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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 Scott Braithwaite, MD


SMDM Meetings



SMDM Annual Meetings

2013 North American Meeting
2014 Asia-Pacific Meeting





Commentary


Commentary

The Epidemiology and Burden of Diabetes in India and China
by Laurent Metz, MD
A Medical Decision Scientist in a Business School: What is the Value Proposition?
by Kevin D. Frick, PhD
What Matters Most
by Thom Walsh, PhD


Other News


Society Updates

Election - Vote Now
Endowment
SMDM Seeks Emeritus Members
Networking Opportunities
Policy Committee
Publications Committee

In Every Issue


In Every Issue

Medical Decision Making
Medical Decision Making-Green or Not
Members News
Recognition of Lifetime Contributors





Events and Opportunities

Be sure to take advantage of all of the events and opportunities SMDM has to offer.
Like 2013 Summer Newsletter - The Latest News from SMDM on Facebook
Renew Your Membership for 2013
Opportunities to Volunteer
Job Postings
Support SMDM
Join SMDM on Facebook
Contact Us




Editors

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
Joshua A. Hemmerich, PhD, Deputy Editor, The University of Chicago
jhemmeri@medicine.bsd.uchicago.edu


Commentators

Laurent Metz, MD, Johnson & Johnson Medical Asia Pacific
Kevin D. Frick, PhD, The Johns Hopkins Carey Business School
Thom Walsh, PhD, The Dartmouth Center for Health Care Delivery Science (guest)



Additional Contributing Authors

Scott Braithwaite, MD, New York University School of Medicine
Heather Taffet Gold, PhD, New York University School of Medicine
Elena Elkin, PhD, Memorial Sloan-Kettering Cancer Center
Jeremy D. Goldhaber-Fiebert, PhD, Stanford University
Scott B. Cantor, PhD, The University of Texas MD Anderson Cancer Center
Amy Tawfik, HBSc, PhD Candidate, University of Toronto
David Chartash, MHSc Candidate, PhD Student, Indiana University
Elbert Huang, MD, The University of Chicago Medicine
Negin Hajizadeh, MD, New York University
Lisa Prosser, PhD, University of Michigan





Scott LaJoieFrom the Editor

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

Summer is well underway – in the Northern Hemisphere, at least - temperatures are climbing, and hopefully your pace of work has slowed at little. Welcome to the summer issue of the SMDM newsletter.

In this issue, we explore how and where to expand the reaches of medical decision making. Kevin Frick, PhD, discusses his move to a business school after spending nearly two decades working within the health sciences and public health. He shows how medical decision scientists can ply their trade in alternative domains. An analysis reported by Laurent Metz, MD, explores the rising rates of diabetes in India and China. The health care challenges facing these two countries (which make up nearly 40 percent of the world population) are staggering. In the third editorial, Thom Walsh, PhD, reflects on the recent International Shared Decision Making conference held in Lima, Peru. South and Central American countries, like many others, struggle to implement health care programs and policies to increase patient engagement. One speaker boiled down the secret to improved shared decision making to a single word.

The first SMDM-Asia meeting, co-chaired by Jeremy Goldhaber-Fiebert, PhD, and Anirban Basu, PhD, will be held in January 2014 in Singapore. Professor Goldhaber-Fiebert shares the highlights of this meeting and encourages us to get our abstracts submitted by August 3rd.

Many new opportunities for members are presented in this newsletter, including new volunteer and committee roles, educational offerings, and membership modifications for our senior members.

With approval from the Board of Trustees, the newsletter is now viewable to the general public, not just to SMDM members. We hope that this increased visibility will encourage the dissemination of ideas and knowledge that make SMDM unique and valuable.

This is my final newsletter as editor and I want to take a moment to acknowledge my colleagues. Donald Brand, PhD, and Scott Cantor, PhD, as senior editors, have been instrumental in working with authors to craft interesting and timely articles. Both are highly skilled and wonderful to work with! Wendy Webber has capably managed the newsletter from behind the scenes. And, of course, Jill Metcalf and the rest of the staff at SMDM have always been helpful. Thank you all!

The SMDM newsletter team welcomes Joshua Hemmerich, PhD, Assistant Professor of Medicine, University of Chicago, as the new Editor-in-chief.

Happy reading,

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Scott Braithwaite
From the President

by Scott Braithwaite, MD, New York University School of Medicine

I hope your summer is going well. I’m going to take a break from singing the praises of unsung heroes in the Society (as in my last two contributions), and instead ask you to ponder our international relevance. Summer is an especially appropriate time to think about internationalism, at least for me, as I contemplate the good sense of my European colleagues, who take vacations very seriously.

Anne Stiggelbout, PhD, is heading up efforts to make SMDM a more relevant and happier home for international members. And, by international members, I mean not only those in Europe, but also in many areas where we are not yet well represented, such as Asia, Africa, and South America. Because SMDMers study how to improve decision making and resource allocation in healthcare, and because many countries in the world are thinking more about these issues (especially countries that have recently jumped an income class and are restructuring or establishing their health systems), there is increasing interest in input from independent scientific experts like us. Indeed, this is likely why we have gained such traction in Singapore and why we have the wonderful opportunity to hold a scientific meeting there in January 2014. Thanks to Jeremy Goldhaber-Fiebert, PhD, and to Anirban Basu, PhD, for the heavy lifting for this event, and to Mark Roberts, MD, for paving its way by teaching a fabulously-received short course. And thanks to Bruce Schackman, PhD, for doing a wonderful job stewarding the program that enables scholars from abroad to attend SMDM scientific meetings.

Meanwhile, please join our Past President (Anne Stiggelbout, Netherlands), our current Vice President (Uwe Siebert, MD, Austria), and our President Elect (Murray Krahn, MD, Canada) in thinking about ways to make SMDM more compelling outside of Europe and North America, especially as we transition from a society that is chiefly active at annual meetings to a society that is active all year long. Please think about the following questions with regard to a non-North American, non-European country you are familiar with:
  • What activity already occurring in the Society would be of most interest to scientists and stakeholders from that country?
  • What is the best way to reach out about this activity?
  • What activities not yet occurring in the Society would be of most interest to scientists and stakeholders from that country?
  • Which of these activities are well aligned with SMDM’s mission?
Contact Anne (a.m.stiggelbout@lumc.nl) with any inspirations or insights. Meanwhile, have a relaxing yet edifying summer. I look forward to seeing you at BOTH upcoming meetings (Baltimore, USA, October 2013; and Singapore, January 2014).


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2013 North American Meeting

With Focus on Policy, Special Symposia Highlight Theme of Annual Meeting

by Heather Taffet Gold, PhD, New York University School of Medicine and Elena Elkin, PhD, Memorial Sloan-Kettering Cancer Center

Gold and ElkinPreparations for the 35th North American Meeting of the Society for Medical Decision Making, October 20-23, 2013, in Baltimore, MD, are well underway, and this year’s meeting promises an exciting scientific program. The program will feature four special symposia that highlight the meeting’s theme − Bench, Bedside and Beyond: Medical Decision Making and Public Policy. A symposium planned by the SMDM Policy Committee will bring together analysts from agencies in the US and UK to discuss modeling methods used in government policy making and forecasting. In another session, experts in aging and decision psychology will discuss decision support for older adults. A third symposium will feature science and health journalists from both print and broadcast media, discussing strategies for disseminating research results to the press and the public. And in this year’s pre-meeting dinner symposium, US and Canadian researchers and leaders of the American Cancer Society and the American Society of Clinical Oncology will discuss strategies for influencing clinical policy and practice in cancer care.

As always, the SMDM North American meeting will offer oral presentations and poster sessions for original research in medical decision making, a variety of half and full-day short courses, and opportunities for networking and career development. The keynote address will given by Dr. David Eddy, Founder and Chief Medical Officer Emeritus of Archimedes, Inc. and former professor at Stanford and Duke. Meeting registration opens on Friday, August 24, 2013. Stay tuned for more information about the SMDM meeting in the next newsletter.


2013 Annual Meeting Planning Committee:
Meeting Co-chairs: Elena Elkin, PhD, (elkine@mskcc.org) and Heather Taffet Gold, PhD, (Heather.Gold@nyumc.org)
Scientific Review Committee Co-chairs: Eran Bendavid, MD, and Tanya Bentley, PhD
Short Course Committee Co-chairs: Stacey Sheridan, MD, MPH, James Stahl, MD, MPH, Ahmed Bayoumi, MD, MSc, and Uwe Siebert, MD, MPH, MSc, ScD
Career Development co-chairs: Natasha Stout, PhD, and Beate Sander, PhD




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SMDM to Hold Inaugural Asia Conference in January 2014

by Jeremy D. Goldhaber-Fiebert, PhD, Stanford University

Jeremy Goldhaber-FiebertThe Society for Medical Decision Making will hold its inaugural SMDM-Asia (SMDM-A) conference January 6 – 8, 2014, in Singapore with the theme “Informing Health Care Decision-Making with Evidence”. The conference goals align with those of the annual SMDM meeting held in North America and the biennial SMDM-Europe conference to promote medical decision making principles and skills internationally, to delve deeply into region-specific priority areas, and to build both a regional and international network of colleagues working in this area.

The meeting has several very special highlights. It features a Keynote address by the Honorable Dr. Chih-Liang Yaung, who was Taiwan’s Minister of Health and the Dean of the College of Public Health at National Taiwan University, during which he led Taiwan’s health insurance reform and faced crises including severe acute respiratory syndrome (SARS). Dr. Yaung  is currently on faculty in the Department of Healthcare Administration at Asia University. Along with Dr. Yaung, the conference will host multiple distinguished speakers from around the globe.

In addition to a stellar scientific program (submissions are open until Saturday, August 3, 2013, at https://smdm.confex.com/smdm/apm2014/cfp.cgi), the meeting features two special symposia. The first is Developing and Implementing Effective Models of Patient Centered Care in the Culturally Diverse and/or Resource Challenged Environments of the Asia-Pacific Region. It will discuss institutional innovations and barriers to improving Patient-Centered Care (PCC)/Shared Decision Making (SDM) in the Asia-Pacific Region. Panelist will highlight PCC/SDM models that have been successful in the Asia/Pacific regions and discuss similarities and dissimilarities of these models to western models/programs that are popular in the literature. The second is Health Policy Round: Responses to Dementia in an Aging Asia. The Health Policy Round will showcase, discuss and debate responses to dementia in the Asia-Pacific region. The discussions will incorporate key stakeholders from the region and also other experts around the world who have worked to meet such challenges elsewhere.

The meeting is organized by co-chairs Jeremy Goldhaber-Fiebert, PhD, and Anirban Basu, PhD, and a committee that includes Dana Alden, PhD, Eric Finkelstein, PhD, Sun-Young Kim, PhD, Yee Wei Lim, PhD, David Matchar, MD, Scott Ramsey, MD, and Mark Roberts, MD.

Singapore

Singapore is an amazing, cosmopolitan venue for holding the inaugural meeting. It features the confluence of multiple cultures and languages, excellent infrastructure and multi-ethnic cuisines, beautiful tropical flora.

The inaugural SMDM-Asia meeting in 2014 represents the first step in a long-term strategic commitment on the part of SMDM to building stronger connections with the medical and health policy and decision making, research, and education communities located in the Asian region. The inaugural SMDM-Asia meeting is planned to kick-off biennial meetings to be held on a rotating basis in countries around the region. The inaugural meeting will also serve as a launch pad for ongoing regional coordinating activities. You are cordially invited to participate.

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Commentary


The opinions stated in the following commentaries are solely those of the authors and do not reflect the opinions of the Society for Medical Decision Making.


Laurent MetzThe Epidemiology and Burden of Diabetes in India and China

by Laurent Metz, MD, Johnson & Johnson Medical Asia Pacific

Understanding the burden of diseases in the Asia-Pacific region is one of the key priorities of our health economics department. According to the International Diabetes Federation (IDF), type 2 diabetes mellitus (T2DM) affects over 371 million adults worldwide. As Asian countries have advanced socioeconomically and adopted certain Western lifestyles, they have experienced a rapid increase in the prevalence of this disease. This increasing prevalence, especially in India and China, prompted us to investigate the epidemiology and burden of diabetes in these two countries.

We gathered data on epidemiology, disease burden, and economic implications of T2DM by searching PubMed and EMBASE along with the Chinese bibliographic databases wanfangdata.com, cqvip.com, cnki.net, docin.com, and wenku.baidu.com and the Database of Medical Research in India, IndMED, MedIND, Journal of the Association of Physicians of India, and the National Medical Journal of India.

Epidemiologic Forecast

India:
  • In 1998, the World Health Organization (WHO) predicted that the number of Indians with diabetes would exceed 57.2 million by the year 2025, but the IDF reported that this figure was reached almost 15 years earlier.

  • In 2010, the IDF projected that diabetes would burden almost 87 million Indians in 2030, but a year later the IDF revised these predictions in light of preliminary data from a well-designed nationally representative study.

  • Based on current trends, IDF now predicts that in 2030 the number of Indians with diabetes will reach about 101 million, representing a prevalence of 9.9%.
     

  • The IDF also projected 21 million Indians with Impaired Glucose Tolerance (IGT) in 2012 and 32.2 million by 2030.  IGT is a precursor to T2DM.


Estimated Number of Diabetics in India


China:
  • In 2004, the WHO predicted that the number of Chinese diabetics would exceed 42 million by the year 2030, but the IDF reported that this figure was reached more than 20 years earlier.
  • In 2010, the IDF projected that diabetes would burden almost 63 million Chinese in 2030; a year later, in light of new data from a large nationwide study, the IDF revised their predictions.
  • Based on current trends, IDF now predicts that in 2030 the population of Chinese diabetics will rise to around 130 million with the prevalence rate of 10.6%.

Estimated Number of Diabetics in China


These predictions and revisions reveal uncertainty about the future prevalence of diabetes, but it is clear that diabetes rates are climbing faster in India and China than had been previously believed.

Economic Burden

India

Recent IDF estimates presented in the fifth edition of its Diabetes Atlas show that total diabetes-related health expenditures in 2012 were 4.28 billion USD, or 68 USD per person with diabetes.
India has the second largest population of diabetics in the world, but the mean expenditure per patient is only 1/19th the global average, suggesting that most diabetics in India do not receive adequate care.

In 2010, the IDF projected that by the year 2030 overall expenditures for diabetes in India would range from 4.84 to 8.53 billion USD depending on various assumptions. Nevertheless, these forecasts did not take into account the recent results of epidemiological studies showing that the burden of T2DM is actually higher than previously thought. Therefore, the predictions issued by IDF should be considered underestimates.

China
Initial results of a study conducted by the Chinese Diabetes Federation and IDF showed that 13% of Chinese medical expenditures, or 25 billion USD, will be spent on diabetes. Recently, the IDF estimated that mean diabetes-related expenditures per Chinese diabetic patient in 2012 were 194 USD, far less than average global expenditures for this disease. The U.S. spends an average of 1,270 USD per diabetic patient.  Nevertheless, due to a large diabetic population in China, the overall medical expenditures for diabetes in China reaches almost 18 billion USD, ranking China fifth highest in diabetes-related expenditures in the world. Importantly, the burden of diabetes has been increasing faster than the Chinese gross domestic product (GDP). In 1993, diabetes care accounted for 0.07% of China's GDP; ten years later it had doubled, consuming 0.15% of GDP.

Relation between estimated number of diabetics and diabetes-related health care expenditures in five countries




Future perspective
Diabetes mellitus has already reached epidemic proportions in India and China, and several epidemiological and socioeconomic factors predispose a further increase of diabetes burden. These include an increasing rate of diabetes in children, rapid aging of the population, large scale migration towards cities, a high rate of pre-diabetes and IGT, low awareness of T2DM, particularly in rural communities, and growing prevalence of obesity in China and India.

Conclusions
Urgent effective measures should be undertaken to reduce the rise of T2DM in China and India. These measures should include cost-effective interventions aimed at the prevention and management of this disease.

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Kevin FrickA Medical Decision Scientist in a Business School: What is the Value Proposition?

by Kevin D. Frick, PhD, The Johns Hopkins Carey Business School
 
After 3 years of undergraduate education focused on health policy, 5 years of training at a school of public health, and more than 16 years on the faculty of the Johns Hopkins Bloomberg School of Public Health, I moved to the Johns Hopkins Carey Business School on April 1. When the SMDM Newsletter editor asked me, “What is the value proposition for a medical decision scientist in a business school?” it was easy to find a quick answer: hard money. Seriously, while that helps to pay the bills, it does not address the question of professional fulfillment outside the medical campus setting. Let me detail three ways in which I find a clear and positive value proposition in a business school.

First, one key area in many business schools is decision modeling. Not everyone in SMDM specializes in decision modeling, but this is an area that occupies many members’ intellectual energy. With a need for efficiency in the public and private sectors and health care accounting for a large fraction of the economy that includes government and private industry, I wonder if there could be a better area to which to apply this skill set. The objective function might be different, short-term and long-term profit rather than the societal perspective, but at a school with the tag line “Where business is taught with humanity in mind,” I feel quite certain that the bottom line is not the only argument in the objective function.
 
Second, the need for models of profitability and sustainability leads to a clear focus on the hot topics of comparative effectiveness and translational research.  How can a program be implemented in an efficient, sustainable manner when the target population may have different preferences and constraints or may behave differently from the one studied?  Elements of marketing and market research are central to the discussion. These activities may exist in a school of public health, but they are the bread and butter of business schools.

Third, to turn the findings of medical decision making into action requires strong communication skills. We have an entire course on business communication. Many faculty members are used to lecturing about presentation slides with technical scientific details. That may work for an audience of similarly trained professionals. However, that presentation format doesn’t translate so well to decision makers who have limited time to make potentially risky decisions. So, the skill of communicating about business proposals (which is essentially what many new developments in medicine and public health interventions are) is critical.

To summarize, I have found a new professional home both because I care about the education (in my position as Vice Dean for Education) and because I find value in the combination of modeling, using models to address real world problems with solutions that may be in the private space, and finding ways to communicate these efficiently and effectively. I feel right at home.

Others may find it worthwhile to consider similar opportunities for primary or joint appointments as they arise.

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What Matters Most

By Thom Walsh, PhD, The Dartmouth Center for Health Care Delivery Science

Thom WalshSeveral members of our research group recently returned from the 7th International Shared Decision Making (ISDM) conference in Lima, Peru.  As one of several keynote speakers, Glyn Elwyn addressed the conference theme, “Pacientes @ the centre of healthcare,” by reviewing our progress to date and emphasizing how much work remains.  Maggie Breslin and Peter Ubel recounted their experiences as care providers active in the field of physician-patient communication, yet dizzied by a health care system that struggles to stay focused on the needs and wants of patients. A Peruvian physician, Gonzalo Gianella, offered a sobering perspective from his own country. He described human rights violations in Peru, where women have been sterilized without their knowledge. While we may promote the view that shared decision making and informed choice should be pinnacles of patient centered care, Gianella reminded us that many around the world are just beginning this journey. Victor Montori, the conference chair, summed things up with a single word: respect. This word helps him explain the concept of shared decision making to often puzzled health professionals in Peru. After all, most of us started as patients, we all have the potential to become a patient again at any point, and we all want respect.

Energized by the conference, we returned to our Dartmouth laboratory reflecting on recent trends in patient decision support and shared decision making. The traditional paradigm describes a patient facing a single decision with two competing alternatives. Watchful waiting versus surgery for a man with prostate cancer is the classic example. Here, the strategy for placing patients at the center of care consists of educating and activating them while providing clinicians with risk-communication tools, such as an educational video for the patient to watch outside of the patient-provider interaction.

In reality, the dissemination of these tools has been quite limited, and their implementation has proven challenging. While the tools do help patients acquire knowledge about their condition, reduce decisional regret, and result in treatments more congruent with their preferences, patients remain fearful of questioning their providers or even displaying their new found knowledge. The tools, by themselves, are not enough. Furthermore, many patients have multiple chronic conditions and face recurring decisions, not a single decision pertaining to one clinical condition. It is nearly impossible for the patient or the provider to know which decisions will be encountered ahead of time. Typical decision support interventions, such as booklets or videos, do not work in this setting.

How do we put these patients at the center of care? How do we train and support providers to maintain that focus amidst the barrage of tasks required to meet administrative and billing needs?

What matters most, we believe, is for a patient’s voice to be heard and acted upon.  This requires more than patient activation and decision support outside the patient-provider encounter. Attention must shift to the consultation, itself. How do the best providers deliberately engage and collaborate with patients? Can those skills be taught? Is it possible to measure, from the patient’s perspective, the qualities that make for an exceptional provider capable of educating, eliciting patient preferences, and integrating those preferences into a treatment plan?
 
Such a high level of patient engagement demands an active and focused approach that creates a setting conducive to reciprocal inquiry. Providers have expertise in clinical medicine, while patients are the experts when it comes to their personal preferences and values but, ultimately, patients turn to providers for help. Providers lead the interaction, so they need to recognize clinical situations with multiple treatment options and variable patient preferences. They also need skills that enable them to educate patients about the options, elicit patient preferences, and incorporate those preferences into treatment planning, all during the compressed time frame of a typical appointment.

This level of patient engagement is not the norm. We need clinicians to acknowledge this reality, hold a mirror to their practice style, and ask, “Would I accept this care for myself or my partner, child, or parent”? Breslin and Ubel answered "no" at the conference in Peru. Their loved ones do not receive patient centered care. Their care is not acceptable. Gianella and Elwyn both acknowledged the long climb ahead of us. We must act. We must keep moving forward. As Montori reminded us, we must respect the needs and wants of the humans around us. It is not okay to accept the status quo.

How will we know that we are progressing on our path? Shared decision making within the encounter could be measured from the patient’s perspective. To do so would require involving patients in each step of the development of the measurement tool. Decision support interventions and shared decision making currently use measures developed by clinicians and scientists. Patients have not been engaged at the center of this development process. As the proverb says, “What gets measured gets attention.” Putting patients at the center of our measures can help to put patients at the center of health care.

We hope you will join us at the next ISDM meeting in Sydney, Australia, in 2015. We’ll have progress to share.

This guest editorial was written with contributions by staff of The Preference Laboratory, The Dartmouth Center for Health Care Delivery Science: Paul Barr, Marie Anne Durand, Stuart Grande, Richard Lehman, Rachel Thompson, Maka Tsulukidze, and led by Glyn Elwyn.

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Election Announcement

Voting for the SMDM Board of Trustees is open to members until August 16! This year, SMDM members are electing a President Elect, a Vice President Elect and 3 Trustees.

Go to http://common.proaxs.net/smdm/vote/index.php to review biographies and personal statements from the candidates and to cast your vote.


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SMDM Outstanding Paper by a Young Investigator Endowment
John Clarke
John R. Clarke, MD, Drexel Surgery, presents SMDM President Scott Braithwaite, MD, NYU School of Medicine, a donation to endow support of the SMDM Outstanding Paper by a Young Investigator Award. Thank you, John!

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SMDM Seeks Emeritus Members

Scott B. Cantor, PhD, The University of Texas MD Anderson Cancer Center

Scott CantorMost SMDM members join as Regular or Trainee members. However, there are a few members who have reached “Emeritus” status.

As stated in the SMDM Regulations, an Emeritus member is: any member of the Society who reaches the age of 65, with five years of active membership, or any member who, by reason of permanent disability or undue hardship, has been rendered unable to continue active membership, may apply for Emeritus membership by written application to the Secretary of the Society. The Emeritus classification will be awarded by a majority vote of the Board of Trustees. The dues and other fees for Emeritus members are set from time to time by the Board of Trustees. Emeritus members shall retain all privileges of Active members except the right to hold elective office, excluding the office of Historian.

As of July 1, 2013, there are 12 Emeritus members. They are:

  • Hal Arkes, PhD, Department of Psychology, The Ohio State University
  • Sue Bogner, PhD, President and Chief Scientist, Institute for the Study of Human Error, LLC
  • C. Ralph Buncher, ScD, University of Cincinnati Medical Center
  • Arthur Elstein, PhD, University of Illinois at Chicago
  • Dennis Fryback, PhD, Prof. Emeritus, University of Wisconsin
  • Gabriel Mulcahy, MD, Jersey City, NJ
  • Charles Phelps, PhD, University of Rochester
  • David Rovner, MD, Professor Emeritus, Michigan State University
  • Thomas Stewart, PhD, Research Professor Emeritus, Rockefeller College, University at Albany
  • David Sugano, DrPH, Cleveland Clinic
  • Fredric Wolf, PhD, Department of Biomedical Informatics & Medical Education, University of Washington, School of Medicine
  • Harold Sox, MD, Professor of Medicine, Geisel School of Medicine at Dartmouth

The SMDM Board believes that there may be many more who are eligible for Emeritus status. Some may have let their memberships lapse as they retired. The Board would like to re-engage these persons back into the Society. Their participation is needed to enhance the Society – either through their participation at annual meetings – including giving research presentations, chairing scientific sessions, and mentoring – as well as providing guidance to the Board regarding strategic initiatives. If you believe that you – or someone you know – might be eligible for SMDM Emeritus membership status, please contact Jill Metcalf jill.metcalf@smdm.org. Emeritus members are eligible for substantial discounts on annual dues and the scientific meetings.

SMDM has always recognized the importance of our younger members. It is also important to recognize those who have achieved “senior” status. Step up! Stay connected!

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New Networking Opportunities for Members

by Amy Tawfik and David Chartash, Career Development and Networking Committees

The Career Development and Networking Committees are offering two new opportunities for members to network with trainees, junior faculty, or other members seeking career advice: 1) the opportunity for mentors to meet with mentees during conference breaks at the annual meeting, and 2) the opportunity to provide career consultation on an as-needed basis throughout the year.   

As a new component to the one-to-one mentorship program at our annual meetings, mentees will now be able to meet mentors informally in groups during conference breaks in four rooms.  Each room will represent one of four core research specialties: 1) decision psychology and shared decision making, 2) health economics and health services research, 3) quantitative methods and theoretical developments, and 4) health policy and implementation. 

Rooms will be open during each break at the annual meeting, allowing mentors and mentees to attend whichever time slot best suits their schedule. This will provide an excellent opportunity for mentees to gain exposure to a broad group of experts and other members with similar research interests. Mentor/mentee matches can meet in-person during the breaks, and others can network with each other during these informal group gatherings. 

We are also excited to offer opportunities for career consultation between annual meetings. Mentors and others are invited to sign up for this career consultation during which they might be asked to provide manuscript review or feedback, serve as a consultant on grant proposals for those who are seeking specific expertise, provide guidance about career transitions to new positions, discuss non-academic career paths, advise on promotion and tenure guidelines, provide advice about how to create a new center or Division, or discuss other career questions that trainees might have throughout the year. These requests will be made on an as-needed basis, and signing up does not commit mentors to performing any of these tasks if they are unavailable at the time the request is made. This opportunity provides ways for SMDM members to connect between annual meetings to gain career or research advice, and can build collaborative relationships between members within the SMDM community.

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Calling all SMDM Members Interested in Healthcare Policy!

by Elbert Huang, MD, and Negin Hajizadeh, MD, SMDM Policy Committee

Policy ChairsThe SMDM Policy Committee is seeking new members. The charge to the Policy Committee is to identify national and international policy issues relevant to the SMDM community and to facilitate SMDM having a voice regarding policy issues among decision-makers.
The focus of the Policy Committee is:
  1. to support and advance funding for research and educational initiatives in the area of medical decision making, and
  2. to provide guidance to decision-makers on policy that is based on sound principles of medical decision making.

Currently, we are looking for volunteers to assist with three specific areas:
  • Refining the Policy Committee agenda
  • Methods to expand our surveillance of policy activities relevant to SMDM
  • Methods for responding to requests from outside agencies for SMDM policy inputs
At a minimum, committee members will be asked to call in for bi-monthly one hour meetings.

If you are interested in learning more, please email Elbert Huang at ehuang@medicine.bsd.uchicago.edu or Negin Hajizadeh at Negin.Hajizadeh@nyumc.org.

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The SMDM Publications Committee is Seeking New Members

Lisa Prosserby Lisa Prosser, PhD, Chair, SMDM Publications Committee

The charge to the Publications Committee is to develop, implement and/or oversee the general policies of the Society with regard to its publications, including the journal, newsletter, website and social media outlets.

SMDM is about to start the search for a new journal publisher and would be particularly interested in potential members with relevant experience. We will be forming a subcommittee to lead this search. If you are interested in this subcommittee (but not necessarily permanent membership in the Publications Committee), please let me know.

If you are interested in learning more, please email me at lisapros@med.umich.edu. Thank you!



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July Journal Available

We hope you enjoy the latest issue of our journal


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Medical Decision Making—Green or Not?

by Donald A. Brand, PhD, Winthrop University Hospital and A. Scott LaJoie, PhD, MSPH, University of Louisville

Brand / LaJoieSince 2010, our academic journal, Medical Decision Making, has offered the option of online-only subscriptions. Subscribers who forgo the print version do not receive a discount, so their decision to go paperless must be motivated by something else. Does their choice reflect a desire to help their professional society by reducing its expenses for printing and postage? Are they good citizens choosing the green alternative to minimize environmental impact? Or, have they simply run out of space on their bookshelves?

We don't know the answers, but given the absence of a financial incentive, we were surprised to learn that more than one-third of current subscribers choose online only. Non-U.S. subscribers are more than twice as likely to go paperless as compared with their U.S. counterparts (60% vs. 26%), suggesting that delays in international mail delivery may play a role.

We offer our own personal accounts to illustrate why a subscriber might or might not choose the more environmentally friendly option:
 
DAB:  I have failed to wean myself from the printed version but know I won't be able to hold out much longer. Not only have I exhausted my shelf space, but the world of publishing is changing so fast that I will need to catch up or shrivel up.

It does not seem so long ago that I had to walk to the library to copy articles from bound volumes, so I have to admit that I love instant downloads. To someone of my generation, it still seems like magic. Nevertheless, when I want to peruse a single issue of a journal or newspaper, I find it easier if I can hold it in my hand and flip the pages. Maybe that isn't true for the e-reader generation. Maybe I need to get over it. But until I do, I will continue to look forward to the arrival of Medical Decision Making each month in its clear plastic wrapper.

ASL: As an early adopter of all things digital, the choice to go paperless was simple, and in fact, a choice for which I have passionately advocated at SMDM and other professional societies. Belonging to several such organizations, I find my bookshelves sagging under the weight of a myriad of journals. Recycling or donating old issues are options I thought I would choose, but have not. I just keep adding more bookshelves.

Going paperless is a much better alternative. Receiving an email with a link to the monthly journal makes browsing and archiving articles easier and more efficient. And I can get my journal when I am away from the office.

Like others, I sometimes prefer to read from the printed page – especially when I need to make annotations – and thus I print those particular articles. Printing a single article rather than the entire journal saves a lot of paper and reduces environment impact. Lastly, while I still get the Sunday paper delivered to my doorstep, I am trying to convert all of my magazine and news subscriptions to electronic delivery. Having articles (fun and/or academic) in my phone, laptop, or tablet means that I can consume information when and where I want. With the improvement in displays, reading on my mobile devices has become less straining on my eyes.

SMDM would love to hear your opinions about going paperless vs. receiving the printed journal in the mail. Go to the SMDM Facebook page and leave a comment!

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Member News


A new SMDM member, Marquita R. Decker, MD, MPH, University of Wisconsin, was recently awarded a US Fulbright Student Program award for a project on cost-effectiveness of personalized mammographic breast cancer screening. The collaborative project between SMDM members at University of Wisconsin in Madison, USA and Erasmus University in Rotterdam, Netherlands will begin in August, 2013. decker.renee@gmail.com


The following paper, co-authored by four SMDM members, was recently published: Combining deliberation and intuition in patient decision support, Patient Education and Counseling 91 (2013) 154–160 r. Marieke de Vries, PhD, (a,b); Angela Fagerlin, PhD, (c,d,e); Holly O. Witteman, PhD, (e,f,g); and Laura D. Scherer, PhD, (c,e,h)  a.Tilburg Institute for Behavioral Economics Research (TIBER), Department of Social Psychology, Tilburg University, Tilburg, the Netherlands  b. Department of Medical Decision Making, Leiden University Medical Center, Leiden, the Netherlands  c. VA Ann Arbor Center for Clinical Management Research, Ann Arbor, USA  d. Division of General Internal Medicine and Department of Psychology, University of Michigan, Ann Arbor, USA  e. Center for Bioethics and Social Sciences in Medicine, University of Michigan, Ann Arbor, USA  f.Vice-décanat à la pédagogie et au développement professionnel continu, Faculté de médecine, Université Laval, Quebec City, Quebec, Canada  g. Département de médecine familiale et médecine d'urgence, Faculté de médecine, Université Laval, Quebec City, Quebec, Canada  h. University of Missouri, Department of Psychological Sciences and Department of Health Sciences    MariekedeVries@TilburgUniversity.edu


Nilanjana Dwibedi completed his PhD in Pharmacy Administration in Fall 2012 and received an employment offer in October 2012 to serve as a tenure track Assistant Professor at the West Virginia University School of Pharmacy. "This was a life changing event for me, I moved to Morgantown, West Virginia from Houston, Texas on February 18, 2013. More importantly, I started teaching 'Patient Reported Outcomes' course to the PhD students in Spring and Summer 2013."   nidwibedi@hsc.wvu.edu


In Norway, the health authorities are implementing a health care reform in which general practitioners (GPs) are expected to spend more time on individuals with risk factors, preventive health clinics, school health services and people certified unfit for work. In a survey of 1,308 GPs, we found that handling common symptoms and complaints, chronic diseases, risk conditions and terminal care were the top ranked activities in terms of meaningfulness and priority, whereas many GPs wanted to spend less time on follow up of people certified unfit for work, school health services and preventive health clinics. We concluded that care for individual patients in terms of diagnosis and treatment was the most highly valued task among the GPs and that their priorities were partly at odds with those of health authorities and policy makers.  Halvorsen PA, Edwards A, Aaraas IJ, Aasland OG, Kristiansen IS. "What professional activities do general practitioners find most meaningful?  Cross sectional survey of Norwegian general practitioners." BMC Family Practice 2013,14:41. SMDM Members involved in the research include Adrian Edwards, MD, PhD, Cardiff University, UK, Ivar Sønbø Kristiansen, MD, PhD, MPH, University of Olso, Norway, and Peder A.Halvorsen, MD, PhD, University of Tromsø, Norway.  peder.halvorsen@kraftlaget.no


Kevin D. Frick, PhD, was appointed Vice Dean for Education at The Johns Hopkins Carey Business School. (See viewpoint by Kevin above.) kfrick@jhu.edu


On March 25th, 2013, the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) was released simultaneously and endorsed by 10 journals. Don Husereau, BScPharm MSc, Senior Associate, Institute of Health Economics; Adjunct Professor, Faculty of Medicine at the University of Ottawa, and Senior Scientist, University for Health Sciences, Medical Informatics and Technology, Tirol, Austria, chaired an international Task Force of editors and content experts to develop the guidance. They used a Delphi Panel technique to identify a minimum number of items that should be reported in these evaluations. The journals that have currently published and endorsed this guidance include  BMC Medicine, BMJ, BJOG: An International Journal of Obstetrics and Gynecology, Clinical Therapeutics, Cost Effectiveness and Resource Allocation, The European Journal of Health Economics, International Journal of Technology Assessment in Health Care, Journal of Medical Economics and Pharmacoeconomics, and Value in Health. Participation across different publishers for this effort was commendable and speaks to its importance.

CHEERS attempted to consolidate and update previous efforts that provided guidance for reporting economic evaluation in health including Drummond's checklist for the BMJ and a checklist from the CEA Panel. Contemporary approaches for developing methods-neutral reporting guidance seen in other efforts were followed, including CONSORT, PRISMA, STROBE and STREGA. We hope CHEERS will improve consistency and transparency in study reports and make sure clinicians, patients and health care leaders using these reports do not make costly mistakes. Information about CHEERS including the checklist can be found on the CHEERS Task Force web site. The full task force report, which includes additional examples and explanation can also be found there. The co authors of CHEERS are: Dan Greenberg, PhD, Senior Lecturer, Department of Health Systems Management, Faculty of Health Sciences, University of the Negev, Beer-Sheva, Israel, Andrew H. Briggs, MSc, DPhil, Associate Editor, Medical Decision Making; Co-Editor, Health Economics; and William R Lindsay, Chair of Health Economics, Health Economics & Health Technology Assessment, Institute of Health & Wellbeing, University of Glasgow, Glasgow, Scotland.  don.husereau@gmail.com


Matthew Nielsen, MD, MS, Assistant Professor of Urologic Surgery and Adjunct Assistant Professor of Epidemiology at University of North Carolina Chapel Hill, was recently awarded a Mentored Research Scholar Grant from the American Cancer Society for his application entitled, "Optimizing survivorship and decision-making in low risk bladder cancer." The project will build on preliminary data published in MDM this February, examining the comparative effectiveness of alternative surveillance practices for patients with low grade noninvasive bladder cancer using simulation modeling. In addition, we will assess utilities and stated preferences in a cross-sectional study of bladder cancer survivors. Dr. Nielsen credits SMDM with providing access and exposure to the superb mentoring panel [Michael Pignone, MD, MPH, University of North Carolina, Evan Myers, MD, MPH, Duke University, Brian Denton, PhD, University of Michigan, Brett Hauber, PhD, RTI International, and Ann Zauber, PhD, Memorial Sloan-Kettering] who will supervise his work in this application.  mnielsen@med.unc.edu


Benjavan Upatising, BSIE, MSE in IOE, pursuing PhD, Purdue University, Mayo Clinic, was recognized as Purdue's 5 Students Who are Health Makers in February 2013. Her research article on home telemonitoring effects on frailty transitions and death was also recently published in March.   benjavan.den@gmail.com


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SMDM Lifetime Contributors

SMDM extends its heartfelt appreciation to members for their charitable contributions over the years. Donations received Oct. 2005 – May 31, 2013. Bold indicates a new donor or a donor who has advanced their level of recognition in 2013.

Pareto Level
(Contributions total $1,000 or more)
Michael Barry (’06, ’07, ’08, ’09, ’10)
John Clarke (13)
Dennis Fryback (’05, ’06, ’07, ’08, ’09, ’10, ’11, ’12)
Mark Helfand (’05, ’07, ’10, ’11)
Joseph King (’06, ’07, ’08, ’09, ’10, ’11)
William Lawrence (’06, ’10, ’11)
David Rovner & Margaret Holmes-Rovner (’05, ’06, ’07, ’08, ’09, ’11, ’12)
Uwe Siebert ('11)
Frank Sonnenberg (’06, ’09)
Harold and Carol Sox (’10, ’11, ’13)
Sankey Williams (’06, ’07, ’08)
John Wong (’06, ’07, ’08, ’09, ’10, ’11, ’12)

Edwards Level
(Contributions total $750 - $999)
David Meltzer (’07, ’09)
Stephen Pauker (’06, ’09)
Marilyn Schapira (’07, ’08, ’09, ’10, ’11, ’12)
Joel Tsevat (’06, ’09, ’10)

Tversky Level
(Contributions total $500 - $749)
Robert Beck (’07)
Scott Cantor & Lisa Stone (’07, ’08, ’09, ’10, ’11, ’12)
Kate Christensen (’09)
Nananda Col (’05, ’06, ’07, ’08, ’09)
Neal Dawson (’05, ’06, ’07, ’08, ’09, ’10, ’11, ’12)
Kathryn McDonald (’07, ’09, ’10)
Jill Metcalf (’07, ’08, ’09, ’10, ’11, ’12)
David Paltiel (’07, ’09)
Mark Roberts (’08, ’09)
Bruce Schackman (’06, ’07, ’08, ’09, ’10, ’11)
Seema Sonnad (’06, ’07, ’09, ’12)

von Neumann-Morgenstern Level
(Contributions total $250 - $499)
Ahmed Bayoumi (’06, ’09, ’10, ’11, ’12)
Dena Bravata (’06, ’09, ’10, ’11)
Randall Cebul (’06, ’08, ’10)
Mark Eckman (’06, ’09)
Arthur Elstein (’06, ’07, ’09, ’10)
Peder Halvorsen ('11, ’12)
Sara Knight (’05, ’06, ’07, ’08, ’09, ’10, ’11, ’12)
Karen Kuntz (’09, ’11)
Steven Kymes (’05, ’06, ’07, ’08, ’09, ’12)
James Stahl (’06, ’09, ’10, ’12)
David Sugano (’07, ’09, ’10, ’11)

Markov Level
(Contributions total $100 - $249)
Dana Alden (’12)
Amber Barnato (’05, ’07, ’08, ’11, ’12)
Cathy Bradley (’07)
Scott Braithwaite (’09)
Linda Canty (’12)
Phaedra Corso (’06, ’07, ’08)
Elena Elkin (’07)
Alan Garber (’10)
Heather Taffet Gold (’08, ’11)
Robert Hamm (’06, ’08)
Myriam Hunink (’05, ’06, ’07, ’08, ’09, ’10, ’11, ’12)
Esther Kaufmann ('11)
Miriam Kuppermann (’06, ’07, ’08, ’09, ’10, ’12)
Curtis Langlotz (’12)
Lisa Maillart (’10)
Richard Orr (’05, ’06)
Brian Rittenhouse (’07)
Allison Rosen (’07)
Alan Schwartz (’07, ’10, ’12)
Joanne Sutherland (’08, ’09)
Thomas Tape (’10, ’11)
John Thornbury (’05)
George Torrance (’05)
Jef Van den Ende (’10)
Robert Wigton (’10, ’11)
Brian Zikmund-Fisher (’08, ’09, ’10, ’11, ’12)

Bayes Level
(Contributions total up to $100)
Hilary Bekker (’12)
Eran Bendavid (’11)
Denise Bijlenga (’08)
Kimberly Blake (’09)
Rowland Chang (’06, ’07)
Carmel Crock (’09)
James Dolan (’09)
Arna Dresser (’10, ’12)
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)
Joseph Ladapo (’12)
Andrew Scott LaJoie (’10)
Andreas Maetzel (’09)
Daniel Masica (’08)
Evan Myers (’12)
Thomas B. Newman (’10)
Jesse D. Ortendahl ('11)
Jane Pai ('10)
George Papadopoulos (’08)
Lisa Prosser (’08)
Michael Rothberg (’09, ’10, ’11, ’12)
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)

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