Impact of antidepressants on the risk of suicide in patients with depression in real-life conditions: a decision analysis model

BackgroundThe impact of antidepressant drug treatment (ADT) on the risk of suicide is uncertain. The aim of this study was to determine in a real-life setting whether ADT is associated with an increased or a reduced risk of suicide compared to absence of ADT (no-ADT) in patients with depression.MethodA decision analysis method was used to estimate the number of suicides prevented or induced by ADT in children and adolescents (10–19 years old), adults (20–64 years old) and the elderly (⩾65 years) diagnosed with major depression. The impact of gender and parasuicide history on the findings was explored within each age group. Sensitivity analyses were used to assess the robustness of the models.ResultsPrescribing ADT to all patients diagnosed with depression would prevent more than one out of three suicide deaths compared to the no-ADT strategy, irrespective of age, gender or parasuicide history. Sensitivity analyses showed that persistence in taking ADT would be the main characteristic influencing the effectiveness of ADT on suicide risk.ConclusionsPublic health decisions that contribute directly or indirectly to reducing the number of patients with depression who are effectively administered ADT may paradoxically induce a rise in the number of suicides.

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Using decision analysis to explore cable television delivery

Journal of Modelling in Management ◽

10.1108/jm2-07-2015-0046 ◽

2017 ◽

Vol 12 (2) ◽

pp. 291-302

Author(s):

Keith Willoughby ◽

Christopher Zappe

Keyword(s):

Decision Analysis ◽

Cable Television ◽

Quantitative Model ◽

Sensitivity Analyses ◽

Decision Analysis Model ◽

Analysis Model ◽

Initial Attempt ◽

Content Type ◽

Staff Members ◽

Trade Offs

Purpose The purpose of this paper is to demonstrate the efficacy of decision analysis in determining the most efficient strategy for installing cable television in the residence halls of Bucknell University. Design/methodology/approach The decision analysis model compared five distinct approaches for achieving and maintaining a successful delivery of cable television service to students enrolled in this private, residential institution. For each alternative, the model incorporated installation costs, likelihood of installation failure, installation failure costs, likelihood of obsolescence and obsolescence-related costs. In addition to considering the trade-offs between cost, timing and riskiness of the various alternatives, a thorough set of sensitivity analyses was performed to gain insight into the parameters that most strongly influence this decision-making process. Findings The quantitative model advocated the adoption of the university’s data network as the mode for cable delivery. Sensitivity analysis further supported this notion. Practical implications The analysis of this problem incorporated the knowledge and judgments of senior administrators and staff members, thus demonstrating the critical contributions offered by subject-matter experts in advising, informing and launching successful decision analysis projects. Incorporating stakeholder viewpoints enhances model understanding and, eventually, model implementation. Decision analysis represents a powerful approach in communicating uncertainties and advising on the benefits of particular alternatives. Originality/value To the best of the researchers’ knowledge, this paper represents an initial attempt to investigate cable delivery options within a decision analysis framework.

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The Surgical Treatment of Cubital Tunnel Syndrome: A Decision Analysis

Journal of Hand Surgery (European Volume) ◽

10.1016/j.jhse.2007.07.001 ◽

2007 ◽

Vol 32 (6) ◽

pp. 654-662 ◽

Cited By ~ 33

Author(s):

C. A. BRAUER ◽

B. GRAHAM

Keyword(s):

Decision Analysis ◽

Expected Utility ◽

Cubital Tunnel Syndrome ◽

Sensitivity Analyses ◽

Cubital Tunnel ◽

Decision Analysis Model ◽

Tunnel Syndrome ◽

Subcutaneous Transposition ◽

Simple Decompression ◽

The Impact

The objective of our study was to use decision analysis to compare four common surgical treatments for cubital tunnel syndrome: simple decompression of the cubital tunnel, medial epicondylectomy, anterior subcutaneous transposition and anterior submuscular transposition. The variables used for this decision analysis model were based on data from the literature. Extensive sensitivity analyses were carried out to test the impact of the values given to these variables on the outcome of the model. The highest expected utility, 0.973, was associated with simple decompression. The expected utility was 0.969 for subcutaneous transposition and 0.965 for submuscular transposition. Medial epicondylectomy had the lowest expected utility at 0.961. Simple decompression remained the preferred strategy in extensive one-way sensitivity analyses.

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Exposure to Tuberculosis among Newborns in a Nursery: Decision Analysis for Initiation of Prophylaxis

Infection Control and Hospital Epidemiology ◽

10.1086/504359 ◽

2006 ◽

Vol 27 (6) ◽

pp. 604-611 ◽

Cited By ~ 3

Author(s):

Frank E. Berkowitz ◽

Johan L. Severens ◽

Henry M. Blumberg

Keyword(s):

Cost Effectiveness ◽

Decision Analysis ◽

Incremental Cost ◽

Sensitivity Analyses ◽

Local Health ◽

Decision Analysis Model ◽

Analysis Model ◽

Infected Infant ◽

Probability Of Survival ◽

Prophylaxis Strategy

Objective.Newborns in a hospital nursery were exposed to a mother whose sputum was direct-smear negative for acid-fast bacilli but culture positive for Mycobacterium tuberculosis. Given the low risk for exposure, the high susceptibility of infants to M. tuberculosis infection, and the possibility of hepatotoxicity due to isoniazid therapy, a decision analysis model was used to determine whether administration of isoniazid prophylaxis against tuberculosis is preferable to no administration of prophylaxis.Design.A decision analysis tree was constructed with software, using probabilities from the literature and costs from local health facilities. The expected values for each strategy were obtained, and sensitivity analyses were performed.Results.For the strategy in which prophylaxis was administered under direct observation (DO), the probability for survival was 0.999980. For the strategy in which no prophylaxis was administered, the probability of survival was 0.999950, which corresponds to 3 more deaths per 100,000 patients than with the DO prophylaxis strategy. The incremental cost-effectiveness of the DO prophylaxis strategy was $21,710,000 per death prevented. Sensitivity analysis for survival showed that the DO prophylaxis strategy was preferable to the strategy in which no prophylaxis is given if the probability of infection was >0.0002, the probability of tuberculous disease in an infected infant who did not receive prophylaxis was greater than 0.12, the probability of dying from tuberculosis was greater than 0.025, the probability of hepatotoxicity was less than 0.004, and the probability of dying from hepatotoxicity was less than 0.04. For the strategy in which prophylaxis was administered under non-DO conditions (ie, by parents), the incremental cost-effectiveness was $929,500 per death prevented, which is approximately 5% of the incremental cost-effectiveness of the DO prophylaxis strategy.Conclusion.This model provides a structure for determining the preferable prophylaxis strategies for different risks of exposure to tuberculosis in a nursery. Administration of prophylaxis is preferable to no administration of prophylaxis, unless the probability of infection is extremely low.

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A cost effective decision analysis model comparing two strategies for maintaining hepalitis B immunity in hemodialysis patients

Gastroenterology ◽

10.1016/s0016-5085(01)82763-3 ◽

2001 ◽

Vol 120 (5) ◽

pp. A556-A556

Author(s):

S WESTON ◽

S SAAB ◽

D LY ◽

M BREZINA ◽

H YEE ◽

...

Keyword(s):

Decision Analysis ◽

Cost Effective ◽

Hemodialysis Patients ◽

Decision Analysis Model ◽

Analysis Model ◽

Effective Decision

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Management of Patients with Pancreatic Ductal Adenocarcinoma in the Real-Life Setting: Lessons from the French National Hospital Database

Cancers ◽

10.3390/cancers13143515 ◽

2021 ◽

Vol 13 (14) ◽

pp. 3515

Author(s):

Christelle de la Fouchardière ◽

Mustapha Adham ◽

Anne-Marie Marion-Audibert ◽

Antoine Duclos ◽

Claude Darcha ◽

...

Keyword(s):

Pancreatic Ductal Adenocarcinoma ◽

Real Life ◽

Ductal Adenocarcinoma ◽

University Hospitals ◽

National Hospital ◽

Curative Intent ◽

The Real ◽

Oncological Treatment ◽

Real Life Setting ◽

Number Of Patients

Pancreatic ductal adenocarcinoma (PDAC) remains a major public health challenge, and faces disparities and delays in the diagnosis and access to care. Our purposes were to describe the medical path of PDAC patients in the real-life setting and evaluate the overall survival at 1 year. We used the national hospital discharge summaries database system to analyze the management of patients with newly diagnosed PDAC over the year 2016 in Auvergne-Rhône-Alpes region (AuRA) (France). A total of 1872 patients met inclusion criteria corresponding to an incidence of 22.6 per 100,000 person-year. Within the follow-up period, 353 (18.9%) were operated with a curative intent, 743 (39.7%) underwent chemo- and/or radiotherapy, and 776 (41.4%) did not receive any of these treatments. Less than half of patients were operated in a high-volume center, defined by more than 20 PDAC resections performed annually, mainly university hospitals. The 1-year survival rate was 47% in the overall population. This study highlights that a significant number of patients with PDAC are still operated in low-volume centers or do not receive any specific oncological treatment. A detailed analysis of the medical pathways is necessary in order to identify the medical and territorial determinants and their impact on the patient’s outcome.

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Cost Benefit and Utility Decision Analysis of Turbinoplasty with Adenotonsillectomy for Pediatric Sleep-Disordered Breathing

Otolaryngology ◽

10.1177/0194599819841882 ◽

2019 ◽

Vol 161 (2) ◽

pp. 343-347 ◽

Cited By ~ 1

Author(s):

Grace Baik ◽

Scott E. Brietzke

Keyword(s):

Sensitivity Analysis ◽

Decision Analysis ◽

Sleep Disordered Breathing ◽

Treatment Success ◽

Cost Benefit ◽

Decision Analysis Model ◽

Analysis Model ◽

Baseline Model ◽

Turbinate Hypertrophy ◽

Disordered Breathing

Objectives Use decision analysis techniques to assess the potential utility gains/losses and costs of adding bilateral inferior turbinoplasty to tonsillectomy/adenoidectomy (T/A) for the treatment of obstructive sleep-disordered breathing (oSDB) in children. Use sensitivity analysis to explore the key variables in the scenario. Study Design Cost-utility decision analysis model. Setting Hypothetical cohort. Subjects and Methods Computer software (TreeAge Software, Williamstown, Massachusetts) was used to construct a decision analysis model. The model included the possibility of postoperative complications and persistent oSDB after surgery. Baseline clinical and quality-adjusted life year (QALY) parameters were estimated using published data. Cost data were estimated from Centers for Medicare and Medicaid 2018 databases ( www.cms.gov ). Sensitivity analyses were completed to assess for key model parameters. Results The utility analysis of the baseline model favored the addition of turbinoplasty (0.8890 vs 0.8875 overall utility) assuming turbinate hypertrophy was present. Sensitivity analysis indicated the treatment success increase (%) provided by concurrent turbinoplasty was the key parameter in the model. A treatment success increase of 3% of turbinoplasty was the threshold where concurrent turbinoplasty was favored over T/A alone. The incremental cost-effectiveness ratio (ICER) of $27,333/QALY for the baseline model was favorable to the willingness-to-pay threshold of $50,000 to $100,000/QALY for industrialized nations. Conclusions The addition of turbinoplasty for children with turbinate hypertrophy to T/A for the treatment of pediatric oSDB is beneficial from both a utility and cost-benefit analysis standpoint even if the benefits of turbinoplasty are relatively modest.

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A Decision Analysis Model for the Brand Experience of Branded Apps Using Consistency Fuzzy Linguistic Preference Relations

Symmetry ◽

10.3390/sym13071151 ◽

2021 ◽

Vol 13 (7) ◽

pp. 1151

Author(s):

Tsuen-Ho Hsu ◽

Chun-Hsien Chen ◽

Ya-Wun Yang

Keyword(s):

Customer Loyalty ◽

Pairwise Comparison ◽

Brand Experience ◽

Decision Analysis Model ◽

Analysis Model ◽

Pairwise Comparison Matrix ◽

Preference Relations ◽

New Business ◽

Fuzzy Linguistic ◽

The Impact

Branded apps are not only an important platform for enterprises and customers to have real-time interactions and communicate marketing messages, but also a new business model that encourages value co-creation between the two. In order to explore the impact of branded apps on customers, this study constructs a fuzzy multi-criteria decision making (FMCDM) analysis model, and it uses consistent fuzzy linguistic preference relations (CFLPR) to set up a symmetric pairwise comparison matrix, which greatly reduces the complexity and error rate of calculations. Empirical research findings show that brand experience attributes and the influence of brand experience on customer loyalty and satisfaction can be more accurately measured. As a consequence of this study, we show that, among the brand experience facets of two retail chain branded apps, behavioral experience is the most favored, while affective experience is the least favored. Furthermore, brand attachment and active participation should be strengthened to enhance customer loyalty. Through the analytical model employed in this study, enterprises can regularly monitor changes in the brand experience preferences of branded app users and evaluate app performance to flexibly adjust mobile device-based marketing campaigns and strategies. It can also aid enterprises in using mobile devices effectively to improve customer loyalty and address the issue of diminishing brand loyalty.

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