Cost-Effectiveness of ED HIV Testing Program Agent-Based Modeling Approach

ED HIV 检测计划基于代理的建模方法的成本效益

• 批准号: 8531145
• 负责人: Yu-Hsiang Hsieh
• 金额: $ 13.4万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-08-15 至 2016-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8531145
• 关键词: AIDS prevention; AIDS/HIV problem; Accident and Emergency department; Acute; Address; Affect; Area; Baltimore; Behavior; Caring; Centers for Disease Control and Prevention (U.S.); Characteristics; Cities; Clinic; Clinical Trials; Communicable Diseases; Communities; Complex; Computer Simulation; Computer software; Computing Methodologies; Cost Effectiveness Analysis; Coupled; Data; Development; Diagnostic tests; Discipline; Doctor of Philosophy; Ear; Effectiveness; Emergency Medicine; Emergency Situation; Environment; Epidemic; Epidemiologic Studies; Epidemiology; Evaluation; Exposure to; Funding; Goals; HIV; Health Care Seeking Behavior; Healthcare; Heterogeneity; High Prevalence; Human; Human immunodeficiency virus test; Incidence; Individual; Infection; Infection Control; Influenza A Virus, H1N1 Subtype; Intervention; Lead; Maryland; Measures; Medical; Mentored Research Scientist Development Award; Mentors; Mentorship; Methods; Mission; Modeling; Movement; Observational Study; Outcomes Research; Play; Population; Prevention strategy; Public Health; Recording of previous events; Relative (related person); Research; Research Design; Research Personnel; Research Project Grants; Research Scientist Award; Seroepidemiologic Studies; Services; Sex Behavior; Simulate; Smallpox; Societies; Structure; Techniques; Testing; Time; Training; United States; United States National Institutes of Health; Universities; Validation; Work; base; care seeking; career; career development; cost; cost effective; cost effectiveness; demographics; design; disorder prevention; experience; high risk behavior; injection drug use; inner city; innovation; insight; mathematical model; methicillin resistant Staphylococcus aureus; novel strategies; outreach; professor; programs; prospective; response; responsible research conduct; routine practice; screening; skills; social; transmission process

DESCRIPTION (provided by applicant): This four-year K01 award application is to provide intensive multi-disciplinary training and career development guidance for Dr. Yu-Hsiang Hsieh, PhD, an Assistant Professor in Emergency Medicine at the Johns Hopkins University, leading to his becoming an independent investigator. Under the guidance of world renowned, NIH-funded, experienced mentors, Drs. Richard Rothman, Joshua Epstein, and David Holtgrave, Dr. Hsieh will gain a set of complementary inter-disciplinary skills which will allow him to pursue research with a focus on devising and evaluating public health interventions for infectious diseases seen in acute care settings. The applicant will receive mentoring in: public health aspects of emergency medicine; infectious disease computational mathematical modeling; and cost-effectiveness analysis. The rationale for the work, evaluation of HIV screening strategies, comes from the fact that HIV incidence has remained unchanged in the U.S. over the past decade, with one in five infected remaining unaware of their serostatus. One of the cornerstones recently advanced by the CDC for controlling the epidemic is widespread screening in emergency department (ED) settings. While, increasing numbers of EDs across the U.S. have developed strategies to adapt HIV testing into routine practice, there have been no efforts to systematically address how effective ED-based HIV testing has been (relative to no ED-based testing), or, which of several testing strategies is optimal with regard to identifying the largest number of unrecognized cases, and decreasing community HIV transmission. A relatively new and innovative method of computational modeling, agent-based modeling (ABM), offers a potential means for handling the complexity of temporal dynamics of HIV epidemiology and human behaviors associated with availability of ED-based HIV testing services, and represents a promising approach for overcoming many of the shortcoming of conventional study designs. The goal of this research project is to: 1) derive a computational model for measuring the impact of ED HIV testing programs on the HIV epidemic in Baltimore, Maryland, using ABM methods; 2) validate the derived ABM model; and 3) assess relative cost- effectiveness of ED HIV testing programs based on findings from the validated ABM model. The results of this study will provide new insights regarding current approaches to ED-based HIV testing programs and provide important cost-effectiveness data to inform local and national HIV testing strategies. The K01 award will provide Dr. Hsieh an intensive and directed mentored research experience in two new disciplines for him - infectious disease computational mathematical modeling, particularly ABM, and cost-effectiveness analysis. He will also receive needed training in the responsible conduct of research as well as longitudinal career guidance from an experience team. Together these experiences will equip him with the essential training and mentorship necessary to become an outstanding interdisciplinary independent public health investigator, who will build a research program focused on the study of infectious diseases in emergent, and acute care venues.

描述（由申请人提供）：这个为期四年的K 01奖申请是为约翰霍普金斯大学急诊医学助理教授谢宇祥博士提供密集的多学科培训和职业发展指导，使他成为一名独立研究员。在世界知名的NIH资助的经验丰富的导师Richard Rothman，约书亚爱泼斯坦和大卫霍尔特格雷夫博士的指导下，谢博士将获得一套互补的跨学科技能，这将使他能够专注于设计和评估急性护理环境中出现的传染病的公共卫生干预措施。申请人将接受指导：急诊医学的公共卫生方面;传染病计算数学建模;和成本效益分析。这项工作的基本原理是评估艾滋病毒筛查策略，这是因为在过去十年中，美国的艾滋病毒发病率保持不变，五分之一的感染者仍然不知道自己的血清状态。疾病预防控制中心最近提出的控制流行病的基石之一是在急诊科（艾德）环境中广泛进行筛查。虽然美国各地越来越多的ED已经制定了将HIV检测纳入常规实践的策略，但还没有系统地 解决基于ED的艾滋病毒检测的有效性（相对于没有基于ED的检测），或者，在确定最大数量的未识别病例和减少社区艾滋病毒传播方面，几种检测策略中哪一种是最佳的。一个相对较新的和创新的计算建模方法，基于代理的建模（ABM），提供了一个潜在的手段来处理的时间动态的艾滋病毒流行病学和人类行为的复杂性与可用性的ED为基础的艾滋病毒检测服务，并代表了一个有前途的方法，克服了许多传统的研究设计的缺点。本研究计画的目标是：1）使用ABM方法，推导出一个计算模型，以衡量艾德HIV检测项目对马里兰州巴尔的摩市HIV流行的影响; 2）验证推导出的ABM模型; 3）根据验证的ABM模型的结果，评估艾德HIV检测项目的相对成本效益。这项研究的结果将为目前基于ED的HIV检测计划提供新的见解，并提供重要的成本效益数据，为地方和国家的HIV检测策略提供信息。K 01奖将为Hsieh博士提供两个新学科的密集和指导性指导研究经验-传染病计算数学建模，特别是ABM和成本效益分析。他还将接受必要的培训，负责进行研究，以及从经验团队的纵向职业指导。这些经验将使他获得必要的培训和指导，成为一名优秀的跨学科独立公共卫生调查员，他将建立一个专注于紧急和急性护理场所传染病研究的研究项目。