Prostate cancer: a review of common underwriting problems, Part 1

Part 1 of a two-part discussion of Prostate Cancer from an underwriting perspective, covers the epidemiology and screening for prostate cancer. Included is a "Primer on Screening Tests" that discusses problems with digital rectal exam (DRE) and prostate specific antigen (PSA) as screening tests. Approaches to enhancing the use of PSA for screening including age and race specific ranging, PSA density, PSA velocity, free PSA, and complexed PSA are discussed. Arguments for and against the use of PSA for prostate cancer are presented. The widespread use of PSA testing in the insurance setting is contrasted with cautious statements concerning general use of PSA in the clinical preventive care setting. In a future issue, Part 2 will cover staging and follow-up of treated prostate cancer.     

The role of low expectations in health and education investment and hazardous consumption

Abstract .  Young people with little 'social or health capital' may be more likely to take up hazardous consumption and shun investments in human capital, raising their likelihood of a 'rags to rags' sequence. First, diminishing marginal utility could raise the marginal benefit of hazardous consumption and the cost of investment. But poor youths may also have lower expectations of future success, independent of the choices they make. Lower expectations of success could reduce the future cost of hazardous consumption and benefit of investment. We test the effect of expectations on decisions to smoke, drink hazardously, exercise, and complete high school, using a longitudinal study of youth in New Zealand. We find that 15-year-olds' expectations of success predict the subsequent onset of smoking, lack of exercise, and failure to complete high school, but not hazardous drinking. While some of the influence of expectations can be explained by low social and health capital, IQ, and other factors, expectations retain a direct effect on smoking and exercise once these other factors are controlled for.     

The reversal of large stock price declines: The case of large firms

This paper examines the long-run reversal pattern for a sample of large U.S. firms that experienced significant stock price declines of more than 20 percent during a specific month. The results from the analysis are largely consistent with the overreaction hypothesis and significantly greater in magnitude than those reported by previous studies. Six and 12 months after their initial price decline, the stocks of large firms earn approximately 4 and 12 percent in excess of what was expected, respectively. However, the magnitude and trend of that reversal differs substantially across industries. Technology stocks experience the largest and strongest reversal pattern followed by manufacturing stocks, while service industry stocks exhibit a clear downward drift that lasts up to three years and can be described as investorunderreaction to the large price drop.     

Sarcoidosis: a review

Sarcoidosis is a systemic inflammatory disorder characterized by non-caseating granulomas found in the lung, lymphatic systems, and potentially in a host of other tissues and organs. Despite intriguing hints of infectious or environmental etiology, causation remains a mystery. The diagnosis, therefore, requires demonstration of granulomatous inflammation in more than one organ and exclusion of any of the known causes of granulomatous disease or local sarcoid reaction. Clinicians and underwriters alike frequently forget the latter requirement. For this reason, the other causes of granulomatous inflammation will be included in this treatise. Although the vast majority of applicants with sarcoidosis exhibit limited or remitting disease, the remaining applicants represent increased risk of both morbidity and mortality. This paper reviews the relevant clinical, radiographic, and laboratory findings that may help identify those applicants with increased or prohibitive risk for life or disability insurance.     

Images paired with concrete claims improve skeptical consumers’ responses to advertising promoting a firm’s good deeds

Previous research has focused attention on state skepticism over corporate social responsibility (CSR) communications, but little work has focused on how to override preexisting differences in consumer skepticism. To gain insight into this issue, the present studies explore whether company ads promoting a firm’s good deeds generate more positive responses when the ads contain concrete claims and/or images related to the firm’s corporate social responsibility claims, and how these elements of the CSR communication interact with individual differences in advertising skepticism. Results show that highly skeptical consumers (a) respond less favorably to ads than less skeptical consumers, overall; (b) respond more favorably to ads that contain a combination of concrete claims and images supporting those claims; and (c) respond as favorably as less skeptical consumers when ads feature concrete claims with supporting images. Additional results suggest that images are effective among highly skeptical consumers because skeptical consumers have a reduced ability to visualize advertising claims. Implications and future research directions are discussed.     

Bond Market Response to the Collapse of Prominent Investment Banks

We find that the Bear Stearns rescue in March 2008 elicited a neutral or moderately favorable impact on bond prices. Conversely, we find that the Lehman Brothers failure (combined with news about Merrill Lynch and American International Group) in September 2008 elicited a pronounced negative impact. Bond prices of financial firms suffered more than bonds of nonfinancial firms following the Lehman failure. Our multivariate analysis shows that bonds issued by financial institutions that were previously presumed to be protected (based on bond rating and firm size) suffered more pronounced losses in response to the Lehman failure.     

The limits to stock index arbitrage: Examining S&P 500 futures and SPDRS

This study examines factors affecting stock index spot versus futures pricing and arbitrage opportunities by using the S&P 500 cash index and the S&P 500 Standard and Poor's Depository Receipt (SPDR) Exchange‐Traded Fund (ETF) as “underlying cash assets.” Potential limits to arbitrage when using the cash index are the staleness of the underlying cash index, trading costs, liquidity (volume) issues of the underlying assets, the existence of sufficient time to execute profitable arbitrage transactions, short sale restrictions, and the extent to which volatility affects mispricing. Alternatively, using the SPDR ETF as the underlying asset mitigates staleness and trading cost problems as well as the effects of volatility associated with the staleness of the cash index. Minute‐by‐minute prices are compared over different volatility levels to determine how these factors affect the limits of S&P 500 futures arbitrage. Employing the SPDR as the cash asset examines whether a liquid tradable single asset with low trading costs can be used for pricing and arbitrage purposes. The analysis examines how long mispricing lasts, the impact of volatility on mispricing, and whether sufficient volume exists to implement arbitrage. The minute‐by‐minute liquidity of the futures market is examined using a new transaction volume futures database. The results show that mispricings exist regardless of the choice of the underlying cash asset, with more negative mispricings for the SPDR relative to the S&P 500 cash index. Furthermore, mispricings are more frequent in high‐ and mid‐volatility months than in low‐volatility months and are associated with higher volume during high‐volatility months. © 2008 Wiley Periodicals, Inc. Jrl Fut Mark 28:1182–1205, 2008     

Trading Halts and Price Discovery

Trading halts have their proponents and opponents. Recent literature has examined the benefits of halts, if any, by studying the consequences of halts on order flow and price volatility. This study complements existing literature by examining the consequences of trading halts on price discovery. Our results indicate that stock price adjustments surrounding trading halts are conditioned on the underlying event that caused the halt. The weighted price contributions of all subsamples are concentrated in the halt period and some subsamples show significant price contribution in the pre-halt period as well. We find minimal evidence of price discovery continuing after the halt is removed. In addition, cross-sectional analysis shows that price discovery in the pre-halt and halt periods are more pronounced for larger firms and for firms with specific news events.      

Underwriting idiopathic interstitial lung diseases

Interstitial lung disease (ILD) incorporates a large number of pathologic processes that have in the interstitial compartment of the lung. This article focuses on the diagnosis, morbidity and mortality implications of persons diagnosed with idiopathic interstitial pneumonias/fibrosis. Even within this category, the mortality and morbidity varies greatly (from months to near-normal mortality) given the specific disease present.