Resources Repository
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ArticlePublication 2023Simulation-Based Comparative Effectiveness Analysis of Policies to Improve Global Maternal Health Outcomes
The Sustainable Development Goals include a target to reduce the global maternal mortality ratio (MMR) …
The Sustainable Development Goals include a target to reduce the global maternal mortality ratio (MMR) to less than 70 maternal deaths per 100,000 live births by 2030, with no individual country exceeding 140. However, on current trends the goals are unlikely to be met. The authors used an empirically calibrated Global Maternal Health microsimulation model, which simulates individual women in 200 countries and territories to evaluate the impact of different interventions and strategies from 2022…
Mathematical Models | Health Outcomes | Global | Microsimulation | Calibration/Validation | Maternal/Reproductive Health | Health Systems | Clinical Care | Health/Medicine -
ArticlePublication 2023Simulation-Based Estimates and Projections of Global, Regional and Country-Level Maternal Mortality by Cause, 1990-2050
While progress has been made globally to reduce maternal deaths, measurement remains a challenge given …
While progress has been made globally to reduce maternal deaths, measurement remains a challenge given the many causes and frequent underreporting of maternal deaths. The authors developed a structural microsimulation model of Global Maternal Health (GMatH) for 200 countries and territories using demographic, epidemiologic, clinical and health system data synthesized from the medical literature, Civil Registration Vital Statistics systems and Demographic and Health Survey data. The model was calibrated to empirical data from 1990 to…
Evidence Synthesis | Health Outcomes | Global | Microsimulation | Calibration/Validation | Maternal/Reproductive Health | Health Systems | Clinical Care | Health/Medicine -
ArticlePublication 2010Alternative Strategies to Reduce Maternal Mortality in India: A Cost-Effectiveness Analysis
This article, published in PLoS Medicine, conducted a cost-effectiveness analysis of strategies to improve pregnancy …
This article, published in PLoS Medicine, conducted a cost-effectiveness analysis of strategies to improve pregnancy and childbirth safety in India. Country- and region-specific data were synthesized using a computer-based model that simulates the natural history of pregnancy and pregnancy-associated complications in individual women, and considers delivery location, attendant, and facility level. Model validation compared projected maternal indicators with empiric data. Strategies consisted of improving coverage of effective interventions that could be provided individually or packaged…
Evidence Synthesis | Mathematical Models | Global | Microsimulation | Cost-Effectiveness Analysis | Maternal/Reproductive Health | Economics/Finance | Health/Medicine | Asia & Pacific -
ArticlePublication 2022Comparative Health Systems Analysis of Differences in Catastrophic Health Expenditure
The growing burden of non-communicable diseases (NCDs) in low- and middle-income countries may have implications …
The growing burden of non-communicable diseases (NCDs) in low- and middle-income countries may have implications for health system performance in the area of financial risk protection, as measured by catastrophic health expenditure (CHE). This article compares non-communicable diseases catastrophic health expenditure to the CHE cases caused by communicable diseases across health systems to examine whether: (1) disease burden and catastrophic health expenditure are linked, (2) Catastrophic health expenditures secondary to NCDs disproportionately affect wealthier households and (3) whether the drivers…
Evidence Synthesis | Costing Methods | Global | Cost-Effectiveness Analysis | Infectious Diseases | Chronic Disease/Risk | Health Systems | Economics/Finance | Health/Medicine -
ArticlePublication 2021New Microsimulation Models to Inform Cervical Cancer Control
Health decision models consider the lifetime natural history of human papillomavirus (HPV) infection and pathogenesis …
Health decision models consider the lifetime natural history of human papillomavirus (HPV) infection and pathogenesis of cervical cancer, and estimate the long-term impact of preventive interventions. We propose a new health decision modeling framework that de-emphasizes previously used cytologic-colposcopic-histologic diagnoses, which are subjective and lack reproducibility, relying instead on HPV type and duration of infection as the major determinants of model transition probabilities. We posit that new model health states and corollary transitions are universal,…
Mathematical Models | Decision Analysis | Global | Microsimulation | Calibration/Validation | Cost-Effectiveness Analysis | Infectious Diseases -
ArticlePublication 2022WHO ACTION-I Trial in Low Resource Countries
This study evaluated the cost-effectiveness of dexamethasone administration in dexamethasone in pregnant women at risk …
This study evaluated the cost-effectiveness of dexamethasone administration in dexamethasone in pregnant women at risk of early preterm birth using data from a multicentre, randomized, placebo-controlled trial in Bangladesh, India, Kenya, Nigeria, and Pakistan. Primary cost data were collected in 28 hospitals across the 5 countries. A decision tree model was used to compare dexamethasone treatment to no intervention from a health-care sector perspective. Administration of dexamethasone averted 38 neonatal deaths per 1000 woman–baby units…
Mathematical Models | Health Outcomes | Global | Cost-Effectiveness Analysis | Maternal/Reproductive Health | Child/Nutrition | Clinical Care | Sub-Saharan Africa | Asia & Pacific -
ArticlePublication 2020Infectious Disease Pandemic Planning and Response: Incorporating Decision Analysis
During a pandemic, decisions must be made under rapidly changing, uncertain conditions. Despite advances in …
During a pandemic, decisions must be made under rapidly changing, uncertain conditions. Despite advances in analytical methods for gaining early situational awareness (i.e., of a disease’s transmissibility and severity) and for predicting the likely effectiveness of interventions, a major gap exists globally in terms of integrating this information in policy documents. The authors argue that mathematical and statistical models are important tools for pandemic planning and response. Once an outbreak of pandemic potential has been…
Mathematical Models | Decision Analysis | Global | Health Systems | Government/Law | Health/Medicine -
EditorialPublication 2020Waiting for Certainty on COVID-19 Antibody Tests — At What Cost?
This perspective anticipates the availability of serologic antibody testing and considers its potential usefulness in mitigation …
This perspective anticipates the availability of serologic antibody testing and considers its potential usefulness in mitigation policy to reduce COVID-19 transmission. For example: Could we screen for serologic antibodies as a proxy for possible immunity and identify people who could return to the workplace with less severe mitigation measures? The authors acknowledge the uncertainties raised by many policy actors, including the WHO, such as, "Do antibodies confer immunity and, if so, for how long? How accurate is…
Probability/Bayes | Test Performance | Global | Technology Assessment | Infectious Diseases | Health Systems | Policy/Regulation | Government/Law | Health/Medicine | North America -
ArticlePublication 2020Interpreting COVID-19 Test Results: A Bayesian Approach
This article considers the following question with respect to interpreting the results of polymerase chain reaction …
This article considers the following question with respect to interpreting the results of polymerase chain reaction (PCR) assays from nasal and pharyngeal swabs for COVID-19 to inform clinical decision making: "While a positive result in an acutely ill patient is straightforward, how should physicians interpret negative tests in patients with suspected COVID-19 infection?" Using an assumption of near-perfect specificity of PCR assays for COVID-19, the authors acknowledge the uncertainty of test sensitivity. They consider two clinical scenarios…
Probability/Bayes | Test Performance | Global | Infectious Diseases | Health/Medicine | Science/Technology