Setting priorities in clinical and health services research: Properties of an adapted and updated method

Objectives: The objectives of this study is to review the set of criteria of the Institute of Medicine (IOM) for priority-setting in research with addition of new criteria if necessary, and to develop and evaluate the reliability and validity of the final priority score. Methods: Based on the evaluation of 199 research topics, forty-five experts identified additional criteria for priority-setting, rated their relevance, and ranked and weighted them in a three-round modified Delphi technique. A final priority score was developed and evaluated. Internal consistency, test–retest and inter-rater reliability were assessed. Correlation with experts’ overall qualitative topic ratings were assessed as an approximation to validity. Results: All seven original IOM criteria were considered relevant and two new criteria were added (“potential for translation into practice”, and “need for knowledge”). Final ranks and relative weights differed from those of the original IOM criteria: “research impact on health outcomes” was considered the most important criterion (4.23), as opposed to “burden of disease” (3.92). Cronbach’s alpha (0.75) and test–retest stability (interclass correlation coefficient = 0.66) for the final set of criteria were acceptable. The area under the receiver operating characteristic curve for overall assessment of priority was 0.66. Conclusions: A reliable instrument for prioritizing topics in clinical and health services research has been developed. Further evaluation of its validity and impact on selecting research topics is required

The materiality of the immaterial. Services sectors and CO2 emissions in Uruguay

This paper analyzes the carbon dioxide emissions of the services sectors subsystem of Uruguay in 2004. Services, with the exception of transport, are often considered intangible because of their low level of direct emissions. However, the provision of services requires inputs produced by other sectors, including several highly materialintensive sectors. Through input–output analysis we investigate the relationship between the services subsystem and the rest of the economy as regards carbon dioxide emissions. This approach allows us to study the importance of the set of services branches as a unit in the economic structure as well as to analyze in detail the relationship between the branches. The results depict that services’ direct emissions are the main component, as a consequence of transport-related sectors. However, the pollution that the services subsystem makes the rest of the economy produce is very significant, and it is almost all explained by non-transport-related sectors. This analysis is useful for determining the sectors in which mitigation policies are more effective, and whether they would be better tackled through technical improvements and better practices or through demand policies.

On money as a medium of exchange when goods vary by supply and demand

Models of the exchange process based on search theory can be usedto analyze the features of objects that make them more or less likely toemerge as ``money'' in equilibrium. These models illustrate the trade--offbetween endogenous acceptability (an equilibrium property) and intrinsiccharacteristics of goods, such as storability, recognizability, etc. Inthis paper, we look at how the relative supply and demand for various goodsaffect their likelihood of becoming money. Intuitively, goods in highdemand and/or low supply are more likely to appear as commodity money,subject to the qualification that which object ends up circulating as amedium of exchange depends at least partly on convention. Welfare propertiesare discussed.

Disparities in work, risk and health between immigrants and native-born Spaniards

We analyse the impact of working and contractual conditions, particularly exposure to job risks, on the probability of acquiring a permanent disability, controlling for other personal and firm characteristics. We postulate a model in which this impact is mediated by the choice of occupation, with a level of risk associated with it. We assume this choice is endogenous, and that it depends on preferences and opportunities in the labour market, both of which may differ between immigrants and natives. To test this hypothesis we apply a bivariate probit model to data for 2006 from the Continuous Sample of Working Lives provided by the Spanish Social Security system, containing records for over a million workers. We find that risk exposure increases the probability of permanent disability arising from any cause - by almost 5%.