Discrete-event Simulation and Optimization to Improve the Performance of a Healthcare System

Thesis (Ph.D.)--University of Washington, 2016-08

Investigating output accuracy for a discrete event simulation model and an agent based simulation model

In this paper, we investigate output accuracy for a Discrete Event Simulation (DES) model and Agent Based Simulation (ABS) model. The purpose of this investigation is to find out which of these simulation techniques is the best one for modelling human reactive behaviour in the retail sector. In order to study the output accuracy in both models, we have carried out a validation experiment in which we compared the results from our simulation models to the performance of a real system. Our experiment was carried out using a large UK department store as a case study. We had to determine an efficient implementation of management policy in the store’s fitting room using DES and ABS. Overall, we have found that both simulation models were a good representation of the real system when modelling human reactive behaviour.

Évaluation pharmacoéconomique d'un test de prédisposition génétique aux effets secondaires musculaires reliés aux statines

Introduction : Les statines ont prouvé leur efficacité dans le traitement des dyslipidémies. Cependant, ces molécules sont associées à des effets secondaires d’ordre musculaire. Puisque ces effets peuvent avoir des conséquences graves sur la vie des patients en plus d’être possiblement à l’origine de la non-observance d’une proportion importante des patients recevant une statine, un outil pharmacogénomique qui permettrait d’identifier a priori les patients susceptibles de développer des effets secondaires musculaires induits par une statine (ESMIS) serait très utile. L’objectif de la présente étude était donc de déterminer la valeur monétaire d’un tel type d’outil étant donné que cet aspect représenterait une composante importante pour sa commercialisation et son implantation dans la pratique médicale courante. Méthode : Une première simulation fut effectuée à l’aide de la méthode de Markov, mais celle-ci ne permettait pas de tenir compte de tous les éléments désirés. C’est pourquoi la méthode de simulation d'évènements discrets fut utilisée pour étudier une population de 100 000 patients hypothétiques nouvellement initiés sur une statine. Cette population virtuelle a été dupliquée pour obtenir deux cohortes de patients identiques. Une cohorte recevait le test et un traitement approprié alors que l'autre cohorte recevait le traitement standard actuel—i.e., une statine. Le modèle de simulation a permis de faire évoluer les deux cohortes sur une période de 15 ans en tenant compte du risque de maladies cardio-vasculaires (MCV) fatal ou non-fatal, d'ESMIS et de mortalité provenant d’une autre cause que d’une MCV. Les conséquences encourues (MCV, ESMIS, mortalité) par ces deux populations et les coûts associés furent ensuite comparés. Finalement, l’expérience fut répétée à 25 reprises pour évaluer la stabilité des résultats et diverses analyses de sensibilité ont été effectuées. Résultats : La différence moyenne des coûts en traitement des MCV et des ESMIS, en perte de capital humain et en médicament était de 28,89 $ entre les deux cohortes pour la durée totale de l’expérimentation (15 ans). Les coûts étant plus élevés chez celle qui n’était pas soumise au test. Toutefois, l’écart-type à la moyenne était considérable (416,22 $) remettant en question la validité de l’estimation monétaire du test pharmacogénomique. De plus, cette valeur était fortement influencée par la proportion de patients prédisposés aux ESMIS, par l’efficacité et le coût des agents hypolipidémiants alternatifs ainsi que par les coûts des traitements des ESMIS et de la valeur attribuée à un mois de vie supplémentaire. Conclusion : Ces résultats suggèrent qu’un test de prédisposition génétique aux ESMIS aurait une valeur d’environ 30 $ chez des patients s’apprêtant à commencer un traitement à base de statine. Toutefois, l’incertitude entourant la valeur obtenue est très importante et plusieurs variables dont les données réelles ne sont pas disponibles dans la littérature ont une influence importante sur la valeur. La valeur réelle de cet outil génétique ne pourra donc être déterminée seulement lorsque le modèle sera mis à jour avec des données plus précises sur la prévalence des ESMIS et leur impact sur l’observance au traitement puis analysé avec un plus grand nombre de patients.

Metodologia para utilização de algoritmos genéticos em modelos de simulação computacional em ambientes de manufatura

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Design and management of a supply chain: a joint location-inventory problem under uncertainty (Part B)

In recent years, global supply chains have increasingly suffered from reliability issues due to various external and difficult to-manage events. The following paper aims to build an integrated approach for the design of a Supply Chain under the risk of disruption and demand fluctuation. The study is divided in two parts: a mathematical optimization model, to identify the optimal design and assignments customer-facility, and a discrete-events simulation of the resulting network. The first one describes a model in which plant location decisions are influenced by variables such as distance to customers, investments needed to open plants and centralization phenomena that help contain the risk of demand variability (Risk Pooling). The entire model has been built with a proactive approach to manage the risk of disruptions assigning to each customer two types of open facilities: one that will serve it under normal conditions and a back-up facility, which comes into operation when the main facility has failed. The study is conducted on a relatively small number of instances due to the computational complexity, a matheuristic approach can be found in part A of the paper to evaluate the problem with a larger set of players. Once the network is built, a discrete events Supply Chain simulation (SCS) has been implemented to analyze the stock flow within the facilities warehouses, the actual impact of disruptions and the role of the back-up facilities which suffer a great stress on their inventory due to a large increase in demand caused by the disruptions. Therefore, simulation follows a reactive approach, in which customers are redistributed among facilities according to the interruptions that may occur in the system and to the assignments deriving from the design model. Lastly, the most important results of the study will be reported, analyzing the role of lead time in a reactive approach for the occurrence of disruptions and comparing the two models in terms of costs.

The effect of demand information sharing in a supply chain under demand uncertainty: a simulation study

Dissertação para obtenção do Grau de Mestre em Engenharia e Gestão Industrial

Simulation methods with extended stability for stiff biochemical kinetics

Background: With increasing computer power, simulating the dynamics of complex systems in chemistry and biology is becoming increasingly routine. The modelling of individual reactions in (bio)chemical systems involves a large number of random events that can be simulated by the stochastic simulation algorithm (SSA). The key quantity is the step size, or waiting time, τ, whose value inversely depends on the size of the propensities of the different channel reactions and which needs to be re-evaluated after every firing event. Such a discrete event simulation may be extremely expensive, in particular for stiff systems where τ can be very short due to the fast kinetics of some of the channel reactions. Several alternative methods have been put forward to increase the integration step size. The so-called τ-leap approach takes a larger step size by allowing all the reactions to fire, from a Poisson or Binomial distribution, within that step. Although the expected value for the different species in the reactive system is maintained with respect to more precise methods, the variance at steady state can suffer from large errors as τ grows. Results: In this paper we extend Poisson τ-leap methods to a general class of Runge-Kutta (RK) τ-leap methods. We show that with the proper selection of the coefficients, the variance of the extended τ-leap can be well-behaved, leading to significantly larger step sizes.Conclusions: The benefit of adapting the extended method to the use of RK frameworks is clear in terms of speed of calculation, as the number of evaluations of the Poisson distribution is still one set per time step, as in the original τ-leap method. The approach paves the way to explore new multiscale methods to simulate (bio)chemical systems.

A practical guide for operational validation of discrete simulation models

As the number of simulation experiments increases, the necessity for validation and verification of these models demands special attention on the part of the simulation practitioners. By analyzing the current scientific literature, it is observed that the operational validation description presented in many papers does not agree on the importance designated to this process and about its applied techniques, subjective or objective. With the expectation of orienting professionals, researchers and students in simulation, this article aims to elaborate a practical guide through the compilation of statistical techniques in the operational validation of discrete simulation models. Finally, the guide's applicability was evaluated by using two study objects, which represent two manufacturing cells, one from the automobile industry and the other from a Brazilian tech company. For each application, the guide identified distinct steps, due to the different aspects that characterize the analyzed distributions. © 2011 Brazilian Operations Research Society.

Simulation in NS-2 of DNP3 protocol encapsulated over TCP/IP in smart grid applications

In dealing with computer networks, these allow the flow of information through the resources of various equipment's. This work describes the implementation through the encapsulation of Protocol DNP3, usually employed in Smart Grid communication, in a simulator of discrete events. The NS-2 is a simulator in open source of network events, that facilitate the development of communication networks scenarios considering the protocols involved, in wireless or wired technologies. The objective of this work is to develop the DNP3 protocol encapsulation over a TCP/IP in the in the discrete event Simulator NS-2, allowing an analysis of behavior of a middle or large network sized in Smart Grid applications. © 2013 IEEE.

Human Behavious Modelling for Discrete Event and Agent Based Simulation: A Case Study

This study is about the comparison of simulation techniques between Discrete Event Simulation (DES) and Agent Based Simulation (ABS). DES is one of the best-known types of simulation techniques in Operational Research. Recently, there has been an emergence of another technique, namely ABS. One of the qualities of ABS is that it helps to gain a better understanding of complex systems that involve the interaction of people with their environment as it allows to model concepts like autonomy and pro-activeness which are important attributes to consider. Although there is a lot of literature relating to DES and ABS, we have found none that focuses on exploring the capability of both in tackling the human behaviour issues which relates to queuing time and customer satisfaction in the retail sector. Therefore, the objective of this study is to identify empirically the differences between these simulation techniques by stimulating the potential economic benefits of introducing new policies in a department store. To apply the new strategy, the behaviour of consumers in a retail store will be modelled using the DES and ABS approach and the results will be compared. We aim to understand which simulation technique is better suited to human behaviour modelling by investigating the capability of both techniques in predicting the best solution for an organisation in using management practices. Our main concern is to maximise customer satisfaction, for example by minimising their waiting times for the different services provided.

Modelling and analysing human behaviour in a department store using discrete event and agent based simulation

Discrete Event Simulation (DES) is a very popular simulation technique in Operational Research. Recently, there has been the emergence of another technique, namely Agent Based Simulation (ABS). Although there is a lot of literature relating to DES and ABS, we have found less that focuses on exploring the capabilities of both in tackling human behaviour issues. In order to understand the gap between these two simulation techniques, therefore, our aim is to understand the distinctions between DES and ABS models with the real world phenomenon in modelling and simulating human behaviour. In achieving the aim, we have carried out a case study at a department store. Both DES and ABS models will be compared using the same problem domain which is concerning on management policy in a fitting room. The behaviour of staffs while working and customers’ satisfaction will be modelled for both models behaviour understanding.

Comparing simulation output accuracy of discrete event and agent based models: a quantitative approach

In our research we investigate the output accuracy of discrete event simulation models and agent based simulation models when studying human centric complex systems. In this paper we focus on human reactive behaviour as it is possible in both modelling approaches to implement human reactive behaviour in the model by using standard methods. As a case study we have chosen the retail sector, and here in particular the operations of the fitting room in the women wear department of a large UK department store. In our case study we looked at ways of determining the efficiency of implementing new management policies for the fitting room operation through modelling the reactive behaviour of staff and customers of the department. First, we have carried out a validation experiment in which we compared the results from our models to the performance of the real system. This experiment also allowed us to establish differences in output accuracy between the two modelling methods. In a second step a multi-scenario experiment was carried out to study the behaviour of the models when they are used for the purpose of operational improvement. Overall we have found that for our case study example both, discrete event simulation and agent based simulation have the same potential to support the investigation into the efficiency of implementing new management policies.

A simulation-based evolutionary multiobjective approach to manufacturing cell formation

The purpose of this paper is to propose a multiobjective optimization approach for solving the manufacturing cell formation problem, explicitly considering the performance of this said manufacturing system. Cells are formed so as to simultaneously minimize three conflicting objectives, namely, the level of the work-in-process, the intercell moves and the total machinery investment. A genetic algorithm performs a search in the design space, in order to approximate to the Pareto optimal set. The values of the objectives for each candidate solution in a population are assigned by running a discrete-event simulation, in which the model is automatically generated according to the number of machines and their distribution among cells implied by a particular solution. The potential of this approach is evaluated via its application to an illustrative example, and a case from the relevant literature. The obtained results are analyzed and reviewed. Therefore, it is concluded that this approach is capable of generating a set of alternative manufacturing cell configurations considering the optimization of multiple performance measures, greatly improving the decision making process involved in planning and designing cellular systems. (C) 2010 Elsevier Ltd. All rights reserved.

Análise do desempenho da tecnologia 4G LTE

O objectivo deste trabalho passa pelo desenvolvimento de uma ferramenta de simulação dinâmica de recursos rádio em LTE no sentido descendente, com recurso à Framework OMNeT++. A ferramenta desenvolvida permite realizar o planeamento das estações base, simulação e análise de resultados. São descritos os principais aspectos da tecnologia de acesso rádio, designadamente a arquitectura da rede, a codificação, definição dos recursos rádio, os ritmos de transmissão suportados ao nível de canal e o mecanismo de controlo de admissão. Foi definido o cenário de utilização de recursos rádio que inclui a definição de modelos de tráfego e de serviços orientados a pacotes e circuitos. Foi ainda considerado um cenário de referência para a verificação e validação do modelo de simulação. A simulação efectua-se ao nível de sistema, suportada por um modelo dinâmico, estocástico e orientado por eventos discretos de modo a contemplar os diferentes mecanismos característicos da tecnologia OFDMA. Os resultados obtidos permitem a análise de desempenho dos serviços, estações base e sistema ao nível do throughput médio da rede, throughput médio por eNodeB e throughput médio por móvel para além de permitir analisar o contributo de outros parâmetros designadamente, largura de banda, raio de cobertura, perfil dos serviços, esquema de modulação, entre outros. Dos resultados obtidos foi possível verificar que, considerando um cenário com estações base com raio de cobertura de 100 m obteve-se um throughput ao nível do utilizador final igual a 4.69494 Mbps, ou seja, 7 vezes superior quando comparado a estações base com raios de cobertura de 200m.

From simulation to statistical analysis: timeliness assessment of ethernet/IP-based distributed systems

A number of characteristics are boosting the eagerness of extending Ethernet to also cover factory-floor distributed real-time applications. Full-duplex links, non-blocking and priority-based switching, bandwidth availability, just to mention a few, are characteristics upon which that eagerness is building up. But, will Ethernet technologies really manage to replace traditional Fieldbus networks? Ethernet technology, by itself, does not include features above the lower layers of the OSI communication model. In the past few years, it is particularly significant the considerable amount of work that has been devoted to the timing analysis of Ethernet-based technologies. It happens, however, that the majority of those works are restricted to the analysis of sub-sets of the overall computing and communication system, thus without addressing timeliness at a holistic level. To this end, we are addressing a few inter-linked research topics with the purpose of setting a framework for the development of tools suitable to extract temporal properties of Commercial-Off-The-Shelf (COTS) Ethernet-based factory-floor distributed systems. This framework is being applied to a specific COTS technology, Ethernet/IP. In this paper, we reason about the modelling and simulation of Ethernet/IP-based systems, and on the use of statistical analysis techniques to provide usable results. Discrete event simulation models of a distributed system can be a powerful tool for the timeliness evaluation of the overall system, but particular care must be taken with the results provided by traditional statistical analysis techniques.