Strategic Planning to Reduce the Burden of Stroke among Veterans: Using Simulation
Modeling to Inform Decision Making
K Hassmiller Lich, PhD; Y Tian, MSc; CA Beadles, MD, PhD; L Williams, MD; DM Bravata, MD;
EM Cheng, MD; HB Bosworth, PhD; JB Homer, PhD; D Matchar, MD
This website provides an overview of a System Dynamics stroke model for United States Veteran population (VA). This model was designed to inform strategic planning by the national Stroke Quality Enhancement Research Initiative (Stroke QUERI). The model was developed with engagement of QUERI decision-makers, stroke experts and modelers. Model parameterization, and procedure of analysis will be explained in great details to enhance the transparency of the model, and discussion are welcomed.
This website serves also as Supplementary Material to "Strategic Planning to Reduce the Burden of Stroke among Veterans: Using simulation modeling to inform decision making" (K Hassmiller Lich, PhD; Y Tian, MSc; CA Beadles, MD, PhD; L Williams, MD; DM Bravata, MD; EM Cheng, MD; HB Bosworth, PhD; JB Homer, PhD; D Matchar, MD) which is accepted by Stroke.
Simulation modeling provides an attractive vehicle both for simulating highly complex and dynamic processes (such as stroke care) and for supporting heuristic strategic planning before committing real health resources. In this model, we explicitly simulated 15 stroke interventions:
The readers can navigate to different pages to get detailed information of the model, simulation settings and sensititivity analysis.
This website serves also as Supplementary Material to "Strategic Planning to Reduce the Burden of Stroke among Veterans: Using simulation modeling to inform decision making" (K Hassmiller Lich, PhD; Y Tian, MSc; CA Beadles, MD, PhD; L Williams, MD; DM Bravata, MD; EM Cheng, MD; HB Bosworth, PhD; JB Homer, PhD; D Matchar, MD) which is accepted by Stroke.
Simulation modeling provides an attractive vehicle both for simulating highly complex and dynamic processes (such as stroke care) and for supporting heuristic strategic planning before committing real health resources. In this model, we explicitly simulated 15 stroke interventions:
- Hypertension control for all VA users
- Hypertension control for diabetics
- Hypertension control for VA users with the highest systolic blood pressure (SBP>160mmHG)
- Hypertension and anticoagulation for VA users with prior cerebrovascular disease
- Anticoagulation for all with atrial fibrillation
- Accuracy/timeliness of transient ischemic attack (TIA) diagnosis
- Timely to hospitals within 60 minutes of stroke symptoms onset
- Management of recently diagnosed TIA
- Carotid endarterectomy for post-TIA
- Thrombolytic therapy (tPA)
- Deep venous thromboembolism (DVT) Prophylaxis
- Dysphagia screening
- Comprehensive post-stroke management
- Carotid endarterectomy post stroke
- Rehabilitation
The readers can navigate to different pages to get detailed information of the model, simulation settings and sensititivity analysis.
The website is designed by Yuan Tian with support from Duke-NUS Graduate Medical School Singapore.