Economic Valuation for Information Security Investment: A Systematic Literature Review

Research on technological aspects of information security risk is a well-established area and familiar territory for most information security professionals. The same cannot be said about the economic value of information security investments in organisations. While there is an emerging research base investigating suitable approaches measuring the value of investments in information security, it remains difficult for practitioners to identify key approaches in current research. To address this issue, we conducted a systematic literature review on approaches used to evaluate investments in information security. Following a defined review protocol, we searched several databases for relevant primary studies and extracted key details from the identified studies to answer our research questions. The contributions of this work include: a comparison framework and a catalogue of existing approaches and trends that would help researchers and practitioners navigate existing work; categorisation and mapping of approaches according to their key elements and components; and a summary of key challenges and benefits of existing work, which should help focus future research efforts

Risk Stratification of COVID-19 Patients Using Ambulatory Oxygen Saturation in the Emergency Department

Introduction: It is difficult to determine illness severity for coronavirus disease 2019 (COVID-19) patients, especially among stable-appearing emergency department (ED) patients. We evaluated patient outcomes among ED patients with a documented ambulatory oxygen saturation measurement.Methods: This was a retrospective chart review of ED patients seen at New York University Langone Health during the peak of the COVID-19 pandemic in New York City. We identified ED patients who had a documented ambulatory oxygen saturation. We studied the outcomes of high oxygen requirement (defined as >4 liters per minute) and mechanical ventilation among admitted patients and bounceback admissions among discharged patients. We also performed logistic regression and compared the performance of different ambulatory oxygen saturation cutoffs in predicting these outcomes.Results: Between March 15–April 14, 2020, 6194 patients presented with fever, cough, or shortness of breath at our EDs. Of these patients, 648 (11%) had a documented ambulatory oxygen saturation, of which 165 (24%) were admitted. Notably, admitted and discharged patients had similar initial vital signs. However, the average ambulatory oxygen saturation among admitted patients was significantly lower at 89% compared to 96% among discharged patients (p<0.01). Among admitted patients with an ambulatory oxygen saturation, 30% had high oxygen requirements and 8% required mechanical ventilation. These rates were predicted by low ambulatory oxygen saturation (p<0.01). Among discharged patients, 50 (10%) had a subsequent ED visit resulting in admission. Although bounceback admissions were predicted by ambulatory oxygen saturation at the first ED visit (p<0.01), our analysis of cutoffs suggested that this association may not be clinically useful.Conclusion: Measuring ambulatory oxygen saturation can help ED clinicians identify patients who may require high levels of oxygen or mechanical ventilation during admission. However, it is less useful for identifying which patients may deteriorate clinically in the days after ED discharge and require subsequent hospitalization.