Blinded continuous monitoring in clinical trials with recurrent event endpoints

In studies with recurrent event endpoints, misspecified assumptions of event rates or dispersion can lead to underpowered trials or overexposure of patients. Specification of overdispersion is often a particular problem as it is usually not reported in clinical trial publications. Changing event rates over the years have been described for some diseases, adding to the uncertainty in planning. To mitigate the risks of inadequate sample sizes, internal pilot study designs have been proposed with a preference for blinded sample size reestimation procedures, as they generally do not affect the type I error rate and maintain trial integrity. Blinded sample size reestimation procedures are available for trials with recurrent events as endpoints. However, the variance in the reestimated sample size can be considerable in particular with early sample size reviews. Motivated by a randomized controlled trial in paediatric multiple sclerosis, a rare neurological condition in children, we apply the concept of blinded continuous monitoring of information, which is known to reduce the variance in the resulting sample size. Assuming negative binomial distributions for the counts of recurrent relapses, we derive information criteria and propose blinded continuous monitoring procedures. The operating characteristics of these are assessed in Monte Carlo trial simulations demonstrating favourable properties with regard to type I error rate, power, and stopping time, ie, sample size.     

An Interview with Joyce Edward: Exemplary Clinician, Advocate, and Scholar

Over the years, noteworthy social workers have been interviewed for the Clinical Social Work Journal. This article features an interview with Joyce Edward who is recognized for her many extraordinary contributions to clinical social work. Joyce has co-written or co-edited three exceptional books for the social work clinician, she has been an esteemed teacher and a vocal activist for quality mental health care. In this interview Joyce reflects on family influences, her work as a social caseworker, the psychoanalytic luminaries with whom she trained, her concerns about the clinical education of today's social work students, and finally, her perspective on managed mental health care.     

关于研究生教育若干问题的思考

研究生教育是高等教育结构中的高层次教育。文章围绕创建科学的研究生教育体系问题 ,从自主招生、导师队伍建设、学位授权点、学术监控以及办学理念等方面进行了探讨     

谈企业组织形式之球队组织特征

球队结构组织理论是作者新近提出的一种组织结构理论 ,论文对该组织结构模式的特征进行了详尽的分析研究。作为一种适合未来经济与组织发展需要的新组织结构 ,球队组织具有高度的动态性与开放性特征 ;同时 ,球队组织事实上还是一个无边界的组织 ,我们很难对球队组织的边界进行界定 ;最后 ,球队组织是一个彻底分权的组织     

团队生产、计量难题与企业的性质

阿尔奇安和德姆塞茨(1972)从团队生产引发的“计量难题”及其解决机制的角度来解释企业的性质。本文在概述该企业理论的概念框架的基础上,指出了该理论存在的一个缺陷,即它忽视了企业的监督者-剩余索取者和其他成员之间的利益冲突及其解决机制。     

加强西部地区普通高校人才队伍建设

当今世界,知识和人才成为经济发展和社会进步的主要推动力,人才资源已经成为最重要的战略资源。树立科学人才观,准确把握科学人才观的重要内涵,对加强西部地区普通高校人才队伍建设从而促进高校各项事业发展具有重要的指导作用。     

建设学习型教师队伍

在知识经济时代,学习的重要性不言而喻。教师作为一个传播文化知识的职业群体,自觉学习乃至终身学习是他们的职业需要。构建学习型教师队伍不仅可以帮助教师个体成长和发展,而且还能使教师个体和教师群体以及学校组织同步发展。本文简要论述了建设学习型教师队伍的意义,提出构建学习型教师队伍和学习型组织的具体策略。     

我国高职师资问题及国际视野中的解决路径探析

在世界经济一体化和全球化的大背景下,无论发达国家还是发展中国家,都将把提高职业教育的整体质量作为保持和提高国际竞争力的重要手段.发展高等职业教育是我国高等教育为适应经济和社会发展做出的战略性选择.文章针对我国高等职业教育发展中师资队伍建设中存在的问题,就如何提升职教师资的学历层次,提高职教师资的培养质量等问题进行了探讨.     

论企业统计队伍的继续教育

加强企业统计人才队伍的继续教育,是企业统计改革与发展的关键。本文通过对企业统计人员的现状剖析,根据企业对统计人才的需求,提出了企业统计人才队伍继续教育的具体思路与方法。     

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.