Resources Repository
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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…
Test Performance | Health/Medicine | Science/Technology | Global | Infectious Diseases | Probability/Bayes -
ArticlePublication 2017Costing of National STI Program Implementation, 2016-2021
In 2016 the World Health Assembly adopted the Global Strategy on Sexually Transmitted Infections (STI) …
In 2016 the World Health Assembly adopted the Global Strategy on Sexually Transmitted Infections (STI) 2016–2021 aiming to reduce curable STIs by 90% by 2030. This analysis costed scaling-up priority interventions to achieve coverage targets. Strategy-targeted declines in Chlamydia trachomatis, Neisseria gonorrhoeae, Treponema pallidum and Trichomonas vaginalis were applied to WHO-estimated regional burdens at 2012 levels. Case management was costed for the curable STIs, symptomatic Herpes Simplex Virus 2 (HSV-2), and non-STI vaginal syndromes, with incrementally expanding diagnoses. Service…
Costing Methods | Health/Medicine | Global | Clinical Care | Infectious Diseases | Evidence Synthesis | Economics/Finance -
ArticlePublication 2017When Cost-Effective Interventions Are Unaffordable
Many health interventions deemed cost-effective are not affordable. Despite the importance of affordability to policymakers, …
Many health interventions deemed cost-effective are not affordable. Despite the importance of affordability to policymakers, little of the cost-effectiveness literature in global health addresses this issue. Budget impact analysis (BIA) describes an intervention's short-term costs and savings from the payer's perspective. This paper assesses the current use of budget impact analysis (BIA) and cost-effectiveness analysis (CEA) in health economic assessments conducted for low- and middle-income countries (LMICs). The authors recommend steps researchers and policymakers can…
Costing Methods | Health/Medicine | Science/Technology | Global | Infectious Diseases | Priority Setting/Ethics | Cost-Effectiveness Analysis | Chronic Disease/Risk | Health Systems | Economics/Finance | Government/Law -
ArticlePublication 2016Estimating the Cost-Effectiveness of Implementation: Is Sufficient Evidence Available?
Timely implementation of recommended interventions can provide health benefits to patients and cost savings to …
Timely implementation of recommended interventions can provide health benefits to patients and cost savings to the health service provider. Effective approaches to increase the implementation of guidance are needed. Since investment in activities that improve implementation competes for funding against other health generating interventions, it should be assessed in term of its costs and benefits. In 2010, the National Institute for Health and Care Excellence released a clinical guideline recommending natriuretic peptide (NP) testing in…
Operations Research | Health Outcomes | Health/Medicine | Europe | Clinical Care | Cost-Effectiveness Analysis | Chronic Disease/Risk | Health Systems | Economics/Finance -
ArticlePublication 2023Simulation-Based Comparative Effectiveness Analysis of Policies to Improve Global Maternal Health Outcomes
The Sustainable Development Goals include a target to reduce the global maternal mortality ratio (MMR) …
The Sustainable Development Goals include a target to reduce the global maternal mortality ratio (MMR) to less than 70 maternal deaths per 100,000 live births by 2030, with no individual country exceeding 140. However, on current trends the goals are unlikely to be met. The authors used an empirically calibrated Global Maternal Health microsimulation model, which simulates individual women in 200 countries and territories to evaluate the impact of different interventions and strategies from 2022…
Health Outcomes | Health/Medicine | Global | Clinical Care | Mathematical Models | Microsimulation | Calibration/Validation | Maternal/Reproductive Health | Health Systems -
ArticlePublication 2023Simulation-Based Estimates and Projections of Global, Regional and Country-Level Maternal Mortality by Cause, 1990-2050
While progress has been made globally to reduce maternal deaths, measurement remains a challenge given …
While progress has been made globally to reduce maternal deaths, measurement remains a challenge given the many causes and frequent underreporting of maternal deaths. The authors developed a structural microsimulation model of Global Maternal Health (GMatH) for 200 countries and territories using demographic, epidemiologic, clinical and health system data synthesized from the medical literature, Civil Registration Vital Statistics systems and Demographic and Health Survey data. The model was calibrated to empirical data from 1990 to…
Health Outcomes | Health/Medicine | Global | Clinical Care | Evidence Synthesis | Microsimulation | Calibration/Validation | Maternal/Reproductive Health | Health Systems -
ArticlePublication 2023Single-Arm Trial Design Estimates Efficacy
Studies to confirm the efficacy of a single HPV vaccine dose, of vaccine durability, and …
Studies to confirm the efficacy of a single HPV vaccine dose, of vaccine durability, and of vaccination modifications are needed, but randomized controlled trials are costly and face logistical and ethical challenges. In this study, the authors demonstrate proof-of-principle that a single-arm design yields valid estimates with similar precision to a randomized controlled trial.
Health Outcomes | Health/Medicine | Global | Infectious Diseases | Maternal/Reproductive Health | Policy/Regulation -
ArticlePublication 2022Comparative Health Systems Analysis of Differences in Catastrophic Health Expenditure
The growing burden of non-communicable diseases (NCDs) in low- and middle-income countries may have implications …
The growing burden of non-communicable diseases (NCDs) in low- and middle-income countries may have implications for health system performance in the area of financial risk protection, as measured by catastrophic health expenditure (CHE). This article compares non-communicable diseases catastrophic health expenditure to the CHE cases caused by communicable diseases across health systems to examine whether: (1) disease burden and catastrophic health expenditure are linked, (2) Catastrophic health expenditures secondary to NCDs disproportionately affect wealthier households and (3) whether the drivers…
Costing Methods | Health/Medicine | Global | Infectious Diseases | Evidence Synthesis | Cost-Effectiveness Analysis | Chronic Disease/Risk | Health Systems | Economics/Finance -
ArticlePublication 2017Cost-Effectiveness of Testing and Treatment for Latent TB
Testing for and treating latent tuberculosis infection (LTBI) is among the main strategies to achieve …
Testing for and treating latent tuberculosis infection (LTBI) is among the main strategies to achieve TB elimination in the United States. This analysis estimated health outcomes, costs, and cost-effectiveness of LTBI testing and treatment among non-US born residents with and without medical comorbidities (e.g., diabetes, HIV infection, and end-stage renal disease). A decision analytic tree and Markov cohort simulation model was used to compare the following strategies: no testing, tuberculin skin test (TST), interferon gamma release assay…
Test Performance | Health/Medicine | Global | Infectious Diseases | State-Transition | Microsimulation | Cost-Effectiveness Analysis | Chronic Disease/Risk | Health Systems | Economics/Finance | North America