Many shared service centres are being established in the Dutch government as part of an egovernment program, primarily in order to save costs. However, as literature shows, developing shared service centres proves to be a complex task. In this exploratory research, an initial taxonomy is created presenting various organisational, managerial and technological challenges that organisations can en...

We report a case of intolerance to warfarin dosing due to impaired drug metabolism in a patient with CYP2C9*3/*4. A 73-yr-old woman with atrial fibrilation was taking warfarin. She attained a high prothrombin time international normalized ratio (INR) at the standard doses during the induction of anticoagulation and extremely low dose of warfarin (6.5 mg/week) was finally chosen to reach the tar...

Globalization of operations, reduced time to market, increased need to respond quickly to customers’ needs worldwide and reduced cost of operations have encouraged many business organizations to adopt global virtual teams for their business activities. In this study, we explore a comprehensive model consisting of different variables that impact performance of such global virtual teams and valid...

BACKGROUND In 2007, the US FDA added information about pharmacogenomics to the warfarin label based on the influence of the CYP2C9 and VKORC1 genes on anticoagulation-related outcomes. Payers will be facing increasing demand for coverage decisions regarding this technology, but the potential clinical and economic impacts of testing are not clear. OBJECTIVE To develop a policy model to evaluat...

A usual activity performed to ensure quality is software testing. Although important, testing is an expensive activity. For that reason, test teams should be able to estimate the required effort to perform their test activities on the schedule and to request more resources or negotiate deadlines when necessary. This is even more important when regarding regression testing, where the execution o...

The advent of high quality PC based instruments, combined with the normal day to day skills of linear test engineers, eliminates the need for general purpose linear testers in many cases. Linear applications are dominated by custom DUT boards; therefore a few application card tricks and some PC instruments can replace the general purpose linear tester and significantly reduce cost and size with...

The estimated cost of software maintenance exceeds 70 percent of total software costs [1], and large portion of this maintenance expenses is devoted to regression testing. Regression testing is an expensive and frequently executed maintenance activity used to revalidate the modified software. Any reduction in the cost of regression testing would help to reduce the software maintenance cost. Tes...

OBJECTIVE To illustrate how laboratorians and pathologists must demonstrate accountability for efficiency (how well something is done), effectiveness (what is done), and cost-effectiveness (a proxy for value, in which value equals quality per cost). DATA SOURCES A literature search was conducted, including documents in the National Library of Medicine. STUDY SELECTION The literature on cost...

Medical opinions are divided between the ‘testers’ who investigate before therapy is instituted and’ treaters’ who do not investigate to save costs. The ‘treaters’ have suggested that allergy testing is not always necessary in patients with allergy symptoms and prefer to treat with pharmacotherapy without identification of specific triggers. An example of this is a recent editorial in this jour...

INTRODUCTION Biologic therapies have proven efficacious for patients with moderate-to-severe psoriasis. However, their economic value compared with standard of care in Italy has not been explored. This study estimates the cost-effectiveness of intermittent therapy with etanercept in patients with moderate-to-severe plaque-type psoriasis in comparison with nonsystemic therapy in Italy. METHODS...