Deploying a spreadsheet tool for early economic value assessment of medical device innovations with healthcare decision makers

Early stage evaluation of medical device innovations is important for healthcare decision-makers as much as for manufacturers, meaning that a wider application of a basic cost-effectiveness analysis is becoming necessary outside the usual expert base of health technology assessment specialists. Resulting from an academic-industry-healthcare professional collaboration, a spreadsheet tool is described that was designed to be accessible both to professionals in healthcare delivery organisations and to innovators in the healthcare technology industry who are non-experts in the field of health economics. The tool enables a basic cost-effectiveness analysis to be carried out, using a simplified decision-tree model to compare costs and patient benefit for a new device-related procedure with that of standard care employing an incumbent device or other alternative. Such a tool is useful to healthcare professionals because it enables them to rapidly elucidate the cost-effectiveness of heterogeneous innovations by means of the standard quality adjusted life year (QALY) measure of clinical outcome, which is intended to be broadly comparable across treatments. For the innovator or manufacturer it helps them focus on what is required for future stages of development, in order to fill gaps in the input data and so further strengthen their case from a health economics perspective. Results are presented of first experiences from deploying the tool on three medical device exemplars, in face-to-face meetings of the NHS National Innovation Centre (NIC) along with the innovator or clinical champion. The results show that mapping of device-related innovations to the tool is achievable in a short meeting between the NIC and the innovator using expected costs, outcomes data from the literature and estimates of ranges for unknown input data. Whilst the result of a simplified analysis is not expected to be definitive, the process of reasoning is found to be illuminating for the parties involved, enabling innovators to articulate the benefits of their innovations and for all parties to highlight gaps in data and evidence that will be required to take the innovation forward. The partnership model of the authors’ organisation supports the kind of cooperative design approach that is necessary to produce the kind of tool described.---------------------------7dd39101208fa Content-Disposition: form-data; name="c14_creators_1_name_family" Crave

Learning commonsense human-language descriptions from temporal and spatial sensor-network data

Thesis (S.M.)--Massachusetts Institute of Technology, School of Architecture and Planning, Program in Media Arts and Sciences, 2006.Includes bibliographical references (p. 105-109) and index.Embedded-sensor platforms are advancing toward such sophistication that they can differentiate between subtle actions. For example, when placed in a wristwatch, such platforms can tell whether a person is shaking hands or turning a doorknob. Sensors placed on objects in the environment now report many parameters, including object location, movement, sound, and temperature. A persistent problem, however, is the description of these sense data in meaningful human-language. This is an important problem that appears across domains ranging from organizational security surveillance to individual activity journaling. Previous models of activity recognition pigeon-hole descriptions into small, formal categories specified in advance; for example, location is often categorized as "at home" or "at the office." These models have not been able to adapt to the wider range of complex, dynamic, and idiosyncratic human activities. We hypothesize that the commonsense, semantically related, knowledge bases can be used to bootstrap learning algorithms for classifying and recognizing human activities from sensors.(cont.) Our system, LifeNet, is a first-person commonsense inference model, which consists of a graph with nodes drawn from a large repository of commonsense assertions expressed in human-language phrases. LifeNet is used to construct a mapping between streams of sensor data and partially ordered sequences of events, co-located in time and space. Further, by gathering sensor data in vivo, we are able to validate and extend the commonsense knowledge from which LifeNet is derived. LifeNet is evaluated in the context of its performance on a sensor-network platform distributed in an office environment. We hypothesize that mapping sensor data into LifeNet will act as a "semantic mirror" to meaningfully interpret sensory data into cohesive patterns in order to understand and predict human action.by Bo Morgan.S.M

Is 125I iothalamate an ideal marker for glomerular filtration?

Is 125I iothalamate an ideal marker for glomerular filtration? The triiodinated angiographic contrast medium, iothalamate, has (usually labelled 125I) been used extensively as a marker for glomerular filtration. We have studied the renal handling of 125I iothalamate (IOT) in vivo and in vitro in several species. In renal cortical slices from chicken, rabbit, rat, and monkey, the tissue-to-medium ratio of IOT was twice that of 51Cr-EDTA (EDTA) at 37°C; a difference that was abolished at 0°C and markedly reduced by added o-iodohippurate or iodipamide. In five chickens the steady-state renal clearance of IOT (CIOT) was twice (P < 0.05) that of EDTA (CEDTA) or 3H inulin (C1); a difference that was abolished by administration of 100 mg/kg/hr of novobiocin, an organic anion transport inhibitor. CEDTA was similar to C1 before as well as after transport inhibition. Utilizing the Sperber technique the mean apparent tubular excretion fraction (ATEF) of IOT was 8%, while that of EDTA was 1% (P < 0.01; N = 10). After novobiocin coinfusion (new steady-state) ATEFIOT was significantly reduced (P < 0.01) and not different from that of EDTA (-1%). In the same animals the total urinary recovery of IOT was 84 and 57% (P < 0.01) before and after novobiocin, respectively, while corresponding values for EDTA was unchanged by the inhibitor. In seven rats the renal extraction of IOT was reduced from 29 to 17% (P < 0.05) by coinfusion of probenecid (5 mg/kg/hr). Corresponding extractions were 82 to 34% (P < 0.005) and 22% (unchanged) for PAH and EDTA, respectively. In six healthy volunteers the renal clearance of unlabelled IOT (HPLC method) equated that of creatinine but exceeded that of inulin with 38% (P < 0.01). This difference was reduced 34% (P<0.05) by probenecid (1 g i.v.). In nineteen patients with a single or two kidneys the average plasma clearance (single injection technique; slope-intercept method) of IOT was 13% higher than that of EDTA (P < 0.001); a difference which was significantly (P < 0.01) reduced to half after pretreatment with probenecid (1 g i.v.); in some patients this difference was marked. The results show that IOT is subject to a significant and in some cases marked renal tubular secretion in chicken, rats, and humans. IOT, therefore, is not an ideal marker for glomerular filtration.Le 125I iothalamate est-il un marqueur idéal de la filtration glomérulaire? L'iothalamate, un produit de contraste angiographique tri-iodé a été largement utilisé (habituellement marqué à 125I) comme marqueur de la filtration glomérulaire. Nous avons étudié l'excrétion rénale du 125I iothalamate (IOT) in vivo et in vitro dans différentes espèces. Dans des tranches corticales de rein de poulet, de lapin, de rat, et de singe, le rapport tissu sur milieu de l'IOT était le double de celui du 51Cr-EDTA (EDTA) à 37°C; une différence abolie à 0°C et réduite de façon marquée par l'addition de O-iodohippurate ou d'iodipamide. Chez cinq poulets la clearance rénale à l'équilibre d'IOT (CIOT) était le double (P < 0,05) de celle de l'EDTA (CEDTA) ou de 3H inuline (CI); une différence abolie par l'administration de 100 mg/kg/hr de novobiocine, un inhibiteur du transport des anions organiques. CEDTA était identique à CI avant comme après l'inhibition du transport. En utilisant la technique de Sperber, la fraction d'excrétion tubulaire apparente moyenne (ATEF) de l'IOT était de 8%, alors que celle de l'EDTA était de 1% {P < 0,01; N = 10). Après coperfusion de novobiocine (nouvel équilibre) ATEFIOT était significativement réduite (P < 0,01) et non différente de celle de l'EDTA (- 1%). Chez les mêmes animaux, la récupération urinaire totale d'IOT était de 84 et 57% (P < 0,01) avant et après novobiocine, respectivement, alors que les valeurs correspondantes pour l'EDTA étaient inchangées par l'inhibiteur. Chez sept rats, l'extraction rénale d'IOT était réduite de 29 à 17% (P < 0,05) par coperfusion de probénécide (5 mg/kg/hr). Les extractions correspondant étaient de 82 à 34% (P < 0,005) et de 22% (inchangées) pour le PAH et l'EDTA, respectivement. Chez six volontaires sains, la clearance rénale de l'IOT non marqué (méthode HPLC) était égale à celle de la créatinine mais dépassait celle de l'inuline de 38% (P < 0,01). Cette différence était réduite de 34% (P < 0,05) par le probénécide (1 g i.v.). Chez dix-neuf malades avec un ou deux reins, la clearance plasmatique moyenne (technique par injection unique; méthode d'interception de la courbe) de l'IOT était 13% plus élevée que celle de l'EDTA (P < 0,01); une différence qui était significativement (P < 0,01) réduite de moitié après prétraîtement par le probénécide (1 g i.v.); chez certains malades cette différence était marquée. Ces résultats montrent que l'IOT est sujet à une sécrétion tubulaire rénale significative et parfois marquée chez le poulet, le rat, et l'homme. L'IOT n'est donc pas un marqueur idéal de la filtration glomérulaire

Annotation of Bacteriophage BigPaolini

Bacteriophages were discovered nearly 100 years ago. With new interest in phages many phages are being analyzed and annotated to understand the diversity within the phage world.https://digitalcommons.mtech.edu/urp_aug_2018/1010/thumbnail.jp

Can health economics aid decision making in healthcare innovation in academia?

Health economics is extensively used by reimbursement agencies to make decisions on whether to adopt new medical technologies. It is also used by the healthcare industry as an aid to decision making during product development. This paper proposes that academic healthcare technology transfer could also benefit from adopting health economics. The study investigated the knowledge and attitudes of academic staff involved in developing and transferring healthcare technologies. The participants had little or no prior knowledge of health economics; however, the majority reported that this method had the potential to aid development and commercialisation. The innovations developed by the workshop attendees and their commercialisation plans were of a type that could potentially benefit from cost-effectiveness calculations. Health economics has the potential to make valuable contribution to academic healthcare innovation. Research is required to develop this method further and ensure that it can be successfully applied in academia

Repeated Randomization and Matching in Multi‐Arm Trials

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/102047/1/biom12077.pd

Copalic Acid Analogs Down-regulate Androgen Receptor and Inhibit Small Chaperone Protein

Copalic acid, one of the diterpenoid acids in copaiba oil, inhibited the chaperone function of α-crystallin and heat shock protein 27 kD (HSP27). It also showed potent activity in decreasing an HSP27 client protein, androgen receptor (AR), which makes it useful in prostate cancer treatment or prevention. To develop potent drug candidates to decrease the AR level in prostate cancer cells, more copalic acid analogs were synthesized. Using the level of AR as the readout, 15 of the copalic acid analogs were screened and two compounds were much more potent than copalic acid. The compounds also dose-dependently inhibited AR positive prostate cancer cell growth. Furthermore, they inhibited the chaperone activity of α-crystallin as well

Copalic Acid Analogs Down-regulate Androgen Receptor and Inhibit Small Chaperone Protein

Copalic acid, one of the diterpenoid acids in copaiba oil, inhibited the chaperone function of α-crystallin and heat shock protein 27 kD (HSP27). It also showed potent activity in decreasing an HSP27 client protein, androgen receptor (AR), which makes it useful in prostate cancer treatment or prevention. To develop potent drug candidates to decrease the AR level in prostate cancer cells, more copalic acid analogs were synthesized. Using the level of AR as the readout, 15 of the copalic acid analogs were screened and two compounds were much more potent than copalic acid. The compounds also dose-dependently inhibited AR positive prostate cancer cell growth. Furthermore, they inhibited the chaperone activity of α-crystallin as well