Digital health technologies (DHTs) can optimise healthcare costs and improve quality and efficiency of care. However, the fast-paced rate of innovation and varying evidence standards can make it ...difficult for decision-makers to assess these technologies in an efficient and evidence-based manner. We sought to develop a comprehensive framework to assess the value of novel patient-facing DHTs used to manage chronic diseases by eliciting stakeholder value preferences.
Literature review and primary data collection from a three-round web-Delphi exercise was utilized. 79 participants from 5 stakeholder groups (patients, physicians, industry, decision makers, and influencers) and 3 countries (United States of America, United Kingdom, and Germany) took part. Likert scale data were statistically analyzed to determine intergroup differences in both country and stakeholder groups, stability of results, and overall consensus.
The resulting co-created framework comprised 33 stable indicators with consensus from quantitative value judgments across domains: health inequalities, data rights and governance, technical and security, economic characteristics, clinical characteristics, and user preferences. Lack of stakeholder consensus was observed on the importance of value-based care models, optimizing resources for sustainable systems, and stakeholder involvement in DHT design, development, and implementation; however, this was because of high rates of neutrality and not negative judgments. Supply-side actors and academic experts were the most unstable stakeholder groups.
Stakeholder value judgments revealed a need for a coordinated regulatory and health technology assessment policy response that updates laws to meet technological innovations, offers a pragmatic approach to evidence standards to assess DHTs, and involves stakeholders to understand and meet their needs.
•Digital health technologies (DHTs) differ from traditional medical technologies because they involve widespread, and sometimes continuous, collection, analysis, and transmission of patient data after market entry. There is currently no technology-agnostic wide-reaching value framework for evaluating DHTs, capturing multiple stakeholder value preferences in different health system archetypes. Through a Delphi exercise, we incorporated diverse stakeholder viewpoints from the United Kingdom, United States, and Germany to propose an evidence-based value framework for assessing patient-facing DHTs focused on chronic disease management.•Statistically significant stakeholder consensus relates to clinical and economic characteristics, which align with current regulations and health technology assessment methodologies and around value indicators that are not reflected in current regulations and health technology assessment policies, particularly regarding personal data rights. Lack of stakeholder consensus centers around the importance of value-based care models, optimizing resources for sustainable systems, and stakeholder involvement in DHT design, development, and implementation and results from high rates of neutrality rather than negative judgments.•We have created a value framework comprising 33 stable indicators with consensus across 6 value domains, notably health inequalities, data rights and governance, technical and security, economic characteristics, clinical characteristics and user preferences. Included indicators are split between ratings of “very important” and “important” resulting from consensus between key stakeholder groups consisting of patients, physicians, supply-side actors, decision makers, and influencers. Decision makers can utilize this framework when assessing potential technologies to include in their health system packages.
Purpose
Prevailing corporate culture coupled with affective trust in co-workers and affective organizational commitment may promote or hinder the tendency for people to share knowledge. This study ...aims to determine whether knowledge-sharing tendency varies from one form of organizational culture to another by examining the concurrent mediation of affective trust in co-workers and affective organizational commitment and provide insights for appropriate knowledge-sharing initiatives.
Design/methodology/approach
Adult learners (N = 408) enrolled in the MBA and MSc postgraduate programs at five private universities in Singapore participated in a two-part self-administered anonymous survey. Data were analyzed with SmartPLS partial-least squares structural equation modeling using a two-stage analytical technique that examined the measurement and structural models.
Findings
The concurrent effects of affective trust in co-workers and affective organizational commitment complementarily mediated the relationship of organizational culture on the knowledge-sharing tendency for adhocracy, clan and market cultures but fully mediated for hierarchy culture.
Practical implications
This study provides insights for managers to understand the characteristics of their organizational culture and choose appropriate practices for improving knowledge-sharing tendency among its employees.
Originality/value
A model is established to determine the type of organizational culture that facilitates knowledge-sharing tendency. It offers new theoretical insights into how and why affective trust in co-workers and affective organizational commitment impact the relationship of organizational culture on knowledge-sharing tendency. Understanding these relationships can provide valuable insights into various strategies for different organizational cultures to increase employees’ knowledge-sharing tendency.
This research aims to evaluate the ideal culture that determines the satisfaction of employees. The level of satisfaction at the job should be based on recruiting more professionals because it is ...vital to attract and retain professionals. Nevertheless, the organizational culture was addressed as a significant factor affecting qualified professionals' job satisfaction. Thirty empirical papers from the period from 2014 to 2019 were chosen for this research. There are many types of research being conducted about job satisfaction, but there is limited research being conducted to explore professionals' job satisfaction. It reviews competing value frameworks studies and theories on organizational culture toward job satisfaction and also the concepts of clan, market, clan, adhocracy, market, hierarchy, and knowledge sharing cultures. The result of this literature study found that the impact of the clan, adhocracy, and knowledge sharing culture significantly influences the professional’s job satisfaction.
To conduct a value assessment of an immuno-oncology (IO) therapy for a rare cancer and evaluate whether existing frameworks consider challenges associated with valuing IOs for rare cancers.
Value ...frameworks developed by American Society of Clinical Oncologists, Memorial Sloan Kettering Cancer Center and National Comprehensive Cancer Network were used to estimate the value of an IO therapy in a rare cancer based on single-arm trial data and retrospective studies.
Paucity of direct evidence comparing rare cancer treatments and lack of acceptance of indirect comparisons hinder appropriate value assessment. Measurement of value based on short-term outcomes may not capture the value of IOs, where survival is often characterized by a plateau.
Further work is required to factor in nuances associated with rare cancers and guide end users of the frameworks. To capture true value, multiple or more holistic value assessments are required.
In recent years, peer‐to‐peer (P2P) lending has been gaining popularity amongst borrowers and individual investors. This can mainly be attributed to the easy and quick access to loans and the higher ...possible returns. However, the risk involved in these investments is considerable, and for most investors, being nonprofessionals, this increases the complexity and the importance of investment decisions. In this study, we focus on generating optimal investment decisions to lenders for selecting loans. We treat the loan selection process in P2P lending as a portfolio optimization problem, with the aim being to select a set of loans that provide a required return while minimizing risk. In the process, we use internal rate of return as the measure of return. As the starting point of the model, we use machine‐learning algorithms to predict the default probabilities and calculate expected values for the loans based on historical data. Afterwards, we calculate the distance between loans using (i) default probabilities and, as a novel step, (ii) expected value. In the calculations, we utilize kernel functions to obtain similarity weights of loans as the input of the optimization models. Two optimization models are tested and compared on data from the popular P2P platform Lending Club. The results show that using the expected‐value framework yields higher return.
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•Economic evaluation (EE) considers few of 18 vaccination value concepts identified.•Expert analysis identified 3 priority concepts to expand EE of vaccines.•Selection criteria ...included decision-making relevance and measurement feasibility.•Priorities: macroeconomic impact, social ethics/equity, health system strengthening.•Relevant robust methods and evidence are needed to support new value elements in EE.
A value of vaccination framework for economic evaluation (EE) identified unique value concepts for the broad benefits vaccination provides to individuals, society, healthcare systems and national economies. The objectives of this paper were to work with experts in developed countries to objectively identify three priority concepts to extend current EE.
The previously developed classification of value concepts in vaccination distinguished 18 concepts, categorised as conventional payer and societal perspective concepts and novel broader societal concepts. Their inclusion in current EE guidelines was assessed. Experts identified eight criteria relevant to decision-making and measurement feasibility, which were weighted and used to score each concept. The relative ranking of concepts by importance and the gaps in guidelines were used to identify three priority concepts on which to focus immediate efforts to extend EE.
The EE guidelines review highlighted differences across countries and between guidelines and practice. Conventional payer perspective concepts (e.g., individual and societal health gains and medical costs) were generally included, while gaps were evident for conventional societal perspective concepts (e.g., family/caregiver health and economic gains). Few novel broader societal benefits were considered, and only in ad hoc cases. The top-three concepts for near-term consideration: macroeconomic gains (e.g., benefiting the economy, tourism), social equity and ethics (e.g., equal distribution of health outcomes, reduced health/financial equity gaps) and health systems strengthening, resilience and security (e.g., efficiency gains, reduced disruption, increased capacity).
Gaps, inconsistencies and limited assessment of vaccination value in EE can lead to differences in policy and vaccination access. The three priority concepts identified provide a feasible approach for capturing VoV more broadly in the near-term. Robust methods for measuring and valuing these concepts in future assessments will help strengthen the evidence used to inform decisions, improving access to vaccines that are demonstrably good value for money from society’s point of view.
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•Vaccination produces important individual health gains and broad societal benefits.•Current vaccine economic evaluation (EE) approach often excludes broader benefits.•A novel Value ...of Vaccination framework was developed with unique concepts for EE.•Dimensions include conventional payer and societal, and novel societal concepts.•Conventional and novel societal gain concepts need to be appraised in EE.
Vaccination provides significant health gains to individuals and society and can potentially improve health equity, healthcare systems and national economies. Policy decisions, however, are rarely informed by comprehensive economic evaluations (EE) including vaccination’s wide-ranging value. The objective of this analysis was to focus on health technology assessment systems to identify relevant value concepts in order to improve current EE of non-pandemic vaccines.
Following a literature review, a novel Value of Vaccination (VoV) framework was developed with experts in vaccine EE from developed countries with established health technology assessment systems.
Forty-four studies presenting value frameworks or concepts applicable to vaccination were included. Eighteen unique value concepts relevant to EE were identified and defined. These were categorised within the VoV framework using three dimensions, moving from a narrow payer perspective to a more expansive and societal perspective. The dimensions were: (I) conventional payer perspective concepts (e.g., health gains in vaccinees, direct medical costs); (II) conventional societal perspective concepts (e.g., indirect health/economic gains to caregivers/households, productivity in vaccinees); and (III) novel societal concepts (e.g., financial risk protection, peace of mind, societal health gains, healthcare systems security, political stability, social equity and macroeconomic gains). While good quality evidence and methods are available to support concepts in Dimensions I and II, further work is needed to generate the required evidence for vaccination impact on Dimension III concepts.
The devastating effect on nations of the COVID-19 pandemic has helped to highlight the potential far-reaching benefits that many vaccination programmes can offer. This VoV framework is particularly relevant to policy decisions considering EE, and the potential future expansion of non-pandemic vaccination value considerations. The framework helps to understand and compare current value considerations across countries and payer versus societal perspectives. It provides decision-makers with a transparent and logical path to broaden consideration of VoV in EE.
This article analyzes how the concept of sustainable value is used in the business model literature to understand and structure the concepts used in analyzing the value creation process in business ...models to date. We found that in discussing sustainable business models, sustainable value, a term encompassing the environmental, social, and economic benefits of a given model, has been used in place of the conventional term, value. However, the conceptual implications of this substitution have not been sufficiently addressed. A systematic literature review reveals both positive and negative perspectives of value as well as the misuse of several multilevel value concepts. We categorize these concepts according to their meaning, differences, similarities, and implications. As a result, we propose a holistic framework that structures them, integrates both positive and negative perspectives of value, and proposes an activity‐based analysis for sustainable value in business models. The contributions of this paper are twofold: theoretically, it structures value concepts in order to better understand the sustainable value process in business models, and practically, it offers a tool for sustainable development by providing a framework to analyze sustainable value in a variety of business models as a basis for improvement in sustainability.
This study examines object-based and existential authenticity using a multidimensional approach to perceived value. The effects of value perceptions on satisfaction are also examined. Data was ...collected from tourists at the Singapore Chinatown heritage precinct. The findings revealed that object-based authenticity, existential authenticity, and perceived monetary value positively influenced overall perceived value and subsequently, satisfaction. This paper provides researchers with a theoretical framework of authenticity and perceived value for future empirical studies in the heritage tourism context. It also provides insight into how destination marketers and policy makers can develop effective and sustainable strategies for heritage destinations.
Limitations in conventional cost-effectiveness methods have led to calls for incorporation of additional value elements in assessments of health technologies. However, gaps remain in how additional ...value elements may inform decision making. This study aimed to prioritize additional value elements from the perspective of healthy individuals without a specific condition or indicated for a specific treatment in the United States among a multistakeholder panel and compare the importance of perspective-specific value elements.
Additional value elements were prioritized in 2 phases: (1) we identified and categorized additional value elements in a targeted literature review, and (2) we convened a multistakeholder group-based preference elicitation study (N = 28) to evaluate the description of each value element and rank and generate normalized weights of each value element for its significance in value assessment. The importance of additional value elements was also weighted relative to patient-centric value elements.
The rank and weight of contextual value elements among 28 stakeholders were "severity of the disease" (26.2%), "disadvantaged and vulnerable target populations highly represented" (21.8%), "broader economic impact" (17.3%), "risk protection" (13.8%), "rarity of the disease" (11.3%), and "novel mechanism of action" (9.7%). Relative weight of the additional value elements versus patient-centric value elements was 52% and 48%, respectively.
Study findings may inform priority setting for value frameworks and emerging US government assessments. The group-based elicitation method is repeatable and useful for structured deliberative processes in value assessment and may help improve the consistency and predictability of what is important to stakeholders.
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