Psychometric validation of anti-clot treatment scale and treatment satisfaction questionnaire for medication version II in Japanese patients with atrial fibrillation

Aims: The Anti-Clot Treatment Scale (ACTS) and Treatment Satisfaction Questionnaire for Medication version II (TSQM-II) are validated treatment satisfaction patient-reported outcome (PRO) instruments. The ACTS includes two domains: Burdens and Benefits; the TSQM-II includes four: Effectiveness, Side Effects, Convenience, and Global Satisfaction. Japanese-language versions of the ACTS and TSQM-II have been developed and linguistically validated. This study aimed to assess their psychometric properties in Japanese patients with atrial fibrillation (AF).

Materials and methods: ACTS and TSQM-II data from 534 patients with AF were collected in a Japanese post-marketing surveillance study of a direct oral-anticoagulant, rivaroxaban. Four key psychometric properties, in line with best practice guidelines from the US Food and Drug Administration, were examined using traditional psychometric methods: acceptability, scaling assumptions, reliability (i.e. internal consistency reliability, test-retest reliability), and construct validity (i.e. convergent validity and known groups).

Results: ACTS Burdens and Benefits and TSQM-II Effectiveness, Convenience, and Global Satisfaction scales were found to be acceptable (e.g. item-level missing data at baseline <4%), with all scales having good internal consistency (Cronbach’s alpha > 0.80). test-retest reproducibility intraclass correlation coefficients for the ACTS Burdens and Benefits were 0.59 and 0.65, respectively, and between 0.54–0.61 for the TSQM-II scales. Known-groups validity for the ACTS and TSQM-II was supported by differences in scale scores by positive and negative impact (p?<?0.05). Correlations between the ACTS and TSQM-II (convergent validity) were lower than expected (range r?=?0.09–0.48), but in line with the original ACTS development study.

Limitations: Evaluation of test-retest reproducibility was limited by assessment period, which was longer (3 months) than recommended guidelines (usually up to 2 weeks).

Conclusions: Overall, Japanese versions of ACTS and TSQM-II scales satisfied internal consistency reliability and traditional validity criteria. Our study supports the ACTS and TSQM-II as appropriate PRO instruments to measure satisfaction with anticoagulant treatment in Japanese patients with AF.

Trial registration: NCT01598051, clinicaltrials.gov; registered April 20, 2012.     

Price competition in the spatial real estate market: allies or rivals?

This paper examines whether real estate firms can avoid price competition when properties in the vicinity are priced by allies. An oligopoly model with differentiated products generally suggests that real estate firms engage in price competition with their spatially closest rivals. Yet, they can raise property prices when the market share of their allies increases. To test this prediction, a spatial autoregressive model with spatial autoregressive disturbances, including a share of allies in the vicinity, is estimated using data on the prices of residential condos in central Tokyo, Japan. The model prediction is supported by the empirical results. In the data set, the magnitude of the market share on property prices increases with the expansion of the size of the spatial market.     

Shift of the short-term temperature mortality relationship by a climate factor - some evidence necessary to take account of in estimating the health effect of global warming

Several studies have reported a 'V'-shaped relationship between short-term temperature and mortality rates, characterized by mortality rates that are higher when the temperature is extremely low or high than when the temperature is moderate. To quantify the effect of adaptation to a certain climate on this V-shaped short-term temperature-mortality relationship, we studied the prefecture-specific relationship between daily maximum temperature and mortality rates for 65+-years-old Japanese from 1972 to 1990. For both genders, the optimum daily maximum temperature (OT) category at which the mortality rate was minimum ranged from 23C-28 C to 33+C, and the OT level became lower when the climate became colder. The mean OT level was lower for women than for men by 1.7C. The mortality rate at the OT was almost constant across prefectures, regardless of the climate. From the results, we considered that the adaptation effect on the short-term temperature-mortality relationship is mainly described by the 'horizontal shift model': the V-shape moves horizontally according to the climate. This 'shift' should be taken into account in estimating the health effect of global warming, and the model would be useful for the estimation.     

Identifying the sources of energy use change: Multiple calibration decomposition analysis and structural decomposition analysis

Decomposition methodologies are requisite to identify the sources of changes in energy use or carbon dioxide emissions. This paper is an inquiry into the theoretical properties of such decomposition methodologies. The study first presents our new decomposition methodology – the Multiple Calibration Decomposition Analysis (MCDA) – as a tool for the investigation. Then, it theoretically reexamines an established decomposition methodology – the Structural Decomposition Analysis proposed by Casler and Rose (1998). Subsequently, the study empirically investigates the properties of both methodologies, applying them to an actual case: the changes in energy use and carbon dioxide emissions in Japan during the oil crises period, when the oil price had a significant influence on the economy. The result shows that understanding the theoretical properties of decomposition methodologies is essential for a precise interpretation of empirical results.     

A flexible dynamic model of multiproduct technology for the West German economy

This paper tests symmetry and negativity of the Slutsky matrix for a system of demand functions derived from an aggregate model of multi product technology within a flexible dynamic framework. The model considers three inputs and three outputs, including imports and exports of intermediate goods. We derive a static demand model from a trans log cost function and specify the data generation process by a stationary ARX (1, 1) model. Results based on West German quarterly data indicate that the integrability conditions are not rejected when imposed on the ARX (1, 1) model, whereas they are rejected for all the less general dynamic models considered.     

Particulate matter air pollution control programs in Japan — an analysis of cost savings in the absence of future remediation

The objectives of this study were to assess avoided economic costs (or anticipated ‘benefits’) of not implementing new environmental policies for particulate matter (PM) in Japan and compare these future benefits to estimates of future health risks developed in a separate analysis. The estimates for the benefits of avoided PM pollution control in the year 2010 were (1) $27 billion USD for stationary source controls, (2) $2.1 billion to $3.3 billion USD for diesel motor vehicle controls, (3) $41 million USD for governmental employee salaries, (4) $470 million USD for governmental financial assistance, (5) $510 million USD for special diesel vehicle control measures in Tokyo, and (6) $31 billion USD for total costs.

Using human health and productivity risks, calculated in a separate study to be $56 billion USD, the best net ratio of benefits to costs was 1.8 to 1. Inexpensive control options include road watering or paving for unpaved dirt roads and road vacuuming for paved roads. Intermediate options include differential road pricing, retrofitting diesel particulate filters, and reformulating diesel fuel. High cost options include adding particulate controls, such as wet scrubbers, baghouses, and electrostatic precipitators on uncontrolled stationary sources.     

Public health improvements and mortality in interwar Tokyo: a Bayesian disease mapping approach

Recent studies have found that modern water supply systems played an important role in mitigating the mortality risks in major US cities in the early twentieth century. Modern water supply systems were installed also in Japanese cities during the interwar period. This study examines how the modern water supply system in Tokyo City reduced mortality risks in the interwar period. By employing a Bayesian disease mapping approach with a block-level lattice dataset of Tokyo for 1930, we found that wider access to purified water through water supply systems played an important role in mitigating mortality risks during the study period. Our estimation results show that clean water accounted for approximately 41.3 and 34.9 % of improvements in crude and child death rates, respectively, between 1921 and 1937 in Tokyo.     

The regulations for indoor air pollution in Japan: a public health perspective

In recent years public health problems caused by indoor air pollution, known as ‘Sick Building Syndrome in housing’, or ‘Sick House Syndrome’ in Japan, have been drawing strong public concern. After conducting extensive exposure assessment, government authorities have taken effective measures to solve the problem. However, as a result of diversification and increase in quantities of industrial chemicals, existing regulations do not cover enough ranges of various potential hazardous chemicals. Hence, the regulations seek to be changed from hazard‐based regulation to a risk‐based one. Good indoor air quality (IAQ), which does not pose unacceptable health risks from all pollutants affecting indoor air, should be ensured for all public people. The objective of this study is to clarify the remaining issues to be solved urgently, related to the regulations to ensure a good IAQ. We reviewed enormous numbers of the existing governmental and industrial voluntary standards and/or guidelines, literature and documents concerning IAQ research in the past 40 years. Our results showed six subjects from those remaining issues. Based on these subjects we created a new scheme to control the IAQ; we especially regarded a comprehensive labeling system as one of the important strategies.     

Impacts of robotization on the Japanese economy

The introduction of robots leads to a reduction of direct labor, whereas it stimulates the investment activity of firms and thereby brings about a rise in indirect employment. This paper attempts to evaluate relative magnitudes of both effects of robotization on employment. The method of analysis depends on the application of an econometric model. The results of the survey at the individual firm level are also utilized. The forecast for the current five years (1985–1990) is that robotization will result in a net effect of a 23 thousand person decrease in employment.     

Resale Externality and the Used Housing Market

The selling prices of used houses may not fully reflect the maintenance spending of current owners when prospective buyers are unable to conduct a thorough inspection before purchase. This article investigates how this resale externality problem affects the maintenance expenditures of homeowners. After considering both observable and unobservable repair expenses, the analysis shows that the resale externality reduces not only maintenance expenditures, but also household mobility. A treatment effects model is used to estimate the simultaneous relationship between mobility and maintenance in the Japanese resale housing market. The results indicate that the resale externality has a significant negative impact on maintenance expenditures.