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CBSSM, in conjunction with the UM Risk Science Center, is pleased to release iconarray.com: A free, tailorable, embeddable generator of the type of icon array ("pictograph") risk graphics that CBSSM researchers have long used and built an evidence base to support. Click here for more information.

Fri, February 14, 2014

Dr Peter Ubel, the previous director of CBDSM, discusses health care policy in his Forbes article "Is The Profit Motive Ruining American Healthcare?" He says, "when we debate healthcare costs in the U.S., we need to be clear on whether we are focusing on profits, per se, or instead on the simple fact that everyone in the healthcare industry – from for-profit insurance companies to private practice physiotherapists – understandably need to focus on their own bottom lines," 
 

Mon, June 11, 2018

A new study shows how to personalize the lung cancer screening decision for every patient. The results could help doctors fine-tune their advice to patients, so that it’s based not just on a patient’s individual lung cancer risk and the potential benefits and harms of screening, but also a likely range of patient attitudes about looking for problems and dealing with the consequences.

Published in the Annals of Internal Medicine, the study forms the backbone for new free online decision tools aimed at physicians and their teams, and at members of the public.

http://ihpi.umich.edu/news/scan-or-not-scan-research-shows-how-personali... tool for clinicians, called Lung Decision Precision, was designed by a University of Michigan and Veterans Affairs team to help clinicians talk with patients and their loved ones about whether to a lung CT scan might be a good idea for them.

The same team has also launched a website for patients and their loved ones, www.shouldiscreen.com, that gives easy-to-understand information about the positives and potential negatives of lung cancer screening, and allows individuals to calculate their personal risk of lung cancer.

Tanner Caverly, M.D., M.P.H., led the team that did the new computer-based simulation analysis using data from major studies of lung cancer screening, and national data on the potential screening population under the current guidelines.

Free Market Madness: Why Human Nature Is at Odds with Economics--and Why It Matters is the third book by former CBSSM Peter Ubel, MD. Dr. Ubel explains that our free-market economy is based on the assumption that we always act in our own self-interest. But, using his understanding of psychology and behavior, he then shows that humans are not always rational, and he argues that in some cases government must regulate markets for our own health and well-being. Dr. Ubel's vivid stories bring his message home to anyone interested in improving the way American society works. This publication of Harvard Business Press can be ordered at amazon.com, borders.com, or barnesandnoble.com

Internet Survey Lab

Overview

The Internet Survey Lab at the Center for Bioethics and Social Sciences in Medicine (CBSSM), led by Dr. Brian Zikmund-Fisher, facilitates the programming of complex experimental designs, using the graphical and interactive capabilities of the Internet. CBSSM has extensive experience in developing, programming and conducting survey research using Internet-based methodologies. 

Why We Use the Internet

A key advantage of Internet surveys is that they can shape and direct a user's experience in response to computer generated randomization and/or respondents' own answers to questions earlier in the survey. Additionally, page and answer order can be truly randomized as appropriate to limit cognitive biases. The unique advantage of Internet surveys, however, is that many different types of stimuli can be randomized or varied; static visual images, movies, or sounds can all be used in addition to text. Furthermore, the nature of the browser interface enables user-directed interactivity, such as user-adjustable risk communication graphics, that provide unique opportunities for both knowledge communication and response assessment.

Using the Internet to conduct survey research is also very efficient: we can develop and test surveys in only a few months' time, and once a survey is ready, large scale data collection (e.g., 1500-3000 completed surveys) can be completed in only 2-3 weeks.  Such surveys can also be cost effective, since while significant effort goes into development, creation, and testing of the survey, almost no personnel effort is required for data collection, entering, coding, or cleaning.  In addition, oftentimes several small surveys can be combined into a single instrument, creating further efficiencies.

Sometimes, our studies use large, demographically diverse samples obtained through commercial survey research firms. This methodology allows us to tailor the population being surveyed on multiple demographic variables (e.g., sampling only women age 40-75 for a study about breast cancer treatments) and provides us with ample statistical power to conduct multi-factorial experimental tests. Other times, we use more inexpensive samples from Amazon Mechanical Turk (MTurk) for quick pilot testing or to enable rapid, iterative testing of designs. Regardless, the use of randomized designs ensures high internal validity for the research despite the use of an Internet-only sample.

CBSSM Surveys

CBSSM has had considerable success using this methodology, publishing multiple manuscripts in highly regarded peer-reviewed journals. Studies that have used this methodology have addressed a variety of topics, including:

  • The use of pictographs to display risk (20082008, 2014) including in comparison to other graphical formats (2008, 2010, 2010). 
    Note: to create your own pictographs, see www.iconarray.com.
  • Misprediction of happiness between younger and older adults (2005)
  • Elicitation of utility and willingness to pay (200720072008)
  • Research ethics, e.g., participation of mentally vs. medically ill in research (2005)
  • Risk communications that emphasize incremental risks instead of absolute risks (2008)
  • Simplifying risk communications about adjuvant therapy options (2008).
  • Effect of risk labels on prenatal screening decisions (2007).
  • Time-insensitivity in people's understanding of survival curves (20052007)
  • Self-other discrepancies in medical decisions (20062008)
  • Sequential vs. all at once presentations of risk information (2011)
  • Testing of animated or interactive risk graphics (2011, 2012, 2014)
  • Optimal levels of precision in risk communications (2011, 2012)
  • Framing of health promotion messages (2012)
  • Exploration of role of narratives in decision making (2010)
  • Values Clarification (2015)
  • Intuition and Deliberation in Decision Making (2015)

Contact Us

For questions about our methods or inquiries about potential Internet survey research collaborations, please contact Brian Zikmund-Fisher at bzikmund@umich.edu.

Caring for an ailing spouse may prolong your life. Stephanie Brown explains her research in a vodcast, featured on the University of Michigan website:  http://www.ns.umich.edu/podcast/vodcast.php. This vodcast was, appropriately, the university's home page lead for the week of Thanksgiving.

Fri, April 10, 2015

Dr. Jagsi was interviewed by MedicalResearch.com, discussing her study which finds many breast cancer patients have an unmet need to discuss genetic testing with their healthcare provider. The study found that 35 percent of women with breast cancer expressed a strong desire for genetic testing, but 43 percent of those women did not have a relevant discussion with a healthcare professional. "By more routinely addressing genetic risk with patients, we can better inform them of their true risk of cancer returning or of developing a new cancer," Dr. Jagsi explains in the interview. "This could potentially alleviate worry and reduce confusion about cancer risk."

Thu, March 03, 2016

In an interview with MedicalResearch.com, Dr. Sarah Hawley discusses her new study regarding breast cancer patients' understanding of risk. She states, "Research has shown that breast cancer patients do not have a good understanding of their risk of distant recurrence, and and that the fear of cancer spreading is one of the biggest concerns that patients have. The research that has been done shows that most patients over-esimate this risk, and think they have a bigger chance of the cancer coming back than they actually have."

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