Improving Cancer-Related Patient Decision Making

背景：高质量的临床决策是实现新兴癌症预防和治疗策略的全部益处所必需的。目前，患者和提供者往往没有资源或技能来实施高质量的决策过程。整合认知心理学、医学经济学和卫生服务研究领域的专业知识，可以改善与癌症相关的决策研究和实践。职业目标：在这份提案中，我寻求在北卡罗来纳大学建立一个强大的多学科研究项目，以患者为导向，与癌症相关的决策制定，包括新的研究，初级研究人员的指导，并建立一个北卡罗来纳大学决策研究中心，以提高癌症预防，治疗和生存的目标。这些目标将在K24项目期间通过减少其他临床和行政职责而成为可能。新研究：我建议投入10%的精力进行新的临床研究，使用陈述偏好技术来改善结直肠癌筛查的决策。我还将在使用陈述偏好技术方面发展更多的专业知识，通过与卫生经济学家的指导阅读，以及与条件评估专家大卫·惠内斯（David Whynes）一起休假，来得出患者的价值。指导：我将投入40%的精力来指导北卡罗来纳大学的初级研究人员，重点是让初级教师从指导K奖过渡到独立资助。我将继续担任K30和癌症控制奖学金的教员，我将在癌症治疗和生存领域接受新的培训。我的目标是一次与4-7名学员进行高强度训练。建设研究基础设施：我将开发一个北卡罗来纳大学决策研究中心，其中包括一个扩大的决策支持实验室，增加空间和人员，用于形成性和实验性研究；一个小型拨款项目，为我的学员提供资金，在癌症相关决策方面进行试点研究；关于癌症决策研究的地方和国家跨学科合作和交流的系列演讲；扩大每周为学员和导师举办的工作研讨会。

Background: High quality clinical decision making is necessary to realize the full benefits of emerging cancer prevention and treatment strategies. Currently, patients and providers are often without the resources or skills to implement high quality decision making processes. Integrating expertise from the fields of cognitive psychology, medical economics, and health services research can improve cancer-related decision making research and practice. Career Goals: In this proposal, I seek to build a strong multidisciplinary research program at UNC in patient-oriented, cancer-related decision making that includes new research, mentorship of junior investigators, and creation of a UNC Center for Decision Making Research, with a goal of improving cancer care across the spectrum of prevention, treatment, and survivorship. These goals will be made possible during the K24 award through a reduction in other clinical and administrative responsibilities. New Research: I propose to devote 10% effort to new clinical research on the use of stated preference techniques to improve decision making in colorectal cancer screening. I will also develop additional expertise in the use of stated preference techniques for eliciting patient values through directed readings with health economists and a sabbatical to work with David Whynes, an expert in contingent valuation. Mentoring: I will devote 40% effort to mentoring junior investigators at UNC, with a focus on junior faculty making the transition from mentored K awards to independent funding. I will continue to serve as faculty in the K30 and Cancer Control Fellowships and I will take on new trainees in the areas of cancer treatment and survivorship. My goal is to work intensively with 4-7 trainees at a time. Building Research Infrastructure: I will develop a UNC Center for Decision Making Research that will include an expanded decision support laboratory with increased space and personnel for formative and experimental research; a small grant program to provide my trainees with funding to perform pilot studies in cancer-related decision making; a speaker series for local and national inter-disciplinary collaboration and cross-fertilization on cancer decision making research; and expansion of our weekly working seminar for trainees and mentors.