Resources Repository
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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…
Evidence Synthesis | Preferences/Values | Microsimulation | Clinical Care | Health Outcomes | Test Performance | Cost-Effectiveness Analysis | Chronic Disease/Risk | Health Systems | Health/Medicine | Science/Technology | North America -
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…
Evidence Synthesis | Microsimulation | Clinical Care | Health Outcomes | Calibration/Validation | Maternal/Reproductive Health | Health Systems | Health/Medicine | Global -
ArticlePublication 2019Global Childhood Cancer Survival Estimates and Priority-Setting: A Simulation-Based Analysis
This modelling study provides estimates of global childhood cancer survival, accounting for the impact of …
This modelling study provides estimates of global childhood cancer survival, accounting for the impact of multiple factors that affect cancer outcomes in children. The authors developed a microsimulation model to simulate childhood cancer survival for 200 countries/territories, accounting for clinical and epidemiologic factors, including country-specific treatment variables, such as availability of chemotherapy, radiation, and surgery, and calibrated the model to empirical data from the CONCORD-2 and CONCORD-3 studies using an Approximate Bayesian Computation approach. The…
Priority Setting/Ethics | Microsimulation | Clinical Care | Health Outcomes | Child/Nutrition | 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.
Priority Setting/Ethics | Preferences/Values | Clinical Care | Health Outcomes | Health Systems | Health/Medicine -
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.
Evidence Synthesis | Priority Setting/Ethics | Clinical Care | Health/Medicine -
ArticlePublication 2015Population Health Model (POHEM): An Overview
This paper provides an overview of the rationale, methodology and applications of the Population Health …
This paper provides an overview of the rationale, methodology and applications of the Population Health Model (POHEM). POHEM is a health microsimulation model, developed at Statistics Canada in the early 1990s. The authors describe that POHEM draws together rich multivariate data from a wide range of sources to simulate the lifecycle of the Canadian population, specifically focusing on aspects of health. The model dynamically simulates individuals’ disease states, risk factors, and health determinants, in order…
Evidence Synthesis | Microsimulation | Clinical Care | Costing Methods | Mathematical Models | Calibration/Validation | Chronic Disease/Risk | Health Systems | Policy/Regulation | Economics/Finance | Health/Medicine | 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,…
Microsimulation | State-Transition | Clinical Care | Mathematical Models | Health Systems | Health/Medicine -
ArticlePublication 2011Model-Based Analyses to Compare Health and Economic Outcomes of Cancer Control: Inclusion of Disparities
In order to identify strategies that improve both population health and ensure its equitable distribution, …
In order to identify strategies that improve both population health and ensure its equitable distribution, the authors developed a typology of cancer disparities that considers types of inequalities among black, white, and Hispanic populations across different cancers. This paper reports on the typology using an existing disease simulation model of cervical cancer that was calibrated to clinical, epidemiological, and cost data in the United States and presents characteristics important for policy discussions. The typology proposed…
Priority Setting/Ethics | State-Transition | Clinical Care | Cost-Effectiveness Analysis | Chronic Disease/Risk | Social Determinants | Health Systems | Culture/Society | Health/Medicine | Science/Technology | North America -
ArticlePublication 2023Cost-Effectiveness of Pharmacist Prescribing for Managing Hypertension
This study estimates the cost-effectiveness of implementing a pharmacist-prescribing intervention to improve blood pressure control …
This study estimates the cost-effectiveness of implementing a pharmacist-prescribing intervention to improve blood pressure control in the US. A cost-effectiveness analysis was conducted using a Markov model based on the pharmacist-prescribing intervention used in The Alberta Clinical Trial in Optimizing Hypertension (or RxACTION). Outcomes included cardiovascular (CV) events, end-stage kidney disease events, life years, quality-adjusted life years (QALYs), lifetime costs, and lifetime incremental cost-effectiveness ratio (ICER). Costs were based on reimbursement rates, published literature, national…
State-Transition | Clinical Care | Mathematical Models | Cost-Effectiveness Analysis | Chronic Disease/Risk | Health/Medicine | North America