<title>Simulation-based research and development: technology assessment process</title>

Technology acquisition among Korean and Taiwanese firms in the United States

Health technology assessment (HTA) can be used both to promote access to safe, efficacious, and cost-effective technologies, and to discourage access to undesirable ones. Yet HTA has had less success than might be hoped in pursuing the latter goal. This paper examines the scope of HTA as currently practiced to contribute to regulation of access to undesirable technologies. The study design is a critical analysis of HTA's methods, based on an exposition of the normative issues involved in restriction of access to health technologies. The paper classifies technologies that might figure as potential candidates for exclusion into five categories and underscores the key social and ethical dilemmas associated with limiting their use. For four of the five categories of technology outlined, limitation of access necessarily involves denial of benefit. Limitation of access thus inevitably raises difficult normative issues. We show that these are ill-addressed by the range of "evidence" typically considered in technology assessments, which centers predominantly on clinical and technical features such as efficacy, safety, and costs. If HTA is to enhance our ability to make reasonable decisions concerning the use and diffusion of health technologies, it must better integrate consideration of the social, political, and ethical dimensions of health technologies into the process of technology assessment. We suggest a framework within which to approach this goal.

The Capability Assessment and Tradeoff Environment (CATE) for Advanced Aerospace Vehicle and Technology Assessment

The objective of the technology assessment (TA) process is to understand problematic and undesirable consequences from the development and application of technology. TA advocates for the engagement of technology experts and stakeholders to understand the effects of technology. However, TA is often criticized that the decision-making process is not transparent - leaving stakeholders wondering if their contributions were heard. Furthermore, the methods have limited capability for conducting tradeoff analysis between the organizational objectives and conflicting stakeholder perspectives that can result in unintended consequences. Finally, these methods are static making it difficult to update and reassess decision alternatives when new information about issues becomes available. This dissertation research addresses these problems by developing a new technology assessment methodology using Fuzzy Cognitive Mapping (Fuzzy Cognitive TA - FCTA). This novel approach supports both stages of the process: capturing expert and stakeholder perspectives in cognitive maps, and then using FCM for assessment and decision-making. The methodology shows how experts and stakeholders perceive the value or harm of a technology alternative, which stakeholders share the same perspectives, and how these perspectives change over time. The methodology also shows the degree to which expert and stakeholder perspectives are in support or in conflict with the organizational objectives to help avoid the direct and indirect consequences associated with the decision. Finally, the methodology shows how new or changing perspectives by experts and stakeholders affect the outcome of the decision to improve system knowledge. The research applies the FCTA methodology with a real-world Environmental Impact Study conducted by the Bonneville Power Administration (BPA). BPA is a U.S. federal agency that provides about a third of the electric power and 75 percent of the high-voltage electric transmission in the Pacific Northwest.

IntroductionThe process of health technology assessment (HTA) is a valuable tool for the pursuit of equitable and sustainable healthcare systems. Various countries have established organizations dedicated to conducting HTAs, adapting such institutions to local healthcare ecosystems. The aim of this study was to evaluate the structure, methods, and processes of organizations responsible for national-level HTAs globally.MethodsA scoping review was conducted assessing organizations responsible for conducting HTAs for national-level decision-making in any country. Identification of eligible organizations was performed through a review of member organizations of INAHTA, EUnetHTA, RedETSA, and HTAsiaLink networks, as well as organizations evaluated in reviews with a similar scope. For each organization, the following data were searched: country, year of foundation, organizational nature, role in decision-making, funding, technologies assessed, criteria considered for decision-making (such as efficacy and safety, costs, impact on equity, among others), type of economic evaluation, and patient involvement.ResultsWe identified 69 organizations, from 56 countries, mainly European (n=39; 56%). Fifty-three (77%) are government-affiliated; most (n=51; 74%) have a consultative role. Public funding is the main funding, and 12 (17%) organizations charge fees for conducting HTA. Technologies assessed include drugs (n=61; 88%), devices (n=47; 68%), and procedures (n=33; 48%). HTA is usually initiated upon request from the manufacturer (n=45; 65%). Patient involvement is not clearly described in 32 organizations (46%); in 29 organizations (42%), the role of patients is to provide information that is considered during decision-making.ConclusionsAmong the evaluated organizations, it is observed that the majority are government-affiliated, have public funding, and play a consultative role. The results of this study serve as an important reference for the development and improvement of organizations responsible for conducting HTAs.

Previous papers focused on the importance of the Technology and Economic Assessment Panel (TEAP) and the technology assessment process in the context of the political process. TEAP supports not only the political process of the Montreal Protocol but also plays a large role in the transfer of technology. The objective of this paper is to describe the contribution of TEAP to international technology cooperation and the implementation of technologies that have been identified throughout the process. This additional channel of support for the replacement of ozone-depleting substances has been fundamental to the success of the Montreal Protocol and should be carefully considered for other global environmental issues. The TEAP has been successful in this task through: 1) selection of best technical experts; 2) members “professional growth” through the work; 3) ensuring objectivity via technical and geographical diversity; and 4) receipt of support from a wide range of organizations.

<p>Urban development and densification are increasing rapidly; this fact has been globally reported. According to a 2014 United Nations report, the world population will increase by 25% in the next three decades. This significant growth means urban density will also increase drastically, creating an increase in high-rise apartment living quarters to cater for the population growth. Subsequently, the development of housing has been advancing - especially around construction techniques which are becoming more efficient to meet the demand of fast-growing urban populations. This thesis proposes that simply supplying housing is no longer sufficient to address the requirements of citizens. Denser living environments result in increased dissatisfaction, especially among those living in high-density housing. This research looks specifically into enabling homebuyers to voice their needs and design their living space. In this context, the social paradigm of high-density housing has not progressed much. There is still more a notion of supplying the needed quantity and homebuyers accepting the housing without question. Homebuyers, the main users of the housing, are often absent from both the planning and design process. Recent studies have shown that participation in their community is one of the key themes towards social sustainability. Many public participatory projects and platforms only allow participation in large scale urban developments and planning processes. There is a significant lack of initiatives that include homebuyers in the context of high-rise, high-density housing. The aim of this research is to explore how a computational tool within a virtual environment can facilitate and support design collaboration and interactions – not only between architects and homebuyers, but among individual and collective homebuyers too. The methodology of the research includes using focus groups to examine how digital tools can support and contribute to the collaborative design process of high-rise, high-density housing. The study is then tested with the public to determine if such design tools facilitate and support design collaborations. Three studies were undertaken: The first is a pre-tool development study. It uses a focus group to understand the factors necessary to engage homebuyers, and those factors that hinder such process. A digital tool for collaboration was then developed, based on analysis of the focus group results. A second study determines if the factors identified are sufficient for design collaboration within a digital environment. Based on this analysis, the tool was enhanced and integrated with third party visualisation software to enable the desired digital collaboration. A final study involves the public, examining whether such a design tool facilitates and supports their design collaborations. Throughout the research development, gamification techniques were introduced and adopted to further explore driving factors and to enhance design interactions. The target audience of this research is homebuyers, who are laypersons in architectural design processes and techniques. Gamification is, therefore, an effective technique to simplify the design process and enable homebuyers to immerse themselves in a collaborative design process. Virtual Reality is used at the final stage to immerse homebuyers further into the design environment and give them clearer feedback about their design decisions. The findings of the research confirm the benefits this novel collaborative design process has on the overall outcome of high-rise, high-dense buildings. It demonstrates how a virtual design tool can influence the process of consultation and procurement for homebuyers. A metadesign framework has been developed to provide a guide to the decision-making support necessary for such a collaborative design process. Finally, the research explains how such an enhanced communicative design operation can achieve the kind of synergies that break out of the current housing paradigm and take a major step forward in urban development.</p>

He obtained training in biomedical electronics and has been working in medical equipment maintenance and management for nearly 23 years.His responsibilities often mirror those of a hospital executive who oversees clinical engineering-budgets, personnel, long-term equipment planning-but there's no mistaking the differences that come with the uniform.Now nearing his military retirement, Curry recently spoke with BI&T about his years in military

As Accessible as a Book on a Library Shelf: The Imperative of Routine Simulation in Modern Health Care

TTDABC is a relatively new costing management technique, initially developed for manufacturing processes, which is gaining attention in libraries. This is because TDABC is a fast and simple method that only requires two parameters, an estimation of time required to perform an activity and the unit cost per time of supplying capacity. A few case studies have been documented with regard to TDABC in libraries; all of them being oriented to analyse specific library activities such as inter-library loan, acquisition and circulation processes. The primary focus of this paper is to describe TDABC implementation in one of the most important library processes, namely cataloguing. In particular, original and copy cataloguing are analysed through a case study to demonstrate the applicability and usefulness of TDABC to perform cost analysis of cataloguing processes.

In Brief Utilizing their knowledge of human factors, regulatory processes and principles of design and safety engineering, clinical engineers can have a major impact on reducing injuries, deaths, and clinical complications resulting from medical errors. These processes, which are part of the biomedical/clinical engineering curriculum, are inherent in minimizing healthcare hazards as well as reducing the risk of bad clinical outcomes resulting from the technology assessment process in selection of new medical devices. Medical equipment standardization and initial user training are essential concepts that must be employed to create a lower risk environment. Removing equipment that does not conform to the standardization process will provide a uniform process of clinical standards for patient treatment and thus increase the familiarity of medical equipment use. This familiarity will lower the risk of clinical errors related to technology frustration and inadvertent user error. Clinical engineers should be at the core of the technology assessment process and make their expertise known to hospital administrators. When hospital administrators realize that input from clinical engineers contribute to a safe environment within the hospital and thus affect the bottom line, their expertise will be a sought after value added commodity. Utilizing their knowledge of human factors, regulatory processes and principles of design and safety engineering, clinical engineers can have a major impact on reducing injuries, deaths, and clinical complications resulting from medical errors. These processes, which are part of the biomedical/clinical engineering curriculum, are inherent in minimizing healthcare hazards as well as reducing the risk of bad clinical outcomes resulting from the technology assessment process in selection of new medical devices. When hospital administrators realize that input from clinical engineers contribute to a safe environment within the hospital and thus affect the bottom line, their expertise will be a sought-after value-added commodity.

RISK MANAGEMENT IN THE PROGRAM/PROJECT ENVIRONMENT: The Risk Management process is assuming greater influence in the process of Project and Program Management. The requirements of NPG 7120.5A [NPG, 1998] have created inroads for the results of identifying risk to influence project decisions. Program needs and the interdependencies of risks among projects are receiving increasing attention on major JPL projects. Creating Risk Management plans and requiring risk reporting are beginning to make project personnel aware of the benefit of identifying and mitigating potential future adverse consequences and understanding the trade-offs involved in spending reserves for prevention as opposed to recovery from problems. Risk-based decision-making in the planning phase is allowing risks balancing to be considered, and hard decisions in the cost-capped environment require even reduction in expected mission return in order to provide adequate performance assurance. RISK ASSESSMENT TOOLS USED IN DESIGN AND ASSURANCE: The paper will describe the use of Risk-revealing checklists and compilations of engineering guidance principles as enabling tools for comprehensive risk identification. Also, effective risk assessment methods (such as Failure Modes Effects Analyses (FMEAs), and Probabilistic Risk Analyses (PRAs) will be discussed. Tracking tools appropriate to maintaining cognizance of risk will be covered. INTEGRATING RISK AND MANAGING PROJECT RESOURCES: JPL is in the process of identifying a standardized Risk Management methodology, which is based on the two pioneering methodologies developed on the Space Infrared Telescope Facility (SIRTF) and Mars Global Surveyor (MGS) projects. Criteria for assessing risk will be “normalized” with tailoring allowed. Database tools are available now to support this approach for flight projects. The Risk Management team at JPL has developed such a tool, which is in use on many of our projects. An advanced version of the JPL tool has been demonstrated which will provide options for quantitative analysis and resource management trade-offs. Implementation of risk tracking metrics in cost and schedule management systems, and design tools, will allow change to be quickly detected. Also, experience on the MGS project suggests that project management can make effective use of risk impact assessments based on cost, and can therefore gain insight into the effective use of project reserves. Utilizing common risk metrics between the risk management process and design metrics, Problem/ Failure Reports (PFRs), earned value reporting, and other management areas will provide more confidence in the impact of project decisions. INDEPENDENT ASSESSMENTS AND THE SYSTEMS MANAGEMENT OFFICE (SMO): The requirement to balance faithful service to the project customer while at the same time provide an objective assessment of the health of the project to the JPL administration and to the agency will be facilitated through the SMO function. Risk Assessments using criteria common to those that the project uses but identification and assessment by independent “eyes” will allow added possibility for early detection and correction of problems. This will enhance the Risk Management effectiveness on the project, and undoubtedly increase the likelihood of mission success.

AIthough much is known about how people make the decisions in the abstract, as well as in specific fields such as medicine, this knowledge has not yet been applied to the assistive technology (AT) assessment process. This article is an attempt to identify lessons that therapists can apply to their own practice based on what is known about how people make decisions. This article also identifies strategies that clinicians can use to help clients, caregivers, and third-party payers make better decisions. Finally, this article suggests how technology might further improve the decision making process. It should be noted that we are directly familiar with the assessment process for computer access, augmentative communication, electronic aids to daily living, and wheeled mobility, but the same principles of decision science are likely to apply to other disciplines within AT in which a clinician (or team of clinicians) works with a client, the client's caregivers, durable medical equipment (DME) vendors, and third-party payers to identify the most appropriate AT for the client (e.g., orthotics and prosthetics).

: This final technical report contains a summary and highlights of the research funded by the Air Force under AFOSR PRET Grant F49620-96-1-0329, titled Sensitivity and Adjoint Methods for Design of Aerospace Systems. This research was conducted by the Air Force Center for Optimal Design and Control (CODAC), during the period 1 July 1996 to 31 December 2001. The Center conducts a wide range of research and educational programs, and promotes linkages between Air Force Laboratories, industry and university scientists. The PRET grant focuses on transition through industrial partnerships. During this period, CODAC researchers produced more than 115 scientific papers, made more than 150 presentations at conferences and colloquium and directed more than 20 graduate students and 7 postdocs. The research effort has produced several new computational tools for optimal design and these tools have already been transitioned into commercial software packages. Progress was made on a new sensitivity based method for estimating rotary stability derivatives. A new approach improved the efficiency of automatic differentiation when used in shape optimization. In the area of control, a new computational tool for controller reduction was devised and tested. This tool is based on proper orthogonal decomposition techniques. In addition, this report outlines some of the interactions between CODAC, industrial partners and Air Force facilities.

Renewable Energy Sources (RES) are becoming the backbone of the electric power infrastructure. Their role will be more dominant in the coming years, since the European Union aims to generate up to 80 % of the total electric demand by RES by 2050. However, the planners of the RES-based power plants are receiving more and more opposition from the local population regarding installing new power plants. The main reason lies mainly on their non-engagement in the planning and decision-making processes. The development of smart grid rural areas represents a good test field to realize and test new planning design tools, as is shown in the smart grid project in Dardesheim (Germany). This paper presents a new concept of an interactive planning methodology to be implemented in the design tool for planning and operating energy power infrastructure within rural areas. The main characteristic of the design tool developed is based on the multi-criteria approach used, which considers technical, social and economic aspects. This research is carried out by the project “RIGRID — Rural Intelligent Grid” within the framework of the initiative “ERA-Net Smart Grids Plus.”