Resources Repository
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ArticlePublication 2021COVID and the Age–VSL Relationship
In this article, the researchers explore the approach used to value COVID-19 mortality risk reductions …
In this article, the researchers explore the approach used to value COVID-19 mortality risk reductions in analyses of lockdowns and other policies. Many rely on a population-average estimate of the value per statistical life (VSL); others adjust VSL for life expectancy at the age of death. The article explores the implications of theory and empirical studies, which suggest that the relationship between age and VSL is uncertain; these uncertainties in turn may affect whether the…
Benefit-Cost Analysis | Preferences/Values | Infectious Diseases | Government/Law | Health/Medicine | North America -
ArticlePublication 2020Testing for SARS-CoV-2 Antibodies
Antibody testing can determine previous exposure to SARS-CoV-2 virus. Recently, the UK government has made …
Antibody testing can determine previous exposure to SARS-CoV-2 virus. Recently, the UK government has made antibody testing available to anyone wanting it, even if there is no clinical indication. The purpose of this article is to provide guidance for when to consider antibody testing in individuals with and without symptoms suggestive of current or past SARS-CoV-2 infection. Key points made by the authors include: (1) antibody testing is likely to be most useful 2 weeks…
Test Performance | Probability/Bayes | Technology Assessment | Infectious Diseases | Clinical Care | Health/Medicine -
ArticlePublication 2020Bayes' Theorem, COVID-19, and Screening Tests
This article reviews the implications of increased testing for COVID-19 using reverse transcriptase polymerase chain …
This article reviews the implications of increased testing for COVID-19 using reverse transcriptase polymerase chain reaction (rRT-PCR) through the application of Bayes’ Theorem for three hypothetical, stylized case scenarios. The scenarios involve three patients with a low, moderate, and high pre-test probability of COVID-19 infection. The category of low probability would include "asymptomatic individuals in a presumed low prevalence environment" and might vary from 10 to 20%. The category of moderate probability would include "individuals…
Test Performance | Probability/Bayes | Infectious Diseases | Clinical Care | Health/Medicine -
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…
Test Performance | Probability/Bayes | Infectious Diseases | Health/Medicine | Science/Technology | Global -
ArticlePublication 2020Translating Population Evidence to Individual Patients
In this paper, the authors describe the differences in population level outcomes compared to individual …
In this paper, the authors describe the differences in population level outcomes compared to individual patients and discuss ways that these are differences. The authors cover topics including the difference between relative and absolute risk and benefit. They use an example of the decision to start anticoagulation in new-onset atrial fibrillation to discuss translating population level evidence to treatment of an individual. These options include generalizability, subgroup analysis, prediction rules, following response to therapy, and even…
Test Performance | Evidence Synthesis | Health Systems | Clinical Care | Health/Medicine -
ArticlePublication 2020Clinical Decision Making: Using a Diagnostic Test
This article is part of a 6-part series on clinical decision making. The authors use …
This article is part of a 6-part series on clinical decision making. The authors use two clinical examples to review the principles of interpreting diagnostic test results. They outline an approach that can be used to determine how to select and apply tests and their results to the practice of internal medicine. Topics covered in the two case studies include sensitivity and specificity, positive predictive and negative predictive value of tests, and how to estimate…
Test Performance | Probability/Bayes | Clinical Care | Health/Medicine -
ArticlePublication 2020Premature Deaths, Statistical Lives, and Years of Life
This article clarifies some misconceptions about mortality risk and economic valuation. The mortality effects of …
This article clarifies some misconceptions about mortality risk and economic valuation. The mortality effects of exposure to environmental hazards such as air pollution are often described by the estimated number of “premature deaths” and the economic value of an exposure reduction as the number of “statistical lives saved” multiplied by the “value per statistical life.” These terms can be misleading because the number of deaths advanced by exposure cannot be determined from mortality data; it…
Benefit-Cost Analysis | Preferences/Values | Health Outcomes | Environmental Health | Policy/Regulation | College | Graduate | Critical Thinking/Analysis -
ArticlePublication 2019Measuring Progress Towards Universal Health Coverage
This article, published in BMJ Global Health, aims to estimate the 2015 national and subnational …
This article, published in BMJ Global Health, aims to estimate the 2015 national and subnational universal health coverage (UHC) service coverage status for Ethiopia. The UHC service coverage index is constructed from the geometric means of component indicators: first, within each of four major categories and then across all components to obtain the final summary index. The authors estimate UHC service coverage at the subnational level using a variety of surveys and routinely collected administrative…
Test Performance | Health Systems | Health/Medicine | Sub-Saharan Africa -
ArticlePublication 2001Cost-Benefit Analysis of a Strategy to Vaccinate Healthy Working Adults against Influenza
The authors performed a cost-benefit analysis to assess the economic impact of vaccinating healthy working …
The authors performed a cost-benefit analysis to assess the economic impact of vaccinating healthy working adults between 18 and 64 years old with an influenza vaccine. Monte Carlo simulation was used to calculate the direct and indirect costs associated with vaccination and those prevented by vaccination. The authors found that vaccinating healthy working adults was, on average, cost-saving.
Benefit-Cost Analysis | Infectious Diseases | Health/Medicine | North America