Lonely at the top and stuck in the middle? The ongoing challenge of using cost-effectiveness information in priority setting Comment on “Use of cost-effectiveness data in priority setting decisions: experiences from the national guidelines for heart diseases in Sweden”

The topic of how cost-effectiveness information informs priority setting in healthcare remains important to both policy and practice. This commentary considers the study carried out by Eckard and colleagues in Sweden. In it we distinguish between the conditions at national and local levels and put forward some recommendations for research into local priority setting in particular

The Momentum Distribution of Liquid 3^3He

We present high-resolution neutron Compton scattering measurements of liquid $^3$He below its renormalized Fermi temperature. Theoretical predictions are in excellent agreement with the experimental data when instrumental resolution and final state effects are accounted for. Our results resolve the long-standing inconsistency between theoretical and experimental estimates of the average atomic kinetic energy.Comment: 5 pages, 4 figure

BFKL dynamics at hadron colliders

Hadron colliders can provide important tests of BFKL `small-x' dynamics. We discuss two examples of such tests, the inclusive dijet jet cross section at large rapidity separation and the number of associated `mini-jets' in Higgs boson production.Hadron colliders can provide important tests of BFKL `small-x' dynamics. We discuss two examples of such tests, the inclusive dijet jet cross section at large rapidity separation and the number of associated `mini-jets' in Higgs boson production

Health Services Research Spending and Healthcare System Impact Comment on “Public Spending on Health Service and Policy Research in Canada, the United Kingdom, and the United States: A Modest Proposal”

Abstract The challenges associated with translating health services and policy research (HSPR) evidence into practice are many and long-standing. Indeed, those challenges have themselves spawned new areas of research, including knowledge translation and implementation science. These sub-disciplines have increased our understanding of the critical success factors associated with the uptake of research evidence into (system) practice. Engaging those for whom research evidence is likely to help solve implementation and/or policy problems, and ensuring that they are key partners throughout the research life-cycle, appear to us (based on current evidence) to be the most direct and effective paths to improved knowledge translation. In that regard, building on Canada’s recent Strategy for Patient Oriented Research (SPOR) would seem to offer considerable promise. The “modest” proposals offered by Thakkar and Sullivan seem less likely to bear fruit

Respondent Understanding in Discrete Choice Experiments : A Scoping Review

Acknowledgements The authors would like to acknowledge the contributions of Brendan Mulhern, who gave feedback on the initial project proposal and helped with the full-text reviews, and Bernadette Carr, the librarian who gave assistance developing and implementing the search strategy. Funding During part of this project, Alison Pearce was supported by a University of Technology Sydney Chancellor’s Postdoctoral Research Fellowship and the University of Technology Sydney International Researcher Development Scheme. Mark Harrison is supported by a Michael Smith Foundation for Health Research Scholar Award 2017 (#16813), and holds the UBC Professorship in Sustainable Health Care, which, between 2014 and 2017, was funded by Amgen Canada, AstraZeneca Canada, Eli Lilly Canada, GlaxoSmithKline, Merck Canada, Novartis Pharmaceuticals Canada, Pfizer Canada, Boehringer Ingelheim (Canada), Hoffman-La Roche, LifeScan Canada, and Lundbeck Canada. The Health Economics Research Unit (HERU) receives funding from the Chief Scientist Office (CSO) of the Scottish Government Health and Social Care Directorates.Peer reviewedPublisher PD

Protocol for a randomised controlled trial of telemonitoring and self-management in the control of hypertension: telemonitoring and self-management in hypertension. [ISRCTN17585681].

BACKGROUND: Controlling blood pressure with drugs is a key aspect of cardiovascular disease prevention, but until recently has been the sole preserve of health professionals. Self-management of hypertension is an under researched area in which potential benefits for both patients and professionals are great. METHODS AND DESIGN: The telemonitoring and self-management in hypertension trial (TASMINH2) will be a primary care based randomised controlled trial with embedded economic and qualitative analyses in order to evaluate the costs and effects of increasing patient involvement in blood pressure management, specifically with respect to home monitoring and self titration of antihypertensive medication compared to usual care. Provision of remote monitoring results to participating practices will ensure that practice staff are able to engage with self management and provide assistance where required. 478 patients will be recruited from general practices in the West Midlands, which is sufficient to detect clinically significant differences in systolic blood pressure between self-management and usual care of 5 mmHg with 90% power. Patients will be excluded if they demonstrate an inability to self monitor, their blood pressure is below 140/90 or above 200/100, they are on three or more antihypertensive medications, have a terminal disease or their blood pressure is not managed by their general practitioner. The primary end point is change in mean systolic blood pressure (mmHg) between baseline and each follow up point (6 months and 12 months). Secondary outcomes will include change in mean diastolic blood pressure, costs, adverse events, health behaviours, illness perceptions, beliefs about medication, medication compliance and anxiety. Modelling will evaluate the impact of costs and effects on a system wide basis. The qualitative analysis will draw upon the views of users, informal carers and professionals regarding the acceptability of self-management and prerequisites for future widespread implementation should the trial show this approach to be efficacious. DISCUSSION: The TASMINH2 trial will provide important new evidence regarding the costs and effects of self monitoring with telemonitoring in a representative primary care hypertensive population.RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are

A comparison of maternal and newborn health services costs in Sindh Pakistan

Pakistani women suffer the highest rate of maternal mortality in South Asia. A lack of comprehensive knowledge about maternal and newborn health (MNH) services costs impedes policy decisions to maximize the benefit from existing, as well as emerging, MNH interventions in Pakistan. We compared MNH service costs at different levels of care. A cross-sectional survey was conducted during January to March 2016 as part of a large economic evaluation in Sindh, Pakistan. Health providers and facilities were selected from a sampling frame, inclusive of public and private sectors. This study utilized a broad perspective (i.e. costs to the health system and patients/families). The unit costs of MNH services were determined through a simultaneous allocation method in the public facilities; and patient billing department in the private facilities. Descriptive analysis was performed, and an analysis of variance (ANOVA) test was applied to compare overall mean costs both within and between health facilities. A total of 31 eligible health providers and facilities (n = 25 in private; n = 7 in public) were included in the final analysis. An ambulatory visit (AV) for routine antenatal care (ANC) costs $3.6 and$0.9 at secondary- and tertiary-level public facilities, respectively. In the private sector, the costs of an AV for ANC were slightly less ($2.8) at secondary-level and much higher ($6) at tertiary-level facilities compared to the public sector. Diagnostic test costs were much higher in private facilities. The average costs of inpatient admissions were $30.5 at general ward (GW), and$151 at the intensive care unit (ICU) in public facilities. In-patient admissions costs were lower such as $9.3 at GW and$36.5 at ICU in private facilities. Understanding cost is critical to guide decisions of resource allocation within the public sector; and risk mitigation for excessive OOP costs through third party payer for services in the private secto