Representing Progression and Interactions of Comorbidities in Aggregate and Individual-Based Systems Models Osgood, N. Proceedings, The 27th International Conference of the System Dynamics Society, July 2009, Albuquerque

Healthcare simulation models have attracted significant offered important insights in to health policy selection. More complete accounting for the cost and health implications of upstream interventions is hindered by the need to consider impact on, and interactions between, multiple comorbidities. Within this paper, we explore several distinct approaches for representing comorbidities, some of them at the aggregate level, and some of them at the individual level. All of these representations have the virtue of being declarative, in that they allow the user to focus on what is to be characterized, rather than how it is to be implemented. Our exploration suggests that while several aggregate representations of comorbidities are possible, they suffer from a variety of shortcomings, ranging from low fidelity to combinatorial blowup. While individual-level representations impose a heavy performance load, greater difficulties in calibration and less rapid analysis, such representations do offer greater transparency, modifiability, scalability, and modularity, and ease of representing transmission and influence networks. With much to recommend each approach, further research is needed to shed additional light on the tradeoffs and identify situations where one representation is preferable to another.
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The GAP-DRG Model: Simulation of Outpatient Care for Comparison of Different Reimbursement Schemes Patrick Einzinger, Niki Popper, Felix Breitenecker et al., Proceedings of the 2013 Winter Simulation Conference

In healthcare the reimbursement of medical providers is an important topic and can influence the overall outcome. We present the agent-based healthcare model, which allows a comparison of reimbursement schemes in outpatient care. It models patients and medical providers as agents. In the simulation of healthcare system, patients develop medical problems (i.e., diseases) and a need for medical services. This leads to utilization of medical providers. The reimbursement system receives information on the patients’ visits via its generic interface, which facilitates an easy replacement. We describe the assumptions of the model in detail and show how it makes extensive use of available Austrian routine care data for its parameterization. The model design is optimized for utilizing as much of these data as possible. However, many assumptions have to be simplifications. Further work and detailed comparisons with healthcare data will provide insight on which assumptions are valid descriptions of the real process.
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Agent-Based Simulation of a Tuberculosis Epidemic Parastu Kasaie, David W. Dowdy, W. David Kelton, Proceedings of the 2013 Winter Simulation Conference

We propose an epidemic agent-based simulation model for disease (TB) transmission dynamics study and to find out the role of various contact networks. Our model simulates the TB epidemic course across a single population and uses a hierarchical network of contacts in three levels, typical to the transmission of airborne diseases (Mossong et al. 2005). Parameters are chosen from the literature, and the model is calibrated to a setting of high TB incidence. We use our model to study the transmission dynamics at an individual level with regard to the timing and distribution of secondary infections from a single source. The average time for disease diffusion to reach 50% of infections at an individual level is estimated, and the timing patterns are compared among different networks. We perform sensitivity analysis of results with regard to multiple parameter values, and discuss the implications for TB control policy.
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West Nile Virus System Dynamics Investigation In Dallas County, TX Mohammad F. Obeid, John Shull, Proceedings of the 2013 Winter Simulation Conference

After its first introduction in 1999, West Nile Virus (WNV) has spread very widely along the east coasts of the United States before appearing in Texas where 1792 cases were reported of which 82 were fatal in 2012. The interesting patterns and behavior of the virus and its amplified impact on the county of Dallas drove this work. This paper encompasses a thorough development of a systems dynamics simulation model of virus's infectious behavior and dynamics in Dallas County, TX utilizing historical data collected and the aid of suitable software packages.
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A Modular Simulation Model For Assessing Interventions For Abdominal Aortic Aneurysms Christoph Urach, Günther Zauner, Gottfried Endel, Ingrid Wilbacher, Felix Breitenecker, Proceedings of the 2013 Winter Simulation Conference

This paper discusses the development of an individual based simulation of interventions for better treatment of patients with abdominal aortic aneurysms (AAA). The interdisciplinary subject required collaboration of medical doctors, Health Technology Assessment (HTA) experts and modelers.
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Prospective Healthcare Decision-Making By Combined System Dynamics, Discrete-Event And Agent-Based Simulation Anatoli Djanatliev, Reinhard German, Proceedings of the 2013 Winter Simulation Conference

Prospective Health Technology Assessment allows early decision making for innovative health care technologies. In our recent publications a hybrid simulation approach with System Dynamics and Agent-Based Modeling has been presented. This paper presents a mechanism to generate agents dynamically from SD models and extends the previously presented hybrid approach by process-oriented Discrete Event Simulation for hospital modeling.
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Large Scale Healthcare Modeling by Hybrid Simulation Techniques using AnyLogic Anatoli Djanatliev and Reinhard German, Computer Networks and Communication Systems Department of Computer Science 7. Proceedings of the 6th International ICST Conference on Simulation Tools and Techniques

This paper describes a methodical and practical approach of hybrid model creation using the simulation tool AnyLogic. We focus on general modeling aspects and on advanced techniques using a Level-Based Architecture that help to develop large scale hybrid simulation models. An implementation of a stroke therapy use-case and its simulation results will be discussed. Finally, some practical ideas for validation will be outlined, as we experienced during the stroke use-case development.
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Simulazione discreta con il software AnyLogic. Caratteristiche generali e applicazione ad unostudio oculistico Mattia Munaro, the University of Padua, Faculty of Engineering, 2009-2010

AnyLogic è un ambiente di modellazione virtuale di sistemi discreti, continui ed ibridi. Con questo strumento è possibile creare prototipi di sistemi durante le fasi di studio, progettazione o sviluppo, attraverso cui esplorare aspetti e dettagli della progettazione o della implementazione dei relativi sistemi in modo semplice e privo di rischi
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A simulation modeling approach for improving oral health outcomes of older adults Michael J. Widener, University at Buffalo

This interdisciplinary research focuses on improving the oral health of older adults as a means of enhancing their overall wellbeing and quality of life. Periodontal disease is a risk factor for other chronic illnesses, notably diabetes and cardiovascular disease. In order to identify policies that improve oral health for older adults, a dynamic modeling approach that considers community and individual level factors is utilized.
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VirSim - a Model to Support Pandemic Policy Making Tobias Fasth, Marcus Ihlar, Lisa Brouwers. PLoS Currents: Influenza. September 2010.

A simulation model called VirSim was developed to aid policy making in Sweden. The model simulates the spread of pandemic influenza, using real population data on a national and regional level. Swedish authorities wanted a model that was both quick to run and to implement as a complement to the existing model MicroSim.
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