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Fuller NM, McQuaid CF, Harker MJ, Weerasuriya CK, McHugh TD, Knight GM. Mathematical models of drug-resistant tuberculosis lack bacterial heterogeneity: A systematic review. PLoS Pathog 2024; 20:e1011574. [PMID: 38598556 PMCID: PMC11060536 DOI: 10.1371/journal.ppat.1011574] [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: 07/25/2023] [Revised: 04/30/2024] [Accepted: 03/25/2024] [Indexed: 04/12/2024] Open
Abstract
Drug-resistant tuberculosis (DR-TB) threatens progress in the control of TB. Mathematical models are increasingly being used to guide public health decisions on managing both antimicrobial resistance (AMR) and TB. It is important to consider bacterial heterogeneity in models as it can have consequences for predictions of resistance prevalence, which may affect decision-making. We conducted a systematic review of published mathematical models to determine the modelling landscape and to explore methods for including bacterial heterogeneity. Our first objective was to identify and analyse the general characteristics of mathematical models of DR-mycobacteria, including M. tuberculosis. The second objective was to analyse methods of including bacterial heterogeneity in these models. We had different definitions of heterogeneity depending on the model level. For between-host models of mycobacterium, heterogeneity was defined as any model where bacteria of the same resistance level were further differentiated. For bacterial population models, heterogeneity was defined as having multiple distinct resistant populations. The search was conducted following PRISMA guidelines in five databases, with studies included if they were mechanistic or simulation models of DR-mycobacteria. We identified 195 studies modelling DR-mycobacteria, with most being dynamic transmission models of non-treatment intervention impact in M. tuberculosis (n = 58). Studies were set in a limited number of specific countries, and 44% of models (n = 85) included only a single level of "multidrug-resistance (MDR)". Only 23 models (8 between-host) included any bacterial heterogeneity. Most of these also captured multiple antibiotic-resistant classes (n = 17), but six models included heterogeneity in bacterial populations resistant to a single antibiotic. Heterogeneity was usually represented by different fitness values for bacteria resistant to the same antibiotic (61%, n = 14). A large and growing body of mathematical models of DR-mycobacterium is being used to explore intervention impact to support policy as well as theoretical explorations of resistance dynamics. However, the majority lack bacterial heterogeneity, suggesting that important evolutionary effects may be missed.
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Affiliation(s)
- Naomi M. Fuller
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Antimicrobial Resistance Centre, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Tuberculosis Centre, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Christopher F. McQuaid
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Antimicrobial Resistance Centre, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Tuberculosis Centre, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Martin J. Harker
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Antimicrobial Resistance Centre, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Tuberculosis Centre, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Chathika K. Weerasuriya
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Antimicrobial Resistance Centre, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Tuberculosis Centre, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Timothy D. McHugh
- UCL Centre for Clinical Microbiology, Division of Infection & Immunity, Royal Free Campus, University College London, London, United Kingdom
| | - Gwenan M. Knight
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Antimicrobial Resistance Centre, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Tuberculosis Centre, London School of Hygiene and Tropical Medicine, London, United Kingdom
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Picetti R, Juel R, Milner J, Bonell A, Karakas F, Dangour AD, Yeung S, Wilkinson P, Hughes R. Effects on child and adolescent health of climate change mitigation policies: A systematic review of modelling studies. ENVIRONMENTAL RESEARCH 2023; 238:117102. [PMID: 37689334 DOI: 10.1016/j.envres.2023.117102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 07/30/2023] [Accepted: 09/06/2023] [Indexed: 09/11/2023]
Abstract
There is a growing body of modelling evidence that demonstrates the potential for immediate and substantial benefits to adult health from greenhouse gas mitigation actions, but the effects on the health of younger age groups is largely unknown. We conducted a systematic review to identify the available published evidence of the modelled effects on child and adolescent health (≤18 years of age) of greenhouse gas mitigation. We searched six databases of peer-reviewed studies published between January 1, 1990 and July 27, 2022, screened 27,282 original papers and included 23 eligible papers. All included studies were set in high- and middle-income countries; and all studies modelled the effects of interventions that could mitigate greenhouse gas emissions and improve air quality. Most of the available evidence suggests positive benefits for child and adolescent respiratory health from greenhouse gas mitigation actions that simultaneously reduce air pollution (specifically PM2.5 and nitrogen dioxide). We found scant evidence on child and adolescent health from regions more vulnerable to climate change, or on mitigation interventions that could affect exposures other than air pollution.
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Affiliation(s)
- Roberto Picetti
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, UK; Department of Population Health, London School of Hygiene & Tropical Medicine, London, UK.
| | - Rachel Juel
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, UK; Department of Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - James Milner
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, UK; Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Ana Bonell
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, UK; Centre for Maternal Adolescent Reproductive & Child Health (MARCH), London School of Hygiene & Tropical Medicine, London, UK; Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK
| | - Filiz Karakas
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, UK; Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Alan D Dangour
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, UK; Department of Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Shunmay Yeung
- Centre for Maternal Adolescent Reproductive & Child Health (MARCH), London School of Hygiene & Tropical Medicine, London, UK; Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK
| | - Paul Wilkinson
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, UK; Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Robert Hughes
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, UK; Department of Population Health, London School of Hygiene & Tropical Medicine, London, UK; Centre for Maternal Adolescent Reproductive & Child Health (MARCH), London School of Hygiene & Tropical Medicine, London, UK
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3
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Hernandez D, Wagner F, Hernandez-Villafuerte K, Schlander M. Economic Burden of Pancreatic Cancer in Europe: a Literature Review. J Gastrointest Cancer 2023; 54:391-407. [PMID: 35474568 PMCID: PMC10435615 DOI: 10.1007/s12029-022-00821-3] [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] [Accepted: 03/25/2022] [Indexed: 11/09/2022]
Abstract
PURPOSE Pancreatic cancer is characterized by its high mortality, usually attributed to its diagnosis in already advanced stages. This article aims at presenting an overview of the economic burden of pancreatic cancer in Europe. METHODS A systematic literature review was conducted. It made use of the search engines EconLit, Google Scholar, PubMed and Web of Science, and retrieved articles published after December 31st, 1992, and before April 1st, 2020. Study characteristics and cost information were extracted. Cost per patient and cost per patient per month (PPM) were calculated, and drivers of estimate heterogeneity was analysed. Results were converted into 2019 Euros. RESULTS The literature review yielded 26 studies on the economic burden attributable to pancreatic cancer in Europe. Cost per patient was on average 40,357 euros (median 15,991), while figures PPM were on average 3,656 euros (median 1,536). Indirect costs were found to be on average 154,257 euros per patient or 14,568 euros PPM, while direct costs 20,108 euros per patient and 2,004 euros PPM. Nevertheless, variation on cost estimations was large and driven by study methodology, patient sample characteristics, such as type of tumour and cancer stage and cost components included in analyses, such as type of procedure. CONCLUSION Pancreatic cancer direct costs PPM are in the upper bound relative to other cancer types; however, direct per patient costs are likely to be lower because of shorter survival. Indirect costs are substantial, mainly attributed to high mortality.
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Affiliation(s)
- Diego Hernandez
- Division of Health Economics, German Cancer Research Center (DKFZ), Heidelberg, Germany.
| | - Fabienne Wagner
- Division of Health Economics, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | | | - Michael Schlander
- Division of Health Economics, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
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Barbosa C, Dowd WN, Neuwahl SJ, Rehm J, Imtiaz S, Zarkin GA. Modeling the impact of COVID-19 pandemic-driven increases in alcohol consumption on health outcomes and hospitalization costs in the United States. Addiction 2022; 118:48-60. [PMID: 35915549 PMCID: PMC9539393 DOI: 10.1111/add.16018] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 07/13/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIMS Alcohol consumption increased in the early phases of the COVID-19 pandemic in the United States. Alcohol use disorder (AUD) and risky drinking are linked to harmful health effects. This paper aimed to project future health and cost impacts of shifts in alcohol consumption during the COVID-19 pandemic. DESIGN An individual-level simulation model of the long-term drinking patterns for people with life-time AUD was used to simulate 10 000 individuals and project model outcomes to the estimated 25.9 million current drinkers with life-time AUD in the United States. The model considered three scenarios: (1) no change (counterfactual for comparison); (2) increased drinking levels persist for 1 year ('increase-1') and (3) increased drinking levels persist for 5 years ('increase-5'). SETTING United States. PARTICIPANTS Current drinkers with life-time AUD. MEASUREMENTS Life expectancy [life-years (LYs)], quality-adjusted life-years (QALYs), alcohol-related hospitalizations and associated hospitalization costs and alcohol-related deaths, during a 5-year period. FINDINGS Short-term increases in alcohol consumption (increase-1 scenario) resulted in a loss of 79 000 [95% uncertainty interval (UI]) 26 000-201 000] LYs, a loss of 332 000 (104 000-604 000) QALYs and 295 000 (82 000-501 000) more alcohol-related hospitalizations, costing an additional $5.4 billion ($1.5-9.3 billion) over 5 years. Hospitalizations for cirrhosis of the liver accounted for approximately $3.0 billion ($0.9-4.8 billion) in hospitalization costs, more than half the increase across all alcohol-related conditions. Health and cost impacts were more pronounced for older age groups (51+), women and non-Hispanic black individuals. Increasing the duration of pandemic-driven increases in alcohol consumption in the increase-5 scenario resulted in larger impacts. CONCLUSIONS Simulations show that if the increase in alcohol consumption observed in the United States in the first year of the pandemic continues, alcohol-related mortality, morbidity and associated costs will increase substantially over the next 5 years.
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Affiliation(s)
| | - William N. Dowd
- Community Health Research DivisionRTI International, Research Triangle ParkNCUSA
| | | | - Jürgen Rehm
- Institute for Mental Health Policy Research and Campbell Family Mental Health Research InstituteCentre for Addiction and Mental Health (CAMH)TorontoONCanada,Dalla Lana School of Public HealthTorontoONCanada,Institute of Health Policy, Management and Evaluation and Department of PsychiatryUniversity of Toronto (UofT)TorontoONCanada,PAHO/WHO Collaborating Centre for Addiction and Mental HealthTechnische Universität Dresden, Klinische Psychologie and PsychotherapieDresdenGermany
| | - Sameer Imtiaz
- PAHO/WHO Collaborating Centre for Addiction and Mental HealthTechnische Universität Dresden, Klinische Psychologie and PsychotherapieDresdenGermany
| | - Gary A. Zarkin
- Community Health Research DivisionRTI International, Research Triangle ParkNCUSA
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Lo NC, Andrejko K, Shukla P, Baker T, Sawin VI, Norris SL, Lewnard JA. Contribution and quality of mathematical modeling evidence in World Health Organization guidelines: A systematic review. Epidemics 2022; 39:100570. [PMID: 35569248 DOI: 10.1016/j.epidem.2022.100570] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 02/23/2022] [Accepted: 04/24/2022] [Indexed: 01/13/2023] Open
Abstract
Mathematical modeling studies are frequently conducted to guide policy in global health. However, the contribution of mathematical modeling studies to World Health Organization (WHO) guideline recommendations, and the quality of evidence contributed by these studies remains unknown. We conducted a systematic review of the WHO Guidelines Review Committee database to identify guideline recommendations that included evidence from mathematical modeling studies since inception of the Guidelines Review Committee on 1 December, 2007. We included WHO guideline recommendations citing a mathematical modeling study in the primary evidence base. We defined a mathematical model as a framework that predicted epidemiologic, health or economic impact of an intervention or decision in the clinical or public health context. The primary outcome was inclusion of evidence from mathematical modeling studies in a guideline recommendation. We evaluated each unique modeling study across multiple domains of quality. Between 1 December 2007 and 1 April 2019, the WHO Guidelines Review Committee approved 154 guidelines providing 1619 guideline recommendations. Mathematical modeling studies informed 46 WHO guidelines (29.9%) and 101 unique guideline recommendations (6.2%). Modeling evidence addressed topics related to infectious diseases in 38 guidelines (82.6%) and 81 recommendations (80.2%), most commonly for HIV and tuberculosis. Evidence from modeling studies was assessed in the GRADE evidence profile for 12 recommendations (12.9%) and GRADE evidence-to-decision framework for 45 recommendations (44.6%). Modeling-informed recommendations were more likely than other recommendations within the same guidelines to be issued with a "conditional" rather than "strong" strength of recommendation (53.5% versus 37.8%), and the evidence underlying modeling-informed recommendations was more likely to be assessed as very low quality (41.6% versus 24.1%). Upon review of individual modeling studies, we estimated that 33.8% of models performed a calibration, 29.4% of models performed a validation of results, and 20.6% of models reported a change in the study conclusion in the sensitivity analysis. While policy recommendations in WHO guidelines are informed by evidence from modeling studies, the validity of modeling studies included in guidelines development is heterogeneous. Quality assessment is needed to support the evaluation and incorporation of evidence from mathematical modeling studies in guidelines development.
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Affiliation(s)
- Nathan C Lo
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, CA, USA.
| | - Kristin Andrejko
- Division of Epidemiology, University of California, Berkeley, School of Public Health, Berkeley, CA, USA
| | - Poojan Shukla
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, CA, USA
| | - Tess Baker
- Division of Epidemiology, University of California, Berkeley, School of Public Health, Berkeley, CA, USA
| | - Veronica Ivey Sawin
- Department of Quality of Norms and Standards, Science Division, World Health Organization, Geneva, Switzerland
| | - Susan L Norris
- Department of Quality of Norms and Standards, Science Division, World Health Organization, Geneva, Switzerland
| | - Joseph A Lewnard
- Division of Epidemiology, University of California, Berkeley, School of Public Health, Berkeley, CA, USA; Division of Infectious Diseases and Vaccinology, University of California, Berkeley, School of Public Health, Berkeley, CA, USA; Center for Computational Biology, College of Engineering, University of California, Berkeley, CA, USA
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6
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Frank JW, Marion G, Doeschl-Wilson A. Development of a critical appraisal tool for models predicting the impact of 'test, trace, and protect' programmes on COVID-19 transmission. Public Health 2021; 201:55-60. [PMID: 34784502 PMCID: PMC8520882 DOI: 10.1016/j.puhe.2021.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 10/01/2021] [Accepted: 10/08/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To develop a critical appraisal tool for non-computational-specialist public health professionals to assess the quality and relevance of modelling studies about Test and Trace (and Protect - TTP) programmes' impact on COVID-19 transmission. STUDY DESIGN Decision-making tool development. METHODS Using Tugwell et al.'s 1985 Health Care Effectiveness equation as a conceptual framework, combined with a purposive search of the relevant early modeling literature, we developed six critical appraisal questions for the rapid assessment of modeling studies related to the evaluation of TTP programmes' effectiveness. RESULTS By applying the critical appraisal tool to selected recent COVID-19 modeling studies, we demonstrate how models can be evaluated using the six questions to evaluate internal and external validity and relevance. CONCLUSIONS These six critical appraisal questions are able to discriminate between modeling studies of higher and lower quality and relevance to evaluating TTP programmes' impact. However, these questions require independent validation in a larger and systematic sample of relevant modeling studies which have appeared in later stages of the pandemic.
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Affiliation(s)
- J W Frank
- Usher Institute, University of Edinburgh, Teviot Hall, Edinburgh EH8 9DX, Scotland, UK.
| | - G Marion
- Biomathematics and Statistics Scotland, James Clerk Maxwell Building, Edinburgh EH9 3FD, Scotland, UK.
| | - A Doeschl-Wilson
- The Roslin Institute, University of Edinburgh, Roslin Institute Building, Easter Bush EH25 9RG, Scotland, UK.
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Hawkes MT, Lee BE, Kanji JN, Zelyas N, Wong K, Barton M, Mukhi S, Robinson JL. Seasonality of Respiratory Viruses at Northern Latitudes. JAMA Netw Open 2021; 4:e2124650. [PMID: 34529066 PMCID: PMC8446819 DOI: 10.1001/jamanetworkopen.2021.24650] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
IMPORTANCE Every year, respiratory viruses exact a heavy burden on Canadian hospitals during winter months. Generalizable seasonal patterns of respiratory virus transmission may estimate the evolution of SARS-CoV-2 or other emerging pathogens. OBJECTIVE To describe the annual and biennial variation in respiratory virus seasonality in a northern climate. DESIGN, SETTING, AND PARTICIPANTS This cohort study is an epidemiological assessment using population-based surveillance of patients with medically attended respiratory tract infection from 2005 through 2017 in Alberta, Canada. Incident cases of respiratory virus infection and infant respiratory syncytial virus (RSV) hospitalizations in Alberta were extracted from the Data Integration for Alberta Laboratories platform and Alberta Health Services Discharge Abstract Database, respectively. A deterministic susceptible-infected-recovered-susceptible mathematical model with seasonal forcing function was fitted to the data for each virus. The possible future seasonal course of SARS-CoV-2 in northern latitudes was modeled on the basis of these observations. The analysis was conducted between December 15, 2020, and February 10, 2021. EXPOSURES Seasonal respiratory pathogens. MAIN OUTCOMES AND MEASURES Incidence (temporal pattern) of respiratory virus infections and RSV hospitalizations. RESULTS A total of 37 719 incident infections with RSV, human metapneumovirus, or human coronaviruses 229E, NL63, OC43, or HKU1 among 35 375 patients (18 069 [51.1%] male; median [interquartile range], 1.29 [0.42-12.2] years) were documented. A susceptible-infected-recovered-susceptible model mirrored the epidemiological data, including a striking biennial variation with alternating severe and mild winter peaks. Qualitative description of the model and numerical simulations showed that strong seasonal contact rate and temporary immunity lasting 6 to 12 months were sufficient to explain biennial seasonality in these various respiratory viruses. The seasonality of 10 212 hospitalizations among children younger than 5 years with RSV was also explored. The median (interquartile range) rate of hospitalizations per 1000 live births was 18.6 (17.6-19.9) and 11.0 (10.4-11.7) in alternating even (severe) and odd (less-severe) seasons, respectively (P = .001). The hazard of admission was higher for children born in severe (even) seasons compared with those born in less-severe (odd) seasons (hazard ratio, 1.68; 95% CI, 1.61-1.75; P < .001). CONCLUSIONS AND RELEVANCE In this modeling study of respiratory viruses in Alberta, Canada, the seasonality followed a pattern estimated by simple mathematical models, which may be informative for anticipating future waves of pandemic SARS-CoV-2.
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Affiliation(s)
- Michael T. Hawkes
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
- Department of Medical Microbiology and Immunology, University of Alberta, Edmonton, Alberta, Canada
- University of Alberta School of Public Health, Edmonton, Alberta, Canada
- Stollery Science Lab, University of Alberta, Edmonton, Alberta, Canada
- Women and Children’s Research Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Bonita E. Lee
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
- Women and Children’s Research Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Jamil N. Kanji
- Public Health Laboratory, Alberta Precision Laboratories, University of Alberta Hospital, Edmonton, Alberta, Canada
- Division of Infectious Diseases, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Nathan Zelyas
- Public Health Laboratory, Alberta Precision Laboratories, University of Alberta Hospital, Edmonton, Alberta, Canada
- Department of Laboratory Medicine and Pathology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Kerry Wong
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Michelle Barton
- London Health Sciences Centre, Western University, London, Ontario, Canada
| | - Shamir Mukhi
- Canadian Network for Public Health Intelligence, Edmonton, Alberta, Canada
| | - Joan L. Robinson
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
- Women and Children’s Research Institute, University of Alberta, Edmonton, Alberta, Canada
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Hintermeier M, Gencer H, Kajikhina K, Rohleder S, Hövener C, Tallarek M, Spallek J, Bozorgmehr K. SARS-CoV-2 among migrants and forcibly displaced populations: A rapid systematic review. J Migr Health 2021; 4:100056. [PMID: 34151312 PMCID: PMC8205550 DOI: 10.1016/j.jmh.2021.100056] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 05/09/2021] [Accepted: 06/13/2021] [Indexed: 12/23/2022] Open
Abstract
The economic and health consequences of the COVID-19 pandemic pose a particular threat to vulnerable groups, such as migrants, particularly forcibly displaced populations. The aim of this review is (i) to synthesize the evidence on risk of infection and transmission among migrants, refugees, asylum seekers and internally displaced populations, and (ii) the effect of lockdown measures on these populations. We searched MEDLINE and WOS, preprint servers, and pertinent websites between 1st December 2019 and 26th June 2020. The included studies showed a high heterogeneity in study design, population, outcome and quality. The incidence risk of SARS-CoV-2 varied from 0•12% to 2•08% in non-outbreak settings and from 5•64% to 21•15% in outbreak settings. Migrants showed a lower hospitalization rate compared to non-migrants. Negative impacts on mental health due to lockdown measures were found across respective studies. However, findings show a tenuous and heterogeneous data situation, showing the need for more robust and comparative study designs.
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Affiliation(s)
- Maren Hintermeier
- Section for Health Equity Studies and Migration, Department of General Practice and Health Services Research, University Hospital Heidelberg, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany
| | - Hande Gencer
- Leibniz Institute for Prevention Research and Epidemiology – BIPS, Department Prevention and Evaluation, Unit Social Epidemiology, Achterstr. 30, 28359 Bremen, Germany
| | - Katja Kajikhina
- Robert Koch Institute, Unit 28 Social Determinants of Health, Department of Health monitoring and Epidemiology, General-Pape-Straße 62, 12101, Berlin, Germany
- Robert Koch Institute, Unit 38 Crisis management, outbreak investigations and training programmes, Department for Infectious Disease Epidemiolog, Seestr. 10, 13353 Berlin, Germany
| | - Sven Rohleder
- Section for Health Equity Studies and Migration, Department of General Practice and Health Services Research, University Hospital Heidelberg, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany
- Department of Population Medicine and Health Services Research, School of Public Health, Bielefeld University, D- 33501 Bielefeld, Germany
| | - Claudia Hövener
- Robert Koch Institute, Unit 28 Social Determinants of Health, Department of Health monitoring and Epidemiology, General-Pape-Straße 62, 12101, Berlin, Germany
| | - Marie Tallarek
- Department of Public Health, Brandenburg University of Technology Cottbus-Senftenberg, Universitätsplatz 1, 01968 Senftenberg, Germany
| | - Jacob Spallek
- Department of Public Health, Brandenburg University of Technology Cottbus-Senftenberg, Universitätsplatz 1, 01968 Senftenberg, Germany
| | - Kayvan Bozorgmehr
- Section for Health Equity Studies and Migration, Department of General Practice and Health Services Research, University Hospital Heidelberg, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany
- Department of Population Medicine and Health Services Research, School of Public Health, Bielefeld University, D- 33501 Bielefeld, Germany
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Wang XL, Lin X, Yang P, Wu ZY, Li G, McGoogan JM, Jiao ZT, He XJ, Li SQ, Shi HH, Wang JY, Lai SJ, Huang C, Wang QY. Coronavirus disease 2019 outbreak in Beijing's Xinfadi Market, China: a modeling study to inform future resurgence response. Infect Dis Poverty 2021; 10:62. [PMID: 33962683 PMCID: PMC8103671 DOI: 10.1186/s40249-021-00843-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 04/14/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND A local coronavirus disease 2019 (COVID-19) case confirmed on June 11, 2020 triggered an outbreak in Beijing, China after 56 consecutive days without a newly confirmed case. Non-pharmaceutical interventions (NPIs) were used to contain the source in Xinfadi (XFD) market. To rapidly control the outbreak, both traditional and newly introduced NPIs including large-scale management of high-risk populations and expanded severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) PCR-based screening in the general population were conducted in Beijing. We aimed to assess the effectiveness of the response to the COVID-19 outbreak in Beijing's XFD market and inform future response efforts of resurgence across regions. METHODS A modified susceptible-exposed-infectious-recovered (SEIR) model was developed and applied to evaluate a range of different scenarios from the public health perspective. Two outcomes were measured: magnitude of transmission (i.e., number of cases in the outbreak) and endpoint of transmission (i.e., date of containment). The outcomes of scenario evaluations were presented relative to the reality case (i.e., 368 cases in 34 days) with 95% Confidence Interval (CI). RESULTS Our results indicated that a 3 to 14 day delay in the identification of XFD as the infection source and initiation of NPIs would have caused a 3 to 28-fold increase in total case number (31-77 day delay in containment). A failure to implement the quarantine scheme employed in the XFD outbreak for defined key population would have caused a fivefold greater number of cases (73 day delay in containment). Similarly, failure to implement the quarantine plan executed in the XFD outbreak for close contacts would have caused twofold greater transmission (44 day delay in containment). Finally, failure to implement expanded nucleic acid screening in the general population would have yielded 1.6-fold greater transmission and a 32 day delay to containment. CONCLUSIONS This study informs new evidence that in form the selection of NPI to use as countermeasures in response to a COVID-19 outbreak and optimal timing of their implementation. The evidence provided by this study should inform responses to future outbreaks of COVID-19 and future infectious disease outbreak preparedness efforts in China and elsewhere.
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Affiliation(s)
- Xiao-Li Wang
- Beijing Research Center for Preventive Medicine, Beijing Center for Disease Prevention and Control, Beijing, China
- School of Public Health, Capital Medical University, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Xin Lin
- School of Computer Science and Engineering, Beihang University, Beijing, China
| | - Peng Yang
- Beijing Research Center for Preventive Medicine, Beijing Center for Disease Prevention and Control, Beijing, China
- School of Public Health, Capital Medical University, Beijing, China
| | - Zun-You Wu
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Gang Li
- Beijing Research Center for Preventive Medicine, Beijing Center for Disease Prevention and Control, Beijing, China
| | | | - Zeng-Tao Jiao
- Yidu Cloud AI Lab, Yidu Cloud (Beijing) Technology Co., Ltd, Beijing, China
| | - Xin-Jun He
- Yidu Cloud AI Lab, Yidu Cloud (Beijing) Technology Co., Ltd, Beijing, China
| | - Si-Qi Li
- Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Hong-Hao Shi
- School of Computer Science and Engineering, Beihang University, Beijing, China
| | - Jing-Yuan Wang
- School of Computer Science and Engineering, Beihang University, Beijing, China.
| | - Sheng-Jie Lai
- WorldPop, School of Geography and Environmental Science, University of Southampton, Southampton, UK.
- School of Public Health, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, China.
| | - Chun Huang
- Beijing Research Center for Preventive Medicine, Beijing Center for Disease Prevention and Control, Beijing, China.
| | - Quan-Yi Wang
- Beijing Research Center for Preventive Medicine, Beijing Center for Disease Prevention and Control, Beijing, China.
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China.
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10
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Ezeofor V‘S, Bray N, Bryning L, Hashmi F, Hoel H, Parker D, Edwards RT. Economic model to examine the cost-effectiveness of FlowOx home therapy compared to standard care in patients with peripheral artery disease. PLoS One 2021; 16:e0244851. [PMID: 33444396 PMCID: PMC7808667 DOI: 10.1371/journal.pone.0244851] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 12/17/2020] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Critical limb ischaemia is a severe stage of lower limb peripheral artery disease which can lead to tissue loss, gangrene, amputation and death. FlowOx™ therapy is a novel negative-pressure chamber system intended for home use to increase blood flow, reduce pain and improve wound healing for patients with peripheral artery disease and critical limb ischaemia. METHODS A Markov model was constructed to assess the relative cost-effectiveness of FlowOx™ therapy compared to standard care in lower limb peripheral artery disease patients with intermittent claudication or critical limb ischaemia. The model used data from two European trials of FlowOx™ therapy and published evidence on disease progression. From an NHS analysis perspective, various FlowOx™ therapy scenarios were modelled by adjusting the dose of FlowOx™ therapy and the amount of other care received alongside FlowOx™ therapy, in comparison to standard care. RESULTS In the base case analysis, consisting of FlowOx™ therapy plus nominal care, the cost estimates were £12,704 for a single dose of FlowOx™ therapy per annum as compared with £15,523 for standard care. FlowOx™ therapy patients gained 0.27 additional quality adjusted life years compared to standard care patients. This equated to a dominant incremental cost-effectiveness ratio per QALY gained. At the NICE threshold WTP of £20,000 and £30,000 per QALY gained, FlowOx™ therapy in addition to standard care had a 0.80 and 1.00 probability of being cost-effectiveness respectively. CONCLUSIONS FlowOx™ therapy delivered as a single annual dose may be a cost-effective treatment for peripheral artery disease. FlowOx™ therapy improved health outcomes and reduced treatment costs in this modelled cohort. The effectiveness and cost-effectiveness of FlowOx™ therapy is susceptible to disease severity, adherence, dose and treatment cost. Research assessing the impact of FlowOx™ therapy on NHS resource use is needed in order to provide a definitive economic evaluation.
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Affiliation(s)
- Victory ‘Segun Ezeofor
- Centre for Health Economics and Medicines Evaluation, Bangor University, Bangor, Gwynedd, Wales, United Kingdom
- * E-mail:
| | - Nathan Bray
- Centre for Health Economics and Medicines Evaluation, Bangor University, Bangor, Gwynedd, Wales, United Kingdom
| | - Lucy Bryning
- Centre for Health Economics and Medicines Evaluation, Bangor University, Bangor, Gwynedd, Wales, United Kingdom
| | - Farina Hashmi
- School of Health and Society, University of Salford, Manchester, United Kingdom
| | - Henrik Hoel
- Otivio AS, Oslo, Norway
- Department of Vascular Surgery, Oslo University Hospital, Oslo, Norway
| | - Daniel Parker
- School of Health and Society, University of Salford, Manchester, United Kingdom
| | - Rhiannon Tudor Edwards
- Centre for Health Economics and Medicines Evaluation, Bangor University, Bangor, Gwynedd, Wales, United Kingdom
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11
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Hess JJ, Ranadive N, Boyer C, Aleksandrowicz L, Anenberg SC, Aunan K, Belesova K, Bell ML, Bickersteth S, Bowen K, Burden M, Campbell-Lendrum D, Carlton E, Cissé G, Cohen F, Dai H, Dangour AD, Dasgupta P, Frumkin H, Gong P, Gould RJ, Haines A, Hales S, Hamilton I, Hasegawa T, Hashizume M, Honda Y, Horton DE, Karambelas A, Kim H, Kim SE, Kinney PL, Kone I, Knowlton K, Lelieveld J, Limaye VS, Liu Q, Madaniyazi L, Martinez ME, Mauzerall DL, Milner J, Neville T, Nieuwenhuijsen M, Pachauri S, Perera F, Pineo H, Remais JV, Saari RK, Sampedro J, Scheelbeek P, Schwartz J, Shindell D, Shyamsundar P, Taylor TJ, Tonne C, Van Vuuren D, Wang C, Watts N, West JJ, Wilkinson P, Wood SA, Woodcock J, Woodward A, Xie Y, Zhang Y, Ebi KL. Guidelines for Modeling and Reporting Health Effects of Climate Change Mitigation Actions. ENVIRONMENTAL HEALTH PERSPECTIVES 2020; 128:115001. [PMID: 33170741 PMCID: PMC7654632 DOI: 10.1289/ehp6745] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 09/08/2020] [Accepted: 10/13/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Modeling suggests that climate change mitigation actions can have substantial human health benefits that accrue quickly and locally. Documenting the benefits can help drive more ambitious and health-protective climate change mitigation actions; however, documenting the adverse health effects can help to avoid them. Estimating the health effects of mitigation (HEM) actions can help policy makers prioritize investments based not only on mitigation potential but also on expected health benefits. To date, however, the wide range of incompatible approaches taken to developing and reporting HEM estimates has limited their comparability and usefulness to policymakers. OBJECTIVE The objective of this effort was to generate guidance for modeling studies on scoping, estimating, and reporting population health effects from climate change mitigation actions. METHODS An expert panel of HEM researchers was recruited to participate in developing guidance for conducting HEM studies. The primary literature and a synthesis of HEM studies were provided to the panel. Panel members then participated in a modified Delphi exercise to identify areas of consensus regarding HEM estimation. Finally, the panel met to review and discuss consensus findings, resolve remaining differences, and generate guidance regarding conducting HEM studies. RESULTS The panel generated a checklist of recommendations regarding stakeholder engagement: HEM modeling, including model structure, scope and scale, demographics, time horizons, counterfactuals, health response functions, and metrics; parameterization and reporting; approaches to uncertainty and sensitivity analysis; accounting for policy uptake; and discounting. DISCUSSION This checklist provides guidance for conducting and reporting HEM estimates to make them more comparable and useful for policymakers. Harmonization of HEM estimates has the potential to lead to advances in and improved synthesis of policy-relevant research that can inform evidence-based decision making and practice. https://doi.org/10.1289/EHP6745.
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Affiliation(s)
- Jeremy J. Hess
- Center for Health and the Global Environment, University of Washington, Seattle, Washington, USA
| | | | - Chris Boyer
- Center for Health and the Global Environment, University of Washington, Seattle, Washington, USA
| | | | - Susan C. Anenberg
- Milken Institute School of Public Health, George Washington University, Washington, District of Columbia, USA
| | - Kristin Aunan
- CICERO Center for International Climate Research, Oslo, Norway
| | - Kristine Belesova
- Department of Public Health, Environments, and Society, London School of Hygiene & Tropical Medicine, London, UK
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Michelle L. Bell
- School of Forestry and Environmental Studies, Yale University, New Haven, Connecticut, USA
| | - Sam Bickersteth
- Rockefeller Foundation Economic Council on Planetary Health, Oxford, UK
| | | | - Marci Burden
- Center for Health and the Global Environment, University of Washington, Seattle, Washington, USA
| | - Diarmid Campbell-Lendrum
- Department of Environment Climate Change and Health, World Health Organization, Geneva, Switzerland
| | - Elizabeth Carlton
- Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado, Aurora, Colorado, USA
| | - Guéladio Cissé
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Francois Cohen
- Smith School for Enterprise and the Environment and Institute for New Economic Thinking at the Oxford Martin School, University of Oxford, Oxford, UK
| | - Hancheng Dai
- Laboratory of Energy & Environmental Economics and Policy (LEEEP), College of Environmental Sciences and Engineering, Peking University, Beijing, China
- College of Environmental Sciences and Engineering, Peking University, Beijing, China
| | - Alan David Dangour
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Purnamita Dasgupta
- Environmental and Resource Economics Unit, Institute of Economic Growth, Delhi, India
| | | | - Peng Gong
- Department of Earth System Science, Tsinghua University, Beijing, China
| | - Robert J. Gould
- Center for Climate Change Communication, George Mason University, Fairfax, Virginia, USA
| | - Andy Haines
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Simon Hales
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Ian Hamilton
- UCL Energy Institute, University College London, London, UK
| | - Tomoko Hasegawa
- National Institute for Environmental Studies, Tsukuba, Japan
| | - Masahiro Hashizume
- Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Yasushi Honda
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan
| | - Daniel E. Horton
- Department of Earth and Planetary Sciences, Northwestern University, Evanston, Illinois, USA
| | | | - Ho Kim
- Department of Epidemiology and Biostatistics, School of Public Health, Seoul National University, Seoul, South Korea
| | - Satbyul Estella Kim
- Center for Climate Change Adaptation, National Institute for Environmental Studies, Tsukuba, Japan
| | - Patrick L. Kinney
- Department of Environmental Health, Boston University School of Public Health, Boston, USA
| | - Inza Kone
- Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d’Ivoire
- Université Félix Houphouet-Boigny, Abidjan, Côte d’Ivoire
| | - Kim Knowlton
- Natural Resources Defense Council, New York, New York, USA
| | - Jos Lelieveld
- Max Planck Institute for Chemistry, Dept. of Atmospheric Chemistry, Mainz, Germany
| | | | - Qiyong Liu
- National Institute for Communicable Disease Control and Prevention, Beijing, China
| | - Lina Madaniyazi
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
- Department of Paediatric Diseases, Institute of Tropical Medicine, Nagasaki, Japan
| | - Micaela Elvira Martinez
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, New York, USA
- Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Denise L. Mauzerall
- Woodrow Wilson School of Public and International Affairs and the Department of Civil and Environmental Engineering, Princeton University, Princeton, New Jersey, USA
| | - James Milner
- Department of Public Health, Environments, and Society, London School of Hygiene & Tropical Medicine, London, UK
| | | | - Mark Nieuwenhuijsen
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiologia y Salud Publica (CIBERESP), Barcelona, Spain
| | | | - Frederica Perera
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Helen Pineo
- Bartlett Faculty of the Built Environment, University College London, London, UK
| | - Justin V. Remais
- Division of Environmental Health Sciences, University of California, Berkeley, Berkeley, California, USA
| | - Rebecca K. Saari
- Civil and Environmental Engineering, University of Waterloo, Ontario, Canada
| | - Jon Sampedro
- Basque Centre for Climate Change (BC3), Leioa, Spain
| | - Pauline Scheelbeek
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, UK
- Department of Epidemiology & Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Joel Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Heath, Boston, Massachusetts, USA
| | - Drew Shindell
- Nicholas School of the Environment, Duke University, Durham, North Carolina, USA
| | | | - Timothy J. Taylor
- European Centre for Environment and Human Health, University of Exeter Medical School, Truro, Cornwall, UK
| | - Cathryn Tonne
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiologia y Salud Publica (CIBERESP), Barcelona, Spain
| | - Detlef Van Vuuren
- PBL Netherlands Environmental Assessment Agency, The Hague, Netherlands
| | - Can Wang
- School of Environment, Tsinghua University, Beijing, China
| | - Nicholas Watts
- Institute for Global Health, University College London, London, UK
| | - J. Jason West
- Environmental Sciences & Engineering, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Paul Wilkinson
- Department of Public Health, Environments, and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Stephen A. Wood
- School of Forestry and Environmental Studies, Yale University, New Haven, Connecticut, USA
- The Nature Conservancy, New Haven, Connecticut, USA
| | - James Woodcock
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Alistair Woodward
- Epidemiology and Biostatistics, University of Auckland, Auckland, New Zealand
| | - Yang Xie
- School of Economics and Management, Beihang University, Beijing, China
- Beijing Advanced Innovation Center for Big Data-based Precision Medicine, Beihang University, Beijing, China
| | - Ying Zhang
- School of Public Health, University of Sydney, New South Wales, Australia
| | - Kristie L. Ebi
- Center for Health and the Global Environment, University of Washington, Seattle, Washington, USA
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12
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Brozek JL, Canelo-Aybar C, Akl EA, Bowen JM, Bucher J, Chiu WA, Cronin M, Djulbegovic B, Falavigna M, Guyatt GH, Gordon AA, Hilton Boon M, Hutubessy RCW, Joore MA, Katikireddi V, LaKind J, Langendam M, Manja V, Magnuson K, Mathioudakis AG, Meerpohl J, Mertz D, Mezencev R, Morgan R, Morgano GP, Mustafa R, O'Flaherty M, Patlewicz G, Riva JJ, Posso M, Rooney A, Schlosser PM, Schwartz L, Shemilt I, Tarride JE, Thayer KA, Tsaioun K, Vale L, Wambaugh J, Wignall J, Williams A, Xie F, Zhang Y, Schünemann HJ. GRADE Guidelines 30: the GRADE approach to assessing the certainty of modeled evidence-An overview in the context of health decision-making. J Clin Epidemiol 2020; 129:138-150. [PMID: 32980429 DOI: 10.1016/j.jclinepi.2020.09.018] [Citation(s) in RCA: 64] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 09/08/2020] [Accepted: 09/17/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVES The objective of the study is to present the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) conceptual approach to the assessment of certainty of evidence from modeling studies (i.e., certainty associated with model outputs). STUDY DESIGN AND SETTING Expert consultations and an international multidisciplinary workshop informed development of a conceptual approach to assessing the certainty of evidence from models within the context of systematic reviews, health technology assessments, and health care decisions. The discussions also clarified selected concepts and terminology used in the GRADE approach and by the modeling community. Feedback from experts in a broad range of modeling and health care disciplines addressed the content validity of the approach. RESULTS Workshop participants agreed that the domains determining the certainty of evidence previously identified in the GRADE approach (risk of bias, indirectness, inconsistency, imprecision, reporting bias, magnitude of an effect, dose-response relation, and the direction of residual confounding) also apply when assessing the certainty of evidence from models. The assessment depends on the nature of model inputs and the model itself and on whether one is evaluating evidence from a single model or multiple models. We propose a framework for selecting the best available evidence from models: 1) developing de novo, a model specific to the situation of interest, 2) identifying an existing model, the outputs of which provide the highest certainty evidence for the situation of interest, either "off-the-shelf" or after adaptation, and 3) using outputs from multiple models. We also present a summary of preferred terminology to facilitate communication among modeling and health care disciplines. CONCLUSION This conceptual GRADE approach provides a framework for using evidence from models in health decision-making and the assessment of certainty of evidence from a model or models. The GRADE Working Group and the modeling community are currently developing the detailed methods and related guidance for assessing specific domains determining the certainty of evidence from models across health care-related disciplines (e.g., therapeutic decision-making, toxicology, environmental health, and health economics).
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Affiliation(s)
- Jan L Brozek
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada; Department of Medicine, McMaster University, Hamilton, Ontario, Canada; McMaster GRADE Centre & Michael DeGroote Cochrane Canada Centre, McMaster University, Hamilton, Ontario, Canada
| | - Carlos Canelo-Aybar
- Department of Paediatrics, Obstetrics and Gynaecology, Preventive Medicine, and Public Health. PhD Programme in Methodology of Biomedical Research and Public Health. Universitat Autònoma de Barcelona, Bellaterra, Spain; Iberoamerican Cochrane Center, Biomedical Research Institute (IIB Sant Pau-CIBERESP), Barcelona, Spain
| | - Elie A Akl
- Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
| | - James M Bowen
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada; Toronto Health Economics and Technology Assessment (THETA) Collaborative, Toronto, Ontario, Canada
| | - John Bucher
- National Toxicology Program, National Institute of Environmental Health Sciences, Durham, NC, USA
| | - Weihsueh A Chiu
- Department of Veterinary Integrative Biosciences, Texas A&M University, College Station, TX, USA
| | - Mark Cronin
- School of Pharmacy and Chemistry, Liverpool John Moores University, Liverpool, UK
| | - Benjamin Djulbegovic
- Center for Evidence-Based Medicine and Health Outcome Research, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA
| | - Maicon Falavigna
- Institute for Education and Research, Hospital Moinhos de Vento, Porto Alegre, Rio Grande do Sul, Brazil
| | - Gordon H Guyatt
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada; Department of Medicine, McMaster University, Hamilton, Ontario, Canada; McMaster GRADE Centre & Michael DeGroote Cochrane Canada Centre, McMaster University, Hamilton, Ontario, Canada
| | | | | | - Raymond C W Hutubessy
- Department of Immunization, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland
| | - Manuela A Joore
- Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre+, Maastricht, the Netherlands
| | | | - Judy LaKind
- LaKind Associates, LLC, Catonsville, MD, USA; Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Miranda Langendam
- Department of Clinical Epidemiology, Biostatistics, and Bioinformatics, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Veena Manja
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada; Department of Surgery, University of California Davis, Sacramento, CA, USA; Department of Medicine, Department of Veterans Affairs, Northern California Health Care System, Mather, CA, USA
| | | | - Alexander G Mathioudakis
- Division of Infection, Immunity and Respiratory Medicine, University Hospital of South Manchester, University of Manchester, Manchester, UK
| | - Joerg Meerpohl
- Institute for Evidence in Medicine, Medical Center, University of Freiburg, Freiburg-am-Breisgau, Germany; Cochrane Germany, Freiburg-am-Breisgau, Germany
| | - Dominik Mertz
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Roman Mezencev
- National Center for Environmental Assessment, U.S. Environmental Protection Agency, Washington, DC, USA
| | - Rebecca Morgan
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Gian Paolo Morgano
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada; McMaster GRADE Centre & Michael DeGroote Cochrane Canada Centre, McMaster University, Hamilton, Ontario, Canada
| | - Reem Mustafa
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada; Department of Medicine, University of Kansas Medical Center, Kansas City, KS, USA
| | - Martin O'Flaherty
- Institute of Population Health Sciences, University of Liverpool, Liverpool, UK
| | - Grace Patlewicz
- National Center for Computational Toxicology, U.S. Environmental Protection Agency, Durham, NC, USA
| | - John J Riva
- McMaster GRADE Centre & Michael DeGroote Cochrane Canada Centre, McMaster University, Hamilton, Ontario, Canada; Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Margarita Posso
- Iberoamerican Cochrane Center, Biomedical Research Institute (IIB Sant Pau-CIBERESP), Barcelona, Spain
| | - Andrew Rooney
- National Toxicology Program, National Institute of Environmental Health Sciences, Durham, NC, USA
| | - Paul M Schlosser
- National Center for Environmental Assessment, U.S. Environmental Protection Agency, Washington, DC, USA
| | - Lisa Schwartz
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Ian Shemilt
- EPPI-Centre, Institute of Education, University College London, London, UK
| | - Jean-Eric Tarride
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada; Programs for Assessment of Technology in Health, McMaster University, Hamilton, Ontario, Canada
| | - Kristina A Thayer
- Department of Medicine, Department of Veterans Affairs, Northern California Health Care System, Mather, CA, USA
| | - Katya Tsaioun
- Evidence-Based Toxicology Collaboration, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Luke Vale
- Health Economics Group, Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - John Wambaugh
- National Center for Computational Toxicology, U.S. Environmental Protection Agency, Durham, NC, USA
| | | | | | - Feng Xie
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Yuan Zhang
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada; Health Quality Ontario, Toronto, Ontario, Canada
| | - Holger J Schünemann
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada; Department of Medicine, McMaster University, Hamilton, Ontario, Canada; McMaster GRADE Centre & Michael DeGroote Cochrane Canada Centre, McMaster University, Hamilton, Ontario, Canada
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13
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Barbosa C, Dowd WN, Zarkin G. Economic Evaluation of Interventions to Address Opioid Misuse: A Systematic Review of Methods Used in Simulation Modeling Studies. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2020; 23:1096-1108. [PMID: 32828223 DOI: 10.1016/j.jval.2020.03.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 02/28/2020] [Accepted: 03/15/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES Several evidence-based interventions exist for people who misuse opioids, but there is limited guidance on optimal intervention selection. Economic evaluations using simulation modeling can guide the allocation of resources and help tackle the opioid crisis. This study reviews methods employed by economic evaluations using computer simulations to investigate the health and economic effects of interventions meant to address opioid misuse. METHODS We conducted a systematic mapping review of studies that used simulation modeling to support the economic evaluation of interventions targeting prevention, treatment, or management of opioid misuse or its direct consequences (ie, overdose). We searched 6 databases and extracted information on study population, interventions, costs, outcomes, and economic analysis and modeling approaches. RESULTS Eighteen studies met the inclusion criteria. All of the studies considered only one segment of the continuum of care. Of the studies, 13 evaluated medications for opioid use disorder, and 5 evaluated naloxone distribution programs to reduce overdose deaths. Most studies estimated incremental cost per quality-adjusted life-years and used health system and/or societal perspectives. Models were decision trees (n = 4), Markov (n = 10) or semi-Markov models (n = 3), and microsimulations (n = 1). All of the studies assessed parameter uncertainty though deterministic and/or probabilistic sensitivity analysis, 4 conducted formal calibration, only 2 assessed structural uncertainty, and only 1 conducted expected value of information analyses. Only 10 studies conducted validation. CONCLUSIONS Future economic evaluations should consider synergies between interventions and examine combinations of interventions to inform optimal policy response. They should also more consistently conduct model validation and assess the value of further research.
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Affiliation(s)
- Carolina Barbosa
- Behavioral Health Research Division, RTI International, Chicago, IL, USA.
| | - William N Dowd
- Behavioral Health Research Division, RTI International, Research Triangle Park, NC, USA
| | - Gary Zarkin
- Behavioral Health Research Division, RTI International, Research Triangle Park, NC, USA
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14
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Behrend MR, Basáñez MG, Hamley JID, Porco TC, Stolk WA, Walker M, de Vlas SJ. Modelling for policy: The five principles of the Neglected Tropical Diseases Modelling Consortium. PLoS Negl Trop Dis 2020; 14:e0008033. [PMID: 32271755 PMCID: PMC7144973 DOI: 10.1371/journal.pntd.0008033] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Affiliation(s)
- Matthew R. Behrend
- Neglected Tropical Diseases, Bill & Melinda Gates Foundation, Seattle, Washington, United States of America
- Blue Well 8, Seattle, Washington, United States of America
- * E-mail:
| | - María-Gloria Basáñez
- MRC Centre for Global Infectious Disease Analysis and London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
| | - Jonathan I. D. Hamley
- MRC Centre for Global Infectious Disease Analysis and London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
| | - Travis C. Porco
- Francis I. Proctor Foundation for Research in Ophthalmology, Department of Epidemiology and Biostatistics, and Department of Ophthalmology, University of California, San Francisco, United States of America
| | - Wilma A. Stolk
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Martin Walker
- London Centre for Neglected Tropical Disease Research, Department of Pathobiology and Population Sciences, Royal Veterinary College, Hatfield, Hertfordshire, United Kingdom
- London Centre for Neglected Tropical Disease Research and Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
| | - Sake J. de Vlas
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
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15
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A systematic review and evaluation of Zika virus forecasting and prediction research during a public health emergency of international concern. PLoS Negl Trop Dis 2019; 13:e0007451. [PMID: 31584946 PMCID: PMC6805005 DOI: 10.1371/journal.pntd.0007451] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 10/22/2019] [Accepted: 08/27/2019] [Indexed: 01/04/2023] Open
Abstract
INTRODUCTION Epidemic forecasting and prediction tools have the potential to provide actionable information in the midst of emerging epidemics. While numerous predictive studies were published during the 2016-2017 Zika Virus (ZIKV) pandemic, it remains unknown how timely, reproducible, and actionable the information produced by these studies was. METHODS To improve the functional use of mathematical modeling in support of future infectious disease outbreaks, we conducted a systematic review of all ZIKV prediction studies published during the recent ZIKV pandemic using the PRISMA guidelines. Using MEDLINE, EMBASE, and grey literature review, we identified studies that forecasted, predicted, or simulated ecological or epidemiological phenomena related to the Zika pandemic that were published as of March 01, 2017. Eligible studies underwent evaluation of objectives, data sources, methods, timeliness, reproducibility, accessibility, and clarity by independent reviewers. RESULTS 2034 studies were identified, of which n = 73 met the eligibility criteria. Spatial spread, R0 (basic reproductive number), and epidemic dynamics were most commonly predicted, with few studies predicting Guillain-Barré Syndrome burden (4%), sexual transmission risk (4%), and intervention impact (4%). Most studies specifically examined populations in the Americas (52%), with few African-specific studies (4%). Case count (67%), vector (41%), and demographic data (37%) were the most common data sources. Real-time internet data and pathogen genomic information were used in 7% and 0% of studies, respectively, and social science and behavioral data were typically absent in modeling efforts. Deterministic models were favored over stochastic approaches. Forty percent of studies made model data entirely available, 29% provided all relevant model code, 43% presented uncertainty in all predictions, and 54% provided sufficient methodological detail to allow complete reproducibility. Fifty-one percent of predictions were published after the epidemic peak in the Americas. While the use of preprints improved the accessibility of ZIKV predictions by a median of 119 days sooner than journal publication dates, they were used in only 30% of studies. CONCLUSIONS Many ZIKV predictions were published during the 2016-2017 pandemic. The accessibility, reproducibility, timeliness, and incorporation of uncertainty in these published predictions varied and indicates there is substantial room for improvement. To enhance the utility of analytical tools for outbreak response it is essential to improve the sharing of model data, code, and preprints for future outbreaks, epidemics, and pandemics.
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Tanuseputro P, Arnason T, Hennessy D, Smith B, Bennett C, Kopec J, Pinto AD, Perez R, Tuna M, Manuel D. Simulation modeling to enhance population health intervention research for chronic disease prevention. Canadian Journal of Public Health 2018; 110:52-57. [PMID: 30039263 DOI: 10.17269/s41997-018-0109-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Accepted: 06/27/2018] [Indexed: 11/17/2022]
Abstract
Population Health Intervention Research (PHIR) is an expanding field that explores the health effects of population-level interventions conducted within and outside of the health sector. Simulation modeling-the use of mathematical models to predict health outcomes in populations given a set of specified inputs-is a useful, yet underutilized tool for PHIR. It can be employed at several phases of the research process: (1) planning and designing PHIR studies; (2) implementation; and (3) knowledge translation of findings across settings and populations. Using the example of community-wide, built environment interventions for the prevention of type 2 diabetes, we demonstrate how simulation models can be a powerful technique for chronic disease prevention research within PHIR. With increasingly available data on chronic disease risk factors and outcomes, the use of simulation modeling in PHIR for chronic disease prevention is anticipated to grow. There is a continued need to ensure models are appropriately validated and researchers should be cautious in their interpretation of model outputs given the uncertainties that are inherent with simulation modeling approaches. However, given the complexity of disease pathways and methodological challenges of PHIR studies, simulation models can be a valuable tool for researchers studying population interventions that hold the potential to improve health and reduce health inequities.
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Affiliation(s)
- Peter Tanuseputro
- Bruyère Research Institute, 43 Bruyère Street, Ottawa, ON, K1N 5C8, Canada. .,Ottawa Hospital Research Institute, Ottawa Hospital - Civic Campus, 1053 Carling Ave Box 693, 2-005 Admin Services Building, Ottawa, ON, K1Y 4E9, Canada. .,Institute for Clinical Evaluative Sciences, Civic Campus, Administrative Services Building, 1st Floor, 1053 Carling Avenue, Box 684, Ottawa, ON, K1Y 4E9, Canada. .,Department of Medicine, Division of Palliative Care, University of Ottawa, Ottawa, Canada.
| | - Trevor Arnason
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, NS, B3H 1V7, Canada
| | - Deirdre Hennessy
- Ottawa Hospital Research Institute, Ottawa Hospital - Civic Campus, 1053 Carling Ave Box 693, 2-005 Admin Services Building, Ottawa, ON, K1Y 4E9, Canada
| | - Brendan Smith
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON, M5T 3M7, Canada.,Public Health Ontario, 480 University Ave, Toronto, ON, M5G 1V2, Canada
| | - Carol Bennett
- Institute for Clinical Evaluative Sciences, Civic Campus, Administrative Services Building, 1st Floor, 1053 Carling Avenue, Box 684, Ottawa, ON, K1Y 4E9, Canada
| | - Jacek Kopec
- School of Population and Public Health, University of British Columbia, Milan Ilich Arthritis Research Centre, 5591 No. 3 Road, Richmond, BC, V6X 2C7, Canada
| | - Andrew D Pinto
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON, M5T 3M7, Canada.,Department of Family and Community Medicine, St. Michael's Hospital, Toronto, Canada.,Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, Toronto, Canada.,Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada
| | - Richard Perez
- Institute for Clinical Evaluative Sciences, Civic Campus, Administrative Services Building, 1st Floor, 1053 Carling Avenue, Box 684, Ottawa, ON, K1Y 4E9, Canada
| | - Meltem Tuna
- Institute for Clinical Evaluative Sciences, Civic Campus, Administrative Services Building, 1st Floor, 1053 Carling Avenue, Box 684, Ottawa, ON, K1Y 4E9, Canada
| | - Douglas Manuel
- Bruyère Research Institute, 43 Bruyère Street, Ottawa, ON, K1N 5C8, Canada.,Ottawa Hospital Research Institute, Ottawa Hospital - Civic Campus, 1053 Carling Ave Box 693, 2-005 Admin Services Building, Ottawa, ON, K1Y 4E9, Canada.,Institute for Clinical Evaluative Sciences, Civic Campus, Administrative Services Building, 1st Floor, 1053 Carling Avenue, Box 684, Ottawa, ON, K1Y 4E9, Canada.,Department of Family Medicine, University of Ottawa, Ottawa, K1H 8M5, Canada
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What do we know about managing Dupuytren's disease cost-effectively? BMC Musculoskelet Disord 2018; 19:34. [PMID: 29370792 PMCID: PMC5785840 DOI: 10.1186/s12891-018-1949-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 01/17/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Dupuytren's disease (DD) is a common and progressive, fibroproliferative disorder of the palmar and digital fascia of the hand. Various treatments have been recommended for advanced disease or to retard progression of early disease and to prevent deterioration of the finger contracture and quality of life. Recent studies have tried to evaluate the clinical and cost-effectiveness of therapies for DD, but there is currently no systematic assessment and appraisal of the economic evaluations. METHODS A systematic literature review was conducted, following PRISMA guidelines, to identify studies reporting economic evaluations of interventions for managing DD. Databases searched included the Ovid MEDLINE/Embase (without time restriction), National Health Service (NHS) Economic Evaluation Database (all years) and the National Institute for Health Research (NIHR) Journals Library) Health Technology Assessment (HTA). Cost-effectiveness analyses of treating DD were identified and their quality was assessed using the CHEERS assessment tool for quality of reporting and Phillips checklist for model evaluation. RESULTS A total of 103 studies were screened, of which 4 met the study inclusion criteria. Two studies were from the US, one from the UK and one from Canada. They all assessed the same interventions for advanced DD, namely collagenase Clostridium histolyticum injection, percutaneous needle fasciotomy and partial fasciectomy. All studies conducting a cost-utility analysis, two implemented a decision analytic model and two a Markov model approach. None of them were based on a single randomised controlled trial, but rather synthesised evidence from various sources. Studies varied in their time horizon, sources of utility estimates and perspective of analysis. The overall quality of study reporting was good based on the CHEERS checklist. The quality of the model reporting in terms of model structure, data synthesis and model consistency varied across the included studies. CONCLUSION Cost-effectiveness analyses for patients with advanced DD are limited and have applied different approaches with respect to modelling. Future studies should improve the way they are conducted and report their findings according to established guidance for conducting economic modelling of health care technologies. TRIAL REGISTRATION The protocol was registered ( CRD42016032989 ; date 08/01/2016) with the PROSPERO international prospective register of systematic reviews.
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Modifications in the Consumption of Energy, Sugar, and Saturated Fat among the Mexican Adult Population: Simulation of the Effect When Replacing Processed Foods that Comply with a Front of Package Labeling System. Nutrients 2018; 10:nu10010101. [PMID: 29351257 PMCID: PMC5793329 DOI: 10.3390/nu10010101] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 01/05/2018] [Accepted: 01/08/2018] [Indexed: 11/16/2022] Open
Abstract
A Mexican Committee of Nutrition Experts (MCNE) from the National Institute of Public Health (INSP), free from conflict of interest, established food content standards to place the front-of-package (FOP) logo on foods that meet these nutrition criteria. The objectives were to simulate the effect on nutrient intake in the Mexican adult population (20–59 years old) after replacing commonly consumed processed foods with those that meet the FOP nutrition-labeling criteria. Twenty-four hour dietary recalls were collected from the 2012 Mexican National Health and Nutrition Survey (n = 2164 adults). A food database from the INSP was used. Weighted medians and 25–75 inter-quartile ranges (IQR) of energy and nutrient intake were calculated for all subjects by sociodemographic characteristics before and after replacing foods. Significant decreases were observed in energy (−5.4%), saturated fatty acids (−18.9%), trans-fatty acids (−20%), total sugar (−36.8%) and sodium (−10.7%) intake and a significant increase in fiber intake (+15.5%) after replacing foods, using the MCNE nutrition criteria. Replacing commonly consumed processed foods in the diet with foods that meet the FOP nutrition-labeling criteria set by the MCNE can lead to improvements in energy and nutrient intake in the Mexican adult population.
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Arnold M. Simulation modeling for stratified breast cancer screening - a systematic review of cost and quality of life assumptions. BMC Health Serv Res 2017; 17:802. [PMID: 29197417 PMCID: PMC5712150 DOI: 10.1186/s12913-017-2766-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Accepted: 11/24/2017] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The economic evaluation of stratified breast cancer screening gains momentum, but produces also very diverse results. Systematic reviews so far focused on modeling techniques and epidemiologic assumptions. However, cost and utility parameters received only little attention. This systematic review assesses simulation models for stratified breast cancer screening based on their cost and utility parameters in each phase of breast cancer screening and care. METHODS A literature review was conducted to compare economic evaluations with simulation models of personalized breast cancer screening. Study quality was assessed using reporting guidelines. Cost and utility inputs were extracted, standardized and structured using a care delivery framework. Studies were then clustered according to their study aim and parameters were compared within the clusters. RESULTS Eighteen studies were identified within three study clusters. Reporting quality was very diverse in all three clusters. Only two studies in cluster 1, four studies in cluster 2 and one study in cluster 3 scored high in the quality appraisal. In addition to the quality appraisal, this review assessed if the simulation models were consistent in integrating all relevant phases of care, if utility parameters were consistent and methodological sound and if cost were compatible and consistent in the actual parameters used for screening, diagnostic work up and treatment. Of 18 studies, only three studies did not show signs of potential bias. CONCLUSION This systematic review shows that a closer look into the cost and utility parameter can help to identify potential bias. Future simulation models should focus on integrating all relevant phases of care, using methodologically sound utility parameters and avoiding inconsistent cost parameters.
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Affiliation(s)
- Matthias Arnold
- Munich Center of Health Sciences, LMU, Munich, Germany. .,Institute of Health Economics and Health Care Management, Helmholtz Zentrum München, Neuherberg, Germany. .,Institut für Gesundheitsökonomie und Management im Gesundheitswesen, Ludwig-Maximilians-Universität München, Ludwigstr. 28 RG, 5. OG, 80539, Munich, Germany.
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Egger M, Johnson L, Althaus C, Schöni A, Salanti G, Low N, Norris SL. Developing WHO guidelines: Time to formally include evidence from mathematical modelling studies. F1000Res 2017; 6:1584. [PMID: 29552335 PMCID: PMC5829466 DOI: 10.12688/f1000research.12367.2] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/19/2018] [Indexed: 12/15/2022] Open
Abstract
In recent years, the number of mathematical modelling studies has increased steeply. Many of the questions addressed in these studies are relevant to the development of World Health Organization (WHO) guidelines, but modelling studies are rarely formally included as part of the body of evidence. An expert consultation hosted by WHO, a survey of modellers and users of modelling studies, and literature reviews informed the development of recommendations on when and how to incorporate the results of modelling studies into WHO guidelines. In this article, we argue that modelling studies should routinely be considered in the process of developing WHO guidelines, but particularly in the evaluation of public health programmes, long-term effectiveness or comparative effectiveness. There should be a systematic and transparent approach to identifying relevant published models, and to commissioning new models. We believe that the inclusion of evidence from modelling studies into the Grading of Recommendations Assessment, Development and Evaluation (GRADE) process is possible and desirable, with relatively few adaptations. No single "one-size-fits-all" approach is appropriate to assess the quality of modelling studies. The concept of the 'credibility' of the model, which takes the conceptualization of the problem, model structure, input data, different dimensions of uncertainty, as well as transparency and validation into account, is more appropriate than 'risk of bias'.
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Affiliation(s)
- Matthias Egger
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, 3012, Switzerland.,Centre for Infectious Disease Epidemiology and Research (CIDER), University of Cape Town, Cape Town, 7925, South Africa
| | - Leigh Johnson
- Centre for Infectious Disease Epidemiology and Research (CIDER), University of Cape Town, Cape Town, 7925, South Africa
| | - Christian Althaus
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, 3012, Switzerland
| | - Anna Schöni
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, 3012, Switzerland
| | - Georgia Salanti
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, 3012, Switzerland
| | - Nicola Low
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, 3012, Switzerland
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Egger M, Johnson L, Althaus C, Schöni A, Salanti G, Low N, Norris SL. Developing WHO guidelines: Time to formally include evidence from mathematical modelling studies. F1000Res 2017; 6:1584. [PMID: 29552335 DOI: 10.12688/f1000research.12367.1] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/11/2017] [Indexed: 12/15/2022] Open
Abstract
In recent years, the number of mathematical modelling studies has increased steeply. Many of the questions addressed in these studies are relevant to the development of World Health Organization (WHO) guidelines, but modelling studies are rarely formally included as part of the body of evidence. An expert consultation hosted by WHO, a survey of modellers and users of modelling studies, and literature reviews informed the development of recommendations on when and how to incorporate the results of modelling studies into WHO guidelines. In this article, we argue that modelling studies should routinely be considered in the process of developing WHO guidelines, but particularly in the evaluation of public health programmes, long-term effectiveness or comparative effectiveness. There should be a systematic and transparent approach to identifying relevant published models, and to commissioning new models. We believe that the inclusion of evidence from modelling studies into the Grading of Recommendations Assessment, Development and Evaluation (GRADE) process is possible and desirable, with relatively few adaptations. No single "one-size-fits-all" approach is appropriate to assess the quality of modelling studies. The concept of the 'credibility' of the model, which takes the conceptualization of the problem, model structure, input data, different dimensions of uncertainty, as well as transparency and validation into account, is more appropriate than 'risk of bias'.
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Affiliation(s)
- Matthias Egger
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, 3012, Switzerland.,Centre for Infectious Disease Epidemiology and Research (CIDER), University of Cape Town, Cape Town, 7925, South Africa
| | - Leigh Johnson
- Centre for Infectious Disease Epidemiology and Research (CIDER), University of Cape Town, Cape Town, 7925, South Africa
| | - Christian Althaus
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, 3012, Switzerland
| | - Anna Schöni
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, 3012, Switzerland
| | - Georgia Salanti
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, 3012, Switzerland
| | - Nicola Low
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, 3012, Switzerland
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Pandya A, Sy S, Cho S, Alam S, Weinstein MC, Gaziano TA. Validation of a Cardiovascular Disease Policy Microsimulation Model Using Both Survival and Receiver Operating Characteristic Curves. Med Decis Making 2017; 37:802-814. [PMID: 28490271 DOI: 10.1177/0272989x17706081] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Despite some advances, cardiovascular disease (CVD) remains the leading cause of death and healthcare costs in the United States. We therefore developed a comprehensive CVD policy simulation model that identifies cost-effective approaches for reducing CVD burden. This paper aims to: 1) describe our model in detail; and 2) perform model validation analyses. METHODS The model simulates 1,000,000 adults (ages 35 to 80 years) using a variety of CVD-related epidemiological data, including previously calibrated Framingham-based risk scores for coronary heart disease and stroke. We validated our microsimulation model using recent National Health and Nutrition Examination Survey (NHANES) data, with baseline values collected in 1999-2000 and cause-specific mortality follow-up through 2011. Model-based (simulated) results were compared to observed all-cause and CVD-specific mortality data (from NHANES) for the same starting population using survival curves and, in a method not typically used for disease model validation, receiver operating characteristic (ROC) curves. RESULTS Observed 10-year all-cause mortality in NHANES v. the simulation model was 11.2% (95% CI, 10.3% to 12.2%) v. 10.9%; corresponding results for CVD mortality were 2.2% (1.8% to 2.7%) v. 2.6%. Areas under the ROC curves for model-predicted 10-year all-cause and CVD mortality risks were 0.83 (0.81 to 0.85) and 0.84 (0.81 to 0.88), respectively; corresponding results for 5-year risks were 0.80 (0.77 to 0.83) and 0.81 (0.75 to 0.87), respectively. LIMITATIONS The model is limited by the uncertainties in the data used to estimate its input parameters. Additionally, our validation analyses did not include non-fatal CVD outcomes due to NHANES data limitations. CONCLUSIONS The simulation model performed well in matching to observed nationally representative longitudinal mortality data. ROC curve analysis, which has been traditionally used for risk prediction models, can also be used to assess discrimination for disease simulation models.
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Affiliation(s)
- Ankur Pandya
- Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA, USA (AP, SS, SA, MCW, TAG)
| | - Stephen Sy
- Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA, USA (AP, SS, SA, MCW, TAG)
| | - Sylvia Cho
- Department of Biomedical Informatics, Columbia University, New York, NY, USA (SC)
| | - Sartaj Alam
- Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA, USA (AP, SS, SA, MCW, TAG)
| | - Milton C Weinstein
- Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA, USA (AP, SS, SA, MCW, TAG)
| | - Thomas A Gaziano
- Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA, USA (AP, SS, SA, MCW, TAG).,Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA, USA (TAG)
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Glantz SA. Need for Examination of Broader Range of Risks When Predicting the Effects of New Tobacco Products. Nicotine Tob Res 2017; 19:266-267. [PMID: 28082476 PMCID: PMC5234358 DOI: 10.1093/ntr/ntw231] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Accepted: 08/09/2016] [Indexed: 01/31/2023]
Affiliation(s)
- Stanton A Glantz
- Center for Tobacco Control Research and Education, University of California, San Francisco, San Francisco, CA
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Manuel DG, Garner R, Finès P, Bancej C, Flanagan W, Tu K, Reimer K, Chambers LW, Bernier J. Alzheimer's and other dementias in Canada, 2011 to 2031: a microsimulation Population Health Modeling (POHEM) study of projected prevalence, health burden, health services, and caregiving use. Popul Health Metr 2016; 14:37. [PMID: 27822143 PMCID: PMC5095994 DOI: 10.1186/s12963-016-0107-z] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Accepted: 10/05/2016] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Worldwide, there is concern that increases in the prevalence of dementia will result in large demands for caregivers and supportive services that will be challenging to address. Previous dementia projections have either been simple extrapolations of prevalence or macrosimulations based on dementia incidence. METHODS A population-based microsimulation model of Alzheimer's and related dementias (POHEM:Neurological) was created using Canadian demographic data, estimates of dementia incidence, health status (health-related quality of life and mortality risk), health care costs and informal caregiving use. Dementia prevalence and 12 other measures were projected to 2031. RESULTS Between 2011 and 2031, there was a projected two-fold increase in the number of people living with dementia in Canada (1.6-fold increase in prevalence rate). By 2031, the projected informal (unpaid) caregiving for dementia in Canada was two billion hours per year, or 100 h per year per Canadian of working age. CONCLUSIONS The projected increase in dementia prevalence was largely related to the expected increase in older Canadians, with projections sensitive to changes in the age of dementia onset.
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Affiliation(s)
- Douglas G Manuel
- Health Analysis Division, Statistics Canada, Ottawa, Ontario Canada ; Ottawa Hospital Research Institute, Ottawa, Ontario Canada ; Department of Family Medicine, University of Ottawa, Ottawa, Ontario Canada ; Bruyère Research Institute, Ottawa, Ontario Canada ; School of Public and Population Health, University of Ottawa, Ottawa, Ontario Canada ; Institute for Clinical Evaluative Sciences, Ottawa and Toronto, Ottawa, Ontario Canada
| | - Rochelle Garner
- Health Analysis Division, Statistics Canada, Ottawa, Ontario Canada
| | - Philippe Finès
- Health Analysis Division, Statistics Canada, Ottawa, Ontario Canada
| | | | - William Flanagan
- Health Analysis Division, Statistics Canada, Ottawa, Ontario Canada
| | - Karen Tu
- Institute for Clinical Evaluative Sciences, Ottawa and Toronto, Ottawa, Ontario Canada ; Department of Family Medicine, University of Toronto, Toronto, Ontario Canada
| | - Kim Reimer
- BC Ministry of Health, Victoria, British Columbia Canada
| | - Larry W Chambers
- Department of Family Medicine, University of Ottawa, Ottawa, Ontario Canada ; Bruyère Research Institute, Ottawa, Ontario Canada ; School of Public and Population Health, University of Ottawa, Ottawa, Ontario Canada ; Alzheimer's Society of Canada, Toronto, Ontario Canada ; Faculty of Health, York University, Toronto, Ontario Canada ; Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario Canada
| | - Julie Bernier
- Health Analysis Division, Statistics Canada, Ottawa, Ontario Canada
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Lecky F, Russell W, Fuller G, McClelland G, Pennington E, Goodacre S, Han K, Curran A, Holliman D, Freeman J, Chapman N, Stevenson M, Byers S, Mason S, Potter H, Coats T, Mackway-Jones K, Peters M, Shewan J, Strong M. The Head Injury Transportation Straight to Neurosurgery (HITS-NS) randomised trial: a feasibility study. Health Technol Assess 2016; 20:1-198. [PMID: 26753808 DOI: 10.3310/hta20010] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Reconfiguration of trauma services, with direct transport of traumatic brain injury (TBI) patients to neuroscience centres (NCs), bypassing non-specialist acute hospitals (NSAHs), could potentially improve outcomes. However, delays in stabilisation of airway, breathing and circulation (ABC) and the difficulties in reliably identifying TBI at scene may make this practice deleterious compared with selective secondary transfer from nearest NSAH to NC. National Institute for Health and Care Excellence guidance and systematic reviews suggested equipoise and poor-quality evidence - with regard to 'early neurosurgery' in this cohort - which we sought to address. METHODS Pilot cluster randomised controlled trial of bypass to NC conducted in two ambulance services with the ambulance station (n = 74) as unit of cluster [Lancashire/Cumbria in the North West Ambulance Service (NWAS) and the North East Ambulance Service (NEAS)]. Adult patients with signs of isolated TBI [Glasgow Coma Scale (GCS) score of < 13 in NWAS, GCS score of < 14 in NEAS] and stable ABC, injured nearest to a NSAH were transported either to that hospital (control clusters) or bypassed to the nearest NC (intervention clusters). PRIMARY OUTCOMES recruitment rate, protocol compliance, selection bias as a result of non-compliance, accuracy of paramedic TBI identification (overtriage of study inclusion criteria) and pathway acceptability to patients, families and staff. 'Open-label' secondary outcomes: 30-day mortality, 6-month Extended Glasgow Outcome Scale (GOSE) and European Quality of Life-5 Dimensions. RESULTS Overall, 56 clusters recruited 293 (169 intervention, 124 control) patients in 12 months, demonstrating cluster randomised pre-hospital trials as viable for heath service evaluations. Overall compliance was 62%, but 90% was achieved in the control arm and when face-to-face paramedic training was possible. Non-compliance appeared to be driven by proximity of the nearest hospital and perceptions of injury severity and so occurred more frequently in the intervention arm, in which the perceived time to the NC was greater and severity of injury was lower. Fewer than 25% of recruited patients had TBI on computed tomography scan (n = 70), with 7% (n = 20) requiring neurosurgery (craniotomy, craniectomy or intracranial pressure monitoring) but a further 18 requiring admission to an intensive care unit. An intention-to-treat analysis revealed the two trial arms to be equivalent in terms of age, GCS and severity of injury. No significant 30-day mortality differences were found (8.8% vs. 9.1/%; p > 0.05) in the 273 (159/113) patients with data available. There were no apparent differences in staff and patient preferences for either pathway, with satisfaction high with both. Very low responses to invitations to consent for follow-up in the large number of mild head injury-enrolled patients meant that only 20% of patients had 6-month outcomes. The trial-based economic evaluation could not focus on early neurosurgery because of these low numbers but instead investigated the comparative cost-effectiveness of bypass compared with selective secondary transfer for eligible patients at the scene of injury. CONCLUSIONS Current NHS England practice of bypassing patients with suspected TBI to neuroscience centres gives overtriage ratios of 13 : 1 for neurosurgery and 4 : 1 for TBI. This important finding makes studying the impact of bypass to facilitate early neurosurgery not plausible using this study design. Future research should explore an efficient comparative effectiveness design for evaluating 'early neurosurgery through bypass' and address the challenge of reliable TBI diagnosis at the scene of injury. TRIAL REGISTRATION Current Controlled Trials ISRCTN68087745. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 20, No. 1. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Fiona Lecky
- EMRiS Group, Health Services Research, School of Health and Related Research (SCHaRR), University of Sheffield, Sheffield, UK
| | - Wanda Russell
- Trauma Audit and Research Network, Center of Occupational and Environmental Health, Institute of Population, University of Manchester, Manchester, UK
| | - Gordon Fuller
- EMRiS Group, Health Services Research, School of Health and Related Research (SCHaRR), University of Sheffield, Sheffield, UK
| | - Graham McClelland
- Research and Development Department, North East Ambulance Service NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Elspeth Pennington
- Research and Development Department, North West Ambulance Service, Carlisle, UK
| | - Steve Goodacre
- EMRiS Group, Health Services Research, School of Health and Related Research (SCHaRR), University of Sheffield, Sheffield, UK
| | - Kyee Han
- Research and Development Department, North East Ambulance Service NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Andrew Curran
- Research and Development Department, North West Ambulance Service, Carlisle, UK
| | - Damien Holliman
- Department of Neurosurgery, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Jennifer Freeman
- EMRiS Group, Health Services Research, School of Health and Related Research (SCHaRR), University of Sheffield, Sheffield, UK
| | - Nathan Chapman
- EMRiS Group, Health Services Research, School of Health and Related Research (SCHaRR), University of Sheffield, Sheffield, UK
| | - Matt Stevenson
- EMRiS Group, Health Services Research, School of Health and Related Research (SCHaRR), University of Sheffield, Sheffield, UK
| | - Sonia Byers
- Research and Development Department, North East Ambulance Service NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Suzanne Mason
- EMRiS Group, Health Services Research, School of Health and Related Research (SCHaRR), University of Sheffield, Sheffield, UK
| | - Hugh Potter
- Potter Rees Serious Injury Solicitors LLP, Manchester, UK
| | - Tim Coats
- Department of Cardiovascular Sciences, University of Leicester/University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Kevin Mackway-Jones
- Research and Development Department, North West Ambulance Service, Carlisle, UK
| | - Mary Peters
- Research and Development Department, North West Ambulance Service, Carlisle, UK
| | - Jane Shewan
- Research and Development Department, Yorkshire Ambulance Services NHS Trust, Wakefield, UK
| | - Mark Strong
- EMRiS Group, Health Services Research, School of Health and Related Research (SCHaRR), University of Sheffield, Sheffield, UK
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Hennessy DA, Flanagan WM, Tanuseputro P, Bennett C, Tuna M, Kopec J, Wolfson MC, Manuel DG. The Population Health Model (POHEM): an overview of rationale, methods and applications. Popul Health Metr 2015; 13:24. [PMID: 26339201 PMCID: PMC4559325 DOI: 10.1186/s12963-015-0057-x] [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: 07/17/2014] [Accepted: 08/21/2015] [Indexed: 12/22/2022] Open
Abstract
The POpulation HEalth Model (POHEM) is a health microsimulation model that was developed at Statistics Canada in the early 1990s. POHEM draws together rich multivariate data from a wide range of sources to simulate the lifecycle of the Canadian population, specifically focusing on aspects of health. The model dynamically simulates individuals’ disease states, risk factors, and health determinants, in order to describe and project health outcomes, including disease incidence, prevalence, life expectancy, health-adjusted life expectancy, quality of life, and healthcare costs. Additionally, POHEM was conceptualized and built with the ability to assess the impact of policy and program interventions, not limited to those taking place in the healthcare system, on the health status of Canadians. Internationally, POHEM and other microsimulation models have been used to inform clinical guidelines and health policies in relation to complex health and health system problems. This paper provides a high-level overview of the rationale, methodology, and applications of POHEM. Applications of POHEM to cardiovascular disease, physical activity, cancer, osteoarthritis, and neurological diseases are highlighted.
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Affiliation(s)
- Deirdre A Hennessy
- Health Analysis Division, Statistics Canada, 100 Tunney's Pasture Driveway, Ottawa, ON K1A 0T6 Canada
| | - William M Flanagan
- Health Analysis Division, Statistics Canada, 100 Tunney's Pasture Driveway, Ottawa, ON K1A 0T6 Canada
| | - Peter Tanuseputro
- Ottawa Hospital Research Institute, Room 2-012 Administrative Services Building, Box 684, 1053 Carling Ave., Ottawa, ON K1Y 4E9 Canada ; C.T. Lamont Primary Health Care Research Centre and Bruyere Research Institute, 43 Bruyere Street, Ottawa, ON K1N 5C8 Canada
| | - Carol Bennett
- Ottawa Hospital Research Institute, Room 2-012 Administrative Services Building, Box 684, 1053 Carling Ave., Ottawa, ON K1Y 4E9 Canada ; The Institute for Clinical Evaluative Sciences, G1 06, 2075 Bayview Avenue, Toronto, ON M4N 3M5 Canada
| | - Meltem Tuna
- Ottawa Hospital Research Institute, Room 2-012 Administrative Services Building, Box 684, 1053 Carling Ave., Ottawa, ON K1Y 4E9 Canada ; The Institute for Clinical Evaluative Sciences, G1 06, 2075 Bayview Avenue, Toronto, ON M4N 3M5 Canada
| | - Jacek Kopec
- School of Population and Public Health, University of British Columbia and the Arthritis Research Centre of Canada, 895 West 10th Avenue, Vancouver, BC V5Z 1L7 Canada
| | - Michael C Wolfson
- Faculty of Medicine, University of Ottawa, 451 Smyth Road, Ottawa, ON K1H 8M5 Canada
| | - Douglas G Manuel
- Health Analysis Division, Statistics Canada, 100 Tunney's Pasture Driveway, Ottawa, ON K1A 0T6 Canada ; Ottawa Hospital Research Institute, Room 2-012 Administrative Services Building, Box 684, 1053 Carling Ave., Ottawa, ON K1Y 4E9 Canada ; C.T. Lamont Primary Health Care Research Centre and Bruyere Research Institute, 43 Bruyere Street, Ottawa, ON K1N 5C8 Canada ; The Institute for Clinical Evaluative Sciences, G1 06, 2075 Bayview Avenue, Toronto, ON M4N 3M5 Canada ; The Department of Family and Department of Epidemiology and Community Medicine, University of Ottawa, Room 3105, 451 Smyth Road, Ottawa, ON K1H 8M5 Canada
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Casals M, Girabent-Farrés M, Carrasco JL. Methodological quality and reporting of generalized linear mixed models in clinical medicine (2000-2012): a systematic review. PLoS One 2014; 9:e112653. [PMID: 25405342 PMCID: PMC4236119 DOI: 10.1371/journal.pone.0112653] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Accepted: 10/10/2014] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Modeling count and binary data collected in hierarchical designs have increased the use of Generalized Linear Mixed Models (GLMMs) in medicine. This article presents a systematic review of the application and quality of results and information reported from GLMMs in the field of clinical medicine. METHODS A search using the Web of Science database was performed for published original articles in medical journals from 2000 to 2012. The search strategy included the topic "generalized linear mixed models","hierarchical generalized linear models", "multilevel generalized linear model" and as a research domain we refined by science technology. Papers reporting methodological considerations without application, and those that were not involved in clinical medicine or written in English were excluded. RESULTS A total of 443 articles were detected, with an increase over time in the number of articles. In total, 108 articles fit the inclusion criteria. Of these, 54.6% were declared to be longitudinal studies, whereas 58.3% and 26.9% were defined as repeated measurements and multilevel design, respectively. Twenty-two articles belonged to environmental and occupational public health, 10 articles to clinical neurology, 8 to oncology, and 7 to infectious diseases and pediatrics. The distribution of the response variable was reported in 88% of the articles, predominantly Binomial (n = 64) or Poisson (n = 22). Most of the useful information about GLMMs was not reported in most cases. Variance estimates of random effects were described in only 8 articles (9.2%). The model validation, the method of covariate selection and the method of goodness of fit were only reported in 8.0%, 36.8% and 14.9% of the articles, respectively. CONCLUSIONS During recent years, the use of GLMMs in medical literature has increased to take into account the correlation of data when modeling qualitative data or counts. According to the current recommendations, the quality of reporting has room for improvement regarding the characteristics of the analysis, estimation method, validation, and selection of the model.
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Affiliation(s)
- Martí Casals
- CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
- Bioestadística, Departament de Salut Pública, Universitat de Barcelona, Barcelona, Spain
- Departament de Ciencies Basiques, Universitat Internacional de Catalunya, Barcelona, Spain
- Servei d’Epidemiologia, Agència de Salut Pública de Barcelona, Barcelona, Spain
| | - Montserrat Girabent-Farrés
- Departament de Fisioteràpia (unitat de Bioestadística), Universitat Internacional de Catalunya, Barcelona, Spain
| | - Josep L. Carrasco
- Bioestadística, Departament de Salut Pública, Universitat de Barcelona, Barcelona, Spain
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Hess JJ, Eidson M, Tlumak JE, Raab KK, Luber G. An evidence-based public health approach to climate change adaptation. ENVIRONMENTAL HEALTH PERSPECTIVES 2014; 122:1177-86. [PMID: 25003495 PMCID: PMC4216160 DOI: 10.1289/ehp.1307396] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2013] [Accepted: 07/03/2014] [Indexed: 05/03/2023]
Abstract
BACKGROUND Public health is committed to evidence-based practice, yet there has been minimal discussion of how to apply an evidence-based practice framework to climate change adaptation. OBJECTIVES Our goal was to review the literature on evidence-based public health (EBPH), to determine whether it can be applied to climate change adaptation, and to consider how emphasizing evidence-based practice may influence research and practice decisions related to public health adaptation to climate change. METHODS We conducted a substantive review of EBPH, identified a consensus EBPH framework, and modified it to support an EBPH approach to climate change adaptation. We applied the framework to an example and considered implications for stakeholders. DISCUSSION A modified EBPH framework can accommodate the wide range of exposures, outcomes, and modes of inquiry associated with climate change adaptation and the variety of settings in which adaptation activities will be pursued. Several factors currently limit application of the framework, including a lack of higher-level evidence of intervention efficacy and a lack of guidelines for reporting climate change health impact projections. To enhance the evidence base, there must be increased attention to designing, evaluating, and reporting adaptation interventions; standardized health impact projection reporting; and increased attention to knowledge translation. This approach has implications for funders, researchers, journal editors, practitioners, and policy makers. CONCLUSIONS The current approach to EBPH can, with modifications, support climate change adaptation activities, but there is little evidence regarding interventions and knowledge translation, and guidelines for projecting health impacts are lacking. Realizing the goal of an evidence-based approach will require systematic, coordinated efforts among various stakeholders.
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Affiliation(s)
- Jeremy J Hess
- Climate and Health Program, Division of Environmental Hazards and Health Effects, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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