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Decision model

Kai Yeung, Kangho Suh, Anirban Basu, Louis P Garrison, Aasthaa Bansal, Josh J Carlson
BACKGROUND: High-priced medications with curative potential, such as the newer hepatitis C therapies, have contributed to the recent growth in pharmaceutical expenditure. Despite the obvious benefits, health care decision makers are just beginning to grapple with questions of how to value and pay for curative therapies that may feature large upfront cost, followed by health benefits that are reaped over a patient's lifespan. Alternative policy options have been proposed to promote high value and financially sustainable use of these therapies...
October 2017: Journal of Managed Care & Specialty Pharmacy
Helge Hass, Kristina Masson, Sibylle Wohlgemuth, Violette Paragas, John E Allen, Mark Sevecka, Emily Pace, Jens Timmer, Joerg Stelling, Gavin MacBeath, Birgit Schoeberl, Andreas Raue
Targeted therapies have shown significant patient benefit in about 5-10% of solid tumors that are addicted to a single oncogene. Here, we explore the idea of ligand addiction as a driver of tumor growth. High ligand levels in tumors have been shown to be associated with impaired patient survival, but targeted therapies have not yet shown great benefit in unselected patient populations. Using an approach of applying Bagged Decision Trees (BDT) to high-dimensional signaling features derived from a computational model, we can predict ligand dependent proliferation across a set of 58 cell lines...
2017: NPJ Systems Biology and Applications
Paméla Lagrange, Olivier Gimenez, Blandine Doligez, Roger Pradel, Dany Garant, Fanie Pelletier, Marc Bélisle
Breeding dispersal is a key process of population structure and dynamics and is often triggered by an individual's breeding failure. In both colonial and territorial birds, reproductive success of conspecifics (RSc) can also lead individuals to change breeding sites after a failure on a site. Yet, few studies have simultaneously investigated the independent contribution of individual reproductive success (RSi) and of RSc on dispersal decision. Here, we develop a modeling framework to disentangle the effects of RSi and RSc on demographic parameters, while accounting for imperfect individual detection and other confounding factors such as age or dispersal behavior in the previous year...
September 2017: Ecology and Evolution
Ashwini Venkatasubramaniam, Julian Wolfson, Nathan Mitchell, Timothy Barnes, Meghan JaKa, Simone French
BACKGROUND: In many studies, it is of interest to identify population subgroups that are relatively homogeneous with respect to an outcome. The nature of these subgroups can provide insight into effect mechanisms and suggest targets for tailored interventions. However, identifying relevant subgroups can be challenging with standard statistical methods. MAIN TEXT: We review the literature on decision trees, a family of techniques for partitioning the population, on the basis of covariates, into distinct subgroups who share similar values of an outcome variable...
2017: Emerging Themes in Epidemiology
Cristóbal Moënne-Loccoz, Rodrigo C Vergara, Vladimir López, Domingo Mery, Diego Cosmelli
Our daily interaction with the world is plagued of situations in which we develop expertise through self-motivated repetition of the same task. In many of these interactions, and especially when dealing with computer and machine interfaces, we must deal with sequences of decisions and actions. For instance, when drawing cash from an ATM machine, choices are presented in a step-by-step fashion and a specific sequence of choices must be performed in order to produce the expected outcome. But, as we become experts in the use of such interfaces, is it possible to identify specific search and learning strategies? And if so, can we use this information to predict future actions? In addition to better understanding the cognitive processes underlying sequential decision making, this could allow building adaptive interfaces that can facilitate interaction at different moments of the learning curve...
2017: Frontiers in Computational Neuroscience
Beatriz López, Ferran Torrent-Fontbona, Ramón Viñas, José Manuel Fernández-Real
OBJECTIVE: The use of artificial intelligence techniques to find out which Single Nucleotide Polymorphisms (SNPs) promote the development of a disease is one of the features of medical research, as such techniques may potentially aid early diagnosis and help in the prescription of preventive measures. In particular, the aim is to help physicians to identify the relevant SNPs related to Type 2 diabetes, and to build a decision-support tool for risk prediction. METHODS: We use the Random Forest (RF) technique in order to search for the most important attributes (SNPs) related to diabetes, giving a weight (degree of importance), ranging between 0 and 1, to each attribute...
September 21, 2017: Artificial Intelligence in Medicine
Joseph B Babigumira, Fady I Sharara, Louis P Garrison
PURPOSE: The Cap-Score™ was developed to assess the capacitation status of men, thereby enabling personalized management of unexplained infertility by choosing timed intrauterine insemination (IUI), versus immediate in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) in individuals with a low Cap-Score™. The objective of this study was to estimate the differences in outcomes and costs comparing the use of the Cap-Score™ with timed IUI (CS-TI) and the standard of care (SOC), which was assumed to be three IUI cycles followed by three IVF-ICSI cycles...
September 23, 2017: Journal of Assisted Reproduction and Genetics
Warren K Bickel, Alexandra M Mellis, Sarah E Snider, Liqa N Athamneh, Jeffrey S Stein, Derek A Pope
This review critically examines neurobehavioral theoretical developments in decision making in addiction in the 21st century. We specifically compare each theory reviewed to seven benchmarks of theoretical robustness, based on their ability to address: why some commodities are addictive; developmental trends in addiction; addiction-related anhedonia; self-defeating patterns of behavior in addiction; why addiction co-occurs with other unhealthy behaviors; and, finally, means for the repair of addiction. We have included only self-contained theories or hypotheses which have been developed or extended in the 21st century to address decision making in addiction...
September 20, 2017: Pharmacology, Biochemistry, and Behavior
Caroline Fenlon, Luke O'Grady, John F Mee, Stephen T Butler, Michael L Doherty, John Dunnion
The aim of this study was to build and compare predictive models of calving difficulty in dairy heifers and cows for the purpose of decision support and simulation modeling. Models to predict 3 levels of calving difficulty (unassisted, slight assistance, and considerable or veterinary assistance) were created using 4 machine learning techniques: multinomial regression, decision trees, random forests, and neural networks. The data used were sourced from 2,076 calving records in 10 Irish dairy herds. In total, 19...
September 20, 2017: Journal of Dairy Science
Sara Osama Ahmed, Reda Mazloum, Hala Abou-Ali
This paper analyses the spatiotemporal variability of air pollutants in Egypt using monthly averages from the air quality monitoring network from 2011 to 2015. Particulate Matters (PM10) Nitrogen Dioxide (NO2) and Sulfur Dioxide (SO2), measured by the monitoring stations network are studied. A log transformation is applied for the three pollutants to achieve normality. The sum-metric function is utilized for modelling the spatiotemporal variogram as it gave the smallest Mean Squared Error (MSE) compared to other forms namely separable, metric, and product sum models...
September 20, 2017: Environmental Research
Robert M Cooper, Claire E Raphael, Max Liebregts, Nandan S Anavekar, Josef Veselka
Hypertrophic cardiomyopathy is the leading cause of sudden death in young individuals and an important cause of heart failure at any age. In this review we discuss advances in investigation and management of this heterogenous disease. Improved cardiac imaging has allowed us to detail many of the structural abnormalities whereas the use of new techniques, predominantly in cardiac magnetic resonance imaging, has given us a greater insight in to tissue architecture, mechanism of contractile abnormalities, and function...
October 2017: Canadian Journal of Cardiology
R An, H Xue, L Wang, Y Wang
OBJECTIVE: This study aimed to project the societal cost and benefit of an expansion of a water access intervention that promotes lunchtime plain water consumption by placing water dispensers in New York school cafeterias to all schools nationwide. METHODS: A decision model was constructed to simulate two events under Markov chain processes - placing water dispensers at lunchtimes in school cafeterias nationwide vs. no action. The incremental cost pertained to water dispenser purchase and maintenance, whereas the incremental benefit was resulted from cases of childhood overweight/obesity prevented and corresponding lifetime direct (medical) and indirect costs saved...
September 22, 2017: Pediatric Obesity
J Hwang, K Lee, D Walsh, S W Kim, J M Sleeman, H Lee
Wildlife-associated diseases and pathogens have increased in importance; however, management of a large number of diseases and diversity of hosts is prohibitively expensive. Thus, the determination of priority wildlife pathogens and risk factors for disease emergence is warranted. We used an online questionnaire survey to assess release and exposure risks, and consequences of wildlife-associated diseases and pathogens in the Republic of Korea (ROK). We also surveyed opinions on pathways for disease exposure, and risk factors for disease emergence and spread...
September 22, 2017: Transboundary and Emerging Diseases
Loïc Pellissier, Camille Albouy, Jordi Bascompte, Nina Farwig, Catherine Graham, Michel Loreau, Maria Alejandra Maglianesi, Carlos J Melián, Camille Pitteloud, Tomas Roslin, Rudolf Rohr, Serguei Saavedra, Wilfried Thuiller, Guy Woodward, Niklaus E Zimmermann, Dominique Gravel
Knowledge of species composition and their interactions, in the form of interaction networks, is required to understand processes shaping their distribution over time and space. As such, comparing ecological networks along environmental gradients represents a promising new research avenue to understand the organization of life. Variation in the position and intensity of links within networks along environmental gradients may be driven by turnover in species composition, by variation in species abundances and by abiotic influences on species interactions...
September 22, 2017: Biological Reviews of the Cambridge Philosophical Society
Vipul Patel, Marco Sandri, Angelica Anna Chiara Grasso, Elisa De Lorenzis, Franco Palmisano, Giancarlo Albo, Rafael Ferreira Coelho, Alexander Mottrie, Harvey Tadzia, Darian Kameh, Hariharan Palayapalayam, Peter Wiklund, Silvano Bosari, Stefano Puliatti, Paola Zuccolotto, Giampaolo Bianchi, Bernardo Rocco
OBJECTIVES: To create a statistical tool for the estimation of extra-capsular extension (ECE) level of prostate cancer and determine the nerve sparing (NS) approach that can be safely performed during radical prostatectomy (RP). PATIENTS AND METHODS: A total of 11,794 lobes, from 6,360 patients who underwent robot¬ assisted RP between 2008 and 2016 were evaluated. Clinicopathological features were included in a statistical algorithm for the prediction of the maximum ECE width...
September 22, 2017: BJU International
Pierre Blanchard, John W Davis, Steven J Frank, Jeri Kim, Curtis A Pettaway, Thomas J Pugh, Louis L Pisters, John F Ward, Seungtaek Choi, Brian F Chapin, Karen Hoffman, Neema Navai, Mary Achim, Sean E McGuire, Surena F Matin, Quynh Nguyen, Usama Mahmood, William J Graber, Hsiang-Chun Chen, Xuemei Wang, Deborah A Kuban
BACKGROUND: Quality of life (QoL) has become an important issue in cancer care. Better data on QoL after prostate cancer treatment could help patients make an informed decision regarding the treatment of their choice. METHODS: Pathologically proven, non-metastatic, T1-T3bN0 prostate cancer patients were included in this prospective non-randomized study if they were to receive curative intent treatment. Sample size was at least 181 patients per cohort/treatment type...
September 20, 2017: BJU International
Kesshi M Jordan, Bagrat Amirbekian, Anisha Keshavan, Roland G Henry
BACKGROUND: Diffusion-weighted magnetic resonance imaging tractography can be used to create models of white matter fascicles. Anatomical and pathological variability between subjects can drastically alter the tractography output, so standardizing results across a cohort is nontrivial. Furthermore, tractography methods have inherently low reproducibility due to stochasticity (for probabilistic methods) and subjective decisions, since the final fascicle model often requires a manual intervention step performed by an expert human operator to control both outliers and systematic false-positive pathways, as defined by prior knowledge of anatomy...
September 21, 2017: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
Dennis D Tarasi, Robert K Peet
Biological invasions can have dramatic impacts on communities and biodiversity, and are critical considerations in conservation and management decisions. We present a novel analysis to determine how exotic species success varies with community richness and scale of measurement. Using 5022 plots representing natural vegetation of the Carolinas, we calculated native and exotic species richness of all vascular plants at five grain sizes. To avoid spatial pseudoreplication, we randomly selected unique subplots from each larger plot, re-selecting 100 times to develop an empirical distribution of the native-exotic richness relationship (NERR)...
September 21, 2017: Ecology
Md Y Reja, Samuel D Brody, Wesley E Highfield, Galen D Newman
Recovery after hurricane events encourages new development activities and allows reconstruction through the conversion of naturally occurring wetlands to other land uses. This research investigates the degree to which hurricane recovery activities in coastal communities are undermining the ability of these places to attenuate the impacts of future storm events. Specifically, it explores how and to what extent wetlands are being affected by the CWA Section 404 permitting program in the context of post-Hurricane Ike 2008 recovery...
September 22, 2017: Environmental Management
Zhenyu Liu, Xiao-Yan Zhang, Yan-Jie Shi, Lin Wang, Hai-Tao Zhu, Zhen-Chao Tang, Shuo Wang, Xiao-Ting Li, Jie Tian, Ying-Shi Sun
PURPOSE: To develop and validate a radiomics model for evaluating pathological complete response (pCR) to neoadjuvant chemoradiotherapy in patients with locally advanced rectal cancer (LARC). EXPERIMENTAL DESIGN: We enrolled 222 patients (152 in the primary cohort and 70 in the validation cohort) with clinicopathologically confirmed LARC who received chemoradiotherapy before surgery. All patients underwent T2-weighted and diffusion-weighted imaging before and after chemoradiotherapy; 2252 radiomic features were extracted from each patient pre- and post-treatment imaging...
September 22, 2017: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
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