Resources Repository
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BookPublication 2014Decision Making in Health and Medicine: Integrating Evidence and Values
Decision making in health care involves consideration of a complex set of diagnostic, therapeutic and …
Decision making in health care involves consideration of a complex set of diagnostic, therapeutic and prognostic uncertainties. Medical therapies have side effects, surgical interventions may lead to complications, and diagnostic tests can produce misleading results. Furthermore, patient values and service costs must be considered. Decisions in clinical and health policy require careful weighing of risks and benefits and are commonly a trade-off of competing objectives: maximizing quality of life vs maximizing life expectancy vs minimizing…
Probability/Bayes | Decision Analysis | Health Outcomes | Health Systems | Preferences/Values | Costing Methods | Test Performance | Value of Information | Mathematical Models | Cost-Effectiveness Analysis | Economics/Finance | Government/Law | Health/Medicine | Global | North America | Europe | Graduate | Doctoral | Professional | 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 -
ExerciseNone, Teaching Resource 2024Lab: Giant Cell Arteritis Decision Tree Model
This tutorial walks through the development of a decision tree model focused on Giant Cell …
This tutorial walks through the development of a decision tree model focused on Giant Cell Arteritis. It describes how to build the model structure, assign probabilities and outcomes based on imperfect test characteristics and epidemiologic estimates, evaluate alternative treatment strategies, and conduct one-way sensitivity analyses to assess which model parameters may impact the optimal treatment choice. Amua, the Swahili word meaning “decide”/“solve”, is an open source modeling framework and probabilistic programming language for decision analysis…
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 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 | Health Systems | Clinical Care | Mathematical Models | Microsimulation | Calibration/Validation | Maternal/Reproductive Health | 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…
Health Outcomes | Health Systems | Clinical Care | Evidence Synthesis | Microsimulation | Calibration/Validation | Maternal/Reproductive Health | Health/Medicine | Global -
ArticlePublication 2021Impact of Treatment and Imaging Modalities on Global Breast Cancer Survival
This analysis used a microsimulation model of global cancer survival to simulate 5-year net survival …
This analysis used a microsimulation model of global cancer survival to simulate 5-year net survival for women with newly diagnosed breast cancer in 200 countries/territories in 2018, accounting for the availability and stage-specific survival impact of specific treatment modalities (chemotherapy, radiotherapy, surgery, and targeted therapy), imaging modalities (ultrasound, x-ray, CT, MRI, PET, and single-photon emission computed tomography [SPECT]), and quality of cancer care. The model was calibrated to empirical data on 5-year net breast cancer…
Health Outcomes | Health Systems | Clinical Care | Microsimulation | Calibration/Validation | Chronic Disease/Risk | Global -
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 | Health Systems | Clinical Care | Preferences/Values | Priority Setting/Ethics | 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 | Health Systems | Clinical Care | State-Transition | Cost-Effectiveness Analysis | Child/Nutrition | Chronic Disease/Risk | Food/Agriculture | Health/Medicine | Oceania