Resources Repository
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ArticlePublication 2020Testing for SARS-CoV-2 Antibodies
Antibody testing can determine previous exposure to SARS-CoV-2 virus. Recently, the UK government has made …
Antibody testing can determine previous exposure to SARS-CoV-2 virus. Recently, the UK government has made antibody testing available to anyone wanting it, even if there is no clinical indication. The purpose of this article is to provide guidance for when to consider antibody testing in individuals with and without symptoms suggestive of current or past SARS-CoV-2 infection. Key points made by the authors include: (1) antibody testing is likely to be most useful 2 weeks…
Test Performance | Infectious Diseases | Probability/Bayes | Technology Assessment | Clinical Care | Health/Medicine -
EditorialPublication 2020Waiting for Certainty on COVID-19 Antibody Tests — At What Cost?
This perspective anticipates the availability of serologic antibody testing and considers its potential usefulness in mitigation …
This perspective anticipates the availability of serologic antibody testing and considers its potential usefulness in mitigation policy to reduce COVID-19 transmission. For example: Could we screen for serologic antibodies as a proxy for possible immunity and identify people who could return to the workplace with less severe mitigation measures? The authors acknowledge the uncertainties raised by many policy actors, including the WHO, such as, "Do antibodies confer immunity and, if so, for how long? How accurate is…
Test Performance | Infectious Diseases | Probability/Bayes | Technology Assessment | Health Systems | Policy/Regulation | Government/Law | Health/Medicine | Global | North America -
ArticlePublication 2020Bayes' Theorem, COVID-19, and Screening Tests
This article reviews the implications of increased testing for COVID-19 using reverse transcriptase polymerase chain …
This article reviews the implications of increased testing for COVID-19 using reverse transcriptase polymerase chain reaction (rRT-PCR) through the application of Bayes’ Theorem for three hypothetical, stylized case scenarios. The scenarios involve three patients with a low, moderate, and high pre-test probability of COVID-19 infection. The category of low probability would include "asymptomatic individuals in a presumed low prevalence environment" and might vary from 10 to 20%. The category of moderate probability would include "individuals…
Test Performance | Infectious Diseases | Probability/Bayes | Clinical Care | Health/Medicine -
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 | Infectious Diseases | Probability/Bayes | Health/Medicine | Science/Technology | Global -
ArticlePublication 2019Systematic Review of Economic Evaluations of Vaccination Strategies Against Tuberculosis
Bacillus Calmette-Guérin (BCG) is the only licensed vaccine for tuberculosis, but its effectiveness is limited …
Bacillus Calmette-Guérin (BCG) is the only licensed vaccine for tuberculosis, but its effectiveness is limited and varies by age, so a valid cost-effectiveness study is needed to assist decision-makers in the implementation of cost-effective strategies for BCG vaccination. Using the Quality of Health Economic Studies (QHES) instrument, the authors assessed the quality of published studies involving economic evaluations of BCG vaccination strategies in a variety of regions, target populations, and vaccine types. Most of the…
Evidence Synthesis | Infectious Diseases | Mathematical Models | Cost-Effectiveness Analysis | Health/Medicine | Global -
ArticlePublication 2019Assessment of the Feasibility and Cost of Hepatitis C Elimination in Pakistan
This study investigates the feasibility and cost of hepatitis C virus (HCV) elimination in Pakistan …
This study investigates the feasibility and cost of hepatitis C virus (HCV) elimination in Pakistan using a decision analytical model and microsimulation techniques from 2015 to 2030. Various scenarios, including the status quo and seven elimination strategies, were evaluated based on Pakistan-specific variables. Main outcomes included trends in HCV prevalence, mortality, disability-adjusted life-years, and total costs of HCV care. Results suggest that to achieve HCV elimination by 2030, significant scale-up of testing and treatment is…
Decision Analysis | Infectious Diseases | Chronic Disease/Risk | Health/Medicine | Asia & Pacific -
ArticlePublication 2018Should We Treat Acute Hepatitis C? A Decision and Cost-Effectiveness Analysis
This study examines the potential benefits of treating acute hepatitis C virus (HCV) infection compared …
This study examines the potential benefits of treating acute hepatitis C virus (HCV) infection compared to deferring treatment until the chronic phase, utilizing a microsimulation model. By projecting long-term outcomes such as quality-adjusted life years (QALYs) and costs, the analysis evaluates the cost-effectiveness of initiating therapy during the acute phase. Results indicate that treating acute HCV increases QALYs by 0.02 and costs by $483 per patient not at risk of transmitting HCV, yielding an incremental…
Decision Analysis | Infectious Diseases | Microsimulation | Cost-Effectiveness Analysis | Chronic Disease/Risk | Health/Medicine | North America -
ArticleWeb Portal 2017PLoS Collection: Prevention, Diagnosis and Treatment of Sexually Transmitted Infections
Globally, the World Health Organization (WHO) estimates that more than one million new sexually transmitted …
Globally, the World Health Organization (WHO) estimates that more than one million new sexually transmitted infections (STIs) occur each day, incurring a very substantial burden of morbidity, mortality and additional infections. The pathogens responsible include bacteria, parasites and viruses, and intensive research is needed to address the substantial barriers to diagnosis and treatment of STIs, and the behavioral challenges of prevention. This PLOS collection, published in collaboration with WHO, focuses on global policy and systems…
Costing Methods | Infectious Diseases | Priority Setting/Ethics | Mathematical Models | Dynamic Transmission | Cost-Effectiveness Analysis | Health Systems | Economics/Finance | Health/Medicine | Sub-Saharan Africa | Middle East & North Africa | Latin America & Caribbean | Asia & Pacific -
ArticlePublication 2017Estimating the Fitness Cost and Benefit of Cefixime Resistance in Neisseria Gonorrhoeae
Gonorrhoea is one of the most common bacterial sexually transmitted infections in England, and more …
Gonorrhoea is one of the most common bacterial sexually transmitted infections in England, and more than half of annual infections occur in men who have sex with men (MSM). As the bacterium has developed resistance to each first-line antibiotic in turn, an improved understanding is needed of fitness benefits and costs of antibiotic resistance to inform control policy and planning. The authors developed a stochastic compartmental model representing the natural history and transmission of cefixime-sensitive…
Decision Analysis | Infectious Diseases | Dynamic Transmission | Risk Analysis | Health Systems | Policy/Regulation | Government/Law | Health/Medicine | Science/Technology | Global