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mber of QALYs because of the disutility associated with the continuous treatment Policy makers increasingly seek to complement data from clinical trials with information from routine care This study aims to provide a detailed account of the hospital resource use and associated costs of patients with advanced breast cancer in The Netherlands Data from 597 patients with advanced breast cancer diagnosed between 2010 and 2014 were retrieved from the Southeast Netherlands Advanced Breast Cancer Registry Database lock for this study was in October 2017 We report the observed hospital costs for different resource categories and the lifetime costs per patient adjusted for censoring using Lins method The relationship between patients characteristics and costs was studied using multivariable regression The average SE lifetime hospital costs of patients with advanced breast cancer were 52 709 405 Costs differed considerably between patient subgroups ranging from 29 803 for patients with a triplenegative subtype to 92 272 for patients with hormone receptor positive and human epidermal growth factor receptor 2 positive cancer Apart from the cancer subtype several other factors including age and survival time were independently associated with patient lifetime costs Overall a large share of costs was attributed to systemic therapies 56 predominantly to a few expensive agents such as trastuzumab 15 everolimus 10 and bevacizumab 9 as well as to inpatient hospital days 20 This realworld study shows the high degree of variability in hospital resource use and associated costs in advanced breast cancer care The presented resource use and costs data provide researchers and policy makers with key figures for economic evaluations and budget impact analyses This realworld study shows the high degree of variability in hospital resource use and associated costs in advanced breast cancer care The presented resource use and costs data provide researchers and policy makers with key figures for economic evaluations and budget impact analyses Our study investigates the extent to which uptake of a COVID19 digital contacttracing DCT app among the Dutch population is affected by its configurations its societal effects and government policies toward such an app We performed a discrete choice experiment among Dutch adults including 7 attributes that is who gets a notification waiting time for testing possibility for shops to refuse customers who have not installed the app stopping condition for contact tracing number of people unjustifiably quarantined number of deaths prevented and number of households with financial problems prevented The data were analyzed by means of panel mixed logit models The prevention of deaths and financial problems of households had a very strong influence on the uptake of the app Predicted app uptake rates ranged from 24 to 78 for the worst and best possible app for these societal effects We found a strong positive relationship between peoples trust in government and peoples propensity to install the DCT app The uptake levels we find are much more volatile than the uptake levels predicted in comparable studies that did not include societal effects in their discrete choice experiments Our finding that the societal effects are a major factor in the uptake of the DCT app results in a chickenortheegg causality dilemma That is the societal effects of the app are severely influenced by the uptake of the app but the uptake of the app is severely influenced by its societal effects The uptake levels we find are much more volatile than the uptake levels predicted in comparable studies that did not include societal effects in their discrete choice experiments Our finding that the societal effects are a major factor in the uptake of the DCT app results in a chickenortheegg causality dilemma That is the societal effects of the app are severely influenced by the uptake of the app but the uptake of the app is severely influenced by its societal effects Coronavirus disease 2019 has put unprecedented pressure on healthcare systems worldwide leading to a reduction of the available healthcare capacity Our objective was to develop a decision model to estimate the impact of postponing semielective surgical procedures on health to support prioritization of care from a utilitarian perspective A cohort statetransition model was developed and applied to 43 semielective nonpediatric surgical procedures commonly performed in academic hospitals Scenarios of delaying surgery from 2 weeks were compared with delaying up to 1 year and no surgery at all Model parameters were based on registries scientific literature and the World Health Organization Global Burden of Disease study For each surgical procedure the model estimated the average expected disabilityadjusted lifeyears DALYs per month of delay Given the best available evidence the 2 surgical procedures associated with most DALYs owing to delay were bypass surgery for Fontaine IIIIV peripheral adifferent ethical perspectives and combined with capacity management tools to facilitate largescale implementation Researchers studying treatment of coronavirus disease 2019 COVID19 have reported findings of randomized trials comparing standard care with care augmented by experimental drugs Many trials have small sample sizes so estimates of treatment effects are imprecise Hence clinicians may find it difficult to decide when to treat patients with experimental drugs A conventional practice when comparing standard care and an innovation is to choose the innovation only if the estimated treatment effect is positive and statistically significant This practice defers to standard care as the status quo We study treatment choice from the perspective of statistical decision theory which considers treatment options symmetrically when assessing trial findings We use the concept of nearoptimality to evaluate criteria for treatment choice This concept jointly considers the probability and magnitude of decision errors httpswwwselleckchemcomproductsraphin1html An appealing criterion from this perspective is the empirical success rule which chooses the treatment with the highest observed average patient outcome in the trial