A short-term cost-effectiveness study comparing robot-assisted laparoscopic and open retropubic radical prostatectomy

Abstract

Objective:

To evaluate cost effectiveness and cost utility comparing robot-assisted laparoscopic prostatectomy (RALP) versus retropubic radical prostatectomy (RRP).

Methods:

In a retrospective cohort study a total of 231 men between the age of 50 and 69 years and with clinically localised prostate cancer underwent radical prostatectomy (RP) at the Department of Urology, Aarhus University Hospital, Skejby from 1 January 2004 to 31 December 2007, were included.

The RALP and RRP patients were matched 1:2 on the basis of age and the D’Amico Risk Classification of Prostate Cancer; 77 RALP and 154 RRP.

An economic evaluation was made to estimate direct costs of the first postoperative year and an incremental cost-effectiveness ratio (ICER) per successful surgical treatment and per quality-adjusted life-year (QALY). A successful RP was defined as: no residual cancer (PSA <0.2?ng/ml, preserved urinary continence and erectile function. A one-way sensitivity analysis was made to investigate the impact of changing one variable at a time.

Results:

The ICER per extra successful treatment was €64,343 using RALP. For indirect costs, the ICER per extra successful treatment was €13,514 using RALP. The difference in effectiveness between RALP and RRP procedures was 7% in favour of RALP. In the present study no QALY was gained 1 year after RALP, however this result is uncertain due to a high degree of missing data. The sensitivity analysis did not change the results noticeably.

Limitations:

The study was limited by the design resulting in a low percentage of information on the effect of medication for erectile dysfunction and only short-term quality of life was measured at 1 year postoperatively.

Conclusion:

RALP was more effective and more costly. A way to improve the cost effectiveness may be to perform RALP at fewer high volume urology centres and utilise the full potential of each robot.     

Robotics projects and learning concepts in science, technology and problem solving

This paper presents a study about learning and the problem solving process identified among junior high school pupils participating in robotics projects in the Lego Mindstorm environment. The research was guided by the following questions: (1) How do pupils come up with inventive solutions to problems in the context of robotics activities? (2) What type of knowledge pupils address in working on robotics projects? and (3) How do pupils regard or exploit informal instruction of concepts in science, technology and problem solving within a project-based program? Data collection was made through observations in the class, interviews with the pupils, observations of the artifacts the pupils had constructed, and analyses of their reflections on each project. The study revealed that the pupils had often come up with inventive solutions to problems they tackled by intuitively using diverse kinds of heuristic searches. However, they encountered difficulties in reflecting on the problem solving process they had used. In robotics projects, the pupils deal primarily with qualitative knowledge, namely, the ability to identify specific phenomena in a system or factors that affect system performance. The study also showed that pupils are likely to benefit from implementing informal instruction on concepts in science, technology and problem solving into a project-based program. This type of instruction should take place in the context of pupils’ work on their projects, and adopt a qualitative approach rather than try to communicate in the class procedural knowledge learned by rote.     

Preference for robot service or human service in hotels? Impacts of the COVID-19 pandemic

Robots and artificial intelligence (AI) technologies are becoming more prominent in the tourism industry. Nowadays, consumers are faced with multiple options involving both human and robot interactions. A series of experimental studies were implemented. Four experiments demonstrated that consumers had a more positive attitude toward robot-staffed (vs. human-staffed) hotels when COVID-19 was salient. The results were different from previous studies, which were conducted before the COVID-19 pandemic. Since the moderating role of perceived threat in consumers’ preference for robot-staffed hotels was significant, the respondents’ preference was attributed to the global health crisis. This research provides a number of theoretical and managerial implications by improving the understanding of technology acceptance during a health crisis.     

“十四五”规划下中国制造供给能力及发展路径思考

研究目标:探究我国“十四五”时期智能制造供给能力存在的关键问题及发展路径。研究方法:围绕供给能力,分析美、德、日等国智能制造领域的政策重点及战略意图,结合产业发展现状,研究我国智能制造政策制定和实施过程中存在的问题。在此基础上,针对机器人和工业软件领域,以发那科、ABB和西门子等国际巨头为例,对比分析我国在制造装备和工业软件等方面的成果及差距,提出智能制造供给能力的发展建议。研究发现:经过多年的发展,我国在智能制造装备、工业软件技术水平和市场竞争力上仍存在较大劣势。机器人产量和集群方面在“十三五”期间已达成目标,但核心零部件和稳定性方面的缺陷仍未解决。国产工业软件技术更为薄弱,市场基本被国外垄断,在研发设计、核心技术和商业化程度上差距明显。建议从政策精准扶持、鼓励头部企业推行自研加并购、深化产业集群效应、培养复合尖端人才等角度综合提升供给能力。研究创新:从业务变革、市场竞争、技术研发和资本并购等视角,综合研究供给能力的发展路径。研究价值:为“十四五”时期提升我国智能制造供给能力提供经验依据和决策参考。     

工业机器人应用对城镇居民收入差距的影响

研究目标:实证研究工业机器人应用对城镇居民收入差距的影响,并对相关影响机制进行探讨。研究方法:运用双向固定效应模型、工具变量等方法进行因果推断。研究发现:工业机器人的应用显著拉大了城镇居民的收入差距,通过多种稳健性检验和内生性处理后,结论仍然成立。机制分析表明,工业机器人的应用通过对劳动力市场中不同群体就业机会和工资水平的异质性影响进而对整体的收入差距产生作用。此外,分样本回归发现,工业机器人引起的收入差距扩大作用更多地表现在低收入、低教育地区。研究创新:首次利用中国家庭追踪调查和工业机器人使用数据进行研究,并对相关机制进行深入探究。研究价值:从劳动力市场的角度进行分析并为政府决策提供参考。     

Knowledge,firm boundaries,and innovation: Mitigating the incumbent's curse during radical technological change

We explore the relationship between a firm's organization and its ability to face a radical technological change. We suggest that, during such a change, the presence of both in‐house upstream knowledge and downstream market linkages, within a firm's boundary, has its advantages. We test our predictions in the context of the robotics industry where manufacturers of mechanically controlled “brawny” robots, which were valued mainly for their payload capacity, faced the advent of electrically controlled “brainy” robots that emphasized accuracy and repeatability. We find that “preadapted” firms—the ones with prior relevant technological knowledge and with access to internal users of “brainy” robots—were the innovation leaders in the emerging new technology but were laggards in the old technology. Copyright © 2014 John Wiley & Sons, Ltd.     

机器人使用、工艺创新与质量改进——来自中国企业综合调查(CEGS)的经验证据

文章通过独特的"中国企业综合调查"数据,应用OLS、IV和中介效应的实证方法,验证了机器人的使用对于质量改进的显著效应。机器人的使用带来了工艺创新,也就是新的加工方式、生产流程以及检测方法的应用,从而改进了企业的质量。文章的政策启示为,我国加快推进质量强国战略,一个非常重要的抓手就是要在制造业企业中全面推进机器人使用;我国制造业的技改项目中,要突出对机器人使用工艺的创新;我国各级政府的科研项目中,要突出对机器人共性技术的公共投入。关键词机器人工艺创新质量中国企业综合调查DOI：10.19592/j.cnki.scje.370714     

Rulers of the world,unite! The challenges and opportunities of artificial intelligence

A decade ago, we published an article in Business Horizons about the challenges and opportunities of social media with a call to action: “Users of the world, unite!” To celebrate its anniversary, we look at artificial intelligence and the need to create the rules necessary for peaceful coexistence between humanity and AI. Hence, we now are urging: “Rulers of the world, unite!” In this article, we outline six debates surrounding AI in areas like artificial superintelligence, geographical progress, and robotics; in doing so, we shed light on what is fact and what is utopia. Then, using the PESTEL framework, we talk about the six dilemmas of AI and its potential threat and use. Finally, we provide six directions on the future of AI regarding its requirements and expectations, looking at enforcement, employment, ethics, education, entente, and evolution. Understanding AI’s potential future will enable governments, corporations, and societies at large (i.e., the rulers of this world) to prepare for its challenges and opportunities. This way, we can avoid a scenario in which we return in 10 years to write the article: “Dreamers of the world, unite!”