Resources Repository
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ArticlePublication 2023Simulation-Based Comparative Effectiveness Analysis of Policies to Improve Global Maternal Health Outcomes
The Sustainable Development Goals include a target to reduce the global maternal mortality ratio (MMR) …
The Sustainable Development Goals include a target to reduce the global maternal mortality ratio (MMR) to less than 70 maternal deaths per 100,000 live births by 2030, with no individual country exceeding 140. However, on current trends the goals are unlikely to be met. The authors used an empirically calibrated Global Maternal Health microsimulation model, which simulates individual women in 200 countries and territories to evaluate the impact of different interventions and strategies from 2022…
Maternal/Reproductive Health | Clinical Care | Health Outcomes | Mathematical Models | Microsimulation | Calibration/Validation | Health Systems | Health/Medicine | Global -
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…
Maternal/Reproductive Health | Clinical Care | Health Outcomes | Evidence Synthesis | Microsimulation | Calibration/Validation | Health Systems | Health/Medicine | Global -
ArticlePublication 2008Cost-Effectiveness of Rapid Point-of-Care Prenatal Syphilis Screening in Sub-Saharan Africa
This paper investigates the cost-effectiveness of using rapid point-of-care tests for prenatal syphilis screening among …
This paper investigates the cost-effectiveness of using rapid point-of-care tests for prenatal syphilis screening among pregnant women in sub-Saharan Africa, a region with syphilis prevalence rates as high as 17%, and where traditional multi-test screening methods have been challenging to implement. Focusing on newly available rapid point-of-care screening tests, strategies differed by the initial test [rapid plasma reagin (RPR), immunochromographic strip (ICS)], need for confirmation with Treponema pallidum hemagglutination assay, and number of visits required.…
Maternal/Reproductive Health | Clinical Care | Costing Methods | Test Performance | Mathematical Models | Cost-Effectiveness Analysis | Technology Assessment | Infectious Diseases | Health/Medicine | Sub-Saharan Africa -
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…
Maternal/Reproductive Health | Clinical Care | Health Outcomes | Mathematical Models | Cost-Effectiveness Analysis | Child/Nutrition | Global | Sub-Saharan Africa | Asia & Pacific -
ArticlePublication 2023Cost-Effectiveness of Pharmacist Prescribing for Managing Hypertension
This study estimates the cost-effectiveness of implementing a pharmacist-prescribing intervention to improve blood pressure control …
This study estimates the cost-effectiveness of implementing a pharmacist-prescribing intervention to improve blood pressure control in the US. A cost-effectiveness analysis was conducted using a Markov model based on the pharmacist-prescribing intervention used in The Alberta Clinical Trial in Optimizing Hypertension (or RxACTION). Outcomes included cardiovascular (CV) events, end-stage kidney disease events, life years, quality-adjusted life years (QALYs), lifetime costs, and lifetime incremental cost-effectiveness ratio (ICER). Costs were based on reimbursement rates, published literature, national…
Clinical Care | Mathematical Models | State-Transition | Cost-Effectiveness Analysis | Chronic Disease/Risk | Health/Medicine | North America -
ArticlePublication 2023Cost-Effectiveness of Intensive vs. Standard Blood Pressure Control Among Older Patients
This economic analysis explored the cost-effectiveness of intensive vs standard blood pressure control in older …
This economic analysis explored the cost-effectiveness of intensive vs standard blood pressure control in older hypertensive patients between 60 and 80 years in China, the US, and the UK. Treatment outcome data from the Trial of Intensive Blood-Pressure Control in Older Patients with Hypertension (STEP trial) and different cardiovascular risk assessment models for a hypothetical cohort of STEP-eligible patients were used. Costs and utilities were obtained from published sources. A Markov model was used to…
Clinical Care | Mathematical Models | Cost-Effectiveness Analysis | Chronic Disease/Risk | North America -
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…
Clinical Care | Health Outcomes | Decision Analysis | Health/Medicine -
ArticlePublication 2021CEA of Alternative Colorectal Cancer Screening Strategies in High-Risk Individuals
Fecal occult blood testing with an immunochemical test (FIT) is generally considered as the most …
Fecal occult blood testing with an immunochemical test (FIT) is generally considered as the most cost-effective alternative in colorectal cancer screening programs for average risk individuals without family history. Colorectal screening guidelines recommend colonoscopy every 3-5 years for high-risk individuals with a family history. The authors use a microsimulation model of the natural history of colorectal cancer (CRC) to compare the costs, quality-adjusted life years, and cost effectiveness associated with several screening strategies in high-risk individuals,…
Clinical Care | Cost-Effectiveness Analysis | Health/Medicine -
ArticlePublication 2010Alternative Strategies to Reduce Maternal Mortality in India: A Cost-Effectiveness Analysis
This article, published in PLoS Medicine, conducted a cost-effectiveness analysis of strategies to improve pregnancy …
This article, published in PLoS Medicine, conducted a cost-effectiveness analysis of strategies to improve pregnancy and childbirth safety in India. Country- and region-specific data were synthesized using a computer-based model that simulates the natural history of pregnancy and pregnancy-associated complications in individual women, and considers delivery location, attendant, and facility level. Model validation compared projected maternal indicators with empiric data. Strategies consisted of improving coverage of effective interventions that could be provided individually or packaged…
Maternal/Reproductive Health | Evidence Synthesis | Mathematical Models | Microsimulation | Cost-Effectiveness Analysis | Economics/Finance | Health/Medicine | Global | Asia & Pacific