Nothing
## ----include = FALSE----------------------------------------------------------
knitr::opts_chunk$set(
collapse = TRUE,
comment = "#>"
)
## ----setup--------------------------------------------------------------------
library(twig)
## -----------------------------------------------------------------------------
mytwig <- twig() +
decisions(names=c(DoNotTreat, Treat, Biopsy)) + # treatment options
event(name = DIE, # first event
options = c(yes, none), # either occurs or doesn't occur
probs = c(pDie, leftover), # occurs with prob pDie and doesn't occur with 1-pDie (leftover)
transitions = c(Death, HVE_event)) + # if it occurs, transitions to Death, otherwise the HVE_event
event(name = HVE_event, # similarly, HVE_event occurs with f_HVE but if not it will be OVE
options = c(yes, none),
probs = c(f_HVE, leftover),
transitions = c(get_HVE_comp, get_OVE_comp)) +
event(name = get_HVE_comp, # evaluate whether HVE complications occured
options = c(yes, none),
probs = c(p_comp, leftover),
transitions = c(HVE_comp, no_HVE_comp)) +
event(name = get_OVE_comp, # evaluate whether other viral encephalitis (OVE) complications occured
options = c(yes, none),
probs = c(p_comp, leftover),
transitions = c(OVE_comp, no_OVE_comp)) +
payoffs(names = c(cost, utility)) # finally measure the cost and utilities
## -----------------------------------------------------------------------------
params <- list(
# Probabilities,
p_HVE = 0.52 ,# prevalence of HVE
p_HVE_comp = 0.71 ,# complications with untreated HVE
p_OVE_comp = 0.01 ,# complications with untreated OVE
p_HVE_comp_tx = 0.36 ,# complications with treated HVE
p_OVE_comp_tx = 0.20 ,# complications with treated OVE
p_biopsy_death = 0.005 ,# probability of death due to biopsy
# Costs,
c_VE = 1200 ,# cost of viral encephalitis care without complications
c_VE_comp = 9000 ,# cost of viral encephalitis care with complications
c_tx = 9500 ,# cost of treatment
c_biopsy = 25000 ,# cost of brain biopsy
# QALYs,
q_VE = 20 ,# remaining QALYs for those without VE-related complications
q_VE_comp = 19 ,# remaining QALYs for those with VE-related complications
q_loss_biopsy = 0.01 ,# one-time QALY loss due to brain biopsy
q_death_biopsy = 0 # remaining QALYs for those who died during biopsy
)
## -----------------------------------------------------------------------------
pDie <- function(decision, p_biopsy_death){
p_biopsy_death * (decision == "Biopsy")
}
## -----------------------------------------------------------------------------
p_comp <- function(decision, HVE_event, p_HVE_comp, p_OVE_comp,
p_HVE_comp_tx, p_OVE_comp_tx) {
# complication of untreated HVE
p_HVE_comp * (decision == "DoNotTreat" & HVE_event=="yes") +
# complication of untreated OVE
p_OVE_comp * (decision %in% c("DoNotTreat", "Biopsy") & HVE_event=="none") +
# complications of treated HVE
p_HVE_comp_tx * (decision %in% c("Treat", "Biopsy") & HVE_event=="yes") +
# complications of treated OVE
p_OVE_comp_tx * (decision == "Treat" & HVE_event=="none")
}
## -----------------------------------------------------------------------------
f_HVE <- function(p_HVE){
p_HVE
}
## -----------------------------------------------------------------------------
cost <- function(decision, outcome, c_biopsy, c_tx, c_VE_comp, c_VE){
# cost of biopsy
c_biopsy*(decision=="Biopsy") +
# cost of treatment if treated or biopsy was +ve for HVE
c_tx*(decision=="Treat" | (decision=="Biopsy" & outcome %in% c("HVE_comp", "no_HVE_comp"))) +
# cost of complication if outcomes are in either HVE or OVE complications
c_VE_comp*(outcome %in% c("HVE_comp", "OVE_comp")) +
# cost of viral encephalitis if complications didn't occur
c_VE*(outcome %in% c("no_HVE_comp", "no_OVE_comp"))
}
## -----------------------------------------------------------------------------
utility <- function(decision, outcome, q_loss_biopsy, q_VE_comp, q_VE){
# apply utility discount for biopsy
-q_loss_biopsy*(decision=="Biopsy") +
# apply utility values for complications
q_VE_comp*(outcome %in% c("HVE_comp", "OVE_comp")) +
# apply utility values if complications didn't occur
q_VE*(outcome %in% c("no_HVE_comp", "no_OVE_comp"))
}
## -----------------------------------------------------------------------------
results <- run_twig(twig_obj = mytwig, params = params, parallel = FALSE, progress_bar = FALSE)
results$sim_ev
## -----------------------------------------------------------------------------
calculate_icers(results$mean_ev)
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