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PurposeTo compare an individual’s Personal Performance in Mammographic Screening (PERFORMS) score with their Breast Screening Information System (BSIS) real-life performance data and determine which parameters in the PERFORMS scheme offer the best reflection of BSIS real-life performance metrics.Materials and MethodsIn this retrospective study, the BSIS real-life performance metrics of individual readers (n = 452) in the National Health Service Breast Screening Program (NHSBSP) in England were compared with performance in the test set–based assessment scheme over a 3-year period from 2013 to 2016. Cancer detection rate (CDR), recall rate, and positive predictive value (PPV) were calculated for each reader, for both real-life screening and the PERFORMS test. For each metric, real-life and test set versions were compared using a Pearson correlation. The real-life CDR, recall rate, and PPV of outliers were compared against other readers (nonoutliers) using analysis of variance.ResultsBSIS real-life CDRs, recall rates, and PPVs showed positive correlations with the equivalent PERFORMS measures (P < .001, P = .002, and P < .001, respectively). The mean real-life CDR of PERFORMS outliers was 7.2 per 1000 women screened and was significantly lower than other readers (nonoutliers) where the real-life CDR was 7.9 (P = .002). The mean real-life screening PPV of PERFORMS outliers was 0.14% and was significantly lower than the nonoutlier group who had a mean PPV of 0.17% (P = .006).ConclusionThe use of test set–based assessment schemes in a breast screening program has the potential to predict and identify poor performance in real life.

In this paper we examine the impact of a tailored health warning on health outcomes. We exploit the design of a household panel survey that provided feedback to participants on their blood-pressure levels as a quasi-experiment. We find that many participants who were told their blood-pressure was high went on to get a formal diagnosis of hypertension from a medical practitioner. The effect of getting a formal hypertension diagnosis was to reduce the incidence of smoking and improve the quality of diets. However, we do not find changes in monthly alcohol spending. The behavioural changes (plus any prescribed medications) were large enough to reduce the incidence of cardiovascular disease.

We provide causal evidence of the impact of the Brexit referendum vote on hate crime in the United Kingdom (UK). Using various data sources, including unique data collected from the UK Police Forces by Freedom of Information (FOI) requests, and various estimation methods (difference-in-differences, event-study analysis and synthetic control methods), we find that the Brexit referendum led to an increase in hate crime by around 15-25%. This effect was concentrated in the first quarter after the referendum and was larger in areas that voted to leave the European Union (EU). We also provide evidence against the hypotheses that this was due to victims' greater willingness to report crimes or due to changes in police behaviour and perceptions of the victims. We also present suggestive evidence that the media and social media played a small but significant role in the increase in hate crime.

We investigate whether short-term everyday stressors leads to unhealthier dietary choices among low socioeconomic status mothers. We propose a novel stress protocol that aims to mimic everyday stressors experienced by this population, involving time and financial pressure. We evaluate the impact of stress on immediate and planned food choices, comparing a group exposed to our stress protocol relative to a control group. Immediate consumption is measured with in-laboratory consumption of low calorie and high calorie snacks; planned consumption is measured with an incentivized food shopping task. The stressfulness of the stress protocol is evaluated using subjective assessments, as well as physiological measurements (heart rate and salivary cortisol levels). We find no evidence of an effect of stress on the nutritional content of immediate or planned food consumption, thus no support for the hypothesis that everyday stressors are a likely explanation for unhealthy food choices.

We examine the impact of financial distress conditions at the individual firm level, the operating industry level, and economy-wide, on the stock price reaction to divestment announcements. This allows us to isolate distinct fire sale and financing theoretical explanations of asset divestments. We find that abnormal returns are significantly lower when firms divest assets during periods of industry-wide distress. During these periods the natural buyers of the divested assets are likely to have liquidity constraints, and so selling firms receive a lower price (Shleifer and Vishny, 1992). Fire sale effects from divestments are driven by financially constrained firms, firms selling core assets, small firms, and increase with deal size. We find some support for the financing explanation of the stock price response to divestments during periods of overlapping firm-level and economy-wide financial distress conditions, suggesting that divesting assets reduce the expected value of bankruptcy costs for selling firms under these conditions.

Supplemental Digital Content is available in the text, Objective: To investigate differences in methylation between patients with nondysplastic Barrett esophagus who progress to invasive adenocarcinoma and those who do not. Background: Identifying patients with nondysplastic Barrett esophagus who progress to invasive adenocarcinoma remains a challenge. Previous studies have demonstrated the potential utility of epigenetic markers for identifying this group. Methods: A whole genome methylation interrogation using the Illumina HumanMethylation 450 array of patients with nondysplastic Barrett esophagus who either develop adenocarcinoma or remain static, with validation of findings by bisulfite pyrosequencing. Results: In all, 12 patients with “progressive” versus 12 with “nonprogressive” nondysplastic Barrett esophagus were analyzed via methylation array. Forty-four methylation markers were identified that may be able to discriminate between nondysplastic Barrett esophagus that either progress to adenocarcinoma or remain static. Hypomethylation of the recently identified tumor suppressor OR3A4 (probe cg09890332) validated in a separate cohort of samples (median methylation in progressors 67.8% vs 96.7% in nonprogressors; P = 0.0001, z = 3.85, Wilcoxon rank-sum test) and was associated with the progression to adenocarcinoma. There were no differences in copy number between the 2 groups, but a global trend towards hypomethylation in the progressor group was observed. Conclusion: Hypomethylation of OR3A4 has the ability to risk stratify the patient with nondysplastic Barrett esophagus and may form the basis of a future surveillance program.

This paper tests an intervention aimed at facilitating (cognitively) the adoption of healthy dietary habits. We provide easy-to-understand information about the risks of developing diabetes or heart diseases and give easy-to-follow dietary recommendations to minimize these risks. We implement two variations, one consisting of generic information, the other consisting of information tailored to the individual, the latter resembling newly developed on-line health assessment tools. On top of the information treatment, we implement a second experimental variation nudging people into spending more time thinking about their dietary choices. We find evidence that the information intervention leads to healthier choices in the short run, but mostly in the generic treatment. Surprisingly, we find that people are on average pessimistic about their health, and therefore receive good news on average when the information is tailored to them. We find no evidence that increasing the time available to make choices leads to healthier choices, and find no evidence of long-term changes in habits. These results do not support a bounded rationality explanation for poor dietary choices.

We present and evaluate a new incentive-based tool to measure people’s dietarychoices in a low-cost and time effective manner. Respondents are asked to allocatea fixed monetary budget across a choice of around a hundred grocery items with theprospect of receiving these items with some probability delivered to their home by areal supermarket. The tool has the advantage of offering a broad coverage of dietarychoices, allows inference of macro-nutrients and calorie, and allows the researcher to fixthe choice set participants can choose from. We compare the information derived fromour incentivized tool, and compare it to alternative low-cost ways of measuring dietaryintake, namely the food frequency questionnaire and a one-shot version of the 24hour dietary recall, which are both based on self-reports. We invited 255 low incomeparticipants to our laboratory and collected measures using these three alternativetools. We compare the calorie intake indicators derived from each tool with a numberof biometric measures for each subject, namely weight, body-mass-index (BMI) andwaist size. The results show that the dietary information collected is only weaklycorrelated across the three tools. We also find that only the calorie intake measure fromour incentivized tool is positively and significantly related to each of these biometricindicators. By contrast, we find no significant correlations for either of the two measuresbased on self-reports. We therefore argue that our tool may be useful for researchconducted with limited time and budget.