Clinical Events

[ddbaptiste]

Meeting

[2023-10-04 Wed]

Treatment Group Decisions/Flow

Rachel is reaching out to other clinicians about treatment group decision-making.
Genotype is still something that's in question whether we should break groups down in that way.

Genotype 3 vs all other genotypes?
Cirrhotic vs non-cirrhotic.

We like that genotypes add face-validity to the model, especially for hepatologists. Emily finds that the first three numbers in the input file should be taken out, since they're the numbers that end up being changed frequently.
This later became that we remove the bottom 4 values in the excerpt below.

  # PIs say that this needs to be different for each regimen
  Treatment Cost:                                         12748.28

  Treatment Utility:                                      0.99
  Probability of Treatment Initiation:                    0.92 # will be ignored and set to 1 if this is the 2nd treatment in the row

  Cost of Toxicity:                                       139.50
  Utility of Toxicity:                                    0.21

Different rates of success in GT3 cirrhotics.

DECISION: [ Genotype 3/No, Cirrhotic/No, Re-treatment/No ]

General Definitions about Treatment

• Treatment Cycle: An individual treatment with a single drug or combination of drugs before a rest period to allow a patient's body to recover

• Treatment Course: A series of cycles of treatment

• Treatment Regimen: A structured treatment plan designed to improve and maintain health. Similar to a treatment course.

  Quoth Ben: A regimen is multiple courses, as a treatment course may fail and then treatment must be continued

Treatment Design Planning

• Course:
  • Determined based on the person's cirrhotic state, genotype, and number treatments for this infection of HCV
  • Contains multiple regimens (two?)
  • There is a gap period between treatment regimens
• Regimen:
  • Starts after some initial treatment "gap"
  • Person has a probability of withdrawing from treatment in any time step, including the initial gap
  • If a person remains in treatment through the entire duration, their outcome is drawn from [SVR, Toxicity, No Change]
  • If a person achieves SVR, half of the cost of their HCV is subtracted

Screening

If intervention screened, cannot be background screened the same cycle.

Linkage to Care

Eligibility:

• Determine if a person needs 1 test or 2
• If 2 tests, decide if you want to take the max or the latest result

End-of-Timestep Calculations

Transmission (stratified by sex):

• requires determination of how many people are in current IDU and how many of those people are infected