We hope you enjoy the Winter Newsletter from the Society for Medical Decision Making


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

by Anne Stiggelbout, PhD

Society Updates

Society Updates

Board of Trustees / Nominations Committee
Membership Survey
SMDM Awards
SMDM Journal


SMDM Meetings

SMDM Meetings

2012 Biennial SMDM European Meeting
Scholarships Available for European Meeting
2011 North American Meeting Recap

Global Health Working Group Has Record Attendance at 2011 Annual Meeting



What is the Basic Psychology of Medical Decision Making?
by Robert M. Hamm, PhD
Risk Analysis and Communication:
A Multinational Research Effort

by Jesper Bo Nielsen, PhD, MSc
by Stephen G. Pauker, MD
Cancer Communication Meets Social Media
by Sylvia Wen-Ying Chou, PhD, MPH

Other News

Other News

Comparative Effectiveness Research Meeting
Members in the News

Recognition of Lifetime Contributors

Events and Opportunities

Be sure to take advantage of the events and opportunities SMDM has to offer.
2012 Biennial European Meeting
Opportunities to Volunteer
Call for Nominations, SMDM Officers & Trustees

Call for Nominations, SMDM 2012 Awards
Job Postings
Support SMDM
Join SMDM on Facebook
Contact Us


A. Scott LaJoie, PhD, MSPH, Editor-in-chief, University of Louisville
Donald A. Brand, PhD, Senior Editor, Winthrop University Hospital

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

Contributing Writers

Robert M. Hamm, PhD, University of Oklahoma Health Sciences Center
Jesper Bo Nielsen, PhD, MSc, University of Southern Denmark
Stephen G. Pauker, MD, MACP, ABMH, Tufts Medical Center
Sylvia Wen-Ying Chou, PhD, MPH, National Cancer Institute
Michael W. Kattan, PhD, Case Western Reserve University

From the Editor

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

A. Scott LaJoieHappy New Year and welcome to the winter edition of the SMDM newsletter. The Annual Meeting this past October was, by all accounts, a smashing success with record or near record attendance and participation. The behavioral economics theme rang loudly throughout the conference. Leslie Johns, PhD, who offered SMDM’s first short course in behavioral economics to a full classroom, demonstrated the close relationship between behavioral economics and the research of many of our members. In his keynote address, George Loewenstein, PhD, encouraged us to consider the subtle ways in which potential conflicts of interest can lead to unintended biases and consequences in the patient-provider relationship. Peter Ubel, MD, Kevin Volpp, MD, PhD, and Kit Sundararaman, PhD, helped close out the conference by illustrating the uneasy balance between nudging and shoving individuals to embrace healthy behaviors.

Also at the meeting, the SMDM board thanked outgoing president, Marilyn Schapira, MD, MPH, and welcomed Anne Stiggelbout, PhD, as our new president. Representing a growing body of international members, Dr. Stiggelbout pledged to make SMDM more inclusive of non-North American colleagues and encouraged all who would listen to submit abstracts and attend the Society's European Meeting this June in Oslo, Norway.

The October meeting marked a change in the leadership of the Lee Lusted Award committee: a special “thank you” was extended to Robert Wigton, MD, who has led the evaluation and selection of the Lee Lusted Award winners for the past 25 years. Howard Raiffa, PhD, was recognized for his career achievement and withstood a barrage of camera flashes from students, mentees, colleagues and admirers wishing to capture images of him.

In addition to wrapping up the meeting, this issue presents several articles that readers should find interesting and informing. Jesper Bo Nielsen, PhD, MSc, provides evidence for why SMDM is, and must continue to be, a multi-national and multi-disciplinary collaborative effort to improve medical decision making. Stephen Pauker, MD, discusses the factors impacting impact factors. Robert Hamm, PhD, emphasizes the relevance and importance of the field of psychology to medical decision making and Wen-ying Sylvia Chou, PhD, MPH, explores the impact of social media on cancer communication.. Please enjoy these and the many other stories and useful tidbits contained within this newsletter. Along with our senior editors Donald Brand, PhD, and Scott Cantor, PhD, I encourage you to contribute stories and photographs to upcoming newsletters.

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From the President

by Anne Stiggelbout, PhD
Anne Stiggelbout, President
I feel honored and excited to be this year’s President of SMDM. I had a very inspiring start of my term in Chicago! Of course the Chicago meeting was the product of excellent work from the Co-Chairs Anirban Basu, PhD, and Dan Polsky, PhD, with a fantastic team of others, such as the Scientific and Short course Co-Chairs, and too many to name. But for me, the meeting was also evidence that we, the leadership team, together with our Executive Director, Jill Metcalf, and the many members active on the Board, in Committees and Interest Groups and in various other functions, are on the right track. And after a year’s work as President-Elect, behind the scenes, it felt really good to see what all the work had led to, and is still leading to. The Society is buzzing with activity, and if you also wish to become involved, please contact me, or any other Board member.

Of course, first and foremost, there was the great scientific content, the mission of our Society. We are a scholarly forum that connects and educates researchers, providers, policy-makers, and the public. This year’s meeting also provided excellent opportunities to connect, particularly for new members, first time attendees, and for international attendees. One of the missions I have for my term as President is to have more visibility of and active involvement from the non-North American members. For those who are not native English speakers or whose culture at times seems very different from the American culture, it may feel difficult to let one’s voice be heard. I hope that in the years to come this will change. In Chicago, I spoke to many of the international attendees, and from what I heard, times are already a-changin’, with people feeling more included. If you want to share your views, or are interested in becoming more active, let me know! I think one of the important (and the fun!) aspects of SMDM is that we are an international Society, and that we can learn from one another, all around the world.

An important issue in the coming years is the financial stability of the Society. We are an active Society, with a strong mission, and have developed many initiatives, such as the fellowship programs. But attention should also be focused on initiatives from which the Society can profit. The Business Development Committee, chaired by Newell McElwee, PharmD, MSPH, has been created to look into these matters. If you have ideas in this area, please contact Jill Metcalf or Newell McElwee.

And of course, while we may still be thinking back to the wonderful Chicago meeting, the Chairs of the European Meeting, to be held in Oslo, Norway, are busy preparing for another exciting meeting and the call for abstracts has already gone out. Hope to see you there!

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Board of Trustees / Nominations

Among the many highlights of this year’s annual meeting was the opportunity to welcome new members to the SMDM Board of Trustees. New to the Board are President-Elect Scott Braithwaite, MD, Vice President-Elect Uwe Siebert, MD, MPH, MSc, ScD, and Trustees Elisabeth Fenwick, PhD, MSc, Jeremy Goldhaber-Fiebert, PhD, and Robert Hamm, PhD. More information about the Board and links to member bios can be found at

With the excitement of welcoming new members onto the Board, we said goodbye to those who served our Society so well during their tenure. This year, SMDM thanked outgoing Past President Kathryn McDonald, MM, Vice President Alan Schwartz, PhD, Secretary-Treasurer Miriam Kuppermann, PhD, MPH, and Board Members Scott Braithwaite, MD, Cindy Bryce, PhD, and Bruce Schackman, PhD, for their many contributions to the growth and future of the Society.

We welcome your participation in the leadership of SMDM. We are soliciting nominations for the positions of President-Elect, Vice President–Elect, Secretary-Treasurer Elect and 3 Trustees for the 2012-2013 term. The deadline is February 10, 2012. Self-nominations are welcome. For complete information, please see our 2012 Call for Board Nominations.

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Membership Survey

by James Stahl, MD, MPH, Membership Committee Chair

James Stahl, Membership ChairAs most people reading this newsletter will know, we had a very good annual meeting this year in Chicago, Illinois. We have started a new initiative - to start regularly surveying our membership. The purpose of this is to take the pulse of our members, to allow all voices to be heard, and to gain a deeper understanding of our member's needs and goals.

This year, we started by surveying new members at the annual meeting. We had 85 respondents. We asked questions such as: How did you hear about SMDM? Where do you come from? Where do you work? What do you like and not like about SMDM?

Most new members were MDs and PhDs who became involved either through a colleague or from their training program or mentor and most were based in academic institutions (fewer than 5 new members came from industry). People joined the Society at all levels of their career, though 75% joined prior to becoming senior in their field. Most new members were from the US (n=58) with the next highest countries having 2-3 members each from France, Canada, Philippines, Switzerland, and the United Kingdom.

People had a variety of reasons for joining the Society this year, but the meeting, the community, the journal, mentorship, and methods came out on top. People were generally satisfied with the Society’s characteristics, especially the annual meeting, methodological rigor, and SMDM’s values. They were least satisfied with the levels of interdisciplinary opportunities, leadership opportunities, and policy influence. We expect that this information will help us in better planning on how to meet our members’ needs.

We hope to follow this and future member cohorts over time, as well as expand coverage to current members this upcoming year. We thank everyone for participating and we hope to continue learn from each other and to provide you with information you want and need.
If anyone wants to help out or has questions they wish to explore, please do not hesitate to contact me or any member of the membership committee.

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SMDM Awards

by John Wong, MD, Awards Committee Chair
John Wong and Amber Barnato, Awards Chairs
On behalf of the Awards Committee and my co-chair for the Lusted Award Committee, Amber Barnato, MD, MPH, I am pleased and proud to share with you the 2011 awardees.

First, for the 2011 SMDM LEADERSHIP AWARDS:

Career Achievement Award

Howard Raiffa, PhD, Harvard University, the Frank Plumpton Ramsey Professor of Managerial Economics Emeritus, joint chair of the Business and Kennedy Schools received the Career Achievement Award to recognize his seminal work in medical decision making. He has received several honorary doctorates for his lifetime contributions to the field of decision science and for his work on conflict resolution. His wife Estelle accompanied him to a heart-warming and memorable acceptance speech. Watch for his autobiography.

Howard Raiffa receives the Career Achievement Award

We asked a few former students to comment on their experiences with Howard Raffia.

“Without Howard, the inventor of decision analysis, the Society for Medical Decision Making would not exist as we now know it. Many if not most members of SMDM are either his students, students of his students, students of their students, or collaborators in research or teaching with one or more of Howard’s intellectual descendants.”
Milton C. Weinstein, PhD
Harvard School of Public Health

“Howard Raiffa made us students think hard about simple problems. He followed that approach in his work, and mentored us to follow that approach in our research projects.”
Scott B. Cantor, PhD
The University of Texas MD Anderson Cancer Center

“Howard is like a lighthouse, always giving us direction, encouragement, and warmth that lasts forever.”
Ching-Pu Chen, PhD
Yuan Ze University

“Howard has struck a remarkable balance between his relentless faith that analytical thinking can improve decision making, while also recognizing that human decision making is deeply affected by persistent decision biases. He is one of the kindest and warmest individuals I've ever met.”
George Wu, PhD
University of Chicago

“Howard taught me to try simple and common sense approaches. Howard made me think in applied manner. He has influenced my teaching and above all, the way I supervise research students. I always give them the advice I received from Howard. He told me at the very beginning to write down the Table of Contents of the final thesis. At the beginning I would have a vague idea about the chapters, then I should add sub-chapters, write a few sentences for each sub-chapter, expand the sentences to a few paragraphs and then I will have the finished thesis! It is analogous to a jigsaw puzzle where you start out with the frame and then try to fit in all the small pieces.”
Joseph Pliskin, PhD
Ben-Gurion University

Eugene Saenger Award for Distinguished Service

David Sugano received Distinguished Service Award

David Sugano, DrPH, Novartis Pharmaceuticals Corporation received the Eugene Saenger Award for Distinguished Service to SMDM to recognize his exceptional efforts in support of the Society as Vice President, Trustee, and Chair of the Membership Committee. In his acceptance, David referred to Malcolm Gladwell's (a speaker at the 2007 annual meeting in Pittsburgh) distinction between puzzles and mysteries and encouraged all to listen to the questions being asked at SMDM.


Outstanding Paper by a Young Investigator

Claire McKenna, PhD, MSci, MPhil, MSc, received the Outstanding Paper by a Young Investigator for the paper: Budgetary policies and available actions: a generalisation of decision rules for allocation and research decisions. McKenna C, Chalabib Z, Epstein D, Claxton K. Journal of Health Economics 2010; 29:170-181. In the nomination letter, as a framework to merge statistical decision theory, economic evaluation and the complexity of medical decision making at a systems level, "This work helps us understand the limitations of the type of practical decision rules currently available in CEA to inform both adoption and research decisions. In doing so it is able to indicate those circumstances where these practical proxies are and are not likely to be a reasonable approximation to optimal ex-ante decisions. In addition, it has direct policy relevance to questions of whether budgetary constraints (or cost containment policies) should be hard or whether, with a soft constraint, the close monitoring of decisions by the budget holder might be worthwhile. It also demonstrates the importance of understanding the type of information that will be revealed (whether the constraint is likely to be violated), when it is revealed and the actions available to stay within the constraint. This provides a framework within which the value of more timely information about realised costs (and effects) in a budgetary period can be considered." Dr. McKenna is a research fellow at the Centre for Health Economics at the University of York.

Outstanding Short Course

Outstanding Short Course

The 2011 Award for Outstanding Short Course was given to Gregory S. Zaric, PhD, University of Western Ontario, David W. Hutton, PhD, University of Michigan School of Public Health; Lauren E. Cipriano, BSc, BA, PhD Candidate, Stanford University; and Eva Enns, MS, PhD Candidate, Stanford University for their course entitled DETERMINISTIC DECISION ANALYTIC MODELS IN MICROSOFT EXCEL. Teaching remains the foundation for intellectual dissemination for SMDM, and this course continues that long tradition.

Lee B. Lusted Student Prizes

Lee Lusted Winners

The Society encourages and recognizes exceptional work by young investigators. Trainee achievement is recognized by the annual presentation of the Lee B. Lusted Student Prizes for outstanding presentations of research at the Annual Meeting.

The 2011 Lee B. Lusted Student Prize for Behavioral Economics was awarded to Ellen Green, MA, for her presentation on PAYMENT STRUCTURES IN THE MEDICAL COMMUNITY: AN EXPERIMENTAL STUDY.

The Lusted Award for Applied Health Economics, Services, and Policy Research was presented to April D. Kimmel, PhD, for her abstract entitled INTERNAL VALIDATION AND CALIBRATION OF A MODEL TO FORECAST HIV TREATMENT DEMAND AND CAPACITY IN HAITI.

The Lusted Award for Decision Psychology and Shared Decision Making was given to Emelie Heintz, MSc, for her presentation entitled THE IMPACT OF SUBJECTIVE LIFE EXPECTANCY ON HEALTH STATE VALUATION WITH THE TIME TRADE-OFF METHOD.

The Lusted Award for Quantitative Methods and Theoretical Developments went to Theodore H. Yuo, MD, for his presentation, APPLYING THE PAYOFF TIME FRAMEWORK TO CAROTID DISEASE MANAGEMENT.

As has been the case for many meetings, two of the awardees presented oral abstracts and the other two presented poster presentations. You may also notice that two of the awardees were predoctoral students and the other two were postdoctoral with one an MD and the other a PhD. In support of the Lusted Committee, we had an all-time record number of judges.

Eisenberg Lecture

Carolyn Clancy, MD, Director of Agency for Healthcare Research and Quality (AHRQ) presented the Eisenberg lecture recognizing John Eisenberg's exemplary leadership in the practical application of medical decision making research. Her 1988 American Journal of Medicine publication is the first time a decision analysis was used in a randomized clinical trial. She demonstrated that the decision analysis increased recommended screening or vaccination. It is a seminal landmark paper that at the time was not as well recognized as it could have been. She has been a leader in helping steer AHRQ into areas of quality, safety and information technology as well as the AHRQ Evidence-based Practice Centers.

Special Service Award

Bob Wigton receives a Special Service Award

Lastly, Amber and I had the pleasure of recognizing Bob Wigton, MD, FACP, with a special service award acknowledging his 25 years as chair of the SMDM Lusted Award Committee. As I was tabulating the Lusted judge scores late Tuesday night, I came to estimate that Bob had entered and analyzed over 10,000 scores. I can't speak for Amber, but don't expect 25 years from me.

SMDM 2012 Awards - Call for Nominations - Deadline March 2, 2012
Nominations for the 2012 SMDM Awards must be received no later than March 2, 2012. A letter of support for your candidate and if available the nominee’s CV is recommended but not required. Nominations should be submitted via email to SMDM Executive Director, Jill Metcalf. The awards will be presented at the 2012 SMDM Annual Meeting in Phoenix, AZ. Check our website for complete rules and requirements.

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SMDM Journal: Medical Decision Making
Search for New Editor-in-Chief

by Lauren Saxton, Editorial Manager and Mark Helfand, MD, MPH, Editor-in-Chief

Dr. Mark Helfand will be stepping down after many years of service as Editor-in-Chief of the Journal at the end of 2012. The Publications Committee is in the process of searching for a new Editor-in-Chief. A Search Committee has been formed and complete details can be found here. The Committee plans to review applications and hold candidate interviews with an anticipated announcement by August 2012. Stay tuned for details on the search process in the coming months

The upcoming journal editor transition will certainly be a challenge for Medical Decision Making (MDM) and we are committed to assisting the Society and the future MDM editor in making the handoff as smooth as possible. While we can assume the transition will have its fair share of difficulties we feel assured by the fact that we have the next year to prepare for it and that we have over seven years of experience to bring to it. In this time we have implemented various procedures and processes that we hope will be a benefit to the editor and editorial staff when the journal moves to a new office in 2013. In our time at MDM, we have worked to grow the stature of the journal by exploring ways to extend the reach and broaden the impact of the material we publish. We have had our setbacks, but moreover we have had successes and we are confident that under the careful watch of the next editor, MDM will continue to thrive.

Medical Decision Making

The November/December 2011 Issue of Medical Decision Making is available online. Please be sure to check it out here.

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14th Biennial SMDM European Meeting
Oslo, Norway: June 10-12, 2012

Abstract submission is now open!

by Peder Halvorsen, MD, PhD, and Ivar Sønbø Kristiansen, MD, PhD, MPH

We welcome abstracts and proposals for oral presentations, posters, panel discussions and workshops. Although the main theme of this congress is Infectious Diseases, we do not restrict abstracts and proposals to this particular topic. On the contrary, we encourage abstracts covering a broad range of SMDM topics. The main theme will be covered in keynote lectures, invited short courses, panel discussions and/or workshops. The deadline for abstracts is February 15, 2012.

The scientific program beyond the keynote lectures depend on contributions from the participants and remains to be decided. The social program, however, is settled. There will be a get-together-party at the University of Oslo Sunday afternoon June 10, combined with the first poster session. The festive dinner will take place in the Banner Hall at Akershus Fortress. The Band of the Oslo Brigade will play old military music well suited for the old fortress. A top ranked group of dancers will perform traditional folk dance. Tuesday evening, we are invited by the Mayor to Oslo City Hall. The city hall is known for its collection of Munch paintings and for its Nobel Peace Prize ceremony.

The formal SMDM meeting ends Tuesday evening, but we offer a post-conference workshop on quality-of-life research on Wednesday.

Oslo usually has nice weather in the middle of June with temperatures in the low 20's (centigrade) and mostly sunshine. It is a perfect time for vacation. Western Norway offers fiords and mountains. You can get to Western Norway easily by plane, but even better by train from Oslo to Bergen and then boat onwards. Also, Northern Norway, not least the Lofoten islands, is attractive in June. Midnight sun adds to the attractions.

We are looking forward to receiving abstracts and seeing you all in Oslo!

Pictured above: (left) Akershus Fortress where the festive dinner will be hosted and (right) Oslo City Hall with Munch paintings.


Scholarships Available!

The SMDM Global Health Working Group is pleased to announce the availability of travel scholarships for residents of middle and low income countries to attend the 14th Biennial SMDM European Meeting in Oslo, Norway to be held on June 10-12, 2012. The theme of the meeting is “Preventing Infections in a Globalized World. What Can Decision Analysts Do?”

The scholarship application deadline is February 3, 2012, and the application can be downloaded at

We look forward to seeing you in Oslo!
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2011 North American Meeting Recap

2011 Fall Meeting
The 33rd Annual Meeting of the Society for Medical Decision Making, "From Evidence to Decision Making: Role of Behavioral Economics in Medicine," was held October 22 - 26, 2011, at the Hyatt Regency in Chicago, IL.

Abstracts Available

Abstracts from the 2011 Annual meeting can be downloaded to your computer or e-reader from the meeting website

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Global Health Working Group Has Record Attendance at 2011 Annual Meeting

Global Health Working Group has record Attendance

by Ruzanna Grigoryan, MD, MPH, and Bruce Schackman, PhD

The SMDM Global Health Working Group held a meeting on October 24, 2011, at the Annual Meeting. Over 30 researchers and government representatives from around the world with a variety of backgrounds and from diverse academic disciplines came together to discuss the progress of the Global Health Working Group and decide on directions for future collaboration. Attendees included 12 recipients of 2011 International Travel Scholarships from the University of the Philippines College of Medicine, China Health Economic Institute, Chinese Ministry of Health and a provincial health authority, Institute for Clinical Effectiveness and Health Policy in Buenos Aires, American University of Armenia, and India-Singapore Collaboration for Evidence-Based Medical Decision Making. Also in attendance were representatives from the U.S. Centers for Disease Control and Prevention and Johnson & Johnson Medical Asia Pacific who assisted in obtaining funding for the travel awards.
The group discussed a successful collaboration that started as a result of discussions at SMDM Global Health Working Group Meeting in 2010. In this collaboration, Global Health Policy Working Group members from Argentina, Ecuador and California, and the US have been working on an ongoing project "Prices and Affordability of Essential Medicines across Pacific Latin America during Economic Crisis," funded by the Executive Committee of the Pacific Rim Research Program. The Working Group members discussed opportunities to expand the project to more countries and to medical procedures in addition to medicines. They also discussed starting new collaborations and sustained interactions among researchers in low and middle income countries about how to advance proactive systematic approaches in clinical decision making and evidence based policy formation to improve health outcomes.

For more information about how to get involved, visit the SMDM Global Health web page or contact Bruce Schackman, PhD, at

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Risk Analysis and Communication:
A Multinational Research Effort

by Jesper Bo Nielsen, PhD, MSc
University of Southern Denmark

Jesper Bo Nielsen, PhDOur Society thrives on international collaborations. Our members recognize that general principles may govern medical decision making, but that cultural, economic, and political differences among nations must also be taken into account. The need to combine global and local perspectives requires a broad-based professional community to conduct research and address policy. As a result, much of the work published in our journal, Medical Decision Making, describes multinational research efforts (e.g., PMID: 21173438), our recently elected President comes from outside of North America, and many of our members are involved in organized multinational research collaborations.

One such collaboration, the Odense Risk Group, was established 10 years ago at the Institute of Public Health, University of Southern Denmark, in Odense. It was founded by Ivar Sønbo Kristiansen, Jørgen Nexøe, Dorte Gyrd-Hansen, and Jesper Bo Nielsen to facilitate collaborative research in medical risk analysis and risk communication. Headed by Nielsen, the group operates as a dynamic and open network of researchers from health sciences, health economics, psychology, and health promotion. In addition to its Danish members, the group includes participants from Norway, Wales, England, and the United States.

The group's current research on medical risk communication focuses on the patient, the physician, and the interaction between them. The goal is to learn:

* How individuals understand risk and risk reduction in the context of chronic disease processes, including causes and treatment options.

* How well doctors and patients comprehend information about the effectiveness of interventions to slow the progression of chronic diseases and reduce the risk of adverse outcomes.

* How to make risk information understandable to decision makers.

* What monetary values should be placed on health improvements and risk reductions.

In short, the aim of the Odense Risk Group is to help patients and doctors make informed, balanced decisions that maximise desirable outcomes and minimise undesirable outcomes. The group has gathered data using face-to-face interviews, Internet surveys, and discrete-choice experiments involving patients, physicians, or representative samples from the general population. Study subjects have been asked to indicate their acceptance of treatments, preferences, or willingness to pay. Future studies will focus on development of criteria for effective shared decision making and on the topic of adherence to treatment.

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What is the Basic Psychology of Medical Decision Making?

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

Robert M. HammPsychological concepts are central to the understanding of medical decision making. They figure in the physician's approach to diagnosis and therapy, the patient's understanding of risks and adherence to recommended life styles, the doctor-patient relationship, the behavior of individuals in teams and organizations, and the interaction of humans with computer systems. Much of the research addressing these concepts is interdisciplinary.

Recognizing the relevance of psychological concepts to its core mission, SMDM publishes many scholarly articles addressing these issues, and the psychology of medical decision making figures prominently in the posters, podium presentations, and short courses offered at the Society's North American and European meetings. The breadth and multidisciplinary nature of the topic is reflected in the cast of characters who teach the short courses: physicians, economists, biostatisticians, and psychologists. Recent North American meetings have included courses addressing psychological aspects of decision making in the elderly (2011), how to build a good decision aid (2010), behavioral economics (2011), and intuitive and deliberative modes of thought (2011). Other courses consider the measurement of health utilities using judgment and choice techniques and the reasons why physicians often do not practice according to the evidence. Courses such as these appeal to the full range of disciplines represented in SMDM. The courses offer the chance for a thoughtful, extended engagement in ideas. The experience differs from the fast flow of information that occurs in the large meeting rooms during the main program.

If you would like to offer a course related to the psychology of medical decision making, I encourage you to respond to one of the calls for short courses. The call for the June meeting in Oslo closes January 9, and the call for the October meeting in Phoenix will be issued soon. If you have not taught a short course before, your colleagues with previous experience are often happy to provide guidance and share their slides with you, or perhaps you could initially teach along with them to gain familiarity with the process.

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by Stephen G. Pauker, MD, MACP, ABMH
Historian (aka old man)
Tufts Medical Center

Stephen G. PaukerAsk not what SMDM can do for you, rather ask what YOU can do for SMDM – an apt paraphrase of John Kennedy’s inaugural address given almost a half century ago, well before many of you were born. (Kennedy himself seems to have borrowed this thought from Jean Jacques Rousseau or Oliver Wendell Holmes.)

Back in the late seventies and early eighties, there were few journal editors willing to publish the research upon which we thrive. When Lee Lusted and Gene Saenger (among others) were midwives to SMDM, we found a forum for growth and development. Our journal Medical Decision Making (MDM) remains central to our ability to document our work and spread the gospel. It has been a joy to watch it grow and to see its impact on medical research in general evolve. As we well know, the quality of a journal must be measured by outcomes – its ability to influence a field and its researchers.

Such direct measures of outcome may require a long time horizon to become evident, but more proximate process measures exist and are important. One of these is the Thomson-Reuters impact factor, published annually, reflecting over a two-year time period the number of times that articles published in MDM are cited in other scientific papers (the numerator) compared to the total number of citable articles in MDM in that two year window (the denominator). The raw impact factor is sometimes corrected (or lowered) by excluding “self citations,” ie, citations within articles published in MDM. Also, understand that citations only count after paper publication. Citations to “On-Line First” papers are not counted. At the annual meeting of the SMDM Board of Trustees, our editor Mark Helfand informed us that our impact factor this past year dropped, perhaps having to do with our publishing additional articles in an extra issue. Although surely temporary and small, such a decline tarnishes the Society’s ego. (Figure 1)

But it occurred to me, as an inveterate manipulator of numbers and minds that MDM’s impact factor remains well within our sphere of influence and likely our sphere of control. I am told that for every 70 additional citations our impact factor will increase by one point. I firmly believe that MDM contains some of the best technical and methodological papers published in our field, and these papers can and should be more widely cited. SMDM has almost 1000 members. Although I am unable to count or estimate how many articles our membership publish each year, we are a prolific bunch. I would not be surprised if our community’s publication count were 100 or more articles a year. MDM published approximately 70 articles a year. If we could commit to making reference to one MDM article, on average, from the past two years in each paper we publish, our journal’s impact factor would recover nicely. Please note that I am not proposing that we manipulate our impact factor inappropriately, but that we merely give credit where credit is justly due.

So please join me in citing MDM articles published within two years (not just the “classics” and avoiding on-line first references) when you submit manuscripts. Although you have not asked what you can do for SMDM, I have been so bold (and suggestive) to point out the impact of your citations on MDM and thereby on SMDM.

Figure 1: SMDM Impact Factor by Year

SMDM Impact Factor

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Cancer Communication Meets Social Media

by Wen-ying Sylvia Chou, PhD, MPH
Health Communication and Informatics Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute

Wen-ying Sylvia ChouEmerging Internet technologies have dramatically altered the health communication landscape. Social media, Web 2.0, and mHealth have shifted the online experience from passive to participatory, from unidirectional to collaborative (Musser et al. 2006). In cancer communication, traditional health promotion models are being challenged by innovative methods intended to harness the power of social media. Only very recently, however, have empirical studies begun to evaluate the impact of social media on cancer control efforts. These studies are needed to answer critical questions. To what extent has participation in social media affected health-related attitudes, beliefs, and decision making? What are the outcomes of social media-based cancer communication interventions? How do we distill hype from reality through rigorous communication science? Finally, what are the implications of social media for health disparities? Answering these questions will require consideration of several key topics as we design future research studies.

User Demographics
Over two-thirds of U.S. adults currently report using the Internet (PEW data). While the “digital divide” in access to the Internet persists, a more nuanced picture of the divide is emerging with the advent of social media. In particular, according to several recent national surveys, among Internet-accessing US adults, race/ethnicity no longer predict social media participation; in other words, minorities are just as likely, if not more likely, to be on social networking sites, blogs, and micromedia (Chou et al. 2009, Fox 2010). On the other hand, one factor that continues to predict social media participation is younger age, though those between ages 50 and 65 represent the highest rate of social media adoption. These findings have implications for public health communication practice: Equitable internet access for poor and rural populations could potentially further narrow the divide. Moreover, social media may provide opportunities to reach under-served and marginalized populations in their online communities, consequently limiting the divide. Finally, since age is the single most important predictor of social media use, health interventions may be most appropriate and have the broadest reach and impact with adolescents and young adults.

A Cluttered Online Landscape
The Health Information National Trends Survey (HINTS) suggests that while both social media utilization and online health-information seeking are on the rise, general health-related Internet use has not increased proportionately (Chou et al. 2011). The health activities surveyed in HINTS included online support group participation, purchasing medicine online, and emailing healthcare providers. Moreover, better large-scale data showing the use of social media for health-related functions and discussions is necessary. The web space is cluttered and attention is at a premium; just because one is constantly on a social networking space does not mean he/she is receptive and responsive to particular health messages. Cancer information and discussions (e.g. on topics related to prevention, treatment, and healthy lifestyle) compete with all other types of information for the audience members’ attention in this overwhelming online space.

Tapping Social Media for Cancer Communication
The unique functions of these participative media truly distinguish the Web 2.0 environment from other means of health communication. Leveraging the capacity of user-generated content, social media present unique opportunities for peer support and connection. For example, in sites such as Patientslikeme or YouTube, individuals can share their personal illness experience and in the process connect to friends, strangers, and with others suffering from similar conditions. This opportunity to present one’s authentic voice online is empowering and engaging. In addition, self-selection on the social media spaces (e.g., choosing a particular Facebook group, membership on a site through mutual interests) potentially enables more individualized communication, allowing for evidence-based communication techniques such as targeting and tailoring to suit the unique profile and preferences of the intended audience.

Building the Evidence Base: from Observation to Intervention
Observational studies examining current social media conversations and user behaviors continue to provide important insights to inform opportunities for cancer communication. Given the unprecedented transparency and openness of online behaviors, new web-based analytic techniques are used to ascertain the quality of information, to measure exposure, reach, and engagement in particular platforms. Only recently are we starting to see social media-based interventions for cancer control and prevention, and most of these studies to date are in pilot form with little conclusive evidence. Building the empirical evidence for social media-based interventions is a high priority in cancer communication research in order to distill hype from reality.

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Other News

CER Symposium at Washington University School of Medicine

The Comparative Effectiveness Research Center at the Washington University School of Medicine will host a symposium titled “Shared Decision Making: Opportunities to Implement Comparative Effectiveness Research in Clinical Practice.” The symposium will be held in St. Louis, Missouri, on March 13 and 14, 2012. Keynote speakers include Michael S. Lauer, MD, director, Division of Cardiovascular Sciences at the NHLBI and France Légaré, MD, PhD, CCFP, FCFP, professor, Department of Family Medicine at Université Laval and Canada Research Chair, Implementation of Shared Decision Making in Primary Care. Additional invited speakers include Victor M. Montori, MD, MS, Nilay D. Shah, PhD, and Annie LeBlanc, PhD (Mayo Clinic), Dominick L. Frosch, PhD (Palo Alto Medical Foundation and UCLA), Sandeep Vijan, MD (University of Michigan Health System), Carmen L. Lewis, MD, MPH (University of North Carolina at Chapel Hill), and Margaret M. Byrne, PhD (University of Miami School of Medicine).

This activity has been approved for AMA PRA Category 1 Credits. This program is supported in part by the Agency for Healthcare Research and Quality, Grant number 1R13 HS020933-01 (PI: Mary C. Politi), the National Cancer Institute of the National Institutes of Health, Grant Number 1KM1CA156708-01 (PI: Victoria J. Fraser), and Clinical and Translational Science Award (CTSA) program of the National Center for Research Resources at the National Institutes of Health Grant Numbers UL1 RR024992, KL2 RR024994, TL1 RR024995.

Learn more about the symposium and register online by visiting

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Member News

Anirban, Basu, PhD, University of Washington, recently published an article about patient-centered outcomes research: Basu A. Economics of individualization in comparative effectiveness research and a basis for a patient-centered healthcare. Journal of Health Economics 2011; 30(3): 549-559.

EmmiDecide, a new web-based, multimedia decision aide for patients with Crohn's Disease who are considering immunomodulators and anti-TNF medications, is being released. This program was created by EmmiSolutions in partnership with Dr. Corey Siegel at Dartmouth and other board certified physicians, and of course, with patients. If anyone is interested in taking a look at it, contact Geri Lynn Baumblatt, MA, Emmi Solutions, LLC.

Jagpreet Chhatwal, PhD, joined the faculty of the Department of Health Policy & Management at the University of Pittsburgh in Fall 2011. His research interests broadly lie in the area of operations research methods for health policy analysis including decision sciences, cost-effectiveness analysis, simulation and mathematical modeling. He looks forward to getting more involved in the SMDM community.

Kate Clay, MA, BSN, has been at the Dartmouth Institute for Health Policy and Clinical Practice (TDI) since April 2011. She just wrapped up her first 5-week online course, a blend of synchronous and asynchronous modules to teach Shared Decision Making in Patient-Centered Care, an Introduction to SDM. This is one of a series of courses on SDM that are (or soon will be) available alongside TDI's other core courses in ethics, finance, variations and quality by design.

Farah Farahati, PhD, has recently begun work as the Statistical/Methods Editor of the Health Affairs Journal, headquartered in Bethesda, Maryland. She brings with her years of experience in decision analysis, cost-effectiveness analysis, health care technology assessment, and medical economics.

Zachary Goldberger, MD, MS, University of Michigan, presented his work on the duration of resuscitation during in-hospital arrest at the American Heart Association's Resuscitation Science Symposium as part of the Best Poster Sessions. In addition, he was a finalist for the American College of Cardiology's Young Investigator Award in cardiovascular health outcomes.

Ansar Haroun, MD, psychiatrist at UCSD School of Medicine-Psychiatry, has just published a book with David Naimark through W.W. Norton & Company titled, Poker Face in Mental Health Practice - A Primer on Deception Analysis. The authors provide a detailed definition of deception, explain why, how, and when clients deceive, and offer specific advice on how to detect deception.

Steven Z. Kussin, MD, Medical Advocate, Clinton, New York, and author of Doctor, Your Patient Will See You Now has recently appeared in Women's Day, and the New York Times. He is currently blogging on an internationally followed website on patient empowerment fostering health literacy and consumerism.

France Légaré, MD, PhD, Laval University, Quebec, Canada, has been awarded the 2011 Family Medicine Researcher of the Year award from the College of Family Physicians in Canada. A physician, professor in family medicine, and Tier 2 Canada Research Chair in Implementation of Shared Decision-Making in Primary Care at Laval University in Quebec, Dr Légaré's research focuses on shared decision making in primary care, which promotes an active role for both the physician and the patient in determining care and treatment options. Dr. Légaré has examined both the implementation and impact of shared decision making on health professionals and patient outcomes. Her work on knowledge translation has resulted in the development of creative strategies for translating evidence into practice, increasing knowledge uptake, and innovative methods of sharing decisions in daily practice. Dr Légaré has spearheaded the creation of a practice-based research network entitled “Laboratory in Implementation of Shared Decision Making in Primary Care.” She was presented with her award at the College of Family Physicians Section of Researchers Dinner on November 2, 2011. Dr. Légaré will be a featured speaker at the CER symposium at Washington University this spring.

Richard W. Martin, MD, Professor of Medicine, Rheumatology, Michigan State University, has a new publication in Patient Education and Counseling relating to patient decision aid design and the replication of experimental psychology laboratory experiments with patients in the clinic. The study (now Epub ahead of print at Patient Educ Couns. 2011 Jul 11), is titled, "An experimental evaluation of patient decision aid design to communicate the effects of medications on the rate of progression of structural joint damage in rheumatoid arthritis." The objective was to explore how effectively information presentation formats used in a patient decision aid communicated the ability of a disease modifying anti-rheumatic drug to slow the rate of progression of rheumatoid arthritis related structural joint damage (SJD). They concluded rate of progression as communicated by narrative statement plus a graphic element (i.e. speedometer metaphor or pictograph) aided recall better than a narrative statement alone. The results suggest that testing decision aid components with non-patients may provide data generalizable to patient populations.

Joseph Mathew, MD, Advanceed Pediatrics Centre, PGIMER, Chandigarh, India, has attempted to bridge the gap between research evidence and clinical practice through his work with the Cochrane Collaboration and Health Technology Assessment International (HTAi). He is the Founder Chair of the HTAi Interest Sub-Group on Developing Countries (2008). Dr. Mathew's “KNOW ESSENTIALS”- a tool for evidence-informed appraisal of health technologies in resource constrained health-care settings lacking formal HTA systems was recently published in an international peer-reviewed journal: Mathew JL. KNOW ESSENTIALS: A tool for informed decisions in the absence of formal HTA systems. Int J Tech Assess Health Care 2011; 27: 139-150. KNOW ESSENTIALS is a pneumonic for 13 elements necessary to make evidence-informed decisions about any health technology (medication, vaccine, surgical procedure, health-policy, etc). The tool facilitates objective assessment of each element and assigns a color code.

Dennis Mazur, MD, PhD, Portland VA Medical Center, and Oregon Health and Science University, Portland, published two papers in 2011:
  1. Full Disclosure of the ‘Raw Data’ of Research on Humans: Citizens’ Rights, Product Manufacturers’ Obligations and the Quality of the Scientific Database, Philosophy Compass, Volume 6, Issue 2, pages 90–99, February 2011.
  2. Teaching & Learning Guide for: Full Disclosure of the ‘Raw Data’ of Research on Humans: Citizens’ Rights, Product Manufacturers’ Obligations and the Quality of the Scientific Database, Philosophy Compass, Volume 6, Issue 2, pages 152–157, February 2011.

Bruce Schackman, PhD, Chief of the Division of Health Policy, Weill Medical College of Cornell University, has been granted tenure as Associate Professor of Public Health. He was appointed Chief of the Division of Health Policy in 2006. Dr. Schackman is a national leader in the Society for Medical Decision Making. He has been an advisor to the Institute of Medicine and served on review committees for several Institutes of the National Institutes of Health (National Institute of Allergy and Infectious Diseases/AIDS Clinical Trials Group, National Institute on Drug Abuse, National Institute on Alcohol Abuse and Alcoholism). He has also advised the U.S. Health Resources and Services Administration, the Doris Duke Charitable Foundation, and the Ontario HIV Treatment Network.

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Lifetime Contributors

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

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

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

Tversky Level
(Contributions total $500 - $749)
Robert Beck (’07)
Nananda Col (’05, ’06, ’07, ’08, ’09)
Kate Christensen (’09)
Kathryn McDonald (’07, ’09, ’10)
David Paltiel (’07, ’09)
Mark Roberts (’08, ’09)
Bruce Schackman (’06, ’07, ’08, ’09, ’10)
Marilyn Schapira (’07, ’08, ’09, ’10, ’11)
Hal Sox (’10, ’11)

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

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

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

*Donations received Oct. 2005 – Nov. 11, 2011

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