Search Results

Cost Effectiveness of Influenza Vaccination
A study by the Office of Technology Assessment (OTA) that "evaluates influenza vaccination on the basis of another criterion-cost effectiveness"
The Costs and Effectiveness of Cervical Cancer Screening in Elderly Women
This paper examines what is known about the course of cervical cancer in elderly women; the effectiveness of the Pap test and its accuracy in this age group; the relative costs and effectiveness of different screening test schedules for elderly women; and the implications of these findings for Medicare.
Costs and Effectiveness of Cholesterol Screening in the Elderly
This paper reviews the evidence that elevation of serum cholesterol (hypercholesterolemia) is an independent risk factor for cardiovascular disease in the elderly and that the detection and treatment of hypercholesterolemia in an elderly individual who does not have clinically apparent heart disease will diminish overall morbidity or mortality. It also estimates health care expenditures associated with screening and treatment of hypercholesterolemia in the elderly.
Costs and Effectiveness of Colorectal Cancer Screening in the Elderly
In this paper OTA summarizes the evidence on the effectiveness and costs of colorectal cancer screening in the elderly and explores the implications for Medicare of offering this preventive technology as a Medicare benefit. Nowhere are the hard choices between potential medical benefits and high costs illustrated more clearly than with this cancer screening technology.
Costs and Effectiveness of Prostate Cancer Screening in Elderly Men
The background paper summarizes the evidence on the effectiveness and costs of prostate cancer screening and treatment in elderly men and explores the implications for Medicare of offering this preventive technology as a Medicare benefit.
The Costs of AIDS and other HIV infections: review of the estimates
A report on analyzes the reasons behind widely divergent estimates of the costs associated with AIDS. Because of the great variation in methods used, the results are not strictly comparable across studies.
Coverage of Laser Technology by Health Insurers
This paper presents some empirical information on how insurers consider payment for new medical devices. It describes the survey results of medical directors affiliated with private health insurers about their coverage decisions using, as examples, three applications of lasers: laser angioplasty for opening narrowed or blocked coronary arteries; laser discectomy for treating herniated intervertebral discs; and photodynamic therapy (using a light–sensitive dye) for bladder cancer.
Coverage of Preventive Services: Provisions of Selected Current Health Care Reform Proposals
This paper first describes prevention and clinical preventive services, and specialties the way in which OTA uses the concept of preventive services in its analysis of current health care reform proposals. Second, the paper provides a “roadmap” to four major approaches to reform. Third, the paper summarizes the preventive services proposed under selected health care reform proposals.
Criminal justice: new technologies and the constitution: special report
This report describes the new technologies being used in criminal justice and, as in all of the reports of this series, addresses that delicate balance to be maintained between the national interest and individual rights.
Criteria for Evaluating the Implementation Plan Required By the Earthquake Hazards Reduction Act of 1977: A Background Paper
An assessment by the Office of Technology Assessment (OTA) that looks at the Earthquake Hazards Reduction Act of 1977 and "identifies 14 basic issues or conflicts with which th [sic] implementation plan must cope in order to achieve its objectives" (Introduction).
Critical Connections: Communication for the Future
The U.S. communication infrastructure is changing rapidly as a result of technological advances, deregulation, and an economic climate that is increasingly competitive. This change is affecting the way in which information is created, processed, transmitted, and provided to individuals and institutions. The report analyzes the implications of new communication technologies for business, politics, culture, and individuals, and suggests possible strategies and options for congressional consideration.
Current Status of Federal Involvement in U.S. Aquaculture
The purpose of this paper is to provide information on technology issues of immediate importance to the U.S. aquaculture industry.
Cystic Fibrosis and DNA Tests: Implications of Carrier Screening
This report concludes that the value of the cystic fibrosis (CF) carrier test is the information it provides. No one can estimate in common terms what it means to an individual to possess information about his or her genetic status, especially when the value concerns reproductive decision-making. As our knowledge of the human genome increases, what we do with information such as CF carrier status will depend on the perceptions and beliefs of all Americans.
Data Format Standards for Civilian Remote Sensing Satellites
This report discusses the earth data—positional, topographic, climatological, meteorological, man–made features, and changes over time in all of these, which are increasingly important to the military. Data from these systems are bought and extensively used by the military and intelligence communities. The need to integrate data from military-unique systems as well only complicates the situation.
Defending secrets, sharing data: new locks and keys for electronic information
This report examines Federal policies directed at protecting information, particularly in electronic communications systems.
Defense Conversion: Redirecting R&D
Part one of this report analyzes how R&D institutions currently pursuing defense missions could be more responsive and useful to civilian technology development. The Report focuses particularly on the Department of Energy’s (DOE’s) three nuclear weapons laboratories, Livermore National Laboratory, Los Alamos National Laboratory, and Sandia National Laboratories. The report examines two sectors in Part Two: new kinds of automobiles that pollute less and could reduce dependence on foreign oil, and high speed surface transportation.
The defense technology base: introduction & overview
This special report is the first product of that assessment. It provides an overview of the subject, including specific concerns about the health of the defense technology base and the related issues before Congress. Subsequent reports will probe aspects of this immense problem in greater detail.
Defensive Medicine and Medical Malpractice
This report discusses the medical malpractice system that has frequently been cited as a contributor to increasing health care costs and has been targeted in many health care reform proposals as a potential source of savings. The report first examines the nature of defensive medicine, adopting a working definition of defensive medicine that embraces the complexity of the problem from both the physician and broader public policy perspectives. Finally, it comments on the potential impact of a variety of medical malpractice reforms on the practice of defensive medicine.
Defining "Rural" Areas: Impact on Health Care Policy and Research
This paper examines dichotomous designations used to define rural and urban areas and discusses how they are applied in certain Federal programs. In addition, several topologies are described that are useful in showing the diversity that exists within rural areas.
Delivering the Goods: Public Works Technologies, Management, and Financing
This report identifies several immediate steps the Federal Government could take. First, new environmental standards, population shifts, and industrial changes have transformed the nature of many public works problems, and Federal programs must be refocused to fit the new circumstances. Second, if we expect to maintain our economic health, the Nation must increase its investment in public works, despite budget dilemmas.
Dementia among nursing home patients: defining the condition, characteristics of the demented, and dementia on the RUG-II classification system
This report discusses how dementia affects the quality of life, the increasing number of demented persons, the onset of dementia conditions.
Demographic Trends and the Scientific and Engineering Workforce
A technical memorandum by the Office of Technology Assessment (OTA) that "explores the effect that changes in the size and composition of the U.S. population may have on the science and engineering work force" (p. iii).
The Department of Defense Kuwait Oil Health Fire Risk Assessment (The "Persian Gulf Veterans' Registry")
This paper describes briefly the work on DoD’s Kuwait Oil Fire Health Risk Assessment to date, including the results of a pilot study of health risks, and then answers the questions addressed to OTA in PL 102-585.
The Department of Veterans Affairs Persian Gulf Veterans' Health Registry
This report focuses on the VA “Persian Gulf War Veterans Health Registry,” which is referred to here as the “examination registry.”
Developing law on professional standards and peer review in quality assessment activities
This report describes the expanding role of professional standards and peer review activities in health-care quality assessment initiatives. It also describes how some traditional and some new quality assessment activities that involve professional and peer review are either building on or in conflict with existing legal processes and public policy.
Development Assistance, Export Promotion, and Environmental Technology
This background paper provides an overview of developing country environmental problems and markets for environmental technologies and services. It discusses preliminary estimates on the amount and purposes of environmental aid provided by donor countries in 1991. The paper discusses the commercial implications of other countries’ aid for U.S. environmental firms, and the Helsinki package adopted by the OECD in late 1991 to limit commercial advantage from use of tied aid credits.
Development of Medical Technology: Opportunities for Assessment
A report by the Office of Technology Assessment (OTA) examining the human and financial costs to the healthcare system caused by research and development. It "discusses possibilities for and obstacles to assessing the social impacts of new medical technologies during the stages of research and development that precede their wiespread acceptance" (p. 3).
Diagnosis Related Groups (DRGs) and the Medicare Program: Implications for Medical Technology
A technical memorandum by the Office of Technology Assessment that evaluates the results of Diagnosis Related Groups and "their implications for use in the Medicare program" (p. iii).
Difficult-To-Reuse Needles for the Prevention of HIV Infection Among Injecting Drug Abusers
This paper reviews various possibilities of using non-reusable injection technologies for reducing HIV transmission among injecting drug users in the United States. It does not put forth the redesign of injection equipment as a policy option for congressional consideration; it merely examines some of the implications of a proposal put forth by some health experts.
Dioxin Treatment Technologies
This paper presents the status of national efforts to cleanup dioxin-contaminated sites and the technologies that have been used, proposed, and researched. It covers thermal and nonthermal treatment techniques as well as approaches such as stabilization and storage. It discusses the development of these technologies as well as advantages and disadvantages of their use.
The Direct Use of Coal
A report by the Office of Technology Assessment (OTA) that "examines the complete coal system, from extraction to combustion, including the key steps and institutions that policy can influence" (p. iii).
Directed Energy Missile Defense in Space: Background Paper
A background paper by the Office of Technology Assessment (OTA) that "describes and assesses current concepts for directed-energy ballistic missile defense in space" (p. 3).
Dismantling the Bomb and Managing the Nuclear Materials
This report presents the results of OTA’s investigations and analyses regarding the types of adverse environmental and health impacts that resulted from nuclear weapons production in the past. In this report, OTA suggests various initiatives that Congress could consider to establish a national policy, determine the next steps in warhead dismantlement and nuclear materials management, approach decisions on the ultimate disposition of nuclear materials, enhance the institutional capabilities necessary to ensure success, and encourage sound dismantlement and materials management in Russia.
Displaced Homemakers: Programs and Policy: An Interim Report
A report by the Office of Technology Assessment (OTA) that focuses on the "problems of and programs for displaced homemakers" (p. iii).
Disposal of Chemical Weapons: Alternative Technologies
This background paper briefly describes the Army’s chemical weapons destruction program, discusses the factors that could affect a decision to develop alternatives, discusses the alternatives, and illustrates the difficulty of gaining public acceptance of complex technical systems.
Distance education and the transformation of schooling
This report discusses the benefits and challenges of distance education. It address the question how distance learning can change our approach to learning and how it can change us.
Distance learning case studies
This report discuses distance learning projects, and ways telecommunications technologies such as satellites, cable television, fiber optics, slow scan TV, instructional television fixed services, and microcomputer networking have opened up opportunities for school districts to coordinate schedules and to share resources.
Distributed Interactive Simulation of Combat
This background paper complements OTA’s background paper, Virtual Reality and Technologies of Combat Simulation, which focuses on the human-computer interface technologies used in simulations.
Distributive justice and the allocation of technological resources to the elderly
This report examines the problems if distributive justice and the allocation of technological resources to the elderly. The second part of this report looks more narrowly at the specific question of the use of age as a criterion in the allocating of technological resources. The third part provides a closer examination of health care resources seeing whether the nature of the resources may have a bearing on how they are distributed.
Do Insects Transmit AIDS?
In this report: 1) the evidence for the possibility of insect transmission of HIV infection is summarized, and 2) areas for further investigation are identified.
Do Medicaid and Medicare Patients Sue More Often Than Other Patients?
This background paper also responds to the request of the Congressional Sunbelt Caucus that OTA examine and judge the available evidence on whether Medicaid and Medicare patients, particularly obstetrics patients, are more litigious than other patients.
Does Health Insurance Make a Difference?
This background paper reviews and evaluates the available literature linking health insurance coverage with the utilization and process of health care services and with individual health outcomes.
Does Vocational Education Help the "Forgotten Half"?: Short-term Economic Consequences of High School Vocational Education for Non-College Students
This background paper uses very recent data to address that question for individuals just one year out of high school. The paper also presents data on the types of occupations that these young people engage in, and rough statistical correlations between those occupations and types of high-school-level vocational coursework.
Drug Bioequivalence
Report of the findings from a panel of the Office of Technology Assessment (OTA) regarding drug bioequivalence therapies. According to the report, the purpose of the Drug Bioequivalence Study Panel "was to examine the relationships between the chemical and therapeutic equivalence of drug products and to assess the capability of current technology -- short of therapeutic trials in man -- to determine whether drug products with the same physical and chemical composition produce comparable therapeutic effects" (p. 5).
Drug Labeling in Developing Countries
This report discusses the pharmaceutical labeling requirements imposed on U.S.-based companies by the laws of the United States and the barriers to U.S. regulation of their labeling in other countries.
Drugs in Livestock Feed: Volume 1: Technical Report
A report by the Office of Technology Assessment (OTA) over the use of drugs in livestock feed
Economic considerations in regulating neurotoxic substances
This report discusses economic consideration in regulating neurotoxic substances which involves balancing the economic benefits of utilizing these substances commercially against their actual or potential risks to human health and the environment.
Economic incentives and disincentives for recycling of municipal solid waste
This report is divided into an Executive Summary and four chapters. These chapters examine Federal subsidies to virgin materials, the potential for Federal subsidies for recycled materials, Federal subsidies for alternative energy sources, and state efforts at increasing recycling through tax incentives.
Educating scientists and engineers: grade school to grad school
This report examines how and why students are drawn toward or deterred from pursuing a career in science or engineering. Schools, families, peers, informal education efforts-such as museums, science centers, special programs, and television— all play a role. The subtitle of this report—Grade School to Grad School—emphasizes that many factors and institutions must be understood as all one system.
Education and Technology: Future Visions
This paper summarizes the workshop discussion and contains the commissioned papers in their entirety. In June 1995, the contractors and a number of other prominent educators were invited to OTA for an all-day workshop to discuss these papers and the issues more broadly.
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