Resources Repository
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ArticlePublication 2020Weighing Evidence to Inform Clinical Decisions
The authors use a clinical example to simulate how treatment discussions can be complicated when new evidence is introduced …
The authors use a clinical example to simulate how treatment discussions can be complicated when new evidence is introduced that conflicts with existing guidelines. Even when evidence is consistent, the authors point out that current guidelines can have interpretations that don't agree with available evidence. They develop a step-wise algorithm to help guide individual clinical decisions even in the absence of general consensus related to appropriate testing and treatment.
Clinical Care | Priority Setting/Ethics | Evidence Synthesis | 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…
Clinical Care | Probability/Bayes | Test Performance | Health/Medicine -
Resource PackWeb Portal, Teaching Resource 2018Resource Pack: Cervical Cancer Models
This resource pack, curated by the Center for Health Decision Science, is a collection of …
This resource pack, curated by the Center for Health Decision Science, is a collection of models of HPV-related cervical cancer, differing in design, structure and features based on analytic objectives. In many ways, HPV and its related diseases represent a prototypical public health problem given the communicable and non-communicable nature of disease, opportunities for intervention along the entire disease spectrum (e.g., primary and secondary prevention, diagnosis, treatment), the varied ages at which interventions are targeted…
Microsimulation | Clinical Care | Mathematical Models | State-Transition | Dynamic Transmission | Calibration/Validation | Dynamic Simulation | Cost-Effectiveness Analysis | Infectious Diseases | Chronic Disease/Risk | Health Systems | Business/Industry | Economics/Finance | Health/Medicine | Science/Technology | Global -
ArticlePublication 2017Cost-Effectiveness of Screening for Hypertension and Counseling for Prevention
This article aimed to compare the health and economic impact of 3 services recommended by …
This article aimed to compare the health and economic impact of 3 services recommended by the US Preventive Services Task Force for the primary prevention of cardiovascular disease (CVD): (1) aspirin counseling for the primary prevention of CVD and colorectal cancer, (2) screening and treatment for lipid disorders (usually high cholesterol), and (3) screening and treatment for hypertension. A microsimulation model was used to compare lifetime outcomes from the societal perspective for a US-representative birth…
Microsimulation | Clinical Care | Cost-Effectiveness Analysis | Chronic Disease/Risk | Policy/Regulation | Health/Medicine | North America -
ArticlePublication 2017Changing the South African National ART Guidelines: The Role of Cost Modelling
This analysis was motivated by the South African Department of Health's request to assess the …
This analysis was motivated by the South African Department of Health's request to assess the cost implications of adopting sets of ART guidelines issued by the World Health Organization between 2010 and 2016.Using data from large South African ART clinics (n = 24,244 patients), projections of patients in need of ART, and cost data from bottom-up cost analyses, the authors constructed a population-level health-state transition model with 6-monthly transitions between health states depending on patients’ age,…
Clinical Care | Costing Methods | State-Transition | Infectious Diseases | Health Systems | Economics/Finance | Health/Medicine | Sub-Saharan Africa -
ArticlePublication 2017Costs of Facility-Based HIV Testing in Malawi, Zambia and Zimbabwe
Providing HIV testing at health facilities remains the most common approach to ensuring access to …
Providing HIV testing at health facilities remains the most common approach to ensuring access to HIV treatment and prevention services for the millions of undiagnosed HIV-infected individuals in sub-Saharan Africa. The authors sought to explore the costs of providing these services across three southern African countries with high HIV burden.Primary costing studies were undertaken in 54 health facilities providing HIV testing services (HTS) in Malawi, Zambia and Zimbabwe. Routinely collected monitoring and evaluation data for…
Clinical Care | Costing Methods | Technology Assessment | Infectious Diseases | Health Systems | Health/Medicine | Sub-Saharan Africa -
ArticlePublication 2016Cost-Effectiveness of Blood Pressure Treatment Guidelines in Adults 35-74
In this article the authors used the CVD Policy Model to compare the cost-effectiveness of …
In this article the authors used the CVD Policy Model to compare the cost-effectiveness of conservative versus intensive blood pressure treatment guidelines in adult hypertensive patients aged 35 to 74 years. Outcomes included in the study were CVD events, treatment costs, quality-adjusted life years, and drug and monitoring costs projected over the years 2016 to 2026. The effectiveness and costs of hypertension were calculated for treatment according to the 2003 Joint National Committee (JNC)-7 or…
Microsimulation | Clinical Care | Cost-Effectiveness Analysis | Chronic Disease/Risk | Health/Medicine | North America -
ReviewPublication 2016Cochrane Review: Strategies to Improve the Implementation of Obesity Prevention
Despite the existence of effective interventions and best-practice guideline recommendations for childcare services to implement …
Despite the existence of effective interventions and best-practice guideline recommendations for childcare services to implement policies, practices, and programs to promote child healthy eating, physical activity, and prevent unhealthy weight gain, many services fail to do so. The primary aim of the review was to examine the effectiveness of strategies aimed to improve the implementation of policies, practices, or programs by childcare services that promote child healthy eating, physical activity, and/or obesity prevention. The secondary…
Clinical Care | Evidence Synthesis | Child/Nutrition | Chronic Disease/Risk | Health Systems | Policy/Regulation | Culture/Society | Education/Labor | Health/Medicine | Global -
ArticlePublication 2016Estimating the Cost-Effectiveness of Implementation: Is Sufficient Evidence Available?
Timely implementation of recommended interventions can provide health benefits to patients and cost savings to …
Timely implementation of recommended interventions can provide health benefits to patients and cost savings to the health service provider. Effective approaches to increase the implementation of guidance are needed. Since investment in activities that improve implementation competes for funding against other health generating interventions, it should be assessed in term of its costs and benefits. In 2010, the National Institute for Health and Care Excellence released a clinical guideline recommending natriuretic peptide (NP) testing in…
Clinical Care | Health Outcomes | Cost-Effectiveness Analysis | Operations Research | Chronic Disease/Risk | Health Systems | Economics/Finance | Health/Medicine | Europe