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We hope you enjoy the Summer edition of the Society for Medical Decision Making Newsletter
SMDM Newsletter
Welcome

Welcome

From the Editor
by A. Scott LaJoie, PhD, MSPH
From the President
by Anne Stiggelbout, PhD


Society Updates


Society Updates

Elections Still Open - Vote Today
Education Committee

Career Development
SMDM Journal


 

SMDM Meetings


SMDM Meetings

2012 Biennial SMDM European Meeting
First Hand Reports
Meeting Photos

2012 North American Meeting


Commentary



Commentary

Choosing Wisely Campaign
by Robert M. Hamm, PhD
Supreme Court Decision
by Dena M. Bravata, MD, MS
International Engagement
by Joseph L. Mathew, MD




Other News

Other News

Members in the News
Students in the News
Recognition of Lifetime Contributors






Events and Opportunities

Be sure to take advantage of all of the events and opportunities SMDM has to offer.
2012 North American Meeting
Opportunities to Volunteer
Job Postings
Support SMDM
Join SMDM on Facebook
Contact Us




Editors

A. Scott LaJoie, PhD, MSPH, Editor-in-chief, University of Louisville
lajoie@louisville.edu
Donald A. Brand, PhD, Senior Editor, Winthrop University Hospital
dbrand@winthrop.org

Scott B. Cantor, PhD, Senior Editor, The University of Texas MD Anderson Cancer Center
sbcantor@mdanderson.org


Contributing Writers

Ahmed Bayoumi, MD, MSc, University of Toronto
Ava John-Baptiste, PhD, MHSc, St. Michael's, Cancer Care Ontario & Women's College Research Institute
Gunhild Hagen, MPhil, Norwegian Knowledge Centre for the Health Services
Scott Braithwaite, MD, MS, FACP, NYU School of Medicine
Robert M. Hamm, PhD, University of Oklahoma Health Sciences Center
Dena M. Bravata, MD, MS, Castlight Health
Joseph L. Mathew, MD, Post Graduate Institute of Medical Education and Research






From the Editor

by A. Scott LaJoie, PhD, MSPH, Editor-in-chief, University of Louisville

A. Scott LaJoieWelcome to the summer edition of the SMDM newsletter! And, summer it is for sure – temperatures in Kentucky at the time of my writing are nearing 104 degrees Fahrenheit. This summer also marks the historic ruling returned by the United States Supreme Court upholding the Patient Protection and Affordable Care Act. As the details of the 193-page ruling are digested by scholars and pundits alike, I am confident many of our SMDM members will be engaged in thoughtful and informed discussions. Exactly how this Act will influence healthcare in this country is unknown; our membership can and probably should be at the table crafting the policy modifications needed in response to this Act. Already some SMDM members are influencing the programs being piloted by the Patient-Centered Outcomes Research Institute (PCORI). As many readers know, PCORI is a U.S. Congress-authorized initiative to fund research that will facilitate the provision of evidence-based health care and shared decision making to improve health outcomes.

Recently, I attended the European SMDM meeting in Oslo, Norway. Despite the record number of attendees, the meeting provided ample opportunities for engaging with others. The quality of research and especially the keynote and invited speakers easily rivaled the best of the North American SMDM meetings. Please see my first hand report below.

Special thanks to all of our contributing writers to this issue. If you are interested in submitting an article for our next issue, feel free to let me know.


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From the President

by Anne Stiggelbout, PhD, Leiden University Medical Center
Anne Stiggelbout, President

Summer has arrived, even though the weather in Western Europe does not give us that impression. At our European meeting in Oslo, temperatures did not rise above 20oC, but this didn’t prevent the meeting from being a big success. See elsewhere in this Newsletter for details, but as President I can say that it was a very exciting and high quality meeting. This was a truly international meeting, with registrants from 48 countries representing all continents except Antarctica! As an example, the short course on shared decision making and decision aids I gave with Marilyn Schapira, MD, MPH, and Dana Alden, PhD, was attended by 19 individuals representing 14 nationalities: 8 from Europe, 3 from the North America, 4 from Asia, and 4 from Africa. Given my mission statement to increase the international presence at SMDM when I ran for President, I cannot be anything but extremely happy with this turnout. The meeting also saw presentations covering the full breadth of research on medical decision making, from modeling and cost effectiveness analysis to shared decision making and risk communication, judgment and decision making, and even ethical and legal aspects. Another highlight for me was the SMDM collaborative workshop with Health Technology Assessment International (HTAi), in which members from both societies discussed issues related to personalized medicine (PM). We will repeat this workshop on June 24 at the HTAi meeting in Bilbao. These two workshops are the result of collaboration between the two societies that was started by Marilyn Schapira during her presidency. This collaboration will hopefully result in two or three white papers on issues related to PM. In any case, Marilyn managed to organize an excellent symposium!

In Oslo, members of the International Engagement and Business Development committees discussed their wish to organize a small meeting and short courses in southeast Asia in 2013. This will be quite a challenge but, again, a very exciting one! As a first step, Mark Roberts, MD, MPP will teach an introductory course on decision modeling during a public health conference in Singapore in October 2012 organized by the National University of Singapore. Members who have contacts in the region and want to think along with us, please contact Jill Metcalf (jill.metcalf@smdm.org) or me (a.m.stiggelbout@lumc.nl). Finally, the organizers of the Paris 2014 meeting, Gwenaelle Vidal-Trecan, MD, PhD, and Isabelle Durand-Zaleski, MD, PhD, presented some of their ideas for the next European meeting.

And now we are looking forward to the North American Annual Meeting in Phoenix in October. The abstracts have been reviewed, and by the time you read this Newsletter, those of you who submitted an abstract will have been notified about acceptance. Hopefully, many of those that I met in Oslo will be there again, as well as many others. I am looking forward to seeing y’all there!



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Elections Still Open - Vote Now

Vote Today

Voting for the SMDM Board of Trustees is Open June 19 – August 21!

This year, SMDM members are electing a President Elect, Vice President Elect, Secretary-Treasurer Elect and 3 Trustees.

Click on the vote button to review biographies and personal statements from the candidates and to cast your vote.


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Education Committee

by Ahmed Bayoumi, MD, MSc, Education Committee Co-Chair
Ahmed Bayoumi, Education Committe Co-Chair

Report on Core Short Courses

The SMDM Core Short Courses will be launched at the 2012 North American Annual Meeting in Phoenix. The core courses are an initiative to ensure that the short course offerings each year include the “basics” of medical decision making. The curricula will be offered at an introductory level, so that someone coming to the meeting without a lot of background in such areas would be able to learn enough to attend the meeting.

Our goal is to have core courses in four foundational aspects of medical decision making: the psychology of medical decision making, decision modeling, cost-effectiveness analysis, and shared decision making. For the 2012 meeting, we will have introductory level courses in each of these areas; by 2013 there will be full core courses that have the following characteristics:
  • A half day in duration
  • Involve a diverse group of faculty members
  • Course materials that are owned by SMDM and will be used for future courses.
Each course will have a designated director and the course content will be established by the directors in consultation with the education committee chair, the incoming chair, and the short course chairs.

Future plans include granting a certificate for individuals who attend all four courses. Once the core courses are established, we are also interested in expanding to more courses at an advanced level. There are lots of opportunities to get involved and volunteers are invited to contact the education committee.


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Career Development Committee

by Ava John-Baptiste, PhD, MHSc, Career Development Committee Co-Chair

Announcing the 2012 Mentoring Program

Ava John-BaptisteThe SMDM Career Development Committee is excited to offer our one-to-one mentoring program this year. These sessions at the Annual Meeting offer the opportunity for new meeting attendees, trainees, junior faculty, and others to meet and get advice from established members of the Society in an informal setting. The purpose of the programs is to provide mentoring about career trajectories and research topics as well as to establish new networks of colleagues. Other potential discussion topics include navigating the annual meeting, discussion about presented research, advice and insight about professional development, or how to become more active in the Society.

Be on the lookout for more announcements in the upcoming months!

For more information or to participate, please contact: Ava John-Baptiste, PhD, MHSc, a.john.baptiste@gmail.com or Amy Tawfik, HBSc, PhD Candidate, amy.tawfik@utoronto.ca

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SMDM Journal: Medical Decision Making
 

Medical Decision Making JournalThe May/June 2012 Issue of Medical Decision Making is available online.

Please be sure to check it out here.





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2012 Biennial European Meeting


First Hand Report: Great Success

by Gunhild Hagen, MPhil, Norwegian Knowledge Centre for the Health Services

Gunhild HagenGreetings from Oslo (the green and blue city of salmon, expensive alcohol and “socialist medicine”)! June 10 - 12, the 14th biennial European SMDM meeting was held at the Department of Health Management and Health Economics at the University of Oslo. Two-hundred and seventy-five SMDM members, old and new, from 48 different countries gathered in what is said to be a record for the European SMDM meeting. The theme for this year’s conference was "Preventing Infections in a Globalized World - What Can Decision Analysts Do?” It’s difficult to sum up a very extensive program in just a few words, and it seems almost unjust to mention only a few when so many people participated in making this year’s conference a memorable event. Still, some events have to be reported on.

Monday morning, Director General for Health and Chief Medical Officer of Norway, Bjørn Inge Larsen, MD, opened the conference by sharing his experience with decision making under uncertainty in the case of the 2009 swine flu pandemic. We also got more than a bit scared when he made us aware that the entire genome of smallpox is mapped, published and apparently not too hard to replicate.

The conference dinner at the Akershus fortress, I am told, was excellent with very impressive folk dancing. The highlight of the conference, however, was for many people Tuesday's keynote speaker, Professor Gerd Gigerenzer. His talk was funny, gave room for thought and was also very inspiring. He reminded us, among other things, that relative risk is not a concept easily grasped among patients and doctors. His talk was important, because it’s often very easy to forget that the main audience of our research is not each other, but decision makers at all levels of the health care system. My guess is that his books showed an upturn in sales in the days after the conference, I know I at least have looked them up on Amazon.

As always with SMDM, choosing which parallel session or workshop or panel to attend proved real a challenge (why must the interesting things always collide?). One with a more striking title was “Cost-effectiveness analysis: Born in the USA, spurned by Americans, adopted by Europeans” hosted by Uwe Siebert, MD, MPH, MSc, ScD, Ivar Sønbø Kristiansen, MD, PhD, MPH, (hereinafter referred to as “children” of Milt Weinstein), Milt Weinstein, PhD, and Olivia Wu, MSc. Tuesday evening all participants were invited to a reception free of charge at the Oslo city hall, the place where the Nobel Peace Prize is awarded. As a native Oslo dweller, I had never before visited the inside of the City Hall (although it’s generally open to the public) and to my surprise I found it extensively decorated with murals.

It was a great meeting with plenty of opportunity to meet old friends and new. It also reminded me how friendly a society SMDM is. My guess is that many of this year’s new SMDMers will continue to participate in the society in the years to come. Many thanks to the co-chairs Ivar Sønbø Kristiansen, Peder Halvorsen, MD, PhD, Elisabeth Fenwick, PhD, MSc, and Uwe Siebert for a diverse and interesting program and to the organizers and students from the Department of Health Management and Health Economics for producing a conference that ran smoothly and was easy to navigate.

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First Hand Report: Outstanding Program

by A. Scott LaJoie, PhD, MSPH, University of Louisville

Using examples from the 2009 H1N1 pandemic, Professor Neil M. Ferguson, of the Imperial College London, demonstrated the basic principles of infectious disease modeling and encouraged listeners to continue to develop methods for making decisions with imperfect information. Bjørn-Inge Larsen, the Chief Medical Officer of Norway, introduced his lecture on pandemics by alluding to Schrödinger's cat-in-the-box paradox from quantum physics: the cat may or may not have been killed inside the box by a random event. According to quantum theory, the cat is both alive and dead until an observer opens the box. Likewise, he said, it is impossible to know how severe a pandemic will be until it arrives. Decision makers, such as those at the World Health Organization, must choose to declare a pandemic and/or recommend a vaccine without having perfect information. Acting without perfect information, for instance without knowing the risks of side-effects from a vaccine, can lead to unintended consequences. Dr. Larsen implored our Society to continue to develop evidence based decision making approaches for deciding whether to declare a pandemic and implement a vaccine program.

Professor Gerd Gigerenzer’s keynote lecture, “Helping doctors and patients make sense of health statistics,” explained how the presentation of statistical information can sometimes obfuscate meaning and lead to errors. As an example, Dr Gigerenzer provided a real-world example in which the risks of thrombosis brought on by one contraceptive compared with another were misinterpreted by the news outlets as meaning a 100% increase in risk – despite the fact that the absolute risks were very small; as a consequence of the reporting, British women apparently stopped taking the oral contraceptives and for some, unwanted pregnancies occurred.

The problem, Gigerenzer said, stems from the failure of medical schools to adequately teach doctors risk literacy and the resulting “intellectual inaccuracy.” He encouraged medical professors in the audience to introduce or strengthen the basic education of students in medical statistics. More effective risk communication is called for, as well. For example, providing clear information about the “class” to which the risk information refers is helpful.

To illustrate:
Suppose the prevalence of cancer in a given population of women is 0.01, the sensitivity of a diagnostic test is 0.90, and the false positive rate is 0.09. What is the likelihood that a patient who tests positively has cancer?
-vs-
Out of 100 women, 1 has cancer. If a woman with cancer is evaluated with a diagnostic test, she will test positively 9 out of 10 times. If a women without cancer is evaluated, she will test positively 9 out of 100 times. What is the likelihood that a woman with a positive test result has cancer?

The first presentation requires a working knowledge of Bayes theorem and the application of some mathematical computations. Intuition usually fails when information is presented this way. The latter presentation, however, is much more often correctly interpreted and is better suited for fast, intuitive decisions, Gigerenzer said. Thus, Gigerenzer implores risk communicators to convert conditional probabilities to natural frequencies and to specify the class to which data refers. He showed examples of “Fact Boxes” that present medical risk information using a natural frequency approach. Below, is an example of a fact box from the website (http://www.harding-center.com/fact-boxes/mammography ) of Gigerenzer’s lab, the Harding Center for Risk Literacy.


Breast Cancer Early Detection

Another example from the keynote presentation came from a recent study from the Harding Centre (Wegwarth, 2012). The authors found that the majority of participants (over 400 primary care physicians in the U.S.) believed that increased survival rates and higher incidence rates prove that cancer screening tests reduce mortality rates. This incorrect belief that screening tests save lives, he said, reflects a failure to understand “lead-time bias.” An example from the presentation illustrates the misunderstanding: Imagine a group of men who, after showing symptoms, are diagnosed with prostate cancer at age 67 and die 3 years later from this cancer. (The 5-year survival is 0%). Another group of men are given a screening test and the cancer is found much earlier (age 60); however these men still die at age 70. The 5-year survival rate increases from 0% to 100% without a single life having been saved.

Professor Gigerenzer emphasized that we need to do a better job teaching our medical students risk literacy skills and to be more transparent about risk information in our journals and patient literature. Failing to do so, he said, will eventually cause patients to loose trust in medicine.

Reference:
Wegwarth, O., Schwartz, L. M., Woloshin, S., Gaissmaier, W., & Gigerenzer, G. (2012). Do physicians understand cancer screening statistics? A national survey of primary care physicians. Annals of Internal Medicine 156:340-349.


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European Meeting Photos
 

General Session


2012 European Program


Poster Sessions

2012 European Poster Session


Social Program


2012 European Meeting Social Event

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2012 North American Meeting

by Scott Braithwaite, MD, MS, FACP, NYU School of Medicine

2012 North American Meeting

An embarrassment of riches awaits you at the SMDM Annual Meeting, October 17-20 in Phoenix, AZ.

The meeting theme, Using health information technology for better health decisions, builds on the critical mass of local expertise in bioinformatics at Arizona State University and Mayo Clinic Arizona. The theme also aligns with questions under intense debate within the federal Office of the National Coordinator for Health Information Technology (ONC): How should health information systems evolve to facilitate patient-centered medicine, including communication of information, consideration of values, prioritization, guideline application, quality evaluation, and incentivization? Leadership from this office will be joining us at the meeting, and they will be featured in a “Reports from the Field” session (see below). Attendees will be challenged to consider how medical decision-making methods could improve development of health information systems. Will rubber meet the road or the sky? Be there and participate in this important discussion.

INFORMS: The Institute for Operations Research and the Management Sciences (INFORMS), an 8000-or-so-strong congregation of operations research experts and modeling mavens, shifts the intellectual center of gravity wherever it assembles. In 2012, this juggernaut of brainpower lands in Phoenix, and our two meetings have been designed to overlap. We will be co-hosting many sessions, including exciting topics like health system quality improvement and error reduction. If you’ve ever contemplated attending INFORMS or checking them out, this is the year to do it. Our combined sessions will culminate in a symposium organized by our very own Mark Roberts, MD, MPP, past SMDM President, who will assemble an international panel of experts to discuss parallels and differences between increasing safety in aviation and in healthcare.

Reports from the Field: Leadership from the Patient-Centered Outcomes Research Institute (PCORI), Agency for Healthcare Research and Quality (AHRQ), and ONC will share goings-on and talk about their victories, defeats, and stalemates. Get an inside view on these important organizations and a sneak peak at the issues they are wrestling with. What’s next on their agendas? Where will funding be headed tomorrow? Come and find out.

Stakeholder Symposium/Workshop: This symposium will be the “grand finale” of the 2012 SMDM meeting: SMDM researchers will be able to brainstorm and dialogue with prominent decision makers who are particularly interested in their areas of investigation. The Stakeholder Symposium will combine elements of workshops and roundtables, catalyzing two-way conversations. Goals will be (a) to enable stakeholders to share perspectives where additional work is needed, (b) to enable methodological experts to share perspectives of where scientific work is under-used, and (c) to generate concrete ideas for future collaboration between stakeholders and methodological experts. Participating stakeholders include leaders from a wide variety of stakeholder groups: consumer advocacy, payers, funders, regulators, and health authorities. Participants will include Nirav Shah, Commissioner of Health, New York State; John Santa, Consumers Union; Robin Gelburd, FAIR Health; Jean Slutsky, AHRQ; Moupali Das, San Francisco Health Department; and John Blandford, Centers for Disease Control and Prevention.

Career development and networking: Would you like a job? Or a better job? Or would you like to navigate the next step in your career arc? The SMDM annual meeting draws international leaders and job-creators in academia, industry, and government. Meet them in person. Get their advice! This is a friendly meeting.

Last but not least: If you’ve never been to the Grand Canyon, now is the time to go. Take the family! The greater Phoenix area is a paradise of ridge walks, purple sunsets, cacti, open sky, and proximity to some of the most dramatic and unearthly desert landscapes. If you inhabit a densely populated urban center, you can luxuriate in space and openness. Phoenix is also home to the Heard Museum, which has the world’s most impressive collection of Native American art, crafts, and cultural artifacts.

It is very unusual and special to have an international scientific event in the middle of a desert – bring your cameras, hiking boots, and water bottles.




2012 Annual Meeting Planning Committee

Meeting Co-Chairs: Scott Braithwaite, MD, MS, FACP, and Liana Fraenkel, MD, MPH
Scientific Review Committee Co-Chairs: Mary Politi, PhD, Eran Bendavid, MD, MS, and Paul K. Han, MD, MA, MPH
Short Course Co-Chairs: Katia Noyes, PhD, MPH, Claire Wang, MD, ScD and Stacey Sheridan, MD, MPH

For additional details on the meeting, click here.


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Commentary


SMDM Endorses Choosing Wisely Campaign

by Robert M. Hamm, PhD, University of Oklahoma Health Sciences Center

Robert M. Hamm, PhDSMDM has endorsed the American Board of Internal Medicine (ABIM) Foundation's Choosing Wisely campaign. This initiative aims to reduce wasteful spending by invoking physicians' professionalism to increase their commitment to avoiding treatments, diagnostic procedures, or other practices that lack evidence of cost effectiveness (http://choosingwisely.org/) The Choosing Wisely campaign partners with specialty societies committed to identifying high cost, but low value, medical interventions that are often unnecessary in certain situations. Each society agrees to name 5 such interventions.

This innovative approach, recently suggested by Brody (2010), has received widespread endorsement (Beller, 2012; Berwick & Hackbarth, 2012; Cassel & Guest, 2012). Professional societies take leadership in cutting costs, while partnering with patient and consumer organizations to design and disseminate educational messages.

Nine specialty societies in the United States have already identified their lists of "Five Things Physicians and Patients Should Question" (http://choosingwisely.org/?page_id=13):

  1. American Academy of Allergy, Asthma & Immunology
  2. American Academy of Family Physicians
  3. American College of Cardiology
  4. American College of Physicians
  5. American College of Radiology
  6. American Gastroenterological Association
  7. American Society of Clinical Oncology
  8. American Society of Nephrology
  9. American Society of Nuclear Cardiology

The lists represent specific, evidence-based guidelines physicians and patients should discuss to help them make wise decisions about the most appropriate care based on their individual situations. Eight additional specialty societies and 11 "Consumer Communication Collaborator" organizations (http://choosingwisely.org/?page_id=10) are currently working on the process. Campaign leaders are continuing to work with the societies to reduce wasteful practices by mounting initiatives to call attention to the pertinent guidelines.

SMDM wants to encourage our members to look for ways to participate in or support the Choosing Wisely campaign, whether through participating in their own clinical specialty’s process of selecting 5 targets and promoting behavioral change, offering methodological expertise, or encouraging their home institutions to support participating specialties in discovering ways to attain their respective goals. While it should be straightforward for you to offer your methodological expertise to your own specialty society, to offer it more broadly you might consider participating in the SMDM's Methodology Concierge program. Contact Scott Braithwaite (scott.braithwaite@nyumc.org) to identify your methodological expertise and indicate your availability.

Each specialty society faces the challenge of designing a campaign to communicate with its members to motivate behavioral change and to communicate with its patients regarding the low value that a particular practice offers. Often a given practice reflects high patient demand. If you have experience in professional behavior change or patient persuasion, your expertise might be particularly useful to specialty societies. You could let Scott know or contact the ABIM Foundation directly through the choosingwisely.org web site.

Choosing Wisely Campaign


References
Beller, G. A. (2012). Tests that may be overused or misused in cardiology: The Choosing Wisely (R) campaign. J Nucl Cardiol.

Berwick, D. M., & Hackbarth, A. D. (2012). Eliminating waste in US health care. Jama, 307(14), 1513-1516.

Brody, H. (2010). Medicine's ethical responsibility for health care reform--the Top Five list. N Engl J Med, 362(4), 283-285.

Cassel, C. K., & Guest, J. A. (2012). Choosing wisely: helping physicians and patients make smart decisions about their care. JAMA, 307(17), 1801-1802.
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The Supreme Court Decision on the Affordable Care Act:

The Work of SMDM is More Important than Ever in this Era of Consumer-Directed Healthcare

by Dena M. Bravata, MD, MS, Chief Medical Officer, Castlight Health; Affiliate, Center for Primary Care & Outcomes Research, Stanford University

Dena BravataThe members of SMDM have been responsible for landmark research on the psychology of patient decision-making and the evidence on effective and cost effective care that inform clinical practice guidelines and should inform patient decision-making. The recent Supreme Court decision on the Affordable Care Act will result in expansions of “consumer-directed” health plans for millions of Americans. These health plans not only demand that consumers pay more out-of-pocket for their healthcare but also that they play a more active role in determining the care they receive and the providers from whom they receive it. Consumers urgently need the work of the members of SMDM translated into a usable, accessible format to make wise decisions, increasingly without the help of their healthcare providers.

What information can consumers access today to make informed decisions about healthcare providers and facilities? Well, some can access limited information about the cost of services from their health plans’ sites, provided they have insurance through one of the few commercial carriers with a cost estimator tool. However, there aren’t tools that provide comprehensive information about the cost effectiveness of treatment or test alternatives consumers may be considering. They can access quality information about hospitals from sites like Healthcare.gov and LeapfrogGroup.org, although interpreting the information on these sites can be cumbersome and they don’t provide information for patients seeking many common services like psychiatric care. Consumers can find information about ways to save money on prescription drugs at their PBM’s (pharmacy benefit manager) websites; however, not if they are trying to find where they can get low cost drugs like the $4 prescriptions typically offered outside their pharmacy benefit. They can go to an overwhelming number of sites including excellent ones like the CDC’s, ConsumerReports’s, and the Mayo Clinic’s that provide detailed information about clinical guidelines and treatment options by condition or symptom; however, not if they want those guidelines to reflect their own health status or preferences—for example, if they have two or more chronic conditions. If consumers want to compare providers, they can access information about doctors’ educational information and some patient satisfaction survey data on sites like Healthgrades; but if they want clinical quality information, they are largely out of luck. Notable exceptions include those consumers who live in Minnesota, where they can access clinical quality data for a few common conditions provided by the Minnesota Community Measurement organization at the group practice level (not individual provider) at MNHealthScores.org. Patients comparing the outcomes and experience of surgeons from whom they may receive bypass surgery have a vastly better chance of finding information than those looking for a nurse practitioner for their routine primary care or an Ob/Gyn to deliver a healthy baby.

Clearly, patients in the increasingly self-service world of consumer-directed healthcare require comprehensive information (for example, personalized clinical guidelines displayed with the relevant cost and quality of those who provide that care) presented in accordance with the best practices for informing preference-sensitive decision-making—the best practices that have been rigorously developed and evaluated by members of SMDM.

By dramatically expanding the number of patients in consumer-directed plans who’ll be shopping for care on the exchanges and also increasing the transparency efforts as mandated by the Affordable Care Act, the Supreme Court decision provides SMDMers with a compelling opportunity to inform both the data and methods of presenting those data available from transparency tools to directly inform consumers’ choices of healthcare services and providers.

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International Engagement

by Joseph L. Mathew, MD, Post Graduate Institute of Medical Education and Research

Joseph MathewOn Monday, June 11, 2012, representatives from the SMDM International Engagement Committee and the 2012 (Europe) SMDM International Scholarship Awardees convened in Oslo, Norway. The two-fold objective of the meeting was to network with other Awardees and to better understand the current situation in developing countries as a way for SMDM to facilitate improvements. The SMDM International Engagement Committee was represented by Jeff Van den Ende, MD, PhD, (Netherlands), Peder Halvorsen, MD, PhD, MPH, (Norway) and Joseph Mathew, MD, (India). The SMDM International Scholarship Awardees represented a global spread and included countries from Africa (Ghana, Burkina Faso, Uganda, Ethiopia, Tunisia), Asia (India), Eastern Europe (Ukraine, Georgia), and Latin America (Brazil, Colombia). The highlights of the discussion during the Meeting were as follows:
  1. Brief Explanation of the 2012 Abstract Selection Process.

Peder Halvorsen and Jeff Van den Ende outlined the process of selecting abstracts for the SMDM 2012 (Europe) meeting. The important messages for members from developing countries are:

  • Abstracts of various types are accepted at the SMDM Annual Meeting. The key requirements is that it should be clearly presented and contain a central idea and a clear message. It is not necessary to submit research abstracts alone. SMDM Meetings include important abstracts reflecting a policy or a process change as well.

  • SMDM Annual Meetings have dedicated time allocated for poster viewing. During these sessions, senior members are often present to discuss (their own as well as other) posters. This provides for high quality of content and also the opportunity for networking amongst members. Meetings held at hotels provide an opportunity for posters to be presented during a breakfast session.

  • The SMDM meetings in North America often encourage poster presenters to bring handouts, as a means of wider dissemination of their work.

 

  1. Current situation of decision-making in Developing Countries.

SMDM International Scholarship awardees highlighted various issues that hampered rational decision-making systems in their respective countries. Some of the issues were common across developing countries, while others were specific to particular situations. The highlights are:

  • There is an emerging interest amongst health-care stakeholders in developing countries to develop a scientific decision-making system.

  • Some countries have Units in the Ministry of Health; while others are trying to include MDM in the curriculum of Universities. Some countries in eastern Europe are trying to emulate the processes used in Western Europe.

  • However, many countries lack a robust system in place.

  • Sometimes, there are rapid changes in Government officials, especially Ministers in some countries, which adversely affects the plans and actions set in motion by the previous leadership.

  • There are islands of excellence in scientific decision-making processes/systems in some countries. These include Cochrane Centres in India, Brazil, Argentina etc. There are also HTA Units and Health Economics units in some countries. However, integration amongst these disciplines is lacking.
     

  1. Participants’ Expectations from SMDM.

The SMDM International Scholarship Awardees outlined their expectations from the SMDM Annual Meeting as well as engagement with the Society. These include:

  • Gain in personal knowledge and expertise.

  • Networking opportunities with experienced scholars and researchers.

  • Development of a joint research study protocol.

  • Development of short courses for members from developing countries.

  • Enhancing collaboration between researchers in developed and developing countries.

  • Building a critical mass of people interested in a long-term development of SMDMs vision and goals in developing countries.

  • Development of SMDM national/regional chapters.



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Other News


Member News

The multimedia decision aid program: Treatment Options for Crohn's Disease EmmiDecide(R) program won a ClearMark Plain Language Award of Distinction. Geri Lynn Baumblatt, MA, co-wrote and developed the program with the Emmi production team and a team of medical advisors. geri@emmisolutions.com


Poker Face in Mental Health Practice by Ansar Haroun, MD, UC San Diego School of Medicine, was recently published by Norton & Co. This book reviews deception in psychiatric practice. Dr Haroun first became interested in this topic during his time with the San Diego Superior Court, where he evaluated many criminal defendants, who were not always truthful, and then during his deployment to Afghanistan with the US Army, where he consulted with Psy. Ops around issues of deception. ansar.haroun@gmail.com
 

Josh Hemmerich, PhD, Arthur Elstein, PhD, and William Dale, MD, PhD, report that their manuscript on the decision making of surgeons and geriatricians in an abdominal aortic aneurysm simulation was recently accepted by the Journal Social Science & Medicine. The article includes decision making data from the experiment with physicians, as well as a laboratory validation of the emotional effects of the simulation.  jhemmeri@medicine.bsd.uchicago.edu


Congratulations to Hector and Ava John-Baptise on the birth of their daughter, Emilee Angeline John-Baptiste born on March 26th!  a.john.baptiste@gmail.com
 


This month, the Institute for Clinical and Economic Review (ICER), a leading academic comparative effectiveness research group based at the Massachusetts General Hospital’s Institute for Technology Assessment, announced that SDM member, Christopher Jones, DPhil, MSc, FRSM, was among a group of new members named to the 2012 New England Comparative Effectiveness Public Advisory Council (CEPAC). The 19 members of CEPAC come from all six New England states. The group’s goal is to provide objective, independent guidance on the application of medical evidence to clinical practice and payer policy decisions across the region. Supported by a federal grant from the Agency for Healthcare Research and Quality (AHRQ), and with backing from a consortium of New England state health policy leaders, CEPAC consists of practicing physicians and methodologists with experience in evaluating and using evidence in the practice of healthcare, as well as patient/public members with experience in health policy, patient advocacy and public health. Dr. Jones joined the University of Vermont in 2011, as Assistant Professor of Surgery, where he directs the newly formed Global Health Economics Unit in conjunction with the Center for Clinical and Translational Science, UVM College of Medicine.  chris.jones@vtmednet.org


Eric Nsiah-Boateng, MPH, Bsc, National Health Insurance Scheme (NHIS), Ghana, reports: I am really happy to use this platform to share the good news with members of Society for Medical Decision Making (SMDM) and the general public. Between February and April, 2012, I have received two travel awards to attend International Conferences in Oslo, Norway, and Bilbao, Spain, and two scholarships to pursue masters programs in the USA and Netherlands. The awards are as follows:  SMDM International Travel Scholarship to attend the 14th Biennial European Meeting in Oslo, Norway, June 10-12, 2012; Health Technology Assessment international (HTAi) Travel Grant to attend the 9th HTAi Annual Meeting in Bilbao, Spain, June 24-27, 2012. I will also present my research abstract entitled “Performance Assessment of Ga District Mutual Health Insurance Scheme in the Greater Accra Region, Accra, Ghana”; Lions Club Maastricht Trajectum Scholarship to pursue a master’s degree in Public Policy and Human Development at Maastricht Graduate School of Governance (MGSoG), Maastricht University, Maastricht, Netherlands; and a partial scholarship to pursue a master’s degree in International Health Policy and Management at the Heller School for Social Policy and Management, Brandeis University, Massachusetts, USA. I would like to thank God and Authorities of these Associations and Institutions for these awards.  nsiahboateng@gmai.com

 

In March, Syllene Nunes, MD, PhD, IHEA, Nunes & Salvador Ltda, received the 2012 Women of Excellence award offered by The Center of Industries of the State of Sao Paulo South. In April, Dr. Nunes gave a lecture in the Annual Meeting of The American Society for Laser Medicine & Surgery (ASLMS), emphasizing the importance of the cost effectiveness and technology incorporation in laser field. And in May, Dr. Nunes attended a meeting with Prof. David Naylor, President of The University of Toronto at CCBC focusing the improvement of Brazil-Canada's partnerships in scientific research and industry (new products). sylgil@uol.com.br

 

Ankur Pandya, PhD, Weill Cornell Medical College, reports, “I defended my dissertation on April 6, 2012, accepted an assistant professor position at Weill Cornell Medical College (Department of Public Health, Division of Health Policy), and my first child was born on May 7th (mother and baby are in great health). It has been a busy month!”  apandya@fas.harvard.edu
 

In October, Michael B. Rothberg, MD, MPH, will be moving to the Cleveland Clinic to become the Vice Chair for Research in the Medicine Institute and Director of the Institute's Center for Research and Innovation. He looks forward to working closely with Michael W. Kattan, MBA, PhD. He will also be recruiting additional faculty, so stay tuned!  Michael.Rothberg@bhs.org
 

Jane R. Schubart, PhD, MS, MBA, Assistant Professor, Department of Surgery, Penn State College of Medicine, was awarded the 2012 Mark J. Young International Health Policy Conference/Workshop Scholarship, Pennsylvania State University. Dr. Schubart will use the funds provided by this award to attend the International Conference on Communication in Healthcare, European Association for Communication in Healthcare to be held at St. Andrews University, Scotland in September where she will present two manuscripts describing her research initiatives using an interactive decision aid for advance care planning, Making Your Wishes Known (MYWK), developed by colleagues Michael J. Green, MD, MS, and Benjamin H. Levi, MD, PhD. Studies have demonstrated that users are highly satisfied with MYWK, that even patients with advanced cancer, heart disease, lung disease, and amyotrophic lateral sclerosis find MYWK easy to use, and that doing so does not raise users’ anxiety or decrease their sense of hope. Study results also demonstrate that use of MYWK improves patients’ knowledge about advance care planning; generates an advance directive that users report accurately reflects their wishes regarding future medical decisions; and can help healthcare providers make decisions on behalf of patients who cannot speak for themselves.  jschubart@hmc.psu.edu
 

It is with great pleasure that we share our research team's latest publication entitled  ''Assessing patients' involvement in decision making during the nutritional consultation with a dietitian.'' It was published in March, 2012 in Health Expectations. To the best of our knowledge, this research project is the first to analyse decision-making process during nutritional consultations with a validated and reliable third-observer instrument, which in this case is the OPTION scale (Observing Patient Involvement in Decision Making). Results from this study were previously presented before publication during the 33rd Annual Meeting of SMDM in October 2011 in Chicago, IL. The research team includes Hugues Vaillancourt RD, MSc(c), France Légaré MD, PhD, Annie Lapointe RD, PhD, Sarah-Maude Deschênes RD, MSc, and Sophie Desroches RD, PhD (corresponding author). The full text article is available on the website of Health Expectations; The article's abstract and reference in PubMed.



Dave Vanness, PhD, was promoted to Associate Professor (with tenure) at the Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health on July 1, 2012. dvanness@wisc.edu

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Student News

Congratulations to the following student members of SMDM

Policarpo deMattos, PhD; Graduation Date - 12/01/2012; pcdematt@ncat.edu; Area of Study - Industrial and Systems Engineering; Advisor - Eui Park, PhD; Dissertation Title - Modeling Decision Making in Trauma Centers from the Standpoint of Complex Adaptive Systems; Position Seeking - Professor, Teaching or Research University
 

Negin Fouladi, PhD, Health Policy & Health Services Research; Graduation Date - 06/01/2012; Negin.Fouladi@uth.tmc.edu; Area of Study - Translation and Dissemination research; Evidence-Informed Decision-Making; Advisor, Robert Morgan, PhD; Dissertation Title - Translating Research into Action: Information Needs of Decision-Makers in Healthcare; Position Seeking - Post-doc; Academic; Government; Non-profit research
 

Hawre Jalal, MD, MSc, PhD Candidate; Graduation Date - 12/01/2012; jala0018@umn.edu; Area of Study - Health Decision Sciences; Advisor - Karen M. Kuntz, ScD; Dissertation Title - Long-term Comparative Effectiveness of Rheumatoid Arthritis Treatment Strategies; Position Seeking - Academic; Past Presentations at the SMDM Annual Meeting - Propensity Score Methods for Estimating Causal Treatment Effects Using Observational Data, 2010, Causal Inference and Causal Diagrams in Medical Decision Making, 2010, The Measurement of Health States, 2011, Methods of Disease Model Calibration: Theory and Practice, 2011
 

Brian Wells, PhD; Graduation Date - 05/01/2012; wellsb@ccf.org; Area of Study - Epidemiology and Biostatistics; Advisor - Michael Kattan, PhD; Dissertation Title - The Prediction and Prevention of Colorectal Cancer; Position Seeking - Academic; Past Presentations at the SMDM Annual Meeting - Comparison of Variable Selection Methods for the Generation of Parsimonious Prediction Models for use in Clinical Practice, 2011, Risk of Developing Heart Failure in Patients with Type 2 Diabetes on a Single Oral Agent, 2009, Predicting Six-year Coronary Heart Disease Risk in Diabetic Patients, 2008


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Lifetime Contributors

The Society for Medical Decision Making extends its heartfelt appreciation to the following members for their charitable contributions over the years. *

Pareto Level
(Contributions total $1,000 or more)
Michael Barry (’06, ’07, ’08, ’09, ’10)
Dennis Fryback (’05, ’06, ’07, ’08, ’09, ’10, ’11)
Mark Helfand (’05, ’07, ’10, ’11)
Joseph King (’06, ’07, ’08, ’09, ’10, ’11)
William Lawrence (’06, ’10, ’11)
Uwe Siebert ('11)
Frank Sonnenberg (’06, ’09)
Hal Sox (’10, ’11)
Sankey Williams (’06, ’07, ’08)
John Wong (’06, ’07, ’08, ’09, ’10, ’11)

Edwards Level
(Contributions total $750 - $999)
David Meltzer (’07, ’09)
Stephen Pauker (’06, ’09)
David Rovner & Margaret Holmes-Rovner (’05, ’06, ’07, ’08, ’09, ’11)
Marilyn Schapira (’07, ’08, ’09, ’10, ’11)
Joel Tsevat (’06, ’09, ’10)

Tversky Level
(Contributions total $500 - $749)
Robert Beck (’07)
Scott Cantor & Lisa Stone (’07, ’08, ’09, ’10, ’11)
Kate Christensen (’09)
Nananda Col (’05, ’06, ’07, ’08, ’09)
Kathryn McDonald (’07, ’09, ’10)
Jill Metcalf (’07, ’08, ’09, ’10, ’11)
David Paltiel (’07, ’09)
Mark Roberts (’08, ’09)
Bruce Schackman (’06, ’07, ’08, ’09, ’10, ’11)

von Neumann-Morgenstern Level
(Contributions total $250 - $499)
Ahmed Bayoumi (’06, ’09, ’10, ’11)
Dena Bravata (’06, ’09, ’10, ’11)
Randall Cebul (’06, ’08, ’10)
Neal Dawson (’05, ’06, ’07, ’08, ’09, ’10, ’11)
Mark Eckman (’06, ’09)
Arthur Elstein (’06, ’07, ’09, ’10)
Sara Knight (’05, ’06, ’07, ’08, ’09, ’10, ’11)
Karen Kuntz (’09, ’11)
Steven Kymes (’05, ’06, ’07, ’08, ’09)
Seema Sonnad (’06, ’07, ’09)
David Sugano (’07, ’09, ’10, ’11)

Markov Level
(Contributions total $100 - $249)
Amber Barnato (’05, ’07, ’08, ’11)
Cathy Bradley (’07)
Scott Braithwaite (’09)
Phaedra Corso (’06, ’07, ’08)
Elena Elkin (’07)
Alan Garber (’10)
Heather Taffet Gold (’08, ’11)
Peder Halvorsen ('11)
Robert Hamm (’06, ’08)
Myriam Hunink (’05, ’06, ’07, ’08, ’09, ’10, ’11)
Esther Kaufmann ('11)
Miriam Kuppermann (’06, ’07, ’08, ’09, ’10)
Lisa Maillart (’10)
Richard Orr (’05, ’06)
Brian Rittenhouse (’07)
Allison Rosen (’07)
Alan Schwartz (’07, ’10)
James Stahl (’06, ’09, ’10)
Joanne Sutherland (’08, ’09)
Thomas Tape (’10, ’11)
John Thornbury (’05)
George Torrance (’05)
Jef Van den Ende (’10)
Robert Wigton (’10, ’11)

Bayes Level
(Contributions total up to $100)
Eran Bendavid (’11)
Denise Bijlenga (’08)
Kimberly Blake (’09)
Rowland Chang (’06, ’07)
Carmel Crock (’09)
James Dolan (’09)
Arna Dresser (’10)
Ted Ganiats (’05)
Lee Green (’07, ’09)
Amit Gupta (’06)
Michael Hagen (’10)
David Howard (’09)
David Katz (’08)
Job Kievit (’09)
Kerry Kilbridge (’05, ’07, ’08)
Sun-Young Kim (’07, ’08, ’09)
Ivar Sonbo Kristiansen (’10)
Andrew Scott LaJoie (’10)
Andreas Maetzel (’09)
Daniel Masica (’08)
Thomas B. Newman (’10)
Jesse D. Ortendahl ('11)
Jane Pai ('10)
George Papadopoulos (’08)
Lisa Prosser (’08)
Michael Rothberg (’09, ’10, ’11)
Gillian Sanders (’07)
Jha Saurabh (’09)
Ewout Steyerberg (’06, ’09, ’11)
Anne Stiggelbout (’06)
Carol Stockman (’05)
Danielle Timmermans (’07)
Hugues Vaillancourt (’11)
Milton Weinstein (’09, ’11)
Robert Werner (’08)
Brian Zikmund-Fisher (’08, ’09, ’10, ’11)

*Donations received Oct. 2005 – May 31, 2012

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