Resources Repository
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ArticlePublication 2007Modeling HPV and Cervical Cancer in the U.S. for Analyses of Screening and Vaccination
This paper discusses a model of human papillomavirus (HPV) and cervical cancer that incorporates uncertainty …
This paper discusses a model of human papillomavirus (HPV) and cervical cancer that incorporates uncertainty about the natural history of disease that was used to provide quantitative insight into U.S. policy choices for cervical cancer prevention. The authors developed a stochastic microsimulation of cervical cancer that distinguishes different HPV types by their incidence, clearance, persistence, and progression. For each set of sampled input parameters, likelihood-based goodness-of-fit (GOF) scores were computed based on comparisons between model-predicted…
Microsimulation | Calibration/Validation | Infectious Diseases | Chronic Disease/Risk | Clinical Care | Health/Medicine | Science/Technology | North America -
ArticlePublication 2007Multiparameter Calibration of a Natural History Model of Cervical Cancer
This paper presents a two-step approach to model calibration of a comprehensive natural history model …
This paper presents a two-step approach to model calibration of a comprehensive natural history model of human papillomavirus (HPV) and cervical cancer. Using primary epidemiologic data from a longitudinal study of women in Brazil, a plausible range for each input parameter was identified that would produce model output within the 95% confidence intervals of the data. The authors then performed a simultaneous search over all input parameters to identify parameter sets that produced output consistent…
Microsimulation | Mathematical Models | Calibration/Validation | Infectious Diseases | Chronic Disease/Risk | Health/Medicine | Latin America & Caribbean -
ArticlePublication 2006Can Discrete Event Simulation be of Use in Modeling Major Depression?
This article, published in Cost Effectiveness and Resource Allocation, reviews the published literature on Markov …
This article, published in Cost Effectiveness and Resource Allocation, reviews the published literature on Markov models in depression and identified potential limitations in using this particular modelling approach in this disease area. Additionally, the authors develop a “Discrete Event Simulation” (DES) model to investigate the benefits and drawbacks of this simulation method compared with Markov modelling techniques. The findings of this study indicate that the most important limitation of using Markov models in depression is…
Microsimulation | State-Transition | Decision Analysis | Mental Health | Health/Medicine -
ReviewPublication 2006Ethical Issues in Resource Allocation, Research, and New Product Development
Ethical dilemmas arising in setting priorities among interventions and among individuals in need of care …
Ethical dilemmas arising in setting priorities among interventions and among individuals in need of care are most acute when needs are great and resources few. This chapter from the Disease Control Priorities in Developing Countries 2nd edition addresses some of these concerns, identifying some of the principal ethical issues that arise in the development and allocation of effective interventions for developing countries and discussing some alternative resolutions. Resource allocation in health and elsewhere should satisfy two main…
Cost-Effectiveness Analysis | Preferences/Values | Priority Setting/Ethics | Culture/Society | Government/Law | Health/Medicine | Science/Technology -
ReviewPublication 2006Public Health Policy for Cervical Cancer Prevention: Decision Science, Economic Evaluation, & Mathematical Modeling
Several factors are changing the landscape of cervical cancer control, including a better understanding of …
Several factors are changing the landscape of cervical cancer control, including a better understanding of the natural history of human papillomavirus (HPV), reliable assays for detecting high-risk HPV infections, and a soon to be available HPV-16/18 vaccine. There are important differences in the relevant policy questions for different settings. By synthesizing and integrating the best available data, the use of modeling in a decision analytic framework can identify those factors most likely to influence outcomes,…
Cost-Effectiveness Analysis | Mathematical Models | Decision Analysis | Infectious Diseases | Chronic Disease/Risk | Economics/Finance | Health/Medicine | Science/Technology | Global -
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 -
ReviewPublication 2003Public Health Policy and Cost-Effectiveness Analysis
This chapter presents an overview of the uses for cost-effectiveness analysis and disease-simulation modeling to …
This chapter presents an overview of the uses for cost-effectiveness analysis and disease-simulation modeling to rigorously evaluate alternatives to reduce mortality from cervical cancer. Scientific advances have provided opportunities over time to revisit strategies for cervical cancer prevention. How to invest health resources wisely, such that public health benefits are maximized-and opportunity costs are minimized-is a critical question in the setting of enhanced cytologic screening methods, human papillomavirus DNA testing, and vaccine development. Developing sound…
Cost-Effectiveness Analysis | Mathematical Models | Infectious Diseases | Chronic Disease/Risk | Health Systems | Policy/Regulation | Health/Medicine | Global -
ArticlePublication 2000Preference-Based Measures in Economic Evaluation in Health Care
Estimating preferences for states of health has been an active area of research in recent …
Estimating preferences for states of health has been an active area of research in recent years. Unlike psychophysical approaches, which discriminate levels of health status, preference-based approaches incorporate values or utilities for health outcomes and can be used in cost-effectiveness analyses to aid resource allocation decisions. This chapter considers issues and controversies involved in using preference-based measures in economic evaluation in health care, with a particular emphasis on cost-utility analysis and the estimation of quality-adjusted…
Cost-Effectiveness Analysis | Preferences/Values | Health/Medicine | North America | Europe -
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 | Probability/Bayes | Value of Information | Decision Analysis | Health/Medicine