Resources Repository
-
ArticlePublication 2022Duration & Cost-Effectiveness of Hepatocellular Carcinoma Surveillance in Hepatitis C Patients After Viral Eradication
This study assesses the cost-effectiveness of biannual surveillance for hepatocellular carcinoma (HCC) in patients cured …
This study assesses the cost-effectiveness of biannual surveillance for hepatocellular carcinoma (HCC) in patients cured of hepatitis C virus (HCV) using oral direct-acting antivirals (DAAs). A microsimulation model of HCC natural history in individuals with HCV-related advanced fibrosis or cirrhosis post-DAAs was developed, integrating data on HCC incidence, tumor progression, surveillance adherence, and health state costs/utilities. Biannual ultrasound and alpha-fetoprotein surveillance were compared to no surveillance over varying durations (5 years to lifetime). Results indicate…
Microsimulation | Cost-Effectiveness Analysis | Chronic Disease/Risk | Health/Medicine | North America -
ArticlePublication 2022Cost-Effectiveness of Screening for Atrial Fibrillation Using Wearable Devices
This economic evaluation assesses the cost-effectiveness of atrial fibrillation (AF) screening strategies, particularly utilizing wrist-worn …
This economic evaluation assesses the cost-effectiveness of atrial fibrillation (AF) screening strategies, particularly utilizing wrist-worn wearable devices, to prevent strokes. Conducted using a microsimulation decision-analytic model, the study spans from September 8, 2020, to May 23, 2022, incorporating 30 million simulated individuals representative of the US population aged 65 years or older. Eight screening strategies, including six employing wrist-worn devices and two using traditional methods, were compared against no screening. Results indicate that all wrist-worn…
Microsimulation | Cost-Effectiveness Analysis | Chronic Disease/Risk | 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 -
ToolInteractive 2020COVID-19 Antibody Tests: Calculator for Interpreting Test Results
Antibody testing can determine previous exposure to SARS-CoV-2 virus. This interactive calculator, linked to the article …
Antibody testing can determine previous exposure to SARS-CoV-2 virus. This interactive calculator, linked to the article below* on antibody testing for SARS-CoV-2 virus, allows users to vary the prior probability of infection, the sensitivity of SARS-CoV-2 antibody testing, and the specificity of SARS-CoV-2 antibody testing. Key points made in the article accompanying the interactive include: (1) antibody testing is likely to be most useful 2 weeks after infection, (2) sensitivity and specificity will vary over time and…
Test Performance | Probability/Bayes | Technology Assessment | Infectious Diseases | Clinical Care | Health/Medicine | Science/Technology -
ArticlePublication 2021Health Opportunity Cost Threshold for CEA in the U.S.
Using a modeled cohort of 100,000 individuals in the United States with private health insurance, …
Using a modeled cohort of 100,000 individuals in the United States with private health insurance, the authors simulated the short-term mortality and morbidity resulting from increased premium related cancelation of insurance coverage. The authors used this model to estimate cost-effectiveness thresholds, in dollars per quality-adjusted life year (QALY) gained based on health opportunity costs. They reported the number of persons who dropped insurance coverage, resulting number of additional deaths and QALYs lost from mortality and…
Microsimulation | Priority Setting/Ethics | Health Outcomes | Evidence Synthesis | Cost-Effectiveness Analysis | Health Systems | Policy/Regulation | Health/Medicine | North America -
EditorialPublication 2020Waiting for Certainty on COVID-19 Antibody Tests — At What Cost?
This perspective anticipates the availability of serologic antibody testing and considers its potential usefulness in mitigation …
This perspective anticipates the availability of serologic antibody testing and considers its potential usefulness in mitigation policy to reduce COVID-19 transmission. For example: Could we screen for serologic antibodies as a proxy for possible immunity and identify people who could return to the workplace with less severe mitigation measures? The authors acknowledge the uncertainties raised by many policy actors, including the WHO, such as, "Do antibodies confer immunity and, if so, for how long? How accurate is…
Test Performance | Probability/Bayes | Technology Assessment | Infectious Diseases | Health Systems | Policy/Regulation | Government/Law | Health/Medicine | Global | North America -
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 -
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…
Test Performance | Probability/Bayes | 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…
Test Performance | Probability/Bayes | Infectious Diseases | Health/Medicine | Science/Technology | Global