This K24 proposal combines mentoring in patient oriented cancer control research; research to translate evidence-based shared decision-support for screening mammography to the clinic; and career development in Implementation Science. The PI, Dr. Elizabeth Burnside, has been an influential mentor throughout her career at the University of Wisconsin (UW), fostered by leadership positions like her role as the co-lead of the Cancer Control Program in the UW NCI designated Comprehensive Cancer Center. Her mentoring and research both promote team science, which unites medical and translational disciplines like informatics, engineering, and population health, all areas for which she has expertise and departmental affiliate appointments. This award would carve out the necessary time for her to build a platform on which to formalize her mentoring approach and a curriculum to support a cadre of physician/scientists developing decision support tools aimed for clinical translation. This proposal takes advantage of a successful Clinical Translational Science Award (CTSA) funded at UW in 2006, committed to mentoring, patient oriented team science, and translational research.
The aims i ncluded in this proposal are closely aligned with the UW CTSA -KL2 and other institutional training grants and fully leverage the rich mentoring and career development resources. The patient oriented scientific aims proposed arise from healthcare shortfalls that she, a radiologist practicing in breast imaging, sees every day in clinic. They buid on her NCI funded R01 which asks the question: How can decision support in the clinic help healthcare providers optimize breast cancer screening and diagnosis in aging women? Breast cancer screening recommendations are ambiguous for women = 65 and poorer breast cancer outcomes are seen in this population. Accurate and personalized strategies are needed to decrease morbidity and mortality, while minimizing harms (false positives and overdiagnosis-the detection of cancer that would not go on to cause symptoms or death). Though validated decision aids currently exist, immense opportunities still remain: personalization, integration in the clinical workflow, and implementation with high fidelity; all goals of this proposal. Personalized decision support tools will only be useful if they are thoughtfully designed and rigorously implemented. Both her scientific aims and her career development plans integrate the new discipline of Implemenation Science. These methodologies will enable her to translate advances into an EMR-embedded decision tool for improved breast cancer screening decision-making for women = 65 and their physicians. Innovation is substantial; creating a tool that incorporates national simulation models to accurately convey outcomes that is integrated into the EMR has not been done. This award will enable Dr. Burnside to become an influential mentor of clinician-scientists using implementation science to advance personalized decision support into the clinic.

Public Health Relevance

This grant proposes to build a mentorship program for clinicians who are developing tools that use a patient's unique characteristics to help make optimal health care decisions. The proposed research exemplifies this important goal by using the newest scientific techniques to develop and test a personalized decision tool to help women age 65 or over decide (with their physician) whether to undergo breast cancer screening. By combining mentoring, research, and new scientific methodologies, this plan will powerfully translate the science of personalized prediction to patients to help make decisions that are right for them.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Midcareer Investigator Award in Patient-Oriented Research (K24)
Project #
5K24CA194251-04
Application #
9495679
Study Section
Subcommittee I - Transistion to Independence (NCI)
Program Officer
Radaev, Sergey
Project Start
2015-07-15
Project End
2020-06-30
Budget Start
2018-07-01
Budget End
2019-06-30
Support Year
4
Fiscal Year
2018
Total Cost
Indirect Cost
Name
University of Wisconsin Madison
Department
Radiation-Diagnostic/Oncology
Type
Schools of Medicine
DUNS #
161202122
City
Madison
State
WI
Country
United States
Zip Code
53715
Schrager, Sarina; Burnside, Elizabeth (2018) Breast Cancer Screening in Primary Care: A Call for Development and Validation of Patient-Oriented Shared Decision-Making Tools. J Womens Health (Larchmt) :
Bulu, Hakan; Sippo, Dorothy A; Lee, Janie M et al. (2018) Proposing New RadLex Terms by Analyzing Free-Text Mammography Reports. J Digit Imaging 31:596-603
Schumacher, Jessica R; Neuman, Heather B; Chang, George J et al. (2018) A National Study of the Use of Asymptomatic Systemic Imaging for Surveillance Following Breast Cancer Treatment (AFT-01). Ann Surg Oncol 25:2587-2595
Net, Jose M; Whitman, Gary J; Morris, Elizabteh et al. (2018) Relationships Between Human-Extracted MRI Tumor Phenotypes of Breast Cancer and Clinical Prognostic Indicators Including Receptor Status and Molecular Subtype. Curr Probl Diagn Radiol :
DuBenske, Lori L; Schrager, Sarina B; Hitchcock, Mary E et al. (2018) Key Elements of Mammography Shared Decision-Making: a Scoping Review of the Literature. J Gen Intern Med 33:1805-1814
van Ravesteyn, Nicolien T; van den Broek, Jeroen J; Li, Xiaoxue et al. (2018) Modeling Ductal Carcinoma In Situ (DCIS): An Overview of CISNET Model Approaches. Med Decis Making 38:126S-139S
Feld, Shara I; Fan, Jun; Yuan, Ming et al. (2018) Utility of Genetic Testing in Addition to Mammography for Determining Risk of Breast Cancer Depends on Patient Age. AMIA Jt Summits Transl Sci Proc 2017:81-90
van den Broek, Jeroen J; van Ravesteyn, Nicolien T; Mandelblatt, Jeanne S et al. (2018) Comparing CISNET Breast Cancer Incidence and Mortality Predictions to Observed Clinical Trial Results of Mammography Screening from Ages 40 to 49. Med Decis Making 38:140S-150S
Wu, Yirong; Fan, Jun; Peissig, Peggy et al. (2018) Quantifying predictive capability of electronic health records for the most harmful breast cancer. Proc SPIE Int Soc Opt Eng 10577:
Burnside, Elizabeth S; Vulkan, Daniel; Blanks, Roger G et al. (2018) Association between Screening Mammography Recall Rate and Interval Cancers in the UK Breast Cancer Service Screening Program: A Cohort Study. Radiology 288:47-54

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