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Validation cost effectiveness simulation

Wolfram Wiest, Alexander Rack, Simon Zabler, Alex Schaer, Michael Swain, Katja Nelson
State-of-the art, two-piece dental implants made from titanium alloys exhibit a complex micromechanical behavior under dynamical load. Its understanding, especially the formation of microgaps, is of crucial importance in order to predict and improve the long-term performance of such implants. Microgap formation in a loaded dental implant with a conical implant-abutment connection can be studied and quantified by synchrotron radiography with micrometer accuracy. Due to the high costs and limited access to synchrotron radiation sources, alternative approaches are needed in order to depict the microgap formation...
February 2018: Heliyon
Temitope Adebayo, Michael Abendroth, Gaytri Gupta Elera, Allen Kunselman, Elizabeth Sinz, Amanda Ely, Amr Elkamshoushy, Ajay Soni
PURPOSE: To demonstrate that a nonbiologic strabismus surgery simulator is not inferior to a biologic wet lab for teaching the key steps of strabismus surgery. METHODS: A total of 41 medical students were randomly assigned to one of two groups: biologic wet lab or nonbiologic simulator. The students trained according to the group's protocol then participated in a recorded final assessment using a realistic strabismus surgery model. Two independent reviewers, masked to training method, graded the video recordings using three scoring systems: the International Council of Ophthalmology Approved-Ophthalmology Surgical Competency Assessment Rubric for Strabismus Surgery (ICO-OSCAR), the Global Rating Scale of Objective Structured Assessment of Technical Skills (OSATS), and the Alphabetic Summary Scale (ASS)...
March 10, 2018: Journal of AAPOS: the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
David C Schwebel, Joan Severson, Yefei He
Various programs effectively teach children to cross streets more safely, but all are labor- and cost-intensive. Recent developments in mobile phone technology offer opportunity to deliver virtual reality pedestrian environments to mobile smartphone platforms. Such an environment may offer a cost- and labor-effective strategy to teach children to cross streets safely. This study evaluated usability, feasibility, and validity of a smartphone-based virtual pedestrian environment. A total of 68 adults completed 12 virtual crossings within each of two virtual pedestrian environments, one delivered by smartphone and the other a semi-immersive kiosk virtual environment...
September 2017: Virtual Reality
Ronald W Gimbel, Ronald G Pirrallo, Steven C Lowe, David W Wright, Lu Zhang, Min-Jae Woo, Paul Fontelo, Fang Liu, Zachary Connor
BACKGROUND: The frequency of head computed tomography (CT) imaging for mild head trauma patients has raised safety and cost concerns. Validated clinical decision rules exist in the published literature and on-line sources to guide medical image ordering but are often not used by emergency department (ED) clinicians. Using simulation, we explored whether the presentation of a clinical decision rule (i.e. Canadian CT Head Rule - CCHR), findings from malpractice cases related to clinicians not ordering CT imaging in mild head trauma cases, and estimated patient out-of-pocket cost might influence clinician brain CT ordering...
March 12, 2018: BMC Medical Informatics and Decision Making
Matic Grom, Mirijam Kozorog, Simon Caserman, Andrej Pohar, Blaž Likozar
Protein A-based affinity chromatography is a highly-efficient separation method to capture, purify and isolate biosimilar monoclonal antibodies (mAb) - an important medical product of biopharmaceutical industrial manufacturing. It is considered the most expensive step in purification downstream operations; therefore, its performance optimization offers a great cost saving in the overall production expenditure. The biochemical mixture-separating specific interaction experiments with Chinese hamster ovary (CHO) cell culture harvest, containing glycosylated extracellular immunoglobulins (Ig), were made using five different state-of-the-art commercial resins...
March 1, 2018: Journal of Chromatography. B, Analytical Technologies in the Biomedical and Life Sciences
M Cóndor, T Rüberg, C Borau, J Piles, J M García-Aznar
Advances in microfabrication have allowed the development and popularization of microfluidic devices, which are powerful tools to recreate three-dimensional (3-D) biologically relevant in vitro models. These microenvironments are usually generated by using hydrogels and induced chemical gradients. Going further, computational models enable, after validation, the simulation of such conditions without the necessity of real experiments, thus saving costs and time. In this work we present a web-based application that allows, based on a previous numerical model, the assessment of different chemical gradients induced within a 3-D extracellular matrix...
February 6, 2018: Computers in Biology and Medicine
Elena Losina, Ilana M Usiskin, Savannah R Smith, James K Sullivan, Karen C Smith, David J Hunter, Stephen P Messier, A David Paltiel, Jeffrey N Katz
OBJECTIVE: The cost-effectiveness of the recently-introduced generic celecoxib in knee OA has not been examined. METHOD: We used the Osteoarthritis Policy (OAPol) Model, a validated computer simulation of knee OA, to evaluate long-term clinical outcomes, costs, and cost-effectiveness of generic celecoxib in persons with knee OA. We examined eight treatment strategies consisting of generic celecoxib, over-the-counter (OTC) naproxen, or prescription naproxen, with or without prescription or OTC proton-pump-inhibitors (PPIs) to reduce gastrointestinal (GI) toxicity...
February 23, 2018: Osteoarthritis and Cartilage
F Kashanian, M M Masoudi, A Shamloo, M Habibi-Rezaei, A A Moosavi-Movahedi
Miniaturized systems based on the principles of microfluidics are widely used in various fields, such as biochemical and biomedical applications. Systematic design processes are demanded the proper use of these microfluidic devices based on mathematical simulations. Aggregated proteins (e.g., inclusion bodies) in solution with chaotropic agents (such as urea) at high concentration in combination with reducing agents are denatured. Refolding methods to achieve the native proteins from inclusion bodies of recombinant protein relying on denaturant dilution or dialysis approaches for suppressing protein aggregation is very important in the industrial field...
February 22, 2018: Bioprocess and Biosystems Engineering
Steven J McAnany, Robert K Merrill, Samuel C Overley, Jun S Kim, Robert L Brochin, Sheeraz A Qureshi
Study Design: Cost-effectiveness analysis. Objectives: To determine the 7-year cost-effectiveness of cervical disc replacement (CDR) and anterior cervical discectomy and fusion (ACDF). Methods: We analyzed 7-year Short Form-36 Health Survey data collected from the Prestige Cervical Disc investigational device exemption study (IDE). The SF-6D algorithm was used to convert this data into health state utilities. Costs were calculated from the payer perspective, and quality adjusted life years (QALYs) were used to represent effectiveness...
February 2018: Global Spine Journal
Guoxiao Li, Rongbiao Zhang, Ning Yang, Changsheng Yin, Mingji Wei, Yecheng Zhang, Jian Sun
To overcome the drawbacks such as low automation and high cost, an approach for cell viability online detection is proposed, based on the extracted lensfree cell diffraction fingerprint characteristics. The cell fingerprints are acquired by a constructed large field-of-view (FOV) diffraction imaging platform without any lenses. The approach realizes distinguishing live and dead cells online and calculating cell viability index based on the number of live cells. With theoretical analysis and simulation, diffraction fingerprints of cells with different morphology are simulated and two characteristics are discovered to be able to reflect cell viability status effectively...
February 7, 2018: Biosensors & Bioelectronics
Barbara de Graaff, Lei Si, Amanda L Neil, Kwang Chien Yee, Kristy Sanderson, Lyle C Gurrin, Andrew J Palmer
INTRODUCTION: HFE-associated haemochromatosis, the most common monogenic disorder amongst populations of northern European ancestry, is characterised by iron overload. Excess iron is stored in parenchymal tissues, leading to morbidity and mortality. Population screening programmes are likely to improve early diagnosis, thereby decreasing associated disease. Our aim was to develop and validate a health economics model of screening using utilities and costs from a haemochromatosis cohort...
March 2017: PharmacoEconomics Open
Jie-Bin Lew, D James, B St John, Finlay A Macrae, Jon D Emery, Hooi C Ee, Mark A Jenkins, Emily He, Paul Grogan, Michael Caruana, Diana Sarfati, Marjolein Je Greuter, Veerle Mh Coupé, Karen Canfell
The Australian National Bowel Cancer Screening Program (NBCSP) will fully roll-out 2-yearly screening using immunochemical Faecal Occult Blood Test (iFOBT) in people aged 50-74 years by 2020. In this study, we aimed to estimate the comparative health benefits, harms, and cost-effectiveness of screening with iFOBT, versus other potential alternative or adjunctive technologies. A comprehensive validated microsimulation model, Policy1-Bowel, was used to simulate a total of 13 screening approaches involving use of iFOBT, colonoscopy, sigmoidoscopy, computed tomographic colonography (CTC), faecal DNA (fDNA) and plasma DNA (pDNA), in people aged 50-74 years...
February 14, 2018: International Journal of Cancer. Journal International du Cancer
Seyed Abdolmajid Yousefsani, Amir Shamloo, Farzam Farahmand
A transverse-plane hyperelastic micromechanical model of brain white matter tissue was developed using the embedded element technique (EET). The model consisted of a histology-informed probabilistic distribution of axonal fibers embedded within an extracellular matrix, both described using the generalized Ogden hyperelastic material model. A correcting method, based on the strain energy density function, was formulated to resolve the stiffness redundancy problem of the EET in large deformation regime. The model was then used to predict the homogenized tissue behavior and the associated localized responses of the axonal fibers under quasi-static, transverse, large deformations...
February 3, 2018: Journal of the Mechanical Behavior of Biomedical Materials
Chunlin Li, Miao Liu, Yuanman Hu, Rongqing Han, Tuo Shi, Xiuqi Qu, Yilin Wu
As urbanization progresses, increasingly impervious surfaces have changed the hydrological processes in cities and resulted in a major challenge for urban stormwater control. This study uses the urban stormwater model to evaluate the performance and costs of low impact development (LID) scenarios in a micro urban catchment. Rainfall-runoff data of three rainfall events were used for model calibration and validation. The pre-developed (PreDev) scenario, post-developed (PostDev) scenario, and three LID scenarios were used to evaluate the hydrologic performance of LID measures...
February 5, 2018: International Journal of Environmental Research and Public Health
Wendy Liu, Jessica J Outlaw, Nathan Wineinger, Debra Boeldt, Cinnamon S Bloss
Existing research in consumer behavior suggests that perceptions and usage of a product post-purchase depends, in part, on how the product was marketed, including price paid. In the current study, we examine the effect of providing an out-of-pocket co-payment for consumer genomic testing (CGT) on consumer post-purchase behavior using both correlational field evidence and a hypothetical online experiment. Participants were enrolled in a longitudinal cohort study of the impact of CGT and completed behavioral assessments before and after receipt of CGT results...
January 29, 2018: Translational Behavioral Medicine
Madhuri Pattamatta, Boudewijn J J Smeets, Silvia M A A Evers, Harm J T Rutten, Misha D P Luyer, Mickael Hiligsmann
BACKGROUND: Postoperative ileus (POI) and anastomotic leakage (AL) following colorectal surgery severely increase healthcare costs and decrease quality of life. This study evaluates the effects of reducing POI and AL via perioperative gum chewing compared to placebo (control) on in-hospital costs, health-related quality of life (HRQoL), and assesses cost-effectiveness. METHODS: In patients undergoing elective, open colorectal surgery, changes in HRQoL were assessed using EORTC-QLQ-C30 questionnaires and costs were estimated from a hospital perspective...
January 30, 2018: Acta Chirurgica Belgica
Doris H Fuertinger, Alice Topping, Franz Kappel, Stephan Thijssen, Peter Kotanko
In silico approaches have been proposed as a novel strategy to increase the repertoire of clinical trial designs. Realistic simulations of clinical trials can provide valuable information regarding safety and limitations of treatment protocols and have been shown to assist in the cost-effective planning of clinical studies. In this report, we present a blueprint for the stepwise integration of internal, external, and ecological validity considerations in virtual clinical trials (VCTs). We exemplify this approach in the context of a model-based in silico clinical trial aimed at anemia treatment in patients undergoing hemodialysis (HD)...
January 25, 2018: CPT: Pharmacometrics & Systems Pharmacology
Stefan Stevanovic, Boris Pervan
We propose a novel GPS phase-lock loop (PLL) performance metric based on the standard deviation of tracking error (defined as the discriminator's estimate of the true phase error), and explain its advantages over the popular phase jitter metric using theory, numerical simulation, and experimental results. We derive an augmented GPS phase-lock loop (PLL) linear model, which includes the effect of coherent averaging, to be used in conjunction with this proposed metric. The augmented linear model allows more accurate calculation of tracking error standard deviation in the presence of additive white Gaussian noise (AWGN) as compared to traditional linear models...
January 19, 2018: Sensors
Wouter M IJgosse, Harry van Goor, Jan-Maarten Luursema
BACKGROUND: Residents find it hard to commit to structural laparoscopic skills training. Serious gaming has been proposed as a solution on the premise that it is effective and more motivating than traditional simulation. We establish construct validity for the laparoscopic serious game Underground by comparing laparoscopic simulator performance for a control group and an Underground training group. METHODS: A four-session laparoscopic basic skills course is part of the medical master students surgical internship at the Radboud University Medical Centre...
January 18, 2018: Surgical Endoscopy
Javier Sánchez-Fernández, Jaime Bachiller-Burgos, Alvaro Serrano-Pascual, José Manuel Cózar-Olmo, Idoia Díaz-Güemes, Miguel Angel Sánchez-Hurtado, Belén Moreno-Naranjo, Silvia Enciso-Sanz, Laura Correa-Martín, Blanca Fernández-Tomé, María Mar Pérez-López, José Luis Alvarez-Ossorio, Francisco Miguel Sánchez-Margallo
Urology needs models of competencies assessment, although there is a wide range of tools not yet integrated into the official training programs. CONTEXT: At present, there is no universal framework for measuring surgeons' level of competence. Urology training programs should provide and consider knowledge, pyschomotor/cognitive skills, and simulator, cadaver or animal models-based training. Validity is a complex concept that refers to the capacity of the evaluation tool, so it is necessary to demonstrate several types of validation to assure the capacity of a method, reinforced with different reliability tests and calculation of internal consistency between evaluators...
January 2018: Archivos Españoles de Urología
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