@article{meghan. c. c. o'leary_lich_mayorga_hicklin_davis_brenner_reuland_birken_wheeler_2023, title={Engaging stakeholders in the use of an interactive simulation tool to support decision-making about the implementation of colorectal cancer screening interventions}, volume={5}, ISSN={["1573-7225"]}, DOI={10.1007/s10552-023-01692-0}, abstractNote={Abstract}, journal={CANCER CAUSES & CONTROL}, author={Meghan. C. C. O'Leary and Lich, Kristen Hassmiller and Mayorga, Maria. E. E. and Hicklin, Karen and Davis, Melinda. M. M. and Brenner, Alison. T. T. and Reuland, Daniel. S. S. and Birken, Sarah. A. A. and Wheeler, Stephanie. B. B.}, year={2023}, month={May} }
 @article{lich_meghan c. o'leary_nambiar_townsley_mayorga_hicklin_frerichs_shafer_davis_wheeler_2019, title={Estimating the impact of insurance expansion on colorectal cancer and related costs in North Carolina: A population-level simulation analysis}, volume={129}, ISSN={["1096-0260"]}, url={http://dx.doi.org/10.1016/j.ypmed.2019.105847}, DOI={10.1016/j.ypmed.2019.105847}, abstractNote={Although screening is effective in reducing incidence, mortality, and costs of treating colorectal cancer (CRC), it remains underutilized, in part due to limited insurance access. We used microsimulation to estimate the health and financial effects of insurance expansion and reduction scenarios in North Carolina (NC). We simulated the full lifetime of a simulated population of 3,298,265 residents age-eligible for CRC screening (ages 50-75) during a 5-year period starting January 1, 2018, including polyp incidence and progression and CRC screening, diagnosis, treatment, and mortality. Insurance scenarios included: status quo, which in NC includes access to the Health Insurance Exchange (HIE) under the Affordable Care Act (ACA); no ACA; NC Medicaid expansion, and Medicare-for-all. The insurance expansion scenarios would increase percent up-to-date with screening by 0.3 and 7.1 percentage points for Medicaid expansion and Medicare-for-all, respectively, while insurance reduction would reduce percent up-to-date by 1.1 percentage points, compared to the status quo (51.7% up-to-date), at the end of the 5-year period. Throughout these individuals' lifetimes, this change in CRC screening/testing results in an estimated 498 CRC cases averted with Medicaid expansion and 6031 averted with Medicare-for-all, and an additional 1782 cases if health insurance gains associated with ACA are lost. Estimated cost savings - balancing increased CRC screening/testing costs against decreased cancer treatment costs - are approximately $30 M and $970 M for Medicaid expansion and Medicare-for-all scenarios, respectively, compared to status quo. Insurance expansion is likely to improve CRC screening both overall and in underserved populations while saving money, with the largest savings realized by Medicare.}, journal={PREVENTIVE MEDICINE}, author={Lich, Kristen Hassmiller and Meghan C. O'Leary and Nambiar, Siddhartha and Townsley, Rachel M. and Mayorga, Maria E. and Hicklin, Karen and Frerichs, Leah and Shafer, Paul R. and Davis, Melinda M. and Wheeler, Stephanie B.}, year={2019}, month={Dec} }
 @article{davis_nambiar_mayorga_sullivan_hicklin_meghan c. o'leary_dillon_lich_gu_lind_et al._2019, title={Mailed FIT (fecal immunochemical test), navigation or patient reminders? Using microsimulation to inform selection of interventions to increase colorectal cancer screening in Medicaid enrollees}, volume={129}, ISSN={["1096-0260"]}, url={http://dx.doi.org/10.1016/j.ypmed.2019.105836}, DOI={10.1016/j.ypmed.2019.105836}, abstractNote={Colorectal cancer (CRC) can be effectively prevented or detected with guideline concordant screening, yet Medicaid enrollees experience disparities. We used microsimulation to project CRC screening patterns, CRC cases averted, and life-years gained in the population of 68,077 Oregon Medicaid enrollees 50-64 over a five year period starting in January 2019. The simulation estimated the cost-effectiveness of five intervention scenarios - academic detailing plus provider audit and feedback (Detailing+), patient reminders (Reminders), mailing a Fecal Immunochemical Test (FIT) directly to the patient's home (Mailed FIT), patient navigation (Navigation), and mailed FIT with Navigation (Mailed FIT + Navigation) - compared to usual care. Each intervention scenario raised CRC screening rates compared to usual care, with improvements as high as 11.6 percentage points (Mailed FIT + Navigation) and as low as 2.5 percentage points (Reminders) after one year. Compared to usual care, Mailed FIT + Navigation would raise CRC screening rates 20.2 percentage points after five years - averting nearly 77 cancer cases (a reduction of 113 per 100,000) and exceeding national screening targets. Over a five year period, Reminders, Mailed FIT and Mailed FIT + Navigation were expected to be cost effective if stakeholders were willing to pay $230 or less per additional year up-to-date (at a cost of $22, $59, and $227 respectively), whereas Detailing+ and Navigation were more costly for the same benefits. To approach national CRC screening targets, health system stakeholders are encouraged to implement Mailed FIT with or without Navigation and Reminders.}, journal={PREVENTIVE MEDICINE}, author={Davis, Melinda M. and Nambiar, Siddhartha and Mayorga, Maria E. and Sullivan, Eliana and Hicklin, Karen and Meghan C. O'Leary and Dillon, Kristen and Lich, Kristen Hassmiller and Gu, Yifan and Lind, Bonnie K. and et al.}, year={2019}, month={Dec} }
 @article{hicklin_ivy_wilson_cobb payton_viswanathan_myers_2019, title={Simulation model of the relationship between cesarean section rates and labor duration}, volume={22}, ISSN={1386-9620 1572-9389}, url={http://dx.doi.org/10.1007/S10729-018-9449-3}, DOI={10.1007/s10729-018-9449-3}, abstractNote={Cesarean delivery is the most common major abdominal surgery in many parts of the world, and it accounts for nearly one-third of births in the United States. For a patient who requires a C-section, allowing prolonged labor is not recommended because of the increased risk of infection. However, for a patient who is capable of a successful vaginal delivery, performing an unnecessary C-section can have a substantial adverse impact on the patient's future health. We develop two stochastic simulation models of the delivery process for women in labor; and our objectives are (i) to represent the natural progression of labor and thereby gain insights concerning the duration of labor as it depends on the dilation state for induced, augmented, and spontaneous labors; and (ii) to evaluate the Friedman curve and other labor-progression rules, including their impact on the C-section rate and on the rates of maternal and fetal complications. To use a shifted lognormal distribution for modeling the duration of labor in each dilation state and for each type of labor, we formulate a percentile-matching procedure that requires three estimated quantiles of each distribution as reported in the literature. Based on results generated by both simulation models, we concluded that for singleton births by nulliparous women with no prior complications, labor duration longer than two hours (i.e., the time limit for labor arrest based on the Friedman curve) should be allowed in each dilation state; furthermore, the allowed labor duration should be a function of dilation state.}, number={4}, journal={Health Care Management Science}, publisher={Springer Science and Business Media LLC}, author={Hicklin, Karen T. and Ivy, Julie S. and Wilson, James R. and Cobb Payton, Fay and Viswanathan, Meera and Myers, Evan R.}, year={2019}, month={Dec}, pages={635–657} }