Resources Repository
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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 2005Implications of Modern Decision Science for Military Decision-Support Systems
This review monograph was prepared in response to a request from the United States Air …
This review monograph was prepared in response to a request from the United States Air Force Research Laboratory for a study of modern decision science that would aid in its planning of research programs and, more specifically, developing methods and tools for decision support. The emphasis is on relatively high-level decisionmaking rather than, say, that of pilots or intelligence analysts in the midst of real-time operations. They focus largely on what the military refers to as…
Decision Psychology | Decision Theory | Decision Analysis | Military/Defense | North America -
ReviewPublication 2003Public Health Policy and Cost-Effectiveness Analysis
This chapter presents an overview of the uses for cost-effectiveness analysis and disease-simulation modeling to …
This chapter presents an overview of the uses for cost-effectiveness analysis and disease-simulation modeling to rigorously evaluate alternatives to reduce mortality from cervical cancer. Scientific advances have provided opportunities over time to revisit strategies for cervical cancer prevention. How to invest health resources wisely, such that public health benefits are maximized-and opportunity costs are minimized-is a critical question in the setting of enhanced cytologic screening methods, human papillomavirus DNA testing, and vaccine development. Developing sound…
Mathematical Models | Cost-Effectiveness Analysis | Infectious Diseases | Chronic Disease/Risk | Health Systems | Policy/Regulation | Health/Medicine | Global -
ReportPublication 2003ISPOR Task Force Report: Good Practice for Decision Analytic Modeling in Health-Care
This report describes the consensus of a task force convened to provide modelers with guidelines …
This report describes the consensus of a task force convened to provide modelers with guidelines for conducting and reporting modeling studies. While published more than a decade ago, it remains a clearly written resource for thinking about how to accurately describe the components of models and their quality. Criteria for assessing the quality of models fell into three areas: model structure, data used as inputs to models, and model validation. Several major themes cut across…
Mathematical Models | Calibration/Validation | Health/Medicine | Science/Technology | Global -
ArticlePublication 2002Empirically Calibrated Model of Hepatitis C Virus Infection in the United States
This article presents an epidemiologic model of hepatitis C in the United States. The authors …
This article presents an epidemiologic model of hepatitis C in the United States. The authors used empirical calibration of model parameters to gain insights into uncertainty in the natural history of hepatitis C and to improve future projections. The authors identified model inputs by way of a systematic review. Model simulations were conducted and model predictions were compared with epidemiologic data on infection prevalence and mortality from liver cancer. Goodness-of-fit criteria were used to identify…
Mathematical Models | State-Transition | Calibration/Validation | Infectious Diseases | Chronic Disease/Risk | Health/Medicine | North America -
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…
Mathematical Models | Priority Setting/Ethics | Evidence Synthesis | Technology Assessment | Environmental Health | Health Systems | Policy/Regulation | Business/Industry | Climate/Environment | Economics/Finance | Energy/Engineering | Government/Law | Health/Medicine | North America -
BookPublication 1996Cost-Effectiveness in Health and Medicine, 1st Edition
In 1993, the US Public Health Service convened a panel of 13 nongovernment scientists and …
In 1993, the US Public Health Service convened a panel of 13 nongovernment scientists and scholars with expertise in economics, clinical medicine, ethics, and statistics to review the state of cost-effectiveness analysis and to develop recommendations for its conduct and use in health and medicine. Publishing their results in 1996, they proposed the most explicit set of guidelines (together with their rationale) ever defined on the conduct of CEAs. The panel recommended analysts include a "reference-case"…
Costing Methods | Preferences/Values | Priority Setting/Ethics | Health Outcomes | Evidence Synthesis | Value of Information | Cost-Effectiveness Analysis | Health Systems | Policy/Regulation | Economics/Finance | 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