Course: EPI 213: Decision and Cost Effectiveness Analysis in Medicine (Winter 2022)

Section outline

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Decision and Cost-Effectiveness
Analysis in Medicine

(Click for Course Description)

EPI 213 Winter 2022 (2 units).
Course Director: Elliot Marseille, DrPH, MPP

Select activity News forum

News forum
Select activity Schedule of lectures and HW

Schedule of lectures and HW File
Select activity Tools and resources

Tools and resources Folder

This folder contains a set of tools, templates and examples that you are likely to find useful at various points in the class. For simplicity we will keep all of them here in this one folder.

Select section Thursday, January 6, 2022; 3:15 PM – 5:00 PM

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Thursday, January 6, 2022; 3:15 PM – 5:00 PM
Course Overview

Goal, organization, student projects, grading, substantive snapshot.

Core Lecture 1: Decision Analysis

Purpose and indications for decision analysis; Steps -- formal question, decision trees, probabilities, outcomes, sensitivity analysis.

Faculty: Elliot Marseille

Location (Access restricted to registered students): MH-1406
- Select activity Session Audio/Video Recording (Access restricted t...
  
  Session Audio/Video Recording (Access restricted to registered students):
- Select activity Course Introduction video
  
  Course Introduction video URL
  
  This video is from 2019. The schedule presented here has changed a little, but otherwise it still provides good orientation.
- Select activity Jan 6 2022 lectures
  
  Jan 6 2022 lectures Media Resource
  
  Not available unless: You belong to a group in Registered Students Only
- Select activity Session Slides:
  
  Session Slides:
- Select activity Course Overview
  
  Course Overview File
- Select activity Lecture 1 - Decision Analysis
  
  Lecture 1 - Decision Analysis File
- Select activity CEA Purpose
  
  CEA Purpose URL
  
  Not available unless: You belong to Registered Students Only
- Select activity Required Reading:
  
  Required Reading:
- Select activity Lecture 1 Notes
  
  Lecture 1 Notes File
- Select activity Sox HC et al Expected Value Decision Making Ch 6 in Sox HC et al--Medical Decision Making 1988
  
  Sox HC et al Expected Value Decision Making Ch 6 in Sox HC et al--Medical Decision Making 1988 File
- Select activity Assignment: HW1
  
  Assignment: HW1
- Select activity HW1 Assignment
  
  HW1 Assignment File
- Select activity Assignment Due Date: Thursday, January 13 at 3:15 ...
  
  Assignment Due Date: Thursday, January 13 at 3:15 PM
- Select activity Turn in HW1 - Mammography (all students)
  
  Turn in HW1 - Mammography (all students) Assignment
  
  Students must
  
  Make a submission
Select section Thursday, January 13, 2022; 3:15 PM – 5:00 PM

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Thursday, January 13, 2022; 3:15 PM – 5:00 PM
Lecture: Software Tutorials
Group Discussion: Decision analysis (trees)

Faculty: Elliot Marseille
Location (Access restricted to registered students): MH 1406
- Select activity Session Audio/Video Recording (Access restricted t...
  
  Session Audio/Video Recording (Access restricted to registered students):
- Select activity TreeAge tutorial from 2021 by TA - excellent intro to TreeAge
  
  TreeAge tutorial from 2021 by TA - excellent intro to TreeAge Media Resource
  
  Not available unless: You belong to Registered Students Only
- Select activity Excel tutorial and trees Jan 13 2022
  
  Excel tutorial and trees Jan 13 2022 Media Resource
  
  Not available unless: You belong to Registered Students Only
- Select activity ICER Man Commeth - CEA approaches and ICERs
  
  ICER Man Commeth - CEA approaches and ICERs URL
  
  Not available unless: You belong to Registered Students Only
- Select activity Optional Reading:
  
  Optional Reading:
- Select activity Detsky Part1 Primer Medical Decision-Making Getting started
  
  Detsky Part1 Primer Medical Decision-Making Getting started File
- Select activity Detsky Part2 Primer Medical Decision-Making Building a tree
  
  Detsky Part2 Primer Medical Decision-Making Building a tree File
- Select activity Detsky-Naglie Part3 Primer Medical Decision-Making Est Probs and Utilities
  
  Detsky-Naglie Part3 Primer Medical Decision-Making Est Probs and Utilities File
- Select activity Resources:
  
  Resources:
- Select activity DCEA22_Aneurysm_TreeAge_tutorial.trex
  
  DCEA22_Aneurysm_TreeAge_tutorial.trex File
- Select activity Decision tree template
  
  Decision tree template File
- Select activity Instant CEA of ICD
  
  Instant CEA of ICD File
  
  This is a hypothetical but realistic example which shows step-by-step the construction of a CEA
Select section Thursday, January 20, 2022; 3:15 PM – 5:00 PM

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Thursday, January 20, 2022; 3:15 PM – 5:00 PM
Core Lecture 2: Health Outcomes (QALYs, DALYs)
Specification, measurement, calculation, and incorporation of health status indicators. Discounting.
Lecture: Special Topic: HIV prevention cost-effectiveness
CEA of two interventions in global health context - female condom and vertical transmission prevention

Faculty: Elliot Marseille

Location (Access restricted to registered students): Zoom URL
- Select activity Session Slides:
  
  Session Slides:
- Select activity PPt Slides
  
  PPt Slides File
  
  Slides on Utilities, QALYs, DALYs, Discounting
- Select activity PPt slides on 2 HIV interventions
  
  PPt slides on 2 HIV interventions File
- Select activity Session Audio/Video Recording (Access restricted t...
  
  Session Audio/Video Recording (Access restricted to registered students):
- Select activity Zoom recording of Jan 20, 2022 lecture
  
  Zoom recording of Jan 20, 2022 lecture Media Resource
  
  EPI 213 January 20, 2022 Lecture on Outcomes, QALYs, DALYs., Discounting
  
  Not available unless: You belong to a group in Registered Students Only
- Select activity ICER Man Commeth - DALYs and QALYs
  
  ICER Man Commeth - DALYs and QALYs URL
  
  Not available unless: You belong to Registered Students Only
- Select activity Required Reading:
  
  Required Reading:
- Select activity Lecture 2 Notes QALYs DALYs discounting
  
  Lecture 2 Notes QALYs DALYs discounting File
- Select activity Optional Reading:
  
  Optional Reading:
- Select activity Shlipak MG Decision Analysis Ch 2 in Friedland DJ et al--Evidence-Based Medicine 1998
  
  Shlipak MG Decision Analysis Ch 2 in Friedland DJ et al--Evidence-Based Medicine 1998 File
- Select activity Murray Lancet2012 DALYs 219 countries GBD 2010
  
  Murray Lancet2012 DALYs 219 countries GBD 2010 File
- Select activity Resources:
  
  Resources:
- Select activity Lecture 2 The DALYs Show
  
  Lecture 2 The DALYs Show File
- Select activity QALYs DALYs discounting template
  
  QALYs DALYs discounting template File
- Select activity Assignment: HW2
  
  Assignment: HW2
- Select activity HW2 Assignment
  
  HW2 Assignment File
- Select activity Mammog HW2
  
  Mammog HW2 File
- Select activity Assignment Due Date:  Thursday, January 27 at...
  
  Assignment Due Date: Thursday, January 27 at 3:15 PM
- Select activity Turn in HW2 - Mammography (all students)
  
  Turn in HW2 - Mammography (all students) Assignment
  
  Students must
  
  Make a submission
Select section Thursday, January 27, 2022; 3:15 PM – 5:00 PM

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Thursday, January 27, 2022; 3:15 PM – 5:00 PM
Core Lecture 3: Cost-Effectiveness
Conceptual approach to CEA. Incorporation of costs into the analysis, calculation of the incremental cost-effectiveness ratio (ICER).

Faculty: Elliot Marseile

Location (Access restricted to registered students): Zoom URL
- Select activity Session Slides:
  
  Session Slides:
- Select activity DCEA Lecture on cost-effectiveness analysis
  
  DCEA Lecture on cost-effectiveness analysis File
- Select activity Session Audio/Video Recording (Access restricted t...
  
  Session Audio/Video Recording (Access restricted to registered students):
- Select activity Lecture 3 on cost-effectiveness analysis - zoom recording -
  
  Lecture 3 on cost-effectiveness analysis - zoom recording - Media Resource
  
  Not available unless: You belong to Registered Students Only
- Select activity ICER Man Commeth - Timing in CEAs
  
  ICER Man Commeth - Timing in CEAs URL
  
  Not available unless: You belong to Registered Students Only
- Select activity ICER man cometh - CEA Research Questions
  
  ICER man cometh - CEA Research Questions URL
  
  Not available unless: You belong to Registered Students Only
- Select activity ICER man Cometh - Decision Trees for CEAs
  
  ICER man Cometh - Decision Trees for CEAs URL
  
  Not available unless: You belong to Registered Students Only
- Select activity Required Reading:
  
  Required Reading:
- Select activity Lecture 3 Notes - Cost-effectiveness
  
  Lecture 3 Notes - Cost-effectiveness File
- Select activity Salomon_disability_weight_GBD_2010_Lancet_2013
  
  Salomon_disability_weight_GBD_2010_Lancet_2013 File
- Select activity Jonsson Ten Arguments Societal Perspective 2009
  
  Jonsson Ten Arguments Societal Perspective 2009 File
- Select activity Jamison
  
  Jamison File
  
  Not available unless: Your ID number contains 02
- Select activity Kahn
  
  Kahn File
  
  Not available unless: Your ID number contains 02
- Select activity Russell
  
  Russell File
  
  Not available unless: Your ID number contains 02
- Select activity Assignment: HW3
  
  Assignment: HW3
- Select activity HW3 Assignment
  
  HW3 Assignment File
- Select activity DCEA_Mammog_HW3.xls
  
  DCEA_Mammog_HW3.xls File
- Select activity Assignment Due Date:  Thursday, February 3 at...
  
  Assignment Due Date: Thursday, February 3 at 3:15 PM
- Select activity Turn in HW3 - Mammography (all students)
  
  Turn in HW3 - Mammography (all students) Assignment
  
  Students must
  
  Make a submission
Select section Thursday, February 3, 2022; 3:15 PM – 5:00 PM

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Thursday, February 3, 2022; 3:15 PM – 5:00 PM
Obtaining Input Data
Core Lecture 4: Data inputs (Faculty: Elliot Marseille)

General approach (base case, range); Health inputs (health outcomes, population traits, hierarchy of evidence); Cost inputs (direct, time); Presentation.
Location: Zoom URL
- Select activity Session Slides: Data inputs
  
  Session Slides: Data inputs
- Select activity Session Audio/Video Recording (Access restricted t...
  
  Session Audio/Video Recording (Access restricted to registered students):
- Select activity Data for CE models - sources and quality
  
  Data for CE models - sources and quality Media Resource
- Select activity Lecture 4 - Health and cost data inputs
  
  Lecture 4 - Health and cost data inputs File
- Select activity Required Reading:
  
  Required Reading:
- Select activity DCEA Core Lecture 4 Notes
  
  DCEA Core Lecture 4 Notes File
- Select activity US Preventive Services Task Force Methodology Ch 2 in USPSTF Guide to Clinical Preventative Services 1996
  
  US Preventive Services Task Force Methodology Ch 2 in USPSTF Guide to Clinical Preventative Services 1996 File
- Select activity Resources:
  
  Resources:
- Select activity Qualitative review of cost studies
  
  Qualitative review of cost studies File
  
  Example of a systematic qualitative assessment of disparate medical care cost studies - from E. Marseille's CEA of MDMA for PTSD.
- Select activity Assignment: HW4 (copy)
  
  Assignment: HW4
- Select activity HW4 Assignment
  
  HW4 Assignment File
- Select activity Assignment Due Date:  Thursday, February 10 a...
  
  Assignment Due Date: Thursday, February 10 at 3:15 PM
- Select activity Turn in HW4 (2-credit track only)
  
  Turn in HW4 (2-credit track only) Assignment
  
  Students must
  
  Make a submission
Select section Thursday, February 10, 2022; 3:15 PM – 5:00 PM

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Thursday, February 10, 2022; 3:15 PM – 5:00 PM
Core Lecture 5: Markov Disease State Modeling
Uses and design of portrayal of disease states in decision trees.

Faculty: Elliot Marseille

Location: Zoom URL
- Select activity Session Slides:
  
  Session Slides:
- Select activity Lecture 5 - Markov and CEA of MDMA to treat PTSD
  
  Lecture 5 - Markov and CEA of MDMA to treat PTSD File
- Select activity MAPS CEA of MDMA for PTSD
  
  MAPS CEA of MDMA for PTSD File
- Select activity Session Audio/Video Recording (Access restricted t...
  
  Session Audio/Video Recording (Access restricted to registered students):
- Select activity Lecture on Markov Models
  
  Lecture on Markov Models Media Resource
- Select activity Required Reading:
  
  Required Reading:
- Select activity Lecture 5 Notes - Markov
  
  Lecture 5 Notes - Markov File
- Select activity Naimark D et al Primer on Medical DA--Part 5--Working with Markov Processes In Med Decis Making Apr-Jun 1997
  
  Naimark D et al Primer on Medical DA--Part 5--Working with Markov Processes In Med Decis Making Apr-Jun 1997 File
  
  Not available unless: Your ID number contains 02
- Select activity Nutt Current status of psychedelics in psychiatry 2020.pdf
  
  Nutt Current status of psychedelics in psychiatry 2020.pdf File
- Select activity Assignment: HW5
  
  Assignment: HW5
- Select activity HW 5 Assignment (choose either 5A or 5B)
  
  HW 5 Assignment (choose either 5A or 5B) File
- Select activity Revised Markov template
  
  Revised Markov template File
- Select activity DCEA21_HW5_Markov.trex (for HW 5B)
  
  DCEA21_HW5_Markov.trex (for HW 5B) File
- Select activity Assignment Due Date: Thursday, February 17 at 3:15...
  
  Assignment Due Date: Thursday, February 17 at 3:15 PM
- Select activity Turn in HW5 (2-credit track only)
  
  Turn in HW5 (2-credit track only) Assignment
  
  Students must
  
  Make a submission
Select section Thursday, February 17, 2022; 3:15 PM – 5:00 PM

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Thursday, February 17, 2022; 3:15 PM – 5:00 PM
Core Lecture 6: Sensitivity Analysis
Lecture Description: Types of uncertainty; Deterministic SA (one-way, multi-way, scenario); Probabilistic SA (reasons for, data needs, methods); Uses (planning, checking, thresholds, policy.)

Faculty: Elliot Marseille

Location: Zoom URL
- Select activity Session Slides:
  
  Session Slides:
- Select activity Lecture 6 - Sensitivity analysis
  
  Lecture 6 - Sensitivity analysis File
- Select activity Session Audio/Video Recording (Access restricted t...
  
  Session Audio/Video Recording (Access restricted to registered students):
- Select activity Sensitivity Analysis Lecture - Zoom
  
  Sensitivity Analysis Lecture - Zoom Media Resource
- Select activity ICERMAN Cometh - Sensitivity Analyses
  
  ICERMAN Cometh - Sensitivity Analyses URL
  
  Not available unless: You belong to Registered Students Only
- Select activity Required Reading:
  
  Required Reading:
- Select activity Lecture 6 Notes - Sensitivity Analysis
  
  Lecture 6 Notes - Sensitivity Analysis File
- Select activity Krahn MD Primer on Med DA--Part 4--Analyzing the Model Interpreting the Results Med Decis Making Apr-Jun 1997
  
  Krahn MD Primer on Med DA--Part 4--Analyzing the Model Interpreting the Results Med Decis Making Apr-Jun 1997 File
  
  Not available unless: Your ID number contains 02
- Select activity Assignment: HW6
  
  Assignment: HW6
- Select activity HW6 Assignment
  
  HW6 Assignment File
- Select activity DCEA_Mammog_HW6
  
  DCEA_Mammog_HW6 File
- Select activity DCEA what-if-analysis data table for sensitivity analysis v2
  
  DCEA what-if-analysis data table for sensitivity analysis v2 File
- Select activity Assignment Due Date: Thursday, February 24 at 3:15...
  
  Assignment Due Date: Thursday, February 24 at 3:15 PM
- Select activity Turn in HW6 - Mammography (all students)
  
  Turn in HW6 - Mammography (all students) Assignment
  
  Students must
  
  Make a submission
Select section Thursday, February 24, 2022; 3:15 PM – 5:00 PM

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Thursday, February 24, 2022; 3:15 PM – 5:00 PM
Core Lecture 7: Cost-Effectiveness Thresholds
Critique of WHO thresholds and the way forward

Faculty: Elliot Marseille

Location: MH 1406
- Select activity CE Threshold Lecture - Zoom
  
  CE Threshold Lecture - Zoom Media Resource
- Select activity Session Slides:
  
  Session Slides:
- Select activity Lecture 7 - Cost-effectiveness thresholds
  
  Lecture 7 - Cost-effectiveness thresholds File
- Select activity Session Audio/Video Recording (Access restricted t...
  
  Session Audio/Video Recording (Access restricted to registered students):
- Select activity ICER Man Commeth - CEA Results Table
  
  ICER Man Commeth - CEA Results Table URL
  
  Not available unless: You belong to Registered Students Only
- Select activity Required Reading
  
  Required Reading
- Select activity Marseille WHO CE Threshold - Critique 2015
  
  Marseille WHO CE Threshold - Critique 2015 File
Select section Thursday, March 3, 2022; 3:15 PM – 5:00 PM

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Thursday, March 3, 2022; 3:15 PM – 5:00 PM
Lecture: Special Topic: Ethics of Cost-Effectiveness
Utilitarian and competing ethical principles.
Faculty: Elliot Marseille
Location: Zoom URL
- Select activity Lecture 8 zoom recording
  
  Lecture 8 zoom recording Media Resource
  
  Not available unless: You belong to Registered Students Only
- Select activity Session Slides:
  
  Session Slides:
- Select activity Lecture 8.1 - Ethical Foundations of CEA
  
  Lecture 8.1 - Ethical Foundations of CEA File
- Select activity Lecture 8.2 - Equity efficiency and the SW quadrant
  
  Lecture 8.2 - Equity efficiency and the SW quadrant File
- Select activity Session Audio/Video Recording (Access restricted t...
  
  Session Audio/Video Recording (Access restricted to registered students):
- Select activity Watch - Live Lecture
  
  Watch - Live Lecture URL
  
  Not available unless: You belong to a group in Registered Students Only
- Select activity ICER Man Commeth - CEA Next Steps
  
  ICER Man Commeth - CEA Next Steps URL
  
  Not available unless: You belong to Registered Students Only
- Select activity Marseille and Kahn Ethical foundations of CEA 2019
  
  Marseille and Kahn Ethical foundations of CEA 2019 File
- Select activity Turn in HW7 on March 10
  
  Turn in HW7 on March 10 Assignment
  
  Students must
  
  Make a submission
Select section Thursday, March 10, 2022; 3:15 PM – 5:00 PM

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Thursday, March 10, 2022; 3:15 PM – 5:00 PM
Article Review

Location: MH1406
- Select activity In-Class Journal Club Articles and Discussion Ques...
  
  In-Class Journal Club Articles and Discussion Questions:
- Select activity Orlando CE of HAART in pMTCT of HIV 2010
  
  Orlando CE of HAART in pMTCT of HIV 2010 File
- Select activity Kazi PCSK9 Familial Hypercholesterolemia JAMA 2016
  
  Kazi PCSK9 Familial Hypercholesterolemia JAMA 2016 File
- Select activity Journal Club In-class Discussion Questions
  
  Journal Club In-class Discussion Questions File
- Select activity Session Slides - Special lecture
  
  Session Slides - Special lecture
- Select activity CEA female condom HIV/AIDS - Africa
  
  CEA female condom HIV/AIDS - Africa File
- Select activity Session Audio/Video Recording (Access restricted t... (copy)
  
  Session Audio/Video Recording (Access restricted to registered students):
- Select activity Watch - Live Lecture
  
  Watch - Live Lecture URL
  
  Not available unless: You belong to a group in Registered Students Only
- Select activity Required reading
  
  Required reading
- Select activity Lindfors 1995 - CE of mammography
  
  Lindfors 1995 - CE of mammography File
- Select activity Assignment: HW7
  
  Assignment: HW7
- Select activity HW7 Assignment
  
  HW7 Assignment File
- Select activity Assignment Due Date:  Thursday, March 10 at 3...
  
  Assignment Due Date: Thursday, March 10 at 3:15 PM
- Select activity Turn in HW7 (all students)
  
  Turn in HW7 (all students) Assignment
  
  Students must
  
  Make a submission
- Select activity Lecture 9 zoom recording
  
  Lecture 9 zoom recording Media Resource
  
  Not available unless: You belong to Registered Students Only
Select section Thursday, March 17, 2022; 3:15 PM - 5:00 PM

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Thursday, March 17, 2022; 3:15 PM - 5:00 PM
Iron CEA America

Fun team competition -- with apologies to Iron Chef America
Faculty: Elliot Marseille / Tracy Lin

Location: MH1406
- Select activity Session Materials:
  
  Session Materials:
- Select activity Iron CEA America
  
  Iron CEA America File
- Select activity Iron CEA start
  
  Iron CEA start File
- Select activity Session Audio/Video Recording (Access restricted t... (copy) (copy)
  
  Session Audio/Video Recording (Access restricted to registered students):
- Select activity Watch - Live Lecture
  
  Watch - Live Lecture URL
  
  Not available unless: You belong to a group in Registered Students Only
- Select activity Lindfors KK et al CE of Mammo Screening Strategies In JAMA 20Sept1995 ocr
  
  Lindfors KK et al CE of Mammo Screening Strategies In JAMA 20Sept1995 ocr File
  
  Not available unless: Your ID number contains 02
- Select activity Zoom of March 17 2022 Class
  
  Zoom of March 17 2022 Class Media Resource
  
  Critique of Lindfors mammography article and more

Sunday	Monday	Tuesday	Wednesday	Thursday	Friday	Saturday
			No events, Wednesday, July 1 No events, Wednesday, July 1	No events, Thursday, July 2 No events, Thursday, July 2	No events, Friday, July 3 No events, Friday, July 3	No events, Saturday, July 4 No events, Saturday, July 4
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No events, Sunday, July 19 No events, Sunday, July 19	No events, Monday, July 20 No events, Monday, July 20	No events, Tuesday, July 21 No events, Tuesday, July 21	No events, Wednesday, July 22 No events, Wednesday, July 22	No events, Thursday, July 23 No events, Thursday, July 23	No events, Friday, July 24 No events, Friday, July 24	No events, Saturday, July 25 No events, Saturday, July 25
No events, Sunday, July 26 No events, Sunday, July 26	No events, Monday, July 27 No events, Monday, July 27	No events, Tuesday, July 28 No events, Tuesday, July 28	No events, Wednesday, July 29 No events, Wednesday, July 29	No events, Thursday, July 30 No events, Thursday, July 30	No events, Friday, July 31 No events, Friday, July 31

July 2026

Section outline

Core Lecture 1: Decision Analysis

Lecture: Software Tutorials

Group Discussion: Decision analysis (trees)

Lecture: Special Topic: HIV prevention cost-effectiveness

Article Review

Iron CEA America