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Thu, February 04, 2010

Angela Fagerlin, PhD, talked with Financial Planning about how research on decision aids in healthcare might be used to help financial planners convey complex information to their clients. She discussed specifics: use of absolute vs relative risk data, frequencies vs. percentages, and graphical representations such as bar graphs and pictographs. 

Health Communication and Decision Making

A major theme of CBSSM involves using techniques from basic and applied research to determine the best practices for communicating health information to patients and the public more generally. This special interest group explores topics related to understanding and improving patient and public decision making about medical issues.

Research that falls within this programmatic area includes topics such as:

  • Risk communication and perception
  • Health communication and education
  • Development and testing of decision aids/patient education materials
  • Visualization and contextualization of health data
  • Communication of genomic information to patients and providers
  • Numeracy and literacy
  • Utility and survey methods
  • Patient decision making
  • Patient-physician communication

National Cancer Institute (NCI)

Funding Years: 2012-2018

Treatments for cancer impose substantial burden and morbidity but net survival benefit of different strategies is often small and virtually always uncertain. Thus, clinicians may do more harm than good if treatment is too aggressive. There are a number of management strategies for breast cancer aimed at reducing unnecessary morbidity and burden on patients with favorable disease. A key barrier to advancing these initiatives is the need for a better understanding of the challenges of individualizing cancer care. The goal of this program is to improve population health by helping clinicians and their patients address the challenges of individualizing treatment of breast cancer for patients with favorable prognosis. Objective 1: To examine the challenges of individualizing treatment for women with breast cancer. Two projects will each undertake an observational study of patients newly diagnosed with breast cancer (including their attending clinicians) who were reported to the SEER registries of Georgia and New Jersey during an 18 month period to examine patient and clinician factors associated with key evaluative tests, treatments, and patient appraisal of decision quality. Project 1 will focus on challenges for surgeons and their patients with regard to locoregional therapy. Project 2 will focus on challenges for medical oncologists and their patients with regard to systemic therapy. Objective 2: To improve treatment decision quality. Project 3 will perform a randomized controlled trial of a practice based online decision tool for patients newly diagnosed with breast cancer in the Detroit and Atlanta SEER regions intended to improve decision quality. Objective 3: To accelerate the dissemination of SEER-based research findings by implementing and evaluating a tailored online portal aimed at all surgeons and medical oncologists who treated the patient samples in P1 and P2 to evaluate whether our research findings can more directly and promptly inform clinicians knowledge and attitudes about individualizing treatment. Objective 4: To advance methods in SEER population translational research focused on quality of cancer care. We propose four shared resource cores that will support program project activities, advance innovative methods in oncology population sciences, and advance team mission and long-term strategic planning.

PI(s): Steven Katz

Co-I(s): Lawrence An, Michael Elliott, Angela Fagerlin, Sarah Hawley, Timothy Hofer, Reshma Jagsi, Nancy Janz, Yun Li, Kenneth Resnicow, Jeremy Taylor, Christopher Friese

Funded by NIH - Department of Health and Human Services
Funding Years: 2016-2021

Post stroke disability represents a significant public health problem as there are over 7 million stroke survivors in the US, most of whom have persistent disability. Despite the fact that acute stroke treatments dramatically reduce post-stroke disability and are cost saving, they are markedly underutilized. There is no region in the US where acute stroke treatments are more underutilized than in Flint, Michigan. Flint is an urban, underserved city of about 100,000 residents of whom about 60% are African American.

The Peoples Health partnership was formed in 2009, consisting of stroke neurologists, experts in health behavior and health education, nurses, and Bridges into the Future, a faith based organization dedicated to improving the health of the community. The goal of the partnership was to reduce the burden of cardiovascular disease in Flint. The Peoples Health partnership completed a community needs assessment, designed and tested a peer-led, health behavior theory-based stroke preparedness (recognizing stroke warning signs and the importance of calling 911) intervention in African American churches. This community intervention, Stroke Ready, successfully increased stroke preparedness. This application represents the larger scale adaption and testing of the Stroke Ready intervention to increase the Flint community?s acute stroke treatment rates.

Stroke Ready expands to a multi-level intervention aims to increase acute stroke treatment through both community stroke preparedness and Emergency Department readiness. The cornerstone of the pilot Stroke Ready intervention was a stroke music video which will now be adapted into a stand-alone intervention. For community stroke preparedness, the music video, mass multimedia circulation, interactive workshops, and print workbooks will all be delivered throughout the Flint community. We will also intervene in a Flint area safety net Emergency Department in great need of improved acute stroke care to optimize treatment pathways. The primary outcome of the project will be change in acute stroke treatments which will directly benefit the community by reducing post-stroke disability.

This project will benefit the Flint community and other urban communities with low acute stroke treatment rates. Sustainability will be achieved in Flint by training of peer leaders, wide dissemination of Stroke Ready materials, ease of re-administering the intervention, hospital improvements and continued commitment and engagement of the community advisory board. To assist other safety net-hospitals outside of Flint, we will create a protocol to assess barriers to optimal acute stroke care. More broadly, this project will address a central unanswered scientific question of the relative importance of interventions in the community and/or hospital to increase acute stroke treatments. Thus other communities with limited resources who are interested in increasing their acute stroke rates will have a better understanding of whether to invest in community stroke preparedness or hospital readiness.

PI(s): Lesli Skolarus

Co-I(s): Anne Sales, James Burke, Lewis Morgenstern, William Meurer, Marc Zimmerman

Funded by National Institutes of Health.

Funding Years: 2011-2016

 

Making decisions about the medical care of a loved-one with acute brain hemorrhage is a difficult and frightening time for families. This project will work to improve the processes that doctors and families use to make these decisions in the future. For more information, visit NIH Reporter

PI(s): Darin Zahuranec, Brisa Sanchez

Co-I(s): Renee Anspach, Angela Fagerlin, Lewis Morgenstern, Phillip Rodgers

 

 

Funded by American Cancer Society.

Funding Years: 2014-2017.

The study will examine how informal decision supporters (e.g., partners, family, and friends) contribute decisions about surgery, radiation, and chemotherapy treatment, and how these roles may vary by race and ethnicity. The project will utilize existing resources from the Cancer Surveillance and Outcomes Research Team's (CanSORT) Program Project Grant "The Challenge of Individualizing Treatments for Patients with Breast Cancer," a $13 million award received from NCI in 2012.

PI(s): Sarah Hawley

Co-I(s): Jennifer Griggs, Nancy Janz, Steven Katz, Yun Li

 

CBSSM researcher Brian J. Zikmund-Fisher, PhD, and collaborator Mick Couper, PhD, from the UM Institute for Social Research spoke to the Medical Editors Meeting of the Foundation for Informed Medical Decision Making in Jackson Hole, Wyoming. Drs. Couper and Zikmund-Fisher reported on "Methods and Early Results from the National Survey of Medical Decisions." This pioneering survey reveals surprising information about the epidemiology of ten common medical decisions that are made by older Americans. Discussion of the presentation was lively!

The Foundation for Informed Medical Decision Making, which funded this CBSSM research, is a nonprofit organization dedicated to assuring that people understand their choices and have the information they need to make sound decisions affecting their health and well being.
Learn more at http://www.fimdm.org

Sun, October 17, 2010

Brian Zikmund-Fisher, PhD, was featured in an interview by the U-M News Service on September 29, 2010.  Dr. Zikmund-Fisher served as the featured guest editor for a special supplement to Medical Decision Making, Sept/Oct 2010, that focused on the DECISIONS study. In the interview, Dr. Zikmund-Fisher highlighted the need for health care providers to do a better job of educating patients about the medical decisions they face.  A video highlights the findings of the study and can be found at: http://ns.umich.edu/htdocs/releases/story.php?id=8008.  CBSSM faculty also involved in the DECISIONS study included Angela Fagerlin, PhD, and Mick Couper, PhD

Amanda Dillard, PhD, was awarded a $25,000 George Bennett Postdoctoral Grant by the Foundation for Informed Medical Decision Making. With this funding, Dr. Dillard will conduct surveys to examine whether certain types of patient testimonials have a beneficial influence on knowledge, satisfaction, and interest in shared health care decision making, specifically in the context of a decision aid related to colon cancer screening. She will use social cognitive theory, social comparison theory, and risk processing perspectives to guide her hypotheses about testimonials.

Dr. Dillard’s postdoctoral position at CBSSM was funded by VA Health Services Research and Development, Ann Arbor, Michigan.

CBSSM Seminar: Jacob Solomon, PhD

Thu, November 19, 2015, 3:00pm to 4:00pm
Location: 
NCRC, Building 16, Room 266C

Jacob Solomon, PhD


CBSSM Postodoctoral Fellow

Title:

Designing the information cockpit: The impact of customizable algorithms on computer-supported decision making

Abstract:

Intelligent systems that provide decision support necessitate interaction between a human decision maker and powerful yet complex and often opaque algorithms. I will discuss my research on end-user control of these algorithms and show that designing highly customizable decision aids can make it difficult for decision makers to identify when the system is giving poor advice.

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