Resources Repository
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ArticlePublication 2009Cost Effectiveness Analysis of Including Boys in a HPV Vaccination Program in the U.S.
This article reports on a societal-perspective cost effectiveness analysis of including preadolescent boys in a …
This article reports on a societal-perspective cost effectiveness analysis of including preadolescent boys in a routine human papillomavirus (HPV) vaccination program for preadolescent girls. The analysis included girls and boys aged 12 years; interventions included HPV vaccination of girls alone and of girls and boys in the context of screening for cervical cancer. The authors found that with 75% vaccination coverage and an assumption of complete, lifelong vaccine efficacy, routine HPV vaccination of 12-year-old girls…
Clinical Care | Dynamic Transmission | Microsimulation | Calibration/Validation | Cost-Effectiveness Analysis | Infectious Diseases | Chronic Disease/Risk | Economics/Finance | Health/Medicine | North America -
ArticlePublication 2009Cost-Effectiveness of Rotavirus Vaccination in Vietnam
This article reports on a cost-effectiveness analysis of rotavirus vaccination, including varying degrees of severity, …
This article reports on a cost-effectiveness analysis of rotavirus vaccination, including varying degrees of severity, age-dependency of clinical manifestation, and additional features of the disease (e.g., the possibility of reinfection and varying degrees of partial immunity conferred by natural infection). The authors developed a Markov model that reflects key features of rotavirus infection, using the most recent data available at the time of their analysis. They applied the model to the 2004 Vietnamese birth cohort…
Child/Nutrition | Mathematical Models | Calibration/Validation | Cost-Effectiveness Analysis | Infectious Diseases | Health Systems | Health/Medicine | Asia & Pacific -
ArticlePublication 2008Health and Economic Implications of HPV Vaccination in the U.S.
This article reports on a study using models of HPV-16 and HPV-18 transmission and cervical …
This article reports on a study using models of HPV-16 and HPV-18 transmission and cervical carcinogenesis to compare the health and economic outcomes of vaccinating preadolescent girls in the US (at 12 years of age), and vaccinating older girls and women in catch-up programs (to 18, 21, or 26 years of age). The study also examined the health benefits of averting other HPV-16-related and HPV-18-related cancers, the prevention of HPV-6-related and HPV-11-related genital warts and…
Clinical Care | Dynamic Transmission | Microsimulation | Calibration/Validation | Cost-Effectiveness Analysis | Infectious Diseases | Chronic Disease/Risk | Health Systems | Economics/Finance | Health/Medicine | Science/Technology | North America -
ArticlePublication 2008Health and Economic Impact of HPV 16 and 18 Vaccination and Cervical Cancer Screening in India
As cervical cancer is a leading cause of cancer death among women in low-income countries, …
As cervical cancer is a leading cause of cancer death among women in low-income countries, with approximately 25% of cases worldwide occurring in India, these authors estimated the potential health and economic impact of different cervical cancer prevention strategies in India. After empirically calibrating a cervical cancer model to country-specific epidemiologic data, they projected cancer incidence, life expectancy, and lifetime costs (I$2005), and calculated incremental cost-effectiveness ratios (I$/YLS) for the following strategies: pre-adolescent vaccination of…
Clinical Care | Microsimulation | Calibration/Validation | Cost-Effectiveness Analysis | Infectious Diseases | Chronic Disease/Risk | Health Systems | Economics/Finance | Health/Medicine | Science/Technology | Asia & Pacific -
ArticlePublication 2007Including Boys in an HPV Vaccination Program: A CEA in a Low-Resource Setting
This paper looks at the cost-effectiveness of including boys vs girls alone in a pre-adolescent vaccination …
This paper looks at the cost-effectiveness of including boys vs girls alone in a pre-adolescent vaccination program against human papillomavirus (HPV) types 16 and 18 in Brazil. Using demographic, epidemiological, and cancer data from Brazil, the authors developed a dynamic transmission model of HPV infection between males and females. Model-projected reductions in HPV incidence under different vaccination scenarios were applied to a stochastic model of cervical carcinogenesis to project lifetime costs and benefits. They found that at 90%…
Clinical Care | Microsimulation | Calibration/Validation | Cost-Effectiveness Analysis | Infectious Diseases | Chronic Disease/Risk | Health/Medicine | Latin America & Caribbean -
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…
Clinical Care | Microsimulation | Calibration/Validation | Infectious Diseases | Chronic Disease/Risk | Health/Medicine | Science/Technology | North America -
ReviewPublication 2001Modeling for Health Care and Other Policy Decisions: Uses, Roles and Validity
This is a review article of the role of modeling approaches to guide decision making …
This is a review article of the role of modeling approaches to guide decision making in health care and other domains. The role of models to support recommendations on the cost-effective use of medical technologies and pharmaceuticals is controversial. At the heart of the controversy is the degree to which experimental or other empirical evidence should be required prior to model use. The authors argue that the controversy stems in part from a misconception that…
Environmental Health | Priority Setting/Ethics | Evidence Synthesis | Mathematical Models | Technology Assessment | Health Systems | Policy/Regulation | Business/Industry | Climate/Environment | Economics/Finance | Energy/Engineering | Government/Law | Health/Medicine | 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…
Child/Nutrition | Probability/Bayes | Preferences/Values | Costing Methods | Health Outcomes | Test Performance | Value of Information | State-Transition | Decision Analysis | Cost-Effectiveness Analysis | Infectious Diseases | Chronic Disease/Risk | Economics/Finance | Health/Medicine | Global | North America | Europe | Graduate | Doctoral | Critical Thinking/Analysis | Decision Making/Leadership | Quantitative Literacy -
ReviewPublication 1978Basic Principles of ROC Analysis
The limitations of diagnostic "accuracy" as a measure of decision performance require introduction of the …
The limitations of diagnostic "accuracy" as a measure of decision performance require introduction of the concepts of the "sensitivity" and "specificity" yet even these do not provide a unique description of diagnostic performance because they depend on the arbitrary selection of a decision threshold. The receiver operating characteristic (ROC) curve is shown to be a simple yet complete empirical description of this decision threshold effect, indicating all possible combinations of the relative frequencies of the…
Clinical Care | Test Performance | Health/Medicine