Evidence map›Paper›PMID 42310733›Full record

ArticleBMC medicine2026

Diagrams-to-Dynamics (D2D): Exploring causal loop diagram leverage points under uncertainty.

Jeroen F Uleman, Loes Crielaard, Leonie K Elsenburg, Guido A Veldhuis, Naja Hulvej Rod, Rick Quax, Vítor V Vasconcelos

Abstract read
In one paragraph

Article in BMC medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Jeroen F UlemanCopenhagen Health Complexity Center, University of Copenhagen, Copenhagen, Denmark. jeroen.uleman@sund.ku.dk.
Loes CrielaardDepartment of Public and Occupational Health, Amsterdam UMC University of Amsterdam, Amsterdam, The Netherlands.
Leonie K ElsenburgCopenhagen Health Complexity Center, University of Copenhagen, Copenhagen, Denmark.
Guido A VeldhuisTNO - The Netherlands Organization for Applied Scientific Research, The Hague, the Netherlands.
Naja Hulvej RodCopenhagen Health Complexity Center, University of Copenhagen, Copenhagen, Denmark.
Rick QuaxComputational Science Lab, Informatics Institute, University of Amsterdam, Amsterdam, The Netherlands.
Vítor V VasconcelosComputational Science Lab, Informatics Institute, University of Amsterdam, Amsterdam, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCausal loop diagrams (CLDs) are widely used in health and environmental research to represent hypothesized causal structures underlying complex problems. However, as qualitative and static representations, CLDs are limited in their ability to support dynamic analysis and inform intervention strategies. We propose Diagrams-to-Dynamics (D2D), a method for converting CLDs into exploratory system dynamics models in the absence of empirical data. With minimal user input-following a protocol to label variables as stocks, flows or auxiliaries, and constants-D2D utilizes the structural information already encoded in CLDs, namely the existence and polarity of causal connections, to simulate hypothetical interventions and explore potentially influential places to intervene, known as 'leverage points,' under uncertainty.

resultsD2D helps distinguish between high- and low-ranked leverage points. We compare D2D to a calibrated system dynamics model constructed from the same CLD and variable labels. D2D showed greater consistency with the calibrated model than did static network centrality analysis, while also providing uncertainty estimates and guidance for future data collection.

conclusionsThe D2D method is implemented in a Python package and a web-based application to support further testing and to lower the barrier to dynamic modeling for researchers working with CLDs. Future studies could help establish the approach's utility across a broad range of cases and domains.

Indexed as

Models, TheoreticalHumansUncertaintyAnalysisCausal loop diagramNetworkPackagePythonQuantificationSystem dynamics

Identifiers

PMID42310733
PMCPMC13471294

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.