Nananda F. Col

MD, MPP, MPH, FACP

Director, Senior Scientist

Center for Outcomes Research and Evaluation

(207) 622-4757 Office

(207) 662-3119 Fax

Dr. Nananda Col joined CORE as the Director and Senior Scientist in 2007. Dr. Col is a graduate of Dartmouth College, The Kennedy School of Government (MPP), and the University of Massachusetts Medical School (MD, MPH). Her clinical training is in Internal and Preventive Medicine, and she completed a fellowship in clinical decision–making, informatics, and telemedicine at Tufts. A national expert in women’s health and clinical decision-making, Dr. Col pioneered work in the area of risk modeling and personalized decision support, developing patient-specific risk models and strategies for developing and integrating sophisticated computerized decision support into primary care to help doctors and patients make more informed treatment decisions. Current research interests are at the juncture of evidence-based medicine, decision sciences, and medical informatics -- bridging population-based outcomes research with shared decision making. Specific research interests include integrating decision support into clinical practice, meta-analyses, decision modeling, measuring and incorporating patient preferences into decision support, communicating uncertainty about the risks and benefits of treatments, and adapting social marketing techniques to change patient and physician behavior.

Selected peer-review publications (in chronological order) (from 64)

Col N, Fanale JE, Kronholm P. The role of medication noncompliance and adverse drug reactions in hospitalizations of the elderly. Arch Intern Med 1990; 150:841-845
Gurwitz JH, Col NF, Avorn J. The exclusion of the elderly and women from clinical trials in acute myocardial infarction. JAMA 1992; 268:1417-1422.
Col NF, McLaughlin TJ, Soumerai SB, Hosmer DW, Yarzebski J., Gurwitz JH, Gore JM, Goldberg RJ. The impact of clinical trials on the use of medications for acute myocardial infarction. Results of a community based study. Arch Intern Med 1996; 156:54-60.
Col NF, Eckman MH, Karas RH, Pauker S., Goldberg RJ, Ross EM, Orr RK, Wong JB. Patient-specific decisions about hormone replacement therapy in postmenopausal women. JAMA 1997; 277:1140-7.
Col NF, Moulton AW, Cyr MG. Weighing the risks and benefits of hormone replacement therapy on an individual basis-- A clinical framework. Infert & Reprod Med Clinics of N Am 1999; 10:229-42.
Santoro NF, Col NF, Eckman MH, Wong JB, Pauker SG, Cauley JA, Zmuda J, Crawford S, Johannes CB, Rossouw JE, C.Noel Bairey Merz. Therapeutic controversy: Hormone replacement therapy--Where are we going? J Clin Endocrinol Metab 1999; 84:1798-1812.
Col NF, Pauker SG, Goldberg RJ, Eckman MH, Orr RK, Ross EM, Wong JB. Individualizing therapy to prevent long-term consequences of estrogen deficiency in postmenopausal women. Arch Intern Med 1999; 159:458-66.
Orr RK, Hoehn JL, Col NF. The learning curve for sentinel node biopsy in breast cancer: practical considerations. Arch Surg 1999; 134(7):764-7.
Orr RK, Col NF, Kuntz KM. A cost-effectiveness analysis of axillary node dissection in postmenopausal women with ER-positive breast cancer and clinically negative axillary nodes. Surgery 1999; 126:568-76.
Ross EM, Rosenberg IH, Dawson-Hughes B, Col NF, Wong JB. Fitting nutrition into the medical model: The role of decision analytic cost-effectiveness techniques. Eur J Clin Nutr 1999; 53:S25-28.
Col NF, Hirota LK, Orr RK, Erban JK, Wong JB, Lau J. Hormone replacement therapy after breast cancer: A systematic review and quantitative assessment of risk. J Clin Oncol 2001; 19(8):2357-2363.
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.
Bond B, Hirota L, Fortin J, Col N. Women like me: Reflections on health and hormones from women treated for breast cancer. J Psychosoc Onc 2002; 20:39-56.
Chlebowski R, Col N, Winer EP, Collyar DE, Cummings SR, Vogel VG 3rd, Burstein HJ, Eisen A, Lapkus I, Pfister DG. American Society of Clinical Oncology technology assessment of pharmacologic interventions for breast cancer risk reduction including tamoxifen, raloxifene, and aromatase inhibition. J Clin Onc 2002; 20:3328-43.
Col NF, Goldberg RJ, Orr RK, Erban JK, Fortin JM, Chlebowski RJ. Survival impact of tamoxifen for breast cancer risk reduction: Projections from a patient-specific markov model. Med Decis Making 2002; 22:386-93.
Braithwaite RS, Col NF, Wong JB. Estimating hip fracture morbidity, mortality and costs. J Am Geriatr Soc 2003; 51:364-70.
Braithwaite S, Chlebowski R, Lau J, Col NF. Meta-analysis of vascular and neoplastic events associated with tamoxifen. J Gen Intern Med 2003; 18:937-47.
Col NF. The use of gene tests to detect hereditary predisposition to chronic disease-- is cost-effectiveness relevant? Med Decis Making 2003; 23:441-8.
Chlebowski RC, Kim JA, Col NF. Estrogen deficiency symptom management in breast cancer survivors in the changing context of menopausal hormone therapy. Seminars in Oncology 2003; 30:776-88.
Col NF, Pauker SG. Discrepancy between observational studies and randomized trials of menopausal hormone therapy: Did expectations shape experience? Ann Intern Med 2003; 139:923-929.
Surks MI, Ortiz E, Daniels GH, Sawin CT, Col NF, Cobin RH, Franklyn JA, Hershman JM, Burman KD, Denke MA, Gorman C, Cooper RS, Weissman NJ. Evidence-based consensus guidelines for the diagnosis and management of subclinical thyroid disease. JAMA 2004; 291:228-238.
Col NF, Surks MI, Daniels GH. Subclinical Thyroid Disease: Clinical Context. JAMA 2004; 291:239-243.
Chlebowski RC, Col NF. Menopausal hormone therapy after breast cancer. Lancet 2004; 363:410-411.
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.
Col NF, Weber G, Short-term menopausal hormone therapy for symptom relief: An updated decision model. Arch Intern Med 2004; 164:1634-1640.
Col NF. Challenges in translating research into practice. J Women’s Health 2005:14:87-95.
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, Kim JA, Chlebowski RT. Menopausal hormone therapy after breast cancer: A meta-analysis and critical appraisal of the evidence. Breast Cancer Research 2005; 7:R535-40.
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.
Chlebowski RC, Garnet L. Anderson GL, Geller M, Col N. Coronary heart disease and stroke with aromatase inhibitor, tamoxifen and menopausal hormone therapy use. Clin Breast Cancer 2006; 6:S58-65.
Col NF. Editorial: Decision making at the margins. Arch Int Med 2006; 166(4):389-90.
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, Duffy C, Cyr MG. The pitfalls of non-evidence based guidelines. Menopause 2006; 13(3):334-7.
Col NF. Using internet technologies to improve and simplify counseling about menopause. Maturitas 2007; 57:95-99.
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.
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.
O’Connor AM, Bennett C, Stacey D, Barry MJ, Col F, Eden KB, Entwise 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.
Col NF, Fortin J, Ngo L, Goldberg RJ, O'Connor AM. 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.
Politi MC, Han PKJ, Col NF. Communicating the uncertainty of harms and benefits of medical interventions. Medical Decision Making 2007; 27: 681-695.
Hohenhaus MH, McGarry KA, Col NF. Hormone therapy for the prevention of bone loss in menopausal women with osteopenia: is it a viable option? Drugs 2007; 67(16):2311-21.
Col NF, Chlebowski RC. Managing the risk of breast cancer in postmenopausal women. Menopause 2008; In press.
Politi M, Schleinitz M, Col NF. Revisiting the duration of vasomotor symptoms of menopause: a meta-analysis. J Gen Int Med 2008; In press.
Chlebowski RT, Col NF. Pharmacogenomic variation of CYP2D6 and the choice of optimal adjuvant endocrine therapy for postmenopausal breast cancer: a modeling analysis. J NCI , 2008, in press.