Liana Fraenkel, MD, MPH
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About
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Professor Adjunct
Biography
Dr. Fraenkel’s research interests lie in applying scientifically rigorous approaches to better understand and improve both patient and physician decision making. Her efforts have resulted in a series of papers describing the use and value of conjoint analysis to ascertain patient treatment preferences across a range of sociodemographic groups and diseases, and customization of the original software program to improve use with patients. Dr. Fraenkel’s work has also led to new insights into decision making which have important clinical implications. For example, using conjoint analysis, she has demonstrated that rheumatoid arthritis patient preferences for more aggressive treatment with disease modifying antirheumatic drugs differ by race, with Black patients preferring less aggressive treatment compared to White patients with similar disease severity. These results may help explain the disparity in utilization of newer riskier drugs in minority patients. Dr. Fraenkel has also developed decision support tools, based on Fuzzy Trace theory, for patients facing decision involving medications with significant risks of toxicity.
Appointments
Rheumatology
Professor AdjunctPrimary
Other Departments & Organizations
Education & Training
- Fellow
- Boston University (1998)
- MPH
- Boston University (1997)
- MD
- McGill University (1990)
- BS
- McGill University (1986)
Research
Overview
I am currently using interactive computer tools to quantify the trade-offs that patients make when faced with multiple
alternatives and to predict treatment choices. My long-term goal is to develop innovative approaches to improve
decision making to ensure that patients are well–informed of available alternatives and to help providers effectively
communicate complex medical information to their patients in a manageable way.
Medical Research Interests
ORCID
0000-0002-6148-610X
Research at a Glance
Yale Co-Authors
Publications Timeline
Research Interests
David Y Hwang, MD, FAAN (Neurology), FCCM, FNCS
Kevin Sheth, MD
David Fiellin, MD
E. Jennifer Edelman, MD, MHS, BS
Evelyn Hsieh, MD, PhD
Farah Kidwai-Khan
Decision Making
Rheumatology
Decision Making, Computer-Assisted
Publications
2024
The Feasibility and Acceptability of a Clinical Pharmacist-delivered Intervention to Reduce Bothersome Health Symptoms from Polypharmacy and Alcohol Use and Communicate Risk among People with HIV: Pilot Study Protocol
Womack J, Leblanc M, Sager A, Zaets L, Maisto S, Garcia A, Aoun-Barakat L, Brown S, Edelman E, Fiellin D, Fisher J, Fraenkel L, Kidwai-Khan F, Marconi V, Martino S, Pulk R, Satre D, Virata M, Justice A, Hsieh E. The Feasibility and Acceptability of a Clinical Pharmacist-delivered Intervention to Reduce Bothersome Health Symptoms from Polypharmacy and Alcohol Use and Communicate Risk among People with HIV: Pilot Study Protocol. AIDS And Behavior 2024, 1-15. PMID: 39465468, DOI: 10.1007/s10461-024-04533-6.Peer-Reviewed Original ResearchConceptsUnhealthy alcohol useAlcohol usePharmacist-delivered interventionVeterans Aging Cohort StudyPilot study protocolStudy protocolElectronic health recordsSupport behavior changePre-test/post-test designAging Cohort StudySelf-administered surveyAlcohol use disorderAlcohol Research CenterBothersome symptomsPre-test/post-testCommunicating riskHealth recordsLong-term medicationHealth symptomsCounseling interventionCounseling sessionsSessions 2 weeksQualitative interviewsAlcohol consumptionUse disorder380 WHAT TREATMENT WOULD PATIENTS WITH ACL INJURY CONSIDER TO PREVENT POST-TRAUMATIC OSTEOARTHRITIS?
Kennedy K, Waddell L, Easterbrook A, Katz J, Jacobs C, Jones M, Selzer F, Losina E, Fraenkel L, Bansback N. 380 WHAT TREATMENT WOULD PATIENTS WITH ACL INJURY CONSIDER TO PREVENT POST-TRAUMATIC OSTEOARTHRITIS? Osteoarthritis And Cartilage 2024, 32: s272. DOI: 10.1016/j.joca.2024.02.392.Peer-Reviewed Original ResearchAn Emergency Department-based system intervention to improve osteoporosis screening for older adults at high-risk of fracture
Jackson L, Skains R, Mudano A, Techarukpong N, Booth J, Saag K, Fraenkel L, Danila M. An Emergency Department-based system intervention to improve osteoporosis screening for older adults at high-risk of fracture. JBMR Plus 2024, 8: ziae038. PMID: 38681999, PMCID: PMC11055962, DOI: 10.1093/jbmrpl/ziae038.Peer-Reviewed Original ResearchConceptsElectronic medical record alertsBone mineral density testingElectronic medical recordsOsteoporosis careEmergency departmentED visitsOlder adultsOsteoporosis screeningLong-term care residentsTertiary-care emergency departmentImprove osteoporosis screeningBone mineral densityFracture riskHigh risk of fractureHigh riskScreening educationCare deliveryFall riskCare residentsChief complaintTest referralsAbstract FallsStudy staffBMD testingParticipant refusalPreferences and decisional considerations relating to opioid agonist therapy among Ukrainian people who use drugs: A conjoint analysis survey.
Bromberg D, Madden L, Fraenkel L, Muthulingam D, Rhoades D, Dvoriak S, Dumchev K, Pykalo I, Altice F. Preferences and decisional considerations relating to opioid agonist therapy among Ukrainian people who use drugs: A conjoint analysis survey. PLOS Global Public Health 2024, 4: e0002725. PMID: 38277422, PMCID: PMC10817130, DOI: 10.1371/journal.pgph.0002725.Peer-Reviewed Original ResearchCitationsConceptsOpioid agonist therapyWithdrawal symptomsAdverse side effectsAgonist therapySide effectsOpioid use disorderQuality-of-life improvementUse disorderCombined HIVHIV incidenceClinical decision-makingDosing frequencyRespondent-driven samplingOpioidOpioid epidemicAssess preferencesClinical concernPatient preferencesPatientsDelivery strategiesTherapyDisordersHIVPatient concernsWithdrawalThe Art of Communicating Risk and Benefit to Promote Shared Decision‐Making, Informed by Behavioral Economic Principles
Curtis J, Fraenkel L. The Art of Communicating Risk and Benefit to Promote Shared Decision‐Making, Informed by Behavioral Economic Principles. Arthritis & Rheumatology 2024, 76: 493-496. PMID: 37909387, DOI: 10.1002/art.42742.Peer-Reviewed Original ResearchCitationsAltmetric
2023
Mortality Rate Among Patients with Alcohol Use Disorder with Two or More Readmissions to the Hospital
Terechin O, Johansen P, Rosen A, Morgan M, Fraenkel L. Mortality Rate Among Patients with Alcohol Use Disorder with Two or More Readmissions to the Hospital. Journal Of Community Hospital Internal Medicine Perspectives 2023, 13: 90-93. PMID: 37868665, PMCID: PMC10589033, DOI: 10.55729/2000-9666.1235.Peer-Reviewed Original ResearchAltmetricConceptsAlcohol use disorderMore hospital readmissionsHigh mortality rateUse disordersMortality rateHospital readmissionPsychiatric careUtilization of medicationsHazardous alcohol consumptionSerious medical conditionMore readmissionsChart reviewMost patientsDeceased patientsHigh morbidityClinical dataSurvival statusMedical conditionsPatientsAlcohol consumptionSignificant burdenPsychiatric conditionsReadmissionDisordersMedications
2018
Characteristics of Surrogate Decision Makers Selecting Life-sustaining Therapy for Severe Intracerebral Hemorrhage Patients: a Neuropalliative Care Survey of the US Population (S7.003)
Hwang D, Knies A, White D, Holloway R, Sheth K, Fraenkel L. Characteristics of Surrogate Decision Makers Selecting Life-sustaining Therapy for Severe Intracerebral Hemorrhage Patients: a Neuropalliative Care Survey of the US Population (S7.003). Neurology 2018, 90 DOI: 10.1212/wnl.90.15_supplement.s7.003.Peer-Reviewed Original Research
2017
Priorities of surrogate decision makers when making decisions for intracerebral hemorrhage patients with poor prognosis: a latent class analysis of the US population (P3.033)
Hwang D, Knies A, Holloway R, White D, Sheth K, Fraenkel L. Priorities of surrogate decision makers when making decisions for intracerebral hemorrhage patients with poor prognosis: a latent class analysis of the US population (P3.033). Neurology 2017, 88 DOI: 10.1212/wnl.88.16_supplement.p3.033.Peer-Reviewed Original Research
2012
A Pilot Randomized Controlled Trial of a Decision Support Tool to Improve the Quality of Communication and Decision‐Making in Individuals with Atrial Fibrillation
Fraenkel L, Street RL, Towle V, O'Leary JR, Iannone L, Van Ness P, Fried TR. A Pilot Randomized Controlled Trial of a Decision Support Tool to Improve the Quality of Communication and Decision‐Making in Individuals with Atrial Fibrillation. Journal Of The American Geriatrics Society 2012, 60: 1434-1441. PMID: 22861171, PMCID: PMC3419306, DOI: 10.1111/j.1532-5415.2012.04080.x.Peer-Reviewed Original ResearchCitationsAltmetricMeSH Keywords and ConceptsConceptsNonvalvular atrial fibrillationIntervention participantsAtrial fibrillationControl groupTreatment planPrimary care clinicsCurrent treatment planPatient-clinician communicationPhysician-patient communicationDecisional Conflict ScaleSecondary outcomesPrimary outcomeStroke riskCare clinicsControlled TrialsIntervention groupSide effectsValues clarityMedicationsFibrillationStrokeLower scoresRiskTrialsVisitsDecision tool to improve the quality of care in rheumatoid arthritis
Fraenkel L, Peters E, Charpentier P, Olsen B, Errante L, Schoen RT, Reyna V. Decision tool to improve the quality of care in rheumatoid arthritis. Arthritis Care & Research 2012, 64: 977-985. PMID: 22392766, PMCID: PMC3375390, DOI: 10.1002/acr.21657.Peer-Reviewed Original ResearchCitationsAltmetricMeSH Keywords and ConceptsConceptsRheumatoid arthritisBiologic therapyDisease-modifying antirheumatic drugsOngoing active diseaseProportion of subjectsQuality of careActive diseaseAntirheumatic drugsRA patientsClinical trialsPatients' willingnessClinical practiceClarity of valuesValues clarityBiologicsArthritisPatientsTherapyPreliminary evidencePerceived knowledgeCareEfficacyRiskSubjectsDisease
Academic Achievements & Community Involvement
honor ACR Henry Kunkel Young Investigator Award
National AwardAmerican College of RheumatologyDetails11/10/2009United States
News
News
- November 14, 2023Source: American College of Rheumatology
Liana Fraenkel, MD, MPH Steps Up to Become President of the ACR’s Rheumatology Research Foundation
- October 28, 2022
Dr. Betty Hsiao Receives Rheumatology Research Foundation’s Innovative Research Grant
- July 21, 2022Source: Contemporary Clinical Trials
Yale Study: Opioid Tapering Support Using a Web-based App
- August 16, 2021Source: Arthritis Foundation
Actemra Infusions in Short Supply
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