AIM:To assess the appropriateness of the indication and route of administration of proton-pump-inhibitors (PPIs) and their associated cost impact. METHODS:Data collection was performed prospec-tively during a 6-mo per...AIM:To assess the appropriateness of the indication and route of administration of proton-pump-inhibitors (PPIs) and their associated cost impact. METHODS:Data collection was performed prospec-tively during a 6-mo period on 340 patients who re-ceived omeprazole intravenously during their hospital stay in non-intensive care floors. Updated guidelines were used to assess the appropriateness of the indication and route of administration. RESULTS:Complete data collection was available for 286 patients which were used to assess intravenous (IV) PPIs utilization. Around 88% of patients were receiving PPIs for claimed stress ulcer prophylaxis (SUP) indication; of which,only 17% met the guideline criteria for SUP indication,14% met the criteria for non-steroidal-anti-inflammatory drugs-induced ulcer prophylaxis,while the remaining 69% were identifi ed as having an unjustified indication for PPI use. Theinitiation of IV PPIs was appropriate in 55% of pa-tients. Half of these patients were candidates for switching to the oral dosage form during their hos-pitalization,while only 36.7% of these patients were actually switched. The inappropriate initiation of PPIs via the IV route was more likely to take place on the medical floor than the surgical floor (53% vs 36%,P = 0.003). The cost analysis associated with the appro-priateness of the indication for PPI use as well as the route of administration of PPI revealed a possible saving of up to $17 732.5 and $14 571,respectively. CONCLUSION:This study highlights the over-utili-zation of IV PPIs in non-intensive care unit patients. Restriction of IV PPI use for justified indications and route of administration is recommended.展开更多
This paper focuses on the problem of non-fragile hybrid guaranteed cost control for a class of uncertain switched linear systems. The controller gain to be designed is assumed to have additive gain variations. Based o...This paper focuses on the problem of non-fragile hybrid guaranteed cost control for a class of uncertain switched linear systems. The controller gain to be designed is assumed to have additive gain variations. Based on multiple-Lyapunov function technique, the design of non-fragile hybrid guaranteed cost controllers is derived to make the corresponding closed-loop system asymptotically stable for all admissible uncertainties. Furthermore, a convex optimization approach with LMIs constraints is introduced to select the optimal non-fragile guaranteed cost controllers. Finally, a simulation example illustrates the effectiveness of the proposed approach.展开更多
Objective: To evaluate the cost-effectiveness of atezolizumab plus pemetrexed and platinum-based (APP) in the first-line treatment of non-squamous non- small cell lung cancer (NSCLC). Methods: A partitioned survival m...Objective: To evaluate the cost-effectiveness of atezolizumab plus pemetrexed and platinum-based (APP) in the first-line treatment of non-squamous non- small cell lung cancer (NSCLC). Methods: A partitioned survival model (PSM) was constructed based on the IMpower132 clinical trial. Total cost, quality- adjusted life years (QALY), and incremental cost-effectiveness ratio (ICER) were the main outputs of the model. Deterministic sensitivity analysis and probabilistic sensitivity analysis were adopted to test the uncertainty of the parameters. Results: The results of the base-case analysis illustrated that compared with PP, the incremental cost of APP was CNY 591040.94, the incremental utility was 0.46 QALY, and the ICER was CNY 1291414.83/QALY. Deterministic sensitivity analysis results illustrated that atezolizumab and other parameters have a greater impact on ICER. Probabilistic sensitivity analysis results show that no matter how each parameter changes, under the willingness to pay threshold of 3-times Chinese per capita GDP, the probability of APP has cost-effectiveness is 0. Conclusion: From the perspective of the Chinese health system, APP is not cost-effective for first-line treatment of non-squamous non-small cell lung cancer without sensitizing EGFR or ALK genetic alterations.展开更多
In this paper, the problem of non-response with significant travel costs in multivariate stratified sample surveys has been formulated of as a Multi-Objective Geometric Programming Problem (MOGPP). The fuzzy programmi...In this paper, the problem of non-response with significant travel costs in multivariate stratified sample surveys has been formulated of as a Multi-Objective Geometric Programming Problem (MOGPP). The fuzzy programming approach has been described for solving the formulated MOGPP. The formulated MOGPP has been solved with the help of LINGO Software and the dual solution is obtained. The optimum allocations of sample sizes of respondents and non respondents are obtained with the help of dual solutions and primal-dual relationship theorem. A numerical example is given to illustrate the procedure.展开更多
This paper concerns the robust non-fragile guaranteed cost control for nonlinear time delay discrete-time systems based on Takagi-Sugeno （T-S） model. The problem is to design a guaranteed cost state feedback control...This paper concerns the robust non-fragile guaranteed cost control for nonlinear time delay discrete-time systems based on Takagi-Sugeno （T-S） model. The problem is to design a guaranteed cost state feedback controller which can tolerate uncertainties from both models and gain variation. Sufficient conditions for the existence of such controller are given based on the linear matrix inequality （LMI） approach combined with Lyapunov method and inequality technique. A numerical example is given to illustrate the feasibility and effectiveness of our result.展开更多
The ability to accurately estimate the cost needed to complete a specific project has been a challenge over the past decades. For a successful software project, accurate prediction of the cost, time and effort is a ve...The ability to accurately estimate the cost needed to complete a specific project has been a challenge over the past decades. For a successful software project, accurate prediction of the cost, time and effort is a very much essential task. This paper presents a systematic review of different models used for software cost estimation which includes algorithmic methods, non-algorithmic methods and learning-oriented methods. The models considered in this review include both the traditional and the recent approaches for software cost estimation. The main objective of this paper is to provide an overview of software cost estimation models and summarize their strengths, weakness, accuracy, amount of data needed, and validation techniques used. Our findings show, in general, neural network based models outperforms other cost estimation techniques. However, no one technique fits every problem and we recommend practitioners to search for the model that best fit their needs.展开更多
Cognitive behaviors are determined by underlying neural networks. Many brain functions, such as learning and memory, have been successfully described by attractor dynamics. For decision making in the brain, a quantita...Cognitive behaviors are determined by underlying neural networks. Many brain functions, such as learning and memory, have been successfully described by attractor dynamics. For decision making in the brain, a quantitative description of global attractor landscapes has not yet been completely given. Here, we developed a theoretical framework to quantify the landscape associated with the steady state probability distributions and associated steady state curl flux, measuring the degree of non-equilibrium through the degree of detailed balance breaking for decision making. We quantified the decision-making processes with optimal paths from the undecided attractor states to the decided attractor states, which are identified as basins of attractions, on the landscape. Both landscape and flux determine the kinetic paths and speed. The kinetics and global stability of decision making are explored by quantifying the landscape topography through the barrier heights and the mean first passage time. Our theoretical predictions are in agreement with experimental observations： more errors occur under time pressure. We quantitatively explored two mechanisms of the speed-accuracy tradeoff with speed emphasis and further uncovered the tradeoffs among speed, accuracy, and energy cost. Our results imply that there is an optimal balance among speed, accuracy, and the energy cost in decision making. We uncovered the possible mechanisms of changes of mind and how mind changes improve performance in decision processes. Our landscape approach can help facilitate an understanding of the underlying physical mechanisms of cognitive processes and identify the key factors in the corresponding neural networks.展开更多
Despite lung cancer(LC) screening by low-dose computerized tomography(LDCT) gaining many proponents worldwide, for many years it was not recognized as a life-prolonging and cost-effective procedure, until recently. Pr...Despite lung cancer(LC) screening by low-dose computerized tomography(LDCT) gaining many proponents worldwide, for many years it was not recognized as a life-prolonging and cost-effective procedure, until recently. Prospective observational studies had not been able to prove that this screening prolongs survival, but they helped to specify the inclusion and exclusion criteria. Long-awaited results of a prospective, randomized trial finally provided the evidence that LC screening with LDCT can prolong survival of the screened population. Several costeffectiveness analyses were performed to justify mass introduction of this screening. Results of these analyses are equivocal, although conclusions highly depend upon inclusion and exclusion criteria, methods of analysis and prices of medical procedures which differ between countries as well as the incidence of other pulmonary nodules, especially tuberculosis. Therefore, costeffectiveness analysis should be performed separately for every country. Cost-effectiveness depends especially upon the rate of false-positive results and the rate of unnecessary diagnostic, screening and treatment procedures. To ensure high cost-effectiveness, LC screening should be performed in accordance with screening protocol, in dedicated screening centers equipped with nodule volume change analysis, or as a prospective non-randomized trial, to ensure compliance with the inclusion and exclusion criteria. To ensure high cost-effectiveness of LC screening, future research should concentrate on determination of highrisk groups and further specifying the inclusion and exclusion criteria.展开更多
目的以中国卫生体系为研究角度,评价安罗替尼对比安慰剂三线治疗晚期非小细胞肺癌的经济性,为安罗替尼的临床合理应用以及医保循证决策提供参考依据。方法利用临床试验数据和相关文献数据,应用TreeAge Pro 2022软件建立安罗替尼治疗晚...目的以中国卫生体系为研究角度,评价安罗替尼对比安慰剂三线治疗晚期非小细胞肺癌的经济性,为安罗替尼的临床合理应用以及医保循证决策提供参考依据。方法利用临床试验数据和相关文献数据,应用TreeAge Pro 2022软件建立安罗替尼治疗晚期非小细胞肺癌的Markov模型,模型以3周为一循环周期,模拟时限为10年,成本和效用值采用5%的贴现率进行贴现,确定两方案各自的成本、寿命年、质量调整生命年(QALYs),模型以增量成本-效用比(ICUR)为评价指标。采用2022年我国3倍人均GDP(257094元/QALY)作为药物经济学评价的意愿支付阈值(WTP),以判断两种方案的经济性。进行单因素敏感性分析和概率敏感性分析以判断参数改变对模型结果稳健性的影响。结果经模型模拟10年后,安罗替尼组成本为79919.41元,安慰剂组总成本为21938.43元,安罗替尼组可获得1.78个寿命年,0.8个QALYs,安慰剂组可获0.96个寿命年,0.39个QALYs,两组相比的ICUR值为141417.02元/QALY,远低于我国的意愿支付阈值(257094元/QALY)。单因素敏感性分析的结果显示无进展状态效用值和安罗替尼的价格是对结果影响最显著的因素。概率敏感性分析结果显示当阈值为257094元/QALY时,安罗替尼组具有经济性的概率为100%。结论安罗替尼对比安慰剂三线治疗我国晚期非小细胞肺癌患者时更具有经济性。展开更多
文摘AIM:To assess the appropriateness of the indication and route of administration of proton-pump-inhibitors (PPIs) and their associated cost impact. METHODS:Data collection was performed prospec-tively during a 6-mo period on 340 patients who re-ceived omeprazole intravenously during their hospital stay in non-intensive care floors. Updated guidelines were used to assess the appropriateness of the indication and route of administration. RESULTS:Complete data collection was available for 286 patients which were used to assess intravenous (IV) PPIs utilization. Around 88% of patients were receiving PPIs for claimed stress ulcer prophylaxis (SUP) indication; of which,only 17% met the guideline criteria for SUP indication,14% met the criteria for non-steroidal-anti-inflammatory drugs-induced ulcer prophylaxis,while the remaining 69% were identifi ed as having an unjustified indication for PPI use. Theinitiation of IV PPIs was appropriate in 55% of pa-tients. Half of these patients were candidates for switching to the oral dosage form during their hos-pitalization,while only 36.7% of these patients were actually switched. The inappropriate initiation of PPIs via the IV route was more likely to take place on the medical floor than the surgical floor (53% vs 36%,P = 0.003). The cost analysis associated with the appro-priateness of the indication for PPI use as well as the route of administration of PPI revealed a possible saving of up to $17 732.5 and $14 571,respectively. CONCLUSION:This study highlights the over-utili-zation of IV PPIs in non-intensive care unit patients. Restriction of IV PPI use for justified indications and route of administration is recommended.
基金This work was supported by the National Natural Science Foundation of China (No.60274009, 60574013), and the Natural Science Foundation ofLiaoning Province(No.20032020).
文摘This paper focuses on the problem of non-fragile hybrid guaranteed cost control for a class of uncertain switched linear systems. The controller gain to be designed is assumed to have additive gain variations. Based on multiple-Lyapunov function technique, the design of non-fragile hybrid guaranteed cost controllers is derived to make the corresponding closed-loop system asymptotically stable for all admissible uncertainties. Furthermore, a convex optimization approach with LMIs constraints is introduced to select the optimal non-fragile guaranteed cost controllers. Finally, a simulation example illustrates the effectiveness of the proposed approach.
文摘Objective: To evaluate the cost-effectiveness of atezolizumab plus pemetrexed and platinum-based (APP) in the first-line treatment of non-squamous non- small cell lung cancer (NSCLC). Methods: A partitioned survival model (PSM) was constructed based on the IMpower132 clinical trial. Total cost, quality- adjusted life years (QALY), and incremental cost-effectiveness ratio (ICER) were the main outputs of the model. Deterministic sensitivity analysis and probabilistic sensitivity analysis were adopted to test the uncertainty of the parameters. Results: The results of the base-case analysis illustrated that compared with PP, the incremental cost of APP was CNY 591040.94, the incremental utility was 0.46 QALY, and the ICER was CNY 1291414.83/QALY. Deterministic sensitivity analysis results illustrated that atezolizumab and other parameters have a greater impact on ICER. Probabilistic sensitivity analysis results show that no matter how each parameter changes, under the willingness to pay threshold of 3-times Chinese per capita GDP, the probability of APP has cost-effectiveness is 0. Conclusion: From the perspective of the Chinese health system, APP is not cost-effective for first-line treatment of non-squamous non-small cell lung cancer without sensitizing EGFR or ALK genetic alterations.
文摘In this paper, the problem of non-response with significant travel costs in multivariate stratified sample surveys has been formulated of as a Multi-Objective Geometric Programming Problem (MOGPP). The fuzzy programming approach has been described for solving the formulated MOGPP. The formulated MOGPP has been solved with the help of LINGO Software and the dual solution is obtained. The optimum allocations of sample sizes of respondents and non respondents are obtained with the help of dual solutions and primal-dual relationship theorem. A numerical example is given to illustrate the procedure.
文摘This paper concerns the robust non-fragile guaranteed cost control for nonlinear time delay discrete-time systems based on Takagi-Sugeno （T-S） model. The problem is to design a guaranteed cost state feedback controller which can tolerate uncertainties from both models and gain variation. Sufficient conditions for the existence of such controller are given based on the linear matrix inequality （LMI） approach combined with Lyapunov method and inequality technique. A numerical example is given to illustrate the feasibility and effectiveness of our result.
文摘The ability to accurately estimate the cost needed to complete a specific project has been a challenge over the past decades. For a successful software project, accurate prediction of the cost, time and effort is a very much essential task. This paper presents a systematic review of different models used for software cost estimation which includes algorithmic methods, non-algorithmic methods and learning-oriented methods. The models considered in this review include both the traditional and the recent approaches for software cost estimation. The main objective of this paper is to provide an overview of software cost estimation models and summarize their strengths, weakness, accuracy, amount of data needed, and validation techniques used. Our findings show, in general, neural network based models outperforms other cost estimation techniques. However, no one technique fits every problem and we recommend practitioners to search for the model that best fit their needs.
基金Project supported by the National Natural Science Foundation of China(Grant Nos.21190040,91430217,and 11305176)
文摘Cognitive behaviors are determined by underlying neural networks. Many brain functions, such as learning and memory, have been successfully described by attractor dynamics. For decision making in the brain, a quantitative description of global attractor landscapes has not yet been completely given. Here, we developed a theoretical framework to quantify the landscape associated with the steady state probability distributions and associated steady state curl flux, measuring the degree of non-equilibrium through the degree of detailed balance breaking for decision making. We quantified the decision-making processes with optimal paths from the undecided attractor states to the decided attractor states, which are identified as basins of attractions, on the landscape. Both landscape and flux determine the kinetic paths and speed. The kinetics and global stability of decision making are explored by quantifying the landscape topography through the barrier heights and the mean first passage time. Our theoretical predictions are in agreement with experimental observations： more errors occur under time pressure. We quantitatively explored two mechanisms of the speed-accuracy tradeoff with speed emphasis and further uncovered the tradeoffs among speed, accuracy, and energy cost. Our results imply that there is an optimal balance among speed, accuracy, and the energy cost in decision making. We uncovered the possible mechanisms of changes of mind and how mind changes improve performance in decision processes. Our landscape approach can help facilitate an understanding of the underlying physical mechanisms of cognitive processes and identify the key factors in the corresponding neural networks.
文摘Despite lung cancer(LC) screening by low-dose computerized tomography(LDCT) gaining many proponents worldwide, for many years it was not recognized as a life-prolonging and cost-effective procedure, until recently. Prospective observational studies had not been able to prove that this screening prolongs survival, but they helped to specify the inclusion and exclusion criteria. Long-awaited results of a prospective, randomized trial finally provided the evidence that LC screening with LDCT can prolong survival of the screened population. Several costeffectiveness analyses were performed to justify mass introduction of this screening. Results of these analyses are equivocal, although conclusions highly depend upon inclusion and exclusion criteria, methods of analysis and prices of medical procedures which differ between countries as well as the incidence of other pulmonary nodules, especially tuberculosis. Therefore, costeffectiveness analysis should be performed separately for every country. Cost-effectiveness depends especially upon the rate of false-positive results and the rate of unnecessary diagnostic, screening and treatment procedures. To ensure high cost-effectiveness, LC screening should be performed in accordance with screening protocol, in dedicated screening centers equipped with nodule volume change analysis, or as a prospective non-randomized trial, to ensure compliance with the inclusion and exclusion criteria. To ensure high cost-effectiveness of LC screening, future research should concentrate on determination of highrisk groups and further specifying the inclusion and exclusion criteria.
文摘目的以中国卫生体系为研究角度,评价安罗替尼对比安慰剂三线治疗晚期非小细胞肺癌的经济性,为安罗替尼的临床合理应用以及医保循证决策提供参考依据。方法利用临床试验数据和相关文献数据,应用TreeAge Pro 2022软件建立安罗替尼治疗晚期非小细胞肺癌的Markov模型,模型以3周为一循环周期,模拟时限为10年,成本和效用值采用5%的贴现率进行贴现,确定两方案各自的成本、寿命年、质量调整生命年(QALYs),模型以增量成本-效用比(ICUR)为评价指标。采用2022年我国3倍人均GDP(257094元/QALY)作为药物经济学评价的意愿支付阈值(WTP),以判断两种方案的经济性。进行单因素敏感性分析和概率敏感性分析以判断参数改变对模型结果稳健性的影响。结果经模型模拟10年后,安罗替尼组成本为79919.41元,安慰剂组总成本为21938.43元,安罗替尼组可获得1.78个寿命年,0.8个QALYs,安慰剂组可获0.96个寿命年,0.39个QALYs,两组相比的ICUR值为141417.02元/QALY,远低于我国的意愿支付阈值(257094元/QALY)。单因素敏感性分析的结果显示无进展状态效用值和安罗替尼的价格是对结果影响最显著的因素。概率敏感性分析结果显示当阈值为257094元/QALY时,安罗替尼组具有经济性的概率为100%。结论安罗替尼对比安慰剂三线治疗我国晚期非小细胞肺癌患者时更具有经济性。
