DO JURORS HOLD AUDITORS TO A DIFFERENT NEGLIGENCE STANDARD UNDER U.S. GAAP AND IFRS?

In order to fulfill the requirements of East Carolina University’s Honors College, I created the research study described in this paper to examine the effects on auditor liability under United States Generally Accepted Accounting Principles compared to the International Financial Reporting Standards. The Financial Accounting Standards Board and the International Accounting Standards Board have been working towards convergence between U.S. GAAP, a rules-based system, and IFRS, a principles-based system. This research study examines whether potential jurors would hold auditors to a different negligence standard between rules-based and principles-based accounting. This study also explores how juror assessments of auditor responsibility differ when auditor liability is limited, as opposed to, unlimited. An experiment was conducted with students at a large state university representing jurors. I found evidence that auditor liability was held to a higher dollar value under unlimited liability and when relevant accounting standards were rules-based

QALY variables related to HS, and events entered in the microsimulation model.

<p>HS: Health state; QALY: Quality-adjusted life years; CHD: Coronary heart disease; CKD: Chronic kidney disease; OI Opportunistic infection</p

Incremental cost effectiveness ratio plan, presenting the results of the probabilistic sensitivity analysis of LPV/r vs. ATV+r 1 regimens.

<p>Incremental cost effectiveness ratio plan, presenting the results of the probabilistic sensitivity analysis of LPV/r vs. ATV+r 1 regimens.</p

Costs of treatments and adverse events in euro for each Health State.

<p>Costs of treatments and adverse events in euro for each Health State.</p

Parameters used within the sensitivity analysis performed.

<p>CHD: Coronary heart disease; CKD: Chronic kidney disease; OI: Opportunistic infection; TC: Total cholesterol; HDL: High-density lipoprotein; HS: Health state; QALY: Quality-adjusted life years.</p>*<p>Ranges are: minimum and maximum or percentage variation of base-case values for uniform distributions; mean and standard deviation for normal distributions; alpha and beta are shape parameters for beta distributions.</p>‡<p>Risk values of diarrhoea, hyperbilirubinemia and opportunistic infections distributed according to a beta probability distribution.</p

Structure of the microsimulation model at the individual level.

<p>Circle: event that does not determine a change of line of treatment. Rhombus: event that determine a change of line of treatment. HS: Health State. CHD: Coronary heart disease. CKD: Chronic kidney disease. OI: Opportunistic infection. VL: Viral load. § event that may lead to death. * Detectable viral load for two consecutive semesters. Patients enter the model being in first-line treatment (LPV/r or ATV+r). After each cycle, patients may change health state, die or experience events that may lead to a change in the line of treatment (patients in second-line had different treatment options that excluded those on first-line). Diarrhoea and hyperbilirubinemia may be experienced only by patients in first-line treatment, since these adverse events are associated with LPV/r and ATV+r therapies.</p

Incremental cost effectiveness ratio plan, presenting the results of the probabilistic sensitivity analysis of LPV/r vs. ATV+r 2 regimens.

<p>Incremental cost effectiveness ratio plan, presenting the results of the probabilistic sensitivity analysis of LPV/r vs. ATV+r 2 regimens.</p

Base-case estimates used within the model

<p>SD: standard deviation; DM: diabetes mellitus; CHD: Coronary heart disease; TC: Total cholesterol; HDL: High-density lipoprotein; VL: Viral load; HS: Health state; OI: Opportunistic infection; CKD: Chronic kidney disease</p>*<p>Estimates gathered from the literature and expressed as incidence rates (i.e., event/person-years) were converted into semestral probabilities using standard formulas</p>†<p>Transition probabilities of transitioning to a state with greater viral load (≥ 50 copies/mL) are 19% lesser than LPV/r</p>‡<p>Effect on TC:HDL ratio is considered null in second-line treatment</p

Lifetime results of the model divided per treatment.

<p>QALY: Quality-adjusted life years; CHD: Coronary heart disease; CKD: Chronic kidney disease; OI: Opportunistic infection; AE: Adverse event; VL: Viral load.</p

HIV Clinical Pathway: A New Approach to Combine Guidelines and Sustainability of Anti-Retroviral Treatment in Italy

<div><p>The present article describes the case study of a “real world” HIV practice within the debate concerning the strategic role of Clinical Governance (CG) tools in the management of a National Healthcare System’s sustainability. The study aimed at assessing the impact of a Clinical Pathway (CP) implementation, required by the Regional Healthcare Service, in terms of effectiveness (virological and immunological conditions) and efficiency (economic resources absorption), from the budget holder perspective. Data derived from a multi-centre cohort of patients treated in 6 Hospitals that provided care to approximately 42% of the total HIV+ patients, in Lombardy Region, Italy. Two phases were compared: Pre-CP (2009–2010) <i>vs</i>. Post-CP implementation (2011–2012). All HIV infected adults, observed in the participating hospitals during the study periods, were enrolled and stratified into the 3 categories defined by the Regional CP: first-line, switch for toxicity/other, and switch for failure. The study population was composed of 1,284 patients (Pre-CP phase) and 1,135 patients (Post-CP phase). The results showed that the same level of virological and immunological effectiveness was guaranteed to HIV+ patients: 81.2% of Pre-CP phase population and 83.2% of Post-CP phase population had undetectable HIV-RNA (defined as <50 copies/mL) at 12-month follow up. CD4⁺ cell counts increased by 28 ± 4 cells/mm³ in Pre-CP Phase and 39 ± 5 cells/mm³ in Post-CP Phase. From an economic point of view, the CP implementation led to a substantial advantage: the mean total costs related to the management of the HIV disease (ART, hospital admission and laboratory tests) decreased (-8.60%) in the Post-CP phase (p-value < 0.0001). Results confirmed that the CP provided appropriateness and quality of care, with a cost reduction for the budget holder.</p></div