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neonatal antibiotics intervention model, based on neontal cpap intervention model #1587

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merged 9 commits into from
Feb 5, 2025

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aflaxman
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This is very similar to #1585 , but for a different (cause, treatment) pair. I suspect I will have some edits to make to both of them when we go over them with the engineers tomorrow.


- We assume that antibiotics availability captures actual use, and not simply the treatment being in the facility
- We assume that the delivery facility is the final facility in the care continum for deliveries that are transferred due to complications
- We assume that the relative risk of sepsis mortality with antibiotics in practice is a value that we can find in the literature
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You could also add the limitation that currently we won't be modeling antibiotics effect on pneumonia mortality, which we have currently grouped with 'other causes'.

@@ -45,9 +51,9 @@ This section describes how a CPAP intervention can be implemented and calibrated
Baseline Coverage Data
++++++++++++++++++++++++

39.3% of CMONC facilities and 7.5% of BMONC facilities have CPAP, according to the 2016 Ethiopia EmONC Final Report. Please use these as a placeholder for now while we try to find reliable values for Nigeria and Pakistan.
39.3% of CEmONC facilities and 7.5% of BEmONC facilities have CPAP, according to the 2016 Ethiopia EmONC Final Report. Please use these as a placeholder for now while we try to find reliable values for Nigeria and Pakistan.
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Suggested change
39.3% of CEmONC facilities and 7.5% of BEmONC facilities have CPAP, according to the 2016 Ethiopia EmONC Final Report. Please use these as a placeholder for now while we try to find reliable values for Nigeria and Pakistan.
76.8% of CEmONC facilities and 30.2% of BEmONC facilities have antibiotics for neonatal sepsis, according to the 2016 Ethiopia EmONC Final Report. Please use these as a placeholder for now while we try to find reliable values for Nigeria and Pakistan.


We will then use the conditional probabilities for simulants with and without access to determine which simulants die from sepsis.

While we are searching the literature, we will use a placeholder relative risk of 0.50 (95% CI 0.25-0.75) of sepsis mortality for neonates with access to antibiotics.
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This contradicts the placeholder of 0.72 in #1588

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I will make them match, but in a future PR, I would like to make it so that there is a single place for this in the docs.

p(\text{sepsis})
&= \sum_{\text{paths without antibiotics}} p(\text{path})\cdot p(\text{sepsis_wo})\\
&+ \sum_{\text{paths with antibiotics}} p(\text{path})\cdot p(\text{sepsis_w})\\[.1in]
p(\text{sepsis_w}) &= \text{RR}_\text{antibiotics} \cdot p(\text{sepsis_wo})
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Once again, the $LaTeX$ is bad because of the underscores inside the \text{} commands (it renders on Read the Docs, but not on GitHub).

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Huh, TIL! I guess you need \_ (or on GitHub \\_ since the backslash also needs to be escaped).

$$\text{sepsis\_w}$$

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I'm going to switch to notation that uses conditional probabilities, I think it will be clearer as well as better typeset

@aflaxman aflaxman merged commit 40a3406 into main Feb 5, 2025
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@aflaxman aflaxman deleted the neonatal_antibiotics branch February 5, 2025 17:27
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5 participants