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Mon, October 02, 2017

Sarah Hawley, Brian Zikmund-Fisher, and Reshma Jagsi are co-authors of a recent study published in Medical Decision Making, which was highlighted in MHealth Lab. Their study found that talking to clinicians is the best way for breast cancer patients to understand their recurrence risk. They also found that clinician discussions about recurrence risk should address uncertainty and the relevance of family and personal history. Kamaria Lee is first author of the article.

Wed, October 11, 2017

In an editorial in Nature Human Behaviour, Brian Zikmund-Fisher discusses the findings of a recent study about the unintended consequences of argument dilution in direct-to-consumer drug advertising. In a series of experiments, study authors, Niro Sivanathan and Hemant Kakker found that long lists of serious and minor side effects found in drug advertisements actually "dilute" consumers' judgments of the overall risk from side effects.

Thu, October 26, 2017

In a new analysis in Health Affairs, CBSSM's Jeffrey Kullgren and fellow researchers found that while the "Choosing Wisely" campaign to reduce overtesting and overtreatment is off to a strong start, more work is still needed to cut back on low-value care.

CBSSM Seminar: Jan Van den Bulck, PhD

Tue, November 28, 2017, 3:00pm
Location: 
NCRC, Building 16, Room 266C

Jan Van den Bulck, PhD
Professor, Communication Studies

Topic:
"Are the media (re-)defining how we interact with each other and with the world?

We know everything there is to know about people we have never even met. Through social media, we follow their every move. We even know their pets. Our media use interferes with healthy sleep, family meals, or even our work. Our children need levels of self-control to manage distractions that threaten their schoolwork. Or do they?"

Tue, November 28, 2017

In a study published in JAMA Internal Medicine, Jeff Kullgren and co-authors found that few individuals enrolled in High-Deductible Health Plans (HDHPs) in the United States are engaging in consumer behaviors.

Bioethics Grand Rounds -Nicholson Price, Asst Professor of Law

Wed, September 27, 2017, 12:00pm
Location: 
UH Ford Auditorium

Nicholson Price, Asst Professor of Law - "Black-Box Medicine"

Big data has been coming to health care for several years, and artificial intelligence is approaching even more rapidly.  What happens when these two phenomena meet in the context of clinical care?  How should clinicians deal with algorithms (whether embedded in EHRs or found on patients’ smartphones) that can predict outcomes, suggest diagnoses, and even recommend courses of treatment—all without explaining how they reach their conclusions?  This talk will describe the burgeoning field of black-box medicine, consider how the FDA can and should regulate this technology, and address liability and implementation concerns for clinicians today and in the near future.

 

Fri, December 15, 2017

In light of the #MeToo campaign denouncing sexual assault and harassment, Reshma Jagsi has written a perspective piece in the New England Journal of Medicine about sexual harrassment in academic medicine. Also check out her interview in MHealth Lab and several other articles citing her NEJM article.

Research Topics: 

CBSSM's Director, Reshma Jagsi, M.D., D.Phil., was selected to receive the 2017 Clinical and Health Services Research Award from the Dean's Awards program. Andrew R. Barnosky, D.O., MPH was awarded the Lifetime Achievement Award in Medical Education.

The Dean’s Awards Program recognizes Medical School faculty and staff who demonstrate exceptional accomplishment in the areas of teaching, research, clinical care, community service, innovation and administration. Award recipients will be honored at the annual Dean's Awards Dinner on November 15.

Congratulations to Dr. Jagsi and Dr. Barnosky!

 

Funded by VA Health Services Research and Development Career Development Award

Funding Years: 2015-2019

Heart attack and stroke, which together are called cardiovascular disease, cause over 1/3 of all deaths in VA patients. The current guidelines for the prevention of these conditions focus on lowering patients'blood pressure and cholesterol levels. A new treatment strategy, which I call benefit-based tailored treatment, that instead guides treatment decisions based on the likelihood that a medication would prevent a heart attack or stroke could prevent more cardiovascular disease, with lower medication use, and be more patient centered. The purpose of this Career Development Award is to develop and assess tools and approaches that could enable the implementation of benefit-based tailored treatment of cardiovascular disease, in particular a decision support tool and educational program for clinicians and a performance profiling system. The decision support tool will enable better care by showing clinicians patient-specific estimates of the likelihood that their medication decisions will prevent a cardiovascular disease event. The performance profiling system will encourage better care by assessing the quality of care provided at VA sites and in PACT teams based on how well the medical care provided follows this treatment strategy. The project will have three aims:
Aim 1 : In the first aim, I will seek to understand clinicians' and patients' perceptions of and receptivity to the use of benefit-based tailored treatment for cardiovascular disease. Information gained from qualitative research with clinicians will help assess and improve the usability and effectiveness of the decision support tool and educational program for clinicians, along with the acceptability of the treatment strategies in general. Information gained from focus groups with patients will help learn their priorities in cardiovascular disease prevention, to help identify ways to make the interventions and their assessments more patient-centered.
Aim 2 : In the second aim, the decision support tool and educational program will be assessed in a real-world randomized pilot study involving thirty clinicians. Half of the clinicians will be provided the decision support tool and education intervention for ten patients each, the other half will receive a traditional quality improvement program and treatment reminders. The study will have formative goals of ensuring that clinicians and patients believe the tool is valuable and does not disrupt care processes or workflow for anyone in the PACT team. This will be studied with qualitative and survey assessments. The primary summative outcome will be the influence of the intervention on clinicians'treatment decisions. Secondary outcomes will assess patients'satisfaction with their visits and their clinicians.
Aim 3 : The third aim will develop and evaluate a novel performance measurement system based on benefit- based tailored treatment. First, the performance profiling system will be developed. Then the profiling system's ability to reliably differentiate high quality from low-quality care will be evaluated.

PI: Jeremy Sussman

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