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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.

Funded by National Institutes of Health; National Institute on Aging

Funding Years; 2011-2016

A cornerstone of the nation's social science research infrastructure, the Panel Study of Income Dynamics (PSID) is a longitudinal survey of a nationally representative sample of U.S. families. Begun in 1968, 36 waves of data have now been collected on PSID families and their descendents. Its long-term measures of economic and social wellbeing have spurred researchers and policy makers to attend to the fundamental dynamism inherent in social and behavioral processes. The PSID is increasingly being used to answer innovative social and behavioral research questions in the context of an aging society. This application proposes to collect, process, and disseminate three modules in the 2013 and 2015 waves of the PSID: 1. Health module: Including 15 minutes of survey questions on health status, health behaviors, health insurance coverage & health care costs. Linkages to the National Death Index and Medicare will be extended; 2. Wealth module: Including 10 minutes of survey questions on wealth, active savings, and pensions. Linkage to Social Security earnings and benefits records for active sample and decedents will be undertaken for the first time, and a new module to minimize errors in reports of wealth changes will be developed and implemented; and 3. Wellbeing module with related psychosocial measures: We will design and implement a mixed-mode (web/mail out) questionnaire to collect content from both respondents and spouses about their wellbeing and related psychosocial measures (e.g., personality, intelligence), with an experiment to identify (and allow researchers to adjust for if necessary) mode effects. After collection, the data will be processed and distributed in the PSID Online Data Center, which will allow users to create customized extracts and codebooks using a cross-year variable index.

PI(s): Robert Schoeni

Co-I(s): Charles Brown, James House, Mick Couper

Check out  Naomi Laventhal’s KevinMD article, “Nice job, mama! How a physician makes breastfeeding work” about the woes of working women who breastfeed.

Bioethics Grand Rounds

Wed, September 28, 2016, 12:00pm
Location: 
UH Ford Amphitheater & Lobby

Carl Schneider, JD -- “Can Informed-Consent Laws Work? Evaluating Compelled Disclosure as a Method of Regulation”

Abstract: The law of informed consent is an example of a form of legal regulation called mandated disclosure.  In such regulation, one party to a transaction is required to give the other party to the transaction information to use in making decisions about the parties’ relationship.  There are hundreds of examples of such legal rules besides medical informed consent. This talk asks how well these rules have worked outside medicine. It concludes that there is little evidence that those rules ever work, explores some of the reasons for this surprising failure, and asks what the failure of mandated disclosure outside medicine tells us about the success of informed-consent laws in medicine.

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