Resources Repository
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ArticlePublication 2020Testing for SARS-CoV-2 Antibodies
Antibody testing can determine previous exposure to SARS-CoV-2 virus. Recently, the UK government has made …
Antibody testing can determine previous exposure to SARS-CoV-2 virus. Recently, the UK government has made antibody testing available to anyone wanting it, even if there is no clinical indication. The purpose of this article is to provide guidance for when to consider antibody testing in individuals with and without symptoms suggestive of current or past SARS-CoV-2 infection. Key points made by the authors include: (1) antibody testing is likely to be most useful 2 weeks…
Probability/Bayes | Test Performance | Technology Assessment | Infectious Diseases | Clinical Care | Health/Medicine -
ReportPublication 2015Improving Diagnosis in Health Care
Getting the right diagnosis is a key aspect of health care - it provides an …
Getting the right diagnosis is a key aspect of health care - it provides an explanation of a patient's health problem and informs subsequent health care decisions. The diagnostic process is a complex, collaborative activity that involves clinical reasoning and information gathering to determine a patient's health problem. This report, Improving Diagnosis in Health Care, explains that diagnostic errors-inaccurate or delayed diagnoses-persist throughout all settings of care and continue to harm an unacceptable number of patients.…
Probability/Bayes | Test Performance | Value of Information | Health Outcomes | Health Systems | Health/Medicine | North America -
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.…
Test Performance | Technology Assessment | Costing Methods | Mathematical Models | Cost-Effectiveness Analysis | Infectious Diseases | Maternal/Reproductive Health | Clinical Care | Health/Medicine | Sub-Saharan Africa -
ArticlePublication 2022Economic Value of Clinical Artificial Intelligence
Artificial intelligence (AI) is increasingly used in clinical applications. Nevertheless, its flexibility and difficulties around …
Artificial intelligence (AI) is increasingly used in clinical applications. Nevertheless, its flexibility and difficulties around collecting data on its clinical impacts make value assessment challenging. This article uses a value framework as the basis for assessing how AI may create value depending on how it is used. Authors also provide advice to health economists seeking to model AI’s clinical impacts. There are multiple ways that AI challenges traditional health technology assessment methodology. Authors highlight several…
Technology Assessment | Value of Information | Economics/Finance | Science/Technology | Global -
ArticlePublication 2021Rational Policymaking during a Pandemic
Policymaking during a pandemic can be extremely challenging. As COVID-19 is a new disease and …
Policymaking during a pandemic can be extremely challenging. As COVID-19 is a new disease and its global impacts are unprecedented, decisions are taken in a highly uncertain, complex, and rapidly changing environment. In such a context, in which human lives and the economy are at stake, the authors argue that using ideas and constructs from modern decision theory, even informally, will make policymaking a more responsible and transparent process.
Priority Setting/Ethics | Decision Theory | Infectious Diseases | Policy/Regulation | Government/Law | Health/Medicine | Science/Technology | Global -
ArticlePublication 2020Bayes' Theorem, COVID-19, and Screening Tests
This article reviews the implications of increased testing for COVID-19 using reverse transcriptase polymerase chain …
This article reviews the implications of increased testing for COVID-19 using reverse transcriptase polymerase chain reaction (rRT-PCR) through the application of Bayes’ Theorem for three hypothetical, stylized case scenarios. The scenarios involve three patients with a low, moderate, and high pre-test probability of COVID-19 infection. The category of low probability would include "asymptomatic individuals in a presumed low prevalence environment" and might vary from 10 to 20%. The category of moderate probability would include "individuals…
Probability/Bayes | Test Performance | Infectious Diseases | Clinical Care | Health/Medicine -
ArticlePublication 2020Interpreting COVID-19 Test Results: A Bayesian Approach
This article considers the following question with respect to interpreting the results of polymerase chain reaction …
This article considers the following question with respect to interpreting the results of polymerase chain reaction (PCR) assays from nasal and pharyngeal swabs for COVID-19 to inform clinical decision making: "While a positive result in an acutely ill patient is straightforward, how should physicians interpret negative tests in patients with suspected COVID-19 infection?" Using an assumption of near-perfect specificity of PCR assays for COVID-19, the authors acknowledge the uncertainty of test sensitivity. They consider two clinical scenarios…
Probability/Bayes | Test Performance | Infectious Diseases | Health/Medicine | Science/Technology | Global -
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 2016An Economic Evaluation of the PEN Program in Indonesia
Responding to the economic and health burden of noncommunicable diseases (NCDs), the World Health Organization (WHO) …
Responding to the economic and health burden of noncommunicable diseases (NCDs), the World Health Organization (WHO) introduced the Package of Essential Noncommunicable disease (PEN) interventions. Several countries, including Indonesia, implemented the PEN program. To assess the value of the investment in the current program, an economic evaluation of the program was conducted with collaboration between the Ministry of Health in Indonesia, the WHO, and the International Decision Support Initiative (iDSI). This study evaluated the delivery of…
Priority Setting/Ethics | Technology Assessment | Cost-Effectiveness Analysis | Chronic Disease/Risk | Health Systems | Economics/Finance | Government/Law | Health/Medicine | Asia & Pacific