Resources Repository
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ArticlePublication 2019Global Childhood Cancer Survival Estimates and Priority-Setting: A Simulation-Based Analysis
This modelling study provides estimates of global childhood cancer survival, accounting for the impact of …
This modelling study provides estimates of global childhood cancer survival, accounting for the impact of multiple factors that affect cancer outcomes in children. The authors developed a microsimulation model to simulate childhood cancer survival for 200 countries/territories, accounting for clinical and epidemiologic factors, including country-specific treatment variables, such as availability of chemotherapy, radiation, and surgery, and calibrated the model to empirical data from the CONCORD-2 and CONCORD-3 studies using an Approximate Bayesian Computation approach. The…
Priority Setting/Ethics | Health Outcomes | Clinical Care | Child/Nutrition | Microsimulation | Chronic Disease/Risk | Global -
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 | Decision Analysis | Health Outcomes | Child/Nutrition | Preferences/Values | Costing Methods | Test Performance | Value of Information | State-Transition | 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 -
Tutorial/PrimerPublication, Teaching Resource 2024Tutorial: Building Decision Trees
This tutorial illustrates the basic steps needed to develop decision trees in Amua using a …
This tutorial illustrates the basic steps needed to develop decision trees in Amua using a disease screening example. It details the process of how to build the structure of a decision tree, parameterize the model with probabilities and relevant outcomes (i.e., life expectancy), evaluate three alternative screening strategies in a baseline scenario, and perform one-way sensitivity analyses to assess the robustness of the results to different parameter values. Amua, the Swahili word meaning “decide”/“solve”, is…
Probability/Bayes | Decision Analysis | Clinical Care | Mathematical Models | Health/Medicine | Graduate | Doctoral | Professional -
ArticlePublication 2013Modeling the Effectiveness of Initial Management Strategies for Ductal Carcinoma in Situ
This paper compares alternative strategies to manage ductal carcinoma in situ (DCIS). The authors used …
This paper compares alternative strategies to manage ductal carcinoma in situ (DCIS). The authors used a disease simulation model to simulate the clinical events after six treatments (lumpectomy alone, lumpectomy with radiation, lumpectomy with radiation and tamoxifen, lumpectomy with tamoxifen, and mastectomy with and without breast reconstruction). Outcomes included disease-free, invasive disease-free, overall survival and breast preservation. Data were from the published literature. The results showed that for women aged 45 years at diagnosis, both mastectomy…
Decision Analysis | Health Outcomes | Clinical Care | Health/Medicine -
ArticlePublication 2023Simulation-Based Estimates and Projections of Global, Regional and Country-Level Maternal Mortality by Cause, 1990-2050
While progress has been made globally to reduce maternal deaths, measurement remains a challenge given …
While progress has been made globally to reduce maternal deaths, measurement remains a challenge given the many causes and frequent underreporting of maternal deaths. The authors developed a structural microsimulation model of Global Maternal Health (GMatH) for 200 countries and territories using demographic, epidemiologic, clinical and health system data synthesized from the medical literature, Civil Registration Vital Statistics systems and Demographic and Health Survey data. The model was calibrated to empirical data from 1990 to…
Evidence Synthesis | Health Outcomes | Clinical Care | Microsimulation | Calibration/Validation | Maternal/Reproductive Health | Health Systems | Health/Medicine | Global -
ArticlePublication 2022WHO ACTION-I Trial in Low Resource Countries
This study evaluated the cost-effectiveness of dexamethasone administration in dexamethasone in pregnant women at risk …
This study evaluated the cost-effectiveness of dexamethasone administration in dexamethasone in pregnant women at risk of early preterm birth using data from a multicentre, randomized, placebo-controlled trial in Bangladesh, India, Kenya, Nigeria, and Pakistan. Primary cost data were collected in 28 hospitals across the 5 countries. A decision tree model was used to compare dexamethasone treatment to no intervention from a health-care sector perspective. Administration of dexamethasone averted 38 neonatal deaths per 1000 woman–baby units…
Health Outcomes | Clinical Care | Child/Nutrition | Mathematical Models | Cost-Effectiveness Analysis | Maternal/Reproductive Health | Global | Sub-Saharan Africa | Asia & Pacific -
ArticlePublication 2022Priority Setting in Early Childhood Development: An Analytical Framework
Early childhood development (ECD) sets the foundation for healthy and successful lives with important consequences …
Early childhood development (ECD) sets the foundation for healthy and successful lives with important consequences for education, labor market outcomes, and other domains of well-being. Even though many ECD interventions are implemented and evaluated globally, there is currently no standardized framework for comparing these interventions’ relative cost-effectiveness. The investigators developed an economic evaluation framework that focuses on the immediate impact of ECD interventions targeting motor, cognitive, language, and socioemotional skills. They applied the framework to compute…
Priority Setting/Ethics | Decision Analysis | Child/Nutrition | Cost-Effectiveness Analysis | Global -
ArticlePublication 2021Individual and Social Determinants of COVID-19 Vaccine Uptake
This article examined the individual, communication and social determinants associated with COVID-19 vaccine uptake using …
This article examined the individual, communication and social determinants associated with COVID-19 vaccine uptake using national survey data collected before vaccines were available in the U.S. Of note, individuals under the federal poverty level and racial and ethnic minorities were oversampled. Outcomes included the likelihood of vaccinating self and dependents (e.g., children). Independent variables included perceptions of risk, exposure to different media for COVID-19 news, political party identification, confidence in scientists and social determinants of…
Evidence Synthesis | Health Outcomes | Clinical Care | Infectious Diseases | Social Determinants | Policy/Regulation | Culture/Society | Health/Medicine | Science/Technology | North America -
ArticlePublication 2020Incorporating Perspective into Clinical Decisions
Part of a six-part series of articles on clinical decision making, in this article, the …
Part of a six-part series of articles on clinical decision making, in this article, the authors discuss how to incorporate perspective into clinical decisions, explicitly acknowledging that the treating physician is not the only stakeholder in these decisions. The authors use 2 case studies to demonstrate how changes in perspective can alter the clinical decision as well lead to both intended and unintended consequences to the outcomes.
Priority Setting/Ethics | Health Outcomes | Clinical Care | Preferences/Values | Health Systems | Health/Medicine