Healthcare burden and reimbursement of hospitalization during chemotherapy for adults with Ph-negative relapsed or refractory B-cell precursor acute lymphoblastic leukemia in France: a retrospective chart review

Objective: Philadelphia chromosome negative [Ph(?)] relapsed or refractory (R/R) B-precursor acute lymphoblastic leukemia (ALL) is an extremely rare condition requiring intensive treatment. This retrospective chart review aimed to quantify hospitalizations and reimbursement in this patient population in France.

Methods: Patients aged ≥18 years and with at least one hospitalization for Ph(?) R/R B-precursor ALL were included in the study. They were relapsed with first remission lasting <12 months, relapsed after first salvage therapy, relapsed any time after hematopoietic stem cell transplant (HSCT), or were refractory to initial or salvage therapy. Data were collected from the index date (first diagnosis of R/R ALL) until death or loss to follow-up. The chemotherapy period was defined as the first chemotherapy date after the index date to the earliest of death, loss to follow-up, last chemotherapy dose plus 30 days, or initiation of HSCT. The primary outcome was the percentage of time hospitalized during the chemotherapy period.

Results: Thirty-three patients were included, with a mean age of 49 years. The mean proportion of time spent in the hospital during the chemotherapy period was 46% (95% CI =34–57%). Patients had a mean of 2.2 (SD =1.5) inpatient hospitalizations and the mean length of stay per hospitalization was 16.8 (SD =14.8) days. During the chemotherapy period, the mean amount reimbursed per hospitalization was €31 067 (SD = €4850) and the total hospitalization reimbursement per patient was €68 344. From the index date to death, excluding HSCT, the total reimbursement per patient was €108 873.

Limitations: The sample size was small, although this was expected given the rarity of the patient population.

Conclusions: Adults with Ph(?) R/R B-precursor ALL had repeated and prolonged hospitalizations during salvage chemotherapy. Approximately half the follow-up period was spent in the hospital, and this time was associated with high economic burden in France.     

Visual displays: analytical study and applications to graphs and real data

Principal axis methods such as principal component analysis (PCA) and correspondence analysis (CA) are useful for identifying structures in data through interesting planar graphic displays. However, some kinds of data sets can be dealt alternatively with PCA or CA. This paper focuses on methods, such as PCA and CA, and on visual displays. Our aim is to illustrate the implications for a potential user of selecting either method, and its advantages and disadvantages, from an applied point of view. This is a matter covered broadly in textbooks and elsewhere considering theoretical arguments. Our purpose is to contribute to the comparison between these methods, over the same data set, in order to illustrate them for the practitioner. In the first part of this paper we present a novel analytical study of a binary matrix associated with a non-oriented axis-symmetric graph and show that CA outperforms standardized PCA for the reconstitution and visualization of such kind of graphs. In the second part we present a case using real data dealing with the distribution of employees in different economic sectors for the countries of the European Union, analyzed by means of standardized PCA and two-way CA, in order to see the differences between the two methods in practice.     

Value-in-context in crowdfunding ecosystems: how context frames value co-creation

The aim of this paper is to analyse the phenomenon of crowdfunding and determine whether it can be considered a service ecosystem, where the context frames innovation through value co-creation. A qualitative, multiple case study approach is used to analyse three platforms and six initiatives in the Spanish arts sector. The findings reveal that crowdfunding can be considered an ecosystem where value-in-context frames seven types of value co-creation, offering a contribution both to ecosystem theory and to the field of co-creation.     

GEM research: achievements and challenges

This article analyzes the content and evolution of research based on the Global Entrepreneurship Monitor (GEM) project. We conducted a rigorous search of articles published in journals within the Thomson Reuters’ Social Sciences Citation Index^® through an exploratory analysis focused on articles using GEM data. The main findings of this study reveal that the institutional approach is the most commonly used conceptual framework. Also, although there are still few academic publications using GEM data, the number of articles is increasing, as are opportunities for future research.     

The Size of Strategic Alliances and the Role Played by Managers

Journal of Industry, Competition and Trade - The vast empirical literature on strategic alliances has often overlooked their theoretical foundations. We pose a hypothesis: do small and medium...     

Extending the enterprise evolution contextualisation model

Enterprise engineering (EE) emerged as a new discipline to encourage comprehensive and consistent enterprise design. Since EE is multidisciplinary, various researchers study enterprises from different perspectives, which resulted in a plethora of applicable literature and terminology, but without shared meaning. Previous research specifically focused on the fragmentation of knowledge for designing and aligning the information and communication technology (ICT) subsystem of the enterprise in order to support the business organisation subsystem of the enterprise. As a solution for this fragmented landscape, a business-IT alignment model (BIAM) was developed inductively from existing business-IT alignment approaches. Since most of the existing alignment frameworks addressed the alignment between the ICT subsystem and the business organisation subsystem, BIAM also focused on the alignment between these two subsystems. Yet, the emerging EE discipline intends to address a broader scope of design, evident in the existing approaches that incorporate a broader scope of design/alignment/governance. A need was identified to address the knowledge fragmentation of the EE knowledge base by adapting BIAM to an enterprise evolution contextualisation model (EECM), to contextualise a broader set of approaches, as identified by Lapalme. The main contribution of this article is the incremental development and evaluation of EECM. We also present guiding indicators/prerequisites for applying EECM as a contextualisation tool.     

Perceptions of poverty attributions in Europe: a multilevel mixture model approach

The perception of the causes of poverty has long been recognized as a very important factor in the broader study of this social phenomenon. This study covers 15 European Union countries and considers three types of poverty attributions: individualistic, societal, and fatalistic. The individualistic view perception believes the poor are responsible for their situation, the societal perspective blames society for poverty and the fatalistic view considers poverty to be the result of bad luck or fate. A multilevel mixture model with three clusters of countries and six clusters of individuals was identified. Despite the generalization of the social explanations of poverty at the individual or micro level, there are also groups that emphasize more individualistic explanations, blaming the poor for their condition. At the country or macro level, the most developed cluster believes in the individualistic and fatalistic causes of poverty, whereas the least developed clusters explain poverty based on the injustices of society. There is diversity in the way these countries perceive poverty.