Jifan Gao, Philip Mar, Zheng-Zheng Tang, Guanhua Chen
Objective: This study aims to develop machine learning models that provide both accurate and equitable predictions of 2-year stroke risk for patients with atrial fibrillation across diverse racial groups.
Materials and methods: Our study utilized structured electronic health records (EHR) data from the All of Us Research Program. Machine learning models (LightGBM) were utilized to capture the relations between stroke risks and the predictors used by the widely recognized CHADS2 and CHA2DS2-VASc scores. We mitigated the racial disparity by creating a representative tuning set, customizing tuning criteria, and setting binary thresholds separately for subgroups. We constructed a hold-out test set that not only supports temporal validation but also includes a larger proportion of Black/African Americans for fairness validation.
Results: Compared to the original CHADS2 and CHA2DS2-VASc scores, significant improvements were achieved by modeling their predictors using machine learning models (Area Under the Receiver Operating Characteristic curve from near 0.70 to above 0.80). Furthermore, applying our disparity mitigation strategies can effectively enhance model fairness compared to the conventional cross-validation approach.
Discussion: Modeling CHADS2 and CHA2DS2-VASc risk factors with LightGBM and our disparity mitigation strategies achieved decent discriminative performance and excellent fairness performance. In addition, this approach can provide a complete interpretation of each predictor. These highlight its potential utility in clinical practice.
Conclusions: Our research presents a practical example of addressing clinical challenges through the All of Us Research Program data. The disparity mitigation framework we proposed is adaptable across various models and data modalities, demonstrating broad potential in clinical informatics.
{"title":"Fair prediction of 2-year stroke risk in patients with atrial fibrillation.","authors":"Jifan Gao, Philip Mar, Zheng-Zheng Tang, Guanhua Chen","doi":"10.1093/jamia/ocae170","DOIUrl":"https://doi.org/10.1093/jamia/ocae170","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to develop machine learning models that provide both accurate and equitable predictions of 2-year stroke risk for patients with atrial fibrillation across diverse racial groups.</p><p><strong>Materials and methods: </strong>Our study utilized structured electronic health records (EHR) data from the All of Us Research Program. Machine learning models (LightGBM) were utilized to capture the relations between stroke risks and the predictors used by the widely recognized CHADS2 and CHA2DS2-VASc scores. We mitigated the racial disparity by creating a representative tuning set, customizing tuning criteria, and setting binary thresholds separately for subgroups. We constructed a hold-out test set that not only supports temporal validation but also includes a larger proportion of Black/African Americans for fairness validation.</p><p><strong>Results: </strong>Compared to the original CHADS2 and CHA2DS2-VASc scores, significant improvements were achieved by modeling their predictors using machine learning models (Area Under the Receiver Operating Characteristic curve from near 0.70 to above 0.80). Furthermore, applying our disparity mitigation strategies can effectively enhance model fairness compared to the conventional cross-validation approach.</p><p><strong>Discussion: </strong>Modeling CHADS2 and CHA2DS2-VASc risk factors with LightGBM and our disparity mitigation strategies achieved decent discriminative performance and excellent fairness performance. In addition, this approach can provide a complete interpretation of each predictor. These highlight its potential utility in clinical practice.</p><p><strong>Conclusions: </strong>Our research presents a practical example of addressing clinical challenges through the All of Us Research Program data. The disparity mitigation framework we proposed is adaptable across various models and data modalities, demonstrating broad potential in clinical informatics.</p>","PeriodicalId":50016,"journal":{"name":"Journal of the American Medical Informatics Association","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141499494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-03DOI: 10.1016/j.tourman.2024.104998
Ali Selcuk Can, Yuksel Ekinci, Setenay Dilek-Fidler
Narrative storytelling, a cornerstone of narrative persuasion theory, plays a crucial role in nurturing robust consumer-brand relationships. Understanding persuasive narratives within the social media domain is critical for destination brands. Hence, this study investigates the impact of realistic narratives on attitudinal destination brand loyalty, mediated by self-congruence and brand attachment across two experiments. Study 1 provides evidence for the superiority of adventure-themed realistic fictional narratives over fantasy one in Facebook advertisements. Study 2 supports the findings of Study 1 with a romantic-themed narrative and a diverse destination in Instagram advertisements. Moreover, Study 2 reveals that consumer fantasy proneness diminishes the influence of realistic fictional narratives on self-congruence. These findings suggest a strategic shift toward realistic narratives over fantasy ones to stimulate self-congruence and cultivate destination brand attachment, ultimately fortifying the bonds between travellers and destination brands.
{"title":"Fantasy or reality? Unveiling the power of realistic narratives in tourism social media advertising","authors":"Ali Selcuk Can, Yuksel Ekinci, Setenay Dilek-Fidler","doi":"10.1016/j.tourman.2024.104998","DOIUrl":"https://doi.org/10.1016/j.tourman.2024.104998","url":null,"abstract":"Narrative storytelling, a cornerstone of narrative persuasion theory, plays a crucial role in nurturing robust consumer-brand relationships. Understanding persuasive narratives within the social media domain is critical for destination brands. Hence, this study investigates the impact of realistic narratives on attitudinal destination brand loyalty, mediated by self-congruence and brand attachment across two experiments. Study 1 provides evidence for the superiority of adventure-themed realistic fictional narratives over fantasy one in Facebook advertisements. Study 2 supports the findings of Study 1 with a romantic-themed narrative and a diverse destination in Instagram advertisements. Moreover, Study 2 reveals that consumer fantasy proneness diminishes the influence of realistic fictional narratives on self-congruence. These findings suggest a strategic shift toward realistic narratives over fantasy ones to stimulate self-congruence and cultivate destination brand attachment, ultimately fortifying the bonds between travellers and destination brands.","PeriodicalId":48469,"journal":{"name":"Tourism Management","volume":null,"pages":null},"PeriodicalIF":12.7,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141521342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"管理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yingxiang Li, Yung-Fang Chen, Ziyi Wang, Ziqiang Han
Persons with disabilities (PwDs) face a disproportionately high risk due to their physical or mental limitations and socioeconomic barriers during emergencies. To better understand and empower PwDs for disaster preparedness, this study used an updated national representative survey (2021 Federal Emergency Management Agency National Household Survey) from the United States to examine the differences between PwDs and their counterparts concerning disaster preparedness with the guidance of the protection motivation theory. The results of the Tobit regression models indicated that being disabled was negatively correlated with the level of preparedness. Furthermore, disability status significantly and negatively modified the relationship between risk perception and disaster preparedness. Likewise, self-efficacy was less strongly correlated with preparedness activities if people self-reported themselves as having a disability. Moreover, for people with disabilities, their beliefs about the effectiveness of preventive behaviours (response efficacy) predicted decreased adoption of preparedness measures. Promoting disaster risk reduction education, strengthening self-efficacy and developing more inclusive and targeted intervention strategies for PwDs can be used to improve their preparedness degree and capacity for disaster prevention.
{"title":"Risk perception, efficacies and disaster preparedness: A comparison between people with and without disability","authors":"Yingxiang Li, Yung-Fang Chen, Ziyi Wang, Ziqiang Han","doi":"10.1111/1468-5973.12597","DOIUrl":"https://doi.org/10.1111/1468-5973.12597","url":null,"abstract":"<p>Persons with disabilities (PwDs) face a disproportionately high risk due to their physical or mental limitations and socioeconomic barriers during emergencies. To better understand and empower PwDs for disaster preparedness, this study used an updated national representative survey (2021 Federal Emergency Management Agency National Household Survey) from the United States to examine the differences between PwDs and their counterparts concerning disaster preparedness with the guidance of the protection motivation theory. The results of the Tobit regression models indicated that being disabled was negatively correlated with the level of preparedness. Furthermore, disability status significantly and negatively modified the relationship between risk perception and disaster preparedness. Likewise, self-efficacy was less strongly correlated with preparedness activities if people self-reported themselves as having a disability. Moreover, for people with disabilities, their beliefs about the effectiveness of preventive behaviours (response efficacy) predicted decreased adoption of preparedness measures. Promoting disaster risk reduction education, strengthening self-efficacy and developing more inclusive and targeted intervention strategies for PwDs can be used to improve their preparedness degree and capacity for disaster prevention.</p>","PeriodicalId":47674,"journal":{"name":"Journal of Contingencies and Crisis Management","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141536935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"管理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jan Acedański, Grzegorz Maciejewski, Jacek Pietrucha
This study examined why consumers who typically pay electronically at points of sale still carry cash and explained the inertia of demand for cash by considering the additional (perceived by consumers) characteristics of cash. The research was motivated by the growing discussion on why cash, despite the increasing importance of e-payments, remains a significant part of the demand for money. The study focused on psychological factors and consumers' perceptions of certain features of cash, which make it an attractive additional option for precautionary reasons, and therefore, explored beyond the typical discussion of money as a means of payment. The structural equation modeling based on data collected as part of a survey of Polish consumers was used to verify the hypotheses. It was revealed that cash becomes a reserve solution for consumers, which is kept “just in case” to expand the scope of personal freedom and flexibility in making payments and protect against various potential restrictions and threats related to e-payments. Consumers' holding of cash as an additional option depends on three key factors: attitude toward cash, particularly the flexibility it offers, unusual purchasing situations, and perceived card or mobile payment risk, considered as a moderator. In the debate on the future of cash, the study supports the position that cash has a place in the modern payment system, although it plays a different role. Cash is a supportive backup solution. Eliminating cash significantly reduces consumer welfare.
{"title":"Cash holding by consumers: The role of the perceived characteristics of money","authors":"Jan Acedański, Grzegorz Maciejewski, Jacek Pietrucha","doi":"10.1111/ijcs.13075","DOIUrl":"https://doi.org/10.1111/ijcs.13075","url":null,"abstract":"<p>This study examined why consumers who typically pay electronically at points of sale still carry cash and explained the inertia of demand for cash by considering the additional (perceived by consumers) characteristics of cash. The research was motivated by the growing discussion on why cash, despite the increasing importance of e-payments, remains a significant part of the demand for money. The study focused on psychological factors and consumers' perceptions of certain features of cash, which make it an attractive additional option for precautionary reasons, and therefore, explored beyond the typical discussion of money as a means of payment. The structural equation modeling based on data collected as part of a survey of Polish consumers was used to verify the hypotheses. It was revealed that cash becomes a reserve solution for consumers, which is kept “just in case” to expand the scope of personal freedom and flexibility in making payments and protect against various potential restrictions and threats related to e-payments. Consumers' holding of cash as an additional option depends on three key factors: attitude toward cash, particularly the flexibility it offers, unusual purchasing situations, and perceived card or mobile payment risk, considered as a moderator. In the debate on the future of cash, the study supports the position that cash has a place in the modern payment system, although it plays a different role. Cash is a supportive backup solution. Eliminating cash significantly reduces consumer welfare.</p>","PeriodicalId":48192,"journal":{"name":"International Journal of Consumer Studies","volume":null,"pages":null},"PeriodicalIF":8.6,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141536936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"管理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This paper studies how a federal procurement regulation, known as the Truth in Negotiations Act (TINA), affects the competitiveness and execution of government contracts. TINA stipulates how contracting officials (COs) can ensure reasonable prices. Following TINA, for contracts above a certain size threshold, COs can no longer rely solely on their own judgment that a price is reasonable. Instead, they must either require suppliers to provide accounting data supporting their proposed prices or expect multiple bids. Using a regression discontinuity design, I find that above-threshold contracts experience greater competition (i.e., more bids), improved performance (i.e., less frequent renegotiations and cost overruns), and reduced use of the harder-to-monitor cost-plus pricing, compared to below-threshold contracts. These findings suggest that TINA's requirements enhance competition and oversight for above-threshold contracts.
{"title":"Show Your Hand: The Impacts of Fair Pricing Requirements in Procurement Contracting","authors":"BRAD NATHAN","doi":"10.1111/1475-679x.12561","DOIUrl":"https://doi.org/10.1111/1475-679x.12561","url":null,"abstract":"This paper studies how a federal procurement regulation, known as the Truth in Negotiations Act (TINA), affects the competitiveness and execution of government contracts. TINA stipulates how contracting officials (COs) can ensure reasonable prices. Following TINA, for contracts above a certain size threshold, COs can no longer rely solely on their own judgment that a price is reasonable. Instead, they must either require suppliers to provide accounting data supporting their proposed prices or expect multiple bids. Using a regression discontinuity design, I find that above-threshold contracts experience greater competition (i.e., more bids), improved performance (i.e., less frequent renegotiations and cost overruns), and reduced use of the harder-to-monitor cost-plus pricing, compared to below-threshold contracts. These findings suggest that TINA's requirements enhance competition and oversight for above-threshold contracts.","PeriodicalId":48414,"journal":{"name":"Journal of Accounting Research","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141496071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"管理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-03DOI: 10.1007/s11365-024-00993-3
Vanitha Prasannath, Rajendra P. Adhikari, Sarel Gronum, Morgan P. Miles
Small and medium enterprises (SMEs) are often resource-constrained and motivated by necessity or opportunity. They play an essential role in national economies due to their contributions to employment, human capital development, knowledge spillovers, and social mobility in maintaining diverse entrepreneurial ecosystems. Government support policies (GSP), both financial and nonfinancial, can directly impact SME performance or indirectly by developing an entrepreneurial orientation (EO). Few studies have investigated the important question of how GSP simultaneously may impact both the EO and the performance of an SME. Thus, this paper aims to identify the current understanding of how different forms of GSPs relate to and impact the EO and the performance of SMEs. A systematic literature review was conducted using the PRISMA methodology to synthesize this understanding, resulting in 65 relevant articles from the ABI/INFORM, ScienceDirect, Scopus and Web of Science databases. The relationships between the constructs were analyzed using thematic and semantic analyses, employing computer-assisted data analysis software (NVivo 12 and Leximancer 4.5). This resulted in the categorization of GSPs as direct and indirect support policies, with financial and nonfinancial-subcategories, and depicted their pathways of influence on SMEs’ EO and performance. The study found that GSPs have four different pathways by which they can impact performance. Both direct and indirect policies have moderating effects that can magnify the impact of EO on performance. The review established that the direct effect of GSP on EO varies by sector, SME growth-intention, and type of GSP. Based on the findings, we recommend policymakers develop support policies tailored to SMEs’ specific sector and its intentions to enhance performance.
中小型企业(SMEs)往往资源有限,出于需要或机遇。它们在国民经济中发挥着至关重要的作用,因为它们在维持多样化创业生态系统的过程中促进了就业、人力资本发展、知识外溢和社会流动。政府的财政和非财政支持政策(GSP)可以直接影响中小企业的表现,也可以通过培养创业导向(EO)间接影响中小企业的表现。对于 GSP 如何同时影响中小企业的创业导向和绩效这一重要问题,很少有研究进行过调查。因此,本文旨在确定目前对不同形式的全球战略优先事项如何与创业导向和中小企业绩效相关并产生影响的理解。本文采用 PRISMA 方法进行了系统的文献综述,从 ABI/INFORM、ScienceDirect、Scopus 和 Web of Science 数据库中收集了 65 篇相关文章。利用计算机辅助数据分析软件(NVivo 12 和 Leximancer 4.5),通过主题分析和语义分析,分析了各构念之间的关系。研究结果将普惠制分为直接支持政策和间接支持政策,以及财政支持政策和非财政支持政策两个子类别,并描绘了普惠制对中小企业企业经营和绩效的影响路径。研究发现,普惠制有四种影响绩效的不同途径。直接和间接政策都有调节作用,可以放大企业经营对绩效的影响。研究发现,普惠制对企业经营绩效的直接影响因行业、中小企业增长意愿和普惠制类型而异。根据研究结果,我们建议政策制定者针对中小企业的具体行业及其提高绩效的意图制定相应的支持政策。
{"title":"Impact of government support policies on entrepreneurial orientation and SME performance","authors":"Vanitha Prasannath, Rajendra P. Adhikari, Sarel Gronum, Morgan P. Miles","doi":"10.1007/s11365-024-00993-3","DOIUrl":"https://doi.org/10.1007/s11365-024-00993-3","url":null,"abstract":"<p>Small and medium enterprises (SMEs) are often resource-constrained and motivated by necessity or opportunity. They play an essential role in national economies due to their contributions to employment, human capital development, knowledge spillovers, and social mobility in maintaining diverse entrepreneurial ecosystems. Government support policies (GSP), both financial and nonfinancial, can directly impact SME performance or indirectly by developing an entrepreneurial orientation (EO). Few studies have investigated the important question of how GSP simultaneously may impact both the EO and the performance of an SME. Thus, this paper aims to identify the current understanding of how different forms of GSPs relate to and impact the EO and the performance of SMEs. A systematic literature review was conducted using the PRISMA methodology to synthesize this understanding, resulting in 65 relevant articles from the ABI/INFORM, ScienceDirect, Scopus and Web of Science databases. The relationships between the constructs were analyzed using thematic and semantic analyses, employing computer-assisted data analysis software (NVivo 12 and Leximancer 4.5). This resulted in the categorization of GSPs as direct and indirect support policies, with financial and nonfinancial-subcategories, and depicted their pathways of influence on SMEs’ EO and performance. The study found that GSPs have four different pathways by which they can impact performance. Both direct and indirect policies have moderating effects that can magnify the impact of EO on performance. The review established that the direct effect of GSP on EO varies by sector, SME growth-intention, and type of GSP. Based on the findings, we recommend policymakers develop support policies tailored to SMEs’ specific sector and its intentions to enhance performance.</p>","PeriodicalId":48058,"journal":{"name":"International Entrepreneurship and Management Journal","volume":null,"pages":null},"PeriodicalIF":5.6,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141511750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"管理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}