Resources Repository
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ArticlePublication 2020Testing for SARS-CoV-2 Antibodies
Antibody testing can determine previous exposure to SARS-CoV-2 virus. Recently, the UK government has made …
Antibody testing can determine previous exposure to SARS-CoV-2 virus. Recently, the UK government has made antibody testing available to anyone wanting it, even if there is no clinical indication. The purpose of this article is to provide guidance for when to consider antibody testing in individuals with and without symptoms suggestive of current or past SARS-CoV-2 infection. Key points made by the authors include: (1) antibody testing is likely to be most useful 2 weeks…
Clinical Care | Probability/Bayes | Test Performance | Technology Assessment | Infectious Diseases | Health/Medicine -
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 -
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…
Cost-Effectiveness Analysis | Clinical Care | 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 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 -
ArticlePublication 2019Cost-Effectiveness of Clinic, Home, or Ambulatory Blood Pressure Measurement for Hypertension Diagnosis
This study compared three methods of blood pressure (BP) measurement for diagnosing hypertension in primary …
This study compared three methods of blood pressure (BP) measurement for diagnosing hypertension in primary care settings, accounting for the possibility of false-positive (white-coat hypertension) and false-negative (masked hypertension) clinic measurements. Outcomes included quality-adjusted life years (QALYs) and lifetime costs associated with clinic BP measurement, home BP monitoring, and ambulatory blood pressure monitoring (ABPM) under two scenarios: positive and negative initial screening. Data were from published literature, public data sources, and expert input. In the…
Cost-Effectiveness Analysis | Clinical Care | Mathematical Models | Chronic Disease/Risk | Health/Medicine | North America -
ArticlePublication 2019Country Contextualization of Cost-Effectiveness Studies
This article, published in BMJ Global Health, provides experiences of country contextualization of WHO-CHOICE methods …
This article, published in BMJ Global Health, provides experiences of country contextualization of WHO-CHOICE methods and models to a country level. Results from three contextualized cost-effectiveness analyses (CEAs) are presented, and the authors discuss how this evidence can inform priority setting in Ethiopia. This method of contextualized CEAs requires inclusion of national analysts and use of country-specific inputs for either costs, epidemiology, demography, baseline coverage or effects. Rank ordering of interventions by incremental cost-effectiveness ratios…
Cost-Effectiveness Analysis | Clinical Care | Health Systems | Policy/Regulation | Health/Medicine | Sub-Saharan Africa -
ReportPublication 2018Understanding the Economics of Microbial Threats: Proceedings of a Workshop
This report follows a June 2018, Forum on Microbial Threats that was held at the …
This report follows a June 2018, Forum on Microbial Threats that was held at the National Academies of Sciences, Engineering, and Medicine. This was a 1.5-day public workshop with the goal being an assessment of the current understanding of the interaction of infectious disease threats and economic activity in order to suggest future areas of research. This workshop built on prior work of the Forum and aimed to build more mutual understanding between those in…
Health Outcomes | Clinical Care | Evidence Synthesis | Technology Assessment | Infectious Diseases | Policy/Regulation | Global Governance | Business/Industry | Economics/Finance | Health/Medicine | Global -
ArticlePublication 2017Cost-Effectiveness of Screening for Hypertension and Counseling for Prevention
This article aimed to compare the health and economic impact of 3 services recommended by …
This article aimed to compare the health and economic impact of 3 services recommended by the US Preventive Services Task Force for the primary prevention of cardiovascular disease (CVD): (1) aspirin counseling for the primary prevention of CVD and colorectal cancer, (2) screening and treatment for lipid disorders (usually high cholesterol), and (3) screening and treatment for hypertension. A microsimulation model was used to compare lifetime outcomes from the societal perspective for a US-representative birth…
Cost-Effectiveness Analysis | Clinical Care | Microsimulation | Chronic Disease/Risk | Policy/Regulation | Health/Medicine | North America