Peter Ubel

..On balance, the available evidence suggests that, whereas patients misreport their well-being, healthy people also mispredict the emotional impact that chronic illness and disability will have on their lives...

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..The persistent use of these agents raises questions as to whether physicians perceive ACE inhibitors and calcium channel blockers to be better than beta-blockers and diuretics...

..Physicians are relatively reluctant to abandon common screening strategies, even when they learn that they are expensive, and are hesitant to adopt unfamiliar screening strategies, even when they learn that they are inexpensive...

..g., scale recalibration) with true causes of changing QoL (e.g., hedonic adaptation). We propose abandoning the term response shift, in favor of less ambiguous terms, like scale recalibration and adaptation...

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..In this article, I describe some of these contextual factors, and lay out the challenges these factors raise for clinicians' efforts to help their patients make informed decisions...

..The 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...

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..In this article, 2 new studies are reported that explore whether people's preferences for equity versus efficiency are susceptible to a framing effect...

..Decisions about whose values to measure for the purposes of economic analyses, and how to measure discrepancies, should take these potential contributing factors into account...

..Previous 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...

..To explore public attitudes toward the incorporation of cost-effectiveness analysis into clinical decisions...

..The authors surveyed kidney transplant patients, both before and after transplant, to test whether they would overestimate the benefits of a successful transplant for their quality of life...

..This 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...

..Helping valued loved ones may promote caregivers' well-being...

..To evaluate the ability of six graph formats to impart knowledge about treatment risks/benefits to low and high numeracy individuals...

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..Understanding the effect of asymmetry on psychosocial functioning is essential for patients to make an informed choice for surgery...

..In 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...

..Presenting adverse reaction risks in this manner may improve patient comprehension of the effects of treatment decisions and support effective risk communication...

..To review research from the behavioral sciences that demonstrates how predictions of future events--and memories of past events--are often systematically biased...

..The authors explore whether people would be more willing to make tradeoffs if the focus was changed from trading off groups of patients to choosing the best decision or evaluating treatment benefits...

..To test whether providing comparative risk information changes risk perceptions...

..To summarize existing research on individual numeracy and methods for presenting risk information to patients...

..Basic 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...

..We conclude with a call for expanded research into developing new tools for quantifying health-related quality of life that are more valid, more sensitive to changes in health status, and less biased...

..We sought to estimate the accuracy with which women were able to predict their final parity...

..Yet no study has specifically examined how and when a representative sample of patients considered, discussed, and made medical decisions...

..The graphical format typically displays 4 outcomes simultaneously: survival, mortality due to cancer, other-cause mortality, and incremental survival due to adjuvant treatment...

..Decision aids (DAs) offer a promising method of helping them make this decision. But concern lingers that DAs might introduce cognitive biases...

..Concerns 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...

..Based on prior research and theorizing, the authors hypothesized that, paradoxically, those with irreversible colostomies would adapt more fully, and become happier, than would those with colostomies that were potentially reversible...

..After viewing the DA, women demonstrated good understanding of tamoxifen's risks and benefits, but most were not interested in taking tamoxifen for breast cancer chemoprevention...

..We sought to discuss and put into context several lines of research that have explored the links between emotion and risk perceptions...

..Relationships 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...

..These findings suggest that it may be premature to conclude that health risks for caregivers are due to providing active help. Indeed, under some circumstances, caregivers may actually benefit from providing care...

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..However, the graphical format used to display these results (a set of 4 horizontal stacked bars) may be suboptimal. The authors tested whether using simpler formats would improve comprehension of the relevant risk statistics...

..We aimed to determine whether implementation of MELD affected the quality of organs transplanted, the type of patients who receive the higher-risk organs, and the impact of these changes on their posttransplant survival...

..Adequate representation of women in research has been deemed essential...

..In this study, the authors examine a method to incorporate competing ethical principles in a decision analysis of liver transplantation for a patient with acute liver failure (ALF)...

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..However, this hypothesis has not been tested in actual encounters of patients with their own physicians...

..9 v. 6.7, P = 0.051). The results suggest that clinicians and developers of patient information materials alike should consider information evaluability when deciding how to present health care options to patients...

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..Our findings suggest that asking non-patients to do an adaptation exercise before giving QoL ratings may help close the gap in ratings between patients and citizen non-patients...

..001). Asking people to estimate risks influenced their subsequent perceptions of the risk of breast cancer...

..g., in the title) and remind readers that attending to graph axis labels is the only way to pierce these visual illusions...

..People'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...

..We also found some evidence that the buffering effect of wealth faded with time, as below-median participants recovered some of their well-being...

..We conducted a national survey evaluating potential differences in physicians' management of RA hand deformities...

..Many 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...

..The current investigation extends this work by testing whether standard survey introductions alter the observed associations between variables...

..We tested whether adding interpretive labels (eg, "negative test") to prenatal genetic screening test results changes perceived risk and preferences for amniocentesis...

..This study assessed the proportion of people choosing nonoptimal treatments (treatments which reduced survival chances) when presented with hypothetical cancer scenarios which varied by outcome cause...

..We then use 2 ongoing behavioral intervention projects to illustrate the usefulness of FFDs. FFDs should be supplemented with follow-up experiments in the refining phase so any critical assumptions about interactions can be verified...

..The objective of this study is to assess, at discharge, patients' comprehension of their ED care and instructions and their awareness of deficiencies in their comprehension...

..This relative negativity in controls' estimates of their own moods could also contribute to their underestimation of the moods and overall well-being of patients...

..CONCLUSIONS: Rheumatologists view rheumatoid hand surgery as significantly less effective than do hand surgeons, which highlights the disagreements between the 2 specialties about the management of this clinical problem...

..The narrative also increased risk perception for colorectal cancer and interest in screening in the next year...

..Subjects made, on average, equally consistent judgments for the 3 comparisons. A computerized PTO elicitation protocol produced results of similar quality to that of a face-to-face interview...

..This study sought to determine the relationship between the likelihood of a successful appeal, appeals process length, and severity of the health condition and physicians' willingness to sanction deception...

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..Some physicians seem to be willing to sanction deception of insurance companies. Little is known about public attitudes regarding this practice...

..Physician 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...

..To evaluate physicians' preferences for referring patients to, and using information from, active-controlled trials (ACTs) versus placebo-controlled trials (PCTs) of new antihypertensive drugs...

..It is unclear, however, what the appropriate role of physicians' recommendations ought to be in this new shared decision-making paradigm. One way to approach this question is to assess the influence of physicians' recommendations...

..However, the effect of framing as survival versus mortality on understanding and treatment choice is not known...

..Second, the authors argue that the goal of reducing decisional conflict is conceptually untenable and propose that it be eliminated as an objective of decision aids...

..This study was conducted to determine the effect of a tailored decision support system (DSS) that provides individualized survival and cancer incidence curves specific to expected outcomes of alternative management strategies...

..To 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...

..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...

..We investigated whether the perceived importance of age in resource allocation decisions differs among intervention-types...

..The discrepancy varied in size and direction across disorders. Subjects also thought that they would be less affected than others...

..The authors provide examples, discuss implications of their findings for medical decision-making, and describe strategies that we might employ to minimize or eliminate the biases that might be introduced into decision-making processes...

..044). CONCLUSIONS: There is a strong disposition among neonatologists toward respecting parental wishes. This disposition is stronger when neonatologists are given additional reason to be concerned about litigation...

..To investigate the nature of public preferences in the allocation of donor liver grafts for transplantation...

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..This work is essential to ensuring that patients are fully informed and able to participate in decision making regarding their medical care. ..

..This work is essential to ensuring that patients are fully informed and able to participate in decision making regarding their medical care. ..

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..It is not clear how the quality of life, and comorbidity measures will be used in these models. ..

..The goal is to evaluate whether PTO determinations can be an effective solution to the problems that arise when conventional utility assessment is applied to the evaluation of health care programs for the elderly and disabled. ..

..This work is essential to ensuring that patients are fully informed and able to participate in decision making regarding their medical care. ..