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Biomedical subjects

L J Belzer

Publications and source records attributed to L J Belzer.

4 recordsLinked to original sources

Psychosocial factors and enrollment in a televised smoking cessation program.

Registrants for a smoking cessation program on the evening television news in the Chicago metropolitan area were compared with other smokers in the population to identify psychosocial factors that distinguished registrants. Telephone interviews were conducted before the intervention with random samples of 641 registrants and 2,398 smokers who regularly viewed the evening news. A nested series of three contrasts compared registrants with (1) smokers who regularly viewed the evening television news on any channel, (2) smokers who were regular viewers of the evening news on the intervention channel, and (3) smokers who were regular viewers of the evening news on the intervention channel and were planning to quit smoking. Registration was associated with a smoker's cognitive appraisal of the quitting process, with registrants distinguished by (1) recognition of a need to act (perceived severity of and susceptibility to lung cancer), (2) high outcome expectancies for quitting as an effective means for health promotion, (3) realistic expectations about the effort required to quit, (4) concern about the burden of lung cancer on significant others and related social influence factors, and (5) motivation to quit smoking. The findings suggest that the effectiveness of minimal-contact intervention programs may be enhanced by targeting smokers according to their psychosocial characteristics and by cognitively preparing smokers to attempt to quit.

Adult↗

Instruction in medical decision making. A report of two surveys.

Results of two surveys (D and E) that assessed the current structure and status of instruction in medical decision making are reported. Both samples (Survey D, N = 80; Survey E, N = 92) consisted of members of the Society for Medical Decision Making. A consensus was obtained on topics considered important for teaching an introduction to clinical decision analysis to medical professionals. These topics were Bayes' theorem, decision trees, 2 X 2 tables, test sensitivity and specificity, utility, and ROC analysis. There was little agreement on course structure, level, or the preferred method for teaching decision analysis within medical settings. It was concluded that medical educators are in the process of constructing a knowledge base in decision-analytic techniques within academic medicine. It will soon be time to consider the place of more advanced topics within the continuum of medical education.

Bayes Theorem↗

Hormonal replacement therapy: analysis of clinical strategies used by residents.

The authors investigated strategies employed by resident physicians to decide whether to prescribe hormonal replacement therapy (HRT) for menopausal women, a matter of continuing clinical controversy. Verbal protocols were obtained from 21 residents in three specialties as they responded to 12 brief case descriptions. The cases incorporated three levels of cancer risk and two levels of osteoporosis risk in a 3 x 2 factorial design with two replications in each cell. Substantial variation in willingness to prescribe HRT was observed. By clustering subjects with relatively similar approaches to the problem, three treatment strategies were formulated that accounted for the decisions of 20 subjects. Each strategy is a simplified representation of the conflicting considerations in this clinical dilemma that facilitates rapid decision making. The differences between these representations and formal decision-analytic models help to explain why observed clinical decisions were inconsistent with expected utility maximization.

Breast Neoplasms↗