Clinical Decision Making

LEADERSHIP

Dr. Nananda Col is an expert in the field of clinical decision-making. She presently serves on the Cochrane Collaboration and the International Patient Decision Aid Standards (IPDAS), two of the leading reviews of clinical decision aids. Dr. Col is on the Board of Trustees of the Society for Medical Decision Making, and is a member of the Editorial Board of Medical Decision Making. She has served on numerous review boards and expert panels for the Agency for Healthcare Research and Quality (AHRQ). Dr. Kathleen Fairfield is involved in educating residents about decision making, serving as the Director of Resident Scholarly Activities and Evidence Based Medicine at Maine Medical Center, and is a clinical advisor for the Foundation for Informed Medical Decision Making (FIMDM). Many CORE members won Fellowships to the Dartmouth Summer Institute on Informed Patient Choice, a weeklong conference that brought together experts from around the world. CORE Investigators won the Innovation in Practice Management Award at the Society of General Internal Medicine 31st Annual Conference for their web-based smoking cessation intervention.

PROJECTS (Current and Completed in the past 3 years)

For details and descriptions of the clinical decision making projects at CORE, please visit the Women’s Health page. Women's Health

SELECTED PUBLICATIONS (Since 2000)

• Cohn W, Jones S, Miesfeldt S. “Are You at Risk for Hereditary Breast Cancer?” Development of a Personal Risk Assessment Tool for Hereditary Breast and Ovarian Cancer. J Genet Couns 2008;17:64-78.
• Col NF. Using internet technologies to improve and simplify counseling about menopause. Maturitas 2007; 57:95-99.
• Col NF, Fortin J, Ngo L, O’Connor AM, Goldberg RG. Can computerized decision support help patients make complex treatment decisions? A randomized controlled trial of an individualized menopause decision aid. Med Decis Making 2007; 27: 585-598.
• Matloff ET, Shannon KM, Moyer A, Col NF. Should menopausal women at increased risk for breast cancer use tamoxifen, raloxifene, or hormone therapy? A framework for personalized risk assessment and counseling. J Cancer Edu 2007; 22:10-14.
• O’Connor AM, Bennett C, Stacey D, Barry MJ, Col NF, Eden KB, Entwistle V, Fiset V, Holmes-Rovner M, Khangura S, Llewellyn-Thomas H, Rovner D. Do patient decision aids meet effectiveness criteria of the international patient decision aid standards collaboration? A systematic review and meta-analysis. Med Decis Making 2007; 27: 554-574.
• Politi MC, Han PKJ, Col NF. Communicating the uncertainty of harms and benefits of medical interventions. Medical Decision Making 2007; 27: 681-695.
• Rose JS, Chassin JL, Presson CC, Sherman SJ, Stein MD, Col NF. A latent class typology of young women smokers. Addiction 2007; 102:1310-1319.
• Col NF. Editorial: Decision making at the margins. Arch Int Med 2006; 166(4):389-90.
• Col NF, Duffy C, Cyr MG. The pitfalls of non-evidence based guidelines. Menopause 2006; 13(3):334-7.
• Lindor L, Peterson G, Hadley D, Kinney A, Miesfeldt S, Lu K, Lynch P, Burke W, Press N: Recommendations for care of individuals with an inherited predisposition to Lynch Syndrome. JAMA 2006; 296:1507-17.
• Matloff ET, Moyer A, Shannon KM, Niendorf, KB, Col NF. Healthy women with a family history of breast cancer: impact of a tailored genetic counseling intervention on risk perception, knowledge, and menopausal therapy decision-making. J Women’s Health 2006; 15(7):843-56.
• Col NF. Challenges in translating research into practice. J Women’s Health 2005:14:87-95.
• Col NF. The impact of risk status, preexisting morbidity, and polypharmacy on treatment decisions concerning menopausal symptoms. Am J Med 2005; 118 (12):1411.
• Col NF, Bowlby LA, McGarry K. The role of menopausal hormone therapy in preventing osteoporotic fractures: A critical review of the clinical evidence. Minerva Medica 2005; 96(5):331-42.
• Col NF, Duffy C, Landau C. Commentary-Surgical decisions after breast cancer: Can patients be too involved in decision making? Health Services Research 2005 40:769-80.
• Col NF, Weber G, Stiggelbout A, Chou J, D’Agostino R, Corso P. Short-term menopausal hormone therapy for symptom relief: An updated decision model. Arch Intern Med 2004; 164:1634-1640.
• , Chen WY, Colditz GA, Emmons KM, Fletcher SW. Colon cancer risk counseling by healthcare providers: perceived barriers and response to an internet-based cancer risk appraisal instrument. J Cancer Educ 2004; 19:95-97.
• Hanauer D, Dibble E, Fortin J, Col NF. Internet usage among community college students: Implications in designing health care interventions. J Am College Health 2004; 52(5):197-202.
• Surks MI, Ortiz E, Daniels GH, Sawin CT, Col NF, Cobin RH, Franklyn JA, Hershman JM, Burman KD, Denke MA, Gorum C, Cooper RS, Weissman NJ. Evidence-based consensus guidelines for the diagnosis and management of subclinical thyroid disease. JAMA 2004; 291:228-238.
• Braithwaite RS, Col NF, Wong JB. Estimating hip fracture morbidity, mortality and costs. J Am Geriatr Soc 2003; 51:364-70.
• Cohn W, Ropka M, Jones S, Fraser G, Miesfeldt S. Information needs about hereditary breast cancer reported by women with early-onset breast cancer. Cancer Det and Prev 2003; 27:345-352.
• Miesfeldt S, Cohn W, Jones S, Ropka W, Weinstein J. Breast cancer survivors’ attitudes about communication of breast cancer risk to their children. AJMG 2003; 119C:45-50.
• Bond B, Hirota L, Fortin J, Col NF. Women like me: Reflections on health and hormones from women treated for breast cancer. J Psychosoc Onc 2002; 20:39-56.
• Fortin JM, Hirota LK, Bond B, O’Connor AM, Col NF. Identifying patient preferences for communicating risk estimates: a descriptive pilot study. BMC Med Inform Decis Mak 2001; 1:2.
• Geer K, Cohn W, Ropka M, Jones S, Miesfeldt S. Attitudes related to patients’ decisions to decline cancer genetics counseling services. J Genetic Counseling 2001; 10:25-40.

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