WP 2016-349

We provide evidence from a field experiment — a correspondence study — on age discrimination in hiring for retail sales jobs. We collect experimental data in all 50 states and then relate measured age discrimination — the difference in callback rates between old and young applicants — to variation across states in antidiscrimination laws offering protections to older workers that are stronger than the federal age and disability discrimination laws. We do a similar analysis for nonexperimental data on differences across states in hiring rates of older versus younger workers. The experimental evidence points consistently to evidence of hiring discrimination against older men and more so against older women. However, the evidence on the relationship between hiring discrimination against older workers and state variation in age and disability discrimination laws is not so clear; at a minimum, there is not a compelling case that stronger state protections reduce hiring discrimination against older workers. In contrast, the nonexperimental evidence suggests that stronger disability discrimination protections increase the relative hiring of older workers.Social Security Administration, RRC08098401, UM16-04,http://deepblue.lib.umich.edu/bitstream/2027.42/135722/1/wp349.pdfDescription of wp349.pdf : Working pape

Applying Trial-Derived Treatment Effects to Real-World Populations:Generalizing Cost-Effectiveness Estimates When Modeling Complex Hazards

Objectives: Generalizability of trial-based cost-effectiveness estimates to real-world target populations is important for decision making. In the context of independent aggregate time-to-event baseline and relative effects data, complex hazards can make modeling of data for use in economic evaluation challenging. Our article provides an overview of methods that can be used to apply trial-derived relative treatment effects to external real-world baselines when faced with complex hazards and follows with a motivating example. Methods: Approaches for applying trial-derived relative effects to real-world baselines are presented in the context of complex hazards. Appropriate methods are applied in a cost-effectiveness analysis using data from a previously published study assessing the real-world cost-effectiveness of a treatment for carcinoma of the head and neck as a motivating example. Results: Lack of common hazards between the trial and target real-world population, a complex baseline hazard function, and nonproportional relative effects made the use of flexible models necessary to adequately estimate survival. Assuming common distributions between trial and real-world reference survival substantially affected survival and cost-effectiveness estimates. Modeling time-dependent vs proportional relative effects affected estimates to a lesser extent, dependent on assumptions used in cost-effectiveness modeling. Conclusions: Appropriately capturing reference treatment survival when attempting to generalize trial-derived relative treatment effects to real-world target populations can have important impacts on cost-effectiveness estimates. A balance between model complexity and adequacy for decision making should be considered where multiple data sources with complex hazards are being evaluated.</p

Applying Trial-Derived Treatment Effects to Real-World Populations:Generalizing Cost-Effectiveness Estimates When Modeling Complex Hazards

Objectives: Generalizability of trial-based cost-effectiveness estimates to real-world target populations is important for decision making. In the context of independent aggregate time-to-event baseline and relative effects data, complex hazards can make modeling of data for use in economic evaluation challenging. Our article provides an overview of methods that can be used to apply trial-derived relative treatment effects to external real-world baselines when faced with complex hazards and follows with a motivating example. Methods: Approaches for applying trial-derived relative effects to real-world baselines are presented in the context of complex hazards. Appropriate methods are applied in a cost-effectiveness analysis using data from a previously published study assessing the real-world cost-effectiveness of a treatment for carcinoma of the head and neck as a motivating example. Results: Lack of common hazards between the trial and target real-world population, a complex baseline hazard function, and nonproportional relative effects made the use of flexible models necessary to adequately estimate survival. Assuming common distributions between trial and real-world reference survival substantially affected survival and cost-effectiveness estimates. Modeling time-dependent vs proportional relative effects affected estimates to a lesser extent, dependent on assumptions used in cost-effectiveness modeling. Conclusions: Appropriately capturing reference treatment survival when attempting to generalize trial-derived relative treatment effects to real-world target populations can have important impacts on cost-effectiveness estimates. A balance between model complexity and adequacy for decision making should be considered where multiple data sources with complex hazards are being evaluated.</p

A qualitative study exploring the factors influencing admission to hospital from the emergency department

Objective: The number of emergency admissions to hospital in England and Wales has risen sharply in recent years and is a matter of concern to clinicians, policy makers and patients alike. However, the factors that influence this decision are poorly understood. We aimed to ascertain how non-clinical factors can affect hospital admission rates. Method: We conducted semistructured interviews with 21 participants from three acute hospital trusts. Participants included 11 emergency department (ED) doctors, 3 ED nurses, 3 managers and 4 inpatient doctors. A range of seniority was represented among these roles. Interview questions were developed from key themes identified in a theoretical framework developed by the authors to explain admission decision-making. Interviews were recorded, transcribed and analysed by two independent researchers using framework analysis. Findings: Departmental factors such as busyness, time of day and levels of senior support were identified as non-clinical influences on a decision to admit rather than discharge patients. The 4-hour waiting time target, while overall seen as positive, was described as influencing decisions around patient admission, independent of clinical need. Factors external to the hospital such as a patient’s social support and community follow-up were universally considered powerful influences on admission. Lastly, the culture within the ED was described as having a strong influence (either negatively or positively) on the decision to admit patients. Conclusion: Multiple factors were identified which go some way to explaining marked variation in admission rates observed between different EDs. Many of these factors require further inquiry through quantitative research in order to understand their influence further

Is It Harder for Older Workers to Find Jobs? New and Improved Evidence from a Field Experiment

We design and implement a large-scale resume correspondence study to address limitations of existing field experiments testing for age discrimination that may bias their results. One limitation that may bias results is giving older and younger applicants similar experience to make them “otherwise comparable.” A second limitation is that greater unobserved differences in human capital investment of older applicants may bias the results against finding age discrimination. On the basis of over 40,000 job applications, we find robust evidence of age discrimination in hiring against older women, especially those near retirement age, but considerably less evidence of age discrimination against men

Experimental Age Discrimination Evidence and the Heckman Critique

We design and implement a large-scale field experiment on age discrimination to address limitations of past research that may bias their results. One limitation is the practice of giving older and younger applicants similar experience in the job to which they are applying, to make them "otherwise comparable." The second limitation is ignoring the likelihood of greater variation in unobserved differences among older workers owing to human capital investment. Based on evidence from over 40,000 job applications, we find robust evidence of age discrimination in hiring against older women, but considerably less evidence of age discrimination against older men

Towards an art and science of decision aiding for water management and planning: a participatory modelling process

Planning and management of water resources are faced with increasingly high levels of complexity, uncertainty and conflict. Traditional technical and top-down management strategies have proved inadequate, forcing a move to more integrated forms of management, planning and decision making that can include stakeholders and communities, as well as technical experts and policy makers. These integrated forms of management require not only good technical or scientific ability, but a range of art-like skills including communication, creativity and the capacity to acknowledge and integrate diverse points of view. However, processes designed to aid such inter-organisational or multi-stakeholder decisionmaking are rare and in need of investigation. This paper proposes a process of participatory modelling using a series of semi-structured collective decision cycles which can aid decisions involving multiple stakeholders in water management and planning. The participatory modelling process outlined in this paper is designed to capture and integrate both tacit and explicit knowledge from stakeholders, right from the problem identification phase through to the final decision making, implementation and ongoing monitoring and evaluation. A brief idealised example of the participatory modelling process testing in Montpellier, France, is highlighted, as well as further questions and identified priority research areas

Towards an art and science of decision aiding for water management and planning: a participatory modelling process

Planning and management of water resources are faced with increasingly high levels of complexity, uncertainty and conflict. Traditional technical and top-down management strategies have proved inadequate, forcing a move to more integrated forms of management, planning and decision making that can include stakeholders and communities, as well as technical experts and policy makers. These integrated forms of management require not only good technical or scientific ability, but a range of art-like skills including communication, creativity and the capacity to acknowledge and integrate diverse points of view. However, processes designed to aid such inter-organisational or multi-stakeholder decisionmaking are rare and in need of investigation. This paper proposes a process of participatory modelling using a series of semi-structured collective decision cycles which can aid decisions involving multiple stakeholders in water management and planning. The participatory modelling process outlined in this paper is designed to capture and integrate both tacit and explicit knowledge from stakeholders, right from the problem identification phase through to the final decision making, implementation and ongoing monitoring and evaluation. A brief idealised example of the participatory modelling process testing in Montpellier, France, is highlighted, as well as further questions and identified priority research areas