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…
Probability/Bayes | Technology Assessment | Infectious Diseases | Test Performance | 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 | Technology Assessment | Infectious Diseases | Test Performance | Health Systems | Policy/Regulation | Government/Law | Health/Medicine | Global | North America -
BookPublication 1980Clinical Decision Analysis
This text was conceived and developed in the Harvard T.H. Chan School of Public Health …
This text was conceived and developed in the Harvard T.H. Chan School of Public Health at the Center for the Analysis of Health Practices. The book had its origins in a set of classroom materials developed during the academic year 1974-75 for an elective course in medical decision making at the Harvard Medical School. In this book students are shown how to structure clinical decision problems, how to systematically formulate the intertwining roles of diagnosis and treatment, how to…
Probability/Bayes | Value of Information | Infectious Diseases | Preferences/Values | Costing Methods | Health Outcomes | Test Performance | State-Transition | Decision Analysis | Cost-Effectiveness Analysis | Child/Nutrition | Chronic Disease/Risk | Economics/Finance | Health/Medicine | Global | North America | Europe | Graduate | Doctoral | Critical Thinking/Analysis | Decision Making/Leadership | Quantitative Literacy -
ArticlePublication 2008Cost-Effectiveness of Rapid Point-of-Care Prenatal Syphilis Screening in Sub-Saharan Africa
This paper investigates the cost-effectiveness of using rapid point-of-care tests for prenatal syphilis screening among …
This paper investigates the cost-effectiveness of using rapid point-of-care tests for prenatal syphilis screening among pregnant women in sub-Saharan Africa, a region with syphilis prevalence rates as high as 17%, and where traditional multi-test screening methods have been challenging to implement. Focusing on newly available rapid point-of-care screening tests, strategies differed by the initial test [rapid plasma reagin (RPR), immunochromographic strip (ICS)], need for confirmation with Treponema pallidum hemagglutination assay, and number of visits required.…
Technology Assessment | Infectious Diseases | Costing Methods | Test Performance | Mathematical Models | Cost-Effectiveness Analysis | Maternal/Reproductive Health | Clinical Care | Health/Medicine | Sub-Saharan Africa -
ArticlePublication 2022Emerging Therapies for COVID-19: The Value of Information From More Clinical Trials
The COVID-19 pandemic necessitated time-sensitive policy and implementation decisions regarding new therapies in the face …
The COVID-19 pandemic necessitated time-sensitive policy and implementation decisions regarding new therapies in the face of uncertainty. This study aimed to quantify consequences of approving therapies or pursuing further research. The authors used a cohort state-transition model for hospitalized patients with COVID-19 to estimate quality-adjusted life-years (QALYs) and costs associated with multiple drug regimens and usual care. For each they assessed immediate approval, use only in research, emergency use authorization or reject. They conducted cost-effectiveness…
Value of Information | Infectious Diseases | State-Transition | Benefit-Cost Analysis | Policy/Regulation | Economics/Finance | North America | Europe -
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 -
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…
Probability/Bayes | Infectious Diseases | Test Performance | Health/Medicine | Science/Technology | Global -
BookPublication 2019Non-Communicable Disease Prevention: Best Buys, Wasted Buys, Contestable Buys
Non-communicable diseases (NCDs) are the leading cause of death worldwide, and the majority of these …
Non-communicable diseases (NCDs) are the leading cause of death worldwide, and the majority of these deaths occur in low- and middle-income countries. This book provides practical guidelines and lessons learned through real-world case studies. It is intended to be informative to NCD program managers, policy officers and decision-makers in low- and middle-income countries, who need to comparatively assess interventions for the prevention and control of NCDs.The authors emphasize the importance of context in NCD control…
Technology Assessment | Infectious Diseases | Priority Setting/Ethics | Cost-Effectiveness Analysis | Chronic Disease/Risk | Health Systems | Policy/Regulation | Health/Medicine | Global -
ReportPublication 2018Understanding the Economics of Microbial Threats: Proceedings of a Workshop
This report follows a June 2018, Forum on Microbial Threats that was held at the …
This report follows a June 2018, Forum on Microbial Threats that was held at the National Academies of Sciences, Engineering, and Medicine. This was a 1.5-day public workshop with the goal being an assessment of the current understanding of the interaction of infectious disease threats and economic activity in order to suggest future areas of research. This workshop built on prior work of the Forum and aimed to build more mutual understanding between those in…
Technology Assessment | Infectious Diseases | Health Outcomes | Evidence Synthesis | Policy/Regulation | Global Governance | Clinical Care | Business/Industry | Economics/Finance | Health/Medicine | Global