Resources Repository
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ArticlePublication 2022Early HPV Natural History Transitions
Microsimulation models used to evaluate the cost-effectiveness of novel cervical cancer screening technologies rely on …
Microsimulation models used to evaluate the cost-effectiveness of novel cervical cancer screening technologies rely on accurate transition risks for human papillomavirus (HPV) infection, persistence (or absence of HPV clearance), progression to precancerous lesions, and invasion. To inform the refinement of such models, we compared the early natural history of HPV types using prospective data from immunocompetent women in the Guanacaste Natural History Study, the ASCUS-LSIL Triage Study, and the Costa Rica HPV Vaccine Trial. We…
Microsimulation | Latin America & Caribbean | North America | Mathematical Models | Cost-Effectiveness Analysis | Infectious Diseases -
ArticlePublication 2017Cost-Effectiveness of Testing and Treatment for Latent TB
Testing for and treating latent tuberculosis infection (LTBI) is among the main strategies to achieve …
Testing for and treating latent tuberculosis infection (LTBI) is among the main strategies to achieve TB elimination in the United States. This analysis estimated health outcomes, costs, and cost-effectiveness of LTBI testing and treatment among non-US born residents with and without medical comorbidities (e.g., diabetes, HIV infection, and end-stage renal disease). A decision analytic tree and Markov cohort simulation model was used to compare the following strategies: no testing, tuberculin skin test (TST), interferon gamma release assay…
Microsimulation | North America | Global | Test Performance | State-Transition | Cost-Effectiveness Analysis | Infectious Diseases | Chronic Disease/Risk | Health Systems | Economics/Finance | Health/Medicine -
ArticlePublication 2023Simulation-Based Comparative Effectiveness Analysis of Policies to Improve Global Maternal Health Outcomes
The Sustainable Development Goals include a target to reduce the global maternal mortality ratio (MMR) …
The Sustainable Development Goals include a target to reduce the global maternal mortality ratio (MMR) to less than 70 maternal deaths per 100,000 live births by 2030, with no individual country exceeding 140. However, on current trends the goals are unlikely to be met. The authors used an empirically calibrated Global Maternal Health microsimulation model, which simulates individual women in 200 countries and territories to evaluate the impact of different interventions and strategies from 2022…
Microsimulation | Global | Health Outcomes | Mathematical Models | Calibration/Validation | Maternal/Reproductive Health | Health Systems | Clinical Care | Health/Medicine -
ArticlePublication 2023Simulation-Based Estimates and Projections of Global, Regional and Country-Level Maternal Mortality by Cause, 1990-2050
While progress has been made globally to reduce maternal deaths, measurement remains a challenge given …
While progress has been made globally to reduce maternal deaths, measurement remains a challenge given the many causes and frequent underreporting of maternal deaths. The authors developed a structural microsimulation model of Global Maternal Health (GMatH) for 200 countries and territories using demographic, epidemiologic, clinical and health system data synthesized from the medical literature, Civil Registration Vital Statistics systems and Demographic and Health Survey data. The model was calibrated to empirical data from 1990 to…
Microsimulation | Global | Health Outcomes | Evidence Synthesis | Calibration/Validation | Maternal/Reproductive Health | Health Systems | Clinical Care | Health/Medicine -
ArticlePublication 2010Alternative Strategies to Reduce Maternal Mortality in India: A Cost-Effectiveness Analysis
This article, published in PLoS Medicine, conducted a cost-effectiveness analysis of strategies to improve pregnancy …
This article, published in PLoS Medicine, conducted a cost-effectiveness analysis of strategies to improve pregnancy and childbirth safety in India. Country- and region-specific data were synthesized using a computer-based model that simulates the natural history of pregnancy and pregnancy-associated complications in individual women, and considers delivery location, attendant, and facility level. Model validation compared projected maternal indicators with empiric data. Strategies consisted of improving coverage of effective interventions that could be provided individually or packaged…
Microsimulation | Global | Evidence Synthesis | Mathematical Models | Cost-Effectiveness Analysis | Maternal/Reproductive Health | Economics/Finance | Health/Medicine | Asia & Pacific -
ArticlePublication 2022Re-Evaluating the Health Impact and Cost-Effectiveness of Tuberculosis Prevention for Modern ART Cohorts
TB preventive therapy (TPT) is widely accepted to be cost-effective for reducing TB incidence in …
TB preventive therapy (TPT) is widely accepted to be cost-effective for reducing TB incidence in HIV-infected individuals receiving antiretroviral therapy (ART). However, as individuals initiate ART earlier in the course of disease, TB incidence is lower, and it is unclear how ART cost-effectiveness has changed. This study assessed the cost-effectiveness of TPT in contemporary ART cohorts. The authors developed a microsimulation model of TB and HIV and parameterised it using data from a large HIV…
Microsimulation | Global | Cost-Effectiveness Analysis | Infectious Diseases | Health/Medicine | Sub-Saharan Africa -
ArticlePublication 2022Cost-Effectiveness of Masked Hypertension Screening and Treatment
The study assessed the health and economic outcomes of screening and treating masked hypertension in …
The study assessed the health and economic outcomes of screening and treating masked hypertension in U.S. adults using the Cardiovascular Disease (CVD) Policy Model, a microsimulation model. The model simulated 100,000 adults suspected of having masked hypertension (office blood pressure [BP] of 120–129/<80 mm Hg, not on antihypertensive medications, and without a history of CVD). Interventions included: usual care alone, usual care with ambulatory BP monitoring (ABPM), and usual care with home BP monitoring (HBPM).…
Microsimulation | North America | Cost-Effectiveness Analysis | Chronic Disease/Risk | Clinical Care | Health/Medicine -
ArticlePublication 2021New Microsimulation Models to Inform Cervical Cancer Control
Health decision models consider the lifetime natural history of human papillomavirus (HPV) infection and pathogenesis …
Health decision models consider the lifetime natural history of human papillomavirus (HPV) infection and pathogenesis of cervical cancer, and estimate the long-term impact of preventive interventions. We propose a new health decision modeling framework that de-emphasizes previously used cytologic-colposcopic-histologic diagnoses, which are subjective and lack reproducibility, relying instead on HPV type and duration of infection as the major determinants of model transition probabilities. We posit that new model health states and corollary transitions are universal,…
Microsimulation | Global | Mathematical Models | Calibration/Validation | Decision Analysis | Cost-Effectiveness Analysis | Infectious Diseases -
ArticlePublication 2019Estimating the Total Incidence of Global Childhood Cancer: A Simulation-Based Analysis
This study describes the development of a microsimulation model to simulate childhood cancer incidence for …
This study describes the development of a microsimulation model to simulate childhood cancer incidence for 200 countries/territories, taking into account trends in population growth and urbanicity, geographical variation in cancer incidence, and health system barriers to access and referral that contribute to underdiagnosis. The model was calibrated to publicly available cancer registry data, and the total incidence of childhood cancer (diagnosed and undiagnosed) was estimated for each country in 2015 and projections made to 2030.…
Microsimulation | Global | Health Outcomes | Child/Nutrition | Chronic Disease/Risk | Health Systems