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: 8467090
• 负责人: Yu-Hsiang Hsieh
• 金额: $ 13.63万
• 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/8467090
• 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; Drug usage; 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; Injection of therapeutic agent; 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; Screening procedure; 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; inner city; innovation; insight; mathematical model; methicillin resistant Staphylococcus aureus; novel strategies; outreach; professor; programs; prospective; response; responsible research conduct; routine practice; 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. PROJECT NARRATIVE: Emergency department-based HIV testing programs in the United States have identified thousands of previously undiagnosed HIV-infected individuals since 2006, when the Centers of Disease Control and Prevention began to aggressively promote testing in this non-traditional health care venue. The applicant will pursue a period of intensive multi-disciplinary training in infectious disease mathematical modeling - particularly agent based modeling, and cost-effectiveness analysis, applying these methods to study public health screening in acute care settings. The rich research environment of Johns Hopkins University coupled with the nationally recognized team of expert mentors will lead to independent investigator status, and a career dedicated to research in the development and evaluation of public health intervention strategies which address a wide array of infectious diseases' threats seen in emergency and other acute episodic care settings.

描述（由申请人提供）：这项四年的K01奖励申请是为约翰·霍普金斯大学急诊医学助理教授Yu-Hsiang Hsieh博士提供密集的多学科培训和职业发展指导，导致他成为独立的研究员。在世界知名，拥有NIH资助的经验丰富的导师的指导下。理查德·罗斯曼（Richard Rothman），约书亚·爱泼斯坦（Joshua Epstein）和戴维·霍尔特格雷夫（David Holtgrave），HSIEH博士将获得一系列补充的跨学科技能，这将使他能够从事研究和评估急性护理环境中传染病的研究和评估公共卫生干预措施。申请人将在：急诊医学的公共卫生方面获得指导；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，对艾滋病毒筛查策略的评估是源于过去十年在美国保持艾滋病毒的发病率不变的事实，五分之一的感染者仍未意识到他们的血统。疾病预防控制中心最近在急诊科（ED）环境中广泛筛查的基石之一是控制流行病。尽管美国越来越多的EDS制定了将HIV测试调整为常规实践的策略，但没有努力系统地 解决了基于ED的HIV测试的有效性（相对于没有基于ED的测试），或者，几种测试策略中的哪种在确定最大数量的未识别病例并减少社区HIV传播方面是最佳的。一种相对较新的计算建模方法，基于代理的建模（ABM），为处理HIV流行病学的时间动态的复杂性和与基于ED的HIV HIV测试服务相关的人类行为的复杂性提供了一种潜在的手段，并代表了克服许多传统研究缺点的有前途的方法。该研究项目的目的是：1）得出一种计算模型，用于测量使用ABM方法在马里兰州巴尔的摩的ED HIV测试计划对HIV流行的影响； 2）验证派生的ABM模型； 3）根据验证的ABM模型的发现，评估ED HIV测试计划的相对成本效益。这项研究的结果将提供有关基于ED的HIV测试计划当前方法的新见解，并提供重要的成本效益数据，以告知本地和国家HIV测试策略。 K01奖将为HSIEH博士提供在他的两个新学科的密集和指导的研究经验 - 传染病计算数学建模，尤其是ABM和成本效益分析。他还将接受经验团队的负责任进行研究以及纵向职业指导所需的培训。这些经验共同使他拥有成为一名出色的跨学科独立公共卫生调查员所必需的必要培训和指导，他们将建立一项研究计划，重点是新兴的传染病研究和急诊护理场所。 项目叙述：自2006年以来，美国已经确定了数千个先前未经诊断的HIV感染的人，当时疾病控制和预防中心开始积极促进这个非传统卫生保健场地的测试，因此已经确定了数千个先前未经诊断的HIV感染的人。申请人将在传染病数学建模（尤其是基于代理的建模和成本效益分析）中进行一段密集的多学科培训，并应用这些方法来研究急性护理环境中的公共卫生筛查。约翰·霍普金斯大学（Johns Hopkins University）的丰富研究环境以及全国认可的专家导师团队将导致独立的研究者地位，并致力于研究公共卫生干预策略的开发和评估，以解决各种传染病在紧急情况和其他急诊室中看到的广泛的感染性疾病威胁。