Deadlines, Procrastination, and Inattention in Charitable Tasks: A Field Experiment

We conduct a field experiment to analyze the effect of deadline length on charitable tasks. Participants are invited to complete an online survey, with a donation going to charity if they do so. Participants are given either one week, one month or no deadline by which to respond. Completions are lower for the one month deadline, than for the other two treatments, consistent with the model of inattention developed in Taubinsky (2014) and also with the idea that not specifying a deadline conveys urgency

Creating a priority list of non-communicable diseases to support health research funding decision-making

Objective To develop and pilot a framework based on multi-criteria decision analysis (MCDA) to prioritize non-communicable diseases (NCDs) to support health research funding decision-making. Methods The framework involves identifying NCDs to be prioritized, specifying prioritization criteria and determining their weights from a survey of stakeholders. The mean weights from the survey are applied to the NCDs’ ratings on the criteria to generate a ‘total score’ for each NCD, by which the NCDs are prioritized. Results Nineteen NCDs and five criteria were included. The criteria, in decreasing order of importance (mean weights in parentheses), are: deaths across the population (27.7 %), loss of quality-of-life across the population (23.0 %), cost to patients and families (18.6 %), cost to the health system (17.2 %), and whether vulnerable groups are disproportionately affected (13.4 %). The priority list of NCDs, stratified into four tiers of importance, is: ‘Very critical’ priority: coronary heart disease, back and neck pain, diabetes mellitus; ‘Critical’ priority: dementia and Alzheimer’s disease, stroke; ‘High’ priority: colon and rectum cancer, depressive disorders, chronic obstructive pulmonary disease, chronic kidney disease, breast cancer, prostate cancer, arthritis, lung cancer; and ‘Medium’ priority: asthma, hearing loss, melanoma skin cancer, addictive disorders, non-melanoma skin cancer, headaches. Conclusion The results indicate the framework for prioritizing NCDs for research funding is feasible and effective. The framework could also be used for other health conditions

Deadlines, Procrastination, and Forgetting in Charitable Tasks: A Field Experiment

We conduct a field experiment to test theoretical predictions regarding the effect of deadline length on task completion. We place our test in a charitable task setting in which participants are invited to complete an online survey, with a donation going to charity if they do so. Participants are given either one week, one month or no deadline by which to respond. Completions are lowest for the one month deadline and highest when no deadline is specified. Our results point out that a short deadline, and not specifying a deadline, signals urgency. By contrast, providing a longer (one month) deadline gives people permission to procrastinate, with people ultimately forgetting to complete the task

Procrastination and the Non-Monotonic Effect of Deadlines on Task Completion

We conduct a field experiment to test the non-monotonic effect of deadline length on task completion. Participants are invited to complete an online survey in which a donation goes to charity. They are given either one week, one month or no deadline to respond. Responses are lowest for the one-month deadline and highest when no deadline is specified. No deadline and the one-week deadline feature a large number of early responses, while providing a one-month deadline appears to give people permission to procrastinate. If they are inattentive, they might forget to complete the task

A new tool for creating personal and social EQ-5D-5L value sets, including valuing ‘dead’

A new online tool for creating personal and social EQ-5D-5L value sets was recently developed and trialled in New Zealand (NZ). Health state values for each participant are determined using the PAPRIKA method – in the present context, a novel type of adaptive discrete choice experiment – and any health states worse than dead are identified using a binary search algorithm. Following testing and refinement, the tool was distributed in an online survey to a representative sample of NZ adults (N=5112), whose personal value sets were created. Extensive data quality checks were performed, resulting in a ‘high-quality’ sub-sample of 2468 participants whose personal value sets were, in effect, averaged to create a social value set for NZ, as represented by social ‘disutility coefficients’ (consistent with the EQ-5D literature). These results overall and participants’ feedback indicate that the new valuation tool is feasible and acceptable to participants and enables valuation data to be relatively easily and cheaply collected. The tool could also be used in other countries, tested against other methods for creating EQ-5D-5L value sets, applied in personalised medicine and adapted to create value sets for other health descriptive systems

Clinical reasoning for complex cervical spine conditions

Clinical reasoning is at the cornerstone of clinical practice. Case studies are not viewed as highly in the evidence hierarchy as randomised controlled trials but they provide valuable insights into individual cases and clinicians often relate well to these as there are parallels with patients they see in their own clinics. This master class presents three cases related to cervical spine pathologies as assessed or managed by three physiotherapists. These therapist are experienced clinicians and academics and bring their expertise of both worlds (clinical and academic) to these cases providing an overview of the case, followed by their interpretation and rationale for care with their clinical reasoning insights. The cases where originally presented at a recent international physiotherapy conference and reworked for journal publication

Use of alternate coreceptors on primary cells by two HIV-1 isolates

AbstractTwo HIV-1 isolates (CM4 and CM9) able to use alternate HIV-1 coreceptors on transfected cell lines were tested for their sensitivity to inhibitors of HIV-1 entry on primary cells. CM4 was able to use CCR5 and Bob/GPR15 efficiently in transfected cells. The R5 isolate grew in Δ32/Δ32 CCR5 PBMC in the absence or presence of AMD3100, a CXCR4-specific inhibitor, indicating that it uses a receptor other than CCR5 or CXCR4 on primary cells. It was insensitive to the CCR5 entry inhibitors RANTES and PRO140, but was partially inhibited by vMIP-1, a chemokine that binds CCR3, CCR8, GPR15 and CXCR6. The coreceptor used by this isolate on primary cells is currently unknown. CM9 used CCR5, CXCR4, Bob/GPR15, CXCR6, CCR3, and CCR8 on transfected cells and was able to replicate in the absence or presence of AMD3100 in Δ32/Δ32 CCR5 PBMC. It was insensitive to eotaxin, vMIP-1 and I309 when tested individually, but was inhibited completely when vMIP-1 or I309 was combined with AMD3100. Both I309 and vMIP-1 bind CCR8, strongly suggesting that this isolate can use CCR8 on primary cells. Collectively, these data suggest that some HIV-1 isolates can use alternate coreceptors on primary cells, which may have implications for strategies that aim to block viral entry

Using MCDA (Multi-Criteria Decision Analysis) to prioritise publicly-funded health care

New Zealand, like many other countries, is grappling with the problem of how to allocate limited resources across a range of health and disability support services at a time when demand for health care continues to grow faster than health budgets. It is becoming increasingly important for decision-makers to adopt robust processes for setting priorities so that limited health resources are allocated efficiently, effectively and transparently. In my thesis I use multi-criteria decision analysis (MCDA) to build a framework (at the meso-level of health care funding) which can be used by decision-makers to assist them in priority-setting. Potential criteria, elicited from six focus groups (including members of the public, private and public health care providers, health professionals and policy makers), are combined with advice from health experts and criteria from comparable studies in the literature to establish six prioritisation criteria: ‘need’, ‘individual benefit’, ‘societal benefit, ‘age’, ‘lifestyle’ and ‘no alternative treatment’. An online decision survey implemented through 1000Minds software (Ombler & Hansen 2012) and the PAPRIKA method (Hansen & Ombler 2008) is used to determine the relative importance of the criteria. According to the results of a ‘test re-test’, the decision survey accurately captures the preferences of respondents. The results of the decision survey reveal that ‘need’ and ‘individual benefit’ are the most important prioritisation criteria, and though patients are unlikely to be prioritised according to their age or lifestyle (because of discrimination), greater preference is shown for ‘age’ and ‘lifestyle’ compared to ‘societal benefit’ and ‘no alternative treatment’. Regression analysis (including the application of a fractional multinomial logit model) and cluster analysis are used to determine whether the demographic characteristics of respondents can predict preferences. Several relationships are found. For example, health care workers, respondents on low incomes and Maori place more importance on ‘need’ (relative to the other criteria) compared to respondents who do not work in health care, respondents on middle or high incomes and non-Maori. Though several statistically significant results are found, it appears that overall the variation in preferences is largely due to the idiosyncrasies of respondents and not to particular demographic characteristics. The criteria weights from the random sample are then brought together with cost and other additional factors in a prioritisation framework. With the aid of a Value for Money (VfM) chart and associated budget allocation table, decision-makers can consider all the prioritisation variables in a transparent and consistent way. The framework can be used as a communication tool, to allocate fixed budgets across a range of services, to keep track of previous decisions or to re-allocate resources when the budget has been cut. The framework developed in this thesis illustrates how health care can be prioritised at the meso-level of health care funding in New Zealand. Ultimately it is up to the decision-makers to choose which treatments to fund, but if decisions are made explicitly within a transparent and robust framework that includes all relevant considerations (including the preferences of key stakeholders), then there is likely to be more acceptance in the outcome