scholarly journals Modelling the Population Health Impacts of Heated Tobacco Products in Japan

2020 ◽  
Author(s):  
Oscar M. Camacho ◽  
Andrew Hill ◽  
Stacy Fiebelkorn ◽  
Joshua Jones ◽  
Krishna Prasad ◽  
...  
Keyword(s):  
Population Health ◽  
Health Benefit ◽  
Population Level ◽  
Time Frame ◽  
Baseline Scenario ◽  
Case Scenario ◽  
Cross Sectional ◽  
Worst Case ◽  
Health Gains ◽  
Life Years

Few data are available on the health impact of tobacco heating products (THPs) at the population level. We used systems dynamics modelling to estimate effects in the established THP market in Japan. We projected effects of THP use in overall mortality up to 2100 and compare those projections against a baseline scenario based on smoking rates pre-THP launch, i.e., smoking only. The model was informed using data from publicly available sources and the literature, including population size, yearly deaths and smoking prevalence with initialisation year (2004) and, births and migration from 2004 to 2065. Transitions between products were estimated from cross-sectional population surveys in Japan. Potential life-years saved with the introduction of THPs was 13 million by 2100 compared with smoking only. In worst-case scenario, population health gains would be seen with THPs risk 10–50% lower risk than smoking. Assuming equal risk for dual use and smoking, THP risk would need to be at least 10% lower than smoking to achieve a population health benefit by 2100. In credible scenarios, substantial population health gains will follow the introduction of THPs in Japan in a relatively short time frame.

scholarly journals Modeling the Population Health Impacts of Heated Tobacco Products in Japan

2021 ◽  
Vol 7 (3) ◽  
pp. 221-231
Author(s):  
Oscar M. Camacho ◽  
Andrew Hill ◽  
Stacy Fiebelkorn ◽  
Joshua D. Jones ◽  
Krishna Prasad ◽  
...  
Keyword(s):  
Population Health ◽  
Health Benefit ◽  
Health Impact ◽  
Baseline Scenario ◽  
Case Scenario ◽  
Cross Sectional ◽  
Worst Case ◽  
Tobacco Products ◽  
Life Years ◽  
And Migration

Objective: We evaluated the potential population health impact of launching heated tobacco products (HTP) in Japan. Method: We use a modeling approach to project the effects of HTP use in overall mortality up to 2100 and compare those projections against a baseline scenario based on smoking rates pre-HTP launch, ie, smoking only. The model was informed using data from publicly available sources and the literature, including population size, yearly deaths, and smoking prevalence with the initial year of 2004, and births and migration from 2004 to 2065. Transitions between products were estimated from cross-sectional population surveys in Japan. Result: In a worst-case scenario, population health gains would be seen with HTPs risk about 50% lower risk than smoking. Assuming equal risk for dual use and smoking, HTP risk would need to be at least 10% lower than smoking to achieve a population health benefit by 2100. Potential reduction in life-years lost with the introduction of HTPs was 13 million by 2100 compared with smoking only. Conclusions: In credible scenarios, substantial population harm reduction will follow the introduction of HTPs in Japan.

scholarly journals Modeling the Population Health Impact of ENDS in the U.S.

2021 ◽  
Vol 45 (3) ◽  
pp. 588-610
Author(s):  
Rasmus Wissmann ◽  
Changhua Zhan ◽  
Kenneth D'Amica ◽  
Shivaani Prakash ◽  
Yingying Xu
Keyword(s):  
Population Health ◽  
Health Benefit ◽  
Population Level ◽  
Health Impact ◽  
Sensitivity Analyses ◽  
Base Case ◽  
Premature Deaths ◽  
Key Population ◽  
The Us ◽  
Health Model

Objectives: Our objective was to improve understanding of the population health impact of electronic nicotine delivery systems (ENDS) availability in the US via computational modeling. Methods: We present an agent-based population health model (PHM) that simulates annual smoking, ENDS use, and associated mortality for individual agents representing the US population, both adults and youth, between 2000 and 2100. Model transitions were derived from key population surveys and a large longitudinal study of JUUL purchasers. The mortality impact of ENDS is modeled as excess risk relative to smoking. Outcomes are compared between a cigarettes-only Base Case and a Modified Case where ENDS are introduced in 2010. Model validation demonstrates that the PHM simulates population-level behavior and outcomes realistically. Results: The availability of ENDS in the US is projected to reduce smoking and prevent 2.5 million premature deaths by 2100 in the Modified Case. Sensitivity analyses show that a significant population health benefit occurs under all plausible scenarios. Conclusions: Our results suggest the availability of ENDS is likely to result in a significant health benefit to the US population as a whole, after accounting for both beneficial and harmful uses.

scholarly journals The Clinical and Economic Value of a Successful Shutdown During the SARS-CoV-2 Pandemic in Germany

2020 ◽  
Author(s):  
Afschin Gandjour
Keyword(s):  
Economic Value ◽  
Health Gain ◽  
Mortality Data ◽  
Base Case ◽  
German Population ◽  
Case Scenario ◽  
Worst Case ◽  
Herd Protection ◽  
Life Years ◽  
Per Capita

Background and aim: A shutdown of businesses enacted during the SARS-CoV-2 pandemic can serve different goals, e.g., preventing the intensive care unit (ICU) capacity from being overwhelmed ("flattening the curve") or keeping the reproduction number substantially below one ("squashing the curve"). The aim of this study was to determine the clinical and economic value of a shutdown that is successful in "flattening" or "squashing the curve" in Germany. Methods: In the base case, the study compared a successful shutdown to a worst-case scenario with no ICU capacity left to treat COVID-19 patients. To this end, a decision model was developed using, e.g., information on age-specific fatality rates, ICU outcomes, and the herd protection threshold. The value of an additional life year was borrowed from new, innovative oncological drugs, as cancer reflects a condition with a similar morbidity and mortality burden in the general population in the short term as COVID-19. Results: A shutdown that is successful in "flattening the curve" is projected to yield an average health gain between 0.02 and 0.08 life years (0.2 to 0.9 months) per capita in the German population. The corresponding economic value ranges between 1543 and 8027 euros per capita or, extrapolated to the total population, 4% to 19% of the gross domestic product (GDP) in 2019. A shutdown that is successful in "squashing the curve" is expected to yield a minimum health gain of 0.10 life years (1.2 months) per capita, corresponding to 24% of the GDP in 2019. Results are particularly sensitive to mortality data and the prevalence of undetected cases.

scholarly journals SARS-CoV-2 epidemic in India: epidemiological features and in silico analysis of the effect of interventions

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 315 ◽  
Author(s):  
Archisman Mazumder ◽  
Mehak Arora ◽  
Vishwesh Bharadiya ◽  
Parul Berry ◽  
Mudit Agarwal ◽  
...  
Keyword(s):  
In Silico ◽  
In Silico Analysis ◽  
Contact Tracing ◽  
Contact Rate ◽  
Case Scenario ◽  
Cross Sectional ◽  
Worst Case ◽  
Current Contact ◽  
The Government ◽  
And Gender

Background: After SARS-CoV-2 set foot in India, the Government took a number of steps to limit the spread of the virus in the country. This included restricted testing, isolation, contact tracing and quarantine, and enforcement of a nation-wide lockdown starting 25 March 2020. The objectives of this study were to i) describe the age,gender distribution and mortality among COVID-19 patients identified till 14 April 2020 and predict the range of contact rate; and ii) predict the number of active COVID-19 patients after 40 days of lockdown. Methods: We used a cross-sectional descriptive design for first objective and a susceptible-infected-removed model for in silico predictions. We collected data from government-controlled and crowdsourced websites. Results: Studying age and gender parameters of 1161 Indian COVID-19 patients, the median age was 38 years (IQR, 27-52) with 20-39 year-old males being the most affected group. The number of affected patients were 854 (73.6%) men and 307 (26.4%) women. If the current contact rate continues (0.25-27), India may have 110460 to 220575 infected persons at the end of 40 days lockdown. Conclusion: The disease is majorly affecting a younger age group in India. Interventions have been helpful in preventing the worst-case scenario in India, but will be unable to prevent the spike in number of cases.

scholarly journals Cost-effectiveness of whole area testing of asymptomatic SARS-CoV-2 infections in Merthyr Tydfil, 2020: A Modelling and economic analysis

2021 ◽  
Author(s):  
Mark Drakesmith ◽  
Brendan Collins ◽  
Kelechi Nnoaham ◽  
Angela Jones ◽  
Daniel Rhys Thomas
Keyword(s):  
Cost Effectiveness ◽  
Health Benefit ◽  
Cost Effective ◽  
Cost Effectiveness Analysis ◽  
Cost Ratio ◽  
Case Scenario ◽  
Monetary Benefit ◽  
Effectiveness Analysis ◽  
Life Years ◽  
Net Monetary Benefit

Objectives: To evaluate the cost effectiveness of an asymptomatic SARS-CoV-2 whole area testing pilot. Design: Epidemiological modelling and cost effectiveness analysis. Setting: The community of Merthyr Tydfil County Borough between20 Nov and 21 Dec 2020. Participants: A total of 33,822 people tested as part of the pilot in Merthyr Tydfil County Borough, 712 of whom tested positive by lateral flow test and reported being asymptomatic. Main outcome measures: Estimated number of cases, hospitalisations, ICU admissions and deaths prevented, and associated costs per quality-adjusted life years (QALYs) gained and monitory cost to the healthcare system. Results: An initial conservative estimate of 360 (95% CI: 311 - 418) cases were prevented by the mass testing, representing a would-be reduction of 11% of all cases diagnosed in Merthyr Tydfil residents during the same period. Modelling healthcare burden estimates that 24 (16 - 36) hospitalizations, 5 (3 - 6) ICU admissions and 15 (11 - 20) deaths were prevented, representing 6.37%, 11.1% and 8.19%, respectively of the actual counts during the same period. A less conservative, best-case scenario predicts a much higher number of cases prevented of 2328 (1761 - 3107), representing 80% reduction in would-be cases. Cost effectiveness analysis indicates 108 (80 - 143) QALYs gained, an incremental cost ratio of &#163 2,143 (&#163 860-&#163 4,175) per QALY gained and net monetary benefit of &#163 6.2m (&#163 4.5m-&#163 8.4m). In the less conservative scenario, the net monetary benefit increases to &#163 15.9m (&#163 12.3m-&#163 20.5m). Conclusions: A significant number of cases, hospitalisations and deaths were prevented by the mass testing pilot. Considering QALYs lost and healthcare costs avoided, the pilot was cost-effective. These findings suggest mass testing with LFDs in areas of high prevalence (>2%) is likely to provide significant public health benefit. It is not yet clear whether similar benefits will be obtained in low prevalence settings.

scholarly journals EXPOSURE TO WORKPLACE BULLYING AND SUICIDAL IDEATION: AN EXPLORATORY STUDY

2019 ◽  
Vol 3 (1) ◽  
pp. 55-75
Author(s):  
Ernesto Rosario- Hernández ◽  
Lillian V. Rovira Millán ◽  
Stephanie Vega Vélez ◽  
Rosael Zeno- Santi ◽  
Pamela Farinacci García ◽  
...  
Keyword(s):  
Suicidal Ideation ◽  
Workplace Bullying ◽  
Theoretical Models ◽  
Case Scenario ◽  
Cross Sectional ◽  
Worst Case ◽  
Effective Manner ◽  
Cross Sectional Design ◽  
The Impact ◽  
The Relationship

There is evidence of the effects of exposure to workplace bullying on victims who may manifest symptoms of depression, anxiety, burnout, somatization, sleep difficulties, and posttraumatic stress; however, few studies have examined the impact of workplace bullying on suicidal ideation. The purpose of the present study was to examine the relationship between exposure to workplace bullying and suicidal ideation and how feelings of defeat and entrapment mediate this relationship. Also, it was intended to examine how rumination moderates this relationship. As a framework, it was used the Integrated Motivational-Volitional Model of Suicide Behavior (IMV) in which has been integrated several theoretical models of suicide. A total of 898 employed subjects participated in this cross-sectional design study. To examine the hypotheses, PLS-SEM model was used using the SMART-PLS program. Exposure to workplace bullying,defeat and entrapment were positively and significantly related to suicidal ideation. Meanwhile,feelings of defeat and entrapment mediated the relationship between exposure to workplace bullying and suicidal ideation and rumination moderated the relation between exposure to workplace bullying and feelings defeat. The results of the present study have both theoretical and practical implications, among which we can mention that results support and expand the IMV model of suicidal behavior. The exposure to workplace bullying brings a challenge for the psychologists in the occupational health context, and human resources practitioners in the management of this phenomenon in organizations to prevent it and in a worst case scenario, to respond in an effective manner due to its individual and organizational impact.

scholarly journals Cost/effectiveness model of dabigatran in the prevention of venous thromboembolism in major orthopedic surgery: Adaptation for Italy

2010 ◽  
Vol 11 (2) ◽  
pp. 91-101 ◽  
Author(s):  
Orietta Zaniolo ◽  
Sorrel E. Wolowacz ◽  
Lorenzo Pradelli
Keyword(s):  
Cost Effectiveness ◽  
Orthopedic Surgery ◽  
Case Scenario ◽  
Worst Case ◽  
Worst Case Scenario ◽  
Life Years ◽  
Major Orthopedic Surgery ◽  
Acquisition Costs ◽  
Alternative Scenarios ◽  
The Uk

Venous thromboembolic events (VTE) represent a dangerous complication of major orthopedic surgery, especially in total hip replacement (THR) and total knee replacement (TKR) procedures. Dabigatran etexilate (DBG), a direct and reversible thrombin inhibitor, has proven its non-inferiority with respect to enoxaparin 40mg once-daily, a low molecular weight heparin (LMWH), in the prevention of VTE in patients undergoing THR and TKR, in the RE-NOVATE and RE-MODEL trials, respectively. The objective of this analysis was to estimate cost/effectiveness and cost/utility of DBG compared to standard care for the prevention of VTE in Italy. A decision analytic, Markov-chain based model, originally developed for the UK, was adapted to the Italian context. The adaptation involved cost and demographic characteristics, clinical and utility data were not altered. Costs were taken from national observational studies, where available. Otherwise, current prices and tariffs were applied. Resource consumption was derived from practice guidelines or taken from the UK model. According to the prevalent national practice, extended prophylaxis is considered for both surgical procedures. The time horizon of the analysis was patients’ lifetimes. In order to consider different alternatives for drug dispensation and, consequently, National Health Service acquisition costs, alternative scenarios were developed. A further scenario, excluding LMWHs administration costs (“worst-case” scenario), was considered. Compared to LMWHs, DBG was associated with an expected increase of 0.019 life-years (LYs) and 0.014 quality-adjusted life-years (QALYs) per THR patient and of 0.024 LYs and 0.019 QALYs per TKR patient. DBG-related costs were lower than LMWH in both procedures, with a mean difference ranging from 89 to 116 € for THR, and 107 to 142 for TKR, depending on the LMWH product. Higher acquisition costs for DBG were completely offset and inverted by avoided administration expenses and, to a lesser extent, by savings in VTE management. The results of alternative scenarios confirm the dominance of DBG, with a net saving ranging between 119 €, when both drugs were obtained by auction, and 32 €, when the auction price was applied but DBG was dispensed through territorial pharmacies. The corresponding estimates for TKR were 148 and 54 €. In the “worst-case” scenario, DBG was no longer dominant, with a cost per LYs of 2,788 and 4,514 € and a cost per QALY gained of 3,619 and 5,926 €, for TKR and THR respectively. In conclusion, DBG dominated LMWHs, and was cost-saving and non-inferior in terms of efficacy and safety, except for in the “worst-case” scenario, in which the incremental cost/effectiveness ratio estimate was lower than commonly accepted thresholds in health economics.

scholarly journals Challenging the scientific basis of the Paris climate agreement

2019 ◽  
Vol 11 (1) ◽  
pp. 18-34 ◽  
Author(s):  
Antero Ollila
Keyword(s):  
Temperature Increase ◽  
Oil And Gas ◽  
Scientific Basis ◽  
Baseline Scenario ◽  
Case Scenario ◽  
Worst Case ◽  
Content Type ◽  
Temperature Trends ◽  
Significant Difference ◽  
Paris Climate Agreement

Purpose The purpose of this paper is to analyze the scientific basis of the Paris climate agreement. Design/methodology/approach The analyses are based on the IPCC’s own reports, the observed temperatures versus the IPCC model-calculated temperatures and the warming effects of greenhouse gases based on the critical studies of climate sensitivity (CS). Findings The future emission and temperature trends are calculated according to a baseline scenario by the IPCC, which is the worst-case scenario RCP8.5. The selection of RCP8.5 can be criticized because the present CO2 growth rate 2.2 ppmy−1 should be 2.8 times greater, meaning a CO2 increase from 402 to 936 ppm. The emission target scenario of COP21 is 40 GtCO2 equivalent, and the results of this study confirm that the temperature increase stays below 2°C by 2100 per the IPCC calculations. The IPCC-calculated temperature for 2016 is 1.27°C, 49 per cent higher than the observed average of 0.85°C in 2000. Originality/value Two explanations have been identified for this significant difference in the IPCC’s calculations: The model is too sensitive for CO2 increase, and the positive water feedback does not exist. The CS of 0.6°C found in some critical research studies means that the temperature increase would stay below the 2°C target, even though the emissions would follow the baseline scenario. This is highly unlikely because the estimated conventional oil and gas reserves would be exhausted around the 2060s if the present consumption rate continues.

scholarly journals Evaluating the impact of implementing public bicycle share programs on cycling: the International Bikeshare Impacts on Cycling and Collisions Study (IBICCS)

2019 ◽  
Vol 16 (1) ◽  
Author(s):  
Kate Hosford ◽  
Meghan Winters ◽  
Lise Gauvin ◽  
Andi Camden ◽  
Anne-Sophie Dubé ◽  
...  
Keyword(s):  
New York ◽  
Program Implementation ◽  
Population Level ◽  
Rapid Expansion ◽  
Cross Sectional ◽  
Physically Active ◽  
Health Gains ◽  
Triple Difference ◽  
The Impact ◽  
Over Time

Abstract Background Despite rapid expansion of public bicycle share programs (PBSP), there are limited evaluations of the population-level impacts of these programs on cycling, leaving uncertainty as to whether these programs lead to net health gains at a population level or attract those that already cycle and are sufficiently physically active. Our objective was to determine whether the implementation of PBSPs increased population-level cycling in cities across the US and Canada. Methods We conducted repeat cross-sectional surveys with 23,901 residents in cities with newly implemented PBSPs (Chicago, New York), existing PBSPs (Boston, Montreal, Toronto) and no PBSPs (Detroit, Philadelphia, Vancouver) at three time points (Fall 2012, 2013, 2014). We used a triple difference in differences analysis to assess whether there were increases in cycling over time amongst those living in closer proximity (< 500 m) to bicycle share docking stations in cities with newly implemented and existing PBSPs, relative to those in cities with no PBSPs. Results Living in closer proximity to bicycle share predicted increases in cycling over time for those living in cities with newly implemented PBSPs at 2-year follow-up. No change was seen over time for those living in closer proximity to bicycle share in cities with existing PBSPs relative to those in cities with no PBSP. Conclusion These findings indicate that PBSPs are associated with increases in population-level cycling for those who live near to a docking station in the second year of program implementation.

scholarly journals Cost-effectiveness of a novel smartphone application to mobilize first responders after witnessed OHCA in Belgium

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Steven Vercammen ◽  
Esther Moens
Keyword(s):  
Cost Effectiveness ◽  
Emergency Services ◽  
Smartphone Application ◽  
Baseline Scenario ◽  
Case Scenario ◽  
Worst Case ◽  
Baseline Case ◽  
Positive Balance ◽  
The Cost ◽  
Hospital Cardiac Arrest

Abstract Background EVapp (Emergency Volunteer Application) is a Belgian smartphone application that mobilizes volunteers to perform cardiopulmonary resuscitation (CPR) and defibrillation with publicly available automatic external defibrillators (AED) after an emergency call for suspected out of hospital cardiac arrest (OHCA). The aim is to bridge the time before the arrival of the emergency services. Methods An accessible model was developed, using literature data, to simulate survival and cost-effectiveness of nation-wide EVapp implementation. Initial validation was performed using field data from a first pilot study of EVapp implementation in a city in Flanders, covering 2.5 years of implementation. Results Simulation of nation-wide EVapp implementation resulted in an additional yearly 910 QALY gained over the current baseline case scenario (worst case 632; best case 3204). The cost per QALY associated with EVapp implementation was comparable to the baseline scenario, i.e., 17 vs 18 k€ QALY−1. Conclusions EVapp implementation was associated with a positive balance on amount of QALY gained and cost of QALY. This was a consequence of both the lower healthcare costs for patients with good neurological outcome and the more efficient use of yet available resources, which did not outweigh the costs of operation.

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