Resources Repository
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ArticlePublication 2022Comparative Health Systems Analysis of Differences in Catastrophic Health Expenditure
The growing burden of non-communicable diseases (NCDs) in low- and middle-income countries may have implications …
The growing burden of non-communicable diseases (NCDs) in low- and middle-income countries may have implications for health system performance in the area of financial risk protection, as measured by catastrophic health expenditure (CHE). This article compares non-communicable diseases catastrophic health expenditure to the CHE cases caused by communicable diseases across health systems to examine whether: (1) disease burden and catastrophic health expenditure are linked, (2) Catastrophic health expenditures secondary to NCDs disproportionately affect wealthier households and (3) whether the drivers…
Infectious Diseases | Evidence Synthesis | Costing Methods | Cost-Effectiveness Analysis | Chronic Disease/Risk | Health Systems | Economics/Finance | Health/Medicine | Global -
ArticlePublication 2022Spatial-Mechanistic Model to Estimate Sub-National Tuberculosis Burden in Brazilian Municipalities
Reliable subnational estimates of TB incidence are needed to focus disease control resources in areas …
Reliable subnational estimates of TB incidence are needed to focus disease control resources in areas of highest need. This study developed an approach for generating small area estimates of TB incidence, and the fraction of individuals missed by routine case detection, based on available notification and mortality data. The approach is demonstrated by estimating TB outcomes for 5568 municipalities in Brazil, revealing substantial subnational differences in disease burden and other metrics useful for designing high-impact…
Infectious Diseases | Mathematical Models | Health Outcomes | Health/Medicine | Latin America & Caribbean -
ArticlePublication 2021New Microsimulation Models to Inform Cervical Cancer Control
Health decision models consider the lifetime natural history of human papillomavirus (HPV) infection and pathogenesis …
Health decision models consider the lifetime natural history of human papillomavirus (HPV) infection and pathogenesis of cervical cancer, and estimate the long-term impact of preventive interventions. We propose a new health decision modeling framework that de-emphasizes previously used cytologic-colposcopic-histologic diagnoses, which are subjective and lack reproducibility, relying instead on HPV type and duration of infection as the major determinants of model transition probabilities. We posit that new model health states and corollary transitions are universal,…
Infectious Diseases | Mathematical Models | Microsimulation | Calibration/Validation | Decision Analysis | Cost-Effectiveness Analysis | Global -
ArticlePublication 2022Early HPV Natural History Transitions
Microsimulation models used to evaluate the cost-effectiveness of novel cervical cancer screening technologies rely on …
Microsimulation models used to evaluate the cost-effectiveness of novel cervical cancer screening technologies rely on accurate transition risks for human papillomavirus (HPV) infection, persistence (or absence of HPV clearance), progression to precancerous lesions, and invasion. To inform the refinement of such models, we compared the early natural history of HPV types using prospective data from immunocompetent women in the Guanacaste Natural History Study, the ASCUS-LSIL Triage Study, and the Costa Rica HPV Vaccine Trial. We…
Infectious Diseases | Mathematical Models | Microsimulation | Cost-Effectiveness Analysis | North America | Latin America & Caribbean -
ReviewPublication 2022Systematic Review of Economic Evaluations of COVID-19 Interventions: Non-Health Impacts and Distributional Issues
The authors conducted a systematic review of economic evaluations of COVID-19 interventions and assessed whether …
The authors conducted a systematic review of economic evaluations of COVID-19 interventions and assessed whether they incorporated non-health impacts and distributional concerns. Among the 70 articles included, more than half (56%) included at least one non-health impact, although only 21% incorporated non-economic consequences. Only 17% examined subgroups of interest. The median ICER for the entire sample was $67,000/quality-adjusted life-year (QALY) (interquartile range [IQR] $9000-$893,000/QALY). Interventions including a pharmaceutical component yielded a median ICER of $93,000/QALY (IQR…
Infectious Diseases | Evidence Synthesis | Cost-Effectiveness Analysis | Social Determinants | Culture/Society | Economics/Finance | Health/Medicine | North America -
ArticlePublication 2022Cost-Effectiveness & Value-of-Information Analysis Using Machine Learning-Based Metamodeling: A Case of Hepatitis C Treatment
This study compares machine learning (ML)-based metamodels with conventional metamodeling approaches in replicating the outcomes …
This study compares machine learning (ML)-based metamodels with conventional metamodeling approaches in replicating the outcomes of a complex simulation model of hepatitis C virus (HCV) natural history. Three ML-based metamodels (random forest, support vector regression, and artificial neural networks) and a linear regression-based metamodel were developed from the simulation model's 40 input parameters. Performance evaluation included root mean squared error (RMSE) and Pearson's R2 on normalized data. ML-based metamodels generally outperformed linear regression, with random…
Infectious Diseases | Mathematical Models | Chronic Disease/Risk | Health/Medicine -
ArticlePublication 2022Child Health Inequity through Case Management of Under-Five Malaria in Nigeria: An ECEA
This study assesses the potential impact of subsidies covering the direct and indirect costs of …
This study assesses the potential impact of subsidies covering the direct and indirect costs of under-five malaria case management in Nigeria, utilizing an extended cost-effectiveness analysis (ECEA) and a decision tree model. Findings reveal that fully subsidizing medical, non-medical, and indirect costs could annually avert over 19,000 under-five deaths, 8,600 cases of catastrophic health expenditure (CHE), and US$187 million in out-of-pocket (OOP) spending. Per US$1 million invested, this translates to a significant reduction in under-five…
Infectious Diseases | Mathematical Models | Health Outcomes | Cost-Effectiveness Analysis | Child/Nutrition | Policy/Regulation | Health/Medicine | Sub-Saharan Africa -
ArticlePublication 2021Individual and Social Determinants of COVID-19 Vaccine Uptake
This article examined the individual, communication and social determinants associated with COVID-19 vaccine uptake using …
This article examined the individual, communication and social determinants associated with COVID-19 vaccine uptake using national survey data collected before vaccines were available in the U.S. Of note, individuals under the federal poverty level and racial and ethnic minorities were oversampled. Outcomes included the likelihood of vaccinating self and dependents (e.g., children). Independent variables included perceptions of risk, exposure to different media for COVID-19 news, political party identification, confidence in scientists and social determinants of…
Infectious Diseases | Evidence Synthesis | Health Outcomes | Social Determinants | Policy/Regulation | Clinical Care | Culture/Society | Health/Medicine | Science/Technology | North America -
ArticlePublication 2021COVID-19 Vaccine Hesitancy: The Five C's to Tackle Behavioral and Sociodemographic Factors
Reversing and mitigating the ongoing damage associated with the COVID-19 pandemic requires that 60-70% of …
Reversing and mitigating the ongoing damage associated with the COVID-19 pandemic requires that 60-70% of the world’s population needs to be vaccinated. This article acknowledges that hesitancy is one of the most substantial hurdles to vaccination uptake at levels that would achieve herd immunity. Authors define hesitancy as “a delay in acceptance or refusal despite availability.” Five factors are proposed to tackle vaccine hesitancy, referred to as the five “C’s”: Confidence (importance, safety and efficacy…
Infectious Diseases | Evidence Synthesis | Decision Psychology | Preferences/Values | Health Outcomes | Social Determinants | Culture/Society | Health/Medicine | Science/Technology | North America