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Luo L, Zhang R, Zhuo M, Shan R, Yu Z, Li W, Wu P, Sun X, Wang Q. Medical Resource Management in Emergency Hierarchical Diagnosis and Treatment Systems: A Research Framework. Healthcare (Basel) 2024; 12:1358. [PMID: 38998892 PMCID: PMC11241035 DOI: 10.3390/healthcare12131358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Revised: 06/18/2024] [Accepted: 07/01/2024] [Indexed: 07/14/2024] Open
Abstract
The occurrence of major public health crises, like the COVID-19 epidemic, present significant challenges to healthcare systems and the management of emergency medical resources worldwide. This study, by examining the practices of emergency medical resource management in select countries during the COVID-19 epidemic, and reviewing the relevant literature, finds that emergency hierarchical diagnosis and treatment systems (EHDTSs) play a crucial role in managing emergency resources effectively. To address key issues of emergency resource management in EHDTSs, we examine the features of EHDTSs and develop a research framework for emergency resource management in EHDTSs, especially focusing on the management of emergency medical personnel and medical supplies during evolving epidemics. The research framework identifies key issues of emergency medical resource management in EHDTSs, including the sharing and scheduling of emergency medical supplies, the establishment and sharing of emergency medical supply warehouses, and the integrated dispatch of emergency medical personnel. The proposed framework not only offers insights for future research but also can facilitate better emergency medical resource management in EHDTSs during major public health emergencies.
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Affiliation(s)
- Li Luo
- Business School, Sichuan University, Chengdu 610065, China
| | - Renshan Zhang
- Business School, Sichuan University, Chengdu 610065, China
| | - Maolin Zhuo
- School of Finance and Trade Management, Chengdu Industry & Trade College, Chengdu 611731, China
| | - Renbang Shan
- Business School, Sichuan University, Chengdu 610065, China
- School of Management, Hangzhou Dianzi University, Hangzhou 310018, China
| | - Zhoutianqi Yu
- Business School, Sichuan University, Chengdu 610065, China
| | - Weimin Li
- West China Hospital, Sichuan University, Chengdu 610041, China
| | - Peng Wu
- Business School, Sichuan University, Chengdu 610065, China
| | - Xin Sun
- West China Hospital, Sichuan University, Chengdu 610041, China
| | - Qingyi Wang
- Business School, Sichuan University, Chengdu 610065, China
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2
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Zhu K, Yin L, Liu K, Liu J, Shi Y, Li X, Zou H, Du H. Generating synthetic population for simulating the spatiotemporal dynamics of epidemics. PLoS Comput Biol 2024; 20:e1011810. [PMID: 38346079 PMCID: PMC10890746 DOI: 10.1371/journal.pcbi.1011810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 02/23/2024] [Accepted: 01/08/2024] [Indexed: 02/25/2024] Open
Abstract
Agent-based models have gained traction in exploring the intricate processes governing the spread of infectious diseases, particularly due to their proficiency in capturing nonlinear interaction dynamics. The fidelity of agent-based models in replicating real-world epidemic scenarios hinges on the accurate portrayal of both population-wide and individual-level interactions. In situations where comprehensive population data are lacking, synthetic populations serve as a vital input to agent-based models, approximating real-world demographic structures. While some current population synthesizers consider the structural relationships among agents from the same household, there remains room for refinement in this domain, which could potentially introduce biases in subsequent disease transmission simulations. In response, this study unveils a novel methodology for generating synthetic populations tailored for infectious disease transmission simulations. By integrating insights from microsample-derived household structures, we employ a heuristic combinatorial optimizer to recalibrate these structures, subsequently yielding synthetic populations that faithfully represent agent structural relationships. Implementing this technique, we successfully generated a spatially-explicit synthetic population encompassing over 17 million agents for Shenzhen, China. The findings affirm the method's efficacy in delineating the inherent statistical structural relationship patterns, aligning well with demographic benchmarks at both city and subzone tiers. Moreover, when assessed against a stochastic agent-based Susceptible-Exposed-Infectious-Recovered model, our results pinpointed that variations in population synthesizers can notably alter epidemic projections, influencing both the peak incidence rate and its onset.
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Affiliation(s)
- Kemin Zhu
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Ling Yin
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Kang Liu
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Junli Liu
- Hangzhou Institute of Technology, Xidian University, Hangzhou, China
| | - Yepeng Shi
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Xuan Li
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Hongyang Zou
- College of Management and Economics, Tianjin University, Tianjin, China
- National Industry-Education Platform of Energy Storage, Tianjin University, Tianjin, China
| | - Huibin Du
- College of Management and Economics, Tianjin University, Tianjin, China
- National Industry-Education Platform of Energy Storage, Tianjin University, Tianjin, China
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3
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Shamsi Gamchi N, Esmaeili M. A novel mathematical model for prioritization of individuals to receive vaccine considering governmental health protocols. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2023; 24:633-646. [PMID: 35900675 PMCID: PMC9330986 DOI: 10.1007/s10198-022-01491-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Accepted: 06/09/2022] [Indexed: 05/12/2023]
Abstract
Infectious diseases drive countries to provide vaccines to individuals. Due to the limited supply of vaccines, individuals prioritize receiving vaccinations worldwide. Although, priority groups are formed based on age groupings due to the restricted decision-making time. Governments usually ordain different health protocols such as lockdown policy, mandatory use of face masks, and vaccination during the pandemics. Therefore, this study considers the case of COVID-19 with a SEQIR (susceptible-exposed-quarantined-infected-recovered) epidemic model and presents a novel prioritization technique to minimize the social and economic impacts of the lockdown policy. We use retail units as one of the affected parts to demonstrate how a vaccination plan may be more effective if individuals such as retailers were prioritized and age groups. In addition, we estimate the total required vaccine doses to control the epidemic disease and compute the number of vaccine doses supplied by various suppliers. The vaccine doses are determined using optimal control theory in the solution technique. In addition, we consider the effect of the mask using policy in the number of vaccine doses allocated to each priority group. The model's performance is evaluated using an illustrative scenario based on a real case.
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Affiliation(s)
- N Shamsi Gamchi
- Department of Industrial Engineering, Faculty of Engineering, Alzahra University, Tehran, Iran
| | - M Esmaeili
- Department of Industrial Engineering, Faculty of Engineering, Alzahra University, Tehran, Iran.
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4
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Joshi K, Rumpler E, Kennedy-Shaffer L, Bosan R, Lipsitch M. Comparative performance of between-population vaccine allocation strategies with applications for emerging pandemics. Vaccine 2023; 41:1864-1874. [PMID: 36697312 PMCID: PMC10075509 DOI: 10.1016/j.vaccine.2022.12.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 12/19/2022] [Accepted: 12/20/2022] [Indexed: 01/25/2023]
Abstract
Vaccine allocation decisions during emerging pandemics have proven to be challenging due to competing ethical, practical, and political considerations. Complicating decision making, policy makers need to consider vaccine allocation strategies that balance needs both within and between populations. When vaccine stockpiles are limited, doses should be allocated in locations to maximize their impact. Using a susceptible-exposed-infectious-recovered (SEIR) model we examine optimal vaccine allocation decisions across two populations considering the impact of characteristics of the population (e.g., size, underlying immunity, heterogeneous risk structure, interaction), vaccine (e.g., vaccine efficacy), pathogen (e.g., transmissibility), and delivery (e.g., varying speed and timing of rollout). Across a wide range of characteristics considered, we find that vaccine allocation proportional to population size (i.e., pro-rata allocation) performs either better or comparably to nonproportional allocation strategies in minimizing the cumulative number of infections. These results may argue in favor of sharing of vaccines between locations in the context of an epidemic caused by an emerging pathogen, where many epidemiologic characteristics may not be known.
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Affiliation(s)
- Keya Joshi
- Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard TH Chan School of Public Health, 02115 Boston, MA, USA
| | - Eva Rumpler
- Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard TH Chan School of Public Health, 02115 Boston, MA, USA
| | - Lee Kennedy-Shaffer
- Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard TH Chan School of Public Health, 02115 Boston, MA, USA; Department of Mathematics & Statistics, Vassar College, 12604 Poughkeepsie, NY, USA
| | - Rafia Bosan
- Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard TH Chan School of Public Health, 02115 Boston, MA, USA
| | - Marc Lipsitch
- Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard TH Chan School of Public Health, 02115 Boston, MA, USA
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5
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Chu J, Li X, Yuan Z. Emergency medical resource allocation among hospitals with non-regressive production technology: A DEA-based approach. COMPUTERS & INDUSTRIAL ENGINEERING 2022; 171:108491. [PMID: 35892084 PMCID: PMC9304119 DOI: 10.1016/j.cie.2022.108491] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Revised: 06/04/2022] [Accepted: 07/18/2022] [Indexed: 06/15/2023]
Abstract
This paper proposes an approach for medical resource allocation among hospitals under public health emergencies based on data envelopment analysis (DEA). First, the DEA non-regressive production technology is adopted to ensure that the DMU can always refer to the most advanced production technology throughout all production periods. Based on the non-regressive production technology, two efficiency evaluation models are presented to calculate the efficiencies of DMUs before and after resource allocation. Our theoretical analysis shows that all the DMUs can be efficient after medical resource allocation, and thus a novel resource allocation possibility set is developed. Further, two objectives are considered and a bi-objective resource allocation model is developed. One objective is to maximize the output target realizability of the DMUs, while the other is to ensure the allocated resource to each DMU fits with its operation size, preperformance, and operation practice (i.e., proportion of critically ill patients). Additionally, a trade-off model is proposed to solve the bi-objective model to obtain the final resource allocation results. The proposed approach contributes by ensuring that the medical resources are allocated in such a way that they can all be efficiently used as well as considering multiple objectives and practical constraints that make the approach more fitted with the practical application scenarios. Finally, a case study of 30 hospitals in Wuhan during the COVID-19 epidemic is applied to illustrate the proposed approach.
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Affiliation(s)
- Junfei Chu
- School of Business, Central South University, Changsha, Hunan 410083, PR China
| | - Xiaoxue Li
- School of Business, Central South University, Changsha, Hunan 410083, PR China
| | - Zhe Yuan
- Léonard de Vinci Pôle Universitaire, Research Center, 92 916 Paris La Défense, France
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6
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Joshi K, Rumpler E, Kennedy-Shaffer L, Bosan R, Lipsitch M. Comparative performance of between-population vaccine allocation strategies with applications for emerging pandemics. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2022:2021.06.18.21259137. [PMID: 34212161 PMCID: PMC8246345 DOI: 10.1101/2021.06.18.21259137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Vaccine allocation decisions during emerging pandemics have proven to be challenging due to competing ethical, practical, and political considerations. Complicating decision making, policy makers need to consider vaccine allocation strategies that balance needs both within and between populations. Due to limited vaccine stockpiles, vaccine doses should be allocated in locations where their impact will be maximized. Using a susceptible-exposed-infectious-recovered (SEIR) model we examine optimal vaccine allocation decisions across two populations considering the impact of population size, underlying immunity, continuous vaccine roll-out, heterogeneous population risk structure, and differences in disease transmissibility. We find that in the context of an emerging pathogen where many epidemiologic characteristics might not be known, equal vaccine allocation between populations performs optimally in most scenarios. In the specific case considering heterogeneous population risk structure, first targeting individuals at higher risk of transmission or death due to infection leads to equal resource allocation across populations.
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Affiliation(s)
- Keya Joshi
- Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard TH Chan School of Public Health, 02115 Boston, Massachusetts
| | - Eva Rumpler
- Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard TH Chan School of Public Health, 02115 Boston, Massachusetts
| | - Lee Kennedy-Shaffer
- Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard TH Chan School of Public Health, 02115 Boston, Massachusetts
- Department of Mathematics & Statistics, Vassar College, 12604 Poughkeepsie, New York
| | - Rafia Bosan
- Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard TH Chan School of Public Health, 02115 Boston, Massachusetts
| | - Marc Lipsitch
- Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard TH Chan School of Public Health, 02115 Boston, Massachusetts
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7
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Shiri M, Ahmadizar F. An equitable and accessible vaccine supply chain network in the epidemic outbreak of COVID-19 under uncertainty. JOURNAL OF AMBIENT INTELLIGENCE AND HUMANIZED COMPUTING 2022; 14:1-25. [PMID: 35692508 PMCID: PMC9171116 DOI: 10.1007/s12652-022-03865-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 04/26/2022] [Indexed: 06/15/2023]
Abstract
Vaccination is one of the most efficient ways to restrict and control the spread of epidemic outbreaks such as COVID-19. Due to the limited COVID-19 vaccine supply, an equitable and accessible plan should be prepared to cope with. This research focuses on designing a vaccine supply chain while aiming to achieve an equitable and accessible network. We present a novel mathematical formulation that helps to optimize vaccine distribution to inoculate people with various priority levels to achieve an equitable plan. The transshipment strategy is also incorporated into the model to enhance the accessibility of COVID-19 vaccine types between health facilities. The nature of COVID-19 is dynamic over time due to mutations, and the protection level of each vaccine type against this disease is not exact. Besides, complete information about the demand for different vaccine types is not available. Hence, we use Multi-Stage Stochastic Programming as a reliable strategy that is organized to manage stochastic data in a dynamic environment for the first time in the vaccine supply chain network. The scenarios in this approach are generated using a Monte Carlo simulation method, and then a forward scenario reduction technique is conducted to construct a suitable scenario tree. The practicality and capability of the model are shown in a real-life case of Iran. The results show that the performance of the Multi-Stage Stochastic Programming is significantly improved compared with the two-stage stochastic programming regarding the total cost of the vaccine supply chain and the number of the shortage units.
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Affiliation(s)
- Mahdyeh Shiri
- Department of Industrial Engineering, University of Kurdistan, Sanandaj, Iran
| | - Fardin Ahmadizar
- Department of Industrial Engineering, University of Kurdistan, Sanandaj, Iran
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8
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Juneau CE, Pueyo T, Bell M, Gee G, Collazzo P, Potvin L. Lessons from past pandemics: a systematic review of evidence-based, cost-effective interventions to suppress COVID-19. Syst Rev 2022; 11:90. [PMID: 35550674 PMCID: PMC9096744 DOI: 10.1186/s13643-022-01958-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Accepted: 04/11/2022] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND In an unparalleled global response, during the COVID-19 pandemic, 90 countries asked 3.9 billion people to stay home. Yet other countries avoided lockdowns and focused on other strategies, like contact tracing. How effective and cost-effective are these strategies? We aimed to provide a comprehensive summary of the evidence on past pandemic controls, with a focus on cost-effectiveness. METHODS Following PRISMA guidelines, MEDLINE (1946 to April week 2, 2020) and EMBASE (1974 to April 17, 2020) were searched using a range of terms related to pandemic control. Articles reporting on the effectiveness or cost-effectiveness of at least one intervention were included. RESULTS We found 1653 papers; 62 were included. The effectiveness of hand-washing and face masks was supported by randomized trials. These measures were highly cost-effective. For other interventions, only observational and modelling studies were found. They suggested that (1) the most cost-effective interventions are swift contact tracing and case isolation, surveillance networks, protective equipment for healthcare workers, and early vaccination (when available); (2) home quarantines and stockpiling antivirals are less cost-effective; (3) social distancing measures like workplace and school closures are effective but costly, making them the least cost-effective options; (4) combinations are more cost-effective than single interventions; and (5) interventions are more cost-effective when adopted early. For 2009 H1N1 influenza, contact tracing was estimated to be 4363 times more cost-effective than school closure ($2260 vs. $9,860,000 per death prevented). CONCLUSIONS AND CONTRIBUTIONS For COVID-19, a cautious interpretation suggests that (1) workplace and school closures are effective but costly, especially when adopted late, and (2) scaling up as early as possible a combination of interventions that includes hand-washing, face masks, ample protective equipment for healthcare workers, and swift contact tracing and case isolation is likely to be the most cost-effective strategy.
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Affiliation(s)
- Carl-Etienne Juneau
- Direction Régionale de Santé Publique, CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montréal, QC, Canada
| | | | - Matt Bell
- COVID-19 Work Group, Washington, D.C., USA
| | | | - Pablo Collazzo
- Danube University, Dr. Karl Dorrek Straße 30, 3500, Krems, Austria.
| | - Louise Potvin
- École de Santé Publique, Université de Montréal, C.P. 6128, Succursale Centre-ville, Montréal, QC, H3C 3J7, Canada
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9
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Ostropolets A, Ryan P, Schuemie M, Hripcsak G. Differential anchoring effects of vaccination comparator selection: characterizing a potential bias due to healthcare utilization in COVID-19 versus influenza. JMIR Public Health Surveill 2022; 8:e33099. [PMID: 35482996 PMCID: PMC9250064 DOI: 10.2196/33099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 01/27/2022] [Accepted: 04/26/2022] [Indexed: 12/12/2022] Open
Abstract
Background Observational data enables large-scale vaccine safety surveillance but requires careful evaluation of the potential sources of bias. One potential source of bias is the index date selection procedure for the unvaccinated cohort or unvaccinated comparison time (“anchoring”). Objective Here, we evaluated the different index date selection procedures for 2 vaccinations: COVID-19 and influenza. Methods For each vaccine, we extracted patient baseline characteristics on the index date and up to 450 days prior and then compared them to the characteristics of the unvaccinated patients indexed on (1) an arbitrary date or (2) a date of a visit. Additionally, we compared vaccinated patients indexed on the date of vaccination and the same patients indexed on a prior date or visit. Results COVID-19 vaccination and influenza vaccination differ drastically from each other in terms of the populations vaccinated and their status on the day of vaccination. When compared to indexing on a visit in the unvaccinated population, influenza vaccination had markedly higher covariate proportions, and COVID-19 vaccination had lower proportions of most covariates on the index date. In contrast, COVID-19 vaccination had similar covariate proportions when compared to an arbitrary date. These effects attenuated, but were still present, with a longer lookback period. The effect of day 0 was present even when the patients served as their own controls. Conclusions Patient baseline characteristics are sensitive to the choice of the index date. In vaccine safety studies, unexposed index event should represent vaccination settings. Study designs previously used to assess influenza vaccination must be reassessed for COVID-19 to account for a potentially healthier population and lack of medical activity on the day of vaccination.
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Affiliation(s)
- Anna Ostropolets
- Department of Biomedical Informatics, Columbia University Irving Medical Center, 622 W. 168th Street, PH20, New York, US
| | - Patrick Ryan
- Epidemiology Analytics, Janssen Research and Development, Titusville, US
| | - Martijn Schuemie
- Epidemiology Analytics, Janssen Research and Development, Titusville, US
| | - George Hripcsak
- Department of Biomedical Informatics, Columbia University Irving Medical Center, 622 W. 168th Street, PH20, New York, US.,Medical Informatics Services, New York-Presbyterian Hospital, New York, US
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10
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Guerstein S, Romeo-Aznar V, Dekel M, Miron O, Davidovitch N, Puzis R, Pilosof S. The interplay between vaccination and social distancing strategies affects COVID19 population-level outcomes. PLoS Comput Biol 2021; 17:e1009319. [PMID: 34415900 PMCID: PMC8409608 DOI: 10.1371/journal.pcbi.1009319] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 09/01/2021] [Accepted: 08/02/2021] [Indexed: 12/16/2022] Open
Abstract
Social distancing is an effective population-level mitigation strategy to prevent COVID19 propagation but it does not reduce the number of susceptible individuals and bears severe social consequences-a dire situation that can be overcome with the recently developed vaccines. Although a combination of these interventions should provide greater benefits than their isolated deployment, a mechanistic understanding of the interplay between them is missing. To tackle this challenge we developed an age-structured deterministic model in which vaccines are deployed during the pandemic to individuals who do not show symptoms. The model allows for flexible and dynamic prioritization strategies with shifts between target groups. We find a strong interaction between social distancing and vaccination in their effect on the proportion of hospitalizations. In particular, prioritizing vaccines to elderly (60+) before adults (20-59) is more effective when social distancing is applied to adults or uniformly. In addition, the temporal reproductive number Rt is only affected by vaccines when deployed at sufficiently high rates and in tandem with social distancing. Finally, the same reduction in hospitalization can be achieved via different combination of strategies, giving decision makers flexibility in choosing public health policies. Our study provides insights into the factors that affect vaccination success and provides methodology to test different intervention strategies in a way that will align with ethical guidelines.
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Affiliation(s)
- Sharon Guerstein
- Department of Life Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Victoria Romeo-Aznar
- Department of Ecology & Evolution, University of Chicago, Chicago, Illinois, United States of America
- Department of Ecology, Genetics & Evolution, and IEGEBA (UBA-CONICET), Faculty of Exact and Natural Sciences, University of Buenos Aires, Buenos-Aires, Argentina
| | - Ma’ayan Dekel
- Department of Life Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Oren Miron
- School of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Nadav Davidovitch
- School of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Rami Puzis
- Software and Information Systems Engineering, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Shai Pilosof
- Department of Life Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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11
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Zhou S, Zhou S, Zheng Z, Lu J. Optimizing Spatial Allocation of COVID-19 Vaccine by Agent-Based Spatiotemporal Simulations. GEOHEALTH 2021; 5:e2021GH000427. [PMID: 34179672 PMCID: PMC8207830 DOI: 10.1029/2021gh000427] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 05/13/2021] [Accepted: 05/18/2021] [Indexed: 05/21/2023]
Abstract
Optimizing allocation of vaccine, a highly scarce resource, is an urgent and critical issue during fighting against on-going COVID-19 epidemic. Prior studies suggested that vaccine should be prioritized by age and risk groups, but few of them have considered the spatial prioritization strategy. This study aims to examine the spatial heterogeneity of COVID-19 transmission in the city naturally, and optimize vaccine distribution strategies considering spatial prioritization. We proposed an integrated spatial model of agent-based model and SEIR (susceptible-exposed-infected-recovered). It simulated spatiotemporal process of COVID-19 transmission in a realistic urban context. Individual movements were represented by trajectories of 8,146 randomly sampled mobile phone users on December 28, 2016 in Guangzhou, China, 90% of whom aged 18-60. Simulations were conducted under seven scenarios. Scenarios 1 and 2 examined natural spreading process of COVID-19 and its final state of herd immunity. Scenarios 3-6 applied four vaccination strategies (random strategy, age strategy, space strategy, and space & age strategy), and identified the optimal vaccine strategy. Scenario 7 assessed the most appropriate vaccine coverage. The results demonstrates herd immunity is heterogeneously distributed in space, thus, vaccine intervention strategies should be spatialized. Among four strategies, space & age strategy is substantially most efficient, with 7.7% fewer in attack rate and 44 days longer than random strategy under 20% vaccine uptake. Space & age strategy requires 30%-40% vaccine coverage to control the epidemic, while the coverage for a random strategy is 60%-70% as a comparison. The application of our research would greatly improves the effectiveness of the vaccine usability.
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Affiliation(s)
- Shuli Zhou
- School of Geography and PlanningSun Yat‐sen UniversityGuangzhouChina
- Guangdong Provincial Engineering Research Center for Public Security and DisasterGuangzhouChina
| | - Suhong Zhou
- School of Geography and PlanningSun Yat‐sen UniversityGuangzhouChina
- Guangdong Provincial Engineering Research Center for Public Security and DisasterGuangzhouChina
| | - Zhong Zheng
- Center for Territorial Spatial Planning and Real Estate StudiesBeijing Normal UniversityZhuhaiChina
| | - Junwen Lu
- School of Geography and PlanningSun Yat‐sen UniversityGuangzhouChina
- Guangdong Provincial Engineering Research Center for Public Security and DisasterGuangzhouChina
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12
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Lee EK, Li ZL, Liu YK, LeDuc J. Strategies for Vaccine Prioritization and Mass Dispensing. Vaccines (Basel) 2021; 9:vaccines9050506. [PMID: 34068985 PMCID: PMC8157047 DOI: 10.3390/vaccines9050506] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 04/22/2021] [Accepted: 04/30/2021] [Indexed: 02/07/2023] Open
Abstract
We propose a system that helps decision makers during a pandemic find, in real time, the mass vaccination strategies that best utilize limited medical resources to achieve fast containments and population protection. Our general-purpose framework integrates into a single computational platform a multi-purpose compartmental disease propagation model, a human behavior network, a resource logistics model, and a stochastic queueing model for vaccination operations. We apply the modeling framework to the current COVID-19 pandemic and derive an optimal trigger for switching from a prioritized vaccination strategy to a non-prioritized strategy so as to minimize the overall attack rate and mortality rate. When vaccine supply is limited, such a mixed vaccination strategy is broadly effective. Our analysis suggests that delays in vaccine supply and inefficiencies in vaccination delivery can substantially impede the containment effort. Employing an optimal mixed strategy can significantly reduce the attack and mortality rates. The more infectious the virus, the earlier it helps to open the vaccine to the public. As vaccine efficacy decreases, the attack and mortality rates rapidly increase by multiples; this highlights the importance of early vaccination to reduce spreading as quickly as possible to lower the chances for further mutations to evolve and to reduce the excessive healthcare burden. To maximize the protective effect of available vaccines, of equal importance are determining the optimal mixed strategy and implementing effective on-the-ground dispensing. The optimal mixed strategy is quite robust against variations in model parameters and can be implemented readily in practice. Studies with our holistic modeling framework strongly support the urgent need for early vaccination in combating the COVID-19 pandemic. Our framework permits rapid custom modeling in practice. Additionally, it is generalizable for different types of infectious disease outbreaks, whereby a user may determine for a given type the effects of different interventions including the optimal switch trigger.
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Affiliation(s)
- Eva K. Lee
- NSF-Whitaker Center for Operations Research in Medicine and HealthCare, Georgia Institute of Technology, Atlanta, GA 30332, USA; (Z.L.L.); (Y.K.L.)
- Correspondence: ; Tel.: +1-404-432-6835
| | - Zhuonan L. Li
- NSF-Whitaker Center for Operations Research in Medicine and HealthCare, Georgia Institute of Technology, Atlanta, GA 30332, USA; (Z.L.L.); (Y.K.L.)
| | - Yifan K. Liu
- NSF-Whitaker Center for Operations Research in Medicine and HealthCare, Georgia Institute of Technology, Atlanta, GA 30332, USA; (Z.L.L.); (Y.K.L.)
| | - James LeDuc
- Galveston National Laboratory, University of Texas Medical Branch, Galveston, TX 77550, USA;
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13
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Bhatta M, Nandi S, Dutta S, Saha MK. Coronavirus (SARS-CoV-2): a systematic review for potential vaccines. Hum Vaccin Immunother 2021; 18:1865774. [PMID: 33545014 PMCID: PMC8920137 DOI: 10.1080/21645515.2020.1865774] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
COVID-19 is an international public health emergency in need of effective and safe vaccines for SARS-CoV-2. A systematic review has been done to analyze the availability, development and status of new COVID-19 vaccine candidates as well as the status of vaccines for other diseases that might be effective against SARS-CoV-2 infection. PubMed, MEDLINE, EMBASE, Science Direct, Google Scholar, Cochrane library, ClinicalTrials.gov, Web of Science and different trial registries were searched for currently available and probable future vaccines. Articles and ongoing clinical trials are included to ascertain the availability and developmental approaches of new vaccines that could limit the present and future outbreaks. Pharmaceutical companies and institutions are at different stages of developing new vaccines, and extensive studies and clinical trials are still required.
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Affiliation(s)
- Mihir Bhatta
- Division of Virology, ICMR-National Institute of Cholera and Enteric Diseases, Kolkata, India
| | - Srijita Nandi
- Division of Virology, ICMR-National Institute of Cholera and Enteric Diseases, Kolkata, India
| | - Shanta Dutta
- Division of Bacteriology, ICMR-National Institute of Cholera and Enteric Diseases, Kolkata, India
| | - Malay Kumar Saha
- Division of Virology, ICMR-National Institute of Cholera and Enteric Diseases, Kolkata, India
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14
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Atkinson JA, Skinner A, Lawson K, Rosenberg S, Hickie IB. Bringing new tools, a regional focus, resource-sensitivity, local engagement and necessary discipline to mental health policy and planning. BMC Public Health 2020; 20:814. [PMID: 32498676 PMCID: PMC7273655 DOI: 10.1186/s12889-020-08948-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 05/18/2020] [Indexed: 12/11/2022] Open
Abstract
Background While reducing the burden of mental and substance use disorders is a global challenge, it is played out locally. Mental disorders have early ages of onset, syndromal complexity and high individual variability in course and response to treatment. As most locally-delivered health systems do not account for this complexity in their design, implementation, scale or evaluation they often result in disappointing impacts. Discussion In this viewpoint, we contend that the absence of an appropriate predictive planning framework is one critical reason that countries fail to make substantial progress in mental health outcomes. Addressing this missing infrastructure is vital to guide and coordinate national and regional (local) investments, to ensure limited mental health resources are put to best use, and to strengthen health systems to achieve the mental health targets of the 2015 Sustainable Development Goals. Most broad national policies over-emphasize provision of single elements of care (e.g. medicines, individual psychological therapies) and assess their population-level impact through static, linear and program logic-based evaluation. More sophisticated decision analytic approaches that can account for complexity have long been successfully used in non-health sectors and are now emerging in mental health research and practice. We argue that utilization of advanced decision support tools such as systems modelling and simulation, is now required to bring a necessary discipline to new national and local investments in transforming mental health systems. Conclusion Systems modelling and simulation delivers an interactive decision analytic tool to test mental health reform and service planning scenarios in a safe environment before implementing them in the real world. The approach drives better decision-making and can inform the scale up of effective and contextually relevant strategies to reduce the burden of mental disorder and enhance the mental wealth of nations.
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Affiliation(s)
- Jo-An Atkinson
- Brain and Mind Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia. .,Computer Simulation and Advanced Research Technologies, Sydney, Australia. .,Menzies Centre for Health Policy, The University of Sydney, Sydney, Australia. .,Translational Health Research Institute, Western Sydney University, Penrith, Australia.
| | - Adam Skinner
- Brain and Mind Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.,Menzies Centre for Health Policy, The University of Sydney, Sydney, Australia
| | - Kenny Lawson
- Translational Health Research Institute, Western Sydney University, Penrith, Australia.,Hunter Medical Research Institute, Newcastle, Australia
| | - Sebastian Rosenberg
- Brain and Mind Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.,Research School of Population Health, The Australian National University, Canberra, Australia
| | - Ian B Hickie
- Brain and Mind Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
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15
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Bartsch SM, Ferguson MC, McKinnell JA, O'Shea KJ, Wedlock PT, Siegmund SS, Lee BY. The Potential Health Care Costs And Resource Use Associated With COVID-19 In The United States. Health Aff (Millwood) 2020; 39:927-935. [PMID: 32324428 PMCID: PMC11027994 DOI: 10.1377/hlthaff.2020.00426] [Citation(s) in RCA: 222] [Impact Index Per Article: 55.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
With the coronavirus disease 2019 (COVID-19) pandemic, one of the major concerns is the direct medical cost and resource use burden imposed on the US health care system. We developed a Monte Carlo simulation model that represented the US population and what could happen to each person who got infected. We estimated resource use and direct medical costs per symptomatic infection and at the national level, with various "attack rates" (infection rates), to understand the potential economic benefits of reducing the burden of the disease. A single symptomatic COVID-19 case could incur a median direct medical cost of $3,045 during the course of the infection alone. If 80 percent of the US population were to get infected, the result could be a median of 44.6 million hospitalizations, 10.7 million intensive care unit (ICU) admissions, 6.5 million patients requiring a ventilator, 249.5 million hospital bed days, and $654.0 billion in direct medical costs over the course of the pandemic. If 20 percent of the US population were to get infected, there could be a median of 11.2 million hospitalizations, 2.7 million ICU admissions, 1.6 million patients requiring a ventilator, 62.3 million hospital bed days, and $163.4 billion in direct medical costs over the course of the pandemic.
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Affiliation(s)
- Sarah M Bartsch
- Sarah M. Bartsch is a project director at Public Health Informatics, Computational, and Operations Research (PHICOR), Graduate School of Public Health and Health Policy, City University of New York, in New York City
| | - Marie C Ferguson
- Marie C. Ferguson is a project director at PHICOR, Graduate School of Public Health and Health Policy, City University of New York
| | - James A McKinnell
- James A. McKinnell is an associate professor of medicine in the Infectious Disease Clinical Outcomes Research Unit, Lundquist Institute, Harbor-UCLA Medical Center, in Los Angeles, California
| | - Kelly J O'Shea
- Kelly J. O'Shea is a senior research analyst at PHICOR, Graduate School of Public Health and Health Policy, City University of New York
| | - Patrick T Wedlock
- Patrick T. Wedlock is a senior research analyst at PHICOR, Graduate School of Public Health and Health Policy, City University of New York
| | - Sheryl S Siegmund
- Sheryl S. Siegmund is director of operations at PHICOR, Graduate School of Public Health and Health Policy, City University of New York
| | - Bruce Y Lee
- Bruce Y. Lee is a professor of health policy and management at the Graduate School of Public Health and Health Policy and executive director of PHICOR, both at the City University of New York
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16
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Development of a computational modeling laboratory for examining tobacco control policies: Tobacco Town. Health Place 2020; 61:102256. [PMID: 32329725 DOI: 10.1016/j.healthplace.2019.102256] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 09/24/2019] [Accepted: 11/15/2019] [Indexed: 11/20/2022]
Abstract
A key focus of recent policy efforts to curb tobacco product usage has been the role of place-specifically the density of retail and advertising and the resulting spatial pattern of access and exposure for consumers. Policies can alter the environment by reducing density or shifting distribution of tobacco retail and thus limiting access and exposure. Since little empirical evidence exists for the potential impact of these policies across potentially heterogeneous places, we develop and apply an original spatial computational model to simulate place-based retail tobacco control policies. The model is well-grounded in theory and available empirical evidence. We apply the model in four representative settings to demonstrate the utility of this approach as a policy laboratory, to develop general insights on the relationship between retailer density, retail interventions, and tobacco costs incurred by consumers, and to provide a framework to guide future modeling and empirical studies. Our results suggest that the potential impact on costs of reducing tobacco retailer density are highly dependent on context. Projected impacts are also influenced by assumptions made about agent (smoker) purchasing decision-making processes. In the absence of evidence in this area, we tested and compared three alternative decision rules; these interact with environmental properties to produce different results. Agent properties, namely income and cigarettes per day, also shape purchasing patterns before and after policy interventions. We conclude that agent-based modeling in general, and Tobacco Town specifically, hold much potential as a platform for testing and comparing the impact of various retail-based tobacco policies across different communities. Initial modeling efforts uncover important gaps in both data and theory and can provide guidance for new empirical studies in tobacco control.
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17
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Atkinson JA, Song YJC, Merikangas KR, Skinner A, Prodan A, Iorfino F, Freebairn L, Rose D, Ho N, Crouse J, Zipunnikov V, Hickie IB. The Science of Complex Systems Is Needed to Ameliorate the Impacts of COVID-19 on Mental Health. Front Psychiatry 2020; 11:606035. [PMID: 33324266 PMCID: PMC7724045 DOI: 10.3389/fpsyt.2020.606035] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 10/30/2020] [Indexed: 12/16/2022] Open
Affiliation(s)
- Jo-An Atkinson
- Youth Mental Health and Technology, Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia.,Computer Simulation and Advanced Research Technologies (CSART), Sydney, NSW, Australia
| | - Yun Ju Christine Song
- Youth Mental Health and Technology, Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
| | - Kathleen R Merikangas
- Intramural Research Program, National Institute of Mental Health, Bethesda, MD, United States
| | - Adam Skinner
- Youth Mental Health and Technology, Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
| | - Ante Prodan
- Youth Mental Health and Technology, Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia.,Computer Simulation and Advanced Research Technologies (CSART), Sydney, NSW, Australia.,School of Computer, Data and Mathematical Sciences, Western Sydney University, Penrith, NSW, Australia
| | - Frank Iorfino
- Youth Mental Health and Technology, Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
| | - Louise Freebairn
- Youth Mental Health and Technology, Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia.,The Australian Prevention Partnership Centre, Sydney, NSW, Australia
| | - Danya Rose
- Youth Mental Health and Technology, Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
| | - Nicholas Ho
- Youth Mental Health and Technology, Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
| | - Jacob Crouse
- Youth Mental Health and Technology, Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
| | - Vadim Zipunnikov
- Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Ian B Hickie
- Youth Mental Health and Technology, Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
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18
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McMorrow ML, Tempia S, Walaza S, Treurnicht FK, Ramkrishna W, Azziz-Baumgartner E, Madhi SA, Cohen C. Prioritization of risk groups for influenza vaccination in resource limited settings - A case study from South Africa. Vaccine 2019; 37:25-33. [PMID: 30471956 PMCID: PMC6470296 DOI: 10.1016/j.vaccine.2018.11.048] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 11/16/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND Due to competing health priorities, low- and middle-income countries (LMIC) may need to prioritize between different influenza vaccine risk groups. Risk group prioritization may differ in LMIC based upon programmatic feasibility, country-specific prevalence of risk conditions and influenza-associated morbidity and mortality. METHODS In South Africa, we collected local disease burden data (both published and unpublished) and published vaccine efficacy data in risk groups and healthy adults. We used these data to aid policy makers with risk group prioritization for influenza vaccination. We used the following formula to assess potential vaccine averted disease in each risk group: rate of influenza-associated hospitalization (or death) per 100,000 population * influenza vaccine efficacy (VE). We further estimated the cost per hospital day averted and the cost per year of life saved by influenza vaccination. RESULTS Pregnant women, HIV-infected adults, and adults and children with tuberculosis disease had among the highest estimates of hospitalizations averted per 100,000 vaccinated and adults aged 65 years and older had the highest estimated deaths averted per 100,000 vaccinated. However, when assessing both the cost per hospital day averted (range: USD148-1,344) and the cost per year of life saved (range: USD112-1,230); adults and children with TB disease, HIV-infected adults and pregnant women had the lowest cost per outcome averted. DISCUSSION An assessment of the potential disease outcomes averted and associated costs may aid policymakers in risk group prioritization for influenza vaccination.
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Affiliation(s)
- Meredith L McMorrow
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, United States; Influenza Program, Centers for Disease Control and Prevention, Pretoria, South Africa; U.S. Public Health Service, Rockville, MD, United States.
| | - Stefano Tempia
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, United States; Influenza Program, Centers for Disease Control and Prevention, Pretoria, South Africa; Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa.
| | - Sibongile Walaza
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa; School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Florette K Treurnicht
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
| | - Wayne Ramkrishna
- Communicable Disease Cluster, National Department of Health, South Africa
| | - Eduardo Azziz-Baumgartner
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, United States; U.S. Public Health Service, Rockville, MD, United States
| | - Shabir A Madhi
- Medical Research Council, Respiratory and Meningeal Pathogens Research Unit, University of the Witwatersrand, Johannesburg, South Africa; Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases, University of the Witwatersrand, Johannesburg, South Africa
| | - Cheryl Cohen
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa; School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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19
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Keyes KM, Rutherford C, Miech R. Historical trends in the grade of onset and sequence of cigarette, alcohol, and marijuana use among adolescents from 1976-2016: Implications for "Gateway" patterns in adolescence. Drug Alcohol Depend 2019; 194:51-58. [PMID: 30399500 PMCID: PMC6390293 DOI: 10.1016/j.drugalcdep.2018.09.015] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 09/15/2018] [Accepted: 09/21/2018] [Indexed: 10/28/2022]
Abstract
INTRODUCTION In the past decade, marijuana use prevalence among adolescents has remained relatively steady while cigarette and alcohol prevalence has declined. We examined historical trends in: average grade of onset of marijuana, alcohol, and cigarette use by 12th grade; proportion who try alcohol/cigarettes before first marijuana use, among those who use by 12th grade; and conditional probability of marijuana use by 12th grade after trying alcohol/cigarettes. METHODS Data were drawn from 40 yearly, cross-sectional surveys of 12th grade US adolescents. A subset of students (N = 246,050) were asked when they first used each substance. We reconstructed cohorts of substance use from grade-of-onset to determine sequence of drug use, as well as probability of marijuana use in the same or later grade. RESULTS Average grade of first alcohol and cigarette use by 12th grade increased across time; e.g., first cigarette increased from grade 7.9 in 1986 to 9.0 by 2016 (β=0.04, SE = 0.001, p < 0.01). The proportion of 12th grade adolescents who smoke cigarettes before marijuana fell below 50% in 2006. Each one-year increase was associated with 1.11 times increased odds of first cigarette in a grade after first marijuana (95% C.I. 1.11-1.12). Among those who initiate alcohol/cigarettes prior to marijuana by 12th grade, the probability of subsequent marijuana use is increasing. CONCLUSION Marijuana is increasingly the first substance in the sequence of adolescent drug use. Reducing adolescent smoking has been a remarkable achievement of the past 20 years; those who continue to smoke are at higher risk for progression to marijuana use.
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Affiliation(s)
- Katherine M. Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA,Center for Research on Society and Health, Universidad Mayor, Santiago, Chile
| | - Caroline Rutherford
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Richard Miech
- Institute for Social Research, University of Michigan, Ann Arbor, MI
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20
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Cannizzo S, Lorenzoni V, Palla I, Pirri S, Trieste L, Triulzi I, Turchetti G. Rare diseases under different levels of economic analysis: current activities, challenges and perspectives. RMD Open 2018; 4:e000794. [PMID: 30488003 PMCID: PMC6241967 DOI: 10.1136/rmdopen-2018-000794] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 10/08/2018] [Accepted: 10/08/2018] [Indexed: 01/08/2023] Open
Abstract
Rare diseases imply clinical and economic burden as well as a significant challenge for health systems. One relevant objective of the activities planned within the European Reference Network on Rare and Complex Connective Tissue and Musculoskeletal Diseases (ERN ReCONNET) is to address the economic dimensions of rare diseases to identify, develop and suggest strategies to improve research and patients' access to orphan drugs (ODs) and highly specialised health technologies. This paper presents a preliminary review of the existing policies on rare diseases in the countries of the Network members. It also introduces and discusses the theme of how to perform health economic evaluations of rare diseases and of existing or new treatments for rare diseases. To obtain a preliminary overview aiming at defining the state of the art of rare diseases policies and initiatives in ERN ReCONNET countries, we collected and analysed the rare diseases national plans of all the eight countries of the ERN ReCONNET participants. The preliminary overview that has been performed showed that in all the ERN ReCONNET countries are in place national plans for rare diseases; however, heterogeneity exists in the reimbursement of ODs, direct provision by the healthcare system, involvement of patients' associations in decision making and implementation of clinical practice guidelines.
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Affiliation(s)
- Sara Cannizzo
- Institute of Management, Scuola Superiore Sant’Anna, Pisa, Italy
| | | | - Ilaria Palla
- Institute of Management, Scuola Superiore Sant’Anna, Pisa, Italy
| | - Salvatore Pirri
- Institute of Management, Scuola Superiore Sant’Anna, Pisa, Italy
| | - Leopoldo Trieste
- Institute of Management, Scuola Superiore Sant’Anna, Pisa, Italy
| | - Isotta Triulzi
- Institute of Management, Scuola Superiore Sant’Anna, Pisa, Italy
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21
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Bartsch SM, Taitel MS, DePasse JV, Cox SN, Smith-Ray RL, Wedlock P, Singh TG, Carr S, Siegmund SS, Lee BY. Epidemiologic and economic impact of pharmacies as vaccination locations during an influenza epidemic. Vaccine 2018; 36:7054-7063. [PMID: 30340884 PMCID: PMC6279616 DOI: 10.1016/j.vaccine.2018.09.040] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Revised: 09/14/2018] [Accepted: 09/18/2018] [Indexed: 11/24/2022]
Abstract
Introduction: During an influenza epidemic, where early vaccination is crucial, pharmacies may be a resource to increase vaccine distribution reach and capacity. Methods: We utilized an agent-based model of the US and a clinical and economics outcomes model to simulate the impact of different influenza epidemics and the impact of utilizing pharmacies in addition to traditional (hospitals, clinic/physician offices, and urgent care centers) locations for vaccination for the year 2017. Results: For an epidemic with a reproductive rate (R0) of 1.30, adding pharmacies with typical business hours averted 11.9 million symptomatic influenza cases, 23,577 to 94,307 deaths, $1.0 billion in direct (vaccine administration and healthcare) costs, $4.2–44.4 billion in productivity losses, and $5.2–45.3 billion in overall costs (varying with mortality rate). Increasing the epidemic severity (R0 of 1.63), averted 16.0 million symptomatic influenza cases, 35,407 to 141,625 deaths, $1.9 billion in direct costs, $6.0–65.5 billion in productivity losses, and $7.8–67.3 billion in overall costs (varying with mortality rate). Extending pharmacy hours averted up to 16.5 million symptomatic influenza cases, 145,278 deaths, $1.9 billion direct costs, $4.1 billion in productivity loss, and $69.5 billion in overall costs. Adding pharmacies resulted in a cost-benefit of $4.1 to $11.5 billion, varying epidemic severity, mortality rate, pharmacy hours, location vaccination rate, and delay in the availability of the vaccine. Conclusions: Administering vaccines through pharmacies in addition to traditional locations in the event of an epidemic can increase vaccination coverage, mitigating up to 23.7 million symptomatic influenza cases, providing cost-savings up to $2.8 billion to third-party payers and $99.8 billion to society. Pharmacies should be considered as points of dispensing epidemic vaccines in addition to traditional settings as soon as vaccines become available.
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Affiliation(s)
- Sarah M Bartsch
- Public Health Computational and Operations Research (PHICOR), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States; Global Obesity Prevention Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Michael S Taitel
- Walgreens Center for Health & Wellbeing Research, Walgreens Company, Deerfield, IL, United States
| | - Jay V DePasse
- Pittsburgh Super Computing Center (PSC), Carnegie Mellon University, Pittsburgh, PA, United States
| | - Sarah N Cox
- Public Health Computational and Operations Research (PHICOR), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States; Global Obesity Prevention Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Renae L Smith-Ray
- Walgreens Center for Health & Wellbeing Research, Walgreens Company, Deerfield, IL, United States
| | - Patrick Wedlock
- Public Health Computational and Operations Research (PHICOR), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States; Global Obesity Prevention Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Tanya G Singh
- Walgreens Center for Health & Wellbeing Research, Walgreens Company, Deerfield, IL, United States
| | - Susan Carr
- Johns Hopkins Healthcare Solutions, Johns Hopkins University, Baltimore, MD, United States
| | - Sheryl S Siegmund
- Public Health Computational and Operations Research (PHICOR), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States; Global Obesity Prevention Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Bruce Y Lee
- Public Health Computational and Operations Research (PHICOR), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States; Global Obesity Prevention Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.
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22
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Nguyen VK, Mikolajczyk R, Hernandez-Vargas EA. High-resolution epidemic simulation using within-host infection and contact data. BMC Public Health 2018; 18:886. [PMID: 30016958 PMCID: PMC6050668 DOI: 10.1186/s12889-018-5709-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 06/14/2018] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Recent epidemics have entailed global discussions on revamping epidemic control and prevention approaches. A general consensus is that all sources of data should be embraced to improve epidemic preparedness. As a disease transmission is inherently governed by individual-level responses, pathogen dynamics within infected hosts posit high potentials to inform population-level phenomena. We propose a multiscale approach showing that individual dynamics were able to reproduce population-level observations. METHODS Using experimental data, we formulated mathematical models of pathogen infection dynamics from which we simulated mechanistically its transmission parameters. The models were then embedded in our implementation of an age-specific contact network that allows to express individual differences relevant to the transmission processes. This approach is illustrated with an example of Ebola virus (EBOV). RESULTS The results showed that a within-host infection model can reproduce EBOV's transmission parameters obtained from population data. At the same time, population age-structure, contact distribution and patterns can be expressed using network generating algorithm. This framework opens a vast opportunity to investigate individual roles of factors involved in the epidemic processes. Estimating EBOV's reproduction number revealed a heterogeneous pattern among age-groups, prompting cautions on estimates unadjusted for contact pattern. Assessments of mass vaccination strategies showed that vaccination conducted in a time window from five months before to one week after the start of an epidemic appeared to strongly reduce epidemic size. Noticeably, compared to a non-intervention scenario, a low critical vaccination coverage of 33% cannot ensure epidemic extinction but could reduce the number of cases by ten to hundred times as well as lessen the case-fatality rate. CONCLUSIONS Experimental data on the within-host infection have been able to capture upfront key transmission parameters of a pathogen; the applications of this approach will give us more time to prepare for potential epidemics. The population of interest in epidemic assessments could be modelled with an age-specific contact network without exhaustive amount of data. Further assessments and adaptations for different pathogens and scenarios to explore multilevel aspects in infectious diseases epidemics are underway.
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Affiliation(s)
- Van Kinh Nguyen
- Frankfurt Institute for Advanced Studies, Ruth-Moufang-Str. 1, Frankfurt am Main, 60438 Germany
- Helmholtz Centre for Infection Research, Inhoffen Str. 7, Braunschweig, 38124 Germany
| | - Rafael Mikolajczyk
- German Centre for Infection Research, Site Braunschweig-Hannover, Germany
- Hannover Medical School, Hannover, Germany
- Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Esteban Abelardo Hernandez-Vargas
- Frankfurt Institute for Advanced Studies, Ruth-Moufang-Str. 1, Frankfurt am Main, 60438 Germany
- Helmholtz Centre for Infection Research, Inhoffen Str. 7, Braunschweig, 38124 Germany
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23
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Padek M, Allen P, Erwin PC, Franco M, Hammond RA, Heuberger B, Kasman M, Luke DA, Mazzucca S, Moreland-Russell S, Brownson RC. Toward optimal implementation of cancer prevention and control programs in public health: a study protocol on mis-implementation. Implement Sci 2018; 13:49. [PMID: 29566717 PMCID: PMC5865376 DOI: 10.1186/s13012-018-0742-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Accepted: 03/13/2018] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Much of the cancer burden in the USA is preventable, through application of existing knowledge. State-level funders and public health practitioners are in ideal positions to affect programs and policies related to cancer control. Mis-implementation refers to ending effective programs and policies prematurely or continuing ineffective ones. Greater attention to mis-implementation should lead to use of effective interventions and more efficient expenditure of resources, which in the long term, will lead to more positive cancer outcomes. METHODS This is a three-phase study that takes a comprehensive approach, leading to the elucidation of tactics for addressing mis-implementation. Phase 1: We assess the extent to which mis-implementation is occurring among state cancer control programs in public health. This initial phase will involve a survey of 800 practitioners representing all states. The programs represented will span the full continuum of cancer control, from primary prevention to survivorship. Phase 2: Using data from phase 1 to identify organizations in which mis-implementation is particularly high or low, the team will conduct eight comparative case studies to get a richer understanding of mis-implementation and to understand contextual differences. These case studies will highlight lessons learned about mis-implementation and identify hypothesized drivers. Phase 3: Agent-based modeling will be used to identify dynamic interactions between individual capacity, organizational capacity, use of evidence, funding, and external factors driving mis-implementation. The team will then translate and disseminate findings from phases 1 to 3 to practitioners and practice-related stakeholders to support the reduction of mis-implementation. DISCUSSION This study is innovative and significant because it will (1) be the first to refine and further develop reliable and valid measures of mis-implementation of public health programs; (2) bring together a strong, transdisciplinary team with significant expertise in practice-based research; (3) use agent-based modeling to address cancer control implementation; and (4) use a participatory, evidence-based, stakeholder-driven approach that will identify key leverage points for addressing mis-implementation among state public health programs. This research is expected to provide replicable computational simulation models that can identify leverage points and public health system dynamics to reduce mis-implementation in cancer control and may be of interest to other health areas.
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Affiliation(s)
- Margaret Padek
- Prevention Research Center in St. Louis, Brown School at Washington University in St. Louis, 1 Brookings Drive, Campus Box 1196, St. Louis, MO 63130 USA
| | - Peg Allen
- Prevention Research Center in St. Louis, Brown School at Washington University in St. Louis, 1 Brookings Drive, Campus Box 1196, St. Louis, MO 63130 USA
| | - Paul C. Erwin
- Department of Public Health, University of Tennessee, Knoxville, TN USA
| | - Melissa Franco
- Prevention Research Center in St. Louis, Brown School at Washington University in St. Louis, 1 Brookings Drive, Campus Box 1196, St. Louis, MO 63130 USA
| | - Ross A. Hammond
- Center on Social Dynamics and Policy, The Brookings Institution, Washington DC, USA
| | - Benjamin Heuberger
- Center on Social Dynamics and Policy, The Brookings Institution, Washington DC, USA
| | - Matt Kasman
- Center on Social Dynamics and Policy, The Brookings Institution, Washington DC, USA
| | - Doug A. Luke
- Center for Public Health System Science, Brown School at Washington University in St Louis, St. Louis, MO USA
| | - Stephanie Mazzucca
- Prevention Research Center in St. Louis, Brown School at Washington University in St. Louis, 1 Brookings Drive, Campus Box 1196, St. Louis, MO 63130 USA
| | - Sarah Moreland-Russell
- Prevention Research Center in St. Louis, Brown School at Washington University in St. Louis, 1 Brookings Drive, Campus Box 1196, St. Louis, MO 63130 USA
| | - Ross C. Brownson
- Prevention Research Center in St. Louis, Brown School at Washington University in St. Louis, 1 Brookings Drive, Campus Box 1196, St. Louis, MO 63130 USA
- Department of Surgery (Division of Public Health Sciences) and Alvin J. Siteman Cancer Center, Washington University School of Medicine, Washington University in St. Louis, St. Louis, USA
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Lee BY, Ferguson MC, Hertenstein DL, Adam A, Zenkov E, Wang PI, Wong MS, Gittelsohn J, Mui Y, Brown ST. Simulating the Impact of Sugar-Sweetened Beverage Warning Labels in Three Cities. Am J Prev Med 2018; 54:197-204. [PMID: 29249555 PMCID: PMC5783749 DOI: 10.1016/j.amepre.2017.11.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 10/05/2017] [Accepted: 11/02/2017] [Indexed: 01/12/2023]
Abstract
INTRODUCTION A number of locations have been considering sugar-sweetened beverage point-of-purchase warning label policies to help address rising adolescent overweight and obesity prevalence. METHODS To explore the impact of such policies, in 2016 detailed agent-based models of Baltimore, Philadelphia, and San Francisco were developed, representing their populations, school locations, and food sources, using data from various sources collected between 2005 and 2014. The model simulated, over a 7-year period, the mean change in BMI and obesity prevalence in each of the cities from sugar-sweetened beverage warning label policies. RESULTS Data analysis conducted between 2016 and 2017 found that implementing sugar-sweetened beverage warning labels at all sugar-sweetened beverage retailers lowered obesity prevalence among adolescents in all three cities. Point-of-purchase labels with 8% efficacy (i.e., labels reducing probability of sugar-sweetened beverage consumption by 8%) resulted in the following percentage changes in obesity prevalence: Baltimore: -1.69% (95% CI= -2.75%, -0.97%, p<0.001); San Francisco: -4.08% (95% CI= -5.96%, -2.2%, p<0.001); Philadelphia: -2.17% (95% CI= -3.07%, -1.42%, p<0.001). CONCLUSIONS Agent-based simulations showed how warning labels may decrease overweight and obesity prevalence in a variety of circumstances with label efficacy and literacy rate identified as potential drivers. Implementing a warning label policy may lead to a reduction in obesity prevalence. Focusing on warning label design and store compliance, especially at supermarkets, may further increase the health impact.
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Affiliation(s)
- Bruce Y Lee
- Global Obesity Prevention Center (GOPC), Johns Hopkins University, Baltimore, Maryland; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
| | - Marie C Ferguson
- Global Obesity Prevention Center (GOPC), Johns Hopkins University, Baltimore, Maryland; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Daniel L Hertenstein
- Global Obesity Prevention Center (GOPC), Johns Hopkins University, Baltimore, Maryland; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Atif Adam
- Global Obesity Prevention Center (GOPC), Johns Hopkins University, Baltimore, Maryland; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Eli Zenkov
- Global Obesity Prevention Center (GOPC), Johns Hopkins University, Baltimore, Maryland; Pittsburgh Supercomputing Center, Carnegie Mellon University, Pittsburgh, Pennsylvania
| | - Peggy I Wang
- Global Obesity Prevention Center (GOPC), Johns Hopkins University, Baltimore, Maryland; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Michelle S Wong
- Global Obesity Prevention Center (GOPC), Johns Hopkins University, Baltimore, Maryland; Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Joel Gittelsohn
- Global Obesity Prevention Center (GOPC), Johns Hopkins University, Baltimore, Maryland; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Yeeli Mui
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Shawn T Brown
- Global Obesity Prevention Center (GOPC), Johns Hopkins University, Baltimore, Maryland; Pittsburgh Supercomputing Center, Carnegie Mellon University, Pittsburgh, Pennsylvania
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25
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Nau C, Kumanyika S, Gittelsohn J, Adam A, Wong MS, Mui Y, Lee BY. Identifying Financially Sustainable Pricing Interventions to Promote Healthier Beverage Purchases in Small Neighborhood Stores. Prev Chronic Dis 2018; 15:E12. [PMID: 29369758 PMCID: PMC5798217 DOI: 10.5888/pcd15.160611] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Introduction Residents of low-income communities often purchase sugar-sweetened beverages (SSBs) at small, neighborhood “corner” stores. Lowering water prices and increasing SSB prices are potentially complementary public health strategies to promote more healthful beverage purchasing patterns in these stores. Sustainability, however, depends on financial feasibility. Because in-store pricing experiments are complex and require retailers to take business risks, we used a simulation approach to identify profitable pricing combinations for corner stores. Methods The analytic approach was based on inventory models, which are suitable for modeling business operations. We used discrete-event simulation to build inventory models that use data representing beverage inventory, wholesale costs, changes in retail prices, and consumer demand for 2 corner stores in Baltimore, Maryland. Model outputs yielded ranges for water and SSB prices that increased water demand without loss of profit from combined water and SSB sales. Results A 20% SSB price increase allowed lowering water prices by up to 20% while maintaining profit and increased water demand by 9% and 14%, for stores selling SSBs in 12-oz cans and 16- to 20-oz bottles, respectively. Without changing water prices, profits could increase by 4% and 6%, respectively. Sensitivity analysis showed that stores with a higher volume of SSB sales could reduce water prices the most without loss of profit. Conclusion Various combinations of SSB and water prices could encourage water consumption while maintaining or increasing store owners’ profits. This model is a first step in designing and implementing profitable pricing strategies in collaboration with store owners.
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Affiliation(s)
- Claudia Nau
- Kaiser Permanente Southern California, Southern California Permanente Medical Group, Department for Research and Evaluation, Office 041R02, 100 S Los Robles, Pasadena CA 91101.
| | - Shiriki Kumanyika
- Department of Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.,Global Obesity Prevention Center, Johns Hopkins University, Baltimore, Maryland
| | - Joel Gittelsohn
- Global Obesity Prevention Center, Johns Hopkins University, Baltimore, Maryland.,Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Atif Adam
- Global Obesity Prevention Center, Johns Hopkins University, Baltimore, Maryland.,Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Michelle S Wong
- Global Obesity Prevention Center, Johns Hopkins University, Baltimore, Maryland.,Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Yeeli Mui
- Food Systems Planning and Healthy Communities Lab, University at Buffalo, State University of New York, Buffalo, New York
| | - Bruce Y Lee
- Global Obesity Prevention Center, Johns Hopkins University, Baltimore, Maryland.,Carey Business School, Johns Hopkins University, Baltimore, Maryland
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Abstract
Agent-based modeling is a computational approach in which agents with a specified set of characteristics interact with each other and with their environment according to predefined rules. We review key areas in public health where agent-based modeling has been adopted, including both communicable and noncommunicable disease, health behaviors, and social epidemiology. We also describe the main strengths and limitations of this approach for questions with public health relevance. Finally, we describe both methodologic and substantive future directions that we believe will enhance the value of agent-based modeling for public health. In particular, advances in model validation, comparisons with other causal modeling procedures, and the expansion of the models to consider comorbidity and joint influences more systematically will improve the utility of this approach to inform public health research, practice, and policy.
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Affiliation(s)
- Melissa Tracy
- Department of Epidemiology and Biostatistics, School of Public Health, University at Albany, State University of New York, Rensselaer, New York 12144, USA;
| | - Magdalena Cerdá
- Department of Emergency Medicine, University of California, Davis, Sacramento, California 95616, USA;
| | - Katherine M Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA;
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Cannizzo S, Lorenzoni V, Palla I, Pirri S, Trieste L, Triulzi I, Turchetti G. Rare diseases under different levels of economic analysis: current activities, challenges and perspectives. RMD Open 2018. [PMID: 30488003 DOI: 10.1136/rmdopen-2018-000794.pmid:30488003;pmcid:pmc6241967] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2023] Open
Abstract
Rare diseases imply clinical and economic burden as well as a significant challenge for health systems. One relevant objective of the activities planned within the European Reference Network on Rare and Complex Connective Tissue and Musculoskeletal Diseases (ERN ReCONNET) is to address the economic dimensions of rare diseases to identify, develop and suggest strategies to improve research and patients' access to orphan drugs (ODs) and highly specialised health technologies. This paper presents a preliminary review of the existing policies on rare diseases in the countries of the Network members. It also introduces and discusses the theme of how to perform health economic evaluations of rare diseases and of existing or new treatments for rare diseases. To obtain a preliminary overview aiming at defining the state of the art of rare diseases policies and initiatives in ERN ReCONNET countries, we collected and analysed the rare diseases national plans of all the eight countries of the ERN ReCONNET participants. The preliminary overview that has been performed showed that in all the ERN ReCONNET countries are in place national plans for rare diseases; however, heterogeneity exists in the reimbursement of ODs, direct provision by the healthcare system, involvement of patients' associations in decision making and implementation of clinical practice guidelines.
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Affiliation(s)
- Sara Cannizzo
- Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy
| | | | - Ilaria Palla
- Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Salvatore Pirri
- Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Leopoldo Trieste
- Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Isotta Triulzi
- Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy
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Smith TC. Medicine in the Antibiotic Apocalypse. JOURNAL OF MICROBIOLOGY & BIOLOGY EDUCATION 2017; 18:jmbe-18-70. [PMID: 29854061 PMCID: PMC5976057 DOI: 10.1128/jmbe.v18i3.1349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Accepted: 11/03/2017] [Indexed: 06/08/2023]
Affiliation(s)
- Tara C. Smith
- Corresponding author. Mailing address: Kent State University E-mail:
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Xu Z, Glass K, Lau CL, Geard N, Graves P, Clements A. A Synthetic Population for Modelling the Dynamics of Infectious Disease Transmission in American Samoa. Sci Rep 2017; 7:16725. [PMID: 29196679 PMCID: PMC5711879 DOI: 10.1038/s41598-017-17093-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Accepted: 11/20/2017] [Indexed: 11/09/2022] Open
Abstract
Agent-based modelling is a useful approach for capturing heterogeneity in disease transmission. In this study, a synthetic population was developed for American Samoa using an iterative approach based on population census, questionnaire survey and land use data. The population will be used as the basis for a new agent-based model, intended specifically to fill the knowledge gaps about lymphatic filariasis transmission and elimination, but also to be readily adaptable to model other infectious diseases. The synthetic population was characterized by the statistically realistic population and household structure, and high-resolution geographic locations of households. The population was simulated over 40 years from 2010 to 2050. The simulated population was compared to estimates and projections of the U.S. Census Bureau. The results showed the total population would continuously decrease due to the observed large number of emigrants. Population ageing was observed, which was consistent with the latest two population censuses and the Bureau's projections. The sex ratios by age groups were analysed and indicated an increase in the proportion of males in age groups 0-14 and 15-64. The household size followed a Gaussian distribution with an average size of around 5.0 throughout the simulation, slightly less than the initial average size 5.6.
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Affiliation(s)
- Zhijing Xu
- Research School of Population Health, Australian National University, Canberra, Australia.
| | - Kathryn Glass
- Research School of Population Health, Australian National University, Canberra, Australia
| | - Colleen L Lau
- Research School of Population Health, Australian National University, Canberra, Australia
| | - Nicholas Geard
- School of Computing and Information Systems, University of Melbourne, Melbourne, Australia.,Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Patricia Graves
- College of Public Health, Medical and Veterinary Sciences, Division of Tropical Health and Medicine, James Cook University, Cairns, Australia
| | - Archie Clements
- Research School of Population Health, Australian National University, Canberra, Australia
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30
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Willem L, Verelst F, Bilcke J, Hens N, Beutels P. Lessons from a decade of individual-based models for infectious disease transmission: a systematic review (2006-2015). BMC Infect Dis 2017; 17:612. [PMID: 28893198 PMCID: PMC5594572 DOI: 10.1186/s12879-017-2699-8] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Accepted: 08/22/2017] [Indexed: 02/18/2023] Open
Abstract
Background Individual-based models (IBMs) are useful to simulate events subject to stochasticity and/or heterogeneity, and have become well established to model the potential (re)emergence of pathogens (e.g., pandemic influenza, bioterrorism). Individual heterogeneity at the host and pathogen level is increasingly documented to influence transmission of endemic diseases and it is well understood that the final stages of elimination strategies for vaccine-preventable childhood diseases (e.g., polio, measles) are subject to stochasticity. Even so it appears IBMs for both these phenomena are not well established. We review a decade of IBM publications aiming to obtain insights in their advantages, pitfalls and rationale for use and to make recommendations facilitating knowledge transfer within and across disciplines. Methods We systematically identified publications in Web of Science and PubMed from 2006-2015 based on title/abstract/keywords screening (and full-text if necessary) to retrieve topics, modeling purposes and general specifications. We extracted detailed modeling features from papers on established vaccine-preventable childhood diseases based on full-text screening. Results We identified 698 papers, which applied an IBM for infectious disease transmission, and listed these in a reference database, describing their general characteristics. The diversity of disease-topics and overall publication frequency have increased over time (38 to 115 annual publications from 2006 to 2015). The inclusion of intervention strategies (8 to 52) and economic consequences (1 to 20) are increasing, to the detriment of purely theoretical explorations. Unfortunately, terminology used to describe IBMs is inconsistent and ambiguous. We retrieved 24 studies on a vaccine-preventable childhood disease (covering 7 different diseases), with publication frequency increasing from the first such study published in 2008. IBMs have been useful to explore heterogeneous between- and within-host interactions, but combined applications are still sparse. The amount of missing information on model characteristics and study design is remarkable. Conclusions IBMs are suited to combine heterogeneous within- and between-host interactions, which offers many opportunities, especially to analyze targeted interventions for endemic infections. We advocate the exchange of (open-source) platforms and stress the need for consistent “branding”. Using (existing) conventions and reporting protocols would stimulate cross-fertilization between research groups and fields, and ultimately policy making in decades to come. Electronic supplementary material The online version of this article (doi:10.1186/s12879-017-2699-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Lander Willem
- Centre for Health Economics Research & Modeling Infectious Diseases, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium.
| | - Frederik Verelst
- Centre for Health Economics Research & Modeling Infectious Diseases, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - Joke Bilcke
- Centre for Health Economics Research & Modeling Infectious Diseases, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - Niel Hens
- Centre for Health Economics Research & Modeling Infectious Diseases, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium.,Interuniversity Institute for Biostatistics and statistical Bioinformatics, UHasselt, Hasselt, Belgium
| | - Philippe Beutels
- Centre for Health Economics Research & Modeling Infectious Diseases, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium.,School of Public Health and Community Medicine, The University of New South Wales, Sydney, Australia
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Does cost-effectiveness of influenza vaccine choice vary across the U.S.? An agent-based modeling study. Vaccine 2017; 35:3974-3981. [PMID: 28606814 DOI: 10.1016/j.vaccine.2017.05.093] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Revised: 04/26/2017] [Accepted: 05/31/2017] [Indexed: 11/24/2022]
Abstract
BACKGROUND In a prior agent-based modeling study, offering a choice of influenza vaccine type was shown to be cost-effective when the simulated population represented the large, Washington DC metropolitan area. This study calculated the public health impact and cost-effectiveness of the same four strategies: No Choice, Pediatric Choice, Adult Choice, or Choice for Both Age Groups in five United States (U.S.) counties selected to represent extremes in population age distribution. METHODS The choice offered was either inactivated influenza vaccine delivered intramuscularly with a needle (IIV-IM) or an age-appropriate needle-sparing vaccine, specifically, the nasal spray (LAIV) or intradermal (IIV-ID) delivery system. Using agent-based modeling, individuals were simulated as they interacted with others, and influenza was tracked as it spread through each population. Influenza vaccination coverage derived from Centers for Disease Control and Prevention (CDC) data, was increased by 6.5% (range 3.25%-11.25%) to reflect the effects of vaccine choice. RESULTS Assuming moderate influenza infectivity, the number of averted cases was highest for the Choice for Both Age Groups in all five counties despite differing demographic profiles. In a cost-effectiveness analysis, Choice for Both Age Groups was the dominant strategy. Sensitivity analyses varying influenza infectivity, costs, and degrees of vaccine coverage increase due to choice, supported the base case findings. CONCLUSION Offering a choice to receive a needle-sparing influenza vaccine has the potential to significantly reduce influenza disease burden and to be cost saving. Consistent findings across diverse populations confirmed these findings.
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Epidemiological and economic impact of pandemic influenza in Chicago: Priorities for vaccine interventions. PLoS Comput Biol 2017; 13:e1005521. [PMID: 28570660 PMCID: PMC5453424 DOI: 10.1371/journal.pcbi.1005521] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Accepted: 04/14/2017] [Indexed: 11/19/2022] Open
Abstract
The study objective is to estimate the epidemiological and economic impact of vaccine interventions during influenza pandemics in Chicago, and assist in vaccine intervention priorities. Scenarios of delay in vaccine introduction with limited vaccine efficacy and limited supplies are not unlikely in future influenza pandemics, as in the 2009 H1N1 influenza pandemic. We simulated influenza pandemics in Chicago using agent-based transmission dynamic modeling. Population was distributed among high-risk and non-high risk among 0–19, 20–64 and 65+ years subpopulations. Different attack rate scenarios for catastrophic (30.15%), strong (21.96%), and moderate (11.73%) influenza pandemics were compared against vaccine intervention scenarios, at 40% coverage, 40% efficacy, and unit cost of $28.62. Sensitivity analysis for vaccine compliance, vaccine efficacy and vaccine start date was also conducted. Vaccine prioritization criteria include risk of death, total deaths, net benefits, and return on investment. The risk of death is the highest among the high-risk 65+ years subpopulation in the catastrophic influenza pandemic, and highest among the high-risk 0–19 years subpopulation in the strong and moderate influenza pandemics. The proportion of total deaths and net benefits are the highest among the high-risk 20–64 years subpopulation in the catastrophic, strong and moderate influenza pandemics. The return on investment is the highest in the high-risk 0–19 years subpopulation in the catastrophic, strong and moderate influenza pandemics. Based on risk of death and return on investment, high-risk groups of the three age group subpopulations can be prioritized for vaccination, and the vaccine interventions are cost saving for all age and risk groups. The attack rates among the children are higher than among the adults and seniors in the catastrophic, strong, and moderate influenza pandemic scenarios, due to their larger social contact network and homophilous interactions in school. Based on return on investment and higher attack rates among children, we recommend prioritizing children (0–19 years) and seniors (65+ years) after high-risk groups for influenza vaccination during times of limited vaccine supplies. Based on risk of death, we recommend prioritizing seniors (65+ years) after high-risk groups for influenza vaccination during times of limited vaccine supplies. The study objective is to estimate the epidemiological and economic impact of vaccine interventions during an influenza pandemic in Chicago, to assist in vaccine intervention priorities. Population dynamics play an important role in influenza pandemic planning and response. To optimally allocate limited vaccine resources, it is important to inform decision makers and public health officials about both the direct benefit among vaccinated population and the indirect benefit among non-vaccinated population. This study adds to the evidence of prior studies by using a detailed agent-based model for estimating the direct and indirect benefits of epidemiological and economic impact of vaccine-based interventions. This study can be extended to analyze for a range of vaccine compliance and efficacy values at different attack rates of influenza pandemics in different rural and urban areas of the United States and at the country level, to infer objective prioritization criteria for influenza vaccine interventions among different risk and age groups.
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DePasse JV, Smith KJ, Raviotta JM, Shim E, Nowalk MP, Zimmerman RK, Brown ST. Does Choice of Influenza Vaccine Type Change Disease Burden and Cost-Effectiveness in the United States? An Agent-Based Modeling Study. Am J Epidemiol 2017; 185:822-831. [PMID: 28402385 DOI: 10.1093/aje/kww229] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Accepted: 06/30/2016] [Indexed: 12/22/2022] Open
Abstract
Offering a choice of influenza vaccine type may increase vaccine coverage and reduce disease burden, but it is more costly. This study calculated the public health impact and cost-effectiveness of 4 strategies: no choice, pediatric choice, adult choice, or choice for both age groups. Using agent-based modeling, individuals were simulated as they interacted with others, and influenza was tracked as it spread through a population in Washington, DC. Influenza vaccination coverage derived from data from the Centers for Disease Control and Prevention was increased by 6.5% (range, 3.25%-11.25%), reflecting changes due to vaccine choice. With moderate influenza infectivity, the number of cases averaged 1,117,285 for no choice, 1,083,126 for pediatric choice, 1,009,026 for adult choice, and 975,818 for choice for both age groups. Averted cases increased with increased coverage and were highest for the choice-for-both-age-groups strategy; adult choice also reduced cases in children. In cost-effectiveness analysis, choice for both age groups was dominant when choice increased vaccine coverage by ≥3.25%. Offering a choice of influenza vaccines, with reasonable resultant increases in coverage, decreased influenza cases by >100,000 with a favorable cost-effectiveness profile. Clinical trials testing the predictions made based on these simulation results and deliberation of policies and procedures to facilitate choice should be considered.
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Dalgıç ÖO, Özaltın OY, Ciccotelli WA, Erenay FS. Deriving effective vaccine allocation strategies for pandemic influenza: Comparison of an agent-based simulation and a compartmental model. PLoS One 2017; 12:e0172261. [PMID: 28222123 PMCID: PMC5319753 DOI: 10.1371/journal.pone.0172261] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Accepted: 02/02/2017] [Indexed: 12/05/2022] Open
Abstract
Individuals are prioritized based on their risk profiles when allocating limited vaccine stocks during an influenza pandemic. Computationally expensive but realistic agent-based simulations and fast but stylized compartmental models are typically used to derive effective vaccine allocation strategies. A detailed comparison of these two approaches, however, is often omitted. We derive age-specific vaccine allocation strategies to mitigate a pandemic influenza outbreak in Seattle by applying derivative-free optimization to an agent-based simulation and also to a compartmental model. We compare the strategies derived by these two approaches under various infection aggressiveness and vaccine coverage scenarios. We observe that both approaches primarily vaccinate school children, however they may allocate the remaining vaccines in different ways. The vaccine allocation strategies derived by using the agent-based simulation are associated with up to 70% decrease in total cost and 34% reduction in the number of infections compared to the strategies derived by using the compartmental model. Nevertheless, the latter approach may still be competitive for very low and/or very high infection aggressiveness. Our results provide insights about potential differences between the vaccine allocation strategies derived by using agent-based simulations and those derived by using compartmental models.
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Affiliation(s)
- Özden O. Dalgıç
- Department of Management Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Osman Y. Özaltın
- Edward P. Fitts Department of Industrial and Systems Engineering, North Carolina State University, Raleigh, North Carolina, United States of America
| | - William A. Ciccotelli
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
- Grand River Hospital, Kitchener, Ontario, Canada
| | - Fatih S. Erenay
- Department of Management Sciences, University of Waterloo, Waterloo, Ontario, Canada
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Rachaniotis N, Dasaklis TK, Pappis C. Controlling infectious disease outbreaks: A deterministic allocation-scheduling model with multiple discrete resources. JOURNAL OF SYSTEMS SCIENCE AND SYSTEMS ENGINEERING 2017; 26:219-239. [PMID: 32288410 PMCID: PMC7104597 DOI: 10.1007/s11518-016-5327-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Infectious disease outbreaks occurred many times in the past and are more likely to happen in the future. In this paper the problem of allocating and scheduling limited multiple, identical or non-identical, resources employed in parallel, when there are several infected areas, is considered. A heuristic algorithm, based on Shih's (1974) and Pappis and Rachaniotis' (2010) algorithms, is proposed as the solution methodology. A numerical example implementing the proposed methodology in the context of a specific disease outbreak, namely influenza, is presented. The proposed methodology could be of significant value to those drafting contingency plans and healthcare policy agendas.
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Affiliation(s)
| | - Thomas K. Dasaklis
- Department of Industrial Management and Technology, University of Piraeus, Piraeus, Greece
| | - Costas Pappis
- Department of Industrial Management and Technology, University of Piraeus, Piraeus, Greece
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Ling MH, Wong SY, Tsui KL. Efficient heterogeneous sampling for stochastic simulation with an illustration in health care applications. COMMUN STAT-SIMUL C 2017. [DOI: 10.1080/03610918.2014.977914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- M. H. Ling
- Department of Mathematics and Information Technology, The Education University of Hong Kong, Tai Po, Hong Kong SAR, China
| | - S. Y. Wong
- Department of Systems Engineering and Engineering Management, City University of Hong Kong, Kowloon Tong, Hong Kong SAR, China
- Center for Clinical Epidemiology, Graduate School of Public Health Planning Office, St. Luke's International University, Tokyo, Japan
| | - K. L. Tsui
- Department of Systems Engineering and Engineering Management, City University of Hong Kong, Kowloon Tong, Hong Kong SAR, China
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Probert WJM, Shea K, Fonnesbeck CJ, Runge MC, Carpenter TE, Dürr S, Garner MG, Harvey N, Stevenson MA, Webb CT, Werkman M, Tildesley MJ, Ferrari MJ. Decision-making for foot-and-mouth disease control: Objectives matter. Epidemics 2015; 15:10-9. [PMID: 27266845 DOI: 10.1016/j.epidem.2015.11.002] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Revised: 11/03/2015] [Accepted: 11/25/2015] [Indexed: 11/18/2022] Open
Abstract
Formal decision-analytic methods can be used to frame disease control problems, the first step of which is to define a clear and specific objective. We demonstrate the imperative of framing clearly-defined management objectives in finding optimal control actions for control of disease outbreaks. We illustrate an analysis that can be applied rapidly at the start of an outbreak when there are multiple stakeholders involved with potentially multiple objectives, and when there are also multiple disease models upon which to compare control actions. The output of our analysis frames subsequent discourse between policy-makers, modellers and other stakeholders, by highlighting areas of discord among different management objectives and also among different models used in the analysis. We illustrate this approach in the context of a hypothetical foot-and-mouth disease (FMD) outbreak in Cumbria, UK using outputs from five rigorously-studied simulation models of FMD spread. We present both relative rankings and relative performance of controls within each model and across a range of objectives. Results illustrate how control actions change across both the base metric used to measure management success and across the statistic used to rank control actions according to said metric. This work represents a first step towards reconciling the extensive modelling work on disease control problems with frameworks for structured decision making.
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Affiliation(s)
- William J M Probert
- Center for Infectious Disease Dynamics, Department of Biology, Eberly College of Science, The Pennsylvania State University, University Park, PA, United States; Department of Biology and Intercollege Graduate Degree Program in Ecology, 208 Mueller Laboratory, The Pennsylvania State University, University Park, PA, United States; School of Veterinary Medicine and Science, University of Nottingham, Leicestershire LE12 5RD, United Kingdom.
| | - Katriona Shea
- Center for Infectious Disease Dynamics, Department of Biology, Eberly College of Science, The Pennsylvania State University, University Park, PA, United States; Department of Biology and Intercollege Graduate Degree Program in Ecology, 208 Mueller Laboratory, The Pennsylvania State University, University Park, PA, United States
| | | | - Michael C Runge
- US Geological Survey, Patuxent Wildlife Research Center, 12100 Beech Forest Rd, Laurel, MD, United States
| | - Tim E Carpenter
- EpiCentre, Institute of Veterinary, Animal and Biomedical Sciences, Massey University, Palmerston North, New Zealand
| | - Salome Dürr
- Veterinary Public Health Institute, University of Bern, Bern, Switzerland
| | - M Graeme Garner
- Animal Health Policy Branch, Australian Government, Department of Agriculture, GPO Box 858, Canberra 2601, ACT, Australia
| | - Neil Harvey
- Department of Computing and Information Science, University of Guelph, Guelph, ON, Canada N1G 2W1
| | - Mark A Stevenson
- Faculty of Veterinary Science, University of Melbourne, Melbourne, VIC, Australia
| | - Colleen T Webb
- Department of Biology, Colorado State University, Fort Collins, CO, United States
| | - Marleen Werkman
- Central Veterinary Institute, Wageningen University and Research Centre, Houtribweg 39, 8221 RA Lelystad, The Netherlands; School of Veterinary Medicine and Science, University of Nottingham, Leicestershire LE12 5RD, United Kingdom
| | - Michael J Tildesley
- School of Veterinary Medicine and Science, University of Nottingham, Leicestershire LE12 5RD, United Kingdom
| | - Matthew J Ferrari
- Center for Infectious Disease Dynamics, Department of Biology, Eberly College of Science, The Pennsylvania State University, University Park, PA, United States
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Burke JG, Lich KH, Neal JW, Meissner HI, Yonas M, Mabry PL. Enhancing dissemination and implementation research using systems science methods. Int J Behav Med 2015; 22:283-91. [PMID: 24852184 DOI: 10.1007/s12529-014-9417-3] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Dissemination and implementation (D&I) research seeks to understand and overcome barriers to adoption of behavioral interventions that address complex problems, specifically interventions that arise from multiple interacting influences crossing socio-ecological levels. It is often difficult for research to accurately represent and address the complexities of the real world, and traditional methodological approaches are generally inadequate for this task. Systems science methods, expressly designed to study complex systems, can be effectively employed for an improved understanding about dissemination and implementation of evidence-based interventions. PURPOSE The aims of this study were to understand the complex factors influencing successful D&I of programs in community settings and to identify D&I challenges imposed by system complexity. METHOD Case examples of three systems science methods-system dynamics modeling, agent-based modeling, and network analysis-are used to illustrate how each method can be used to address D&I challenges. RESULTS The case studies feature relevant behavioral topical areas: chronic disease prevention, community violence prevention, and educational intervention. To emphasize consistency with D&I priorities, the discussion of the value of each method is framed around the elements of the established Reach Effectiveness Adoption Implementation Maintenance (RE-AIM) framework. CONCLUSION Systems science methods can help researchers, public health decision makers, and program implementers to understand the complex factors influencing successful D&I of programs in community settings and to identify D&I challenges imposed by system complexity.
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Pawelek KA, Salmeron C, Del Valle S. Connecting within and between-hosts dynamics in the influenza infection-staged epidemiological models with behavior change. ACTA ACUST UNITED AC 2015; 3:233-243. [PMID: 29075652 DOI: 10.1166/jcsmd.2015.1082] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Influenza viruses are a major public health problem worldwide. Although influenza has been extensively researched, there are still many aspects that are not fully understood such as the effects of within and between-hosts dynamics and their impact on behavior change. Here, we develop mathematical models with multiple infection stages and estimate parameters based on within-host data to investigate the impact of behavior change on influenza dynamics. We divide the infected population into three and four groups based on the age of the infection, which corresponds to viral load shedding. We consider within-host data on viral shedding to estimate the length and force of infection of the different infectivity stages. Our results show that behavior changes, due to exogenous events (e.g., media coverage) and disease symptoms, are effective in delaying and lowering an epidemic peak. We show that the dynamics of viral shedding and symptoms, during the infection, are key features when considering epidemic prevention strategies. This study improves our understanding of the spread of influenza virus infection in the population and provides information about the impact of emergent behavior and its connection to the within and between-hosts dynamics.
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Affiliation(s)
- Kasia A Pawelek
- Department of Mathematics and Computational Science, University of South Carolina Beaufort, Bluffton, SC 29909, USA
| | - Cristian Salmeron
- Department of Mathematics and Computational Science, University of South Carolina Beaufort, Bluffton, SC 29909, USA
| | - Sara Del Valle
- Department of Mathematics and Computational Science, University of South Carolina Beaufort, Bluffton, SC 29909, USA
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Hickmann KS, Fairchild G, Priedhorsky R, Generous N, Hyman JM, Deshpande A, Del Valle SY. Forecasting the 2013-2014 influenza season using Wikipedia. PLoS Comput Biol 2015; 11:e1004239. [PMID: 25974758 PMCID: PMC4431683 DOI: 10.1371/journal.pcbi.1004239] [Citation(s) in RCA: 106] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Accepted: 03/13/2015] [Indexed: 11/18/2022] Open
Abstract
Infectious diseases are one of the leading causes of morbidity and mortality around the world; thus, forecasting their impact is crucial for planning an effective response strategy. According to the Centers for Disease Control and Prevention (CDC), seasonal influenza affects 5% to 20% of the U.S. population and causes major economic impacts resulting from hospitalization and absenteeism. Understanding influenza dynamics and forecasting its impact is fundamental for developing prevention and mitigation strategies. We combine modern data assimilation methods with Wikipedia access logs and CDC influenza-like illness (ILI) reports to create a weekly forecast for seasonal influenza. The methods are applied to the 2013-2014 influenza season but are sufficiently general to forecast any disease outbreak, given incidence or case count data. We adjust the initialization and parametrization of a disease model and show that this allows us to determine systematic model bias. In addition, we provide a way to determine where the model diverges from observation and evaluate forecast accuracy. Wikipedia article access logs are shown to be highly correlated with historical ILI records and allow for accurate prediction of ILI data several weeks before it becomes available. The results show that prior to the peak of the flu season, our forecasting method produced 50% and 95% credible intervals for the 2013-2014 ILI observations that contained the actual observations for most weeks in the forecast. However, since our model does not account for re-infection or multiple strains of influenza, the tail of the epidemic is not predicted well after the peak of flu season has passed.
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Affiliation(s)
- Kyle S. Hickmann
- Theoretical Division Los Alamos National Laboratory, Los Alamos, New Mexico, United States of America
- * E-mail:
| | - Geoffrey Fairchild
- Defense Systems Analysis Division Los Alamos National Laboratory, Los Alamos, New Mexico, United States of America
| | - Reid Priedhorsky
- High Performance Computing Division Los Alamos National Laboratory, Los Alamos, New Mexico, United States of America
| | - Nicholas Generous
- Defense Systems Analysis Division Los Alamos National Laboratory, Los Alamos, New Mexico, United States of America
| | - James M. Hyman
- Department of Mathematics, Tulane University, New Orleans, Louisiana, United States of America
| | - Alina Deshpande
- Defense Systems Analysis Division Los Alamos National Laboratory, Los Alamos, New Mexico, United States of America
| | - Sara Y. Del Valle
- Defense Systems Analysis Division Los Alamos National Laboratory, Los Alamos, New Mexico, United States of America
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Ruan J, Shi P, Lim CC, Wang X. Relief supplies allocation and optimization by interval and fuzzy number approaches. Inf Sci (N Y) 2015. [DOI: 10.1016/j.ins.2015.01.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Abstract
BACKGROUND Influenza vaccination is administered throughout the influenza disease season, even as late as March. Given such timing, what is the value of vaccinating the population earlier than currently being practiced? METHODS We used real data on when individuals were vaccinated in Allegheny County, Pennsylvania, and the following 2 models to determine the value of vaccinating individuals earlier (by the end of September, October, and November): Framework for Reconstructing Epidemiological Dynamics (FRED), an agent-based model (ABM), and FluEcon, our influenza economic model that translates cases from the ABM to outcomes and costs [health care and lost productivity costs and quality-adjusted life-years (QALYs)]. We varied the reproductive number (R0) from 1.2 to 1.6. RESULTS Applying the current timing of vaccinations averted 223,761 influenza cases, $16.3 million in direct health care costs, $50.0 million in productivity losses, and 804 in QALYs, compared with no vaccination (February peak, R0 1.2). When the population does not have preexisting immunity and the influenza season peaks in February (R0 1.2-1.6), moving individuals who currently received the vaccine after September to the end of September could avert an additional 9634-17,794 influenza cases, $0.6-$1.4 million in direct costs, $2.1-$4.0 million in productivity losses, and 35-64 QALYs. Moving the vaccination of just children to September (R0 1.2-1.6) averted 11,366-1660 influenza cases, $0.6-$0.03 million in direct costs, $2.3-$0.2 million in productivity losses, and 42-8 QALYs. Moving the season peak to December increased these benefits, whereas increasing preexisting immunity reduced these benefits. CONCLUSION Even though many people are vaccinated well after September/October, they likely are still vaccinated early enough to provide substantial cost-savings.
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Multi-scale modeling for the transmission of influenza and the evaluation of interventions toward it. Sci Rep 2015; 5:8980. [PMID: 25757402 PMCID: PMC4355742 DOI: 10.1038/srep08980] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Accepted: 02/13/2015] [Indexed: 12/22/2022] Open
Abstract
Mathematical modeling of influenza epidemic is important for analyzing the main cause of the epidemic and finding effective interventions towards it. The epidemic is a dynamic process. In this process, daily infections are caused by people's contacts, and the frequency of contacts can be mainly influenced by their cognition to the disease. The cognition is in turn influenced by daily illness attack rate, climate, and other environment factors. Few existing methods considered the dynamic process in their models. Therefore, their prediction results can hardly be explained by the mechanisms of epidemic spreading. In this paper, we developed a heterogeneous graph modeling approach (HGM) to describe the dynamic process of influenza virus transmission by taking advantage of our unique clinical data. We built social network of studied region and embedded an Agent-Based Model (ABM) in the HGM to describe the dynamic change of an epidemic. Our simulations have a good agreement with clinical data. Parameter sensitivity analysis showed that temperature influences the dynamic of epidemic significantly and system behavior analysis showed social network degree is a critical factor determining the size of an epidemic. Finally, multiple scenarios for vaccination and school closure strategies were simulated and their performance was analyzed.
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Responding to vaccine safety signals during pandemic influenza: a modeling study. PLoS One 2014; 9:e115553. [PMID: 25536228 PMCID: PMC4275236 DOI: 10.1371/journal.pone.0115553] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Accepted: 11/25/2014] [Indexed: 01/04/2023] Open
Abstract
Background Managing emerging vaccine safety signals during an influenza pandemic is challenging. Federal regulators must balance vaccine risks against benefits while maintaining public confidence in the public health system. Methods We developed a multi-criteria decision analysis model to explore regulatory decision-making in the context of emerging vaccine safety signals during a pandemic. We simulated vaccine safety surveillance system capabilities and used an age-structured compartmental model to develop potential pandemic scenarios. We used an expert-derived multi-attribute utility function to evaluate potential regulatory responses by combining four outcome measures into a single measure of interest: 1) expected vaccination benefit from averted influenza; 2) expected vaccination risk from vaccine-associated febrile seizures; 3) expected vaccination risk from vaccine-associated Guillain-Barre Syndrome; and 4) expected change in vaccine-seeking behavior in future influenza seasons. Results Over multiple scenarios, risk communication, with or without suspension of vaccination of high-risk persons, were the consistently preferred regulatory responses over no action or general suspension when safety signals were detected during a pandemic influenza. On average, the expert panel valued near-term vaccine-related outcomes relative to long-term projected outcomes by 3∶1. However, when decision-makers had minimal ability to influence near-term outcomes, the response was selected primarily by projected impacts on future vaccine-seeking behavior. Conclusions The selected regulatory response depends on how quickly a vaccine safety signal is identified relative to the peak of the pandemic and the initiation of vaccination. Our analysis suggested two areas for future investment: efforts to improve the size and timeliness of the surveillance system and behavioral research to understand changes in vaccine-seeking behavior.
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Lukens S, DePasse J, Rosenfeld R, Ghedin E, Mochan E, Brown ST, Grefenstette J, Burke DS, Swigon D, Clermont G. A large-scale immuno-epidemiological simulation of influenza A epidemics. BMC Public Health 2014; 14:1019. [PMID: 25266818 PMCID: PMC4194421 DOI: 10.1186/1471-2458-14-1019] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Accepted: 09/18/2014] [Indexed: 01/02/2023] Open
Abstract
Background Agent based models (ABM) are useful to explore population-level scenarios of disease spread and containment, but typically characterize infected individuals using simplified models of infection and symptoms dynamics. Adding more realistic models of individual infections and symptoms may help to create more realistic population level epidemic dynamics. Methods Using an equation-based, host-level mathematical model of influenza A virus infection, we develop a function that expresses the dependence of infectivity and symptoms of an infected individual on initial viral load, age, and viral strain phenotype. We incorporate this response function in a population-scale agent-based model of influenza A epidemic to create a hybrid multiscale modeling framework that reflects both population dynamics and individualized host response to infection. Results At the host level, we estimate parameter ranges using experimental data of H1N1 viral titers and symptoms measured in humans. By linearization of symptoms responses of the host-level model we obtain a map of the parameters of the model that characterizes clinical phenotypes of influenza infection and immune response variability over the population. At the population-level model, we analyze the effect of individualizing viral response in agent-based model by simulating epidemics across Allegheny County, Pennsylvania under both age-specific and age-independent severity assumptions. Conclusions We present a framework for multi-scale simulations of influenza epidemics that enables the study of population-level effects of individual differences in infections and symptoms, with minimal additional computational cost compared to the existing population-level simulations. Electronic supplementary material The online version of this article (doi:10.1186/1471-2458-14-1019) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sarah Lukens
- Department of Mathematics, University of Pittsburgh, Pittsburgh, PA, USA.
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Zhang WD, Zu ZH, Xu Q, Xu ZJ, Liu JJ, Zheng T. Optimized strategy for the control and prevention of newly emerging influenza revealed by the spread dynamics model. PLoS One 2014; 9:e84694. [PMID: 24392151 PMCID: PMC3879330 DOI: 10.1371/journal.pone.0084694] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Accepted: 11/26/2013] [Indexed: 11/18/2022] Open
Abstract
No matching vaccine is immediately available when a novel influenza strain breaks out. Several nonvaccine-related strategies must be employed to control an influenza epidemic, including antiviral treatment, patient isolation, and immigration detection. This paper presents the development and application of two regional dynamic models of influenza with Pontryagin's Maximum Principle to determine the optimal control strategies for an epidemic and the corresponding minimum antiviral stockpiles. Antiviral treatment was found to be the most effective measure to control new influenza outbreaks. In the case of inadequate antiviral resources, the preferred approach was the centralized use of antiviral resources in the early stage of the epidemic. Immigration detection was the least cost-effective; however, when used in combination with the other measures, it may play a larger role. The reasonable mix of the three control measures could reduce the number of clinical cases substantially, to achieve the optimal control of new influenza.
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Affiliation(s)
- Wen-Dou Zhang
- Center for Biosecurity Strategy Management, Beijing Institute of Biotechnology, Beijing, China
| | - Zheng-Hu Zu
- Center for Biosecurity Strategy Management, Beijing Institute of Biotechnology, Beijing, China
| | - Qing Xu
- Center for Biosecurity Strategy Management, Beijing Institute of Biotechnology, Beijing, China
| | - Zhi-Jing Xu
- Center for Biosecurity Strategy Management, Beijing Institute of Biotechnology, Beijing, China
| | - Jin-Jie Liu
- Center for Biosecurity Strategy Management, Beijing Institute of Biotechnology, Beijing, China
| | - Tao Zheng
- Center for Biosecurity Strategy Management, Beijing Institute of Biotechnology, Beijing, China
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Wagner MM, Levander JD, Brown S, Hogan WR, Millett N, Hanna J. Apollo: giving application developers a single point of access to public health models using structured vocabularies and Web services. AMIA ... ANNUAL SYMPOSIUM PROCEEDINGS. AMIA SYMPOSIUM 2013; 2013:1415-1424. [PMID: 24551417 PMCID: PMC3900155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This paper describes the Apollo Web Services and Apollo-SV, its related ontology. The Apollo Web Services give an end-user application a single point of access to multiple epidemic simulators. An end user can specify an analytic problem-which we define as a configuration and a query of results-exactly once and submit it to multiple epidemic simulators. The end user represents the analytic problem using a standard syntax and vocabulary, not the native languages of the simulators. We have demonstrated the feasibility of this design by implementing a set of Apollo services that provide access to two epidemic simulators and two visualizer services.
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Affiliation(s)
- Michael M Wagner
- Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, PA
| | - John D Levander
- Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, PA
| | - Shawn Brown
- Pittsburgh Supercomputing Center, Carnegie Mellon University, Pittsburgh, PA
| | - William R Hogan
- Division of Biomedical Informatics, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Nicholas Millett
- Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, PA
| | - Josh Hanna
- Division of Biomedical Informatics, University of Arkansas for Medical Sciences, Little Rock, AR
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Lee B, Haidari L, Lee M. Modelling during an emergency: the 2009 H1N1 influenza pandemic. Clin Microbiol Infect 2013; 19:1014-22. [DOI: 10.1111/1469-0691.12284] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Grefenstette JJ, Brown ST, Rosenfeld R, DePasse J, Stone NTB, Cooley PC, Wheaton WD, Fyshe A, Galloway DD, Sriram A, Guclu H, Abraham T, Burke DS. FRED (a Framework for Reconstructing Epidemic Dynamics): an open-source software system for modeling infectious diseases and control strategies using census-based populations. BMC Public Health 2013; 13:940. [PMID: 24103508 PMCID: PMC3852955 DOI: 10.1186/1471-2458-13-940] [Citation(s) in RCA: 96] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2013] [Accepted: 09/25/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mathematical and computational models provide valuable tools that help public health planners to evaluate competing health interventions, especially for novel circumstances that cannot be examined through observational or controlled studies, such as pandemic influenza. The spread of diseases like influenza depends on the mixing patterns within the population, and these mixing patterns depend in part on local factors including the spatial distribution and age structure of the population, the distribution of size and composition of households, employment status and commuting patterns of adults, and the size and age structure of schools. Finally, public health planners must take into account the health behavior patterns of the population, patterns that often vary according to socioeconomic factors such as race, household income, and education levels. RESULTS FRED (a Framework for Reconstructing Epidemic Dynamics) is a freely available open-source agent-based modeling system based closely on models used in previously published studies of pandemic influenza. This version of FRED uses open-access census-based synthetic populations that capture the demographic and geographic heterogeneities of the population, including realistic household, school, and workplace social networks. FRED epidemic models are currently available for every state and county in the United States, and for selected international locations. CONCLUSIONS State and county public health planners can use FRED to explore the effects of possible influenza epidemics in specific geographic regions of interest and to help evaluate the effect of interventions such as vaccination programs and school closure policies. FRED is available under a free open source license in order to contribute to the development of better modeling tools and to encourage open discussion of modeling tools being used to evaluate public health policies. We also welcome participation by other researchers in the further development of FRED.
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Affiliation(s)
- John J Grefenstette
- Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
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Yonas MA, Burke JG, Brown ST, Borrebach JD, Garland R, Burke DS, Grefenstette JJ. Dynamic simulation of crime perpetration and reporting to examine community intervention strategies. HEALTH EDUCATION & BEHAVIOR 2013; 40:87S-97S. [PMID: 24084404 PMCID: PMC3964320 DOI: 10.1177/1090198113493090] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To develop a conceptual computational agent-based model (ABM) to explore community-wide versus spatially focused crime reporting interventions to reduce community crime perpetrated by youth. METHOD Agents within the model represent individual residents and interact on a two-dimensional grid representing an abstract nonempirically grounded community setting. Juvenile agents are assigned initial random probabilities of perpetrating a crime and adults are assigned random probabilities of witnessing and reporting crimes. The agents' behavioral probabilities modify depending on the individual's experience with criminal behavior and punishment, and exposure to community crime interventions. Cost-effectiveness analyses assessed the impact of activating different percentages of adults to increase reporting and reduce community crime activity. Community-wide interventions were compared with spatially focused interventions, in which activated adults were focused in areas of highest crime prevalence. RESULTS The ABM suggests that both community-wide and spatially focused interventions can be effective in reducing overall offenses, but their relative effectiveness may depend on the intensity and cost of the interventions. Although spatially focused intervention yielded localized reductions in crimes, such interventions were shown to move crime to nearby communities. Community-wide interventions can achieve larger reductions in overall community crime offenses than spatially focused interventions, as long as sufficient resources are available. CONCLUSION The ABM demonstrates that community-wide and spatially focused crime strategies produce unique intervention dynamics influencing juvenile crime behaviors through the decisions and actions of community adults. It shows how such models might be used to investigate community-supported crime intervention programs by integrating community input and expertise and provides a simulated setting for assessing dimensions of cost comparison and intervention effect sustainability. ABM illustrates how intervention models might be used to investigate community-supported crime intervention programs.
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Affiliation(s)
- Michael A. Yonas
- Allegheny County Department of Human Services, Pittsburgh, PA, USA
| | - Jessica G. Burke
- Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | | | | | - Richard Garland
- Allegheny County Department of Human Services, Pittsburgh, PA, USA
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