Resources Repository
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ArticlePublication 2021New Microsimulation Models to Inform Cervical Cancer Control
Health decision models consider the lifetime natural history of human papillomavirus (HPV) infection and pathogenesis …
Health decision models consider the lifetime natural history of human papillomavirus (HPV) infection and pathogenesis of cervical cancer, and estimate the long-term impact of preventive interventions. We propose a new health decision modeling framework that de-emphasizes previously used cytologic-colposcopic-histologic diagnoses, which are subjective and lack reproducibility, relying instead on HPV type and duration of infection as the major determinants of model transition probabilities. We posit that new model health states and corollary transitions are universal,…
Decision Analysis | Calibration/Validation | Mathematical Models | Microsimulation | Cost-Effectiveness Analysis | Infectious Diseases | Global -
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 | Technology Assessment | Test Performance | Infectious Diseases | Clinical Care | Health/Medicine -
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…
Probability/Bayes | Decision Analysis | Decision Theory | Preferences/Values | Operations Research | Business/Industry | Economics/Finance | Energy/Engineering | Health/Medicine -
ArticlePublication 2023Estimated Reductions in Opioid Overdose Deaths with Sustainment of Public Health Interventions in 4 U.S. States
This study utilizes a decision analytical model to simulate the opioid epidemic in four heavily …
This study utilizes a decision analytical model to simulate the opioid epidemic in four heavily impacted states: Kentucky, Massachusetts, New York, and Ohio. By analyzing the effects of increased initiation and retention of medications for opioid use disorder (MOUDs) and enhanced naloxone distribution over a 2 to 5-year timeframe, the research assesses the potential reduction in opioid overdose deaths (OODs). Results indicate that sustaining a combination of interventions could lead to substantial reductions in OODs,…
Decision Analysis | Mathematical Models | North America -
ArticlePublication 2013Modeling the Effectiveness of Initial Management Strategies for Ductal Carcinoma in Situ
This paper compares alternative strategies to manage ductal carcinoma in situ (DCIS). The authors used …
This paper compares alternative strategies to manage ductal carcinoma in situ (DCIS). The authors used a disease simulation model to simulate the clinical events after six treatments (lumpectomy alone, lumpectomy with radiation, lumpectomy with radiation and tamoxifen, lumpectomy with tamoxifen, and mastectomy with and without breast reconstruction). Outcomes included disease-free, invasive disease-free, overall survival and breast preservation. Data were from the published literature. The results showed that for women aged 45 years at diagnosis, both mastectomy…
Decision Analysis | Health Outcomes | Clinical Care | Health/Medicine -
ArticlePublication 1984Using Fire in Forest Management: Decision Making under Uncertainty
Prescribed fires are fires that are started under controlled conditions. This is an important strategy …
Prescribed fires are fires that are started under controlled conditions. This is an important strategy used by professionals in modern forest management. Designing, planning, and executing strategies that rely on prescribed fires is challenging because of multiple uncertainties (e.g., weather, fire behavior, etc.). In this paper, decision analysis techniques are used to evaluate prescribed fire decisions in three national forest case study applications.
Decision Analysis | Environmental Health | Climate/Environment -
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…
Calibration/Validation | Health Outcomes | Mathematical Models | Microsimulation | Maternal/Reproductive Health | Health Systems | Clinical Care | Health/Medicine | Global -
ArticlePublication 2023Simulation-Based Estimates and Projections of Global, Regional and Country-Level Maternal Mortality by Cause, 1990-2050
While progress has been made globally to reduce maternal deaths, measurement remains a challenge given …
While progress has been made globally to reduce maternal deaths, measurement remains a challenge given the many causes and frequent underreporting of maternal deaths. The authors developed a structural microsimulation model of Global Maternal Health (GMatH) for 200 countries and territories using demographic, epidemiologic, clinical and health system data synthesized from the medical literature, Civil Registration Vital Statistics systems and Demographic and Health Survey data. The model was calibrated to empirical data from 1990 to…
Calibration/Validation | Health Outcomes | Evidence Synthesis | Microsimulation | Maternal/Reproductive Health | Health Systems | Clinical Care | Health/Medicine | 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.…
Technology Assessment | Costing Methods | Test Performance | Mathematical Models | Cost-Effectiveness Analysis | Infectious Diseases | Maternal/Reproductive Health | Clinical Care | Health/Medicine | Sub-Saharan Africa