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Fri, October 04, 2013

The US News & World Report quoted Sarah Hawley and cited her research in a story about the tendency of young women with breast cancer to overestimate their risk of getting cancer in the opposite, healthy breast. 

An excerpt from the article, "Unfounded Fear Prompts Some Preventive Mastectomies: Study":

The findings echo some previous research, according to Sarah Hawley, an associate professor of internal medicine at the University of Michigan Health System, in Ann Arbor. In her study, presented last year at a medical meeting, Hawley found that nearly 70 percent of women choosing the contralateral prophylactic mastectomy actually had a low risk of developing cancer in the healthy breast.

"Their findings are consistent with ours, in that desire to prevent cancer in the non-affected breast is a big reason patients reported for getting [contralateral prophylactic mastectomy]," Hawley said.

Better communication is needed to be sure women know the risks and benefits, and lack of benefit of getting the preventive surgery, Hawley pointed out. Better strategies to help patients manage anxiety and worry would help, too, she added.

 

Research Topics: 
Thu, December 08, 2016

Reshma Jagsi, MD, discusses the risk of complications on patients receiving radiation therapy if they've had implant reconstruction. Radiation therapy may affect outcomes of breast construction, and more is needed to help patients make informed choices.

San Antonio Breast Cancer Symposium (SABCS) Presentation Title: Impact of radiotherapy on complications and patient-reported satisfaction with breast reconstruction: Findings from the prospective multicenter MROC study

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.

Bioethics Grand Rounds: “Examining the Ethics of Victors Care”

Wed, February 28, 2018, 12:00pm
Location: 
Univerisity Hospital Ford Auditorium

Michigan Medicine has launched Victors Care, a concierge medical care model designed to deliver increased access, convenience and individually-tailored support within a primary care practice for patients who pay for membership. Like all concierge care programs, Victors Care raises ethical issues relating to justice, fairness, access, and consistency with the mission of Michigan Medicine. This Bioethics Grand Rounds will address the ethical issues of concierge care in a panel format with institutional leaders. The panel will address your questions directly. Questions will be solicited during the session, and can be submitted in advance via: https://umichumhs.qualtrics.com/jfe/form/SV_b4nJWM70ahHQtjD.

Panelists
Marschall S. Runge, M.D., Ph.D., EVPMA and Dean
Reshma Jagsi, M.D., D.Phil, Director, Center for Bioethics and Social Sciences in Medicine
David J. Brown, M.D., Associate Vice President and Associate Dean for Health Equity and Inclusion

Facilitators
Andrew Shuman, M.D., F.A.C.S & Christian J. Vercler, M.D, M.A, F.A.C.S – Service Chiefs, Clinical Ethics Service, Center for Bioethics and Social Sciences in Medicine

2014 Bishop Lecture featuring Myra Christopher

Thu, May 15, 2014 (All day)
Location: 
Vandenberg Meeting Hall (2nd floor), The Michigan Hall, 911 N. University, Ann Arbor, MI.

The CBSSM Research Colloquium featured the Bishop Lecture in Bioethics as the keynote address.  Myra Christopher presented the Bishop Lecture with a talk entitled: "The Moral Imperative to Transform the Way Pain is Perceived, Judged and Treated".

Myra Christopher holds the Kathleen M. Foley Chair in Pain and Palliative Care at the Center for Practical Bioethics.  Prior to December 2011, Ms. 

Christopher was President and CEO of the Center for Practical Bioethics since its inception in 1984 through December 2011.  From 1998-2003, Christopher also served as the national program officer of the Robert Wood Johnson Foundation’s National Program Office for State-based Initiatives to Improve End-of Life Care which was housed at the Center.  These roles have allowed Christopher to continue her lifelong mission to improve care for those who are seriously ill and their families.

Since the late 1990s, Christopher has expanded the scope of her work to include the under treatment of chronic pain.  She is currently the Director of the Pain Action Initiative: A National Strategy (PAINS) and serves as Chair of the PAINS Steering Committee. From 2010-2011 she served as a member of Pain Study Committee at the Institute of Medicine focused on the under-treatment of pain.  In 2012 she was appointed by the Secretary of Health and Human Services, Kathleen Sibelius, to the Interagency Pain Research Coordinating Committee (IPRCC) at the National Institutes of Health. In that capacity, she also serves on the Oversight Committee for the National Pain Strategy Task Force. 

The Center for Bioethics and Social Sciences in Medicine (CBSSM) Research Colloquium was held Thursday, May 15, 2014 at the Vandenberg Meeting Hall (2nd floor), The Michigan League, 911 N. University Ave, Ann Arbor, MI 48109.

Funded by Michigan Department of Health and Human Services (Subcontract)

Investigators from University of Michigan’s Institute for Healthcare Policy and Innovation (IHPI), in partnership with the Detroit Health Department, the Southfield-Joy Community Development Corporation and five health plans insuring Detroit-based Medicaid and Healthy Michigan enrollees have collaboratively developed an innovative new model for a Community Health Worker-led (CHW) demonstration project in Detroit’s Cody Rouge neighborhood. The demonstration project will evaluate a potentially financially sustainable model targeting neighborhoods with high numbers of high- and under-health care utilizing Medicaid enrollees. The health plans will each deploy one of their CHWs to the project for a 12-month period. After undergoing joint training through the Michigan Community Health Worker Alliance (MICHWA) program and using assessment tools that cover shared domains, the CHWs will proactively reach out to identified beneficiaries to conduct an initial health and social needs assessment, develop an individualized ‘action plan’ with each beneficiary, work with neighborhood-based organizations to address each enrollee’s unique needs, and provide follow-up support as needed. CHWs will work closely with local organizations both to meet program participants’ needs and to strengthen community capacity to bridge gaps between healthcare services and community-level social determinants of health. The Detroit Health Department will provide office space for the CHWs to meet weekly in a neighborhood facility and provide ongoing booster support and mentorship. UM investigators will evaluate the program in a parallel, two-armed, randomized controlled pragmatic trial. We will evaluate effect on health care utilization among high-utilizing participants and zero-utilizing participants (ED visits, hospitalizations, primary care use) and health care costs at 6- and 12-months and compared to eligible individuals not yet enrolled in the project, on key patient-centered outcomes, and project costs, return on investment, and barriers and facilitators to adoption, implementation, maintenance, and potential spread.

PI: Michele Heisler, MD, MPA

CBSSM Co-I: H. Myra Kim, ScD

Funded by Blue Cross Blue Shield of Michigan Foundation

Investigators from University of Michigan’s Institute for Healthcare Policy and Innovation (IHPI), in partnership with the Detroit Health Department, the Southfield-Joy Community Development Corporation and five health plans insuring Detroit-based Medicaid and Healthy Michigan enrollees have collaboratively developed an innovative new model for a Community Health Worker-led (CHW) demonstration project in Detroit’s Cody Rouge neighborhood. The demonstration project will evaluate a potentially financially sustainable model targeting neighborhoods with high numbers of high- and under-health care utilizing Medicaid enrollees. The health plans will each deploy one of their CHWs to the project for a 12-month period. After undergoing joint training through the Michigan Community Health Worker Alliance (MICHWA) program and using assessment tools that cover shared domains, the CHWs will proactively reach out to identified beneficiaries to conduct an initial health and social needs assessment, develop an individualized ‘action plan’ with each beneficiary, work with neighborhood-based organizations to address each enrollee’s unique needs, and provide follow-up support as needed. CHWs will work closely with local organizations both to meet program participants’ needs and to strengthen community capacity to bridge gaps between healthcare services and community-level social determinants of health. The Detroit Health Department will provide office space for the CHWs to meet weekly in a neighborhood facility and provide ongoing booster support and mentorship. UM investigators will evaluate the program in a parallel, two-armed, randomized controlled pragmatic trial. We will evaluate effect on health care utilization among high-utilizing participants and zero-utilizing participants (ED visits, hospitalizations, primary care use) and health care costs at 6- and 12-months and compared to eligible individuals not yet enrolled in the project, on key patient-centered outcomes, and project costs, return on investment, and barriers and facilitators to adoption, implementation, maintenance, and potential spread.

PI: Michele Heisler
CBSSM Co-I: H. Myra Kim

Wendy Uhlmann, MS, CGC

Faculty

Wendy R. Uhlmann, MS, CGC is the genetic counselor/clinic coordinator of the Medical Genetics Clinic at the University of Michigan. She is a Clinical Professor in the Departments of Internal Medicine and Human Genetics and an executive faculty member of the genetic counseling training program. Wendy Uhlmann is a Past President of the National Society of Genetic Counselors and previously served on the Board of Directors of the Genetic Alliance and as NSGC’s liaison to the National Advisory Council for Human Genome Research.

Last Name: 
Uhlmann

Funded by the Agency for Health Care Research and Quality

Funding Years: 2010-2011

This study will evaluate a broad-based collaboration between the largest insurer in Michigan (BCBSM) and physician organizations throughout the state to implement components of the Patient-Centered Medical Home, and will provide valuable lessons for PCMH initiatives throughout the country. Because of the wide range of independent practices of varying structure, demographics, and geographic locations participating in this collaboration, the lessons learned from this study will provide greater external validity for the vast majority of primary care practices than do the experiences of large, integrated health systems with employed physician staff and centralized administrative control. Results from this study could also help primary care teams prepare for their journey toward a fully- functioning PCMH by preparing them in advance for challenges that may arise during PCMH implementation, and having information on how others have overcome those challenges.

UM Affiliated Investigators: Michael Fetters (PI), Lee Green (Co-I), Jeffrey Alexander (Co-I).

More details can be found at NIH Reporter.

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