Resources Repository
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ArticlePublication 2013Modeling the Effectiveness of Initial Management Strategies for Ductal Carcinoma in Situ
This paper compares alternative strategies to manage ductal carcinoma in situ (DCIS). The authors used …
This paper compares alternative strategies to manage ductal carcinoma in situ (DCIS). The authors used a disease simulation model to simulate the clinical events after six treatments (lumpectomy alone, lumpectomy with radiation, lumpectomy with radiation and tamoxifen, lumpectomy with tamoxifen, and mastectomy with and without breast reconstruction). Outcomes included disease-free, invasive disease-free, overall survival and breast preservation. Data were from the published literature. The results showed that for women aged 45 years at diagnosis, both mastectomy…
Health Outcomes | Health/Medicine | Decision Analysis | Clinical Care -
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…
Health Outcomes | Health/Medicine | Mathematical Models | Microsimulation | Calibration/Validation | Maternal/Reproductive Health | Health Systems | Clinical Care | Global -
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…
Health Outcomes | Health/Medicine | Evidence Synthesis | Microsimulation | Calibration/Validation | Maternal/Reproductive Health | Health Systems | Clinical Care | Global -
ArticlePublication 2008Cost-Effectiveness of Rapid Point-of-Care Prenatal Syphilis Screening in Sub-Saharan Africa
This paper investigates the cost-effectiveness of using rapid point-of-care tests for prenatal syphilis screening among …
This paper investigates the cost-effectiveness of using rapid point-of-care tests for prenatal syphilis screening among pregnant women in sub-Saharan Africa, a region with syphilis prevalence rates as high as 17%, and where traditional multi-test screening methods have been challenging to implement. Focusing on newly available rapid point-of-care screening tests, strategies differed by the initial test [rapid plasma reagin (RPR), immunochromographic strip (ICS)], need for confirmation with Treponema pallidum hemagglutination assay, and number of visits required.…
Costing Methods | Health/Medicine | Test Performance | Mathematical Models | Cost-Effectiveness Analysis | Technology Assessment | Infectious Diseases | Maternal/Reproductive Health | Clinical Care | Sub-Saharan Africa -
ArticlePublication 2021Racial and Ethnic Inequities in the Early Distribution of U.S. COVID-19 Testing Sites and Mortality
In 2020, U.S. COVID-19 testing sites were pivotal not just for diagnosis but also to …
In 2020, U.S. COVID-19 testing sites were pivotal not just for diagnosis but also to provide data that would contribute to understanding transmission. This research explored how these sites were distributed in relation to racial and ethnic demographics and its connection to observed disparities in COVID-19 outcomes. Data from mid-April to late May 2020 revealed that testing sites were not equally distributed among racial groups. Specifically, there was an overrepresentation of testing sites in areas…
Health Outcomes | Health/Medicine | Test Performance | Infectious Diseases | Social Determinants | Policy/Regulation | Culture/Society | Science/Technology | North America -
ArticlePublication 2023Single-Arm Trial Design Estimates Efficacy
Studies to confirm the efficacy of a single HPV vaccine dose, of vaccine durability, and …
Studies to confirm the efficacy of a single HPV vaccine dose, of vaccine durability, and of vaccination modifications are needed, but randomized controlled trials are costly and face logistical and ethical challenges. In this study, the authors demonstrate proof-of-principle that a single-arm design yields valid estimates with similar precision to a randomized controlled trial.
Health Outcomes | Health/Medicine | Infectious Diseases | Maternal/Reproductive Health | Policy/Regulation | Global -
ArticlePublication 2023Achieving the Cancer Moonshot Goal
The Cancer Moonshot seeks to reduce age-standardized cancer mortality rates by at least 50% over …
The Cancer Moonshot seeks to reduce age-standardized cancer mortality rates by at least 50% over the next 25 years. This article estimates trends in U.S. cancer mortality for all cancers and the six leading types and reviews opportunities to prevent, detect, and treat these common cancers.
Priority Setting/Ethics | Health/Medicine | Mathematical Models | Health Systems | Clinical Care | North America -
ArticlePublication 2023Benefits and Costs of COVID-19 Vaccine Mandates
Written mid-pandemic, this article evaluates the direct costs and health benefits of requiring COVID-19 vaccinations …
Written mid-pandemic, this article evaluates the direct costs and health benefits of requiring COVID-19 vaccinations for U.S. federal employees and healthcare and private sector workers. These mandates were controversial and some were halted by litigation. If they had been implemented as intended, the net benefits would depend on the course of the pandemic. If a more transmissible variant (such as Omicron) emerges, the net benefits may be large. If the pandemic instead fades, the benefits…
Benefit-Cost Analysis | Health/Medicine | Mathematical Models | State-Transition | Infectious Diseases | Policy/Regulation | Business/Industry | Economics/Finance | Government/Law | North America -
ArticlePublication 2023Out-of-Pocket Expenditures & Financial Risks Associated with Treatment of Vaccine-Preventable Diseases in Ethiopia
This study investigates out-of-pocket (OOP) expenditures and associated catastrophic health expenditures (CHEs) for vaccine-preventable diseases …
This study investigates out-of-pocket (OOP) expenditures and associated catastrophic health expenditures (CHEs) for vaccine-preventable diseases (VPDs) in Ethiopia. Through a cross-sectional costing analysis, data on OOP direct medical and nonmedical expenditures were collected from 995 households in 54 health facilities nationwide. The study focuses on VPDs in children under 5 years for pneumonia, diarrhea, measles, and pertussis, and in children under 15 years for meningitis. Mean OOP expenditures per disease episode ranged from $5·6 to…
Costing Methods | Health/Medicine | Mathematical Models | Cost-Effectiveness Analysis | Child/Nutrition | Chronic Disease/Risk | Sub-Saharan Africa