Resources Repository
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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,…
Probability/Bayes | Test Performance | Decision Analysis | Value of Information | Health/Medicine -
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 | Decision Analysis | Preferences/Values | Costing Methods | Health Outcomes | Value of Information | State-Transition | Cost-Effectiveness Analysis | Infectious Diseases | Child/Nutrition | Chronic Disease/Risk | Economics/Finance | Health/Medicine | 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 | Decision Analysis | Preferences/Values | Cost-Effectiveness Analysis | Chronic Disease/Risk | Clinical Care | Economics/Finance | Health/Medicine | Science/Technology | North America | Europe | Graduate | Doctoral | Professional | Critical Thinking/Analysis | Policy Translation | Quantitative Literacy -
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 | Technology Assessment | Costing Methods | Mathematical Models | Cost-Effectiveness Analysis | Infectious Diseases | Maternal/Reproductive Health | Clinical Care | Health/Medicine | Sub-Saharan Africa -
ReviewPublication 2023Handbook of Vaccine Health Economics
The open-access book, "Handbook of Applied Health Economics in Vaccines," looks at the complexities of …
The open-access book, "Handbook of Applied Health Economics in Vaccines," looks at the complexities of vaccine discovery, financing, and distribution. It highlights the inadequacy of standard economic models for vaccines. The book explores alternative principles challenging market-based approaches and equips readers with tools for assessing costs and benefits through practical exercises. It serves as a comprehensive resource for decision-making in vaccine development and distribution and emphasizes the importance of considering broader perspectives beyond economic efficiency.…
Evidence Synthesis | Decision Analysis | Costing Methods | Health Outcomes | Benefit-Cost Analysis | Cost-Effectiveness Analysis | Policy/Regulation | Health/Medicine | Global | Graduate | Doctoral | Professional -
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…
Probability/Bayes | Test Performance | Infectious Diseases | Clinical Care | Health/Medicine -
Tools/ModelsInteractive, Teaching Resource 2020Interactive Graphic: Interpreting a COVID-19 Test Result
Currently, the most common diagnostic test for COVID-19 relies on reverse transcriptase polymerase chain reaction …
Currently, the most common diagnostic test for COVID-19 relies on reverse transcriptase polymerase chain reaction (RT-PCR), and most often uses samples obtained from the respiratory tract by nasopharyngeal swab. This interactive graphic demonstrates the influence of the prior probability of COVID-19, the test sensitivity (i.e., the probability of a positive test conditional on disease presence), and the test specificity (i.e., the probability of a negative test conditional on disease absence) on the post-test probability of…
Probability/Bayes | Test Performance | Infectious Diseases | Clinical Care | Health/Medicine | Science/Technology | High School | College | Graduate | Doctoral | Professional | Graphics/Visualization | Quantitative Literacy -
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 | 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…
Evidence Synthesis | Test Performance | Health Systems | Clinical Care | Health/Medicine