Effectiveness and safety of betrixaban extended prophylaxis for venous thromboembolism compared with standard-duration prophylaxis intervention in acute medically ill patients: a systematic literature review and network meta-analysis

Abstract

Aims: To determine the clinical effectiveness and safety of venous thromboembolism (VTE) prophylaxis using US- and Europe-approved anticoagulants relative to extended-duration VTE prophylaxis with betrixaban. Low molecular weight heparins (LMWHs), unfractionated heparin (UFH), fondaparinux sodium and placebo were each compared to betrixaban, as standard-duration VTE prophylaxis for hospitalized, non-surgical patients with acute medical illness at risk of VTE.

Materials and methods: A systematic literature review was conducted up to June 2019 to identify randomized controlled trials (RCTs) of VTE prophylaxis in hospitalized, non-surgical patients with acute medical illness at risk of VTE. Studies that reported the occurrence of VTE events (including death) and, where possible, major bleeding, from treatment initiation to 20–50?days thereafter were retrieved and extracted. A Bayesian fixed effect network meta-analysis was used to estimate efficacy and safety of betrixaban compared with standard-duration VTE prophylaxis.

Results: Seven RCTs were analyzed which compared betrixaban, LMWHs, UFH, fondaparinux sodium, or placebo. There were significantly higher odds (median odds [95% credible interval]) of VTE with LMWHs (1.38 [1.12–1.70]), UFH (1.60 [1.05–2.46]), and placebo (2.37 [1.55–3.66]) compared with betrixaban. There were significantly higher odds of VTE-related death with placebo (7.76 [2.14–34.40]) compared with betrixaban. No significant differences were observed for the odds of major bleeding with all comparators, VTE-related death with any active standard-duration VTE prophylaxis, or of VTE with fondaparinux sodium, compared with betrixaban.

Limitations and conclusions: In this indirect comparison, betrixaban was shown to be an effective regimen with relative benefits compared with LMWHs and UFH. This indicates that betrixaban could reduce the burden of VTE in at-risk hospitalized patients with acute medical illness who need extended prophylaxis, though without direct comparative evidence, stronger conclusions cannot be drawn.     

Institutional framing and perceptions of fairness

This paper's goal is to construct a positive theory of economic fairness. Using the theoretical schema developed by Hurwicz and others, the paper makes precise the notions of an “institution,” “fairness fraiming,” and “institutional framing.” Four fairness propositions yield an important corollary: the economic environment, the operative institution and history give meaning to the often used FORMAL PRINCIPLE OF DISTRIBUTIVE JUSTICE (“equals should be treated equally, and unequals unequellay, in proportion to relevant similarities and differences”). We support these four propositions and corollary by an analysis of laboratory, survey, and anecdotal evidence. Finally we describe a number of areas for future research. The authors would like to thank Allen Buchanan, James Buchanan, Joel Feinberg, Elizabeth Hoffman, David Schmitz, Linda Schnabel Stizer, Vernon Smith, Richard Wagner, the participants in the Aspen Institute's Conference on “Local Justice and Fair Allocation”, the members of the Industrial Organization Workshop of the Department of Economics at the University of Arizona, and panel participants at the Public Choice Society Meeting for their help and comments at various stages of this paper's preparation. Responsibility for errors is the authors' alone.     

The evolution of Indian accounting standards: Its history and current status with regard to International Financial Reporting Standards

This paper addresses the adoption and applicability of International Accounting Standards (IAS) and International Financial Reporting Standards (IFRS), issued by the International Accounting Standards Board (IASB) to India. Specifically, the paper highlights some major areas where the country lacked harmonization with IAS in 1993 and the rapid congruence with IAS in the decade that followed. The attempt to achieve congruence with IAS appears to be more a by-product of the country's rapid economic growth rather than its catalyst. However, continued growth and the attraction of foreign capital to domestic ventures will depend on the transparency of the financial dealings. The Institute of the Chartered Accountants of India, (ICAI), India's standard setting body, is increasingly attempting to provide this transparency by revisions and additions to accounting standards, and by Exposure Drafts which aim to bring India more in line with International Financial Reporting Standards.     

Broadband and contributions to economic growth: Lessons from the US experience

The connection between broadband deployment and economic prosperity in the United States has garnered public attention due to stimulus plan funding authorized in February 2009 for broadband planning and deployment initiatives. The importance of innovation for a nation's economic well-being is fairly well understood. Through a literature survey, this article analyzes the connection between information and communications technologies and economic growth, as well as the connection between broadband and economic growth. There appears to be a positive economic impact from expanded broadband deployment and adoption. However, various research challenges including methodological problems and access to sufficiently granular data have prevented the authors from drawing more definitive conclusions from the US broadband experience. Another finding is the time lag for businesses to effectively exploit innovative broadband applications.     

Reputation gaps and the performance of service organizations

Links between the reputation of organizations and their financial performance are intuitively attractive to assume, but often difficult to demonstrate convincingly. Gaps between employee and customer perceptions of corporate reputation have traditionally been associated with poor performance. In the context of service business and applying assimilation‐contrast theory, we hypothesize that the nature of such gaps will, in reality, have a differential effect on future revenue depending on the size and valence of the gap. The effects of small gaps should be assimilated by customers, but larger ones have a greater potential of creating a contrast effect resulting in significant increases or decreases in subsequent sales. In businesses where employees have a more positive view of the company reputation than customers, we hypothesize a growth in future sales, and where they have a relatively more negative view, a decline. We test the effects of what we label as reputation gaps in 56 business units drawn from nine service organizations and confirm our hypotheses. Among the implications of our findings are that managing reputation by elevating employee perceptions of a company's reputation above those perceived by its customers holds the potential to enhance future sales. Copyright © 2009 John Wiley & Sons, Ltd.     

ONLINE FREE MARKETS AND ENTREPRENEURSHIP IN THE MUSLIM WORLD

For centuries, networks of free exchange enabled populations of the Islamic world to thrive. Today, by contrast, the largest Muslim countries lag in international measures of economic freedom. At this critical time, hundreds of online markets for 'telework' are bringing global business opportunities within reach of many in the Muslim and non-Muslim worlds alike. Individuals with internet access can directly engage in the global online economy without having to wait for the results of domestic policy liberalisation or needing to relocate in search of higher wages.     

Preference for equivalent random variables: A price for unbounded utilities

Savage's expected utility theory orders acts by the expectation of the utility function for outcomes over states. Therefore, preference between acts depends only on the utilities for outcomes and the probability distribution of states. When acts have more than finitely many possible outcomes, then utility is bounded in Savage's theory. This paper explores consequences of allowing preferences over acts with unbounded utility. Under certain regularity assumptions about indifference, and in order to respect (uniform) strict dominance between acts, there will be a strict preference between some pairs of acts that have the same distribution of outcomes. Consequently in these cases, preference is not a function of utility and probability alone.     

Simplified Implementation of the Heckman Estimator of the Dynamic Probit Model and a Comparison with Alternative Estimators*

This paper presents a convenient shortcut method for implementing the Heckman estimator of the dynamic random effects probit model and other dynamic nonlinear panel data models using standard software. It then compares the estimators proposed by Heckman, Orme and Wooldridge, based on three alternative approximations, first in an empirical model for the probability of unemployment and then in a set of simulation experiments. The results indicate that none of the three estimators dominates the other two in all cases. In most cases, all three estimators display satisfactory performance, except when the number of time periods is very small.