ALL-BIAS DESIGNS FOR POLYNOMIAL SPLINE REGRESSION MODELS

Polynomial spline regression models of low degree have proved useful in modeling responses from designed experiments in science and engineering when simple polynomial models are inadequate. Where there is uncertainty in the number and location of the knots, or breakpoints, of the spline, then designs that minimize the systematic errors resulting from model misspecification may be appropriate. This paper gives a method for constructing such all‐bias designs for a single variable spline when the distinct knots in the assumed and true models come from some specified set. A class of designs is defined in terms of the inter‐knot intervals and sufficient conditions are obtained for a design within this class to be all‐bias under linear, quadratic and cubic spline models. An example of the construction of all‐bias designs is given.     

A modified random-effect procedure for combining risk difference in sets of 2×2 tables from clinical trials

Summary Meta-analyses of sets of clinical trials often combine risk differences from several 2×2 tables according to a random-effects model. The DerSimonian-Laird random-effects procedure, widely used for estimating the populaton mean risk difference, weights the risk difference from each primary study inversely proportional to an estimate of its variance (the sum of the between-study variance and the conditional within-study variance). Because those weights are not independent of the risk differences, however, the procedure sometimes exhibits bias and unnatural behavior. The present paper proposes a modified weighting scheme that uses the unconditional within-study variance to avoid this source of bias. The modified procedure has variance closer to that available from weighting by ideal weights when such weights are known. We studied the modified procedure in extensive simulation experiments using situations whose parameters resemble those of actual studies in medical research. For comparison we also included two unbiased procedures, the unweighted mean and a sample-size-weighted mean; their relative variability depends on the extent of heterogeneity among the primary studies. An example illustrates the application of the procedures to actual data and the differences among the results. This research was supported by Grant HS 05936 from the Agency for Health Care Policy and Research to Harvard University.     

“WHAT DOES SHE SEE IN HIM?”: THE EFFECT OF SHARING ON THE CHOICE OF SPOUSE

All husbands and wives share in the spoils of marriage. Sharing makes each partner a residual claimant and encourages spouses to provide marital inputs. However, because each spouse is only a partial residual claimant, each may be inclined to provide a "suboptimal" level of marital inputs. The choice of spouse influences the level of distortion, and under some circumstances the efficient mating is between individuals of equal value     

Improving the contributions of technology assessment to the health care system of the U.S.A.

Summary Based on 14 case studies of highly effective therapies and the reasons they succeeded less frequently than they could, we propose a variety of steps to improve the health care system of the U.S.A. Whatever proposal emerges from current national debates until innovations are shown to be safe and effective, they should not be supported; when slightly better technologies are much more expensive than other good ones we need to consider appropriate choices carefully; simplified billing and bookkeping would reduce our costs; when a technology is rapidly introduced cautionnary measures may be needed; tracking immunization and repairing their omissions requires a new system; educational programs such as seen effective in hypertension should be applied in other areas such as vaccination; in organ transplantation the nation should consider “presumed consent”; our payment system sometimes creates perverse incentives and therefore needs review; and the preferences of the public in allocation of health resources need to be discovered once the public is informed about the issues. Research supported by Andrew W. Mellon Foundation.     

Labor relations and technological change at Canadian Pacific Railway

There was a time in this fair land when the railroad did not run When the wild majestic mountains stood alone against the sun Long before the white man and long before the wheel When the green dark forest was too silent to be real For they looked into the future and what did they see They saw an iron road running from the sea to the sea Bringing the goods to a young growing land All up through the seaports and into their hands From “Canadian Railroad Trilogy” by Gordon Lightfoot The authors thank CPR managers and union officials representing CPR employees for their cooperation and patience in explaining the intricacies of the railroad industry. Special appreciation is extended to Jason Copping, Labour Relations Manager, for his facilitating our initial access to the company.