Doctoral candidate John Giardina interned at the Health Decision Sciences Center (HDSC) at Massachusetts General Hospital in Summer, 2019. With funding from a GSAS Graduate Society Summer Predissertation Fellowship, John worked on a project titled “Shared-Decision Making from a Policy Perspective: Effects of Individualized Patient Decisions on Cost and Health Outcomes in a Decision Analytic Model.” The project sought to analyze whether the use of shared decision making (SDM)-based decision aids for common orthopedic surgeries (e.g., hip and knee replacement) helps match patients to the optimal treatment in terms of both cost and health outcomes. Ideally, only patients who stand to see a significant benefit from surgery should choose to actually get the procedure; the goal of a decision aid is to help patients and their physicians evaluate the likelihood of a positive benefit from surgery relative to other non-surgical treatment options. The project’s goals were to estimate the effect of decision aid use on health outcomes and the rate of surgery (a primary predictor of treatment costs), and to integrate these effect estimates into a cost-effectiveness analysis (CEA) comparing treatment decisions made with and without a decision aid. The results of this CEA will inform whether the use of a decision aid for common orthopedic surgeries helps patients choose the optimal treatment from a cost-effectiveness perspective.
Led by Karen Sepucha and Leigh Simmons, HDSC is focused on improving the quality of healthcare decisions that patients make with their doctors, and is a leader in developing and evaluating interventions that promote shared-decision making (SDM) between patients and their providers.
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