CanSORT recognizes the importance of translating the results of population-based research into interventions to improve the quality of care for patients. Over nearly the past 10 years, CanSORT research has uncovered a need to improve patient understanding of the benefits and risks of screening and treatment options, particularly for racial and ethnic minorities that have cancer. Inspired and based on this evidence, the team has developed decision tools to improve the quality of cancer screening treatment decisions for breast and colorectal cancer. A unique feature of CanSORT web-based tools are the use of a preference elicitation method that allows patients to compare and choose between attributes related to different surgical options, and to use feedback from the site in making their treatment decision. We have recently received additional funding to build a prototype of a virtual integrated shared learning system for patients with breast cancer and their clinicians. CanSORT works in collaboration with the University of Michigan Center for Health Communications Research, to develop and test our novel interventions and they have been positively reviewed by the patients who use them during evaluative testing. A long-term goal of CanSORT is to test and permanently release these tools into large, integrated health systems that serve diverse groups of cancer patients.
National Cancer Institute: Developing a Tool to Improve the Quality of Breast Cancer Treatment Decisions. (R21 CA129859-01, P.I. Sarah Hawley, PhD, MPH) The major goals of this project are to develop a decision tool designed to improve breast cancer treatment decision making, and to pilot-test the tool among newly diagnosed breast cancer patients.
National Cancer Institute: Evaluating a Preference-Tailored Intervention to Increase Colorectal Cancer Screening. (R01 CA131041-01A1, P.I. Sarah Hawley, PhD, MPH) The goal of this study is to test the effectiveness of a preference-tailored vs. standard information intervention for increasing primary care patients’ colorectal screening adherence in a randomized controlled trial of 650 patients at 2 large medical centers in Detroit and San Francisco. We will develop a web- based interactive decision tool using conjoint analysis to assess preferences for colorectal cancer screening in real time and provide feedback to participants.
National Cancer Institute: Individualizing Decision Quality for Patients with Breast Cancer: A RCT of a Comprehensive Breast Cancer Treatment Patient Decision Tool (Sarah Hawley, PhD, MPH- Project Lead) This project is an RCT of an online deliberation portal (iCanDecide) for patients newly diagnosed with breast cancer. The P3 tool was developed with the Center for Health Communication Research and recently deployed in local Detroit area and Atlanta-based surgical oncology practices. The goal of this trial is to evaluate the impact of the decision tool on locoregional and systemic therapy decisions. The tool was developed to support high quality medical decision-making, defined as a decision that is informed and demonstrates concordance between the treatment received and patient values and preferences. This project also utilizes baseline and follow-up surveys (4 weeks and 9 months after using the decision tool) to collect information about women’s decision making methods.
University of Michigan Comprehensive Cancer Center Innovation Grant (P.I. Steven Katz, MD, MPH)
Through this grant, we will make our current online breast cancer treatment decision making tool, iCanDecide available for in-clinic computer use at the University of Michigan Breast Care Center and extend home-use availability to University of Michigan Comprehensive Cancer Center (UMCCC) patients. We will work collaboratively with clinical teams there to determine best processes for integrating the tool into clinic flow of a large health system and build a storyboard to aid in further refining our implementation process.
We will also work with MCIT to determine feasibility and process for linking the iCanDecide tool to the MiChart interface and integrating electronic medical record (EMR) data with information from the decision tool. This work will enable further enhancements to the iCanDecide tool such as a clinician dashboard allowing the care team to monitor key indicators of quality decision-making and take action when needed. We envision a dashboard allowing clinicians to monitor their patients’ progress through the treatment decision making process and learn about any difficulties (e.g. key knowledge deficits or misconceptions, emotional distress, discordance between planned vs. preferred treatments) the patient may be experiencing. The dashboard can be reviewed with patients to begin the dialogue about treatment decision making.