Why Simulation Reports Need More Than a Prediction
A statement such as “the simulated concentration was adequate” leaves essential questions unanswered: adequate for which outcome, at what time, in which population, and under what parameter assumptions? A useful report lets readers trace a prediction back to the objective, model, inputs, and simulation procedure that produced it. It also distinguishes uncertainty in the model-based result from variability among simulated individuals and from the numerical error of using a finite number of simulations.
This tutorial concerns how to report those elements, not how to establish that a model is true. A simulated prediction is conditional on the model and inputs used. Reporting the conditions makes the result interpretable and reproducible; it does not turn the prediction into an observation or remove the assumptions behind it.
Specify the Question and the Simulation Inputs
State the objective as a question that can be answered by the simulation. Name the population or simulated unit, the intervention or regimen, the time horizon, the outcome, and any threshold used to classify an outcome. “Compare predicted trough concentration at steady state for two regimens in adults with the stated covariate distribution” is more informative than “simulate exposure.”
Parameter reporting should make clear which values are fixed, which vary between simulated individuals, and which are varied to represent parameter uncertainty. Give sources and scales: for example, a clearance estimate from the fitted model in L/h, a between-subject variability estimate on the log scale, or a parameter distribution obtained from a stated uncertainty procedure. If values come from different sources, identify each source rather than presenting the input set as if it were a single observed data set.
A scenario is a complete, interpretable set of simulation conditions. List the regimen, relevant covariates or population characteristics, model structure, and other inputs that differ across scenarios. State what remains the same. That distinction matters: if two scenarios differ in dose and renal function, a difference in predictions cannot be attributed to dose alone.
Name the population, regimen or intervention, endpoint, time point, and any decision threshold.
Give the model, parameter values or distributions, units, sources, and which quantities are fixed or sampled.
Specify each scenario and identify exactly which inputs change between them.
State the number of simulations, summaries, uncertainty represented, and checks relevant to interpreting the output.
Worked Example: A Conditional Concentration Prediction
Suppose a hypothetical report evaluates concentration 6 hours after a single 100 mg intravenous bolus. For illustration, use a one-compartment model with first-order elimination and fixed clearance \(CL=5.00\ \mathrm{L/h}\) and volume \(V=50.0\ \mathrm{L}\). The objective is to predict concentration at that time for this specified parameter set.
The model assumes instantaneous delivery into the compartment, constant volume, and elimination at rate \(CL/V\). Under these assumptions, the concentration after an intravenous bolus is:
Substitute dose \(100\ \mathrm{mg}\), volume \(50.0\ \mathrm{L}\), clearance \(5.00\ \mathrm{L/h}\), and time \(6.00\ \mathrm{h}\):
A transparent report would call this a conditional prediction for the stated parameter set, not a population prediction or an observed concentration. It would name the model, units, time point, and fixed parameter values. The assumptions used in the calculation are explicit: this example does not include absorption, between-subject variability, residual error, or parameter uncertainty.
State Which Uncertainty the Simulation Represents
“Uncertainty” can refer to different quantities, so state what was varied and what a reported interval summarizes. A conditional prediction holds the model and parameters fixed. A population predictive distribution may represent between-subject variability and, if specified, residual variability. Parameter uncertainty represents uncertainty in estimated model parameters, commonly by drawing parameter sets from a stated distribution or procedure. These components can be included together, but their inclusion should not be assumed from the word “simulation.”
A separate issue is Monte Carlo error: finite simulation runs approximate the result implied by the simulation mechanism. For a target-attainment proportion, this numerical error can be quantified from the number of simulated outcomes. That interval describes precision of the Monte Carlo estimate under the specified simulation mechanism; it is not automatically an interval for the true clinical target-attainment probability, nor does it incorporate omitted model uncertainty.
For a proportion, the Monte Carlo calculation follows from the simulated indicators. Let \(I_j=1\) if simulation \(j\) meets the target and \(I_j=0\) otherwise. If the \(M\) simulations are independent draws under the same specified mechanism, then each indicator has modeled success probability \(q\), and the estimated proportion is \(\hat{q}=\sum_{j=1}^M I_j/M\). Since a Bernoulli indicator has variance \(q(1-q)\), independence gives:
This standard error estimates Monte Carlo error for the simulated proportion. A Wilson interval is often preferable to a simple normal interval, especially when proportions are near zero or one or the number of simulations is modest. For a 95% Wilson interval, use \(z=1.96\), \(M\) simulations, and the observed proportion \(\hat{q}\):
The independent, identically distributed indicator assumption is important for this calculation. If simulations are weighted, clustered, or dependent, this binomial standard error and interval may not be appropriate without adapting the calculation to the simulation design.
Worked Example: Target Attainment and Monte Carlo Error
In a hypothetical simulation of \(M=200\) independent individuals, 146 meet a prespecified concentration target. The objective is to estimate the target-attainment proportion under the stated model and simulation inputs.
The estimated proportion is \(\hat{q}=146/200=0.730\), or 73.0%. Its estimated Monte Carlo standard error is:
For the 95% Wilson interval, the denominator is \(1+1.96^2/200=1.0192\). The center is \((0.730+1.96^2/(2\times200))/1.0192=0.7257\), and the half-width is \(0.0611\). The resulting interval is approximately 0.665 to 0.787.
A suitable interpretation is: under this simulation mechanism, the estimated target-attainment proportion is 73.0%, with a 95% Wilson interval of approximately 66.5% to 78.7% describing Monte Carlo uncertainty in that estimate. The interval does not, by itself, account for uncertainty in the model structure or parameters. The report should also define the target, the simulated population, the source of any parameter distributions, and whether variability was included.
Compare Scenarios Without Hiding Their Differences
A scenario comparison is informative when the reader can see both the inputs and the outputs. Use a table or parallel prose to show the common assumptions, the inputs that differ, and the same outcome summary for each scenario. Report differences in the outcome’s natural units: for proportions, percentage points; for concentrations, the concentration unit; for time-to-event predictions, a time unit.
When comparing scenarios, using the same simulated individuals or parameter draws can make the comparison more focused. This is often called a paired or common-random-number approach: each simulated unit is evaluated under both scenarios, so the contrast is based on within-unit differences. If scenarios are simulated independently, say so. Marginal scenario proportions alone do not reveal the uncertainty of a paired difference; that calculation requires the paired outcomes or their differences.
Worked Example: Reporting a Two-Regimen Comparison
A hypothetical report compares two regimens using the same specified simulated population of 1,000 individuals and the same target definition. Assume the simulation output is 730 target-attaining individuals for regimen A and 820 for regimen B. All model assumptions and the population distribution are held fixed; only the regimen differs.
For regimen A, the simulated proportion is \(730/1{,}000=0.730\), or 73.0%. For regimen B, it is \(820/1{,}000=0.820\), or 82.0%. The absolute difference is \(0.820-0.730=0.090\), which is 9.0 percentage points in favor of regimen B in this simulation.
| Scenario | Target attained | Simulated proportion |
|---|---|---|
| Regimen A | 730 of 1,000 | 73.0% |
| Regimen B | 820 of 1,000 | 82.0% |
| Regimen B minus A | 90 additional of 1,000 | 9.0 percentage points |
The conclusion is limited to the stated simulation: regimen B has a 9.0-percentage-point higher simulated target-attainment proportion under these inputs. The marginal counts do not show how many individuals changed from failing to meeting the target, or the Monte Carlo uncertainty of the paired difference. To report that paired contrast’s uncertainty, the report would need to retain and analyze the paired outcomes or individual-level differences.
Reproducibility, Diagnostics, and Common Reporting Failures
A reader should be able to identify enough detail to reproduce the simulation or understand why exact reproduction is unavailable. Report the software and relevant version, simulation code or algorithm, number of replicates, random-number seed when applicable, parameter inputs and sources, scenario definitions, and summaries calculated. A seed alone is not sufficient if the parameter inputs, code, or random-number implementation are missing.
Check both the model output and the simulation process. Confirm that units and time scales agree, generated values are plausible under the model, and calculated outcomes follow the stated endpoint definition. Look for unexpected missing or non-finite outputs, implausible parameter draws, and a target proportion that changes materially when the number of replicates increases. Where parameter uncertainty is sampled, inspect whether draws obey the specified parameterization and constraints. If a simulation fails or requires an unplanned change, report the deviation and its effect on the result rather than silently replacing the planned procedure.
A useful comparison is between a single deterministic prediction and a simulation distribution. The deterministic result is simpler and can isolate how a specified input set maps through the model, as in the concentration calculation above. It does not describe a distribution across individuals or parameter values. Simulation can represent those distributions, but only when the relevant variation is explicitly encoded and adequately summarized. Neither approach removes dependence on the model assumptions.
- Pitfall: “The 95% interval means there is a 95% probability the true clinical rate is in this range.” If the interval is a Wilson interval from simulated indicators, it describes Monte Carlo uncertainty for the modeled proportion under the simulation mechanism. It does not automatically quantify clinical sampling uncertainty or all model uncertainty.
- Pitfall: “The higher simulated proportion proves the regimen is better.” The comparison establishes a difference between model-based predictions under specified inputs. It does not establish a causal or clinical conclusion beyond those assumptions.
- Pitfall: “We varied all important parameters.” This is not reproducible unless the report names the parameters, their sources and distributions, and how they were sampled.
- Pitfall: reporting only a mean prediction. A mean can conceal the spread, tail behavior, or fraction crossing a decision threshold. Choose summaries that answer the stated objective and report their units.
Check Your Understanding
Answer each question, then compare your reasoning with the solutions below.
- A report gives a median predicted concentration of 1.4 mg/L but no time point. Name two other details needed to make the objective interpretable.
- In 500 independent simulations, 350 outcomes meet the target. What is the simulated proportion, and what uncertainty does a binomial interval around it describe?
- A report samples between-subject variability but holds estimated fixed effects constant. Has it represented parameter uncertainty? Explain.
- Two scenarios have simulated target proportions of 62% and 70%. What is their absolute difference in percentage points, and what additional information is needed to estimate uncertainty for a paired difference?
- Why is a random-number seed alone insufficient to reproduce a simulation?
Solutions. (1) State at least the simulated population and the time point; also specify the regimen, endpoint definition, and model inputs as appropriate. (2) The proportion is \(350/500=0.700\), or 70.0%. A binomial interval describes Monte Carlo uncertainty for the modeled proportion under the specified simulation mechanism, not all model or clinical uncertainty. (3) No. The simulation represents between-subject variability, but fixed-effect parameter uncertainty is not represented if those estimates are held constant. (4) The difference is \(70\%-62\%=8\) percentage points. For a paired uncertainty calculation, retain the paired outcomes or individual-level differences; marginal proportions alone are insufficient. (5) Reproduction also requires the model and parameter inputs, scenario definitions, simulation code or algorithm, and relevant software details.