Resources Repository
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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 -
ArticlePublication 2013Nutritional Policy Changes in SNAP: A Microsimulation and Cost-Effectiveness Analysis
This analysis estimated the health effects and cost-effectiveness of banning or taxing sugar-sweetened beverages (SSBs) …
This analysis estimated the health effects and cost-effectiveness of banning or taxing sugar-sweetened beverages (SSBs) or subsidizing fruits and vegetables purchased with SNAP. The target population was adults in the U.S. and the time horizon was 10 years. Results showed that banning SSB purchases using SNAP benefits would be expected to avert 510,000 diabetes person-years and 52,000 deaths from MIs and strokes over the next decade, with a savings of $2900 per QALY saved. A…
Microsimulation | Health/Medicine | Mathematical Models | Cost-Effectiveness Analysis | Chronic Disease/Risk | Policy/Regulation | Economics/Finance | Food/Agriculture | Government/Law | North America -
ArticlePublication 2019Cost-Effectiveness of U.S. National SSB Tax with a Multistakeholder Approach: Who Pays and Who Benefits
This analysis estimated the health impact and cost-effectiveness of a national penny-per-ounce sugar-sweetened beverage (SSB) …
This analysis estimated the health impact and cost-effectiveness of a national penny-per-ounce sugar-sweetened beverage (SSB) tax, overall and with stratified costs and benefits for nine distinct stakeholder groups. A microsimulation model (CVD PREDICT) was used to estimate cardiovascular disease reductions, quality-adjusted life years gained, and cost-effectiveness for U.S. adults aged 35 to 85 years, evaluating full and partial consumer price pass-through. Results showed that from both a health care and societal perspective, the SSB tax was…
Microsimulation | Health/Medicine | Cost-Effectiveness Analysis | Chronic Disease/Risk | Policy/Regulation | Business/Industry | Economics/Finance | Government/Law | North America -
ArticlePublication 2016Mexico's SSB Tax Policy Impact on Diabetes and Cardiovascular Disease: Modeling Study
In 2014, Mexico instituted a nationwide tax on sugar-sweetened beverages (SSBs) in order to reduce …
In 2014, Mexico instituted a nationwide tax on sugar-sweetened beverages (SSBs) in order to reduce the high level of SSB consumption, a preventable cause of diabetes and cardiovascular disease (CVD). In this analyses, a computer simulation model of CVD was used to project potential long-range health and economic impacts of SSB taxation in Mexico. Two main scenarios were modeled: (1) a 10% reduction in SSB consumption (corresponding to the reduction observed after tax implementation) and…
Microsimulation | Health/Medicine | Mathematical Models | Cost-Effectiveness Analysis | Chronic Disease/Risk | Policy/Regulation | Economics/Finance | Food/Agriculture | Government/Law | Latin America & Caribbean -
ArticlePublication 2019Health Impact and Cost-Effectiveness of SSB Taxes for Reducing Cancer Burden in the U.S.
This analysis evaluated the health outcomes, costs, and cost-effectiveness of a national sugar-sweetened beverage (SSB) …
This analysis evaluated the health outcomes, costs, and cost-effectiveness of a national sugar-sweetened beverage (SSB) tax policy for reducing obesity-related cancer in the U.S. A probabilistic cohort state-transition model, the Diet Cancer Outcome Model (DiCOM), was used to project the effect of a national $0.01 per ounce SSB excise tax on 13 obesity-associated cancers among U.S. adults age 20 and older over their lifetime. Cost-effectiveness was evaluated using both government affordability and societal perspectives. Results showed…
Microsimulation | Health/Medicine | Mathematical Models | Cost-Effectiveness Analysis | Chronic Disease/Risk | Policy/Regulation | Economics/Finance | Government/Law | North America -
ArticlePublication 2018Cost-Effectiveness of Financial Incentives and Disincentives for Improving Food Purchases and Health through SNAP
This analysis estimated the health impact, costs, and cost-effectiveness of food incentives, disincentives, or restrictions …
This analysis estimated the health impact, costs, and cost-effectiveness of food incentives, disincentives, or restrictions in the Supplemental Nutrition Assistance Program (SNAP). A microsimulation model (CVD-PREDICT) was used to compare three policy interventions: (1) a 30% incentive for fruits and vegetables (F&V), (2) a 30% F&V incentive with a restriction of sugar-sweetened beverages (SSBs), and (3) a broader incentive/disincentive program for multiple foods that also preserves choice (SNAP-plus). From a societal perspective, all three scenarios…
Microsimulation | Health/Medicine | Cost-Effectiveness Analysis | Chronic Disease/Risk | Policy/Regulation | Business/Industry | Economics/Finance | Government/Law | North America -
ArticlePublication 2020Weighing Evidence to Inform Clinical Decisions
The authors use a clinical example to simulate how treatment discussions can be complicated when new evidence is introduced …
The authors use a clinical example to simulate how treatment discussions can be complicated when new evidence is introduced that conflicts with existing guidelines. Even when evidence is consistent, the authors point out that current guidelines can have interpretations that don't agree with available evidence. They develop a step-wise algorithm to help guide individual clinical decisions even in the absence of general consensus related to appropriate testing and treatment.
Priority Setting/Ethics | Health/Medicine | Evidence Synthesis | Clinical Care -
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 | Health/Medicine | Test Performance | Clinical Care -
ArticlePublication 2020Expanding Oral Disease Treatment is Cost Effective
This study developed a stochastic microsimulation model of oral health conditions, type-2 diabetes (T2D), T2D-related …
This study developed a stochastic microsimulation model of oral health conditions, type-2 diabetes (T2D), T2D-related microvascular diseases, and CVD, to project the cost-effectiveness of expanding periodontal treatment coverage among patients with T2D and periodontitis. Previous randomized trials found that treating periodontitis improved glycemic control in patients with type 2 diabetes (T2D), thus lowering the risks of developing T2D-related microvascular diseases and cardiovascular disease (CVD). The micro-simulation model parameters were obtained from the nationally representative National…
Microsimulation | Health/Medicine | Mathematical Models | Calibration/Validation | Cost-Effectiveness Analysis | Chronic Disease/Risk | North America | Graduate