Impact numbers in health policy decisions

Objective: To outline the major methodological issues appropriate to the use of the population impact number (PIN) and the disease impact number (DIN) in health policy decision making. Design: Review of literature and calculation of PIN and DIN statistics in different settings. Setting: Previously proposed extensions to the number needed to treat (NNT): the DIN and the PIN, which give a population perspective to this measure. Main results: The PIN and DIN allow us to compare the population impact of different interventions either within the same disease or in different diseases or conditions. The primary studies used for relative risk estimates should have outcomes, time periods and comparison groups that are congruent and relevant to the local setting. These need to be combined with local data on disease rates and population size. Depending on the particular problem, the target may be disease incidence or prevalence and the effects of interest may be either the incremental impact or the total impact of each intervention. For practical application, it will be important to use sensitivity analyses to determine plausible intervals for the impact numbers. Conclusions: Attention to various methodological issues will permit the DIN and PIN to be used to assist health policy makers assign a population perspective to measures of risk.

Principles versus artifacts in computer science curriculum design

Computer Science is a subject which has difficulty in marketing itself. Further, pinning down a standard curriculum is difficult-there are many preferences which are hard to accommodate. This paper argues the case that part of the problem is the fact that, unlike more established disciplines, the subject does not clearly distinguish the study of principles from the study of artifacts. This point was raised in Curriculum 2001 discussions, and debate needs to start in good time for the next curriculum standard. This paper provides a starting point for debate, by outlining a process by which principles and artifacts may be separated, and presents a sample curriculum to illustrate the possibilities. This sample curriculum has some positive points, though these positive points are incidental to the need to start debating the issue. Other models, with a less rigorous ordering of principles before artifacts, would still gain from making it clearer whether a specific concept was fundamental, or a property of a specific technology. (C) 2003 Elsevier Ltd. All rights reserved.