Resources Repository
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ReportPublication 2015Improving Diagnosis in Health Care
Getting the right diagnosis is a key aspect of health care - it provides an …
Getting the right diagnosis is a key aspect of health care - it provides an explanation of a patient's health problem and informs subsequent health care decisions. The diagnostic process is a complex, collaborative activity that involves clinical reasoning and information gathering to determine a patient's health problem. This report, Improving Diagnosis in Health Care, explains that diagnostic errors-inaccurate or delayed diagnoses-persist throughout all settings of care and continue to harm an unacceptable number of patients.…
North America | Probability/Bayes | Health Outcomes | Test Performance | Value of Information | Health Systems | Health/Medicine -
ArticlePublication 2014Cost-Effectiveness of Second-Generation Antipsychotics for the Treatment of Schizophrenia
This article, published in Value in Health, describes a Markov model that compares the cost-effectiveness …
This article, published in Value in Health, describes a Markov model that compares the cost-effectiveness of alternate sequences of treatment strategies using second-generation antipsychotics (SGAs) for patients with schizophrenia. First-line treatments include one of the four SGAs: olanzapine (OLZ), risperidone (RSP), quetiapine (QTP), and ziprasidone (ZSD). Patients are able switch to another of these antipsychotics as second-line therapy, and only clozapine (CLZ) is allowed as third-line treatment. Model input parameters were obtained from the Clinical…
Cost-Effectiveness Analysis | North America | State-Transition | Mental Health | Health/Medicine -
ArticlePublication 2013Contribution of H. Pylori and Smoking to US Incidence of Gastric Adenocarcinoma: A Microsimulation Model
Although gastric cancer has declined dramatically in the US, the disease remains the second leading …
Although gastric cancer has declined dramatically in the US, the disease remains the second leading cause of cancer mortality worldwide. This analysis estimates the contribution of risk factor trends on past and future intestinal-type non-cardia gastric adenocarcinoma (NCGA) incidence. The authors developed a population-based microsimulation model of intestinal-type NCGA and calibrated it to U.S. epidemiologic data on precancerous lesions and cancer. The model explicitly incorporated the impact of Helicobacter pylori and smoking on disease natural history, for which…
Microsimulation | North America | Calibration/Validation | Chronic Disease/Risk | Social Determinants | Culture/Society | Health/Medicine -
ArticlePublication 2012Modeling the Risks and Benefits of Depression Treatment for Children and Young Adults
This article, published in Value in Health, presents a discrete event simulation model to quantify …
This article, published in Value in Health, presents a discrete event simulation model to quantify the trade-offs with respect to clinical benefits and the risk of fatal and non-fatal suicidal behavior of alternative treatment strategies for a U.S. pediatric population with major depressive disorder. The authors evaluate treatment strategies including: selective serotonin reuptake inhibitors (SSRIs), cognitive behavioral therapy (CBT), and a combination of both. The results show that the use of SSRIs is associated with…
Microsimulation | North America | Health Outcomes | Technology Assessment | Mental Health | Health/Medicine -
ArticlePublication 2010Empirically Evaluating Decision-Analytic Models
To augment model credibility, evaluation via comparison to independent, empirical studies is recommended. The authors …
To augment model credibility, evaluation via comparison to independent, empirical studies is recommended. The authors developed a structured reporting format for model evaluation and conducted a structured literature review to characterize current model evaluation recommendations and practices. As an illustration, they applied the reporting format to evaluate a microsimulation of human papillomavirus and cervical cancer. The model's outputs and uncertainty ranges were compared with multiple outcomes from a study of long-term progression from high-grade precancer…
Microsimulation | North America | Calibration/Validation | Infectious Diseases | Chronic Disease/Risk | Health/Medicine -
ArticlePublication 2007Modeling HPV and Cervical Cancer in the U.S. for Analyses of Screening and Vaccination
This paper discusses a model of human papillomavirus (HPV) and cervical cancer that incorporates uncertainty …
This paper discusses a model of human papillomavirus (HPV) and cervical cancer that incorporates uncertainty about the natural history of disease that was used to provide quantitative insight into U.S. policy choices for cervical cancer prevention. The authors developed a stochastic microsimulation of cervical cancer that distinguishes different HPV types by their incidence, clearance, persistence, and progression. For each set of sampled input parameters, likelihood-based goodness-of-fit (GOF) scores were computed based on comparisons between model-predicted…
Microsimulation | North America | Calibration/Validation | Infectious Diseases | Chronic Disease/Risk | Clinical Care | Health/Medicine | Science/Technology -
GuidelinesPublication 2007Preference Measurement in Economic Analysis
This guide includes an overview of the concepts of preference measurement and quality-adjusted life years, …
This guide includes an overview of the concepts of preference measurement and quality-adjusted life years, a description of the most common techniques used for measuring preferences in economic evaluation, a summary of experience measuring preferences in the VA Cooperative Studies Program.
North America | Preferences/Values | Health Outcomes | Health/Medicine -
ReviewPublication 2001Modeling for Health Care and Other Policy Decisions: Uses, Roles and Validity
This is a review article of the role of modeling approaches to guide decision making …
This is a review article of the role of modeling approaches to guide decision making in health care and other domains. The role of models to support recommendations on the cost-effective use of medical technologies and pharmaceuticals is controversial. At the heart of the controversy is the degree to which experimental or other empirical evidence should be required prior to model use. The authors argue that the controversy stems in part from a misconception that…
North America | Priority Setting/Ethics | Evidence Synthesis | Mathematical Models | Technology Assessment | Environmental Health | Health Systems | Policy/Regulation | Business/Industry | Climate/Environment | Economics/Finance | Energy/Engineering | Government/Law | Health/Medicine