Resources Repository
-
ArticlePublication 2022Hospital Closures amid COVID-19
The recent trend of hospital closures in the US has accelerated during the COVID-19 pandemic, …
The recent trend of hospital closures in the US has accelerated during the COVID-19 pandemic, as hospitals have experienced financial hardship from reduced patient volume and elective surgery cases, as well as the thin financial margins for treating patients with COVID-19. This trend of hospital closures is concerning for patients, healthcare providers, and policymakers. This current opinion piece describes the challenges caused by hospital closures and discusses what policymakers should know based on the existing…
Operations Research | Health Systems | Health/Medicine | North America -
ArticlePublication 2021Employee Health Plans Powered by Analytics
This article describes a business model for the employee health plans of large firms to …
This article describes a business model for the employee health plans of large firms to bypass insurers and instead use direct contracts with hospitals which have been designated as centers of excellence. The authors propose methods of machine learning and data analytics to identify efficient and effective delivery systems, with the ultimate goal of improving health care quality.
Operations Research | Health Systems | North America -
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 -
ToolInteractive 2020COVID-19 Antibody Tests: Calculator for Interpreting Test Results
Antibody testing can determine previous exposure to SARS-CoV-2 virus. This interactive calculator, linked to the article …
Antibody testing can determine previous exposure to SARS-CoV-2 virus. This interactive calculator, linked to the article below* on antibody testing for SARS-CoV-2 virus, allows users to vary the prior probability of infection, the sensitivity of SARS-CoV-2 antibody testing, and the specificity of SARS-CoV-2 antibody testing. Key points made in the article accompanying the interactive include: (1) antibody testing is likely to be most useful 2 weeks after infection, (2) sensitivity and specificity will vary over time and…
Test Performance | Infectious Diseases | Probability/Bayes | Technology Assessment | Clinical Care | Health/Medicine | Science/Technology -
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 -
Tools/ModelsInteractive, Teaching Resource 2020Interactive Graphic: Interpreting a COVID-19 Test Result
Currently, the most common diagnostic test for COVID-19 relies on reverse transcriptase polymerase chain reaction …
Currently, the most common diagnostic test for COVID-19 relies on reverse transcriptase polymerase chain reaction (RT-PCR), and most often uses samples obtained from the respiratory tract by nasopharyngeal swab. This interactive graphic demonstrates the influence of the prior probability of COVID-19, the test sensitivity (i.e., the probability of a positive test conditional on disease presence), and the test specificity (i.e., the probability of a negative test conditional on disease absence) on the post-test probability of…
Test Performance | Infectious Diseases | Probability/Bayes | Clinical Care | Health/Medicine | Science/Technology | High School | College | Graduate | Doctoral | Professional | Graphics/Visualization | Quantitative Literacy -
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 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…
Test Performance | Health Systems | Evidence Synthesis | Clinical Care | Health/Medicine -
ToolInteractive, Teaching Resource 2020RAND Critical Care Surge Response Tool
This Excel-based model allows decisionmakers at all levels (i.e., hospitals, health care systems, states, regions) …
This Excel-based model allows decisionmakers at all levels (i.e., hospitals, health care systems, states, regions) to examine the current critical care capacity in the nation’s hospitals and rapidly explore strategies for increasing capacity to provide care for the sickest COVID-19 patients. The tool was developed by the RAND Corporation in response to the 2020 COVID-19 pandemic. Model input parameters to the Excel spreadsheet include baseline number of beds, critical care doctors and nurses, respiratory therapists,…
Operations Research | Infectious Diseases | Priority Setting/Ethics | Mathematical Models | Health/Medicine | North America | Professional | Policy Translation