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2025 update -- Spectrum ART adjustment and allocation #44

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merged 4 commits into from
Nov 18, 2024
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jeffeaton
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@jeffeaton jeffeaton commented Nov 13, 2024

The first update in here adds new Spectrum feature for ART adjustment by absolute count. The second two are small fixes to align EPP-ASM simulation with Spectrum (small impact).

Also addresses backward compatibility issue with previously saved .shiny90 zip that resulted in error in Naomi tests (@r-ash ).

first90 1.7.1

  • Implement Spectrum adult ART adjustment by absolute count. This is a user
    input that adjust the number on ART count by an absolute value. It is
    intended to be used to account for clients receiving services in or
    from another region; typically with subnational Spectrum files.

    If both absolute count and ratio adjustments are specified in the same
    year, the absolute count is applied first and then ratio is applied.
    If ART is specified as a percentage, then adjustments do not have any
    influence.

    Previously entered ART adjustments were applied or not via a checkbox in
    Spectrum. The checkbox has been removed in Spectrum 6.38 beta 18. For
    backward compatability with previously simulated Spectrum outputs, if the
    checkbox flag exists in the .DP file, it is still used to determine
    application of the ratios; if the .DP file does not contain the checkbox
    flag, then the ratio is applied.

  • Patch ART dropout implementation. Spectrum converts input ART dropout percent to an
    annual rate using [dropout rate] = -log(1.0 - [input percent]).

  • Implement Spectrum ART allocation.

    There has been a longstanding discrepancy betweeen EPP-ASM and Spectrum in ART allocation.
    For ART allocation by 'expected mortality', EPP-ASM allocated according to mortality by CD4
    and age.

    Spectrum allocates ART in a two step process: first, ART is allocated by CD4 category based
    on the 'expected mortality' and 'proportional to eligibility' weight. Second, within
    CD4 categories, ART is allocated by age solely proportional to number in each age
    group (propotional to eligibility).

    This has modest overall difference, but was a source of numerical differences between
    Spectrum and EPP-ASM.

@m-maheu-giroux
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I will wait for rob to review before merging. if not required, let me know.

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@r-ash r-ash left a comment

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Thanks! This has sorted out the Naomi build errors I was seeing.

@r-ash r-ash merged commit 84713f5 into master Nov 18, 2024
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3 participants