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Using gamification to enhance clinical trial start-up activities
- Karen Lane, Ryan Majkowski, Joshua Gruber, Daniel Amirault, Shannon Hillery, Cortney Wieber, Dixie D Thompson, Jacqueline Huvane, Jordan Bridges, E. Paul Ryu, Lindsay M. Eyzaguirre, Marianne Gildea, Richard E. Thompson, Daniel E. Ford, Daniel Hanley
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- Journal:
- Journal of Clinical and Translational Science / Volume 6 / Issue 1 / 2022
- Published online by Cambridge University Press:
- 19 May 2022, e75
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- Article
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- Open access
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Background:
The Trial Innovation Network (TIN) is a collaborative initiative within the National Center for Advancing Translational Science (NCATS) Clinical and Translational Science Awards (CTSA) Program. To improve and innovate the conduct of clinical trials, it is exploring the uses of gamification to better engage the trial workforce and improve the efficiencies of trial activities. The gamification structures described in this article are part of a TIN website gamification toolkit, available online to the clinical trial scientific community.
Methods:The game designers used existing electronic trial platforms to gamify the tasks required to meet trial start-up timelines to create friendly competitions. Key indicators and familiar metrics were mapped to scoreboards. Webinars were organized to share and applaud trial and game performance.
Results:Game scores were significantly associated with an increase in achieving start-up milestones in activation, institutional review board (IRB) submission, and IRB approval times, indicating the probability of completing site activation faster by using games. Overall game enjoyment and feelings that the game did not apply too much pressure appeared to be an important moderator of performance in one trial but had little effect on performance in a second.
Conclusion:This retrospective examination of available data from gaming experiences may be a first-of-kind use in clinical trials. There are signals that gaming may accelerate performance and increase enjoyment during the start-up phase of a trial. Isolating the effect of gamification on trial outcomes will depend on a larger sampling from future trials, using well-defined, hypothesis-driven statistical analysis plans.
Contributors
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- By Núria Duran Adroher, Sergio Aguilar-Gaxiola, Jordi Alonso, Ali Obaid Al-Hamzawi, Laura Helena Andrade, Matthias C. Angermeyer, James Anthony, Corina Benjet, Guilherme Borges, Joshua Breslau, Evelyn J. Bromet, Ronny Bruffaerts, Brendan Bunting, Huibert Burger, José Miguel Caldas de Almeida, Graça Cardoso, Somnath Chatterji, Wai Tat Chiu, Giovanni de Girolamo, Ron de Graaf, Peter de Jonge, Koen Demyttenaere, John Fayyad, Alize J. Ferrari, Silvia Florescu, Anne M. Gadermann, Meyer Glantz, Jen Green, Michael J. Gruber, Oye Gureje, Josep Maria Haro, Yanling He, Steven G. Heeringa, Hristo Hinkov, Chiyi Hu, Yueqin Huang, Irving Hwang, Robert Jin, Elie G. Karam, Norito Kawakami, Ronald C. Kessler, Lola Kola, Viviane Kovess-Masféty, Michael C. Lane, Carmen Lara, William LeBlanc, Sing Lee, Jean-Pierre Lépine, Daphna Levinson, Zhaorui Liu, Gustavo Loera, Herbert Marschinger, Katie A. McLaughlin, Maria Elena Medina-Mora, Elizabeth Miller, Samuel D. Murphy, Aimee Nasser Karam, Matthew K. Nock, Mark A. Oakley Browne, Siobhan O’Neill, Johan Ormel, Beth-Ellen Pennell, Maria V. Petukhova, José Posada-Villa, Rajesh Sagar, Mohammad Salih Khalaf, Nancy A. Sampson, Kathleen Saunders, Michael Schoenbaum, Kate M. Scott, Soraya Seedat, Victoria Shahly, Dan J. Stein, Hisateru Tachimori, Nezar Ismet Taib, Adley Tsang, T. Bedirhan Üstün, Maria Carmen Viana, Gemma Vilagut, Michael R. Von Korff, J. Elisabeth Wells, Harvey A. Whiteford, David R. Williams, Ben Wu, Miguel Xavier, Alan M. Zaslavsky
- Edited by Jordi Alonso, Universitat Pompeu Fabra, Barcelona, Somnath Chatterji, World Health Organization, Geneva, Yanling He
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- Book:
- The Burdens of Mental Disorders
- Print publication:
- 09 May 2013, pp ix-xii
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4 - How Elastic Is the Corporate Income Tax Base?
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- By Jonathan Gruber, Massachusetts Institute of Technology and NBER, Joshua Rauh, University of Chicago and NBER
- Edited by Alan J. Auerbach, University of California, Berkeley, James R. Hines, Jr., University of Michigan, Ann Arbor, Joel Slemrod, University of Michigan, Ann Arbor
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- Book:
- Taxing Corporate Income in the 21st Century
- Published online:
- 30 July 2009
- Print publication:
- 16 April 2007, pp 140-163
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Summary
The federal government of the United States primarily finances its expenditures from income taxation, at both the individual and corporate levels. Traditionally, corporate income taxation was about half as large as individual income taxation as a source of federal revenue; today, the ratio of corporate tax revenues to individual tax revenues is only about 15 percent. Nevertheless, a large economics literature continues to consider the corporate tax as a primary determinant of corporate behavior in the United States. Numerous articles have addressed the impact of the corporate tax on corporate investment and financing.
Oddly, this literature has not addressed directly the question of how sensitive the base of corporate income taxation is to the corporate tax rate. Past literature has addressed pieces of this question, but there is no clear estimate that emerges from past work. As emphasized by Saez (2004), what determines the ultimate efficiency of a tax system, absent external effects of taxation, is the elasticity of the base of taxable income with respect to the tax rate. Indeed, a large literature has arisen in public economics devoted to estimating this elasticity with respect to the individual income tax system. Yet there is no comparable work on corporate taxation.
In this chapter, we estimate the impact of the corporate tax rate on the level of corporate taxable income. An obvious difficulty with such an exercise is that the tax rate itself is determined by the level of taxable income.