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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/28199180/marketing-authorization-procedures-for-advanced-cancer-drugs
#1
Christel Protière, Rachel Baker, Dominique Genre, Anthony Goncalves, Patrice Viens
BACKGROUND: The past decades have seen advances in cancer treatments in terms of toxicity and side effects but progress in the treatment of advanced cancer has been modest. New drugs have emerged improving progression free survival but with little impact on overall survival, raising questions about the criteria on which to base decisions to grant marketing authorizations and about the authorization procedure itself. For decisions to be fair, transparent and accountable, it is necessary to consider the views of those with relevant expertise and experience...
February 1, 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/28199179/experienced-probabilities-increase-understanding-of-diagnostic-test-results-in-younger-and-older-adults
#2
Bonnie Armstrong, Julia Spaniol
BACKGROUND: With advancing age, the frequency of medical screening increases. Interpreting the results of medical tests involves estimation of posterior probabilities such as positive predictive values (PPVs) and negative predictive values (NPVs). Both laypeople and experts are typically poor at estimating posterior probabilities when the relevant statistics are communicated descriptively. The current study examined whether an experience format would improve posterior probability judgments in younger and older adults, relative to a description format...
February 1, 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/28199178/response-to-comment-on-decisional-conflict-regret-and-the-burden-of-rational-decision-making
#3
Andrew Vickers
No abstract text is available yet for this article.
February 1, 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/28199177/comment-on-decisional-conflict-regret-and-the-burden-of-rational-decision-making
#4
Anita D Misra-Hebert, Michael W Kattan
No abstract text is available yet for this article.
February 1, 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/28199176/handling-protest-responses-in-contingent-valuation-surveys
#5
Mark Pennington, Manuel Gomes, Cam Donaldson
OBJECTIVES: Protest responses, whereby respondents refuse to state the value they place on the health gain, are commonly encountered in contingent valuation (CV) studies, and they tend to be excluded from analyses. Such an approach will be biased if protesters differ from non-protesters on characteristics that predict their responses. The Heckman selection model has been commonly used to adjust for protesters, but its underlying assumptions may be implausible in this context. We present a multiple imputation (MI) approach to appropriately address protest responses in CV studies, and compare it with the Heckman selection model...
February 1, 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/28195755/prioritizing-rare-diseases
#6
Johanna Wiss, Lars-Ake Levin, David Andersson, Gustav Tinghög
BACKGROUND: Measuring societal preferences for rarity has been proposed to determine whether paying premium prices for orphan drugs is acceptable. OBJECTIVE: To investigate societal preferences for rarity and how psychological factors affect such preferences. METHOD: A postal survey containing resource allocation dilemmas involving patients with a rare disease and patients with a common disease, equal in severity, was sent out to a randomly selected sample of the population in Sweden (return rate 42...
February 1, 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/28192029/the-n-by-t-target-discharge-strategy-for-inpatient-units
#7
Pratik J Parikh, Nicholas Ballester, Kylie Ramsey, Nan Kong, Nancy Pook
BACKGROUND: Ineffective inpatient discharge planning often causes discharge delays and upstream boarding. While an optimal discharge strategy that works across all units at a hospital is likely difficult to identify and implement, a strategy that provides a reasonable target to the discharge team appears feasible. METHODS: We used observational and retrospective data from an inpatient trauma unit at a Level 2 trauma center in the Midwest US. Our proposed novel n-by-T strategy-discharge n patients by the Tth hour-was evaluated using a validated simulation model...
February 1, 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/28112994/regulator-loss-functions-and-hierarchical-modeling-for-safety-decision-making
#8
Laura A Hatfield, Christine M Baugh, Vanessa Azzone, Sharon-Lise T Normand
BACKGROUND: Regulators must act to protect the public when evidence indicates safety problems with medical devices. This requires complex tradeoffs among risks and benefits, which conventional safety surveillance methods do not incorporate. OBJECTIVE: To combine explicit regulator loss functions with statistical evidence on medical device safety signals to improve decision making. METHODS: In the Hospital Cost and Utilization Project National Inpatient Sample, we select pediatric inpatient admissions and identify adverse medical device events (AMDEs)...
January 1, 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/28061043/an-overview-of-r-in-health-decision-sciences
#9
Hawre Jalal, Petros Pechlivanoglou, Eline Krijkamp, Fernando Alarid-Escudero, Eva Enns, M G Myriam Hunink
As the complexity of health decision science applications increases, high-level programming languages are increasingly adopted for statistical analyses and numerical computations. These programming languages facilitate sophisticated modeling, model documentation, and analysis reproducibility. Among the high-level programming languages, the statistical programming framework R is gaining increased recognition. R is freely available, cross-platform compatible, and open source. A large community of users who have generated an extensive collection of well-documented packages and functions supports it...
January 1, 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/28061042/assessing-the-expected-value-of-research-studies-in-reducing-uncertainty-and-improving-implementation-dynamics
#10
Sabine E Grimm, Simon Dixon, John W Stevens
BACKGROUND: With low implementation of cost-effective health technologies being a problem in many health systems, it is worth considering the potential effects of research on implementation at the time of health technology assessment. Meaningful and realistic implementation estimates must be of dynamic nature. OBJECTIVE: To extend existing methods for assessing the value of research studies in terms of both reduction of uncertainty and improvement in implementation by considering diffusion based on expert beliefs with and without further research conditional on the strength of evidence...
January 1, 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/28061040/the-role-of-qualitative-research-methods-in-discrete-choice-experiments
#11
Caroline Vass, Dan Rigby, Katherine Payne
BACKGROUND: The use of qualitative research (QR) methods is recommended as good practice in discrete choice experiments (DCEs). This study investigated the use and reporting of QR to inform the design and/or interpretation of healthcare-related DCEs and explored the perceived usefulness of such methods. METHODS: DCEs were identified from a systematic search of the MEDLINE database. Studies were classified by the quantity of QR reported (none, basic, or extensive)...
January 1, 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/28076183/markov-influence-diagrams
#12
Francisco J Díez, Mar Yebra, Iñigo Bermejo, Miguel A Palacios-Alonso, Manuel Arias Calleja, Manuel Luque, Jorge Pérez-Martín
Markov influence diagrams (MIDs) are a new type of probabilistic graphical model that extends influence diagrams in the same way that Markov decision trees extend decision trees. They have been designed to build state-transition models, mainly in medicine, and perform cost-effectiveness analyses. Using a causal graph that may contain several variables per cycle, MIDs can model various patient characteristics without multiplying the number of states; in particular, they can represent the history of the patient without using tunnel states...
February 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/27803361/a-markov-decision-process-model-for-cervical-cancer-screening-policies-in-colombia
#13
Raha Akhavan-Tabatabaei, Diana Marcela Sánchez, Thomas G Yeung
Cervical cancer is the second most common cancer in women around the world, and the human papillomavirus (HPV) is universally known as the necessary agent for developing this disease. Through early detection of abnormal cells and HPV virus types, cervical cancer incidents can be reduced and disease progression prevented. We propose a finite-horizon Markov decision process model to determine the optimal screening policies for cervical cancer prevention. The optimal decision is given in terms of when and what type of screening test to be performed on a patient based on her current diagnosis, age, HPV contraction risk, and screening test results...
February 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/27681992/sensitivity-analysis-in-sequential-decision-models
#14
Qiushi Chen, Turgay Ayer, Jagpreet Chhatwal
BACKGROUND: Sequential decision problems are frequently encountered in medical decision making, which are commonly solved using Markov decision processes (MDPs). Modeling guidelines recommend conducting sensitivity analyses in decision-analytic models to assess the robustness of the model results against the uncertainty in model parameters. However, standard methods of conducting sensitivity analyses cannot be directly applied to sequential decision problems because this would require evaluating all possible decision sequences, typically in the order of trillions, which is not practically feasible...
February 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/27681989/understanding-the-effects-of-competition-for-constrained-colonoscopy-services-with-the-introduction-of-population-level-colorectal-cancer-screening
#15
Leslie Anne Campbell, John T Blake, George Kephart, Eva Grunfeld, Donald MacIntosh
BACKGROUND: Median wait times for gastroenterology services in Canada exceed consensus-recommended targets and have worsened substantially over the past decade. Meanwhile, efforts to control colorectal cancer have shifted their focus to screening asymptomatic, average-risk individuals. Along with increasing prevalence of colorectal cancer due to an aging population, screening programs are expected to add substantially to the existing burden on colonoscopy services, and create competition for limited services among individuals of varying risk...
February 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/27646567/progression-and-transmission-of-hiv-aids-path-2-0
#16
Chaitra Gopalappa, Paul G Farnham, Yao-Hsuan Chen, Stephanie L Sansom
BACKGROUND: HIV transmission is the result of complex dynamics in the risk behaviors, partnership choices, disease stage and position along the HIV care continuum-individual characteristics that themselves can change over time. Capturing these dynamics and simulating transmissions to understand the chief sources of transmission remain important for prevention. METHODS: The Progression and Transmission of HIV/AIDS (PATH 2.0) is an agent-based model of a sample of 10,000 people living with HIV (PLWH), who represent all men who have sex with men (MSM) and heterosexuals living with HIV in the U...
February 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/27553208/determinants-of-change-in-the-cost-effectiveness-threshold
#17
Mike Paulden, James O'Mahony, Christopher McCabe
The cost-effectiveness threshold in health care systems with a constrained budget should be determined by the cost-effectiveness of displacing health care services to fund new interventions. Using comparative statics, we review some potential determinants of the threshold, including the budget for health care, the demand for existing health care interventions, the technical efficiency of existing interventions, and the development of new health technologies. We consider the anticipated direction of impact that would affect the threshold following a change in each of these determinants...
February 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/27491558/risk-assessment-for-venous-thromboembolism-in-chemotherapy-treated-ambulatory-cancer-patients
#18
Patrizia Ferroni, Fabio Massimo Zanzotto, Noemi Scarpato, Silvia Riondino, Umberto Nanni, Mario Roselli, Fiorella Guadagni
OBJECTIVE: To design a precision medicine approach aimed at exploiting significant patterns in data, in order to produce venous thromboembolism (VTE) risk predictors for cancer outpatients that might be of advantage over the currently recommended model (Khorana score). DESIGN: Multiple kernel learning (MKL) based on support vector machines and random optimization (RO) models were used to produce VTE risk predictors (referred to as machine learning [ML]-RO) yielding the best classification performance over a training (3-fold cross-validation) and testing set...
February 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/27465113/using-simulation-to-model-and-validate-invasive-breast-cancer-progression-in-women-in-the-study-and-control-groups-of-the-canadian-national-breast-screening-studies-i-and-ii
#19
Sharareh Taghipour, Laurent N Caudrelier, Anthony B Miller, Bart Harvey
BACKGROUND: Modeling breast cancer progression and the effect of various risk is helpful in deciding when a woman should start and end screening, and how often the screening should be undertaken. METHODS: We modeled the natural progression of breast cancer using a hidden Markov process, and incorporated the effects of covariates. Patients are women aged 50-59 (older) and 40-49 (younger) years from the Canadian National Breast Screening Studies. We included prevalent cancers, estimated the screening sensitivities and rates of over-diagnosis, and validated the models using simulation...
February 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/27317437/why-do-health-economists-promote-technology-adoption-rather-than-the-search-for-efficiency-a-proposal-for-a-change-in-our-approach-to-economic-evaluation-in-health-care
#20
Graham Scotland, Stirling Bryan
At a time of intense pressure on health care budgets, the technology management challenge is for disinvestment in low-value technologies and reinvestment in higher value alternatives. The aim of this article is to explore ways in which health economists might begin to redress the observed imbalance between the evaluation of new and existing in-use technologies. The argument is not against evaluating new technologies but in favor of the "search for efficiency," where the ultimate objective is to identify reallocations that improve population health in the face of resource scarcity...
February 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
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