Meta-modelling Markov Model Simulations for cost effectiveness analyses ICTR-PHE 2012 Daniel Abler 1 Steve Harris 2 Jim Davies 2 1CERN 2Department of Computer Science, University of Oxford daniel.abler@cern.ch , { steve.harris, jim.davies } @cs.ox.ac.uk 01.03.2012 Daniel Abler (CERN) Meta-modelling Markov Model Simulations 01.03.2012 1 / 6
. . . . . . . . . Motivation . Cost-Effectiveness studies... . . ..., it is recommended not to adopt particle therapy as standard treatment in NSCLC yet. More evidence is needed ... [Grutters et al., The cost-effectiveness of particle therapy in non-small cell lung cancer: Exploring decision uncertainty and areas for future research , Cancer Treatment Reviews, 36, 6, 2010] . . . . ... and reporting guidelines . . information about: such as: Study Design effectiveness, quality, costing data Data Collection details on modelling Analysis and interpretation of results ... [Drummond et al. Guidelines for authors and peer reviewers of economic submissions to the BMJ , BMJ 1996;313:275] . . . Daniel Abler (CERN) Meta-modelling Markov Model Simulations 01.03.2012 2 / 6
Motivation . Cost-Effectiveness studies... . . ..., it is recommended not to adopt particle therapy as standard treatment in NSCLC yet. More evidence is needed ... [Grutters et al., The cost-effectiveness of particle therapy in non-small cell lung cancer: Exploring decision uncertainty and areas for future research , Cancer Treatment Reviews, 36, 6, 2010] . . . . ... and reporting guidelines . . information about: such as: Study Design effectiveness, quality, costing data Data Collection details on modelling Analysis and interpretation of results ... [Drummond et al. Guidelines for authors and peer reviewers of economic submissions to the BMJ , BMJ 1996;313:275] . . . . Objective . . To facilitate exchange, interpretation and re-use of Markov Model Simulations (MMS) by creating a candidate model sufficiently expressive to describe modelling assumptions, data input and computational specifications. . . . Daniel Abler (CERN) Meta-modelling Markov Model Simulations 01.03.2012 2 / 6
Markov Models in CEA . Markov Models . . model stochastic processes costs and utilities assigned to states and transitions here: disease progress of a patient probabilities assigned to transitions between states . . . . . . . . . . . . . . . . . s 1 p 11 assymptomatic start . . . . . . . . . . State * p 12 2 0..* p 13 p 22 s 2 progressive disease PayOff 0..* p 23 1..* Transition * s 3 p 33 = 1 death Daniel Abler (CERN) Meta-modelling Markov Model Simulations 01.03.2012 3 / 6
Model for Markov Model Simulations Metamodel of . features . . . . . . Markov Model . . Simulations Instance of Markov Model Simulation specifies simulation settings Markov Model instances (and thus Values ) used in instance simulation results obtained by simulation specific specific → can serve as processing instruction for simulation Markov Model specific Markov Model programme and documentation of computed MMS Simulation Markov Model Simulation . . . Simulation . . . . . . . . . . . . . . . . . . . . . Values Markov Model Simulation Markov Model distribution of data simulation settings modalities * 1..* * 1..* e.g. halfCycle correction, source payOff classes initialAge, modalities,... unit cycle duration results ... State * 2 Results 0..* results for individual markov PayOff model comparative results 0..* 1..* Transition * Daniel Abler (CERN) Meta-modelling Markov Model Simulations 01.03.2012 4 / 6
Textual Language for MMS markovModelSimulation AnExampleSimulation { s i m u l a t i o n S e t t i n g s { simulationType : d e t e r m i n i s t i c numberOfCycles { markovModel G ru tte rs 20 10 1 : 1 , markovModel G rut te rs 20 10 2 : 5 } h a l f C y c l e C o r r e c t i o n : 1 u s e M o d a l i t i e s { modalityType p r o t o n , modalityType carbon } useMarkovModels { markovModel G r u t t e r s 2 0 1 0 1 , markovModel Gr ut te r s2 01 0 2 } t r a n s f e r { markovModel G ru tt e r s20 10 1 : s t a t e State treatmentDeath − > markovModel G ru tt e r s20 10 2 : s t a t e S t a t e d e a t h , . . . } markovModel G ru tt e r s2 010 1 { . . . } markovModel G ru tt e r s2 010 2 { . . . } . . . } . [Language Workbench Spoofax : [example from: http://strategoxt.org/Spoofax] Grutters et al., The cost-effectiveness of particle therapy in non-small cell lung cancer: Exploring decision uncertainty and areas for future research , Cancer Treatment Reviews, 36, 2010] Daniel Abler (CERN) Meta-modelling Markov Model Simulations 01.03.2012 5 / 6
Textual Language for MMS State_init, PO_treatTime_CI, PO_treatCost_CI , PO_DeathTreat 1 - TPacPneumGt3 + TableTPacOesophGt3, POCostsDyspnPerYear markovModelSimulation AnExampleSimulation { State_treatNoAcuteAes, PO_UtilityNoAeDurTreat s i m u l a t i o n S e t t i n g s { simulationType : d e t e r m i n i s t i c numberOfCycles { markovModel G ru tte rs 20 10 1 : 1 , markovModel G rut te rs 20 10 2 : 5 } S_treatDeath transfer h a l f C y c l e C o r r e c t i o n : 1 u s e M o d a l i t i e s { modalityType p r o t o n , modalityType carbon } useMarkovModels { markovModel G r u t t e r s 2 0 1 0 1 , markovModel Gr ut te r s2 01 0 2 } Visualisation of states and transi- t r a n s f e r { markovModel G ru tt e r s20 10 1 : s t a t e State treatmentDeath − State_woDysp, PO_FollowUp, > PO_UtilityNoAeAfterTreat markovModel G ru tt e r s20 10 2 : s t a t e S t a t e d e a t h , tions used in this study, generated . . . from the MMS description. } transfer TPotherMort markovModel G ru tt e r s2 010 1 { . . . State_withDysp, } TPdiseaseMort, PO_CostsDyspnPerYear, PO_DeathOther PO_DeathCancer PO_FollowUp, PO_UtilityDyspAfterTreat markovModel G ru tt e r s2 010 2 { . . . } TPdiseaseMort, TPotherMort, PO_DeathOther . . . . . } . PO_DeathCancer State_death [Language Workbench Spoofax : [example from: http://strategoxt.org/Spoofax] Grutters et al., The cost-effectiveness of particle therapy in non-small cell lung cancer: Exploring decision uncertainty and areas for future research , Cancer Treatment Reviews, 36, 2010] Daniel Abler (CERN) Meta-modelling Markov Model Simulations 01.03.2012 5 / 6
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