Franco Taroni, Silvia Bozza, Alex Biedermann
Two items of evidence, no putative source: an inference problem in forensic intelligence
Journal of forensic sciences
people connecticut likely die drugrelated overdose traffic accident connecticut success slowing rise overdose death rates substantial additional progress necessary developed verified calibrated mechanistic simulation alternative overdose prevention policy options including scaling naloxone nlx distribution community medications opioid use disorder oud among people incarcerated moudinc community moudcom simulated cohort people oud connecticut estimated maximally scaling option individually combinations would impact 5year overdose deaths lifeyears qualityadjusted lifeyears costs assessed 2021 usd employing health sector perspective basecase analyses societal perspective sensitivity analyses using 3 discount rate 5year lifetime time horizons maximally scaling nlx alone reduces overdose deaths 20 next 5 years favorable incremental costeffectiveness ratio icer injectable rather intranasal nlx distributed 240 additional overdose deaths could prevented maximally scaling moudcom moudinc alone reduce overdose deaths 14 6 respectively favorable icers considering permutations scaling policies scaling nlx moudcom together costeffective choice reducing overdose deaths 32 icer 19000qaly sensitivity analyses using societal perspective policy options cost saving overdose deaths reduced 33 5 years saving society 338000 per capita simulated cohort lifetime maximally scaling access naloxone moud community reduce 5year overdose deaths 32 among people oud connecticut realistic budget scenarios societal cost savings due increased productivity reduced crime costs considered onethird overdose deaths reduced maximally scaling three policy options saving money