Resources Repository
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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 | Test Performance | Technology Assessment | Infectious Diseases | Clinical Care | Health/Medicine -
ArticlePublication 2008Cost-Effectiveness of Rapid Point-of-Care Prenatal Syphilis Screening in Sub-Saharan Africa
This paper investigates the cost-effectiveness of using rapid point-of-care tests for prenatal syphilis screening among …
This paper investigates the cost-effectiveness of using rapid point-of-care tests for prenatal syphilis screening among pregnant women in sub-Saharan Africa, a region with syphilis prevalence rates as high as 17%, and where traditional multi-test screening methods have been challenging to implement. Focusing on newly available rapid point-of-care screening tests, strategies differed by the initial test [rapid plasma reagin (RPR), immunochromographic strip (ICS)], need for confirmation with Treponema pallidum hemagglutination assay, and number of visits required.…
Test Performance | Technology Assessment | Costing Methods | Mathematical Models | Cost-Effectiveness Analysis | Infectious Diseases | Maternal/Reproductive Health | Clinical Care | Health/Medicine | Sub-Saharan Africa -
ArticlePublication 2022Economic Value of Clinical Artificial Intelligence
Artificial intelligence (AI) is increasingly used in clinical applications. Nevertheless, its flexibility and difficulties around …
Artificial intelligence (AI) is increasingly used in clinical applications. Nevertheless, its flexibility and difficulties around collecting data on its clinical impacts make value assessment challenging. This article uses a value framework as the basis for assessing how AI may create value depending on how it is used. Authors also provide advice to health economists seeking to model AI’s clinical impacts. There are multiple ways that AI challenges traditional health technology assessment methodology. Authors highlight several…
Technology Assessment | Value of Information | Economics/Finance | Science/Technology | Global -
ArticlePublication 2022Emerging Therapies for COVID-19: The Value of Information From More Clinical Trials
The COVID-19 pandemic necessitated time-sensitive policy and implementation decisions regarding new therapies in the face …
The COVID-19 pandemic necessitated time-sensitive policy and implementation decisions regarding new therapies in the face of uncertainty. This study aimed to quantify consequences of approving therapies or pursuing further research. The authors used a cohort state-transition model for hospitalized patients with COVID-19 to estimate quality-adjusted life-years (QALYs) and costs associated with multiple drug regimens and usual care. For each they assessed immediate approval, use only in research, emergency use authorization or reject. They conducted cost-effectiveness…
State-Transition | Value of Information | Benefit-Cost Analysis | Infectious Diseases | Policy/Regulation | Economics/Finance | North America | Europe -
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 | Test Performance | Infectious Diseases | Clinical Care | Health/Medicine -
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 | Infectious Diseases | Health/Medicine | Science/Technology | Global -
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…
Probability/Bayes | Test Performance | Clinical Care | Health/Medicine -
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 -
OrganizationWeb Portal 2024Institute for Clinical and Economic Review (ICER)
ICER is a non-profit organization that evaluates evidence on a range of topics including the value …
ICER is a non-profit organization that evaluates evidence on a range of topics including the value of medical tests, treatments and delivery system innovations and moves that evidence into action to improve the health care system. To accomplish this goal ICER performs analyses on effectiveness and costs, supports specific programs, and develops reports using innovative methods that make it easier to translate evidence into decisions that can align efforts to use evidence to drive improvements in both…
Technology Assessment | Value of Information | Preferences/Values | Priority Setting/Ethics | Evidence Synthesis | Cost-Effectiveness Analysis | Infectious Diseases | Chronic Disease/Risk | Mental Health | Health Systems | Business/Industry | Economics/Finance | Government/Law | Health/Medicine | Science/Technology | North America | Europe