“Economic and Political Integration in Europe: A Time-Series Quasi-Experimental Analysis”

1971 ◽  
Vol 65 (2) ◽  
pp. 418-433 ◽  
Author(s):  
James A. Caporaso ◽  
Alan L. Pelowski
Keyword(s):  
Time Series ◽  
Statistical Significance ◽  
Interrupted Time Series ◽  
Political Integration ◽  
Interrupted Time Series Analysis ◽  
Political Decision ◽  
Ex Post ◽  
Positive Growth ◽  
Ex Post Facto ◽  
Quasi Experimental

Changes in political decision-making outputs and trading activities in the European Economic Community are examined around three quasi-experimental events (formation of the EEC in 1958, first agricultural package in 1962, and the agricultural crisis in 1965–66). On the basis of a preliminary analysis, nine variables were selected for inclusion in the study (three political decision variables and six trade indicators); these were then subjected to “interrupted time-series analysis,” through which the quasi-experimental effects of the three events were assessed for statistical significance (t-tests and autocorrelation measures) and theoretical validity (through the elimination of plausible rival interpretations).Political integration in the EEC is viewed as (1) positive growth in system indicators, and (2) increased mutual responsiveness among the major components or subsystems of the EEC. Results of the quasi-experimental analyses suggest that despite high positive growth in the selected variables, mutual responsiveness among system parts remains quite low; therefore, the principal conclusion drawn is that the EEC is a “weakly” integrating system—a collection of structures growing rapidly in many directions, with each structure very imperfectly responsive to the behavior of others.The paper urges and attempts to demonstrate the methodological usefulness of applying the logic of experimentation to ex-post-facto research. This approach entails the demonstration that non-random variation in independent and dependent variables has occurred, that these variables are related in some way, and that the relationship is nonspurious—that is, that the important confounding variables have been controlled by eliminating plausible rival hypotheses through statistical and analytical procedures.

scholarly journals Impact of Removal of Automatic 7-Day Stop Orders for Inpatient Antimicrobials

2020 ◽  
Vol 41 (S1) ◽  
pp. s264-s265
Author(s):  
Afia Adu-Gyamfi ◽  
Keith Hamilton ◽  
Leigh Cressman ◽  
Ebbing Lautenbach ◽  
Lauren Dutcher
Keyword(s):  
Time Series ◽  
Time Series Analysis ◽  
Interrupted Time Series ◽  
Antibiotic Use ◽  
Interrupted Time Series Analysis ◽  
Series Analysis ◽  
Treatment Interruptions ◽  
Days Of Therapy ◽  
Quasi Experimental ◽  
The Impact

Background: Automatic discontinuation of antimicrobial orders after a prespecified duration of therapy has been adopted as a strategy for reducing excess days of therapy (DOT) as part of antimicrobial stewardship efforts. Automatic stop orders have been shown to decrease antimicrobial DOT. However, inadvertent treatment interruptions may occur as a result, potentially contributing to adverse patient outcomes. To evaluate the effects of this practice, we examined the impact of the removal of an electronic 7-day ASO program on hospitalized patients. Methods: We performed a quasi-experimental study on inpatients in 3 acute-care academic hospitals. In the preintervention period (automatic stop orders present; January 1, 2016, to February 28, 2017), we had an electronic dashboard to identify and intervene on unintentionally missed doses. In the postintervention period (April 1, 2017, to March 31, 2018), the automatic stop orders were removed. We compared the primary outcome, DOT per 1,000 patient days (PD) per month, for patients in the automatic stop orders present and absent periods. The Wilcoxon rank-sum test was used to compare median monthly DOT/1,000 PD. Interrupted time series analysis (Prais-Winsten model) was used to compared trends in antibiotic DOT/1,000 PD and the immediate impact of the automatic stop order removal. Manual chart review on a subset of 300 patients, equally divided between the 2 periods, was performed to assess for unintentionally missed doses. Results: In the automatic stop order period, a monthly median of 644.5 antibiotic DOT/1,000 PD were administered, compared to 686.2 DOT/1,000 PD in the period without automatic stop orders (P < .001) (Fig. 1). Using interrupted time series analysis, there was a nonsignificant increase by 46.7 DOT/1,000 PD (95% CI, 40.8 to 134.3) in the month immediately following removal of automatic stop orders (P = .28) (Fig. 2). Even though the slope representing monthly change in DOT/1,000 PD increased in the period without automatic stop orders compared to the period with automatic stop orders, it was not statistically significant (P = .41). Manual chart abstraction revealed that in the period with automatic stop orders, 9 of 150 patients had 17 unintentionally missed days of therapy, whereas none (of 150 patients) in the period without automatic stop orders did. Conclusions: Following removal of the automatic stop orders, there was an overall increase in antibiotic use, although the change in monthly trend of antibiotic use was not significantly different. Even with a dashboard to identify missed doses, there was still a risk of unintentionally missed doses in the period with automatic stop orders. Therefore, this risk should be weighed against the modest difference in antibiotic utilization garnered from automatic stop orders.Funding: NoneDisclosures: None

scholarly journals Reduced dengue incidence following deployments of Wolbachia-infected Aedes aegypti in Yogyakarta, Indonesia: a quasi-experimental trial using controlled interrupted time series analysis

2020 ◽  
Author(s):  
Citra Indriani ◽  
Warsito Tantowijoyo ◽  
Edwige Rancès ◽  
Bekti Andari ◽  
Equatori Prabowo ◽  
...  
Keyword(s):  
Time Series ◽  
Time Series Analysis ◽  
Interrupted Time Series ◽  
Control Area ◽  
Northern Australia ◽  
Interrupted Time Series Analysis ◽  
Endemic Setting ◽  
Experimental Trial ◽  
Series Analysis ◽  
Quasi Experimental

AbstractBackgroundAe. aegypti mosquitoes stably transfected with the intracellular bacterium Wolbachia pipientis (wMel strain) have been deployed for the biocontrol of dengue and related arboviral diseases in multiple countries. Field releases in northern Australia have previously demonstrated near elimination of local dengue transmission from Wolbachia-treated communities, and pilot studies in Indonesia have demonstrated the feasibility and acceptability of the method. We conducted a quasi-experimental trial to evaluate the impact of scaled Wolbachia releases on dengue incidence in an endemic setting in Indonesia.Methods and findingsIn Yogyakarta City, Indonesia, following an extensive community engagement campaign, wMel Wolbachia-carrying mosquitoes were released every two weeks for 13–15 release rounds over seven months in 2016–17, in a contiguous 5 km2 area (population 65,000). A 3 km2 area (population 34,000) on the opposite side of the city was selected a priori as an untreated control area, on the basis of comparable socio-demographic characteristics and historical dengue incidence. Passive surveillance data on notified hospitalised dengue patients was used to evaluate the epidemiological impact of Wolbachia deployments, using controlled interrupted time series analysis. Rapid and sustained introgression of wMel Wolbachia into local Ae. aegypti populations was achieved. Thirty-four dengue cases were notified from the intervention area and 53 from the control area (incidence 26 vs 79 per 100,000 person-years) during the 24 months after Wolbachia was deployed. This corresponded in the regression model to a 73% reduction in dengue incidence (95% confidence interval 49%,86%) associated with the Wolbachia intervention. Exploratory analysis including an additional 6 months of post-intervention observations showed a small strengthening of this effect (30 vs 115 per 100,000 person-years; 76% reduction in incidence, 95%CI 60%,86%).ConclusionsThese findings demonstrate a significant reduction in dengue incidence following successful introgression of Wolbachia into local Ae. aegypti populations in an endemic setting in Indonesia. These results are consistent with previous field trials in northern Australia, and support the effectiveness of this novel approach for the control of dengue and other Aedes-borne diseases.

scholarly journals Digital cognitive behavioural therapy for insomnia and primary care costs in England: an interrupted time series analysis

BJGP Open ◽  
2021 ◽  
pp. BJGPO.2021.0146
Author(s):  
Chris Sampson ◽  
Eleanor Bell ◽  
Amanda Cole ◽  
Christopher B Miller ◽  
Tracey Marriott ◽  
...  
Keyword(s):  
Primary Care ◽  
Time Series ◽  
Cognitive Behavioural Therapy ◽  
Interrupted Time Series ◽  
Behavioural Therapy ◽  
Interrupted Time Series Analysis ◽  
Cognitive Behavioural ◽  
Before And After ◽  
Quasi Experimental ◽  
Care Costs

BackgroundSleepio is an automated digital programme that delivers cognitive behavioural therapy for insomnia (dCBT-I). Sleepio has been proven effective in improving sleep difficulties. However, evidence for the possible impact of Sleepio use on health care costs in the United Kingdom has not previously been developed.AimWe sought to identify the effect of a population-wide rollout of Sleepio in terms of primary care costs in the National Health Service (NHS) in England.Design & settingThe study was conducted in the Thames Valley region of England, where access to Sleepio was made freely available to all residents between October 2018 and January 2020. The study relies on a quasi-experimental design, using an interrupted time series to compare the trend in primary care costs before and after the rollout of Sleepio.MethodWe use primary care data for people with relevant characteristics from nine general practices in Buckinghamshire. Primary care costs include general practice contacts and prescriptions. Segmented regression analysis was used to estimate primary and secondary outcomes.ResultsFor the 10,704 patients included in our sample, the total saving over the 65-week follow-up period was £71,027. This corresponds to £6.64 per person in our sample or around £70.44 per Sleepio user. Secondary analyses suggest that savings may be driven primarily by reductions in prescribing.ConclusionSleepio rollout reduced primary care costs. National adoption of Sleepio may reduce primary care costs by £20 million in the first year. The expected impact on primary care costs in any particular setting will depend on the uptake of Sleepio.

scholarly journals Assessment of the Impact of COVID-19 pandemic on population level interest in Skincare: Evidence from a google trends-based Infodemiology study

2020 ◽  
Author(s):  
Hasan Symum ◽  
Md. F. Islam ◽  
Habsa K. Hiya ◽  
Kh M. Ali Sagor
Keyword(s):  
Time Series ◽  
Moving Average ◽  
Arima Model ◽  
Population Level ◽  
Interrupted Time Series ◽  
Interrupted Time Series Analysis ◽  
Search Volume ◽  
Quasi Experimental ◽  
Relative Search Volume ◽  
The Impact

AbstractBackgroundCOVID-19 pandemic created an unprecedented disruption of daily life including the pattern of skin related treatments in healthcare settings by issuing stay-at-home orders and newly coronaphobia around the world.ObjectiveThis study aimed to evaluate whether there are any significant changes in population interest for skincare during the COVID-19 pandemic.MethodsFor the skincare, weekly RSV data were extracted for worldwide and 23 counties between August 1, 2016, and August 31, 2020. Interrupted time-series analysis was conducted as the quasi-experimental approach to evaluate the longitudinal effects of COVID-19 skincare related search queries. For each country, autoregressive integrated moving average (ARIMA) model relative search volume (RSV) time series and then testing multiple periods simultaneously to examine the magnitude of the interruption. Multivariate linear regression was used to estimate the correlation between countries’ relative changes in RSV with COVID-19 confirmed cases/ per 10000 patients and lockdown measures.ResultsOut of 23 included countries in our study, 17 showed significantly increased (p<0.01) RSVs during the lockdown period compared with the ARIMA forecasted data. The highest percentage of increments occurs in May and June 2020 in most countries. There was also a significant correlation between lockdown measures and the number of COVID-19 cases with relatives changes in population interests for skincare.ConclusionUnderstanding the trend and changes in skincare public interest during COVID-19 may assist health authorities to promote accessible educational information and preventive initiatives regarding skin problems.

scholarly journals Impact of the WHO Framework Convention on Tobacco Control on global cigarette consumption: quasi-experimental evaluations using interrupted time series analysis and in-sample forecast event modelling

BMJ ◽  
2019 ◽  
pp. l2287 ◽  
Author(s):  
Steven J Hoffman ◽  
Mathieu J P Poirier ◽  
Susan Rogers Van Katwyk ◽  
Prativa Baral ◽  
Lathika Sritharan
Keyword(s):  
Time Series ◽  
Time Series Analysis ◽  
Tobacco Control ◽  
Interrupted Time Series ◽  
Cigarette Consumption ◽  
Interrupted Time Series Analysis ◽  
Series Analysis ◽  
Annual Consumption ◽  
Quasi Experimental ◽  
National Estimates

Abstract Objective To evaluate the impact of the WHO Framework Convention on Tobacco Control (FCTC) on global cigarette consumption. Design Two quasi-experimental impact evaluations, using interrupted time series analysis (ITS) and in-sample forecast event modelling. Setting and population 71 countries for which verified national estimates of cigarette consumption from 1970 to 2015 were available, representing over 95% of the world’s cigarette consumption and 85% of the world’s population. Main outcome measures The FCTC is an international treaty adopted in 2003 that aims to reduce harmful tobacco consumption and is legally binding on the 181 countries that have ratified it. Main outcomes were annual national estimates of cigarette consumption per adult from 71 countries since 1970, allowing global, regional, and country comparisons of consumption levels and trends before and after 2003, with counterfactual control groups modelled using pre-intervention linear time trends (for ITS) and in-sample forecasts (for event modelling). Results No significant change was found in the rate at which global cigarette consumption had been decreasing after the FCTC’s adoption in 2003, using either ITS or event modelling. Results were robust after realigning data to the year FCTC negotiations commenced (1999), or to the year when the FCTC first became legally binding in each country. By contrast to global consumption, high income and European countries showed a decrease in annual consumption by over 1000 cigarettes per adult after 2003, whereas low and middle income and Asian countries showed an increased annual consumption by over 500 cigarettes per adult when compared with a counterfactual event model. Conclusions This study finds no evidence to indicate that global progress in reducing cigarette consumption has been accelerated by the FCTC treaty mechanism. This null finding, combined with regional differences, should caution against complacency in the global tobacco control community, motivate greater implementation of proven tobacco control policies, encourage assertive responses to tobacco industry activities, and inform the design of more effective health treaties.

scholarly journals Colorado’s Statewide Antimicrobial Stewardship (AMS) Collaborative Final Results. Facilitating Syndrome-Specific Interventions for Skin and Soft-tissue Infection (SSTI) and Urinary Tract Infection (UTI)

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S62-S62 ◽  
Author(s):  
Heidi Wald ◽  
Teri Hulett ◽  
Bryan Knepper ◽  
Gerard Barber ◽  
Kati Shihadeh ◽  
...  
Keyword(s):  
Time Series ◽  
Statistical Significance ◽  
Guideline Implementation ◽  
Interrupted Time Series ◽  
Baseline Period ◽  
Interrupted Time Series Analysis ◽  
Prescribing Practices ◽  
Gram Negative ◽  
Secondary Analyses ◽  
The Individual

Abstract Background Colorado Hospital Association (CHA) led a statewide collaborative to engage hospitals in AMS, focused on interventions for UTI and SSTI. The collaborative goals were to reduce the use of fluoroquinolones (FQs) for UTIs, increase the proportion of diagnosed UTIs meeting objective criteria, reduce exposure to antibiotics with broad Gram-negative activity for SSTI, and shorten treatment durations for UTI and SSTI. We evaluated the effect of the collaborative on these measures. Methods Diagnostic (UTI) and treatment guidance (UTI and SSTI) were developed by a local expert panel. Collaborative methodology was used to engage local hospital AMS teams in guideline implementation. Teams submitted data for 80 cases during the baseline period (2014) and 20 cases per quarter during the intervention period (October 2015–December 2016) for each condition. Primary analyses were changes in trends of the main outcomes by interrupted time series analysis. Secondary analyses were the aggregate changes in the main outcomes between the baseline and intervention periods. Results Twenty-seven acute care hospitals (bed range 15–567) participated in the collaborative. Data were reported for 1,530 UTI and 722 SSTI cases from the baseline period and for 2,514 UTI and 1,030 SSTI cases from the intervention. Interrupted time series analyses of the main outcomes are shown in Figure. The trend in exposure to FQs for UTIs decreased significantly from baseline to the intervention (P = 0.03). Changes in the trends for the other outcomes did not reach statistical significance. In the secondary analyses, exposure to FQs declined from 49% at baseline to 40% during the intervention (UTI), and the proportion of diagnosed UTIs meeting objective criteria increased from 51% to 54% (P = 0.10). Among SSTI cases, exposure to antibiotics with broad Gram-negative activity declined from 61% to 53% (P = 0.001), and the median duration of therapy declined from 13 to 11 days (P &lt; 0.0001). Conclusion A statewide collaborative successfully engaged hospitals to participate in AMS. Intended changes in prescribing practices for the collaborative were observed; however, the degree of success varied by outcome. Additional work is needed to explore factors associated with success or lack thereof among the individual hospitals. Disclosures H. Wald, Colorado Hospital Association: Consultant, Consulting fee; T. Hulett, Colorado Hospital Association: Consultant and Employee, Salary; G. Barber, Merck: Speaker’s Bureau, Speaker honorarium

scholarly journals Digital cognitive behavioural therapy for insomnia and primary care costs in England: an interrupted time series analysis

2021 ◽  
Author(s):  
Chris Sampson ◽  
Eleanor Bell ◽  
Amanda Cole ◽  
Christopher B. Miller ◽  
James Rose
Keyword(s):  
Primary Care ◽  
Time Series ◽  
Cognitive Behavioural Therapy ◽  
Interrupted Time Series ◽  
Behavioural Therapy ◽  
Interrupted Time Series Analysis ◽  
Cognitive Behavioural ◽  
Before And After ◽  
Quasi Experimental ◽  
Care Costs

AbstractBackgroundSleepio is an automated digital programme that delivers cognitive behavioural therapy for insomnia. Sleepio has been proven effective in improving sleep difficulties. However, evidence for the possible impact of Sleepio use on health care costs in the United Kingdom has not previously been developed. In this study, we assessed the effect of a population-wide rollout of Sleepio in terms of primary care costs in the National Health Service (NHS) in England.MethodsThe study was conducted in the Thames Valley region of England, where access to Sleepio was made freely available to all residents between October 2018 and January 2020. We use primary care data for people with relevant characteristics from nine general practices in Buckinghamshire. The study relies on a quasi-experimental design, using an interrupted time series to compare the trend in primary care costs before and after the rollout of Sleepio. Primary care costs include general practice contacts and prescriptions. Segmented regression analysis was used to estimate primary and secondary outcomes.ResultsFor the 10,704 patients included in our sample, the total saving over the 65-week follow-up period was £71,027. This corresponds to £6.64 per person in our sample or around £70.44 per Sleepio user. Secondary analyses suggest that savings may be driven primarily by reductions in prescriptions.ConclusionSleepio rollout reduced primary care costs. National adoption of Sleepio may reduce primary care costs by £20 million in the first year. The expected impact on primary care costs in any particular setting will depend on the uptake of Sleepio.

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