1,721,105 research outputs found
A review if telemedicine cost-effectiveness studies
No full textAs interest in telemedicine grows, many of its proponents and vendors increasingly suggest that it is now time to move to full-scale implementation of telemedicine services in a variety of contexts throughout the world, and question the need for further evidence of its utility and cost-effectiveness. We have reviewed the published literature relating to cost-effectiveness studies in telemedicine and have identified some important weaknesses. Ten recommendations regarding the design of economic evaluations of telemedicine are suggested
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Influence of patient co-payments on atypical antipsychotic choice in Poland: implications once generic atypicals are available.
No full textDespite recent concerns over the effectiveness and safety of atypical antipsychotics compared with first-generation antipsychotics, prescribing of atypical antipsychotics continues to increase. The use of generic atypical antipsychotics is one way to address cost concerns, especially if there are no major differences in outcomes between generic and originator formulations. Market forces do appear to help lower prices if patients have to cover any difference between higher priced generics and originators and the current reference-priced products themselves, which they try to avoid, and if companies strive to gain market share. However, this approach may compromise individualizing atypical choice if reference classes consist of several atypicals between which there are significant co-payment differences.First, to assess whether differences in patient co-payment levels between the various atypical antipsychotic formulations alter the atypical formulation prescribed and/or dispensed in practice in Poland. Second, to assess whether market forces in Poland help drive down generic prices in reality as successive generics are launched. Third, to assess the impact of the reduction in reference prices on the overall expenditure on atypicals by the National Health Fund in Poland.Prescription and reimbursed expenditure data for olanzapine and risperidone were provided by the National Health Fund from 2002 to 2006, although no individual patient data were available. Reimbursement limits for the various presentations of olanzapine and risperidone were based on regulations from the Ministry of Health.Analysis of the data showed that the level of patient co-payment appeared to impact on the atypical antipsychotic dispensed, with utilization of olanzapine growing once its co-payment was reduced when generic olanzapine became available. The reverse was seen with risperidone, with only limited growth in utilization when co-payment levels increased.Market forces resulted in a 40\% reduction in the reimbursed reference price (based on the defined daily dose) of olanzapine and a 77\% reduction for risperidone from 2002 to July 2008. These price reductions helped moderate the growth in atypical expenditure in Poland despite appreciably increased utilization, especially for olanzapine. Continued moderation (or even a reduction) in the growth of expenditure on atypicals is envisaged, despite increasing utilization, as more generic formulations are launched, with further reductions in the reference price for both olanzapine and risperidone.Market forces appear to drive down the prices of generics and originators as more atypical formulations are launched. However, alternative approaches may be needed if significant co-payment differences compromise individualized care
Generic olanzapine: health authority opportunity or nightmare?
No full textPressures to contain pharmaceutical expenditure have led to increased prescribing and dispensing of generic drugs in addition to low prices for generics. Atypical antipsychotics are prescribed for schizophrenia leading to resource pressures with their higher acquisition costs than typical antipsychotics. Drug costs can be reduced once multiple sources are available. However, this must be balanced against possible efficacy, safety and compliance concerns given the high cost of relapses for patients with schizophrenia. Generic clozapine has been launched. There was an increase in relapse rates with early formulations in the USA. However, this has not been the case with more recent formulations. Despite this, there could be patient and physician concerns when additional generic atypicals, such as olanzapine are available, reducing potential savings. A retrospective survey of patients prescribed Zyprexa®, generic olanzapine or both, over an extensive period was undertaken in Poland to help address these concerns given the difficulties with conducting randomized clinical trials with generics in complex situations. The survey showed similar effective doses of olanzapine in all groups. Relapse rates were similar in patients before and after switching to generic olanzapine, and no untoward side effects were seen in any patient prescribed generic olanzapine. Consequently, generic olanzapine should be welcomed with savings redirected to improving compliance or funding new premium priced drugs that can reduce relapses in refractory patients. This should give reassurance to health authorities to continue their reforms where pertinent to optimize resources by increasing availability of generics
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