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Simulation-based learning is emerging as an alternative educational tool in this era of a relative shortfall of teaching anesthesiologists.
The relative shortfall approach is based on the notion that people of all ages have a legitimate claim to fulfil their health potential.
In addition, studies are also often limited in power as there is sequencing bias within/between taxa, most organisms contain just dozens of TCS proteins, and at most taxonomic levels there is a relative shortfall in the number of available genomes, all of which can distort conclusions [ 1, 11– 13].
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Since proportional shortfall is a relative measure, both younger and older individuals can experience a low or high proportional shortfall.
The equity weights placed on the different QALY gains (the value of gained QALYs relative to the underlying proportional shortfall) remain uncertain, although existing evidence may inform policy makers to some extent (see for example [ 41]).
Whereas fair innings and prospective health equalize absolute health outcomes in terms of total and future health, proportional shortfall proposes to equalize relative attainments.
Proportional shortfall of QALYs, which focuses on relative current and prospective health losses, is not sensitive to large absolute differences in expected lifetime health.
Proportional shortfall of QALYs discriminates between conditions with respect to relative differences in prospective health.
To use the decision-making framework in practice, the (relative) values assigned to QALY gains for different levels of proportional shortfall have to be elicited, for instance, from the public.
Proportional shortfall of QALYs is estimated by calculating the expected future loss of QALYs due to disease relative to a perfectly healthy life expectancy (QALEN).
Proportional shortfall of QALYs is a severity measure identifying the worse off as those with the greater current and expected health losses relative to a remaining lifetime spent in perfect health [ 9, 18].
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