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"Decision model"

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https://www.readbyqxmd.com/read/27893160/integrating-household-risk-mitigation-behavior-in-flood-risk-analysis-an-agent-based-model-approach
#1
Toon Haer, W J Wouter Botzen, Hans de Moel, Jeroen C J H Aerts
Recent studies showed that climate change and socioeconomic trends are expected to increase flood risks in many regions. However, in these studies, human behavior is commonly assumed to be constant, which neglects interaction and feedback loops between human and environmental systems. This neglect of human adaptation leads to a misrepresentation of flood risk. This article presents an agent-based model that incorporates human decision making in flood risk analysis. In particular, household investments in loss-reducing measures are examined under three economic decision models: (1) expected utility theory, which is the traditional economic model of rational agents; (2) prospect theory, which takes account of bounded rationality; and (3) a prospect theory model, which accounts for changing risk perceptions and social interactions through a process of Bayesian updating...
November 28, 2016: Risk Analysis: An Official Publication of the Society for Risk Analysis
https://www.readbyqxmd.com/read/27893135/screening-for-colorectal-cancer-and-evolving-issues-for-physicians-and-patients-a-review
#2
REVIEW
David Lieberman, Uri Ladabaum, Marcia Cruz-Correa, Carla Ginsburg, John M Inadomi, Lawrence S Kim, Francis M Giardiello, Richard C Wender
Importance: Colorectal cancer (CRC) is the second-leading cause of cancer death in the United States. Screening can reduce CRC mortality and incidence, and numerous screening options, although available, complicate informed decision making. This review provides evidence-based tools for primary care physicians to identify patients with higher-than-average-risk and engage patients in informed decision making about CRC screening options. Observations: Recently, the US Preventive Services Task Force recommended any of 8 CRC screening approaches for average-risk individuals, beginning at age 50 years...
November 22, 2016: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/27892501/a-social-contagious-model-of-the-obesity-epidemic
#3
He Huang, Zhijun Yan, Yahong Chen, Fangyan Liu
Obesity has been recognized as a global epidemic by WHO, followed by many empirical evidences to prove its infectiousness. However, the inter-person spreading dynamics of obesity are seldom studied. A distinguishing feature of the obesity epidemic is that it is driven by a social contagion process which cannot be perfectly described by the infectious disease models. In this paper, we propose a novel belief decision model based on the famous Dempster-Shafer theory of evidence to model obesity epidemic as the competing spread of two obesity-related behaviors: physical inactivity and physical activity...
November 28, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27881258/cost-effectiveness-analysis-of-tocilizumab-in-comparison-with-infliximab-in-iranian-rheumatoid-arthritis-patients-with-inadequate-response-to-tdmards-a-multistage-markov-model
#4
Amir Hashemi-Meshkini, Shekoufeh Nikfar, Elizabeth Glaser, Ahmadreza Jamshidi, Seyed Alireza Hosseini
OBJECTIVES: To analyze the cost-effectiveness of two common treatment strategies in Iran, comparing infliximab plus methotrexate with tocilizumab plus methotrexate in patients with rheumatoid arthritis with inadequate response to traditional disease-modifying antirheumatic drugs. METHODS: A multistage Markov decision model was applied to assess the incremental cost-effectiveness ratio (ICER) of a tocilizumab-containing regimen versus an infliximab-containing regimen over a 5-year time period...
May 2016: Value in Health Regional Issues
https://www.readbyqxmd.com/read/27872018/preventive-therapy-for-latent-tuberculosis-infection-the-promise-and-the-challenges
#5
REVIEW
G J Fox, C C Dobler, B J Marais, J T Denholm
Around one third of the world's population may harbour latent tuberculosis infection (LTBI), an asymptomatic immunological state that confers a heightened risk of subsequently developing tuberculosis (TB). Effectively treating LTBI will be essential if the End TB Strategy is to be realised This review evaluates the evidence the effectiveness preventive antibiotic therapy to treat LTBI due to both drug susceptible and drug resistant bacteria. We summarise current national and international preventive therapy guidelines, as well as ongoing randomised trials evaluating regimen to prevent drug resistant TB...
November 18, 2016: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/27871490/predictive-models-for-mortality-after-ruptured-aortic-aneurysm-repair-do-not-predict-futility-and-are-not-useful-for-clinical-decision-making
#6
Patrick C Thompson, Ronald L Dalman, E John Harris, Venita Chandra, Jason T Lee, Matthew W Mell
OBJECTIVE: The clinical decision-making utility of scoring algorithms for predicting mortality after ruptured abdominal aortic aneurysms (rAAAs) remains unknown. We sought to determine the clinical utility of the algorithms compared with our clinical decision making and outcomes for management of rAAA during a 10-year period. METHODS: Patients admitted with a diagnosis rAAA at a large university hospital were identified from 2005 to 2014. The Glasgow Aneurysm Score, Hardman Index, Vancouver Score, Edinburgh Ruptured Aneurysm Score, University of Washington Ruptured Aneurysm Score, Vascular Study Group of New England rAAA Risk Score, and the Artificial Neural Network Score were analyzed for accuracy in predicting mortality...
December 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27869198/sub-optimality-in-motor-planning-is-retained-throughout-9-days-practice-of-2250-trials
#7
Keiji Ota, Masahiro Shinya, Kazutoshi Kudo
Optimality in motor planning, as well as accuracy in motor execution, is required to maximize expected gain under risk. In this study, we tested whether humans are able to update their motor planning. Participants performed a coincident timing task with an asymmetric gain function, in which optimal response timing to gain the highest total score depends on response variability. Their behaviours were then compared using a Bayesian optimal decision model. After 9 days of practicing 2250 trials, the total score increased, and temporal variance decreased...
November 21, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27862980/using-decision-modeling-to-guide-drug-allocation-during-a-shortage
#8
Heidi V Russell, M Brooke Bernhardt, Stacey Berg
BACKGROUND: Drug shortages require clinical teams to decide how to allocate drugs in limited supply among their patients. Ethical frameworks are invaluable for promoting rational approaches to drug distribution, but gaps remain between ethical theory and clinical application. The goal of this work was to explore how decision modeling could supplement ethical frameworks to inform drug distribution from the perspective of a clinical team. PROCEDURE: We created a hypothetical pediatric oncology clinic with a limited supply of 50,000 mg of methotrexate (MTX) and 21 patients due for treatment on one of six regimens...
November 15, 2016: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/27856550/a-case-study-documenting-the-process-by-which-biology-instructors-transition-from-teacher-centered-to-learner-centered-teaching
#9
Gili Marbach-Ad, Carly Hunt Rietschel
In this study, we used a case study approach to obtain an in-depth understanding of the change process of two university instructors who were involved with redesigning a biology course. Given the hesitancy of many biology instructors to adopt evidence-based, learner-centered teaching methods, there is a critical need to understand how biology instructors transition from teacher-centered (i.e., lecture-based) instruction to teaching that focuses on the students. Using the innovation-decision model for change, we explored the motivation, decision-making, and reflective processes of the two instructors through two consecutive, large-enrollment biology course offerings...
2016: CBE Life Sciences Education
https://www.readbyqxmd.com/read/27829041/cognitive-bias-in-ambiguity-judgements-using-computational-models-to-dissect-the-effects-of-mild-mood-manipulation-in-humans
#10
Kiyohito Iigaya, Aurelie Jolivald, Wittawat Jitkrittum, Iain D Gilchrist, Peter Dayan, Elizabeth Paul, Michael Mendl
Positive and negative moods can be treated as prior expectations over future delivery of rewards and punishments. This provides an inferential foundation for the cognitive (judgement) bias task, now widely-used for assessing affective states in non-human animals. In the task, information about affect is extracted from the optimistic or pessimistic manner in which participants resolve ambiguities in sensory input. Here, we report a novel variant of the task aimed at dissecting the effects of affect manipulations on perceptual and value computations for decision-making under ambiguity in humans...
2016: PloS One
https://www.readbyqxmd.com/read/27822262/a-cost-utility-and-cost-effectiveness-analysis-of-different-oral-antiviral-medications-in-patients-with-hbeag-negative-chronic-hepatitis-b-in-iran-an-economic-microsimulation-decision-model
#11
Khosro Keshavarz, Abbas Kebriaeezadeh, Seyed Moayed Alavian, Ali Akbari Sari, Mohsen Rezaei Hemami, Farhad Lotfi, Amir Hashemi Meshkini, Mehdi Javanbakht, Maryam Keshvari, Shekoufeh Nikfar
BACKGROUND: Although hepatitis B infection is the major cause of chronic liver disease in Iran, no studies have employed economic evaluations of the medications used to treat Iranian patients with chronic hepatitis B (CHB). Therefore, the cost-effectiveness of the different treatment options for this disease in Iran is unknown. OBJECTIVES: The aim of this study was to compare the cost utility and cost-effectiveness of medication strategies tailored to local conditions in patients with HB e antigen (HBeAg)-negative CHB infection in Iran...
September 2016: Hepatitis Monthly
https://www.readbyqxmd.com/read/27816248/are-different-methotrexate-regimens-as-first-line-therapy-for-low-risk-gestational-trophoblastic-neoplasia-more-cost-effective-than-the-dactinomycin-regimen-used-in-gog-0174
#12
Caela R Miller, Nicole P Chappell, Caitlin Sledge, Charles A Leath, Neil T Phippen, Laura J Havrilesky, Jason C Barnett
OBJECTIVES: Gynecologic Oncology Group (GOG) 0174 compared weekly intramuscular methotrexate (MTX) with biweekly pulsed intravenous dactinomycin (Act-D) as single-agent chemotherapy for low-risk gestational trophoblastic neoplasia (GTN). Act-D had a higher rate of initial complete response (CR) (70% vs. 53%, p=0.01), but multi-day regimens of MTX have higher historic success rates. We assessed the cost-effectiveness of Act-D vs. MTX per GOG 0174 and explored multi-day MTX regimens. METHODS: A cost effectiveness decision model was constructed with data from GOG 0174...
November 2, 2016: Gynecologic Oncology
https://www.readbyqxmd.com/read/27814820/performance-goals-for-an-adjunct-diagnostic%C3%A2-test%C3%A2-to-reduce-unnecessary-biopsies%C3%A2-after-screening-mammography-analysis%C3%A2-of-costs-benefits-and-consequences
#13
Christoph I Lee, Mark E Bensink, Kristin Berry, Zahra Musa, Carolyn Bodnar, Robert Dann, Jeffrey G Jarvik, Constance D Lehman, Scott D Ramsey
PURPOSE: Because benign biopsies resulting from false-positive mammographic findings are a known harm of breast cancer screening, physicians and test manufacturers are searching for ways to reduce their frequency. The aim of this study was to estimate potential costs and consequences associated with using an adjunct diagnostic test for triaging women with suspicious mammographic findings before biopsy. METHODS: A decision model was developed to compare the use of an adjunct test before biopsy to the current standard of care for suspicious mammographic findings...
November 2016: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/27811206/economic-considerations-of-early-rule-in-rule-out-algorithms-for-the-diagnosis-of-myocardial-infarction-in-the-emergency-department-using-cardiac-troponin-and-glycemic-biomarkers
#14
Colleen Shortt, Feng Xie, Richard Whitlock, Jinhui Ma, Natasha Clayton, Jonathan Sherbino, Stephen A Hill, Guillaume Pare, Matthew McQueen, Shamir R Mehta, P J Devereaux, Andrew Worster, Peter Kavsak
BACKGROUND: We have previously demonstrated the utility of a rule-in/rule-out strategy for myocardial infarction (MI) using glycemic biomarkers in combination with cardiac troponin in the emergency department (ED). Given that the cost of assessing patients with possible MI in the ED is increasing, we sought to compare the health services cost of our previously identified early rule-in/rule-out approaches for MI among patients who present to the ED with symptoms suggestive of acute coronary syndrome (ACS)...
November 3, 2016: Clinical Chemistry
https://www.readbyqxmd.com/read/27807111/cost-analysis-of-ceramic-heads-in-primary-total-hip-arthroplasty
#15
Keith J Carnes, Susan M Odum, Jennifer L Troyer, Thomas K Fehring
BACKGROUND: The advent of adverse local tissue reactions seen in metal-on-metal bearings, and the recent recognition of trunnionosis, have led many surgeons to recommend ceramic-on-polyethylene articulations for primary total hip arthroplasty. However, to our knowledge, there has been little research that has considered whether the increased cost of ceramic provides enough benefit over cobalt-chromium to justify its use. The primary purpose of this study was to compare the cost-effectiveness of ceramic-on-polyethylene implants and metal-on-polyethylene implants in patients undergoing total hip arthroplasty...
November 2, 2016: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/27799804/relative-cost-effectiveness-of-using-an-extensively-hydrolyzed-casein-formula-in-managing-infants-with-cow-s-milk-allergy-in-brazil
#16
Julian F Guest, Ariana C Yang, Jane Oba, Maraci Rodrigues, Rosane Caetano, Lilian Polster
OBJECTIVE: To estimate the cost-effectiveness of three alternative dietetic strategies for cow's milk allergy in Brazil: 1) using an extensively hydrolyzed casein formula (eHCF; Nutramigen) as a first-line formula, but switching to an amino acid formula (AAF) if infants remain symptomatic; 2) using an AAF as a first-line formula and then switching to an eHCF after 4 weeks once infants are symptom-free, but switching back to an AAF if infants become symptomatic; and 3) using an AAF as a first-line formula and keeping all infants on that formula...
2016: ClinicoEconomics and Outcomes Research: CEOR
https://www.readbyqxmd.com/read/27786570/ulipristal-acetate-for-pre-operative-treatment-of-moderate-to-severe-uterine-fibroids-in-women-of-reproductive-age-in-the-netherlands-cost-minimization-analysis-and-budget-impact-analysis
#17
N Zakiyah, Adi van Asselt, M J Postma
OBJECTIVE: Ulipristal acetate has been found to be non-inferior to other pre-operative treatments of uterine fibroids, particularly leuprolide. The objective of this study was to assess the pharmacoeconomic profile of ulipristal acetate compared to leuprolide for the pre-operative treatment of moderate to severe uterine fibroids in women of reproductive age in The Netherlands. The analysis was performed and applied within the framework of the ulipristal acetate submission for reimbursement in 2012...
October 27, 2016: Journal of Medical Economics
https://www.readbyqxmd.com/read/27780583/development-of-an-evidence-based-decision-pathway-for-vestibular-schwannoma-treatment-options
#18
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
https://www.readbyqxmd.com/read/27770602/rapid-diagnostic-test-for-g6pd-deficiency-in-plasmodium-vivax-infected-men-a-budget-impact-analysis-based-in-brazilian-amazon
#19
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 with 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
https://www.readbyqxmd.com/read/27758942/cost-effectiveness-of-endovascular-stroke-therapy-a-patient-subgroup-analysis-from-a-us-healthcare-perspective
#20
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...
November 2016: Stroke; a Journal of Cerebral Circulation
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