Resources Repository
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ArticlePublication 2014Cost of a Primary Care-Based Childhood Obesity Prevention Intervention
This study evaluated the cost of a primary care-based obesity prevention intervention (High Five for …
This study evaluated the cost of a primary care-based obesity prevention intervention (High Five for Kids) for children ages 2-6 years, compared to usual care. U.S. pediatric guidelines recommend that childhood obesity counseling be done in primary care settings. The clinical trial aimed to modify children’s nutrition and TV viewing habits through a motivational interviewing intervention. The authors assessed the visit-related costs for children enrolled in the trial, and found that the mean costs for…
Decision Analysis | Costing Methods | Clinical Care | Child/Nutrition | Chronic Disease/Risk | Economics/Finance | Health/Medicine | North America -
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…
Decision Analysis | Clinical Care | Health Outcomes | Health/Medicine -
ArticlePublication 2008Cost-Effectiveness of Rapid Point-of-Care Prenatal Syphilis Screening in Sub-Saharan Africa
This paper investigates the cost-effectiveness of using rapid point-of-care tests for prenatal syphilis screening among …
This paper investigates the cost-effectiveness of using rapid point-of-care tests for prenatal syphilis screening among pregnant women in sub-Saharan Africa, a region with syphilis prevalence rates as high as 17%, and where traditional multi-test screening methods have been challenging to implement. Focusing on newly available rapid point-of-care screening tests, strategies differed by the initial test [rapid plasma reagin (RPR), immunochromographic strip (ICS)], need for confirmation with Treponema pallidum hemagglutination assay, and number of visits required.…
Costing Methods | Clinical Care | Test Performance | Mathematical Models | Cost-Effectiveness Analysis | Technology Assessment | Infectious Diseases | Maternal/Reproductive Health | Health/Medicine | Sub-Saharan Africa -
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 2017Costing of National STI Program Implementation, 2016-2021
In 2016 the World Health Assembly adopted the Global Strategy on Sexually Transmitted Infections (STI) …
In 2016 the World Health Assembly adopted the Global Strategy on Sexually Transmitted Infections (STI) 2016–2021 aiming to reduce curable STIs by 90% by 2030. This analysis costed scaling-up priority interventions to achieve coverage targets. Strategy-targeted declines in Chlamydia trachomatis, Neisseria gonorrhoeae, Treponema pallidum and Trichomonas vaginalis were applied to WHO-estimated regional burdens at 2012 levels. Case management was costed for the curable STIs, symptomatic Herpes Simplex Virus 2 (HSV-2), and non-STI vaginal syndromes, with incrementally expanding diagnoses. Service…
Costing Methods | Clinical Care | Evidence Synthesis | Infectious Diseases | Economics/Finance | Health/Medicine | Global -
ArticlePublication 2017Changing the South African National ART Guidelines: The Role of Cost Modelling
This analysis was motivated by the South African Department of Health's request to assess the …
This analysis was motivated by the South African Department of Health's request to assess the cost implications of adopting sets of ART guidelines issued by the World Health Organization between 2010 and 2016.Using data from large South African ART clinics (n = 24,244 patients), projections of patients in need of ART, and cost data from bottom-up cost analyses, the authors constructed a population-level health-state transition model with 6-monthly transitions between health states depending on patients’ age,…
Costing Methods | Clinical Care | State-Transition | Infectious Diseases | Health Systems | Economics/Finance | Health/Medicine | Sub-Saharan Africa -
ArticlePublication 2017Costs of Facility-Based HIV Testing in Malawi, Zambia and Zimbabwe
Providing HIV testing at health facilities remains the most common approach to ensuring access to …
Providing HIV testing at health facilities remains the most common approach to ensuring access to HIV treatment and prevention services for the millions of undiagnosed HIV-infected individuals in sub-Saharan Africa. The authors sought to explore the costs of providing these services across three southern African countries with high HIV burden.Primary costing studies were undertaken in 54 health facilities providing HIV testing services (HTS) in Malawi, Zambia and Zimbabwe. Routinely collected monitoring and evaluation data for…
Costing Methods | Clinical Care | Technology Assessment | Infectious Diseases | Health Systems | Health/Medicine | Sub-Saharan Africa