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 | Technology Assessment | Test Performance | 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.…
Technology Assessment | Costing Methods | Test Performance | 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 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 -
ReportPublication 2018Understanding the Economics of Microbial Threats: Proceedings of a Workshop
This report follows a June 2018, Forum on Microbial Threats that was held at the …
This report follows a June 2018, Forum on Microbial Threats that was held at the National Academies of Sciences, Engineering, and Medicine. This was a 1.5-day public workshop with the goal being an assessment of the current understanding of the interaction of infectious disease threats and economic activity in order to suggest future areas of research. This workshop built on prior work of the Forum and aimed to build more mutual understanding between those in…
Technology Assessment | Health Outcomes | Evidence Synthesis | Infectious Diseases | Policy/Regulation | Global Governance | Clinical Care | Business/Industry | Economics/Finance | Health/Medicine | Global -
ReportPublication 2010Priorities for the National Vaccine Plan
The authors examine the complexities of the vaccine enterprise, a fundamental component of preventive medicine …
The authors examine the complexities of the vaccine enterprise, a fundamental component of preventive medicine and public health, from research and development of new vaccines to financing and reimbursement of immunization services. The current climate, socially, economically and politically, presents challenges and opportunities to the U.S. to strengthen the existing systems of developing, manufacturing, regulating, distributing, funding, and administering safe and effective vaccines for all people. The authors present recommendations for priority actions intended to…
Technology Assessment | Evidence Synthesis | Infectious Diseases | Chronic Disease/Risk | Health Systems | Policy/Regulation | Economics/Finance | Health/Medicine | Science/Technology | North America -
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