Estimating healthcare resource use associated with the treatment of metastatic melanoma in eight countries

Objectives Studies reporting healthcare resourse use (HRU) for melanoma, one of the most costly cancers to treat, are limited. Using consistent, robust methodology, this study estimated HRU associated with the treatment of metastatic melanoma in eight countries.

Methods Using published literature and clinician input, treatment phases were identified: active systemic treatment (pre-progression); disease progression; best supportive care (BSC)/palliative care; and terminal care. HRU elements were identified for each phase and estimates of the magnitude and frequency of use in clinical practice were obtained through country-specific Delphi panels, comprising healthcare professionals with experience in oncology (n?=?8).

Results Medical oncologists are the key care providers for patients with metastatic melanoma, although in Germany dermato-oncologists also lead care. During the active systemic treatment phase, each patient was estimated to require 0.83–2 consultations with a medical oncologist/month across countries; the median number of such assessments in 3 months was highest in Canada (range?=?3.5–5) and lowest in France, the Netherlands and Spain (1). Resource use during the disease progression phase was intensive and similar across countries: all patients were estimated to consult with medical oncologists and 10–40% with a radiation oncologist; up to 40% were estimated to require a brain MRI scan. During the BSC/palliative care phase, all patients were estimated to consult with medical oncologists, and most to consult with a primary care physician (40–100%).

Limitations Panelists were from centers of excellence, thus results may not reflect care within smaller hospitals; data obtained from experts may be less variable than data from broader clinical practice. Treatments for metastatic melanoma are continually emerging, thus some elements of our work could be superseded.

Conclusions HRU estimates were substantial and varied across countries for some resources. These data could be used with country-specific costs to elucidate costs for the management of metastatic melanoma.     

Assessing the Impacts of US‐Japan Bilateral Trade Agreements, 1980–1995

The paper presents three different viewpoints on the effects of US‐Japan bilateral trade agreements and finds some evidence to support each one using trade data from 1980–1995. For most of the 25 industry‐agreement cases, the data do not support a conclusion of significant positive impacts of the agreements on Japan's imports of targeted manufactured products from either the US or non‐US sources. In at least one high‐profile case involving autos, I find evidence suggesting positive impacts on imports from the US, but in this case the data suggests trade diversion benefiting US0based producers at the expense of European ones. I also find a few cases where the agreements may have produced positive effects on Japan's imports from non‐US sources.     

South Africa’s transition from apartheid: The role of professional closure in the experiences of black chartered accountants

As apartheid gave way to political freedom in South Africa in the last quarter of the 20th century, chartered accounting firms began to hire black South African trainees for the first time. The study examines the oral histories of black chartered accountants within the context of social closure theory and South Africa’s changing political and ideological landscape. The evidence indicates that processes of professional closure and credentialing excluded the majority population from the ranks of the profession on basis of race and class throughout the period 1976–2000.     

Caregiver priorities for endpoints to evaluate treatments for Prader-Willi syndrome: a best–worst scaling

Abstract

Objectives: Prader-Willi syndrome (PWS) is a rare genetic disorder associated with varying degrees of hyperphagia, obesity, intellectual disability, and anxiety across the affected individuals’ lifetimes. This study quantified caregiver priorities for potential treatment endpoints to identify unmet needs in PWS.

Methods: The authors partnered with the International Consortium to Advance Clinical Trials for PWS (PWS-CTC) and a diverse stakeholder advisory board to develop a best–worst scaling instrument. Seven relevant endpoints were assessed using a balanced incomplete block design. Caregivers were asked to determine the most and least important of a sub-set of four endpoints in each task. Caregivers were recruited nationally though patient registries, email lists, and social media. Best–worst score was calculated to determine caregiver priorities; ranging from 0 (least important) to 10 (most important). A novel kernel-smoothing approach was used to analyze caregiver endpoint priority variations with relation to age of the PWS individual.

Results: In total, 457 caregivers participated in the study. Respondents were mostly parents (97%), females (83%), and Caucasian (87%) who cared for a PWS individual ranging from 4–54 years. Caregivers value treatments addressing hyperphagia (score?=?7.08, SE?=?0.17) and anxiety (score?=?6.35, SE?=?0.16) as most important. Key variations in priorities were observed across age, including treatments targeting anxiety, temper outbursts, and intellectual functions.

Conclusions: This study demonstrates that caregivers prioritize hyperphagia and, using a novel method, demonstrates that this is independent of the age of the person with PWS. This is even the case for parents of young children who have yet to experience hyperphagia, indicating that these results are not subject to a hypothetical bias.     

AIA submission: CEO overconfidence and the incidence of financial restatement

The role of the Chief Executive Officer (hereafter, CEO) in financial reporting is almost universally assumed to be significant (Carcello, Neal, Palmrose & Scholz, 2011; Cohen, Krishnamoorthy, & Wright, 2002; Connelly, 2005; Paredes, 2004). While academics and regulators agree that the CEO can have a large impact on financial reporting decisions, there is very little research on how individual CEO characteristics actually influence the financial reporting process. This paper examines the impact of one such CEO characteristic – CEO overconfidence – on the incidence of financial restatement. We utilize a matched-pairs research design consisting of 75 restatement firms (obtained through the GAO restatement sample) and a set of 75 non-restatement control firms. Using an options-based measure of CEO overconfidence developed by Malmendier and Tate (2008), we document a statistically significant positive relation between CEO overconfidence and financial statement restatement.     

Profiling consumers in home ware stores according to their decision‐making process: an exploratory study

Despite the growing interest of South African consumers regarding home ware, insufficient research is available regarding their decision making of this product category. The objectives of this exploratory study were to evaluate consumers' decision‐making process regarding home ware, and to suggest consumer profiles of the home ware based on the decision‐making process. A qualitative research strategy was used to purposively recruit both male and female participants walking around a home ware store. Semi‐structured interviews were used to collect data from 33 participants at which point data saturation was reached. Each step of the decision‐making process was investigated during the interviews, using questions relevant to the purchasing of home ware. The results indicated clear differences as well as similarities in home ware consumers' decision‐making process. It was evident that the decision‐making process was a result of their specific need for a home ware product. Consumers evaluated home ware based on their needs, values and personal style, while making their final product choice based on product quality, appearance and price. It was also possible to identify home ware consumer profiles based on an evaluation of their decision‐making process. Four profiles were identified, namely, the quality‐conscious, the fashion‐conscious, the lifestyle‐orientated and the impulsive home ware consumer. The characteristics associated with each profile should provide the growing home ware market with insight regarding the specific needs and preferences of the consumer. Seeing that this study was only exploratory in nature, it is recommended that further research regarding the purchasing of home ware should be done.