Estimating the burden of antimicrobial resistance: a systematic literature review.

Background: Accurate estimates of the burden of antimicrobial resistance (AMR) are needed to establish the magnitude of this global threat in terms of both health and cost, and to paramaterise cost-effectiveness evaluations of interventions aiming to tackle the problem. This review aimed to establish the alternative methodologies used in estimating AMR burden in order to appraise the current evidence base. Methods: MEDLINE, EMBASE, Scopus, EconLit, PubMed and grey literature were searched. English language studies evaluating the impact of AMR (from any microbe) on patient, payer/provider and economic burden published between January 2013 and December 2015 were included. Independent screening of title/abstracts followed by full texts was performed using pre-specified criteria. A study quality score (from zero to one) was derived using Newcastle-Ottawa and Philips checklists. Extracted study data were used to compare study method and resulting burden estimate, according to perspective. Monetary costs were converted into 2013 USD. Results: Out of 5187 unique retrievals, 214 studies were included. One hundred eighty-seven studies estimated patient health, 75 studies estimated payer/provider and 11 studies estimated economic burden. 64% of included studies were single centre. The majority of studies estimating patient or provider/payer burden used regression techniques. 48% of studies estimating mortality burden found a significant impact from resistance, excess healthcare system costs ranged from non-significance to $1 billion per year, whilst economic burden ranged from$21,832 per case to over $3 trillion in GDP loss. Median quality scores (interquartile range) for patient, payer/provider and economic burden studies were 0.67 (0.56-0.67), 0.56 (0.46-0.67) and 0.53 (0.44-0.60) respectively. Conclusions: This study highlights what methodological assumptions and biases can occur dependent on chosen outcome and perspective. Currently, there is considerable variability in burden estimates, which can lead in-turn to inaccurate intervention evaluations and poor policy/investment decisions. Future research should utilise the recommendations presented in this review. Trial registration: This systematic review is registered with PROSPERO (PROSPERO CRD42016037510)

WEGA. Wiederverwendbare und erweiterbare Geschaeftsprozess- und Anwendungssystemarchitekturen

SIGLEAvailable from TIB Hannover: F98B1821+a / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekBundesministerium fuer Bildung, Wissenschaft, Forschung und Technologie, Bonn (Germany)DEGerman

Chancen und Risiken der digitalen Transformation für die Rechnungslegung

Die heutige Gestalt des Rechnungswesens geht auf konzeptionelle Überlegungen früherer Dekaden zurück. Auch jüngere Entwicklungen in Finanzberichterstattung und Controlling sind davon nicht ausgenommen. Durch die digitale Transformation haben sich die realwirtschaftlichen Geschäftsmodelle mittlerweile – im Vergleich zu jenen dieser Entstehungszeit – aber fundamental geändert. Altbekannte Verfahren und Instrumente müssen entsprechend angepasst werden. Durch neue Technologien sind hierfür mannigfaltige Möglichkeiten gegeben, welche allerdings auch mit Herausforderungen einhergehen. Vor allem der Mensch, welcher nach wie vor primärer Entscheidungsträger und Nutzer von Informationen des Rechnungswesens ist, sollte in diesem Kontext nicht außer Acht gelassen werden, um Entscheidungs‐ und Steuerungsfehler zu vermeiden