E-Commerce Digital Information Transparency and Satisfaction. Can We Have Too Much of a Good Thing?

Despite core product and service quality improvements and advances in shopping processes and technology, customers often report being unsatisfied with their online purchases. One plausible reason for lower customer satisfaction rates is too much or too little information that is shared with the customers about their orders. We show that when forming their perceptions about the purchases, customers form digital information satisfaction (DIS) levels as they evaluate supplementary informational services in addition to the core product being purchased. We believe that DIS is one of the dimensions of overall customer satisfaction. We also show that supplementary informational services are essential in meeting the increased informational needs of online shopping and, thus, can explain the decreased overall customer satisfaction level through the decreases in DIS. We develop and test the Digital Information Transparency and Satisfaction (DITS) model that shows how supplemental informational services influence digital information satisfaction (DIS_ in e-commerce. By doing so, this dissertation introduces a new dimension of satisfaction in the era of online shopping. This helps close the knowledge gap in the current research on overall customer satisfaction by showing that too much information transparency can harm the overall experience of the customers, thus leading to decreases in DIS. The study results provide a platform for future research on the influence of informational services provided during online shopping. Explaining the role of information shared with the customers in their perceptions of transparency and, consequently, DIS may help provide crucial practical business insights. Thus, by proposing the DITS model, this dissertation brings contributions to both theory and praxis by enhancing the understanding of DIS, which can serve as a robust foundation for future research on decreasing levels of overall customer satisfaction in a digital setting, as well as help companies improve their customer relationships

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Effect of Antiplatelet Therapy on Survival and Organ Support–Free Days in Critically Ill Patients With COVID-19

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