Resources Repository
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ReportPublication 2014Redirecting Innovation in U.S. Health Care
This report from RAND Health explores methods of reducing health care spending and developing medical …
This report from RAND Health explores methods of reducing health care spending and developing medical products that provide cost value with health benefits. It summarizes literature and explores case studies to provide policy recommendations to meet these goals. It identifies a wide range of factors that affect the costs, risks, and rewards of medical product invention. Some of these features include treatment creep, the medical arms race, costs and risks of FDA approval, limited reward…
Evidence Synthesis | Government/Law | Health/Medicine | North America | Costing Methods | Health Outcomes | Health Systems | Policy/Regulation | Economics/Finance | Science/Technology -
ArticlePublication 2013Contribution of H. Pylori and Smoking to US Incidence of Gastric Adenocarcinoma: A Microsimulation Model
Although gastric cancer has declined dramatically in the US, the disease remains the second leading …
Although gastric cancer has declined dramatically in the US, the disease remains the second leading cause of cancer mortality worldwide. This analysis estimates the contribution of risk factor trends on past and future intestinal-type non-cardia gastric adenocarcinoma (NCGA) incidence. The authors developed a population-based microsimulation model of intestinal-type NCGA and calibrated it to U.S. epidemiologic data on precancerous lesions and cancer. The model explicitly incorporated the impact of Helicobacter pylori and smoking on disease natural history, for which…
Microsimulation | Calibration/Validation | Health/Medicine | North America | Chronic Disease/Risk | Social Determinants | Culture/Society -
GuidelinesPublication 2013Decision and Simulation Modeling in Systematic Reviews
The purpose of this review is to provide guidance for determining when incorporating a decision-analytic …
The purpose of this review is to provide guidance for determining when incorporating a decision-analytic model alongside a systemic review would be of added value for decision making purposes. The purpose of systematic reviews is to synthesize the current scientific literature on a particular topic in the form of evidence reports and technology assessments to assist public and private organizations in developing strategies that improve the quality of health care and decision making. However, there…
Evidence Synthesis | Mathematical Models | Health/Medicine | North America | Decision Analysis | Infectious Diseases | Child/Nutrition | Chronic Disease/Risk -
ArticlePublication 2010Empirically Evaluating Decision-Analytic Models
To augment model credibility, evaluation via comparison to independent, empirical studies is recommended. The authors …
To augment model credibility, evaluation via comparison to independent, empirical studies is recommended. The authors developed a structured reporting format for model evaluation and conducted a structured literature review to characterize current model evaluation recommendations and practices. As an illustration, they applied the reporting format to evaluate a microsimulation of human papillomavirus and cervical cancer. The model's outputs and uncertainty ranges were compared with multiple outcomes from a study of long-term progression from high-grade precancer…
Microsimulation | Calibration/Validation | Health/Medicine | North America | Infectious Diseases | Chronic Disease/Risk -
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 | Health/Medicine | North America | Infectious Diseases | Chronic Disease/Risk | Clinical Care | Science/Technology -
ArticlePublication 2022Estimated Transmission Outcomes and Costs of SARS-CoV-2 Diagnostic Testing, Screening, and Surveillance Strategies Among a Simulated Population of Primary School Students
In the wake of the COVID-19 pandemic's significant educational disruptions, the U.S. government allocated $10 …
In the wake of the COVID-19 pandemic's significant educational disruptions, the U.S. government allocated $10 billion in March 2021 for testing in schools. The study aimed to analyze the costs and benefits of different COVID-19 testing strategies, particularly focusing on full-time, in-person elementary and middle school education. Utilizing an updated agent-based network model, the study simulated transmission scenarios in schools, considering various testing strategies ranging from diagnostic testing (test-to-stay) to reduce symptom-based isolations, routine screening…
Mathematical Models | Health/Medicine | North America | Test Performance | Cost-Effectiveness Analysis | Infectious Diseases | Clinical Care | Science/Technology -
ArticlePublication 2022Modeling the Effectiveness of Healthcare Personnel Reactive Testing and Screening for the SARS-Cov-2 Omicron Variant within Nursing Homes
The Omicron variant of SARS-CoV-2 has been hypothesized to exhibit faster clearance (time from peak …
The Omicron variant of SARS-CoV-2 has been hypothesized to exhibit faster clearance (time from peak viral concentration to clearance of acute infection), may be less detectable by antigen tests (decreased sensitivity), and may be more likely to evade immunity conferred by past infection or vaccination) compared to prior variants. This calls for a reassessment of strategies to prevent its spread, especially in vulnerable settings like nursing homes. Using a model that tracks viral shedding patterns,…
Mathematical Models | Health/Medicine | North America | Test Performance | Infectious Diseases -
ArticlePublication 2023Achieving the Cancer Moonshot Goal
The Cancer Moonshot seeks to reduce age-standardized cancer mortality rates by at least 50% over …
The Cancer Moonshot seeks to reduce age-standardized cancer mortality rates by at least 50% over the next 25 years. This article estimates trends in U.S. cancer mortality for all cancers and the six leading types and reviews opportunities to prevent, detect, and treat these common cancers.
Mathematical Models | Health/Medicine | North America | Priority Setting/Ethics | Health Systems | Clinical Care -
ArticlePublication 2020Data-Driven Management of Post-Transplant Medications
Organ-transplanted patients typically receive high amounts of immunosuppressive drugs as a mechanism to reduce their …
Organ-transplanted patients typically receive high amounts of immunosuppressive drugs as a mechanism to reduce their risk of organ rejection. However, because of the diabetogenic effect of these drugs, this practice exposes them to a greater risk of new-onset diabetes after transplantation (NODAT), and hence, becoming insulin dependent. This study develops effective medication management strategies to address the common conundrum of balancing the risk of organ rejection versus that of NODAT. The article presents a robust…
Mathematical Models | Health/Medicine | North America | Operations Research | Chronic Disease/Risk