Modelling the population cost-effectiveness of current and evidence-based optimal treatment for anxiety disorders

Background. The present paper describes a component of a large Population cost-effectiveness study that aimed to identify the averted burden and economic efficiency of current and optimal treatment for the major mental disorders. This paper reports on the findings for the anxiety disorders (panic disorder/agoraphobia, social phobia, generalized anxiety disorder, post-traumatic stress disorder and obsessive-compulsive disorder). Method. Outcome was calculated as averted 'years lived with disability' (YLD), a population summary measure of disability burden. Costs were the direct health care costs in 1997-8 Australian dollars. The cost per YLD averted (efficiency) was calculated for those already in contact with the health system for a mental health problem (current care) and for a hypothetical optimal care package of evidence-based treatment for this same group. Data sources included the Australian National Survey of Mental Health and Well-being and published treatment effects and unit costs. Results. Current coverage was around 40% for most disorders with the exception of social phobia at 21%. Receipt of interventions consistent with evidence-based care ranged from 32% of those in contact with services for social phobia to 64% for post-traumatic stress disorder. The cost of this care was estimated at $400 million, resulting in a cost per YLD averted ranging from $7761 for generalized anxiety disorder to $34 389 for panic/agoraphobia. Under optimal care, costs remained similar but health gains were increased substantially, reducing the cost per YLD to < $20 000 for all disorders. Conclusions. Evidence-based care for anxiety disorders would produce greater population health gain at a similar cost to that of current care, resulting in a substantial increase in the cost-effectiveness of treatment.

Simple texture-based liberation modelling of ores

Mineralogical analysis is often used to assess the liberation properties of particles. A direct method of estimating liberation is to actually break particles and then directly obtain liberation information from applying mineralogical analysis to each size-class of the product. Another technique is to artificially apply random breakage to the feed particle sections to estimate the resultant distribution of product particle sections. This technique provides a useful alternative estimation method. Because this technique is applied to particle sections, the actual liberation properties for particles can only be estimated by applying stereological correction. A recent stereological technique has been developed that allows the discrepancy between the linear intercept composition distribution and the particle section composition distribution to be used as guide for estimating the particle composition distribution. The paper will show results validating this new technique using numerical simulation. (C) 2004 Elsevier Ltd. All rights reserved.

Influence of charge size distribution on net-power draw of tumbling mill based on DEM modelling

Modelling and optimization of the power draw of large SAG/AG mills is important due to the large power draw which modern mills require (5-10 MW). The cost of grinding is the single biggest cost within the entire process of mineral extraction. Traditionally, modelling of the mill power draw has been done using empirical models. Although these models are reliable, they cannot model mills and operating conditions which are not within the model database boundaries. Also, due to its static nature, the impact of the changing conditions within the mill on the power draw cannot be determined using such models. Despite advances in computing power, discrete element method (DEM) modelling of large mills with many thousands of particles could be a time consuming task. The speed of computation is determined principally by two parameters: number of particles involved and material properties. The computational time step is determined by the size of the smallest particle present in the model and material properties (stiffness). In the case of small particles, the computational time step will be short, whilst in the case of large particles; the computation time step will be larger. Hence, from the point of view of time required for modelling (which usually corresponds to time required for 3-4 mill revolutions), it will be advantageous that the smallest particles in the model are not unnecessarily too small. The objective of this work is to compare the net power draw of the mill whose charge is characterised by different size distributions, while preserving the constant mass of the charge and mill speed. (C) 2004 Elsevier Ltd. All rights reserved.

Population-based continuous optimization, probabilistic modelling and mean shift

Evolutionary algorithms perform optimization using a population of sample solution points. An interesting development has been to view population-based optimization as the process of evolving an explicit, probabilistic model of the search space. This paper investigates a formal basis for continuous, population-based optimization in terms of a stochastic gradient descent on the Kullback-Leibler divergence between the model probability density and the objective function, represented as an unknown density of assumed form. This leads to an update rule that is related and compared with previous theoretical work, a continuous version of the population-based incremental learning algorithm, and the generalized mean shift clustering framework. Experimental results are presented that demonstrate the dynamics of the new algorithm on a set of simple test problems.

Modelling the structure of latexin-carboxypeptidase A complex based on chemical cross-linking and molecular docking

We have determined the three-dimensional structure of the protein complex between latexin and carboxypeptidase A using a combination of chemical cross-linking, mass spectrometry and molecular docking. The locations of three intermolecular cross-links were identified using mass spectrometry and these constraints were used in combination with a speed-optimised docking algorithm allowing us to evaluate more than 3 x 10(11) possible conformations. While cross-links represent only limited structural constraints, the combination of only three experimental cross-links with very basic molecular docking was sufficient to determine the complex structure. The crystal structure of the complex between latexin and carboxypeptidase A4 determined recently allowed us to assess the success of this structure determination approach. Our structure was shown to be within 4 angstrom r.m.s. deviation of C alpha atoms of the crystal structure. The study demonstrates that cross-linking in combination with mass spectrometry can lead to efficient and accurate structural modelling of protein complexes.

Evaluating the effectiveness of Bayesian feature selection

A practical Bayesian approach for inference in neural network models has been available for ten years, and yet it is not used frequently in medical applications. In this chapter we show how both regularisation and feature selection can bring significant benefits in diagnostic tasks through two case studies: heart arrhythmia classification based on ECG data and the prognosis of lupus. In the first of these, the number of variables was reduced by two thirds without significantly affecting performance, while in the second, only the Bayesian models had an acceptable accuracy. In both tasks, neural networks outperformed other pattern recognition approaches.

A study of business user based information systems development, and modelling success factors

This thesis describes research into business user involvement in the information systems application building process. The main interest of this research is in establishing and testing techniques to quantify the relationships between identified success factors and the outcome effectiveness of 'business user development' (BUD). The availability of a mechanism to measure the levels of the success factors, and quantifiably relate them to outcome effectiveness, is important in that it provides an organisation with the capability to predict and monitor effects on BUD outcome effectiveness. This is particularly important in an era where BUD levels have risen dramatically, user centred information systems development benefits are recognised as significant, and awareness of the risks of uncontrolled BUD activity is becoming more widespread. This research targets the measurement and prediction of BUD success factors and implementation effectiveness for particular business users. A questionnaire instrument and analysis technique has been tested and developed which constitutes a tool for predicting and monitoring BUD outcome effectiveness, and is based on the BUDES (Business User Development Effectiveness and Scope) research model - which is introduced and described in this thesis. The questionnaire instrument is designed for completion by 'business users' - the target community being more explicitly defined as 'people who primarily have a business role within an organisation'. The instrument, named BUD ESP (Business User Development Effectiveness and Scope Predictor), can readily be used with survey participants, and has been shown to give meaningful and representative results.