An economic evaluation attached to a single-centre,parallel group,unmasked, randomized controlled trial of a 3-day intensive social cognitive treatment (can do treatment) in patients with relapsing remitting multiple sclerosis and low disability

Abstract

Aims: This trial-based economic evaluation (EE) assesses from a societal perspective the cost-effectiveness of an intensive 3-day cognitive theory-based intervention (CDT), compared to care-as-usual, in patients with relapsing remitting multiple sclerosis (RRMS) and low disability (Expanded Disability Status Scale [EDDS] score < 4.0).

Materials and methods: The trial of the EE was registered in the Dutch Trial Register: Trial NL5158 (NTR5298). The incremental cost-effectiveness ratio (ICER) was expressed in cost on the Control sub-scale of the Multiple Sclerosis Self-Efficacy Scale (MSSES) and the incremental cost-utility ratio (ICUR) in the cost per Quality Adjusted Life Years (QALY) using the EQ-5D-5L. Bootstrap, sensitivity, and sub-group analyses were performed to determine the robustness of the findings.

Results: The two groups of 79 patients were similar in baseline characteristics. The base case ICER is situated in the northeast quadrant (€72 (40.74/€2,948)) due to a higher MSSES Control score and higher societal costs in the CDT group. The ICUR is situated in the northwest (inferior) quadrant due to losses in QALY and higher societal costs for the CDT group (?0.02/€2,948). Overall, bootstrap, sensitivity, and sub-group analyses confirm the base case findings. However, when the SF-6D is used as a study outcome, there is a high probability that the ICUR is situated in the northeast quadrant.

Limitations: The relative short follow-up time (6?months) and the unexpected increase in MSSES Control in the control group.

Conclusions: When using the EQ-5D-5L to calculate a QALY, CDT is not a cost-effective alternative in comparison to care as usual. However, when using self-efficacy or SF-6D as outcomes, there is a probability that CDT is cost-effective. Based on the current results, CDT for patients with RRMS clearly show its potential. However, an extended follow-up for the economic evaluation is warranted before a final decision on implementation can be made.     

Review

Peter Young & Paul Reynolds, The Amnesia of Reform. A Review of Post‐Communist Privatization. London: Adam Smith Research Trust, 1994, 40 pp., p/b.

Michael Kaser, Privatization in the CIS. London: Royal Institute of International Affairs, 1995, 62 pp., p/b.     

Geopolitics and territorial issues: Relevance for South America

This paper surveys the impact of geopolitical thinking as applied to issues of territory in Latin America, with special emphasis upon its Southern Cone. The relevance of geopolitics is examined as an ideological doctrine and as a normative framework to understand territorial changes, territorial conflicts that have not escalated into fully‐fledged wars, and rare cases of actual wars fought in the twentieth century in South America. I question the changing meaning of geopolitical doctrines following the ‘third wave’ of democratization in Latin America by suggesting more ‘positive’ avenues for the former pernicious “implications of geopolitical doctrines, including economic development and regional integration. Finally, I juxtapose ‘conventional’ geopolitics with more recent ideas of ‘critical’ geopolitics and its potential implementation in the region.     

Documenting Territory: Passportisation,Territory, and Exception in Abkhazia and South Ossetia

Despite the crucial role it played in the 2008 war between Russia and Georgia, the phenomenon of passportisation has not received a great deal of scholarly attention. Much of the literature has treated the mass distribution of Russian passports to the residents of Abkhazia and South Ossetia as little more than a strategy to manufacture an excuse to go to war with Georgia. Drawing on recent scholarship on territory and territoriality, as well as with literature addressing Agamben's theories of exceptional spaces, this paper contributes to a more nuanced understanding of passportisation by analysing the territorial effects it produced. It argues that the wholesale conversion of Abkhazians and South Ossetians into Russian citizens did not merely manufacture a casus belli, it also produced exceptional spaces within the territory of the Republic of Georgia, where the norms of international law and the modern state system were effectively suspended.     

Firm size and types of innovation

We propose a general theory of innovation that illustrates the relative benefits of performing process versus product R&D when firm size is endogenous. A firm's size, scope, and R&D portfolio are shown to reflect the same underlying characteristic of the firm, namely manufacturing efficiency. We demonstrate that efficient firms become larger, have greater scope, and perform more of both process and product R&D. In light of decreasing returns to R&D, this implies small firms obtain more product innovations per dollar of R&D than large firms, which is consistent with evidence we present that small firms are more innovative than large firms as they obtain more patent counts and citations per dollar of R&D.     

What do professional forecasters actually predict?

This paper studies what professional forecasters predict. We use spectral analysis and state space modeling to decompose economic time series into trend, business cycle, and irregular components. We examine which components are captured by professional forecasters by regressing their forecasts on the estimated components extracted from both the spectral analysis and the state space model. For both decomposition methods, we find that, in the short run, the Survey of Professional Forecasters can predict almost all of the variation in the time series due to the trend and the business cycle, but that the forecasts contain little or no significant information about the variation in the irregular component.     

Does ethics improve stock market resilience in times of instability?

This paper compares the resilience of ethical (Islamic and socially responsible) indexes among five developed (US, UK, Japan, Canada, Australia) and three emerging markets (Brazil, India, South Africa) during the period following the 2008 subprime crisis. It relies on a multivariate CAPM-EGARCH model that accounts for sudden changes in volatility through the application of an iterated cumulative sums of squares (ICSS) algorithm on daily data over the sample period 2008–2014 to model time-varying volatility and ensure reliable estimates. The study confirms the lower systemic risk associated with Islamic indexes during the bearish period and reports that SRI, despite being more subject to systemic risk, offered higher alphas in highly integrated markets, while Islamic indexes performed better in less integrated ones. The evidence also reveals a very limited increase in the models’ predictability power from the integration of sudden changes in volatility into the EGARCH models during the full sample period. This limit is more marked during the bearish sub-period. Our findings have important implications for international investment and portfolio diversification perspectives in times of financial downturn.     

The impact of purchasing strategy-structure (mis)fit on purchasing cost and innovation performance

The organizational design literature strongly supports the notion of “structure follows strategy”, and suggests that a misfit between the two has a negative effect on performance. Building on this line of argument, we examine to what extent the (mis)fit between purchasing strategy and purchasing structure impacts purchasing performance. We focus on cost and innovation purchase category strategies, and examine how the deviation from an ideal purchasing structure defined along three dimensions (centralization, formalization, and cross-functionality) impacts purchasing performance. Analysing data collected from 469 firms in ten countries, we demonstrate that a strategy-structure misfit negatively impacts purchasing performance in both cost and innovation strategies. We also find that purchasing proficiency is a mediator in this relationship between misfit and performance. Our findings aid managerial decision making by empirically validating the necessity of having the right purchasing structure for successfully executing different purchasing strategies.     

Déjà lu: On the limits of data reuse across multiple publications

Scholars in our field, Operations and Supply Chain Management (OSCM), are under high pressure to show research productivity. At most schools, this productivity is measured by the number of journal articles published. One possible response to such pressure is to improve research efficiency: publishing more journal articles from each data collection effort. In other words, using one dataset for multiple publications. As long as each publication makes a sufficient contribution, and authors ensure transparency in methods and consistency across publications, generating more than one publication from one data collection effort is possible. The aim of this Notes and Debates article, however, is to draw attention to inappropriate reuse of empirical data in OSCM research, to explain its implications and to suggest ways in which to promote research quality and integrity. Based on two cases of extensive data reuse in OSCM, eighteen problematic practices associated with the reuse of data across multiple journal articles are identified. Recommendations on this issue of data reuse are provided for authors, reviewers, editors and readers.