Stony Brook Surgeon, Sociologist Awarded Grants for Collaborative Research Project

Stony Brook's Isadora Botwinick, MD, Department of Surgery, Division of Trauma, Emergency Surgery and Surgical Critical Care, and Wan-Zi Lu, PhD, Department of Sociology, have been awarded two internal grants for their collaborative research project titled, "Quality Measures and Shared Decision-Making in Emergency Surgery." The grants, the Center for Interprofessional Innovation's (CIPI) inaugural mini grant, and the Faculty in the Arts, Humanities and Social Sciences (FAHSS) Interdisciplinary Research Award, total $8,000.

Their research is based on a tool for surgeons who daily confront difficult decisions about whether to perform surgery, which is called Shared Decision Making (SDM). SDM is a model used by surgeons in which they work together with patients and their loved ones to create a treatment plan that fits their goals and preferences.

SDM is an ideal choice, but it is currently underutilized in the surgical decision-making process, especially in emergency surgery cases. Research has been done on SDM use in general medicine, but very few studies have focused on emergency surgery. In addition, surgeons must also consider external quality metrics. These metrics, created by regulatory bodies and professional societies, may inadvertently influence a surgeon's decision-making process when considering treatment options.

This is what sparked Botwinick's and Lu's study. They aim to examine the role of external quality metrics and their influence on SDM in emergency surgery decisions.

"Surgeons should speak out about how external metrics impact clinical decision-making," said Botwinick. "Our input can help regulatory bodies better align metrics with patient-centered care."

According to Lu, this research project was prompted by her and Botwinick's shared interest in learning what makes SDM possible in surgical situations. They also want to examine the influence of performance metrics and quality measures on a surgeon's treatment choices.

"The project advances key questions in medical sociology by examining the conditions that enable or constrain shared decision-making in clinical care," said Lu. "By investigating how metrics influence everyday surgical practice, our research can help inform institutional designs that better support patient-centered care while respecting professional expertise."

They launched their study by surveying faculty, residents and physician extenders in Stony Brook Medicine's Department of Surgery. The mini grants will allow them to expand that pool by conducting research at multiple centers and additional study populations to create a comparative analysis. They will use computational and natural language processing techniques combined with qualitative thematic coding to analyze how metrics shape surgical decision-making.

"Our goal is to eventually develop strategies to better align quality metrics with ethical principles of equity and patient-centered care," said Botwinick.

"This broader scope will strengthen the quality and impact of our findings, allowing us to generate insights that are relevant across different clinical and organizational contexts," added Lu.

The study is unique in its interprofessional collaboration between sociology and medicine. This, and the team's recognition of the interconnectedness of high-risk medical conditions and social considerations of health, were supporting factors in awarding the mini grants.

Read more on the Stony Brook Medicine Surgery blog.