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Microsimulation

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https://www.readbyqxmd.com/read/28918407/burden-of-non-adherence-to-latent-tuberculosis-infection-drug-therapy-and-the-potential-cost-effectiveness-of-adherence-interventions-in-canada-a-simulation-study
#1
Anik R Patel, Jonathon R Campbell, Mohsen Sadatsafavi, Fawziah Marra, James C Johnston, Kirsten Smillie, Richard T Lester
OBJECTIVE: Pharmaceutical treatment of latent tuberculosis infection (LTBI) reduces the risk of progression to active tuberculosis (TB); however, poor adherence tempers the protective effect. We aimed to estimate the health burden of non-adherence, the maximum allowable cost of hypothetical new adherence interventions to be cost-effective and the potential value of existing adherence interventions for patients with low-risk LTBI in Canada. DESIGN: A microsimulation model of LTBI progression over 25 years...
September 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/28900839/behavioral-health-integration-into-primary-care-a-microsimulation-of-financial-implications-for-practices
#2
Sanjay Basu, Bruce E Landon, John W Williams, Asaf Bitton, Zirui Song, Russell S Phillips
BACKGROUND: New payments from Medicare encourage behavioral health services to be integrated into primary care practice activities. OBJECTIVE: To evaluate the financial impact for primary care practices of integrating behavioral health services. DESIGN: Microsimulation model. PARTICIPANTS: We simulated patients and providers at federally qualified health centers (FQHCs), non-FQHCs in urban and rural high-poverty areas, and practices outside of high-poverty areas surveyed by the National Association of Community Health Centers, National Ambulatory Medical Care Survey, National Health and Nutrition Examination Survey, and National Health Interview Survey...
September 12, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28886141/the-impact-of-vehicle-moving-violations-and-freeway-traffic-flow-on-crash-risk-an-application-of-plugin-development-for-microsimulation
#3
Junhua Wang, Yumeng Kong, Ting Fu, Joshua Stipancic
This paper presents the use of the Aimsun microsimulation program to simulate vehicle violating behaviors and observe their impact on road traffic crash risk. Plugins for violations of speeding, slow driving, and abrupt stopping were developed using Aimsun's API and SDK module. A safety analysis plugin for investigating probability of rear-end collisions was developed, and a method for analyzing collision risk is proposed. A Fuzzy C-mean Clustering algorithm was developed to identify high risk states in different road segments over time...
2017: PloS One
https://www.readbyqxmd.com/read/28874487/high-levels-of-capitation-payments-needed-to-shift-primary-care-toward-proactive-team-and-nonvisit-care
#4
Sanjay Basu, Russell S Phillips, Zirui Song, Asaf Bitton, Bruce E Landon
Capitated payments in the form of fixed monthly payments to cover all of the costs associated with delivering primary care could encourage primary care practices to transform the way they deliver care. Using a microsimulation model incorporating data from 969 US practices, we sought to understand whether shifting to team- and non-visit-based care is financially sustainable for practices under traditional fee-for-service, capitated payment, or a mix of the two. Practice revenues and costs were computed for fee-for-service payments and a range of capitated payments, before and after the substitution of team- and non-visit-based services for low-complexity in-person physician visits...
September 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28869989/reconciling-the-effects-of-screening-on-prostate-cancer-mortality-in-the-erspc-and-plco-trials
#5
Alex Tsodikov, Roman Gulati, Eveline A M Heijnsdijk, Paul F Pinsky, Sue M Moss, Sheng Qiu, Tiago M de Carvalho, Jonas Hugosson, Christine D Berg, Anssi Auvinen, Gerald L Andriole, Monique J Roobol, E David Crawford, Vera Nelen, Maciej Kwiatkowski, Marco Zappa, Marcos Luján, Arnauld Villers, Eric J Feuer, Harry J de Koning, Angela B Mariotto, Ruth Etzioni
Background: The ERSPC (European Randomized Study of Screening for Prostate Cancer) found that screening reduced prostate cancer mortality, but the PLCO (Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial) found no reduction. Objective: To evaluate whether effects of screening on prostate cancer mortality relative to no screening differed between the ERSPC and PLCO. Design: Cox regression of prostate cancer death in each trial group, adjusted for age and trial...
September 5, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28862051/the-projected-public-health-and-economic-impact-of-vitamin-d-fortified-dairy-products-for-fracture-prevention-in-france
#6
Mickael Hiligsmann, Jean-Yves Reginster
BACKGROUND: There is a paucity of research that projects the public health and economic impact of healthcare interventions in the future. In this study, we aimed to estimate the public health and economic impact of vitamin D fortified dairy products for the years 2020, 2030, 2040, 2050 and 2060. METHODS: We used a previously validated Markov microsimulation model that was designed to assess the public health and economic impact of dairy products for fracture prevention in the French general population aged over 60 years in the year 2015...
September 7, 2017: Expert Review of Pharmacoeconomics & Outcomes Research
https://www.readbyqxmd.com/read/28859580/simulated-effects-of-policies-to-reduce-diabetes-risk-among-adults-with-schizophrenia-receiving-antipsychotics
#7
Andrew W Mulcahy, Sharon-Lise Normand, John W Newcomer, Benjamin Colaiaco, Julie M Donohue, Judith R Lave, Emmett Keeler, Mark J Sorbero, Marcela Horvitz-Lennon
OBJECTIVE: Second-generation antipsychotics increase the risk of diabetes and other metabolic conditions among individuals with schizophrenia. Although metabolic testing is recommended to reduce this risk, low testing rates have prompted concerns about negative health consequences and downstream medical costs. This study simulated the effect of increasing metabolic testing rates on ten-year prevalence rates of prediabetes and diabetes (diabetes conditions) and their associated health care costs...
September 1, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/28859154/the-cost-effectiveness-of-phq-screening-and-collaborative-care-for-depression-in-new-york-city
#8
Boshen Jiao, Zohn Rosen, Martine Bellanger, Gary Belkin, Peter Muennig
BACKGROUND: Depression is under-diagnosed and under-treated in most areas of the US. New York City is currently looking to close gaps in identifying and treating depression through the adoption of a screening and collaborative care model deployed throughout the city. METHODS: We examine the cost-effectiveness of universal two-stage screening with the 2- and 9-item Patient Health Questionnaires (PHQ-2 and PHQ-9) in New York City followed by collaborative care for those who screen positive...
2017: PloS One
https://www.readbyqxmd.com/read/28845611/socioeconomic-status-and-differential-lifetime-costs-of-overweight-and-obesity-an-application-of-microsimulations
#9
Tapan Mehta, Allyson Hall
No abstract text is available yet for this article.
September 2017: Obesity
https://www.readbyqxmd.com/read/28840772/a-health-economic-lifetime-treatment-pathway-model-for-low-back-pain-in-sweden
#10
Gylfi Olafsson, Emma Jonsson, Peter Fritzell, Olle Hägg, Fredrik Borgström
AIMS: To develop a health economic model to evaluate the long-term costs and outcomes over the healthcare treatment pathway for patients with low back pain (LBP). MATERIALS AND METHODS: A health economic model, consisting of a decision tree structure with a Markov microsimulation model at the end of each branch, was created. Patients were followed from first observed clinical presentation with LBP until the age of 100 years or death. The underlying data to populate the model were based on Swedish national and regional registry data on healthcare resource use and sickness insurance in patients presenting with LBP in the Swedish region Västra Götaland during 2008-2012...
September 11, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28838313/trade-off-between-benefits-harms-and-economic-efficiency-of-low-dose-ct-lung-cancer-screening-a-microsimulation-analysis-of-nodule-management-strategies-in-a-population-based-setting
#11
Marina Treskova, Ines Aumann, Heiko Golpon, Jens Vogel-Claussen, Tobias Welte, Alexander Kuhlmann
BACKGROUND: In lung cancer screening, a nodule management protocol describes nodule assessment and thresholds for nodule size and growth rate to identify patients who require immediate diagnostic evaluation or additional imaging exams. The Netherlands-Leuvens Screening Trial and the National Lung Screening Trial used different selection criteria and nodule management protocols. Several modelling studies have reported variations in screening outcomes and cost-effectiveness across selection criteria and screening intervals; however, the effect of variations in the nodule management protocol remains uncertain...
August 25, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28834469/cost-effectiveness-of-intensive-versus-standard-blood-pressure-control
#12
Adam P Bress, Brandon K Bellows, Jordan B King, Rachel Hess, Srinivasan Beddhu, Zugui Zhang, Dan R Berlowitz, Molly B Conroy, Larry Fine, Suzanne Oparil, Donald E Morisky, Lewis E Kazis, Natalia Ruiz-Negrón, Jamie Powell, Leonardo Tamariz, Jeff Whittle, Jackson T Wright, Mark A Supiano, Alfred K Cheung, William S Weintraub, Andrew E Moran
BACKGROUND: In the Systolic Blood Pressure Intervention Trial (SPRINT), adults at high risk for cardiovascular disease who received intensive systolic blood-pressure control (target, <120 mm Hg) had significantly lower rates of death and cardiovascular disease events than did those who received standard control (target, <140 mm Hg). On the basis of these data, we wanted to determine the lifetime health benefits and health care costs associated with intensive control versus standard control...
August 24, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28830258/cost-effectiveness-of-golimumab-for-the-treatment-of-patients-with-moderate-to-severe-ulcerative-colitis-in-quebec-using-a-patient-level-state-transition-microsimulation
#13
Sean Stern, Alexandra J Ward, Catherine Saint-Laurent Thibault, Fernando Camacho, Elham Rahme, Dominik Naessens, Guy Aumais, Edmond-Jean Bernard, Raymond Bourdages, Albert Cohen, Pierre Pare, Peter Dyrda
OBJECTIVE: To conduct cost-effectiveness analyses comparing the addition of golimumab to the standard of care (SoC) for treatment of patients with moderate-to-severe ulcerative colitis (UC) who are refractory to conventional therapies in Quebec (Canada). METHODS: An individual patient state transition microsimulation model was developed to project health outcomes and costs over 10 years, using a payer perspective. The incremental benefit estimates for golimumab were driven by induction response and risk of a flare...
September 1, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28817782/cost-effectiveness-of-a-patient-navigation-program-to-improve-cervical-cancer-screening
#14
Yan Li, Erin Carlson, Roberto Villarreal, Leah Meraz, José A Pagán
OBJECTIVES: To assess the cost-effectiveness of a community-based patient navigation program to improve cervical cancer screening among Hispanic women 18 or older in San Antonio, Texas. STUDY DESIGN: We used a microsimulation model of cervical cancer to project the long-term cost-effectiveness of a community-based patient navigation program compared with current practice. METHODS: We used program data from 2012 to 2015 and published data from the existing literature as model input...
July 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28815573/impact-of-adenoma-detection-on-the-benefit-of-faecal-testing-versus-colonoscopy-for-colorectal-cancer
#15
Reinier G S Meester, Chyke A Doubeni, Ann G Zauber, Marjolein van Ballegooijen, Douglas A Corley, Iris Lansdorp-Vogelaar
Colonoscopy quality, as measured by adenoma detection rates, varies widely across providers and is inversely related with patients' post-colonoscopy cancer risk. This has unknown consequences for the benefits of faecal immunochemical testing (FIT) versus primary colonoscopy screening for colorectal cancer. Using an established microsimulation model, we predicted the lifetime colorectal cancer incidence and mortality benefits of annual FIT versus ten-yearly colonoscopy screening at differing ADR levels (quintiles; averages 15...
August 17, 2017: International Journal of Cancer. Journal International du Cancer
https://www.readbyqxmd.com/read/28800151/cost-comparison-of-prediction-based-decision-making-for-periodontally-affected-molars
#16
Falk Schwendicke, Michael Stolpe, Christian Graetz
AIM: Tooth loss prediction could improve decision-making for periodontally-affected molars. We analyzed the costs of removing all, none or only those molars predicted to be at-risk for extraction during supportive periodontal therapy (SPT). METHODS: This is a model-based study using a German private-payer-perspective. Building mainly on cost and effectiveness data from 2039 molars (301 patients) which received long-term SPT, five (exemplary) prediction/decision strategies were compared: Retaining all molars, removing molars with furcation-involvement (FI) ≥I/≥II/III, or removing all molars...
August 11, 2017: Journal of Clinical Periodontology
https://www.readbyqxmd.com/read/28797417/implications-of-coronary-artery-calcium%C3%A2-testing-for-treatment-decisions-among-statin-candidates-according-to%C3%A2-the%C3%A2-acc-aha-cholesterol-management%C3%A2-guidelines-a-cost-effectiveness-analysis
#17
REVIEW
Jonathan C Hong, Ron Blankstein, Leslee J Shaw, William V Padula, Alejandro Arrieta, Jonathan A Fialkow, Roger S Blumenthal, Michael J Blaha, Harlan M Krumholz, Khurram Nasir
This review evaluates the cost-effectiveness of using coronary artery calcium (CAC) to guide long-term statin therapy compared with treating all patients eligible for statins according to 2013 American College of Cardiology/American Heart Association cholesterol management guidelines for atherosclerotic cardiovascular disease. The authors used a microsimulation model to compare costs and effectiveness from a societal perspective over a lifetime horizon. Both strategies resulted in similar costs and quality-adjusted life years (QALYs)...
August 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28775179/health-and-economic-benefits-of-reducing-sugar-intake-in-the-usa-including-effects-via-non-alcoholic-fatty-liver-disease-a-microsimulation-model
#18
Rick A Vreman, Alex J Goodell, Luis A Rodriguez, Travis C Porco, Robert H Lustig, James G Kahn
OBJECTIVES: Excessive consumption of added sugars in the human diet has been associated with obesity, type 2 diabetes (T2D), coronary heart disease (CHD) and other elements of the metabolic syndrome. Recent studies have shown that non-alcoholic fatty liver disease (NAFLD) is a critical pathway to metabolic syndrome. This model assesses the health and economic benefits of interventions aimed at reducing intake of added sugars. METHODS: Using data from US National Health Surveys and current literature, we simulated an open cohort, for the period 2015-2035...
August 3, 2017: BMJ Open
https://www.readbyqxmd.com/read/28764731/evaluation-of-the-colorectal-cancer-screening-programme-in-the-basque-country-spain-and-its-effectiveness-based-on-the-miscan-colon-model
#19
I Idigoras, A Arrospide, I Portillo, E Arana-Arri, L Martínez-Indart, J Mar, H J de Koning, R Lastra, M Soto-Gordoa, M van der Meulen, I Lansdorp-Vogelaar
The population-based Basque Colorectal Cancer (CRC) Screening Programme started in 2009 with a biennial immunochemical quantitative test (FIT) biennial and colonoscopy under sedation in positive cases. The population target of 586,700 residents was from 50 to 69 years old and the total coverage was reached at the beginning of 2014. The aim of our study was to determine possible scenarios in terms of incidence, mortality and reduction of Life-years-Lost (L-y-L) in the medium and long term of CRC. METHODS: Invitations were sent out by the Programme from 2009 to 2014, with combined organizational strategies...
August 1, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28745476/extending-marketplace-tax-credits-would-make-coverage-more-affordable-for-middle-income-adults
#20
Jodi Liu, Christine Eiber
ISSUE: Affordability of health coverage is a growing challenge for Americans facing rising premiums, deductibles, and copayments. The Affordable Care Act's tax credits make marketplace insurance more affordable for eligible lower-income individuals. However, individuals lose tax credits when their income exceeds 400 percent of the federal poverty level, creating a steep cliff. GOALS: To analyze the effects of extending eligibility for tax credits to individuals with incomes above 400 percent of the federal poverty level...
July 2017: Issue Brief of the Commonwealth Fund
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