Resources Repository
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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 | Decision Analysis | Global | Infectious Diseases | Microsimulation | Calibration/Validation | Cost-Effectiveness Analysis -
ArticlePublication 2014Cost-Effectiveness of Female HPV Vaccination in 179 Countries: A PRIME Modelling Study
The authors present a simple generic model, Papillomavirus Rapid Interface for Modelling and Economics (PRIME), …
The authors present a simple generic model, Papillomavirus Rapid Interface for Modelling and Economics (PRIME), used to assess cost-effectiveness and health effects of vaccination of girls against HPV before sexual debut in terms of burden of cervical cancer and mortality. The PRIME models incidence according to proposed vaccine efficacy against HPV 16/18, vaccine coverage, cervical cancer incidence and mortality, and HPV type distribution. It assumes lifelong vaccine protection and no changes to other screening programs…
Mathematical Models | Health Outcomes | Global | Infectious Diseases | Calibration/Validation | Cost-Effectiveness Analysis | Chronic Disease/Risk | Health Systems | Health/Medicine | Sub-Saharan Africa | Middle East & North Africa | Latin America & Caribbean | Asia & Pacific -
ReviewPublication 2006Public Health Policy for Cervical Cancer Prevention: Decision Science, Economic Evaluation, & Mathematical Modeling
Several factors are changing the landscape of cervical cancer control, including a better understanding of …
Several factors are changing the landscape of cervical cancer control, including a better understanding of the natural history of human papillomavirus (HPV), reliable assays for detecting high-risk HPV infections, and a soon to be available HPV-16/18 vaccine. There are important differences in the relevant policy questions for different settings. By synthesizing and integrating the best available data, the use of modeling in a decision analytic framework can identify those factors most likely to influence outcomes,…
Mathematical Models | Decision Analysis | Global | Infectious Diseases | Cost-Effectiveness Analysis | Chronic Disease/Risk | Economics/Finance | Health/Medicine | Science/Technology -
ArticlePublication 2023Single-Arm Trial Design Estimates Efficacy
Studies to confirm the efficacy of a single HPV vaccine dose, of vaccine durability, and …
Studies to confirm the efficacy of a single HPV vaccine dose, of vaccine durability, and of vaccination modifications are needed, but randomized controlled trials are costly and face logistical and ethical challenges. In this study, the authors demonstrate proof-of-principle that a single-arm design yields valid estimates with similar precision to a randomized controlled trial.
Health Outcomes | Global | Infectious Diseases | Maternal/Reproductive Health | Policy/Regulation | Health/Medicine -
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 | Global | Infectious Diseases | Cost-Effectiveness Analysis | Economics/Finance | Health/Medicine -
ArticlePublication 2022Comparative Health Systems Analysis of Differences in Catastrophic Health Expenditure
The growing burden of non-communicable diseases (NCDs) in low- and middle-income countries may have implications …
The growing burden of non-communicable diseases (NCDs) in low- and middle-income countries may have implications for health system performance in the area of financial risk protection, as measured by catastrophic health expenditure (CHE). This article compares non-communicable diseases catastrophic health expenditure to the CHE cases caused by communicable diseases across health systems to examine whether: (1) disease burden and catastrophic health expenditure are linked, (2) Catastrophic health expenditures secondary to NCDs disproportionately affect wealthier households and (3) whether the drivers…
Costing Methods | Global | Infectious Diseases | Evidence Synthesis | Cost-Effectiveness Analysis | Chronic Disease/Risk | Health Systems | Economics/Finance | Health/Medicine -
ArticlePublication 2021COVID-19 Mortality and Self-Imposed Behavior Change/Government Regulations
Countries have adopted different approaches, at different times, to reduce the transmission of COVID-19. Cross-country …
Countries have adopted different approaches, at different times, to reduce the transmission of COVID-19. Cross-country comparison could indicate the relative efficacy of these approaches. This article assesses various nonpharmaceutical interventions, comparing the effects of voluntary behavior change and of changes enforced via official regulations, by examining their impacts on subsequent death rates. Voluntarily reduced mobility, occurring prior to government policies, decreases the percent change in deaths per day by 9.2% (95% confidence interval [CI] 4.5–14.0).…
Health Outcomes | Global | Infectious Diseases | Policy/Regulation -
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 | Global | Infectious Diseases | Probability/Bayes | Technology Assessment | Health Systems | Policy/Regulation | Government/Law | Health/Medicine | North America -
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 | Global | Infectious Diseases | Probability/Bayes | Health/Medicine | Science/Technology