Erratum to: Methods for evaluating medical tests and biomarkers

[This corrects the article DOI: 10.1186/s41512-016-0001-y.]

Evidence synthesis to inform model-based cost-effectiveness evaluations of diagnostic tests: a methodological systematic review of health technology assessments

Background: Evaluations of diagnostic tests are challenging because of the indirect nature of their impact on patient outcomes. Model-based health economic evaluations of tests allow different types of evidence from various sources to be incorporated and enable cost-effectiveness estimates to be made beyond the duration of available study data. To parameterize a health-economic model fully, all the ways a test impacts on patient health must be quantified, including but not limited to diagnostic test accuracy. Methods: We assessed all UK NIHR HTA reports published May 2009-July 2015. Reports were included if they evaluated a diagnostic test, included a model-based health economic evaluation and included a systematic review and meta-analysis of test accuracy. From each eligible report we extracted information on the following topics: 1) what evidence aside from test accuracy was searched for and synthesised, 2) which methods were used to synthesise test accuracy evidence and how did the results inform the economic model, 3) how/whether threshold effects were explored, 4) how the potential dependency between multiple tests in a pathway was accounted for, and 5) for evaluations of tests targeted at the primary care setting, how evidence from differing healthcare settings was incorporated. Results: The bivariate or HSROC model was implemented in 20/22 reports that met all inclusion criteria. Test accuracy data for health economic modelling was obtained from meta-analyses completely in four reports, partially in fourteen reports and not at all in four reports. Only 2/7 reports that used a quantitative test gave clear threshold recommendations. All 22 reports explored the effect of uncertainty in accuracy parameters but most of those that used multiple tests did not allow for dependence between test results. 7/22 tests were potentially suitable for primary care but the majority found limited evidence on test accuracy in primary care settings. Conclusions: The uptake of appropriate meta-analysis methods for synthesising evidence on diagnostic test accuracy in UK NIHR HTAs has improved in recent years. Future research should focus on other evidence requirements for cost-effectiveness assessment, threshold effects for quantitative tests and the impact of multiple diagnostic tests

Erratum to: Methods for evaluating medical tests and biomarkers

[This corrects the article DOI: 10.1186/s41512-016-0001-y.]

Why one size fits all approach to transition in Disability Employment Services hinders employability of young people with physical and neurological disabilities in Australia

The education-to-work pathways for young people with disabilities are becoming more diverse and lengthier in our post-industrial economy. Furthermore, it is recognized that a multitude of barriers still remain in securing employment at the end of these pathways. In this paper, we focus on Australia’s Disability Employment Services (DES) to understand how views of transition in DES policy may be influencing program rules in supporting secondary and tertiary students with physical and/or neurological disabilities in their employability and employment. We do this through critical policy analysis of DES and in-depth interpretive accounts from service providers and advocacy organizations

Seamless journeys to work for young adults with physical / Neurological disabilities: Stage 1 Report - Disability employment policy and program influences on education-to-employment transition for young adults

Executive Summary The findings described in this report relate to stage 1 of a larger Australian Research Council Linkage project: Seamless Journeys to Work for Young People with Physical / Neurological Disabilities. Stage 1 of the study takes a deeper look at Disability Employment Services (DES) and intersecting service systems to understand policy and program influences on the transition to work for young adults with disabilities, with a specific focus on those with primary physical and neurological impairments. The intention was to identify not just what the policy and program rules say about transition and young people with disabilities, but importantly, how implementing organisations (e.g. service providers) experience, understand and practice the policy and program logic as well as the potential implications and conflicts that exist with regard to supporting young adults with disabilities in their pathways to employment. The data informing the analysis were interviews with 22 participants (from organisations - DES providers and peak body/systematic advocacy organisation), as well as 16 publicly available submissions to the Australian Government’s 2015 discussion paper on DES reform..

Interpretative accounts of work capacity assessment policy for young adults with disabilities

Young adults with disabilities are a specific target of the welfare-to-work policy introduced by many OECD countries over the past decade. The implementation of these policies is a significant concern for service delivery organisations and advocates in Australia and internationally due to complex intersecting structural barriers that persist for many young adults with disabilities. A particular focus of this article is work capacity assessments. Drawing on socio-political theories and interpretive policy analysis, the 22 in-depth interviews with personnel from service delivery organisations and advocacy organisations reveal how the deemed capacity to work process is not only interpreted as flawed, but the current policy approach disables young adults, perpetuates stigma, and creates division between service users and service providers. The accounts reinforce the need to contest such assessments and instead turn towards a rights-based capability approach permitting young adults with disability self-determination over their education-to-employment pathway