Do large mergers increase or decrease the productivity of pharmaceutical R&D?

There is current uncertainty regarding the effects of mergers on pharmaceutical R&D productivity, with various mechanisms reported by which mergers could either help or harm R&D, and mixed empirical findings in prior analyses. Here, we present an analysis that is novel in several ways: we use downstream measures of R&D productivity, account for both inputs and outputs in our calculations, and use a self-controlled design. We find that recent large pharmaceutical mergers are associated with statistically significant increases in R&D productivity. These results are perhaps not surprising in light of the broader literature on R&D productivity that points to two factors as instrumental in driving higher R&D productivity (depth of scientific information, and objectivity of decision-making based on that information), both of which could be expected to increase because of a merger.

Knowledge-based bioterrorism surveillance.

An epidemic resulting from an act of bioterrorism could be catastrophic. However, if an epidemic can be detected and characterized early on, prompt public health intervention may mitigate its impact. Current surveillance approaches do not perform well in terms of rapid epidemic detection or epidemic monitoring. One reason for this shortcoming is their failure to bring existing knowledge and data to bear on the problem in a coherent manner. Knowledge-based methods can integrate surveillance data and knowledge, and allow for careful evaluation of problem-solving methods. This paper presents an argument for knowledge-based surveillance, describes a prototype of BioSTORM, a system for real-time epidemic surveillance, and shows an initial evaluation of this system applied to a simulated epidemic from a bioterrorism attack.

A student-initiated interactive course as a model for teaching reproductive health.

OBJECTIVE: Medical students at Stanford University established an elective lecture series in reproductive health to teach 10 women's health competencies to preclinical medical students. In the second year, student organizers implemented interactive components to improve the number of competencies students learned. STUDY DESIGN: We surveyed students from the first two years this series was offered to assess their preferred modes of learning and the number of competencies students perceived they had gained. Students were asked to self-assess their learning of key reproductive health competencies taught in the course. RESULTS: We identified 4 factors associated with statistically significant improvements in the number of competencies students learned, according to self-assessment. CONCLUSION: Students who felt they learned more competencies agreed that they were active participants in the course, that their preferred style of learning was matched by the course, and that they had received academic credit for the course. Furthermore, students who attended an innovative reproductive health fair organized by students participating in the course perceived that they had learned significantly more competencies. We expect these self-assessed improvements to correlate with increased demonstration of the competencies as students progress to the clinical level.