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 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 | Decision Analysis | Decision Theory | Probability/Bayes | 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 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.…
Test Performance | Costing Methods | Mathematical Models | Cost-Effectiveness Analysis | Technology Assessment | Infectious Diseases | Maternal/Reproductive Health | Clinical Care | Health/Medicine | Sub-Saharan Africa -
ArticlePublication 2023Performance of Rapid Antigen Tests to Detect Symptomatic and Asymptomatic SARS-CoV-2 Infection
The objective of this study was to evaluate the performance of rapid antigen tests (Ag-RDTs) …
The objective of this study was to evaluate the performance of rapid antigen tests (Ag-RDTs) for detection of SARS-CoV-2 among symptomatic and asymptomatic participants. The general findings were that the performance of Ag-RDTs was optimized when asymptomatic participants tested 3 times at 48-hour intervals and when symptomatic participants tested 2 times separated by 48 hours. Participants completed Ag-RDTs and reverse transcriptase polymerase chain reaction (RT-PCR) testing for SARS-CoV-2 every 48 hours for 15 days. They…
Test Performance | Infectious Diseases | Clinical Care | Health/Medicine | Science/Technology | North America -
ArticlePublication 2020Variation in False-Negative Rate of Reverse Transcriptase Polymerase Chain Reaction-Based SARS-CoV-2 Tests by Time Since Exposure
This study aimed to determine the false-negative rate of RT-PCR tests for SARS-CoV-2 infection based …
This study aimed to determine the false-negative rate of RT-PCR tests for SARS-CoV-2 infection based on the timeline of exposure and symptom onset. Drawing from data in seven studies involving 1,330 upper respiratory tract samples, a Bayesian model was used to estimate these rates. Findings showed that in the initial four days prior to typical symptom onset, the false-negative rate decreased from 100% on day 1 to 67% on day 4. By the day of…
Test Performance | Infectious Diseases | Clinical Care | Health/Medicine | Science/Technology | North America