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Biomedical subjects

Jennifer E Kreke

Publications and source records attributed to Jennifer E Kreke.

2 recordsLinked to original sources

Simulation and critical care modeling.

PURPOSE OF REVIEW: Decisions made in critical care are often complicated, requiring an in-depth understanding of the relations between complex diseases, available interventions, and patients with a wide range of characteristics. Standard modeling techniques such as decision trees and statistical modeling have difficulty in capturing these interactions as the complexity of the problem increases. RECENT FINDINGS: Recent models in the literature suggest that simulation modeling techniques such as Markov modeling, Monte Carlo simulation, and discrete-event simulation are useful tools for analyzing complex systems in critical care. These simulation techniques are reviewed briefly, and examples from the literature are presented to demonstrate their usefulness in understanding real problems in critical care. SUMMARY: Simulation models provide useful tools for organizing and analyzing the interactions between therapies, tradeoffs, and outcomes.

Computer Simulation↗

A clinically based discrete-event simulation of end-stage liver disease and the organ allocation process.

BACKGROUND: The optimal allocation of scarce donor livers is a contentious health care issue requiring careful analysis. The objective of this article was to design a biologically based discrete-event simulation to test proposed changes in allocation policies. METHODS: The authors used data from multiple sources to simulate end-stage liver disease and the complex allocation system. To validate the model, they compared simulation output with historical data. RESULTS: Simulation outcomes were within 1% to 2% of actual results for measures such as new candidates, donated livers, and transplants by year. The model overestimated the yearly size of the waiting list by 5% in the last year of the simulation and the total number of pretransplant deaths by 10%. CONCLUSION: The authors created a discrete-event simulation model that represents the biology of end-stage liver disease and the health care organization of transplantation in the United States.

Adolescent↗