Benefit Appraisals Research Articles

Evaluating train protection systems

This paper arose from the work carried out for the Cullen/Uff Joint Inquiry into Train Protection Systems. It is concerned with the problem of evaluating the benefits of safety enhancements in order to avoid rare, but catastrophic accidents, and the role of Operations Research in the process. The problems include both input values and representation of outcomes. A key input is the value of life. This paper briefly discusses why the value of life might vary from incident to incident and reviews alternative estimates before producing a ‘best estimate’ for rail. When the occurrence of an event is uncertain, the normal method is to apply a single ‘expected’ value. This paper argues that a more effective method of representing such situations is through Monte-Carlo simulation and demonstrates the use of the methodology on a case study of the decision as to whether or not advanced train protection (ATP) should have been installed on a route to the west of London. This paper suggests that the output is more informative than traditional cost–benefit appraisals or engineering event tree approaches. It also shows that, unlike the results from utilizing the traditional approach, the value of ATP on this route would be positive over 50% of the time.

How does cystitis affect a comparative risk profile of tiaprofenic acid with other non-steroidal antiinflammatory drugs? An international study based on spontaneous reports and drug usage data. ADR Signals Analysis Project (ASAP) Team.

Series of well-documented case reports strongly suggest a causal association between tiaprofenic acid and a form of aseptic cystitis, which can cause serious and long-term morbidity if the drug is not withdrawn promptly. These findings are supported in the Australian and UK spontaneous reporting data-bases. Using sales data as the denominator, a comparison of NSAIDs in the WHO drug monitoring data-base indicates that the reaction is specific to tiaprofenic acid and cannot be accounted for by changes in reporting patterns in certain countries or years. Delayed recognition is an important feature of this reaction and possible reasons for this are discussed. Comparison of the risk profiles of seven NSAIDs indicated that tiaprofenic acid had the poorest risk profile, compared with NSAIDs of similar efficacy, when cystitis reports were included. The results suggest that combining spontaneous reports, classified according to severity, with sales data may enhance the ability of drug monitoring data-bases to contribute to risk benefit appraisals.

Situational coping and coping dispositions in a stressful transaction.

After reporting dispositional coping styles, students reported situational coping and 4 classes of affect (from threat, challenge, harm, and benefit appraisals) 2 days before an exam, after the exam but before grades were posted, and after posting of grades. Coping did not predict lower levels of future distress; indeed, some coping seemed to induce feelings of threat. Feelings of harm before the exam induced several kinds of coping after the exam, mostly dysfunctional. Confidence about one's grade was a better predictor of emotions throughout than was coping. Dispositional coping predicted comparable situational coping at low-moderate levels in most cases. Coping dispositions did not reliably predict emotions, however, with these exceptions: Dispositional denial was related to threat, as was dispositional use of social support; dispositional use of alcohol was related to both threat and harm.

Perceiving control, construing benefits, and daily processes in rheumatoid arthritis.

AbstractTo examine the influence of perceived pain control and pain benefit appraisals on adjustment to rheumatoid arthritis (RA), we followed fifty-four RA patients for seventy-five days. After completing measures of dispositional optimism and appraisals of control over, and benefits from, their ch