A Perspective on Economic Impact

The institutions responsible for water resources management in the United States have originated as political responses to major social issues. Each agency institutionalized a procedure for structuring and comparing alternatives in the formulation of its total program. Each agency originally sought to promote effective resolution of its social issue (flood control, development of arid lands, soil erosion, etc.), but more recent efforts have sought better coordination among agency practices through a common procedure largely derived from economic theory. Any procedure, however, varies in application with the interpretation and judgment of individual planners. Today, public pressures have brought political directives requiring consideration of the local and nationwide impacts of projects that occur through direct, indirect, and secondary means in the spheres of economic, social and environmental effects. The body of the study reviews fourteen specific impact issues with the goals of providing planners a methodology for dealing with each one and of providing the theoretically inclined a basis for improving each methodology. The issues are reservoir effects on local property values, reservoir effects on the economy of the local county, changes in income and employment patterns around large reservoirs, patterns of land use change around reservoirs, reservoir effects on revenues and expenditures of local government, reservoir recreation benefits, application of marginal economic analysis to reservoir recreation planning, economic value of natural areas for recreational hunting, for stream fishing, the personal value of real property to its owner, reservoir project caused income redistribution, achievement of more flexible procedures for reservoir operation in order to match changes in demand for project output with time, estimation of flood damages by the time pattern in which they occur, and operation of reservoir systems for flood control. Each study ls presented in detail in a referenced report, and this report discusses the significance of the findings of the studies, individually and as a group

Role of genetic testing for inherited prostate cancer risk: Philadelphia prostate cancer consensus conference 2017

Purpose: Guidelines are limited for genetic testing for prostate cancer (PCA). The goal of this conference was to develop an expert consensus-dri

Event-Free Survival, a Prostate-Specific Antigen-Based Composite End Point, Is Not a Surrogate for Overall Survival in Men With Localized Prostate Cancer Treated With Radiation.

PURPOSE Recently, we have shown that metastasis-free survival is a strong surrogate for overall survival (OS) in men with intermediate- and high-risk localized prostate cancer and can accelerate the evaluation of new (neo)adjuvant therapies. Event-free survival (EFS), an earlier prostate-specific antigen (PSA)-based composite end point, may further expedite trial completion. METHODS EFS was defined as the time from random assignment to the date of first evidence of disease recurrence, including biochemical failure, local or regional recurrence, distant metastasis, or death from any cause, or was censored at the date of last PSA assessment. Individual patient data from trials within the Intermediate Clinical Endpoints in Cancer of the Prostate-ICECaP-database with evaluable PSA and disease follow-up data were analyzed. We evaluated the surrogacy of EFS for OS using a 2-stage meta-analytic validation model by determining the correlation of EFS with OS (patient level) and the correlation of treatment effects (hazard ratios [HRs]) on both EFS and OS (trial level). A clinically relevant surrogacy was defined a priori as an ≥ 0.7. RESULTS Data for 10,350 patients were analyzed from 15 radiation therapy-based trials enrolled from 1987 to 2011 with a median follow-up of 10 years. At the patient level, the correlation of EFS with OS was 0.43 (95% CI, 0.42 to 0.44) as measured by Kendall's tau from a copula model. At the trial level, the was 0.35 (95% CI, 0.01 to 0.60) from the weighted linear regression of log(HR)-OS on log(HR)-EFS. CONCLUSION EFS is a weak surrogate for OS and is not suitable for use as an intermediate clinical end point to substitute for OS to accelerate phase III (neo)adjuvant trials of prostate cancer therapies for primary radiation therapy-based trials