Hackathon Revolutionizes Care with Plan to Reduce Deadly Opiate Overdoses

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Members of We Are Allies, from left, Jessica Moreno, PharmD, Kristian Olson, MD, and Benjamin Bearnot, MD

When it comes to stopping the deadly effects of an opiate overdose, time is of the essence. Every moment that the brain is deprived of oxygen increases the risk of permanent damage or death. Overdoses can be reversed by administering a drug called Narcan, but the treatment has to be delivered quickly. A team of clinical specialists at Massachusetts General Hospital is hoping to revolutionize the way we respond to overdoses by putting Narcan in the hands of team of citizen volunteers who are ready to help whenever—and wherever—an overdose happens.

The Opioid Epidemic

There were 1,531 confirmed deaths attributed to opioid overdoses in Massachusetts in 2015, according to statistics recently released by the state. With the opioid epidemic continuing to spiral out of control nationwide, there’s a need to find a solution to curb the staggering number of deaths by overdose.

Help could be on the way thanks to an innovative new concept that emerged from a Fall 2016 hackathon put on by the Center for Affordable Medical Technologies (CAMTech) and Global Medicine at Mass General and sponsored by the GE Foundation.

The Allies Concept

The three-day hackathon provided an opportunity for three Mass General specialists—Kristian Olson, MD, the Medical Director of CAMTech and a core educator in the Department of Medicine, Benjamin Bearnot, MD, a primary care physician and Innovation Fellow at MGH Charlestown, and Jessica Moreno, PharmD, a clinical pharmacist at Mass General—to collaborate on a plan for reversing overdoses before they do lasting damage.

Olson, Bearnot and Moreno were part of a nine-person team that also featured an industrial designer, an engineer, an industry pharmacologist, and importantly, people in recovery.

Their plan, titled We Are Allies, calls for equipping everyday citizen volunteers with an easy to administer spray version of anti-overdose drug naloxone, commonly known by the brand name Narcan®.

Overdoses can be deadly because opiates bind to receptors in the brain and spinal cord that are responsible for keeping us breathing. When an overdose occurs, these receptors can slow down or stop working all together, which means the body can essentially “forget” to keep breathing. Naloxone reverses the effects of an overdose by releasing the hold that opiates have on the receptors.

It does not have an adverse affect on someone who is not having an opioid overdose, which makes it safe to administer if an overdose is suspected but not confirmed.

The team believes that getting naloxone into the hands of more people will increase the odds that someone will be nearby to help when an overdose occurs. Naloxone is relatively easy to get and safe to use, but many people—even doctors—don’t carry it with them on a regular basis.

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The Allies’ distinctive purple carrying case is designed to let others know that the person is carrying the anti-overdose drug naloxone

Another key component of the team’s plan is to have the Allies carry their naloxone in a bright purple pouch that can be attached to their handbag or workbag. This distinctive design will let others know that the person is carrying naloxone and is ready to help if needed.

“Not enough people have easy access to this life-saving medication, especially in situations where it is needed most,” says Moreno. “On top of that, those who do need it may be afraid or ashamed to seek it out due to the stigma they face every day. We hope to address both of these issues head-on by encouraging Allies to essentially wear the naloxone on their sleeves in our carrying cases.”

Reducing Stigma

The team hopes the high visibility purple pouches and indicator pins will also raise the public profile of the Allies in the community, which may help to foster new conversations about opioid use disorder and reduce the stigma and sense of isolation that many who suffer from the disorder experience.

“We thought that ‘ally’ was such a great term,” explained Olson. “We rallied around it because it changed the notion of isolation. We wanted to say; ‘We’re all allies in fighting opioid use disorder.’”

For more details on the program including training videos and information on how to sign up as an ally, please visit http://www.becomeanally.com/.

More than Just Hindering Fires – Can Flame Retardants Interfere with Fertility?

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In a new study published in Environmental Health Perspectives, a team of researchers investigated the potential connection between exposure to flame retardant chemicals found in household products— called PFRs — and pregnancy. While we can’t conclude from the results that products like yoga mats cause infertility, the findings bolster pre-existing research suggesting an association between PFRs and reproductive complications.

What are PFRs?
PFRs (organophosphate flame retardants) are a class of chemicals that are commonly used in the polyurethane foam in upholstered furniture, baby products such as nursing pillows, bouncers, and swings, and yoga mats (to name a few) to make them less flammable.

What’s the risk with PFRs?
They can spread from the foam into the air and dust. Considering the ubiquity of PFR-containing products, we likely inhale the chemicals on a regular basis without even knowing it. Although scientists don’t yet have enough conclusive evidence to say that PFRs are bad for our overall health, a growing body of research suggests exposure to PFRs can disrupt the hormones involved in reproduction and embryo/fetus growth. This new study expanded the evidence base by specifically looking at possible connections between exposure to PFRs and pregnancy.

What did the study involve and what did they find?
A team of researchers, including Mass General’s Russ Hauser, MD, MPH, ScD, followed 211 women who went to the Mass General Fertility Center to be evaluated for in vitro fertilization (IVF). The researchers checked the women’s urine for traces of PFRs and found that more than 80% of the women had traces of three types PFRs in their urine. After a cycle of IVF treatments, those with high levels of the chemicals were 31% less likely to have the embryo successfully implant in the uterus, 41% less likely to achieve pregnancy, and a 38% less likely to have a live birth than those with low levels.

What do the results mean? The research team looked at the correlation between traces of PFR and pregnancy outcomes but did not study whether PFR exposure was the cause of pregnancy complications.  Thus, we can’t conclude that exposure to PFR-containing products leads to infertility. However, the findings suggest an association between high levels of PFR exposure and poor pregnancy outcomes. Additionally, because researchers didn’t look at which specific PFR-containing products were the source of the chemical exposure, we can’t single out yoga mats or sofas as the culprits.

Are there limitations to the study?
The study participants were drawn from a small pool of women who were living in and around Boston, so it is not representative of the population at large. Plus, all participants were recruited from an IVF clinic, which suggests they many participants were predisposed to fertility issues coming into the study.

What’s next?
There’s an ongoing debate about the rational for putting flame retardants like PFRs in household products. Studies like this one provide compelling evidence for a potential association between PFR exposure and negative health outcomes like infertility, though more research needs to be conducted.  There are also questions as to how effectively PFRs prevent fires. In 2010, a group of 145 scientists from 22 countries published a statement detailing their concerns that flame retardants weren’t worth the health risks they posed.

What can people do to protect themselves in the meantime?
While it’s nearly impossible to fully avoid PFRs, consumers can minimize exposure by looking for products that have a natural flame retardant like leather or wool fabric, or seek out organic yoga mats. In a Huffington Post article, lead author Courtney Carignan of the Harvard T. Chan School for Public Health said that other precautions, like good-hand washing practices before meals, can also help lower levels of these chemicals in the body.

Evaluating the Impact of Cutbacks to HIV Programs in Resource-Limited Nations

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Proposed reductions in U.S. foreign aid would have a devastating impact on HIV treatment and prevention programs in countries receiving such aid, an international team of investigators reports. In their paper published online in Annals of Internal Medicine, the team led by researchers at Massachusetts General Hospital and the Yale School of Public Health describes how a 33 percent cutback in funds earmarked for HIV/AIDS prevention, treatment and research in recent budget proposals would only save $900 per year of life lost in the countries of South Africa and Côte d’Ivoire.

Read the full press release here.

Cuts to NIH Program Could Disrupt Infectious Disease Research at Mass General and Around the World

Mass General researchers working to stop the spread of infectious disease are worried that proposed cuts to the NIH budget would eliminate a key resource for global health efforts.

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Drs. Stephen Calderwood, Ed Ryan, Regina LaRocque, Ana Weil, and researchers at the International Centre for Diarrheal Disease Research in Dhaka, Bangladesh

Back in the 1950s, there was a global effort to control mosquito populations with the hope of eradicating mosquito-borne diseases such as malaria and yellow fever. Unfortunately, the program was stopped before its goals could be met. Fast forward to the present where the issue of mosquito-borne diseases in some countries is much bigger than it was 50 years ago.

Investigators working to stop the spread of infectious disease around the world, including those at Massachusetts General Hospital, are worried that this same cycle could repeat itself if President Trump’s proposed cuts to the National Institutes of Health (NIH) budget are approved, which would eliminate the Fogarty International Center, a key resource for global health efforts.

“To avoid repeating the same mistake with infectious diseases, we must look ahead and provide the resources necessary now to find an answer to Ebola, HIV, cholera and many other diseases internationally,” explains Stephen Calderwood, MD, former Chief of the Division of Infectious Disease at Mass General.

“People are often unaware of what has been prevented, since by definition what has been prevented has not occurred,” adds Edward Ryan, MD, Director of Global Infectious Disease at Mass General. “The U.S. has and will continue to dodge bullets because of the Fogarty. We would be short-sighted to let this defensive wall fall.”

Closing the Fogarty could put an end to decades of progress into international infectious disease research, say advocates at Mass General. Moreover, doctors and scientists from at-risk countries could face even more barriers to conducting their own research and finding solutions that could directly benefit their communities and curb the spread of infectious diseases around the world. Continue reading “Cuts to NIH Program Could Disrupt Infectious Disease Research at Mass General and Around the World”

Overcoming the “Curse of Knowledge” To Effectively Communicate Your Science

Gene Kinney, PhD, president and CEO of Prothena, a global biotechnology company, published a great article in Xconomy earlier this year about the importance of communicating science.

He says researchers need be strategic about how they talk about their work in order to enhance the public’s understanding of science and its impact on society. Using jargon-free language and developing a compelling narrative can help engage an audience and explain the science.

But Kinney acknowledges this is easier said than done. A little thing called the “curse of knowledge” can hurt a scientist’s ability to communicate with those who don’t share their baseline of expertise. Researchers need to cope with the curse and understand that buzzwords within their given field like “novel target” and “in vitro” hold little to no meaning to outsiders. Kinney emphasizes the importance of overcoming this bias and shifting assumptions about an audience’s knowledge base in order to improve scientific literacy.

Overall, scientists must begin to see themselves not only as researchers but also as communicators.

You can read the full article here.

More Than Just a Pastime: How Video Games Change Your Brain

Editor’s Note: This summer we have two communications interns working with us to write stories about research at the hospital and their experiences being part of the hospital community. This is a post by our intern Shika Lakshman, a student at Emerson College .

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Video games. We all play them, whether it’s Candy Crush on the way to work, or hours-long sessions of Call of Duty.

So when I recently read an article about a new research study detailing the positive and negative effects of playing video games, I decided to follow up. According to the lead author of the study, Marc Palaus, “It’s likely that video games have both positive (on attention, visual and motor skills) and negative aspects (risk of addiction), and it is essential we embrace this complexity”.

Paulus and a team of researchers from Catalonia University and Massachusetts General Hospital recently conducted an assessment of research studies looking at how brains change as a result of playing video games.

What did they find? Video games can change how you pay attention, improving sustained and selective attentions. It also means that the areas in the brain responsible for attention need less stimuli to activate. Additionally, video games can physically  change the structure of your brain, making the parts of your brain responsible for visuospatial skills bigger and more efficient.

So, video games make it easier for gamers to focus on specific stimuli (like games) for longer periods of time, while also allowing for better recognition of shapes, from faces to cars to trees. That’s the good part.

However, as you’ve probably heard, video games can also be addictive. It’s not just something your mom said to get you to do your homework, it’s called “internet gaming disorder”. It mostly affects men, ages 12-20, and primarily in Asia.

Addictive disorders can also cause structural changes to the brain, and gaming addictions are no different. The neural rewards system in your brain can be affected by “cravings” stemming from video games, and researchers say they are the same changes that other addictions cause.

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What does the research tell us? From what I can gather, most video game studies are slanted towards reinforcing the idea that “video games are bad, they cause violence, antisocial behavior, etc.”

I wanted to get a more balanced opinion. So, I did what anyone my age would do: I posted on Facebook, and hoped for responses. I made a survey, asking people about their opinions on video games and some of the study results, and most responded positively.

A few respondents said video games helped them learn English. Many said it allowed them to make friends, and others said it helped with anxiety, stress and their mental wellbeing. Overall, people weren’t entirely shocked to learn that video games can physically change your brain, although they did think the positive effects of outweigh the negative ones. In fact, one respondent actually credited video games with healing a brain injury, “I have a brain injury that affects my coordination. Playing video games has helped me to regain back some of the hand-eye coordination that I feel like I lost.”

One respondent summed it up nicely. “As with anything, moderation is key. Sure, too much time in games stunts our social growth and tricks our brains into thinking we’ve accomplished things. But a moderate amount of time enjoying a favorite game and socializing with friends isn’t a negative thing”.

Here is the poll I used, thought it might be useful so people can see exactly what I asked: https://goo.gl/forms/sETvFUldAjZIPEKO2

What is your name? *

How old are you? *

What age did you start playing video games? *

How would you characterize your video game use? *

1 casual (mostly on your commute, only on your phone, etc.)

2

3

4

5 professional (you play/have played in competitions and/or earn money for playing)

Have you noticed any changes since you started playing video games, such as a change in attention span? *

How many hours a week do you spend playing video games? *

1-5

6-10

11-20

21+

If you selected 21+ above, please estimate the number of hours each week.

Would you be surprised if video games were physically changing your brain? *

Yes

No

Do you think there are more positive or negative effects of video games? *

Positive

Negative

They balance out

Any final thoughts on the effects of video games?

The Science Behind my Compulsion to Shop – and How to Become a Smarter Spender

Editor’s Note: This summer we have two communications interns working with us to write stories about research at the hospital and their experiences being part of the hospital community. This is a post by our intern Catherine Iannucci, a student at Emerson College .

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My name is Catherine, and I am a compulsive buyer.

As a college student living in Boston, I have a limited budget. Realistically, I know I need money for groceries yet I still insist on buying that weird face spray stuff that’s supposed to make my makeup look better.

But now thanks to a recent article in the Boston Globe Magazine on why humans are driven to over consume,  at least I know why.  And may I just say, “thank goodness,” because I need something to tell my mother when she asks why I have no savings.

The article, “Why is it so hard to stop buying more stuff?” features the insights of Ann-Christine Duhaime, MD, a neurosurgeon at the Mass General Hospital for Children who is investigating the link between our biological makeup and our habits of overconsumption.

Her research has shown that our brains encourage repetitive spending to get a chemical reaction that produces a feeling similar to a “short-term high”. This biological reaction was originally used to encourage us to gather the resources we needed to survive, but now it’s making us hoard a bunch of stuff we don’t need.

According to Dr. Duhaime, “No behavior happens without [the brain’s] complex and amazingly designed reward system weighing in.”

I can see this happening in my shopping decision, as well as those of my friends. My best friend, whose money goes out as fast as it comes in, normally acknowledges out loud, “I really have to start saving money!” even as she hands cash over to a Forever 21 employee who has heard that a million times before and is holding back an eye roll. Even my friend who is a budget master—and probably reads three finance books a month—has difficulty sticking to his pre-planned budget due to spur-of-the-moment purchase decisions.

When we can’t resist this intrinsic motivation to buy more stuff, we create more waste. When we finally run out of room and decide to purge some of the older, but probably still usable, things cluttering up our lives, we are adding to the massive amount of waste that already exists.

Dr. Duhaime proposes a solution that will help to redirect our buying-obsessed brains and help the environment at the same time. Instead of buying new makeup spray or Forever 21 clothes to get that high, we need to retrain our brains to get that same “high” from renovating and repurposing existing possessions to fit current needs. Maybe reupholster an old couch instead of wasting money on a new one, reuse old wood pallets to make a cute DIY bookshelf, or find some other fun project that will trigger the same “reward” system in your brain with a less wasteful outcome.

CatFor me the best course of action is just to go cold turkey on the impulse buys and spend my money only on food and bars of soap.

Of course I’m kidding. We all know that’s wildly unrealistic. But, I am going to start reusing that Dunkin Donuts hot cup that I insist on getting as a koozy for my iced coffee. Plus, I’m pretty sure that makeup spray is a complete hoax anyway, so that will have to go too.

Artificial Intelligence Makes Waves in Healthcare

There’s so much more to artificial intelligence (AI) than what you’ve seen in sci-fi movies. In fact, advancements in machine learning could provide new opportunities for medical research and diagnosis.

Keith J. Dreyer, DO, PhD, Vice Chairman of Radiology and Executive Director of the MGH & BWH Center for Clinical Data Science, says AI and machine learning has the potential to impact health care as profoundly as the discovery of the microscope.

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Here are five things to know from a recent interview with Dreyer:

  1. AI is created through a process called machine learning. Unlike traditional computer programming where the process of moving from point A to point B is entirely mapped out by the programming team before being loaded onto the computer, in machine learning the computer is given a vast repository of data and told what the data indicates. The computer then has to identify the underlying logic that connects the data to the results. In creating this algorithm, it can predict answers when given new data in the future.
  2. Although the concept of using machines to create AI has been around for more than 50 years, faster computation speeds and more accurate algorithms are now enticing health care companies to invest in AI.
  3. Researchers have trained computers to develop algorithms that distinguish between millions of simple images such as dogs, cat, and beaches. For example, researchers will show a computer many different images of dogs and tell the computer, “these are dogs.” The computer will then have to develop an algorithm that can be used to identify dogs from a new set of images that includes dogs, cats, horses or anything at all.
  4. Now researchers are asking computers to apply that same knowledge to look at millions of MRI, CT, and X-ray images to detect things such as lung cancer, breast cancer or a hemorrhagic stroke. A computer could be shown millions of mammogram images from patients who subsequently developed a certain type of breast cancer. The goal would be to see if there is an underlying pattern that could lead to earlier diagnosis and treatment.
  5. Mass General is poised to be a leader in the field of AI. The hospital has incredibly large amounts of electronic data that can be used to develop new algorithms for screening and diagnosis. Mass General also has a vast community of clinicians and researchers who can work together to develop these tools and integrate them into the delivery of care.

You can read the full interview here.

The Elephant in the Waiting Room: Survey Data Helps Address Racial and Ethnic Disparities in Healthcare

5 strategies for addressing disparities.pngAddressing disparities in healthcare remains an important but difficult issue to tackle, in part due to the uncomfortable nature of discussing racial and ethnic divides.

Research has shown that members of racial and ethnic minority groups often receive lower quality health care compared to their white counterparts. Providers may unintentionally make assumptions based on their patients’ race or ethnicity that could influence the level of care they provide.

Furthermore, patients from low income/ethnic minorities may have a language barrier which can lead to a patient feeling confused about the healthcare advice and failing to comply with medical regimens. Communication can also be hindered by cultural differences between the healthcare provider and the patient.

These factors, plus many more, contribute to poorer health outcomes and lead to higher overall healthcare costs.

A new report, published in the June issue of Health Affairs, identifies challenges to and strategies for addressing disparities in healthcare organizations. The authors also acknowledge that this is an uncomfortable subject to discuss.

“Unlike other areas of quality improvement that might be straightforward to execute, addressing disparities is a more sensitive, hot-button issue,” says Joseph Betancourt, MD, MPH, Director of the Mass General Disparities Solutions Center (DSC) and corresponding author of the report.

The report analyzed survey data compiled from participants in the Massachusetts General Hospital-based Disparities Leadership Program (DLP) – a yearlong executive-level education initiative designed to help health care leaders from around the world address racial and ethnic disparities in health care settings.

Teams at participating organizations completed surveys at the end of the program year. The Health Affairs report covers survey data responses from 97 organizations that participated from 2007 to 2016.

Participant responses demonstrated that:

  • The DLP helped engage and amplify the voices of staff from multiple levels of participating organizations as well as the broader community.
  • Getting buy-in from leadership was a struggle, though once leaders were engaged in the process, they were more likely to support and champion disparities efforts.
  • Successful projects incorporated disparities into other pre-existing initiatives and demonstrated how this work can help address other organizational priorities.

Survey feedback was compiled into five strategies that participants found effective in implementing projects at their institutions.

These strategies, and commentary from participants, are outlined in the report as follows:

1. Know who to involve. It’s important to engage leadership as well as midlevel and front-line staff. However, leadership turnover often presents a challenge to making equity a key component of the organization’s work and mission.

One participant said, “The biggest challenge we faced with buy-in amongst our executive leadership was framing health care disparities in such a way…that they placed it as a priority amongst all of the other competing priorities and allocated the proper resources to make our initiative a success.”

2. Shape organizational culture. Internal organizational cultural barriers to equity include competing priorities and lack of buy-in and awareness of disparities. Increasing awareness and integrating efforts to reduce disparities into the organization’s mission help facilitate equity.

“There continues to be competing priorities within the business and, although everyone we spoke with does believe and understand the importance of our health equity work, there are only limited funds available,” said a participant.

3. Create urgency and a vision to make a rational and emotional case. It’s important to create a sense of urgency for equity-related efforts. Grounding the work in a vision and communication strategy that integrates addressing disparities into the core work of the organization can help illustrate the pressing need to tackle this issue.

One participant reported, “Being part of the DLP gave me the opportunity to sit down with a small group of leaders including the Chief Medical Officer to explain health care disparities, and the link with data collection and quality improvement.”

4. Engage your organization and your audience. Engaging and partnering with key stakeholders is crucial. This includes internal partnerships across the organization, as well as external partnerships with stakeholders in the community.

“The work of promoting and implementing the best practices advocated by the DLP required work teams that crossed divisions/ departments and disciplines,” said a participant. “This collaborative effort helped to cement a unified actionable vision for assessment and reduction of healthcare inequities within [our] Medical Center.”

5. Harness the power of a collaborative network. Being a part of a collaborative network focused on equity promotes the development of strategic leadership skills and sharing of ideas, resources, and strategies.

One participant said, “[I received] great help from the leaders of the DLP and fellow DLP teammates by sharing ideas on coalition building, framing the message and the urgency and effective methods on educating leadership to get “buy in” on the collection of race, ethnicity and language data. The exchange of ideas and the sharing of best practices with the group proved to be invaluable.”

 

Moving forward, the DLP will continue its efforts to address disparities.

“We now have assembled a large and powerful network of DLP alumni dedicated to identifying and addressing disparities in health care,” says Betancourt. “Creating a movement of this nature is unprecedented, and we plan to continue to build and expand it so we can shape health care delivery and policy.”

Boosting the Voice of the Patient in the Medical Decision Making Process

banner-healthdecisionsciencesIn medicine, many diagnostic questions can be answered in yes or no, black and white terms. Is the pain in your back and legs due to a herniated disc? Is your cholesterol too high?

When it comes to determining the best treatment plan for each patient, however, there are many more shades of gray.

For a herniated disc, is the best course of action to fix the disc via surgery, which could provide quicker relief but may cause a serious complication? Or is it better to manage the pain through physical therapy, which is less invasive than surgery, but may not solve the problem?

If you have high cholesterol, should you take statin drugs, which are effective but can cause side effects such as pain and muscle fatigue? Or to try improving your diet and exercising more, which is often easier said than done?

“In medicine, there are tradeoffs everywhere you look,” says Karen Sepucha, PhD, Director of the Health Decisions Sciences Center (HDSC) at Massachusetts General Hospital. “We can’t know what’s best for someone unless we know who that person is, what’s important to them, and how they might view the tradeoffs. Patients may make different decisions than their provider would when faced with the same situation.”

To acknowledge these tradeoffs and prompt more productive discussions between patients and their providers, the HDSC team has created a series of print, online and video-based decision aids for patients with conditions such as herniated discs, high blood pressure, depression, diabetes, breast cancer, prostate cancer, anxiety and more.

The goal of this approach, called Shared Decision Making, is to present the patient with an objective view of all treatment options, and discuss the pros and cons of each.

“It’s like being able to consult the best doctors and hear from a range of ‘experienced’ individuals who have chosen different approaches. You can learn what the different treatments are like and why folks might make different decisions based on what is most important to them,” Sepucha explains.

The HDSC team also works with clinicians and health care providers to assist them with implementing decision-making tools in their practices. According to Leigh Simmons, MD, an internal medicine physician at Mass General and member of the HDSC team, the process is not always easy.

Simmons explains that many clinicians who already feel strapped for time in their daily practice worry that their patient visits will become longer if they have to address all of the questions that a decision aid can raise.

In practice, however, patient visits tend to stay the same length when a decision aid is distributed beforehand, Simmons says. “It’s the nature of the conversation that changes.”

Clinicians find that they don’t have to spend as much time going through the basics of the medical problem or treatment plan, and can talk more about the pros and cons of each option to see what will work best for each patient. “We usually advise that using a decision aid may not necessarily save time, but it makes for a better conversation with their patients, which everyone likes more, Simmons says. “The questions that get asked are more advanced, and the visit is more productive.”

Another barrier that physicians have to confront is that when you give your patients high-quality information about reasonable treatment options, they may choose something you would not have chosen for them, Simmons says. “That is something we have to be aware of and be honest with ourselves as doctors, and we recognize that sometimes our patients know best about what is right for them.”

From a research standpoint, the HDSC team is working on strategies to determine if decision-making aids are increasing patient involvement and improving treatment outcomes, Sepucha says. “Are patients more informed, are they more engaged in the decision-making process and are clinicians doing a good job of matching the right patient to the right treatment?”

How we make decisions with our patients is important, and some of our research has shown that our patients who are well-informed and received their preferred treatment have better outcomes.”

For more information about the Health Decisions Sciences Program, please visit www.massgeneral.org/decisionsciences.