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.
Priority Setting/Ethics | Preferences/Values | Health/Medicine | Health Outcomes | Health Systems | Clinical Care -
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…
Priority Setting/Ethics | Preferences/Values | Health/Medicine | Health Outcomes | Health Systems | Culture/Society | Economics/Finance | 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,…
Priority Setting/Ethics | Preferences/Values | Health/Medicine | Cost-Effectiveness Analysis | Infectious Diseases | Economics/Finance | Sub-Saharan Africa -
ArticlePublication 2017Using Cost-Effectiveness Analysis to Address Health Equity Concerns
This article serves as a guide to using cost-effectiveness analysis (CEA) to address health equity …
This article serves as a guide to using cost-effectiveness analysis (CEA) to address health equity concerns. The authors introduce the "equity impact plane," a tool for considering trade-offs between improving total health-the objective underpinning conventional CEA-and equity objectives, such as reducing social inequality in health or prioritizing the severely ill. Improving total health may clash with reducing social inequality in health, for example, when effective delivery of services to disadvantaged communities requires additional costs. Who…
Priority Setting/Ethics | Preferences/Values | Health/Medicine | Cost-Effectiveness Analysis | Health Systems | Policy/Regulation | Global -
ArticlePublication 2016“Nudges” in Law and Policy
This article describes research on Americans’ preferences for types of “nudges” in the context of …
This article describes research on Americans’ preferences for types of “nudges” in the context of law and public policy—those that target “system 1” thinking, meaning the intuitive, emotion-based mechanisms, such as graphic warnings and default rules, versus those that target “system 2” thinking, the rational, deliberative form of cognition, such as statistical information or education-based messages.
Priority Setting/Ethics | Preferences/Values | Health/Medicine | Decision Psychology | Policy/Regulation | Culture/Society | Government/Law -
ArticlePublication 2015Broader Economic Impact of Vaccination: Reviewing and Appraising the Strength of Evidence
Economic evaluations of public health programs such as immunization often consider only direct health benefits and …
Economic evaluations of public health programs such as immunization often consider only direct health benefits and medical cost savings. Evidence linking immunization to important benefits in indicators such as childhood development, household behavior, and other macro-economic data are unclear. A conceptual framework of the pathways between immunization and these broader economic benefits was developed through expert consultation. The authors obtained articles from previous reviews, snowballing, and expert consultation, and associated them with one of the pathways and assessed them using modified Grading…
Priority Setting/Ethics | Preferences/Values | Health/Medicine | Costing Methods | Evidence Synthesis | Benefit-Cost Analysis | Cost-Effectiveness Analysis | Infectious Diseases | Social Determinants | Economics/Finance | Education/Labor -
ArticlePublication 2007Decision Analysis: A Personal Account of How It Got Started and Evolved
In this chapter, Howard Raiffa discusses the evolution of decision analysis and his personal involvement …
In this chapter, Howard Raiffa discusses the evolution of decision analysis and his personal involvement in its development. He describes the early days of Operations Research (OR) in the late 1940s with its approach to complex, strategic decision making. After reading John von Neumann and Oskar Morgenstern’s Theory of Games and Economic Behavior (1947) and Abraham Wald’s two books (1947, 1950), he became involved in statistical decision theory. A few years later, after reading Leonard…
Preferences/Values | Decision Analysis | Health/Medicine | Decision Theory | Probability/Bayes | Operations Research | Business/Industry | Economics/Finance | Energy/Engineering -
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…
Decision Analysis | Health/Medicine | Health Outcomes | 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…
Calibration/Validation | Health/Medicine | Health Outcomes | Mathematical Models | Microsimulation | Maternal/Reproductive Health | Health Systems | Clinical Care | Global