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dc.contributor.authorRydzak, Chara Elaine
dc.contributor.authorCotich, Kara L.
dc.contributor.authorSax, Paul Edward
dc.contributor.authorHsu, Heather Emery Smith
dc.contributor.authorWang, Bingxia
dc.contributor.authorLosina, Elena
dc.contributor.authorFreedberg, Kenneth Alan
dc.contributor.authorWeinstein, Milton C.
dc.contributor.authorGoldie, Sue J.
dc.date.accessioned2011-05-09T03:50:10Z
dc.date.issued2010
dc.identifier.citationRydzak, Chara E., Kara L. Cotich, Paul E. Sax, Heather E. Hsu, Bingxia Wang, Elena Losina, Kenneth A. Freedberg, Milton C. Weinstein, and Sue J. Goldie. 2010. Assessing the Performance of a Computer-Based Policy Model of HIV and AIDS. PLoS ONE 5(9): e12647.en_US
dc.identifier.urihttp://nrs.harvard.edu/urn-3:HUL.InstRepos:4882985
dc.description.abstractBackground: Model-based analyses, conducted within a decision analytic framework, provide a systematic way to combine information about the natural history of disease and effectiveness of clinical management strategies with demographic and epidemiological characteristics of the population. Among the challenges with disease-specific modeling include the need to identify influential assumptions and to assess the face validity and internal consistency of the model. Methods and Findings: We describe a series of exercises involved in adapting a computer-based simulation model of HIV disease to the Women’s Interagency HIV Study (WIHS) cohort and assess model performance as we re-parameterized the model to address policy questions in the U.S. relevant to HIV-infected women using data from the WIHS. Empiric calibration targets included 24-month survival curves stratified by treatment status and CD4 cell count. The most influential assumptions in untreated women included chronic HIV-associated mortality following an opportunistic infection, and in treated women, the ‘clinical effectiveness’ of HAART and the ability of HAART to prevent HIV complications independent of virologic suppression. Good-fitting parameter sets required reductions in the clinical effectiveness of 1st and 2nd line HAART and improvements in 3rd and 4th line regimens. Projected rates of treatment regimen switching using the calibrated cohortspecific model closely approximated independent analyses published using data from the WIHS. Conclusions: The model demonstrated good internal consistency and face validity, and supported cohort heterogeneities that have been reported in the literature. Iterative assessment of model performance can provide information about the relative influence of uncertain assumptions and provide insight into heterogeneities within and between cohorts. Description of calibration exercises can enhance the transparency of disease-specific models.en_US
dc.language.isoen_USen_US
dc.relation.isversionofdoi:10.1371/journal.pone.0012647en_US
dash.licenseLAA
dc.titleAssessing the Performance of a Computer-Based Policy Model of HIV and AIDSen_US
dc.typeJournal Articleen_US
dc.description.versionVersion of Recorden_US
dc.relation.journalPLoS ONEen_US
dash.depositing.authorFreedberg, Kenneth Alan
dc.date.available2011-05-09T03:50:10Z
dash.affiliation.otherHMS^Medicine-Massachusetts General Hospitalen_US
dash.affiliation.otherSPH^Health Policy and Managementen_US
dash.affiliation.otherSPH^Center for Risk Analysisen_US
dash.affiliation.otherSPH^Health Policy and Managementen_US
dash.affiliation.otherHMS^Medicine-Brigham and Women's Hospitalen_US
dash.affiliation.otherSPH^Health Policy and Managementen_US
dc.identifier.doi10.1371/journal.pone.0012647*
dash.contributor.affiliatedRydzak, Chara Elaine
dash.contributor.affiliatedHsu, Heather
dash.contributor.affiliatedWang, Bingxia
dash.contributor.affiliatedSax, Paul
dash.contributor.affiliatedGoldie, Sue
dash.contributor.affiliatedFreedberg, Kenneth
dash.contributor.affiliatedLosina, Elena
dash.contributor.affiliatedWeinstein, Milton


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