Resources Repository
-
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.
Priority Setting/Ethics | Clinical Care | Evidence Synthesis | 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 -
ReportPublication 2018Understanding the Economics of Microbial Threats: Proceedings of a Workshop
This report follows a June 2018, Forum on Microbial Threats that was held at the …
This report follows a June 2018, Forum on Microbial Threats that was held at the National Academies of Sciences, Engineering, and Medicine. This was a 1.5-day public workshop with the goal being an assessment of the current understanding of the interaction of infectious disease threats and economic activity in order to suggest future areas of research. This workshop built on prior work of the Forum and aimed to build more mutual understanding between those in…
Technology Assessment | Clinical Care | Health Outcomes | Evidence Synthesis | Infectious Diseases | Policy/Regulation | Global Governance | Business/Industry | Economics/Finance | Health/Medicine | Global -
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 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,…
Costing Methods | Clinical Care | State-Transition | Infectious Diseases | Health Systems | Economics/Finance | Health/Medicine | Sub-Saharan Africa -
ArticlePublication 2016Cost-Effectiveness of Blood Pressure Treatment Guidelines in Adults 35-74
In this article the authors used the CVD Policy Model to compare the cost-effectiveness of …
In this article the authors used the CVD Policy Model to compare the cost-effectiveness of conservative versus intensive blood pressure treatment guidelines in adult hypertensive patients aged 35 to 74 years. Outcomes included in the study were CVD events, treatment costs, quality-adjusted life years, and drug and monitoring costs projected over the years 2016 to 2026. The effectiveness and costs of hypertension were calculated for treatment according to the 2003 Joint National Committee (JNC)-7 or…
Cost-Effectiveness Analysis | Clinical Care | Microsimulation | Chronic Disease/Risk | Health/Medicine | North America -
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 | Clinical Care | Evidence Synthesis | Mathematical Models | Chronic Disease/Risk | Health Systems | Health/Medicine | Science/Technology | North America