American Journal of Operations Research, 2022, 12, 250-260
https://www.scirp.org/journal/ajor
ISSN Online: 2160-8849
ISSN Print: 2160-8830
DOI: 10.4236/ajor.2022.126014 Nov. 24, 2022 250 American Journal of Operations Research
Discrete Event Simulation to Evaluate Different
Treatments of Diabetic Retinopathy Disease
Salma Kanoun
1
, Badreddine Jerbi
2
, Hichem Kamoun
1
1
Laboratory of Modeling and Optimization for Decisional, Industrial and Logistic Systems, College of Economic Sciences and
Management, University of Sfax, Sfax, Tunisia
2
Higher Institute of Management, Gabes, Tunisia, Detached to Quassim University, College of Business and Economics,
Saudi Arabia
Abstract
Modeling approach using discrete event simulation has been proven to work
well in modeling in health care. The aim of our paper is to propose a simula-
tion approach which shows realistic models presenting different possible treat-
ments in different stages of diabetic retinopathy. We have presented three
models in order to choose the best treatment for diabetic retinopathy patients.
The first model describes the flow of a patient through stages without any
medical treatments. It takes 13 years to reach blindness. The second model
which includes the laser photocoagulation treatments leads to blindness after
46 years. Then, the third model illustrates the involvement of vitrectomy op-
eration and delays blindness by 23 years. To construct the models, data were
taken from experienced doctors and professors of the ophthalmology de-
partment in the University hospital Habib Bourguiba and the endocrinology
department in the University hospital Hedi Chaker in Sfax, Tunisia. Our ob-
jective is to delay reaching the blindness stage as late as possible. Three mod-
els were developed, verified and validated through many iterative implemen-
tations with ARENA simulation software.
Keywords
Diabetic Retinopathy, Modeling, Discrete Event Simulation, Health Care,
ARENA Simulation Software
1. Introduction
Diabetic Mellitus (DM) is defined by a state of chronic hyperglycemia which fol-
lows an abnormal secretion of insulin or insulin action or both associated anoma-
lies. This chronic disease is classified into two basic forms: Type I and Type II
How to cite this paper: Kanoun, S., Jerbi,
B. and Kamoun, H. (2022) Discrete Event
Simulation to Evaluate Different Treatments
of Diabetic Retinopathy Disease. American
Journal of Operations Research, 12, 250-260.
https://doi.org/10.4236/ajor.2022.126014
Received: May 7, 2022
Accepted: November 21, 2022
Published: November 24, 2022
Copyright © 2022 by author(s) and
Scientific Research Publishing Inc.
This work is licensed under the Creative
Commons Attribution International
License (CC BY 4.0).
http://creativecommons.org/licenses/by/4.0/
Open Access