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Cathal Walsh

Publications and source records attributed to Cathal Walsh.

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Incorporating additional evidence as prior information to resolve non-identifiability in Bayesian disease model calibration. A tutorial

Disease models are used to examine the likely impact of therapies, interventions and public policy changes. Ensuring that these are well calibrated on the basis of available data and that the uncertainty in their projections is properly quantified is an important part of the process. The question of non-identifiability poses a challenge to disease model calibration where multiple parameter sets generate identical model outputs. For statisticians evaluating the impact of policy interventions such as screening or vaccination, this is a critical issue. This study explores the use of the Bayesian framework to provide a natural way to calibrate models and address non-identifiability in a probabilistic fashion in the context of disease modelling. We present Bayesian approaches for incorporating expert knowledge and external data to ensure that appropriately informative priors are specified on the joint parameter space. These approaches are applied to two common disease models: a basic Susceptible-Infected-Susceptible (SIS) model and a much more complex agent-based model which has previously been used to address public policy questions in HPV and cervical cancer. The conditions which allow the problem of non-identifiability to be resolved are demonstrated for the SIS model. For the larger HPV model an overview of the findings is presented, but of key importance is a discussion on how the non-identifiability impacts the calibration process. Through case studies, we demonstrate how informative priors can help resolve non-identifiability and improve model inference. We also discuss how sensitivity analysis can be used to assess the impact of prior specifications on model results. Overall, this work provides an important tutorial for researchers interested in applying Bayesian methods to calibrate models and handle non-identifiability in disease models.

stat.CO

An Alternative Formulation of Coxian Phase-type Distributions with Covariates: Application to Emergency Department Length of Stay

In this paper we present a new methodology to model patient transitions and length of stay in the emergency department using a series of conditional Coxian phase-type distributions, with covariates. We reformulate the Coxian models (standard Coxian, Coxian with multiple absorbing states, joint Coxian, and conditional Coxian) to take into account heterogeneity in patient characteristics such as arrival mode, time of admission and age. The approach differs from previous research in that it reduces the computational time, and it allows the inclusion of patient covariate information directly into the model. The model is applied to emergency department data from University Hospital Limerick in Ireland.

stat.AP

On the Non-uniqueness of Representations of Coxian Phase-Type Distributions

Parameter estimation in Coxian phase-type models can be challenging due to their non-unique representation leading to a multi-modal likelihood. Since each representation corresponds to a different underlying data-generating mechanism, it is of interest to identify those supported by given data (i.e., find all likelihood modes). The standard approach is to simply refit using various initial values, but this has no guarantee of working. Thus, we develop new properties specific to this class of models, and employ these to determine all the equivalent model representations. The proposed approach only requires fitting the model once, and is guaranteed to find all representations.

math.ST