• No results found

Patient Reported Outcomes in Cleft Lip and Palate Stiernman, Mia

N/A
N/A
Protected

Academic year: 2022

Share "Patient Reported Outcomes in Cleft Lip and Palate Stiernman, Mia"

Copied!
63
0
0

Loading.... (view fulltext now)

Full text

(1)

LUND UNIVERSITY PO Box 117 221 00 Lund +46 46-222 00 00

Patient Reported Outcomes in Cleft Lip and Palate

Stiernman, Mia

2019

Document Version:

Publisher's PDF, also known as Version of record Link to publication

Citation for published version (APA):

Stiernman, M. (2019). Patient Reported Outcomes in Cleft Lip and Palate. [Doctoral Thesis (compilation), Department of Clinical Sciences, Malmö]. Lund University: Faculty of Medicine.

Total number of authors:

1

General rights

Unless other specific re-use rights are stated the following general rights apply:

Copyright and moral rights for the publications made accessible in the public portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognise and abide by the legal requirements associated with these rights.

• Users may download and print one copy of any publication from the public portal for the purpose of private study or research.

• You may not further distribute the material or use it for any profit-making activity or commercial gain • You may freely distribute the URL identifying the publication in the public portal

Read more about Creative commons licenses: https://creativecommons.org/licenses/

Take down policy

If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim.

(2)

Patient Reported Outcomes in Cleft Lip and Palate

MIA STIERNMAN

CLINICAL SCIENCES, MALMÖ | FACULTY OF MEDICINE | LUND UNIVERSITY

(3)

Department of Clinical Sciences, Malmö Lund University, Faculty of Medicine

Doctoral Dissertation Series 2019:83 ISBN 978-91-7619-812-4 ISSN 1652-8220 MIA STIERNMAN is currently working as a surgical resident (ST-läkare) at the

Department of Plastic and Reconstructive Surgery, Skåne Univeristy Hospital, Malmö, Sweden. In this thesis, patient reported outcomes in cleft lip and pal- ate are studied. Questionnaire, focus group discussion and interview research methods were used. Patient reported outcomes are an important source of information to guide clinical work, for development of care and in research on cleft lip and palate.

9789176198124

(4)

3DWLHQW5HSRUWHG2XWFRPHVLQ

&OHIW/LSDQG3DODWH

0LD6WLHUQPDQ

'2&725$/',66(57$7,21

E\GXHSHUPLVVLRQRIWKH)DFXOW\RI0HGLFLQH/XQG8QLYHUVLW\6ZHGHQ

7REHGHIHQGHGDW/RFXV0HGLFXV0DOPRHQVLV'DWHDW

Faculty opponent

$VVRFLDWH3URIHVVRU$JQHWD0DUFXVVRQ''63K'

0D[LORIDFLDO8QLW'HSDUWPHQWRI&OLQLFDODQG([SHULPHQWDO0HGLFLQH

/LQN|SLQJ8QLYHUVLW\/LQN|SLQJ6ZHGHQ

(5)

2UJDQL]DWLRQ /81'81,9(56,7<

'RFXPHQWQDPH3DWLHQW5HSRUWHG2XWFRPHVLQ&OHIW/LSDQG

3DODWH

'DWHRILVVXH

$XWKRU V 0LD6WLHUQPDQ 6SRQVRULQJRUJDQL]DWLRQ

7LWOHDQGVXEWLWOH3DWLHQW5HSRUWHG2XWFRPHVLQ&OHIW/LSDQG3DODWH

$EVWUDFW

$LP 3DWLHQWUHSRUWHGRXWFRPHPHDVXUHV 3520V TXDQWLI\YDULRXVGRPDLQVRIKHDOWKUHODWHGTXDOLW\RIOLIH +542/  IURPWKHSDWLHQWSHUVSHFWLYH7KHRYHUDOODLPRIWKLVWKHVLVZDVWRLQYHVWLJDWH SDWLHQWUHSRUWHGRXWFRPHV 352V LQ

SDWLHQWVZLWKFOHIWOLSDQGRUSDODWH &/3 

0HWKRG 352VZHUH LQYHVWLJDWHGLQWKH&/3SRSXODWLRQZLWK3520V DQGLQWHUYLHZV+HDOWKFDUHSURIHVVLRQDO +&3  H[SHULHQFHRILPSOHPHQWLQJ352VZDVLQYHVWLJDWHGZLWKIRFXVJURXSGLVFXVVLRQ3DWLHQWV ZKRKDGEHHQLQYHVWLJDWHG

IRU YHORSKDU\QJHDOG\VIXQFWLRQ 93' FRPSOHWHGDTXHVWLRQQDLUHRQVDWLVIDFWLRQZLWKVSHHFK3DUHQWVRIFKLOGUHQZLWK

&/3DQG+&3VZHUHLQWHUYLHZHGUHJDUGLQJSV\FKRVRFLDODQGHGXFDWLRQDOLVVXHV7KH&OHIW+HDULQJ$SSHDUDQFHDQG

6SHHFK4XHVWLRQQDLUH &+$64 ZDVWUDQVODWHGDQGLPSOHPHQWHGLQFRXQWULHV&+$64ZDVWHVWHGLQDFRQWURO

SRSXODWLRQDQGFRPSDUHGZLWKUHVXOWVRIWKH&/3SRSXODWLRQ5HVXOWVRI&+$64DQG&/()74ZHUHFRPSDUHGDQG

SDWLHQWRSLQLRQRQWKHWZR3520VZHUHLQYHVWLJDWHG

5HVXOWV 0RVWSDWLHQWVZLWK93' ZKRXQGHUZHQWHYDOXDWLRQDQGWUHDWPHQWIHOWWKDWVXUJHU\DQGVSHHFKWKHUDS\KDG

LPSURYHGWKHLUVSHHFKEXWXOWLPDWHO\ RQO\DSSUR[LPDWHO\ RIWKHPZHUHVDWLVILHGZLWKWKHTXDOLW\RIWKHLUVSHHFK

3DUHQWDOH[SHULHQFHDQGYLHZVZHUHGLYHUVHUDQJLQJIURPWKHRSLQLRQWKDWWKHUHZHUHQRVSHFLILFSUREOHPVUHODWHGWR

WKHFOHIW WRDFOHDUH[SUHVVLRQ RIERWKHPRWLRQDODQGHGXFDWLRQDOLVVXHV7KHYLHZVDQGOHYHORINQRZOHGJHRI+&3V DOVRYDULHG$OO+&3VKRZHYHUZLVKHGIRUPRUHLQIRUPDWLRQDQGWUDLQLQJUHJDUGLQJSV\FKRVRFLDODQGHGXFDWLRQDO

LVVXHVDQGWUHDWPHQW7KH&+$64ZDVWUDQVODWHGLQWRHLJKW ODQJXDJHV%XOJDULDQ(VWRQLDQ*UHHN/DWYLDQ

0DFHGRQLDQ5RPDQLDQ6HUELDQDQG6ZHGLVK'LIIHUHQWOHYHOVRIVDWLVIDFWLRQEHWZHHQFRXQWULHV ZHUHUHYHDOHG

7KHUHZHUHSDWLHQWVLQDOOFRXQWULHVZKRZHUHOHVV VDWLVILHGWKDQH[SHFWHGDQGWKHUHIRUH VKRXOGEHLGHQWLILHGIRU

IXUWKHULQYHVWLJDWLRQRUWUHDWPHQW&OLQLFLDQVLQPXOWLSOH FRXQWULHV H[SUHVVHGWKHXVHIXOQHVVRI &+$64LQWKHLUFOLQLFDO

ZRUN,WZDVSHUFHLYHGDVXVHIXOVKRUWDQGHDV\WRLPSOHPHQW&+$64FRXOG EHDQ HIIHFWLYH LQVWUXPHQWIRUFROOHFWLRQ

RI352V RQVDWLVIDFWLRQZLWKKHDULQJDSSHDUDQFHDQGVSHHFK &KLOGUHQDQG\RXQJSHRSOHZLWK&/3 ZHUHDVVDWLVILHG

ZLWKWKHLUDSSHDUDQFHKHDULQJDQGVSHHFKDVFKLOGUHQDQG\RXQJSHRSOHZLWKRXW&/3 6FRUHVIURP&+$64DQG

&/()74FRUUHODWHGZHOO3DWLHQWVWKRXJKWWKDW &+$64 ZDVHDVLHUWRFRPSOHWHWKDQ&/()74 7KH\ OLNHG &/()74 PRUHDQGWKRXJKWWKDW LW EHWWHULQIRUPHG+&3V DERXWWKHLUWKRXJKWVRSLQLRQVDQGIHHOLQJVWKDQ &+$64

&RQFOXVLRQ 352VLQWKH&/3SRSXODWLRQLQGLFDWHDJHQHUDOO\KLJKOHYHORIVDWLVIDFWLRQZLWKRXWFRPH ZKLFKLV

FRPSDUDEOHWRWKDWRIDFRQWUROSRSXODWLRQLQUHJDUGWRVDWLVIDFWLRQZLWKKHDULQJDSSHDUDQFHDQGVSHHFK $3520

FRXOGEHDXVHIXOLQVWUXPHQWIRULPSURYHGFRPPXQLFDWLRQEHWZHHQFOLQLFLDQVDQGSDWLHQWVDQGWKHLUIDPLOLHV(IIRUWVIRU

FDUHDQGUHVHDUFKLQWKH&/3SRSXODWLRQ VKRXOGLQFOXGHLPSOHPHQWDWLRQRID&/3VSHFLILFDQGKROLVWLF3520

&RQVHQVXVRQDQ LQWHUQDWLRQDOOHYHO RI DGDSWLRQRIWKHVDPH3520DQGPHWKRGIRULPSOHPHQWDWLRQLVIDYRXUDEOH

.H\ZRUGV3DWLHQW5HSRUWHG2XWFRPHV&OHIW/LSDQG3DODWH+HDOWK5HODWHG4XDOLW\RI/LIH

&ODVVLILFDWLRQV\VWHPDQGRULQGH[WHUPV LIDQ\

6XSSOHPHQWDU\ELEOLRJUDSKLFDOLQIRUPDWLRQ /DQJXDJH

,661 DQGNH\WLWOH  ,6%1 

5HFLSLHQW¶VQRWHV 1XPEHU RI SDJHV 3ULFH

6HFXULW\FODVVLILFDWLRQ

,WKHXQGHUVLJQHGEHLQJWKHFRS\ULJKWRZQHURIWKHDEVWUDFWRIWKHDERYHPHQWLRQHGGLVVHUWDWLRQKHUHE\JUDQWWRDOO

UHIHUHQFHVRXUFHVSHUPLVVLRQWRSXEOLVKDQGGLVVHPLQDWHWKHDEVWUDFWRIWKHDERYHPHQWLRQHGGLVVHUWDWLRQ

6LJQDWXUH 'DWH

(6)

3DWLHQW5HSRUWHG2XWFRPHV,Q

&OHIW/LSDQG3DODWH

0LD6WLHUQPDQ0'

)DFXOW\RI0HGLFLQH 'HSDUWPHQWRI3ODVWLFDQG5HFRQVWUXFWLYH6XUJHU\

'HSDUWPHQWRI&OLQLFDO6FLHQFHV0DOP|/XQG8QLYHUVLW\6ZHGHQ

6XSHUYLVRU$VVRFLDWH3URIHVVRU0DJQXV%HFNHU0'3K'

)DFXOW\RI0HGLFLQH 'HSDUWPHQWRI3ODVWLFDQG5HFRQVWUXFWLYH6XUJHU\

'HSDUWPHQWRI&OLQLFDO6FLHQFHV0DOP|/XQG8QLYHUVLW\6ZHGHQ

&RVXSHUYLVRU.ULVWLQD.OLQW|06F3K'

)DFXOW\RI0HGLFLQH'HSDUWPHQWRI2WRUKLQRODU\QJRORJ\

'HSDUWPHQWRI&OLQLFDO6FLHQFHV0DOP|/XQG8QLYHUVLW\6ZHGHQ

&RVXSHUYLVRU$VVRFLDWH3URIHVVRU0DUWLQ3HUVVRQ03+ 06F3K'

)DFXOW\RI+HDOWK6FLHQFHV.ULVWLDQVWDG8QLYHUVLW\6ZHGHQ

&RVXSHUYLVRU3URIHVVRU+HQU\6YHQVVRQ0'3K'

)DFXOW\RI0HGLFLQH'HSDUWPHQWRI3ODVWLFDQG5HFRQVWUXFWLYH6XUJHU\

'HSDUWPHQWRI&OLQLFDO6FLHQFHV0DOP|/XQG8QLYHUVLW\6ZHGHQ

(7)

&RYHUSKRWR E\ 0LD6WLHUQPDQPRGHO-RKDQQD*XGMRQVGRWWLU

&RYHUSKRWREDFNE\'DYLG1RUGOXQG

&RS\ULJKW0LD6WLHUQPDQ

3DSHU‹-RXUQDORI3ODVWLF6XUJHU\DQG +DQG6XUJHU\

3DSHU‹(XURSHDQ-RXUQDORI3ODVWLF6XUJHU\

3DSHU‹(XURSHDQ-RXUQDORI3ODVWLF6XUJHU\

3DSHU‹E\WKH$XWKRUV 0DQXVFULSWXQSXEOLVKHG  3DSHU ‹E\WKH$XWKRUV 0DQXVFULSWXQSXEOLVKHG 

)DFXOW\ RI0HGLFLQH

'HSDUWPHQW RI&OLQLFDO6FLHQFHV, 0DOP|

,6%1

,661

3ULQWHGLQ6ZHGHQE\0HGLD7U\FN/XQG8QLYHUVLW\

/XQG

(8)

Science is a powerful force for change in modern society and plastic surgeons have a responsibility to shepherd that change with thoughtful advocacy and careful ethical scrutiny of their own behaviour (Sterodimas et al. 2011).

(9)

7DEOHRI&RQWHQWV

2ULJLQDOVWXGLHV 7KHVLVDWDJODQFH

$EEUHYLDWLRQV ,QWURGXFWLRQ

&OHIWOLSDQGRUSDODWH &/3 

&/3WUHDWPHQWLQ6ZHGHQ 7KH6ZHGLVK&/3UHJLVWU\ +HDOWK5HODWHG4XDOLW\RI/LIH +542/  3DWLHQW5HSRUWHG2XWFRPH0HDVXUHV 3520V  3V\FKRPHWULFPHWKRGV 4XDOLW\RI3520V /HYHORIVSHFLILFLW\RI3520VLQ&/3+542/UHVHDUFK ,PSDFWRI&/3RQ+542/ 5HODWLRQEHWZHHQKHDULQJDSSHDUDQFHVSHHFKDQG+542/LQLQGLYLGXDOV

ZLWK&/3 +HDULQJ

$SSHDUDQFH 6SHHFK /LPLWDWLRQVRIHDUOLHUUHVHDUFKRQSDWLHQWUHSRUWHGRXWFRPHV 352V LQ

SDWLHQWVZLWK&/3 6SHFLILF3520VXVHGLQWKLVWKHVLV 0DOP|VSHHFKTXHVWLRQQDLUH

&+$64

&/()74

$LP 6SHFLILFDLPV 6WXG\, 6WXG\,, 6WXG\,,, 6WXG\,9

(10)

6WXG\9 0DWHULDOVDQGPHWKRGV 6SHFLILFPDWHULDOVDQGPHWKRGV 6WXG\, 6WXG\,, 6WXG\,,, 6WXG\,9 6WXG\9 5HVXOWV 6XPPDU\RIVSHFLILFUHVXOWV 6WXG\, 6WXG\,, 6WXG\,,, 6WXG\,9 6WXG\9 'LVFXVVLRQ ,PSRUWDQFHRI3520VLQ&/3FDUH 3520VDVDQLQVWUXPHQWIRULPSURYHGFRPPXQLFDWLRQEHWZHHQSDWLHQWVDQG

KHDOWKFDUHSURIHVVLRQDOV +&3V 

*HQHUDOL]DELOLW\RI352VLQSDWLHQWVZLWK&/3 3UHIHUUHG3520LQ&/3UHVHDUFKDQGFOLQLFDOZRUN ,PSOHPHQWDWLRQRID3520LQ&/3FDUH 6WUHQJWKVDQGOLPLWDWLRQV )XWXUHFRQVLGHUDWLRQVGLUHFWLRQV

&RQFOXVLRQV

6XPPDU\LQ6ZHGLVK3RSXOlUYHWHQVNDSOLJVDPPDQIDWWQLQJSnVYHQVND

*UDQWVDQGDFNQRZOHGJHPHQWV

$FNQRZOHGJHPHQW 5HIHUHQFHV

$SSHQGL[,,9 6WXGLHV,9

(11)



2ULJLQDOVWXGLHV

7KLVWKHVLVLVEDVHGRQWKHIROORZLQJRULJLQDOVWXGLHV7KH\ZLOOEH UHIHUUHGWRLQ

5RPDQQXPHUDOVLQWKLVWKHVLV

6WXG\, 6WLHUQPDQ0..OLQW|$'$O4DWDQL%6FK|QPH\UDQG0%HFNHU

 6XEMHFWLYHRXWFRPHVDIWHUWUHDWPHQWIRUYHORSKDU\QJHDOG\VIXQFWLRQ

-3ODVW6XUJ+DQG6XUJ   

6WXG\,, 6WLHUQPDQ0.gVWHUOLQG15XPVH\0%HFNHUDQG03HUVVRQ  

3DUHQWDODQG+HDOWK&DUH3URIHVVLRQDO9LHZVRQ3V\FKRVRFLDODQG

(GXFDWLRQDO2XWFRPHVLQ3DWLHQWVZLWK&OHIW/LSDQGRU&OHIW3DODWH

(XURSHDQ-RXUQDORI3ODVWLF6XUJHU\  

6WXG\,,, 6WLHUQPDQ0,0DXOLQD,=HSD7-DJRPlJL17DQDVNRYLF3.QHåHYLü

5 9HOLNRYD<$QDVWDVVRY-5DGRMLüLü=3HVLF%7ULIXQRYLü0

'UHYHQVHN56SDWDUX7%ROMHYLF5'LPRYVND61DXPRYVNL15XPVH\

) =XFFKHOOL16KDUUDWW0$UJ\ULGHV..OLQW|0%HFNHUDQG03HUVVRQ  7UDQVODWLRQDQG3LORW6WXG\RIWKH&OHIW+HDULQJ$SSHDUDQFHDQG 6SHHFK4XHVWLRQQDLUH &+$64 (XURSHDQ-RXUQDORI3ODVWLF6XUJHU\

KWWSVGRLRUJV

6WXG\,9 6FRUHVRIWKH&OHIW+HDULQJ$SSHDUDQFHDQG6SHHFK4XHVWLRQQDLUH &+$64  LQ6ZHGLVKSDWLHQWVZLWKFOHIWOLSDQGRUFOHIWSDODWHDQGDFRQWUROSRSXODWLRQ

6WLHUQPDQ0 .OLQW| . 3HUVVRQ 0 %HFNHU0 ,QPDQXVFULSW

6WXG\9 &RPSDULVRQRIVFRUHVIURPWKH&+$64DQGWKH&/()74LQ6ZHGLVKSDWLHQWV

ZLWKFOHIWOLSDQGRUSDODWH6WLHUQPDQ0.OLQW|.3HUVVRQ0 %HFNHU0

,QPDQXVFULSW

3DSHU,LVWKHDFFHSWHGPDQXVFULSWRIDQDUWLFOHSXEOLVKHGDVWKHYHUVLRQRIUHFRUG

LQ -RXUQDO RI 3ODVWLF 6XUJHU\ DQG +DQG 6XUJHU\ ‹  ,QIRUPD 8. /LPLWHG

WUDGLQJDV7D\ORUDQG)UDQFLV*URXSKWWSZZZWDQGIRQOLQHFRP3DSHUV,,DQG,,,

DUH 2SHQ $FFHVV DQG GLVWULEXWHG XQGHU WKH WHUPV RI WKH &UHDWLYH &RPPRQV

$WWULEXWLRQ,QWHUQDWLRQDO/LFHQVH

(12)



7KHVLVDWDJODQFH

6WXG\ $LPV 0DWHULDOVDQG

PHWKRGV

0DLQUHVXOWV

, 7RHYDOXDWHVDWLVIDFWLRQZLWK

VSHHFKSHUFHLYHGVSHHFK

TXDOLW\DQGSHUFHLYHG

LPSURYHPHQWLQSDWLHQWVZLWK

YHORSKDU\QJHDOG\VIXQFWLRQ

93' 

SDWLHQWVZLWK93'

FRPSOHWHGD

TXHVWLRQQDLUHRQ

VDWLVIDFWLRQZLWK

VSHHFKSHUFHLYHG

VSHHFKTXDOLW\DQG

SHUFHLYHGLPSURYHPHQW

IURPWUHDWPHQW

6HYHQW\RQHSHUFHQWRISDWLHQWVSHUFHLYHG

WKHLUVSHHFKWREHQRUPDORUVOLJKWO\GHYLDQW

EXWRQO\ZHUHVDWLVILHGZLWKWKHLU

VSHHFK*UHDWHUVDWLVIDFWLRQZLWKVSHHFK

FRUUHODWHGZLWKJUHDWHUSHUFHLYHG

LPSURYHPHQWIURPVXUJHU\RUVSHHFK

WKHUDS\6DWLVIDFWLRQZLWKVSHHFKFRUUHODWHG

VLJQLILFDQWO\ZLWKSHUFHLYHGVSHHFKTXDOLW\

,, 7RLQYHVWLJDWHFXUUHQWEHOLHIV

DQGNQRZOHGJHRIKHDOWKFDUH

SURIHVVLRQDOV +&3V DQG

SDUHQWVRIFKLOGUHQZLWK&/3

LQVRXWKHUQ6ZHGHQ

UHJDUGLQJSV\FKRVRFLDODQG

HGXFDWLRQDOLVVXHVUHODWHGWR

JURZLQJXSZLWKDYLVLEOHFOHIW

SDUHQWVRIFKLOGUHQ

ZLWKDYLVLEOHFOHIWDQG

+&3VZHUH

LQWHUYLHZHG'DWDZDV

DQDO\]HGZLWKWKHPDWLF

DQDO\VLV

7KHUHVXOWVUHYHDOHGWKDWSDUHQWH[SHULHQFH

DQGYLHZVZHUHGLYHUVHIURPQRVSHFLILF

SUREOHPVUHODWHGWRWKHFOHIWWRERWK

HPRWLRQDODQGHGXFDWLRQDOLVVXHV7KH

EHOLHIVDQGOHYHORINQRZOHGJHLQ+&3VDOVR

YDULHG$OO+&3VKRZHYHUZLVKHGIRUPRUH

LQIRUPDWLRQDQGWUDLQLQJUHJDUGLQJ

SV\FKRVRFLDOLVVXHV

,,, 7RWUDQVODWH&OHIW+HDULQJ

$SSHDUDQFHDQG6SHHFK

4XHVWLRQQDLUH &+$64 LQWR

HLJKW(XURSHDQODQJXDJHVWR

LQYHVWLJDWHZKHWKHUOHYHOVRI

352VLQSDWLHQWVZLWK&/3

ZHUHFRPSDUDEOHDFURVV

FRXQWULHVDQGWRLQYHVWLJDWH

FOLQLFLDQH[SHULHQFHRIWKH

LQVWUXPHQW

7UDQVODWLRQDFFRUGLQJ

WR0DSL5HVHDUFK7UXVW

JXLGHOLQGHV&+$64

ZDVLPSOHPHQWHGRQ

SDWLHQWVDWURXWLQH

YLVLWVWRFOLQLFV

+&3VSDUWLFLSDWHGLQD

IRFXVJURXSGLVFXVVLRQ

UHJDUGLQJWKHVWUHQJWKV

DQGFKDOOHQJHVRQWKH

XVHRI&+$64

&+$64ZDVWUDQVODWHGLQWRODQJXDJHV

%XOJDULDQ(VWRQLDQ*UHHN/DWYLDQ

0DFHGRQLDQ5RPDQLDQ6HUELDQDQG

6ZHGLVK7KLVVWXG\DOVRUHYHDOHGGLIIHUHQW

OHYHOVRIVDWLVIDFWLRQZLWKKHDULQJ

DSSHDUDQFHDQGVSHHFKEHWZHHQFRXQWULHV

&+$64ZDVSHUFHLYHGDVXVHIXOVKRUWDQG

HDV\WRLPSOHPHQW&+$64FRXOGEHDQ

HIIHFWLYHLQVWUXPHQWIRUFROOHFWLRQRISDWLHQW

UHSRUWHGRXWFRPHV

,9 7RLQYHVWLJDWHVFRUHVRI

&+$64LQSDWLHQWVZLWK&/3

DQGDFRQWUROSRSXODWLRQ7KH

VHFRQGDLPZDVWRFRPSDUH

&/3DQGFRQWUROSRSXODWLRQ

VFRUHVLQWKLVVWXG\ZLWKD

%ULWLVKQRUP&/3SRSXODWLRQ

SDWLHQWVZLWK&/3

DQGSDUWLFLSDQWVLQD

FRQWUROSRSXODWLRQ

FRPSOHWHG&+$64

&KLOGUHQDQG\RXQJSHRSOHZLWK&/3LQWKLV

VWXG\ZHUHDVVDWLVILHGZLWKWKHLU

DSSHDUDQFHKHDULQJDQGVSHHFKDVFKLOGUHQ

DQG\RXQJSHRSOHZLWKRXW&/36ZHGLVK

&+$64VFRUHVRIERWK&/3DQGQRQ&/3

UHODWHGIHDWXUHVRIWKHIDFHZHUHVLPLODUWR

WKHPHDQVFRUHVLQWKH%ULWLVKQRUP

SRSXODWLRQ

9 7RLQYHVWLJDWHWKHUHODWLRQRI

VFRUHVEHWZHHQWZRH[LVWLQJ

&/3VSHFLILF3520V

&+$64DQG&/()747KH

VHFRQGDLPRIWKHVWXG\ZDV

WRLQYHVWLJDWHSDWLHQWRSLQLRQ

RQWKHWZRLQVWUXPHQWV

SDWLHQWVZLWK&/3

DQVZHUHG&+$64

&/()74DQGDQH[WUD

VXUYH\UHJDUGLQJWKHLU

RSLQLRQVRQWKHWZR

3520V

$OOLWHPVRQVDWLVIDFWLRQZLWKDSSHDUDQFHRI

WKHIDFHVSHFLILFSDUWVRIWKHIDFHDQG

VSHHFKLQ&+$64FRUUHODWHGVLJQLILFDQWO\

ZLWKFRUUHVSRQGLQJVFDOHVLQ&/()74$

PDMRULW\SDWLHQWV  OLNHG&/()74

PRUHWKDQ&+$64(LJKWHHQSDWLHQWV   WKRXJKW&+$64ZDVHDVLHUWRFRPSOHWHDQG

  WKDW&/()74ZRXOGEHWWHULQIRUP

+&3VDERXWWKHLUWKRXJKWVRSLQLRQVDQG

IHHOLQJV

(13)



$EEUHYLDWLRQV

$'+' $WWHQWLRQ'HILFLW+\SHUDFWLYLW\'LVRUGHU

&$7 &RPSXWHULVHG$GDSWLYH7HVWLQJ

&+$64 &OHIW+HDULQJ$SSHDUDQFHDQG6SHHFK4XHVWLRQQDLUH

&/3 &OHIWOLSDQGRUSDODWH

&2+,3 &KLOG2UDO+HDOWK,PSDFW3URILOH

&77 &ODVVLFDO7HVW7KHRU\

+&3 +HDOWK&DUH3URIHVVLRQDOV

+542/ +HDOWK5HODWHG4XDOLW\RI/LIH

,&6 ,QWHOOLJLELOLW\LQ&RQWH[W6FDOH

,&+20 7KH ,QWHUQDWLRQDO &RQVRUWLXP IRU +HDOWK 2XWFRPHV

0HDVXUHPHQW

,6242/ ,QWHUQDWLRQDO6RFLHW\IRU4XDOLW\RI/LIH5HVHDUFK

126( 1DVDO2EVWUXFWLRQ6\PSWRP(YDOXDWLRQ6FDOH

352 3DWLHQW5HSRUWHG2XWFRPH

3520 3DWLHQW5HSRUWHG2XWFRPH0HDVXUH

507 5DVFK0HDVXUHPHQW7KHRU\

6/3 6SHHFKDQG/DQJXDJH3DWKRORJLVW

6:$ 6DWLVIDFWLRQ:LWK$SSHDUDQFH4XHVWLRQQDLUH

93' 9HORSKDU\QJHDO'\VIXQFWLRQ

(14)



,QWURGXFWLRQ

7KHLQWURGXFWLRQWRWKLVWKHVLVILUVWGHVFULEHVWKHSDWLHQWSRSXODWLRQWKHGLDJQRVLV

FOHIWOLSDQGRUSDODWH &/3 DQGWKHWUHDWPHQWDQGIROORZXSSURJUDPLQ6ZHGHQ

+HDOWK UHODWHG TXDOLW\ RI OLIH +542/  DQG SDWLHQW UHSRUWHG RXWFRPH 352  LV

WKHQGHILQHGDQGUHODWHGWRWKHSDWLHQWSRSXODWLRQ$QRYHUYLHZRIHDUOLHUZRUNRQ

+542/ DQG 352V LQ WKH &/3 SRSXODWLRQ LV SUHVHQWHG )LQDOO\ WKH SDWLHQW

UHSRUWHGRXWFRPHPHDVXUHV 3520V XVHGLQWKHVWXGLHVFRPSULVLQJWKLVWKHVLVDUH

SUHVHQWHGLQJUHDWHUGHWDLO

&OHIWOLSDQGRUSDODWH &/3 

&/3 LV WKH PRVW FRPPRQ FRQJHQLWDO FUDQLRIDFLDO PDOIRUPDWLRQ DIIHFWLQJ

DSSUR[LPDWHO\WZRLQOLYHELUWKVLQ6ZHGHQ +DJEHUJHWDO 7KHUHDUH

PDQ\ SKHQRW\SHV DQG FRPELQDWLRQV RI FOHIW RI WKH OLS DOYHROXV DQG SDODWH $Q

XSGDWHGFODVVLILFDWLRQLVRIIHUHGE\$OORULHWDO  DQGDOODEEUHYLDWLRQVDQG

GHVFULSWLRQVRISKHQRW\SHVLQWKLVWKHVLVZLOOIROORZWKHUHFRPPHQGDWLRQVLQWKDW

SXEOLFDWLRQ 0RVW FRPPRQ &/3 W\SHV DQG WUHDWPHQW LQ 6ZHGHQ LV SUHVHQWHG LQ

7DEOH&/3PD\DIIHFWSDWLHQWDSSHDUDQFHVSHHFKKHDULQJRFFOXVLRQGHQWLWLRQ

DQG HDWLQJ IXQFWLRQ WR GLIIHUHQW GHJUHHV GHSHQGLQJ RQ WKH VHYHULW\ DQG GLIIHULQJ

DQDWRP\ LQYROYHG ,Q DSSUR[LPDWHO\  RI FDVHV &/3 LV DVVRFLDWHG ZLWK RWKHUELUWKGHIHFWVDGGLWLRQDOFRJQLWLYHRISV\FKRORJLFDOFRQGLWLRQVRULVSDUWRID

V\QGURPH +DJEHUJHWDO)HUDJHQHWDO 7UHDWPHQWRXWFRPHVPD\EH

DIIHFWHG QHJDWLYHO\ E\ DQ DGGLWLRQDO FRQGLWLRQ RU GHYHORSPHQWDO GHOD\ )HUDJHQ

DQG 6WRFN  )HUDJHQ HW DO   7KH WUHDWPHQW RI &/3 FRQVLVWV RI

UHFRQVWUXFWLYH SODVWLF VXUJHU\ DQG PRVW RIWHQ WUHDWPHQW ZLWK D VSHHFK DQG

ODQJXDJH SDWKRORJLVW 6/3  DQ HDU QRVH DQG WKURDW VSHFLDOLVW DQ RUWKRGRQWLVW

SV\FKRORJLVWRUSV\FKRWKHUDSLVWDQGD VSHFLDOL]HGQXUVH0RVW&/3FHQWUHVKDYH

VWDQGDUGL]HG WUHDWPHQW SURWRFROV IRU WUHDWPHQW LQGLFDWLRQ DQG WLPLQJ +RZHYHU

WHFKQLTXHVDQGWLPLQJVRIWUHDWPHQWYDU\LQGLIIHUHQWSDUWVRIWKHZRUOGDVZHOODV

ZLWKLQ6ZHGHQ

(15)



7DEOH&RPPRQ&/3W\SHVDQGWUHDWPHQWLQ6ZHGHQ

6FKHPDWLFDQDWRP\ 7LPHRIGLDJQRVLV )LUVWPRQWKVDIWHU

ELUWK $SSUR[LPDWHO\

PRQWKVRIDJH

&OHIWSDODWH

RQO\ &3

,QIRUPDWLRQWRIDPLO\

ZLWKLQILUVWZHHNV

DIWHUELUWKDERXW

GLDJQRVLVDQG

WUHDWPHQWSODQ

,QIRUPDWLRQRQVSHFLDO

IHHGLQJQHHGVLI

LQGLFDWHG0HHWLQJ

ZLWKVSHFLDOLVWV

LQYROYHGLQWUHDWPHQW

SODQ

&OHIWOLS

RQO\ &/ 7DSHDQGKRRNWR

OLIWOLSDQGQRVH

/LSUHSDLU

VXUJHU\

&OHIWOLS

ZLWKFOHIW

DOYHROXV

&/$

7DSHDQGKRRNWR

OLIWOLSDQGQRVH

&OHIWOLSDQG

SDODWH

&/3

7DSHDQGKRRNWR

OLIWOLSDQGQRVH

3DODWHSODWHLI

LQGLFDWHG

%LODWHUDO

FOHIWOLSDQG

SDODWH

E&/3

(16)



7DEOH&RPPRQ&/3W\SHVDQGWUHDWPHQWLQ6ZHGHQFRQWLQXHG

 PRQWKVRIDJH \HDUVRIDJH $SSUR[LPDWHO\

 \HDUVRIDJH $SSUR[LPDWHO\

\HDUVRIDJH

&OHIWSDODWH

RQO\ &3

3DODWHUHSDLUVXUJHU\

LQRQHVWDJHDWWR

PRQWKVRI DJHRU

WZRVWDJHUHSDLU RI

VRIWSDODWHDW

PRQWKVDQGKDUG

SDODWHDWPRQWKV

RIDJH*URPPHWV

LQVHUWHGGXULQJ

VXUJHU\LILQGLFDWHG

6SHHFKDQG

ODQJXDJHWUHDWPHQW

LILQGLFDWHG 

9HORSKDU\QJHDOIODS

VHFRQGDU\SDODWH

PXVFOHUHSDLURU

EXFFDOIODSWR

LPSURYHVSHHFK LI

LQGLFDWHG 

2UWKRGRQWLF

WUHDWPHQWZLWK

H[SDQVLRQRIXSSHU

MDZPD\EH

QHHGHG

&OHIWOLS

RQO\ &/

/LSVFDUFRUUHFWLRQ

6HFRQGDU\VXUJHU\LI

LQGLFDWHG

&OHIWOLSZLWK

FOHIW

DOYHROXV

&/$

%UDFHVRU

RUWKRGRQWLF

WUHDWPHQWZLWK

H[SDQVLRQRIXSSHU

MDZPD\EH

QHHGHG

$OYHROXVUHSDLU

VXUJHU\ZLWK

VHFRQGDU\ERQH

JUDIWLQPL[HG

GHQWLWLRQ

&RUUHFWLRQRIQRVHRUOLS

6HFRQGDU\VXUJHU\LI

LQGLFDWHG

&OHIWOLSDQG

SDODWH

&/3 3DODWHUHSDLUVXUJHU\

LQRQHVWDJHDWWR

PRQWKVRIDJH RU

WZRVWDJHUHSDLURI

VRIWSDODWHDW

PRQWKVDQGKDUG

SDODWHDWPRQWKV

RIDJH *URPPHWV

LQVHUWHGGXULQJ

VXUJHU\LILQGLFDWHG

6SHHFKDQG

ODQJXDJHWUHDWPHQW

LILQGLFDWHG 

9HORSKDU\QJHDOIODS

VHFRQGDU\SDODWH

PXVFOHUHSDLURU

EXFFDOIODSWR

LPSURYHVSHHFK LI

LQGLFDWHG 

&RUUHFWLRQRIQRVHOLSRU

MDZ 6HFRQGDU\VXUJHU\

LILQGLFDWHG

%LODWHUDO

FOHIWOLSDQG

SDODWH

E&/3

(17)



&/3WUHDWPHQWLQ6ZHGHQ

7KHWUHDWPHQWRISDWLHQWVZLWK&/3YDULHVVOLJKWO\DPRQJFHQWUHVLQ6ZHGHQ7KH

PDLQGLIIHUHQFHLVWKHFOHIWSDODWHVXUJHU\ZKLFKLVSHUIRUPHGLQRQHVWDJHDWWZR

FHQWUHV 0DOP| DQG /LQN|SLQJ  DQG SHUIRUPHG LQ WZR VWDJHV DW IRXU FHQWUHV

*RWKHQEXUJ 6WRFNKROP 8SSVDOD DQG 8PHn  %HFNHU DQG .OLQW|   7KH

HVVHQWLDO WUHDWPHQW SURJUDP LV GHVFULEHG LQ 7DEOH  $OO FHQWUHV IROORZ D

VWDQGDUGLVHG IROORZXS SURJUDP &KLOGUHQ YLVLW WKHLU UHJLRQDO FHQWUH UHJXODUO\ WR

PRQLWRU WUHDWPHQW UHVXOWV JURZWK RI WKH SDUWV RI WKH IDFH DIIHFWHG E\ &/3

GHQWLWLRQRFFOXVLRQ VSHHFK DQG KHDULQJ 7KH YLVLWV RFFXU DSSUR[LPDWHO\ HYHU\

WKUHH \HDUV XS WR  \HDUV RI DJH DQG DUH DWWHQGHG E\ PXOWLSOH KHDOWK FDUH

SURIHVVLRQDOV +&3V  IURP GLIIHUHQW GLVFLSOLQHV $W WKH IROORZXS YLVLWV FKLOGUHQ

DQGWKHLUIDPLOLHVDUHLQIRUPHGDERXWWUHDWPHQWSURJUHVVDQGKDYHWKHRSSRUWXQLW\

WRDVNTXHVWLRQV,IQHFHVVDU\WKH +&3VFDQGLVFXVVDQGDOWHUWKHWUHDWPHQWSODQ

DFFRUGLQJWRWKHFKLOG¶VVWDWXV7KHIROORZXSYLVLWVFRXOGDOVREHDQRSSRUWXQLW\

IRUFROOHFWLRQRI352V $URUDDQG+DM 

7KH6ZHGLVK&/3UHJLVWU\

7KH6ZHGLVK&/3UHJLVWU\ZDVDSSRLQWHGDVDQDWLRQDOTXDOLW\UHJLVWU\LQE\

WKH 1DWLRQDO %RDUG RI +HDOWK DQG :HOIDUH ,Q 6ZHGLVK 6RFLDOVW\UHOVHQ DQG WKH

6ZHGLVK $VVRFLDWLRQ RI /RFDO $XWKRULWLHV DQG 5HJLRQV ,Q 6ZHGLVK 6YHULJHV

.RPPXQHURFK/DQGVWLQJ  %HFNHUDQG.OLQW| 7KHDLPRIWKHUHJLVWU\LVWR

FRPSDUH UHVXOWV DQG OHDUQ IURP WKH GLIIHUHQW &/3 WHDPV LQ 6ZHGHQ DV OLVWHG

EHORZ

x 7R HYDOXDWH UHVXOWV RI GLIIHUHQW WUHDWPHQW PHWKRGV E\ DVVHVVLQJ WKH GHYHORSPHQWRIDSSHDUDQFHGHQWLWLRQRFFOXVLRQDQGVSHHFK

x 7RHQVXUHHTXDOWUHDWPHQWIRUFKLOGUHQDQGDGROHVFHQWVERUQZLWK&/3LQ 6ZHGHQ

x 7RIDFLOLWDWHFRRSHUDWLRQEHWZHHQ&/3FHQWUHVLQ6ZHGHQ

x 7RLPSURYHWUHDWPHQWPHWKRGVRI&/3

5HVXOWV IURP &/3 FHQWUHV UHJDUGLQJ W\SH WLPLQJ DQG QXPEHU RI WUHDWPHQW

SURFHGXUHVDQGFRPSOLFDWLRQVDUHUHJLVWHUHG7UHDWPHQWUHVXOWVDUHUHJLVWHUHGDW

PRQWKV DQGILYH   DQG  \HDUV RIDJH DQGDUH UHSRUWHG DQQXDOO\ $V \HW

RQO\ RQH 3520 LV LQFOXGHG LQ WKLV UHJLVWU\ WKH ,QWHOOLJLELOLW\ LQ &RQWH[W 6FDOH

,&6  0F/HRGHWDO ZKLFKLVFRPSOHWHGE\SDUHQWVRISDWLHQWVZLWK&/3

DW ILYH DQG  \HDUV RI DJH 7KH UHJLVWU\ LV D SRVVLEOH SODWIRUP IRU IXUWKHU

FROOHFWLRQDQGIXWXUHHYDOXDWLRQRI352VLQ6ZHGHQ

(18)



7KH ,QWHUQDWLRQDO &RQVRUWLXP IRU +HDOWK 2XWFRPHV 0HDVXUHPHQW ,&+20  KDV

VHWXSDPXOWLGLVFLSOLQDU\DQGLQWHUQDWLRQDOZRUNLQJJURXSWRGHYHORSDVWDQGDUG

VHW RI RXWFRPH PHDVXUHV LQ &/3 FDUH $OORUL HW DO   7KH JRDO RI WKH

FROODERUDWLRQ ZDV WR SURGXFH D PLQLPDO VHW RI RXWFRPH PHDVXUHV IRU DOO &/3

WHDPV WR FROOHFW :LWK VWDQGDUG RXWFRPH PHDVXUHV DQG 3520V WHDPV FDQ

FRPSDUH DQG EHQHILW IURP HDFK RWKHU WR LPSURYH &/3 FDUH DV DQ LQWHUQDWLRQDO

&/3FROOHFWLYH 9RLQHVNRVHWDO'REEVHWDO*HRJKHJDQHWDO 

3520V LQ WKH VWDQGDUG VHW LQFOXGHG E\ WKH ,&+20 ZRUNLQJ JURXS DUH YDULRXV

&/()74VFDOHVDQGWKUHHDGGLWLRQDO3520V±&KLOG2UDO+HDOWK,PSDFW3URILOH

&2+,3  %URGHU HW DO   1DVDO 2EVWUXFWLRQ 6\PSWRP (YDOXDWLRQ VFDOH

126(  6WHZDUWHWDO DQG,&6 0F/HRGHWDO 

+HDOWK5HODWHG4XDOLW\RI/LIH +542/ 

+542/ LV GHILQHG E\ WKH ,QWHUQDWLRQDO 6RFLHW\ IRU 4XDOLW\ RI /LIH 5HVHDUFK DV

µWKHIXQFWLRQDOHIIHFWRIDPHGLFDOFRQGLWLRQDQGRULWVFRQVHTXHQWWKHUDS\XSRQD

SDWLHQW+542/LVWKXVVXEMHFWLYHDQGPXOWLGLPHQVLRQDOHQFRPSDVVLQJSK\VLFDO

DQG RFFXSDWLRQDO IXQFWLRQ SV\FKRORJLFDO VWDWH VRFLDO LQWHUDFWLRQ DQG VRPDWLF

VHQVDWLRQ¶ ,6242/ 9DULRXVDVSHFWVRI+542/PD\EHDIIHFWHGE\&/3

DQG WUHDWPHQW WKHUHRI +LJK +542/ LV RQH RI WKH PRVW LPSRUWDQW JRDOV LQ WKH

WUHDWPHQWRI&/3DVFOHDUO\H[SUHVVHGE\.ODVVHQHWDO  

3DWLHQW5HSRUWHG2XWFRPH0HDVXUHV 3520V 

3520V TXDQWLI\ YDULRXV 352V DQG FRQFHSWV RI +542/ IURP WKH SDWLHQW

SHUVSHFWLYH 3DWLHQW RSLQLRQ DQG SHUVSHFWLYH DUH FHQWUDO LQ HYDOXDWLQJ UHVXOWV RI

&/3 WUHDWPHQW VLQFH PDQ\ LQWHUYHQWLRQV IRFXV RQ LQFUHDVLQJ TXDOLW\ RI OLIH DQG

LPSURYLQJ SDWLHQW VHOI SHUFHSWLRQ 6HPE HW DO  :RUPDOG DQG 5RGULJXHV

 'REEV HW DO  *HRJKHJDQ HW DO   ,PSOHPHQWLQJ 352V LQWR

VWDQGDUGFOLQLFDOSUDFWLFHLVLQOLQHZLWKWKHSDUDGLJPVKLIWDQGHWKLFDODSSURDFKRI

SDWLHQWFHQWUHGFDUHZKLFKLVHQGRUVHGERWK LQ6ZHGHQ 6ZHGLVK$VVRFLDWLRQRI

/RFDO$XWKRULWLHVDQG5HJLRQV1DWLRQDO%RDUGRI+HDOWKDQG:HOIDUH  DQGLQWHUQDWLRQDOO\ %ODFN:+2 ,WLVDOVRDZD\WRLPSURYHDQGWR

FRPSDUHTXDOLW\RIFDUHEHWZHHQLQVWLWXWLRQVDQGEHWZHHQGLIIHUHQWSDWLHQWJURXSV

%ODFN 3520VDOVRKDYHWKHSRWHQWLDOWRIDFLOLWDWHVKDUHGGHFLVLRQPDNLQJ

EHWZHHQSDWLHQWVDQGFOLQLFLDQVJXLGHLPSURYHPHQWRIFRVWHIIHFWLYHQHVVLQSODVWLF

DQG UHFRQVWUXFWLYH VXUJHU\ 'REEV HW DO   LPSURYH SDWLHQWGRFWRU

FRPPXQLFDWLRQ DQG LQ DGGLWLRQ HQKDQFH SDWLHQW VDWLVIDFWLRQ :RUPDOG DQG

5RGULJXHV 7KHUHZDVQRLQWHUQDWLRQDOO\DFFHSWHG&/3VSHFLILFDQGKROLVWLF

(19)



3520WRLPSOHPHQWDW&/3FHQWUHVXQWLODQGWKHSXEOLFDWLRQRIWKHVWXG\

SURWRFRORIWKH &/()74SURMHFW :RQJ5LIIHWDO DQGWKHSV\FKRPHWULF

ILQGLQJVRIWKHLQWHUQDWLRQDOILHOGWHVWRI&/()74 .ODVVHQHWDO 

3V\FKRPHWULFPHWKRGV

3V\FKRPHWULFV LV WKH VFLHQFH RI TXDQWLWDWLYHO\ PHDVXULQJ DEVWUDFW DQG WKHRUHWLFDO

FRQFHSWVLQSV\FKRORJ\HGXFDWLRQDQGVRFLDOVFLHQFHV &DQRHWDO ,QHDUOLHU

SXEOLFDWLRQV WKH WHUPV FRQFHSW GRPDLQ DQG FRQVWUXFW KDYH EHHQ XVHG

LQWHUFKDQJHDEO\ &DQRHWDO1HOVRQ&DQRDQG+REDUW5HHYHHW

DO  'REEV HW DO  6WRFN HW DO   ,QVWUXPHQWV XVHG IRU PHDVXULQJ

SV\FKRORJLFDOFRQVWUXFWVDUHIRUH[DPSOHUDWLQJVFDOHVTXHVWLRQQDLUHVRU3520V

7KHPDMRULW\RI3520VLQXVHLQSODVWLFVXUJHU\WRGD\KDYHEHHQPDGHDQGWHVWHG

ZLWK&ODVVLFDO7HVW7KHRU\ &77  &DQRHWDO&DQRDQG+REDUW 7KH

VFRUHSURGXFHGE\D&773520LVRUGLQDOOHYHOGDWDDQGLQWHUYDOVRQGLIIHUHQW

SDUWVRIWKHVFDOHGRQRWQHFHVVDULO\LPSO\HTXDOFKDQJHLQWKHPHDVXUHGFRQVWUXFW

)RU H[DPSOHWKHVDWLVIDFWLRQ ZLWKDSSHDUDQFH RI D SDWLHQW ZKRKDV XQGHUJRQHD VXUJLFDO LQWHUYHQWLRQ FDQ LQFUHDVH IURP µQRW VDWLVILHG¶ WR µPRGHUDWHO\ VDWLVILHG¶

)RU DQRWKHU SDWLHQW KLV RU KHU VDWLVIDFWLRQ ZLWK DSSHDUDQFH PD\ LQFUHDVH IURP

µPRGHUDWHO\VDWLVILHG¶ WRµYHU\VDWLVILHG¶DIWHUDVXUJLFDOLQWHUYHQWLRQ%RWKSDWLHQWV

ZLOOKDYHLQFUHDVHGWKHLUVDWLVIDFWLRQZLWKRQHRUGLQDOOHYHOVWHSRQWKHPHDVXULQJ

VFDOH EXW LW ZLOO QRW EH FOHDU LI WKHLU VDWLVIDFWLRQ ZLWK DSSHDUDQFH LQFUHDVHG

HTXDOO\5DVFK0HDVXUHPHQW7KHRU\ 507 KDVEHHQSUHVHQWHGDVDQDOWHUQDWLYH

ZD\ RI PHDVXULQJ 352 LQ KHDOWK FDUH LQ JHQHUDO DV ZHOO DV LQ SODVWLF DQG

UHFRQVWUXFWLYH VXUJHU\ &DQR HW DO  &DQR DQG +REDUW  'REEV HW DO

 9RLQHVNRV HW DO  :RUPDOG DQG 5RGULJXHV   507 3520V

SURGXFH LQWHUYDOOHYHO GDWD ZKHUH GLIIHUHQFHV LQ VFRUHV DUH HTXDO DFURVV D VFDOH

)XUWKHUGLVWLQFWLRQVEHWZHHQ&77DQG507DUHOLVWHGLQ7DEOH

(20)



7DEOH6WUHQJWKVDQGOLPLWDWLRQVRI3520VGHYHORSHGZLWK&ODVVLFDO7HVW7KHRU\DQG5DVFK0HDVXUHPHQW

7KHRU\ &DQR HW DO  &DQR DQG +REDUW  'REEV HW DO  9RLQHVNRV HW DO  :RUPDOG DQG

5RGULJXHV 

&ODVVLFDO7HVW7KHRU\ 5DVFK0HDVXUHPHQW7KHRU\

6WUHQJWKV 6FRUHVFDQHDVLO\EHFRPSXWHGZLWKRXW

FRQYHUVLRQWDEOHV 3URGXFHVLQWHUYDOOHYHOVFRUHGDWDIURPRUGLQDOOHYHOLWHP

GDWD

$OORZVJHQHUDWLRQRIDILQDOVFRUHIURPVXEVHWVRILWHPVLQ

DVFDOHDQGFRPSXWHULVHGDGDSWLYHWHVWLQJ

$OORZVIRUPLVVLQJGDWD

3UHFLVHHQRXJKIRUFOLQLFDOGHFLVLRQPDNLQJRQWKH

LQGLYLGXDOOHYHO

/LPLWDWLRQV 3URGXFHVRUGLQDOOHYHOGDWD &RPSOH[PDWKHPDWLFDOPRGHO

5HTXLUHVVSHFLDOLVHGVRIWZDUHRUFRQYHUVLRQWDEOH

*UHDWHUGHYHORSPHQWFRVWVGXHWRODUJHVDPSOHVRIVWXG\

SDUWLFLSDQWVDQGKLJKPDWKHPDWLFDOH[SHUWLVHLQ

GHYHORSPHQWWHDP

4XDOLW\RI3520V

+LJKTXDOLW\RI3520VHQVXUHVWKDWUHVHDUFKDQGFOLQLFDOZRUNRQ352VLVYDOLG

$DURQVRQ HW DO  'REEV HW DO  :RUPDOG DQG 5RGULJXHV   +LJK

YDOLGLW\ LPSOLHV WKDW WKH WHVW PHDVXUHV ZKDW LW SXUSRUWV WR PHDVXUH DQG KDV ORZ

V\VWHPDWLFHUURU +LJK UHOLDELOLW\ LV DOVRHVVHQWLDO LQRUGHU WR HQVXUHORZUDQGRP

HUURURIWKHWHVW5HVSRQVLYHQHVVLVWKHFKDUDFWHULVWLFWKDWHQDEOHVWKHWHVWWRGHWHFW

D FKDQJH DIWHU DQ LQWHUYHQWLRQ $DURQVRQ HW DO   7KHUH DUH PLQLPXP

VWDQGDUGVUHFRPPHQGHGE\,6242/WRJXLGHWKHFKRLFHDQGDVVHVVPHQWRIZKLFK

3520V WR XVH LQ FOLQLFDO SUDFWLFH DQG UHVHDUFK 5HHYH HW DO   7KH SRLQWV

LQFOXGHGLQWKHPLQLPDOVWDQGDUGVDUHVXPPDULVHGLQ7DEOH3520VZKLFKGR

QRWKDYHHPSLULFDOHYLGHQFHWRVXSSRUWKLJKTXDOLW\RQHDFKSRLQWPD\VWLOOEHWKH

EHVWRSWLRQIRUUHVHDUFKLQDVSHFLILFVWXG\GXHWRODFNRIEHWWHULQVWUXPHQWV7KH

YDOLGLW\ RI D 3520 PD\ EH VWUHQJWKHQHG RYHU WLPH DV WKH LQVWUXPHQW LV PRUH

H[WHQVLYHO\VWXGLHGDQGWHVWHG 5HHYHHWDO 

(21)



7DEOH6XPPDU\RISRLQWVRIHYDOXDWLRQRID3520EDVHGRQ5HHYHHWDO

&RQFHSWXDODQG

PHDVXUHPHQWPRGHO 'RFXPHQWDWLRQDERXWZKLFKFRQVWUXFWVWKHLQVWUXPHQWPHDVXUHVDQGZKLFK

SRSXODWLRQLWLVLQWHQGHGIRU

5HOLDELOLW\ 7KHGHJUHHWRZKLFKWKH3520LVIUHHIURPUDQGRPHUURU5HOLDELOLW\FDQEHWHVWHG

ZLWKLQWHUQDOFRQVLVWHQF\WHVWUHWHVWUHOLDELOLW\ &KURQEDFK¶VDOID VKRXOGEH! RU

LWHPUHVSRQVHWKHRU\ SHUVRQVHSDUDWLRQLQGH[VKRXOGEH! )RU DPXOWLLWHP

3520LQWHUQDOFRQVLVWHQF\LVDPHDVXUHPHQWRIKRZZHOOWKHLWHPVPHDVXUHWKH

VDPHFRQVWUXFW7HVWUHWHVWUHOLDELOLW\PHDVXUHVKRZVWDEOHWKH3520PHDVXUHVD

FRQVWUXFWRYHUWLPHRUEHWZHHQUHVSRQGHQWVZKHQRWKHUFRQGLWLRQVUHPDLQ WKH

VDPH

9DOLGLW\ 7KHGHJUHHWRZKLFKWKH3520LVIUHHIURPV\VWHPDWLFHUURUPHDVXUHVZKDWLWLV

VXSSRVHGWRPHDVXUH

D&RQWHQWYDOLGLW\ +RZZHOOWKH3520LQFOXGHVDOOUHOHYDQWSDUWVRIWKHPHDVXUHGFRQVWUXFW7KLVFDQ

EHWHVWHGZLWKTXDOLWDWLYHLQWHUYLHZVZLWKSDWLHQWVLQWKHLQWHQGHGWDUJHWSRSXODWLRQ

E&RQVWUXFWYDOLGLW\ +RZZHOOWKH3520FRUUHVSRQGVZLWKRWKHU3520VREVHUYDWLRQV DQGWKHRUHWLFDO

K\SRWKHVHVRIWKHVDPHFRQVWUXFW

F5HVSRQVLYHQHVV +RZZHOOWKH3520FDQGHWHFWVLJQLILFDQWFKDQJHRIWKHPHDVXUHGFRQVWUXFWRYHU

WLPH7KLVFDQEHWHVWHGZLWKD3520EHIRUHDQGDIWHUDQLQWHUYHQWLRQ

,QWHUSUHWDELOLW\RIVFRUHV 7KH3520VKRXOGKDYHGRFXPHQWDWLRQWRDLGLQWHUSUHWDWLRQRIWKHVFRUHVSURGXFHG

)RUH[DPSOH QRUPVRIWKHWDUJHWSRSXODWLRQRUDFRQWUROSRSXODWLRQDQGFXWRIIVIRU

VFRUHVDERYHRUEHORZWKHQRUPLQGLFDWLQJSDWKRORJ\

7UDQVODWLRQRIWKH3520 'RFXPHQWDWLRQRIWUDQVODWLRQSURFHVVDQGWHVWLQJRIWKH3520LQWKHWDUJHW

ODQJXDJH7KLVFDQEHWHVWHGTXDOLWDWLYHO\ZLWKFRJQLWLYHWHVWLQJIRUH[DPSOH

LQWHUYLHZZLWKSDWLHQWIRULGHQWLILFDWLRQRIXQFOHDUZRUGLQJRUOLQJXLVWLFDOO\RUFXOWXUDOO\

LOOVXLWHGWH[W

3DWLHQWDQGLQYHVWLJDWRU

EXUGHQ 7KHEXUGHQRIFRPSOHWLQJDQGDGPLQLVWUDWLQJWKH3520VKRXOGEHFRQVLGHUHGLQ

UHODWLRQWRWKHLQWHQGHGVWXG\RUFOLQLFDOSURWRFRO7KHOHYHORIOLWHUDF\QHHGHGWR

FRPSOHWHWKH3520VKRXOGEHGRFXPHQWHG

/HYHO RI VSHFLILFLW\ RI 3520V LQ &/3 +542/

UHVHDUFK

%RWKJHQHULFDQGGLVHDVHVSHFLILFTXHVWLRQQDLUHVKDYHEHHQXVHGWRH[SORUH352V

LQSRSXODWLRQVZLWK&/3$JHQHULFTXHVWLRQQDLUHLVRQHWKDWLVLQWHQGHGWREHDEOH

WR EH XVHG LQ YDULRXV SRSXODWLRQV 2QH GUDZEDFN LV WKDW WKH\ PLJKW QRW LQFOXGH

UHOHYDQW TXHVWLRQV LPSRUWDQW WR LQGLYLGXDOV ZLWK &/3 &DQR DQG +REDUW 

5LFNHWWV HW DO  :RUPDOG DQG 5RGULJXHV   $ GLVHDVH VSHFLILF

TXHVWLRQQDLUHLVPDGHVSHFLILFDOO\ZLWKWKHWDUJHWSRSXODWLRQLQPLQG2QWKHRWKHU

KDQG D GUDZEDFN RI GLVHDVH VSHFLILF TXHVWLRQQDLUHV LV WKDW WKH\ DUH KDUG WR

FRPSDUH ZLWK QRUP YDOXHV RI LQGLYLGXDOV ERUQ ZLWKRXW &/3 &DQR DQG +REDUW

+HUNUDWKHWDO:RUPDOGDQG5RGULJXHV ,WLVOLNHO\WKDWVWXGLHV

RI ERWK GLVHDVH VSHFLILF DQG JHQHULF 3520V DUH QHFHVVDU\ IRU D EHWWHU

XQGHUVWDQGLQJRIWKHUHVHDUFKILHOG )LW]SDWULFNHWDO&DQRDQG+REDUW

&UHUDQGHWDO 7KHODFNRIFRPSDULVRQVRI&/3UHODWHGRXWFRPHVZLWKWKRVH

LQ QRUP SRSXODWLRQV KDV EHHQ SRLQWHG RXW LQ HDUOLHU VWXGLHV %HUJHU DQG 'DOWRQ

)HUDJHQHWDO6WRFNDQG)HUDJHQ6WRFNHWDO 'DWDIURP

GLIIHUHQWSHUVSHFWLYHVLVDOVRLPSRUWDQWLQRUGHUWRREWDLQDQLQGHSWKSLFWXUHRIWKH

SDWLHQWVLWXDWLRQ 7KRPDVHWDO)HUDJHQHWDO ,WLVWKHUHIRUHQHFHVVDU\

(22)



WR FRPELQH REMHFWLYH RI WUHDWPHQW RXWFRPHV ZLWK DVVHVVPHQWV RI SURIHVVLRQDOV

SDUHQWVDVZHOODVSDWLHQWUHSRUWHGGDWDLQFOLQLFDOURXWLQH )LW]SDWULFNHWDO 

,PSDFWRI&/3RQ+542/

9DULRXV DVSHFWV RI SDWLHQW +542/ PD\ EH DIIHFWHG E\ WKH &/3 GLDJQRVLV DQG

WUHDWPHQWSURWRFRO 6WRFNHWDO 6DWLVIDFWLRQZLWKKHDULQJDSSHDUDQFHDQG

VSHHFK LV LQWHUGHSHQGHQWO\ FRQQHFWHG ZLWK SDWLHQW +542/ EXW UHPDLQV WR EH

IXUWKHU LQYHVWLJDWHG 5XPVH\ DQG +DUFRXUW  6WRFN DQG )HUDJHQ   )RU

GHFDGHV SDWLHQWUHSRUWHG GDWDUHJDUGLQJ VDWLVIDFWLRQZLWK DSSHDUDQFH DQG VSHHFK

KDVEHHQVKRZQWREHDXVHIXOLQGLFDWRUIRUWKHQHHGRISV\FKRORJLFDOHYDOXDWLRQ

DQG LQWHUYHQWLRQ 5LFKPDQ  7KRPDV HW DO  %HUJHU DQG 'DOWRQ 

)HUDJHQ HW DO   5HYLHZV FRQFOXGH WKDW SDWLHQWV ZLWK &/3 DUH LQ JHQHUDO

ZHOODGMXVWHGDQGKDYHQRPDMRUSV\FKRVRFLDOSUREOHPV +XQWHWDO6WRFN

DQG )HUDJHQ   +RZHYHU VHYHUDO FRQFHUQV LQ VSHFLILF GRPDLQV RI +542/

EHFDPH HYLGHQW ZKHQ H[DPLQHG LQ JUHDWHU GHWDLO UDWKHU WKDQ DV SDUW RI D ZLGHU

+542/ FRQFHSW 7KHVH GRPDLQV ZHUH EHKDYLRXUDO SUREOHPV VDWLVIDFWLRQ ZLWK

IDFLDODSSHDUDQFHGHSUHVVLRQDQGDQ[LHW\ +XQWHWDO FRQFHUQVDERXWYLVXDO

GLIIHUHQFHDQGH[SHULHQFHRIEXOO\LQJ 6KDULIHWDO SV\FKRORJLFDOKHDOWKDQG

YLWDOLW\ +HUNUDWKHWDO GLVVDWLVIDFWLRQZLWKDSSHDUDQFHVSHFLILFGHILFLWVLQ

FRJQLWLYH DQG ODQJXDJH GHYHORSPHQW UDLVHG OHYHOV RI VHOIFRQVFLRXVQHVV DQG

DQ[LHW\ 6WRFNDQG)HUDJHQ 

(YHQWKRXJKVRPHGRPDLQVRI+542/VHHPWREHDIIHFWHGRQDJURXSOHYHOLQWKH

&/3SRSXODWLRQLWLVFOHDUWKDWPDQ\LQGLYLGXDOVFRSHHIIHFWLYHO\ZLWKWKHDERYH

PHQWLRQHG FKDOOHQJHV 6RPH DOVR WXUQ WKHLU XQLTXH H[SHULHQFHV DQG YLHZSRLQWV

LQWR SRVLWLYH LQVLJKWV DQG SHUVRQDO VWUHQJWKV 6WUDXVV  )HUDJHQ  

,QFUHDVHGUHVHDUFKIRFXVRQSRVLWLYHRXWFRPHVDQGVWUHQJWKVGLVSOD\HGE\SHRSOH

ZLWK&/3KDVEHHQFDOOHGIRU 6WUDXVV6WRFNHWDO 6WXGLHVIRFXVLQJ

RQ SRVLWLYH RXWFRPHV KDYH WKXV IDU SURGXFHG LQVLJKWV RQ KDYLQJ D IDFLDO

GLIIHUHQFH VXFK DV SDUWLFLSDQWV SHUFHSWLRQ RI LPSURYHG FRPPXQLFDWLRQ DELOLWLHV

VHUYLFHWRRWKHUVREVHUYDWLRQDOVNLOOVLQQHUVWUHQJWKDELOLWLHVWRTXHVWLRQVRFLHW\D

YDOXHG VRFLDO FLUFOH SHUFHSWLRQ RI EHLQJ QRUPDO EHFDXVH RI WKH GLIIHUHQFH

(LVHUPDQ LQFUHDVHGYDOXHLQGLYHUVLW\DQGLQGLYLGXDOLW\DVZHOODVSRVLWLYH

SV\FKRORJLFDOJURZWK 6WRFNHWDO 6SHFLILFGRPDLQVLQZKLFKSHRSOHZLWK

&/3KDYHUHSRUWHGEHWWHU+542/WKDQDFRQWUROSRSXODWLRQDUHQRQFOHIWUHODWHG

DSSHDUDQFHRYHUDOODSSHDUDQFHKLJKHUSHUFHSWLRQRIVRFLDOHQYLURQPHQW %HUJHU

DQG 'DOWRQ   PRUH SRVLWLYH IXQFWLRQLQJ LQ DQG SHUFHSWLRQ RI IULHQGVKLSV

KLJKHU OHYHOV RI VRFLDO DFFHSWDQFH PRUH SRVLWLYH VHOISHUFHSWLRQV RI DSSHDUDQFH

DQGOHVVHPRWLRQDOGLVWUHVV )HUDJHQHWDO 

(23)



5HVXOWV IURP VWXGLHV RQ +542/ LQ WKH FOHIW SRSXODWLRQ DSSHDU LQFRQVLVWHQW ,Q

PDQ\GRPDLQVUHVXOWVYDU\FRQVLGHUDEO\ERWKZLWKLQDQGEHWZHHQVWXGLHVOHDGLQJ

WRFRQIOLFWLQJFRQFOXVLRQV4XDOLWDWLYHVWXGLHVVKHGOLJKWRQWKHQRUPDOO\RFFXUULQJ

FRPSOH[SV\FKRORJLFDOSURFHVVHVDQGODUJHLQGLYLGXDOYDULDWLRQRI+542/ZLWKLQ

WKHVDPHGRPDLQ 6WRFNHWDO.DSSHQHWDO ,WPD\EHKHOSIXOWRWKLQN

RID&/3DVDQXQGHUO\LQJSV\FKRORJLFDOVWUHVVRUZKLFKLQWHUDFWVZLWKGLIIHUHQW

SV\FKRORJLFDOGRPDLQVWRDYDU\LQJGHJUHHGHSHQGLQJRQSHUVRQDOGLVSRVLWLRQDQG

DJH 6WRFNHWDO6WRFNHWDO 

$IHZLPSRUWDQWSV\FKRORJLFDOFRQFHSWVZKLFKKDYHEHHQPHQWLRQHGDQGVWXGLHG

LQ UHODWLRQ WR LQGLYLGXDOV ZLWK &/3 DUH DGMXVWPHQW UHVLOLHQFH DQG FRSLQJ

$GMXVWPHQWLVDEURDGWHUPGHVFULELQJWKHSURFHVVRIDGDSWLQJDQGDGMXVWLQJWRD

FLUFXPVWDQFHWREHDEOHWRIXQFWLRQDGHTXDWHO\$GMXVWPHQWKDVEHHQGHVFULEHGDV

IOXFWXDWLQJDQGGLIILFXOWWRGHILQHRUFDSWXUHLQDFRPSUHKHQVLYHZD\ 6WRFNHWDO

  )RU SHRSOH ZLWK &/3 JRRG DGMXVWPHQW FDQ EH VHHQ DV RQH RI WKH PDLQ

JRDOV LQ WUHDWPHQW  WKDW WKH SHUVRQ FDQ IXQFWLRQ DGHTXDWHO\ LQ KLV RU KHU OLIH

GHVSLWH SRVVLEOH DSSHDUDQFH RU VSHHFK GLIIHUHQFHV )HUDJHQ  6WRFN HW DO

  5HVLOLHQFH LV WKH DELOLW\ WR PDLQWDLQ D KLJK 42/ RU DGMXVWPHQW GHVSLWH

DGYHUVLW\RUFULVLV /XWKDUHWDO /HYHORIUHVLOLHQFHKDVDOVREHHQDVVRFLDWHG

ZLWKVDWLVIDFWLRQZLWKDSSHDUDQFHDQGVSHHFKLQSHRSOHZLWK&/3 )HUDJHQHWDO

  &RSLQJ UHODWHV WR D VSHFLILF VWUHVV DQG WKH FRQVFLRXV HIIRUWV WKDW DQ

LQGLYLGXDO PDNHV WR GHDO ZLWK WKDW VWUHVV /D]DUXV DQG )RONPDQ   :KLFK

FRSLQJ VW\OH D SHUVRQ ZLWK &/3 XVHV KDV EHHQ VHHQ WR KDYH DQ HIIHFW RQ WKH

LQGLYLGXDO¶VDVZHOODVWKHIDPLO\¶VOHYHORISV\FKRVRFLDODGMXVWPHQW %DNHUHWDO

%HUJHUDQG'DOWRQ0RVVDQG5RVVHU ,WLVDOVRLPSRUWDQWWRNHHS

LQ PLQG WKDW WKH DERYHPHQWLRQHG FRQFHSWV DUH FORVHO\ UHODWHG DQG WKDW WKH\

LQWHUDFW ZLWK WKH RFFXUUHQFH RI &/3 RQ DQ LQGLYLGXDO VRFLDO DQG VRFLRFXOWXUDO

OHYHO )HUDJHQ6WRFNHWDO6WRFNHWDO 

:KHQDSDWLHQWKDVDKLJK+542/JRRGIXQFWLRQRIVSHHFKJRRGRFFOXVLRQDQG

KHDULQJ DQG WKH SDWLHQW LV VDWLVILHG ZLWK DSSHDUDQFH QR WUHDWPHQW LV QHFHVVDU\

:KHQ D SDWLHQW SUHVHQWV ZLWK LVVXHV UHODWHG WR WUHDWPHQW UHVXOWV RU XQDFFHSWDEOH

IXQFWLRQRIVSHHFKRFFOXVLRQRUKHDULQJDQGDQDSSURSULDWHWUHDWPHQWLQWHUYHQWLRQ

LVDYDLODEOHWKDWWUHDWPHQWVKRXOGEHRIIHUHGWRWKHSDWLHQW:KHQDWUHDWPHQWLVVXH

GRHVQRWKDYHDQDSSURSULDWHWUHDWPHQWLQWHUYHQWLRQWRLQFUHDVH+542/WKLVKDV

WR EH FOHDUO\ FRPPXQLFDWHG WR WKH SDWLHQW DQG DOWHUQDWLYH SDWKZD\V RI UHIHUUDO

SUHVHQWHGVXFKDVSV\FKRORJLFDOFRXQVHOOLQJDQGWUHDWPHQW

(24)



5HODWLRQ EHWZHHQ KHDULQJ DSSHDUDQFH VSHHFK DQG

+542/LQLQGLYLGXDOVZLWK&/3

+HDULQJ

)HUDJHQ HW DO IRXQG WKDW KHDULQJ ZDV QRW DQ LQIOXHQWLDO EDFNJURXQG YDULDEOH LQ

UHODWLRQ WR VSHHFK ODQJXDJH UHDGLQJ DQG SV\FKRORJLFDO DGMXVWPHQW LQ D &/3

SRSXODWLRQ )HUDJHQ HW DO   7KLV LV LQ DFFRUGDQFH ZLWK TXDQWLWDWLYH UHVXOWV

IURP D VWXG\ E\ 2RVWHUNDPS HW DO   +RZHYHU WKHUH DUH LQGLFDWLRQV WKDW

KHDULQJLPSDLUPHQWPD\DIIHFW+542/LQSDWLHQWVZLWK&/3DVLQWKHTXDOLWDWLYH

VHFWLRQ RI WKLV VWXG\ SDUWLFLSDQWV GLG LQ IDFW UHSRUW FRQFHUQV UHJDUGLQJ KHDULQJ

ZKLFK ZHUH DVVXPHG WR LPSDFW RQ +542/ )XUWKHUPRUH KHDULQJ GLIILFXOWLHV

UHODWHG WR RWLWLV PHGLD ZLWK HIIXVLRQ KDYH EHHQ UHSRUWHG WR EH DVVRFLDWHG ZLWK

VRFLDOLPSDLUPHQWLQFKLOGUHQZLWK&/3 7LHUQH\HWDO ,QDGGLWLRQLQRQH

VWXG\ DGXOWV ZLWK &/3 UHSRUWHG WKDW KHDULQJ GLIILFXOWLHV DIIHFWHG WKHLU VRFLDO

LQWHJUDWLRQJUHDWHUWKDQWKHFOHIWLWVHOI 6WRFNHWDO 

$SSHDUDQFH

6DWLVIDFWLRQ ZLWK DSSHDUDQFH LQ LQGLYLGXDOV ZLWK &/3 JHQHUDOO\ FRUUHODWHV ZLWK

VHOIUHSRUWHG SV\FKRVRFLDO IXQFWLRQLQJ ZHOOEHLQJ DQG +542/ 7KRPDV HW DO

 2RVWHUNDPS HW DO  )HUDJHQ DQG %RUJH  )HUDJHQ HW DO 

)HUDJHQHWDO)HUDJHQDQG6WRFN +LJKVDWLVIDFWLRQZLWKDSSHDUDQFH

DQG VSHHFK DQG ORZ DPRXQW RI UHSRUWHG WHDVLQJ KDV DOVR EHHQ DVVRFLDWHG ZLWK

KLJKHU SV\FKRVRFLDO UHVLOLHQFH LQ SDWLHQWV ZLWK &/3 )HUDJHQ HW DO   $V

VKRZQLQWKHVDPHVWXG\YLVLELOLW\RIWKHFOHIWGLGQRWFRUUHODWHZLWKWKHOHYHORI

UHVLOLHQFH$IXUWKHUVWXG\FRQFOXGHGWKDWSDWLHQWVRFLDOH[SHULHQFHZDVWKHPRVW

LQIOXHQWLDO IDFWRU IRU SV\FKRVRFLDO DGMXVWPHQW IROORZHG E\ OHYHO RI SHUFHLYHG

VSHHFK GLIILFXOWLHV OHYHO RI VDWLVIDFWLRQ ZLWK DSSHDUDQFH DQG FRSLQJ VW\OH &OHIW

W\SHKRZHYHUZDVQRWDSUHGLFWRURIDGMXVWPHQW %HUJHUDQG'DOWRQ 

,WKDVEHHQVWDWHGWKDWSDWLHQWRSLQLRQRQDSSHDUDQFHLVPRUHLPSRUWDQWIRUSDWLHQW

ZHOOEHLQJ WKDQ WKH REMHFWLYH UHVXOW RU SURIHVVLRQDO RU OD\PDQUDWLQJ 5LFKPDQ

 0RVV  )HUDJHQ HW DO  0DQL HW DO  )HUDJHQ HW DO 

3DXVFKHWDO6WRFNDQG)HUDJHQ0XOGHUHWDO ,QDVWXG\GHVLJQ

XVHG E\ 5LFKPDQ   VHOIUHSRUWV IURP SDWLHQWV RQ VRFLDO DGMXVWPHQW ZHUH

FRPSDUHGWRVWUXFWXUHGLQWHUYLHZRXWFRPHVZLWKDSV\FKRORJLVWXVLQJREMHFWLYHO\

FDWHJRUL]HGUHVSRQVHFKRLFHV7KHDXWKRUVXJJHVWVWKDWWKHVWXG\UHVXOWVVWUHQJWKHQ

WKH YDOLGLW\ RI SDWLHQWUHSRUWHG GDWD VLQFH REMHFWLYH OHYHOV RI VRFLDO DGMXVWPHQW

FRUUHODWHGZLWKWKH352 5LFKPDQ 

(25)



5HVHDUFKRQWKHUHODWLRQEHWZHHQVDWLVIDFWLRQZLWKDSSHDUDQFHDQG+542/LVQRW

KRZHYHU XQDQLPRXV )HUDJHQ DQG 6WRFN   VKRZHG WKDW WKH FRUUHODWLRQ

EHWZHHQVDWLVIDFWLRQZLWKDSSHDUDQFHDQGULVNRIORZVRFLDOFRJQLWLYHHPRWLRQDO

DQGEHKDYLRXUDODGMXVWPHQWZDVZHDNRULQVLJQLILFDQWIRU\HDUROGV5DWKHUWKH

ULVNIRUORZVRFLDOHPRWLRQDODQGEHKDYLRXUDODGMXVWPHQWDQGGLVVDWLVIDFWLRQZLWK

DSSHDUDQFH ZDV FRUUHODWHG ZLWK WKH SUHVHQFH RI DGGLWLRQDO FRQGLWLRQV VXFK DV

GHYHORSPHQWDOGHOD\OHDUQLQJGLIILFXOWLHVDXWLVPVSHFWUXPGLVRUGHUVRU DWWHQWLRQ

GHILFLWK\SHUDFWLYLW\GLVRUGHU $'+'  )HUDJHQDQG6WRFN $W\HDUVRI

DJH KRZHYHU DQ DVVRFLDWLRQ ZDVIRXQG EHWZHHQGLVVDWLVIDFWLRQ ZLWK DSSHDUDQFH

DQG HOHYDWHG ULVN IRU ORZ HPRWLRQDO DGMXVWPHQW LQ ERWK &/3 DQG QRQ&/3

SDUWLFLSDQWV )HUDJHQHWDO 7KHULVNRIORZDGMXVWPHQWKRZHYHUVHHPHGWR

EH VSHFLILF WRD VWXGLHG GRPDLQ UDWKHUWKDQWR +542/ LQ JHQHUDO )RU H[DPSOH

ORZVDWLVIDFWLRQZLWKDSSHDUDQFHDIIHFWHGWKHGRPDLQRIHPRWLRQDODGMXVWPHQWEXW

WKLV HIIHFW GLG QRW VSLOO RYHU LQWR RWKHU GRPDLQV RI DGMXVWPHQW 7KH DXWKRUV DOVR

FRQFOXGHG WKDW HPRWLRQDO DQG DSSHDUDQFH UHODWHG GLVWUHVV ZDV FRPPRQ LQ ERWK

&/3DQGQRQ&/3SDUWLFLSDQWVDW\HDUVRIDJH

,QVXPPDU\WKHUHODWLRQEHWZHHQ+542/DQGREMHFWLYHDSSHDUDQFHRUFOHIWW\SH

LV XQFOHDU 6HOIUHSRUWHGVDWLVIDFWLRQ ZLWKDSSHDUDQFH KRZHYHU KDV DQ LQIOXHQFH

RQ+542/7KHHIIHFWVRIVHOIUHSRUWHGVDWLVIDFWLRQZLWKDSSHDUDQFHRQ+542/

PD\YDU\ZLWKDJHDQGUHVXOWVPD\DOVRYDU\GHSHQGLQJRQZKLFKVSHFLILFGRPDLQV

RI+542/DUHPHDVXUHG

6SHHFK

(DUOLHU UHVHDUFK KDV UHSRUWHG WKDW VDWLVIDFWLRQ ZLWK VSHHFK FRUUHODWHV ZLWK

SV\FKRORJLFDO DGMXVWPHQW %HUJHU DQG 'DOWRQ   UDWKHU WKDQ ZLWK UHVXOWV RI

SHUFHSWXDO VSHHFK DVVHVVPHQW E\ VSHHFK ODQJXDJH SDWKRORJLVWV +DYVWDP HW DO

 )HUDJHQ HW DO   1R FRUUHODWLRQ ZDV IRXQG EHWZHHQ +542/ DQG

VDWLVIDFWLRQ ZLWK VSHHFK LQ TXDQWLWDWLYH UHVXOWV LQ D VWXG\ E\ 2RVWHUNDPS HW DO

  ,Q WKH TXDOLWDWLYH VHFWLRQ RI WKDW VWXG\ KRZHYHU SDUWLFLSDQWV GLG UHSRUW

FRQFHUQV UHJDUGLQJ VSHHFK ZKLFK ZHUH DVVXPHG WR LPSDFW RQ +542/ 3DWLHQW

UHSRUWHG DWWLWXGH WRZDUG FRPPXQLFDWLRQ KDV EHHQ FRUUHODWHG ZLWK UHVXOWV RI

SHUFHSWXDODVVHVVPHQWRIVSHHFKLQSDWLHQWVZLWK&/3 +DYVWDPHWDO ,Q

WKLVVWXG\SDWLHQWVZKRKDGDKLJKHUTXDOLW\RIVSHHFKDOVRKDGDPRUHSRVLWLYH

DWWLWXGHWRZDUGVSHDNLQJ

,Q FRQFOXVLRQ SURIHVVLRQDO RSLQLRQ RQ TXDOLW\ RI VSHHFK KDV EHHQ VKRZQ QRW WR

FRUUHODWHSDUWLFXODUO\ZHOOZLWK+542/3DWLHQWVDWLVIDFWLRQZLWKVSHHFKKDVQRQ

WKH OHVV VKRZQ WR KDYH D FOHDUHU DVVRFLDWLRQ ZLWK +542/ DQG SV\FKRORJLFDO

DGMXVWPHQW 3DWLHQWUHSRUWHG GDWD UHJDUGLQJ VDWLVIDFWLRQ ZLWK VSHHFK DV ZLWK

DSSHDUDQFH FRXOG WKHUHIRUH EH D XVHIXO LQGLFDWRU IRU WKH QHHG RI SV\FKRORJLFDO

HYDOXDWLRQDQGLQWHUYHQWLRQ %HUJHUDQG'DOWRQ)HUDJHQHWDO 

(26)



/LPLWDWLRQV RI HDUOLHU UHVHDUFK RQ SDWLHQW UHSRUWHG

RXWFRPHV 352V LQSDWLHQWVZLWK&/3

2QHREVWDFOHDVVRFLDWHGZLWK352DQDO\VLVLQUHVHDUFKUHJDUGLQJ&/3LVWKHODFN

RI D ZLGHO\ DFFHSWHG PHDVXUHPHQW LQVWUXPHQW ,Q D UHYLHZ RI FXUUHQW 352

+542/VWXGLHVLWZDVIRXQGWKDWPRVW3520VKDGEHHQXVHGLQRQHVWXG\RQO\

.ODVVHQ HW DO   1HLWKHU GLG WKH 3520V PHHW VFLHQWLILF VWDQGDUGV RI

UHOLDELOLW\YDOLGLW\DQGUHVSRQVLYHQHVV (FNVWHLQHWDO $QRWKHUUHYLHZRI

352V LQ SODVWLF VXUJHU\ UHYHDOHG WKDW DOPRVW DOO GLVHDVHVSHFLILF PHDVXUHV ZHUH

DGKRFPHDVXUHVSURGXFHGIRUDSDUWLFXODUVWXG\ &DQRHWDO 6WXG\UHVXOWV

DUH WKHUHIRUH GLIILFXOW WR FRPSDUH GUDZ FRQFOXVLRQV IURP DQG WR EXLOG XSRQ

6WRFNDQG)HUDJHQ 

7KHUH DUH D QXPEHU RI ELDVHV UHODWHG WR 352 FRQFHUQLQJ SDWLHQW VDWLVIDFWLRQ RI

ZKLFK UHVHDUFKHUV QHHG WR EH DZDUH )RU H[DPSOH HYHQ WKRXJK WKH FOLQLFDO

RXWFRPH RI RUDO KHDOWK GHQWRIDFLDO IRUP DQG TXDOLW\ RI ERQH JUDIWLQJ ZHUH

GLVDSSRLQWLQJDOPRVWDOOSDWLHQWVDQGSDUHQWVZHUHVDWLVILHGRUPRGHUDWHO\VDWLVILHG

ZLWKRXWFRPHRIWUHDWPHQW :LOOLDPVHWDO ,WZDVK\SRWKHVL]HGWKDWSDUHQWV

KDYHJUHDWWUXVWLQ+&3VEXWODFNFRPSDUDWLYHNQRZOHGJHRI&/3WUHDWPHQWDQG

RXWFRPH ,Q WKH (XURFOHIWVWXG\ IHZ SDWLHQWV RU SDUHQWV ZHUH GLVVDWLVILHG ZLWK

RYHUDOO UHVXOWV RI WUHDWPHQW GHVSLWH UDWKHU GLVDSSRLQWLQJ REMHFWLYH UDWLQJV RI

RXWFRPH 6HPEHWDO $OWKRXJKUHSRUWHGVDWLVIDFWLRQIXUWKHUWUHDWPHQW

ZDV VWLOO GHVLUHG 'HVSLWH  RI SDWLHQWV LQ DQRWKHU VWXG\ EHLQJ VDWLVILHG ZLWK

RYHUDOO FOHIWFDUH  RI SDWLHQWV DQG  RI SDUHQWV QRQHWKHOHVV SXW IRUZDUG

VXJJHVWLRQVIRUIXUWKHUWUHDWPHQW 7XUQHUHWDO  7KHDXWKRUVSURSRVHGWKDW

IDPLOLHV ZKR KDG UHFHLYHG FDUH IURP &/3 WHDPV PLJKW UHSRUW KLJK VDWLVIDFWLRQ

ZLWKWUHDWPHQWGXHWRJUDWHIXOQHVVDQGDOVRWRMXVWLI\WKHLUHPRWLRQDOLQYHVWPHQWLQ

WKHWUHDWPHQW,WKDVEHHQVXJJHVWHGWKDWRYHUWKH\HDUVROGHUSDWLHQWVFRXOGKDYH

UHSUHVVHG RU IRUJRWWHQ WKH SDLQIXO IHHOLQJV H[SHULHQFHG ZKHQ JURZLQJ XS ZLWK

&/3,QUHWURVSHFWLYHVWXGLHVWKLVFRXOGOHDGWRKLJKHUUHSRUWVRIVDWLVIDFWLRQ7KH

IHDU RI PRUH VXUJLFDO LQWHUYHQWLRQV FRXOG DOVR UHVXOW LQ SDWLHQWV UHSRUWLQJ KLJKHU

VDWLVIDFWLRQZLWKDSSHDUDQFH %URGHUHWDO 7KLVK\SRWKHVLVZRXOGKRZHYHU

RQO\DSSO\WRDVXESRSXODWLRQVLQFHDPDMRULW\RISDWLHQWVLQWKHEHIRUHPHQWLRQHG

VWXGLHV DVNHG IRU DQG PDGH VXJJHVWLRQV IRU DGGLWLRQDO LQWHUYHQWLRQV )XUWKHU

OLPLWDWLRQVRIWKHXVHRI3520VLQJHQHUDOLVWKHDGGHGDGPLQLVWUDWLYHEXUGHQDQG

ULVNRIH[FOXVLRQRISDUWLFLSDQWVZLWKORZOLWHUDF\ :RUPDOGDQG5RGULJXHV 

(27)



6SHFLILF3520VXVHGLQWKLVWKHVLV

7KHUHDUHPXOWLSOH3520VLQXVHLQ&/3UHVHDUFK7KRVHXVHGLQWKLVWKHVLVZLOO EHSUHVHQWHGLQJUHDWHUGHWDLO

0DOP|VSHHFKTXHVWLRQQDLUH

0DOP| VSHHFK TXHVWLRQQDLUH FRQWDLQHG TXHVWLRQV FRQFHUQLQJ WKH SDWLHQW¶V

EDFNJURXQG VDWLVIDFWLRQ ZLWK VSHHFK SHUFHLYHG VSHHFK TXDOLW\ DQG SHUFHLYHG

LPSURYHPHQW IURP WUHDWPHQW ,W FDQ EH IRXQG LQ $SSHQGL[ , $Q HYDOXDWLRQ RI

0DOP|VSHHFKTXHVWLRQQDLUHEDVHGRQSRLQWVIURP5HHYHHWDOFDQEHIRXQG

LQ7DEOH

7DEOH (YDOXDWLRQRI0DOP|VSHHFKTXHVWLRQQDLUHEDVHGRQSRLQWVIURP5HHYHHWDO

&RQFHSWXDODQG

PHDVXUHPHQWPRGHO 0DOP|VSHHFKTXHVWLRQQDLUHLVDQDGKRFTXHVWLRQQDLUHZLWKQRSULRUGRFXPHQWDWLRQ

RIFRQVWUXFWVPHDVXUHGRULQWHQGHGWDUJHWSRSXODWLRQ

5HOLDELOLW\ 7KHUHLVQRWHVWLQJRITXHVWLRQQDLUHSURSHUWLHVUHJDUGLQJ WHVWUHWHVWUHOLDELOLW\RU

LQWHUQDOFRQVLVWHQF\7KHTXHVWLRQQDLUHSURVVLEO\ PHDVXUHVVHYHUDOFRQVWUXFWV

D&RQWHQWYDOLGLW\ 1RWHYDOXDWHG

E&RQVWUXFWYDOLGLW\ 1RWHYDOXDWHG

F5HVSRQVLYHQHVV 1RWHYDOXDWHG

,QWHUSUHWDELOLW\RIVFRUHV 1RQRUPVKDYHEHHQHYDOXDWHG

7UDQVODWLRQRIWKH3520 4XHVWLRQQDLUHZDVGHYHORSHGLQ6ZHGLVK1RRWKHUWUDQVODWLRQVDUH DYDOLDEOH

3DWLHQWDQGLQYHVWLJDWRU

EXUGHQ

3DWLHQWVFDQFRPSOHWHWKHTXHVWLRQQDLUHLQDSSUR[LPDWHO\ILYH PLQXWHV7KHOHYHORI

OLWHUDF\QHHGHGWRFRPSOHWHWKHTXHVWLRQQDLUHKDVQRWEHHQHYDOXDWHG

&+$64

7KHSV\FKRPHWULFSURSHUWLHVRI&+$64KDYHEHHQHYDOXDWHGZLWK&77&+$64

DQG LWV SUHGHFHVVRU 6DWLVIDFWLRQ :LWK $SSHDUDQFH 4XHVWLRQQDUH 6:$  KDYH

SUHYLRXVO\ EHHQ XVHG LQ FOLQLFDO UHVHDUFK LQ (XURSH %HUJHU DQG 'DOWRQ 

)HUDJHQHWDO)HUDJHQDQG%RUJH0DQLHWDO0DQLHWDO

)HUDJHQHWDO)HUDJHQDQG6WRFN&UHUDQGHWDO 7KHVFRUHIRU

HDFKLWHPUDQJHVIURP]HURWRSRLQWV&+$64LQ6ZHGLVKDQG(QJOLVKDQGWKH

8VHU *XLGH IRU WKH &+$64 FDQ EH IRXQG LQ $SSHQGL[ ,,,9 $Q HYDOXDWLRQ RI

&+$64EDVHGRQWKHSRLQWVIURP5HHYHHWDOFDQEHIRXQGLQ7DEOH

(28)



7DEOH (YDOXDWLRQRI&+$64EDVHGRQSRLQWVIURP5HHYHHWDO

&RQFHSWXDODQG

PHDVXUHPHQWPRGHO 'RFXPHQWDWLRQLVDYDLODEOHKRZHYHUQRWSXEOLVKHGUHJDUGLQJWKHGHYHORSPHQWDQG

XVDJHRI &+$64 &OHIW3V\FKRORJ\&OLQLFDO([FHOOHQFH1HWZRUN  &+$64LVD

PRGLILHGYHUVLRQRIWKH6:$6:$ZDVGHVLJQHGE\WKH&OHIW3V\FKRORJ\6SHFLDO

,QWHUHVW*URXS&UDQLRIDFLDO6RFLHW\RI*UHDW%ULWDLQDQG,UHODQGVSHFLILFDOO\IRU

SDWLHQWVZLWKIDFLDOGLVILJXUHPHQW (PHUVRQHWDO 

5HOLDELOLW\ 7KHUHDUHWZRIDFWRUORDGLQJVZLWKLQ &+$64 &OHIW3V\FKRORJ\&OLQLFDO([FHOOHQFH

1HWZRUN  )DFWRUORDGLQJLWHPVFRQVLVWRIQLQHLWHPVUHJDUGLQJIHDWXUHV

W\SLFDOO\DIIHFWHGE\DFOHIWDQGIDFWRUORDGLQJLWHPVFRQVLVWRI VL[LWHPVUHJDUGLQJ

IHDWXUHVQRWW\SLFDOO\DIIHFWHGE\DFOHIW7KHUHIRUH&+$64SURGXFHVWZRVFRUHV

VXPRIIDFWRUORDGLQJLWHPV WRWDOIHDWXUHV DQGVXPRIIDFWRUORDGLQJLWHPV

WRWDOIHDWXUHV 7KHLQWHUQDOFRQVLVWHQF\ZLWKLQWKHWZRIDFWRUORDGLQJVKDYHEHHQ

WHVWHGZLWK&URQEDFK¶VDOIDIDFWRUORDGLQJIHDWXUHV  DQGIDFWRUORDGLQJ

LWHPV  7HVWUHWHVWUHOLDELOLW\KDVQRWEHHQHYDOXDWHGIRU&+$64

D&RQWHQWYDOLGLW\ &RQWHQWYDOLGLW\KDVQRWEHHQHYDOXDWHGZLWKTXDOLWDWLYHLQWHUYLHZVZLWKPHPEHUVRI

WKHSDWLHQWSRSXODWLRQ

E&RQVWUXFWYDOLGLW\ &+$64KDVVKRZQFRQVWUXFWYDOLGLW\VLQFHWKHVFRUHRIIDFWRUORDGLQJLWHPVDIWHU

RUWKRJQDWLFVXUJHU\LPSURYHGZKLOHVFRUHRIIDFWRUORDGLQJLWHPVGLGQRW

VLJQLILFDQWO\LPSURYH &OHIW3V\FKRORJ\&OLQLFDO([FHOOHQFH1HWZRUN 

F5HVSRQVLYHQHVV &OLQLFDOO\PHDQLQJIXOFKDQJHVLQ&+$64VFRUHVKDYHQRW \HW EHHQHYDOXDWHG

,QWHUSUHWDELOLW\RIVFRUHV 1RUPVKDYHEHHQFDOFXODWHGRQ&/3 SDWLHQWVIURPWKH8QLWHG.LQJGRPWRDLG

LQWHUSUHWDWLRQRI VFRUHVIURP&+$646FRUHVLQWKHWK SHUFHQWLOHLQGLFDWHORZHU

VDWLVIDFWLRQWKDQH[SHFWHGDQGVFRUHVLQWKHWK SHUFHQWLOH LQGLFDWHYHU\PXFKORZHU

VDWLVIDFWLRQWKDQH[SHFWHG &OHIW3V\FKRORJ\&OLQLFDO([FHOOHQFH1HWZRUN 

7UDQVODWLRQRIWKH3520 4XHVWLRQQDLUHGHYHORSHGLQ(QJOLVK1RRWKHUWUDQVODWLRQVDYDOLDEOH

3DWLHQWDQGLQYHVWLJDWRU

EXUGHQ 3DWLHQWVFDQFRPSOHWH &+$64LQDSSUR[LPDWHO\ILYH PLQXWHV7KHOHYHORI OLWHUDF\

QHHGHGWRFRPSOHWH &+$64KDVQRWEHHQHYDOXDWHG

&/()74

&/()74 KDV EHHQ GHYHORSHG ZLWK 507 ,W FRQVLVWV RI  VFDOHV DQG RQH

FKHFNOLVW ,W KDV EHHQ ILHOG WHVWHG LQ  FRXQWULHV .ODVVHQ HW DO   7KH

&/()74 VFDOHV DQG WKH 8VHU *XLGH IRU &/()74 FDQ EH IRXQG DW

ZZZTSRUWIROLRRUJ 'DWD IURP &RPSXWHULVHG DGDSWLYH WHVWLQJ &$7  KDV EHHQ

WHVWHGRQGDWDIURP&/()74 +DUULVRQHWDO 7KHVWXG\VKRZHGWKDW

DFFXUDF\ RIHQGUHVXOW FRXOG EHREWDLQHG E\ XVLQJ RQO\  LWHPV   RIWKH

LWHPVLQWKHIXOOVFDOHV$QHYDOXDWLRQRI&/()74EDVHGRQWKHSRLQWVIURP

5HHYHHWDO FDQEHIRXQGLQ7DEOH

References

Related documents

VRIWZDUH DQG WHFKQLTXHV WKH LQIRUPDWLRQ VKRXOG EH SUHVHQWHG WR WKH SXEOLF LQ DQ HDV\WRXVH DQG HDV\WR XQGHUVWDQG ZD\ LQ RUGHU WR UHDFK WKH ODUJHVW SRVVLEOH SHUFHQWDJH RI WKH WDUJHW

Wklv uhvxow kdv lpsruwdqw lpsolfdwlrqv1 Iluvw/ lw lv wkh hqwluh yroxph ri zruog wudgh wkdw pdwwhuv iru lqhtxdolw|dqg qrw wkh vpdoo yroxphv ri Qruwk0 Vrxwk wudgh rqo|1 Lq wklv

EHLQJ WRR WRSGRZQ DQG LQIOH[LEOH &gt;@ WDNLQJ DZD\ WKH EHQHILWV RI DXWRQRP\ WR

Dv fdq eh vhhq iurp Iljxuh  dqg Iljxuh 2 wkh htxdwlrq E  jlyhv d eldvhg uhvxow iru qlwh vdpsoh vl}hv1 Orrnlqj edfn dw wkh ghulydwlyhv ri htxdwlrq E  lw fdq eh vhhq wkdw

 2SWLPLVDWLRQ RI WKH SURWHFWLRQ HTXLSPHQW GHSHQGLQJ RQ WKH YROWDJH VDJ  PDJQLWXGH DQG GXUDWLRQ  IRU D V\QFKURQRXV PDFKLQH WR NHHS V\QFKURQLVP. ZKHQ

'HWHUPLQDWLRQ RI WKH SDUWLDO FRHIILFLHQW ηγ P  ZLWK WKH WDEOH PHWKRG DQG WKH SUREDELOLVWLFPHWKRGJLYHVVOLJKWO\GLIIHUHQWUHVXOWVIRUWKHVHYHQEULGJHVEHWZHHQ /XOHn

Wkh sxusrvh ri wklv uhsruw lv wr ghvfuleh wkh prgho wkdw wkh Vzhglvk Qdwlrqdo Ghew R!fh kdv ghyhorshg iru vwxg|lqj wkh hhfwv ri wkh fkrlfh ri gxudwlrq dqg fxuuhqf| frpsrvlwlrq lq

Lq ghyhorslqj wkh vlpxodwlrq prgho/rxu dpelwlrq kdv ehhq wr nhhs wkh prgho vlpsoh dqg wr plqlpl}h wkh qxpehu ri yduldeohv wr eh prghoohg1 Frq0 vhtxhqwo|/wkh prgho jlyhv d