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Validation cost effectiveness simulation

Amy Ming-Fang Yen, Hsiu-Hsi Chen
Multistate Markov regression models used for quantifying the effect size of state-specific covariates pertaining to the dynamics of multistate outcomes have gained popularity. However, the measurements of multistate outcome are prone to the errors of classification, particularly when a population-based survey/research is involved with proxy measurements of outcome due to cost consideration. Such a misclassification may affect the effect size of relevant covariates such as odds ratio used in the field of epidemiology...
May 21, 2018: Statistics in Medicine
Jonathon Van Schelt, Daniel Smith, Nicholas Fong, Dolla Toomeh, Patricia A Sponseller, Derek W Brown, Meghan W Macomber, Nina A Mayr, Shilpen Patel, Adam Shulman, G V Subrahmanyam, K Govindarajan, Eric C Ford
PURPOSE: We propose a novel compensator-based IMRT system designed to provide a simple, reliable, and cost-effective adjunct technology, with the goal of expanding global access to advanced radiotherapy techniques. The system would employ easily-reusable tungsten bead compensators that operate independent of a gantry (e.g. mounted in a ring around the patient). Thereby the system can be retrofitted to existing linac and cobalt teletherapy units. This study explores the quality of treatment plans from the proposed system and the dependence on associated design parameters...
May 19, 2018: Medical Physics
Todd Gilmer, Patrick J O'Connor, Jeffrey S Schiff, Gretchen Taylor, Gabriela Vazquez-Benitez, Joyce E Garrett, Houa Vue-Her, Sarah Rinn, Julie Anderson, Jay Desai
OBJECTIVE: To examine the cost-effectiveness of a community-based Diabetes Prevention Program (DPP) for Medicaid beneficiaries from the perspective of the health care sector. DATA SOURCES/STUDY SETTING: A total of 847 Medicaid enrollees at high risk for type 2 diabetes participating in a community-based DPP. STUDY DESIGN: Pre- and post clinical outcome and cost data were used as inputs into a validated diabetes simulation model. The model was used to evaluate quality-adjusted life years (QALYs) and health care costs over a 40-year time horizon from the perspective of the health care sector...
May 16, 2018: Health Services Research
Mingkai Qu, Yan Wang, Biao Huang, Yongcun Zhao
Spatial uncertainty information of the environmental risk of soil heavy metal is crucial for precise environmental management. This study first compared three geostatistical methods for spatial simulation of soil Copper (Cu) in a peri-urban agriculture area of Wuhan city, China, that are sequential Gaussian co-simulation (CoSGS) with auxiliary in-situ portable X-ray fluorescence (PXRF) data (CoSGS_in-situ), CoSGS with auxiliary ex-situ PXRF data (CoSGS_ex-situ), and sequential Gaussian simulation without auxiliary data (SGS)...
May 4, 2018: Environmental Pollution
Binbin Wang, Shiyou Xu, Wenzhen Wu, Pengjiang Hu, Zengping Chen
Focusing on the inverse synthetic aperture radar (ISAR) imaging of maneuvering targets, this paper presents a new imaging method which works well when the target's maneuvering is not too severe. After translational motion compensation, we describe the equivalent rotation of maneuvering targets by two variables-the relative chirp rate of the linear frequency modulated (LFM) signal and the Doppler focus shift. The first variable indicates the target's motion status, and the second one represents the possible residual error of the translational motion compensation...
April 27, 2018: Sensors
Dayne Ortved, T Lee-Ann Hawkins, Jo-Ann Johnson, Jon Hyett, Amy Metcalfe
OBJECTIVE: Pre-eclampsia (PE) remains a leading cause of maternal and fetal morbidity and mortality. A first trimester screening algorithm predicting the risk of early onset PE has been developed and validated. Early prediction coupled with initiation of aspirin at 11 to 13 weeks in women identified as high risk is effective at reducing the prevalence of early onset PE. The aim of this study is to evaluate the cost-effectiveness of this first trimester screening program coupled with early use of low-dose aspirin in women at high risk of developing early onset PE versus current practice...
April 27, 2018: Ultrasound in Obstetrics & Gynecology
Bilal Khan, Hsuan-Wei Lee, Ian Fellows, Kirk Dombrowski
Size estimation is particularly important for populations whose members experience disproportionate health issues or pose elevated health risks to the ambient social structures in which they are embedded. Efforts to derive size estimates are often frustrated when the population is hidden or hard-to-reach in ways that preclude conventional survey strategies, as is the case when social stigma is associated with group membership or when group members are involved in illegal activities. This paper extends prior research on the problem of network population size estimation, building on established survey/sampling methodologies commonly used with hard-to-reach groups...
2018: PloS One
Heather Ourth, Jordan Nelson, Patrick Spoutz, Anthony P Morreale
BACKGROUND: A data collection tool was developed and nationally deployed to clinical pharmacists (CPs) working in advanced practice provider roles within the Department of Veterans Affairs to document interventions and associated clinical outcomes. Intervention and short-term clinical outcome data derived from the tool were used to populate a validated clinical outcomes modeling program to predict long-term clinical and economic effects. OBJECTIVE: To predict the long-term effect of CP-provided pharmacotherapy management on outcomes and costs for patients with type 2 diabetes...
May 2018: Journal of Managed Care & Specialty Pharmacy
Erika Cordova, Tala Al-Rousan, Manuel Castillo-Angeles, Saima Aftab, Brett D Nelson
OBJECTIVE: To evaluate the impact of a post-Helping Babies Breathe bundle of interventions on the retention of provider-level knowledge and skills. METHOD: The present prospective pre-post study following a 1-day Helping Babies Breathe training of professional midwives, physicians, and nurses was conducted in Cajamarca Province, Peru between January 1 and July 31, 2017. The interventions to improve retention included structured worksite practice before every shift, weekly in-service simulated scenarios, and monthly supervised peer-to-peer abbreviated refresher trainings...
April 24, 2018: International Journal of Gynaecology and Obstetrics
Robert Brett McQueen, Marc D Breton, Joyce Craig, Hayden Holmes, Melanie D Whittington, Markus A Ott, Jonathan D Campbell
OBJECTIVE: The objective was to model clinical and economic outcomes of self-monitoring blood glucose (SMBG) devices with varying error ranges and strip prices for type 1 and insulin-treated type 2 diabetes patients in England. METHODS: We programmed a simulation model that included separate risk and complication estimates by type of diabetes and evidence from in silico modeling validated by the Food and Drug Administration. Changes in SMBG error were associated with changes in hemoglobin A1c (HbA1c) and separately, changes in hypoglycemia...
April 1, 2018: Journal of Diabetes Science and Technology
Fabio Cericola, Ingo Lenk, Dario Fè, Stephen Byrne, Christian S Jensen, Morten G Pedersen, Torben Asp, Just Jensen, Luc Janss
Ryegrass single plants, bi-parental family pools, and multi-parental family pools are often genotyped, based on allele-frequencies using genotyping-by-sequencing (GBS) assays. GBS assays can be performed at low-coverage depth to reduce costs. However, reducing the coverage depth leads to a higher proportion of missing data, and leads to a reduction in accuracy when identifying the allele-frequency at each locus. As a consequence of the latter, genomic relationship matrices (GRMs) will be biased. This bias in GRMs affects variance estimates and the accuracy of GBLUP for genomic prediction (GBLUP-GP)...
2018: Frontiers in Plant Science
Lincoln L Berland, Nancy W Berland, Matthew W Berland
Changes in the certification program of the ABR were first described in some detail in 2008 and have since undergone refinements. Controversies surrounding these changes have included the relevance of test questions, costs, effects of altering the examination scheduling, residency program curriculum changes, and issues related to preparing for the examinations. However, the role of psychometric testing in radiology itself, as the technical foundation for the new ABR Core and Certification Examinations, has undergone less scrutiny...
March 31, 2018: Journal of the American College of Radiology: JACR
Oscar M Crespin, Allan Okrainec, Andrea V Kwong, Ilay Habaz, Maria Carolina Jimenez, Peter Szasz, Ethan Weiss, Cecilia G Gonzalez, Jeffrey D Mosko, Louis W C Liu, Lee L Swanstrom, Silvana Perretta, Eran Shlomovitz
BACKGROUND: The fundamentals of laparoscopic surgery (FLS) training box is a validated tool, already accessible to surgical trainees to hone their laparoscopic skills. We aim to investigate the feasibility of adapting the FLS box for the practice and assessment of endoscopic skills. This would allow for a highly available, reusable, low-cost, mechanical trainer. METHODS: The design and development process was based on a user-centered design, which is a combination of the design thinking method and cognitive task analysis...
April 2, 2018: Surgical Endoscopy
Jan Thorsten Klein, Jens Rassweiler, Marie-Claire Charlotte Rassweiler-Seyfried
INTRODUCTION: Nephrolithiasis is one of the most common diseases in urology. According to the EAU Guidelines, a percutaneous nephrolitholapaxy (PNL) is recommended when treating a kidney stone >2 cm. Nowadays PNL is performed even for smaller stones (<1 cm) using miniaturized instruments. The most challenging part of any PNL is the puncture of the planned site. PNL-novice surgeons need to practice this step in a safe environment with an ideal training model. We developed and evaluated a new, easy to produce, in-vitro model for the training of the freehand puncture of the kidney...
March 29, 2018: Journal of Endourology
Yan Su, Xin Tong, Nan Liu, Guowei Han, Chaowei Si, Jin Ning, Zhaofeng Li, Fuhua Yang
With an aim to reduce the cost of prototype development, this paper establishes a PSPICE hybrid model for the simulation of capacitive microelectromechanical systems (MEMS) gyroscopes. This is achieved by modeling gyroscopes in different modules, then connecting them in accordance with the corresponding principle diagram. Systematic simulations of this model are implemented along with a consideration of details of MEMS gyroscopes, including a capacitance model without approximation, mechanical thermal noise, and the effect of ambient temperature...
March 28, 2018: Sensors
Christopher V Almario, Benjamin D Noah, Alma Jusufagic, Daniel Lew, Brennan M R Spiegel
BACKGROUND & AIMS: Diagnosis of diarrhea-predominant irritable bowel syndrome (IBS-D) relies on the Rome IV symptom-based criteria, which are imperfect for separating functional vs organic disease. Biomarker tests for IBS-D might be added to symptom data to allow clinicians to make more accurate and precise diagnoses in a cost-effective manner. We tested the economic consequences of using a range of hypothetical IBS-D biomarkers, and explored at what cost and level of accuracy a biomarker becomes cost effective...
March 27, 2018: Clinical Gastroenterology and Hepatology
John M Brooks, Cole G Chapman, Mary C Schroeder
BACKGROUND: Patient-centred care requires evidence of treatment effects across many outcomes. Outcomes can be beneficial (e.g. increased survival or cure rates) or detrimental (e.g. adverse events, pain associated with treatment, treatment costs, time required for treatment). Treatment effects may also be heterogeneous across outcomes and across patients. Randomized controlled trials are usually insufficient to supply evidence across outcomes. Observational data analysis is an alternative, with the caveat that the treatments observed are choices...
March 27, 2018: Applied Health Economics and Health Policy
Leilei Zeng, Richard J Cook, Ker-Ai Lee
Therapeutic advances in cancer mean that it is now impractical to performed phase III randomized trials evaluating experimental treatments on the basis of overall survival. As a result, the composite endpoint of progression-free survival has been routinely adopted in recent years as it is viewed as enabling a more timely and cost-effective approach to assessing the clinical benefit of novel interventions. This article considers design of cancer trials directed at the evaluation of treatment effects on progression-free survival...
March 26, 2018: Statistics in Medicine
Agustín Sáez, Juan M Morales, Carolina L Morales, Lawrence D Harder, Marcelo A Aizen
Globally, agriculture increasingly depends on pollinators to produce many seed and fruit crops. However, what constitutes optimal pollination service for pollinator-dependent crops remains unanswered. We developed a simulation model to identify the optimal pollination service that maximizes fruit quality in crops. The model depicts the pollination (i.e. autonomous self-fertilization, pollen deposition) and post-pollination (i.e. pollen germination, and time from germination to ovule fertilization) processes leading to fruit and seed set and allows for negative flower-pollinator interactions, specifically pistil damage...
March 24, 2018: Ecological Applications: a Publication of the Ecological Society of America
Ka Keat Lim, Sook Yee Yoon, Nur Aishah Mohd Taib, Fatiha Hana Shabaruddin, Maznah Dahlui, Yin Ling Woo, Meow Keong Thong, Soo Hwang Teo, Nathorn Chaiyakunapruk
OBJECTIVE: Previous studies showed that offering BRCA mutation testing to population subgroups at high risk of harbouring the mutation may be cost effective, yet no evidence is available for low- or middle-income countries (LMIC) and in Asia. We estimated the cost effectiveness of BRCA mutation testing in early-stage breast cancer patients with high pre-test probability of harbouring the mutation in Malaysia, an LMIC in Asia. METHODS: We developed a decision analytic model to estimate the lifetime costs and quality-adjusted life-years (QALYs) accrued through BRCA mutation testing or routine clinical surveillance (RCS) for a hypothetical cohort of 1000 early-stage breast cancer patients aged 40 years...
June 2018: Applied Health Economics and Health Policy
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