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Archive for June, 2012

J.D. Power and Associations 2012 Auto Insurance Study

June 30, 2012 Comments off

JD Power and Associates 2012 Auto Insurance Study
Source: J.D. Power and Associates

Led primarily by increases in satisfaction with policy offerings and billing and payment, overall customer satisfaction with auto insurance companies has reached an all-time high, according to the J.D. Power and Associates 2012 U.S. Auto Insurance StudySM released today.

The study measures customer satisfaction with auto insurance companies across five factors: interaction; price; policy offerings; billing and payment; and claims. Overall satisfaction with auto insurance companies is 804 (on a 1,000-point scale), up 14 points from 2011. Satisfaction levels in 2012 are the highest since the study was launched in 2000.

Satisfaction increases in all factors in 2012, with significant improvements in policy offerings (+30 points) and interaction (+19 points). Satisfaction with price is essentially unchanged from 2011.

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EconSouth Examines How Trucks Move the Economy

June 30, 2012 Comments off

EconSouth Examines How Trucks Move the Economy
Source: Federal Reserve Bank of Atlanta

With trucks responsible for moving more than two-thirds of the nation’s goods, the industry is inextricably linked to the health of the U.S. economy. In “Truckonomics: An Industry on the Move,” associate editor Nancy Condon explores the factors affecting the industry.

Given trucking’s linkages to the national economy, perhaps it’s no surprise that the industry was hit hard by the 2007–09 recession. As demand plummeted, carriers were forced to lower their rates. Many smaller companies failed or were bought by larger companies.

Postrecession, the industry faces a new set of challenges, Condon explains. The consolidation that occurred during the downturn left carriers with a shortage of capacity, and the surviving carriers are operating with an aging fleet. Additionally, the industry faces tougher federal regulations and higher diesel fuel prices.

Constrained capacity has an upside for the industry, however. It’s as simple as the law of supply and demand: “Tonnage is up, capacity is down, and so trucking companies have the pricing power to raise their rates,” Condon writes. Though, the industry’s recovery ultimately hinges on overall economic performance, she concludes.

Marriage Structure and Resistance to the Gender Revolution in the Workplace

June 30, 2012 Comments off

Marriage Structure and Resistance to the Gender Revolution in the Workplace
Source: Social Science Research Network

In this article, we examine a heretofore neglected pocket of resistance to the gender revolution in the workplace: married male employees who have stay-at-home wives. We develop and empirically test the theoretical argument suggesting that such organizational members, compared to male employees in modern marriages, are more likely to exhibit attitudes, beliefs, and behaviors that are harmful to women in the workplace. To assess this hypothesis, we conducted four studies with a total of 718 married, male participants. We found that employed husbands in traditional marriages, compared to those in modern marriages, tend to (a) view the presence of women in the workplace unfavorably, (b) perceive that organizations with higher numbers of female employees are operating less smoothly, (c) find organizations with female leaders as relatively unattractive, and (d) deny, more frequently, qualified female employees opportunities for promotion. The consistent pattern of results found across multiple studies employing multiple methods and samples demonstrates the robustness of the findings. We discuss the theoretical and practical import of our findings and suggest directions for future research.

Green Technologies and Practices — August 2011

June 30, 2012 Comments off

Green Technologies and Practices — August 2011
Source: Bureau of Labor Statistics

About three-quarters of business establishments reported the use of at least one green technology or practice during August 2011, the U.S. Bureau of Labor Statistics reported today. Green technologies and practices (GTP) are those that lessen the environmental impact of an establishment’s operations. About 854,700 jobs, representing approximately 0.7 percent of total U.S. employment, were held by workers who spent more than half of their time involved in green technologies and practices in August 2011. Over one-quarter of these GTP jobs were in building and grounds cleaning and maintenance occupations or in installation, maintenance, and repair occupations.a

Country Analysis Brief: Colombia

June 30, 2012 Comments off

Country Analysis Brief: Colombia
Source: Energy Information Administration

The enactment of a series of regulatory reforms to make the oil and natural gas sector more attractive to foreign investors served as an incentive for rising production. In addition, the government has implemented a partial privatization of state oil company Ecopetrol in an attempt to revive its upstream oil industry. The security situation in the country also has improved over the last decade, with fewer attacks against oil and natural gas infrastructure in recent years. Expanded oil production will require further investment in transport infrastructure and refining capacity.

In 2009, Colombia consumed 1.3 quadrillion Btus of total energy. Oil constituted the largest part of this amount, followed by hydroelectricity, natural gas, and coal. The country relies upon hydropower for the bulk of its electricity needs, so it is able to export most of the coal that it produces. Natural gas consumption in Colombia has also risen over the last decade.

New From the GAO

June 29, 2012 Comments off

New GAO Reports

Source: Government Accountability Office

1. Foreclosure Mitigation: Agencies Could Improve Effectiveness of Federal Efforts with Additional Data Collection and Analysis. GAO-12-296, June 28.
http://www.gao.gov/products/GAO-12-296
Highlights – http://www.gao.gov/assets/600/592029.pdf
Podcast – http://www.gao.gov/multimedia/podcasts/591994

A live video chat on this report with Director Mathew Scire will be conducted at 12:30pm ET on Monday, July 2:
http://www.ustream.tv/channel/gaolive

2. Critical Infrastructure Protection: DHS Could Better Manage Security Surveys and Vulnerability Assessments. GAO-12-378, May 31.
http://www.gao.gov/products/GAO-12-378
Highlights – http://www.gao.gov/assets/600/591293.pdf

3. Oil Dispersants: Additional Research Needed, Particularly on Subsurface and Arctic Applications. GAO-12-585, May 30.
http://www.gao.gov/products/GAO-12-585
Highlights – http://www.gao.gov/assets/600/591293.pdf

4. Military Base Realignments and Closures: The National Geospatial-Intelligence Agency’s Technology Center Construction Project. GAO-12-770R, June 29.
http://www.gao.gov/products/GAO-12-770R

5. Employment For People With Disabilities: Little Is Known About the Effectiveness of Fragmented And Overlapping Programs. GAO-12-677, June 29.
http://www.gao.gov/products/GAO-12-677
Highlights – http://www.gao.gov/assets/600/592075.pdf

6. Navy Training: Observations on the Navy’s Use of Live and Simulated Training. GAO-12-725R, June 29.
http://www.gao.gov/products/GAO-12-725R

7. Military Base Realignments and Closures: Updated Costs and Savings Estimates from BRAC 2005. GAO-12-709R, June 29.
http://www.gao.gov/products/GAO-12-709R

Gender Differences in the Salaries of Physician Researchers

June 29, 2012 Comments off

Gender Differences in the Salaries of Physician Researchers

Source: Journal of the American Medical Association

Context

It is unclear whether male and female physician researchers who perform similar work are currently paid equally.

Objectives

To determine whether salaries differ by gender in a relatively homogeneous cohort of physician researchers and, if so, to determine if these differences are explained by differences in specialization, productivity, or other factors.

Design and Setting

A US nationwide postal survey was sent in 2009-2010 to assess the salary and other characteristics of a relatively homogeneous population of physicians. From all 1853 recipients of National Institutes of Health (NIH) K08 and K23 awards in 2000-2003, we contacted the 1729 who were alive and for whom we could identify a mailing address.

Participants

The survey achieved a 71% response rate. Eligibility for the present analysis was limited to the 800 physicians who continued to practice at US academic institutions and reported their current annual salary.

Main Outcome Measures

A linear regression model of self-reported current annual salary was constructed considering the following characteristics: gender, age, race, marital status, parental status, additional graduate degree, academic rank, leadership position, specialty, institution type, region, institution NIH funding rank, change of institution since K award, K award type, K award funding institute, years since K award, grant funding, publications, work hours, and time spent in research.

Results

The mean salary within our cohort was $167 669 (95% CI, $158 417-$176 922) for women and $200 433 (95% CI, $194 249-$206 617) for men. Male gender was associated with higher salary (+$13 399; P = .001) even after adjustment in the final model for specialty, academic rank, leadership positions, publications, and research time. Peters-Belson analysis (use of coefficients derived from regression model for men applied to women) indicated that the expected mean salary for women, if they retained their other measured characteristics but their gender was male, would be $12 194 higher than observed.

Conclusion

Gender differences in salary exist in this select, homogeneous cohort of mid-career academic physicians, even after adjustment for differences in specialty, institutional characteristics, academic productivity, academic rank, work hours, and other factors.

From Real-Time Intercepts to Stored Records: Why Encryption Drives the Government to Seek Access to the Cloud

June 29, 2012 Comments off

From Real-Time Intercepts to Stored Records: Why Encryption Drives the Government to Seek Access to the Cloud
Source: Social Science Research Network

This paper explains how changing technology, especially the rising adoption of encryption, is shifting law enforcement and national security lawful access to far greater emphasis on stored records, notably records stored in the cloud. The major and growing reliance on surveillance access to stored records results from the following changes:

      Encryption. Adoption of strong encryption is becoming much more common for data and voice communications, via virtual private networks, encrypted webmail, SSL web sessions, and encrypted Voice over IP voice communications.

        Declining effectiveness of traditional wiretaps. Traditional wiretap techniques at the ISP or local telephone network increasingly encounter these encrypted communications, blocking the effectiveness of the traditional techniques.

          New importance of the cloud. Government access to communications thus increasingly relies on a new and limited set of methods, notably featuring access to stored records in the cloud.

            The “haves” and “have-nots.” The first three changes create a new division between the “haves” and “have-nots” when it comes to government access to communications. The “have-nots” become increasingly dependent, for access to communications, on cooperation from the “have” jurisdictions.

          Part 1 of the paper describes the changing technology of wiretaps and government access. Part 2 documents the growing adoption of strong encryption in a wide and growing range of settings of interest to government agencies. Part 3 explains how these technological trends create a major shift from real-time intercepts to stored records, especially in the cloud.

The 10 Largest Hispanic Origin Groups: Characteristics, Rankings, Top Counties

June 29, 2012 Comments off

The 10 Largest Hispanic Origin Groups: Characteristics, Rankings, Top Counties
Source: Pew Hispanic Center

Among the 50.7 million Hispanics in the United States, nearly two-thirds (65%), or 33 million, self-identify as being of Mexican origin, according to tabulations of the 2010 American Community Survey (ACS) by the Pew Hispanic Center, a project of the Pew Research Center. No other Hispanic subgroup rivals the size of the Mexican-origin population. Puerto Ricans, the nation’s second largest Hispanic origin group, make up just 9% of the total Hispanic population in the 50 states and the District of Columbia.

Read the full report which includes these sections:

  • The demographics of each group
  • Educational attainment
  • English proficiency and citizenship
  • Economic and health insurance
  • Regional distribution of Hispanic origin groups
  • Changes in the characteristics of the Hispanic population

Scaling up in agriculture, rural development, and nutrition

June 29, 2012 Comments off

Scaling up in agriculture, rural development, and nutrition
Source: International Food Policy Research Institute

Taking successful development interventions to scale is critical if the world is to achieve the Millennium Development Goals and make essential gains in the fight for improved agricultural productivity, rural incomes, and nutrition. How to support scaling up in these three areas, however, is a major challenge. This collection of policy briefs is designed to contribute to a better understanding of the experience to date and the lessons for the future.

Scaling up means expanding, replicating, adapting, and sustaining successful policies, programs, or projects to reach a greater number of people; it is part of a broader process of innovation and learning. A new idea, model, or approach is typically embodied in a pilot project of limited impact; with monitoring and evaluation, the knowledge acquired from the pilot experience can be used to scale up the model to create larger impacts. The process generally occurs in an iterative and interactive cycle, as the experience from scaling up feeds back into new ideas and learning.

The authors of the 20 policy briefs included here explore the experience of scaling up successful interventions in agriculture, rural development, and nutrition under five broad headings: (1) the role of rural community engagement, (2) the importance of value chains, (3) the intricacies of scaling up nutrition interventions, (4) the lessons learned from institutional approaches, and (5) the experience of international aid donors.

Set in Stone: Building America’s New Generation of Arts Facilities 1994-2008

June 29, 2012 Comments off

Set in Stone: Building America’s New Generation of Arts Facilities 1994-2008

Source: Cultural Policy Center (University of Chicago)

From press release:

Civic leaders, arts organizations, donors and government officials can better plan new or expanded arts facilities by first focusing on the arts organizations’ missions and assessing demand for the projects, according to a new study from the Cultural Policy Center at the University of Chicago.

The study, “Set in Stone,” looks at a major building boom of museums, performing arts centers and theaters in the United States from 1994 to 2008. It is the first scientifically prepared study of its kind and was requested both by cultural leaders and major foundations that had, in many cases, provided support for these building projects.

The work was based on interviews with people in more than 500 organizations and drew data from more than 700 building projects, including both new facilities and major renovations. The costs of the projects ranged from $4 million to $335 million. It relied on rare, behind-the-scenes access to the discussions surrounding the buildings.

See: Report shows overspending on cultural institutions in boom years (EurekAlert!)

Skin in the Game: How Consumer-Directed Plans Affect the Cost and Use of Health Care

June 29, 2012 Comments off

Skin in the Game: How Consumer-Directed Plans Affect the Cost and Use of Health Care

Source: RAND Corporation

If half of Americans with employer-sponsored insurance switched from a traditional health plan to a consumer-directed health plan, annual health care costs would fall by an estimated $57 billion.

Texas Dominates List of Fastest-Growing Large Cities Since 2010 Census, Census Bureau Reports

June 29, 2012 Comments off

Texas Dominates List of Fastest-Growing Large Cities Since 2010 Census, Census Bureau Reports

Source: U.S. Census Bureau

Texas had eight of the 15 most rapidly growing large cities between Census Day (April 1, 2010) and July 1, 2011, according to population estimates for all of the nation’s incorporated cities and towns and minor civil divisions released today by the U.S. Census Bureau.

“These estimates provide our first look at how much the total population has changed in each of our nation’s cities since we conducted the 2010 Census,” Census Bureau Director Robert Groves said. “These numbers provide further evidence of a continuation of the trend of rapid population growth in Texas we observed between the 2000 and 2010 censuses.”

Although Texas dominated the list as a whole, the fastest-growing large city was outside the state. Among cities with populations of 100,000 or more in 2010, New Orleans, still rebounding from the effects of Hurricane Katrina in 2005, ranked first, growing by 4.9 percent to 360,740. This puts the city’s population at 79.2 percent of the pre-Katrina July 1, 2005, estimate of 455,188.

One of Texas cities that made the list of fastest-growing cities — Round Rock — broke the 100,000 mark since the 2010 Census. Another, nearby Austin, cracked the 800,000 mark. (See Table 1 for complete list.)

Looking at the highest numerical growth, New York topped the list, adding nearly 70,000 people since the 2010 Census. Again, Texas was well-represented, with six cities among the top 15, including Houston, San Antonio and Austin, which ranked second, third and fourth, respectively. California checked in with three cities, including Los Angeles, San Diego and San Jose; Phoenix; Denver; Charlotte, N.C.; New Orleans; and Washington also made the list. (See Table 2 for a complete list.)

New York continued to be the nation’s most populous city by a large margin, with 8.2 million residents in 2011, followed by Los Angeles and Chicago. The 15 most populous cities remained unchanged since the 2010 Census. However, Austin, Texas, moved up from 14th to 13th in total population, supplanting San Francisco. (See Table 3 for complete list.)

US Election Note: International Trade Policy after 2012

June 29, 2012 Comments off

US Election Note: International Trade Policy after 2012
Source: Chatham House

The 2012 presidential election is occurring as the US economy emerges from a significant recession. While trade is a small part of the campaign debate, it remains an emotional ‘wedge issue’ for the electorate. This paper lays out the likely trade policy of either a second-term Barack Obama administration or an incoming Mitt Romney administration.

Collective behavior in the spatial spreading of obesity

June 29, 2012 Comments off

Collective behavior in the spatial spreading of obesity
Source: Scientific Reports

Obesity prevalence is increasing in many countries at alarming levels. A difficulty in the conception of policies to reverse these trends is the identification of the drivers behind the obesity epidemics. Here, we implement a spatial spreading analysis to investigate whether obesity shows spatial correlations, revealing the effect of collective and global factors acting above individual choices. We find a regularity in the spatial fluctuations of their prevalence revealed by a pattern of scale-free long-range correlations. The fluctuations are anomalous, deviating in a fundamental way from the weaker correlations found in the underlying population distribution indicating the presence of collective behavior, i.e., individual habits may have negligible influence in shaping the patterns of spreading. Interestingly, we find the same scale-free correlations in economic activities associated with food production. These results motivate future interventions to investigate the causality of this relation providing guidance for the implementation of preventive health policies.

French National Identity and Integration: Who Belongs to the National Community?

June 29, 2012 Comments off

French National Identity and Integration: Who Belongs to the National Community? (PDF)
Source: Migration Policy Institute

Since the mid-1980s, France has faced a contentious debate of crucial importance for immigrants and their descendents — defining what it means to be French. Though countries with rich histories of immigration have long accepted “dual belonging,” this concept has been criticized and perceived as at odds with a person’s commitment to French identity. A recent survey of French immigrants, however, shows that multiple allegiances are not an impediment to integration; it is possible to “feel French” and maintain links with a country of origin. However, because of external perceptions, native French citizens are far less likely to accept this adoption of French identity.

New From the GAO

June 28, 2012 Comments off

New GAO Reports and Testimonies

Source: Government Accountability Office

+ Reports

1. Freedom of Information Act: Key Website Is Generally Reliable, but Action Is Needed to Ensure Completeness of Its Reports. GAO-12-754, June 28.
http://www.gao.gov/products/GAO-12-754
Highlights – http://www.gao.gov/assets/600/592011.pdf

2. Defense Management: Steps Taken to Better Manage Fuel Demand but Additional Information Sharing Mechanisms Are Needed. GAO-12-619, June 28.
http://www.gao.gov/products/GAO-12-619
Highlights – http://www.gao.gov/assets/600/592023.pdf

3. Internal Revenue Service: Status of GAO Financial Audit and Related Financial Management Recommendations. GAO-12-695, June 28.
http://www.gao.gov/products/GAO-12-695
Highlights – http://www.gao.gov/assets/600/592016.pdf

+ Testimonies

1. Mission Iraq: State and DOD Face Challenges in Finalizing Support and Security Capabilities, by Michael J. Courts, acting director, international affairs and trade, before the Subcommittee on National Security, Homeland Defense, and Foreign Operations, House Committee on Oversight and Government Reform. GAO-12-856T, June 28.
http://www.gao.gov/products/GAO-12-856T
Highlights – http://www.gao.gov/assets/600/591998.pdf

2. Residential Appraisals: Regulators Should Take Actions to Strengthen Appraisal Oversight, by William B. Shear, director, financial markets and community investment, before the Subcommittee on Insurance, Housing and Community Opportunity, House Committee on Financial Services. GAO-12-840T, June 28.
http://www.gao.gov/products/GAO-12-840T
Highlights – http://www.gao.gov/assets/600/592001.pdf

3. Information Security: Cyber Threats Facilitate Ability to Commit Economic Espionage, by Gregory C. Wilshusen, director, information security issues, before the Subcommittee on Counterterrorism and Intelligence, House Committee on Homeland Security. GAO-12-876T, June 28.
http://www.gao.gov/products/GAO-12-876T
Highlights – http://www.gao.gov/assets/600/592009.pdf

4. Modernizing the Nuclear Security Enterprise: Observations on the Organization and Management of the National Nuclear Security Administration, by Gene Aloise, director, natural resources and environment, before the Subcommittee on Strategic Forces, House Committee on Armed Services. GAO-12-867T, June 27.
http://www.gao.gov/products/GAO-12-867T
Highlights – http://www.gao.gov/assets/600/591975.pdf

Presentation by the Comptroller General

1. Partnership and Collaboration: Meeting the Challenges Across All Levels of Government, by Gene L. Dodaro, Comptroller General of the United States, before the 19th Biennial Forum of Government Auditors, Alexandria Virginia. GAO-12-882CG, June 27.
http://www.gao.gov/products/GAO-12-882CG

Terrorism and Anti-Americanism: 9/11 Ten Years After

June 28, 2012 Comments off

Terrorism and Anti-Americanism: 9/11 Ten Years After (PDF)

Source: Hungarian Journal of English and American Studies

The shocking attacks on the United States by al-Qaeda terrorists on September 11, 2001 changed the course of history. It was a cataclysmic event, like the assassination of President Kennedy or the attack on Pearl Harbor: everyone can recall exactly what they were doing when they got the news or first saw the footage on CNN. An eventful ten years have passed since then. Americans became painfully aware that they were not untouchable anymore: the myth of Fortress America collapsed in an hour of mayhem. The US launched a war on terror, attacked Afghanistan and Iraq, and warned Iran and North Korea. The Bush administration gradually lost its support, and Republicans were voted out of power in favor of America’s first black president, Barack Obama in 2008. Subsequent attacks on the US were prevented, but her allies (especially Britain and Spain) proved less fortunate. Al-Qaeda was reduced to a regional, Middle Eastern terrorist organization, but anti-American sentiments continue to flourish all around the world. Iraqi dictator Saddam Hussein and al-Qaeda leader Osama bin Laden were liquidated, but both incidents raised just as many questions about America’s alliances as they answered. At home, a “9/11 truth movement” emerged, and conspiracy theories about the attacks continue to abound. Much to the amazement of the outside observer, many Americans tend to believe in fantastic and elaborate conspiracy theories1 rather than the official findings of the 9/11 Commission, whose final report was published in 2004. What follows are: 1) a historian’s take on America’s rise as a European colonizer in the Middle East; 2) an explanation of how the US subsequently became the target of Middle Eastern terrorism; 3) an evaluation of anti-Americanism and well-founded criticism leveled at the United States; 4) a review of the nature and scope of 9/11 conspiracy theories; and 5) an overview of what happened in the past ten years.

Underage alcohol policies across 50 California cities: An assessment of best practices

June 28, 2012 Comments off

Underage alcohol policies across 50 California cities: An assessment of best practices

Source: Substance Abuse Treatment, Prevention, and Policy

Background

We pursue two primary goals in this article: (1) to test a methodology and develop a dataset on U.S. local-level alcohol policy ordinances, and (2) to evaluate the presence, comprehensiveness, and stringency of eight local alcohol policies in 50 diverse California cities in relationship to recommended best practices in both public health literature and governmental recommendations to reduce underage drinking.

Methods

Following best practice recommendations from a wide array of authoritative sources, we selected eight local alcohol policy topics (e.g., conditional use permits, responsible beverage service training, social host ordinances, window/billboard advertising ordinances), and determined the presence or absence as well as the stringency (restrictiveness) and comprehensiveness (number of provisions) of each ordinance in each of the 50 cities in 2009. Following the alcohol policy literature, we created scores for each city on each type of ordinance and its associated components. We used these data to evaluate the extent to which recommendations for best practices to reduce underage alcohol use are being followed.

Results

(1) Compiling datasets of local-level alcohol policy laws and their comprehensiveness and stringency is achievable, even absent comprehensive, on-line, or other legal research tools. (2) We find that, with some exceptions, most of the 50 cities do not have high scores for presence, comprehensiveness, or stringency across the eight key policies. Critical policies such as responsible beverage service and deemed approved ordinances are uncommon, and, when present, they are generally neither comprehensive nor stringent. Even within policies that have higher adoption rates, central elements are missing across many or most cities’ ordinances.

Conclusion

This study demonstrates the viability of original legal data collection in the U.S. pertaining to local ordinances and of creating quantitative scores for each policy type to reflect comprehensiveness and stringency. Analysis of the resulting dataset reveals that, although the 50 cities have taken important steps to improve public health with regard to underage alcohol use and abuse, there is a great deal more that needs to be done to bring these cities into compliance with best practice recommendations.

[Category
Substance Abuse Treatment, alcohol, adolescents]

Mining Online Social Network Data for Biomedical Research: A Comparison of Clinicians’ and Patients’ Percept ions About Amyotrophic Lateral Sclerosis Treatments

June 28, 2012 Comments off

Mining Online Social Network Data for Biomedical Research: A Comparison of Clinicians’ and Patients’ Perceptions About Amyotrophic Lateral Sclerosis Treatments

Source: Journal of Medical Internet Research

Background:

While only one drug is known to slow the progress of amyotrophic lateral sclerosis (ALS), numerous drugs can be used to treat its symptoms. However, very few randomized controlled trials have assessed the efficacy, safety, and side effects of these drugs. Due to this lack of randomized controlled trials, consensus among clinicians on how to treat the wide range of ALS symptoms and the efficacy of these treatments is low. Given the lack of clinical trials data, the wide range of reported symptoms, and the low consensus among clinicians on how to treat those symptoms, data on the prevalence and efficacy of treatments from a patient’s perspective could help advance the understanding of the symptomatic treatment of ALS.

Objective:

To compare clinicians’ and patients’ perspectives on the symptomatic treatment of ALS by comparing data from a traditional survey study of clinicians with data from a patient social network.

Methods:

We used a survey of clinicians’ perceptions by Forshew and Bromberg as our primary data source and adjusted the data from PatientsLikeMe to allow for comparisons. We first extracted the 14 symptoms and associated top four treatments listed by Forshew and Bromberg. We then searched the PatientsLikeMe database for the same symptom–treatment pairs. The PatientsLikeMe data are structured and thus no preprocessing of the data was required.

Results: After we eliminated pairs with a small sample, 15 symptom–treatment pairs remained. All treatments identified as useful were prescription drugs. We found similarities and discrepancies between clinicians’ and patients’ perceptions of treatment prevalence and efficacy. In 7 of the 15 pairs, the differences between the two groups were above 10%. In 3 pairs the differences were above 20%. Lorazepam to treat anxiety and quinine to treat muscle cramps were among the symptom–treatment pairs with high concordance between clinicians’ and patients’ perceptions. Conversely, amitriptyline to treat labile emotional effect and oxybutynin to treat urinary urgency displayed low agreement between clinicians and patients.

Conclusions:

Assessing and comparing the efficacy of the symptomatic treatment of a complex and rare disease such as ALS is not easy and needs to take both clinicians’ and patients’ perspectives into consideration. Drawing a reliable profile of treatment efficacy requires taking into consideration many interacting aspects (eg, disease stage and severity of symptoms) that were not covered in the present study. Nevertheless, pilot studies such as this one can pave the way for more robust studies by helping researchers anticipate and compensate for limitations in their data sources and study design.

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