Resources Repository
-
ArticlePublication 2024Hypertension Care Cascades and Reducing Inequities in Cardiovascular Disease in LMIC
This study investigates the distributional implications of enhancing hypertension control in low- and middle-income countries …
This study investigates the distributional implications of enhancing hypertension control in low- and middle-income countries (LMICs) across wealth quintiles. Using individual-level data from nationally representative surveys in 44 LMICs, the researchers simulated improvements in the hypertension care cascade and assessed the distributional benefits. They raised diagnosis and treatment levels for all wealth quintiles to match the best-performing country quintile and estimated the resulting change in 10-year cardiovascular disease (CVD) risk. Results indicate greater health benefits…
Cost-Effectiveness Analysis | Chronic Disease/Risk | Health/Medicine -
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…
Health Outcomes | Clinical Care | 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,…
Cost-Effectiveness Analysis | Clinical Care | Health/Medicine -
ArticlePublication 2023Designing Guidelines for Those Who Do Not Follow Them: Impact of Adherence Assumptions on Optimal Screening Guidelines
This study examines the impact of real-world screening adherence on the cost-effectiveness of cervical cancer …
This study examines the impact of real-world screening adherence on the cost-effectiveness of cervical cancer screening guidelines. Using a microsimulation model of cervical carcinogenesis, the researchers projected long-term health and economic outcomes for 18 screening algorithms under various adherence scenarios. These included perfect adherence, eight high- and low-coverage "random-complier" scenarios, and three "systematic-complier" scenarios reflecting conditional screening behavior over a lifetime. Results showed that perfect adherence favored the least intensive screening strategy, while any level…
Cost-Effectiveness Analysis | Chronic Disease/Risk | Mathematical Models | Microsimulation | Health/Medicine -
ArticlePublication 2023New Type 2 Diabetes Microsimulation Model to Estimate Long-Term Health Outcomes, Costs, Cost-Effectiveness
This study presents a microsimulation model designed to estimate the health effects, costs, and cost-effectiveness …
This study presents a microsimulation model designed to estimate the health effects, costs, and cost-effectiveness of interventions for type 2 diabetes in the United States. Unlike existing models that rely on UK data, this model incorporates newly derived risk equations based on US studies, enhancing its applicability to the US context. The model features a highly modular architecture allowing for easy addition of new modules and interventions, facilitating policy decision-making. Internal validation showed good performance,…
Cost-Effectiveness Analysis | Chronic Disease/Risk | Microsimulation | Health/Medicine | North America -
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…
Health Outcomes | Calibration/Validation | Clinical Care | Mathematical Models | Microsimulation | Maternal/Reproductive Health | Health Systems | Health/Medicine | Global -
ArticlePublication 2023Performance of Rapid Antigen Tests to Detect Symptomatic and Asymptomatic SARS-CoV-2 Infection
The objective of this study was to evaluate the performance of rapid antigen tests (Ag-RDTs) …
The objective of this study was to evaluate the performance of rapid antigen tests (Ag-RDTs) for detection of SARS-CoV-2 among symptomatic and asymptomatic participants. The general findings were that the performance of Ag-RDTs was optimized when asymptomatic participants tested 3 times at 48-hour intervals and when symptomatic participants tested 2 times separated by 48 hours. Participants completed Ag-RDTs and reverse transcriptase polymerase chain reaction (RT-PCR) testing for SARS-CoV-2 every 48 hours for 15 days. They…
Test Performance | Clinical Care | Infectious Diseases | Health/Medicine | Science/Technology | North America -
ArticlePublication 2020Variation in False-Negative Rate of Reverse Transcriptase Polymerase Chain Reaction-Based SARS-CoV-2 Tests by Time Since Exposure
This study aimed to determine the false-negative rate of RT-PCR tests for SARS-CoV-2 infection based …
This study aimed to determine the false-negative rate of RT-PCR tests for SARS-CoV-2 infection based on the timeline of exposure and symptom onset. Drawing from data in seven studies involving 1,330 upper respiratory tract samples, a Bayesian model was used to estimate these rates. Findings showed that in the initial four days prior to typical symptom onset, the false-negative rate decreased from 100% on day 1 to 67% on day 4. By the day of…
Test Performance | Clinical Care | Infectious Diseases | Health/Medicine | Science/Technology | North America -
ArticlePublication 2022Comparison of Home Antigen Testing With RT-PCR and Viral Culture During the Course of SARS-CoV-2 Infection
As the availability of at-home self-collected antigen tests for SARS-CoV-2 increases, understanding their efficacy is …
As the availability of at-home self-collected antigen tests for SARS-CoV-2 increases, understanding their efficacy is crucial. A study in San Diego and Denver between January and May 2021 assessed the reliability of these tests against standard RT-PCR tests and viral cultures. Of the 225 participants with confirmed infections, the antigen test sensitivity was found to be 50% during the infectious period, 64% against the same-day RT-PCR, and 84% against the same-day cultures. Sensitivity was highest…
Test Performance | Clinical Care | Infectious Diseases | Culture/Society | Health/Medicine | Science/Technology