Model-Based Methods to Translate Adolescent Medicine Trials Network for HIV/AIDS Interventions Findings Into Policy Recommendations: Rationale and Protocol for a Modeling Core (ATN 161)
Model-Based Methods to Translate Adolescent Medicine Trials Network for HIV/AIDS Interventions Findings Into Policy Recommendations: Rationale and Protocol for a Modeling Core (ATN 161)
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DOI：
10.2196/resprot.9898
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发表时间：
2019-04-01
影响因子：
1.7
通讯作者：
Ciaranello, Andrea L.
中科院分区：
文献类型：
--
作者：
Neilan, Anne M.;Patel, Kunjal;Ciaranello, Andrea L.
背景：美国疾病控制和预防中心估计，大约有60,000名美国青年感染了艾滋病毒。与成年人相比，美国青年HIV感染者（YLWH）的预后较差，包括诊断率、参与度、保留率和病毒学抑制率较低。在艾滋病毒/艾滋病干预措施青少年药物试验网络（ATN）的支持下，正在进行以青年为中心的干预措施的新试验，以提高青年妇女的护理保留率和药物依从性。目的：本研究旨在使用计算机模拟模型，即预防艾滋病并发症的成本-效果(CEPAC)-青少年模型，评估选择的正在进行和即将进行的ATN干预措施，以改善YLWH中的病毒载量抑制，并确定吸收，有效性，效果持久性和成本的基准，使这些干预措施在临床上有益和具有成本效益。方法：atn161协议建立了ATN建模核心。建模核心利用已成功完成的美国国立卫生研究院支持的研究收集的大量数据，开发新的方法来模拟YLWH中HIV疾病和护理的关键组成部分。随着在奖励期间正在进行的ATN试验中关于新干预措施有效性的新数据的出现，cepac -青少年模拟模型将作为预测其长期临床影响和成本效益的灵活工具。建模核心将获得模型输入参数并创建一个模型结构，该模型结构反映了YLWH中HIV感染，进展和治疗的关键方面。在ATN领导层和科学专家的指导下，ATN建模核心指导委员会将选择和优先考虑特定的基于模型的分析，并就模型输入参数和模型假设的推导提供反馈。特定项目小组将帮助为基于模型的分析构建研究问题，并就特定项目的输入、结果、敏感性分析和政策结论提供反馈。结果：本项目于2017年9月获得资助。结论：ATN建模核心将提供关键信息，以指导ATN干预措施的扩大，并将ATN数据转化为美国YLWH的政策建议。
Background: The United States Centers for Disease Control and Prevention estimates that approximately 60,000 US youth are living with HIV. US youth living with HIV (YLWH) have poorer outcomes compared with adults, including lower rates of diagnosis, engagement, retention, and virologic suppression. With Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATN) support, new trials of youth-centered interventions to improve retention in care and medication adherence among YLWH are underway.Objective: This study aimed to use a computer simulation model, the Cost-Effectiveness of Preventing AIDS Complications (CEPAC)-Adolescent Model, to evaluate selected ongoing and forthcoming ATN interventions to improve viral load suppression among YLWH and to define the benchmarks for uptake, effectiveness, durability of effect, and cost that will make these interventions clinically beneficial and cost-effective.Methods: This protocol, ATN 161, establishes the ATN Modeling Core. The Modeling Core leverages extensive data-already collected by successfully completed National Institutes of Health-supported studies-to develop novel approaches for modeling critical components of HIV disease and care in YLWH. As new data emerge from ongoing ATN trials during the award period about the effectiveness of novel interventions, the CEPAC-Adolescent simulation model will serve as a flexible tool to project their long-term clinical impact and cost-effectiveness. The Modeling Core will derive model input parameters and create a model structure that reflects key aspects of HIV acquisition, progression, and treatment in YLWH. The ATN Modeling Core Steering Committee, with guidance from ATN leadership and scientific experts, will select and prioritize specific model-based analyses as well as provide feedback on derivation of model input parameters and model assumptions. Project-specific teams will help frame research questions for model-based analyses as well as provide feedback regarding project-specific inputs, results, sensitivity analyses, and policy conclusions.Results: This project was funded as of September 2017.Conclusions: The ATN Modeling Core will provide critical information to guide the scale-up of ATN interventions and the translation of ATN data into policy recommendations for YLWH in the United States.