38th Annual Meeting of the Society for Medical Decision Making: Vancouver, Canada, October 23-26, 2016
(Source: Medical Decision Making)
Source: Medical Decision Making - November 28, 2016 Category: Health Management Tags: Web-Only Abstracts Source Type: research
Linked Sensitivity Analysis, Calibration, and Uncertainty Analysis Using a System Dynamics Model for Stroke Comparative Effectiveness Research
Conclusions. For complex health care models, a mixed approach was applied to examine the uncertainty surrounding key stroke outcomes and the robustness of conclusions. We demonstrate that this rigorous approach can be practical and advocate for such analysis to promote understanding of the limits of certainty in applying models to current decisions and to guide future data collection. (Source: Medical Decision Making)
Source: Medical Decision Making - September 28, 2016 Category: Health Management Authors: Tian, Y., Hassmiller Lich, K., Osgood, N. D., Eom, K., Matchar, D. B. Tags: Tutorial Source Type: research
Contemporary Context of Drug-Eluting Stents in Brazil: A Cost Utility Study
Conclusion. DES is not a good value for money in SUS perspective, despite its benefit in reducing target vessel revascularization. Since the cost-effectiveness of DES is mainly driven by the stents’ cost difference, they should cost less than twice the BMS price to become a cost-effective alternative. (Source: Medical Decision Making)
Source: Medical Decision Making - September 28, 2016 Category: Health Management Authors: Stella, S. F., Gehling Bertoldi, E., Polanczyk, C. A. Tags: Original Articles Source Type: research
The Impact of Diabetes-Related Complications on Preference-Based Measures of Health-Related Quality of Life in Adults with Type I Diabetes
Conclusion. Utility decrements have been calculated for a wide variety of health states in T1DM that can be used in economic analyses. However, despite the large data set, the low incidence of several complications leads to uncertainty in calculating the utility weights. Depression and diabetic foot disease result in a substantial loss in HRQoL for patients with T1DM. HbA1c (%) appears to have an independent negative impact on HRQoL, although concerns remain regarding the potential endogeneity of this variable. (Source: Medical Decision Making)
Source: Medical Decision Making - September 28, 2016 Category: Health Management Authors: Peasgood, T., Brennan, A., Mansell, P., Elliott, J., Basarir, H., Kruger, J. Tags: Original Articles Source Type: research
The Influence of Safety, Efficacy, and Medical Condition Severity on Natural versus Synthetic Drug Preference
We present 5 studies in which participants were asked to consider a hypothetical situation in which they had a medical issue requiring pharmacological therapy. Participants ( N = 1223) were asked to select a natural, plant-derived, or synthetic drug. In studies 1a and 1b, approximately 79% of participants selected the natural v. synthetic drug, even though the safety and efficacy of the drugs were identical. Furthermore, participants rated the natural drug as safer than the synthetic drug, and as that difference increased, the odds of choosing the natural over synthetic drug increased. In studies 2 and 3, approximately 20%...
Source: Medical Decision Making - September 28, 2016 Category: Health Management Authors: Meier, B. P., Lappas, C. M. Tags: Original Articles Source Type: research
Quantitative Framework for Retrospective Assessment of Interim Decisions in Clinical Trials
This article presents a quantitative way of modeling the interim decisions of clinical trials. While statistical approaches tend to focus on the epistemic aspects of statistical monitoring rules, often overlooking ethical considerations, ethical approaches tend to neglect the key epistemic dimension. The proposal is a second-order decision-analytic framework. The framework provides means for retrospective assessment of interim decisions based on a clear and consistent set of criteria that combines both ethical and epistemic considerations. The framework is broadly Bayesian and addresses a fundamental question behind many c...
Source: Medical Decision Making - September 28, 2016 Category: Health Management Authors: Stanev, R. Tags: Original Articles Source Type: research
A Generalized Assessment of the Impact of Regionalization and Provider Learning on Patient Outcomes
We present a generalized model to assess the impact of regionalization on patient care outcomes in the presence of heterogeneity in provider learning. The model characterizes best regionalization policies as optimal allocations of patients across providers with heterogeneous learning abilities. We explore issues that arise when solving for best regionalization, which depends on statistically estimated provider learning curves. We explain how to maintain the problem’s tractability and reformulate it into a binary integer program problem to improve solvability. Using our model, best regionalization solutions can be com...
Source: Medical Decision Making - September 28, 2016 Category: Health Management Authors: Zhang, Y., Lee, S.-Y. D., Gilleskie, D. B., Sun, Y., Padakandla, A., Jacobs, B. L., Montgomery, J. S., Montie, J. E., Wei, J. T., Hollenbeck, B. K. Tags: Original Articles Source Type: research
Logistic Regression-Based Trichotomous Classification Tree and Its Application in Medical Diagnosis
The classification tree is a valuable methodology for predictive modeling and data mining. However, the current existing classification trees ignore the fact that there might be a subset of individuals who cannot be well classified based on the information of the given set of predictor variables and who might be classified with a higher error rate; most of the current existing classification trees do not use the combination of variables in each step. An algorithm of a logistic regression–based trichotomous classification tree (LRTCT) is proposed that employs the trichotomous tree structure and the linear combination ...
Source: Medical Decision Making - September 28, 2016 Category: Health Management Authors: Zhu, Y., Fang, J. Tags: Original Articles Source Type: research
Analyzing Health-Related Quality of Life in the EVOLVE Trial: The Joint Impact of Treatment and Clinical Events
Conclusions: By contrast with a conventional comparison, a regression analysis demonstrated large decrements in HRQoL after events and a modest improvement in HRQoL with cinacalcet. As randomized controlled trials are rarely powered to detect differences in HRQoL, a prespecified regression analysis may be acceptable to improve precision of the effects and understand their origin. (Source: Medical Decision Making)
Source: Medical Decision Making - September 28, 2016 Category: Health Management Authors: Briggs, A. H., Parfrey, P. S., Khan, N., Tseng, S., Dehmel, B., Kubo, Y., Chertow, G. M., Belozeroff, V. Tags: Original Articles Source Type: research
Changing Cycle Lengths in State-Transition Models: Challenges and Solutions
We present an accurate approach that is based on finding the root of a transition probability matrix using eigendecomposition. We present underlying mathematical challenges of converting cycle length in state-transition models and provide numerical approximation methods when the eigendecomposition method fails. Several examples and analytical proofs show that our approach is more general and leads to more accurate estimates of model outcomes than the commonly used approach. MATLAB codes and a user-friendly online toolkit are made available for the implementation of the proposed methods. (Source: Medical Decision Making)
Source: Medical Decision Making - September 28, 2016 Category: Health Management Authors: Chhatwal, J., Jayasuriya, S., Elbasha, E. H. Tags: Original Articles Source Type: research
What Determines the Shape of an EQ-5D Index Distribution?
Conclusions. Analyzing EQ-5D profile data enables a better understanding of the resulting distribution of EQ-5D scores. The distinctive shape observed for these distributions is the result of both the classification system and the weights applied to it. (Source: Medical Decision Making)
Source: Medical Decision Making - September 28, 2016 Category: Health Management Authors: Parkin, D., Devlin, N., Feng, Y. Tags: Original Articles Source Type: research
Some Health States Are Better Than Others: Using Health State Rank Order to Improve Probabilistic Analyses
Conclusions. Analysts can characterize the joint uncertainty in QoL weights to improve PSA and value-of-information estimates using Open Source implementations of our method. (Source: Medical Decision Making)
Source: Medical Decision Making - September 28, 2016 Category: Health Management Authors: Goldhaber-Fiebert, J. D., Jalal, H. J. Tags: Original Articles Source Type: research
A Randomized Trial Examining Three Strategies for Supporting Health Insurance Decisions among the Uninsured
Conclusions. Those developing materials about the health insurance marketplace to support health insurance decisions might consider starting with plain language tables, presenting health insurance terminology in context, and organizing information according to ways the uninsured might use and value insurance features. Individuals with limited health literacy and numeracy skills and those with lower education face unique challenges selecting health insurance and weighing tradeoffs between cost and coverage. (Source: Medical Decision Making)
Source: Medical Decision Making - August 30, 2016 Category: Health Management Authors: Politi, M. C., Kaphingst, K. A., Liu, J., Perkins, H., Furtado, K., Kreuter, M. W., Shacham, E., McBride, T. Tags: Original Articles Source Type: research
What Strategies Do Physicians and Patients Discuss to Reduce Out-of-Pocket Costs? Analysis of Cost-Saving Strategies in 1,755 Outpatient Clinic Visits
Conclusions. Despite price opacity, physicians and patients discuss a variety of out-of-pocket cost reduction strategies during clinic visits. Almost half of cost discussions mention 1 or more cost-saving strategies, with more frequent mention of those not requiring care-plan changes. (Source: Medical Decision Making)
Source: Medical Decision Making - August 30, 2016 Category: Health Management Authors: Hunter, W. G., Zhang, C. Z., Hesson, A., Davis, J. K., Kirby, C., Williamson, L. D., Barnett, J. A., Ubel, P. A. Tags: Original Articles Source Type: research
Inspecting the Mechanism: A Longitudinal Analysis of Socioeconomic Status Differences in Perceived Influenza Risks, Vaccination Intentions, and Vaccination Behaviors during the 2009-2010 Influenza Pandemic
Conclusions. Closing the socioeconomic gap in influenza vaccination requires multipronged strategies that not only increase vaccination intentions by improving knowledge, attitudes, and beliefs but also facilitate follow-through on initial vaccination plans by improving behavioral control and access to vaccination for individuals with low education, employed persons, and the uninsured. (Source: Medical Decision Making)
Source: Medical Decision Making - August 30, 2016 Category: Health Management Authors: Maurer, J. Tags: Original Articles Source Type: research
