Resources Repository
-
ArticlePublication 2007Decision Analysis: A Personal Account of How It Got Started and Evolved
In this chapter, Howard Raiffa discusses the evolution of decision analysis and his personal involvement …
In this chapter, Howard Raiffa discusses the evolution of decision analysis and his personal involvement in its development. He describes the early days of Operations Research (OR) in the late 1940s with its approach to complex, strategic decision making. After reading John von Neumann and Oskar Morgenstern’s Theory of Games and Economic Behavior (1947) and Abraham Wald’s two books (1947, 1950), he became involved in statistical decision theory. A few years later, after reading Leonard…
Probability/Bayes | Decision Analysis | Health/Medicine | Decision Theory | Preferences/Values | Operations Research | Business/Industry | Economics/Finance | Energy/Engineering -
ArticlePublication 2013Modeling the Effectiveness of Initial Management Strategies for Ductal Carcinoma in Situ
This paper compares alternative strategies to manage ductal carcinoma in situ (DCIS). The authors used …
This paper compares alternative strategies to manage ductal carcinoma in situ (DCIS). The authors used a disease simulation model to simulate the clinical events after six treatments (lumpectomy alone, lumpectomy with radiation, lumpectomy with radiation and tamoxifen, lumpectomy with tamoxifen, and mastectomy with and without breast reconstruction). Outcomes included disease-free, invasive disease-free, overall survival and breast preservation. Data were from the published literature. The results showed that for women aged 45 years at diagnosis, both mastectomy…
Decision Analysis | Health/Medicine | Health Outcomes | Clinical Care -
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…
Calibration/Validation | Health/Medicine | Health Outcomes | Mathematical Models | Microsimulation | Maternal/Reproductive Health | Health Systems | Clinical Care | Global -
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…
Calibration/Validation | Health/Medicine | Health Outcomes | Evidence Synthesis | Microsimulation | Maternal/Reproductive Health | Health Systems | Clinical Care | Global -
ArticlePublication 2022Vaccinations versus Lockdowns to Prevent COVID-19 Mortality
This analysis estimated the costs associated with preventing Covid-19 deaths by vaccinations versus lockdowns. Publicly …
This analysis estimated the costs associated with preventing Covid-19 deaths by vaccinations versus lockdowns. Publicly available datasets from the Israeli Ministry of Health were used to model the parameters of the pandemic in Israel. The Oxford COVID-19 Government Response Tracker was used for quantitative data on government policies. Data on the Israeli economy were taken from the Central Bureau of Statistics. The models demonstrate that the first lockdown prevented 1022 COVID-19 deaths at the cost…
Decision Analysis | Health/Medicine | Decision Theory | Costing Methods | Health Outcomes | State-Transition | Infectious Diseases | Policy/Regulation | Economics/Finance | Government/Law | Middle East & North Africa -
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…
Decision Analysis | Health/Medicine | Mathematical Models | Health Systems | Government/Law | Global -
ArticlePublication 2020Testing for SARS-CoV-2 Antibodies
Antibody testing can determine previous exposure to SARS-CoV-2 virus. Recently, the UK government has made …
Antibody testing can determine previous exposure to SARS-CoV-2 virus. Recently, the UK government has made antibody testing available to anyone wanting it, even if there is no clinical indication. The purpose of this article is to provide guidance for when to consider antibody testing in individuals with and without symptoms suggestive of current or past SARS-CoV-2 infection. Key points made by the authors include: (1) antibody testing is likely to be most useful 2 weeks…
Probability/Bayes | Health/Medicine | Test Performance | Technology Assessment | Infectious Diseases | Clinical Care -
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…
Probability/Bayes | Health/Medicine | Test Performance | Infectious Diseases | Clinical Care -
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 | Health/Medicine | Test Performance | Infectious Diseases | Science/Technology | Global