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Modeling Comparative Effectiveness and the Value of Research

Anirban Basu, PhD; and David Meltzer, MD, PhD
[+] Article, Author, and Disclosure Information

From The University of Chicago, Chicago, IL 60637.

Potential Financial Conflicts of Interest: None disclosed.

Requests for Single Reprints: David Meltzer, MD, PhD, Section of Hospital Medicine and Center for Health and the Social Sciences, The University of Chicago, 5841 South Maryland, MC 2007, Chicago, IL 60637; e-mail, dmeltzer@medicine.bsd.uchicago.edu.

Current Author Addresses: Drs. Basu and Meltzer: Section of Hospital Medicine and Center for Health and the Social Sciences, The University of Chicago, 5841 South Maryland, MC 2007, Chicago, IL 60637.

Ann Intern Med. 2009;151(3):210-211. doi:10.7326/0003-4819-151-3-200908040-00010
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Mathematical models of the effects of alternative medical treatments or health policies are important tools for comparative effectiveness research (12). In this issue, Walensky and colleagues (3) report the results of a mathematical model of the effects of antiretroviral therapy (ART) use for HIV in South Africa. They attempt to answer 2 related policy questions. First, given that randomized clinical trials are under way to determine the optimal starting point for ART, what would be the likely cost-effectiveness of a higher (<0.350 × 109 cells/L) versus lower (<0.250 × 109 cells/L) CD4 count threshold for initiating ART while waiting 5 years for the trial results? Second, what would be the likely lifetime cost-effectiveness of such policies?

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