Resources Repository
-
ReportPublication 2015Improving Diagnosis in Health Care
Getting the right diagnosis is a key aspect of health care - it provides an …
Getting the right diagnosis is a key aspect of health care - it provides an explanation of a patient's health problem and informs subsequent health care decisions. The diagnostic process is a complex, collaborative activity that involves clinical reasoning and information gathering to determine a patient's health problem. This report, Improving Diagnosis in Health Care, explains that diagnostic errors-inaccurate or delayed diagnoses-persist throughout all settings of care and continue to harm an unacceptable number of patients.…
Probability/Bayes | Health Outcomes | Value of Information | Health Systems | Test Performance | Health/Medicine | North America -
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 | Health Systems | Mathematical Models | Microsimulation | Maternal/Reproductive Health | 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…
Calibration/Validation | Health Outcomes | Health Systems | Evidence Synthesis | Microsimulation | Maternal/Reproductive Health | Clinical Care | Health/Medicine | Global -
ArticlePublication 2021Racial and Ethnic Inequities in the Early Distribution of U.S. COVID-19 Testing Sites and Mortality
In 2020, U.S. COVID-19 testing sites were pivotal not just for diagnosis but also to …
In 2020, U.S. COVID-19 testing sites were pivotal not just for diagnosis but also to provide data that would contribute to understanding transmission. This research explored how these sites were distributed in relation to racial and ethnic demographics and its connection to observed disparities in COVID-19 outcomes. Data from mid-April to late May 2020 revealed that testing sites were not equally distributed among racial groups. Specifically, there was an overrepresentation of testing sites in areas…
Health Outcomes | Social Determinants | Infectious Diseases | Test Performance | Policy/Regulation | Culture/Society | Health/Medicine | Science/Technology | North America -
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 | Infectious Diseases | Mathematical Models | Microsimulation | Cost-Effectiveness Analysis | Global -
ArticlePublication 2019Projected U.S. State-Level Prevalence of Adult Obesity and Severe Obesity
This analysis estimates state-specific and demographic subgroup-specific trends and projections of the prevalence of categories …
This analysis estimates state-specific and demographic subgroup-specific trends and projections of the prevalence of categories of body-mass index (BMI) in the United States. Self-reported BMI from the Behavioral Risk Factor Surveillance System Survey (1993-1994 and 1999-2016) were obtained and corrected for quantile-specific self-reporting bias. Multinomial regressions were then fitted for each state and subgroup to estimate the prevalence of four BMI categories from 1990 through 2030: underweight or normal weight (BMI <25), overweight (25 to…
Calibration/Validation | Health Outcomes | Social Determinants | Mathematical Models | Chronic Disease/Risk | North America -
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 | Health Systems | Priority Setting/Ethics | Microsimulation | Chronic Disease/Risk | Global -
ArticlePublication 2022Excess Mortality and Elevated Body Weight in the U.S.
This analysis estimates excess mortality associated with elevated body weight in the United States by …
This analysis estimates excess mortality associated with elevated body weight in the United States by state and demographic subgroup. The authors developed a nationally-representative microsimulation (individual-level) model of US adults between 1999 and 2016, based on risk factor data from the Behavioral Risk Factor Surveillance System and body-mass index (BMI) mortality hazard ratios from a global pooling dataset. The model was calibrated to empirical all-cause mortality rates from CDC WONDER by state and subgroup, and…
Calibration/Validation | Health Outcomes | Social Determinants | Microsimulation | Chronic Disease/Risk | North America -
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…
Calibration/Validation | Health Outcomes | Infectious Diseases | Microsimulation | Chronic Disease/Risk | Latin America & Caribbean