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From the Editor

by Dana L. Alden, PhD, Editor-in-chief, University of Hawai'i

Our 2015 SMDM Annual Meeting is just around the corner and your Fall Newsletter will get you in the mood for a great experience in St. Louis! Here are some highlights of what you’ll find in this issue. 

Starting us off on a very positive and thoughtful note, President Ahmed Bayoumi’s letter focuses on the Society’s strategic plan that was developed last spring by our Board of Trustees. I think you’ll agree that the Board has done an excellent job setting the strategic priorities for the Society for the next five years. A companion Commentary section article, also by Ahmed, describes the strategic plan’s three central objectives in greater detail. A central theme in both Ahmed’s letter and Commentary is the role that all of us can play in implementing the plan. This is truly an exciting time to be an active member of SMDM!

Also, in the Commentary section, you’ll find three very interesting articles. The first describes the establishment of a new Center for Health Economics of Treatment for Substance Users at Cornell Medical College. Led by Bruce Schackman in collaboration with Daniel Polsky and Brandon Aden, the Center will conduct economic research that will aid other researchers, policymakers and practitioners who are on the front lines of the important effort to more effectively address substance abuse challenges. The second article by Arianna Blaine emphasizes the value of developing decision support tools that reduce patient processing burdens and, in that spirit, reports on three initiatives undertaken by the Preference Laboratory at the Dartmouth Institute for Health Policy and Clinical Practice. The third article discusses SMDM ad hoc committee members’ Tanya Bentley, Scott Cantor, Elena Elkin, Heather Taffet Gold, and David Howard response to the American Society for Clinical Oncology’s (ASCO) request for input on their new cancer chemotherapy care scoring algorithm for “specific indications.” 

All three Commentary articles are great reads. No doubt their authors and/or individuals mentioned in their articles will attend the SMDM Annual Meeting. Feel free to thank them for their contributions to the Newsletter and engage them in discussion of points raised.  

Speaking of the Annual Meeting, please be sure to congratulate our Board of Trustees President-elect, Angie Fagerlin and Vice-President-elect, Lisa Prosser as well as newly elected Trustees, Ava John-Baptiste, Beate Jahn, and Jane J. Kim! You’ll find bios for each of our newly elected Officers and Trustees in Society Updates.  

Also in this section, we are pleased to announce this year’s winners of our Society’s awards for research and service: Al Mushlin, Anne Stiggelbout, Alan Schwartz, and Josh Roth. Congratulations to all of you!  

In Society Updates, you’ll also find the latest on the educational and career achievements of your fellow SMDM members and colleagues; job postings; student news; and recognition of SMDM members whose generous contributions allow our Society to make a difference, for example, by providing travel support to medical decision researchers from lower income countries. 

Please also note the inclusion of a new section that invites you to describe current projects that are either in the formative stage or underway. The idea is to enable all of us to learn more about the ongoing activities of our Society and to potentially connect members with like interests on a regular basis.

And, if you would like to write a Commentary article in the next newsletter, or are interested in joining our Editorial Team as Associate Editor, please don’t hesitate to contact me (dalden@hawaii.edu).  I’m looking forward to “Meeting You in St. Louis!”  


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From the President

by Ahmed Bayoumi, MD, MSc, University of Toronto

In this issue of the Newsletter, you will find an overview of the new SMDM strategic plan. I want to thank the Board for the time and effort theyput into developing the plan and also the planning committee which helped to organize the day, including our guest facilitator, Hal Sox, who returned again to facilitate the process. I think the strategic plan is an excellent guide for SMDM over the next 5 years. It’s also a fantastic opportunity for SMDM members to get involved in shaping the future of our Society.  While there is much to discuss in this regard, I want to hightlight three topics that I think are important for understanding how the Society can maximally benefit from the strategic plan.
 

What is the purpose of the strategic plan?


We approached this strategic planning exercise a bit differently than we had the last one. Our last plan was comprehensive - it listed the things that we do well as well as new areas to explore. However, it was probably too exhaustive. Strategic planning should be about setting new priorities, taking risks, and focusing strategic investments of financial and other resources.

Accordingly, we approached the planning process differently. We focused on defining strategic objectives that differentiate SMDM from other organizations, are innovative, and offer the greatest opportunity for impact and growth. Board members challenged themselves to define new areas we want SMDM to address. We did not focus streamlining and organizing what we do more efficiently or securing financial stability, each of which will be addressed separately. We are trying to think big! I hope we succeeded, but I think we can still benefit from being encouraged to aim even higher.

 

What does patient and public engagement mean?


Our third strategic plan objective is to “develop and promote expertise in patient and public engagement in medical decision making.” In discussing the plan with people, this is the objective that seems to be most opaque. However, I think it represents a return to our Society’s historical orientation, a strengthening of some of our strongest current activities, and an opportunity for future growth. Much of the early medical decision making literature focused on how to address patients’ preferences in decision making. While this remains a central focus of some aspects of our research, such as the brilliant work our members do in shared decision making and preference assessment, I fear that we sometimes slip into doing research “on” patients rather than doing research “with” patients. Meanwhile, there has been a large and growing interest in community-based research, which has its own set of principles and practices. In many countries, there is a renewed interest in having patients meaningfully involved at all stages of research (see, for example, the BMJ’s appointment of patient editors or the establishment of the Patient-Centered Outcomes Research Institute in the United States). SMDM should be at the forefront of such initiatives and should, I think, identify ways to increase patient involvement in our activities. 

Some have asked me about “public” engagement and how that differs from “patient” engagement. To my mind, they are complementary but distinct processes. Defining public values for decision making (usually to guide public investments) is perhaps even more challenging than defining patient engagement, but many countries have started to address these questions. For example, Canada has public members on its national health technology advisory committee, while the United Kingdom’s National Institute for Health and Care Excellence has a Citizens Council to provide a “public perspective on overarching moral and ethical issues.” Focusing on patient and public engagement offers fertile opportunities for both methodological and applied work where SMDM can have a real impact on improving real world decision making.


 

How will we implement and monitor progress on the strategic plan?


Our next steps for the strategic plan are to address how we implement it and how we monitor its progress. While the Board has ideas about implementation strategies, I think it is important for the Society to offer multiple opportunities for members to present their own innovative ideas. Our progress should be measured against how we are doing in relation to our overall goals, not in relation to individual implementation strategies. We also need to be self-critical about where we are being successful in implementation. This may mean stopping some initiatives that are not meeting expectations. My hope is that we view the implementation strategy as a living process – one that is far-reaching and ambitious in its scope, but realistic and reflective in its execution. Above all, implementation and monitoring will benefit from feedback from both SMDM members and from our partners. The strategic plan is your invitation to shape the Society. Please get involved!

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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.

The New SMDM Strategic Plan

by Ahmed Bayoumi, MD, MSc, University of Toronto

In the spring, the Board of Trustees met to identify strategic objectives for the Society for the next 5 years. The Board reviewed existing SMDM priorities and activities, brainstormed about potential targets and initiatives, refined the ideas we generated into specific objectives, and used iterative voting processes and discussion between members to come up with our final list of strategic objectives. 

The Board identified three strategic objectives that are central to achieving the Society’s mission at this time:

 

1. Support increased international growth and influence 


Increased growth of the Society and its activities in regions outside of North America is essential both to further the scientific and policy aims of the Society and to further our goals for membership and meeting attendance.  Activities to support this objective include: increasing membership and involvement from outside of North America, continuing to conduct profitable international meetings, expanding our teaching of medical decision making internationally, engaging decision making organizations and stakeholders internationally, and developing SMDM leaders outside of North America.

    

2. Increase engagement with both clinical and health decision making organizations and stakeholders 


Increasing the Society’s impact on clinical and health decision making processes requires enhanced engagement with both clinical societies and decision making organizations that influence clinical care, guideline development, and health policy. In particular, the Board noted that there is a renewed emphasis globally on optimal decision making for clinical decisions and that SMDM could offer particular expertise in this area. Engagement with clinical societies, policy organizations, and governmental bodies must be active, ongoing, and collaborative. Jointly planned and branded events or courses support both the achievement of shared goals and provide concrete evidence of the relationship.

 

3. Develop and promote expertise in patient and public engagement in medical decision making
 

Globally, there are several initiatives to increase the involvement of patients and the public in individual-level decision making, guideline development, and reimbursement decisions. The Board believes that SMDM’s expertise in patient and public engagement is a key, but comparatively underdeveloped and underutilized, resource for strengthening the Society’s impact and increasing its membership. SMDM can contribute to the knowledge base regarding patient and public preferences in guideline development and research priority setting,  sponsor and endorse literature that advances the conceptual framework for addressing patient and public engagement in medical decision making, and develop SMDM branded or facilitated products focused on patient engagement and preferences.


The audience for the strategic plan is both internal and external. Internally, it serves as a roadmap for where we want the Society to go in the future. Externally, the plan identifies the most important topics for the field of medical decision making. The strategic also serves as a guide for some of our fundraising activities as we  partnerhips with funding agencies to improve medical decision making globally.



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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.

 

Center for Health Economics of Treatment for Substance Users Is Established at Weill Cornell Medical College


Bruce ShackmanThe high costs of treating the more than 7 million people with a substance use disorder may be daunting to public and private payers. The costs of not treating them may be even higher, especially if you consider the costs of failing to screen for and treat HIV and hepatitis C in this population. Sorting out the complex economics of treating substance use disorder is the goal of a new center funded by a $5.8 million grant from the National Institute on Drug Abuse.

SMDM member Bruce R. Schackman, PhD, professor of healthcare policy and research and the Saul P. Steinberg Distinguished Professor of Psychiatry and Public Health at Weill Cornell Medical College (pictured right) will lead the cross-institutional Center for Health Economics of Treatment Interventions for Substance Use Disorder, HCV, and HIV ("CHERISH"). The Center will serve as a national resource for substance use health economics research by developing and disseminating economic evidence that informs substance use treatment policy and hepatitis C and HIV care for substance users. Dr. Schackman currently serves as SMDM’s Secretary-Treasurer and leader of its Global Health Interest Group.

"This new funding allows us to create an infrastructure that will enhance existing research projects, promote state-of-the art economic research methods, and improve the ability of substance use economic researchers to communicate with decision makers and address changes in today's healthcare system," says Dr. Schackman.

CHERISH is a collaboration among researchers at Weill Cornell Medical College, Boston Medical Center, the Leonard Davis Institute of Health Economics (LDI) at the University of Pennsylvania, and the University of Miami. Another SMDM member who will play a prominent role as co-Director of the CHERISH Dissemination and Policy Core is Daniel Polsky, PhD, who is Executive Director of LDI, Robert D Eilers Professor of Healthcare Management at the Wharton School, and professor of medicine at the University of Pennsylvania. SMDM member Brandon Aden, MD, MPH who is an assistant professor of medicine and healthcare policy and research at Weill Cornell Medical College, will lead the CHERISH Pilot Grant and Training Core.
 

For additional information on this program, Bruce R. Shackman, PhD, can be reached at brs2006@med.cornell.edu.
 
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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.

 

Warding off the Dark Side of Shared Decision Making: Reflections on the 2015 ISDM/ISEHC Conference


by Arianna Blaine, MS, Program Manager, Option Grid Collaborative, The Dartmouth Institute for Health Policy and Clinical Practice


Arianna Blaine
At the joint conference of the International Shared-Decision Making Group (ISDM) and the International Society for Evidence Based Health Care (ISEHC), held in July in Sydney, Australia, one of the most powerful rallying cries was Victor Montori’s call for the field to “be kind and careful” above all else. To do this, we first need to acknowledge the dark side of SDM that can interfere with being kind and careful - the burden that tools and measures can place on patients and clinicians, negating well-intended efforts.
 
When patients with literacy or numeracy challenges are handed decision aids that are misaligned with their reading or numeracy abilities, they experience psychological burden. Clinicians and patients alike are burdened when tools and measures designed to improve SDM are too lengthy and unwieldy, taking up an undue amount of time. The most powerful methods of achieving SDM will surely develop with the reduction of burden in mind.
 
This realization renewed my appreciation for the approach taken by the Preference Laboratory at the Dartmouth Institute for Health Policy and Clinical Practice. The group focuses on developing tools and interventions to improve SDM, but, more specifically, tools and measures that are ‘fast and frugal’ (short and to the point) while still being effective.
 
The Lab’s experience with this approach has been positive thus far and I attribute this success partially to the commitment to reducing burden for end users. For example:
  • Clinicians who have integrated Option Grids - brief, 1-page decision aids - into their daily practice are reporting increased patient knowledge and SDM without an increase in the encounter length and with minimal training needed to use the tools. This reminds us that more is not always better and that shorter tools are easier for patients to use and for clinicians to integrate into workflow.
  • A study led by Dr Paul Barr is examining patients’ preferred method of receiving CollaboRATE - a short three-item patient-reported measure of SDM - after their clinical encounter. Findings regarding the most effective delivery method (SMS, email, interactive voice response) will very likely reflect the level of burden involved in each method.
  • Work is also underway to better understand patient perspectives on audio recordings of their clinical encounters - a controversial but promising practice that may help reduce the burden of trying to take notes on the clinician’s key points while experiencing emotional swings during the consultation. More on this is available in recent papers in BMJPloS One and the British Journal of Hospital Medicine.
Examples such as these demonstrate the potential to reduce patient burden by emphasizing high levels of carefulness and encouraging the practice of kindness in clinical settings.


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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.

 

SMDM Responds to American Society of Clinical Oncology’s Value Framework 


by Tanya Bentley, Director of Health Economics at the Partnership for Health Analytic Research, Elena Elkin, Research Scientist at Memorial Sloan Kettering Cancer Center, and Heather Gold, Assistant Director of Health Disparities and Outcomes Research at the NYU Cancer Institute


ASCOAsserting expertise and leadership in the areas of value and cost measurement, SMDM recently responded to an invitation for public comment from the American Society of Clinical Oncology (ASCO). This summer ASCO published a conceptual framework to assess the value of cancer treatment options. Recognizing the increasing cost of new cancer drugs, ASCO’s Value in Cancer Care task force developed the framework, which includes an explicit scoring algorithm, to help patients and providers understand the net benefit of chemotherapy agents for specific indications. 

ASCO’s value algorithm involves two domains: clinical benefit and toxicity. Benefit is scored and weighted according to improvement observed in a randomized trial, with relative improvement in median overall survival receiving the greatest weight, followed by progression-free survival and response rate. In the advanced-disease setting, bonus points are awarded for palliation of cancer symptoms and improvement in treatment-free interval. The scoring algorithm does not include cost. Rather, ASCO recommends that the “net health benefit score” be presented alongside estimates of drug acquisition cost and cost to the patient.

SMDM’s response to ASCO was drafted by an ad hoc committee of SMDM members with expertise in cancer outcomes research and reviewed by the Society’s leadership. Chief among the committee’s concerns was the framework’s reliance on measures of relative rather than absolute benefit. Other concerns were the exclusion of observational data sources and of diagnostic tests required for delivery of targeted agents. The committee also suggested that the framework explicitly incorporate patient preferences (using, for example, established methods of health-state utility elicitation) and leverage existing knowledge and tools to advance physician-patient communication about value and cost. The SMDM committee suggested that patient costs be considered with regard to their timing, explicitly acknowledging that out-of-pocket costs may vary over a calendar year due to health insurance features such as deductibles and out-of-pocket limits. SMDM also offered to collaborate with ASCO on future iterations of the framework.

Tanya Bentley, Director of Health Economics at the Partnership for Health Analytic Research, and Elena Elkin, Research Scientist at Memorial Sloan Kettering Cancer Center, spearheaded SMDM’s response, joined by Scott Cantor (MD Anderson Cancer Center), David Howard (Emory Univeristy), and Heather Taffet Gold (New York University). Asked about the importance of the ASCO statement and SMDM’s response, Bentley said, “SMDM members have been thinking about value and cost in this way for years. It’s exciting to see clinical societies take an interest in these issues. This was a unique opportunity to contribute our expertise to clinical policy around cancer costs.” Gold, Assistant Director of Health Disparities and Outcomes Research at the NYU Cancer Institute, added that while ASCO’s current value framework focuses on pharmaceutical interventions, it could be expanded to include other cancer treatments, such as novel radiation therapies. 

In a preface to the value framework, ASCO acknowledged existing methods for assessing value and cost of cancer care, including quality-adjusted life-years (QALYs) and incremental cost-effectiveness analysis. The ASCO task force concluded that limitations of these methods necessitated the development of their new framework. The draft framework was published online in the Journal of Clinical Oncologyin July. The public comment period ended in August, and a final statement is forthcoming. 

http://www.asco.org/practice-research/value-cancer-care
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Congratulations: 2015 SMDM Elected Officers and Trustees 


Congratulations to the 2015-2016 Officers and Trustees for the Society of Medical Decision Making! Thank you to everyone who voted and especially to everyone who was willing to serve. Your contributions make the Society stronger! Please feel free to reach out to our new slate to welcome them and become more involved in the Society's activities.
 

 

President-Elect: Angie Fagerlin, PhD

Angie Fagerlin is a Professor of Medicine at the University of Michigan where she also Co-Directs the Center for Bioethics and Social Sciences in Medicine. She is also a Research Scientist at the Ann Arbor VA. Her research focuses on how to communicate complex risk and benefit information within patient decision aids. She has also conducted numerous studies that have tested the use of decision aids in a variety of medical conditions (e.g., breast, prostate, and colorectal cancers, diabetes, dialysis). Her current research focuses on the impact of decision aids on patient-physician communication (using mixed methods: surveys and audio recordings of the treatment discussion between patients and physicians) and determining the most influential risk communication strategies for communicating about pandemic conditions (e.g., influenza, measles, Ebola, MERS).

She has contributed to SMDM in multiple ways over the last 15 years since she first joined the society. She is currently serving as Vice President and has previously served as a trustee, the chair of the publications committee (where she presided over an editor search and a publisher search), an MDM editorial board member, and a frequent mentor in the one-on-one mentoring program and dinner with the experts. Finally, she was honored to receive SMDM’s award for Outstanding Paper by a Young Investigator. 
 

 

Lisa ProsserVice-President Elect: Lisa Prosser, PhD 

Dr. Prosser is an Associate Professor and Director of the Child Health Evaluation and Research Unit at the University of Michigan. Her research focuses on measuring the comparative effectiveness and cost-effectiveness of childhood health interventions using methods of decision sciences and economics. Current research topics include evaluating long-term health and economic outcomes for newborn screening programs using simulation modeling, measuring public values for screening programs, and developing new methods for valuing family spillover effects of childhood illness.

Dr. Prosser's research on the economic impact of influenza vaccination has been used in setting national vaccine policy for children and for prioritizing subgroups in vaccine shortage years. Her studies using decision science modeling to project long-term health outcomes for proposed newborn screening programs have been used to inform national newborn screening policy decisions. She is currently a member of the evidence review group for the Advisory Committee on Heritable Disorders in Newborns and Children and the ACIP Zoster Working Group. She is also a member of the 2nd Panel on Cost- Effectiveness in Health and Medicine.

Dr. Prosser holds a PhD in Health Policy from Harvard University, MS degrees in management and technology policy from MIT, and BA in mathematics from Cornell University. 
 

 

Beate JahnInternational Trustee: Beate Jahn, PhD  

Beate Jahn, Dipl.-Math. oec., Dr.rer.soc., is a Senior Scientist and Head of the Program of Personalized Medicine at the Institute of Public Health, Medical Decision Making and Health Technology Assessment, at UMIT - University for Health Sciences, Medical Informatics and Technology in Hall i.T., Austria.

Dr. Beate Jahn studied Mathematics and Economics, worked in Project Finance in Germany and started her academic career at the University of Innsbruck in Austria where she earned her doctoral degree in Social Science with the focus on health-economic evaluation. She joined the Institute of Public Health at UMIT in 2007 and spent several months as a Visiting Researcher at the PATH Research Institute (Programs for Assessment of Technology in Health) in Hamilton, Canada, and at THETA (Toronto Health Economics and Technology Assessment Collaborative).

Her research interests include decision-analytic modelling, budget-impact modelling, mathematical methods and quality-of-life assessments. Currently, she focuses on the application of discrete event simulation (DES). Her field research includes the development of a breast cancer outcome model, a multi-country budget-impact study for chronic hepatitis C treatment to guide Health Technology Assessment (HTA) agencies and a project on decision support methods and models based on linked real world data funded by the European Commission. Dr. Jahn is member of the EUnetHTA Joint action 2. At UMIT she is a lecturer and coordinates the international hands-on Workshop 'Modeling Approaches for HTA'. She is also responsible for the scientific project management of Area 4 ‘HTA and Bioinformatics’ in the ONCOTYROL Centre for Personalized Cancer Medicine. Her research has been presented at international conferences, published in scientific articles and included in a text book chapter.

She has led pre-conference workshops on decision analysis, modelling and DES at SMDM meetings in Europe, North America and Asia. For her Short Course on DES at the 2012 SMDM Meeting in Oslo, she received the SMDM Award for the Best Short Course. She is a member of the ISPOR-SMDM Modeling Good Research Practices Task Force. As a former member of the SMDM Education Committee she organized the first European SMDM fellowship program in 2014. At SMDM meetings, she has mentored new scientists, judged presentations and chaired sessions. 
 

 

Ava John-BaptistsTrustee: Ava John-Baptiste, PhD 

Ava John-Baptiste is an assistant professor in the Department of Anesthesia & Perioperative Medicine, in the Schulich School of Medicine and Dentistry at Western University. She is also a health economist in the Centre for Medical Evidence, Decision Integrity and Clinical Impact (MEDICI). The MEDICI unit supports health policy decision making at the London hospitals (London Health Sciences Center, St. Joseph’s Healthcare London) and the Southwestern Ontario Local Health Integration Network (LHIN). Through MEDICI, Dr. John-Baptiste collaborates with clinicians and scientists on initiatives to appraise the safety, effectiveness and cost-effectiveness of health technologies. In addition to applied health policy projects, she is interested in methodological research on health technology assessment in the hospital setting. Dr. John-Baptiste teaches in the Schulich Interfaculty Program in Public Health and in the Department of Epidemiology and Biostatistics. 
 

 

Jane KimTrustee: Jane J. Kim, PhD 

Dr. Kim is an Associate Professor of Health Decision Science in the Department of Health Policy and Management and the Center for Health Decision Science at the Harvard T.H. Chan School of Public Health. She holds a Master’s degree in Health Policy and Management (2001) and a Ph.D. in Health Policy and Decision Sciences (2005) from Harvard. Her research focuses on the development and application of mathematical modeling methods to evaluate health policy issues related to women’s health. She has developed and used models to perform cost-effectiveness analyses of cervical cancer prevention strategies for informed decision making globally. Her methodological interests include capitalizing on different methods of operations research to inform resource allocation decisions in low- and middle-income countries, such as quantifying the impact of budget and human resource constraints on program effectiveness. She was the recipient of the Society’s Lee Lusted student award in 2002 and 2005 and the Association of Schools of Public Health (ASPH) Young Investigator’s Research Award in 2010 and has been recognized for her teaching and mentoring. She has been an active member of SMDM since 2001 with membership in the Education Committee since 2011. 
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Thank You for Your Service!


With the excitement of welcoming new members to the SMDM Board of Trustees, we must also say goodbye to those who have completed their terms. Please join SMDM in offering its sincere gratitude to the following members who have served our Society so well!

Pictured below from left to right, top row:
Murray Krahn - Past President and Nominations Chair
Angie Fagerlin - Vice President and Education Chair
Bruce Schackman â€“ Secretary Treasurer
 
Bottom row, left to right:
Michael Kattan – Trustee 
Mary Politi – Trustee and Networking Chair
Beate Sander – Trustee, Interest Group Chair and Career Development Chair

Thank you Trustees 

From left to right:
Elbert Huang and Negin Hajizadeh â€“ Policy Committee Chairs
Scott LaJoie and James Stahl â€“ St. Louis Meeting Chairs

Thank You Committee Chairs
 
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2015 SMDM Award Winners


The SMDM is pleased to announce the winners of the 2015 SMDM Awards. 

The Career Achievement Award recognizes distinguished senior investigators who have made significant contributions to the field of medical decision making. The 2015 recipient is Alvin I. Mushlin, MD, ScM.
 
The Eugene Saenger Award for Distinguished Service recognizes service to SMDM in terms of leadership, role in the operations of the Society, and contributions to the scientific and educational activities of the Society. The 2015 recipient is Anne Stiggelbout, PhD.
 
The John M. Eisenberg Award for Practical Application of Medical Decision Making Research recognizes an individual or organization that has demonstrated sustained leadership in translating medical decision making research into practice, and that has taken exceptional steps to communicate the principles and/or substantive findings of medical decision making research to policy makers, to clinical decision makers, and to the general public. The 2015 recipient is Alan Schwartz, PhD.
 
The Young Investigator Award is presented annually for the best paper published by a trainee or junior faculty member. The 2015 recipient is Joshua A. Roth, PhD, MHA, for his paper, Economic Return From the Women’s Health Initiative Estrogen Plus Progestin Clinical Trial: A Modeling Study. Annals of Internal Medicine. 2014;160(9):594-602.

These individuals will be honored at the upcoming meeting in St. Louis, MO. Please join us in congratulating all the winners and thanking the Awards Committee for their work: John Wong, Chair, Amber Barnato, Liz Fenwick, Don Redelmeier, Ursula Rochau and Ankur Pandya.

Pictured below the 2015 Award winners (top row, l to r): Al Mushlin, Anne Stiggelbout, (bottom row, l to r) Alan Schwartz and Josh Roth

SMDM Award Winners
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Member News



Tom Achoki, MD, MPH, University of Washington, recently published a global burden of disease study that shows an increasing life expectancy in Kenya, with women living longer than men. However, the increase in health life expectancy has not been so dramatic, meaning people are living longer with disability and illness.  n_achoki@yahoo.com


Dr. E.W. (Esther) de Bekker-Grob was awarded a Personal VENI grant from the Netherlands Organisation for Scientific Research for her project entitled: Is patients' choice predictable?. Obtaining insights into patients' preferences is important to reach optimal clinical and policy decisions. This research proposal determines how well stated preferences of patients are consistent with revealed preferences, why these deviate, and how choice behaviour of patients can be better predicted.  In addition, her article, Sample size requirements for Discrete Choice Experiments in health care: a practical guide. 2015, was one of the five most downloaded articles in The Patient in the last quarter.  e.debekker@erasmusmc.nl


Peder A. HalvorsenOlaf Gjerløw Aasland and Ivar Sønbø Kristiansen recently published a paper entitled "Decisions on statin therapy by patients’ opinions about survival gains: cross sectional survey of general practitioners".  Salient findings were that: GPs overestimated survival gains from statin therapy; they were insensitive to patient preferences regarding survival gain when recommending statin therapy; and that their recommendations were strongly associated with their own estimates of survival gain. The study was presented at the SMDM meeting in Toronto in 2010 and published in BMC Family Practice, July 2015.  peder.halvorsen@kraftlaget.no


L. Robin Keller is the 2015 recipient of the Ramsey Medal for lifetime contributions to the field of decision analysis, awarded by the Decision Analysis Society of INFORMS. She also recently published: “A Markov Model to Evaluate Cost-Effectiveness of Antiangiogenesis Therapy Using Bevacizumab in Advanced Cervical Cancer”, Gynecologic Oncology, 137 (3), June 2015, 490-496. The conclusions: Increased cost is primarily related to the cost of drug and not the management of bevacizumab-induced complications. Cost reductions in bevacizumab result in dramatic declines in the ICER, suggesting that cost reconciliation in advanced cervical cancer may be possible through the availability of biosimilars, and/or less expensive, equally efficacious anti-angiogenesis agents. Her newest paper, Yitong Wang, Liangyan Wang, L. Robin Keller, Discounting over Subjective Time: Subjective Time Perception Helps Explain Multiple Discounted Utility Anomalies, will soon be published in the International Journal of Research in Marketing.  LRKeller@uci.edu


Dr. France Légaré has been appointed “Lead of the HEALTH AND SOCIAL SERVICES SYSTEMS, KNOWLEDGE TRANSLATION AND IMPLEMENTATION platform of the Support for People and Patient-Oriented Research and Trials Unit of the Province of Québec”  He has also been recognized as one of the Top 20 Pioneers of Family Medicine Research in Canada by the College of Family Physicians of Canada for her research with decision aids and how they can be used in practice.

 
Dr. Neal C. Murphy, a QA consultant, expert witness and periodontist in Los Angeles is working with two other MD's in composing an academic treatise tentatively titled "The Existential Doctor: taking healthcare back home."(c) As a popular treatise on rational thought in compassionate human care collaborators from all aspects of the most relevant SMDM. The emphasis is placed on chronic conditions (hypertension, periodontitis, diabetes) where psychology, philosophy, ethics, nursing biology, and decision theory intersect in a context of the highest humanist endeavor.  neal.murphy@case.edu


Mark S. Roberts, MD, MPP, Chair of the Department of Health Policy and Management, was named Director of the Public Health Dynamics Laboratory at the University of Pittsburgh School of Public Health. The laboratory has developed large, agent-based simulation models of infectious disease, and has been continuously funded by the Modeling Infectious Disease Agent Study (MIDAS) for over 10 years.  mroberts@pitt.edu


Alan Schwartz has been named the Michael Reese Endowed Professor of Medical Education at the University of Illinois at Chicago.


The Belgian Antibiotic Policy Coordination Committee; (BAPCOC) produced a fantastic comic, ‘Auntie Biotica’ as part of its annual national awareness campaigns to achieve correct use of antibiotics. The comic is also available online in Dutch, French, German and in English and is endorsed by European Antibiotic Awareness Day coordinated by the European Center for Disease Prevention and Control (ECDC).  samuel.coenen@uantwerpen.be



On September 18 2015, at Akershus University Hospital, Lørenskog, Norway, Eirik Hugaas Ofstad defended his PhD thesis entitled, “Medical Decisions in 372 hospital encounters.” Professor Glyn Elwyn, Dartmouth Institute for Health Policy and Clinical Practice was first opponent, while Associate Professors Hilde Grimstad, Norwegian University Of Science And Technology and Erik Werner, University of Oslo, served as second and third opponents, respectively. In his trial lecture, Dr. Ofstad outlined the field of natural language processing and how it might affect health research communication. In his thesis, based on 372 video taped hospital encounters, Dr. Ofstad showed that even though the number of medical decisions per encounter was quite high (mean 13), patient involvement was exceedingly rare. He also presented a novel taxonomy for decision identification and classification. After an engaging and thoughtful discussion, the opponents concluded that Dr. Ofstad’s work will stand out as one of the most important contributions to his field of inquiry. The event was proudly witnessed by SMDM member professor, PÃ¥l Gulbrandsen, Dr Ofstad’s main supervisor, other SMDM members, colleagues, family, and friends. 
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Student News



Aaron Scherer, https://sites.google.com/site/schererpsych/aaschere@umich.edu
Degree: PhD, Decision Psychology
Expected Graduation: 5/1/2014
Position Seeking: academic

Papers Presented:
The impact of the “illusion of explanatory depth” on health-related decision making preferences (2015)    Block it out! Presenting test results with clearly defined categories increases understanding of the results (2015)

Short Courses Attended:
Principles of Effective Data Visualization (2015)

Interest Groups: 
Decision Psychology; Diagnosis & Clinical Decision Making

SMDM Mentor:
Olga Kostopoulou (2014)
 
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What Are You Working On?


SMDM members Jesse Ortendahl and Tanya Bentley, both of the Partnership for Health Analytic Research, have recently been developing models to assess the costs and cost-effectiveness of clinical pathway implementation in oncology. Given rising healthcare costs and budgetary constraints, insurance plans and hospitals have been designing and implementing treatment pathways aimed at improving clinical outcomes while controlling costs. Programs are being developed which aim to shift patients towards on-pathway treatment regimens, however such efforts often require an upfront cost for pathway development, incentives to promote usage of recommended treatments, and monitoring to determine pathway adherence. While the growth in evidence of the cost effectiveness of specific treatments is welcome, it often takes the form of identifying a single optimal treatment for an entire population without inclusion of external factors including the costs of promoting usage and partial adherence. In our current work, Tanya and Jesse are using TreeAge and Microsoft Excel models to explore the factors that go into pathway implementation, measure the benefits of incentive programs, and assess how the financial outlays compare to potential clinical and economic gains. Feedback from any SMDM members with experience in this area is welcome!   jesse@pharllc.com

 


We Want to Hear from You!
This new section of the Newsletter invites you to describe current projects that are either in the formative stage or underway. The idea is to enable all of us to learn more about the ongoing activities of our Society and to potentially connect members with like interests on a regular basis! Please consider submitting news about projects in the idea stage as well as those that are ongoing to this section, and if you are looking for collaborators or advice in a specialized area, don’t hesitate to include that information in your submission. 
 
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Job Postings


The following positions have been recently posted in the Resource Section of SMDM Connect
  • Assistant or Associate Professor (Research) – Brown University School of Public Health
  • Postdoctoral Position in Health and Social Services Systems, Knowledge Translation and Implementation – Laval University
  • Assistant, Associate or Full Professor – Center for Primary Care and Outcomes Research, Department of Medicine, Stanford University School of Medicine
  • Faculty Position – University of Alabama at Birmingham
  • Open Rank Faculty Position in Communication and Health – Northwestern University School of Communication
  • Lecturer Position in Communication and Health – Northwestern University School of Communication
  • Division Chief of Comparative Effectiveness and Outcomes Research – Department of Healthcare Policy and Research, Weill Cornell Medical College
Check out all the details and the latest Job Postings Here
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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 – September 22, 2015. 
Bolded individuals made contributions since the last report.
Italicized individuals moved up a level of giving in 2015.

Raiffa-Kahneman Circle
(Contributions total $5,000 or more)
John Clarke ('13, '14)
Jeremy Goldhaber-Fiebert ('13, '14)
Mark Helfand (‘05, ‘07, '10, '11)
Joseph King (‘06 - '14)
James Stahl, Stahl Family/Stahl Bioethics Foundation in honor of Dr. Eva Bamberger Stahl (‘06, ‘09, '10, '12, ‘15)

Pareto Level
(Contributions total $1,000 - $4,999)
Dana Alden ('12, '13, '14)
Michael Barry (‘06 - '10)
Ahmed Bayoumi (‘06, '08 - ‘15)
Dennis Fryback (‘05 -'15)
Michael Kattan ('13, '14)
Murray Krahn ('13, '14)
William Lawrence (‘06, '10, '11, '13)
David Rovner & Margaret Holmes-Rovner (‘05 - '15)
Bruce Schackman (‘06 -'14)
Marilyn Schapira (‘07 - '12, '14 - '15)
Uwe Siebert ('11, '13, '14)
Frank Sonnenberg (‘06, ‘09)
Harold and Carol Sox ('10 - '14)
Sankey Williams (‘06 - ‘08, '13, '14)
John Wong (‘06 - '13)

Edwards Level
(Contributions total $750 - $999)
Neal Dawson (‘05 - '15)
David Meltzer ('07, '09)
Jill Metcalf (‘07 - '14)
Stephen Pauker (‘06, ‘09)
Seema Sonnad (‘06, ‘07, ‘09, '12 - '14)
Joel Tsevat (‘06, ‘09, '10)

Tversky Level
(Contributions total $500 - $749)
Anirban Basu ('13)
Robert Beck (‘07) 
Scott Cantor & Lisa Stone (‘07 - '14) 
Kate Christensen (‘09)
Nananda Col (‘05 - ‘09)
Peder Halvorsen ('11 - '15)
Myriam Hunink (‘05 - '14)
Sara Knight (‘05 - '14)
Steven Kymes (‘05 - ‘09, '12, '15)
Kathryn McDonald (‘07, '09, '10, '14)
David Paltiel ('07, '09)
Mark Roberts (‘08, ‘09, '13)
Alan Schwartz (‘07, '10 - '15)
David Sugano (‘07, ’09 – '11, '13)
Jef van den Ende (’10, '14)

von Neumann-Morgenstern Level
(Contributions total $250 - $499)
Amber Barnato (‘05, ‘07, '11, '12, '14)
Donald Brand ('13, '14)
Dena Bravata (‘06, ’09 -  '11)
Andy Briggs ('14)
Randall Cebul (‘06, ‘08, '10)
Mark Eckman (’06, ‘09)
Elena Elkin (‘07, '14)
Arthur Elstein (‘06, ‘07, ‘09, ‘10) 
Angela Fagerlin ('14)
Heather Taffet Gold (‘08, '11, '14)
Don Husereau ('13)
Karen Kuntz (‘09, '11)
Miriam Kuppermann (‘06 - '10, '12, '14 - '15)
Thomas Tape ('10, '11, '14)
Robert Wigton ('10, '11, '14)

Markov Level
(Contributions total $100 - $249)
Cathy Bradley (‘07)
Scott Braithwaite (’09)
Linda Canty ('12)
Phaedra Corso (‘06, ‘07, ‘08)
Magdelena Flatscher-Thöni ('14)
Alan Garber ('10)
Robert Hamm (‘06, ‘08, '14)
Paal Joranger (‘14)
Esther Kaufmann ('11)
Sun-Young Kim (‘07, ‘08, ‘10, '13)
Joseph Ladapo ('12 - '15)
Curtis Langlotz ('12)
Lisa Maillart ('10)
Peter Neumann ('14)
Richard Orr (‘05, ‘06)
Jesse D. Ortendahl ('11, '12, '13)
Roy Poses ('14)
Brian Rittenhouse (‘07)
Ursula Rochau ('14)
Allison Rosen (‘07)
Natasha Stout ('14)
Verena Stühlinger ('14)
Joanne Sutherland (‘08, ‘09)
John Thornbury (‘05)
George Torrance (‘05)
Benjavan Upatising ('13)
Brian Zikmund-Fisher (‘08 - '15)

Bayes Level
(Contributions total up to $100)
Jessica Ancker ('14)
Hilary Bekker ('12)
Eran Bendavid ('11)
Tanya Bentley ('14)
Denise Bijlenga (‘08)
Kimberly Blake (‘09)
Cindy Bryce ('14)
Rowland Chang (‘06, ‘07)
Carmel Crock (‘09)
James Dolan (‘09)
Arna Dresser ('10, 12, '14)
Rohan D'Sousa ('15)
Liz Fenwick ('14)
Ted Ganiats (‘05)
Lee Green (‘07, ‘09)
Amit Gupta (‘06)
Michael Hagen ('10)
Negin Hajizadeh ('14)
Sarah Hawley ('14)
Kristin Hendrix ('14)
David Howard (‘09)
David Katz (’08)
Job Kievit (‘09)
Kerry Kilbridge (‘05, ‘07, ‘08)
April Kimmel ('14)
Sarah Kobrin ('14)
Ivar Sonbo Kristiansen ('10)
Andrew Scott LaJoie ('10)
Clara Lee ('15)
Sarah Lillie ('14 – ‘15)
Andreas Maetzel (‘09)
Daniel Masica (‘08)
Evan Myers ('12)
Thomas B. Newman ('10)
Jane Pai ('10)
George Papadopoulos (‘08)
Mary Politi ('14)
Lisa Prosser (‘08)
Valeria Reyna ('14)
Michael Rothberg (‘09 - '12)
Gillian Sanders (‘07)
Jha Saurabh (‘09)
Karen Sepucha ('14)
Ewout Steyerberg (‘06, ‘09, '11, '13)
Anne Stiggelbout (‘06)
Carol Stockman (‘05)
Danielle Timmermans (‘07)
Hugues Vaillancourt ('11)
Erika Waters ('14)
Milton Weinstein (‘09, '11)
Robert Werner (‘08)
Holly Witteman ('14)
Eve Wittenberg ('14)
Theodore Yuo ('15)
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Meeting News
SMDM meetings provide a highly interactive forum for discussion of novel research based on decision and behavior theory and analytical models applied to health related decisions. Presentations of original research, keynote talks, special symposia and short courses offer attendees the opportunity to explore diverse topics in medical decision making and the unique ability to connect with colleagues one to one. We hope to see you there! 

The North American Meeting begins next week in St. Louis, MO! Click here for the latest news and follow #SMDM15 for updates! See you there!

Plans for the 16th Biennial European SMDM Conference in London Moving Forward


by Olga Kostopoulou, PhD, MSc, Imperial College London

The 16th Biennial European SMDM Conference, taking place in London (12-14 June 2016) is shaping up to be an exciting and rewarding meeting. With Olga Kostopoulou serving as Chair and Anne Stiggelbout and Liz Fenwick as Co-chairs, the conference focuses on Improving Diagnostic Decision Making. 

The meeting (and the social event) will take place at 30 Euston Square, a historic building with modern conference facilities, at the heart of London (https://30eustonsquare.co.uk). The venue is very close to two major railway stations (Euston station and King’s Cross station) and to St Pancras International, home to Eurostar. Thus, it is perfectly located for visitors arriving from Europe on the Eurostar, as well as overseas visitors who wish to explore Europe after the London meeting! 

Professor Ralph Hertwig, Managing Director of the Max Planck Institute for Human Development in Berlin, will deliver the keynote speech with the provocative and thoughtful topic “Beyond nudging: How to boost medical decision making.” As Professor Herwig notes, “Nudging bets that changing people’s choice architecture will alter their otherwise detrimental behaviors in positive and predictable ways. In this talk, I will be concerned with policy interventions that do not nudge but boost, that is, extend people's decision-making competence rather than co-opting their deficits. I will discuss boosts taken from the domains of diagnostic inference, surrogate decision making, patient communication and dietary choices.” 

The meeting will also feature a symposium on vaccination decision making with Cornelia Betsch, Robert Böhm, Stephan Lewandowsky, and Adele Diederich.  Addressing the timeliness and relevance of the session topic, symposium Chair, Dr Betsch said: “In the last decade, scientists have suggested a large amount of interventions that influence vaccine decision making to increase vaccine uptake – such as debunking vaccination myths, stressing disease risks or appealing to social motives. In the face of recent measles outbreaks, even discussion about compulsory vaccinations recurred. This session will provide an overview of the reasons for vaccine, propose interventions to raise vaccine uptake, provide insight into the know-how of applying promising approaches, and discuss the need for and potentially detrimental effects of compulsory vaccinations.”  

There will be another invited symposium on early cancer diagnosis (for details, please check the meeting website (http://smdm.org/meeting/16th-biennial-european-meeting), and the possibility of a second keynote speaker. 

Finally, London! London does not need an introduction. It is a world city, boasting important museums, famous theatres, beautiful parks, historic monuments, outdoor markets, and tireless nightlife. You are never bored in London – “tired of London, tired of life”. Most important, it is a safe city with a convenient and extensive public transport system.

Olga will be at the St Louis meeting, so if you have ideas for short courses that you’d like to offer at the London meeting, speak to her! We hope to see you in London in June! 


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Updates on the 2nd Biennial Asia-Pacific SMDM Conference


by Katrina Tsang, MBChB, BSc, The Chinese University of Hong Kong

The 2nd Biennial Asia Pacific SMDM Conference, held at the Chinese University of Hong Kong, is shaping up to be an invaluable event, promoting medical decision making principles and skills in the theme of end of life care and ageing, while delving deeply into specific priority areas for the Asia-Pacific region.

The 2nd Biennial Asia-Pacific SMDM Conference will be held at The Chinese University of Hong Kong from January 8-10, 2016. The theme of the Conference is, "Making Difficult Clinical and Policy Decisions: The Example of Ageing and End of Life Care in Asia-Pacific".

Dr. Iona Heath, former president of the Royal College of General Practitioners and British Medical Journal columnist, will deliver the keynote speech. In addition, there will be a plenary session on individual-level decision making chaired by Professor Jean Woo, Emeritus Professor of Medicine, Chairman of Department of Medicine and Therapeutics, Head of Division of Geriatrics, and Directors for S.H. Ho Centre for Gerontology and Geriatrics, and Institute of Aging.

We are also pleased that researchers from 17 countries in North America, Europe, and many from Asia have submitted abstracts with the following relevant  themes: 'Making Difficult Clinical Decisions,’ 'Making Difficult Policy Decisions,’  and 'Methodological and Theoretical Developments.’  This conference is shaping up to be an invaluable event, promoting medical decision making principles and skills, while delving deeply into specific priority areas for the Asia-Pacific region.

There will also be ample opportunities during the conference to network with regional and international colleague while exploring different parts of Hong Kong.  A few examples include: riding the â€‹25-minute cable car that takes you through the mountains of Lantau in a glass-bottom cabin to visit the world's tallest, outdoor, seated bronze Buddha;  taking a stroll along the Avenue of Stars on the Victoria Harbor Waterfront while enjoying Hong Kong's iconic skyline lit up by "A Symphony of Lights" staged on both sides of the harbor;  finding good bargains from the Ladies' Markets that span 1km;  exploring the famous Temple Street Night Market while appreciating Cantonese opera singers and hearing fortune tellers unveil your future;  or exercising your taste buds in the culinary extravaganza of eateries and cuisines from all parts of the world (and getting some physical exercise afterwards).

We look forward to learning more about your work and welcoming you to the beautiful city of Hong Kong, where the East meets the West, the ancient meets the modern, science meets art, and where shared decision can make an impact on everyone's end of life and ageing.



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The Fall issue of our Journal, Medical Decision Making, is available for your review.

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