## ----echo=FALSE, include=FALSE------------------------------------------------ library(heemod) library(ggplot2) ## ----------------------------------------------------------------------------- param <- define_parameters( age_init = 60, sex = 0, # age increases with cycles age = age_init + model_time, # operative mortality rates omrPTHR = .02, omrRTHR = .02, # re-revision mortality rate rrr = .04, # parameters for calculating primary revision rate cons = -5.49094, ageC = -.0367, maleC = .768536, lambda = exp(cons + ageC * age_init + maleC * sex), gamma = 1.45367786, rrNP1 = .260677, # revision probability of primary procedure standardRR = 1 - exp(lambda * ((model_time - 1) ^ gamma - model_time ^ gamma)), np1RR = 1 - exp(lambda * rrNP1 * ((model_time - 1) ^ gamma - model_time ^ gamma)), # age-related mortality rate sex_cat = ifelse(sex == 0, "FMLE", "MLE"), mr = get_who_mr(age, sex_cat, local = TRUE), # state values u_SuccessP = .85, u_RevisionTHR = .30, u_SuccessR = .75, c_RevisionTHR = 5294 ) param ## ----------------------------------------------------------------------------- mat_standard <- define_transition( state_names = c( "PrimaryTHR", "SuccessP", "RevisionTHR", "SuccessR", "Death" ), 0, C, 0, 0, omrPTHR, 0, C, standardRR, 0, mr, 0, 0, 0, C, omrRTHR+mr, 0, 0, rrr, C, mr, 0, 0, 0, 0, 1 ) mat_standard mat_np1 <- define_transition( state_names = c( "PrimaryTHR", "SuccessP", "RevisionTHR", "SuccessR", "Death" ), 0, C, 0, 0, omrPTHR, 0, C, np1RR, 0, mr, 0, 0, 0, C, omrRTHR+mr, 0, 0, rrr, C, mr, 0, 0, 0, 0, 1 ) mat_np1 ## ----fig.width = 6, fig.height=6, fig.align='center'-------------------------- plot(mat_standard) ## ----------------------------------------------------------------------------- strat_standard <- define_strategy( transition = mat_standard, PrimaryTHR = define_state( utility = 0, cost = 0 ), SuccessP = define_state( utility = discount(u_SuccessP, .015), cost = 0 ), RevisionTHR = define_state( utility = discount(u_RevisionTHR, .015), cost = discount(c_RevisionTHR, .06) ), SuccessR = define_state( utility = discount(u_SuccessR, .015), cost = 0 ), Death = define_state( utility = 0, cost = 0 ), starting_values = define_starting_values( cost = 394 ) ) strat_standard strat_np1 <- define_strategy( transition = mat_np1, PrimaryTHR = define_state( utility = 0, cost = 0 ), SuccessP = define_state( utility = discount(u_SuccessP, .015), cost = 0 ), RevisionTHR = define_state( utility = discount(u_RevisionTHR, .015), cost = discount(c_RevisionTHR, .06) ), SuccessR = define_state( utility = discount(u_SuccessR, .015), cost = 0 ), Death = define_state( utility = 0, cost = 0 ), starting_values = define_starting_values( cost = 579 ) ) strat_np1 ## ----------------------------------------------------------------------------- res_mod <- run_model( standard = strat_standard, np1 = strat_np1, parameters = param, cycles = 60, cost = cost, effect = utility ) ## ----------------------------------------------------------------------------- summary(res_mod) ## ----fig.width = 6, fig.height=6, fig.align='center'-------------------------- plot(res_mod, type = "counts", panel = "by_state", free_y = TRUE) + theme_bw() + scale_color_brewer( name = "Strategy", palette = "Set1" )