Using decision analysis to explore cable television delivery

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.

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

2008 ◽  
Vol 39 (8) ◽  
pp. 1307-1315 ◽  
Author(s):  
A. Cougnard ◽  
H. Verdoux ◽  
A. Grolleau ◽  
Y. Moride ◽  
B. Begaud ◽  
...  
Keyword(s):  
Decision Analysis ◽  
Antidepressant Drug ◽  
Real Life ◽  
The Elderly ◽  
Sensitivity Analyses ◽  
Decision Analysis Model ◽  
Analysis Model ◽  
Real Life Setting ◽  
Number Of Patients ◽  
The Impact

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.

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

2006 ◽  
Vol 27 (6) ◽  
pp. 604-611 ◽  
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.

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

2019 ◽  
Vol 161 (2) ◽  
pp. 343-347 ◽  
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.

Scenario based evaluation of a cost risk model through sensitivity analysis

2015 ◽  
Vol 22 (4) ◽  
pp. 403-423 ◽  
Author(s):  
Önder Ökmen ◽  
Ahmet Öztaş
Keyword(s):  
Risk Factors ◽  
Risk Analysis ◽  
Risk Model ◽  
Practical Method ◽  
Cost Evaluation ◽  
Sensitivity Analyses ◽  
Analysis Model ◽  
Content Type ◽  
Detailed Evaluation ◽  
Cost Risk

Purpose – Actual costs frequently deviate from the estimated costs in either favorable or adverse direction in construction projects. Conventional cost evaluation methods do not take the uncertainty and correlation effects into account. In this regard, a simulation-based cost risk analysis model, the Correlated Cost Risk Analysis Model, previously has been proposed to evaluate the uncertainty effect on construction costs in case of correlated costs and correlated risk-factors. The purpose of this paper is to introduce the detailed evaluation of the Cost Risk Analysis Model through scenario and sensitivity analyses. Design/methodology/approach – The evaluation process consists of three scenarios with three sensitivity analyses in each and 28 simulations in total. During applications, the model’s important parameter called the mean proportion coefficient is modified and the user-dependent variables like the risk-factor influence degrees are changed to observe the response of the model to these modifications and to examine the indirect, two-sided and qualitative correlation capturing algorithm of the model. Monte Carlo Simulation is also applied on the same data to compare the results. Findings – The findings have shown that the Correlated Cost Risk Analysis Model is capable of capturing the correlation between the costs and between the risk-factors, and operates in accordance with the theoretical expectancies. Originality/value – Correlated Cost Risk Analysis Model can be preferred as a reliable and practical method by the professionals of the construction sector thanks to its detailed evaluation introduced in this paper.

Screening blood donors for hereditary hemochromatosis: Decision analysis model based on a 30-year database

1995 ◽  
Vol 109 (1) ◽  
pp. 177-188 ◽  
Author(s):  
Paul C. Adams ◽  
James C. Gregor ◽  
Ann E. Kertesz ◽  
Leslie S. Valberg
Keyword(s):  
Decision Analysis ◽  
Blood Donors ◽  
Hereditary Hemochromatosis ◽  
Decision Analysis Model ◽  
Analysis Model ◽  
Model Based

Percutaneous Stenting of Incidental Unilateral Renal Artery Stenosis: Decision Analysis of Costs and Benefits

2003 ◽  
Vol 10 (3) ◽  
pp. 546-556 ◽  
Author(s):  
David A. Axelrod ◽  
A. Mark Fendrick ◽  
Ruth C. Carlos ◽  
Robert J. Lederman ◽  
James B. Froehlich ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Decision Analysis ◽  
Renal Artery ◽  
Incremental Cost ◽  
Renal Artery Stenosis ◽  
Cost Effective ◽  
Artery Stenosis ◽  
Decision Analysis Model ◽  
Analysis Model ◽  
Refractory Hypertension

Purpose: To determine the incremental cost-effectiveness of prophylactic percutaneous transluminal angioplasty with stent placement (PTA-S) in patients with incidentally discovered, asymptomatic renal artery stenosis (RAS) compared to delaying PTA-S until patients develop refractory hypertension or renal insufficiency (therapeutic PTA-S). Methods: The Markov decision analysis model was used to determine the incremental cost per quality adjusted life year (QALY) saved for prophylactic PTA-S as compared to therapeutic PTA-S in a hypothetical cohort of patients with 50% unilateral atherosclerotic RAS followed from age 61 to death. Results: Prophylactic PTA-S compared to therapeutic PTA-S results in more QALYs/patient (10.9 versus 10.3) at higher lifetime costs ($23,664 versus $16,558). The incremental cost effectiveness of prophylactic PTA-S was estimated to be $12,466/QALY. Prophylactic stenting was not cost effective (>$50,000/QALY) if the modeled incidence of stent restenosis exceeded 15%/year and the incidence of progression in the contralateral renal artery was <2% of arteries/year. Conclusions: PTA-S of incidental, asymptomatic unilateral RAS may improve patients' quality of life at an acceptable incremental cost. However, this technology should be used hesitantly until a randomized comparison confirms its effectiveness.

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