Resources Repository
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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…
Test Performance | Infectious Diseases | Health Outcomes | Social Determinants | Policy/Regulation | Culture/Society | Health/Medicine | Science/Technology | North America -
ArticlePublication 2022Comparison of Home Antigen Testing With RT-PCR and Viral Culture During the Course of SARS-CoV-2 Infection
As the availability of at-home self-collected antigen tests for SARS-CoV-2 increases, understanding their efficacy is …
As the availability of at-home self-collected antigen tests for SARS-CoV-2 increases, understanding their efficacy is crucial. A study in San Diego and Denver between January and May 2021 assessed the reliability of these tests against standard RT-PCR tests and viral cultures. Of the 225 participants with confirmed infections, the antigen test sensitivity was found to be 50% during the infectious period, 64% against the same-day RT-PCR, and 84% against the same-day cultures. Sensitivity was highest…
Test Performance | Infectious Diseases | Clinical Care | Culture/Society | Health/Medicine | Science/Technology -
ArticlePublication 2023Benefits and Costs of COVID-19 Vaccine Mandates
Written mid-pandemic, this article evaluates the direct costs and health benefits of requiring COVID-19 vaccinations …
Written mid-pandemic, this article evaluates the direct costs and health benefits of requiring COVID-19 vaccinations for U.S. federal employees and healthcare and private sector workers. These mandates were controversial and some were halted by litigation. If they had been implemented as intended, the net benefits would depend on the course of the pandemic. If a more transmissible variant (such as Omicron) emerges, the net benefits may be large. If the pandemic instead fades, the benefits…
Mathematical Models | Infectious Diseases | State-Transition | Benefit-Cost Analysis | Policy/Regulation | Business/Industry | Economics/Finance | Government/Law | Health/Medicine | North America -
ArticlePublication 2023Cost-Effectiveness of Novel TB Vaccines: A Modeling Study
A modeling study assessed future costs, cost-savings, and cost-effectiveness of introducing novel tuberculosis (TB) vaccines …
A modeling study assessed future costs, cost-savings, and cost-effectiveness of introducing novel tuberculosis (TB) vaccines in 105 low- and middle-income countries (LMICs) for a range of product characteristics and delivery strategies, compared to a ‘no-new-vaccine’ counterfactual. Vaccine scenarios considered two vaccine product profiles (one targeted at infants, one at adolescents/adults), both assumed to prevent progression to active TB. Vaccine introduction was estimated to require substantial near-term resources, offset by future cost-savings from averted TB burden.…
Mathematical Models | Infectious Diseases | Cost-Effectiveness Analysis | Economics/Finance | Health/Medicine | Global -
ArticlePublication 2022Spatial-Mechanistic Model to Estimate Sub-National Tuberculosis Burden in Brazilian Municipalities
Reliable subnational estimates of TB incidence are needed to focus disease control resources in areas …
Reliable subnational estimates of TB incidence are needed to focus disease control resources in areas of highest need. This study developed an approach for generating small area estimates of TB incidence, and the fraction of individuals missed by routine case detection, based on available notification and mortality data. The approach is demonstrated by estimating TB outcomes for 5568 municipalities in Brazil, revealing substantial subnational differences in disease burden and other metrics useful for designing high-impact…
Mathematical Models | Infectious Diseases | Health Outcomes | Health/Medicine | Latin America & Caribbean -
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,…
Mathematical Models | Infectious Diseases | Microsimulation | 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…
Mathematical Models | Infectious Diseases | Microsimulation | Cost-Effectiveness Analysis | North America | Latin America & Caribbean -
ArticlePublication 2022Cost-Effectiveness & Value-of-Information Analysis Using Machine Learning-Based Metamodeling: A Case of Hepatitis C Treatment
This study compares machine learning (ML)-based metamodels with conventional metamodeling approaches in replicating the outcomes …
This study compares machine learning (ML)-based metamodels with conventional metamodeling approaches in replicating the outcomes of a complex simulation model of hepatitis C virus (HCV) natural history. Three ML-based metamodels (random forest, support vector regression, and artificial neural networks) and a linear regression-based metamodel were developed from the simulation model's 40 input parameters. Performance evaluation included root mean squared error (RMSE) and Pearson's R2 on normalized data. ML-based metamodels generally outperformed linear regression, with random…
Mathematical Models | Infectious Diseases | Chronic Disease/Risk | Health/Medicine -
ArticlePublication 2022Child Health Inequity through Case Management of Under-Five Malaria in Nigeria: An ECEA
This study assesses the potential impact of subsidies covering the direct and indirect costs of …
This study assesses the potential impact of subsidies covering the direct and indirect costs of under-five malaria case management in Nigeria, utilizing an extended cost-effectiveness analysis (ECEA) and a decision tree model. Findings reveal that fully subsidizing medical, non-medical, and indirect costs could annually avert over 19,000 under-five deaths, 8,600 cases of catastrophic health expenditure (CHE), and US$187 million in out-of-pocket (OOP) spending. Per US$1 million invested, this translates to a significant reduction in under-five…
Mathematical Models | Infectious Diseases | Health Outcomes | Cost-Effectiveness Analysis | Child/Nutrition | Policy/Regulation | Health/Medicine | Sub-Saharan Africa