Publications

Street, DJ & Burgess, L 2007, The Construction of Optimal Stated Choice Experiments, 1, Wiley, Hoboken, New Jersey.
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© 2007 by John Wiley & Sons, Inc. All rights reserved. The most comprehensive and applied discussion of stated choice experiment constructions available. The Construction of Optimal Stated Choice Experiments provides an accessible introduction to the construction methods needed to create the best possible designs for use in modeling decision-making. Many aspects of the design of a generic stated choice experiment are independent of its area of application, and until now there has been no single book describing these constructions. This book begins with a brief description of the various areas where stated choice experiments are applicable, including marketing and health economics, transportation, environmental resource economics, and public welfare analysis. The authors focus on recent research results on the construction of optimal and near-optimal choice experiments and conclude with guidelines and insight on how to properly implement these results. Features of the book include: Construction of generic stated choice experiments for the estimation of main effects only, as well as experiments for the estimation of main effects plus two-factor interactions. Constructions for choice sets of any size and for attributes with any number of levels. A discussion of designs that contain a none option or a common base option. Practical techniques for the implementation of the constructions. Class-tested material that presents theoretical discussion of optimal design. Complete and extensive references to the mathematical and statistical literature for the constructions. Exercise sets in most chapters, which reinforce the understanding of the presented material. The Construction of Optimal Stated Choice Experiments serves as an invaluable reference guide for applied statisticians and practitioners in the areas of marketing, health economics, transport, and environmental evaluation. It is also ideal as a supplemental text for courses in the design of experiments, d...

Teerawattananon, Y, Rattanavipapong, W, Santatiwongchai, B, Bussabawalai, T, Thiboonboon, K & Dabak, S 2007, 'POLICYMAKER COMMENTARY More than a List: Reforming a Country’s Health Benefits Package—A Rigorous Approach to Tackling Costly Overutilization' in Glassman, A, Giedion, U & Smith, P (eds), What's In, What's Out: Designing Benefits for Universal Health Coverage, Brookings Institution Press, Washington DC, pp. 253-267.

Anderson, R, Allen, KJ, Nisselle, AE, Gurrin, L, Hall, JP, Powell, LW & Delatycki, MB 2007, 'Exploring the cost-effectiveness of community genetic screening for hereditary haemochromatosis: A life-time simulation using a Markov model', AMERICAN JOURNAL OF HEMATOLOGY, vol. 82, no. 6, pp. 579-579.
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Birch, S, Haas, M, Savage, E & Van Gool, K 2007, 'Targeting services to reduce social inequalities in utilisation: an analysis of breast cancer screening in New South Wales', Australia and New Zealand Health Policy, vol. 4, no. 1, pp. 1-9.
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Abstract Background Many jurisdictions have used public funding of health care to reduce or remove price at the point of delivery of services. Whilst this reduces an important barrier to accessing care, it does nothing to discriminate between groups considered to have greater or fewer needs. In this paper, we consider whether active targeted recruitment, in addition to offering a 'free' service, is associated with a reduction in social inequalities in self-reported utilization of the breast screening services in NSW, Australia. Methods Using the 1997 and 1998 NSW Health Surveys we estimated probit models on the probability of having had a screening mammogram in the last two years for all women aged 40–79. The models examined the relative importance of socio-economic and geographic factors in predicting screening behaviour in three different needs groups – where needs were defined on the basis of a woman's age. Results We find that women in higher socio-economic groups are more likely to have been screened than those in lower groups for all age groups. However, the socio-economic effect is significantly less among women who were in the actively targeted age group. Conclusion This indicates that recruitment and follow-up was associated with a modest reduction in social inequalities in utilisation although significant income differences remain.

De, ALR, Houltram, J & Pearce, G 2007, 'Assessment of the cost-effectiveness in Australia of cetuximab in the treatment of patients with locally advanced squamous cell cancers of the head and neck', VALUE IN HEALTH, vol. 10, no. 6, pp. A326-A326.

Gallego, G & van Gool, K 2007, 'Letters to the Editor: Can we deny patients expensive drugs?', Australian Prescriber, vol. 30, no. 3, pp. 59-63.
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Haas, M, Chaplin, M, Joy, P, Wiley, V, Black, C & Wilcken, B 2007, 'Healthcare use and costs of medium-chain acyl-CoA dehydrogenase deficiency in Australia: Screening versus no screening', JOURNAL OF PEDIATRICS, vol. 151, no. 2, pp. 121-126.
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Objective To describe and analyze the use and costs of hospital services for children diagnosed with medium-chain acyl-CoA dehydrogenase (MCAD) deficiency either with newborn screening or clinical diagnosis in Australia between 1994 and 2002. MCAD deficiency is a potentially lethal disorder of fatty-acid oxidation. Study design We conducted a retrospective audit of medical records supplemented by a parental survey. Results A total of 59 children with MCAD deficiency were identified, 24 by using newborn screening. In the first 4 years of life, screening children cost an average of $A1676 (US$1297) per year for inpatient, emergency department, and outpatient visits, compared with $A1796 (US$1390) for children in whom a clinical diagnosis was made. Forty-two percent of the children who underwent screening were admitted to the hospital, compared with 71% of children who did not undergo screening. Children who did not undergo screening used significantly more inpatient services and cost significantly more in emergency services. There were also some significant differences in use on a year-by-year basis. Conclusions Children who do not undergo screening may be more likely to be admitted to the hospital and to incur higher emergency department costs than children who underwent screening, and children seem more likely to attend hospital outpatient clinics. Screening does not result in higher costs from a hospital perspective.

King, MT, Hall, J, Lancsar, E, Fiebig, D, Hossain, I, Louviere, J, Reddel, HK & Jenkins, CR 2007, 'Patient preferences for managing asthma: results from a discrete choice experiment', HEALTH ECONOMICS, vol. 16, no. 7, pp. 703-717.
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Effective control of asthma requires regular preventive medication. Poor medication adherence suggests that patient preferences for medications may differ from the concerns of the prescribing clinicians. This study investigated patient preferences for preventive medications across symptom control, daily activities, medication side-effects, convenience and costs, using a discrete choice experiment embedded in a randomized clinical trial involving patients with mild-moderate persistent asthma. The present data were collected after patients had received 6 weeks' treatment with one of two drugs. Three choice options were presented, to continue with the current drug, to change to an alternative, hypothetical drug, or to take no preventive medication. Analysis used random parameter multinomial logit. Most respondents chose to continue with their current drug in most choice situations but this tendency differed depending on which medication they had been allocated. Respondents valued their ability to participate in usual daily activities and sport, preferred minimal symptoms, and were less likely to choose drugs with side-effects. Cost was also significant, but other convenience attributes were not. Demographic characteristics did not improve the model fit. This study illustrates how discrete choice experiments may be embedded in a clinical trial to provide insights into patient Preferences. Copyright © 2007 John Wiley & Sons, Ltd.

Lancsar, EJ, Hall, JP, King, M, Kenny, P, Louviere, JJ, Fiebig, DG, Hossain, I, Thien, FCK, Reddel, HK & Jenkins, CR 2007, 'Using discrete choice experiments to investigate subject preferences for preventive asthma medication', RESPIROLOGY, vol. 12, no. 1, pp. 127-136.
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Background and objective: Long-term adherence to inhaled corticosteroids is poor despite the crucial role of preventer medications in achieving good asthma outcomes. This study was undertaken to explore patient preferences in relation to their current inhaled corticosteroid medication, a hypothetical preventer or no medication. Methods: A discrete choice experiment was conducted in 57 adults with mild-moderate asthma and airway hyper-responsiveness, who were using inhaled corticosteroid ≤500 μg/day (beclomethasone equivalent). In the discrete choice experiment, subjects evaluated 16 hypothetical scenarios made up of 10 attributes that described the process and outcomes of taking asthma medication, with two to four levels for each attribute. For each scenario, subjects chose between the hypothetical medication, the medication they were currently taking and no asthma medication. A random parameter multinomial logit model was estimated to quantify subject preferences for the aspects of taking asthma medication and the influence of attributes on medication decisions. Results: Subjects consistently made choices in favour of being able to do strenuous and sporting activities with or without reliever, experiencing no side-effects and never having to monitor their peak flow. Frequency of collecting prescriptions, frequency of taking the medication, its route of administration and the strength of the doctor recommendation about the medication were not significant determinants of choice. Conclusions: The results of this study suggest that patients prefer a preventer that confers capacity to maximize physical activity, has no side-effects and does not require daily peak flow monitoring. © 2007 The Authors.

Lindsay, C, Munro, A & Wise, S 2007, 'Making equalities work? Scottish trade unions’ approaches to equal opportunities', Equal Opportunities International, vol. 26, no. 5, pp. 465-481.
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PurposeThis paper seeks to analyse trade unions’ approaches to equal opportunities in Scotland, focusing on issues of: recruitment of membership from different groups; promoting diversity in post‐holding; and the role of “key equalities issues” in collective bargaining.Design/methodology/approachThe paper draws on in‐depth interviews with equalities officers of 26 unions in Scotland. The analysis takes as its starting point the three models of equality policies identified by Rees: the “sameness”, “difference” and “transformation” models.FindingsThe paper argues that, although some equalities officers demonstrated a thorough understanding of the issues, union approaches to equalities in practice reflect the “sameness”, and to some extent “difference”, models: attacking direct discrimination and insisting that members should be treated the same, establishing some limited mechanisms to reflect on the different needs of groups, but being less able to tackle the underlying structural causes of inequality. It is suggested that unions need to develop a more sophisticated analysis of equal opportunities which fully reflects the differences between the experiences of groups of workers and which challenges the fundamental, structural inequalities within (and therefore seeks to transform) organisations and labour markets. A key element of this agenda must be the mainstreaming of equal opportunities within collective bargaining.Research limitations/implicationsFurther research is required on how unions are beginning to deal with the issues raised in the paper. The paper is also limited to the views of individual...

Osborne, RH, De Abreu Lourenco, R, Dalton, A, Houltram, J, Dowton, D, Joshua, DE, Lindeman, R & Ho, PJ 2007, 'Quality of life related to oral versus subcutaneous iron chelation: A time trade-off study', VALUE IN HEALTH, vol. 10, no. 6, pp. 451-456.
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Owen, K, Haas, M, Viney, R, Pettman, T & Misan, G 2007, 'Expectations of outcomes and individuals' framing of the benefits and effort required in diet and exercise', INTERNATIONAL JOURNAL OF OBESITY, vol. 31, no. Suppl 1, pp. S147-S147.

Page, L & Page, K 2007, 'The second leg home advantage: Evidence from European football cup competitions', Journal of Sports Sciences, vol. 25, no. 14, pp. 1547-1556.
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Salisbury, C, Goodall, S, Montgomery, AA, Pickin, DM, Edwards, S, Sampson, F, Simons, L & Lattimer, V 2007, 'Does Advanced Access improve access to primary health care? Questionnaire survey of patients.', Br J Gen Pract, vol. 57, no. 541, pp. 615-621.
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BACKGROUND: General practices in England have been encouraged to introduce Advanced Access, but there is no robust evidence that this is associated with improved access in ways that matter to patients. AIM: To compare priorities and experiences of patients consulting in practices which do or do not operate Advanced Access. DESIGN OF STUDY: Patient questionnaire survey. SETTING: Forty-seven practices in 12 primary care trust areas of England. METHOD: Questionnaire administered when patients consulted. RESULTS: Of 12,825 eligible patients, 10,821 (84%) responded. Most (70%) were consulting about a problem they had had for at least 'a few weeks'. Patients obtained their current appointment sooner in Advanced Access practices, but were less likely to have been able to book in advance. They could usually see a doctor more quickly than those in control practices, but were no more satisfied overall with the appointment system. The top priority for patients was to be seen on a day of choice rather than to be seen quickly, but different patient groups had different priorities. Patients in Advanced Access practices were no more or less likely to obtain an appointment that matched their priorities than those in control practices. Patients in both types of practice experienced problems making contact by telephone. CONCLUSION: Patients are seen more quickly in Advanced Access practices, but speed of access is less important to patients than choice of appointment; this may be because most consultations are about long-standing problems. Appointment systems need to be flexible to accommodate the different needs of different patient groups.

Salisbury, C, Montgomery, AA, Simons, L, Sampson, F, Edwards, S, Baxter, H, Goodall, S, Smith, H, Lattimer, V & Pickin, DM 2007, 'Impact of Advanced Access on access, workload, and continuity: controlled before-and-after and simulated-patient study.', Br J Gen Pract, vol. 57, no. 541, pp. 608-614.
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BACKGROUND: Case studies from the US suggest that Advanced Access appointment systems lead to shorter delays for appointments, reduced workload, and increased continuity of care. AIM: To determine whether implementation of Advanced Access in general practice is associated with the above benefits in the UK. DESIGN OF STUDY: Controlled before-and-after and simulated-patient study. SETTING: Twenty-four practices that had implemented Advanced Access and 24 that had not. METHOD: Anonymous telephone calls were made monthly to request an appointment. Numbers of appointments and patients consulting were calculated from practice records. Continuity was determined from anonymised patient records. RESULTS: The wait for an appointment with any doctor was slightly shorter at Advanced Access practices than control practices (mean 1.00 day and 1.87 days respectively, adjusted difference -0.75; 95% confidence interval [CI] = -1.51 to 0.004 days). Advanced Access practices met the NHS Plan 48-hour access target on 71% of occasions and control practices on 60% of occasions (adjusted odds ratio 1.61; 95% CI = 0.78 to 3.31; P = 0.200). The number of appointments offered, and patients seen, increased at both Advanced Access and control practices over the period studied, with no evidence of differences between them. There was no difference between Advanced Access and control practices in continuity of care (adjusted difference 0.003; 95% CI = -0.07 to 0.07). CONCLUSION: Advanced Access practices provided slightly shorter waits for an appointment compared with control practices, but performance against NHS access targets was considerably poorer than officially reported for both types of practice. Advanced Access practices did not have reduced workload or increased continuity of care.

van Gool, K, Gallego, G, Haas, M, Viney, R, Hall, J & Ward, R 2007, 'Economic evidence at the local level - Options for making it more useful', PHARMACOECONOMICS, vol. 25, no. 12, pp. 1055-1062.
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Like other countries, Australia has had some success in incorporating economic evidence into national healthcare decisions. However, it has been recognised that this coverage does not extend to the local hospital or health region level. An extensive body of research has identified barriers to the use of economic evidence at the local level, leading some commentators to suggest that economic evaluation should only be targeted at national decision-making bodies. Yet, local decision makers in Australia and elsewhere make important choices about the uptake and diffusion of healthcare technologies. We propose a number of interrelated options to address the barriers that currently prohibit the use of economic evaluation by local decision makers in many jurisdictions. These include wider dissemination of user friendly models, inclusion of assessments of the cost impact of interventions on various budgets, and the establishment of an authoritative body that ensures the production of high quality economic models. It is argued that these options can have a significant impact on the way economic evaluations are conducted, reported, disseminated and used. © 2007 Adis Data Information BV. All rights reserved.

Wilcken, B, Haas, M, Joy, P, Wiley, V, Chaplin, M, Black, C, Fletcher, J, McGill, J & Boneh, A 2007, 'Outcome of neonatal screening for medium-chain acyl-CoA dehydrogenase deficiency in Australia: a cohort study', The Lancet, vol. 369, no. 9555, pp. 37-42.
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Background Medium-chain acyl-CoA dehydrogenase (MCAD) deficiency is the disorder thought most to justify neonatal screening by tandem-mass spectrometry because, without screening, there seems to be substantial morbidity and mortality. Our aim was to asse

Wise, S 2007, 'Wanted: the next generation of nurse and midwifery managers', International Journal of Public Sector Management, vol. 20, no. 6, pp. 473-483.
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PurposeTo explore whether ward management is an aspiration for junior nurses and midwives in the National Health Service in Scotland (NHSS) in the context of service redesign that is expanding career options in clinical practice.Design/methodology/approachThe findings are drawn from research conducted in a large acute NHSS Trust. The fieldwork involved face‐to‐face interviews with 64 nurses and midwives and 1,084 survey returns (29 per cent response rate). Logistic regression was used to predict the characteristics of those who wanted to move into their line manager's role.FindingsMoving into their line manager's job was a career aspiration for only 10 per cent of nurses and midwives and current managers reported there were already difficulties recruiting to senior posts. Those who wanted vertical progression preferred the clinical specialist/advanced practitioner route. By comparison, the ward manager (charge nurse) role was perceived to be very unattractive because of: too little patient contact; the stress involved in meeting the workload demands of multiple roles; and poor pay and rewards.Research limitations/implicationsThe research and policy review covers the devolved NHSS though similar trends have been noted elsewhere in the UK and internationally. The paper is of broader interest to those interested in the impact of managerial responsibility on healthcare professionals.Practical implicationsThe paper highlights the need for reform in the ward leadership role since it is pivotal in the operation of...

Wise, S, Smith, C, Valsecchi, R, Mueller, F & Gabe, J 2007, 'Controlling working time in the ward and on the line', Employee Relations, vol. 29, no. 4, pp. 352-366.
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PurposeThe purpose of this article is to assess whether tele‐nursing in Scotland (NHS24), when compared with traditional face‐to‐face nursing, facilitates greater employee control over working time and therefore a potentially better work‐life balance.Design/methodology/approachThe article draws on evidence from two independent research projects; a survey of 64 ward nurses and midwives, which involved face‐to‐face interviews; and a field study of tele‐nursing in a large site in Scotland, using interviews and observations of 15 nurse advisors or tele‐nurses.FindingsThree elements of work organisation are central in shaping nurses' working hours and their control over the balance between their work and their home life: the management of working hours; the degree of mutual dependency of nurses within teams; and the nature of patient care.Research limitations/implicationsThe two pieces of research reported offer a strong basis for comparative study. However, the two projects were designed independently, though research questions overlapped and one researcher conducted the field work in both settings; there is an imbalance in the number of interviews conducted in each setting; and the nurse advisor interviewees are of the same clinical grade, whereas a variety of grades and clinical areas are represented among the hospital nurse interviewees.Originality/valueThis is the first study of work‐life balance amongst tele‐nurses. The research demonstrates that call centre work has rationalised, depersonalised and yet en...

Zapart, S, Kenny, P, Hall, J, Servis, B & Wiley, S 2007, 'Home-based palliative care in Sydney, Australia: the carer's perspective on the provision of informal care', HEALTH & SOCIAL CARE IN THE COMMUNITY, vol. 15, no. 2, pp. 97-107.
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The provision of home-based palliative care requires a substantial unpaid contribution from family and friends (i.e. informal care). The present cross-sectional descriptive study, conducted between September 2003 and April 2004, describes this contribution and the impact it has on those providing informal care. The participants were 82 informal carers of patients registered with two community palliative care services in Sydney, Australia (40% of eligible carers). Carers were interviewed to assess the care recipient's care needs, the care provided by the informal carer and the health status of the carer (using the 36-Item Short Form Health Survey). A number of open-ended questions asked about the impact of providing care and the type of support that carers would find helpful. Most carers reported that care recipients required help with household tasks and many needed assistance with personal activities of daily living, taking medications and organisational tasks. In the majority of cases, the principal carer provided all or most of this help. Although, on average, the physical health of carers was similar to that of the Australian population, their mental health scores were lower. Many carers reported effects on social and family relationships, restrictions on their participation in work and leisure activities, and a range of emotional reactions to their caring situation. The support carers said they would like included information and advice, in-home respite, help with household tasks, and financial support. The present study supports the view that effective support for carers must recognise the pre-existing relationship between carer and recipient, and the differing needs of individual carers. © 2006 The Authors, Journal compilation © 2006 Blackwell Publishing Ltd.

De Abreu Lourenco, R 1970, 'Assessment of the cost-effectiveness in Australia of cetuximab in the treatment of patients with locally advanced squamous cell cancers of the head and neck', ISPOR 10th Annual European Congress, Dublin, Ireland.

Fiebig, DG, Haas, MR & Viney, RC 1970, 'Preferences for new and alternative cervical cancer screening technologies: Results from a discrete choice experiment with nested choices', Australian Conference of Health Economists, Brisbane.

Gallego, G, Van Gool, K & Hall, JP 1970, 'Setting priorities at the local level: criteria, processes and considerations for success', 5th Health Services & Policy Research Conference, Auckland.

Goodall, S, King, MT, Ewing, JE & Smith, NF 1970, 'What support services do adolescents and young adults with a life threatening illness prefer? A discrete choice experiment of patients and their families', Australian Conference of Health Economists, Brisbane.

Haas, M, Fiebig, DG, Hossain, I & Viney, R 1970, 'Decisions About Pap Tests: What Influences Women and Providers?', iHEA 6th World Congress on Health Economics, Copenhagen, Denmark.

Hall, J, Kenny, P & Hossain, I 1970, 'The provision of informal care in terminal illness: An analysis of carers? needs using a discrete choice experiment', Brisbane.
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There is an increasing expectation that families will provide care at home for those with chronic, acute and terminal illness. There is a range of services available to support the home care of these patients. Carers of those in the terminal phase of illness face different demands and challenges than those caring for the chronically ill, disabled or aging; the patient?s health is deteriorating, often rapidly, and death is imminent. Yet the needs and requirements of this group of carers has been far less studied than those caring for people with chronic and continuing conditions. We argue that considering the reciprocal nature of relationships is important in understanding the provision of informal care. Carers? feelings for which tasks and responsibilities are most difficult are not the same as their preferences for additional support services. Carers preferences are influenced by their relationship with the patient.This study investigates carers? preferences for services to support their caregiving role. Carer preferences were investigated using a discrete choice experiment, in which 168 carers were asked first to choose between two packages of care and then between the chosen package and their current support. Data were analysed using mixed logit.The DCE results showed that the support most wanted was palliative care nursing, general nursing, and telephone advice available 24 hours. Carers providing high levels of care wanted respite care provided at home and help with the patient?s personal care. Where the care-giving need was relatively low, carers wanted help with household tasks, transport and a case co-ordinator. Overall, carers appeared to be satisfied with the support they received from palliative care services, but this varied with the personal circumstances of the carer.This study provides useful insights for those who plan and deliver palliative care in the community. It supports the view that effective support for carers must recognise t...

Hall, J, Kenny, P & Louviere, JJ 1970, 'Understanding the Preferences of Informal Caregivers Providing Palliative Care at Home', iHEA 6th World Congress on Health Economics, Copenhagen, Denmark.

Kenny, PM, Hall, JP, Zapart, S, Davis, P & Hossain, I 1970, 'Informal care and home-based palliative care: the carersâ preferences for support', 5th Health Services & Policy Research Conference, Auckland.

King, MT, Smith, DP, Fowler, S, Hossein, I, Viney, R & Armstrong, BK 1970, 'Men's preferences for treatment of early stage prostate cancer: results from a discrete choice experiment', BJU INTERNATIONAL, 60th Annual Scientific Meeting of the Urological-Society-of-Australia-and-New-Zealand, BLACKWELL PUBLISHING, Adelaide, AUSTRALIA, pp. 3-4.

Mitchell, AS & Viney, R 1970, 'Learning from Experience: Revision of the Australian Pharmaceutical Benefits Advisory Committee Guidelines', iHEA 6th World Congress on Health Economics, Copenhagen, Denmark.

Norman, R, Cronin, PA, Viney, RC, King, MT, Street, D, Brazier, JE & Ratcliffe, J 1970, 'Issues in the valuation of health using multi-attribute utility measures; the EQ-5D', Australian Conference of Health Economists, Brisbane.

Tomkin, DF, Thomas, LE, Day, MB, Burke, PF, Franklin, J, Smith, G, Louviere, JJ & Street, D 1970, 'Solar Light for rooms without windows', Sustainable Innovation 07, Farnham, Surrey, UK.

Van Gool, K, Gallego, G, Haas, MR & Fisher, K 1970, 'Economic Evaluation of Early childhood intervention programs: How hard is it to make rational investments for the future?', 29th Australian Conference for Health Economists, Brisbane.

Van Gool, K, Vu, M, Savage, EJ, Haas, MR & Birch, S 1970, 'Equitable use of breast screening services in NSW: The role of income, age and locality', 29th Australian Conference for Health Economists, Brisbane.

Viney, R, Savage, E, King, M & Hossain, I 1970, 'Using Choice Experiments to Estimate QALYs: An Application to Prostate Cancer', iHEA 6th World Congress on Health Economics, Copenhagen, Denmark.

Viney, RC, Savage, EJ, King, MT & Hossain, I 1970, 'Using choice experiments to estimate QALYs: An application to prostate cancer', Australian Conference of Health Economists, Brisbane.

Vu, M, Van Gool, K, Savage, EJ, Haas, MR & Birch, S 1970, 'The role of income and locality in breast screening participation', 5th Health Services & Policy Research Conference, Auckland.

Duffield, CM, Roche, MA, O'Brien-Pallas, L, Diers, D, Aisbett, C, King, MT, Aisbett, K & Hall, JP Centre for Health Services Management, UTS 2007, Glueing it together: nurses, their work environment and patient safety., pp. 1-243, Sydney.

Goodall, S, Norman, R & Gallego, G CHERE 2007, Cost-effectiveness analysis of alternate strategies to address iodine deficiency in Australia, CHERE Project Report for the Department of Health and Ageing, Australian Government, pp. 1-99, Sydney.

Sansoni, J, Marosszeky, N, Jeon, Y, Chenoweth, L, Hawthorne, G, King, MT, Budge, M, Zapart, S, Sansoni, E, Senior, K, Kenny, PM & Low, L Centre for Health Service Development, University of Wollongong 2007, Dementia Outcomes Measurement Suite (DOMS) Project: Final Report, pp. 1-523, Wollongong, Australia.
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The purpose of this project is to develop a set of recommended measures/tools for routine use in the assessment, diagnosis, screening and outcomes monitoring of dementia conditions and the evaluation of treatments that are applicable for the Australian health care context. By developing a set of recommended measures it is hoped to standardise the assessment and evaluation procedures used in this field to enhance comparability of findings across research and practice settings. Put simply, we a trying to create a tool-kit of measures for clinicians and researchers to use with people with dementia, in order to assist with communication across the field. A related aim is to make recommendations concerning the clarification and standardization of the clinical terminology applicable in this field. To enhance comparisons between studies it is important that standardized approaches to diagnosis and patient classification be undertaken.

Bird, A, Norman, R & Goodall, S 2007, 'Economic Evaluation of Positron Emission Tomography (PET) in Non Small Cell Lung Cancer (NSCLC), CHERE Working Paper 2007/6', CHERE Working Paper.
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Background: There are several perceived benefits from introducing positron emission tomography (PET) scanning into the staging of non small lung cancer (NSCLC). However, its greatest primary benefit is the role it can potential perform in reducing the number of unnecessary diagnostic examinations and futile surgeries. Objectives: To evaluate the economic impact and cost effectiveness of PET scanning in the management of potentially operable NSCLC patients using a cost-utility model. Methods: A literature review was conducted to find relevant studies and appropriate parameters to construct a decision model. Two strategies were compared. The first strategy was a conventional work up (CWU) consisting of an x-ray, a chest computer tomography (CT) scan and brochoscopy; the second strategy consisted of a CWU plus a whole body PET scan. These two strategies were applied to two sub-groups of NSCLC patients; those that had received a positive result on their CT scan and those that got a negative result on their CT scan. The cost-effectiveness of each strategy was dependent on a number of variables that were taken from a literature review. Costs were based on the Australian diagnostic related groups, a cost calculation for a chemotherapy course and values obtained from the literature. The life expectancy and utility scores were also taken from the literature and combined to create an incremental quality adjusted life year (QALY) value for PET for each of the patient groups. Results: The mean costs in CT negative and CT positive patients were lower in the CWU strategy, costing $A 20,427 and $A 23,578 per patient respectively compared to the PET strategy ($A 20,826 and $A 24,083 per patient respectively). The mean QALYs for both the CT positive and CT negative patients were higher in PET with 2.91 and 2.11 respectively compared to the CWU of 2.88 and 2.09. The incremental cost effectiveness ratio (ICER) for the CT negative strategy was $A 14,581 and $A 52,039 for t...

Fiebig, DG, Haas, MR, Hossain, I & Viney, RC 2007, 'Decisions about Pap tests: What influences women and providers?, CHERE Working Paper 2007/11', CHERE Working Paper.
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Despite the success internationally of cervical screening programs debate continues about optimal program design. This includes increasing participation rates among under-screened women, reducing unnecessary early re-screening, improving accuracy of and confidence in screening tests, and determining the cost-effectiveness of program parameters, such as type of screening test, screening interval and target group. For all these issues, information about consumer and provider preferences and insight into the potential impact of any change to program design on consumer and provider behaviour are essential inputs into evidence-based health policy decision making. This paper reports the results of discrete choice experiments to investigate womenâs choices and providersâ recommendations in relation to cervical screening in Australia. Separate experiments were conducted with women and general practitioners, with attributes selected to allow for investigation of interaction between womenâs and providersâ preferences and to determine how women and general practitioners differ in their preferences for common attributes. The results provide insight into the agency relationship in this context. Our results indicate a considerable commonality in preferences but the alignment was not complete. Women put relatively more weight on cost, chance of a false positive and if the recommended screening interval were changed to one year.

Haas, M, Zapart, S & Viney, R 2007, 'Patients? perceptions of the value of PET in diagnosis and management of non-small call lung cancer, CHERE Working Paper 2007/5', CHERE Working Paper.
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A randomized controlled trial comparing the use of PET versus no PET provided the opportunity to investigate the value patients placed on any additional information provided by the PET scan. Interviews were undertaken with patients after their diagnosis had been made and, in the case of those who had surgery, once they had returned home following the operation. Content analysis was used to describe and analyse the text of the interviews. The aims of the research were to explore with people receiving PET their perceptions of its impact on aspects of well being, acquire a better understanding of how patients understand and deal with the outcomes (both benefits and dis-benefits) of PET, and assess the decision making processes regarding PET and subsequent treatment (surgical and non-surgical) from the patients? perspectives with the aim of providing information which can be used by providers of care in improving the process of care. Interviews were conducted with a sub-sample of 59 trial participants between February 2000 and July 2001, between six and eight weeks post-surgery. Thirty-three, (56%) had received a PET scan and 26 (44%) had not. The majority of patients consulted a surgeon in the expectation of having surgery to remove their cancer. Participants viewed PET (along with the other tests) as being most likely to provide information and reassurance to the surgeon, rather than having any impact on their (patients?) decisions. As far as these participants were concerned, there was only one important decision - whether to have surgery - and that decision was in the hands of the surgeon. All other decisions were subordinate to this major milestone and thus did not appear significant to patients. Thus, on its own, PET appeared to be of little additional value to this group of patients. Between 23%-45% of respondents reported some complications whilst in hospital or some difficulties at home but these were mostly of a relatively minor nature. Even thoug...

Hall, JP, Kenny, PM & Hossain, I 2007, 'The provision of informal care in terminal illness: An analysis of carers' needs using a discrete choice experiment. CHERE Working paper 2007/12', CHERE Working Paper.

King, M, Winstanley, J, Kenny, P, Viney, R, Zapart, S & Boyer, M 2007, 'Validity, reliability and responsiveness of the EORTC QLQ-C30 and the EORTC QLQ-LC13 in Australians with early stage non-small cell lung cancer, CHERE Working Paper 2007/13', CHERE Working Paper.
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Aim: To assess the validity, reliability and responsiveness of two questionnaires, the QLQ-C30 and LC-13, as measures of health-related quality of life (HRQOL) in an Australian sample of people with early stage non-small cell lung cancer. Background: These two questionnaires are complementary components of the European Organisation for Research and Treatment of Cancer?s (EORTC?s) modular approach to measuring HRQOL: the QLQ-C30 is the core questionnaire, containing 30 items relevant to all cancers; the QLQ-LC13 contains 13 items specific to lung cancer. Methods: These two complementary questionnaires were assessed with data obtained from 183 participants of a randomised control trial investigating the use of Positron Emission Tomography in the management of stage I or II non-small cell lung cancer. A cohort of 173 participants, were treated by surgery and then followed for two years. Participants completed HRQOL questionnaires before the PET scan, before and after surgery, one month after surgery, and then four monthly for two years. Construct validity was tested with confirmatory factor analysis and correlation analysis was used to test for convergent/divergent validity. Discriminant validity was tested by assessing the sensitivity of the scales to the effects of moving from early to late stage disease, asymptomatic to mildly symptomatic, and to the effects of age, gender and number of comorbitities. Mean differences (standardized response means (SRM)) and effect sizes were estimated for: patients with Stage 1/11 and metastatic disease; ECOG score 0 and ECOG score 1; older and younger patients; men and women; patients with no comorbidities and those with 1 or more comorbidities. Reliability was assessed in terms of internal consistency and test-retest reliability. Responsiveness to the effects of major thoracic surgery, adjuvant radiotherapy, and disease recurrence was assessed by estimating mean differences (standardized response meansSRM?s and effect...

Norman, R, Cronin, P, Viney, R, King, M, Street, D, Brazier, J & Ratcliffe, J 2007, 'Valuing EQ-5D health states: A review and analysis, CHERE Working Paper 2007/9', CHERE Working Paper.
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Objective: To identify the key methodological issues in the construction of population-level EQ-5D / Time Trade-Off (TTO) preference elicitation studies. Study Design: This study involves three components. The first was to identify existing population-level EQ-5D TTO studies. The second was to illustrate and discuss the key areas of divergence between studies, including the international comparison of tariffs. The third was to portray the relative merits of each of the approaches, and to compare the results of studies across countries. Results: While most papers report use of the protocol developed in the original UK study, we identified three key areas of divergence in the construction and analysis of surveys. These are the number of health states valued in order to determine the algorithm for estimating all health states, the approach to valuing states worse than immediate death, and the choice of algorithm. Finally, the evidence on international comparisons suggests differences between countries, although it is difficult to disentangle differences in cultural attitudes with random error and differences due to methodological divergence. Conclusion: Differences in methods are likely to obscure true differences in values between countries. However, population-specific valuation sets for countries engaging in economic evaluation would better represent societal attitudes.

Van Gool, K, Gallego, G, Haas, MR, Viney, RC, Hall, JP & Ward, R 2007, 'Incorporating economic evidence into cancer care: searching for the missing link, CHERE Working Paper 2007/3', CHERE Working Paper.

Van Gool, K, Haas, MR, Sainsbury, P & Gilbert, R 2007, 'When is an ounce of prevention worth a pound of cure? The case of cardiovascular disease, CHERE Working Paper 2007/1', CHERE Working Paper.

Vu, M, van Gool, K, Savage, E, Haas, M & Birch, S 2007, 'The use of breast screening services in NSW: Are we moving towards greater equity? [Draft - not for quotation or citation], CHERE Working Paper 2007/7', CHERE Working Paper.
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Introduction: Since 1991 State and Federal Governments, under the auspices of BreastScreen Australia, have been providing mammography services free at the point of delivery to women aged 40 and over. One of the stated aims of the program is to provide equitable access to all women in the target group. Methods: Data on self-reported utilisation of breast screening services came from the 1997/98 and 2002/04 NSW Health Surveys. Probit regression analysis was used to examine the relationship between income and breast screening behaviour of women in NSW aged 50 to 69. Results: The results for 2002 and 2004 show that income has a positive and significant impact on the likelihood that a woman chooses to screen for breast cancer at regular intervals. The role of income was consistent across most regions. Women born overseas have a lower likelihood of screening regularly. Results from the pooled dataset show that the income gradient appears to be steeper in 2002/04 compared to 1997/98. Conclusions: These results indicate that the current program has not ensured equitable take-up of mammography services and that further research and investment is needed to meet program objectives.