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 -
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 | Value of Information | Health/Medicine | Probability/Bayes | Decision Analysis -
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…
Test Performance | Value of Information | Health/Medicine | Probability/Bayes | Preferences/Values | Costing Methods | Health Outcomes | State-Transition | Decision Analysis | Cost-Effectiveness Analysis | Infectious Diseases | Child/Nutrition | Chronic Disease/Risk | Economics/Finance | Global | North America | Europe | Graduate | Doctoral | Critical Thinking/Analysis | Decision Making/Leadership | Quantitative Literacy -
Resource PackWeb Portal, Teaching Resource 2023Resource Pack: Cost-Effectiveness of Screening and Treatment for Hypertension
Hypertension is a relevant example for teaching clinical decision making, diagnostic test performance, positivity criterion, …
Hypertension is a relevant example for teaching clinical decision making, diagnostic test performance, positivity criterion, and cost-effectiveness analysis. This resource pack provides examples of decision analyses and cost-effectiveness analyses for the management and treatment of hypertension, with a predominant focus on the U.S. Analyses are included that predate the 2017 American College of Cardiology/American Heart Association Clinical Practice Guidelines, along with more recent examples that followed release of the guidelines. Resources are also included that…
Test Performance | Health/Medicine | Preferences/Values | Decision Analysis | Cost-Effectiveness Analysis | Chronic Disease/Risk | Clinical Care | Economics/Finance | Science/Technology | North America | Europe | Graduate | Doctoral | Professional | Critical Thinking/Analysis | Policy Translation | Quantitative Literacy -
ReviewPublication 2021Review of Web-Based Tools for Value-of-Information Analysis
Value-of-information analysis (VOI) is an analytic approach used to inform research priorities, guide clinical trial …
Value-of-information analysis (VOI) is an analytic approach used to inform research priorities, guide clinical trial design, and provide information for decisions about reimbursement. The authors review existing web-based tools to facilitate VOI calculations. These include Sheffield Accelerated Value of Information (SAVI), the web interface to the BCEA (Bayesian Cost-Effectiveness Analysis) R package (BCEAweb), Rapid Assessment of Need for Evidence (RANE), and Value of Information for Cardiovascular Trials and Other Comparative Research (VICTOR).
Value of Information | Health/Medicine | Decision Theory | Priority Setting/Ethics | Cost-Effectiveness Analysis | Economics/Finance -
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 | Health/Medicine | Costing Methods | Mathematical Models | Cost-Effectiveness Analysis | Technology Assessment | Infectious Diseases | Maternal/Reproductive Health | Clinical Care | 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 | Health/Medicine | Infectious Diseases | Clinical Care | 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 | Health/Medicine | Infectious Diseases | Clinical Care | Science/Technology | North America -
ReviewPublication 2021Considerations for Diagnostic COVID-19 Tests
During the initial stages of the COVID-19 pandemic, there was a rush by numerous diagnostic …
During the initial stages of the COVID-19 pandemic, there was a rush by numerous diagnostic test manufacturers to create, validate, and implement testing methods. This review discusses the pivotal role of diagnostic tests during the pandemic's first global wave, highlighting the challenges in technology and implementation experienced early on. The study also offers insights for enhancing the use of diagnostics, especially syndromic ones, should there be future spikes or regional outbreaks of COVID-19. The overarching…
Test Performance | Health/Medicine | Infectious Diseases | Clinical Care | Science/Technology | North America