Resources Repository
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ArticlePublication 2020Bayes' Theorem, COVID-19, and Screening Tests
This article reviews the implications of increased testing for COVID-19 using reverse transcriptase polymerase chain …
This article reviews the implications of increased testing for COVID-19 using reverse transcriptase polymerase chain reaction (rRT-PCR) through the application of Bayes’ Theorem for three hypothetical, stylized case scenarios. The scenarios involve three patients with a low, moderate, and high pre-test probability of COVID-19 infection. The category of low probability would include "asymptomatic individuals in a presumed low prevalence environment" and might vary from 10 to 20%. The category of moderate probability would include "individuals…
Clinical Care | Probability/Bayes | Test Performance | Infectious Diseases | Health/Medicine -
Tools/ModelsInteractive, Teaching Resource 2020Interactive Graphic: Interpreting a COVID-19 Test Result
Currently, the most common diagnostic test for COVID-19 relies on reverse transcriptase polymerase chain reaction …
Currently, the most common diagnostic test for COVID-19 relies on reverse transcriptase polymerase chain reaction (RT-PCR), and most often uses samples obtained from the respiratory tract by nasopharyngeal swab. This interactive graphic demonstrates the influence of the prior probability of COVID-19, the test sensitivity (i.e., the probability of a positive test conditional on disease presence), and the test specificity (i.e., the probability of a negative test conditional on disease absence) on the post-test probability of…
Clinical Care | Probability/Bayes | Test Performance | Infectious Diseases | Health/Medicine | Science/Technology | High School | College | Graduate | Doctoral | Professional | Graphics/Visualization | Quantitative Literacy -
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.
Clinical Care | Preferences/Values | Priority Setting/Ethics | Health Outcomes | Health Systems | Health/Medicine -
Resource PackPublication, Teaching Resource 2022Resource Pack: Decision Analysis & Childhood Obesity
This resource pack on childhood obesity was curated by the Center for Health Decision Science …
This resource pack on childhood obesity was curated by the Center for Health Decision Science to showcase existing cost-effectiveness analyses and motivate students, educators, and others to pursue new applications of decision science methods to the public health challenge of obesity. The resource pack was motivated by the NEJM article entitled Simulation of Growth Trajectories of Childhood Obesity into Adulthood published on November 30, 2017, with CHDS co-authors Zach Ward and Stephen Resch. Citation: Ward Z, Long M,…
Clinical Care | Costing Methods | Health Outcomes | Cost-Effectiveness Analysis | Child/Nutrition | Chronic Disease/Risk | Policy/Regulation | Culture/Society | Economics/Finance | Food/Agriculture | Health/Medicine | North America -
ArticlePublication 2019Cost-Effectiveness of Community-Based Childhood Obesity Prevention Interventions in Australia
This study examined the cost-effectiveness of community-based obesity prevention interventions (CBIs) consisting of strategies to …
This study examined the cost-effectiveness of community-based obesity prevention interventions (CBIs) consisting of strategies to promote healthy eating and physical activity for Australian children aged between 5-18 years. A multiple cohort Markov model that simulates diseases associated with overweight and obesity was used to estimate the health benefits, measured as health-adjusted life years (HALYs) and healthcare-related cost offsets from diseases averted due to exposure to the intervention. Health and cost outcomes were estimated over the…
Clinical Care | Health Outcomes | State-Transition | Cost-Effectiveness Analysis | Child/Nutrition | Chronic Disease/Risk | Health Systems | Food/Agriculture | Health/Medicine | Oceania -
ArticlePublication 2019Long-Term Cost-Effectiveness of Obesity Prevention Interventions in the Early Years of Life
This analysis estimated the long-term health benefits and health care cost-savings of reductions in body …
This analysis estimated the long-term health benefits and health care cost-savings of reductions in body mass index (BMI) for the Australian population of children aged between 2 and 5 years. A proportional multistate, multiple cohort, lifetable model estimated the health benefits and health care cost-savings related to hypothetical reductions in BMI, informed by a scoping review of systematic reviews reporting the effectiveness of obesity prevention interventions in preschool aged children. Results suggested significant potential for…
Clinical Care | Cost-Effectiveness Analysis | Child/Nutrition | Chronic Disease/Risk | Health Systems | Economics/Finance | Health/Medicine | Oceania -
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.
Clinical Care | Priority Setting/Ethics | 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…
Clinical Care | Evidence Synthesis | Test Performance | 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…
Clinical Care | Probability/Bayes | Test Performance | Health/Medicine