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OHSU Online · School of Medicine

Medical Decision Making

  • Winter 2020
  • 3 Credits
  • 01/06/2020 to 03/20/2020
  • Modified 02/07/2020


This course introduces the student to decision analysis (modeling of decisions). Given uncertain information and limited resources, students will learn to model uncertainty and expected outcomes of various decisions. Course will cover Bayesian theory, decision trees, patient utilities, quality of life and cost related to health outcomes. Students will apply decision analysis techniques in addressing real world problems using software (by TreeAge, Inc.) and participate in online discussion of decision analyses in the medical literature.
Prerequisite: None, but basic understanding of probability is helpful.
Offering: Online: Winter

This syllabus is forBMI 538 OL W20,BMI 638 OL W20

Contact Information

Course Instructor: Karen Eden, Ph.D.

Office: BICC 507; Phone: 503-494-2456; [email protected]

Wei-Chun Lin, [email protected] and Meena Mishra, [email protected], will assist in the course.

Jemal Ebrahim, [email protected], will serve as the course TA.

Meeting Times

This will be a distance course taught via Sakai. Lectures, reading materials and assignments will be uploaded by 12 PM PST Wednesday afternoons, and homework assignments will be due before noon (PST) on Wednesday of the following week.  The two quizzes, the expected value lab, and the TreeAge tutorial will also be due before Wednesday noon on the date designated.  With the exception of the final exam, everything is due by noon (not midnight) on Wednesdays.

For any technical questions or if you need help logging in, please contact the Sakai Help Desk. Hours: Sakai Help Desk is available Mon – Thurs, 8 am – 7 pm, Fridays 8-5, Pacific, and Sundays 12-5.

Contact Information:
(Toll-free) 877-972-5249
(Email) [email protected]

All course work and communication will be via Sakai and email. Karen has dedicated “office hours” on Mondays, Wednesdays and Thursdays – meaning she will check the Sakai discussion boards on these days.  Jemal will check on Wednesdays, Fridays and weekends. If you pose questions on the discussion boards specifically for the instructors, responses will likely be made on these days. 



Decision Making in Health and Medicine: Integrating Evidence and Values (Paperback) by Myriam Hunink, 2nd edition, Cambridge University Press; Book (December 8, 2014) I978-1107690479.  The first edition, while available, lacks some key information contained in the second edition so we ask that you purchase the second edition.    

Software: Student version of TreeAge Pro Suite ( which will cost $55 to download and is good for 6 months for use with student activities. 


Additional references distributed during class.  There will be 3-4 supplemental papers distributed for online discussion.  Each small group will discuss 3 of these papers during 3 different weeks.  See syllabus for dates of discussion.

Course Goals

Course Competencies, Outcomes, and Objectives


Grades are based on: 3 quizzes, a final exam, 1 lab report, 1 software tutorial, a critique paper, and online discussion.

Distance Learning Activities:

All materials will be available via Sakai, this includes:

  • Weekly audio/visual or text seminars.
  • Small group discussion (via Sakai discussion board) of current decision analysis literature.
  • Small group discussion (via Sakai discussion board) of decision analysis projects.
  • Email support of student homework.


Grades are assigned based on the following criteria:

A             92-100

A-           90-91.99

B+          88-89.99

B             82-87.99                    

B-            80-81.99                    

C+           78-79.99                    

C             72-77.99                    

C-            70-71.99                    

F              <70        

Quiz 1 (10%), Quiz 2 (10%), Quiz 3 (5%),TreeAge Tutorial (5%) and Expected Value Lab (10%)

Journal Article Critique (20%), Online discussion (5%), Learning Activity (5%), Final Exam (30%)

The details of each of these tasks are explained:

Quizzes and Final Exam

There will be 3 quizzes and one final exam given online. (Hint: Questions on the quizzes and final exam will be very similar to homework problems and online discussion of published decision analyses.) The quizzes and final exam are open-book.  Students will have a few days to complete and submit the quiz which will involve 2x2 tables, creating basic decision models, computing answers and providing interpretation, understanding various decision making approaches.  The final is designed to take less than 2 hours for students who have successfully completed all homework assignments and quizzes. 

The final exam will be posted by 8 AM (US, PST) on March 12th and is multiple-choice.   Once students have signed onto the exam, they will have 2 hours to complete it.  The Sakai helpdesk will be available should questions arise related to Sakai.  Karen, Meena, Wei-Chun and Jemal will also be available by email if clarification is needed on questions.  The final exam must be completed by 5 PM (US, PST) on Saturday, March 14th.

 Lab report, Software tutorial and Weekly Assignments

There will be one lab report submitted this term.  This is a decision analysis project (Expected value lab).  There will also be one submission with figures that are created once the software tutorial (for TreeAge) is completed. 

Weekly homework is not graded but STRONGLY recommended to be successful.  The quizzes and final exam are very similar to assigned homework.  We have set up a homework forum that Karen, Meena, Wei-Chun and Jemal  will moderate.  It is likely that a peer will respond with a suggestion before we can.  We encourage this dialog around homework.  Jemal is also available to review submitted homework and give specific feedback when asked, via email.  Submit your homework named as follows:  LastName.WeekXAssignment.docFor students who submit the homework on time, the answer key will be emailed after the due date.

  Journal Article Critique

Each student will select one journal article (from a list available online via Sakai) with a decision analysis focus. More than one student will likely have the same article. Each discussant will submit to his/her small group a one-page, single-spaced summary/critique (including potential biases) of the article and post two questions (on Sakai discussion board) for classmates to respond to. The discussants of a paper should take the lead on responding to classmates’ comments and additional questions. At the end of the week’s discussion, the discussant should post a 1-2 paragraph summary of the group discussion that all small groups can view. Grading will based on the critique, participation in small group discussions (of all 3 articles) and posted summary for own critique. 

Online Discussion

Each student will have multiple opportunities to participate in online discussion. Grading will be based on participation (thoughtful questions and comments, frequency of postings) throughout the term. Participation online is extremely important to the value everyone derives from this class.


Course & Instructor Evaluations









Chapter in Hunink


January 8

Introduction to Decision Analysis and Probability

Pick Discussant Paper



January 15

2x2 Tables, Interpreting Diagnostic Information,




January 22

Introduction to TreeAge software (TreeAge Tutorial due January 29th)



January 29

Outcome Analysis/Utility Assessment/Attitude Towards Risk.  Choosing the best treatment, Quiz 1 (due February 5th)



February 5

Expected Value Decision Making

Deciding to test, Expected Value lab (due Feb 19th)



February 12

Markov Models (basic and applied lectures)

Dual Processes

Mankuta Article Discussion



February 19

Comparative and Cost Effectiveness, Intro to Data Science

Ross Article Discussion

Quiz 2 (due February 26th)



February 26

Comparison of decision methods

Shared decision making, Decision aids, Decision Science continued (optional)

Jagsi/Yao Article Discussion. 



March 4

Decision support

Review lecture and review problems



March 11

 Final distributed at 8 AM Thursday, March 12th. Exams must be completed by Saturday, March 14th, 5 PM (US, PST).



March 16

Overview of novel approaches to decision approaches.  Course evaluation due.  Learning Activity due March 18thFinal Quiz due March 20th by 5 PM.


*Most weeks the course materials will be available on Monday but always will be posted by noon on Wednesday (please note exception, week 10).

Course Policies and Resources

School Policies and Resources

Graduate Studies Guidelines:

Students are responsible for following all OHSU School of Medicine, Graduate Studies, and program/department guidelines & policies. For more information, please visit here. For program/department guidelines & policies, please inquiry with the program/department director and/or coordinator.

School of Medicine Conduct Policy (housed under the graduate studies guidelines section)

Students are responsible for their own academic work. Students are expected to have read and practice principles of academic honesty, as presented in the Graduate Studies Student Handbook.

The School of Medicine reserves the privilege of retaining only those students who, in the judgement of the faculty, satisfy the requirements of scholarship and clinical performance necessary to maintain the highest standards. The Student Handbook has information about academic standards and probation and dismissal policies.

Grading Criteria, Academic Standards, & Release of Final Grades:

Graduate Studies in the OHSU School of Medicine is committed to providing grades to students in a timely manner. Course instructors will provide students with information in writing at the beginning of each course that describes the grading policies and procedures including but not limited to evaluation criteria, expected time needed to grade individual student examinations and type of feedback they will provide.

All coursework applied towards degree requirements must meet the minimum cumulative grade point average of at least 3.0.

Refer to the School of Medicine Graduate Studies Forms & Policies for withdraw, incomplete, and in-progress grading standards. Final course grades will be posted with the OHSU Registrar the Monday following the last day of the term. On those occasions when a grade has not been submitted by the deadline, the following procedure shall be followed:

  1. The Department*/Program** Coordinator will immediately contact the Instructor requesting the missing grade, with a copy to the Program Director and Registrar.
  2. If the grade is still overdue by the end of next week, the Department*/Program** Coordinator will email the Department Chair directly, with a copy to the Instructor and Program Director requesting resolution of the missing grade.
  3. If, after an additional week the grade is still outstanding, the student or Department*/Program** Coordinator may petition the Office of Graduate Studies for final resolution.

*For courses that are run by a specific department.

**For the conjoined courses (course number is preceded by CON) that are run by Graduate Studies.

Graduate Studies Inclement Weather Procedures

Inclement weather procedures can be found here. In the case of inclement weather, the faculty member will email or place a voice-mail greeting on her/his office telephone number by 6:00am on the day of the clinical or class to give instructions to students about the class schedule.

Graduate Studies Copyright Information

Every reasonable effort has been made to protect the copyright requirements of materials used in this course. Class participants are warned not to copy, audio, or videotape in violation of copyright laws. Journal articles will be kept on reserve at the library or online for student access. Copyright law does allow for making one personal copy of each article from the original article. This limit also applies to electronic sources.

DMICE Communication Policy

  1. If the syllabus directs the student to contact the TA before contacting the instructor, the student should do so. Otherwise, the student should contact the instructor and allow 2 business days (not including weekends) for a response.
  2. If the student does not receive a response from the instructor within 2 business days, s/he should contact the TA (if there is one). When contacting the TA s/he should cc the instructor and Diane Doctor at [email protected].
  3. If a student does not receive a response from the TA within 1 business day (not including weekends), s/he should contact Diane Doctor at [email protected] and cc the instructor and the TA.
  4. If Diane does not reply within 1 business day (not including weekends), the student should contact Andrea Ilg at [email protected].
  5. Students having difficulties with Sakai should contact the Sakai Help Desk at [email protected] or at (877) 972-5249. Sakai help is available M-F from 8am to 10-pm and weekends from Noon to 5pm. Do not contact the instructor.

When Problems Arise

It is critical to contact the appropriate person when problems arise:

  • For basic Sakai problems and course issues (e.g., cannot log in, after-hours technical assistance, Course Materials or Forum not available/accessible during regular business hours/days), contact the Sakai Help Desk: Toll-Free - (877) 972-5249; email - [email protected] Sakai help is available M-F from 8 am to 9 pm and weekends from Noon to 5pm.

  • For questions about course content (e.g., do not understand a topic or disagree with homework quiz answer), contact the Teaching Assistant, who will be announced at the beginning of the course: go to the Email Tab after logging into the course and choose “Associate” role to send message to the TA or post a question in the Forums.

Examination Policy

It is OHSU policy that any exam offered online and worth more than 10% of the final course grade must be virtually proctored. In this course, we will be using the services of Examity, a remote proctoring services company. You will be required to schedule your exam three (3) weeks ahead of time. There is no cost to the student. More information will be provided to you regarding setup, scheduling, and requirements in the Course Materials.

Policy number: 02-70-050

Turn It In

In an effort to uphold the principles and practice of academic honesty, faculty members at OHSU may use originality checking systems such as Turnitin to compare a student’s submitted work against multiple sources. To protect student privacy in this process, it will be necessary to remove all personal information, i.e. student name, email address, student u-number, or any other personal information, from documents BEFORE submission.

Sakai and TLC Help Desk

You will learn through the Sakai learning management software at The online component includes reading material, lectures (including streaming presentations and handouts), project material, learning assignments, and online discussions.  If you have any technical questions or if you need help logging in, please contact the Sakai Help Desk, which is open Mon – Fri, 8 am – 9 pm and weekends 12 pm – 5 pm, Pacific Time.

Contact Information:

(Toll-free) 877-972-5249


(Email) [email protected]

Online Etiquette

Please use professional etiquette when communicating with peers and the instructor. This means avoiding aggressive or offensive language, showing respect for others’ opinions and positions, and conducting yourself as if you were face to face with them. Please pay special attention to etiquette in class forums and when using email. If you notice someone violating this policy, please make the instructor and TA aware of the problem.

School Competencies

OHSU Competencies

List of OHSU Graduation Core Competencies
  1. Professional Knowledge and Skills
  2. Reasoning and Judgement
  3. Evidence-Based Practice and Research
  4. Lifelong Learning
  5. Communication
  6. Professionalism and Ethics
  7. Teamwork
  8. Safety and Quality Improvement
  9. Systems
  10. Patient/Client-Centered Care (Clinical)
To access a descriptive list of OHSU Graduation Core Competencies:  OHSU Graduation Core Competencies

Institutional Policies and Resources

Statement Regarding Students with Disabilities:

OHSU is committed to inclusive and accessible learning environments in compliance with federal and state law. If you have a disability or think you may have a disability (mental health, attention-related, learning, vision, hearing, physical or health impacts) contact the Office for Student Access at (503) 494-0082 or OHSU Student Access to have a confidential conversation about academic accommodations. Information is also available at Student Access Website. Because accommodations may take time to implement and cannot be applied retroactively, it is important to have this discussion as soon as possible.

Portland State students also have similar resources available via the PSU Disability Resource Center (website ). Please contact the DRC at tel. (503) 725-4150 or email at [email protected]

Student Evaluation of Courses:

Course evaluation results are extremely important and used to help improve courses and the learning experience of future students. Responses will always remain anonymous and will only be available to instructors after grades have been posted. The results of scaled questions and comments go to both the instructor and their unit head/supervisor. Refer to Student Evaluation of Courses and Instructional Effectiveness, *Policy No. 02-50-035.

*To access the OHSU Student Evaluation of Courses and Instructional Effectiveness Policy, you must log into the OHSU O2 website.

Copyright Information:

Copyright laws and fair use policies protect the rights of those who have produced the material. The copy in this course has been provided for private study, scholarship, or research. Other uses may require permission from the copyright holder. The user of this work is responsible for adhering to copyright law of the U.S. (Title 17, U.S. Code). To help you familiarize yourself with copyright and fair use policies, the University encourages you to visit its Copyright Web Page

Sakai course web sites contain material protected by copyrights held by the instructor, other individuals or institutions. Such material is used for educational purposes in accord with copyright law and/or with permission given by the owners of the original material. You may download one copy of the materials on any single computer for non-commercial, personal, or educational purposes only, provided that you (1) do not modify it, (2) use it only for the duration of this course, and (3) include both this notice and any copyright notice originally included with the material. Beyond this use, no material from the course web site may be copied, reproduced, re-published, uploaded, posted, transmitted, or distributed in any way without the permission of the original copyright holder. The instructor assumes no responsibility for individuals who improperly use copyrighted material placed on the web site.

Syllabi Changes and Retention:

Syllabi are considered to be a learning agreement between students and the faculty of record. Information contained in syllabi, other than the minimum requirements, may be subject to change as deemed appropriate by the faculty of record in concurrence with the academic program and the Office of the Provost. Refer to the *Course Syllabi Policy, 02-50-050.

*To access the OHSU Course Syllabus Policy, you must log into the OHSU O2 website.

Commitment to Diversity & Inclusion:

OHSU is committed to creating and fostering a learning and working environment based on open communication and mutual respect. If you encounter sexual harassment, sexual misconduct, sexual assault, or discrimination based on race, color, religion, age, national origin, veteran’s status, ancestry, sex, marital status, pregnancy or parenting status, sexual orientation, gender identity, disability or any other protected status please contact the Affirmative Action and Equal Opportunity Department at 503-494-5148 or [email protected]. Inquiries about Title IX compliance or sex/gender discrimination and harassment may be directed to the OHSU Title IX Coordinator at 503-494-0258 or [email protected]

Modified Operations, Policy 01-40-010:

Portland Campus:  Marquam Hill and South Waterfront

Students should review O2 or call OHSU’s weather alert line at 503-494-9021 for the most up-to-date information on OHSU-wide modified operations which include but are not limited to delays or closures for inclement weather.

If your home institution is not on the Portland campus (Marquam Hill or South Waterfront, contact your home institution for more information.

OHSU Resources Available to Students*:

Registrar’s Office
Mackenzie Hall, Rm. 1120
503-494-7800; Email the Registrar

Student Registration Information: 
To Register for Classes

OHSU ITG Help Desk
Regular staff hours are 6 a.m. to 6 p.m., Monday through Friday, but phones are answered seven days a week, 24 hours a day. Call 503 494-2222.

Teaching and Learning Center
Academic Support Counseling and Sakai Course Management System, please contact the TLC Help Desk at 877-972-5249 or email TLC Help Desk

Concourse Syllabus Management
For help with accessing your Concourse Syllabus:  Please contact the Sakai help Desk for all other Concourse inquiries please visit the Concourse Tutorial Website or please contact the Mark Rivera at [email protected] or call 503-494-0934

Public Safety

OHSU Public Safety-Portland Campus (Marquam Hill and South Waterfront)

*Joseph B. Trainer Health & Wellness Center 
Baird Hall, Rm. 18 (Primary Care) and Rm. 6 (Behavioral Health)
503-494-8665; For urgent care after hours, 503-494-8311 and ask for the Nurse on call.
Wellness Center Information  
Wellness Center Website

If your home institution is not on the Portland campus, contact your home institution student support services for more information.

Ombudsman Office
Gaines Hall, Rm. 117
707 SW Gaines Street, Portland, OR 97239
503-494-5397; Contact OmbudsmanOmbudsman Website

Library: Biomedical Information Communication Center
BICC Library Hours of Operation

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