Resources Repository
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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 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 | Mathematical Models | Calibration/Validation | Cost-Effectiveness Analysis | Chronic Disease/Risk | Health/Medicine | North America | Graduate -
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 2016Health and Economic Benefits of Public Financing of Epilepsy Treatment in India
This study uses extended cost-effectiveness analysis (ECEA) to evaluate the impact of three scenarios of …
This study uses extended cost-effectiveness analysis (ECEA) to evaluate the impact of three scenarios of publicly financed national epilepsy programs in India that provide (1) first line antiepilepsy drugs (AEDs), (2) first- and second-line AEDs, and (3) first- and second-line AEDs and surgery. Outcome measures include disability-adjusted life years (DALYs) averted, and cost per DALY averted. Economic benefit measures estimated include out-of-pocket (OOP) expenditure averted and money-metric value of insurance. All three scenarios represent a…
Microsimulation | Priority Setting/Ethics | Cost-Effectiveness Analysis | Chronic Disease/Risk | Economics/Finance | Health/Medicine | Asia & Pacific -
ArticlePublication 2019Decision-Making for Universal Access to Tuberculosis Diagnosis In India
The authors evaluated the costs of centralized and decentralized testing for tuberculosis with Xpert MTB/RIF …
The authors evaluated the costs of centralized and decentralized testing for tuberculosis with Xpert MTB/RIF (Xpert), a WHO-endorsed test. They used an agent-based simulation of TB transmission in a hypothetical representative region in India to assess the impact and cost-effectiveness of various strategies to provide universal access to diagnosis and drug susceptibility testing (DST) for tuberculosis. The authors found that decentralization was most favorable compared to centralized testing when volume at decentralized facilities was high,…
Microsimulation | Cost-Effectiveness Analysis | Infectious Diseases | Health/Medicine | Asia & Pacific -
ArticlePublication 2019POC Diagnosis of TB With Truenat Assay: CEA for India's Public Sector
Using a microsimulation model, the authors compared four TB diagnostic strategies for HIV-negative adults with …
Using a microsimulation model, the authors compared four TB diagnostic strategies for HIV-negative adults with presumptive TB in order to evaluate the potential cost-effectiveness of strategies that incorporate Truenat, a molecular assay that rapidly detects TB and rifampicin-resistance. They projected life expectancy, costs, incremental cost-effectiveness ratios (ICERs), and 5-year budget impact of deploying Truenat POC in India's public sector. Used at the point-of-care in India, Truenat for TB diagnosis should improve linkage-to-care, increase life expectancy,…
Microsimulation | Cost-Effectiveness Analysis | Infectious Diseases | Health/Medicine | Asia & Pacific -
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 -
ArticlePublication 2018Should We Treat Acute Hepatitis C? A Decision and Cost-Effectiveness Analysis
This study examines the potential benefits of treating acute hepatitis C virus (HCV) infection compared …
This study examines the potential benefits of treating acute hepatitis C virus (HCV) infection compared to deferring treatment until the chronic phase, utilizing a microsimulation model. By projecting long-term outcomes such as quality-adjusted life years (QALYs) and costs, the analysis evaluates the cost-effectiveness of initiating therapy during the acute phase. Results indicate that treating acute HCV increases QALYs by 0.02 and costs by $483 per patient not at risk of transmitting HCV, yielding an incremental…
Microsimulation | Decision Analysis | Cost-Effectiveness Analysis | Infectious Diseases | Chronic Disease/Risk | Health/Medicine | North America