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Division of Clinical Decision Making, Informatics + Telemedicine

We use data and decision analysis software to help doctors and patients.
Peter Neumann, ScD, Director, Center for the Evaluation of Value and Risk in Health at the Institute for Clinical Research and Health Policy Studies works with colleague at whiteboard.
A new approach to improving patient care

The Division of Clinical Decision Making, Informatics and Telemedicine began as a collaboration between computer scientists at the Massachusetts Institute of Technology (MIT) and physicians at Tufts Medical Center (Tufts MC) and Tufts University School of Medicine. Under the guidance of Drs. Stephen Pauker and Jerome Kassirer, it was formally established within the Department of Medicine in 1980 to conduct research, teach, train physicians and provide consultations.

Applying decision analysis, utility assessment, literature synthesis, medical informatics and artificial intelligence in medicine, the division focuses on clinical decision analysis, cost-effectiveness and health policy analysis at institutional and policy levels. It has been involved with technology assessment, guideline development, health outcome analysis, consensus conferences, expert panels, clinical informatics, clinical decision support, quality of care assessment and theory of constraints.

The division uses techniques for computerized decision analysis in medical decision-making:

  • Decision tree construction
  • Markov model development
  • Monte Carlo simulation
  • Bayesian interpretation of diagnostic tests
  • Measurement of patient preferences
  • Cost-effectiveness analysis
  • Literature review
  • Meta-analysis
  • Discrete event simulation

Contact info

Department research

The Division of Clinical Decision Making participates in research across Tufts MC, including the use of clinical decision analysis, cost-effectiveness analysis, patient preference or utility assessment for quality of life, literature synthesis and meta-analysis, clinical cognition (how doctors think) and medical informatics. 

By incorporating the patient's perspective and their health preferences and goals, clinical decision analysis instantiates patient-centered outcome research by explicitly examining the choices (alternative treatments or tests), the chances (the uncertainty of harmful or beneficial outcomes) and the consequences (the health outcomes or prognosis personalized for the patient's values) and determining the optimal strategy and the circumstances under which an alternative might be preferable. 

At the health policy level, including the NIH, CDC, AHRQ, ACP, AMA, IOM and WHO, the division has been involved with technology assessment, guideline development, health outcome analysis, consensus conferences, expert panels, clinical informatics, clinical decision support, quality of care assessment, performance measures, decision aids, shared decision making, theory of constraints and telemedicine. Division members have participated in translating evidence into quality improvement and quality performance measures for consideration and adoption by the National Quality Forum. View some of our recent publications.

Residencies + fellowships

Trainees in the Clinical Decision Making Fellowship spend 2 or 3 years in the program, participating in all division activities. Our fellows are interested in pursuing a career in academic medicine and have good analytic skills. We are located at Tufts MC, the principal teaching hospital for the Tufts University School of Medicine in downtown Boston. Candidates must arrange their own funding.

The fellowship consists of 1 to 3 years of postdoctoral research training in clinical informatics, clinical decision analysis, cost-effectiveness (especially pharmaco-economics) and health policy analysis, guideline development, clinical decision support, clinical cognition and clinical reasoning and telemedicine.

Depending on funding, fellows can take formal courses at local institutions such as Tufts University, Boston University, MIT and Harvard as part of the program. Trainees are strongly encouraged to develop independent projects in informatics, pharmaco-economics or decision theory, which lead to publications and presentations at national meetings.

Learn more

Our leadership

Our leadership team gives us the guidance and support we need to ensure that the clinical, research and training goals of the department are met.

Pharmacy Resident, Dylan Freeman, meeting with Kevin Wu, Clinical Staff Pharmacist, and Erin Greel, Clinical Staff Pharmacist, at a computer station at Lowell General Hospital on D4.
Our locations

From regular office visits to inpatient stays, our specialists across Tufts Medicine offer the best in healthcare, when and where our patients need it.

Physician Assistant, Rakhi Patel reviewing clinical information on a computer with nurses (Elizabeth Levesque, Delaney McCarthy and Fionna Donovan) in the neurology trauma unit at Tufts Medical Center.
Our doctors + care team

Our specialists and care team members across Tufts Medicine deliver unmatched healthcare with a personalized touch.

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