Resources Repository
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ArticlePublication 2020Weighing Evidence to Inform Clinical Decisions
The authors use a clinical example to simulate how treatment discussions can be complicated when new evidence is introduced …
The authors use a clinical example to simulate how treatment discussions can be complicated when new evidence is introduced that conflicts with existing guidelines. Even when evidence is consistent, the authors point out that current guidelines can have interpretations that don't agree with available evidence. They develop a step-wise algorithm to help guide individual clinical decisions even in the absence of general consensus related to appropriate testing and treatment.
Priority Setting/Ethics | Clinical Care | Evidence Synthesis | Health/Medicine -
ArticlePublication 2020Translating Population Evidence to Individual Patients
In this paper, the authors describe the differences in population level outcomes compared to individual …
In this paper, the authors describe the differences in population level outcomes compared to individual patients and discuss ways that these are differences. The authors cover topics including the difference between relative and absolute risk and benefit. They use an example of the decision to start anticoagulation in new-onset atrial fibrillation to discuss translating population level evidence to treatment of an individual. These options include generalizability, subgroup analysis, prediction rules, following response to therapy, and even…
Test Performance | Clinical Care | Evidence Synthesis | Health Systems | Health/Medicine -
ArticlePublication 2020Clinical Decision Making: Using a Diagnostic Test
This article is part of a 6-part series on clinical decision making. The authors use …
This article is part of a 6-part series on clinical decision making. The authors use two clinical examples to review the principles of interpreting diagnostic test results. They outline an approach that can be used to determine how to select and apply tests and their results to the practice of internal medicine. Topics covered in the two case studies include sensitivity and specificity, positive predictive and negative predictive value of tests, and how to estimate…
Test Performance | Clinical Care | Probability/Bayes | Health/Medicine -
ArticlePublication 2020Equity & Distributional Impact on Stunting of a Nutritional Package, Children Aged 6-36 Months in China: Modeling Study Findings
This article evaluates the potential impact of rolling out the Ying Yang Bao (YYB) nutritional …
This article evaluates the potential impact of rolling out the Ying Yang Bao (YYB) nutritional package on child stunting across provinces and wealth groups in China, focusing on equity. Utilizing data from the China Family Panel Studies and extended cost-effectiveness analysis methods, the study estimates the distributional impact of a 12-month YYB program for children aged 6-36 months across 25 provinces and two wealth groups. Results indicate that a 75% coverage of YYB could avert…
Cost-Effectiveness Analysis | Child/Nutrition | Health Outcomes | Mathematical Models | Health/Medicine | Asia & Pacific -
ArticlePublication 2020Premature Deaths, Statistical Lives, and Years of Life
This article clarifies some misconceptions about mortality risk and economic valuation. The mortality effects of …
This article clarifies some misconceptions about mortality risk and economic valuation. The mortality effects of exposure to environmental hazards such as air pollution are often described by the estimated number of “premature deaths” and the economic value of an exposure reduction as the number of “statistical lives saved” multiplied by the “value per statistical life.” These terms can be misleading because the number of deaths advanced by exposure cannot be determined from mortality data; it…
Benefit-Cost Analysis | Environmental Health | Preferences/Values | Health Outcomes | Policy/Regulation | College | Graduate | Critical Thinking/Analysis -
ArticlePublication 2019Cost-Effectiveness of Clinic, Home, or Ambulatory Blood Pressure Measurement for Hypertension Diagnosis
This study compared three methods of blood pressure (BP) measurement for diagnosing hypertension in primary …
This study compared three methods of blood pressure (BP) measurement for diagnosing hypertension in primary care settings, accounting for the possibility of false-positive (white-coat hypertension) and false-negative (masked hypertension) clinic measurements. Outcomes included quality-adjusted life years (QALYs) and lifetime costs associated with clinic BP measurement, home BP monitoring, and ambulatory blood pressure monitoring (ABPM) under two scenarios: positive and negative initial screening. Data were from published literature, public data sources, and expert input. In the…
Cost-Effectiveness Analysis | Clinical Care | Mathematical Models | Chronic Disease/Risk | Health/Medicine | North America -
ArticlePublication 2019Country Contextualization of Cost-Effectiveness Studies
This article, published in BMJ Global Health, provides experiences of country contextualization of WHO-CHOICE methods …
This article, published in BMJ Global Health, provides experiences of country contextualization of WHO-CHOICE methods and models to a country level. Results from three contextualized cost-effectiveness analyses (CEAs) are presented, and the authors discuss how this evidence can inform priority setting in Ethiopia. This method of contextualized CEAs requires inclusion of national analysts and use of country-specific inputs for either costs, epidemiology, demography, baseline coverage or effects. Rank ordering of interventions by incremental cost-effectiveness ratios…
Cost-Effectiveness Analysis | Clinical Care | Health Systems | Policy/Regulation | Health/Medicine | Sub-Saharan Africa -
ArticlePublication 2019CEA of Maternal and Neonatal Health Interventions
This article, published in Health Policy and Planning, examines the cost-effectiveness of several maternal and …
This article, published in Health Policy and Planning, examines the cost-effectiveness of several maternal and neonatal health (MNH) interventions in an Ethiopian setting. The authors employ a static life table model to estimate the health impact of a 20% increase in intervention coverage relative to baseline. The results indicate that many MNH interventions are highly cost-effective. This evidence can be useful to inform the ongoing essential health services package revision in Ethiopia.
Cost-Effectiveness Analysis | Child/Nutrition | Maternal/Reproductive Health | Health Systems | Health/Medicine | Sub-Saharan Africa -
ArticlePublication 2017Adolescent Pregnancy Prevention Program in Zambia
This article, published in Trials, outlines a protocol for a cost-benefit analysis (CBA) and an …
This article, published in Trials, outlines a protocol for a cost-benefit analysis (CBA) and an extended cost-effectiveness analysis (ECEA) of a comprehensive adolescent pregnancy prevention program in Zambia. The study will be conducted alongside a cluster-randomized controlled trial, which tests the hypothesis that economic support with or without community dialogue is an effective strategy for reducing adolescent childbearing rates. The ECEA will estimate the costs of the intervention packages per unit health and non-health gain…
Cost-Effectiveness Analysis | Child/Nutrition | Maternal/Reproductive Health | Social Determinants | Health Systems | Health/Medicine | Sub-Saharan Africa