Structure, parameters, refs (.csv)

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28		Description of Events and Parameters
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30		Property/event		Description	Notes and Major Assumptions
31		ep_seiz_stat		epilepsy seizure status (0 = never epilepsy, 1 = previous seizures none now, 2 = infrequent seizures, 3 = frequent seizures)
32		ep_antiep		on anti-epileptic
33		ep_epi_death		death caused directly by epilepsy
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37		Parameter	Proposed value	Description	Notes and Major Assumptions
38		init_epil_seiz_status	0.9875, 0.004, 0.008, 0.0005	proportions in each seizure status category at baseline	Estimates of prevalence of epilepsy vary by setting but are in this region for sub Saharan Africa (Ba-Diop et al 2014)
39		init_prop_antiepileptic	0, 0.25, 0.3, 0.30	initial proportions on antiepileptic by seizure status	Ba-Diop et al 2014 provide estimates of treatment gap in SSA - based on text description, treatment gap is likely to often be larger in practice
40		base_3m_prob_epilepsy	0.0003	base probability of epilepsy per 3 month period if age < 20	informed by Ngugi 2012
41		rr_epilepsy_age_ge20	0.3	rate ratio for incidence of epilepsy for age > 20 vs < 20	age 20 is not a clearly established threshold, but rate declines with age (Ngugi 2012, Ba-Diop 2014)
42		prop_inc_epilepsy_seiz_freq	0.1	proportion of incident epilepsy cases with frequent (vs infrequent) seizures (frequent defined as >= 3 per month, Ngugi et al)	Ngugi et al 2012
43		base_prob_3m_seiz_stat_freq_infreq	0.005	base probability per 3 months of seizure status frequent if current infrequent	no direct estimate identified but rate assumed low*
44		rr_effectiveness_antiepileptics	5	relative rate of seizure status transitions if on antiepileptic (for negativetransitions, effect is 1/ rr_effectiveness_antiepileptics	effect of treatment - assumed to act with the same relative effect on all transitions between seizure status - difficult to ascertain effect of treatment per se rather than each specific drug (assume 0.2) - informed by Shorvon et al 2018*
45		base_prob_3m_seiz_stat_freq_infreq	0.005	base probability per 3 months of seizure status infrequent if current frequent	no direct estimate identified but rate assumed low*
46		base_prob_3m_seiz_stat_infreq_freq	0.05	base probability per 3 months of seizure status infrequent if current frequent	few data identified on natural transitions without treatment - informed partially by rate in placebo arms of trials (Shorvon et al)*
47		base_prob_3m_seiz_stat_none_freq	0.05	base probability per 3 months of seizure status nonenow if current frequent	few data identified on natural transitions without treatment - informed partially by rate in placebo arms of trials (Shorvon et al)*
48		base_prob_3m_seiz_stat_infreq_none	0.005	base probability per 3 months of seizure status infrequent if nonenow	no direct estimate identified but rate assumed low*
49		base_prob_3m_seiz_stat_none_infreq	0.05	base probability per 3 months of seizure status nonenow if current infrequent	few data identified on natural transitions without treatment =- assume 0.05 per 3 months but expect to modify in future once further data identifed*
50		base_prob_3m_antiepileptic	0.02	base probability per 3 months of starting antiepileptic, if frequent seizures	depends on access - will depend on health care system component - using place-holder value for now (relevant data in US Faught et al 2018, suggest ~ 0.1 / per 3 months)*
51		rr_antiepileptic_seiz_infreq_or_freq	0.8	relative rate of starting antiepileptic if infrequent seizures	depends on drug access and eligibility policy - assume initially that rate is 0.3 times*
52		base_prob_3m_stop_antiepileptic	0.1	base probability per 3 months of stopping antiepileptic, if nonenow seizures	will vary by setting and clinical guidance - use place holder of 0.05 for now*
53		rr_stop_antiepileptic_seiz_infreq_or_freq	0.5	relative rate of stopping antiepileptics if having infrequent or frequent seizures
54		base_prob_3m_epi_death	0.001	base probability per 3 months of epilepsy death	informed by Ngugi et al 2012 but data not directly comparable*
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56					* all these parameter values are together consistent with the initial values for prevalence and treatment use described (init_epil_seiz_status and init_prop_antiepileptic
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59		Additional relevant references		Cited papers are in Dropbox Resources
60		Berg and others 2009
61		Kwan and Brodie 2000
62		Schiller and Najjar 2008
63		Semah and others 1998
64		Jette, Reid, and Wiebe 2014
65		Chisholm, D., and WHO-CHOICE. 2005. “Cost-Effectiveness of First-Line Antiepileptic Drug Treatments in the Developing World: A Population-Level Analysis.” Epilepsia 46 (5): 751–59.