has been established by analyzing population sets of nearly 4,000 items representative of casework evidence. First, this research identifies material-specific relevant features for duct tapes and automotive polymers. Then, this study develops reporting templates to facilitate thorough and systematic documentation of an analyst’s decision-making process and minimize risks of bias. It also establishes criteria for utilizing a quantitative edge similarity score (ESS) for tapes and automotive polymers that yield relatively high accuracy (85% to 100%) and, notably, no false positives. Finally, the practicality and performance of the ESS method for duct tape physical fits are evaluated by forensic practitioners through two interlaboratory exercises. Across these studies, accuracy using the ESS method ranges between 95-99%, and again no false positives are reported. The practitioners’ feedback demonstrates the method’s potential to assist in training and improve peer verifications. This research also develops and trains computational algorithms to support analysts making decisions on sample comparisons. The automated algorithms in this research show the potential to provide objective and probabilistic support for determining a physical fit and demonstrate comparative accuracy to the analyst. Furthermore, additional models are developed to extract feature edge information from the systematic comparison templates of tapes and textiles to provide insight into the relative importance of each comparison feature. A decision tree model is developed to assist physical fit examinations of duct tapes and textiles and demonstrates comparative performance to the trained analysts. The computational tools also evaluate the suitability of partial sample comparisons that simulate situations where portions of the item are lost or damaged. Finally, an objective approach to interpreting complex spectral data is presented. A comparison metric consisting of spectral angle contrast ratios (SCAR) is used as a model to assess more than 94 different-source and 20 same-source electrical tape backings. The SCAR metric results in a discrimination power of 96% and demonstrates the capacity to capture information on the variability between different-source samples and the variability within same-source samples. Application of the random-forest model allows for the automatic detection of primary differences between samples. The developed threshold could assist analysts with making decisions on the spectral comparison of chemically similar samples. This research provides the forensic science community with novel approaches to comparing materials commonly seen in forensic laboratories. The outcomes of this study are anticipated to offer forensic practitioners new and accessible tools for incorporation into current workflows to facilitate systematic and objective analysis and interpretation of forensic materials and support analysts’ opinions

Geometric margin domain description with instance-specific margins

Support vector domain description (SVDD) is a useful tool in data mining, used for analysing the within-class distribution of multi-class data and to ascertain membership of a class with known training distribution. An important property of the method is its inner-product based formulation, resulting in its applicability to reproductive kernel Hilbert spaces using the “kernel trick”. This practice relies on full knowledge of feature values in the training set, requiring data exhibiting incompleteness to be pre-processed via imputation, sometimes adding unnecessary or incorrect data into the classifier. Based on an existing study of support vector machine (SVM) classification with structurally missing data, we present a method of domain description of incomplete data without imputation, and generalise to some times of kernel space. We review statistical techniques of dealing with missing data, and explore the properties and limitations of the SVM procedure. We present two methods to achieve this aim: the first provides an input space solution, and the second uses a given imputation of a dataset to calculate an improved solution. We apply our methods first to synthetic and commonly-used datasets, then to non-destructive assay (NDA) data provided by a third party. We compare our classification machines to the use of a standard SVDD boundary, and highlight where performance improves upon the use of imputation

Spartan Daily, March 19, 1985

Volume 84, Issue 35https://scholarworks.sjsu.edu/spartandaily/7288/thumbnail.jp

On the adaptive advantage of always being right (even when one is not)

We propose another positive illusion – overconfidence in the generalisability of one’s theory – that fits with McKay & Dennett’s (M&D’s) criteria for adaptive misbeliefs. This illusion is pervasive in adult reasoning but we focus on its prevalence in children’s developing theories. It is a strongly held conviction arising from normal functioning of the doxastic system that confers adaptive advantage on the individual

Développement de l'approche conséquentielle pour l'analyse de la durabilité du cycle de vie: cas d’un bâtiment hybride multiétages

Il est indéniable que l'industrie du bâtiment doit évoluer vers des bâtiments plus durables à l'avenir. Les décideurs dans le secteur du bâtiment doivent prendre en compte les aspects sociaux et économiques dans leur prise de décision, en plus de l'aspect environnemental. Ces évaluations doivent également inclure la perspective du cycle de vie. L’approche conséquentielle est nécessaire pour évaluer les conséquences à long terme par rapport à l’approche attributionnelle qui se concentre sur l’évaluation d’un profil donné. Ce projet de recherche montre comment l'approche conséquentielle est intégrée dans l'analyse du cycle de vie (ACV), l’analyse du coût du cycle de vie (ACCV) et l'analyse sociale du cycle de vie (AsCV) dans le cadre de l'analyse de la durabilité du cycle de vie (ADCV). Ce mémoire de thèse contient huit chapitres pour atteindre les objectifs de recherche susmentionnés. Le chapitre 1 décrit le contexte de l'étude et l'organisation de la thèse. Le chapitre 2 présente les défis et les opportunités actuels de l'évaluation de la durabilité du cycle de vie qui a été publié et auquel il est fait référence comme premier article de cette thèse. Le premier article présentait les lacunes identifiées dans l'harmonisation des trois méthodes discutées (ACV, ACCV et AsCV). Dans l'intégration de l'ACV et du ACCV, la question de la temporalité est toujours absente dans l'ACV, en plus de la perspective conséquentielle dans l'ACV et l’ACCV. Dans l'intégration de ACCV et AsCV, deux lacunes de recherche sont également trouvées : la différence de perspective lors de l'utilisation à la fois de la méthode, en plus du manque de la perspective conséquentielle. Dans l'intégration de l’AsCV et de l'ACV, les problèmes qui se posent sont : la présence d'impact négatif et positif dans l’ AsCV, par rapport à l'ACV (dont les impacts sont presque toujours négatifs), sans oublier l'absence de l’approche conséquentielle dans l’AsCV. Lors de l'application de l’ADCV dans un contexte politique, nous avons suggéré que le cadre a besoin d'une perspective conséquentielle pour faciliter la capture non seulement des impacts directs, mais aussi des conséquences indirectes. Le chapitre 4 présente l'énoncé du problème et les questions de recherche, le but et les objectifs de la recherche, ainsi que la définition du projet. Le chapitre 5 décrit l'ACV et le CCV d'un bâtiment hybride à plusieurs étages avec une étude de cas au Québec, Canada. Il a également été publié et fait référence au deuxième article de cette thèse. Le deuxième article a démontré la pertinence de l'utilisation complémentaire d'approches attributionnelle et conséquentielle avec l'étude de cas d'un bâtiment hybride à plusieurs étages, et ce du point de vue environnemental et économique. Les résultats de l'ensemble du cycle de vie indiquent des différences potentielles entre les deux approches de modélisation sous-jacentes. Par exemple, la production de matériaux est l'étape la plus impactante sur le plan environnemental (avec une contribution de 86 à 98 %) et économique (72 %) dans l'approche attributionnelle. Cependant, dans l'approche conséquentielle, la production de matériaux est moins responsable sur le plan environnemental (46 à 94 %) et pourtant plus responsable sur le plan économique (59 %). Cela démontre que l'ACV et l’ACCV conséquentielle peuvent révéler des informations complémentaires (non disponible d’un point de vue attributionnelle). Même si l'étude est soumise à des limitations et des incertitudes notables, telle que la disponibilité et la qualité des données, la réalisation d'une ACV-ACCV attributionnelle et conséquentielle d'un produit pourrait donner plus d’informations pertinentes pour une prise de décision plus robuste. Le chapitre 6 présente l'ACVS du même bâtiment en utilisant l'analyse multiniveau et constitue le troisième article publié dans cette thèse. Dans le troisième article, l'analyse sociale du cycle de vie (ASCV) a été réalisée en évaluant l'impact social potentiel et les bénéfices du cycle de vie du bâtiment. L'utilisation d'une analyse à plusieurs niveaux (résolutions), qui est appliquée à l'ACV sociale conséquentielle et attributionnelle, pourrait aider à combler les lacunes dans les données. Bien que davantage de données ne soient pas toujours meilleures, cela peut aider à comprendre les points chauds possibles de l'impact/bénéfice social et le champ d'influence de l'impact/bénéfice social pour les parties prenantes. Combler les lacunes dans les données est important de deux manières : 1) combler les lacunes des données sur les indicateurs et 2) combler les lacunes des données sur le cycle de vie du système de produits (du berceau à la tombe). En utilisant une analyse à plusieurs niveaux dans une ACV sociale conséquentielle, il a été observé que l'importation d'acier et/ou d'aluminium de Chine est potentiellement associée à certains impacts sociaux négatifs (restrictions à l'association des travailleurs, risque pour la santé et la sécurité et travail des enfants), mais aussi des contributions bénéfiques (emploi). En fin de compte, révéler ces types d'indicateurs peut aider les décideurs politiques à prévoir et à planifier les conséquences négatives avant qu'elles ne surviennent, et vice versa à promouvoir des avantages positifs. Plus important encore, comme pour l'ACV, la nécessité d'inclure une perspective du cycle de vie complet existe, car l'impact tout au long de la phase du cycle de vie du produit est souvent négligé en raison de données manquantes. Enfin, le chapitre 7 présente la discussion de la recherche tandis que le chapitre 8 montre les conclusions, les contributions, les limites et fournit des recommandations pour les recherches futures. En conclusion, l'utilisation de trois outils ADCV (ACV, CCV et AsCV) dans l'approche conséquente signifie que le LCSA conséquent a également été réalisé. L'optique prospective de l'approche conséquentielle permet d'améliorer les performances de durabilité de manière causale. Les impacts du processus, de l'activité ou de la technologie évalués sont ceux du processus, de l'activité ou de la technologie qui vont répondre à la demande accrue. Ainsi, l'évaluation a pour logique de répondre aux conséquences futures. Cela inclut éventuellement l'implication des fournisseurs de matériaux mondiaux de l'étranger, comme observé dans cette étude, où les conséquences sociales peuvent avoir différents résultats possibles. La situation sociale et les conditions de travail dans d'autres pays (en particulier dans les pays en développement) peuvent présenter de mauvaises pratiques. L'approche conséquentielle aide les décideurs politiques à anticiper l'impact des différents résultats possibles et à identifier les faiblesses. Par exemple, les décideurs peuvent découvrir qu'il faut réduire l'acier et les importations de l'étranger et se concentrer davantage sur l'utilisation de produits locaux. Un plan de transformation peut être élaboré à l'avance pour faire face à d'éventuels problèmes techniques et opérationnels liés au passage de l'étranger au local et offrir une valeur future plus mesurable.Abstract: It is undeniable that building industry needs to move to more sustainable buildings in the future. Building policy-makers need to include social and economic aspect into consideration, beside environmental one. These assessments also need to include a life cycle perspective. Consequential life cycle approach is suitable for assessing long-term consequences ,as compared to attributional approach that only focus on the impact accounting itself. This research project aims to demonstrate how the consequential approach when applied to life cycle assessment (LCA), life cycle costing (LCC) and social life cycle assessment (S-LCA) (under the life cycle sustainability assessment umbrella) can shed light on important insights that can’t be identified when using the attributional one. This thesis dissertation contains eight chapters to achieve the aforementioned research objectives. Chapter 1 describes the context of the study and dissertation organization. Chapter 2 presents the current challenges and opportunities of life cycle sustainability assessment that has been published and referred as first paper in this thesis. The first paper presented the identified gaps shown in the harmonization of the three presented methods (LCA, LCC, and SLCA). In the integration of LCA and LCC, temporality issue is still missing in LCA (issue, here it is called research gap [RG 1]), in addition to the missing consequential perspective in LCA and LCC (RG 2). In the integration of LCC and S-LCA, two research gaps are also found: the difference in stakeholder perspective when using both method (RG 3), in addition to the missing consequential perspective (RG 4). In the integration of S-LCA and LCA, the identified issues are (not extensive list): the presence of negative and positive impact in S-LCA, as compared to LCA (RG 5), the scales of assessment applied in each method differs (RG 6), in addition to the absence of a consequential approach in S-LCA. When applying LCSA in a policy context, it is suggested that the framework needs a consequential perspective to facilitate capturing not only direct impacts but also indirect consequences. Chapter 3 presents the updated and recent literature review with the same topic as in Chapter 2. Chapter 4 shows the problem statement and research questions, research goal and objectives, and project definition. Chapter 5 describes the LCA and LCC of hybrid multistory building with case study in Quebec, Canada. It is also has been published and referred as second paper in this thesis. The second paper showed the added value of using attributional and consequential approaches with the case study of hybrid multistory building, from environmental and economic perspectives. For example, material production is the most impactful stage environmentally (with 86–98% contribution) and economically (72%) in the attributional approach. However, in the consequential approach, material production is less environmentally responsible (46–94%), while from an economic perspective the contribution reached 59%. By implementing consequential LCA-LCC, additional insights are gained from the consequential impacts of constructing hybrid wood multistory buildings. Even though the study is a subject to notable limitations and uncertainties, such as data availability and quality, conducting attributional and consequential LCA-LCC of a building can give a broader/more comprehensive spectrum of possible results for a robust decision-making. Chapter 6 provides S-LCA of the same building using multilevel analysis and referred as third published paper in this thesis. In the third paper, the social life cycle assessment was carried out by evaluating the potential social impact and benefit from the product's life cycle. Using a multilevel analysis, applied to consequential and attributional social LCA, helped in filling data gaps, particularly for the consequential perspective. While more data is not always better, it can help to understand the possible hotspots of social impact/benefit. Filling data gaps is important in two ways: 1) filling data gaps on indicators and 2) filling data gaps on the product system's life cycle (cradle to grave). As a matter of fact, when using multilevel analysis in consequential social LCA, it was noticed that importing steel and/or aluminum from China is potentially associated with negative social impacts (restrictions on worker association, risk on health and safety, and child labor) but also some beneficial contributions (employment). Ultimately, revealing these types of trade-offs may help policymakers predict and plan for negative consequences before they occur, and vice versa promote positive benefit. More importantly, as with LCA, the need to include a full life cycle perspective exists because the impact throughout the product's life cycle phase is frequently overlooked due to missing data. Finally, Chapter 7 presents the research discussion while Chapter 8 shows conclusions, contributions, limitations, and provides recommendations for future research. In conclusion, having three tools of LCSA (LCA, LCC and S-LCA) performed in consequential approach mean that consequential LCSA also have been carried out. The forward-looking lens of consequential approach helps to improve sustainability performance in causal-effect manner. The impacts of the process or activity or technology assessed are the ones from process or activity or technology that are going to supply the increased demand. Thus, the assessment has logic on answering the future consequences. This possibly includes the involvement of global material suppliers from abroad such observed in this study where the social consequences can have different possible outcomes. The social working situation and labor condition in other countries (especially in developing countries) may have poor practices. Having consequential approach helps the policy makers anticipate the impact of different possible outcomes and identify weaknesses. For example, policy makers may discover that it needs to reduce the steel and import from abroad and more focus on using local products. A transformation plan can be made in advance to cope with possible technical and operational problems from shifting from abroad to local and deliver more measurable future value

Advanced Information Systems and Technologies

This book comprises the proceedings of the V International Scientific Conference "Advanced Information Systems and Technologies, AIST-2017". The proceeding papers cover issues related to system analysis and modeling, project management, information system engineering, intelligent data processing computer networking and telecomunications. They will be useful for students, graduate students, researchers who interested in computer science

Research Paper: Process Mining and Synthetic Health Data: Reflections and Lessons Learnt

Analysing the treatment pathways in real-world health data can provide valuable insight for clinicians and decision-makers. However, the procedures for acquiring real-world data for research can be restrictive, time-consuming and risks disclosing identifiable information. Synthetic data might enable representative analysis without direct access to sensitive data. In the first part of our paper, we propose an approach for grading synthetic data for process analysis based on its fidelity to relationships found in real-world data. In the second part, we apply our grading approach by assessing cancer patient pathways in a synthetic healthcare dataset (The Simulacrum provided by the English National Cancer Registration and Analysis Service) using process mining. Visualisations of the patient pathways within the synthetic data appear plausible, showing relationships between events confirmed in the underlying non-synthetic data. Data quality issues are also present within the synthetic data which reflect real-world problems and artefacts from the synthetic dataset’s creation. Process mining of synthetic data in healthcare is an emerging field with novel challenges. We conclude that researchers should be aware of the risks when extrapolating results produced from research on synthetic data to real-world scenarios and assess findings with analysts who are able to view the underlying data