Resources Repository
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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 | Probability/Bayes | Clinical Care | Health/Medicine -
ArticlePublication 2020Premature Deaths, Statistical Lives, and Years of Life
This article clarifies some misconceptions about mortality risk and economic valuation. The mortality effects of …
This article clarifies some misconceptions about mortality risk and economic valuation. The mortality effects of exposure to environmental hazards such as air pollution are often described by the estimated number of “premature deaths” and the economic value of an exposure reduction as the number of “statistical lives saved” multiplied by the “value per statistical life.” These terms can be misleading because the number of deaths advanced by exposure cannot be determined from mortality data; it…
Preferences/Values | Health Outcomes | Benefit-Cost Analysis | Environmental Health | Policy/Regulation | College | Graduate | Critical Thinking/Analysis -
ArticlePublication 2019Measuring Progress Towards Universal Health Coverage
This article, published in BMJ Global Health, aims to estimate the 2015 national and subnational …
This article, published in BMJ Global Health, aims to estimate the 2015 national and subnational universal health coverage (UHC) service coverage status for Ethiopia. The UHC service coverage index is constructed from the geometric means of component indicators: first, within each of four major categories and then across all components to obtain the final summary index. The authors estimate UHC service coverage at the subnational level using a variety of surveys and routinely collected administrative…
Test Performance | Health Systems | Health/Medicine | Sub-Saharan Africa -
ArticlePublication 2018Trading Bankruptcy for Health: A Discrete-Choice Experiment
This article in Value in Health evaluates the importance of improved health as compared to …
This article in Value in Health evaluates the importance of improved health as compared to improved financial risk protection in the general United States population. Using a discrete-choice experiment, it finds that 31.3% of the population values cure at all costs, and 8.5% of the population use financial solvency to dominate medical decision making. This study shares insight to the US population values and trade-offs between health outcomes and financial health, and highlights the difficult…
Preferences/Values | Priority Setting/Ethics | Health Outcomes | Health Systems | Culture/Society | Economics/Finance | Health/Medicine | North America -
ArticlePublication 2017Revealed Willingness-to-Pay vs. Standard Cost-Effectiveness Thresholds
This study estimates the cost-effectiveness thresholds (CETs) of 16 HIV programs in South Africa. The …
This study estimates the cost-effectiveness thresholds (CETs) of 16 HIV programs in South Africa. The use of CETs based on a country’s income per capita has been criticized for not being grounded in theory or evidence, especially in low and middle-income countries (LMICs). An alternative has been produced for South Africa, based on estimates of life years saved and the country’s committed HIV budget. The authors used a previously -published optimization method to estimate CETs,…
Preferences/Values | Priority Setting/Ethics | Cost-Effectiveness Analysis | Infectious Diseases | Economics/Finance | Health/Medicine | Sub-Saharan Africa -
ArticlePublication 2017Cost-Effectiveness of Testing and Treatment for Latent TB
Testing for and treating latent tuberculosis infection (LTBI) is among the main strategies to achieve …
Testing for and treating latent tuberculosis infection (LTBI) is among the main strategies to achieve TB elimination in the United States. This analysis estimated health outcomes, costs, and cost-effectiveness of LTBI testing and treatment among non-US born residents with and without medical comorbidities (e.g., diabetes, HIV infection, and end-stage renal disease). A decision analytic tree and Markov cohort simulation model was used to compare the following strategies: no testing, tuberculin skin test (TST), interferon gamma release assay…
Test Performance | State-Transition | Microsimulation | Cost-Effectiveness Analysis | Infectious Diseases | Chronic Disease/Risk | Health Systems | Economics/Finance | Health/Medicine | Global | North America -
ArticlePublication 2017Predicting Carer Health Effects for Use in Economic Evaluation
Illnesses and interventions can affect the health status of family carers in addition to patients. …
Illnesses and interventions can affect the health status of family carers in addition to patients. However economic evaluation studies rarely incorporate data on health status of carers. In order to investigate whether changes in carer health status could be ‘predicted’ from the health data of those they provide care to, as a means of incorporating carer outcomes in economic evaluation, the authors used regression models to analyse changes in carers’ health status. They derive predictive algorithms based on…
Preferences/Values | Health Outcomes | Cost-Effectiveness Analysis | Infectious Diseases | Health/Medicine | North America | Europe -
ArticlePublication 2017Valuing Non-Fatal Risks: Monetary and Health-Utility Measures
This article discusses metrics for valuing environmental, health, and safety policies, which should be consistent …
This article discusses metrics for valuing environmental, health, and safety policies, which should be consistent with both the preferences of affected individuals and social preferences for distribution of health risks in the population. Two classes of metrics are widely used: monetary measures (e.g., willingness to pay) and health-utility measures (e.g., quality-adjusted life years (QALYs), disability-adjusted life years (DALYs)). Health-utility measures impose more structure than monetary measures, with the result that individuals’ preferences often appear inconsistent…
Preferences/Values | Benefit-Cost Analysis | Policy/Regulation | Climate/Environment | College | Graduate | Critical Thinking/Analysis -
ArticlePublication 2017Using Cost-Effectiveness Analysis to Address Health Equity Concerns
This article serves as a guide to using cost-effectiveness analysis (CEA) to address health equity …
This article serves as a guide to using cost-effectiveness analysis (CEA) to address health equity concerns. The authors introduce the "equity impact plane," a tool for considering trade-offs between improving total health-the objective underpinning conventional CEA-and equity objectives, such as reducing social inequality in health or prioritizing the severely ill. Improving total health may clash with reducing social inequality in health, for example, when effective delivery of services to disadvantaged communities requires additional costs. Who…
Preferences/Values | Priority Setting/Ethics | Cost-Effectiveness Analysis | Health Systems | Policy/Regulation | Health/Medicine | Global