Conducting value for money analyses for non-randomised interventional studies including service evaluations : an educational review with recommendations

This article provides an educational review covering the consideration of conducting ‘value for money’ analyses as part of non-randomised study designs including service evaluations. These evaluations represent a vehicle for producing evidence such as value for money of a care intervention or service delivery model. Decision makers including charities and local and national governing bodies often rely on evidence from non-randomised data and service evaluations to inform their resource allocation decision-making. However, as randomised data obtained from randomised controlled trials are considered the ‘gold standard’ for assessing causation, the use of this alternative vehicle for producing an evidence base requires careful consideration. We refer to value for money analyses, but reflect on methods associated with economic evaluations as a form of analysis used to inform resource allocation decision-making alongside a finite budget. Not all forms of value for money analysis are considered a full economic evaluation with implications for the information provided to decision makers. The type of value for money analysis to be conducted requires considerations such as the outcome(s) of interest, study design, statistical methods to control for confounding and bias, and how to quantify and describe uncertainty and opportunity costs to decision makers in any resulting value for money estimates. Service evaluations as vehicles for producing evidence present different challenges to analysts than what is commonly associated with research, randomised controlled trials and health technology appraisals, requiring specific study design and analytic considerations. This educational review describes and discusses these considerations, as overlooking them could affect the information provided to decision makers who may make an ‘ill-informed’ decision based on ‘poor’ or ‘inaccurate’ information with long-term implications. We make direct comparisons between randomised controlled trials relative to non-randomised data as vehicles for assessing causation; given ‘gold standard’ randomised controlled trials have limitations. Although we use UK-based decision makers as examples, we reflect on the needs of decision makers internationally for evidence-based decision-making specific to resource allocation. We make recommendations based on the experiences of the authors in the UK, reflecting on the wide variety of methods available, used as documented in the empirical literature. These methods may not have been fully considered relevant to non-randomised study designs and/or service evaluations, but could improve and aid the analysis conducted to inform the relevant value for money decision problem

Why national health research systems matter

Some of the most outstanding problems in Computer Science (e.g. access to heterogeneous information sources, use of different e-commerce standards, ontology translation, etc.) are often approached through the identification of ontology mappings. A manual mapping generation slows down, or even makes unfeasible, the solution of particular cases of the aforementioned problems via ontology mappings. Some algorithms and formal models for partial tasks of automatic generation of mappings have been proposed. However, an integrated system to solve this problem is still missing. In this paper, we present AMON, a platform for automatic ontology mapping generation. First of all, we show the general structure. Then, we describe the current version of the system, including the ontology in which it is based, the similarity measures that it uses, the access to external sources, etc

Evidence-informed health policy: are we beginning to get there at last

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited

Language, the Parent of Thought: Speculating with Hegel

We speculate with Hegel about language, critiquing interpretations of Hegel's views on language given by Jim Vernon, John McCumber, Stephen Houlgate, and Michael N. Forster, as well as defending Sophisticated Radical Whorfianism from the objections of Maria Francisca Reines and Jesse Prinz.  Prior to discussing Forster, we explicate Hegel's views on mechanical memory.  We conclude by discussing why, although thought grows up, it does not move out

Pico without public keys

This document is the Accepted Manuscript version of the following paper: Frank Stajano, Bruce Christianson, Mark Lomas, Graeme Jenkinson, Jeunese Payne, Max Spencer, and Quentin Stafford Fraser, 'Pico without Public Keys', Security Protocols XXIII, 23rd International Workshop Cambridge, March 31- April 2, 2015, Revised Selected Papers, pp. 195-211, part of the Lecture Notes in Computer Science book series (LNCS, Vol. 9379), first online 25 November 2015, ISBN: 978-3-319-26095-2. The final publication is available at Springer via: https://link.springer.com/chapter/10.1007%2F978-3-319-26096-9_21v.Pico is a user authentication system that does not require remembering secrets. It is based on a personal handheld token that holds the user’s credentials and that is unlocked by a “personal aura” generated by digital accessories worn by the owner. The token, acting as prover, engages in a public-key-based authentication protocol with the verifier. What would happen to Pico if success of the mythical quantum computer meant secure public key primitives were no longer available, or if for other reasons such as energy consumption we preferred not to deploy them? More generally, what would happen under those circumstances to user authentication on the web, which relies heavily on public key cryptography through HTTPS/TLS? Although the symmetric-key-vs-public-key debate dates back to the 1990s, we note that the problematic aspects of public key deployment that were identified back then are still ubiquitous today. In particular, although public key cryptography is widely deployed on the web, revocation still doesn’t work. We discuss ways of providing desirable properties of public-key-based user authentication systems using symmetric-key primitives and tamperevident tokens. In particular, we present a protocol through which a compromise of the user credentials file at one website does not require users to change their credentials at that website or any other. We also note that the current prototype of Pico, when working in compatibility mode through the Pico Lens (i.e. with websites that are unaware of the Pico protocols), doesn’t actually use public key cryptography, other than that implicit in TLS. With minor tweaks we adopt this as the native mode for Pico, dropping public key cryptography and achieving much greater deployability without any noteworthy loss in security

Doing Better with "Bad Kids": What Stops Us from Using the Research Evidence?

Conduct disorder, or persistent antisocial behaviour in children and youth, is an important public mental health problem in Canada. There is much research evidence about causal risk factors, prevention and treatment, yet little of the research is incorporated into legislative, administrative or clinical policy decision-making. Decision-making in Hamilton, Ontario is used as a case study to illustrate this research-policy gap. This gap is then explained using a framework for health policy analysis that incorporates values (ideologies, beliefs, and interests), institutional structures for decision-making, and research information. Values and institutional structures need to be considered if research evidence is to be disseminated and applied by policy decision-makers to prevent and treat conduct disorder more effectively