Resources Repository
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ArticlePublication 2007Including Boys in an HPV Vaccination Program: A CEA in a Low-Resource Setting
This paper looks at the cost-effectiveness of including boys vs girls alone in a pre-adolescent vaccination …
This paper looks at the cost-effectiveness of including boys vs girls alone in a pre-adolescent vaccination program against human papillomavirus (HPV) types 16 and 18 in Brazil. Using demographic, epidemiological, and cancer data from Brazil, the authors developed a dynamic transmission model of HPV infection between males and females. Model-projected reductions in HPV incidence under different vaccination scenarios were applied to a stochastic model of cervical carcinogenesis to project lifetime costs and benefits. They found that at 90%…
Calibration/Validation | Health/Medicine | Microsimulation | Cost-Effectiveness Analysis | Infectious Diseases | Chronic Disease/Risk | Clinical Care | Latin America & Caribbean -
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…
Operations Research | Health/Medicine | Decision Theory | Probability/Bayes | Preferences/Values | Decision Analysis | Business/Industry | Economics/Finance | Energy/Engineering -
ArticlePublication 2007Economic Evaluation of Hepatitis B Vaccination in Low-Income Countries: Cost-Effectiveness Affordability Curves
In the face of uncertainties about both the health and economic consequences of a vaccine …
In the face of uncertainties about both the health and economic consequences of a vaccine program, as well as the availability and magnitude of resources needed to fund the program, cost-effectiveness affordability curves can provide information to decision-makers about the probability that a program will be both cost-effective and affordable: these are distinct but equally relevant considerations in resource-poor settings. This paper describes the application of this method to assess a hepatitis B vaccination program in the…
State-Transition | Health/Medicine | Costing Methods | Mathematical Models | Microsimulation | Cost-Effectiveness Analysis | Infectious Diseases | Health Systems | Economics/Finance | Sub-Saharan Africa -
ArticlePublication 2007Multiparameter Calibration of a Natural History Model of Cervical Cancer
This paper presents a two-step approach to model calibration of a comprehensive natural history model …
This paper presents a two-step approach to model calibration of a comprehensive natural history model of human papillomavirus (HPV) and cervical cancer. Using primary epidemiologic data from a longitudinal study of women in Brazil, a plausible range for each input parameter was identified that would produce model output within the 95% confidence intervals of the data. The authors then performed a simultaneous search over all input parameters to identify parameter sets that produced output consistent…
Calibration/Validation | Health/Medicine | Mathematical Models | Microsimulation | Infectious Diseases | Chronic Disease/Risk | Latin America & Caribbean -
ArticlePublication 2006Can Discrete Event Simulation be of Use in Modeling Major Depression?
This article, published in Cost Effectiveness and Resource Allocation, reviews the published literature on Markov …
This article, published in Cost Effectiveness and Resource Allocation, reviews the published literature on Markov models in depression and identified potential limitations in using this particular modelling approach in this disease area. Additionally, the authors develop a “Discrete Event Simulation” (DES) model to investigate the benefits and drawbacks of this simulation method compared with Markov modelling techniques. The findings of this study indicate that the most important limitation of using Markov models in depression is…
State-Transition | Health/Medicine | Microsimulation | Decision Analysis | Mental Health -
Tutorial/PrimerPublication, Teaching Resource 2005Refining Clinical Diagnosis with Likelihood Ratios
This article serves as a concise tutorial about the interpretation and use of likelihood ratios …
This article serves as a concise tutorial about the interpretation and use of likelihood ratios in clinical decision-making. Likelihood ratios can refine clinical diagnosis on the basis of signs and symptoms; however, they are underused for patients' care. A likelihood ratio is the percentage of ill people with a given test result divided by the percentage of well individuals with the same result. Ideally, abnormal test results should be much more typical in ill individuals…
Test Performance | Health/Medicine | Value of Information -
ReviewPublication 2004Decision Analysis Applications in Operations Research
This article reviews trends and developments in decision analysis applications, based primarily on a survey of …
This article reviews trends and developments in decision analysis applications, based primarily on a survey of decision analysis applications published in the period 1990–2001 in major English-language operations research and closely related journals. It serves as a guide to those interested in recent applications in specific areas or in applications that illustrate the use of particular methods. The authors identify and discuss noteworthy trends in, and developments affecting, published applications, including those in computer software and…
Operations Research | Health/Medicine | Decision Analysis | Business/Industry -
Tutorial/PrimerPublication, Teaching Resource 1980Threshold Approach to Clinical Decision Making
This classic paper provides a "tutorial" for students learning about diagnostic testing, probability revision, and …
This classic paper provides a "tutorial" for students learning about diagnostic testing, probability revision, and how to calculate thresholds for testing, treatment, and no treatment. The authors describe how a physician's estimate of the probability that a patient has a particular disease is a principal factor in the determination of whether to withhold treatment, obtain more data by testing, or treat without subjecting the patient to the risks of further diagnostic tests. Using the concepts of decision analysis,…
Test Performance | Health/Medicine | Probability/Bayes | Value of Information | Decision Analysis -
ReviewPublication 1978Basic Principles of ROC Analysis
The limitations of diagnostic "accuracy" as a measure of decision performance require introduction of the …
The limitations of diagnostic "accuracy" as a measure of decision performance require introduction of the concepts of the "sensitivity" and "specificity" yet even these do not provide a unique description of diagnostic performance because they depend on the arbitrary selection of a decision threshold. The receiver operating characteristic (ROC) curve is shown to be a simple yet complete empirical description of this decision threshold effect, indicating all possible combinations of the relative frequencies of the…
Test Performance | Health/Medicine | Clinical Care