Epidemic modeling with discrete-space scheduled walkers: extensions and research opportunities.

BACKGROUND: This exploratory paper outlines an epidemic simulator built on an agent-based, data-driven model of the spread of a disease within an urban environment. An intent of the model is to provide insight into how a disease may reach a tipping point, spreading to an epidemic of uncontrollable proportions. METHODS: As a complement to analytical methods, simulation is arguably an effective means of gaining a better understanding of system-level disease dynamics within a population and offers greater utility in its modeling capabilities. Our investigation is based on this conjecture, supported by data-driven models that are reasonable, realistic and practical, in an attempt to demonstrate their efficacy in studying system-wide epidemic phenomena. An agent-based model (ABM) offers considerable flexibility in extending the study of the phenomena before, during and after an outbreak or catastrophe. RESULTS: An agent-based model was developed based on a paradigm of a 'discrete-space scheduled walker' (DSSW), modeling a medium-sized North American City of 650,000 discrete agents, built upon a conceptual framework of statistical reasoning (law of large numbers, statistical mechanics) as well as a correct-by-construction bias. The model addresses where, who, when and what elements, corresponding to network topography and agent characteristics, behaviours, and interactions upon that topography. The DSSW-ABM has an interface and associated scripts that allow for a variety of what-if scenarios modeling disease spread throughout the population, and for data to be collected and displayed via a web browser. CONCLUSION: This exploratory paper also presents several research opportunities for exploiting data sources of a non-obvious and disparate nature for the purposes of epidemic modeling. There is an increasing amount and variety of data that will continue to contribute to the accuracy of agent-based models and improve their utility in modeling disease spread. The model developed here is well suited to diseases where there is not a predisposition for contraction within the population. One of the advantages of agent-based modeling is the ability to set up a rare event and develop policy as to how one may mitigate damages arising from it.

Models of emergency departments for reducing patient waiting times.

In this paper, we apply both agent-based models and queuing models to investigate patient access and patient flow through emergency departments. The objective of this work is to gain insights into the comparative contributions and limitations of these complementary techniques, in their ability to contribute empirical input into healthcare policy and practice guidelines. The models were developed independently, with a view to compare their suitability to emergency department simulation. The current models implement relatively simple general scenarios, and rely on a combination of simulated and real data to simulate patient flow in a single emergency department or in multiple interacting emergency departments. In addition, several concepts from telecommunications engineering are translated into this modeling context. The framework of multiple-priority queue systems and the genetic programming paradigm of evolutionary machine learning are applied as a means of forecasting patient wait times and as a means of evolving healthcare policy, respectively. The models' utility lies in their ability to provide qualitative insights into the relative sensitivities and impacts of model input parameters, to illuminate scenarios worthy of more complex investigation, and to iteratively validate the models as they continue to be refined and extended. The paper discusses future efforts to refine, extend, and validate the models with more data and real data relative to physical (spatial-topographical) and social inputs (staffing, patient care models, etc.). Real data obtained through proximity location and tracking system technologies is one example discussed.