IDEAS home Printed from https://ideas.repec.org/a/gam/jmathe/v11y2023i7p1602-d1107775.html
   My bibliography  Save this article

DESnets: A Graphical Representation for Discrete Event Simulation and Cost-Effectiveness Analysis

Author

Listed:
  • Carmen María Yago

    (Department of Artificial Intelligence, Universidad Nacional de Educación a Distancia (UNED), 28040 Madrid, Spain)

  • Francisco Javier Díez

    (Department of Artificial Intelligence, Universidad Nacional de Educación a Distancia (UNED), 28040 Madrid, Spain)

Abstract

Cost-effectiveness analysis (CEA) is used increasingly in medicine to determine whether the health benefit of an intervention is worth the economic cost. Discrete event simulation (DES) is playing an increasing role in CEA thanks to several advantages, such as the possibility of modeling time and heterogeneous populations. It is usually implemented with general-purpose programming languages or commercial software packages. To our knowledge, no artificial intelligence technique has been applied to DES for CEA. Our objective is to develop a graphical representation, an algorithm, and a software tool that allows non-programmers to easily build models and perform CEA. We present DESnets (discrete event simulation networks) as a new type of probabilistic graphical model inspired by probabilistic influence diagrams, an algorithm for evaluating and an implementation as an OpenMarkov plug-in. DESnets are compared qualitatively and empirically with six alternative tools using as a running example a model about osteoporosis by the British National Institute for Health and Care Excellence (NICE). In our experiments, the implementation of DESnets allowed the building of a typical DES model declaratively. Its evaluation process ranked among the most efficient. DESnets compare favorably with alternative tools in terms of ease of use, expressive power, transparency, and computational efficiency.

Suggested Citation

  • Carmen María Yago & Francisco Javier Díez, 2023. "DESnets: A Graphical Representation for Discrete Event Simulation and Cost-Effectiveness Analysis," Mathematics, MDPI, vol. 11(7), pages 1-24, March.
  • Handle: RePEc:gam:jmathe:v:11:y:2023:i:7:p:1602-:d:1107775
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/2227-7390/11/7/1602/pdf
    Download Restriction: no

    File URL: https://www.mdpi.com/2227-7390/11/7/1602/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Matthew J. Glover & Edmund Jones & Katya L. Masconi & Michael J. Sweeting & Simon G. Thompson, 2018. "Discrete Event Simulation for Decision Modeling in Health Care: Lessons from Abdominal Aortic Aneurysm Screening," Medical Decision Making, , vol. 38(4), pages 439-451, May.
    2. Jonathan Karnon & Hossein Haji Ali Afzali, 2014. "When to Use Discrete Event Simulation (DES) for the Economic Evaluation of Health Technologies? A Review and Critique of the Costs and Benefits of DES," PharmacoEconomics, Springer, vol. 32(6), pages 547-558, June.
    3. Jackson, Christopher, 2016. "flexsurv: A Platform for Parametric Survival Modeling in R," Journal of Statistical Software, Foundation for Open Access Statistics, vol. 70(i08).
    4. Becky Pennington & Alex Filby & Lesley Owen & Matthew Taylor, 2018. "Smoking Cessation: A Comparison of Two Model Structures," PharmacoEconomics, Springer, vol. 36(9), pages 1101-1112, September.
    5. Fernando Alarid-Escudero & Eline M. Krijkamp & Petros Pechlivanoglou & Hawre Jalal & Szu-Yu Zoe Kao & Alan Yang & Eva A. Enns, 2019. "A Need for Change! A Coding Framework for Improving Transparency in Decision Modeling," PharmacoEconomics, Springer, vol. 37(11), pages 1329-1339, November.
    6. Syed Salleh & Praveen Thokala & Alan Brennan & Ruby Hughes & Simon Dixon, 2017. "Discrete Event Simulation-Based Resource Modelling in Health Technology Assessment," PharmacoEconomics, Springer, vol. 35(10), pages 989-1006, October.
    7. Jonathan Karnon & James Stahl & Alan Brennan & J. Jaime Caro & Javier Mar & Jörgen Möller, 2012. "Modeling Using Discrete Event Simulation," Medical Decision Making, , vol. 32(5), pages 701-711, September.
    8. Alan Brennan & Stephen E. Chick & Ruth Davies, 2006. "A taxonomy of model structures for economic evaluation of health technologies," Health Economics, John Wiley & Sons, Ltd., vol. 15(12), pages 1295-1310, December.
    9. Jörgen Möller & Sarah Davis & Matt Stevenson & J. Jaime Caro, 2017. "Validation of a DICE Simulation Against a Discrete Event Simulation Implemented Entirely in Code," PharmacoEconomics, Springer, vol. 35(10), pages 1103-1109, October.
    10. Drummond, Michael F. & Sculpher, Mark J. & Claxton, Karl & Stoddart, Greg L. & Torrance, George W., 2015. "Methods for the Economic Evaluation of Health Care Programmes," OUP Catalogue, Oxford University Press, edition 4, number 9780199665884, Decembrie.
    11. John Graves & Shawn Garbett & Zilu Zhou & Jonathan S. Schildcrout & Josh Peterson, 2021. "Comparison of Decision Modeling Approaches for Health Technology and Policy Evaluation," Medical Decision Making, , vol. 41(4), pages 453-464, May.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Jérémie Schutz & Christophe Sauvey & Eduard Laurențiu Nițu & Ana Cornelia Gavriluță, 2025. "A Practical and Sustainable Approach to Industrial Engineering Discrete-Event Simulation with Free Mathematical and Programming Software," Sustainability, MDPI, vol. 17(9), pages 1-55, April.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Hossein Haji Ali Afzali & Laura Bojke & Jonathan Karnon, 2018. "Model Structuring for Economic Evaluations of New Health Technologies," PharmacoEconomics, Springer, vol. 36(11), pages 1309-1319, November.
    2. Borja García-Lorenzo & Ania Gorostiza & Nerea González & Igor Larrañaga & Maider Mateo-Abad & Ana Ortega-Gil & Janika Bloemeke & Oliver Groene & Itziar Vergara & Javier Mar & Sarah N. Lim Choi Keung &, 2023. "Assessment of the Effectiveness, Socio-Economic Impact and Implementation of a Digital Solution for Patients with Advanced Chronic Diseases: The ADLIFE Study Protocol," IJERPH, MDPI, vol. 20(4), pages 1-14, February.
    3. Sarah Bates & Thomas Bayley & Paul Norman & Penny Breeze & Alan Brennan, 2020. "A Systematic Review of Methods to Predict Weight Trajectories in Health Economic Models of Behavioral Weight-Management Programs: The Potential Role of Psychosocial Factors," Medical Decision Making, , vol. 40(1), pages 90-105, January.
    4. Jen-Yu Amy Chang & James B. Chilcott & Nicholas R. Latimer, 2024. "Challenges and Opportunities in Interdisciplinary Research and Real-World Data for Treatment Sequences in Health Technology Assessments," PharmacoEconomics, Springer, vol. 42(5), pages 487-506, May.
    5. Matthew J. Glover & Edmund Jones & Katya L. Masconi & Michael J. Sweeting & Simon G. Thompson, 2018. "Discrete Event Simulation for Decision Modeling in Health Care: Lessons from Abdominal Aortic Aneurysm Screening," Medical Decision Making, , vol. 38(4), pages 439-451, May.
    6. Roberta Ara & Tessa Peasgood & Clara Mukuria & Helene Chevrou-Severac & Donna Rowen & Ismail Azzabi-Zouraq & Suzy Paisley & Tracey Young & Ben Hout & John Brazier, 2017. "Sourcing and Using Appropriate Health State Utility Values in Economic Models in Health Care," PharmacoEconomics, Springer, vol. 35(1), pages 7-9, December.
    7. John Graves & Shawn Garbett & Zilu Zhou & Jonathan S. Schildcrout & Josh Peterson, 2021. "Comparison of Decision Modeling Approaches for Health Technology and Policy Evaluation," Medical Decision Making, , vol. 41(4), pages 453-464, May.
    8. Vojtěch Kamenský & Vladimír Rogalewicz & Ondřej Gajdoš & Gleb Donin, 2022. "Discrete Event Simulation Model for Cost-Effectiveness Evaluation of Screening for Asymptomatic Patients with Lower Extremity Arterial Disease," IJERPH, MDPI, vol. 19(18), pages 1-16, September.
    9. Penny R. Breeze & Hazel Squires & Kate Ennis & Petra Meier & Kate Hayes & Nik Lomax & Alan Shiell & Frank Kee & Frank de Vocht & Martin O’Flaherty & Nigel Gilbert & Robin Purshouse & Stewart Robinson , 2023. "Guidance on the use of complex systems models for economic evaluations of public health interventions," Health Economics, John Wiley & Sons, Ltd., vol. 32(7), pages 1603-1625, July.
    10. Elizabeth A. Handorf & J. Robert Beck & Andres Correa & Chethan Ramamurthy & Daniel M. Geynisman, 2023. "Cost-Effectiveness Analysis for Therapy Sequence in Advanced Cancer: A Microsimulation Approach with Application to Metastatic Prostate Cancer," Medical Decision Making, , vol. 43(7-8), pages 949-960, October.
    11. Gemma E. Shields & Paul Clarkson & Ash Bullement & Warren Stevens & Mark Wilberforce & Tracey Farragher & Arpana Verma & Linda M. Davies, 2024. "Advances in Addressing Patient Heterogeneity in Economic Evaluation: A Review of the Methods Literature," PharmacoEconomics, Springer, vol. 42(7), pages 737-749, July.
    12. Ashley Layer & Emma McManus & N. J. Levell, 2020. "A Systematic Review of Model-Based Economic Evaluations of Treatments for Venous Leg Ulcers," PharmacoEconomics - Open, Springer, vol. 4(2), pages 211-222, June.
    13. Reda Lebcir & Usame Yakutcan & Eren Demir, 2022. "A decision support tool with health economic modelling for better management of DVT patients," Health Economics Review, Springer, vol. 12(1), pages 1-16, December.
    14. Irina Pokhilenko & Luca M. M. Janssen & Aggie T. G. Paulus & Ruben M. W. A. Drost & William Hollingworth & Joanna C. Thorn & Sian Noble & Judit Simon & Claudia Fischer & Susanne Mayer & Luis Salvador-, 2023. "Development of an Instrument for the Assessment of Health-Related Multi-sectoral Resource Use in Europe: The PECUNIA RUM," Applied Health Economics and Health Policy, Springer, vol. 21(2), pages 155-166, March.
    15. Chiranjeev Sanyal & Don Husereau, 2020. "Systematic Review of Economic Evaluations of Services Provided by Community Pharmacists," Applied Health Economics and Health Policy, Springer, vol. 18(3), pages 375-392, June.
    16. Yesim Tozan & Joshua Kiyingi & Sooyoung Kim & Flavia Namuwonge & Florence Namuli & Vicent Ssentumbwe & Rashida Namirembe & Edwinnah Kasidi & Ozge Sensoy Bahar & Mary M Mckay & Fred M Ssewamala, 2024. "Micro-costing analysis of a combination intervention for improved mental health and HIV risk behaviors among school-going adolescent girls in Uganda," PLOS Mental Health, Public Library of Science, vol. 1(7), pages 1-14, December.
    17. Dong-Won Kang & Patricio B. Lynn & Li Wang & Shouhao Zhou & Chan Shen, 2025. "Cost-Effectiveness of Fruquintinib for Refractory Metastatic Colorectal Cancer in the USA," PharmacoEconomics - Open, Springer, vol. 9(1), pages 93-101, January.
    18. Andrew J. Mirelman & Miqdad Asaria & Bryony Dawkins & Susan Griffin & Richard Cookson & Peter Berman, 2020. "Fairer Decisions, Better Health for All: Health Equity and Cost-Effectiveness Analysis," World Scientific Book Chapters, in: Paul Revill & Marc Suhrcke & Rodrigo Moreno-Serra & Mark Sculpher (ed.), Global Health Economics Shaping Health Policy in Low- and Middle-Income Countries, chapter 4, pages 99-132, World Scientific Publishing Co. Pte. Ltd..
    19. Valentina Prevolnik Rupel & Marko Ogorevc, 2023. "EQ-5D-5L Value Set for Slovenia," PharmacoEconomics, Springer, vol. 41(11), pages 1515-1524, November.
    20. Julie A. Campbell & Glen J. Henson & Valery Fuh Ngwa & Hasnat Ahmad & Bruce V. Taylor & Ingrid Mei & Andrew J. Palmer, 2025. "Estimation of Transition Probabilities from a Large Cohort (> 6000) of Australians Living with Multiple Sclerosis (MS) for Changing Disability Severity Classifications, MS Phenotype, and Disease-Modif," PharmacoEconomics, Springer, vol. 43(2), pages 223-239, February.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jmathe:v:11:y:2023:i:7:p:1602-:d:1107775. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.