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B. Jahn, U Rochau, J. Shterjovska, C. Kurzthaler, M. Kluibenschädl, C. Urach, P. Einzinger, H. Piringer, N. Popper, U. Siebert:
"Visualizing A Discrete-Event-Simulation Model-The Application Of Alternative Methods For A Breast Cancer Decision- Analytic Model";
Vortrag: 15th Biennial European Meeting of the Society for Medical Decision Making, Antwerpen, Belgien; 08.06.2014 - 10.06.2014; in: "15th Biennial European Meeting of the Society for Medical Decision Making: ESMDM Meeting Abstracts", Medical Decision Making, 34 (2014), ISSN: 0272-989x; S. 26.

Purpose: Discrete event simulation (DES) is a commonly used
modeling method to analyze the comparative effectiveness of
alternative health technologies and to optimize resource alloca-
tion in health care settings. DES models are often rather com-
plex, and visualization is used for the conceptual model, to
support programming (i.e., visual programming languages
VPLs]), and to display the results. This study aims to illustrate
and contrast alternative visualization techniques using a deci-
sion-analytic model for breast cancer as an illustrating case
example.
Methods: Visualization methods and their applications in
health care, engineering, and operations research were sought
from a wide variety of sources, including literature databases
(e.g., PubMed) and webpages of simulation conferences (e.g.,
WSC), academic societies, and further publications (e.g., FIPS
PUBS). Based on this review, alternative visualization techniques
for the conceptual model, such as flow charts, state charts, and
Integration DEFinition diagrams (IDEF0), were selected and
applied on a real-world modeling example.
Results: For depicting the conceptual model, visualization
methods such as event graphs, activity diagrams, IDEF diagrams,
process-flow diagrams, or petri nets are used in engineering and
operations research. For example, event-graph diagrams are well
suited for simple problems. Interactions among individuals (e.g.,
queues), resources, and decisions are not made explicit, how-
ever. Therefore, more elaborated techniques such as IDEF dia-
grams or process-flow diagrams are applied. In health care, the
recently published ISPOR-SMDM Modeling Good Research
Practice guidelines recommend flow diagrams or state charts to
represent the key elements of a model, including the possible
pathways and the presence of queues and decision points. The
application of selected methods showed that for flow charts,
there are standards and guidelines that could support harmoni-
zation of process-oriented models in health care. Flow charts,
however, may lack the information of health states and transi-
tions between health states that are relevant for clinicians to
review the model. In state charts, health states could be named
explicitly, but treatment processes and resource use are less
explicit. IDEF0 is very comprehensive but less intuitive at the
beginning.
Conclusions: Flow charts are a suitable, intuitive technique,
but health states should be made explicit. In the case example,
there was no superior visualization technique.