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Health Economics Aspects of Digital Therapeutics
Published in Oleksandr Sverdlov, Joris van Dam, Digital Therapeutics, 2023
Jennifer Lavanture, Owen McCarthy
In jurisdictions with multiple payer entities or less structured technology assessment processes, the use of economic models in coverage determinations is less clear and likely more variable. In a 2014 survey of 1200 payers in the US,4 forty-five percent (45%) of respondents indicated that they used cost-effectiveness models most often in their reimbursement decisions, compared to 28% for budget impact models and 15% for administrative claims data analyses. For those that do utilize models provided by industry, the models are often considered for multiple purposes, including learning more about the disease state, clinical product data, and using data as a starting point for the development of internal models.
Modelling Three-Dimensional Vestibular Responses During Complex Motion Stimulation
Published in Michael Fetter, Thomas Haslwanter, Hubert Misslisch, Douglas Tweed, Three-Dimensional Kinematics of Eye, Head and Limb Movements, 2020
As a conceptual basis, the principle of an internal model will be applied (see Figure 1). An internal model (not to be confused with the overall model) is an integral component of estimation techniques like observer theory and optimal estimation theory (i.e., Kalman filters), but internal models also have a long history in psychophysics (e.g., efference copy and correlation storage are essential components of an internal model). The purpose of internal models is to estimate external variables (like gravity, acceleration, velocity etc.) by mimicking the physical relationships between those variables and the sensory systems and thereby predicting their time-course from incomplete, noisy, and/or inaccurate sensory information.
Bidirectional Neural Interfaces
Published in Chang S. Nam, Anton Nijholt, Fabien Lotte, Brain–Computer Interfaces Handbook, 2018
Mikhail A. Lebedev, Alexei Ossadtchi
Going beyond reflexes and voluntary movements, some developers of robots (Hoffmann et al. 2010), prostheses (Pazzaglia & Molinari 2016), and NIs (Alimardani et al. 2016; Lebedev & Nicolelis 2006) build their ideas around the concept of body schema. This concept was proposed by Head and Holmes (1911) as an explanation of how the brain integrates multiple streams of information from peripheral sensors to form a coherent model of the body (Maravita & Iriki 2004; Maravita et al. 2003). The internal model theory (Kawato 1999; Wolpert et al. 1995) is a modern version of the body schema theoretical framework. The internal model theory delineates two components: the controlled object (e.g., a body part) and the neural controller. To optimize the performance, the controller builds an internal model that describes the properties of the object. When planning a movement, the controller utilizes the internal model to form an expectation of how the body part would move. Next, during motor execution, afferent information from the body part is compared with the expectation, and a correcting command is issued if the incoming sensory information is different from the expected state. It has been proposed that NI should utilize an internal model to perform better (Cui 2016; Golub et al. 2012). Similar optimization ideas can be found in the theory of optimal feedback control (Todorov 2004; Todorov & Jordan 2002) that was recently applied to NI design (Benyamini & Zacksenhouse 2015; Shanechi et al. 2016).
Movement imagery as a predictor of online control in typically developing children
Published in Developmental Neuropsychology, 2018
Marcus Sooley, Erin K. Cressman, Rose Martini
The central nervous system is hypothesized to create an internal representation of the sensorimotor system, termed an internal model, in order to facilitate the transformation of incoming sensory information to appropriate motor commands (Wolpert & Ghahramani, 2000). This internal model is comprised of an inverse model and a forward model. The inverse model is purported to allow an individual to choose the correct motor plan to produce the desired displacement based on current visual and kinesthetic sensory information regarding limb position and target location (Desmurget & Grafton, 2000). The forward model uses a predicted state estimate, including predicted incoming sensory information, as a baseline with which to compare the incoming sensory information (Wolpert & Ghahramani, 2000). Should sensory discrepancies arise, for example due to a change in target location, an error signal is generated and the motor plan is updated online to minimize the error signal (Wolpert & Ghahramani, 2000). This combination of feedfoward (predictive) and feedback processes allow online corrections to be made rapidly in response to changes in the environment (Castiello, Paulignan, & Jeannerod, 1991; Farne et al., 2003). In childhood, reaching proficiency improves in a gradual, but nonlinear way; however, it has yet to be established whether this development corresponds to a better integration of these described feedforward/feedback based mechanisms (Wilson & Hyde, 2013).
Experiences of internal and hybrid employee assistance program managers: Factors associated with successful, at-risk, and eliminated programs
Published in Journal of Workplace Behavioral Health, 2018
Jodi Jacobson Frey, John Pompe, David Sharar, Rachel Imboden, Lauren Bloom
Those making decisions about their EAP investment and delivery model have several choices, from the traditional to the modern; from the complex to the simple; from the expensive to the low cost. The once-standard internal model appears to be less common, in spite of equivalent outcomes compared to other models and their unique benefits to the workplace. Through the experiences of current and past internal EAP managers, the current study advances our understanding of how workplace and managerial variables may relate to the success of internal and hybrid EAP models. There appear to be circumstances where these EAPs thrive and may be considered a viable alternative to the external commercial EAP products.
In search of pathobiological endotypes: a systems approach to early rheumatoid arthritis
Published in Expert Review of Clinical Immunology, 2020
Jessica R. Tarn, Dennis W. Lendrem, John D. Isaacs
We note that the interpretation of results is often confounded by comorbidities associated with the disease. Combining information from multiple studies is often complicated by the choice of different metrics to define response to treatment or remission. In the haste to publish, candidate biomarkers and putative pathobiological endotypes often arise from relatively small studies using relatively untried methods. Many researchers then rely upon internal model validation efforts with little regard to external validation. In addition, validation studies are less likely to be published, and ‘failed’ external validation efforts have a limited audience. This gives rise to serious publication bias.