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…
Test Performance | Decision Analysis | Costing Methods | Health Outcomes | Value of Information | Global | Chronic Disease/Risk | Infectious Diseases | Probability/Bayes | Preferences/Values | State-Transition | Cost-Effectiveness Analysis | Child/Nutrition | Economics/Finance | Health/Medicine | North America | Europe | Graduate | Doctoral | Critical Thinking/Analysis | Decision Making/Leadership | Quantitative Literacy -
ArticlePublication 2014Cost-Effectiveness of Female HPV Vaccination in 179 Countries: A PRIME Modelling Study
The authors present a simple generic model, Papillomavirus Rapid Interface for Modelling and Economics (PRIME), …
The authors present a simple generic model, Papillomavirus Rapid Interface for Modelling and Economics (PRIME), used to assess cost-effectiveness and health effects of vaccination of girls against HPV before sexual debut in terms of burden of cervical cancer and mortality. The PRIME models incidence according to proposed vaccine efficacy against HPV 16/18, vaccine coverage, cervical cancer incidence and mortality, and HPV type distribution. It assumes lifelong vaccine protection and no changes to other screening programs…
Calibration/Validation | Health Outcomes | Middle East & North Africa | Global | Chronic Disease/Risk | Infectious Diseases | Mathematical Models | Cost-Effectiveness Analysis | Health Systems | Health/Medicine | Sub-Saharan Africa | Latin America & Caribbean | Asia & Pacific -
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 | Global | Chronic Disease/Risk | Infectious Diseases | Cost-Effectiveness Analysis | Health Systems | Economics/Finance | Health/Medicine -
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…
Evidence Synthesis | Calibration/Validation | Health Outcomes | Global | Maternal/Reproductive Health | Microsimulation | Health Systems | Clinical Care | Health/Medicine -
ArticlePublication 2022Vaccinations versus Lockdowns to Prevent COVID-19 Mortality
This analysis estimated the costs associated with preventing Covid-19 deaths by vaccinations versus lockdowns. Publicly …
This analysis estimated the costs associated with preventing Covid-19 deaths by vaccinations versus lockdowns. Publicly available datasets from the Israeli Ministry of Health were used to model the parameters of the pandemic in Israel. The Oxford COVID-19 Government Response Tracker was used for quantitative data on government policies. Data on the Israeli economy were taken from the Central Bureau of Statistics. The models demonstrate that the first lockdown prevented 1022 COVID-19 deaths at the cost…
Decision Analysis | Costing Methods | Health Outcomes | Middle East & North Africa | Infectious Diseases | Decision Theory | State-Transition | Policy/Regulation | Economics/Finance | Government/Law | Health/Medicine -
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…
Calibration/Validation | Health Outcomes | Global | Maternal/Reproductive Health | Mathematical Models | Microsimulation | Health Systems | Clinical Care | Health/Medicine -
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 | Global | Maternal/Reproductive Health | Infectious Diseases | Policy/Regulation | Health/Medicine -
ArticlePublication 2021New Microsimulation Models to Inform Cervical Cancer Control
Health decision models consider the lifetime natural history of human papillomavirus (HPV) infection and pathogenesis …
Health decision models consider the lifetime natural history of human papillomavirus (HPV) infection and pathogenesis of cervical cancer, and estimate the long-term impact of preventive interventions. We propose a new health decision modeling framework that de-emphasizes previously used cytologic-colposcopic-histologic diagnoses, which are subjective and lack reproducibility, relying instead on HPV type and duration of infection as the major determinants of model transition probabilities. We posit that new model health states and corollary transitions are universal,…
Decision Analysis | Calibration/Validation | Global | Infectious Diseases | Mathematical Models | Microsimulation | Cost-Effectiveness Analysis -
ArticlePublication 2020Impact of Treatment and Imaging Modalities on 5-Year Net Survival of 11 Cancers in 200 Countries
This analysis describes the development of a microsimulation model of stage-specific cancer survival in 200 …
This analysis describes the development of a microsimulation model of stage-specific cancer survival in 200 countries/territories for 11 cancers (oesophagus, stomach, colon, rectum, anus, liver, pancreas, lung, breast, cervix uteri, and prostate). The paper estimated current 5-year net survival for diagnosed cancers in each country and potential survival gains from increasing the availability of individual treatment and imaging modalities, and more comprehensive packages of scale-up. Global 5-year net survival for all 11 cancers (combined) is…
Calibration/Validation | Health Outcomes | Global | Chronic Disease/Risk | Priority Setting/Ethics | Microsimulation | Health Systems