{
  "modelVersion": "0.1",
  "preparedOn": "2026-10-18",
  "budgetUSD": 100,
  "estimateType": "Exploratory program-cost scenario; gross physical pain relief",
  "currency": "USD",
  "currencyYear": 2026,
  "currencyBasis": "Nominal WSI planning assumptions chosen in October 2026. No verified current provider quote or inflation conversion.",
  "population": "Adults with inadequately controlled moderate or severe cancer pain receiving additional clinically supervised palliative care in Uganda. Not all hospice patients.",
  "counterfactual": "Pain that would be experienced with care otherwise available during the same funded week. The assumed reduction is additional to that care, not a before-and-after trial difference.",
  "referenceIntensityHours": 47.25,
  "intensityExponent": 1,
  "daysPerFundedWeek": 7,
  "reportedEvidence": {
    "source": "H1",
    "reviewStudies": 62,
    "reviewParticipants": 4241,
    "participantsWithNoWorseThanMildPain": 362,
    "participantsWithThatOutcomeReported": 377,
    "useInModel": "Supports potential for cancer-pain relief only. The 362/377 proportion is not multiplied into the model: it is not an additional effect versus no comparable care."
  },
  "choices": {
    "cost": "40 USD per patient-week is a provisional WSI allowance for medicines, clinical assessment, follow-up, transport and administration. It is not a price quoted by Hospice Africa Uganda. Alternatives of 20 and 80 USD test halving and doubling this unknown; household costs and patient time excluded.",
    "intensityReduction": "1 point on the WSI 0–10 scale, averaged across all 168 hours and all funded eligible patient-weeks, relative to otherwise available care. Includes milder periods, sleep, interruptions, nonresponse and shortened exposure. Hours after death contribute zero. Not a validated mapping from clinical pain scores.",
    "duration": "Credit one seven-day budget window only. Fractional patient-weeks are accounting equivalents, not a recommendation to stop care after a week. Repeated weeks need new funding and evidence that the assumed relief continues.",
    "additionality": "Program budget must enable additional care. No extra success, adherence or mortality factor is multiplied into the already averaged intensity reduction. No claim about marginal unrestricted donations.",
    "harms": "Medication side effects and treatment burdens remain unestimated. This is gross pain relief, not complete net benefit."
  },
  "scenarios": {
    "lower": {
      "label": "Lower",
      "costPerPatientWeekUSD": 80,
      "averageIntensityReduction": 0.5,
      "outputsPer100USD": {
        "patientWeekEquivalents": 1.25,
        "fundedPatientDayEquivalents": 8.75,
        "grossUSUAverted": 2.2222222222222223,
        "deathsPrevented": null,
        "netUSU": null
      }
    },
    "central": {
      "label": "Central",
      "costPerPatientWeekUSD": 40,
      "averageIntensityReduction": 1,
      "outputsPer100USD": {
        "patientWeekEquivalents": 2.5,
        "fundedPatientDayEquivalents": 17.5,
        "grossUSUAverted": 8.88888888888889,
        "deathsPrevented": null,
        "netUSU": null
      }
    },
    "higher": {
      "label": "Higher",
      "costPerPatientWeekUSD": 20,
      "averageIntensityReduction": 2,
      "outputsPer100USD": {
        "patientWeekEquivalents": 5.0,
        "fundedPatientDayEquivalents": 35.0,
        "grossUSUAverted": 35.55555555555556,
        "deathsPrevented": null,
        "netUSU": null
      }
    },
    "no_effect": {
      "label": "No additional relief",
      "costPerPatientWeekUSD": 40,
      "averageIntensityReduction": 0,
      "outputsPer100USD": {
        "patientWeekEquivalents": 2.5,
        "fundedPatientDayEquivalents": 17.5,
        "grossUSUAverted": 0.0,
        "deathsPrevented": null,
        "netUSU": null
      }
    }
  },
  "deathsPrevented": null,
  "netUSU": null,
  "remainingFundingGapUSD": null,
  "unestimated": [
    "Other symptom relief",
    "Psychological and spiritual support",
    "Caregiver relief and bereavement",
    "Medication harms and treatment burden",
    "Household costs and patient time",
    "Relief beyond the funded week",
    "Deaths prevented"
  ],
  "sources": [
    {
      "id": "H1",
      "title": "Wiffen, Wee and Moore (2016): Oral morphine for cancer pain",
      "url": "https://www.cochrane.org/evidence/CD003868_oral-morphine-cancer-pain",
      "use": "Original Cochrane review: evidence of analgesia, study limitations and adverse effects. DOI: 10.1002/14651858.CD003868.pub4. Not a causal estimate of this Ugandan program or a USU calibration."
    },
    {
      "id": "H2",
      "title": "WHO (2020): Palliative care",
      "url": "https://www.who.int/news-room/fact-sheets/detail/palliative-care",
      "use": "Scope of palliative care and its place alongside other treatment. Reviewed 18 October 2026."
    },
    {
      "id": "H3",
      "title": "Hospice Africa Uganda: Holistic Palliative Care",
      "url": "https://hospice-africa.org/en/services/holistic-palliative-care",
      "use": "Provider description of clinical care, outreach and patient support. Reviewed 18 October 2026; does not establish our cost or intensity assumptions."
    },
    {
      "id": "H4",
      "title": "Logie and Harding (2005): Evaluation of Uganda’s morphine access program",
      "url": "https://link.springer.com/article/10.1186/1471-2458-5-82",
      "use": "Primary implementation study: prescribing, supply and follow-up barriers. Historical evidence, not a current price or outcome estimate."
    },
    {
      "id": "H5",
      "title": "Hospice Africa: official donation options",
      "url": "https://www.hospice-africa.org/en/donate",
      "use": "Official local and international support routes checked 18 October 2026. Allocation and remaining funding gap unverified."
    }
  ],
  "interpretation": "All quantitative cost and USU-effect inputs are WSI assumptions. Scenarios are not confidence intervals, guarantees or a ranking. No organization has endorsed this model. Pain relief does not imply cure or a death prevented."
}