Resources Repository
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ArticlePublication 2020Incorporating Perspective into Clinical Decisions
Part of a six-part series of articles on clinical decision making, in this article, the …
Part of a six-part series of articles on clinical decision making, in this article, the authors discuss how to incorporate perspective into clinical decisions, explicitly acknowledging that the treating physician is not the only stakeholder in these decisions. The authors use 2 case studies to demonstrate how changes in perspective can alter the clinical decision as well lead to both intended and unintended consequences to the outcomes.
Preferences/Values | Priority Setting/Ethics | Health Outcomes | Health Systems | 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…
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…
Calibration/Validation | Mathematical Models | Microsimulation | 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…
Preferences/Values | Health Outcomes | Benefit-Cost Analysis | Environmental Health | Policy/Regulation | College | Graduate | Critical Thinking/Analysis -
Working PaperPublication 2018Valuing Nonfatal Health Risk Reductions
This paper explores approaches for valuing nonfatal risk reductions associated with policy choices in low- …
This paper explores approaches for valuing nonfatal risk reductions associated with policy choices in low- and middle-income countries. The approach for valuation ideally would be based on estimates of individuals’ willingness to pay for changes in their own risks. However, high quality valuation research is not available for many nonfatal conditions even in high-income settings. Typically, two approaches are used either alone or in combination as rough proxies. The first involves applying an estimate of…
Preferences/Values | Priority Setting/Ethics | Health Outcomes | Decision Analysis | Benefit-Cost Analysis | Social Determinants | Policy/Regulation | Economics/Finance | Health/Medicine | Global | Critical Thinking/Analysis -
ArticlePublication 2018Trading Bankruptcy for Health: A Discrete-Choice Experiment
This article in Value in Health evaluates the importance of improved health as compared to …
This article in Value in Health evaluates the importance of improved health as compared to improved financial risk protection in the general United States population. Using a discrete-choice experiment, it finds that 31.3% of the population values cure at all costs, and 8.5% of the population use financial solvency to dominate medical decision making. This study shares insight to the US population values and trade-offs between health outcomes and financial health, and highlights the difficult…
Preferences/Values | Priority Setting/Ethics | Health Outcomes | Health Systems | Culture/Society | Economics/Finance | Health/Medicine | North America -
ArticlePublication 2017Revealed Willingness-to-Pay vs. Standard Cost-Effectiveness Thresholds
This study estimates the cost-effectiveness thresholds (CETs) of 16 HIV programs in South Africa. The …
This study estimates the cost-effectiveness thresholds (CETs) of 16 HIV programs in South Africa. The use of CETs based on a country’s income per capita has been criticized for not being grounded in theory or evidence, especially in low and middle-income countries (LMICs). An alternative has been produced for South Africa, based on estimates of life years saved and the country’s committed HIV budget. The authors used a previously -published optimization method to estimate CETs,…
Preferences/Values | Priority Setting/Ethics | Cost-Effectiveness Analysis | Infectious Diseases | Economics/Finance | Health/Medicine | Sub-Saharan Africa -
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 -
ArticlePublication 2017Predicting Carer Health Effects for Use in Economic Evaluation
Illnesses and interventions can affect the health status of family carers in addition to patients. …
Illnesses and interventions can affect the health status of family carers in addition to patients. However economic evaluation studies rarely incorporate data on health status of carers. In order to investigate whether changes in carer health status could be ‘predicted’ from the health data of those they provide care to, as a means of incorporating carer outcomes in economic evaluation, the authors used regression models to analyse changes in carers’ health status. They derive predictive algorithms based on…
Preferences/Values | Health Outcomes | Cost-Effectiveness Analysis | Infectious Diseases | Health/Medicine | North America | Europe