Correlation and Causality in the Petaflop Age

Science Translational Medicine
21 July 2010 vol 2, issue 41
http://stm.sciencemag.org/content/current

High-Performance Computing
Closing the Scientific Loop: Bridging Correlation and Causality in the Petaflop Age
Gary An

Abstract
Advances in computing capability offer the biomedical research community the prospect of creating simulations at a previously unimaginable scale. A diagnostic analysis of the underpinnings of the translational dilemma suggests that the current high-throughput, data-rich research environment has led to an imbalance in the relationship between determinations of correlation and the evaluation of causality. Here I describe the use of high-performance computing technologies to facilitate high-throughput hypothesis evaluation combined with an evolutionary paradigm for the advancement of scientific knowledge. This combination provides a roadmap for closing the scientific loop between correlation and causality, a necessary step if translational endeavors are to succeed.

Clostridium difficile vaccine: An economic computer simulation model

Vaccine
http://www.sciencedirect.com/science/journal/0264410X

Volume 28, Issue 32, Pages 5145-5386 (19 July 2010)

The potential value of Clostridium difficile vaccine: An economic computer simulation model
Pages 5245-5253
Bruce Y. Lee, Michael J. Popovich, Ye Tian, Rachel R. Bailey, Paul J. Ufberg, Ann E. Wiringa, Robert R. Muder

Abstract
Efforts are currently underway to develop a vaccine against Clostridium difficile infection (CDI). We developed two decision analytic Monte Carlo computer simulation models: (1) an Initial Prevention Model depicting the decision whether to administer C. difficile vaccine to patients at-risk for CDI and (2) a Recurrence Prevention Model depicting the decision whether to administer C. difficile vaccine to prevent CDI recurrence. Our results suggest that a C. difficile vaccine could be cost-effective over a wide range of C. difficile risk, vaccine costs, and vaccine efficacies especially, when being used post-CDI treatment to prevent recurrent disease.

Duty to treat in influenza pandemic

Vaccine
http://www.sciencedirect.com/science/journal/0264410X
Volume 28, Issue 32, Pages 5145-5386 (19 July 2010)

The duty to treat in the context of an influenza pandemic
Pages 5260-5264
C.P. van der Weijden, A.L. Bredenoord, J.J.M. van Delden

Abstract
The recent influenza pandemic proved that an influenza pandemic is no longer a future scenario. It may urge health care workers to undergo certain or even large risks. According to the WHO as well as commentators, a strong case can be made for adopting a duty to treat during a disease outbreak. Many current professional codes of ethics, however, fail to provide explicit guidance sufficient to set policy or assure the public in the event of an infectious disease outbreak. This paper aims to assess whether there is a duty to treat in the case of an influenza pandemic. As we conclude that there are valid reasons that support the duty to treat in this specific context, we will subsequently explore its scope and limits.

HPV vaccine effectiveness: A comparative model-based analysis

Vaccine
http://www.sciencedirect.com/science/journal/0264410X
Volume 28, Issue 33, Pages 5387-5512 (26 July 2010)

Understanding differences in predictions of HPV vaccine effectiveness: A comparative model-based analysis
Pages 5473-5484
Nicolas Van de Velde, Marc Brisson, Marie-Claude Boily

Abstract
Mathematical models of HPV vaccine effectiveness and cost-effectiveness have produced conflicting results. The aim of this study was to use mathematical models to compare and isolate the impact of the assumptions most commonly made when modeling the effectiveness of HPV vaccines. Our results clearly show that differences in how we model natural immunity, herd immunity, partnership duration, HPV types, and waning of vaccine protection lead to important differences in the predicted effectiveness of HPV vaccines. These results are important and useful to assist modelers/health economists in choosing the appropriate level of complexity to include in their models, provide epidemiologists with insight on key data necessary to increase the robustness of model predictions, and help decision makers better understand the reasons underlying conflicting results from HPV models.

Communication skills in HPV prevention: Italian HCWs

Vaccine
http://www.sciencedirect.com/science/journal/0264410X
Volume 28, Issue 34, Pages 5513-5652 (2 August 2010)

Communication skills in HPV prevention: an audit among Italian healthcare workers
Pages 5609-5613
S. Tafuri, D. Martinelli, M.M. Vece, M. Quarto, C. Germinario, R. Prato

Abstract
This study aims to investigate the knowledge, the attitudes and practices on HPV vaccination of health professionals of Mother and Child Service of Puglia Region (Italy). The study was conducted through a standardized questionnaire. Of 455 respondents, 74.2% judged HPV vaccine very important for immunization calendar. 88.9% did not believe that the administration of HPV vaccine implies consent to the initiation of sexual activity but 34.2% sustained that vaccine can give a false sense of protection against sexually transmitted diseases. 62.2% believed that boys should also be vaccinated. Skills necessary in the implementation of strategies in the promotion of health are partially inadequate and appropriate ongoing education should be carried out for health care workers.

Parental acceptance of a potential cytomegalovirus vaccine

Vaccine
http://www.sciencedirect.com/science/journal/0264410X
Volume 28, Issue 35, Pages 5653-5756 (9 August 2010)

Assessment of parental acceptance of a potential cytomegalovirus vaccine for adolescent females
Pages 5686-5690
Tiffany J. Petty, S. Todd Callahan, Qingxia Chen, Kathryn M. Edwards, Amanda F. Dempsey

Abstract
The development of a vaccine against cytomegalovirus (CMV) has been designated as a high priority and adolescent females are a likely target population for CMV vaccination. A self-administered, internet-based survey was developed using constructs from the Health Belief Model to identify factors that may be associated with parental acceptance of a CMV vaccine for their adolescent daughters. Data from 516 parents were analyzed, the majority of whom were female, white, and college educated. Parental acceptance of a CMV vaccine was generally high. Perceived benefits of vaccine were independently associated with vaccine acceptance while history of previous vaccine refusal, concerns about safety and cost of the vaccine were negatively associated. These findings provide initial data on factors that are likely to influence parental acceptance of a CMV vaccine for adolescent girls.

A/H1N1: HCWs refusal of vaccination in Istanbul

Vaccine
http://www.sciencedirect.com/science/journal/0264410X
Volume 28, Issue 35, Pages 5653-5756 (9 August 2010)

Vaccination against pandemic influenza A/H1N1 among healthcare workers and reasons for refusing vaccination in Istanbul in last pandemic alert phase
Pages 5703-5710
Sebahat D. Torun, Fuat Torun

Abstract
“Coverage of the HCWs as target population is one of the important determinants for the impact of vaccination. To determine the vaccination against the pandemic influenza A/H1N1 among HCWs, we conducted a cross-sectional questionnaire survey in a public hospital in Istanbul from December 7 to December 22, 2009. Out of total 941 HCWs 718 (76.3%) completed the questionnaires. Nearly one-fourth (23.1%) of the participants were vaccinated against pandemic influenza A/H1N1. Occupation (being a doctor), receiving seasonal influenza vaccine in 2009, agreement with safety of pandemic influenza A/H1N1 vaccine and being comprehend that HCWs have a professional responsibility for getting vaccinated was the strongest independent predictive factor for accepting the pandemic influenza A/H1N1 vaccine (p < .0001). The most frequent reasons for refusing pandemic vaccine were fear of side effects and doubts about vaccine efficacy. Among HCWs 59.6% were recommending pandemic influenza vaccination to a patient even if indicated. In conclusion vaccination against pandemic influenza A/H1N1 is insufficient among HCWs. Misinformed or inadequately informed HCWs are important barrier to pandemic influenza vaccine coverage of the general public also. Educational campaigns concerning HCWs should include evidence based and comprehensible information about possible adverse effects and their incidence besides the advantages of vaccine.”