Annual Report 2007 - abdn.ac.uk

H E A L T H E C O N O M I C S R E S E A R C H U N I T

HERU is supported by the Chief Scientist Office (CSO)of the Scottish Executive Health Department (SEHD)The views expressed here are those of the unit andare not necessarily those of CSO.

www.abdn.ac.uk/heru

Annual Report2007

CYAN MAGENTA YELLOW BLACK



http://www.abdn.ac.uk/heruvisit us at

The Health Economics Research Unit (HERU) was established at the University of Aberdeen in 1977. TheUnit is part of the Institute of Applied Health Sciences (IAHS) within the College of Life Sciences and Medicineand is based in the University of Aberdeen Medical School.

Core funding for the Unit is received from the Chief Scientist Office (CSO) of the Scottish GovernmentHealth Directorates and the University of Aberdeen. HERU is one of two CSO funded research units basedwithin the IAHS. Our sister unit is the Health Services Research Unit (HSRU).

The CSO remit for the Health Economics Research Unit requires HERU to “develop new methods within healtheconomics and to encourage the use of health economics”. More specifically the remit is to:

• Research into economic approaches to health and health care;

• Develop economic techniques to be readily applied by economists and/or health care personnel;

• Demonstrate and test the approaches and techniques; and

• Accumulate and make available to the health service a body of expertise in health economics.

This general remit is given specific form in the research programmes undertaken by HERU and in the manyresearch projects and capacity building activities undertaken by the Unit.

Contact Details for HERU are:

The Health Economics Research UnitUniversity of AberdeenInstitute of Applied Health SciencesPolwarth BuildingForesterhillAberdeenAB25 2ZD

Tel: +44 (0) 1224 553480/553733Fax: +44 (0) 1224 550926E-mail: [email protected]

http://www.abdn.ac.uk/heru


Prom

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HealthEconom

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4 2

This year is the 30th since the establishment of the Health Economics Research Unit at the University of Aberdeenin 1977. Over this period the Unit has made a substantial contribution to the health service in Scotland and hasbeen central to the development of economic approaches in health and health care in the UK. In 2007, we continuedto address our core remit by developing new economic techniques, demonstrating their applicability to health andhealth care and generating a body of economic expertise and evidence for health service decision-making. Severaldevelopments and key achievements demonstrate the progress we are making.

In 2006, we welcomed the Scottish Funding Council’s support for a new capacity-building programme, the ScottishInstitute for Research in Economics (SIRE) (http://www.econ.ed.ac.uk/sire/index.html). In 2007, HERU has beena major contributor to the programme of research into Work and Wellbeing, one of SIRE’s three programmes. 2007saw the launch of the Work and Wellbeing Programme. Two HERU researchers (Ada Ma and Barbara Eberth)presented at one of SIRE’s first activities, a workshop held in June and one of HERU’s PhD students (EmmanouilMentzakis) co-organised the first in a series of SIRE PhD Workshops in May. In August, we welcomed Ulf Gerdthamfrom Lund University in Sweden. His joint Professorial appointment between HERU and the Department of Economicsreflects the success of SIRE in attracting new talents to the Scottish economics community. We are particularlypleased to welcome this distinguished researcher to Scotland.

We are also pleased to welcome Murray Smith, who joined us as a Senior Research Fellow from the University ofSydney. Murray arrived in February to work on the Medical Research Council (MRC) National Prevention ResearchInitiative (NPRI) funded project on the prevention of obesity. His econometric expertise will enable us to make aunique contribution on this health priority and represents a further strengthening of the links we are buildingbetween health economics and our core discipline.

HERU is supporting the next phase of Aberdeen University’s international research on maternal mortality and childhealth. In March, we welcomed Laura Ternent and Zahidul Quayyum as research fellows to support our contributionto the new initiative for Programme Assessment & Capacity Training (iPACT), which will apply economic techniquesto evaluate maternal and child health programmes in low and middle income countries.

We welcomed Karen Miller as HERU’s Information Officer in July but we said farewell to Heather Mackintosh, whohas worked as the Distance Learning Course Secretary since 2004. We wish her the very best for the future. Atthe end of 2007 we also said farewell to Maria Odejar, who worked with Mandy Ryan on the Health Foundationgrant. We wish her every success in the future.

In addition to the new appointments, we were also delighted with the Professorial appointments of two longstandingmembers of HERU (Anne Ludbrook and Luke Vale) during this last year. These promotions are in recognition oftheir important and wide-ranging contributions to HERU’s success.

A critical aspect of our work is capacity-building. Terry Porteous a joint PhD student with HERU and the Departmentof General Practice and Primary Care, University of Aberdeen was awarded her PhD. Our congratulations to Terry.We were successful in obtaining funding for two MRC Capacity Building PhD Studentships, due to start in October2008, on ‘dietary and physical activity behaviours’ and ‘NHS staff skill mix and local labour markets’. Thesestudentships will enable us to sustain our contribution to training the next generation of health economists.

Alongside our publications and project work, HERU staff make direct policy contributions through advisory roles,high profile presentations and membership of national committees. This year, Ulf Gerdtham, Anne Ludbrook andMatt Sutton participated in the Chief Medical Officer’s workshops on Measuring Health Inequalities, Matt Suttonwas appointed as Budget Adviser to the Scottish Parliament’s Health and Sport Committee and as a member ofAudit Scotland’s Advisory Group for their review of the new general practice contract, I participated in the

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STAFF LISTHERU staff,identifying their source of funding,as at 31st December 2007


3

Prom

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Prom

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contents1

DISSEMINATION 19

ENHANCING CAPACITY 20

(2) Publications - 2007 50

(1) Projects in Progress and Completed in 2007 25

VALUATION AND IMPLEMENTATION PROGRAMME 16

BEHAVIOUR, PERFORMANCE AND ORGANISATION OF CARE PROGRAMME 13

EVALUATION OF HEALTH IMPROVEMENT PROGRAMME 10

ECONOMIC EVALUATION PROGRAMME 7

THE UNIT’S RESEARCH 6

STAFF LIST (including contact details) 4

DIRECTOR’S OVERVIEW 2

APPENDICES 24

(3) Presentations - 2007 55

(4) Publications - 2006 60

(5) Presentations - 2006 64

NEW STAFF AND VISITORS TO HERU 18

Members of theHealth Economics Research Unit

International Medical Workforce Collaborative in Vancouver, and Anne Ludbrook participated in an expert workshopconvened by Scottish Health Action on Alcohol Problems, which resulted in the report Alcohol: Price, Policy andPublic Health. Luke Vale was appointed advisor to the Independent Scrutiny Panel looking at the proposals of NHSGreater Glasgow and Clyde’s proposal for service change in the Clyde area.

Each of HERU’s four research programmes had notable achievements this year. The Economic Evaluation Programmehas received funding for two major Health Technology Assessment research projects entitled: (i) Improving thevalue of screening for diabetic macular oedema using surrogate photographic markers, and (ii) Systematic reviewand economic modelling of the effectiveness and efficiency of non-surgical treatments for women with stressurinary incontinence. The Evaluation of Health Improvement programme continued their contribution to researchin smoking with presentations at the Towards a Smoke-Free Society conference held to mark the successfulimplementation of smoke free public places in Scotland. The Behaviour, Performance and Organisation of CareProgramme hosted a policy conference in Edinburgh in October on pay and performance in the Scottish NHS, atwhich they presented key findings from recent research projects to a national policy audience. The Valuation andImplementation Programme published the first general textbook on the development and use of Discrete ChoiceExperiments in health economics. This captures the evolution of this technique, spearheaded at HERU, into anestablished instrument within the field.

Further information on the principal activities and achievements of each of the four Research Programmes arefeatured in this Report. In addition, more information and copies of our publications (including this and previousAnnual Reports, our Newsletters and Briefing Papers) are available on our website (www.abdn.ac.uk/heru). Formore information on specific projects, please contact the named HERU researcher(s).

Bob ElliottDirector


4 2

This year is the 30th since the establishment of the Health Economics Research Unit at the University of Aberdeenin 1977. Over this period the Unit has made a substantial contribution to the health service in Scotland and hasbeen central to the development of economic approaches in health and health care in the UK. In 2007, we continuedto address our core remit by developing new economic techniques, demonstrating their applicability to health andhealth care and generating a body of economic expertise and evidence for health service decision-making. Severaldevelopments and key achievements demonstrate the progress we are making.

In 2006, we welcomed the Scottish Funding Council’s support for a new capacity-building programme, the ScottishInstitute for Research in Economics (SIRE) (http://www.econ.ed.ac.uk/sire/index.html). In 2007, HERU has beena major contributor to the programme of research into Work and Wellbeing, one of SIRE’s three programmes. 2007saw the launch of the Work and Wellbeing Programme. Two HERU researchers (Ada Ma and Barbara Eberth)presented at one of SIRE’s first activities, a workshop held in June and one of HERU’s PhD students (EmmanouilMentzakis) co-organised the first in a series of SIRE PhD Workshops in May. In August, we welcomed Ulf Gerdthamfrom Lund University in Sweden. His joint Professorial appointment between HERU and the Department of Economicsreflects the success of SIRE in attracting new talents to the Scottish economics community. We are particularlypleased to welcome this distinguished researcher to Scotland.

We are also pleased to welcome Murray Smith, who joined us as a Senior Research Fellow from the University ofSydney. Murray arrived in February to work on the Medical Research Council (MRC) National Prevention ResearchInitiative (NPRI) funded project on the prevention of obesity. His econometric expertise will enable us to make aunique contribution on this health priority and represents a further strengthening of the links we are buildingbetween health economics and our core discipline.

HERU is supporting the next phase of Aberdeen University’s international research on maternal mortality and childhealth. In March, we welcomed Laura Ternent and Zahidul Quayyum as research fellows to support our contributionto the new initiative for Programme Assessment & Capacity Training (iPACT), which will apply economic techniquesto evaluate maternal and child health programmes in low and middle income countries.

We welcomed Karen Miller as HERU’s Information Officer in July but we said farewell to Heather Mackintosh, whohas worked as the Distance Learning Course Secretary since 2004. We wish her the very best for the future. Atthe end of 2007 we also said farewell to Maria Odejar, who worked with Mandy Ryan on the Health Foundationgrant. We wish her every success in the future.

In addition to the new appointments, we were also delighted with the Professorial appointments of two longstandingmembers of HERU (Anne Ludbrook and Luke Vale) during this last year. These promotions are in recognition oftheir important and wide-ranging contributions to HERU’s success.

A critical aspect of our work is capacity-building. Terry Porteous a joint PhD student with HERU and the Departmentof General Practice and Primary Care, University of Aberdeen was awarded her PhD. Our congratulations to Terry.We were successful in obtaining funding for two MRC Capacity Building PhD Studentships, due to start in October2008, on ‘dietary and physical activity behaviours’ and ‘NHS staff skill mix and local labour markets’. Thesestudentships will enable us to sustain our contribution to training the next generation of health economists.

Alongside our publications and project work, HERU staff make direct policy contributions through advisory roles,high profile presentations and membership of national committees. This year, Ulf Gerdtham, Anne Ludbrook andMatt Sutton participated in the Chief Medical Officer’s workshops on Measuring Health Inequalities, Matt Suttonwas appointed as Budget Adviser to the Scottish Parliament’s Health and Sport Committee and as a member ofAudit Scotland’s Advisory Group for their review of the new general practice contract, I participated in the

DIRECTOR’S OVERVIEW

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deja

r BS

c, M

Sc,

PhD

Rese

arch

Fel

low

Hea

lth

Foun

dati

on(0

1224

) 55

1898

m

.a.o

deja

r@ab

dn.a

c.uk

Dr

Dam

ilola

Ola

jide

MA

, M

Sc,

PhD

Rese

arch

Fel

low

CSO

(012

24)

5519

10 d

.ola

jide

@ab

dn.a

c.uk

Zahi

dul Q

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um M

SS,

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arch

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low

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(012

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5559

37 z

.qua

yyum

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Gra

ham

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d BS

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ello

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rsit

y of

Abe

rdee

n(0

1224

) 55

5980

g

.sco

tlan

d@ab

dn.a

c.uk

Dr

Mur

ray

Smit

h BE

c, P

hDSe

nior

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earc

h Fe

llow

Exte

rnal

Fun

ding

(012

24)

5519

17 m

urra

y.sm

ith@

abdn

.ac.

uk

Dr

Dia

ne S

kåtu

n M

A,

MSc

, Ph

DRe

sear

ch F

ello

wCS

O(0

1224

) 55

1911

d

.ska

tun@

abdn

.ac.

uk

Laur

a Te

rnen

t BA

, M

ScRe

sear

ch F

ello

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tern

al F

undi

ng(0

1224

) 55

4687

l.

tern

ent@

abdn

.ac.

uk

* Ro

byn

de V

erte

uil M

ARe

sear

ch A

ssis

tant

Exte

rnal

Fun

ding

(012

24)

5519

09 r

.dev

erte

uil@

abdn

.ac.

uk

Dr

Veri

ty W

atso

n M

A,

MSc

, Ph

DRe

sear

ch F

ello

wCS

O(0

1224

) 55

1914

v

.wat

son@

abdn

.ac.

uk

Dr

Deo

khee

Yi B

Sc,

MPH

, Ph

DRe

sear

ch F

ello

wU

nive

rsit

y of

Abe

rdee

n(0

1224

) 55

1903

d

.yi@

abdn

.ac.

uk

STAFF LISTHERU staff,identifying their source of funding,as at 31st December 2007


Programme Directors: Dr Marjon van der Pol, Dr Paul McNamee, Professor Luke Vale

Economic evaluation is a method of assessing the efficiency of alternative forms of health care delivery. This

programme develops and applies these methods to address questions of practical and policy relevance to the health

service, and conducts work to enhance the research methods used by ourselves and others. Emphasis is placed

on priority areas for the NHS in Scotland (and the rest of the UK) and on major research themes within the Institute

of Applied Health Sciences (IAHS), University of Aberdeen. Simultaneously with this work we are involved in research

to improve the methods used to value outcomes, and on the development of methods of evidence synthesis in

economic evaluation.

Marjon van der Pol, Paul McNamee and Luke Vale co-direct the Economic Evaluation programme. Marjon van der

Pol coordinates projects involving national collaboration. Paul McNamee provides economic input to the IAHS and

contributes to the new initiative for Programme Assessment and Capacity Training (iPACT). Luke Vale leads the

economic component of projects carried out in collaboration with our sister Unit, HSRU (where Luke has a joint

appointment). This also involves directing the economic component of Technology Assessment Reviews (TARs),

which are conducted on behalf of the NICE and other national agencies.

In this section we provide a description of some of the larger projects that began or were completed in 2007.

Several notable projects started during the year. These included a CSO funded randomised trial of the effectiveness

and cost-effectiveness of exercise training in older patients with heart failure, to be undertaken with colleagues

at the University of Dundee. In addition, we received funding from the National Institute of Health Research Health

Technology Assessment Programme, to conduct an 18 month study of the effectiveness and efficiency of non-

surgical treatments for women with stress urinary incontinence. An evaluation of tele-endoscopy services in Shetland

and the Western Isles for the Scottish Centre for Telehealth also began. Funding has also been received for an 18-

month study of the clinical effectiveness and cost-effectiveness of different surveillance regimes after primary

breast cancer and a large multicentered trial of alternative surgical methods of treating varicose veins. Finally,

work started on a new Cancer Research UK (CRUK) funded study, examining the cost-effectiveness of early neck

dissection in oral cancer treatment. We anticipate that these large-scale studies will provide valuable information

to assist practitioners and policy-makers both nationally and internationally in resource allocation decisions.

Turning to completed projects, we highlight 2 studies. In one, funded by the MRC and undertaken with colleagues

at the University of Dundee, we examined the effectiveness and cost-effectiveness of early acyclovir and/or

prednisoline for Bell’s palsy. The results were that treatment with prednisoline was more effective and likely to

be more cost-effective than acyclovir. In another study, funded by CSO and conducted in collaboration with the

Nursing, Midwifery and Allied Health Professions (NMAHP) Unit, University of Stirling, and other colleagues at York

University, we found that a decision aid to help midwives diagnose early labour was no more effective than standard

practice.

Technology Assessment Reviews (TARs) remained a prominent element of our research. During 2007, two TARs

commenced, the first investigated the use of oesophageal Doppler monitoring amongst critically ill patients or

patients undergoing major surgery and was completed in August. The second ongoing study is investigating the

use of photodynamic diagnosis and novel urine biomarker tests in the detection and follow-up of bladder cancer.

5 7

ECONOMICEVALUATION PROGRAMME

PhD

Stu

dent

s

Nam

eSo

urce

of

Fund

ing

Cont

act

Det

ails

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Feng

BSc

, M

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stit

ute

of A

ppli

ed H

ealt

h Sc

ienc

es(0

1224

) 55

1899

y

.fen

g@ab

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c.uk

Patr

icia

Fer

nand

esEx

tern

al/I

nsti

tute

of

App

lied

Hea

lth

Scie

nces

(012

24)

5519

20 p

.fer

nand

es@

abdn

.ac.

uk

Emm

anou

il M

entz

akis

BSc

, M

ScM

RC/U

nive

rsit

y of

Abe

rdee

n(0

1224

) 55

5189

e

.men

tzak

is@

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.ac.

uk

Dea

n Re

gier

BA

, M

AEx

tern

al/U

nive

rsit

y of

Abe

rdee

n(0

1224

) 55

5937

d

.rei

ger@

abdn

.ac.

uk

Mic

hela

Tin

elli

Phar

m D

, M

ScM

RC/E

SRC/

Uni

vers

ity

of A

berd

een

(012

24)

5513

88 m

.tin

elli@

abdn

.ac.

uk

Ada

m T

ippe

r M

A,

MSc

MRC

(012

24)

5513

88 a

.tip

per@

abdn

.ac.

uk

Uni

t Su

ppor

t St

aff

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tle

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f Fu

ndin

gCo

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t D

etai

ls

Ann

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ws

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CSO

(012

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nit

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Serv

ices

Res

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nit.


ECONOMIC EVALUATION PROGRAMMEA third TAR concerning the clinical and cost effectiveness of minimal invasive total hip replacement was also

completed. The latter study was conducted in collaboration with the Canadian Agency for Drugs and Technologies

in Health (CADTH). These will be important in providing guidance on both management and future research for

these conditions.

Part of our work has a more methodological focus. One strand concerns valuation of health outcomes, and some

of this work has now reached the dissemination stage. Further details of the presentations we have given are

provided in Appendix 2

The year saw many other examples of dissemination of the results of research undertaken in this programme. Our

studies were widely presented to different audiences of practitioners, policy-makers and researchers. Invited

presentations were made at the Consensus Conference on Early Chronic Kidney Disease (Royal College of Physicians

of Edinburgh), the IMMPACT International Symposium (Royal College of Obstetricians and Gynaecology) and to the

West African Health Organisation, at a strategy meeting discussing policy options to achieve Millennium Development

Goal (MDG) targets.

In addition, our continued engagement with national committees and groups in 2007 saw us further strengthening

links with NHS Quality Improvement Scotland (QIS), through regular monthly visits to provide advice and guidance

to staff in developing assessments of new health care policies.

Finally, there were some changes in staffing in 2007. We were pleased to welcome Laura Ternent and Zahidul

Quayyum to the Programme, who joined as Research Fellows following previous positions within the IMMPACT

programme. Last but not least, we were delighted that the contributions of Luke Vale were recognised with a

promotion to Professor.

Further details of all Economic Evaluation in progress and completed projects are detailed inAppendix 1.

8 6

HERU’s research is organised in four research programmes. Three of these are focused on particular applied issues

and the other is largely methodological, but a desire to produce fresh insights through advances in the design and

application of research method drives all of our work.

Our four programmes are:

Economic Evaluation (EE) - brings together information on the effectiveness and cost-effectiveness of health

care interventions to promote the efficient use of scarce health care resources by the NHS and the Scottish

Government Health Directorates.

Evaluation of Health Improvement (EHI) - contributes to the evidence base relating to the effectiveness

and cost-effectiveness of improving health through interventions that impact on health through lifestyle or life

circumstances.

Behaviour, Performance and the Organisation of Care (BPOC) - conducts research to understand the

behaviour and performance of individuals and organisations in health care systems.

Valuation and Implementation Programme (VIP) - develops and applies contingent valuation (CV) and

discrete choice experiments (DCEs) in health economics.

There is considerable collaboration between the programmes and much cross-programme working. This is exemplified

by our current research for the MRC National Prevention Research Initiative on obesity, which involves staff from

three of our programmes and uses a wide variety of methods from econometric modelling of health behaviours

to discrete choice experiments and economic evaluation simulation modelling of costs and benefits. The critical

mass of health economists in HERU enables us to build expertise in areas of priority for the Scottish Government

and NHS Scotland, to draw together expertise on large collaborative projects such as this and to identify and

develop areas in health economics to which we are able to make a distinct and leading contribution.

Key achievements and activities of each of these four programmes of research are provided in the following pages.

These summaries are supported by a series of appendices giving details of recent and ongoing projects and

publications and presentations.

Summary

THE UNIT’S RESEARCH


Programme Directors: Dr Marjon van der Pol, Dr Paul McNamee, Professor Luke Vale

Economic evaluation is a method of assessing the efficiency of alternative forms of health care delivery. This

programme develops and applies these methods to address questions of practical and policy relevance to the health

service, and conducts work to enhance the research methods used by ourselves and others. Emphasis is placed

on priority areas for the NHS in Scotland (and the rest of the UK) and on major research themes within the Institute

of Applied Health Sciences (IAHS), University of Aberdeen. Simultaneously with this work we are involved in research

to improve the methods used to value outcomes, and on the development of methods of evidence synthesis in

economic evaluation.

Marjon van der Pol, Paul McNamee and Luke Vale co-direct the Economic Evaluation programme. Marjon van der

Pol coordinates projects involving national collaboration. Paul McNamee provides economic input to the IAHS and

contributes to the new initiative for Programme Assessment and Capacity Training (iPACT). Luke Vale leads the

economic component of projects carried out in collaboration with our sister Unit, HSRU (where Luke has a joint

appointment). This also involves directing the economic component of Technology Assessment Reviews (TARs),

which are conducted on behalf of the NICE and other national agencies.

In this section we provide a description of some of the larger projects that began or were completed in 2007.

Several notable projects started during the year. These included a CSO funded randomised trial of the effectiveness

and cost-effectiveness of exercise training in older patients with heart failure, to be undertaken with colleagues

at the University of Dundee. In addition, we received funding from the National Institute of Health Research Health

Technology Assessment Programme, to conduct an 18 month study of the effectiveness and efficiency of non-

surgical treatments for women with stress urinary incontinence. An evaluation of tele-endoscopy services in Shetland

and the Western Isles for the Scottish Centre for Telehealth also began. Funding has also been received for an 18-

month study of the clinical effectiveness and cost-effectiveness of different surveillance regimes after primary

breast cancer and a large multicentered trial of alternative surgical methods of treating varicose veins. Finally,

work started on a new Cancer Research UK (CRUK) funded study, examining the cost-effectiveness of early neck

dissection in oral cancer treatment. We anticipate that these large-scale studies will provide valuable information

to assist practitioners and policy-makers both nationally and internationally in resource allocation decisions.

Turning to completed projects, we highlight 2 studies. In one, funded by the MRC and undertaken with colleagues

at the University of Dundee, we examined the effectiveness and cost-effectiveness of early acyclovir and/or

prednisoline for Bell’s palsy. The results were that treatment with prednisoline was more effective and likely to

be more cost-effective than acyclovir. In another study, funded by CSO and conducted in collaboration with the

Nursing, Midwifery and Allied Health Professions (NMAHP) Unit, University of Stirling, and other colleagues at York

University, we found that a decision aid to help midwives diagnose early labour was no more effective than standard

practice.

Technology Assessment Reviews (TARs) remained a prominent element of our research. During 2007, two TARs

commenced, the first investigated the use of oesophageal Doppler monitoring amongst critically ill patients or

patients undergoing major surgery and was completed in August. The second ongoing study is investigating the

use of photodynamic diagnosis and novel urine biomarker tests in the detection and follow-up of bladder cancer.

5 7

ECONOMICEVALUATION PROGRAMME

PhD

Stu

dent

s

Nam

eSo

urce

of

Fund

ing

Cont

act

Det

ails

Yan

Feng

BSc

, M

ScIn

stit

ute

of A

ppli

ed H

ealt

h Sc

ienc

es(0

1224

) 55

1899

y

.fen

g@ab

dn.a

c.uk

Patr

icia

Fer

nand

esEx

tern

al/I

nsti

tute

of

App

lied

Hea

lth

Scie

nces

(012

24)

5519

20 p

.fer

nand

es@

abdn

.ac.

uk

Emm

anou

il M

entz

akis

BSc

, M

ScM

RC/U

nive

rsit

y of

Abe

rdee

n(0

1224

) 55

5189

e

.men

tzak

is@

abdn

.ac.

uk

Dea

n Re

gier

BA

, M

AEx

tern

al/U

nive

rsit

y of

Abe

rdee

n(0

1224

) 55

5937

d

.rei

ger@

abdn

.ac.

uk

Mic

hela

Tin

elli

Phar

m D

, M

ScM

RC/E

SRC/

Uni

vers

ity

of A

berd

een

(012

24)

5513

88 m

.tin

elli@

abdn

.ac.

uk

Ada

m T

ippe

r M

A,

MSc

MRC

(012

24)

5513

88 a

.tip

per@

abdn

.ac.

uk

Uni

t Su

ppor

t St

aff

Nam

eTi

tle

Sour

ce o

f Fu

ndin

gCo

ntac

t D

etai

ls

Ann

e Be

ws

Seni

or S

ecre

tary

CSO

(012

24)

5537

33 a

.bew

s@ab

dn.a

c.uk

Shon

a Ch

rist

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nit

Adm

inis

trat

orCS

O(0

1224

) 55

4065

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.w.c

hris

tie@

abdn

.ac.

uk

Mill

erIn

form

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erCS

O(0

1224

) 55

3262

k

.mill

er@

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.ac.

uk

* D

enot

es j

oint

app

oint

men

t w

ith

the

Hea

lth

Serv

ices

Res

earc

h U

nit.


ECONOMIC EVALUATION PROGRAMMEA third TAR concerning the clinical and cost effectiveness of minimal invasive total hip replacement was also

completed. The latter study was conducted in collaboration with the Canadian Agency for Drugs and Technologies

in Health (CADTH). These will be important in providing guidance on both management and future research for

these conditions.

Part of our work has a more methodological focus. One strand concerns valuation of health outcomes, and some

of this work has now reached the dissemination stage. Further details of the presentations we have given are

provided in Appendix 2

The year saw many other examples of dissemination of the results of research undertaken in this programme. Our

studies were widely presented to different audiences of practitioners, policy-makers and researchers. Invited

presentations were made at the Consensus Conference on Early Chronic Kidney Disease (Royal College of Physicians

of Edinburgh), the IMMPACT International Symposium (Royal College of Obstetricians and Gynaecology) and to the

West African Health Organisation, at a strategy meeting discussing policy options to achieve Millennium Development

Goal (MDG) targets.

In addition, our continued engagement with national committees and groups in 2007 saw us further strengthening

links with NHS Quality Improvement Scotland (QIS), through regular monthly visits to provide advice and guidance

to staff in developing assessments of new health care policies.

Finally, there were some changes in staffing in 2007. We were pleased to welcome Laura Ternent and Zahidul

Quayyum to the Programme, who joined as Research Fellows following previous positions within the IMMPACT

programme. Last but not least, we were delighted that the contributions of Luke Vale were recognised with a

promotion to Professor.

Further details of all Economic Evaluation in progress and completed projects are detailed inAppendix 1.

8 6

HERU’s research is organised in four research programmes. Three of these are focused on particular applied issues

and the other is largely methodological, but a desire to produce fresh insights through advances in the design and

application of research method drives all of our work.

Our four programmes are:

Economic Evaluation (EE) - brings together information on the effectiveness and cost-effectiveness of health

care interventions to promote the efficient use of scarce health care resources by the NHS and the Scottish

Government Health Directorates.

Evaluation of Health Improvement (EHI) - contributes to the evidence base relating to the effectiveness

and cost-effectiveness of improving health through interventions that impact on health through lifestyle or life

circumstances.

Behaviour, Performance and the Organisation of Care (BPOC) - conducts research to understand the

behaviour and performance of individuals and organisations in health care systems.

Valuation and Implementation Programme (VIP) - develops and applies contingent valuation (CV) and

discrete choice experiments (DCEs) in health economics.

There is considerable collaboration between the programmes and much cross-programme working. This is exemplified

by our current research for the MRC National Prevention Research Initiative on obesity, which involves staff from

three of our programmes and uses a wide variety of methods from econometric modelling of health behaviours

to discrete choice experiments and economic evaluation simulation modelling of costs and benefits. The critical

mass of health economists in HERU enables us to build expertise in areas of priority for the Scottish Government

and NHS Scotland, to draw together expertise on large collaborative projects such as this and to identify and

develop areas in health economics to which we are able to make a distinct and leading contribution.

Key achievements and activities of each of these four programmes of research are provided in the following pages.

These summaries are supported by a series of appendices giving details of recent and ongoing projects and

publications and presentations.

Summary

THE UNIT’S RESEARCH


9 11

At the end of 2007 the Economic Evaluation team and their principal areas of research were:

Rodolfo Hernandez Research Fellow Health Technology Assessment, Modelling

Mary Kilonzo Research Fellow Modelling, Outcome Valuation

Lynda McKenzie Research Fellow Economic Evaluation alongside Trials,Outcome Valuation

Paul McNamee Senior Research Fellow and Ageing, International Health Outcome ValuationJoint Programme Director

Emmanouil Mentzakis* PhD student Informal Care

Marjon van der Pol Senior Research Fellow and Time Preferences, Outcome ValuationJoint Programme Director

Zahidul Quayyum Research Fellow International Health, Efficiency and Equity,Resource Allocation

Graham Scotland Research Fellow Outcome Valuation, Economics of AssistedReproduction

Laura Ternent Research Fellow International Health, Outcome Valuation

# Luke Vale Professor and Methodology of Economic EvaluationJoint Programme Director Applied to Trials and Systematic Reviews

# Robyn de Verteuil Research Assistant Health Technology Assessment, Modelling

* denotes working across more than one programme

# denotes joint appointment with the Health Services Research Unit.

targeting different problems and different population groups. Dami Olajide is continuing to investigate dietary

factors across different data sets as an adjunct to the NPRI study.

Barbara Eberth’s research on the economic drivers of obesity has resulted in presentations to the Scottish Economic

Society and the SIRE Health and Wellbeing at Work conference on the relationship between body mass index and

physical activity at work, at home and in leisure activities. Barbara and Ulf have begun new work on socioeconomic

inequalities in obesity in England and Scotland. We are continuing to collaborate with colleagues in HSRU, in the

Public Health Nutrition group at the Rowett Research Institute, and the Department of Public Health in Aberdeen,

as well as colleagues further afield, to develop innovative research to tackle obesity problems.

Economic status and health focuses on the impact that income and employment status have on health. Adam

Tipper has continued to work on his thesis The Family, Economic Status and Health. Ulf Gerdtham has been working

on socioeconomic inequalities in health in Sweden and further work on income and health inequalities using UK

data is planned for 2008.

Intervention studies continues to encompass our economic evaluations conducted alongside interventions and also

research to develop the methods of economic evaluation in response to the different challenges posed by public

health interventions. During 2007, our studies of breastfeeding support and housing improvements concluded and

the results are being written up. Funding applications have been submitted for new initiatives in this area and

we are particularly encouraged with the move to develop larger scale trials of public health interventions.

During 2007 we have also been developing our policy contribution and our links with the Scottish health service

at various levels. An overview of our obesity research was presented to economists and policy-makers in the Scottish

Government and we have been working with NHS Grampian on evaluating aspects of the local Keep Well programme,

targeting health improvement at deprived communities.

The new Scottish Government has set out its policy directions for health in Better Health, Better Care. This

document includes a strong commitment to improving health, tackling health inequalities and reducing risk factors

associated with lifestyles, reflecting the broad consensus that exists across the political spectrum regarding the

importance of these policy concerns. Therefore, 2008 is set to provide many opportunities to continue to address

the challenging policy and research agenda in improving public health.

Further details of all Evaluation of Health Improvement in progress and completed projects aredetailed in Appendix 1.

Members of theEE Team


12

As at the end of 2007 the Evaluation of Health Improvement team and their principal areas ofresearch are:

Mabel Amaya-Amaya* Research Fellow Smoking, Economic Evaluation

Barbara Eberth* Research Fellow Obesity

Ulf Gerdtham Professor Alcohol, Income & Health and Health inequalities

Anne Ludbrook Programme Director Smoking, Alcohol, Obesity, Economic Evaluation

Damilola Olajide* Research Fellow Obesity and Smoking

Murray Smith Senior Research Fellow Microeconometrics

Matt Sutton* Professor and Economic Status and Health,BPOC Programme Director Applied econometrics

Adam Tipper PhD student Economic Status and Health


10

Programme Director: Professor Anne LudbrookThe Evaluation of Health Improvement programme undertakes research which aims to contribute to the development

of the evidence base for public health interventions; it focuses on the efficiency and effectiveness of interventions

to improve the health of the population through changes in lifestyles or life circumstances.

The main activities of the EHI programme are:

• reviewing existing evidence relating to effectiveness and cost-effectiveness of health improvement interventions;

• using published studies and secondary data to model the costs and consequences of health improvement

interventions;

• conducting economic evaluations alongside health improvement interventions; and

• contributing to the understanding of health behaviour from an economic perspective.

These activities provide information to support decision-making at national and local levels and contribute to the

development of better interventions.

The EHI research programme is structured around three areas:

• Lifestyle and health

• Economic status and health

• Intervention studies

Lifestyle and health research has a primary focus on smoking and obesity, although we remain conscious of the

policy concerns around alcohol consumption both in its own right and as a contributory factor in obesity. Indeed,

concerns around the health and other harms of excessive alcohol consumption have been increasing during 2007.

In September, Anne Ludbrook participated in an expert workshop on alcohol and price convened by the Scottish

Health Action on Alcohol Problems, a group established by the Scottish Medical Royal Colleges and Faculties to

raise awareness. The appointment of Professor Ulf Gerdtham, who brings to this programme research expertise

in the area of alcohol problems in Sweden, is particularly welcome.

Our research on smoking was presented at the 6th International Health Economics Association conference in July

and at the Towards a Smoke free Society conference held in Edinburgh in September, which featured research

on the impact of smoke-free legislation in Scotland. This included the results of a study of bar-workers health in

which we were engaged considering the economic effects of these health changes.

Our National Prevention Research Initiative project on the economic evaluation of obesity prevention is progressing

well. Systematic reviews of randomised controlled trials and cohort studies have been completed by colleagues

in HSRU and Public Health and qualitative research has been conducted to elicit the views of potential recipients

of interventions, NHS practitioners and policy makers. The Discrete Choice Experiment component is being developed

and fieldwork will be undertaken in 2008. Quantitative analysis is proceeding in parallel with the other components

and we were pleased to welcome Murray Smith to the team to work on this. Funding is being sought to extend

the modelling approach to other lifestyle issues and to the problem of setting priorities between interventions

EVALUATION OF HEALTH IMPROVEMENT PROGRAMME

EVALUATION OFHEALTH IMPROVEMENT PROGRAMME

Members of theEHI Team


9 11

At the end of 2007 the Economic Evaluation team and their principal areas of research were:

Rodolfo Hernandez Research Fellow Health Technology Assessment, Modelling

Mary Kilonzo Research Fellow Modelling, Outcome Valuation

Lynda McKenzie Research Fellow Economic Evaluation alongside Trials,Outcome Valuation

Paul McNamee Senior Research Fellow and Ageing, International Health Outcome ValuationJoint Programme Director

Emmanouil Mentzakis* PhD student Informal Care

Marjon van der Pol Senior Research Fellow and Time Preferences, Outcome ValuationJoint Programme Director

Zahidul Quayyum Research Fellow International Health, Efficiency and Equity,Resource Allocation

Graham Scotland Research Fellow Outcome Valuation, Economics of AssistedReproduction

Laura Ternent Research Fellow International Health, Outcome Valuation

# Luke Vale Professor and Methodology of Economic EvaluationJoint Programme Director Applied to Trials and Systematic Reviews

# Robyn de Verteuil Research Assistant Health Technology Assessment, Modelling


# denotes joint appointment with the Health Services Research Unit.

targeting different problems and different population groups. Dami Olajide is continuing to investigate dietary

factors across different data sets as an adjunct to the NPRI study.

Barbara Eberth’s research on the economic drivers of obesity has resulted in presentations to the Scottish Economic

Society and the SIRE Health and Wellbeing at Work conference on the relationship between body mass index and

physical activity at work, at home and in leisure activities. Barbara and Ulf have begun new work on socioeconomic

inequalities in obesity in England and Scotland. We are continuing to collaborate with colleagues in HSRU, in the

Public Health Nutrition group at the Rowett Research Institute, and the Department of Public Health in Aberdeen,

as well as colleagues further afield, to develop innovative research to tackle obesity problems.

Economic status and health focuses on the impact that income and employment status have on health. Adam

Tipper has continued to work on his thesis The Family, Economic Status and Health. Ulf Gerdtham has been working

on socioeconomic inequalities in health in Sweden and further work on income and health inequalities using UK

data is planned for 2008.

Intervention studies continues to encompass our economic evaluations conducted alongside interventions and also

research to develop the methods of economic evaluation in response to the different challenges posed by public

health interventions. During 2007, our studies of breastfeeding support and housing improvements concluded and

the results are being written up. Funding applications have been submitted for new initiatives in this area and

we are particularly encouraged with the move to develop larger scale trials of public health interventions.

During 2007 we have also been developing our policy contribution and our links with the Scottish health service

at various levels. An overview of our obesity research was presented to economists and policy-makers in the Scottish

Government and we have been working with NHS Grampian on evaluating aspects of the local Keep Well programme,

targeting health improvement at deprived communities.

The new Scottish Government has set out its policy directions for health in Better Health, Better Care. This

document includes a strong commitment to improving health, tackling health inequalities and reducing risk factors

associated with lifestyles, reflecting the broad consensus that exists across the political spectrum regarding the

importance of these policy concerns. Therefore, 2008 is set to provide many opportunities to continue to address

the challenging policy and research agenda in improving public health.

Further details of all Evaluation of Health Improvement in progress and completed projects aredetailed in Appendix 1.

Members of theEE Team


12

As at the end of 2007 the Evaluation of Health Improvement team and their principal areas ofresearch are:

Mabel Amaya-Amaya* Research Fellow Smoking, Economic Evaluation

Barbara Eberth* Research Fellow Obesity

Ulf Gerdtham Professor Alcohol, Income & Health and Health inequalities

Anne Ludbrook Programme Director Smoking, Alcohol, Obesity, Economic Evaluation

Damilola Olajide* Research Fellow Obesity and Smoking

Murray Smith Senior Research Fellow Microeconometrics

Matt Sutton* Professor and Economic Status and Health,BPOC Programme Director Applied econometrics

Adam Tipper PhD student Economic Status and Health


10

Programme Director: Professor Anne LudbrookThe Evaluation of Health Improvement programme undertakes research which aims to contribute to the development

of the evidence base for public health interventions; it focuses on the efficiency and effectiveness of interventions

to improve the health of the population through changes in lifestyles or life circumstances.

The main activities of the EHI programme are:

• reviewing existing evidence relating to effectiveness and cost-effectiveness of health improvement interventions;

• using published studies and secondary data to model the costs and consequences of health improvement

interventions;

• conducting economic evaluations alongside health improvement interventions; and

• contributing to the understanding of health behaviour from an economic perspective.

These activities provide information to support decision-making at national and local levels and contribute to the

development of better interventions.

The EHI research programme is structured around three areas:

• Lifestyle and health

• Economic status and health

• Intervention studies

Lifestyle and health research has a primary focus on smoking and obesity, although we remain conscious of the

policy concerns around alcohol consumption both in its own right and as a contributory factor in obesity. Indeed,

concerns around the health and other harms of excessive alcohol consumption have been increasing during 2007.

In September, Anne Ludbrook participated in an expert workshop on alcohol and price convened by the Scottish

Health Action on Alcohol Problems, a group established by the Scottish Medical Royal Colleges and Faculties to

raise awareness. The appointment of Professor Ulf Gerdtham, who brings to this programme research expertise

in the area of alcohol problems in Sweden, is particularly welcome.

Our research on smoking was presented at the 6th International Health Economics Association conference in July

and at the Towards a Smoke free Society conference held in Edinburgh in September, which featured research

on the impact of smoke-free legislation in Scotland. This included the results of a study of bar-workers health in

which we were engaged considering the economic effects of these health changes.

Our National Prevention Research Initiative project on the economic evaluation of obesity prevention is progressing

well. Systematic reviews of randomised controlled trials and cohort studies have been completed by colleagues

in HSRU and Public Health and qualitative research has been conducted to elicit the views of potential recipients

of interventions, NHS practitioners and policy makers. The Discrete Choice Experiment component is being developed

and fieldwork will be undertaken in 2008. Quantitative analysis is proceeding in parallel with the other components

and we were pleased to welcome Murray Smith to the team to work on this. Funding is being sought to extend

the modelling approach to other lifestyle issues and to the problem of setting priorities between interventions

EVALUATION OF HEALTH IMPROVEMENT PROGRAMME

EVALUATION OFHEALTH IMPROVEMENT PROGRAMME

Members of theEHI Team


13 15

As at the end of 2007 the Behaviour, Performance and Organisation of Care team and their principal areasof research are:

Bob Elliott Professor and Director of HERU Public Sector Pay, Labour Markets

Shelley Farrar Research Fellow Performance, Hospital Behaviour

Yan Feng PhD Student Incentives

Patricia Fernandes PhD Student Hospital Costs, Rurality

Claudia Geue Research Assistant Nurses’ Labour Markets

Divine Ikenwilo Research Fellow Physicians’ Labour Markets

Ada Ma Research Fellow Public Sector Pay, Labour Markets

Alasdair Munro Senior Research Fellow Performance, Productivity

Damilola Olajide* Research Fellow Resource Allocation, Primary Care

Diane Skåtun Research Fellow Nurses’ Labour Markets

Matt Sutton* Professor and Programme Resource Allocation, Primary Care

Director

Deokhee Yi* Research Fellow Hospital Payment Systems

Also associated with the programme are:

Martin Chalkley Honorary Professor Incentives

Tony Scott Honorary Professor Labour Markets

*denotes working across more than one programme

Members of theBPOC Team

Programme Director: Professor Matt SuttonThrough studying NHS financing and the reactions of healthcare staff and NHS organisations to changes in financial incentives

and organisational rules, the work of the Behaviour, Performance and Organisation of Care (BPOC) programme aims to further

our understanding of individual and organisational behaviour and thus to improve the evidence-base for NHS policy making.

During 2007 we devoted much of our effort to dissemination of our completed and ongoing research projects. We targeted a

wide range of audiences, including economists, health economists, national organisation advisers and policymakers, and included

in our dissemination activities were Scottish, UK and international conferences. In October, we hosted a policy conference in

Edinburgh on pay and performance in the Scottish NHS. We presented the findings of our research on the consequences of the

new contracts for general practices and hospital consultants, the appropriateness of introducing regional pay for NHS staff,

and the impact of the introduction of activity-based financing for hospitals in England. We welcomed key policymakers and

advisers from the NHS in Scotland and national organisations in Scotland and England and discussed the consequences and

relevance of these developments for Scotland. In addition to the positive feedback from participants on the event, we benefited

from insightful comments on our research and suggestions for future work.

We also extended our direct contribution to policy this year. Matt Sutton was appointed as Adviser to the Health and Sport

Committee of the Scottish Parliament for their scrutiny of the Scottish Government’s Draft Budget and as a member of the

Advisory Group for Audit Scotland’s review of the new General Medical Services contract. Alasdair Munro contributed to the

option appraisal for reorganisation of children’s cancer services and Shelley Farrar provided expert advice and input to the

option appraisal for the NOSCAN Brachytherapy Service Review.

The work of BPOC is focused on three themes: workforce; resource allocation and performance. The progress we have made

with our research and our dissemination activities in each of these areas are summarised below.

Workforce

During 2006, we had undertaken a follow-up to our 2001/2 postal survey of all non training-grade doctors working for the NHS

in Scotland. Our analysis of the data during 2007 included a comparison of the changes in job satisfaction experienced by GPs,

consultants and Staff and Associate Specialists, which was presented to the International Medical Workforce Collaborative

(IMWC) in Vancouver in March. We also identified factors associated with the changes in job satisfaction reported by consultants

and presented this analysis at the Scottish Economic Society conference in March. We presented our analysis of changes in

consultant productivity in Bergen in July and in the retirement plans of consultants at the UK Health Economists’ Study Group

(HESG) meeting in September. Our analysis of GPs’ perceptions of changes in the quality of care was presented to the Nordic

HESG meeting in Estonia in August.

During 2007, we began the fieldwork for an Economic and Social Research Council (ESRC) funded study investigating the labour

market of registered nurses in the UK. The study considers the importance of pay and non-pay aspects within the reward

structure for nurses. The study will identify how nurses’ trade-off pay against other working conditions and compare the

preferences for pay and working conditions. Piloting of the questionnaire took place in the summer of 2007, with phase 1 of

the main survey completed in December 2007.

We also began a study of non-medical factors and their association with renal replacement therapy (RRT) incidence, effectiveness

and efficiency during 2007. The incidence of RRT varies considerably across economically developed countries and, like services

for other health conditions, renal services in different countries have developed in different ways and with different incentives

and regulations. This study aims to establish the extent to which variations in RRT incidence reflects underlying variation in

established renal failure rather than variation in organisation of renal services. It is being undertaken with colleagues from

the European Renal Register, Nephrology in Bristol and Medical Therapeutics in NHSGrampian.

BEHAVIOUR,PERFORMANCE AND ORGANISATION OF CARE


VALUATIONAND IMPLEMENTATION PROGRAMME (VIP)

16 14

Programme Director: Professor Mandy RyanThe focus of VIP is the development and application of contingent valuation (CV) and discrete choice experiments(DCEs). Recent years have seen widespread application of these techniques to address policy questions in healthcare. 2007 saw VIP sustain its contribution to high quality policy related research. VIP ensures that research canbe underpinned by methodological work, whilst it seeks to build research capacity in the application of thesetechniques through dissemination and training.

The year saw publication of a book edited by Mandy Ryan and Mabel Amaya-Amaya, in collaboration with Dr KarenGerard from the University of Southampton. Using Discrete Choice Experiments to Value Health and Health Careis part of a series edited by Professor Ian Bateman on The Economics of Non-Market Goods and Resources. Thebook, published by Springer, takes a fresh and contemporary look at the growing interest in the development andapplication of DCEs in health economics, and gives the reader a better understanding of issues raised in the designand application of DCEs. The book will be of interest to post-graduate students and applied researchers with aninterest in the use of DCEs for valuing health and health care.

As part of VIP’s training strategy, we have developed an Expert Workshop on Discrete Choice Experiments (DCEs).The aim of this Workshop is to provide information on practical and theoretical issues faced when conducting DCEs.During 2007 Professor Ryan ran a 2-day workshop for the Dutch Health Technology Assessment Group at theUniversity of Maastricht, Holland. New courses are being developed to reflect recent methodological advances inthe modelling and application of DCEs, and further courses will be offered in 2008/9.

Students play a crucial role in the methodological work conducted within VIP. 2007 saw Terry Porteous successfullydefend her PhD. PhD Methodological work was conducted by Dean Regier and Emmanouil Mentzakis and bothpresented at the International Health Economic Association conference in Copenhagen. Dean Regier was given aBest Student Podium Presentation Award by the International Society for Pharmacoeconomics and OutcomesResearch (ISPOR) at their 10th Annual European Conference, in Dublin, Ireland.

Funded by a visiting fellowship, Mandy Ryan spent one month at the Melbourne Institute of Applied Economic andSocial Policy Research, University of Melbourne, Australia in February. During her time there she worked withProfessor Kostas Mavromaras, developing work within the area of reducing obesity.

2007 saw completion of the Health Foundation grant to translate methodological work to the policy arena. Duringthis 5-year project we have applied DCEs to a wide range of policy areas. The completion of this project sees ussay good-bye to Dr Maria Odejar who was a Research Fellow within this programme of research. We would like towish her well. The Chief Scientist Office funded project to investigate preferences for the treatment of chronicback pain also came to an end, and a report was successfully submitted to the Scottish Government.

Continued progress was made on a number of other externally funded projects, including the National Institutefor Health and Clinical Excellence (NICE) and National Centre for Coordinating Health Technology Assessment(NCCHTA) funded project concerned with estimating the Social Value of a Quality Adjusted Life Year (QALY), theCancer Research UK funded project to investigate the potential for primary care to tackle social inequalities inestablished colorectal cancer, the MRC National Prevention Research Initiative project concerned with an economicevaluation of obesity prevention and a Wellcome Trust funded project, looking at public preferences for treatmentof common symptoms.

Further details of all Valuation & Implementation Programme in progress and completed projectsare detailed in Appendix 1.

Resource allocationEarly in 2007 we completed our projects on two cost adjustments included in resource allocation formulae in the UK:

(i) The Market Forces Factor (MFF) in England, and

(ii) The Excess Cost Adjustment Applied in Scotland.

Our research on the MFF established, for the first time, empirical evidence that spatial variations in private sector pay influence

the ability of NHS organisations to recruit and retain NHS staff. We have subsequently presented the findings of this research

at conferences organised by the IMWC, Royal Economic Society, the Office of Manpower Economics, the Centre for Market and

Public Organisation (CMPO), the Scottish Initiative for Research in Economics, the British Medical Association, the Office for

National Statistics and the Department of Work and Pensions.

During 2007 we also contributed to reviews of the needs component of the NHS funding formula used to allocate resources to

PCTs in England, the level of healthcare spending in Northern Ireland and the setting of practice prescribing budgets in NHS

Lothian.

Performance

We completed our national evaluation of the new activity-based financing system for hospitals in England, Payment by Results,

during the year. Our evaluation included design of a theoretical framework for evaluating the policy, findings from three rounds

of structured interviews with decision-makers and econometric analysis of changes in key outcomes in England and Scotland.

Findings from the research were presented at the International Health Economics Association conference in Copenhagen in

July and to the Department of Health’s External Advisory Group in December.

This year we also collaborated with colleagues from the University of Bristol on an ESRC funded project examining the

consequences of the introduction of targets on NHS waiting times. This work compares the more stringently-enforced, escalating

targets adopted in England with those in existence in Scotland. Our initial finding that the ‘targets and terror’ regime adopted

in England led to a substantial reduction in waiting times relative to Scotland were published in the Journal of Economic Analysis

and Policy. We are continuing to analyse the consequences of the targets for the prioritisation of patients and service quality.

We also continued our research on the Quality and Outcomes Framework (QOF) of the new contract for general practices this

year. We presented our examination of gaming undertaken with the University of York at the Royal Economic Society conference,

the International Health Economics Association conference and a policy conference organised by the CMPO and the University

of York. We also concluded our examination of changes in the quality of risk factor recording arising from the QOF. Our finding

that the introduction of the QOF was associated with significantly larger increases in the recording of incentivised activities

compared to un-incentivised activities was presented at the UK HESG meeting in the summer.

Staff

There were no changes in BPOC staff during 2007. Divine Ikenwilo and Yan Feng progressed successfully through their nine-

month assessments for their PhD studies.

Visiting Honorary Staff

We were pleased to have visits from our two of HERU’s honorary Professors, Martin Chalkley and Anthony Scott, during 2007.

Martin visited frequently from Dundee and Tony visited from Melbourne in July, both to collaborate on the Payment by Results

evaluation, undertake PhD assessments and present seminars.

Further details of all Behaviour, Performance and Organisation of Care in progress and completed projectsare detailed in Appendix 1.

BEHAVIOUR, PERFORMANCE AND ORGANISATION OF CARE


13 15

As at the end of 2007 the Behaviour, Performance and Organisation of Care team and their principal areasof research are:

Bob Elliott Professor and Director of HERU Public Sector Pay, Labour Markets

Shelley Farrar Research Fellow Performance, Hospital Behaviour

Yan Feng PhD Student Incentives

Patricia Fernandes PhD Student Hospital Costs, Rurality

Claudia Geue Research Assistant Nurses’ Labour Markets

Divine Ikenwilo Research Fellow Physicians’ Labour Markets

Ada Ma Research Fellow Public Sector Pay, Labour Markets

Alasdair Munro Senior Research Fellow Performance, Productivity

Damilola Olajide* Research Fellow Resource Allocation, Primary Care

Diane Skåtun Research Fellow Nurses’ Labour Markets

Matt Sutton* Professor and Programme Resource Allocation, Primary Care

Director

Deokhee Yi* Research Fellow Hospital Payment Systems

Also associated with the programme are:

Martin Chalkley Honorary Professor Incentives

Tony Scott Honorary Professor Labour Markets

*denotes working across more than one programme

Members of theBPOC Team

Programme Director: Professor Matt SuttonThrough studying NHS financing and the reactions of healthcare staff and NHS organisations to changes in financial incentives

and organisational rules, the work of the Behaviour, Performance and Organisation of Care (BPOC) programme aims to further

our understanding of individual and organisational behaviour and thus to improve the evidence-base for NHS policy making.

During 2007 we devoted much of our effort to dissemination of our completed and ongoing research projects. We targeted a

wide range of audiences, including economists, health economists, national organisation advisers and policymakers, and included

in our dissemination activities were Scottish, UK and international conferences. In October, we hosted a policy conference in

Edinburgh on pay and performance in the Scottish NHS. We presented the findings of our research on the consequences of the

new contracts for general practices and hospital consultants, the appropriateness of introducing regional pay for NHS staff,

and the impact of the introduction of activity-based financing for hospitals in England. We welcomed key policymakers and

advisers from the NHS in Scotland and national organisations in Scotland and England and discussed the consequences and

relevance of these developments for Scotland. In addition to the positive feedback from participants on the event, we benefited

from insightful comments on our research and suggestions for future work.

We also extended our direct contribution to policy this year. Matt Sutton was appointed as Adviser to the Health and Sport

Committee of the Scottish Parliament for their scrutiny of the Scottish Government’s Draft Budget and as a member of the

Advisory Group for Audit Scotland’s review of the new General Medical Services contract. Alasdair Munro contributed to the

option appraisal for reorganisation of children’s cancer services and Shelley Farrar provided expert advice and input to the

option appraisal for the NOSCAN Brachytherapy Service Review.

The work of BPOC is focused on three themes: workforce; resource allocation and performance. The progress we have made

with our research and our dissemination activities in each of these areas are summarised below.

Workforce

During 2006, we had undertaken a follow-up to our 2001/2 postal survey of all non training-grade doctors working for the NHS

in Scotland. Our analysis of the data during 2007 included a comparison of the changes in job satisfaction experienced by GPs,

consultants and Staff and Associate Specialists, which was presented to the International Medical Workforce Collaborative

(IMWC) in Vancouver in March. We also identified factors associated with the changes in job satisfaction reported by consultants

and presented this analysis at the Scottish Economic Society conference in March. We presented our analysis of changes in

consultant productivity in Bergen in July and in the retirement plans of consultants at the UK Health Economists’ Study Group

(HESG) meeting in September. Our analysis of GPs’ perceptions of changes in the quality of care was presented to the Nordic

HESG meeting in Estonia in August.

During 2007, we began the fieldwork for an Economic and Social Research Council (ESRC) funded study investigating the labour

market of registered nurses in the UK. The study considers the importance of pay and non-pay aspects within the reward

structure for nurses. The study will identify how nurses’ trade-off pay against other working conditions and compare the

preferences for pay and working conditions. Piloting of the questionnaire took place in the summer of 2007, with phase 1 of

the main survey completed in December 2007.

We also began a study of non-medical factors and their association with renal replacement therapy (RRT) incidence, effectiveness

and efficiency during 2007. The incidence of RRT varies considerably across economically developed countries and, like services

for other health conditions, renal services in different countries have developed in different ways and with different incentives

and regulations. This study aims to establish the extent to which variations in RRT incidence reflects underlying variation in

established renal failure rather than variation in organisation of renal services. It is being undertaken with colleagues from

the European Renal Register, Nephrology in Bristol and Medical Therapeutics in NHSGrampian.

BEHAVIOUR,PERFORMANCE AND ORGANISATION OF CARE


VALUATIONAND IMPLEMENTATION PROGRAMME (VIP)

16 14

Programme Director: Professor Mandy RyanThe focus of VIP is the development and application of contingent valuation (CV) and discrete choice experiments(DCEs). Recent years have seen widespread application of these techniques to address policy questions in healthcare. 2007 saw VIP sustain its contribution to high quality policy related research. VIP ensures that research canbe underpinned by methodological work, whilst it seeks to build research capacity in the application of thesetechniques through dissemination and training.

The year saw publication of a book edited by Mandy Ryan and Mabel Amaya-Amaya, in collaboration with Dr KarenGerard from the University of Southampton. Using Discrete Choice Experiments to Value Health and Health Careis part of a series edited by Professor Ian Bateman on The Economics of Non-Market Goods and Resources. Thebook, published by Springer, takes a fresh and contemporary look at the growing interest in the development andapplication of DCEs in health economics, and gives the reader a better understanding of issues raised in the designand application of DCEs. The book will be of interest to post-graduate students and applied researchers with aninterest in the use of DCEs for valuing health and health care.

As part of VIP’s training strategy, we have developed an Expert Workshop on Discrete Choice Experiments (DCEs).The aim of this Workshop is to provide information on practical and theoretical issues faced when conducting DCEs.During 2007 Professor Ryan ran a 2-day workshop for the Dutch Health Technology Assessment Group at theUniversity of Maastricht, Holland. New courses are being developed to reflect recent methodological advances inthe modelling and application of DCEs, and further courses will be offered in 2008/9.

Students play a crucial role in the methodological work conducted within VIP. 2007 saw Terry Porteous successfullydefend her PhD. PhD Methodological work was conducted by Dean Regier and Emmanouil Mentzakis and bothpresented at the International Health Economic Association conference in Copenhagen. Dean Regier was given aBest Student Podium Presentation Award by the International Society for Pharmacoeconomics and OutcomesResearch (ISPOR) at their 10th Annual European Conference, in Dublin, Ireland.

Funded by a visiting fellowship, Mandy Ryan spent one month at the Melbourne Institute of Applied Economic andSocial Policy Research, University of Melbourne, Australia in February. During her time there she worked withProfessor Kostas Mavromaras, developing work within the area of reducing obesity.

2007 saw completion of the Health Foundation grant to translate methodological work to the policy arena. Duringthis 5-year project we have applied DCEs to a wide range of policy areas. The completion of this project sees ussay good-bye to Dr Maria Odejar who was a Research Fellow within this programme of research. We would like towish her well. The Chief Scientist Office funded project to investigate preferences for the treatment of chronicback pain also came to an end, and a report was successfully submitted to the Scottish Government.

Continued progress was made on a number of other externally funded projects, including the National Institutefor Health and Clinical Excellence (NICE) and National Centre for Coordinating Health Technology Assessment(NCCHTA) funded project concerned with estimating the Social Value of a Quality Adjusted Life Year (QALY), theCancer Research UK funded project to investigate the potential for primary care to tackle social inequalities inestablished colorectal cancer, the MRC National Prevention Research Initiative project concerned with an economicevaluation of obesity prevention and a Wellcome Trust funded project, looking at public preferences for treatmentof common symptoms.

Further details of all Valuation & Implementation Programme in progress and completed projectsare detailed in Appendix 1.

Resource allocationEarly in 2007 we completed our projects on two cost adjustments included in resource allocation formulae in the UK:

(i) The Market Forces Factor (MFF) in England, and

(ii) The Excess Cost Adjustment Applied in Scotland.

Our research on the MFF established, for the first time, empirical evidence that spatial variations in private sector pay influence

the ability of NHS organisations to recruit and retain NHS staff. We have subsequently presented the findings of this research

at conferences organised by the IMWC, Royal Economic Society, the Office of Manpower Economics, the Centre for Market and

Public Organisation (CMPO), the Scottish Initiative for Research in Economics, the British Medical Association, the Office for

National Statistics and the Department of Work and Pensions.

During 2007 we also contributed to reviews of the needs component of the NHS funding formula used to allocate resources to

PCTs in England, the level of healthcare spending in Northern Ireland and the setting of practice prescribing budgets in NHS

Lothian.

Performance

We completed our national evaluation of the new activity-based financing system for hospitals in England, Payment by Results,

during the year. Our evaluation included design of a theoretical framework for evaluating the policy, findings from three rounds

of structured interviews with decision-makers and econometric analysis of changes in key outcomes in England and Scotland.

Findings from the research were presented at the International Health Economics Association conference in Copenhagen in

July and to the Department of Health’s External Advisory Group in December.

This year we also collaborated with colleagues from the University of Bristol on an ESRC funded project examining the

consequences of the introduction of targets on NHS waiting times. This work compares the more stringently-enforced, escalating

targets adopted in England with those in existence in Scotland. Our initial finding that the ‘targets and terror’ regime adopted

in England led to a substantial reduction in waiting times relative to Scotland were published in the Journal of Economic Analysis

and Policy. We are continuing to analyse the consequences of the targets for the prioritisation of patients and service quality.

We also continued our research on the Quality and Outcomes Framework (QOF) of the new contract for general practices this

year. We presented our examination of gaming undertaken with the University of York at the Royal Economic Society conference,

the International Health Economics Association conference and a policy conference organised by the CMPO and the University

of York. We also concluded our examination of changes in the quality of risk factor recording arising from the QOF. Our finding

that the introduction of the QOF was associated with significantly larger increases in the recording of incentivised activities

compared to un-incentivised activities was presented at the UK HESG meeting in the summer.

Staff

There were no changes in BPOC staff during 2007. Divine Ikenwilo and Yan Feng progressed successfully through their nine-

month assessments for their PhD studies.

Visiting Honorary Staff

We were pleased to have visits from our two of HERU’s honorary Professors, Martin Chalkley and Anthony Scott, during 2007.

Martin visited frequently from Dundee and Tony visited from Melbourne in July, both to collaborate on the Payment by Results

evaluation, undertake PhD assessments and present seminars.

Further details of all Behaviour, Performance and Organisation of Care in progress and completed projectsare detailed in Appendix 1.

BEHAVIOUR, PERFORMANCE AND ORGANISATION OF CARE


Conference PresentationsPresentations at conferences are vital to our work. In the early stages of projects, we use conference presentations to gainfeedback on our ideas and open them to the scrutiny of our peers. In the later stages of projects, we find opportunities todisseminate our findings to a wider range of audiences.

An important element of our core remit involves presentation of our work to advisers and decision makers. During 2007 wehosted another of our Policy Conferences aimed at highlighting our work within the policy making community in Scotland. BPOChosted the conference on pay and performance in NHSScotland in Edinburgh in October.

HERU’s research was well represented at the key health economics conferences during 2007. We presented 17 papers at theInternational Health Economics Association and 8 papers at the UK Health Economists’ Study Group. In addition, as well as ourcontributions to SIRE, we focused more of our dissemination at economics conferences, including 2 presentations at the ScottishEconomic Society conference in April and 3 papers at the Royal Economics Society conference also in April.

We continued to target clinical audiences with our economic evaluation work. These included presentations at the ConsensusConference on Early Chronic Kidney Disease, at the International symposium of the Royal College of Obstetricians and Gynaecologyand at a meeting of the British Prostate Group.

Newsletters, Briefing Paper & WebsiteDuring 2007, we produced three Newsletters, each edited by one of our research programmes. We use our Newsletters to alertour audience to the latest news about the Unit. These cover updates on research strategies within programmes; news onforthcoming policy conferences; new PhD Studentship awards; and new appointments to the Unit. A large part of the Newsletteris dedicated to our current or completed research projects. These articles showcase the wide range of topics researched acrossour four programmes.

Our Briefing Papers are also an important dissemination tool; in 2007 we produced five. We mail these to our collaboratorsand target specific audiences depending on the research topics covered. Below is a list of Briefing Papers produced in 2007along with links to our website where these can be viewed or downloaded.

Feb 07 – Changes in Job Satisfaction, Work Commitments and Attitudes to Workload Following Contractual Reform.http://www.abdn.ac.uk/heru/publications/briefings/documents/doctors_survey_briefing_paper_feb_07.pdf

Feb 07 – Using Tariffs to Pay for Hospital Carehttp://www.abdn.ac.uk/heru/publications/briefings/documents/tariffs_briefing_paper_feb_07.pdf

July 07 – The Value of Myocardial Perfusion Scintigraphy in the Diagnosis and Management of Angina and Myocardial Infraction:A Probabilistic Economic Analysishttp://www.abdn.ac.uk/heru/publications/briefings/documents/july_07_a.pdf

July 07 – Preferences for Self-Care or Consulting a Health Professional in Minor Illnesshttp://www.abdn.ac.uk/heru/publications/briefings/documents/july_07_b.pdf

Oct 07 – The Cost-Effectiveness of Laparoscopic Surgery for Colorectal Cancerhttp://www.abdn.ac.uk/heru/publications/briefings/documents/October07.pdf

The HERU Website is another of our dissemination vehicles. Here we keep our audiences up to date with our research programmes,their wide-ranging research projects and details of the variety of ways they disseminate their research findings to the researchcommunity. We use the website to bring to your attention details of conferences and workshops given and attended and reporton Policy Conferences, current vacancies within the Unit, our seminar programme and HERU’s latest news. The web addressis www.abdn.ac.uk/heru.

17

DISSEMINATION

19

As at the end of 2007 the Valuation & Implementation Programme team and their principal areasof research are:

Mabel Amaya-Amaya* Research Fellow Decision heuristics and context

Barbara Eberth* Research Fellow Validity of CV and DCEs

Emmanouil Mentzakis* PhD Student Valuing informal care

Maria Odejar Health Foundation Development of econometric techniques;

Research Fellow Translation to the policy arena

Dean Regier PhD Student Employing Bayesian methods in the design and

analysis of DCEs

Mandy Ryan Professor and Decision heuristics and context; Testing the validity

Programme Director of CV and DCEs; Developing of econometric

techniques; Translation to the policy arena

Michela Tinelli MRC/ESRC/ Development of econometric techniques

University of Aberdeen Translation to the policy arena (in Pharmacy)

PhD Student

Verity Watson Health Foundation Testing the validity of CV, Development of

Research Fellow econometric techniques; Translation to the policy

area

Deokhee Yi* Research Fellow Using DCEs in primary care


VALUATION AND IMPLEMENTATION PROGRAMME

Members of theVIP Team


20 18

ENHANCING CAPACITYWorkshopsWe deliver workshops to aid understanding of health economics methods and encourage their use within the research and policycommunities. The VIP programme delivers Expert Workshops on Discrete Choice Experiments (DCEs). The aim of these Workshopsis to provide information on practical and theoretical issues faced when conducting DCEs. New courses are being developedto reflect recent methodological advances in the modelling and application of DCEs. Further courses will be offered in 2008/9.Mandy Ryan ran an expert workshop on DCEs for the Dutch Health Technology Assessment Group whilst Murray Smith providedseminars on econometric methods in Aberdeen and Melbourne.

TeachingUndergraduate and Postgraduate TeachingThe Unit co-ordinated and taught Health Economics modules for the BSc in Health Sciences, MSc in Health Services and PublicHealth Research and the MA in Economics at the University of Aberdeen. With economists from the Universities of Dundee andEdinburgh, HERU provide the Health Economics module of the Scottish Graduate Programme in Economics located at theUniversity of Edinburgh. HERU also contributed to the Research Methods in Health Care course offered by NHS Education forScotland, and to the BSc Medical Sciences at the University of Aberdeen. Bob Elliott, Mandy Ryan, Matt Sutton and GrahamScotland ran a course in health economics for graduate students on the Dottorato in Economia e Finanza AmministrazionePubblica at the Universita Cattolica, Milan, Italy.

The Distance Learning “Postgraduate Certificate in Health Economics”A key component of HERU’s teaching programme is the distance-learning course. This course is designed for health careprofessionals who want to gain a recognised qualification in health economics and comprises 4 modules:

(i) Module 1 – introduces students to the key principles of economics and considers their application to health care

(ii) Module 2 – discusses issues around the valuation of costs and benefits within the framework of an economic evaluation

(iii) Module 3 - discusses pragmatic approaches to the incorporation of economics into policy making, including systematicreviews and modelling, the use of economic alongside randomised controlled trials, programme-budgeting, marginalanalysis and option appraisal

(iv) Module 4 – demonstrates how health economics can address questions beyond economic evaluation such as how we payour GPs and what is the optimal way to provide and finance health care

For more information on the course, please visit our website: www.abdn.ac.uk/heru/teaching

20 students were awarded the Certificate in 2006/7, with one student taking another module at a later date. The coursebeginning October 2007 saw 26 students enrolled. Whilst the majority of our students are UK based, students were registeredfrom as far afield as the US, Canada and Singapore. Backgrounds of our 2007 students, range across pharmaceutical companies,the NHS and Government departments.

For more information on the course, please visit our website: www.abdn.ac.uk/heru/teaching/home

Students2007 saw Terry Porteous a joint PhD student with the Department of GeneralPractice and Primary Care awarded her PhD. Two HERU students, Michela Tinelliand Patricia Fernandes also submitted their PhD Theses. Two further PhD studentsDean Regier and Emmanouil Mentzakis entered the third year of their studies.Dean’s project is “Investigating the societal benefits and costs of new geneticdiagnostic technology, microarray comparative genomic hybridization (mA-CGH)on families of children with idiopathic (unknown cause) developmental retardation”and Emmanouil is researching “Valuing informal care using stated preferencemethodologies”. Yan Feng, our 2nd year PhD continued with her project entitled“Microeconometric analysis of health care datasets - an economic analysis ofextrinsic and intrinsic motivation in the supply of Health Care”.

NEW STAFF ANDVISITORS TO HERU

New StaffDuring 2007 we welcomed five new staff to the Unit, in both Research and Administration. We also said goodbye to Heather

Mackintosh our secretary for the past four years. In February, Murray Smith joined the Unit as Senior Research Fellow. In March

Laura Ternent and Zahidul Quayyum joined HERU, we appointed Karen Miller in July as our Information Officer and also welcomed

Professor Ulf Gerdtham from Sweden at the end of August. Below are short profiles on the research interests and backgrounds

of our new recruits prior to joining HERU.

Before he joined the Unit as a Senior Research Fellow, Dr Murray Smith was an Associate Professor in Econometrics

and Business Statistics at the University of Sydney. Murray brings considerable expertise in econometrics to the

Unit and will be contributing to the MRC NPRI Research project entitled “An economic evaluation of obesity

prevention in UK adults”.

Laura Ternent and Zahidul Quayyum join us from the Aberdeen University Initiative for Maternal Mortality

Programme Assessment (IMMPACT) project, where they formed part of a larger team of researchers

conducting methodological and applied work in maternal health in Ghana, Burkina Faso and Indonesia.

They are Research Fellows in the Economic Evaluation programme. In addition, they also contribute

to the successor to the IMMPACT project, iPACT (initiative for Programme Assessment & Capacity

Training) which is concerned with policy evaluation of maternal and child health programmes in low and middle income countries.

Professor Ulf Gerdtham was appointed in August 2007. Ulf holds a joint appointment between HERU and the

Department of Economics, in the University of Aberdeen Business School. Previously a Professor of Health Economics

at Lund University in Sweden. Ulf researches across a wide range of areas within health economics. In recent

years he has focused on the effects of economic factors at the individual level on health and Ulf Gerdtham

health care as well as effects of contextual area level and time dependent factors, inequalities in health and

economic consequences of health related behaviour.

Karen Miller joined HERU as Part-time Information Officer in July 2007. Prior to this she worked at the Orkney

Library and Archive for 20 years as Assistant Librarian, with responsibility for Children’s and Schools Services.

VisitorsA wide range of colleagues have visited the Unit this year for collaboration on projects, presentations of research seminars

and to hear and learn more about our work. In addition, we had a number of longer-term visitors to the Unit. Murat Genc visited

from New Zealand in May to work with Murray Smith on a project on which wage regressions were estimated for a New Zealand

dataset taking into account potential sample selection biases arising from the exclusion of individuals with no market income.

Dr Sergio Maeso Martinez visited from Spain in November and December to work with Rodolfo Hernandez on the cost-effectiveness

of oesophageal Doppler monitoring system in critically ill and high risk surgical patients. The aim was to develop an economic

model and to compare the cost effectiveness of this technology in the UK and the Spanish settings. Alun Griffith came to HERU

for his MSc dissertation under the supervision of Ada Ma, Matt Sutton and Shelley Farrar between July and October, and Johan

Jarl began a one-year visit in November to work with Ulf Gerdtham on a project which will be estimating the avoidable cost

of alcohol consumption in Sweden. They will develop and apply methods for estimating the avoidable cost and to illustrate

its use in cost-effectiveness analysis by conducting evaluation of two existing alcohol interventions. We hope that all of them

enjoyed their visits.

>> Distance Learning Students from 2007/08


Conference PresentationsPresentations at conferences are vital to our work. In the early stages of projects, we use conference presentations to gainfeedback on our ideas and open them to the scrutiny of our peers. In the later stages of projects, we find opportunities todisseminate our findings to a wider range of audiences.

An important element of our core remit involves presentation of our work to advisers and decision makers. During 2007 wehosted another of our Policy Conferences aimed at highlighting our work within the policy making community in Scotland. BPOChosted the conference on pay and performance in NHSScotland in Edinburgh in October.

HERU’s research was well represented at the key health economics conferences during 2007. We presented 17 papers at theInternational Health Economics Association and 8 papers at the UK Health Economists’ Study Group. In addition, as well as ourcontributions to SIRE, we focused more of our dissemination at economics conferences, including 2 presentations at the ScottishEconomic Society conference in April and 3 papers at the Royal Economics Society conference also in April.

We continued to target clinical audiences with our economic evaluation work. These included presentations at the ConsensusConference on Early Chronic Kidney Disease, at the International symposium of the Royal College of Obstetricians and Gynaecologyand at a meeting of the British Prostate Group.

Newsletters, Briefing Paper & WebsiteDuring 2007, we produced three Newsletters, each edited by one of our research programmes. We use our Newsletters to alertour audience to the latest news about the Unit. These cover updates on research strategies within programmes; news onforthcoming policy conferences; new PhD Studentship awards; and new appointments to the Unit. A large part of the Newsletteris dedicated to our current or completed research projects. These articles showcase the wide range of topics researched acrossour four programmes.

Our Briefing Papers are also an important dissemination tool; in 2007 we produced five. We mail these to our collaboratorsand target specific audiences depending on the research topics covered. Below is a list of Briefing Papers produced in 2007along with links to our website where these can be viewed or downloaded.

Feb 07 – Changes in Job Satisfaction, Work Commitments and Attitudes to Workload Following Contractual Reform.http://www.abdn.ac.uk/heru/publications/briefings/documents/doctors_survey_briefing_paper_feb_07.pdf

Feb 07 – Using Tariffs to Pay for Hospital Carehttp://www.abdn.ac.uk/heru/publications/briefings/documents/tariffs_briefing_paper_feb_07.pdf

July 07 – The Value of Myocardial Perfusion Scintigraphy in the Diagnosis and Management of Angina and Myocardial Infraction:A Probabilistic Economic Analysishttp://www.abdn.ac.uk/heru/publications/briefings/documents/july_07_a.pdf

July 07 – Preferences for Self-Care or Consulting a Health Professional in Minor Illnesshttp://www.abdn.ac.uk/heru/publications/briefings/documents/july_07_b.pdf

Oct 07 – The Cost-Effectiveness of Laparoscopic Surgery for Colorectal Cancerhttp://www.abdn.ac.uk/heru/publications/briefings/documents/October07.pdf

The HERU Website is another of our dissemination vehicles. Here we keep our audiences up to date with our research programmes,their wide-ranging research projects and details of the variety of ways they disseminate their research findings to the researchcommunity. We use the website to bring to your attention details of conferences and workshops given and attended and reporton Policy Conferences, current vacancies within the Unit, our seminar programme and HERU’s latest news. The web addressis www.abdn.ac.uk/heru.

17

DISSEMINATION

19

As at the end of 2007 the Valuation & Implementation Programme team and their principal areasof research are:

Mabel Amaya-Amaya* Research Fellow Decision heuristics and context

Barbara Eberth* Research Fellow Validity of CV and DCEs

Emmanouil Mentzakis* PhD Student Valuing informal care

Maria Odejar Health Foundation Development of econometric techniques;

Research Fellow Translation to the policy arena

Dean Regier PhD Student Employing Bayesian methods in the design and

analysis of DCEs

Mandy Ryan Professor and Decision heuristics and context; Testing the validity

Programme Director of CV and DCEs; Developing of econometric

techniques; Translation to the policy arena

Michela Tinelli MRC/ESRC/ Development of econometric techniques

University of Aberdeen Translation to the policy arena (in Pharmacy)

PhD Student

Verity Watson Health Foundation Testing the validity of CV, Development of

Research Fellow econometric techniques; Translation to the policy

area

Deokhee Yi* Research Fellow Using DCEs in primary care


VALUATION AND IMPLEMENTATION PROGRAMME

Members of theVIP Team


20 18

ENHANCING CAPACITYWorkshopsWe deliver workshops to aid understanding of health economics methods and encourage their use within the research and policycommunities. The VIP programme delivers Expert Workshops on Discrete Choice Experiments (DCEs). The aim of these Workshopsis to provide information on practical and theoretical issues faced when conducting DCEs. New courses are being developedto reflect recent methodological advances in the modelling and application of DCEs. Further courses will be offered in 2008/9.Mandy Ryan ran an expert workshop on DCEs for the Dutch Health Technology Assessment Group whilst Murray Smith providedseminars on econometric methods in Aberdeen and Melbourne.

TeachingUndergraduate and Postgraduate TeachingThe Unit co-ordinated and taught Health Economics modules for the BSc in Health Sciences, MSc in Health Services and PublicHealth Research and the MA in Economics at the University of Aberdeen. With economists from the Universities of Dundee andEdinburgh, HERU provide the Health Economics module of the Scottish Graduate Programme in Economics located at theUniversity of Edinburgh. HERU also contributed to the Research Methods in Health Care course offered by NHS Education forScotland, and to the BSc Medical Sciences at the University of Aberdeen. Bob Elliott, Mandy Ryan, Matt Sutton and GrahamScotland ran a course in health economics for graduate students on the Dottorato in Economia e Finanza AmministrazionePubblica at the Universita Cattolica, Milan, Italy.

The Distance Learning “Postgraduate Certificate in Health Economics”A key component of HERU’s teaching programme is the distance-learning course. This course is designed for health careprofessionals who want to gain a recognised qualification in health economics and comprises 4 modules:

(i) Module 1 – introduces students to the key principles of economics and considers their application to health care

(ii) Module 2 – discusses issues around the valuation of costs and benefits within the framework of an economic evaluation

(iii) Module 3 - discusses pragmatic approaches to the incorporation of economics into policy making, including systematicreviews and modelling, the use of economic alongside randomised controlled trials, programme-budgeting, marginalanalysis and option appraisal

(iv) Module 4 – demonstrates how health economics can address questions beyond economic evaluation such as how we payour GPs and what is the optimal way to provide and finance health care

For more information on the course, please visit our website: www.abdn.ac.uk/heru/teaching

20 students were awarded the Certificate in 2006/7, with one student taking another module at a later date. The coursebeginning October 2007 saw 26 students enrolled. Whilst the majority of our students are UK based, students were registeredfrom as far afield as the US, Canada and Singapore. Backgrounds of our 2007 students, range across pharmaceutical companies,the NHS and Government departments.

For more information on the course, please visit our website: www.abdn.ac.uk/heru/teaching/home

Students2007 saw Terry Porteous a joint PhD student with the Department of GeneralPractice and Primary Care awarded her PhD. Two HERU students, Michela Tinelliand Patricia Fernandes also submitted their PhD Theses. Two further PhD studentsDean Regier and Emmanouil Mentzakis entered the third year of their studies.Dean’s project is “Investigating the societal benefits and costs of new geneticdiagnostic technology, microarray comparative genomic hybridization (mA-CGH)on families of children with idiopathic (unknown cause) developmental retardation”and Emmanouil is researching “Valuing informal care using stated preferencemethodologies”. Yan Feng, our 2nd year PhD continued with her project entitled“Microeconometric analysis of health care datasets - an economic analysis ofextrinsic and intrinsic motivation in the supply of Health Care”.

NEW STAFF ANDVISITORS TO HERU

New StaffDuring 2007 we welcomed five new staff to the Unit, in both Research and Administration. We also said goodbye to Heather

Mackintosh our secretary for the past four years. In February, Murray Smith joined the Unit as Senior Research Fellow. In March

Laura Ternent and Zahidul Quayyum joined HERU, we appointed Karen Miller in July as our Information Officer and also welcomed

Professor Ulf Gerdtham from Sweden at the end of August. Below are short profiles on the research interests and backgrounds

of our new recruits prior to joining HERU.

Before he joined the Unit as a Senior Research Fellow, Dr Murray Smith was an Associate Professor in Econometrics

and Business Statistics at the University of Sydney. Murray brings considerable expertise in econometrics to the

Unit and will be contributing to the MRC NPRI Research project entitled “An economic evaluation of obesity

prevention in UK adults”.

Laura Ternent and Zahidul Quayyum join us from the Aberdeen University Initiative for Maternal Mortality

Programme Assessment (IMMPACT) project, where they formed part of a larger team of researchers

conducting methodological and applied work in maternal health in Ghana, Burkina Faso and Indonesia.

They are Research Fellows in the Economic Evaluation programme. In addition, they also contribute

to the successor to the IMMPACT project, iPACT (initiative for Programme Assessment & Capacity

Training) which is concerned with policy evaluation of maternal and child health programmes in low and middle income countries.

Professor Ulf Gerdtham was appointed in August 2007. Ulf holds a joint appointment between HERU and the

Department of Economics, in the University of Aberdeen Business School. Previously a Professor of Health Economics

at Lund University in Sweden. Ulf researches across a wide range of areas within health economics. In recent

years he has focused on the effects of economic factors at the individual level on health and Ulf Gerdtham

health care as well as effects of contextual area level and time dependent factors, inequalities in health and

economic consequences of health related behaviour.

Karen Miller joined HERU as Part-time Information Officer in July 2007. Prior to this she worked at the Orkney

Library and Archive for 20 years as Assistant Librarian, with responsibility for Children’s and Schools Services.

VisitorsA wide range of colleagues have visited the Unit this year for collaboration on projects, presentations of research seminars

and to hear and learn more about our work. In addition, we had a number of longer-term visitors to the Unit. Murat Genc visited

from New Zealand in May to work with Murray Smith on a project on which wage regressions were estimated for a New Zealand

dataset taking into account potential sample selection biases arising from the exclusion of individuals with no market income.

Dr Sergio Maeso Martinez visited from Spain in November and December to work with Rodolfo Hernandez on the cost-effectiveness

of oesophageal Doppler monitoring system in critically ill and high risk surgical patients. The aim was to develop an economic

model and to compare the cost effectiveness of this technology in the UK and the Spanish settings. Alun Griffith came to HERU

for his MSc dissertation under the supervision of Ada Ma, Matt Sutton and Shelley Farrar between July and October, and Johan

Jarl began a one-year visit in November to work with Ulf Gerdtham on a project which will be estimating the avoidable cost

of alcohol consumption in Sweden. They will develop and apply methods for estimating the avoidable cost and to illustrate

its use in cost-effectiveness analysis by conducting evaluation of two existing alcohol interventions. We hope that all of them

enjoyed their visits.

>> Distance Learning Students from 2007/08


21 23

Econometrics Workshops

Health Econometrics Working GroupThe Health Econometrics Working Group (HEWG), initiated in 2005, continued to run a successful and informative programmein 2007. It drew upon contributions from a large number of researchers from all HERU programmes. In weekly workshop, ongoingresearch is presented to invite critical debate, advance knowledge, and provide an informal opportunity to practice dissemination.The focus of the group is on applied analysis of micro-econometric datasets and econometric techniques. As in earlier years,each member of the group has presented on aspects of at least two ongoing research projects.

Murray Smith presented a mini lecture series on Sample Selection. The group invited three external speakers in 2007. Dr HolgerBergmann from the University of Aberdeen Business School presented “Framing effects and their influence on Willingness toPay for nature-linked goods in Scotland – a meta analysis”. Dr Arne Risa Hole from the Centre of Health Economics at theUniversity of York presented on “Estimating mixed logit models using simulated maximum likelihood in STATA” and Peter Sivey,a PhD student from the Centre of Health Economics at the University of York, presented work from his PhD thesis entitled“Mixed multinomial logit models to analyse the determinants of choice of hospital for cataract operations in the NHS”.

For further information on the Health Econometrics Working Group and forthcoming presentations please visithttp://www.abdn.ac.uk/heru/presentations/internal/economectrics.php or contact Dr Barbara Eberth [email protected].

Four staff within HERU are currently registered for their PhD’s. They are Graham Scotland, Divine Ikenwilo, Laura Ternent andZahidul Quayyum. Below we outline these PhD’s.

Divine Ikenwilo

TITLE: Understanding job satisfaction in the labour market for doctors (PhD)

Outline - Job satisfaction has been a policy issue within the UK and in Europe for some time. Economists have shown thatjob satisfaction is correlated with objective labour market outcomes such as performance, productivity, absenteeism,mobility and turnover. These objective measures of labour market activity have implications for the recruitment andretention of doctors in Scotland and in the UK. It is therefore important to understand how job satisfaction affects (and isaffected by) labour market outcomes.

Graham Scotland

TITLE: Valuing outcomes in economic evaluations of maternal and reproductive health care interventions

Outline - This thesis will adapt valuation methods for application in economic evaluations of reproductive and maternalhealth care interventions to assess (i) the relative weights individuals place on benefits that accrue to mothers and theirchildren and (ii) how sensitive policy recommendations are to the use of different approaches to valuing benefits.

Laura Ternent

TITLE: Testing methods to value health outcomes in developing countries using stated preference techniques

Outline - The aim of this PhD is to test methods to elicit individual preferences for health outcomes in a developingcountry setting using stated preference (SP) methods. The PhD will test different methods of elicitation in Ghana andBurkina Faso, in both rural and urban populations, and with literate and non-literate respondents.

Zahidul Quayyum

TITLE: The Principle of Need Based Allocation for Distribution of Public Funds in Health Care: Adapting Need BasedResource Allocation Principle for Bangladesh and Indonesia

Outline - The main objective of this research is to examine the existing resource allocation principle in the public sectorhealth care in Bangladesh and in Indonesia and to develop alternative resource allocation principle that would generatean equitable and needs based geographical allocation of public funds for health care. The study will also examine themajor barriers in the development and implementation of need based allocation formulae for equitable distribution ofhealth care resources.

Staff DevelopmentThe Unit is committed to supporting and providing staff development in many ways. During 2007 we again secured, through acompetitive application process funding opportunities to support many different development activities. These enabled membersof the Unit to attend for the second year the Marie Curie Health Economist Masterclass in Applied Health Economics and avariety of other seminars and workshops.

Our new Information Officer, Karen Miller benefited from a personalised staff development programme. This included on-line-search courses and arrangements for mentoring by the Information Officer from our sister Unit, HSRU.

Research staff in HERU undertake training to enhance their research, and where they perform an administrative role withinthe Unit, training to support these roles.

HERU will continue to invest in all areas of training and development for HERU staff and PhD students. Below we detail thevariety of courses which Research staff, Administrative staff and PhD Students attended during 2007.


HERU PROJECTS,PUBLICATIONS & PRESENTATIONS

APPENDIX 1 PROJECTS IN PROGRESS AND COMPLETED IN 2007

APPENDIX 2 PUBLICATIONS 2007

APPENDIX 3 PRESENTATIONS 2007



24 22

ENHANCING CAPACITY

Research TrainingCourse Title Location Undertaken By Title

Advanced methods of cost Health Economics Research Zahidul Quayyum Research Felloweffectiveness analysis Centre, University of York

Applied Social Sciences (CASS) University of Aberdeen Claudia Geue Research AssistantQuestionnaire Design

ASPIRE PhD Training - Leadership, University of Aberdeen Divine Ikenwilo Research FellowTeam Working and Creative Thinking

Beginner’s statistics (ASPIRE) University of Aberdeen Yan Feng PhD Student

Eric Maskin Seminar & Public Edinburgh Ada Ma, Deokhee Yi Research FellowsHealth Lecture

Experimental Economics Economics Department Marjon van der Pol Senior Research FellowUniversity of Aberdeen

Experimental Economics Economics Department Mary Kilonzo, Dami Olajide, Research FellowsUniversity of Aberdeen Verity Watson and Ada Ma

Experimental Economics Economics Department Dean Regier PhD StudentUniversity of Aberdeen

Introduction to Research Quality Edinburgh Paul McNamee Senior Research FellowAssurance

Introductory course in R (Software) University of Aberdeen Emmanouil Mentzakis PhD Student

Introduction to more advanced University of Aberdeen Emmanouil Mentzakis PhD Studentstatistical methods using R (Software)

Master class in applied health Bergen, Norway Barbara Eberth Research Felloweconomics (2007)

Maternal and newborn health Geneva Laura Tennant Research Fellowprogramming

Mind mapping (ASPIRE) University of Aberdeen Yan Feng PhD Student

Networking for Researchers University of Aberdeen Graham Scotland Research Fellow

New Health Information Specialists London Zahidul Quayyum Research FellowConference

PhD Student’s Workshop Brechin Emmanouil Mentzakis, PhD StudentsMichela Tinelli and Yan Feng

Scottish Longitudinal Study Training St. Andrews Dami Olajide Research FellowWorkshop

Time management Foresterhill Shelley Farrar Research Fellow

Virtual Microdata Laboratory (VML) London Ada Ma Research FellowEarnings Workshop

Voice training workshop University of Aberdeen Verity Watson & Ada Ma Research Fellows

Administration TrainingCourse Title Location Undertaken By Title

Appraiser Training University of Aberdeen Murray Smith Senior Research Fellow

Effective writing course Mabon Consultants, Aberdour Shona Christie Unit Administrator

Effective writing course Mabon Consultants, Aberdour Anne Bews Unit Secretary

E-mail calendaring University of Aberdeen Karen Miller Information Officer

Online searching (Basic) BMA House, London Karen Miller Information Officer

Performance Management University of Aberdeen Marjon van der Pol, Programme DirectorsMatt Sutton


21 23

Econometrics Workshops

Health Econometrics Working GroupThe Health Econometrics Working Group (HEWG), initiated in 2005, continued to run a successful and informative programmein 2007. It drew upon contributions from a large number of researchers from all HERU programmes. In weekly workshop, ongoingresearch is presented to invite critical debate, advance knowledge, and provide an informal opportunity to practice dissemination.The focus of the group is on applied analysis of micro-econometric datasets and econometric techniques. As in earlier years,each member of the group has presented on aspects of at least two ongoing research projects.

Murray Smith presented a mini lecture series on Sample Selection. The group invited three external speakers in 2007. Dr HolgerBergmann from the University of Aberdeen Business School presented “Framing effects and their influence on Willingness toPay for nature-linked goods in Scotland – a meta analysis”. Dr Arne Risa Hole from the Centre of Health Economics at theUniversity of York presented on “Estimating mixed logit models using simulated maximum likelihood in STATA” and Peter Sivey,a PhD student from the Centre of Health Economics at the University of York, presented work from his PhD thesis entitled“Mixed multinomial logit models to analyse the determinants of choice of hospital for cataract operations in the NHS”.

For further information on the Health Econometrics Working Group and forthcoming presentations please visithttp://www.abdn.ac.uk/heru/presentations/internal/economectrics.php or contact Dr Barbara Eberth [email protected].

Four staff within HERU are currently registered for their PhD’s. They are Graham Scotland, Divine Ikenwilo, Laura Ternent andZahidul Quayyum. Below we outline these PhD’s.

Divine Ikenwilo

TITLE: Understanding job satisfaction in the labour market for doctors (PhD)

Outline - Job satisfaction has been a policy issue within the UK and in Europe for some time. Economists have shown thatjob satisfaction is correlated with objective labour market outcomes such as performance, productivity, absenteeism,mobility and turnover. These objective measures of labour market activity have implications for the recruitment andretention of doctors in Scotland and in the UK. It is therefore important to understand how job satisfaction affects (and isaffected by) labour market outcomes.

Graham Scotland

TITLE: Valuing outcomes in economic evaluations of maternal and reproductive health care interventions

Outline - This thesis will adapt valuation methods for application in economic evaluations of reproductive and maternalhealth care interventions to assess (i) the relative weights individuals place on benefits that accrue to mothers and theirchildren and (ii) how sensitive policy recommendations are to the use of different approaches to valuing benefits.

Laura Ternent

TITLE: Testing methods to value health outcomes in developing countries using stated preference techniques

Outline - The aim of this PhD is to test methods to elicit individual preferences for health outcomes in a developingcountry setting using stated preference (SP) methods. The PhD will test different methods of elicitation in Ghana andBurkina Faso, in both rural and urban populations, and with literate and non-literate respondents.

Zahidul Quayyum

TITLE: The Principle of Need Based Allocation for Distribution of Public Funds in Health Care: Adapting Need BasedResource Allocation Principle for Bangladesh and Indonesia

Outline - The main objective of this research is to examine the existing resource allocation principle in the public sectorhealth care in Bangladesh and in Indonesia and to develop alternative resource allocation principle that would generatean equitable and needs based geographical allocation of public funds for health care. The study will also examine themajor barriers in the development and implementation of need based allocation formulae for equitable distribution ofhealth care resources.

Staff DevelopmentThe Unit is committed to supporting and providing staff development in many ways. During 2007 we again secured, through acompetitive application process funding opportunities to support many different development activities. These enabled membersof the Unit to attend for the second year the Marie Curie Health Economist Masterclass in Applied Health Economics and avariety of other seminars and workshops.

Our new Information Officer, Karen Miller benefited from a personalised staff development programme. This included on-line-search courses and arrangements for mentoring by the Information Officer from our sister Unit, HSRU.

Research staff in HERU undertake training to enhance their research, and where they perform an administrative role withinthe Unit, training to support these roles.

HERU will continue to invest in all areas of training and development for HERU staff and PhD students. Below we detail thevariety of courses which Research staff, Administrative staff and PhD Students attended during 2007.


HERU PROJECTS,PUBLICATIONS & PRESENTATIONS






24 22

ENHANCING CAPACITY

Research TrainingCourse Title Location Undertaken By Title

Advanced methods of cost Health Economics Research Zahidul Quayyum Research Felloweffectiveness analysis Centre, University of York

Applied Social Sciences (CASS) University of Aberdeen Claudia Geue Research AssistantQuestionnaire Design

ASPIRE PhD Training - Leadership, University of Aberdeen Divine Ikenwilo Research FellowTeam Working and Creative Thinking

Beginner’s statistics (ASPIRE) University of Aberdeen Yan Feng PhD Student

Eric Maskin Seminar & Public Edinburgh Ada Ma, Deokhee Yi Research FellowsHealth Lecture

Experimental Economics Economics Department Marjon van der Pol Senior Research FellowUniversity of Aberdeen

Experimental Economics Economics Department Mary Kilonzo, Dami Olajide, Research FellowsUniversity of Aberdeen Verity Watson and Ada Ma

Experimental Economics Economics Department Dean Regier PhD StudentUniversity of Aberdeen

Introduction to Research Quality Edinburgh Paul McNamee Senior Research FellowAssurance

Introductory course in R (Software) University of Aberdeen Emmanouil Mentzakis PhD Student

Introduction to more advanced University of Aberdeen Emmanouil Mentzakis PhD Studentstatistical methods using R (Software)

Master class in applied health Bergen, Norway Barbara Eberth Research Felloweconomics (2007)

Maternal and newborn health Geneva Laura Tennant Research Fellowprogramming

Mind mapping (ASPIRE) University of Aberdeen Yan Feng PhD Student

Networking for Researchers University of Aberdeen Graham Scotland Research Fellow

New Health Information Specialists London Zahidul Quayyum Research FellowConference

PhD Student’s Workshop Brechin Emmanouil Mentzakis, PhD StudentsMichela Tinelli and Yan Feng

Scottish Longitudinal Study Training St. Andrews Dami Olajide Research FellowWorkshop

Time management Foresterhill Shelley Farrar Research Fellow

Virtual Microdata Laboratory (VML) London Ada Ma Research FellowEarnings Workshop

Voice training workshop University of Aberdeen Verity Watson & Ada Ma Research Fellows

Administration TrainingCourse Title Location Undertaken By Title

Appraiser Training University of Aberdeen Murray Smith Senior Research Fellow

Effective writing course Mabon Consultants, Aberdour Shona Christie Unit Administrator

Effective writing course Mabon Consultants, Aberdour Anne Bews Unit Secretary

E-mail calendaring University of Aberdeen Karen Miller Information Officer

Online searching (Basic) BMA House, London Karen Miller Information Officer

Performance Management University of Aberdeen Marjon van der Pol, Programme DirectorsMatt Sutton


2725

ECONOMIC EVALUATION

A Pragmatic Randomised Controlled Trial of Intensive Care post-discharge review clinics in improving Longer-term Outcomes from critical illness (PRaCTICaL Trial)

Investigators: B Cuthbertson, (University of Aberdeen) M Johnston, M Campbell, J Norrie, C Pflanz-Sinclair, C Ramsay,A McDonald, G McPherson, (Health Services Research Unit, University of Aberdeen) J Rattray, (University of Dundee) JWildsmith, (University of Dundee) E Wilson, (Ninewells Hospital, Dundee) A Hull, (Murray Royal Hospital, Perth) CWaldman, (Reading) M Gager, (Reading) S Roughton, (Aberdeen) A Smith, (Dundee) R Hernández (HERU) and L Vale(HSRU/HERU)

In addition to the high rates of mortality associated with admission to intensive care units (of the 10000 patients admitted tointensive care units in Scotland per year almost 5000 are dead within one year of admission), it is clear that intensive carepatients continue to experience severe physical and psychological problems for years after discharge from ICU. These problemshave implications not just for patients but represent a continuing financial burden for the NHS. Despite the lack of an evidencebase, over 40 hospitals across the UK have developed Intensive Care post-discharge review clinics in an attempt to improveoutcomes after ICU discharge. We aim to test the hypothesis (using a pragmatic randomised controlled trial) that intensivecare post-discharge review clinics are both effective and cost-effective in improving physical and psychological quality of lifein the year after intensive care discharge. Outcome measures include physical and psychological health-related quality of lifeand morbidity. A formal economic evaluation is an integral part of this project. Cost effectiveness and costs-utility analysiswill be conducted. Deterministic and probabilistic sensitivity analysis will be developed for the trial follow up period; the impactof extrapolating results to a longer time period to that of the trial follow up will be also explored.

Source of funding and total awarded: CSO funded: £225,000

Amount of HERU funding: £8,609

*Cost of live birth after assisted conception at advanced reproductive age in Grampian

Investigators: A Maheshwari, S Bhattacharya, (Department of Obstetrics and Gynaecology, University of Aberdeen)G Scotland (HERU) and J Bell (Department of Public Health, University of Aberdeen)

This project will explore the economic cost of live-birth after assisted reproduction at an advanced reproductive age andcompare it with the cost at a younger age. A higher proportion of women undergoing IVF are more than 35 years old. Althoughfunding for IVF depends on age, early pregnancy and antenatal care is funded by the NHS. This study aims to analyse the costto the NHS of providing IVF to woman of advanced reproductive age for every live birth. In addition to the cost of IVF treatmentitself, we will analyse the cost of early pregnancy losses and antenatal care. Cost per live birth will be calculated for differentage groups and comparison will be made. Since a higher proportion of women are delaying their pregnancy to a later age, andsubsequently presenting for IVF at a later age, the cost implications to the NHS of providing IVF may be increasing considerably.

Source of Funding and Total Awarded: NHS Grampian - £5,600

Amount of HERU Funding: £2,500

Non-pharmacological interventions for adults with impaired glucose tolerance

Investigators: Aberdeen HTA Group (University of Aberdeen), M Gillet (University of Sheffield), G Scotland and P McNamee(HERU)

Literature review and economic modelling will be used to assess the effectiveness and cost-effectiveness of the followinginterventions for preventing diabetes in people with IGT/IFG: i) Weight loss in those who are overweight (BMI 26-29) or obese(BMI 30 and over), by calorie restriction alone or combined with exercise; ii) Exercise therapies – i.e. exercise alone, withoutweight loss; and iii) Qualitative changes in diet without calorie restriction and weight loss. The above interventions are beingcompared to standard practice which is taken as no organised screening; the usual lifestyle advice given opportunistically; andcare of diabetes when it becomes symptomatic. However a survey of primary care using the GPRD database is also beingundertaken to assess recent practice.

Source of funding and total awarded: NHS HTA Programme - to be confirmed

Amount of HERU funding: to be confirmed

Projects in progress:


Applied Projects in CSO Research Priority Areas

A prospective collaborative study of patients with intestinal segments transposed into urinary tract followingsurgery for bladder cancer or benign end stage bladder disease

Investigators: J N’Dow, A Grant, (Health Services Research Unit, University of Aberdeen) L Vale, (HERU/HSRU)R Hernandez (HERU)

The aim of this study is to compare ileal conduit diversion, continent diversion, bladder reconstruction and bladder replacementas methods replacing or improving the function of the lower urinary tract. Outcomes will be quality of life and requirementsfor other health resources at least up to one year after the index procedure. Approximately 600 patients will be recruited from10 hospitals in Great Britain.

Source of funding and total awarded: BUPA, £179,857


Conservative treatment for urinary incontinence in Men after Prostate Surgery (MAPS)

Investigators: C Glazener, A Grant, C Ramsay, D Norrie, J N’Dow, (Health Services Research Unit, University of Aberdeen)L Vale, (HERU/HSRU) M Kilonzo (HERU), G Dorey, (University of West England) S Hagan, (Nursing Research Initiative)K Moore (University of Alberta)

Urinary incontinence is a common complication following surgery for prostate disease. This study aims to assess the effectivenessand cost-effectiveness of active conservative treatment for men with urinary incontinence six weeks after radical prostatectomyfor prostate cancer or endoscopic resection of prostate for benign disease. Men will be recruited from about 26 UK hospitals.The men in the intervention groups will receive an assessment of their symptoms at about six weeks after surgery. Men in thecontrol groups will only receive supportive lifestyle advice by post after randomisation. NHS and personal costs will be estimatedfor every participant. Outcomes will be subjective continence and QALYs at 12 months. Longer term costs and benefits willbe assessed as part of an economic model.

Source of funding and total awarded: NHS R&D HTA Programme, £1,252,961


*Cost effectiveness of exercise training in older patients with heart failure

Investigators: M McMurdo, M Witham, AD Struthers, (Ninewells Hospital & University of Dundee) D Johnston (Universityof Aberdeen) and C Lang (Ninewells Hospital & University of Dundee) and M van der Pol (HERU Participant)

This study will assess the cost-effectiveness of exercise training in older patients with heart failure. Whilst exercise trainingis known to be beneficial in younger people with heart failure, this evidence is not applicable to typical patients who are older.A 112 patient two arm randomised trial is conducted to evaluate the effectiveness and cost-effectiveness of exercise trainingin older patients with heart failure. The exercise training programme comprises of 8 weeks of two sessions therapist-ledsupervised small group intermittent functional aerobic exercise and strength training, with the duration of sessions graduallyincreased to 60 minutes. This is followed by a 16 week home-based exercise phase which will include self-monitoring andtelephone instruction and encouragement from the therapist. The economic outcomes of the study will be incremental costper quality adjusted life year.

Source and Amount of Funding: CSO, £213,465


*Economic evaluation of tele-endoscopy

Investigators: M van der Pol (HERU)

This project will conduct a cost-benefit analysis of tele-endoscopy versus traditional endoscopy. A discrete choice experimentwill be used to elicit the public’s preferences including the monetary value they place on tele-endoscopy.

Source of Funding and Total Awarded: NHS Grampian, £12,643


(Projects marked * started in 2007)ECONOMIC EVALUATION


28 26



Other Applied Projects (continued)

Randomised comparison of macular hole surgery with or without internal limiting membrane peeling

Investigators: N Lois, (Grampian University Hospitals Trust) J Burr, J Norrie, (Health Services Research Unit, Universityof Aberdeen) L Vale, R de Verteuil (HERU/HSRU)

This study will conduct a RCT in patients with stage 2-3 full thickness macular holes (FTMH) and will involve the evaluation ofthe benefits and costs of internal limiting membrane (ILM) peeling. Patients will be recruited from Scotland (Aberdeen, Glasgow,Dundee, and Inverness) and England (Liverpool). Follow-up of patients will be for six months. For the economic evaluation NHScosts will be estimated for every trial participant. The EQ-5D, a generic measure of health status, will be completed at baselineand three and six months and be used to calculate QALYs.

Source of funding and total awarded: CSO and CSO Core, £193,938


Scottish multicentre trial of glutamine and selenium supplemented parenteral nutrition for critically illpatients (SIGNET trial)

Investigators: P Andrews, (University of Edinburgh) A Avenell, M Campbell, (Health Services Research Unit, Universityof Aberdeen) B Croal, D Noble, W Simpson, (NHS Grampian) F MacKirdy, (Scottish Intensive Care Audit) L Vale, R deVerteuil (HERU/HSRU)

Intensive care unit (ICU) and subsequent hospital mortality are high, and infections in ICU are associated with a 2-3 timesincreased risk of death. Systematic reviews suggest that supplementing parenteral nutrition (PN) in critical illness with glutamineor selenium may reduce infections and mortality. Three different strategies are evaluated in this randomised controlled trial:glutamine supplement, selenium supplement, and both glutamine and selenium supplements.

Source of funding and total awarded: CSO Core

Amount of HERU funding: CSO Core

*Systematic review and economic modelling of the effectiveness and efficiency of non-surgical treatmentsfor women with stress urinary incontinence (SUI)

Investigators: L Vale (HSRU/HERU), M Kilonzo (HERU), M Imamura (HSRU), S Zhu (HSRU), J Wardle (Continence Foundation),P Abrams (British Urological Institute), R Pickard (University of Newcastle), C Glazener, J Cody, J Cook, G Mowatt, SWallace, Z Shihua, I Mari (Health Services Research Unit, University of Aberdeen), J N’Dow, G Nabi (Department ofSurgery), A Grant (Institute of Applied Health Science), L Cardozo (King’s College Hospital, London), B Buckley (Incontact),JH Smith (University of Otago, New Zealand), B Christine (NHS Grampian) and S Eustice (NHS Cornwall)

The objectives of the study are: i. to determine the clinical effectiveness of alternative treatments for SUI. ii. To determinethe safety in terms of the magnitude of any risks or side effects of treatment for SUI. iii. To assess whether treatment ormanagement pathways should differ between women presenting with (a) SUI postpartum or at any other time; (b) SUI aloneor mixed urinary incontinence; and (c) SUI with or without the presence of a co-existing anterior wall prolapse. iv. To estimatethe cost-effectiveness of the alternative management pathways. v. To identify areas where future research is required.

Urinary incontinence is a symptom defined as the complaint of any involuntary leakage of urine. Clinically it is classified as:(a) SUI which is the symptom of urine loss on effort, exertion, coughing or sneezing; (b) urgency urinary incontinence (UUI)which is the symptom of urine loss accompanied by or immediately preceded by urinary urgency; and (c) mixed urinaryincontinence (MUI) which is a combination of stress and urgency urinary incontinence. Various surgical and non-surgical therapieshave been developed with the aim of increasing urethral closure pressure in response and so alleviate the symptoms of SUI,improve quality of life and patient satisfaction. The wide range of proposed treatments and the rather disappointing reviewsof efficacy suggest that none of the options yet provide the ideal combination of clinical efficacy, high safety, patient satisfactionand low cost.

Source of Funding and Total Awarded: National Institute of Health Research, Health Technology Assessment Programme£217,150


ECONOMIC EVALUATIONProjects in progress:


(Projects marked * started in 2007)

Applied Projects in CSO Research Priority Areas (continued)

*Systematic review of the clinical and cost-effectiveness and economic evaluation, of photodynamic diagnosisand novel urine biomarker tests in the detection of the follow-up of bladder cancer

Investigators: G Mowatt, S Zhu, C Fraser (Health Services Research Unit, University of Aberdeen), L Vale (HSRU/HERU),M Kilonzo (HERU), J N’Dow, G Nabi, S Swami (Department of Surgery and NHS Grampian) and A Grant (Institute of AppliedHealth Sciences)

Bladder cancer is a common cancer in the UK affecting more than 10,000 individuals each year. Cystoscopy is the gold standardtest for diagnosing cancer of the bladder, but it does not provide complete detection of cancerous lesions. Cystoscopy withbiopsy is currently used to diagnose bladder cancer and repeated operative follow up is advised. Photodynamic diagnosis canbe used to enhance cystoscopy during initial diagnosis and staging of bladder cancer, or as part of follow-up evaluation. It hasshown promise in sensitivity and specificity trials, but further research is needed in the form of a randomised controlled trialto identify whether photodynamic diagnosis makes a difference to patient outcomes compared to cystoscopy alone, and toevaluate its cost effectiveness. There is a hope that novel urine biomarker tests may be used in future, both in diagnosis (orits exclusion) and in follow up so that people who have had bladder cancer will not have repeated cystoscopies.

Source of Funding and Total Awarded: TAR - £224,000


*The effectiveness and cost-effectiveness of elective neck dissection in early oral cancer treatment

Investigators: I Hutchison (Queen Mary, University of London), A Hackshaw (CRUK & UCL Cancer Trials Centre), I Martin(Sunderland Royal Hospital), K Piper (Queen Mary, University of London), G Thomas (University College London Hospital),K Webster, J Olliff (University Hospital Birmingham) and A Korszun (Queen Mary, University of London) and M van derPol (HERU)

This study will assess the effectiveness and cost-effectiveness of elective neck dissection in early oral cancer treatment. Inpatients with early mouth cancer, the cancer often spreads to the lymph glands in the neck. Elective neck dissection is thereforeincreasingly performed at the time when the patient is treated for the early mouth cancer even though there is no evidenceof neck metastases. The procedure is lengthy and expensive compared to resection of the tumour alone but may be cost-effective if it prevents the development of neck metastases that require further surgery and perhaps more radical treatments.652 patients will be randomised to receive either resection of the primary tumour alone or resection with simultaneous selectiveneck dissection. The effectiveness is measured in terms of disease free survival and quality of life. A full cost-utility analysisis performed.

Source of Funding and Total Awarded: CRUK - £799,186


Other Applied Projects

An evaluation of an adapted United States model of pharmaceutical care to improve psychoactive prescribingfor care home residents in Scotland

Investigators: M King, A Lee, C Bond (Department of General Practice and Primary Care, University of Aberdeen) andP McNamee (HERU)

Qualitative assessment (interviews with health professionals) to inform tailoring of the model followed by a pilot of theintervention in two care homes. Process and outcomes to be measured include time required to perform intervention, numberof recommendations made, acceptance rate, prevalence of psychoactive medications, falls, survival, professional satisfactionand change in resource use.

Source of funding and total awarded: CSO - £18,944



2725

ECONOMIC EVALUATION

A Pragmatic Randomised Controlled Trial of Intensive Care post-discharge review clinics in improving Longer-term Outcomes from critical illness (PRaCTICaL Trial)

Investigators: B Cuthbertson, (University of Aberdeen) M Johnston, M Campbell, J Norrie, C Pflanz-Sinclair, C Ramsay,A McDonald, G McPherson, (Health Services Research Unit, University of Aberdeen) J Rattray, (University of Dundee) JWildsmith, (University of Dundee) E Wilson, (Ninewells Hospital, Dundee) A Hull, (Murray Royal Hospital, Perth) CWaldman, (Reading) M Gager, (Reading) S Roughton, (Aberdeen) A Smith, (Dundee) R Hernández (HERU) and L Vale(HSRU/HERU)

In addition to the high rates of mortality associated with admission to intensive care units (of the 10000 patients admitted tointensive care units in Scotland per year almost 5000 are dead within one year of admission), it is clear that intensive carepatients continue to experience severe physical and psychological problems for years after discharge from ICU. These problemshave implications not just for patients but represent a continuing financial burden for the NHS. Despite the lack of an evidencebase, over 40 hospitals across the UK have developed Intensive Care post-discharge review clinics in an attempt to improveoutcomes after ICU discharge. We aim to test the hypothesis (using a pragmatic randomised controlled trial) that intensivecare post-discharge review clinics are both effective and cost-effective in improving physical and psychological quality of lifein the year after intensive care discharge. Outcome measures include physical and psychological health-related quality of lifeand morbidity. A formal economic evaluation is an integral part of this project. Cost effectiveness and costs-utility analysiswill be conducted. Deterministic and probabilistic sensitivity analysis will be developed for the trial follow up period; the impactof extrapolating results to a longer time period to that of the trial follow up will be also explored.

Source of funding and total awarded: CSO funded: £225,000


*Cost of live birth after assisted conception at advanced reproductive age in Grampian

Investigators: A Maheshwari, S Bhattacharya, (Department of Obstetrics and Gynaecology, University of Aberdeen)G Scotland (HERU) and J Bell (Department of Public Health, University of Aberdeen)

This project will explore the economic cost of live-birth after assisted reproduction at an advanced reproductive age andcompare it with the cost at a younger age. A higher proportion of women undergoing IVF are more than 35 years old. Althoughfunding for IVF depends on age, early pregnancy and antenatal care is funded by the NHS. This study aims to analyse the costto the NHS of providing IVF to woman of advanced reproductive age for every live birth. In addition to the cost of IVF treatmentitself, we will analyse the cost of early pregnancy losses and antenatal care. Cost per live birth will be calculated for differentage groups and comparison will be made. Since a higher proportion of women are delaying their pregnancy to a later age, andsubsequently presenting for IVF at a later age, the cost implications to the NHS of providing IVF may be increasing considerably.

Source of Funding and Total Awarded: NHS Grampian - £5,600


Non-pharmacological interventions for adults with impaired glucose tolerance

Investigators: Aberdeen HTA Group (University of Aberdeen), M Gillet (University of Sheffield), G Scotland and P McNamee(HERU)

Literature review and economic modelling will be used to assess the effectiveness and cost-effectiveness of the followinginterventions for preventing diabetes in people with IGT/IFG: i) Weight loss in those who are overweight (BMI 26-29) or obese(BMI 30 and over), by calorie restriction alone or combined with exercise; ii) Exercise therapies – i.e. exercise alone, withoutweight loss; and iii) Qualitative changes in diet without calorie restriction and weight loss. The above interventions are beingcompared to standard practice which is taken as no organised screening; the usual lifestyle advice given opportunistically; andcare of diabetes when it becomes symptomatic. However a survey of primary care using the GPRD database is also beingundertaken to assess recent practice.

Source of funding and total awarded: NHS HTA Programme - to be confirmed

Amount of HERU funding: to be confirmed




A prospective collaborative study of patients with intestinal segments transposed into urinary tract followingsurgery for bladder cancer or benign end stage bladder disease

Investigators: J N’Dow, A Grant, (Health Services Research Unit, University of Aberdeen) L Vale, (HERU/HSRU)R Hernandez (HERU)

The aim of this study is to compare ileal conduit diversion, continent diversion, bladder reconstruction and bladder replacementas methods replacing or improving the function of the lower urinary tract. Outcomes will be quality of life and requirementsfor other health resources at least up to one year after the index procedure. Approximately 600 patients will be recruited from10 hospitals in Great Britain.

Source of funding and total awarded: BUPA, £179,857


Conservative treatment for urinary incontinence in Men after Prostate Surgery (MAPS)

Investigators: C Glazener, A Grant, C Ramsay, D Norrie, J N’Dow, (Health Services Research Unit, University of Aberdeen)L Vale, (HERU/HSRU) M Kilonzo (HERU), G Dorey, (University of West England) S Hagan, (Nursing Research Initiative)K Moore (University of Alberta)

Urinary incontinence is a common complication following surgery for prostate disease. This study aims to assess the effectivenessand cost-effectiveness of active conservative treatment for men with urinary incontinence six weeks after radical prostatectomyfor prostate cancer or endoscopic resection of prostate for benign disease. Men will be recruited from about 26 UK hospitals.The men in the intervention groups will receive an assessment of their symptoms at about six weeks after surgery. Men in thecontrol groups will only receive supportive lifestyle advice by post after randomisation. NHS and personal costs will be estimatedfor every participant. Outcomes will be subjective continence and QALYs at 12 months. Longer term costs and benefits willbe assessed as part of an economic model.

Source of funding and total awarded: NHS R&D HTA Programme, £1,252,961


*Cost effectiveness of exercise training in older patients with heart failure

Investigators: M McMurdo, M Witham, AD Struthers, (Ninewells Hospital & University of Dundee) D Johnston (Universityof Aberdeen) and C Lang (Ninewells Hospital & University of Dundee) and M van der Pol (HERU Participant)

This study will assess the cost-effectiveness of exercise training in older patients with heart failure. Whilst exercise trainingis known to be beneficial in younger people with heart failure, this evidence is not applicable to typical patients who are older.A 112 patient two arm randomised trial is conducted to evaluate the effectiveness and cost-effectiveness of exercise trainingin older patients with heart failure. The exercise training programme comprises of 8 weeks of two sessions therapist-ledsupervised small group intermittent functional aerobic exercise and strength training, with the duration of sessions graduallyincreased to 60 minutes. This is followed by a 16 week home-based exercise phase which will include self-monitoring andtelephone instruction and encouragement from the therapist. The economic outcomes of the study will be incremental costper quality adjusted life year.

Source and Amount of Funding: CSO, £213,465


*Economic evaluation of tele-endoscopy


This project will conduct a cost-benefit analysis of tele-endoscopy versus traditional endoscopy. A discrete choice experimentwill be used to elicit the public’s preferences including the monetary value they place on tele-endoscopy.

Source of Funding and Total Awarded: NHS Grampian, £12,643


(Projects marked * started in 2007)ECONOMIC EVALUATION


28 26




Randomised comparison of macular hole surgery with or without internal limiting membrane peeling

Investigators: N Lois, (Grampian University Hospitals Trust) J Burr, J Norrie, (Health Services Research Unit, Universityof Aberdeen) L Vale, R de Verteuil (HERU/HSRU)

This study will conduct a RCT in patients with stage 2-3 full thickness macular holes (FTMH) and will involve the evaluation ofthe benefits and costs of internal limiting membrane (ILM) peeling. Patients will be recruited from Scotland (Aberdeen, Glasgow,Dundee, and Inverness) and England (Liverpool). Follow-up of patients will be for six months. For the economic evaluation NHScosts will be estimated for every trial participant. The EQ-5D, a generic measure of health status, will be completed at baselineand three and six months and be used to calculate QALYs.

Source of funding and total awarded: CSO and CSO Core, £193,938


Scottish multicentre trial of glutamine and selenium supplemented parenteral nutrition for critically illpatients (SIGNET trial)

Investigators: P Andrews, (University of Edinburgh) A Avenell, M Campbell, (Health Services Research Unit, Universityof Aberdeen) B Croal, D Noble, W Simpson, (NHS Grampian) F MacKirdy, (Scottish Intensive Care Audit) L Vale, R deVerteuil (HERU/HSRU)

Intensive care unit (ICU) and subsequent hospital mortality are high, and infections in ICU are associated with a 2-3 timesincreased risk of death. Systematic reviews suggest that supplementing parenteral nutrition (PN) in critical illness with glutamineor selenium may reduce infections and mortality. Three different strategies are evaluated in this randomised controlled trial:glutamine supplement, selenium supplement, and both glutamine and selenium supplements.



*Systematic review and economic modelling of the effectiveness and efficiency of non-surgical treatmentsfor women with stress urinary incontinence (SUI)

Investigators: L Vale (HSRU/HERU), M Kilonzo (HERU), M Imamura (HSRU), S Zhu (HSRU), J Wardle (Continence Foundation),P Abrams (British Urological Institute), R Pickard (University of Newcastle), C Glazener, J Cody, J Cook, G Mowatt, SWallace, Z Shihua, I Mari (Health Services Research Unit, University of Aberdeen), J N’Dow, G Nabi (Department ofSurgery), A Grant (Institute of Applied Health Science), L Cardozo (King’s College Hospital, London), B Buckley (Incontact),JH Smith (University of Otago, New Zealand), B Christine (NHS Grampian) and S Eustice (NHS Cornwall)

The objectives of the study are: i. to determine the clinical effectiveness of alternative treatments for SUI. ii. To determinethe safety in terms of the magnitude of any risks or side effects of treatment for SUI. iii. To assess whether treatment ormanagement pathways should differ between women presenting with (a) SUI postpartum or at any other time; (b) SUI aloneor mixed urinary incontinence; and (c) SUI with or without the presence of a co-existing anterior wall prolapse. iv. To estimatethe cost-effectiveness of the alternative management pathways. v. To identify areas where future research is required.

Urinary incontinence is a symptom defined as the complaint of any involuntary leakage of urine. Clinically it is classified as:(a) SUI which is the symptom of urine loss on effort, exertion, coughing or sneezing; (b) urgency urinary incontinence (UUI)which is the symptom of urine loss accompanied by or immediately preceded by urinary urgency; and (c) mixed urinaryincontinence (MUI) which is a combination of stress and urgency urinary incontinence. Various surgical and non-surgical therapieshave been developed with the aim of increasing urethral closure pressure in response and so alleviate the symptoms of SUI,improve quality of life and patient satisfaction. The wide range of proposed treatments and the rather disappointing reviewsof efficacy suggest that none of the options yet provide the ideal combination of clinical efficacy, high safety, patient satisfactionand low cost.

Source of Funding and Total Awarded: National Institute of Health Research, Health Technology Assessment Programme£217,150


ECONOMIC EVALUATIONProjects in progress:


(Projects marked * started in 2007)

Applied Projects in CSO Research Priority Areas (continued)

*Systematic review of the clinical and cost-effectiveness and economic evaluation, of photodynamic diagnosisand novel urine biomarker tests in the detection of the follow-up of bladder cancer

Investigators: G Mowatt, S Zhu, C Fraser (Health Services Research Unit, University of Aberdeen), L Vale (HSRU/HERU),M Kilonzo (HERU), J N’Dow, G Nabi, S Swami (Department of Surgery and NHS Grampian) and A Grant (Institute of AppliedHealth Sciences)

Bladder cancer is a common cancer in the UK affecting more than 10,000 individuals each year. Cystoscopy is the gold standardtest for diagnosing cancer of the bladder, but it does not provide complete detection of cancerous lesions. Cystoscopy withbiopsy is currently used to diagnose bladder cancer and repeated operative follow up is advised. Photodynamic diagnosis canbe used to enhance cystoscopy during initial diagnosis and staging of bladder cancer, or as part of follow-up evaluation. It hasshown promise in sensitivity and specificity trials, but further research is needed in the form of a randomised controlled trialto identify whether photodynamic diagnosis makes a difference to patient outcomes compared to cystoscopy alone, and toevaluate its cost effectiveness. There is a hope that novel urine biomarker tests may be used in future, both in diagnosis (orits exclusion) and in follow up so that people who have had bladder cancer will not have repeated cystoscopies.

Source of Funding and Total Awarded: TAR - £224,000


*The effectiveness and cost-effectiveness of elective neck dissection in early oral cancer treatment

Investigators: I Hutchison (Queen Mary, University of London), A Hackshaw (CRUK & UCL Cancer Trials Centre), I Martin(Sunderland Royal Hospital), K Piper (Queen Mary, University of London), G Thomas (University College London Hospital),K Webster, J Olliff (University Hospital Birmingham) and A Korszun (Queen Mary, University of London) and M van derPol (HERU)

This study will assess the effectiveness and cost-effectiveness of elective neck dissection in early oral cancer treatment. Inpatients with early mouth cancer, the cancer often spreads to the lymph glands in the neck. Elective neck dissection is thereforeincreasingly performed at the time when the patient is treated for the early mouth cancer even though there is no evidenceof neck metastases. The procedure is lengthy and expensive compared to resection of the tumour alone but may be cost-effective if it prevents the development of neck metastases that require further surgery and perhaps more radical treatments.652 patients will be randomised to receive either resection of the primary tumour alone or resection with simultaneous selectiveneck dissection. The effectiveness is measured in terms of disease free survival and quality of life. A full cost-utility analysisis performed.

Source of Funding and Total Awarded: CRUK - £799,186



An evaluation of an adapted United States model of pharmaceutical care to improve psychoactive prescribingfor care home residents in Scotland

Investigators: M King, A Lee, C Bond (Department of General Practice and Primary Care, University of Aberdeen) andP McNamee (HERU)

Qualitative assessment (interviews with health professionals) to inform tailoring of the model followed by a pilot of theintervention in two care homes. Process and outcomes to be measured include time required to perform intervention, numberof recommendations made, acceptance rate, prevalence of psychoactive medications, falls, survival, professional satisfactionand change in resource use.

Source of funding and total awarded: CSO - £18,944



29 31

ECONOMIC EVALUATION ECONOMIC EVALUATION

The effectiveness and cost-effectiveness of arthroscopic lavage in the treatment of early osteoarthritis ofthe knee

Investigators: M Campbell, V Entwistle, A Grant, K McCormack, J Norrie, C Ramsay, B Cuthbertson, (Health ServicesResearch Unit, University of Aberdeen) R Carlson, A Donaldson, R Fitzpatrick, (University of Oxford) A Gray, J Hutchison,(Department of Surgery, University of Aberdeen) M Johnston, (Department of Psychology, University of Aberdeen) DMurray, (University of Oxford) D Rowley, (University of Dundee) A Sutherland, (Department of Surgery, University ofAberdeen) L Vale (HERU/HSRU) M Kilonzo (HERU)

This study will assess the effectiveness and cost-effectiveness of arthroscopic lavage (with or without debridement) for patientswith osteoarthritis of the knee versus a sham procedure or non-operative management. The design of this RCT will be informedby the findings of a feasibility phase. Assuming that a sham procedure is found to be acceptable, a three-arm parallel grouptrial will be conducted. Otherwise, a simple two-arm trial of arthroscopic lavage (with or without debridement) versus non-operative management will be conducted. The economic evaluation will be conducted on the two-year trial data and extrapolatedin an economic model.

Source of funding and total awarded: NHS R&D HTA Programme, £816,098


The role of automated level two grading within the Diabetic Retinopathy Screening Collaborative Network

Investigators: J Olson, S Philip, (Grampian Retinal Screening Programme) P Sharp, K Goatman, A Fleming, (Departmentof Bio-Medical Physics and Bio-Engineering, University of Aberdeen) G Prescott, (Department of Public Health, Universityof Aberdeen) P McNamee, G Scotland (HERU)

The primary aim of this proposal is to determine whether automated level-two grading can reduce the workload of manuallevel-two graders in a national screening programme by automatically screening images for features of referable retinopathy.Data will be collected from five Scottish grading centers to ensure that the software developed is truly applicable to thepopulation of Scotland. Building on existing techniques, new computer algorithms will be developed to detect referableretinopathy and will be tested using a case-control study. Data will be gathered on health state values associated with correctand incorrect diagnosis to give us an indication of the impact that false positives/negatives have on the quality of life of peoplewith diabetes. An economic evaluation will be carried out to assess the costs and consequences of automated grading versusmanual grading in the context of Scotland’s national screening programme.

Source of funding and total awarded: CSO, £183,743


*Types of urethral catheter for reducing symptomatic urinary tract infections in hospitalised adults requiringshort-term catheterisation: multicentre randomised controlled trial of antibiotic and antiseptic impregnatedurethral catheters (The Catheter Trial)

Investigators: J N’Dow, (School of Medicine, University of Aberdeen) A Grant, (Institute of Applied Health Sciences,University of Aberdeen) J Norrie, (Health Services Research Unit, University of Aberdeen) R Pickard, (University ofNewcastle upon Tyne) K Orr, (University of Newcastle upon Tyne) B Buckley, (Galway) L Vale, (HSRU/HERU) K Glazener,(Health Services Research Unit, University of Aberdeen) T Lam (Department of Urology, Aberdeen Royal Infirmary) andM Kilonzo (HERU)

This project will investigate how to establish the clinical benefit and cost-effectiveness of using antibiotic- or antiseptic-impregnated urethral catheters over standard urethral catheters in hospitalised adults requiring short-term catheterisation.The study design is an eight-centre randomised controlled trial testing three short-term urinary catheter policies in a rangeof high-volume clinical settings. Participants will be randomised using a handheld computing device at each ward. The studywill be composed of adult patients (�16 years of age) requiring urethral catheterisation (expected to be required for a maximumof two weeks), in pre-selected units with a high volume of short-term catheterisation. There will be two experimental groupsmanaged with: (a) silver alloy impregnated hydrogel urethral catheter (b) nitrofurazone impregnated silicone urethral catheter.There will be one control group managed with a PTFE coated latex urethral catheter - the ‘standard’ control. The primaryclinical outcome will be incidence of symptomatic urinary tract infection up to 6 weeks post catheter insertion (number ofparticipants with at least one occurrence) and the economics one will be incremental cost per infection averted and QALYsgained.

Source of Funding and Total Awarded: Department of Health Research and Development Health Technology AssessmentProgramme, £1,173,470



Cost, benefits and cost-utility of implementing a national screening programme for prostate cancer

Investigators: L Moffat (Grampian University Hospitals NHS Trust) and L Vale (HERU/HSRU)

Prostate cancer is the second most common cause of cancer death in the United Kingdom and causes over 9,500 deaths in theUK per annum. Although it tends to be a disease of the elderly, it can strike at a much earlier age. It is apparent that thedisease represents an important health problem. With the advent of prostatic specific antigen (PSA) testing, cases are beingidentified at an earlier age. Some western countries, but not the UK, have screening programmes. The project aims wereachieved by modelling the costs and consequences of screening within Scotland using data systematically assembled from avariety of sources.



The prevention of progression of asymptomatic diabetic arterial disease (POPADAD) study: a multicentrestudy

Investigators: J Belch, (University of Dundee) J Cairns, (London School of Hygiene and Tropical Medicine) R Hernandez(HERU)

The purpose of this study was to assess the cost-effectiveness of aspirin and antioxidant therapy, separately and together, asmeans of preventing symptomatic vascular disease. Patients were allocated to one of four groups: double placebo; aspirin andplacebo; antioxidant and placebo; and aspirin and antioxidant. The cost-effectiveness of the three interventions (aspirin,antioxidant therapy, and aspirin with antioxidant therapy) was assessed by calculating the cost per unit of outcome for eachof the three interventions with each other and with the placebo group. The primary outcome measure was the absence ofvascular disease symptomatology.

Source of funding and total awarded: Medical Research Council, £1,000,000


What is the clinical and cost effectiveness of minimally invasive hip arthroplasty in the management ofarthritic disease of the hip?

Investigators: C Glazener, M Imamura, S Zhu, L Wyness, C Fraser, A Grant (Health Services Research Unit), I Hutchison,N Munro (Department of Surgery, Aberdeen Royal Infirmary) L Vale and R de Verteuil (HSRU/HERU)

A total hip replacement (arthroplasty) is commonly indicated when a patient has degenerative arthritis (osteoarthritis) of thehip joint. Standard open surgery involves a large incision (20-30cm). Minimally invasive techniques have been developed, someof which use specially designed instruments, in order to insert standard prostheses through either one or two smaller incisions. This study investigated whether minimally invasive techniques might be an effective and cost-effective alternative to standardtotal hip replacement.

Source of funding and total awarded: NHS R&D HTA programme - £80,000


Projects completed:


32 30



Projects completed:


Methodological Projects

*Education, health and time preference


This project will investigate the role of time preference in the relationship between education and health. Education has beenshown to be the most important correlate of health. However, the mechanism through which education influences health hasbeen largely unexplained. Grossman argued that education improves health production efficiency. In contrast, Fuchs arguedthat the association between health and education is not primarily causal but reflects unobserved causes of both outcomes.Instead of education causing better health, some ‘third’ variables may be related to both education and health. The ‘third’variable most frequently mentioned is time preference. The aim of this paper is to investigate the role of time preference inthe relationship between education and health. It exploits a unique dataset of households which incorporated stated preferencequestions eliciting individuals’ time preferences. Empirical models which treat education as exogenous as well as empiricalmodels with endogenous education are explored. The results provide some support for the third variable hypothesis. The effectof education reduces but does not disappear when controlling for individuals’ time preferences.

Source of Funding and Total Awarded: CSO Core

Amount of HERU Funding: CSO Core

Measurement and valuation of inequality aversion and distribution of outcomes in maternal health

Investigators: P McNamee, (HERU) D Newlands, Z Quayyum (IMMPACT, University of Aberdeen)

The aims of this project are to compare the feasibility and validity of different elicitation methods to investigate individuals’preferences for equality and distribution of outcomes in maternal health in Indonesia. More specifically, the research willaddress three research questions: firstly, are individuals averse to differences in the average number of maternal deathsobserved in different parts of society?; secondly, are individuals prepared to trade-off a smaller number of maternal deathsprevented amongst a larger population in exchange for a larger number of deaths prevented in a smaller population?; andthirdly, are these preferences influenced by differences in question framing?

Source of funding and total awarded: University of Aberdeen

Amount of HERU funding: University of Aberdeen

Using disease specific Qol measures to predict geneic Qol


This study investigates the relationship between the EORTC QLQ C-30 and the EQ-5D. The former is a commonly used outcomemeasure in cancer patients whilst the latter is the most popular generic health instrument for use in economic evaluation.Regression analysis is used to establish the relationship between the two instruments and the performance of the model isassessed in terms of how well the responses to the EORTC QLQ C-30 predict the EQ-5D responses.



Valuation of informal care: comparison, development and application of methods

Investigators: M Mentzakis, P McNamee, M Ryan (HERU)

Previous approaches to valuation of informal care time have used either the replacement cost (proxy good) method or theopportunity cost method. The former typically values time using the cost of home care or nursing services provided by theformal care sector. The opportunity cost method values time using wage data. A criticism that can be applied to both methodsis that no account is taken of the marginal valuation of time. This could be expected to vary greatly among people who providedifferent amounts and types of care. A technique that could capture these effects is the Discrete Choice Experiment (DCE)method. This research tests the feasibility and validity of DCEs for valuation of informal care time, compares DCE values withalternative values and applies the values in economic evaluation.

Source of Funding and Total Awarded: MRC Capacity Building PhD Studentship - £13,155, University of Aberdeen - £43,040



A cluster randomised trial to investigate the use of a decision aid for the diagnosis of active labour in termpregnancy

Investigators: H Cheyne, C Niven, (University of Stirling) V Hundley, (University of Stirling & Aberdeen) D Dowding,(University of York) I Greer, (University of Glasgow) M Bland, (University of York) L Aucott, (Department of Public Health,University of Aberdeen) P McNamee, G Scotland (HERU)

Admission of women who are not in labour accounts for 10% to 30% of maternity admissions. This is an unnecessary burden onresources. Women admitted in latent labour have the appearance of a longer labour and are more likely to receive a cascadeof intervention starting with administration of oxytocin and including caesarean section. A study has been conducted whichhas developed and tested a decision aid for diagnosis of active labour and assessed the feasibility of conducting a clusterrandomised trial. This study assessed the efficacy of this decision aid by means of a cluster randomised controlled trial. Twelvematernity units with an average cluster size of 200 women were randomly allocated the use of the decision aid or standardcare. Outcomes included; use of oxytocin, interventions and analgesia in labour, mode of delivery. NHS costs and cost to womenwas assessed.

Source of funding and total awarded: CSO (via University of Stirling), £204,074


Bell’s palsy: Early acicLovir and/or prednisoLone in Scotland “BELLS”: A multicentre factorial trial of theearly administration of steroids and/or antivirals for Bell’s palsy

Investigators: F Sullivan, P Donnan, (Tayside Centre for General Practice, University of Dundee) J Morrison, I Swan,(University of Glasgow) B Smith, (Department of General Practice and Primary Care, University of Aberdeen) B McKinstry,(Lothian and Borders Primary Care Research Network) R Davenport, (Western General Hospital, Edinburgh) J Clarkson,(Dental Health Services Research Unit, University of Dundee) J Cairns, (London School of Hygiene and Tropical Medicine)L Vale, (HSRU/HERU) R Hernandez (HERU)

In this study a randomised 2x2 factorial design to assess whether prednisolone and/or aciclovir commenced within the first72 hours of onset of Bell’s palsy results in the same level of disability and pain after nine months as treatment with placebo.The economic evaluation component of this study estimated the incremental cost per additional neurological deficit resolved.The results of the trial were rendered more informative by also translating the resolution of a neurological deficit into a QALY.This was be achieved by using the Health Utilities Index to measure quality of life.



Effective treatment of fertility

Investigators: S Bhattacharya, (Department of Obstetrics and Gynaecology, University of Aberdeen) P McNamee,G Scotland (HERU)

The primary objective of this study was to measure women’s preferences for potential adverse birth outcomes associated withtwin pregnancy. A secondary objective was to test different ways of administering the standard gamble questions. Due to theroutine practice of transferring two embryos during an IVF cycle, women undergoing this treatment face an increased risk oftwin pregnancy and its associated complications (e.g. premature delivery, perinatal death, etc). Single embryo transfer is aneffective way of reducing these risks but it may reduce the chances of pregnancy compared with double embryo transfer. Thestandard gamble method was used to elicit women’s preferences for these trade-offs, which was subsequently be used to modelthe cost utility of single versus double embryo transfer during IVF treatment. Methodological questions relating to the standardgamble were also addressed.

Source of funding and total awarded: Wellcome Trust, £775,757



29 31

ECONOMIC EVALUATION ECONOMIC EVALUATION

The effectiveness and cost-effectiveness of arthroscopic lavage in the treatment of early osteoarthritis ofthe knee

Investigators: M Campbell, V Entwistle, A Grant, K McCormack, J Norrie, C Ramsay, B Cuthbertson, (Health ServicesResearch Unit, University of Aberdeen) R Carlson, A Donaldson, R Fitzpatrick, (University of Oxford) A Gray, J Hutchison,(Department of Surgery, University of Aberdeen) M Johnston, (Department of Psychology, University of Aberdeen) DMurray, (University of Oxford) D Rowley, (University of Dundee) A Sutherland, (Department of Surgery, University ofAberdeen) L Vale (HERU/HSRU) M Kilonzo (HERU)

This study will assess the effectiveness and cost-effectiveness of arthroscopic lavage (with or without debridement) for patientswith osteoarthritis of the knee versus a sham procedure or non-operative management. The design of this RCT will be informedby the findings of a feasibility phase. Assuming that a sham procedure is found to be acceptable, a three-arm parallel grouptrial will be conducted. Otherwise, a simple two-arm trial of arthroscopic lavage (with or without debridement) versus non-operative management will be conducted. The economic evaluation will be conducted on the two-year trial data and extrapolatedin an economic model.



The role of automated level two grading within the Diabetic Retinopathy Screening Collaborative Network

Investigators: J Olson, S Philip, (Grampian Retinal Screening Programme) P Sharp, K Goatman, A Fleming, (Departmentof Bio-Medical Physics and Bio-Engineering, University of Aberdeen) G Prescott, (Department of Public Health, Universityof Aberdeen) P McNamee, G Scotland (HERU)

The primary aim of this proposal is to determine whether automated level-two grading can reduce the workload of manuallevel-two graders in a national screening programme by automatically screening images for features of referable retinopathy.Data will be collected from five Scottish grading centers to ensure that the software developed is truly applicable to thepopulation of Scotland. Building on existing techniques, new computer algorithms will be developed to detect referableretinopathy and will be tested using a case-control study. Data will be gathered on health state values associated with correctand incorrect diagnosis to give us an indication of the impact that false positives/negatives have on the quality of life of peoplewith diabetes. An economic evaluation will be carried out to assess the costs and consequences of automated grading versusmanual grading in the context of Scotland’s national screening programme.



*Types of urethral catheter for reducing symptomatic urinary tract infections in hospitalised adults requiringshort-term catheterisation: multicentre randomised controlled trial of antibiotic and antiseptic impregnatedurethral catheters (The Catheter Trial)

Investigators: J N’Dow, (School of Medicine, University of Aberdeen) A Grant, (Institute of Applied Health Sciences,University of Aberdeen) J Norrie, (Health Services Research Unit, University of Aberdeen) R Pickard, (University ofNewcastle upon Tyne) K Orr, (University of Newcastle upon Tyne) B Buckley, (Galway) L Vale, (HSRU/HERU) K Glazener,(Health Services Research Unit, University of Aberdeen) T Lam (Department of Urology, Aberdeen Royal Infirmary) andM Kilonzo (HERU)

This project will investigate how to establish the clinical benefit and cost-effectiveness of using antibiotic- or antiseptic-impregnated urethral catheters over standard urethral catheters in hospitalised adults requiring short-term catheterisation.The study design is an eight-centre randomised controlled trial testing three short-term urinary catheter policies in a rangeof high-volume clinical settings. Participants will be randomised using a handheld computing device at each ward. The studywill be composed of adult patients (�16 years of age) requiring urethral catheterisation (expected to be required for a maximumof two weeks), in pre-selected units with a high volume of short-term catheterisation. There will be two experimental groupsmanaged with: (a) silver alloy impregnated hydrogel urethral catheter (b) nitrofurazone impregnated silicone urethral catheter.There will be one control group managed with a PTFE coated latex urethral catheter - the ‘standard’ control. The primaryclinical outcome will be incidence of symptomatic urinary tract infection up to 6 weeks post catheter insertion (number ofparticipants with at least one occurrence) and the economics one will be incremental cost per infection averted and QALYsgained.

Source of Funding and Total Awarded: Department of Health Research and Development Health Technology AssessmentProgramme, £1,173,470



Cost, benefits and cost-utility of implementing a national screening programme for prostate cancer

Investigators: L Moffat (Grampian University Hospitals NHS Trust) and L Vale (HERU/HSRU)

Prostate cancer is the second most common cause of cancer death in the United Kingdom and causes over 9,500 deaths in theUK per annum. Although it tends to be a disease of the elderly, it can strike at a much earlier age. It is apparent that thedisease represents an important health problem. With the advent of prostatic specific antigen (PSA) testing, cases are beingidentified at an earlier age. Some western countries, but not the UK, have screening programmes. The project aims wereachieved by modelling the costs and consequences of screening within Scotland using data systematically assembled from avariety of sources.



The prevention of progression of asymptomatic diabetic arterial disease (POPADAD) study: a multicentrestudy

Investigators: J Belch, (University of Dundee) J Cairns, (London School of Hygiene and Tropical Medicine) R Hernandez(HERU)

The purpose of this study was to assess the cost-effectiveness of aspirin and antioxidant therapy, separately and together, asmeans of preventing symptomatic vascular disease. Patients were allocated to one of four groups: double placebo; aspirin andplacebo; antioxidant and placebo; and aspirin and antioxidant. The cost-effectiveness of the three interventions (aspirin,antioxidant therapy, and aspirin with antioxidant therapy) was assessed by calculating the cost per unit of outcome for eachof the three interventions with each other and with the placebo group. The primary outcome measure was the absence ofvascular disease symptomatology.

Source of funding and total awarded: Medical Research Council, £1,000,000


What is the clinical and cost effectiveness of minimally invasive hip arthroplasty in the management ofarthritic disease of the hip?

Investigators: C Glazener, M Imamura, S Zhu, L Wyness, C Fraser, A Grant (Health Services Research Unit), I Hutchison,N Munro (Department of Surgery, Aberdeen Royal Infirmary) L Vale and R de Verteuil (HSRU/HERU)

A total hip replacement (arthroplasty) is commonly indicated when a patient has degenerative arthritis (osteoarthritis) of thehip joint. Standard open surgery involves a large incision (20-30cm). Minimally invasive techniques have been developed, someof which use specially designed instruments, in order to insert standard prostheses through either one or two smaller incisions. This study investigated whether minimally invasive techniques might be an effective and cost-effective alternative to standardtotal hip replacement.

Source of funding and total awarded: NHS R&D HTA programme - £80,000


Projects completed:


32 30



Projects completed:



*Education, health and time preference


This project will investigate the role of time preference in the relationship between education and health. Education has beenshown to be the most important correlate of health. However, the mechanism through which education influences health hasbeen largely unexplained. Grossman argued that education improves health production efficiency. In contrast, Fuchs arguedthat the association between health and education is not primarily causal but reflects unobserved causes of both outcomes.Instead of education causing better health, some ‘third’ variables may be related to both education and health. The ‘third’variable most frequently mentioned is time preference. The aim of this paper is to investigate the role of time preference inthe relationship between education and health. It exploits a unique dataset of households which incorporated stated preferencequestions eliciting individuals’ time preferences. Empirical models which treat education as exogenous as well as empiricalmodels with endogenous education are explored. The results provide some support for the third variable hypothesis. The effectof education reduces but does not disappear when controlling for individuals’ time preferences.


Amount of HERU Funding: CSO Core

Measurement and valuation of inequality aversion and distribution of outcomes in maternal health

Investigators: P McNamee, (HERU) D Newlands, Z Quayyum (IMMPACT, University of Aberdeen)

The aims of this project are to compare the feasibility and validity of different elicitation methods to investigate individuals’preferences for equality and distribution of outcomes in maternal health in Indonesia. More specifically, the research willaddress three research questions: firstly, are individuals averse to differences in the average number of maternal deathsobserved in different parts of society?; secondly, are individuals prepared to trade-off a smaller number of maternal deathsprevented amongst a larger population in exchange for a larger number of deaths prevented in a smaller population?; andthirdly, are these preferences influenced by differences in question framing?



Using disease specific Qol measures to predict geneic Qol


This study investigates the relationship between the EORTC QLQ C-30 and the EQ-5D. The former is a commonly used outcomemeasure in cancer patients whilst the latter is the most popular generic health instrument for use in economic evaluation.Regression analysis is used to establish the relationship between the two instruments and the performance of the model isassessed in terms of how well the responses to the EORTC QLQ C-30 predict the EQ-5D responses.




Investigators: M Mentzakis, P McNamee, M Ryan (HERU)

Previous approaches to valuation of informal care time have used either the replacement cost (proxy good) method or theopportunity cost method. The former typically values time using the cost of home care or nursing services provided by theformal care sector. The opportunity cost method values time using wage data. A criticism that can be applied to both methodsis that no account is taken of the marginal valuation of time. This could be expected to vary greatly among people who providedifferent amounts and types of care. A technique that could capture these effects is the Discrete Choice Experiment (DCE)method. This research tests the feasibility and validity of DCEs for valuation of informal care time, compares DCE values withalternative values and applies the values in economic evaluation.

Source of Funding and Total Awarded: MRC Capacity Building PhD Studentship - £13,155, University of Aberdeen - £43,040



A cluster randomised trial to investigate the use of a decision aid for the diagnosis of active labour in termpregnancy

Investigators: H Cheyne, C Niven, (University of Stirling) V Hundley, (University of Stirling & Aberdeen) D Dowding,(University of York) I Greer, (University of Glasgow) M Bland, (University of York) L Aucott, (Department of Public Health,University of Aberdeen) P McNamee, G Scotland (HERU)

Admission of women who are not in labour accounts for 10% to 30% of maternity admissions. This is an unnecessary burden onresources. Women admitted in latent labour have the appearance of a longer labour and are more likely to receive a cascadeof intervention starting with administration of oxytocin and including caesarean section. A study has been conducted whichhas developed and tested a decision aid for diagnosis of active labour and assessed the feasibility of conducting a clusterrandomised trial. This study assessed the efficacy of this decision aid by means of a cluster randomised controlled trial. Twelvematernity units with an average cluster size of 200 women were randomly allocated the use of the decision aid or standardcare. Outcomes included; use of oxytocin, interventions and analgesia in labour, mode of delivery. NHS costs and cost to womenwas assessed.

Source of funding and total awarded: CSO (via University of Stirling), £204,074


Bell’s palsy: Early acicLovir and/or prednisoLone in Scotland “BELLS”: A multicentre factorial trial of theearly administration of steroids and/or antivirals for Bell’s palsy

Investigators: F Sullivan, P Donnan, (Tayside Centre for General Practice, University of Dundee) J Morrison, I Swan,(University of Glasgow) B Smith, (Department of General Practice and Primary Care, University of Aberdeen) B McKinstry,(Lothian and Borders Primary Care Research Network) R Davenport, (Western General Hospital, Edinburgh) J Clarkson,(Dental Health Services Research Unit, University of Dundee) J Cairns, (London School of Hygiene and Tropical Medicine)L Vale, (HSRU/HERU) R Hernandez (HERU)

In this study a randomised 2x2 factorial design to assess whether prednisolone and/or aciclovir commenced within the first72 hours of onset of Bell’s palsy results in the same level of disability and pain after nine months as treatment with placebo.The economic evaluation component of this study estimated the incremental cost per additional neurological deficit resolved.The results of the trial were rendered more informative by also translating the resolution of a neurological deficit into a QALY.This was be achieved by using the Health Utilities Index to measure quality of life.



Effective treatment of fertility

Investigators: S Bhattacharya, (Department of Obstetrics and Gynaecology, University of Aberdeen) P McNamee,G Scotland (HERU)

The primary objective of this study was to measure women’s preferences for potential adverse birth outcomes associated withtwin pregnancy. A secondary objective was to test different ways of administering the standard gamble questions. Due to theroutine practice of transferring two embryos during an IVF cycle, women undergoing this treatment face an increased risk oftwin pregnancy and its associated complications (e.g. premature delivery, perinatal death, etc). Single embryo transfer is aneffective way of reducing these risks but it may reduce the chances of pregnancy compared with double embryo transfer. Thestandard gamble method was used to elicit women’s preferences for these trade-offs, which was subsequently be used to modelthe cost utility of single versus double embryo transfer during IVF treatment. Methodological questions relating to the standardgamble were also addressed.

Source of funding and total awarded: Wellcome Trust, £775,757



3533

ECONOMIC EVALUATION

Lifestyle and Health

An economic evaluation of obesity prevention for UK adults

Investigators: L Vale, R Hernandez, M Smith, M Sutton, M Ryan, D Yi, (HERU) Avenell A (HSRU) L Aucott, E van Teiljingen,F Douglas, J Greener, (Department of Public Health, University of Aberdeen) K Mavromaras, A Goode and A Scott(University of Melbourne)

The prevalence of obesity has been rising continuously in the UK with a major impact on mortality, morbidity and well-beingfor a large part of the population. Achieving and maintaining a lower weight significantly reduces the risk of developing manydiseases, especially diabetes, coronary heart disease (CHD) and cancer. The investigation of the acceptability and cost-effectiveness of alternative preventive interventions is necessary for the design and targeting of evidence-based policy.

The study will use the conventional obesity measure of Body Mass Index (BMI) and will concentrate on persons over the age of18 with BMI values between 25 and 34.9 (the WHO pre-obese and obesity class 1 categories, as the emphasis is on prevention). Various different outcomes will be considered, these are dependent upon the phase of the research. Final outcomes of phase6, a cost-benefit analysis, will be estimates of relative efficiency reported as net benefits and balance sheets comparing thealternative interventions considered.

Systematic reviews of both intervention randomised controlled trials and cohort studies have been completed. These haveinformed the qualitative research, and interviews with potential recipients of interventions, NHS practitioners and policy-makers have been carried out. The systematic reviews have also informed the design of the DCE and piloting is underway. Theeconometric analysis of the panel and cross-sectional data sets is on going and this work has been informed by the reviewsand qualitative research and is also being used to develop the DCE questionnaire.

Source of funding and total awarded: National Prevention Research Initiative - £495,656


An investigation of the social and economic drivers of the obesity epidemic

Investigators: B Eberth, A Ludbrook, M Sutton (HERU)

Various theories have been proposed to explain the development of the obesity epidemic, particularly in the USA. This projectis exploring the feasibility of testing these theories with UK and European data. The objective is to determine whether theobesity problem in the UK exhibits the same underlying causes as in the USA and, hence, whether interventions evaluated inthe USA is likely to have similar impacts in the UK. The first stage of this work is examining the ‘technology change’ theoryby analysing physical activity at home and at work.

Source of funding and total awarded: CSO Core and University of Aberdeen

Amount of HERU funding: CSO Core and University of Aberdeen

Bar Workers Health and Environmental Tobacco Smoke Exposure (BHETSE)

Investigators: J Ayres, S Semple, (Department of Environmental Occupational Medicine, University of Aberdeen) F Hurley,G Hughson, (Institute of Occupational Medicine, University of Edinburgh) M Petticrew, (Medical Research Council, Socialand Public Health Services Unit, University of Glasgow) A Ludbrook (HERU)

This research study is one of a number of projects funded by NHS Health Scotland to determine the impact of smoke freelegislation in Scotland. Air quality in bars will be measured before and after the introduction of the legislation and bar workerswill be surveyed about their health. Time off work and use of health services are included in the survey and the economiccomponent of the study will focus on changes in costs related to any improvements in health.

Source of funding and total awarded: NHS Health Scotland, £127,496



Initiative for maternal mortality programme assessment (IMMPACT)

Investigators: W Graham, M Hall, (IMMPACT, University of Aberdeen) C Smith, (Department of Public Health, Universityof Aberdeen) C Bullough, J Hussein, (IMMPACT, University of Aberdeen) P McNamee (HERU)

The objectives of this study were to enhance methods and tools for measuring outcomes relevant to safe motherhood, to assesseffectiveness and cost-effectiveness of different strategies for reducing maternal mortality and severe morbidity, and to increasecapacity in developing countries for evidence-based decision-making in safe motherhood. Enhanced methods and tools wereused to generate new evidence on the effectiveness and cost-effectiveness of strategies to reduce maternal mortality andsevere morbidity that are supportive of and supported by health systems and communities. In addition the implications ofalternative strategies for equity goals and sustainability were identified.

Source of funding and total awarded: USAID, Bill & Melinda Gates Foundation, DFID, European Commission, £19,700,000


The Endometrial Ablation Study: a pragmatic randomised comparison of postmenstrual treatment undergeneral or local anaesthesia: clinical outcomes, patient acceptability and cost

Investigators: M Campbell, J Cook, G McPherson, J Norrie, C Ramsay, (Health Services Research Unit, University ofAberdeen) K Cooper, S Jack, A Sambrook, (Department of Obstetrics and Gynaecology, University of Aberdeen) L Vale,(HERU/HSRU) M Kilonzo (HERU)

Endometrial ablation is the process where by the lining of the womb is destroyed in an attempt to reduce heavy periods andits associated problems. It is a proven conservative alternative to hysterectomy. Microwave Endometrial Ablation (MEA) andThermal Balloon Endometrial Ablation (TBEA) are second generation endometrial ablation techniques which have been adequatelyassessed and recommended by NICE. The uptake of second generation endometrial ablative techniques have, however, beenlargely driven by the manufacturing companies rather than by good quality research. This study was a randomised controlledtrial with the aim of assessing the effectiveness and cost-effectiveness of MEA and TBEA.




A comparison of EQ-5D and SF-6D in coronary heart disease patients

Investigators: C Bond, M Tinelli, (Department of General Practice and Primary Care, University of Aberdeen) J Seymour(University of Melbourne), P McNamee, (HERU) A Scott (University of Melbourne)

Generic preference based instruments with an accompanying set of population based utility weights are being increasingly usedin economic evaluations. The development of a new generic instrument (SF-6D) has prompted researchers to undertake head-to-head comparisons of the SF-6D and the EQ-5D. The aim of this study was to compare the SF-6D and the EQ-5D using alternativemethods of analysis. Data from a multicentre RCT of an intervention for coronary heart disease patients was used as a casestudy.



Risk attitude in health

Investigators: M van der Pol, (HERU) M Ruggeri, (Universita Cattolica, Rome) S Bryan (University of Birmingham)

It is often argued that the Standard Gamble (SG) method is superior because it incorporates uncertainty through the use ofrisk of death as the response scale. However, most uncertainty is not of the ‘life or death’ form. If individuals’ risk attitudeis not constant but depends on the kind of health risk, the argument in favour of SG may not hold. The aim of this study wasto examine whether individuals’ risk attitude for fatal changes in health is different from individuals’ risk attitude for non-fatal changes in health.



EVALUATION OFHEALTH IMPROVEMENT

Projects in progress:(Projects marked * started in 2007)


36 34

APPENDIX 1 PROJECTS IN PROGRESS AND COMPLETED IN 2007APPENDIX 1 PROJECTS IN PROGRESS AND COMPLETED IN 2007

Projects completed:(Projects marked * started in 2007)Projects in progress:

Methodological Projects (continued)

The economic valuation of maternal mortality and morbidity

Investigators: L Ternent, (HERU) D Newlands, (Department of Economics and IMMPACT, University of Aberdeen)P McNamee (HERU)

The aim of this study was to compare the acceptability, consistency and validity of different Contingent Valuation methods,and obtain data on the determinants of positive, zero and protest responses. The aim of this study was also to assess theacceptability, consistency and validity of the bidding game and closed-ended methods.



The measurement and valuation of productivity costs: a household level analysis

Investigators: D Newlands, (Department of Economics and IMMPACT, University of Aberdeen) C Chikwama, (IMMPACT)P McNamee (HERU)

The inclusion of productivity costs is recognised as an important component of economic evaluation. However, there isconsiderable debate over the methods used to measure and value such costs. Furthermore few comparisons have been madebetween methods to test reliability or validity. The sampling frame for this study was households who have experienced orwere currently experiencing maternal mortality or morbidity. The aim of this study was to compare the feasibility, reliabilityand validity of existing questionnaire methods that measure lost production, and to assess the importance of compensatingmechanism questions in the measurement of lost production from paid and unpaid activities.



Lifestyle and Health (continued)

*Diet and health

Investigators: D Olajide, A Ludbrook and M Sutton (HERU)

This project uses data from the Scottish Health Survey to investigate relationships between self reported consumption of variousfood items and health outcomes. Health outcomes are various measures of obesity, self-reported health, cholesterol and bloodpressure, also collected in the Scottish Health Survey, and hospital admissions and mortality available through record linkage.The dietary information in the Scottish Health Survey only covers selected items. Dietary patterning approaches will be usedto attempt to map complete dietary intake data from the UK National Diet and Nutrition Survey onto the Scottish Health Surveydata.



Estimating the expected health benefits to non-smokers of policies to reduce exposure to environmentaltobacco smoke (ETS)

Investigators: P Teckle (BC Cancer Research Centre, Vancouver), A Ludbrook and Matt Sutton

There is considerable evidence of the link between ETS and coronary heart disease and lung cancer. There is less evidenceabout the effect of ETS on respiratory health and general morbidity; in particular, the size of these effects and their associatedcosts. This project uses data from the Scottish Health Survey to investigate relationships between self reported and containedvalidated exposure to ETS and health outcomes. Health outcomes are self reported health and respiratory function measures,also collected in the Scottish Health Survey, and hospital admissions and mortality available through record linkage.



Smoking cessation – analysis of quitters from BHPS

Investigators: M Amaya-Amaya, A Ludbrook, (HERU) K Mavromaras, A Goode, (University of Melbourne)

This project is using British Household Panel Survey data to model relapse rates of ex smokers beyond one year, which is thelongest follow up generally included in intervention studies. The study considers what factors are associated with relapse ormaintenance of non-smoking.



*What explains socioeconomic inequality in obesity between England and Scotland?

Investigators: B Eberth and U Gerdtham (HERU)

This project uses data from the Scottish Health Survey and the Health Survey for England 2003 to measure inequality inoverweight and obesity based on the commonly used concentration index and based on measured indicators of height andweight. The concentration index for overweight and obesity indicators will be calculated for both England and Scotland. Wewill use the recently developed decomposition analysis and Oaxaca type methods to analyze what factors may explain whyconcentration indexes of obesity differ between the two surveys. The decomposition analysis is based on the characteristic ofthe obesity concentration index that can be expressed as a weighted average of the inequality present in key determinants ofobesity between individuals with different incomes in the two surveys. The Oaxaca type method is used to measure which ofthe factors contributing to the difference in the concentration index between the two surveys could explain most of the observedchanges in the concentration index. The analysis will potentially be conducted for males and females separately.




3533

ECONOMIC EVALUATION

Lifestyle and Health

An economic evaluation of obesity prevention for UK adults

Investigators: L Vale, R Hernandez, M Smith, M Sutton, M Ryan, D Yi, (HERU) Avenell A (HSRU) L Aucott, E van Teiljingen,F Douglas, J Greener, (Department of Public Health, University of Aberdeen) K Mavromaras, A Goode and A Scott(University of Melbourne)

The prevalence of obesity has been rising continuously in the UK with a major impact on mortality, morbidity and well-beingfor a large part of the population. Achieving and maintaining a lower weight significantly reduces the risk of developing manydiseases, especially diabetes, coronary heart disease (CHD) and cancer. The investigation of the acceptability and cost-effectiveness of alternative preventive interventions is necessary for the design and targeting of evidence-based policy.

The study will use the conventional obesity measure of Body Mass Index (BMI) and will concentrate on persons over the age of18 with BMI values between 25 and 34.9 (the WHO pre-obese and obesity class 1 categories, as the emphasis is on prevention). Various different outcomes will be considered, these are dependent upon the phase of the research. Final outcomes of phase6, a cost-benefit analysis, will be estimates of relative efficiency reported as net benefits and balance sheets comparing thealternative interventions considered.

Systematic reviews of both intervention randomised controlled trials and cohort studies have been completed. These haveinformed the qualitative research, and interviews with potential recipients of interventions, NHS practitioners and policy-makers have been carried out. The systematic reviews have also informed the design of the DCE and piloting is underway. Theeconometric analysis of the panel and cross-sectional data sets is on going and this work has been informed by the reviewsand qualitative research and is also being used to develop the DCE questionnaire.

Source of funding and total awarded: National Prevention Research Initiative - £495,656


An investigation of the social and economic drivers of the obesity epidemic

Investigators: B Eberth, A Ludbrook, M Sutton (HERU)

Various theories have been proposed to explain the development of the obesity epidemic, particularly in the USA. This projectis exploring the feasibility of testing these theories with UK and European data. The objective is to determine whether theobesity problem in the UK exhibits the same underlying causes as in the USA and, hence, whether interventions evaluated inthe USA is likely to have similar impacts in the UK. The first stage of this work is examining the ‘technology change’ theoryby analysing physical activity at home and at work.



Bar Workers Health and Environmental Tobacco Smoke Exposure (BHETSE)

Investigators: J Ayres, S Semple, (Department of Environmental Occupational Medicine, University of Aberdeen) F Hurley,G Hughson, (Institute of Occupational Medicine, University of Edinburgh) M Petticrew, (Medical Research Council, Socialand Public Health Services Unit, University of Glasgow) A Ludbrook (HERU)

This research study is one of a number of projects funded by NHS Health Scotland to determine the impact of smoke freelegislation in Scotland. Air quality in bars will be measured before and after the introduction of the legislation and bar workerswill be surveyed about their health. Time off work and use of health services are included in the survey and the economiccomponent of the study will focus on changes in costs related to any improvements in health.

Source of funding and total awarded: NHS Health Scotland, £127,496



Initiative for maternal mortality programme assessment (IMMPACT)

Investigators: W Graham, M Hall, (IMMPACT, University of Aberdeen) C Smith, (Department of Public Health, Universityof Aberdeen) C Bullough, J Hussein, (IMMPACT, University of Aberdeen) P McNamee (HERU)

The objectives of this study were to enhance methods and tools for measuring outcomes relevant to safe motherhood, to assesseffectiveness and cost-effectiveness of different strategies for reducing maternal mortality and severe morbidity, and to increasecapacity in developing countries for evidence-based decision-making in safe motherhood. Enhanced methods and tools wereused to generate new evidence on the effectiveness and cost-effectiveness of strategies to reduce maternal mortality andsevere morbidity that are supportive of and supported by health systems and communities. In addition the implications ofalternative strategies for equity goals and sustainability were identified.



The Endometrial Ablation Study: a pragmatic randomised comparison of postmenstrual treatment undergeneral or local anaesthesia: clinical outcomes, patient acceptability and cost

Investigators: M Campbell, J Cook, G McPherson, J Norrie, C Ramsay, (Health Services Research Unit, University ofAberdeen) K Cooper, S Jack, A Sambrook, (Department of Obstetrics and Gynaecology, University of Aberdeen) L Vale,(HERU/HSRU) M Kilonzo (HERU)

Endometrial ablation is the process where by the lining of the womb is destroyed in an attempt to reduce heavy periods andits associated problems. It is a proven conservative alternative to hysterectomy. Microwave Endometrial Ablation (MEA) andThermal Balloon Endometrial Ablation (TBEA) are second generation endometrial ablation techniques which have been adequatelyassessed and recommended by NICE. The uptake of second generation endometrial ablative techniques have, however, beenlargely driven by the manufacturing companies rather than by good quality research. This study was a randomised controlledtrial with the aim of assessing the effectiveness and cost-effectiveness of MEA and TBEA.




A comparison of EQ-5D and SF-6D in coronary heart disease patients

Investigators: C Bond, M Tinelli, (Department of General Practice and Primary Care, University of Aberdeen) J Seymour(University of Melbourne), P McNamee, (HERU) A Scott (University of Melbourne)

Generic preference based instruments with an accompanying set of population based utility weights are being increasingly usedin economic evaluations. The development of a new generic instrument (SF-6D) has prompted researchers to undertake head-to-head comparisons of the SF-6D and the EQ-5D. The aim of this study was to compare the SF-6D and the EQ-5D using alternativemethods of analysis. Data from a multicentre RCT of an intervention for coronary heart disease patients was used as a casestudy.



Risk attitude in health

Investigators: M van der Pol, (HERU) M Ruggeri, (Universita Cattolica, Rome) S Bryan (University of Birmingham)

It is often argued that the Standard Gamble (SG) method is superior because it incorporates uncertainty through the use ofrisk of death as the response scale. However, most uncertainty is not of the ‘life or death’ form. If individuals’ risk attitudeis not constant but depends on the kind of health risk, the argument in favour of SG may not hold. The aim of this study wasto examine whether individuals’ risk attitude for fatal changes in health is different from individuals’ risk attitude for non-fatal changes in health.






36 34

APPENDIX 1 PROJECTS IN PROGRESS AND COMPLETED IN 2007APPENDIX 1 PROJECTS IN PROGRESS AND COMPLETED IN 2007

Projects completed:(Projects marked * started in 2007)Projects in progress:

Methodological Projects (continued)

The economic valuation of maternal mortality and morbidity

Investigators: L Ternent, (HERU) D Newlands, (Department of Economics and IMMPACT, University of Aberdeen)P McNamee (HERU)

The aim of this study was to compare the acceptability, consistency and validity of different Contingent Valuation methods,and obtain data on the determinants of positive, zero and protest responses. The aim of this study was also to assess theacceptability, consistency and validity of the bidding game and closed-ended methods.



The measurement and valuation of productivity costs: a household level analysis

Investigators: D Newlands, (Department of Economics and IMMPACT, University of Aberdeen) C Chikwama, (IMMPACT)P McNamee (HERU)

The inclusion of productivity costs is recognised as an important component of economic evaluation. However, there isconsiderable debate over the methods used to measure and value such costs. Furthermore few comparisons have been madebetween methods to test reliability or validity. The sampling frame for this study was households who have experienced orwere currently experiencing maternal mortality or morbidity. The aim of this study was to compare the feasibility, reliabilityand validity of existing questionnaire methods that measure lost production, and to assess the importance of compensatingmechanism questions in the measurement of lost production from paid and unpaid activities.



Lifestyle and Health (continued)

*Diet and health

Investigators: D Olajide, A Ludbrook and M Sutton (HERU)

This project uses data from the Scottish Health Survey to investigate relationships between self reported consumption of variousfood items and health outcomes. Health outcomes are various measures of obesity, self-reported health, cholesterol and bloodpressure, also collected in the Scottish Health Survey, and hospital admissions and mortality available through record linkage.The dietary information in the Scottish Health Survey only covers selected items. Dietary patterning approaches will be usedto attempt to map complete dietary intake data from the UK National Diet and Nutrition Survey onto the Scottish Health Surveydata.



Estimating the expected health benefits to non-smokers of policies to reduce exposure to environmentaltobacco smoke (ETS)

Investigators: P Teckle (BC Cancer Research Centre, Vancouver), A Ludbrook and Matt Sutton

There is considerable evidence of the link between ETS and coronary heart disease and lung cancer. There is less evidenceabout the effect of ETS on respiratory health and general morbidity; in particular, the size of these effects and their associatedcosts. This project uses data from the Scottish Health Survey to investigate relationships between self reported and containedvalidated exposure to ETS and health outcomes. Health outcomes are self reported health and respiratory function measures,also collected in the Scottish Health Survey, and hospital admissions and mortality available through record linkage.



Smoking cessation – analysis of quitters from BHPS

Investigators: M Amaya-Amaya, A Ludbrook, (HERU) K Mavromaras, A Goode, (University of Melbourne)

This project is using British Household Panel Survey data to model relapse rates of ex smokers beyond one year, which is thelongest follow up generally included in intervention studies. The study considers what factors are associated with relapse ormaintenance of non-smoking.



*What explains socioeconomic inequality in obesity between England and Scotland?

Investigators: B Eberth and U Gerdtham (HERU)

This project uses data from the Scottish Health Survey and the Health Survey for England 2003 to measure inequality inoverweight and obesity based on the commonly used concentration index and based on measured indicators of height andweight. The concentration index for overweight and obesity indicators will be calculated for both England and Scotland. Wewill use the recently developed decomposition analysis and Oaxaca type methods to analyze what factors may explain whyconcentration indexes of obesity differ between the two surveys. The decomposition analysis is based on the characteristic ofthe obesity concentration index that can be expressed as a weighted average of the inequality present in key determinants ofobesity between individuals with different incomes in the two surveys. The Oaxaca type method is used to measure which ofthe factors contributing to the difference in the concentration index between the two surveys could explain most of the observedchanges in the concentration index. The analysis will potentially be conducted for males and females separately.




37 39

Workforce

Non-medical factors and their association with renal replacement therapy incidence, effectiveness andefficiency

Investigators: A McLoed, (Medicine and Therapeutics, University of Aberdeen) R Elliott, (HERU) F Casky (NHS Bristol)and C Geue (HERU)

For this project, data on general numbers of health care workforce as well as spending on health care will be obtained. Asystematic literature review will be undertaken to inform us about factors that influence the provision of nephrology/renal/dialysisservices. We group these factors into four different categories: institutional/organizational, human resources,reimbursement/financial factors, and legal factors.



Who Cares? The Impact of Changing Workforce Patterns in UK Paediatric Intensive Care Services on StaffPractice and Patient Outcomes

Investigators: J Tucker, (Dugald Baird Centre, University of Aberdeen) G Parry, S Jones, (School of Health and RelatedResearch, Sheffield) E Draper, (Health Sciences, Leicester) L McKee, (HSRU), D Skåtun, (HERU) M Darowski, (LeedsTeaching Hospital Trust) N Davey (Health Sciences, Leicester)

The aim of this study is to determine the impact of changing workforce patterns (or who cares for patients) on staff workingand patient outcomes. It will take place in 12 paediatric intensive care units. It will compare units with and without newextended nursing roles (i.e. nurses undertaking tasks previously out with normal nursing practice). It will compare the impactof differing proportions of total staff time and staff groups’ time in direct patient care in relation to quality of care and patientsatisfaction, while taking account of variations in the initial illness severity of patients. Towards ensuring sustainable and highquality services in high-tech acute hospital settings, it will explore how best to manage human resources, support staffdevelopment in new ways of working, and compare staff wellbeing and costs.

Source of funding and total awarded: The NHS Service Delivery Organisation, £252,500


Nurse Labour Markets: Preferences for Pecuniary and Non-Pecuniary Rewards

Investigators: D Skåtun, R Elliott, (HERU) A Scott (University of Melbourne)

This study will investigate the importance of non-pay aspects within the reward structure for nurses in the U.K. A crucialrequirement of the current modernisation of the National Health Service (NHS) is the supply of an adequate number of nurses.A key policy question is whether an increase in resources devoted to recruiting and retaining nurses is best spent on wages orupon improving working conditions. There is some evidence of the effect of wages on nursing labour supply, but little on thevalue placed by nurses on working conditions. Working conditions may become a more important policy instrument in the futurewith the introduction of the new more uniform pay structures agreed in ‘Agenda for Change’. The study will distinguish the‘price’ that nurses are willing to pay to improve their working conditions. It will identify how nurses’ trade-off pay againstother working conditions.

Source of funding and total awarded: ESRC, £116,505


Resource Allocation

Option appraisal of children’s cancer services in Scotland

Investigators: Alasdair Munro (HERU)

This project will examine the costs and benefits of a number of different options for configuring children’s cancer services inScotland. This will include: identifying the patterns of care associated with different options, assessing the effect of theseoptions on revenue and capital costs, examining the non-financial benefits of the options, and taking into account any widereffects such as the impact of travel patterns for patients and relatives.

Source of funding and total awarded: Scottish Executive Health Department - £26,340

Amount of HERU Funding: Core

BEHAVIOUR, PERFORMANCEAND ORGANISATION OF CARE



Economic Status and Health

Analysis of movers and non-movers from poverty

Investigators: A Ludbrook (HERU)

This project is studying individuals who were below the poverty threshold in the first wave of the British Household Panel Surveyand comparing those who move out of poverty with those who do not. The analysis is considering the importance of source ofincome and what other characteristics explain the probability of moving.



Investigation of the empirical relationship between economic status and health status

Investigators: A Tipper, A Ludbrook, M Sutton (HERU)

The positive association between income and health is widely known but the mechanisms’ through which this relationshipoperates is less clearly understood. The thesis combines the literature on economic models of household behaviour with empiricalassessments of the health and income relationship and the demand for health literature. An economic model of householdbehaviour will be constructed to analyse health effects of labour shocks. Individuals within the household respond to incomeshocks by altering labour supply or the amount of resources to each household member. The model will be tested statisticallyusing longitudinal regression techniques. Policy implications will then be sought, to assess whether income support or employmentlegislation is more conducive to health status.

Source of funding and total awarded: Medical Research Council - £56,296


Intervention Studies

The use of short-term health outcomes in economic evaluations of health improvement interventions andimplications for QALYs.


This project uses a systematic review of economic evaluations of public health interventions carried out for the Welsh AssemblyGovernment, to investigate the extent to which short-term health benefits are included in published studies of primary preventionin developed countries. A topic based approach will be adopted; potential topics include smoking cessation, alcohol, diet andphysical activity, selected on the basis of there being plausible short-term benefits. For the selected topics, papers will bereviewed to see to what extent short-term benefits have or have not been included. The research will then consider how short-term benefits could be captured in future studies and whether such benefits could be incorporated into QALYs.

Source of funding and total awarded: Welsh Assembly Government £4,500

Amount of HERU funding: Welsh Assembly Government £4,500


3840


Performance

Delivering health care through managed clinical networks (MCNs): lessons from the North

Investigators: H Davies, P Boyle, A Green, R Rushmer, (University of St Andrews) B Guthrie, B Williams, A Morris, FSullivan, K Smith, (University of Dundee) M Sutton, S Farrar, (HERU) C Baker (Dumfries & Galloway Managed ClinicalNetworks for Coronary Heart Disease)

Since 1999, network-based healthcare delivery that cuts across NHS organisational and professional boundaries has beenencouraged by policymakers and, in the last two years, increasingly made mandatory. Such networks are believed to increaseco-ordination of care and integration of services, and to lead to improved clinical outcomes, better patient experience, greaterequity and improved cost-effectiveness. The overall aim of this project is to generate deeper understandings about the origins,processes and impacts of network delivered care with a view to better enable policy design and implementation. The economicscomponent will use the concept of social capital and the method of social network analysis to examine the impact of clinicalnetworks.

Source of funding and total awarded: NHS Service Delivery and Organisation, £299,998


Personal and professional motivation and the supply of health care

Investigators: Y Feng, S Farrar, M Sutton (HERU)

The project will begin with a comprehensive review of the theoretical and empirical literature with the objectives (i) to identifydifferent existing models of intrinsic motivation and consider their relevance to the health care sector and (ii) to reviewempirical analysis of applications of this theory and again consider what lessons can learned from this for the design of futureanalysis. A model of intrinsic motivation with testable hypotheses for application to the health care sector will be developed. Opportunities to test these models will be identified within the changing policy and contractual environment of the UK NHS.

Source of funding and total awarded: IAHS Studentship - £39,000


Targets and waiting times: exploiting a quasi-experiment to evaluate the use of targets in the provision ofhealth care in the UK

Investigators: F Windmeijer, C Propper (University of Bristol) and M Sutton (HERU)

The aim of our research is to exploit the divergence in policy between Scotland and England: pre-devolution both countrieshad targets, post-devolution Scotland concentrated on other priorities. We will use this as a natural experiment to assess theimpact of targets on the behaviour of NHS hospitals in the two countries.

We will examine two outputs: waiting times and activity levels. In contrast to most other analyses of this issue, we will usedisaggregate (patient level) data for both Scotland and England. We will examine behaviour with respect to targeted and non-targeted activities. Finally, we will use the estimates from our research to make an assessment of the net effect of this policyon patient welfare.

Source of funding and total awarded: ESRC - £96,876

Amount of HERU Funding: £13,253Workforce

APPENDIX 1 PROJECTS IN PROGRESS AND COMPLETED IN 2007 APPENDIX 1 PROJECTS IN PROGRESS AND COMPLETED IN 2007

Projects completed:


The effect of the affordable warmth programme on internal environmental variables and respiratory healthin a vulnerable group: a randomised trial

Investigators: L Osman, G Douglas, (Medicine & Therapeutics, University of Aberdeen) J Ayres, (Environmental &Occupational Medicine, University of Aberdeen) A Ludbrook, (HERU) G Kyle, K Milne, (Castlehill Housing Association)J Lyon, (Aberdeen City Council) M Mackenzie, (Aberdeen Royal Infirmary)

This project evaluated the effectiveness and cost-effectiveness of the Affordable Warmth scheme for patients with bronchitisor emphysema in terms of winter health and reduced risk of hospital admissions. The economic evaluation compared the costsof the interventions with the benefits achieved. No difference was found between intervention and control groups on healthor energy efficiency outcomes based on intention to treat. However, more than half of the homes in the intervention groupdid not have the recommended heating or insulation improvements carried out and some homes in the control group did haveimprovements. Comparing homes on the basis of interventions carried out, regardless of allocation, energy efficiency interventionsdid reduce respiratory symptom scores but this was not reflected in reduced hospital admissions.

Source of funding and total awarded: EAGA Partnership Charitable Trust, £154,830


The BIG Trial: a randomised controlled trial to evaluate the clinical and cost-effectiveness of breastfeedingsupport groups in improving breastfeeding initiation, duration and satisfaction

Investigators: P Hoddinott, D Godden, (Centre for Rural Health, University of Aberdeen) J Mollison, (Department of PublicHealth, University of Aberdeen) A Ludbrook, (HERU) J Britten, R McInnes, D Tappin (University of Glasgow)

This project is a clinical and cost-effectiveness analysis of peer support breastfeeding groups to improve breastfeeding ratesand duration. The cost-effectiveness analysis considered both costs to the NHS and to the participants. Participants were alsoasked to value the breastfeeding support they receive through the use of a contingent valuation questionnaire. The projectfound no significant difference in breastfeeding rates up to 6-8 weeks. Longer follow up was precluded as the routine recordingof breastfeeding data at 8 months ceased during the project. Costs to the NHS were quite modest (£36 per attendance perwoman) and similar to the costs of home visiting by health visitors or midwives. Costs to the women were similar to attendingother postnatal groups.

Source of funding and total awarded: Scottish Government Health Directorates, Chief Scientist Office, £209,603




37 39

Workforce

Non-medical factors and their association with renal replacement therapy incidence, effectiveness andefficiency

Investigators: A McLoed, (Medicine and Therapeutics, University of Aberdeen) R Elliott, (HERU) F Casky (NHS Bristol)and C Geue (HERU)

For this project, data on general numbers of health care workforce as well as spending on health care will be obtained. Asystematic literature review will be undertaken to inform us about factors that influence the provision of nephrology/renal/dialysisservices. We group these factors into four different categories: institutional/organizational, human resources,reimbursement/financial factors, and legal factors.



Who Cares? The Impact of Changing Workforce Patterns in UK Paediatric Intensive Care Services on StaffPractice and Patient Outcomes

Investigators: J Tucker, (Dugald Baird Centre, University of Aberdeen) G Parry, S Jones, (School of Health and RelatedResearch, Sheffield) E Draper, (Health Sciences, Leicester) L McKee, (HSRU), D Skåtun, (HERU) M Darowski, (LeedsTeaching Hospital Trust) N Davey (Health Sciences, Leicester)

The aim of this study is to determine the impact of changing workforce patterns (or who cares for patients) on staff workingand patient outcomes. It will take place in 12 paediatric intensive care units. It will compare units with and without newextended nursing roles (i.e. nurses undertaking tasks previously out with normal nursing practice). It will compare the impactof differing proportions of total staff time and staff groups’ time in direct patient care in relation to quality of care and patientsatisfaction, while taking account of variations in the initial illness severity of patients. Towards ensuring sustainable and highquality services in high-tech acute hospital settings, it will explore how best to manage human resources, support staffdevelopment in new ways of working, and compare staff wellbeing and costs.

Source of funding and total awarded: The NHS Service Delivery Organisation, £252,500


Nurse Labour Markets: Preferences for Pecuniary and Non-Pecuniary Rewards

Investigators: D Skåtun, R Elliott, (HERU) A Scott (University of Melbourne)

This study will investigate the importance of non-pay aspects within the reward structure for nurses in the U.K. A crucialrequirement of the current modernisation of the National Health Service (NHS) is the supply of an adequate number of nurses.A key policy question is whether an increase in resources devoted to recruiting and retaining nurses is best spent on wages orupon improving working conditions. There is some evidence of the effect of wages on nursing labour supply, but little on thevalue placed by nurses on working conditions. Working conditions may become a more important policy instrument in the futurewith the introduction of the new more uniform pay structures agreed in ‘Agenda for Change’. The study will distinguish the‘price’ that nurses are willing to pay to improve their working conditions. It will identify how nurses’ trade-off pay againstother working conditions.

Source of funding and total awarded: ESRC, £116,505


Resource Allocation

Option appraisal of children’s cancer services in Scotland

Investigators: Alasdair Munro (HERU)

This project will examine the costs and benefits of a number of different options for configuring children’s cancer services inScotland. This will include: identifying the patterns of care associated with different options, assessing the effect of theseoptions on revenue and capital costs, examining the non-financial benefits of the options, and taking into account any widereffects such as the impact of travel patterns for patients and relatives.

Source of funding and total awarded: Scottish Executive Health Department - £26,340

Amount of HERU Funding: Core




Economic Status and Health

Analysis of movers and non-movers from poverty


This project is studying individuals who were below the poverty threshold in the first wave of the British Household Panel Surveyand comparing those who move out of poverty with those who do not. The analysis is considering the importance of source ofincome and what other characteristics explain the probability of moving.



Investigation of the empirical relationship between economic status and health status

Investigators: A Tipper, A Ludbrook, M Sutton (HERU)

The positive association between income and health is widely known but the mechanisms’ through which this relationshipoperates is less clearly understood. The thesis combines the literature on economic models of household behaviour with empiricalassessments of the health and income relationship and the demand for health literature. An economic model of householdbehaviour will be constructed to analyse health effects of labour shocks. Individuals within the household respond to incomeshocks by altering labour supply or the amount of resources to each household member. The model will be tested statisticallyusing longitudinal regression techniques. Policy implications will then be sought, to assess whether income support or employmentlegislation is more conducive to health status.

Source of funding and total awarded: Medical Research Council - £56,296



The use of short-term health outcomes in economic evaluations of health improvement interventions andimplications for QALYs.


This project uses a systematic review of economic evaluations of public health interventions carried out for the Welsh AssemblyGovernment, to investigate the extent to which short-term health benefits are included in published studies of primary preventionin developed countries. A topic based approach will be adopted; potential topics include smoking cessation, alcohol, diet andphysical activity, selected on the basis of there being plausible short-term benefits. For the selected topics, papers will bereviewed to see to what extent short-term benefits have or have not been included. The research will then consider how short-term benefits could be captured in future studies and whether such benefits could be incorporated into QALYs.

Source of funding and total awarded: Welsh Assembly Government £4,500

Amount of HERU funding: Welsh Assembly Government £4,500


3840


Performance

Delivering health care through managed clinical networks (MCNs): lessons from the North

Investigators: H Davies, P Boyle, A Green, R Rushmer, (University of St Andrews) B Guthrie, B Williams, A Morris, FSullivan, K Smith, (University of Dundee) M Sutton, S Farrar, (HERU) C Baker (Dumfries & Galloway Managed ClinicalNetworks for Coronary Heart Disease)

Since 1999, network-based healthcare delivery that cuts across NHS organisational and professional boundaries has beenencouraged by policymakers and, in the last two years, increasingly made mandatory. Such networks are believed to increaseco-ordination of care and integration of services, and to lead to improved clinical outcomes, better patient experience, greaterequity and improved cost-effectiveness. The overall aim of this project is to generate deeper understandings about the origins,processes and impacts of network delivered care with a view to better enable policy design and implementation. The economicscomponent will use the concept of social capital and the method of social network analysis to examine the impact of clinicalnetworks.

Source of funding and total awarded: NHS Service Delivery and Organisation, £299,998


Personal and professional motivation and the supply of health care

Investigators: Y Feng, S Farrar, M Sutton (HERU)

The project will begin with a comprehensive review of the theoretical and empirical literature with the objectives (i) to identifydifferent existing models of intrinsic motivation and consider their relevance to the health care sector and (ii) to reviewempirical analysis of applications of this theory and again consider what lessons can learned from this for the design of futureanalysis. A model of intrinsic motivation with testable hypotheses for application to the health care sector will be developed. Opportunities to test these models will be identified within the changing policy and contractual environment of the UK NHS.

Source of funding and total awarded: IAHS Studentship - £39,000


Targets and waiting times: exploiting a quasi-experiment to evaluate the use of targets in the provision ofhealth care in the UK

Investigators: F Windmeijer, C Propper (University of Bristol) and M Sutton (HERU)

The aim of our research is to exploit the divergence in policy between Scotland and England: pre-devolution both countrieshad targets, post-devolution Scotland concentrated on other priorities. We will use this as a natural experiment to assess theimpact of targets on the behaviour of NHS hospitals in the two countries.

We will examine two outputs: waiting times and activity levels. In contrast to most other analyses of this issue, we will usedisaggregate (patient level) data for both Scotland and England. We will examine behaviour with respect to targeted and non-targeted activities. Finally, we will use the estimates from our research to make an assessment of the net effect of this policyon patient welfare.

Source of funding and total awarded: ESRC - £96,876

Amount of HERU Funding: £13,253Workforce

APPENDIX 1 PROJECTS IN PROGRESS AND COMPLETED IN 2007 APPENDIX 1 PROJECTS IN PROGRESS AND COMPLETED IN 2007

Projects completed:


The effect of the affordable warmth programme on internal environmental variables and respiratory healthin a vulnerable group: a randomised trial

Investigators: L Osman, G Douglas, (Medicine & Therapeutics, University of Aberdeen) J Ayres, (Environmental &Occupational Medicine, University of Aberdeen) A Ludbrook, (HERU) G Kyle, K Milne, (Castlehill Housing Association)J Lyon, (Aberdeen City Council) M Mackenzie, (Aberdeen Royal Infirmary)

This project evaluated the effectiveness and cost-effectiveness of the Affordable Warmth scheme for patients with bronchitisor emphysema in terms of winter health and reduced risk of hospital admissions. The economic evaluation compared the costsof the interventions with the benefits achieved. No difference was found between intervention and control groups on healthor energy efficiency outcomes based on intention to treat. However, more than half of the homes in the intervention groupdid not have the recommended heating or insulation improvements carried out and some homes in the control group did haveimprovements. Comparing homes on the basis of interventions carried out, regardless of allocation, energy efficiency interventionsdid reduce respiratory symptom scores but this was not reflected in reduced hospital admissions.

Source of funding and total awarded: EAGA Partnership Charitable Trust, £154,830


The BIG Trial: a randomised controlled trial to evaluate the clinical and cost-effectiveness of breastfeedingsupport groups in improving breastfeeding initiation, duration and satisfaction

Investigators: P Hoddinott, D Godden, (Centre for Rural Health, University of Aberdeen) J Mollison, (Department of PublicHealth, University of Aberdeen) A Ludbrook, (HERU) J Britten, R McInnes, D Tappin (University of Glasgow)

This project is a clinical and cost-effectiveness analysis of peer support breastfeeding groups to improve breastfeeding ratesand duration. The cost-effectiveness analysis considered both costs to the NHS and to the participants. Participants were alsoasked to value the breastfeeding support they receive through the use of a contingent valuation questionnaire. The projectfound no significant difference in breastfeeding rates up to 6-8 weeks. Longer follow up was precluded as the routine recordingof breastfeeding data at 8 months ceased during the project. Costs to the NHS were quite modest (£36 per attendance perwoman) and similar to the costs of home visiting by health visitors or midwives. Costs to the women were similar to attendingother postnatal groups.

Source of funding and total awarded: Scottish Government Health Directorates, Chief Scientist Office, £209,603




41 43

VALUATION AND IMPLEMENTATIONPROGRAMME

METHODOLOGICAL WORK

Decision Making Strategies and Context

Incorporating attribute cutoffs in health care discrete choice models

Investigators: M Amaya-Amaya and M Ryan (HERU)

This study investigates the extent to which incorporating “cut-offs” (constraints dictating acceptable attribute ranges or values)into the analysis of DCE data improves the predictive ability of models. To implement this model two DCEs were used (referralfor bowel investigation and choice of drug treatment for Benign Prostatic Hyperplasia). In these experiments “cut-offs” wereelicited from respondents before they engaged in choice tasks. Choice model results with and without cut-off information arecompared. Models without cut-offs include a multinomial logit and a mixed logit to test the hypothesis that the effects ascribedto cut-offs are not simply arising from individual-level sensitivity to attributes. The model incorporating attribute cut-offsassumes a piecewise penalized utility function allowing for (potentially) “soft” cut-offs, but costly to violate. Provisional resultssuggest a sizeable improvement in the predictive validity of health care choice models when cut-offs information is accountedfor.



Investigating the prominence heuristic in payment card contingent valuation studies

Investigators: M Ryan and V Watson (HERU)

This study investigates the presence of a prominence effect using a number of existing data sets. A prominence effect existswhen respondents are observed to select a disproportionate amount of prominent numbers when expressing their valuation.The existing studies vary in the good being valued, respondents familiarity with the good, the range of values presented inthe payment card, the number of bid amounts presented, the incremental increases in valuation, and the proportion of prominentto non prominent numbers presented.

Source of funding and total awarded: University of Aberdeen and CSO Core

Amount of HERU funding: University of Aberdeen and CSO Core

Is one reason enough? Comparing compensatory and non-compensatory decision-making strategies in DCEs


This project is reanalysing existing data sets. Predicted choices using the traditional compensatory regression analysis and analternative non-compensatory heuristic, based on self reported attribute rankings, are compared to actual choices. Considerationis given to the context of the DCE (e.g. task complexity, familiarity).



The impact of complexity in stated choices: evidence from health care


This project considers the impact of the complexity of a DCE on decision-making strategies. Existing DCE data sets that varywith respect to context are used and the logit scaling approach is employed where scale parameters are allowed to vary withchoice complexity. Latent class models are also considered to obtain further insights into decision strategies and their selection.




Second National Survey of Doctors’ Job Satisfaction

Investigators: M Sutton (HERU) G Needham, F French, (NHS Education for Scotland) D Ikenwilo, D Skåtun (HERU)

The Scottish Executive Pay Modernisation (SEPM) commissioned HERU and NES to repeat the surveys of doctors previouslyundertaken to evaluate factors that would improve flexible working in NHS Scotland. The project helped gain greater understandingof job satisfaction post-implementation of new contracts for consultants and GPs in Scotland and prior to implementation ofModernising Medical Careers (MMC). It also provided data on doctors’ preferences for job attributes and give valuable insightinto issues of recruitment and retention of doctors.

Source of funding and total awarded: Scottish Executive, £86,177


Resource Allocation

Effects of remoteness and rurality on hospital costs

Investigators: P Fernandes (HERU), A Scott (University of Melbourne)

This PhD studentship sought to determine the effects of remoteness and rurality on hospital costs in Scotland. This researchexamined the role of remoteness and rurality in influencing the costs of providing hospital services in Scotland. In addition toreasons of economies of scale, issues such as high labour costs and delayed discharges may contribute to the higher costs ofhospitals in remote and rural areas. This project used panel data on hospital and specialty costs, on delayed discharges andon labour costs.

Source of funding and total awarded: Institute of Applied Health Sciences PhD Scholarship, £8,820


Review of Needs Formula

Investigators: S Morris, (Brunel) R Carr-Hill, (York) P Dixon, (York) N Rice, (York) M Sutton, (HERU) L Vallejo-Torres(Brunel) and D Olajide (HERU)

In this project we reviewed the needs element of the NHS resource allocation formula for HCHS and prescribing in three stages.

In stage 1 we identified potential improvements to the current formulae in terms of methodology and data availability, analysethe relationship between current target allocations and need, compare the current formula with relevant international approachesand delineate improvements to the current utilisation-based approach.

In stage 2 we included all relevant datasets and investigated: full or partial use of an epidemiological approach; inclusion ofoutpatient activity data; methods for costing activity data; the feasibility of modelling community health services activity;use of individual level data; accounting for age-related and additional needs using different procedures; modelling activity atdifferent levels of aggregation across sub-programmes; methods of identifying and controlling for unmet need; and the treatmentof rurality.

In stage 3 we computed target shares for practices. We used bootstrapping techniques to generate confidence intervals aroundPCT and practice needs indices and around the random variation facing planning organisations due to uncertainty in utilisation.

Source of Funding and Total Awarded: Department of Health £169,589


Review of the Resource Allocation Adjustment for the Excess Costs of Supply for Healthcare Services

Investigators: M Sutton, R Elliott, A Munro, A Ma (HERU)

This study provided results to inform the review of the Arbuthnott Formula by the NHSScotland Resource Allocation Committee.It consisted of: a literature review of adjustments for the costs of supply in healthcare resource allocation; an assessment ofwhether consideration of remoteness measures at sub-Board level lead to more accurate reflections of costs in Boards with amix of urban/rural and mainland/island populations; an appraisal of the impact of changes in hospital services provision since1999, especially with regard to new labour contracts; a review of the need for Market Forces Factor adjustments for staff andland/property; and an evaluation of the community health services adjustment.



Resource Allocation (continued)

Projects completed: Projects in progress:(Projects marked * started in 2007)(Projects marked # are funded by the Health Foundation to aid the developmentof methodological work to the policy arena. Total amount awarded £250,000)


44 42



Projects completed:


Review of the Market Forces Factor following the introduction of Payment by Results (2005): Improving thegeneral labour market method

Investigators: R Elliott, D Skåtun, A Ma, M Sutton, (HERU) N Rice, (Centre for Health Economics, University of York) SMorris, (Imperial College London) A McConnachie (Robertson Centre, Glasgow)

This project reviewed whether the estimation of unavoidable staff cost variation in the NHS using the current GLM approachcan be improved upon using more detailed information and the recent evidence on pay variations in the NHS and private sector.The geographical basis for the application of the methodology was reviewed and smoothing techniques adopted to manage‘cliff-edge’ issues.

Source of funding and total awarded: Department of Health, £74,932


Performance

Analyses of SPICE data - before and after analysis of nGMS contract

Investigators: B Guthrie, (Dundee) M Sutton (HERU) and G Watt (Glasgow)

The nGMS contract introduced a new data system for measuring quality (the Quality Outcomes Framework – QOF). Few datasetsexist for comparing the quality of care before and after the introduction of the new contract. SPICE is a voluntary qualitymeasurement initiative in which practices collect and receive feedback on a wide range of aspects of their clinical care. ThenGMS contract has been introduced during the period in which SPICE has operated, offering the opportunity for before andafter comparison of performance on the SPICE indicators. Since SPICE collects information on indicators not measured andrewarded in the nGMS contract, it also offers the opportunity to assess whether nGMS has distorted priorities.

Source of funding and total awarded: NHS Quality Improvement Scotland (via Information Services, NHS National ServicesScotland) - £18,500


Evaluation of ‘Payment by Results’

Investigators: S Farrar, A Munro, A Scott, D Ikenwilo, M Chalkley, (HERU) J Sussex, P Yuen, A Towse (Office of HealthEconomics)

The aim of this project was to evaluate the effects of ‘Payment by Results’ on a number of measurable outcomes, includingactivity rates, waiting times, and throughput. Detailed panel data was obtained to evaluate the effect of the policy. Similarpanel data from Scotland was used as a ‘comparison’ group. Since the policy in England was phased in, this will also providean opportunity to examine the counterfactual using difference-in-difference methodology. In addition, the project interviewedkey stakeholders about the development and operation of the policy as it was introduced. This will help to develop testablehypotheses.



Development of Design and Analysis Techniques

Preferences for the identification of mental retardation: a Bayesian discrete choice experiment and costbenefit analysis

Investigators: D Regier, M Ryan (HERU) E Phimister (Department of Economics, University of Aberdeen) and C Marra(University of British Columbia)

Whilst discrete choice experiments (DCE) have been increasingly used in health economics over the past 15 years, theirapplication within a cost-benefit framework has been limited. Studies that have conducted a cost benefit analysis do not takeinto account the joint uncertainty of costs and benefits (via probabilistic sensitivity analysis; PSA) widely used in the cost-effectiveness literature.

This project is structured around a health technology assessment that investigated the costs, benefit, and net-benefit ofimplementing a novel genetic technology, called array genomic hybridization, as an alternative to karyotyping for identifyinggenetic causes of developmental delay. Costs were measured from the Canadian health care payer perspective and benefitwas quantified using a DCE. From a methodological viewpoint, this project explored i) Bayesian approaches to the design andestimation of discrete choice experiments, ii) the feasibility of incorporating willingness to pay values derived from a DCE intoa decision-analytic model to measure net-benefit; and iii) the use of probabilistic sensitivity analysis to develop a net-benefitcurve.

Source of funding and total awarded: University of Aberdeen (£36,000); Canadian Institutes of Health Research ($75,000)


*Choosing not to choose: Considering serial non-participation in discrete choice experiments

Investigators: M Amaya-Amaya, V Watson (HERU)

Discrete choice experiments (DCEs) often include a status quo (or ‘do nothing’) alternative in the choice sets presented torespondents. This study investigates if respondents who always choose the status quo (a form of serial non-participation) aremotivated by a different behavioural process than respondents who, at least once, choose the alternatives presented. Toinvestigate this, repeated discrete choice models, which include hurdles, are used to analyze DCE data. These models accountfor the panel nature of the data and allow separate data generating processes to explain serial non-participation and participation.



*Comparing modeling strategies for payment card contingent valuation

Investigators: M Mentzakis, V Watson (HERU)

This project is reanalysing existing data sets. This study investigates the sensitivity of WTP estimates to the econometricspecification and distributional assumptions made in the analysis of payment card data. Data from 14 CV studies is used. Thisis the first attempt to simultaneously apply these estimation techniques to such a range of distinct datasets. Preliminary findingsshow that WTP is rarely normally distributed. Further, our findings indicate that the range and the number of the bid amountspresented in the payment card is crucial if the distribution of WTP is to be identified.

Source of funding and total awarded: MRC & University of Aberdeen/ CSO Core


*Does respondent certainty explain anomalies in Double Bounded Dichotomous Choice data

Investigators: S Luchini (Research Group in Quantitative Economics from Aix-Marseilles II (GREQAM), V Watson (HERU)

This study explores respondent’s self-reported uncertainty as a source of heteroscedasticity in contingent valuation data.Respondent’s self-reported uncertainty is often collected as part of a contingent valuation study. To date, this informationhas been used mainly as an ex-post correction for hypothetical bias. We use respondents’ self-reported uncertainty as a measureof how ‘noisy’ respondents perceive their responses to be. Further, we hypothesize that respondents’ certainty will influencetheir susceptibility to framing effects. Both conjectures are tested in an econometric model. Our results indicate that uncertainrespondents have a higher variance than certain respondents. Framing effects are found in responses from both certain anduncertain respondents. However, the magnitude and qualitative interpretation differs according to respondent certainty.





41 43


METHODOLOGICAL WORK


Incorporating attribute cutoffs in health care discrete choice models


This study investigates the extent to which incorporating “cut-offs” (constraints dictating acceptable attribute ranges or values)into the analysis of DCE data improves the predictive ability of models. To implement this model two DCEs were used (referralfor bowel investigation and choice of drug treatment for Benign Prostatic Hyperplasia). In these experiments “cut-offs” wereelicited from respondents before they engaged in choice tasks. Choice model results with and without cut-off information arecompared. Models without cut-offs include a multinomial logit and a mixed logit to test the hypothesis that the effects ascribedto cut-offs are not simply arising from individual-level sensitivity to attributes. The model incorporating attribute cut-offsassumes a piecewise penalized utility function allowing for (potentially) “soft” cut-offs, but costly to violate. Provisional resultssuggest a sizeable improvement in the predictive validity of health care choice models when cut-offs information is accountedfor.



Investigating the prominence heuristic in payment card contingent valuation studies


This study investigates the presence of a prominence effect using a number of existing data sets. A prominence effect existswhen respondents are observed to select a disproportionate amount of prominent numbers when expressing their valuation.The existing studies vary in the good being valued, respondents familiarity with the good, the range of values presented inthe payment card, the number of bid amounts presented, the incremental increases in valuation, and the proportion of prominentto non prominent numbers presented.



Is one reason enough? Comparing compensatory and non-compensatory decision-making strategies in DCEs


This project is reanalysing existing data sets. Predicted choices using the traditional compensatory regression analysis and analternative non-compensatory heuristic, based on self reported attribute rankings, are compared to actual choices. Considerationis given to the context of the DCE (e.g. task complexity, familiarity).



The impact of complexity in stated choices: evidence from health care


This project considers the impact of the complexity of a DCE on decision-making strategies. Existing DCE data sets that varywith respect to context are used and the logit scaling approach is employed where scale parameters are allowed to vary withchoice complexity. Latent class models are also considered to obtain further insights into decision strategies and their selection.




Second National Survey of Doctors’ Job Satisfaction

Investigators: M Sutton (HERU) G Needham, F French, (NHS Education for Scotland) D Ikenwilo, D Skåtun (HERU)

The Scottish Executive Pay Modernisation (SEPM) commissioned HERU and NES to repeat the surveys of doctors previouslyundertaken to evaluate factors that would improve flexible working in NHS Scotland. The project helped gain greater understandingof job satisfaction post-implementation of new contracts for consultants and GPs in Scotland and prior to implementation ofModernising Medical Careers (MMC). It also provided data on doctors’ preferences for job attributes and give valuable insightinto issues of recruitment and retention of doctors.



Resource Allocation

Effects of remoteness and rurality on hospital costs

Investigators: P Fernandes (HERU), A Scott (University of Melbourne)

This PhD studentship sought to determine the effects of remoteness and rurality on hospital costs in Scotland. This researchexamined the role of remoteness and rurality in influencing the costs of providing hospital services in Scotland. In addition toreasons of economies of scale, issues such as high labour costs and delayed discharges may contribute to the higher costs ofhospitals in remote and rural areas. This project used panel data on hospital and specialty costs, on delayed discharges andon labour costs.

Source of funding and total awarded: Institute of Applied Health Sciences PhD Scholarship, £8,820


Review of Needs Formula

Investigators: S Morris, (Brunel) R Carr-Hill, (York) P Dixon, (York) N Rice, (York) M Sutton, (HERU) L Vallejo-Torres(Brunel) and D Olajide (HERU)

In this project we reviewed the needs element of the NHS resource allocation formula for HCHS and prescribing in three stages.

In stage 1 we identified potential improvements to the current formulae in terms of methodology and data availability, analysethe relationship between current target allocations and need, compare the current formula with relevant international approachesand delineate improvements to the current utilisation-based approach.

In stage 2 we included all relevant datasets and investigated: full or partial use of an epidemiological approach; inclusion ofoutpatient activity data; methods for costing activity data; the feasibility of modelling community health services activity;use of individual level data; accounting for age-related and additional needs using different procedures; modelling activity atdifferent levels of aggregation across sub-programmes; methods of identifying and controlling for unmet need; and the treatmentof rurality.

In stage 3 we computed target shares for practices. We used bootstrapping techniques to generate confidence intervals aroundPCT and practice needs indices and around the random variation facing planning organisations due to uncertainty in utilisation.

Source of Funding and Total Awarded: Department of Health £169,589


Review of the Resource Allocation Adjustment for the Excess Costs of Supply for Healthcare Services

Investigators: M Sutton, R Elliott, A Munro, A Ma (HERU)

This study provided results to inform the review of the Arbuthnott Formula by the NHSScotland Resource Allocation Committee.It consisted of: a literature review of adjustments for the costs of supply in healthcare resource allocation; an assessment ofwhether consideration of remoteness measures at sub-Board level lead to more accurate reflections of costs in Boards with amix of urban/rural and mainland/island populations; an appraisal of the impact of changes in hospital services provision since1999, especially with regard to new labour contracts; a review of the need for Market Forces Factor adjustments for staff andland/property; and an evaluation of the community health services adjustment.



Resource Allocation (continued)

Projects completed: Projects in progress:(Projects marked * started in 2007)(Projects marked # are funded by the Health Foundation to aid the developmentof methodological work to the policy arena. Total amount awarded £250,000)


44 42



Projects completed:


Review of the Market Forces Factor following the introduction of Payment by Results (2005): Improving thegeneral labour market method

Investigators: R Elliott, D Skåtun, A Ma, M Sutton, (HERU) N Rice, (Centre for Health Economics, University of York) SMorris, (Imperial College London) A McConnachie (Robertson Centre, Glasgow)

This project reviewed whether the estimation of unavoidable staff cost variation in the NHS using the current GLM approachcan be improved upon using more detailed information and the recent evidence on pay variations in the NHS and private sector.The geographical basis for the application of the methodology was reviewed and smoothing techniques adopted to manage‘cliff-edge’ issues.



Performance

Analyses of SPICE data - before and after analysis of nGMS contract

Investigators: B Guthrie, (Dundee) M Sutton (HERU) and G Watt (Glasgow)

The nGMS contract introduced a new data system for measuring quality (the Quality Outcomes Framework – QOF). Few datasetsexist for comparing the quality of care before and after the introduction of the new contract. SPICE is a voluntary qualitymeasurement initiative in which practices collect and receive feedback on a wide range of aspects of their clinical care. ThenGMS contract has been introduced during the period in which SPICE has operated, offering the opportunity for before andafter comparison of performance on the SPICE indicators. Since SPICE collects information on indicators not measured andrewarded in the nGMS contract, it also offers the opportunity to assess whether nGMS has distorted priorities.

Source of funding and total awarded: NHS Quality Improvement Scotland (via Information Services, NHS National ServicesScotland) - £18,500


Evaluation of ‘Payment by Results’

Investigators: S Farrar, A Munro, A Scott, D Ikenwilo, M Chalkley, (HERU) J Sussex, P Yuen, A Towse (Office of HealthEconomics)

The aim of this project was to evaluate the effects of ‘Payment by Results’ on a number of measurable outcomes, includingactivity rates, waiting times, and throughput. Detailed panel data was obtained to evaluate the effect of the policy. Similarpanel data from Scotland was used as a ‘comparison’ group. Since the policy in England was phased in, this will also providean opportunity to examine the counterfactual using difference-in-difference methodology. In addition, the project interviewedkey stakeholders about the development and operation of the policy as it was introduced. This will help to develop testablehypotheses.




Preferences for the identification of mental retardation: a Bayesian discrete choice experiment and costbenefit analysis

Investigators: D Regier, M Ryan (HERU) E Phimister (Department of Economics, University of Aberdeen) and C Marra(University of British Columbia)

Whilst discrete choice experiments (DCE) have been increasingly used in health economics over the past 15 years, theirapplication within a cost-benefit framework has been limited. Studies that have conducted a cost benefit analysis do not takeinto account the joint uncertainty of costs and benefits (via probabilistic sensitivity analysis; PSA) widely used in the cost-effectiveness literature.

This project is structured around a health technology assessment that investigated the costs, benefit, and net-benefit ofimplementing a novel genetic technology, called array genomic hybridization, as an alternative to karyotyping for identifyinggenetic causes of developmental delay. Costs were measured from the Canadian health care payer perspective and benefitwas quantified using a DCE. From a methodological viewpoint, this project explored i) Bayesian approaches to the design andestimation of discrete choice experiments, ii) the feasibility of incorporating willingness to pay values derived from a DCE intoa decision-analytic model to measure net-benefit; and iii) the use of probabilistic sensitivity analysis to develop a net-benefitcurve.

Source of funding and total awarded: University of Aberdeen (£36,000); Canadian Institutes of Health Research ($75,000)


*Choosing not to choose: Considering serial non-participation in discrete choice experiments

Investigators: M Amaya-Amaya, V Watson (HERU)

Discrete choice experiments (DCEs) often include a status quo (or ‘do nothing’) alternative in the choice sets presented torespondents. This study investigates if respondents who always choose the status quo (a form of serial non-participation) aremotivated by a different behavioural process than respondents who, at least once, choose the alternatives presented. Toinvestigate this, repeated discrete choice models, which include hurdles, are used to analyze DCE data. These models accountfor the panel nature of the data and allow separate data generating processes to explain serial non-participation and participation.



*Comparing modeling strategies for payment card contingent valuation

Investigators: M Mentzakis, V Watson (HERU)

This project is reanalysing existing data sets. This study investigates the sensitivity of WTP estimates to the econometricspecification and distributional assumptions made in the analysis of payment card data. Data from 14 CV studies is used. Thisis the first attempt to simultaneously apply these estimation techniques to such a range of distinct datasets. Preliminary findingsshow that WTP is rarely normally distributed. Further, our findings indicate that the range and the number of the bid amountspresented in the payment card is crucial if the distribution of WTP is to be identified.

Source of funding and total awarded: MRC & University of Aberdeen/ CSO Core


*Does respondent certainty explain anomalies in Double Bounded Dichotomous Choice data

Investigators: S Luchini (Research Group in Quantitative Economics from Aix-Marseilles II (GREQAM), V Watson (HERU)

This study explores respondent’s self-reported uncertainty as a source of heteroscedasticity in contingent valuation data.Respondent’s self-reported uncertainty is often collected as part of a contingent valuation study. To date, this informationhas been used mainly as an ex-post correction for hypothetical bias. We use respondents’ self-reported uncertainty as a measureof how ‘noisy’ respondents perceive their responses to be. Further, we hypothesize that respondents’ certainty will influencetheir susceptibility to framing effects. Both conjectures are tested in an econometric model. Our results indicate that uncertainrespondents have a higher variance than certain respondents. Framing effects are found in responses from both certain anduncertain respondents. However, the magnitude and qualitative interpretation differs according to respondent certainty.





4745




Qualitative investigations of choice experiments (QUINCE)

Investigators: M Ryan, V Watson, (HERU) and V Entwistle (University of Dundee)

This project used a qualitative research technique, ‘verbal protocol analysis’, whereby people were asked to think-aloud whilecompleting a DCE, to investigate respondents’ thought process. The resulting transcripts were analysed to assess respondents’adherence to economic theory’s belief about respondents’ decision-making (utility maximization). Particular attention wasgiven to decision-making heuristics employed by respondents in completing the task.




Comparing alternative approaches to designing Discrete Choice Experiments

Investigators: M Ryan, M Tinelli and M Odejar (HERU)

When employing Discrete Choice Experiments (DCEs) alternatives approaches for the experimental design stage are currentlyused. The importance of testing for the impact of alternative designs on parameter estimates and welfare measures is beingrecognised. This study considered issues raised in measuring the efficiency of designs, compares designs generated from a web-based catalogue and a computer searching algorithm, and compared results in terms of goodness of fit of models, parametersestimates and welfare estimates. Moreover, this study highlighted the effects of sample size, inclusion of a current situationwith levels specified by the respondents, and inclusion of interaction terms on D-error and efficiency. Following this parameterswere estimated using logistic regression techniques and welfare estimates are generated. These were compared for the differentexperimental designs.

Source of funding and total awarded: # and ESRC, £8,875 **

Amount of HERU funding: # and £8,875

Welfare estimates within a DCE with opt-out options

Investigators: M Tinelli, M Ryan and M Odejar (HERU)

Whilst most DCE applications apply forced choices, the importance of allowing for multiple options is being recognised (includingan opt-out option). This project considered the implication of such opt-outs for welfare estimates. More specifically, considerationneeded to be given to the cross elasticity of substitution between alternatives. Initial analysis investigated a data set concernedwith preference for extending the role of pharmacists. A Nested Logit Model (NLM) was used to analyse the data, and considerationgiven to alternative substitution structures, and the resulting impact on welfare estimates. The Inclusive Value was used toguide in choosing nested models consistent with utility maximisation theory. The likelihood dominance criterion was used todetermine the appropriate nesting structure for model consistent with utility maximisation. Welfare estimates were comparedfor the Random Parameter Logit Model (RPL), the NLM and the more commonly used Multinomial Model (MNL).

Source of funding and total awarded: # and ESRC, £8,875 (Other projects funded by this ESRC award are marked **)


Testing the Validity of Stated Preference Elicitation Techniques

Comparing welfare estimates from payment card contingent valuation and discrete choice experiments

Investigators: V Watson and M Ryan (HERU)

This study compared willingness to pay estimates generated from the payment card contingent valuation (PC CV) and discretechoice experiment (DCE) approaches within sample experiment eliciting preferences for Chlamydia screening. The theoreticalvalidity of the results from both techniques was explored. Further mid-point bias and a prominence effect were also exploredwithin the PC responses and non-satiation and yea-saying in the context of the DCE. The study also collected information onscreening behaviour in the actual context. This is compared with hypothetical responses for the CV and DCE.



Development of Design and Analysis Techniques (continued)

*On the statistical gain from modelling choice probabilities

Investigators: M Smith and B Eberth (HERU)

This project will identify the gains, if any and other implications if stated preference survey respondents report the probabilityof making a choice selection, as opposed to the selection itself. (i.e. probabilistic choice versus discrete choice)? We will focusinitially on the statistical aspects of this question, afterwards moving on to empirical settings (in health) once our theoreticalresults are established. The overall statistical context - the random utility model - does not change implying that the basicstatistical issue is effectively one of identifying the gains of directly observing a continuous random variable, as opposed toobserving a censored version of it. In statistical terms, establishing the gains from probabilistic choice over discrete choicecan be examined in terms of the well-known measure.

Source of Funding and Total Awarded: Core and University of Aberdeen

Amount of HERU Funding: Core and University of Aberdeen


Does respondents’ reluctance influence stated valuation results?


In stated preference experiments respondents can choose whether to complete the study and provide information or not. Thus,no information is obtained from non-respondents. This is concerning if there is reason to believe that non-respondents’preferences differ systematically from respondents’ preferences. This is especially true when mail surveys are used where highnon-response rates are often reported. This study reports WTP results for the provision of a national air ambulance service,where respondents are broken down by self-reported and interviewer perceived reluctance to participate in the experiment.



APPLIED WORK

Eliciting Preferences in the Delivery of Health Care

Common symptoms in the community: understanding the public’s responses to inform the development ofinterventions

Investigators: A Elliot, P Hannaford, (Department of General Practice and Primary Care, University of Aberdeen) S Wyke,(Director of the Alliance for Self Care Research) K Hunt (MRC Social and Public Health Sciences Unit) and M Ryan (HERU)

Recent UK government policy has advocated more extensive use of primary care teams, including nurses and pharmacists, forthe management of common ailments, as well as promoting self-care of symptoms indicative of self-limiting illness. We donot currently know how the public is responding to these strategies or what influences their own management decisions. Theaim of this research is to determine patterns of common symptoms in the community, and understand how the public respondsto them, in order to enhance appropriate and effective management of common symptoms. The first phase of the researchwill be a population-based postal survey which will determine the patterns of common symptoms in the community, identifyhow people currently manage their symptoms, and identify factors associated with different patterns of management. Thesecond phase will be a discrete choice experiment which will investigate the relative importance of different factors influencingmanagement decisions and the trade-offs people make when deciding how to manage their symptoms. The final phase will bea literature review of primary care-based interventions previously used to manage common symptoms. The work will lead tothe development of interventions to be used in primary care to optimise appropriate health care.

Source of funding and total awarded: Wellcome Trust £328,847

Amount of HERU funding: University of Aberdeen £2,434

Projects completed:


48 46

Projects in progress:APPENDIX 1 PROJECTS IN PROGRESS AND COMPLETED IN 2007

Projects completed:


Testing the Validity of Stated Preference Elicitation Techniques (continued)

Testing for payment vehicle effects: taxation v charitable donations


This study considered the impact of differing payment vehicles on respondents’ stated WTP for a national air ambulance service.Respondents were randomly split between two payment vehicles: taxation or charitable donation. Both payment vehicles arecurrently used to finance air ambulance provision in England. Willingness to pay estimates derived from parametric anddistribution free methods of analysis were compared.



Testing for ‘yea-saying’, range bias and mid-point bias in WTP experiments

Investigators: S Jareinpitak, (PhD Student – University College London) M Ryan, (HERU) and J Cairns (London School ofHygiene & Tropical Medicine)

This study uses the double bounded dichotomous choice and payment card CV approaches to investigate the value of a prepaymentdental plan for children. The project also considers external validity (see below) and anomalies in CV experiments (‘yea-saying’,and range and mid-point biases).



Testing the external validity of contingent valuation: a field experiment comparing hypothetical and realpayments

Investigators: S Jareinpitak, (PhD Student – University College London) M Ryan (HERU) and J Cairns (London School ofHygiene and Tropical Medicine)

This study developed a field experiment to test external validity of both the payment card and dichotomous choice contingentvaluation techniques. Consideration is also given to methods of calibration of hypothetical and real behavior. The experimentis applied to looking at the demand for a prepayment dental plan.




Developing a Complex Intervention for Chronic Low Back Pain in Primary Care

Investigators: BH Smith, AM Elliott, PC Hannaford, (Department of General Practice and Primary Care, University ofAberdeen) MH Pope, (University of Aberdeen) M Johnston, (Health Services Research Unit, University of Aberdeen) WAChambers, (Aberdeen Royal Infirmary) M Ryan and D Yi (HERU)

As part of a wider study we used a DCE to look at preferences for pain management programmes (PMPs). The attributes forthis study were determined by a literature review, survey of current PMPs, focus group, and consultation with experts. 5attributes were included: programme contents; professionals involved; programme design; size of group and cost per session.

Source of Funding and Total Awarded: CSO - £10,919


Eliciting Preferences in the Delivery of Health Care (continued)

Establishing the potential for primary care to tackle social inequalities in established colorectal cancer

Investigators: N Campbell, (Department of General Practice and Primary Care, University of Aberdeen) U Macleod, EMitchell, (University of Glasgow) M Ryan and D Yi (HERU)

This study aims to gather evidence on what potential there is for interventions in primary care to reduce inequalities in qualityof life and survival in patients with established colorectal cancer and to inform their future development. One of the componentsof this study is to investigate the costs and benefits of different systems of integrated oncology treatment and follow up topatients with colorectal cancer in rural and urban areas. Using DCE, we will quantify the relative importance to patients ofthe amounts of specialist contact and travelling time, degree of continuity of care, professional seen, and degree to whichtreatments are available in one location. Data is currently being collected.

Source of funding and total awarded: CRUK, £197,668


The Social Value of a QALY

Investigators: C Donaldson, S Chilton, M Jones-Lee, H Metcalf, P Shackley, J Wildman, (University of Newcastle) G Loomes,A Robinson, R Smith, I Bateman, R Sugden, M Mugford (University of East Anglia) and M Ryan and M Odejar (HERU)

The National Institute of Health and Clinical Excellence (NICE) makes recommendations to the NHS on the adoption (orcontinuation) of therapies. This requires judgements about whether the values/weights attached to gains in quality and lengthof life should vary according to the characteristics of the patients receiving them, and how much the NHS should be spendingto achieve such gains. To inform such judgements, the aims of the research are: (i) to estimate the relative weights to beattached to health gains according to the characteristics of the recipients of these gains; and (ii) to explore the feasibility ofestimating a monetary value for a quality adjusted life year (QALY), to which these relative weights might then be applied.DCEs are being used to address both these questions. Data is currently being collected.

Source of funding and total awarded: National Institute for Clinical Excellence (NICE) and National Centre Coordinating ResearchMethods (NCCRM), £424,832



Investigators: M Mentzakis, P McNamee and M Ryan (HERU)

Previous approaches to valuation of informal care time have used either the replacement cost (proxy good) method or theopportunity cost method. The former typically values time using the cost of home care or nursing services provided by theformal care sector. The opportunity cost method values time using wage data. A criticism that can be applied to both methodsis that no account is taken of the marginal valuation of time. This could be expected to vary greatly among people who providedifferent amounts and types of care. A DCE is currently being developed to value these effects.

Source of Funding and Total Awarded: MRC Capacity Building PhD Studentship - £13,155, University of Aberdeen £43,040



4745




Qualitative investigations of choice experiments (QUINCE)

Investigators: M Ryan, V Watson, (HERU) and V Entwistle (University of Dundee)

This project used a qualitative research technique, ‘verbal protocol analysis’, whereby people were asked to think-aloud whilecompleting a DCE, to investigate respondents’ thought process. The resulting transcripts were analysed to assess respondents’adherence to economic theory’s belief about respondents’ decision-making (utility maximization). Particular attention wasgiven to decision-making heuristics employed by respondents in completing the task.




Comparing alternative approaches to designing Discrete Choice Experiments

Investigators: M Ryan, M Tinelli and M Odejar (HERU)

When employing Discrete Choice Experiments (DCEs) alternatives approaches for the experimental design stage are currentlyused. The importance of testing for the impact of alternative designs on parameter estimates and welfare measures is beingrecognised. This study considered issues raised in measuring the efficiency of designs, compares designs generated from a web-based catalogue and a computer searching algorithm, and compared results in terms of goodness of fit of models, parametersestimates and welfare estimates. Moreover, this study highlighted the effects of sample size, inclusion of a current situationwith levels specified by the respondents, and inclusion of interaction terms on D-error and efficiency. Following this parameterswere estimated using logistic regression techniques and welfare estimates are generated. These were compared for the differentexperimental designs.

Source of funding and total awarded: # and ESRC, £8,875 **


Welfare estimates within a DCE with opt-out options

Investigators: M Tinelli, M Ryan and M Odejar (HERU)

Whilst most DCE applications apply forced choices, the importance of allowing for multiple options is being recognised (includingan opt-out option). This project considered the implication of such opt-outs for welfare estimates. More specifically, considerationneeded to be given to the cross elasticity of substitution between alternatives. Initial analysis investigated a data set concernedwith preference for extending the role of pharmacists. A Nested Logit Model (NLM) was used to analyse the data, and considerationgiven to alternative substitution structures, and the resulting impact on welfare estimates. The Inclusive Value was used toguide in choosing nested models consistent with utility maximisation theory. The likelihood dominance criterion was used todetermine the appropriate nesting structure for model consistent with utility maximisation. Welfare estimates were comparedfor the Random Parameter Logit Model (RPL), the NLM and the more commonly used Multinomial Model (MNL).

Source of funding and total awarded: # and ESRC, £8,875 (Other projects funded by this ESRC award are marked **)



Comparing welfare estimates from payment card contingent valuation and discrete choice experiments

Investigators: V Watson and M Ryan (HERU)

This study compared willingness to pay estimates generated from the payment card contingent valuation (PC CV) and discretechoice experiment (DCE) approaches within sample experiment eliciting preferences for Chlamydia screening. The theoreticalvalidity of the results from both techniques was explored. Further mid-point bias and a prominence effect were also exploredwithin the PC responses and non-satiation and yea-saying in the context of the DCE. The study also collected information onscreening behaviour in the actual context. This is compared with hypothetical responses for the CV and DCE.



Development of Design and Analysis Techniques (continued)

*On the statistical gain from modelling choice probabilities

Investigators: M Smith and B Eberth (HERU)

This project will identify the gains, if any and other implications if stated preference survey respondents report the probabilityof making a choice selection, as opposed to the selection itself. (i.e. probabilistic choice versus discrete choice)? We will focusinitially on the statistical aspects of this question, afterwards moving on to empirical settings (in health) once our theoreticalresults are established. The overall statistical context - the random utility model - does not change implying that the basicstatistical issue is effectively one of identifying the gains of directly observing a continuous random variable, as opposed toobserving a censored version of it. In statistical terms, establishing the gains from probabilistic choice over discrete choicecan be examined in terms of the well-known measure.

Source of Funding and Total Awarded: Core and University of Aberdeen

Amount of HERU Funding: Core and University of Aberdeen


Does respondents’ reluctance influence stated valuation results?


In stated preference experiments respondents can choose whether to complete the study and provide information or not. Thus,no information is obtained from non-respondents. This is concerning if there is reason to believe that non-respondents’preferences differ systematically from respondents’ preferences. This is especially true when mail surveys are used where highnon-response rates are often reported. This study reports WTP results for the provision of a national air ambulance service,where respondents are broken down by self-reported and interviewer perceived reluctance to participate in the experiment.



APPLIED WORK


Common symptoms in the community: understanding the public’s responses to inform the development ofinterventions

Investigators: A Elliot, P Hannaford, (Department of General Practice and Primary Care, University of Aberdeen) S Wyke,(Director of the Alliance for Self Care Research) K Hunt (MRC Social and Public Health Sciences Unit) and M Ryan (HERU)

Recent UK government policy has advocated more extensive use of primary care teams, including nurses and pharmacists, forthe management of common ailments, as well as promoting self-care of symptoms indicative of self-limiting illness. We donot currently know how the public is responding to these strategies or what influences their own management decisions. Theaim of this research is to determine patterns of common symptoms in the community, and understand how the public respondsto them, in order to enhance appropriate and effective management of common symptoms. The first phase of the researchwill be a population-based postal survey which will determine the patterns of common symptoms in the community, identifyhow people currently manage their symptoms, and identify factors associated with different patterns of management. Thesecond phase will be a discrete choice experiment which will investigate the relative importance of different factors influencingmanagement decisions and the trade-offs people make when deciding how to manage their symptoms. The final phase will bea literature review of primary care-based interventions previously used to manage common symptoms. The work will lead tothe development of interventions to be used in primary care to optimise appropriate health care.

Source of funding and total awarded: Wellcome Trust £328,847

Amount of HERU funding: University of Aberdeen £2,434

Projects completed:


48 46

Projects in progress:APPENDIX 1 PROJECTS IN PROGRESS AND COMPLETED IN 2007

Projects completed:


Testing the Validity of Stated Preference Elicitation Techniques (continued)

Testing for payment vehicle effects: taxation v charitable donations


This study considered the impact of differing payment vehicles on respondents’ stated WTP for a national air ambulance service.Respondents were randomly split between two payment vehicles: taxation or charitable donation. Both payment vehicles arecurrently used to finance air ambulance provision in England. Willingness to pay estimates derived from parametric anddistribution free methods of analysis were compared.



Testing for ‘yea-saying’, range bias and mid-point bias in WTP experiments

Investigators: S Jareinpitak, (PhD Student – University College London) M Ryan, (HERU) and J Cairns (London School ofHygiene & Tropical Medicine)

This study uses the double bounded dichotomous choice and payment card CV approaches to investigate the value of a prepaymentdental plan for children. The project also considers external validity (see below) and anomalies in CV experiments (‘yea-saying’,and range and mid-point biases).



Testing the external validity of contingent valuation: a field experiment comparing hypothetical and realpayments

Investigators: S Jareinpitak, (PhD Student – University College London) M Ryan (HERU) and J Cairns (London School ofHygiene and Tropical Medicine)

This study developed a field experiment to test external validity of both the payment card and dichotomous choice contingentvaluation techniques. Consideration is also given to methods of calibration of hypothetical and real behavior. The experimentis applied to looking at the demand for a prepayment dental plan.




Developing a Complex Intervention for Chronic Low Back Pain in Primary Care

Investigators: BH Smith, AM Elliott, PC Hannaford, (Department of General Practice and Primary Care, University ofAberdeen) MH Pope, (University of Aberdeen) M Johnston, (Health Services Research Unit, University of Aberdeen) WAChambers, (Aberdeen Royal Infirmary) M Ryan and D Yi (HERU)

As part of a wider study we used a DCE to look at preferences for pain management programmes (PMPs). The attributes forthis study were determined by a literature review, survey of current PMPs, focus group, and consultation with experts. 5attributes were included: programme contents; professionals involved; programme design; size of group and cost per session.

Source of Funding and Total Awarded: CSO - £10,919



Establishing the potential for primary care to tackle social inequalities in established colorectal cancer

Investigators: N Campbell, (Department of General Practice and Primary Care, University of Aberdeen) U Macleod, EMitchell, (University of Glasgow) M Ryan and D Yi (HERU)

This study aims to gather evidence on what potential there is for interventions in primary care to reduce inequalities in qualityof life and survival in patients with established colorectal cancer and to inform their future development. One of the componentsof this study is to investigate the costs and benefits of different systems of integrated oncology treatment and follow up topatients with colorectal cancer in rural and urban areas. Using DCE, we will quantify the relative importance to patients ofthe amounts of specialist contact and travelling time, degree of continuity of care, professional seen, and degree to whichtreatments are available in one location. Data is currently being collected.

Source of funding and total awarded: CRUK, £197,668


The Social Value of a QALY

Investigators: C Donaldson, S Chilton, M Jones-Lee, H Metcalf, P Shackley, J Wildman, (University of Newcastle) G Loomes,A Robinson, R Smith, I Bateman, R Sugden, M Mugford (University of East Anglia) and M Ryan and M Odejar (HERU)

The National Institute of Health and Clinical Excellence (NICE) makes recommendations to the NHS on the adoption (orcontinuation) of therapies. This requires judgements about whether the values/weights attached to gains in quality and lengthof life should vary according to the characteristics of the patients receiving them, and how much the NHS should be spendingto achieve such gains. To inform such judgements, the aims of the research are: (i) to estimate the relative weights to beattached to health gains according to the characteristics of the recipients of these gains; and (ii) to explore the feasibility ofestimating a monetary value for a quality adjusted life year (QALY), to which these relative weights might then be applied.DCEs are being used to address both these questions. Data is currently being collected.

Source of funding and total awarded: National Institute for Clinical Excellence (NICE) and National Centre Coordinating ResearchMethods (NCCRM), £424,832



Investigators: M Mentzakis, P McNamee and M Ryan (HERU)

Previous approaches to valuation of informal care time have used either the replacement cost (proxy good) method or theopportunity cost method. The former typically values time using the cost of home care or nursing services provided by theformal care sector. The opportunity cost method values time using wage data. A criticism that can be applied to both methodsis that no account is taken of the marginal valuation of time. This could be expected to vary greatly among people who providedifferent amounts and types of care. A DCE is currently being developed to value these effects.

Source of Funding and Total Awarded: MRC Capacity Building PhD Studentship - £13,155, University of Aberdeen £43,040



5149

HERU PUBLICATIONS 2007

APPENDIX 2

McCormack, K., Rabindranath, K., Kilonzo, M., Vale, L.,Fraser, C., McIntyre, L., Thomas, S., Rothnie, H., Fluck, N.,Gould, I. and Waugh, N.Systematic review of the effectivenessof preventing and treating Staphylococcus aureus carriageon peritoneal catheter-related infections. Health TechnologyAssessment, 2007 vol 11(23).

McLean, G., Guthrie, B. and Sutton, M. Differences in thequality of primary medical care services by remoteness fromurban settlements. Quality and Safety in Health Care, 2007;16:446-449.

McLean, G., Guthrie, B. and Sutton, M. Differences in thequality of primary medical care for CVD and Diabetes acrossthe NHS: evidence from the Quality and Outcomes Framework.BMC Health Services Research, 2007 vol 7, 74.

McNamee, P. What difference does it make?: The calculationof QALY gains from health profiles using patient and generalpopulation values. Health Policy, 2007 vol 84, 321-331.

McNeill, G., Avenell, A., Campbell, M.K., Cook, J.A.,Hannaford, P.C., Kilonzo, M., Milne, A.C., Ramsay, C.R.,Seymour, D.G., Stephen A.I. and Vale, L. Effect of multivitaminand multimineral supplementation on cognitive function inmen and women aged 65 years and over: a randomisedcontrolled trial. Biomed Central Nutrition Journal, 2007, vol6, 10.

Philip, S., Fleming, A.D., Goatman, K.A., Fonseca, S.,McNamee, P., Scotland, G.S., Prescott, G.J., Sharp, P.F.and Olson, J.A. The efficacy of automated “disease/nodisease” grading for diabetic retinopathy in a systematicscreening programme. British Journal of Ophthalmology,2007 vol 91, 1512-1517.

Pitchforth, E., Watson, V., Tucker, J., Ryan, M., vanTeijlingen, E., Farmer, J., Ireland, J., Martin, E., Kiger, A.and Bryers, H. Models of intrapartum care and women’strade-offs in remote and rural Scotland: a mixed-methodsstudy. British Journal of Obstetrics and Gynaecology. OnlineEarly Articles Published article online: 28-Sep-2007 doi:10.1111/j.1471-0528.2007.01516.x.

Pol, van der M. and Shiell, A. Extrinsic goals and Time TradeOff. Medical Decision Making, 2007 vol 27, 406-413.

Prescott, R., Kunkler, I., Williams, L., King, C., Jack, W.,Dixon, J., Pol, van der M., Goh, T., Lindley, R. and Cairns,J. A randomised controlled trial of postoperative radiotherapyfollowing breast-conserving surgery in a minimum-risk olderpopulation (The PRIME trial). Health Technology Assessment,2007 vol 11(31).

Rabindradranath, K., Ali, T.Z., MacLeod, A.M. and Vale, L.Automated vs continuous ambulatory peritoneal dialysis: Asystematic review of randomized controlled trial. NephrologyDialysis and Transplantation. 2007; 22: 2991–2998

Regier, D.A., Bansback, N., Dar Santos, N. and Marra, C.A.Cost-effectiveness of tumour necrosis factor-a in rheumatoidarthritis, psoriatic arthritis, and ankylosing spondylitis. ExpertReview of Pharmacoeconomics and Outcomes Research, 2007vol 7(2), 155-165.

Regier, D.A., Marra, C.A. and Lynd, L. A systematic reviewof economic evaluations of anticoagulants for the prophylaxisof venous thromboemoblism following major trauma. ExpertReview of Pharmacoeconomics and Outcomes Research. 2007;7(4):403-413.

Regier, D.A. and Marra, C.A. Self-managed anticoagulationtherapy. CMAJ, 2007 vol 176(6), 813.

Scott, T., Tinelli, M. and Bond, C. on behalf of the CommunityPharmacy Medicines Management Project Evaluation Team.The costs of a community pharmacist-led medicinesmanagement service for patients with coronary heart disease(CHD) in England. Pharmacoeconomics. 2007; 25: 397-411.

Scotland, G.S., McNamee, P. and Bhattacharya, S. Is electivesingle embryo transfer a cost-effective alternative to doubleembryo transfer. British Journal of Obstetrics andGynaecology, 2007, vol 114, 5-7.

Scotland, G.S., McNamee, P., Peddie, V. and Bhattacharya,S. Safety versus success in elective single embryo transfer:women’s preferences for outcomes of in vitro fertilisation.British Journal of Obstetrics and Gynaecology, 2007, vol114(8) 977-983.

Scotland, G.S., McNamee, P., Philip, S., Fleming, A.D.,Goatman, K.A., Prescott, G.J., Fonseca, S., Sharp, P.F. andOlson, J.A. Cost-effectiveness of implementing automatedgrading within the national screening programme for diabeticretinopathy in Scotland. British Journal of Ophthalmology,2007 vol 91, 1518-1523.

Smith, M.D. Invariance theorems for Fisher Information.Communications in Statistics - Theory and Methods, 2007,vol 36, 2213-2222.

Sullivan, F., Swan, I., Donnan, P., Morrison, J., Smith, B.,McKinstry, B., Davenport, R., Vale, L., Clarkson, J.,Hammersley, V., Hayavi, S., McAteer, A., Stewart, K., Daly,F. Early Treatment with Prednisolone or Acyclovir and Recoveryin Bell’s Palsy. New England Journal of Medicine. 2007,357:1598-1607.

Sutton, M., Ikenwilo, D., Skåtun, D. Evaluation of theintroduction of a pay for performance contract for UK familydoctors using participant perceptions. HEDGE Working PapersWP 07/20, 2007.

Tinelli, M., Ryan, M. and Bond, C. Abstract - Economicevaluation advancement in pharmacy: Discrete choiceexperiments (DCEs). Supplement to the International Journalof Pharmacy Practice 2007, vol 15, A12.

Vale, L., Thomas, R., MacLennan, G. and Grimshaw, J.Systematic review of economic evaluations and cost analysesof guideline implementation strategies. European Journal ofHealth Economics, 2007 vol 8, 111-121.

Watson, V. and Ryan, M. Exploring preference anomalies indouble bounded contingent valuation studies. Journal ofHealth Economics, 2007 26(3): 463-482.

Waugh, N., Scotland, G., McNamee, P., Gillett, M., Brennan,A., Goyder, E. et al. Screening for Type 2 diabetes: literaturereview and economic modelling. Health TechnologyAssessment, 2007, vol 11 (17), 1-140.



The increased role of the pharmacists in the management of drug therapy in primary care: consumers’ andproviders’ preferences

Investigators: M Tinelli, (HERU) C Bond (Department of General Practice & Primary Care, University of Aberdeen) andM Ryan (HERU)

The aim of this study was to investigate patients’ preferences for an innovative prescribing role for pharmacists in themanagement of drug therapies, compared to the more traditional dispensing only role. It was carried out at two GP practicesin Aberdeen, Scotland. A structured self-completed Discrete Choice Experiment (DCE) questionnaire was administered to aconvenience sample of patients aged > 18 years waiting to see their doctor at the surgery. Respondents compared the proposedinnovative service to both their ‘current situation’ and an ‘alternative dispensing only pharmacist’ scenario. Three differentgroups were compared: all respondents; subjects without constant preferences; subjects with constant preferences. 244 peoplewere approached and 204 returned an invaluable questionnaire. Everything else being equal, respondents preferred their‘current situation’ to either the proposed ‘prescribing or dispensing’ role, or an ‘alternative dispensing only’ service. Theywere, for example, willing to pay over £23 for moving from ‘low chance’ to ‘high chance’ of appropriate treatment. Respondentswithout constant preferences preferred the innovative service to either of the other options and they were prepared to pay£30 for the same movement. The older non traders preferred their current service to any other alternative. They reported awillingness to pay of £5.57. Overall, patients’ value input from their pharmacists, but are resistant to change, with evidenceof preferences for the current situation. Younger people, who are willing to trade between alternatives, preferred the innovative‘prescribing and dispensing’ service. Results from the present study show that changes in the pharmaceutical service couldbe supported by the public. The DCE approach is confirmed as being a useful tool in valuing preferences for pharmacy services.

Source of funding and total awarded: ESRC, £8,875 **



52 50

Forthcoming Journal Articles

Battu, H., Ma, A., Phimister, E., Housing tenure, job mobilityand unemployment in the UK. Economic Journal. Forthcoming.

Bissell, P., Blenkinsopp, A., Short, D. and Mason, L., on behalfof the Community Pharmacy Medicines Management EvaluationTeam (including Jaffray, M., Bond, C.M., Watson, M.C.,Hannaford, P., Tinelli, M., Scott, A., Lee, A., Anderson, C.,Avery, A. and Krksa, J.). Patients’ views and experiences ofa medicines management service. Health and Social Care inthe Community. Forthcoming.

Cameron, I., Matheson, C., Bond, C., McNamee, P., Lawrie,T., Robinson, A., Robertson, A. and Eagles, L. Pilot randomisedcontrolled trial of community pharmacy administration ofbuprenorphine versus methadone. International Journal ofPharmacy Practice. Forthcoming.

de Verteuil, R., Imamura, M., Zhu, S., Glazener, C., Fraser,C., Munro, N., Hutchison, J., Grant, A., Coyle, D., Coyle, K.and Vale, L. Systematic review of the clinical effectivenessand cost-effectiveness and economic modelling of minimalincision total hip replacement approaches in the managementof arthritic disease of the hip. Health Technology Assessment.Forthcoming.

Ensor, T., Nadjib, M., Quayyum, Z., Megraini, A. Publicfunding for community based skilled delivery care in Indonesia– to what extent are the poor benefited European Journalof Health Economics. Forthcoming.

Gravelle H, Morris S, Sutton M. Are family physicians goodfor you? Health service Research. Forthcoming.

Hernandez, R., Rabindranath, K., Fraser, C., Vale, L., Azuara-Blanco, A. and Burr, J. Screening for open angle glaucoma:systematic review of cost-effectiveness studies. Journal ofGlaucoma. Forthcoming.

Islam, K., Gerdtham, U.G., Gullberg, B., Lindström, M. andMerlo, J. Social Capital Externalities and Mortality in SwedishMunicipalities. Economics of Human Biology. Forthcoming.

Jarl, J., Eriksson, M., Gerdtham, U.G., Hemström, Ö. andRoom, R. More detailed data does not always raise the costs.Experience from a Swedish cost of alcohol study. ContemporaryDrug Problems. Forthcoming.

Jarl, J., Johansson, P., Eriksson, A., Eriksson, M., Gerdtham,U.G., Hemström, Ö., Hradilova Selin, K., Lenke, L., Ramstedt,M. and Room, R. The Societal Costs of Alcohol Consumption:An estimation of the economic and human cost in Sweden,2002. European Journal of Health Economics. Forthcoming.

Jaffray, M., Krksa, J. and Bond, C., on behalf of the CommunityPharmacy Medicines Management Team (Watson, M.C.,Hannaford, P., Tinelli, M., Scott, A., Lee, A., Blenkinsopp,A., Anderson, C., Avery, A., Bissell, P.). The MEDMAN project:Evaluation of the medicines management training forcommunity pharmacists. Pharmacy Education. Forthcoming.

Krska, J., and Avery, A.J., on behalf of the CommunityPharmacy Medicines Management Team (Bond, C., Hannaford,P., Watson, M.C., Jaffray, M., Tinelli, M., Scott, A., Lee, A.,Blenkinsopp, A., Anderson, C. and Bissell, P.). Evaluation ofmedication reviews conducted by community pharmacists:a quantitative analysis of documented issues andrecommendations. British Journal of Clinical Pharmacology.Forthcoming.

Lourenco, T., Murray, A., Grant, A., McKinley, A., Krukowski,Z. and Vale, L. Laparoscopic surgery for colorectal cancer:safe and effective? – A systematic review, Surgical Endoscopy.Forthcoming.

Lourenco, T., Armstrong, N., Nabi, G., Deverill, M., Pickard,P., Vale, L., MacLennan, G., Fraser, F., McClinton, S., Wong,S., Coutts, A., Mowatt, M., Grant, A. and N’Dow, J. Systematicreview and economic modelling of effectiveness and costutility of surgical treatments for men with benign prostaticenlargement (BPE). Health Technology Assessment.Forthcoming.

Matheson, C., Bond, C. and Tinelli, M. Community Pharmacistsand Drug Misusers: A National Scottish Survey of Attitudesand Practice. Journal of Public Health. Forthcoming.

McLean, G., Sutton, M. and Guthrie, B. Differences in thequality of primary medical care services by remoteness fromurban settlements. Quality and Safety in Health Care.Forthcoming.

McNamee, P. and Seymour, J. Individualizing palliativetreatment for inoperable oesophageal cancer: incorporatingpatients’ preferences regarding the treatment process withinthe QALY framework. Medical Decision Making. Forthcoming.

Mowatt, G., Houston, G., Hernández, R., de Verteuil, R.,Fraser, C., Cuthbertson, B. and Vale, L. Systematic reviewof the clinical effectiveness and cost-effectiveness ofoesophageal Doppler monitoring in critically ill and high risksurgical patients. Health Technology Assessment. Forthcoming.

Pol, van der M. and Ruggeri, M. Is risk attitude outcomespecific within the health domain? Journal of HealthEconomics. Forthcoming.

Rabindranath, K.S., Ali, T.Z., MacLeod, A.M., Vale, L., Cody,J., Wallace, S.A. and Daly, C. Automated vs continuousambulatory peritoneal dialysis: A systematic review ofrandomized controlled trial. The Cochrane Database ofSystematic Reviews. Forthcoming.

Regier, D.A., Marra, C.A. and Lynd, L. A systematic reviewof economic evaluations of anticoagulants for the prophylaxisof venous thromboemoblism following major trauma. ExpertReview of Pharmacoeconomics and Outcomes Research.Forthcoming.

Smith, M.D. Stochastic Frontier Models with Dependent ErrorComponents. The Econometrics Journal. Forthcoming.

Sullivan, F.M., Swan, I.R.C., Donnan, P.T., Morrison, J.M.,Smith, B.H., McKinstry, B., Davenport, R.J., Vale, L., Clarkson,J.E., Hammersley, V., Hayavi, S., McAteer, A., Stewart, K.and Daly, F. Early Treatment with Prednisolone or Acyclovirand Recovery in Bell’s Palsy. New England Journal of Medicine.Forthcoming.


APPENDIX 2

Peer Review Journal Articles

Andrews, P., Avenell, A., Noble, D., Campbell, M., Battison,C., Croal, B., Simpson, W., Norrie, J., Vale, L., Cook, J., deVerteuil, R., Milne, A. Randomised trial of glutamine andselenium supplemented parenteral nutrition for critically illpatients. Protocol Version 9, 19 February 2007. Known asSIGNET (Scottish Intensive care Glutamine or seleNiumEvaluative Trial) Trials 2007. 8:25 (20 Sep 2007),http://www.trialsjournal.com/content/8/1/25.

Anton, S., McKee, L., Harrison, S. and Farrar, S. Involvingthe public in NHS service planning: criteria and methods forevaluating NHS Boards’ Activity. Journal of Health Organizationand Management, 2007 vol 21(4/5), 470-483.

Avenell, A., Campbell, M., Cook, J., Milne, A., Ramsay, C.,Stephen, A., Hannaford, P., Kilonzo, M., Vale, L., McNeill,G. and Seymour, G. The key role of micronutrients. ClinicalNutrition, 2007, vol 26 (1) 159.

Bell, D., Elliott, R.F., Ma, A., Scott, A. and Roberts, E. ThePattern and evolution of Geographic Wage Differences in thePublic and Private Sector in Britain. The Manchester School,2007 vol 75(4), 386-421.

Black, C., de Verteuil, R., Walker, S., Ayres, J., Boland, A.,Bagust, A. and Waugh, N. Population screening for lung cancerusing CT, is there evidence of clinical effectiveness? Asystematic review of the literature. Thorax, 2007, Vol 62,131-138.

Burr, J., Kilonzo, M., Ryan, M. and Vale, L. Developing aPreference Based Glaucoma Utility Index using a DiscreteChoice Experiment. Optometry and Vision Science, 2007 vol84(8), 797-808.

Burr, J., Mowatt, G., Rehman Siddiqui, M., Hernandez, R.,Cook, J., Lourenco, T., Ramsay, C., Vale, L., Fraser, C.,Azura-Blanco, A., Deeks, J., Cairns, J., Wormold, R.,McPherson, S., Wright, D., Rabindranath, K. and Grant, A.The clinical and cost-effectiveness of screening for openangle glaucoma: a systematic review and economic model.Health Technology Assessment. 2007 vol 11(41).

Caldow, J., Bond, C., Ryan, M., Campbell, N., San Miguel,F., Kiger, A. and Lee, A. Treatment of Minor Illness in PrimaryCare: A National Survey of Patient Satisfaction, Attitudesand Preferences regarding a Wider Nursing Role. HealthExpectations, 2007, vol 10, 30-45.

Cheyne, H., Terry, R., Niven, C., Dowding, D., Hundley, V.and McNamee, P. Should I come in now? A study of women’searly labour experiences. British Midwifery Journal 2007,15(10): 604-625.

Cuthbertson, B., Rattray, J., Johnston, M., Wildsmith, J.A.,Wilson, E., Hernández, R., Ramsey, C., Hull, A.M., Norrie,J. and Campbell, M. Study protocol: A Pragmatic Randomised,Controlled Trial of Intensive Care follow up programmes inimproving Longer-term outcomes from critical illness. ThePRACTICAL study. BMC Health Services Research 2007, vol7, 116.

de Verteuil, R., Hernández, R. and Vale, L., on behalf ofAberdeen HTA Group. Economic evaluation of laparoscopicsurgery for colorectal cancer. International Journal ofTechnology Assessment in Health Care. 2007 Vol 23 (4), 464-472.

Elliot, R.F., Mavromaras, K. and Meurs, D. Special Issue onPublic Sector Wage Structures and Regional Competitiveness:Editors’ Introduction. The Manchester School, 2007 Vol 75(4)373-385.

Elliott, R.F., Ma, A., Scott, A., Bell, D. and Roberts, E.Geographically Differentiated Pay in the Labour Market forNurses. Journal of Health Economics, 2007 vol 26(1), 191-212.

French, F., Ikenwilo, D. and Scott, A. What influences thejob satisfaction of hospital doctors? Health ServicesManagement Research, 2007, vol 20, 153.

Gravelle, H., Sutton, M. and Ma, A. Doctor behaviour undera pay for performance contract: evidence from the Qualityand Outcomes Framework. Centre for Health EconomicsResearch Paper 28. University of York. 2007.

Hanlon, P., Lawder, R., Elders, A., Clark, D., Walsh, B. andSutton M. An analysis of the link between behaviouralbiological and social risk factors and subsequent hospitaladmissions in Scotland. Journal of Public Health, 2007;29:405-412.

Hernandez, R., Vale L. The value of myocardial perfusionscintigraphy in the diagnosis and management of angina andmyocardial infraction: a probalistic economic analysis. MedicalDecision Making 2007; 27:772-788.

Ikenwilo, D. and Scott, A. The effect of pay and jobsatisfaction on the labour supply of hospital consultants.Health Economics. 2007; 16:1303-1318.

Ikenwilo, D., French, F and Scott, A. What influences thejob satisfaction of hospital doctors? Health ServicesManagement 2007; 20:153-161.

Jaffray, M., Bond, C.M., Watson, M.C., Hannaford, P., Tinelli,M., Scott, A., Lee, A., Blenkinsopp, A., Anderson, C., Avery,A., Bissell, P. and Krksa, J. The Community Pharmacy MedicinesManagement Project Evaluation Team. Community Pharmacy-led Medicines Management: A randomised controlled trial inpatients with CHD. Family Practice. 2007, vol 24, 189-200.

Jarl, J., Gerdtham, U.G., Lyttkens, C.H., Lithman, T. andMerlo, J. Är Danmark en svensk hälsorisk? En analys avalkoholrelaterad slutenvård i Skåne (Is Denmark a SwedishHealth Risk? An Analysis of Alcohol-Related Hospitalizationsin Southern Sweden). Läkartidningen Nr 23, 2007 vol 104.

Kilonzo, M., Vale, L., Cook, J., Milne, A., Stephen, A.,Avenell, A. and the MAVIS Trial Group. A cost-utility analysisof multivitamin and multimineral supplements in men andwomen aged 65 years and over. Clinical Nutrition, 2007, vol26, 364–370.


APPENDIX 2


5149


APPENDIX 2

McCormack, K., Rabindranath, K., Kilonzo, M., Vale, L.,Fraser, C., McIntyre, L., Thomas, S., Rothnie, H., Fluck, N.,Gould, I. and Waugh, N.Systematic review of the effectivenessof preventing and treating Staphylococcus aureus carriageon peritoneal catheter-related infections. Health TechnologyAssessment, 2007 vol 11(23).

McLean, G., Guthrie, B. and Sutton, M. Differences in thequality of primary medical care services by remoteness fromurban settlements. Quality and Safety in Health Care, 2007;16:446-449.

McLean, G., Guthrie, B. and Sutton, M. Differences in thequality of primary medical care for CVD and Diabetes acrossthe NHS: evidence from the Quality and Outcomes Framework.BMC Health Services Research, 2007 vol 7, 74.

McNamee, P. What difference does it make?: The calculationof QALY gains from health profiles using patient and generalpopulation values. Health Policy, 2007 vol 84, 321-331.

McNeill, G., Avenell, A., Campbell, M.K., Cook, J.A.,Hannaford, P.C., Kilonzo, M., Milne, A.C., Ramsay, C.R.,Seymour, D.G., Stephen A.I. and Vale, L. Effect of multivitaminand multimineral supplementation on cognitive function inmen and women aged 65 years and over: a randomisedcontrolled trial. Biomed Central Nutrition Journal, 2007, vol6, 10.

Philip, S., Fleming, A.D., Goatman, K.A., Fonseca, S.,McNamee, P., Scotland, G.S., Prescott, G.J., Sharp, P.F.and Olson, J.A. The efficacy of automated “disease/nodisease” grading for diabetic retinopathy in a systematicscreening programme. British Journal of Ophthalmology,2007 vol 91, 1512-1517.

Pitchforth, E., Watson, V., Tucker, J., Ryan, M., vanTeijlingen, E., Farmer, J., Ireland, J., Martin, E., Kiger, A.and Bryers, H. Models of intrapartum care and women’strade-offs in remote and rural Scotland: a mixed-methodsstudy. British Journal of Obstetrics and Gynaecology. OnlineEarly Articles Published article online: 28-Sep-2007 doi:10.1111/j.1471-0528.2007.01516.x.

Pol, van der M. and Shiell, A. Extrinsic goals and Time TradeOff. Medical Decision Making, 2007 vol 27, 406-413.

Prescott, R., Kunkler, I., Williams, L., King, C., Jack, W.,Dixon, J., Pol, van der M., Goh, T., Lindley, R. and Cairns,J. A randomised controlled trial of postoperative radiotherapyfollowing breast-conserving surgery in a minimum-risk olderpopulation (The PRIME trial). Health Technology Assessment,2007 vol 11(31).

Rabindradranath, K., Ali, T.Z., MacLeod, A.M. and Vale, L.Automated vs continuous ambulatory peritoneal dialysis: Asystematic review of randomized controlled trial. NephrologyDialysis and Transplantation. 2007; 22: 2991–2998

Regier, D.A., Bansback, N., Dar Santos, N. and Marra, C.A.Cost-effectiveness of tumour necrosis factor-a in rheumatoidarthritis, psoriatic arthritis, and ankylosing spondylitis. ExpertReview of Pharmacoeconomics and Outcomes Research, 2007vol 7(2), 155-165.

Regier, D.A., Marra, C.A. and Lynd, L. A systematic reviewof economic evaluations of anticoagulants for the prophylaxisof venous thromboemoblism following major trauma. ExpertReview of Pharmacoeconomics and Outcomes Research. 2007;7(4):403-413.

Regier, D.A. and Marra, C.A. Self-managed anticoagulationtherapy. CMAJ, 2007 vol 176(6), 813.

Scott, T., Tinelli, M. and Bond, C. on behalf of the CommunityPharmacy Medicines Management Project Evaluation Team.The costs of a community pharmacist-led medicinesmanagement service for patients with coronary heart disease(CHD) in England. Pharmacoeconomics. 2007; 25: 397-411.

Scotland, G.S., McNamee, P. and Bhattacharya, S. Is electivesingle embryo transfer a cost-effective alternative to doubleembryo transfer. British Journal of Obstetrics andGynaecology, 2007, vol 114, 5-7.

Scotland, G.S., McNamee, P., Peddie, V. and Bhattacharya,S. Safety versus success in elective single embryo transfer:women’s preferences for outcomes of in vitro fertilisation.British Journal of Obstetrics and Gynaecology, 2007, vol114(8) 977-983.

Scotland, G.S., McNamee, P., Philip, S., Fleming, A.D.,Goatman, K.A., Prescott, G.J., Fonseca, S., Sharp, P.F. andOlson, J.A. Cost-effectiveness of implementing automatedgrading within the national screening programme for diabeticretinopathy in Scotland. British Journal of Ophthalmology,2007 vol 91, 1518-1523.

Smith, M.D. Invariance theorems for Fisher Information.Communications in Statistics - Theory and Methods, 2007,vol 36, 2213-2222.

Sullivan, F., Swan, I., Donnan, P., Morrison, J., Smith, B.,McKinstry, B., Davenport, R., Vale, L., Clarkson, J.,Hammersley, V., Hayavi, S., McAteer, A., Stewart, K., Daly,F. Early Treatment with Prednisolone or Acyclovir and Recoveryin Bell’s Palsy. New England Journal of Medicine. 2007,357:1598-1607.

Sutton, M., Ikenwilo, D., Skåtun, D. Evaluation of theintroduction of a pay for performance contract for UK familydoctors using participant perceptions. HEDGE Working PapersWP 07/20, 2007.

Tinelli, M., Ryan, M. and Bond, C. Abstract - Economicevaluation advancement in pharmacy: Discrete choiceexperiments (DCEs). Supplement to the International Journalof Pharmacy Practice 2007, vol 15, A12.

Vale, L., Thomas, R., MacLennan, G. and Grimshaw, J.Systematic review of economic evaluations and cost analysesof guideline implementation strategies. European Journal ofHealth Economics, 2007 vol 8, 111-121.

Watson, V. and Ryan, M. Exploring preference anomalies indouble bounded contingent valuation studies. Journal ofHealth Economics, 2007 26(3): 463-482.

Waugh, N., Scotland, G., McNamee, P., Gillett, M., Brennan,A., Goyder, E. et al. Screening for Type 2 diabetes: literaturereview and economic modelling. Health TechnologyAssessment, 2007, vol 11 (17), 1-140.



The increased role of the pharmacists in the management of drug therapy in primary care: consumers’ andproviders’ preferences

Investigators: M Tinelli, (HERU) C Bond (Department of General Practice & Primary Care, University of Aberdeen) andM Ryan (HERU)

The aim of this study was to investigate patients’ preferences for an innovative prescribing role for pharmacists in themanagement of drug therapies, compared to the more traditional dispensing only role. It was carried out at two GP practicesin Aberdeen, Scotland. A structured self-completed Discrete Choice Experiment (DCE) questionnaire was administered to aconvenience sample of patients aged > 18 years waiting to see their doctor at the surgery. Respondents compared the proposedinnovative service to both their ‘current situation’ and an ‘alternative dispensing only pharmacist’ scenario. Three differentgroups were compared: all respondents; subjects without constant preferences; subjects with constant preferences. 244 peoplewere approached and 204 returned an invaluable questionnaire. Everything else being equal, respondents preferred their‘current situation’ to either the proposed ‘prescribing or dispensing’ role, or an ‘alternative dispensing only’ service. Theywere, for example, willing to pay over £23 for moving from ‘low chance’ to ‘high chance’ of appropriate treatment. Respondentswithout constant preferences preferred the innovative service to either of the other options and they were prepared to pay£30 for the same movement. The older non traders preferred their current service to any other alternative. They reported awillingness to pay of £5.57. Overall, patients’ value input from their pharmacists, but are resistant to change, with evidenceof preferences for the current situation. Younger people, who are willing to trade between alternatives, preferred the innovative‘prescribing and dispensing’ service. Results from the present study show that changes in the pharmaceutical service couldbe supported by the public. The DCE approach is confirmed as being a useful tool in valuing preferences for pharmacy services.

Source of funding and total awarded: ESRC, £8,875 **



52 50


Battu, H., Ma, A., Phimister, E., Housing tenure, job mobilityand unemployment in the UK. Economic Journal. Forthcoming.

Bissell, P., Blenkinsopp, A., Short, D. and Mason, L., on behalfof the Community Pharmacy Medicines Management EvaluationTeam (including Jaffray, M., Bond, C.M., Watson, M.C.,Hannaford, P., Tinelli, M., Scott, A., Lee, A., Anderson, C.,Avery, A. and Krksa, J.). Patients’ views and experiences ofa medicines management service. Health and Social Care inthe Community. Forthcoming.


de Verteuil, R., Imamura, M., Zhu, S., Glazener, C., Fraser,C., Munro, N., Hutchison, J., Grant, A., Coyle, D., Coyle, K.and Vale, L. Systematic review of the clinical effectivenessand cost-effectiveness and economic modelling of minimalincision total hip replacement approaches in the managementof arthritic disease of the hip. Health Technology Assessment.Forthcoming.

Ensor, T., Nadjib, M., Quayyum, Z., Megraini, A. Publicfunding for community based skilled delivery care in Indonesia– to what extent are the poor benefited European Journalof Health Economics. Forthcoming.

Gravelle H, Morris S, Sutton M. Are family physicians goodfor you? Health service Research. Forthcoming.

Hernandez, R., Rabindranath, K., Fraser, C., Vale, L., Azuara-Blanco, A. and Burr, J. Screening for open angle glaucoma:systematic review of cost-effectiveness studies. Journal ofGlaucoma. Forthcoming.

Islam, K., Gerdtham, U.G., Gullberg, B., Lindström, M. andMerlo, J. Social Capital Externalities and Mortality in SwedishMunicipalities. Economics of Human Biology. Forthcoming.

Jarl, J., Eriksson, M., Gerdtham, U.G., Hemström, Ö. andRoom, R. More detailed data does not always raise the costs.Experience from a Swedish cost of alcohol study. ContemporaryDrug Problems. Forthcoming.

Jarl, J., Johansson, P., Eriksson, A., Eriksson, M., Gerdtham,U.G., Hemström, Ö., Hradilova Selin, K., Lenke, L., Ramstedt,M. and Room, R. The Societal Costs of Alcohol Consumption:An estimation of the economic and human cost in Sweden,2002. European Journal of Health Economics. Forthcoming.

Jaffray, M., Krksa, J. and Bond, C., on behalf of the CommunityPharmacy Medicines Management Team (Watson, M.C.,Hannaford, P., Tinelli, M., Scott, A., Lee, A., Blenkinsopp,A., Anderson, C., Avery, A., Bissell, P.). The MEDMAN project:Evaluation of the medicines management training forcommunity pharmacists. Pharmacy Education. Forthcoming.

Krska, J., and Avery, A.J., on behalf of the CommunityPharmacy Medicines Management Team (Bond, C., Hannaford,P., Watson, M.C., Jaffray, M., Tinelli, M., Scott, A., Lee, A.,Blenkinsopp, A., Anderson, C. and Bissell, P.). Evaluation ofmedication reviews conducted by community pharmacists:a quantitative analysis of documented issues andrecommendations. British Journal of Clinical Pharmacology.Forthcoming.

Lourenco, T., Murray, A., Grant, A., McKinley, A., Krukowski,Z. and Vale, L. Laparoscopic surgery for colorectal cancer:safe and effective? – A systematic review, Surgical Endoscopy.Forthcoming.

Lourenco, T., Armstrong, N., Nabi, G., Deverill, M., Pickard,P., Vale, L., MacLennan, G., Fraser, F., McClinton, S., Wong,S., Coutts, A., Mowatt, M., Grant, A. and N’Dow, J. Systematicreview and economic modelling of effectiveness and costutility of surgical treatments for men with benign prostaticenlargement (BPE). Health Technology Assessment.Forthcoming.

Matheson, C., Bond, C. and Tinelli, M. Community Pharmacistsand Drug Misusers: A National Scottish Survey of Attitudesand Practice. Journal of Public Health. Forthcoming.

McLean, G., Sutton, M. and Guthrie, B. Differences in thequality of primary medical care services by remoteness fromurban settlements. Quality and Safety in Health Care.Forthcoming.

McNamee, P. and Seymour, J. Individualizing palliativetreatment for inoperable oesophageal cancer: incorporatingpatients’ preferences regarding the treatment process withinthe QALY framework. Medical Decision Making. Forthcoming.

Mowatt, G., Houston, G., Hernández, R., de Verteuil, R.,Fraser, C., Cuthbertson, B. and Vale, L. Systematic reviewof the clinical effectiveness and cost-effectiveness ofoesophageal Doppler monitoring in critically ill and high risksurgical patients. Health Technology Assessment. Forthcoming.

Pol, van der M. and Ruggeri, M. Is risk attitude outcomespecific within the health domain? Journal of HealthEconomics. Forthcoming.


Regier, D.A., Marra, C.A. and Lynd, L. A systematic reviewof economic evaluations of anticoagulants for the prophylaxisof venous thromboemoblism following major trauma. ExpertReview of Pharmacoeconomics and Outcomes Research.Forthcoming.

Smith, M.D. Stochastic Frontier Models with Dependent ErrorComponents. The Econometrics Journal. Forthcoming.

Sullivan, F.M., Swan, I.R.C., Donnan, P.T., Morrison, J.M.,Smith, B.H., McKinstry, B., Davenport, R.J., Vale, L., Clarkson,J.E., Hammersley, V., Hayavi, S., McAteer, A., Stewart, K.and Daly, F. Early Treatment with Prednisolone or Acyclovirand Recovery in Bell’s Palsy. New England Journal of Medicine.Forthcoming.


APPENDIX 2


Andrews, P., Avenell, A., Noble, D., Campbell, M., Battison,C., Croal, B., Simpson, W., Norrie, J., Vale, L., Cook, J., deVerteuil, R., Milne, A. Randomised trial of glutamine andselenium supplemented parenteral nutrition for critically illpatients. Protocol Version 9, 19 February 2007. Known asSIGNET (Scottish Intensive care Glutamine or seleNiumEvaluative Trial) Trials 2007. 8:25 (20 Sep 2007),http://www.trialsjournal.com/content/8/1/25.

Anton, S., McKee, L., Harrison, S. and Farrar, S. Involvingthe public in NHS service planning: criteria and methods forevaluating NHS Boards’ Activity. Journal of Health Organizationand Management, 2007 vol 21(4/5), 470-483.

Avenell, A., Campbell, M., Cook, J., Milne, A., Ramsay, C.,Stephen, A., Hannaford, P., Kilonzo, M., Vale, L., McNeill,G. and Seymour, G. The key role of micronutrients. ClinicalNutrition, 2007, vol 26 (1) 159.

Bell, D., Elliott, R.F., Ma, A., Scott, A. and Roberts, E. ThePattern and evolution of Geographic Wage Differences in thePublic and Private Sector in Britain. The Manchester School,2007 vol 75(4), 386-421.

Black, C., de Verteuil, R., Walker, S., Ayres, J., Boland, A.,Bagust, A. and Waugh, N. Population screening for lung cancerusing CT, is there evidence of clinical effectiveness? Asystematic review of the literature. Thorax, 2007, Vol 62,131-138.

Burr, J., Kilonzo, M., Ryan, M. and Vale, L. Developing aPreference Based Glaucoma Utility Index using a DiscreteChoice Experiment. Optometry and Vision Science, 2007 vol84(8), 797-808.

Burr, J., Mowatt, G., Rehman Siddiqui, M., Hernandez, R.,Cook, J., Lourenco, T., Ramsay, C., Vale, L., Fraser, C.,Azura-Blanco, A., Deeks, J., Cairns, J., Wormold, R.,McPherson, S., Wright, D., Rabindranath, K. and Grant, A.The clinical and cost-effectiveness of screening for openangle glaucoma: a systematic review and economic model.Health Technology Assessment. 2007 vol 11(41).

Caldow, J., Bond, C., Ryan, M., Campbell, N., San Miguel,F., Kiger, A. and Lee, A. Treatment of Minor Illness in PrimaryCare: A National Survey of Patient Satisfaction, Attitudesand Preferences regarding a Wider Nursing Role. HealthExpectations, 2007, vol 10, 30-45.

Cheyne, H., Terry, R., Niven, C., Dowding, D., Hundley, V.and McNamee, P. Should I come in now? A study of women’searly labour experiences. British Midwifery Journal 2007,15(10): 604-625.

Cuthbertson, B., Rattray, J., Johnston, M., Wildsmith, J.A.,Wilson, E., Hernández, R., Ramsey, C., Hull, A.M., Norrie,J. and Campbell, M. Study protocol: A Pragmatic Randomised,Controlled Trial of Intensive Care follow up programmes inimproving Longer-term outcomes from critical illness. ThePRACTICAL study. BMC Health Services Research 2007, vol7, 116.

de Verteuil, R., Hernández, R. and Vale, L., on behalf ofAberdeen HTA Group. Economic evaluation of laparoscopicsurgery for colorectal cancer. International Journal ofTechnology Assessment in Health Care. 2007 Vol 23 (4), 464-472.

Elliot, R.F., Mavromaras, K. and Meurs, D. Special Issue onPublic Sector Wage Structures and Regional Competitiveness:Editors’ Introduction. The Manchester School, 2007 Vol 75(4)373-385.

Elliott, R.F., Ma, A., Scott, A., Bell, D. and Roberts, E.Geographically Differentiated Pay in the Labour Market forNurses. Journal of Health Economics, 2007 vol 26(1), 191-212.

French, F., Ikenwilo, D. and Scott, A. What influences thejob satisfaction of hospital doctors? Health ServicesManagement Research, 2007, vol 20, 153.

Gravelle, H., Sutton, M. and Ma, A. Doctor behaviour undera pay for performance contract: evidence from the Qualityand Outcomes Framework. Centre for Health EconomicsResearch Paper 28. University of York. 2007.

Hanlon, P., Lawder, R., Elders, A., Clark, D., Walsh, B. andSutton M. An analysis of the link between behaviouralbiological and social risk factors and subsequent hospitaladmissions in Scotland. Journal of Public Health, 2007;29:405-412.

Hernandez, R., Vale L. The value of myocardial perfusionscintigraphy in the diagnosis and management of angina andmyocardial infraction: a probalistic economic analysis. MedicalDecision Making 2007; 27:772-788.

Ikenwilo, D. and Scott, A. The effect of pay and jobsatisfaction on the labour supply of hospital consultants.Health Economics. 2007; 16:1303-1318.

Ikenwilo, D., French, F and Scott, A. What influences thejob satisfaction of hospital doctors? Health ServicesManagement 2007; 20:153-161.

Jaffray, M., Bond, C.M., Watson, M.C., Hannaford, P., Tinelli,M., Scott, A., Lee, A., Blenkinsopp, A., Anderson, C., Avery,A., Bissell, P. and Krksa, J. The Community Pharmacy MedicinesManagement Project Evaluation Team. Community Pharmacy-led Medicines Management: A randomised controlled trial inpatients with CHD. Family Practice. 2007, vol 24, 189-200.

Jarl, J., Gerdtham, U.G., Lyttkens, C.H., Lithman, T. andMerlo, J. Är Danmark en svensk hälsorisk? En analys avalkoholrelaterad slutenvård i Skåne (Is Denmark a SwedishHealth Risk? An Analysis of Alcohol-Related Hospitalizationsin Southern Sweden). Läkartidningen Nr 23, 2007 vol 104.

Kilonzo, M., Vale, L., Cook, J., Milne, A., Stephen, A.,Avenell, A. and the MAVIS Trial Group. A cost-utility analysisof multivitamin and multimineral supplements in men andwomen aged 65 years and over. Clinical Nutrition, 2007, vol26, 364–370.


APPENDIX 2



APPENDIX 2

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Sullivan, F., Swan, I.R.C., Donnan, P., Morrison, J.M., Smith,B.H., McKinstry, B., Davenport, R.J., Vale, L., Clarkson, J.E.,Hernández, R., Stewart, K., Hammersley, V., Hayavi, S.,McAteer, A., Gray, D. and Daly, F. BELLS trial: Bell’s palsy:Early acycLovir or prednisoLone in Scotland. Health TechnologyAssessment. Forthcoming.

The REFLUX Trial Group (Vale, L., a member of the writingcommittee). The place of minimal access surgery amongstpeople with gastro-oesophageal reflux disease – a UKcollaborative study. The REFLUX Trial. Health TechnologyAssessment. Forthcoming.

Tinelli, M., Bond, C., Blenkinsopp, A., Jaffray, M., Watson,M. and Hannaford, P. on the behalf of the CommunityPharmacy Medicines Management Evaluation Team (includingJaffray, M., Bond, C.M., Watson, M.C., Hannaford, P., Tinelli,M., Scott, A., Lee, A., Blenkinsopp, A., Anderson, C., Avery,A., Bissell, P. and Krksa, J.). Patients’ experiences with acommunity pharmacy medications management service: focuson attitudes, expectations and satisfaction. Annals ofPharmacotherapy. Forthcoming.

Books and Book Chapters

Dancer, D., Morrison, K. and Smith, M.D. Measuring theimpact of a peer assisted learning program on students’academic performance in econometrics. Proceedings of theForum on Quantitative Analysis of Teaching and Learning inHigher Education in Business, Economics and Commerce,University of Melbourne, 19-42, 2007.

Elliott, R.F. Local Pay. In: Rethinking Reward: the key issues.Corby, S. (ed) Chapter 5, Palgrave MacMillan, 2008Forthcoming.

Gerdtham, U.G. Hälsoekonomi: hur ekonomi kan bidra tillfolkhälsan (How can economics contribute to better health).Book chapter in Public Health as Multidisciplinary Research.Eds. Göran Ejlertsson and Ingemar Andersson. (In Swedish).

Ryan, M., Gerard, K., Amaya-Amaya, M.: Using DiscreteChoice Experiments to Value Health and Health Care. Springer.(Forthcoming).

Reports

Bailey, D., Sutton, M. and Anderson, M.J. Multivariate analysisof factors influencing workload on primary medical services.Report to the Scottish Executive, March 2007.

Bond C., King M., Lee A., McNamee P., Primrose W., HighesC. and Jaffray M. An evaluation of an adapted United Statesmodel of pharmaceutical care to improve psychoactiveprescribing in care home residents in Scotland. CSO FinalReport. October 2007

Cheyne, H., Hundley, V., Dowding, D., Niven, C., Greer, I.,Bland, J.M., Aucott, L. and McNamee, P. A cluster randomisedtrial to investigate the use of a decision aid for the diagnosisof active labour in term pregnancy (The Early Labour Studyin Scotland). CSO Final Report. July 2007.

Cooper, K.G., Campbell, M.K., Cook, J.A., Kilonzo, M., Vale,L. and Sambrook, A. Microwave Endometrial Ablation andThermal Balloon Endometrial Ablation. Focus on Research2007.

Cooper, K.G., Sambrook, A., Campbell, M.K., Cook, J.A.,Kilonzo, M., and Vale, L. The Endometrial Ablation Study:A randomised comparison of treatment in the postmenstrualphase: Clinical outcomes, patient acceptability and cost.Report submitted to the Chief Scientist Office of the ScottishExecutive Health Department, April 2007.

Dibben, C., Atherton, I., Cox, M., Watson, V., Ryan, M. andSutton, M. Investigating the impact of changing weights thatunderpin the Index of Multiple Deprivation 2004. Report tothe Department of Communities and Local Government.January 2007.

Donnan, P.T., Simpson, C., Guthrie, B., Tilley, C., McKinstry,B., Sutton, M., Fischbacher and Morrison, J. Developmentand Validation of an algorithm to predice emergency hospitaladmissions in Scotland. Report to the Chief Scientist OfficeOctober 2007.

Elder, R., Kirkpatrick, M., Ramsay, W., Macleod, M., Guthrie,B., Sutton, M. and Watt, G. Measuring quality in primarymedical services using data from SPICE. Report to NHS QualityImprovement Scotland. ISDScotland July 2007.

Farrar, S., Sussex, J., Yi, D., Chalkley, M., Scott, T., Sutton,M. and Yuen, P. Evaluation of Payment by Results. DraftFinal Report to the Department of Health, November 2007.

Hoddinott, P., Britten, J., Godden, D., Prescott, G., Ludbrook,A., Tappin, D. and McInnes, R. The BIG Trial: a randomisedcontrolled trial to evaluate the clinical and cost-effectivenessof breastfeeding support groups in improving breastfeedinginitiation, duration and satisfaction. Report submitted tothe Chief Scientist Office Scottish Executive HealthDepartment, (reference number CZH/4/156) November 2007.

Morris, S., Carr-hill, R., Dixon, P., Law, M., Rice, N., Sutton,M., Vallejo-Torres L. Combining the age related and additionalneed. 2007 review of the needs formula for hospital servicesand prescribing activity in England. Report submitted to theDepartment of Health November 2007.

Mowatt, G., Houston, G., Hernández, R., de Verteuil, R.,Fraser, C., Cuthbertson, B. and Vale, L. Systematic reviewof the clinical effectiveness and cost-effectiveness ofoesophageal Doppler monitoring in critically ill and high risksurgical patients. Report to NIHR HTA Programme on behalfof PASA/CEP. July-August 2007.

Osman, L.M., Ayres, .JG., Garden, C., Reglitz, K., Lyon, J.,Douglas, J.G., Kyle, G., Milne, K. and Ludbrook, A. Theeffect of energy efficiency improvement on health status ofCOPD patients. Report to the Eaga Charitable Trust November2007.

Shemilt, I., Byford, S., Drummond, M., Eisenstein, E., Knapp,M., Mallender, J., McDaid, D., Mugford, M., Vale, L., Walker,D. Incorporating Economics Evidence. In Higgins, J., Green,S., (eds.) Cochrane Handbook for Systematic Reviews ofInterventions. Chichester: Hohn Wiley & Sons. (In Press).

Invited Presentations

Elliott, R.F. Public Sector Pay and Devolution, Invitedpresentation to BMA “Review Body and Negotiating Event”,London. March 2007.

Ludbrook, A. Obesity – treatable condition or lifestyle choice?Northern Ireland Health Economics Group. Belfast, October2007.

Ludbrook, A. International evidence on the impact of smokefree legislation on the hospitality sector. Towards a smokefree society conference. Edinburgh September 2007.

Sutton, M. Measuring inequalities in health. Invitedpresentation at Measuring Health Inequalities Seminar,Edinburgh, January 2007.

Vale, L. Health Technology Assessment and opportunity costs.Cochrane Colloquium. San Paolo, Brazil. October 2007.

Vale L. Early Chronic Kidney Disease: Can we afford it? AnEconomists perspective. Invited presentation to the ConsensusConference on Early Chronic Kidney Disease. Royal Collegeof Physicians of Edinburgh, Edinburgh, February 2007.

Conference Presentations – Papers Available

Battu, H., Ma, A. and Phimister, E. Housing Tenure, JobMobility and Unemployment in the UK. Paper presented atthe Royal Economics Society, Warwick, April 2007.

Dancer, D., Rammohan, A. and Smith, M.D. Infant mortalityand child nutrition in Bangladesh. Sixteenth European Workshopon Econometrics and Health Economics, Bergen, Norway,September 2007.

de Verteuil, R., Hernandez, R. and Vale, L. Economicevaluation of laparoscopic surgery for colorectal cancer.Paper presentation at the Health Services Research NetworkConference, Sheffield, June 2007.

de Verteuil, R., Hernandez, R. and Vale, L. Economicevaluation of laparoscopic surgery for colorectal cancer.Paper presentation to the Operational Research ModellingConference, Edinburgh 2007.

Eberth, B., Morris, S. and Sutton, M. An empirical investigationinto the relationship between BMI and three types of physicalactivity. Paper presented at the Scottish Economic SocietyConference, Perth, April 2007.

Eberth, B., Morris, S. and Sutton, M. An empirical investigationinto the relationship between BMI and three types of physicalactivity. Paper presented at the SIRE Health and Wellbeingat Work Conference, University of Aberdeen, June 2007.

Elliott, R.F., Sutton, M., Ma, A., McConnachie, A., Morris,S., Rice, N. and Skåtun, D. Spatial wage variation and itsimpact on public sector recruitment and retention: the caseof the NHS. Paper presented at the Royal Economics Society,Warwick, April 2007.

Elliott, R.F., Sutton, M., Ma, A., McConnachie, A., Morris,S., Rice, N. and Skåtun, D. Spatial wage variation and itsimpact on public sector recruitment and retention: the caseof the NHS. Paper presented at the VML Earnings Workshop,ONS, London, October 2007.

Geue, C., Skåtun, D., Sutton, M., French, F., Ikenwilo, D.,Rooke, C. and Needham, G. Should I stay or should I go?Changes in the intentions of consultants to work beyondstatutory retirement age. Paper presented at the HealthEconomists’ Study Group (HESG), Brunel University, September2007.

Gravelle, H., Sutton, M. and Ma, A. Cheat or treat? Doctors’responses to payment based on self-reported treatment rates.Paper presented at the Royal Economics Society, Warwick,April 2007.

Gravelle, H., Sutton, M. and Ma, A. Cheat or treat? Doctors’responses to payment based on self-reported treatment rates.Paper presented at CMPO/University of York “EvaluatingHealth Policy: New Evidence from Administrative Data”,London, September 2007.

Hernández, R., Vale, L. and Burr, J.M. on behalf of the OAGScreening Project Group. Screening for Open Angle Glaucoma:Is it cost-effective? Oral presentation at the 2nd AnnualMeeting Health Services Research Network, Sheffield, June2007.

Hernández, R., Vale, L. and Burr, J.M. for the OAG ScreeningProject Group. Screening for Open Angle Glaucoma: Onemodel, two questions answered? Paper presentation at the4th Annual Meeting of Health Technology AssessmentInternational Society, Barcelona, Spain, June 2007.

Ikenwilo, D. A longitudinal data analysis of consultants’ jobsatisfaction. Paper presented at the Scottish Economic Society,Perth, April 2007.

Kilonzo, M., Ryan, M., Vale, L. and Burr, J. Discrete choiceexperiments and best worst scaling: compliments orsubstitutes? Paper presented at the Health Economists’ StudyGroup (HESG), Brunel University, September 2007.

Ludbrook A. The use of short-term health outcomes ineconomic evaluations of health improvement interventionsand implications for QALYs. Paper presented to the WelshAssembly Government Wanless Health Economics Group,Birmingham, February 2007.

Ma, A., Sutton, M., Skatun, D., Elliott, R.F., Rice, N.,McConnachie, A. and Morris, S. Spatial wage variation inpublic and private sectors in England and their effects onrecruitment and retention in NHS. Paper presented to theVML Quarterly Earnings Workshop, Office of National Statistics,London. October 2007.

Ma, A., Sutton, M., Skatun, D., Elliott, R.F., Rice, N.,McConnachie, A. and Morris, S. Spatial wage variation inthe public and private sectors and their impact on publicsector recruitment and retention the case of the UK NHS.Paper presented to the Work Pensions and Labour EconomicsStudy Group (WPSG), London. December 07.

HERU PRESENTATIONS 2007

APPENDIX 3


56 54

Ma, A., Sutton, M., Skatun, D., Elliott, R.F., Rice, N.,McConnachie, A. and Morris, S. NHS Recruitment and Retentionand Local Labour Market Conditions. Paper presented to theHealth and Wellbeing at Work Conference, Aberdeen, June2007.

McNamee, P., Ternent, L., Belemsaga, D., Gbangou, A. andNewlands, D. A game of two halves? Starting point bias withinthe bidding game method. Paper presented to the HealthEconomists Study Group Conference. Birmingham, January2007.

Morris, S., Elliott, R.F., Ma, A., McConnachie, A., Rice, N.,Skåtun, D. and Sutton, M. An investigation into private andNHS incomes earned by consultants in England. Paperpresented at the Health Economics Study Group, Birmingham,January 2007.

Pol, van der M, and Ruggeri, M. Is risk attitude in healthcontext specific? Paper presented at the 12th annualconference of the Italian Health Economics Association,Florence, October 2007.

Pol, van der M. Education, health and time preference.Paper presented to the Nordic Health Economists’ StudyGroup Meeting, Tartu, Estonia, August 2007.

Regier, D.A., Ryan, M. and Marra, C.A. The development ofan incremental willingness to pay curve derived from adiscrete choice experiment. Paper presented at the ISPOR10th Annual European Conference, Dublin, Ireland, October2007.

Regier, D.A., Ryan, M. and Phimister E. Hierarchical Bayesof Mixed Logit: an application to genetic testing. Paperpresented at the Health Economic Study Group, Brunel,September 2007.

Ryan, M. Analysis Issues in Discrete Choice Experiments withmultiple options. Presented to Welsh Health Economic StudyGroup. University of Cardiff, April 2007.

Ryan, M. Discrete Choice Experiments: what are they andwhat can they do for the Institute? Presented to Institute forSocial and Economic Research, University of Melbourne, March2007.

Ryan, M. Using Discrete Choice Experiments in Primary Care.Presented to Primary Care Research Unit, University ofMelbourne, March 2007.

Skåtun, D., Elliott, R., Ma, A., Sutton, M., Rice, N.,McConnachie, A. and Morris, S. NHS Recruitment and Retentionand Local Labour Market Conditions. Paper presented at theCMPO/OME conference “Issues in Public Sector Pay”, London,September 2007.

Sutton, M., Ikenwilo, D. and Skatun, D. Using participantperceptions to evaluate unpiloted reforms: the benefits thatScottish family doctors attribute to a new pay for performancecontract. Paper presented at NHESG, Estonia, May 2007.

Sutton, M., Elder, R., Guthrie, B. and Watt, G. What qualityimprovement did the Quality and Outcomes Frameworkproduce? Paper presented at the Health Economists’ StudyGroup (HESG), Brunel University, September 2007.

Ternent, L., McNamee, P., Newlands, D., Belemsaga, D.,Gbangou, A. and Coates, A. How important is gender inassessing the value of maternal health outcomes? Paperpresented to the Health Economists Study Group Conference.Birmingham, January 2007.

Other Oral Presentations

Amaya-Amaya, M. and Watson, V. Choosing not to choose:Considering serial non-participation in discrete choiceexperiments. Oral presentation at the International Associationof Health Economics (iHEA) Conference, Copenhagen, July2007.

Currie, G., Kromm, S., Pol, van der M., Ryan, M. and Manns,B. Using a discrete choice experiment to elicit public viewsregarding priority setting of new pharmaceuticals. Oralpresentation to the Sixth world conference of the InternationalHealth Economics Association, Copenhagen, Denmark, July2007.

Douglas, F., van Teijlingen, E., Ludbrook, A., Reid, G.,Robertson, L., Greener, J. and Amaya, M. What men wantand what we think they should have. Well Men’s Services.19th Global International Health Promotion and EducationUnion Conference. Vancouver June 2007.

Farrar, S., Yi, D., Sutton, M., Scott, A. and Chalkley, M.Activity based funding in the English NHS: measuring theeffect on quality. Oral presentation at the internationalHealth Economics Association (iHEA) Conference, Copenhagen,Denmark, July 2007.

French, F., Needham, G., Rooke, C., Sutton, M., Geue, C.,Ikenwilo, D. and Skåtun, D. To what extent does gendercontinue to influence the career choices, working patternsand job satisfaction of doctors in the NHS in Scotland. Oralpresentation at the Work, employment and Society (WES)conference, Aberdeen, September 2007.

Gravelle, H., Sutton, M. and Ma, A. Paying for quality: Britishgeneral practitioners’ performance under the quality andoutcomes framework. Oral presentation at the internationalHealth Economics Association (iHEA) Conference, Copenhagen,Denmark, July 2007.

Islam, K., Gerdtham, U.G., Clarke, C. and Burström, K. Doessocioeconomic health inequality change as the populationages? Evidence from Swedish panel data. Oral presentationat iHEA Copenhagen, July 2007.

Islam, K., Gerdtham, U.G., Clarke, C., Burström, K. Doessocioeconomic health inequality change as the populationages? Evidence from Swedish panel data. Oral Presentationat the University of Aberdeen 2007.

Jarl, J., Gerdtham, U.G. and Hradilova Selin, K. Reconsideringhealth as the link between alcohol and wages: an alternativenon-econometric medical costs-of-alcohol approach. Oralpresentation at iHEA Copenhagen, July 2007.

Lourenco, T., Nabi, G., MacLennan, G., Pickard, R., McClinton,S., Wong, S., Vale, L., Fraser, C., Grant, A. and N’Dow, J.What is the best surgical treatment for benign prostaticenlargement? Oral presentation at the British Prostate Group.Newcastle. March 2007.


APPENDIX 3

Smith, B., Pope, M. and Hannaford, P. et al (Ryan, M., amember of the team). Development study for a complexintervention for chronic low back pain in NHS primary care:Identifying its likely components and assessing its likelyacceptability. Final Report prepared for the Chief ScientistOffice, Scottish Executive (reference number: CZH/4/248).2007.

Sullivan, F., Swan, I.R.C., Donnan, P., Morrison, J.M., Smith,B.H., McKinstry, B., Davenport, R.J., Vale, L., Clarkson, J.E.,Hernández, R., Stewart, K., Hammersley, V., Hayavi, S.,McAteer, A., Gray, D. and Daly, F. BELLS trial: Bell’s palsy:Early acycLovir or prednisoLone in Scotland. Report to theNHS HTA Programme, August 2007.

Other Publications

Coyle, D., Coyle, K., Vale, L., de Verteuil, R., Imamura, M.,Glazener, C., Zhu, S. Cost Effectiveness of Minimally InvasiveHip Arthroplasty in the Management of Arthritic Disease ofthe Hip. Report to Canadian Agency for Drug and HealthTechnology Assessment (CADH). September 2007.


de Verteuil, R. The cost effectiveness of laparoscopic surgeryfor colorectal cancer. HERU Briefing Paper, University ofAberdeen, October 2007.

de Verteuil, R. Commentary on economic evaluation ofsurgical trained assistant medical officers in performing majorobstetric surgery in Mozambique. British Journal of Obstetricsand Gynaecology 2007. Vol 114 (10).

Farrar, S. Using Tariffs to pay for hospital care. HERU BriefingPaper, University of Aberdeen. February 2007.

French, F., Geue, C., Ikenwilo, D., Needham, G., Rooke,C., Skatun, D. Changes in job satisfaction, work commitmentsand attitudes to workload following contractual reform. HERUBriefing Paper, February 2007.

Gravelle, H., Sutton, M., Ma, A. Doctor behaviour under apay for performance contract: evidence from the Qualityand Outcomes Framework. Centre for Health EconomicsResearch paper 28. University of York, 2007.

Hernandez, R. The role of myocardial perfusion scintigraphyin the diagnosis and management of angina and myocardialinfraction: a probalistic economic analysis. HERU BriefingPaper, University of Aberdeen. July 2007.

Sutton, M., Ikenwilo, D., Skatun, D. Evaluation of theintroduction of a pay for performance contract for UK familydoctors. HEDG Working Paper 07/20. University of York,2007.


APPENDIX 2



APPENDIX 2

53 55

Sullivan, F., Swan, I.R.C., Donnan, P., Morrison, J.M., Smith,B.H., McKinstry, B., Davenport, R.J., Vale, L., Clarkson, J.E.,Hernández, R., Stewart, K., Hammersley, V., Hayavi, S.,McAteer, A., Gray, D. and Daly, F. BELLS trial: Bell’s palsy:Early acycLovir or prednisoLone in Scotland. Health TechnologyAssessment. Forthcoming.

The REFLUX Trial Group (Vale, L., a member of the writingcommittee). The place of minimal access surgery amongstpeople with gastro-oesophageal reflux disease – a UKcollaborative study. The REFLUX Trial. Health TechnologyAssessment. Forthcoming.

Tinelli, M., Bond, C., Blenkinsopp, A., Jaffray, M., Watson,M. and Hannaford, P. on the behalf of the CommunityPharmacy Medicines Management Evaluation Team (includingJaffray, M., Bond, C.M., Watson, M.C., Hannaford, P., Tinelli,M., Scott, A., Lee, A., Blenkinsopp, A., Anderson, C., Avery,A., Bissell, P. and Krksa, J.). Patients’ experiences with acommunity pharmacy medications management service: focuson attitudes, expectations and satisfaction. Annals ofPharmacotherapy. Forthcoming.

Books and Book Chapters

Dancer, D., Morrison, K. and Smith, M.D. Measuring theimpact of a peer assisted learning program on students’academic performance in econometrics. Proceedings of theForum on Quantitative Analysis of Teaching and Learning inHigher Education in Business, Economics and Commerce,University of Melbourne, 19-42, 2007.

Elliott, R.F. Local Pay. In: Rethinking Reward: the key issues.Corby, S. (ed) Chapter 5, Palgrave MacMillan, 2008Forthcoming.

Gerdtham, U.G. Hälsoekonomi: hur ekonomi kan bidra tillfolkhälsan (How can economics contribute to better health).Book chapter in Public Health as Multidisciplinary Research.Eds. Göran Ejlertsson and Ingemar Andersson. (In Swedish).

Ryan, M., Gerard, K., Amaya-Amaya, M.: Using DiscreteChoice Experiments to Value Health and Health Care. Springer.(Forthcoming).

Reports

Bailey, D., Sutton, M. and Anderson, M.J. Multivariate analysisof factors influencing workload on primary medical services.Report to the Scottish Executive, March 2007.

Bond C., King M., Lee A., McNamee P., Primrose W., HighesC. and Jaffray M. An evaluation of an adapted United Statesmodel of pharmaceutical care to improve psychoactiveprescribing in care home residents in Scotland. CSO FinalReport. October 2007

Cheyne, H., Hundley, V., Dowding, D., Niven, C., Greer, I.,Bland, J.M., Aucott, L. and McNamee, P. A cluster randomisedtrial to investigate the use of a decision aid for the diagnosisof active labour in term pregnancy (The Early Labour Studyin Scotland). CSO Final Report. July 2007.


Cooper, K.G., Sambrook, A., Campbell, M.K., Cook, J.A.,Kilonzo, M., and Vale, L. The Endometrial Ablation Study:A randomised comparison of treatment in the postmenstrualphase: Clinical outcomes, patient acceptability and cost.Report submitted to the Chief Scientist Office of the ScottishExecutive Health Department, April 2007.

Dibben, C., Atherton, I., Cox, M., Watson, V., Ryan, M. andSutton, M. Investigating the impact of changing weights thatunderpin the Index of Multiple Deprivation 2004. Report tothe Department of Communities and Local Government.January 2007.

Donnan, P.T., Simpson, C., Guthrie, B., Tilley, C., McKinstry,B., Sutton, M., Fischbacher and Morrison, J. Developmentand Validation of an algorithm to predice emergency hospitaladmissions in Scotland. Report to the Chief Scientist OfficeOctober 2007.

Elder, R., Kirkpatrick, M., Ramsay, W., Macleod, M., Guthrie,B., Sutton, M. and Watt, G. Measuring quality in primarymedical services using data from SPICE. Report to NHS QualityImprovement Scotland. ISDScotland July 2007.

Farrar, S., Sussex, J., Yi, D., Chalkley, M., Scott, T., Sutton,M. and Yuen, P. Evaluation of Payment by Results. DraftFinal Report to the Department of Health, November 2007.

Hoddinott, P., Britten, J., Godden, D., Prescott, G., Ludbrook,A., Tappin, D. and McInnes, R. The BIG Trial: a randomisedcontrolled trial to evaluate the clinical and cost-effectivenessof breastfeeding support groups in improving breastfeedinginitiation, duration and satisfaction. Report submitted tothe Chief Scientist Office Scottish Executive HealthDepartment, (reference number CZH/4/156) November 2007.

Morris, S., Carr-hill, R., Dixon, P., Law, M., Rice, N., Sutton,M., Vallejo-Torres L. Combining the age related and additionalneed. 2007 review of the needs formula for hospital servicesand prescribing activity in England. Report submitted to theDepartment of Health November 2007.

Mowatt, G., Houston, G., Hernández, R., de Verteuil, R.,Fraser, C., Cuthbertson, B. and Vale, L. Systematic reviewof the clinical effectiveness and cost-effectiveness ofoesophageal Doppler monitoring in critically ill and high risksurgical patients. Report to NIHR HTA Programme on behalfof PASA/CEP. July-August 2007.

Osman, L.M., Ayres, .JG., Garden, C., Reglitz, K., Lyon, J.,Douglas, J.G., Kyle, G., Milne, K. and Ludbrook, A. Theeffect of energy efficiency improvement on health status ofCOPD patients. Report to the Eaga Charitable Trust November2007.

Shemilt, I., Byford, S., Drummond, M., Eisenstein, E., Knapp,M., Mallender, J., McDaid, D., Mugford, M., Vale, L., Walker,D. Incorporating Economics Evidence. In Higgins, J., Green,S., (eds.) Cochrane Handbook for Systematic Reviews ofInterventions. Chichester: Hohn Wiley & Sons. (In Press).


Elliott, R.F. Public Sector Pay and Devolution, Invitedpresentation to BMA “Review Body and Negotiating Event”,London. March 2007.

Ludbrook, A. Obesity – treatable condition or lifestyle choice?Northern Ireland Health Economics Group. Belfast, October2007.

Ludbrook, A. International evidence on the impact of smokefree legislation on the hospitality sector. Towards a smokefree society conference. Edinburgh September 2007.

Sutton, M. Measuring inequalities in health. Invitedpresentation at Measuring Health Inequalities Seminar,Edinburgh, January 2007.

Vale, L. Health Technology Assessment and opportunity costs.Cochrane Colloquium. San Paolo, Brazil. October 2007.

Vale L. Early Chronic Kidney Disease: Can we afford it? AnEconomists perspective. Invited presentation to the ConsensusConference on Early Chronic Kidney Disease. Royal Collegeof Physicians of Edinburgh, Edinburgh, February 2007.


Battu, H., Ma, A. and Phimister, E. Housing Tenure, JobMobility and Unemployment in the UK. Paper presented atthe Royal Economics Society, Warwick, April 2007.

Dancer, D., Rammohan, A. and Smith, M.D. Infant mortalityand child nutrition in Bangladesh. Sixteenth European Workshopon Econometrics and Health Economics, Bergen, Norway,September 2007.

de Verteuil, R., Hernandez, R. and Vale, L. Economicevaluation of laparoscopic surgery for colorectal cancer.Paper presentation at the Health Services Research NetworkConference, Sheffield, June 2007.

de Verteuil, R., Hernandez, R. and Vale, L. Economicevaluation of laparoscopic surgery for colorectal cancer.Paper presentation to the Operational Research ModellingConference, Edinburgh 2007.

Eberth, B., Morris, S. and Sutton, M. An empirical investigationinto the relationship between BMI and three types of physicalactivity. Paper presented at the Scottish Economic SocietyConference, Perth, April 2007.

Eberth, B., Morris, S. and Sutton, M. An empirical investigationinto the relationship between BMI and three types of physicalactivity. Paper presented at the SIRE Health and Wellbeingat Work Conference, University of Aberdeen, June 2007.

Elliott, R.F., Sutton, M., Ma, A., McConnachie, A., Morris,S., Rice, N. and Skåtun, D. Spatial wage variation and itsimpact on public sector recruitment and retention: the caseof the NHS. Paper presented at the Royal Economics Society,Warwick, April 2007.

Elliott, R.F., Sutton, M., Ma, A., McConnachie, A., Morris,S., Rice, N. and Skåtun, D. Spatial wage variation and itsimpact on public sector recruitment and retention: the caseof the NHS. Paper presented at the VML Earnings Workshop,ONS, London, October 2007.

Geue, C., Skåtun, D., Sutton, M., French, F., Ikenwilo, D.,Rooke, C. and Needham, G. Should I stay or should I go?Changes in the intentions of consultants to work beyondstatutory retirement age. Paper presented at the HealthEconomists’ Study Group (HESG), Brunel University, September2007.

Gravelle, H., Sutton, M. and Ma, A. Cheat or treat? Doctors’responses to payment based on self-reported treatment rates.Paper presented at the Royal Economics Society, Warwick,April 2007.

Gravelle, H., Sutton, M. and Ma, A. Cheat or treat? Doctors’responses to payment based on self-reported treatment rates.Paper presented at CMPO/University of York “EvaluatingHealth Policy: New Evidence from Administrative Data”,London, September 2007.

Hernández, R., Vale, L. and Burr, J.M. on behalf of the OAGScreening Project Group. Screening for Open Angle Glaucoma:Is it cost-effective? Oral presentation at the 2nd AnnualMeeting Health Services Research Network, Sheffield, June2007.

Hernández, R., Vale, L. and Burr, J.M. for the OAG ScreeningProject Group. Screening for Open Angle Glaucoma: Onemodel, two questions answered? Paper presentation at the4th Annual Meeting of Health Technology AssessmentInternational Society, Barcelona, Spain, June 2007.

Ikenwilo, D. A longitudinal data analysis of consultants’ jobsatisfaction. Paper presented at the Scottish Economic Society,Perth, April 2007.

Kilonzo, M., Ryan, M., Vale, L. and Burr, J. Discrete choiceexperiments and best worst scaling: compliments orsubstitutes? Paper presented at the Health Economists’ StudyGroup (HESG), Brunel University, September 2007.

Ludbrook A. The use of short-term health outcomes ineconomic evaluations of health improvement interventionsand implications for QALYs. Paper presented to the WelshAssembly Government Wanless Health Economics Group,Birmingham, February 2007.

Ma, A., Sutton, M., Skatun, D., Elliott, R.F., Rice, N.,McConnachie, A. and Morris, S. Spatial wage variation inpublic and private sectors in England and their effects onrecruitment and retention in NHS. Paper presented to theVML Quarterly Earnings Workshop, Office of National Statistics,London. October 2007.

Ma, A., Sutton, M., Skatun, D., Elliott, R.F., Rice, N.,McConnachie, A. and Morris, S. Spatial wage variation inthe public and private sectors and their impact on publicsector recruitment and retention the case of the UK NHS.Paper presented to the Work Pensions and Labour EconomicsStudy Group (WPSG), London. December 07.


APPENDIX 3


56 54

Ma, A., Sutton, M., Skatun, D., Elliott, R.F., Rice, N.,McConnachie, A. and Morris, S. NHS Recruitment and Retentionand Local Labour Market Conditions. Paper presented to theHealth and Wellbeing at Work Conference, Aberdeen, June2007.

McNamee, P., Ternent, L., Belemsaga, D., Gbangou, A. andNewlands, D. A game of two halves? Starting point bias withinthe bidding game method. Paper presented to the HealthEconomists Study Group Conference. Birmingham, January2007.

Morris, S., Elliott, R.F., Ma, A., McConnachie, A., Rice, N.,Skåtun, D. and Sutton, M. An investigation into private andNHS incomes earned by consultants in England. Paperpresented at the Health Economics Study Group, Birmingham,January 2007.

Pol, van der M, and Ruggeri, M. Is risk attitude in healthcontext specific? Paper presented at the 12th annualconference of the Italian Health Economics Association,Florence, October 2007.

Pol, van der M. Education, health and time preference.Paper presented to the Nordic Health Economists’ StudyGroup Meeting, Tartu, Estonia, August 2007.

Regier, D.A., Ryan, M. and Marra, C.A. The development ofan incremental willingness to pay curve derived from adiscrete choice experiment. Paper presented at the ISPOR10th Annual European Conference, Dublin, Ireland, October2007.

Regier, D.A., Ryan, M. and Phimister E. Hierarchical Bayesof Mixed Logit: an application to genetic testing. Paperpresented at the Health Economic Study Group, Brunel,September 2007.

Ryan, M. Analysis Issues in Discrete Choice Experiments withmultiple options. Presented to Welsh Health Economic StudyGroup. University of Cardiff, April 2007.

Ryan, M. Discrete Choice Experiments: what are they andwhat can they do for the Institute? Presented to Institute forSocial and Economic Research, University of Melbourne, March2007.

Ryan, M. Using Discrete Choice Experiments in Primary Care.Presented to Primary Care Research Unit, University ofMelbourne, March 2007.

Skåtun, D., Elliott, R., Ma, A., Sutton, M., Rice, N.,McConnachie, A. and Morris, S. NHS Recruitment and Retentionand Local Labour Market Conditions. Paper presented at theCMPO/OME conference “Issues in Public Sector Pay”, London,September 2007.

Sutton, M., Ikenwilo, D. and Skatun, D. Using participantperceptions to evaluate unpiloted reforms: the benefits thatScottish family doctors attribute to a new pay for performancecontract. Paper presented at NHESG, Estonia, May 2007.

Sutton, M., Elder, R., Guthrie, B. and Watt, G. What qualityimprovement did the Quality and Outcomes Frameworkproduce? Paper presented at the Health Economists’ StudyGroup (HESG), Brunel University, September 2007.

Ternent, L., McNamee, P., Newlands, D., Belemsaga, D.,Gbangou, A. and Coates, A. How important is gender inassessing the value of maternal health outcomes? Paperpresented to the Health Economists Study Group Conference.Birmingham, January 2007.


Amaya-Amaya, M. and Watson, V. Choosing not to choose:Considering serial non-participation in discrete choiceexperiments. Oral presentation at the International Associationof Health Economics (iHEA) Conference, Copenhagen, July2007.

Currie, G., Kromm, S., Pol, van der M., Ryan, M. and Manns,B. Using a discrete choice experiment to elicit public viewsregarding priority setting of new pharmaceuticals. Oralpresentation to the Sixth world conference of the InternationalHealth Economics Association, Copenhagen, Denmark, July2007.

Douglas, F., van Teijlingen, E., Ludbrook, A., Reid, G.,Robertson, L., Greener, J. and Amaya, M. What men wantand what we think they should have. Well Men’s Services.19th Global International Health Promotion and EducationUnion Conference. Vancouver June 2007.

Farrar, S., Yi, D., Sutton, M., Scott, A. and Chalkley, M.Activity based funding in the English NHS: measuring theeffect on quality. Oral presentation at the internationalHealth Economics Association (iHEA) Conference, Copenhagen,Denmark, July 2007.

French, F., Needham, G., Rooke, C., Sutton, M., Geue, C.,Ikenwilo, D. and Skåtun, D. To what extent does gendercontinue to influence the career choices, working patternsand job satisfaction of doctors in the NHS in Scotland. Oralpresentation at the Work, employment and Society (WES)conference, Aberdeen, September 2007.

Gravelle, H., Sutton, M. and Ma, A. Paying for quality: Britishgeneral practitioners’ performance under the quality andoutcomes framework. Oral presentation at the internationalHealth Economics Association (iHEA) Conference, Copenhagen,Denmark, July 2007.

Islam, K., Gerdtham, U.G., Clarke, C. and Burström, K. Doessocioeconomic health inequality change as the populationages? Evidence from Swedish panel data. Oral presentationat iHEA Copenhagen, July 2007.

Islam, K., Gerdtham, U.G., Clarke, C., Burström, K. Doessocioeconomic health inequality change as the populationages? Evidence from Swedish panel data. Oral Presentationat the University of Aberdeen 2007.

Jarl, J., Gerdtham, U.G. and Hradilova Selin, K. Reconsideringhealth as the link between alcohol and wages: an alternativenon-econometric medical costs-of-alcohol approach. Oralpresentation at iHEA Copenhagen, July 2007.

Lourenco, T., Nabi, G., MacLennan, G., Pickard, R., McClinton,S., Wong, S., Vale, L., Fraser, C., Grant, A. and N’Dow, J.What is the best surgical treatment for benign prostaticenlargement? Oral presentation at the British Prostate Group.Newcastle. March 2007.


APPENDIX 3

Smith, B., Pope, M. and Hannaford, P. et al (Ryan, M., amember of the team). Development study for a complexintervention for chronic low back pain in NHS primary care:Identifying its likely components and assessing its likelyacceptability. Final Report prepared for the Chief ScientistOffice, Scottish Executive (reference number: CZH/4/248).2007.

Sullivan, F., Swan, I.R.C., Donnan, P., Morrison, J.M., Smith,B.H., McKinstry, B., Davenport, R.J., Vale, L., Clarkson, J.E.,Hernández, R., Stewart, K., Hammersley, V., Hayavi, S.,McAteer, A., Gray, D. and Daly, F. BELLS trial: Bell’s palsy:Early acycLovir or prednisoLone in Scotland. Report to theNHS HTA Programme, August 2007.

Other Publications

Coyle, D., Coyle, K., Vale, L., de Verteuil, R., Imamura, M.,Glazener, C., Zhu, S. Cost Effectiveness of Minimally InvasiveHip Arthroplasty in the Management of Arthritic Disease ofthe Hip. Report to Canadian Agency for Drug and HealthTechnology Assessment (CADH). September 2007.


de Verteuil, R. The cost effectiveness of laparoscopic surgeryfor colorectal cancer. HERU Briefing Paper, University ofAberdeen, October 2007.

de Verteuil, R. Commentary on economic evaluation ofsurgical trained assistant medical officers in performing majorobstetric surgery in Mozambique. British Journal of Obstetricsand Gynaecology 2007. Vol 114 (10).

Farrar, S. Using Tariffs to pay for hospital care. HERU BriefingPaper, University of Aberdeen. February 2007.

French, F., Geue, C., Ikenwilo, D., Needham, G., Rooke,C., Skatun, D. Changes in job satisfaction, work commitmentsand attitudes to workload following contractual reform. HERUBriefing Paper, February 2007.

Gravelle, H., Sutton, M., Ma, A. Doctor behaviour under apay for performance contract: evidence from the Qualityand Outcomes Framework. Centre for Health EconomicsResearch paper 28. University of York, 2007.

Hernandez, R. The role of myocardial perfusion scintigraphyin the diagnosis and management of angina and myocardialinfraction: a probalistic economic analysis. HERU BriefingPaper, University of Aberdeen. July 2007.

Sutton, M., Ikenwilo, D., Skatun, D. Evaluation of theintroduction of a pay for performance contract for UK familydoctors. HEDG Working Paper 07/20. University of York,2007.


APPENDIX 2


5957

McNamee, P. The effect of economic status on care decisions:results arising from the Free Personal Care policy in Scotland.Oral presentation to the 6th International Health EconomicsAssociation (iHEA) World Congress, Copenhagen, July 2007.

McNamee, P. and Quayyum, Z. Cost effectiveness of maternaland perinatal health interventions: lessons from DCPP andIMMPACT. Oral presentation to the West African HealthOrganisation Annual Meeting, Accra, Ghana, June 2007.

Mentzakis, E., McNamee, P., Sutton, M. and Ryan, M. Valuinginformal care using compensating income variation. Oralpresentation to the 6th iHEA World Congress: Explorationsin Health, Copenhagen, July 2007.

Mardiati, N., Quayyum, Z., Tim, E., Susilawati, P,K. andSucahya, A.M. Cost of obstetric care and economicconsequences for the households: Are poor mothers protected?Lessons from two districts in Indonesia. Paper presented atthe 6th World Congress of Health Economics. InternationalHealth Economics Association, Copenhagen, Denmark, July2007.

Osman, L.M., Douglas, G., Garden, C., Reglitz, K., Ludbrook,A., Lyons, J. and Ayres, J.G. A community based evaluationof energy efficiency intervention: problems, pitfalls andlessons. Oral presentation at the Public Health AssociationConference, Edinburgh, March 2007.

Regier, D.A., Marra, C.A., Phimister, E. and Ryan, M.Heterogeneous designs for discrete choice experiments usingprior beliefs. Oral presentation at the international HealthEconomics Association (iHEA) Conference, Copenhagen,Denmark, July 2007.

Regier, D.A., Marra, C.A., Phimister, E. and Ryan, M.Accounting for preference heterogeneity in discrete choiceexperiments using hierarchical Bayes. Oral presentation atthe international Health Economics Association (iHEA)Conference, Copenhagen, Denmark, July 2007.

Robinson, A., Baker, R., Bateman, I., Donaldson, C., Loomes,G. et al (Ryan, M., a member of the group). Do members ofthe public wish to give more weight to some QALYs thanothers? Results of a population based study in the UK. Oralpresentation at the international Health Economics Association(iHEA) Conference, Copenhagen, Denmark, July 2007.

Ryan, M., Jareinpituk, S. and Cairns, J. Testing the ExternalValidity of Contingent Valuation: a Field Experiment comparinghypothetical and real payments. Oral presentation at theInternational Health Economics Association 6th World CongressCopenhagen, Denmark, July 2007.

Sauerborn, R., Gbangou, A., Sanou, M., Dong, H. and Pol,van der M. Time preference from an economist’s andanthropologist’s perspective. Oral presentation to the 6thworld conference of the International Health EconomicsAssociation, Copenhagen, Denmark, July 2007.

Quayyum, Z. The direct cost of safe motherhood programmes.Oral presentation at the IMMPACT International Symposium,RCOG, London, February 2007.

Teckle, P., Sutton, M. and Ludbrook, A. Estimating theexpected health benefits to non-smokers of policies to reduceexposure to environmental tobacco smoke. 6th InternationalHealth Economics Association conference. Copenhagen, July2007.

Ternent, L. Willingness to pay for maternal health care: agender perspective. Oral presentation at the IMMPACTInternational Symposium, RCOG, London, February 2007.

Tinelli, M., Ryan, M. and Bond, C. Economic evaluationadvancement in pharmacy: Discrete choice experiments(DCEs). Oral presentation at the Health Services Research &Pharmacy Practice Conference, Keele, April 2007.

Tinelli, M., Ryan, M. and Odejar, M. Alternative approachesto deriving welfare estimates in Discrete Choice Experiments.Oral presentation at the international Health EconomicsAssociation Conference, Copenhagen, July 2007.

Van Teijlinger, E., Douglas, F., Ludbrook, A., Hall, J., Reid,G., Robertson, L. and Greener, J. Hard-to reach: Undefinedand hard to find. 19th Global International Health Promotionand Education conference. Vancouver June 2007.

Watson, V., Carnon, A., Ryan, M. and Cox, D. Involving thePublic in Priority Setting: The use of Discrete ChoiceExperiments in NHS Dumfries & Galloway. Oral presentationat the Annual Public Health Conference, Falkirk, November2007.

Yi, D., Pugh, E. and Farrar, S. The effect of the introductionof a prospective payment system on HRG creep in Englishhospitals: an empirical investigation of Payment by Results.Oral presentation at the international Health EconomicsAssociation, Copenhagen, July 2007.

Poster Presentations

de Verteuil, R., Hernandez, R. and Vale, L. Economicevaluation of laparoscopic surgery for colorectal cancer.Poster presented to the Health Technology AssessmentInternational Society, Barcelona, June 2007.

Elliott, R.F., Sutton, M., Ma, A., Skåtun, D., McConnachie,A., Morris, S. and Rice, N. Distributing public funding to theNHS: taking account of differences in local labour marketconditions on NHS recruitment and retention. Posterpresentation at the 11th International Medical WorkforceCollaborative, Vancouver, Canada. March 2007.

Elliott, R.F., Sutton, M., Ma, A., Skåtun, D., Gravelle, H.,Hole, A., Morris, S. and Sibbald, B. Derivation of geographicpay differentials to equalise the recruitment and retentionof General Practitioners. Poster presentation at the 11thInternational Medical Workforce Collaborative, Vancouver,Canada. March 2007.

Hernández, R., Kilonzo, M., Vale, L., Burr, J.M. and Ryan,M. for the OAG Screening Project Group. Using DiscreteChoice Experiments within a Decision Analysis Framework.Poster presentation at the 4th Annual Meeting of HealthTechnology Assessment International Society, Barcelona,Spain, June 2007.


APPENDIX 3


APPENDIX 3

Policy Presentations

Morris, S., Dixon, P., Sutton, M., Rice, N. and Carr-Hill, R.DH Needs Formula Review 2006/7. Seminar presented to theTechnical Advisory Group, Department of Health, London,August 2007.

Sutton, M. How do we measure health inequalities? Presentedto the CMO Workshop entitled ‘Understanding Inequalities inHealth in Scotland’. Glasgow. January 2007.

Sutton, M. and Olajide, D. Margins between prices paid bythe NHS and by independent community pharmacies forprescription items in Scotland. Seminar presented to theInformation Services Division, NHSScotland, Scottish ExecutiveHealth Department, Edinburgh. September 2007.

Sutton, M., Olajide, D., Elliott, R., Ma, A. and Munro, A.Determinants of geographical variation in hospital unit-costs- interim results of project extension. Seminar presented toNHSScotland Resource Allocation Committee. ScottishExecutive Health Department, Edinburgh. February 2007.

Sutton, M., Elliott, R.F., Ma, A., Munro, A. and Olajide, D.Extension to review of the excess costs of supply adjustmentin the national allocation formula. Seminar presented to theNHSScotland Resource Allocation Committee, ScottishExecutive Health Department, Edinburgh. March 2007.


60 58


APPENDIX 3


APPENDIX 4

Ludbrook, A., Teckle, P. and Sutton, M. Estimating healthbenefits to non-smokers of reduced exposure to environmentaltobacco smoke. Poster presented at Towards a Smoke freeSociety conference Edinburgh September 2007.

Ludbrook, A., Amaya-Amaya, M. and Goode, A. Estimatingsmoking relapse rates for policy evaluation. Poster presentedat Towards a Smoke free Society conference EdinburghSeptember 2007.

Quayyum, Z., Tim, E., Mardiati, N., Purwa, K.S. and Eko, P.Do poor mothers have access to village level midwiferyservices and public facilities for obstetric care? Evidencefrom two districts in Indonesia. Poster presented at the 6thWorld Congress of Health Economics. International HealthEconomics Association. Copenhagen, Denmark, July, 2007.

Seymour, J., McNamee, P., Scott, A., Tinelli, M. and Bond,C. Shedding new light onto the ceiling and floor? A quantileregression approach to compare EQ-5D and SF-6D responses.Poster presented at the international Health EconomicsAssociation Conference, Copenhagen, July 2007.

Sucahya, P.K., Quayyum, Z., Mardiati, N., Purwa, K.S. andTim, E. Costing village midwifery services in two districts ofIndonesia: Lessons for efficiency and cost-effectivenessanalysis of community level midwifery care as safe motherhoodstrategy. Poster presented at the 6th World Congress ofHealth Economics. International Health Economics Association.Copenhagen, Denmark, July 2007.

Sussex, J. and Farrar, S. Activity Based Hospital Funding ina National Health Service – Qualitative Analysis of the Impacton Non-Price Competition. Poster presented at theinternational Health Economics Association (iHEA) Conference,Copenhagen, Denmark, July 2007.

Sutton, M., Geue, C., Ikenwilo, D., Skåtun, D., French, F.,Needham, G. and Rooke, C. Changes in job satisfaction andattitudes to workload following contractual reform. Posterpresentation at the 11th International Medical WorkforceCollaborative, Vancouver, Canada. March 2007.

Ternent, L., Daniels, A., Newlands, D., Asante, F. andMcNamee, P. Using Discrete Choice Experiments to elicitpreferences for maternal health care in Ghana. Posterpresentation to the 6th International Health EconomicsAssociation (iHEA) World Congress, Copenhagen, 2007.

Tinelli, M., Ryan, M. and Bond, C. Economic evaluationadvancement in pharmacy: Discrete choice experiments(DCEs). Poster presented at the 7th ESCP Spring Conferenceon Clinical Pharmacy, Edinburgh, May 2007.

Seminars

Elliott, R.F., Ma, A., Skatun, D., Sutton, M., Rice, N., Morris,S. and McConnachie, A. Why Private Sector Spatial WageVariation Matters to the NHS. Seminar presented to the CentreHealth Economics (CHE), University of York, June 2007.

Farrar, S. and PbR Team. Evaluation of Payment by Results:using differences in differences. Seminar presented to theHealth Economics Research Centre, University of Oxford, May2007.

Kilonzo, M. Using Discrete Choice Experiments (DCE) tomeasure preferences for treatment options an applicationto gastro-oesophageal reflux disease (GORD). Seminarpresented to HSRU’s lunchtime research meeting, Universityof Aberdeen, March 2007.

Ludbrook, A. Obesity related research within HERU. Seminarpresentation to the Scottish Executive Health Department,Edinburgh, March 2007.

Regier, D.A. Bayesian approaches to estimating mixed logitmodels for discrete response data. Invited seminar at theSheffield Health Economics Group, University of Sheffield,November 2007.

Ryan, M. Out of the margin: an economist’s perspective onvaluing women’s health interventions. Presented at seminar‘Measurement Matters: Evaluating Women’s Health’. Universityof Aberdeen, May 2007.

Sutton, M. The influence of working conditions on theproductivity of hospital doctors. Seminar presented to HealthEconomics Bergen (HEB), University of Bergen, May 2007.

Sutton, M. Comparing anxiolytic, hypnotic and antidepressantprescribing. Seminar presenting findings at the end of a CSOfunded project. Glasgow University, February 2007.

Sutton, M. Achievements of NHS Tayside practices on the2004/5 Quality and Outcomes Framework. Seminar presentedat NHS Tayside QOF conference. Isle of Skye Hotel, Perth,March 2007.

Workshops

Elliott, R.F. Ethical Issues in the Allocation of Health CareResources. Presentation at a Workshop convened by theNuffield Council on Bioethics, Nuffield Council, London,December 2007.

Ryan, M. Discrete choice experiments in health care:Theoretical and practical issues. Dutch Health technologyAssessment Group. Maastricht, Rotterdam, November 2007.

Ryan, M. Using discrete choice experiments in healtheconomics. Forum for Medical Decision-Making, ErasmusUniversity, Rotterdam, June 2007.

Ryan, M. Using DCEs to estimate utility weights within theframework of QALYs. Workshop presented at the The Analysisof Discrete Choice Experiments, Bayesian Statistics in HealthEconomics, University of Sheffield, September 2007.

Smith, M.D. Dependence structures in microeconometrics.University of Melbourne Microeconometrics Workshop,Melbourne, March 2007.

Smith, M.D. Stochastic frontier modelling with dependanterror components. Firms and Markets seminar series,Department of economics, University of Aberdeen. November2007.


Au, F., Shiell, A., Pol, van der M., Johnston, D.W. and Tough,S. Does supplementary prenatal nursing and home visitationreduce health care costs in the year after childbirth? Journalof Advanced Nursing, 2006 vol 56, 657-668.

Black, C., Bagust, A., Boland, A., Walker, S., McLeod, C., deVerteuil, R., Ayres, J., Bain, L., Thomas, S., Godden, D. andWaugh, N. The clinical effectiveness and cost-effectivenessof computed tomography screening for lung cancer: systematicreviews. Health Technology Assessment, 2006 Vol 10 No 3.


Grimshaw, J., Eccles, M., Thomas, R., Ramsay, R., Fraser,C., MacLennan, G. and Vale, L. Current evidence (and itslimitations) of the effectiveness of quality improvementstrategies. Journal of General Internal Medicine, 2006 vol21, S14-20.

Guthrie, B., McLean, G. and Sutton, M. Inequalities in therewards for quality under the new GMS contract. BritishJournal of General Practice, 2006, vol 56, 836-41.

Herbert, M.A., Brant R., Hailey, D. and Pol, van derM. Potential and readiness for video-visits in rural palliativehomecare: results of a multi-method study in Canada. Journalof Telemedicine and Telecare, 2006 vol 12(S3), 43-45.

Lock, C., Kaner, E., Heather, N., Purdy, S., McNamee, P.and Pearson, P. The effectiveness and cost-effectiveness ofnurse-led screening and brief alcohol intervention in primaryhealth care: cluster randomised controlled trial. Journal ofAdvanced Nursing, 2006 vol 54(4), 426-439.

Brazzelli, M., McKenzie, L., Fielding, S., Fraser, C., Clarkson,J., Kilonzo, M. and Waugh, N. Systematic review of theeffectiveness and cost effectiveness of HealOzone® for thetreatment of occlusal pit/fissure caries and root caries.Health Technology Assessment Monograph, 2006 Vol 10 No16.

Ma, A., Roberts, E., Elliott, R.F., Bell, D. and Scott, A.Comparing the NES and LFS: An analysis of the differencesbetween the data sets and their implications for the patternof geographical pay in the UK. Regional Studies, 2006 vol40(6), 645-665.

Matheson, C., Bond, C. and Tinelli, M. Community pharmacistsand drug misusers: national trends in attitudes and currentpractice. Supplement to the International Journal of PharmacyPractice, 2006 vol 14, B23-24.

Mavromaras, K.G. and Scott, A. Promotion to hospitalconsultant: regression analysis using NHS administrative data.British Medical Journal, 2006 vol 332, 148-151.

McKenzie, L., de Verteuil, R., Cook, J., Shanmugam, V.,Loudon, M.A., Watson, A.J. and Vale, L. Economic evaluationof stapled haemorrhoidopexy compared with rubber bandligation in first line treatment of symptomatic grade IIhaemorrhoids. British Journal of Surgery, 2006, vol 93(Suppl1),27.

McLean, G., Sutton, M. and Guthrie, B. Deprivation andquality of primary care services: evidence for persistence ofthe inverse care law from the UK quality and outcomesframework. Journal of Epidemiology and Community Health,2006 vol 60, 917-22.

McNamee, P. Quantifying uncertainty in long-term care costsfollowing the introduction of new drug therapy. Swiss Journalof Economics & Statistics, 2006 vol S10, 61-68.

Murray, A., Lourenco, T., de Verteuil, R., Hernandez, R.,Fraser, C., McKinley, A., Krukowski, Z., Vale, L. and Grant,A. Clinical effectiveness and cost-effectiveness of laparoscopicsurgery for colorectal cancer: systematic reviews and economicevaluation. Health Technology Assessment, 2006 vol 10(45).

Morrison, J., Monoz-Arroyo, R. and Sutton, M. Exploringpotential explanations for the increase in anti-depressantprescribing in Scotland using secondary analyses of routinedata. British Journal of General Practice, 2006 vol 56(527),423-428.

Porteous, T., Ryan, M., Bond, C. and Hannaford, P. Preferencesfor self-care or consulting a health professional in minorillness: a discrete choice experiment. British Journal ofGeneral Practice, 2006 vol 56, 911-917.

Regier, D.A., Sunderji, R., Llynd, L.D., Gin, K. and Marra,C.A. Cost-effectiveness of self-managed versus physician-managed oral anticoagulation. Canadian Medical AssociationJournal, 2006 vol 174(13), 1847-52.

Ryan, M., Netten, A., Skåtun, D. and Smith, P. Using discretechoice experiments to estimate a preference-based measureof outcome - an application to social care for older people.Journal of Health Economics, 2006 vol 25(5), 927-944.

Ryan, M. and Watson, V. Counting the cost of fast access:using discrete choice experiments to elicit preferences ingeneral practice. British Journal of General Practice, 2006vol 56(522) 4-5.

Seymour, J., Cairns, J.A., Wilkie, A., Sandercock, P. andWardlaw, D. Geographical access to imaging facilities forstroke patients in Scotland. Health and Place, 2006 vol 12,617-630.

Shanmugam, V., Watson, A.J., Cook, J., Vale, L. and London,M.A. Stapled haemorrhoidopexy achieves better symptomcontrol than rubber ligation in the treatment of symptomaticgrade II haemorrhoids. British Journal of Surgery, 2006 vol93(suppl1), 26.

Shanmugam, V., Watson, A.J., Cook, J., Vale, L. and Loudon,M.A. Stapled haemorrhoidopexy achieves better symptomcontrol than rubber band ligation in the treatment ofsymptomatic grade II haemorrhoids. Colorectal Disease, 2006vol 8(Suppl2), 54.


5957

McNamee, P. The effect of economic status on care decisions:results arising from the Free Personal Care policy in Scotland.Oral presentation to the 6th International Health EconomicsAssociation (iHEA) World Congress, Copenhagen, July 2007.

McNamee, P. and Quayyum, Z. Cost effectiveness of maternaland perinatal health interventions: lessons from DCPP andIMMPACT. Oral presentation to the West African HealthOrganisation Annual Meeting, Accra, Ghana, June 2007.

Mentzakis, E., McNamee, P., Sutton, M. and Ryan, M. Valuinginformal care using compensating income variation. Oralpresentation to the 6th iHEA World Congress: Explorationsin Health, Copenhagen, July 2007.

Mardiati, N., Quayyum, Z., Tim, E., Susilawati, P,K. andSucahya, A.M. Cost of obstetric care and economicconsequences for the households: Are poor mothers protected?Lessons from two districts in Indonesia. Paper presented atthe 6th World Congress of Health Economics. InternationalHealth Economics Association, Copenhagen, Denmark, July2007.

Osman, L.M., Douglas, G., Garden, C., Reglitz, K., Ludbrook,A., Lyons, J. and Ayres, J.G. A community based evaluationof energy efficiency intervention: problems, pitfalls andlessons. Oral presentation at the Public Health AssociationConference, Edinburgh, March 2007.

Regier, D.A., Marra, C.A., Phimister, E. and Ryan, M.Heterogeneous designs for discrete choice experiments usingprior beliefs. Oral presentation at the international HealthEconomics Association (iHEA) Conference, Copenhagen,Denmark, July 2007.

Regier, D.A., Marra, C.A., Phimister, E. and Ryan, M.Accounting for preference heterogeneity in discrete choiceexperiments using hierarchical Bayes. Oral presentation atthe international Health Economics Association (iHEA)Conference, Copenhagen, Denmark, July 2007.

Robinson, A., Baker, R., Bateman, I., Donaldson, C., Loomes,G. et al (Ryan, M., a member of the group). Do members ofthe public wish to give more weight to some QALYs thanothers? Results of a population based study in the UK. Oralpresentation at the international Health Economics Association(iHEA) Conference, Copenhagen, Denmark, July 2007.

Ryan, M., Jareinpituk, S. and Cairns, J. Testing the ExternalValidity of Contingent Valuation: a Field Experiment comparinghypothetical and real payments. Oral presentation at theInternational Health Economics Association 6th World CongressCopenhagen, Denmark, July 2007.

Sauerborn, R., Gbangou, A., Sanou, M., Dong, H. and Pol,van der M. Time preference from an economist’s andanthropologist’s perspective. Oral presentation to the 6thworld conference of the International Health EconomicsAssociation, Copenhagen, Denmark, July 2007.

Quayyum, Z. The direct cost of safe motherhood programmes.Oral presentation at the IMMPACT International Symposium,RCOG, London, February 2007.

Teckle, P., Sutton, M. and Ludbrook, A. Estimating theexpected health benefits to non-smokers of policies to reduceexposure to environmental tobacco smoke. 6th InternationalHealth Economics Association conference. Copenhagen, July2007.

Ternent, L. Willingness to pay for maternal health care: agender perspective. Oral presentation at the IMMPACTInternational Symposium, RCOG, London, February 2007.

Tinelli, M., Ryan, M. and Bond, C. Economic evaluationadvancement in pharmacy: Discrete choice experiments(DCEs). Oral presentation at the Health Services Research &Pharmacy Practice Conference, Keele, April 2007.

Tinelli, M., Ryan, M. and Odejar, M. Alternative approachesto deriving welfare estimates in Discrete Choice Experiments.Oral presentation at the international Health EconomicsAssociation Conference, Copenhagen, July 2007.

Van Teijlinger, E., Douglas, F., Ludbrook, A., Hall, J., Reid,G., Robertson, L. and Greener, J. Hard-to reach: Undefinedand hard to find. 19th Global International Health Promotionand Education conference. Vancouver June 2007.

Watson, V., Carnon, A., Ryan, M. and Cox, D. Involving thePublic in Priority Setting: The use of Discrete ChoiceExperiments in NHS Dumfries & Galloway. Oral presentationat the Annual Public Health Conference, Falkirk, November2007.

Yi, D., Pugh, E. and Farrar, S. The effect of the introductionof a prospective payment system on HRG creep in Englishhospitals: an empirical investigation of Payment by Results.Oral presentation at the international Health EconomicsAssociation, Copenhagen, July 2007.


de Verteuil, R., Hernandez, R. and Vale, L. Economicevaluation of laparoscopic surgery for colorectal cancer.Poster presented to the Health Technology AssessmentInternational Society, Barcelona, June 2007.

Elliott, R.F., Sutton, M., Ma, A., Skåtun, D., McConnachie,A., Morris, S. and Rice, N. Distributing public funding to theNHS: taking account of differences in local labour marketconditions on NHS recruitment and retention. Posterpresentation at the 11th International Medical WorkforceCollaborative, Vancouver, Canada. March 2007.

Elliott, R.F., Sutton, M., Ma, A., Skåtun, D., Gravelle, H.,Hole, A., Morris, S. and Sibbald, B. Derivation of geographicpay differentials to equalise the recruitment and retentionof General Practitioners. Poster presentation at the 11thInternational Medical Workforce Collaborative, Vancouver,Canada. March 2007.

Hernández, R., Kilonzo, M., Vale, L., Burr, J.M. and Ryan,M. for the OAG Screening Project Group. Using DiscreteChoice Experiments within a Decision Analysis Framework.Poster presentation at the 4th Annual Meeting of HealthTechnology Assessment International Society, Barcelona,Spain, June 2007.


APPENDIX 3


APPENDIX 3


Morris, S., Dixon, P., Sutton, M., Rice, N. and Carr-Hill, R.DH Needs Formula Review 2006/7. Seminar presented to theTechnical Advisory Group, Department of Health, London,August 2007.

Sutton, M. How do we measure health inequalities? Presentedto the CMO Workshop entitled ‘Understanding Inequalities inHealth in Scotland’. Glasgow. January 2007.

Sutton, M. and Olajide, D. Margins between prices paid bythe NHS and by independent community pharmacies forprescription items in Scotland. Seminar presented to theInformation Services Division, NHSScotland, Scottish ExecutiveHealth Department, Edinburgh. September 2007.

Sutton, M., Olajide, D., Elliott, R., Ma, A. and Munro, A.Determinants of geographical variation in hospital unit-costs- interim results of project extension. Seminar presented toNHSScotland Resource Allocation Committee. ScottishExecutive Health Department, Edinburgh. February 2007.

Sutton, M., Elliott, R.F., Ma, A., Munro, A. and Olajide, D.Extension to review of the excess costs of supply adjustmentin the national allocation formula. Seminar presented to theNHSScotland Resource Allocation Committee, ScottishExecutive Health Department, Edinburgh. March 2007.


60 58


APPENDIX 3


APPENDIX 4

Ludbrook, A., Teckle, P. and Sutton, M. Estimating healthbenefits to non-smokers of reduced exposure to environmentaltobacco smoke. Poster presented at Towards a Smoke freeSociety conference Edinburgh September 2007.

Ludbrook, A., Amaya-Amaya, M. and Goode, A. Estimatingsmoking relapse rates for policy evaluation. Poster presentedat Towards a Smoke free Society conference EdinburghSeptember 2007.

Quayyum, Z., Tim, E., Mardiati, N., Purwa, K.S. and Eko, P.Do poor mothers have access to village level midwiferyservices and public facilities for obstetric care? Evidencefrom two districts in Indonesia. Poster presented at the 6thWorld Congress of Health Economics. International HealthEconomics Association. Copenhagen, Denmark, July, 2007.

Seymour, J., McNamee, P., Scott, A., Tinelli, M. and Bond,C. Shedding new light onto the ceiling and floor? A quantileregression approach to compare EQ-5D and SF-6D responses.Poster presented at the international Health EconomicsAssociation Conference, Copenhagen, July 2007.

Sucahya, P.K., Quayyum, Z., Mardiati, N., Purwa, K.S. andTim, E. Costing village midwifery services in two districts ofIndonesia: Lessons for efficiency and cost-effectivenessanalysis of community level midwifery care as safe motherhoodstrategy. Poster presented at the 6th World Congress ofHealth Economics. International Health Economics Association.Copenhagen, Denmark, July 2007.

Sussex, J. and Farrar, S. Activity Based Hospital Funding ina National Health Service – Qualitative Analysis of the Impacton Non-Price Competition. Poster presented at theinternational Health Economics Association (iHEA) Conference,Copenhagen, Denmark, July 2007.

Sutton, M., Geue, C., Ikenwilo, D., Skåtun, D., French, F.,Needham, G. and Rooke, C. Changes in job satisfaction andattitudes to workload following contractual reform. Posterpresentation at the 11th International Medical WorkforceCollaborative, Vancouver, Canada. March 2007.

Ternent, L., Daniels, A., Newlands, D., Asante, F. andMcNamee, P. Using Discrete Choice Experiments to elicitpreferences for maternal health care in Ghana. Posterpresentation to the 6th International Health EconomicsAssociation (iHEA) World Congress, Copenhagen, 2007.

Tinelli, M., Ryan, M. and Bond, C. Economic evaluationadvancement in pharmacy: Discrete choice experiments(DCEs). Poster presented at the 7th ESCP Spring Conferenceon Clinical Pharmacy, Edinburgh, May 2007.

Seminars

Elliott, R.F., Ma, A., Skatun, D., Sutton, M., Rice, N., Morris,S. and McConnachie, A. Why Private Sector Spatial WageVariation Matters to the NHS. Seminar presented to the CentreHealth Economics (CHE), University of York, June 2007.

Farrar, S. and PbR Team. Evaluation of Payment by Results:using differences in differences. Seminar presented to theHealth Economics Research Centre, University of Oxford, May2007.

Kilonzo, M. Using Discrete Choice Experiments (DCE) tomeasure preferences for treatment options an applicationto gastro-oesophageal reflux disease (GORD). Seminarpresented to HSRU’s lunchtime research meeting, Universityof Aberdeen, March 2007.

Ludbrook, A. Obesity related research within HERU. Seminarpresentation to the Scottish Executive Health Department,Edinburgh, March 2007.

Regier, D.A. Bayesian approaches to estimating mixed logitmodels for discrete response data. Invited seminar at theSheffield Health Economics Group, University of Sheffield,November 2007.

Ryan, M. Out of the margin: an economist’s perspective onvaluing women’s health interventions. Presented at seminar‘Measurement Matters: Evaluating Women’s Health’. Universityof Aberdeen, May 2007.

Sutton, M. The influence of working conditions on theproductivity of hospital doctors. Seminar presented to HealthEconomics Bergen (HEB), University of Bergen, May 2007.

Sutton, M. Comparing anxiolytic, hypnotic and antidepressantprescribing. Seminar presenting findings at the end of a CSOfunded project. Glasgow University, February 2007.

Sutton, M. Achievements of NHS Tayside practices on the2004/5 Quality and Outcomes Framework. Seminar presentedat NHS Tayside QOF conference. Isle of Skye Hotel, Perth,March 2007.

Workshops

Elliott, R.F. Ethical Issues in the Allocation of Health CareResources. Presentation at a Workshop convened by theNuffield Council on Bioethics, Nuffield Council, London,December 2007.

Ryan, M. Discrete choice experiments in health care:Theoretical and practical issues. Dutch Health technologyAssessment Group. Maastricht, Rotterdam, November 2007.

Ryan, M. Using discrete choice experiments in healtheconomics. Forum for Medical Decision-Making, ErasmusUniversity, Rotterdam, June 2007.

Ryan, M. Using DCEs to estimate utility weights within theframework of QALYs. Workshop presented at the The Analysisof Discrete Choice Experiments, Bayesian Statistics in HealthEconomics, University of Sheffield, September 2007.

Smith, M.D. Dependence structures in microeconometrics.University of Melbourne Microeconometrics Workshop,Melbourne, March 2007.

Smith, M.D. Stochastic frontier modelling with dependanterror components. Firms and Markets seminar series,Department of economics, University of Aberdeen. November2007.


Au, F., Shiell, A., Pol, van der M., Johnston, D.W. and Tough,S. Does supplementary prenatal nursing and home visitationreduce health care costs in the year after childbirth? Journalof Advanced Nursing, 2006 vol 56, 657-668.

Black, C., Bagust, A., Boland, A., Walker, S., McLeod, C., deVerteuil, R., Ayres, J., Bain, L., Thomas, S., Godden, D. andWaugh, N. The clinical effectiveness and cost-effectivenessof computed tomography screening for lung cancer: systematicreviews. Health Technology Assessment, 2006 Vol 10 No 3.


Grimshaw, J., Eccles, M., Thomas, R., Ramsay, R., Fraser,C., MacLennan, G. and Vale, L. Current evidence (and itslimitations) of the effectiveness of quality improvementstrategies. Journal of General Internal Medicine, 2006 vol21, S14-20.

Guthrie, B., McLean, G. and Sutton, M. Inequalities in therewards for quality under the new GMS contract. BritishJournal of General Practice, 2006, vol 56, 836-41.

Herbert, M.A., Brant R., Hailey, D. and Pol, van derM. Potential and readiness for video-visits in rural palliativehomecare: results of a multi-method study in Canada. Journalof Telemedicine and Telecare, 2006 vol 12(S3), 43-45.

Lock, C., Kaner, E., Heather, N., Purdy, S., McNamee, P.and Pearson, P. The effectiveness and cost-effectiveness ofnurse-led screening and brief alcohol intervention in primaryhealth care: cluster randomised controlled trial. Journal ofAdvanced Nursing, 2006 vol 54(4), 426-439.

Brazzelli, M., McKenzie, L., Fielding, S., Fraser, C., Clarkson,J., Kilonzo, M. and Waugh, N. Systematic review of theeffectiveness and cost effectiveness of HealOzone® for thetreatment of occlusal pit/fissure caries and root caries.Health Technology Assessment Monograph, 2006 Vol 10 No16.

Ma, A., Roberts, E., Elliott, R.F., Bell, D. and Scott, A.Comparing the NES and LFS: An analysis of the differencesbetween the data sets and their implications for the patternof geographical pay in the UK. Regional Studies, 2006 vol40(6), 645-665.

Matheson, C., Bond, C. and Tinelli, M. Community pharmacistsand drug misusers: national trends in attitudes and currentpractice. Supplement to the International Journal of PharmacyPractice, 2006 vol 14, B23-24.

Mavromaras, K.G. and Scott, A. Promotion to hospitalconsultant: regression analysis using NHS administrative data.British Medical Journal, 2006 vol 332, 148-151.

McKenzie, L., de Verteuil, R., Cook, J., Shanmugam, V.,Loudon, M.A., Watson, A.J. and Vale, L. Economic evaluationof stapled haemorrhoidopexy compared with rubber bandligation in first line treatment of symptomatic grade IIhaemorrhoids. British Journal of Surgery, 2006, vol 93(Suppl1),27.

McLean, G., Sutton, M. and Guthrie, B. Deprivation andquality of primary care services: evidence for persistence ofthe inverse care law from the UK quality and outcomesframework. Journal of Epidemiology and Community Health,2006 vol 60, 917-22.

McNamee, P. Quantifying uncertainty in long-term care costsfollowing the introduction of new drug therapy. Swiss Journalof Economics & Statistics, 2006 vol S10, 61-68.

Murray, A., Lourenco, T., de Verteuil, R., Hernandez, R.,Fraser, C., McKinley, A., Krukowski, Z., Vale, L. and Grant,A. Clinical effectiveness and cost-effectiveness of laparoscopicsurgery for colorectal cancer: systematic reviews and economicevaluation. Health Technology Assessment, 2006 vol 10(45).

Morrison, J., Monoz-Arroyo, R. and Sutton, M. Exploringpotential explanations for the increase in anti-depressantprescribing in Scotland using secondary analyses of routinedata. British Journal of General Practice, 2006 vol 56(527),423-428.

Porteous, T., Ryan, M., Bond, C. and Hannaford, P. Preferencesfor self-care or consulting a health professional in minorillness: a discrete choice experiment. British Journal ofGeneral Practice, 2006 vol 56, 911-917.

Regier, D.A., Sunderji, R., Llynd, L.D., Gin, K. and Marra,C.A. Cost-effectiveness of self-managed versus physician-managed oral anticoagulation. Canadian Medical AssociationJournal, 2006 vol 174(13), 1847-52.

Ryan, M., Netten, A., Skåtun, D. and Smith, P. Using discretechoice experiments to estimate a preference-based measureof outcome - an application to social care for older people.Journal of Health Economics, 2006 vol 25(5), 927-944.

Ryan, M. and Watson, V. Counting the cost of fast access:using discrete choice experiments to elicit preferences ingeneral practice. British Journal of General Practice, 2006vol 56(522) 4-5.

Seymour, J., Cairns, J.A., Wilkie, A., Sandercock, P. andWardlaw, D. Geographical access to imaging facilities forstroke patients in Scotland. Health and Place, 2006 vol 12,617-630.

Shanmugam, V., Watson, A.J., Cook, J., Vale, L. and London,M.A. Stapled haemorrhoidopexy achieves better symptomcontrol than rubber ligation in the treatment of symptomaticgrade II haemorrhoids. British Journal of Surgery, 2006 vol93(suppl1), 26.

Shanmugam, V., Watson, A.J., Cook, J., Vale, L. and Loudon,M.A. Stapled haemorrhoidopexy achieves better symptomcontrol than rubber band ligation in the treatment ofsymptomatic grade II haemorrhoids. Colorectal Disease, 2006vol 8(Suppl2), 54.


6361

The Royal Society (Ryan, M., a member). Digital healthcare:the impact of information and communication technologieson health and healthcare. Policy Report by The Royal Society37/06. December 2006.

Ternent, L., McNamee, P., Belemsaga, D., Belemsaga, D.,Daniels, A. and Newlands, D. The valuation of maternaloutcomes using discrete choice and contingent valuationmethods. Report to IMMPACT, August 2006.

Tucker, J., Farmer, J., Bryers, H., Kiger, A., van Teijlingen,E., Ryan, M., Pitchforth, E., King, K., Martin. E., Watson,V. and Reid, J. Sustainable maternity services provision inremote and rural Scotland: implementing and evaluatingmaternity care models. Final Report to the NHS ScotlandMaternity Services Project Board, January 2006.

Vale, L. Sustainable maternity services in remote and ruralScotland. Final report submitted to NHS Scotland RARARIMaternity Services Project Board. January 2006.

Other Publications

Kilonzo, M. Cost-Effectiveness Analysis Of ‘Healozone’ ForThe Treatment Of Occlusal Pit/Fissure Caries And Root Caries.HERU Briefing Paper for the NHS. Health Economics ResearchUnit, University of Aberdeen. September 2006.

Sussex, J., Farrar, S. and PbR team. Payment by ResultsEvaluation Newsletter 1. Office of Health Economics, February2006.

Sussex, J., Farrar, S. and PbR team. Payment by ResultsEvaluation Newsletter 2. Office of Health Economics, December2006.

Ryan, M. and Watson, V. Rapid prenatal diagnosis testingfor Down’s syndrome only or longer wait for full karyotype:the views of pregnant women. HERU Briefing Paper for theNHS. Health Economics Research Unit, University of Aberdeen.February 2006.


APPENDIX 4


APPENDIX 4

Shemilt, I., Mugford, M., Drummond, M., Eisenstein, E.,Mallender, J., McDaid, D., Vale, L., Walker, D. and theCampbell & Cochrane Economics Methods Group (CCEMG).Economics methods in Cochrane systematic reviews of healthpromotion and public health related interventions. BMCMedical Research Methodology, 2006 vol 6, 55.

Simoens, S., Ludbrook, A., Matheson, C. and Bond, C.Pharmaco-economics of community maintenance for opiatedependence: A review of evidence and methodology. Drugand Alcohol Dependence, 2006 vol 84, 28-39.

Sutton, M. and McLean, G. Determinants of primary medicalcare quality measured under the new UK contract: crosssectional study. British Medical Journal, 2006 vol 332, 389-90.

Tan, M., Regier, D.A., Esdaile, J. and Marra, C.A. HealthEconomic Evaluation: a primer for the practicingrheumatologist. Arthritis Rheum, 2006 vol 15(4) 648-56.

Tinelli, M., Ryan, M. and Bond C. A patient-centred approachto policy development: a pharmacy-led medicines managementservice. Supplement to the International Journal of PharmacyPractice, 2006 vol 14, B71-72.

Tinelli, M., Ryan, M. and Bond C. Discrete choice experimentsto value increased roles for the pharmacist in the managementof drug therapy. Supplement to the International Journal ofPharmacy Practice, 2006 vol 14, A12-13.

Vale, L. and Noble, D. Overlays or mattresses to preventpressure sores? British Medical Journal, 2006 vol 332, 1401– 1402.

Wood, R., Sutton, M., Clark, D., McKeon, A. and Bain, M.Measuring inequalities in health: the case for health lifeexpectancy. Journal of Epidemiology and Community Health,2006 vol 60, 1089-1092.

Wordsworth, S., Ryan, M., Skåtun, D. and Waugh, N. Women’spreferences for cervical cancer screening: a study using adiscrete choice experiment. International Journal ofTechnology Assessment, 2006 vol 22, 344-350.


Avenell, A., Campbell, M., Cook, J., Milne, A., Ramsay, C.,Stephen, A., Hannaford, P., Kilonzo, M., Vale, L., McNeill,G. and Seymour, G. The key role of micronutrients. ClinicalNutrition. Forthcoming.

Black, C., de Verteuil, R., Walker, S., Ayres, J., Boland, A.,Bagust, A. and Waugh, N. Population screening for lung cancerusing CT, is there evidence of clinical effectiveness? Asystematic review of the literature. Thorax. Forthcoming.

Caldow, J., Bond, C., Ryan, M., Campbell, N., San Miguel,F., Kiger, A. and Lee, A. Treatment of Minor Illness in PrimaryCare: A National Survey of Patient Satisfaction, Attitudesand Preferences regarding a Wider Nursing Role. HealthExpectations. Forthcoming.

Grimshaw, J., Eccles, M., Thomas, R., Ramsay, R., Fraser,C., MacLennan, G. and Vale, L. Current evidence (and itslimitations) of the effectiveness of quality improvementstrategies. Journal of General Internal Medicine. Forthcoming.

French, F., Ikenwilo, D. and Scott, A. What influences thejob satisfaction of hospital doctors? Health ServicesManagement Research. Forthcoming.

Ikenwilo, D. and Scott, A. The effect of pay and job satisfactionon the labour supply of hospital consultants. Health Economics.Forthcoming.

Jaffray, M., Bond, C.M., Watson, M.C., Hannaford, P., Tinelli,M., Scott, A., Lee, A., Blenkinsopp, A., Anderson, C., Avery,A., Bissell, P. and Krksa, J. The Community Pharmacy MedicinesManagement Project Evaluation Team. Community Pharmacy-led Medicines Management: A randomised controlled trial inpatients with CHD. Family Practice. Forthcoming.

Kilonzo, M., Vale, L., Cook, J., Milne, A., Stephen, A.,Avenell, A. and the MAVIS Trial Group. The cost utility analysisof multivitamin and multimineral supplements in men andwomen aged 65 years and over. Clinical Nutrition.Forthcoming.

McCormack, K., Rabindranath, K., Kilonzo, M., Vale, L.,Fraser, C., McIntyre, L., Thomas, S., Rothnie, H., Fluck, N.,Gould, I. and Waugh, N. Systematic review of the effectivenessof preventing and treating Staphylococcus aureus carriageon peritoneal catheter-related infections. Health TechnologyAssessment. Forthcoming.

McLean, G. and Sutton, M. CHD prescribing and the proportionof South Asians. Family Practice. Forthcoming.

Pol, van der M. and Shiell, A. Extrinsic goals and Time TradeOff. Medical Decision Making. Forthcoming, subject torevisions.

Prescott, R., Kunkler, I., Williams, L., King, C., Jack, W.,Dixon, J., Pol, van der M., Goh, T., Lindley, R. and Cairns,J. The PRIME breast cancer trial (postoperative radiotherapyin minimum-risk elderly). Health Technology Assessment.Forthcoming, subject to revisions.

Rabindradranath, K., Ali, T.Z., MacLeod, A.M. and Vale, L.Automated vs continuous ambulatory peritoneal dialysis: Asystematic review of randomized controlled trial. NephrologyDialysis and Transplantation. Forthcoming.


Ryan, M. Preferences for self-care or consulting a healthprofessional in minor illness: a discrete choice experiment.British Journal of General Practice. Forthcoming.

Scotland, G.S., McNamee, P. and Bhattacharya, S. Is electivesingle embryo transfer a cost-effective alternative to doubleembryo transfer. BJOG. Forthcoming.


64 62



Macdonald, A.S., Straughn, J.S. and Sutton, M. Healthy lifeexpectancy measurement in Scotland. Invited presentationat the Fifth Sessional Meeting of the Faculty of Actuaries.Royal College of Physicians, Edinburgh, February 2006.

Sutton M. Productivity in Health Care. Invited presentationat the Annual Conference of the Scottish Association ofMedical Directors, Dunkeld, May 2006.

The Campbell & Cochrane Economics Methods Group (CCEMG)(Vale, L., a member of the Group). Health economics methods:from effectiveness to efficiency in systematic review. InvitedPresentation to the Cochrane Colloquium, Dublin, October2006.

Vale, L. Health Economics and Health Services Research.Invited Presentation to the Health Services ResearchConference, University of Aberdeen, June 2006.


Anton, S., Mckee, L., Harrison, S. and Farrar, S. Involvingthe public in NHS planning: criteria and methods for evaluatingNHS Boards’ Activity. Paper presented at the 5th InternationalConference on Organisational Behaviour in Health Care,University of Aberdeen, April 2006.

Herbert, M.A., Brant, R., Hailey, D. and Pol, M vander. Potential and reality for video-visits in rural palliativehomecare: results of a multi-method study in Canada. Paperpresentation at the 6th International conference on successesand failures in Telehealth, Brisbane, Australia, August 2006.

Ikenwilo, D., Farrar, S. and Sutton, M. Anticipatory behaviourprior to the introduction of a prospective payment systemfor hospitals in England. Paper presented to the EuropeanConference on Health Economics (ECHE), Budapest, July 2006.

McNamee, P., Quayyum, Z., Megraini, A., Nadjib, M. andNewlands, D. To what extent do people care about the sizeof health inequalities? The feasibility of methods to generatedistributional weights. Paper presented to the AdvancingHealth Equity Conference, World Institute of DevelopmentEconomics Research (WIDER), Helsinki, September 2006.

Morris, S., Elliott, R., Gravelle, H., Hole, A., Ma, A., Sibbald,B., Skåtun, D. and Sutton, M. Mobility of the GPworkforce. Paper presented to CES-HESG, City University,London, January 2006.

Morris, S., Sutton, M., Elliott, R., Gravelle, H., Hole, A.,Ma, A., Sibbald, B. and Skåtun, D. Determinants of GP wages.Paper presented to Health Economists Study Group, York,July 2006.

Scotland, G.S. and McNamee, P. A methodological comparisonof alternative standard gamble chaining procedures. Paperpresented at the Health Economists Study Group, York. July2006.

Scott, A., Elliott, R., Skåtun, D., Ikenwilo, D., Bell, D. andRoberts, E. Does relative pay influence shortages of doctorsand nurses? Implications for the cross-national mobility ofhealth professionals. Paper presented at the EuropeanConference on Health Economics (ECHE), Budapest, July 2006.

Sussex, J. and Farrar, S. Payment by Results’ for NationalHealth Service Hospitals in England – Managers’ Experiencesand Expectations. Paper presented to CES-HESG, CityUniversity, London, January, 2006.

Sussex, J. and Farrar, S. Activity Based Hospital Funding ina Cash Limited System – Qualitative Analysis of ‘Payment byResults’ in England. Paper presented at the EuropeanConference on Health Economics, Budapest, July 2006.

Sutton, M., Elliott, R.F., Gravelle, H., Hole, A.R., Ma, A.,Morris, S., Sibbald, B. and Skåtun, D. Local differences infamily doctor recruitment and retention and patterns ofrelative rewards. Paper presented to the 6th EuropeanConference on Health Economics (ECHE), Budapest, July2006.

Tinelli, M. and Ryan, M. Alternative approaches to derivingwelfare estimates in Discrete Choice Experiments. Paperpresented at Health Economists Study Group, York, July2006.

Tinelli, M. Alternative approaches to deriving welfareestimates in discrete choice experiments. Paper presentedat the Health Economists Study Group, York, July 2006.

Yi, D., Farrar, S., Scott, A. and Sutton, M. Preliminaryanalysis of the effects of PbR. Paper presentation at theNHESG, Copenhagen, August 2006.


Amaya-Amaya, M., Ludbrook, A. and Goode, A. Estimatingsmoking cessation relapse rates for policy evaluation. Oralpresentation at the 6th European Conference of HealthEconomists, Budapest, Hungary, July 2006.

Barmby, T. and Eberth, B. Specific human capital accumulationand job match quality – implications for measuring the returnsto tenure. Oral Presentation at the Scottish Economic SocietyConference, April 2006.

Hebert, M.A., Brant, R., Hailey, D. and Pol van der, M. Video-visits in Rural Palliative Homecare: Results of a Multi-methodStudy in Canada. Oral presentation to the 9th Annual Meetingof the Canadian Society for Teleheath, Edmonton, Canada,October 2006.

Hernandez, R. Screening for Open Angle Glaucoma: Is itcost-effective?. Oral presentation at the 3rd Annual Meetingof Health Technology Assessment International Society,Adelaide, Australia, July 2006.

Ludbrook, A. The effect of smoking in Ireland on barsales. Oral presented at Evidence Policy and Practiceconference, Edinburgh, June 2006.

Ludbrook, A. What really works? Oral presentation at theChildhood Obesity Conference, Edinburgh, December 2006.

APPENDIX 5


APPENDIX 4

Watson, V. and Ryan, M. Exploring preference anomalies indouble bounded contingent valuation studies. Journal ofHealth Economics. Forthcoming.

Waugh, N., Scotland, G., Gillett, M., McNamee, P., Williams,R. and John, A. Screening for Type 2 diabetes: literaturereview and economic modelling. Health TechnologyAssessment. Forthcoming.

Books & Book Chapters

Gravelle, H., Morris, S. and Sutton, M. Economic Studies ofequity in the consumption of health care. In: Elgar Companionto Health Economics. Jones, A.M. (ed). Edward Elgar. 2006.

Ryan, M., Gerard, K. and Currie, G. Using Discrete ChoiceExperiments in Health Economics. In: The Elgar Companionto Health Economics. Jones, A.M. (ed). Edward Elgar. 2006.

Sibbald, B., Laurant, M. and Scott, A. Changing task profiles.In: Primary care in the drivers seat? Organizational reformin European primary care. Saltman, R., Rico, A. and Boerma,W. (eds). European Observatory on Health Care Systems.Open University Press, Berkshire, 2006.

Reports

Anton, S., Entwistle, V., Farrar, S., Harrison, S. and McKee,L. Involving the public in NHS service Planning: criteriamethods for evaluating NHS Boards’ activity. Report to theScottish Executive Health Department, September 2006.

BPE Group. Systematic review and economic modelling ofeffectiveness and cost utility of surgical treatments for menwith benign prostatic enlargement (BPE). Report submittedto NHS R&D HTA Programme, November 2006.

Burr, J., Mowatt, G., Rehman Siddiqui, M.A., Hernandez,R., Cook, J., Lourenco, T., Ramsay, C., Vale, L., Fraser, C.,Azuara-Blanco, A., Deeks, J., Cairns, J., Wormald, R.,McPherson, S., Wright, D., Rabindranath, K. and Grant, A.The clinical and cost-effectiveness of screening for openangle glaucoma: a systematic review and economic evaluation.Report submitted to the NHS R&D HTA Programme, June2006.

Caldow, J., Goh, T., Kiger, A., Reid, J., Tucker, J. and Vale,L. An impact assessment of Health Technology Assessmentsconducted by NHS Quality Improvement Scotland. Report tothe NHS Quality Improvement Scotland. January 2006.

Douglas, F., Amaya, M., Greener, J., Ludbrook, A., Reid,G., Robertson, L. and van Teijlingen, E. Well men healthservice pilots evaluation. Report submitted to the ScottishExecutive Health Department, December 2006.

Elliott, R.F., Sutton, M., Gravelle, H., Hole, A., Ma, A.,Morris, S., Sibbald, B. and Skåtun, D. Adjusting the GeneralMedical Services Allocation Formula to Reflect Recruit andRetention Difficulties. A Report to the GMS Formula ReviewGroup, January 2006.

Elliott, R.F., Sutton, M., Ma, A., Munro, A. and Teckle, P.Geographical Differences in the Costs of Delivering HealthServices in Scotland: Implications for the National ResourcesAllocation Formula. Report to the NHSScotland ResourceAllocation Committee, June 2006.

Elliott, R.F., Sutton, M., Ma, A., McConnachie, A., Morris,S., Rice, N. and Skåtun, D. Review of the Market ForcesFactor following the introduction of Payment by Results(2005): Exploring the General Labour Market Method. Reportto the Department of Health, September 2006.

Farrar, S., Yi, D., Scott, A., Sutton, M. and Sussex, J. et al.PbR interim report Parts I and II, III and IV. Reports toDepartment of Health, August and September 2006.

French, F., Geue, C., Ikenwilo, D., Needham, G., Rooke,C., Skåtun, D. and Sutton, M. Changes in job satisfaction,work commitments and attitudes to workload followingcontractual reform. Report to the Scottish Executive PayModernisation, December 2006.

McCormack, K., Rabindranath, K., Kilonzo, M., Vale, L.,Fraser, C., McIntyre, L., Thomas, S., Rothnie, H., Fluck, N.,Gould, I. and Waugh, N. Systematic review of the effectivenessof preventing and treating Staphylococcus aureus carriageon peritoneal catheter-related infections. Report submittedto NHS HTA Programme, April 2006.

McNamee, P. Wanless Social Care Review: Effects of FreePersonal Care Policy in Scotland. An examination of trendsin the use of informal and formal care provision at home andin the care home sector. King’s Fund Background Paper,March 2006.

http://www.kingsfund.org.uk/resources/publications/appendices_to.html

McNamee, P., Megraini, A., Nadjib, M., Quayyum, Z. andNewlands, D. The feasibility of methods to generatedistributional weights for maternal health. Report to IMMPACT,August 2006.

Murray. A., Lourenco, T., de Verteuil, R., Hernández, R.,Fraser, C., McKinley, A., Krukowski, Z., Vale, L. and Grant,A. Systematic review of the clinical effectiveness andcost-effectiveness of laparoscopic surgery for colorectalcancer. Report to the National Institute for Health andClinical Excellence, Apri l 2006. Avai lable at:http://www.nice.org.uk/download.aspx?o=297524

Newlands, D., McNamee, P., Quayyum, Z., Chikwama, C.,Ternent, L., Belemsaga, D., Asante, F., Daniels, A., Megraini,A. and Nadjib, M. Economic Outcomes. Final Report toIMMPACT, August 2006.

Reflux Trial Group. (Vale, L., Kilonzo, M., a member). Theplace of minimal access surgery amongst people with gastro-oesophageal reflux disease – a UK collaborative study. TheREFLUX Trial. Report submitted to NHS R&D HTA Programme,October 2006.

Ryan, M. and Watson, V. Using discrete choice experimentsto inform priority setting. Report submitted to NHS Dumfriesand Galloway, October 2006.


6361

The Royal Society (Ryan, M., a member). Digital healthcare:the impact of information and communication technologieson health and healthcare. Policy Report by The Royal Society37/06. December 2006.

Ternent, L., McNamee, P., Belemsaga, D., Belemsaga, D.,Daniels, A. and Newlands, D. The valuation of maternaloutcomes using discrete choice and contingent valuationmethods. Report to IMMPACT, August 2006.

Tucker, J., Farmer, J., Bryers, H., Kiger, A., van Teijlingen,E., Ryan, M., Pitchforth, E., King, K., Martin. E., Watson,V. and Reid, J. Sustainable maternity services provision inremote and rural Scotland: implementing and evaluatingmaternity care models. Final Report to the NHS ScotlandMaternity Services Project Board, January 2006.

Vale, L. Sustainable maternity services in remote and ruralScotland. Final report submitted to NHS Scotland RARARIMaternity Services Project Board. January 2006.

Other Publications

Kilonzo, M. Cost-Effectiveness Analysis Of ‘Healozone’ ForThe Treatment Of Occlusal Pit/Fissure Caries And Root Caries.HERU Briefing Paper for the NHS. Health Economics ResearchUnit, University of Aberdeen. September 2006.

Sussex, J., Farrar, S. and PbR team. Payment by ResultsEvaluation Newsletter 1. Office of Health Economics, February2006.

Sussex, J., Farrar, S. and PbR team. Payment by ResultsEvaluation Newsletter 2. Office of Health Economics, December2006.

Ryan, M. and Watson, V. Rapid prenatal diagnosis testingfor Down’s syndrome only or longer wait for full karyotype:the views of pregnant women. HERU Briefing Paper for theNHS. Health Economics Research Unit, University of Aberdeen.February 2006.


APPENDIX 4


APPENDIX 4

Shemilt, I., Mugford, M., Drummond, M., Eisenstein, E.,Mallender, J., McDaid, D., Vale, L., Walker, D. and theCampbell & Cochrane Economics Methods Group (CCEMG).Economics methods in Cochrane systematic reviews of healthpromotion and public health related interventions. BMCMedical Research Methodology, 2006 vol 6, 55.

Simoens, S., Ludbrook, A., Matheson, C. and Bond, C.Pharmaco-economics of community maintenance for opiatedependence: A review of evidence and methodology. Drugand Alcohol Dependence, 2006 vol 84, 28-39.

Sutton, M. and McLean, G. Determinants of primary medicalcare quality measured under the new UK contract: crosssectional study. British Medical Journal, 2006 vol 332, 389-90.

Tan, M., Regier, D.A., Esdaile, J. and Marra, C.A. HealthEconomic Evaluation: a primer for the practicingrheumatologist. Arthritis Rheum, 2006 vol 15(4) 648-56.

Tinelli, M., Ryan, M. and Bond C. A patient-centred approachto policy development: a pharmacy-led medicines managementservice. Supplement to the International Journal of PharmacyPractice, 2006 vol 14, B71-72.

Tinelli, M., Ryan, M. and Bond C. Discrete choice experimentsto value increased roles for the pharmacist in the managementof drug therapy. Supplement to the International Journal ofPharmacy Practice, 2006 vol 14, A12-13.

Vale, L. and Noble, D. Overlays or mattresses to preventpressure sores? British Medical Journal, 2006 vol 332, 1401– 1402.

Wood, R., Sutton, M., Clark, D., McKeon, A. and Bain, M.Measuring inequalities in health: the case for health lifeexpectancy. Journal of Epidemiology and Community Health,2006 vol 60, 1089-1092.

Wordsworth, S., Ryan, M., Skåtun, D. and Waugh, N. Women’spreferences for cervical cancer screening: a study using adiscrete choice experiment. International Journal ofTechnology Assessment, 2006 vol 22, 344-350.


Avenell, A., Campbell, M., Cook, J., Milne, A., Ramsay, C.,Stephen, A., Hannaford, P., Kilonzo, M., Vale, L., McNeill,G. and Seymour, G. The key role of micronutrients. ClinicalNutrition. Forthcoming.

Black, C., de Verteuil, R., Walker, S., Ayres, J., Boland, A.,Bagust, A. and Waugh, N. Population screening for lung cancerusing CT, is there evidence of clinical effectiveness? Asystematic review of the literature. Thorax. Forthcoming.

Caldow, J., Bond, C., Ryan, M., Campbell, N., San Miguel,F., Kiger, A. and Lee, A. Treatment of Minor Illness in PrimaryCare: A National Survey of Patient Satisfaction, Attitudesand Preferences regarding a Wider Nursing Role. HealthExpectations. Forthcoming.

Grimshaw, J., Eccles, M., Thomas, R., Ramsay, R., Fraser,C., MacLennan, G. and Vale, L. Current evidence (and itslimitations) of the effectiveness of quality improvementstrategies. Journal of General Internal Medicine. Forthcoming.

French, F., Ikenwilo, D. and Scott, A. What influences thejob satisfaction of hospital doctors? Health ServicesManagement Research. Forthcoming.

Ikenwilo, D. and Scott, A. The effect of pay and job satisfactionon the labour supply of hospital consultants. Health Economics.Forthcoming.

Jaffray, M., Bond, C.M., Watson, M.C., Hannaford, P., Tinelli,M., Scott, A., Lee, A., Blenkinsopp, A., Anderson, C., Avery,A., Bissell, P. and Krksa, J. The Community Pharmacy MedicinesManagement Project Evaluation Team. Community Pharmacy-led Medicines Management: A randomised controlled trial inpatients with CHD. Family Practice. Forthcoming.

Kilonzo, M., Vale, L., Cook, J., Milne, A., Stephen, A.,Avenell, A. and the MAVIS Trial Group. The cost utility analysisof multivitamin and multimineral supplements in men andwomen aged 65 years and over. Clinical Nutrition.Forthcoming.

McCormack, K., Rabindranath, K., Kilonzo, M., Vale, L.,Fraser, C., McIntyre, L., Thomas, S., Rothnie, H., Fluck, N.,Gould, I. and Waugh, N. Systematic review of the effectivenessof preventing and treating Staphylococcus aureus carriageon peritoneal catheter-related infections. Health TechnologyAssessment. Forthcoming.

McLean, G. and Sutton, M. CHD prescribing and the proportionof South Asians. Family Practice. Forthcoming.

Pol, van der M. and Shiell, A. Extrinsic goals and Time TradeOff. Medical Decision Making. Forthcoming, subject torevisions.

Prescott, R., Kunkler, I., Williams, L., King, C., Jack, W.,Dixon, J., Pol, van der M., Goh, T., Lindley, R. and Cairns,J. The PRIME breast cancer trial (postoperative radiotherapyin minimum-risk elderly). Health Technology Assessment.Forthcoming, subject to revisions.

Rabindradranath, K., Ali, T.Z., MacLeod, A.M. and Vale, L.Automated vs continuous ambulatory peritoneal dialysis: Asystematic review of randomized controlled trial. NephrologyDialysis and Transplantation. Forthcoming.


Ryan, M. Preferences for self-care or consulting a healthprofessional in minor illness: a discrete choice experiment.British Journal of General Practice. Forthcoming.

Scotland, G.S., McNamee, P. and Bhattacharya, S. Is electivesingle embryo transfer a cost-effective alternative to doubleembryo transfer. BJOG. Forthcoming.


64 62



Macdonald, A.S., Straughn, J.S. and Sutton, M. Healthy lifeexpectancy measurement in Scotland. Invited presentationat the Fifth Sessional Meeting of the Faculty of Actuaries.Royal College of Physicians, Edinburgh, February 2006.

Sutton M. Productivity in Health Care. Invited presentationat the Annual Conference of the Scottish Association ofMedical Directors, Dunkeld, May 2006.

The Campbell & Cochrane Economics Methods Group (CCEMG)(Vale, L., a member of the Group). Health economics methods:from effectiveness to efficiency in systematic review. InvitedPresentation to the Cochrane Colloquium, Dublin, October2006.

Vale, L. Health Economics and Health Services Research.Invited Presentation to the Health Services ResearchConference, University of Aberdeen, June 2006.


Anton, S., Mckee, L., Harrison, S. and Farrar, S. Involvingthe public in NHS planning: criteria and methods for evaluatingNHS Boards’ Activity. Paper presented at the 5th InternationalConference on Organisational Behaviour in Health Care,University of Aberdeen, April 2006.

Herbert, M.A., Brant, R., Hailey, D. and Pol, M vander. Potential and reality for video-visits in rural palliativehomecare: results of a multi-method study in Canada. Paperpresentation at the 6th International conference on successesand failures in Telehealth, Brisbane, Australia, August 2006.

Ikenwilo, D., Farrar, S. and Sutton, M. Anticipatory behaviourprior to the introduction of a prospective payment systemfor hospitals in England. Paper presented to the EuropeanConference on Health Economics (ECHE), Budapest, July 2006.

McNamee, P., Quayyum, Z., Megraini, A., Nadjib, M. andNewlands, D. To what extent do people care about the sizeof health inequalities? The feasibility of methods to generatedistributional weights. Paper presented to the AdvancingHealth Equity Conference, World Institute of DevelopmentEconomics Research (WIDER), Helsinki, September 2006.

Morris, S., Elliott, R., Gravelle, H., Hole, A., Ma, A., Sibbald,B., Skåtun, D. and Sutton, M. Mobility of the GPworkforce. Paper presented to CES-HESG, City University,London, January 2006.

Morris, S., Sutton, M., Elliott, R., Gravelle, H., Hole, A.,Ma, A., Sibbald, B. and Skåtun, D. Determinants of GP wages.Paper presented to Health Economists Study Group, York,July 2006.

Scotland, G.S. and McNamee, P. A methodological comparisonof alternative standard gamble chaining procedures. Paperpresented at the Health Economists Study Group, York. July2006.

Scott, A., Elliott, R., Skåtun, D., Ikenwilo, D., Bell, D. andRoberts, E. Does relative pay influence shortages of doctorsand nurses? Implications for the cross-national mobility ofhealth professionals. Paper presented at the EuropeanConference on Health Economics (ECHE), Budapest, July 2006.

Sussex, J. and Farrar, S. Payment by Results’ for NationalHealth Service Hospitals in England – Managers’ Experiencesand Expectations. Paper presented to CES-HESG, CityUniversity, London, January, 2006.

Sussex, J. and Farrar, S. Activity Based Hospital Funding ina Cash Limited System – Qualitative Analysis of ‘Payment byResults’ in England. Paper presented at the EuropeanConference on Health Economics, Budapest, July 2006.

Sutton, M., Elliott, R.F., Gravelle, H., Hole, A.R., Ma, A.,Morris, S., Sibbald, B. and Skåtun, D. Local differences infamily doctor recruitment and retention and patterns ofrelative rewards. Paper presented to the 6th EuropeanConference on Health Economics (ECHE), Budapest, July2006.

Tinelli, M. and Ryan, M. Alternative approaches to derivingwelfare estimates in Discrete Choice Experiments. Paperpresented at Health Economists Study Group, York, July2006.

Tinelli, M. Alternative approaches to deriving welfareestimates in discrete choice experiments. Paper presentedat the Health Economists Study Group, York, July 2006.

Yi, D., Farrar, S., Scott, A. and Sutton, M. Preliminaryanalysis of the effects of PbR. Paper presentation at theNHESG, Copenhagen, August 2006.


Amaya-Amaya, M., Ludbrook, A. and Goode, A. Estimatingsmoking cessation relapse rates for policy evaluation. Oralpresentation at the 6th European Conference of HealthEconomists, Budapest, Hungary, July 2006.

Barmby, T. and Eberth, B. Specific human capital accumulationand job match quality – implications for measuring the returnsto tenure. Oral Presentation at the Scottish Economic SocietyConference, April 2006.

Hebert, M.A., Brant, R., Hailey, D. and Pol van der, M. Video-visits in Rural Palliative Homecare: Results of a Multi-methodStudy in Canada. Oral presentation to the 9th Annual Meetingof the Canadian Society for Teleheath, Edmonton, Canada,October 2006.

Hernandez, R. Screening for Open Angle Glaucoma: Is itcost-effective?. Oral presentation at the 3rd Annual Meetingof Health Technology Assessment International Society,Adelaide, Australia, July 2006.

Ludbrook, A. The effect of smoking in Ireland on barsales. Oral presented at Evidence Policy and Practiceconference, Edinburgh, June 2006.

Ludbrook, A. What really works? Oral presentation at theChildhood Obesity Conference, Edinburgh, December 2006.

APPENDIX 5


APPENDIX 4

Watson, V. and Ryan, M. Exploring preference anomalies indouble bounded contingent valuation studies. Journal ofHealth Economics. Forthcoming.

Waugh, N., Scotland, G., Gillett, M., McNamee, P., Williams,R. and John, A. Screening for Type 2 diabetes: literaturereview and economic modelling. Health TechnologyAssessment. Forthcoming.

Books & Book Chapters

Gravelle, H., Morris, S. and Sutton, M. Economic Studies ofequity in the consumption of health care. In: Elgar Companionto Health Economics. Jones, A.M. (ed). Edward Elgar. 2006.

Ryan, M., Gerard, K. and Currie, G. Using Discrete ChoiceExperiments in Health Economics. In: The Elgar Companionto Health Economics. Jones, A.M. (ed). Edward Elgar. 2006.

Sibbald, B., Laurant, M. and Scott, A. Changing task profiles.In: Primary care in the drivers seat? Organizational reformin European primary care. Saltman, R., Rico, A. and Boerma,W. (eds). European Observatory on Health Care Systems.Open University Press, Berkshire, 2006.

Reports

Anton, S., Entwistle, V., Farrar, S., Harrison, S. and McKee,L. Involving the public in NHS service Planning: criteriamethods for evaluating NHS Boards’ activity. Report to theScottish Executive Health Department, September 2006.

BPE Group. Systematic review and economic modelling ofeffectiveness and cost utility of surgical treatments for menwith benign prostatic enlargement (BPE). Report submittedto NHS R&D HTA Programme, November 2006.

Burr, J., Mowatt, G., Rehman Siddiqui, M.A., Hernandez,R., Cook, J., Lourenco, T., Ramsay, C., Vale, L., Fraser, C.,Azuara-Blanco, A., Deeks, J., Cairns, J., Wormald, R.,McPherson, S., Wright, D., Rabindranath, K. and Grant, A.The clinical and cost-effectiveness of screening for openangle glaucoma: a systematic review and economic evaluation.Report submitted to the NHS R&D HTA Programme, June2006.

Caldow, J., Goh, T., Kiger, A., Reid, J., Tucker, J. and Vale,L. An impact assessment of Health Technology Assessmentsconducted by NHS Quality Improvement Scotland. Report tothe NHS Quality Improvement Scotland. January 2006.

Douglas, F., Amaya, M., Greener, J., Ludbrook, A., Reid,G., Robertson, L. and van Teijlingen, E. Well men healthservice pilots evaluation. Report submitted to the ScottishExecutive Health Department, December 2006.

Elliott, R.F., Sutton, M., Gravelle, H., Hole, A., Ma, A.,Morris, S., Sibbald, B. and Skåtun, D. Adjusting the GeneralMedical Services Allocation Formula to Reflect Recruit andRetention Difficulties. A Report to the GMS Formula ReviewGroup, January 2006.

Elliott, R.F., Sutton, M., Ma, A., Munro, A. and Teckle, P.Geographical Differences in the Costs of Delivering HealthServices in Scotland: Implications for the National ResourcesAllocation Formula. Report to the NHSScotland ResourceAllocation Committee, June 2006.

Elliott, R.F., Sutton, M., Ma, A., McConnachie, A., Morris,S., Rice, N. and Skåtun, D. Review of the Market ForcesFactor following the introduction of Payment by Results(2005): Exploring the General Labour Market Method. Reportto the Department of Health, September 2006.

Farrar, S., Yi, D., Scott, A., Sutton, M. and Sussex, J. et al.PbR interim report Parts I and II, III and IV. Reports toDepartment of Health, August and September 2006.

French, F., Geue, C., Ikenwilo, D., Needham, G., Rooke,C., Skåtun, D. and Sutton, M. Changes in job satisfaction,work commitments and attitudes to workload followingcontractual reform. Report to the Scottish Executive PayModernisation, December 2006.

McCormack, K., Rabindranath, K., Kilonzo, M., Vale, L.,Fraser, C., McIntyre, L., Thomas, S., Rothnie, H., Fluck, N.,Gould, I. and Waugh, N. Systematic review of the effectivenessof preventing and treating Staphylococcus aureus carriageon peritoneal catheter-related infections. Report submittedto NHS HTA Programme, April 2006.

McNamee, P. Wanless Social Care Review: Effects of FreePersonal Care Policy in Scotland. An examination of trendsin the use of informal and formal care provision at home andin the care home sector. King’s Fund Background Paper,March 2006.

http://www.kingsfund.org.uk/resources/publications/appendices_to.html

McNamee, P., Megraini, A., Nadjib, M., Quayyum, Z. andNewlands, D. The feasibility of methods to generatedistributional weights for maternal health. Report to IMMPACT,August 2006.

Murray. A., Lourenco, T., de Verteuil, R., Hernández, R.,Fraser, C., McKinley, A., Krukowski, Z., Vale, L. and Grant,A. Systematic review of the clinical effectiveness andcost-effectiveness of laparoscopic surgery for colorectalcancer. Report to the National Institute for Health andClinical Excellence, Apri l 2006. Avai lable at:http://www.nice.org.uk/download.aspx?o=297524

Newlands, D., McNamee, P., Quayyum, Z., Chikwama, C.,Ternent, L., Belemsaga, D., Asante, F., Daniels, A., Megraini,A. and Nadjib, M. Economic Outcomes. Final Report toIMMPACT, August 2006.

Reflux Trial Group. (Vale, L., Kilonzo, M., a member). Theplace of minimal access surgery amongst people with gastro-oesophageal reflux disease – a UK collaborative study. TheREFLUX Trial. Report submitted to NHS R&D HTA Programme,October 2006.

Ryan, M. and Watson, V. Using discrete choice experimentsto inform priority setting. Report submitted to NHS Dumfriesand Galloway, October 2006.


65 67

Sutton, M., Elliott, R., Ma, A., Munro, A. and Teckle,P. Geographic differences in the costs of delivering healthcareservices: implications for the national resource allocationformula. Seminar presented to the NHSScotland ResourceAllocation Committee, Scottish Executive, Edinburgh, May2006.

Sutton, M. and McLean, G. Achievements of NHS Highlandpractices on the 2004/5 Quality and Outcomes Framework:Comparisons with practices in the rest of Scotland. Seminarpresented to NHS Highland, Inverness, July 2006.

Sutton, M. and McLean, G. Achievements of NHS Taysidepractices on the 2004/5 Quality and Outcomes Framework:Comparisons with practices in the rest of Scotland. Seminarpresented to NHS Tayside, Dundee, July 2006.

Sutton, M. and Bailey, D. Multivariate analysis of factorsinfluencing workload on primary medical services. Seminarpresented at the Scottish Allocation Formula Review WorkingGroup, Scottish Executive, Edinburgh, August 2006.

Sutton, M. and McLean, G. Variations in achievement on the2004/5 QOF. Seminar presented to the NHSScotland nGMSQuality and Outcomes Working Group, Alloa, August 2006.

Sutton, M. and Bailey, D. Update of Lothian’s prescribingformula. Seminar presented to NHS Lothian Prescribing Group,Edinburgh, September 2006.

Sutton, M., Needham, G., French, F., Geue, C., Ikenwilo,D., Rooke, C. and Skåtun D. Second national survey of non-training grade doctors in NHSScotland - Main findings. Seminarpresented to the Scottish Executive Health Department,Workforce Directors, Edinburgh, November 2006.

Yi, D. and Farrar, S. PbR Policy: Early quantitative results.Seminar presented to the Analytical Services Division Workshop,Scottish Executive Health Department, Edinburgh, September2006.

Ludbrook, A. Impact of smoking restrictions on smokingprevalence: predicting policy effects from indirect evident.Oral presentation at the 6th European Conference of HealthEconomists, Budapest, Hungary, July 2006.

McNamee, P., Ternent, L., Belemsaga, D., Gbangou, A. andNewlands, D. Assessing the value of maternal health usingcontingent valuation methods. Oral presentation at the 6thAnnual INDEPTH (International Network of field sites withcontinuous Demographic Evaluation of Populations and TheirHealth) General Meeting, Ougadougou, month 2006.

Millar, J., Bond, C., McNamee, P., Morton, M., Selvaraj, S.and Lindsay, S. A feasibility study for a future economicevaluation of instalment dispensing for newly prescribedmedicines. Oral presentation at the Society of AcademicPrimary Care, University of Keele, July 2006.

Pol, van der M. and Ruggeri, M. Is risk attitude in healthcontext specific? Oral presentation to the 6th EuropeanConference on Health Economics, Budapest, Hungary, July2006.

Pol, van der M, Sheill A, Au F. Using open-ended follow-upquestions to test the validity of DCE estimates. Oralpresentation to the 6th European Conference on HealthEconomics, Budapest, Hungary, July 2006.

Ryan, M. Factors influencing the choice between self-careand health professional advice in minor illness: a discretechoice experiment. Oral presentation at the Health SciencesResearch and Pharmacy Practice Conference, University ofBath, April 2006.

Ryan, M. Factors influencing the choice between self-careand health professional advice in minor illness: a discretechoice experiment. Oral presentation at the Social Dimensionsof Health Institute Conference, University of Dundee, May2006.

Scotland, G.S., McNamee, P., Peddie, V. and Bhattacharya,S. Safety versus success in SET: women’s preferences foroutcomes of IVF. Oral presentation at the 22nd Annual Meetingof ESHRE, Prague, June 2006.

Sutton, M. The effect on Patient care. Oral Presentation atNever mind the quality: count the points: the effectivenessof the GMS contract, the University of Glasgow, February2006.

Shanmugam, V., Loudon, M.A., Watson, A., Cook, J.,McKenzie, L., de Verteuil, R. and Vale, L. Economicevaluation of stapled haemorrhoidopexy compared withrubber band ligation in first line treatment of symptomaticgrade II haemorrhoids. Oral presentation at the Associationof Surgeons of Great Britain and Ireland, Edinburgh, May2006.

Shanmugam, V., Loudon, M.A., Watson, A., Cook, J.,McKenzie, L., de Verteuil, R. and Vale, L. Economicevaluation of stapled haemorrhoidopexy compared withrubber band ligation in first line treatment of symptomaticgrade II haemorrhoids. Oral presentation at the Associationof Coloproctology of Great Britain and Ireland, Gateshead,July 2006.

Shanmugam, V., Loudon, M.A., Watson, A., Cook, J.,McKenzie, L., de Verteuil, R. and Vale, L. Economicevaluation of stapled haemorrhoidopexy compared withrubber band ligation in first line treatment of symptomaticgrade II haemorrhoids. Oral presentation at the AmericanSociety of Coloproctology, Miami, 2006.

Shanmugam, V., Watson, A.J., Cook, J., Vale, L. and Loudon,M.A. Stapled haemorrhoidopexy achieves better symptomcontrol than rubber band ligation in the treatment ofsymptomatic grade II haemorrhoids. Oral presentation at theAssociation of Surgeons of GP and Ireland, Edinburgh, May2006.

Shanmugam, V., Watson, A.J., Cook, J., Vale, L. and Loudon,M.A. Stapled haemorrhoidopexy achieves better symptomcontrol than rubber band ligation in the treatment ofsymptomatic grade II haemorrhoids. Oral presentation at theAssociation of Coloproctology of GB and Ireland, Gateshead,July 2006.

Tinelli, M., Ryan, M. and Bond, C. A patient-centred approachto policy development: a pharmacy-led medicines managementservice. Oral presentation to the British PharmaceuticalConference, Manchester, September 2006.

Tinelli, M., Ryan, M. and Bond, C. Patient preferences forincreasing the role of the pharmacist in the management ofdrug therapy. Oral presentation to the Health ServicesResearch & Pharmacy Practice Conference, Bath, April 2006.

Tipper, A. Preferences for financing long term care. Oralpresentation to the European Conference on Health Economics(ECHE), Budapest, July 2006.

Vale, L. Economic evaluation of obesity. Oral presentationto the National Prevention Research Initiative, MedicalResearch Council, London, February 2006.


Hernandez, R. Screening for Open Angle Glaucoma: Is itcost-effective? Poster presented to the Society for MedicalDecision Making, 10th Biennial European Meeting, Birmingham,June 2006.

Ludbrook, A. Estimating the impact of smoking restrictionson bar sales. Poster presented to the 6th European Conferenceon Health Economics, Budapest, Hungary, July 2006.

Prescott, R.J., Kunkler, I.H., Williams, L.J., King, C.C., Jack,W., Dixon, M.J., Pol, van der M., Goh, T.T., Lindley, R. andCairns, J. PRIME I: assessing the impact of adjuvant breastradiotherapy on quality of life in low risk older patientsfollowing breast conservation. Poster presented to the 29thannual San Antonio Breast Cancer Symposium, San Antonio,USA, December 2006.

Rabindradranath, K.S., Ali, T.Z., MacLeod, A.M., Vale, L.,Cody, J., Wallace, S.A. and Daly, C. Automated vs continuousambulatory peritoneal dialysis: A systematic review ofrandomized controlled trial. Poster presented to the AmericanSociety of Nephrology, San Diego, November 2006.


APPENDIX 5


APPENDIX 5


Scotland, G.S., McNamee, P., Philip, S., Fleming, A.,Goatman, K.A., Prescott, G., Fonsea, S., Sharp, P.F., Olson.J.A. Costs and consequences of implementing automatedgrading within a national screening programme for diabeticretinopathy. Poster presented to the Diabetes UK AnnualProfessional Conference, Birmingham, March 2006.

Sidhu, M., Scott, D., Vale, L., and Chambers, M. Myocardialperfusion scintigraphy (MPS) in coronary artery disease (CAD):a review of the economic literature submitted to the UKNational Institute for Health and Clinical Excellence. Posterpresented at the International Society for Pharmacoeconomics& Outcomes Research (ISPOR). 9th Annual European Congress,Copenhagen, October 2006.

Windmeijer, F., Propper, C. and Sutton, M. Impact of targets:NHS waiting times. Poster presented to the ESRC PublicServices Programme: Quality, Performance and Delivery,Edinburgh, October 2006.

Seminars

Baker, R., Donaldson, C. and the Social Value of a QALY (SVQ)Research Team (Ryan, M., a member). The social value ofa QALY. Seminar presented to the National Institute forHealth and Clinical Excellence, London, January 2006.

Tinelli, M. Patient preferences for increasing the role of thepharmacist in the management of drug therapy. Seminarpresented to the Research group meeting, General Practiceand Primary Care Department, University of Aberdeen, June2006.

Tinelli, M. Patient centred approach in policy decision making.Seminar presented to the Research group meeting, GeneralPractice and Primary Care Department, University of Aberdeen,February 2006.

Vale, L. Economic evaluation of obesity prevention. Seminarpresented to the Obesity Research Group, University ofAberdeen, February 2006.

Vale, L. Progressive evaluation of a new technology: A casestudy of on surgical treatments for inguinal hernia repair.Seminar presented to the Wessex Institute for Health Researchand Development, Southampton, May 2006.

Vale, L. Economic evaluation of obesity prevention. Seminarpresented to the Obesity Research Group, University ofAberdeen, November 2006.

Vale, L. Health Technology Assessment and economicevaluation: A case study. Seminar presented to the Universityof Oslo, November 2006.

Vale, L. The Cochrane and Campbell economic method group.Seminar presented to the Wessex Institute for Health Researchand Development, Southampton, May 2006.

Vale, L. Health Economics and Health Services Research.Seminar presented to HSRU’s lunchtime research meeting,University of Aberdeen, May 2006.

Workshops

Farrar, S. and Yi, D. Summary of PbR Policy in England andthe National Evaluation Project. Analytical Services DivisionWorkshop, Scottish Executive Health Department, Edinburgh,September 2006.

Sutton, M. How big is the gap between good and badperformance? Understanding the impact of the GMS contract:research and policy implications. Workshop presented to theRoyal Society of Edinburgh Research Workshop, University ofGlasgow, January 2006.

Tinelli, M., Ryan, M. and Bond, C. Discrete choice experimentsto value increased roles for the pharmacist in the managementof drug therapy. International Pharmacy Practice Workshop,Oxford, July 2006.

Watson, V. and Regier, D. Health Economic Evaluation usingContingent Valuation and Discrete Choice Experiments. Oneday workshop, Centre for Clinical Epidemiology and Evaluationand University of British Colombia, Canada, August 2006.


Elliott, R.F., Sutton, M., Gravelle, H., Hole, A., Ma, A.,Morris, S., Sibbald, B. and Skåtun, D. Adjusting the generalmedical services allocation formula to reflect recruitmentand retention difficulties. Seminar presented to the GMSFormula Review Group, British Library, London, January 2006.

Elliott, R.F., Sutton, M., Ma, A., McConnachie, A., Morris,S., Rice, N. and Skåtun, D. Review of the Market ForcesFactor following the introduction of Payment by Results(2005): Improving the general labour market method. Seminarpresented at the Technical Advisory Group, Department ofHealth, London, February 2006.

Elliott, R.F., Sutton, M., Ma, A., McConnachie, A., Morris,S., Rice, N. and Skåtun, D. Review of the Market ForcesFactor following the introduction of Payment by Results(2005): Improving the general labour market method. Seminarpresented at the Technical Advisory Group, Department ofHealth, London, May 2006.

Elliott, R.F., Sutton, M., Ma, A., McConnachie, A., Morris,S., Rice, N. and Skåtun, D. Review of the Market ForcesFactor following the introduction of Payment by Results(2005): Improving the general labour market method. Seminarpresented at the Technical Advisory Group, Department ofHealth, London, July 2006.

Farrar, S. and PbR team. PbR national evaluation: Interimreport. Seminar presented to PbR advisory group, Departmentof Health, London, November 2006.

Sutton, M., Elliott, R., Ma, A., Munro, A. and Teckle,P. Geographic differences in the costs of delivering healthcareservices: implications for the national resource allocationformula. Seminar presented to the NHSScotland ResourceAllocation Committee, Scottish Executive, Glasgow, March2006.


APPENDIX 5

NOTES

68 66


65 67

Sutton, M., Elliott, R., Ma, A., Munro, A. and Teckle,P. Geographic differences in the costs of delivering healthcareservices: implications for the national resource allocationformula. Seminar presented to the NHSScotland ResourceAllocation Committee, Scottish Executive, Edinburgh, May2006.

Sutton, M. and McLean, G. Achievements of NHS Highlandpractices on the 2004/5 Quality and Outcomes Framework:Comparisons with practices in the rest of Scotland. Seminarpresented to NHS Highland, Inverness, July 2006.

Sutton, M. and McLean, G. Achievements of NHS Taysidepractices on the 2004/5 Quality and Outcomes Framework:Comparisons with practices in the rest of Scotland. Seminarpresented to NHS Tayside, Dundee, July 2006.

Sutton, M. and Bailey, D. Multivariate analysis of factorsinfluencing workload on primary medical services. Seminarpresented at the Scottish Allocation Formula Review WorkingGroup, Scottish Executive, Edinburgh, August 2006.

Sutton, M. and McLean, G. Variations in achievement on the2004/5 QOF. Seminar presented to the NHSScotland nGMSQuality and Outcomes Working Group, Alloa, August 2006.

Sutton, M. and Bailey, D. Update of Lothian’s prescribingformula. Seminar presented to NHS Lothian Prescribing Group,Edinburgh, September 2006.

Sutton, M., Needham, G., French, F., Geue, C., Ikenwilo,D., Rooke, C. and Skåtun D. Second national survey of non-training grade doctors in NHSScotland - Main findings. Seminarpresented to the Scottish Executive Health Department,Workforce Directors, Edinburgh, November 2006.

Yi, D. and Farrar, S. PbR Policy: Early quantitative results.Seminar presented to the Analytical Services Division Workshop,Scottish Executive Health Department, Edinburgh, September2006.

Ludbrook, A. Impact of smoking restrictions on smokingprevalence: predicting policy effects from indirect evident.Oral presentation at the 6th European Conference of HealthEconomists, Budapest, Hungary, July 2006.

McNamee, P., Ternent, L., Belemsaga, D., Gbangou, A. andNewlands, D. Assessing the value of maternal health usingcontingent valuation methods. Oral presentation at the 6thAnnual INDEPTH (International Network of field sites withcontinuous Demographic Evaluation of Populations and TheirHealth) General Meeting, Ougadougou, month 2006.

Millar, J., Bond, C., McNamee, P., Morton, M., Selvaraj, S.and Lindsay, S. A feasibility study for a future economicevaluation of instalment dispensing for newly prescribedmedicines. Oral presentation at the Society of AcademicPrimary Care, University of Keele, July 2006.

Pol, van der M. and Ruggeri, M. Is risk attitude in healthcontext specific? Oral presentation to the 6th EuropeanConference on Health Economics, Budapest, Hungary, July2006.

Pol, van der M, Sheill A, Au F. Using open-ended follow-upquestions to test the validity of DCE estimates. Oralpresentation to the 6th European Conference on HealthEconomics, Budapest, Hungary, July 2006.

Ryan, M. Factors influencing the choice between self-careand health professional advice in minor illness: a discretechoice experiment. Oral presentation at the Health SciencesResearch and Pharmacy Practice Conference, University ofBath, April 2006.

Ryan, M. Factors influencing the choice between self-careand health professional advice in minor illness: a discretechoice experiment. Oral presentation at the Social Dimensionsof Health Institute Conference, University of Dundee, May2006.

Scotland, G.S., McNamee, P., Peddie, V. and Bhattacharya,S. Safety versus success in SET: women’s preferences foroutcomes of IVF. Oral presentation at the 22nd Annual Meetingof ESHRE, Prague, June 2006.

Sutton, M. The effect on Patient care. Oral Presentation atNever mind the quality: count the points: the effectivenessof the GMS contract, the University of Glasgow, February2006.

Shanmugam, V., Loudon, M.A., Watson, A., Cook, J.,McKenzie, L., de Verteuil, R. and Vale, L. Economicevaluation of stapled haemorrhoidopexy compared withrubber band ligation in first line treatment of symptomaticgrade II haemorrhoids. Oral presentation at the Associationof Surgeons of Great Britain and Ireland, Edinburgh, May2006.

Shanmugam, V., Loudon, M.A., Watson, A., Cook, J.,McKenzie, L., de Verteuil, R. and Vale, L. Economicevaluation of stapled haemorrhoidopexy compared withrubber band ligation in first line treatment of symptomaticgrade II haemorrhoids. Oral presentation at the Associationof Coloproctology of Great Britain and Ireland, Gateshead,July 2006.

Shanmugam, V., Loudon, M.A., Watson, A., Cook, J.,McKenzie, L., de Verteuil, R. and Vale, L. Economicevaluation of stapled haemorrhoidopexy compared withrubber band ligation in first line treatment of symptomaticgrade II haemorrhoids. Oral presentation at the AmericanSociety of Coloproctology, Miami, 2006.

Shanmugam, V., Watson, A.J., Cook, J., Vale, L. and Loudon,M.A. Stapled haemorrhoidopexy achieves better symptomcontrol than rubber band ligation in the treatment ofsymptomatic grade II haemorrhoids. Oral presentation at theAssociation of Surgeons of GP and Ireland, Edinburgh, May2006.

Shanmugam, V., Watson, A.J., Cook, J., Vale, L. and Loudon,M.A. Stapled haemorrhoidopexy achieves better symptomcontrol than rubber band ligation in the treatment ofsymptomatic grade II haemorrhoids. Oral presentation at theAssociation of Coloproctology of GB and Ireland, Gateshead,July 2006.

Tinelli, M., Ryan, M. and Bond, C. A patient-centred approachto policy development: a pharmacy-led medicines managementservice. Oral presentation to the British PharmaceuticalConference, Manchester, September 2006.

Tinelli, M., Ryan, M. and Bond, C. Patient preferences forincreasing the role of the pharmacist in the management ofdrug therapy. Oral presentation to the Health ServicesResearch & Pharmacy Practice Conference, Bath, April 2006.

Tipper, A. Preferences for financing long term care. Oralpresentation to the European Conference on Health Economics(ECHE), Budapest, July 2006.

Vale, L. Economic evaluation of obesity. Oral presentationto the National Prevention Research Initiative, MedicalResearch Council, London, February 2006.


Hernandez, R. Screening for Open Angle Glaucoma: Is itcost-effective? Poster presented to the Society for MedicalDecision Making, 10th Biennial European Meeting, Birmingham,June 2006.

Ludbrook, A. Estimating the impact of smoking restrictionson bar sales. Poster presented to the 6th European Conferenceon Health Economics, Budapest, Hungary, July 2006.

Prescott, R.J., Kunkler, I.H., Williams, L.J., King, C.C., Jack,W., Dixon, M.J., Pol, van der M., Goh, T.T., Lindley, R. andCairns, J. PRIME I: assessing the impact of adjuvant breastradiotherapy on quality of life in low risk older patientsfollowing breast conservation. Poster presented to the 29thannual San Antonio Breast Cancer Symposium, San Antonio,USA, December 2006.

Rabindradranath, K.S., Ali, T.Z., MacLeod, A.M., Vale, L.,Cody, J., Wallace, S.A. and Daly, C. Automated vs continuousambulatory peritoneal dialysis: A systematic review ofrandomized controlled trial. Poster presented to the AmericanSociety of Nephrology, San Diego, November 2006.


APPENDIX 5


APPENDIX 5


Scotland, G.S., McNamee, P., Philip, S., Fleming, A.,Goatman, K.A., Prescott, G., Fonsea, S., Sharp, P.F., Olson.J.A. Costs and consequences of implementing automatedgrading within a national screening programme for diabeticretinopathy. Poster presented to the Diabetes UK AnnualProfessional Conference, Birmingham, March 2006.

Sidhu, M., Scott, D., Vale, L., and Chambers, M. Myocardialperfusion scintigraphy (MPS) in coronary artery disease (CAD):a review of the economic literature submitted to the UKNational Institute for Health and Clinical Excellence. Posterpresented at the International Society for Pharmacoeconomics& Outcomes Research (ISPOR). 9th Annual European Congress,Copenhagen, October 2006.

Windmeijer, F., Propper, C. and Sutton, M. Impact of targets:NHS waiting times. Poster presented to the ESRC PublicServices Programme: Quality, Performance and Delivery,Edinburgh, October 2006.

Seminars

Baker, R., Donaldson, C. and the Social Value of a QALY (SVQ)Research Team (Ryan, M., a member). The social value ofa QALY. Seminar presented to the National Institute forHealth and Clinical Excellence, London, January 2006.

Tinelli, M. Patient preferences for increasing the role of thepharmacist in the management of drug therapy. Seminarpresented to the Research group meeting, General Practiceand Primary Care Department, University of Aberdeen, June2006.

Tinelli, M. Patient centred approach in policy decision making.Seminar presented to the Research group meeting, GeneralPractice and Primary Care Department, University of Aberdeen,February 2006.

Vale, L. Economic evaluation of obesity prevention. Seminarpresented to the Obesity Research Group, University ofAberdeen, February 2006.

Vale, L. Progressive evaluation of a new technology: A casestudy of on surgical treatments for inguinal hernia repair.Seminar presented to the Wessex Institute for Health Researchand Development, Southampton, May 2006.

Vale, L. Economic evaluation of obesity prevention. Seminarpresented to the Obesity Research Group, University ofAberdeen, November 2006.

Vale, L. Health Technology Assessment and economicevaluation: A case study. Seminar presented to the Universityof Oslo, November 2006.

Vale, L. The Cochrane and Campbell economic method group.Seminar presented to the Wessex Institute for Health Researchand Development, Southampton, May 2006.

Vale, L. Health Economics and Health Services Research.Seminar presented to HSRU’s lunchtime research meeting,University of Aberdeen, May 2006.

Workshops

Farrar, S. and Yi, D. Summary of PbR Policy in England andthe National Evaluation Project. Analytical Services DivisionWorkshop, Scottish Executive Health Department, Edinburgh,September 2006.

Sutton, M. How big is the gap between good and badperformance? Understanding the impact of the GMS contract:research and policy implications. Workshop presented to theRoyal Society of Edinburgh Research Workshop, University ofGlasgow, January 2006.

Tinelli, M., Ryan, M. and Bond, C. Discrete choice experimentsto value increased roles for the pharmacist in the managementof drug therapy. International Pharmacy Practice Workshop,Oxford, July 2006.

Watson, V. and Regier, D. Health Economic Evaluation usingContingent Valuation and Discrete Choice Experiments. Oneday workshop, Centre for Clinical Epidemiology and Evaluationand University of British Colombia, Canada, August 2006.


Elliott, R.F., Sutton, M., Gravelle, H., Hole, A., Ma, A.,Morris, S., Sibbald, B. and Skåtun, D. Adjusting the generalmedical services allocation formula to reflect recruitmentand retention difficulties. Seminar presented to the GMSFormula Review Group, British Library, London, January 2006.

Elliott, R.F., Sutton, M., Ma, A., McConnachie, A., Morris,S., Rice, N. and Skåtun, D. Review of the Market ForcesFactor following the introduction of Payment by Results(2005): Improving the general labour market method. Seminarpresented at the Technical Advisory Group, Department ofHealth, London, February 2006.

Elliott, R.F., Sutton, M., Ma, A., McConnachie, A., Morris,S., Rice, N. and Skåtun, D. Review of the Market ForcesFactor following the introduction of Payment by Results(2005): Improving the general labour market method. Seminarpresented at the Technical Advisory Group, Department ofHealth, London, May 2006.

Elliott, R.F., Sutton, M., Ma, A., McConnachie, A., Morris,S., Rice, N. and Skåtun, D. Review of the Market ForcesFactor following the introduction of Payment by Results(2005): Improving the general labour market method. Seminarpresented at the Technical Advisory Group, Department ofHealth, London, July 2006.

Farrar, S. and PbR team. PbR national evaluation: Interimreport. Seminar presented to PbR advisory group, Departmentof Health, London, November 2006.

Sutton, M., Elliott, R., Ma, A., Munro, A. and Teckle,P. Geographic differences in the costs of delivering healthcareservices: implications for the national resource allocationformula. Seminar presented to the NHSScotland ResourceAllocation Committee, Scottish Executive, Glasgow, March2006.


APPENDIX 5

NOTES

68 66




http://www.abdn.ac.uk/heruvisit us at

The Health Economics Research Unit (HERU) was established at the University of Aberdeen in 1977. TheUnit is part of the Institute of Applied Health Sciences (IAHS) within the College of Life Sciences and Medicineand is based in the University of Aberdeen Medical School.

Core funding for the Unit is received from the Chief Scientist Office (CSO) of the Scottish GovernmentHealth Directorates and the University of Aberdeen. HERU is one of two CSO funded research units basedwithin the IAHS. Our sister unit is the Health Services Research Unit (HSRU).

The CSO remit for the Health Economics Research Unit requires HERU to “develop new methods within healtheconomics and to encourage the use of health economics”. More specifically the remit is to:

• Research into economic approaches to health and health care;

• Develop economic techniques to be readily applied by economists and/or health care personnel;

• Demonstrate and test the approaches and techniques; and

• Accumulate and make available to the health service a body of expertise in health economics.

This general remit is given specific form in the research programmes undertaken by HERU and in the manyresearch projects and capacity building activities undertaken by the Unit.

Contact Details for HERU are:

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Tel: +44 (0) 1224 553480/553733Fax: +44 (0) 1224 550926E-mail: [email protected]

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HERU is supported by the Chief Scientist Office (CSO)of the Scottish Executive Health Department (SEHD)The views expressed here are those of the unit andare not necessarily those of CSO.

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Annual Report2007


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Annual Report 2007 - abdn.ac.uk