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ArticlePublication 2015Population Health Model (POHEM): An Overview
This paper provides an overview of the rationale, methodology and applications of the Population Health …
This paper provides an overview of the rationale, methodology and applications of the Population Health Model (POHEM). POHEM is a health microsimulation model, developed at Statistics Canada in the early 1990s. The authors describe that 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…
North America | Costing Methods | Evidence Synthesis | Mathematical Models | Microsimulation | Calibration/Validation | Chronic Disease/Risk | Health Systems | Policy/Regulation | Clinical Care | Economics/Finance | Health/Medicine -
ArticlePublication 2012Modeling the Risks and Benefits of Depression Treatment for Children and Young Adults
This article, published in Value in Health, presents a discrete event simulation model to quantify …
This article, published in Value in Health, presents a discrete event simulation model to quantify the trade-offs with respect to clinical benefits and the risk of fatal and non-fatal suicidal behavior of alternative treatment strategies for a U.S. pediatric population with major depressive disorder. The authors evaluate treatment strategies including: selective serotonin reuptake inhibitors (SSRIs), cognitive behavioral therapy (CBT), and a combination of both. The results show that the use of SSRIs is associated with…
North America | Health Outcomes | Microsimulation | Technology Assessment | Mental Health | Health/Medicine -
ArticlePublication 2013Contribution of H. Pylori and Smoking to US Incidence of Gastric Adenocarcinoma: A Microsimulation Model
Although gastric cancer has declined dramatically in the US, the disease remains the second leading …
Although gastric cancer has declined dramatically in the US, the disease remains the second leading cause of cancer mortality worldwide. This analysis estimates the contribution of risk factor trends on past and future intestinal-type non-cardia gastric adenocarcinoma (NCGA) incidence. The authors developed a population-based microsimulation model of intestinal-type NCGA and calibrated it to U.S. epidemiologic data on precancerous lesions and cancer. The model explicitly incorporated the impact of Helicobacter pylori and smoking on disease natural history, for which…
North America | Microsimulation | Calibration/Validation | Chronic Disease/Risk | Social Determinants | Culture/Society | Health/Medicine -
ReviewPublication 2001Modeling for Health Care and Other Policy Decisions: Uses, Roles and Validity
This is a review article of the role of modeling approaches to guide decision making …
This is a review article of the role of modeling approaches to guide decision making in health care and other domains. The role of models to support recommendations on the cost-effective use of medical technologies and pharmaceuticals is controversial. At the heart of the controversy is the degree to which experimental or other empirical evidence should be required prior to model use. The authors argue that the controversy stems in part from a misconception that…
North America | Priority Setting/Ethics | Evidence Synthesis | Mathematical Models | Technology Assessment | Environmental Health | Health Systems | Policy/Regulation | Business/Industry | Climate/Environment | Economics/Finance | Energy/Engineering | Government/Law | Health/Medicine -
ArticlePublication 2002Empirically Calibrated Model of Hepatitis C Virus Infection in the United States
This article presents an epidemiologic model of hepatitis C in the United States. The authors …
This article presents an epidemiologic model of hepatitis C in the United States. The authors used empirical calibration of model parameters to gain insights into uncertainty in the natural history of hepatitis C and to improve future projections. The authors identified model inputs by way of a systematic review. Model simulations were conducted and model predictions were compared with epidemiologic data on infection prevalence and mortality from liver cancer. Goodness-of-fit criteria were used to identify…
North America | Mathematical Models | State-Transition | Calibration/Validation | Infectious Diseases | Chronic Disease/Risk | Health/Medicine -
ArticlePublication 2007Modeling HPV and Cervical Cancer in the U.S. for Analyses of Screening and Vaccination
This paper discusses a model of human papillomavirus (HPV) and cervical cancer that incorporates uncertainty …
This paper discusses a model of human papillomavirus (HPV) and cervical cancer that incorporates uncertainty about the natural history of disease that was used to provide quantitative insight into U.S. policy choices for cervical cancer prevention. The authors developed a stochastic microsimulation of cervical cancer that distinguishes different HPV types by their incidence, clearance, persistence, and progression. For each set of sampled input parameters, likelihood-based goodness-of-fit (GOF) scores were computed based on comparisons between model-predicted…
North America | Microsimulation | Calibration/Validation | Infectious Diseases | Chronic Disease/Risk | Clinical Care | Health/Medicine | Science/Technology -
ArticlePublication 2015Cancer Models and Real-World Data: Better Together
Decision-analytic models synthesize available data on disease burden and intervention effectiveness to project estimates of …
Decision-analytic models synthesize available data on disease burden and intervention effectiveness to project estimates of the long-term consequences of care. While models have been influential in informing US cancer screening guidelines under ideal conditions, incorporating detailed data on real-world screening practice has been limited given the complexity of screening processes and behaviors throughout diverse health delivery systems in the United States. The authors describe the synergies that exist between decision-analytic models and health care utilization…
North America | Evidence Synthesis | Mathematical Models | Calibration/Validation | Chronic Disease/Risk | Health Systems | Clinical Care | Health/Medicine | Science/Technology -
ArticlePublication 2015A Conceptual Model for Breast, Cervical, and Colorectal Cancer Screening
General frameworks of the cancer screening process are available, but none directly compare the process …
General frameworks of the cancer screening process are available, but none directly compare the process in detail across different organ sites. This limits the ability of medical and public health professionals to develop and evaluate coordinated screening programs that apply resources and population management strategies available for one cancer site to other sites. This paper presents a conceptual model that incorporates a single screening episode for breast, cervical, and colorectal cancers into a unified framework based…
North America | Preferences/Values | Health Outcomes | Evidence Synthesis | Test Performance | Microsimulation | Cost-Effectiveness Analysis | Chronic Disease/Risk | Health Systems | Clinical Care | Health/Medicine | Science/Technology -
ArticlePublication 2009Cost Effectiveness Analysis of Including Boys in a HPV Vaccination Program in the U.S.
This article reports on a societal-perspective cost effectiveness analysis of including preadolescent boys in a …
This article reports on a societal-perspective cost effectiveness analysis of including preadolescent boys in a routine human papillomavirus (HPV) vaccination program for preadolescent girls. The analysis included girls and boys aged 12 years; interventions included HPV vaccination of girls alone and of girls and boys in the context of screening for cervical cancer. The authors found that with 75% vaccination coverage and an assumption of complete, lifelong vaccine efficacy, routine HPV vaccination of 12-year-old girls…
North America | Dynamic Transmission | Microsimulation | Calibration/Validation | Cost-Effectiveness Analysis | Infectious Diseases | Chronic Disease/Risk | Clinical Care | Economics/Finance | Health/Medicine -
GuidelinesPublication 2013Decision and Simulation Modeling in Systematic Reviews
The purpose of this review is to provide guidance for determining when incorporating a decision-analytic …
The purpose of this review is to provide guidance for determining when incorporating a decision-analytic model alongside a systemic review would be of added value for decision making purposes. The purpose of systematic reviews is to synthesize the current scientific literature on a particular topic in the form of evidence reports and technology assessments to assist public and private organizations in developing strategies that improve the quality of health care and decision making. However, there…
North America | Evidence Synthesis | Mathematical Models | Decision Analysis | Infectious Diseases | Child/Nutrition | Chronic Disease/Risk | Health/Medicine -
ReportPublication 2016Modeling to Inform Strategies to Improve Population Health
This workshop report summarizes a workshop convened by the Institute of Medicine to explore the potential …
This workshop report summarizes a workshop convened by the Institute of Medicine to explore the potential uses of simulation and other types of modeling for improving health. Participants worked to identify how modeling could inform population health decision making (selecting and refining potential strategies, ranging from interventions to investments) based on lessons learned from models that have been, or have not been, used successfully, opportunities and barriers to incorporating models into decision making, and data needs and…
North America | Mathematical Models | State-Transition | Microsimulation | Dynamic Simulation | Decision Analysis | Chronic Disease/Risk | Environmental Health | Health Systems | Policy/Regulation | Business/Industry | Climate/Environment | Government/Law | Health/Medicine -
GuidelinesPublication 2016Decision Models in Clinical Preventive Services Recommendations
The U.S. Preventive Services Task Force (USPSTF) develops evidence-based recommendations about preventive care based on …
The U.S. Preventive Services Task Force (USPSTF) develops evidence-based recommendations about preventive care based on comprehensive systematic reviews of the best available evidence. Decision models provide a complementary, quantitative approach to support the USPSTF as it deliberates about the evidence and develops recommendations for clinical and policy use. This article describes the rationale for using modeling, an approach to selecting topics for modeling, and how modeling may inform recommendations about clinical preventive services.
North America | Health Outcomes | Evidence Synthesis | Mathematical Models | Decision Analysis | Health Systems | Policy/Regulation | Health/Medicine -
ArticlePublication 2009Cost-Effectiveness of HPV Vaccination and Cervical Cancer Screening in Women Aged 30+ Years in the U.S.
The objective of the study was to assess the health and economic outcomes of HPV …
The objective of the study was to assess the health and economic outcomes of HPV vaccination in older U.S. women. The authors conducted a cost-effectiveness analysis with an empirically calibrated model using data from published literature; interventions included HPV vaccination added to screening strategies that differ by test (cytology or HPV DNA testing), frequency, and start age versus screening alone.They found that in the context of annual or biennial screening, HPV vaccination of women aged…
North America | Microsimulation | Cost-Effectiveness Analysis | Infectious Diseases | Chronic Disease/Risk | Clinical Care | Economics/Finance | Health/Medicine | Science/Technology -
ArticlePublication 2008Health and Economic Implications of HPV Vaccination in the U.S.
This article reports on a study using models of HPV-16 and HPV-18 transmission and cervical …
This article reports on a study using models of HPV-16 and HPV-18 transmission and cervical carcinogenesis to compare the health and economic outcomes of vaccinating preadolescent girls in the US (at 12 years of age), and vaccinating older girls and women in catch-up programs (to 18, 21, or 26 years of age). The study also examined the health benefits of averting other HPV-16-related and HPV-18-related cancers, the prevention of HPV-6-related and HPV-11-related genital warts and…
North America | Dynamic Transmission | Microsimulation | Calibration/Validation | Cost-Effectiveness Analysis | Infectious Diseases | Chronic Disease/Risk | Health Systems | Clinical Care | Economics/Finance | Health/Medicine | Science/Technology
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