MDM Policy and Practice最新文献

{"title":"Learning from the Past to Guide the Future of Research on Risk Communication.","authors":"Kevin E Tiede","doi":"10.1177/23814683251314517","DOIUrl":"10.1177/23814683251314517","url":null,"abstract":"","PeriodicalId":36567,"journal":{"name":"MDM Policy and Practice","volume":"10 1","pages":"23814683251314517"},"PeriodicalIF":1.9,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11848869/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How to Make Sense of the Making Numbers Meaningful Systematic Review.","authors":"Brian J Zikmund-Fisher, Jessica S Ancker","doi":"10.1177/23814683241312337","DOIUrl":"10.1177/23814683241312337","url":null,"abstract":"","PeriodicalId":36567,"journal":{"name":"MDM Policy and Practice","volume":"10 1","pages":"23814683241312337"},"PeriodicalIF":1.9,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11848870/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tolerating Uncertainty About the Communication of Risk.","authors":"Paul K J Han","doi":"10.1177/23814683251314784","DOIUrl":"10.1177/23814683251314784","url":null,"abstract":"","PeriodicalId":36567,"journal":{"name":"MDM Policy and Practice","volume":"10 1","pages":"23814683251314784"},"PeriodicalIF":1.9,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11848874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143492542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reflecting on the Universal Meaning of Numbers in Health and Risk Communication.","authors":"Marilyn M Schapira","doi":"10.1177/23814683251314519","DOIUrl":"10.1177/23814683251314519","url":null,"abstract":"","PeriodicalId":36567,"journal":{"name":"MDM Policy and Practice","volume":"10 1","pages":"23814683251314519"},"PeriodicalIF":1.9,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11848865/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How Difference Tasks Are Affected by Probability Format, Part 2: A Making Numbers Meaningful Systematic Review.","authors":"Natalie C Benda, Brian J Zikmund-Fisher, Mohit M Sharma, Stephen B Johnson, Michelle Demetres, Diana Delgado, Jessica S Ancker","doi":"10.1177/23814683241310242","DOIUrl":"https://doi.org/10.1177/23814683241310242","url":null,"abstract":"<p><p><b>Background.</b> To evaluate the effect of data presentation format on communication of health probabilities, the Making Numbers Meaningful team undertook a systematic review. <b>Purpose.</b> This article presents evidence about difference tasks, in which a reader examines information to evaluate differences between probabilities, such as the effect of a therapy on the chance of recurrence. This article covers the effect of format on 5 outcomes: 1) perceptions of or feelings about effectiveness, 2) behavioral intentions or behaviors, 3) trust, 4) preference for the format, and 5) discrimination. <b>Data Sources.</b> MEDLINE, Embase, CINAHL, the Cochrane Library, PsycINFO, ERIC, ACM Digital Library; hand search. <b>Finding Selection.</b> Experimental/quasi-experimental studies comparing 2 or more formats for presenting quantitative health information. This article covers 205 findings from 101 unique studies reported in 84 articles. <b>Data Extraction.</b> Dual extraction of information on stimulus, task, and perceptual, affective, cognitive, and behavioral outcomes. <b>Data Synthesis.</b> Evidence is moderate to strong that behavioral intention is affected more by relative differences than absolute ones, by numerator-only graphics than part-to-whole graphics, by messages with anecdotes than without, and by information about what others chose. Evidence is strong that perceived and felt effectiveness is affected more by relative differences than by absolute ones and more by numerator-only graphics rather than part-to-whole graphics. For graphic preferences, bar charts were preferred to icon arrays and graphics with data labels to graphics without. Other comparisons had weak or insufficient evidence. <b>Limitations.</b> The detailed approach to evidence syntheses provides narrowly targeted evidence rather than broad statements. <b>Conclusions.</b> Moderate to strong evidence can be derived on effects of probability difference format on behavioral intention, perceived or felt effectiveness, and preference for format.</p><p><strong>Highlights: </strong>Communicating relative risk differences as opposed to absolute risk differences, using numerator-only instead of part-to-whole graphics, and including anecdotes or information about others' decisions will all increase intentions to engage in a behavior.Relative risks (rather than absolute risk differences) and numerator-only graphics (rather than part-to-whole) will also increase felt and perceived effectiveness.To illustrate probability differences, people tend to prefer bar charts over icon arrays and graphics with labels over those without.All findings regarding the impact of different presentation formats for probability differences on trust produced insufficient evidence.</p>","PeriodicalId":36567,"journal":{"name":"MDM Policy and Practice","volume":"10 1","pages":"23814683241310242"},"PeriodicalIF":1.9,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Peer Review Process for the Making Numbers Meaningful Article Collection and Thanks to Collection Editor Marilyn Schapira.","authors":"Lauren E Cipriano","doi":"10.1177/23814683251314513","DOIUrl":"https://doi.org/10.1177/23814683251314513","url":null,"abstract":"","PeriodicalId":36567,"journal":{"name":"MDM Policy and Practice","volume":"10 1","pages":"23814683251314513"},"PeriodicalIF":1.9,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11848877/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prioritizing Patients from the Most Deprived Areas on Elective Waiting Lists in the NHS in England: Estimating the Health and Health Inequality Impact.","authors":"Naomi Kate Gibbs, Susan Griffin, Nils Gutacker, Adrián Villaseñor, Simon Walker","doi":"10.1177/23814683241310146","DOIUrl":"10.1177/23814683241310146","url":null,"abstract":"<p><p><b>Introduction.</b> Reducing hospital waiting lists for elective procedures is a policy concern in the National Health Service (NHS) in England. Following growth in waiting lists after COVID-19, the NHS published an elective recovery plan that includes an aim to prioritize patients from deprived areas. We use a previously developed model to estimate the health and health inequality impact under hypothetical targeted versus universal policies to reduce waiting time. <b>Methods.</b> We use a Markov model to estimate the health impact of waiting, by index of multiple deprivation quintile group, for 8 elective procedures. We estimate patients' remaining quality-adjusted life-years (QALYs) with baseline waiting times and under 2 hypothetical policy scenarios: 1) a universal policy in which all patients receive an equal reduction in wait and 2) a targeted policy in which patients living in the most deprived quintile are prioritized. We estimate individual and population level health under each of the 2 policies and compare it with baseline. We also estimate how health inequality changes from baseline using the slope index of inequality, reflecting the difference in health between the least and most deprived quintile based on QALYs. <b>Results.</b> A universal reduction in waiting time is estimated to improve overall population health but increase health inequality. A targeted reduction would achieve nearly the same overall health gain and would also increase population-level health inequalities but to a lesser extent than the universal policy would. <b>Discussion.</b> If the NHS is successful in prioritizing patients on waiting lists from the most deprived areas, this may result in smaller increases in health inequalities while maintaining a similar level of overall health gain compared with a universal policy.</p><p><strong>Highlights: </strong>The NHS elective recovery plans include prioritizing patients who live in the most deprived areas of England.Evaluating a hypothetical targeted wait time reduction policy against a universal wait time reduction policy suggests almost the same level of population health gain could be achieved while lessening the negative impact on health inequality.Expected outcomes of government health policies should be quantified to explore the impact on both health maximization and health inequality minimization, as both represent legitimate policy concerns.</p>","PeriodicalId":36567,"journal":{"name":"MDM Policy and Practice","volume":"10 1","pages":"23814683241310146"},"PeriodicalIF":1.9,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11748141/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of Concordant and Shared Lung Cancer Screening Decision Making with Decisional Conflict: A Multi-Institution Cross-Sectional Analysis.","authors":"Donald R Sullivan, Sara E Golden, Liana Schweiger, Anne C Melzer, Santanu Datta, James M Davis, Renda Soylemez Wiener, Christopher G Slatore","doi":"10.1177/23814683241309945","DOIUrl":"10.1177/23814683241309945","url":null,"abstract":"<p><p><b>Introduction.</b> Many organizations recommend structured communication processes, including formal shared decision making (SDM), for patients undergoing lung cancer screening (LCS) using low-dose computed tomography (LDCT). We sought to understand if concordant and shared LCS decision making was associated with decisional conflict. <b>Methods.</b> In this prospective, observational study, we enrolled patients from 3 medical centers (2 Veterans Health Administration, 1 academic facility) after a decision-making interaction about undergoing LCS but before receiving the LDCT. We included patients who indicated they accepted or declined to undergo the LDCT. We evaluated preferred and actual decision-making roles and used multivariable linear and logistic regression models to measure the association of concordant (congruence between actual and preferred roles) and shared LCS decision making with decisional conflict to report adjusted odds ratios (AOR). <b>Results.</b> Of the 409 participants with nonmissing information, 83% reported LCS decision-making role concordance. In addition, 223 (58%) reported an indeterminate level and 56 (14%) reported decisional conflict. LCS decision-making role concordance was not associated with decisional conflict (AOR = 0.86, 95% confidence interval [CI]: 0.38-1.94, <i>P</i> = 0.71) compared with role discordance. Participant-reported actual LCS SDM role was not associated with decisional conflict (AOR = 0.99, 95% CI: 0.51-1.93, <i>P</i> = 0.98) compared with patient- or provider-controlled roles. <b>Conclusions.</b> LCS decisional conflict was uncommon, although many patients reported an indeterminate level of decisional conflict. Neither concordant nor shared LCS decision-making role was associated with decisional conflict. Clinicians may be unable to decrease LCS decisional conflict using efforts to enhance decision-making interactions.</p><p><strong>Highlights: </strong>We evaluated patients' preferred and actual decision-making role and decisional conflict following a decision-making interaction about lung cancer screening (LCS).Concordant decision-making preference was not associated with decisional conflict.Actual decision-making role was also not associated with decisional conflict.Efforts to enhance decision-making interactions may not decrease LCS decisional conflict.</p>","PeriodicalId":36567,"journal":{"name":"MDM Policy and Practice","volume":"10 1","pages":"23814683241309945"},"PeriodicalIF":1.9,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11748413/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implications of Diminishing Lifespan Marginal Utility for Valuing Equity in Cost-Effectiveness Analysis.","authors":"R Scott Braithwaite","doi":"10.1177/23814683241305106","DOIUrl":"10.1177/23814683241305106","url":null,"abstract":"<p><p><b>Introduction.</b> Diminishing marginal lifespan utility (DMLU) implies that a particular lifespan increment (e.g., 1 life-year) confers lesser marginal utility if added to longer lifespans (e.g., 90 y to 91 y) than to shorter lifespans (e.g., 60 y to 61 y) if quality of life is unchanged. Because DMLU is difficult to disambiguate from discounting, risk attitude, and other elements of utility \"curvature,\" it is poorly characterized. However, the imperative to consider equity in cost-effectiveness analysis (CEA) renders its characterization more important. <b>Methods.</b> I add certainty to the characterization of DMLU through literature review and illustrative example. The literature review synthesizes stated preference studies of utility curvature that exclude risk or probability. The example compares alternative valuations of approaches to reduce inequality in cystic fibrosis outcomes between US centers serving mostly White patients and centers serving mostly non-Black Hispanic patients, with versus without DMLU. <b>Results.</b> The existence of DMLU is likely, and empirical data support its relevance over typical CEA time horizons. The imperative to consider equity in CEA magnifies the importance of DMLU for several reasons. First, intergenerational CEAs require lower discount rates that are less likely to incidentally absorb DMLU. Second, DMLU is incompatible with the use of absolute measures of inequality aversion. Third, DMLU may bias the interpretation of relative measures of inequality aversion toward prioritarianism. Finally, not considering DMLU implicitly biases life-year-based metrics against equity. <b>Conclusion.</b> DMLU is likely to exist, can benefit from additional characterization, and may merit inclusion in CEA alongside discounting. Omitting consideration of DMLU will sometimes confer an antiequity bias and may affect the interpretation of CEAs incorporating inequality aversion.</p><p><strong>Highlights: </strong>Diminishing marginal lifespan utility (DMLU) means that the value of extending lifespan may differ based on the duration of life already lived.DMLU is not typically considered in cost-effectiveness analyses.Not considering DMLU may bias cost-effectiveness analyses against equity.Not considering DMLU may reduce the accuracy of distributive cost-effectiveness analyses and other approaches to consider equity along with efficiency.</p>","PeriodicalId":36567,"journal":{"name":"MDM Policy and Practice","volume":"10 1","pages":"23814683241305106"},"PeriodicalIF":1.9,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11748391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing Masks and Random Screening Test Usage within K-12 Schools.","authors":"Yiwei Zhang, Maria E Mayorga, Julie S Ivy, Julie L Swann","doi":"10.1177/23814683241312225","DOIUrl":"10.1177/23814683241312225","url":null,"abstract":"<p><p><b>Background.</b> COVID-19 tremendously disrupted the global health system. People of all ages were at risk of becoming infected. Frequent school closures raised concerns about both the physical and mental health of school-age children. Many studies discussed the effectiveness of various interventions, while few focused on optimizing such interventions. <b>Methods.</b> This study aimed to optimize the usage of random screening tests and masking requirements within K-12 schools. We simulated the disease transmission within a school setting and sought to find the most efficient schedules for schools to arrange their weekly screening tests and mask mandates. The goal was to minimize the number of the end-of-semester infections as well as to use the minimum number of resources. We applied the nondominated sorting genetic algorithm, NSGA-II, to solve this multiobjective optimization problem. We also compared results when polymerase chain reaction (PCR) versus rapid antigen tests were used. <b>Results.</b> The NSGA successfully found Pareto solutions when optimizing the end-of-semester infections, the total number of tests, and the total number of weeks masking. The screening tests and masks can serve as alternatives to one another when prioritizing minimizing the number of infections. In addition, due to the faster return of testing results and lower accuracy, the rapid antigen tests had a similar effect as PCR tests. <b>Conclusion.</b> Our study provides policy makers in K-12 schools with valuable insights. The conclusions derived from this research can serve as a solid foundation for making informative decisions regarding random screening tests and universal masking policies.</p><p><strong>Highlights: </strong>Our simulation optimization framework was used to design weekly schedules for random screening tests and masking within K-12 schools to mitigate COVID-19 infections.We considered multiple objectives and applied the NSGA-II algorithm to find a Pareto solution set.Based on local context and preferences, decision makers can trade off testing and masking to achieve a similar number of end-of-semester infections.When a few weeks of masks are mandated, it is best to use them at the beginning of a semester.</p>","PeriodicalId":36567,"journal":{"name":"MDM Policy and Practice","volume":"10 1","pages":"23814683241312225"},"PeriodicalIF":1.9,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11748417/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}