Resources Repository
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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…
Mathematical Models | Calibration/Validation | Health/Medicine | Health Outcomes | Microsimulation | Maternal/Reproductive Health | Health Systems | Clinical Care | Global -
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.…
Mathematical Models | Test Performance | Health/Medicine | Costing Methods | Cost-Effectiveness Analysis | Technology Assessment | Infectious Diseases | Maternal/Reproductive Health | Clinical Care | Sub-Saharan Africa -
ArticlePublication 2022Estimated Transmission Outcomes and Costs of SARS-CoV-2 Diagnostic Testing, Screening, and Surveillance Strategies Among a Simulated Population of Primary School Students
In the wake of the COVID-19 pandemic's significant educational disruptions, the U.S. government allocated $10 …
In the wake of the COVID-19 pandemic's significant educational disruptions, the U.S. government allocated $10 billion in March 2021 for testing in schools. The study aimed to analyze the costs and benefits of different COVID-19 testing strategies, particularly focusing on full-time, in-person elementary and middle school education. Utilizing an updated agent-based network model, the study simulated transmission scenarios in schools, considering various testing strategies ranging from diagnostic testing (test-to-stay) to reduce symptom-based isolations, routine screening…
Mathematical Models | Test Performance | Health/Medicine | Cost-Effectiveness Analysis | Infectious Diseases | Clinical Care | Science/Technology | North America -
ArticlePublication 2022Modeling the Effectiveness of Healthcare Personnel Reactive Testing and Screening for the SARS-Cov-2 Omicron Variant within Nursing Homes
The Omicron variant of SARS-CoV-2 has been hypothesized to exhibit faster clearance (time from peak …
The Omicron variant of SARS-CoV-2 has been hypothesized to exhibit faster clearance (time from peak viral concentration to clearance of acute infection), may be less detectable by antigen tests (decreased sensitivity), and may be more likely to evade immunity conferred by past infection or vaccination) compared to prior variants. This calls for a reassessment of strategies to prevent its spread, especially in vulnerable settings like nursing homes. Using a model that tracks viral shedding patterns,…
Mathematical Models | Test Performance | Health/Medicine | Infectious Diseases | 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 | Health/Medicine | Technology Assessment | Infectious Diseases | Clinical Care -
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 | Health/Medicine | Infectious Diseases | Clinical Care -
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 | Health/Medicine | Infectious Diseases | 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 | Health/Medicine | 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…
Mathematical Models | Calibration/Validation | Health/Medicine | Microsimulation | Cost-Effectiveness Analysis | Chronic Disease/Risk | North America | Graduate