Resources Repository
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ArticlePublication 2016Prevention of Hepatitis C by Screening and Treatment in U.S. Prisons
This study assesses the health and economic impact of hepatitis C virus (HCV) screening and …
This study assesses the health and economic impact of hepatitis C virus (HCV) screening and treatment in U.S. prisons on the broader HCV epidemic. Employing an agent-based microsimulation model of HCV transmission and disease progression, data from published literature inform the analysis. The target populations include individuals in U.S. prisons and the general community over a 30-year timeframe, adopting a societal perspective. Interventions encompass risk-based and universal opt-out HCV screening in prisons, followed by treatment…
Cost-Effectiveness Analysis | Health/Medicine | North America | Infectious Diseases | Microsimulation | Chronic Disease/Risk -
ArticlePublication 2015Cost-Effectiveness & Budget Impact of Hepatitis C Virus Treatment with Sofosbuvir & Ledipasvir in the U.S.
This study evaluates the cost-effectiveness and budget impact of sofosbuvir and ledipasvir for treating chronic …
This study evaluates the cost-effectiveness and budget impact of sofosbuvir and ledipasvir for treating chronic hepatitis C virus (HCV) infection compared to the old standard of care (oSOC). Using a microsimulation model based on HCV natural history, data from published literature, and a third-party payer perspective, the analysis considers treatment-naive and treatment-experienced HCV populations in the United States over a lifetime horizon. Sofosbuvir-based therapies are found to add 0.56 quality-adjusted life-years (QALYs) relative to oSOC,…
Cost-Effectiveness Analysis | Health/Medicine | North America | Infectious Diseases | Microsimulation | Chronic Disease/Risk -
ArticlePublication 2015Clinical Role and Cost-Effectiveness of Long-Acting ART
Long-acting antiretroviral therapy (LA-ART) could potentially improve outcomes in particular for those HIV-infected individuals with …
Long-acting antiretroviral therapy (LA-ART) could potentially improve outcomes in particular for those HIV-infected individuals with poor daily ART adherence. In this study the clinical role and cost-effectiveness of 3 long-acting ART strategies (LA-ART for patients with multiple ART failures; second-line LA-ART for those failing first-line therapy; and first-line LA-ART for ART-naive patients) are compared to daily oral ART using a microsimulation model. The findings of this study showed that LA-ART could improve survival of…
Cost-Effectiveness Analysis | Health/Medicine | North America | Infectious Diseases | Microsimulation -
ArticlePublication 2014HIV Cure Strategies: How Good Must They be to Improve on ART?
This article uses a microsimulation model to explore under what circumstances three HIV cure strategies …
This article uses a microsimulation model to explore under what circumstances three HIV cure strategies (gene therapy, chemotherapy and stem cell transplantation (SCT)) would improve efficacy, toxicity, cost and quality of life outcomes compared to current antiretroviral therapy (ART). Assuming a cost-effectiveness threshold of $100,000 per QALY, results show that gene therapy was cost-effective compared to ART with an efficacy of 10%, relapse rate of 0.5%/month, and cost of $54,000. Chemotherapy was cost-effective with an…
Cost-Effectiveness Analysis | Health/Medicine | North America | Infectious Diseases | Microsimulation -
ArticlePublication 2010Empirically Evaluating Decision-Analytic Models
To augment model credibility, evaluation via comparison to independent, empirical studies is recommended. The authors …
To augment model credibility, evaluation via comparison to independent, empirical studies is recommended. The authors developed a structured reporting format for model evaluation and conducted a structured literature review to characterize current model evaluation recommendations and practices. As an illustration, they applied the reporting format to evaluate a microsimulation of human papillomavirus and cervical cancer. The model's outputs and uncertainty ranges were compared with multiple outcomes from a study of long-term progression from high-grade precancer…
Health/Medicine | North America | Infectious Diseases | Microsimulation | Calibration/Validation | Chronic Disease/Risk -
ArticlePublication 2009Cost-Effectiveness of HPV Vaccination and Cervical Cancer Screening in Women Aged 30+ Years in the U.S.
The objective of the study was to assess the health and economic outcomes of HPV …
The objective of the study was to assess the health and economic outcomes of HPV vaccination in older U.S. women. The authors conducted a cost-effectiveness analysis with an empirically calibrated model using data from published literature; interventions included HPV vaccination added to screening strategies that differ by test (cytology or HPV DNA testing), frequency, and start age versus screening alone.They found that in the context of annual or biennial screening, HPV vaccination of women aged…
Cost-Effectiveness Analysis | Health/Medicine | North America | Infectious Diseases | Microsimulation | Chronic Disease/Risk | Clinical Care | Economics/Finance | Science/Technology -
ArticlePublication 2007Modeling HPV and Cervical Cancer in the U.S. for Analyses of Screening and Vaccination
This paper discusses a model of human papillomavirus (HPV) and cervical cancer that incorporates uncertainty …
This paper discusses a model of human papillomavirus (HPV) and cervical cancer that incorporates uncertainty about the natural history of disease that was used to provide quantitative insight into U.S. policy choices for cervical cancer prevention. The authors developed a stochastic microsimulation of cervical cancer that distinguishes different HPV types by their incidence, clearance, persistence, and progression. For each set of sampled input parameters, likelihood-based goodness-of-fit (GOF) scores were computed based on comparisons between model-predicted…
Health/Medicine | North America | Infectious Diseases | Microsimulation | Calibration/Validation | Chronic Disease/Risk | Clinical Care | Science/Technology -
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…
Cost-Effectiveness Analysis | Health/Medicine | North America | Infectious Diseases | Probability/Bayes | Preferences/Values | Costing Methods | Health Outcomes | Test Performance | Value of Information | State-Transition | Decision Analysis | Child/Nutrition | Chronic Disease/Risk | Economics/Finance | Global | Europe | Graduate | Doctoral | Critical Thinking/Analysis | Decision Making/Leadership | Quantitative Literacy -
ArticlePublication 2022Modeling the Effectiveness of Healthcare Personnel Reactive Testing and Screening for the SARS-Cov-2 Omicron Variant within Nursing Homes
The Omicron variant of SARS-CoV-2 has been hypothesized to exhibit faster clearance (time from peak …
The Omicron variant of SARS-CoV-2 has been hypothesized to exhibit faster clearance (time from peak viral concentration to clearance of acute infection), may be less detectable by antigen tests (decreased sensitivity), and may be more likely to evade immunity conferred by past infection or vaccination) compared to prior variants. This calls for a reassessment of strategies to prevent its spread, especially in vulnerable settings like nursing homes. Using a model that tracks viral shedding patterns,…
Health/Medicine | North America | Infectious Diseases | Test Performance | Mathematical Models