Center on Advancing Decision Making in Aging (CADMA)

描述（由申请人提供）：斯坦福大学老年决策推进中心（CADMA）将促进决策过程和影响晚年健康和福祉的选择决定因素的研究。CADMA研究人员计划对决策过程进行基础和应用研究，目标是开发和实施实用方法，以改善影响老年人福祉的基本决策。这项研究将由心理学家、精神病学家、老年病学家和其他医生、医学信息学专家、流行病学家和经济学家合作进行。CADMA的研究最初将集中在以下几个方面：1)涉及日常生活的决策，例如关于运动和饮食的选择，影响老年人的健康和功能状态；2)将决策支持工具与电子病历系统相结合，为面临医疗选择困难的老年患者提供临床就诊时的决策支持；3)了解与年龄相关的情绪和认知变化在决策中所起的作用，特别是那些围绕复杂（例如，医疗保健计划选择）和/或情绪敏感（例如，预先指示）的主题。

DESCRIPTION (provided by applicant): The Stanford Center on Advancing Decision Making for Aging (CADMA) will promote the study of decision making processes and the determinants of choices that affect health and well-being in the later years of life. CADMA researchers plan to conduct basic and applied research on decision making processes with a goal of developing and implementing practical methods for improving fundamental decisions affecting the well-being of the elderly. The research will be conducted by collaborating psychologists, psychiatrists, geriatricians and other physicians, experts on medical informatics, epidemiologists, and economists. CADMA research will initially focus on the following areas: 1) Decision making involved in day-to-day life, such as choices regarding exercise and diet, that influence health and functional status at advanced ages; 2) decision support at the time of clinical encounters for elderly patients who face difficult medical choices by integrating decision support tools with electronic medical records systems; and 3) understanding the roles that aging-related changes in emotion and cognition play in decision making, especially those surrounding complex (e.g., health care plan choice) and/or emotionally charged (e.g., advance directives) topics. Support is proposed for administrative and communications/dissemination infrastructure (Core A) and new project development (Core B). Both of these cores build upon ongoing activities of Stanford's Center for Health Policy and its Center for Primary Care and Outcomes Research, administratively integrated centers that support research spanning the Medical School, the School of Humanities and Sciences, the Graduate School of Business, and external affiliated institutions such as the Veterans Affairs Palo Alto Health Care System and the Palo Alto Medical Foundation. CADMA will support early stage research and its development into longer term, comprehensive projects, followed by practical implementation via several linked mechanisms: Establishing formal procedures for soliciting and evaluating proposals for pilot projects; providing ongoing project evaluation and mentorship by senior faculty; conducting seminars and using other venues for collaboration and information exchange; giving advice and support for proposals for large-scale research projects; and facilitating collaboration with community affiliates and other external bodies for further testing and dissemination of the products of Roybal Center research. The three first-year pilot projects illustrate the CADMA focus on decision making processes. One of the projects will include the development of new software, called e-Preference, that supports patient access to health decision aids through an interface to electronic medical records; this project will also assess the usability of this technology for shared decision making by older patients and their physicians, A second examines whether older adults exhibit deficits similar to younger adults in affective forecasting, by applying a paradigm that Stanford researchers have used in younger adults for measuring prediction, experience, and recollection of emotional responses to monetary incentives. The third will investigate the roles of emotion and cognition in decision making, exploring whether a focus on deliberative and effortful mental processing could aid older people in making good health plan choices. Each project builds upon multidisciplinary collaboration and has the potential to contribute to a growing body of research that will translate into useful decision making tools.