Resources Repository
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ArticlePublication 2022Comparison of Home Antigen Testing With RT-PCR and Viral Culture During the Course of SARS-CoV-2 Infection
As the availability of at-home self-collected antigen tests for SARS-CoV-2 increases, understanding their efficacy is …
As the availability of at-home self-collected antigen tests for SARS-CoV-2 increases, understanding their efficacy is crucial. A study in San Diego and Denver between January and May 2021 assessed the reliability of these tests against standard RT-PCR tests and viral cultures. Of the 225 participants with confirmed infections, the antigen test sensitivity was found to be 50% during the infectious period, 64% against the same-day RT-PCR, and 84% against the same-day cultures. Sensitivity was highest…
Test Performance | Health/Medicine | Clinical Care | Infectious Diseases | Culture/Society | Science/Technology -
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…
Evidence Synthesis | Costing Methods | Health/Medicine | Infectious Diseases | Cost-Effectiveness Analysis | Chronic Disease/Risk | Health Systems | Economics/Finance | Global -
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 | Health/Medicine | Infectious Diseases | Science/Technology | Global -
ArticlePublication 2020Incorporating Perspective into Clinical Decisions
Part of a six-part series of articles on clinical decision making, in this article, the …
Part of a six-part series of articles on clinical decision making, in this article, the authors discuss how to incorporate perspective into clinical decisions, explicitly acknowledging that the treating physician is not the only stakeholder in these decisions. The authors use 2 case studies to demonstrate how changes in perspective can alter the clinical decision as well lead to both intended and unintended consequences to the outcomes.
Preferences/Values | Health Outcomes | Health/Medicine | Clinical Care | Priority Setting/Ethics | Health Systems -
ArticlePublication 2020Translating Population Evidence to Individual Patients
In this paper, the authors describe the differences in population level outcomes compared to individual …
In this paper, the authors describe the differences in population level outcomes compared to individual patients and discuss ways that these are differences. The authors cover topics including the difference between relative and absolute risk and benefit. They use an example of the decision to start anticoagulation in new-onset atrial fibrillation to discuss translating population level evidence to treatment of an individual. These options include generalizability, subgroup analysis, prediction rules, following response to therapy, and even…
Evidence Synthesis | Test Performance | Health/Medicine | Clinical Care | Health Systems -
ArticlePublication 2020Clinical Decision Making: Using a Diagnostic Test
This article is part of a 6-part series on clinical decision making. The authors use …
This article is part of a 6-part series on clinical decision making. The authors use two clinical examples to review the principles of interpreting diagnostic test results. They outline an approach that can be used to determine how to select and apply tests and their results to the practice of internal medicine. Topics covered in the two case studies include sensitivity and specificity, positive predictive and negative predictive value of tests, and how to estimate…
Probability/Bayes | Test Performance | Health/Medicine | Clinical Care -
ArticlePublication 2018Equity Impact Vaccines May Have on Averting Deaths and Medical Impoverishment
In this analysis, authors estimated the number of deaths averted and the number of cases …
In this analysis, authors estimated the number of deaths averted and the number of cases of medical impoverishment averted of ten antigens and their corresponding vaccines across income quintiles for forty-one low- and middle-income countries. The study found that vaccines administered between 2016 and 2030 would prevent 36 million deaths. Vaccines will have the greatest impact on reducing cases of poverty caused by hepatitis B, helping an estimated 14 million people avoid medical impoverishment. An…
Costing Methods | Health Outcomes | Health/Medicine | Infectious Diseases | Priority Setting/Ethics | Mathematical Models | Cost-Effectiveness Analysis | Child/Nutrition | Global Governance | Economics/Finance | Science/Technology | Sub-Saharan Africa | Middle East & North Africa | Asia & Pacific -
ArticlePublication 2017Changing the South African National ART Guidelines: The Role of Cost Modelling
This analysis was motivated by the South African Department of Health's request to assess the …
This analysis was motivated by the South African Department of Health's request to assess the cost implications of adopting sets of ART guidelines issued by the World Health Organization between 2010 and 2016.Using data from large South African ART clinics (n = 24,244 patients), projections of patients in need of ART, and cost data from bottom-up cost analyses, the authors constructed a population-level health-state transition model with 6-monthly transitions between health states depending on patients’ age,…
Costing Methods | Health/Medicine | Clinical Care | Infectious Diseases | State-Transition | Health Systems | Economics/Finance | Sub-Saharan Africa -
ArticlePublication 2017Costs of Facility-Based HIV Testing in Malawi, Zambia and Zimbabwe
Providing HIV testing at health facilities remains the most common approach to ensuring access to …
Providing HIV testing at health facilities remains the most common approach to ensuring access to HIV treatment and prevention services for the millions of undiagnosed HIV-infected individuals in sub-Saharan Africa. The authors sought to explore the costs of providing these services across three southern African countries with high HIV burden.Primary costing studies were undertaken in 54 health facilities providing HIV testing services (HTS) in Malawi, Zambia and Zimbabwe. Routinely collected monitoring and evaluation data for…
Costing Methods | Health/Medicine | Clinical Care | Infectious Diseases | Technology Assessment | Health Systems | Sub-Saharan Africa