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Model decision analysis

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https://www.readbyqxmd.com/read/28231679/-use-the-markov-decision-tree-model-to-optimize-vaccination-strategies-of-hepatitis-e-among-women-aged-15-to-49
#1
Z M Chen, S B Ji, X L Shi, Y Y Zhao, X F Zhang, H Jin
Objective: To evaluate the cost-utility of different hepatitis E vaccination strategies in women aged 15 to 49. Methods: The Markov-decision tree model was constructed to evaluate the cost-utility of three hepatitis E virus vaccination strategies. Parameters of the models were estimated on the basis of published studies and experience of experts. Both methods on sensitivity and threshold analysis were used to evaluate the uncertainties of the model. Results: Compared with non-vaccination group, strategy on post-screening vaccination with rate as 100%, could save 0...
February 10, 2017: Zhonghua Liu Xing Bing Xue za Zhi, Zhonghua Liuxingbingxue Zazhi
https://www.readbyqxmd.com/read/28231285/the-mother-s-autonomy-in-decision-making-madm-scale-patient-led-development-and-psychometric-testing-of-a-new-instrument-to-evaluate-experience-of-maternity-care
#2
Saraswathi Vedam, Kathrin Stoll, Kelsey Martin, Nicholas Rubashkin, Sarah Partridge, Dana Thordarson, Ganga Jolicoeur
OBJECTIVE: To develop and validate a new instrument that assesses women's autonomy and role in decision making during maternity care. DESIGN: Through a community-based participatory research process, service users designed, content validated, and administered a cross-sectional quantitative survey, including 31 items on the experience of decision-making. SETTING AND PARTICIPANTS: Pregnancy experiences (n = 2514) were reported by 1672 women who saw a single type of primary maternity care provider in British Columbia...
2017: PloS One
https://www.readbyqxmd.com/read/28231042/cost-effectiveness-analysis-of-four-simulated-colorectal-cancer-screening-interventions-north-carolina
#3
Kristen Hassmiller Lich, David A Cornejo, Maria E Mayorga, Michael Pignone, Florence K L Tangka, Lisa C Richardson, Tzy-Mey Kuo, Anne-Marie Meyer, Ingrid J Hall, Judith Lee Smith, Todd A Durham, Steven A Chall, Trisha M Crutchfield, Stephanie B Wheeler
INTRODUCTION: Colorectal cancer (CRC) screening rates are suboptimal, particularly among the uninsured and the under-insured and among rural and African American populations. Little guidance is available for state-level decision makers to use to prioritize investment in evidence-based interventions to improve their population's health. The objective of this study was to demonstrate use of a simulation model that incorporates synthetic census data and claims-based statistical models to project screening behavior in North Carolina...
February 23, 2017: Preventing Chronic Disease
https://www.readbyqxmd.com/read/28230661/predicting-progression-in-barrett-s-esophagus-development-and-validation-of-the-barrett-s-esophagus-assessment-of-risk-score-bear-score
#4
Craig S Brown, Brittany Lapin, Jay L Goldstein, John G Linn, Mark S Talamonti, Joann Carbray, Michael B Ujiki
OBJECTIVE: To develop and validate a scoring tool capable of accurately predicting which patients with Barrett's esophagus (BE) will progress to dysplasia and/or esophageal adenocarcinoma. BACKGROUND: Endoscopic therapies have emerged capable of eradicating BE with high efficacy and low complication rates, but which patients should receive treatment is still debated. Current knowledge of risk factors is insufficient to allow for the accurate prediction of which patients will progress to dysplasia or adenocarcinoma...
February 22, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28229295/benchmarking-of-venous-thromboembolism-prophylaxis-practice-with-ent-uk-guidelines
#5
Ali S Al-Qahtani
The aim of this study was to benchmark our guidelines of prevention of venous thromboembolism (VTE) in ENT surgical population against ENT.UK guidelines, and also to encourage healthcare providers to utilize benchmarking as an effective method of improving performance. The study design is prospective descriptive analysis. The setting of this study is tertiary referral centre (Assir Central Hospital, Abha, Saudi Arabia). In this study, we are benchmarking our practice guidelines of the prevention of VTE in the ENT surgical population against that of ENT...
February 22, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28229209/cost-effective-management-of-pelvic-fracture-urethral-injuries
#6
Niels V Johnsen, David F Penson, W Stuart Reynolds, Douglas F Milam, Roger R Dmochowski, Melissa R Kaufman
PURPOSE: To compare the cost-effectiveness of various treatment strategies in the management of pelvic fracture urethral injuries using decision analysis. METHODS: Five strategies were modeled from the time of injury to resolution of obstructed voiding or progression to urethroplasty. Management consisted of immediate suprapubic tube (SPT) placement and delayed urethroplasty; primary endoscopic realignment (PER) followed by urethroplasty in failed patients; or PER followed by 1-3 direct vision internal urethrotomies (DVIU), followed by urethroplasty...
February 22, 2017: World Journal of Urology
https://www.readbyqxmd.com/read/28228579/network-wide-oscillations-in-the-parkinsonian-state-alterations-in-neuronal-activities-occur-in-the-premotor-cortex-in-parkinsonian-non-human-primates
#7
Jing Wang, Luke A Johnson, Alicia L Jensen, Kenneth B Baker, Jerrold L Vitek
A number of studies suggest that Parkinson's disease (PD) is associated with alterations of neuronal activity patterns in the basal-ganglia-thalamocortical circuit. There are limited electrophysiological data, however, describing how premotor cortex, which is involved in movement and decision making, is likely impacted in PD. In this study, spontaneous local field potential (LFP) and single unit neuronal activity were recorded in the dorsal premotor area of non-human primates in both the naïve and parkinsonian state using the MPTP model of parkinsonism...
February 22, 2017: Journal of Neurophysiology
https://www.readbyqxmd.com/read/28228517/high-monetary-reward-rates-and-caloric-rewards-decrease-temporal-persistence
#8
Bowen J Fung, Stefan Bode, Carsten Murawski
Temporal persistence refers to an individual's capacity to wait for future rewards, while forgoing possible alternatives. This requires a trade-off between the potential value of delayed rewards and opportunity costs, and is relevant to many real-world decisions, such as dieting. Theoretical models have previously suggested that high monetary reward rates, or positive energy balance, may result in decreased temporal persistence. In our study, 50 fasted participants engaged in a temporal persistence task, incentivised with monetary rewards...
February 22, 2017: Proceedings. Biological Sciences
https://www.readbyqxmd.com/read/28227780/impact-of-prostate-biopsy-tumor-amount-on-imaging-based-prognostics-employing-transductive-semi-supervised-regression
#9
Faisal M Khan, Casimir A Kulikowski, Faisal M Khan, Casimir A Kulikowski, Casimir A Kulikowski, Faisal M Khan
For newly diagnosed prostate cancer patients with a positive biopsy, there are a variety of treatment options to consider. To aid physicians and patients in their decision making, a variety of predictive assays have emerged within the last decade, many of them imaging based. These assays build predictive models for survival analysis to provide personalized risk assessments for the patients. However, there have rarely been any published studies on how the amount of tumor in the positive prostate biopsy affects the predictive power of these imaging based assays...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28227617/detection-of-chewing-from-piezoelectric-film-sensor-signals-using-ensemble-classifiers
#10
Muhammad Farooq, Edward Sazonov, Muhammad Farooq, Edward Sazonov, Muhammad Farooq, Edward Sazonov
Selection and use of pattern recognition algorithms is application dependent. In this work, we explored the use of several ensembles of weak classifiers to classify signals captured from a wearable sensor system to detect food intake based on chewing. Three sensor signals (Piezoelectric sensor, accelerometer, and hand to mouth gesture) were collected from 12 subjects in free-living conditions for 24 hrs. Sensor signals were divided into 10 seconds epochs and for each epoch combination of time and frequency domain features were computed...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28225639/cost-effectiveness-comparison-of-imaging-guided-prostate-biopsy-techniques-systematic-transrectal-ultrasound-direct-in-bore-mri-and-image-fusion
#11
Wulphert Venderink, Tim M Govers, Maarten de Rooij, Jurgen J Fütterer, J P Michiel Sedelaar
OBJECTIVE: Three commonly used prostate biopsy approaches are systematic transrectal ultrasound guided, direct in-bore MRI guided, and image fusion guided. The aim of this study was to calculate which strategy is most cost-effective. MATERIALS AND METHODS: A decision tree and Markov model were developed to compare cost-effectiveness. Literature review and expert opinion were used as input. A strategy was deemed cost-effective if the costs of gaining one quality-adjusted life year (incremental cost-effectiveness ratio) did not exceed the willingness-to-pay threshold of €80,000 (≈$85,000 in January 2017)...
February 22, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28223913/neuromorphic-implementation-of-attractor-dynamics-in-a-two-variable-winner-take-all-circuit-with-nmdars-a-simulation-study
#12
Hongzhi You, Da-Hui Wang
Neural networks configured with winner-take-all (WTA) competition and N-methyl-D-aspartate receptor (NMDAR)-mediated synaptic dynamics are endowed with various dynamic characteristics of attractors underlying many cognitive functions. This paper presents a novel method for neuromorphic implementation of a two-variable WTA circuit with NMDARs aimed at implementing decision-making, working memory and hysteresis in visual perceptions. The method proposed is a dynamical system approach of circuit synthesis based on a biophysically plausible WTA model...
2017: Frontiers in Neuroscience
https://www.readbyqxmd.com/read/28221673/breast-cancer-prevention-strategies-in-lobular-carcinoma-in-situ-a-decision-analysis
#13
Stephanie M Wong, Natasha K Stout, Rinaa S Punglia, Ipshita Prakash, Yasuaki Sagara, Mehra Golshan
BACKGROUND: Women diagnosed with lobular carcinoma in situ (LCIS) have a 3-fold to 10-fold increased risk of developing invasive breast cancer. The objective of this study was to evaluate the life expectancy (LE) and differences in survival offered by active surveillance, risk-reducing chemoprevention, and bilateral prophylactic mastectomy among women with LCIS. METHODS: A Markov simulation model was constructed to determine average LE and quality-adjusted LE (QALE) gains for hypothetical cohorts of women diagnosed with LCIS at various ages under alternative risk-reduction strategies...
February 21, 2017: Cancer
https://www.readbyqxmd.com/read/28221338/pathways-towards-instability-in-financial-networks
#14
Marco Bardoscia, Stefano Battiston, Fabio Caccioli, Guido Caldarelli
Following the financial crisis of 2007-2008, a deep analogy between the origins of instability in financial systems and complex ecosystems has been pointed out: in both cases, topological features of network structures influence how easily distress can spread within the system. However, in financial network models, the details of how financial institutions interact typically play a decisive role, and a general understanding of precisely how network topology creates instability remains lacking. Here we show how processes that are widely believed to stabilize the financial system, that is, market integration and diversification, can actually drive it towards instability, as they contribute to create cyclical structures which tend to amplify financial distress, thereby undermining systemic stability and making large crises more likely...
February 21, 2017: Nature Communications
https://www.readbyqxmd.com/read/28219447/medialization-thyroplasty-versus-injection-laryngoplasty-a-cost-minimization-analysis
#15
Samantha Tam, Hongmei Sun, Sisira Sarma, Jennifer Siu, Kevin Fung, Leigh Sowerby
BACKGROUND: Medialization thyroplasty and injection laryngoplasty are widely accepted treatment options for unilateral vocal fold paralysis. Although both procedures result in similar clinical outcomes, little is known about the corresponding medical care costs. Medialization thyroplasty requires expensive operating room resources while injection laryngoplasty utilizes outpatient resources but may require repeated procedures. The purpose of this study, therefore, is to quantify the cost differences in adult patients with unilateral vocal fold paralysis undergoing medialization thyroplasty versus injection laryngoplasty...
February 20, 2017: Journal of Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28218211/a-model-predicting-lymph-node-status-for-patients-with-clinical-stage-t1an0-2m0-nonsmall-cell-lung-cancer
#16
Ruo-Chuan Zang, Bin Qiu, Shu-Geng Gao, Jie He
BACKGROUND: Lymph node status of patients with early-stage nonsmall cell lung cancer has an influence on the choice of surgery. To assess the lymph node status more correspondingly and accurately, we evaluated the relationship between the preoperative clinical variables and lymph node status and developed one model for predicting lymph node involvement. METHODS: We collected clinical and dissected lymph node information of 474 patients with clinical stage T1aN0-2M0 nonsmall cell lung cancer (NSCLC)...
2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28216380/a-population-based-analysis-of-predictors-of-influenza-vaccination-uptake-in-pregnant-women-the-effect-of-gestational-and-calendar-time
#17
Luz Maria Vilca, Aman Verma, David Buckeridge, Magda Campins
Pregnant women are vaccinated against influenza less frequently than other high-risk groups. To design effective vaccination strategies, we must understand how decisions regarding vaccination may vary by trimester and over vaccination campaigns. We used a Cox model indexed by calendar time to estimate the effect of gestational trimester and other factors on vaccination uptake in a large cohort of pregnant women in Catalonia (Spain) during 2008-09 to 2012-13 influenza vaccination campaigns. We analyzed 247,316 pregnancies...
February 16, 2017: Preventive Medicine
https://www.readbyqxmd.com/read/28216281/clinicians-perspectives-on-advance-care-planning-for-patients-with-ckd-in-australia-an-interview-study
#18
Marcus Sellars, Allison Tong, Tim Luckett, Rachael L Morton, Carol A Pollock, Lucy Spencer, William Silvester, Josephine M Clayton
BACKGROUND: Advance care planning (ACP) empowers patients to consider and communicate their current and future treatment goals. However, ACP is not widely implemented in chronic kidney disease (CKD) care settings. This study aims to describe clinicians' beliefs, challenges, and perspectives of ACP in patients with CKD. STUDY DESIGN: Qualitative study. SETTING & PARTICIPANTS: Nephrologists (n=20), nurses (n=7), and social workers (n=4) with a range of experience in facilitating ACP for patients with CKD across Australia...
February 16, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28214469/cost-benefit-analysis-of-chlamydia-trachomatis-screening-in-pregnant-women-in-a-high-burden-setting-in-the-united-states
#19
Jared Ditkowsky, Khushal H Shah, Margaret R Hammerschlag, Stephan Kohlhoff, Tamar A Smith-Norowitz
BACKGROUND: Chlamydia trachomatis is the most common bacterial sexually transmitted infection (STI) in the United States (U.S.) [1] and remains a major public health problem. We determined the cost- benefit of screening all pregnant women aged 15-24 for Chlamydia trachomatis infection compared with no screening. METHODS: We developed a decision analysis model to estimate costs and health-related effects of screening pregnant women for C. trachomatis in a high burden setting (Brooklyn, NY)...
February 18, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28212967/decision-making-on-medical-innovations-in-a-changing-health-care-environment-insights-from-accountable-care-organizations-and-payers-on-personalized-medicine-and-other-technologies
#20
Julia R Trosman, Christine B Weldon, Michael P Douglas, Patricia A Deverka, John B Watkins, Kathryn A Phillips
BACKGROUND: New payment and care organization approaches, such as those of accountable care organizations (ACOs), are reshaping accountability and shifting risk, as well as decision making, from payers to providers, within the Triple Aim context of health reform. The Triple Aim calls for improving experience of care, improving health of populations, and reducing health care costs. OBJECTIVES: To understand how the transition to the ACO model impacts decision making on adoption and use of innovative technologies in the era of accelerating scientific advancement of personalized medicine and other innovations...
January 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
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