Form follows function:model-driven engineering for clinical trials

We argue that, for certain constrained domains, elaborate model transformation technologies-implemented from scratch in general-purpose programming languages-are unnecessary for model-driven engineering; instead, lightweight configuration of commercial off-the-shelf productivity tools suffices. In particular, in the CancerGrid project, we have been developing model-driven techniques for the generation of software tools to support clinical trials. A domain metamodel captures the community's best practice in trial design. A scientist authors a trial protocol, modelling their trial by instantiating the metamodel; customized software artifacts to support trial execution are generated automatically from the scientist's model. The metamodel is expressed as an XML Schema, in such a way that it can be instantiated by completing a form to generate a conformant XML document. The same process works at a second level for trial execution: among the artifacts generated from the protocol are models of the data to be collected, and the clinician conducting the trial instantiates such models in reporting observations-again by completing a form to create a conformant XML document, representing the data gathered during that observation. Simple standard form management tools are all that is needed. Our approach is applicable to a wide variety of information-modelling domains: not just clinical trials, but also electronic public sector computing, customer relationship management, document workflow, and so on. © 2012 Springer-Verlag.

Is there a trade-off between quality and productivity? The case of diagnostic technologies in Portugal

The purpose of this paper is twofold: first, we compute quality-adjusted measures of productivity change for the three most important diagnostic technologies (i.e., the Computerised Tomography Scan, Electrocardiogram and Echocardiogram) in the major Portuguese hospitals. We use the Malmquist–Luenberger index, which allows to measure productivity growth while controlling for the quality of the production. Second, using non-parametric tests, we analyse whether the implementation of the Prospective Payment System may have had a positive impact on the movements of productivity over time. The results show that the PPS has helped hospitals to use these tools more efficiently and to improve their effectiveness.

Measurement of productivity and cost of the direct labour organisation within highways maintenance departments

The objective of this thesis is to investigate, through an empirical study, the different functions of the highways maintenance departments and to suggest methods by means of which road maintenance work could be carried out in a more efficient way by utilising its resources of men, material and plant to the utmost advantage. This is particularly important under the present circumstances of national financial difficulties which have resulted in continuous cuts in public expenditure. In order to achieve this objective, the researcher carried out a survey among several Highways Authorities by means of questionnaire and interview. The information so collected was analysed in order to understand the actual, practical situation within highways manintenance departments, and highlight any existing problems, and try to answer the question of how they could become more efficient. According to the results obtained by the questionnaire and the interview, and the analysis of these results, the researcher concludes that it is the management system where least has been done, and where problems exist and are most complex. The management of highways maintenance departments argue that the reasons for their problems include both financial and organisational difficulties, apart from the political aspect and nature of the activities undertaken. The researcher believes that this ought to necessitate improving the management's analytical tools and techniques in order to achieve the most effective way of performing each activity. To this end the researcher recommends several related procedures to be adopted by the management of the highways maintenance departments. These recommendations, arising from the study, involve the technical, practical and human aspects. These are essential factors of which management should be aware - and certainly should not neglect - in order to achieve its objectives of improved productivity in the highways maintenance departments.