Ellen Engelhardt, PhD

Editor

by Ellen Engelhardt, PhD; SMDM e-newsletter Editor

The SMDM 42nd North American Meeting, redesigned as a virtual conference, is only days away. The virtual format is an opportunity to participate in a meeting that you might otherwise not have been able to attend. This new format allows flexible attendance; however, this can limit our ability to interact with each other. There are many opportunities to connect with each other in the meeting schedule (take a look!), but interaction will require a bit more planning than usual to get the most out of the conference. I also want to call out the SMDM fellows’ column, where they give great tips to maximize learning at the meeting. Let’s be creative and find new ways to make meaningful connections!

We hope that yet again you are willing to participate in a quick Poll. This time we are focusing on how the past 6 months of COVID-19 restrictions/lockdowns and working from home have affected you. Please take 2 minutes and share your experiences with us!

Visit the Society news section to meet the newly elected SMDM Officers and Trustees and the winners of the SMDM awards. Congratulations to all! Do you have pictures taken at past SMDM meetings? Please consider sharing them with us to help celebrate the rich history of the society. Take a look at the call for pictures in the Society News section for more information.

As always, we hope you enjoy this newsletter. Get in touch if you have an idea for a Commentary. We would love to hear what’s going on in your MDM corner of the world. Please contact me ([email protected]) or Aisha ([email protected]), if you’d like to discuss your Commentary idea.

SMDM President's Column: Gender bias and cost-effectiveness analysis

by Lisa Prosser, PhD; University of Michigan

Throughout my career, I’ve had the opportunity to work on programs that promote inclusiveness and diversity, especially for women in STEM fields, in the academic setting. These programs have aimed to address disparities in salaries, job roles and responsibilities; enhance leadership opportunities for faculty through education; and implement new systems designed to reduce disparities.

How does this relate to cost-effectiveness analysis? Over the years, I have noticed several potential areas for gender bias in cost-effectiveness analysis including wage rates for time costs, household production, and informal caregiving, described below. SMDM has always been at the forefront of innovations in methodology and guidance for the conduct of cost-effectiveness analysis. I hope that as a professional society we can be a leader in considering how assumptions may unintentionally contribute to different types of bias in our analyses.

Time costs. Many analyses will include separate cohorts for men and women if disease progression varies by this characteristic. It might feel natural then to also stratify wage rate by gender. However, it’s important to consider what might be driving the differences in wage rates as here in the US, women’s wage rates are on average lower than men’s. Including stratified wage rates can bias the results of a CEA in unanticipated directions. For example, if there are substantial patient time costs associated with treatment, then using a stratified (lower) wage rate for women will result in a more favorable ratio if the intervention is equally effective for men and women. On the other hand, for analyses that include productivity loss associated with poor health, the analysis would result in less favorable ratios for women compared to men.

Household production. When considering time costs, economists will typically segment productivity into ‘market’ and ‘non-market’ activities, with some analyses accounting only for ‘market activities’ (employment that is paid a formal wage). However, a substantial part of our economy consists of household production (for a lengthy treatment of this topic, see: Who Cooked Adam Smith’s Dinner? A Story About Women and Economics, by Katrina Marcal), most often provided by women, and these non-market activities can be similarly interrupted by illness and treatment as market activities. Ignoring these costs can unintentionally bias an analysis.

Informal caregiving. The costs associated with informal caregiving typically provided by a family member represent a staggering amount of time each year. The majority of this care is provided by women, but trends are changing, and more men have become involved in informal caregiving over the past 10 years. Ignoring these costs can unintentionally bias an analysis. In this column, I have focused on costs, but quality of life adjustments could also contribute to potential bias.

It’s important to recognize that data are not always readily available for some of these parameter inputs, especially informal caregiving costs. So, for next steps I’d suggest considering these items when developing or reviewing a CEA, and at a minimum acknowledging and discussing these items even if they are not included. I look forward to SMDM addressing questions of potential bias in our research methods and applications as we continue to lead the field of health decision making forward.

Lisa Prosser, PhD

Gillian Sanders Schmidler, PhD

Kathy McDonald, PhD

by Lisa Prosser, PhD; University of Michigan, and by the SMDM COVID-19 Modeling Special Committee Co-Chairs Gillian Sanders Schmidler, PhD; and Kathy McDonald, PhD

In March 2020 at the start of the COVID-19 pandemic in the US, modelers seeking to share data to parameterize COVID-19 simulation models initiated the COVID-19 Model Repository jointly supported by Duke University, Johns Hopkins University, University of Michigan, and SMDM. Following the launch of this resource, the Gordon and Betty Moore Foundation approached these organizations with an opportunity to partner to provide grant funding for COVID-19 decision models: the COVID-19 Decision Modeling Initiative (CDMI). This unique initiative was designed to quickly provide funding support to projects catalyzing innovation in COVID-19 response decision models for rapid uptake and impact, recognizing the critical need to connect evidence-based decision models to diverse decision makers. The ultimate goal is to provide decision models that will inform clinical, health services delivery, and policy decision making related to the COVID-19 pandemic with results prior to December 2020. This collaborative effort was stewarded by the CDMI leaders with longstanding ties to SMDM – Drs. Kathy McDonald (Johns Hopkins), Lisa Prosser (University of Michigan), and Gillian Sanders Schmidler (Duke University). Crucial input was provided by multiple SMDM members who served as reviewers and study council members as well as research team members from our 3 institutions, Angela Rose, Susanna Young, Lauren Kimmel, Ethan Borre, Hilary Campbell, Kevin Pignone, Megan Knauer, and David Anderson.

This exciting collaboration draws on the unique strengths of SMDM in modeling and decision making as well as the incredible commitment of its members to quickly come together to contribute to increasing knowledge that will assist efforts to control this pandemic.

The CDMI Request for Applications received more than 60 submissions from multiple countries. A study section of expert reviewers was quickly assembled from a group of SMDM volunteers who generously donated their time and vast expertise to the selection process (see below). The study section met 5 times during June and July and selected 9 recipients based on their responsiveness to the initiative’s vision and rigor of their research methods. The amount committed totaled almost $350,000 towards projects over the next 4-6 months to drive their decision models and related research forward.

While their project focus areas are varied, the grant recipients all share a common goal of using decision modeling techniques to aid policy makers and others in decision making for better outcomes in the face of the pandemic’s devastating effects. Their work will build a knowledge base to inform timely and effective response to the COVID-19 pandemic.

We are excited that the recipients of CDMI funding will be highlighted at the upcoming SMDM Virtual Meeting on the first day of the meeting in the Keynote Symposium. This symposium will be prefaced by a keynote presentation from Harvey Fineberg, MD, President of the Gordon and Betty Moore Foundation, Past President of SMDM, and Chair of the newly-formed Standing Committee on Emerging Infectious Diseases and 21st Century Health Threats at the National Academy of Sciences, Engineering, and Medicine. This keynote symposium plenary session will feature presentations and panels from the grant awardees. Three live panel discussions will highlight the decisional, methods, or application context of CDMI funded projects. In each panel, grantees will provide brief 5-minute lightning round presentations summarizing their project followed by a moderated panel discussion with open Q&A with all virtual attendees able to submit questions, in real time and in advance. Conference participants will also have the opportunity to meet and network with the individual CDMI teams in a smaller group setting during breakout sessions moderated by SMDM special committee members.

Project title: Establishing a Dynamic Decision-Making System in Real-Time on the COVID-19 Pandemic in Mexico City

Project title: Informing State-level COVID-19 Testing and Contact Tracing Using the COVID-19 Simulator

Project title: Community-tailored Adaptive Strategies for Managing the Health and Economic Consequences of COVID-19

Project title: Discrete Event Simulation for COVID-19 Testing: Identifying Bottlenecks and Supporting Scale-Up

Project title: Emerging Therapies for COVID-19: The Value of More Clinical Trials vs. Implementation

Project title: Targeted COVID-19 Vaccination Strategies: An Agent-based Modeling Evaluation Considering Limited Vaccination Capacities (TAV-COVID)

Project title: Covid-19 Models and Social Determinants of Health: Evaluating Evidence to Inform Policy Decisions

Project title: Optimizing Societal Reopening Plans and Vaccine Distribution Strategies under COVID-19 using Simulation Optimization Modelling Tools

Project title: Coupling COVID-19 Social Distancing with Influenza Vaccination to Manage Healthcare Surges

Fernando Alarid-Escudero, PhD, Center for Research and Teaching in Economics, CONACyT

Robert Beck, MD, Fox Chase Cancer Center, Temple University School of Medicine

Lauren Cipriano, HBA, MS, PhD, Ivey Business School, Western University: London, ON

Gordon Hazen, MS, PhD, McCormick School of Engineering, Northwestern University

Mark Helfand, MD, MPH, School of Medicine, Oregon Health & Science University

David Hutton, PhD, School of Public Health, University of Michigan

Harold Lehmann, MD, PhD, School of Medicine, Johns Hopkins University

Ben Linas, MD, MPH, School of Medicine, Boston University

Kathy McDonald, PhD, MM, Schools of Medicine and Nursing, Johns Hopkins University

Ankur Pandya, MPH, PhD, Harvard T.H. Chan School of Public Health

Petros Pechlivanoglou, MSc, PhD, Institute of Health Policy, Management and Evaluation, University of Toronto

Lisa Prosser, PhD, Susan B. Meister Child Health Evaluation and Research Center, University of Michigan

Beate Sander, PhD, Institute of Health Policy, Management and Evaluation, University of Toronto

Gillian Sanders Schmidler, PhD, Duke Margolis Center for Health Policy, Duke University

Uwe Siebert, MD, MPH, MSc, ScD, School of Public Health – University for Health Sciences, Medical Informatics and Technology, Harvard T.H. Chan School of Public Health

Michael Stefanek, PhD, Department of Population Health, University of Mississippi Medical Center

Torbjørn Wisløff, MSc, PhD, Department of Community Science, Arctic University of Norway

John Wong, MD, School of Medicine, Tufts University

Study Council Members: Kathy McDonald, Lisa Prosser, Marilyn Schapira (School of Medicine, University of Pennsylvania), Gillian Sanders Schmidler, John Wong

Aisha Langford, PhD

Deputy Editor

By Aisha Langford, PhD; Deputy Editor

There have been a lot of COVID-19 related numbers presented in the news lately, which has the potential to create confusion for the general public and policy makers. For example, modeling new COVID-19 cases, deaths, and children going back-to-school scenarios may differ drastically depending on the inputs and assumptions used. Moreover, it can be challenging to communicate COVID-19 risk information to the general public when what’s known about the novel coronavirus is constantly evolving.

Some SMDM members think about numbers often, whether it be related to numeracy, graph literacy, blood pressure data visualization, genetic risk, or pictographs/icon arrays. However, it’s not every day that absolute risk and relative risk are widely discussed in major media outlets. During a press conference on Sunday, August 23, the U.S. Food and Drug Administration (FDA) Commissioner Stephen Hahn, MD tried to explain the meaning of a 35% reduction in mortality. The specific quote was, “So, let me just put this in perspective. Many of you know I was a cancer doctor before I became FDA commissioner, and a 35 percent improvement in survival is a pretty substantial clinical benefit. What that means is — and if the data continue to pan out — 100 people who are sick with COVID-19, 35 would have been saved because of the administration of plasma.”

His explanation of a 35% reduction in mortality was widely criticized by scientists and medical professionals who noted that it was misleading and inaccurate. The widespread criticism prompted a quick response from Commissioner Hahn on Twitter where he acknowledged that absolute risk reduction -- not relative risk -- should have been presented.

Understanding and explaining numerical information is not only challenging for consumers, it’s also challenging for many health care professionals. Luckily, there are many published papers on how to best present quantitative information and why absolute risk is preferred over relative risks in most cases. Do you need to consult with a numeracy or risk communication expert for an upcoming project? Well, you’re in luck! There are many SMDM members with expertise in these areas. Be sure to connect with them at the 2020 virtual meeting and beyond.

Eline Krijkamp,

PhD Student

Ruth Ndjaboue Njike, PhD

Rachel Pozzar, PhD, RN

Kyu Eun Lee, PhD Candidate

Prior SMDM meetings have thrived because of members’ inspiring and innovative research and interdisciplinary networks. The meeting this year will prosper with members’ commitment to fully participating, sharing ideas, and finding new ways to connect during a virtual meeting. 

Aisha Langford, PhD

Deputy Editor

By Aisha Langford, PhD; Deputy Editor

In the last newsletter, we conducted a poll about how, if at all, SMDM members feel they should be involved in responding to COVID-19 misinformation. This question was raised in light of the ‘COVID-19 infodemic’ as reported in outlets such as the Lancet, Journal of Medical Internet Research and Pew Charitable Trusts.

Overall, 54 SMDM members from Austria, Brazil, Canada, Germany, Norway, Romania, and the United States participated in the survey (Thank you!). People who responded to this survey work in the SMDM subfields of Decision Psychology and Shared Decision Making (21/54); Health Services, Outcomes, and Policy Research (15/54); Applied Health Economics (9/54); Quantitative Methods and Theoretical Developments (5/54); and Patient and Stakeholder Preferences and Engagement (4/54).

For the question, “When, if ever, do you personally try to combat COVID-19 misinformation,” approximately 17% (9/54) reported always, 37% (20/54) reported usually, 37% (20/54) reported sometimes, and 2% (1/54) reported never. Write-in answers included:

For the question about who should take responsibility for ensuring that high-quality information is reaching the public, approximately 94% of respondents said that health professionals and government health agencies (51/54, respectively), followed by the media at 82% (44/54) and charitable organizations at approximately 40% (21/54).

Finally, regarding strategies for potentially dealing with COVID-19 misinformation, approximately 80% of survey participants (43/54) said that the Society should publish tips on finding and vetting health information and 56% (30/54) said that the Society should have a speakers bureau available as needed to speak about misinformation.

Meeting co-chairs: David Meltzer, MD, PhD and Alan Schwartz, PhD

Meeting co-chairs: Beate Jahn, PhD, Silke Siebert, MD, Tobias Kurth, MD, MSc, ScD, and Uwe Siebert, MD, MPH, MSc, ScD

We are delighted to announce that the new dates for the 18th Biennial European Conference to be held in Berlin, Germany will be 6-8 June 2021. While we were missing seeing you all this summer, we are excited to be focusing our efforts on the development of the conference program and events in 2021, including COVID-19 driven research and new insights that we all will benefit from after the crises. Abstract submission will open November 2020.

Updated information about the conference will be posted on the 18th Biennial European Conference homepage. The Meeting Co-Chairs encourage you to download the conference flyer and post it in your university and scientific or decision maker community to help alert others to our conference.

Dawn Stacey, RN, PhD, FAAN, FCAHS, University of Ottawa; Ottawa Hospital Research Institute

Annette O'Connor PhD emeritus professor, University of Ottawa

The Article is available at:

([email protected])

Nicole Fowler, PhD, MHSA, Indiana University and IU Center for Aging Research

Dr. Nicole Fowler was granted promotion to Associate Professor and tenure at Indiana University School of Medicine. ([email protected])

Pete Wegier, PhD, Humber River Hospital

Pete Wegier started his appointment as the Humber River Hospital Research Chair in Optimizing Care Through Technology in September 2020. ([email protected])

Bruce R. Schackman, PhD, MBA, Saul P. Steinberg Distinguished Professor of Population Health Sciences, Weill Cornell Medicine, New York, NY

Benjamin P. Linas, MD, MPH, Associate Professor of Medicine, Boston University School of Medicine.

View the news post on CHERISH website: https://cherishresearch.org/2020/07/cherish-awarded-five-year-center-grant/

([email protected])

Stephen Downs, MD, MS, Wake Forest University

([email protected])

Tanya Bentley, MS, PhD, UCLA; Health and Human Performance Foundation

A poster describing a similar pilot program from last fall can be found here.

([email protected])