Resources Repository
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BookPublication 1980Clinical Decision Analysis
This text was conceived and developed in the Harvard T.H. Chan School of Public Health …
This text was conceived and developed in the Harvard T.H. Chan School of Public Health at the Center for the Analysis of Health Practices. The book had its origins in a set of classroom materials developed during the academic year 1974-75 for an elective course in medical decision making at the Harvard Medical School. In this book students are shown how to structure clinical decision problems, how to systematically formulate the intertwining roles of diagnosis and treatment, how to…
Probability/Bayes | Test Performance | Child/Nutrition | Infectious Diseases | Preferences/Values | Costing Methods | Health Outcomes | Value of Information | State-Transition | Decision Analysis | Cost-Effectiveness Analysis | Chronic Disease/Risk | Economics/Finance | Health/Medicine | Global | North America | Europe | Graduate | Doctoral | Critical Thinking/Analysis | Decision Making/Leadership | Quantitative Literacy -
ArticlePublication 2020Testing for SARS-CoV-2 Antibodies
Antibody testing can determine previous exposure to SARS-CoV-2 virus. Recently, the UK government has made …
Antibody testing can determine previous exposure to SARS-CoV-2 virus. Recently, the UK government has made antibody testing available to anyone wanting it, even if there is no clinical indication. The purpose of this article is to provide guidance for when to consider antibody testing in individuals with and without symptoms suggestive of current or past SARS-CoV-2 infection. Key points made by the authors include: (1) antibody testing is likely to be most useful 2 weeks…
Probability/Bayes | Test Performance | Infectious Diseases | Technology Assessment | Clinical Care | Health/Medicine -
EditorialPublication 2020Waiting for Certainty on COVID-19 Antibody Tests — At What Cost?
This perspective anticipates the availability of serologic antibody testing and considers its potential usefulness in mitigation …
This perspective anticipates the availability of serologic antibody testing and considers its potential usefulness in mitigation policy to reduce COVID-19 transmission. For example: Could we screen for serologic antibodies as a proxy for possible immunity and identify people who could return to the workplace with less severe mitigation measures? The authors acknowledge the uncertainties raised by many policy actors, including the WHO, such as, "Do antibodies confer immunity and, if so, for how long? How accurate is…
Probability/Bayes | Test Performance | Infectious Diseases | Technology Assessment | Health Systems | Policy/Regulation | Government/Law | Health/Medicine | Global | North America -
ArticlePublication 2020Bayes' Theorem, COVID-19, and Screening Tests
This article reviews the implications of increased testing for COVID-19 using reverse transcriptase polymerase chain …
This article reviews the implications of increased testing for COVID-19 using reverse transcriptase polymerase chain reaction (rRT-PCR) through the application of Bayes’ Theorem for three hypothetical, stylized case scenarios. The scenarios involve three patients with a low, moderate, and high pre-test probability of COVID-19 infection. The category of low probability would include "asymptomatic individuals in a presumed low prevalence environment" and might vary from 10 to 20%. The category of moderate probability would include "individuals…
Probability/Bayes | Test Performance | Infectious Diseases | Clinical Care | Health/Medicine -
ArticlePublication 2020Interpreting COVID-19 Test Results: A Bayesian Approach
This article considers the following question with respect to interpreting the results of polymerase chain reaction …
This article considers the following question with respect to interpreting the results of polymerase chain reaction (PCR) assays from nasal and pharyngeal swabs for COVID-19 to inform clinical decision making: "While a positive result in an acutely ill patient is straightforward, how should physicians interpret negative tests in patients with suspected COVID-19 infection?" Using an assumption of near-perfect specificity of PCR assays for COVID-19, the authors acknowledge the uncertainty of test sensitivity. They consider two clinical scenarios…
Probability/Bayes | Test Performance | Infectious Diseases | Health/Medicine | Science/Technology | Global -
Teaching PackPublication, Teaching Resource 2022Teaching Pack: Using Test Information I
In this teaching pack on Using Test Information I, students review the performance of a …
In this teaching pack on Using Test Information I, students review the performance of a dichotomous test and the relationship between sensitivity and specificity, calculate likelihood ratios to describe test performance, and conduct probability revision using the odds-LR form of Bayes. Materials include an instructor's note, videos, companion slides, a glossary, an annotated bibliography, and sample exercises. Learning Objectives Calculate four conditional probabilities describing the performance of a dichotomous test, and explain the…
Probability/Bayes | Test Performance | Child/Nutrition | Decision Analysis | Health/Medicine | College | Graduate | Doctoral | Professional | Critical Thinking/Analysis | Graphics/Visualization | Quantitative Literacy -
ArticlePublication 2013Validation and Calibration of a Simulation Model of Pediatric HIV Infection
The authors developed a microsimulation model of pediatric HIV disease progression using the Cost-Effectiveness of …
The authors developed a microsimulation model of pediatric HIV disease progression using the Cost-Effectiveness of Preventing AIDS Complications (CEPAC) model framework. This CEPAC-Pediatric model was then validated by varying CD4 data and comparing the corresponding model-generated survival curves to empirical survival curves obtained from the International Epidemiologic Database to Evaluate AIDS (IeDEA). The model was calibrated to other African countries by systematically varying immunologic and HIV mortality-related input parameters. In the calibration analyses, the model-generated…
Calibration/Validation | Child/Nutrition | Infectious Diseases | Microsimulation | Health/Medicine | Sub-Saharan Africa -
ArticlePublication 2009Cost-Effectiveness of Rotavirus Vaccination in Vietnam
This article reports on a cost-effectiveness analysis of rotavirus vaccination, including varying degrees of severity, …
This article reports on a cost-effectiveness analysis of rotavirus vaccination, including varying degrees of severity, age-dependency of clinical manifestation, and additional features of the disease (e.g., the possibility of reinfection and varying degrees of partial immunity conferred by natural infection). The authors developed a Markov model that reflects key features of rotavirus infection, using the most recent data available at the time of their analysis. They applied the model to the 2004 Vietnamese birth cohort…
Calibration/Validation | Child/Nutrition | Infectious Diseases | Mathematical Models | Cost-Effectiveness Analysis | Health Systems | Health/Medicine | Asia & Pacific -
ArticlePublication 2008Cost-Effectiveness of Rapid Point-of-Care Prenatal Syphilis Screening in Sub-Saharan Africa
This paper investigates the cost-effectiveness of using rapid point-of-care tests for prenatal syphilis screening among …
This paper investigates the cost-effectiveness of using rapid point-of-care tests for prenatal syphilis screening among pregnant women in sub-Saharan Africa, a region with syphilis prevalence rates as high as 17%, and where traditional multi-test screening methods have been challenging to implement. Focusing on newly available rapid point-of-care screening tests, strategies differed by the initial test [rapid plasma reagin (RPR), immunochromographic strip (ICS)], need for confirmation with Treponema pallidum hemagglutination assay, and number of visits required.…
Test Performance | Infectious Diseases | Costing Methods | Mathematical Models | Cost-Effectiveness Analysis | Technology Assessment | Maternal/Reproductive Health | Clinical Care | Health/Medicine | Sub-Saharan Africa