Data & Parameters
Our Data and Parameters Project addresses important priority areas for applied modeling. Current aims build upon 5 years' experience with the MIDAS-funded Applied Modeling Project, which helped various decision makers better understand the spread and control of infectious diseases through economic and operational infectious disease computational models and simulations. Previous research also assessed the impact of vaccination programs and factors associated with the resurgence of vaccine-preventable diseases. The Data and Parameters project aims to advance the availability and use of detailed, disaggregated, high value computable data sets, and devise improved methods to estimate transmission parameters from those data. Specific current research will focus on the acquisition, curation, and integration of new large scale epidemiologic, vital statistics, and demographic data to improve the case -law of infectious disease dynamics. Research will also create innovative tools for the analysis of spatiotemporal disease transmission patterns.
Van Panhuis WG, Grefenstette J, Jung SY, Chok NS, Cross A, Eng H, Lee BY, Zadorozhny V, Brown S, Cummings D, Burke DS. Contagious Diseases in the United States from 1888 to the Present. NEJM 2013; 369(22): 2152-2158.
Vaccines have prevented more than 100 million cases of serious infectious diseases in the US since 1924.
Van Panhuis WG, Hyun S, Blaney K, Marques ETA, Coelho GE, Siqueira JB, et al. Risk of Dengue for Tourists and Teams during the World Cup 2014 in Brazil. PLoS Negl Trop Dis. 2014 Jan;8(7):e3063.
The risk of dengue among tourists during the World Cup is expected to be small due to immunity among the Brazil host population provided by last year's epidemic with the same DENV serotypes. Quantitative risk estimates by different groups and methodologies should be made routinely for mass gathering events.
Van Panhuis WG, Paul P, Emerson C, Grefenstette J, Wilder R, Herbst AJ, et al. A systematic review of barriers to data sharing in public health. BMC Public Health. 2014 Jan;14(1):1144.
Twenty potential barriers were identified and classified in six categories: technical, motivational, economic, political, legal and ethical. The simultaneous effect of multiple interacting barriers ranging from technical to intangible issues has greatly complicated advances in public health data sharing. A systematic framework of barriers to data sharing in public health will be essential to accelerate the use of valuable information for the global good.
As a signature accomplishment, in late 2013 we developed and released the Project Tycho® database. It is a new data resource providing open access to 125 years of US weekly reportable disease data. The Project Tycho® database creates the first components of an integrated decision support pathway: data collection and data curation. Project Tycho® digitized data comprising 87,950,807 individual cases of notifiable contagious diseases, localized in space and time, and analyzed these comprehensive data to describe quantitatively disease control in the USA over the past 120 years. By accelerating the acquisition, curation, and integration of large-scale historical and current public health data, we created a new data resource that is essential for 21st century infectious disease modeling and meta-modeling. Visit http://www.tycho.pitt.edu/ for open access to a wealth of new high resolution public health data.
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Bailey RR, Stuckey DR, Norman BA, Duggan AP, Bacon KM, Connor DL, et al. Economic value of dispensing home-based preoperative chlorhexidine bathing cloths to prevent surgical site infection. Infection Control and Hospital Epidemiology. 2011;32(5):465-71.
The results of our study favor the routine distribution of bathing kits. Even with low patient compliance and clothefficacy values, distribution of bathing kits is an economically beneficial strategy for the prevention of SSI.
Lee BY, Bailey RR, Smith KJ, Muder RR, Strotmeyer ES, Lewis GJ, et al. Universal methicillin-resistant Staphylococcus aureus (MRSA) surveillance for adults at hospital admission: an economic model and analysis. Infection Control and Hospital Epidemiology. 2010;31(6):598-606.
Universal MRSA surveillance of adults at hospital admission appears to be cost-effective at a wide range of prevalence and basic reproductive rate values. Individual hospitals and healthcare systems could compare their prevailing conditions (eg, the prevalence of MRSA colonization and MRSA transmission dynamics) with the benchmarks in our model to help determine their optimal local strategies.
Lee BY, McGlone SM, Bailey RR, Wettstein ZS, Umscheid CA, Muder RR. Economic impact of outbreaks of norovirus infection in hospitals. Infection Control and Hospital Epidemiology. 2011;32(2):191-3.
The cost savings of early detection and control of infection are not inconsequential. This potential savings could pay for control efforts. Our economic model quantified the potential cost of outbreaks of norovirus infection under different circumstances and the potential value of early detection and control.
Lee BY, McGlone SM, Doi Y, Bailey RR, Harrison LH. Economic impact of Acinetobacter baumannii infection in the intensive care unit. Infection Control and Hospital Epidemiology. 2010;31(10):1087-9.
We demonstrated that, even with a conservative estimate of the proportion of colonizations to develop into infection (at least 20%), the financial burden to hospitals can be substantial.
Lee BY, McGlone SM, Doi Y, Bailey RR, Harrison LH. Economic value of Acinetobacter baumannii screening in the intensive care unit (ICU). Clinical Microbiology and Infection. 2011;17(11):1691-7.
Routine A. baumannii screening of ICU patients may save costs for hospitals.
Lee BY, McGlone SM, Wong KF, Yilmaz SL, Avery TR, Song Y, et al. Modeling the spread of methicillin-resistant Staphylococcus aureus (MRSA) outbreaks throughout the hospitals in Orange County, California. Infection Control and Hospital Epidemiology. 2011;32(6):562-72.
MRSA outbreaks may rarely be confined to a single hospital but instead may affect all of the hospitals in a region. This suggests that prevention and control strategies and policies should account for the interconnectedness of health care facilities.
Lee BY, Popovich MJ, Tian Y, Bailey RR, Ufberg PJ, Wiringa AE, et al. The potential value of Clostridium difficile vaccine: an economic computer simulation model. Vaccine. 2010;28:5245-23.
Our results suggest that a C. difficile vaccine could be cost-effective over a wide range of C. difficile risk, vaccine costs, and vaccine efficacies especially, when being used post-CDI treatment to prevent recurrent disease.
Lee BY, Song Y, McGlone SM, Bailey RR, Feura J, Tai JHY, et al. The economic value of screening haemodialysis patients for methicillin-resistant Staphylococcus aureus in the USA. Clinical Microbiology and Infection. 2011;17(11):1717-26.
Routine periodic testing and decolonization of haemodialysis patients for MRSA may be a cost-effective strategy over a wide range of MRSA prevalences, decolonization success rates, and testing intervals.
Lee BY, Tsui B, Bailey RR, Smith KJ, Muder RR, Lewis GJ, et al. Should vascular surgery patients be screened preoperatively for methicillin-resistant Staphylococcus aureus? Infection Control and Hospital Epidemiology. 2009;30(12):1158-65.
Testing and decolonizing patients for MRSA before vascular surgery may be a cost-effective strategy over a wide range of MRSA prevalence and decolonization success rates.
Lee BY, Ufberg PJ, Bailey RR, Wiringa AE, Smith KJ, Nowalk AJ, et al. The potential economic value of a Staphylococcus aureus vaccine for neonates. Vaccine. 2010;28:4653-60.
Our results suggest that a S. aureus vaccine for the neonatal population would be strongly cost-effective (and in many situations dominant) over a wide range of vaccine efficacies (down to 10%) for vaccine costs (≤$500), and S. aureus attack rates (≥1%).
Lee BY, Wettstein ZS, McGlone SM, Bailey RR, Umscheid CA, Smith KJ, et al. Economic value of norovirus outbreak control measures in healthcare settings. Clinical Microbiology and Infection. 2011;17:640-6.
Implementing increased hand hygiene, using protective apparel, increased disinfection practices or staff exclusion policies for the control and containment of a norovirus outbreak may provide cost-savings to hospitals. Using these strategies in conjunction with each other could maximize the effects of controlling an outbreak. Patient isolation and ward closure may be more costly, especially when not implemented early.
Lee BY, Wiringa AE, Bailey RR, Goyal V, Tsui B, Lewis GJ, et al. The economic effect of screening orthopedic surgery patients preoperatively for methicillin-resistant Staphylococcus aureus. Infection Control and Hospital Epidemiology. 2010;31(11):1130-8.
Routine preoperative screening and decolonization of orthopedic surgery patients may under many circumstances save hospitals and third-party payers money while providing health benefits.
Lee BY, Wiringa AE, Bailey RR, Lewis GJ, Feura J, Muder RR. Staphylococcus aureus vaccine for orthopedic patients: an economic model and analysis. Vaccine. 2010;28:2465-71.
Our results suggest that a S. aureus vaccine for the pre-operative orthopedic population would be very cost-effective over a wide range of MRSA prevalence and vaccine efficacies and costs.
Lee BY, Wiringa AE, Song Y, Mitgang EA, McGlone SM, Afriyie A, et al. Routine pre-cesarean Staphylococcus aureus screening and decolonization: a cost-effectiveness analysis. American Journal of Managed Care. 2011;17(10):693-700.
McGlone SM, Bailey RR, Zimmer SM, Popovich MJ, Tian Y, Ufberg PJ, et al. The economic burden of Clostridium difficile. Clinical Microbiology and Infection. 2011;doi: 10.1111/j.1469-0691.2011.03571.x.
Our results show that C. difficile infection is indeed costly, not only to third-party payers and the hospital, but to society as well. These results are consistent with current literature citing C. difficile as a costly disease.
Lee BY, Wiringa AE, Bailey RR, Goyal V, Lewis GJ, Tsui B, et al. Screening cardiac surgery patients for MRSA: an economic computer model. American Journal of Managed Care. 2010;16(7):e163-e73.
Our results suggest that routine preoperative MRSA screening of cardiac surgery patients could provide substantial economic value to third-party payers and hospitals over a wide range of MRSA colonization prevalence levels, decolonization success rates, and surveillance costs.
Brown ST, Tai JHY, Bailey RR, Cooley PC, Wheaton WD, Potter MA, et al. Would school closure for the 2009 H1N1 influenza epidemic have been worth the cost? A computational simulation of Pennsylvania. BMC Public Health. 2011;11(1):353.
Our study suggests that closing schools during the 2009 H1N1 epidemic could have resulted in substantial costs to society as the potential costs of lost productivity and childcare could have far outweighed the cost savings in preventing influenza cases.
Lee BY, Bacon KM, Donohue JM, Wiringa AE, Bailey RR, Zimmerman RK. From the patient perspective: the economic value of seasonal and H1N1 influenza vaccination. Vaccine. 2011;29:2149-58.
Results indicated that the cost of avoiding influenza was fairly low (with one driver being required vaccination time). To encourage vaccination, decision makers may want to focus on ways to reduce this time, such as vaccinating at work, churches, or other normally frequented locations.
Lee BY, Bailey RR, Wiringa AE, Afriyie A, Wateska AR, Smith KJ, et al. Economics of employer-sponsored workplace vaccination to prevent pandemic and seasonal influenza. Vaccine. 2010;28:5952-9.
Lee BY, Bailey RR, Wiringa AE, Assi T-M, Beigi RH. Antiviral medications for pregnant women for pandemic and seasonal influenza: an economic computer model. Obstetrics and Gynecology. 2009;114:971-80.
These findings support the use of antiviral medications for postexposure prophylaxis among pregnant women in a pandemic influenza scenario but not in a seasonal influenza setting.
Lee BY, Brown ST, Bailey RR, Zimmerman RK, Potter MA, McGlone SM, et al. The benefits to all of ensuring equal and timely access to influenza vaccines in poor communities. Health Affairs. 2011;30(8):1141-50.
We found that limiting or delaying vaccination of residents of poorer counties could raise the total number of influenza infections and the number of new infections per day at the peak of an epidemic throughout the region—even in the wealthier counties that had received more timely and abundant vaccine access. Among other underlying reasons, poorer counties tend to have high-density populations and more children and other higher-risk people per household, resulting in more interactions and both increased transmission of influenza and greater risk for worse influenza outcomes. Thus, policy makers across the country, in poor and wealthy areas alike, have an incentive to ensure that poorer residents have equal access to vaccines.
Lee BY, Brown ST, Cooley P, Potter MA, Wheaton WD, Voorhees RE, et al. Simulating school closure strategies to mitigate an influenza epidemic. Journal of Public Health Management and Practice. 2010;16(3):252-61.
School closures alone may not be able to quell an epidemic but, when maintained for at least 8 weeks, could delay the epidemic peak for up to a week, providing additional time to implement a second more effective intervention such as vaccination.
Lee BY, Brown ST, Cooley PC, Zimmerman RK, Wheaton WD, Zimmer SM, et al. A computer simulation of employee vaccination to mitigate an influenza epidemic. American Journal of Preventive Medicine. 2010;38(3):247-57.
Timely vaccination of at least 20% of the large-company workforce can play an important role in epidemic mitigation.
Lee BY, Brown ST, Korch GW, Cooley P, Zimmerman RK, Wheaton WD, et al. A computer simulation of vaccine prioritization, allocation, and rationing during the 2009 H1N1 influenza pandemic. Vaccine. 2010;28:4875-9.
Our study supported adherence to the ACIP (instead of a children-first policy) prioritization recommendations for the H1N1 influenza vaccine when vaccine is in limited supply and that within the ACIP groups, children should receive highest priority.
Lee BY, McGlone SM, Bailey RR, Wiringa AE, Zimmer SM, Smith KJ, et al. To test or to treat? An analysis of influenza testing and antiviral treatment strategies using economic computer modeling. PLoS One. 2010;5(6):e11284.
Our study delineated the conditions under which different testing and antiviral strategies may be cost-effective, showing the importance of accuracy, as seen with PCR or highly sensitive clinical judgment.
Lee BY, Stalter RM, Bacon KM, Tai JHY, Bailey RR, Zimmer SM, et al. Cost-effectiveness of adjuvanted versus nonadjuvanted influenza vaccine in adult hemodialysis patients. American Journal of Kidney Disease. 2011;57(5):724-32.
Adjuvanted influenza vaccine with adjuvant cost ≤$2 could be a cost-effective strategy in a standard influenza season depending on the potency of the adjuvant.
Lee BY, Tai JHY, Bailey RR, McGlone SM, Wiringa AE, Zimmer SM, et al. Economic model for emergency use authorization of intravenous peramivir. American Journal of Managed Care. 2011;17(1):e1-e9.
Our study supports the use of IV antiviral treatment for hospitalized patients with influenza-like illness.
Lee BY, Brown ST, Cooley P, Grefenstette JJ, Zimmerman RK, Zimmer SM, et al. Vaccination deep into a pandemic wave: potential mechanisms for a "third wave" and the impact of vaccination. American Journal of Preventive Medicine. 2010;39(5):e21-e9.
Additional waves in an epidemic can be mitigated by vaccination even when an epidemic appears to be waning.
Lee BY, Tai JHY, Bailey RR, Smith KJ. The timing of influenza vaccination for older adults (65 years and older). Vaccine. 2009;27:7110-5.
Our results also suggest that vaccination is still cost-effective through the end of February.
Lee BY, Tai JHY, Bailey RR, Smith KJ, Nowalk AJ. Economics of influenza vaccine administration timing for children. American Journal of Managed Care. 2010;16(3):e75-e85.
Policymakers could invest up to $6 million to $9 million a year to get children vaccinated in September or October without expending any net costs.
Lee BY, Tai JHY, McGlone SM, Bailey RR, Wateska AR, Zimmer SM, et al. The potential economic value of a "universal" (multi-year) influenza vaccine. Influenza and Other Respiratory Viruses. 2011;doi: 10.1111/j.1750-2659.2011.00288.x.
Lee BY, Wiringa AE. The 2009 H1N1 influenza pandemic: a case study of how modeling can assist all stages of vaccine decision-making. Human Vaccines. 2011;7(1):115-9.
Lee BY, Connor DL, Kitchen SB, Bacon KM, Shah M, Brown ST, et al. Economic value of dengue vaccine in Thailand. American Journal of Tropical Medicine and Hygiene. 2011;84(5):764-72.
Our results suggest that a dengue vaccine could be of considerable economic value even at fairly high price points and low vaccine efficacy. In fact, in some cases, vaccination could provide net cost savings.
Lee BY, Bacon KM, Bailey RR, Wiringa AE, Smith KJ. The potential economic value of a hookworm vaccine. Vaccine. 2011;29:1201-10.
Results suggest that a vaccine would provide not only cost savings, but potential health benefits to both populations. In fact, the most cost-effective intervention strategy may be to combine vaccine with current drug treatment strategies.
Lee BY, Bacon KM, Connor DL, Willig AM, Bailey RR. The potential economic value of a Trypanosoma cruzi (Chagas Disease) vaccine in Latin America. PLoS Neglected Tropical Diseases. 2010;4(12):e916.
Results indicate that a T. cruzi vaccine could provide substantial economic benefit, depending on the cost of the vaccine, and support continued efforts to develop a human vaccine.
Lee BY, Wateska AR, Bailey RR, Tai JHY, Bacon KM, Smith KJ. Forecasting the economic value of an Enterovirus 71 (EV71) vaccine. Vaccine. 2010;28:7731-6.
Our study favors universal EV71 vaccination of children in China at the current incidence of EV71 at vaccine price points $25 and lower.