scholarly journals A Cost-Effectiveness Protocol for Flood-Mitigation Plans Based on Leeds’ Boxing Day 2015 Floods

Water ◽  
2020 ◽  
Vol 12 (3) ◽  
pp. 652 ◽  
Author(s):  
Onno Bokhove ◽  
Mark A. Kelmanson ◽  
Thomas Kent ◽  
Guillaume Piton ◽  
Jean-Marc Tacnet

Inspired by the Boxing Day 2015 flood of the River Aire in Leeds, UK, and subsequent attempts to mitigate adverse consequences of flooding, the goals considered are: (i) to revisit the concept of flood-excess volume (FEV) as a complementary diagnostic for classifying flood events; (ii) to establish a new roadmap/protocol for assessing flood-mitigation schemes using FEV; and, (iii) to provide a clear, graphical cost-effectiveness analysis of flood mitigation, exemplified for a hypothetical scheme partially based on actual plans. We revisit the FEV concept and present it as a three-panel graph using thresholds and errors. By re-expressing FEV as a 2 m -deep square lake of equivalent capacity, one can visualise its dimensions in comparison with the river valley considered. Cost-effectiveness of flood-mitigation measures is expressed within the FEV square-lake; different scenarios of our hypothetical flood-mitigation scheme are then presented and assessed graphically, with each scenario involving a combination, near and further upstream of Leeds, of higher (than existing) flood-defence walls, enhanced flood-plain storage sites, giving-room-to-the-river bed-widening and natural flood management. Our cost-effectiveness analysis is intended as a protocol to compare and choose between flood-mitigation scenarios in a quantifiable and visual manner, thereby offering better prospects of being understood by a wide audience, including citizens and city-council planners. Using techniques of data analysis combined with general river hydraulics, common-sense and upper-bound estimation, we offer an accessible check of flood-mitigation plans.

2002 ◽  
Author(s):  
Eugene Laska ◽  
Morris Meisner ◽  
Carole Siegel ◽  
Joseph Wanderling

1998 ◽  
Vol 80 (12) ◽  
pp. 887-893 ◽  
Author(s):  
Jacopo Gianetti ◽  
Gianfranco Gensini ◽  
Raffaele De Caterina

SummaryAims. The recent publication of two large trials of secondary prevention of coronary artery disease with oral anticoagulants (WARIS and ASPECT) has caused a revival of the interest for this antithrombotic therapy in a clinical setting where the use of aspirin is common medical practice. Despite this, the preferential use of aspirin has been supported by an American cost-effectiveness analysis (JAMA 1995; 273: 965). Methods and Results. Using the same parameters used in that analysis and incidence of events from the Antiplatelet Trialists Collaboration and the ASPECT study, we re-evaluated the economic odds in favor of aspirin or oral anticoagulants in the Italian Health System, which differs significantly in cost allocation from the United States system and is, conversely, similar to other European settings. Recalculated costs associated with each therapy were 2,150 ECU/ patient/year for oral anticoagulants and 2,187 ECU/patient/year for aspirin. In our analysis, the higher costs of oral anticoagulants versus aspirin due to a moderate excess of bleeding (about 10 ECU/ patient/year) and the monitoring of therapy (168 ECU/ patient/year) are more than offset by an alleged savings for recurrent ischemic syndromes and interventional procedures (249 ECU/ patient/year). Conclusions. Preference of aspirin vs. oral anticoagulants in a pharmaco-economical perspective is highly dependent on the geographical situation whereupon calculations are based. On a pure cost-effectiveness basis, and in the absence of data of direct comparisons between aspirin alone versus I.N.R.-adjusted oral anticoagulants, the latter are not more expensive than aspirin in Italy and, by cost comparisons, in other European countries in the setting of post-myocardial infarction.


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