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The aim of this study is to understand the path for establishing digital health technologies-health technology assessment (DHT-HTA) in India.
Methods
A rapid review of HTA and DHT frameworks on PubMed (MEDLINE) and Google Scholar was conducted to identify DHT-HTA guidelines, and HTA processes in India. MS-Excel template was created with key domains for assessing DHT in resource-constrained settings based on studies and reports identified. Responses received from seventeen experts with varying expertise in DHT, HTA, clinical, and research were contacted using an online form. Following the principles of qualitative research rooted on grounded theory approach, themes and domains were derived for a framework which was again circulated through participants. Weightage for each theme was assigned based on the frequency of responses and qualifiers were used to interpret results. Inductively derived themes from these responses were clubbed together to identify macro-level systems requirements, and finally pre-requisites for setting up DHT-HTA framework was synthesized.
Results
HT are commonly perceived by experts (64.7 percent participants) as a technology strictly connected to health information. Real-world data (i.e., electronic health data) are recognized as a relevant tool in support of decision-making for clinical and managerial levels. Experts identified some pre-requisites for the establishment of DHT-HTA in the country in terms of infrastructure, contextual factors, training, finance, data security, and scale-up.
Conclusion
Our research not only identified the pre-requisites for the adoption of a DHT-HTA framework for India, but confirmed the need to address DHT-HTA’s acceptability among. Hospitals and health insurance providers.
Motivated by applications to COVID dynamics, we describe a model of a branching process in a random environment $\{Z_n\}$ whose characteristics change when crossing upper and lower thresholds. This introduces a cyclical path behavior involving periods of increase and decrease leading to supercritical and subcritical regimes. Even though the process is not Markov, we identify subsequences at random time points $\{(\tau_j, \nu_j)\}$—specifically the values of the process at crossing times, viz. $\{(Z_{\tau_j}, Z_{\nu_j})\}$—along which the process retains the Markov structure. Under mild moment and regularity conditions, we establish that the subsequences possess a regenerative structure and prove that the limiting normal distributions of the growth rates of the process in supercritical and subcritical regimes decouple. For this reason, we establish limit theorems concerning the length of supercritical and subcritical regimes and the proportion of time the process spends in these regimes. As a byproduct of our analysis, we explicitly identify the limiting variances in terms of the functionals of the offspring distribution, threshold distribution, and environmental sequences.
Introduces the two most common numerical methods for heat transfer and fluid dynamics equations, using clear and accessible language. This unique approach covers all necessary mathematical preliminaries at the beginning of the book for the reader to sail smoothly through the chapters. Students will work step-by-step through the most common benchmark heat transfer and fluid dynamics problems, firmly grounding themselves in how the governing equations are discretized, how boundary conditions are imposed, and how the resulting algebraic equations are solved. Providing a detailed discussion of the discretization steps and time approximations, and clearly presenting concepts of explicit and implicit formulations, this graduate textbook has everything an instructor needs to prepare students for their exams and future careers. Each illustrative example shows students how to draw comparisons between the results obtained using the two numerical methods, and at the end of each chapter they can test and extend their understanding by working through the problems provided. A solutions manual is also available for instructors.
The present chapter deals with the FVM as applied to the diffusion equation in one and two dimensions. In the FVM, the domain Ω is divided into a collection of nonoverlapping subdomains, called control volumes and the collection is called a mesh or grid.
In this chapter, we will focus on solving the PDEs governing laminar flows of viscous incompressible fluids using the FVM (this chapter is a counterpart of Chapter 6 on FEM, where velocity–pressure and penalty finite element models of two dimensional flows of viscous incompressible fluids were presented). These equations are expressed in terms of the primitive variable, namely, the velocity field and the pressure. To begin with, we will consider isothermal flows (flows without the presence of the temperature effect), and demonstrate the use of the FVM for two-dimensional laminar flows of viscous incompressible fluids. Then cases of non-isothermal flows with both forced convection and natural convection will be considered in the sequel.
In Chapter 4 we considered finite element analysis of steady state heat transfer. When external stimuli (e.g., boundary conditions and internal heat generation) are independent of time, heat transfer in a medium may attain a steady state; otherwise, the temperature field changes with time (i.e., unsteady state). The governing equations of unsteady heat transfer are obtained using the principle of balance of energy. When unsteady equations are solved the temperature field reaches a steady state if the external stimuli are independent of time (i.e., the time dependence decays with time).
All numerical methods, including the FEM and FVM, ultimately result in a set of linear or nonlinear algebraic equations, relating the values of the dependent variables at the nodal points of the mesh. These algebraic equations can be linear or nonlinear in the nodal values of the primary variables, depending on whether the governing differential equations being solved are linear or nonlinear. When the algebraic equations are nonlinear, we linearize them using certain assumptions and techniques, such as the Picard method or Newton’s method.
The equations governing flows of Newtonian viscous incompressible fluids were reviewed in Chapter 2. The equations are revisited here, in the Cartesian component form, for the two-dimensional case (i.e., set and the derivatives with respect to to zero).
There are several topics that are considered to be “advanced” for this book. We will briefly discuss some (but not all) of these topics to make the readers aware of the fact that the present coverage has precluded them, and then cover three topics in a greater detail.