Economic modelling of antenatal screening and ultrasound scanning programmes for identification of fetal abnormalities

Objective Within the framework of a health technology assessment and using an economic model, to determine the most clinically and cost effective policy of scanning and screening for fetal abnormalities in early pregnancy. Design A discrete event simulation model of 50,000 singleton pregnancies. Setting Maternity services in Scotland. Population Women during the first 24 weeks of their pregnancy. Methods The mathematical model was populated with data on uptake of screening, prevalence, detection and false positive rates for eight fetal abnormalities and with costs for ultrasound scanning and serum screening. Inclusion of abnormalities was based on the relative prevalence and clinical importance of conditions and the availability of data. Six strategies for the identification of abnormalities prenatally including combinations of first and second trimester ultrasound scanning and first and second trimester screening for chromosomal abnormalities were compared. Main outcome measures The number of abnormalities detected and missed, the number of iatrogenic losses resulting from invasive tests, the total cost of strategies and the cost per abnormality detected were compared between strategies. Results First trimester screening for chromosomal abnormalities costs more than second trimester screening but results in fewer iatrogenic losses. Strategies which include a second trimester ultrasound scan result in more abnormalities being detected and have lower costs per anomaly detected. Conclusions The preferred strategy includes both first and second trimester ultrasound scans and a first trimester screening test for chromosomal abnormalities. It has been recommended that this policy is offered to all women in Scotland.

The Role of decision-analytic modelling in German health technology assessments

BACKGROUND: Decision-analytic modelling (DAM) has become a widespread method in health technology assessments (HTA), but the extent to which modelling is used differs among international HTA institutions. In Germany, the use of DAM is optional within HTAs of the German Institute of Medical Documentation and Information (DIMDI). Our study examines the use of DAM in DIMDI HTA reports and its effect on the quality of information provided for health policies. METHODS: A review of all DIMDI HTA reports (from 1998 to September 2012) incorporating an economic assessment was performed. All included reports were divided into two groups: HTAs with DAM and HTAs without DAM. In both groups, reports were categorized according to the quality of information provided for healthcare decision making. RESULTS: Of the sample of 107 DIMDI HTA reports, 17 (15.9%) used DAM for economic assessment. In the group without DAM, conclusions were limited by the quality of economic information in 51.1% of the reports, whereas we did not find limited conclusions in the group with DAM. Furthermore, 24 reports without DAM (26.7%) stated that using DAM would likely improve the quality of information of the economic assessment. CONCLUSION: The use of DAM techniques can improve the quality of HTAs in Germany. When, after a systematic review of existing literature within a HTA, it is clear that DAM is likely to positively affect the quality of the economic assessment DAM should be used.

Economic modelling of grazing systems in the Fitzroy and Burdekin catchments

The Great Barrier Reef (GBR) is the largest reef system in the world; it covers an area of approximately 2,225,000 km² in the northern Queensland continental shelf. There are approximately 750 reefs that exist within 40 km of the Queensland coast. Recent research has identified that poor water quality is having negative impacts on the GBR (Haynes et al. 2007). The Fitzroy Basin covers 143,000 km² and is the largest catchment draining into the GBR as well as being one of the largest catchments in Australia (Karfs et al. 2009). The Burdekin Catchment is the second largest catchment entering into the GBR and covers 133,432 km².The prime determinant for the changes in water quality entering into the GBR have been attributed to grazing, with beef production the largest single land use industry comprising 90% of the land area (Karfs et al. 2009). Extensive beef production contributes over $1 billion dollars to the national economy annually and employs over 9000 people, many in rural communities (Gordon 2007). ‘Economic modelling of grazing systems in the Fitzroy and Burdekin catchments’ was a joint project with the Fitzroy Basin Association and the Queensland Department of Employment Economic Development and Innovation. The project was formed under the federally funded Caring For Our Country and the Reef Rescue programs. The project objectives were as follows; * Quantifying the costs of over-utilising available pasture and the resulting sediment leaving a representative farm for four of the major land systems in the Burdekin or Fitzroy catchments and identifying economically optimal pasture utilisation rates * Estimating the cost of reducing pasture utilisation rates below the determined optimal * Using this information, guide the selection of appropriate tools to achieve reduced utilisation rates e.g. extension process versus incentive payments or a combination of both * Model the biophysical and economic impacts of altering grazing systems to restore land condition e.g. from C condition to B condition for four land systems in the Burdekin or Fitzroy catchments.

Screening of healthcare workers for tuberculosis: development and validation of a new health economic model to inform practice

Methods for determining cost-effectiveness of different treatments are well established, unlike appraisal of non-drug interventions, including novel diagnostics and biomarkers.

Transport energy demand: techno-economic modelling and scenarios for Irish climate policy

The case for energy policy modelling is strong in Ireland, where stringent EU climate targets are projected to be overshot by 2015. Policy targets aiming to deliver greenhouse gas and renewable energy targets have been made, but it is unclear what savings are to be achieved and from which sectors. Concurrently, the growth of personal mobility has caused an astonishing increase in CO2 emissions from private cars in Ireland, a 37% rise between 2000 and 2008, and while there have been improvements in the efficiency of car technology, there was no decrease in the energy intensity of the car fleet in the same period. This thesis increases the capacity for evidenced-based policymaking in Ireland by developing techno-economic transport energy models and using them to analyse historical trends and to project possible future scenarios. A central focus of this thesis is to understand the effect of the car fleet‘s evolving technical characteristics on energy demand. A car stock model is developed to analyse this question from three angles: Firstly, analysis of car registration and activity data between 2000 and 2008 examines the trends which brought about the surge in energy demand. Secondly, the car stock is modelled into the future and is used to populate a baseline “no new policy” scenario, looking at the impact of recent (2008-2011) policy and purchasing developments on projected energy demand and emissions. Thirdly, a range of technology efficiency, fuel switching and behavioural scenarios are developed up to 2025 in order to indicate the emissions abatement and renewable energy penetration potential from alternative policy packages. In particular, an ambitious car fleet electrification target for Ireland is examined. The car stock model‘s functionality is extended by linking it with other models: LEAP-Ireland, a bottom-up energy demand model for all energy sectors in the country; Irish TIMES, a linear optimisation energy system model; and COPERT, a pollution model. The methodology is also adapted to analyse trends in freight energy demand in a similar way. Finally, this thesis addresses the gap in the representation of travel behaviour in linear energy systems models. A novel methodology is developed and case studies for Ireland and California are presented using the TIMES model. Transport Energy

Managing invasive alien species with professional and hobby farmers: insights from ecological-economic modelling

Biosecurity is a great challenge to policy-makers globally. Biosecurity policies aim to either prevent invasions before they occur or to eradicate and/or effectively manage the invasive species and diseases once an invasion has occurred. Such policies have traditionally been directed towards professional producers in natural resource based sectors, including agriculture. Given the wide scope of issues threatened by invasive species and diseases, it is important to account for several types of stakeholders that are involved. We investigate the problem of an invasive insect pest feeding on an agricultural crop with heterogeneous producers: profit-oriented professional farmers and utility-oriented hobby farmers. We start from an ecological-economic model conceptually similar to the one developed by Eiswerth and Johnson [Eiswerth, M.E. and Johnson, W.S., 2002. Managing nonindigenous invasive species: insights from dynamic analysis. Environmental and Resource Economics 23, 319-342.] and extend it in three ways. First, we make explicit the relationship between the invaded state carrying capacity and farmers' planting decisions. Second, we add another producer type into the framework and hence account for the existence of both professional and hobby fanners. Third, we provide a theoretical contribution by discussing two alternative types of equilibria. We also apply the model to an empirical case to extract a number of stylised facts and in particular to assess: a) under which circumstances the invasion is likely to be not controllable; and b) how extending control policies to hobby farmers could affect both types of producers. (C) 2008 Elsevier B.V. All rights reserved.

Techno-economic modelling and cost functions of CO2 capture processes

The paper presents the techno-economic modelling of CO2 capture process in coal-fired power plants. An overall model is being developed to compare carbon capture and sequestration options at locations within the UK, and for studies of the sensitivity of the cost of disposal to changes in the major parameters of the most promising solutions identified. Technological options of CO2 capture have been studied and cost estimation relationships (CERs) for the chosen options calculated. Created models are related to the capital, operation and maintenance cost. A total annualised cost of plant electricity output and amount of CO2 avoided have been developed. The influence of interest rates and plant life has been analysed as well. The CERs are included as an integral part of the overall model.

The incidence and health economic burden of ischemic amputation in Minnesota, 2005-2008

Critical limb ischemia (CLI) is the most severe manifestation of peripheral artery disease (PAD), is associated with high rates of myocardial infarction, stroke, and amputation, and has a high health economic cost. The objective of this study was to estimate the incidence of lower limb amputation, the most serious consequence of CLI, and to create a surveillance methodology for the incidence of ischemic amputation in Minnesota.

An economic modelling approach for vulnerability assesment in irrigation farms in Spain

In the last years, vulnerability assessment has emerged as a need for policy making instead of being a pure academic exercise (Hinkel, 2010). In the current context of changing climate, increasing water scarcity threatens economic activities in many arid or semi-arid regions of the World. Climate change (CC) science and policy debates have traditionally focused on CC mitigation and impact assessment (Krysanova et al., 2010). However, even if mitigation policies are successfully enforced some climate change is still expected. Then, adaptation is strongly necessary and, for that, improved knowledge on vulnerability and adaptive capacity is required.

Homogeneous Spatial Units (HSU) - a Pan-European geographical basis for environmental and socio-economic modelling

The spatial data set delineates areas with similar environmental properties regarding soil, terrain morphology, climate and affiliation to the same administrative unit (NUTS3 or comparable units in size) at a minimum pixel size of 1km2. The scope of developing this data set is to provide a link between spatial environmental information (e.g. soil properties) and statistical data (e.g. crop distribution) available at administrative level. Impact assessment of agricultural management on emissions of pollutants or radiative active gases, or analysis regarding the influence of agricultural management on the supply of ecosystem services, require the proper spatial coincidence of the driving factors. The HSU data set provides e.g. the link between the agro-economic model CAPRI and biophysical assessment of environmental impacts (updating previously spatial units, Leip et al. 2008), for the analysis of policy scenarios. Recently, a statistical model to disaggregate crop information available from regional statistics to the HSU has been developed (Lamboni et al. 2016). The HSU data set consists of the spatial layers provided in vector and raster format as well as attribute tables with information on the properties of the HSU. All input data for the delineation the HSU is publicly available. For some parameters the attribute tables provide the link between the HSU data set and e.g. the soil map(s) rather than the data itself. The HSU data set is closely linked the USCIE data set.

Economic Modelling of Australian Longwall Ventilation

Mine Ventilation - North American Ninth US Mine Ventilation Symposium