# Understanding and Improving Surgical Decision-Making for Persons Living with Dementia, their Family Caregivers, and their Providers: A Mixed Methods Study

> **NIH NIH R01** · BRIGHAM AND WOMEN'S HOSPITAL · 2022 · $292,151

## Abstract

Project Summary/Abstract (30 lines max)
 Our project, R01AG067507: “Understanding and Improving Surgical Decision-Making for Persons Living
with Dementia, their Family Caregivers, and their Providers: A Mixed Methods Study”, has made great
progress toward our goals. As per the criteria of PA-20-272, this proposed work will "increase and preserve
the parent award’s overall impact " by "achieving certain new research objectives… within the original scope of
the peer reviewed and approved project." We have identified four areas of investigation that would benefit
from supplemental funding:
 1) The need for evidence on outcomes for surgeries in addition to ones specified in the original project.
 2) The need to investigate surgery taking place in outpatient settings including Ambulatory Surgery Centers.
 3) The need to investigate medical (non-surgical) alternatives for patients who are eligible for surgery yet
prefer not to proceed.
 4) The need to examine longer term outcomes, such as 4-5 year survival, with more current data.
 We therefore propose to supplement our current project to understand the epidemiology of surgery for
PLWDs, as well as patient, caregiver, and provider practices and challenges of surgical decision-making in
clinical settings.
 Supplemental Aim 1) Develop the evidence base to understand comparative outcomes of surgery
provided to PLWDs. We will use Medicare data to: 1) describe the epidemiology of surgery for PLWDs for
selected elective major cancer (e.g., breast cancer) and non-cancer surgery (e.g., colectomy for benign
conditions, cholecystectomy), and analyze the association of dementia status with outcomes, including 5 year
survival and Excess Days in Acute Care (EDAC); 2) Compare outcomes among alternative surgical
interventions; and 3) Track outcomes for patients with and without surgery.
 Supplemental Aim 2) Characterize surgical decision-making for PLWDs in clinical settings for the surgical
situations described in Supplemental Aim 1.
 Supplemental Aim 3) We will supplement our modified Delphi panel to consider the situations described in
Supplemental Aim 1.
 Impact. Results of this supplemental work will greatly increase the impact of the current project using the
currently funded research infrastructure. Our study will support key advancements in ADRD research by
focusing on under-studied areas of surgical decision-making. Our Aims are linked but not conditional, and
results from Aims 1 and 2 will inform the Delphi panel. Our work also will address other NIH research priorities
including barriers faced by vulnerable populations, goals of care, and better decision-making.

## Key facts

- **NIH application ID:** 10595437
- **Project number:** 3R01AG067507-03S2
- **Recipient organization:** BRIGHAM AND WOMEN'S HOSPITAL
- **Principal Investigator:** Joel S. Weissman
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $292,151
- **Award type:** 3
- **Project period:** 2020-05-01 → 2025-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10595437

## Citation

> US National Institutes of Health, RePORTER application 10595437, Understanding and Improving Surgical Decision-Making for Persons Living with Dementia, their Family Caregivers, and their Providers: A Mixed Methods Study (3R01AG067507-03S2). Retrieved via AI Analytics 2026-06-11 from https://api.ai-analytics.org/grant/nih/10595437. Licensed CC0.

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