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 | Test Performance | Technology Assessment | Infectious Diseases | Clinical Care | Health/Medicine -
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 -
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…
Dynamic Transmission | Priority Setting/Ethics | Costing Methods | Mathematical Models | Cost-Effectiveness Analysis | Infectious Diseases | Health Systems | Economics/Finance | Health/Medicine | Sub-Saharan Africa | Middle East & North Africa | Latin America & Caribbean | Asia & Pacific -
ArticlePublication 2017Estimating the Fitness Cost and Benefit of Cefixime Resistance in Neisseria Gonorrhoeae
Gonorrhoea is one of the most common bacterial sexually transmitted infections in England, and more …
Gonorrhoea is one of the most common bacterial sexually transmitted infections in England, and more than half of annual infections occur in men who have sex with men (MSM). As the bacterium has developed resistance to each first-line antibiotic in turn, an improved understanding is needed of fitness benefits and costs of antibiotic resistance to inform control policy and planning. The authors developed a stochastic compartmental model representing the natural history and transmission of cefixime-sensitive…
Dynamic Transmission | Decision Analysis | Risk Analysis | Infectious Diseases | Health Systems | Policy/Regulation | Government/Law | Health/Medicine | Science/Technology | Global