Identifying cost-effective dynamic policies to control epidemics

Stat Med. 2016 Dec 10;35(28):5189-5209. doi: 10.1002/sim.7047. Epub 2016 Jul 24.

Abstract

We describe a mathematical decision model for identifying dynamic health policies for controlling epidemics. These dynamic policies aim to select the best current intervention based on accumulating epidemic data and the availability of resources at each decision point. We propose an algorithm to approximate dynamic policies that optimize the population's net health benefit, a performance measure which accounts for both health and monetary outcomes. We further illustrate how dynamic policies can be defined and optimized for the control of a novel viral pathogen, where a policy maker must decide (i) when to employ or lift a transmission-reducing intervention (e.g. school closure) and (ii) how to prioritize population members for vaccination when a limited quantity of vaccines first become available. Within the context of this application, we demonstrate that dynamic policies can produce higher net health benefit than more commonly described static policies that specify a pre-determined sequence of interventions to employ throughout epidemics. Copyright © 2016 John Wiley & Sons, Ltd.

Keywords: H1N1; approximate dynamic programming; approximate policy iteration; dynamic resource allocation; epidemics; influenza.

MeSH terms

  • Cost-Benefit Analysis
  • Decision Support Techniques*
  • Epidemics / prevention & control*
  • Health Policy*
  • Humans
  • Influenza, Human / epidemiology*
  • Influenza, Human / prevention & control
  • Models, Theoretical
  • Vaccination