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动态微观模拟模型在健康结果评估中的应用:综述

Dynamic microsimulation models for health outcomes: a review.

机构信息

Biostatistics Unit, Group Health Research Institute, Seattle, WA USA, and Department of Biostatistics, University of Washington School of Public Health and Community Medicine, Seattle, WA USA (CMR)

Department of Health Care Policy Harvard Medical School, Boston, MA USA (AMZ)

出版信息

Med Decis Making. 2011 Jan-Feb;31(1):10-8. doi: 10.1177/0272989X10369005. Epub 2010 May 18.

Abstract

BACKGROUND

Microsimulation models (MSMs) for health outcomes simulate individual event histories associated with key components of a disease process; these simulated life histories can be aggregated to estimate population-level effects of treatment on disease outcomes and the comparative effectiveness of treatments. Although MSMs are used to address a wide range of research questions, methodological improvements in MSM approaches have been slowed by the lack of communication among modelers. In addition, there are few resources to guide individuals who may wish to use MSM projections to inform decisions.

METHODS

. This article presents an overview of microsimulation modeling, focusing on the development and application of MSMs for health policy questions. The authors discuss MSM goals, overall components of MSMs, methods for selecting MSM parameters to reproduce observed or expected results (calibration), methods for MSM checking (validation), and issues related to reporting and interpreting MSM findings(sensitivity analyses, reporting of variability, and model transparency).

CONCLUSIONS

. MSMs are increasingly being used to provide information to guide health policy decisions. This increased use brings with it the need for both better understanding of MSMs by policy researchers, and continued improvement in methods for developing and applying MSMs.

摘要

背景

用于健康结果的微观模拟模型(MSMs)模拟与疾病过程关键组成部分相关的个体事件历史;这些模拟的生命历史可以被汇总,以估计治疗对疾病结果的人群水平效应以及治疗的相对效果。尽管 MSM 被用于解决广泛的研究问题,但由于建模者之间缺乏沟通,MSM 方法的改进一直很缓慢。此外,很少有资源可以指导那些可能希望使用 MSM 预测来为决策提供信息的个人。

方法

本文概述了微观模拟建模,重点介绍了针对健康政策问题开发和应用 MSM 的方法。作者讨论了 MSM 的目标、MSM 的总体组成部分、选择 MSM 参数以复制观察到或预期结果的方法(校准)、MSM 检查方法(验证),以及与报告和解释 MSM 结果相关的问题(敏感性分析、变异性报告和模型透明度)。

结论

MSM 越来越多地被用于提供信息来指导健康政策决策。这种增加的使用带来了政策研究人员对 MSM 的更好理解的需求,以及对开发和应用 MSM 的方法的持续改进的需求。

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