bims-simosr 2026-03-22 papers

bims-simosr

Biomed News

on Simulation models in health service research

Issue of 2026–03–22
six papers selected by
Eunice T. Adwubi, University of Newcastle

Dirichlet-Swing: understanding spatio-temporal aspects of political elections in heterogeneous societies through agent-based simulation.
The Evolution of Principles of Economics: A Comprehensive Journey Through Health Economics for Public Health Practitioners and Researchers.
No Ethics Needed? Towards an Ethics of Care for Public and Patient Involvement and Engagement.
The Young Adult Sleep model: an evolving causal loop diagram of mental health dynamics.
Exploring pathway scenarios for future urban water resilience using systems approach coupled with an agent-based model operated on synthetic social-policy networks.
Enhancing Agent-Based Models with Real-Time Movement Data to Assess Impacts of Biosecurity Interventions on Disease Exposure in Healthcare Settings.

PLoS One. 2026 ;21(3): e0344018

Dirichlet-Swing: understanding spatio-temporal aspects of political elections in heterogeneous societies through agent-based simulation.

Adway Mitra.

Many countries have a system of electing members to their governing bodies through district-based elections. In each district, the party with maximum votes wins the corresponding "seat" in the governing body. However, the final seat distribution is strongly dependent on the geographical distribution of voters of different parties, and the party with most (or least) voters may not win the most (or least) number of seats if their voters are non-homogeneously distributed over the districts. This is further complicated in heterogeneous societies, where political preference of voters depends on their social identities, which is also related to their districts of residence. Projections of outcomes by sample surveys tend to fail in such situations. The aim of this paper is to explore how electoral outcomes are influenced by the geographical distribution of voters and community-centric voting preferences. We consider agent-based modeling of voters along with their locations, community memberships and voting preference. Our models represent the relations between these factors with their uncertainties through conditional probability distributions involving latent variables with Dirichlet Processes. Our models also represent spatio-temporal factors in elections - how geographical proximity between districts influence the voting preferences, and swing of votes across successive elections. We propose two novel models for vote swing between successive elections based on Dirichlet Processes, which is far more powerful than the existing models of Uniform Swing and Proportional Swing. For any choice of parameters, our models can be used to simulate a full election by Monte Carlo Sampling, and such simulations provide us a range of possible outcomes. We can also simulate surveys and study how their projections can deviate from the actual results. We discuss inference approaches to estimate the parameters to fit the model to actual district-based elections held in India.

DOI: https://doi.org/10.1371/journal.pone.0344018
Indian J Community Med. 2026 Jan-Feb;51(1):51(1): 199-204

The Evolution of Principles of Economics: A Comprehensive Journey Through Health Economics for Public Health Practitioners and Researchers.

Gaurav Jyani, Shankar Prinja.

  As we confront the contemporary challenges of escalating healthcare expenditures and widening health inequities, a nuanced grasp of economic theory serves as a guiding light, illuminating the path toward a healthcare system that is more equitable and efficient. Tracing the historical development of economic theory offers insights for scholars of public health and economics, as well as policymakers. This exploration of the evolution of economic thought provides a thorough understanding of the fundamental principles upon that health economics is constructed. From the classical doctrines of Adam Smith to the transformative Keynesian revolution and the ensuing challenges posed by neoliberalism and post-Keynesian principles, each paradigm has contributed significantly to our understanding of economic fundamentals and their applicability in healthcare. Understanding these economic theories helps navigate the complexities of healthcare policy and practice. As we maneuver through the intricacies of modern healthcare systems, this comprehension facilitates better understanding of endeavors aimed at enhancing health outcomes and societal welfare. By leveraging insights from the past, we can chart a course toward a healthcare future that is more equitable, efficient, and sustainable.

Keywords:  Behavioral economics; classical economics; consumer behavior; economic theory; health economics; history; microeconomics; neoclassical economics

DOI:  https://doi.org/10.4103/ijcm.ijcm_659_24
Health Expect. 2026 Apr;29(2): e70638

No Ethics Needed? Towards an Ethics of Care for Public and Patient Involvement and Engagement.

Kanwal Mand, Anna Lavis, Melissa Stepney, Roisin Mooney, Kam Bhui.

INTRODUCTION: Public and Patient Involvement and Engagement (PPIE) enhances the inclusivity, relevance and responsiveness of health research for communities. Although public and patient involvement is grounded in lived experience and typically falls outside formal ethical review, ethical considerations nonetheless arise. This paper therefore examines PPIE concepts and practices through an EoC lens.
METHOD: Through a thematic, iterative review of the literature, this paper examines PPIE practices, analysing these by drawing on feminist scholarship, notably the EoC perspective and intersectionality, to explore how lived experience is constructed within health research.
RESULTS: The EoC perspective can play an important guide for help researchers to promote inclusive team cultures, strengthen their PPIE activity and respond to marginalised groups of people in complex situations. It can help to address criticisms of PPIE, on account of the 'harm' patient/public contributors can experience based on (hidden) emotional labour, alongside power imbalances, and existent health vulnerabilities. Whilst there exists some guidance concerning PPIE in terms of reporting, the paper proposes an EoC lens underlining five overlapping aspects: attentiveness, responsibility, competence, responsiveness and solidarity to improve inclusivity, mitigate harms and reshape relationships between researchers and participants.
CONCLUSION: An EoC approach reframes ethics, for PPIE, not as a procedural task. It highlights that an EoC is a form of relational ethics and underlines the ongoing relational practice that makes up PPIE, which demands attentiveness to lived experience, structural inequalities and the emotional realities of involvement. This perspective strengthens the ethical integrity of PPIE by encouraging more reflexive, compassionate and equitable engagement across research contexts.
PATIENT OR PUBLIC CONTRIBUTION: Members of a parent carer network were involved in preparing the manuscript. They reviewed the paper in both a lay summary version and the longer full version, providing written and verbal feedback. Their suggestions have been incorporated into the main text, including the addition of examples in the table.

DOI: https://doi.org/10.1111/hex.70638
BMC Med. 2026 Mar 16. pii: 159. [Epub ahead of print]24(1):

The Young Adult Sleep model: an evolving causal loop diagram of mental health dynamics.

Jeroen F Uleman, Rushd F M Al-Shama, Adrian G Zucco, Jette Echterhoff, Maartje Luijten, Maaike Verhagen, Jana Vyrastekova, Jorien L Treur, Robyn E Wootton, Sicelo Jones, Martin Dresler, Henning J Drews, Christine Egebjerg, Birgitte R Kornum, Karien Stronks, Naja Hulvej Rod.

   BACKGROUND: This study introduces the Young Adult Sleep model, a comprehensive causal loop diagram (CLD) developed to explore the dynamic feedback mechanisms underlying sleep problems and affective depressive symptoms in young adults-an urgent public health challenge.
METHODS: The CLDs was developed through five asynchronous questionnaire-based assignments completed by a panel of 14 domain experts, two existing CLDs, and targeted reviews of the scientific literature. Natural language processing was used to curate the system variables from questionnaire data.
RESULTS: The CLD integrates extensively interconnected variables across biological, psychological, behavioral, and social domains. It comprises 29 variables and 175 causal connections, forming numerous reinforcing feedback loops that can drive "vicious" cycles, such as the interplay of sleep disturbances and affective depressive symptoms with addictive behaviors like smoking. The experts also identified balancing loops that may counteract these self-reinforcing dynamics. Many loops span multiple domains, underscoring the importance of multidomain interventions and of interdisciplinary research that synthesizes evidence across scientific fields.
CONCLUSIONS: The Young Adult Sleep model is an evolving CLD framework that is intended to be further refined as new evidence becomes available. It supports iterative theory development and hypothesis generation, and serves as a foundation for future computational modeling to simulate intervention strategies to address this complex public health problem.

Keywords:  Causal loop diagram; Complex; Depressive symptoms; Epidemiology; Feedback loop; Mental health; Natural language processing; Sleep; System; Young Adult

DOI:  https://doi.org/10.1186/s12916-026-04738-7
Water Res. 2026 Mar 12. pii: S0043-1354(26)00408-2. [Epub ahead of print]297 125726

Exploring pathway scenarios for future urban water resilience using systems approach coupled with an agent-based model operated on synthetic social-policy networks.

Dineshkumar Muthuvel, Xiaosheng Qin, Saman Maroufpoor.

  This study develops a hybrid system dynamics model coupled with an agent-based model, operating on synthetic social-policy networks, to project future scenarios for water supply and demand dynamics in Singapore. The simulations explore multiple trajectories involving population growth, reductions in imported water, and varying local catchment levels, each evaluated under different policy coverage rates (the proportion of the population motivated by conservation policies). These scenarios are ranked at three future time points according to the volume of water required from alternative sources, namely desalination and recycled water. In the near term (2030), among the assumed trajectories, a rapid decline in imports sharply increases pressure on alternative water sources. By the mid (2045) and long term (2060), however, policy coverage begins to exert a more substantial influence: in approximately 55% to 60% of the best-performing scenarios, a 20% policy coverage rate is associated with reduced reliance on alternative sources. The simulations also reveal two emergent behaviors in response to policy interventions. First, policy coverage generates a cumulative, long-term effect: in 2030, the difference in per capita demand between scenarios with and without policy intervention is 3.4 lpcd (liters per capita per day), increasing to 20.3 lpcd in 2060 in one scenario. This highlights the importance of early and sustained policy engagement to achieve long-term savings. Second, per capita demand reduction plateaus beyond a 30% policy coverage rate, owing to a lower-bound cap imposed on low-consumption agents to maintain equity. Overall, the hybrid model provides policymakers with informative feedback through a range of what-if scenarios, supporting more robust long-term planning and preparedness.

Keywords:  Agent-based model; Multilayer network; Singapore; Socio-hydrology; System dynamics

DOI:  https://doi.org/10.1016/j.watres.2026.125726
ACM BCB. 2025 Oct;pii: 16. [Epub ahead of print]2025

Enhancing Agent-Based Models with Real-Time Movement Data to Assess Impacts of Biosecurity Interventions on Disease Exposure in Healthcare Settings.

Ravi Chandra Thota, Md Yusuf Sarwar Uddin, Majid Bani-Yaghoub, Mohamed Nezar Abourraja, Gary Sutkin, Susanna Paschal.

  Hospital-acquired infections (HAIs) pose a significant challenge in healthcare settings, contributing substantially to patient morbidity, mortality, and increased healthcare costs. HAI incidence arises from complex interactions among healthcare workers, patients, and contaminated medical equipment. Agent-based modeling (ABM) is a well-known tool for simulating HAI dynamics, but existing ABM solutions have limited efficacy because of their reliance on synthetic/random human movement data. To address this gap, we deploy an Ultra-Wideband (UWB) Real-Time Location System (RTLS) in the post-surgery observation unit of a tertiary hospital in our city and collect high-resolution spatiotemporal location data of healthcare workers and medical devices in that unit. We develop an agent-based model of HAI transmission that incorporates epidemiological parameters specific to Clostridioides difficile (C. diff), capturing both direct and indirect transmission routes. The model is calibrated using assimilated RTLS data and is then applied to forecast exposure risk associated with asymptomatic carriers in the presence of biosecurity interventions (i.e., hand hygiene and surface disinfection). Our simulation results, generated in the AnyLogic simulation software, demonstrate that exposure levels vary due to movement behavior and infection control measures. These findings highlight the necessity of integrating real-time location data into ABMs to enhance predictive accuracy and optimize intervention strategies.

Keywords:  Agent-Based Modeling; Applied computing; Biosecurity Measures; Data-Driven Healthcare Policy; Health informatics; Healthcare Worker Movement Data; Hospital-acquired infections (HAIs); Infection Transmission Simulation; Proximity-Based Transmission; UWB Real-Time Location Systems (RTLS)

DOI:  https://doi.org/10.1145/3765612.3767222