Resources Repository
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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…
Test Performance | Health/Medicine | Probability/Bayes | Infectious Diseases | Science/Technology | Global -
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 | Health/Medicine | Priority Setting/Ethics | Health Outcomes | Health Systems | Clinical Care -
ArticlePublication 2019Cost-Effectiveness of Community-Based Childhood Obesity Prevention Interventions in Australia
This study examined the cost-effectiveness of community-based obesity prevention interventions (CBIs) consisting of strategies to …
This study examined the cost-effectiveness of community-based obesity prevention interventions (CBIs) consisting of strategies to promote healthy eating and physical activity for Australian children aged between 5-18 years. A multiple cohort Markov model that simulates diseases associated with overweight and obesity was used to estimate the health benefits, measured as health-adjusted life years (HALYs) and healthcare-related cost offsets from diseases averted due to exposure to the intervention. Health and cost outcomes were estimated over the…
State-Transition | Health/Medicine | Health Outcomes | Cost-Effectiveness Analysis | Child/Nutrition | Chronic Disease/Risk | Health Systems | Clinical Care | Food/Agriculture | Oceania -
ArticlePublication 2020Translating Population Evidence to Individual Patients
In this paper, the authors describe the differences in population level outcomes compared to individual …
In this paper, the authors describe the differences in population level outcomes compared to individual patients and discuss ways that these are differences. The authors cover topics including the difference between relative and absolute risk and benefit. They use an example of the decision to start anticoagulation in new-onset atrial fibrillation to discuss translating population level evidence to treatment of an individual. These options include generalizability, subgroup analysis, prediction rules, following response to therapy, and even…
Test Performance | Health/Medicine | Evidence Synthesis | Health Systems | Clinical Care -
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…
Test Performance | Health/Medicine | Probability/Bayes | Clinical Care -
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 | Health/Medicine | Mathematical Models | Microsimulation | Cost-Effectiveness Analysis | Chronic Disease/Risk | North America | Graduate -
ArticlePublication 2019Measuring Progress Towards Universal Health Coverage
This article, published in BMJ Global Health, aims to estimate the 2015 national and subnational …
This article, published in BMJ Global Health, aims to estimate the 2015 national and subnational universal health coverage (UHC) service coverage status for Ethiopia. The UHC service coverage index is constructed from the geometric means of component indicators: first, within each of four major categories and then across all components to obtain the final summary index. The authors estimate UHC service coverage at the subnational level using a variety of surveys and routinely collected administrative…
Test Performance | Health/Medicine | Health Systems | Sub-Saharan Africa -
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 | Health/Medicine | Priority Setting/Ethics | Health Outcomes | Health Systems | Culture/Society | Economics/Finance | North America -
ArticlePublication 2017Changing the South African National ART Guidelines: The Role of Cost Modelling
This analysis was motivated by the South African Department of Health's request to assess the …
This analysis was motivated by the South African Department of Health's request to assess the cost implications of adopting sets of ART guidelines issued by the World Health Organization between 2010 and 2016.Using data from large South African ART clinics (n = 24,244 patients), projections of patients in need of ART, and cost data from bottom-up cost analyses, the authors constructed a population-level health-state transition model with 6-monthly transitions between health states depending on patients’ age,…
State-Transition | Health/Medicine | Costing Methods | Infectious Diseases | Health Systems | Clinical Care | Economics/Finance | Sub-Saharan Africa