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Discrete event simulation

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https://www.readbyqxmd.com/read/28692434/assessing-intensity-of-nursing-care-needs-using-electronically-available-data
#1
Elaine L Larson, Bevin Cohen, Jianfang Liu, Philip Zachariah, David Yao, Jingjing Shang
Although previous research has confirmed that nurse staffing affects patient outcomes, some potentially important factors have not been accounted for in tools to assess relationships between staffing and outcomes. The aim of this project was to develop and test a Nursing Intensity of Care Index using electronically available data from 152 072 patient discharges from three hospitals. Initially, 1765 procedure codes were reviewed; 69 were confirmed as directly increasing nursing workload by at least 15 minutes per shift...
July 7, 2017: Computers, Informatics, Nursing: CIN
https://www.readbyqxmd.com/read/28675959/adding-events-to-a-markov-model-using-dice-simulation
#2
J Jaime Caro, Jörgen Möller
BACKGROUND: Health care decisions are often made under uncertainty and modeling is used to inform the choices and possible consequences. State-transition ("Markov") models are commonly used but they represent the problem solely in terms of states; events are not explicitly considered. METHODS: Discretely integrated condition event (DICE) simulation provides for both aspects that persist over time ("conditions") and for those happening at a point in time ("events")...
July 1, 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/28674845/discrete-event-simulation-based-resource-modelling-in-health-technology-assessment
#3
REVIEW
Syed Salleh, Praveen Thokala, Alan Brennan, Ruby Hughes, Simon Dixon
OBJECTIVE: The objective of this article was to conduct a systematic review of published research on the use of discrete event simulation (DES) for resource modelling (RM) in health technology assessment (HTA). RM is broadly defined as incorporating and measuring effects of constraints on physical resources (e.g. beds, doctors, nurses) in HTA models. METHODS: Systematic literature searches were conducted in academic databases (JSTOR, SAGE, SPRINGER, SCOPUS, IEEE, Science Direct, PubMed, EMBASE) and grey literature (Google Scholar, NHS journal library), enhanced by manual searchers (i...
July 3, 2017: PharmacoEconomics
https://www.readbyqxmd.com/read/28669122/validation-of-a-dice-simulation-against-a-discrete-event-simulation-implemented-entirely-in-code
#4
Jörgen Möller, Sarah Davis, Matt Stevenson, J Jaime Caro
BACKGROUND: Modeling is an essential tool for health technology assessment, and various techniques for conceptualizing and implementing such models have been described. Recently, a new method has been proposed-the discretely integrated condition event or DICE simulation-that enables frequently employed approaches to be specified using a common, simple structure that can be entirely contained and executed within widely available spreadsheet software. To assess if a DICE simulation provides equivalent results to an existing discrete event simulation, a comparison was undertaken...
July 1, 2017: PharmacoEconomics
https://www.readbyqxmd.com/read/28662601/a-discrete-event-simulation-model-of-patient-flow-in-a-general-hospital-incorporating-infection-control-policy-for-methicillin-resistant-staphylococcus-aureus-mrsa-and-vancomycin-resistant-enterococcus-vre
#5
Erica S Shenoy, Hang Lee, Erin E Ryan, Taige Hou, Rochelle P Walensky, Winston Ware, David C Hooper
BACKGROUND: Hospitalized patients are assigned to available staffed beds based on patient acuity and services required. In hospitals with double-occupancy rooms, patients must be additionally matched by gender. Patients with methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant Enterococcus (VRE) must be bedded in single-occupancy rooms or cohorted with other patients with similar MRSA/VRE flags. METHODS: We developed a discrete event simulation (DES) model of patient flow through an acute care hospital...
June 1, 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/28635362/costs-and-effectiveness-of-fingolimod-versus-alemtuzumab-in-the-treatment-of-highly-active-relapsing-remitting-multiple-sclerosis-in-the-uk-re-treatment-discount-and-disutility
#6
Stephen M Montgomery, Jeanette Kusel, Richard Nicholas, Nicholas Adlard
OBJECTIVE: Patients with relapsing-remitting multiple sclerosis (RRMS) treated with disease modifying therapies (DMTs) who continue to experience disease activity may be considered for escalation therapies such as fingolimod, or may be considered for alemtuzumab. Previous economic modeling used Markov models; applying one alternative technique, discrete event simulation (DES) modeling, allows re-treatment and long-term adverse events (AEs) to be included in the analysis. METHODS: A DES was adapted to model relapse-triggered re-treatment with alemtuzumab and the effect of including ongoing quality-adjusted life year (QALY) decrements for AEs that extend beyond previous 1-year Markov cycles...
July 11, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28603326/modeling-molecular-mechanisms-in-the-axon
#7
R de Rooij, K E Miller, E Kuhl
Axons are living systems that display highly dynamic changes in stiffness, viscosity, and internal stress. However, the mechanistic origin of these phenomenological properties remains elusive. Here we establish a computational mechanics model that interprets cellular-level characteristics as emergent properties from molecular-level events. We create an axon model of discrete microtubules, which are connected to neighboring microtubules via discrete crosslinking mechanisms that obey a set of simple rules. We explore two types of mechanisms: passive and active crosslinking...
March 2017: Computational Mechanics
https://www.readbyqxmd.com/read/28596730/integration-of-continuous-time-dynamics-in-a-spiking-neural-network-simulator
#8
Jan Hahne, David Dahmen, Jannis Schuecker, Andreas Frommer, Matthias Bolten, Moritz Helias, Markus Diesmann
Contemporary modeling approaches to the dynamics of neural networks include two important classes of models: biologically grounded spiking neuron models and functionally inspired rate-based units. We present a unified simulation framework that supports the combination of the two for multi-scale modeling, enables the quantitative validation of mean-field approaches by spiking network simulations, and provides an increase in reliability by usage of the same simulation code and the same network model specifications for both model classes...
2017: Frontiers in Neuroinformatics
https://www.readbyqxmd.com/read/28594478/what-influences-the-cost-effectiveness-of-dabigatran-versus-warfarin-for-stroke-prevention-in-atrial-fibrillation-a-systematic-review
#9
Jathishinie Jegathisawaran, Anne Holbrook, James M Bowen, Natasha Burke, Kaitryn Campbell, Jean-Eric Tarride
OBJECTIVES: The introduction of new oral anticoagulants for the prevention of stroke in atrial fibrillation (AF) has changed the clinical management of AF. To inform decision making around dabigatran by identifying factors influencing cost-effectiveness results, we undertook a systematic review of economic evaluations of dabigatran versus warfarin for the prevention of stroke in AF patients. METHODS: A systematic literature search of Ovid Medline and Embase, Wiley's Cochrane Library, HEED, PubMed databases and grey literature was carried out for primary economic evaluations comparing dabigatran versus warfarin in patients with AF...
May 2, 2017: Journal of Population Therapeutics and Clinical Pharmacology
https://www.readbyqxmd.com/read/28588107/staffs-and-managers-perceptions-of-how-and-when-discrete-event-simulation-modelling-can-be-used-as-a-decision-support-in-quality-improvement-a-focus-group-discussion-study-at-two-hospital-settings-in-sweden
#10
Helena Hvitfeldt-Forsberg, Pamela Mazzocato, Daniel Glaser, Christina Keller, Maria Unbeck
OBJECTIVE: To explore healthcare staffs' and managers' perceptions of how and when discrete event simulation modelling can be used as a decision support in improvement efforts. DESIGN: Two focus group discussions were performed. SETTING: Two settings were included: a rheumatology department and an orthopaedic section both situated in Sweden. PARTICIPANTS: Healthcare staff and managers (n=13) from the two settings. INTERVENTIONS: Two workshops were performed, one at each setting...
June 6, 2017: BMJ Open
https://www.readbyqxmd.com/read/28577263/modelling-for-the-proposed-roll-out-of-the-111-service-in-wales-a-case-study
#11
Mark Tuson, Tracey England, Doris Behrens, Richard Bowen, Dorothy Edwards, John Frankish, Jude Kay
NHS Direct Wales provides a single point of access where members of the public can telephone and seek medical support and/or advice. The service is provided for all the Health Boards in Wales by a single virtual call centre run from a main location in Swansea with 2 satellite locations. Patients in Wales can also access a local General Practitioner service during the evenings and at weekends, by phoning their Out of Hours service. The introduction of a '111' service is intended to combine these two operations on a pan-Wales basis using the existing NHS Direct Wales call centre and staff, with the existing Health Board Out of Hours 'hubs'...
June 2, 2017: Health Care Management Science
https://www.readbyqxmd.com/read/28557517/economic-value-of-pharmacist-led-medication-reconciliation-for-reducing-medication-errors-after-hospital-discharge
#12
Mehdi Najafzadeh, Jeffrey L Schnipper, William H Shrank, Steven Kymes, Troyen A Brennan, Niteesh K Choudhry
OBJECTIVES: Medication discrepancies at the time of hospital discharge are common and can harm patients. Medication reconciliation by pharmacists has been shown to prevent such discrepancies and the adverse drug events (ADEs) that can result from them. Our objective was to estimate the economic value of nontargeted and targeted medication reconciliation conducted by pharmacists and pharmacy technicians at hospital discharge versus usual care. STUDY DESIGN: Discrete-event simulation model...
October 2016: American Journal of Managed Care
https://www.readbyqxmd.com/read/28516345/performance-and-cost-evaluation-of-health-information-systems-using-micro-costing-and-discrete-event-simulation
#13
Olfa Rejeb, Claire Pilet, Sabri Hamana, Xiaolan Xie, Thierry Durand, Saber Aloui, Anne Doly, Pierre Biron, Lionel Perrier, Vincent Augusto
Innovation and health-care funding reforms have contributed to the deployment of Information and Communication Technology (ICT) to improve patient care. Many health-care organizations considered the application of ICT as a crucial key to enhance health-care management. The purpose of this paper is to provide a methodology to assess the organizational impact of high-level Health Information System (HIS) on patient pathway. We propose an integrated performance evaluation of HIS approach through the combination of formal modeling using the Architecture of Integrated Information Systems (ARIS) models, a micro-costing approach for cost evaluation, and a Discrete-Event Simulation (DES) approach...
May 17, 2017: Health Care Management Science
https://www.readbyqxmd.com/read/28508958/modeling-the-critical-care-pathway-for-cardiothoracic-surgery
#14
Nicolas Bahou, Claire Fenwick, Gillian Anderson, Robert van der Meer, Tony Vassalos
The west of Scotland heart and lung center based at the Golden Jubilee National Hospital houses all adult cardiothoracic surgery for the region. Increased demand for scheduled patients and fluctuations in emergency referrals resulted in increasing waiting times and patient cancellations. The main issue was limited resources, which was aggravated by the stochastic nature of the length of stay (LOS) and arrival of patients. Discrete event simulation (DES) was used to assess if an enhanced schedule was sufficient, or more radical changes, such as capacity or other resource reallocations should be considered in order to solve the problem...
May 16, 2017: Health Care Management Science
https://www.readbyqxmd.com/read/28507994/a-step-by-step-framework-on-discrete-events-simulation-in-emergency-department-a-systematic-review
#15
REVIEW
Mahsa Dehghani, Nazila Moftian, Peyman Rezaei-Hachesu, Taha Samad-Soltani
OBJECTIVE: To systematically review the current literature of simulation in healthcare including the structured steps in the emergency healthcare sector by proposing a framework for simulation in the emergency department. METHODS: For the purpose of collecting the data, PubMed and ACM databases were used between the years 2003 and 2013. The inclusion criteria were to select English-written articles available in full text with the closest objectives from among a total of 54 articles retrieved from the databases...
April 2017: Bulletin of Emergency and Trauma
https://www.readbyqxmd.com/read/28502247/assessing-the-costs-and-benefits-of-insuring-psychological-services-as-part-of-medicare-for-depression-in-canada
#16
Helen-Maria Vasiliadis, Anne Dezetter, Eric Latimer, Martin Drapeau, Alain Lesage
OBJECTIVE: The study estimated costs and effects associated with increasing access to publicly funded psychological services for depression in a public health care system. METHODS: Discrete event simulation modeled clinical events (relapse, recovery, hospitalizations, suicide attempts, and suicide), health service use, and cost outcomes over 40 years in a population with incident depression. Parameters included epidemiologic and economic data from the literature and data from a secondary analysis of the 2012 Canadian Community Health Survey on mental health...
May 15, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/28498849/percutaneous-coronary-intervention-with-second-generation-drug-eluting-stent-versus-bare-metal-stent-systematic-review-and-cost-benefit-analysis
#17
Thomas G Poder, Jihane Erraji, Lucien P Coulibaly, Kouamé Koffi
BACKGROUND: Drug-eluting stents (DESs) were considered as ground-breaking technology promising to eradicate restenosis and the necessity to perform multiple revascularization procedures subsequent to percutaneous coronary intervention. Soon after DESs were released on the market, however, there were reports of a potential increase in mortality and of early or late thrombosis. In addition, DESs are far more expensive than bare-metal stents (BMSs), which has led to their limited use in many countries...
2017: PloS One
https://www.readbyqxmd.com/read/28494999/modeling-and-control-of-operator-functional-state-in-a-unified-framework-of-fuzzy-inference-petri-nets
#18
Jian-Hua Zhang, Jia-Jun Xia, Jonathan M Garibaldi, Petros P Groumpos, Ru-Bin Wang
BACKGROUND AND OBJECTIVE: In human-machine (HM) hybrid control systems, human operator and machine cooperate to achieve the control objectives. To enhance the overall HM system performance, the discrete manual control task-load by the operator must be dynamically allocated in accordance with continuous-time fluctuation of psychophysiological functional status of the operator, so-called operator functional state (OFS). The behavior of the HM system is hybrid in nature due to the co-existence of discrete task-load (control) variable and continuous operator performance (system output) variable...
June 2017: Computer Methods and Programs in Biomedicine
https://www.readbyqxmd.com/read/28487459/patient-flow-within-uk-emergency-departments-a-systematic-review-of-the-use-of-computer-simulation-modelling-methods
#19
Syed Mohiuddin, John Busby, Jelena Savović, Alison Richards, Kate Northstone, William Hollingworth, Jenny L Donovan, Christos Vasilakis
OBJECTIVES: Overcrowding in the emergency department (ED) is common in the UK as in other countries worldwide. Computer simulation is one approach used for understanding the causes of ED overcrowding and assessing the likely impact of changes to the delivery of emergency care. However, little is known about the usefulness of computer simulation for analysis of ED patient flow. We undertook a systematic review to investigate the different computer simulation methods and their contribution for analysis of patient flow within EDs in the UK...
May 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/28480535/integrated-continuous-bioprocessing-economic-operational-and-environmental-feasibility-for-clinical-and-commercial-antibody-manufacture
#20
James Pollock, Jon Coffman, Sa V Ho, Suzanne S Farid
This paper presents a systems approach to evaluating the potential of integrated continuous bioprocessing for monoclonal antibody (mAb) manufacture across a product's lifecycle from pre-clinical to commercial manufacture. The economic, operational and environmental feasibility of alternative continuous manufacturing strategies were evaluated holistically using a prototype UCL decisional tool that integrated process economics, discrete-event simulation, environmental impact analysis, operational risk analysis and multi-attribute decision-making...
May 8, 2017: Biotechnology Progress
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