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Medical Decision Making: An International Journal of the Society for Medical Decision Making

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https://www.readbyqxmd.com/read/28884617/strengths-and-gaps-in-physicians-risk-communication-a-scenario-study-of-the-influence-of-numeracy-on-cancer-screening-communication
#1
Dafina Petrova, Olga Kostopoulou, Brendan C Delaney, Edward T Cokely, Rocio Garcia-Retamero
OBJECTIVE: Many patients have low numeracy, which impedes their understanding of important information about health (e.g., benefits and harms of screening). We investigated whether physicians adapt their risk communication to accommodate the needs of patients with low numeracy, and how physicians' own numeracy influences their understanding and communication of screening statistics. METHODS: UK family physicians ( N = 151) read a description of a patient seeking advice on cancer screening...
September 1, 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/28863752/divergent-preferences-for-hiv-prevention-a-discrete-choice-experiment-for-multipurpose-hiv-prevention-products-in-south-africa
#2
Matthew Quaife, Robyn Eakle, Maria A Cabrera Escobar, Peter Vickerman, Maggie Kilbourne-Brook, Mercy Mvundura, Sinead Delany-Moretlwe, Fern Terris-Prestholt
BACKGROUND: The development of antiretroviral (ARV)-based prevention products has the potential to substantially change the HIV prevention landscape; yet, little is known about how appealing these products will be outside of clinical trials, as compared with the existing options. METHODS: We conducted a discrete choice experiment (DCE) to measure preferences for 5 new products among 4 important populations in the HIV response: adult men and women in the general population (aged 18 to 49 y), adolescent girls (aged 16 to 17 y), and self-identifying female sex workers (aged 18 to 49 y)...
September 1, 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/28853340/variability-in-affect-and-willingness-to-take-medication
#3
Liana Fraenkel, Marilyn Stolar, Jonathan R Bates, Richard L Street, Harjinder Chowdhary, Sarah Swift, Ellen Peters
OBJECTIVE: To determine if 1) patients have distinct affective reaction patterns to medication information, and 2) whether there is an association between affective reaction patterns and willingness to take medication. METHODS: We measured affect in real time as subjects listened to a description of benefits and side effects for a hypothetical new medication. Subjects moved a dial on a handheld response system to indicate how they were feeling from "Very Good" to "Very Bad"...
August 1, 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/28823204/methods-for-population-adjusted-indirect-comparisons-in-health-technology-appraisal
#4
David M Phillippo, A E Ades, Sofia Dias, Stephen Palmer, Keith R Abrams, Nicky J Welton
Standard methods for indirect comparisons and network meta-analysis are based on aggregate data, with the key assumption that there is no difference between the trials in the distribution of effect-modifying variables. Methods which relax this assumption are becoming increasingly common for submissions to reimbursement agencies, such as the National Institute for Health and Care Excellence (NICE). These methods use individual patient data from a subset of trials to form population-adjusted indirect comparisons between treatments, in a specific target population...
August 1, 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/28823186/using-cluster-analysis-to-group-countries-for-cost-effectiveness-analysis-an-application-to-sub-saharan-africa
#5
Louise B Russell, Gyan Bhanot, Sun-Young Kim, Anushua Sinha
OBJECTIVE: To explore the use of cluster analysis to define groups of similar countries for the purpose of evaluating the cost-effectiveness of a public health intervention-maternal immunization-within the constraints of a project budget originally meant for an overall regional analysis. METHODS: We used the most common cluster analysis algorithm, K-means, and the most common measure of distance, Euclidean distance, to group 37 low-income, sub-Saharan African countries on the basis of 24 measures of economic development, general health resources, and past success in public health programs...
August 1, 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/28823185/conducting-eq-5d-valuation-studies-in-resource-constrained-countries-the-potential-use-of-shrinkage-estimators-to-reduce-sample-size
#6
Kelvin K W Chan, Feng Xie, Andrew R Willan, Eleanor M Pullenayegum
BACKGROUND: Resource-constrained countries have difficulty conducting large EQ-5D valuation studies, which limits their ability to conduct cost-utility analyses using a value set specific to their own population. When estimates of similar but related parameters are available, shrinkage estimators reduce uncertainty and yield estimators with smaller mean square error (MSE). We hypothesized that health utilities based on shrinkage estimators can reduce MSE and mean absolute error (MAE) when compared to country-specific health utilities...
August 1, 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/28814131/what-factors-influence-women-s-perceptions-of-their-systemic-recurrence-risk-after-breast-cancer-treatment
#7
Kamaria L Lee, Nancy K Janz, Brian J Zikmund-Fisher, Reshma Jagsi, Lauren P Wallner, Allison W Kurian, Steven J Katz, Paul Abrahamse, Sarah T Hawley
BACKGROUND: Breast cancer patients' misunderstanding of their systemic cancer recurrence risk has consequences on decision-making and quality of life. Little is known about how women derive their risk estimates. METHODS: Using Los Angeles and Georgia's SEER registries (2014-2015), a random sample of early-stage breast cancer patients was sent surveys about 2 to 3 months after surgery ( N = 3930; RR, 68%). We conducted an inductive thematic analysis of open-ended responses about why women chose their risk estimates in a uniquely large sub-sample ( N = 1,754)...
August 1, 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/28806143/whose-preferences-matter-a-patient-centered-approach-for-eliciting-treatment-goals
#8
Nananda F Col, Andrew J Solomon, Vicky Springmann, Calvin P Garbin, Carolina Ionete, Lori Pbert, Enrique Alvarez, Brenda Tierman, Ashli Hopson, Christen Kutz, Idanis Berrios Morales, Carolyn Griffin, Glenn Phillips, Long H Ngo
BACKGROUND: Patients facing a high-stakes clinical decision are often confronted with an overwhelming array of options. High-quality decisions about treatment should reflect patients' preferences as well as their clinical characteristics. Preference-assessment instruments typically focus on pre-selected clinical outcomes and attributes chosen by the investigator. OBJECTIVE: We sought to develop a patient-centered approach to elicit and compare the treatment goals of patients with multiple sclerosis (MS) and healthcare providers (HCPs)...
August 1, 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/28735563/a-gaussian-approximation-approach-for-value-of-information-analysis
#9
Hawre Jalal, Fernando Alarid-Escudero
Most decisions are associated with uncertainty. Value of information (VOI) analysis quantifies the opportunity loss associated with choosing a suboptimal intervention based on current imperfect information. VOI can inform the value of collecting additional information, resource allocation, research prioritization, and future research designs. However, in practice, VOI remains underused due to many conceptual and computational challenges associated with its application. Expected value of sample information (EVSI) is rooted in Bayesian statistical decision theory and measures the value of information from a finite sample...
July 1, 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/28699382/an-adaptive-approach-to-locating-mobile-hiv-testing-services
#10
Gregg S Gonsalves, Forrest W Crawford, Paul D Cleary, Edward H Kaplan, A David Paltiel
BACKGROUND: Public health agencies suggest targeting "hotspots" to identify individuals with undetected HIV infection. However, definitions of hotspots vary. Little is known about how best to target mobile HIV testing resources. METHODS: We conducted a computer-based tournament to compare the yield of 4 algorithms for mobile HIV testing. Over 180 rounds of play, the algorithms selected 1 of 3 hypothetical zones, each with unknown prevalence of undiagnosed HIV, in which to conduct a fixed number of HIV tests...
July 1, 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/28691551/who-decides-me-or-we-family-involvement-in-medical-decision-making-in-eastern-and-western-countries
#11
Dana L Alden, John Friend, Ping Yein Lee, Yew Kong Lee, Lyndal Trevena, Chirk Jenn Ng, Sorapop Kiatpongsan, Khatijah Lim Abdullah, Miho Tanaka, Supanida Limpongsanurak
BACKGROUND: Research suggests that desired family involvement (FI) in medical decision making may depend on cultural values. Unfortunately, the field lacks cross-cultural studies that test this assumption. As a result, providers may be guided by incomplete information or cultural biases rather than patient preferences. METHODS: Researchers developed 6 culturally relevant disease scenarios varying from low to high medical seriousness. Quota samples of approximately 290 middle-aged urban residents in Australia, China, Malaysia, India, South Korea, Thailand, and the USA completed an online survey that examined desired levels of FI and identified individual difference predictors in each country...
July 1, 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/28675959/adding-events-to-a-markov-model-using-dice-simulation
#12
J Jaime Caro, Jörgen Möller
BACKGROUND: Health care decisions are often made under uncertainty and modeling is used to inform the choices and possible consequences. State-transition ("Markov") models are commonly used but they represent the problem solely in terms of states; events are not explicitly considered. METHODS: Discretely integrated condition event (DICE) simulation provides for both aspects that persist over time ("conditions") and for those happening at a point in time ("events")...
July 1, 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/28854143/biases-in-individualized-cost-effectiveness-analysis-influence-of-choices-in-modeling-short-term-trial-based-mortality-risk-reduction-and-post-trial-life-expectancy
#13
David van Klaveren, John B Wong, David M Kent, Ewout W Steyerberg
BACKGROUND: The benefits and costs of a treatment are typically heterogeneous across individual patients. Randomized clinical trials permit the examination of individualized treatment benefits over the trial horizon but extrapolation to lifetime horizon usually involves combining trial-based individualized estimates of short-term risk reduction with less detailed (less granular) population life tables. However, the underlying assumption of equal post-trial life expectancy for low- and high-risk patients of the same sex and age is unrealistic...
October 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/28490271/validation-of-a-cardiovascular-disease-policy-microsimulation-model-using-both-survival-and-receiver-operating-characteristic-curves
#14
Ankur Pandya, Stephen Sy, Sylvia Cho, Sartaj Alam, Milton C Weinstein, Thomas A Gaziano
BACKGROUND: Despite some advances, cardiovascular disease (CVD) remains the leading cause of death and healthcare costs in the United States. We therefore developed a comprehensive CVD policy simulation model that identifies cost-effective approaches for reducing CVD burden. This paper aims to: 1) describe our model in detail; and 2) perform model validation analyses. METHODS: The model simulates 1,000,000 adults (ages 35 to 80 years) using a variety of CVD-related epidemiological data, including previously calibrated Framingham-based risk scores for coronary heart disease and stroke...
October 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/28441087/using-the-payoff-time-in-decision-analytic-models-a-case-study-for-using-statins-in-primary-prevention
#15
Alexander Thompson, Bruce Guthrie, Katherine Payne
BACKGROUND: The payoff time represents an estimate of when the benefits of an intervention outweigh the costs. It is particularly useful for benefit-harm decision making for interventions that have deferred benefits but upfront harms. The aim of this study was to expand the application of the payoff time and provide an example of its use within a decision-analytic model. METHODS: Three clinically relevant patient vignettes based on varying levels of estimated 10-year cardiovascular risk (10%, 15%, 20%) were developed...
October 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/28410564/a-review-of-methods-for-analysis-of-the-expected-value-of-information
#16
Anna Heath, Ioanna Manolopoulou, Gianluca Baio
In recent years, value-of-information analysis has become more widespread in health economic evaluations, specifically as a tool to guide further research and perform probabilistic sensitivity analysis. This is partly due to methodological advancements allowing for the fast computation of a typical summary known as the expected value of partial perfect information (EVPPI). A recent review discussed some approximation methods for calculating the EVPPI, but as the research has been active over the intervening years, that review does not discuss some key estimation methods...
October 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/28399375/understanding-the-value-of-individualized-information-the-impact-of-poor-calibration-or-discrimination-in-outcome-prediction-models
#17
Natalia Olchanski, Joshua T Cohen, Peter J Neumann, John B Wong, David M Kent
BACKGROUND: Risk prediction models allow for the incorporation of individualized risk and clinical effectiveness information to identify patients for whom therapy is most appropriate and cost-effective. This approach has the potential to identify inefficient (or harmful) care in subgroups at different risks, even when the overall results appear favorable. Here, we explore the value of personalized risk information and the factors that influence it. METHODS: Using an expected value of individualized care (EVIC) framework, which monetizes the value of customizing care, we developed a general approach to calculate individualized incremental cost effectiveness ratios (ICERs) as a function of individual outcome risk...
October 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/28384413/comparative-effectiveness-of-tacrolimus-based-steroid-sparing-versus-steroid-maintenance-regimens-in-kidney-transplantation-results-from-discrete-event-simulation
#18
Vibha C A Desai, Yann Ferrand, Teresa M Cavanaugh, Christina M L Kelton, J Jaime Caro, Jens Goebel, Pamela C Heaton
BACKGROUND: Corticosteroids used as immunosuppressants to prevent acute rejection (AR) and graft loss (GL) following kidney transplantation are associated with serious cardiovascular and other adverse events. Evidence from short-term randomized controlled trials suggests that many patients on a tacrolimus-based immunosuppressant regimen can withdraw from steroids without increased AR or GL risk. OBJECTIVES: To measure the long-term tradeoff between GL and adverse events for a heterogeneous-risk population and determine the optimal timing of steroid withdrawal...
October 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/28379779/a-procedure-for-deriving-formulas-to-convert-transition-rates-to-probabilities-for-multistate-markov-models
#19
Edmund Jones, David Epstein, Leticia García-Mochón
For health-economic analyses that use multistate Markov models, it is often necessary to convert from transition rates to transition probabilities, and for probabilistic sensitivity analysis and other purposes it is useful to have explicit algebraic formulas for these conversions, to avoid having to resort to numerical methods. However, if there are four or more states then the formulas can be extremely complicated. These calculations can be made using packages such as R, but many analysts and other stakeholders still prefer to use spreadsheets for these decision models...
October 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/28363265/two-stage-biomarker-protocols-for-improving-the-precision-of-early-detection-of-prostate-cancer
#20
Christine L Barnett, Scott A Tomlins, Daniel J Underwood, John T Wei, Todd M Morgan, James E Montie, Brian T Denton
BACKGROUND: New cancer biomarkers are being discovered at a rapid pace; however, these tests vary in their predictive performance characteristics, and it is unclear how best to use them. METHODS: We investigated 2-stage biomarker-based screening strategies in the context of prostate cancer using a partially observable Markov model to simulate patients' progression through prostate cancer states to mortality from prostate cancer or other causes. Patients were screened every 2 years from ages 55 to 69...
October 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
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