Research on medical decision-making makes use of insights from economics and statistics to build quantitative models of clinical decisions. These models rely on assumptions about the use of information by decision-makers, including the core assumption that people process information in a narrowly logical manner. Recently, the psychology of decision-makers, including their emotional states, is being incorporated into these models to augment the role of cognition. Research on older adults differs importantly from other populations in a number of ways that may impact medical decision-making, especially the role of emotions. Pursuing work begun with his dissertation, William Dale, MD, PhD, will enhance his interdisciplinary training in geriatrics and public policy by focusing on a deeper understanding of emotions in medical decision-making in older adults. This research agenda initially utilizes the clinical model of prostate cancer, a widely prevalent disease in older men, and one in which the role of the emotion of anxiety may influence decision-making. Although no consensus exists on the """"""""right"""""""" clinical pathway for detecting and treating prostate cancer, there is wide agreement that patient preferences are vital for making choices. Initial investigations indicate the inclusion of anxiety in utility assessments for men with localized prostate cancer dramatically affect the cost-effectiveness ratios for treatments. Further research to assess the contribution of anxiety to utility assessments for these men is on-going. This study serves as a specific core example of the overall career goal of understanding the role of emotions in medical decision-making in older adults. Older adults care occurs in a complicated socio-medico-psychological context that demands sensitivity to the importance of issues such as functional impairments, multiple co-morbidities, polypharmacy, and care-giver burden. As a geriatrician, Dr. Dale is sensitive of including these concerns in pursuing his research. Enhancing his broad-based training in public policy studies and geriatrics with a targeted, in-depth understanding of psychology and medical decision-making under the expert guidance of his mentors, Dr. Dale will build the necessary expertise for a career researching the role of emotions in medical decisions for older adults.

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
1K23AG024812-01
Application #
6838109
Study Section
Special Emphasis Panel (ZAG1-ZIJ-6 (M1))
Program Officer
Elias, Jeffrey W
Project Start
2004-09-01
Project End
2009-08-31
Budget Start
2004-09-01
Budget End
2005-08-31
Support Year
1
Fiscal Year
2004
Total Cost
$162,152
Indirect Cost
Name
University of Chicago
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
005421136
City
Chicago
State
IL
Country
United States
Zip Code
60637
Hemmerich, Joshua A; Ahmad, Faraz S; Meltzer, David O et al. (2013) African American men significantly underestimate their risk of having prostate cancer at the time of biopsy. Psychooncology 22:338-45
Hemmerich, Joshua A; Elstein, Arthur S; Schwarze, Margaret L et al. (2012) Risk as feelings in the effect of patient outcomes on physicians' future treatment decisions: a randomized trial and manipulation validation. Soc Sci Med 75:367-76
Dale, William; Hemmerich, Joshua; Moliski, Elizabeth et al. (2012) Effect of specialty and recent experience on perioperative decision-making for abdominal aortic aneurysm repair. J Am Geriatr Soc 60:1889-94
Bylow, Kathryn; Hemmerich, Joshua; Mohile, Supriya G et al. (2011) Obese frailty, physical performance deficits, and falls in older men with biochemical recurrence of prostate cancer on androgen deprivation therapy: a case-control study. Urology 77:934-40
Dale, William; Bilir, S Pinar; Hemmerich, Joshua et al. (2011) The prevalence, correlates, and impact of logically inconsistent preferences in utility assessments for joint health states in prostate cancer. Med Care 49:59-66
Basu, Anirban; Dale, William; Elstein, Arthur et al. (2009) A linear index for predicting joint health-states utilities from single health-states utilities. Health Econ 18:403-19
Dale, William; Basu, Anirban; Elstein, Arthur et al. (2008) Predicting utility ratings for joint health States from single health States in prostate cancer: empirical testing of 3 alternative theories. Med Decis Making 28:102-12
Hemmerich, Joshua A; Ghini, Elizabeth A; Schwarze, Margaret L et al. (2007) Vivid bad outcome influences the decisions of older adults about treatment timing: a randomized field experiment with an abdominal aortic aneurysm analog. Transl Res 150:139-46
Bylow, Kathryn; Mohile, Supriya G; Stadler, Walter M et al. (2007) Does androgen-deprivation therapy accelerate the development of frailty in older men with prostate cancer?: a conceptual review. Cancer 110:2604-13
Dale, William; Hemmerich, Joshua; Meltzer, David (2007) Extending the validity of the Memorial Anxiety Scale for Prostate Cancer (MAX-PC) at the time of prostate biopsy in a racially-mixed population. Psychooncology 16:493-8

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