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Background Historically, a priori power and sample size calculations have not been routinely performed cost-effectiveness analyses (CEA), partly because the absence of published cost and effectiveness correlation and variance data, which are essential for power and sample size calculations. Importantly, the empirical correlation between cost and effectiveness has not been examined with respect to the estimation of value-for-money in clinical literature. Therefore, it is not well established if cost-effectiveness studies embedded within randomized-controlled-trials (RCTs) are under- or over-powered to detect changes in value-for-money. However, recently guidelines (such as those from ISPOR) and funding agencies have suggested sample size and power calculations should be considered in CEAs embedded in clinical trials. Methods We examined all RCTs conducted by the Canadian Cancer Trials Group with an embedded cost-effectiveness analysis. Variance and correlation of effectiveness and costs were derived from original-trial data. The incremental net benefit method was used to calculate the power of the cost-effectiveness analysis, with exploration of alternative correlation and willingness-to-pay values. Results We identified four trials for inclusion. We observed that a hypothetical scenario of correlation coefficient of zero between cost and effectiveness led to a conservative estimate of sample size. The cost-effectiveness analysis was under-powered to detect changes in value-for-money in two trials, at willingness-to-pay of $100,000. Based on our observations, we present six considerations for future economic evaluations, and an online program to help analysts include a priori sample size and power calculations in future clinical trials. Conclusion The correlation between cost and effectiveness had a potentially meaningful impact on the power and variance of value-for-money estimates in the examined cost-effectiveness analyses. Therefore, the six considerations and online program, may facilitate a priori power calculations in embedded cost-effectiveness analyses in future clinical trials. Highlights • Analysts may use the online program presented in the present study to examine the a priori power of cost-effectiveness analyses. • Analysts may potentially apply the considerations presented in this paper in the planning stage of future cost-effectiveness analyses.

Skorupski et al present several facts about preoperative anemia in major elective surgery. An estimated 23%-45% of patients undergoing major surgery have anemia, with the most common causes being iron deficiency anemia and anemia of inflammation or chronic disease.

A bstract We study mass deformations of N = 4, d = 4 SYM theory that are spatially modulated in one spatial dimension and preserve some residual supersymmetry. We focus on generalisations of N = 1 ∗ theories and show that it is also possible, for suitably chosen supersymmetric masses, to preserve d = 3 conformal symmetry associated with a co-dimension one interface. Holographic solutions can be constructed using D = 5 theories of gravity that arise from consistent truncations of SO(6) gauged supergravity and hence type IIB supergravity. For the mass deformations that preserve d = 3 superconformal symmetry we construct a rich set of Janus solutions of N = 4 SYM theory which have the same coupling constant on either side of the interface. Limiting classes of these solutions give rise to RG interface solutions with N = 4 SYM on one side of the interface and the Leigh-Strassler (LS) SCFT on the other, and also to a Janus solution for the LS theory. Another limiting solution is a new supersymmetric AdS 4 × S 1 × S 5 solution of type IIB supergravity.

A bstract We construct consistent Kaluza-Klein truncations of type IIA supergravity on (i) Σ 2 × S 3 and (ii) Σ 3 × S 3 , where Σ 2 = S 2 / Γ, ℝ 2 / Γ, or ℍ 2 / Γ, and Σ 3 = S 3 / Γ, ℝ 3 / Γ, or ℍ 3 / Γ, with Γ a discrete group of symmetries, corresponding to NS5-branes wrapped on Σ 2 and Σ 3 . The resulting theories are a D = 5, N = 4 gauged supergravity coupled to three vector multiplets with scalar manifold SO(1 , 1) × SO(5 , 3) / (SO(5) × SO(3)) and gauge group SO(2) × (SO(2) ⋉ Σ 2 ℝ 4 ) which depends on the curvature of Σ 2 , and a D = 4, N = 2 gauged supergravity coupled to one vector multiplet and two hypermultiplets with scalar manifold SU(1 , 1) / U(1) × G 2(2) / SO(4) and gauge group ℝ + × ℝ + for truncations (i) and (ii) respectively. Instead of carrying out the truncations at the 10-dimensional level, we show that they can be obtained directly by performing Inönü-Wigner contractions on the 5 and 4-dimensional gauged supergravity theories that come from consistent truncations of 11-dimensional supergravity associated with M5-branes wrapping Σ 2 and Σ 3 . This suggests the existence of a broader class of lower-dimensional gauged supergravity theories related by group contractions that have a 10 or 11-dimensional origin.

A bstract We construct gravitational solutions that holographically describe two different d = 4 SCFTs joined together at a co-dimension one, planar RG interface and preserving d = 3 superconformal symmetry. The RG interface joins N = 4 SYM theory on one side with the N = 1 Leigh-Strassler SCFT on the other. We construct a family of such solutions, which in general are associated with spatially dependent mass deformations on the N = 4 SYM side, but there is a particular solution for which these deformations vanish. We also construct a Janus solution with the Leigh-Strassler SCFT on either side of the interface. Gravitational solutions associated with superconformal interfaces involving ABJM theory and two d = 3 N = 1 SCFTs with G 2 symmetry are also discussed and shown to have similar properties, but they also exhibit some new features.

A bstract We construct infinite new classes of AdS 4 × S 1 × S 5 solutions of type IIB string theory which have non-trivial SL(2 , ℤ) monodromy along the S 1 direction. The solutions are supersymmetric and holographically dual, generically, to N = 1 SCFTs in d = 3. The solutions are first constructed as AdS 4 × ℝ solutions in D = 5 SO(6) gauged supergravity and then uplifted to D = 10. Unlike the known AdS 4 × ℝ S-fold solutions, there is no continuous symmetry associated with the ℝ direction. The solutions all arise as limiting cases of Janus solutions of d = 4, N = 4 SYM theory which are supported both by a different value of the coupling constant on either side of the interface, as well as by fermion and boson mass deformations. As special cases, the construction recovers three known S-fold constructions, preserving N = 1 , 2 and 4 supersymmetry, as well as a recently constructed N = 1 AdS 4 × S 1 × S 5 solution (not S-folded). We also present some novel “one-sided Janus” solutions that are non-singular.

Background The COVID-19 pandemic greatly impacted primary care and cancer care. We studied how primary care utilization in Ontario, Canada changed for patients who were newly diagnosed with cancer just prior to the COVID-19 pandemic compared to those diagnosed in non-pandemic years. Methods This population-based, retrospective cohort study used linked healthcare databases to compare outcomes for patients with a new malignancy diagnosed within the year prior to the COVID-19 pandemic, between July 1 and September 30, 2019 (COVID-19 cohort) to those diagnosed in the same months in 2018 and 2017 (pre-pandemic cohort). We used Poisson regression models to compare rates of in-person and virtual visits to patients’ usual primary care physician (PCP), emergency department (ED) visits, and hospitalizations, all reported per person-year of follow-up. Results In-person visits to usual PCPs decreased from 4.07/person-year in the pre-pandemic cohort to 2.58 in the COVID-19 cohort ( p  < 0.0001). Virtual visits to usual PCPs increased from 0.00 to 1.53 ( p  < 0.0001). Combined in-person and virtual visits to patients’ usual PCPs was unchanged from 4.07 to 4.12 ( p  = 0.89). The rate of ED visits decreased from 0.99/person-year to 0.88 ( p  < 0.0001). Non-elective hospitalizations remained unchanged, from 0.49/person-year to 0.47 ( p  = 0.1675). Conclusion There was a sizeable shift in primary care visits for cancer patients from in-person to virtual during the pandemic, although there was no resultant increase in hospitalizations. This suggests that early in the pandemic, virtual care allowed for continuity in utilization of primary care, though further studies are required to confirm this persisted later in the pandemic.

BackgroundEconomic analyses based on clinical trial data are costly and time consuming, and alternative methods for performing economic analyses should be explored.Objective and methodsIn this perspective, we examine the emerging role of administrative data for economic analyses in cancer.ResultsCompared with routinely collected clinical trial data, routinely collected administrative data have several strengths including high capture rates for healthcare encounters, less resource utilisation, low rates of misclassification, long follow-up periods and the opportunity to collect data points not traditionally captured in clinical trials. However, there are also limitations including the need for accurate data linkage across multiple databases and systems, the costs and time associated with data linkage, the potential time lag between trial data collection and the availability of administrative data, and limited data on quality of life, toxicity and indirect costs. In this perspective, we identify important barriers and potential solutions to performing economic analyses for oncology using administrative data, and outline strategies to increase research in this field.ConclusionThe use of routinely collected administrative data sets for economic analyses of clinical trials presents a unique opportunity that could complement and validate economic analyses based on trial-level data.