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 | Health/Medicine | Infectious Diseases | Clinical Care -
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 | Health/Medicine | Infectious Diseases | Science/Technology | Global -
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.
Evidence Synthesis | Priority Setting/Ethics | Health/Medicine | Clinical Care -
ArticlePublication 2020Translating Population Evidence to Individual Patients
In this paper, the authors describe the differences in population level outcomes compared to individual …
In this paper, the authors describe the differences in population level outcomes compared to individual patients and discuss ways that these are differences. The authors cover topics including the difference between relative and absolute risk and benefit. They use an example of the decision to start anticoagulation in new-onset atrial fibrillation to discuss translating population level evidence to treatment of an individual. These options include generalizability, subgroup analysis, prediction rules, following response to therapy, and even…
Evidence Synthesis | Test Performance | Health/Medicine | Health Systems | 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 | Test Performance | Health/Medicine | Clinical Care -
ArticlePublication 2017Extended Cost-Effectiveness Analyses of Cardiovascular Risk Factor Reduction Policies
This chapter summarizes lessons learned from three extended cost-effectiveness analyses (ECEAs) conducted on cardiovascular disease …
This chapter summarizes lessons learned from three extended cost-effectiveness analyses (ECEAs) conducted on cardiovascular disease (CVD) risk factor reduction policies, specifically highlighting new insights into the differential impacts of well-established CVD prevention interventions. Tobacco taxation, salt reduction, and primary prevention of CVD in high-risk individuals remain widely regarded as best buys in global noncommunicable disease policy, and the ECEAs confirm the findings of previous CEAs, namely, that these interventions will likely result in large health…
Evidence Synthesis | Priority Setting/Ethics | Health/Medicine | Cost-Effectiveness Analysis | Chronic Disease/Risk | Global -
ReviewPublication 2018Setting Health Sector Priorities: A Brief Overview of Ethiopia's Experience
Based on Ethiopia’s commitment to attain universal health coverage by 2035, the authors use the …
Based on Ethiopia’s commitment to attain universal health coverage by 2035, the authors use the current national strategies including the national essential health service package in Ethiopia as a springboard to explore the criteria and processes Ethiopia uses to set the existing national health sector priorities. Addition the authors highlight the critical need to strengthen country-led efforts and investments in human capital in developing country contexts.
Evidence Synthesis | Priority Setting/Ethics | Health/Medicine | Health Systems | Policy/Regulation | Sub-Saharan Africa -
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…
Priority Setting/Ethics | Benefit-Cost Analysis | Health/Medicine | Cost-Effectiveness Analysis | Health Systems | Global -
ArticleWeb Portal 2017PLoS Collection: Prevention, Diagnosis and Treatment of Sexually Transmitted Infections
Globally, the World Health Organization (WHO) estimates that more than one million new sexually transmitted …
Globally, the World Health Organization (WHO) estimates that more than one million new sexually transmitted infections (STIs) occur each day, incurring a very substantial burden of morbidity, mortality and additional infections. The pathogens responsible include bacteria, parasites and viruses, and intensive research is needed to address the substantial barriers to diagnosis and treatment of STIs, and the behavioral challenges of prevention. This PLOS collection, published in collaboration with WHO, focuses on global policy and systems…
Priority Setting/Ethics | Costing Methods | Health/Medicine | Mathematical Models | Dynamic Transmission | Cost-Effectiveness Analysis | Infectious Diseases | Health Systems | Economics/Finance | Sub-Saharan Africa | Middle East & North Africa | Latin America & Caribbean | Asia & Pacific