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"Decision model"

Faina Linkov, Benita Valappil, Jacob McAfee, Sharon L Goughnour, Douglas M Hildrew, Andrew A McCall, Igor Linkov, Barry Hirsch, Carl Snyderman
OBJECTIVE: To integrate multiple sources of clinical information with patient feedback to build evidence-based decision support model to facilitate treatment selection for patients suffering from vestibular schwannomas (VS). METHODS: This was a mixed methods study utilizing focus group and survey methodology to solicit feedback on factors important for making treatment decisions among patients. Two 90-minute focus groups were conducted by an experienced facilitator...
September 30, 2016: American Journal of Otolaryngology
Henry Maia Peixoto, Marcelo Augusto Mota Brito, Gustavo Adolfo Sierra Romero, Wuelton Marcelo Monteiro, Marcus Vinícius Guimarães de Lacerda, Maria Regina Fernandes de Oliveira
OBJECTIVE: The aim of this study was to estimate the incremental budget impact (IBI) of a rapid diagnostic test to detect G6PDd in male patients infected with Plasmodium vivax in the Brazilian Amazon, as compared to the routine protocol recommended in Brazil which does not include G6PDd testing. METHODS: The budget impact analysis was performed from the perspective of the Brazilian health system, in the Brazilian Amazon for the years 2013, 2014 and 2015. The analysis used a decision model to compare two scenarios: the first consisting of the routine recommended in Brazil which does not include prior diagnosis of dG6PD, and the second based on the use of RDT CareStart(™) G6PD (CS-G6PD) in all male subjects diagnosed with vivax malaria...
October 22, 2016: Tropical Medicine & International Health: TM & IH
Wolfgang G Kunz, M G Myriam Hunink, Wieland H Sommer, Sebastian E Beyer, Felix G Meinel, Franziska Dorn, Stefan Wirth, Maximilian F Reiser, Birgit Ertl-Wagner, Kolja M Thierfelder
BACKGROUND AND PURPOSE: Endovascular therapy in addition to standard care (EVT+SC) has been demonstrated to be more effective than SC in acute ischemic large vessel occlusion stroke. Our aim was to determine the cost-effectiveness of EVT+SC depending on patients' initial National Institutes of Health Stroke Scale (NIHSS) score, time from symptom onset, Alberta Stroke Program Early CT Score (ASPECTS), and occlusion location. METHODS: A decision model based on Markov simulations estimated lifetime costs and quality-adjusted life years (QALYs) associated with both strategies applied in a US setting...
October 6, 2016: Stroke; a Journal of Cerebral Circulation
Andrew Keller, Christian Gericke, Jennifer A Whitty, John Yaxley, Boon Kua, Geoff Coughlin, Troy Gianduzzo
BACKGROUND AND OBJECTIVES: The Göteborg randomised population-based prostate cancer screening trial demonstrated that prostate-specific antigen (PSA)-based screening reduces prostate cancer deaths compared with an age-matched control group. Utilising the prostate cancer detection rates from this study, we investigated the clinical and cost effectiveness of a similar PSA-based screening strategy for an Australian population of men aged 50-69 years. METHODS: A decision model that incorporated Markov processes was developed from a health system perspective...
October 18, 2016: Applied Health Economics and Health Policy
Jason Madan, Tony Ades, Pelham Barton, Laura Bojke, Ernest Choy, Philip Helliwell, Paresh Jobanputra, Ken Stein, Andrew Stevens, Jonathan Tosh, Suzanne Verstappen, Allan Wailoo
INTRODUCTION: Biologic therapies are efficacious but costly. A number of health economic models have been developed to determine the most cost-effective way of using them in the treatment pathway. These models have produced conflicting results, driven by differences in assumptions, model structure, and data, which undermine the credibility of funding decisions based on modeling studies. A Consensus Working Party met to discuss recommendations and approaches for future models of biologic therapies...
December 2015: Rheumatol Ther
Fabiana Gatti de Menezes, Rodrigo Martins Abreu, Alexander Itria
Introduction: Secondary hyperparathyroidism (SHPT) is a consequence of chronic kidney disease. The treatment at the Brazilian Unified Heath System (SUS) is performed with calcitriol, a drug which favors hypercalcemia and/or hyperphosphatemia, hindering the control of SHPT. Another option is paricalcitol, which causes parathormone (PTH) suppression faster than calcitriol, with minor changes in calcium-phosphorus product and calcium and phosphorus serum levels. Objective: This study aims to develop a cost-effectiveness analysis of paricalcitol versus calcitriol for patients in dialytic treatment with SHPT, from the SUS perspective...
July 2016: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
Maartje S Jacobs, Femke Kaasenbrood, Maarten J Postma, Marinus van Hulst, Robert G Tieleman
AIMS: Atrial fibrillation (AF) is the most common arrhythmia and prevalence increases with age. Patients with AF have a high risk of stroke, and screening for AF is recommended in all people aged 65 years or older to identify patients eligible for stroke prevention. A handheld, single-lead electrocardiogram (ECG) device can be used for systematic screening in the population at risk. The objective of this study is to estimate the cost-effectiveness of screening for AF in primary care with the MyDiagnostick(®) during seasonal influenza vaccination in the Netherlands...
October 12, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Amber Kunkel, Frank G Cobelens, Ted Cohen
BACKGROUND: New drugs for the treatment of tuberculosis (TB) are becoming available for the first time in over 40 y. Optimal strategies for introducing these drugs have not yet been established. The objective of this study was to compare different strategies for introducing the new TB drug bedaquiline based on patients' resistance patterns. METHODS AND FINDINGS: We created a Markov decision model to follow a hypothetical cohort of multidrug-resistant (MDR) TB patients under different bedaquiline use strategies...
October 2016: PLoS Medicine
Danish Shaikh, John Hallam, Jakob Christensen-Dalsgaard
The peripheral auditory system of lizards has been extensively studied, because of its remarkable directionality. In this paper, we review the research that has been performed on this system using a biorobotic approach. The various robotic implementations developed to date, both wheeled and legged, of the auditory model exhibit strong phonotactic performance for two types of steering mechanisms-a simple threshold decision model and Braitenberg sensorimotor cross-couplings. The Braitenberg approach removed the need for a decision model, but produced relatively inefficient robot trajectories...
October 7, 2016: Biological Cybernetics
Åsa Svedmark, Mats Djupsjöbacka, Charlotte Häger, Gwendolen Jull, Martin Björklund
BACKGROUND: The evidence for the effect of treatments of neck pain is modest. In the absence of causal treatments, a possibility is to tailor the treatment to the individuals' functional limitations and symptoms. The aim was to evaluate treatment effects of a tailored treatment versus a non-tailored treatment. Our hypothesis was that tailored treatment (TT) would have better effect on pain intensity and disability than either non-tailored treatment (NTT) (same treatment components but applied quasi-randomly) or treatment-as-usual (TAU) (no treatment from the study, no restrictions)...
September 30, 2016: BMC Musculoskeletal Disorders
Martine Hoogendoorn, Talitha L Feenstra, Yumi Asukai, Andrew H Briggs, Sixten Borg, Roberto W Dal Negro, Ryan N Hansen, Sven-Arne Jansson, Reiner Leidl, Nancy Risebrough, Yevgeniy Samyshkin, Margarethe E Wacker, Maureen P M H Rutten-van Mölken
OBJECTIVES: To assess how suitable current chronic obstructive pulmonary disease (COPD) cost-effectiveness models are to evaluate personalized treatment options for COPD by exploring the type of heterogeneity included in current models and by validating outcomes for subgroups of patients. METHODS: A consortium of COPD modeling groups completed three tasks. First, they reported all patient characteristics included in the model and provided the level of detail in which the input parameters were specified...
September 2016: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
Karen M Kuntz
No abstract text is available yet for this article.
September 2016: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
Abdullah Alibrahim, Shinyi Wu
Accountable care organizations (ACO) in the United States show promise in controlling health care costs while preserving patients' choice of providers. Understanding the effects of patient choice is critical in novel payment and delivery models like ACO that depend on continuity of care and accountability. The financial, utilization, and behavioral implications associated with a patient's decision to forego local health care providers for more distant ones to access higher quality care remain unknown. To study this question, we used an agent-based simulation model of a health care market composed of providers able to form ACO serving patients and embedded it in a conditional logit decision model to examine patients capable of choosing their care providers...
October 4, 2016: Health Care Management Science
Theresa Tawiah, Kristian Schultz Hansen, Frank Baiden, Jane Bruce, Mathilda Tivura, Rupert Delimini, Seeba Amengo-Etego, Daniel Chandramohan, Seth Owusu-Agyei, Jayne Webster
BACKGROUND: The presumptive approach of confirming malaria in health facilities leads to over-diagnosis of malaria, over use of anti-malaria drugs and the risk of drug resistance development. WHO recommends parasitological confirmation before treatment with artemisinin-based combination therapy (ACT) in all suspected malaria patients. The use of malaria rapid diagnostic tests (mRDTs) would make it possible for prescribers to diagnose malaria at point-of-care and better target the use of antimalarials...
2016: PloS One
Roger Ratcliff, Per Sederberg, Troy Smith, Russ Childers
Recent work in perceptual decision-making has shown that although two distinct neural components differentiate experimental conditions (e.g., did you see a face or a car), only one tracked the evidence guiding the decision process. In the memory literature, there is a distinction between a fronto-central evoked potential measured with EEG beginning at 350 ms that seems to track familiarity and a late parietal evoked potential that peaks at 600 ms that tracks recollection. Here, we applied single-trial regressor analysis (similar to multivariate pattern analysis MVPA) and diffusion decision modeling to EEG and behavioral data from two recognition memory experiments to test whether these two components contribute to the recognition decision process...
September 29, 2016: Neuropsychologia
Y-K Pang, M Ip, J H S You
Early initiation of antifungal treatment for invasive candidiasis is associated with change in mortality. Beta-D-glucan (BDG) is a fungal cell wall component and a serum diagnostic biomarker of fungal infection. Clinical findings suggested an association between reduced invasive candidiasis incidence in intensive care units (ICUs) and BDG-guided preemptive antifungal therapy. We evaluated the potential cost-effectiveness of active BDG surveillance with preemptive antifungal therapy in patients admitted to adult ICUs from the perspective of Hong Kong healthcare providers...
September 29, 2016: European Journal of Clinical Microbiology & Infectious Diseases
Qiushi Chen, Turgay Ayer, Jagpreet Chhatwal
BACKGROUND: Sequential decision problems are frequently encountered in medical decision making, which are commonly solved using Markov decision processes (MDPs). Modeling guidelines recommend conducting sensitivity analyses in decision-analytic models to assess the robustness of the model results against the uncertainty in model parameters. However, standard methods of conducting sensitivity analyses cannot be directly applied to sequential decision problems because this would require evaluating all possible decision sequences, typically in the order of trillions, which is not practically feasible...
September 28, 2016: Medical Decision Making: An International Journal of the Society for Medical Decision Making
Geraldine Macdonald, Nuala Livingstone, Jennifer Hanratty, Claire McCartan, Richard Cotmore, Maria Cary, Danya Glaser, Sarah Byford, Nicky J Welton, Tania Bosqui, Lucy Bowes, Suzanne Audrey, Gill Mezey, Helen L Fisher, Wendy Riches, Rachel Churchill
BACKGROUND: Child maltreatment is a substantial social problem that affects large numbers of children and young people in the UK, resulting in a range of significant short- and long-term psychosocial problems. OBJECTIVES: To synthesise evidence of the effectiveness, cost-effectiveness and acceptability of interventions addressing the adverse consequences of child maltreatment. STUDY DESIGN: For effectiveness, we included any controlled study...
September 2016: Health Technology Assessment: HTA
Huawang Shi, Hang Yin, Lianyu Wei
The process of bid/no-bid decision-making is su bjected to uncertainty and influence of complex criteria. This paper proposed an application of the integration of rough sets (RS) and improved general regression neural network (GRNN) based on niche particle swarm optimization (NPSO) algorithm for tendering decision making. The decision table of RS and the attribution reduction was processed by MIBARK algorithm to simply the samples of GRNN. In order to improve the general regression neural network (GRNN) network performance, the niche particle swarm optimization (NPSO) was used to optimize the spread parameter σ of GRNN neural network, then a novel Bid/no-bid decision model was established based on RS and NPSO-GRNN neural network algorithm...
2016: SpringerPlus
L T Burgers, W K Redekop, M J Al, S K Lhachimi, N Armstrong, S Walker, C Rothery, M Westwood, J L Severens
AIMS: New generation dual-source coronary CT (NGCCT) scanners with more than 64 slices were evaluated for patients with (known) or suspected of coronary artery disease (CAD) who are difficult to image: obese, coronary calcium score > 400, arrhythmias, previous revascularization, heart rate > 65 beats per minute, and intolerance of betablocker. A cost-effectiveness analysis of NGCCT compared with invasive coronary angiography (ICA) was performed for these difficult-to-image patients for England and Wales...
September 20, 2016: European Journal of Health Economics: HEPAC: Health Economics in Prevention and Care
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