| 1. |
- Kalske, Roope, et al.
(author)
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Arthroscopic Partial Meniscectomy for a Degenerative Meniscus Tear Is Not Cost Effective Compared With Placebo Surgery : An Economic Evaluation Based on the FIDELITY Trial Data
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In: Clinical Orthopaedics and Related Research. - 0009-921X. ; , s. 1-11
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Journal article (peer-reviewed)abstract
- BACKGROUND: In patients with a degenerative tear of the medial meniscus, recent meta-analyses and systematic reviews have shown no treatment benefit of arthroscopic partial meniscectomy (APM) over conservative treatment or placebo surgery. Yet, advocates of APM still argue that APM is cost effective. Giving advocates of APM their due, we note that there is evidence from the treatment of other musculoskeletal complaints to suggest that a treatment may prove cost effective even in the absence of improvements in efficacy outcomes, as it may lead to other benefits, such as diminished productivity loss and reduced costs, and so the question of cost effectiveness needs to be answered for APM.QUESTIONS/PURPOSES: (1) Does APM result in lower postoperative costs compared with placebo surgery? (2) Is APM cost-effective compared with placebo surgery?METHODS: One hundred forty-six adults aged 35 to 65 years with knee symptoms consistent with a degenerative medial meniscus tear and no knee osteoarthritis according to the American College of Rheumatology clinical criteria were randomized to APM (n = 70) or placebo surgery (n = 76). In the APM and placebo surgery groups, mean age was 52 ± 7 years and 52 ± 7 years, and 60% (42 of 70) and 62% (47 of 76) of participants were men, respectively. There were no between-group differences in baseline characteristics. In both groups, a standard diagnostic arthroscopy was first performed. Thereafter, in the APM group, the torn meniscus was trimmed to solid meniscus tissue, whereas in the placebo surgery group, APM was carefully mimicked but no resection of meniscal tissue was performed; as such, surgical costs were the same in both arms and were not included in the analyses. All patients received identical postoperative care including a graduated home-based exercise program. At the 2-year follow-up, two patients were lost to follow-up, both in the placebo surgery group. Cost effectiveness over the 2-year trial period was computed as incremental net monetary benefit (INMB) for improvements in quality-adjusted life years (QALY), using both the societal (primary) and healthcare system (secondary) perspectives. To be able to consider APM cost effective, the CEA analysis should yield a positive INMB value. Nonparametric bootstrapping was used to assess uncertainty. Several one-way sensitivity analyses were also performed.RESULTS: APM did not deliver lower postoperative costs, nor did it convincingly improve quality of life scores when compared with placebo surgery. From a societal perspective, APM was associated with € 971 (95% CI -2013 to 4017) higher costs and 0.015 (95% CI -0.011 to 0.041) improved QALYs over 2-year follow-up compared with placebo surgery. Both differences were statistically inconclusive (a wide 95% CI that crossed the line of no difference). Using the conventional willingness to pay (WTP) threshold of € 35,000 per QALY, APM resulted in a negative INMB of € -460 (95% CI -3757 to 2698). In our analysis, APM would result in a positive INMB only when the WTP threshold rises to about € 65,000 per QALY. The wide 95% CIs suggests uncertain cost effectiveness irrespective of chosen WTP threshold.CONCLUSION: The results of this study lend further support to clinical practice guidelines recommending against the use of APM in patients with a degenerative meniscus tear. Given the robustness of existing evidence demonstrating no benefit or cost effectiveness of APM over nonsurgical treatment or placebo surgery, future research is unlikely to alter this conclusion.Level of Evidence Level III, economic analysis.
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| 2. |
- Sihvonen, Raine, et al.
(author)
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Arthroscopic partial meniscectomy for a degenerative meniscus tear : A 5 year follow-up of the placebo-surgery controlled FIDELITY (Finnish Degenerative Meniscus Lesion Study) trial
- 2020
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In: British journal of sports medicine. - : BMJ. - 0306-3674 .- 1473-0480. ; 54:22, s. 1332-1339
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Journal article (peer-reviewed)abstract
- Objectives: To assess the long-term effects of arthroscopic partial meniscectomy (APM) on the development of radiographic knee osteoarthritis, and on knee symptoms and function, at 5 years follow-up. Design: Multicentre, randomised, participant- A nd outcome assessor-blinded, placebo-surgery controlled trial. Setting: Orthopaedic departments in five public hospitals in Finland. Participants: 146 adults, mean age 52 years (range 35-65 years), with knee symptoms consistent with degenerative medial meniscus tear verified by MRI scan and arthroscopically, and no clinical signs of knee osteoarthritis were randomised. Interventions: APM or placebo surgery (diagnostic knee arthroscopy). Main outcome measures: We used two indices of radiographic knee osteoarthritis (increase in Kellgren and Lawrence grade ≥1, and increase in Osteoarthritis Research Society International (OARSI) atlas radiographic joint space narrowing and osteophyte sum score, respectively), and three validated patient-relevant measures of knee symptoms and function (Western Ontario Meniscal Evaluation Tool (WOMET), Lysholm, and knee pain after exercise using a numerical rating scale). Results: There was a consistent, slightly greater risk for progression of radiographic knee osteoarthritis in the APM group as compared with the placebo surgery group (adjusted absolute risk difference in increase in Kellgren-Lawrence grade ≥1 of 13%, 95% CI-2% to 28%; adjusted absolute mean difference in OARSI sum score 0.7, 95% CI 0.1 to 1.3). There were no relevant between-group differences in the three patient-reported outcomes: Adjusted absolute mean differences (APM vs placebo surgery),-1.7 (95% CI-7.7 to 4.3) in WOMET,-2.1 (95% CI-6.8 to 2.6) in Lysholm knee score, and-0.04 (95% CI-0.81 to 0.72) in knee pain after exercise, respectively. The corresponding adjusted absolute risk difference in the presence of mechanical symptoms was 18% (95% CI 5% to 31%); there were more symptoms reported in the APM group. All other secondary outcomes comparisons were similar. Conclusions: APM was associated with a slightly increased risk of developing radiographic knee osteoarthritis and no concomitant benefit in patient-relevant outcomes, at 5 years after surgery. Trial registration: ClinicalTrials.gov (NCT01052233 and NCT00549172).
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| 3. |
- Abadzhiev, Andrey, 1980-, et al.
(author)
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Managing the complexity of green innovation
- 2022
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In: European Journal of Innovation Management. - : Emerald Group Publishing Limited. - 1460-1060 .- 1758-7115. ; 25:6, s. 850-866
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Journal article (peer-reviewed)abstract
- Purpose Green innovation can promote both environmental sustainability and economic growth. However, its development and implementation can be complex due to the need to align innovation activities within and across companies. In this study, the authors examined how this complexity can be managed by analyzing how individual companies combine different innovation activities to develop green innovation, and how companies along the value chain align to implement these innovations. Design/methodology/approach The dataset comprises both interviews and a survey of senior executives from the Swedish wood construction industry. These data were first analyzed by using fuzzy set qualitative comparative analysis (fsQCA) to identify innovation activity configurations at the level of the individual company. The interviews were then analyzed to identify alignment mechanisms enabling the implementation of green innovation along the value chain. Findings At the company level, the authors found three innovation activity configurations with varying levels of complexity: (1) systemic innovation by proactive companies, (2) process innovation by reactive companies and (3) inaction by technology-independent companies. On the value chain level, the authors found three alignment mechanisms that facilitate the implementation of green innovation along the value chain. These mechanisms promote cooperation by increasing efficiency, opening up new market opportunities and increasing the level of servitization. Originality/value This paper analyzes the complexity of green innovation and provides novel insights into how complexity is managed at the level of both the individual company and the value chain.
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| 4. |
- Hietanen, Joel, et al.
(author)
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Catering to Otherness : Levinasian Consumer Ethics at Restaurant Day
- 2021
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In: Journal of Business Ethics. - : Springer. - 0167-4544 .- 1573-0697. ; 168:2, s. 261-276
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Journal article (peer-reviewed)abstract
- There is a rich tradition of inquiry in consumer research into how collective consumption manifests in various forms and contexts. While this literature has shown how group cohesion prescribes ethical and moral positions, our study explores how ethicality can arise from consumers and their relations in a more emergent fashion. To do so, we present a Levinasian perspective on consumer ethics through a focus on Restaurant Day, a global food carnival that is organized by consumers themselves. Our ethnographic findings highlight a non-individualistic way of approaching ethical subjectivity that translates into acts of catering to the needs of other people and the subversion of extant legislation by foregrounding personal responsibility. These findings show that while consumer gatherings provide participants a license to temporarily subvert existing roles, they also allow the possibility of ethical autonomy when the mundane rules of city life are renegotiated. These sensibilities also create ‘ethical surplus’, which is an affective excess of togetherness. In the Levinasian register, Restaurant Day thus acts as an inarticulable ‘remainder’—a trace of the possibility of being able to live otherwise alongside one another in city contexts.
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| 5. |
- Hietanen, Joel, et al.
(author)
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'Managerial Storytelling’ : How we produce managerial and academic stories in qualitative B2B case study research
- 2014
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In: Journal of Global Scholars of Marketing Science. - : Taylor & Francis Group. - 2163-9159 .- 2163-9167. ; 24:3, s. 295-310
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Journal article (peer-reviewed)abstract
- With a focus on case study research methods, this study continues the epistemological debate about qualitative research approaches in the IMP literature by reconsidering the reliance on managerial interviews as a primary empirical source in the production of knowledge claims. In this empirical approach, researchers seem to often treat the interview process and the analysis and reporting of research findings in a manner that generally gives situational credence to the veracity and factuality of the interview data. In line with several epistemological approaches that have already surfaced in IMP literature, this study further emphasizes the context-dependent, ephemeral and ultimately unstable nature of managerial “truths” imparted in the interviews. We argue that the data should be empathically and reflexively understood as the production of stories and their reporting as a form of academic storytelling of pragmatic academic and managerial value.
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| 6. |
- Hietanen, Joel, et al.
(author)
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Paradox and market renewal Knockoffs and counterfeits as doppelganger brand images of luxury
- 2018
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In: Marketing Intelligence & Planning. - England : Emerald Group Publishing Limited. - 0263-4503 .- 1758-8049. ; 36:7, s. 750-763
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Journal article (peer-reviewed)abstract
- Purpose - The purpose of this paper is to continue the emerging stream of literature that has found knockoffs and counterfeits to be unobtrusive or even beneficial to luxury companies by analyzing how they produce paradoxes of meaning and contribute to the renewal of luxury markets. This is done by exploring them as doppelganger brand images that reappropriate brand imagery for their own purposes. Design/methodology/approach - This is a conceptual paper that focuses on the role of knockoffs and counterfeits in the renewal of luxury markets. Findings - The findings highlight how knockoffs and counterfeits can contribute to the emergence and cyclical diffusion of luxury. As luxury offerings are introduced to the market, knockoffs and counterfeits accelerate the snob effect, aid in anchoring trends and contribute to induced obsolescence. During diffusion, knockoffs and counterfeits can strengthen aspiration, bandwagon and herding effects. In doing so, knockoffs and counterfeits create a paradox as they simultaneously legitimize the idea of the authenticity of genuine offerings through their presence in the market and create cyclical demand for novel offerings by undermining the authenticity claims of existing luxury offerings. Thus, knockoffs and counterfeits can be understood as a paradox of luxury markets that contributes to the market cyclicality not despite but because of this paradoxical interplay. Originality/value - While research on knockoffs and counterfeiting is plentiful in the field of marketing, this is among the few studies that analyze how these offerings contribute to luxury markets and their renewal.
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| 7. |
- Hietanen, Joel, et al.
(author)
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Reimagining society through retail practice
- 2016
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In: Journal of Retailing. - : Elsevier BV. - 0022-4359 .- 1873-3271. ; 92:4, s. 411-425
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Journal article (peer-reviewed)abstract
- Marketing scholars with sociological and anthropological leanings have made great strides in uncovering strategic and theoretical implicationsof consumer collectives and consumption-driven market phenomena. It has not been very common that their perspectives have been brought to bearon retailing practice or theory. This ethnographic study examines a highly successful, globalizing, consumer-driven pop-up retail festival for itspotential lessons about social movements. It reveals new insights into logics and potentialities for retailing as a field of affordances for reimaginingsociety and social practices. It points especially to how eruptions of ‘carnivalesque mood’ unite everyday citizens to imagine change in a highlyregulated social context and how they utilize the practice of retailing collectively to actualize societal change.
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| 8. |
- Hietanen, Joel, et al.
(author)
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Seduced by "fakes" : Producing the excessive interplay of authentic/counterfeit from a Baudrillardian perspective
- 2020
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In: Marketing Theory. - : Sage Publications. - 1470-5931 .- 1741-301X. ; 20:1, s. 23-43
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Journal article (peer-reviewed)abstract
- Authenticity has often been considered to be a key theme in contemporary consumer culture. One of its manifestations is how branded market offerings can maintain authentic meanings, especially in a market increasingly saturated with counterfeit substitutes. By following a Baudrillardian perspective, we focus on fashion objects in the "branded luxury" category to problematize the sanctity of the authentic/counterfeit distinction. We argue that marketing literature generally attempts to normatively maintain and impose the distinction in ways that obscure the complexities of this conceptual interplay. We posit that instead of normative accounts that attempt to sanctify the extant orders of global capitalist markets, literature on luxury consumption should instead recognize the excess of meaning in the semiotic interplay of commodified authentic/counterfeit meanings. Any view of morality in luxury consumption should thus recognize "ambivalence" and "seduction" as its intensive qualities.
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| 9. |
- Huhtala, Juho-Petteri, et al.
(author)
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BARRIERS TO INNOVATION DIFFUSION IN INDUSTRIAL NETWORKS : A SYSTEMATIC COMBINING APPROACH
- 2014
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In: Field Guide to Case Study Research in Business-to-Business Marketing and Purchasing. - BINGLEY : EMERALD GROUP PUBLISHING LTD. - 9781784410803 ; , s. 61-76
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Book chapter (peer-reviewed)abstract
- Over the past 50 years, a substantial interest has been put to research on how innovation spreads within social networks over time (see Rogers, 1962, 2010). Our initial aim was to examine innovation diffusion in industrial networks. We operationalized the research through a case study of an advertising network by using systematic combining as the approach (Dubois & Gadde, 2002, 2014). From the initial focus of innovation diffusion, the rematching of data and theory led us to focus on the barriers of innovation diffusion. By doing so, we found out that multilevel strategizing appears to be an important phenomenon in understanding dynamics of innovation diffusion within industrial networks. Specifically, strategizing occurs in two levels: (1) the groups within the network compete for position, and (2) actors within a group compete for position by trying to differentiate themselves from other group actors. A strategic mismatch between the two levels leads the network to become decelerated or even static in diffusing new innovations (Abrahamsen, Henneberg, & Naude, 2012). Uncovering these findings would not have been possible without the use of systematic combining and the constant matching between theoretical and empirical domains.
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| 10. |
- Huhtala, Juho-Petteri, et al.
(author)
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Market orientation, innovation capability and business performance : Insights from the global financial crisis
- 2014
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In: Baltic Journal of Management. - W Yorkshire : Emerald Group Publishing Limited. - 1746-5265 .- 1746-5273. ; 9:2, s. 134-152
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Journal article (peer-reviewed)abstract
- Purpose - The paper aims to examine the role of market orientation (MO) and innovation capability in determining business performance during an economic upturn and downturn. Design/methodology/approach - The data comprise two national-level surveys conducted in Finland in 2008, representing an economic boom, and in 2010 when the global economic crisis had hit the Finnish market. Partial least square path analysis is used to test the potential mediating effect of innovation capability on the relationship between MO and business performance during economic boom and bust. Findings - The results show that innovation capability fully mediates the performance effects of a MO during an economic upturn, whereas the mediation is only partial during a downturn. Innovation capability also mediates the relationship between a customer orientation and business performance during an upturn, whereas the mediating effect culminates in a competitor orientation during a downturn. Thus, the role of innovation capability as a mediator between the individual market-orientation components varies along the business cycle. Originality/value - This paper is one of the first studies that empirically examine the impact of the economic cycle on the relationship between strategic marketing concepts, such as MO or innovation capability, and the firm's business performance.
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