MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'Medical Decision Making' source. Thu, 09 Feb 2012 10:13:03 +0100 http://www.medworm.com/index.php?rid=5654795&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F32%2F1%2F209%3Frss%3D1 Conclusions. Most economic evaluations that use data from CRTs ignored clustering or correlation. Statistical methods that address these issues are available, and their use should be encouraged. The new checklist can supplement generic CEA guidelines and highlight where research practice can be improved. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=5654795 Tue, 31 Jan 2012 05:00:00 +0100 5654795 http://www.medworm.com/index.php?rid=5654794&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F32%2F1%2F198%3Frss%3D1 Conclusions. Specialty, the influence of guidelines, test concerns, and the "jointness" of the test selection decision distinguished CRC screening recommendation patterns. All patterns were associated with similar overall screening rates. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=5654794 Tue, 31 Jan 2012 05:00:00 +0100 5654794 http://www.medworm.com/index.php?rid=5654793&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F32%2F1%2F188%3Frss%3D1 Conclusions. Applying NLP to EHR records detected more CRC tests than either manual chart review or billing records review alone. NLP had better precision but marginally lower recall to identify patients who were due for CRC screening than billing record review. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=5654793 Tue, 31 Jan 2012 05:00:00 +0100 5654793 http://www.medworm.com/index.php?rid=5654792&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F32%2F1%2F176%3Frss%3D1 Conclusions. The advantage of either setting is not clear-cut. Definition of efficiency depends in part on preference between cost and time. SNFs are more payment efficient; IRFs are more LOS efficient. Variation within SNFs and IRFs blurred setting differences; a simple comparison between SNF and IRF may not be appropriate. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=5654792 Tue, 31 Jan 2012 05:00:00 +0100 5654792 http://www.medworm.com/index.php?rid=5654791&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F32%2F1%2F167%3Frss%3D1 This study estimates the true incidence of hepatitis A virus (HAV) infection in Canada using a catalytic model. Methods. A catalytic model was used to reconcile HAV seroprevalence data with the corresponding true cumulative risk of infection estimated from incidence data. Results. The average annual reported incidence was 6.2 cases per 100 000 from 1980 to 1989 and 7.7/100 000 from 1990 to 1999, indicating that Canada is a low-incidence country. The seroprevalence in Canadian-born individuals (n = 7 studies) was approximately 1%–8% in ages <20, 1%–11% in ages 20–29, 7%–29% in ages 30–39, and higher in older age groups. Between 1980 and 1995, the catalytic model estimated an average annual incidence of 60/100 000 (95% confidence interval, 33–524); appr... Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=5654791 Tue, 31 Jan 2012 05:00:00 +0100 5654791 http://www.medworm.com/index.php?rid=5654790&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F32%2F1%2F154%3Frss%3D1 Conclusions. Adherence-improving interventions can increase expected QALYs by as much as 1.5 years. Given suboptimal adherence to statins, it is optimal to delay the start time for statins; however, changing the start time alone does not lead to significant changes in costs or QALYs. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=5654790 Tue, 31 Jan 2012 05:00:00 +0100 5654790 http://www.medworm.com/index.php?rid=5654789&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F32%2F1%2F145%3Frss%3D1 Conclusions. These divergent origins of influence on guideline adherence point to different approaches for improvement. As habits strongly influence staff members, methods that focus on changing habits (e.g., automated decision support systems) are possible interventions. As residents’ intention seems to be guided mainly by external influences and experienced control, this may make feedback, convenient guideline formats, and guideline familiarization more suitable. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=5654789 Tue, 31 Jan 2012 05:00:00 +0100 5654789 http://www.medworm.com/index.php?rid=5654788&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F32%2F1%2F132%3Frss%3D1 This study compared several nonlatent and latent composite quality scores to evaluate the quality of care using diabetes mellitus (DM) P4P data and discusses their characteristics and implications for P4P policy. The authors describe a cross-sectional study of the DM P4P data collected from the claims data of the Bureau of National Health Insurance (NHI) in Taiwan from January 2007 to December 2007. The DM patient outcome data, such as hemoglobin A1C values, were retrieved from the P4P database sponsored by the Bureau of NHI in Taiwan. The composite scores were derived from the following methods: 1) nonlatent scores methods (e.g., the raw sum score and the all-or-none score methods)and 2) latent scores methods (e.g., item-response theory-based Models I and II and the PRIDIT model). These s... Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=5654788 Tue, 31 Jan 2012 05:00:00 +0100 5654788 http://www.medworm.com/index.php?rid=5654787&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F32%2F1%2F118%3Frss%3D1 Conclusions. This claims signature model allows payers to use claims data to estimate virologic failure rates in their patient populations, thereby better understanding plan costs of failure. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=5654787 Tue, 31 Jan 2012 05:00:00 +0100 5654787 http://www.medworm.com/index.php?rid=5654786&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F32%2F1%2F105%3Frss%3D1 Conclusions. Resource allocation theory can make a significant contribution to decision making about HIV prevention and treatment scale up. What remains now is to develop models that can bridge the gap between theory and practice. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=5654786 Tue, 31 Jan 2012 05:00:00 +0100 5654786 http://www.medworm.com/index.php?rid=5654785&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F32%2F1%2F93%3Frss%3D1 This study sought to identify factors that increase or decrease patient time with a physician, determine which combinations of factors are associated with the shortest and longest visits to physicians, quantify how much physicians contribute to variation in the time they spend with patients, and assess how well patient time with a physician can be predicted. Data were acquired from a modified replication of the 1997–1998 National Ambulatory Medical Care Survey, administered by the Kentucky Ambulatory Network to 56 primary care clinicians at 24 practice sites in 2001 and 2002. A regression tree and a linear mixed model (LMM) were used to discover multivariate associations between patient time with a physician and 22 potentially predictive factors. Patient time with a physician was rel... Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=5654785 Tue, 31 Jan 2012 05:00:00 +0100 5654785 http://www.medworm.com/index.php?rid=5654784&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F32%2F1%2F83%3Frss%3D1 Conclusions. Instrumental variable analyses may provide biased estimates of treatment efficacy if there are cointerventions or confounders associated with treatment at the level of the instrument, although even when these associations may not exist in individuals. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=5654784 Tue, 31 Jan 2012 05:00:00 +0100 5654784 http://www.medworm.com/index.php?rid=5654783&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F32%2F1%2F70%3Frss%3D1 Conclusions. Temporary ART interruption and ART intensification provided neither superior nor inferior HRQoL compared with no interruption and standard ART. Among surviving patients, HRQoL scores declined only slightly over years of follow-up in this advanced HIV cohort; however, approximately one-third of patients died during the trial follow up. Lower HRQoL was associated with adverse clinical events. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=5654783 Tue, 31 Jan 2012 05:00:00 +0100 5654783 http://www.medworm.com/index.php?rid=5654782&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F32%2F1%2F56%3Frss%3D1 Conclusion. One and 2-part Beta regression models provide flexible approaches to regress the outcomes with truncated supports, such as HRQoL, on covariates, after accounting for many idiosyncratic features of the outcomes distribution. This work will provide applied researchers with a practical set of tools to model outcomes in cost-effectiveness analysis. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=5654782 Tue, 31 Jan 2012 05:00:00 +0100 5654782 http://www.medworm.com/index.php?rid=5654781&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F32%2F1%2F41%3Frss%3D1 Conclusions. The Rasch analysis demonstrated that, with some modifications, all domains of the WHOQOL-BREF, except for the social domain, provide an interval scale measure of generic subjective QOL in the context of depressed primary care patients in 6 countries worldwide. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=5654781 Tue, 31 Jan 2012 05:00:00 +0100 5654781 http://www.medworm.com/index.php?rid=5654780&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F32%2F1%2F31%3Frss%3D1 Conclusions. A condition label can affect health state values, but this is dependent on the specific condition and severity. The authors recommend avoiding condition labels in health state descriptions (where possible) to ensure that values are not affected by prior knowledge or preconception of the condition that may distort the health state being valued. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=5654780 Tue, 31 Jan 2012 05:00:00 +0100 5654780 http://www.medworm.com/index.php?rid=5654779&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F32%2F1%2FE25%3Frss%3D1 The dragons mentioned in the title are (a) the failure of HTA methodologists to develop[em dash]and hence practitioners to use—tools for the consideration of equity in economic appraisals of health care technologies; (b) a similar and reinforcing failure to devise and implement processes of decision making that would facilitate the incorporation of equity in HTA. The draconian consequence is that equity is hardly considered at all and certainly does not get the same consideration as efficiency. Some initial suggestions are made as to how these dragons may be slain. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=5654779 Tue, 31 Jan 2012 05:00:00 +0100 5654779 http://www.medworm.com/index.php?rid=5654778&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F32%2F1%2FE20%3Frss%3D1 A challenge of health technology assessment is integrating the information from different disciplines. This talk focuses on the evidence-based medicine perspective and challenges 3 assumptions of health technology assessment: assumptions about effectiveness, assumptions about coverage by health technology assessment, and assumptions about costs being immutable. Challenging these assumptions has several implications. First is the need for better evidence on effects: both low-volume, high-cost technologies and low-cost, high-volume technologies that are ineffective drains on health care systems’ resources. Second, cheap but effective technologies should be better promoted, as they can displace high-cost technologies. Finally, for effective but expensive technologies, we should work to ... Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=5654778 Tue, 31 Jan 2012 05:00:00 +0100 5654778 http://www.medworm.com/index.php?rid=5654777&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F32%2F1%2FE13%3Frss%3D1 Using a 2009 American debate on a federal public health recommendation on mammography screening for women under the age of 50 as a case study, it is argued that public acceptance of health technology assessment (HTA) depends on the ethical acceptability of its recommendations. At the same time, that acceptability cannot be separated from the politics and values of the health care system of which it is part. In the United States, those values display a sharp ideological split between a conservative individual-based ethic and a liberal community-oriented ethic. A clash of this kind cannot be solved by invocation of ethical principles when it is those principles themselves that are in conflict. Inevitably HTA acceptance is threatened by this conflict as is the fate of health care reform. (Sou... Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=5654777 Tue, 31 Jan 2012 05:00:00 +0100 5654777 http://www.medworm.com/index.php?rid=5654776&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F32%2F1%2F11%3Frss%3D1 Conclusions. The scoring system together with the PORPUS comprise an indirect utility instrument, the PORPUS-U, which can be used in clinical and research settings. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=5654776 Tue, 31 Jan 2012 05:00:00 +0100 5654776 http://www.medworm.com/index.php?rid=5654775&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Freprint%2F32%2F1%2F9%3Frss%3D1 (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=5654775 Tue, 31 Jan 2012 05:00:00 +0100 5654775 http://www.medworm.com/index.php?rid=5654774&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Freprint%2F32%2F1%2F7%3Frss%3D1 (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=5654774 Tue, 31 Jan 2012 05:00:00 +0100 5654774 http://www.medworm.com/index.php?rid=5654773&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Freprint%2F32%2F1%2F5%3Frss%3D1 (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=5654773 Tue, 31 Jan 2012 05:00:00 +0100 5654773 http://www.medworm.com/index.php?rid=5654772&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F32%2F1%2FE1%3Frss%3D1 Conclusions. Verification-biased sampling permits substantial savings in the required sample size for PSI validation studies. However, sample sizes still need to be very large for many of the rarer PSIs. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=5654772 Tue, 31 Jan 2012 05:00:00 +0100 5654772 http://www.medworm.com/index.php?rid=5394633&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F31%2F6%2F853%3Frss%3D1 Methods to estimate the cost-effectiveness of technologies are well developed with increasing experience of their application to inform adoption decisions in a timely way. However, the experience of using similarly explicit methods to inform the associated research decisions is less well developed despite appropriate methods being available with an increasing number of applications in health. The authors demonstrate that evaluation of both adoption and research decisions is feasible within typical time and resource constraints relevant to policy decisions, even in situations in which data are sparse and formal elicitation is required. In addition to demonstrating the application of expected value of sample information (EVSI) in these circumstances, the authors examine and carefully disting... Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=5394633 Tue, 08 Nov 2011 05:00:00 +0100 5394633 http://www.medworm.com/index.php?rid=5394632&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F31%2F6%2F839%3Frss%3D1 This article describes a revision to a form of Bayesian Laplace approximation for EVSI computation to support decisions in incomplete data models. The authors develop the approximation, setting out the mathematics for the likelihood and log posterior density function, which are necessary for the method. They compare the accuracy of EVSI estimates in a case study cost-effectiveness model using first- and second-order versions of their approximation formula and traditional Monte Carlo. Computational efficiency gains depend on the complexity of the net benefit functions, the number of inner-level Monte Carlo samples used, and the requirement or otherwise for MCMC methods to produce the posterior distributions. This methodology provides a new and valuable approach for EVSI computation in healt... Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=5394632 Tue, 08 Nov 2011 05:00:00 +0100 5394632 http://www.medworm.com/index.php?rid=5394631&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F31%2F6%2F828%3Frss%3D1 This article addresses this problem by synthesizing diverse theoretical and empirical literature from the fields of communication, decision science, engineering, health services research, and psychology and developing a new integrative conceptual taxonomy of uncertainty. A 3-dimensional taxonomy is proposed that characterizes uncertainty in health care according to its fundamental sources, issues, and locus. It is shown how this new taxonomy facilitates an organized approach to the problem of uncertainty in health care by clarifying its nature and prognosis and suggesting appropriate strategies for its analysis and management. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=5394631 Tue, 08 Nov 2011 05:00:00 +0100 5394631 http://www.medworm.com/index.php?rid=5394630&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F31%2F6%2F816%3Frss%3D1 Conclusions: Surgery-specific and quality of care information are more important than general information when patients choose between hospitals. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=5394630 Tue, 08 Nov 2011 05:00:00 +0100 5394630 http://www.medworm.com/index.php?rid=5394629&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F31%2F6%2F805%3Frss%3D1 Conclusion. Physicians not specifically trained provided enough data to specify complete individual decision models. From the estimates provided, no practical clinical trial could convince hematologists who would treat children on initial presentation with ITP just to simply observe them or could convince those who would just observe to instead treat with available agents. Perceived burdens could be better characterized, perhaps by including parental perceptions and preferences. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=5394629 Tue, 08 Nov 2011 05:00:00 +0100 5394629 http://www.medworm.com/index.php?rid=5394628&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F31%2F6%2F800%3Frss%3D1 Conclusion. This research provides community-based EQ-5D index scores for a wide variety of chronic conditions that can be used to estimate QALYs in cost-effectiveness analyses in the UK. Although using EQ-5D questionnaire responses from the US-based MEPS is less than ideal, the estimates approximate HRQL guidelines by NICE and provide an easily accessible"off-the-shelf" resource for cost-effectiveness and publichealth applications. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=5394628 Tue, 08 Nov 2011 05:00:00 +0100 5394628 http://www.medworm.com/index.php?rid=5394627&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F31%2F6%2F790%3Frss%3D1 Conclusions: The marginal Tobit and CLAD coefficients should not be used as estimates of a utility decrement corresponding to an adverse event or health condition unless the coefficients are small in absolute value, or if the proportion of individuals at the upper utility bound is small. In other settings, the corrected formula or alternative regression methods (e.g. linear models of mean utility) should be considered. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=5394627 Tue, 08 Nov 2011 05:00:00 +0100 5394627 http://www.medworm.com/index.php?rid=5394626&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Freprint%2F31%2F6%2F787%3Frss%3D1 (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=5394626 Tue, 08 Nov 2011 05:00:00 +0100 5394626 http://www.medworm.com/index.php?rid=5394625&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F31%2F6%2FE45%3Frss%3D1 Conclusion. This literature review provides an extensive knowledge base for making PPIPs more effective when developing and implementing CPGs. More research is needed to assess the impact of PPIPs and resources they require. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=5394625 Tue, 08 Nov 2011 05:00:00 +0100 5394625 http://www.medworm.com/index.php?rid=5394624&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F31%2F6%2FE34%3Frss%3D1 Conclusions. These findings show that group mean EQ-5D and SF-6D scores are not directly comparable. This raises serious concerns about the cross-study comparability of economic evaluations that differ in the choice of preference-based measures, although the review focuses on 2 of the available instruments only. Further work is needed to address the practical implications of noninterchangeable utility estimates for cost-per-QALY estimates and decision making. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=5394624 Tue, 08 Nov 2011 05:00:00 +0100 5394624 http://www.medworm.com/index.php?rid=5394623&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F31%2F6%2FE23%3Frss%3D1 Conclusions. Taken together, these data suggest that the traditional method of conveying information in the brief summary is neither the most comprehensible nor the most preferred by consumers. These data provide policy makers and researchers with important information regarding the role of format in consumers’ understanding of the brief summary. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=5394623 Tue, 08 Nov 2011 05:00:00 +0100 5394623 http://www.medworm.com/index.php?rid=5394622&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F31%2F6%2FE1%3Frss%3D1 This article 1) develops a framework to define and classify minimal modeling approaches to VOI, 2) reviews existing VOI studies that apply minimal modeling approaches, and 3) illustrates and discusses the application of the minimal modeling to 2 new clinical applications to which the approach appears well suited because clinical trials with comprehensive outcomes provide preliminary estimates of the uncertainty in outcomes. The authors conclude that minimal modeling approaches to VOI can be readily applied in some instances to estimate the expected benefits of clinical research. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=5394622 Tue, 08 Nov 2011 05:00:00 +0100 5394622 http://www.medworm.com/index.php?rid=5231404&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F31%2F5%2F767%3Frss%3D1 Conclusions. Providing information to patients about possible benefits and/or harms has no consistent effect on the number who decide to start or continue medicines, although it increases patients' knowledge and reduces their decisional conflict. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=5231404 Thu, 15 Sep 2011 04:00:00 +0100 5231404 http://www.medworm.com/index.php?rid=5231403&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F31%2F5%2F754%3Frss%3D1 Conclusions: Almost all participants from each country want to participate in their treatment decisions. Although there are country-specific differences in the amount of information required, wide variation within each country suggests that information that patients feel is essential or desired for DM should be addressed on an individual basis in all countries. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=5231403 Thu, 15 Sep 2011 04:00:00 +0100 5231403 http://www.medworm.com/index.php?rid=5231402&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F31%2F5%2F742%3Frss%3D1 Background. Health-related information found on the Internet is increasing and impacts patient decision making, e.g. regarding vaccination decisions. In addition to statistical information (e.g. incidence rates of vaccine adverse events), narrative information is also widely available such as postings on online bulletin boards. Previous research has shown that narrative information can impact treatment decisions, even when statistical information is presented concurrently. Objectives. As the determinants of this effect are largely unknown, we will vary features of the narratives to identify mechanisms through which narratives impact risk judgments. Methods. An online bulletin board setting provided participants with statistical information and authentic narratives about the occurrence and ... Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=5231402 Thu, 15 Sep 2011 04:00:00 +0100 5231402 http://www.medworm.com/index.php?rid=5231401&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F31%2F5%2F730%3Frss%3D1 Conclusion. The DMCI is an important new tool that can be used to inform our understanding of the voluntariness of treatment and research decisions in medical settings. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=5231401 Thu, 15 Sep 2011 04:00:00 +0100 5231401 http://www.medworm.com/index.php?rid=5231400&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F31%2F5%2F721%3Frss%3D1 Among numerical formats available to express probability, ratios are extensively used in risk communication, perhaps because of the health professional’s intuitive sense of their clarity and simplicity. Moreover, health professionals, in the attempt to make the data more meaningful, tend to prefer proportions with a numerator of 1 and shifting denominators (e.g., 1 in 200) rather than equivalent rates of disease per unit of population exposed to the threat (e.g., 5 in 1000). However, in a series of 7 experiments, it is shown that individual subjective assessments of the same probability presented through proportions rather than rates vary significantly. A 1-in-X format (e.g., 1 in 200) is subjectively perceived as bigger and more alarming than an N-in-X*N format (e.g., 5 in 1000). Th... Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=5231400 Thu, 15 Sep 2011 04:00:00 +0100 5231400 http://www.medworm.com/index.php?rid=5231399&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F31%2F5%2F710%3Frss%3D1 Conclusions: Trust in (hypothetical) clinicians is sensitive to information about their past diagnostic performance. Greater understanding of the cognitive and affective mechanisms by which this occurs may help maintain current high levels of trust. Further research is needed to examine whether findings generalize to real medical decision-making contexts. Clinicians may want to consider the impact their diagnoses have on trust alongside medical and financial considerations. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=5231399 Thu, 15 Sep 2011 04:00:00 +0100 5231399 http://www.medworm.com/index.php?rid=5231398&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Freprint%2F31%2F5%2F707%3Frss%3D1 (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=5231398 Thu, 15 Sep 2011 04:00:00 +0100 5231398 http://www.medworm.com/index.php?rid=5231397&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Freprint%2F31%2F5%2F705%3Frss%3D1 (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=5231397 Thu, 15 Sep 2011 04:00:00 +0100 5231397 http://www.medworm.com/index.php?rid=5231396&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Freprint%2F31%2F5%2F703%3Frss%3D1 (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=5231396 Thu, 15 Sep 2011 04:00:00 +0100 5231396 http://www.medworm.com/index.php?rid=5231395&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Freprint%2F31%2F5%2F701%3Frss%3D1 (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=5231395 Thu, 15 Sep 2011 04:00:00 +0100 5231395 http://www.medworm.com/index.php?rid=5060936&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Freprint%2F31%2F4%2F521%3Frss%3D1 (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=5060936 Wed, 13 Jul 2011 23:00:00 +0100 5060936 http://www.medworm.com/index.php?rid=5034639&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F31%2F4%2F675%3Frss%3D1 Accounting for uncertainty is now a standard part of decision-analytic modeling and is recommended by many health technology agencies and published guidelines. However, the scope of such analyses is often limited, even though techniques have been developed for presenting the effects of methodological, structural, and parameter uncertainty on model results. To help bring these techniques into mainstream use, the authors present a step-by-step guide that offers an integrated approach to account for different kinds of uncertainty in the same model, along with a checklist for assessing the way in which uncertainty has been incorporated. The guide also addresses special situations such as when a source of uncertainty is difficult to parameterize, resources are limited for an ideal exploration o... Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=5034639 Wed, 13 Jul 2011 23:00:00 +0100 5034639 http://www.medworm.com/index.php?rid=5034638&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F31%2F4%2F662%3Frss%3D1 Decision analytic models used for health technology assessment are subject to uncertainties. These uncertainties can be quantified probabilistically, by placing distributions on model parameters and simulating from these to generate estimates of cost-effectiveness. However, many uncertain model choices, often termed structural assumptions, are usually only explored informally by presenting estimates of cost-effectiveness under alternative scenarios. The authors show how 2 recent research proposals represent parts of a framework to formally account for all common structural uncertainties. First, the model is expanded to include parameters that encompass all possible structural choices. Uncertainty can then arise because these parameters are estimated imprecisely from data, for example, a tr... Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=5034638 Wed, 13 Jul 2011 23:00:00 +0100 5034638 http://www.medworm.com/index.php?rid=5034637&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F31%2F4%2F650%3Frss%3D1 This article can be used as a reference for analyzing complex models with more than one type of uncertainty and patient heterogeneity. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=5034637 Wed, 13 Jul 2011 23:00:00 +0100 5034637 http://www.medworm.com/index.php?rid=5034636&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F31%2F4%2F642%3Frss%3D1 Conclusion: An equation that can be derived in the manner described in this article provides a substantial amount of information. The inclusion of such an equation in a report may increase transparency of the reporting of outcomes of health economic models. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=5034636 Wed, 13 Jul 2011 23:00:00 +0100 5034636 http://www.medworm.com/index.php?rid=5034635&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F31%2F4%2F625%3Frss%3D1 Conclusion. The advantages of this strategy are that it draws efficiently from a high-dimensional correlated parameter space. The algorithm is simple to code and runs overnight on a standard desktop PC. Using this method, the parameter sets are drawn according to their posterior probability given calibration data, and thus they correctly summarize the residual uncertainty in the parameter space. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=5034635 Wed, 13 Jul 2011 23:00:00 +0100 5034635 http://www.medworm.com/index.php?rid=5034634&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F31%2F4%2F611%3Frss%3D1 Conclusions. The results imply that MCRC, especially in women, may be more common than suggested by previous studies. In addition, statistics derived from the clinical data and results of the simulation model indicate that gender and age affect the progression of MCRC. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=5034634 Wed, 13 Jul 2011 23:00:00 +0100 5034634 http://www.medworm.com/index.php?rid=5034633&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F31%2F4%2F596%3Frss%3D1 Conclusions. This example illustrates how the method proposed allows decisions in the product development cycle to be based on the best knowledge that is available at each stage. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=5034633 Wed, 13 Jul 2011 23:00:00 +0100 5034633 http://www.medworm.com/index.php?rid=5034632&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F31%2F4%2F582%3Frss%3D1 Conclusion: The payoff time framework may indicate when withholding a guideline with short-term harms and long-term benefits may increase LE and/or QALY. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=5034632 Wed, 13 Jul 2011 23:00:00 +0100 5034632 http://www.medworm.com/index.php?rid=5034631&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F31%2F4%2F571%3Frss%3D1 Conclusions: The proposed method reduces overestimation of benefit and allows the sensitivity to different assumptions about the correlation between disease risks to be determined. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=5034631 Wed, 13 Jul 2011 23:00:00 +0100 5034631 http://www.medworm.com/index.php?rid=5034630&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F31%2F4%2F559%3Frss%3D1 Conclusions. The authors have developed a model for progression of disease in diabetes that has a number of novel features; it captures the observed relationships between measures of quality of life and future outcomes, the number of states have been minimized, and it can be parameterized with just 4 risk equations. Underlying the simple model structure is important patient-level heterogeneity in health and outcomes. The simulations suggest that differences in patients’ EQ-5D utility can account for large differences in QALYs, which could be relevant in cost-utility analyses. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=5034630 Wed, 13 Jul 2011 23:00:00 +0100 5034630 http://www.medworm.com/index.php?rid=5034629&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F31%2F4%2F550%3Frss%3D1 Conclusions. The differences in predicted mortality reductions show the importance of validating models to observed trial mortality data. The stage-shift models considerably overestimated the mortality reduction. Therefore, the stage-shift models should be used with care, especially when modeling the effect of screening for cancers with long lead times, such as prostate cancer. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=5034629 Wed, 13 Jul 2011 23:00:00 +0100 5034629 http://www.medworm.com/index.php?rid=5034628&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F31%2F4%2F540%3Frss%3D1 Conclusions. The authors propose a new measure, the MCLIR, which summarizes the implications for predicted screening effectiveness of differences in natural history assumptions. Including the MCLIR in the standard description of a screening model would improve the transparency of these models. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=5034628 Wed, 13 Jul 2011 23:00:00 +0100 5034628 http://www.medworm.com/index.php?rid=5034627&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F31%2F4%2F530%3Frss%3D1 Conclusions. Models that all match observed data on adenoma prevalence and cancer incidence can produce quite different dwell times and very different answers with respect to the effectiveness of interventions. When conducting applied analyses to inform policy, using multiple models provides a sensitivity analysis on key (unobserved) "deep" model parameters and can provide guidance about specific areas in need of additional research and validation. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=5034627 Wed, 13 Jul 2011 23:00:00 +0100 5034627 http://www.medworm.com/index.php?rid=5034626&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Freprint%2F31%2F4%2F527%3Frss%3D1 (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=5034626 Wed, 13 Jul 2011 23:00:00 +0100 5034626 http://www.medworm.com/index.php?rid=5034625&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Freprint%2F31%2F4%2F524%3Frss%3D1 (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=5034625 Wed, 13 Jul 2011 23:00:00 +0100 5034625 http://www.medworm.com/index.php?rid=5034624&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Freprint%2F31%2F4%2F521%3Frss%3D1 (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=5034624 Wed, 13 Jul 2011 23:00:00 +0100 5034624 http://www.medworm.com/index.php?rid=4860078&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Freprint%2F31%2F3%2F514%3Frss%3D1 (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4860078 Mon, 23 May 2011 23:00:00 +0100 4860078 http://www.medworm.com/index.php?rid=4860077&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Freprint%2F31%2F3%2F511%3Frss%3D1 (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4860077 Mon, 23 May 2011 23:00:00 +0100 4860077 http://www.medworm.com/index.php?rid=4860076&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F31%2F3%2F500%3Frss%3D1 This report examines trends in the occurrence and decision-making process of end-of-life practices in different patient groups since these legal changes. A large-scale retrospective survey in Flanders, Belgium, previously conducted in 1998 and 2001, was repeated in 2007. Questionnaires regarding end-of-life practices and the preceding decision-making process were mailed to physicians who certified a representative sample (N = 6927) of death certificates. The 2007 response rate was 58.4%. In patient groups in which the prevalence of life-ending drug use without explicit patient request has dropped, performance of euthanasia and assisted suicide has increased. The consistent increase in intensified pain and symptom alleviation was found in all patient groups except cancer patients. In 2007, ... Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4860076 Mon, 23 May 2011 23:00:00 +0100 4860076 http://www.medworm.com/index.php?rid=4860075&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F31%2F3%2F494%3Frss%3D1 Conclusions. The identified model, derived from historical data from both a PICU and the local community, produced accurate 1-month and 3-month forecasts of severe viral respiratory illness presentation to the PICU. These results suggest that time series models may be useful tools in forecasting the burden of severe viral respiratory illness at the institutional level, helping institutions make decisions to optimize the distribution of resources. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4860075 Mon, 23 May 2011 23:00:00 +0100 4860075 http://www.medworm.com/index.php?rid=4860074&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F31%2F3%2F481%3Frss%3D1 Conclusions: Mean EQ-5D utility weights can be accurately estimated from the SAQ using a simple linear regression mapping algorithm. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4860074 Mon, 23 May 2011 23:00:00 +0100 4860074 http://www.medworm.com/index.php?rid=4860073&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F31%2F3%2F469%3Frss%3D1 This study applies conjoint analysis to estimate health-related benefit-risk tradeoffs in a non-expected-utility framework. We demonstrate how this method can be used to test for and estimate nonlinear weighting of adverse-event probabilities and we explore the implications of nonlinear weighting on maximum acceptable risk (MAR) measures of risk tolerance. We obtained preference data from 570 Crohn’s disease patients using a web-enabled conjoint survey. Respondents were presented with choice tasks involving treatment options that involve different efficacy benefits and different mortality risks for 3 possible side effects. Using conditional logit maximum likelihood estimation, we estimate preference parameters using 3 models that allow for nonlinear preference weighting of risks&mdas... Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4860073 Mon, 23 May 2011 23:00:00 +0100 4860073 http://www.medworm.com/index.php?rid=4860072&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F31%2F3%2F458%3Frss%3D1 Conclusion. The index values reported in this study offer a new preference-based approach to incorporating the effects on carers in economic evaluation, focusing on care (rather than health)–related quality of life. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4860072 Mon, 23 May 2011 23:00:00 +0100 4860072 http://www.medworm.com/index.php?rid=4860071&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F31%2F3%2F444%3Frss%3D1 Conclusions. The new graph literacy scale seems to be a suitable tool for assessing whether patients understand common graphical formats and shows that not everyone profits from standard visual displays. Research is needed on communication formats that can overcome the barriers of both low numeracy and graph literacy. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4860071 Mon, 23 May 2011 23:00:00 +0100 4860071 http://www.medworm.com/index.php?rid=4860070&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F31%2F3%2F437%3Frss%3D1 Conclusion. One type of graphic image was associated with increased understanding of risk in a small sample of American Indian adults. The authors recommend further investigation of the effectiveness of other types of graphic displays for conveying health risk information to this population. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4860070 Mon, 23 May 2011 23:00:00 +0100 4860070 http://www.medworm.com/index.php?rid=4860069&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F31%2F3%2F432%3Frss%3D1 Conclusions. Frequency formats appear to increase risk perceptions over percentage formats for less-numerate respondents. Health communicators need to be aware that different formats generate different risk perceptions among patients varying in numeracy. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4860069 Mon, 23 May 2011 23:00:00 +0100 4860069 http://www.medworm.com/index.php?rid=4860068&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F31%2F3%2F422%3Frss%3D1 Conclusions. The authors found that African Americans in this study preferred shared decision making as much as whites and were more likely to report initiating more discussions with their doctors about their diabetes care. This research suggests that, among diabetes patients receiving care at community health centers, patient preference or patient behaviors may be an unlikely cause of racial differences in shared decision making. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4860068 Mon, 23 May 2011 23:00:00 +0100 4860068 http://www.medworm.com/index.php?rid=4860067&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F31%2F3%2F412%3Frss%3D1 Conclusion. This report provides new insight into the long-term longitudinal effects of DAs. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4860067 Mon, 23 May 2011 23:00:00 +0100 4860067 http://www.medworm.com/index.php?rid=4860066&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F31%2F3%2F405%3Frss%3D1 Conclusions. Physician overestimation of the likelihood of a positive urine culture in women with symptoms of acute cystitis was associated with unnecessary antibiotic prescribing. Antibiotic overuse may be reduced by developing treatment strategies that deemphasize nonspecific clinical findings that contribute to physician overestimation error. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4860066 Mon, 23 May 2011 23:00:00 +0100 4860066 http://www.medworm.com/index.php?rid=4860065&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F31%2F3%2F395%3Frss%3D1 Conclusions: Physicians selectively complied with electronic recommendations to substitute less costly for more costly drugs. Compliance was neither automatic nor thoughtless and entailed cost containment with possibly marginal compromise on quality of care or none at all, as compliance mostly involved substituting generic for patent drugs. We strongly feel that the results can be generalized to other HMOs as well. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4860065 Mon, 23 May 2011 23:00:00 +0100 4860065 http://www.medworm.com/index.php?rid=4860064&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F31%2F3%2F386%3Frss%3D1 Conclusion. A large number of physicians erroneously based their screening recommendation and judgment of screening’s effectiveness on the 5-y survival rate. Results show that reporting disease-specificmortality rates can offer a simple solution to physicians’ confusion about the real effect of screening. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4860064 Mon, 23 May 2011 23:00:00 +0100 4860064 http://www.medworm.com/index.php?rid=4860063&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F31%2F3%2F380%3Frss%3D1 Conclusion. Cost-effectiveness thresholds for oncologists vary widely for life-prolonging chemotherapy compared to treatments that only enhance quality of life. This difference suggests that oncologists value length of survival more highly than quality of life when making chemotherapy decisions. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4860063 Mon, 23 May 2011 23:00:00 +0100 4860063 http://www.medworm.com/index.php?rid=4860062&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Freprint%2F31%2F3%2F378%3Frss%3D1 (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4860062 Mon, 23 May 2011 23:00:00 +0100 4860062 http://www.medworm.com/index.php?rid=4860061&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Freprint%2F31%2F3%2F376%3Frss%3D1 (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4860061 Mon, 23 May 2011 23:00:00 +0100 4860061 http://www.medworm.com/index.php?rid=4860060&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Freprint%2F31%2F3%2F373%3Frss%3D1 (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4860060 Mon, 23 May 2011 23:00:00 +0100 4860060 http://www.medworm.com/index.php?rid=4569454&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F31%2F2%2F354%3Frss%3D1 Conclusions. The communication of uncertainty regarding cancer risk estimates has complex effects, which include heightening cancer-related worry—consistent with ambiguity aversion—and diminishing the influence of comparative risk information on risk perceptions. These responses are influenced by representational format and personality type, and the influence of format appears to be modifiable and content dependent. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4569454 Thu, 10 Mar 2011 00:00:00 +0100 4569454 http://www.medworm.com/index.php?rid=4569453&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F31%2F2%2F338%3Frss%3D1 Conclusions. Recommendations regarding risky medical treatments with positive expectations appear to depend, in part, on opinions about whether it is reasonable to aggregate medical outcomes over patients or over time. Such opinions vary widely among physicians and others. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4569453 Thu, 10 Mar 2011 00:00:00 +0100 4569453 http://www.medworm.com/index.php?rid=4569452&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F31%2F2%2F325%3Frss%3D1 Conclusion: A Bayesian network is better at detection and can detect errors with less information than existing automated models, suggesting that Bayesian model may be an effective means for reducing medical costs and improving patient safety. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4569452 Thu, 10 Mar 2011 00:00:00 +0100 4569452 http://www.medworm.com/index.php?rid=4569451&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F31%2F2%2F315%3Frss%3D1 Conclusions. The authors’ findings illustrate that for laboratory monitoring to be cost effective, the patient population must be at high enough risk of adverse events. Further inquiry into the willingness to pay for patient safety interventions is needed. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4569451 Thu, 10 Mar 2011 00:00:00 +0100 4569451 http://www.medworm.com/index.php?rid=4569450&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F31%2F2%2F308%3Frss%3D1 Conclusions. The ANN model developed in this study had good discrimination and calibration and would provide decision support to clinicians and increase vigilance for patients at high risk of postinduction hypotension during general anesthesia. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4569450 Thu, 10 Mar 2011 00:00:00 +0100 4569450 http://www.medworm.com/index.php?rid=4569449&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F31%2F2%2F299%3Frss%3D1 It is important to predict osteoporotic fracture risk accurately in order to select high-risk patients for treatment. Previous tree-structured survival analysis (TSSA) methods focused on optimization in statistical performance in construction of survival trees. However, they did not take into account the cost of the predictive variables. Because of the high cost of some predictors, the derived algorithm may have only limited application in practice. In this article, the authors consider the cost-effectiveness in TSSA and propose a cost-saving TSSA (denoted as CSTSSA) to construct the survival tree for identifying subjects at high risk of hip fracture based on the data from Study of Osteoporotic Fractures. The new rule is compared with the optimum classification based on log-rank test stati... Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4569449 Thu, 10 Mar 2011 00:00:00 +0100 4569449 http://www.medworm.com/index.php?rid=4569448&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F31%2F2%2F292%3Frss%3D1 Conclusions. If the goal of health care policy is to optimize health, all important effects should be captured. The scope of economic evaluations should also include health effects in significant others. This study suggests that significant others include both care givers and broader groups of affected individuals, such as family members. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4569448 Thu, 10 Mar 2011 00:00:00 +0100 4569448 http://www.medworm.com/index.php?rid=4569447&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F31%2F2%2F281%3Frss%3D1 Conclusion: This is the first study to derive a condition-specific preference-based measure from an existing measure of health-related quality of life in asthma for use in economic evaluation. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4569447 Thu, 10 Mar 2011 00:00:00 +0100 4569447 http://www.medworm.com/index.php?rid=4569446&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F31%2F2%2F270%3Frss%3D1 Conclusions. This research supports the validity of all systems for measuring change in persons with IDH, without finding a clearly superior system. The unique characteristics of each system revealed in this study should guide system choice. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4569446 Thu, 10 Mar 2011 00:00:00 +0100 4569446 http://www.medworm.com/index.php?rid=4569445&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F31%2F2%2F260%3Frss%3D1 Conclusions. The 2 types of SEM are similar and substantial for all the indexes and vary across health. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4569445 Thu, 10 Mar 2011 00:00:00 +0100 4569445 http://www.medworm.com/index.php?rid=4569444&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F31%2F2%2F254%3Frss%3D1 Conclusion. The models developed from this study can be used to guide the development of stage-based interventions for promoting health care proxy completion. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4569444 Thu, 10 Mar 2011 00:00:00 +0100 4569444 http://www.medworm.com/index.php?rid=4569443&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F31%2F2%2F245%3Frss%3D1 Conclusions. Patients’ preferences for participation in treatment decision making should be considered seriously by doctors during the encounter. Health providers should make a greater effort to improve doctor-patient communication and decrease the mismatch between patients’ perceived and preferred decisional role. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4569443 Thu, 10 Mar 2011 00:00:00 +0100 4569443 http://www.medworm.com/index.php?rid=4569442&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F31%2F2%2F237%3Frss%3D1 Conclusions. Action is preferred to inaction when a malignant tumor is currently diagnosed and active treatments are not allowed in the future; under other conditions, participants prefer inaction (e.g., when active treatments are allowed in the future, or when the tumor is benign) or exhibit no preference (e.g., when it is not specified whether active treatments are allowed in the future). (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4569442 Thu, 10 Mar 2011 00:00:00 +0100 4569442 http://www.medworm.com/index.php?rid=4569441&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F31%2F2%2F229%3Frss%3D1 Conclusions. The Rucker method should be used to estimate treatment, preference, and selection effects in randomized trials, as it adds to our understanding of the effect of choice on patient outcomes. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4569441 Thu, 10 Mar 2011 00:00:00 +0100 4569441 http://www.medworm.com/index.php?rid=4569440&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Freprint%2F31%2F2%2F226%3Frss%3D1 (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4569440 Thu, 10 Mar 2011 00:00:00 +0100 4569440 http://www.medworm.com/index.php?rid=4569439&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Freprint%2F31%2F2%2F223%3Frss%3D1 (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4569439 Thu, 10 Mar 2011 00:00:00 +0100 4569439 http://www.medworm.com/index.php?rid=4569438&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Freprint%2F31%2F2%2F221%3Frss%3D1 (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4569438 Thu, 10 Mar 2011 00:00:00 +0100 4569438 http://www.medworm.com/index.php?rid=4435846&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F31%2F1%2F195%3Frss%3D1 The majority of health-related quality-of-life instruments are not preference-based measures and so cannot be used within cost utility analysis. The Asthma Quality of Life Questionnaire (AQLQ) is one such instrument. The aim of this study was to develop a health state classification that was amenable to valuation from the AQLQ, this being the 1st stage in developing a condition-specific preference-based measure for asthma patients. Rasch models were applied to samples of responders to the AQLQ with the aim of selecting a number of items for a preference-based utility measure (AQL-5D). Selection of items for the evaluation survey was supported with classical psychometric criteria for item selection (feasibility, internal consistency, floor and ceiling effects, and responsiveness). Rasch ana... Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4435846 Fri, 04 Feb 2011 00:00:00 +0100 4435846 http://www.medworm.com/index.php?rid=4435845&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F31%2F1%2F186%3Frss%3D1 Conclusions. Selecting health states not included in the "Measurement and Valuation of Health" dataset in valuation studies is quite specifically encouraged. However, it remains prudent to ensure that the selection of health states covers as wide a range of severity as possible. Setting the number of observations per health state to 150 might allow for correction of any errors in data collection or processing. The extent to which the results of this study based on VAS valuation data can be safely generalized to the design of time tradeoff valuation studies remains an open question. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4435845 Fri, 04 Feb 2011 00:00:00 +0100 4435845 http://www.medworm.com/index.php?rid=4435844&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Freprint%2F31%2F1%2FE181%3Frss%3D1 (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4435844 Fri, 04 Feb 2011 00:00:00 +0100 4435844 http://www.medworm.com/index.php?rid=4435843&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F31%2F1%2F174%3Frss%3D1 Conclusions. This study yielded a mapping algorithm to estimate EQ-5D index scores from the Healthy Days measures for populations of adults 35 years old and older. Such analysis confirms it is feasible to estimate mean EQ-5D index scores with acceptable validity for use in calculating QALYs and cost-utility analyses based on the overall model fit and relatively small differences between the observed and the estimated mean scores. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4435843 Fri, 04 Feb 2011 00:00:00 +0100 4435843 http://www.medworm.com/index.php?rid=4435842&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F31%2F1%2F151%3Frss%3D1 Conclusions. A wide range of communication interventions improve comprehension in clinical informed consent. Decisions to enhance informed consent should consider the importance of different elements of understanding, beyond procedural risks, as well as feasibility and acceptability of the intervention to clinicians and patients. Conceptual clarity regarding the key elements of informed consent knowledge will help to focus improvements and standardize evaluations. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4435842 Fri, 04 Feb 2011 00:00:00 +0100 4435842 http://www.medworm.com/index.php?rid=4435841&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F31%2F1%2F143%3Frss%3D1 Conclusions. Randomly arranged arrays of stick figures should be used with care because viewers’ ability to estimate the proportion in these graphics is so poor that moderate differences between risks may not be visible. In addition, random arrangements may create an initial impression that proportions, especially large ones, are larger than they are. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4435841 Fri, 04 Feb 2011 00:00:00 +0100 4435841 http://www.medworm.com/index.php?rid=4435840&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F31%2F1%2F130%3Frss%3D1 Conclusions. A game-like graphic that allowed consumers to search for stick figures affected by disease had no main effect on risk perception but reduced differences based on numeracy. In one condition, the game-like graphic increased concern about rare risks. Intentions for preventive action were stronger with a question order that focused first on efficacy and disease severity than with one that focused first on perceived risk. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4435840 Fri, 04 Feb 2011 00:00:00 +0100 4435840 http://www.medworm.com/index.php?rid=4435839&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F31%2F1%2F121%3Frss%3D1 Conclusions. A relation between decision aids and adherence is plausible in view of the psychological and medical literature. A systematic search showed that experimental evidence relating decision aids and adherence is inconclusive. Rigorous trials on this topic are worthwhile. Such trials should employ adequate sample sizes, multiple adherence measures, and a control arm delivering usual care. The decision aid should describe the option "being nonadherent" and its outcomes. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4435839 Fri, 04 Feb 2011 00:00:00 +0100 4435839 http://www.medworm.com/index.php?rid=4435838&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F31%2F1%2F108%3Frss%3D1 Conclusions. Many men undergo CaP screening without being fully informed about the decision. These findings support the need for interventions aimed at improving IDM about screening, particularly among men of color, those with lower levels of income and education, and those who have not discussed screening with their provider. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4435838 Fri, 04 Feb 2011 00:00:00 +0100 4435838 http://www.medworm.com/index.php?rid=4435837&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F31%2F1%2F93%3Frss%3D1 Conclusions. Our interactive computer-based decision aid facilitates SDM, but overall effectiveness is determined by the extent to which providers comply with patient preferences. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4435837 Fri, 04 Feb 2011 00:00:00 +0100 4435837 http://www.medworm.com/index.php?rid=4435836&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F31%2F1%2F79%3Frss%3D1 The purpose of this article is to show, using principles from Shannon’s information theory, that it is possible to estimate the amount of information loss that occurs, in relative terms, when multiple continuous biological traits are dichotomized and aggregated, as is the case with many diagnostic definitions. We use metabolic syndrome as a case in point. It is our position that this type of information loss can impede the progress of medical research. This argument will first be made on theoretical grounds and then be supplemented using data from a clinical trial involving 252 women enrolled in cardiac rehabilitation. After laying out relevant principles, we conduct analyses to show how such information loss occurs during data transformation. Our analyses demonstrate that transformi... Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4435836 Fri, 04 Feb 2011 00:00:00 +0100 4435836 http://www.medworm.com/index.php?rid=4435835&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F31%2F1%2F69%3Frss%3D1 Conclusions. Reactive nationwide mass vaccination remains a suboptimal strategy for controlling an expanding smallpox outbreak in all but the most extreme circumstances. Rather, targeted mass vaccination of affected areas is likely to result in fewer deaths. The vaccines administered are also likely to be much fewer because they would probably be distributed to a much smaller number of districts, thus relieving pressure on potentially stretched public health systems. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4435835 Fri, 04 Feb 2011 00:00:00 +0100 4435835 http://www.medworm.com/index.php?rid=4435834&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Freprint%2F31%2F1%2FE54%3Frss%3D1 (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4435834 Fri, 04 Feb 2011 00:00:00 +0100 4435834 http://www.medworm.com/index.php?rid=4435833&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F31%2F1%2F53%3Frss%3D1 Conclusions. We successfully developed and validated a TB model, which uses a proxy for population health to estimate changes in key epidemiology parameters. Population health contributed significantly to improvement in TB outcomes observed in Peru. Changing population health should be incorporated into evaluative models for global TB control. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4435833 Fri, 04 Feb 2011 00:00:00 +0100 4435833 http://www.medworm.com/index.php?rid=4435832&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F31%2F1%2F43%3Frss%3D1 Conclusions. It is concluded that an RCT recruiting between 2000 and 5000 women per arm to evaluate the relative efficacy of alendronate and vitamin K1 appears to be cost effective for informing decision making in England and Wales. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4435832 Fri, 04 Feb 2011 00:00:00 +0100 4435832 http://www.medworm.com/index.php?rid=4435831&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F31%2F1%2F35%3Frss%3D1 Conclusions. For diseases with a more active research and development pipeline, the possibility of a new treatment paradigm may be at least as important to consider in sensitivity analysis as other parameters that are often considered. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4435831 Fri, 04 Feb 2011 00:00:00 +0100 4435831 http://www.medworm.com/index.php?rid=4435830&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F31%2F1%2F19%3Frss%3D1 Cohort analysis is a widespread tool for computing expected costs and quality-adjusted life years (QALYs) in Markov models for medical cost-effectiveness analyses. Although not always explicitly identified, such models commonly have multiple simple factors, or components. In these, a health state consists of a multiple component vector, one component for each factor, and arbitrary combinations of components are possible. The authors show here that when the model does not assume any probabilistic dependence among these factors, then a standard cohort analysis may be decomposed into several independent cohort analyses, one for each factor, and the results may be combined to produce desired expected costs and QALYs. These single-factor cohort analyses are not only simpler but also computation... Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4435830 Fri, 04 Feb 2011 00:00:00 +0100 4435830 http://www.medworm.com/index.php?rid=4435829&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Freprint%2F31%2F1%2FE11%3Frss%3D1 (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4435829 Fri, 04 Feb 2011 00:00:00 +0100 4435829 http://www.medworm.com/index.php?rid=4435828&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F31%2F1%2F10%3Frss%3D1 Conclusions. MSMs are increasingly being used to provide information to guide health policy decisions. This increased use brings with it the need for both better understanding of MSMs by policy researchers, and continued improvement in methods for developing and applying MSMs. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4435828 Fri, 04 Feb 2011 00:00:00 +0100 4435828 http://www.medworm.com/index.php?rid=4435827&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Freprint%2F31%2F1%2F5%3Frss%3D1 (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4435827 Fri, 04 Feb 2011 00:00:00 +0100 4435827 http://www.medworm.com/index.php?rid=4435826&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F31%2F1%2FE1%3Frss%3D1 Conclusion. Risk information appears to be prone to evaluability bias. This suggests that numeric information on health gains is difficult to evaluate in isolation. Consequently, such information may bear too little weight in separate evaluations of risk-reducing interventions. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4435826 Fri, 04 Feb 2011 00:00:00 +0100 4435826 http://www.medworm.com/index.php?rid=4286927&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F30%2F6%2F745%3Frss%3D1 Conclusions . Key opportunities for IM to support diabetes self-management include assessment of information for shared decision making, assistance with problem-solving self-management challenges, and provision of follow-up support. A key current challenge is the linkage of IM supports to the rest of the patient’s care, and collection of cost-effectiveness data is a key need for future research. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4286927 Thu, 23 Dec 2010 00:00:00 +0100 4286927 http://www.medworm.com/index.php?rid=4286926&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F30%2F6%2F732%3Frss%3D1 Over the cancer disease trajectory, from diagnosis and treatment to remission or end of life, patients and their families face difficult decisions. The provision of information and support when most relevant can optimize cancer decision making and coping. An interactive health communication system (IHCS) offers the potential to bridge the communication gaps that occur among patients, family, and clinicians and to empower each to actively engage in cancer care and shared decision making. This is a report of the authors’ experience (with a discussion of relevant literature) in developing and testing a Web-based IHCS—the Comprehensive Health Enhancement Support System (CHESS)—for patients with advanced lung cancer and their family caregivers. CHESS provides information, comm... Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4286926 Thu, 23 Dec 2010 00:00:00 +0100 4286926 http://www.medworm.com/index.php?rid=4286925&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F30%2F6%2F722%3Frss%3D1 Conclusions . EHR-based wiki-style applications may have the potential to improve communication and care coordination among clinicians caring for complex patients. This could lead to improved quality and safety within multidisciplinary disease management programs. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4286925 Thu, 23 Dec 2010 00:00:00 +0100 4286925 http://www.medworm.com/index.php?rid=4286924&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F30%2F6%2F712%3Frss%3D1 Translation of research into clinical practice remains a barrier, with inconsistent adoption of effective treatments and useful tests. Clinical decision rules (CDRs) integrate information from several clinical or laboratory findings to provide quantitative estimates of risk for a diagnosis or clinical outcome. They are increasingly reported in the literature and have the potential to provide a bridge that helps translate findings from original research studies into clinical practice. Unlike formal aids for shared decision making, they are pragmatic solutions that provide discrete quantitative data to aid clinicians and patients in decision making. These quantitative data can help inform the informal episodes of shared decision making that frequently take place at the point of care. Methods... Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4286924 Thu, 23 Dec 2010 00:00:00 +0100 4286924 http://www.medworm.com/index.php?rid=4286923&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F30%2F6%2F701%3Frss%3D1 This article provides an analysis of ‘decision aids’, interventions to support patients facing tough decisions. Interest has increased since the concept of shared decision making has become widely considered to be a means of achieving desirable clinical outcomes. We consider the aims of these interventions and examine assumptions about their use. We propose three categories, interventions that are used in face-to-face encounters, those designed for use outside clinical encounters and those which are mediated, using telephone or other communication media. We propose the following definition: decision support interventions help people think about choices they face; they describe where and why choice exists; they provide information about options, including, where reasonable, the ... Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4286923 Thu, 23 Dec 2010 00:00:00 +0100 4286923 http://www.medworm.com/index.php?rid=4286922&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Freprint%2F30%2F6%2F699%3Frss%3D1 (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4286922 Thu, 23 Dec 2010 00:00:00 +0100 4286922 http://www.medworm.com/index.php?rid=4286921&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Freprint%2F30%2F6%2F696%3Frss%3D1 (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4286921 Thu, 23 Dec 2010 00:00:00 +0100 4286921 http://www.medworm.com/index.php?rid=4286920&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Freprint%2F30%2F6%2F694%3Frss%3D1 (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4286920 Thu, 23 Dec 2010 00:00:00 +0100 4286920 http://www.medworm.com/index.php?rid=4286919&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F30%2F6%2F685%3Frss%3D1 Conclusion. Methodological factors significantly affect lung cancer utilities; therefore, analysts should avoid direct comparisons of lung cancer utility values elicited with dissimilar methods. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4286919 Thu, 23 Dec 2010 00:00:00 +0100 4286919 http://www.medworm.com/index.php?rid=4286918&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F30%2F6%2F672%3Frss%3D1 Conclusions. Building on previous research showing that problems with understanding numerical information often do not reside in the mind but in the representation of the problem, the results show that icon arrays are an effective method of eliminating denominator neglect. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4286918 Thu, 23 Dec 2010 00:00:00 +0100 4286918 http://www.medworm.com/index.php?rid=4286917&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F30%2F6%2F661%3Frss%3D1 Conclusions. Taking a ‘‘less is more’’ approach by omitting redundant mortality outcome statistics can be an effective method of risk communication and may be preferable when using visual formats such as pictographs. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4286917 Thu, 23 Dec 2010 00:00:00 +0100 4286917 http://www.medworm.com/index.php?rid=4286916&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F30%2F6%2F651%3Frss%3D1 Conclusion. Failing to incorporate dependence on prior event history in subsequent relapse risk in Markov models can greatly affect model outcomes, overestimating the impact of prevention and treatment strategies by up to 85% and underestimating the impact in some treatment models by up to 20%. When at least 4 prior episodes are incorporated, bias does not exceed 26% in prevention or 11% in treatment. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4286916 Thu, 23 Dec 2010 00:00:00 +0100 4286916 http://www.medworm.com/index.php?rid=4286915&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F30%2F6%2F639%3Frss%3D1 Conclusions. The authors generated risk prediction models for hospital-acquired AKI using only commonly available electronic data. The models identify patients at high risk for AKI who might benefit from early intervention or increased monitoring. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4286915 Thu, 23 Dec 2010 00:00:00 +0100 4286915 http://www.medworm.com/index.php?rid=4286914&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F30%2F6%2F625%3Frss%3D1 Conclusions. AD progression is characterized by a small number of parameters governing changes in large numbers of correlated indicators of AD severity. The analysis confirmed that the progression of AD represents a complex multidimensional physiological process that is similar across different study cohorts. The estimates suggested that there could be large cost offsets to Medicare and Medicaid from the slowing of AD progression among patients with mild AD. The methodology appears generally applicable in AD modeling. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4286914 Thu, 23 Dec 2010 00:00:00 +0100 4286914 http://www.medworm.com/index.php?rid=4084923&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F30%2F5%2F610%3Frss%3D1 Conclusions. Few studies elicit values for SWD. The lead time approach is a potential alternative to the Torrance and MVH protocols. Key words: QALY; states worse than dead; health state valuation; preference elicitation. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4084923 Mon, 18 Oct 2010 23:00:00 +0100 4084923 http://www.medworm.com/index.php?rid=4084922&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F30%2F5%2F594%3Frss%3D1 Conclusion. The main findings in this study suggest that cardiovascular risk level and previous coronary heart disease are not associated with the way patients value potential benefits of statin treatment. Patients’ views of the treatment’s necessity, harm, and benefits do not seem to be independent dimensions of patient beliefs but rather represent one overall question: is this good for me? (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4084922 Mon, 18 Oct 2010 23:00:00 +0100 4084922 http://www.medworm.com/index.php?rid=4084921&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F30%2F5%2F582%3Frss%3D1 Conclusions. Medicare beneficiaries face a tension between not wanting to choose from too many options and feeling happier with an outcome when they have more alternatives. Interventions that reduce cognitive costs when choice sets are large may make this program more attractive to beneficiaries. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4084921 Mon, 18 Oct 2010 23:00:00 +0100 4084921 http://www.medworm.com/index.php?rid=4084920&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F30%2F5%2F578%3Frss%3D1 The unconscious thought effect refers to improved judgments and decisions after a period of distraction. The authors studied the unconscious thought effect in a complex and error-prone part of clinical decision making: diagnosis. Their aim was to test whether conscious versus unconscious processing influenced diagnosis of psychiatric cases. They used case descriptions from the DSM-IV casebook. Half of the participants were randomly assigned to the conscious-processing-condition (i.e., consciously thinking about the information they read in the case description), the other half to the unconscious-processing condition (i.e., performing an unrelated distracter task). The main dependent measure was the total number of correct classifications. Compared to conscious processing, unconscious proce... Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4084920 Mon, 18 Oct 2010 23:00:00 +0100 4084920 http://www.medworm.com/index.php?rid=4084919&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F30%2F5%2F566%3Frss%3D1 Conclusion. Through testing and iteration the authors identified and addressed several problems, using explanations, rephrasing, and symbols to present scientific concepts. Other problems remain, including how best to present confidence intervals and continuous outcomes. Future research should also test information elements in combination rather than in isolation. The new Plain Language Summary format is being evaluated in a randomized controlled trial. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4084919 Mon, 18 Oct 2010 23:00:00 +0100 4084919 http://www.medworm.com/index.php?rid=4084918&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F30%2F5%2F556%3Frss%3D1 This article focuses on the EQ-5D, but the arguments and their implications for statistical analysis are relevant to all health state descriptive systems. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4084918 Mon, 18 Oct 2010 23:00:00 +0100 4084918 http://www.medworm.com/index.php?rid=4084917&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F30%2F5%2F544%3Frss%3D1 Conclusion. Patients intended to use more information for future choices than they used for past choices. For future choices, most patients prefer a summary measure on quality of care over more detailed measures but seem to value that they were already treated in that hospital or a hospital’s good reputation even more. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4084917 Mon, 18 Oct 2010 23:00:00 +0100 4084917 http://www.medworm.com/index.php?rid=4084916&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F30%2F5%2F536%3Frss%3D1 Discussion: Estimated cost-effectiveness ratios and associated policy decisions may be sensitive to assumptions regarding the mechanism underlying placebo responses. These assumptions should, if possible, be investigated through analysis of trial or observational data and, in the absence of other evidence, sensitivity analysis. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4084916 Mon, 18 Oct 2010 23:00:00 +0100 4084916 http://www.medworm.com/index.php?rid=4084915&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Freprint%2F30%2F5%2F534%3Frss%3D1 (No abstract is available for this citation) (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4084915 Mon, 18 Oct 2010 23:00:00 +0100 4084915 http://www.medworm.com/index.php?rid=4084914&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Freprint%2F30%2F5%2F531%3Frss%3D1 (No abstract is available for this citation) (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4084914 Mon, 18 Oct 2010 23:00:00 +0100 4084914 http://www.medworm.com/index.php?rid=4084913&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Freprint%2F30%2F5%2F529%3Frss%3D1 (No abstract is available for this citation) (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4084913 Mon, 18 Oct 2010 23:00:00 +0100 4084913 http://www.medworm.com/index.php?rid=4084912&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Freprint%2F30%2F5%2F528%3Frss%3D1 (No abstract is available for this citation) (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4084912 Mon, 18 Oct 2010 23:00:00 +0100 4084912 http://www.medworm.com/index.php?rid=4084911&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F30%2F5%2FE29%3Frss%3D1 In this study, the authors propose a general framework for predicting utility for joint health states. This framework includes these 3 nonparametric estimators as special cases. A new simple nonparametric estimator, the adjusted decrement estimator, [Uij = Umin - Umin (1 - Ui )(1 - Uj )], is introduced under the proposed framework. When applied to 2 independent data sources, the new nonparametric estimator not only generated unbiased prediction of utilities for joint health states but also had the least root mean squared error and highest concordance when compared with other nonparametric and parametric estimators. Further research and validation of this new estimator are needed. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4084911 Mon, 18 Oct 2010 23:00:00 +0100 4084911 http://www.medworm.com/index.php?rid=4084910&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F30%2F5%2FE1%3Frss%3D1 Conclusions . The authors caution against generalizing the quantitative results in this study beyond the present example but suggest that the approach presented here may serve as a template for other examinations of model uncertainty. As new research questions arise after the introduction of rotavirus vaccination programs, a reevaluation of model uncertainty is likely to be needed. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4084910 Mon, 18 Oct 2010 23:00:00 +0100 4084910 http://www.medworm.com/index.php?rid=4084937&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F30%2F5_suppl%2F106S%3Frss%3D1 Conclusions. A minority of patients reported using the Internet to make specific common medical decisions, but use varied widely by type of decision. Perhaps reflecting perceived risk and uncertainty, use was lowest for screening decisions and highest for surgical decisions. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4084937 Tue, 28 Sep 2010 23:00:00 +0100 4084937 http://www.medworm.com/index.php?rid=4084936&cid=s_31291_51_f&fid=31291&url=http%3A%2F%2Fmdm.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F30%2F5_suppl%2F96S%3Frss%3D1 Conclusions. Higher perceived risk was associated with greater patient participation, as shown by more information seeking and greater desire for decisional involvement (moderated by gender). The results suggest that perceived risk of cancer could influence patient behavior when deciding about screening. (Source: Medical Decision Making) Medical Decision Making journals http://www.medworm.com/rss/comments.php?id=4084936 Tue, 28 Sep 2010 23:00:00 +0100 4084936