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Microsimulation

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https://www.readbyqxmd.com/read/29150480/effect-of-time-to-diagnostic-testing-for-breast-cervical-and-colorectal-cancer-screening-abnormalities-on-screening-efficacy-a-modeling-study
#1
Carolyn M Rutter, Jane J Kim, Reinier G S Meester, Brian L Sprague, Emily A Burger, Ann G Zauber, Mehmet Ali Ergun, Nicole G Campos, Chyke A Doubeni, Amy Trentham-Dietz, Stephen Sy, Oguz Alagoz, Natasha Stout, Iris Lansdorp-Vogelaar, Douglas A Corley, Anna Tosteson
BACKGROUND: Patients who receive an abnormal cancer screening result require follow-up for diagnostic testing, but the time to follow-up varies across patients and practices. METHODS: We used a simulation study to estimate the change in lifetime screening benefits when time to follow-up for breast, cervical, and colorectal cancers was increased. Estimates were based on four independently developed microsimulation models that each simulated the life course of adults eligible for breast (women aged 50-74 years), cervical (women aged 21-65 years), or colorectal (adults aged 50-75 years) cancer screening...
November 17, 2017: Cancer Epidemiology, Biomarkers & Prevention
https://www.readbyqxmd.com/read/29148342/undiagnosed-and-uncontrolled-chronic-conditions-in-china-could-social-health-insurance-consolidation-make-a-change
#2
Xing Lin Feng
Policy makers in China are considering consolidating the country's fragmented health insurance programs. This system consists of three components. The Urban Employee Basic Medical Insurance (UEBMI) covers formal employees, the New Cooperative Medical Scheme (NCMS) covers rural residents, and the Urban Resident Basic Medical Insurance (URBMI) covers urban residents. Consolidation could, in theory, create a more efficient health system that is better able to address noncommunicable diseases. Using national survey data during 2011 to 2013, I found that 44% to 76% cases of hypertension, diabetes, and dyslipidemia went undiagnosed among Chinese adults aged 45 and older...
February 1, 2017: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/29146652/dynamic-treatment-selection-and-modification-for-personalised-blood-pressure-therapy-using-a-markov-decision-process-model-a-cost-effectiveness-analysis
#3
Sung Eun Choi, Margaret L Brandeau, Sanjay Basu
OBJECTIVE: Personalised medicine seeks to select and modify treatments based on individual patient characteristics and preferences. We sought to develop an automated strategy to select and modify blood pressure treatments, incorporating the likelihood that patients with different characteristics would benefit from different types of medications and dosages and the potential severity and impact of different side effects among patients with different characteristics. DESIGN, SETTING AND PARTICIPANTS: We developed a Markov decision process (MDP) model to incorporate meta-analytic data and estimate the optimal treatment for maximising discounted lifetime quality-adjusted life-years (QALYs) based on individual patient characteristics, incorporating medication adjustment choices when a patient incurs side effects...
November 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/29136117/cost-effectiveness-of-community-based-hiv-self-testing-in-blantyre-malawi
#4
Hendramoorthy Maheswaran, Aileen Clarke, Peter MacPherson, Felistas Kumwenda, David G Lalloo, Elizabeth L Corbett, Stavros Petrou
Background: HIV self-testing (HIVST) is effective, with scale-up underway in sub-Saharan Africa. We assessed cost-effectiveness of adding HIVST to existing facility-based HIV testing and counselling (HTC) services. Both 2010 (initiate at CD4<350 cells/μl) and 2015 (initiate all) WHO guidelines for antiretroviral treatment (ART) were considered. Methods: A microsimulation model was developed that evaluated cost-effectiveness, from both health provider and societal perspectives, of an HIVST service implemented in a cluster-randomised trial (CRT) (ISRCTN02004005) in Malawi...
November 9, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29135654/cost-effectiveness-of-peer-versus-venue-based-approaches-for-detecting-undiagnosed-hiv-among-heterosexuals-in-high-risk-new-york-city-neighborhoods
#5
Elizabeth R Stevens, Kimberly Nucifora, Qinlian Zhou, R Scott Braithwaite, Charles M Cleland, Amanda S Ritchie, Alexandra H Kutnick, Marya V Gwadz
INTRODUCTION: We used a computer simulation of HIV progression and transmission to evaluate the cost-effectiveness of a scale-up of three strategies to seek out and test individuals with undiagnosed HIV in New York City (NYC). SETTING: Hypothetical NYC population METHODS:: We incorporated the observed effects and costs of the three "seek and test" strategies in a computer simulation of HIV in NYC, comparing a scenario in which the strategies were scaled up with a one-year implementation or a long-term implementation with a counterfactual scenario with no scale-up...
November 6, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/29130266/school-based-influenza-vaccination-health-and-economic-impact-of-maine-s-2009-influenza-vaccination-program
#6
Ricardo Basurto-Dávila, Martin I Meltzer, Dora A Mills, Garrett R Beeler Asay, Bo-Hyun Cho, Samuel B Graitcer, Nancy L Dube, Mark G Thompson, Suchita A Patel, Samuel K Peasah, Jill M Ferdinands, Paul Gargiullo, Mark Messonnier, David K Shay
OBJECTIVE: To estimate the societal economic and health impacts of Maine's school-based influenza vaccination (SIV) program during the 2009 A(H1N1) influenza pandemic. DATA SOURCES: Primary and secondary data covering the 2008-09 and 2009-10 influenza seasons. STUDY DESIGN: We estimated weekly monovalent influenza vaccine uptake in Maine and 15 other states, using difference-in-difference-in-differences analysis to assess the program's impact on immunization among six age groups...
December 2017: Health Services Research
https://www.readbyqxmd.com/read/29117791/implementing-generalized-additive-models-to-estimate-the-expected-value-of-sample-information-in-a-microsimulation-model-results-of-three-case-studies
#7
Dustin J Rabideau, Pamela P Pei, Rochelle P Walensky, Amy Zheng, Robert A Parker
BACKGROUND: The expected value of sample information (EVSI) can help prioritize research but its application is hampered by computational infeasibility, especially for complex models. We investigated an approach by Strong and colleagues to estimate EVSI by applying generalized additive models (GAM) to results generated from a probabilistic sensitivity analysis (PSA). METHODS: For 3 potential HIV prevention and treatment strategies, we estimated life expectancy and lifetime costs using the Cost-Effectiveness of Preventing AIDS Complications (CEPAC) model, a complex patient-level microsimulation model of HIV progression...
November 1, 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/29112652/effect-of-cervical-cancer-screening-programs-on-preterm-birth-a-decision-and-cost-effectiveness-analysis
#8
Esmé I Kamphuis, Steffie K Naber, Noor A Danhof, J Dik F Habbema, Christianne J M de Groot, Ben W J Mol
OBJECTIVE: To assess the effect of age at initiation and interval of cervical cancer screening in women of reproductive age on the risk of future preterm birth and subsequent adverse neonatal outcome relative to maternal life-years gained and cost of both screening and preterm birth. METHODS: In this decision and cost-effectiveness analysis, we compared eight cytology-based screening programs varying in age of onset (21, 24, 25, 27, or 30 years) and screening interval (3 or 5 years) in a fictive cohort of 100,000 women...
November 3, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29106531/medicaid-savings-from-the-new-york-university-caregiver-intervention-for-families-with-dementia
#9
Steven S Foldes, James P Moriarty, Paul H Farseth, Mary S Mittelman, Kirsten Hall Long
Purpose of the study: The economic burden of dementia is substantially borne by state Medicaid programs. We estimated savings, from the state payer perspective, from offering the New York University Caregiver Intervention (NYUCI), a well-studied caregiver support and counseling program, to eligible Minnesota Medicaid enrollees. Design and Methods: A population-based microsimulation Markov model predicted and compared costs over 15 years with and without implementation of the NYUCI for family caregivers of community-based Medicaid eligibles with dementia...
July 5, 2017: Gerontologist
https://www.readbyqxmd.com/read/29102616/cost-effectiveness-of-screening-individuals-with-cystic-fibrosis-for-colorectal-cancer
#10
Andrea Gini, Ann G Zauber, Dayna R Cenin, Amir-Houshang Omidvari, Sarah E Hempstead, Aliza K Fink, Albert B Lowenfels, Iris Lansdorp-Vogelaar
BACKGROUND & AIMS: Individuals with cystic fibrosis are at increased risk of colorectal cancer (CRC) compared to the general population, and risk is higher among those who received an organ transplant. We performed a cost-effectiveness analysis to determine optimal CRC screening strategies for patients with cystic fibrosis. METHODS: We adjusted the existing MISCAN-Colon microsimulation model to reflect increased CRC risk and lower life-expectancy in patients with cystic fibrosis...
November 1, 2017: Gastroenterology
https://www.readbyqxmd.com/read/29089403/cost-effectiveness-of-a-clinical-childhood-obesity-intervention
#11
RANDOMIZED CONTROLLED TRIAL
Mona Sharifi, Calvin Franz, Christine M Horan, Catherine M Giles, Michael W Long, Zachary J Ward, Stephen C Resch, Richard Marshall, Steven L Gortmaker, Elsie M Taveras
OBJECTIVES: To estimate the cost-effectiveness and population impact of the national implementation of the Study of Technology to Accelerate Research (STAR) intervention for childhood obesity. METHODS: In the STAR cluster-randomized trial, 6- to 12-year-old children with obesity seen at pediatric practices with electronic health record (EHR)-based decision support for primary care providers and self-guided behavior-change support for parents had significantly smaller increases in BMI than children who received usual care...
November 2017: Pediatrics
https://www.readbyqxmd.com/read/29066374/projected-impacts-of-federal-tax-policy-proposals-on-mortality-burden-in-the-united-states-a-microsimulation-analysis
#12
Daniel Kim
The public health consequences of federal income tax policies that influence income inequality are not well understood. I aimed to project the impacts on mortality of modifying federal income tax structures based on proposals by two recent United States (U.S.) Presidential candidates: Donald Trump and Senator Bernie Sanders. I performed a microsimulation analysis using the latest Internal Revenue Service public-use tax file with state identifiers (2008 tax year), containing nationally-representative data from 139,651 tax returns...
October 21, 2017: Preventive Medicine
https://www.readbyqxmd.com/read/29059461/should-we-treat-acute-hepatitis-c-a-decision-and-cost-effectiveness-analysis
#13
Emily Bethea, Qiushi Chen, Chin Hur, Raymond T Chung, Jagpreet Chhatwal
It is not standard practice to treat patients with acute hepatitis C virus (HCV) infection. However, as the incidence of HCV in the United States continues to rise, it may be time to re-evaluate acute HCV management in the era of direct-acting antiviral agents (DAAs). In this study a microsimulation model was developed to analyze the tradeoffs between initiating HCV therapy in the acute versus chronic phase of infection. By simulating the lifetime clinical course of patients with acute HCV infection, we were able to project long-term outcomes such as quality-adjusted life years (QALYs) and costs...
October 23, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/29057152/modeling-dr-dynasaur-2-0-coverage-and-finance-proposals-effects-of-the-expansion-of-vermont-s-dr-dynasaur-program-to-all-individuals-through-age-25
#14
Andrew W Dick, Carter C Price, Dulani Woods, Deborah Anne Freund, Martin McNamara, Steven P Schramm, Elrycc Berkman, Tom Dehner
The authors assessed an expansion of Vermont's Dr. Dynasaur program that would cover all residents age 25 and younger. The current Dr. Dynasaur program combines Vermont's Medicaid program and Child Health Insurance Program for children ages 0 through 18 to provide a seamless insurance program for those with family incomes below 317 percent of the federal poverty level. The authors used RAND's COMPARE-VT microsimulation model with Vermont-specific demographic, economic, and actuarial data to estimate the effects on health insurance coverage, costs, and premiums...
January 2017: Rand Health Quarterly
https://www.readbyqxmd.com/read/29045647/mechanical-aortic-valve-replacement-in-non-elderly-adults-meta-analysis-and-microsimulation
#15
Nelleke M Korteland, Jonathan R G Etnel, Bardia Arabkhani, M Mostafa Mokhles, Arezo Mohamad, Jolien W Roos-Hesselink, Ad J J C Bogers, Johanna J M Takkenberg
Aims: To support decision-making regarding prosthetic valve selection in non-elderly adults, we aim to provide a detailed overview of outcome after contemporary mechanical aortic valve replacement (AVR). Methods and results: A systematic review was conducted for papers reporting clinical outcome after AVR with bileaflet mechanical valves with a mean patient age ≥18 and ≤55 years, published between 1 January 1995 and 31 December 2015. Through meta-analysis outcomes were pooled and entered into a microsimulation model to calculate (event-free) life expectancy and lifetime event risk...
May 10, 2017: European Heart Journal
https://www.readbyqxmd.com/read/29040291/trade-off-between-jerk-and-time-headway-as-an-indicator-of-driving-style
#16
Teemu H Itkonen, Jami Pekkanen, Otto Lappi, Iisakki Kosonen, Tapio Luttinen, Heikki Summala
Variation in longitudinal control in driving has been discussed in both traffic psychology and transportation engineering. Traffic psychologists have concerned themselves with "driving style", a habitual form of behavior marked by it's stability, and its basis in psychological traits. Those working in traffic microsimulation have searched for quantitative ways to represent different driver-car systems in car following models. There has been unfortunately little overlap or theoretical consistency between these literatures...
2017: PloS One
https://www.readbyqxmd.com/read/29023748/what-cervical-screening-is-appropriate-for-women-who-have-been-vaccinated-against-high-risk-hpv-a-simulation-study
#17
Rebecca Landy, Peter Windridge, Matthew S Gillman, Peter D Sasieni
Women vaccinated against HPV16/18 are approaching the age for cervical screening, however an updated screening algorithm has not been agreed. We use a microsimulation model calibrated to real published data to determine the appropriate screening intensity for vaccinated women. Natural histories in the absence of vaccination were simulated for 300,000 women using 10,000 sets of transition probabilities. Vaccination with i) 100% efficacy against HPV16/18, ii) 15% cross-protection, iii) waning vaccine efficacy, and iv) 100% efficacy against HPV16/18/31/33/45/52/58 was added, as were a range of screening scenarios appropriate to the UK...
October 11, 2017: International Journal of Cancer. Journal International du Cancer
https://www.readbyqxmd.com/read/28988162/organised-screening-for-cervical-cancer-in-france-a-cost-effectiveness-assessment
#18
Stéphanie Barré, Marc Massetti, Henri Leleu, Frédéric De Bels
OBJECTIVE: According to the third cancer plan, organised screening (OS) of cervical cancer (CC) among women aged 25-65 years should be implemented in France in the forthcoming years. The most efficient way to implement OS in the French healthcare system is yet to be determined. METHODS: A microsimulation model was developed adopting a collective 'all payers' perspective. A closed cohort of women eligible for CC screening and representative in terms of age and participation in individual screening (IndScr) by annual Papanicolaou (Pap) testing every 3 years was modelled on a lifetime horizon...
October 6, 2017: BMJ Open
https://www.readbyqxmd.com/read/28988037/cost-effectiveness-of-methods-in-personalized-medicine-results-of-a-decision-analytic-model-in-patients-with-acute-myeloid-leukemia-with-normal-karyotype
#19
Laura Hörster, Richard F Schlenk, Michael Stadler, Maria Gabriel, Felicitas Thol, Jan Schildmann, Jochen Vollmann, Ursula Rochau, Gaby Sroczynski, Jürgen Wasem, Arnold Ganser, Matthias Port, Anja Neumann
BACKGROUND: During the last years, molecular genetic data are increasingly used as prognostic and predictive factors in acute myeloid leukemia (AML). The molecular genetic profile permits a rapid risk categorization and beyond that a prediction of differential treatment efficacy of post-remission chemotherapy versus an allogeneic hematopoietic cell transplantation (HCT) in specific subgroups. METHODS: The aim of this study was to evaluate cost-effectiveness of two different strategies of risk categorization (conventional cytogenetic diagnostics (CCD) versus molecular genetic diagnostics (MGD)) in patients with AML, using a decision-analytic state-transition model...
November 2017: Leukemia Research
https://www.readbyqxmd.com/read/28985732/cost-effectiveness-of-malaria-preventive-treatment-for-hiv-infected-pregnant-women-in-sub-saharan-africa
#20
Sung Eun Choi, Margaret L Brandeau, Eran Bendavid
BACKGROUND: Malaria is a leading cause of morbidity and mortality among HIV-infected pregnant women in sub-Saharan Africa: at least 1 million pregnancies among HIV-infected women are complicated by co-infection with malaria annually, leading to increased risk of premature delivery, severe anaemia, delivery of low birth weight infants, and maternal death. Current guidelines recommend either daily cotrimoxazole (CTX) or intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP) for HIV-infected pregnant women to prevent malaria and its complications...
October 6, 2017: Malaria Journal
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