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Summary
This summary is machine-generated.

This study introduces an open-source discrete event simulation (DES) framework for continuous-time individual-level state-transition models (iSTMs) in healthcare. The reliable DES framework enables more realistic modeling of health processes at lower costs.

Keywords:
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Area of Science:

  • Health economics and outcomes research
  • Computational modeling and simulation
  • Biostatistics

Background:

  • Discrete event simulation (DES) is underutilized in healthcare decision-making due to implementation challenges.
  • Existing methods often lack reliability and reproducibility for complex health processes.

Purpose of the Study:

  • To develop an open-source DES framework for simulating individual-level state-transition models (iSTMs) in continuous time.
  • To provide a reliable and accessible tool for modeling healthcare processes with greater realism.

Main Methods:

  • Developed a modular DES framework using the next-reaction algorithm.
  • Incorporated time-dependent transitions, age-dependent mortality, and treatment effects using validated sampling methods.
  • Implemented the framework in R using the Sick-Sicker Model for demonstration.

Main Results:

  • The framework successfully simulates individual state transitions in continuous time.
  • Epidemiological outcomes, cost-effectiveness, and probabilistic analyses were obtained.
  • Demonstrated the framework's ability to model realistic health dynamics.

Conclusions:

  • The open-source DES framework offers a reliable and cost-effective alternative to discrete-time iSTMs.
  • Enables more realistic simulation of health dynamics, improving medical decision-making.
  • Facilitates advanced analyses such as cost-effectiveness and value-of-information.