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Margaret L. Brandeau
Journal Articles

Cost-effectiveness of voluntary HIV screening in Russia

Swati Tole, AM Bayoumi, Cristina Galvin, TN Vinichenko, Margaret Brandeau, Douglas Owens
International Journal of STD and AIDS , 2009

Russia has one of the world's fastest growing HIV epidemics, and HIV screening has been widespread. Whether such screening is an effective use of resources is unclear. We used epidemiologic and economic data from Russia to develop a Markov model to estimate costs, quality of life and survival associated with a voluntary HIV screening programme compared with no screening in Russia. We measured discounted lifetime health-care costs and quality-adjusted life years (QALYs) gained. We varied our inputs in sensitivity analysis. Early identification of HIV

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Journal Articles

Infectious disease control policy: A role for simulation

Margaret Brandeau
Proceedings - Winter Simulation Conference , 2008

ABSTRACT

Control of infectious diseases is a key global health priority. This paper describes the role that simulation can play in evaluating policies for infectious disease control. We describe ongoing simulation studies in three different areas: HIV prevention and treatment, contact tracing, and hepatitis B prevention and control.

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Journal Articles

The Cost Effectiveness of Counseling Strategies to Improve Adherence to Highly Active Antiretroviral Therapy Among Men Who Have Sex With Men

Gregory Zaric, Ahmed Bayoumi, Margaret L. Brandeau, Douglas Owens
Medical Decision Making , 2008

Objective
Inadequate adherence to highly active antiretroviral therapy (HAART) may lead to poor health outcomes and the development of HIV strains that are resistant to HAART. The authors developed a model to evaluate the cost-effectiveness of counseling interventions to improve adherence to HAART among men who have sex with men (MSM).

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Journal Articles

Modeling the Logistics of Response to Anthrax Bioterrorism

GS Zaric, Dena M. Bravata, Jon-Erik Holty, Kathryn M. McDonald, Douglas K. Owens, Margaret L. Brandeau
Medical Decision Making , 2008

Background: A bioterrorism attack with an agent such as anthrax will require rapid deployment of medical and pharmaceutical supplies to exposed individuals. How should such a logistical system be organized? How much capacity should be built into each element of the bioterrorism response supply chain?

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Journal Articles

An Ounce of Prevention Is Worth a Pound of Cure: Improving Communication to Reduce Mortality During Bioterrorism Responses

Margaret L. Brandeau, Zaric, G.S., Freiesleben, J. Freiesleben, J., Edwards, F.L. Edwards, F.L., Dena M. Bravata
American Journal of Disaster Medicine , 2008

OBJECTIVE: To identify communication needs and evaluate the effectiveness of alternative communication strategies for bioterrorism responses. METHODS: We provide a framework for evaluating communication needs during a bioterrorism response. Then, using a simulation model of a hypothetical response to anthrax bioterrorism in a large metropolitan area, we evaluate the costs and benefits of alternative strategies for communication during a response.

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Journal Articles

Contact Tracing to Control Infectious Disease: When Enough is Enough

B Armbruster, Margaret L. Brandeau
Health Care Management Science , 2007

Two common means of controlling infectious diseases are screening and contact tracing. Which should be used, and when? We consider the problem of determining the cheapest mix of screening and contact tracing necessary to achieve a desired endemic prevalence of a disease or to identify a specified number of cases.

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Journal Articles

Cost-Effectiveness of Screening and Vaccinating Asian and Pacific Islander Adults for Hepatitis B

DW Hutton, D Tan, SK So, Margaret L. Brandeau
Annals of Internal Medicine , 2007

Background: As many as 10% of Asian and Pacific Islander adults in the United States are chronically infected with hepatitis B virus (HBV), and up to two thirds are unaware that they are infected. Without proper medical management and antiviral therapy, up to 25% of Asian and Pacific Islander persons with chronic HBV infection will die of liver disease.

Objective: To assess the cost-effectiveness of 4 HBV screening and vaccination programs for Asian and Pacific Islander adults in the United States.

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Journal Articles

Optimal Mix of Screening and Contact Tracing for Endemic Diseases

B Armbruster, Margaret L. Brandeau
Mathematical Biosciences , 2007

Two common means of controlling infectious diseases are screening and contact tracing. Which should be used, and when? We consider the problem of determining the cheapest mix of screening and contact tracing necessary to achieve a desired endemic prevalence of a disease or to identify a specified number of cases.

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Journal Articles

A Little Planning Goes A Long Way: Multilevel Allocation of HIV Prevention Resources

GS Zaric, Margaret L. Brandeau
Medical Decision Making , 2007

Background: HIV prevention funds are often allocated by decision makers at multiple levels. High-level decision makers may allocate funds to regions, and regional decision makers then allocate those funds to specific programs. Often, funds are allocated proportionally (e.g., in proportion to HIV incidence) rather than efficiently (i.e., to maximize HIV infections averted). The authors investigate the impact of efficient and proportional allocation methods at 2 different decision levels.

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Journal Articles

Effectiveness and Cost-Effectiveness of Expanded Antiretroviral Therapy in St. Petersburg, Russia

EF Long, Margaret L. Brandeau, Cristina Galvin, T Vinichenko, Swati Tole, A Schwartz, Gillian D. Sanders, Douglas K. Owens
AIDS , 2006

Objective:

To assess the effectiveness and cost-effectiveness of treating HIV-infected injection drug users (IDUs) and non-IDUs in Russia with highly active antiretroviral therapy HAART.

Design and Methods:

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Journal Articles

Value of Quantitative D-dimer Assays in Identifying Pulmonary Embolism: Implications from a Sequential Decision Model

RS Duriseti, Ross D. Shachter, Margaret L. Brandeau
Academic Emergency Medicine , 2006

Objectives:

To examine the cost-effectiveness of a quantitative D-dimer assay for the evaluation of patients with suspected pulmonary embolism (PE) in an urban emergency department (ED).

Methods:

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Journal Articles

Reducing Mortality from Anthrax Bioterrorism: Strategies for Stockpiling and Dispensing Medical and Pharmaceutical Supplies

Dena M. Bravata, GS Zaric, Jon-Erik Holty, Margaret L. Brandeau, Emilee Wilhelm-Leen, Kathryn M. McDonald, Douglas Owens
Biosecurity and Bioterrorism , 2006

A critical question in planning a response to bioterrorism is how antibiotics and medical supplies should be stockpiled and dispensed. The objective of this work was to evaluate the costs and benefits of alternative strategies for maintaining and dispensing local and regional inventories of antibiotics and medical supplies for responses to anthrax bioterrorism. We modeled the regional and local supply chain for antibiotics and medical supplies as well as local dispensing capacity.

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Journal Articles

Improved Allocation of HIV Prevention Resources: Using Information About Prevention Program Production Functions

Margaret L. Brandeau, GS Zaric, V de Angelis
Health Care Management Science , 2005

To allocate HIV prevention resources effectively, it is important to have information about the effectiveness of alternative prevention programs as a function of expenditure. We refer to this relationship as the ldquoproduction functionrdquo for a prevention program. Few studies of HIV prevention programs have reported this relationship. This paper demonstrates the value of such information. We present a simple model for allocating HIV prevention resources, and apply the model to an illustrative HIV prevention resource allocation problem.

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Journal Articles

Resource Allocation for Control of Infectious Diseases in Multiple Independent Populations: Beyond Cost-Effectiveness Analysis

Margaret Brandeau, GS Zaric, A Richter
Journal of Health Economics , 2003

Traditional cost-effectiveness analysis (CEA) assumes that program costs and benefits scale linearly with investment-an unrealistic assumption for epidemic control programs. This paper combines epidemic modeling with optimization techniques to determine the optimal allocation of a limited resource for epidemic control among multiple noninteracting populations. We show that the optimal resource allocation depends on many factors including the size of each population, the state of the epidemic in each population before resources are allocated (e.g.

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Journal Articles

Cost-Effectiveness of Improved Adherence to Antiretroviral Therapy

GS Zaric, A Bayoumi, Margaret L Brandeau, Douglas K Owens
Value in Health , 2003
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Journal Articles

HIV Transmission and the Cost-Effectiveness of Methadone Maintenance

GS Zaric, Paul G. Barnett, Margaret L. Brandeau
American Journal of Public Health , 2000

OBJECTIVES: This study determined the cost-effectiveness of expanding methadone maintenance treatment for heroin addiction, particularly its effect on the HIV epidemic.

METHODS: We developed a dynamic epidemic model to study the effects of increased methadone maintenance capacity on health care costs and survival, measured as quality-adjusted life-years (QALYs). We considered communities with HIV prevalence among injection drug users of 5% and 40%.

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