This summer, colleagues from across OPEN Health’s HEOR & Market Access practice travelled to Oslo to attend the 48th Annual Society for Medical Decision Making (SMDM) meeting, and the 1st Annual meeting to be held outside North America. The theme for this year’s conference was, fittingly, given the current environment, “Medical Decision Making in Uncertain Times”. Over 3.5 days, the conference explored how uncertainty impacts the decisions made by patients, clinicians, health policy makers and HTA decision makers.
OPEN Health had a strong and visible presence throughout the meeting. Our teams delivered three pre-conference short courses — on Survival Analysis for HTA, Creating Patient-Centric, Preference-Based Shared Decision-Making Tools, and Handling Uncertainty in HTA — all of which were well received. Our Chief Scientific Officer, Elisabeth Fenwick, also participated in a methods symposium focused on how to incorporate innovative methods to improve HTA decision-making and delivered a podium presentation focused on a new approach to assess alternative survival extrapolation models as well as moderating sessions on applications of healthcare modeling and novel methods for decision-making under uncertainty. Colleagues also engaged actively with special interest groups on preference measurement, the ISPOR–SMDM Model Validation II Task Force, and the SUSTAIN HTA initiative.
Lessons that resonate beyond the event:
- Decision-making is under pressure.
The opening plenary set the tone of the conference, arguing that as budgets tighten and funding cuts endure, health systems globally must become leaner and align on priorities. A key point made was that the methods to accomplish this already exist — they just need to be applied well. - What is the price of innovation?
A headline, lively debate between Professors Karl Claxton and Tomas Philipson explored drug value and affordability, and considered the question of whether the rest of the world “free-rides” on US innovation and, if so, how that situation could or should be resolved. - The latest on the QALY debate
The QALY debate continued, with several sessions questioning whether QALY-based assessment fully captures the needs of patients with rare, fluctuating, or disabling conditions. The emerging view: refine the QALY rather than replace it. - Causal inference takes center stage.
Causal thinking is moving to the center of decision modeling, with directed acyclic graphs (DAGs), target trial emulation, and doubly robust methods increasingly used to strengthen indirect comparisons and real-world evidence. - Patient preferences and shared decision-making retain their key importance.
Discrete choice experiments and latent-class models were featured throughout the event, reinforcing that we’re seeing a shift toward patient-centered, preference-based decision support — and toward using preferences as a tool for equity. - Temper optimism with healthy skepticism in viewing AI.
Sessions on AI in shared decision-making balanced genuine optimism with healthy skepticism about data, trust, and commercial incentives. This echoes the stance our own experts share: carefully monitor AI’s role in research. - Vaccination against misinformation – a positive step for the future.
In the keynote address, Prof Sander Van Der Linden, a Professor of Social Psychology in Society and Director of the Cambridge Social Decision-making lab in the Department of Psychology at University of Cambridge presented work suggesting that exposing individuals to a weakened dose of the types of mis-information that they might experience builds up tolerance and the ability to detect this mis-information.
What we are bringing back
Beyond the headlines, our delegates returned with practical methods to apply in client work, from Bayesian approaches that sharpen how we quantify patient preferences and DAG-led covariate selection and doubly robust estimators for indirect treatment comparisons to survival-extrapolation diagnostics and model-validation checklists that keep our modeling transparent and fit for purpose. Equally valuable were the connections made and the sense of where the field is heading.
SMDM 2026 was a reminder that good decision science is not just about chasing new innovative methods but about applying rigorous, transparent approaches to the questions that matter most for patients and health systems — exactly the space in which OPEN Health works.
For the full set of delegate notes and session summaries, or to discuss any of these themes, please contact our team of experts.
