A new SDM study, funded by PCORI

Press Release

Karen Sepucha, PhD and Leigh Simmons, MD Approved for $2.2 Million in Research Funding for Promoting Informed Decisions about Cancer Screening in Older Adults (PRIMED Study)

Funds awarded by the Patient-Centered Outcomes Research Institute

Drs. Sepucha and Simmons from the Health Decision Sciences Center (HDSC) at Massachusetts General Hospital have been approved for a $2.2 million funding award by the Patient-Centered Outcomes Research Institute (PCORI) to address an important gap in our understanding of how to support clinicians and older patients in making good decisions about whether to continue colorectal cancer (CRC) screening. The study, Promoting Informed Decisions about Cancer Screening in Older Adults (PRIMED Study), will advance our understanding of how to best communicate evidence of cancer screening benefits and harms to older adults and is well aligned with PCORI’s mission.

We are thrilled to be able to pursue this study with our colleagues at Maine Medical Center, and our clinician and patient partners. The HDSC’s patient advisory committee challenged us to ensure that physicians listen to and respect patients’ goals and preferences. A main objective of this study is to examine how effectively our interventions can achieve that goal in the setting of cancer screening.”-Karen Sepucha

National guidelines all recommend against routine cancer screening in patients with life expectancy of less than 10 years; however, these recommendations, based solely on life expectancy, may not result in truly patient-centered care. A shared decision making approach focuses on informing patients about their options and tailoring recommendations to what matters most to the individual patient. As part of the PRIMED study, patient partners will be involved in training clinicians to improve their skills for shared decision making. Better decisions about whether or when to stop tests may reduce unnecessary tests and treatments and allow patients to avoid side effects and potential harms. The PRIMED study results will also have wide reaching implications for use of shared decision making in many other decisions for older adults, such as continuing mammography or prostate cancer screening and continuing medications for high cholesterol or hypertension.

Most studies of shared decision making focus on starting a test or a treatment. An innovative part of this project is its focus on whether or not to stop having a test. An important consideration when offering screening tests is whether the test continues to provide a meaningful benefit to patients, but having these discussions with patients can be challenging.” –Leigh Simmons

“This project was selected for PCORI funding not only for its scientific merit and commitment to engaging patients and other stakeholders, but also for its potential to fill an important gap in our health knowledge and give people information to help them weigh the effectiveness of their care options,” said PCORI Executive Director Joe Selby, MD, MPH. “We look forward to following the study’s progress and working with the team at Massachusetts General Hospital to share the results.”

The PRIMED study was selected for PCORI funding through a highly competitive review process in which patients, clinicians and other stakeholders joined clinical scientists to evaluate the proposals. Applications were assessed for scientific merit, how well they will engage patients and other stakeholders and their methodological rigor among other criteria.

The PRIMED study award has been approved pending completion of a business and programmatic review by PCORI staff and issuance of a formal award contract.

PCORI is an independent, nonprofit organization authorized by Congress in 2010. Its mission is to fund research that will provide patients, their caregivers and clinicians with the evidence-based information needed to make better-informed healthcare decisions. For more information about PCORI’s funding, visit www.pcori.org.

The Health Decision Sciences Center at Massachusetts General Hospital is committed to improving the quality of health care decisions.

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