{"templates":[{"path":"docs/open-botec/templates/lifestyle-diabetes-prevention.v1.json","schemaVersion":"open-botec-template/0.1","archetypeId":"lifestyle-diabetes-prevention","version":"v1","name":"CDC-recognized lifestyle-change diabetes prevention program (National DPP) for adults with prediabetes","causeArea":"chronic-disease","appliesWhen":["The marginal gift funds additional enrolled adults in a year-long group lifestyle program following the CDC National DPP curriculum (YMCA, community health centers, health departments).","Participants are adults with prediabetes or high risk; not children."],"doesNotApplyWhen":["The program is a one-off nutrition class, food distribution, or diabetes self-management education for people who already have diabetes.","The gift funds a cohort an insurer (Medicare MDPP, Medicaid, employer plan) would otherwise pay for, unless fundingAdditionality reflects that."],"nativeOutcome":{"unit":"discounted kg-years of incremental weight loss","notes":"Weight loss relative to an offer-only control, summed over the years it persists. Diabetes cases averted would be a better native unit; v1 keeps the SF model's weight pathway."},"costDenominator":{"unit":"additional enrolled participant offer","costParameter":"costPerParticipant"},"formulas":{"nativeOutcomesPerUnit":"fundingAdditionality * extraKg * transfer * discountedRetentionYears","qalyBridge":{"bridgeId":"weight-loss-kg-year-to-qaly","version":"v1","qalysPerNativeOutcome":"utilityPerKg","notes":"Observational association of weight change with EQ-5D utility. Excludes diabetes-avoidance QALYs beyond what utility captures, so likely conservative for high-risk cohorts and generous for low-risk ones."}},"parameters":{"costPerParticipant":{"scope":"local","label":"Donor cost per additional enrolled participant","unit":"USD per participant","lookup":{"preferredSources":["Provider's per-participant price or grant budget","Medicare MDPP performance-payment schedule for the price year (an upper-bound reimbursement anchor, not cost)","State Medicaid DPP fee schedule"],"fallback":"SF distribution scaled by the local/SF BLS wage ratio for health educators, labeled transferred judgment.","judgmentGuide":"SF $200/$600/$1,200; central $600 is a judgment, not a YMCA quote."}},"fundingAdditionality":{"scope":"local","label":"Share of donor-funded enrollment that would not otherwise be funded","unit":"fraction","lookup":{"preferredSources":["Whether the state Medicaid program covers National DPP","Whether the dominant local public employer/insurer pays the provider","Provider waitlist or unfunded-cohort statement"],"fallback":"SF distribution, flagged as transferred.","judgmentGuide":"SF 0.2/0.5/0.8 reflected Medi-Cal DPP coverage and an SF Health Service System YMCA partnership. Lower it where coverage is broad; raise it where payers do not cover DPP."}},"transfer":{"scope":"local","label":"Retention of trial effect in the local population and provider","unit":"fraction","lookup":{"preferredSources":["Provider's CDC DPRP recognition status (full plus vs pending)","Local cohort completion and weight-loss outcomes"],"fallback":"SF distribution, flagged as transferred.","judgmentGuide":"SF 0.25/0.75/1.0."}},"extraKg":{"scope":"universal","label":"Additional weight loss versus offer-only control","unit":"kg","default":{"value":{"p10":1.1,"p50":2.3,"p90":3.4,"shape":"two-piece-lognormal","basis":"analyst-scenarios"},"scope":"universal","basis":"transferred","rationale":"Randomized YMCA offer trial, with scenario spread.","sources":[{"publisher":"American Journal of Public Health","title":"Ackermann et al.: randomized YMCA offer trial","url":"https://pubmed.ncbi.nlm.nih.gov/26378828/","published":"2015-09-17","retrieved":"2026-09-07"}]}},"discountedRetentionYears":{"scope":"universal","label":"Discounted years over which the weight difference persists","unit":"discounted years","default":{"value":{"p10":0.48549,"p50":2.3713,"p90":4.58021,"shape":"two-piece-lognormal","basis":"analyst-scenarios"},"scope":"universal","basis":"derived","rationale":"Sum over years t of retention[t]/1.03^(t+0.5) for the SF retention profiles [0.25,0.25], [0.5,1,0.75,0.25] and [0.5,1,1,1,1,0.5]. Embeds the 3% discount convention; a v2 template should split persistence from discounting.","sources":[{"publisher":"Diabetes Care","title":"Kuo et al.: prospective NDPP cost and QALY analysis","url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC12178621/","published":"2024-11-20","retrieved":"2026-09-07"}]}},"utilityPerKg":{"scope":"universal","label":"QALY weight gain per kg of weight loss per year","unit":"QALY per kg-year","default":{"value":{"p10":0.0007,"p50":0.0014,"p90":0.002,"shape":"two-piece-lognormal","basis":"analyst-scenarios"},"scope":"universal","basis":"transferred","rationale":"Observational utility association.","sources":[{"publisher":"Obesity","title":"Ackermann et al.: weight change and health utility","url":"https://onlinelibrary.wiley.com/doi/10.1038/oby.2009.114","published":"2009","retrieved":"2026-09-07"}]}}},"excludedEffects":["Diabetes cases averted beyond the utility association","Healthcare savings","Program harms (set to zero in SF)"],"nullBoundary":"If the cohort would have been funded anyway or weight loss does not persist, benefit is zero and there is no finite price.","origin":{"factoredFrom":"data/san-francisco/ymca-dpp-cea-v1.json","reproduces":"At all p50 inputs, reproduces the SF central $2,095,452 per 10 QALYs. Change: the variable-length retention arrays become one derived scalar, and harmQalys (0 in every SF scenario) is dropped."}},{"path":"docs/open-botec/templates/naloxone-distribution.v1.json","schemaVersion":"open-botec-template/0.1","archetypeId":"naloxone-distribution","version":"v1","name":"Community naloxone distribution and overdose-response outreach","causeArea":"overdose","appliesWhen":["The marginal gift buys additional naloxone doses delivered to people likely to witness or experience opioid overdose (street outreach, syringe services, drop-in, mail-based distribution).","The organization reports doses distributed and reversals reported for a recent period."],"doesNotApplyWhen":["Funding pays for overdose prevention sites, treatment (use medications-for-opioid-use-disorder), or policy advocacy.","The organization reports people reached but neither doses nor reversals; use a population-reach variant instead (see localization-test.md, Chicago Recovery Alliance)."],"nativeOutcome":{"unit":"additional opioid-overdose deaths averted","notes":"Counts acute survivals that would not otherwise have occurred. Reported reversals are an output, not this outcome."},"costDenominator":{"unit":"additional naloxone dose distributed","costParameter":"costPerDose"},"derived":{"reversalsPerDose":"reportedReversals / reportedDoses","k":"annualHazard + log(1 + discountRate)"},"formulas":{"nativeOutcomesPerUnit":"reversalsPerDose * marginalYieldRetention * additionalSurvivalPerReversal","qalyBridge":{"bridgeId":"opioid-death-averted-to-qaly","version":"v1","qalysPerNativeOutcome":"utility * (1 - exp(-k * horizonYears)) / k","notes":"Continuous-time discounted survival with a constant all-cause hazard, truncated at horizonYears. Swap this bridge to test different survivor-life assumptions without touching the native estimate."}},"parameters":{"costPerDose":{"scope":"local","label":"Donor cost per additional dose delivered","unit":"USD per dose","lookup":{"preferredSources":["Public contract or grant budget with dose targets for this organization","State or county naloxone program budget divided by doses","Executed program expense divided by doses (average, then adjust upward for expansion)"],"fallback":"Wholesale price of the dominant formulation plus outreach labor, labeled judgment.","judgmentGuide":"SF central $20 = roughly 2x a $9.61 planned bundle/target-dose benchmark, allowing extra outreach effort and shortfalls. If the state supplies drug free, cost is outreach labor only."}},"reportedReversals":{"scope":"org","label":"Reversals reported by the organization in the reference year","unit":"reversals per year","lookup":{"preferredSources":["Organization annual report or service page","State overdose-education and naloxone-distribution (OEND) program reports"],"fallback":"None. Without a reversal count, this template does not apply."}},"reportedDoses":{"scope":"org","label":"Doses distributed by the organization in the same year","unit":"doses per year","lookup":{"preferredSources":["Same document as reportedReversals, same year"],"fallback":"None. Do not mix years between numerator and denominator."}},"marginalYieldRetention":{"scope":"local","label":"Share of reported reversal yield retained at the margin","unit":"fraction","lookup":{"preferredSources":["Local saturation evidence: doses per person who uses opioids, public distribution volume, number of competing distributors"],"fallback":"Copy the SF distribution and flag as transferred judgment.","judgmentGuide":"SF 0.25/0.5/0.75 combines harder-to-reach expansion, displacement, reporting mismatch and repeat recipients. Lower it where public distribution is already saturated."}},"additionalSurvivalPerReversal":{"scope":"local","label":"Additional acute survivals per retained reversal","unit":"fraction","lookup":{"preferredSources":["Local EMS response times and bystander-naloxone prevalence","Local fentanyl share of overdose deaths"],"fallback":"Copy SF distribution, flag as transferred judgment.","judgmentGuide":"SF 0.005/0.02/0.05: most reported reversals are assumed not to be lives saved because of spontaneous survival and alternative rescue."}},"utility":{"scope":"universal","label":"Health utility of survivors","unit":"QALY weight","default":{"value":{"p10":0.6,"p50":0.7,"p90":0.8,"shape":"two-piece-logit","basis":"analyst-scenarios"},"scope":"universal","basis":"transferred","rationale":"Downward transfer from 0.799 for HIV-negative daily heroin injection, allowing comorbidity and population differences.","sources":[{"publisher":"Patton et al., Quality of Life Research","title":"Analyzing quality of life among people with opioid use disorder from the NIDA Data Share initiative","url":"https://link.springer.com/article/10.1007/s11136-024-03729-6","published":"2024-08-08","retrieved":"2026-09-07"}]}},"annualHazard":{"scope":"universal","label":"Annual all-cause mortality hazard after a nonfatal overdose","unit":"per person-year","default":{"value":{"p10":0.055,"p50":0.08,"p90":0.15,"shape":"two-piece-lognormal","basis":"analyst-scenarios"},"scope":"universal","basis":"transferred","rationale":"Central informed by 778.3 deaths per 10,000 person-years in a US overdose-survivor cohort. Note: a higher hazard lowers QALYs, so p90 here is the pessimistic case.","sources":[{"publisher":"Olfson et al., JAMA Psychiatry","title":"Causes of Death After Nonfatal Opioid Overdose","url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC6143082/","published":"2018","retrieved":"2026-09-07"},{"publisher":"Weiner et al., Annals of Emergency Medicine","title":"One-Year Mortality of Patients After Emergency Department Treatment for Nonfatal Opioid Overdose","url":"https://pubmed.ncbi.nlm.nih.gov/31229387/","published":"2020","retrieved":"2026-09-07"}]}},"horizonYears":{"scope":"convention","label":"Credited survival horizon","unit":"years","default":{"value":{"p10":10,"p50":15,"p90":20,"shape":"two-piece-lognormal","basis":"analyst-scenarios"},"scope":"convention","basis":"judgment","rationale":"Truncates benefits because recipient ages and long-term outcomes are unknown; not a life expectancy."}},"discountRate":{"scope":"convention","label":"Annual QALY discount rate","unit":"per year","default":{"value":{"p10":0.03,"p50":0.03,"p90":0.03,"shape":"fixed","basis":"convention"},"scope":"convention","basis":"convention","rationale":"Project-wide 3% convention."}}},"excludedEffects":["Nonfatal brain-injury prevention","Benefits to families","Treatment-navigation health gains","Downstream healthcare costs","Drug supplied free by public programs (counted only if the gift pays for it)"],"nullBoundary":"If the gift replaces existing provision or reaches no otherwise-fatal events, deaths averted are zero and there is no finite price.","origin":{"factoredFrom":"data/san-francisco/sfaf-naloxone-cea-v1.json","reproduces":"At all p50 inputs with SFAF 2025 reported reversals/doses, reproduces the SF central $56,328 per 10 QALYs exactly. Change: the three joint scenarios become per-parameter p10/p50/p90, so the simulator mixes them independently instead of as fixed corners."}},{"path":"docs/open-botec/templates/tai-chi-fall-prevention.v1.json","schemaVersion":"open-botec-template/0.1","archetypeId":"tai-chi-fall-prevention","version":"v1","name":"Therapeutic tai chi (Tai Ji Quan: Moving for Better Balance) course for high-fall-risk older adults","causeArea":"healthy-aging","appliesWhen":["The marginal gift funds additional places in a fidelity-specified 24-week, twice-weekly TJQMBB course for older adults at high fall risk."],"doesNotApplyWhen":["The course is shorter general tai chi (e.g. six-week Sun-style) or recruits relatively well older adults; Day et al. 2015 found no benefit there.","The program is a falls-risk home-modification or medication-review service."],"nativeOutcome":{"unit":"additional fidelity-equivalent high-risk participants completing a 24-week course","notes":"Falls averted would be the better native unit (Li et al. 2018 reports fall incidence vs stretching). v1 keeps the SF utility pathway, so native outcome is a quality-weighted output, not a health outcome."},"costDenominator":{"unit":"additional funded course place","costParameter":"courseCost"},"derived":{"courseCost":"classesPerCourse * paidHoursPerClass * instructorHourlyCost / participantsPerCourse + supportCostPerParticipant"},"formulas":{"nativeOutcomesPerUnit":"additionality * localTransfer","qalyBridge":{"bridgeId":"tjqmbb-course-to-qaly","version":"v1","qalysPerNativeOutcome":"hypothesizedEndpointUtility * horizonYears * onsetFraction","notes":"Linear onset to an endpoint utility gain over a six-month horizon, with no persistence. The endpoint coefficient is ambiguous in the source (see origin)."}},"parameters":{"classesPerCourse":{"scope":"universal","label":"Classes per course","unit":"classes","default":{"value":{"p10":48,"p50":48,"p90":48,"shape":"fixed","basis":"convention"},"scope":"universal","basis":"transferred","rationale":"24 weeks x 2 classes, per the trial protocol.","sources":[{"publisher":"Li et al.","title":"Therapeutic tai ji quan randomized trial","url":"https://pubmed.ncbi.nlm.nih.gov/30208396/","published":"2018","retrieved":"2026-09-07"}]}},"paidHoursPerClass":{"scope":"universal","label":"Paid instructor preparation and delivery hours per class","unit":"hours","default":{"value":{"p10":2,"p50":2,"p90":2,"shape":"fixed","basis":"convention"},"scope":"universal","basis":"judgment","rationale":"SF planning assumption: one hour delivery plus one hour preparation/travel."}},"instructorHourlyCost":{"scope":"local","label":"Loaded instructor cost per paid hour","unit":"USD per hour","lookup":{"preferredSources":["Provider's instructor pay rate","BLS OEWS metro-area wage for Fitness Trainers and Instructors (39-9031), times a benefits/overhead load"],"fallback":"None; this is the main local cost lookup.","judgmentGuide":"SF used $60/hour, an assumed wage, not a quote."}},"participantsPerCourse":{"scope":"org","label":"Enrolled participants per course","unit":"people","lookup":{"preferredSources":["Provider class-size cap"],"fallback":"15 (SF assumed occupancy), flagged as transferred."}},"supportCostPerParticipant":{"scope":"local","label":"Licensing, room, outreach and screening cost per participant","unit":"USD per participant","lookup":{"preferredSources":["Provider budget line items"],"fallback":"SF $200 scaled by local/SF cost ratio, flagged as transferred judgment."}},"localTransfer":{"scope":"local","label":"Local fidelity and population retention of the trial effect","unit":"fraction","lookup":{"preferredSources":["Whether instructors are certified TJQMBB trainers","High-risk eligibility screening in recruitment","Availability of comparable free classes (the trial control was stretching, not nothing)"],"fallback":"SF distribution, flagged as transferred.","judgmentGuide":"SF 0.25/0.5/0.75."}},"additionality":{"scope":"local","label":"Share of funded places that are net-new capacity","unit":"fraction","lookup":{"preferredSources":["Older Americans Act Title III-D evidence-based program funding through the local Area Agency on Aging","Provider waitlist"],"fallback":"SF distribution, flagged as transferred.","judgmentGuide":"SF 0.25/0.5/0.75; no verified offer."}},"hypothesizedEndpointUtility":{"scope":"universal","label":"Hypothesized endpoint utility gain versus stretching","unit":"QALY weight","default":{"value":{"p10":0.01,"p50":0.04,"p90":0.06,"shape":"two-piece-lognormal","basis":"analyst-scenarios"},"scope":"universal","basis":"judgment","rationale":"Independent calibration of .04. The source table labels .04 as incremental QALYs while its prose describes a utility difference; reading it as integrated QALYs would lower the price 4x. Unit ambiguity is unresolved.","sources":[{"publisher":"Li and Harmer et al.","title":"Trial economic evaluation","url":"https://academic.oup.com/biomedgerontology/article/74/9/1504/5284888","published":"2019-01-10","retrieved":"2026-09-07"}]}},"horizonYears":{"scope":"universal","label":"Modeled follow-up horizon","unit":"years","default":{"value":{"p10":0.5,"p50":0.5,"p90":0.5,"shape":"fixed","basis":"convention"},"scope":"universal","basis":"judgment","rationale":"Rounded six-month horizon; no persistence beyond follow-up."}},"onsetFraction":{"scope":"universal","label":"Average fraction of endpoint benefit realized over follow-up","unit":"fraction","default":{"value":{"p10":0.25,"p50":0.5,"p90":0.5,"shape":"two-piece-logit","basis":"analyst-scenarios"},"scope":"universal","basis":"judgment","rationale":"0.5 assumes linear growth from zero to endpoint."}}},"excludedEffects":["Fall injuries, mortality and healthcare savings on top of utility","Six-week Sun-style courses treated as the 24-week trial"],"nullBoundary":"Null or harm remains possible. Zero additionality or a non-fidelity course gives no finite price.","origin":{"factoredFrom":"data/san-francisco/selfhelp-falls-cea-v1.json","reproduces":"The SF $600 course cost is the rounded output of the derived courseCost formula ($584 at $60/hour, 15 participants, $200 support). With courseCost fixed at $600 and all other p50 inputs, reproduces the SF central $2,400,000 per 10 QALYs; the unrounded formula gives $2,336,000. Change: the SF scenarios varied courseCost $300 to $1,200 as one judgment, which the template splits into wage, class size and support lookups."}}]}