This is a reapplication for the Geriatric Mental Health Academic Award that I received when I was Director of Geriatric Psychiatry at the Medical College of Virginia/Virginia Commonwealth University. The original award sought to expand my statistical and epidemiological research training and to pursue a research program examining aspects of aggressive behavior in dementia patients. The results from my initial study lead to a refinement of my research focus. Since medication management represents a primary treatment intervention for aggressive dementia patients, the present proposal will examine medication decision making by physicians using simulation models called """"""""contrastive vignette technique"""""""". This program of research has important health services' and educational applications since it is designed to uncover biases that alter physician decision making, and lead to ill-suited health care decisions by physicians. For example, if a physician harbors a bias that """"""""all male"""""""" dementia patients should be kept on a neuroleptic to keep them """"""""under control,"""""""" then that physician is making a clinical decision based on a biased """"""""rule of thumb"""""""" heuristic. The research program will be complimented by planned educational activities including: supplemental course work in statistics, computer programming and research methodology at the SAS Institute, ongoing research supervision by an assembled panel of experts, and an ongoing participation in the Epidemiological Research Seminar in the Department of Public Health Sciences at Bowman Gray School of Medicine.
