Peter A Ubel
Dados Biográficos
| ID | 1725745 |
|---|---|
| NOME | Peter A Ubel |
| PRENOMES | Peter A |
| SOBRENOME | Ubel |
| ASSINATURA | UBEL P A |
| AFILIAÇÕES | Duke University |
| ORCID | 0000-0001-8218-519X |
| VERIFICADO | Sim |
| TOTAL DE OBRAS | 48 |
| TOTAL DE CITAÇÕES | 102 |
| TOTAL COMO AUTOR | 48 |
| TOTAL COMO EDITOR | 0 |
| PRIMEIRO ANO DE PUBLICAÇÃO | 1996 |
| ANO MAIS RECENTE DE PUBLICAÇÃO | 2025 |
| ÍNDICE H | 6 |
Leadership Experiences and Perceptions of Mid-Career to Senior Clinician-Scientists
The Disproportionate Effects of the Covid-19 Pandemic on the Time Allocation of Recipients of NIH Career Development Awards Who Are Women or Caregivers of Dependents
Neurorights in question
The idea of a ‘right to mental integrity’, sometimes referred to as a ‘right against mental interference,’ is a relatively new concept in bioethics, making its way into debates about neurotechnological advances and the establishment of ‘neurorights.’ In this paper, we interrogate the idea of a right to mental integrity. First, we argue that some experts define the right to mental integrity so broadly that rights violations become ubiquitous, ther…
Private Equity Acquisition of Physician Practices—Looking for Ethical Guidance From Professional Societies
This Viewpoint recommends that professional medical societies provide ethical guidance on private equity acquisitions of physician practices
Limited Evidence of Shared Decision Making for Prostate Cancer Screening in Audio-Recorded Primary Care Visits Among Black Men and their Healthcare Providers
Prostate-specific antigen (PSA)-based prostate cancer screening is a preference-sensitive decision for which experts recommend a shared decision making (SDM) approach. This study aimed to examine PSA screening SDM in primary care. Methods included qualitative analysis of audio-recorded patient-provider interactions supplemented by quantitative description. Participants included 5 clinic providers and 13 patients who were: (1) 40-69 years old, (2)…
Payment of Covid-19 challenge trials
One way to test vaccines is through human challenge trials in which participants are intentionally infected with a contagious organism to expedite the process of assessing the vaccine’s effectiveness. Some experts believe challenge trials may play an important role in fighting COVID-19, especially if the vaccines under current study do not demonstrate sufficient efficacy, if spread of COVID-19 is controlled to a point that radically slows down tr…
Financial Pollution in the US Health Care System
Wasteful health care spending results from low-value care, undertreatment, pricing failures, fraud, and administrative complexity. 1 Such spending costs US residents between $760 billion and $935 billion each year 1 and harms populations through burdensome health insurance prices and taxes
Cure” Versus “Clinical Remission”
Why It's Not Time for Health Care Rationing
In the last few years, the U.S. health care system has seemingly been gripped by “back to the nineties” fever. But there is a notable change in professional debates about how to better control health care costs. Discussion of health care rationing, which was hotly debated in the nineties, has become much more muted. Is health care rationing passé? I contend that debates about health care rationing have waned not because the need to ration has dwi…
The Author Replies
A response to “Rationing Is Still Rationing,” by Robert J. Wells
Patient–physician communication about early stage prostate cancer
BACKGROUND: We know little about patient-physician communication during visits to discuss diagnosis and treatment of prostate cancer. OBJECTIVE: To examine the overall visit structure and how patients and physicians transition between communication activities during visits in which patients received new prostate cancer diagnoses. PARTICIPANTS: Forty veterans and 18 urologists at one VA medical centre. METHODS: We coded 40 transcripts to identify …
How many calories are in my burrito?’ Improving consumers’ understanding of energy (calorie) range information
Objective Energy (calorie) ranges currently appear on menu boards for customized menu items and will likely appear throughout the USA when menu-labelling legislation is implemented. Consumer welfare advocates have questioned whether energy ranges enable accurate energy estimates. In four studies, we examined: (i) whether energy range information improves energy estimation accuracy; (ii) whether misestimates persist because consumers misinterpret …
Potential problems with increasing serving sizes on the Nutrition Facts label
The role of perceived benefits and costs in patients’ medical decisions
Background Many decisions can be understood in terms of actors’ valuations of benefits and costs. The article investigates whether this is also true of patient medical decision making. It aims to investigate (i) the importance patients attach to various reasons for and against nine medical decisions; (ii) how well the importance attached to benefits and costs predicts action or inaction; and (iii) how such valuations are related to decision confi…
Too much experience
People often use their own feelings as a basis to predict others' feelings. For example, when trying to gauge how much someone else enjoys a television show, people might think "How much do I enjoy it?" and use this answer as basis for estimating others' reactions. Although personal experience (such as actually watching the show oneself) often improves empathic accuracy, we found that gaining too much experience can impair it. Five experiments hi…
The Predictable Irrationality of Righteous Minds, and the Work of Ethicists
As Jonathan Haidt explains in The Righteous Mind, it is often our moral intuitions that come first, rapidly or even automatically, with ethical reasoning coming later. Haidt's book is one of many that have come out in recent years highlighting the relevance of psychology (and its close cousin, neuroscience) for understanding human morality. As a behavioral scientist, I have devoured many of these books. I am fascinated by human nature and love tr…
The Hazards of Correcting Myths About Health Care Reform
CONTEXT: Misperceptions are a major problem in debates about health care reform and other controversial health issues. METHODS: We conducted an experiment to determine if more aggressive media fact-checking could correct the false belief that the Affordable Care Act would create "death panels." Participants from an opt-in Internet panel were randomly assigned to either a control group in which they read an article on Sarah Palin's claims about "d…
Repeating an Attending Physician's Unseemly Remarks
A medical student has no duty to refrain from repeating a clinical instructor’s comments except for patient-revealing elements. He may, in fact, have a duty to repeat those remarks to someone who can correct the instructor
Breast cancer anxiety's associations with responses to a chemoprevention decision aid
Compared to what? A joint evaluation method for assessing quality of life
Issue Emergence, Evolution of Controversy, and Implications for Competitive Framing
Although scholarship on competitive framing acknowledges that framing is a dynamic process in which the early stages may matter most, very little research has focused on the dynamics of issue emergence. In this article, we draw on several literatures to develop theories for how controversy related to new issues will emerge and expand in news coverage. Through a comprehensive content analysis of 101 local newspapers across the fifty U.S. states, w…
Partisan Vision Biases Determination of Voter Intent
In close, disputed elections, outcomes can depend on determinations of voter intent for ballots that have been filled out improperly. We surveyed 899 adult Minnesotans during a time when the state's U.S. Senate election was still disputed and presented them with ambiguous ballots similar to ballots under dispute in the same election. We randomized participants to three experimental groups, across which we varied the names on the ballot. We found …
Abandoning the language of “response shift”
Narratives that address affective forecasting errors reduce perceived barriers to colorectal cancer screening
Caregiving Behavior Is Associated With Decreased Mortality Risk
Traditional investigations of caregiving link it to increased caregiver morbidity and mortality, but do not disentangle the effects of providing care from those of being continuously exposed to an ailing loved one with serious health problems. We explored this possible confound in a national, longitudinal survey of elderly married individuals ( N = 3,376). Results showed that spending at least 14 hr per week providing care to a spouse predicted d…
The Polarizing Effect of News Media Messages About the Social Determinants of Health
Framing health problems in terms of the social determinants of health aims to shift policy attention to nonmedical strategies to improve population health, yet little is known about how the public responds to these messages. We conducted an experiment to test the effect of a news article describing the social determinants of type 2 diabetes on the public's support for diabetes prevention strategies. We found that exposure to the social determinan…
Distributing scarce livers
The transplant system has been criticized for not paying enough attention to efficiency in distributing scarce organs. But little research has been done to see how the general public views tradeoffs between efficiency and equity. We surveyed members of the general public to see how they would distribute organs among patients with varying chances of benefiting from them. In addition, we asked subjects to explain their decisions and to tell us abou…
How stable are people's preferences for giving priority to severely ill patients
The role of decision analysis in informed consent
An important goal of informed consent is to present information to patients so that they can decide which medical option is best for them, according to their values. Research in cognitive psychology has shown that people are rapidly overwhelmed by having to consider more than a few options in making choices. Decision analysis provides a quantifiable way to assess patients' values, and it eliminates the burden of integrating these values with prob…
Narratives that address affective forecasting errors reduce perceived barriers to colorectal cancer screening
Issue Emergence, Evolution of Controversy, and Implications for Competitive Framing
Although scholarship on competitive framing acknowledges that framing is a dynamic process in which the early stages may matter most, very little research has focused on the dynamics of issue emergence. In this article, we draw on several literatures to develop theories for how controversy related to new issues will emerge and expand in news coverage. Through a comprehensive content analysis of 101 local newspapers across the fifty U.S. states, w…
Potential problems with increasing serving sizes on the Nutrition Facts label
Too much experience
People often use their own feelings as a basis to predict others' feelings. For example, when trying to gauge how much someone else enjoys a television show, people might think "How much do I enjoy it?" and use this answer as basis for estimating others' reactions. Although personal experience (such as actually watching the show oneself) often improves empathic accuracy, we found that gaining too much experience can impair it. Five experiments hi…
Sensitivity to disgust, stigma, and adjustment to life with a colostomy
The impact of considering adaptation in health state valuation
The influence of cost-effectiveness information on physicians' cancer screening recommendations
Breast cancer anxiety's associations with responses to a chemoprevention decision aid
Distributing scarce livers
The transplant system has been criticized for not paying enough attention to efficiency in distributing scarce organs. But little research has been done to see how the general public views tradeoffs between efficiency and equity. We surveyed members of the general public to see how they would distribute organs among patients with varying chances of benefiting from them. In addition, we asked subjects to explain their decisions and to tell us abou…
Justice and health care
The role of decision analysis in informed consent
An important goal of informed consent is to present information to patients so that they can decide which medical option is best for them, according to their values. Research in cognitive psychology has shown that people are rapidly overwhelmed by having to consider more than a few options in making choices. Decision analysis provides a quantifiable way to assess patients' values, and it eliminates the burden of integrating these values with prob…
Conducting Physician Mail Surveys on a Limited Budget
OBJECTIVES: The effects of incentive size on physicians' response rates to a mail survey were determined. METHODS: One thousand US primary care physicians were assigned randomly to receive a survey with either a $5 bill or a $2 bill as an incentive. For each of the two incentive groups, the overall response rate for three mailing waves, the total cost, and the total cost per usable response were measured. RESULTS: The response rate among those re…
Toward a Broader View of Values in Cost-Effectiveness Analysis of Health
Paul Menzel, Marthe R. Gold, Erik Nord, Jose-Louis Pinto-Prades, Jeff Richardson, Peter Ubel, Toward a Broader View of Values in Cost-Effectiveness Analysis of Health, The Hastings Center Report, Vol. 29, No. 3 (May - Jun., 1999), pp. 7-15
How stable are people's preferences for giving priority to severely ill patients
"Are Preferences for Equity Over Efficiency in Health Care Allocation "All or Nothing
BACKGROUND: In a previous study we showed that within a budget constraint, most people would rather offer a less effective screening test to 100% of a Medicaid population, thereby saving 1,000 lives, than a more effective test to 50% of the population, thereby saving 1,100 lives. We present here a study exploring whether this preference for equity over efficiency persists when neither test can be offered to the entire population. METHODS: Members…
Improving Value Measurement in Cost-Effectiveness Analysis
OBJECTIVE: Before cost-effectiveness analysis (CEA) can fulfill its promise as a tool to guide health care allocation decisions, the method of incorporating societal values into CEA may need to be improved. DESIGN: The study design was a declarative exposition of potential fallacies in the theoretical underpinnings of CEA. Two values held by many people-preferences for giving priority to severely ill patients and preferences to avoid discriminati…
Measuring Patient Expectations
BACKGROUND: Fulfillment of patients' expectations may influence health care utilization, affect patient satisfaction, and be used to indicate quality of care. Several different instruments have been used to measure expectations, yet little is known about how different assessment methods affect outcomes. OBJECTIVE: The object of the study was to determine whether different measurement instruments elicit different numbers and types of expectations …
Is Information Always a Good Thing
In most cases, patient preferences are crucial in making good health care decisions. For example, choices between chemotherapy and radiation treatment usually hinge on trade-offs that only patients can decide about. In recognition of the importance of patient preferences in clinical decisions, health services researchers have begun developing decision aids to help patients understand complex medical information. But these decision aids might lead…
Whose quality of life? A commentary exploring discrepancies between health state evaluations of patients and the general public
The influence of cost-effectiveness information on physicians' cancer screening recommendations
Cost and Clinical Practice Guidelines
In the good old days, physicians did what was best for each individual patient in their care, without considering cost or having to figure out whether an HMO or accreditation board was looking over their shoulders. Physicians never worried about practicing "cost-effective medicine," nor did they concern themselves with whether Health Plan Employer Data and Information Set (HEDIS) or some other standardized quality measure would be used to tabulat…
Altruism, Incentives, and Organ Donation
OBJECTIVES: This study investigated the attitudes of the transplant community toward the current policy of altruistic organ donation and 6 alternative policies offering incentives to the donor family. METHODS: Two hundred forty-nine transplant surgeons, 143 transplant coordinators, and 134 critical-care nurses rated the moral appropriateness and success of the current policy of altruistic donation, rated the moral appropriateness of the alternati…
Thoughts on Koch's Postulates
A journal author defends his research methodology on quality-adjusted life years, arguing that the measurement is imprecise but necessary in order to determine the impact of clinical interventions and cost-effectiveness of new health care technologies. Virtual Mentor is a monthly bioethics journal published by the American Medical Association
What Is Perfect Health to an 85-Year-Old
BACKGROUND: If an 85-year-old man rates his health as 90 on a scale in which 100 represents "perfect health," would his rating mean the same thing as a 90 rating from a 25-year-old? We conducted a randomized trial of 3 different ways of eliciting subjective health ratings from participants in the Health and Retirement Study to test whether the meaning of perfect health changes as people age, causing people to recalibrate their self-reported healt…
The impact of considering adaptation in health state valuation
Why are You Calling Me? How Study Introductions Change Response Patterns
Measuring Numeracy without a Math Test
Background. Basic numeracy skills are necessary before patients can understand the risks of medical treatments. Previous research has used objective measures, similar to mathematics tests, to evaluate numeracy. Objectives. To design a subjective measure (i.e., self-assessment) of quantitative ability that distinguishes low- and high-numerate individuals yet is less aversive, quicker to administer, and more useable for telephone and Internet surve…
Making Numbers Matter
Sensitivity to disgust, stigma, and adjustment to life with a colostomy
Screening Experiments and the Use of Fractional Factorial Designs in Behavioral Intervention Research
Health behavior intervention studies have focused primarily on comparing new programs and existing programs via randomized controlled trials. However, numbers of possible components (factors) are increasing dramatically as a result of developments in science and technology (e.g., Web-based surveys). These changes dictate the need for alternative methods that can screen and quickly identify a large set of potentially important treatment components…
Caregiving Behavior Is Associated With Decreased Mortality Risk
Traditional investigations of caregiving link it to increased caregiver morbidity and mortality, but do not disentangle the effects of providing care from those of being continuously exposed to an ailing loved one with serious health problems. We explored this possible confound in a national, longitudinal survey of elderly married individuals ( N = 3,376). Results showed that spending at least 14 hr per week providing care to a spouse predicted d…
The Polarizing Effect of News Media Messages About the Social Determinants of Health
Framing health problems in terms of the social determinants of health aims to shift policy attention to nonmedical strategies to improve population health, yet little is known about how the public responds to these messages. We conducted an experiment to test the effect of a news article describing the social determinants of type 2 diabetes on the public's support for diabetes prevention strategies. We found that exposure to the social determinan…
Abandoning the language of “response shift”
Psychology (37 obras) · Medicine (34 obras) · Political science (18 obras) · Health Systems, Economic Evaluations, Quality of Life (17 obras) · Family medicine (14 obras) · Economics (13 obras) · Social Psychology (12 obras) · Business (11 obras) · Law (11 obras) · Health care (10 obras)