Resources Repository
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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…
Microsimulation | Clinical Care | Health Outcomes | Mathematical Models | Calibration/Validation | Maternal/Reproductive Health | Health Systems | 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…
Microsimulation | Clinical Care | Health Outcomes | Evidence Synthesis | Calibration/Validation | Maternal/Reproductive Health | Health Systems | Health/Medicine | Global -
ArticlePublication 2022Cost-Effectiveness of Masked Hypertension Screening and Treatment
The study assessed the health and economic outcomes of screening and treating masked hypertension in …
The study assessed the health and economic outcomes of screening and treating masked hypertension in U.S. adults using the Cardiovascular Disease (CVD) Policy Model, a microsimulation model. The model simulated 100,000 adults suspected of having masked hypertension (office blood pressure [BP] of 120–129/<80 mm Hg, not on antihypertensive medications, and without a history of CVD). Interventions included: usual care alone, usual care with ambulatory BP monitoring (ABPM), and usual care with home BP monitoring (HBPM).…
Microsimulation | Clinical Care | Cost-Effectiveness Analysis | Chronic Disease/Risk | Health/Medicine | North America -
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…
Microsimulation | Clinical Care | Priority Setting/Ethics | Health Outcomes | Child/Nutrition | Chronic Disease/Risk | 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…
Microsimulation | Clinical Care | Health Outcomes | Calibration/Validation | Chronic Disease/Risk | Health Systems | Global -
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…
Probability/Bayes | Clinical Care | 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…
Probability/Bayes | Clinical Care | Test Performance | Infectious Diseases | 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…
Probability/Bayes | Clinical Care | Test Performance | Health/Medicine -
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…
Microsimulation | Clinical Care | Cost-Effectiveness Analysis | Chronic Disease/Risk | Policy/Regulation | Health/Medicine | North America