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Geoffrey Barnes, MD, MSc

Faculty

Geoff Barnes is a cardiologist and vascular medicine specialist at the University of Michigan Health System. He completed his undergraduate degree in biomedical engineering at Washington University in St. Louis (2003) followed by medical school at the University of Michigan (2007).  He then completed a residency (2010), chief residency (2011) in internal medicine, cardiology fellowship (2014) and vascular medicine fellowship (2014) at the University of Michigan.  His areas of research interest include anticoagulation, venous thromboembolism, quality improvement and shared decision making.

Research Interests: 
Last Name: 
Barnes

Raymond De Vries, PhD

Associate Director

Raymond De Vries PhD is Associate Director at the Center for Bioethics and Social Sciences in Medicine at the University of Michigan and is a Professor in the Department of Learning Health Sciences and the Department of Obstetrics and Gynecology. He is also visiting professor at CAPHRI School for Public Health and Primary Care, University of Maastricht, the Netherlands.

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De Vries

Funded by the NIH

The overarching goal of our research is to improve opioid analgesic safety and efficacy by optimizing opioid risk recognition, informed analgesic decision-making, and drug storage/disposal behaviors among parents of youth who are prescribed these agents for home use. With this proposal, we aim to demonstrate that our Scenario-Tailored Opioid Messaging Program (STOMP?) will: 1) Improve parents' opioid risk understanding and their analgesic decision-making; 2) Enhance parents' analgesic self-efficacy, analgesic use, storage behaviors and their children's pain outcomes, and 3) To demonstrate that the STOMP? plus provision of a method to get rid of left-over medications will effectively nudge parents to safely dispose of left-over opioid analgesics. For more info: http://grantome.com/grant/NIH/R01-DA044245-01A1

PI: Terri Lewis-Voepel

CBSSM Co-Is: Brian Zikmund-Fisher & Alan Tait

Susan Goold, MD, MHSA, MA

Faculty

Susan Dorr Goold, M.D., M.H.S.A., M.A., studies the allocation of scarce healthcare resources, especially the perspectives of patients and the public. Results from projects using the CHAT (Choosing Healthplans All Together) allocation game have been published and presented in national and international venues. CHAT won the 2003 Paul Ellwood Award and Dr. Goold is listed in the Foundation for Accountability's database of Innovators and Visionaries. Dr.

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Goold
Sat, March 03, 2018

Reshma Jagsi's work was recently highlighted in Emergency Medicine News: "Special Report: Sexual Harassment a Muddle of Fear, Guilt, and Shame."

Research Topics: 

Angela Fagerlin, PhD

Alumni

Dr. Fagerlin served as Co-Director of CBSSM from 2010-2015. She is currently Chair of the Department of Population Health Sciences at University of Utah School of Medicine and Research Scientist, Salt Lake City VA Center for Informatics Decision Enhancement and Surveillance (IDEAS)

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Fagerlin
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What is the price of life? (Aug-03)

Do you think that your life is worth more than the amount that the government usually uses as the maximum to spend to provide one year of life?

Imagine that you are a member of a government panel that is trying to decide how cost-effective a medical treatment must be in order for the government to cover the costs of the treatment. Suppose that a certain treatment could provide one additional year of life to an otherwise healthy person. What is the highest amount the government should be willing to pay per person for this treatment?

How do your answers compare?

For the past twenty years, the figure most often used as the maximum amount to spend to provide one year of life has been $50,000. This figure was originally proposed since it was the cost of a year of kidney dialysis, a lifesaving treatment that the U.S. government funds in Medicare.

Should the number be higher or lower than the current standard?

Conventional wisdom would suggest that the number be higher to take into account the inflation that has occurred in the years since the standard was developed. Current practices such as annual Pap smear screening for women with low risk for cervical cancer, which has a cost of $700,000 per year of life gained, also suggest that society is willing to pay more than the current standard for a year of life. The authors of the cited article recommend, based on current treatment practices and surveys of the general public, that the cost-effectiveness threshold should be revised to be around $200,000.

Should the number increase, decrease, or stay the same over time?

Again, it seems that the threshold amount should increase over time due to inflation. However, other factors come in to play that affect the value.

Since new technologies are emerging all the time, some of which will be deemed cost-effective, there will be more and more treatments to be offered in the future. Also, the rate of use of treatments is an important consideration, because even if a new treatment is more cost-effective than an old one, if it is used more often it will end up costing more to society overall. With more treatments becoming available and more people being given treatments, the threshold cost will probably have to decrease so that insurance companies and the government can keep up with the increasing availability and demand.

Why is this important?

Insurance companies and government health care entities face a continuing struggle when trying to determine which medical treatments to cover. Health care costs are increasing rapidly, so these groups will be facing even tougher decisions in the future. Establishing cost-effectiveness guidelines would be extremely helpful as an aid to making the decisions about treatment coverage. Evidence shows that the current threshold is probably not an accurate reflection of the desires of society or actual prescribing practices. It needs to be adjusted to become useful once again, and must be reevaluated periodically to make sure the value keeps up with trends in the health care market, rather than being left alone without question for two decades as is the current situation.

For more information see:

Ubel PA, Hirth RA, Chernew ME, Fendrick AM. What is the price of life and why doesn't it increase at the rate of inflation? Archives of Internal Medicine. 163:1637-1641, 2003.

Thu, December 20, 2007

A CBSSM study found that colostomy patients who felt that their condition was irreversible reported better quality of life than those who hoped that they would be cured. For a summary, see this press release and video. The researchers are Dylan M. Smith, PhD; Peter A. Ubel, MD; Aleksandra Jankovic, MS (all at the University of Michigan); and George Loewenstein, PhD, (of Carnegie Mellon University). Health Psychology will publish the article in mid-November 2009.

Press coverage of this research has been extensive. Peter Bregman reported on the study in the July 2009 Business Week Online, applying the concepts to help people manage their stressful and unpredictable lives. Read his full article here. Preliminary data from this study were cited in the 7th Annual “Year in Ideas” issue of the New York Times Magazine in December 2007. Read recent international media coverage:
US News and World Report Health Day
Voice of America Radio
Daily Mail UK
Reuters India

Joel Howell, MD, PhD

Faculty

Joel D. Howell is a Professor at the University of Michigan in the departments of Internal Medicine (Medical School), Health Management and Policy (School of Public Health), and History (College of Literature, Science, and the Arts), as well as the Victor C. Vaughan Professor of the History of Medicine. He received his M.D. at the University of Chicago, and stayed at that institution for his internship and residency in internal medicine. At the University of Pennsylvania, he was a Robert Wood Johnson Clinical Scholar, and received his Ph.D. in the History and Sociology of Science.

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Last Name: 
Howell

Lisa Harris, MD, PhD

Faculty

Dr. Harris’ research examines issues at the intersection of clinical obstetrical and gynecological care and law, policy, politics, ethics, history, and sociology. She conducts interdisciplinary, mixed methods research on many issues along the reproductive justice continuum, including abortion, miscarriage, contraception, in vitro fertilization (IVF), infertility and birth, and racial, ethnic, and socioeconomic disparities in access to reproductive health resources.

Last Name: 
Harris

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