Resources Repository
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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 | Clinical Care | Health/Medicine -
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…
Test Performance | Probability/Bayes | Clinical Care | Health/Medicine -
ArticlePublication 2020Equity & Distributional Impact on Stunting of a Nutritional Package, Children Aged 6-36 Months in China: Modeling Study Findings
This article evaluates the potential impact of rolling out the Ying Yang Bao (YYB) nutritional …
This article evaluates the potential impact of rolling out the Ying Yang Bao (YYB) nutritional package on child stunting across provinces and wealth groups in China, focusing on equity. Utilizing data from the China Family Panel Studies and extended cost-effectiveness analysis methods, the study estimates the distributional impact of a 12-month YYB program for children aged 6-36 months across 25 provinces and two wealth groups. Results indicate that a 75% coverage of YYB could avert…
Health Outcomes | Mathematical Models | Cost-Effectiveness Analysis | Child/Nutrition | Health/Medicine | Asia & Pacific -
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…
Health Outcomes | Preferences/Values | Benefit-Cost Analysis | Environmental Health | Policy/Regulation | College | Graduate | Critical Thinking/Analysis -
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 | Cost-Effectiveness Analysis | Chronic Disease/Risk | Health/Medicine | Global -
ArticlePublication 2019Measuring Progress Towards Universal Health Coverage
This article, published in BMJ Global Health, aims to estimate the 2015 national and subnational …
This article, published in BMJ Global Health, aims to estimate the 2015 national and subnational universal health coverage (UHC) service coverage status for Ethiopia. The UHC service coverage index is constructed from the geometric means of component indicators: first, within each of four major categories and then across all components to obtain the final summary index. The authors estimate UHC service coverage at the subnational level using a variety of surveys and routinely collected administrative…
Test Performance | Health Systems | Health/Medicine | Sub-Saharan Africa -
ArticlePublication 2019Systematic Review of Economic Evaluations of Vaccination Strategies Against Tuberculosis
Bacillus Calmette-Guérin (BCG) is the only licensed vaccine for tuberculosis, but its effectiveness is limited …
Bacillus Calmette-Guérin (BCG) is the only licensed vaccine for tuberculosis, but its effectiveness is limited and varies by age, so a valid cost-effectiveness study is needed to assist decision-makers in the implementation of cost-effective strategies for BCG vaccination. Using the Quality of Health Economic Studies (QHES) instrument, the authors assessed the quality of published studies involving economic evaluations of BCG vaccination strategies in a variety of regions, target populations, and vaccine types. Most of the…
Evidence Synthesis | Mathematical Models | Cost-Effectiveness Analysis | Infectious Diseases | Health/Medicine | Global -
ArticlePublication 2018Comparing Cost-per-QALYs Gained to Cost-per-DALYs Averted
The authors examined 6,438 cost-per-QALY and 543 cost-per-DALY studies published through 2016 using two databases, …
The authors examined 6,438 cost-per-QALY and 543 cost-per-DALY studies published through 2016 using two databases, the Tufts Medical Center CEA Registry (cost-per-QALY gained studies), and the Global Cost-Effectiveness Analysis (GHCEA) Registry (cost-per-DALY averted studies). Study characteristics that were analyzed included intervention type, sponsor, country, primary disease, and number of CEAs versus disease burden estimates for major conditions. The authors report that cost-per-QALY studies were most often about pharmaceuticals or interventions in high-income countries while cost-per-DALY…
Evidence Synthesis | Cost-Effectiveness Analysis | Policy/Regulation | Health/Medicine | Global -
ReviewPublication 2018Equity Considerations in CEA: Rotavirus Vaccine in LMIC's
The authors used a systematic review of the literature to identify economic evaluations of rotavirus …
The authors used a systematic review of the literature to identify economic evaluations of rotavirus vaccine in LMICs and assess the extent to which equity was considered in the objectives, analysis, and results. They used equity-related indicators provided in the Guidance on Priority Setting in Health Care (GPS-Health) checklist criteria resulting in 18 unique indicators tracked. The authors found that some articles incorporated the indicators in their model inputs (20%) while the majority (80%) presented…
Evidence Synthesis | Cost-Effectiveness Analysis | Infectious Diseases | Social Determinants | Health/Medicine | Global