Background:The effectiveness of lung cancer screening with low-dose computed tomography(LDCT)has been established.The current study evaluates the cost-effectiveness of lung cancer screening with LDCT in a general popu...Background:The effectiveness of lung cancer screening with low-dose computed tomography(LDCT)has been established.The current study evaluates the cost-effectiveness of lung cancer screening with LDCT in a general population in China.Methods:A previously validated micro-simulation model was used to simulate a cohort of men and women on a lifetime horizon in the presence and absence of LDCT screening.The modeling data were collected from numerous national and international sources.Simulated screening scenarios included different combinations of screening intervals and start and stop ages.Additional costs(valued in Chinese Yuan,CNY;1 USD=6.8976 CNY,1 EUR=7.8755 CNY in 2020),life-years gained(LYG)and mortality reduction due to screening were also determined.The costs and life-years were discounted by 3%.All results were scaled to 1,000 individuals.The average cost-effectiveness ratio(ACER)was calculated.A willingness-to-pay threshold of CNY 217.3k/LYG was considered.A healthcare system perspective was adopted.Results:Compared to no screening,lung cancer screening by LDCT in a general Chinese population yielded 21.0-36.7 LYG in men and 9.2-16.6 LYG in women across the scenarios.For men,biennial LDCT screening yielded an ACER of CNY 171.4k-306.3k/LYG relative to no screening.Biennial screening performed between 55 and 75 years of age was optimal at the defined threshold;it resulted in CNY 174.6k/LYG and a lung cancer mortality reduction of 9.1%,and this scenario had a 75%probability of being cost-effective.For women,the ACER ranged from CNY 364.2k to 1193.3k/LYG.Conclusions:In China,lung cancer screening with LDCT in the general population including never smokers could be cost-effective for men with 75%probability,but not for women.The optimal strategy for men would be performing biennial screening between 55 and 75 years of age.展开更多
Introduction:Myopia has emerged as a major public health challenge affecting the visual health of children and adolescents in China.While evidence confirms the effectiveness of outdoor activity in preventing myopia,co...Introduction:Myopia has emerged as a major public health challenge affecting the visual health of children and adolescents in China.While evidence confirms the effectiveness of outdoor activity in preventing myopia,comprehensive economic analyses of its role in mitigating myopia-related diseases remain limited.Methods:This study employed a microsimulation model to evaluate the cost-effectiveness of increasing outdoor activity across different educational stages—primary,middle,and high school—for myopia prevention in China.The model simulated myopia progression among individuals aged 6 to 18 years,with the intervention defined as an additional 40 minutes of daily outdoor activity.Outcomes measured included changes in myopia prevalence,quality-adjusted life years(QALYs),and associated medical costs.Results:All intervention scenarios proved costeffective,except for those targeting only the high school stage.Interventions focused on primary schools and combined primary–middle school stages not only improved health outcomes but also reduced medical costs.While the all-stages intervention yielded the greatest health benefits,its higher implementation costs make it more suitable for regions with greater resources.Conclusion:These findings highlight the critical importance of early intervention in myopia prevention.Policymakers should prioritize outdoor activity programs at the primary school level and develop tailored prevention strategies based on local resource availability.This study provides empirical evidence for developing scientifically sound,cost-effective myopia prevention strategies for children and adolescents,with relevant implications for other developing countries facing a high myopia burden.展开更多
An error in a previous publication in the calculation of the average age at first infection for the model is corrected here.The average age at first infection for the effective contact rates used to generate the data ...An error in a previous publication in the calculation of the average age at first infection for the model is corrected here.The average age at first infection for the effective contact rates used to generate the data ranges from 1.2 to 3.3 years of age instead of 3e5 years of age as advertised in the previous version of the paper.This change has an effect on the force of infection generated by this model.In this corrigendum,we demonstrate the correct method to calculate the average age at first infection for the model.We compare the forces of infection that correspond to these ages in our model with the forces of infection in other endemic populations.We show that the modified age range corresponds to forces of infection which are higher than those that are known to exist in historical studies of polioendemic regions.Thus,the results in the paper have limited applicability to real-world endemic situations.展开更多
Purpose–This paper aims to present a summary of the performance measurement and evaluation plan of the Wyoming connected vehicle(CV)Pilot Deployment Program(WYDOT Pilot).Design/methodology/approach–This paper identi...Purpose–This paper aims to present a summary of the performance measurement and evaluation plan of the Wyoming connected vehicle(CV)Pilot Deployment Program(WYDOT Pilot).Design/methodology/approach–This paper identified 21 specific performance measures as well as approaches to measure the benefits of the WYDOT Pilot.An overview of the expected challenges that might introduce confounding factors to the evaluation effort was outlined in the performance management plan to guide the collection of system performance data.Findings–This paper presented the data collection approaches and analytical methods that have been established for the real-life deployment of the WYDOT CV applications.Five methodologies for assessing 21 specific performance measures contained within eight performance categories for the operational and safety-related aspects.Analyses were conducted on data collected during the baseline period,and pre-deployment conditions were established for 1 performance measures.Additionally,microsimulation modeling was recommended to aid in evaluating the mobility and safety benefits of the WYDOT CV system,particularly when evaluating system performance under various CV penetration rates and/or CV strategies.Practical implications–The proposed performance evaluation framework can guide other researchers and practitioners identifying the best performance measures and evaluation methodologies when conducting similar research activities.Originality/value–To the best of the authors’knowledge,this is thefirst research that develops performance measures and evaluation plan for low-volume rural freeway CV system under adverse weather conditions.This paper raised some early insights into how CV technology might achieve the goal of improving safety and mobility and has the potential to guide similar research activities conducted by other agencies.展开更多
Background:Small populations that have been isolated by conflict make vaccination and surveillance difficult,threatening polio eradication.Silent circulation is caused by asymptomatic infections.It is currently not cl...Background:Small populations that have been isolated by conflict make vaccination and surveillance difficult,threatening polio eradication.Silent circulation is caused by asymptomatic infections.It is currently not clear whether the dynamics of waning immunity also influence the risk of silent circulation in the absence of vaccination.Such circulation can,nevertheless,be present following a declaration of elimination as a result of inadequate acute flaccid paralysis surveillance(AFPS)or environmental surveillance(ES).Methods:We have constructed a stochastic model to understand how stochastic effects alter the ability of small populations to sustain virus circulation in the absence of vaccination.We analyzed how the stochastic process determinants of the duration of silent circulation that could have been detected by ES were affected by R0,waning dynamics,population size,and AFPS sensitivity in a discrete individual stochastic model with homogeneous contagiousness and random mixing.We measured the duration of silent circulation both by the interval between detected acute flaccid paralysis(AFP)cases and the duration of circulation until elimination.Results:As R0 increased and population size increased,the interval between detected AFP cases and the duration of circulation until elimination increased.As AFPS detection rates decreased,the interval between detected AFP cases increased.There was up to a 22%chance of silent circulation lasting for more than 3 years with 100%AFP detection.The duration of silent circulation was not affected by the waning immunity dynamics.Conclusion:We demonstrated that small populations have the potential to sustain prolonged silent circulation.Surveillance in these areas should be intensified before declaring elimination.To further validate these conclusions,it is necessary to realistically relax the simplifying assumptions about mixing and waning.展开更多
基金support from China Schol-arship Council(CSC file No.201708340072).
文摘Background:The effectiveness of lung cancer screening with low-dose computed tomography(LDCT)has been established.The current study evaluates the cost-effectiveness of lung cancer screening with LDCT in a general population in China.Methods:A previously validated micro-simulation model was used to simulate a cohort of men and women on a lifetime horizon in the presence and absence of LDCT screening.The modeling data were collected from numerous national and international sources.Simulated screening scenarios included different combinations of screening intervals and start and stop ages.Additional costs(valued in Chinese Yuan,CNY;1 USD=6.8976 CNY,1 EUR=7.8755 CNY in 2020),life-years gained(LYG)and mortality reduction due to screening were also determined.The costs and life-years were discounted by 3%.All results were scaled to 1,000 individuals.The average cost-effectiveness ratio(ACER)was calculated.A willingness-to-pay threshold of CNY 217.3k/LYG was considered.A healthcare system perspective was adopted.Results:Compared to no screening,lung cancer screening by LDCT in a general Chinese population yielded 21.0-36.7 LYG in men and 9.2-16.6 LYG in women across the scenarios.For men,biennial LDCT screening yielded an ACER of CNY 171.4k-306.3k/LYG relative to no screening.Biennial screening performed between 55 and 75 years of age was optimal at the defined threshold;it resulted in CNY 174.6k/LYG and a lung cancer mortality reduction of 9.1%,and this scenario had a 75%probability of being cost-effective.For women,the ACER ranged from CNY 364.2k to 1193.3k/LYG.Conclusions:In China,lung cancer screening with LDCT in the general population including never smokers could be cost-effective for men with 75%probability,but not for women.The optimal strategy for men would be performing biennial screening between 55 and 75 years of age.
基金supported by the National Natural Science Foundation of China(72293585,72404183).
文摘Introduction:Myopia has emerged as a major public health challenge affecting the visual health of children and adolescents in China.While evidence confirms the effectiveness of outdoor activity in preventing myopia,comprehensive economic analyses of its role in mitigating myopia-related diseases remain limited.Methods:This study employed a microsimulation model to evaluate the cost-effectiveness of increasing outdoor activity across different educational stages—primary,middle,and high school—for myopia prevention in China.The model simulated myopia progression among individuals aged 6 to 18 years,with the intervention defined as an additional 40 minutes of daily outdoor activity.Outcomes measured included changes in myopia prevalence,quality-adjusted life years(QALYs),and associated medical costs.Results:All intervention scenarios proved costeffective,except for those targeting only the high school stage.Interventions focused on primary schools and combined primary–middle school stages not only improved health outcomes but also reduced medical costs.While the all-stages intervention yielded the greatest health benefits,its higher implementation costs make it more suitable for regions with greater resources.Conclusion:These findings highlight the critical importance of early intervention in myopia prevention.Policymakers should prioritize outdoor activity programs at the primary school level and develop tailored prevention strategies based on local resource availability.This study provides empirical evidence for developing scientifically sound,cost-effective myopia prevention strategies for children and adolescents,with relevant implications for other developing countries facing a high myopia burden.
文摘An error in a previous publication in the calculation of the average age at first infection for the model is corrected here.The average age at first infection for the effective contact rates used to generate the data ranges from 1.2 to 3.3 years of age instead of 3e5 years of age as advertised in the previous version of the paper.This change has an effect on the force of infection generated by this model.In this corrigendum,we demonstrate the correct method to calculate the average age at first infection for the model.We compare the forces of infection that correspond to these ages in our model with the forces of infection in other endemic populations.We show that the modified age range corresponds to forces of infection which are higher than those that are known to exist in historical studies of polioendemic regions.Thus,the results in the paper have limited applicability to real-world endemic situations.
文摘Purpose–This paper aims to present a summary of the performance measurement and evaluation plan of the Wyoming connected vehicle(CV)Pilot Deployment Program(WYDOT Pilot).Design/methodology/approach–This paper identified 21 specific performance measures as well as approaches to measure the benefits of the WYDOT Pilot.An overview of the expected challenges that might introduce confounding factors to the evaluation effort was outlined in the performance management plan to guide the collection of system performance data.Findings–This paper presented the data collection approaches and analytical methods that have been established for the real-life deployment of the WYDOT CV applications.Five methodologies for assessing 21 specific performance measures contained within eight performance categories for the operational and safety-related aspects.Analyses were conducted on data collected during the baseline period,and pre-deployment conditions were established for 1 performance measures.Additionally,microsimulation modeling was recommended to aid in evaluating the mobility and safety benefits of the WYDOT CV system,particularly when evaluating system performance under various CV penetration rates and/or CV strategies.Practical implications–The proposed performance evaluation framework can guide other researchers and practitioners identifying the best performance measures and evaluation methodologies when conducting similar research activities.Originality/value–To the best of the authors’knowledge,this is thefirst research that develops performance measures and evaluation plan for low-volume rural freeway CV system under adverse weather conditions.This paper raised some early insights into how CV technology might achieve the goal of improving safety and mobility and has the potential to guide similar research activities conducted by other agencies.
基金This research was supported in part by the Army Research Office under MURI grant 558153-MA-MUR,Prime Award W91 INF-11-1-0036.
文摘Background:Small populations that have been isolated by conflict make vaccination and surveillance difficult,threatening polio eradication.Silent circulation is caused by asymptomatic infections.It is currently not clear whether the dynamics of waning immunity also influence the risk of silent circulation in the absence of vaccination.Such circulation can,nevertheless,be present following a declaration of elimination as a result of inadequate acute flaccid paralysis surveillance(AFPS)or environmental surveillance(ES).Methods:We have constructed a stochastic model to understand how stochastic effects alter the ability of small populations to sustain virus circulation in the absence of vaccination.We analyzed how the stochastic process determinants of the duration of silent circulation that could have been detected by ES were affected by R0,waning dynamics,population size,and AFPS sensitivity in a discrete individual stochastic model with homogeneous contagiousness and random mixing.We measured the duration of silent circulation both by the interval between detected acute flaccid paralysis(AFP)cases and the duration of circulation until elimination.Results:As R0 increased and population size increased,the interval between detected AFP cases and the duration of circulation until elimination increased.As AFPS detection rates decreased,the interval between detected AFP cases increased.There was up to a 22%chance of silent circulation lasting for more than 3 years with 100%AFP detection.The duration of silent circulation was not affected by the waning immunity dynamics.Conclusion:We demonstrated that small populations have the potential to sustain prolonged silent circulation.Surveillance in these areas should be intensified before declaring elimination.To further validate these conclusions,it is necessary to realistically relax the simplifying assumptions about mixing and waning.
