Cost comparison of continued anticoagulation with rivaroxaban versus placebo based on the 1-year EINSTEIN-Extension trial efficacy and safety results

Aims: The EINSTEIN-Extension trial (EINSTEIN-EXT) found that continued treatment with rivaroxaban for an additional 6 or 12 months (vs placebo) after 6–12 months of initial anticoagulation significantly reduced the risk of recurrent venous thromboembolism (VTE) with a small non-significant increased risk of major bleeding (none fatal or in critical site). This study aimed to compare total healthcare cost between rivaroxaban and placebo, based on the EINSTEIN-EXT event rates.

Methods: Total healthcare cost was calculated as the sum of treatment and clinical event costs from a US managed care perspective. Treatment duration and event rates were obtained from the EINSTEIN-EXT study. Adjustment on treatment duration was made by assuming a 10% non-adherence rate. Drug costs were based on wholesale acquisition costs. Cost estimates for clinical events (i.e. recurrent deep vein thrombosis [DVT], recurrent pulmonary embolism, major bleeding, clinically relevant non-major bleeding) were determined from the literature. Results were examined over a ±20% range of each cost component and over 95% confidence intervals (CIs) of event rate differences in deterministic (one-way) and probabilistic sensitivity analyses (PSA).

Results: Total healthcare cost was $1,454 lower for rivaroxaban-treated (vs placebo-treated) patients in the base-case, with a lower clinical event cost fully offsetting drug cost. The cost savings of recurrent DVT alone (–$3,102) was greater than drug cost ($2,723). Total healthcare cost remained lower for rivaroxaban in the majority (73%) of PSA (cost difference [95% CI]?=?–$1,454 [–$2,396, $1,231]).

Limitations: This study was conducted over the 1-year observation period of the EINSTEIN-EXT trial, which limited “real-world” applicability and examination of long-term economic impact. Assumptions on drug and clinical event costs were US-based and, thus, not applicable to other healthcare systems.

Conclusions: Total healthcare costs were estimated to be lower for patients continuing rivaroxaban therapy compared to those receiving placebo in VTE patients who had completed 6–12 months of VTE treatment.     

The ‘Blogosphere’ as a platform for interpretative phenomenological analysis: the case of TEFL tourism

The use of the Internet is becoming increasingly integral to the day-to-day operations of society, facilitating an interconnected and globalised world, where geographic barriers are no longer a defining criteria for communication. This opens the researcher up to a realm of research opportunities, which to-date have been under-exploited. This paper contributes to the wider body of literature addressing the concept of Online research, demonstrating in practice how it can be utilised in the context of interpretative phenomenological analysis. It is argued that netnography is akin to interpretative phenomenological analysis (IPA) in that it accounts for an individual’s personal perception or account of an event or state, as opposed to attempting to produce an objective record. This paper outlines how blog analysis can be utilised in the context of IPA, demonstrating how this worked in practice during the initial exploratory research phase of the teaching English as a foreign language tourism phenomenon.     

COMPARING PPP WITH TRADITIONAL PROCUREMENT: THE CASE OF SCHOOLS PROCUREMENT IN IRELAND

Advocates of public‐private partnerships (PPPs) argue that they can deliver public infrastructure more efficiently than traditional procurement through timelier completion and superior value for money. Despite these claims comparative analysis of the performance of both procurement methods has received scant attention in the PPP literature to date. This paper addresses this issue by providing an in‐depth, case‐based comparison of PPP versus traditional procurement in the schools sector in Ireland. Through detailed semi‐structured interviews with key stakeholders and an examination of the available documentation, we assess whether the key objectives of using PPP have been achieved. Overall, we find no evidence that PPP leads to faster delivery of infrastructure when the overall procurement process from contract notice to delivery is accounted for. In addition, we find only limited evidence to suggest that PPP results in better value for money.     

Multigroup validation of the service quality,customer satisfaction and performance links in higher education

The notion of ‘students as customers’ continues to be prominent, yet is insufficiently explored, especially from the standpoint of various stakeholders. To address this inadequacy, the present study employs a multigroup analysis of the service profit chain (SPC) model in higher education (HE). Its purpose is to examine the complete SPC model regarding stakeholder perceptions in order to inform its validation and implementation. A cross-sectional survey was employed in order to enable multigroup comparison of a comprehensive research model on subsamples of employees and students by means of structural equation modeling (SEM). Results provide support for the proposed SPC model within the sample of vocational colleges. Besides strongly linked constructs (quality–satisfaction–loyalty), some notable weaknesses (cracked ‘satisfaction mirror’) are found. Multigroup analysis also indicates some important differences between employees and students. Implications are provided for strategic service management in HE, which should acknowledge the differences among stakeholder perceptions.     

Media-Based Sentiment Indices as an Alternative Measure of Consumer Confidence

In this paper, we consider the feasibility of constructing online sentiment indices, using large amounts of media data, as an alternative to the conventional survey method used to create the consumer confidence index in South Africa. A clustering framework is adopted to provide an indication of possible candidate sentiment indices constructed from a combination of different text sources and dictionaries that best mimic the traditional survey-based consumer confidence index from the South African Bureau for Economic Research (BER). The results conclude that it is possible to create an index using sentiment analysis using online editorial data that does resemble the BER’s consumer confidence index. The different media-based sentiment indices (MSI) show a significant level of correlation and co-movement with the BER’s CCI. Impulse responses and cross-correlation functions indicate that the MSI could potentially lead the survey-based method up to two quarters. Furthermore, Granger-causality tests show that the media-based indices are good predictors of future consumer confidence index values. The results provide motivation for further study on the use of sentiment-based techniques and online media data sources to track consumer confidence within an emerging market such as South Africa.     

The mechanism of credit risk contagion among internet P2P lending platforms based on a SEIR model with time-lag

The credit risk contagion of Internet peer-to-peer (P2P) lending platforms is an important part of Internet financial risk management and supervision. This study analyzes the contagion path of credit risk in Internet P2P lending. Based on complex network theory and the theory of infectious disease dynamics, the characteristics of Internet P2P lending development are combined to construct a SEIR model of credit risk transmission among Internet P2P lending platforms with time lag, and the robustness of the model is analyzed and proven. The influence of platform correlations, the susceptible immune rate, the platform elimination rate, contagion latency, the saturation coefficient, and the susceptibility input rate on credit risk contagion behavior among Internet P2P lending platforms is analyzed, using the equilibrium point and threshold value. The impact of each variable is analyzed by simulation. Corresponding countermeasures and suggestions are proposed to prevent and control credit risk contagion among these platforms.     

Economic interpretations of DEA

Research on productive efficiency at the firm level has developed as an important and active strand of research the last decades, both within operations research, management science and economics. Two apparently different definitions of efficiency are examined, but it is shown that when both estimation methods are based on solving linear programming problems the definitions of efficiency are identical. The purpose of the paper is to give the basic ideas of efficiency analyses using DEA as a tool for researchers not so familiar with efficiency analysis and DEA. The concept of shadow prices is given special attention.     

Are China’s regional agricultural productivities converging: How and why?

This article tests the hypotheses of convergence to a single level of total factor productivity (TFP), and a steady state of TFP growth rate in China’s agricultural sector. Based on multilateral TFP estimates we found that China’s agricultural sector has rebounded in recent years from a slower TFP growth in the 2005–2007 period. While convergence test results confirm a “catch-up” effect that provinces with lower TFP levels tend to grow faster than others, estimated rates of β convergence are conditional on how we capture the heterogeneity effect across regions. The rates of β convergence range from 0.016 to 0.039 under different model specifications. Estimates show that higher growth rates of educational attainment, R&D, and intermediate goods density (per unit of labor) can enhance TFP growth. Unfortunately, there is no evidence of an overall σ convergence, indicating that TFP levels are not converging except in the South region. It implies that to catch up with leading provinces, it would require extra efforts for those lagging behind by increasing their region-specific research investment, promoting rural educational attainment, and enhancing embodied technical change.     

自动涂胶系统胶枪的热分析

为研究自动涂胶系统的胶枪最优材质、最佳热源位置和最佳测温位置,利用ANSYS Workbench软件对自粘胶胶枪进行数值模拟.通过分析不同材质胶枪的温度场分布情况,结合经济性和加热性能,选定最优胶枪基材.同时分析得出加热自粘胶至工作温度的时间和保持工作温度的加热功率,确定了热源和测温点位置,拟定了升温策略.进行自粘胶胶枪加热试验,验证了仿真分析结果的准确性.     

Krazy Kimmy's: A Case in Fraud Examination

This two‐part case allows for maximum student engagement through preparation, in‐class discussion, and through a Part B case that is part of the Teaching Note. Through this case, students work to identify possible fraud schemes, plan an investigation, and perform horizontal analysis calculations. Students will learn about the concept of ethical hacking, red flag identification, internal control weaknesses, and investigation considerations for fraud schemes. Further, in‐class planning for next steps and investigation can occur, providing an opportunity for group work and in‐depth learning. This case offers flexibility for instructors in that it can be covered over one class or multiple classes, or can be assigned as an independent or group assignment. This teaching note provides an overview of the case along with guidance for teaching this case.