Mechanical Engineering Commons^™

Optimization Of Psa Screening Policies: A Comparison Of The Patient And Societal Perspectives, Jingyu Zhang, Brian T. Denton, Hari Balasubramanian, Nilay D. Shah, Brant A. Inman

Hari Balasubramanian

Objective—To estimate the benefit of PSA-based screening for prostate cancer from the patient and societal perspectives.

Method—A partially observable Markov decision process (POMDP) model was used to optimize PSA screening decisions. We considered age-specific prostate cancer incidence rates and the mortality rates from prostate cancer and competing causes. Our model trades off the potential benefit of early detection with the cost of screening and loss of patient quality of life due to screening and treatment. PSA testing and biopsy decisions are made based on the patient’s probability of having prostate cancer. Probabilities are inferred based on the patient’s complete PSA …

Improving Clinical Access And Continuity Through Physician Panel Redesign, Hari Balasubramanian, Ritesh Banerjee, Brian Denton, James Naessens, James Stahl

Hari Balasubramanian

BACKGROUND: Population growth, an aging population and the increasing prevalence of chronic disease are projected to increase demand for primary care services in the United States. OBJECTIVE: Using systems engineering methods, to re-design physician patient panels targeting optimal access and continuity of care. DESIGN: We use computer simulation methods to design physician panels and model a practice’s appointment system and capacity to provide clinical service. Baseline data were derived from a primary care group practice of 39 physicians with over 20,000 patients at the Mayo Clinic in Rochester, MN, for the years 2004–2006. Panel design specifically took into account panel …