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

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

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

Broedsucces van kenmerkende kustbroedvogels in de Waddenzee in mineur

De Nederlandse Waddenzee is het grootste aaneengesloten natuurgebied in ons land en vormt, samen met het Waddengebied in Duitsland en Denemarken, één van de belangrijkste natuurgebieden in Europa. Het gehele gebied is recent toegevoegd aan de lijst van werelderfgoedgebieden van UNESCO. Het Waddengebied vervult een zeer belangrijke functie als pleisterplaats en overwinteringsgebied voor 10 tot 12 miljoen watervogels en is tegelijk een belangrijk broedgebied voor ongeveer 35 soorten watervogels, waarvan verschillende soorten bij voorkeur in het gebied broeden. Het reilen en zeilen van deze vogels wordt sinds 1991 gevolgd met twee monitorprogramma’s. Deze paper gaat in op het langjarige onderzoek naar het broedsucces van kenmerkende kustbroedvogels in de Waddenzee

Ganzenoverlast, perceptie en oplossingen

Overwinterende ganzen trekken in het beleid veel aandacht. Met name in denoordelijke provincies houdt de toename van de brandgans (Branta leucopsis) degemoederen bezig. De provincies streven een beleid na dat overlast voor boerenen voldoen aan internationale verplichtingen in balans houdt. Zij hechten sterkaan draagvlak en overleggen intensief met alle betrokkenen (agrariërs, jagers,terreinbeheerders, natuurbeschermers). Over het algemeen blijken de ideeën over effectieve reductie van schade sterk uiteen te lopen bij verschillende belangengroepen. Agrariërs hebben weinig fiducie in de werking van opvanggebieden. Ecologen stellen dat populatiereductie door afschot niet tot evenredige schadereductie leidt. Hoe hier verder te komen

Broedsucces van kustbroedvogels in de Waddenzee : Resultaten 2015-2016 en trends in broedsucces in 2005-2016

Data have been collected on the breeding success of several characteristic coastal breeding birds in the Wadden Sea each year since 2005. Ten birds species considered representative of specific habitats and food groups are being monitored. The monitoring scheme on breeding success in coastal breeding birds is run as an ‘early warning system’ to follow the reproductive capacity of the bird populations in the Wadden Sea and understand the processes underlying fluctuations in populations. It is a valuable addition to the monitoring of population numbers and is carried out under a trilateral agreement with Germany and Denmark (TMAP). The results from 2015–2016 and an analysis of data series from the period 2005–2016 (sometimes longer) show that several species on average reared too few young to sustain stable population size in many of these years, especially the Eurasian Oystercatcher, Pied Avocet, Common Tern and Arctic Tern, and in recent years also the Black-headed Gull, whose breeding success has significantly declined since 1995. Other species showing a significant decline in breeding success are the Spoonbill and Common Tern. The only species to show any significant improvement in breeding success since 2005 is the Lesser Black-backed Gul

Broedsucces van kustbroedvogels in de Waddenzee in 2007 en 2008

Voor het derde en vierde opeenvolgende jaar werd het broedsucces van een aantal kustbroedvogels in de Waddenzee bepaald. Van Eider, Scholekster, Kluut, Kokmeeuw, Zilvermeeuw en Visdief, alsmede van Kleine Mantelmeeuw en Noordse Stern werd informatie verzamelen over het nestsucces en uitvliegsucces (het uiteindelijke broedsucces). Kennis over de jaarlijkse variatie in broedresultaten bij de verschillende soorten is van belang als een early warning systeem om de 'kwaliteit' (het reproducerend vermogen) van de vogelpopulaties in de Waddenzee te volgen en de achterliggende processen van populatieveranderingen te doorgronden. Directe aanleiding voor het project vormde de evaluatie van de effectiviteit van het nieuwe schelpdiervisserijbeleid en de mogelijke gevolgen voor de voedselvoorziening van schelpdieretende vogels