Difference in Restricted Mean Survival Time for Cost-Effectiveness Analysis Using Individual Patient Data Meta-Analysis: Evidence from a Case Study

Objective

In economic evaluation, a commonly used outcome measure for the treatment effect is the between-arm difference in restricted mean survival time (rmstD). This study illustrates how different survival analysis methods can be used to estimate the rmstD for economic evaluation using individual patient data (IPD) meta-analysis. Our aim was to study if/how the choice of a method impacts on cost-effectiveness results.

Methods

We used IPD from the Meta-Analysis of Radiotherapy in Lung Cancer concerning 2,000 patients with locally advanced non-small cell lung cancer, included in ten trials. We considered methods either used in the field of meta-analysis or in economic evaluation but never applied to assess the rmstD for economic evaluation using IPD meta-analysis. Methods were classified into two approaches. With the first approach, the rmstD is estimated directly as the area between the two pooled survival curves. With the second approach, the rmstD is based on the aggregation of the rmstDs estimated in each trial.

Results

The average incremental cost-effectiveness ratio (ICER) and acceptability curves were sensitive to the method used to estimate the rmstD. The estimated rmstDs ranged from 1.7 month to 2.5 months, and mean ICERs ranged from € 24,299 to € 34,934 per life-year gained depending on the chosen method. At a ceiling ratio of € 25,000 per life year-gained, the probability of the experimental treatment being cost-effective ranged from 31% to 68%.

Conclusions

This case study suggests that the method chosen to estimate the rmstD from IPD meta-analysis is likely to influence the results of cost-effectiveness analyses.     

An analysis of relationships among plant community phenology and seasonal metrics of Normalized Difference Vegetation Index in the northern part of the monsoon region of China

This study focuses on relationships between the phenological growing season of plant communities and the seasonal metrics of Normalized Difference Vegetation Index (NDVI) at sample stations and pixels overlying them, and explores the procedure for determining the growing season of terrestrial vegetation at the regional scale, using threshold NDVI values obtained by surface–satellite analysis at individual stations/pixels. The cumulative frequency of phenophases has been calculated for each plant community and each year in order to determine the growing season at the three sample stations from 1982 to 1993. The precise thresholds were arbitrarily set as the dates on which the phenological cumulative frequency reached 5% and 10% (for the beginning) and 90% and 95% (for the end). The beginning and end dates of the growing season were then applied each year as time thresholds, to determine the corresponding 10-day peak greenness values from NDVI curves for 8-km² pixels overlying the phenological stations. According to a trend analysis, a lengthening of the growing seasons and an increase of the integrated growing season NDVI have been detected in the central part of the research region. The correlation between the beginning dates of the growing season and the corresponding threshold NDVI values is very low, which indicates that the satellite-sensor-derived greenness is independent of the beginning time of the growing season of local plant communities. Other than in spring, the correlation between the end dates of the growing season and the corresponding threshold NDVI values is highly significant. The negative correlation shows that the earlier the growing season terminates, the larger the corresponding threshold NDVI value, and vice versa. In order to estimate the beginning and end dates of the growing season using the threshold NDVI values at sites without phenological data from 1982 to 1993, we calculated the spatial correlation coefficients between NDVI time-series at each sample station and other contiguous sites year by year. The results provide the spatial extrapolation area of the growing season for each sample station. Thus, we can use the threshold NDVI value obtained at one sample station/pixel for a year to determine the growing season at the extrapolation sites with a similar vegetation type for the same year. Received: 25 October 2000 / Revised: 19 June 2001 / Accepted: 19 June 2001     

Comparison of Life-Cycle Inventory Databases: A Case Study Using Soybean Production

Three established life-cycle inventories of agricultural operations were used to generate air emissions data for soybean production: the greenhouse gases, regulated emissions, and energy use in transportation (GREET) model; the economic input-output life-cycle assessment (EIO-LCA) model; and SimaPro software equipped with the Franklin database. EIO-LCA and GREET baseline data were compared to evaluate differences in boundary definitions that apply specifically to U.S. soybean agriculture and processing, which resulted in several major findings. The EIO model estimated for emissions of particulate matter less than 10 micrograms (PM10) resulting from wind erosion that were not included in GREET, but neglected indirect nitrous oxide (N2O) and nitrogen oxides (NOx) emissions from fertilizer application. EIO also assumed significantly lower process energy requirements and lower volatile organic compounds (VOC) for soybean crushing and oil extraction. The GREET and SimaPro models were compared using identical boundary and assumption data, to reveal major discrepancies in fundamental assumptions of energy inventories. Key emission factors varied by several orders of magnitude for basic energy generation and combustion processes, potentially impacting results for any inventory analysis that contains significant energy consumption. The Franklin database assumed VOC and sulfur oxides (SOx) emissions more than an order of magnitude higher than GREET for all categories investigated, with significantly lower N2O and methane (CH4) emission factors.     

Correlation analysis of Normalized Different Vegetation Index (NDVI) difference series and climate variables in the Xilingole steppe, China from 1983 to 1999

There is a crucial need in the study of global change to understand how terrestrial ecosystems respond to the climate system. It has been demonstrated by many researches that Normalized Different Vegetation Index (NDVI) time series from remotely sensed data, which provide effective information of vegetation conditions on a large scale with highly temporal resolution, have a good relation with meteorological factors. However, few of these studies have taken the cumulative property of NDVI time series into account. In this study, NDVI difference series were proposed to replace the original NDVI time series with NDVI difference series to reappraise the relationship between NDVI and meteorological factors. As a proxy of the vegetation growing process, NDVI difference represents net primary productivity of vegetation at a certain time interval under an environment controlled by certain climatic conditions and other factors. This data replacement is helpful to eliminate the cumulative effect that exist in original NDVI time series, and thus is more appropriate to understand how climate system affects vegetation growth in a short time scale. By using the correlation analysis method, we studied the relationship between NOAA/AVHRR ten-day NDVI difference series and corresponding meteorological data from 1983 to 1999 from 11 meteorological stations located in the Xilingole steppe in Inner Mongolia. The results show that: (1) meteorological factors are found to be more significantly correlation with NDVI difference at the biomass-rising phase than that at the falling phase; (2) the relationship between NDVI difference and climate variables varies with vegetation types and vegetation communities. In a typical steppe dominated by Leymus chinensis, temperature has higher correlation with NDVI difference than precipitation does, and in a typical steppe dominated by Stipa krylovii, the correlation between temperature and NDVI difference is lower than that between precipitation and NDVI difference. In a typical steppe dominated by Stipa grandis, there is no significant difference between the two correlations. Precipitation is the key factor influencing vegetation growth in a desert steppe, and temperature has poor correlation with NDVI difference; (3) the response of NDVI difference to precipitation is fast and almost simultaneous both in a typical steppe and desert steppe, however, mean temperature exhibits a time-lag effect especially in the desert steppe and some typical steppe dominated by Stipa krylovii; (4) the relationship between NDVI difference and temperature is becoming stronger with global warming. __________ Translated from Acta Phytoecologica Sinica, 2005, 29(5): 753–765 [译自: 植物生态学报]     

Correlation analysis of Normalized Different Vegetation Index (NDVI)difference series and climate variables in the Xilingole steppe,China from 1983 to 1999

There is a crucial need in the study of global change to understand how terrestrial ecosystems respond to the climate system.It has been demonstrated by many researches that Normalized Different Vegetation Index (NDVI)time series from remotely sensed data,which provide effective information of vegetation conditions on a large scale with highly temporal resolution,have a good relation with meteorological factors.However,few of these studies have taken the cumulative property of NDVI time series into account.In this study,NDVI difference series were proposed to replace the original NDVI time series with NDVI difference series to reappraise the relationship between NDVI and meteorological factors.As a proxy of the vegetation growing process,NDVI difference represents net primary productivity of vegetation at a certain time interval under an environment controlled by certain climatic conditions and other factors.This data replacement is helpful to eliminate the cumulative effect that exist in original NDVI time series,and thus is more appropriate to understand how climate system affects vegetation growth in a short time scale.By using the correlation analysis method,we studied the relationship between NOAA/AVHRR ten-day NDVI difference series and corresponding meteorological data from 1983 to 1999 from 11 meteorological stations located in the Xilingole steppe in Inner Mongolia.The results show that:(1)meteorological factors are found to be more significantly correlation with NDVI difference at the biomass-rising phase than that at the falling phase;(2)the relationship between NDVI difference and climate variables varies with vegetation types and vegetation communities.In a typical steppe dominated by Leymus chinensis,temperature has higher correlation with NDVI difference than precipitation does,and in a typical steppe dominated by Stipa krylovii,the correlation between temperature and NDVI difference is lower than that between precipitation and NDVI difference.In a typical steppe dominated by Stipa grandis,there is no significant difference between the two correlations.Precipitation is the key factor influencing vegetation growth in a desert steppe,and temperature has poor correlation with NDVI difference;(3)the response of NDVI difference to precipitation is fast and almost simultaneous both in a typical steppe and desert steppe,however,mean temperature exhibits a time-lag effect especially in the desert steppe and some typical steppe dominated by Stipa krylovii;(4)the relationship between NDVI difference and temperature is becoming stronger with global warming.     

Estimation of Agricultural Water Consumption from Meteorological and Yield Data: A Case Study of Hebei,North China

Over-exploitation of groundwater resources for irrigated grain production in Hebei province threatens national grain food security. The objective of this study was to quantify agricultural water consumption (AWC) and irrigation water consumption in this region. A methodology to estimate AWC was developed based on Penman-Monteith method using meteorological station data (1984–2008) and existing actual ET (2002–2008) data which estimated from MODIS satellite data through a remote sensing ET model. The validation of the model using the experimental plots (50 m²) data observed from the Luancheng Agro-ecosystem Experimental Station, Chinese Academy of Sciences, showed the average deviation of the model was −3.7% for non-rainfed plots. The total AWC and irrigation water (mainly groundwater) consumption for Hebei province from 1984–2008 were then estimated as 864 km³ and 139 km³, respectively. In addition, we found the AWC has significantly increased during the past 25 years except for a few counties located in mountainous regions. Estimations of net groundwater consumption for grain food production within the plain area of Hebei province in the past 25 years accounted for 113 km³ which could cause average groundwater decrease of 7.4 m over the plain. The integration of meteorological and satellite data allows us to extend estimation of actual ET beyond the record available from satellite data, and the approach could be applicable in other regions globally where similar data are available.     

A Comparison of Functional Outcome in Patients Sustaining Major Trauma: A Multicentre,Prospective, International Study

Objectives

To compare 6 month and 12 month health status and functional outcomes between regional major trauma registries in Hong Kong and Victoria, Australia.

Summary Background Data

Multicentres from trauma registries in Hong Kong and the Victorian State Trauma Registry (VSTR).

Methods

Multicentre, prospective cohort study. Major trauma patients and aged ≥18 years were included. The main outcome measures were Extended Glasgow Outcome Scale (GOSE) functional outcome and risk-adjusted Short-Form 12 (SF-12) health status at 6 and 12 months after injury.

Results

261 cases from Hong Kong and 1955 cases from VSTR were included. Adjusting for age, sex, ISS, comorbid status, injury mechanism and GCS group, the odds of a better functional outcome for Hong Kong patients relative to Victorian patients at six months was 0.88 (95% CI: 0.66, 1.17), and at 12 months was 0.83 (95% CI: 0.60, 1.12). Adjusting for age, gender, ISS, GCS, injury mechanism and comorbid status, Hong Kong patients demonstrated comparable mean PCS-12 scores at 6-months (adjusted mean difference: 1.2, 95% CI: −1.2, 3.6) and 12-months (adjusted mean difference: −0.4, 95% CI: −3.2, 2.4) compared to Victorian patients. Keeping age, gender, ISS, GCS, injury mechanism and comorbid status, there was no difference in the MCS-12 scores of Hong Kong patients compared to Victorian patients at 6-months (adjusted mean difference: 0.4, 95% CI: −2.1, 2.8) or 12-months (adjusted mean difference: 1.8, 95% CI: −0.8, 4.5).

Conclusion

The unadjusted analyses showed better outcomes for Victorian cases compared to Hong Kong but after adjusting for key confounders, there was no difference in 6-month or 12-month functional outcomes between the jurisdictions.     

A neotype for Colpodexylon gracilentum Dou (Lycopsida) from the Middle Devonian of North Xinjiang,China

Abstract According to newly collected and well preserved specimens, herbaceous lycopsids Colpodexylon gracilentum Dou and Colpodexylon laminatum Dou from the late Middle Devonian of Xinjiang, NW China are reduced to C. gracilentum, for which a neotype is designated and emended diagnosis is given. Colpodexylon gracilentum has leaves with three nearly equal segments, an elliptical sporangium adaxially attached by a pad on the isomorphic sporophyll.     

A neotype for Colpodexylon gracilentum Dou (Lycopsida) from the Middle Devonian of North Xinjiang,China

According to newly collected and well preserved specimens,herbaceous lycopsids Colpodexylon gracilentum Dou and Colpodexylon laminatum Dou from the late Middle Devonian of Xinjiang,NW China are reduced to C.gracilentum,for which a neotype is designated and emended diagnosis is given.Colpodexylon gracilentum has leaves with three nearly equal segments,an elliptical sporangium adaxially attached by a pad on the isomorphic sporophyll.     

A neotype for Coipodexylon gracilentum Dou (Lycopsida) from the Middle Devonian of North Xinjiang, China

According to newly collected and well preserved specimens,herbaceous lycopsids Colpodexylon gracilentum Dou and Colpodexylon laminatum Dou from the late Middle Devonian of Xinjiang,NW China are reduced to C.gracilentum,for which a neotype is designated and emended diagnosis is given.Colpodexylon gracilentum has leaves with three nearly equal segmems,an elliptical sporangium adaxially attached by a pad on the isomorphic sporophyll.     

外周血炎性指标及炎性复合指标对肥厚性硬脑膜炎诊断价值：附17例病例报告

摘要 目的：寻找可作为肥厚性硬脑膜炎（hypertrophic pachymeningitis, HP）炎性标志物的外周血炎性指标及炎性复合指标。方法：纳入2015年4月至2019年12月期间在北京同仁医院神经内科住院治疗的17例HP患者，对其临床资料、影像学及实验室检查等进行回顾性归纳分析。统计HP最常见症状及首发症状，并对出院不同预后患者的临床资料进行比较。随后纳入32例与HP无明确相关性的其他神经系统非炎性疾病患者（non-inflammatory neurological diseases，OND）作为对照，分析两组外周血炎性指标及炎性复合指标之间差异，找寻在两组间具有鉴别诊断意义的炎性指标及炎性复合指标。结果：纳入HP患者平均年龄为50±16岁，男女比10:7。其中特发性HP 10例，继发性HP 7例。最常见症状为复视（12例），其次是头痛（10例）。最常见首发症状亦为复视（7例）。HP患者脑脊液白细胞数及蛋白水平正常。随访中发现原发性HP与继发性HP预后无差异。HP组和OND组除外周血类风湿因子（rheumatoid factors，RF）、红细胞沉降率（erythrocyte sedimentation rate，ESR）具有统计学差异外（P<0.05），中性粒细胞与淋巴细胞比值（neutrophil to lymphocyte ratio, NLR）这一炎性复合指标亦存在统计学差异（P<0.05）。同时发现上述三指标中ESR联合NLR对HP的排除诊断具有较高特异性。结论：HP按病因分为特发性和继发性。其临床表现多样，本组患者以复视为主要及首发症状，其次为头痛。本研究新发现炎性复合指标NLR在HP中升高且提示外周血急性炎症状态。同时，ESR会同NLR对该病的排除诊断具有重要意义。但炎性指标和炎性复合指标对于预后判断尚有待扩大样本量进一步研究。     

Genetic Engineering of Energy Crops: A Strategy for Biofuel Production in China

Biomass utilization is increasingly considered as a practical way for sustainable energy supply and long-term environment care around the world.In concerns with food security in China,starch or sugar-based bioethanol and edible-oil-derived biodiesel are harshly restricted for large scale production.However,conversion of lignocellulosic residues from food crops is a potential alternative.Because of its recalcitrance,current biomass process is unacceptably expensive,but genetic breeding of energy crops is a p...     

Ecosystem Service Valuation Assessments for Protected Area Management: A Case Study Comparing Methods Using Different Land Cover Classification and Valuation Approaches

Accurate and spatially-appropriate ecosystem service valuations are vital for decision-makers and land managers. Many approaches for estimating ecosystem service value (ESV) exist, but their appropriateness under specific conditions or logistical limitations is not uniform. The most accurate techniques are therefore not always adopted. Six different assessment approaches were used to estimate ESV for a National Nature Reserve in southwest China, across different management zones. These approaches incorporated two different land-use land cover (LULC) maps and development of three economic valuation techniques, using globally or locally-derived data. The differences in ESV across management zones for the six approaches were largely influenced by the classifications of forest and farmland and how they corresponded with valuation coefficients. With realistic limits on access to time, data, skills and resources, and using acquired estimates from globally-relevant sources, the Buffer zone was estimated as the most valuable (2.494 million ± 1.371 million CNY yr^-1 km^-2) and the Non-protected zone as the least valuable (770,000 ± 4,600 CNY yr^-1 km^-2). However, for both LULC maps, when using the locally-based and more time and skill-intensive valuation approaches, this pattern was generally reversed. This paper provides a detailed practical example of how ESV can differ widely depending on the availability and appropriateness of LULC maps and valuation approaches used, highlighting pitfalls for the managers of protected areas.     

Service Lifetime,Storage Time,and Disposal Pathways of Electronic Equipment: A Swiss Case Study

Product lifetime is an essential aspect of dynamic material flow analyses and has been modeled using lifetime distribution functions, mostly average lifetimes. Existing data regarding the lifetime of electronic equipment (EE) are based on diverging definitions of lifetime as well as different temporal and regional scopes. After its active use, EE is often not disposed of immediately, but remains in storage for some time. Specific data on the share of EE that is stored and the time they remain in storage are scarce. This article investigates the service lifetime, storage time, and disposal pathways of ten electronic device types, based on data from an online survey complemented by structured interviews. We distinguish between new and secondhand devices and compute histograms, averages, and medians of the different lifetimes and their change over time. The average service lifetime varies from 3.3 years for mobile phones to 10.8 years for large loudspeakers, the average storage time from 0.8 years for flat panel display televisions to 3.6 years for large loudspeakers. Most service lifetime histograms are positively skewed and show substantial differences among device types. The storage time histograms, being more similar to one another, indicate that the storage behavior is similar for most device types. The data on disposal pathways show that a large proportion of devices are stored and reused before they reach the collection scheme.     

Prevalence,Subtype Classification,and Outcomes of Treatment of Primary Aldosteronism: A Prospective Study in China

ObjectiveTo investigate the prevalence of primary aldosteronism (PA) among participants with hypertension, evaluate the concordance of PA classification between adrenal computed tomography and adrenal venous sampling, and compare the outcomes of surgery and medication for unilateral PA.MethodsA prospective study was conducted among all inpatients with hypertension (n = 7594) at the National Center for Cardiovascular Diseases, China, from May 2016 to April 2018.ResultsOf the 7594 participants, 8.12% (n = 617) with plasma aldosterone-renin ratio ≥3.7 were possible PA cases. Three hundred sixty-seven cases with plasma aldosterone-renin ratio ≥3.7 and plasma aldosterone concentration ≥10 ng/dL were confirmed using the recumbent saline infusion test (69.20%, 182 of 263) or the captopril challenge test (66.5%, 69 of 104, P > .05). The prevalence of PA was 3.31% (n = 251). Of the 251 patients with PA, all of them had multiple comorbidities, and 49.40% (n = 124) had spontaneous hypokalemia. The concordance of PA classification between adrenal computed tomography and adrenal venous sampling was only 47.11%. The patients’ blood pressure declined to normal ranges in the adrenalectomy (85.71%, 30 of 35) and spironolactone (63.04%; 29 of 46) groups (P < .05). Furthermore, hypokalemia was normalized in the adrenalectomy (100.00%; 26 of 26) and spironolactone (94.74%; 18 of 19) groups.ConclusionIt is necessary to incorporate PA screening into routine practice for those with hypertension in the Chinese population. This will assist in ensuring that the best therapeutic schedule based on PA subtypes is devised. Additionally, as a result, it may contribute to restoring the blood pressure levels and reducing the prevalence of comorbidities in these patients with PA.     

Risk Assessment for a Flood Control Engineering System Using Fuzzy Theory: A Case in China

Flood control engineering system risk assessment entails fuzziness. An assessment model is developed, based on the improved fuzzy comprehensive assessment method that developed a new index (S_fin ) to judge the assessment class. The model is used to assess the flood control engineering risk of a case in China. The results show that the proposed model in the present article can rationally determine the risk status of a flood control engineering system, and has higher resolution compared to the two conventional methods, fuzzy comprehensive assessment and matter-element model method. The proposed model is flexible and adaptable for determining flood control engineering system risk status.     

粤北六地森林群落的比较研究

利用植被样方法和重要值计算,对地处广东北部山区的南雄青嶂山、始兴南山、曲江沙溪、翁源青云山、新丰云髻山、河源大桂山的森林群落乔木层优势科、优势种及各地共优种的径级结构进行了比较分析。结果表明,各地共有优势科为壳斗科、樟科、山茶科、金缕梅科、冬青科、杜鹃花科等13科,与他们所处的中亚热带地理位置相适应;6地共有优势种9个,优势度存在明显差异。群落的相似性系数以沙溪与南山之间的75．88％为最大;青云山与大桂山之间的45．64％为最低;南山与其他各地的群落相似性系数均大于60％。共有优势种的种群径级结构中,甜锥（Castanopsis eyrei）、罗浮柿（Diospyros morrisiana）、酸枣（Choerospondias axillaris）种群在粤北6地的个体数量分布,与各地的纬度差异有较明显的相关性。云髻山和沙溪的黧蒴（Castanopsis fissa）种群呈增长趋势,而南山和大桂山的趋于衰退。青云山的木荷（Schima superba）种群呈增长趋势,而其他地区的更新不良。黄樟（Cinnamomum porrectum）在各地分布为散生,种群规模小,径级结构不完整。各地枫香（Liquidambar formosana）种群的径级结构不完整,缺乏Ⅰ级幼苗。杉木（Cunninghamia lanceolata）、马尾松（Pinus massoniana）种群在粤北6地均呈现衰退趋势。研究结果提示,整体上粤北6地森林的非地带性植被趋于衰退,常绿阔叶林的恢复进展顺利。     

Scenario-Based Multi-Objective Optimum Allocation Model for Earthquake Emergency Shelters Using a Modified Particle Swarm Optimization Algorithm: A Case Study in Chaoyang District,Beijing, China

The correct location of earthquake emergency shelters and their allocation to residents can effectively reduce the number of casualties by providing safe havens and efficient evacuation routes during the chaotic period of the unfolding disaster. However, diverse and strict constraints and the discrete feasible domain of the required models make the problem of shelter location and allocation more difficult. A number of models have been developed to solve this problem, but there are still large differences between the models and the actual situation because the characteristics of the evacuees and the construction costs of the shelters have been excessively simplified. We report here the development of a multi-objective model for the allocation of residents to earthquake shelters by considering these factors using the Chaoyang district, Beijing, China as a case study. The two objectives of this model were to minimize the total weighted evacuation time from residential areas to a specified shelter and to minimize the total area of all the shelters. The two constraints were the shelter capacity and the service radius. Three scenarios were considered to estimate the number of people who would need to be evacuated. The particle swarm optimization algorithm was first modified by applying the von Neumann structure in former loops and global structure in later loops, and then used to solve this problem. The results show that increasing the shelter area can result in a large decrease in the total weighted evacuation time from scheme 1 to scheme 9 in scenario A, from scheme 1 to scheme 9 in scenario B, from scheme 1 to scheme 19 in scenario C. If the funding were not a limitation, then the final schemes of each scenario are the best solutions, otherwise the earlier schemes are more reasonable. The modified model proved to be useful for the optimization of shelter allocation, and the result can be used as a scientific reference for planning shelters in the Chaoyang district, Beijing.