Benefits and Burdens of Screening Oldest-old Women: the Case of Mammography

描述（由申请人提供）：随着预期寿命的增加，越来越多的妇女活到80多岁和90多岁，许多临床医生现在照顾许多健康的独立老年妇女。确定这些妇女中的哪些人可能受益于不同的健康促进措施是具有挑战性的，需要关于其中一些措施的结果的数据，以便为老年人提供信息和改进医疗决策。由于益处和风险方面的数据有限，决策变得复杂的一个领域是针对80岁及以上妇女的乳房x光检查。该提案旨在收集更多关于80岁及以上妇女乳房x光检查的数据，并设计工具来帮助决策。在未来，Schonberg博士计划利用她从这个职业发展奖项中获得的技能来探索其他健康促进措施对老年人的好处和风险，并设计工具来改善围绕这些措施的决策。本提案的第一个项目是一项纵向观察研究，旨在描述75名80岁及以上女性与75名65-79岁女性在乳房x光检查异常后的心理影响和决策过程。对于第二个项目，Schonberg博士计划使用她在第一个项目中收集的数据以及她之前收集的数据来设计和评估针对80岁及以上女性及其临床医生的乳房x光检查的决策辅助工具。通过课程、研讨会以及这些严谨研究的发展和完成，Schonberg博士计划提高她的方法技能和对决策科学的理解；发展心理测量测试、设计和评估决策辅助工具方面的专业知识；学习如何在未来的研究中设计随机对照试验来检验决策辅助的疗效；并进一步学习老年医学原理。Schonberg博士的长期职业目标是在改善老年人健康促进决策方面成为一名熟练和成熟的独立调查员。比森老年事业发展奖将使Schonberg博士获得额外的研究技能和专业知识，并收集数据，以帮助老年妇女进行筛查决策。

DESCRIPTION (provided by applicant): As life expectancy increases, more women are living into their 80's and 90's and many clinicians are now caring for many healthy Independent older women. Identifying which of these women may benefit from different health promotion measures is challenging and data are needed on outcomes of several of these measures for the oldest adults to Inform and Improve medical decision-making. One area where decision- making is complicated due to limited data on benefits and risks is the case of mammography screening for women aged 80 and older. This proposal aims to collect more data on mammography screening among women aged 80 and older and to design tools to help with decision-making. In the future, Dr. Schonberg plans to use the skills she obtains from this career development award to explore the benefits and risks of other health promotion measures for older adults and design tools to improve decision-making around these measures. The first project in this proposal is a longitudinal observational study to describe the psychological impact and the decision-making process of 75 women aged 80 and older compared to 75 women aged 65-79 after an abnormal mammogram. For the second project, Dr. Schonberg plans to use data she collects in her first project as well as data she has previously collected to design and evaluate a decision aid on mammography screening for women aged 80 and older and their clinicians. Through coursework, seminars, and the development and completion of these rigorous studies, Dr. Schonberg plans to enhance her methodological skills and understanding of the decision sciences; to develop expertise In psychometric testing and designing and assessing decision aids; to learn how to design randomized control trials for testing the efficacy of decision aids in future studies; and to further her education in geriatric principles and medicine. Dr. Schonberg's long-term career goal is to become a skilled and established independent investigator in the area of improving decision-making around health promotion for older adults. The Beeson Career Development Award in Aging will allow Dr. Schonberg to acquire additional research skills and expertise and to collect data to help with decision-making around screening for older women. RELEVANCE: The population of women 80 and older is increasing, with little information to help them make decisions about screening mammography. Some women aged 80 and older may benefit from screening while others in poor health are unlikely to benefit due to limited life expectancy. This proposal will collect data to design a decision aid to help with decision-making around mammography screening for women 80 and older.