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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/29202637/methods-for-handling-unobserved-covariates-in-a-bayesian-update-of-a-cost-effectiveness-model
#1
Benjamin Thorpe, Orlagh Carroll, Linda Sharples
Health economic decision models often involve a wide-ranging and complicated synthesis of evidence from a number of sources, making design and implementation of such models resource-heavy. When new data become available and reassessment of treatment recommendations is warranted, it may be more efficient to perform a Bayesian update of an existing model than to construct a new model. If the existing model depends on many, possibly correlated, covariates, then an update may produce biased estimates of model parameters if some of these covariates are completely absent from the new data...
December 1, 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/29185378/matching-microsimulation-risk-factor-correlations-to-cross-sectional-data-the-shortest-distance-method
#2
Sze-Chuan Suen, Jeremy D Goldhaber-Fiebert, Sanjay Basu
BACKGROUND: Microsimulation models often compute the distribution of a simulated cohort's risk factors and medical outcomes over time using repeated waves of cross-sectional data. We sought to develop a strategy to simulate how risk factor values remain correlated over time within individuals, and compare it to available alternative methods. METHODS: We developed a method using shortest-distance matching for modeling changes in risk factors in individuals over time, which preserves both the cohort distribution of each risk factor as well as the cross-sectional correlation between risk factors observed in repeated cross-sectional data...
November 1, 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/29166565/hospital-based-physicians-intubation-decisions-and-associated-mental-models-when-managing-a-critically-and-terminally-ill-older-patient
#3
Shannon Haliko, Julie Downs, Deepika Mohan, Robert Arnold, Amber E Barnato
BACKGROUND: Variation in the intensity of acute care treatment at the end of life is influenced more strongly by hospital and provider characteristics than patient preferences. OBJECTIVE: We sought to describe physicians' mental models (i.e., thought processes) when encountering a simulated critically and terminally ill older patient, and to compare those models based on whether their treatment plan was patient preference-concordant or preference-discordant. METHODS: Seventy-three hospital-based physicians from 3 academic medical centers engaged in a simulated patient encounter and completed a mental model interview while watching the video recording of their encounter...
November 1, 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/29141153/using-observational-data-to-calibrate-simulation-models
#4
Eleanor J Murray, James M Robins, George R Seage, Sara Lodi, Emily P Hyle, Krishna P Reddy, Kenneth A Freedberg, Miguel A Hernán
BACKGROUND: Individual-level simulation models are valuable tools for comparing the impact of clinical or public health interventions on population health and cost outcomes over time. However, a key challenge is ensuring that outcome estimates correctly reflect real-world impacts. Calibration to targets obtained from randomized trials may be insufficient if trials do not exist for populations, time periods, or interventions of interest. Observational data can provide a wider range of calibration targets but requires methods to adjust for treatment-confounder feedback...
November 1, 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/29126364/efficient-monte-carlo-estimation-of-the-expected-value-of-sample-information-using-moment-matching
#5
Anna Heath, Ioanna Manolopoulou, Gianluca Baio
BACKGROUND: The Expected Value of Sample Information (EVSI) is used to calculate the economic value of a new research strategy. Although this value would be important to both researchers and funders, there are very few practical applications of the EVSI. This is due to computational difficulties associated with calculating the EVSI in practical health economic models using nested simulations. METHODS: We present an approximation method for the EVSI that is framed in a Bayesian setting and is based on estimating the distribution of the posterior mean of the incremental net benefit across all possible future samples, known as the distribution of the preposterior mean...
November 1, 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/29117791/implementing-generalized-additive-models-to-estimate-the-expected-value-of-sample-information-in-a-microsimulation-model-results-of-three-case-studies
#6
Dustin J Rabideau, Pamela P Pei, Rochelle P Walensky, Amy Zheng, Robert A Parker
BACKGROUND: The expected value of sample information (EVSI) can help prioritize research but its application is hampered by computational infeasibility, especially for complex models. We investigated an approach by Strong and colleagues to estimate EVSI by applying generalized additive models (GAM) to results generated from a probabilistic sensitivity analysis (PSA). METHODS: For 3 potential HIV prevention and treatment strategies, we estimated life expectancy and lifetime costs using the Cost-Effectiveness of Preventing AIDS Complications (CEPAC) model, a complex patient-level microsimulation model of HIV progression...
November 1, 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/29320960/39th-annual-meeting-of-the-society-for-medical-decision-making-pittsburgh-pennsylvania-october-22-25-2017
#7
(no author information available yet)
No abstract text is available yet for this article.
January 2018: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/28627302/taking-costs-and-diagnostic-test-accuracy-into-account-when-designing-prevalence-studies-an-application-to-childhood-tuberculosis-prevalence
#8
Zhuoyu Wang, Nandini Dendukuri, Madhukar Pai, Lawrence Joseph
BACKGROUND: When planning a study to estimate disease prevalence to a pre-specified precision, it is of interest to minimize total testing cost. This is particularly challenging in the absence of a perfect reference test for the disease because different combinations of imperfect tests need to be considered. We illustrate the problem and a solution by designing a study to estimate the prevalence of childhood tuberculosis in a hospital setting. METHODS: All possible combinations of 3 commonly used tuberculosis tests, including chest X-ray, tuberculin skin test, and a sputum-based test, either culture or Xpert, are considered...
November 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/28564551/a-framework-for-treatment-decision-making-at-prostate-cancer-recurrence
#9
Jane M Lange, Bruce J Trock, Roman Gulati, Ruth Etzioni
BACKGROUND: Of the 50,000 men in the US who elect for radical prostatectomy for prostate cancer, 24% to 40% will have a prostate-specific antigen (PSA) recurrence (PSA-R) within 10 years. Deciding whether to administer salvage therapy (ST) at PSA-R presents challenges, as treatment reduces the risk of progression to clinical metastasis but incurs unnecessary side effects should the man die before metastasis. We have developed a new harm-benefit framework using a clinical cohort to inform shared decision making between patients and physicians at PSA-R...
November 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/28564550/d%C3%A3-j%C3%A3-vu-introducing-operations-research-to-health-care
#10
Todd H Wagner, Jeffrey K Jopling
No abstract text is available yet for this article.
November 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/28474962/effects-of-anti-versus-pro-vaccine-narratives-on-responses-by-recipients-varying-in-numeracy-a-cross-sectional-survey-based-experiment
#11
Wändi Bruine de Bruin, Annika Wallin, Andrew M Parker, JoNell Strough, Janel Hanmer
BACKGROUND: To inform their health decisions, patients may seek narratives describing other patients' evaluations of their treatment experiences. Narratives can provide anti-treatment or pro-treatment evaluative meaning that low-numerate patients may especially struggle to derive from statistical information. Here, we examined whether anti-vaccine (v. pro-vaccine) narratives had relatively stronger effects on the perceived informativeness and judged vaccination probabilities reported among recipients with lower (v...
November 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/28423982/from-data-to-improved-decisions-operations-research-in-healthcare-delivery
#12
Muge Capan, Anahita Khojandi, Brian T Denton, Kimberly D Williams, Turgay Ayer, Jagpreet Chhatwal, Murat Kurt, Jennifer Mason Lobo, Mark S Roberts, Greg Zaric, Shengfan Zhang, J Sanford Schwartz
BACKGROUND: The Operations Research Interest Group (ORIG) within the Society of Medical Decision Making (SMDM) is a multidisciplinary interest group of professionals that specializes in taking an analytical approach to medical decision making and healthcare delivery. ORIG is interested in leveraging mathematical methods associated with the field of Operations Research (OR) to obtain data-driven solutions to complex healthcare problems and encourage collaborations across disciplines. This paper introduces OR for the non-expert and draws attention to opportunities where OR can be utilized to facilitate solutions to healthcare problems...
November 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/29084472/how-should-dce-with-duration-choice-sets-be-presented-for-the-valuation-of-health-states
#13
Brendan Mulhern, Richard Norman, Koonal Shah, Nick Bansback, Louise Longworth, Rosalie Viney
BACKGROUND: Discrete Choice Experiments including duration (DCETTO) can be used to generate utility values for health states from measures such as EQ-5D-5L. However, methodological issues concerning the optimum way to present choice sets remain. The aim of the present study was to test a range of task presentation approaches designed to support the DCETTO completion process. METHODS: Four separate presentation approaches were developed to examine different task features including dimension level highlighting, and health state severity and duration level presentation...
October 1, 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/29083251/the-feasibility-of-sophisticated-multicriteria-support-for-clinical-decisions
#14
James G Dolan, Peter J Veazie
BACKGROUND: Multicriteria decision-making (MCDM) methods are well-suited to serve as the foundation for clinical decision support systems. To do so, however, they need to be appropriate for use in busy clinical settings. We compared decision-making processes and outcomes of patient-level analyses done with a range of multicriteria methods that vary in ease of use and intensity of decision support, 2 factors that could affect their ease of implementation into practice. METHODS: We conducted a series of Internet surveys to compare the effects of 5 multicriteria methods that differ in user interface and required user input format on decisions regarding selection of a preferred method for lowering the risk of cardiovascular disease...
October 1, 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/29078054/online-interactive-option-grid-patient-decision-aids-and-their-effect-on-user-preferences
#15
Peter Scalia, Marie-Anne Durand, Jan Kremer, Marjan Faber, Glyn Elwyn
BACKGROUND: Randomized trials have shown that patient decision aids can modify users' preferred healthcare options, but research has yet to identify the attributes embedded in these tools that cause preferences to shift. OBJECTIVES: The aim of this study was to investigate people's preferences as they used decision aids for 5 health decisions and, for each of the following: 1) determine if using the interactive Option Grid led to a pre-post shift in preferences; 2) determine which frequently asked questions (FAQs) led to preference shifts; 3) determine the FAQs that were rated as the most important as users compared options...
October 1, 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/29068246/health-professionals-prefer-to-communicate-risk-related-numerical-information-using-1-in-x-ratios
#16
Miroslav Sirota, Marie Juanchich, Dafina Petrova, Rocio Garcia-Retamero, Lukasz Walasek, Sudeep Bhatia
BACKGROUND: Previous research has shown that format effects, such as the "1-in-X" effect-whereby "1-in-X" ratios lead to a higher perceived probability than "N-in-N*X" ratios-alter perceptions of medical probabilities. We do not know, however, how prevalent this effect is in practice; i.e., how often health professionals use the "1-in-X" ratio. METHODS: We assembled 4 different sources of evidence, involving experimental work and corpus studies, to examine the use of "1-in-X" and other numerical formats quantifying probability...
October 1, 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/29056069/quantifying-the-relationship-between-capability-and-health-in-older-people-can-t-map-won-t-map
#17
Matthew Franklin, Katherine Payne, Rachel A Elliott
BACKGROUND: Intuitively, health and capability are distinct but linked concepts. This study aimed to quantify the link between a measure of health status (EQ-5D-3L) and capability (ICECAP-O) using regression-based methods. METHODS: EQ-5D-3L and ICECAP-O data were collected from a sample of older people ( n = 584), aged over 65 years, requiring a hospital visit and/or care home resident, and recruited to one of 3 studies forming the Medical Crisis in Older People (MCOP) program in England...
October 1, 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/29029580/uncovering-longitudinal-health-care-behaviors-for-millions-of-medicaid-enrollees-a-multistate-comparison-of-pediatric-asthma-utilization
#18
Ross Hilton, Yuchen Zheng, Anne Fitzpatrick, Nicoleta Serban
BACKGROUND: This study introduces a framework for analyzing and visualizing health care utilization for millions of children, with a focus on pediatric asthma, one of the major chronic respiratory conditions. METHODS: The data source is the 2005 to 2012 Medicaid Analytic Extract claims for 10 Southeast states. The study population consists of Medicaid-enrolled children with persistent asthma. We translate multiyear, individual-level medical claims into sequences of discrete utilization events, which are modeled using Markov renewal processes and model-based clustering...
October 1, 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/29025299/simple-decision-analytic-functions-of-the-auc-for-ruling-out-a-risk-prediction-model-and-an-added-predictor
#19
Stuart G Baker
BACKGROUND: When using risk prediction models, an important consideration is weighing performance against the cost (monetary and harms) of ascertaining predictors. METHODS: The minimum test tradeoff (MTT) for ruling out a model is the minimum number of all-predictor ascertainments per correct prediction to yield a positive overall expected utility. The MTT for ruling out an added predictor is the minimum number of added-predictor ascertainments per correct prediction to yield a positive overall expected utility...
October 1, 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/28990449/a-systematic-review-and-meta-analysis-of-childhood-health-utilities
#20
Joseph Kwon, Sung Wook Kim, Wendy J Ungar, Kate Tsiplova, Jason Madan, Stavros Petrou
BACKGROUND: A common feature of most reviews or catalogues of health utilities has been their focus on adult health states or derivation of values from adult populations. More generally, utility measurement in or on behalf of children has been constrained by several methodological concerns. The objective of this study was to conduct the first comprehensive systematic review and meta-analysis of primary utility data for childhood conditions and descriptors, and to determine the effects of methodological factors on childhood utilities...
October 1, 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
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