Tornado Diagram Research Articles

A computational framework and sensitivity analysis for the hormonal treatment of bone

BackgroundOsteoporosis is a bone disease identified by disordering of bone formation and resorption cells. It increases the risk of bone fragility and fracture. Autocrine and paracrine signalling of osteoclasts and osteoblasts plays an important role in the regulation of bone remodelling. Calcitonin is an approved pharmacologic agent for the treatment of osteoporosis. MethodsA novel mathematical model comprising the interaction among osteoclasts and osteoblasts cells with intermittent administration of calcitonin has been presented to study the dynamics of osteoporotic bone. The stability of model and sensitivity of parameters are also discussed. FindingsThe population of osteoclastic and osteoblastic cells has been predicted via numerical simulation. The results of Monte Carlo sensitivity analysis are shown via tornado diagram. InterpretationIt is concluded that intermittent administration of calcitonin is an effective therapy for the treatment of osteoporosis.

Cost-effectiveness analysis of the Un Chez Soi d’Abord randomized controlled trial: a Markov model

Abstract Objectives Providing permanent supported housing (rent subsidies), integrating clinical and social services to homeless people may represent a financial barrier for building a healthier European public policy. Our objective was to conduct a cost-effectiveness analysis of the French Housing First program. Design and methods Between 2011 and 2014, homeless people with severe mental illness from 4 French major cities were randomized to Housing First (HF, n = 353) or Treatment as Usual (TAU, n = 350) and followed over 24 months. Housing stability and survival were assessed. Costs incurred by health (ED visits, hospital admissions, physician consultations), social (shelters, supported accommodations, other residential structures), justice services (court appearances, detention and penitentiary centres), and welfare benefits were collected over 24 months. Markov models of 6-month transition probabilities were compared among HF group (offering an independent house and support from outpatient mental health and social team) and TAU group (receiving pre-existing dedicated homeless-targeted programs and services). Three Markov states were defined: stable housing (at least 90 nights in an independent housing), unstable housing (i.e. inverse) and death. A societal perspective and a life-time horizon were chosen. Robust sensitivity analyses were performed, including Tornado diagram and Monte-Carlo simulations. Results There is evidence of changes (P<.001) in housing stability (246% more days housed) for the HF group compared with TAU group. From the societal perspective, HF was €10,163 (3%) more costly than usual care. ICER was €5.32 per additional night spent in independent housing. In sensitivity analyses, HF was less costly and more effective in 28% of iterations. Conclusions HF proves to be cost-effective in homeless people with mental disorders and may assist decision-makers in defining conditions for further implementation of these innovations in Europe. Key messages Housing First model proves to be cost-effective in homeless people with mental disorders. Housing First model was less costly and more effective in 28% of ieration compared to treatment as usual.

Cost-effectiveness of second-line vasopressors for the treatment of septic shock

PurposeTo determine the cost-effectiveness of escalating doses of norepinephrine or norepinephrine plus the adjunctive use of vasopressin or angiotensin II as a second-line vasopressor for septic shock. Materials and methodsDecision tree analysis was performed to compare costs and outcomes associated with norepinephrine monotherapy or the two adjunctive second-line vasopressors. Short- and long-term outcomes modeled included ICU survival and lifetime quality-adjusted-life-years (QALY) gained. Costs were modeled from a payer's perspective, with a willingness-to-pay threshold set at $100,000/unit gained. One-way (tornado diagrams) and probabilistic sensitivity analyses were performed. ResultsAdjunctive vasopressin was the most cost-effective therapy, and dominated both norepinephrine monotherapy and adjunctive angiotensin II by producing higher ICU survival at less cost. For the lifetime horizon, while norepinephrine monotherapy was least expensive, adjunctive vasopressin was the most cost-effective with an incremental cost-effectiveness ratio of $19,762 / QALY gained. Although adjunctive angiotensin II produced more QALYs compared to norepinephrine monotherapy, it was dominated in the long-term evaluation by second-line vasopressin. Sensitivity analyses demonstrated model robustness and medication costs were not significant drivers of model results. ConclusionsVasopressin is the most cost-effective second-line vasopressor in both the short- and long-term evaluations. Vasopressor price is a minor contributor to overall cost.

Sensitivity analysis of the failure time of reinforcement concrete frame under postearthquake fire loading

AbstractToday, many scholars have drawn attention to consecutive events such as postearthquake fire (PEF). PEF is one of the rare occurrences that leads to many consequences. The resistance of structure against external loads is important for structure and earthquake engineers. The duration of structures' resistance against fire in damaged structures due to earthquake can be different from intact ones. Many parameters have an effect on the resistance of structures. This paper deals with the importance of design parameters and loading for the resistance of reinforced concrete frames during PEF loading. Three methods of Monte Carlo, Tornado diagram, and first‐order second moment have been used to analysis based on random variables. The first failure time in the reinforcement concrete frame (RC) is considered as the strength of the reinforced concrete frame to PEF load. The results depicted that among design parameters, yield stress of rebar is the most significant parameter for the resistance of reinforced concrete frames. Among the loading parameters, the intensity of the seismic load is the most important parameter. The sensitivity of the failure time of members in RC frame shows that during the low intensity of earthquakes, the cover of concrete is the main design parameter after yield strength of rebar. As the intensity of seismic loads increases, the effect of concretes' cover on the resistance of structures against fire decreases. The sensitivity of the failure time to intensity of seismic load is higher between Sa = 0.3 g to Sa = 0.8 g. Also, results show the sensitivity of the design variable decreases by increasing the intensity of the seismic load.

Cost Analysis of Chaff Harvesting Concepts in Germany

This work assesses the costs of exploiting the biomass feedstock chaff. Chaff is a harvest residue generated during the conventional grain harvesting process and usually remains on the field. In this paper, the costs of collecting and supplying chaff to the end user with different harvesting methods and supply chains are analyzed. The costs are estimated for a base case defining a set of general assumptions. The impact of these assumptions is analyzed in a sensitivity analysis by means of tornado diagrams. A full costing method based on the VDI guideline 2067 part 1 is applied for the cost estimation. The cost analysis reveals that ceasing the fractioning of grain, straw and chaff during harvesting and transporting them as a mixture reduces the harvesting costs significantly. The costs are decreased due to a reduction in agricultural operations and processing large amounts of material. The lowest total costs originate from the production of chaff-straw bales. Harvesting chaff as a single fraction leads to the highest costs with the investigated supply chains. Comparing the costs of chaff supply to potential revenues shows that an exploitation of the harvest residue can be economically feasible.

Modeling sensitivity analysis of special concentrically braced frames under short and long duration ground motions

Modeling and simulation of the seismic response of special concentrically braced steel frames (SCBFs) through collapse involves several sources of epistemic uncertainties, e.g. braces low-cycle fatigue model, that could affect the seismic performance assessment. However, longer duration earthquakes, e.g. from subduction zones rupture, could have more damaging effect on SCBFs when associated with the brace fatigue life. The objective of this study is to investigate the influence of modeling parameters on the seismic response of SCBFs as it relates to the earthquake duration. Different OpenSEES modeling parameters were varied deterministically as sources of uncertainties for two single-story SCBFs under 16 different short and long duration earthquakes. Tornado diagram analysis was used to rank the effect of such parameters, and the analysis results were also used to develop two sets of fragility curves under short and long duration earthquakes to understand the effect of duration on SCBFs.

Economic Evaluations of Pharmacological Treatments in Heart Failure Patients: A Methodological Review with a Focus on Key Model Drivers.

Various decision analytic models exist for evaluating the cost-effectiveness of pharmacological interventions for heart failure (HF). Despite this, studies that explore drivers influencing these modeling approaches remain scarce. Through a systematic review of the literature, the present study sought to identify model drivers that emerge from economic evaluations of HF pharmacological interventions. Among the 72 cost effectiveness papers evaluating HF drug interventions, the most frequently identified, top 5 ranked model drivers impacting the incremental cost-effectiveness ratio (ICER) were cost of treatment and utility, identified in 10% of studies, respectively. Other drivers that emerged as top 5 ranked drivers in > 5% of studies included treatment effect on mortality (or cardiovascular mortality), duration of treatment, and baseline cardiovascular mortality. Model drivers reported at the top of tornado diagrams were treatment effect on mortality or on cardiovascular mortality. Collectively, these observations highlight the key importance of treatment effect in driving cost-effectiveness models for HF.Electronic supplementary materialThe online version of this article (10.1007/s41669-019-00173-y) contains supplementary material, which is available to authorized users.

Fragility-based sensitivity analysis on the seismic performance of pile-group-supported bridges in liquefiable ground undergoing scour potentials

Characterizing the effect of varying model parameters on the seismic performance of bridges is a desirable assistance to retrofits of existing bridges and designs of new bridges, especially for those in complex geotechnical conditions where scour and liquefaction potentials are involved. This paper aims to rank the sensitivity of fourteen structural and soil parameters for seismic performance assessment of pile-group-supported bridges in liquefiable ground undergoing scour potentials. To this end, a fragility-based Tornado diagram method for sensitivity analyses is proposed first in this study. An experimentally validated soil-foundation-bridge coupled finite element model considering scour and liquefaction effects is adopted and excited by a set of real ground motions for fragility analyses. Results indicate that the effect of scour depth slightly influence the most sensitive parameters, mainly including column height and diameter and pile diameter, for the performance of bridge components (i.e., bearing, column and pile). However, the increase of scour depth does downgrade the relative sensitivity of column-associated ones (e.g., column height and axial compressive ratio) and soil-related ones (i.e., loose and dense sand relative densities), while upgrade that of the pile-associated ones (e.g., pile diameter, center-to-center distance and longitudinal reinforcement ratio). In addition, to abide the capacity design principle that columns should fail before pile foundations, designs or retrofits of bridges using relatively larger pile diameter, column height, material strengths and longitudinal/transverse reinforcement ratios, together with smaller column diameter and pile center-to-center distance are recommended for mitigating scour and liquefaction effects on the seismic performance of pile foundations.

Treatment for human visceral leishmaniasis: a cost-effectiveness analysis for Brazil.

To estimate the cost-effectiveness of strategies for the treatment of VL in Brazil. Cost-effectiveness study comparing three therapeutic options: meglumine antimoniate (MA), liposomal amphotericin B (LAMB) and a combination of LAMB plus MA (LAMB plus MA), from public health system and societal perspectives. An analytical decision-making model was used to compare strategies for the following outcomes: early therapeutic failure avoided at 30days, days of hospitalisation avoided and VL cure at 180days. The efficacy and safety parameters of the drugs came from a randomised, open-label trial and the cost data came from a cost-of-illness study, both carried out in Brazil. For all outcomes analysed, the LAMB strategy was more effective. The MA strategy was inferior to the LAMB plus MA strategy for the outcomes early therapeutic failure avoided and cure. When only LAMB and MA were compared from a societal perspective, a cost of US$ 278.56 was estimated for each additional early therapeutic failure avoided, a cost of US$ 26.88 for each additional day of hospitalisation avoided and a cost of US$ 89.88 for each additional case of cured VL, for the LAMB strategy vs. MA. In Brazil, the LAMB strategy proved to be cost-effective for treating VL, considering a GDP per capita as the willingness-to-pay threshold, for all of the outcomes analysed in comparison to MA.

Probabilistic assessment of tunneling-induced building damage

This paper presents a rational and efficient probabilistic framework to address the uncertainties of geotechnical properties and the stratigraphic profile in a tunneling-induced building damage assessment. The probabilistic approach is based on the application of a hybrid point estimation method that employs a reduced number of computations without losing accuracy. The framework also relies on sensitivity analyses using tornado diagrams. Analyses of ground movements and building displacements are considered prior to the building damage assessment. The proposed approach was applied to the recently constructed extension of Line 5 of the São Paulo Metro. Two-dimensional (2D) and three-dimensional (3D) numerical analyses were carried out using a commercial finite element code by considering the Mohr-Coulomb and linear elastic constitutive models. Three probabilistic scenarios based on the lower, mean, and upper bound values of the coefficient of variation of input variables were considered. The results obtained using the proposed framework allowed estimating the probabilistic scenario that better provides an ideal coefficient of variation to adopt for input variables. The ground elastic properties and upper layer thickness had the greatest influence on ground movements and building displacements. Finally, the building damage analysis showed good agreement with the settlement data measured in the field.

Cost-Effectiveness of Exercise-Based Cardiac Rehabilitation in Chilean Patients Surviving Acute Coronary Syndrome.

To assess the cost-effectiveness of 3 models of exercise-based cardiac rehabilitation (CR) compared with standard care in survivors of acute coronary syndrome (ACS) within the public health system in Chile. A Markov model was designed using 5 health states: ACS survivor, second ACS, complications, general mortality, and cardiovascular mortality. The transition probabilities between health states for standard care and corresponding relative risk for CR were calculated from a systematic review. Health benefits were measured with the EuroQol 5-dimensional 3-level (EQ-5D-3L) survey. Costs for each health state were quantified using the national cost verification study. The CR cost was estimated with a microcosting methodology. The time horizon was a lifetime and the discount rate was 3% per year for costs and benefits. Deterministic and probabilistic analyses were performed. Structural uncertainty was managed by designing 3 scenarios: CR as currently delivered in a specific Chilean public health center, CR as recommended by South American guidelines, and CR as proposed for low-resource settings. Cardiac rehabilitation versus standard care showed an incremental cost-effectiveness ratio for the standard model of $722, for the South American model of $1247, and for the low-resource model of $666. The tornado diagram showed higher uncertainty in relative risk for the complications state and for the second ACS state. Considering a cost-effectiveness threshold of 1 unit of gross domestic product per capita (∼$19 000), CR is highly cost-effective for the public health system in Chile.

Online community collaborative map: A geospatial and data visualization tool for cancer data.

The aim of this study was to develop an online collaborative map to enable researchers to locate, explore, and share cancer data.This 2-scale (global and country-level) cancer map adopts a database-driven model, which was implemented using the Google Map Application Programming Interface (API) and asynchronous JavaScript and XML (AJAX) technology. Seven visualization techniques were used to present data. Data on worldwide cancer mortality between 1950 and 2013 were taken from the International Agency for Research on Cancer (IARC) database. Incidence data were from the IARC CI5plus database. Survival data were from the IARC SURVCAN study. Prevalence data between 1990 and 2017 were from the Institute for Health Metrics and Evaluation's (IHME) catalog while demographic data were from the World Bank Data Catalog. Cancer data for Taiwan between 1991 and 2016 were obtained from the Department of Health and Welfare. This study used visualization techniques that included: a choropleth map to display the prevalence of cancer; a tornado diagram to show the age-standardized mortality rates of all cancers among men and women in 2013; a treemap to show a ranking of cancer mortality data; a sunburst chart to show mortality rates of all cancers by gender; a line chart to show mortality trends for all cancers; a bar chart to show mortality and incidence rates and a heatmap to show variations in cancer across different countries.The world cancer map generated by this study can be accessed at http://worldmap.csmu-liawyp.tw. Country-level mortality data are presented as crude and age-standardized rates.We used visualization methodologies and constructed an easily maintainable web-based user interface with cancer data from administrative regions in 150 countries. This serves as a platform that allows researchers to manage and disseminate cancer data.

Intelligent Prediction of Clinker Formation Condition for Steam Boiler Tubes Using Artificial Neural Network

Ash, as one of the by-product of combustion either accumulates onto boiler tubes as slag or is collected by electrostatic precipitators attached to the backend of the boiler. Flue gas will transport these ash particles either to the inner surfaces of the boiler or to the dust collecting facilities at the backend of the boiler. Sintered ash deposits formed in the radiant section of the boiler are known as clinkers and they contribute to a wide variety of problems to the boiler. Preventative measures to combat clinker formation is in dire need to the energy sector. In this study, a prediction model using real plan data was developed for detection of clinker formation conditions. Several variations of Artificial Neural Networks were tried and test, with emphasis given on the feed-forward neural network, cascade neural network and recurrent neural network. In addition, sensitivity analysis was also conducted to determine the influence of random input variables to their respective response variables. The Tornado Diagram is selected as the method to determine the most influential parameter for clinker formation. It is expected that the Recurrent Neural Network prediction model and the identified most influential input parameter for clinker formation will assist operators in decision making for the maintenance of boilers.

OP34 One-Way Sensitivity Analysis For Cost Effectiveness Analysis

IntroductionAlthough stochastic analysis has become the accepted standard for decision analytic cost effectiveness models, deterministic one-way sensitivity analysis continues to be used to meet the needs of decision makers to understand the impact that changing the value taken by one specific parameter has on the results of the analysis. However, there are a number of problems with this approach.MethodsWe review the reasons why deterministic one-way sensitivity analysis will provide decision makers with biased and incomplete information. We then describe a new method - stochastic one-way sensitivity analysis (SOWSA), and apply this to a previously published cost effectiveness analysis, to produce a stochastic tornado diagram and conditional incremental net benefit curve. We then discuss how these outputs should be interpreted and the potential barriers to the implementation of SOWSA.ResultsThe results illustrate the shortcomings of the current approaches to deterministic one-way sensitivity analysis. For SOWSA, the expected costs and outcomes are captured, along with the sampled value of the parameter and these are linked to the probability that the parameter takes that value – which can be read off the probability distribution for the parameter used in the stochastic analysis. From these results it is possible to gain insights into probability that a parameter will take a value that will change a decision.ConclusionsAlthough a well-used technique, one-way deterministic sensitivity analysis has a number of shortcomings that may contribute to incorrect conclusions being drawn about the importance of certain parameter values on model results. By providing fuller information on uncertainty in model results, it is hoped that the methods here will lead to more informed decision making. Although, as with all developments in the presentation of analytic results to decision makers, care will be required to ensure that the decision makers understand the information provided to them.

Sensitivity analysis of the plastic hinge region in the wall pier of reinforced concrete bridges

As the bridges are an integral part of the transportation network, their function as one of the most important vital arteries during an earthquake is fundamental. In a design point of view, the bridges piers, and in particular the wall piers, are considered as effective structural elements in the seismic response of bridge structures due to their cantilever performance. Owing to reduced seismic load during design procedure, the response of these structural components should be ductile. This ductile behavior has a direct and decisive correlation to the development of plastic hinge region at the base of the wall pier. Several international seismic design codes and guidelines have suggested special detailing to assure ductile response in this region. In this paper, the parameters which affect the length of plastic hinge region in the reinforced concrete bridge with wall piers were examined and the sensitivity of these parameters was evaluated on the length of the plastic hinge region. Sensitivity analysis was accomplished by independently variable parameters with one standard deviation away from their means. For this aim, the Monte Carlo simulation, tornado diagram analysis, and first order second moment method were used to determine the uncertainties associated with analysis parameters. The results showed that, among the considered design variables, the aspect ratio of the pier wall (length to width ratio) and axial load level were the most important design parameters in the plastic hinge region, while the yield strength of transverse reinforcements had the least effect on determining the length of this region.

Prediction of voluntary dry matter intake in stall fed growing goats

A Monte Carlo Risk Assessment (MCRA) was used to investigate the variability of existing empirical equations to predict dry matter intake (DMI) for weaned Saanen goats. Probability distribution functions were generated for each input variable used in the investigated DMI predictive equations using the Monte Carlo technique, and Spearman correlations (ρ) among the input variables were used to maintain their observed correlation. Probability distribution functions were obtained using an evaluation database containing 515 observations from four studies with Saanen goats (14.4–48.7 kg body weight (BW)). Thus, the pattern of the probability distribution functions relied exclusively on the observed distribution of the input variables. The MCRA simulation had 5000 iterations and used the Latin hypercube sampling approach to enable a balanced sampling throughout the distribution. Subsequently, with the Monte Carlo simulations, we generated tornado plots using standardized regression coefficients to evaluate influential input variables, and estimated the overlap between observed and predicted DMI. The overlap provided the percentage similarity considering the entire distribution shape. Additionally, each extant DMI equation was challenged by varying the input variables (i.e., independent variables) within the 90% confidence intervals of the probability distribution functions to obtain the prediction range of each equation. Finally, we regressed residual (observed – predicted) values on the predicted values centered on their mean values for each extant DMI equation to assess their mean biases. Our results indicated that even though it is clear that DMI is influenced by goat size (i.e., BW, BW0.75, metabolic weight (MW)), significant biases were observed in all tested equations. Six out of ten literature equations tested did not show a mean bias, whereas only one among the ten tested equations did not have a linear bias. Sex class influenced ADG, age, DM digestibility, metabolizability, and relative size (i.e., inputs considered in some tested equations), and DMI (i.e., male goats had 8% greater DMI per unit of BW than females). Tornado diagrams revealed that BW was the most influential input in the equations commonly used for estimating DMI. Thus, goat size (i.e., BW, BW0.66, MW) is a potential reliable predictor of DMI. Given its influence in predicting intake, the dietary NDF would be considered when developing empirical equations. Future studies should focus on defining the role of environment in DMI regulation, and determining an accurate way to adjust DMI considering metabolic regulation mechanisms in goats.

PMD90 - ECONOMIC EVALUATION OF THE IMMUNOCYTOCHEMISTRY TEST FOR THE SIMULTANEOUS QUALITATIVE DETECTION OF PROTEINS P16INKA AND KI-67 (CINTEC PLUS CYTOLOGY KIT®) IN CERVICAL TISSUE

The presence of both P16INKa and KI-67 in cervical tissue indicates HPV infections, as well as precursor and cancerous lesions, given which they can be used as a complementary test to Papanicolau. Additionally, while in Papanicolau the patient needs negative results for three years, with these biomarkers the patient only needs one negative result. A complete economic evaluation of the immunocytochemistry test for the simultaneous qualitative detection of proteins P16INKa and KI-67 (CINtec PLUS Cytology Kit®) in cervical tissue was carried out from the payer perspective, to evaluate the cost-effectiveness of this test in comparison to the available alternatives in the National Formulary. A decision tree approach was used to determine the flow of women through the screening algorithm; then, a markov model was used to evaluate disease progression of those with a diagnosis of CIN3 or cervical cancer, selected from the first model. The efficacy of the alternatives was obtained from a meta-analysis developed from a systematic review. Cost are expressed in Mexican pesos. The time horizon was 3 years with a discount rate of 5%. Deterministic and probabilistic sensitivity analysis were performed on the variables that could generate uncertainty. CINtec PLUS Cytology Kit® showed higher effectiveness than its comparator (standard monitoring) in detecting lesions CIN2 with a cost-saving of $1,852.00 and an extra effectiveness of 0.03. In cases where cervical cancer was detected, CINtec™ PLUS Cytology Kit also showed a higher effectiveness in the prompt detection (incremental effectiveness of 0.14) and a cost-saving per patient of $1,678.70. Tornado diagram showed that the costs of routine visits are the ones that affect most the results. The immunocytochemistry test CINtec PLUS Cytology Kit® for the simultaneous detection of proteins P16INKa and KI-67 in cervical tissue is a cost-effective option in comparison to available alternatives in public health institutions in Mexico.

Sensitivity Analysis for Ship-to-Shore Container Crane Design

Ship-to-shore (STS) container cranes are important pieces of equipment in container terminals for container handling, so they need to be properly designed to avoid damage or collapse due to natural hazards (i.e., storms or earthquakes). However, the dynamic analyses necessary for this can be cost- and time-consuming because of the need to consider the time history of ground motions and several sources of uncertainty. Thus, sensitivity analysis on the input parameters to the responses of the structures is needed to categorize which sources of uncertainty are significant enough to be considered as random variables. In this study, an investigation is carried out into the sensitivity of some sources of uncertainty to the seismic response of a Korean container crane structure. The input random variables studied include ground motion intensity, ground motion profiles, mass, damping, and elastic modulus of steel. Nonlinear dynamic analyses are conducted using a set of 20 natural ground motions scaled to three ground motion intensity levels, in compliance with the Korean Design Standard. The method of deterministic sensitivity analysis using the so-called tornado diagram is applied for the evaluation of structural systems. For the studied type of Korean container crane, it can be stated that the intensity of ground motions (i.e., spectral acceleration) is the most significant input parameter on the response of the structure, as measured in terms of portal drift, vertical reaction of the crane’s legs, and total base shear. The next most significant influencing factors are the mass of the structure and the characteristics of every ground motion. Damping plays a relatively important role on the total base shear, while it shows almost no impact on the axial reaction of the crane’s legs. Of the three engineering design parameters (portal drift, vertical reaction, and total base shear), the elastic modulus exhibits a low effect, but it should be considered a source of uncertainty in seismic analysis.

Development of a non-linear PCI model for homogeneous zones of concrete airport pavements

The pavement condition index (PCI) is a tool for evaluating pavement performance and is based on the type and severity of surface distress. It is used to determine maintenance times, methods and location priorities. Most previous PCI prediction models have considered only pavement age or traffic volume as a variable, without consideration of other factors that affect pavement distress. In this study, data from 12 airports were analysed using reports published from 1994 to 2013. The airport pavements were divided into homogeneous zones according to their function and structure. For improved management of concrete airport pavements, a non-linear PCI model was developed for the homogeneous zones and tornado diagrams were used to analyse the sensitivity of the PCI according to the independent variables of the model. The results showed that the developed model can predict the PCI of homogeneous zones of concrete airport pavements more reasonably by considering various factors that affect pavement distress.

Cost-effectiveness of molar single-implant versus fixed dental prosthesis

BackgroundThis study evaluates the cost-effectiveness of implants (Implant), insurance fixed dental prosthesis (IFDP) and private fixed dental prosthesis (PFDP) for a single intermediate missing tooth in the molar region to calculate the Incremental Cost Effectiveness Ratio (ICER).MethodsThe Markov model for cost-effectiveness analysis of the Implant, IFDP and PFDP was carried over maximum 30 years. The starting age for prosthetic treatment was decided to be 50 years. The General Oral Health Assessment Index (GOHAI) was used for the indicator of effectiveness as an oral health QOL value. The GOHAI value was collected from patients who visited the Department of Oral Implantology of Osaka Dental University between September 2014 and March 2016. In addition, the Tornado diagram was drawn and Monte-Carlo simulations made for sensitivity analysis.ResultsFrom the analysis of survey of QOL of each stage and treatment, the selection of an Implant led to a higher QOL value than FDP. However, the estimated 30-year cost for IFDP was lower than Implant. It also became evident that PFDP had an extended dominated condition compared with IFDP and Implants. The ICER on the Implant versus IFDP was €1423.00.ConclusionsThese results suggest that a better of QOL value can be obtained from an Implant than from IFDP or PFDP. An evaluation form using an indexed scale for oral health-related aspects needs to be developed that is also consistent as an indicator of effect.