Resources Repository
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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…
Calibration/Validation | North America | Clinical Care | Infectious Diseases | Microsimulation | Chronic Disease/Risk | Health/Medicine | Science/Technology -
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…
Test Performance | Cost-Effectiveness Analysis | North America | Infectious Diseases | Probability/Bayes | Preferences/Values | Costing Methods | Health Outcomes | Value of Information | State-Transition | Decision Analysis | Child/Nutrition | Chronic Disease/Risk | Economics/Finance | Health/Medicine | Global | Europe | Graduate | Doctoral | Critical Thinking/Analysis | Decision Making/Leadership | Quantitative Literacy -
ArticlePublication 2023Cost-Effectiveness of Pharmacist Prescribing for Managing Hypertension
This study estimates the cost-effectiveness of implementing a pharmacist-prescribing intervention to improve blood pressure control …
This study estimates the cost-effectiveness of implementing a pharmacist-prescribing intervention to improve blood pressure control in the US. A cost-effectiveness analysis was conducted using a Markov model based on the pharmacist-prescribing intervention used in The Alberta Clinical Trial in Optimizing Hypertension (or RxACTION). Outcomes included cardiovascular (CV) events, end-stage kidney disease events, life years, quality-adjusted life years (QALYs), lifetime costs, and lifetime incremental cost-effectiveness ratio (ICER). Costs were based on reimbursement rates, published literature, national…
Cost-Effectiveness Analysis | North America | Clinical Care | Mathematical Models | State-Transition | Chronic Disease/Risk | Health/Medicine -
ArticlePublication 2023Cost-Effectiveness of Intensive vs. Standard Blood Pressure Control Among Older Patients
This economic analysis explored the cost-effectiveness of intensive vs standard blood pressure control in older …
This economic analysis explored the cost-effectiveness of intensive vs standard blood pressure control in older hypertensive patients between 60 and 80 years in China, the US, and the UK. Treatment outcome data from the Trial of Intensive Blood-Pressure Control in Older Patients with Hypertension (STEP trial) and different cardiovascular risk assessment models for a hypothetical cohort of STEP-eligible patients were used. Costs and utilities were obtained from published sources. A Markov model was used to…
Cost-Effectiveness Analysis | North America | Clinical Care | Mathematical Models | Chronic Disease/Risk -
ArticlePublication 2022Modeling the Effectiveness of Healthcare Personnel Reactive Testing and Screening for the SARS-Cov-2 Omicron Variant within Nursing Homes
The Omicron variant of SARS-CoV-2 has been hypothesized to exhibit faster clearance (time from peak …
The Omicron variant of SARS-CoV-2 has been hypothesized to exhibit faster clearance (time from peak viral concentration to clearance of acute infection), may be less detectable by antigen tests (decreased sensitivity), and may be more likely to evade immunity conferred by past infection or vaccination) compared to prior variants. This calls for a reassessment of strategies to prevent its spread, especially in vulnerable settings like nursing homes. Using a model that tracks viral shedding patterns,…
Test Performance | North America | Infectious Diseases | Mathematical Models | Health/Medicine -
ArticlePublication 2022Cost-Effectiveness of Masked Hypertension Screening and Treatment
The study assessed the health and economic outcomes of screening and treating masked hypertension in …
The study assessed the health and economic outcomes of screening and treating masked hypertension in U.S. adults using the Cardiovascular Disease (CVD) Policy Model, a microsimulation model. The model simulated 100,000 adults suspected of having masked hypertension (office blood pressure [BP] of 120–129/<80 mm Hg, not on antihypertensive medications, and without a history of CVD). Interventions included: usual care alone, usual care with ambulatory BP monitoring (ABPM), and usual care with home BP monitoring (HBPM).…
Cost-Effectiveness Analysis | North America | Clinical Care | Microsimulation | Chronic Disease/Risk | Health/Medicine -
ArticlePublication 2022Early HPV Natural History Transitions
Microsimulation models used to evaluate the cost-effectiveness of novel cervical cancer screening technologies rely on …
Microsimulation models used to evaluate the cost-effectiveness of novel cervical cancer screening technologies rely on accurate transition risks for human papillomavirus (HPV) infection, persistence (or absence of HPV clearance), progression to precancerous lesions, and invasion. To inform the refinement of such models, we compared the early natural history of HPV types using prospective data from immunocompetent women in the Guanacaste Natural History Study, the ASCUS-LSIL Triage Study, and the Costa Rica HPV Vaccine Trial. We…
Cost-Effectiveness Analysis | North America | Infectious Diseases | Mathematical Models | Microsimulation | Latin America & Caribbean -
ReviewPublication 2022Systematic Review of Economic Evaluations of COVID-19 Interventions: Non-Health Impacts and Distributional Issues
The authors conducted a systematic review of economic evaluations of COVID-19 interventions and assessed whether …
The authors conducted a systematic review of economic evaluations of COVID-19 interventions and assessed whether they incorporated non-health impacts and distributional concerns. Among the 70 articles included, more than half (56%) included at least one non-health impact, although only 21% incorporated non-economic consequences. Only 17% examined subgroups of interest. The median ICER for the entire sample was $67,000/quality-adjusted life-year (QALY) (interquartile range [IQR] $9000-$893,000/QALY). Interventions including a pharmaceutical component yielded a median ICER of $93,000/QALY (IQR…
Cost-Effectiveness Analysis | North America | Infectious Diseases | Evidence Synthesis | Social Determinants | Culture/Society | Economics/Finance | Health/Medicine -
ArticlePublication 2021Cost-Effectiveness of Hypertension Treatment by Pharmacists in Black Barbershops
The Los Angeles Barbershop Blood Pressure Study (LABBPS) examined the effectiveness and cost of a …
The Los Angeles Barbershop Blood Pressure Study (LABBPS) examined the effectiveness and cost of a one-year pharmacist-led hypertension care intervention in Black-owned barbershops in Los Angeles County, focused on non-Hispanic Black men with uncontrolled hypertension. Using a discrete event simulation, the researchers projected the 10-year health outcomes and health care costs associated with the intervention compared to a control group. The costs and quality-adjusted life-years (QALYs) were calculated from a health care sector perspective, with…
Cost-Effectiveness Analysis | North America | Clinical Care | Mathematical Models | Chronic Disease/Risk | Health/Medicine