Purchasing complex services on the Internet; An analysis of mortgage loan acquisitions

In contrast to, for example, books and compact discs, the number of complex services offered on the Internet is still small. A good example of such a service concerns mortgage loans. The decision-making process differs for complex services in that they have an extra intermediate step of `indication of interest'. The web site is (1) visited and searched for information, subsequently (2) a request for the service is made, which may lead to (3) a purchase. This difference in the buying process and the complexity of the decision-making process, requires afurther investigation on purchasing complex services on the Internet. We therefore focus on online purchases of complex services, paying special attention to the determinants of a purchase of such services. To this end, we acquired a unique data set from an online Dutch financial service provider, which offers services like mortgage loans and insurances on the Internet. This data contains, besides clickstream data, also data on user-specific information like demographics. We also obtained information on whether the request for the service re-sulted in a purchase. Search behavior, product familiarity and trust appear to be useful determinants of purchase of complex services. Direct managerial applications of our model include the ability to identify customer characteristics of successful applicants, and subsequently the selection of customers

Effect of wound healing period and temperature, irradiation and post irradiation storage temperature on the keeping quality of potatoes

The effect of irradiation doses, wound healing temperature, post harvest irradiation time (wound healing period) and storage temperature on a number of quality parameters such as loss of weight, sprout inhibition and rot incidence, chemical parameters such as sugar and vitamin e content, sensory parameters taste and colour and also wound healing ability were investigated. The potatoes were irradiated with a dose range of 50 to 100 Gy, after a wound healing period varying from 0 to 6 weeks at 15 or 20 °C. The product was stored at 10 and 20 °C and 90% relative humidity

Automated entire thrombus density measurements for robust and comprehensive thrombus characterization in patients with acute ischemic stroke

Background and Purpose: In acute ischemic stroke (AIS) management, CT-based thrombus density has been associated with treatment success. However, currently used thrombus measurements are prone to inter-observer variability and oversimplify the heterogeneous thrombus composition. Our aim was first to introduce an automated method to assess the entire thrombus density and then to compare the measured entire thrombus density with respect to current standard manual measurements. Materials and Method: In 135 AIS patients, the density distribution of the entire thrombus was determined. Density distributions were described usingmedians, interquartile ranges (IQR), kurtosis, and skewedness. Differences between themedian of entire thrombusmeasurements and commonly applied manualmeasurements using 3 regions of interest were determined using linear regression. Results: Density distributions varied considerably with medians ranging from 20.0 to 62.8 HU and IQRs ranging from 9.3 to 55.8 HU. The average median of the thrombus density distributions (43.5 ± 10.2 HU) was lower than the manual assessment (49.6 ± 8.0 HU) (p<0.05). The difference between manual measurements and median density of entire thrombus decreased with increasing density (r = 0.64; p<0.05), revealing relatively higher manual measurements for low density thrombi such that manual density measurement tend overestimates the real thrombus density. Conclusions: Automatic measurements of the full thrombus expose a wide variety of thrombi density distribution, which is not grasped with currently used manual measurement. Furthermore, d

Two-year clinical follow-up of the Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in The Netherlands (MR CLEAN): Design and statistical analysis plan of the extended follow-up study

Background: MR CLEAN was the first randomized trial to demonstrate the short-term clinical effectiveness of endovascular treatment in patients with acute ischemic stroke caused by large vessel occlusion in the anterior circulation. Several other trials confirmed that endovascular treatment improves clinical outcome at three months. However, limited data are available on long-term clinical outcome. We aimed to estimate the effect of endovascular treatment on functional outcome at two-year follow-up in patients with acute ischemic stroke. Secondly, we aimed to assess the effect of endovascular treatment on major vascular events and mortality during two years of follow-up. Methods: MR CLEAN is a multicenter clinical trial with randomized treatment allocation, open-label treatment, and blinded endpoint evaluation. Patients included were 18 years or older with acute ischemic stroke caused by a proven anterior proximal artery occlusion who could be treated within six hours after stroke onset. The intervention contrast was endovascular treatment and usual care versus no endovascular treatment and usual care. The current study extended the follow-up duration from three months to two years. The primary outcome is the score on the modified Rankin scale at two years. Secondary outcomes include all-cause mortality and the occurrence of major vascular events within two years of follow-up. Discussion: The results of our study provide information on the long-term clinical effectiveness of endovascular treatment, which may have implications for individual treatment decisions and estimates of cost-effectiveness. Trial registration:NTR1804. Registered on 7 May 2009; ISRCTN10888758. Registered on 24 July 2012 (main MR CLEAN trial); NTR5073. Registered on 26 February 2015 (extended follow-up study)

Purschasing complex services on the Internet; An analysis of mortgage loan acquisitions

In contrast to, for example, books and compact discs, the number of complex services offered on the Internet is still small. A good example of such a service concerns mortgage loans. The decision-making process differs for complex services in that they have an extra intermediate step of `indication of interest'. The web site is (1) visited and searched for information, subsequently (2) a request for the service is made, which may lead to (3) a purchase. This difference in the buying process and the complexity of the decision-making process, requires afurther investigation on purchasing complex services on the Internet. We therefore focus on online purchases of complex services, paying special attention to the determinants of a purchase of such services. To this end, we acquired a unique data set from an online Dutch financial service provider, which offers services like mortgage loans and insurances on the Internet. This data contains, besides clickstream data, also data on user-specific information like demographics. We also obtained information on whether the request for the service re-sulted in a purchase. Search behavior, product familiarity and trust appear to be useful determinants of purchase of complex services. Direct managerial applications of our model include the ability to identify customer characteristics of successful applicants, and subsequently the selection of customers.decision support system;internet;trust;online purchasing behavior;search behavior

Responsiveness and minimal clinically important change of the Pain Disability Index in patients with chronic back pain

ABSTRACT: Study Design. Prospective cohort study.Objective. The objective of this study was to test the responsiveness and minimal clinically important change (MCIC) of the PDI in patients with Chronic Back Pain (CBP).Summary of background data. Treatment of patients with CBP is primarily focused on reduction of disability. For disability measurement, the Pain Disability Index (PDI) is a widely used questionnaire. There are, however, no data available on responsiveness and MCIC.Methods. 242 Patients with CBP were included in this study. Patients filled in the PDI at baseline and at discharge. The PDI consists of two subscales: one measuring voluntary activities and one measuring obligatory activities. PDI was anchored at two self-reported global perceived effect (GPE) scales for complaints and self-care, respectively. Responsiveness was considered sufficient when Area Under the Receiver Operating Characteristic Curve (AUC) was > 0.70. To test interpretability, change scores and MCIC were calculated. MCIC was tested by determination of optimal cut-off point of the ROC-curve and determination of specificity and sensitivity of the Optimal Cut off Point (OCP).Results. AUCs were 0.76 and 0.77 depending on the external criterion. The sub-scale obligatory activities did not meet the criteria for responsiveness (AUC 0.63-0.69). MCIC of the PDI was 9.5 points for GPE 'complaints' and 8.5 for GPE 'self-care'.Conclusion. The total score of the PDI as well as the subscale of voluntary activities are responsive. Partly because of floor effects, the subscale obligatory activities is not sufficiently responsive in patients with CBP. However, the responsiveness of this sub-scale in other patient groups should be further tested. In patients with CBP, change can be considered clinically important when PDI score has decreased 8.5 to 9.5 points

Clinimetric properties of the EuroQol-5D in patients with chronic low back pain

BACKGROUND CONTEXT: Clinimetric properties of the EuroQol-5D (EQ-5D) in patients with nonspecific chronic low back pain (CLBP) are largely unknown. PURPOSE: To study the criterion validity, responsiveness, and minimal clinically important change (MCIC) of EQ-5D in patients with CLBP. STUDY DESIGN: Prospective study design carried out in a multispecialist Spine Center in The Netherlands. PATIENT SAMPLE: One hundred fifty-one patients with CLBP. OUTCOME MEASURES: Quality of life (QOL) was measured with EQ-5D, consisting of two scales: one scale measuring QOL with five categorical questions and the other measuring health state on a visual analog scale (0-100). Criterion measures were disability, measured with the Pain Disability Index (PDI) and the Roland Morris Disability Questionnaire (RMDQ), and pain intensity, measured with a numeric rating scale (NRS). METHODS: Pearson correlation coefficients between the EQ-5D and RMDQ, PDI, and NRS were calculated to test the criterion validity. Correlations were interpreted based on predefined criteria. Responsiveness of the EQ-5D was calculated with area under the receiver operating characteristics (ROC) curve. Minimal clinically important change was calculated with the optimal cutoff point under the ROC curve, and sensitivity and specificity were also calculated. RESULTS: Correlations between EQ-5D and criterion measures ranged between 0.39 and 0.59 and were considered moderate to good. Areas under the ROC curve ranged from 0.59 to 0.72 depending on the external criterion and EQ-5D subscale. The MCIC was 0.03 points for the categorical scales of the EQ-5D and 10.5 points for the EQ-5D visual analog scale. CONCLUSIONS: The EQ-5D is a valid and responsive QOL scale in patients with CLBP

Utility of the stroke-thrombolytic predictive instrument

Objective: The goal of this study was to evaluate the utility of the stroke thrombolytic predictive instrument (s-TPI) in predicting clinical outcome in patients with acute ischaemic stroke treated with intravenous tissue plasminogen activator (t-PA). Methods: The study assessed the external validity of the s-TPI in 301 consecutive stroke patients treated with intravenous t-PA. Clinical outcome was measured with the modified Rankin scale (mRs) at 3 months. The study used the s-TPI to calculate probabilities of a good outcome (mRs 0-1) and a poor outcome (mRs 5-6). We compared these probabilities with the observed outcome using receiver-operator characteristics (ROC) curves and calibration curves. Subgroup analyses for different onset-to-treatment time windows were performed. Results: According to the s-TPI, the mean predicted probability of a good and a poor outcome in the validation cohort were 0.45 and 0.17. The area under the ROC curves were 0.80 (4.5-hour time window), 0.82 (3-hour time window) and 0.77 (3-4.5 hours time window) for predicting good outcome, and 0.78 (4.5 hours), 0.80 (3 hours) and 0.74 (3-4.5 hours) for predicting poor outcome. Calibration curves revealed a slight overestimation of probabilities of a good outcome and underestimation of probabilities of a poor outcome. Conclusions: The s-TPI appears to be reasonably valid for predicting outcome after t-PA treatment in daily practice, although a slight overestimation of a good and underestimation of a poor outcome was observed