Got DEAL?

Photo: Molly Beinfeld

Jeff Belkora studies and teaches strategies for improving leadership, teamwork, and decision-making. Below are some scientific articles summarizing key concepts, methods, and measures.

Selected articles by Jeff Belkora and colleagues:

1.    Esserman L, Belkora J, Lenert L. Potentially ineffective care. A new outcome to assess the limits of critical care. JAMA. 1995 Nov 15;274(19):1544-51. http://jama.ama-assn.org/cgi/content/abstract/274/19/1544

2.    Sepucha K, Belkora J, Tripathy D, Esserman L. Building bridges between physicians and patients: results of a pilot study examining new tools for collaborative decision making in breast cancer. J Clin Oncol. 2000 Mar;18(6):1230-8. http://jco.ascopubs.org/cgi/content/full/18/6/1230

3.    Burnside E, Belkora J, Esserman L. The impact of alternative practices on the cost and quality of mammographic screening in the United States. Clin Breast Cancer. 2001 Jul;2(2):145-52.  http://cigjournals.metapress.com/content/7q505347l225w777/

4.    Sepucha K, Belkora J, Mutchnick S, Esserman L. Consultation planning to help breast cancer patients prepare for medical consultations: effect on communication and satisfaction for patients and physicians. J Clin Oncol. 2002 Jun 1;20(11):2695-700. http://jco.ascopubs.org/cgi/content/full/20/11/2695

5.    Sepucha K, Belkora J, Aviv C, Mutchnik S, Esserman L. Improving the quality of decision making in breast cancer: consultation planning template and consultation recording template. Oncol Nurs Forum. 2003 Jan-Feb;30(1):99-106. http://ons.metapress.com/content/tmx6704563542313/

6.    Belkora, J. Use of the Decision Dialogue Process for Improving the Quality of Medical Decisions [online]. In: Coiera, Enrico (Editor); Chu, Stephen (Editor); Simpson, Carmel (Editor). HIC 2003 RACGP12CC [combined conference]: Proceedings. Brunswick East, Vic.: Health Informatics Society of Australia (HISA); Royal Australian College of General Practitioners (RACGP), 2003: [385-397]. http://search.informit.com.au/documentSummary;dn=936349164604705;res=IELHEA

7.    Belkora J, Katapodi M, Moore D, Franklin L, Hopper K, Esserman L. Evaluation of a visit preparation intervention implemented in two rural, underserved counties of Northern California. Patient Educ Couns, 2006. 64(1-3): p. 350-9. http://http://www.ncbi.nlm.nih.gov/pubmed/16904859

8.    Sepucha K, Belkora J: Putting shared decision making to work in breast and prostate cancers: tools for community oncologists. Commun Oncol 2007, 4(11):685-689, 691.  http://www.communityoncology.net/co/journal/articles/0411685.pdf

9.    Belkora J, Edlow B, Aviv C, Sepucha K, Esserman L: Training community resource center and clinic personnel to prompt patients in listing questions for doctors: follow-up interviews about barriers and facilitators to the implementation of Consultation Planning. Implementation Science 2008, 3:6. http://www.implementationscience.com/content/3/1/6

10.   Belkora J, Rugo H, Moore D, Hutton D, and Esserman L, Risk communication with patients with breast cancer: cautionary notes about printing Adjuvant! estimates. Lancet Oncol, 2008. 9: p. 602-3 http://www.thelancet.com/journals/lanonc/article/PIIS147020450870158X/abstract

11.   Belkora J, Loth M, Chen D, Chen J, Volz S, and Esserman L, Monitoring the Implementation of Consultation Planning, Recording, and Summarizing in a Breast Care Center. Patient Educ Couns, 2008 Dec;73(3):536-43.  http://www.sciencedirect.com/science/article/B6TBC-4T9TC3F-1/2/62b9f97ed06ccc24b0cba4d8f49a5bf0

12.   Ozanne E, Braithwaite D, Sepucha K, Moore D, Esserman L, Belkora J. Sensitivity to Input Variability of the Adjuvant! Online Breast Cancer Prognostic Model. J Clin Oncol. Jan 10 2009;27(2):214-219.  http://jco.ascopubs.org/cgi/doi/10.1200/JCO.2008.17.3914

13.   Braithwaite D, Moore D, Liebman M, Belkora J, West D, Satariano W, Tammemagi C, Ozanne E, Hiatt R, Esserman L. Hypertension is an independent predictor of survival disparity between African American and white breast cancer patients. Int J Cancer. 2009 Mar 1;124(5):1213-9.  http://www3.interscience.wiley.com/journal/121431839/abstract?CRETRY=1&SRETRY=0

14.   Belkora J, Moore D, Hutton D. Assessing risk communication in breast cancer: Are continuous measures of patient knowledge better than categorical? Patient Educ Couns 2009, 76(1):106-112. http://www.sciencedirect.com/science/article/B6TBC-4V8N7H8-1/2/69bcce336b74be885cfcd43b46284ad0

15.   Belkora J, Rugo HS, Moore D, Hutton D, Chen F, Esserman L: Oncologist use of the Adjuvant! model for risk communication: a pilot study examining patient knowledge of 10-year prognosis. BMC Cancer 2009, 9:127. http://www.biomedcentral.com/1471-2407/9/127

16.   Hutton D, Belkora J, Shachter R, Moore D. Are patients getting the "gist" in risk communication: patient knowledge of breast cancer therapy prognosis. J Cancer Educ 2009, 24(3):194-199.  http://www.informaworld.com/smpp/section?content=a912376147&fulltext=713240928

17.   Belkora J, Franklin L, O'Donnell S, Ohnemus J, and Stacey D. Adaptation of Consultation Planning for Native American and Latina women with breast cancer. Journal of Rural Health 2009;25:384-7.  http://www3.interscience.wiley.com/cgi-bin/fulltext/122606544/HTMLSTART

18.    Belkora J, Loth M, Volz S, and Rugo H. Implementing decision and communication aids to facilitate patient-centered care in breast cancer: A case study. Patient Educ Couns 2009;77:360-8 http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19850438

19.   Franklin L, Belkora J, O'Donnell S, Elsbree D, Hardin J, Ingle B, and Johnson N. Consultation support for rural women with breast cancer: Results of a community-based participatory research study. Patient Educ Couns 2010;80:80-87. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19889509 

20.   Sepucha K, Belkora J. Importance of Decision Quality in Breast Cancer Care. Psicooncología. Vol. 7, Núm. 2-3, 2010, pp. 313-328. http://seom.org/seomcms/images/stories/recursos/sociosyprofs/documentacion/psicooncologia/vol7_numero2-3/articulo7.pdf

21.   Belkora J, Teng A, Volz S, Loth M, Esserman L. Expanding the reach of decision and communication aids in a breast care center: a quality improvement study. Patient Education and Counseling. 2011;83:234-9.  http://www.sciencedirect.com/science/article/pii/S0738399110004040

22.   Lee C, Belkora J, Chang Y, Moy B, Partridge A, Sepucha K. Are patients making high-quality decisions about breast reconstruction after mastectomy? Plast Reconstr Surg. 2011 Jan;127(1):18-26. http://www.ncbi.nlm.nih.gov/pubmed/21200195

23.   Belkora J, Hutton D, Moore D, Siminoff L. Does use of the Adjuvant! model influence use of adjuvant therapy through better risk communication? JNCCN-The Journal of the National Comprehensive Cancer Network. 2011 Jul; 9(7):707-12.  http://www.ncbi.nlm.nih.gov/pubmed/21715722

24.   Belkora J, Franklin L, O'Donnell S. Using the Critical Incident Technique in Community-based Participatory Research. Progress in Community Health Partnerships: Research, Education, and Action. 2011 Winter;5(4):443-51. http://www.ncbi.nlm.nih.gov/pubmed/22616212

25.   Lee C, Chang Y, Adimorah N, Belkora J, Moy B, Partridge A, Ollila D, Sepucha K. Decision making about surgery for early stage breast cancer. Journal of the American College of Surgeons. 2012 Jan;214(1):1-10. http://www.ncbi.nlm.nih.gov/pubmed/22056355

26.   Belkora J, Volz S, Teng A, Moore D, Loth M, Sepucha K. Impact of decision aids in a sustained implementation at a breast care center. Patient Education and Counseling, 2012 Feb;86(2):195-204. http://www.sciencedirect.com/science/article/pii/S0738399111002370

27.   Pass M, Belkora J, Moore D, Volz S, Sepucha K. Patient and observer ratings of physician shared decision making behaviors in breast cancer consultations. Patient Education and Counseling 2012; 88(1): 93-99. http://www.ncbi.nlm.nih.gov/pubmed/22322069

28.   Cohen E, Belkora J, Tyler J, Schreiner J, Deering MJ, Grama L, Duggan B, Illi J, Pederson J, Anand A, Teng A, McCreary E, Moore D, Tripathy D, Hogarth M, Lieberman M, Park J, Esserman L. Adoption, Acceptability, and Accuracy of an Online Clinical Trial Matching Website for Breast Cancer. J Med Internet Res 2012;14(4):e97.  http://www.jmir.org/2012/4/e97/

29.   Hacking B, Wallace LM, Scott S, Kosmala-Anderson J, Belkora J, McNeill A. Decision Navigation intervention for early stage prostate cancer patients in Scotland – A Randomised Controlled Trial. Psychooncology. 2013 May;22(5):1017-24. http://www.ncbi.nlm.nih.gov/pubmed/22570252

30.   Sepucha K, Belkora J, Chang Y, Cosenza C, Levin C, Moy B, Partridge A, Lee C. Measuring decision quality: psychometric evaluation of a new instrument for breast cancer surgery. BMC Med Inform Decis Mak. 2012 Jun 8;12(1):51. http://www.biomedcentral.com/1472-6947/12/51

31.   Belkora J, Stupar L, O'Donnell S, Loucks A, Moore D, Jupiter C, Johnson N, Wilson L. Decision Support by Telephone: Randomized Controlled Trial in a Rural Community Setting. Patient Education and Counseling 2012; 89 (1): 134-142. http://www.ncbi.nlm.nih.gov/pubmed/22776761

32.   Pass M, Volz S, Teng A, Esserman L, Belkora J. Physician behaviors surrounding the implementation of decision and communication aids in a breast cancer clinic: a qualitative analysis of staff intern perceptions. J Cancer Educ. 2012 Dec;27(4):764-9. http://www.ncbi.nlm.nih.gov/pubmed/22923382

33.   Youm J, Chenok K, Belkora J, Chiu V,  Bozic K. The Emerging Case for Shared Decision Making in Orthopaedics. Instr Course Lect.[1]  2013;62:587-94. http://www.ncbi.nlm.nih.gov/pubmed/23395061

34.   Frongillo M, Feibelmann S, Belkora J, Lee C, Sepucha K. Is there shared decision making when the provider makes a recommendation? Patient Education and Counseling, 2013 Jan;90(1):69-73. http://www.pec-journal.com/article/S0738-3991(12)00344-8/fulltext

35.   Volz S, Moore D, Belkora J. Do patients use decision and communication aids as prompted when meeting with breast cancer specialists? Health Expect. 2013 Jan 7. [Epub ahead of print]. http://www.ncbi.nlm.nih.gov/pubmed/23294338

36.   Belkora J, Miller M, Crawford B, Coyne K, Stauffer M, Buzaglo J, Blakeney N, Michaels M, Golant M. Evaluation of question-listing at the Cancer Support Community. Translational Behavioral Medicine. Transl Behav Med. 2013 Jun;3(2):162-71. http://www.ncbi.nlm.nih.gov/pubmed/24073167

37.   Bozic K, Belkora J, Chan V, Youm J, Zhou T, Dupaix J, Nava Bye A, Braddock C, Chenok K, Huddleston J. Shared Medical Decision Making in Patients with Osteoarthritis of the Hip and Knee: Results of a Randomized, Controlled Clinical Trial. J Bone Joint Surg Am[2] . 2013 Sep 18;95(18):1633-9. http://www.ncbi.nlm.nih.gov/pubmed/24048550

38.   Stacey D, Kryworuchko J, Belkora J, Davison J, Durand M-A, Eden K, Hoffman A, Koerner M, Légaré F, Loiselle M-C, and Street R. Coaching and guidance with patient decision aids: A review of theoretical and empirical evidence. BMC Medical Informatics and Decision Making 2013, 13(Suppl 2):S11. http://www.biomedcentral.com/1472-6947/13/S2/S11

39.   Kurian A, Mitani A, Desai M, Yu P, Seto T, Weber S, Olson C, Kenkare P, Gomez S, Leung R, Lee W-N, de Bruin M, Horst K, Belkora J, May S, Frosch D, Blayney D, Luft HS, and Das AK, Breast cancer treatment across health care systems: linking electronic medical records and state registry data to enable outcomes research. Cancer[3] . 2013 Sep 24. [Epub ahead of print]. http://www.ncbi.nlm.nih.gov/pubmed/24101577

40.   Zarin-Pass M, Belkora J, Volz S, Esserman L. Making Better Doctors: Premedical interns working as health coaches. Zarin-Pass M, Belkora J, Volz S, Esserman L. Making Better Doctors: Premedical interns working as health coaches. J Cancer Educ. 2013 Oct 28. [Epub ahead of print]. http://www.ncbi.nlm.nih.gov/pubmed/24163016

41.   Danesh M, Belkora J, Volz S, Rugo H. Informational Needs of Patients with Metastatic Breast Cancer: What questions do they ask, and are physicians answering them? J Cancer Educ. 2013 Oct 19. [Epub ahead of print]. http://www.ncbi.nlm.nih.gov/pubmed/24142513

42.   Hacking B, Scott SE, Wallace LM, Shepherd SC, and Belkora J. Navigating healthcare: a qualitative study exploring prostate cancer patients' and doctors’ experience of consultations using a decision support intervention. Psychooncology. 2014 Jun;23(6):665-71. http://www.ncbi.nlm.nih.gov/pubmed/24677394

43.   Youm J, Chan V, Belkora J, Bozic K. Impact of Socioeconomic Factors on Informed Decision Making and Treatment Choice in Patients with Hip and Knee OA. J Arthroplasty. 2014 Sep 16. http://www.ncbi.nlm.nih.gov/pubmed/25301018

Lee C, Wetschler M, Chang Y, Belkora J, Moy B, Partridge A, Sepucha K. Measuring decision quality: psychometric evaluation of a new instrument for breast cancer chemotherapy. BMC Medical Informatics and Decision Making, 2014 Aug 20;14:73. http://www.ncbi.nlm.nih.gov/pubmed/25142035

45.   Katz S, Belkora J, Elwyn G. Shared Decision-Making for Treatment of Cancer - Challenges and Opportunities. Journal of Oncology Practice, Vol 10, Issue 3, 206-208 (May 2014). http://jop.ascopubs.org/content/10/3/206.full

46.   Bozic K, Chenok K, Schindel J, Chan V,  Huddleston J,  Braddock C, and Belkora J. Patient, Surgeon, and Healthcare Purchaser Views on the use of Decision and Communication Aids in Orthopaedic Surgery: A Mixed Methods Study. BMC Health Serv Res. 2014 Aug 31;14(1):366. http://www.ncbi.nlm.nih.gov/pubmed/25176023

47.   Belkora J, Miller M, Dougherty K, Gayer C, Golant M, Buzaglo J. The need for decision and communication aids: a survey of breast cancer survivors. Journal of Community and Supportive Oncology. 2015;13:104-112. http://www.oncologypractice.com/fileadmin/content_pdf/co/JCSO_March_2015_104_Belkora.pdf

 48. Belkora, Jeff. "Evaluating Client Discovery Interviews at a Financial Advisory Firm." The Journal of Wealth Management. 18.1 (2015): 9-23. 

49. Belkora J, Volz S, Loth M, Teng A, Zarin-Pass M, Moore D, Esserman L. Coaching patients in the use of decision and communication aids: RE-AIM evaluation of a patient support program. 2015, 15:209. http://www.biomedcentral.com/1472-6963/15/209

Systematic Reviews of decision and communication aids

McClement, S.E. and T.F. Hack, Audio-taping the oncology treatment consultation: a literature review. Patient Educ Couns, 1999. 36(3): p. 229-38.

Harrington, J., L.M. Noble, and S.P. Newman, Improving patients' communication with doctors: a systematic review of intervention studies. Patient Educ Couns, 2004. 52(1): p. 7-16.

Griffin, S.J., et al., Effect on health-related outcomes of interventions to alter the interaction between patients and practitioners: a systematic review of trials. Ann Fam Med, 2004. 2(6): p. 595-608.

O'Connor AM, Stacey D, Entwistle V, Llewellyn-Thomas H, Rovner D, Holmes-Rovner M, Tait V, Tetroe J, Fiset V, Barry M, Jones J. Decision aids for people facing health treatment or screening decisions. Cochrane Database Syst Rev 2003:CD001431.

Scott, J.T., et al., Recordings or summaries of consultations for people with cancer. Cochrane Database Syst Rev, 2003(2) CD001539.

Murray E, et al., Interactive Health Communication Applications for people with chronic disease. Cochrane Database Syst Rev, 2005 (4): CD004274.

Kinnersley P, Edwards A, Hood K, Cadbury N, Ryan R, Prout H, Owen D, MacBeth F, Butow P, Butler C. Interventions before consultations for helping patients address their information needs. Cochrane Database of Systematic Reviews: Reviews 2007 Issue 3 John Wiley & Sons, Ltd Chichester, UK DOI:

Dimoska A, Tattersall MH, Butow PN, Shepherd H, and Kinnersley P,Can a "prompt list" empower cancer patients to ask relevant questions?Cancer, 2008. 113: p. 225-37.

Selected Studies of visit preparation, consultation support, or decision aiding

Roter, D.L., Patient participation in the patient-provider interaction: the effects of patient question asking on the quality of interaction, satisfaction and compliance. Health Educ Monogr, 1977. 5(4): p. 281-315.

Greenfield, S., S. Kaplan, and J. Ware, Expanding Patient Involvement in Care: Effects on Patient Outcomes. Annals of Internal Medicine, 1985. 102: p. 520-528.

Greenfield, S., Kaplan S, et al., Patient's Participation in Medical Care: Effects on Blood Sugar Control and Quality of Life in Diabetes. Journal of Internal Medicine, 1988. 3 (Sept/Oct): p. 448-457.

Butow, P.N., et al., Patient participation in the cancer consultation: evaluation of a question prompt sheet. Ann Oncol, 1994. 5(3): p. 199-204.

Brown, R., et al., Promoting patient participation in the cancer consultation: evaluation of a prompt sheet and coaching in question-asking. Br J Cancer, 1999. 80(1-2): p. 242-8.

Brown, R.F., et al., Promoting patient participation and shortening cancer consultations: a randomised trial. Br J Cancer, 2001. 85(9): p. 1273-9.

Tattersall, M.H., Consultation audio-tapes: an information aid, and a quality assurance and research tool. Support Care Cancer, 2002. 10(3): p. 217-21.

Information and communication needs

Rutten, L.J., et al., Information needs and sources of information among cancer patients: a systematic review of research (1980-2003). Patient Educ Couns, 2005. 57(3): p. 250-61.

Hack, T.F., L.F. Degner, and P.A. Parker, The communication goals and needs of cancer patients: a review. Psychooncology, 2005. 14(10): p. 831-45; discussion 846-7.

Fellowes D, Wilkinson S, and Moore P, Communication skills training for health care professionals working with cancer patients, their families and/or carers. Cochrane Database Syst Rev, 2004: p. CD003751

Kennedy Sheldon L, Communication in oncology care: the effectiveness of skills training workshops for healthcare providers. Clinical Journal of Oncology Nursing, 2005. 9: p. 305-12

Stewart MA, Effective physician-patient communication and health outcomes: a review. CMAJ, 1995. 152: p. 1423-33