Simulation, Outcomes, and Sensitivity Analysis
We estimated medical outcomes, costs, and QALYs
associated with each scenario, accounting for uncertainty
in each of the model’s key parameters. We simulated each
scenario 1000 times, holding prevalence constant and using
1 of 1000 sets of parameters, wherein each parameter
was selected randomly from its distribution. We report the
mean of the simulated values for the overall population
outcomes and the mean and the empirical 95% credible
interval for per-person costs and QALYs. We used these
values to calculate the incremental cost-effectiveness ratios
(ICERs) and their credible intervals of the birth-cohort
screening scenario compared with the baseline risk-based
scenario. The ICER was calculated as the incremental difference
in medical cost between 2 scenarios divided by the
incremental difference in QALYs.