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In late October 2009, the U.S. Preventive Services Task Force (USPSTF), an independent panel of primary care experts, was preparing to release their updated guidelines for the use of screening mammograms, which were given to women in an attempt to detect evidence of breast cancer at a treatable stage. The new guidelines, based on rigorous scientific research and tests, now recommended routine screening starting at age 50 rather than at age 40. The challenge the USPSTF faced was that this shift in the recommended starting age was likely to spark significant debate among medical professionals and in the press.

The emergency department of any large hospital is frequently subject to substantial patient crowding, a result of arrivals by foot and ambulance, and limited resources. The San Francisco General Hospital is particularly crowded due to its prominence as the only trauma centre in the city. As a result, it is on ambulance diversion almost 25 per cent of the time, more than any other hospital in the area. Hospital managers are looking for ways to alleviate emergency department crowding and ambulance diversion.

Excel spreadsheet for students.

An investment banking associate from the metals and mining group of a multinational financial services company was preparing to accompany his managing director on a client trip to provide a market update and discuss various debt structures the client might use in the future to finance potential development projects. As part of the meeting, the associate wanted to include an analysis of recent trends in prices for platinum, palladium gold and copper. A spreadsheet supplement is available as product 7B13E009.

The emergency department of any large hospital is frequently subject to substantial patient crowding, a result of arrivals by foot and ambulance, and limited resources. The San Francisco General Hospital is particularly crowded due to its prominence as the only trauma centre in the city. As a result, it is on ambulance diversion almost 25 per cent of the time, more than any other hospital in the area. Hospital managers are looking for ways to alleviate emergency department crowding and ambulance diversion.

An Excel macro is a series of commands that can perform certain tasks automatically, such as obtaining data from another Excel file or the web, updating computations, generating reports, and running models. Macros can save time, reduce user errors, and complete tasks that would be extremely difficult for a user to do otherwise. This note uses examples and screenshots to introduce macros and macro recording in Microsoft Excel.

The web query feature of Microsoft Excel can be a great help in retrieving data from the web. A web query can be set up in Excel in a similar way to browsing a web page. In this note, historical stock prices are obtained from the web for use in Microsoft Excel, and a macro recorder is used to process the data and view and modify the corresponding Visual Basic for Applications (VBA) code.

The executive director of British Columbia’s Neonatal Services Program was thinking about her last meeting with the officials at the British Columbia Ministry of Health Services (MHS). Following a report indicating that from 2007 to 2008 the province sent 98 expectant mothers and newborns to the United States for treatment, the province was considering adding more neonatal intensive care capacity. Political pressure was mounting after one of Canada’s national newspapers covered the problem in a front-page story. The MHS asked the executive director to suggest bed allocations and other improvements to address the situation.

The executive director of British Columbia's Neonatal Services Program (BCNSP) is thinking about her last meeting with the officials at the British Columbia Ministry of Health Services (MHS). Following a report indicating that in 2007 to 2008 the province had sent 98 expectant mothers and newborns to the United States for treatment, the province was considering adding more neonatal intensive care (NICU) capacity. Political pressure was mounting after one of Canada's national newspapers covered the problem in a front page story. The MHS asked the executive director to suggest bed allocations and other improvements to address the situation.<br><br> This case is useful in a management science of service operations course. Students may be asked to describe a model to address the situation, and students with familiarity with a graphical simulation could be asked to build a model.

The media frequently report on the high cost of various health-related treatments. As there is a limit to the resources available to public and private health plans, they are not able to make all new treatments available. This raises questions about how to determine which treatments should be offered under a health plan. Cost effectiveness analysis has emerged as a powerful tool to help determine priorities and guide these policy decisions. This note is intended as a background reading for a first class on pharmacoeconomics or cost effectiveness analysis.

The media frequently report on the high cost of various health-related treatments. As there is a limit to the resources available to public and private health plans, they are not able to make all new treatments available. This raises questions about how to determine which treatments should be offered under a health plan. Cost effectiveness analysis has emerged as a powerful tool to help determine priorities and guide these policy decisions. This note is intended as a background reading for a first class on pharmacoeconomics or cost effectiveness analysis.

In recent years, many countries with publicly funded healthcare have started using cost-effectiveness analysis (CEA) along with review of clinical data as a tool to assess the overall benefit of a new drug to the society and set priorities with regards to health care budget. Cost effectiveness was formally incorporated into the Ontario drug review system in 1993 and the Canadian drug-review system in 2003. The issue of using cost effectiveness has become increasingly contentious in recent years: some newly approved cancer drugs cost $3,000 to $6,000 or more for one treatment cycle, but their high prices means that they were often classified as being not cost effective. This note reviews many of the competing interests in debates over drug funding and dilemmas about healthcare financing decisions in the presence of limited budgets.

A freelance geologist was asked for advice regarding two mining claims to property on Sturgeon Lake, near Thunder Bay, Ontario. Specifically, he was asked if there was enough gold on the property to pursue an economically feasible mining opportunity. The geologist determined that an analytical approach would best aid the analysis of the multiple factors he would need to consider in arriving at a decision about whether or not to proceed with the mining operation. The first stage in ore extraction involved building an access road, and the second stage was to implement a drilling program. There was considerable uncertainty surrounding the costs and actual feasibility of completion of these stages; yet only when these stages were completed could actual mining of the property begin. If mining proceeded, it was assumed it would take 10 years to extract all the gold from the site, and the total amount of gold in the mine would be extracted at an even rate over the 10-year period. Mining costs were assumed to be $30 an ounce, and the geologist used a discount rate of 20 per cent before taxes when evaluating projects.

<p style="color: rgb(197, 183, 131);"><strong> AWARD WINNER -INFORMS Case and Teaching Materials Competition, 3rd place</strong></p><br>A freelance geologist was asked for advice regarding two mining claims to property on Sturgeon Lake, near Thunder Bay, Ontario. Specifically, he was asked if there was enough gold on the property to pursue an economically feasible mining opportunity. The geologist determined that an analytical approach would best aid the analysis of the multiple factors he would need to consider in arriving at a decision about whether or not to proceed with the mining operation. The first stage in ore extraction involved building an access road, and the second stage was to implement a drilling program. There was considerable uncertainty surrounding the costs and actual feasibility of completion of these stages; yet only when these stages were completed could actual mining of the property begin. If mining proceeded, it was assumed it would take 10 years to extract all the gold from the site, and the total amount of gold in the mine would be extracted at an even rate over the 10-year period. Mining costs were assumed to be $30 an ounce, and the geologist used a discount rate of 20 per cent before taxes when evaluating projects.

In recent years, many countries with publicly funded healthcare have started using cost-effectiveness analysis (CEA) along with review of clinical data as a tool to assess the overall benefit of a new drug to the society and set priorities with regards to health care budget. Cost effectiveness was formally incorporated into the Ontario drug review system in 1993 and the Canadian drug-review system in 2003. The issue of using cost effectiveness has become increasingly contentious in recent years: some newly approved cancer drugs cost $3,000 to $6,000 or more for one treatment cycle, but their high prices means that they were often classified as being not cost effective. This note reviews many of the competing interests in debates over drug funding and dilemmas about healthcare financing decisions in the presence of limited budgets.

This note presents an overview of ways in which statistical arguments are used in court cases. Topics covered include linear regression, significance, independence, bias, conditional probability, Baye's Theorem and inversion of conditional probabilities. In addition to these topics, the note contains a number of true examples where statistical reasoning has been used or misused as part of a legal argument.

This note gives step-by-step instructions on how to build a Monte Carlo simulation model in Microsoft Excel without using spreadsheet add-ins. The note explains the difference between random and uniformly distributed. The note also explains: how the Excel function RAND() works, how to use Excel functions like NORMINV() to simulate random numbers from distributions other than the uniform; how to use VLOOKUP() with tabulated data to simulate numbers from any arbitrary distribution, and how to use Data Tables to produce multiple iterations of a simulation model. The note concludes with an example that illustrates the use of all of these concepts.

In May 2008, the business manager at Western Day Care Centre (WDCC) was considering expanding the company's services at its Emery Street location. WDCC was currently running at full capacity with a continuously growing waiting list and demand for day care services was increasing. The business manager was evaluating the financial feasibility of renovating the first-floor gymnasium and converting it into a classroom. Incorporating the care requirements and regulations under Ontario's Day Nurseries Act, she wanted to know the total cost of the renovation, as well as the amount of new revenue that would be generated and the payback period. Financial modeling in a spreadsheet, cost-benefit analysis (differential analysis), and determining the decision variables are all techniques used to determine the feasibility of the renovation.

Instructor spreadsheet for product 8B09E06.

This note gives step-by-step instructions on how to build a Monte Carlo simulation model in Microsoft Excel without using spreadsheet add-ins. The note explains the difference between "random" and "uniformly distributed." The note also explains: how the Excel function RAND() works, how to use Excel functions like NORMINV() to simulate random numbers from distributions other than the uniform; how to use VLOOKUP() with tabulated data to simulate numbers from any arbitrary distribution, and how to use Data Tables to produce multiple iterations of a simulation model. The note concludes with an example that illustrates the use of all of these concepts.