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…
Preferences/Values | Probability/Bayes | Decision Analysis | Health Outcomes | Infectious Diseases | Costing Methods | Test Performance | Value of Information | State-Transition | Cost-Effectiveness Analysis | Child/Nutrition | Chronic Disease/Risk | Economics/Finance | Health/Medicine | Global | North America | Europe | Graduate | Doctoral | Critical Thinking/Analysis | Decision Making/Leadership | Quantitative Literacy -
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…
Microsimulation | Calibration/Validation | Health Outcomes | Maternal/Reproductive Health | Mathematical Models | Health Systems | Clinical Care | Health/Medicine | Global -
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…
Microsimulation | Calibration/Validation | Health Outcomes | Maternal/Reproductive Health | Evidence Synthesis | Health Systems | Clinical Care | Health/Medicine | Global -
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,…
Microsimulation | Decision Analysis | Calibration/Validation | Infectious Diseases | Mathematical Models | Cost-Effectiveness Analysis | Global -
ArticlePublication 2021Impact of COVID-19 on Cancer Diagnosis and Survival in Chile
This paper estimates the impact of the COVID-19 pandemic on delays in cancer diagnosis in …
This paper estimates the impact of the COVID-19 pandemic on delays in cancer diagnosis in Chile, using a microsimulation model of five cancers: breast, cervix, colorectal, prostate, and stomach. The model simulates cancer incidence and progression, as well as stage-specific cancer detection and survival probabilities, and was calibrated to empirical data on monthly detected cases, stage at diagnosis, and 5-year net survival. The analysis accounted for the impact of COVID-19 on month-by-month excess mortality and…
Microsimulation | Calibration/Validation | Health Outcomes | Infectious Diseases | Chronic Disease/Risk | Latin America & Caribbean -
ArticlePublication 2021COVID-19 Vaccine Hesitancy: The Five C's to Tackle Behavioral and Sociodemographic Factors
Reversing and mitigating the ongoing damage associated with the COVID-19 pandemic requires that 60-70% of …
Reversing and mitigating the ongoing damage associated with the COVID-19 pandemic requires that 60-70% of the world’s population needs to be vaccinated. This article acknowledges that hesitancy is one of the most substantial hurdles to vaccination uptake at levels that would achieve herd immunity. Authors define hesitancy as “a delay in acceptance or refusal despite availability.” Five factors are proposed to tackle vaccine hesitancy, referred to as the five “C’s”: Confidence (importance, safety and efficacy…
Preferences/Values | Decision Psychology | Health Outcomes | Infectious Diseases | Evidence Synthesis | Social Determinants | Culture/Society | Health/Medicine | Science/Technology | North America -
ArticlePublication 2015Broader Economic Impact of Vaccination: Reviewing and Appraising the Strength of Evidence
Economic evaluations of public health programs such as immunization often consider only direct health benefits and …
Economic evaluations of public health programs such as immunization often consider only direct health benefits and medical cost savings. Evidence linking immunization to important benefits in indicators such as childhood development, household behavior, and other macro-economic data are unclear. A conceptual framework of the pathways between immunization and these broader economic benefits was developed through expert consultation. The authors obtained articles from previous reviews, snowballing, and expert consultation, and associated them with one of the pathways and assessed them using modified Grading…
Priority Setting/Ethics | Preferences/Values | Benefit-Cost Analysis | Infectious Diseases | Costing Methods | Evidence Synthesis | Cost-Effectiveness Analysis | Social Determinants | Economics/Finance | Education/Labor | 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 | Maternal/Reproductive Health | Infectious Diseases | Policy/Regulation | Health/Medicine | Global -
ArticlePublication 2021Health Gains and Financial Protection from HPV Vaccination
High out-of-pocket medical expenses for cervical cancer can lead to catastrophic health expenditures and medical …
High out-of-pocket medical expenses for cervical cancer can lead to catastrophic health expenditures and medical impoverishment in many low-resource settings. This article uses a static cohort model that captures the main features of HPV vaccines and population demographics to project health and economic outcomes associated with routine HPV vaccination in Ethiopia. The findings show that, assuming 100% vaccine efficacy against HPV-16/18 and 50% vaccination coverage, routine HPV vaccination could avert up to 970 000 cases…
Priority Setting/Ethics | Microsimulation | Infectious Diseases | Sub-Saharan Africa