Resources Repository
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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 | Calibration/Validation | Infectious Diseases | Chronic Disease/Risk | Clinical Care | Health/Medicine | Science/Technology | North America -
ArticlePublication 2007Multiparameter Calibration of a Natural History Model of Cervical Cancer
This paper presents a two-step approach to model calibration of a comprehensive natural history model …
This paper presents a two-step approach to model calibration of a comprehensive natural history model of human papillomavirus (HPV) and cervical cancer. Using primary epidemiologic data from a longitudinal study of women in Brazil, a plausible range for each input parameter was identified that would produce model output within the 95% confidence intervals of the data. The authors then performed a simultaneous search over all input parameters to identify parameter sets that produced output consistent…
Microsimulation | Mathematical Models | Calibration/Validation | Infectious Diseases | Chronic Disease/Risk | Health/Medicine | Latin America & Caribbean -
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.
Health Outcomes | Preferences/Values | Health/Medicine | North America -
ArticlePublication 2006Can Discrete Event Simulation be of Use in Modeling Major Depression?
This article, published in Cost Effectiveness and Resource Allocation, reviews the published literature on Markov …
This article, published in Cost Effectiveness and Resource Allocation, reviews the published literature on Markov models in depression and identified potential limitations in using this particular modelling approach in this disease area. Additionally, the authors develop a “Discrete Event Simulation” (DES) model to investigate the benefits and drawbacks of this simulation method compared with Markov modelling techniques. The findings of this study indicate that the most important limitation of using Markov models in depression is…
Microsimulation | State-Transition | Decision Analysis | Mental Health | Health/Medicine -
Tutorial/PrimerPublication, Teaching Resource 2005Refining Clinical Diagnosis with Likelihood Ratios
This article serves as a concise tutorial about the interpretation and use of likelihood ratios …
This article serves as a concise tutorial about the interpretation and use of likelihood ratios in clinical decision-making. Likelihood ratios can refine clinical diagnosis on the basis of signs and symptoms; however, they are underused for patients' care. A likelihood ratio is the percentage of ill people with a given test result divided by the percentage of well individuals with the same result. Ideally, abnormal test results should be much more typical in ill individuals…
Test Performance | Value of Information | 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…
Evidence Synthesis | Priority Setting/Ethics | Mathematical Models | Technology Assessment | Environmental Health | Health Systems | Policy/Regulation | Business/Industry | Climate/Environment | Economics/Finance | Energy/Engineering | Government/Law | Health/Medicine | North America -
Tutorial/PrimerPublication, Teaching Resource 1980Threshold Approach to Clinical Decision Making
This classic paper provides a "tutorial" for students learning about diagnostic testing, probability revision, and …
This classic paper provides a "tutorial" for students learning about diagnostic testing, probability revision, and how to calculate thresholds for testing, treatment, and no treatment. The authors describe how a physician's estimate of the probability that a patient has a particular disease is a principal factor in the determination of whether to withhold treatment, obtain more data by testing, or treat without subjecting the patient to the risks of further diagnostic tests. Using the concepts of decision analysis,…
Test Performance | Probability/Bayes | Value of Information | Decision Analysis | Health/Medicine -
ReviewPublication 1978Basic Principles of ROC Analysis
The limitations of diagnostic "accuracy" as a measure of decision performance require introduction of the …
The limitations of diagnostic "accuracy" as a measure of decision performance require introduction of the concepts of the "sensitivity" and "specificity" yet even these do not provide a unique description of diagnostic performance because they depend on the arbitrary selection of a decision threshold. The receiver operating characteristic (ROC) curve is shown to be a simple yet complete empirical description of this decision threshold effect, indicating all possible combinations of the relative frequencies of the…
Test Performance | Clinical Care | Health/Medicine