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Jointly Modelling Economics and Epidemiology to Support Public Policy Decisions for the COVID-19 Response: A Review of UK Studies.

ABSTRACT: COVID-19 in the UK has had a profound impact on population health and other socially important outcomes, including on education and the economy. Although a range of evidence has guided policy, epidemiological models have been central. It is less clear whether models to support decision making have sought to integrate COVID-19 epidemiology with a consideration of broader health, wellbeing and economic implications. We report on a rapid review of studies seeking to integrate epidemiological and economic modelling to assess the impacts of alternative policies. Overall, our results suggest that few studies have explored broader impacts of different COVID-19 policies in the UK. Three studies looked only at health, capturing impacts on individuals with and without COVID-19, with various methods used to model the latter. Four models considered health and wider impacts on individuals' economic outcomes, such as wages. However, these models made no attempt to consider the dynamic impacts on economic outcomes of others and the wider economy. The most complex analyses sought to link epidemiological and dynamic economic models. Studies compared a wide range of policies, although most were defined in general terms with minimal consideration of their granular specifications. There was minimal exploration of uncertainty, with no consideration in half the studies. Selecting appropriate models to inform decisions requires careful thought of factors relevant to the decision options under consideration such as the outcomes of interest, sectors likely to be impacted and causal pathways. In summary, better linking epidemiological and economic modelling would help to inform COVID-19 policy.

SUBMITTER: Duarte A

PROVIDER: S-EPMC8213532 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:ImportanceDespite broad public support for gun safety policies, minimal policy implementation has occurred.ObjectiveTo investigate factors that encourage greater private support for and public action on gun safety policy.Design, setting, and participantsThree studies were conducted: a public opinion survey (Study 1) was conducted from January 8 to 22, 2019, and 2 experiments (Studies 2 and 3) were conducted from August 27 to October 17, 2019, and April 15 to 21, 2020, respectively. Adults living in the US were eligible to participate in Studies 1 and 3. Students 18 years and older participating in a research experience program were eligible to participate in Study 2. Study 1 was administered online by Ipsos, a market research company. A nationally representative sample of 1000 US adults was obtained from Ipsos' online KnowledgePanel, of whom 508 completed the public opinion survey. For Study 2, which was conducted in a university laboratory, 354 participants were recruited from a university research pool, all of whom completed the study. Study 3 was administered online by the market research company YouGov, which identified 727 US gun owners from its opt-in panel, from which it constructed a census-matched sample of 400 participants.ExposuresParticipants read a statement about the 2018 Marjory Stoneman Douglas High School shooting. Content was manipulated as a 2 (corrective information vs no corrective information) × 2 (system changeable vs system not changeable) between-subjects factorial design with random assignment. The corrective information included polling data highlighting widespread support among gun owners for several gun safety policies. System changeable described gun safety policies passed by Florida's legislature.Main outcomes and measuresMain outcomes were support for gun safety policies and public disclosure of support.ResultsThe 3 studies included a total of 1262 participants (Study 1: 508 participants; weighted mean [SD] age, 47.7 [17.5] years; 261.9 women [51.6%]; 82.5 Hispanic [16.2%] and 60.3 Black [11.9%]; Study 2: 354 participants; mean [SD] age, 20.0 [2.3] years; 232 women [65.9%]; 100 Asian [28.3%] and 37 Black [10.5%]; Study 3: 400 participants; weighted mean [SD] age, 52.1 [16.4] years; 187.3 women [46.8%]; 295.5 White [73.9%], 44.5 Hispanic [11.1%], and 32.4 Black [8.1%]). Study 1 found that 63% to 91% of gun owners and 83% to 93% of non-gun owners supported key gun safety policies, yet both groups significantly underestimated gun owners' support for these policies by between 12% and 31%. Studies 2 and 3 found that exposure to corrective information was associated with a small increase in support for 2 gun safety policies of between 4% and 15%, both in terms of participants' privately held beliefs and the beliefs they would be willing to share publicly.Conclusions and relevanceThis survey study found that many US adults failed to recognize that most gun owners support key gun safety policies. Correcting this misperception was associated with greater private and public support for gun safety policy.

Project description:BackgroundIn England, the responsibility to address food insecurity lies with local government, yet the prevalence of this social inequality is unknown in small subnational areas. In 2018 an index of small-area household food insecurity risk was developed and utilised by public and third sector organisations to target interventions; this measure needed updating to better support decisions in different settings, such as urban and rural areas where pressures on food security differ.MethodsWe held interviews with stakeholders (n = 14) and completed a scoping review to identify appropriate variables to create an updated risk measure. We then sourced a range of open access secondary data to develop an indices of food insecurity risk in English neighbourhoods. Following a process of data transformation and normalisation, we tested combinations of variables and identified the most appropriate data to reflect household food insecurity risk in urban and rural areas.ResultsEight variables, reflecting both household circumstances and local service availability, were separated into two domains with equal weighting for a new index, the Complex Index, and a subset of these to make up the Simple Index. Within the Complex Index, the Compositional Domain includes population characteristics while the Structural Domain reflects small area access to resources such as grocery stores. The Compositional Domain correlated well with free school meal eligibility (rs = 0.705) and prevalence of childhood obesity (rs = 0.641). This domain was the preferred measure for use in most areas when shared with stakeholders, and when assessed alongside other configurations of the variables. Areas of highest risk were most often located in the North of England.ConclusionWe recommend the use of the Compositional Domain for all areas, with inclusion of the Structural Domain in rural areas where locational disadvantage makes it more difficult to access resources. These measures can aid local policy makers and planners when allocating resources and interventions to support households who may experience food insecurity.

Project description:BackgroundSystems science methods such as dynamic simulation modelling are well suited to address questions about public health policy as they consider the complexity, context and dynamic nature of system-wide behaviours. Advances in technology have led to increased accessibility and interest in systems methods to address complex health policy issues. However, the involvement of policy decision makers in health-related simulation model development has been lacking. Where end-users have been included, there has been limited examination of their experience of the participatory modelling process and their views about the utility of the findings. This paper reports the experience of end-user decision makers, including senior public health policy makers and health service providers, who participated in three participatory simulation modelling for health policy case studies (alcohol related harm, childhood obesity prevention, diabetes in pregnancy), and their perceptions of the value and efficacy of this method in an applied health sector context.MethodsSemi-structured interviews were conducted with end-user participants from three participatory simulation modelling case studies in Australian real-world policy settings. Interviewees were employees of government agencies with jurisdiction over policy and program decisions and were purposively selected to include perspectives at different stages of model development.ResultsThe 'co-production' aspect of the participatory approach was highly valued. It was reported as an essential component of building understanding of the modelling process, and thus trust in the model and its outputs as a decision-support tool. The unique benefits of simulation modelling included its capacity to explore interactions of risk factors and combined interventions, and the impact of scaling up interventions. Participants also valued simulating new interventions prior to implementation in the real world, and the comprehensive mapping of evidence and its gaps to prioritise future research. The participatory aspect of simulation modelling was time and resource intensive and therefore most suited to high priority complex topics with contested options for intervening.ConclusionThese findings highlight the value of a participatory approach to dynamic simulation modelling to support its utility in applied health policy settings.

Project description:Over the years, IVF/ICSI protocols have continued to evolve with efforts to improve outcomes. As a result, treatment success may be related to certain procedural factors, including number of embryos transferred and stage at which they are transferred. This review aims to assess the safety and effectiveness of IVF/ICSI in comparison to spontaneous conception and less invasive ARTs and the impact of procedure-related factors on the outcomes of IVF/ICSI in order to support the development of local clinical and policy guidance. Following Cochrane Collaboration guidelines and the PRISMA statement, a comprehensive systematic review of literature examining the impact of procedural characteristics on the safety or effectiveness of IVF/ICSI from 2007 to date was performed. 33 systematic reviews and 3 primary studies evaluating the impact of procedural differences, IVF/ICSI in comparison to less invasive ARTs, and ARTs in comparison to spontaneous conception were found. IVF was shown to offer significant benefits over no treatment and IUI in achieving pregnancy and live birth among couples with endometriosis or unexplained infertility. Frozen and blastocyst-stage embryo transfers were as effective as fresh and cleavage-stage embryo transfers, respectively. In comparison to single embryo transfer, double embryo transfer significantly increased pregnancy, live birth and multiple pregnancy/birth rates. IVF/ICSI was associated with more complications during pregnancy and delivery, and in infants compared to naturally conceived pregnancies, particularly when multiple embryo transfer was used. Frozen embryo transfer had fewer adverse events during pregnancy and delivery than fresh embryo transfer, and was at least as safe in terms of infant outcomes. The potential complications of IVF/ICSI may be minimized through procedural choices, but such choices often impact effectiveness. Thus, in developing clinical and policy guidance around IVF/ICSI, the risk-benefit trade-offs patients and providers are willing to accept must be carefully considered.

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Jointly Modelling Economics and Epidemiology to Support Public Policy Decisions for the COVID-19 Response: A Review of UK Studies.

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