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Jeff Kullgren's editorial "Injecting Facts Into the Heated Debates Over Medicaid Expansion" was recently published in the Annals of Internal Medicine. In this editorial, Dr. Kullgren reviews Wherry and Miller's study on the effects of ACA on coverage, access, utilization, and health. 

Wherry LR, Miller S. Early coverage, access, utilization, and health effects associated with the Affordable Care Act Medicaid expansions. A quasi-experimental study. Ann Intern Med 2016

Link to IHPI article.

Funded by the NIH (R01-MH075023)

Funding Years: 2005-2010

This project examines whether persons with Alzheimer’s Disease (AD) who are incapable of providing independent informed consent to enroll in research still retain other important ethically relevant abilities—in particular, the capacity to appoint a proxy for research decision-making.

UM Affiliated Investigators: Scott Kim (PI), H. Myra Kim (Co-I)

More details can be found at NIH Reporter.

What We Do

RESEARCH

Research has been the focus and the strength of the faculty members affiliated with CBSSM. Researchers have pursued groundbreaking investigations topics such as:

  • doctor-patient communication
  • psychological adaptation to disability
  • health care rationing
  • social cognition
  • decision aids to communicate risk
  • informed consent
  • deliberative democracy

EDUCATION

An important mission of CBSSM is to extend the ethics education medical students receive at the University of Michigan. Our current curriculum efforts are focused on enriching the existing curriculum and on making instruction on medical ethics for undergraduate medical students at UM more systematic and focused. Our goal is to increase medical student interest in ethics and their competence in recognizing and resolving ethical issues. Our strategy is to weave ethics into the curriculum throughout the 4 years of training in a way that allows students to build upon what they know of ethical theory and to apply that knowledge to their clinical practice. Additionally, given CBSSM faculty expertise, our aim is to create novel ethics curriculum components that incorporate our empirical work in bioethics and our particular expertise in decision science. 

POLICY/OUTREACH

CBSSM scholars perform the basic and applied scientific research that will improve health care policy and practice, to benefit patients and their families, health care providers, third-party payers, policy makers, and the general public. In our Decision of the Month web feature, we turn a recent research finding into an interactive decision that a patient or a policy maker might face.

PROGRAM IN CLINICAL ETHICS

The Program in Clinical Ethics within CBSSM represents an expansion of existing services designed to promote a culture of patient-centered excellence by developing a comprehensive set of ethics-related activities.  The aims of this program are to: liaise with and provide support to the adult and pediatrics ethics committees; streamline clinical ethics consultation; assist with ethics-related policy development on a regular and proactive basis; organize and administer structured educational programs in clinical ethics; and coordinate empiric research with relevance to clinical ethics within CBSSM.

 

The article, "The DECISIONS Study: A Nationwide Survey of United States Adults Regarding 9 Common Medical Decisions," authored by Brian Zikmund-Fisher et al. in Medical Decision Making (September-October 2010) was recently identified as the most downloaded article in the journal of all articles published in 2009 and 2010. 

Funded by NIH: National Cancer Institute

Funding Years: 2008-2014

Prostate cancer is a leading cause of cancer death among men, and thousands of men must make treatment decisions every year. Decision making for localized prostate cancer is especially challenging as clinical trials have shown that the standard treatment options of active surveillance, surgery and radiation are comparable in terms of survival. Thus, treatment for prostate cancer is a preference-sensitive decision, with the best choice depending in part on patient attitudes towards the risks and benefits of treatment alternatives. Therefore, ideally the treatment decision will be made with full consideration of patient preferences. As such, it is recommended that patients and their physicians discuss any preferences patients have that might be relevant to the treatment decision. This dialogue is complicated by patients’ lack of experience with sharing in these types of decisions. Additionally, physicians often use medical jargon, making it more difficult for patients to understand their diagnosis and treatment options.  Research is needed to determine the best methods for helping patients communicate their preferences to their physicians so that patient values hold considerable weight in treatment decisions.

The goals of this study are two-fold:

  • To demonstrate to patients some of the issues that might arise during their diagnosis visit that may prevent them from communicating preferences to physicians.
  • To provide solutions that would enable greater patient participation in medical decision making.

PI(s): Angela Fagerlin, PhD and Peter A. Ubel, MD

Co-I(s): John T. Wei, MD; Brian Zikmund-Fisher, PhD; Margaret Holmes-Rovner, PhD; James Tulsky, MD; Stewart Alexander, PhD

Parent grantMichigan Center for Health Communication Research II

Mon, October 23, 2017

In a recent blog post, Brian Zikmund-Fisher writes about the often unrecognized problem of finding meaning in the flood of health data.

Research Topics: 

Target specific oral anticoagulants (TSOAC)s including dabigatran, rivaroxaban, and apixaban represent novel alternatives to vitamin K antagonists. These medications provide an attractive choice for both physicians and patients alike due to their predictable pharmacokinetics, fixed-dose regimens, lack of routine monitoring, and fewer drug-drug interactions as compared to warfarin. However, these anticoagulants are not without their own unique features and risks, including required dose adjustments for patient specific factors such as renal function, weight, and age, and lack of a routine monitoring parameter to follow patient adherence with therapy. In addition, the cost of TSOACs and the growing number of indications they are currently approved for makes ensuring affordability as well as the correct dosage based on indication for therapy extremely important.

PI(s): Geoffrey Barnes

Co-I(s): Emily Ashjian

Bioethics Grand Rounds - Dr. Michael Jibson

Wed, August 26, 2015, 12:00pm
Location: 
Ford Auditorium

This month's grand rounds features: Michael Jibson, MD, Psychiatry Department speaking about "Psychiatry, Law, and Society: Ethical and Legal Issues in Mental Health"

Lunch provided!

Please join us for a lively discussion of medical ethics. The Bioethics Grand Rounds is co-sponsored by the Center for Bioethics and Social Sciences in Medicine, the UMHS Adult and Pediatric Medical Ethics Committee, and the Program of Society and Medicine. This educational session is open to all faculty and staff and members of the public. CME credit is available. 

To meet ACCME requirements for Faculty Planner disclosure and Presenter Disclosure to participants of CME activities at UM, please be advised that the following faculty planner(s)/co-planner(s) and presenter have no personal financial relationships relevant to the activity listed below:
Planners: 

  • Andrew Shuman, MD
  • Christian Vercler, MD

Journeys in Genetics: Ethical, Legal, and Social Implications

Tue, September 27, 2016, 3:00pm
Location: 
2610 SPH I

Journeys in Genetics: Ethical, Legal, and Social Implications
with Toby Citrin, J.D. and Scott Roberts, Ph.D.


September 27, 2016
3:00 - 4:00 p.m.
2610 SPH I
1415 Washington Heights
Ann Arbor, MI 48109-2029


Sponsored by Certificate Program in Public Health Genetics 20th Anniversary Seminar Series


"Journeys in Genetics" is an interactive series of seminars that will highlight the unique personal and professional paths that the Certificate Program in Public Health Genetics (CPHG) faculty members have traversed throughout their careers in the field of public health genetics. In this seminar, Professor Citrin will describe a phone call from Detroit's Mayor in 1970, a request from Francis Collins in the early '90s, creation of the Center for Public Health and Community Genomics in 2001, and projects engaging minority communities in learning about genetics and helping to shape policies to guide the field. Professor Roberts will discuss his research program on how individuals appraise and respond to personal genetic information in contexts including genetic susceptibility testing for Alzheimer's disease, cancer genomics, and direct-to-consumer genetic testing.

Funding: NIH/Harvard

Specific aims are to (1) examine the impact of a family-based preventive intervention on outcomes of parent-child relationships, family functioning, and child mental health using a Hybrid Type 2Effectiveness-Implementation Design (families with children aged 7-17 in a two-arm randomized controlled trial); (2) identify barriers and facilitators to implementation of the FSI-R by community health workers by conducting a process evaluation concurrent with the delivery of the intervention; and (3) strengthen the science of community engagement to address health disparities by fortifying CBPR-based pathways of change via collaborative partnerships between refugee communities, service providers, and academic stakeholders.

For more info: http://grantome.com/grant/NIH/U01-MD010613-01

UM PI: Michael Fetters

 

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