Medical Decision Making

How health professionals and patients make treatment decisions, and the barriers to, and facilitators of, effective decision making.

Rise of the Machines in Health Care?

Feb. 22, 2019

Artificial intelligence (AI) is moving fast and breaking things everywhere. It is built into multinational supply chains, web-based services, cars, and, slowly, health care. Although the adoption of AI in health care has been bumpy, it continues unabated. Last year, the U.S.

Measuring Emergency Care Survival: The Implications of Risk-Adjusting for Race and Poverty

Jun. 20, 2018

Kimon L.H. Ioannides, Avi Baehr, David N. Karp, Douglas J. Wiebe, Brendan G. Carr,...

ABSTRACT [FROM JOURNAL]

Objectives: We determined the impact of including race, ethnicity, and poverty in risk adjustment models for emergency care sensitive conditions mortality that could be used for hospital pay‐for‐performance initiatives. We hypothesized that adjusting for race, ethnicity, and poverty would bolster rankings for hospitals that cared for a disproportionate share of non‐white, Hispanic, or poor patients.

Methods: We performed a cross‐sectional analysis

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Head and Neck Cancer in the Elderly: Frailty, Shared Decisions, and Avoidance of Low Value Care

Leila J. Mady, MD, PhD, MPH
Feb. 22, 2018

Leila J. Mady, Marci L. Nilsen, Jonas T. Johnson

Abstract [from journal]

Head and neck cancer (HNC) is a disease of older adults. Recurrent and metastatic head and neck squamous cell carcinoma portends a poor prognosis, with median overall survival of less than 12 months. Within this vulnerable population, significant treatment-related toxicities and physical and psychosocial sequelae can be devastating to quality of life at the end of life. Shared decision making and early comprehensive palliative and support services are at the crux of the approach to older adults with HNC. In doing so, low-value care

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When Physicians Support Financial Penalties to Reduce Low-Value Care (and When They Don’t)

Dec. 16, 2017

Despite professional consensus, guidelines, and national campaigns, physicians continue to provide many low-value services. These services are defined as having little to no benefit, little benefit relative to their cost, or outsized potential harm compared to their benefit. Policies have tried to promote high-value care by altering physician compensation, but have had limited success in part because they are rarely based on theories of physician behavior.

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