Patient-level simulation TSD
A technical support document about patient-level simulation produced by the Nice DSU.
TSD 15 one-page summary (PDF, 124KB)
- Appendix A: Visual basic code for discrete event simulation example model (PDF, 140KB)
- Appendix B: R code for DES example model (PDF, 168KB)
- Appendix C: Simul8 documentation (PDF, 155KB)
- Code for Excel (.zip, 2.4MB)
- Code for R (.zip, 6KB)
- Code for Simul8 (.zip, 31KB)
- Code for TreeAge (.zip, 18KB)
- Code for DICE version (.zip, 335KB)
All the documents above are also available in a zip file (.zip, 3.3MB).
Economic models can use either a patient- or cohort-level modelling approach to estimate the expected costs and outcomes across a particular population. In a patient-level simulation, the outcomes are modelled for individual patients and then the average is taken across a sufficiently large sample of patients. In a cohort-level model the outcomes are estimated for the cohort as a whole, without considering the outcomes for individual patients within that cohort.
The aims of this technical support document (TSD) on patient-level simulation are to:
- Increase awareness of patient-level modelling approaches and highlight the key differences between patient-level and cohort-level modelling approaches.
- Provide guidance on situations in which patient-level modelling approaches may be preferable to cohort-level modelling approaches.
- Provide a description of how to implement a patient-level simulation using either a patient-level state-transition or discrete event simulation (DES) framework in a variety of software environments (Microsoft Excel®, R, TreeAge Pro®).
- Provide example models illustrating how to implement a simple cost-effectiveness model using a patient-level approach. The example models cover both DES (R, Visual Basic module within Microsoft Excel®, TreeAge Pro®) and patient-level state-transition (Microsoft Excel® and TreeAge Pro®) frameworks.
- Provide guidance on good practice when developing and reporting a patient-level simulation to inform a NICE TA.
The focus of this document is on the application of patient-level simulation to systems where patients can be assumed to be independent as systems incorporating patient interaction are not a common feature with Technology Appraisal.
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