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Validation and Calibration of a Computer Simulation Model of Pediatric HIV Infection

Author

Listed:
  • Andrea L Ciaranello
  • Bethany L Morris
  • Rochelle P Walensky
  • Milton C Weinstein
  • Samuel Ayaya
  • Kathleen Doherty
  • Valeriane Leroy
  • Taige Hou
  • Sophie Desmonde
  • Zhigang Lu
  • Farzad Noubary
  • Kunjal Patel
  • Lynn Ramirez-Avila
  • Elena Losina
  • George R Seage III
  • Kenneth A Freedberg

Abstract

Background: Computer simulation models can project long-term patient outcomes and inform health policy. We internally validated and then calibrated a model of HIV disease in children before initiation of antiretroviral therapy to provide a framework against which to compare the impact of pediatric HIV treatment strategies. Methods: We developed a patient-level (Monte Carlo) model of HIV progression among untreated children 1,300 untreated, HIV-infected African children. Results: In internal validation analyses, model-generated survival curves fit IeDEA data well; modeled and observed survival at 16 months of age were 91.2% and 91.1%, respectively. RMSE varied widely with variations in CD4% parameters; the best fitting parameter set (RMSE = 0.00423) resulted when CD4% was 45% at birth and declined by 6%/month (ages 0-3 months) and 0.3%/month (ages >3 months). In calibration analyses, increases in IeDEA-derived mortality risks were necessary to fit UNAIDS survival data. Conclusions: The CEPAC-Pediatric model performed well in internal validation analyses. Increases in modeled mortality risks required to match UNAIDS data highlight the importance of pre-enrollment mortality in many pediatric cohort studies.

Suggested Citation

  • Andrea L Ciaranello & Bethany L Morris & Rochelle P Walensky & Milton C Weinstein & Samuel Ayaya & Kathleen Doherty & Valeriane Leroy & Taige Hou & Sophie Desmonde & Zhigang Lu & Farzad Noubary & Kunj, 2013. "Validation and Calibration of a Computer Simulation Model of Pediatric HIV Infection," PLOS ONE, Public Library of Science, vol. 8(12), pages 1-1, December.
    • Handle: RePEc:plo:pone00:0083389
    DOI: 10.1371/journal.pone.0083389
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    References listed on IDEAS

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    1. Natasha Stout & Amy Knudsen & Chung Kong & Pamela McMahon & G. Gazelle, 2009. "Calibration Methods Used in Cancer Simulation Models and Suggested Reporting Guidelines," PharmacoEconomics, Springer, vol. 27(7), pages 533-545, July.
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    3. Schackman, B.R. & Goldie, S.J. & Weinstein, M.C. & Losina, E. & Zhang, H. & Freedberg, K.A., 2001. "Cost-effectiveness of earlier initiation of antiretroviral therapy for uninsured HIV-infected adults," American Journal of Public Health, American Public Health Association, vol. 91(9), pages 1456-1463.
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