Coverage with evidence development: applications and issues

Copyright © Cambridge University Press, 2010OBJECTIVES: The aim of this study was to describe the current issues surrounding Coverage with Evidence Development (CED). CED is characterized by restricted coverage for a new technology in parallel with targeted research when the stated goal of the research or data collection is to provide definitive evidence for the clinical or cost-effectiveness impact of the new technology. METHODS: Presented here is information summarized and interpreted from presentations and discussions at the 2008 Health Technology Assessment International (HTAi) meeting and additional information from the medical literature. This study describes the differences between CED and other conditional coverage agreements, provides a brief history of CED, describes real-world examples of CED, describes the areas of consensus between the stakeholders, discusses the areas for future negotiation between stakeholders, and proposes criteria to assist stakeholders in determining when CED could be appropriate. RESULTS: Payers could interpret the evidence obtained from a CED program either positively or negatively, and a range of possible changes to the reimbursement status of the new technology may result. Striking an appropriate balance between the demands for prompt access to new technology and acknowledging that some degree of uncertainty will always exist is a critical challenge to the uptake of this innovative form of conditional coverage. CONCLUSIONS: When used selectively for innovative procedures, pharmaceuticals, or devices in the appropriate disease areas, CED may provide patients access to promising medicines or technologies while data to minimize uncertainty are collected.The development of the manuscript was funded by Medicines Australi

Flexible high-voltage supply for experimental electron microscope

Scanning microscope uses a field-emission tip for the electron source, an electron gun that simultaneously accelerates and focuses electrons from the source, and one auxiliary lens to produce a final probe size at the specimen on the order of angstroms

Maine\u27s Centennial Hymn

https://digitalcommons.library.umaine.edu/mmb-me/1598/thumbnail.jp

Observations of cosmic ray induced phosphenes

Phosphene observations by astronauts on flights near and far from earth atmosphere are discussed. It was concluded that phosphenes could be observed by the naked eye. Further investigation is proposed to determine realistic human tolerance levels for extended missions and to evaluate the need to provide special spacecraft shielding

Non-linear screening of spherical and cylindrical colloids: the case of 1:2 and 2:1 electrolytes

From a multiple scale analysis, we find an analytic solution of spherical and cylindrical Poisson-Boltzmann theory for both a 1:2 (monovalent co-ions, divalent counter-ions) and a 2:1 (reversed situation) electrolyte. Our approach consists in an expansion in powers of rescaled curvature $1/(\kappa a)$, where $a$ is the colloidal radius and $1/\kappa$ the Debye length of the electrolytic solution. A systematic comparison with the full numerical solution of the problem shows that for cylinders and spheres, our results are accurate as soon as $\kappa a>1$. We also report an unusual overshooting effect where the colloidal effective charge is larger than the bare one.Comment: 9 pages, 11 figure

Realistic Expanding Source Model for Invariant One-Particle Multiplicity Distributions and Two-Particle Correlations in Relativistic Heavy-Ion Collisions

We present a realistic expanding source model with nine parameters that are necessary and sufficient to describe the main physics occuring during hydrodynamical freezeout of the excited hadronic matter produced in relativistic heavy-ion collisions. As a first test of the model, we compare it to data from central Si + Au collisions at p_lab/A = 14.6 GeV/c measured in experiment E-802 at the AGS. An overall chi-square per degree of freedom of 1.055 is achieved for a fit to 1416 data points involving invariant pi^+, pi^-, K^+, and K^- one-particle multiplicity distributions and pi^+ and K^+ two-particle correlations. The 99-percent-confidence region of parameter space is identified, leading to one-dimensional error estimates on the nine fitted parameters and other calculated physical quantities. Three of the most important results are the freezeout temperature, longitudinal proper time, and baryon density along the symmetry axis. For these we find values of 92.9 +/- 4.4 MeV, 8.2 +/- 2.2 fm/c, and 0.0222 + 0.0096 / - 0.0069 fm^-3, respectively.Comment: 37 pages and 12 figures. RevTeX 3.0. Submitted to Physical Review C. Complete preprint, including device-independent (dvi), PostScript, and LaTeX versions of the text, plus PostScript files of all figures, are available at http://t2.lanl.gov/publications/publications.html or at ftp://t2.lanl.gov/publications/res

Down in Maine

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The Submillimeter Polarization Spectrum of M17

We present 450 {\mu}m polarimetric observations of the M17 molecular cloud obtained with the SHARP polarimeter at the Caltech Submillimeter Observatory. Across the observed region, the magnetic field orientation is consistent with previous submillimeter and far-infrared polarization measurements. Our observations are centered on a region of the molecular cloud that has been compressed by stellar winds from a cluster of OB stars. We have compared these new data with previous 350 {\mu}m polarimetry and find an anti-correlation between the 450 to 350 {\mu}m polarization magnitude ratio and the ratio of 21 cm to 450 {\mu}m intensity. The polarization ratio is lower near the east end of the studied region where the cloud is exposed to stellar winds and radiation. At the west end of the region, the polarization ratio is higher. We interpret the varying polarization spectrum as evidence supporting the radiative alignment torque (RAT) model for grain alignment, implying higher alignment efficiency in the region that is exposed to a higher anisotropic radiation field.Comment: 24 pages, 10 figure