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癌症相关决策的研究和实践。职业目标：在这项提案中，我寻求建立一个强大的多学科研究计划，以患者为导向，与癌症相关的决策，包括新的研究，初级研究人员的指导，并建立一个决策研究中心，其目标是改善整个预防，治疗和生存范围内的癌症护理。这些目标将通过减少其他临床和行政责任在K24奖项期间实现。新研究：我建议投入10%的精力用于使用陈述偏好技术的新临床研究，以改善结直肠癌筛查的决策。我还将通过与健康经济学家的定向阅读，以及与或有价值评估专家大卫怀恩斯（David Whynes）的休假，在使用陈述偏好技术来引发患者价值方面发展更多的专业知识。指导：我将投入40%的精力来指导初级研究人员，重点是初级教师从辅导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，并将在癌症治疗和生存领域接受新的学员。我的目标是一次与4-7名学员进行密集的工作。建设研究基础设施：我将建立一个决策研究中心，其中包括一个扩大的决策支持实验室，增加空间和人员进行形成性和实验性研究;一个小额赠款计划，为我的学员提供资金，以进行癌症相关决策的试点研究;一个演讲者系列，用于地方和国家跨学科合作和癌症决策研究的交叉施肥;并扩大我们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.