Home About us Contact
|
Home About us Contact | ||
|
|
||
Modest Effects (modest + effects)
Kinds of Modest Effects Selected AbstractsEffects of dietary caffeine on EEG, performance and mood when rested and sleep restricted,HUMAN PSYCHOPHARMACOLOGY: CLINICAL AND EXPERIMENTAL, Issue 8 2008Michael A. Keane Abstract Rationale: Until recently, little account had been taken of the confounding effects of caffeine withdrawal and withdrawal reversal when examining the net effects of dietary caffeine. Objectives: By including a manipulation involving sleep restriction, the present study aimed to extend recent findings from research in which caffeine withdrawal and withdrawal reversal were controlled. The main aims of the study were to examine the net effects of caffeine, as well as its potential restorative effects following sleep restriction, on EEG, performance and mood. Method: A randomised cross-over design was used in which 15 participants alternated weekly between ingesting placebo and caffeine (1.75,mg/kg) three times daily for four consecutive weeks following either usual sleep or sleep restriction. EEG activity was measured at 32 sites during eyes closed, eyes open and performance of a vigilance task. Results: Modest effects of caffeine were found in the delta and beta bandwidths, but no main effects of caffeine were observed in the theta or alpha bandwidths. Overall, the effects of caffeine on EEG activity were relatively few, weak and inconsistent, and no evidence was found of net restorative effects of caffeine for any outcome variables. Conclusions: The findings do not support the use of caffeine as a means for enhancing human function or as an antidote to the negative effects of sleep loss. Copyright © 2008 John Wiley & Sons, Ltd. [source] BETTER GUN ENFORCEMENT, LESS CRIME,CRIMINOLOGY AND PUBLIC POLICY, Issue 4 2005JENS LUDWIG Research Summary: Project Safe Neighborhoods (PSN), which for the past several years has been the major federal initiative to combat gun violence, includes several elements (such as gun locks and other efforts to reduce gun availability) that research suggests are likely to have at best modest effects on gun crime. In general, enforcement activities targeted at the "demand side" of the underground gun market currently enjoy stronger empirical support. However much of PSN's budget has been devoted to increasing the severity of punishment, such as by federaliz-ing gun cases, which seems to be less effective than targeted street-level enforcement designed to increase the probability of punishment for gun carrying or use in crime. Policy Implications: PSN and other enforcement activities could be made more effective by redirecting resources toward activities such as targeted patrols against illegal gun carrying. Given the substantial social costs of gun violence, an efficiency argument can also be made for increasing funding beyond previous levels. [source] ,I'm the Boss': testing the feasibility of an evidence-based patient education programme using problem-based learningEUROPEAN DIABETES NURSING, Issue 1 2004K Wikblad FEND Professor in Diabetes Nursing Abstract Patient education programmes have shown only small to modest effects on diabetes self-care and metabolic control. Despite that, almost all diabetes teams agree that patient education is an extremely important part of the treatment of diabetes. It is, therefore, important to identify components of successful patient education as a basis for creating and testing an evidence-based education programme. In a review of controlled studies evaluating patient education such components were identified and these were then used in building up the new programme. This programme, called ,I'm the Boss', is based on the notion that the patient is an active care participant, setting his own self-care goals, and is the one responsible for his own life. The content of the programme did not, therefore, focus on diabetes as such, but on life with diabetes. Six themes were explored during six three-hour weekly sessions. The educational method used was problem-based learning. This method is founded in cognitive theory and views the learner as active in seeking knowledge and able to solve the self-care problems identified. The aim of this study was to explore the feasibility of the programme which was tested in four small groups (five to eight participants) of diabetic patients together with two facilitators. After completing the programme, the patients participated in focus group interviews to evaluate the programme. They identified both positive and negative factors. After each session the two facilitators reflected upon the group dynamics. In particular, problems with allowing patients to be the experts should be highlighted. This programme has been modified according to the evaluation and it is now being tested in a randomised, controlled, multicentre study. Copyright © 2004 FEND. [source] Effects of sequential depositional basins on lake response to urban and agricultural pollution: a palaeoecological analysis of the Qu'Appelle Valley, Saskatchewan, CanadaFRESHWATER BIOLOGY, Issue 3 2000Aruna S. Dixit 1. Palaeolimnological analyses of fossil diatoms and pigments were conducted in four lakes of the Qu'Appelle Valley, Saskatchewan, Canada, to quantify the effect of upstream depositional basins on lake response to urban and agricultural human activities. Pasqua, Echo, Mission and Katepwa lakes exhibit similar modern limnological characteristics, lie sequentially downstream from urban point sources of growth-limiting nitrogen (N), yet drain similarly large areas of farmland (38,40 × 103 km2). 2. Analyses indicated that all lakes were naturally productive, contained eutrophic diatoms (i.e. Stephanodiscus niagarae, S. hantzchii, S. parvus and Aulacoseira granulata), and supported blooms of colonial (as myxoxanthophyll) and potentially toxic N-fixing cyanobacteria (aphanizophyll), even prior to the onset of European settlement (ca. 1890) and urban development (ca. 1930). 3. The onset of agricultural practices ca. 1890 had only modest effects on algal communities in the Qu'Appelle lakes, with subtle increases in eutrophic diatom species (Pasqua, Mission and Katepwa lakes) and 25,50% increases in pigment-inferred algal abundance (Echo, Mission and Katepwa lakes). 4. Despite naturally high production, total algal abundance (,-carotene) in upstream Pasqua Lake increased by more than 350% after intense urbanization beginning ca. 1930, while eutrophic diatoms became more common and cyanobacteria populations increased ten-fold. Principal components analysis (PCA) explained 64% of diatom variance, and identified three eras corresponding to baseline, pre-agricultural communities (1776,1890), an era of high production (ca. 1925,1960) and recent variable community composition following tertiary treatment of urban sewage (ca. 1977,1990). 5. Analyses of three downstream lakes demonstrated that urban impacts following 1930 remained evident in fossil profiles of ,-carotene and myxoxanthophyll, but that large blooms of N-fixing cyanobacteria were restricted to the past 25 years at downstream Mission and Katepwa lakes. Similarly, PCA showed that fossil diatom assemblages exhibited little directional variation until the 1970s. 6. Together, these analyses support the hypothesis that upstream lakes were effective at reducing the impacts of point-source urban nutrients on downstream lakes. In contrast, diffuse agricultural activities had only limited impacts on water quality and these were less well ameliorated by upstream basins. [source] Overcoming the Glass Barriers: Reflection and Action in the ,Women to the Top' ProgrammeGENDER, WORK & ORGANISATION, Issue 2 2008Ulla Eriksson-Zetterquist Numerous equality programmes have been launched with the aim of promoting a more gender equal work life, yet little substantial action has been reported. This article presents a study of the Women to the Top programme in Sweden, supported by the European Union (EU) and aimed at promoting more women into top management positions. The research suggests that large-scale projects assembling such heterogeneous actors as industry representatives, politicians and scholars tend to generate further reflection and discussion rather than promoting adequate and highly needed action. Drawing upon Brunsson's distinction between action rationality and decision rationality, the relatively modest effects of large-scale equality programmes are examined, not in terms of a lack of commitment or competence on the part of the participants but as a matter of the disjunction between reflection and action. Reconciling reflection and action, that is, emphasizing not only reflection on gender inequality but also privileging various forms of practical action (such as new policies, the appointment of female managers, restructuring gendered wage inequalities or new recruitment procedures), is therefore a top priority for policymakers desiring more substantial changes in the gendered outline of industry. [source] Simple estimates of haplotype relative risks in case-control dataGENETIC EPIDEMIOLOGY, Issue 6 2006Benjamin French Abstract Methods of varying complexity have been proposed to efficiently estimate haplotype relative risks in case-control data. Our goal was to compare methods that estimate associations between disease conditions and common haplotypes in large case-control studies such that haplotype imputation is done once as a simple data-processing step. We performed a simulation study based on haplotype frequencies for two renin-angiotensin system genes. The iterative and noniterative methods we compared involved fitting a weighted logistic regression, but differed in how the probability weights were specified. We also quantified the amount of ambiguity in the simulated genes. For one gene, there was essentially no uncertainty in the imputed diplotypes and every method performed well. For the other, ,60% of individuals had an unambiguous diplotype, and ,90% had a highest posterior probability greater than 0.75. For this gene, all methods performed well under no genetic effects, moderate effects, and strong effects tagged by a single nucleotide polymorphism (SNP). Noniterative methods produced biased estimates under strong effects not tagged by an SNP. For the most likely diplotype, median bias of the log-relative risks ranged between ,0.49 and 0.22 over all haplotypes. For all possible diplotypes, median bias ranged between ,0.73 and 0.08. Results were similar under interaction with a binary covariate. Noniterative weighted logistic regression provides valid tests for genetic associations and reliable estimates of modest effects of common haplotypes, and can be implemented in standard software. The potential for phase ambiguity does not necessarily imply uncertainty in imputed diplotypes, especially in large studies of common haplotypes. Genet. Epidemiol. 2006. © 2006 Wiley-Liss, Inc. [source] Chemokine receptor-dependent alloresponsesIMMUNOLOGICAL REVIEWS, Issue 1 2003Wayne W. Hancock Summary:, Immunologists have typically viewed alloreactivity schematically as a function of antigen presentation, expansion of alloreactive T and B cells within regional lymphoid tissues, and cellular infiltration and destruction of an allograft. Actual details of the steps between immune activation and accumulation of effector cells within a graft typically have not received much attention. However, just how cells ,know' to move to and migrate within a graft or not is proving to be of increasing interest, as the chemokine-dependent mechanisms underlying leukocyte recruitment to a transplant are dissected. Experimentally, chemokine receptor targeting can prolong or induce permanent allograft survival, despite preservation of alloresponses within secondary lymphoid tissues, whereas current immunosuppressive protocols have only modest effects on chemokine production and leukocyte homing. Recent knowledge of the chemokine-dependent nature of allograft rejection, acceptance, and tolerance induction are presented as a basis for understanding the rationale for preclinical trials of chemokine receptor-targeted therapies currently underway in primate recipients of solid organ allografts. [source] Effects of modification of membrane lipid composition on Bacillus subtilis sporulation and spore propertiesJOURNAL OF APPLIED MICROBIOLOGY, Issue 6 2009K.K. Griffiths Abstract Aims:, To determine effects of inner membrane lipid composition on Bacillus subtilis sporulation and spore properties. Methods and Results:, The absence of genes encoding lipid biosynthetic enzymes had no effect on B. subtilis sporulation, although the expected lipids were absent from spores' inner membrane. The rate of spore germination with nutrients was decreased c. 50% with mutants that lacked the major cardiolipin (CL) synthase and another enzyme for synthesis of a major phospholipid. Spores lacking the minor CL synthase or an enzyme essential for glycolipid synthesis exhibited 50,150% increases in rates of dodecylamine germination, while spores lacking enzymes for phosphatidylethanolamine (PE), phosphatidylserine (PS) and lysylphosphatidylglycerol (l-PG) synthesis exhibited a 30,50% decrease. Spore sensitivity to H2O2 and tert-butylhydroperoxide was increased 30,60% in the absence of the major CL synthase, but these spores' sensitivity to NaOCl or OxoneÔ was unaffected. Spores of lipid synthesis mutants were less resistant to wet heat, with spores lacking enzymes for PE, PS or l-PG synthesis exhibiting a two to threefold decrease and spores of other strains exhibiting a four to 10-fold decrease. The decrease in spore wet heat resistance correlated with an increase in core water content. Conclusions:, Changing the lipid composition of the B. subtilis inner membrane did not affect sporulation, although modest effects on spore germination and wet heat and oxidizing agent sensitivity were observed, especially when multiple lipids were absent. The increases in rates of dodecylamine germination were likely due to increased ability of this compound to interact with the spore's inner membrane in the absence of some CL and glycolipids. The effects on spore wet heat sensitivity are likely indirect, because they were correlated with changes in core water content. Significance and Impact of the Study:, The results of this study provide insight into roles of inner membrane lipids in spore properties. [source] Plant response to solar ultraviolet-B radiation in a southern South American Sphagnum peatlandJOURNAL OF ECOLOGY, Issue 4 2002Peter S. Searles Summary 1Plant growth and pigmentation of the moss Sphagnum magellanicum and the vascular plants Empetrum rubrum, Nothofagus antarctica and Tetroncium magellanicum were measured under near-ambient (90% of ambient) and reduced (20%) ultraviolet-B (UV-B) radiation for three growing seasons in a Sphagnum peatland in Tierra del Fuego, Argentina (55° S). 2Reduction of solar UV-B increased height growth but decreased volumetric density in S. magellanicum so that biomass production was not influenced during the 3 years. The morphology of vascular plants tended not to respond to UV-B reduction. 3A 10,20% decrease in UV-B-absorbing compounds occurred in T. magellanicum under solar UV-B reduction. No effects were seen on chlorophyll or carotenoids in S. magellanicum, although, for UV-B-absorbing compounds, a significant interaction between UV-B and year suggests some response to solar UV-B reduction. 4The climate-related growth of the dwarf shrub E. rubrum was assessed retrospectively by correlating an 8-year record of annual stem elongation with macroclimatic factors including solar UV-B and visible radiation, precipitation and temperature. 5No significant negative correlations were found between annual E. rubrum stem elongation and ambient solar UV-B, the ratio of UV-B : visible radiation, or the 305-nm : 340-nm irradiance ratio for an 8-year record (1990,91 to 1997,98), nor was stem elongation affected by solar UV-B reduction in our experimental field plots after 3 years. 6The role of solar UV-B radiation on plant growth in Sphagnum peatlands in Tierra del Fuego, Argentina, is likely to depend on the severity of stratospheric ozone depletion over the next several decades. The increases in ambient solar UV-B associated with ozone depletion over the last 20 years are less than the difference between our radiation treatments. Therefore, providing that the ozone layer substantially recovers by the middle of this century, only modest effects of increased solar UV-B on plant growth may be expected. [source] The DAF-2 insulin-like signaling pathway independently regulates aging and immunity in C. elegansAGING CELL, Issue 6 2008Eric A. Evans Summary The Caenorhabditis elegans DAF-2 insulin-like signaling pathway, which regulates lifespan and stress resistance, has also been implicated in resistance to bacterial pathogens. Loss-of-function daf-2 and age-1 mutants have increased lifespans and are resistant to a variety of bacterial pathogens. This raises the possibility that the increased longevity and the pathogen resistance of insulin-like signaling pathway mutants are reflections of the same underlying mechanism. Here we report that regulation of lifespan and resistance to the bacterial pathogen Pseudomonas aeruginosa is mediated by both shared and genetically distinguishable mechanisms. We find that loss of germline proliferation enhances pathogen resistance and this effect requires daf-16, similar to the regulation of lifespan. In contrast, the regulation of pathogen resistance and lifespan is decoupled within the DAF-2 pathway. Long-lived mutants of genes downstream of daf-2, such as pdk-1 and sgk-1, show wildtype resistance to pathogens. However, mutants of akt-1 and akt-2, which we find to individually have modest effects on lifespan, show enhanced resistance to pathogens. We also demonstrate that pathogen resistance of daf-2, akt-1, and akt-2 mutants is associated with restricted bacterial colonization, and that daf-2 mutants are better able to clear an infection after challenge with P. aeruginosa. Moreover, we find that pathogen resistance among insulin-like signaling mutants is associated with increased expression of immunity genes during infection. Other processes that affect organismal longevity, including Jun kinase signaling and caloric restriction, do not affect resistance to bacterial pathogens, further establishing that aging and innate immunity are regulated by genetically distinct mechanisms. [source] Serotonin receptors antagonistically modulate Caenorhabditis elegans longevityAGING CELL, Issue 4 2007Hana Murakami Summary The neurotransmitter serotonin has been implicated in affecting the variation of longevity in natural Drosophila populations and age-related diseases in mammals. Based on these observations, it has been predicted that serotonin signal, perhaps at levels of serotonin biosynthesis, may control lifespan. Here, we investigated a variety of mutations in serotonin-signal genes, including serotonin biosynthesis genes, a serotonin transporter gene, and serotonin receptor genes. Despite this prediction, mutations in the serotonin biosynthesis genes had little or modest effects on lifespan, while the mod-5 mutation with increased availability of serotonin caused a modest life-shortening effect. In contrast, a deletion mutation of the ser-1 serotonin receptor gene increased longevity by up to 46%, likely through the insulin/insulin-like growth factor 1 pathway. This result suggests an interaction between the serotonin pathway and the insulin/insulin-like growth factor 1 pathway. A deletion mutation of another serotonin receptor gene, ser-4, shortened early to mid lifespan. The results suggest that serotonin signal antagonistically modulates longevity through different serotonin receptors. This study may indicate serotonin receptors as a potential target for antigeric interventions. [source] Molecular simulation of ammonia absorption in the ionic liquid 1-ethyl-3-methylimidazolium bis(trifluoromethylsulfonyl)imide ([emim][Tf2N])AICHE JOURNAL, Issue 9 2009Wei Shi Isotherms for ammonia absorption in the ionic liquid 1-ethyl-3-methylimidazolium bis(trifluoromethylsulfonyl)imide ([emim][Tf2N]) are computed at temperatures ranging from 298 K to 348 K using osmotic ensemble Monte Carlo simulations. The results agree well with previous experimental measurements. Activity coefficients vary from 0.5 to 0.8, indicating negative deviations from Raoult's Law. The computed enthalpy of mixing ranges from ,2 to ,11 kJ/mol. Computed partial molar volumes are on the order of 25,30 cm3/mol. Energy and radial distribution analyses indicate that ammonia interacts more strongly with the cation than the anion, in contrast to observations made of other gases in ionic liquids such as CO2. The reason for this behavior is that ammonia forms a strong hydrogen bond with the ring hydrogen atoms of the cation. The simulations predict that strategies aimed at changing the solubility of ammonia should focus on altering the hydrogen bond donating ability of the cation, and that altering the anion will have more modest effects. It is shown that this hypothesis is consistent with available experimental data. © 2009 American Institute of Chemical Engineers AIChE J, 2009 [source] Low-level lead exposure and childrenJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 5 2001NR Wigg Abstract: The adverse effects of environmental lead exposure on the mental development of young children are well established. There is no safe level of blood lead below which children are not affected. Recent research expands our understanding of the impact of lead exposure continuing into later childhood, as well as its effects on children's behaviour. However, social and other environmental factors also contribute to variance in measures of developmental and behavioural outcomes. Lead is associated with only modest effects on children's development, but is a potentially modifiable risk factor. As environmental exposure to lead declines for the whole population, continued specific attention is needed for children living in industrial areas. [source] Menatetrenone (Vitamin K2) and Bone Quality in the Treatment of Postmenopausal OsteoporosisNUTRITION REVIEWS, Issue 12 2006Jun Iwamoto MD Menatetrenone (vitamin K2) reduces the incidence of vertebral fractures but has only modest effects on bone mineral density (BMD) in postmenopausal women with osteoporosis. Combined treatment with bisphosphonates and menatetrenone may be more effective than treatment with bisphosphonates alone in preventing vertebral fractures, despite the lack of an additive effect of menatetrenone on the BMD increase by bisphosphonates. Menatetrenone improves bone architecture in ovariectomized rats, and the mineral/ matrix ratio of the bone in terms of matrix volume and bone strength (without increasing bone mass) in rats with magnesium deficiency. Thus, available evidence supports an effect of menatetrenone on bone quality during osteoporosis treatment [source] Impact of regulatory labeling for troglitazone and rosiglitazone on hepatic enzyme monitoring compliance: findings from the state of Ohio medicaid program,PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 1 2005Robert J. Cluxton Jr PharmD Abstract Purpose Troglitazone, the first drug of the thiazolidinediones class for type II diabetes, was first marketed in March 1997 and was removed from the U.S. market 36 months later after 90 cases of liver failure were reported despite multiple warnings containing liver enzyme monitoring recommendations. Rosiglitazone has been available since June 1999 and is still on the market. The purpose of this study was to evaluate the impact of labeled hepatic enzyme monitoring for troglitazone and rosiglitazone. Methods Drug cohorts were assembled, using population-based fee-for-service Medicaid claims, for patients between 18 and 65 years of age who had received at least one troglitazone (n,=,7226) or rosiglitazone (n,=,1480) prescription between 1 April, 1997, and 21 March, 2000. The outcome of interest was the percentage of patients, based on their first treatment episode, who had baseline and post-baseline liver enzyme testing. Results Overall baseline testing was under 9% before regulatory actions, increased to 14% after the first two ,Dear Doctor' letters issued by the FDA in October and December 1997, and peaked to about 26% afterwards. Coincident with the marketing of rosiglitazone and the fourth ,Dear Doctor' letter issued in June 1999, baseline testing dropped to 18%. Baseline testing increased 2.5-fold (race-sex-age adjusted) after regulatory action. Achieving 50% post-baseline testing took approximately 6 months for both drugs. Conclusion Regulatory actions had only modest effects on the incidence of liver monitoring. More effective and timely communication strategies, health provider prescribing interventions and modification of health provider behaviors to enhance compliance with recommended risk management measures need to be identified, evaluated and implemented. Copyright © 2004 John Wiley & Sons, Ltd. [source] States' Senior Residential Property Tax Abatements: Uncontroversial Benefit or Looming but Unrecognized Problem?POLITICS & POLICY, Issue 4 2010CHARLES LOCKHART All the U.S. states create residential property tax abatement policies that provide important benefits for a rapidly growing older population. These policies vary sharply, and we seek to explain variation in their generosity. We employ regression in conjunction with a cross-sectional data set of the 50 states focused early in the current decade. Several variables prominent in explaining cross-state variation in other public policies exert only modest effects on these programs. Rather, the primary influence is a positive one for a cultural orientation toward government helping a broad swath of the citizenry. We attribute this unusual pattern of explanatory factors to (1) abatement programs' older target populations; (2) their tax expenditure status; and (3) their tendency to be categorized as economic development rather than social programs. This explanatory pattern holds theoretical importance inasmuch as it provides few constraints on the growth of at least some programs serving older citizens. Todos los estados de la Unión Americana establecen políticas de reducción de impuestos para las propiedades residenciales que dan beneficios importantes para la población, en rápido crecimiento, de adultos mayores. Estas políticas varían bruscamente y buscamos explicar la variación en su generosidad. Empleamos una regresión conjuntamente con datos transversales de 50 estados y enfocados en el principio de la década actual. Diversas variables que explican la variación entre estados en otras políticas públicas sólo ejercen efectos modestos en estos programas de reducción de impuestos. En cambio, la influencia más importante es una positiva para la orientación cultural relacionada con la ayuda del gobierno para una amplia porción de la ciudadanía. Atribuimos este diseño inusual de factores explicativos a: (1) la población objetivo de adultos mayores de estos programas de reducciones; (2) al estatus de los adultos mayores en los programas de reducciones y (3) a la tendencia de que la reducción de impuestos para las propiedades residenciales sea categorizada como desarrollo económico en lugar de programas sociales. Este patrón explicativo mantiene una importancia teórica dado que provee pocas restricciones para el desarrollo en el futuro de al menos algunos programas de ayuda a la ciudadanía de adultos mayores. [source] The impact of prognosis without treatment on doctors' and patients' resource allocation decisions and its relevance to new drug recommendation processesBRITISH JOURNAL OF CLINICAL PHARMACOLOGY, Issue 2 2008D. Ross Camidge What is already known about this subject ,,The dominant health economic units upon which new treatment funding decisions are made are the incremental cost per life year gained (LYG) or the cost per quality-adjusted life year (QALY) gained. ,,Neither of these units modifies the amount of health gained, by the amount of health patients would have had if they had not been given the treatment under consideration, which may unfairly undervalue the treatments for poor prognosis conditions. ,,How certain patients make decisions about their own treatment has previously been explored, but not how they, or doctors, would allocate hypothetical resource within a healthcare system given information on disease-treatment scenarios' prognoses with and without treatment. What this study adds ,,Information on prognosis without treatment is used within the resource allocation strategies of many doctors and most patients. ,,Individuals use this information in a variety of different ways and a single dominant strategy for quantitative modification of health units is not apparent. ,,Information on prognosis without treatment, or prognosis with standard treatment, is available from the control arm of randomized controlled clinical trials and should be used qualitatively to facilitate decision-making around the second inflexion point on cost per QALY/LYG acceptability curves. Aims Health economic assessments increasingly contribute to funding decisions on new treatments. Treatments for many poor prognosis conditions perform badly in such assessments because of high costs and modest effects on survival. We aimed to determine whether underlying shortness of prognosis should also be considered as a modifier in such assessments. Methods Two hundred and eighty-three doctors and 201 oncology patients were asked to allocate treatment resource between hypothetical patients with unspecified life-shortening diseases. The prognoses with and without treatment were varied such that consistent use of one of four potential allocation strategies could be deduced: life years gained (LYGs) , which did not incorporate prognosis without treatment information; percentage increase in life years (PILY); life expectancy with treatment (LEWT) or immediate risk of death (IRD). Results Random choices were rare; 47% and 64% of doctors and patients, respectively, used prognosis without treatment in their strategies; while 50% and 32%, respectively, used pure LYG-based strategies. Ranking orders were LYG > PILY > IRD > LEWT (doctors) and LEWT > LYG > IRD > PILY (patients). When LYG information alone could not be used, 76% of doctors prioritized shorter prognoses, compared with 45% of patients. Conclusions Information on prognosis without treatment is used within the resource allocation strategies of many doctors and most patients, and should be considered as a qualitative modifier during the health economic assessments of new treatments for life-shortening diseases. A single dominant strategy incorporating this information for any quantitative modification of health units is not apparent. [source] | ||||||||||||||||