Developing a health state classification system from NEWQOL for epilepsy using classical psychometric techniques and Rasch analysis: a technical report

Aims: Resource allocation amongst competing health care interventions is informed by evidence of both clinical- and cost-effectiveness. Cost-utility analysis is increasingly used to assess cost effectiveness through the use of Quality Adjusted Life Years (QALYs). This requires health state values. Generic measures of health related quality of life (HRQL) are usually used to produce these values, but there are concerns about their relevance and sensitivity in epilepsy. This study develops a health state classification system for epilepsy from the NEWQOL battery, a validated questionnaire measuring QoL in epilepsy. The classification system will be amenable to valuation for calculating QALYs. Methods: Factor and other psychometric analyses were undertaken to investigate the factor structure of the battery, and assess the validity and responsiveness of the items. These analyses were used alongside Rasch analysis to select the dimensions included in the classification system, and the items used to represent each domain. Analysis was carried out on a trial dataset of patients with epilepsy (n=1611). Rasch and factor analysis were performed on one half of the sample and validated on the remaining half. Dimensions and items were selected that performed well across all analyses. Results: The battery was found to demonstrate reliability and validity but responsiveness across time periods for many of the items was low. A six dimension classification system was developed: worry about seizures, depression, memory, cognition, stigmatism and control, each with four response levels. Conclusions: It is feasible to develop a health state classification system from a battery of instruments using a combination of classical psychometric, factor and Rasch analysis. This is the first condition-specific health state classification developed for epilepsy and the next stage will produce preference weights to enable the measure to be used in cost-utility analysis.quality adjusted life years; health related quality of life; Rasch analysis; preference-based measures of health; health states; epilepsy

Developing a health state classification system from NEWQOL for epilepsy using classical psychometric techniques and Rasch analysis: A technical report

Aims: Resource allocation amongst competing health care interventions is informed by evidence of both clinical- and cost-effectiveness. Cost-utility analysis is increasingly used to assess cost effectiveness through the use of Quality Adjusted Life Years (QALYs). This requires health state values. Generic measures of health related quality of life (HRQL) are usually used to produce these values, but there are concerns about their relevance and sensitivity in epilepsy. This study develops a health state classification system for epilepsy from the NEWQOL battery, a validated questionnaire measuring QoL in epilepsy. The classification system will be amenable to valuation for calculating QALYs. Methods: Factor and other psychometric analyses were undertaken to investigate the factor structure of the battery, and assess the validity and responsiveness of the items. These analyses were used alongside Rasch analysis to select the dimensions included in the classification system, and the items used to represent each domain. Analysis was carried out on a trial dataset of patients with epilepsy (n=1611). Rasch and factor analysis were performed on one half of the sample and validated on the remaining half. Dimensions and items were selected that performed well across all analyses. Results: The battery was found to demonstrate reliability and validity but responsiveness across time periods for many of the items was low. A six dimension classification system was developed: worry about seizures, depression, memory, cognition, stigmatism and control, each with four response levels. Conclusions: It is feasible to develop a health state classification system from a battery of instruments using a combination of classical psychometric, factor and Rasch analysis. This is the first condition-specific health state classification developed for epilepsy and the next stage will produce preference weights to enable the measure to be used in cost-utility analysis

A Quick Guide for Computer-Assisted Instruction in Computational Biology and Bioinformatics

Introduction: Computational Biology and Bioinformatics (CBB) are indispensable components in the training of life scientists [1–3]. Current curricula in the life sciences should prepare graduates who master quantitative and computer skills for increased levels of performance [4–6]. Equally important is that the application of the curricula is driven by an appropriate instructional paradigm and effective learning experiences. Teaching and learning with computers bring specific issues that should be considered beforehand by any instructor. The following Quick Guide for Computer-Assisted Instruction (CAI) outlines ten principles for effective teaching. The principles are aligned with current developments on human cognition and learning [7] and have been drawn from our own experience using CAI in seminars, tutorials, and distance education, in courses on Molecular Life Sciences at the undergraduate level, taught to majors in biology or in other subjects (e.g., nutrition, teaching of physics and chemistry, teaching of biology, sports). The Guide refers to the preparation, presentation, and assessment of CAI. It should be an aid for those who teach CBB with CAI in class, and it is expected to stimulate student motivation and deeper learning in CBB, thus making class time more effective and improving satisfaction of both students and instructors

Rappresentare e narrare i paesaggi: una sperimentazione riferita ad alcuni paesaggi dell\u2019anfiteatro morenico di Ivrea

Fra le diverse azioni della ricerca “Progetto di sperimentazione per l’attuazione del piano paesaggistico del Piemonte” promossa nel 2018 dalla Compagnia di San Paolo, d’intesa con la Regione e il Segretariato regionale MiBACT, è stato intrapreso uno specifico lavoro di rappresentazione cartografica e di narrazione dei paesaggi. Inizialmente non prevista, questa azione è stata avviata a fronte della necessità di comprendere e far comprendere un paesaggio molto articolato, che la Scheda d’ambito del Piano paesaggistico restituisce in termini necessariamente aggregati. Lo sguardo sul lungo periodo, sulle permanenze e capacità di adattamento alle mutevoli variabili esterne, offre alcune riflessioni interessanti sulla resilienza intesa come processo di apprendimento site-specific

L^2 stability estimates for shock solutions of scalar conservation laws using the relative entropy method

We consider scalar nonviscous conservation laws with strictly convex flux in one spatial dimension, and we investigate the behavior of bounded L^2 perturbations of shock wave solutions to the Riemann problem using the relative entropy method. We show that up to a time-dependent translation of the shock, the L^2 norm of a perturbed solution relative to the shock wave is bounded above by the L^2 norm of the initial perturbation.Comment: 17 page

The angular diameter of R Doradus: a nearby Mira-like star

We find the angular diameter of R Doradus to be 57 +/- 5 mas, exceeding that of Betelgeuse and implying that R Dor is larger in apparent size than every star except the Sun. R Dor is shown to be closely related to the Mira variables. We estimate an effective temperature of 2740 +/- 190 K, a distance of 61 +/- 7 pc, a luminosity of 6500 +/- 1400 Lsol and a radius of 370 +/- 50 Rsol. The characteristics of R Dor are consistent with it being near the edge of a Mira instability strip. We detect non-zero closure phases from R Dor, indicating an asymmetric brightness distribution. We also observed W Hya, a small-amplitude Mira, for which we find an angular diameter of 44 +/- 4 mas.Comment: MNRAS (accepted); 7 pages, LaTeX with necessary style file and PostScript figure

Alpha-defensin and the Synovasure lateral flow device for the diagnosis of prosthetic joint infection: a systematic review and meta-analysis

AimsThe aim of this review is to evaluate the available literature and to calculate a pooled diagnostic sensitivity and specificity for the different alpha-defensin test systems to diagnose peri-prosthetic infection.Materials and MethodsStudies using alpha-defensin or Synovasure to diagnose periprosthetic joint infection were identified from systematic searches of electronic databases. Study quality was evaluated using the QUADAS tool. Meta-analysis was completed using a bivariate model.ResultsEleven eligible studies were included. Median QUADAS score was 13 [I.Q.R. 13-13] out of 14. Significant conflicts of interest were identified in five studies. Pooled sensitivity for the laboratory alpha-defensin test was 0.95 (95% CI 0.91-0.98) and specificity 0.97 (95% CI 0.95-0.98) for four studies with a threshold level of 5.2mgl-a. Pooled sensitivity for the lateral flow cassette test was 0.85 (95% CI 0.74-0.92) and specificity was 0.90 (95% CI 0.91-0.98). There was a statistically significant difference in sensitivity but not specificity.ConclusionLaboratory based alpha-defensin testing remains a promising tool for diagnosing periprosthetic joint infection. The lateral flow cassette has a significantly lower performance and pooled results are comparable to the leucocyte esterase test. Further studies are essential before the widespread adoption of the lateral flow cassette alpha-defensin test. Take home messageAlpha defensin testing for periprosthetic joint infection has excellent sensitivity and specificity when performed in a laboratory. The pooled sensitivity and specificity is much lower when results are combined for the lateral flow cassette (Synovasure devise

Electronic submission and the movement towards a paperless law office in a modern university

The Government’s target of 50% of all under 30 year olds studying at higher education institutions by 2010, coupled with the National Committee Inquiry into Higher Education’ (1997) concluding that further expansion of higher education could not be afforded under the existing funding arrangements, may have serious ramifications for higher education in the UK. Alongside this increase in numbers, students are increasingly seen as educational consumers with increased choice in a demand-led market which universities must recognise. To compete in this academic environment these institutions are having to be ever more consumer aware in the services they offer and are having to increase choice to attract customers from rival enterprises. Information technology is playing an increasing role in the learning experience as noted by institutional commentators such as the Higher Education Funding Council for England, the Joint Information Systems Committee, the Electronic Books ON-screen Interface group and Lord Dearing’s Report. Technology’s use is further evidenced through institutions’ employment of the internet, e-mail and web-based learning to harness the power of this medium. This paper focuses on the concept of commercialism in the university sector and how a movement to a paperless office may be one way in which a university could gain an early competitive advantage over its rivals. The paper takes a student perspective to demonstrate whether students would wish to move towards electronic methods of submission of assessed work and considers the current problems that are encountered in physical submission of documents. This is the first paper in an on-going research project investigating the benefits and viability of a paperless law office, and the results demonstrate both that the students desire more flexibility in submission of university work and that their acceptance may be the easy first step on the road to the paperless law school