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Model decision analysis

Jan M Sargeant, Annette M O'Connor
Meta-analysis, the statistical combination of results from multiple studies, can be used to summarize all of the available research on an intervention, etiology, descriptive, or diagnostic test accuracy question. Meta-analysis should be conducted as a component of a systematic review, to increase transparency in the selection of studies and to incorporate an evaluation of the risk of bias in the individual studies included in the meta-analysis. The process of meta-analysis may include a forest plot to graphically display the study results and the calculation of a weighted average summary effect size...
October 2016: Microbiology Spectrum
J Stevanović, L A de Jong, B S Kappelhoff, E P Dvortsin, M Voorhaar, M J Postma
BACKGROUND: Dabigatran was proven to have similar effect on the prevention of recurrence of venous thromboembolism (VTE) and a lower risk of bleeding compared to vitamin K antagonists (VKA). The aim of this study is to assess the cost-effectiveness (CE) of dabigatran for the treatment and secondary prevention in patients with VTE compared to VKAs in the Dutch setting. METHODS: Previously published Markov model was modified and updated to assess the CE of dabigatran and VKAs for the treatment and secondary prevention in patients with VTE from a societal perspective in the base-case analysis...
2016: PloS One
Marc Aerts, Girma Minalu, Stefan Bösner, Frank Buntinx, Bernard Burnand, Jörg Haasenritter, Lilli Herzig, J André Knottnerus, Staffan Nilsson, Walter Renier, Carol Sox, Harold Sox, Norbert Donner-Banzhoff
OBJECTIVE: To construct a clinical prediction rule for coronary artery disease (CAD) presenting with chest pain in primary care. STUDY DESIGN: Meta-Analysis using 3099 patients from 5 studies. To identify candidate predictors, we used random forest trees, multiple imputation of missing values and logistic regression within individual studies. To generate a prediction rule on the pooled data, we applied a regression model that took account of the differing standard data sets collected by the 5 studies...
October 20, 2016: Journal of Clinical Epidemiology
Angie L Cradock, Jessica L Barrett, Erica L Kenney, Catherine M Giles, Zachary J Ward, Michael W Long, Stephen C Resch, Andrea A Pipito, Emily R Wei, Steven L Gortmaker
Participation in recommended levels of physical activity promotes a healthy body weight and reduced chronic disease risk. To inform investment in prevention initiatives, we simulate the national implementation, impact on physical activity and childhood obesity and associated cost-effectiveness (versus the status quo) of six recommended strategies that can be applied throughout childhood to increase physical activity in US school, afterschool and childcare settings. In 2016, the Childhood Obesity Intervention Cost Effectiveness Study (CHOICES) systematic review process identified six interventions for study...
October 20, 2016: Preventive Medicine
Laith A Hadidi, Mohamed Mahmoud Omer
Municipal Solid Waste (MSW) generation in Saudi Arabia is increasingly growing at a fast rate, as it hurtles towards ever increasing urban development coupled with rapid developments and expanding population. Saudi Arabia's energy demands are also rising at a faster rate. Therefore, the importance of an integrated waste management system in Saudi Arabia is increasingly rising and introducing Waste to Energy (WTE) facilities is becoming an absolute necessity. This paper analyzes the current situation of MSW management in Saudi Arabia and proposes a financial model to assess the viability of WTE investments in Saudi Arabia in order to address its waste management challenges and meet its forecasted energy demands...
October 20, 2016: Waste Management
Leo F Buckley, Enrique Seoane-Vazquez, Judy W M Cheng, Ahmed Aldemerdash, Irene M Cooper, Lina Matta, Danika S Medina, Mandeep R Mehra, Kristina Navarro-Velez, Elaine L Shea, Joanne R Weintraub, Lynne W Stevenson, Akshay S Desai
Innovative treatment strategies for decompensated heart failure (HF) are required to achieve cost savings and improvements in outcomes. We developed a decision analytic model from a hospital perspective to compare 2 strategies for the treatment of decompensated HF, ambulatory diuretic infusion therapy, and hospitalization (standard care), with respect to total HF hospitalizations and costs. The ambulatory diuretic therapy strategy included outpatient treatment with high doses of intravenous loop diuretics in a specialized HF unit whereas standard care included hospitalization for intravenous loop diuretic therapy...
November 1, 2016: American Journal of Cardiology
Henry Maia Peixoto, Marcelo Augusto Mota Brito, Gustavo Adolfo Sierra Romero, Wuelton Marcelo Monteiro, Marcus Vinícius Guimarães de Lacerda, Maria Regina Fernandes de Oliveira
OBJECTIVE: The aim of this study was to estimate the incremental budget impact (IBI) of a rapid diagnostic test to detect G6PDd in male patients infected with Plasmodium vivax in the Brazilian Amazon, as compared to the routine protocol recommended in Brazil which does not include G6PDd testing. METHODS: The budget impact analysis was performed from the perspective of the Brazilian health system, in the Brazilian Amazon for the years 2013, 2014 and 2015. The analysis used a decision model to compare two scenarios: the first consisting of the routine recommended in Brazil which does not include prior diagnosis of dG6PD, and the second based on the use of RDT CareStart(™) G6PD (CS-G6PD) in all male subjects diagnosed with vivax malaria...
October 22, 2016: Tropical Medicine & International Health: TM & IH
Morteza Behnam, Hossein Pourghassem
BACKGROUND: EEG signal analysis of pediatric patients plays vital role for making a decision to intervene in presurgical stages. NEW METHOD: In this paper, an offline seizure detection algorithm based on definition of a seizure-specific wavelet (Seizlet) is presented. After designing the Seizlet, by forming cone of influence map of the EEG signal, four types of layouts are analytically designed that are called Seizure Modulus Maximas Patterns (SMMP). By mapping CorrEntropy Induced Metric (CIM) series, four structural features based on least square estimation of fitted non-tilt conic ellipse are extracted that are called CorrEntropy Ellipse Features (CEF)...
October 18, 2016: Journal of Neuroscience Methods
Minh D Pham, Paul A Agius, Lorena Romero, Peter McGlynn, David Anderson, Suzanne M Crowe, Stanley Luchters
BACKGROUND: Point-of-care (POC) CD4 testing increases patient accessibility to assessment of antiretroviral therapy eligibility. This review evaluates field performance in low and middle-income countries (LMICs) of currently available POC CD4 technologies. METHODS: Eight electronic databases were searched for field studies published between January 2005 and January 2015 of six POC CD4 platforms: PointCare NOW™, Alere Pima™ CD4, Daktari™ CD4 Counter, CyFlow® CD4 miniPOC, BD FACSPresto™, and MyT4™ CD4...
October 21, 2016: BMC Infectious Diseases
Ashleigh A McGirr, Kevin L Schwartz, Upton Allen, Melinda Solomon, Beate Sander
Background Children with cystic fibrosis (CF) are at higher risk of severe respiratory syncytial virus (RSV) infection, which can lead to a decline in lung function. A monoclonal antibody, palivizumab (PMB), effectively prevents RSV hospitalizations; however, the high cost of PMB, approximately C$10,000 per patient per RSV season, limits its widespread use. We assess the cost-effectiveness of PMB prophylaxis in CF children less than 2 years of age from the Canadian healthcare payer's perspective. Methods In 2014, a Markov cohort model of CF disease and infant RSV infections in the Canadian setting was developed based on literature data...
October 21, 2016: Human Vaccines & Immunotherapeutics
Eeva-Liisa Paattiniemi, Santra Karumaa, Anna-Mari Viita, Pauliina Kärpänoja, Marjukka Mäkelä, Jaana Isojärvi, Hannu Sarkkinen
Urine culture samples comprise a large proportion of the workload in clinical microbiology laboratories, and most of the urine samples show no growth or insignificant growth. A flow cytometry-based analyzer (Sysmex Corporation, Japan) has been used to screen out negative urine samples prior to culture in the Päijät-Häme district. We applied decision analytic modelling to analyze, from a laboratory perspective, the economic feasibility of the screening method as compared to culture only (conventional method) for diagnosis of urinary tract infection...
October 21, 2016: Infectious Diseases
Jason W Beckstead
BACKGROUND: Brunswik's Lens Model and lens model equation (LME) have been applied extensively in medical decision making. Clinicians often face the dual challenge of formulating a judgment of patient risk for some adverse outcome and making a yes or no decision regarding a particular risk-reducing treatment option. OBJECTIVE: In this article, I examine the correlation between clinical risk judgments and treatment-related decisions, referring to this linkage as "cohesion"...
October 20, 2016: Medical Decision Making: An International Journal of the Society for Medical Decision Making
Evgenii Belykh, Alexander V Krutko, Evgenii S Baykov, Morgan B Giers, Mark C Preul, Vadim A Byvaltsev
BACKGROUND CONTEXT: Recurrence of lumbar disc herniation (rLDH) is one of the unfavorable outcomes after microdiscectomy. Prediction of the patient population with increased risk of rLDH is important because patients may benefit from preventive measures or other surgical options. PURPOSE: The study assessed preoperative factors associated with rLDH after microdiscectomy and created a mathematical model for estimation of chances for rLDH. STUDY DESIGN/SETTING: This is a retrospective case-control study...
October 17, 2016: Spine Journal: Official Journal of the North American Spine Society
Fan Zhang, Min Wu, Chee Keong Kwoh, Jie Zheng
Extracellular signals are captured and transmitted by signaling proteins inside a cell. An important type of cellular responses to the signals is the cell fate decision, e.g., apoptosis. However, the underlying mechanisms of cell fate regulation are still unclear, thus comprehensive and detailed kinetic models are not yet available. Alternatively, data-driven models are promising to bridge signaling data with the phenotypic measurements of cell fates. The traditional linear model for data-driven modeling of signaling pathways has its limitations because it assumes that the a cell fate is proportional to the activities of signaling proteins, which is unlikely in the complex biological systems...
2016: PloS One
Natasa M Milic, Srdjan Masic, Jelena Milin-Lazovic, Goran Trajkovic, Zoran Bukumiric, Marko Savic, Nikola V Milic, Andja Cirkovic, Milan Gajic, Mirjana Kostic, Aleksandra Ilic, Dejana Stanisavljevic
BACKGROUND: The scientific community increasingly is recognizing the need to bolster standards of data analysis given the widespread concern that basic mistakes in data analysis are contributing to the irreproducibility of many published research findings. The aim of this study was to investigate students' attitudes towards statistics within a multi-site medical educational context, monitor their changes and impact on student achievement. In addition, we performed a systematic review to better support our future pedagogical decisions in teaching applied statistics to medical students...
2016: PloS One
Nilton Lavatori Correa, Lidia Vasconcellos de Sá, Rossana Corbo
: An increase in the incidence of second primary cancers (SPC) is the late effect of greatest concern that could occur in differentiated thyroid carcinoma (DTC) patients treated with radioactive iodine (RAI). The decision to treat a patient with RAI should therefore incorporate a careful risk-benefit analysis. The objective of this work is to adapt the risk estimation models developed by the Biological Effects of Ionizing Radiation Committee (BEIR VII) to local epidemiological characteristics, to assess the carcinogenesis risk from radiation in a population of Brazilian DTC patients treated with RAI...
October 20, 2016: Thyroid: Official Journal of the American Thyroid Association
S Malfait, K Eeckloo, J Hellings, G De Bodt, A Van Hecke
INTRODUCTION: In many health care systems, strategies are currently deployed to engage patients and other stakeholders in decisions affecting hospital services. In this paper, a model for stakeholder involvement is presented and evaluated in three Flemish hospitals. In the model, a stakeholder committee advises the hospital's board of directors on themes of strategic importance. OBJECTIVES: To study the internal hospital's decision processes in order to identify the impact of a stakeholder involvement committee on strategic themes in the hospital decision processes...
October 20, 2016: Acta Clinica Belgica
S A Kulkarni, E Benfenati, T S Barton-Maclaren
One of the key challenges of Canada's Chemicals Management Plan (CMP) is assessing chemicals with limited/no empirical hazard data for their risk to human health. In some instances, these chemicals have not been tested broadly for their toxicological potency; as such, limited information exists on their potential to induce human health effects following exposure. Although (quantitative) structure activity relationship ((Q)SAR) models are able to generate predictions to address data gaps for certain toxicological endpoints, the confidence in predictions also needs to be addressed...
October 20, 2016: SAR and QSAR in Environmental Research
Jie Liu, Liang Guo, Jiping Jiang, Dexun Jiang, Peng Wang
In the emergency management relevant to chemical contingency spills, efficiency emergency rescue can be deeply influenced by a reasonable assignment of the available emergency materials to the related risk sources. In this study, an emergency material scheduling model (EMSM) with time-effective and cost-effective objectives is developed to coordinate both allocation and scheduling of the emergency materials. Meanwhile, an improved genetic algorithm (IGA) which includes a revision operation for EMSM is proposed to identify the emergency material scheduling schemes...
October 20, 2016: Environmental Science and Pollution Research International
Qirui Zhong, Ye Huang, Huizhong Shen, Yilin Chen, Han Chen, Tianbo Huang, Eddy Y Zeng, Shu Tao
The quantification of carbon monoxide (CO) emissions is necessary for atmospheric research and has been studied extensively. Aiming to build an inventory with both high spatial resolution and detailed source information, this study estimated the monthly nation-level CO emissions from 79 major sources from 1960 to 2013, based on which a 0.1° × 0.1° gridded emission map was developed for 2011 using a recent energy product. The high sectorial resolution of this inventory can help scientists to study the influence of socioeconomic development on emissions, help decision makers to formulate abatement strategies, and potentially benefit emission-reduction scenario modeling and cost-benefit analysis...
October 19, 2016: Environmental Science and Pollution Research International
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