Brian Zikmund-Fisher, PhD
Ellen Engelhardt, PhD
Deputy Editor
by Brian Zikmund-Fisher , PhD; University of Michigan

Welcome! I have the pleasure of taking over as Editor of the SMDM Newsletter starting this year.

Now, as many of you know, I’m a survey guy. As I started planning to lead the Newsletter, I thought about how we could leverage our readership to the benefit of the Society. I am therefore announcing in this issue the inaugural Scientific Issues in MDM Poll . Hopefully, each quarter, we will field a very short poll that will ask questions regarding scientific opinions and/or behaviors of interest to the SMDM community. I’ll provide a brief summary of responses in the following newsletter to provoke some discussion amongst our community.

The Winter 2018 poll focuses on cost-effectiveness thresholds. While cost-effectiveness thresholds are commonly used in SMDM research to identify which interventions are deemed worthy of implementation, there has been much debate and ambiguity regarding what levels should be used for decision making. We want to know what cost per QALY threshold you believe is appropriate. Also, does this differ from the threshold used in your country? Let us know what you think!

Let me be clear: These polls are not going to be just for small subsets of SMDM members who happen to care about a specific topic. I want them to be part of taking the pulse of the SMDM membership. So, even if you don’t do cost-effectiveness research, please take the poll and share your thoughts . It’s literally 4 questions that will take you less than 2 minutes   to complete . How hard is that???
I also want to express sincere thanks to Dana Alden for his years of service as the Newsletter editor. Dana has been instrumental in establishing the Newsletter as a source of informed, timely commentaries from SMDM members, a tradition I hope will continue. In this issue, we have the first letter from our new SMDM President, Uwe Siebert , as well as 4 commentaries:

  • Nicole Campos and Jane Kim discussing the connection between decision science and implementation science
  • John Friend on engaging with culture in SMDM
  • Roosmaryn Pilgram, Nanon Labrie, and Francisca Snoeck Henkemans on connecting argumentation theory and shared decision making
  • Mark Liebow on the U.S. Congress kicking the fiscal can down the road

I strongly believe that communicating the value and importance of our work to broader audiences needs to be one of the most important priorities of SMDM. We cannot expect other health professionals, let alone patients or members of the media, to understand how SMDM work can make a real difference in the world without reaching out to them. Writing a commentary for SMDM could set you up for writing something for a broader public venue (e.g.,, a wonderful source of academic-authored commentaries on both new science and current events). Showing the value of SMDM work supports us all by raising our profile in discussion of health care needs, grant funding allocation decisions, etc.

But, above all, I hope that the SMDM Newsletter can be… whatever we need it to be. A gathering place for ideas as well as a source of updates. Not just communications, but inspirations, and perhaps some aspirations. So, if you have thoughts regarding how the Newsletter can be of value, please drop a line to either myself , Ellen Engelhardt (Deputy Editor), or the irrepressibly helpful Trevor Scholl at the SMDM office. We’re looking forward to your ideas!
Uwe Siebert,
by Uwe Siebert, MD, MPH, MSc, ScD UMIT - University for Health Sciences, Medical Informatics and Technology, Austria and Harvard University, USA

Coming Together

Happy, Healthy and Peaceful New Year!

I feel very honored to serve as SMDM President this year. Let it be a year of coming together more closely and a year of continuing the path of connecting stakeholders, countries, cultures, disciplines, perspectives and visions.

I had a very exciting and inspiring start of my term at the wonderful and successful 2017 Annual North American Meeting in Pittsburgh. We owe a great debt of gratitude to the meeting Co-chairs Kenneth Smith and Janel Hanmer for bringing together such a stimulating program.

The Society is in very good shape, there are great opportunities ahead of us, and our solid financial position allows us to pursue our Society’s goals. We owe this to all of the members of the Society and to the inspiring leadership and hard work of our Past President Angie Fagerlin , Executive Director Jill Metcalf , PMA Management Team, and Trustees, Officers, Editors, Staff, Committees, Interest Groups, and our active membership.

I would also like to welcome our new members. I hope our Society will become a scientific home for you – as it has become for so many of us - and a place to meet colleagues and friends coming together from different disciplines, environments, life experiences, cultures, or countries. If you felt after your first meeting that you are coming from or to a different planet, then welcome to our diverse, borderless, and integrative universe of medical decision making!

There are numerous ongoing activities ranging from strategic implementations to new plans and creative ideas, and I want to invite you all to actively engage in this journey. We are currently in the middle of our 5-year phase (2016-2020) of strategic development and implementation, with the objectives to (1) support increased international growth and influence, (2) increase our engagement with both clinical and health decision making organizations, and (3) develop and promote SMDM’s expertise in patient and public engagement.

This plan includes several aspects of “coming together.” I would like to share with you some of the specific goals and initiatives that I want to focus on during my presidency and ask for your input, help and support.

1) Joining forces of evaluation/modeling and patient-shared decision making:
The impact of our Society could be increased if we were to come together more closely to enhance and combine current approaches and to facilitate the translation of our research into useful information and processes for patients, providers and policy makers. This initiative will build on the work of the Implementation Design Team ‘Patient and Public Engagement in MDM’ led by Past-President Angie Fagerlin . Together, we will connect analytic evaluation and modeling with patient-shared decision making. I will visit institutions and working groups involved in methods for developing clinical guidelines (e.g., GRADE, WHO) to explore potential opportunities for cross-fertilization and to advance the use of patient preferences and values together with model-based decision aids.

2) Developing mobile and online international educational MDM programs
We want to expand the existing SMDM Short Course Program by developing more “mobile” international educational programs and web-based concepts to reach those who are unable to attend our courses or annual meetings. These tools will be developed jointly with the Educational Committee, Past Vice President Lisa Prosser , Vice President James Stahl and Vice President-Elect Beate Sander . With our global educational efforts, we aim at catalyzing a “truly global conversation about making decisions in health and medicine”, as Murray Krahn described it in his president letter four years ago. We welcome any educational ideas and activities.

3) Advancing international SMDM processes
This year, we will also complete a more proactive process for selecting sites and chairs for future European Conferences. President-Elect Heather Gold , the Chairs of the European Conference in Leiden Anne Stiggelbout and Ewout Steyerberg , and International Trustee Beate Jahn , who also leads the Implementation Design Team ‘International Growth’, will participate in this initiative.

4) Extending the international funding campaign
We will continue and extend our International Funding Campaign led by Executive SMDM Director Jill Metcalf , and explore suitable options for funding administration within SMDM.

We will also continue to integrate patient views and patient voices into SMDM. In the Summer 2017 Newsletter, Past President Angie Fagerlin elaborated on our mission of patient engagement and the importance of new areas of patient integration such as guideline development, modeling, comparative effectiveness research, journal review processes, and meeting organization.

This is also a good opportunity for me to remind you about our upcoming SMDM meetings. This year, we will hold two SMDM meetings, the European Conference in Leiden, The Netherlands, and the North American Meeting in Montreal, QC, Canada.

SMDM is about coming together. We need your input, support and ideas. Please feel free to contact me any time ( with comments, questions, suggestions, or if you are interested in becoming more actively involved. Also check out our homepage and find your favorite committee or interest group and join!

If you want to participate in our “virtual coming together” through our Newsletter , please contact Editor Brian Zikmund-Fisher or Deputy Editor Ellen Engelhardt ; or submit a manuscript or letter to our Journals Medical Decision Making and MDM Policy & Practice (Editor: Alan J. Schwartz ).

Finally, it is donation month. Over the past weeks, many have made generous donations to SMDM. A list of donors can be found here . Please join them by making an online donation or e-mail Trevor Scholl with any questions.

I look forward to working with you and coming together at our meetings in Leiden and Montreal.
The opinions stated in the following commentaries are solely those of the authors and do not reflect the opinions of the Society for Medical Decision Making.
Nicole G. Campos, PhD
Jane J. Kim, PhD
Decision Science and Implementation Science: Powerful Partners in Translating Research into Practice
by  Nicole G. Campos , PhD and Jane J. Kim , PhD

Clinical research takes an estimated 17 years to be translated into practice, and only ~14% of research findings ultimately influence patient care (Balas & Boren Yearbook of Medical Informatics 2000). As scientists dedicated to improving health care decision making, many of us evaluate the effectiveness and efficiency of interventions, which hopefully facilitates their acceptance and use. But how can we contribute to reducing this time lag and ensuring that the cost-effective, evidence-based practices identified by our research are implemented?
Implementation science may hold some of the answers. According to the U.S. National Institutes of Health, the field of implementation science is “the scientific study of the use of strategies to adopt and integrate evidence-based health interventions into clinical and community settings in order to improve patient and population health outcomes” (NIH PAR-16-238). Of particular interest to both of us is a) how economic evaluations can inform the development of implementation strategies, and b), once effective implementation strategies are identified, how the cost-effectiveness of the implementation strategy can be evaluated alongside the evidence-based intervention to ensure that scarce resources are used efficiently. Frameworks have been developed and described in Medical Decision Making and elsewhere to determine the expected value of perfect implementation and the value of implementation activities.

Yet research on the cost-effectiveness of implementation strategies is sparse. In our own research on the health and economic impact of cervical cancer prevention, opportunities for implementation research abound. In Kim et al. (2015), we compared the costs, health benefits, and cost-effectiveness of current screening practice relative to improved adherence to U.S. screening guidelines. We estimated the incremental net monetary benefit (INMB) of singular and multiple improvements in the screening process at different willingness-to-pay thresholds. Because the costs of specific interventions to improve adherence were not included in calculations, the INMB can be interpreted as the maximum cost that could be additionally incurred per woman before the incremental cost-effectiveness ratio associated with the improvement exceeds the willingness-to-pay threshold. Such findings provide a springboard for identifying where in the screening process implementation strategies might achieve the greatest impact, and how much could be efficiently spent on implementation.

We encourage members of the SMDM community to seek interdisciplinary collaboration with implementation scientists to accelerate the adoption and implementation of efficient, evidence-based health interventions. Decision science and implementation science each provide critically important information to decision makers. Synergistic application of these two areas of study has the potential to achieve powerful improvements in speed of adoption, health outcomes, and efficiency.

For further reading:
Faria R, Walker S, Whyte S, et al. How to invest in getting cost-effective technologies into practice? A framework for value of implementation analysis applied to novel oral anticoagulants. Medical Decision Making 2017;37:148-161.

Fenwick E, Claxton K, Sculpher M. The value of implementation and the value of information: Combined and uneven development. Medical Decision Making 2008;28:21-32.

Hoomans T, Severens JL. Economic evaluation of implementation strategies in health care. Implementation Science 2014;9:168.

Kim JJ, Campos NG, Sy S, et al. Inefficiencies and high-value improvements in U.S. screening practice. Annals of Internal Medicine 2015;163(8):589-97.

Whyte S, Dixon S, Faria R, et al. Estimating the cost-effectiveness of implementation: Is sufficient evidence available? Value in Health 2016;19:138-144.
John Friend, PhD
Engaging Culture Throughout SMDM
by John Friend , PhD; College of St. Benedict and St. John's University

As the shared decision making (SDM) approach to medical care diffuses globally, international collaboration has become more important, as increased scholarly and professional interaction will, undoubtedly, improve patient-centered care across diverse societies. Recognizing the relevance of cultural differences in health care is timely, as recent research on health decision making in both Western and non-Western societies has shown that cultural beliefs, values, and attitudes shape patient-provider communication and SDM preferences, such as desire for family involvement in the treatment decision making process (e.g., Alden et al., Medical Decision Making , 2017). In fact, with the development of sophisticated decision support tools, it is now possible to culturally target and tailor these and similar SDM technologies.

SMDM itself can support this process by providing a forum that values different cultural perspectives on health and the use of interdisciplinary methodologies. One of SMDM’s 3 current strategic objectives is “to increase international growth and influence,” and the Board of Trustees seeks to globalize SMDM by engaging decision making organizations and stakeholders outside of North America. On my part, I have collaborated with other members of our Society on issues related to medical decision making throughout the Asia-Pacific region (most recently advance care planning in Japan). Our research and the work of others have highlighted the barriers to SDM in these countries and the progress made by dedicated researchers and clinicians to address old and new obstacles to positive health outcomes. By increasing membership and involvement from outside of North America, SMDM can assist these experts and facilitate much needed scholarly exchange.

Within SMDM, Interest Groups (IGs), in particular, can play a vital role in engaging with cultural issues in our work. As IG Coordinator, I look forward to working closely with IG leaders to find new ways of increasing collaboration among members and improving the visibility of the Society internationally. I welcome any suggestions for how to achieve these objectives and can be reached at .
Roosmaryn Pilgram, PhD
Nanon Labrie, PhD
Francisca Snoeck Henkemans, PhD 
Integrating Insights from Argumentation Theory and Shared Decision Making  
by Roosmaryn Pilgram , PhD; Leiden University & University of Amsterdam ( ); Nanon Labrie , PhD; Academic Medical Center, University of Amsterdam; Francisca Snoeck Henkemans , PhD; University of Amsterdam

On October 26th and 27th 2017, the symposium on Medical Argumentation and Patient Centered Care  was held at the University of Amsterdam. This symposium brought together researchers from the fields of argumentation theory, health communication, health decision making, and medicine to investigate to what extent insights from argumentation theory can be beneficial to the conceptualization and practice of shared decision-making (SDM).

Over the past decades, SDM has increasingly been studied from an argumentation theoretical perspective. The reason for this is that the SDM process can be regarded as an applied case of argumentation because doctors need to present arguments in favor and against treatments, and patients need to weigh these arguments to constructively come to a shared treatment decision, especially if this decision is preference sensitive. We believe that SDM researchers and professionals in the field of SDM might benefit from applying argumentation theoretical insights to SDM, as it can help in precisely analyzing what is going on (and what is going wrong) in SDM. To argumentation theorists, on the other hand, SDM is an interesting example of how reasonable discussion may take place in a specific institutional practice.

Argumentation theory provides tools for analyzing when arguments can be considered reasonable (stand a critical test) and what kind of behavior might negatively influence the reasonableness of the discussion between doctor and patient about the appropriate choice of a medical treatment. The pragma-dialectical argumentation theory provides a set of rules that need to be observed to test the acceptability of a standpoint in a reasonable way. One such rule is that discussants should be free to present any doubts, criticisms, alternative standpoints or arguments. The importance of this rule for SDM is clear: SDM is impossible if doctors authoritatively impose a specific treatment plan, disallowing patients to question this treatment proposal (e.g., by stating that the patient simply needs to undergo a treatment, or by more subtly suggesting this through formulations such as “we are in favor of treatment X”, while it is unclear who the persons referred to actually are).

Argumentation research also studies the conditions under which a positive decision process can occur. Such conditions concern external circumstances (e.g., there should be enough time for discussion) as well as conditions having to do with the state of mind of the participants (e.g., they should be able to comprehend the argumentation that has been presented). Interestingly, barriers to SDM can also be directly linked to these conditions. SDM is sometimes seen as too lengthy to be completely viable during a medical consultation, or patients are considered to lack the relevant medical background to fully allow for SDM. Depending on the type of condition at issue, different types of solutions are required.

Applying argumentation theoretical insights to SDM can help both in precisely analyzing particular cases of SDM and in theorizing about SDM. It provides a clearer idea about how to overcome barriers to SDM. If barriers to SDM arise from the doctor’s unreasonable discussion behavior during consultation, they can be overcome by providing discussion training, and specifying medical guidelines and codes of conduct. In contrast, if barriers to SDM arise because of external discussion circumstances or the internal states of mind of the doctors and patients, they can be overcome by altering the consultation circumstances and more extensively informing patients about their medical problems before the consultation.

Selected source for further reading:
A concise introduction to argumentation theory can be found in: Eemeren, Frans H. van & A. Francisca Snoeck Henkemans (2016). Argumentation. Analysis and Evaluation. Leiden: Taylor & Francis Ltd.
Mark Liebow,
Kicking the Can Down the Road (Again)
by Mark Liebow , MD, MPH, Mayo Clinic

The Federal government will be open for at least the first three weeks of 2018, due to a temporary spending bill passed just before Christmas. Except for providing $3 billion to fund the CHIP program, which had expired September 30, the spending bill ducked almost all the controversial issues Congress is facing. Refunding the CHIP program was necessary because states were running out of whatever leftover CHIP money they had and lots of children were about to lose health insurance. Other programs were continued at levels very close to their Fiscal Year 2017 appropriations. It’s anyone’s guess as to whether Congress will enact one or more appropriations bills for the remaining 8.5 months of Fiscal Year 2018 or just have more continuing resolutions for those months. President Trump should be announcing his proposed Fiscal 2019 budget in February and it’s likely he will again propose deep cuts in funding for Federal research agencies.

As of when this was written, it’s hard to comment on the implications for research of the tax bill recently signed into law. Its complexity and the speed at which it was enacted means many are still poring through the bill and trying to figure out what it does. A provision that would have raised taxes substantially on graduate students by making tuition waivers taxable income did not make it into the final bill.

Tom Price, M.D., the Secretary of the U.S. Department of Health and Human Services resigned late in September after news broke he had been chartering private planes for official travel far more often than was typical for Cabinet officials. In November, the President nominated Alex Azar, an attorney who had been Deputy Secretary of the Department of Health and Human Services from 2005-2007. Mr. Azar had been the President of the U.S. branch of Lilly until January 2017. He has not yet been confirmed by the Senate, but that could take place in January.  
SMDM 39th Annual Meeting in Review: Pittsburgh, PA
Expert researchers, clinicians, and trainees from health economics, biostatistics, psychology, epidemiology, and other health-related disciplines gathered in Pittsburgh from October 22 - 25, 2017 for the Society for Medical Decision Making (SMDM) 39th Annual North American Meeting.

575 attendees attended the four-day event, which included a plethora of workshops, panels, and presentations on medical decision making, with a focus on Better Decisions through Better Data Processes .

Meeting co-chairs Dr. Kenneth Smith and Dr. Janel Hanmer provided a warm welcome to attendees on the Monday morning as they opened the meeting. Kathleen Sebelius, who served in President Barack Obama’s Cabinet as the 21st Secretary of the Department of Health and Human Services, was this year’s Keynote Speaker. Ms. Sebelius is perhaps best known for her work to pass and implement the Affordable Care Act.

Awards were presented to key leaders and mentors in the field of medical decision making: Dr. Uwe Siebert received the SMDM Award for Distinguished Service; Dr. Gillian Sanders-Schmidler received the John M. Eisenberg Award for Practical Application of Medical Decision Making Research; and Dr. Valerie Reyna received the SMDM Career Achievement Award.

Outstanding Paper by a Young Investigator was awarded to two deserving co-recipients, Dr. Phuc Le and Dr. Ellen Engelhardt . 10 trainees received the Lee B. Lusted Finalists Student Prize for outstanding presentations of research. The Lusted Student Award for Decision Psychology and Shared Decision Making was re-named this year in honor of a distinguished member of the SMDM community, Dr. Margaret Holmes-Rovner .

Past President Dr. Angie Fagerlin passed the gavel to incoming President Dr. Uwe Siebert at the SMDM Annual Business Meeting.
Ever Wonder What it Would be Like to Attend a SMDM Annual Meeting? 
For a first person account, take a look at the attendees' highlights and biggest insights gathered from the Twitter hashtag #SMDM17 on  Storify .
Best Short Course at the 2017 Annual Meeting
by  Hawre Jalal , PhD, MD and  David Whitehurst , PhD, MSc
2017 Annual Meeting Short Course Co-Chairs
This year, we offered 19 short courses and had 281 registrants (ranging from 8 to 28 per course) at the 2017 SMDM Annual Meeting. The course that received the highest rating from its attendees, as judged by the Short Course Co-Chairs, was Introduction to Cost-Effectiveness Analysis . This beginner level, half-day course is one of the SMDM four core short courses. The course introduces participants new to the field of cost-effectiveness analysis to the important concepts for “smart shopping” for healthcare. It provides participants with the background and confidence to ask the Who, Why, When, Where, What and How questions of SMDM meeting presenters and to better understand the responses conveyed irrespective of language (plain, math, graph and jargon).   

Congratulations to   Jeff Hoch , PhD  – a very worthy winner!  
SMDM 17th Biennial European Conference Call for Abstracts,
Short Courses and Workshops Deadline: Monday, February 5, 2018
SMDM is now accepting abstract, short course and workshop proposals to be presented at its 17th Biennial European Conference. The deadline to submit proposals is Monday, February 5, 2018. All submissions will be reviewed and notifications sent out in late March 2018. 

The Society for Medical Decision Making is pleased to announce its 17th Biennial SMDM European Conference will be held June 10-12, 2018 in Leiden, The Netherlands. Leiden is a beautiful historic city, and only 20 minutes by direct train from Schiphol International Airport.

For decades, SMDM members have sought to improve decision making, incorporating the strength of current evidence and methods to weigh risks and benefits from the perspectives of the individual, health system, and society. The 2018 conference special focus is on  Personalized and Value-Based Health Care .

Our aim is to bring together high quality oral and poster presentations from health services research, psychology, epidemiology, health economics, and other scientific disciplines involved in the study of medical decision making. The combination of short courses, symposia and research presentations continues to foster lively debates and deeper understandings of how our scientific research can be applied to improve care.

Conference attendees will enjoy opportunities to interact with leaders in prediction and decision modelling, cost-effectiveness analysis, implementation research, shared decision making, and the other areas encompassed by medical decision making, as well as with policy makers at both the hospital and national level.

Conference Co-Chairs: Anne M. Stiggelbout, PhD and Ewout W. Steyerberg, PhD
Save the Date!
SMDM 40th Annual Meeting: Montreal, Canada
October 14 - 17, 2018
Join SMDM in Montreal at the 40th Annual Meeting being held at the Fairmont Queen Elizabeth Hotel in Montreal, Canada. The meeting theme is Decision Making Across the Lifespan . The call for abstracts and short courses will open in March 2018 and more information will be posted to the 40th Annual Meeting homepage in the coming months.

Meeting co-chairs: Holly Witteman, PhD; William Dale , MD, PhD; Isabel Jordan , Parent/Patient Partner and Beverly Canin , Patient Partner
2018 Call for Officer and Trustee Nominations
The Nominations Committee of the Society for Medical Decision Making is soliciting nominations for the following positions:

Vice President-Elect
Secretary-Treasurer Elect
3 Trustees (including 1 International Trustee)

The committee invites SMDM members to submit the names of members whom you believe would serve the Society well. Self-nominations are encouraged. The Nominations Committee will consider all submitted names. At least 2 nominees will be selected for each position. Upon approval of the slate by the Board of Trustees, the list of nominees will be sent to all SMDM members. Additional nominees then will be accepted by petition, as described by the Society’s regulations.

The deadline to submit Officer and Trustee nominations is Friday, February 23, 2018 at 5 PM ET.

2018 Nominations Committee:
Angie Fagerlin, PhD - Chair
Mark Helfand , MD, MPH
Beate Jahn , PhD
Olga Kostopoulou , PhD
Gillian D. Sanders-Schmidler , PhD
Pictured Above: The 2017 SMDM Officers and Trustees met in Pittsburgh at the Annual Meeting. Please consider nominating yourself or a colleague to join the leadership of your Society.
2018 Call for Award Nominations

The Awards Committee for the Society for Medical Decision Making is soliciting nominations for the following awards:

Career Achievement Award
The Career Achievement Award recognizes a senior investigator who has made significant contributions to the field of medical decision making. The nominee need not be a member of SMDM.

SMDM Award for Distinguished Service
This award recognizes service to SMDM in terms of leadership, role in the operations of the Society, and contributions to the scientific and educational activities of the Society. The nominee must be a member of SMDM. 

John M. Eisenberg Award for Practical Application of Medical Decision Making Research
This award recognizes sustained leadership in translating medical decision making research into practice, including taking exceptional steps to communicate the principles and/or substantive findings of medical decision making research to policy makers, clinical decision makers, or the general public. The nominee need not be a member of SMDM.
Outstanding Paper by a Young Investigator
This award was conceived as a means of recognizing outstanding work by a young researcher and assisting the recipient in the tenure process. The award is for a paper published, online or in print, in the calendar year prior to the award (journal must be published in 2017 for the 2018 award). The nominee must be in the first six (6) years of full-time employment after the end of “training” however that is defined within the country and field of the nominee.

Nominations sought for naming of the Lee B. Lusted Award in Quantitative Methods & Theoretical Developments Category
SMDM seeks nominations of exceptional candidates who have made contributions in the area of Quantitative Methods & Theoretical Developments (QMTD) to have the Lee B. Lusted Student Awards in QMTD named after him/her. The honoree will have the sub-award named for him/her for five years.

Candidates for the QMTD sub-award will be evaluated according to the following criteria:
  • Made a seminal contribution to the field
  • Ongoing contributions/involvement with the Society
  • Role in teaching and mentoring
The goal is for the named set of awards to reflect the diversity of our SMDM community as well as the diversity of our research as a Society. There are five categories for the Lee B. Lusted Awards: Decision Psychology and Shared Decision Making, Quantitative Methods and Theoretical Developments, Applied Health Economics, Heath Services and Policy Research, and Patient and Stakeholder Preferences and Engagement. For the period 2017-2022, the Lee B. Lusted Student Award in the Decision Psychology & Shared Decision Making (DEC) category is named in honor of Dr. Margaret Holmes-Rovner
The deadline to submit all award nominations is Friday, February 23, 2018 at 5 PM ET. Please consider nominating a colleague, mentor, or mentee for an award and/or ask your mentors or colleagues to nominate you for an award!
Latest News From Your Fellow Members
Marc Probst , MD, MS, Mount Sinai School of Medicine, recently published a paper proposing a conceptual approach to shared decision-making in the emergency department. ( )
Research presented by Valerie F. Reyna , PhD, Cornell University, and Christopher Wolfe , PhD, Miami University (Ohio), at the 2016 SMDM Annual Meeting was published in December 2017. The paper by Wolfe, C. R., Reyna, V. F., & Smith, R. J. titled "On Judgments of Approximately Equal" will be published in the Journal of Behavioral Decision Making .
Anirban Basu , PhD, University of Washington, won the American Statistical Association Health Policy Statistics Section (HPSS)’s 2018 Mid-Career Award . The award will be given at the 2018 International Conference on Health Policy Statistics (ICHPS) in Charleston, SC in January.
Muge Capan, PhD , Christiana Care Health System Value Institute and colleagues from Christiana Care Health System Emergency Department have recently published a study titled, " We All Make Choices: A Decision Analysis Framework for Disposition Decision in the Emergency Department " in the American Journal of Emergency Medicine.

The study addresses the discharge decision in the Emergency Department (ED) which is a key decision process as it involves interconnected patient-, provider-, and system-level factors. Understanding the factors contributing to ED discharge decision and risk tolerance of providers with regards to associated consequences is fundamental to improving quality of care and safety. While the importance of the ED disposition as a clinical decision making process has been studied, there is a need for further investigation of data-driven approaches and novel visualization methods to better understand the complex nature of discharge decisions. This study aimed to gain a better understanding of ED providers’ disposition decision and risk tolerance by utilizing decision mapping, survey research, statistical analysis, and word clouds.

This approach provides a framework to enhance the understanding of how ED providers arrive to disposition decision. Key findings indicate the potential benefit of further exploration of the relationship between provider characteristics, disposition decision process, and perception of potential consequences. Specifically, survey results showed that risk of negative outcome prompted providers to be less tolerant to higher risk level compared to 72-hour return to the ED. Lack of patient resources at home caused risk tolerance to be lower than lack of access to primary care, and indicated that patient resources make a greater impact on the disposition decision. The decision map highlighted the connections between patient-, provider-, and system-related factors contributing to the disposition decision. ( )
Findings from a model-based cost-effectiveness analysis conducted by SMDM members from the Health Economic Research Unit at the British Columbia Centre for Excellence in HIV/AIDS were recently published in Annals of Internal Medicine with an accompanying editorial . Emanuel Krebs, MA , Benjamin Enns, MA and Dr. Bohdan Nosyk, PhD used state-level linked administrative data on drug treatment, criminal justice system engagement and vital statistics to determine the cost-effectiveness of immediate access to opioid agonist treatment versus medically supervised withdrawal for all patients seeking treatment in California’s publicly funded treatment program. Their results suggested that providing immediate access to opioid agonist treatment with methadone is more effective and less costly than medically supervised withdrawal for patients with opioid use disorder. ( )
In response to recent guidance from the Second Panel on Cost-Effectiveness in Health and Medicine encouraging researchers to broaden their analytic perspective, researchers affiliated with the Center for Health Economics of Treatment Interventions for Substance Use Disorder, HCV, and HIV (CHERISH) recently published an article providing an up-to-date summary of relevant monetary conversion factors , focusing on the domains that are relevant for substance use disorders. These domains include medical and behavioral health services, substance use disorder treatment, infectious disease consequences, productivity, criminal activity and criminal justice system contacts, social services, and disability. Having an updated and standardized source of monetary conversion factors will facilitate and improve future economic evaluations of interventions targeting SUDs and other risky behaviors. The article is available open access in the Journal of Substance Abuse Treatment . Lead author Dr. Kathryn McCollister serves as Methodology Core Co-Director for CHERISH, and SMDM member and article senior author Bruce Schackman , PhD serves as CHERISH Center Director.
The Cochrane Review "Decision aids for people facing health treatment or screening decisions" (2014 version) was the most cited review in the Cochrane Library in 2016 (Wiley, 2017). The review was cited 215 times and accessed 6925 times.

This review was updated in 2017 and included 105 trials. Compared to usual care, people exposed to patient decision aids:

• feel more knowledgeable (high-quality evidence)
• feel better informed (high-quality evidence)
• are clearer about their values (high-quality evidence)
• probably have a more active role in decision making (moderate-quality evidence)
• probably have more accurate risk perceptions (moderate-quality evidence)
• may achieve decisions that are consistent with their informed values
(low-quality evidence)

A new sub-analysis indicated improved knowledge and accurate risk perceptions when patient decision aids are used either within or in preparation for the consultation.

SMDM members Dawn Stacey , RN, PhD, University of Ottawa; France Legare , MD, PhD, Laval University Quebec City; Michael Barry , MD, Harvard Medical School; Karen Eden , PhD, Oregon Health and Science University; Margaret Holmes-Rovner , PhD, Michigan State University; and Lyndal Trevena , PhD, The University of Sydney co-authored the paper. ( )

For more information:

Stacey D, Légaré F, Lewis K, Barry MJ, Bennett CL, Eden KB, Holmes-Rovner M, Llewellyn-Thomas H, Lyddiatt A, Thomson R, Trevena L. (2017) Decision aids for people facing health treatment or screening decisions. Cochrane Database Syst Rev. Apr 12;4:1-297; CD001431. doi: 10.1002/14651858.CD001431.pub5. (available for download free of charge at )

Stacey D, Legare F, Lewis KB (2017). Patient decision aids to engage adults in treatment and screening decisions. JAMA; 318(7): 657-658. doi: 10.1001/jama.2017.10289.
What Are You Working On? 
Connect and collaborate with your fellow members on their latest projects:
Jag Chhatwal , PhD, Mass General, Harvard Medical School

In collaboration with the World Health Organization, we created an online, interactive model – Hep C Calculator – that evaluates the cost-effectiveness of hepatitis C treatment in 28+ countries. The Calculator allows users to enter local cost data (including the price of antiviral treatment) and see cost-effectiveness results in real-time. The tool’s targeted audience includes policymakers, government officials and patient advocates. By providing the value of hepatitis C treatment with new antivirals, we anticipate that the tool will be useful in increasing funding/resources needed to treat hep C in these countries.

This interactive tool may also overcome some typical limitations of modeling methods, such as being perceived as 'black box' by policymakers, and provide a more transparent method for disseminating the cost-effectiveness results.

We would like to get feedback from the SMDM community on how to improve Hep C Calculator or extend it further.
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The SMDM Lifetime Contributors list acknowledges donations, and in-kind donations, received Oct. 2005 - December 31, 2017.
Editor in Chief
University of Michigan
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VU University Medical Center, Amsterdam