Determining information systems contribution to manufacturing agility for SME's in dynamic business environments

This thesis was submitted for the degree of Doctor of Philosophy and awarded by Brunel University.Since the concept of agile manufacturing was coined in the early nineties, the study of the contribution of information systems to agility has lacked a thorough analysis. Information systems have been labelled in the academic literature as critical, key and important in achieving and supporting agility. On the other hand, there is a large number of documented cases where IS have failed to deliver expected benefits. The aim of this study has been to determine the contribution of information systems to manufacturing agility. This study required the development of a research survey with the purpose of testing seven IT/IS proficiency characteristics of agility, three characteristics of a dynamic business environment and the type of IS applications used in manufacturing organisations. The analysis of the survey suggested that the business environment does not exert great influence on the IT/IS proficiency characteristics; also no association was found with the use of a specific type of manufacturing IS and the IT/IS proficiency characteristics. The results of the analysis of the survey were further expanded in a multiple case-study. Profitable SMEs with some agile processes in place participated in a multiple case-study that covered the agility of manufacturing and other business process, business and IT strategies, and skills and expertise of employees affecting the realisation of benefits of IS. The study revealed that information systems are neither the most important, the most overwhelming, the most difficult part of the equation to achieve agility nor are they principal enablers of manufacturing. Identified principal enablers of agile manufacturing include providing training to employees, right attitude of workforce towards change, having a flexible manufacturing base and people's knowledge and skills. Moreover, the use of low performing information systems was not an impediment to moving towards agility. The results of the multiple case-study tend to indicate that information systems play a more significant role in enhancing agility once principal enablers have been implemented. Certainly, IS may be required to support manufacturing agility but that information systems are not sufficient to achieve it. The study revealed that skills and expertise of people were used as means to overcome the problems and shortcomings generated by low performing IS. A new taxonomy of enablers of agility has been defined, identifying IS as second-order enablers of agility. Also, a proposed new framework has considered the adoption of an IT strategy to influencing a business strategy as a mean of enhancing the agility of business processes already achieved through the implementation of principal enablers

Association between convalescent plasma treatment and mortality in COVID-19: a collaborative systematic review and meta-analysis of randomized clinical trials.

Funder: laura and john arnold foundationBACKGROUND: Convalescent plasma has been widely used to treat COVID-19 and is under investigation in numerous randomized clinical trials, but results are publicly available only for a small number of trials. The objective of this study was to assess the benefits of convalescent plasma treatment compared to placebo or no treatment and all-cause mortality in patients with COVID-19, using data from all available randomized clinical trials, including unpublished and ongoing trials (Open Science Framework, https://doi.org/10.17605/OSF.IO/GEHFX ). METHODS: In this collaborative systematic review and meta-analysis, clinical trial registries (ClinicalTrials.gov, WHO International Clinical Trials Registry Platform), the Cochrane COVID-19 register, the LOVE database, and PubMed were searched until April 8, 2021. Investigators of trials registered by March 1, 2021, without published results were contacted via email. Eligible were ongoing, discontinued and completed randomized clinical trials that compared convalescent plasma with placebo or no treatment in COVID-19 patients, regardless of setting or treatment schedule. Aggregated mortality data were extracted from publications or provided by investigators of unpublished trials and combined using the Hartung-Knapp-Sidik-Jonkman random effects model. We investigated the contribution of unpublished trials to the overall evidence. RESULTS: A total of 16,477 patients were included in 33 trials (20 unpublished with 3190 patients, 13 published with 13,287 patients). 32 trials enrolled only hospitalized patients (including 3 with only intensive care unit patients). Risk of bias was low for 29/33 trials. Of 8495 patients who received convalescent plasma, 1997 died (23%), and of 7982 control patients, 1952 died (24%). The combined risk ratio for all-cause mortality was 0.97 (95% confidence interval: 0.92; 1.02) with between-study heterogeneity not beyond chance (I2 = 0%). The RECOVERY trial had 69.8% and the unpublished evidence 25.3% of the weight in the meta-analysis. CONCLUSIONS: Convalescent plasma treatment of patients with COVID-19 did not reduce all-cause mortality. These results provide strong evidence that convalescent plasma treatment for patients with COVID-19 should not be used outside of randomized trials. Evidence synthesis from collaborations among trial investigators can inform both evidence generation and evidence application in patient care