scholarly journals Should rapid antigen tests be government funded in Australia? An economic evaluation

2022 ◽  
Author(s):  
Jonathan Karnon
Keyword(s):  
Decision Tree ◽  
Input Parameter ◽  
Decision Tree Model ◽  
Tree Model ◽  
Public Health Response ◽  
Detection Rates ◽  
The Public ◽  
Scenario Analyses ◽  
The Government ◽  
Antigen Tests

Objective: Easy and equitable access to testing is a cornerstone of the public health response to COVID-19. Currently in Australia, testing using Polymerase Chain Reaction (PCR) tests for COVID-19 is free-to-the-user, but the public purchase their own Rapid Antigen Tests (RATs). We conduct an economic analysis of government-funded RATs in Australia. Design: An interactive decision tree model was developed to compare one policy in which government-funded RATs are free-to-the-user, and one in which individuals purchase their own RATs. The decision tree represents RAT and PCR testing pathways for a cohort of individuals without COVID-19-like symptoms, to estimate the likelihood of COVID-19 positive individuals isolating prior to developing symptoms and the associated costs of testing, from a government perspective. Data sources: Test costs and detection rates were informed by published studies, other input parameter values are unobservable and uncertain, for which a range of scenario analyses are presented. Data synthesis: Assuming 10% prevalence of COVID-19 in a cohort of 10,000 individuals who would use government-funded RATs, the model estimates an additional 464 individuals would isolate early at a cost to the government of around $52,000. Scenario analyses indicate that the incremental cost per additional COVID-19 positive individual isolating with no symptoms remains at a few hundred dollars at 5% prevalence, rising to $2,052 at 1% prevalence. Conclusions: Based on the presented decision tree model, even only minor reductions in COVID-19 transmission rates due to early isolation would justify the additional costs associated with a policy of government-funded RATs.

A novel enhanced decision tree model for detecting chronic kidney disease

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Avijit Kumar Chaudhuri ◽  
Deepankar Sinha ◽  
Dilip K. Banerjee ◽  
Anirban Das
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Decision Tree ◽  
Decision Tree Model ◽  
Tree Model

scholarly journals Risk of Pre-Malignancy or Malignancy in Postmenopausal Endometrial Polyps: A CHAID Decision Tree Analysis

Diagnostics ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 1094
Author(s):  
Michael Wong ◽  
Nikolaos Thanatsis ◽  
Federica Nardelli ◽  
Tejal Amin ◽  
Davor Jurkovic
Keyword(s):  
Decision Tree ◽  
Expectant Management ◽  
Decision Tree Model ◽  
Decision Tree Analysis ◽  
Focal Lesions ◽  
Tree Model ◽  
Normal Endometrium ◽  
Endometrial Polyps ◽  
Tree Analysis ◽  
Interaction Detection

Background and aims: Postmenopausal endometrial polyps are commonly managed by surgical resection; however, expectant management may be considered for some women due to the presence of medical co-morbidities, failed hysteroscopies or patient’s preference. This study aimed to identify patient characteristics and ultrasound morphological features of polyps that could aid in the prediction of underlying pre-malignancy or malignancy in postmenopausal polyps. Methods: Women with consecutive postmenopausal polyps diagnosed on ultrasound and removed surgically were recruited between October 2015 to October 2018 prospectively. Polyps were defined on ultrasound as focal lesions with a regular outline, surrounded by normal endometrium. On Doppler examination, there was either a single feeder vessel or no detectable vascularity. Polyps were classified histologically as benign (including hyperplasia without atypia), pre-malignant (atypical hyperplasia), or malignant. A Chi-squared automatic interaction detection (CHAID) decision tree analysis was performed with a range of demographic, clinical, and ultrasound variables as independent, and the presence of pre-malignancy or malignancy in polyps as dependent variables. A 10-fold cross-validation method was used to estimate the model’s misclassification risk. Results: There were 240 women included, 181 of whom presented with postmenopausal bleeding. Their median age was 60 (range of 45–94); 18/240 (7.5%) women were diagnosed with pre-malignant or malignant polyps. In our decision tree model, the polyp mean diameter (≤13 mm or >13 mm) on ultrasound was the most important predictor of pre-malignancy or malignancy. If the tree was allowed to grow, the patient’s body mass index (BMI) and cystic/solid appearance of the polyp classified women further into low-risk (≤5%), intermediate-risk (>5%–≤20%), or high-risk (>20%) groups. Conclusions: Our decision tree model may serve as a guide to counsel women on the benefits and risks of surgery for postmenopausal endometrial polyps. It may also assist clinicians in prioritizing women for surgery according to their risk of malignancy.

scholarly journals Reanalysis and External Validation of a Decision Tree Model for Detecting Unrecognized Diabetes in Rural Chinese Individuals

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Zhong Xin ◽  
Lin Hua ◽  
Xu-Hong Wang ◽  
Dong Zhao ◽  
Cai-Guo Yu ◽  
...  
Keyword(s):  
Decision Tree ◽  
Predictive Value ◽  
Early Stage ◽  
Current Model ◽  
External Validation ◽  
Area Under The Curve ◽  
Decision Tree Model ◽  
Tree Model ◽  
Chinese Adult ◽  
Significant Difference

We reanalyzed previous data to develop a more simplified decision tree model as a screening tool for unrecognized diabetes, using basic information in Beijing community health records. Then, the model was validated in another rural town. Only three non-laboratory-based risk factors (age, BMI, and presence of hypertension) with fewer branches were used in the new model. The sensitivity, specificity, positive predictive value, negative predictive value, and area under the curve (AUC) for detecting diabetes were calculated. The AUC values in internal and external validation groups were 0.708 and 0.629, respectively. Subjects with high risk of diabetes had significantly higher HOMA-IR, but no significant difference in HOMA-B was observed. This simple tool will help general practitioners and residents assess the risk of diabetes quickly and easily. This study also validates the strong associations of insulin resistance and early stage of diabetes, suggesting that more attention should be paid to the current model in rural Chinese adult populations.

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