The use of economic evaluation in CAM : an introductory framework

Background For CAM to feature prominently in health care decision-making there is a need to expand the evidence-base and to further incorporate economic evaluation into research priorities. In a world of scarce health care resources and an emphasis on efficiency and clinical efficacy, CAM, as indeed do all other treatments, requires rigorous evaluation to be considered in budget decision-making. Methods Economic evaluation provides the tools to measure the costs and health consequences of CAM interventions and thereby inform decision making. This article offers CAM researchers an introductory framework for understanding, undertaking and disseminating economic evaluation. The types of economic evaluation available for the study of CAM are discussed, and decision modelling is introduced as a method for economic evaluation with much potential for use in CAM. Two types of decision models are introduced, decision trees and Markov models, along with a worked example of how each method is used to examine costs and health consequences. This is followed by a discussion of how this information is used by decision makers. Conclusions Undoubtedly, economic evaluation methods form an important part of health care decision making. Without formal training it can seem a daunting task to consider economic evaluation, however, multidisciplinary teams provide an opportunity for health economists, CAM practitioners and other interested researchers, to work together to further develop the economic evaluation of CAM.

Potential of St John's Wort for the treatment of depression : the economic perspective

The burden of rising health care expenditures has created a demand for information regarding the clinical and economic outcomes associated with complementary and alternative medicines. Meta-analyses of randomized controlled trials have found Hypericum perforatum preparations to be superior to placebo and similarly effective as standard antidepressants in the acute treatment of mild to moderate depression. A clear advantage over antidepressants has been demonstrated in terms of the reduced frequency of adverse effects and lower treatment withdrawal rates, low rates of side effects and good compliance, key variables affecting the cost-effectiveness of a given form of therapy. The most important risk associated with use is potential interactions with other drugs, but this may be mitigated by using extracts with low hyperforin content. As the indirect costs of depression are greater than five times direct treatment costs, given the rising cost of pharmaceutical antidepressants, the comparatively low cost of Hypericum perforatum extract makes it worthy of consideration in the economic evaluation of mild to moderate depression treatments.

Aircraft automation tasks requiring switching control

A key feature in future aircraft operations will be automation of various aircraft processes, such as air traffic separation management and the management of forced landing events. Automated versions of these processes will often involve consideration of multiple modes of operations and hence require consideration of automated decision processes able to switch between various available modes of operations. This paper proposes a switching algorithm on the basis of max-min decision theory. This algorithm is particularly suitable in situations where each operational mode has access to different set of partial information. We apply our proposed algorithm to the air traffic separation management problem. A simulation study is presented that illustrates the performance of the proposed switching algorithm.

Control of aircraft for inspection of linear infrastructure

Inspection aircraft equipped with cameras and other sensors are routinely used for asset location, inspection, monitoring and hazard identification of oil-gas pipelines, roads, bridges and power transmission grids. This paper is concerned with automated flight of fixed-wing inspection aircraft to track approximately linear infrastructure. We propose a guidance law approach that seeks to maintain aircraft trajectories with desirable position and orientation properties relative to the infrastructure under inspection. Furthermore, this paper also proposes the use of an adaptive maneuver selection approach, in which maneuver primitives are adaptively selected to improve the aircraft’s attitude behaviour. We employ an integrated design methodology particularly suited for an automated inspection aircraft. Simulation studies using full nonlinear semi-coupled six degree-of-freedom equations of motion are used to illustrate the effectiveness of the proposed guidance and adaptive maneuver selection approaches in realistic flight conditions. Experimental flight test results are given to demonstrate the performance of the design.

Flight testing of an augmented separation management system providing separation protection during failure of the central communication network

Future air traffic management concepts often involve the proposal of automated separation management algorithms that replaces human air traffic controllers. This paper proposes a new type of automated separation management algorithm (based on the satisficing approach) that utilizes inter-aircraft communication and a track file manager (or bank of Kalman filters) that is capable of resolving conflicts during periods of communication failure. The proposed separation management algorithm is tested in a range of flight scenarios involving during periods of communication failure, in both simulation and flight test (flight tests were conducted as part of the Smart Skies project). The intention of the conducted flight tests was to investigate the benefits of using inter-aircraft communication to provide an extra layer of safety protection in support air traffic management during periods of failure of the communication network. These benefits were confirmed.

Green, Greener, BPM?

I am sure you’ve heard it too: Green is the new Black. While this was true back in the days when Henry Ford introduced process standardization with his assembly line for the Ford Model T (over 15 million of these were sold!), Green is also the color of choice for many business organizations, private and public. I am not talking about the actual color of their business shirts or their logo 2.0.; I am referring to the eco-aware movement that has pushed sustainability into the top ten list of business buzz-words. What used to be a boutique market for tourism and political activists has become the biggest business revolution since the e-commerce boom. Public and private organizations alike push towards “sustainable” solutions and practices. That push is partly triggered by the immense reputational gains associated with branding your organization as “green”, and partly by emerging societal, legal and constitutional regulations that force organizations to become more ecologically aware and sustainable. But the boom goes beyond organizational reality. Even in academia, sustainability has become a research “fashion wave” (see [1] if you are interested in research fashion waves) similar to the hype around Neuroscience that our colleagues in the natural sciences are witnessing these days. Mind you, I’m a fan. A big fan in fact. As academics, we are constantly searching for problem areas that are characterized by an opportunity to do rigorous research (studies that are executed to perfection) on relevant topics (studies that have applied practical value and provide impact to the community). What would be a better playground than exploring the options that Business Process Management provides for creating a sustainable, green future? I’m getting excited just writing about this! So, join me in exploring some of the current thoughts around how BPM can contribute to the sustainability fashion parade and let me introduce you to some of the works that scholars have produced recently in their attempts to identify solutions.

Journalism at the movies

Welcome to the first of what will be a regular review essay on films about journalism, covering recent releases as well as looking back at established classics and under-rated obscurities. And there is plenty to write about. Since 2008, and the end of the research period which informed my 2010 book on Journalists in Film there has been a steady stream of films in which a journalist is a primary character, and in which the nature and functioning of journalism is a theme. Morning Glory (Roger Michell, 2010), the story of a ‘serious’ news man (Harrison Ford) having to adapt to the infotainment environment of breakfast news, came out early in 2011 in the United Kingdom. The well-received UK indie Monsters (Gareth Edwards, 2010), a sci-fi with a journalist at its heart, was released in 2010. In The Soloist (Joe Wright, 2009) Robert Downey Jr played a feature journalist who befriends a mentally ill street musician and seeks to rescue him through his writing. Stieg Larsson’s Millennium trilogy has produced three Swedish films, all of them focused on the campaigning journalist Mikael Blomkvist. The first of these is being remade by Hollywood as of this writing.

Practical stability of approximating discrete-time filters with respect to model mismatch using relative entropy concepts

This paper establishes practical stability results for an important range of approximate discrete-time filtering problems involving mismatch between the true system and the approximating filter model. Using local consistency assumption, the practical stability established is in the sense of an asymptotic bound on the amount of bias introduced by the model approximation. Significantly, these practical stability results do not require the approximating model to be of the same model type as the true system. Our analysis applies to a wide range of estimation problems and justifies the common practice of approximating intractable infinite dimensional nonlinear filters by simpler computationally tractable filters.

Optimal-stopping control for airborne collision avoidance and return-to-course flight

This paper considers an aircraft collision avoidance design problem that also incorporates design of the aircraft’s return-to-course flight. This control design problem is formulated as a non-linear optimal-stopping control problem; a formulation that does not require a prior knowledge of time taken to perform the avoidance and return-to-course manoeuvre. A dynamic programming solution to the avoidance and return-to-course problem is presented, before a Markov chain numerical approximation technique is described. Simulation results are presented that illustrate the proposed collision avoidance and return-to-course flight approach.

Relative entropy rate based design for linear hybrid system models

Hybrid system representations have been applied to many challenging modeling situations. In these hybrid system representations, a mixture of continuous and discrete states is used to capture the dominating behavioural features of a nonlinear, possible uncertain, model under approximation. Unfortunately, the problem of how to best design a suitable hybrid system model has not yet been fully addressed. This paper proposes a new joint state measurement relative entropy rate based approach for this design purpose. Design examples and simulation studies are presented which highlight the benefits of our proposed design approaches.

Practical stability with respect to model mismatch of approximate discrete-time output feedback control

This paper establishes a practical stability result for discrete-time output feedback control involving mismatch between the exact system to be stabilised and the approximating system used to design the controller. The practical stability is in the sense of an asymptotic bound on the amount of error bias introduced by the model approximation, and is established using local consistency properties of the systems. Importantly, the practical stability established here does not require the approximating system to be of the same model type as the exact system. Examples are presented to illustrate the nature of our practical stability result.