Resources Repository
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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…
Test Performance | Health/Medicine | Clinical Care | Probability/Bayes | Infectious Diseases -
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.
Health Outcomes | Health/Medicine | Clinical Care | Preferences/Values | Priority Setting/Ethics | Health Systems -
ArticlePublication 2019Cost-Effectiveness of Community-Based Childhood Obesity Prevention Interventions in Australia
This study examined the cost-effectiveness of community-based obesity prevention interventions (CBIs) consisting of strategies to …
This study examined the cost-effectiveness of community-based obesity prevention interventions (CBIs) consisting of strategies to promote healthy eating and physical activity for Australian children aged between 5-18 years. A multiple cohort Markov model that simulates diseases associated with overweight and obesity was used to estimate the health benefits, measured as health-adjusted life years (HALYs) and healthcare-related cost offsets from diseases averted due to exposure to the intervention. Health and cost outcomes were estimated over the…
Health Outcomes | Health/Medicine | Clinical Care | State-Transition | Cost-Effectiveness Analysis | Child/Nutrition | Chronic Disease/Risk | Health Systems | Food/Agriculture | 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.
Evidence Synthesis | Health/Medicine | Clinical Care | Priority Setting/Ethics -
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…
Test Performance | Health/Medicine | Clinical Care | Probability/Bayes -
ReportPublication 2013Decision and Simulation Modeling Alongside Systematic Reviews
This chapter is part of a report entitled, Decision and Simulation Modeling in Systematic Reviews, that seeks …
This chapter is part of a report entitled, Decision and Simulation Modeling in Systematic Reviews, that seeks to provide guidance for determining when incorporating a decision-analytic model alongside a systemic review would be of added value for decision making purposes. The chapter discusses the role of decision analysis and decision-analytic models in health care, specifically within the context of the current emphasis on evidence-based medicine and the proliferation of systematic reviews. It describes the types of model available…
Evidence Synthesis | Health/Medicine | Clinical Care | State-Transition | Dynamic Transmission | Microsimulation | Dynamic Simulation | Health Systems -
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 | Health/Medicine | Clinical Care | State-Transition | Infectious Diseases | Health Systems | Economics/Finance | 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 | Health/Medicine | Clinical Care | Technology Assessment | Infectious Diseases | Health Systems | Sub-Saharan Africa -
ReviewPublication 2016Cochrane Review: Strategies to Improve the Implementation of Obesity Prevention
Despite the existence of effective interventions and best-practice guideline recommendations for childcare services to implement …
Despite the existence of effective interventions and best-practice guideline recommendations for childcare services to implement policies, practices, and programs to promote child healthy eating, physical activity, and prevent unhealthy weight gain, many services fail to do so. The primary aim of the review was to examine the effectiveness of strategies aimed to improve the implementation of policies, practices, or programs by childcare services that promote child healthy eating, physical activity, and/or obesity prevention. The secondary…
Evidence Synthesis | Health/Medicine | Clinical Care | Child/Nutrition | Chronic Disease/Risk | Health Systems | Policy/Regulation | Culture/Society | Education/Labor | Global