Resources Repository
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BookPublication 2014Decision Making in Health and Medicine: Integrating Evidence and Values
Decision making in health care involves consideration of a complex set of diagnostic, therapeutic and …
Decision making in health care involves consideration of a complex set of diagnostic, therapeutic and prognostic uncertainties. Medical therapies have side effects, surgical interventions may lead to complications, and diagnostic tests can produce misleading results. Furthermore, patient values and service costs must be considered. Decisions in clinical and health policy require careful weighing of risks and benefits and are commonly a trade-off of competing objectives: maximizing quality of life vs maximizing life expectancy vs minimizing…
Probability/Bayes | Test Performance | Health Outcomes | Global | Preferences/Values | Costing Methods | Value of Information | Mathematical Models | Decision Analysis | Cost-Effectiveness Analysis | Health Systems | Economics/Finance | Government/Law | Health/Medicine | North America | Europe | Graduate | Doctoral | Professional | Critical Thinking/Analysis | Decision Making/Leadership | Quantitative Literacy -
BookPublication 1980Clinical Decision Analysis
This text was conceived and developed in the Harvard T.H. Chan School of Public Health …
This text was conceived and developed in the Harvard T.H. Chan School of Public Health at the Center for the Analysis of Health Practices. The book had its origins in a set of classroom materials developed during the academic year 1974-75 for an elective course in medical decision making at the Harvard Medical School. In this book students are shown how to structure clinical decision problems, how to systematically formulate the intertwining roles of diagnosis and treatment, how to…
Probability/Bayes | Test Performance | Health Outcomes | Global | Preferences/Values | Costing Methods | Value of Information | State-Transition | Decision Analysis | Cost-Effectiveness Analysis | Infectious Diseases | Child/Nutrition | Chronic Disease/Risk | Economics/Finance | Health/Medicine | North America | Europe | Graduate | Doctoral | Critical Thinking/Analysis | Decision Making/Leadership | Quantitative Literacy -
Resource PackPublication, Teaching Resource 2023Resource Pack: Diagnostic Tests, Bayes, and COVID-19
This resource pack provides a curated set of articles, perspectives, and interactives about diagnostic testing …
This resource pack provides a curated set of articles, perspectives, and interactives about diagnostic testing for COVID-19. The pack provides materials that will be particularly useful for educators who are teaching diagnostic test performance, value of information, and probability revision using Bayes’ theorem. The majority of papers focus on PCR or rapid antigen testing on samples obtained from the respiratory tract by nasopharyngeal swab. The mechanism of false negative results (e.g., timing of sample collection…
Probability/Bayes | Test Performance | Global | Value of Information | Decision Analysis | Health/Medicine | Science/Technology | High School | College | Graduate | Doctoral | Professional | Critical Thinking/Analysis | Graphics/Visualization | Quantitative Literacy -
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 | Global | Mathematical Models | Microsimulation | Maternal/Reproductive Health | Health Systems | Clinical Care | Health/Medicine -
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 | Global | Evidence Synthesis | Microsimulation | Maternal/Reproductive Health | Health Systems | Clinical Care | Health/Medicine -
ArticlePublication 2020Impact of Treatment and Imaging Modalities on 5-Year Net Survival of 11 Cancers in 200 Countries
This analysis describes the development of a microsimulation model of stage-specific cancer survival in 200 …
This analysis describes the development of a microsimulation model of stage-specific cancer survival in 200 countries/territories for 11 cancers (oesophagus, stomach, colon, rectum, anus, liver, pancreas, lung, breast, cervix uteri, and prostate). The paper estimated current 5-year net survival for diagnosed cancers in each country and potential survival gains from increasing the availability of individual treatment and imaging modalities, and more comprehensive packages of scale-up. Global 5-year net survival for all 11 cancers (combined) is…
Calibration/Validation | Health Outcomes | Global | Priority Setting/Ethics | Microsimulation | Chronic Disease/Risk | Health Systems -
ArticlePublication 2021Impact of Treatment and Imaging Modalities on Global Breast Cancer Survival
This analysis used a microsimulation model of global cancer survival to simulate 5-year net survival …
This analysis used a microsimulation model of global cancer survival to simulate 5-year net survival for women with newly diagnosed breast cancer in 200 countries/territories in 2018, accounting for the availability and stage-specific survival impact of specific treatment modalities (chemotherapy, radiotherapy, surgery, and targeted therapy), imaging modalities (ultrasound, x-ray, CT, MRI, PET, and single-photon emission computed tomography [SPECT]), and quality of cancer care. The model was calibrated to empirical data on 5-year net breast cancer…
Calibration/Validation | Health Outcomes | Global | Microsimulation | Chronic Disease/Risk | Health Systems | Clinical Care -
EditorialPublication 2020Waiting for Certainty on COVID-19 Antibody Tests — At What Cost?
This perspective anticipates the availability of serologic antibody testing and considers its potential usefulness in mitigation …
This perspective anticipates the availability of serologic antibody testing and considers its potential usefulness in mitigation policy to reduce COVID-19 transmission. For example: Could we screen for serologic antibodies as a proxy for possible immunity and identify people who could return to the workplace with less severe mitigation measures? The authors acknowledge the uncertainties raised by many policy actors, including the WHO, such as, "Do antibodies confer immunity and, if so, for how long? How accurate is…
Probability/Bayes | Test Performance | Global | Technology Assessment | Infectious Diseases | Health Systems | Policy/Regulation | Government/Law | Health/Medicine | North America -
ArticlePublication 2020Interpreting COVID-19 Test Results: A Bayesian Approach
This article considers the following question with respect to interpreting the results of polymerase chain reaction …
This article considers the following question with respect to interpreting the results of polymerase chain reaction (PCR) assays from nasal and pharyngeal swabs for COVID-19 to inform clinical decision making: "While a positive result in an acutely ill patient is straightforward, how should physicians interpret negative tests in patients with suspected COVID-19 infection?" Using an assumption of near-perfect specificity of PCR assays for COVID-19, the authors acknowledge the uncertainty of test sensitivity. They consider two clinical scenarios…
Probability/Bayes | Test Performance | Global | Infectious Diseases | Health/Medicine | Science/Technology