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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Sarah Hawley's perspective piece, "Half of women with early-stage breast cancer consider prophylactic double mastectomy" was recently published in Healio ITJ (in the journals).
Full article can be found here.
Congratulations to Kayte Spector-Bagdady on her election to the American Society for Bioethics and Humanities (ASBH) Board of Directors!
Brian Zikmund-Fisher, PhD, a CBSSM investigator and Director of the CBSSM Internet Survey lab, is the principal investigator on an Investigator Initiated Research award from the Foundation for Informed Medical Decision Making that began in October 2008. The grant, entitled "Learning by Doing: Improving Risk Communication Through Active Processing of Interactive Pictographs," will fund the development and testing of of Flash-based interactive risk graphics that research participants or patients can use to visually demonstrate how likely they believe some event is to occur. Dr. Zikmund-Fisher hopes that people who create risk graphics themselves will have a better intuitive understanding of risk than people who just view static images. Co-investigators on the award include Angela Fagerlin, Peter A. Ubel, and Amanda Dillard.
Brian Zikmund-Fisher, PhD, is the featured guest editor for a special supplement to Medical Decision Making's September/October 2010 issue, highlighting the DECISIONS study, a nationwide survey of adults in the US regarding common medical decisions. Lead author on the main paper of the supplement, Zikmund-Fisher and co-authors (including CBSSM faculty Angela Fagerlin, PhD and Mick Couper, PhD) describe the DECISIONS study, a telephone interview of a nationally representative sample of 3010 adults age 40 and over faced with making a medical decision in the past two years. Researchers defined medical decisions as the patient having initiated medications, been screened, or had surgery within the past 2 years or having discussed these actions with a health care provider during the same interval. Key findings from the study:
Although patients frequently receive information about the benefits of a procedure or medication, they don't always learn about the disadvantages.
Healthcare providers don't always ask patients what they want to do.
Most patients don't use the Internet to help them make common medical decisions; healthcare professionals remain the most important source of information.
Patients often don't know as much as they think they do. Many patients feel well informed even when they don't know key facts that would help them make a better decision.
African-Americans and Hispanics were less knowledgeable than other patients about medications to treat high cholesterol. In addition, they were more likely to say their doctor made decisions about cholesterol medications for them.
Most patients think they are more likely to get cancer than they really are, and tend to view cancer screenings as more accurate than they are.
Men and women think about cancer risks differently. Women are more active participants in cancer screening decisions regardless of their perception of risk, whereas men tended to get involved only if they felt at higher risk.
Funded by National Institutes of Health
Funding Years: 2015-2020
Every day in hospitals across the country, patients with severe stroke and their families are faced with decisions about life-sustaining treatments in the initial hours of admission. These decisions about resuscitation status, invasive treatments, or possible transitions to comfort care are typically made by a surrogate decision- maker due to communication or cognitive deficits in the patient. This surrogate must consider the patient's life goals and values to determine if their loved one would choose on-going intensive treatments where they may survive and yet have long term disabilities, or prioritize comfort and accept the likelihood of an earlier death. Serving as a surrogate decision maker for a patient in the intensive care unit can have long lasting negative consequences. However, almost nothing is known about surrogate decision makers in diverse populations with stroke. Hispanic Americans are now the largest minority group in the US, rapidly growing and aging, with Mexican Americans comprising the largest subgroup. Multiple disparities have been identified in stroke incidence and outcome between Mexican Americans and non-Hispanic Whites, particularly in the use of life- sustaining treatments. Minority populations may be particularly vulnerable to inadequate communication about end-of-life issues due to socioeconomic disadvantage, poor health literacy, and lack of provider empathy and health system strategies to improve communication. However, Mexican American culture includes strong values of family support and religiosity that may have a positive influence on discussions about life-sustaining treatment and adapting to stroke-related disabilities. There is currently a critical gap in understanding the perspectives and outcomes of stroke surrogate decision makers, making it impossible to design interventions to help diverse populations of patients and families through this incredibly trying time.
PI(s): Lewis Morgenstern, Darin Zahuranec
Co-I(s): Lynda Lisabeth, Brisa Sanchez
Brian Zikmund-Fisher, PhD, gave a presentation at the Methods of Analysis Program in the Social Sciences at Stanford University, Palo Alto, CA, on April 8, 2011.
Feedback on Medical Improv Project