Alison McCallum

Parameter Heterogeneity In Breast Cancer Cost Regressions - Evidence From Five European Countries

Abstract We investigate parameter heterogeneity in breast cancer 1‐year cumulative hospital costs across five European countries as part of the EuroHOPE project. The paper aims to explore whether conditional mean effects provide a suitable representation of the national variation in hospital costs. A cohort of patients with a primary diagnosis of invasive breast cancer (ICD‐9 codes 174 and ICD‐10 C50 codes) is derived using routinely collected individual breast cancer data from Finland, the metropolitan area of Turin (Italy), Norway, Scotland and Sweden. Conditional mean effects are estimated by ordinary least squares for each country, and quantile regressions are used to explore heterogeneity across the conditional quantile distribution. Point estimates based on conditional mean effects provide a good approximation of treatment response for some key demographic and diagnostic specific variables (e.g. age and ICD‐10 diagnosis) across the conditional quantile distribution. For many policy variables of interest, however, there is considerable evidence of parameter heterogeneity that is concealed if decisions are based solely on conditional mean results. The use of quantile regression methods reinforce the need to consider beyond an average effect given the greater recognition that breast cancer is a complex disease reflecting patient heterogeneity.

Parameter Heterogeneity In Breast Cancer Cost Regressions - Evidence From Five European Countries.

Abstract We investigate parameter heterogeneity in breast cancer 1‐year cumulative hospital costs across five European countries as part of the EuroHOPE project. The paper aims to explore whether conditional mean effects provide a suitable representation of the national variation in hospital costs. A cohort of patients with a primary diagnosis of invasive breast cancer (ICD‐9 codes 174 and ICD‐10 C50 codes) is derived using routinely collected individual breast cancer data from Finland, the metropolitan area of Turin (Italy), Norway, Scotland and Sweden. Conditional mean effects are estimated by ordinary least squares for each country, and quantile regressions are used to explore heterogeneity across the conditional quantile distribution. Point estimates based on conditional mean effects provide a good approximation of treatment response for some key demographic and diagnostic specific variables (e.g. age and ICD‐10 diagnosis) across the conditional quantile distribution. For many policy variables of interest, however, there is considerable evidence of parameter heterogeneity that is concealed if decisions are based solely on conditional mean results. The use of quantile regression methods reinforce the need to consider beyond an average effect given the greater recognition that breast cancer is a complex disease reflecting patient heterogeneity.

Drugs policy will not change as long as UK government refuses to acknowledge the need for change

The Royal College of Physicians calls for drug policy to shift from criminal justice to public health,1 but the recent response from the Home Office to the government’s own advisory committee refuses to contemplate the introduction of safe injecting environments for the most damaging drug use.2 As well as relying only on criminal justice information, and without acknowledging the …

European Monitoring Centre for Drugs and Drug Addiction has a vital role in the UK’s ability to respond to illicit drugs and organised crime

Much attention has been devoted to the consequences of the European Medicines Agency’s departure from London because of Brexit.12 Yet exclusion from other EU agencies, including the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), will also have serious consequences for public health in the United Kingdom. Founded in 1993 in Lisbon,3 the EMCDDA derives its mandate from Regulation (EC) No 1920/20063, which involves surveillance, establishing best practice, facilitating exchange of knowledge and data, providing leadership on new psychoactive substances, and assisting with policy making in countries and in the EU. By adopting certain “red lines,” including oversight by the Court of Justice of the European Union, the UK will exclude itself from full membership.34 The EMCDDA has provided the EU and its member states with accurate and timely intelligence and evidence based overviews of the European drug landscape …