scholarly journals Information Avoidance and Medical Screening: A Field Experiment in China

2020 ◽  
Author(s):  
Yufeng Li ◽  
Juanjuan Meng ◽  
Changcheng Song ◽  
Kai Zheng
Keyword(s):  
High Risk ◽  
Decision Analysis ◽  
Field Experiment ◽  
Transaction Cost ◽  
Disease Risk ◽  
Medical Screening ◽  
Information Avoidance ◽  
Subjective Beliefs ◽  
Price Increases

Will individuals, especially high-risk individuals, avoid a disease test because of information avoidance? We conduct a field experiment to investigate this issue. We vary the price of a diabetes test (price experiment) and offer both a diabetes test and a cancer test (disease experiment) after eliciting participants’ subjective beliefs about their disease risk. We find evidence that, first, some people avoid the test even when there is neither a monetary nor a transaction cost, and second, both low- and high-risk individuals select out of the test as the price increases. We explain our findings using three classes of models of anticipatory utility. This paper was accepted by Yan Chen, decision analysis.

scholarly journals A Peri-Implant Disease Risk Score for Patients with Dental Implants: Validation and the Influence of the Interval between Maintenance Appointments

2019 ◽  
Vol 8 (2) ◽  
pp. 252 ◽  
Author(s):  
Miguel de Araújo Nobre ◽  
Francisco Salvado ◽  
Paulo Nogueira ◽  
Evangelista Rocha ◽  
Peter Ilg ◽  
...  
Keyword(s):  
High Risk ◽  
Risk Score ◽  
Disease Risk ◽  
Disease Incidence ◽  
Risk Groups ◽  
Risk Profile ◽  
Moderate Risk ◽  
C Statistic ◽  
Disease Risk Score ◽  
Very High

Background: There is a need for tools that provide prediction of peri-implant disease. The purpose of this study was to validate a risk score for peri-implant disease and to assess the influence of the recall regimen in disease incidence based on a five-year retrospective cohort. Methods: Three hundred and fifty-three patients with 1238 implants were observed. A risk score was calculated from eight predictors and risk groups were established. Relative risk (RR) was estimated using logistic regression, and the c-statistic was calculated. The effect/impact of the recall regimen (≤ six months; > six months) on the incidence of peri-implant disease was evaluated for a subset of cases and matched controls. The RR and the proportional attributable risk (PAR) were estimated. Results: At baseline, patients fell into the following risk profiles: low-risk (n = 102, 28.9%), moderate-risk (n = 68, 19.3%), high-risk (n = 77, 21.8%), and very high-risk (n = 106, 30%). The incidence of peri-implant disease over five years was 24.1% (n = 85 patients). The RR for the risk groups was 5.52 (c-statistic = 0.858). The RR for a longer recall regimen was 1.06, corresponding to a PAR of 5.87%. Conclusions: The risk score for estimating peri-implant disease was validated and showed very good performance. Maintenance appointments of < six months or > six months did not influence the incidence of peri-implant disease when considering the matching of cases and controls by risk profile.

Algeria aims to put its finances on a sustainable path

2021 ◽  
Keyword(s):  
High Risk ◽  
Income Tax ◽  
Oil And Gas ◽  
Prime Minister ◽  
Policy Reforms ◽  
Content Type ◽  
Finance Minister ◽  
Price Increases ◽  
Investment Law ◽  
Subsidy Reform

Significance The prime minister and finance minister, Aymane Benabderrahmane, has loaded some substantive policy reforms into the 2022 budget law, including a provision for reform of the subsidy system, revisions to the investment law and changes to income tax. Impacts There is a high risk that within the next five years there will be a slump in oil and gas prices. Algeria’s heavy reliance on hydrocarbons makes it particularly vulnerable once momentum builds up for global decarbonisation. Subsidy reform will entail price increases, even if they are gradually applied.

Assessment of foot-and-mouth disease risk areas in mainland China based spatial multi-criteria decision analysis

2021 ◽  
Author(s):  
Wang Haoran ◽  
Xiao Jianhua ◽  
Ouyang Maolin ◽  
Gao Hongyan ◽  
Bie Jia ◽  
...  
Keyword(s):  
Risk Factors ◽  
Decision Analysis ◽  
Disease Risk ◽  
Mainland China ◽  
Foot And Mouth Disease ◽  
Mouth Disease ◽  
Multi Criteria Decision Analysis ◽  
Foot And Mouth ◽  
Risk Areas ◽  
And Control

Abstract Background Foot-and-mouth disease (FMD) is a highly contagious viral disease of cloven-hoofed animals. As a transboundary animal disease, the prevention and control of FMD are important. This study was based on spatial multi-criteria decision analysis (MCDA) to assess FMD risk areas in mainland China. Ten risk factors were identified for constructing risk maps by scoring, and the analytic hierarchy process (AHP) was used to calculate the criteria weights of all factors. Different risk factors had different units and attributes, and fuzzy membership was used to standardize the risk factors. The weighted linear combination (WLC) and one-at-a-time (OAT) were used to obtain risk and uncertainty maps as well as to perform sensitivity analysis. Results Four major risk areas were identified in mainland China, including western (Xinjiang and Tibet), southern (Yunnan, Guizhou, Guangxi and Guangdong), northern (Gansu, Ningxia and Inner Mongolia), and eastern (Hebei, Henan, Anhui, Jiangsu and Shandong). We found spring as the main season for FMD outbreaks. Risk areas were associated with the distance to previous outbreak points, grazing areas and cattle density. Receiver operating characteristic (ROC) analysis indicated that the risk map had good predictive power (AUC = 0.8532). Conclusions These results can be used to delineate FMD risk areas in mainland China, and provinces can adopt the targeted preventive measures and control strategies.

scholarly journals Predicting 10-year cardiovascular risk using WHO/ISH risk prediction chart among urban population in Salem

2018 ◽  
Vol 5 (12) ◽  
pp. 5228
Author(s):  
K. Premanandh ◽  
R. Shankar
Keyword(s):  
Cardiovascular Risk ◽  
High Risk ◽  
Risk Prediction ◽  
Disease Risk ◽  
Smoking Status ◽  
Cardiovascular Disease Risk ◽  
Total Serum ◽  
Total Serum Cholesterol ◽  
Cvd Risk ◽  
Very High

Background: Coronary vascular disease (CVD) risk estimation tools are a simple means of identifying those at high risk in a community and hence a potentially cost-effective strategy for CVD prevention in resource-poor countries. The WHO /ISH risk prediction charts provide approximate estimates of cardiovascular disease risk in people who do not have established coronary heart disease, stroke or other atherosclerotic disease.Methods: A total of 280 subjects between 40 to 70 years of age were included in this cross sectional study. Eligible households was selected randomly (every 5th household) for the interview using systematic random sampling. Age, gender, smoking status, systolic blood pressure, presence or absence of diabetes and total serum cholesterol were used to compute the total CVD risk using WHO/ISH CVD risk prediction chart. The chart stratify an individual into low (<10%), moderate (10% to <20%), high (20% to <30%), and very high (>30%) risk groups.Results: Moderate and high CVD risk were 12.14% and 7.5% respectively. Of total study participants, 2.5% had very high risk (>40%). High risk (binge drinking) alcohol drinkers (p=0.04) and abdominal obesity (p=0.0001) were significantly associated with higher CVD risk. Higher prevalence of behavioral risk factors was also reported in our study population.Conclusions: A large proportion of the population is at moderate and high cardiovascular risk. Risk stratification and identification of individuals with a high risk for CHD who could potentially benefit from intensive primary prevention efforts are critically important in reducing the burden of CVD in India.

scholarly journals Clinical Trials in High-Risk Medulloblastoma: Evolution of the SIOP-Europe HR-MB Trial

Cancers ◽  
2022 ◽  
Vol 14 (2) ◽  
pp. 374
Author(s):  
Simon Bailey ◽  
Nicolas André ◽  
Lorenza Gandola ◽  
Maura Massimino ◽  
Stefan Rutkowski ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Clinical Trials ◽  
High Risk ◽  
Disease Risk ◽  
Risk Groups ◽  
Randomised Clinical Trial ◽  
Paediatric Oncology ◽  
High Dose ◽  
The Status ◽  
Risk Patients

Medulloblastoma patients receive adapted therapies stratified according to their risk-profile. Favourable, standard, and high disease-risk groups are each defined by the status of clinical and pathological risk factors, alongside an evolving repertoire of diagnostic and prognostic biomarkers. Medulloblastoma clinical trials in Europe are coordinated by the International Society for Paediatric Oncology (SIOP-Europe) brain tumour group. Favourable and standard-risk patients are eligible for the SIOP-PNET5-MB clinical trial protocol. In contrast, therapies for high-risk disease worldwide have, to date, encompassed a range of different treatment philosophies, with no clear consensus on approach. Higher radiotherapy doses are typically deployed, delivered either conventionally or in hyper-fractionated/accelerated regimens. Similarly, both standard and high-dose chemotherapies were assessed. However, trials to date in high-risk medulloblastoma have commonly been institutional or national, based on modest cohort sizes, and have not evaluated the relative performance of different strategies in a randomised fashion. We describe the concepts and design of the SIOP-E high-risk medulloblastoma clinical trial (SIOP-HR-MB), the first international biomarker-driven, randomised, clinical trial for high-risk medulloblastoma. SIOP-HR-MB is programmed to recruit >800 patients in 16 countries across Europe; its primary objectives are to assess the relative efficacies of the alternative established regimens. The HR-MB patient population is molecularly and clinically defined, and upfront assessments incorporate a standardised central review of molecular pathology, radiology, and radiotherapy quality assurance. Secondary objectives include the assessment of (i) novel therapies within an upfront ‘window’ and (ii) therapy-associated neuropsychology, toxicity, and late effects, alongside (iii) the collection of materials for comprehensive integrated studies of biological determinants within the SIOP-HR-MB cohort.

scholarly journals A Novel Strategy to Identify Haematology Patients at High Risk of Developing Aspergillosis

2021 ◽  
Vol 12 ◽  
Author(s):  
James S. Griffiths ◽  
P. Lewis White ◽  
Aiysha Thompson ◽  
Diogo M. da Fonseca ◽  
Robert J. Pickering ◽  
...  
Keyword(s):  
High Risk ◽  
Disease Risk ◽  
Low Risk ◽  
Fungal Resistance ◽  
Haematopoietic Stem Cell ◽  
Cell Transplant ◽  
Negative Results ◽  
Risk Patients ◽  
Haematology Patients ◽  
Anti Fungal

Invasive Aspergillosis (IA), typically caused by the fungus Aspergillus fumigatus, is a leading cause of morbidity and mortality in immunocompromised patients. IA remains a significant burden in haematology patients, despite improvements in the diagnosis and treatment of Aspergillus infection. Diagnosing IA is challenging, requiring multiple factors to classify patients into possible, probable and proven IA cohorts. Given the low incidence of IA, using negative results as exclusion criteria is optimal. However, frequent false positives and severe IA mortality rates in haematology patients have led to the empirical use of toxic, drug-interactive and often ineffective anti-fungal therapeutics. Improvements in IA diagnosis are needed to reduce unnecessary anti-fungal therapy. Early IA diagnosis is vital for positive patient outcomes; therefore, a pre-emptive approach is required. In this study, we examined the sequence and expression of four C-type Lectin-like receptors (Dectin-1, Dectin-2, Mincle, Mcl) from 42 haematology patients and investigated each patient’s anti-Aspergillus immune response (IL-6, TNF). Correlation analysis revealed novel IA disease risk factors which we used to develop a pre-emptive patient stratification protocol to identify haematopoietic stem cell transplant patients at high and low risk of developing IA. This stratification protocol has the potential to enhance the identification of high-risk patients whilst reducing unnecessary treatment, minimizing the development of anti-fungal resistance, and prioritising primary disease treatment for low-risk patients.

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