scholarly journals Measuring the Impact of an Open Web-Based Prescribing Data Analysis Service on Clinical Practice: Cohort Study on NHS England Data (Preprint)

2018 ◽  
Author(s):  
Alex J Walker ◽  
Helen J Curtis ◽  
Richard Croker ◽  
Seb Bacon ◽  
Ben Goldacre
Keyword(s):  
Clinical Practice ◽  
Fixed Effects ◽  
Positive Impact ◽  
Fixed Effects Model ◽  
Web Based ◽  
Practice Level ◽  
Prescribing Quality ◽  
Two Measures ◽  
The Impact

BACKGROUND OpenPrescribing is a freely accessible service that enables any user to view and analyze the National Health Service (NHS) primary care prescribing data at the level of individual practices. This tool is intended to improve the quality, safety, and cost-effectiveness of prescribing. OBJECTIVE We aimed to measure the impact of OpenPrescribing being viewed on subsequent prescribing. METHODS Having preregistered our protocol and code, we measured three different metrics of prescribing quality (mean percentile across 34 existing OpenPrescribing quality measures, available “price-per-unit” savings, and total “low-priority prescribing” spend) to see whether they changed after the viewing of Clinical Commissioning Group (CCG) and practice pages. We also measured whether practices whose data were viewed on OpenPrescribing differed in prescribing, prior to viewing, compared with those who were not. We used fixed-effects and between-effects linear panel regression to isolate change over time and differences between practices, respectively. We adjusted for the month of prescribing in the fixed-effects model to remove underlying trends in outcome measures. RESULTS We found a reduction in available price-per-unit savings for both practices and CCGs after their pages were viewed. The saving was greater at practice level (−£40.42 per thousand patients per month; 95% CI −54.04 to −26.81) than at CCG level (−£14.70 per thousand patients per month; 95% CI −25.56 to −3.84). We estimate a total saving since launch of £243 thosand at practice level and £1.47 million at CCG level between the feature launch and end of follow-up (August to November 2017) among practices viewed. If the observed savings from practices viewed were extrapolated to all practices, this would generate £26.8 million in annual savings for the NHS, approximately 20% of the total possible savings from this method. The other two measures were not different after CCGs or practices were viewed. Practices that were viewed had worse prescribing quality scores overall prior to viewing. CONCLUSIONS We found a positive impact from the use of OpenPrescribing, specifically for the class of savings opportunities that can only be identified by using this tool. Furthermore, we show that it is possible to conduct a robust analysis of the impact of such a Web-based service on clinical practice.

scholarly journals Measuring the Impact of an Open Online Prescribing Data Analysis Service on Clinical Practice: a Cohort Study in NHS England Data

2018 ◽  
Author(s):  
Alex J Walker ◽  
Helen J Curtis ◽  
Richard Croker ◽  
Seb Bacon ◽  
Ben Goldacre
Keyword(s):  
Clinical Practice ◽  
Confidence Interval ◽  
Fixed Effects ◽  
Positive Impact ◽  
Fixed Effects Model ◽  
Practice Level ◽  
Prescribing Quality ◽  
Two Measures ◽  
Clinically Significant ◽  
The Impact

AbstractBackgroundOpenPrescribing is a freely accessible service that enables any user to view and analyse NHS primary care prescribing data at the level of individual practices. This tool is intended to improve the quality, safety, and cost-effectiveness of prescribing.ObjectivesWe set out to measure the impact of OpenPrescribing being viewed on subsequent prescribing.MethodsHaving pre-registered our protocol and code, we measured three different metrics of prescribing quality (mean percentile across 34 existing OpenPrescribing quality measures, available “price-per-unit” savings, and total “low-priority prescribing” spend) to see if they changed after CCG and practice pages were viewed. We also measured whether practices whose data were viewed on OpenPrescribing differed in prescribing, prior to viewing, to those who were not. We used fixed effects and between effects linear panel regression, to isolate change over time and differences between practices respectively. We adjusted for month of prescribing in the fixed effects model, to remove underlying trends in outcome measures.ResultsWe found a reduction in available price-per-unit savings for both practices and CCGs after their pages were viewed. The saving was greater at the practice level (−£40.42 per thousand patients per month, 95% confidence interval −54.04 to −26.01) than at CCG level (−£14.70 per thousand patients per month, 95% confidence interval −25.56 to −3.84). We estimate a total saving since launch of £243k at practice level and £1.47m at CCG level between the feature launch and end of follow-up (August to November 2017) among practices viewed. If the observed savings from practices viewed were extrapolated to all practices, this would generate £26.8m in annual savings for the NHS, approximately 20% of the total possible savings from this method. The other two measures were not different after CCGs/practices were viewed. Practices which were viewed had worse prescribing quality scores overall, prior to viewing.ConclusionsWe found a clinically significant positive impact from use of OpenPrescribing, specifically for the class of savings opportunities that can only be identified by using this tool. We also show that it is possible to conduct a robust analysis of the impact of such an online service on clinical practice.

scholarly journals ANALISIS PENGARUH NON-TARIFF MEASURES EKSPOR KOMODITI CRUDE PALM OIL (CPO) INDONESIA KE NEGARA TUJUAN EKSPOR UTAMA

2018 ◽  
Vol 3 (2) ◽  
pp. 111-135 ◽  
Author(s):  
Ayu Renita Sari ◽  
Dedi Budiman Hakim ◽  
Lukytawati Anggraeni
Keyword(s):  
Gravity Model ◽  
Palm Oil ◽  
Fixed Effects ◽  
Positive Impact ◽  
Trade Flow ◽  
Trade Barriers ◽  
Fixed Effects Model ◽  
Crude Palm Oil ◽  
Phytosanitary Measures ◽  
The Impact

The study of this paper is aimed to evaluate the effects of non-tariff measures (NTM) upon Indonesian crude palm oil (CPO) export in the main destinations. Identified the competitiveness analysis using the Revealed Comparative Advantage index and the impact of the measures has estimated using a panel data gravity model constructed with disaggregated data about bilateral export trade flow of crude palm oil between Indonesia and its main trade partners for the period from 2003 to 2013. NTM represented binary variable that specified with a dummy variable. The gravity model has estimated with a fixed effects model and the results indicated that the existence of trade barriers to trade (TBT) appears to impede the Indonesian exports of CPO. But the existence of sanitary and phytosanitary measures (SPS) which related to food safety and the existence of trade remedy (antidumping, subsidy, safeguard) presented a positive impact upon the Indonesian exports of CPO. Keywords: Export, Non-Tariff Measures (NTM), Sanitary and Phytosanitary (SPS), Trade Barriers to Trade (TBT), Trade Remedy, Crude Palm Oil

scholarly journals The Impact of Haze on the Availability of Company Debt Financing: Evidence for Sustainability of Chinese Listed Companies

2019 ◽  
Vol 11 (3) ◽  
pp. 806 ◽  
Author(s):  
Bin Li ◽  
Peixiang Guo ◽  
Yating Zeng
Keyword(s):  
Development Strategy ◽  
Fixed Effects ◽  
Negative Impact ◽  
Positive Impact ◽  
Listed Companies ◽  
Debt Financing ◽  
Enterprise Management ◽  
Fixed Effects Model ◽  
Marginal Increment ◽  
The Impact

Based on the data of A-share listed companies in Shanghai and Shenzhen Stock Exchanges from 2013 to 2017 and the air quality monitoring data released by China Environmental Monitoring Station, the paper examines the impact of haze on the availability of company debt financing by using fixed-effects model and quantile regression model. The empirical results show that: Firstly, haze has a positive impact on the demand of company debt financing, and the positive effect is marginal increment. Secondly, haze has a negative impact on the availability of company debt financing, and the negative impact is also marginal increment. Further study found that heavy polluting industry characteristics weaken the impact of haze on company debt financing availability. The paper analyzes the influence of air pollution on enterprise management from the perspective of company debt financing and explains the necessity for companies to implement an environmentally sustainable development strategy.

scholarly journals ANALISIS PENGARUH NON-TARIFF MEASURES EKSPOR KOMODITI CRUDE PALM OIL (CPO) INDONESIA KE NEGARA TUJUAN EKSPOR UTAMA

2018 ◽  
Vol 3 (2) ◽  
pp. 111-135
Author(s):  
Ayu Renita Sari ◽  
Dedi Budiman Hakim ◽  
Lukytawati Anggraeni
Keyword(s):  
Gravity Model ◽  
Palm Oil ◽  
Fixed Effects ◽  
Positive Impact ◽  
Trade Flow ◽  
Trade Barriers ◽  
Fixed Effects Model ◽  
Crude Palm Oil ◽  
Phytosanitary Measures ◽  
The Impact

The study of this paper is aimed to evaluate the effects of non-tariff measures (NTM) upon Indonesian crude palm oil (CPO) export in the main destinations. Identified the competitiveness analysis using the Revealed Comparative Advantage index and the impact of the measures has estimated using a panel data gravity model constructed with disaggregated data about bilateral export trade flow of crude palm oil between Indonesia and its main trade partners for the period from 2003 to 2013. NTM represented binary variable that specified with a dummy variable. The gravity model has estimated with a fixed effects model and the results indicated that the existence of trade barriers to trade (TBT) appears to impede the Indonesian exports of CPO. But the existence of sanitary and phytosanitary measures (SPS) which related to food safety and the existence of trade remedy (antidumping, subsidy, safeguard) presented a positive impact upon the Indonesian exports of CPO. Keywords: Export, Non-Tariff Measures (NTM), Sanitary and Phytosanitary (SPS), Trade Barriers to Trade (TBT), Trade Remedy, Crude Palm Oil

Is the economic benefit of Bt cotton dying away in China

2015 ◽  
Vol 7 (2) ◽  
pp. 322-336 ◽  
Author(s):  
Fangbin Qiao ◽  
Yi Yao
Keyword(s):  
Economic Benefit ◽  
Fixed Effects ◽  
Positive Impact ◽  
Labor Cost ◽  
Bt Cotton ◽  
Fixed Effects Model ◽  
Content Type ◽  
Cotton Price ◽  
The Impact ◽  
Sown Area

Purpose – The purpose of this paper is to try to empirically answer whether the economic benefit of Bt cotton is dying away in China. As the development of the pest resistance and the outbreak of the secondary pest, it was believed that economic benefit of Bt cotton is dying away. And reduction of cotton sown area in recent years had been considered as one of the consequences. This study empirically estimates the impact of Bt cotton adoption on cotton sown area. Design/methodology/approach – This paper uses regression techniques based on provincial level data. In addition, the fixed-effects model is used to control the impact of those time-consistent variables. Finally, several scenarios are estimated for the robustness of the estimation results. Findings – This study shows that the adoption of Bt cotton has positive impact on cotton sown area. On the other hand, the increasing labor cost and decreasing cotton price might be the real reasons behind the decrease of cotton sown area. Originality/value – This, it is believed, is one of the first studies to empirically answer the impact of Bt cotton adoption on cotton sown area in China, using national representative data.

Dampak Kebijakan Moneter Pada Output Di Negara-Negara ASEAN Tahun 1980-2014

2017 ◽  
Vol 4 (1) ◽  
pp. 58-70
Author(s):  
Nur Widiastuti
Keyword(s):  
Monetary Policy ◽  
Interest Rate ◽  
Fixed Effects ◽  
Empirical Studies ◽  
Negative Relationship ◽  
Least Square ◽  
Fixed Effects Model ◽  
State Data ◽  
Ordinary Least Square ◽  
The Impact

The Impact of monetary Policy on Ouput is an ambiguous. The results of previous empirical studies indicate that the impact can be a positive or negative relationship. The purpose of this study is to investigate the impact of monetary policy on Output more detail. The variables to estimatate monetery poicy are used state and board interest rate andrate. This research is conducted by Ordinary Least Square or Instrumental Variabel, method for 5 countries ASEAN. The state data are estimated for the period of 1980 – 2014. Based on the results, it can be concluded that the impact of monetary policy on Output shown are varied.Keyword: Monetary Policy, Output, Panel Data, Fixed Effects Model

scholarly journals Cultural and Creative Cities and Regional Economic Efficiency: Context Conditions as Catalyzers of Cultural Vibrancy and Creative Economy

2021 ◽  
Vol 13 (13) ◽  
pp. 7150
Author(s):  
Silvia Cerisola ◽  
Elisa Panzera
Keyword(s):  
Fixed Effects ◽  
Local Context ◽  
Creative Economy ◽  
Fixed Effects Model ◽  
Creative Cities ◽  
Economic Output ◽  
Innovative Methodology ◽  
Holistic Conception ◽  
Panel Fixed Effects ◽  
The Impact

Following the hype that has been given to culture and creativity as triggers and enhancers of local economic performance in the last 20 years, this work originally contributes to the literature with the objective of assessing the impact of cultural and creative cities (CCCs) on the economic output of their regions. In this sense, the cultural and creative character of cities is considered a strategic strength and opportunity that can spillover, favoring the economic system of the entire regions in which the cities are located. Through an innovative methodology that exploits a regional production function estimated by a panel fixed effects model, the effect of cities’ cultural vibrancy and creative economy on the output of their regions is econometrically explored. The data source is the Cultural and Creative Cities Monitor (CCCM) provided by the JRC, which also allows the investigation of the possible role played by the enabling environment in catalyzing the action of cultural vibrancy and creative economy. The results are thoroughly examined: especially through cultural vibrancy, CCCs strategically support the output of their region. This is particularly the case when local context conditions—such as human capital and education, openness, tolerance and trust, and quality of governance—catalyze their effect. Overall, CCCs contribute to feeding a long-term self-supporting system, interpreted according to a holistic conception that includes economic, social, cultural, and environmental domains.

scholarly journals Is the use of two versus one long-acting bronchodilator by patients with COPD associated with a higher risk of acute coronary syndrome in real-world clinical practice?

2021 ◽  
Vol 8 (1) ◽  
pp. e000840
Author(s):  
Lianne Parkin ◽  
Sheila Williams ◽  
David Barson ◽  
Katrina Sharples ◽  
Simon Horsburgh ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Clinical Practice ◽  
Real World ◽  
Chronic Obstructive ◽  
Treatment Intensification ◽  
Cardiovascular Comorbidity ◽  
Coronary Syndrome ◽  
Long Acting ◽  
The Impact

BackgroundCardiovascular comorbidity is common among patients with chronic obstructive pulmonary disease (COPD) and there is concern that long-acting bronchodilators (long-acting muscarinic antagonists (LAMAs) and long-acting beta2 agonists (LABAs)) may further increase the risk of acute coronary events. Information about the impact of treatment intensification on acute coronary syndrome (ACS) risk in real-world settings is limited. We undertook a nationwide nested case–control study to estimate the risk of ACS in users of both a LAMA and a LABA relative to users of a LAMA.MethodsWe used routinely collected national health and pharmaceutical dispensing data to establish a cohort of patients aged >45 years who initiated long-acting bronchodilator therapy for COPD between 1 February 2006 and 30 December 2013. Fatal and non-fatal ACS events during follow-up were identified using hospital discharge and mortality records. For each case we used risk set sampling to randomly select up to 10 controls, matched by date of birth, sex, date of cohort entry (first LAMA and/or LABA dispensing), and COPD severity.ResultsFrom the cohort (n=83 417), we identified 5399 ACS cases during 281 292 person-years of follow-up. Compared with current use of LAMA therapy, current use of LAMA and LABA dual therapy was associated with a higher risk of ACS (OR 1.28 (95% CI 1.13 to 1.44)). The OR in an analysis restricted to fatal cases was 1.46 (95% CI 1.12 to 1.91).ConclusionIn real-world clinical practice, use of two versus one long-acting bronchodilator by people with COPD is associated with a higher risk of ACS.

Farm wages and public works

2015 ◽  
Vol 8 (1) ◽  
pp. 19-72 ◽  
Author(s):  
Kanika Mahajan
Keyword(s):  
Theoretical Model ◽  
Wage Rate ◽  
Fixed Effects ◽  
Positive Impact ◽  
Wage Growth ◽  
State Level ◽  
Random Allocation ◽  
Farm Sector ◽  
Content Type ◽  
The Impact

Purpose – The purpose of this paper is to examine the impact of National Rural Employment Guarantee Scheme (NREGS) on farm sector wage rate. This identification strategy rests on the assumption that all districts across India would have had similar wage trends in the absence of the program. The author argues that this assumption may not be true due to non-random allocation of districts to the program’s three phases across states and different economic growth paths of the states post the implementation of NREGS. Design/methodology/approach – To control for overall macroeconomic trends, the author allows for state-level time fixed effects to capture the differences in growth trajectories across districts due to changing economic landscape in the parent-state over time. The author also estimates the expected farm sector wage growth due to the increased public work employment provision using a theoretical model. Findings – The results, contrary to the existing studies, do not find support for a significantly positive impact of NREGS treatment on private cultivation wage rate. The theoretical model also shows that an increase in public employment work days explains very little of the total growth in cultivation wage post 2004. Originality/value – This paper looks specifically at farm sector wage growth and the possible impact of NREGS on it, accounting for state specific factors in shaping farm wages. Theoretical estimates are presented to overcome econometric limitations.

scholarly journals Recombinant Human Thyrotropin-Stimulated Radioiodine Therapy in Patients with Multinodular Goiters: A Meta-Analysis of Randomized Controlled Trials

2020 ◽  
Vol 52 (12) ◽  
pp. 841-849
Author(s):  
Chunmei Xu ◽  
Ping Wang ◽  
Huikai Miao ◽  
Tianyue Xie ◽  
Xiaojun Zhou ◽  
...  
Keyword(s):  
Fixed Effects ◽  
Dose Group ◽  
Low Dose ◽  
Radioiodine Therapy ◽  
Meta Analysis ◽  
High Dose Group ◽  
High Dose ◽  
Fixed Effects Model ◽  
Recombinant Human Thyrotropin

AbstractA potential reduction of goiter volume (GV) of recombinant human thyrotropin (rhTSH) on multinodular goiters (MNG) was previously reported but controversial. Hence we conducted a meta-analysis to estimate the effect of rhTSH-stimulated radioiodine therapy in patients with MNG. PubMed, Cochrane, CNKI, VIP, and Wanfang databases were searched. Mean difference (MD) and odds ratios with 95% confidence intervals (95% CI) were derived by using an inverse variance random-effects model and fixed-effects model, respectively. Six studies (n=237) were involved in the analysis. For 12 months follow up, high dose (>0.1 mg) of rhTSH significantly reduced GV (MD=17.61; 95% CI=12.17 to 23.04; p<0.00001) compared with placebo. No effective pooled results of low dose of rhTSH (<0.1 mg) were applicable for only one study included. For 6 months follow up, the source of heterogeneity was determined by subgroup and sensitivity analysis. High dose group showed vast improvement in GV reduction (MD=16.62; 95% CI=1.34 to 31.90; p=0.03). The reduction of low dose group compared with placebo was inferior to high dose group. No available data were obtained to assess the influence of rhTSH after 36 months follow up for the only included study. Hypothyroidism incidence was higher for rhTSH group. No publication bias was seen. High dose of rhTSH treatment-stimulated radioactive 131I therapy after 6 months and 12 months follow up had a better effect in reducing GV, but with higher incidence of hypothyroidism. Owing to the limited methodological quality, more clinical researches are warranted in the future.

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