Optimal maintenance strategies for systems with partial repair options and without assuming bounded costs

We study a repairable system with Markovian deterioration and partial repair options, carried out at fixed times $n=1,2,\ldots$ and look for optimal strategies under certain conditions. Two optimality criteria are considered: expected discounted cost and long-run average cost. Douer and Yechiali found conditions under which a policy in the class of generalized control limit policies is optimal. In this paper conditions are found under which an optimal policy is a control-limit policy. We explicitly explain how to derive this optimal policy; numerical examples are given, too

A discounted model for a repairable system with continuous state space

We examine repairable systems with a continous state space and partial repair options, carried out at fixed times $n=1,2,...$. Every time interval $[n,n+1)$ there is a manufacturing cost and a repair cost. These cost functions are not restricted to the class of bounded functions in this study. Conditions are found under which a control-limit replacement policy minimizes the discounted cost. Hence these conditions guarantee that there is an optimal policy under the discounted cost criterion which does not use partial repairs. We explicitly explain how to derive this optimal policy

From registration to publication: A study on Dutch academic randomized controlled trials

Introduction: Registration of clinical trials has been initiated in order to assess adherence of the reported results to the original trial protocol. This study aimed to investigate the publication rates, timely dissemination of results, and the prevalence of consistency in hypothesis, sample size, and primary endpoint of Dutch investigator-initiated randomized controlled clinical trials (RCTs). Methods: All Dutch investigator-initiated RCTs with a completion date between December 31, 2010, and January 1, 2012, and registered in the Trial Register of The Netherlands database were included. PubMed was searched for the publication of these RCT results until September 2016, and the time to the publication date was calculated. Consistency in hypothesis, sample size, and primary endpoint compared with the registry data were assessed. Results: The search resulted in a total of 168 Dutch investigator-initiated RCTs. In September 2016, the results of 129 (77%) trials had been published, of which 50 (39%) within 2 years after completion of accrual. Consistency in hypothesis with the original protocol was observed in 108 (84%) RCTs; in 71 trials (55%), the planned sample size was reached; and 103 trials (80%) presented the original primary endpoint. Consistency in all three parameters was observe

Rivaroxaban with or without Aspirin in Stable Cardiovascular Disease

BACKGROUND We evaluated whether rivaroxaban alone or in combination with aspirin would be more effective than aspirin alone for secondary cardiovascular prevention. METHODS In this double-blind trial, we randomly assigned 27,395 participants with stable atherosclerotic vascular disease to receive rivaroxaban (2.5 mg twice daily) plus aspirin (100 mg once daily), rivaroxaban (5 mg twice daily), or aspirin (100 mg once daily). The primary outcome was a composite of cardiovascular death, stroke, or myocardial infarction. The study was stopped for superiority of the rivaroxaban-plus-aspirin group after a mean follow-up of 23 months. RESULTS The primary outcome occurred in fewer patients in the rivaroxaban-plus-aspirin group than in the aspirin-alone group (379 patients [4.1%] vs. 496 patients [5.4%]; hazard ratio, 0.76; 95% confidence interval [CI], 0.66 to 0.86; P<0.001; z=−4.126), but major bleeding events occurred in more patients in the rivaroxaban-plus-aspirin group (288 patients [3.1%] vs. 170 patients [1.9%]; hazard ratio, 1.70; 95% CI, 1.40 to 2.05; P<0.001). There was no significant difference in intracranial or fatal bleeding between these two groups. There were 313 deaths (3.4%) in the rivaroxaban-plus-aspirin group as compared with 378 (4.1%) in the aspirin-alone group (hazard ratio, 0.82; 95% CI, 0.71 to 0.96; P=0.01; threshold P value for significance, 0.0025). The primary outcome did not occur in significantly fewer patients in the rivaroxaban-alone group than in the aspirin-alone group, but major bleeding events occurred in more patients in the rivaroxaban-alone group. CONCLUSIONS Among patients with stable atherosclerotic vascular disease, those assigned to rivaroxaban (2.5 mg twice daily) plus aspirin had better cardiovascular outcomes and more major bleeding events than those assigned to aspirin alone. Rivaroxaban (5 mg twice daily) alone did not result in better cardiovascular outcomes than aspirin alone and resulted in more major bleeding events. (Funded by Bayer; COMPASS ClinicalTrials.gov number, NCT01776424.

Optimal strategies for a replacement model

We examine a replacement system with discrete-time Markovian deterioration and finite state space $\{0,\ldots,N\}$. State 0 stands for a new system, and the higher the state the worse the system; a system in state $N$ is considered to be in a {\it bad state}. We impose the condition that the fraction of replacements in state $N$ should not be larger than some fixed number. We prove that a generalized control limit policy maximizes the expected time between two successive replacements and we explain explicitly how to derive this optimal policy. Some numerical examples are given