Digital Public Defence: Lars Asphaug
MSc Lars Asphaug at Institute of Health and Society will be defending the thesis “Economic Analyses of Targeted Prevention” for the degree of PhD (Philosophiae Doctor).
Photo: Geir Anders Rybakken Ørslien
The University of Oslo is closed and the public defence will be held as a video conference over Zoom.
The defence will follow regular procedure as far as possible, hence it will be open to the public and the audience can ask ex auditorio questions when invited to do so.
Digital trial Lecture – time and place
- First opponent: Professor Luke Connelly, University of Queensland, Australia
- Second opponent: Associate Professor Bethany Shinkins, University of Leeds, UK
- Third member and chair of the evaluation committee: Associate Professor Jon Michael Gran, University of Oslo
Chair of the Defence
Professor Emeritus Ivar Sønbø Kristiansen, University of Oslo
Associate Professor Hans Olav Melberg, University of Oslo
New diagnostic tests are needed to enable reducing the burden from preventable health problems. Recent technological advancement in testing has improved our abilities to identify markers of increased disease risk, at a molecular level of detail. Higher than normal risk may for some diseases call for early intervention to avoid manifestation or worsening of an existing condition. In other cases, there may be ambiguity in how much of a health hazard an increased risk really is. If so, the need for prevention may be less urgent, especially if the preventive measures themselves have a certain health burden. Empirical support for a risk marker’s degree of harmfulness takes time to compile, and evidence may be weak initially. This is often the case for novel mutations associated with risk of future cancer development. For such tests, it is less clear whether test-positives will get a better future health by undergoing preventive measures such as risk-reducing surgery. It is therefore not obvious whether testing to uncover such mutations should be part of standard practice efforts. In other instances, preventive options for test-positives may be somewhat ineffective at reducing risk, making it difficult to establish the value of targeting prevention via such a test. The overall health outcomes of new targeted preventive options can therefore be in sum both positive and negative. Similarly, these efforts may reduce healthcare costs as potentially costly future disease is avoided, yet costs tend to increase in the short term to identify at-risk individuals and give them the appropriate preventive treatment. These trade-offs are central themes of this thesis. Through three research papers and an interrelating synopsis, the health economic consequences of new targeted preventive strategies are explored. Mathematical decision models are used to establish predictions of future value to patients’ health and the economic acceptability to healthcare payers.
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