Announcing 2019 CBSSM Pilot Project Awardees

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CBSSM recently announced the availability of funds to support pilot projects for CBSSM members relevant to CBSSM’s mission. These areas include: ethical, legal, and social implications of genomic medicine; human subjects research ethics; empirical clinical ethics; global bioethics; gender equity; reproductive justice; deliberative democracy; resource allocation; health equity; ethics of learning health systems; health communication; risk communication; visualization and contextualization of health data; or patient/provider decision making.

The Center for Bioethics and Social Sciences in Medicine (CBSSM) is proud to announce 4 funded pilot projects.


What Explains Oncologists’ Use of Ineffective Chemotherapy Near the End of Life?
Principal Investigator: Chithra Perumalswami, MD, MSc, CBSSM Postdoctoral Research Fellow
Collaborators: Reshma Jagsi, MD, DPhil; Jennifer Griggs, MD, MPH; Raymond De Vries, PhD; Susan Goold, MD, MHSA, MA

Chemotherapy use in patients with advanced cancer near the end of life is widely recognized as an overly aggressive practice that physicians should avoid and was listed as the first target in the American Society of Clinical Oncology (ASCO)’s Choosing Wisely campaign to end commonly used, costly practices for which evidence of clinical value is lacking. Little is known about what explains physicians’ persistent use of late chemotherapy, what methods and approaches can successfully induce physicians to reduce their use of this ineffective intervention, and what barriers physicians currently face when seeking to discontinue this practice. This translational mixed methods study will examine the underpinnings of oncologists’ decisions to offer chemotherapy, evaluate their familiarity and experiences with interventions aiming to influence end of life recommendations, and generate evidence to inform the development of knowledge and behavioral interventions that can reduce this practice. This work is also supported by the Michigan Institute for Clinical and Health Research.

Reproductive health and pregnancy decision-making in CKD: A qualitative needs assessment of patients and nephrologists
Principal Investigator: Andrea Oliverio, MD, Clinical Lecturer/Research Fellow, Division of Nephrology
Collaborators: Julie Wright Nunes, MD, MPH; Sarah Hawley, PhD, MPH

Women with chronic kidney disease are at high risk of pregnancy-associated complications but prior studies have suggested that women often feel unsupported by their nephrologists before and during pregnancy. This pilot study seeks to qualitatively explore the information and decision-making needs to support informed and value-congruent reproductive health and pregnancy decisions among women with CKD and nephrologists.

What is the Reception of Article X Among National Science Foundation Grant Awardees?
Principal Investigator: Chithra Perumalswami, MD, MSc, CBSSM Postdoctoral Research Fellow
Collaborators: Reshma Jagsi, MD, DPhil; Kayte Spector-Bagdady, JD, MBE; Lilia Cortina, PhD

Increased public awareness of sexual harassment has led to policy windows during which active change is underway at the national level. In October 2018, in an attempt to leverage its influence to help address this major issue confronting the scientific community, the National Science Foundation (NSF) implemented Article X, requiring awardee institutions to notify the NSF of findings related to principal investigators and co-principal investigators who perpetrate sexual harassment. This study seeks to understand NSF grant awardees’ knowledge, perspectives, and concerns about Article X in order to inform future policy. This work is also supported by the Institute for Research on Women and Gender and the University of Michigan Office of Research.

Measuring the Relationship Between Patients’ Adverse Visceral States and Stated Preferences for Healthcare Services
Principal Investigator: Jeffrey DeWitt, PhD, CBSSM Postdoctoral Research Fellow and VA CCMR Post-doctoral fellow
Collaborator: Jeffrey Kullgren, MD, MS, MPH

This pilot project explores a potential behavioral barrier to the utilization of recommended preventive health care services - experiencing adverse "visceral states" during a visit.  By surveying Veterans immediately before a primary care visit at the Ann Arbor VA Medical Center, we will assess the frequency/intensity of specific adverse visceral states (e.g. pain, fatigue, and stress) using validated measures.  The survey will also elicit stated preferences for clinical preventive services in hypothetical scenarios and allow us to test a potential psychological mediator of service utilization which could be an intervention target.  In addition, we will link each survey to the patient's medical records from the subsequent primary care visit to test associations between adverse visceral states and health care utilization.  Our primary analyses will test the hypothesis that patients who are experiencing more intense adverse visceral states are more likely to forego or delay recommended preventive and diagnostic services.