Resources Repository
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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 -
Resource PackWeb Portal, Teaching Resource 2018Resource Pack: Cervical Cancer Models
This resource pack, curated by the Center for Health Decision Science, is a collection of …
This resource pack, curated by the Center for Health Decision Science, is a collection of models of HPV-related cervical cancer, differing in design, structure and features based on analytic objectives. In many ways, HPV and its related diseases represent a prototypical public health problem given the communicable and non-communicable nature of disease, opportunities for intervention along the entire disease spectrum (e.g., primary and secondary prevention, diagnosis, treatment), the varied ages at which interventions are targeted…
Cost-Effectiveness Analysis | Clinical Care | Mathematical Models | State-Transition | Dynamic Transmission | Microsimulation | Calibration/Validation | Dynamic Simulation | Infectious Diseases | Chronic Disease/Risk | Health Systems | Business/Industry | Economics/Finance | Health/Medicine | Science/Technology | Global -
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…
Clinical Care | Evidence Synthesis | State-Transition | Dynamic Transmission | Microsimulation | Dynamic Simulation | Health Systems | 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…
Cost-Effectiveness Analysis | Clinical Care | Microsimulation | Chronic Disease/Risk | Policy/Regulation | Health/Medicine | North America -
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,…
Clinical Care | Costing Methods | 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…
Clinical Care | Costing Methods | Technology Assessment | Infectious Diseases | Health Systems | Health/Medicine | Sub-Saharan Africa