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Study background: While the strategic advantage of Medical Value (MV) products is widely accepted in developed markets, it remains unclear if varying societal wealth influences the perception of customers on MV products. Methods: 231 of 240 Internal Medicine physicians from 8 countries participated in a survey with 5 multiple choice questions on MV. Responses from countries have been allocated to income levels according to world-bank data. Three groups have been defined (high-income countries: Canada, Norway and Switzerland=developed markets, upper-mid income markets: Argentina, China, Mexico and Turkey, lower-mid income counties: India=emerging markets). Answers have been statistically analyzed in subgroups (emerging markets vs. developed markets). Results: The majority of physicians believed that reliable and clinically validated treatment algorithms should accompany a product qualifying for MV. Algorithms should be created, predominantly for existing markers. Emphasis has been given to the discovery of better markers for well-known diseases in developed markets. Physicians` answers on pivotal factors for MV products yielded highest emphasis for generalizability (global technical standardization and data comparability). Technical excellence was given lower priority in developed markets comparing to emerging markets. Cost control was emphasized mainly in high-income markets. Conclusion: Both developed and emerging markets demand more clinical trials to establish algorithms for diagnostic tests. The prove of clinical utility is a pivotal factor for sustainable business success.

To compare venous drainage patterns and associated intracranial hydrodynamics between subjects who experienced mild traumatic brain injury (mTBI) and age- and gender-matched controls. Thirty adult subjects (15 with mTBI and 15 age- and gender-matched controls) were investigated using a 3T MR scanner. Time since trauma was 0.5 to 29 years (mean 11.4 years). A 2D-time-of-flight MR-venography of the upper neck was performed to visualize the cervical venous vasculature. Cerebral venous drainage through primary and secondary channels, and intracranial compliance index and pressure were derived using cine-phase contrast imaging of the cerebral arterial inflow, venous outflow, and the craniospinal CSF flow. The intracranial compliance index is the defined as the ratio of maximal intracranial volume and pressure changes during the cardiac cycle. MR estimated ICP was then obtained through the inverse relationship between compliance and ICP. Compared to the controls, subjects with mTBI demonstrated a significantly smaller percentage of venous outflow through internal jugular veins (60.9±21% vs. controls: 76.8±10%; p = 0.01) compensated by an increased drainage through secondary veins (12.3±10.9% vs. 5.5±3.3%; p