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 -
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 2017Cost-Effectiveness of Testing and Treatment for Latent TB
Testing for and treating latent tuberculosis infection (LTBI) is among the main strategies to achieve …
Testing for and treating latent tuberculosis infection (LTBI) is among the main strategies to achieve TB elimination in the United States. This analysis estimated health outcomes, costs, and cost-effectiveness of LTBI testing and treatment among non-US born residents with and without medical comorbidities (e.g., diabetes, HIV infection, and end-stage renal disease). A decision analytic tree and Markov cohort simulation model was used to compare the following strategies: no testing, tuberculin skin test (TST), interferon gamma release assay…
Test Performance | State-Transition | Microsimulation | Cost-Effectiveness Analysis | Infectious Diseases | Chronic Disease/Risk | Health Systems | Economics/Finance | Health/Medicine | Global | North America -
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…
Preferences/Values | Test Performance | Health Outcomes | Evidence Synthesis | Microsimulation | Cost-Effectiveness Analysis | Chronic Disease/Risk | Health Systems | Clinical Care | Health/Medicine | Science/Technology | North America -
ArticlePublication 2007Decision Analysis: A Personal Account of How It Got Started and Evolved
In this chapter, Howard Raiffa discusses the evolution of decision analysis and his personal involvement …
In this chapter, Howard Raiffa discusses the evolution of decision analysis and his personal involvement in its development. He describes the early days of Operations Research (OR) in the late 1940s with its approach to complex, strategic decision making. After reading John von Neumann and Oskar Morgenstern’s Theory of Games and Economic Behavior (1947) and Abraham Wald’s two books (1947, 1950), he became involved in statistical decision theory. A few years later, after reading Leonard…
Preferences/Values | Probability/Bayes | Decision Theory | Decision Analysis | Operations Research | Business/Industry | Economics/Finance | Energy/Engineering | Health/Medicine -
ArticlePublication 2023Cost-Effectiveness of Pharmacist Prescribing for Managing Hypertension
This study estimates the cost-effectiveness of implementing a pharmacist-prescribing intervention to improve blood pressure control …
This study estimates the cost-effectiveness of implementing a pharmacist-prescribing intervention to improve blood pressure control in the US. A cost-effectiveness analysis was conducted using a Markov model based on the pharmacist-prescribing intervention used in The Alberta Clinical Trial in Optimizing Hypertension (or RxACTION). Outcomes included cardiovascular (CV) events, end-stage kidney disease events, life years, quality-adjusted life years (QALYs), lifetime costs, and lifetime incremental cost-effectiveness ratio (ICER). Costs were based on reimbursement rates, published literature, national…
State-Transition | Mathematical Models | Cost-Effectiveness Analysis | Chronic Disease/Risk | Clinical Care | 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 | Costing Methods | Mathematical Models | Cost-Effectiveness Analysis | Technology Assessment | Infectious Diseases | Maternal/Reproductive Health | Clinical Care | Health/Medicine | Sub-Saharan Africa