Resources Repository
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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 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…
Benefit-Cost Analysis | Preferences/Values | Health Outcomes | Environmental Health | Policy/Regulation | College | Graduate | Critical Thinking/Analysis -
ArticlePublication 2001Cost-Benefit Analysis of a Strategy to Vaccinate Healthy Working Adults against Influenza
The authors performed a cost-benefit analysis to assess the economic impact of vaccinating healthy working …
The authors performed a cost-benefit analysis to assess the economic impact of vaccinating healthy working adults between 18 and 64 years old with an influenza vaccine. Monte Carlo simulation was used to calculate the direct and indirect costs associated with vaccination and those prevented by vaccination. The authors found that vaccinating healthy working adults was, on average, cost-saving.
Benefit-Cost Analysis | Infectious Diseases | Health/Medicine | North America -
ArticlePublication 2018Resource Allocation in Decision Support Frameworks
Multi-criteria decision-making frameworks expand on typical decision analyses (cost-effectiveness and cost-benefit) by explicitly incorporating value …
Multi-criteria decision-making frameworks expand on typical decision analyses (cost-effectiveness and cost-benefit) by explicitly incorporating value tradeoffs from decision makers and summarizing the performance of investment options. This is done across all chosen dimensions of value, based on the weights provided by the decision makers, but comes at a cost. Currently there is no widely accepted method to suggest how to determine a budget constraint using multi-attribute models or to measure willingness to pay for incremental…
Benefit-Cost Analysis | Priority Setting/Ethics | Cost-Effectiveness Analysis | Health Systems | Health/Medicine | Global -
ArticlePublication 2017Benefit and Harm of Intensive Blood Pressure Treatment: Derivation and Validation of Risk Models Using Data from the Sprint and Accord Trials
Intensive blood pressure (BP) treatment can avert cardiovascular disease (CVD) events but can cause some …
Intensive blood pressure (BP) treatment can avert cardiovascular disease (CVD) events but can cause some serious adverse events. The authors sought to create risk calculators to estimate individual patients’ chances of benefit and harm from intensive treatment. They developed statistical models of cardiovascular events and serious adverse events from individual participant data from the Systolic Blood Pressure Intervention Trial (SPRINT) of intensive blood pressure treatment (N = 9,069 with complete covariate data) and validated them…
Probability/Bayes | Health Outcomes | Evidence Synthesis | Chronic Disease/Risk -
ArticlePublication 2014Evaluation of FDA Benefit-Cost Analysis of Graphic Warning Labels
The Food and Drug Administration (FDA) is required to do a regulatory impact analysis assessing …
The Food and Drug Administration (FDA) is required to do a regulatory impact analysis assessing the costs and benefits of its tobacco products and other regulations. This paper provides a critical review of the approach the FDA used in its proposed and final graphic warning label rule, and includes recommendations on how to improve the analysis in ways that account for the differences between tobacco use and consumption of most consumer products. To date, FDA…
Benefit-Cost Analysis | Costing Methods | Chronic Disease/Risk | Policy/Regulation | Government/Law | Health/Medicine | North America -
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…
Benefit-Cost Analysis | Preferences/Values | Policy/Regulation | Climate/Environment | College | Graduate | Critical Thinking/Analysis