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

Open Access
Authors
  • Jeroen F. Uleman
  • Loes Crielaard
  • Leonie K. Elsenburg
  • Guido A. Veldhuis
Publication date 18 June 2026
Journal BMC Medicine
Article number 443
Volume | Issue number 24
Number of pages 14
Organisations
  • Faculty of Science (FNWI) - Informatics Institute (IVI)
  • Interfacultary Research - Institute for Advanced Study (IAS)
Abstract
Background: Causal 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.
Results: D2D 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.
Conclusions: The 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.
Document type Article
Language English
Published at
https://doi.org/10.1186/s12916-026-04971-0 (Final published version)
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Diagrams-to-Dynamics (D2D) (Final published version)
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