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Funded by the National Institutes of Health

Funding years: 2009-2014

The Specific Aims of this study are (1) to examine patterns and correlates of quality of adjuvant chemotherapy in a population-based sample of women, (2) to examine patterns and correlates of quality of breast cancer hormonal therapy in a population-based sample of women with breast cancer, and (3) to estimate the frequency of classification error in key pathologic variables-ER and HER2 status-in a population-based sample of women with breast cancer and explore the impact of such error on receipt of optimal adjuvant systemic therapy. We propose to investigate these factors through patient interview, medical record review, and repeat assessment of pathologic variables on primary tumor specimens. The results of this study will be used to advance methods in oncology outcomes research and to inform policy and practice interventions to improve the quality of breast cancer care in the United States. For more information, visit NIH Reporter.

PI(s): Jennifer Griggs, Steven Katz

Co-I: Sarah Hawley

CBSSM Seminar: Kirsten McCaffery, BSc (Hons), PhD

Thu, November 05, 2015, 3:00pm to 4:00pm
NCRC, South Atrium, Building 10

This seminar features Kirsten McCaffery, BSc (Hons), PhD; Professorial Research Fellow, School of Public Health; Sydney Medical School; NHMRC Career Development Fellow' Deputy Director, Public Health Section, Centre for Medical Psychology and Evidence based Decision Making (CeMPED)

Title: Communicating overdiagnosis in breast cancer screening: a randomised trial of a decision aid among women approaching target screening age.

Abstract: Mammography screening can reduce breast cancer mortality. However, most women are unaware that
inconsequential disease can also be detected by screening, leading to overdiagnosis and overtreatment. We aimed to investigate whether including information about overdiagnosis of breast cancer in a decision aid would help women aged around 50 years to make an informed choice about breast screening. Women (n=879) aged 48-50 were randomised to 1 of 2 decision aids. Both booklets presented evidence based information on key screening outcomes (breast cancer mortality benefit and false positives); 1 booklet also included overdiagnosis information. Study outcomes included informed choice (knowledge, attitudes and intentions) decisional conflict, anxiety, worry, anticipated regret and acceptability of the decision aid. Implications for the effective communication of overdiagnosis in screening and the development of optimal strategies for future information delivery will be discussed.

Mon, April 17, 2017

Brian Zikmund-Fisher is quoted in a recent MarketWatch article, "How doctors are getting patients more involved in their own care." Dr. Zikmund-Fisher points out, "Patients are often overwhelmed by massive amounts of data they now have access to. The easier we make it for them to understand, the more likely it is they will use it and the less time the doctor has to spend explaining it.” The article goes on to cite a web-based application developed by Dr. Zikmund-Fisher and colleagues that allows health-care providers and researchers to create graphics that use icons in arrays that show risk information in ways that make it easier for people to grasp information.

A study by former CBSSM Co-Director, Angela Fagerlin, is also cited in the article.

Co-sponsored by the Center for Ethics in Public Life and the Center for Bioethics and Social Sciences in Medicine, the 2nd annual Bioethics Colloquium took place on Friday, May 20, 8:30-3:30 pm, in the Alumni Center.  The colloquium featured presentations of research in or about bioethics conducted by U-M faculty, fellows, and students.

The keynote speaker was Susan Dorr Goold, MD, MHSA, MA, who gave a talk entitled, "Market failures, moral failures, and health reform."

Nearly 70 people attended the event, which featured 10 presentations by faculty, graduate students, and undergraduate students drawn from a variety of disciplines.

CBSSM Co-director Scott Kim, MD, PhD, has recentlybeen funded by the NIH for a project on therapeutic misconception and the ethics of sham surgery. Ethicists have raisedconcerns that elderly patients with a progressively debilitating disease suchas Parkinson’s disease (PD) may be too vulnerable for research that involvesnovel, invasive interventions thatuse a controversial masking design, i.e., sham neurosurgical controls. Arethese subjects laboring under a therapeutic misconception, erroneously believing that research, rather than being anexperimental procedure for the sake of creating knowledge to help futurepatients, is actually a novel form of treatment intended to help them? Dr.Kim’s project will study four actual PDclinical trials that involve a sham surgery control. Collaborators include R. DeVries, K. Kieburtz, R. Wilson, S.Frank, and H.M. Kim. Pilot funding came from the Michael J. Fox Foundation.

Funded by the Alzheimer's Association

Active Year(s): 2008-2011

The goal of the MCI Risk Communication Study is to develop and evaluate a risk communication protocol to convey diagnostic and risk information to MCI patients and family members. A multi-step protocol will be created, taking into account principles of health risk communication, patient and provider preferences, and ethical issues involved in working with cognitively impaired populations. The protocol will be delivered by health care professionals with risk communication experience and tested on 10 patient/care-partner dyads recruited from Alzheimer’s Disease Centers at the University of Michigan and Boston University. The results of this pilot study will help inform the fourth trial of REVEAL.

PI: J. Scott Roberts, PhD

CBSSM Seminar: Stephanie Kukora, MD

Wed, November 05, 2014, 3:00pm to 4:00pm
NCRC 16-266C

Stephanie Kukora, MD
Neonatal-Perinatal Medicine Fellow

"Choosing Wisely: using past medical decisions in allocating scarce ECMO resources"

This talk will examine the ethical complexities of distributing limited ECMO resources to a growing population of eligible patients across the age spectrum and varying prognosis, describe the ramifications of influenza vaccine refusal among otherwise healthy adults, and explore the moral permissibility of allocating scarce ECMO resources based on previous medical decision-making, such as declining the seasonal influenza vaccine.

Interim Co-Director Brian Zikmund-Fisher was featured in “Medicine at Michigan.” Brian shared his personal experience with risk and probability in medical decision making.  This experience provided him with the personal career goal of improving patients’ lives by making health information easier to understand.

This is the first featured story in the new section “Gray Matters,” which gives our faculty members the opportunity to write about complex issues in medicine, such as ethics and decision-making.

"A Calculation of Risk"

Thu, October 01, 2015

Dr. Reshma Jagsi, radiation oncologist and CBSSM research investigator, has conducted research on how doctors play a role in soliciting donations from grateful patients, and whether or not they should. Her study, recently published online in the Journal of Oncology, was featured in the NY Times. Arthur L. Caplan, head of the division of medical ethics at NYU Langone Medical Center, addressed this issue as “extraordinarily important,” adding that he had never seen a paper that examined the issues as thoroughly as Dr. Jagsi’s. “Hopefully, this paper will start a long overdue discussion."

Research Topics: 

CBSSM recently hosted a "Concussion" Film Screening & Moderated Discussion on March 30th. Co-Director, Raymond De Vries moderated. Our panelists included: Ellen Arruda, PhD, Professor, Mechanical Engineering; Karen Kelly-Blake, PhD, Assistant Professor, Center for Ethics and Humanities in the Life Sciences, MSU; and Matthew Lorincz, MD, PhD, Associate Professor, Neurology, Co-Director, Michigan NeuroSport.

The panel discussion related to key bioethical and scientific issues brought up by the film, as well as current research into brain injury and brain injury prevention.