Literature DB >> 20524723

Assessing the relationship between computational speed and precision: a case study comparing an interpreted versus compiled programming language using a stochastic simulation model in diabetes care.

Phil McEwan1, Klas Bergenheim, Yong Yuan, Anthony P Tetlow, Jason P Gordon.   

Abstract

BACKGROUND: Simulation techniques are well suited to modelling diseases yet can be computationally intensive. This study explores the relationship between modelled effect size, statistical precision, and efficiency gains achieved using variance reduction and an executable programming language.
METHODS: A published simulation model designed to model a population with type 2 diabetes mellitus based on the UKPDS 68 outcomes equations was coded in both Visual Basic for Applications (VBA) and C++. Efficiency gains due to the programming language were evaluated, as was the impact of antithetic variates to reduce variance, using predicted QALYs over a 40-year time horizon.
RESULTS: The use of C++ provided a 75- and 90-fold reduction in simulation run time when using mean and sampled input values, respectively. For a series of 50 one-way sensitivity analyses, this would yield a total run time of 2 minutes when using C++, compared with 155 minutes for VBA when using mean input values. The use of antithetic variates typically resulted in a 53% reduction in the number of simulation replications and run time required. When drawing all input values to the model from distributions, the use of C++ and variance reduction resulted in a 246-fold improvement in computation time compared with VBA - for which the evaluation of 50 scenarios would correspondingly require 3.8 hours (C++) and approximately 14.5 days (VBA).
CONCLUSIONS: The choice of programming language used in an economic model, as well as the methods for improving precision of model output can have profound effects on computation time. When constructing complex models, more computationally efficient approaches such as C++ and variance reduction should be considered; concerns regarding model transparency using compiled languages are best addressed via thorough documentation and model validation.

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Year:  2010        PMID: 20524723     DOI: 10.2165/11535350-000000000-00000

Source DB:  PubMed          Journal:  Pharmacoeconomics        ISSN: 1170-7690            Impact factor:   4.981


  18 in total

1.  Alternative decision modelling techniques for the evaluation of health care technologies: Markov processes versus discrete event simulation.

Authors:  Jonathan Karnon
Journal:  Health Econ       Date:  2003-10       Impact factor: 3.046

2.  Modelling in the economic evaluation of health care: selecting the appropriate approach.

Authors:  Pelham Barton; Stirling Bryan; Suzanne Robinson
Journal:  J Health Serv Res Policy       Date:  2004-04

3.  Evaluation of the costs and outcomes from changes in risk factors in type 2 diabetes using the Cardiff stochastic simulation cost-utility model (DiabForecaster).

Authors:  Phil McEwan; John R Peters; Klas Bergenheim; Craig J Currie
Journal:  Curr Med Res Opin       Date:  2006-01       Impact factor: 2.580

4.  Increasing the efficiency of Monte Carlo cohort simulations with variance reduction techniques.

Authors:  Steven M Shechter; Andrew J Schaefer; R Scott Braithwaite; Mark S Roberts
Journal:  Med Decis Making       Date:  2006 Sep-Oct       Impact factor: 2.583

5.  A Bayesian approach to stochastic cost-effectiveness analysis. An illustration and application to blood pressure control in type 2 diabetes.

Authors:  A H Briggs
Journal:  Int J Technol Assess Health Care       Date:  2001       Impact factor: 2.188

6.  Bayesian methods in cost-effectiveness studies: objectivity, computation and other relevant aspects.

Authors:  C Armero; G García-Donato; A López-Quílez
Journal:  Health Econ       Date:  2010-06       Impact factor: 3.046

7.  A model to estimate the lifetime health outcomes of patients with type 2 diabetes: the United Kingdom Prospective Diabetes Study (UKPDS) Outcomes Model (UKPDS no. 68).

Authors:  P M Clarke; A M Gray; A Briggs; A J Farmer; P Fenn; R J Stevens; D R Matthews; I M Stratton; R R Holman
Journal:  Diabetologia       Date:  2004-10-27       Impact factor: 10.122

8.  The impact of diabetes-related complications on healthcare costs: results from the United Kingdom Prospective Diabetes Study (UKPDS Study No. 65).

Authors:  P Clarke; A Gray; R Legood; A Briggs; R Holman
Journal:  Diabet Med       Date:  2003-06       Impact factor: 4.359

9.  Estimating utility values for health states of type 2 diabetic patients using the EQ-5D (UKPDS 62).

Authors:  Philip Clarke; Alastair Gray; Rury Holman
Journal:  Med Decis Making       Date:  2002 Jul-Aug       Impact factor: 2.583

10.  Probabilistic analysis and computationally expensive models: Necessary and required?

Authors:  Susan Griffin; Karl Claxton; Neil Hawkins; Mark Sculpher
Journal:  Value Health       Date:  2006 Jul-Aug       Impact factor: 5.725

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  8 in total

1.  Cost effectiveness of saxagliptin and metformin versus sulfonylurea and metformin in the treatment of type 2 diabetes mellitus in Germany: a Cardiff diabetes model analysis.

Authors:  Wilma Erhardt; Klas Bergenheim; Isabelle Duprat-Lomon; Phil McEwan
Journal:  Clin Drug Investig       Date:  2012-03-01       Impact factor: 2.859

Review 2.  The place of DPP-4 inhibitors in the treatment algorithm of diabetes type 2: a systematic review of cost-effectiveness studies.

Authors:  Alexandre Baptista; Inês Teixeira; Sónia Romano; António Vaz Carneiro; Julian Perelman
Journal:  Eur J Health Econ       Date:  2016-10-17

3.  Treatment of type 2 diabetes with saxagliptin: a pharmacoeconomic evaluation in Argentina.

Authors:  Jorge F Elgart; Joaquin E Caporale; Lorena Gonzalez; Eleonora Aiello; Maximiliano Waschbusch; Juan J Gagliardino
Journal:  Health Econ Rev       Date:  2013-04-27

Review 4.  Cost-Effectiveness of Saxagliptin versus Acarbose as Second-Line Therapy in Type 2 Diabetes in China.

Authors:  Shuyan Gu; Yuhang Zeng; Demin Yu; Xiaoqian Hu; Hengjin Dong
Journal:  PLoS One       Date:  2016-11-22       Impact factor: 3.240

5.  Cost-Effectiveness of Dapagliflozin versus Acarbose as a Monotherapy in Type 2 Diabetes in China.

Authors:  Shuyan Gu; Yiming Mu; Suodi Zhai; Yuhang Zeng; Xuemei Zhen; Hengjin Dong
Journal:  PLoS One       Date:  2016-11-02       Impact factor: 3.240

6.  The Health Economic Value of Changes in Glycaemic Control, Weight and Rates of Hypoglycaemia in Type 1 Diabetes Mellitus.

Authors:  Phil McEwan; Hayley Bennett; Jonathan Fellows; Jennifer Priaulx; Klas Bergenheim
Journal:  PLoS One       Date:  2016-09-15       Impact factor: 3.240

7.  Choice across 10 pharmacologic combination strategies for type 2 diabetes: a cost-effectiveness analysis.

Authors:  Shuyan Gu; Lizheng Shi; Hui Shao; Xiaoyong Wang; Xiaoqian Hu; Yuxuan Gu; Hengjin Dong
Journal:  BMC Med       Date:  2020-12-03       Impact factor: 8.775

8.  Validation of the UKPDS 82 risk equations within the Cardiff Diabetes Model.

Authors:  Philip McEwan; Thomas Ward; Hayley Bennett; Klas Bergenheim
Journal:  Cost Eff Resour Alloc       Date:  2015-08-04
  8 in total

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