A Comparison of Sensitivity Analysis Techniques for Complex Models for Environmental Management

Computer based modelling methods are being used increasingly to replicate natural systems in order to review both large and small scale policy measures prior to their implementation. Integrated Assessment Modelling (IAM) incorporates knowledge from several different disciplines into one model in order to provide an overarching assessment of the impact of different management decisions. The importance of IAM is that the environmental, social and economic impacts of management choices can be assessed within a single model, further allowing assessment in relation to sustainability criteria. The considerable detail facilitated by these models often requires the inclusion of a large number of parameters and model inputs, many of whose values may not be known with certainty. For this reason and because models do not always behave intuitively (in particular when there are non-linearities involved), sensitivity analysis (SA) of the model to changes in its parameters and inputs is an important stage of model development. Current SA methods have not kept pace with rapid increases in computing power and availability and more importantly the resultant increases in model size and complexity. Also related to the complexity is increased difficulty in finding and fitting distributions to all parameters. Further, the complex nature of integrated models requires SA that is flexible and can be implemented regardless of model structure. This research aims to establish new criteria for SA used in the context of integrated models for environmental management and decision-making. These criteria are believed to reflect the current requirements specific to this type of modelling. Desirable criteria are identified as: high computational efficiency; ability to take into account higher order parameter interactions; ability to account for model non-linearities; not requiring knowledge of parameter probability distributions; and use in decision making. SA of an integrated model of the Namoi River catchment is performed using the Fourier Amplitude Sensitivity Testing (FAST) method, Morris method, method of Sobol', and regression and correlation coefficients. The results from these analyses are used as a basis for comparing the SA methods by the new criteria outlined above. The Namoi model is a combination of a flow model with a non-linear component, a policy model, an economic model and an extraction model. It can be used for assessing management options for the river. SA of two different potential management options for the catchment is undertaken to facilitate comparison of sensitivity between two slightly different models. Comparison of the different SA methods shows that none of the methods meet all of the criteria and, in particular, there are no methods that are effective for use when comparing management options. This lack of an adequate SA method for integrated models indicates that development of a new method of SA specifically for integrated models for environmental management is desirable. The FAST method is shown to meet the criteria most effectively, being able to account for model non-linearity and non-monotonicity, requiring only parameter ranges (not distributions), and being relatively computationally efficient (although this does come at a loss of some resolution). Results from the FAST SA of the Namoi model show the model to be sensitive to several parameters within the non-linear loss module. Further, one management option shows sensitivity to the decision variables within the model while the other does not. This means that the first management option clearly corresponds to the more controllable form of the model

Dexamethasone intravitreal implant in previously treated patients with diabetic macular edema : Subgroup analysis of the MEAD study

Background: Dexamethasone intravitreal implant 0.7 mg (DEX 0.7) was approved for treatment of diabetic macular edema (DME) after demonstration of its efficacy and safety in the MEAD registration trials. We performed subgroup analysis of MEAD study results to evaluate the efficacy and safety of DEX 0.7 treatment in patients with previously treated DME. Methods: Three-year, randomized, sham-controlled phase 3 study in patients with DME, best-corrected visual acuity (BCVA) of 34.68 Early Treatment Diabetic Retinopathy Study letters (20/200.20/50 Snellen equivalent), and central retinal thickness (CRT) 65300 \u3bcm measured by time-domain optical coherence tomography. Patients were randomized to 1 of 2 doses of DEX (0.7 mg or 0.35 mg), or to sham procedure, with retreatment no more than every 6 months. The primary endpoint was 6515-letter gain in BCVA at study end. Average change in BCVA and CRT from baseline during the study (area-under-the-curve approach) and adverse events were also evaluated. The present subgroup analysis evaluated outcomes in patients randomized to DEX 0.7 (marketed dose) or sham based on prior treatment for DME at study entry. Results: Baseline characteristics of previously treated DEX 0.7 (n = 247) and sham (n=261) patients were similar. In the previously treated subgroup, mean number of treatments over 3 years was 4.1 for DEX 0.7 and 3.2 for sham, 21.5 % of DEX 0.7 patients versus 11.1 % of sham had 6515-letter BCVA gain from baseline at study end (P = 0.002), mean average BCVA change from baseline was +3.2 letters with DEX 0.7 versus +1.5 letters with sham (P = 0.024), and mean average CRT change from baseline was -126.1 \u3bcm with DEX 0.7 versus -39.0 \u3bcm with sham(P < 0.001). Cataract-related adverse events were reported in 70.3 % of baseline phakic patients in the previously treated DEX 0.7 subgroup; vision gains were restored following cataract surgery. Conclusions: DEX 0.7 significantly improved visual and anatomic outcomes in patients with DME previously treated with laser, intravitreal anti-vascular endothelial growth factor, intravitreal triamcinolone acetonide, or a combination of these therapies. The safety profile of DEX 0.7 in previously treated patients was similar to its safety profile in the total study population

Compounding Impacts of Human-Induced Water Stress and Climate Change on Water Availability

The terrestrial phase of the water cycle can be seriously impacted by water management and human water use behavior (e.g., reservoir operation, and irrigation withdrawals). Here we outline a method for assessing water availability in a changing climate, while explicitly considering anthropogenic water demand scenarios and water supply infrastructure designed to cope with climatic extremes. The framework brings a top-down and bottom-up approach to provide localized water assessment based on local water supply infrastructure and projected water demands. When our framework is applied to southeastern Australia we find that, for some combinations of climatic change and water demand, the region could experience water stress similar or worse than the epic Millennium Drought. We show considering only the influence of future climate on water supply, and neglecting future changes in water demand and water storage augmentation might lead to opposing perspectives on future water availability. While human water use can significantly exacerbate climate change impacts on water availability, if managed well, it allows societies to react and adapt to a changing climate. The methodology we present offers a unique avenue for linking climatic and hydrologic processes to water resource supply and demand management and other human interactions

Dexamethasone intravitreal implant in previously treated patients with diabetic macular edema: Subgroup analysis of the MEAD study

Background: Dexamethasone intravitreal implant 0.7 mg (DEX 0.7) was approved for treatment of diabetic macular edema (DME) after demonstration of its efficacy and safety in the MEAD registration trials. We performed subgroup analysis of MEAD study results to evaluate the efficacy and safety of DEX 0.7 treatment in patients with previously treated DME. Methods: Three-year, randomized, sham-controlled phase 3 study in patients with DME, best-corrected visual acuity (BCVA) of 34.68 Early Treatment Diabetic Retinopathy Study letters (20/200.20/50 Snellen equivalent), and central retinal thickness (CRT) 65300 \u3bcm measured by time-domain optical coherence tomography. Patients were randomized to 1 of 2 doses of DEX (0.7 mg or 0.35 mg), or to sham procedure, with retreatment no more than every 6 months. The primary endpoint was 6515-letter gain in BCVA at study end. Average change in BCVA and CRT from baseline during the study (area-under-the-curve approach) and adverse events were also evaluated. The present subgroup analysis evaluated outcomes in patients randomized to DEX 0.7 (marketed dose) or sham based on prior treatment for DME at study entry. Results: Baseline characteristics of previously treated DEX 0.7 (n = 247) and sham (n=261) patients were similar. In the previously treated subgroup, mean number of treatments over 3 years was 4.1 for DEX 0.7 and 3.2 for sham, 21.5 % of DEX 0.7 patients versus 11.1 % of sham had 6515-letter BCVA gain from baseline at study end (P = 0.002), mean average BCVA change from baseline was +3.2 letters with DEX 0.7 versus +1.5 letters with sham (P = 0.024), and mean average CRT change from baseline was -126.1 \u3bcm with DEX 0.7 versus -39.0 \u3bcm with sham(P < 0.001). Cataract-related adverse events were reported in 70.3 % of baseline phakic patients in the previously treated DEX 0.7 subgroup; vision gains were restored following cataract surgery. Conclusions: DEX 0.7 significantly improved visual and anatomic outcomes in patients with DME previously treated with laser, intravitreal anti-vascular endothelial growth factor, intravitreal triamcinolone acetonide, or a combination of these therapies. The safety profile of DEX 0.7 in previously treated patients was similar to its safety profile in the total study population