Comparison of Timed Automata with Discrete Event Simulation for Modeling Personalized Treatment Decisions: the Case of Metastatic Castration Resistant Prostate Cancer

Koen Degeling, Erik Koffijberg, Stefano Schivo, Rom Langerak, Maarten J. IJzerman

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Abstract

Objectives: The aim of this study is to compare the usefulness of two promising alternative modeling techniques, Timed Automata (TA) originating from informatics, and Discrete Event Simulation (DES) known in operations research, for modeling todays complex and personalized treatment decisions over time, involving multiple interactions and decision gates.

Methods: The usefulness of both modeling techniques was assessed in a case study on the treatment of metastatic Castration Resistant Prostate Cancer (mCRPC) in which Circulating Tumor Cells (CTC) may be used as a response marker for switching first to second line treatment. Techniques were compared on user-friendliness, input requirements, input possibilities, model checking facilities, and results. Input parameters were similar for both models, consisting of costs, QoL, treatment effectiveness, diagnostic performance, physicians’ behavior and survival. Primary outcome measures were health outcomes, expressed in QALYs, and costs.

Results: Modelling was considered easier using TA, as this approach allows independent modeling of the actors and elements comprising the treatment process, such as patients, physicians, tests and treatments, and their mutual interaction and communication. Furthermore, the statistical model checking feature in the TA software was found to be a powerful tool for validation. Input requirements and possibilities were similar for both modelling approaches in this case study. Both modelling approaches yield comparable results. Using TA, CTC reduced first and second line treatment by, on average, 108.9 and 107.6 days, respectively. Using DES, treatment was reduced by 83.6 and 85.0 days. CTC therefore reduced healthcare costs by €28,998 and €21,992 according to TA and DES, respectively.

Conclusions: Both Timed Automata and Discrete Event Simulation seem to be suitable for modeling complex and personalized treatment processes like that of mCRPC. Timed Automata is a new and interesting alternative modeling technique, as it allows explicit separation of model components and supports statistical model checking to validate models.
Original languageEnglish
Pages (from-to)A343-A344
Number of pages1
JournalValue in health
Volume18
Issue number7
DOIs
Publication statusPublished - Nov 2015
EventISPOR 18th Annual European Congress 2015 - MiCo - Milano Congressi, Milan, Italy
Duration: 7 Nov 201511 Nov 2015
Conference number: 18
https://www.ispor.org/event/index/2015milan

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Castration
Prostatic Neoplasms
Circulating Neoplastic Cells
Statistical Models
Therapeutics
Operations Research
Physicians
Costs and Cost Analysis
Informatics
Quality-Adjusted Life Years
Health Care Costs
Software
Communication
Outcome Assessment (Health Care)
Survival
Health

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title = "Comparison of Timed Automata with Discrete Event Simulation for Modeling Personalized Treatment Decisions: the Case of Metastatic Castration Resistant Prostate Cancer",
abstract = "Objectives: The aim of this study is to compare the usefulness of two promising alternative modeling techniques, Timed Automata (TA) originating from informatics, and Discrete Event Simulation (DES) known in operations research, for modeling todays complex and personalized treatment decisions over time, involving multiple interactions and decision gates.Methods: The usefulness of both modeling techniques was assessed in a case study on the treatment of metastatic Castration Resistant Prostate Cancer (mCRPC) in which Circulating Tumor Cells (CTC) may be used as a response marker for switching first to second line treatment. Techniques were compared on user-friendliness, input requirements, input possibilities, model checking facilities, and results. Input parameters were similar for both models, consisting of costs, QoL, treatment effectiveness, diagnostic performance, physicians’ behavior and survival. Primary outcome measures were health outcomes, expressed in QALYs, and costs.Results: Modelling was considered easier using TA, as this approach allows independent modeling of the actors and elements comprising the treatment process, such as patients, physicians, tests and treatments, and their mutual interaction and communication. Furthermore, the statistical model checking feature in the TA software was found to be a powerful tool for validation. Input requirements and possibilities were similar for both modelling approaches in this case study. Both modelling approaches yield comparable results. Using TA, CTC reduced first and second line treatment by, on average, 108.9 and 107.6 days, respectively. Using DES, treatment was reduced by 83.6 and 85.0 days. CTC therefore reduced healthcare costs by €28,998 and €21,992 according to TA and DES, respectively.Conclusions: Both Timed Automata and Discrete Event Simulation seem to be suitable for modeling complex and personalized treatment processes like that of mCRPC. Timed Automata is a new and interesting alternative modeling technique, as it allows explicit separation of model components and supports statistical model checking to validate models.",
author = "Koen Degeling and Erik Koffijberg and Stefano Schivo and Rom Langerak and IJzerman, {Maarten J.}",
year = "2015",
month = "11",
doi = "10.1016/j.jval.2015.09.159",
language = "English",
volume = "18",
pages = "A343--A344",
journal = "Value in health",
issn = "1098-3015",
publisher = "Elsevier",
number = "7",

}

TY - JOUR

T1 - Comparison of Timed Automata with Discrete Event Simulation for Modeling Personalized Treatment Decisions: the Case of Metastatic Castration Resistant Prostate Cancer

AU - Degeling, Koen

AU - Koffijberg, Erik

AU - Schivo, Stefano

AU - Langerak, Rom

AU - IJzerman, Maarten J.

PY - 2015/11

Y1 - 2015/11

N2 - Objectives: The aim of this study is to compare the usefulness of two promising alternative modeling techniques, Timed Automata (TA) originating from informatics, and Discrete Event Simulation (DES) known in operations research, for modeling todays complex and personalized treatment decisions over time, involving multiple interactions and decision gates.Methods: The usefulness of both modeling techniques was assessed in a case study on the treatment of metastatic Castration Resistant Prostate Cancer (mCRPC) in which Circulating Tumor Cells (CTC) may be used as a response marker for switching first to second line treatment. Techniques were compared on user-friendliness, input requirements, input possibilities, model checking facilities, and results. Input parameters were similar for both models, consisting of costs, QoL, treatment effectiveness, diagnostic performance, physicians’ behavior and survival. Primary outcome measures were health outcomes, expressed in QALYs, and costs.Results: Modelling was considered easier using TA, as this approach allows independent modeling of the actors and elements comprising the treatment process, such as patients, physicians, tests and treatments, and their mutual interaction and communication. Furthermore, the statistical model checking feature in the TA software was found to be a powerful tool for validation. Input requirements and possibilities were similar for both modelling approaches in this case study. Both modelling approaches yield comparable results. Using TA, CTC reduced first and second line treatment by, on average, 108.9 and 107.6 days, respectively. Using DES, treatment was reduced by 83.6 and 85.0 days. CTC therefore reduced healthcare costs by €28,998 and €21,992 according to TA and DES, respectively.Conclusions: Both Timed Automata and Discrete Event Simulation seem to be suitable for modeling complex and personalized treatment processes like that of mCRPC. Timed Automata is a new and interesting alternative modeling technique, as it allows explicit separation of model components and supports statistical model checking to validate models.

AB - Objectives: The aim of this study is to compare the usefulness of two promising alternative modeling techniques, Timed Automata (TA) originating from informatics, and Discrete Event Simulation (DES) known in operations research, for modeling todays complex and personalized treatment decisions over time, involving multiple interactions and decision gates.Methods: The usefulness of both modeling techniques was assessed in a case study on the treatment of metastatic Castration Resistant Prostate Cancer (mCRPC) in which Circulating Tumor Cells (CTC) may be used as a response marker for switching first to second line treatment. Techniques were compared on user-friendliness, input requirements, input possibilities, model checking facilities, and results. Input parameters were similar for both models, consisting of costs, QoL, treatment effectiveness, diagnostic performance, physicians’ behavior and survival. Primary outcome measures were health outcomes, expressed in QALYs, and costs.Results: Modelling was considered easier using TA, as this approach allows independent modeling of the actors and elements comprising the treatment process, such as patients, physicians, tests and treatments, and their mutual interaction and communication. Furthermore, the statistical model checking feature in the TA software was found to be a powerful tool for validation. Input requirements and possibilities were similar for both modelling approaches in this case study. Both modelling approaches yield comparable results. Using TA, CTC reduced first and second line treatment by, on average, 108.9 and 107.6 days, respectively. Using DES, treatment was reduced by 83.6 and 85.0 days. CTC therefore reduced healthcare costs by €28,998 and €21,992 according to TA and DES, respectively.Conclusions: Both Timed Automata and Discrete Event Simulation seem to be suitable for modeling complex and personalized treatment processes like that of mCRPC. Timed Automata is a new and interesting alternative modeling technique, as it allows explicit separation of model components and supports statistical model checking to validate models.

U2 - 10.1016/j.jval.2015.09.159

DO - 10.1016/j.jval.2015.09.159

M3 - Meeting Abstract

VL - 18

SP - A343-A344

JO - Value in health

JF - Value in health

SN - 1098-3015

IS - 7

ER -