Resources Repository
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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 | Health Outcomes | Value of Information | Health Systems | Health/Medicine | North America -
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…
Test Performance | Health Outcomes | Infectious Diseases | Social Determinants | Policy/Regulation | Culture/Society | Health/Medicine | Science/Technology | North America -
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 -
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 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 2015A Conceptual Model for Breast, Cervical, and Colorectal Cancer Screening
General frameworks of the cancer screening process are available, but none directly compare the process …
General frameworks of the cancer screening process are available, but none directly compare the process in detail across different organ sites. This limits the ability of medical and public health professionals to develop and evaluate coordinated screening programs that apply resources and population management strategies available for one cancer site to other sites. This paper presents a conceptual model that incorporates a single screening episode for breast, cervical, and colorectal cancers into a unified framework based…
Test Performance | Health Outcomes | Preferences/Values | Evidence Synthesis | Microsimulation | Cost-Effectiveness Analysis | Chronic Disease/Risk | Health Systems | Clinical Care | Health/Medicine | Science/Technology | North America -
ArticlePublication 2024GBD Study 2021 Estimates: Implications for Health Policy & Research
The article discusses findings from the Global Burden of Diseases, Injuries, and Risk Factors Study …
The article discusses findings from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021, published in The Lancet, which presents estimates of disease burden worldwide from 1990 to 2021. Despite an overall increase in global disability-adjusted life years (DALYs), age-standardized rates have decreased, particularly for communicable diseases like HIV/AIDS and diarrheal diseases. Post-COVID-19 impacts, including long COVID, are highlighted. GBD aids in tracking progress towards global health goals but its iterative nature…
Health Outcomes | Health/Medicine | Global