TY - JOUR A1 - Lewkowicz, Daniel A1 - Böttinger, Erwin A1 - Siegel, Martin T1 - Economic evaluation of digital therapeutic care apps for unsupervised treatment of low back pain BT - Monte Carlo Simulation JF - JMIR mhealth and uhealth N2 - Background: Digital therapeutic care (DTC) programs are unsupervised app-based treatments that provide video exercises and educational material to patients with nonspecific low back pain during episodes of pain and functional disability. German statutory health insurance can reimburse DTC programs since 2019, but evidence on efficacy and reasonable pricing remains scarce. This paper presents a probabilistic sensitivity analysis (PSA) to evaluate the efficacy and cost-utility of a DTC app against treatment as usual (TAU) in Germany. Objective: The aim of this study was to perform a PSA in the form of a Monte Carlo simulation based on the deterministic base case analysis to account for model assumptions and parameter uncertainty. We also intend to explore to what extent the results in this probabilistic analysis differ from the results in the base case analysis and to what extent a shortage of outcome data concerning quality-of-life (QoL) metrics impacts the overall results. Methods: The PSA builds upon a state-transition Markov chain with a 4-week cycle length over a model time horizon of 3 years from a recently published deterministic cost-utility analysis. A Monte Carlo simulation with 10,000 iterations and a cohort size of 10,000 was employed to evaluate the cost-utility from a societal perspective. Quality-adjusted life years (QALYs) were derived from Veterans RAND 6-Dimension (VR-6D) and Short-Form 6-Dimension (SF-6D) single utility scores. Finally, we also simulated reducing the price for a 3-month app prescription to analyze at which price threshold DTC would result in being the dominant strategy over TAU in Germany. Results: The Monte Carlo simulation yielded on average a euro135.97 (a currency exchange rate of EUR euro1=US $1.069 is applicable) incremental cost and 0.004 incremental QALYs per person and year for the unsupervised DTC app strategy compared to in-person physiotherapy in Germany. The corresponding incremental cost-utility ratio (ICUR) amounts to an additional euro34,315.19 per additional QALY. DTC yielded more QALYs in 54.96% of the iterations. DTC dominates TAU in 24.04% of the iterations for QALYs. Reducing the app price in the simulation from currently euro239.96 to euro164.61 for a 3-month prescription could yield a negative ICUR and thus make DTC the dominant strategy, even though the estimated probability of DTC being more effective than TAU is only 54.96%. Conclusions: Decision-makers should be cautious when considering the reimbursement of DTC apps since no significant treatment effect was found, and the probability of cost-effectiveness remains below 60% even for an infinite willingness-to-pay threshold. More app-based studies involving the utilization of QoL outcome parameters are urgently needed to account for the low and limited precision of the available QoL input parameters, which are crucial to making profound recommendations concerning the cost-utility of novel apps. KW - cost-utility analysis KW - cost KW - probabilistic sensitivity analysis KW - Monte Carlo simulation KW - low back pain KW - pain KW - economic KW - cost-effectiveness KW - Markov model KW - digital therapy KW - digital health app KW - mHealth KW - mobile health KW - health app KW - mobile app KW - orthopedic KW - QUALY KW - DALY KW - quality-adjusted life years KW - disability-adjusted life years KW - time horizon KW - veteran KW - statistics Y1 - 2023 U6 - https://doi.org/10.2196/44585 SN - 2291-5222 VL - 11 PB - JMIR Publications CY - Toronto ER - TY - JOUR A1 - Videla, Santiago A1 - Guziolowski, Carito A1 - Eduati, Federica A1 - Thiele, Sven A1 - Gebser, Martin A1 - Nicolas, Jacques A1 - Saez-Rodriguez, Julio A1 - Schaub, Torsten A1 - Siegel, Anne T1 - Learning Boolean logic models of signaling networks with ASP JF - Theoretical computer science N2 - Boolean networks provide a simple yet powerful qualitative modeling approach in systems biology. However, manual identification of logic rules underlying the system being studied is in most cases out of reach. Therefore, automated inference of Boolean logical networks from experimental data is a fundamental question in this field. This paper addresses the problem consisting of learning from a prior knowledge network describing causal interactions and phosphorylation activities at a pseudo-steady state, Boolean logic models of immediate-early response in signaling transduction networks. The underlying optimization problem has been so far addressed through mathematical programming approaches and the use of dedicated genetic algorithms. In a recent work we have shown severe limitations of stochastic approaches in this domain and proposed to use Answer Set Programming (ASP), considering a simpler problem setting. Herein, we extend our previous work in order to consider more realistic biological conditions including numerical datasets, the presence of feedback-loops in the prior knowledge network and the necessity of multi-objective optimization. In order to cope with such extensions, we propose several discretization schemes and elaborate upon our previous ASP encoding. Towards real-world biological data, we evaluate the performance of our approach over in silico numerical datasets based on a real and large-scale prior knowledge network. The correctness of our encoding and discretization schemes are dealt with in Appendices A-B. (C) 2014 Elsevier B.V. All rights reserved. KW - Answer set programming KW - Signaling transduction networks KW - Boolean logic models KW - Combinatorial multi-objective optimization KW - Systems biology Y1 - 2015 U6 - https://doi.org/10.1016/j.tcs.2014.06.022 SN - 0304-3975 SN - 1879-2294 VL - 599 SP - 79 EP - 101 PB - Elsevier CY - Amsterdam ER - TY - JOUR A1 - Corbett, Tim A1 - Siegel, Björn A1 - Thulin, Mirjam A1 - Csáky, Moritz A1 - Hödl, Klaus A1 - Kasper-Marienberg, Verena A1 - Berkovich, Ilya A1 - Czakai, Johannes A1 - Maślak-Maciejewska, Alicja A1 - Stechauner, Martin A1 - Dodou, Lida-Maria A1 - Heimann-Jelinek, Felicitas A1 - Nasr, Omar T. A1 - Halbinger, Monika A1 - Jánošíková, Magdaléna A1 - Keßler, Katrin A1 - Kauders, Anthony D. A1 - Piskačová, Zora A1 - Arnold, Rafael D. A1 - Schulz, Michael K. A1 - Shapira, Elena A1 - Sidky, Sean A1 - Sun, Cheuk Him Ryan A1 - Tirosh-Samuelson, Hava A1 - Tusan, Michelle Elizabeth A1 - Weigand, Susanne ED - Siegel, Björn ED - Thulin, Mirjam ED - Corbett, Tim ED - Czendze, Oskar T1 - Intersections between Jewish Studies and Habsburg Studies T2 - PaRDeS : Journal of the Association for Jewish Studies in Germany T2 - PaRDeS : Zeitschrift der Vereinigung für Jüdische Studien e. V. N2 - In the aftermath of the Shoah and the ostensible triumph of nationalism, it became common in historiography to relegate Jews to the position of the “eternal other” in a series of binaries: Christian/Jewish, Gentile/Jewish, European/Jewish, non-Jewish/Jewish, and so forth. For the longest time, these binaries remained characteristic of Jewish historiography, including in the Central European context. Assuming instead, as the more recent approaches in Habsburg studies do, that pluriculturalism was the basis of common experience in formerly Habsburg Central Europe, and accepting that no single “majority culture” existed, but rather hegemonies were imposed in certain contexts, then the often used binaries are misleading and conceal the complex and sometimes even paradoxical conditions that shaped Jewish life in the region before the Shoah. The very complexity of Habsburg Central Europe both in synchronic and diachronic perspective precludes any singular historical narrative of “Habsburg Jewry,” and it is not the intention of this volume to offer an overview of “Habsburg Jewish history.” The selected articles in this volume illustrate instead how important it is to reevaluate categories, deconstruct historical narratives, and reconceptualize implemented approaches in specific geographic, temporal, and cultural contexts in order to gain a better understanding of the complex and pluricultural history of the Habsburg Empire and the region as a whole. T3 - PaRDeS : Zeitschrift der Vereinigung für Jüdische Studien e.V. - 29 KW - Habsburg Studies KW - Jewish Studies KW - Intersections KW - Central Europe KW - Habsburg Empire KW - Habsburgstudien KW - Jüdische Studien KW - Überschneidungen KW - Zentraleuropa KW - Habsburgisches Reich Y1 - 2024 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-622072 SN - 978-3-86956-574-3 SN - 1614-6492 SN - 1862-7684 IS - 29 PB - Universitätsverlag Potsdam CY - Potsdam ER -