Error message

The page you requested does not exist. For your convenience, a search was performed using the query about us interactive decision month 2015 09.

Page not found

You are here

Please consider attending the Health Services Research Group Launch Symposium at the North Campus Research Complex (Building 18) on Thursday, May 26, 7:30am - 5:00 pm.  The purpose is to discuss the HSR Group's goals and future plans, discuss relevant topics in healthcare policy, and network with colleagues.  Even if you are unable to attend, go to the registration page to indicate your interest in health services research and health policy so that you may be contacted again in the future.  Click here to register.

In addition, there is an effort to collect information on all HSR groups on campus for purposes of networking and for junior investigators or newcomers to U-M to find colleagues and collaborators.  Preliminary information will be provided at the Symposium and later a Wiki website will be created.  Please send the main research theme(s) of the group/center; rough idea about the investigators, divisions, departments, schools; website URL, if applicable; seminar information, if applicable; and contact information to Joe Zogaib at

The Genetics in Primary Care Institute recently launched its new website, featuring co-chairperson Beth Tarini, M.D., assistant professor of pediatrics at the University of Michigan’s C.S. Mott Children’s Hospital.

Along with Robert Saul, M.D., Tarini co-chairs the Institute, which aims to take genetic advances made during the last decade and help make them useful in the practice of primary care pediatrics.

The new website,, features information for primary care providers related to genetics testing, ethical, legal and social issues, patient communication and family history.

Tarini’s research focuses on the communication process and the health outcomes associated with genetic testing in pediatrics. She is particularly interested in pediatric population-based screening programs, such as newborn screening. Through her research, Tarini seeks to optimize communication about genetic testing between parents and providers in an effort to maximize health and minimize harm.

The UMHS press release can be found here. Dr. Tarini's featured page can be found here

Mon, June 06, 2016

A recent internet study on the effect of the VAERS (Vaccine Adverse Event Reporting System) on vaccine acceptance and trust was featured in "The Conversation." This study found telling participants about VAERS, without having them read the actual reports, improved vaccine acceptance only very slightly. However, when participants read the detailed reports, both vaccine acceptance and trust in the CDC’s conclusion that vaccines are safe declined significantly. This was true, even though the vast majority of respondents believed that the vaccine caused few or none of the reported deaths and disabilities.

For the original study:

Scherer LD, Shaffer VA, Patel N, Zikmund-Fisher BJ. Can the vaccine adverse event reporting system be used to increase vaccine acceptance and trust?. Vaccine. 2016 May 5;34(21):2424-9.

Research Topics: 
Wed, February 15, 2017

According to a study by Reshma Jagsi and colleagues, doctors often fail to recommend genetic testing for breast-cancer patients, even those who are at high risk for mutations linked to ovarian and other cancers. They surveyed 2,529 breast-cancer patients and found that although two-thirds of the women reported wanting genetic testing, less than a third actually got it. About 8 in 10 women at highest risk for BRCA mutations — because of family history or ancestry — said they had wanted testing, but only a little more than half received it.

In videos for The Trust Project, bioethicist and sociologist Raymond De Vries explores trust in medicine from a sociological perspective.

In How Trust Shapes the Medical Field: A Sociologist's Perspective, De Vries offers a historical perspective on trust in medicine:

  • What role did industrialization play in changing interpersonal trust?
  • What can we learn about trusting relationships from past societies?

In The Rise of Bioethics in Response to Medical Distrust: Key Findings, De Vries discusses some key research in the field of trust and bioethics:

  • How did the erosion of trust in medicine lead to the rise in the study of bioethics?
  • Does the bureaucracy that comes with research ethics committees enhance or undermine trust?

An another video, Evolution of Trust in Bioethics medical research ethics.

The Trust Project at Northwestern University features scholars and executives exploring Trust in videos that cover theory, research and practice. By combining multiple and diverse perspectives, The Trust Project aspires to illuminate new insights for research and management.

CBSSM Seminar: Peter Jacobson, J.D., M.P.H.

Tue, October 10, 2017, 3:00pm
NCRC, Building 16, Room 266C

Peter Jacobson, J.D., M.P.H.
Professor of Health Law and Policy
Director, Center for Law, Ethics, and Health

Title:  Addressing Health Equity Through Health in All Policies Initiatives.

Scholars and public health advocates have expressed optimism about the potential for Health in All Policies (HiAP) initiatives to improve both health equity and population health. HiAP is a collaborative approach across multiple sectors. In a qualitative study to assess these concepts, we found considerable variation across the sites on: how HiAP and equity initiatives are defined and governed; the integration of equity as a core goal; institutional capacity; and the determination of actual policy changes. We found a general migration from a HiAP-centered strategy to one based more on health equity. Regardless of the specific nomenclature, the implementation focus was directed more toward changing practices than policies.


Joel Howell, MD, PhD


Joel D. Howell is a Professor at the University of Michigan in the departments of Internal Medicine (Medical School), Health Management and Policy (School of Public Health), and History (College of Literature, Science, and the Arts), as well as the Victor C. Vaughan Professor of the History of Medicine. He received his M.D. at the University of Chicago, and stayed at that institution for his internship and residency in internal medicine. At the University of Pennsylvania, he was a Robert Wood Johnson Clinical Scholar, and received his Ph.D. in the History and Sociology of Science.

Research Interests: 
Last Name: 

Funded by National Institutes of Health

Funding Years: 2014-2016

Nearly half of patients undergoing coronary artery bypass grafting (CABG) nationwide are exposed to red blood cell (RBC) products. While large volumes (3+ units) of transfusions may be delivered to a given patient to preserve life in cases of acute blood loss, evidence suggests that even small amounts (1-2 units) of RBCs often transfused to address poor oxygen delivery are associated with a 16% increase in a patient's risk of mortality and a 27% increase in morbidity, even after case mix adjustment. It is vitally important to allocate RBC products appropriately, given both that cardiac surgery utilizes between 20-25% of the total national blood supply, and the Red Cross reports that 32 of their 36 regions had less than a day's supply available to meet hospital needs. In short, it is important to improve our understanding of how and in what context decisions are made regarding 1-2 units of RBCs, given its association with morbidity, mortality and resource utilization. Growing evidence suggests that some transfusions may be discretionary. In the state of Michigan, nearly 40% of CABG patients are exposed to 1-2 units of RBCs, although the absolute rate varies 32% across institutions. Center-specific variation in transfusion practices is likely attributed to thelack of consensus regarding the indications, setting and hematocrit trigger for transfusions. Given this uncertainty, transfusion rates may be the consequence of differences in organizational (e.g. protocols, types of decision-makers, lack of performance feedback regarding transfusion practice) and provider (e.g. knowledge, beliefs concerning the benefit/harm of transfusions, and inclination to transfuse) factors. Interventions to reduce the rate of unnecessary transfusions first require identifying the set of determinants (at the organizational or provider level) that mot fully explain the observed variation in RBC utilization across regional medical centers. We will use the prospective data and infrastructure of the Michigan Society of Thoracic and Cardiovascular Surgeons Quality Collaborative (MSTCVS-QC), a consortium of all 33 cardiac surgical programs in Michigan, to: (1) Develop, pilot, and implement surveys to hospitals and clinical providers within the state of Michigan to describe determinants of 1-2 units of RBC transfusions during cardiac surgery, and (2) Identify the primary organizational and provider characteristics contributing to variability in transfusions. Results from this study will set the sage for a behavioral modification study aimed at reducing the rate of RBC transfusions in the setting of cardiac surgery.

PI(s): Richard Prager, Donald Likosky

Co-I(s): Darin Zahuranec, Min Zhang, Marc Zimmerman, Milo Engoren

Working Group

The Working Group provides a forum for project focused discussions and interdisciplinary collaborations in topics related to bioethics, health communication, decision making and any other topic that fits within the 5 domains of CBSSM.

Working group meetings provide an opportunity for investigators to receive feedback on research proposals, drafts of papers, grant applications, or any other aspects of projects at any stage of development. These sessions are to help move forward a project in any stage of its development. So if your project is in the works, in the planning stages, or perhaps it is still just an idea, you design the session and determine how to best solicit the help and support of your colleagues.
Some examples could be:

  • Outline sketch of specific aims for a grant. (Presenter would provide a one page summary before the session)
  • Outline of a proposed paper or paper in draft stage. (Discussion would be based on one page summary. Presenter would walk the group through the outline or draft, and solicit feedback on significance and coherence of ideas)
  • Determining a paper’s relevance. (Presenter could ask group members to read a paper, in order to discuss/determine if that paper is crucial to the project that the person has in mind-- different from a journal club exercise.)

This meeting is designed as an informal working group not a formal presentation.

The working group usually meets on Tuesdays or Wednesdays at 4pm in NCRC B16-266C. To be added to the email list, please contact Amy Lynn at OR join our email list.





Raymond De Vries, PhD

Associate Director

Raymond De Vries PhD is Associate Director at the Center for Bioethics and Social Sciences in Medicine at the University of Michigan and is a Professor in the Department of Learning Health Sciences and the Department of Obstetrics and Gynecology. He is also visiting professor at CAPHRI School for Public Health and Primary Care, University of Maastricht, the Netherlands.

Last Name: 
De Vries