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Geoffrey Barnes has been selected as one of 12 IHPI junior faculty members to serve on the Junior Faculty Advisory Council (JFAC) to advocate for junior faculty professional development programs and activities within IHPI, and to provide perspective and feedback on issues and opportunities identified and brought to the JFAC by the Institute Leadership Team.

Brian Zikmund-Fisher, PhD, is the senior author on a study led by Donna M. Zulman, MD, that reveals about a third of doctors and their patients with diabetes do not agree on which of the patient's health conditions is most important. In the study, 38% of physicians (compared to 18% of patients) ranked hypertension as the most important condition. Patients were more likely to prioritize symptoms such as pain and depression. Read the article, in the Journal of General Internal Medicine, here. Read a press release about the article here.

Funded by: NIH

Funding Years: 2016-2021

 

There is a fundamental gap in understanding how Mild Cognitive Impairment (MCI) influences treatment and Decision Making for serious illnesses, like Cardiovascular disease (CVD), in older patients. Poor understanding of Clinical Decision Making is a critical barrier to the design of interventions to improve the quality and outcomes of CVD care of in older patients with MCI. The long-term goal of this research is to develop, test, and disseminate interventions aimed to improve the quality and outcomes of CVD care and to reduce CVD-related disability in older Americans with MCI. The objective of this application is to determine the extent to which people with MCI are receiving sub-standard care for the two most common CVD events, Acute myocardial infarction (AMI) and acute ischemic stroke, increasing the chance of mortality and morbidity in a population with otherwise good quality of life, and to determine how MCI influences patient preferences and physician recommendations for treatment. AMI and acute ischemic stroke are excellent models of serious, acute illnesses with a wide range of effective therapies for acute management, Rehabilitation, and secondary prevention. Our central hypothesis is that older Adults with MCI are undertreated for CVD because patients and physicians overestimate their risk of dementia and underestimate their risk of CVD. This hypothesis has been formulated on the basis of preliminary data from the applicants' pilot research. The rationale for the proposed research is that understanding how patient preferences and physician recommendations contribute to underuse of CVD treatments in patients with MCI has the potential to translate into targeted interventions aimed to improve the quality and outcomes of care, resulting in new and innovative approaches to the treatment of CVD and other serious, acute illnesses in Adults with MCI. Guided by strong preliminary data, this hypothesis will be tested by pursuing two specific aims: 1) Compare AMI and stroke treatments between MCI patients and cognitively normal patients and explore differences in Clinical outcomes associated with treatment differences; and 2) Determine the influence of MCI on patient and surrogate preferences and physician recommendations for AMI and stroke treatment. Under the first aim, a health services research approach- shown to be feasible in the applicants' hands-will be used to quantify the extent and outcomes of treatment differences for AMI and acute ischemic stroke in older patients with MCI. Under the second aim, a multi-center, mixed-methods approach and a national physician survey, which also has been proven as feasible in the applicants' hands, will be used to determine the influence of MCI on patient preferences and physician recommendations for AMI and stroke treatment. This research proposal is innovative because it represents a new and substantially different way of addressing the important public health problem of enhancing the health of older Adults by determining the extent and causes of underuse of effective CVD treatments in those with MCI. The proposed research is significant because it is expected to vertically advance and expand understanding of how MCI influences treatment and Decision Making for AMI and ischemic stroke in older patients. Ultimately, such knowledge has the potential to inform the development of targeted interventions that will help to improve the quality and outcomes of CVD care and to reduce CVD-related disability in older Americans.

PI: Deborah Levine

CO(s): Darin Zahuranec, MD & Ken Lenga, MD. PhD.

Wed, February 03, 2016

Beth Tarini, MD, MS and colleagues are back in the news regarding their 2013 article in Pediatrics entitled, “Blindness in Walnut Grove: How Did Mary Ingalls Lose Her Sight?” Their article was cited in CNNCBS NewsNew York TimesAnnarbor.com and many others. 

Citation: Allexan SS,  Byington CL, Finkelstein JI, Tarini  BA (2013 ). "Blindness in Walnut Grove: How Did Mary Ingalls Lose Her Sight?" Pediatrics; DOI: 10.1542/peds.2012-1438 [Epub ahead of print]

Research Topics: 

The 2012 CBSSM Research Colloquium took place on Thursday, May 10, and was attended by over 130 people.  This year's colloquium focused on research around medical decision making, and featured presentations by numerous faculty, fellows, and students.  In addition, the CBSSM Research Colloquium featured the annual Bishop Lecture in Bioethics as its keynote address.  Drs. Jerome Groopman and Pamela Hartzband of Harvard Medical School jointly presented the Bishop Lecture with a talk entitled, "When Experts Disagree: The Art of Medical Decision Making."  For more information about the event and to view photos and a video of the Bishop Lecture, click here.

Michael Volk, MSc, MD

Alumni

Michael Volk was an Assistant Professor of Medicine in the Division of Gastroenterology and Hepatology at the University of Michigan. His clinical practice focuses on the care of patients with liver disease, including those undergoing liver transplantation and those with hepatocellular carcinoma. His research interests focus on the ethics of resource allocation, patient and physician decision making, and chronic disease management. In particular, he has conducted a series of studies designed to improve the way decisions are made about using high risk liver transplant organs.

Last Name: 
Volk

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.

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, www.geneticsinprimarycare.org, 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, January 06, 2014

Dr. Reshma Jagsi worked on a study detailing the decline of US research spending versus the increase in spending in Japan and China. In the UMHS article, she says, "The United States has long been a world leader in driving research and development in the biomedical science. It's important to maintain that leadership role because biomedical research has a number of long term downstream economic benefits, especially around job creation," 

Research Topics: 

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