Adjunct faculty typically have an academic or research appointment at another institution and contribute or collaborate with one or more School of Medicine faculty members or programs.
Adjunct rank detailsLiana Fraenkel, MD, MPH
Professor AdjunctAbout
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Titles
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
- MPH
- Boston University (1997)
- MD
- McGill University (1990)
- BS
- McGill University (1986)
Research
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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
Amy Justice, MD, PhD
Brent A Moore, PhD
Danielle Wesolowicz, PhD
David Fiellin, MD
E. Jennifer Edelman, MD, MHS, AAHIVS
Evelyn Hsieh, MD, PhD
Decision Making
Rheumatology
Decision Making, Computer-Assisted
Publications
2026
Summit program to taper long-term opioid therapy in Veterans: A mixed-methods feasibility study
Edmond S, Wesolowicz D, Moore B, Ibarra J, Grant A, Chhabra M, Fraenkel L, Becker W. Summit program to taper long-term opioid therapy in Veterans: A mixed-methods feasibility study. Journal Of Pain 2026, 41: 106207. PMID: 41666948, DOI: 10.1016/j.jpain.2026.106207.Peer-Reviewed Original ResearchAltmetricConceptsLong-term opioid therapyWeb-based appMixed-methods feasibility studyProgram utilizationSummit programSessions of motivational interviewingContact with study staffFully-powered trialOpioid therapyPilot feasibility trialIntervention acceptabilityLack of resourcesFeasibility trialRecruitment targetOpioid dose reductionMotivational interviewingStudy staffStudy retentionEnrollment approachesQualitative interviewsOpioid taperPrimary outcomeLack of benefitPilot studyBehavioral therapy
2025
Preferences for post‐traumatic osteoarthritis prevention strategies in individuals with anterior cruciate ligament injury
Kennedy K, Waddell L, Easterbrook A, Katz J, Jacobs C, Jones M, Selzer F, Losina E, Fraenkel L, Bansback N. Preferences for post‐traumatic osteoarthritis prevention strategies in individuals with anterior cruciate ligament injury. Arthritis Care & Research 2025 PMID: 40884030, DOI: 10.1002/acr.25641.Peer-Reviewed Original ResearchAltmetricConceptsDiscrete choice experimentMild side effectsSide effectsOut-of-pocket costsPost-traumatic osteoarthritisDaily knee painACL injuryOsteoarthritis prevention strategiesAnterior cruciate ligament (ACL) injuryHistory of ACL injuryAnterior cruciate ligament injuryCruciate ligament injuryLatent class modelKnee painTreatment acceptabilityMixed logitNo treatmentChoice experimentLigament injuriesPotential treatmentMultinomial logitKnee OAClass 1 membersMinimal important differences of measurement instruments used in rheumatoid arthritis: a scoping review
Yaacoub S, Zouhbi A, Zeid Daou M, Nahra V, Mokbel A, Hneiny L, Fraenkel L, Johnston B, Akl E. Minimal important differences of measurement instruments used in rheumatoid arthritis: a scoping review. BMC Rheumatology 2025, 9: 83. PMID: 40624678, PMCID: PMC12235810, DOI: 10.1186/s41927-025-00524-9.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsAltmetricConceptsMinimal important difference estimatesMinimal important differenceAnchor-based methodsScoping ReviewHealth Assessment Questionnaire Disability IndexMeasurement instrumentsRheumatoid Arthritis studyPhysical functionClinical decision-makingDisability IndexHealth statusImportant differenceRheumatoid arthritisSystematic reviewFull-textClinical recommendationsArthritis studiesHealthContinuous variablesTabular formatDecision-makingResearch reportsOutcomesArthritisBackgroundManyStandardizing health outcomes for people with rheumatoid arthritis receiving disease modifying drug therapy: A rapid review of patient-decision aids and preference studies to inform the development of OMERACT Health Outcome Descriptors
Raskin N, Hiligsmann M, Rebutoc A, Bansback N, Boonen A, Buchbinder R, Falahee M, Fraenkel L, Marshall D, Maxwell L, Nieuwlaat R, Proulx L, Saadat P, Shea B, Tugwell P, Wiercioch W, Beaton D, Richards P, Schünemann H, Guillemin F, Hazlewood G. Standardizing health outcomes for people with rheumatoid arthritis receiving disease modifying drug therapy: A rapid review of patient-decision aids and preference studies to inform the development of OMERACT Health Outcome Descriptors. Seminars In Arthritis And Rheumatism 2025, 74: 152769. PMID: 40544704, DOI: 10.1016/j.semarthrit.2025.152769.Peer-Reviewed Original ResearchAltmetricConceptsHealth outcome descriptorsPatient decision aidsHealth outcomesPatient-important outcomesPatient preference studiesOutcome descriptorsThematic content analysisOutcome descriptionsNarrative summaryPreference studiesPtDAsRA outcomesAuthor consensusRheumatoid arthritisData extractionModifying drug therapySymptoms patientsContent analysisAdverse eventsDrug therapyDisease modifying drug therapyLack of descriptionHealthOutcomesAIDSPatient Perceptions of Medication Therapy for Prevention of Posttraumatic Osteoarthritis Following Anterior Cruciate Ligament Injury: A Qualitative Content Analysis
Waddell L, Mitchener D, Frier K, Jones M, Losina E, Bansback N, Fraenkel L, Kim J, Katz J, Selzer F, Easterbrook A. Patient Perceptions of Medication Therapy for Prevention of Posttraumatic Osteoarthritis Following Anterior Cruciate Ligament Injury: A Qualitative Content Analysis. Arthritis Care & Research 2025, 77: 881-891. PMID: 39936242, PMCID: PMC12209493, DOI: 10.1002/acr.25508.Peer-Reviewed Original ResearchCitationsAltmetricConceptsPosttraumatic osteoarthritisAnterior cruciate ligament injuryQualitative content analysis approachParticipants expressed greater interestPrevention of posttraumatic osteoarthritisOsteoarthritis Outcome Score pain scoreUptake of preventive treatmentsContent analysis approachQualitative content analysisCruciate ligament injuryYear of enrollmentMedical therapyAudio transcriptsAnterior cruciate ligament (ACL) tearsPatients' perceptionsSemistructured interviewsOsteoarthritis incidenceACL injuryKnee injuriesFocus groupsLigament injuriesComponent of treatmentContent analysisPreventive therapyPain scores
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, 29: 482-496. PMID: 39465468, PMCID: PMC12323700, DOI: 10.1007/s10461-024-04533-6.Peer-Reviewed Original ResearchCitationsAltmetricConceptsUnhealthy 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 disorderAn 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 refusalAcceptance of Virtual Reality Among Adults with Rheumatologic Conditions
Garza K, Yang H, Richardson A, Seals C, Hawkins G, Rose C, Nowell W, Gavigan K, Stewart P, Fraenkel L, Curtis J. Acceptance of Virtual Reality Among Adults with Rheumatologic Conditions. Journal Of Medical Extended Reality 2024, 1: 282-289. DOI: 10.1089/jmxr.2024.0024.Peer-Reviewed Original ResearchCitationsConceptsPatient-Powered Research NetworkPractice-Based Research NetworkHealth care interventionsResearch NetworkRheumatologic conditionsBenefits of health care interventionsWeb-based surveyCare interventionsPatient educationStudy participantsSurvey itemsReport acceptanceVirtual realityAcceptance of VRCompare acceptabilityParticipantsCommunicating riskPatient populationRisk communicationEducational toolInterventionSurveyAdultsClinical characteristicsMedical treatmentPreferences 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 ResearchCitationsAltmetricConceptsOpioid 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
Academic Achievements & Community Involvement
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Honors
honor ACR Henry Kunkel Young Investigator Award
11/10/2009National AwardAmerican College of RheumatologyDetailsUnited States
News
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News
- August 25, 2025
Bringing the Patient Experience into the Classroom
- 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
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