If you were a policymaker, which treatment would you disinvest? A participatory value evaluation on public preferences for active disinvestment of health care interventions in the Netherlands.

INTRODUCTION: Currently, it is not known what attributes of health care interventions citizens consider important in disinvestment decision-making (i.e. decisions to discontinue reimbursement). Therefore, this study aims to investigate the preferences of citizens of the Netherlands toward the relative importance of attributes of health care interventions in the context of disinvestment. METHODS: A participatory value evaluation (PVE) was conducted in April and May 2020. In this PVE, 1143 Dutch citizens were asked to save at least €100 million by selecting health care interventions for disinvestment from a list of eight unlabeled health care interventions, described solely with attributes. A portfolio choice model was used to analyze participants' choices. RESULTS: Participants preferred to disinvest health care interventions resulting in smaller gains in quality of life and life expectancy that are provided to older patient groups. Portfolios (i.e. combinations of health care interventions) resulting in smaller savings were preferred for disinvestment over portfolios with larger savings. CONCLUSION: The disinvestment of health care interventions resulting in smaller health gains and that are targeted at older patient groups is likely to receive most public support. By incorporating this information in the selection of candidate interventions for disinvestment and the communication on disinvestment decisions, policymakers may increase public support for disinvestment.

Differences in muscle load between computer and non-computer work among office workers.

Introduction of more non-computer tasks has been suggested to increase exposure variation and thus reduce musculoskeletal complaints (MSC) in computer-intensive office work. This study investigated whether muscle activity did, indeed, differ between computer and non-computer activities. Whole-day logs of input device use in 30 office workers were used to identify computer and non-computer work, using a range of classification thresholds (non-computer thresholds (NCTs)). Exposure during these activities was assessed by bilateral electromyography recordings from the upper trapezius and lower arm. Contrasts in muscle activity between computer and non-computer work were distinct but small, even at the individualised, optimal NCT. Using an average group-based NCT resulted in less contrast, even in smaller subgroups defined by job function or MSC. Thus, computer activity logs should be used cautiously as proxies of biomechanical exposure. Conventional non-computer tasks may have a limited potential to increase variation in muscle activity during computer-intensive office work.

Coarse-to-fine eye movement strategy in visual search.

Oculomotor behavior contributes importantly to visual search. Saccadic eye movements can direct the fovea to potentially interesting parts of the visual field. Ensuing stable fixations enables the visual system to analyze those parts. The visual system may use fixation duration and saccadic amplitude as optimizers for visual search performance. Here we investigate whether the time courses of fixation duration and saccade amplitude depend on the subject's knowledge of the search stimulus, in particular target conspicuity. We analyzed 65,000 saccades and fixations in a search experiment for (possibly camouflaged) military vehicles of unknown type and size. Mean saccade amplitude decreased and mean fixation duration increased gradually as a function of the ordinal saccade and fixation number. In addition we analyzed 162,000 saccades and fixations recorded during a search experiment in which the location of the target was the only unknown. Whether target conspicuity was constant or varied appeared to have minor influence on the time courses of fixation duration and saccade amplitude. We hypothesize an intrinsic coarse-to-fine strategy for visual search that is even used when such a strategy is not optimal.