Project SCORE
Project SCORE (Streamlined Consents for Research) will develop and test a visual consent template to describe the key information about studies, and test its feasibility, acceptability, and appropriateness across three participating institutions (Washington University School of Medicine in St. Louis, University of Utah, and University of North Carolina—Chapel Hill).
B.R.E.A.S.T. Choice
B.R.E.A.S.T. Choice (Breast Reconstruction Education and Support Tool) helps women considering mastectomy decide whether or not to have breast reconstruction, and which breast reconstruction option is best for them. This multi-site randomized controlled trial is implementing a decision support tool and testing its effectiveness in clinical practice.
Ongoing projects and collaborations can be found here.
Selected Past Studies and Projects are listed below.
Cost talk: A randomized stepped wedge trial of interventions helping patients discuss cancer care costs with clinicians during shared decision making
Dr. Politi and co-investigator Glyn Elwyn, MD, PhD, MSc (The Dartmouth Institute for Health Policy and Clinical Practice) received a grant from the Robert Wood Johnson Foundation to investigate whether an encounter decision aid (used during a consultation) containing cost information about localized prostate cancer treatment options, combined with clinician training about cost discussions and available financial resources, influence urologic surgeon-patient cost conversations, referrals to address costs, patients’ FT, and high-quality decision-making. Read more about the study in this Trials protocol paper and read our outcomes in this Health Expectations paper.
Implementing a Breast Reconstruction Decision Support Tool in Diverse Practice Settings
Dr. Politi and co-investigators Drs. Terence Myckatyn, Margaret Olsen, Randi Foraker, along with co-PI from Ohio State University Dr. Clara Lee, received a grant (R18HS026699) from the Agency for Health Care Research and Quality to implement a previously developed breast reconstruction decision tool (BREASTChoice) into routine care across diverse clinical practices. Read about the tool here and here. See study website for more details.
Implementing a Patient-Centered Intervention to Reduce Cancer Patients’ Financial Toxicity
Dr. Politi and co-investigators Dr. Abigail Barker, and Lindsay Kuroki received a grant to adapt, implement, and test the effectiveness of an intervention to reduce the financial toxicity associated with cancer care among patients with breast, colorectal and/or lung cancer. This project is associated with a larger program project (Washington University Implementation Science Center for Cancer Control (WU-ISCCC)) that aims to eliminate cancer disparities in rural and other underserved communities.
Supporting Cancer Patients Health Insurance Decisions
Dr. Politi and co-investigators Drs. Aimee James, Esther Lu, Lindsay Kuroki, Abigail Barker and Timothy McBride received a grant from the American Cancer Society to help cancer patients and survivors choose health insurance plans that best meet their health and financial needs. A decision support is tailored based on patients’ unique health needs and preferences, and the tool was evaluated with a 3-arm randomized trial. Read more about the formative work to develop this tool in a Medical Care Research and Review publication.
Comparative Effectiveness of Encounter Decision Aids for Early-Stage Breast Cancer across Socioeconomic Strata
Dr. Marie-Anne Durand and Dr. Glyn Elwyn at Dartmouth College and co-investigators Drs. Politi and Margenthaler received a PCORI award to support women of low socioeconomic status through early-stage breast cancer treatment decisions by providing patients with point-of-care decision aids. Read more about the study protocol in a BMC Public Health publication.
Optimizing Decision-Making about Breast Reconstruction after Mastectomy: A Patient-Centered Approach
Dr. Politi and Dr. Terence Myckatyn received a Pre-R01 grant through the Siteman Investment Program, with co-investigators Drs. Margaret Olsen and Rajiv Parikh, to develop a preference-sensitive decision support tool for patients considering breast reconstruction after mastectomy. The tool provides patient education, elicit patients’ preferences, and include personalized risk prediction to aid in the decision making process. Read more about this project in an Annals of Surgery publication. Read about the formative work in a Plastic and Reconstructive Surgery: Global Open publication and a Health Equity publication.
Development and Validation of a Shared-Decision Making Tool for Initiation of Treatment in Patients with Hepatitis C Infection and Advanced Chronic Kidney Disease
Dr. Politi and co-investigators Drs. Tinging Li and Kevin Korenblat received an award to develop a patient-centered decision tool for patients with Hepatitis C virus and advanced kidney disease. The tool (available here) includes patient education, values clarification, and a physician discussion guide to support decisions about treatment for Hepatitis C and chronic kidney disease. Read more about this project in a Kidney Medicine publication.
Supporting Decisions About Cancer Clinical Trials in Rural Cancer Centers
Dr. Politi and Dr. Swati Pathak received an award through the Collaborative Cancer Disparities Research Program for a pilot partnership between Washington University and Southern Illinois University School of Medicine. The project will bring evidence-based decision tools to rural communities and attempt to support rural cancer patients’ participation in clinical trials. Read some findings from the study in the Journal of Cancer Education.
Supporting Decisions about Health Insurance to Improve Care for the Uninsured
This project evaluated the impact of health insurance decision support tools on decision making for uninsured individuals as they prepared to enroll in the Affordable Care Act marketplace plans. Read some findings from the study in BMC Health Services Research or Medical Decision Making Policy and Practice.
Accuracy of Information about the Intrauterine Device on the Internet
Intrauterine devices (IUDs) are highly effective methods of contraception, but use remains low in the U.S. Our objective was to evaluate the quality of information about IUDs among websites providing contraceptive information to the public. Read more about this project in an American Journal of Obstetrics and Gynecology publication.
Facilitating Shared Decision Making About Lung Cancer Screening
This project developed a decision tool to help patients understand the evidence about lung cancer screening and facilitate patients’ choices about whether yearly screening is right for them.
Clinician’s Reactions to Discussions With Parents About Clinical Evidence
This study examined how clinician trainees think, feel, and work with vaccine-hesitant parents to develop an intervention to improve patient-provider interactions. A randomized experiment compared clinicians’ responses to vaccine-hesitant parents with their responses to parents in situations of clinical equipoise or potential overuse of interventions. Learn more about this project in a 2017 Patient and Education Counseling publication.
A Mixed Methods Study to Reduce Disparities in Cancer Clinical Trials by Supporting Decisions About Cancer Clinical Trials
This project aimed to address disparities in cancer clinical trial participation through the implementation of a decision aid. The tool was tested against a usual care website to examine patient-centered outcomes. Read more in The Oncologist publication.