The Relevance of Socioeconomic and Health Policy Issues to Clinical Research: The Case of MRI and Neuroradiology

1989 ◽  
Vol 5 (2) ◽  
pp. 195-206 ◽  
Author(s):  
Eric B. Larson ◽  
Daniel L. Kent
Keyword(s):  
Public Policy ◽  
New Technologies ◽  
Medical Profession ◽  
New Technology ◽  
Sound Studies ◽  
Leadership Role ◽  
Early Evaluation ◽  
Diagnostic Technology ◽  
Magnetic Resonance Imaging Mri ◽  
Diagnostic Technologies

Magnetic resonance imaging (MRI) is a high-cost, new technology with great potential for improving patient care. The lack of a coherent public policy for MRI, or its predecessor computed tomography (CT), has caused considerable problems. Lack of an enunciated public policy has led to inconsistent reimbursement and reimbursement levels that develop in haphazard ways. Furthermore, diffusion has been unpredictable and has led to geographical excesses and deficiencies.Technology assessments of MRI, although numerous, have used inconsistent criteria to rate MRI's clinical efficacy. The lack of methodologically sound studies of MRI severely hampered early evaluation. This article examines these problems and suggests that the medical profession take a stronger leadership role in developing policies for expensive, promising new diagnostic technologies. The profession should promote, demand, and perform rigorous clinical evaluations of new technologies, and help develop a consensus regarding the criteria for what constitutes a clinically valuable advance in diagnostic technology.

Medical Ethical and Policy Issues Arising from RIA

2008 ◽  
pp. 324-332
Author(s):  
Jimmie L. Joseph ◽  
David P. Cook
Keyword(s):  
Public Policy ◽  
Clinical Trials ◽  
New Technologies ◽  
Medical Profession ◽  
Leading Edge ◽  
Medical Treatments ◽  
Life Saving ◽  
Life Threatening ◽  
Care Technology ◽  
Social Upheaval

New technologies can lead to social upheaval and ethical dilemmas which are unrecognized at the time of their introduction. Medical care technology has advanced rapidly over the course of the past two decades and has frequently been accompanied by unforeseen consequences for individuals, the medical profession and government budgets, with concomitant implications for society and public policy (Magner, 1992; Marti-Ibanez, 1962). Advances in information technology (IT) during the last decade and a half are now impacting the medical profession, and the delivery of medical advances, in ways that will impact public policy debates for the foreseeable future. The World Wide Web (Web) makes information that was once the eminent domain of medical professionals available to average citizens who are increasingly demanding medical treatments from the leading edge of medical technology. For example, CenterWatch (www.centerwatch. com) provides a wealth of information concerning clinical trials and offers a conduit by which patients can become involved in such studies. The availability of such information has also led to patients suffering from life-threatening diseases not part of such clinical trials to request special access to potentially life-saving therapies. As a result, the Web is increasing the complexity of answering public policy questions surrounding what medical technologies to make available to the public, who will be eligible to receive new medical treatments, and at what cost.

scholarly journals HEADROOM BEYOND THE QUALITY- ADJUSTED LIFE-YEAR: THE CASE OF COMPLEX PEDIATRIC NEUROLOGY

2017 ◽  
Vol 33 (1) ◽  
pp. 5-10 ◽  
Author(s):  
Kirsten J.M. van Nimwegen ◽  
Richard J. Lilford ◽  
Gert J. van der Wilt ◽  
Janneke P.C. Grutters
Keyword(s):  
New Technologies ◽  
Diagnostic Yield ◽  
New Technology ◽  
Cost Effective ◽  
Quality Adjusted Life Year ◽  
Qaly Gain ◽  
Maximum Effect ◽  
Pediatric Neurology ◽  
Early Evaluation ◽  
Quality Adjusted Life

Objectives: The headroom method was introduced for the very early evaluation of the potential value of new technologies. It allows for establishing a ceiling price for technologies to still be cost-effective by combining the maximum effect a technology might yield, the maximum willingness-to-pay (WTP) for this effect, and potential downstream expenses and savings. Although the headroom method is QALY-based, not all innovations are expected to result in QALY gain.Methods: This study explores the feasibility and usefulness of the headroom method in the evaluation of technologies that are unlikely to result in QALY gain. This will be illustrated with the diagnostic trajectory of complex pediatric neurology (CPN).Results: Our headroom analysis showed a large room for improvement in the current diagnostic trajectory of CPN in terms of diagnostic yield. Combining this with a maximum WTP value for an additional diagnosis and the potential downstream expenses and savings, resulted in a total headroom of €15,028. This indicates that a new technology in this particular diagnostic trajectory, might be cost-effective as long as its costs do not exceed €15,028.Conclusions: The headroom method seems a useful tool in the very early evaluation of medical technologies, also in cases when immediate QALY gain is unlikely. It allows for allocating healthcare resources to those technologies that are most promising. It should be kept in mind, however, that the headroom assumes an optimistic scenario, and for that reason cannot guarantee future cost-effectiveness. It might be most useful for ruling out those technologies that are unlikely to be cost-effective.

Medical Ethical and Policy Issues Arising from RIA

2011 ◽  
pp. 1910-1919
Author(s):  
Jimmie L. Joseph ◽  
David P. Cook
Keyword(s):  
Public Policy ◽  
Clinical Trials ◽  
New Technologies ◽  
Medical Profession ◽  
Leading Edge ◽  
Medical Treatments ◽  
Life Saving ◽  
Life Threatening ◽  
Care Technology ◽  
Social Upheaval

New technologies can lead to social upheaval and ethical dilemmas which are unrecognized at the time of their introduction. Medical care technology has advanced rapidly over the course of the past two decades and has frequently been accompanied by unforeseen consequences for individuals, the medical profession and government budgets, with concomitant implications for society and public policy (Magner, 1992; Marti- Ibanez, 1962). Advances in information technology (IT) during the last decade and a half are now impacting the medical profession, and the delivery of medical advances, in ways that will impact public policy debates for the foreseeable future. The World Wide Web (Web) makes information that was once the eminent domain of medical professionals available to average citizens who are increasingly demanding medical treatments from the leading edge of medical technology. For example, CenterWatch (www.centerwatch. com) provides a wealth of information concerning clinical trials and offers a conduit by which patients can become involved in such studies. The availability of such information has also led to patients suffering from life-threatening diseases not part of such clinical trials to request special access to potentially life-saving therapies. As a result, the Web is increasing the complexity of answering public policy questions surrounding what medical technologies to make available to the public, who will be eligible to receive new medical treatments, and at what cost.

How Important is the Scientific Literature in Guiding Clinical Decisions?: The Case of Magnetic Resonance Imaging

1993 ◽  
Vol 9 (2) ◽  
pp. 253-262 ◽  
Author(s):  
Scott D. Ramsey ◽  
Alan L. Hillman ◽  
Laura R. Renshaw ◽  
John R. Kimberly ◽  
Mark V. Pauly ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Information Dissemination ◽  
Scientific Literature ◽  
New Technology ◽  
Sources Of Information ◽  
Resonance Imaging ◽  
Publication Patterns ◽  
Magnetic Resonance Imaging Mri ◽  
Diagnostic Technologies

AbstractLittle is known about how information diffuses to clinicians and influences their purchase and use of new technology. This is especially true about the role of the scientific literature. As a case study, we examined the literature for magnetic resonance imaging (MRI) during the years preceding and the first five years following its clinical introduction. Using a computerized retrieval system, we identified approximately 1,700 citations in which MRI was the major topic. The clinical literature on MRI was heavily concentrated in radiology journals. Less than 28% of articles compared MRI with alternative diagnostic technologies. During the first five years of clinical availability, the diffusion patterns of scientific articles and operational units mirrored the example set by computerized tomography (CT), in that a substantial number of units were purchased in both research and nonresearch settings before studies were available comparing them to alternative diagnostic technologies. These patterns of diffusion, combined with other studies of the MRI literature's content and methodology, suggest that less comprehensive and objective sources of information were important in early purchasing decisions. This study also suggests that the present readership and publication patterns of professional journals may not facilitate effective, rapid information dissemination about innovations to a broad spectrum of clinicians.

The Recent Revolution in High Performance Computing

MRS Bulletin ◽  
1997 ◽  
Vol 22 (10) ◽  
pp. 5-6
Author(s):  
Horst D. Simon
Keyword(s):  
High Performance Computing ◽  
High Performance ◽  
New Technologies ◽  
New Technology ◽  
Parallel Architecture ◽  
Time Frame ◽  
Good News ◽  
Computing Industry ◽  
Time And Energy ◽  
Performance Computing

Recent events in the high-performance computing industry have concerned scientists and the general public regarding a crisis or a lack of leadership in the field. That concern is understandable considering the industry's history from 1993 to 1996. Cray Research, the historic leader in supercomputing technology, was unable to survive financially as an independent company and was acquired by Silicon Graphics. Two ambitious new companies that introduced new technologies in the late 1980s and early 1990s—Thinking Machines and Kendall Square Research—were commercial failures and went out of business. And Intel, which introduced its Paragon supercomputer in 1994, discontinued production only two years later.During the same time frame, scientists who had finished the laborious task of writing scientific codes to run on vector parallel supercomputers learned that those codes would have to be rewritten if they were to run on the next-generation, highly parallel architecture. Scientists who are not yet involved in high-performance computing are understandably hesitant about committing their time and energy to such an apparently unstable enterprise.However, beneath the commercial chaos of the last several years, a technological revolution has been occurring. The good news is that the revolution is over, leading to five to ten years of predictable stability, steady improvements in system performance, and increased productivity for scientific applications. It is time for scientists who were sitting on the fence to jump in and reap the benefits of the new technology.

Tradition and Innovation in Cataloguing Medieval Manuscripts

2021 ◽  
Vol 139 (1) ◽  
pp. 32-58
Author(s):  
Orietta Da Rold
Keyword(s):  
New Technologies ◽  
New Technology ◽  
Early Career ◽  
Digital Environment ◽  
Digital Form ◽  
Postgraduate Students ◽  
Medieval Manuscripts ◽  
Early Career Researchers ◽  
History Of ◽  
And Training

Abstract In this essay, I offer a brief history of manuscript cataloguing and some observations on the innovations this practice introduced especially in the digital form. This history reveals that as the cataloguing of medieval manuscripts developed over time, so did the research needs it served. What was often considered traditional cataloguing practices had to be mediated to accommodate new scholarly advance, posing interesting questions, for example, on what new technologies can bring to this discussion. In the digital age, in particular, how do digital catalogues interact with their analogue counterparts? What skills and training are required of scholars interacting with this new technology? To this end, I will consider the importance of the digital environment to enable a more flexible approach to cataloguing. I will also discuss new insights into digital projects, especially the experience accrued by the The Production and Use of English Manuscripts 1060 to 1220 Project, and then propose that in the future cataloguing should be adaptable and shareable, and make full use of the different approaches to manuscripts generated by collaboration between scholars and librarians or the work of postgraduate students and early career researchers.

scholarly journals A Component-Sizing Methodology for a Hybrid Electric Vehicle Using an Optimization Algorithm

Energies ◽  
2021 ◽  
Vol 14 (11) ◽  
pp. 3147
Author(s):  
Kiyoung Kim ◽  
Namdoo Kim ◽  
Jongryeol Jeong ◽  
Sunghwan Min ◽  
Horim Yang ◽  
...  
Keyword(s):  
Energy Efficiency ◽  
Electric Vehicle ◽  
Optimization Algorithm ◽  
Hybrid Electric Vehicle ◽  
New Technologies ◽  
New Technology ◽  
Dynamic Performance ◽  
Minimum Principle ◽  
Component Sizing ◽  
Hybrid Electric

Many leading companies in the automotive industry have been putting tremendous effort into developing new powertrains and technologies to make their products more energy efficient. Evaluating the fuel economy benefit of a new technology in specific powertrain systems is straightforward; and, in an early concept phase, obtaining a projection of energy efficiency benefits from new technologies is extremely useful. However, when carmakers consider new technology or powertrain configurations, they must deal with a trade-off problem involving factors such as energy efficiency and performance, because of the complexities of sizing a vehicle’s powertrain components, which directly affect its energy efficiency and dynamic performance. As powertrains of modern vehicles become more complicated, even more effort is required to design the size of each component. This study presents a component-sizing process based on the forward-looking vehicle simulator “Autonomie” and the optimization algorithm “POUNDERS”; the supervisory control strategy based on Pontryagin’s Minimum Principle (PMP) assures sufficient computational system efficiency. We tested the process by applying it to a single power-split hybrid electric vehicle to determine optimal values of gear ratios and each component size, where we defined the optimization problem as minimizing energy consumption when the vehicle’s dynamic performance is given as a performance constraint. The suggested sizing process will be helpful in determining optimal component sizes for vehicle powertrain to maximize fuel efficiency while dynamic performance is satisfied. Indeed, this process does not require the engineer’s intuition or rules based on heuristics required in the rule-based process.

Technological Change and the International System

2021 ◽  
Vol 73 (3) ◽  
pp. 545-589 ◽  
Author(s):  
Helen V. Milner ◽  
Sondre Ulvund Solstad
Keyword(s):  
Technology Adoption ◽  
Technological Change ◽  
Technology Use ◽  
New Technologies ◽  
Causal Effect ◽  
International System ◽  
New Technology ◽  
World Politics ◽  
Adoption Of Technology ◽  
Adoption Of New Technology

ABSTRACTDo world politics affect the adoption of new technology? States overwhelmingly rely on technology invented abroad, and their differential intensity of technology use accounts for many of their differences in economic development. Much of the literature on technology adoption focuses on domestic conditions. The authors argue instead that the structure of the international system is critical because it affects the level of competition among states, which in turn affects leaders’ willingness to enact policies that speed technology adoption. Countries adopt new technology as they seek to avoid being vulnerable to attack or coercion by other countries. By systematically examining states’ adoption of technology over the past two hundred years, the authors find that countries adopt new technologies faster when the international system is less concentrated, that changes in systemic concentration have a temporally causal effect on technology adoption, and that government policies to promote technology adoption are related to concerns about rising international competition. A competitive international system is an important incentive for technological change and may underlie global technology waves.

New Technologies and the Prospects for Europe's Farmers

1988 ◽  
Vol 17 (1) ◽  
pp. 2-6
Author(s):  
Patrick Commins ◽  
James V. Higgins
Keyword(s):  
New Technologies ◽  
New Technology ◽  
Economic Resources ◽  
Agricultural Producers ◽  
Future Developments ◽  
Commercial Viability

This article examines possible future developments with particular references to the role of new technology and the implications for Europe's agricultural producers. The main proposition is that the maintenance of commercial viability will oblige producers to adopt innovations and new practices, but the most successful will be farmers with the greater economic resources and superior managerial abilities. The outcome will be increasing socio-economic differentiation within the EEC population of agricultural producers and an increasing proportion of farm output coming from the top 20 per cent of farmers in the Community.

scholarly journals Technology Adoption and Consumer Payments: Evidence from Survey Data

2003 ◽  
Vol 2 (2) ◽  
Author(s):  
Fumiko Hayashi ◽  
Elizabeth Klee
Keyword(s):  
Technology Adoption ◽  
Survey Data ◽  
New Technologies ◽  
New Technology ◽  
The Internet ◽  
Electronic Payment ◽  
Point Of Sale ◽  
Goods And Services ◽  
Transaction Value ◽  
Debit Cards

Consumers pay for hundreds of goods and services each year, but across households and across goods, consumers do not choose to pay the same way. This paper posits that payment choices depend in part on consumers' propensity to adopt new technologies and in part on the nature of the transaction. To test this hypothesis, this paper analyzes consumer's payment instrument use at the point of sale and for bill payment. The sample includes consumers surveyed in 2001, who are primarily users of the Internet. The results indicate that consumers who use new technology or computers are more likely to use electronic forms of payment, such as debit cards and electronic bill payments. Particularly, the use of direct deposit is a significant predictor of electronic payment use. Furthermore, the results indicate that payment choice depends on the characteristics of the transaction, such as the transaction value, the physical characteristics of the point of sale, and a bill's frequency and value variability.

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