Insurance loss data for improved climate change adaptation. Conditions for data sharing and utilization

Climate change has led to an increased risk of damage to buildings and infrastructure. Norwegian municipalities have intensified their efforts to address climate change adaptation and the prevention of climate-related damage due to natural hazards. The Norwegian Directorate for Civil Protection (DSB) has developed a so-called ‘Knowledge Bank’, which is a Norwegian web-based data platform containing information about risk and vulnerability related to natural events. The Knowledge Bank serves to compile civil protection data and makes these available to municipalities, providing them with an improved overview and knowledge about undesirable events and natural disasters as a basis for cost-benefit analysis, risk, and vulnerability assessments. The platform also includes data related to natural and weather-related damage derived from insurance companies. Previous research related to insurance data and the Knowledge Bank carried out at the Klima 2050 Centre has addressed attitudes to data sharing among insurance companies, the value of insurance data, and the potential to use these data to predict events. It has also addressed the municipalities' initial perceptions and experiences. Expectations linked to a new system for sharing insurance loss data in the Knowledge Bank are high, but several issues still need to be resolved before the system can be fully exploited. There is need to improve the understanding of key factors related primarily to data sharing and quality, as well as the relevant regulatory frameworks. This will enable insurance data to become available via the Knowledge Bank so that they can be utilized by municipalities in a way that will benefit wider society. This report presents the results of a study that addresses the critical factors required for the establishment of a new system allowing insurance companies to share insurance loss data with municipalities, using the Knowledge Bank platform.publishedVersio

User evaluation of a national web portal for climate change adaptation – A qualitative case study of the Knowledge Bank

This paper describes the development and first user evaluation of a web portal (The Knowledge Bank) for collecting and presenting national data relevant to climate change adaptation in Norway, including insurance loss data for damages arising from natural hazards and weather events. The paper examines the major drivers for municipal decision-makers to use the Knowledge Bank, presenting the results of a qualitative case study with group interviews with 11 users representing both smaller and larger Norwegian municipalities, and an individual interview with one of the developers. The findings show that the drivers for using the Knowledge Bank depend on the level of user expectations, user trust in the tool and the data, expectations for a contribution to efficiency, expectations for increased cooperation between municipal departments and municipalities, and the ability to interact with the portal, especially the ability to transfer data to and from their own data systems. Increased uptake and use of the Knowledge Bank could be reinforced with networks of users sharing awareness of the portal, teaching other users, and promoting improvement. The study provides insights into the challenges and opportunities encountered in the development of the Knowledge Bank and gives examples of how the size of the municipality may shape the drivers for uptake. These insights may also apply to the development of other national web portals for climate change adaptation data, especially when trying to incorporate sharing of insurance loss data.publishedVersio

Circulating Tumor DNA in Patients with Renal Cell Carcinoma. A Systematic Review of the Literature

CONTEXT: Over the past decade there has been increasing interest in the potential of liquid biopsies and systematic biomarkers in the diagnosis and management of kidney cancer, as they may provide a tool for early detection of disease and monitoring of treatment response. OBJECTIVE: To identify and summarize relevant published data on circulating tumor DNA (ctDNA) in patients with renal cell carcinoma (RCC). EVIDENCE ACQUISITION: We performed a systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement of studies identified in PubMed, MEDLINE, EMBASE, and Cochrane Library up to January 15, 2021. Two reviewers independently screened all articles and performed the data extraction. EVIDENCE SYNTHESIS: Nineteen studies investigating ctDNA in RCC (1237 patients) were included and analyzed in the final review. The study size and design varied widely, and the studies were divided into five groups according to the method used for ctDNA detection. The outcome data included (1) the sensitivity/specificity if available; (2) the method used for ctDNA detection; and (3) the main findings in the studies. CONCLUSIONS: The studies highlight that the level of ctDNA in RCC appears to be low. Studies using multiple methods for ctDNA detection indicate that tumor-guided analysis improves the ctDNA detection rate and suggest that cell-free methylated DNA immunoprecipitation and high-throughput sequencing may be a very sensitive method for ctDNA detection in RCC. PATIENT SUMMARY: We systematically reviewed the literature to identify all relevant studies investigating circulating tumor DNA in patients with kidney cancer to investigate its use and potential in this highly malignant disease. We found that the level of circulating tumor DNA is low in kidney cancer and that very sensitive methods have to be used for detection in this disease