4 results
USING BEST-WORST SCALING IN HORIZON SCANNING FOR HEPATOCELLULAR CARCINOMA TECHNOLOGIES
- Gisselle Gallego, John F.P. Bridges, Terry Flynn, Barri M. Blauvelt, Louis W. Niessen
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- Journal:
- International Journal of Technology Assessment in Health Care / Volume 28 / Issue 3 / July 2012
- Published online by Cambridge University Press:
- 14 September 2012, pp. 339-346
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Objectives: There is a growing need for efficient procedures for identification of emerging technologies by horizon scanning systems. We demonstrate the value of best-worst scaling (BWS) in exploring clinicians’ views on emerging technologies that will impact outcomes in hepatocellular carcinoma (HCC) in the next 5 to 10 years.
Methods: Clinicians in Asia, Europe, and the United States were surveyed and their views about eleven emerging technologies relevant to HCC were explored using BWS (case 1). This involved systematically presenting respondents with subsets of five technologies and asking them to identify those that will have the most and least impact on HCC within 5 to 10 years. Statistical analysis was based on sequential best-worst and analyzed using conditional logistic regression.
Results: A total of 120 clinicians uniformly distributed across ten countries completed the survey (37 percent response rate). Respondents were predominately hepatologist (41 percent) who focused on HCC (65 percent) and had national influence in this field (39 percent). Respondents viewed molecular targeted therapy (p < .001) and early detection of HCC (p < .001) as having most potential, while improved surgical techniques (p < .001) and biopsy free HCC diagnostics (p < .001) were viewed upon negatively.
Conclusions: We demonstrate that BWS could be an important research tool to facilitate horizon scanning and HTA more broadly. Our research demonstrates the value of including clinicians’ preferences as a source of data in horizon scanning, but such methods could be used to incorporate the opinions of a broad array of stakeholders, including those in advocacy and public policy.
19 - Global change: fresh insights, no simple answers
- from Part Two - Exploring images of the future
- Edited by Jan Rotmans, National Institute of Public Health and Environment (RIVM), The Netherlands, Bert de Vries, National Institute of Public Health and Environment (RIVM), The Netherlands
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- Book:
- Perspectives on Global Change
- Published online:
- 06 July 2010
- Print publication:
- 16 October 1997, pp 417-434
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Summary
Introduction
We know that the future is inherently uncertain, yet we are fascinated by insights into ways in which we may be influencing the planet. This interest is intensified because there is widespread perception that the world is changing at an unprecedented speed. Undeniably, many parts of the global system are accelerating or decelerating compared to previously observed, natural rates of change. For some people these processes of change may just look like more of the same. There are, however, underlying behavioural and structural changes at work which suggest deeper, more radical change in the longer term. Many of those long-term changes can be viewed as part of transition processes. Several of these are within the human system: from many to 1 or 2 children per family, twice as many older people per thousand compared to today, a factor of 3 to 5 less energy and water use per unit of economic activity, increasing pressure to cultivate more land and use it more intensively to feed the population. More gradual, but possibly of overriding importance, are the changes in the environmental system, such as the accelerating increase in the concentration of some atmospheric gases and increasing accumulation of pollutants in soils and water bodies which are the result of past and present practices. It is difficult to disentangle the human-induced, structural long-term changes from the natural changes, which makes it even harder to see where the world is heading.
4 - The Population and Health submodel
- from Part One - The TARGETS model
- Edited by Jan Rotmans, National Institute of Public Health and Environment (RIVM), The Netherlands, Bert de Vries, National Institute of Public Health and Environment (RIVM), The Netherlands
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- Book:
- Perspectives on Global Change
- Published online:
- 06 July 2010
- Print publication:
- 16 October 1997, pp 55-82
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Summary
This is the first of five chapters which focus on submodels within TARGETS. The framework of the Population and Health submodel includes socio-economic and environmental pressures, simulations of fertility, disease-specific mortality and morbidity, and their impact on population size, structure and health levels. The response subsystem comprises policies in the field of fertility and health. Whereas there are a number of separate models of fertility and population, the innovative aspect of the approach adopted here is that it is highly integrative, incorporating both population and health dynamics.
Introduction
During the past century, most populations of the world have experienced an increase in their levels of social welfare and economic development. These changes have shown a concomitant increase in the average life expectancy at birth and a decrease, although slower, in fertility levels (UNFPA, 1996; World Bank, 1993). The result has been an increase in world population size and a demand for resources unprecedented in history (UN, 1992; WCED, 1987). Reduction of health risks and the increased access to health services have resulted in a world-wide average life expectancy of more than 65 years during the past decades (WHO, 1996). Even though fertility rates are dropping, for some countries even rapidly, the world population is still growing at 1.5% per year. Presently, world population size in the year 2050 is estimated to be determined for about 50% merely by the present size of the fertile female population.
3 - The TARGETS model
- from Part One - The TARGETS model
- Edited by Jan Rotmans, National Institute of Public Health and Environment (RIVM), The Netherlands, Bert de Vries, National Institute of Public Health and Environment (RIVM), The Netherlands
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- Book:
- Perspectives on Global Change
- Published online:
- 06 July 2010
- Print publication:
- 16 October 1997, pp 33-54
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Summary
When tackling a subject as complex as global change and sustainable development, it is essential to be able to ‘frame the issues’. This was one of the main reasons for developing the TARGETS model, an integrated model of the global system, consisting of metamodels of important subsystems. In this chapter we introduce TARGETS. Building on the previous chapters, we elaborate on the possibilities and limitations of integrated assessment models. Some of the key issues discussed are aggregation, model calibration and validation, and dealing with uncertainty.
Introduction
One of the main tools used in integrated assessment of global change issues is the Integrated Assessment (IA) model. This chapter introduces such an integrated model, TARGETS, which builds upon the systems approach and related concepts introduced in Chapter 2. Previous integrated modelling attempts either focused on specific aspects of global change, for instance the climate system (IPCC, 1995), or consisted merely of conceptual descriptions (Shaw et al., 1992). We have tried to go one step further, linking a series of cause-effect chains of global change. Although we realise the shortcomings in our current version of the TARGETS model, we felt there was a need to present our model to a wide audience. We first give some advantages and limitations of IA models. Next, we discuss issues of aggregation, calibration, validation and uncertainty. We proceed with a brief description of the five TARGETS submodels which coincides with the PSIR concept and the vertical integration as introduced in Chapter 2. A more detailed description of these submodels is given in Chapters 4 to 8.