Resources Repository
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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…
Health Outcomes | Health/Medicine | Clinical Care | Decision Analysis -
ArticlePublication 2023Achieving the Cancer Moonshot Goal
The Cancer Moonshot seeks to reduce age-standardized cancer mortality rates by at least 50% over …
The Cancer Moonshot seeks to reduce age-standardized cancer mortality rates by at least 50% over the next 25 years. This article estimates trends in U.S. cancer mortality for all cancers and the six leading types and reviews opportunities to prevent, detect, and treat these common cancers.
Health/Medicine | Clinical Care | Priority Setting/Ethics | Mathematical Models | Health Systems | North America -
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 | Health/Medicine | Clinical Care | Test Performance | Technology Assessment | Infectious Diseases -
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 | Health/Medicine | Clinical Care | Test Performance | Infectious Diseases -
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.
Health/Medicine | Clinical Care | Priority Setting/Ethics | Evidence Synthesis -
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 | Health/Medicine | Clinical Care | Test Performance -
ArticlePublication 2016Estimating the Cost-Effectiveness of Implementation: Is Sufficient Evidence Available?
Timely implementation of recommended interventions can provide health benefits to patients and cost savings to …
Timely implementation of recommended interventions can provide health benefits to patients and cost savings to the health service provider. Effective approaches to increase the implementation of guidance are needed. Since investment in activities that improve implementation competes for funding against other health generating interventions, it should be assessed in term of its costs and benefits. In 2010, the National Institute for Health and Care Excellence released a clinical guideline recommending natriuretic peptide (NP) testing in…
Health Outcomes | Health/Medicine | Clinical Care | Cost-Effectiveness Analysis | Operations Research | Chronic Disease/Risk | Health Systems | Economics/Finance | Europe -
ArticlePublication 2015Cancer Models and Real-World Data: Better Together
Decision-analytic models synthesize available data on disease burden and intervention effectiveness to project estimates of …
Decision-analytic models synthesize available data on disease burden and intervention effectiveness to project estimates of the long-term consequences of care. While models have been influential in informing US cancer screening guidelines under ideal conditions, incorporating detailed data on real-world screening practice has been limited given the complexity of screening processes and behaviors throughout diverse health delivery systems in the United States. The authors describe the synergies that exist between decision-analytic models and health care utilization…
Calibration/Validation | Health/Medicine | Clinical Care | Evidence Synthesis | Mathematical Models | Chronic Disease/Risk | Health Systems | Science/Technology | North America -
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…
Calibration/Validation | Health/Medicine | Clinical Care | Costing Methods | Evidence Synthesis | Mathematical Models | Microsimulation | Chronic Disease/Risk | Health Systems | Policy/Regulation | Economics/Finance | North America