Colour depth-from-defocus incorporating experimental point spread function measurements

Depth-From-Defocus (DFD) is a monocular computer vision technique for creating depth maps from two images taken on the same optical axis with different intrinsic camera parameters. A pre-processing stage for optimally converting colour images to monochrome using a linear combination of the colour planes has been shown to improve the accuracy of the depth map. It was found that the first component formed using Principal Component Analysis (PCA) and a technique to maximise the signal-to-noise ratio (SNR) performed better than using an equal weighting of the colour planes with an additive noise model. When the noise is non-isotropic the Mean Square Error (MSE) of the depth map by maximising the SNR was improved by 7.8 times compared to an equal weighting and 1.9 compared to PCA. The fractal dimension (FD) of a monochrome image gives a measure of its roughness and an algorithm was devised to maximise its FD through colour mixing. The formulation using a fractional Brownian motion (mm) model reduced the SNR and thus produced depth maps that were less accurate than using PCA or an equal weighting. An active DFD algorithm to reduce the image overlap problem has been developed, called Localisation through Colour Mixing (LCM), that uses a projected colour pattern. Simulation results showed that LCM produces a MSE 9.4 times lower than equal weighting and 2.2 times lower than PCA. The Point Spread Function (PSF) of a camera system models how a point source of light is imaged. For depth maps to be accurately created using DFD a high-precision PSF must be known. Improvements to a sub-sampled, knife-edge based technique are presented that account for non-uniform illumination of the light box and this reduced the MSE by 25%. The Generalised Gaussian is presented as a model of the PSF and shown to be up to 16 times better than the conventional models of the Gaussian and pillbox

Why licensing authorities need to consider the net value of new drugs in assigning review priorities: Addressing the tension between licensing and reimbursement

Pharmaceutical regulators and healthcare reimbursement authorities operate in different intellectual paradigms and adopt very different decision rules. As a result, drugs that have been licensed are often not available to all patients who could benefit because reimbursement authorities judge that the cost of therapies is greater than the health produced. This finding creates uncertainty for pharmaceutical companies planning their research and development investment, as licensing is no longer a guarantee of market access. In this study, we propose that it would be consistent with the objectives of pharmaceutical regulators to use the Net Benefit Framework of reimbursement authorities to identify those therapies that should be subject to priority review, that it is feasible to do so and that this would have several positive effects for patients, industry, and healthcare systems

A Pilot Study of Value of Information Analysis to Support Research Recommendations for the National Institute for Health and Clinical Excellence

Background - This project developed as a result of the activities of the Research Teams at the Centre for Health Economics, University of York, and ScHARR at the University of Sheffield in the methods and application of decision analysis and value of information analysis as a means of informing the research recommendations made by NICE, as part of its Guidance to the NHS in England and Wales, and informing the deliberations of the NICE Research and Development Committee. Objectives - The specific objectives of the pilot study were to: • Demonstrate the benefits of using appropriate decision analytic methods and value of information analysis to inform research recommendations. • Establish the feasibility and resource implications of applying these methods in a timely way, to inform NICE. • Identify critical issues and methodological challenges to the use of value of information methods for research recommendations (with particular regard to the new reference case as a suitable basis for this type of analysis).

Evidence-Based Inventory of Criminal Justice Programs in Nebraska

This report is the product of collaborative efforts from the Nebraska Center for Justice Research, the School of Criminology and Criminal Justice, Industrial and Organizational Psychology and the Criminology and Criminal Justice department at Portland State University. The purpose of this report is to provide an overview of the importance of using evidence-based practices and programs, examine the quantity and needs addressed by adult criminal justice programs, and provide a snapshot of operating evidence-based programs throughout Nebraska. This report provides findings related to the discovery of programs and a review of branded programs operating in Nebraska. Product 1 – Inventory of Nebraska Programs Hundreds of programs and services are offered throughout Nebraska to assist the adult justice-involved population. The research team gathered a list of these programs through an examination of publicly available online sources on criminal justice agency websites. Hundreds of programs were identified after a review of these sources. Given the substantial quantity of programs, the researchers utilized a methodology to examine the programs and practices most appropriate for review and evaluation. Programs developed in Nebraska, and not yet rigorously evaluated, were determined ineligible for a more extensive review and should be examined in more depth under different guidelines. Upon conclusion of our review determination, the researchers identified 714 eligible programs and services in total. Product 2 – Branded Programming Review After a list was compiled, programs were sorted into two categories: homegrown (621) and branded (93). Peer reviewed research was gathered on the branded programs (frequently used synonymously with ‘evidence-based programs’ or ‘off-the-shelf programs’ …these are programs that tend to be well-known brand names with research evidence to backing their use). Based on the results of the acquired studies, programs were ranked on their ability to move participants towards desired outcomes, including reducing recidivism, increasing meaningful employment, reducing substance abuse or addiction symptoms, and improving overall health and well-being. Using the ranking criteria located in Table 3, programs were classified as either evidence-based (11), research-based (18), promising-practice (6), consensus-based (13), or no evidence (45). Future Proposed Deliverables – Describe and Review of Program Practices Although this report lays the foundation to encourage more agencies and program providers to adopt evidence-based programs, additional work should examine whether program provider practices are in line with program protocols and otherwise best practices. Therefore, the research team proposes doing a component analysis outlined by Campbell et al. (2018), which includes gathering program manuals and interviewing/ survey program staff to examine if practices are consistent with recommendation

Ethnic Variation in Inflammatory Profile in Tuberculosis

PMCID: PMC3701709This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited

Brentuximab vedotin in relapsed/refractory Hodgkin lymphoma post-autologous stem cell transplant : a cost-effectiveness analysis in Scotland

OBJECTIVE: To evaluate cost-effectiveness of brentuximab vedotin in patients with relapsed/refractory Hodgkin lymphoma who have received autologous stem cell transplantation, from a Scottish healthcare payer perspective. METHODS: A Microsoft Excel-based partitioned survival model comprising three health states (progression-free survival [PFS], post-progression survival, and death) was developed. Relevant comparators were chemotherapy with or without radiotherapy (C/R) and C/R with intent to allogeneic hematopoietic stem cell transplantation (alloSCT). Data were obtained from the pivotal phase II single-arm trial in 102 patients (SG035-0003; NCT00848926), a systematic literature review and clinical expert opinions (where empirical evidence was unavailable). PFS and overall survival for brentuximab vedotin were estimated using 5-year follow-up data from SG035-0003, and extrapolated using event rates observed for comparator treatments from published survival data. Resource use included drug acquisition and administration; alloSCT; treatment of adverse events; and long-term follow-up. Deterministic and probabilistic sensitivity analyses were conducted to evaluate the impact of uncertainty. RESULTS: In the base case, the incremental cost-effectiveness ratio (ICER) for brentuximab vedotin was £38,769 per quality-adjusted life year (QALY) vs C/R, whereas C/R with intent to alloSCT was dominated by brentuximab vedotin. ICERs for brentuximab vedotin generated by the deterministic sensitivity analysis ranged between £32,000-£54,000 per QALY. Including productivity benefits reduced the ICER to £28,881 per QALY. LIMITATIONS: Limitations include lack of comparative data from this single arm study and the heterogeneous population. Inconsistent baseline characteristic reporting across studies prevented complete assessment of heterogeneity and the extent of potential bias in clinical and cost-effectiveness estimates. CONCLUSIONS: Although the base case ICER is above the threshold usually applied in Scotland, it is relatively low compared with other orphan drugs, and lower than the ICER generated using a previous data cut of SG035-0003 that informed a positive recommendation from the Scottish Medicines Consortium, under its decision-making framework for assessment of ultra-orphan medicines

Cost-Effectiveness of New Cardiac and Vascular Rehabilitation Strategies for Patients with Coronary Artery Disease

Objective: Peripheral arterial disease (PAD) often hinders the cardiac rehabilitation program. The aim of this study was evaluating the relative cost-effectiveness of new rehabilitation strategies which include the diagnosis and treatment of PAD in patients with coronary artery disease (CAD) undergoing cardiac rehabilitation. Data Sources: Best-available evidence was retrieved from literature and combined with primary data from 231 patients. Methods: We developed a Markov decision model to compare the following treatment strategies: 1. cardiac rehabilitation only; 2. ankle-brachial index (ABI) if cardiac rehabilitation fails followed by diagnostic work-up and revascularization for PAD if needed; 3. ABI prior to cardiac rehabilitation followed by diagnostic work-up and revascularization for PAD if needed. Quality-adjusted-life years (QALYs), life-time costs (US $), incremental cost-effectiveness ratios (ICER), and gain in net health benefits (NHB) in QALY equivalents were calculated. A threshold willingness-to-pay of$75 000 was used. Results: ABI if cardiac rehabilitation fails was the most favorable strategy with an ICER of $44 251 per QALY gained and an incremental NHB compared to cardiac rehabilitation only of 0.03 QALYs (95$75 000/QALY. After sensitivity analysis, a combined cardiac and vascular rehabilitation program increased the success rate and would dominate the other two strategies with total lifetime costs of $30 246 a quality-adjusted life expectancy of 3.84 years, and an incremental NHB of 0.06 QALYs (95%CI:−0.24, 0.46) compared to current practice. The results were robust for other different input parameters. Conclusion: ABI measurement if cardiac rehabilitation fails followed by a diagnostic work-up and revascularization for PAD if needed are potentially cost-effective compared to cardiac rehabilitation only

A comparison of two methods for expert elicitation in health technology assessments.

BACKGROUND: When data needed to inform parameters in decision models are lacking, formal elicitation of expert judgement can be used to characterise parameter uncertainty. Although numerous methods for eliciting expert opinion as probability distributions exist, there is little research to suggest whether one method is more useful than any other method. This study had three objectives: (i) to obtain subjective probability distributions characterising parameter uncertainty in the context of a health technology assessment; (ii) to compare two elicitation methods by eliciting the same parameters in different ways; (iii) to collect subjective preferences of the experts for the different elicitation methods used. METHODS: Twenty-seven clinical experts were invited to participate in an elicitation exercise to inform a published model-based cost-effectiveness analysis of alternative treatments for prostate cancer. Participants were individually asked to express their judgements as probability distributions using two different methods - the histogram and hybrid elicitation methods - presented in a random order. Individual distributions were mathematically aggregated across experts with and without weighting. The resulting combined distributions were used in the probabilistic analysis of the decision model and mean incremental cost-effectiveness ratios and the expected values of perfect information (EVPI) were calculated for each method, and compared with the original cost-effectiveness analysis. Scores on the ease of use of the two methods and the extent to which the probability distributions obtained from each method accurately reflected the expert's opinion were also recorded. RESULTS: Six experts completed the task. Mean ICERs from the probabilistic analysis ranged between £162,600-£175,500 per quality-adjusted life year (QALY) depending on the elicitation and weighting methods used. Compared to having no information, use of expert opinion decreased decision uncertainty: the EVPI value at the £30,000 per QALY threshold decreased by 74-86 % from the original cost-effectiveness analysis. Experts indicated that the histogram method was easier to use, but attributed a perception of more accuracy to the hybrid method. CONCLUSIONS: Inclusion of expert elicitation can decrease decision uncertainty. Here, choice of method did not affect the overall cost-effectiveness conclusions, but researchers intending to use expert elicitation need to be aware of the impact different methods could have.This paper presents independent research funded by the National Institute of Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (CLAHRC) for the South West Peninsula