Values and value conflicts in snack providing of Dutch, Polish, Indonesian and Italian mothers

This study investigates which values play a role in the decision of mothers about snacks to offer to their young children with a focus on the value conflicts that might occur. The study explores whether national culture is reflected in mothers' values in snack choice for their young children and the related value conflicts. Semi-structured interviews with 67 mothers of 2–7 years old children divided over 4 national cultures (Dutch, Polish, Indonesian and Italian) were conducted. Questions were asked about their values and value conflicts when providing a snack to their young children. Four key themes could be distinguished to cluster the mentioned values. The health-related key theme includes all values that are associated with the healthiness of the product, the child-related key theme all values that connects to the child, the time-related key theme includes the value convenience and the product-related key theme includes all values that are associated with the product itself. Dutch and Polish mothers mostly valued health of the snack, whereas Indonesian and Italian mothers mostly valued the preference of their child. Data also shows specific prevalence between values and nationalities: convenience was very important for Dutch mothers, valuing organic food was typical for Polish mothers, religion played a role for Indonesian mothers, while Italian mothers placed more value on brand compared to the mothers of other cultures. In all cultures, the value conflicts mentioned were mainly related to health.</p

Erratum to: Methods for evaluating medical tests and biomarkers

[This corrects the article DOI: 10.1186/s41512-016-0001-y.]

Evidence synthesis to inform model-based cost-effectiveness evaluations of diagnostic tests: a methodological systematic review of health technology assessments

Background: Evaluations of diagnostic tests are challenging because of the indirect nature of their impact on patient outcomes. Model-based health economic evaluations of tests allow different types of evidence from various sources to be incorporated and enable cost-effectiveness estimates to be made beyond the duration of available study data. To parameterize a health-economic model fully, all the ways a test impacts on patient health must be quantified, including but not limited to diagnostic test accuracy. Methods: We assessed all UK NIHR HTA reports published May 2009-July 2015. Reports were included if they evaluated a diagnostic test, included a model-based health economic evaluation and included a systematic review and meta-analysis of test accuracy. From each eligible report we extracted information on the following topics: 1) what evidence aside from test accuracy was searched for and synthesised, 2) which methods were used to synthesise test accuracy evidence and how did the results inform the economic model, 3) how/whether threshold effects were explored, 4) how the potential dependency between multiple tests in a pathway was accounted for, and 5) for evaluations of tests targeted at the primary care setting, how evidence from differing healthcare settings was incorporated. Results: The bivariate or HSROC model was implemented in 20/22 reports that met all inclusion criteria. Test accuracy data for health economic modelling was obtained from meta-analyses completely in four reports, partially in fourteen reports and not at all in four reports. Only 2/7 reports that used a quantitative test gave clear threshold recommendations. All 22 reports explored the effect of uncertainty in accuracy parameters but most of those that used multiple tests did not allow for dependence between test results. 7/22 tests were potentially suitable for primary care but the majority found limited evidence on test accuracy in primary care settings. Conclusions: The uptake of appropriate meta-analysis methods for synthesising evidence on diagnostic test accuracy in UK NIHR HTAs has improved in recent years. Future research should focus on other evidence requirements for cost-effectiveness assessment, threshold effects for quantitative tests and the impact of multiple diagnostic tests

Erratum to: Methods for evaluating medical tests and biomarkers

[This corrects the article DOI: 10.1186/s41512-016-0001-y.]

Tension band wiring for simple olecranon fractures: evaluation of surgical technique

Background: In some settings, specific techniques for open reduction and internal fixation are preferred based on the eminence of a surgeon or professional organization. An emphasis on technical aspects of surgery that are not proved superior and vary substantially from surgeon to surgeon can be confusing for trainees. This study applied a numerical grading of the technical aspects of tension band wire (TBW) fixation for olecranon fracture; assessed the interobserver agreement of each criterion; and measured the correlation of the technical grading and objective and subjective long-term outcomes. Materials and methods Forty observers were invited to rate the technical aspects of TBW fixation of the olecranon on 26 post-operative radiographs. The interobserver reliability of the rating was measured using the intra-class correlation coefficient. The correlation between the rating and motion, Mayo elbow performance index, and disabilities of the arm, shoulder and hand score was tested with the Spearman’s rank correlation test. Results: None of the figure-of-eight TBW constructs were considered perfect according to the numerical grading: the majority of observers found three deviations per fixation. The interobserver agreement was only fair for the total number of deviations and no correlation between the number of deviations and long-term objective and subjective outcome was found. Conclusions: A rating of the technical aspects of TBW for olecranon fractures was unreliable and did not correlate with subjective and objective outcomes. Emphasis on specific technical aspects of fixation might be confusing for trainees and could distract them from the principles of effective treatment. Level of evidence Level IV diagnostic study

Erratum to: Methods for evaluating medical tests and biomarkers

The original MEMTAB Abstracts in Diagnostic and Prognostic Research contains the incorrect year on individual abstracts in the PDF [1].“Diagnostic and Prognostic Research 2016” under the correspondence line should therefore have been written as “Diagnostic and Prognostic Research 2017” as the journal did not launch until 2017