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Funded by the Department of Health and Human Services, NIH.

Funding Years: 2010-2014.

The overarching goal of this proposal is to improve decision making about organ quality in Liver Transplantation, specifically by increasing transparency, improving patient knowledge and satisfaction, and maintaining patient and public trust in the transplant system. In addition, this research may improve patient outcomes by ensuring that high risk organs go to patients who are most likely to benefit from them. For more information, visit NIH Reporter.

PI(s): Michael Volk

 

Tue, September 20, 2011

The CBS News website recently featured 10 tips to make better decisions about cancer care from U-M’s Angela Fagerlin, Ph.D., associate professor of internal medicine. Below is an excerpt from the article:

Cancer is scary, and doctors sometimes sound as if they’re speaking a foreign language when talking about the disease and its treatment. But “people are making life and death decisions that may affect their survival and they need to know what they’re getting themselves into,” says Fagerlin “Cancer treatments and tests can be serious. Patients need to know what kind of side effects they might experience as a result of the treatment they undergo.”

 

Maria Silveira, MD, MPH, is the lead author on an article in the New England Journal of Medicine (April 1, 2010) on end-of-life decision making. Silveira and her colleagues found in a large-scale study that more than a quarter of the elderly lacked decision-making capacity as they approached death. Those who had advance directives were very likely to get the care that they wanted. Co-authors on the study are Kenneth Langa, MD, PhD, and Scott Y.H. Kim, MD, PhD. Read a press release about the article here.

A new $13.6 million program award from the National Cancer Institute awarded to a national team of researchers centered at the U-M Comprehensive Cancer Center will examine how patients make treatment decisions, how doctors make treatment recommendations and how to improve the process for better outcomes.

Steven J Katz, MD, MPH, Co-Director of the Socio-Behavioral Program at the UM Comprehensive Cancer Center is theprincipal investigator on this new program grant.

Several CBSSM-affiliated faculty are involved with this project: Sarah Hawley, PhD, MPH and Jennifer Griggs, MD, MPH are program lead investigators,and Angela Fagerlin, PhD (CBSSM Co-Director) and Reshma Jagsi, MD, PhD are also investigators on this grant. Click here for more information.
 

 

Funded by National Institutes of Health.

Funding Years: 2013-2016.

With the growing importance of biobank research, concerns have been raised about how to protect the interests of donors. The current ethics framework mainly focuses on protecting against risks to donors' welfare and to their privacy. However, there has been little systematic empirical, normative, or policy focus on the non-welfare interests of donors, i.e., concerns about the moral, societal, or religious implications of research using their donation that may affect their willingness to donate. Although important theoretical discussions, mentions in commission reports, and insights from several qualitative studies have drawn attention to the serious nature of these interests, we lack important data for policy development: (1) systematic data on the nature and extent of potential impact of non-welfare interests and (2) high quality (i.e., informed and considered) policy preferences of the public addressing how to balance these non-welfare interests with the promise of biobank research. Our project will fill these gaps with two complementary projects. First, a national survey will assess the contours of the potential impact of non-welfare interests on biobank research, by addressing: what kinds of non-welfare interests substantially affect willingness to donate biological materials?; how common are these interests?; how much do donors want to know about the potential involvement of such non-welfare interests when donating?; how are non-welfare interests affected by such factors as race or ethnicity, socioeconomic status, trust in medical research, religious beliefs and practice, or political orientation? Second, we will obtain considered, informed judgments of the public regarding how to handle the tension between the public good of biobanks and the conflicting non-welfare interests of potential donors, using a democratic deliberation method in which subjects will attend an all-day education and peer deliberation session. The impact of the deliberation will be validated using a randomized, experimental design. In summary, despite the ethical significance of non-welfare interests for biobank research, there is a paucity of systematic data regarding both their potential impact and the potential policy solutions. This project will provide a highly generalizable assessment of the potential impact of non-welfare interests as well as policy recommendations based on informed, deliberative opinions of the general public. Visit the NIH website for more information.

PI(s): Tom Tomlinson, Raymond De Vries 

Co-I(s): Karen Kelly-Blake, H. Myra Kim, Blake J Roessler 

Sarah Hawley, PhD, MPH

Faculty

Dr. Sarah T. Hawley is a Professor in the Division of General Medicine at the University of Michigan and a Research Investigator at the Ann Arbor VA Center of Excellence in Health Services Research & Development. She holds a PhD in health services research from the University of North Carolina and an MPH from Yale University Department of Public Health. Her primary research is in decision making related to cancer prevention and control, particularly among racial/ethnic minority and underserved populations.

Last Name: 
Hawley

Funded by Health and Human Services, Department of-National Institutes of Health

Funding Years: 2014 - 2016.

Nearly 800,000 people suffer a stroke each year in the US and the cost of stroke reaches $105 billion annually. Stroke is also a leading cause of disability in the US. Post-stroke disability is dramatically reduced among patients who receive tissue plasminogen activator (tPA). For clinical effectiveness, tPA must be administered within 4.5 hours from the start of stroke symptoms. Unfortunately, tPA is vastly underutilized with about 3% of stroke patients receiving tPA. The majority of patients fail to receive tPA because they arrive to the hospital after the treatment time window has elapsed (this barrier to tPA administration is known as prehospital delay). Researchers have shown that if 911 were called at the time of stroke onset, over 28% of all stroke patients would receive tPA. Therefore, translational research to increase stroke preparedness (defined as the ability to recognize stroke warning signs and call 911 immediately) is urgently needed. However, the field of stroke preparedness is severely limited by the absence of intermediate end points to test behavioral interventions. Before embarking on large scale, expensive, community intervention trials, phase 2 studies using intermediate end points are needed. An intermediate end point allows for testing of several interventions (phase 2 studies) before deciding on the most promising intervention that warrants phase 3 testing. Intermediate end points also facilitate testing interventions for selected populations such as high risk groups like racial/ethnic minorities or those with low socioeconomic status, rather than an entire community. In this project, we will develop and validate a psychometrically rigorous test of stroke preparedness using video vignettes - the video stroke action test (video-STAT). Because of the increased burden of stroke among African Americans, Hispanics and those with low socioeconomic status, we will oversample from these groups in development and validating of the video-STAT. At completion of this study, an innovative stroke preparedness intermediate end point will be created and critical steps toward validating it will be performed. As the US population ages, stroke will only claim more victims and at greater expense to individuals, families and society. It is critical that we rapidly develop rigorous scientific interventions that increase delivery of acute stroke therapy to decrease post-stroke disability and reduce the enormous impact of this devastating disease.

PI(s): Lesli Skolarus, Lewis Morgenstern

Co-I(s): Brisa Sanchez

Funded by the National Institutes of Health

Funding years: 2011-2015

Colorectal cancer has a major impact on Americans, yet its screening rate remains suboptimal. This study aims to improve colorectal cancer screening rate by using an innovative and interactive decision aid that helps patients choose among colorectal cancer screening options. The study will also elucidate how patients and physicians discuss colorectal cancer screening options. for more information visit NIH Reporter.

PI: Masahito Jimbo

Co-I: Sarah Hawley

Funded by NIH - Department of Health and Human Services

Funding Years: 2011-2016

The MROC Study seeks to evaluate and compare from the patient's point of view the leading options for breast reconstruction after mastectomy. This study will help patients, physicians, payers and policy makers better understand the various surgeries available for breast reconstruction. Although many women choose reconstruction, the number of options as well as their pros and cons can make decision making difficult and stressful. From this research, we hope to learn more about what works best for patients undergoing these operations.

PI: Edwin Wilkins

Co-I(s): H. Myra Kim

2016 Bishop Lecture featuring William Dale, MD, PhD

Wed, April 27, 2016, 10:30am
Location: 
Founders Room, Alumni Center, 200 Fletcher St., Ann Arbor, MI

The 2016 Bishop Lecture in Bioethics was presented by William Dale, MD, PhD, Associate Professor of Medicine; Chief, Section of Geriatrics & Palliative Medicine; and Director, Specialized Oncology Care & Research in the Elderly (SOCARE) Clinic at the University of Chicago. Dr. Dale presented, "Why Do We So Often Overtreat, Undertreat, and Mistreat Older Adults with Cancer?" The Bishop Lecture served as the keynote address during the CBSSM Research Colloquium.

Abstract: The US health care system is being confronted with the consequences of aging as the baby-boomers join Social Security and Medicare, with cancer care front-and-center.  Two recent IOM reports, Retooling for an Aging America and Delivering High-Quality Cancer Care: Charting a New Course for a System in Crisis, highlight these intersecting areas.  Delivering high quality care for older adults with cancer, at an affordable cost, in a transforming health delivery system will be addressed from a personal, clinical, and policy perspective.

William Dale, MD, PhD, is an Associate Professor of Medicine and the Section Chief of Geriatrics & Palliative Medicine at the University of Chicago, with a secondary appointment in Hematology/Oncology.  He is a board-certified internist and geriatrician with a doctorate in health policy. He completed his medical and graduate school training at the University of Chicago, did his residency in internal medicine and fellowship in geriatrics at the University of Pittsburgh, and then returned to the University of Chicago.

Dr. Dale has devoted his career to the care of older adults with cancer.  In 2006, He established, and now co-directs, the Specialized Oncology Care & Research in the Elderly (SOCARE) Clinic at the University of Chicago. SOCARE offers interdisciplinary, individualized, and integrated treatment for older cancer patients. It provides a special environment for addressing the issues relevant to older cancer patients and their loved ones and integrating research into this special clinic environment.

Dr. Dale is an international speaker who has published over 50 papers in top journals on medical decision making, behavioral economics, quality of life, and frailty assessment in older adults, particularly those with cancer. He and his team have shown the important role emotions like anxiety play in medical decisions for older adults. He has received grants from the National Institute on Aging (NIA), National Cancer Institute (NCI), American Cancer Society, and the Foundation of Informed Medical Decision Making. With NIH funding, he has co-led a series of national conferences with international experts on geriatric-oncology.  He is a co-investigator for the National Social Life, Health, and Aging Project (NSHAP), a survey and biomeasure collection on the health, well-being, and social life of over 3,000 older adults.

  • Click here for the video recording of the 2016 Bishop Lecture.

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