Validation of a DICE Simulation Against a Discrete Event Simulation Implemented Entirely in Code

Area of Science:

• Health Technology Assessment
• Computational Modeling
• Health Economics

Background:

• Modeling is crucial for health technology assessment (HTA).
• Various modeling techniques exist, but often require specialized software.
• Discretely Integrated Condition Event (DICE) simulation offers a novel, spreadsheet-based approach.

Purpose of the Study:

• To compare the results of a DICE simulation with a traditional discrete event simulation (DES).
• To assess the validity and applicability of the DICE simulation method in HTA.

Main Methods:

• A published discrete event simulation model for osteoporosis management was adapted.
• A DICE simulation model was developed in Microsoft Excel using the original model's structure.
• Both models were run with identical inputs and settings for comparison.

Main Results:

• The DICE simulation produced results nearly identical to the original DES model.
• Discrepancies in incremental cost-effectiveness ratios were less than 1%, not impacting decision direction.
• The DICE approach maintained the stochastic nature of the original model.

Conclusions:

• DICE simulation provides a valid alternative for designing and implementing decision-analytic models.
• This method eliminates the need for specialized software or custom programming.
• A key limitation is the slower execution speed of the DICE version, requiring further optimization.