A scoping review of metamodeling applications and opportunities for advanced health economic analyses

Introduction: Metamodels, also known as meta-models, surrogate models, or emulators, are used in several fields of research to negate runtime issues with analyzing computational demanding simulation models. This study introduces metamodeling and presents results of a review on metamodeling applications in health economics. Areas covered: A scoping review was performed to identify studies that applied metamodeling methods in a health economic context. After search and selection, 13 publications were found to employ metamodeling methods in health economics. Metamodels were used to perform value of information analysis (n = 5, 38%), deterministic sensitivity analysis (n = 4, 31%), model calibration (n = 1, 8%), probabilistic sensitivity analysis (n = 1), or optimization (n = 1, 8%). One study was found to extrapolate a simulation model to other countries (n = 1, 8%). Applied metamodeling techniques varied considerably between studies, with linear regression being most frequently applied (n = 7, 54%). Expert commentary: Although it has great potential to enable computational demanding analyses of health economic models, metamodeling in health economics is still in its infancy, as illustrated by the limited number of applications and the relatively simple metamodeling methods applied. Comprehensive guidance specific to health economics is needed to provide modelers with the information and tools needed to utilize the full potential of metamodels

Introduction to metamodeling for reducing computational burden of advanced analyses with health economic models : a structured overview of metamodeling methods in a 6-step application process

Metamodels can be used to reduce the computational burden associated with computationally demanding analyses of simulation models, though applications within health economics are still scarce. Besides a lack of awareness of their potential within health economics, the absence of guidance on the conceivably complex and time-consuming process of developing and validating metamodels may contribute to their limited uptake. To address these issues, this paper introduces metamodeling to the wider health economic audience and presents a process for applying metamodeling in this context, including suitable methods and directions for their selection and use. General (i.e., non-health economic specific) metamodeling literature, clinical prediction modeling literature, and a previously published literature review were exploited to consolidate a process and to identify candidate metamodeling methods. Methods were considered applicable to health economics if they are able to account for mixed (i.e., continuous and discrete) input parameters and continuous outcomes. Six steps were identified as relevant for applying metamodeling methods within health economics, i.e. 1) the identification of a suitable metamodeling technique, 2) simulation of datasets according to a design of experiments, 3) fitting of the metamodel, 4) assessment of metamodel performance, 5) conduct the required analysis using the metamodel, and 6) verification of the results. Different methods are discussed to support each step, including their characteristics, directions for use, key references, and relevant R and Python packages. To address challenges regarding metamodeling methods selection, a first guide was developed towards using metamodels to reduce the computational burden of analyses of health economic models. This guidance may increase applications of metamodeling in health economics, enabling increased use of state-of-the-art analyses, e.g. value of information analysis, with computationally burdensome simulation models

PRM113 - Timed Automata Modeling of The Personalized Treatment Decisions In Metastatic Castration Resistant Prostate Cancer

Objectives\ud The Timed Automata modeling paradigm has emerged from Computer Science as a mature tool for the functional analysis and performance evaluation of timed distributed systems. This study is a first exploration of the suitability of Timed Automata for health economic modeling, using a case study on personalized treatment for metastatic Castration Resistant Prostate Cancer (mCRPC).\ud \ud Methods\ud The treatment process has been modeled by creating several independent timed automata, where an automaton represents a patient, a physician, a test, or a treatment/testing guideline schedule. These automata interact via message passing and are fully parameterized with quantitative information. Messages can be passed, asynchronously, from one automaton to one or more other automata, at any point in time, thereby triggering events and decisions in the treatment process. In the automata time is continuous, and both QALYs and costs can be incorporated using (assignable) local clocks. Uncertainty can be modeled using probabilities and timing intervals that can be uniformly or exponentially distributed. Software for building timed automata is freely available for academic use and includes procedures for statistical model checking (SMC) to validate the (internal) behavior and results of the model.\ud \ud Results\ud In several days a Timed Automata model has been produced that is compositional, easy to understand and easy to update. The behavior and results of the model have been assessed using the SMC tool. Actual results for the mCRPC case study obtained from the Timed Automata model are compared with results of a Discrete Event Simulation model in a separate study.\ud \ud Conclusions\ud The Timed Automata paradigm can be successfully applied to evaluate the potential benefits of a personalized treatment process of mCRPC. The compositional nature of the resulting model provides a good separation of all relevant components. This leads to models that are easy to formulate, validate, understand, maintain and update

Entanglements of affect, space, and evidence in pandemic healthcare: An analysis of Australian healthcare workers' experiences of COVID-19.

The COVID-19 pandemic continues to highlight both global interconnectedness and schisms across place, context and peoples. While countries such as Australia have securitised their borders in response to the global spread of disease, flows of information and collective affect continue to permeate these boundaries. Drawing on interviews with Australian healthcare workers, we examine how their experiences of the pandemic are shaped by affect and evidence 'traveling' across time and space. Our analysis points to the limitations of global health crisis responses that focus solely on material risk and spatial separation. Institutional responses must, we suggest, also consider the affective and discursive dimensions of health-related risk environments

Van Allen probes observations of a three-dimensional field line resonance at a plasmaspheric plume

Funding: JKS, KRM, and IJR acknowledge support from NERC Grants NE/P017185/2, NE/V002554/2, and STFC Grants ST/V006320/1, ST/X001008/1. DPH acknowledges NASA Grant 80NSSC20K1324. ANW was funded in part by STFC Grant ST/W001195/1. AWS was supported by NERC Independent Research Fellowship NE/W009129/1.Field Line Resonances (FLRs) are a critical component in Earth's magnetospheric dynamics, associated with the transfer of energy between Ultra Low Frequency waves and local plasma populations. In this study we investigate how the polarisation of FLRs are impacted by cold plasma density distributions during geomagnetic storms. We present an analysis of Van Allen Probe A observations, where the spacecraft traversed a storm time plasmaspheric plume. We show that the polarisation of the FLR is significantly altered at the sharp azimuthal density gradient of the plume boundary, where the polarisation is intermediate with significant poloidal and toroidal components. These signatures are consistent with magnetohydrodynamic modeling results, providing the first observational evidence of a 3D FLR associated with a plume in Earth's magnetosphere. These results demonstrate the importance of cold plasma in controlling wave dynamics in the magnetosphere, and have important implications for wave-particle interactions at a range of energies.Publisher PDFPeer reviewe

Integrative concepts and practices of health in transdisciplinary social ecology

Increasing recognition of interdependencies of the health of humans, other organisms and ecosystems, and of their importance to socio-ecological systems, necessitates application of integrative concepts such as One Health and EcoHealth. These concepts open new perspectives for research and practice but also generate confusion and divergent opinion, prompting new theories, and call for empirical clarification and evaluation. Through a semi-systematic evaluation of knowledge generation in scientific publications (comprised of literature reviews, conceptual models and analyses of communities of practice), we show how integrative concepts and approaches to health evolve and are adopted. Our findings indicate that while their contexts, goals and rationales vary, integrative concepts of health essentially arise from shared interests in living systems. Despite recent increased attention to ecological and societal aspects of health including broader sustainability issues, the focus remains anthropocentric and oriented towards biomedicine. Practices reflect and in turn transform these concepts, which together with practices also influence ways of integration. Overarching narratives vary between optimism and pessimism towards integrated health and knowledge. We conclude that there is an urgent need for better, coherent and more deeply integrative health concepts, approaches and practices to foster the well-being of humans, other animals and ecosystems. Consideration of these concepts and practices has methodological and political importance, as it will transform thinking and action on both society and nature and specifically can enrich science and practice, expanding their scope and linking them better. Transdisciplinary efforts are crucial to developing such concepts and practices to properly address the multiple facets of health and to achieve their appropriate integration for the socio-ecological systems at stake. We propose the term “transdisciplinary health” to denote the new approaches needed

How Do Ultra‐Low Frequency Waves Access the Inner Magnetosphere During Geomagnetic Storms?

Wave‐particle interactions play a key role in radiation belt dynamics. Traditionally, ultra‐low frequency (ULF) wave‐particle interaction is parameterized statistically by a small number of controlling factors for given solar wind driving conditions or geomagnetic activity levels. Here we investigate solar wind driving of ULF wave power and the role of the magnetosphere in screening that power from penetrating deep into the inner magnetosphere. We demonstrate that during enhanced ring current intensity, the Alfvén continuum plummets, allowing lower frequency waves to penetrate deeper into the magnetosphere than during quiet periods. With this penetration, ULF wave power is able to accumulate closer to the Earth than characterized by statistical models. During periods of enhanced solar wind driving such as coronal mass ejection driven storms, where ring current intensities maximize, the observed penetration provides a simple physics‐based reason for why storm time ULF wave power is different compared to nonstorm time waves

The First Shared Online Curriculum Resources for Veterinary Undergraduate Learning and Teaching in Animal Welfare and Ethics in Australia and New Zealand

The need for undergraduate teaching of Animal Welfare and Ethics (AWE) in Australian and New Zealand veterinary courses reflects increasing community concerns and expectations about AWE; global pressures regarding food security and sustainability; the demands of veterinary accreditation; and fears that, unless students encounter AWE as part of their formal education, as veterinarians they will be relatively unaware of the discipline of animal welfare science. To address this need we are developing online resources to ensure Australian and New Zealand veterinary graduates have the knowledge, and the research, communication and critical reasoning skills, to fulfill the AWE role demanded of them by contemporary society. To prioritize development of these resources we assembled leaders in the field of AWE education from the eight veterinary schools in Australia and New Zealand and used modified deliberative polling. This paper describes the role of the poll in developing the first shared online curriculum resource for veterinary undergraduate learning and teaching in AWE in Australia and New Zealand. The learning and teaching strategies that ranked highest in the exercise were: scenario-based learning; a quality of animal life assessment tool; the so-called ‘Human Continuum’ discussion platform; and a negotiated curriculum. Keywords: animal ethics; animal welfare; online curriculum resources; learning and teaching; scenarios; quality of life assessmentALT gran