Resources Repository
-
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 | Value of Information | Health/Medicine -
BookPublication 2003WHO Guide to Cost-Effectiveness Analysis
This 2003 guide provides a method of assessing the cost-effectiveness of health interventions for an …
This 2003 guide provides a method of assessing the cost-effectiveness of health interventions for an international audience. The authors aim to inform the policy maker and to maximize the generalizability of results across settings. Part I begins with a description of cost-effectiveness analysis. It then considers issues relating to study design, estimating costs, assessing health effects, discounting, uncertainty and sensitivity analysis, and reporting results. Part II provides examples to illustrate the principles in Part I. Detailed discussions…
Evidence Synthesis | Priority Setting/Ethics | Costing Methods | Health Outcomes | Mathematical Models | Cost-Effectiveness Analysis | Health Systems | Health/Medicine | Global -
ReviewPublication 2001Modeling for Health Care and Other Policy Decisions: Uses, Roles and Validity
This is a review article of the role of modeling approaches to guide decision making …
This is a review article of the role of modeling approaches to guide decision making in health care and other domains. The role of models to support recommendations on the cost-effective use of medical technologies and pharmaceuticals is controversial. At the heart of the controversy is the degree to which experimental or other empirical evidence should be required prior to model use. The authors argue that the controversy stems in part from a misconception that…
Evidence Synthesis | Priority Setting/Ethics | Mathematical Models | Technology Assessment | Environmental Health | Health Systems | Policy/Regulation | Business/Industry | Climate/Environment | Economics/Finance | Energy/Engineering | Government/Law | Health/Medicine | North America -
BookPublication 1996Cost-Effectiveness in Health and Medicine, 1st Edition
In 1993, the US Public Health Service convened a panel of 13 nongovernment scientists and …
In 1993, the US Public Health Service convened a panel of 13 nongovernment scientists and scholars with expertise in economics, clinical medicine, ethics, and statistics to review the state of cost-effectiveness analysis and to develop recommendations for its conduct and use in health and medicine. Publishing their results in 1996, they proposed the most explicit set of guidelines (together with their rationale) ever defined on the conduct of CEAs. The panel recommended analysts include a "reference-case"…
Evidence Synthesis | Preferences/Values | Priority Setting/Ethics | Costing Methods | Health Outcomes | Value of Information | Cost-Effectiveness Analysis | Health Systems | Policy/Regulation | Economics/Finance | Health/Medicine | North America -
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 | Probability/Bayes | Value of Information | Decision Analysis | Health/Medicine -
BookPublication 1980Clinical Decision Analysis
This text was conceived and developed in the Harvard T.H. Chan School of Public Health …
This text was conceived and developed in the Harvard T.H. Chan School of Public Health at the Center for the Analysis of Health Practices. The book had its origins in a set of classroom materials developed during the academic year 1974-75 for an elective course in medical decision making at the Harvard Medical School. In this book students are shown how to structure clinical decision problems, how to systematically formulate the intertwining roles of diagnosis and treatment, how to…
Test Performance | Probability/Bayes | Preferences/Values | Costing Methods | Health Outcomes | Value of Information | State-Transition | Decision Analysis | Cost-Effectiveness Analysis | Infectious Diseases | Child/Nutrition | Chronic Disease/Risk | Economics/Finance | Health/Medicine | Global | North America | Europe | Graduate | Doctoral | Critical Thinking/Analysis | Decision Making/Leadership | Quantitative Literacy -
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 | Clinical Care | Health/Medicine