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…
Probability/Bayes | Clinical Care | Test Performance | Infectious Diseases | Health/Medicine -
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.
Health Outcomes | Clinical Care | Preferences/Values | Priority Setting/Ethics | Health Systems | Health/Medicine -
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…
Health Outcomes | Clinical Care | State-Transition | Cost-Effectiveness Analysis | Child/Nutrition | Chronic Disease/Risk | Health Systems | Food/Agriculture | Health/Medicine | Oceania -
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…
Probability/Bayes | Clinical Care | Test Performance | Health/Medicine -
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…
Health Outcomes | Environmental Health | Preferences/Values | Benefit-Cost Analysis | Policy/Regulation | College | Graduate | Critical Thinking/Analysis -
ArticlePublication 2017Reduced Burden of Childhood Diarrheal Diseases through Increased Access to Water and Sanitation in India: Modeling Analysis
This analysis estimates the health and economic benefits of scaling up the coverage of piped …
This analysis estimates the health and economic benefits of scaling up the coverage of piped water and improved sanitation to a near-universal 95% level among Indian households. The authors used an agent-based microsimulation platform, IndiaSim, to model disease progression and individual healthcare-seeking behavior in India, and use ECEA to estimate health and economic outcomes over time. They found that scaling up access to piped water and improved sanitation could avert 43,352 diarrheal episodes and 68…
Health Outcomes | Environmental Health | Priority Setting/Ethics | Costing Methods | Microsimulation | Cost-Effectiveness Analysis | Child/Nutrition | Social Determinants | Economics/Finance | Energy/Engineering | Health/Medicine | Science/Technology | Asia & Pacific -
ArticlePublication 2016Estimating the Cost-Effectiveness of Implementation: Is Sufficient Evidence Available?
Timely implementation of recommended interventions can provide health benefits to patients and cost savings to …
Timely implementation of recommended interventions can provide health benefits to patients and cost savings to the health service provider. Effective approaches to increase the implementation of guidance are needed. Since investment in activities that improve implementation competes for funding against other health generating interventions, it should be assessed in term of its costs and benefits. In 2010, the National Institute for Health and Care Excellence released a clinical guideline recommending natriuretic peptide (NP) testing in…
Health Outcomes | Clinical Care | Cost-Effectiveness Analysis | Operations Research | Chronic Disease/Risk | Health Systems | Economics/Finance | Health/Medicine | Europe -
ArticlePublication 2015A Conceptual Model for Breast, Cervical, and Colorectal Cancer Screening
General frameworks of the cancer screening process are available, but none directly compare the process …
General frameworks of the cancer screening process are available, but none directly compare the process in detail across different organ sites. This limits the ability of medical and public health professionals to develop and evaluate coordinated screening programs that apply resources and population management strategies available for one cancer site to other sites. This paper presents a conceptual model that incorporates a single screening episode for breast, cervical, and colorectal cancers into a unified framework based…
Health Outcomes | Clinical Care | Preferences/Values | Evidence Synthesis | Test Performance | Microsimulation | Cost-Effectiveness Analysis | Chronic Disease/Risk | Health Systems | Health/Medicine | Science/Technology | North America -
ArticlePublication 2015Universal Public Finance of Tuberculosis Treatment in India: An Extended CEA
This paper evaluates the consequences of universal public finance (UPF) for tuberculosis treatment in India …
This paper evaluates the consequences of universal public finance (UPF) for tuberculosis treatment in India using extended cost-effectiveness analysis (ECEA). The authors evaluated the impact of UPF on health gains, financial consequences, and catastrophic health expenditures, and concluded that the health gains and insurance value of UPF would accrue mostly to the poor. However, reductions in out-of-pocket expenditures were found to be more uniformly distributed across income quintiles. A variant on the base case suggests…
Health Outcomes | Clinical Care | Priority Setting/Ethics | Costing Methods | Cost-Effectiveness Analysis | Infectious Diseases | Social Determinants | Health Systems | Policy/Regulation | Economics/Finance | Health/Medicine | Asia & Pacific