This questionnaire has the potential to assist in better understanding barriers to warfarin use with a view to addressing and then overcoming warfarin underutilization. Preliminary data suggest patient preference and capabilities are at least as important as medical characteristics as barriers to prescribing warfarin in AF patients.

The funder had no role in study design, data collection and analysis, the decision to publish, or preparation of the manuscript. We thank persons in managerial positions from four Swedish municipalities (Bengtsfors, Färgelanda, Sotenäs, and Strömstad), and from the private organization Team Olivia AB, who volunteered their time by providing information for the current study, and the HR-managers from these organizations (Anders Alin, Helene Evensen, Erika Hassellöv, Marie Söderman, and Per Wahlén) for providing mail lists with potential participants. Gunne Grankvist and anonymous evaluators contributed to the translation process of the IWPQ. Åke Hellström contributed to the description of the project, to the translation process of the IWPQ, as well as performed parallel analysis and the MAP test, discussed factor analyses with the first author, read several versions of the manuscript before the submission, and gave valuable suggestions, which improved the final version of this article. Petri Kajonius contributed to the project with methodological advice.

This article explores the use of organizational learning mechanisms to create actionable knowledge in a pharmaceutical company. An action research based approach was used to explore the nature and issues associated with fostering the dynamic learning capability within the firm. The results indicate that dynamic learning capability is embedded and influenced by company culture, existing skills and competence, organizational structure, incentives for learning, capacity for continuous change and leadership. It is argued that enabling actionable knowledge creation is a fragile process that has to be managed with care, and is far more complex than the literature suggests.

Objectives: For medical devices, benefits other than direct clinical effects may have a large impact on the patients' well-being, but a standardized method for measuring these benefits is unavailable. The objective was to explore potential patient benefits provided by medical devices, and to assess the relative preferences of these benefits in the general Swedish population. Methods: To identify attributes of patient benefit, healthcare personnel within a wide range of disease areas were interviewed. The generalized attributes were then validated among healthcare personnel, patient organizations, and manufacturers; in two pilot studies in the general population; and in two rounds of cognitive interviews. The general population's preferences of the attributes were measured with a usability-tested questionnaire in a final responding sample of 3,802 individuals, representative of the Swedish population. Results: Twenty attributes were identified, encompassing aspects of integrity, sense of security, social participation, and convenience. When measuring the relative preferences, the response rate was 37.0 percent, and the results showed that the attributes with the highest preferences concerned reliability, reduced need for assistance, and sense of control of the illness/disability. Conclusions: A set of twenty attributes of patient benefit relevant to users of medical devices was identified and validated. A questionnaire for patient-reported assessment of the benefits provided by a medical device was developed, based on the attributes. The questionnaire, designated MedTech20, provides a generic measurement method for the evaluation of medical devices used in a wide range of diseases/disabilities. Keywords: Medical device, Patient satisfaction, Surveys and questionnaires, Health technology assessment, Healthcare evaluation mechanisms Medical devices encompass a wide range of nonpharmaceutical products used for treatment, alleviation, monitoring, or prevention of a disease or disability (1). This has become an increas-The authors thank all interviewees and questionnaire participants, and Kantar Sifo Sweden for access to Web-based panels. The authors also thank members of The Dental and Pharmaceutical Benefits Agency (TLV) in Sweden for valuable comments at various stages in the project. The work has been presented in abstract form at the 18th Annual European International Society for Pharmacoeconomics and Outcomes Research (ISPOR) Congress, 2015. Financial support: This project has received funding from Almi/Vinnova (governmental authority, grant number Beviljning_401510) and the European Regional Development Fund (grant number RUN 624-0632-14). NHE Licence AB owns intellectual property of the MedTech20 Questionnaire. Conflict of interest: E.L., F.O., A.I., and I.B. are employed by Nordic Health Economics AB. Nordic Health Economics AB is a consultancy and research company working with the pharmaceutical and medical device industry as well as with healthcare organizations and universities. The MedTech20 Questionnaire...

Knowledge and knowledge management have become two of the latest buzzwords in the management literature. However, the literature presents primarily normative, undersocialized models of how knowledge could be administrated and developed as an organizational resource, and does not sufficiently recognize the social, political and emotional aspects of knowledge. In general, the knowledge of knowledge management is not situational. For instance, in what respect does the notion of knowledge take gender issues into account? This paper presents a study of clinical research activities in a major multinational pharmaceutical company and it suggests that the processes of knowing are always embedded in existing social and political, gendered assumptions and beliefs. Therefore, knowledge management need to be further developed to avoid general problematic positions.