Software: Sequential operating programs and data which instruct the functioning of a digital computer.Insurance, Health: Insurance providing coverage of medical, surgical, or hospital care in general or for which there is no specific heading.Meaningful Use: Using certified ELECTRONIC HEALTH RECORDS technology to improve quality, safety, efficiency, and reduce HEALTHCARE DISPARITIES; engage patients and families in their health care; improve care coordination; improve population and public health; while maintaining privacy and security.Dictionaries, MedicalUser-Computer Interface: The portion of an interactive computer program that issues messages to and receives commands from a user.Insurance Coverage: Generally refers to the amount of protection available and the kind of loss which would be paid for under an insurance contract with an insurer. (Slee & Slee, Health Care Terms, 2d ed)Computer Graphics: The process of pictorial communication, between human and computers, in which the computer input and output have the form of charts, drawings, or other appropriate pictorial representation.Data Mining: Use of sophisticated analysis tools to sort through, organize, examine, and combine large sets of information.Solutions: The homogeneous mixtures formed by the mixing of a solid, liquid, or gaseous substance (solute) with a liquid (the solvent), from which the dissolved substances can be recovered by physical processes. (From Grant & Hackh's Chemical Dictionary, 5th ed)Information Storage and Retrieval: Organized activities related to the storage, location, search, and retrieval of information.Amputation: The removal of a limb or other appendage or outgrowth of the body. (Dorland, 28th ed)Angioplasty, Balloon: Use of a balloon catheter for dilation of an occluded artery. It is used in treatment of arterial occlusive diseases, including renal artery stenosis and arterial occlusions in the leg. For the specific technique of BALLOON DILATION in coronary arteries, ANGIOPLASTY, BALLOON, CORONARY is available.Ischemia: A hypoperfusion of the BLOOD through an organ or tissue caused by a PATHOLOGIC CONSTRICTION or obstruction of its BLOOD VESSELS, or an absence of BLOOD CIRCULATION.Tibial Arteries: The anterior and posterior arteries created at the bifurcation of the popliteal artery. The anterior tibial artery begins at the lower border of the popliteus muscle and lies along the tibia at the distal part of the leg to surface superficially anterior to the ankle joint. Its branches are distributed throughout the leg, ankle, and foot. The posterior tibial artery begins at the lower border of the popliteus muscle, lies behind the tibia in the lower part of its course, and is found situated between the medial malleolus and the medial process of the calcaneal tuberosity. Its branches are distributed throughout the leg and foot.Intermittent Claudication: A symptom complex characterized by pain and weakness in SKELETAL MUSCLE group associated with exercise, such as leg pain and weakness brought on by walking. Such muscle limpness disappears after a brief rest and is often relates to arterial STENOSIS; muscle ISCHEMIA; and accumulation of LACTATE.Lower Extremity: The region of the lower limb in animals, extending from the gluteal region to the FOOT, and including the BUTTOCKS; HIP; and LEG.Thromboangiitis Obliterans: A non-atherosclerotic, inflammatory thrombotic disease that commonly involves small and medium-sized arteries or veins in the extremities. It is characterized by occlusive THROMBOSIS and FIBROSIS in the vascular wall leading to digital and limb ISCHEMIA and ulcerations. Thromboangiitis obliterans is highly associated with tobacco smoking.Gangrene: Death and putrefaction of tissue usually due to a loss of blood supply.Leg: The inferior part of the lower extremity between the KNEE and the ANKLE.Limb Salvage: An alternative to amputation in patients with neoplasms, ischemia, fractures, and other limb-threatening conditions. Generally, sophisticated surgical procedures such as vascular surgery and reconstruction are used to salvage diseased limbs.Wood: A product of hard secondary xylem composed of CELLULOSE, hemicellulose, and LIGNANS, that is under the bark of trees and shrubs. It is used in construction and as a source of CHARCOAL and many other products.Pinus: A plant genus in the family PINACEAE, order Pinales, class Pinopsida, division Coniferophyta. They are evergreen trees mainly in temperate climates.Trees: Woody, usually tall, perennial higher plants (Angiosperms, Gymnosperms, and some Pterophyta) having usually a main stem and numerous branches.Dipterocarpaceae: A plant family of the order Theales.Standard of Care: The minimum acceptable patient care, based on statutes, court decisions, policies, or professional guidelines.Ophiostomatales: An order of fungi in the phylum ASCOMYCOTA that are important plant pathogens.Specific Gravity: The ratio of the density of a material to the density of some standard material, such as water or air, at a specified temperature.Plant Stems: Parts of plants that usually grow vertically upwards towards the light and support the leaves, buds, and reproductive structures. (From Concise Dictionary of Biology, 1990)Beetles: INSECTS of the order Coleoptera, containing over 350,000 species in 150 families. They possess hard bodies and their mouthparts are adapted for chewing.Tropical Climate: A climate which is typical of equatorial and tropical regions, i.e., one with continually high temperatures with considerable precipitation, at least during part of the year. (McGraw-Hill Dictionary of Scientific and Technical Terms, 4th ed)Hospitals, Veterans: Hospitals providing medical care to veterans of wars.Veterans: Former members of the armed services.United States Department of Veterans Affairs: A cabinet department in the Executive Branch of the United States Government concerned with overall planning, promoting, and administering programs pertaining to VETERANS. It was established March 15, 1989 as a Cabinet-level position.United StatesVeterans Health: The concept covering the physical and mental conditions of VETERANS.New York CityRetrospective Studies: Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons.Veterans Disability Claims: Disorders claimed as a result of military service.History, 20th Century: Time period from 1901 through 2000 of the common era.History, 19th Century: Time period from 1801 through 1900 of the common era.Life Style: Typical way of life or manner of living characteristic of an individual or group. (From APA, Thesaurus of Psychological Index Terms, 8th ed)Adaptation, Physiological: The non-genetic biological changes of an organism in response to challenges in its ENVIRONMENT.Insulin: A 51-amino acid pancreatic hormone that plays a major role in the regulation of glucose metabolism, directly by suppressing endogenous glucose production (GLYCOGENOLYSIS; GLUCONEOGENESIS) and indirectly by suppressing GLUCAGON secretion and LIPOLYSIS. Native insulin is a globular protein comprised of a zinc-coordinated hexamer. Each insulin monomer containing two chains, A (21 residues) and B (30 residues), linked by two disulfide bonds. Insulin is used as a drug to control insulin-dependent diabetes mellitus (DIABETES MELLITUS, TYPE 1).Diabetes Mellitus, Type 1: A subtype of DIABETES MELLITUS that is characterized by INSULIN deficiency. It is manifested by the sudden onset of severe HYPERGLYCEMIA, rapid progression to DIABETIC KETOACIDOSIS, and DEATH unless treated with insulin. The disease may occur at any age, but is most common in childhood or adolescence.Insulin Resistance: Diminished effectiveness of INSULIN in lowering blood sugar levels: requiring the use of 200 units or more of insulin per day to prevent HYPERGLYCEMIA or KETOSIS.Islets of Langerhans: Irregular microscopic structures consisting of cords of endocrine cells that are scattered throughout the PANCREAS among the exocrine acini. Each islet is surrounded by connective tissue fibers and penetrated by a network of capillaries. There are four major cell types. The most abundant beta cells (50-80%) secrete INSULIN. Alpha cells (5-20%) secrete GLUCAGON. PP cells (10-35%) secrete PANCREATIC POLYPEPTIDE. Delta cells (~5%) secrete SOMATOSTATIN.Models, Biological: Theoretical representations that simulate the behavior or activity of biological processes or diseases. For disease models in living animals, DISEASE MODELS, ANIMAL is available. Biological models include the use of mathematical equations, computers, and other electronic equipment.Insulin-Secreting Cells: A type of pancreatic cell representing about 50-80% of the islet cells. Beta cells secrete INSULIN.Diabetes Mellitus, Experimental: Diabetes mellitus induced experimentally by administration of various diabetogenic agents or by PANCREATECTOMY.Cell Hypoxia: A condition of decreased oxygen content at the cellular level.
(1/664) Long-term results of pancreas transplantation under tacrolius immunosuppression.

BACKGROUND: The long-term safety and efficacy of tacrolimus in pancreas transplantation has not yet been demonstrated. The observation of prolonged pancreatic graft function under tacrolimus would indicate that any potential islet toxicity is short-lived and clinically insignificant. We report herein the results of pancreas transplantation in patients receiving primary tacrolimus immunosuppression for a minimum of 2 years. METHODS: From July 4, 1994 until April 18, 1996, 60 patients received either simultaneous pancreas-kidney transplant (n=55), pancreas transplant only (n=4), or pancreas after kidney transplantation (n=1). Baseline immunosuppression consisted of tacrolimus and steroids without antilymphocyte induction. Azathioprine was used as a third agent in 51 patients and mycophenolate mofetil in 9. Rejection episodes within the first 6 months occurred in 48 (80%) patients and were treated with high-dose corticosteroids. Antilymphocyte antibody was required in eight (13%) patients with steroid-resistant rejection. RESULTS: With a mean follow-up of 35.1+/-5.9 months (range: 24.3-45.7 months), 6-month and 1-, 2-, and 33-year graft survival is 88%, 82%, 80%, and 80% (pancreas) and 98%, 96%, 93%, and 91% (kidney), respectively. Six-month and 1-, 2-, and 3-year patient survival is 100%, 98%, 98%, and 96.5%. Mean fasting glucose is 91.6+/-13.8 mg/dl, and mean glycosylated hemoglobin is 5.1+/-0.7% (normal range: 4.3-6.1%). Mean tacrolimus dose is 6.5+/-2.6 mg/day and mean prednisone dose 2.0+/-2.9 mg/day at follow-up. Complete steroid withdrawal was possible in 31 (65%) of the 48 patients with functioning pancreases. CONCLUSIONS: These data show for the first time that tacrolimus is a safe and effective long-term primary agent in pancreas transplantation and provides excellent long-term islet function without evidence of toxicity while permitting steroid withdrawal in the majority of patients.  (+info)

(2/664) Pediatric renal transplantation under tacrolimus-based immunosuppression.

BACKGROUND: Tacrolimus has been used as a primary immunosuppressive agent in adult and pediatric renal transplant recipients, with reasonable outcomes. Methods. Between December 14, 1989 and December 31, 1996, 82 pediatric renal transplantations alone were performed under tacrolimus-based immunosuppression without induction anti-lymphocyte antibody therapy. Patients undergoing concomitant or prior liver and/or intestinal transplantation were not included in the analysis. The mean recipient age was 10.6+/-5.2 years (range: 0.7-17.9). Eighteen (22%) cases were repeat transplantations, and 6 (7%) were in patients with panel-reactive antibody levels over 40%. Thirty-four (41%) cases were with living donors, and 48 (59%) were with cadaveric donors. The mean donor age was 27.3+/-14.6 years (range: 0.7-50), and the mean cold ischemia time in the cadaveric cases was 26.5+/-8.8 hr. The mean number of HLA matches and mismatches was 2.8+/-1.2 and 2.9+/-1.3; there were five (6%) O-Ag mismatches. The mean follow-up was 4.0+/-0.2 years. RESULTS: The 1- and 4-year actuarial patient survival was 99% and 94%. The 1- and 4-year actuarial graft survival was 98% and 84%. The mean serum creatinine was 1.1+/-0.5 mg/dl, and the corresponding calculated creatinine clearance was 88+/-25 ml/min/1.73 m2. A total of 66% of successfully transplanted patients were withdrawn from prednisone. In children who were withdrawn from steroids, the mean standard deviation height scores (Z-score) at the time of transplantation and at 1 and 4 years were -2.3+/-2.0, -1.7+/-1.0, and +0.36+/-1.5. Eighty-six percent of successfully transplanted patients were not taking anti-hypertensive medications. The incidence of acute rejection was 44%; between December 1989 and December 1993, it was 63%, and between January 1994 and December 1996, it was 23% (P=0.0003). The incidence of steroid-resistant rejection was 5%. The incidence of delayed graft function was 5%, and 2% of patients required dialysis within 1 week of transplantation. The incidence of cytomegalovirus was 13%; between December 1989 and December 1992, it was 17%, and between January 1993 and December 1996, it was 12%. The incidence of early Epstein-Barr virus-related posttransplant lymphoproliferative disorder (PTLD) was 9%; between December 1989 and December 1992, it was 17%, and between January 1993 and December 1996, it was 4%. All of the early PTLD cases were treated successfully with temporary cessation of immunosuppression and institution of antiviral therapy, without patient or graft loss. CONCLUSIONS: These data demonstrate the short- and medium-term efficacy of tacrolimus-based immunosuppression in pediatric renal transplant recipients, with reasonable patient and graft survival, routine achievement of steroid and anti-hypertensive medication withdrawal, gratifying increases in growth, and, with further experience, a decreasing incidence of both rejection and PTLD.  (+info)

(3/664) Tolerability and efficacy of carvedilol in patients with New York Heart Association class IV heart failure.

OBJECTIVES: The purpose of this study was to assess the tolerability and efficacy of carvedilol in patients with New York Heart Association (NYHA) functional class IV symptoms. BACKGROUND: Carvedilol, a nonselective beta-adrenergic blocking drug with alpha-adrenergic blocking and antioxidant properties, has been shown to improve left ventricular function and clinical outcome in patients with mild to moderate chronic heart failure. METHODS: We retrospectively analyzed the outcomes of 230 patients with heart failure treated with carvedilol who were stratified according to baseline functional class: 63 patients were NYHA class IV and 167 were NYHA class I, II or III. Carvedilol was commenced at 3.125 mg b.i.d. and titrated to 25 mg b.i.d. as tolerated. Patients with class IV symptoms were older (p = 0.03), had lower left ventricular fractional shortening (p < 0.001), had lower six-min walk distance (p < 0.001) and were receiving more heart failure medications at baseline compared with less symptomatic patients. RESULTS: Nonfatal adverse events while taking carvedilol occurred more frequently in class IV patients (43% vs. 24%, p < 0.0001), and more often resulted in permanent withdrawal of the drug (25% vs. 13%, p < 0.01). Thirty-seven (59%) patients who were NYHA class IV at baseline had improved by one or more functional class at 3 months, 8 (13%) were unchanged and 18 (29%) had deteriorated or died. Among the less symptomatic group, 62 (37%) patients had improved their NYHA status at 3 months, 73 (44%) were unchanged and 32 (19%) had deteriorated or died. The differences in symptomatic outcome at three months between the two groups were statistically significant (p = 0.001, chi-square analysis). Both groups demonstrated similar significant improvements in left ventricular dimensions and systolic function. CONCLUSIONS: Patients with chronic NYHA class IV heart failure are more likely to develop adverse events during initiation and dose titration when compared with less symptomatic patients but are more likely to show symptomatic improvement in the long term. We conclude that carvedilol is a useful adjunctive therapy for patients with NYHA class IV heart failure; however, they require close observation during initiation and titration of the drug.  (+info)

(4/664) The potential role of risk-equalization mechanisms in health insurance: the case of South Africa.

International agencies such as the World Bank have widely advocated the use of health insurance as a way of improving health sector efficiency and equity in developing countries. However, in developing countries with well-established, multiple-player health insurance markets, such as South Africa, extension of insurance coverage is now inhibited by problems of moral hazard, and associated cost escalation and fragmentation of insurer risk-pools. Virtually no research has been done on the problem of risk selection in health insurance outside developed countries. This paper provides a brief overview of the problem of risk fragmentation as it has been studied in developed countries, and attempts to apply this to middle-income country settings, particularly that of South Africa. A number of possible remedial measures are discussed, with risk-equalization funds being given the most attention. An overview is given of the risk-equalization approach, common misconceptions regarding its working and the processes that might be required to assess its suitability in different national settings. Where there is widespread public support for social risk pooling in health care, and government is willing and able to assume a regulatory role to achieve this, risk-equalization approaches may achieve significant efficiency and equity gains without destroying the positive features of private health care financing, such as revenue generation, competition and free choice of insurer.  (+info)

(5/664) Impact of prophylactic immediate posttransplant ganciclovir on development of transplant atherosclerosis: a post hoc analysis of a randomized, placebo-controlled study.

BACKGROUND: Coronary artery disease occurs in an accelerated fashion in the donor heart after heart transplantation (TxCAD), but the cause is poorly understood. The risk of developing TxCAD is increased by cytomegalovirus (CMV) infection and decreased by use of calcium blockers. Our group observed that prophylactic administration of ganciclovir early after heart transplantation inhibited CMV illness, and we now propose to determine whether this therapy also prevents TxCAD. METHODS AND RESULTS: One hundred forty-nine consecutive patients (131 men and 18 women aged 48+/-13 years) were randomized to receive either ganciclovir or placebo during the initial 28 days after heart transplantation. Immunosuppression consisted of muromonab-CD3 (OKT-3) prophylaxis and maintenance with cyclosporine, prednisone, and azathioprine. Mean follow-up time was 4.7+/-1.3 years. In a post hoc analysis of this trial designed to assess efficacy of ganciclovir for prevention of CMV disease, we compared the actuarial incidence of TxCAD, defined by annual angiography as the presence of any stenosis. Because calcium blockers have been shown to prevent TxCAD, we analyzed the results by stratifying patients according to use of calcium blockers. TxCAD could not be evaluated in 28 patients because of early death or limited follow-up. Among the evaluable patients, actuarial incidence of TxCAD at follow-up (mean, 4.7 years) in ganciclovir-treated patients (n=62) compared with placebo (n=59) was 43+/-8% versus 60+/-10% (P<0.1). By Cox multivariate analysis, independent predictors of TxCAD were donor age >40 years (relative risk, 2.7; CI, 1.3 to 5.5; P<0.01) and no ganciclovir (relative risk, 2.1; CI, 1.1 to 5.3; P=0.04). Stratification on the basis of calcium blocker use revealed differences in TxCAD incidence when ganciclovir and placebo were compared: no calcium blockers (n=53), 32+/-11% (n=28) for ganciclovir versus 62+/-16% (n=25) for placebo (P<0.03); calcium blockers (n=68), 50+/-14% (n=33) for ganciclovir versus 45+/-12% (n=35) for placebo (P=NS). CONCLUSIONS: TxCAD incidence appears to be lower in patients treated with ganciclovir who are not treated with calcium blockers. Given the limitations imposed by post hoc analysis, a randomized clinical trial is required to address this issue.  (+info)

(6/664) Survival 12 years after randomization to streptokinase: the influence of thrombolysis in myocardial infarction flow at three to four weeks.

OBJECTIVES: The purpose of this study was to determine whether the mortality benefit of intravenous streptokinase administered within 4 h of the onset of acute myocardial infarction is maintained at 12 years, and whether Thrombolysis in Myocardial Infarction (TIMI) flow grades independently influence late survival. BACKGROUND: Treatment with reperfusion therapies and achievement of TIMI 3 flow are associated with increased short- and medium-term survival after infarction. Whether infarct artery flow independently influences survival more than five years after infarction is unknown. METHODS: The late survival of patients randomized to receive either streptokinase (1,500,000 IU over 30 to 60 min) or a matching placebo within 4 h of symptom onset in 1984-1986 was determined. Angiography was performed in surviving patients at three to four weeks, and TIMI flow grades were assessed blind to randomization and outcomes. The late vital status was determined in 99% of patients. RESULTS: Patients randomized to receive streptokinase (n = 107) had improved survival compared with those randomized to placebo (n = 112) at five years (84% vs. 70%; p = 0.023) and 12 years (66% vs. 51%; p = 0.022). At five years 94% of patients with TIMI grade 3 flow, 81% of those with TIMI grade 2 flow and 72% of those with TIMI grade 0-1 flow survived (p = 0.005). At 12 years 72% of patients with TIMI 3, 67% of those with TIMI 2 and 54% of those with TIMI 0-1 flow survived (p = 0.023). Multivariate analysis identified the ejection fraction (p = 0.014), exercise duration (p = 0.013) and TIMI 3 flow (p = 0.04 compared with TIMI 0-2 flow) as important factors for five-year survival. At 12 years multivariate predictors of late survival were the ejection fraction (p = 0.006), exercise duration (p = 0.003) and myocardial score (p = 0.013). The end-systolic volume index was similar to the ejection fraction as a predictor of survival at five and 12 years. CONCLUSIONS: The survival benefits of streptokinase persist for 12 years after infarction. TIMI flow at three to four weeks is an independent predictor of five-year survival.  (+info)

(7/664) Long-term follow-up of patients with rectal cancer managed by local excision with and without adjuvant irradiation.

OBJECTIVE: The long-term outcomes of patients undergoing local excision with or without pelvic irradiation were examined to define the role of adjuvant irradiation after local excision of T1 and T2 rectal cancers. METHODS: Ninety-nine patients with T1 or T2 rectal cancers underwent local excision with or without adjuvant irradiation at Massachusetts General Hospital and Emory University Hospital between January 1966 and January 1997. Of these, 52 patients were treated by local excision alone and 47 patients by local excision plus adjuvant irradiation. Twenty-six of these 47 patients were treated by irradiation in combination with 5-fluorouracil chemotherapy. The outcomes of these groups were compared. RESULTS: The 5-year actuarial local control and recurrence-free survival rates were 72% and 66%, respectively, for the local excision alone group and 90% and 74%, respectively, for the adjuvant irradiation group. This improvement in outcome was evident despite the presence of a higher-risk patient population in the adjuvant irradiation group. Adverse pathologic features such as poorly differentiated histology and lymphatic or blood vessel invasion decreased local control and recurrence-free survival rates in the local excision only group. Adjuvant irradiation significantly improved 5-year outcomes in patients with high-risk pathologic features. Four cases of late local recurrence were seen at 64, 72, 86, and 91 months in the adjuvant irradiation group. CONCLUSIONS: The authors recommend adjuvant chemoradiation for all patients undergoing local excision for T2 tumors, and for T1 tumors with high-risk pathologic features. The four cases of late local failures beyond 5 years in the adjuvant irradiation group underscores the need for careful long-term follow-up in these patients.  (+info)

(8/664) Local failure is responsible for the decrease in survival for patients with breast cancer treated with conservative surgery and postoperative radiotherapy.

PURPOSE: The aim of the present study was to evaluate the role of local failure (LF) in the survival of patients treated with lumpectomy and postoperative radiotherapy and to investigate whether LF is not only a marker for distant metastasis (DM) but also a cause. METHODS: Charts of patients treated with breast conservative surgery between 1969 and 1991 were reviewed retrospectively. There were 2,030 patients available for analysis. The median duration of follow-up was 6 years. A Cox regression multivariate analysis was performed using LF as a time-dependent covariate. RESULTS: Local control (LC) was 87% at 10 years. Local failure led to poorer survival at 10 years than local control (55% v 75%, P < .00). In a Cox model, local failure was a powerful predictor of mortality. The relative risk associated with LF was 3.6 for mortality and 5.1 for DM (P < .00). In patients with LF, the rate of DM peaked at 5 to 6 years, whereas it peaked at 2 years for patients with LC. The mean time between surgery and DM was 1,050 days for patients without LF and 1,650 days for patients with LF (P < .00). CONCLUSION: Our results show that local failure is associated with an increase in mortality. The difference in the time distribution of distant metastasis for LF and LC could imply distinct mechanisms of dissemination. Local failure should be considered not only as a marker of occult circulating distant metastases but also as a source for new distant metastases and subsequent mortality.  (+info)

*  Aneurysm
"Actuarial analysis of variables associated with rupture of small abdominal aortic aneurysms". Surgery. 98 (3): 472-83. PMID ... A meta-analysis and systematic review". The Neuroradiology Journal. 29 (1): 66-71. doi:10.1177/1971400915621321. ISSN 1971-4009 ...
*  Government Actuary's Department
"Actuarial analysis - For the public sector - From the public sector". The services GAD provides are: Actuarial valuations and ... and Other actuarial and statistical advice on areas, including statistical analysis, healthcare financing and actuarial ... By the 1980s GAD had grown into a significant actuarial consultancy within government and in 1989 the financing of GAD through ... is a department of the Government of the United Kingdom responsible for providing actuarial advice to public sector clients. It ...
*  Thomas N. E. Greville
... actuarial mathematician in the U.S. Bureau of the Census (1940-46); chief of the Actuarial Analysis section of the National ... He proposed his method particularly in the context of the 1930s controversy on the proper analysis of tests in extrasensory ... Milton, J., & Wiseman, R. (1999). A meta-analysis of mass-media tests of extrasensory perception. British Journal of Psychology ... Thomas Nall Eden Greville (December 27, 1910 - 1998) was an American mathematician, specializing in statistical analysis, ...
*  Numerical analysis
Insurance companies use numerical programs for actuarial analysis. The rest of this section outlines several important themes ... The overall goal of the field of numerical analysis is the design and analysis of techniques to give approximate but accurate ... Analysis of algorithms Computational science List of numerical analysis topics Numerical differentiation Numerical Recipes ... Numerical analysis naturally finds applications in all fields of engineering and the physical sciences, but in the 21st century ...
*  Assistant Secretary for Planning and Evaluation
Actuarial analysis and modeling to support the development of policy alternatives relating to ACA provisions regarding coverage ... The Division of Data and Technical Analysis is responsible for the development, analysis, and coordination of research, ... The division provides support for policy development through data analysis, modeling, cost and impact analyses, and the ... The Division's responsibilities include long-range planning, budget and economic analysis, program analysis, review of ...
*  Dynamic financial analysis
2004, May) Introduction to Dynamic Financial Analysis. Retrieved October 23, 2009, from Casualty Actuarial Society website: ... Without effective analysis and presentation, managers can hardly make any sense out of the vast amount of data that DFA ... Dynamic financial analysis (DFA) is a simulation approach that looks at an insurance enterprise's risks holistically as opposed ... Support the DFA analysis with other available information within the company. Kaufmann, Roger. Andeas Gadmer. Ralf Klett. ( ...
*  Service life
... efforts at actuarial analysis are not taken to the same extent as found with that needed to support insurance decisions. ... For maintainable items, those wear-out items that are determined by logistical analysis to be provisioned for sparing and ... service life as part of business policy involves using tools and calculations from maintainability and reliability analysis. ...
*  List of MeSH codes (N05)
... actuarial analysis MeSH N05.715.360.750.125 --- analysis of variance MeSH N05.715.360.750.125.500 --- multivariate analysis ... matched-pair analysis MeSH N05.715.360.780.515 --- meta-analysis MeSH N05.715.360.780.675 --- random allocation MeSH N05.715. ... regression analysis MeSH N05.715.360.750.695.440 --- least-squares analysis MeSH N05.715.360.750.695.460 --- linear models MeSH ... discriminant analysis MeSH N05.715.360.750.350 --- factor analysis, statistical MeSH N05.715.360.750.500 --- matched-pair ...
*  Copula (probability theory)
... dependence modelling with copula functions is widely used in applications of financial risk assessment and actuarial analysis ... Copulas are being used for warranty data analysis in which the tail dependence is analysed Copulas are used in modelling ... ISBN 978-981-270-949-3. Donnelly, C; Embrechts, P, (2010). "The devil is in the tails: actuarial mathematics and the subprime ... Recently, copula functions have been successfully applied to the database formulation for the reliability analysis of highway ...
*  AMP Building, Rockhampton
It was not until 1881, after some actuarial analysis of existing policies and owing to intense rivalry from other insurance ...
*  Actuarial credentialing and exams
... risk analysis, actuarial modeling); and third level (investment and risk management, non-life insurance, life insurance, health ... The Actuarial Education Company, a subsidiary of BPP Actuarial Education Ltd.), which is contracted to provide actuarial ... The Actuarial Society of Bangladesh is the unique Professional Body of Actuaries in Bangladesh. Actuarial Society of Bangladesh ... in Actuarial Science. University of Dhaka, Rajshahi University, Jahangirnagar University provide a few course of Actuarial ...
*  Scenario optimization
Fields of application include: prediction, systems theory, regression analysis, Actuarial science,optimal control, financial ... a deep theoretical analysis has been established which shows that the probability that a new constraint is not satisfied ...
*  Medical statistics
Benjamin, Bernard (1993). The analysis of mortality and other actuarial statistics. England, Institute of Actuaries,: Oxford. ... Actuarial statistics: The statistics used by actuaries to calculate liabilities, evaluate risks and plan the financial course ... This can be from issues of design of experiments, to analysis of drug trials, to issues of commercialization of a medicine. ... Odds ratio Relative risk reduction Relative risk Relative survival Minimal clinically important difference Survival analysis ...
*  American Academy of Actuaries
... the Academy provides independent and objective actuarial information, analysis, and education for the formation of sound public ... American Academy of Actuaries Actuarial Board for Counseling and Discipline Actuarial Standards Board US Actuarial News. ... "Actuarial Standards Board". Actuarial Standards Board. Retrieved 2010-06-13. "Academy Policies: Membership Requirements". ... The Actuarial Board for Counseling and Discipline (ABCD) was formed to serve the academy and all other U.S. actuarial ...
*  Office of Financial Markets (U.S.)
... and provides actuarial and mathematical analyses and computations as required for Treasury market financing, the Federal ... and investment activities and performs actuarial and mathematical analyses and computations as required, for Treasury market ... Led by the Deputy Assistant Secretary for Government Financing Policy, OGFP provides analyses of agency and legislative ... led by the Director of the Office of Debt Management The ODM is responsible for providing advice and analysis on matters ...
*  Tweedie distribution
... actuarial studies assay analysis survival analysis ecology analysis of alcohol consumption in British teenagers medical ... Actuarial applications of generalized linear models. In Statistics in Finance, D. J. Hand and S. D. Jacka (eds), Arnold, London ... Regression analysis of quantity data with exact zeros. Proceedings of the Second Australia--Japan Workshop on Stochastic Models ... Casualty Actuarial Forum, Winter 2000. Smyth, G.K.; Jørgensen, B. (2002). "Fitting Tweedie's compound Poisson model to ...
*  ENSAE ParisTech
Actuarial Science Market Analysis & Corporate Finance Quantitative Finance Quantitative Methods & Social Sciences Forecasting ... Former ENSAE graduates work in finance, management, consulting, economic analysis and research (in economics and statistics). ... economic analysis 4% consulting 3% audit Since the ENSAE was founded, more than 5,000 statisticians economists have graduated. ... the National School for Statistics and Analysis Areas information (ENSAI, relocated to Rennes). The "administrateurs" training ...
*  Viktor Bunyakovsky
His other scientific interests included: mathematical physics, condensed matter physics, mathematical analysis, differential ... equations, actuarial mathematics, and mathematics education with a focus on mathematical terminology. He worked on theoretical ...
*  Office of the Chief Actuary
... of the Chief Actuary at the Social Security Administration plans and directs a program of actuarial estimates and analyses ... In addition, the Office is charged with conducting cost analyses relating to the Supplemental Security Income (SSI) program, a ... The Office of the Chief Actuary is a government agency that has responsibility for actuarial estimates regarding social welfare ... performs actuarial and demographic research on social insurance and related program issues, and projects future workloads. ...
*  FM Global
... business model whereby risk and premiums are determined by engineering analysis as opposed to historically based actuarial ... The group later began performing appraisals and adjustments, loss analysis and research activities associated with preventing ... RIMS: FM Global Finds Engineering Study Superior to Actuarial Predictions https://www.fmglobal.com/about-us/our-business/ ...
*  Nalini Ravishanker
... is an Indian statistician interested in time series analysis and in applications of statistics to actuarial ...
*  Herman Wold
"A synthesis of pure demand analysis II". Skandinavisk Aktuarietidskrift [Scandinavian Actuarial Journal]. 26. 1943b. pp. 220- ... "A synthesis of pure demand analysis III". Skandinavisk Aktuarietidskrift [Scandinavian Actuarial Journal]. 27. 1944. pp. 69-120 ... His book Demand Analysis (1952) brought together his work on the theory of demand, the theory of stochastic processes, the ... Demand Analysis: A Study in Econometrics, with Lars Juréen. 1954. "Causality and Econometrics," Econometrica, 22(2), p p. 162- ...
*  List of women in statistics
Indian statistician interested in time series analysis and applications to actuarial science, business, and transportation ... and survival analysis Grace Y. Yi, Chinese-Canadian expert in event history analysis with missing data in medicine, engineering ... functional data analysis, and aging Mei-Cheng Wang, Taiwanese biostatistician known for her work on survival analysis and ... president of International Society for Bayesian Analysis Betsy Becker, American researcher on meta-analysis and educational ...
*  Vehicle insurance in the United States
Insurers use actuarial science to determine the rates, which involves statistical analysis of the various characteristics of ... Analysis of Personal Auto Uninsured/Underinsured Motorist Stacking and Trigger Provisions. "Buying or Leasing a Car: What you ...
*  Tillinghast
TAS Tillinghast Actuarial Software: a software package layer over the MoSes platform for analysis and reporting of life and ... Actuarial consulting services include funding/pricing analysis, loss reserve and financial statement accruals, retention ... Tillinghast was the world's largest actuarial practice focused on insurance and a unit of Towers Perrin specializing in risk ... Tillinghast is the leading global actuarial consulting firm and the largest consulting employer of qualified casualty actuaries ...
*  Employee Retirement Income Security Act of 1974
A three-part analysis is used to decide whether ERISA preempts state law. First, preemption is presumed if the state law " ... It also created the Joint Board for the Enrollment of Actuaries, which licenses actuaries to perform a variety of actuarial ... The third step of the ERISA preemption analysis concerns the "deemer" clause. State insurance regulation may be saved only to ... Increases in the plan's liabilities due to benefit improvements, changes in actuarial assumptions, and any other reasons were ...
Medical utilization and cost impact of significantly reducing proton pump inhibitor coverage: An actuarial analysis - Milliman...  Medical utilization and cost impact of significantly reducing proton pump inhibitor coverage: An actuarial analysis - Milliman...
Medical utilization and cost impact of significantly reducing proton pump inhibitor coverage: An actuarial analysis. ... Milliman named actuarial firm winner by this year's U.S. Captive Review Awards ...
more infohttp://www.milliman.com/insight/research/health/Medical-utilization-and-cost-impact-of-significantly-reducing-proton-pump-inhibitor-coverage-An-actuarial-analysis/
Cardiovascular event incidence and cost in type 2 diabetes: A commercial and Medicare claim based actuarial analysis - Milliman...  Cardiovascular event incidence and cost in type 2 diabetes: A commercial and Medicare claim based actuarial analysis - Milliman...
An analysis to identify the annual rate and cost of cardiovascular (CV) events in patients with type 2 diabetes mellitus (T2DM ... Cardiovascular event incidence and cost in type 2 diabetes: A commercial and Medicare claim based actuarial analysis. ... This analysis identifies the annual rate and cost of cardiovascular (CV) events in patients with type 2 diabetes mellitus (T2DM ...
more infohttp://www.milliman.com/insight/2016/Cardiovascular-event-incidence-and-cost-in-type-2-diabetes-A-commercial-and-Medicare-claim-based-actuarial-analysis/
Insights for Payers-RMS Treatment Considerations and Real-World Evidence Based on a Milliman Actuarial Analysis : Academy of...  Insights for Payers-RMS Treatment Considerations and Real-World Evidence Based on a Milliman Actuarial Analysis : Academy of...
Insights for Payers-RMS Treatment Considerations and Real-World Evidence Based on a Milliman Actuarial Analysis. ... as reported in a 2016 Milliman commercial claims data analysis. ... AMCP Letters, Statements & Analysis. *Medicare Fraud, Waste & ...
more infohttp://amcp.org/SITOct262016/
PPT - The Poisson log-bilinear Lee Carter model: Efficient bootstrap in life annuity actuarial analysis PowerPoint Presentation...  PPT - The Poisson log-bilinear Lee Carter model: Efficient bootstrap in life annuity actuarial analysis PowerPoint Presentation...
Efficient bootstrap in life annuity actuarial analysis. Valeria D'Amato 1 , Emilia Di Lorenzo 2 , Steven Haberman 3 , Maria ... The Poisson log-bilinear Lee Carter model:Efficient bootstrap in life annuity actuarial analysis. Valeria D'Amato1, Emilia Di ... The Poisson log-bilinear Lee Carter model: Efficient bootstrap in life annuity actuarial analysis - PowerPoint PPT Presentation ... The Poisson log-bilinear Lee Carter model: Efficient bootstrap in life annuity actuarial analysis. Valeria D'Amato 1 , Emilia ...
more infohttps://www.slideserve.com/Sophia/the-poisson-log-bilinear-lee-carter-model-efficient-bootstrap-in-life-annuity-actuarial-analysis
Actuarial Analysis and Premium Development - Kennell and Associates, Inc.  Actuarial Analysis and Premium Development - Kennell and Associates, Inc.
Kennell has provided actuarial support to DoD as the Department has explored a wide range of options to update the cost-sharing ... Kennell's actuarial work has included the development of premiums for voluntary DoD health programs, evaluation of the cost ... A hallmark of Kennell's actuarial approach is the ability to explain highly technical calculations and to enable clients to ... Kennell and Associates provides expert actuarial consulting to Department of Defense (DoD) and other clients. ...
more infohttp://www.kennellinc.com/mental-health-studies/
The actuarial survival analysis of the surgical and non-surgical therapy regimen for chronic thromboembolic pulmonary...  The actuarial survival analysis of the surgical and non-surgical therapy regimen for chronic thromboembolic pulmonary...
Aim To characterize the in-hospital mortality and the actuarial survival of surgical and non-surgical therapy regimen in the ... The actuarial survival of the two groups was determined with the Kaplan-Meier survival curves. Univariate analysis and ... The actuarial survival analysis of the surgical and non-surgical therapy regimen for chronic thromboembolic pulmonary ... For the proximal type of CTEPH, the actuarial survival at 10 and 15 years of the surgical group and non-surgical group were ...
more infohttps://link.springer.com/article/10.1007%2Fs11239-009-0319-1
Significance testing with survival analysis (actuarial method) | Statistics Help @ Talk Stats Forum  Significance testing with survival analysis (actuarial method) | Statistics Help @ Talk Stats Forum
I'm teaching myself survival analysis with free resources on the web. I'm quite confident that I'm correct, but I just want to ... Survival analysis takes it into account automatically. You just have to specify how long the individual has been followed (i.e ... I have a very large dataset (in the 100s of thousands) so I am using the actuarial method. My syntax is as follows. proc ... Hence the need for survival analysis. Thank you so much in advance for your help! Also, please let me know if you require any ...
more infohttp://talkstats.com/threads/significance-testing-with-survival-analysis-actuarial-method.26695/
A Report on the Actuarial, Marketing, and Legal Analyses of the CLASS Program | ASPE  A Report on the Actuarial, Marketing, and Legal Analyses of the CLASS Program | ASPE
A Report on the Actuarial, Marketing, and Legal Analyses of the CLASS Program * U.S. Department of Health and Human Services ... A Report on the Actuarial, Marketing, and Legal Analyses of the CLASS Program 10/14/2011 ...
more infohttps://aspe.hhs.gov/report/report-actuarial-marketing-and-legal-analyses-class-program
Survival analysis: Life table (actuarial method) vs Kaplan-Meier estimation - Cross Validated  Survival analysis: Life table (actuarial method) vs Kaplan-Meier estimation - Cross Validated
Survival analysis: Life table (actuarial method) vs Kaplan-Meier estimation. Ask Question ... I had a couple of exercises about building a table for survival analysis under two different hypothesis: actuarial method and ... From these tables it seems that in actuarial method, we compute the survival at the beginning of the interval, whereas in the ... The only differences I know between this two approaches are the length of the intervals (given in actuarial method and " ...
more infohttps://stats.stackexchange.com/questions/257415/survival-analysis-life-table-actuarial-method-vs-kaplan-meier-estimation
Insurance Analytics Software & Big Data Solutions | SAS  Insurance Analytics Software & Big Data Solutions | SAS
Actuarial analysis and ratemaking. Create more competitive pricing models by using multivariate statistical techniques to ... Perform in-depth analyses in real time to assess the scope of a catastrophe. Then make critical decisions that could ... Social media analysis. Listen to and monitor conversations about your company on social media and online channels. Add context ... Risk analysis. Reduce the impact of risks on your business. Our advanced analytics let you anticipate enterprise risks and ...
more infohttps://www.sas.com/es_ar/industry/insurance.html
Insurance Analytics Software & Big Data Solutions | SAS  Insurance Analytics Software & Big Data Solutions | SAS
Actuarial analysis and ratemaking. Create more competitive pricing models by using multivariate statistical techniques to ... Perform in-depth analyses in real time to assess the scope of a catastrophe. Then make critical decisions that could ... Social media analysis. Listen to and monitor conversations about your company on social media and online channels. Add context ... Risk analysis. Reduce the impact of risks on your business. Our advanced analytics let you anticipate enterprise risks and ...
more infohttps://www.sas.com/tr_tr/industry/insurance.html
Hierarchical Segmented Regression Models with Application to Wood Density Analysis - Statistics and Actuarial Science - Simon...  Hierarchical Segmented Regression Models with Application to Wood Density Analysis - Statistics and Actuarial Science - Simon...
project entitled 'Hierarchical Segmented Regression Models with Application to Wood Density Analysis' on 5 April 2007. ... Department of Statistics & Actuarial Science. Simon Fraser University. Room SC K10545. 8888 University Drive. Burnaby, B.C.. ... SFU Statistics and Actuarial Science Partners with MOJ.IO To Host Case Study ... Kasra Yousefi wins the 2013 Randy Sitter Annual Graduate Scholarship in Statistics and Actuarial Science ...
more infohttp://stat.sfu.ca/research/theses/OLDabstracts/Xing-2007.html
Sources Sought Notice - C- Project Number 526-15-113 Renovate ICU - InsuranceNewsNet  Sources Sought Notice - C- Project Number 526-15-113 Renovate ICU - InsuranceNewsNet
Iowa Stopgap Measure Economic and Actuarial Analysis Released. Advisor News. *Consumers Seek Multiple Sources Of Financial ...
more infohttps://insurancenewsnet.com/oarticle/sources-sought-notice-c-project-number-526-15-113-renovate-icu
Epilepsy in Childhood Shunted Hydrocephalus | SpringerLink  Epilepsy in Childhood Shunted Hydrocephalus | SpringerLink
Piatt JJ, Carlson C (1996) Hydrocephalus and epilepsy: an actuarial analysis. Neurosurgery 39(4):722-727.; ; discussion 727-8 ... Chadduck W, Adametz J (1988) Incidence of seizures in patients with myelomeningocele: a multifactorial analysis. Surg Neurol 30 ...
more infohttps://link.springer.com/referenceworkentry/10.1007%2F978-3-319-31889-9_88-1
Mead A[au] - PubMed - NCBI  Mead A[au] - PubMed - NCBI
Perampanel for the treatment of epilepsy; Longitudinal actuarial analysis and dose responses based on monthly outcomes. ... A spatial temporal analysis of the Fusarium graminearum transcriptome during symptomless and symptomatic wheat infection. ... Unravelling Intratumoral Heterogeneity through High-Sensitivity Single-Cell Mutational Analysis and Parallel RNA Sequencing. ...
more infohttps://www.ncbi.nlm.nih.gov/pubmed?cmd=search&term=Mead+A%5Bau%5D&dispmax=50
Coverage of Obesity Problematic for Most Health Plans | Managed Care magazine  Coverage of Obesity Problematic for Most Health Plans | Managed Care magazine
Summary of an Actuarial Analysis and Report. multiple-sclerosis-new-perspectives-patient-journey-2019-biogen.svg. ...
more infohttps://www.managedcaremag.com/archives/2002/7/coverage-obesity-problematic-most-health-plans
Relapsing Multiple Sclerosis Patients Can Look to Second Oral Agent | Managed Care magazine  Relapsing Multiple Sclerosis Patients Can Look to Second Oral Agent | Managed Care magazine
Summary of an Actuarial Analysis and Report. multiple-sclerosis-new-perspectives-patient-journey-2019-biogen.svg. ... Real-World Analysis of Dispensed International Units of Coagulation Factor VIII and Resultant Expenditures for Hemophilia A ... A Financial Analysis of New York City Start-up Health Plans and Reasons for Their Losses ...
more infohttps://www.managedcaremag.com/archives/2013/2/relapsing-multiple-sclerosis-patients-can-look-second-oral-agent
  • We identify the actual contribution of the considered refined methodologies in constructing the survival probabilities in actuarial entities that can be immediately interpreted and used for risk management and solvency assessment purposes. (slideserve.com)
  • Kennell's actuarial work has included the development of premiums for voluntary DoD health programs, evaluation of the cost impact of benefit and program changes, and the various studies related to the development, implementation, and evaluation of risk adjustment mechanisms. (kennellinc.com)
  • Univariate analysis and multivariate binary logistic regression and Cox proportional hazard analysis were used to identify the risk factors for the in-hospital and late deaths. (springer.com)
  • This analysis identifies the annual rate and cost of cardiovascular (CV) events in patients with type 2 diabetes mellitus (T2DM) and the contribution of these CV events to both T2DM annual costs as well as total Medicare fee-for-service and commercially insured population annual costs. (milliman.com)
  • Chadduck W, Adametz J (1988) Incidence of seizures in patients with myelomeningocele: a multifactorial analysis. (springer.com)
  • The presentation will provide an overview of relapsing multiple sclerosis (RMS) treatment considerations and pharmacoeconomic insights for MS, as reported in a 2016 Milliman commercial claims data analysis. (amcp.org)
  • For the proximal type of CTEPH, the actuarial survival at 10 and 15 years of the surgical group and non-surgical group were 94.60 ± 2.38%, 90.96 ± 4.24% and 81.4 ± 7.14%, 56.43 ± 14.7%, respectively (χ 2 = 12.33, P = 0.0004). (springer.com)
  • For the distal type of CTEPH, the actuarial survival at 10 and 15 years of the surgical group and non-surgical group were 71.78 ± 4.66%, 29.57 ± 15.1% and 69.84 ± 7.78%, 32.59 ± 13.7%, respectively (χ 2 = 0.03, P = 0.874). (springer.com)
  • Actuarial analysis indicates a projected survival rate of 93% three years postoperative. (ahajournals.org)
  • Industry analysts compare market participants and measure performance through in-depth interviews, analysis, and extensive secondary research to identify best practices in the industry. (prnewswire.com)