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Microsimulation

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https://www.readbyqxmd.com/read/28542274/detecting-infection-hotspots-modeling-the-surveillance-challenge-for-elimination-of-lymphatic-filariasis
#1
Julie R Harris, Ryan E Wiegand
BACKGROUND: During the past 20 years, enormous efforts have been expended globally to eliminate lymphatic filariasis (LF) through mass drug administration (MDA). However, small endemic foci (microfoci) of LF may threaten the presumed inevitable decline of infections after MDA cessation. We conducted microsimulation modeling to assess the ability of different types of surveillance to identify microfoci in these settings. METHODS: Five or ten microfoci of radius 1, 2, or 3 km with infection marker prevalence (intensity) of 3, 6, or 10 times background prevalence were placed in spatial simulations, run in R Version 3...
May 19, 2017: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/28520716/expected-population-weight-and-diabetes-impact-of-the-1-peso-per-litre-tax-to-sugar-sweetened-beverages-in-mexico
#2
Tonatiuh Barrientos-Gutierrez, Rodrigo Zepeda-Tello, Eliane R Rodrigues, Arantxa Colchero-Aragonés, Rosalba Rojas-Martínez, Eduardo Lazcano-Ponce, Mauricio Hernández-Ávila, Juan Rivera-Dommarco, Rafael Meza
STUDY QUESTION: What effect on body mass index, obesity and diabetes can we expect from the 1-peso-per-litre tax to sugar sweetened beverages in Mexico? METHODS: Using recently published estimates of the reductions in beverage purchases due to the tax, we modelled its expected long-term impacts on body mass index (BMI), obesity and diabetes. Microsimulations based on a nationally representative dataset were used to estimate the impact of the tax on BMI and obesity...
2017: PloS One
https://www.readbyqxmd.com/read/28515110/do-men-and-women-need-to-be-screened-differently-with-faecal-immunochemical-testing-a-cost-effectiveness-analysis
#3
Miriam P van der Meulen, Atija Kapidzic, Monique E van Leerdam, Alex van der Steen, Ernst J Kuipers, Manon C Spaander, Harry J de Koning, Lieke Hol, Iris Lansdorp-Vogelaar
BACKGROUND: Several studies suggest test characteristics for the faecal immunochemical test (FIT) differ by gender, triggering a debate whether men and women should be screened differently. We used the microsimulation model MISCAN-Colon to evaluate whether screening stratified by gender is cost-effective. METHODS: We estimated gender-specific FIT characteristics based on first round positivity and detection rates observed in a FIT screening pilot (CORERO-1). Subsequently, we used the model to estimate harms, benefits and costs of 480 gender-specific FIT screening strategies and compared them with uniform screening...
May 17, 2017: Cancer Epidemiology, Biomarkers & Prevention
https://www.readbyqxmd.com/read/28499887/what-is-the-impact-on-the-healthcare-system-if-access-to-bariatric-surgery-is-delayed
#4
Ricardo V Cohen, Alexandre Luque, Silvio Junqueira, Rodrigo Antonini Ribeiro, Carel W Le Roux
BACKGROUND: Bariatric surgery has been available as part of the Brazilian Public Health System for patients with body mass index>40 kg/m(2) (or>35 kg/m(2) with co-morbidities) since 1999. However, access to surgery is challenging, with eligible patients waiting up to 7 years before surgery. OBJECTIVE: Our objective was to compare costs and effectiveness of different waiting times before surgery versus prompt surgery. SETTINGS: Public practice...
March 31, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28495977/modelling-the-implications-of-reducing-smoking-prevalence-the-public-health-and-economic-benefits-of-achieving-a-tobacco-free-uk
#5
Daniel Hunt, André Knuchel-Takano, Abbygail Jaccard, Arti Bhimjiyani, Lise Retat, Chit Selvarajah, Katrina Brown, Laura L Webber, Martin Brown
INTRODUCTION: Smoking is still the most preventable cause of cancer, and a leading cause of premature mortality and health inequalities in the UK. This study modelled the health and economic impacts of achieving a 'tobacco-free' ambition (TFA) where, by 2035, less than 5% of the population smoke tobacco across all socioeconomic groups. METHODS: A non-linear multivariate regression model was fitted to cross-sectional smoking data to create projections to 2035. These projections were used to predict the future incidence and costs of 17 smoking-related diseases using a microsimulation approach...
May 11, 2017: Tobacco Control
https://www.readbyqxmd.com/read/28481128/traditional-growing-rod-versus-magnetically-controlled-growing-rod-for-treatment-of-early-onset-scoliosis-cost-analysis-from-implantation-till-skeletal-maturity
#6
Carlos King Ho Wong, Jason Pui Yin Cheung, Prudence Wing Hang Cheung, Cindy Lo Kuen Lam, Kenneth Man Chee Cheung
PURPOSE: To compare the yearly cost involved per patient in the use of magnetically controlled growing rod (MCGR) and traditional growing rods (TGRs) in the treatment of early onset scoliosis (EOS) and to assess the overall cost burden of MCGR with reference to patient and health-care infrastructure. METHODS: For a hypothetical case of a 5-year-old girl with a diagnosis of EOS, a decision-tree model using TreeAge Software was developed to simulate annual health state transitions and compare the 8-year accumulative direct, indirect, and total cost among the four groups: (1) dual MCGRs with exchange every 2 years, (2) dual MCGRs with exchange every 3 years, (3) TGR with surgical distraction every year, and (4) TGR with surgical distraction every 6 months...
May 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28463708/improving-spatial-microsimulation-estimates-of-health-outcomes-by-including-geographic-indicators-of-health-behaviour-the-example-of-problem-gambling
#7
Francis Markham, Martin Young, Bruce Doran
Gambling is an important public health issue, with recent estimates ranking it as the third largest contributor of disability adjusted life years lost to ill-health. However, no studies to date have estimated the spatial distribution of gambling-related harm in small areas on the basis of surveys of problem gambling. This study extends spatial microsimulation approaches to include a spatially-referenced measure of health behaviour as a constraint variable in order to better estimate the spatial distribution of problem gambling...
April 29, 2017: Health & Place
https://www.readbyqxmd.com/read/28462893/cost-effectiveness-of-gastric-band-surgery-for-overweight-but-not-obese-adults-with-type-2-diabetes-in-the-u-s
#8
John M Wentworth, Kim M Dalziel, Paul E O'Brien, Paul Burton, Frackson Shaba, Philip M Clarke, Neda Laiteerapong, Wendy A Brown
AIM: To determine the cost-effectiveness of gastric band surgery in overweight but not obese people who receive standard diabetes care. METHOD: A microsimulation model (United Kingdom Prospective Diabetes Study outcomes model) was used to project diabetes outcomes and costs from a two-year Australian randomized trial of gastric band (GB) surgery in overweight but not obese people (BMI 25 to 30kg/m(2)) on to a comparable population of U.S. adults from the National Health and Nutrition Examination Survey (N=254)...
April 13, 2017: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/28457614/corneal-collagen-cross-linking-in-the-management-of-keratoconus-in-canada-a-cost-effectiveness-analysis
#9
Victoria C Leung, Petros Pechlivanoglou, Hall F Chew, Wendy Hatch
PURPOSE: To use patient-level microsimulation models to evaluate the comparative cost-effectiveness of early corneal cross-linking (CXL) and conventional management with penetrating keratoplasty (PKP) when indicated in managing keratoconus in Canada. DESIGN: Cost-utility analysis using individual-based, state-transition microsimulation models. PARTICIPANTS: Simulated cohorts of 100 000 individuals with keratoconus who entered each treatment arm at 25 years of age...
April 27, 2017: Ophthalmology
https://www.readbyqxmd.com/read/28435751/hawai-i-physician-workforce-assessment-2016-improvement-in-physician-numbers-but-physician-suicides-of-concern
#10
Kelley Withy, Priscilla Mapelli, John Perez, Ariel Finberg, Josh Green
Hawai'i's Physician Workforce Assessment project was launched in 2010. Over the past 5 years the State has experienced decreases and increases in physician workforce. This current article describes the status of the physician workforce, past trends and anticipated projections as well as recent insights into why people leave Hawai'i. Survey data, internet searches and direct dialing methodologies were utilized to clarify and elucidate practice location, full time equivalency of time providing patient care and specialty of non-military physicians caring for Hawai'i's population...
March 2017: Hawai'i Journal of Medicine & Public Health: a Journal of Asia Pacific Medicine & Public Health
https://www.readbyqxmd.com/read/28431415/potential-impact-of-affordable-care-act-related-insurance-expansion-on-trauma-care-reimbursement
#11
John W Scott, Pooja U Neiman, Peter A Najjar, Thomas C Tsai, Kirstin W Scott, Mark G Shrime, David M Cutler, Ali Salim, Adil H Haider
BACKGROUND: Nearly one quarter of trauma patients are uninsured and hospitals recoup less than 20% of inpatient costs for their care. This study examines changes to hospital reimbursement for inpatient trauma care if the full coverage expansion provisions of the Affordable Care Act (ACA) were in effect. METHODS: We abstracted nonelderly adults (ages 18-64 years) admitted for trauma from the Nationwide Inpatient Sample during 2010-the last year before most major ACA coverage expansion policies...
May 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28419541/when-should-active-surveillance-for-prostate-cancer-stop-if-no-progression-is-detected
#12
Tiago M de Carvalho, Eveline A M Heijnsdijk, Harry J de Koning
BACKGROUND: A significant proportion of screen-detected men with prostate cancer may be overdiagnosed. Active Surveillance (AS) has emerged as a way to mitigate this problem, by delaying treatment of men, who are at low-risk until this becomes necessary. However, it is not known after how much time or biopsy rounds should patients stop AS and transition to conservative management (CM), if no progression is detected. METHODS: We used a microsimulation model with natural history of prostate cancer based on ERSPC and SEER data...
June 2017: Prostate
https://www.readbyqxmd.com/read/28408016/a-practical-anova-approach-for-uncertainty-analysis-in-population-based-disease-microsimulation-models
#13
Behnam Sharif, Hubert Wong, Aslam H Anis, Jacek A Kopec
OBJECTIVES: To provide a practical approach for calculating uncertainty intervals and variance components associated with initial-condition and dynamic-equation parameters in computationally expensive population-based disease microsimulation models. METHODS: In the proposed uncertainty analysis approach, we calculated the required computational time and the number of runs given a user-defined error bound on the variance of the grand mean. The equations for optimal sample sizes were derived by minimizing the variance of the grand mean using initial estimates for variance components...
April 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/28391272/in-office-application-of-fluoride-gel-or-varnish-cost-effectiveness-and-expected-value-of-perfect-information-analysis
#14
Falk Schwendicke, Michael Stolpe
Application of fluoride gel/varnish (FG/FV) reduces caries increments but generates costs. Avoiding restorative treatments by preventing caries might compensate for these costs. We assessed the cost-effectiveness of dentists applying FG/FV in office and the expected value of perfect information (EVPI). EVPI analyses estimate the economic value of having perfect knowledge, assisting research resource allocation. A mixed public-private-payer perspective in Germany was adopted. A population of 12-year-olds was followed over their lifetime, with caries increments modelled using wide intervals to reflect the uncertainty of caries risk...
April 8, 2017: Caries Research
https://www.readbyqxmd.com/read/28376459/health-benefits-and-cost-effectiveness-of-brief-clinician-tobacco-counseling-for-youth-and-adults
#15
Michael V Maciosek, Amy B LaFrance, Steven P Dehmer, Dana A McGree, Zack Xu, Thomas J Flottemesch, Leif I Solberg
PURPOSE: To help clinicians and care systems determine the priority for tobacco counseling in busy clinic schedules, we assessed the lifetime health and economic value of annually counseling youth to discourage smoking initiation and of annually counseling adults to encourage cessation. METHODS: We conducted a microsimulation analysis to estimate the health impact and cost effectiveness of both types of tobacco counseling in a US birth cohort of 4,000,000. The model used for the analysis was constructed from nationally representative data sets and structured literature reviews...
January 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/28376458/health-benefits-and-cost-effectiveness-of-asymptomatic-screening-for-hypertension-and-high-cholesterol-and-aspirin-counseling-for-primary-prevention
#16
Steven P Dehmer, Michael V Maciosek, Amy B LaFrance, Thomas J Flottemesch
PURPOSE: Our aim was to update estimates of the health and economic impact of clinical services recommended for the primary prevention of cardiovascular disease (CVD) for the comparative rankings of the National Commission on Prevention Priorities, and to explore differences in outcomes by sex and race/ethnicity. METHODS: We used a single, integrated, microsimulation model to generate comparable results for 3 services recommended by the US Preventive Services Task Force: aspirin counseling for the primary prevention of CVD and colorectal cancer, screening and treatment for lipid disorders (usually high cholesterol), and screening and treatment for hypertension...
January 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/28376457/updated-priorities-among-effective-clinical-preventive-services
#17
Michael V Maciosek, Amy B LaFrance, Steven P Dehmer, Dana A McGree, Thomas J Flottemesch, Zack Xu, Leif I Solberg
PURPOSE: The Patient Protection and Affordable Care Act's provisions for first-dollar coverage of evidence-based preventive services have reduced an important barrier to receipt of preventive care. Safety-net providers, however, still serve a substantial uninsured population, and clinician and patient time remain limited in all primary care settings. As a consequence, decision makers continue to set priorities to help focus their efforts. This report updates estimates of relative health impact and cost-effectiveness for evidence-based preventive services...
January 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/28367539/the-potential-cost-effectiveness-of-hiv-vaccines-a-systematic-review
#18
Blythe Adamson, Dobromir Dimitrov, Beth Devine, Ruanne Barnabas
OBJECTIVE: The aim of this paper was to review and compare HIV vaccine cost-effectiveness analyses and describe the effects of uncertainty in model, methodology, and parameterization. METHODS: We systematically searched MEDLINE (1985 through May 2016), EMBASE, the Tufts CEA Registry, and reference lists of articles following Cochrane guidelines and PRISMA reporting. Eligibility criteria included peer-reviewed manuscripts with economic models estimating cost-effectiveness of preventative HIV vaccines...
March 2017: Pharmacoeconom Open
https://www.readbyqxmd.com/read/28343930/cost-effectiveness-of-different-post-retained-restorations
#19
Falk Schwendicke, Michael Stolpe
OBJECTIVES: Dentists can choose between metal and fiber post systems to provide post-retained restorations. The risk of tooth loss and other complications differs between different post systems, as do the initial treatment costs. We aimed to assess the cost-effectiveness of (1) cast metal (MC), (2) preformed metal (MP), (3) glass fiber (GF), and (4) carbon fiber (CF) post-retained restorations. METHODS: A mixed public-private payer's perspective within German healthcare was taken...
March 23, 2017: Journal of Endodontics
https://www.readbyqxmd.com/read/28327833/-burden-of-smoking-related-disease-and-potential-impact-of-cigarette-price-increase-in-peru
#20
Ariel E Bardach, Joaquín E Caporale, Andrea Alcaraz, Federico Augustovski, Leandro Huayanay-Falconí, Cesar Loza-Munarriz, Akram Hernández-Vásquez, Andrés Pichon-Riviere
Objectives: . To calculate the burden of smoking-related disease and evaluate the potential economic and health impact of tax-induced cigarette price increase in Peru. Materials and methods.: A microsimulation model was used to estimate smoking-attributable impact on mortality, quality of life, and costs associated with heart and cerebrovascular disease, chronic obstructive pulmonary disease, pneumonia, lung cancer, and another nine cancers. Three scenarios, involving increased taxes, were evaluated...
October 2016: Revista Peruana de Medicina Experimental y Salud Pública
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