Resources Repository
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ArticlePublication 2024Hepatitis C Elimination in Rwanda: Progress, Feasibility, Economic Evaluation
This study evaluates the impact of Rwanda's national program launched in 2018 to eliminate hepatitis …
This study evaluates the impact of Rwanda's national program launched in 2018 to eliminate hepatitis C virus (HCV) and identifies strategies to achieve World Health Organization (WHO) elimination goals by 2030. Employing a microsimulation model spanning 2015 to 2050, the analysis assesses HCV epidemic trends, prevalence, mortality, and total care costs under various scenarios. Results show that between 2018 and 2022, over 7 million people were screened and 60,000 treated, projecting Rwanda's potential achievement of…
Microsimulation | Infectious Diseases | Chronic Disease/Risk | Health/Medicine | Sub-Saharan Africa -
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…
Microsimulation | Infectious Diseases | Priority Setting/Ethics | Sub-Saharan Africa -
ArticlePublication 2022Re-Evaluating the Health Impact and Cost-Effectiveness of Tuberculosis Prevention for Modern ART Cohorts
TB preventive therapy (TPT) is widely accepted to be cost-effective for reducing TB incidence in …
TB preventive therapy (TPT) is widely accepted to be cost-effective for reducing TB incidence in HIV-infected individuals receiving antiretroviral therapy (ART). However, as individuals initiate ART earlier in the course of disease, TB incidence is lower, and it is unclear how ART cost-effectiveness has changed. This study assessed the cost-effectiveness of TPT in contemporary ART cohorts. The authors developed a microsimulation model of TB and HIV and parameterised it using data from a large HIV…
Microsimulation | Infectious Diseases | Cost-Effectiveness Analysis | Health/Medicine | Global | Sub-Saharan Africa -
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 | Infectious Diseases | Mathematical Models | Calibration/Validation | Decision Analysis | Cost-Effectiveness Analysis | Global -
ArticlePublication 2022Early HPV Natural History Transitions
Microsimulation models used to evaluate the cost-effectiveness of novel cervical cancer screening technologies rely on …
Microsimulation models used to evaluate the cost-effectiveness of novel cervical cancer screening technologies rely on accurate transition risks for human papillomavirus (HPV) infection, persistence (or absence of HPV clearance), progression to precancerous lesions, and invasion. To inform the refinement of such models, we compared the early natural history of HPV types using prospective data from immunocompetent women in the Guanacaste Natural History Study, the ASCUS-LSIL Triage Study, and the Costa Rica HPV Vaccine Trial. We…
Microsimulation | Infectious Diseases | Mathematical Models | Cost-Effectiveness Analysis | North America | Latin America & Caribbean -
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 | Infectious Diseases | Health Outcomes | Calibration/Validation | Chronic Disease/Risk | Latin America & Caribbean -
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…
Probability/Bayes | Infectious Diseases | Test Performance | 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…
Probability/Bayes | Infectious Diseases | Test Performance | 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…
Probability/Bayes | Infectious Diseases | Test Performance | Clinical Care | Health/Medicine