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Resources Repository
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ArticlePublication 2016Departures from Cost-Effectiveness Recommendations: Health System Constraints
Cost-effectiveness analysis assumes a single constraint, in the form of the budget constraint, whereas in reality …
Cost-effectiveness analysis assumes a single constraint, in the form of the budget constraint, whereas in reality decision makers may be faced with numerous other constraints. The objective of this article is to develop a typology of constraints that may act as barriers to implementation of cost-effectiveness recommendations. Six categories of constraints are considered: the design of the health system; costs of implementing change; system interactions between interventions; uncertainty in estimates of costs and benefits; weak governance;…
Cost-Effectiveness Analysis | Health/Medicine | Policy/Regulation | Priority Setting/Ethics | Health Systems | Economics/Finance | Education/Labor | Government/Law | Sub-Saharan Africa | Middle East & North Africa | Latin America & Caribbean | Asia & Pacific -
ArticlePublication 2015Valuing Regulations Affecting Addictive or Habitual Goods
The analysis of regulations affecting addictive or habitual goods has drawn considerable controversy. Some studies …
The analysis of regulations affecting addictive or habitual goods has drawn considerable controversy. Some studies have suggested that such regulations have only small welfare benefits, as consumers value these goods despite health benefits from quitting, while other studies suggest that information or behavioral problems make existing consumption decisions a poor guide to welfare evaluation. This analysis examines potential utility offsets to health benefits of regulations affecting addictive or habitual goods theoretically and empirically. The paper…
Benefit-Cost Analysis | Health/Medicine | Policy/Regulation | Preferences/Values | Chronic Disease/Risk | Social Determinants | Culture/Society | Economics/Finance | North America -
ReviewPublication 2014Markov Modeling & Discrete Event Simulation in Health Care: Systematic Comparison
This review assesses whether the use of Markov modeling (MM) or discrete event simulation (DES) …
This review assesses whether the use of Markov modeling (MM) or discrete event simulation (DES) for cost-effectiveness analysis (CEA) may alter healthcare resource allocation decisions. A systematic literature search and review of empirical and non-empirical studies comparing MM and DES techniques used in the CEA of healthcare technologies was conducted. The primary advantages described for DES over MM were the ability to model queuing for limited resources, capture individual patient histories, accommodate complexity and uncertainty,…
Mathematical Models | Health/Medicine | Clinical Care | State-Transition | Microsimulation | Health Systems -
ArticlePublication 2010Clinical Benefits, Costs, and Cost-Effectiveness of Neonatal Intensive Care in Mexico
This article reports on a study to estimate the clinical outcomes, costs, and cost-effectiveness of …
This article reports on a study to estimate the clinical outcomes, costs, and cost-effectiveness of neonatal intensive care in Mexico. The authors conducted a cost-effectiveness analysis using a decision analytic model of health and economic outcomes following preterm birth. Model parameters governing health outcomes were estimated from Mexican vital registration and hospital discharge databases, supplemented with meta-analyses and systematic reviews from the published literature. Costs were estimated on the basis of data provided by the…
Cost-Effectiveness Analysis | Health/Medicine | Clinical Care | State-Transition | Child/Nutrition | Health Systems | Latin America & Caribbean -
ArticlePublication 2009Cost Effectiveness Analysis of Including Boys in a HPV Vaccination Program in the U.S.
This article reports on a societal-perspective cost effectiveness analysis of including preadolescent boys in a …
This article reports on a societal-perspective cost effectiveness analysis of including preadolescent boys in a routine human papillomavirus (HPV) vaccination program for preadolescent girls. The analysis included girls and boys aged 12 years; interventions included HPV vaccination of girls alone and of girls and boys in the context of screening for cervical cancer. The authors found that with 75% vaccination coverage and an assumption of complete, lifelong vaccine efficacy, routine HPV vaccination of 12-year-old girls…
Cost-Effectiveness Analysis | Health/Medicine | Clinical Care | Dynamic Transmission | Microsimulation | Calibration/Validation | Infectious Diseases | Chronic Disease/Risk | Economics/Finance | North America -
ArticlePublication 2007Including Boys in an HPV Vaccination Program: A CEA in a Low-Resource Setting
This paper looks at the cost-effectiveness of including boys vs girls alone in a pre-adolescent vaccination …
This paper looks at the cost-effectiveness of including boys vs girls alone in a pre-adolescent vaccination program against human papillomavirus (HPV) types 16 and 18 in Brazil. Using demographic, epidemiological, and cancer data from Brazil, the authors developed a dynamic transmission model of HPV infection between males and females. Model-projected reductions in HPV incidence under different vaccination scenarios were applied to a stochastic model of cervical carcinogenesis to project lifetime costs and benefits. They found that at 90%…
Cost-Effectiveness Analysis | Health/Medicine | Clinical Care | Microsimulation | Calibration/Validation | Infectious Diseases | Chronic Disease/Risk | Latin America & Caribbean -
ReviewPublication 1978Basic Principles of ROC Analysis
The limitations of diagnostic "accuracy" as a measure of decision performance require introduction of the …
The limitations of diagnostic "accuracy" as a measure of decision performance require introduction of the concepts of the "sensitivity" and "specificity" yet even these do not provide a unique description of diagnostic performance because they depend on the arbitrary selection of a decision threshold. The receiver operating characteristic (ROC) curve is shown to be a simple yet complete empirical description of this decision threshold effect, indicating all possible combinations of the relative frequencies of the…
Test Performance | Health/Medicine | Clinical Care