Newsroom

For Immediate Release:

Contact: Vicky Jaffe
MS&L
Phone: 617-937-2578
Vicky.jaffe@mslpr.com or
Lyn Paget
Foundation for Informed Medical Decision-Making
Phone: 617-367-2000, x 243

Boston, MA October 2, 2007 – The Foundation for Informed Medical Decision-Making announces seven investigator-initiated grant awards up to $100,000 each, to support research at universities throughout the world that advances the field of shared decision making in medical care.

“The Foundation believes strongly in supporting university investigator-initiated research to improve the informed medical decision making process for patients with a variety of healthcare conditions,” said Jack Fowler, president of the Foundation for Informed Medical Decision Making. “Today’s patients face a complex array of treatment, prevention and screening options, so the better informed they are about their various choices, the greater chance they have of getting the healthcare that’s right for them.”

U.S. Research Grants

University of California Los Angeles (UCLA) researchers Dominic Frosch, PhD and Carol Mangione, MD, MSPH are studying how to activate seniors to improve chronic disease care. Chronic diseases are the primary cause of morbidity and mortality for older Americans. Active patient participation in treatment decision-making has the potential to significantly improve outcomes in chronic disease care, but interventions to increase participation remain underused. This study targets adults in senior centers using a randomized encouragement design to test the effectiveness of a modest financial incentive on increasing seniors’ participation in group screenings. They will evaluate the effects of the intervention on seniors’ decision making role preferences, attitudes, perceived social norms and self efficacy for asking questions of their physician, health-related quality of life, physical activity, and changes in prescribed treatment regimens and self-care.

Researchers at Johns Hopkins School of Medicine in Baltimore, MD are studying the quality of decision making communication and outcomes of care for African Americans with depression. Lisa Cooper, MD, MPH and Gail Daumit, MD, MHS will examine the quality of shared decision-making communication between primary care providers and African American patients with depression.  Studies have revealed racial differences in patient attitudes and patient-provider communication, and it has been suggested that these factors play a role in mental healthcare disparities, but little empirical work has tested this assumption or identified particular patient or provider behaviors for future intervention. This study looks to increase understanding of the role of shared decision making in improving outcomes for patients with depression and in reducing racial disparities in mental health care.

James Dolan, MD and Peter Veazie, PhD of the University of Rochester are studying the effectiveness of patient decision aids based on the “Consumer’s guide to choosing pain medicine for osteoarthritis,” recently published by the Agency for Health Care Research and Quality (AHRQ). A major objective of the study is to prepare for a subsequent comparative clinical trial. The study will proceed in five phases. In Phase one, the researchers will determine what information the decision aid should contain. In Phase two, they will develop a prototype, and in Phase three, will conduct a series of small focus group sessions to test the prototype and make revisions as necessary. Phase four will test the prototype decision aid's clarity and ease of use in a sample of 40 patients with osteoarthritis pain. Phase five will be devoted to summarizing and disseminating the study results.

At Seattle’s Group Health Center for Health Studies, David Arterburn, MD, MPH, Stephen Bock, MD, Onchee Yu, MS, Emily Westbrook, BA, and Daniel Cherkin, PhD are conducting a randomized controlled trial of the Foundation for Informed Medical Decision Making’s Patient Decision Aid for bariatric surgery. Bariatric (weight loss) surgical procedures have been shown to significantly improve the health and quality of life of morbidly obese adults; however, there are also substantial risks associated with this surgery. Thus, a morbidly obese patient’s decision regarding bariatric surgery should be based on his or her evaluation of accurate information on the possible risks and benefits of the various treatment options. Anecdotal reports suggest that bariatric treatment decisions may be more heavily influenced by insurance coverage and reimbursement rates than patient preferences. The main objective of this research is to examine the impact of the decision aid, Weight loss surgery: Is it right for you? on decision quality in primary care and specialty practice settings. The researchers will assess the effect of this decision aid on bariatric-specific measures of patient knowledge, values, and choice of weight management strategy.

University of Ottawa researchers Dawn Stacey, PhD, Gillian Hawker MD, MSc, and Annette O'Connor, RN, PhD are evaluating the effectiveness of patient decision aids for total joint replacement, looking at whether they are cost-effective and optimize the surgical referral process from primary care. Among clinically appropriate candidates for hip/knee total joint arthroplasty (TJA), patients’ surgical preferences are low and strongly associated with misperceptions. This study uses a randomized controlled trial of 290 patients referred for hip/knee TJA to examine whether patient decision aids, combined with surgical eligibility screening, will improve misperceptions and optimize the referral process because eligible candidates may make informed choices to forgo surgery.

University of Sydney Australia researchers Alexandra Barratt, PhD, Martin Tattersall, PhD, Lyndal Trevena, MD and Phyllis Butow, PhD are testing the effect of consumer questions on prompting clinicians to discuss and apply evidence to the care of an individual patient within a randomized trial using standardized patients.  Other studies have tested the effect of preparing patients to ask questions to address their information needs with respect to a particular condition (most often cancer), but this study will be the first to test the effect of consumers asking questions specifically designed to prompt physicians to discuss and apply evidence to them as individuals, and as such, it tests a simple intervention to increase evidence-based, shared decision making.  While consumer questions may represent an effective way to increase evidence-based practice and shared decision making, they need evaluation to identify their effects on care, and clinical processes (such as length of consultation).  This work is being undertaken in both primary care and specialist care, with results expected to be broadly applicable to international health care delivery.

At the Max Planck Institute in Berlin, Germany, Mirta Galestic, PhD, Wolfgang Gaissmair, PhD, and Gerd Gigerenzer, PhD are researching how to help people with low numeracy to better understand medical information. Informed medical decision making depends critically on communication of quantitative medical data. People with low numeracy skills may have particular problems with understanding such data correctly. Building on previous research showing that problems with understanding numeric information often do not reside in the mind, but in the representation of the problem, the researchers are investigating five presentation formats that might be particularly suitable for people with lower numeracy skills. These formats are: relating very large numbers to examples from everyday life, using analogies to explain predictive accuracy of medical screenings, making consequences of risky behaviors more tangible, using icon displays to explain risks and risk reductions, and using evolutionary plausible group sizes as risk denominators. The formats will be examined within Web-based experiments on probabilistic samples, and results will be contrasted for people with low vs. high numeracy skills. To examine cross-cultural effectiveness of the formats, the investigators will compare the results from two countries with different medical systems and different traditions in risk communication: the United States and Germany.

About Foundation for Informed Medical Decision Making
The Foundation for Informed Medical Decision Making’s mission is to assure that people understand their choices and have the information they need to make sound decisions affecting their health and well being. The Foundation organizes and frames medical evidence in an unbiased manner to help people evaluate their options, particularly in instances where differences in individual preferences and perspectives are likely to affect personal choice. For more information, visit www.fimdm.org.