Resources Repository
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ArticlePublication 2020Weighing Evidence to Inform Clinical Decisions
The authors use a clinical example to simulate how treatment discussions can be complicated when new evidence is introduced …
The authors use a clinical example to simulate how treatment discussions can be complicated when new evidence is introduced that conflicts with existing guidelines. Even when evidence is consistent, the authors point out that current guidelines can have interpretations that don't agree with available evidence. They develop a step-wise algorithm to help guide individual clinical decisions even in the absence of general consensus related to appropriate testing and treatment.
Evidence Synthesis | Priority Setting/Ethics | Clinical Care | Health/Medicine -
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…
Evidence Synthesis | Test Performance | Health Systems | Clinical Care | Health/Medicine -
ArticlePublication 2020Premature Deaths, Statistical Lives, and Years of Life
This article clarifies some misconceptions about mortality risk and economic valuation. The mortality effects of …
This article clarifies some misconceptions about mortality risk and economic valuation. The mortality effects of exposure to environmental hazards such as air pollution are often described by the estimated number of “premature deaths” and the economic value of an exposure reduction as the number of “statistical lives saved” multiplied by the “value per statistical life.” These terms can be misleading because the number of deaths advanced by exposure cannot be determined from mortality data; it…
Preferences/Values | Health Outcomes | Benefit-Cost Analysis | Environmental Health | Policy/Regulation | College | Graduate | Critical Thinking/Analysis -
ArticlePublication 2017Extended Cost-Effectiveness Analyses of Cardiovascular Risk Factor Reduction Policies
This chapter summarizes lessons learned from three extended cost-effectiveness analyses (ECEAs) conducted on cardiovascular disease …
This chapter summarizes lessons learned from three extended cost-effectiveness analyses (ECEAs) conducted on cardiovascular disease (CVD) risk factor reduction policies, specifically highlighting new insights into the differential impacts of well-established CVD prevention interventions. Tobacco taxation, salt reduction, and primary prevention of CVD in high-risk individuals remain widely regarded as best buys in global noncommunicable disease policy, and the ECEAs confirm the findings of previous CEAs, namely, that these interventions will likely result in large health…
Evidence Synthesis | Priority Setting/Ethics | Cost-Effectiveness Analysis | Chronic Disease/Risk | Health/Medicine | Global -
ArticlePublication 2019Systematic Review of Economic Evaluations of Vaccination Strategies Against Tuberculosis
Bacillus Calmette-Guérin (BCG) is the only licensed vaccine for tuberculosis, but its effectiveness is limited …
Bacillus Calmette-Guérin (BCG) is the only licensed vaccine for tuberculosis, but its effectiveness is limited and varies by age, so a valid cost-effectiveness study is needed to assist decision-makers in the implementation of cost-effective strategies for BCG vaccination. Using the Quality of Health Economic Studies (QHES) instrument, the authors assessed the quality of published studies involving economic evaluations of BCG vaccination strategies in a variety of regions, target populations, and vaccine types. Most of the…
Evidence Synthesis | Mathematical Models | Cost-Effectiveness Analysis | Infectious Diseases | Health/Medicine | Global -
ArticlePublication 2018Comparing Cost-per-QALYs Gained to Cost-per-DALYs Averted
The authors examined 6,438 cost-per-QALY and 543 cost-per-DALY studies published through 2016 using two databases, …
The authors examined 6,438 cost-per-QALY and 543 cost-per-DALY studies published through 2016 using two databases, the Tufts Medical Center CEA Registry (cost-per-QALY gained studies), and the Global Cost-Effectiveness Analysis (GHCEA) Registry (cost-per-DALY averted studies). Study characteristics that were analyzed included intervention type, sponsor, country, primary disease, and number of CEAs versus disease burden estimates for major conditions. The authors report that cost-per-QALY studies were most often about pharmaceuticals or interventions in high-income countries while cost-per-DALY…
Evidence Synthesis | Cost-Effectiveness Analysis | Policy/Regulation | Health/Medicine | Global -
ArticlePublication 2018Examining Evaluation Methods for Health Equity Policies
This article reviews diverse methods for evaluating public policies that address social determinants of health …
This article reviews diverse methods for evaluating public policies that address social determinants of health equity. Understanding approaches to evaluating public policies is essential in strengthening the evidence base that informs policy change. Examining 50 studies in the article, the authors find that most studies evaluating policies for health equity outcomes use observational research designs and regression techniques to analyze impact. Furthermore, the studies reviewed primarily relied on secondary data, and nearly three out of…
Evidence Synthesis | Health Outcomes | Social Determinants | Global Governance | Government/Law | Global -
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 | Priority Setting/Ethics | Health Outcomes | Health Systems | Culture/Society | Economics/Finance | Health/Medicine | North America -
ArticlePublication 2017Costing of National STI Program Implementation, 2016-2021
In 2016 the World Health Assembly adopted the Global Strategy on Sexually Transmitted Infections (STI) …
In 2016 the World Health Assembly adopted the Global Strategy on Sexually Transmitted Infections (STI) 2016–2021 aiming to reduce curable STIs by 90% by 2030. This analysis costed scaling-up priority interventions to achieve coverage targets. Strategy-targeted declines in Chlamydia trachomatis, Neisseria gonorrhoeae, Treponema pallidum and Trichomonas vaginalis were applied to WHO-estimated regional burdens at 2012 levels. Case management was costed for the curable STIs, symptomatic Herpes Simplex Virus 2 (HSV-2), and non-STI vaginal syndromes, with incrementally expanding diagnoses. Service…
Evidence Synthesis | Costing Methods | Infectious Diseases | Clinical Care | Economics/Finance | Health/Medicine | Global