Scholars@Duke
Peter A Ubel

Peter A Ubel

Madge and Dennis T. McLawhorn University Distinguished Professor
Fuqua School of Business
peter.ubel@duke.edu
Duke Box 90120, 100 Fuqua Drive, Durham, NC 27708-0120
100 Fuqua Dr, Box 90120, Room W309, Durham, NC 27708-0120

Selected Publications

Limited Evidence of Shared Decision Making for Prostate Cancer Screening in Audio-Recorded Primary Care Visits Among Black Men and their Healthcare Providers.

Journal Article Journal of immigrant and minority health · October 2024 Prostate-specific antigen (PSA)-based prostate cancer screening is a preference-sensitive decision for which experts recommend a shared decision making (SDM) approach. This study aimed to examine PSA screening SDM in primary care. Methods included qualitat ... Full text Cite

Shared Decision-Making Communication and Prognostic Misunderstanding in the ICU.

Journal Article JAMA Netw Open · October 1, 2024 IMPORTANCE: Surrogate misunderstanding of patient survival prognosis in the intensive care unit (ICU) is associated with poor patient and surrogate outcomes. Shared decision-making (SDM) may reduce misunderstanding. OBJECTIVE: To evaluate the association b ... Full text Link to item Cite

Talking About Suffering in the Intensive Care Unit.

Journal Article AJOB Empir Bioeth · September 9, 2024 BACKGROUND: Some have hypothesized that talk about suffering can be used by clinicians to motivate difficult decisions, especially to argue for reducing treatment at the end of life. We examined how talk about suffering is related to decision-making for cr ... Full text Link to item Cite

Neurorights in question: rethinking the concept of mental integrity.

Journal Article Journal of medical ethics · September 2024 The idea of a 'right to mental integrity', sometimes referred to as a 'right against mental interference,' is a relatively new concept in bioethics, making its way into debates about neurotechnological advances and the establishment of 'neurorights.' In th ... Full text Cite

Systemic treatments for advanced prostate cancer: relationship between health insurance plan and treatment costs.

Journal Article Am J Manag Care · September 1, 2024 OBJECTIVES: The high costs of cancer care can cause significant harm to patients and society. Prostate cancer, the leading nonskin malignancy in men, is responsible for the second-highest out-of-pocket (OOP) payments among all malignancies. Multiple first- ... Full text Link to item Cite

Willingness to trade-off years of life for an HIV cure - an experimental exploration of affective forecasting.

Journal Article AIDS Res Ther · August 6, 2024 BACKGROUND: In the US, 1.2 million people live with HIV (PWH). Despite having near-normal life expectancies due to antiretroviral therapy (ART), many PWH seek an HIV cure, even if it means risking their lives. This willingness to take risks for a cure rais ... Full text Link to item Cite

Classification of Patients' Judgments of Their Physicians in Web-Based Written Reviews Using Natural Language Processing: Algorithm Development and Validation.

Journal Article Journal of medical Internet research · August 2024 BackgroundPatients increasingly rely on web-based physician reviews to choose a physician and share their experiences. However, the unstructured text of these written reviews presents a challenge for researchers seeking to make inferences about pa ... Full text Cite

Ethical Complexities in Utilizing Artificial Intelligence for Surrogate Decision Making.

Journal Article The American journal of bioethics : AJOB · July 2024 Full text Cite

Burnout Among Mid-Career Academic Medical Faculty.

Journal Article JAMA network open · June 2024 ImportanceStudies reveal that most physicians report symptoms of burnout. Less is known about burnout in mid-career medical faculty specifically.ObjectiveTo characterize burnout and its risk factors, particularly differences by gender, am ... Full text Cite

Professional Experiences and Career Trajectories of Mid- to Senior-Career Women Clinician-Scientists: A Qualitative Study.

Journal Article JAMA network open · April 2024 ImportanceDespite increasing evidence and recognition of persistent gender disparities in academic medicine, qualitative data detailing the association of gender-based experiences with career progression remain sparse, particularly at the mid- to ... Full text Cite

Integrating Cost into Shared Decision-Making for Heart Failure with Reduced Ejection Fraction (POCKET-COST-HF): A Trial Providing Out-of-Pocket Costs for Heart Failure Medications during Clinical Encounters.

Journal Article American heart journal · March 2024 BackgroundEvidence-based medical therapy for heart failure with reduced ejection fraction (HFrEF) often entails substantial out-of-pocket costs that can vary appreciably between patients. This has raised concerns regarding financial toxicity, equi ... Full text Cite

What Do Psychiatrists Think About Caring for Patients Who Have Extremely Treatment-Refractory Illness?

Journal Article AJOB neuroscience · January 2024 Questions about when to limit unhelpful treatments are often raised in general medicine but are less commonly considered in psychiatry. Here we describe a survey of U.S. psychiatrists intended to characterize their attitudes about the management of suicida ... Full text Cite

Cancer Treatment Decision-Making for People Living With HIV: Physician-Reported Barriers, Facilitators, and Recommendations.

Journal Article J Acquir Immune Defic Syndr · December 15, 2023 BACKGROUND: Compared with the general cancer population, people living with HIV (PLWH) and cancer are less likely to receive treatment and have significantly elevated cancer-specific mortality for many common cancer types. Physician recommendations drive t ... Full text Link to item Cite

Prognostic Discordance Among Parents and Physicians Caring for Infants with Neurologic Conditions.

Journal Article J Pediatr · December 2023 OBJECTIVE: To determine the frequency, degree, and nature of prognostic discordance between parents and physicians caring for infants with neurologic conditions. STUDY DESIGN: In this observational cohort study, we enrolled parents and physicians caring fo ... Full text Link to item Cite

Workplace Harassment, Cyber Incivility, and Climate in Academic Medicine.

Journal Article JAMA · June 2023 ImportanceThe culture of academic medicine may foster mistreatment that disproportionately affects individuals who have been marginalized within a given society (minoritized groups) and compromises workforce vitality. Existing research has been li ... Full text Cite

Modifying an Open Science Online Grocery for parents of youth with anorexia nervosa: A proof-of-concept study.

Journal Article The International journal of eating disorders · May 2023 ObjectiveFor youth with anorexia nervosa (AN), remission requires high caloric goals to achieve weight restoration, consumption of a wide variety of calorically dense foods, and reintroduction of eliminated foods. Family-based treatment (FBT), the ... Full text Cite

Improving Cancer Care for People Living With HIV: A Qualitative Study of Provider Knowledge, Attitudes, and Practice.

Journal Article Int J Radiat Oncol Biol Phys · May 1, 2023 PURPOSE: Cancer is now the leading cause of non-AIDS death in the US population with HIV. People living with HIV (PLWH) are known to have lower cancer treatment rates and worse cancer outcomes. Disparate cancer treatment is driven by health system, patient ... Full text Link to item Cite

Medication Payments by Insurers and Patients for the Treatment of Metastatic Castrate-Resistant Prostate Cancer.

Journal Article JCO Oncol Pract · April 2023 PURPOSE: The implications of high prices for cancer drugs on health care costs and patients' financial burdens are a growing concern. Patients with metastatic castrate-resistant prostate cancer (mCRPC) are often candidates for multiple first-line systemic ... Full text Link to item Cite

Deciding Whether to Take Sacubitril/Valsartan: How Cardiologists and Patients Discuss Out-of-Pocket Costs.

Journal Article Journal of the American Heart Association · April 2023 Background Out-of-pocket costs have significant implications for patients with heart failure and should ideally be incorporated into shared decision-making for clinical care. High out-of-pocket cost is one potential reason for the slow uptake of newer guid ... Full text Cite

Patient-Reported Outcomes of Breast Reconstruction: Does the Quality of Decisions Matter?

Journal Article Ann Surg Oncol · March 2023 BACKGROUND: Little is known about how the quality of decisions influences patient-reported outcomes (PROs). We hypothesized that higher decision quality for breast reconstruction would be independently associated with better PROs. METHODS: We conducted a p ... Full text Link to item Cite

The ALIGN Framework: A Parent-Informed Approach to Prognostic Communication for Infants With Neurologic Conditions.

Journal Article Neurology · February 21, 2023 BACKGROUND AND OBJECTIVES: Clinicians often communicate complex, uncertain, and distressing information about neurologic prognosis to parents of critically ill infants. Although communication tools have been developed in other disciplines and settings, non ... Full text Link to item Cite

Definitely, Maybe: Helping Patients Make Decisions about Surgery When Prognosis Is Uncertain.

Journal Article The Journal of clinical ethics · January 2023 AbstractThe sudden onset of severe traumatic brain injury (sTBI) is an event suffered by millions of individuals each year. Regardless of this frequency in occurrence, accurate prognostication remains difficult to achieve among physicians. There are many v ... Full text Cite

Two Specialists, Two Recommendations: Discordance Between Urologists' & Radiation Oncologists' Prostate Cancer Treatment Recommendations.

Journal Article Urology · November 2022 OBJECTIVE: To examine the treatment recommendation patterns among urologists and radiation oncologists, the level of concordance or discordance between physician recommendations, and the association between physician recommendations and the treatment that ... Full text Link to item Cite

Characterizing the Language Used to Discuss Death in Family Meetings for Critically Ill Infants.

Journal Article JAMA Netw Open · October 3, 2022 IMPORTANCE: Communication during conversations about death is critical; however, little is known about the language clinicians and families use to discuss death. OBJECTIVE: To characterize (1) the way death is discussed in family meetings between parents o ... Full text Link to item Cite

Prognostic Discussion for Infants with Neurologic Conditions: Qualitative Analysis of Family Conferences.

Journal Article Ann Neurol · October 2022 OBJECTIVE: We characterize the content and role of prognostic discussion for infants with neurologic conditions. METHODS: In this descriptive qualitative study, we prospectively enrolled infants (age < 1 year) in the intensive care unit with a neurologic c ... Full text Link to item Cite

Open Science Online Grocery: A Tool for Studying Choice Context and Food Choice

Journal Article Journal of the Association for Consumer Research · October 1, 2022 The purpose of this article is to introduce a new tool—the Open Science Online Grocery—for studying the effects of the choice context on purchasing decisions. We first review the features of the tool: a mock online grocery store containing over 11,000 prod ... Full text Cite

Hydroxychloroquine for COVID-19: Variation in Regional Political Preferences Predicted New Prescriptions after President Trump's Endorsement.

Journal Article Journal of health politics, policy and law · August 2022 ContextOn March 19, 2020, President Donald Trump endorsed using hydroxychloroquine for COVID-19 treatment despite inconclusive evidence of the drug's effectiveness. This study sought to understand the influence of political preferences on prescrip ... Full text Cite

How can healthcare organizations improve cost-of-care conversations? A qualitative exploration of clinicians' perspectives.

Journal Article Patient Educ Couns · August 2022 OBJECTIVES: Clinicians increasingly believe they should discuss costs with their patients. We aimed to learn what strategies clinicians, clinic leaders, and health systems can use to facilitate vital cost-of-care conversations. METHODS: We conducted focus ... Full text Link to item Cite

Why Too Many Vitamins Feels Just About Right.

Journal Article JAMA internal medicine · August 2022 Full text Cite

Association of quantitative information and patient knowledge about prostate cancer outcomes.

Journal Article Health psychology : official journal of the Division of Health Psychology, American Psychological Association · July 2022 ObjectiveWhen the volume or complexity of health information exceeds the capacity to process it, patients may misinterpret or ignore critical information. Numerical information is especially challenging to process for many patients, yet no empiric ... Full text Cite

A Disease Identification Algorithm for Medical Crowdfunding Campaigns: Validation Study.

Journal Article J Med Internet Res · June 21, 2022 BACKGROUND: Web-based crowdfunding has become a popular method to raise money for medical expenses, and there is growing research interest in this topic. However, crowdfunding data are largely composed of unstructured text, thereby posing many challenges f ... Full text Link to item Cite

Two Minds, One Patient: Clearing up Confusion About "Ambivalence".

Journal Article The American journal of bioethics : AJOB · June 2022 Patients who experience difficulty making medical decisions are often referred to as "ambivalent." However, the current lack of attention to the nuances between a cluster of phenomena that resemble ambivalence means that we are not always recognizing what ... Full text Cite

Palliative Care Consultations in Patients with Severe Traumatic Brain Injury: Who Receives Palliative Care Consultations and What Does that Mean for Utilization?

Journal Article Neurocrit Care · June 2022 BACKGROUND: Palliative care has the potential to improve goal-concordant care in severe traumatic brain injury (sTBI). Our primary objective was to illuminate the demographic profiles of patients with sTBI who receive palliative care encounters (PCEs), wit ... Full text Open Access Link to item Cite

Decisional Satisfaction, Regret, and Conflict Among Parents of Infants with Neurologic Conditions.

Journal Article J Pediatr · June 2022 OBJECTIVE: To characterize decisional satisfaction, regret, and conflict among parents of critically ill infants with neurologic conditions. STUDY DESIGN: In this prospective cohort study, we enrolled parents of infants with neurologic conditions in the in ... Full text Link to item Cite

Impact of Financial Considerations on Willingness to Take Sacubitril/Valsartan for Heart Failure.

Journal Article Journal of the American Heart Association · June 2022 Background Sacubitril/valsartan improves health outcomes for heart failure with reduced ejection fraction relative to angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, but it carries higher out-of-pocket costs. Neither the impact o ... Full text Cite

Attitudes and Beliefs of Patients With Left-Ventricular Assist Devices Toward COVID-19 Vaccination and Willingness to Seek Care During the Pandemic.

Journal Article The Permanente journal · June 2022 Given the stalling improvement in vaccine hesitancy rates in the United States (US), it is important to understand why a chronically ill group, patients with left-ventricular assist devices (LVADs), might not get vaccinated and to delineate the barriers th ... Full text Cite

Preparing Patients with Early Stage Prostate Cancer to Participate in Clinical Appointments Using a Shared Decision Making Training Video.

Journal Article Med Decis Making · April 2022 BACKGROUND: Rates of shared decision making (SDM) are relatively low in early stage prostate cancer decisions, as patients' values are not well integrated into a preference-sensitive treatment decision. The study objectives were to develop a SDM training v ... Full text Link to item Cite

Motivated Inferences of Price and Quality in Healthcare Decisions

Journal Article Journal of the Association for Consumer Research · April 1, 2022 Policy makers have increasingly advocated for healthcare price transparency, whereby prices are made salient before services are rendered. While such policies may empower consumers, they also bring price to the forefront of healthcare choices as never befo ... Full text Cite

Assessment of parent understanding in conferences for critically ill neonates.

Conference Patient Educ Couns · March 2022 OBJECTIVES: This study aimed to characterize the use and impact of assessments of understanding in parent-clinician communication for critically ill infants. METHODS: We enrolled parents and clinicians participating in family conferences for infants with n ... Full text Link to item Cite

Decision Making for Infants With Neurologic Conditions.

Journal Article J Child Neurol · March 2022 Parents and clinicians caring for infants with neurologic disease often make high-stakes decisions about infant care. To characterize how these decisions occur, we enrolled infants with neurologic conditions, their parents, and their clinicians in a longit ... Full text Link to item Cite

Gender Differences in Work-Family Conflict Experiences of Faculty in Academic Medicine.

Journal Article Journal of general internal medicine · January 2022 Full text Cite

Supported Decision Making: A Concept at the Margins vs. Center of Autonomy?

Journal Article The American journal of bioethics : AJOB · November 2021 Full text Cite

Accuracy of Physician Estimates of Out-of-Pocket Costs for Medication Filling.

Journal Article JAMA Netw Open · November 1, 2021 IMPORTANCE: One-third of US residents have trouble paying their medical bills. They often turn to their physicians for help navigating health costs and insurance coverage. OBJECTIVE: To determine whether physicians can accurately estimate out-of-pocket exp ... Full text Link to item Cite

Clinical Trial Protocol for a Randomized Trial of Community Health Worker-led Decision Coaching to Promote Shared Decision-making on Prostate Cancer Screening Among Black Male Patients and Their Providers.

Journal Article European urology focus · September 2021 We propose a randomized controlled trial to evaluate the effectiveness of a community health worker-led decision-coaching program to facilitate shared decision-making for prostate cancer screening decisions by Black men at a primary care federally qualifie ... Full text Cite

Strategies for research participant engagement: A synthetic review and conceptual framework.

Journal Article Clin Trials · August 2021 BACKGROUND: Research participant engagement, which we define as recruitment and retention in clinical trials, is a costly and challenging issue in clinical research. Research teams have leveraged a variety of strategies to increase research participant eng ... Full text Link to item Cite

A novel decision aid for acute myeloid leukemia: a feasibility and preliminary efficacy trial.

Journal Article Support Care Cancer · July 2021 PURPOSE: Acute myeloid leukemia (AML) is a hematologic malignancy characterized by a poor prognosis but also a paradoxical possibility of cure. This renders decision-making complex and imminent. Unfortunately, many patients with AML misestimate their progn ... Full text Link to item Cite

Applying Behavioral Economics to Improve Adolescent and Young Adult Health: A Developmentally-Sensitive Approach.

Journal Article The Journal of adolescent health : official publication of the Society for Adolescent Medicine · July 2021 Each day, adolescents and young adults (AYAs) choose to engage in behaviors that impact their current and future health. Behavioral economics represents an innovative lens through which to explore decision-making among AYAs. Behavioral economics outlines a ... Full text Cite

Framing Benefits in Decision Aids: Effects of Varying Contextualizing Statements on Decisions About Sacubitril-Valsartan for Heart Failure.

Journal Article MDM policy & practice · July 2021 Background. Presenting numeric data alone may result in patients underappreciating clinically significant benefits. Contextualizing statements to counter this may raise concern about absence of neutrality. These issues arose during construction of a ... Full text Cite

Head to head randomized trial of two decision aids for prostate cancer.

Journal Article BMC Med Inform Decis Mak · May 12, 2021 BACKGROUND: While many studies have tested the impact of a decision aid (DA) compared to not receiving any DA, far fewer have tested how different types of DAs affect key outcomes such as treatment choice, patient-provider communication, or decision proces ... Full text Link to item Cite

The shifting perspectives study protocol: Cognitive remediation therapy as an adjunctive treatment to family based treatment for adolescents with anorexia nervosa.

Journal Article Contemporary clinical trials · April 2021 BackgroundAdolescents with anorexia nervosa have set-shifting inefficiencies that can be exacerbated by starvation and that may interfere with outcomes of treatment interventions. Cognitive Remediation Therapy (CRT), an adjunctive treatment focuse ... Full text Cite

Vaccinating Health Care Employees - Do They All Deserve Early Access?

Journal Article The New England journal of medicine · March 2021 Full text Cite

Financial Pollution in the US Health Care System.

Journal Article JAMA Health Forum · March 1, 2021 Full text Link to item Cite

Gain-loss framing and patients' decisions: a linguistic examination of information framing in physician-patient conversations.

Journal Article J Behav Med · February 2021 When discussing risks and benefits with cancer patients, physicians could focus on losses such as mortality rates and cancer recurrence or, alternatively, gains such as survival rates and curing cancer. Previous research has shown that the way health infor ... Full text Link to item Cite

Randomized trial of community health worker-led decision coaching to promote shared decision-making for prostate cancer screening among Black male patients and their providers.

Journal Article Trials · February 2021 BackgroundBlack men are disproportionately affected by prostate cancer, the most common non-cutaneous malignancy among men in the USA. The United States Preventive Services Task Force (USPSTF) encourages prostate-specific antigen (PSA) testing dec ... Full text Cite

HIV, cancer, and coping: The cumulative burden of a cancer diagnosis among people living with HIV.

Journal Article J Psychosoc Oncol · 2021 OBJECTIVES: People living with HIV (PLWH) have increased risk for cancer and worse cancer-specific survival. We explored the emotional burden of cancer and HIV as a potential driver of cancer mortality. RESEARCH APPROACH: Semi-structured qualitative interv ... Full text Link to item Cite

How Hospital Stays Resemble Enhanced Interrogation.

Journal Article Annals of internal medicine · October 2020 Full text Cite

Withdrawal of Life-supporting Treatment in Severe Traumatic Brain Injury.

Journal Article JAMA Surg · August 1, 2020 IMPORTANCE: There are limited data on which factors affect the critical and complex decision to withdraw life-supporting treatment (LST) in patients with severe traumatic brain injury (sTBI). OBJECTIVE: To determine demographic and clinical factors associa ... Full text Link to item Cite

"Cure" Versus "Clinical Remission": The Impact of a Medication Description on the Willingness of People Living with HIV to Take a Medication.

Journal Article AIDS Behav · July 2020 Many people living with HIV (PLWHIV) state that they would be willing to take significant risks to be "cured" of the virus. However, how they interpret the word "cure" in this context is not clear. We used a randomized survey to examine whether PLWHIV had ... Full text Link to item Cite

Racial differences in veterans' response to a standard vs. patient-centered decision aid for prostate cancer: Implications for decision making in African American and White men.

Journal Article Patient Educ Couns · June 3, 2020 OBJECTIVE: To determine whether racial differences exist in patient preferences for prostate cancer treatment after being informed about options using a patient-centered vs. a standard decision aid (DA). METHODS: This article reports secondary analyses of ... Full text Link to item Cite

The Cost of Applying to Medical School. Reply.

Journal Article The New England journal of medicine · January 2020 Full text Cite

Surgical decision making in the setting of severe traumatic brain injury: A survey of neurosurgeons.

Journal Article PLoS One · 2020 BACKGROUND: Surgical decision-making in severe traumatic brain injury (TBI) is complex. Neurosurgeons weigh risks and benefits of interventions that have the potential to both maximize the chance of recovery and prolong suffering. Inaccurate prognosticatio ... Full text Link to item Cite

Neurologic Outcome after Prematurity: Perspectives of Parents and Clinicians

Journal Article Obstetrical and Gynecological Survey · December 1, 2019 Full text Cite

Sick to debt: How smarter markets lead to better care

Book · November 26, 2019 The United States has the most expensive healthcare system in the world. While policy makers have argued over who is at fault for this, the system has been quietly moving toward high-deductible insurance plans that require patients to pay large amounts out ... Cite

HIV Cure Research: Risks Patients Expressed Willingness to Accept.

Journal Article Ethics Hum Res · November 2019 Despite doing well on antiretroviral therapy, many people living with HIV have expressed a willingness to accept substantial risks for an HIV cure. To date, few studies have assessed the specific quantitative maximal risk that future participants might tak ... Full text Link to item Cite

Neurodevelopmental Risk: A Tool to Enhance Conversations With Families of Infants.

Journal Article J Child Neurol · October 2019 Parents of infants at risk of neurodevelopmental impairment require clear and individualized information about what to expect for their child, yet data suggest they have difficulty knowing how to ask for this information. Here, we pilot a Question Prompt L ... Full text Link to item Cite

The Cost of Applying to Medical School - A Barrier to Diversifying the Profession.

Journal Article The New England journal of medicine · October 2019 Full text Cite

Medicaid and CHIP Child Health Beneficiary Incentives: Program Landscape and Stakeholder Insights.

Journal Article Pediatrics · August 2019 OBJECTIVES: To describe the landscape of Medicaid and the Children's Health Insurance Program beneficiary incentive programs for child health and garner key stakeholder insights on incentive program rationale, child and family engagement, and program evalu ... Full text Link to item Cite

Neurologic Outcome After Prematurity: Perspectives of Parents and Clinicians.

Journal Article Pediatrics · July 2019 BACKGROUND: Parents and clinicians caring for premature infants face high-stakes and time-sensitive decisions about care. We aimed to characterize how parents and clinicians discuss outcome in the context of decision-making for premature infants. METHODS: ... Full text Link to item Cite

What risk of death would people take to be cured of HIV and why? A survey of people living with HIV.

Journal Article J Virus Erad · April 1, 2019 People living with HIV (PLWHIV) can reasonably expect near-normal longevity, yet many express a willingness to assume significant risks to be cured. We surveyed 200 PLWHIV who were stable on antiretroviral therapy (ART) to quantify associations between the ... Full text Link to item Cite

A whole genome approach for discovering the genetic basis of blood group antigens: independent confirmation for P1 and Xga.

Journal Article Transfusion · March 2019 BackgroundAlthough P1 and Xga are known to be associated with the A4GALT and XG genes, respectively, the genetic basis of antigen expression has been elusive. Recent reports link both P1 and Xga expression with nucleotide cha ... Full text Cite

The Roles Of Assisters And Automated Decision Support Tools In Consumers' Marketplace Choices: Room For Improvement.

Journal Article Health Aff (Millwood) · March 2019 Assisters provide in-person and phone-based support to help consumers narrow their plan options on the Affordable Care Act's health insurance Marketplaces. We elicited the perspectives of a national sample of thirty-two assisters from ten states on consume ... Full text Link to item Cite

Engaging Beneficiaries In Medicaid Programs That Incentivize Health-Promoting Behaviors.

Journal Article Health Aff (Millwood) · March 2019 Medicaid programs are increasingly adopting incentive programs to improve health behaviors among beneficiaries. There is limited evidence on what incentives are being offered to Medicaid beneficiaries, how programs are engaging beneficiaries, and how progr ... Full text Link to item Cite

The Impact of Cost Conversations on the Patient-Physician Relationship.

Journal Article Health Commun · January 2019 Previous research has suggested that fear of harm to the patient-physician relationship is an important barrier to conversations about cost of care. However, few experimental studies have investigated the effects of cost of care conversations on the patien ... Full text Link to item Cite

Don't Count Calorie Labeling Out: Calorie Counts on the Left Side of Menu Items Lead to Lower Calorie Food Choices

Journal Article Journal of Consumer Psychology · January 1, 2019 Providing calorie counts on restaurants’ menus/menu boards is one of the most prominent policy interventions that has been implemented to combat the obesity epidemic in America. However, previous research across multiple disciplines has found little effect ... Full text Cite

Beyond Nudges - When Improving Health Calls for Greater Assertiveness.

Journal Article The New England journal of medicine · January 2019 Full text Cite

In Defense of "Denial": Difficulty Knowing When Beliefs Are Unrealistic and Whether Unrealistic Beliefs Are Bad.

Journal Article The American journal of bioethics : AJOB · September 2018 Bioethicists often draw sharp distinctions between hope and states like denial, self-deception, and unrealistic optimism. But what, exactly, is the difference between hope and its more suspect cousins? One common way of drawing the distinction focuses on a ... Full text Cite

Truth be told: not all nudging is bullshit.

Journal Article Journal of medical ethics · August 2018 Full text Cite

How Primary Care Providers Talk to Patients about Genome Sequencing Results: Risk, Rationale, and Recommendation.

Journal Article Journal of general internal medicine · June 2018 BackgroundGenomics will play an increasingly prominent role in clinical medicine.ObjectiveTo describe how primary care physicians (PCPs) discuss and make clinical recommendations about genome sequencing results.DesignQualitative ... Full text Cite

Automated typing of red blood cell and platelet antigens: a whole-genome sequencing study.

Journal Article The Lancet. Haematology · June 2018 BackgroundThere are more than 300 known red blood cell (RBC) antigens and 33 platelet antigens that differ between individuals. Sensitisation to antigens is a serious complication that can occur in prenatal medicine and after blood transfusion, pa ... Full text Cite

Accuracy of Predictions of Patients With Breast Cancer of Future Well-being After Immediate Breast Reconstruction.

Journal Article JAMA surgery · April 2018 ImportanceMaking a good decision about breast reconstruction requires predicting how one would feel after the procedure, but people tend to overestimate the impact of events on future well-being.ObjectiveTo assess how well patients predic ... Full text Cite

No question too small: development of a question prompt list for parents of critically ill infants.

Journal Article J Perinatol · April 2018 OBJECTIVE: To develop a question prompt list tailored to the needs of parents of critically ill infants at risk of neurodevelopmental impairment. STUDY DESIGN: Question content was derived from audio-recorded neonatal intensive care unit family meetings an ... Full text Link to item Cite

Finding Health Care Prices Online-How Difficult Is It to Be an Informed Health-Care Consumer?

Journal Article JAMA Intern Med · March 1, 2018 This study examines the availability of pricing information for 4 nonemergency medical interventions using 2 online search engines in 8 US cities. ... Full text Link to item Cite

Unhealthy consumerism: The challenge of trading off price and quality in health care

Journal Article Behavioural Public Policy · January 15, 2018 Over the last decade, health care in many parts of the world has shifted toward a more patient-centric, consumeristic model, marked by an emphasis on choice and a proliferation of typical consumer-facing information (e.g. price and quality data). However, ... Full text Cite

Eye-tracking evidence shows that non-fit messaging impacts attention, attitudes and choice.

Journal Article PloS one · January 2018 When patients have strong initial attitudes about a medical intervention, they might not be open to learning new information when choosing whether or not to receive the intervention. We aim to show that non-fit messaging (messages framed in a manner that i ... Full text Cite

Discussing Health Care Expenses in the Oncology Clinic: Analysis of Cost Conversations in Outpatient Encounters.

Journal Article J Oncol Pract · November 2017 PURPOSE: ASCO identified oncologist-patient conversations about cancer costs as an important component of high-quality care. However, limited data exist characterizing the content of these conversations. We sought to provide novel insight into oncologist-p ... Full text Link to item Cite

Empowerment Failure: How Shortcomings in Physician Communication Unwittingly Undermine Patient Autonomy.

Journal Article Am J Bioeth · November 2017 Many health care decisions depend not only upon medical facts, but also on value judgments-patient goals and preferences. Until recent decades, patients relied on doctors to tell them what to do. Then ethicists and others convinced clinicians to adopt a pa ... Full text Link to item Cite

Factors Associated With Success of Clinician-Researchers Receiving Career Development Awards From the National Institutes of Health: A Longitudinal Cohort Study.

Journal Article Academic medicine : journal of the Association of American Medical Colleges · October 2017 PurposeUnderstanding the careers of recent career development awardees is essential to guide interventions to ensure gender equity and success in academic medicine.MethodIn 2010-2011 (T1) and 2014 (T2), 1,719 clinician-researchers who rec ... Full text Cite

Quality of Patient Decisions About Breast Reconstruction After Mastectomy.

Journal Article JAMA Surg · August 1, 2017 IMPORTANCE: Breast reconstruction has the potential to improve a person's body image and quality of life but has important risks. Variations in who undergoes breast reconstruction have led to questions about the quality of patient decisions. OBJECTIVE: To ... Full text Link to item Cite

The Impact of Whole-Genome Sequencing on the Primary Care and Outcomes of Healthy Adult Patients: A Pilot Randomized Trial.

Journal Article Annals of internal medicine · August 2017 BackgroundWhole-genome sequencing (WGS) in asymptomatic adults might prevent disease but increase health care use without clinical value.ObjectiveTo describe the effect on clinical care and outcomes of adding WGS to standardized family hi ... Full text Cite

Can Appealing to Patient Altruism Reduce Overuse of Health Care Services? An Experimental Survey.

Journal Article Journal of general internal medicine · July 2017 BackgroundA challenge to reducing overuse of health services is communicating recommendations against unnecessary health services to patients. The predominant approach has been to highlight the limited benefit and potential harm of such services f ... Full text Cite

Discussing Out-of-Pocket Expenses During Clinical Appointments: An Observational Study of Patient-Psychiatrist Interactions.

Journal Article Psychiatr Serv · June 1, 2017 OBJECTIVE: High out-of-pocket expenses for medical treatment have been associated with worse quality of life, decreased treatment adherence, and increased risk of adverse health outcomes. Treatment of depression potentially has high out-of-pocket expenses. ... Full text Link to item Cite

Risk tolerance and attitudes toward chemotherapy: Who chooses palliative treatment when cure is possible?

Conference Journal of Clinical Oncology · May 20, 2017 10054 Background: Many patients with acute myeloid leukemia (AML) face a difficult choice about whether to receive palliative chemotherapy or high-dose, potentially-curative chemotherapy that poses a risk of early death. How peop ... Full text Cite

Anxiety symptoms prior to a prostate cancer diagnosis: Associations with knowledge and openness to treatment.

Journal Article British journal of health psychology · February 2017 AimResearch suggests that anxiety may be a common response to a cancer diagnosis, but research is needed to examine anxiety before diagnosis. Anxiety before diagnosis may relate to the comprehension of relevant health information or openness to po ... Full text Cite

Treatment Availability Influences Physicians' Portrayal of Robotic Surgery During Clinical Appointments.

Journal Article Health Commun · January 2017 In order to empower patients as decision makers, physicians must educate them about their treatment options in a factual, nonbiased manner. We propose that site-specific availability of treatment options may be a novel source of bias, whereby physicians de ... Full text Link to item Cite

The Physician Recommendation Coding System (PhyReCS): A Reliable and Valid Method to Quantify the Strength of Physician Recommendations During Clinical Encounters.

Journal Article Med Decis Making · January 2017 BACKGROUND: Physicians' recommendations affect patients' treatment choices. However, most research relies on physicians' or patients' retrospective reports of recommendations, which offer a limited perspective and have limitations such as recall bias. OBJE ... Full text Link to item Cite

Physician Recommendations Trump Patient Preferences in Prostate Cancer Treatment Decisions.

Journal Article Med Decis Making · January 2017 OBJECTIVE: To assess the influence of patient preferences and urologist recommendations in treatment decisions for clinically localized prostate cancer. METHODS: We enrolled 257 men with clinically localized prostate cancer (prostate-specific antigen <20; ... Full text Link to item Cite

Poor Consumer Comprehension and Plan Selection Inconsistencies Under the 2016 HealthCare.gov Choice Architecture.

Journal Article MDM Policy Pract · 2017 BACKGROUND: Many health policy experts have endorsed insurance competition as a way to reduce the cost and improve the quality of medical care. In line with this approach, health insurance exchanges, such as HealthCare.gov, allow consumers to compare insur ... Full text Open Access Link to item Cite

How Informed Is the Decision About Breast Reconstruction After Mastectomy?: A Prospective, Cross-sectional Study.

Journal Article Ann Surg · December 2016 OBJECTIVE: To assess how informed patients are about breast reconstruction, and how involved they are in decision making. SUMMARY BACKGROUND DATA: Breast reconstruction is an important treatment option for patients undergoing mastectomy. Wide variations in ... Full text Link to item Cite

Copay Assistance for Expensive Drugs: A Helping Hand That Raises Costs.

Journal Article Annals of internal medicine · December 2016 Full text Cite

Should Neonatologists Give Opinions Withdrawing Life-sustaining Treatment?

Journal Article Pediatrics · December 2016 An infant has a massive intracranial hemorrhage. She is neurologically devastated and ventilator-dependent. The prognosis for pulmonary or neurologic recovery is bleak. The physicians and parents face a choice: withdraw the ventilator and allow her to die ... Full text Link to item Cite

Gunmen and Ice Cream Cones: Harm to Autonomy and Harm to Persons.

Journal Article The American journal of bioethics : AJOB · November 2016 Full text Cite

Who chooses palliative chemotherapy when a cure is possible? Results of a risk tolerance survey of laypersons.

Conference Journal of Clinical Oncology · October 9, 2016 35 Background: Many patients with acute myeloid leukemia (AML) face a difficult choice about whether to receive palliative chemotherapy or high-dose, potentially-curative chemotherapy that poses a risk of early death. How people ... Full text Cite

What Strategies Do Physicians and Patients Discuss to Reduce Out-of-Pocket Costs? Analysis of Cost-Saving Strategies in 1,755 Outpatient Clinic Visits.

Journal Article Medical decision making : an international journal of the Society for Medical Decision Making · October 2016 BackgroundMore than 1 in 4 Americans report difficulty paying medical bills. Cost-reducing strategies discussed during outpatient physician visits remain poorly characterized.ObjectiveWe sought to determine how often patients and physicia ... Full text Cite

New strategies for aligning physicians with health system incentives.

Journal Article The American journal of managed care · September 2016 Cite

Communication challenges for nongeneticist physicians relaying clinical genomic results.

Journal Article Personalized medicine · September 2016 AimIdentify the behavioral challenges to the use of genome sequencing (GS) in a clinical setting.Materials & methodsWe observed how general internists and nongenetic specialists delivered GS results to patients enrolled in the MedSeq Proj ... Full text Cite

A Mixed-Methods Investigation of the Motivations, Goals, and Aspirations of Male and Female Academic Medical Faculty.

Journal Article Academic medicine : journal of the Association of American Medical Colleges · August 2016 PurposeUnderstanding the goals and aspirations of the physician-scientist workforce can inform policies to promote retention. The authors explored gender differences therein, given women's increasing representation.MethodIn 2010-2011, the ... Full text Cite

Erratum: Clinical Sequencing Exploratory Research Consortium: Accelerating Evidence-Based Practice of Genomic Medicine (American Journal of Human Genetics (2016) 98(6) (1067–1076) (S0002929716301069) (10.1016/j.ajhg.2016.04.011))

Journal Article American Journal of Human Genetics · July 7, 2016 (The American Journal of Human Genetics 98, 1051–1066; June 2, 2016) In the originally published version of this article, the first name of Christian R. Tilley, a member of the CSER Consortium, was unfortunately misspelled. His name appears correctly here ... Full text Cite

Effect of physician disclosure of specialty bias on patient trust and treatment choice.

Journal Article Proceedings of the National Academy of Sciences of the United States of America · July 2016 This paper explores the impact of disclosures of bias on advisees. Disclosure-informing advisees of a potential bias-is a popular solution for managing conflicts of interest. Prior research has focused almost exclusively on disclosures of financial conflic ... Full text Cite

Show Me My Health Plans: Using a Decision Aid to Improve Decisions in the Federal Health Insurance Marketplace.

Journal Article MDM policy & practice · July 2016 IntroductionSince the Affordable Care Act was passed, more than 12 million individuals have enrolled in the health insurance marketplace. Without support, many struggle to make an informed plan choice that meets their health and financial needs. Full text Cite

Understanding and Utilizing Patient Preferences in Cancer Treatment Decisions.

Journal Article Journal of the National Comprehensive Cancer Network : JNCCN · May 2016 Shared decision-making is a complex endeavor that should take into account the patient's personal preferences regarding treatment options. To truly empower patients to be partners in decision-making, especially in situations in which their preferences are ... Full text Cite

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Journal Article · April 1, 2016 Full text Cite

Patient-physician discussions about costs: definitions and impact on cost conversation incidence estimates.

Journal Article BMC health services research · March 2016 BackgroundNearly one in three Americans are financially burdened by their medical expenses. To mitigate financial distress, experts recommend routine physician-patient cost conversations. However, the content and incidence of these conversations a ... Full text Cite

Using Behavioral Economics to Design Physician Incentives That Deliver High-Value Care.

Journal Article Annals of internal medicine · January 2016 Behavioral economics provides insights about the development of effective incentives for physicians to deliver high-value care. It suggests that the structure and delivery of incentives can shape behavior, as can thoughtful design of the decision-making en ... Full text Cite

Potential problems with increasing serving sizes on the Nutrition Facts label.

Journal Article Appetite · December 2015 The United States Food and Drug Administration recently announced that the serving sizes on the Nutrition Facts labels for many products will be increased, but the effect of these increases remains unclear. The present research examined consumers' interpre ... Full text Cite

Informed Decision Making: Assessment of the Quality of Physician Communication about Prostate Cancer Diagnosis and Treatment.

Journal Article Medical decision making : an international journal of the Society for Medical Decision Making · November 2015 IntroductionLittle is known about how physicians present diagnosis and treatment planning in routine practice in preference-sensitive treatment decisions. We evaluated completeness and quality of informed decision making in localized prostate canc ... Full text Cite

Patient-physician communication about early stage prostate cancer: analysis of overall visit structure.

Journal Article Health Expect · October 2015 BACKGROUND: We know little about patient-physician communication during visits to discuss diagnosis and treatment of prostate cancer. OBJECTIVE: To examine the overall visit structure and how patients and physicians transition between communication activit ... Full text Link to item Cite

The utility of cost discussions between patients with cancer and oncologists.

Journal Article Am J Manag Care · September 2015 OBJECTIVES: Patients with cancer can experience substantial financial burden. Little is known about patients' preferences for incorporating cost discussions into treatment decision making or about the ramifications of those discussions. The objective of th ... Link to item Cite

The author replies.

Journal Article The Hastings Center report · July 2015 Full text Cite

Summarizing polygenic risks for complex diseases in a clinical whole-genome report.

Journal Article Genetics in medicine : official journal of the American College of Medical Genetics · July 2015 PurposeDisease-causing mutations and pharmacogenomic variants are of primary interest for clinical whole-genome sequencing. However, estimating genetic liability for common complex diseases using established risk alleles might one day prove clinic ... Full text Cite

Healthcare.gov 3.0 - Behavioral economics and insurance exchanges

Journal Article Obstetrical and Gynecological Survey · June 17, 2015 Full text Cite

Medical Facts versus Value Judgments--Toward Preference-Sensitive Guidelines.

Journal Article The New England journal of medicine · June 2015 Full text Cite

Gender differences in resources and negotiation among highly motivated physician-scientists.

Journal Article Journal of general internal medicine · April 2015 BackgroundResources, including space, equipment, funding, personnel, and protected time, are essential in academic medical careers. Negotiation often plays a key role in the distribution of these resources.ObjectiveThis study explored gen ... Full text Cite

Why It's Not Time for Health Care Rationing.

Journal Article The Hastings Center report · March 2015 Full text Cite

The role of professional societies in limiting indication creep.

Journal Article Journal of general internal medicine · February 2015 New technology is a major driver of health care inflation. One contributor to this inflation is indication creep, the diffusion of interventions that have been proven beneficial in specific patient populations into untested broader populations who may be l ... Full text Cite

Creating value in health by understanding and overcoming resistance to de-innovation.

Journal Article Health affairs (Project Hope) · February 2015 As hard as it may be for clinicians to adopt new practices, it is often harder for them to "de-innovate," or give up old practices, even when new evidence reveals that those practices offer little value. In this article we explore recent controversies over ... Full text Cite

Healthcare.gov 3.0--behavioral economics and insurance exchanges.

Journal Article The New England journal of medicine · February 2015 Full text Cite

'How many calories are in my burrito?' Improving consumers' understanding of energy (calorie) range information.

Journal Article Public health nutrition · January 2015 ObjectiveEnergy (calorie) ranges currently appear on menu boards for customized menu items and will likely appear throughout the USA when menu-labelling legislation is implemented. Consumer welfare advocates have questioned whether energy ranges e ... Full text Cite

How behavioral economics can help to avoid 'The last mile problem' in whole genome sequencing.

Journal Article Genome medicine · January 2015 Failure to consider lessons from behavioral economics in the case of whole genome sequencing may cause us to run into the 'last mile problem' - the failure to integrate newly developed technology, on which billions of dollars have been invested, into socie ... Full text Cite

Transplantation traffic--geography as destiny for transplant candidates.

Journal Article The New England journal of medicine · December 2014 Full text Cite

The black box of out-of-pocket cost communication. A path toward illumination.

Journal Article Annals of the American Thoracic Society · December 2014 Full text Cite

Surcharges plus unhealthy labels reduce demand for unhealthy menu items

Journal Article Journal of Marketing Research · December 1, 2014 Three laboratory experiments and a field experiment in a restaurant demonstrate that neither a price surcharge nor an unhealthy label is enough on its own to curtail the demand for unhealthy food. However, when the two are combined as an unhealthy label su ... Full text Cite

Nudging the obese: a UK-US consideration.

Journal Article Health economics, policy, and law · July 2014 Over recent years, nudge policies have become increasingly popular (if somewhat confused) internationally. This article attempts to clarify what a nudge entails, and critically summarises some of the nudge policies that have been proposed to motivate weigh ... Full text Cite

Overcoming barriers to discussing out-of-pocket costs with patients.

Journal Article JAMA internal medicine · June 2014 Full text Cite

Does cancer treatment-related financial distress worsen over time?

Conference Journal of Clinical Oncology · May 20, 2014 Full text Cite

Patient understanding of medical jargon: a survey study of U.S. medical students.

Journal Article Patient Educ Couns · May 2014 OBJECTIVE: With increasing exposure, medical students may forget that technical jargon is unfamiliar to laypeople. To investigate this possibility, authors assessed student perceptions of patient understanding across different years in medical school. METH ... Full text Link to item Cite

Patient-oncologist cost communication, financial distress, and medication adherence.

Journal Article J Oncol Pract · May 2014 BACKGROUND: Little is known about the association between patient-oncologist discussion of cancer treatment out-of-pocket (OOP) cost and medication adherence, a critical component of quality cancer care. METHODS: We surveyed insured adults receiving antica ... Full text Link to item Cite

Promoting population health through financial stewardship.

Journal Article The New England journal of medicine · April 2014 Full text Cite

Does comparative effectiveness research promote rationing of cancer care?

Journal Article Lancet Oncol · March 2014 Comparative effectiveness research aims to inform health-care decisions by patients, clinicians, and policy makers. However, questions related to what information is relevant, and how to view the relative attributes of alternative interventions have politi ... Full text Link to item Cite

Using behavioral economics to design more effective food policies to address obesity

Journal Article Applied Economic Perspectives and Policy · March 1, 2014 Many policy interventions that address rising obesity levels in the United States have been designed to provide consumers with more nutrition information, with the goal of encouraging consumers to decrease their caloric intake. We discuss existing informat ... Full text Cite

Sex, role models, and specialty choices among graduates of US medical schools in 2006-2008.

Journal Article Journal of the American College of Surgeons · March 2014 BackgroundUndergraduate education studies have suggested instructor sex can influence female students to pursue a discipline. We sought to evaluate a similar hypothesis in medical students.Study designWe obtained Association of American M ... Full text Cite

The MedSeq Project: a randomized trial of integrating whole genome sequencing into clinical medicine.

Journal Article Trials · March 2014 BackgroundWhole genome sequencing (WGS) is already being used in certain clinical and research settings, but its impact on patient well-being, health-care utilization, and clinical decision-making remains largely unstudied. It is also unknown how ... Full text Cite

Gender differences in time spent on parenting and domestic responsibilities by high-achieving young physician-researchers.

Journal Article Annals of internal medicine · March 2014 BackgroundFemale physician-researchers do not achieve career success at the same rate as men. Differences in nonprofessional responsibilities may partially explain this gap.ObjectiveTo investigate the division of domestic labor by gender ... Full text Cite

Mentoring and the career satisfaction of male and female academic medical faculty.

Journal Article Academic medicine : journal of the Association of American Medical Colleges · February 2014 PurposeTo explore aspects of mentoring that might influence medical faculty career satisfaction and to discover whether there are gender differences.MethodIn 2010-2011, the authors surveyed 1,708 clinician-researchers who received (in 200 ... Full text Cite

Too much experience: a desensitization bias in emotional perspective taking.

Journal Article Journal of personality and social psychology · February 2014 People often use their own feelings as a basis to predict others' feelings. For example, when trying to gauge how much someone else enjoys a television show, people might think "How much do I enjoy it?" and use this answer as basis for estimating others' r ... Full text Cite

The role of perceived benefits and costs in patients' medical decisions.

Journal Article Health expectations : an international journal of public participation in health care and health policy · February 2014 BackgroundMany decisions can be understood in terms of actors' valuations of benefits and costs. The article investigates whether this is also true of patient medical decision making. It aims to investigate (i) the importance patients attach to va ... Full text Cite

AJOB Empirical Bioethics: A home for empirical bioethics scholarship

Journal Article AJOB Empirical Bioethics · January 1, 2014 Full text Cite

Agency is messy: get used to it.

Journal Article The American journal of bioethics : AJOB · January 2014 Full text Cite

Health numeracy: the importance of domain in assessing numeracy.

Journal Article Medical decision making : an international journal of the Society for Medical Decision Making · January 2014 Background and objectiveExisting research concludes that measures of general numeracy can be used to predict individuals' ability to assess health risks. We posit that the domain in which questions are posed affects the ability to perform mathemat ... Full text Cite

Work-life balance in academic medicine: narratives of physician-researchers and their mentors.

Journal Article Journal of general internal medicine · December 2013 BackgroundLeaders in academic medicine are often selected from the ranks of physician-researchers, whose demanding careers involve multiple professional commitments that must also be balanced with demands at home.ObjectiveTo gain a more n ... Full text Cite

Patient-oncologist cost communication, financial distress, and medication adherence.

Conference Journal of Clinical Oncology · November 1, 2013 2 Background: Little is known about the association between patient-oncologist discussion of cancer treatment out-of-pocket (OOP) cost and medication adherence, a critical component of quality cancer care. Methods: We conducted a ... Full text Cite

Gender differences in salary in a recent cohort of early-career physician-researchers.

Journal Article Academic medicine : journal of the Association of American Medical Colleges · November 2013 PurposeStudies have suggested that male physicians earn more than their female counterparts. The authors examined whether this disparity exists in a recently hired cohort.MethodIn 2010-2011, the authors surveyed recent recipients of Natio ... Full text Cite

Full disclosure--out-of-pocket costs as side effects.

Journal Article N Engl J Med · October 17, 2013 Full text Link to item Cite

Belief in numbers: When and why women disbelieve tailored breast cancer risk statistics.

Journal Article Patient education and counseling · August 2013 ObjectiveTo examine when and why women disbelieve tailored information about their risk of developing breast cancer.Methods690 women participated in an online program to learn about medications that can reduce the risk of breast cancer. T ... Full text Cite

Effort Aversion: Job choice and compensation decisions overweight effort

Journal Article Journal of Economic Behavior and Organization · August 1, 2013 The current research proposes that people avoid choosing effortful work even when they predict that it will provide them with a better working experience, a phenomenon we call Effort Aversion. In each of the studies, we presented a choice between an effort ... Full text Cite

Results from a randomized trial of a web-based, tailored decision aid for women at high risk for breast cancer.

Journal Article Patient education and counseling · June 2013 ObjectiveTo assess the impact of Guide to Decide (GtD), a web-based, personally-tailored decision aid designed to inform women's decisions about prophylactic tamoxifen and raloxifene use.MethodsPostmenopausal women, age 46-74, with BCRAT ... Full text Cite

The financial burden of cancer care: Do patients know what to expect?

Conference JOURNAL OF CLINICAL ONCOLOGY · May 20, 2013 Link to item Cite

Imagining life with an ostomy: does a video intervention improve quality-of-life predictions for a medical condition that may elicit disgust?

Journal Article Patient education and counseling · April 2013 ObjectiveTo test a video intervention as a way to improve predictions of mood and quality-of-life with an emotionally evocative medical condition. Such predictions are typically inaccurate, which can be consequential for decision making.Method ... Full text Cite

Mentor networks in academic medicine: moving beyond a dyadic conception of mentoring for junior faculty researchers.

Journal Article Academic medicine : journal of the Association of American Medical Colleges · April 2013 PurposeCareer development award programs often require formal establishment of mentoring relationships. The authors sought to gain a nuanced understanding of mentoring from the perspective of a diverse national sample of faculty clinician-research ... Full text Cite

Batting 300 is good: perspectives of faculty researchers and their mentors on rejection, resilience, and persistence in academic medical careers.

Journal Article Academic medicine : journal of the Association of American Medical Colleges · April 2013 PurposeProfessional rejection is a frequent experience in an academic medical career. The authors sought to understand how rejection affects those pursuing such careers and why some individuals may be more resilient than others in a population of ... Full text Cite

Negotiation in academic medicine: narratives of faculty researchers and their mentors.

Journal Article Academic medicine : journal of the Association of American Medical Colleges · April 2013 PurposeFew researchers have explored the negotiation experiences of academic medical faculty even though negotiation is crucial to their career success. The authors sought to understand medical faculty researchers' experiences with and perceptions ... Full text Cite

The hazards of correcting myths about health care reform.

Journal Article Medical care · February 2013 ContextMisperceptions are a major problem in debates about health care reform and other controversial health issues.MethodsWe conducted an experiment to determine if more aggressive media fact-checking could correct the false belief that ... Full text Cite

Breast cancer anxiety's associations with responses to a chemoprevention decision aid.

Journal Article Social science & medicine (1982) · January 2013 Few studies have examined how specific emotions may affect decision-making processes. Anxiety may be especially relevant in health decisions such as those related to cancer in which thoughts of illness or death may be abundant. We examined associations bet ... Full text Cite

Informed choice about breast cancer prevention: randomized controlled trial of an online decision aid intervention.

Journal Article Breast cancer research : BCR · January 2013 IntroductionTamoxifen and raloxifene are chemopreventive drugs that can reduce women’s relative risk of primary breast cancer by 50%; however, most women eligible for these drugs have chosen not to take them. The reasons for low uptake may be rela ... Full text Cite

Repeating an attending physician's unseemly remarks.

Journal Article The virtual mentor : VM · September 2012 Full text Cite

After Adversity Strikes: Predictions, Recollections and Reality Among People Experiencing the Onset of Adverse Circumstances

Journal Article Journal of Happiness Studies · August 1, 2012 Numerous studies on affective forecasting have demonstrated that people frequently underestimate their ability to adapt to adverse circumstances. But to date, these studies have not assessed people's affective forecasts early in the experience of these new ... Full text Cite

Gender differences in the salaries of physician researchers.

Journal Article JAMA · June 2012 ContextIt is unclear whether male and female physician researchers who perform similar work are currently paid equally.ObjectivesTo determine whether salaries differ by gender in a relatively homogeneous cohort of physician researchers an ... Full text Cite

In a survey, marked inconsistency in how oncologists judged value of high-cost cancer drugs in relation to gains in survival.

Journal Article Health affairs (Project Hope) · April 2012 Amid calls for physicians to become better stewards of the nation's health care resources, it is important to gain insight into how physicians think about the cost-effectiveness of new treatments. Expensive new cancer treatments that can extend life raise ... Full text Cite

Issue emergence, evolution of controversy, and implications for competitive framing: The case of the HPV vaccine

Journal Article International Journal of Press/Politics · April 1, 2012 Although scholarship on competitive framing acknowledges that framing is a dynamic process in which the early stages may matter most, very little research has focused on the dynamics of issue emergence. In this article, we draw on several literatures to de ... Full text Cite

What's it worth? Public willingness to pay to avoid mental illnesses compared with general medical illnesses.

Journal Article Psychiatric services (Washington, D.C.) · April 2012 ObjectiveAllocation of resources for the treatment of mental illness is low relative to the burden imposed by these illnesses. The reason for this discrepancy has not been established. Few studies have directly and systematically compared public e ... Full text Cite

Contracts with patients in clinical practice.

Journal Article Lancet (London, England) · January 2012 Full text Cite

Risk perception measures' associations with behavior intentions, affect, and cognition following colon cancer screening messages.

Journal Article Health psychology : official journal of the Division of Health Psychology, American Psychological Association · January 2012 ObjectiveRisk perception is important for motivating health behavior (e.g., Janz & Becker, 1984), but different measures of the construct may change how important that relationship appears. In two studies, we examined associations between four mea ... Full text Cite

Similarities and differences in the career trajectories of male and female career development award recipients.

Journal Article Academic medicine : journal of the Association of American Medical Colleges · November 2011 PurposeTo examine the careers of career development award recipients.MethodIn 2009, a postal survey was conducted of 818 recipients of K08 and K23 awards in 2000-2001 to examine career paths and personal characteristics.ResultsOf ... Full text Cite

'I'll do what they did": social norm information and cancer treatment decisions.

Journal Article Patient education and counseling · November 2011 ObjectiveUsing a cancer-treatment scenario, we tested whether descriptive norm information (e.g., the proportion of other people choosing a particular treatment) would influence people's hypothetical treatment choices.MethodsWomen from an ... Full text Cite

Helping patients decide: ten steps to better risk communication.

Journal Article Journal of the National Cancer Institute · October 2011 With increasing frequency, patients are being asked to make complex decisions about cancer screening, prevention, and treatment. These decisions are fraught with emotion and cognitive difficulty simultaneously. Many Americans have low numeracy skills makin ... Full text Cite

The distinct role of comparative risk perceptions in a breast cancer prevention program.

Journal Article Annals of behavioral medicine : a publication of the Society of Behavioral Medicine · October 2011 BackgroundComparative risk perceptions may rival other types of information in terms of effects on health behavior decisions.PurposeWe examined associations between comparative risk perceptions, affect, and behavior while controlling for ... Full text Cite

Compared to what? A joint evaluation method for assessing quality of life.

Journal Article Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · October 2011 PurposeThis study tests whether a joint evaluation method for assessing quality of life can stabilize ratings by providing contextual information, thereby helping participants calibrate responses on a rating scale. We also use the method to test f ... Full text Cite

Ignorance is bliss? - Reply

Journal Article Archives of Internal Medicine · September 26, 2011 Full text Cite

The choice for breast cancer surgery: can women accurately predict postoperative quality of life and disease-related stigma?

Journal Article Annals of surgical oncology · September 2011 BackgroundTo make an informed choice, breast cancer patients facing surgery must imagine the effect of surgery on their future life experiences. However, the accuracy of patient predictions of postoperative quality of life (QoL) and disease-relate ... Full text Cite

The benefits of discussing adjuvant therapies one at a time instead of all at once.

Journal Article Breast cancer research and treatment · August 2011 Breast cancer patients must often decide between multiple adjuvant therapy options to prevent cancer recurrence. Standard practice, as implemented in current decision support tools, is to present information about all options simultaneously, but psychology ... Full text Cite

Rule of rescue or the good of the many? An analysis of physicians' and nurses' preferences for allocating ICU beds.

Journal Article Intensive care medicine · July 2011 PurposeTo examine intensive care unit (ICU) clinicians' willingness to trade off societal benefits in favor of a small chance of rescuing an identifiable critically ill patient.MethodsWe sent mixed-methods questionnaires to national sampl ... Full text Cite

Women's interest in taking tamoxifen and raloxifene for breast cancer prevention: response to a tailored decision aid.

Journal Article Breast cancer research and treatment · June 2011 Although tamoxifen can prevent primary breast cancer, few women use it as a preventive measure. A second option, raloxifene, has recently been approved. The objective of the study was to determine women's interest in tamoxifen and raloxifene after reading ... Full text Cite

How long and how well: oncologists' attitudes toward the relative value of life-prolonging v. quality of life-enhancing treatments.

Journal Article Medical decision making : an international journal of the Society for Medical Decision Making · May 2011 ObjectiveTo determine how oncologists value quality-enhancing v. life-prolonging outcomes attributable to chemotherapy.MethodsThe authors surveyed a random sample of 1379 US medical oncologists (members of the American Society of Clinical ... Full text Cite

Physicians recommend different treatments for patients than they would choose for themselves.

Journal Article Archives of internal medicine · April 2011 BackgroundPatients facing difficult decisions often ask physicians for recommendations. However, little is known regarding the ways that physicians' decisions are influenced by the act of making a recommendation.MethodsWe surveyed 2 repre ... Full text Cite

Afterword: Giving good advice: it is not what doctors say, but how they say it.

Journal Article Current problems in pediatric and adolescent health care · April 2011 Full text Cite

The experimental imperative.

Journal Article The Hastings Center report · March 2011 Full text Cite

Science and behavior.

Journal Article The American journal of bioethics : AJOB · February 2011 Full text Cite

Behavioral equipoise: a way to resolve ethical stalemates in clinical research.

Journal Article The American journal of bioethics : AJOB · February 2011 Randomized trials depend on clinicians feeling that they are morally justified in allowing their patients to be randomized across treatment arms. Typically such justification rides on what has been called "clinical equipoise"--when there is disagreement of ... Full text Cite

Partisan vision biases determination of voter intent

Journal Article PS - Political Science and Politics · January 1, 2011 In close, disputed elections, outcomes can depend on determinations of voter intent for ballots that have been filled out improperly. We surveyed 899 adult Minnesotans during a time when the state's U.S. Senate election was still disputed and presented the ... Full text Cite

Images of illness: how causal claims and racial associations influence public preferences toward diabetes research spending.

Journal Article Journal of health politics, policy and law · December 2010 Despite the salience of health disparities in media and policy discourse, little previous research has investigated if imagery associating an illness with a certain racial group influences public perceptions. This study evaluated the influence of the media ... Full text Cite

Risky feelings: why a 6% risk of cancer does not always feel like 6%.

Journal Article Patient education and counseling · December 2010 ObjectiveEmotion plays a strong role in the perception of risk information but is frequently underemphasized in the decision-making and communication literature. We sought to discuss and put into context several lines of research that have explore ... Full text Cite

Controversy undermines support for state mandates on the human papillomavirus vaccine.

Journal Article Health affairs (Project Hope) · November 2010 State actions requiring adolescent girls to receive the human papillomavirus (HPV) vaccine created controversy following the vaccine's approval in 2006. Some health professionals worried that the controversy might dampen public support for those state poli ... Full text Cite

A demonstration of ''less can be more'' in risk graphics.

Journal Article Medical decision making : an international journal of the Society for Medical Decision Making · November 2010 BackgroundOnline tools such as Adjuvant! provide tailored estimates of the possible outcomes of adjuvant therapy options available to breast cancer patients. The graphical format typically displays 4 outcomes simultaneously: survival, mortality du ... Full text Cite

Continental Divide? The attitudes of US and Canadian oncologists on the costs, cost-effectiveness, and health policies associated with new cancer drugs.

Journal Article Journal of clinical oncology : official journal of the American Society of Clinical Oncology · September 2010 PurposeOncologists in the United States and Canada work in different health care systems, but physicians in both countries face challenges posed by the rising costs of cancer drugs. We compared their attitudes regarding the costs and cost-effectiv ... Full text Cite

Deficits and variations in patients' experience with making 9 common medical decisions: the DECISIONS survey.

Journal Article Medical decision making : an international journal of the Society for Medical Decision Making · September 2010 BackgroundAlthough many researchers have examined patient involvement and patient-provider interactions within specific clinical environments, no nationally representative data exist to characterize patient perceptions of decision making and patie ... Full text Cite

The DECISIONS study: a nationwide survey of United States adults regarding 9 common medical decisions.

Journal Article Medical decision making : an international journal of the Society for Medical Decision Making · September 2010 BackgroundPatient involvement is required before patients' preferences can be reflected in the medical care they receive. Furthermore, patients are a vital link between physicians' assessments of patients' needs and actual implementation of approp ... Full text Cite

Testing whether decision aids introduce cognitive biases: results of a randomized trial.

Journal Article Patient education and counseling · August 2010 ObjectiveWomen at high risk of breast cancer face a difficult decision whether to take medications like tamoxifen to prevent a first breast cancer diagnosis. Decision aids (DAs) offer a promising method of helping them make this decision. But conc ... Full text Cite

Narratives that address affective forecasting errors reduce perceived barriers to colorectal cancer screening.

Journal Article Social science & medicine (1982) · July 2010 Narratives from similar others may be an effective way to increase important health behaviors. In this study, we used a narrative intervention to promote colorectal cancer screening. Researchers have suggested that people may overestimate barriers to color ... Full text Cite

Foreigners traveling to the U.S. for transplantation may adversely affect organ donation: a national survey.

Journal Article American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · June 2010 The aims of this study were (1) to determine attitudes among the American public regarding foreigners coming to the United States for the purposes of transplantation, and (2) to investigate the impact this practice might have on the public's willingness to ... Full text Cite

Sex differences in career development awardees' subsequent grant attainment

Journal Article Annals of Internal Medicine · May 4, 2010 Full text Cite

Why should changing the bathwater have to harm the baby?

Journal Article Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · May 2010 Full text Cite

Abandoning the language of "response shift": a plea for conceptual clarity in distinguishing scale recalibration from true changes in quality of life.

Journal Article Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · May 2010 Quality of life researchers have been studying "response shift" for a decade now, in an effort to clarify how best to measure QoL over time and across changing circumstances. However, we contend that this line of research has been impeded by conceptual con ... Full text Cite

Failure to discount for conflict of interest when evaluating medical literature: a randomised trial of physicians.

Journal Article Journal of medical ethics · May 2010 ContextPhysicians are regularly confronted with research that is funded or presented by industry.ObjectiveTo assess whether physicians discount for conflicts of interest when weighing evidence for prescribing a new drug.Design and set ... Full text Cite

Does a helping hand mean a heavy heart? Helping behavior and well-being among spouse caregivers.

Journal Article Psychology and aging · March 2010 Being a caregiver for an ill or disabled loved one is widely recognized as a threat to the caregiver's quality of life. Nonetheless, research indicates that helping behavior, broadly construed, promotes well-being. Could helping behavior in a caregiving co ... Full text Cite

Attitudes of the American public toward organ donation after uncontrolled (sudden) cardiac death.

Journal Article American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · March 2010 Concerns about public support for organ donation after cardiac death have hindered expansion of this practice, particularly rapid organ recovery in the context of uncontrolled (sudden) cardiac death (uDCD). A nationally representative Internet-based panel ... Full text Cite

Women's decisions regarding tamoxifen for breast cancer prevention: responses to a tailored decision aid.

Journal Article Breast cancer research and treatment · February 2010 Tamoxifen reduces primary breast cancer incidence, yet causes serious side effects. To date, few women with increased breast cancer risk have elected to use tamoxifen for chemoprevention. The objective of the study was to determine women's knowledge of and ... Full text Cite

Cancer therapy costs influence treatment: a national survey of oncologists.

Journal Article Health affairs (Project Hope) · January 2010 A national survey of medical oncologists indicates that rising cancer treatment costs are influencing clinical practice, even as oncologists tend not to communicate with patients about costs. The survey shows that 84 percent of oncologists say that patient ... Full text Cite

Beyond costs and benefits: understanding how patients make health care decisions.

Journal Article The oncologist · January 2010 Many medical decisions are "preference sensitive," where the best choice depends on the values a specific patient places on relevant outcomes. For example, a decision may require a patient to make a trade-off between a small increase in chance for survival ... Full text Cite

The polarizing effect of news media messages about the social determinants of health.

Journal Article American journal of public health · December 2009 Framing health problems in terms of the social determinants of health aims to shift policy attention to nonmedical strategies to improve population health, yet little is known about how the public responds to these messages. We conducted an experiment to t ... Full text Cite

Sex differences in attainment of independent funding by career development awardees.

Journal Article Annals of internal medicine · December 2009 BackgroundConcerns have been raised about the career pipeline in academic medicine, including whether women with a demonstrated commitment to research succeed at the same rate as male colleagues.ObjectiveTo determine the subsequent academ ... Full text Cite

Happily hopeless: adaptation to a permanent, but not to a temporary, disability.

Journal Article Health psychology : official journal of the Division of Health Psychology, American Psychological Association · November 2009 ObjectiveThe authors tracked patients with either irreversible or reversible colostomies over a 6-month period, beginning a week after the procedure, to examine how they adapted hedonically over time. Based on prior research and theorizing, the au ... Full text Cite

Up from crisis: overhauling healthcare information, payment, and delivery in extraordinary times. Dialogue with featured speakers from the 6th annual connected health symposium.

Journal Article Telemedicine journal and e-health : the official journal of the American Telemedicine Association · September 2009 Full text Cite

American Society of Clinical Oncology guidance statement: the cost of cancer care.

Journal Article Journal of clinical oncology : official journal of the American Society of Clinical Oncology · August 2009 Advances in early detection, prevention, and treatment have resulted in consistently falling cancer death rates in the United States. In parallel with these advances have come significant increases in the cost of cancer care. It is well established that th ... Full text Cite

How bad is depression? Preference score estimates from depressed patients and the general population.

Journal Article Health services research · August 2009 ObjectiveTo compare depression health state preference scores across four groups: (1) general population, (2) previous history of depression but not currently depressed, (3) less severe current depression, and (4) more severe current depression. Full text Cite

Under-representation of women in high-impact published clinical cancer research.

Journal Article Cancer · July 2009 BackgroundAdequate representation of women in research has been deemed essential.MethodsCancer research published in 8 journals in 2006 was reviewed. The percentage of women among study participants was compared with the proportion expect ... Full text Cite

Frequency, nature, effects, and correlates of conflicts of interest in published clinical cancer research.

Journal Article Cancer · June 2009 BackgroundRelationships between clinical researchers and industry are becoming increasingly complex. The frequency and impact of conflicts of interest in the full range of high-impact, published clinical cancer research is unknown.Methods ... Full text Cite

What price for a year of life? A survey of US and Canadian oncologists

Conference JOURNAL OF CLINICAL ONCOLOGY · May 20, 2009 Link to item Cite

Caregiving behavior is associated with decreased mortality risk.

Journal Article Psychological science · April 2009 Traditional investigations of caregiving link it to increased caregiver morbidity and mortality, but do not disentangle the effects of providing care from those of being continuously exposed to an ailing loved one with serious health problems. We explored ... Full text Cite

Patient comprehension of emergency department care and instructions: are patients aware of when they do not understand?

Journal Article Annals of emergency medicine · April 2009 Study objectiveTo be able to adhere to discharge instructions after a visit to the emergency department (ED), patients should understand both the care that they received and their discharge instructions. The objective of this study is to assess, a ... Full text Cite

Pruning the regulatory tree.

Journal Article Nature · January 2009 Full text Cite

Can a moral reasoning exercise improve response quality to surveys of healthcare priorities?

Journal Article Journal of medical ethics · January 2009 ObjectiveTo determine whether a moral reasoning exercise can improve response quality to surveys of healthcare prioritiesMethodsA randomised internet survey focussing on patient age in healthcare allocation was repeated twice. From 2574 i ... Full text Cite

Improving understanding of adjuvant therapy options by using simpler risk graphics.

Journal Article Cancer · December 2008 BackgroundTo help oncologists and breast cancer patients make informed decisions about adjuvant therapies, online tools such as Adjuvant! provide tailored estimates of mortality and recurrence risks. However, the graphical format used to display t ... Full text Cite

Will running the numbers first violate the principles of patient-centered care?

Journal Article Annals of internal medicine · December 2008 Full text Cite

The impact of the format of graphical presentation on health-related knowledge and treatment choices.

Journal Article Patient education and counseling · December 2008 ObjectiveTo evaluate the ability of six graph formats to impart knowledge about treatment risks/benefits to low and high numeracy individuals.MethodsParticipants were randomized to receive numerical information about the risks and benefit ... Full text Cite

Are they really that happy? Exploring scale recalibration in estimates of well-being.

Journal Article Health psychology : official journal of the Division of Health Psychology, American Psychological Association · November 2008 ObjectiveThe authors addressed a lingering concern in research on hedonic adaptation to adverse circumstances. This research typically relies on self-report measures of well-being, which are subjective and depend on the standards that people use i ... Full text Cite

Communicating side effect risks in a tamoxifen prophylaxis decision aid: the debiasing influence of pictographs.

Journal Article Patient education and counseling · November 2008 ObjectiveTo experimentally test whether using pictographs (image matrices), incremental risk formats, and varied risk denominators would influence perceptions and comprehension of side effect risks in an online decision aid about prophylactic use ... Full text Cite

Impact of the model for end-stage liver disease allocation policy on the use of high-risk organs for liver transplantation.

Journal Article Gastroenterology · November 2008 Background & aimsAlthough priority for liver transplantation is determined by the model for end-stage liver disease (MELD) score, the quality of organs used is subject to physician discretion. We aimed to determine whether implementation of MELD a ... Full text Cite

Mispredicting and misremembering: patients with renal failure overestimate improvements in quality of life after a kidney transplant.

Journal Article Health psychology : official journal of the Division of Health Psychology, American Psychological Association · September 2008 ObjectivePeople tend to overestimate the impact that future events will have on their quality of life. In the case of a medical treatment like kidney transplant, this should result in biased predictions--overestimates of how much the transplant wi ... Full text Cite

Beyond utilitarianism: a method for analyzing competing ethical principles in a decision analysis of liver transplantation.

Journal Article Medical decision making : an international journal of the Society for Medical Decision Making · September 2008 BackgroundThe utilitarian foundation of decision analysis limits its usefulness for many social policy decisions. In this study, the authors examine a method to incorporate competing ethical principles in a decision analysis of liver transplantati ... Full text Cite

Screening experiments and the use of fractional factorial designs in behavioral intervention research.

Journal Article American journal of public health · August 2008 Health behavior intervention studies have focused primarily on comparing new programs and existing programs via randomized controlled trials. However, numbers of possible components (factors) are increasing dramatically as a result of developments in scien ... Full text Cite

The accuracy of predicting parity as a prerequisite for cesarean delivery on maternal request.

Journal Article Obstetrics and gynecology · August 2008 ObjectiveThe National Institutes of Health and American College of Obstetricians and Gynecologists consensus guidelines state that cesarean delivery on maternal request is not recommended for women desiring several children. We sought to estimate ... Full text Cite

Effect of esthetic outcome after breast-conserving surgery on psychosocial functioning and quality of life.

Journal Article Journal of clinical oncology : official journal of the American Society of Clinical Oncology · July 2008 PurposeAlthough breast-conserving surgery (BCS) is often assumed to result in minimal deformity, many patients report postoperative breast asymmetry. Understanding the effect of asymmetry on psychosocial functioning is essential for patients to ma ... Full text Cite

Pain and suffering awards: They shouldn't be (just) about pain and suffering

Journal Article Journal of Legal Studies · June 1, 2008 In this paper, we challenge the conventional view that pain-and-suffering awards should be interpreted literally as a compensation for feelings of pain and suffering. People adapt to conditions as serious as paraplegia and blindness, returning rapidly to n ... Full text Cite

Considering adaptation in preference elicitations.

Journal Article Health psychology : official journal of the Division of Health Psychology, American Psychological Association · May 2008 ObjectivePatients with chronic health conditions usually place higher utility on their condition than the public does. One explanation for this discrepancy is that healthy people focus on the negative aspects of the condition without considering t ... Full text Cite

Alternate methods of framing information about medication side effects: incremental risk versus total risk of occurrence.

Journal Article Journal of health communication · March 2008 Communications of treatment risk, such as medication package inserts, commonly report total rates of adverse reactions (e.g., 4% get heartburn with placebo, 9% with medication). This approach, however, requires mental arithmetic to distinguish the incremen ... Full text Cite

Hedonic adaptation and the role of decision and experience utility in public policy

Journal Article Journal of Public Economics · February 1, 2008 Many economists are becoming supportive of 'soft' paternalistic interventions that help people to avoid common decision errors without curtailing individual autonomy. To identify when such interventions could be beneficial, and to assess their success, req ... Full text Cite

Are subjective well-being measures any better than decision utility measures?

Journal Article Health economics, policy, and law · January 2008 There are a number of substantial problems with using decision-based utility measures such as the time trade off and standard gamble to value improvements in health. Dolan (this issue) argues that because of these problems, it would be better to use measur ... Full text Cite

Mispredictions and misrecollections: challenges for subjective outcome measurement.

Journal Article Disability and rehabilitation · January 2008 PurposeTo review research from the behavioral sciences that demonstrates how predictions of future events--and memories of past events--are often systematically biased.MethodDescription of how these biases present challenges for subjectiv ... Full text Cite

"If I'm better than average, then I'm ok?": Comparative information influences beliefs about risk and benefits.

Journal Article Patient education and counseling · December 2007 ObjectiveTo test whether providing comparative risk information changes risk perceptions.MethodsTwo hundred and forty-nine female visitors to a hospital cafeteria were randomized to one of two conditions which differed in whether their hy ... Full text Cite

Does labeling prenatal screening test results as negative or positive affect a woman's responses?

Journal Article American journal of obstetrics and gynecology · November 2007 ObjectiveWe tested whether adding interpretive labels (eg, "negative test") to prenatal genetic screening test results changes perceived risk and preferences for amniocentesis.Study designWomen (N = 1688) completed a hypothetical pregnanc ... Full text Cite

Harnessing the power of default options to improve health care.

Journal Article The New England journal of medicine · September 2007 Full text Cite

Confessions of a bedside rationer: commentary on Hurst and Danis.

Journal Article Kennedy Institute of Ethics journal · September 2007 Samia Hurst and Marion Danis provide a thoughtful framework for how to judge the morality of bedside rationing decisions. In this commentary, I applaud Hurst and Danis for advancing the level of debate about bedside rationing. But when I attempt to apply t ... Full text Cite

Validation of the Subjective Numeracy Scale: effects of low numeracy on comprehension of risk communications and utility elicitations.

Journal Article Medical decision making : an international journal of the Society for Medical Decision Making · September 2007 BackgroundIn a companion article, the authors describe the Subjective Numeracy Scale (SNS), a self-assessment of numerical aptitude and preferences for numbers that correlates strongly with objective numeracy.ObjectiveThe objective of thi ... Full text Cite

Measuring numeracy without a math test: development of the Subjective Numeracy Scale.

Journal Article Medical decision making : an international journal of the Society for Medical Decision Making · September 2007 BackgroundBasic numeracy skills are necessary before patients can understand the risks of medical treatments. Previous research has used objective measures, similar to mathematics tests, to evaluate numeracy.ObjectivesTo design a subjecti ... Full text Cite

Rethinking the objectives of decision aids: a call for conceptual clarity.

Journal Article Medical decision making : an international journal of the Society for Medical Decision Making · September 2007 Health decision aids are a potentially valuable adjunct to patient-physician communication and decision making. Although the overarching goal of decision aids--to help patients make informed, preference-sensitive choices--is widely accepted, experts do not ... Full text Cite

Making numbers matter: present and future research in risk communication.

Journal Article American journal of health behavior · September 2007 ObjectiveTo summarize existing research on individual numeracy and methods for presenting risk information to patients.MethodsWe selectively retrieved articles from MEDLINE and the Social Sciences Citation Index.ResultsMany Ameri ... Full text Cite

Sensitivity to disgust, stigma, and adjustment to life with a colostomy.

Journal Article Journal of research in personality · August 2007 We examined whether trait disgust sensitivity predicts well-being in colostomy patients, and whether disgust predicts stigmatizing attitudes about colostomy in non-patients. 195 patients with a colostomy returned a mailed survey including measures of disgu ... Full text Cite

The ethics of swimming pools.

Journal Article The Hastings Center report · July 2007 Full text Cite

Assessing the economic challenges posed by orphan drugs: A response to McCabe et al. [2]

Journal Article International Journal of Technology Assessment in Health Care · July 1, 2007 Full text Cite

Why people refuse to make tradeoffs in person tradeoff elicitations: a matter of perspective?

Journal Article Medical decision making : an international journal of the Society for Medical Decision Making · May 2007 ObjectivePerson tradeoff (PTO) elicitations assess people's values for health states by asking them to compare the value of treatment programs. For example, people might be asked how many patients need to be cured of health condition X to equal th ... Full text Cite

Mortality versus survival graphs: improving temporal consistency in perceptions of treatment effectiveness.

Journal Article Patient education and counseling · April 2007 ObjectivePrevious research has demonstrated that people perceive treatments as less effective when survival graphs show fewer years of data versus more data. We tested whether using mortality graphs would reduce this temporal inconsistency bias. Full text Cite

Assessing the economic challenges posed by orphan drugs.

Journal Article International journal of technology assessment in health care · January 2007 Historically, patients with rare diseases have been underserved by commercial drug development. In several jurisdictions, specific legislation has been enacted to encourage the development of drugs for rare diseases (orphan drugs), which would otherwise no ... Full text Cite

Patient decision making

Journal Article · December 1, 2006 A 73-year-old man requests a prostate-specific antigen (PSA) test from his primary care physician, but the physician does not believe the test is in the patient's best interest. A woman with metastatic colon cancer has continued to progress on standard the ... Full text Cite

Who decides? Living donor liver transplantation for advanced hepatocellular carcinoma.

Journal Article Transplantation · November 2006 Few effective treatment options are available for patients with advanced hepatocellular carcinoma (HCC). Some transplant centers have begun offering living donor liver transplantation (LDLT) for selected patients whose HCC exceeds Milan criteria by a small ... Full text Cite

Tough questions, even harder answers.

Journal Article Journal of general internal medicine · November 2006 Full text Cite

Misremembering colostomies? Former patients give lower utility ratings than do current patients.

Journal Article Health psychology : official journal of the Division of Health Psychology, American Psychological Association · November 2006 Community members often evaluate health conditions more negatively than do the patients who have them. The authors investigated whether experience with a health condition reduces this discrepancy by surveying colostomy patients by mail (n = 195), some of w ... Full text Cite

Hope I die before I get old: Mispredicting happiness across the adult lifespan

Journal Article Journal of Happiness Studies · June 1, 2006 The tendency to overestimate the influence of circumstances on well-being has been demonstrated for a range of life events, but the perceived impact of aging on well-being has been largely overlooked. People seem to dread growing old, despite evidence that ... Full text Cite

A matter of perspective: choosing for others differs from choosing for yourself in making treatment decisions.

Journal Article Journal of general internal medicine · June 2006 BackgroundMany people display omission bias in medical decision making, accepting the risk of passive nonintervention rather than actively choosing interventions (such as vaccinations) that result in lower levels of risk.ObjectiveTesting ... Full text Cite

Why are you calling me? How study introductions change response patterns.

Journal Article Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · May 2006 PurposeResearch on survey methodology has demonstrated that seemingly innocuous aspects of a survey's design, such as the order of questions, can produce biased results. The current investigation extends this work by testing whether standard surve ... Full text Cite

Can Avoidance of Complications Lead to Biased Healthcare Decisions?

Journal Article Judgment and decision making · 2006 Cite

Individualized survival curves improve satisfaction with cancer risk management decisions in women with BRCA1/2 mutations.

Journal Article Journal of clinical oncology : official journal of the American Society of Clinical Oncology · December 2005 PurposeWomen with BRCA1/2 mutations are faced with complex decisions about breast and ovarian cancer risk management. This study was conducted to determine the effect of a tailored decision support system (DSS) that provides individualized surviva ... Full text Cite

Do incentives matter? Providing benefits to families of organ donors.

Journal Article American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · December 2005 Whether the number of organs available for transplant would be positively or negatively affected by providing benefits to families of organ donors has been debated by policymakers, ethicists and the transplant community at large. We designed a telephone su ... Full text Cite

Trading people versus trading time: what is the difference?

Journal Article Population health metrics · November 2005 BackgroundPerson trade-off (PTO) elicitations yield different values than standard utility measures, such as time trade-off (TTO) elicitations. Some people believe this difference arises because the PTO captures the importance of distributive prin ... Full text Cite

Cure me even if it kills me: preferences for invasive cancer treatment.

Journal Article Medical decision making : an international journal of the Society for Medical Decision Making · November 2005 PurposeWhen making medical decisions, people often care not only about what happens but also about whether the outcome was a result of actions voluntarily taken or a result of inaction. This study assessed the proportion of people choosing nonopti ... Full text Cite

What is perfect health to an 85-year-old?: evidence for scale recalibration in subjective health ratings.

Journal Article Medical care · October 2005 BackgroundIf an 85-year-old man rates his health as 90 on a scale in which 100 represents "perfect health," would his rating mean the same thing as a 90 rating from a 25-year-old? We conducted a randomized trial of 3 different ways of eliciting su ... Full text Cite

Changing times, changing opinions: history informing the family presence debate.

Journal Article Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · October 2005 Full text Cite

Health, wealth, and happiness: financial resources buffer subjective well-being after the onset of a disability.

Journal Article Psychological science · September 2005 We examined the hypothesis that the relationship between financial status and subjective well-being, typically found to be very small in cross-sectional studies, is moderated by health status. Specifically, we predicted that wealth would buffer well-being ... Full text Cite

Reducing the influence of anecdotal reasoning on people's health care decisions: is a picture worth a thousand statistics?

Journal Article Medical decision making : an international journal of the Society for Medical Decision Making · July 2005 BackgroundPeople's treatment decisions are often influenced by anecdotal rather than statistical information. This can lead to patients making decisions based on others' experiences rather than on evidence-based medicine.Objective. To tes ... Full text Cite

Misimagining the unimaginable: the disability paradox and health care decision making.

Journal Article Health psychology : official journal of the Division of Health Psychology, American Psychological Association · July 2005 Good decision making often requires accurate predictions about how potential outcomes will make one feel. However, people often mispredict the emotional impact of unfamiliar circumstances. For example, they often overestimate the emotional impact that chro ... Full text Cite

The impact of considering adaptation in health state valuation.

Journal Article Social science & medicine (1982) · July 2005 Patients with chronic health conditions often rate their quality of life (QoL) significantly higher than non-patients. One explanation for this discrepancy is that non-patients focus on the negative aspects of the onset of a condition, especially the early ... Full text Cite

The importance of age in allocating health care resources: does intervention-type matter?

Journal Article Health economics · July 2005 BackgroundRecent proposals to reform cost-effectiveness analysis (CEA) by weighting health benefits [(Quality-adjusted life-years) QALYs] by recipients' age are based on studies examining age-related preferences in life-saving contexts. We investi ... Full text Cite

Disability and sunshine: can hedonic predictions be improved by drawing attention to focusing illusions or emotional adaptation?

Journal Article Journal of experimental psychology. Applied · June 2005 People frequently mispredict the long-term emotional impact of circumstances. The authors examine 2 causes of such mispredictions-a focusing illusion and underappreciation of adaptation. In Experiment 1, the authors found, in 852 adults, that quality of li ... Full text Cite

What's time got to do with it? Inattention to duration in interpretation of survival graphs.

Journal Article Risk analysis : an official publication of the Society for Risk Analysis · June 2005 Reports of randomized clinical trials often use survival curves to summarize clinical outcomes over time and graphically demonstrate evidence of treatment effectiveness. Survival curves can also be used in patient communications to display how health risks ... Full text Cite

How making a risk estimate can change the feel of that risk: shifting attitudes toward breast cancer risk in a general public survey.

Journal Article Patient education and counseling · June 2005 Counseling women about breast cancer risks has been found to decrease screening compliance. We investigated whether women's reactions to risk information are an artifact of requiring women to estimate the risk of breast cancer prior to receiving risk infor ... Full text Cite

Ignorance of hedonic adaptation to hemodialysis: a study using ecological momentary assessment.

Journal Article Journal of experimental psychology. General · February 2005 Healthy people generally underestimate the self-reported well-being of people with disabilities and serious illnesses. The cause of this discrepancy is in dispute, and the present study provides evidence for 2 causes. First, healthy people fail to anticipa ... Full text Cite

Thoughts on Koch's postulates

Journal Article Virtual Mentor · January 1, 2005 Full text Cite

Medical study: aspiring parents, genotypes and phenotypes: the unexamined myth of the perfect baby.

Journal Article Albany law review · January 2005 Although many have argued that assisted reproductive technologies ("ARTs") attract those with a desire to genetically engineer their offspring, this claim has yet to be verified. To address this question, we surveyed three groups: the general public, peopl ... Cite

Emotions, decisions, and the limits of rationality: symposium introduction.

Journal Article Medical decision making : an international journal of the Society for Medical Decision Making · January 2005 In this symposium, three speakers describe research that examines ways in which people's decision-making is affected by emotions. In his paper, Dr. Loewenstein describes research on the properties and effects of "projection bias," the tendency to allow one ... Full text Cite

In a mailed physician survey, questionnaire length had a threshold effect on response rate.

Journal Article Journal of clinical epidemiology · January 2005 ObjectiveTo examine the association between questionnaire length and response rate in a mailed survey of generalist physicians randomly selected from the American Medical Association master file.Study design and settingIn a pilot study, o ... Full text Cite

Do unmet expectations for specific tests, referrals, and new medications reduce patients' satisfaction?

Journal Article J Gen Intern Med · November 2004 BACKGROUND: Patient-centered care requires clinicians to recognize and act on patients' expectations. However, relatively little is known about the specific expectations patients bring to the primary care visit. OBJECTIVE: To describe the nature and preval ... Full text Link to item Cite

Altruism, incentives, and organ donation: attitudes of the transplant community.

Journal Article Medical care · April 2004 ObjectivesThis study investigated the attitudes of the transplant community toward the current policy of altruistic organ donation and 6 alternative policies offering incentives to the donor family.MethodsTwo hundred forty-nine transplant ... Full text Cite

Racial/ethnic disparities in the treatment of localized/regional prostate cancer.

Journal Article The Journal of urology · April 2004 PurposeRacial/ethnic disparities in the utilization of definitive therapy for prostate cancer are well recognized in the United States. The effect of race on the use of contemporary definitive therapies, including brachytherapy, and the assessment ... Full text Cite

The costs of denying scarcity.

Journal Article Archives of internal medicine · March 2004 Full text Cite

"Is 28% good or bad?" Evaluability and preference reversals in health care decisions.

Journal Article Medical decision making : an international journal of the Society for Medical Decision Making · March 2004 Choices of health care providers can become inconsistent when people lack sufficient context to assess the value of available information. In a series of surveys, general population samples were randomized to read descriptions of either 2 possible health c ... Full text Cite

Does competition for transplantable hearts encourage 'gaming' of the waiting list?

Journal Article Health affairs (Project Hope) · March 2004 Transplant centers may "game" the severity of listed patients to increase their patients' likelihood of receiving transplantable organs. Recent lawsuits allege gaming at some centers, and listing policies were modified in 1999 to clarify listing criteria. ... Full text Cite

The validity of person tradeoff measurements: randomized trial of computer elicitation versus face-to-face interview.

Journal Article Medical decision making : an international journal of the Society for Medical Decision Making · March 2004 Can person tradeoff (PTO) value judgments be elicited by a computer, or is a face-to-face interview needed? The authors randomly assigned 95 subjects to interview or computer methods for the PTO, a valuation measure that is often difficult for subjects. Th ... Full text Cite

Lying to insurance companies: the desire to deceive among physicians and the public.

Journal Article The American journal of bioethics : AJOB · January 2004 This study examines the public's and physicians' willingness to support deception of insurance companies in order to obtain necessary healthcare services and how this support varies based on perceptions of physicians' time pressures. Based on surveys of 70 ... Full text Cite

Misperceptions about beta-blockers and diuretics: a national survey of primary care physicians.

Journal Article Journal of general internal medicine · December 2003 BackgroundBased on a series of clinical trials showing no difference in the effectiveness or tolerability of most major classes of antihypertensive medications, the Joint National Commission on High Blood Pressure Treatment recommends that physici ... Full text Cite

When do patients and their physicians agree on diabetes treatment goals and strategies, and what difference does it make?

Journal Article Journal of general internal medicine · November 2003 BackgroundFor patients with chronic illnesses, it is hypothesized that effective patient-provider collaboration contributes to improved patient self-care by promoting greater agreement on patient-specific treatment goals and strategies. However, t ... Full text Cite

Effect of assessment method on the discrepancy between judgments of health disorders people have and do not have: a web study.

Journal Article Medical decision making : an international journal of the Society for Medical Decision Making · September 2003 Three experiments on the World Wide Web asked subjects to rate the severity of common health disorders such as acne or arthritis. People who had a disorder ("Haves") tended to rate it as less severe than people who did not have it ("Not-haves"). Two explan ... Full text Cite

Public response to cost-quality tradeoffs in clinical decisions.

Journal Article Medical decision making : an international journal of the Society for Medical Decision Making · September 2003 PurposeTo explore public attitudes toward the incorporation of cost-effectiveness analysis into clinical decisions.MethodsThe authors presented 781 jurors with a survey describing 1 of 6 clinical encounters in which a physician has to cho ... Full text Cite

Whose quality of life? A commentary exploring discrepancies between health state evaluations of patients and the general public.

Journal Article Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · September 2003 There is often a discrepancy between quality of life estimates from patients and the general public. These discrepancies are of concern to the disability community, who worry that the public does not understand how valuable life can be for people with disa ... Full text Cite

Setting organ allocation priorities: should we care what the public cares about?

Journal Article Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society · August 2003 ObjectiveTo investigate the nature of public preferences in the allocation of donor liver grafts for transplantation.DesignA qualitative study based upon the transcripts of four focus groups.SettingDerby, Derbyshire, UK.Parti ... Full text Cite

What is the price of life and why doesn't it increase at the rate of inflation?

Journal Article Archives of internal medicine · July 2003 Full text Cite

Surgical management of the rheumatoid hand: consensus and controversy among rheumatologists and hand surgeons.

Journal Article The Journal of rheumatology · July 2003 ObjectiveRheumatoid arthritis (RA) is a common cause of debilitating hand deformities, but management of these deformities is controversial, characterized by large variations in the surgical rates of common RA hand procedures. We conducted a natio ... Cite

When money is saved by reducing healthcare costs, where do US primary care physicians think the money goes?

Journal Article The American journal of managed care · June 2003 BackgroundPhysician willingness to reduce medical costs is mixed. Some physicians might be unwilling to reduce medical costs because they are concerned about where the savings would go.ObjectiveTo determine whether primary care physicians ... Cite

The influence of cost-effectiveness information on physicians' cancer screening recommendations.

Journal Article Social science & medicine (1982) · April 2003 Physicians are increasingly faced with choices in which one screening strategy is both more effective and more expensive than another. One way to make such choices is to examine the cost-effectiveness of the more costly strategy over the less costly one. H ... Full text Cite

Support for physician deception of insurance companies among a sample of Philadelphia residents.

Journal Article Annals of internal medicine · March 2003 BackgroundSome physicians seem to be willing to sanction deception of insurance companies. Little is known about public attitudes regarding this practice.ObjectiveTo assess public attitudes regarding physician deception of insurance compa ... Full text Cite

Comments to 'a note on cost-value analysis'

Journal Article Health Economics · March 1, 2003 Full text Cite

Don't ask, don't tell: a change in medical student attitudes after obstetrics/gynecology clerkships toward seeking consent for pelvic examinations on an anesthetized patient.

Journal Article American journal of obstetrics and gynecology · February 2003 ObjectiveWe explore whether the completion of an obstetrics/gynecology clerkship is associated with a decline in the importance that students place on seeking permission from the patient before conducting a pelvic examination while she is anesthet ... Full text Cite

Incremental and average cost-effectiveness ratios: will physicians make a distinction?

Journal Article Risk analysis : an official publication of the Society for Risk Analysis · February 2003 Physicians are increasingly asked to use cost-effectiveness information when evaluating alternative health care interventions. Little is known about how the way such information is presented can influence medical decision making. We presented physicians wi ... Full text Cite

Effectiveness of rheumatoid hand surgery: contrasting perceptions of hand surgeons and rheumatologists.

Journal Article The Journal of hand surgery · January 2003 PurposeSurgical management of rheumatoid hand diseases is controversial with large variation in practice pattern in the U.S. The purpose of this study is to evaluate the attitudes of hand surgeons and rheumatologists toward the effectiveness of rh ... Full text Cite

Responding to the immunoglobulin shortage: a case study.

Journal Article Journal of health politics, policy and law · December 2002 In fall 1997, a shortage of intravenous immunoglobulin (IVIG) developed in the United States because of increased demand for the product, reduced supply, and product recalls. This shortage is a useful model for understanding how our health care system resp ... Full text Cite

Organ transplantation in HIV-infected patients.

Journal Article The New England journal of medicine · November 2002 Full text Cite

Types of inconsistency in health-state utility judgments

Journal Article Organizational Behavior and Human Decision Processes · November 1, 2002 In making judgments of health-related quality of life, respondents often compare the relative magnitude of two intervals between health states, such as the interval between normal health and blindness compared to that between normal health and death. We ex ... Full text Cite

Is information always a good thing? Helping patients make "good" decisions.

Journal Article Medical care · September 2002 In most cases, patient preferences are crucial in making good health care decisions. For example, choices between chemotherapy and radiation treatment usually hinge on trade-offs that only patients can decide about. In recognition of the importance of pati ... Full text Cite

Randomized trial of 5 dollars versus 10 dollars monetary incentives, envelope size, and candy to increase physician response rates to mailed questionnaires.

Journal Article Medical care · September 2002 BackgroundThe validity of the results of mailed surveys is often threatened by nonresponse bias, which is made more likely when response rates are low. However, the effectiveness and cost-effectiveness of several strategies to increase response ra ... Full text Cite

Physicians' preferences for active-controlled versus placebo-controlled trials of new antihypertensive drugs.

Journal Article Journal of general internal medicine · September 2002 ObjectiveTo evaluate physicians' preferences for referring patients to, and using information from, active-controlled trials (ACTs) versus placebo-controlled trials (PCTs) of new antihypertensive drugs.Design and settingNationwide mailed ... Full text Cite

Exploring the role of order effects in person trade-off elicitations.

Journal Article Health policy (Amsterdam, Netherlands) · August 2002 BackgroundThe person trade-off (PTO) has been advocated by some as an alternative measure for the purposes of cost-effectiveness analyses. However, the measurement properties of PTO elicitations are still being defined.MethodsWe presented ... Full text Cite

Solid-organ transplantation in HIV-infected patients.

Journal Article The New England journal of medicine · July 2002 Full text Cite

Interest in BRCA1/2 testing in a primary care population.

Journal Article Preventive medicine · June 2002 BackgroundMutations in the breast cancer susceptibility genes BRCA1 and BRCA2 are found in less than 1/1,000 women in the general population. Experts and professional organizations recommend targeting testing to women with risk factors for carryin ... Full text Cite

Fear of litigation may increase resuscitation of infants born near the limits of viability.

Journal Article The Journal of pediatrics · June 2002 ObjectivesTo explore how fear of litigation influences neonatal treatment decisions.Study designIn a mailed survey, we presented a hypothetical vignette of a premature infant to 1000 neonatologists. We asked them to estimate prognosis, in ... Full text Cite

The "Hassle Factor": what motivates physicians to manipulate reimbursement rules?

Journal Article Archives of internal medicine · May 2002 BackgroundSome physicians are willing to misrepresent clinical information to insurance companies to circumvent appeals processes. Whether characteristics of appeals processes affect the likelihood of misrepresentation is unknown. This study sough ... Full text Cite

The role of physicians' recommendations in medical treatment decisions.

Journal Article Medical decision making : an international journal of the Society for Medical Decision Making · May 2002 BackgroundA shift away from the medical paternalism of the past has occurred, and today, the law and ethics advocate that physicians share decision-making responsibility with their patients. It is unclear, however, what the appropriate role of phy ... Full text Cite

Effect of framing as gain versus loss on understanding and hypothetical treatment choices: survival and mortality curves.

Journal Article Medical decision making : an international journal of the Society for Medical Decision Making · January 2002 BackgroundPresentation of information using survival or mortality (i.e., incidence) curves offers a potentially powerful method of communication because such curves provide information about risk over time in a relatively simple graphic format. Ho ... Full text Cite

Physicians' willingness to participate in the process of lethal injection for capital punishment.

Journal Article Annals of internal medicine · November 2001 BackgroundIt has been found that physicians condone colleague involvement in capital punishment. Physicians' own willingness to participate has not been explored.ObjectiveTo examine physicians' willingness to be involved in cases of capit ... Full text Cite

Between two worlds medical student perceptions of humor and slang in the hospital setting.

Journal Article Journal of general internal medicine · August 2001 ObjectiveResidents frequently use humor and slang at the expense of patients on the clinical wards. We studied how medical students react to and interpret the "appropriateness" of derogatory and cynical humor and slang in a clinical setting.De ... Full text Cite

Who will enroll? Predicting participation in a phase II AIDS vaccine trial.

Journal Article Journal of acquired immune deficiency syndromes (1999) · July 2001 BackgroundThe problems of underenrollment and selective enrollment may undermine AIDS vaccine trials. If prospective study subjects' stated willingness to participate (WTP) in hypothetical vaccine trials predicts future enrollment, then measuring ... Full text Cite

Using survival curve comparisons to inform patient decision making can a practice exercise improve understanding?

Journal Article Journal of general internal medicine · July 2001 BackgroundPatients often face medical decisions that involve outcomes that occur and change over time. Survival curves are a promising communication tool for patient decision support because they present information about the probability of an out ... Full text Cite

Revising a priority list based on cost-effectiveness: the role of the prominence effect and distorted utility judgments.

Journal Article Medical decision making : an international journal of the Society for Medical Decision Making · July 2001 BackgroundPeople sometimes object to the results of cost-effectiveness analysis when the analysis produces a ranking of options based on both cost and benefit. We suggest 2 new reasons for these objections: the prominence effect, in which people a ... Full text Cite

Allocation of transplantable organs: do people want to punish patients for causing their illness?

Journal Article Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society · July 2001 Some people believe patients with alcoholic cirrhosis should not receive equal priority for scarce transplantable organs. This may reflect a belief that these patients (1) are personally responsible for causing their own illnesses, (2) have poor transplant ... Full text Cite

Truth in the most optimistic way.

Journal Article Annals of internal medicine · June 2001 Full text Cite

Do nonpatients underestimate the quality of life associated with chronic health conditions because of a focusing illusion?

Journal Article Medical decision making : an international journal of the Society for Medical Decision Making · May 2001 BackgroundA number of studies show that the general public often estimates that the quality of life (QOL) associated with various health conditions is worse than patients say it is. These studies raise the possibility that people overestimate the ... Full text Cite

Preference for equity as a framing effect.

Journal Article Medical decision making : an international journal of the Society for Medical Decision Making · May 2001 BackgroundIn previous studies, the authors found that most people, given a fixed budget, would rather offer a less effective screening test to 100% of a Medicaid population than a more effective test to 50% of the population. In a subsequent study ... Full text Cite

Money talks, patients walk?

Journal Article Journal of general internal medicine · March 2001 Full text Cite

Measuring patient expectations: does the instrument affect satisfaction or expectations?

Journal Article Medical care · January 2001 BackgroundFulfillment of patients' expectations may influence health care utilization, affect patient satisfaction, and be used to indicate quality of care. Several different instruments have been used to measure expectations, yet little is known ... Full text Cite

Rationing HIV medications: what do patients and the public think about allocation policies?

Journal Article Journal of acquired immune deficiency syndromes (1999) · January 2001 BackgroundNew medications for treating HIV/AIDS are effective, but expensive, and funding shortfalls have led many state AIDS Drug Assistance Programs (ADAPs) to ration these drugs. Little is known about the views of those most directly affected b ... Full text Cite

Barriers to influenza immunization in a low-income urban population.

Journal Article American journal of preventive medicine · January 2001 BackgroundAlthough influenza immunization significantly reduces mortality from influenza, over one third of elderly Americans are not immunized each year. Low rates of immunization are particularly concerning among African-American low-income popu ... Full text Cite

The inclusion of patient testimonials in decision aids: effects on treatment choices.

Journal Article Medical decision making : an international journal of the Society for Medical Decision Making · January 2001 BackgroundDecision aids often provide statistical information and patient testimonials to guide treatment choices. This raises the possibility that the testimonials will overwhelm the statistical information.MethodsProspective jurors in P ... Full text Cite

Analog scale, magnitude estimation, and person trade-off as measures of health utility: Biases and their correction

Journal Article Journal of Behavioral Decision Making · January 1, 2001 Subjects judged the disutility of health conditions (e.g. blindness) using one of them (e.g. blindness+deafness) as a standard, using three elicitation methods: analog scale (AS, how bad is blindness compared to blindness+deafness?); magnitude estimation ( ... Full text Cite

Physicians, thou shalt ration: the necessary role of bedside rationing in controlling healthcare costs.

Journal Article HealthcarePapers · January 2001 Physicians are often asked to be "gatekeepers," determining their patients' access to medical therapies and technologies. At the same time, most physicians have been taught that they should act as patient advocates, pursuing patients' best interests regard ... Full text Cite

Finding a place for public preferences in liver allocation decisions.

Journal Article Transplantation · November 2000 Over the last decade there have been major advances in all aspects of liver transplantation with the consequence that the number of patients who could benefit from the procedure is increasing. As a result, the number of patients listed for liver transplant ... Full text Cite

Physicians' attitudes about involvement in lethal injection for capital punishment.

Journal Article Archives of internal medicine · October 2000 BackgroundPhysicians could play various roles in carrying out capital punishment via lethal injection. Medical societies like the American Medical Association (AMA) and American College of Physicians have established which roles are acceptable and ... Full text Cite

The Nature and Prevalence of Patient Expectations in a VA General Medicine Clinic

Journal Article Journal of General Internal Medicine · October 2000 Full text Cite

Improving value measurement in cost-effectiveness analysis.

Journal Article Medical care · September 2000 ObjectiveBefore cost-effectiveness analysis (CEA) can fulfill its promise as a tool to guide health care allocation decisions, the method of incorporating societal values into CEA may need to be improved.DesignThe study design was a decla ... Full text Cite

Lying to each other: when internal medicine residents use deception with their colleagues.

Journal Article Archives of internal medicine · August 2000 BackgroundWhile lying is morally problematic, physicians have been known to use deception with their patients and with third parties. Little is known, however, about the use of deception between physicians.ObjectivesTo determine the likel ... Full text Cite

Beliefs about breast cancer risk and use of postmenopausal hormone replacement therapy.

Journal Article Medical decision making : an international journal of the Society for Medical Decision Making · July 2000 BackgroundPostmenopausal hormone replacement therapy (HRT) decreases the risks of coronary heart disease and osteoporosis, but increases the risk of breast cancer. Although only 20-30% of postmenopausal women in the United States take HRT, the rel ... Full text Cite

Understanding racial variation in the use of coronary revascularization procedures: the role of clinical factors.

Journal Article Archives of internal medicine · May 2000 BackgroundBlack patients undergo coronary artery bypass grafting and percutaneous transluminal coronary angioplasty less often than white patients. It is unclear how racial differences in clinical factors contribute to this variation.Methods Full text Cite

Are preferences for equity over efficiency in health care allocation "all or nothing"?

Journal Article Medical care · April 2000 BackgroundIn a previous study we showed that within a budget constraint, most people would rather offer a less effective screening test to 100% of a Medicaid population, thereby saving 1,000 lives, than a more effective test to 50% of the populati ... Full text Cite

Spiritual values in the setting of health care priorities.

Journal Article Kennedy Institute of Ethics journal · March 2000 Cite

Societal value, the person trade-off, and the dilemma of whose values to measure for cost-effectiveness analysis.

Journal Article Health economics · March 2000 In a previous paper, it was argued that Societal Value measurement through person trade-off (PTO) elicitation offers a way to include the values of both general public and patients into cost-effectiveness analysis (CEA). It was said that patients' values c ... Full text Cite

Are patients willing to participate in medical education?

Journal Article The Journal of clinical ethics · January 2000 Cite

Further explorations of medical decisions for individuals and for groups.

Journal Article Medical decision making : an international journal of the Society for Medical Decision Making · January 2000 BackgroundImportant discrepancies between clinical practice and health policy may be related to the ways in which physicians and others make decisions about individuals and groups. Previous research has found that physicians and laypersons asked t ... Full text Cite

Educational content and the effectiveness of influenza vaccination reminders.

Journal Article Journal of general internal medicine · November 1999 ObjectiveTo determine if a mailed patient education brochure (addressing demonstrated reasons for vaccination refusal) would result in a higher rate of influenza vaccination than a mailed postcard reminder without educational content.Design Full text Cite

How stable are people's preferences for giving priority to severely ill patients?

Journal Article Social science & medicine (1982) · October 1999 BackgroundPrevious studies have suggested that people favor allocating resources to severely ill patients even when they benefit less from treatment than do less severely ill patients. This study explores the stability of people's preferences for ... Full text Cite

The challenge of measuring community values in ways appropriate for setting health care priorities.

Journal Article Kennedy Institute of Ethics journal · September 1999 The move from a notion that community values ought to play a role in health care decision making to the creation of health care policies that in some way reflect such values is a challenging one. No single method will adequately measure community values in ... Full text Cite

Erosion in medical students' attitudes about telling patients they are students.

Journal Article Journal of general internal medicine · August 1999 ObjectiveTo study the attitudes of preclinical and clinical medical students toward the importance of telling patients they are students, and to compare their attitudes with those of patients.MethodsWe conducted a cross-sectional survey o ... Full text Cite

Toward a broader view of values in cost-effectiveness analysis of health.

Journal Article The Hastings Center report · May 1999 Full text Cite

Geographic favoritism in liver transplantation.

Journal Article The New England journal of medicine · March 1999 Full text Cite

Incorporating societal concerns for fairness in numerical valuations of health programmes.

Journal Article Health economics · February 1999 The paper addresses some limitations of the QALY approach and outlines a valuation procedure that may overcome these limitations. In particular, we focus on the following issues: the distinction between assessing individual utility and assessing societal v ... Full text Cite

Life-saving treatments and disabilities. Are all QALYs created equal?

Journal Article International journal of technology assessment in health care · January 1999 ObjectivesDecision-makers and the general public are often reluctant to adopt policy recommendations based exclusively upon cost-utility analyses. One possible reason explored here is that patients' previous health state before experiencing the on ... Cite

Geographic favoritism in liver transplantation--unfortunate or unfair?

Journal Article The New England journal of medicine · October 1998 Full text Cite

Does bedside rationing violate patients' best interests? An exploration of "moral hazard".

Journal Article The American journal of medicine · October 1998 Cite

Encourage qualitative research to improve students' clinical skills!

Journal Article Academic medicine : journal of the Association of American Medical Colleges · September 1998 Full text Cite

Physicians' experiences with patient-initiated health insurance fraud.

Journal Article Delaware medical journal · July 1998 Cite

Medical student name tags.

Journal Article Journal of general internal medicine · April 1998 Full text Cite

Public preferences for prevention versus cure: what if an ounce of prevention is worth only an ounce of cure?

Journal Article Medical decision making : an international journal of the Society for Medical Decision Making · April 1998 BackgroundThe belief that small preventive efforts bring large benefits may explain why many people say they value prevention above all other types of health care. However, it often takes a great deal of preventive medicine to prevent a bad outcom ... Full text Cite

'Rationing' health care. Not all definitions are created equal.

Journal Article Archives of internal medicine · February 1998 Full text Cite

Value measurement in cost-utility analysis: explaining the discrepancy between rating scale and person trade-off elicitations.

Journal Article Health policy (Amsterdam, Netherlands) · January 1998 Previous studies have shown a discrepancy between common utility elicitation methods, such as rating scale (RS) elicitations, and person trade-off (PTO) elicitations. This discrepancy has generally been felt to be due to the fact that RS elicitations ask p ... Full text Cite

Conducting physician mail surveys on a limited budget. A randomized trial comparing $2 bill versus $5 bill incentives.

Journal Article Medical care · January 1998 ObjectivesThe effects of incentive size on physicians' response rates to a mail survey were determined.MethodsOne thousand US primary care physicians were assigned randomly to receive a survey with either a $5 bill or a $2 bill as an ince ... Full text Cite

How preliminary data affect people's stated willingness to enter a hypothetical randomized controlled trial.

Journal Article Journal of investigative medicine : the official publication of the American Federation for Clinical Research · December 1997 PurposeTo explore how preliminary trial data affect the general public's stated willingness to enter a randomized clinical trial.MethodsWe asked 165 prospective jurors to imagine that their physicians wanted them to enroll in a clinical t ... Cite

Rationing by any other name.

Journal Article The New England journal of medicine · November 1997 Full text Cite

Medical student name tags: identification or obfuscation?

Journal Article Journal of general internal medicine · November 1997 ObjectiveTo explore how U.S. medical students doing clinical rotations are physically identified to patients via their name tags, and how patients interpret the educational status conveyed by those name tags.Measurements and main resultsA ... Full text Cite

Kidney transplant candidates' views of the transplant allocation system.

Journal Article Journal of general internal medicine · August 1997 ObjectivesThe point system used to distribute scarce transplantable kidneys places great emphasis on antigen matching. This contributes to increased waiting times for African Americans, who have a disproportionate share of rare antigens. We conduc ... Full text Cite

Rationing by any other name.

Journal Article The New England journal of medicine · June 1997 Full text Cite

Transplantation in alcoholics: separating prognosis and responsibility from social biases.

Journal Article Liver transplantation and surgery : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society · May 1997 The general public does not favor transplanting livers into patients with alcoholic cirrhosis. This opinion may reflect a sense that we should not distribute scarce resources to people who are personally responsible for their illness. It may also reflect a ... Cite

The role of decision analysis in informed consent: choosing between intuition and systematicity.

Journal Article Social science & medicine (1982) · March 1997 An important goal of informed consent is to present information to patients so that they can decide which medical option is best for them, according to their values. Research in cognitive psychology has shown that people are rapidly overwhelmed by having t ... Full text Cite

Confidentiality and health insurance fraud.

Journal Article Archives of internal medicine · March 1997 BackgroundHealth insurance fraud committed by patients may be an increasing problem given the number of underinsured and uninsured people in the United States. Physicians recognizing acts of health insurance fraud perpetrated by patients face an e ... Full text Cite

Recognizing bedside rationing: clear cases and tough calls.

Journal Article Annals of internal medicine · January 1997 Under increasing pressure to contain medical costs, physicians find themselves wondering whether it is ever proper to ration health care at the bedside. Opinion about this is divided, but one thing is clear; Whether physicians should ration at the bedside ... Full text Cite

Semantic and moral debates about hastening death: a survey of bioethicists.

Journal Article The Journal of clinical ethics · January 1997 Cite

Helping physicians recognize bedside rationing [9] (multiple letters)

Journal Article Annals of Internal Medicine · January 1, 1997 Full text Cite

Managed care organizations should not disclose their physicians' financial incentives.

Journal Article The American journal of managed care · January 1997 Cite

Cost-effectiveness analysis and budget constraints.

Journal Article The New England journal of medicine · November 1996 Full text Cite

Public perceptions of the importance of prognosis in allocating transplantable livers to children.

Journal Article Medical decision making : an international journal of the Society for Medical Decision Making · July 1996 BackgroundThe system to allocate scarce transplantable livers has been criticized for not giving enough weight to the prognoses of the patients receiving the transplants, but little research has been done looking at how the public weights the rela ... Full text Cite

Safety of dapsone as Pneumocystis carinii pneumonia prophylaxis in human immunodeficiency virus-infected patients with allergy to trimethoprim/sulfamethoxazole.

Journal Article The American journal of medicine · June 1996 ObjectiveTo assess the safety of dapsone prophylaxis of Pneumocystis carinii pneumonia (PCP) in patients with prior intolerance to trimethoprim/sulfamethoxazole (TMP/SMX).MethodsWe conducted a retrospective study in the categorical human ... Full text Cite

The public's preference for bedside rationing.

Journal Article Archives of internal medicine · June 1996 Full text Cite

Informed consent. From bodily invasion to the seemingly mundane.

Journal Article Archives of internal medicine · June 1996 Full text Cite

Cost-effectiveness analysis in a setting of budget constraints--is it equitable?

Journal Article The New England journal of medicine · May 1996 BackgroundOne of the promises of cost-effective analysis is that it can demonstrate how to maximize health benefits attainable within a specific limited budget. Many people argue, however, that when there are budget limitations, the use of cost-ef ... Full text Cite

Distributing scarce livers: the moral reasoning of the general public.

Journal Article Social science & medicine (1982) · April 1996 The transplant system has been criticized for not paying enough attention to efficiency in distributing scarce organs. But little research has been done to see how the general public views tradeoffs between efficiency and equity. We surveyed members of the ... Full text Cite

Individual utilities are inconsistent with rationing choices: A partial explanation of why Oregon's cost-effectiveness list failed.

Journal Article Medical decision making : an international journal of the Society for Medical Decision Making · April 1996 ObjectiveTo test whether cost-effectiveness analysis and present methods of eliciting health condition "utilities" capture the public's values for health care rationing.DesignTwo surveys of economics students. The first survey measured th ... Full text Cite

Can We Continue to Afford Organ Transplants in an Era of Managed Care?

Journal Article American Journal of Managed Care · 1996 Cite

Acceptance of external funds by physician organizations: issues and policy options.

Journal Article Journal of general internal medicine · November 1995 Full text Cite

The efficacy and equity of retransplantation: an experimental survey of public attitudes.

Journal Article Health policy (Amsterdam, Netherlands) · November 1995 PurposeTo measure the relative importance people place on prognosis and retransplantation status in allocating scarce transplantable livers.Methods138 subjects were asked to distribute scarce livers amongst transplant candidates with eith ... Full text Cite

The unbearable rightness of bedside rationing. Physician duties in a climate of cost containment.

Journal Article Archives of internal medicine · September 1995 A local internist is in the process of ordering an intravenous pyelogram for a patient she suspects of having kidney problems, when a medical student shadowing her in clinic interrupts. The student wants to know why the physician is not ordering a low-osmo ... Full text Cite

Elevator talk: observational study of inappropriate comments in a public space.

Journal Article The American journal of medicine · August 1995 ObjectivesWe conducted a study to determine the type and frequency of inappropriate comments made by hospital employees while riding hospital elevators.MethodsFour observers rode in elevators at five hospitals, listening for any comments ... Full text Cite

Doctor talk: technology and modern conversation.

Journal Article The American journal of medicine · June 1995 Full text Cite

Fever: blessing or curse?

Journal Article Annals of internal medicine · December 1994 Full text Cite

Retransplantation of scarce organs: The ethical lessons [1]

Journal Article Journal of the American Medical Association · 1994 Cite

Rationing failure. The ethical lessons of the retransplantation of scarce vital organs.

Journal Article JAMA · November 1993 Because of a shortage of transplantable livers and hearts, the transplant community has had to decide--by who gets an organ--who lives or dies. Despite this shortage, whether one has previously received a transplant is not used as a criterion to distribute ... Full text Cite

Assisted suicide and the case of Dr. Quill and Diane.

Journal Article Issues in law & medicine · January 1993 Cite

Third-party payers and investigational therapy.

Journal Article The New England journal of medicine · November 1988 Full text Cite