Resources Repository
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ArticlePublication 2014HIV Cure Strategies: How Good Must They be to Improve on ART?
This article uses a microsimulation model to explore under what circumstances three HIV cure strategies …
This article uses a microsimulation model to explore under what circumstances three HIV cure strategies (gene therapy, chemotherapy and stem cell transplantation (SCT)) would improve efficacy, toxicity, cost and quality of life outcomes compared to current antiretroviral therapy (ART). Assuming a cost-effectiveness threshold of $100,000 per QALY, results show that gene therapy was cost-effective compared to ART with an efficacy of 10%, relapse rate of 0.5%/month, and cost of $54,000. Chemotherapy was cost-effective with an…
Microsimulation | North America | Infectious Diseases | Cost-Effectiveness Analysis | Health/Medicine -
BookPublication 2014Decision Making in Health and Medicine: Integrating Evidence and Values
Decision making in health care involves consideration of a complex set of diagnostic, therapeutic and …
Decision making in health care involves consideration of a complex set of diagnostic, therapeutic and prognostic uncertainties. Medical therapies have side effects, surgical interventions may lead to complications, and diagnostic tests can produce misleading results. Furthermore, patient values and service costs must be considered. Decisions in clinical and health policy require careful weighing of risks and benefits and are commonly a trade-off of competing objectives: maximizing quality of life vs maximizing life expectancy vs minimizing…
Test Performance | North America | Health Systems | Probability/Bayes | Preferences/Values | Costing Methods | Health Outcomes | Value of Information | Mathematical Models | Decision Analysis | Cost-Effectiveness Analysis | Economics/Finance | Government/Law | Health/Medicine | Global | Europe | Graduate | Doctoral | Professional | Critical Thinking/Analysis | Decision Making/Leadership | Quantitative Literacy -
ArticlePublication 2011Model-Based Analyses to Compare Health and Economic Outcomes of Cancer Control: Inclusion of Disparities
In order to identify strategies that improve both population health and ensure its equitable distribution, …
In order to identify strategies that improve both population health and ensure its equitable distribution, the authors developed a typology of cancer disparities that considers types of inequalities among black, white, and Hispanic populations across different cancers. This paper reports on the typology using an existing disease simulation model of cervical cancer that was calibrated to clinical, epidemiological, and cost data in the United States and presents characteristics important for policy discussions. The typology proposed…
Priority Setting/Ethics | North America | Health Systems | State-Transition | Cost-Effectiveness Analysis | Chronic Disease/Risk | Social Determinants | Clinical Care | Culture/Society | Health/Medicine | Science/Technology -
ArticlePublication 2010Empirically Evaluating Decision-Analytic Models
To augment model credibility, evaluation via comparison to independent, empirical studies is recommended. The authors …
To augment model credibility, evaluation via comparison to independent, empirical studies is recommended. The authors developed a structured reporting format for model evaluation and conducted a structured literature review to characterize current model evaluation recommendations and practices. As an illustration, they applied the reporting format to evaluate a microsimulation of human papillomavirus and cervical cancer. The model's outputs and uncertainty ranges were compared with multiple outcomes from a study of long-term progression from high-grade precancer…
Microsimulation | North America | Infectious Diseases | Calibration/Validation | Chronic Disease/Risk | Health/Medicine -
ArticlePublication 2009Cost-Effectiveness of HPV Vaccination and Cervical Cancer Screening in Women Aged 30+ Years in the U.S.
The objective of the study was to assess the health and economic outcomes of HPV …
The objective of the study was to assess the health and economic outcomes of HPV vaccination in older U.S. women. The authors conducted a cost-effectiveness analysis with an empirically calibrated model using data from published literature; interventions included HPV vaccination added to screening strategies that differ by test (cytology or HPV DNA testing), frequency, and start age versus screening alone.They found that in the context of annual or biennial screening, HPV vaccination of women aged…
Microsimulation | North America | Infectious Diseases | Cost-Effectiveness Analysis | Chronic Disease/Risk | Clinical Care | Economics/Finance | Health/Medicine | Science/Technology -
ArticlePublication 2009Cost Effectiveness Analysis of Including Boys in a HPV Vaccination Program in the U.S.
This article reports on a societal-perspective cost effectiveness analysis of including preadolescent boys in a …
This article reports on a societal-perspective cost effectiveness analysis of including preadolescent boys in a routine human papillomavirus (HPV) vaccination program for preadolescent girls. The analysis included girls and boys aged 12 years; interventions included HPV vaccination of girls alone and of girls and boys in the context of screening for cervical cancer. The authors found that with 75% vaccination coverage and an assumption of complete, lifelong vaccine efficacy, routine HPV vaccination of 12-year-old girls…
Microsimulation | North America | Infectious Diseases | Dynamic Transmission | Calibration/Validation | Cost-Effectiveness Analysis | Chronic Disease/Risk | Clinical Care | Economics/Finance | Health/Medicine -
ArticlePublication 2007Modeling HPV and Cervical Cancer in the U.S. for Analyses of Screening and Vaccination
This paper discusses a model of human papillomavirus (HPV) and cervical cancer that incorporates uncertainty …
This paper discusses a model of human papillomavirus (HPV) and cervical cancer that incorporates uncertainty about the natural history of disease that was used to provide quantitative insight into U.S. policy choices for cervical cancer prevention. The authors developed a stochastic microsimulation of cervical cancer that distinguishes different HPV types by their incidence, clearance, persistence, and progression. For each set of sampled input parameters, likelihood-based goodness-of-fit (GOF) scores were computed based on comparisons between model-predicted…
Microsimulation | North America | Infectious Diseases | Calibration/Validation | Chronic Disease/Risk | Clinical Care | Health/Medicine | Science/Technology -
ReviewPublication 2001Modeling for Health Care and Other Policy Decisions: Uses, Roles and Validity
This is a review article of the role of modeling approaches to guide decision making …
This is a review article of the role of modeling approaches to guide decision making in health care and other domains. The role of models to support recommendations on the cost-effective use of medical technologies and pharmaceuticals is controversial. At the heart of the controversy is the degree to which experimental or other empirical evidence should be required prior to model use. The authors argue that the controversy stems in part from a misconception that…
Priority Setting/Ethics | North America | Health Systems | Evidence Synthesis | Mathematical Models | Technology Assessment | Environmental Health | Policy/Regulation | Business/Industry | Climate/Environment | Economics/Finance | Energy/Engineering | Government/Law | Health/Medicine -
BookPublication 1996Cost-Effectiveness in Health and Medicine, 1st Edition
In 1993, the US Public Health Service convened a panel of 13 nongovernment scientists and …
In 1993, the US Public Health Service convened a panel of 13 nongovernment scientists and scholars with expertise in economics, clinical medicine, ethics, and statistics to review the state of cost-effectiveness analysis and to develop recommendations for its conduct and use in health and medicine. Publishing their results in 1996, they proposed the most explicit set of guidelines (together with their rationale) ever defined on the conduct of CEAs. The panel recommended analysts include a "reference-case"…
Priority Setting/Ethics | North America | Health Systems | Preferences/Values | Costing Methods | Health Outcomes | Evidence Synthesis | Value of Information | Cost-Effectiveness Analysis | Policy/Regulation | Economics/Finance | Health/Medicine