The use of generalized audit software by Egyptian external auditors: the effect of audit software features

YesPurpose - This study aims to explore: the actual usage of GAS features among Egyptian external auditors, through the technology acceptance model (TAM); how the conceptual complexity of GAS features impact its actual usage; and what factors influencing the GAS use by Egyptian external auditors. Design/methodology/approach - External audit professionals at twelve international audit firms, including the Big 4 and eight medium-sized firms, in Egypt were surveyed. Findings - The results show that the basic features including database queries, ratio analysis, and audit sampling were higher in GAS use, perceived usefulness, and perceived ease of use among Egyptian external auditors than the advanced features: digital analysis, regression/ANOVA, and data mining classification. The SEM analysis by GAS features suggests that perceived ease of use has a stronger effect on GAS use when the conceptual complexity of GAS features is high. The analysis also support that the use of GAS by Egyptian external auditors is more affected by co-worker, supervisor, or organization through perceived usefulness, but not by job relevance, output quality, and result demonstration. Research limitations/implications - Although Egyptian external auditors participated in this study may limit the extent to which the findings may be generalized, the responses provide an insight into the actual usage of GAS features by external auditors and the impact of conceptual complexity of GAS features, which is consistent with the literature concerning the relatively low level of utilizing the advanced features of GAS by internal auditors, suggesting that the issues revealed should be of concern. Practical implications - The results reported in this paper are useful to audit software developers and audit firms in their understanding of factors influencing GAS usage in a different audit context. Originality/value - The study adds value to prior research by providing context-contingent insight into the application of technology acceptance model in an unexplored audit context

Effects of the new regulations of the audit profession on the audit firms’ strategies

Submitted for the degree of Doctor of Philosophy (PhD) University of BedfordshireThe audit firms play an important role in the capital markets by verifying that auditors provide reliable information to the decision makers. However, trust in auditing firms has been questioned following Enron‘s failure and accounting scandals at WorldCom and other companies. As a result, Arthur Anderson failed and the number of big audit firms fell to four firms and no one knows who might be next. Defond and Francis (2005) believe that a critical trigger occurred when Deloitte & Touch issued a “clean” peer review report on Arthur Andersen in December 2001, just a few weeks before Andersen publicly announced that it had shredded documents related to Enron audit. The credibility and integrity of the profession‘s self-regulation program was immediately in doubt. To protect public interests and to restore confidence in the capital markets, the USA government issued the Sarbanes-Oxley Act (SOX) in 2002. Similarly, the Financial Reporting Council in the UK provided the Professional Oversight Board with similar mission. This thesis aims to explore the role of independent audit regulators in promoting confidence in the audit profession, and analyse the big four firms’ strategies that react toward these regulatory changes in the audit markets. The lack of studies in this area supports the use of grounded theory as a research methodology. 24 semi-structured interviews were conducted with the top management level of the audit regulators and big four firms’ partners. This study contributes to the literature as it provides a better understanding of the satisfaction of the big four audit firms toward the new independent regulators, and how these firms react toward the additional requirements of the independent inspectors

Personal A-constant in relation to axial length with various intraocular lenses

Purpose: To study the relationship between the axial length and personal A-constant for the 1-piece Tecnis (Abbott ZCB00), AcrySof MA60AC (Alcon) and the Quatrix aspheric preloaded (CROMA) intraocular lenses (IOL). Materials and Methods: Patients matching the inclusion criteria were further subdivided according to the implanted IOL in this prospective comparative study. The obtained refractive outcomes were introduced into the formula installed in the biometry machine (Humphrey model 820 ultrasonic biometer) to obtain the personal A-constant for each eye. Polynomial regression analysis was done to study the individualized A-constant for each type of IOL in relation to preoperative axial length measurement. Results: Two hundred and forty five eyes of 186 patients were enrolled into this study, of whom 73 eyes with Tecnis 1-piece, 116 eyes with MA60AC, and 56 eyes with Quatrix. The median of personalized A-constant for Tecnis 1-piece, MA60AC, and Quatrix were 119.21 (SD 1.3, Std. Mean error 0.15), 119 (SD 1.2, Std. Mean error 0.11) and 120.4 (SD 1.2, Std. Mean error 0.16) respectively. Regression plots for the same range of axial length among all the groups showed that the Tecnis1 group followed the same pattern of the Quatrix group in which there was a linear relationship of a trend towards myopia when the axial length had increased and a hyperopic shift when decreased. This relationship changed into a plateau when the axial length became in the range of 23.5 mm to 27 mm in the MA60AC group. Conclusions: Personal A-constant follows different trends with different IOLs even for the same range of axial length

Impact of the COVID-19 pandemic on patients with paediatric cancer in low-income, middle-income and high-income countries: a multicentre, international, observational cohort study

OBJECTIVES: Paediatric cancer is a leading cause of death for children. Children in low-income and middle-income countries (LMICs) were four times more likely to die than children in high-income countries (HICs). This study aimed to test the hypothesis that the COVID-19 pandemic had affected the delivery of healthcare services worldwide, and exacerbated the disparity in paediatric cancer outcomes between LMICs and HICs. DESIGN: A multicentre, international, collaborative cohort study. SETTING: 91 hospitals and cancer centres in 39 countries providing cancer treatment to paediatric patients between March and December 2020. PARTICIPANTS: Patients were included if they were under the age of 18 years, and newly diagnosed with or undergoing active cancer treatment for Acute lymphoblastic leukaemia, non-Hodgkin's lymphoma, Hodgkin lymphoma, Wilms' tumour, sarcoma, retinoblastoma, gliomas, medulloblastomas or neuroblastomas, in keeping with the WHO Global Initiative for Childhood Cancer. MAIN OUTCOME MEASURE: All-cause mortality at 30 days and 90 days. RESULTS: 1660 patients were recruited. 219 children had changes to their treatment due to the pandemic. Patients in LMICs were primarily affected (n=182/219, 83.1%). Relative to patients with paediatric cancer in HICs, patients with paediatric cancer in LMICs had 12.1 (95% CI 2.93 to 50.3) and 7.9 (95% CI 3.2 to 19.7) times the odds of death at 30 days and 90 days, respectively, after presentation during the COVID-19 pandemic (p<0.001). After adjusting for confounders, patients with paediatric cancer in LMICs had 15.6 (95% CI 3.7 to 65.8) times the odds of death at 30 days (p<0.001). CONCLUSIONS: The COVID-19 pandemic has affected paediatric oncology service provision. It has disproportionately affected patients in LMICs, highlighting and compounding existing disparities in healthcare systems globally that need addressing urgently. However, many patients with paediatric cancer continued to receive their normal standard of care. This speaks to the adaptability and resilience of healthcare systems and healthcare workers globally

Pancreatic surgery outcomes: multicentre prospective snapshot study in 67 countries

Background: Pancreatic surgery remains associated with high morbidity rates. Although postoperative mortality appears to have improved with specialization, the outcomes reported in the literature reflect the activity of highly specialized centres. The aim of this study was to evaluate the outcomes following pancreatic surgery worldwide.Methods: This was an international, prospective, multicentre, cross-sectional snapshot study of consecutive patients undergoing pancreatic operations worldwide in a 3-month interval in 2021. The primary outcome was postoperative mortality within 90 days of surgery. Multivariable logistic regression was used to explore relationships with Human Development Index (HDI) and other parameters.Results: A total of 4223 patients from 67 countries were analysed. A complication of any severity was detected in 68.7 percent of patients (2901 of 4223). Major complication rates (Clavien-Dindo grade at least IIIa) were 24, 18, and 27 percent, and mortality rates were 10, 5, and 5 per cent in low-to-middle-, high-, and very high-HDI countries respectively. The 90-day postoperative mortality rate was 5.4 per cent (229 of 4223) overall, but was significantly higher in the low-to-middle-HDI group (adjusted OR 2.88, 95 per cent c.i. 1.80 to 4.48). The overall failure-to-rescue rate was 21 percent; however, it was 41 per cent in low-to-middle-compared with 19 per cent in very high-HDI countries.Conclusion: Excess mortality in low-to-middle-HDI countries could be attributable to failure to rescue of patients from severe complications. The authors call for a collaborative response from international and regional associations of pancreatic surgeons to address management related to death from postoperative complications to tackle the global disparities in the outcomes of pancreatic surgery (NCT04652271; ISRCTN95140761)

Twelve-month observational study of children with cancer in 41 countries during the COVID-19 pandemic

Childhood cancer is a leading cause of death. It is unclear whether the COVID-19 pandemic has impacted childhood cancer mortality. In this study, we aimed to establish all-cause mortality rates for childhood cancers during the COVID-19 pandemic and determine the factors associated with mortality